scholarly journals Assessing sleep-wake survival dynamics in relation to sleep quality in a placebo-controlled pharmacological intervention study with people with insomnia and healthy controls

2020 ◽  
Vol 238 (1) ◽  
pp. 83-94
Author(s):  
Lieke W. A. Hermans ◽  
Marta Regis ◽  
Pedro Fonseca ◽  
Sebastiaan Overeem ◽  
Tim R. M. Leufkens ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Onset ◽  
Sleep Fragmentation ◽  
Pharmacological Intervention ◽  
Segment Length ◽  
Prediction Errors ◽  
Sleep Onset Latency ◽  
Healthy Controls ◽  
Subjective Sleep Quality ◽  
Double Blind

Abstract Rationale The mechanisms underlying impaired sleep quality in insomnia are not fully known, but an important role for sleep fragmentation has been proposed. Objectives The aim of this study is to explore potential mechanisms of sleep fragmentation influencing alterations of perceived sleep quality. Methods We analyzed polysomnography (PSG) recordings from a double-blind crossover study with zopiclone 7.5 mg and placebo, in elderly participants with insomnia complaints and age-matched healthy controls. We compared survival dynamics of sleep and wake across group and treatment. Subsequently, we used a previously proposed model to estimate the amount of sleep onset latency (SOL) misperception from PSG-defined sleep fragmentation. Self-reported and model-estimated amount of SOL misperception were compared across group and treatment, as well as model prediction errors. Results In the zopiclone night, the average segment length of NREM sleep was increased (group F = 1.16, p = 0.32; treatment F = 8.89, p< 0.01; group x treatment F = 0.44, p = 0.65), while the segment length of wake was decreased (group F = 1.48, p = 0.23; treatment F = 11.49, p< 0.01; group x treatment F = 0.36, p = 0.70). The self-reported and model-estimated amount of SOL misperception were lower during the zopiclone night (self-reported group F = 6.08, p< 0.01, treatment F = 10.8, p< 0.01, group x treatment F = 2.49, p = 0.09; model-estimated F = 1.70, p = 0.19, treatment F = 16.1, p< 0.001, group x treatment F = 0.60, p = 0.55). The prediction error was not altered (group F = 1.62, p = 0.20; treatment F = 0.20, p = 0.65; group x treatment F = 1.01, p = 0.37). Conclusions Impaired subjective sleep quality is associated with decreased NREM stability, together with increased stability of wake. Furthermore, we conclude that zopiclone-induced changes in SOL misperception can be largely attributed to predictable changes of sleep architecture.

scholarly journals Subjective sleep quality and objective sleep physiology in migraineurs: a meta-analysis

2021 ◽  
Author(s):  
E.C. Stanyer ◽  
H. Creeney ◽  
A.D. Nesbitt ◽  
P. R. Holland ◽  
J. Hoffmann
Keyword(s):  
Sleep Quality ◽  
Meta Analysis ◽  
Empirical Studies ◽  
Sleep Onset ◽  
Lower Percentage ◽  
Sleep Onset Latency ◽  
Healthy Controls ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Sleep Physiology

AbstractObjectivesSleep disturbance is often associated with migraine. However, there is a paucity of research investigating objective and subjective measures of sleep in migraineurs. This meta-analysis aims to determine whether there are differences in subjective sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and objective sleep physiology measured using polysomnography between adult and pediatric migraineurs, and healthy controls.MethodsA systematic search of five databases was conducted to find case-controlled studies which measured polysomnography and/or PSQI in migraineurs. Effect sizes (Hedges’ g) were entered into a random effects model meta-analysis.Results32 separate studies were eligible. Overall, adult migraineurs had higher PSQI scores than healthy controls (g = 0.75, p < .001). This effect was larger in chronic than episodic migraineurs (g = 1.03, p < .001, g = 0.63, p < .001 respectively). For polysomnographic studies, adult and pediatric migraineurs displayed a lower percentage of REM sleep (g = −0.22, p = 0.017, g = −0.71, p = 0.025 respectively) than healthy controls. Pediatric migraineurs also displayed less total sleep time (g = −1.37, p = 0.039), more wake (g = 0.52, p < .001) and shorter sleep onset latency (g = −0.37, p < .001) than healthy controls.ConclusionMigraineurs have significantly poorer subjective sleep quality, and altered sleep compared to healthy individuals – a finding which is particularly evident in children. This has implications for developing appropriate treatments. Further longitudinal empirical studies are required to enhance our understanding of this relationship.

