scholarly journals Relationships of sleep disturbance, intestinal microbiota, and postoperative pain in breast cancer patients: a prospective observational study

Author(s):  
Zhi-Wen Yao ◽  
Bing-Cheng Zhao ◽  
Xiao Yang ◽  
Shao-Hui Lei ◽  
Yu-Mei Jiang ◽  
...  

Abstract Purpose Our study was designed to examine the possible relationship between gut microbiota, sleep disturbances, and acute postoperative pain. Methods Using 16S rRNA sequencing, we analyzed preoperative fecal samples from women undergoing breast cancer surgery. Preoperative sleep disturbance was evaluated with the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Peak and average pain at rest and movement were evaluated 24 h after surgery, using a numerical rating scale (NRS). Preoperative symptoms of depression and anxiety were assessed with the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Inflammation was measured using white blood cell and neutrophil counts, together with platelet-lymphocyte ratio, and neutrophil-lymphocyte ratio. Results Preoperative sleep disturbance was associated with more severe acute postoperative pain. At the phylum level, women with poor sleep quality had higher relative abundance of Firmicutes (p = 0.021) and lower relative abundance of Bacteroidetes (p = 0.013). At the genus level, women with poor sleep quality harbored higher relative abundance of Acidaminococcus and lower relative abundance of several genera. The genus Alloprevotella was negatively associated with peak pain at movement during the first 24 h (r = − 0.592, p < 0.001). The genus Desulfovibrio was negatively associated with symptoms of anxiety (r = − 0.448, p = 0.006). However, partial correlations suggested that the relationship between Alloprevotella and peak pain at movement during the first 24 h was not statistically significant after controlling for sleep (r = − 0.134, p = 0.443). Conclusion These findings suggest that the changed gut microbiota may be involved in sleep-pain interaction and could be applied as a potential preventive method for postoperative pain. Trial registration The present clinical study has been registered on Chinese Clinical Trial Registry (www.chictr.org.cn); the clinical trial registration number is ChiCTR1900021730; the date of registration is March 7, 2019.

2017 ◽  
Vol 44 (9) ◽  
pp. 1369-1374 ◽  
Author(s):  
Ian T.Y. Wong ◽  
Vinod Chandran ◽  
Suzanne Li ◽  
Dafna D. Gladman

Objective.We aimed to determine the prevalence and quality of sleep in patients with psoriatic arthritis (PsA) and those with psoriasis without PsA (PsC) followed in the same center, to identify factors associated with sleep disturbance, and to compare findings to those of healthy controls (HC).Methods.The study included 113 PsA [ClASsification for Psoriatic ARthritis (CASPAR) criteria] and 62 PsC (PsA excluded by a rheumatologist) patients and 52 HC. Clinical variables were collected using a standard protocol. The sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Other patient-reported outcomes collected included the Health Assessment Questionnaire (HAQ), Dermatology Life Quality Index, EQ-5D, Medical Outcomes Study Short Form-36 survey, patient’s global assessment, and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) scale. Statistical analyses included descriptive statistics, Wilcoxon rank-sum test, and linear regression.Results.The prevalence of poor sleep quality was 84%, 69%, and 50% in PsA, PsC, and HC, respectively. Total PSQI score was higher in both patients with PsA and patients with PsC compared with HC (p < 0.01) and higher in patients with PsA compared to patients with PsC (p < 0.0001). EQ-5D anxiety component, EQ-5D final, and FACIT-fatigue were independently associated with worse PSQI in patients with PsC and those with PsA (p < 0.05). Actively inflamed (tender or swollen) joints are independently associated with worse PSQI in patients with PsA (p < 0.01).Conclusion.Patients with psoriatic disease have poor sleep quality. Poor sleep is associated with fatigue, anxiety, and lower EQ-5D. In patients with PsA, poor sleep is associated with active joint inflammation.


