Search Results (9)

Cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder (CDD) is an X-linked rare neurodevelopmental disorder associated with severe sleep disturbances. However, little is known about the mechanisms underlying sleep disturbances in CDD patients. Here, we employed the electroencephalogram (EEG) recording to characterize sleep–wake behaviors and EEG activity in male CDKL5-deficient mice. We found that young adult and middle-aged Cdkl5 knockout (KO) mice recapitulated sleep phenotypes in patients with CDD, including difficulties in initiating and maintaining sleep, reduction in total sleep time, and frequent night awakenings. Cdkl5 KO mice exhibited pre-sleep arousal, but normal circadian rhythm and homeostatic sleep response. Conditional knockout (cKO) of Cdkl5 in glutamatergic neurons resulted in reduced sleep time and difficulty in sleep maintenance. Further, the rate of age-associated decline in sleep and EEG activity in Cdkl5 KO mice was comparable to that of wild-type littermates. Together, these results confirm a causative role for CDKL5 deficiency in sleep disturbances observed in CDD patients and establish an animal model for translational research of sleep treatment in CDD. Moreover, our results provide valuable information for developing therapeutic strategies and identifying sleep and EEG parameters as potential biomarkers for facilitating preclinical and clinical trials in CDD. Full article

Alarm symptoms are widely used in pediatric gastroenterology to discern when abdominal pain needs further workup. Despite wide use, the data supporting the validity of these symptoms are not well established. This study explored one alarm symptom—nighttime waking with pain—and its associations with histologic inflammation of the upper gastrointestinal tract, psychological dysfunction, and disordered sleep. This retrospective study evaluated 240 patients with abdominal pain-related disorders of the gut–brain axis (AP-DGBI). Patients underwent questionnaires related to sleep disturbance, behavioral assessment, and gastrointestinal symptoms, including Rome IV criteria for AP-DGBI. Routine upper endoscopy with standardized biopsies was performed in 205 patients. Endoscopy results showed no association between esophageal, gastric, or duodenal histologic inflammation and nighttime waking with pain. Nocturnal pain was associated with increased scores for both psychological and sleep disorders, including social stress, depression, disorders of initiation and maintenance of sleep (DIMS), disorders of daytime somnolence (DOES), and sleep hyperhidrosis (SHY). This study concluded that nocturnal pain is not a reliable predictor of upper gastrointestinal inflammation but may be a prognosticator for psychological distress and sleep disturbances. Full article

Caregivers experience high levels of emotional stress and must cope with several clinical and hospital-related environmental factors that seriously impact their night’s rest. The purpose of this study was to establish the prevalence of insomnia symptoms in a sample of caregivers of adult hospitalized patients and to examine the relationships between insomnia symptoms and patient and caregiver-associated factors. A total of 152 caregivers were enrolled from the two main hospitals in Granada, Spain. Sociodemographic, economic, and care-related data were collected. Insomnia symptoms, burden, anxiety and depression, social support, and resilience were assessed. Information on patients’ hospital admission, dependence, and neuropsychiatric symptoms was also obtained. Most caregivers were middle-aged women caring for their spouses. Self-reported insomnia prevalence was set at 45.4%. Comparison analyses between caregivers suffering from insomnia symptoms and non-insomniacs showed significantly higher burden, anxiety and depression and patients’ neuropsychiatric symptoms (p < 0.05) and lower resilience and social support in the former (p < 0.01). A regression analysis showed that anxiety (ORa = 1.15; p < 0.05) and higher caregiver education level (ORa = 5.50; p < 0.05) were factors significantly associated with insomnia symptoms. Patients’ neuropsychiatric symptoms showed a trend toward statistical significance as well (ORa = 1.09; p = 0.06). There is an acute need to address, prevent and treat insomnia problems in caregivers. Full article

