Pub Date : 2022-10-21eCollection Date: 2022-01-01DOI: 10.1093/sleepadvances/zpac036
John A Lesku, Niels C Rattenborg
Sleep serves many important functions. And yet, emerging studies over the last decade indicate that some species routinely sleep little, or can temporarily restrict their sleep to low levels, seemingly without cost. Taken together, these systems challenge the prevalent view of sleep as an essential state on which waking performance depends. Here, we review diverse case-studies, including elephant matriarchs, post-partum cetaceans, seawater sleeping fur seals, soaring seabirds, birds breeding in the high Arctic, captive cavefish, and sexually aroused fruit flies. We evaluate the likelihood of mechanisms that might allow more sleep than is presently appreciated. But even then, it appears these species are indeed performing well on little sleep. The costs, if any, remain unclear. Either these species have evolved a (yet undescribed) ability to supplant sleep needs, or they endure a (yet undescribed) cost. In both cases, there is urgent need for the study of non-traditional species so we can fully appreciate the extent, causes, and consequences of ecological sleep loss.
{"title":"The missing cost of ecological sleep loss.","authors":"John A Lesku, Niels C Rattenborg","doi":"10.1093/sleepadvances/zpac036","DOIUrl":"10.1093/sleepadvances/zpac036","url":null,"abstract":"<p><p>Sleep serves many important functions. And yet, emerging studies over the last decade indicate that some species routinely sleep little, or can temporarily restrict their sleep to low levels, seemingly without cost. Taken together, these systems challenge the prevalent view of sleep as an essential state on which waking performance depends. Here, we review diverse case-studies, including elephant matriarchs, post-partum cetaceans, seawater sleeping fur seals, soaring seabirds, birds breeding in the high Arctic, captive cavefish, and sexually aroused fruit flies. We evaluate the likelihood of mechanisms that might allow more sleep than is presently appreciated. But even then, it appears these species are indeed performing well on little sleep. The costs, if any, remain unclear. Either these species have evolved a (yet undescribed) ability to supplant sleep needs, or they endure a (yet undescribed) cost. In both cases, there is urgent need for the study of non-traditional species so we can fully appreciate the extent, causes, and consequences of ecological sleep loss.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10104415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-20eCollection Date: 2022-01-01DOI: 10.1093/sleepadvances/zpac038
Mathias Basner
Study objectives: The Psychomotor Vigilance Test (PVT) is a widely used and sensitive assay of the cognitive deficits associated with sleep loss and circadian misalignment. As even shorter versions of the PVT are often considered too long, I developed and validated an adaptive duration version of the 3 min PVT (PVT-BA).
Methods: The PVT-BA algorithm was trained on data from 31 subjects participating in a total sleep deprivation protocol and validated in 43 subjects undergoing 5 days of partial sleep restriction under controlled laboratory conditions. With each subject response, the algorithm updated the odds of the test being high, medium or low performance based on lapses plus false starts on the full 3 min PVT-B.
Results: With a decision threshold of 99.619%, PVT-BA classified 95.1% of training data tests correctly without incorrect classifications across two performance categories (i.e. high as low or low as high) and resulted in an average test duration of 1 min 43 s with a minimum duration of 16.4 s. Agreement corrected for chance between PVT-B and PVT-BA was "almost perfect" for both the training (kappa = 0.92) and validation data (kappa = 0.85). Across the three performance categories and data sets, sensitivity averaged 92.2% (range 74.9-100%) and specificity averaged 96.0% (range 88.3-99.2%).
Conclusions: PVT-BA is an accurate adaptive version of PVT-B and, to my knowledge, the shortest version to date that maintains key properties of the standard 10 min duration PVT. PVT-BA will facilitate the use of the PVT in settings in which it was previously considered impractical.