2020 ◽  
Author(s):  
Nebiyu Mengistu ◽  
Telake Azale ◽  
Solomon Yimer ◽  
Mahilet Fikreyesus ◽  
Elsa Melaku ◽  
...  

Abstract Background: Sleep disturbance is a common complaint in people living with HIV/AIDS. Despite the influence of sleep disturbance on treatment adherence, quality of life, work productivity, risk of chronic illness, it remains under-recognized and under-studied in Ethiopia. Therefore it is necessary to produce scientific evidence to fill the knowledge gap and areas of management. The current study aimed to assess sleep quality and its associated factors among people living with HIV/AIDS. Methods: An institution-based cross-sectional study was utilized among 408 participants who were selected by a systematic random sampling technique at Zewditu memorial hospital from April to May 2018. The Pittsburgh Sleep Quality Index questionnaire was used to measure sleep quality. Ethical clearance was obtained from the joint ethics committee of the University of Gondar and Amanuel Mental Specialized Hospital. Oral informed consent was obtained from each participant. Binary and multivariable logistic regression models were fitted. Odds ratios (OR) with the corresponding 95% confidence interval (95%CI) was computed. Results: The magnitude of poor sleep quality was 55.6%. Being female [AOR=3.40, 95% CI: (1.80, 6.41)], depression [AOR =3.52, 95% CI: (1.95, 6.32)], CD4count ≤ 200 cells/mm3 [AOR=3.18,95%CI: (1.65,6.13)], duration of HIV/AIDS diagnosis [AOR=3.43,95% CI: (1.61,7.29)], current use of tobacco [AOR=5.69, 95% CI: (2.04,15.9)] and chat or caffeinated drinks [AOR=2.65, 95% CI: (1.06,6.64)] and poor sleep hygiene [AOR=3.55, 95% CI: (1.85, 6.78)] were significantly associated with poor sleep quality.Conclusions: More than half of the study participants were found to have poor sleep quality. A range factors influence quality of sleep of people with HIV/AIDS. Routine screening of sleep condition among people living with HIV/AIDS and early intervention based on the findings is suggested.


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4786-4786
Author(s):  
Marlise Luskin ◽  
Eric Zhou ◽  
Zilu Zhang ◽  
Daniel J. DeAngelo ◽  
Richard Stone ◽  
...  

BACKGROUND: Most patients with myelodysplastic syndromes (MDS) describe difficulty sleeping (Luskin et al Br J Haem 2017) and sleep disturbance is a likely contributor to the fatigue experienced by patients with MDS and acute leukemia. Data are sparse regarding the sleep of this patient population as formally assessed with sleep-focused survey instruments. METHODS: We surveyed consecutive adult patients with MDS, AML or ALL at the Dana-Farber Leukemia clinic. With permission from the treating oncologist, patients with a physician-assessed life expectancy ≥ 12 weeks were mailed a questionnaire packet assessing insomnia symptom severity (Insomnia Severity Index; ISI), sleep quality (Pittsburgh Sleep Quality Index; PSQI), obstructive sleep apnea risk (STOP-Bang), and depressive symptoms (Patient Health Questionnaire-9; PHQ-9). Respondents underwent concomitant medical record review. RESULTS: Of 332 eligible patients contacted, 158 (47.6%) responded. Responders were 56% male with a median age of 67 years. Overall, 42% of patients reported insomnia symptoms (ISI ≥10) with the prevalence of such symptoms similar among patients with MDS and acute leukemia (48% vs 38%, p=0.23). OSA risk was high (58%), particularly in patients with MDS (67% vs 52% p=0.10). Those with high OSA risk were more likely to have clinical insomnia as defined by ISI ≥10 (OR 2.6, p=0.01). Depression was uncommon: only 7% had PHQ-measured moderately severe or severe depression. Median sleep duration for the entire cohort was 6.9 hours (range 3-12) indicating that over half of respondents slept less than the 7 hours per night recommended by the National Sleep Foundation for healthy adults. Poor sleep quality (PSQI "Bad Sleep") was seen in 79% of the overall cohort. CONCLUSION: When measured with validated tools, disturbed sleep is common among patients with MDS and acute leukemia. OSA risk is also prevalent but does not likely explain all of the poor sleep quality seen. These data suggest that strategies are needed to improve both quantity and quality of sleep in this population. Table Disclosures DeAngelo: Abbvie: Research Funding; GlycoMimetics: Research Funding; Blueprint: Consultancy, Research Funding; Amgen: Consultancy; Celgene: Consultancy; Shire: Consultancy; Incyte: Consultancy; Novartis: Consultancy, Research Funding; Takeda Pharmaceuticals: Consultancy; Jazz Pharmaceuticals Inc: Consultancy; Pfizer: Consultancy. Garcia:Abbvie: Research Funding; Genentech: Research Funding. Winer:Jazz Pharmaceuticals, Pfizer: Consultancy. Steensma:Aprea: Research Funding; Arrowhead: Equity Ownership; Pfizer: Consultancy; H3 Biosciences: Other: Research funding to institution, not investigator.; Astex: Consultancy; Onconova: Consultancy; Stemline: Consultancy; Summer Road: Consultancy.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tammam M. Alanazi ◽  
Hazim S. Alghamdi ◽  
Meshal S. Alberreet ◽  
Abdulaziz M. Alkewaibeen ◽  
Abdulrahman M. Alkhalefah ◽  
...  

