Sleep disturbances in early clinical stages of psychotic and bipolar disorders: A meta-analysis

2021 ◽  
pp. 000486742110683
Author(s):  
Clément Dondé ◽  
Antoine Jaffiol ◽  
Charles Khouri ◽  
Arnaud Pouchon ◽  
Renaud Tamisier ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Sleep Disturbances ◽  
Early Stage ◽  
Sleep Onset ◽  
Bipolar Disorders ◽  
First Episode ◽  
Mean Deviation ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Ultra High Risk

Objective: To provide a qualitative view and quantitative measure of sleep disturbances across and between early stages – clinical ultra high-risk and first episode – of psychotic and bipolar disorders. Methods: Electronic databases (PubMed, Cochrane, Embase, PsychINFO) were searched up to March 2021 for studies comparing sleep measures between individuals with an early stage and controls. Standard mean deviations (Cohen’s d effect sizes) were calculated for all comparisons and pooled with random-effects models. Chi-square tests were used for direct between-subgroups (ultra high-risk vs first episode) comparisons of standard mean deviations. The effects of age, sex ratio, symptoms and treatment were examined in meta-regression analyses. Results: A database search identified 13 studies that contrasted sleep measures between individuals with an early stage ( N = 537) and controls ( N = 360). We observed poorer subjective sleep quality (standard mean deviation = 1.32; 95% confidence interval, [1.01, 1.62]), shorter total sleep time (standard mean deviation =−0.44; 95% confidence interval, [−0.67, −0.21]), lower sleep efficiency (standard mean deviation = −0.72; 95% confidence interval, [−1.08, −0.36]), longer sleep onset latency (standard mean deviation = 0.75; 95% confidence interval, [0.45, 1.06]) and longer duration of wake after sleep onset (standard mean deviation = 0.49; 95% confidence interval, [0.21, 0.77]) were observed in early stages compared to controls. No significant differences were observed for any of the reported electroencephalographic parameters of sleep architecture. No significant between-subgroups differences were observed. Meta-regressions revealed a significant effect of the age and the antipsychotic status on subjective measures of sleep. Conclusion: The early stage population presents with significant impairments of subjective sleep quality continuity, duration and initiation. Systematic assessments of sleep in early intervention settings may allow early identification and treatment of sleep disturbances in this population.

Actigraph Estimates of the Sleep of Australian Midwives

2011 ◽  
Vol 15 (2) ◽  
pp. 191-199 ◽  
Author(s):  
Rebecca Tremaine ◽  
Jillian Dorrian ◽  
Jessica Paterson ◽  
Annabelle Neall ◽  
Ellie Piggott ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbances ◽  
Night Shift ◽  
Sleep Onset ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Metropolitan Hospital ◽  
Shift Schedules ◽  
Night Shifts ◽  
Chronic Sleep

Midwives often work night and rotating shift schedules, which can lead to sleep disturbances, increased fatigue, and greater likelihood of accidents or errors. This study investigated the sleep of midwives ( n = 17) in an Australian metropolitan hospital. Midwives completed work and sleep logbooks and wore wrist actigraphs for 28 days. Midwives worked combinations of morning, afternoon, and/or night shifts on constant ( n = 6) or rotating schedules ( n = 11). They obtained less than recommended amounts of sleep, getting only 6–7 hr per 24-hr period. Morning shifts were associated with the lowest sleep durations, lowest subjective sleep quality, and highest postsleep fatigue ratings. Despite the significantly higher amount of wake after sleep onset (51 min), the sleep before afternoon shifts had significantly lower postsleep fatigue ratings and was rated as significantly higher quality than sleep before other shifts or days off. Those who were married or living with a partner reported significantly more sleep and lower postsleep fatigue than those who were separated or divorced ( p < .05). Seventy-one percent of midwives took naps, primarily before night shifts, with nearly 40% of nightshifts preceded by a nap. Average nap durations were nearly 1.5 hr. Midwives reported feeling moderately to very physically or mentally exhausted on 22–50% of all shifts and days off. Exhaustion was most common on night shift. This study suggests that midwives may be suffering from chronic sleep loss and as a consequence may be at risk of impairments in functioning that accompany fatigue.

scholarly journals 0552 Investigating Pre-Sleep Processes and How They Influence Sleep: A Diary and Actigraphy Study

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A211-A211
Author(s):  
T Maeder ◽  
J Whitford ◽  
P Feinaigle ◽  
W Karlen ◽  
E Seifritz ◽  
...  
Keyword(s):  
At Risk ◽  
Medical Students ◽  
Sleep Disturbances ◽  
Linear Models ◽  
Sleep Onset ◽  
Sleep Time ◽  
Negative Influence ◽  
Sleep Onset Latency ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