{"title":"Ultra-short objective alertness assessment: an adaptive duration version of the 3 minute PVT (PVT-BA) accurately tracks changes in psychomotor vigilance induced by sleep restriction.","authors":"Mathias Basner","doi":"10.1093/sleepadvances/zpac038","DOIUrl":"10.1093/sleepadvances/zpac038","url":null,"abstract":"<p><strong>Study objectives: </strong>The Psychomotor Vigilance Test (PVT) is a widely used and sensitive assay of the cognitive deficits associated with sleep loss and circadian misalignment. As even shorter versions of the PVT are often considered too long, I developed and validated an adaptive duration version of the 3 min PVT (PVT-BA).</p><p><strong>Methods: </strong>The PVT-BA algorithm was trained on data from 31 subjects participating in a total sleep deprivation protocol and validated in 43 subjects undergoing 5 days of partial sleep restriction under controlled laboratory conditions. With each subject response, the algorithm updated the odds of the test being high, medium or low performance based on lapses plus false starts on the full 3 min PVT-B.</p><p><strong>Results: </strong>With a decision threshold of 99.619%, PVT-BA classified 95.1% of training data tests correctly without incorrect classifications across two performance categories (i.e. high as low or low as high) and resulted in an average test duration of 1 min 43 s with a minimum duration of 16.4 s. Agreement corrected for chance between PVT-B and PVT-BA was \"almost perfect\" for both the training (kappa = 0.92) and validation data (kappa = 0.85). Across the three performance categories and data sets, sensitivity averaged 92.2% (range 74.9-100%) and specificity averaged 96.0% (range 88.3-99.2%).</p><p><strong>Conclusions: </strong>PVT-BA is an accurate adaptive version of PVT-B and, to my knowledge, the shortest version to date that maintains key properties of the standard 10 min duration PVT. PVT-BA will facilitate the use of the PVT in settings in which it was previously considered impractical.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/3f/zpac038.PMC10104405.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9857394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-20eCollection Date: 2023-01-01DOI: 10.1093/sleepadvances/zpac039
Mary A Carskadon
{"title":"Introducing a new <i>SLEEP Advances</i> initiative: Living Legends.","authors":"Mary A Carskadon","doi":"10.1093/sleepadvances/zpac039","DOIUrl":"10.1093/sleepadvances/zpac039","url":null,"abstract":"","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10108631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9469688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Study objectives: Sleep spindles play a crucial role in multiple neuronal network functions. Initiation and termination of spindles are regulated by the thalamic reticular nucleus and thalamocortical network, and the spindle can be an index for brain organization. We conducted a preliminary study of the parameters of sleep spindles, focusing on sleep-stage temporal distribution in children with autism spectrum disorder (ASD) with normal intelligence/developmental quotients.
Methods: We performed overnight polysomnography in 14 children with ASD (4-10 years) with normal full-scale intelligence quotient/developmental quotient (≥75) and 14 community samples (CS) of children. Sleep stages were scored according to the Rechtschaffen and Kales criteria. Spindle parameters were quantified and compared between these groups and the identified subgroups.
Results: Sleep parameters did not differ between the ASD and CS groups, except for a higher rate of rapid eye movement (REM) sleep duration in ASD. Spindle parameters did not significantly differ between the groups, but spindle density was distributed in a broader range in the ASD group. Five children with ASD had a higher spindle density in stage 3 than in stage 2. The ratio of spindle density in stage 3 to that in stage 2 (stage 3/2 ratio) was significantly higher in ASD than in CS cases.
Conclusions: The lower spindle density in stage 2 and relatively higher density in stage 3 in children with ASD may represent an abnormal generation of spindles due to insufficient maturation of the thalamic reticular nucleus and thalamocortical network.
