Elusive hypersomnolence in seasonal affective disorder: actigraphic and self-reported sleep in and out of depressive episodes

2021 ◽  
pp. 1-10
Author(s):  
Delainey L. Wescott ◽  
Peter L. Franzen ◽  
Brant P. Hasler ◽  
Megan A. Miller ◽  
Adriane M. Soehner ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Self Report ◽  
Clinical Interviews ◽  
Sleep Diaries ◽  
Time In Bed ◽  
Research Findings ◽  
Depressive Episodes

Abstract Background Hypersomnolence has been considered a prominent feature of seasonal affective disorder (SAD) despite mixed research findings. In the largest multi-season study conducted to date, we aimed to clarify the nature and extent of hypersomnolence in SAD using multiple measurements during winter depressive episodes and summer remission. Methods Sleep measurements assessed in individuals with SAD and nonseasonal, never-depressed controls included actigraphy, daily sleep diaries, retrospective self-report questionnaires, and self-reported hypersomnia assessed via clinical interviews. To characterize hypersomnolence in SAD we (1) compared sleep between diagnostic groups and seasons, (2) examined correlates of self-reported hypersomnia in SAD, and (3) assessed agreement between commonly used measurement modalities. Results In winter compared to summer, individuals with SAD (n = 64) reported sleeping 72 min longer based on clinical interviews (p < 0.001) and 23 min longer based on actigraphy (p = 0.011). Controls (n = 80) did not differ across seasons. There were no seasonal or group differences on total sleep time when assessed by sleep diaries or retrospective self-reports (p's > 0.05). Endorsement of winter hypersomnia in SAD participants was predicted by greater fatigue, total sleep time, time in bed, naps, and later sleep midpoints (p's < 0.05). Conclusion Despite a winter increase in total sleep time and year-round elevated daytime sleepiness, the average total sleep time (7 h) suggest hypersomnolence is a poor characterization of SAD. Importantly, self-reported hypersomnia captures multiple sleep disruptions, not solely lengthened sleep duration. We recommend using a multimodal assessment of hypersomnolence in mood disorders prior to sleep intervention.

scholarly journals 0771 Explaining Self-reported Hypersomnolence In Seasonal Depression

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A292-A293
Author(s):  
D L Wescott ◽  
B P Hasler ◽  
P L Franzen ◽  
K A Roecklein
Keyword(s):  
Sleep Duration ◽  
Daytime Sleepiness ◽  
Seasonal Affective Disorder ◽  
Seasonal Pattern ◽  
Sleep Time ◽  
Self Report ◽  
Depression Severity ◽  
Time In Bed ◽  
Long Sleep ◽  
Post Hoc

Abstract Introduction Hypersomnolence is commonly reported in Major Depressive Disorder with Seasonal Pattern (Seasonal Affective Disorder; SAD). However, self-reported hypersomnolence may conflate long sleep duration, daytime sleepiness, fatigue, increased time in bed, or maladaptive sleep cognitions, undermining treatment efforts. Methods Eighty-eight participants ages 18-65 years old were recruited during the winter (SAD = 43, Control = 45). Depression severity was assessed by a clinician rated interview, and self-reported hypersomnolence was determined by assessing self-reported sleep duration. Participants wore an Actiwatch for 4-14 days and completed self-report measures of daytime sleepiness and fatigue. We performed a hierarchical linear regression to determine which factors best explain self-reported winter hypersomnolence: actigraphic total sleep time (TST), time in bed (TIB), depression severity, sleepiness, or fatigue. Due to collinearity of TST and TIB, we separated those variables into two models predicting hypersomnolence. Results SAD participants endorsed greater hypersomnolence than controls during the winter (B = .714; p &lt; .001). In model 1, TST (OR(1,14) = .024, p &lt;.001) and daytime sleepiness (OR(1,14) = .208, p = .03) significantly predicted the presence of self-reported winter hypersomnolence above and beyond age, gender, depression, and fatigue. In model 2, only TIB (OR(1, 14) = .021, p = .001) was a significant predictor. Post-hoc analyses indicated that fatigue and depression severity significantly predicted self-reported hypersomnolence when entered separately into the model. Sleepiness accounted for the largest change in pseudo-R2 in bth models. Conclusion We found evidence for the multifaceted etiology of self-reported hypersomnolence. Daytime sleepiness, sleep duration, time in bed, and the shared variance between fatigue and depression severity all explained self-reported hypersomnolence. Treatment of hypersomnolence should include actigraphy, and should be individually tailored based on presentation. Support NIMH K.A.R. MH103303

scholarly journals Does the Croatian Stock Market Have Seasonal Affective Disorder?