AbstractSleep disturbances are commonly reported by patients with asthma. However, the prevalence of sleep disturbance and its association with the level of asthma control is unknown. The primary objective was to determine the prevalence of sleep disturbance among Saudi adult asthmatic patients attending pulmonary clinics at King Abdulaziz Medical City (KAMC). The study also aimed to compare sleep quality between controlled and uncontrolled asthma patients. The study was carried out in the outpatient pulmonary clinics at KAMC and utilized a cross-sectional survey. The survey included five different questionnaires: asthma control test and questionnaires related to the quality of sleep (Pittsburgh sleep quality index [PSQI], Epworth sleepiness scale [ESS], Berlin questionnaire [a measure of obstructive sleep apnea risk], and insomnia severity index [ISI]). Among the 200 asthma patients, 66% suffered from poor sleep quality (PSQI > 5), 43% were at high risk for obstructive sleep apnea, 25% had excessive daytime sleepiness (ESS > 10), and 46.5% had significant clinical insomnia (ISI ≥ 10). Poor sleep quality was less common in patients with well-controlled asthma (37%) compared to those with partially controlled asthma (78%) and uncontrolled asthma (82%) (p < 0.001). Poor sleep quality was common among patients with asthma, particularly those with suboptimal levels of asthma control. Further studies are needed to better understand the interaction between these two conditions.


Author(s):  
Gladius Jennifer H. ◽  
Sowmiya K. ◽  
Vidya D. C. ◽  
Archana Lakshmi P. A. ◽  
Roseline Fatima William

Background: Today’s world has led students to mobile phone as a mode of communication and social networking. This also has bought about psychological dependency towards mobile phones which causes sleep deprivation and increased stress affecting them academically. However, very few studies were conducted among medical students. Hence, this study was attempted with an objective to assess the effect of mobile phone usage on sleep disturbance, stress and academic performance among under graduate medical students.Methods: An observational Study was conducted among under graduate medical students in KIMS, Tamil Nadu, during September to November 2016. Among first to final year students 203 were selected by simple random sampling. Data were collected after obtaining the consent using a self administered questionnaire, containing demographic details, variables on mobile usages, PSQI and PSS scales. Mean, median, standard deviation and percentages were calculated; Chi square test and correlation coefficient were calculated at 5% level of significance.Results: Among 203 study participants everyone had smart phones which were used for communication and social media. The hours of usage of mobile ranged from 5 minutes to 10 hours per day. Most of them (61%) used during night hours, 72.4% of the study participants had poor sleep quality, 66.5% had moderate stress, 14.8% had severe stress. There was significant association of poor sleep quality and academic performance with mobile phone usage (p<0.01).Conclusions: There is an association of mobile phone usage with sleep quality and academic performance.