{"title":"A preliminary study of sleep spindles across non-rapid eye movement sleep stages in children with autism spectrum disorder.","authors":"Midori Kawahara, Kuriko Kagitani-Shimono, Kumi Kato-Nishimura, Noboru Ohki, Masaya Tachibana, Takafumi Kato, Masako Taniike, Ikuko Mohri","doi":"10.1093/sleepadvances/zpac037","DOIUrl":"10.1093/sleepadvances/zpac037","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep spindles play a crucial role in multiple neuronal network functions. Initiation and termination of spindles are regulated by the thalamic reticular nucleus and thalamocortical network, and the spindle can be an index for brain organization. We conducted a preliminary study of the parameters of sleep spindles, focusing on sleep-stage temporal distribution in children with autism spectrum disorder (ASD) with normal intelligence/developmental quotients.</p><p><strong>Methods: </strong>We performed overnight polysomnography in 14 children with ASD (4-10 years) with normal full-scale intelligence quotient/developmental quotient (≥75) and 14 community samples (CS) of children. Sleep stages were scored according to the Rechtschaffen and Kales criteria. Spindle parameters were quantified and compared between these groups and the identified subgroups.</p><p><strong>Results: </strong>Sleep parameters did not differ between the ASD and CS groups, except for a higher rate of rapid eye movement (REM) sleep duration in ASD. Spindle parameters did not significantly differ between the groups, but spindle density was distributed in a broader range in the ASD group. Five children with ASD had a higher spindle density in stage 3 than in stage 2. The ratio of spindle density in stage 3 to that in stage 2 (stage 3/2 ratio) was significantly higher in ASD than in CS cases.</p><p><strong>Conclusions: </strong>The lower spindle density in stage 2 and relatively higher density in stage 3 in children with ASD may represent an abnormal generation of spindles due to insufficient maturation of the thalamic reticular nucleus and thalamocortical network.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10104411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9486409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1093/sleepadvances/zpac029
{"title":"Author Index.","authors":"","doi":"10.1093/sleepadvances/zpac029","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpac029","url":null,"abstract":"","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/7c/zpac029.PMC10174475.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9469687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1093/sleepadvances/zpac029.179
B. Shenoy, N. McArdle, J. Walsh, G. Cadby, D. Hillman, B. McQuillan, J. Hung, S. Dhaliwal, Subhabrata Mukherjee, L. Palmer, B. Singh
Abstract Background Obstructive sleep apnoea (OSA) is a complex heterogeneous disorder, and patients with similar disease severity present with different symptom profiles and outcomes. It is unclear whether OSA symptom subtypes independently predict incident major adverse cardiovascular events (MACE). Method Consecutive patients attending a tertiary sleep clinic from 2006 to 2010 were prospectively investigated and linked to administrative health data. Data from 1,767 patients with severe OSA (apnoea-hypopnoea index ≥30 events/hour) were used in latent class analysis to identify symptom subtypes. Associations between symptom subtypes and incident MACE were assessed using Cox proportional hazards models, with adjustment for known cardiovascular risk factors. Results On average, patients were middle-aged (mean± SD 52.5±13.2 years), obese (BMI, 35.4±7.9 kg/m²), and male (71.7%). Four symptom subtypes were identified: high symptom burden: severe sleepiness (26.0%), high symptom burden: sleep onset insomnia (34.8%), moderate symptom burden (18.4%), and minimal symptoms (20.7%). Over a median follow-up of 7 years, 330 (18.7%) patients developed MACE. After adjustment for covariates, the high symptom burden: sleep onset insomnia subtype was associated with increased risk for MACE relative to those with moderate (HR, 1.59; 95%CI, 1.12–2.25; P=0.010) or minimal (HR, 1.47; 95%CI, 1.07–2.03; P=0.018) symptom burden. Discussion Distinct symptom subtypes can be identified among severe OSA patients. In symptomatic patients, those with a high prevalence of sleep onset insomnia were at increased risk of MACE, relative to those with moderate or minimal symptom burden. Our findings suggest that symptom subtypes may be clinically relevant in risk stratification for MACE in severe OSA.