778 Poor Sleep Quality is Associated with Reduced Myelination in Patients with Psychotic Disorders

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A303-A303
Author(s):  
Cagri Yuksel ◽  
Xi Chen ◽  
Lauren Watford ◽  
Margaret Gardner ◽  
Kathryn Lewandowski ◽  
...  
Keyword(s):  
White Matter ◽  
Sleep Quality ◽  
Psychotic Disorders ◽  
Sleep Onset ◽  
Sleep Loss ◽  
Magnetization Transfer Ratio ◽  
Poor Sleep ◽  
Sleep Onset Latency ◽  
Healthy Controls ◽  
Poor Sleep Quality

Abstract Introduction Recent studies show that sleep favors oligodendrocyte proliferation and myelination, and sleep loss is associated with alterations in white matter structure and decreased myelination. Psychotic disorders are characterized by disrupted white matter integrity, and abnormal axon and myelin structure. Despite common sleep disturbances in these disorders, little is known about the relationship between sleep quality and white matter findings. A novel in vivo neuroimaging technique that combines diffusion tensor spectroscopy (DTS) and magnetization transfer ratio (MTR) allows separately examining the axon structure and glial function, and myelin content, respectively. Using this method, we examined the association of sleep quality with white matter biology in a sample of patients with psychotic disorders and matched healthy controls. Methods Participants included patients diagnosed with bipolar disorder with psychotic features (euthymic or depressed, n=12) and schizophrenia spectrum disorders (n=9), and age and sex matched healthy controls (n=20). DTS and MTR data was collected from the right prefrontal white matter at 4T. DTS measures included apparent diffusion coefficients of water, NAA, creatine and choline. Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI). Results PSQI total score was significantly higher in patients. and patient sample included a higher percentage of poor sleepers (PSQI total score&gt;5). In patients, total PSQI score and sleep onset latency were significantly and negatively associated with MTR (F=6.9, p=0.02 and F=9.7, p=0.007, respectively). There was no difference in any DTS measures between groups. Conclusion Our preliminary results show that poor sleep quality is associated with decreased myelin content in the frontal lobe, in patients with psychotic disorders. This finding suggests that sleep loss may be a mediator of white matter alterations in psychosis. Support (if any) This work is supported by National Institute of Mental Health K23MH119322 to Cagri Yuksel

scholarly journals 317 Sleep-wake survival dynamics in people with insomnia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A127-A127
Author(s):  
Lieke Hermans ◽  
Marta Regis ◽  
Pedro Fonseca ◽  
Bertram Hoondert ◽  
Tim Leufkens ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Sleep Quality ◽  
Rem Sleep ◽  
Scale Parameter ◽  
Sleep Onset ◽  
Nrem Sleep ◽  
Sleep Fragmentation ◽  
Healthy Controls ◽  
Shape Parameters ◽  
Impaired Sleep

Abstract Introduction Assessing objective measures of sleep fragmentation could yield important features reflecting impaired sleep quality in people with insomnia. Survival analysis allows the specific examination of the stability of NREM sleep, REM sleep and wake. The objective of this study was to assess the differences between survival dynamics of NREM sleep, REM sleep and wake between people with insomnia and healthy controls. Methods We analyzed polysomnography recordings from 88 people with insomnia and 92 healthy controls. For each participant, survival dynamics of REM sleep, NREM sleep and wake were represented using Weibull distributions. We used lasso penalized linear regression to analyze the difference between participant groups with respect to the Weibull scale and shape parameters, while correcting for age, sex, total sleep time and relevant interaction effects. Because comparisons were done for scale and shape parameters of REM sleep, NREM sleep and wake, a Bonferroni correction was applied, resulting in an alpha value of 0.05/6 = 0.0083. Results Significant effects of group were found for the NREM scale parameter (unstandardized model coefficient B=-0.79, t=-3.0, p=0.0035), and for the scale and shape parameters of wake (scale parameter B=7.6, t=2.8, p=0.0065; shape parameter B=0.20, t=2.9, p=0.0048). Results indicated that people with insomnia had less stable NREM sleep and more stable wake after sleep onset compared to healthy controls. Additionally, the altered distribution of wake segment lengths indicated an increased difficulty to fall asleep after longer awakenings in the insomnia group. However, these differences were mainly observed in younger participants. Significant effects of group for the survival parameters of REM sleep were not found. Conclusion As illustrated by our results, survival analysis can be very useful for disentangling different types of sleep fragmentation in people with insomnia. For instance, the current findings suggest that people with insomnia have an increased fragmentation of NREM sleep, but not necessarily of REM sleep. Additional research into the underlying mechanisms of NREM sleep fragmentation could possibly lead to a better understanding of impaired sleep quality in people with insomnia, and consequently to improved treatment. Support (if any):