Abstract Introduction The current study examined the relationship between pre-sleep processes and sleep in the context of real-world stress exposure in medical students during an internship. Medical students are often exposed to a variety of stressors and potentially traumatic events and have been shown to be at risk to develop psychopathology. Previous research has shown an association between stress, psychological distress, and sleep disturbances. In this context, studies have investigated possible predictors for sleep disturbances. Recently, the period just prior to sleep onset has received increased interest. At the moment, little is known, however, about the influence of such pre-sleep processes. In this study, we investigated the influence of pre-sleep rumination and mindfulness on sleep disturbances. Methods In a prospective study, we examined a sample of 50 medical students from the University of Zurich. All participants completed their first medical internship over 9 months as part of medical school. Pre-sleep processes and sleep were indexed mid-internship using sleep diaries over seven consecutive days. Additionally, a Fitbit tracking device was used to objectively measure sleep. Correlational analyses and multilevel linear models were conducted. Results Results show associations between pre-sleep processes and sleep disturbances in this stress-exposed at-risk population. Multilevel mixed-effects models showed that over the period of 7 consecutive nights, pre-sleep rumination was a significant predictor of lower subjective sleep quality (B = -.085, SE = .036, p = .02), lower subjective total sleep time (B = -.124, SE = .043, p = .005), higher subjective sleep onset latency (B = 1.535, SE = .678, p = .025), and higher subjective wake-up frequency (B = .033, SE = .011, p = .003). Conclusion Together, our data suggest pre-sleep processes as potential targets for stress-prevention programs that could help reduce the negative influence of stress in at risk populations. Support NA

scholarly journals 1121 Nonmotor Symptoms Affect Sleep Quality in Early-Stage Parkinson’s Disease Patients With or Without Cognitive Dysfunction

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A427-A427
Author(s):  
L Zhang ◽  
J Zhu
Keyword(s):  
Sleep Quality ◽  
Sleep Disorders ◽  
Cognitive Dysfunction ◽  
Sleep Disturbances ◽  
Rating Scale ◽  
Early Stage ◽  
Motor Symptoms ◽  
Nonmotor Symptoms ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

Abstract Introduction Parkinson’s disease (PD) patients frequently present with sleep disorders. This study was designed to assess the impact of nonmotor symptoms (NMSs) on subjective sleep quality in early-stage PD patients with and without cognitive dysfunction. Methods A sample of 389 early-stage PD patients (Hoehn and Yahr score ≤2.5, duration ≤5 years) was recruited for the present study. The Non-Motor Symptoms Questionnaire (NMS-Quest) was used to screen for global NMSs. Depressive symptoms were assessed using the Hamilton Rating Scale for Depression (HAMD). PD motor symptoms were measured with the Unified PD Rating Scale (UPDRS), part III. The Montreal Cognitive Assessment (MoCA) was used to evaluate global cognitive status, and the PD Sleep Scale (PDSS) was used to quantify sleep quality. Logistic regression models were built to identify factors associated with sleep disturbances. Results In our sample, approximately one-quarter of the PD patients suffered from sleep disturbances (23.7%). Our results also confirmed the high prevalence of cognitive dysfunction in patients with PD (39.8%). In total, the patients who suffered from NMSs, such as depressive symptoms, anxiety symptoms, urinary tract symptoms and hallucinations/delusions, had poorer sleep quality. Better cognition may protect against sleep disorders. In patients with cognitive dysfunction, the NMS-Hallucinations/delusions score was the most important risk factor for sleep disorders. In patients without cognitive dysfunction, NMSs such as anxiety and cognition and medication were related to sleep disorder. Conclusion NMSs in early-stage PD are highly associated with and are determinants of subjective sleep quality. Future studies should focus on elucidating the pathophysiology of these symptoms. Support Special Funds of the Jiangsu Provincial Key Research and Development Projects (grant No. BE2018610)

The Effect of Uncoupled Sleep and Dysfunctional Sleep Beliefs on Sleep Outcomes in Older Adults following Online Cognitive Behavioral Therapy for Insomnia: A Single-Group Non-randomized Trial (Preprint)

2021 ◽  
Author(s):  
Yvonne Kutzer ◽  
Lisa Whitehead ◽  
Eimear Quigley ◽  
Shih Ching Fu ◽  
Mandy Stanley
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Sleep Quality ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