{"title":"P109 Predicting major adverse cardiovascular events using symptom subtypes of severe obstructive sleep apnoea","authors":"B. Shenoy, N. McArdle, J. Walsh, G. Cadby, D. Hillman, B. McQuillan, J. Hung, S. Dhaliwal, Subhabrata Mukherjee, L. Palmer, B. Singh","doi":"10.1093/sleepadvances/zpac029.179","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpac029.179","url":null,"abstract":"Abstract Background Obstructive sleep apnoea (OSA) is a complex heterogeneous disorder, and patients with similar disease severity present with different symptom profiles and outcomes. It is unclear whether OSA symptom subtypes independently predict incident major adverse cardiovascular events (MACE). Method Consecutive patients attending a tertiary sleep clinic from 2006 to 2010 were prospectively investigated and linked to administrative health data. Data from 1,767 patients with severe OSA (apnoea-hypopnoea index ≥30 events/hour) were used in latent class analysis to identify symptom subtypes. Associations between symptom subtypes and incident MACE were assessed using Cox proportional hazards models, with adjustment for known cardiovascular risk factors. Results On average, patients were middle-aged (mean± SD 52.5±13.2 years), obese (BMI, 35.4±7.9 kg/m²), and male (71.7%). Four symptom subtypes were identified: high symptom burden: severe sleepiness (26.0%), high symptom burden: sleep onset insomnia (34.8%), moderate symptom burden (18.4%), and minimal symptoms (20.7%). Over a median follow-up of 7 years, 330 (18.7%) patients developed MACE. After adjustment for covariates, the high symptom burden: sleep onset insomnia subtype was associated with increased risk for MACE relative to those with moderate (HR, 1.59; 95%CI, 1.12–2.25; P=0.010) or minimal (HR, 1.47; 95%CI, 1.07–2.03; P=0.018) symptom burden. Discussion Distinct symptom subtypes can be identified among severe OSA patients. In symptomatic patients, those with a high prevalence of sleep onset insomnia were at increased risk of MACE, relative to those with moderate or minimal symptom burden. Our findings suggest that symptom subtypes may be clinically relevant in risk stratification for MACE in severe OSA.","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75261047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1093/sleepadvances/zpac029.152
P. Newman, E. Oldenhof, B. Swierzbiolek, J. Andersonwurf, J. Szeto, P. Staiger
Abstract Insomnia is a prevalent issue in AOD settings. Many use substances for their sedative effect or experience insomnia as a consequence of substance use, insomnia is a common feature of withdrawal and often linked to relapse. In this study, a community-based AOD service is piloting a stepped-care intervention for insomnia. Nine AOD clinicians underwent CBT-I training to deliver a 3-step intervention: (1) a 60-minute information session, (2) A guided self-help booklet + ≤ 3 sessions with an AOD clinician, and (3) an 8-week CBT-I Group. The primary outcome is the insomnia severity index (ISI) and secondary outcomes relate to mental health and substance use. Focus groups and online questionnaires are being used to evaluate its implementation. This presentation will outline how a stepped-care model for sleep treatment was integrated within an AOD setting and discuss the available evidence on its effectiveness, feasibility and acceptability. Of the 299 enrolled to date (M=57.4 years ±14.3yrs; 74.6% women), initial findings show significant improvements in ISI scores after Step 1 (17.5 to 15.6; P < 0.01) (d = 0.33), and 54% of eligible participants have moved into Step 2. So far, participant engagement and retention rates suggest good feasibility. Clinicians report high levels of satisfaction with the program, perceiving that it addresses an otherwise inconsistently met need, and enjoy the contrast in work to their usual role. Barriers to delivering the program include limited time and resources. Findings demonstrate this stepped-care program has the potential to improve outcomes and enhance recovery in AOD settings.
{"title":"P082 Lesson's learnt from an AOD team delivering a stepped-care intervention for sleep","authors":"P. Newman, E. Oldenhof, B. Swierzbiolek, J. Andersonwurf, J. Szeto, P. Staiger","doi":"10.1093/sleepadvances/zpac029.152","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpac029.152","url":null,"abstract":"Abstract Insomnia is a prevalent issue in AOD settings. Many use substances for their sedative effect or experience insomnia as a consequence of substance use, insomnia is a common feature of withdrawal and often linked to relapse. In this study, a community-based AOD service is piloting a stepped-care intervention for insomnia. Nine AOD clinicians underwent CBT-I training to deliver a 3-step intervention: (1) a 60-minute information session, (2) A guided self-help booklet + ≤ 3 sessions with an AOD clinician, and (3) an 8-week CBT-I Group. The primary outcome is the insomnia severity index (ISI) and secondary outcomes relate to mental health and substance use. Focus groups and online questionnaires are being used to evaluate its implementation. This presentation will outline how a stepped-care model for sleep treatment was integrated within an AOD setting and discuss the available evidence on its effectiveness, feasibility and acceptability. Of the 299 enrolled to date (M=57.4 years ±14.3yrs; 74.6% women), initial findings show significant improvements in ISI scores after Step 1 (17.5 to 15.6; P < 0.01) (d = 0.33), and 54% of eligible participants have moved into Step 2. So far, participant engagement and retention rates suggest good feasibility. Clinicians report high levels of satisfaction with the program, perceiving that it addresses an otherwise inconsistently met need, and enjoy the contrast in work to their usual role. Barriers to delivering the program include limited time and resources. Findings demonstrate this stepped-care program has the potential to improve outcomes and enhance recovery in AOD settings.","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74700347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1093/sleepadvances/zpac029.021