scholarly journals Adults Consuming an Energy-Restricted US Healthy-Style Eating Pattern at Either the Recommended or a Higher Protein Quantity Perceive a Shift from “Poor” to “Good” Sleep

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 528-528
Author(s):  
Joshua Hudson ◽  
Jing Zhou ◽  
Wayne Campbell
Keyword(s):  
Sleep Quality ◽  
Dietary Protein ◽  
Sleep Onset ◽  
Sleep Onset Latency ◽  
Quality Indices ◽  
Subjective Sleep Quality ◽  
Eating Pattern ◽  
Subjective Sleep ◽  
Good Sleep ◽  
Over Time

Abstract Objectives Limited evidence from secondary analyses suggests consuming a higher protein diet during weight loss improves subjective indices of sleep in adults who are overweight and obese. We sought to a priori assess the effects consuming a U.S. Healthy–Style Eating Pattern with the recommended versus a higher amount of protein and moderate energy-restriction on sleep quality indices. Methods Using of a randomized, parallel-design, 51 men and women (mean ± SEM; age: 47 ± 1 y; BMI: 32.6 ± 0.5 kg/m2) consumed a controlled U.S. Healthy-Style Eating Pattern containing 750 kcal/d less than their estimated energy requirement for 12 wk. The additional dietary protein (7.5 oz-eq/d) came from animal-based protein sources and displaced primarily whole and reined grains. Objective and subjective sleep quality indices were measured using wrist-worn actigraphy and questionnaires (Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale), respectively, at pre-, mid- (week 6), and post-intervention (week 12). Results Among all participants, body mass decreased (-6.2 ± 0.4 kg). Dietary protein intake did not affect any of the objective or subjective sleep quality outcomes measured. Over time, objective measures of time spend in bed, time spent sleeping, sleep efficiency, sleep onset latency, and time awake after sleep onset did not change. Subjective measures of global sleep score (GSS, −3.8 ±0.4 au) and daytime sleepiness score (−3.8 ± 0.4 au; both P &lt; 0.001) improved over time. The GSS improvement transitioned the group of participants from being categorized with a poor to a good sleep condition (GSS &gt;5 versus ≤5 au of 0–21 au scale; Pre 7.9 ± 0.5 au, Post: 4.0 ± 0.6 au). Conclusions Although objective sleep quality may not improve, adults with poor sleep may perceive becoming good sleepers while consuming a moderately energy-restricted U.S. Healthy-Style Eating Pattern containing either the recommended or a higher amount of protein. Funding Sources The Beef Checkoff and American Egg Board-Egg Nutrition Center.

Effectiveness of a Multicomponent Group Treatment for Insomnia

1995 ◽  
Vol 23 (2) ◽  
pp. 109-127 ◽  
Author(s):  
Elisabeth Schramm ◽  
Fritz Hohagen ◽  
Jutta Backhaus ◽  
Stefanie Lis ◽  
Mathias Berger
Keyword(s):  
Sleep Quality ◽  
Group Treatment ◽  
Psychological Treatment ◽  
Sleep Onset ◽  
Sleep Diary ◽  
Management Problem ◽  
Sleep Onset Latency ◽  
Subjective Sleep Quality ◽  
Significant Treatment ◽  
Problem Solving Skills