2021 ◽  
Vol 14 (2) ◽  
pp. 89
Author(s):  
Tihana Škrinjarić ◽  
Branka Marasović ◽  
Boško Šego
Keyword(s):  
Stock Market ◽  
Stock Returns ◽  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Stock Exchange ◽  
Trading Strategies ◽  
Future Research ◽  
Winter Solstice ◽  
Daily Data ◽  
Depressive Episodes

This paper explores mood anomalies, specifically the seasonal affective disorder (SAD) effect on the Zagreb Stock Exchange (ZSE). SAD is defined as a syndrome of depressive episodes in human behavior due to the changing of the season. Thus, the motive of this research is to gain better insights into the investors’ sentiment regarding SAD effects. The purpose of the research is to observe how investors’ sentiment affects the return and risk series on ZSE and if this could be exploitable. Using daily data on stock market return CROBEX for the period January 2010—February 2021, SAD effects are tested to explore if seasonal changes affect the stock returns and risk. Besides the SAD variable in the model, some control variables are included as well: Monday, tax, and COVID-19 effect. The results indicate that SAD effects exist on ZSE, even with controlling for mentioned effects; and asymmetries around winter solstice exist. Implications of such findings can be found in simulating trading strategies, which could incorporate such information to gain profits. Limitations of the research focus on one market, observing static parameters of the estimated models, and observing simple trading strategies. Thus, future research should focus on international diversification possibilities, time-varying models, and fully exploring the exploitation possibilities of such findings.

scholarly journals Personality Traits and Insomnia Symptoms in Shift Workers

2021 ◽  
Vol 12 ◽  
Author(s):  
Brigitte Holzinger ◽  
Lucille Mayer ◽  
Gerhard Klösch
Keyword(s):  
Sleep Quality ◽  
Personality Traits ◽  
Sleep Duration ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Work Schedule ◽  
Shift Workers ◽  
Time In Bed ◽  
Shift Schedules ◽  
Insomnia Symptoms

The discrepancy between natural sleep-wake rhythm and actual sleep times in shift workers can cause sleep loss and negative daytime consequences. Irregular shift schedules do not follow a fixed structure and change frequently, which makes them particularly harmful and makes affected individuals more susceptible to insomnia. The present study compares insomnia symptoms of non-shift workers, regular shift workers, and irregular shift workers and takes into account the moderating role of the Big Five personality traits and levels of perfectionism. Employees of an Austrian railway company completed an online survey assessing shift schedules, sleep quality and duration, daytime sleepiness, and personality traits. A total of 305 participants, of whom 111 were non-shift workers, 60 regular shift workers, and 134 irregular shift workers, made up the final sample. Irregular shift workers achieved significantly worse scores than one or both of the other groups in time in bed, total sleep time, sleep efficiency, sleep duration, sleep quality, sleep latency, and the number of awakenings. However, the values of the irregular shifts workers are still in the average range and do not indicate clinical insomnia. Participants working regular shifts reported the best sleep quality and longest sleep duration and showed the least nocturnal awakenings, possibly due to higher conscientiousness- and lower neuroticism scores in this group. Agreeableness increased the effect of work schedule on total sleep time while decreasing its effect on the amount of sleep medication taken. Perfectionism increased the effect of work schedule on time in bed and total sleep time. Generalization of results is limited due to the high percentage of males in the sample and using self-report measures only.

