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Temporal associations between nightly sleep with daytime eating and activity levels in free-living young adults. 自由生活的年轻人夜间睡眠与白天饮食和活动水平之间的时间联系。
IF 5.3 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-11-08 DOI: 10.1093/sleep/zsad123
Elissa K Hoopes, Benjamin Brewer, Shannon M Robson, Melissa A Witman, Michele N D'Agata, Susan K Malone, David G Edwards, Freda Patterson

Study objectives: This study aimed to quantify the temporal associations between nightly sleep quantity and timing with daytime eating behavior and activity levels in free-living (i.e. non-experimental) settings.

Methods: Generally healthy young adults (N = 63; 28.9 ± 7.1 years) completed concurrent sleep (wrist actigraphy), eating (photo-assisted diet records), and activity (waist actigraphy) assessments over 14 days. Multilevel models quantified the associations between nightly sleep (total sleep time, timing of sleep and wake onset) with next-day eating behavior (diet quality, caloric intake, timing of eating onset/offset, eating window duration) and activity levels (total physical activity, sedentary time). Associations in the reverse direction (i.e. eating and activity predicting sleep) were explored. Models adjusted for demographic and behavioral confounders and accounted for multiple testing.

Results: At within- and between-subject levels, nights with greater-than-average total sleep time predicted a shorter eating window the next day (all p ≤ 0.002). Later-than-average sleep and wake timing predicted within- and between-subject delays in next-day eating onset and offset, and between-subject reductions in diet quality and caloric intake (all p ≤ 0.008). At within- and between-subject levels, total sleep time was bidirectionally, inversely associated with sedentary time (all p < 0.001), while later-than-average sleep and wake timing predicted lower next-day physical activity (all p ≤ 0.008).

Conclusions: These data underscore the complex interrelatedness between sleep, eating behavior, and activity levels in free-living settings. Findings also suggest that sleep exerts a greater influence on next-day behavior, rather than vice versa. While testing in more diverse samples is needed, these data have potential to enhance health behavior interventions and maximize health outcomes.

研究目的:本研究旨在量化在自由生活(即非实验)环境下夜间睡眠量和时间与白天饮食行为和活动水平之间的时间关联。方法:一般健康的青壮年(N = 63;28.9±7.1岁)在14天内完成同步睡眠(手腕活动记录仪)、饮食(光辅助饮食记录)和活动(腰部活动记录仪)评估。多层次模型量化了夜间睡眠(总睡眠时间、睡眠时间和醒来时间)与第二天饮食行为(饮食质量、热量摄入、饮食开始/抵消时间、饮食窗口持续时间)和活动水平(总体力活动、久坐时间)之间的关系。相反方向的关联(即饮食和活动预测睡眠)被探索。模型根据人口统计学和行为混杂因素进行了调整,并考虑了多重测试。结果:在受试者内部和受试者之间水平上,总睡眠时间大于平均水平的夜晚预示着第二天的进食窗口时间更短(均p≤0.002)。睡眠和醒来时间晚于平均水平预示着受试者内部和受试者之间第二天进食开始和抵消的延迟,以及受试者之间饮食质量和热量摄入的降低(均p≤0.008)。在受试者内部和受试者之间,总睡眠时间与久坐时间呈双向负相关(均p < 0.001),而晚于平均睡眠时间和起床时间预示着第二天的体力活动较低(均p≤0.008)。结论:这些数据强调了自由生活环境下睡眠、饮食行为和活动水平之间复杂的相互关系。研究结果还表明,睡眠对第二天行为的影响更大,反之亦然。虽然需要在更多样化的样本中进行测试,但这些数据有可能加强健康行为干预并最大限度地提高健康结果。
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引用次数: 0
Sleep Measurement in Mild Cognitive Impairment and Early Dementia: Is It Time for a Rethink? 轻度认知障碍和早期痴呆的睡眠测量:是时候重新思考了吗?
IF 5.6 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-11-08 DOI: 10.1093/sleep/zsad185
Jonathan Blackman, Anneka Butters, Cerys Oliver, Elizabeth Coulthard
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引用次数: 0
Glymphatic system dysfunction in restless legs syndrome: evidenced by diffusion tensor imaging along the perivascular space. 不宁腿综合征的淋巴系统功能障碍:沿血管周围间隙扩散张量成像证明。
IF 5.6 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-11-08 DOI: 10.1093/sleep/zsad239
Kang Min Park, Keun Tae Kim, Dong Ah Lee, Gholam K Motamedi, Yong Won Cho