2021 ◽  
Vol 37 (8) ◽  
Author(s):  
Lailah Maria Luiza Gonzaga Cavalcanti ◽  
Rodrigo Antunes Lima ◽  
Caroline ramos de Moura Silva ◽  
Mauro Virgilio Gomes de Barros ◽  
Fernanda Cunha Soares

This study aims to evaluate factors associated with sleep quality (overall and by domains) in adolescents. A cross-sectional study. This study was conducted with 1,296 first-year high school students from public schools in the Northern Region of the State of Pernambuco, Brazil. Demographic, socioeconomic, and behavioral data were obtained with a questionnaire. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) Body mass index (BMI) was calculated based on the ratio of weight and height squared. Multilevel linear and logistic regressions evaluated factors associated with sleep quality. We observed 53% of adolescents reported poor sleep quality. Adolescents at higher risk of clinical depression were 3.45 times more likely to have poor sleep quality (95%CI: 2.04; 5.81), and each additional unit in the social anxiety score presented 1.03 (95%CI: 1.01; 1.05) higher odds of adolescents having poor sleep quality. Adolescents with depressive symptoms had higher sleep latency, greater sleep disturbance, and greater daytime sleep dysfunction. Social anxiety was associated with sleep latency, sleep disturbance, and daytime sleep dysfunction. Higher risk of clinical depression was associated with all domains related to sleep quality. Negative health perception was associated with sleep disturbance, and physical inactivity was associated with daytime sleep dysfunction. Social anxiety and especially higher risk of clinical depression were determinants of poor sleep quality. Changes in sleep latency, sleep disturbance and daytime sleep dysfunction seems to be relevant to poor sleep quality.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yao Gao ◽  
Shan Wei ◽  
Fan Gao ◽  
Ling Gao ◽  
Liangjun Dang ◽  
...  

Objective: Growing evidence suggests that sleep disturbance is a risk factor for Alzheimer's disease (AD). Amyloid-β (Aβ) deposition in the brain is a main pathophysiology of AD. Considering that peripheral Aβ level is associated with brain Aβ deposition, the present study investigated the relationship between sleep disturbance and plasma Aβ levels.Methods: This is a population-based cross-sectional study. A total of 1,459 participants from a village in the suburbs of Xi'an, China, were enrolled from January 3, 2017 to March 26, 2017. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and a PSQI score of &lt;5 points was considered as good sleep quality and a PSQI score of &gt;10 points as poor sleep quality. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). Fasting venous blood was taken in the morning, and the plasma Aβ levels were measured using ELISA. The relationships between plasma Aβ levels and sleep quality were analyzed using multiple linear regression.Results: Among the participants, 231 had poor sleep quality (15.83%). The log-transformed Aβ40 level had significant differences among the different sleep groups (F = 3.216, p = 0.040). The log-transformed Aβ40 level was higher in the poor sleep quality group than that in the general sleep quality group [87.17 (73.42, 107.34) vs. 89.69 (74.81, 125.79) pg/ml, p = 0.016]. In bivariate analysis, sleep quality was negatively associated with the log-transformed plasma Aβ40 level (β = −0.025, p = 0.011).Conclusion: In the community population, poorer sleep quality is associated with a higher plasma Aβ40 level. This indicated that sleep disturbance might also involve in dysfunction of peripheral Aβ clearance.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Yao Jie Xie ◽  
Alice Yuen Loke ◽  
Daphne Cheung ◽  
Bernice O.C. Lam Nogueira ◽  
Karry Liu ◽  
...  