Consecutive Days of Racing Does Not Affect Sleep in Professional Road Cyclists

2021 ◽  
pp. 1-4
Author(s):  
Charli Sargent ◽  
Shona L. Halson ◽  
David T. Martin ◽  
Gregory D. Roach
Keyword(s):  
Sleep Duration ◽  
Sleep Onset ◽  
Self Report ◽  
Activity Monitors ◽  
Sleep Diaries ◽  
Time In Bed ◽  
Road Cycling ◽  
Offset Time ◽  
The Impact

Purpose: Professional road cycling races are physiologically demanding, involving successive days of racing over 1 to 3 weeks of competition. Anecdotal evidence indicates that cyclists’ sleep duration either increases or deteriorates during these competitions. However, sleep duration in professional cyclists during stage races has not been assessed. This study examined the amount/quality of sleep obtained by 14 professional cyclists competing in the Australian Tour Down Under. Methods: Sleep was assessed using wrist activity monitors and self-report sleep diaries on the night prior to start of the race and on each night during the race. The impact of each day of the race on sleep onset, sleep offset, time in bed, sleep duration, and wake duration was assessed using separate linear mixed effects models. Results: During the race, cyclists obtained an average of 6.8 (0.9) hours of sleep between 23:30 and 07:27 hours and spent 13.9% (4.7%) of time in bed awake. Minor differences in sleep onset (P = .023) and offset times (P ≤.001) were observed during the week of racing, but these did not affect the amount of sleep obtained by cyclists. Interestingly, the 3 best finishers in the general classification obtained more sleep than the 3 worst finishers (7.2 [0.3] vs 6.7 [0.3] h; P = .049). Conclusions: Contrary to anecdotal reports, the amount of sleep obtained by cyclists did not change over the course of the 1-week race and was just below the recommended target of 7 to 9 hours for adults.

scholarly journals 0409 The Efficacy of Afternoon-Evening Sleep Following Night Shifts on Sleep and Alertness in Nurses with Rotating Shift Work Schedule: Real World Data

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A156-A157
Author(s):  
J Kim ◽  
S Han ◽  
S Kim ◽  
J Duffy
Keyword(s):  
Sleep Duration ◽  
Shift Work ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Hospital Nurses ◽  
Sleep Timing ◽  
Time In Bed ◽  
Shift Schedules ◽  
Sleep Schedule ◽  
Night Shifts

Abstract Introduction The aim of this study was to investigate the efficacy of changing sleep timing to afternoon-evening following nightshifts in hospital nurses with three rapid rotating shift schedules. Methods Hospital nurses with three rotating shift schedules were enrolled for a 1-month pre-intervention and a 1-month intervention study. During the Intervention, sleep timing following nightshifts was directed to afternoon-evening sleep for 8h time-in-bed (TIB) after 1 PM, and ad-lib sleep schedule for other shifts. Baseline and follow-up evaluation included sleep schedule, sleep duration, Epworth sleepiness scale (ESS), insomnia severity index (ISI) for each shift, Beck depression inventory (BDI), and Beck anxiety inventory (BAI). Sleep was assessed by sleep diary and actigraphy. Alertness during the night shift was evaluated using the Karolinska sleepiness scale (KSS) in the beginning and at the end of the shift by texts sent to their cell phones. The participants were asked to give feedback and a willingness to continue this intervention. Results A total of 26 subjects (30.7±8.5years, 25 female) finished the study among 29 nurses who participated in the study. The shift work was 6.5±8.0years. The mean morningness-eveningness scale was 42.1±8.0(31-62). TIB following nightshifts were 379.9±91.2 and 478.4±48.7 min for preintervention and intervention, respectively (p=0.001). Total sleep time (TST) was 328.0±91.0 vs. 361.0±70.4min, respectively following nightshifts (p=0.187, Cohen’s drm = 0.467). BDI, BAI, ESS, and ISI were significantly improved after the intervention. 60.7% and 49% of the participants reported improved alertness, and work efficiency during the nightshift. 17.9% and 42.9% of the participants reported increased sleep duration, and improved sleep quality after nightshift, respectively. Only eight participants were willing to continue the afternoon-evening sleep schedule following night shifts. KSS was not different between pre-intervention and intervention. Conclusion The afternoon-evening sleep schedule modestly increased total sleep time following nightshift. The overall mood, sleepiness and insomnia scale improved after the intervention although the alertness assessed by KSS failed to show the difference. The individual difference should be considered for applying afternoon-evening sleep for rapid rotating shift schedules. Support 2018 Research award grants from the Korean sleep research society and NRF-2019R1A2C1090643 funded by the Korean national research foundation