BACKGROUND The current Covid-19 pandemic has brought about a marked interest in sleep health, as well as an increased demand for telehealth services, such as online Cognitive Behavioral Therapy for insomnia (CBT-I). Older adults in particular report a high rate of sleep problems. Recent studies have suggested that dysfunctional sleep beliefs could contribute to the high rates of self-reported insomnia in this age group. In addition, older adults have an increased rate of uncoupled sleep, e.g. displaying an insomnia complaint in the absence of objectively measured poor sleep. It is essential to determine the prevalence of coupled and uncoupled sleep in older adults and to examine the efficacy of online CBT-I to improve sleep outcomes. OBJECTIVE This study aims to assess objective and subjective sleep quality and dysfunctional sleep beliefs in a sample of community-dwelling older adults aged 60-80 years with and without uncoupled sleep in Western Australia following digitally delivered CBT-I. METHODS Objective sleep was measured using wrist actigraphy, and subjective sleep quality via sleep diaries and the Pittsburgh Sleep Quality Index (PSQI). Dysfunctional sleep beliefs were assessed by the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16) prior to and following a four-week online CBT-I programme. Linear mixed model and generalised linear mixed model analyses were conducted to examine objective and subjective sleep onset latency, total sleep time, wake after sleep onset and number of awakenings as well as PSQI and DBAS16 scores, respectively. RESULTS 62 participants (55 females; 88.7%) completed the study. CBT-I effectively reduced dysfunctional sleep beliefs and PSQI scores across all sleep classifications, even in good sleepers without a sleep complaint. Objective and self-reported changes in sleep parameters were mainly demonstrated in complaining poor sleepers. Complaining good sleepers reported a decrease in the number of subjective sleep awakenings only. CONCLUSIONS Online CBT-I was effective in improving the sleep outcomes of individuals who had both subjective and objective poor sleep. However, as the online CBT-I reduced dysfunctional sleep beliefs in all sleep groups, further examination of dysfunctional sleep beliefs and whether they mediate the outcomes of digital CBT-I in older adults will need to be conducted. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451 INTERNATIONAL REGISTERED REPORT RR2-32705

scholarly journals Prevalence and Determinants of Bad Sleep Perception among Italian Children and Adolescents

2020 ◽  
Vol 17 (24) ◽  
pp. 9363
Author(s):  
Serena Malloggi ◽  
Francesca Conte ◽  
Giorgio Gronchi ◽  
Gianluca Ficca ◽  
Fiorenza Giganti
Keyword(s):  
Sleep Quality ◽  
Depressed Mood ◽  
Behavioral Problems ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Sleep Latency ◽  
Sleep Habits ◽  
Subjective Sleep Quality ◽  
Quality Perception ◽  
Subjective Sleep

Although sleep problems at young ages are well investigated, the prevalence of bad sleepers and the determinants of sleep quality perception remain unexplored in these populations. For this purpose, we addressed these issues in a sample of children (n = 307), preadolescents (n = 717), and adolescents (n = 406) who completed the School Sleep Habits Survey, addressing sleep quality perception, sleep habits, sleep features, daytime behavior and sleep disturbances, circadian preference, and dreaming. The sample was split in “good sleepers” and “bad sleepers”, based on the answer to the question item assessing overall subjective sleep quality. Being a bad sleeper was reported by 11.7% of the sample, with significant between-groups differences (children: 8.3%; preadolescents: 11.3%; adolescents: 15.3%; p = 0.01). At all ages, relative to good sleepers, bad sleepers showed higher eveningness, sleepiness, and depression, longer sleep latency, more frequent insufficient sleep, nocturnal awakenings, sleep–wake behavioral problems, and unpleasant dreams (all p’s ≤ 0.01). Sleep quality perception was predicted: in children, by depressed mood, eveningness, and unpleasant dreams (all p’s ≤ 0.01); in preadolescents, by sleep latency, awakening frequency, depressed mood, sufficiency of sleep, and unpleasant dreams (all p’s < 0.01); in adolescents, by awakening frequency, depressed mood, and sufficiency of sleep (all p’s < 0.001). In children, bad subjective sleep quality appears to be mainly determined by daytime psychological features, for example, depressed mood, whereas at later ages, sleep characteristics, such as frequent awakenings, add to the former determinants. This could depend on (a) the appearance, with increasing age, of objective sleep modifications and (b) a greater attention paid by adolescents to their sleep characteristics.