Study objectives: There is growing evidence pointing at glymphatic system dysfunction in diseases with circadian disruption, such as sleep disorders. Lower diffusivity in the direction of perivascular space has been shown in several neurological and sleep-related disorders; however, its role in restless legs syndrome (RLS) is unclear. We hypothesized that similarly, in RLS the diffusivity in glymphatic system is decreased. Here, we aimed to evaluate glymphatic system functionality in patients with RLS, compare it to healthy controls, and analyze the correlation between its function and clinical characteristics.

Methods: Sixty-nine patients with primary RLS and 51 healthy controls were recruited at a tertiary hospital. All participants underwent diffusion tensor imaging (DTI) and magnetic resonance imaging (MRI) using a 3T MRI scanner, and the DTI along the perivascular space (DTI-ALPS) index was calculated using DTI data. We compared the DTI-ALPS index between the patients with RLS and healthy controls. We also conducted the correlation analysis between the DTI-ALPS index and clinical characteristics, including age, age of onset, symptom duration, and RLS severity.

Results: DTI-ALPS index differed significantly between the patients with RLS and healthy controls; the DTI-ALPS index in the patients with RLS was lower than that in the healthy controls (1.48 vs. 0.60, p = 0.008). There was no significant correlation between the DTI-ALPS index and clinical characteristics.

Conclusion: A significantly lower DTI-ALPS index in patients with RLS suggests that the glymphatic system function is impaired in patients with RLS.

研究目的:越来越多的证据表明,淋巴系统功能障碍与昼夜节律紊乱的疾病有关,如睡眠障碍。在一些神经和睡眠相关疾病中,血管周围空间方向的低弥漫性已被证实;然而,它在不宁腿综合征(RLS)中的作用尚不清楚。我们同样假设,在RLS中,淋巴系统的弥散性降低。在此,我们旨在评估RLS患者的淋巴系统功能,将其与健康对照进行比较,并分析其功能与临床特征之间的相关性。方法:在某三级医院招募69例原发性RLS患者和51例健康对照者。所有参与者均使用3T MRI扫描仪进行弥散张量成像(DTI)和磁共振成像(MRI),并利用DTI数据计算沿血管周围间隙的DTI (DTI- alps)指数。我们比较了RLS患者与健康对照者的DTI-ALPS指数。我们还对DTI-ALPS指数与年龄、发病年龄、症状持续时间、RLS严重程度等临床特征进行了相关性分析。结果:RLS患者的DTI-ALPS指数与健康对照组有显著差异;RLS患者DTI-ALPS指数低于健康对照组(1.48 vs. 0.60, p = 0.008)。DTI-ALPS指数与临床特征无显著相关性。结论:RLS患者DTI-ALPS指数明显降低,提示RLS患者淋巴系统功能受损。
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引用次数: 0
Poorer neurocognitive function of retired night shift workers: a risk assessment. 退休夜班工人较差的神经认知功能:风险评估。
IF 5.6 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-11-08 DOI: 10.1093/sleep/zsad187
Tomoyuki Kawada
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引用次数: 0
An approach for determining the reliability of manual and digital scoring of sleep stages. 一种确定人工和数字睡眠阶段评分可靠性的方法。
IF 5.6 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-11-08 DOI: 10.1093/sleep/zsad248
Bethany Gerardy, Samuel T Kuna, Allan Pack, Clete A Kushida, James K Walsh, Bethany Staley, Grace W Pien, Magdy Younes

Study objectives: Inter-scorer variability in sleep staging is largely due to equivocal epochs that contain features of more than one stage. We propose an approach that recognizes the existence of equivocal epochs and evaluates scorers accordingly.

Methods: Epoch-by-epoch staging was performed on 70 polysomnograms by six qualified technologists and by a digital system (Michele Sleep Scoring [MSS]). Probability that epochs assigned the same stage by only two of the six technologists (minority score) resulted from random occurrence of two errors was calculated and found to be <5%, thereby indicating that the stage assigned is an acceptable variant for the epoch. Acceptable stages were identified in each epoch as stages assigned by at least two technologists. Percent agreement between each technologist and the other five technologists, acting as judges, was determined. Agreement was considered to exist if the stage assigned by the tested scorer was one of the acceptable stages for the epoch. Stage assigned by MSS was likewise considered in agreement if included in the acceptable stages made by the technologists.