J. Guzzetti, T. Sundelin, B. Holding, K. Wright, John Axelsson
Abstract The light-dark cycle is the primary time cue for the synchronization of the internal human circadian system with the external world. Our previous research has shown the capacity of the circadian system to adapt to seasonal variations in the light-dark cycle at latitude ~40oN in the Rocky Mountains following curtailment of artificial light exposure. In the current study, we examined the circadian response to a longer photoperiod in summer by measuring melatonin timing before and after a week of camping outdoors in Sweden. Actigraphy-derived (Actiwatch Spectrum) assessments of sleep, activity and light exposure were carried out for 2 weeks. Week 1 was under modern urban living conditions with exposure to natural and artificial light in Stockholm, Sweden (~59oN; 18 hr 37 min: 5 hr 23 min light-dark cycle). Week 2 was spent rough camping in nature with exposure to only natural light at the Swedish High Coast (~63oN; 20 hr 40 min: 3 hr 20 min). Dim-light melatonin onset (DLMO) assessments were conducted in laboratory over two 24 hr periods immediately before and after camping to assess melatonin levels in hourly saliva samples. On average, participants’ (n = 10) melatonin midpoint and offset advanced ~0.7 and ~1.3 hr (p < 0.01), respectively, with no change in onset (p = 0.45). As sleep duration, and timing were similar between environments (p > 10), melatonin offset occurred closer to sleep offset after camping. Consistent with prior findings, the end of biological night is timed closer to waketime in the natural environment.
{"title":"O022 Response of Sleep and the Circadian System to a Long Summer Photoperiod at High Latitude","authors":"J. Guzzetti, T. Sundelin, B. Holding, K. Wright, John Axelsson","doi":"10.1093/sleepadvances/zpac029.021","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpac029.021","url":null,"abstract":"Abstract The light-dark cycle is the primary time cue for the synchronization of the internal human circadian system with the external world. Our previous research has shown the capacity of the circadian system to adapt to seasonal variations in the light-dark cycle at latitude ~40oN in the Rocky Mountains following curtailment of artificial light exposure. In the current study, we examined the circadian response to a longer photoperiod in summer by measuring melatonin timing before and after a week of camping outdoors in Sweden. Actigraphy-derived (Actiwatch Spectrum) assessments of sleep, activity and light exposure were carried out for 2 weeks. Week 1 was under modern urban living conditions with exposure to natural and artificial light in Stockholm, Sweden (~59oN; 18 hr 37 min: 5 hr 23 min light-dark cycle). Week 2 was spent rough camping in nature with exposure to only natural light at the Swedish High Coast (~63oN; 20 hr 40 min: 3 hr 20 min). Dim-light melatonin onset (DLMO) assessments were conducted in laboratory over two 24 hr periods immediately before and after camping to assess melatonin levels in hourly saliva samples. On average, participants’ (n = 10) melatonin midpoint and offset advanced ~0.7 and ~1.3 hr (p < 0.01), respectively, with no change in onset (p = 0.45). As sleep duration, and timing were similar between environments (p > 10), melatonin offset occurred closer to sleep offset after camping. Consistent with prior findings, the end of biological night is timed closer to waketime in the natural environment.","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76484417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1093/sleepadvances/zpac029.173
K. Sansom, A. Reynolds, D. Windred, A. Phillips, J. Walsh, K. Maddison, B. Singh, P. Eastwood, N. McArdle
Abstract Little is known about the association of irregular sleep patterns with obstructive sleep apnoea (OSA) and hypertension. This study examined whether irregular sleep patterns determined by the sleep regularity index (SRI) were associated with OSA and hypertension, and whether SRI modified the known association between OSA and hypertension. 635 adults (age mean[range]=57[42-77]years, female=58.6%) from the community-based Raine Study who were not current shift workers were assessed for OSA (in-laboratory polysomnography, AHI ≥5events/hour; time spent with oxygen saturation <90% (T90) ≥median), hypertension (doctor diagnosed or systolic BP ≥140mmHg and/or diastolic ≥90mmHg) and sleep (maximum 7 days of wrist actigraphy). The SRI was calculated from actigraphy (≥4 days) based on variation in usual sleep and wake times. Participants were categorised as regular sleepers (first tertile), average sleepers (second tertile), or irregular sleepers (third tertile). Logistical regression models examined the independent and combined associations between SRI, OSA and hypertension. Covariates included age, sex, body mass index, actigraphy sleep duration, insomnia, depression, activity, alcohol, smoking and anti-hypertensive medication. Compared to regular sleepers, irregular sleepers had increased odds of OSA defined by the AHI (OR 1.77 95% CI 1.10-2.83) and T90 (OR 1.69 95% CI 1.10-2.61) but not hypertension. There was no difference in hypertension odds for regular and irregular sleepers when the data were stratified by participants with and without OSA. Individuals with OSA are more likely to have irregular sleep patterns, which might exacerbate associated adverse health outcomes. However, irregular sleep patterns do not appear to modify the association between OSA and hypertension.