Among women, breast cancer is the most commonly diagnosed cancer worldwide. Sleep problems impair 40–70% of breast cancer survivors. This randomized controlled trial evaluates the effect of auricular acupuncture on sleep quality in breast cancer survivors suffering from insomnia. Fifty-two female breast cancer survivors with insomnia (mean age 55.73 ± 8.10 years) were randomized either to 10 treatments of auricular acupuncture within five weeks (n = 26), or to a single session of psychoeducation plus an insomnia advice booklet (n = 26). The primary outcome was sleep quality (measured by the Pittsburgh Sleep Quality Index) at week 5. Secondary outcomes were inflammation parameter (interleukin-6), stress, anxiety, depression, quality of life, and fatigue at week 5, and sleep quality, stress, anxiety, depression, quality of life, and fatigue 17 and 29 weeks after randomization. Intention-to-treat analysis showed a significantly stronger increase in sleep quality in the auricular acupuncture group compared to the psychoeducation group (p = 0.031; η²_p = 0.094) at week 5. Furthermore, auricular acupuncture improved stress (p = 0.030; η²_p = 0.094), anxiety (p = 0.001; η²_p = 0.192), and fatigue (p = 0.006; η²_p = 0.148) at week 5 compared to psychoeducation. No significant group difference was found concerning the other outcomes at week 5, or in any outcome at week 17 or week 29. No serious adverse events occurred during the study period. In conclusion, a semi-standardized group auricular acupuncture might be an effective and safe intervention in treating insomnia in breast cancer survivors in the short term, and may reduce stress, anxiety, and fatigue as well. Long-term effects remain questionable. Full article

Although low neighborhood social cohesion (nSC) has been linked with poor sleep, studies of racially/ethnically diverse participants using multiple sleep dimensions remain sparse. Using National Health Interview Survey data, we examined overall, age, sex/gender, and racial/ethnic-specific associations between nSC and sleep health among 167,153 adults. Self-reported nSC was categorized into low, medium, and high. Very short sleep duration was defined as <6 hours; short as <7 h, recommended as 7–9 h, and long as ≥9 h. Sleep disturbances were assessed based on trouble falling and staying asleep, waking up feeling unrested, and using sleep medication (all ≥3 days/times in the previous week). Adjusting for sociodemographics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for sleep dimensions by low and medium vs. high nSC. The mean age of the sample was 47 ± 0.1 years, 52% of those included were women, and 69% were Non-Hispanic (NH)-White. Low vs. high nSC was associated with a higher prevalence of very short sleep (PR = 1.29; (95% CI = 1.23–1.36)). After adjustment, low vs. high nSC was associated with very short sleep duration among NH-White (PR = 1.34 (95% CI = 1.26–1.43)) and NH-Black (PR = 1.14 (95% CI = 1.02–1.28)) adults. Low nSC was associated with shorter sleep duration and sleep disturbances. Full article

Nearly one-third of the population reports new onset or acute insomnia in a given year. Similarly, it is estimated that approximately 10% of the population endorses sleep initiation and maintenance problems consistent with diagnostic criteria for chronic insomnia. For decades, acute and chronic insomnia have been considered variations of the same condition or disorder, only really differentiated in terms of chronicity of symptoms (days/weeks versus months). Whether or not acute and chronic insomnia are part of the same phenomena is an important question, one that has yet to be empirically evaluated. The goal of the present theoretical review was to summarize the definitions of acute and chronic insomnia and discuss the role that hyperarousal may have in explaining how the pathophysiology of acute and chronic insomnia is likely different (i.e., what biopsychological factors precipitate and/or perpetuate acute insomnia, chronic insomnia, or both?). Full article