Results: Agreement of technologists tested against five qualified judges increased from 80.8% (range 70.5%-86.4% among technologists) when using the majority rule, to 96.1 (89.8%-98.5%) by the proposed approach. Agreement between unedited MSS and same judges was 90.0% and increased to 92.1% after brief editing.

Conclusions: Accounting for equivocal epochs provides a more accurate estimate of a scorer's (human or digital) competence in scoring sleep stages and reduces inter-scorer disagreements. The proposed approach can be implemented in sleep-scoring training and accreditation programs.

研究目的:评分者之间睡眠阶段的差异很大程度上是由于包含多个阶段特征的模糊时期。我们提出了一种方法,承认存在模棱两可的时代,并相应地评估得分。方法:采用Michele睡眠评分(MSS)数字系统,由6名专业技术人员对70张多导睡眠图进行分期。计算了由于随机出现两个错误而导致6名技术人员中只有2名(少数分数)分配同一阶段的概率,并发现结果:对5名合格裁判进行测试的技术人员的同意度从使用多数决定原则时的80.8%(技术人员的范围为70.5%-86.4%)增加到使用建议方法时的96.1(89.8%-98.5%)。未编辑的MSS与同一法官的一致性为90.0%,经过简短编辑后提高到92.1%。结论:考虑模棱两可的时代,可以更准确地估计计分员(人或数字)对睡眠阶段进行评分的能力,并减少计分员之间的分歧。所提出的方法可以在睡眠评分培训和认证项目中实施。
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引用次数: 0
Microglial voltage-dependent anion channel 1 signaling modulates sleep deprivation-induced transition to chronic postsurgical pain. 小胶质细胞电压依赖性阴离子通道1信号调节睡眠剥夺诱导的慢性术后疼痛的转变。
IF 5.6 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-11-08 DOI: 10.1093/sleep/zsad039
Shi-Nan Wei, Hao Zhang, Yan Lu, Hui-Jie Yu, Tao Ma, Si-Nian Wang, Kun Yang, Mou-Li Tian, Ai-Hua Huang, Wei Wang, Feng-Sheng Li, Yong-Wang Li

Study objectives: This study verified that sleep deprivation before and after skin/muscle incision and retraction (SMIR) surgery increased the risk of chronic pain and investigated the underlying roles of microglial voltage-dependent anion channel 1 (VDAC1) signaling.

Methods: Adult mice received 6 hours of total sleep deprivation from 1 day prior to SMIR until the third day after surgery. Mechanical and heat-evoked pain was assessed before and within 21 days after surgery. Microglial activation and changes in VDAC1 expression and oligomerization were measured. Minocycline was injected to observe the effects of inhibiting microglial activation on pain maintenance. The VDAC1 inhibitor 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS) and oligomerization inhibitor VBIT-4 were used to determine the roles of VDAC1 signaling on microglial adenosine 5' triphosphate (ATP) release, inflammation (IL-1β and CCL2), and chronicity of pain.

Results: Sleep deprivation significantly increased the pain duration after SMIR surgery, activated microglia, and enhanced VDAC1 signaling in the spinal cord. Minocycline inhibited microglial activation and alleviated sleep deprivation-induced pain maintenance. Lipopolysaccharide (LPS)-induced microglial activation was accompanied by increased VDAC1 expression and oligomerization, and more VDAC1 was observed on the cell membrane surface compared with control. DIDS and VBIT-4 rescued LPS-induced microglial ATP release and IL-1β and CCL2 expression. DIDS and VBIT-4 reversed sleep loss-induced microglial activation and pain chronicity in mice, similar to the effects of minocycline. No synergistic effects were found for minocycline plus VBIT-4 or DIDS.

Conclusions: Perioperative sleep deprivation activated spinal microglia and increases the risk of chronic postsurgical pain in mice. VDAC1 signaling regulates microglial activation-related ATP release, inflammation, and chronicity of pain.