关于不规律睡眠模式与阻塞性睡眠呼吸暂停(OSA)和高血压之间的关系，人们知之甚少。本研究考察了由睡眠规律指数(SRI)确定的不规则睡眠模式是否与OSA和高血压相关，以及SRI是否修正了OSA和高血压之间已知的关联。来自社区Raine研究的635名成人(年龄平均[42-77]=57岁，女性=58.6%)，目前不是轮班工人，被评估为OSA(实验室多导睡眠图，AHI≥5事件/小时;血氧饱和度<90% (T90)≥中位数)、高血压(医生诊断或收缩压≥140mmHg和/或舒张压≥90mmHg)和睡眠(最多7天腕部活动记录)的时间。SRI是根据活动记录仪(≥4天)根据正常睡眠和醒来时间的变化计算的。参与者被分为规律睡眠者(第一分位)、平均睡眠者(第二分位)和不规则睡眠者(第三分位)。逻辑回归模型检验了SRI、OSA和高血压之间的独立关联和联合关联。协变量包括年龄、性别、体重指数、活动记录仪睡眠时间、失眠、抑郁、活动、酒精、吸烟和抗高血压药物。与规律睡眠者相比，不规则睡眠者患由AHI (OR 1.77 95% CI 1.10-2.83)和T90 (OR 1.69 95% CI 1.10-2.61)定义的OSA的几率增加，但没有高血压。当数据被有和没有阻塞性睡眠呼吸暂停综合症的参与者分层时，规律睡眠者和不规律睡眠者患高血压的几率没有差异。患有阻塞性睡眠呼吸暂停的人更有可能有不规律的睡眠模式，这可能会加剧相关的不良健康后果。然而，不规律的睡眠模式似乎并没有改变阻塞性睡眠呼吸暂停和高血压之间的关系。
{"title":"P103 Associations between sleep regularity, OSA and hypertension in a middle-aged community population","authors":"K. Sansom, A. Reynolds, D. Windred, A. Phillips, J. Walsh, K. Maddison, B. Singh, P. Eastwood, N. McArdle","doi":"10.1093/sleepadvances/zpac029.173","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpac029.173","url":null,"abstract":"Abstract Little is known about the association of irregular sleep patterns with obstructive sleep apnoea (OSA) and hypertension. This study examined whether irregular sleep patterns determined by the sleep regularity index (SRI) were associated with OSA and hypertension, and whether SRI modified the known association between OSA and hypertension. 635 adults (age mean[range]=57[42-77]years, female=58.6%) from the community-based Raine Study who were not current shift workers were assessed for OSA (in-laboratory polysomnography, AHI ≥5events/hour; time spent with oxygen saturation <90% (T90) ≥median), hypertension (doctor diagnosed or systolic BP ≥140mmHg and/or diastolic ≥90mmHg) and sleep (maximum 7 days of wrist actigraphy). The SRI was calculated from actigraphy (≥4 days) based on variation in usual sleep and wake times. Participants were categorised as regular sleepers (first tertile), average sleepers (second tertile), or irregular sleepers (third tertile). Logistical regression models examined the independent and combined associations between SRI, OSA and hypertension. Covariates included age, sex, body mass index, actigraphy sleep duration, insomnia, depression, activity, alcohol, smoking and anti-hypertensive medication. Compared to regular sleepers, irregular sleepers had increased odds of OSA defined by the AHI (OR 1.77 95% CI 1.10-2.83) and T90 (OR 1.69 95% CI 1.10-2.61) but not hypertension. There was no difference in hypertension odds for regular and irregular sleepers when the data were stratified by participants with and without OSA. Individuals with OSA are more likely to have irregular sleep patterns, which might exacerbate associated adverse health outcomes. However, irregular sleep patterns do not appear to modify the association between OSA and hypertension.","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82047216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1093/sleepadvances/zpac029.049
D. Bensen-Boakes, H. Scott, L. Lack, N. Lovato
Abstract Introduction Individuals with chronic insomnia often self-report more wakefulness and less sleep than is derived from objective measures, which is called sleep-wake state discrepancy (SWSD). This study investigated associations between SWSD and clinical characteristics in older adults with sleep maintenance insomnia before and after Cognitive Behaviour Therapy (CBTi). Method Seventy-three adults (female=53%, mean age=63.2, SD=6.3) were recruited. Participants completed sleep diaries and wore actigraphy for one week, as well as questionnaires related to sleep quality and daytime functioning immediately before