scholarly journals Sleep and Circadian Rhythm Disturbance in Remitted Schizophrenia and Bipolar Disorder: A Systematic Review and Meta-analysis

2020 ◽  
Vol 46 (5) ◽  
pp. 1126-1143 ◽  
Author(s):  
Nicholas Meyer ◽  
Sophie M Faulkner ◽  
Robert A McCutcheon ◽  
Toby Pillinger ◽  
Derk-Jan Dijk ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Circadian Rhythm ◽  
Motor Activity ◽  
Sleep Latency ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Mean Difference ◽  
Effect Sizes ◽  
Time In Bed ◽  
Modifiable Factors

Abstract Background Sleep and circadian rhythm disturbances in schizophrenia are common, but incompletely characterized. We aimed to describe and compare the magnitude and heterogeneity of sleep-circadian alterations in remitted schizophrenia and compare them with those in interepisode bipolar disorder. Methods EMBASE, Medline, and PsycINFO were searched for case–control studies reporting actigraphic parameters in remitted schizophrenia or bipolar disorder. Standardized and absolute mean differences between patients and controls were quantified using Hedges’ g, and patient–control differences in variability were quantified using the mean-scaled coefficient of variation ratio (CVR). A wald-type test compared effect sizes between disorders. Results Thirty studies reporting on 967 patients and 803 controls were included. Compared with controls, both schizophrenia and bipolar groups had significantly longer total sleep time (mean difference [minutes] [95% confidence interval {CI}] = 99.9 [66.8, 133.1] and 31.1 [19.3, 42.9], respectively), time in bed (mean difference = 77.8 [13.7, 142.0] and 50.3 [20.3, 80.3]), but also greater sleep latency (16.5 [6.1, 27.0] and 2.6 [0.5, 4.6]) and reduced motor activity (standardized mean difference [95% CI] = −0.86 [−1.22, −0.51] and −0.75 [−1.20, −0.29]). Effect sizes were significantly greater in schizophrenia compared with the bipolar disorder group for total sleep time, sleep latency, and wake after sleep onset. CVR was significantly elevated in both diagnoses for total sleep time, time in bed, and relative amplitude. Conclusions In both disorders, longer overall sleep duration, but also disturbed initiation, continuity, and reduced motor activity were found. Common, modifiable factors may be associated with these sleep-circadian phenotypes and advocate for further development of transdiagnostic interventions that target them.

scholarly journals Sleep and Physical Activity Patterns in Urban American Indian Children

2020 ◽  
Vol 44 (1) ◽  
pp. 67-75
Author(s):  
Vernon M. Grant ◽  
Emily J. Tomayko ◽  
Raymond D. Kingfisher
Keyword(s):  
Physical Activity ◽  
American Indian ◽  
Screen Time ◽  
Total Sleep Time ◽  
Activity Patterns ◽  
Sleep Time ◽  
Indian Children ◽  
Time In Bed ◽  
Prevention Interventions ◽  
Urban American Indian