研究目的:本研究证实了皮肤/肌肉切开和收缩(SMIR)手术前后的睡眠剥夺增加了慢性疼痛的风险,并研究了小胶质电压依赖性阴离子通道1 (VDAC1)信号的潜在作用。方法:从SMIR前1天到手术后第三天,成年小鼠接受6小时的完全睡眠剥夺。在手术前和术后21天内评估机械疼痛和热诱发疼痛。测量小胶质细胞的激活、VDAC1表达和寡聚化的变化。注射二甲胺四环素,观察抑制小胶质细胞活化对疼痛维持的影响。采用VDAC1抑制剂4,4'-二异硫氰酸二苯乙烯-2,2'-二磺酸(DIDS)和寡聚化抑制剂VBIT-4来测定VDAC1信号在小胶质腺苷5'三磷酸(ATP)释放、炎症(IL-1β和CCL2)和慢性疼痛中的作用。结果:睡眠剥夺显著增加SMIR手术后疼痛持续时间,激活小胶质细胞,增强脊髓VDAC1信号。二甲胺四环素抑制小胶质细胞激活,减轻睡眠剥夺引起的疼痛维持。脂多糖(LPS)诱导的小胶质细胞活化伴随着VDAC1表达和寡聚化的增加,与对照组相比,细胞膜表面的VDAC1增加。DIDS和VBIT-4可挽救lps诱导的小胶质细胞ATP释放和IL-1β和CCL2表达。在小鼠中,DIDS和VBIT-4逆转了睡眠缺失引起的小胶质细胞激活和疼痛的慢性性,类似于二甲胺四环素的作用。米诺环素联合VBIT-4或DIDS未发现协同效应。结论:围手术期睡眠剥夺激活了脊髓小胶质细胞,增加了小鼠术后慢性疼痛的风险。VDAC1信号调节小胶质细胞激活相关的ATP释放、炎症和慢性疼痛。
{"title":"Microglial voltage-dependent anion channel 1 signaling modulates sleep deprivation-induced transition to chronic postsurgical pain.","authors":"Shi-Nan Wei, Hao Zhang, Yan Lu, Hui-Jie Yu, Tao Ma, Si-Nian Wang, Kun Yang, Mou-Li Tian, Ai-Hua Huang, Wei Wang, Feng-Sheng Li, Yong-Wang Li","doi":"10.1093/sleep/zsad039","DOIUrl":"10.1093/sleep/zsad039","url":null,"abstract":"<p><strong>Study objectives: </strong>This study verified that sleep deprivation before and after skin/muscle incision and retraction (SMIR) surgery increased the risk of chronic pain and investigated the underlying roles of microglial voltage-dependent anion channel 1 (VDAC1) signaling.</p><p><strong>Methods: </strong>Adult mice received 6 hours of total sleep deprivation from 1 day prior to SMIR until the third day after surgery. Mechanical and heat-evoked pain was assessed before and within 21 days after surgery. Microglial activation and changes in VDAC1 expression and oligomerization were measured. Minocycline was injected to observe the effects of inhibiting microglial activation on pain maintenance. The VDAC1 inhibitor 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS) and oligomerization inhibitor VBIT-4 were used to determine the roles of VDAC1 signaling on microglial adenosine 5' triphosphate (ATP) release, inflammation (IL-1β and CCL2), and chronicity of pain.</p><p><strong>Results: </strong>Sleep deprivation significantly increased the pain duration after SMIR surgery, activated microglia, and enhanced VDAC1 signaling in the spinal cord. Minocycline inhibited microglial activation and alleviated sleep deprivation-induced pain maintenance. Lipopolysaccharide (LPS)-induced microglial activation was accompanied by increased VDAC1 expression and oligomerization, and more VDAC1 was observed on the cell membrane surface compared with control. DIDS and VBIT-4 rescued LPS-induced microglial ATP release and IL-1β and CCL2 expression. DIDS and VBIT-4 reversed sleep loss-induced microglial activation and pain chronicity in mice, similar to the effects of minocycline. No synergistic effects were found for minocycline plus VBIT-4 or DIDS.</p><p><strong>Conclusions: </strong>Perioperative sleep deprivation activated spinal microglia and increases the risk of chronic postsurgical pain in mice. VDAC1 signaling regulates microglial activation-related ATP release, inflammation, and chronicity of pain.</p>","PeriodicalId":49514,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
A longitudinal study of infant 24-hour sleep: comparisons of sleep diary and accelerometer with different algorithms. 婴儿24小时睡眠的纵向研究:不同算法下睡眠日记和加速计的比较。
IF 5.6 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-11-08 DOI: 10.1093/sleep/zsad160
Tiange Liu, Sara E Benjamin-Neelon

Study objectives: To longitudinally compare sleep/wake identification and sleep parameter estimation from sleep diaries to accelerometers using different algorithms and epoch lengths in infants.