Background: There were inconsistent results in the relationship between poor sleep quality and obesity among different population in previous studies. Our study evaluated the association between sleep quality and obesity in a representative adult population of Chinese subjects living in the Macao Special Administrative Region, China. Methods: This cross-sectional study was an analysis of 1426 participants aged 18 to 90 years from a community-based health needs assessment study titled “Healthy Living, Longer Lives”. Recruitment was conducted in seven districts of Macao from 2017 to 2018. Stratified sampling by age and gender strata was adopted. The Chinese version of Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. Higher score of PSQI indicates worse sleep quality. Height, weight, and other covariates were collected by self-administered questionnaire. Obesity was defined as body mass index (BMI) ≥ 25 kg/m 2 according to the WHO standard. Results: Of all participants, 263 (18.4%) were obese and 285 (20.0%) were overweight. The average BMI and global score of PSQI were 22.9±3.0 kg/m 2 and 4.48±2.58 for men, 22.1±3.3 kg/m 2 and 5.05±2.92 for women, respectively. After adjustment of age, sex, income, marital status, education, smoking, and drinking, a significant negative relationship was found between sleep quality and BMI: higher PSQI global score was associated with higher BMI (β = 0.09, 95% CI: 0.03 - 0.15; P < 0.01). Within the 7 domains of PSQI, higher sleep disturbance score (β = 0.63, 95% CI: 0.34 - 0.93) and daytime dysfunction score (β = 0.41, 95% CI: 0.13 - 0.68) predicted higher BMI (both P < 0.01). The poor sleep status (global PSQI score > 5) was associated with 39.2% greater odds of being obese (95% CI: 1.04-1.87; P < 0.05). Conclusions: In a population of young to older adult Macao residents, we found an inverse linear association between sleep quality and BMI. People with sleep disturbance and daytime dysfunction were more likely to be fat. Poor sleep quality was strongly associated with greater obesity.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S67-S68
Author(s):  
Donncha Hanna ◽  
Ciaran James Shannon ◽  
Stephen Clarke ◽  
Sarah Davidson ◽  
Ciaran Mulholland

Abstract Background Background: One factor known to be associated with attenuated psychotic symptoms is poor sleep but it is not known if poor sleep increases the likelihood of experiencing multiple attenuated psychotic symptoms, which research suggests may be suggestive of an At-Risk Mental State (ARMS). The study aimed to determine if poor sleep quality makes a unique contribution to predicting the number of attenuated psychotic symptoms endorsed in a prodromal questionnaire and the level of distress associated with the symptoms, when accounting for demographics, depression and drug/alcohol use variables. Methods Method: An online survey was conducted using Amazon’s online crowdsourcing service Mechanical Turk (MTurk). The sample was 1,013 adults (18 to 36 years) from the general population in the USA. The survey consisted of the Prodromal Questionnaire 16 (PQ-16), the Pittsburgh Sleep Quality Index, the Patient Health Questionnaire 9 (PHQ-9), the DAST-10 and the AUDIT. Regression analyses were performed with the PQ-16 as the dependent variable, and sleep quality as the predictor variable, while controlling for sociodemographic variables, depression, and alcohol/drug abuse. Results Results: 37% of the sample endorsed six or more PQ-16 items, which may be suggestive of an at-risk mental state, with sleep disturbance significantly increasing the likelihood (Odds ratio 2.09 &lt;.001) of endorsing six or more PQ-16 items. After controlling for socio-demographic variables, depression and drug/alcohol abuse, poor sleep quality made a unique contribution of 5.8% of the variance accounted for in level of distress experienced by attenuated psychotic symptoms. Discussion Conclusion: A significant proportion of young adults in the general population may have an at-risk mental state. The results add to the evidence that sleep disturbance is a contributory factor in attenuated psychotic symptoms. Further research is required to investigate the possible mechanisms (e.g. impaired cognitive processes) through which poor sleep influences attenuated psychotic symptoms and if effective treatment of sleep disturbance can influence the likelihood of developing an at-risk mental state.


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