Links between sleep and body mass index in bipolar disorders: An exploratory study

2015 ◽  
Vol 30 (1) ◽  
pp. 89-93 ◽  
Author(s):  
C. Boudebesse ◽  
P.-A. Geoffroy ◽  
C. Henry ◽  
A. Germain ◽  
J. Scott ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Bipolar Disorders ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Sleep Onset Latency ◽  
Cross Sectional ◽  
Sleep Parameters

AbstractStudy objectives:Obesity and excess bodyweight are highly prevalent in individuals with bipolar disorders (BD) and are associated with adverse consequences. Multiple factors may explain increased bodyweight in BD including side effects of psychotropic medications, and reduced physical activity. Research in the general population demonstrates that sleep disturbances may also contribute to metabolic burden. We present a cross-sectional study of the associations between body mass index (BMI) and sleep parameters in patients with BD as compared with healthy controls (HC).Methods:Twenty-six French outpatients with remitted BD and 29 HC with a similar BMI completed a 21-day study of sleep parameters using objective (actigraphy) and subjective (PSQI: Pittsburgh Sleep Quality Index) assessments.Results:In BD cases, but not in HC, higher BMI was significantly correlated with lower sleep efficiency (P = 0.009) and with several other sleep parameters: shorter total sleep time (P = 0.01), longer sleep onset latency (P = 0.05), higher fragmentation index (P = 0.008), higher inter-day variability (P = 0.05) and higher PSQI total score (P = 0.004).Conclusions:The findings suggest a link between a high BMI and several sleep disturbances in BD, including lower sleep efficiency. Physiological mechanisms in BD cases may include an exaggeration of phenomena observed in non-clinical populations. However, larger scale studies are required to clarify the links between metabolic and sleep-wake cycle disturbances in BD.

scholarly journals Sleep quality in medical students: a comparison across the various phases of the medical course

2017 ◽  
Vol 43 (4) ◽  
pp. 285-289 ◽  
Author(s):  
Camila de Castro Corrêa ◽  
Felipe Kazan de Oliveira ◽  
Diego Scherlon Pizzamiglio ◽  
Erika Veruska Paiva Ortolan ◽  
Silke Anna Theresa Weber
Keyword(s):  
Medical Students ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Subjective Sleep Quality ◽  
Cross Sectional ◽  
Subjective Sleep ◽  
Group A ◽  
Group B

ABSTRACT Objective: To evaluate and compare subjective sleep quality in medical students across the various phases of the medical course. Methods: This was a cross-sectional study involving medical undergraduates at one medical school in the city of Botucatu, Brazil. All first- to sixth-year students were invited to complete the Pittsburgh Sleep Quality Index, which has been validated for use in Brazil. Participants were divided into three groups according to the phase of the medical course: group A (first- and second-years); group B (third- and fourth-years); and group C (fifth- and sixth-years). The results obtained for the instrument components were analyzed for the total sample and for the groups. Results: Of the 540 students invited to participate, 372 completed the instrument fully. Of those, 147 (39.5%) reported their sleep quality to be either very or fairly bad; 110 (29.5%) reported taking more than 30 min to fall asleep; 253 (68.0%) reported sleeping 6-7 h per night; 327 (87.9%) reported adequate sleep efficiency; 315 (84.6%) reported no sleep disturbances; 32 (8.6%) reported using sleeping medication; and 137 (36.9%) reported difficulty staying awake during the day at least once a week. Group comparison revealed that students in group A had worse subjective sleep quality and greater daytime dysfunction than did those in groups B and C. Conclusions: Medical students seem to be more exposed to sleep disturbance than other university students, and first- and second-years are more affected than those in other class years because they have worse subjective sleep quality. Active interventions should be implemented to improve sleep hygiene in medical students.

scholarly journals Effect of kidney transplantation on sleep quality in patients admitted in ICU:a cross-section study in China

2019 ◽  
Author(s):  
Lu Long ◽  
Jia Liu ◽  
Jin Yan ◽  
Jian fei Xie ◽  
Huan Liu ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Sleep Quality ◽  
Linear Regression Analysis ◽  
Sleep Onset ◽  
Sleep Time ◽  
Middle Level ◽  
Sleep Disruption ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

Abstract Background Although evidences showed that sleep disorder is common in patient with end stage renal disease (ESRD), less is known about their sleep quality after early post-kidney transplantation (kTx) especially in Intensive Care Unite (ICU). Thus, the purpose of this study is to investigate sleep quality of kTx recipients in ICU and explore factors related poor sleep, second, to measure the correlation of subjective sleep quality and sleep architecture assessed by PSG in kTx recipients. Methods This study recruited participants from ESRD patients registered in transplantation waiting list at the third xiangya hospital of central south university in China. Participants required to complete the Pittsburgh sleep quality index(PSQI) and demographic questionnaire as baseline data and received one night of Polysomnography (PSG) in the ICU within 96 hours of surgery, during which time sound and light data were monitored. After that Richards Campbell sleep questionnaires (RCSQ) also need completed. Results 26 participants self-reported sleep quality and sleep efficiency based on RCSQ was at middle level (49.2 ± 25.6mm), and 14/26(53.8%) kTx recipients in ICU were poor sleepers defined by RCSQ <50. PSG showed that most kTx recipients in ICU had shallow sleep with mainly stage 2 sleep time (80.90 ±70.10 min), lower total sleep time (136.50 ±86.41 min), higher awakening frequency after sleep onset (8.87 ±5.92 times) and long awaken time (94.67 ±75.09 min) when a sleep disruption occured. multiple linear regression analysis showed that self-reported noise and pain were the significant factor affecting sleep(P < 0.05).Conclusion Subjective sleep quality based on RCSQ scored better than objective one measured by PSG in kTx recipients, sleep disruption always remained a substantial problem and affected by self-reported noise and pain.