Methods: Mothers and other caregivers from the Nurture study (southeastern United States, 2013-2018) reported infants' 24-hour sleep in sleep diaries for 4 continuous days, while infants concurrently wore accelerometers on the left ankle at 3, 6, 9, and 12 months of age. We applied the Sadeh, Sadeh Infant, Cole, and Count-scaled algorithm to accelerometer data at 15 and 60 seconds epochs. For sleep/wake identification, we assessed agreement by calculating epoch-by-epoch percent agreement and kappas. We derived sleep parameters from sleep diaries and accelerometers separately and evaluated agreement using Bland-Altman plots. We estimated longitudinal trajectories of sleep parameters using marginal linear and Poisson regressions with generalized estimation equation estimation.

Results: Among the 477 infants, 66.2% were black and 49.5% were female. Agreement for sleep/wake identification varied by epoch length and algorithm. Relative to sleep diaries, we observed similar nighttime sleep offset, onset, and total nighttime sleep duration from accelerometers regardless of algorithm and epoch length. However, accelerometers consistently estimated about 1 less nap per day using the 15 seconds epoch, 70 and 50 minutes' shorter nap duration per day using the 15 and 60 seconds epoch, respectively; but accelerometers estimated over 3 times more wake after nighttime sleep onset (WASO) per night. Some consistent sleep parameter trajectories from 3 to 12 months from accelerometers and sleep diaries included fewer naps and WASOs, shorter total daytime sleep, longer total nighttime sleep, and higher nighttime sleep efficiency.

Conclusions: Although there is no perfect measure of sleep in infancy, our findings suggest that a combination of accelerometer and diary may be needed to adequately measure infant sleep.

研究目的:纵向比较使用不同算法和历元长度的婴儿睡眠/觉醒识别和睡眠参数估计从睡眠日记到加速度计。方法:来自Nurture研究(美国东南部,2013-2018)的母亲和其他照顾者在连续4天的睡眠日记中报告了婴儿24小时睡眠,而婴儿在3、6、9和12个月大时同时在左脚踝上佩戴加速度计。我们将Sadeh、Sadeh Infant、Cole和count -scale算法应用于加速度计数据,每次15秒和60秒。对于睡眠/清醒识别,我们通过计算每个时代的一致性百分比和kappa来评估一致性。我们分别从睡眠日记和加速计中获得睡眠参数,并使用Bland-Altman图评估一致性。我们使用广义估计方程估计的边际线性回归和泊松回归估计睡眠参数的纵向轨迹。结果:477例新生儿中,黑人占66.2%,女婴占49.5%。睡眠/觉醒识别的一致性因历元长度和算法而异。相对于睡眠日记,我们从加速度计中观察到类似的夜间睡眠偏移量、开始时间和夜间总睡眠时间,而不考虑算法和历元长度。然而,加速度计一致地估计,使用15秒epoch,每天的午睡时间减少了1分钟,使用15秒和60秒epoch,每天的午睡时间分别缩短了70分钟和50分钟;但加速度计估计每晚夜间睡眠后醒来(WASO)超过3倍。从加速计和睡眠日记中获得的3至12个月的一致睡眠参数轨迹包括:更少的小睡和WASOs,更短的白天总睡眠,更长的夜间总睡眠,以及更高的夜间睡眠效率。结论:虽然没有完美的婴儿睡眠测量方法,但我们的研究结果表明,可能需要结合加速度计和日记来充分测量婴儿睡眠。
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引用次数: 0
Retired night shift workers exhibit poorer neurocognitive function compared to retired day workers. 与退休的白班工人相比,退休的夜班工人表现出更差的神经认知功能。
IF 5.6 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-11-08 DOI: 10.1093/sleep/zsad098
Ashlyn Runk, H Matthew Lehrer, Meryl A Butters, Daniel J Buysse, Marissa A Evans, Robert T Krafty, Martica H Hall

Study objectives: Shift work is associated with compromised cognitive function, and with chronic exposure, may place shift workers at elevated risk for dementia. However, evidence of cognitive impairment among former night shift workers is mixed, possibly due to inconsistencies regarding retirement status, work history classification, and cognitive assessments. To address these limitations, this study compared neurocognitive function between retired night shift workers and retired day workers using a well-characterized sample and a rigorous neurocognitive test battery.