Background: World Trade Center (WTC) dust-exposed subjects have multiple comorbidities that affect sleep. These include obstructive sleep apnea (OSA), chronic rhinosinusitis (CRS), gastroesophageal-reflux disorder (GERD) and post-traumatic stress disorder (PTSD). We examined the impact of these conditions to sleep-related outcomes. Methods: Demographics, co-morbidities and symptoms were obtained from 626 WTC (109F/517M), 33–87years, BMI = 29.96 ± 5.53 kg/m²) subjects. OSA diagnosis was from a 2-night home sleep test (ARES^TM). Subjective sleep quality, sleep-related quality of life (QOL, Functional Outcomes of Sleep Questionnaire), excessive daytime sleepiness (Epworth Sleepiness Scale), sleep duration and sleep onset and maintenance complaints were assessed. Results: Poor sleep quality and complaints were reported by 19–70% of subjects and average sleep duration was 6.4 h. 74.8% of subjects had OSA. OSA diagnosis/severity was not associated with any sleep-related outcomes. Sleep duration was lower in subjects with all conditions (p < 0.05) except OSA. CRS was a significant risk factor for poor sleep-related QOL, sleepiness, sleep quality and insomnia; PTSD for poor sleep-related QOL and insomnia; GERD for poor sleep quality. These associations remained significant after adjustment for, age, BMI, gender, sleep duration and other comorbidities. Conclusions: Sleep complaints are common and related to several health conditions seen in WTC responders. Initial interventions in symptomatic patients with both OSA and comorbid conditions may need to be directed at sleep duration, insomnia or the comorbid condition itself, in combination with intervention for OSA. Full article

Background: In this paper, we aimed to examine the patterns of sleep disturbance in adjustment disorder (AD) and depressive episode (DE), to examine the variables associated with sleep disturbance in AD and DE and associated impairment in functioning. Methods: This is a multi-centre case-control study of 370 patients: 185 patients with AD and 185 patients with a diagnosis of DE, recruited from the liaison psychiatry services of three Dublin hospitals. We examined the participants’ sleep pathology using the sleep disturbance items on the Schedule for Clinical Assessment in Neuropsychiatry, and the Inventory of Depressive Symptoms—Clinician-rated-30. Results: Patients with a diagnosis of AD were less likely to report disturbed sleep than those with a diagnosis of DE (p = 0.002). On multivariate analysis, sleep disturbance was significantly associated with greater severity of certain depressive symptoms: decreased appetite (p < 0.001) and psychomotor agitation (p = 0.009). Decreased appetite, younger age and single marital status were significantly associated with sleep disturbance in male patients, and decreased appetite and psychomotor agitation were significantly associated with sleep disturbance in female participants. Conclusions: This is the largest study to date which has examined sleep disturbance in adjustment disorder. Disturbance of sleep is a significant symptom in AD and may represent a potential target for treatment. With further research, patterns of sleep disturbance may be useful in differentiating AD from DE. Full article

In the United States, racial minorities generally experience poorer cardiovascular health compared to whites, and differences in alcohol consumption and sleep could contribute to these disparities. With a nationally representative sample of 187,950 adults in the National Health Interview Survey from 2004 to 2015, we examined the relationship between alcohol-drinking patterns and sleep duration/quality by race and sex. Using Poisson regression models with robust variance, we estimated sex-specific prevalence ratios for each sleep duration/quality category among blacks compared to whites within categories of alcohol-drinking pattern, adjusting for socioeconomic status and other potential confounders. Across alcohol drinking patterns, blacks were less likely than whites to report recommended sleep of 7–<9 h/day. Short (PR = 1.30 [95% CI: 1.22–1.39]) and long (PR = 1.30 [95% CI: 1.07–1.58]) sleep were 30% more prevalent among black-male infrequent heavy drinkers compared to white-male infrequent heavy drinkers. Short (PR = 1.27 [95% CI: 1.21–1.34]) sleep was more prevalent among black-female infrequent heavy drinkers compared to white-female infrequent heavy drinkers, but there was no difference for long sleep (PR = 1.09 [95% CI: 0.97–1.23]). Black female infrequent moderate drinkers, however, had a 16% higher (PR = 1.16 [95% CI: 1.01–1.33]) prevalence of long sleep compared to their white counterparts. Environmental, social, and biological factors contributing to these findings, along with their impact on disparate health outcomes, should be studied in greater detail. Full article