The present study evaluates a multifaceted cognitive-behavioral group treatment in a routine clinical setting. The program consists of directly sleep related strategies such as sleep education, sleep restriction, stimulus control, relaxation, and cognitive restructuring. Also included are techniques that target illness maintaining factors such as stress-management, problem solving skills, and increase of activities. Twenty-eight physician-referred outpatients with chronic primary insomnia according to DSM-III-R criteria attended 11 weekly therapy-sessions. Results were obtained on a subjective and objective level using a sleep diary, questionnaires, and polysomnography, respectively. Pre- and post-treatment comparisons indicated significant changes on all main sleep diary variables, i.e. total sleep time, sleep efficiency, number of awakenings, sleep onset latency and wake after sleep onset, as well as for the global subjective sleep quality. Maximum improvement was reached after the more directly sleep-related part of the program. In addition, the intervention helped patients to reduce the amount and frequency of sleeping aids over time and improved their daytime-functioning. Subjective therapeutic gains were maintained at 3- and 12-month follow-ups. No significant treatment effects could be obtained on polysomnographic measures, taking into account that the baseline values were already in the normative range. After the intervention the patients were able to give a more realistic evaluation of their sleep. These results suggest that a multicomponent psychological treatment is beneficial for the improvement of sleep quality on a subjective level.

B-24 Objective and Subjective Sleep Measures are Associated with Neurocognition in Middle-Aged and Older Adults With and Without HIV

2019 ◽  
Vol 34 (6) ◽  
pp. 970-970
Author(s):  
L Campbell ◽  
M Kohli ◽  
A Heaton ◽  
M Higgins ◽  
E Lee ◽  
...  
Keyword(s):  
Working Memory ◽  
Sleep Quality ◽  
Neuropsychological Testing ◽  
Sleep Onset ◽  
Sleep Fragmentation ◽  
Self Report ◽  
People Living With Hiv ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Wrist Actigraphy

Abstract Objective Poorer sleep quality is related to worse cognitive functioning in the general population and people living with HIV; however, many studies use self-report sleep questionnaires that rely on retrospective recall. This study aimed to examine the relationship between objective (wrist actigraphy) and subjective sleep quality with neurocognitive functioning. Method Eighty-five adults aged 50-74 years with and without HIV (HIV+ n = 53, HIV- n = 32) were recruited from the community and ongoing studies at UC San Diego. Participants completed comprehensive neuropsychological testing assessing global and domain-specific cognition. Participants wore actigraphy watches for 14 nights after neuropsychological testing to objectively assess sleep quality (i.e., total sleep time (TST), efficiency, wake after sleep onset, and sleep fragmentation). The Pittsburgh Sleep Quality Index assessed subjective sleep quality. Results After adjusting for demographic variables and use of sleep medications, there were no differences in any sleep quality measures by HIV status (p’s>0.05). In separate adjusted linear regression models, lower sleep efficiency (p = 0.02; 95% CI: -9.5, -1.1) and greater sleep fragmentation (p = 0.02; 95% CI: -0.82, -0.09) were associated with worse learning. Less TST was associated with worse working memory (p = 0.02; 95% CI: -9.2, -0.8). In contrast, worse subjective sleep quality was associated with worse executive function (p < 0.01; 95% CI: -1.18, -0.23) and working memory (p = 0.03; 95% CI: -1.22, -0.07). Conclusion Both objective and subjective sleep quality were associated with cognition in both persons with and without HIV; however, subjective and objective sleep quality were associated with different cognitive domains. Therefore, both objective and subjective sleep quality are important health behaviors to assess.

scholarly journals Palmitoylethanolamide for sleep disturbance. A double-blind, randomised, placebo-controlled interventional study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Amanda Rao ◽  
Phillippa Ebelt ◽  
Alistair Mallard ◽  
David Briskey
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Acid Amide ◽  
Sleep Onset ◽  
Trial Registration ◽  
Sleep Onset Latency ◽  
Double Blind ◽  
Endogenous Fatty Acid ◽  
Wrist Actigraphy ◽  
Wide Range