Methods: Participants (N = 61; mean age: 67.9 ± 4.7 years; 61% females; 13% non-white) were 31 retired day workers and 30 retired night shift workers equated on age, sex, race/ethnicity, premorbid IQ, years retired, and diary-assessed habitual sleep characteristics. Participants completed a neurocognitive battery assessing six cognitive domains (language, visuospatial ability, attention, immediate and delayed memory, executive function) and self-reported cognitive function. Linear regression models compared groups on individual cognitive domains, adjusting for age, sex, race/ethnicity, education level, and habitual sleep quality.

Results: Retired night shift workers scored lower than retired day workers on attention (B = -0.38, 95% CI [-0.75, -0.02], p = .040) and executive function (B = -0.55, 95% CI [-0.92, -0.17], p = .005). In post hoc analyses, attention and executive function were unrelated to diary-assessed habitual sleep characteristics (disruption, timing, and irregularity) in retired night shift workers.

Conclusions: The observed cognitive weaknesses in retired night shift workers may suggest increased risk for future dementia. Retired night shift workers should be followed to determine whether observed weaknesses progress.

研究目标:轮班工作与认知功能受损有关,长期接触可能会使轮班工人患痴呆症的风险增加。然而,前夜班工人认知障碍的证据喜忧参半,可能是由于退休状态、工作史分类和认知评估不一致。为了解决这些局限性,本研究使用一个特征明确的样本和一个严格的神经认知测试组,比较了退休夜班工人和退休日工的神经认知功能。方法:参与者(N=61;平均年龄:67.9+/-4.7岁;61%为女性;13%为非白人)是31名退休的日工和30名退休的夜班工人,他们的年龄、性别、种族/民族、病前智商、退休年限和日记评估的习惯性睡眠特征相等。参与者完成了一个神经认知组,评估了6个认知领域(语言、视觉空间能力、注意力、即时记忆和延迟记忆、执行功能)和自我报告的认知功能。线性回归模型在个体认知领域对各组进行比较,并根据年龄、性别、种族/民族、教育水平和习惯性睡眠质量进行调整。结果:退休夜班工人在注意力(B=-0.38,95%CI[0.75,-0.02],p=0.040)和执行功能(B=-0.55,95%CI[0.92,-0.117],p=0.005)方面的得分低于退休白班工人。在事后分析中,退休夜班工人的注意力和执行功能与日记评估的习惯性睡眠特征(中断、时间安排、不规律)无关。结论:观察到的退休夜班工人的认知弱点可能表明未来患痴呆症的风险增加。应跟踪退休夜班工人,以确定观察到的薄弱环节是否进展。
{"title":"Retired night shift workers exhibit poorer neurocognitive function compared to retired day workers.","authors":"Ashlyn Runk, H Matthew Lehrer, Meryl A Butters, Daniel J Buysse, Marissa A Evans, Robert T Krafty, Martica H Hall","doi":"10.1093/sleep/zsad098","DOIUrl":"10.1093/sleep/zsad098","url":null,"abstract":"<p><strong>Study objectives: </strong>Shift work is associated with compromised cognitive function, and with chronic exposure, may place shift workers at elevated risk for dementia. However, evidence of cognitive impairment among former night shift workers is mixed, possibly due to inconsistencies regarding retirement status, work history classification, and cognitive assessments. To address these limitations, this study compared neurocognitive function between retired night shift workers and retired day workers using a well-characterized sample and a rigorous neurocognitive test battery.</p><p><strong>Methods: </strong>Participants (N = 61; mean age: 67.9 ± 4.7 years; 61% females; 13% non-white) were 31 retired day workers and 30 retired night shift workers equated on age, sex, race/ethnicity, premorbid IQ, years retired, and diary-assessed habitual sleep characteristics. Participants completed a neurocognitive battery assessing six cognitive domains (language, visuospatial ability, attention, immediate and delayed memory, executive function) and self-reported cognitive function. Linear regression models compared groups on individual cognitive domains, adjusting for age, sex, race/ethnicity, education level, and habitual sleep quality.</p><p><strong>Results: </strong>Retired night shift workers scored lower than retired day workers on attention (B = -0.38, 95% CI [-0.75, -0.02], p = .040) and executive function (B = -0.55, 95% CI [-0.92, -0.17], p = .005). In post hoc analyses, attention and executive function were unrelated to diary-assessed habitual sleep characteristics (disruption, timing, and irregularity) in retired night shift workers.</p><p><strong>Conclusions: </strong>The observed cognitive weaknesses in retired night shift workers may suggest increased risk for future dementia. Retired night shift workers should be followed to determine whether observed weaknesses progress.</p>","PeriodicalId":49514,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9427377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of once-nightly sodium oxybate (FT218) in narcolepsy type 1 and type 2: post hoc analysis from the Phase 3 REST-ON Trial. 每晚一次的氧酸钠(FT218)治疗1型和2型发作性睡病的疗效:来自3期REST-ON试验的事后分析
IF 5.6 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-11-08 DOI: 10.1093/sleep/zsad152
Yves Dauvilliers, Thomas Roth, Richard Bogan, Michael J Thorpy, Anne Marie Morse, Asim Roy, Jordan Dubow, Jennifer Gudeman