Objectives: In this study, we examined patterns of obesity, physical activity (PA), sleep, and screen time in urban American Indian (AI) youth in the 6th-8th grade. Methods: A youth sample (N = 36) from 3 middle schools was recruited to participate in this observational sample of convenience. Youth completed a demographic and screen time survey, measurements of height and weight, and wore a wrist accelerometer continuously for 7 days to assess PA and sleep. Results: Approximately 42% of participants were overweight or obese. Average weekday screen time was 254.7±98.1 minutes. Compared to weekdays, weekend sedentary activity increased (weekday, 159.2±81.1 minutes vs weekend, 204.3±91.7 minutes; p = .03) and vigorous PA (weekday, 20.9±19.1 minutes vs weekend, 5.7±8.1 minutes; p = .0001) and moderate-to-vigorous PA (weekday, 192.65±62.3 minutes vs weekend, 141±71.7 minutes; p = .002) decreased. Compared to weekdays, weekend total sleep time (weekday, 512.8±48.6 minutes vs weekend, 555.3±84.3 minutes; p = .007) and time in bed (weekday, 487.3±49.6 minutes vs weekend, 528.6±71.2 minutes; p = .01) increased. Conclusions: Weekday to weekend shifts in PA and sleep must be considered when designing targeted obesity prevention interventions.

Postpartum maternal sleep and mothers’ perceptions of their attachment relationship with the infant among women with a history of depression during pregnancy

2012 ◽  
Vol 36 (6) ◽  
pp. 440-448 ◽  
Author(s):  
Liat Tikotzky ◽  
Andrea S. Chambers ◽  
Jamie Kent ◽  
Erika Gaylor ◽  
Rachel Manber
Keyword(s):  
Total Sleep Time ◽  
Sleep Time ◽  
Regression Analyses ◽  
Infant Attachment ◽  
Attachment Relationship ◽  
Sleep Diaries ◽  
Maternal Sleep ◽  
History Of ◽  
History Of Depression ◽  
Positive Effect

This study assessed the links between maternal sleep and mothers’ perceptions of their attachment relationship with their infant among women at risk for postpartum depression by virtue of having been depressed during pregnancy. Sixty-two mothers completed sleep diaries and questionnaires at 3 and 6 months postpartum. Regression analyses, controlling for depression severity and infant temperament, revealed significant prospective correlation between maternal shorter total sleep time at 3 months and lower scores on a mother–infant attachment questionnaire at 6 months. At 6 months, the longer time mothers were awake tending to their infants the lower were their attachment scores. The findings suggest that improving sleep of mothers who suffered from prenatal depression may have a positive effect on mothers’ self-reported relationship with their infants.

scholarly journals Direct Health Care Costs of Treating Seasonal Affective Disorder: A Comparison of Light Therapy and Fluoxetine

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Amy Cheung ◽  
Carolyn Dewa ◽  
Erin E. Michalak ◽  
Gina Browne ◽  
Anthony Levitt ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Affective Disorder ◽  
Health Care Costs ◽  
Seasonal Affective Disorder ◽  
Light Therapy ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Care Costs

Objective.To compare the direct mental health care costs between individuals with Seasonal Affective Disorder randomized to either fluoxetine or light therapy.Methods.Data from the CANSAD study was used. CANSAD was an 8-week multicentre double-blind study that randomized participants to receive either light therapy plus placebo capsules or placebo light therapy plus fluoxetine. Participants were aged 18–65 who met criteria for major depressive episodes with a seasonal (winter) pattern. Mental health care service use was collected for each subject for 4 weeks prior to the start of treatment and for 4 weeks prior to the end of treatment. All direct mental health care services costs were analysed, including inpatient and outpatient services, investigations, and medications.Results.The difference in mental health costs was significantly higher after treatment for the light therapy group compared to the medication group—a difference of $111.25 (z=−3.77,P=0.000). However, when the amortized cost of the light box was taken into the account, the groups were switched with the fluoxetine group incurring greater direct care costs—a difference of $75.41 (z=−2.635,P=0.008).Conclusion.The results suggest that individuals treated with medication had significantly less mental health care cost after-treatment compared to those treated with light therapy.

scholarly journals Level of Sleepiness and Total Sleep Time Following Various Time in Bed Conditions

SLEEP ◽  
1993 ◽  
Vol 16 (3) ◽  
pp. 226-232 ◽  
Author(s):  
Leon Rosenthal ◽  
Timothy A. Roehrs ◽  
Allison Rosen ◽  
Tom Roth
Keyword(s):  
Total Sleep Time ◽  
Sleep Time ◽  
Time In Bed
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