and after CBTi. SWSD was calculated as the difference between subjective (sleep diary reported) and objective (actigraphy derived) total sleep time (TST) at pre- and post-treatment. Results Before treatment, SWSD was not associated with age or any clinical variables, ps > .05. Following treatment, SWSD significantly reduced (p<.001), despite no improvement in objective TST, and was significantly associated with improvements in insomnia severity (r=-.57), fatigue (r=-.26), sleep self-efficacy (r=.33), and beliefs about sleep (r=-.38), ps < .05. Discussion These findings suggest SWSD does not correlate with any other routinely-measured clinical characteristic prior to treatment. Given the associations with treatment outcomes, the need to incorporate objective measures, in conjunction with sleep diary assessments, to determine the degree of discrepancy and therapeutically address using CBTi is warranted. Following treatment, the reduction in discrepancy was driven by sleep diary reported TST that more closely matched objective TST, which remained relatively unchanged from pre-treatment. This has important implications for CBTi and suggests improvements in the accuracy of perceived sleep is a major therapeutic mechanism.
{"title":"O050 Associations between sleep-wake state discrepancy and clinical characteristics in older adults with chronic insomnia before and after Cognitive Behaviour Therapy (CBTi)","authors":"D. Bensen-Boakes, H. Scott, L. Lack, N. Lovato","doi":"10.1093/sleepadvances/zpac029.049","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpac029.049","url":null,"abstract":"Abstract Introduction Individuals with chronic insomnia often self-report more wakefulness and less sleep than is derived from objective measures, which is called sleep-wake state discrepancy (SWSD). This study investigated associations between SWSD and clinical characteristics in older adults with sleep maintenance insomnia before and after Cognitive Behaviour Therapy (CBTi). Method Seventy-three adults (female=53%, mean age=63.2, SD=6.3) were recruited. Participants completed sleep diaries and wore actigraphy for one week, as well as questionnaires related to sleep quality and daytime functioning immediately before and after CBTi. SWSD was calculated as the difference between subjective (sleep diary reported) and objective (actigraphy derived) total sleep time (TST) at pre- and post-treatment. Results Before treatment, SWSD was not associated with age or any clinical variables, ps > .05. Following treatment, SWSD significantly reduced (p<.001), despite no improvement in objective TST, and was significantly associated with improvements in insomnia severity (r=-.57), fatigue (r=-.26), sleep self-efficacy (r=.33), and beliefs about sleep (r=-.38), ps < .05. Discussion These findings suggest SWSD does not correlate with any other routinely-measured clinical characteristic prior to treatment. Given the associations with treatment outcomes, the need to incorporate objective measures, in conjunction with sleep diary assessments, to determine the degree of discrepancy and therapeutically address using CBTi is warranted. Following treatment, the reduction in discrepancy was driven by sleep diary reported TST that more closely matched objective TST, which remained relatively unchanged from pre-treatment. This has important implications for CBTi and suggests improvements in the accuracy of perceived sleep is a major therapeutic mechanism.","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79999816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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