Study objectives: Post hoc analyses from the phase 3 REST-ON trial evaluated efficacy of extended-release once-nightly sodium oxybate (ON-SXB; FT218) vs placebo for daytime sleepiness and disrupted nighttime sleep in narcolepsy type 1 (NT1) and 2 (NT2).

Methods: Participants were stratified by narcolepsy type and randomized 1:1 to ON-SXB (4.5 g, week 1; 6 g, weeks 2-3; 7.5 g, weeks 4-8; and 9 g, weeks 9-13) or placebo. Assessments included mean sleep latency on Maintenance of Wakefulness Test (MWT) and Clinical Global Impression-Improvement (CGI-I) rating (coprimary endpoints) and sleep stage shifts, nocturnal arousals, and patient-reported sleep quality, refreshing nature of sleep, and Epworth Sleepiness Scale (ESS) score (secondary endpoints) separately in NT1 and NT2 subgroups.

Results: The modified intent-to-treat population comprised 190 participants (NT1, n = 145; NT2, n = 45). Significant improvements were demonstrated with ON-SXB vs placebo in sleep latency for NT1 (all doses, p < .001) and NT2 (6 and 9 g, p < .05) subgroups. Greater proportions of participants in both subgroups had CGI-I ratings of much/very much improved with ON-SXB vs placebo. Sleep stage shifts and sleep quality significantly improved in both subgroups (all doses vs placebo, p < .001). Significant improvements with all ON-SXB doses vs placebo in refreshing nature of sleep (p < .001), nocturnal arousals (p < .05), and ESS scores (p ≤ .001) were reported for NT1 with directional improvements for NT2.

Conclusions: Clinically meaningful improvements of a single ON-SXB bedtime dose were shown for daytime sleepiness and DNS in NT1 and NT2, with less power for the limited NT2 subgroup.