Abstract Background Sleep is essential for wellbeing, yet sleep disturbance is a common problem linked to a wide range of health conditions. Palmitoylethanolamide (PEA) is an endogenous fatty acid amide proposed to promote better sleep via potential interaction with the endocannabinoid system. Methods This double-blind, randomised study on 103 adults compared the efficacy and tolerability of 8 weeks of daily supplemented PEA formulation (350 mg Levagen + ®) to a placebo. Sleep quality and quantity were measured using wrist actigraphy, a sleep diary and questionnaires. Results At week 8, PEA supplementation reduced sleep onset latency, time to feel completely awake and improved cognition on waking. After 8 weeks, both groups improved their sleep quality and quantity scores similarly. There was no difference between groups at baseline or week 8 for sleep quantity or quality as measured from actigraphy or sleep diaries. Conclusion These findings support PEA as a potential sleeping aid capable of reducing sleep onset time and improving cognition on waking. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618001339246. Registered 9th August 2018.

scholarly journals Palmitoylethanolamide for Sleep Disturbance. A Double-blind, Randomised, Placebo-controlled Interventional Study

2021 ◽  
Author(s):  
Amanda Rao ◽  
Phillippa Ebelt ◽  
Alistair Mallard ◽  
David Briskey
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Acid Amide ◽  
Sleep Onset ◽  
Trial Registration ◽  
Sleep Onset Latency ◽  
Double Blind ◽  
Endogenous Fatty Acid ◽  
Wrist Actigraphy ◽  
Wide Range

Abstract Background: Sleep is essential for wellbeing, yet sleep disturbance is a common problem linked to a wide range of health conditions. Palmitoylethanolamide (PEA) is an endogenous fatty acid amide proposed to promote better sleep via potential interaction with the endocannabinoid system.Methods: This double-blind, randomized study on 103 adults compared the efficacy and tolerability of 8 weeks of daily supplemented PEA formulation (350 mg Levagen+TM) to a placebo. Sleep quality and quantity were measured using wrist actigraphy, a sleep diary and questionnaires. Results: At week 8, PEA supplementation reduced sleep onset latency, time to feel completely awake and improved cognition on waking. After 8 weeks, both groups improved their sleep quality and quantity scores similarly. There was no difference between groups at baseline or week 8 for sleep quantity or quality as measured from actigraphy or sleep diaries. Conclusion: These findings support PEA as a potential sleeping aid capable of reducing sleep onset time and improving cognition on waking. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12618001339246. Registered 9th August 2018, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375493&isReview=true

scholarly journals Optimisation and Validation of a Nutritional Intervention to Enhance Sleep Quality and Quantity

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2579
Author(s):  
Shona L. Halson ◽  
Gregory Shaw ◽  
Nathan Versey ◽  
Dean J. Miller ◽  
Charli Sargent ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Cognitive Performance ◽  
Postural Sway ◽  
Sleep Onset ◽  
Nutritional Intervention ◽  
Sleep Architecture ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

Background: Disturbed sleep may negatively influence physical health, cognitive performance, metabolism, and general wellbeing. Nutritional interventions represent a potential non-pharmacological means to increase sleep quality and quantity. Objective: (1) Identify an optimal suite of nutritional ingredients and (2) validate the effects of this suite utilising polysomnography, and cognitive and balance tests. Methods: The optimal and least optimal combinations of six ingredients were identified utilising 55 male participants and a Box–Behnken predictive model. To validate the model, 18 healthy, male, normal sleepers underwent three trials in a randomised, counterbalanced design: (1) optimal drink, (2) least optimal drink, or (3) placebo were provided before bed in a double-blinded manner. Polysomnography was utilised to measure sleep architecture. Cognitive performance, postural sway, and subjective sleep quality, were assessed 30 min after waking. Results: The optimal drink resulted in a significantly shorter sleep onset latency (9.9 ± 12.3 min) when compared to both the least optimal drink (26.1 ± 37.4 min) and the placebo drink (19.6 ± 32.0 min). No other measures of sleep, cognitive performance, postural sway, and subjective sleep quality were different between trials. Conclusion: A combination of ingredients, optimised to enhance sleep, significantly reduced sleep onset latency. No detrimental effects on sleep architecture, subjective sleep quality or next day performance were observed.

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