scholarly journals Actigraphic and Self-reported Sleep in Traffic Accident Victims

2021 ◽  
pp. 1-6
Author(s):  
V. Renner ◽  
M. Keller ◽  
M. Beuth ◽  
W.T. Roth ◽  
K. Petrowski
Keyword(s):  
Sleep Quality ◽  
Traffic Accident ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Group Differences ◽  
Sleep State ◽  
Subjective Sleep Quality ◽  
Sleep Log ◽  
Healthy Participants

Background: Some accident victims report poorer sleep during the months after the trauma, which may double the risk for and is a mediator of the development of a PTSD. Furthermore, subjective and objective sleep measures are often discrepant in PTSD-patients, which is why a ‘sleep state misperception’ of PTSD patients is often hypothesized. Objective: The goal of this study is to assess differences in sleep quality in victims of a traffic accident compared to healthy participants without an accident history as well as differences between objective and subjective sleep quality measures. Methods: We recruited 25 hospitalized accident victims within ten days of an accident and 31 age and sex-matched controls without an accident history. Three months later, participants were given a structured clinical interview (SCID), they completed the Pittsburg Sleep Quality Index (PSQI) for the previous two weeks, wore a wrist actigraph, and kept a sleep log for two consecutive nights. Results: At the three-month follow-up, none of the victims met the criteria for any kind of mental disorder, but scored higher on the Posttraumatic Diagnostic Scale. On the PSQI they reported slightly worse sleep than controls for the previous two weeks, although sleep log and actigraphy measures on the two recording nights showed no group differences. Actigraphy measures showed shorter sleep onset latencies compared to log measures. Conclusions: The accident victims suffered only minimal sleep disturbances three months later. The assumption of a ‘sleep state misperception’ in traffic accident victims is questioned by these results.

scholarly journals The serotonin transporter gene-linked polymorphic region (5-HTTLPR) and the sleep-promoting effects of tryptophan: A randomized placebo-controlled crossover study

2019 ◽  
Vol 33 (8) ◽  
pp. 948-954
Author(s):  
Jens H van Dalfsen ◽  
C Rob Markus
Keyword(s):  
Sleep Quality ◽  
Allelic Variation ◽  
Sleep Onset ◽  
Treatment Protocol ◽  
Sleep Diary ◽  
Transporter Gene ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Allele Group ◽  
S Allele

Background:The low-expressive short (S) allele of a functional polymorphism (5-HTTLPR) within the serotonin (5-hydroxytriptamine; 5-HT) transporter gene (SLC6A4) has been associated with a reduced functioning of the brain 5-HT system relative to the long (L) allele. As a consequence, the S-allele is found to predispose individuals to a higher risk of sleep quality reduction and clinical insomnia.Aims:The present study investigated whether subchronic pre-sleep tryptophan administration could compensate for this predisposition by improving sleep in 5-HTTLPR S-allele carriers.Methods:In a double-blind placebo-controlled crossover design a sample of homozygous 5-HTTLPR S-allele ( n = 47) and L-allele ( n = 51) carriers were assessed for subjective (sleep diary) and objective (actigraphy) sleep during a treatment protocol consisting of 1 week of placebo (1000 mg/day) and 1 week of tryptophan administration (1000 mg/day).Results:The results support the sleep-promoting effects of tryptophan. Tryptophan improved objective sleep efficiency and objective wake after sleep onset irrespective of allelic variation. There was a marginally significant improvement of subjective sleep quality in the 5-HTTLPR S-allele group but not in the L-allele group following tryptophan relative to placebo intake. In contrast, a significantly poorer sleep quality in the S-allele as opposed to the L-allele group in the placebo condition was not observed in the tryptophan condition.Conclusions:Tryptophan augmentation promises to be a valuable treatment strategy for sleep impairments related to genetic deficiencies in 5-HT functioning.

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