研究目的:3期REST-ON试验的事后分析评估了每晚一次的缓释氧酸钠(ON-SXB;FT218)与安慰剂对1型(NT1)和2型(NT2)发作性睡病患者白天嗜睡和夜间睡眠中断的影响。方法:参与者按发作性睡病类型分层,按1:1随机分配ON-SXB (4.5 g,第1周;6克,2-3周;7.5 g,第4-8周;9克(第9-13周)或安慰剂。评估包括NT1和NT2亚组中清醒维持测试(MWT)和临床总体印象改善(gi - i)评分的平均睡眠潜伏期(主要终点)和睡眠阶段变化、夜间觉醒、患者报告的睡眠质量、睡眠的清新性和Epworth嗜睡量表(ESS)评分(次要终点)。结果:修正意向治疗人群包括190名参与者(NT1, n = 145;NT2, n = 45)。与安慰剂相比,ON-SXB在NT1(所有剂量,p < 0.001)和NT2(6和9 g, p < 0.05)亚组的睡眠潜伏期有显著改善。与安慰剂相比,两个亚组中更大比例的参与者使用ON-SXB的CGI-I评分得到了很大/非常大的改善。两个亚组的睡眠阶段变化和睡眠质量都有显著改善(所有剂量与安慰剂相比,p < 0.001)。与安慰剂相比,所有ON-SXB剂量在NT1的睡眠清新性(p < 0.001)、夜间唤醒(p < 0.05)和ESS评分(p≤0.001)方面均有显著改善,而NT2则有方向性改善。结论:单一ON-SXB睡前剂量对NT1和NT2患者的日间嗜睡和DNS有临床意义的改善,对有限NT2亚组的作用较小。
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引用次数: 0
Rest-activity rhythms across the lifespan: cross-sectional findings from the US representative National Health and Nutrition Examination Survey. 一生中的休息活动节奏:美国代表性国家健康和营养检查调查(NHANES)的横断面调查结果。
IF 5.3 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-11-08 DOI: 10.1093/sleep/zsad220
Danielle A Wallace, Dayna A Johnson, Susan Redline, Tamar Sofer, Joe Kossowsky

Study objectives: Rest-activity rhythms (RAR) may mark development, aging, and physical and mental health. Understanding how they differ between people may inform intervention and health promotion efforts. However, RAR characteristics across the lifespan have not been well-studied. Therefore, we investigated the association between RAR measures with demographic and lifestyle factors in a US nationally representative study.

Methods: RAR metrics of interdaily stability (IS), intradaily variability (IV), relative amplitude (RA), and mean amplitude and timing of high (M10) and low (L5) activity were derived from 2011 to 2012 and 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) actigraphy data. Population-weighted linear and logistic regression models were fit to examine the associations of age, gender, smoking, alcohol, season, body mass index (BMI), income-to-poverty ratio, and race/ethnicity with RAR. Significance was based on a false-discovery rate-corrected P-value of <0.05.

Results: Among n = 12 526 NHANES participants (3-≥80 years), IS (higher = greater day-to-day regularity) and RA (higher = greater rhythm strength) generally decreased with age and were lower among males, whereas IV (higher = greater rhythm fragmentation) increased with age (p < 0.05). Dynamic changes in RAR trajectories were observed during childhood and adolescence. Income, BMI, smoking, and alcohol use were associated with RAR metrics, as well as season among children and teenagers (p < 0.05). RAR also differed by race/ethnicity (p < 0.05), with trajectories initially diverging in childhood and continuing into adulthood.

Conclusions: RAR differed by demographic and health-related factors, representing possible windows for public health intervention and sleep health promotion. RAR differences by race/ethnicity begin in childhood, are evident in early adolescence, and persist throughout adulthood.

研究目的:休息活动节律(RAR)可能标志着发育、衰老以及身心健康。了解它们在人与人之间的差异可能会为干预和健康促进工作提供信息。然而,RAR在整个寿命期间的特性尚未得到很好的研究。因此,我们在一项具有美国全国代表性的研究中调查了RAR指标与人口统计学和生活方式因素之间的关系。方法:从2011-2012年和2013-2014年国家健康和营养检查调查(NHANES)活动图数据中获得日间稳定性(IS)、日间变异性(IV)、相对振幅(RA)以及高(M10)和低(L5)活动的平均振幅和时间的RAR指标。人口加权线性和逻辑回归模型适用于检验年龄、性别、吸烟、饮酒、季节、体重指数(BMI)、收入与贫困率以及种族/民族与RAR的关系。显著性基于错误发现率(FDR)校正的p值。结果:在n=12526名NHANES参与者(3-80+岁)中,IS(较高=更大的日常规律性)和RA(较高=更强的节律强度)通常随着年龄的增长而下降,在男性中较低,而IV(更高=更大的节律碎片)随着年龄的增长而增加(P结论:RAR因人口统计学和健康相关因素而异,代表了公共卫生干预和促进睡眠健康的可能窗口。不同种族/民族的RAR差异始于儿童期,在青春期早期明显,并在整个成年期持续存在。
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