Sleep onset insomnia, daytime sleepiness and sleep duration in relationship to Toxoplasma gondii IgG seropositivity and serointensity

AbstractToxoplasma gondii (T. gondii) infects central nervous tissue and is kept in relative dormancy by a healthy immune system. Sleep disturbances have been found to precipitate mental illness, suicidal behavior and car accidents, which have been previously linked to T. gondii as well. We speculated that if sleep disruption, particularly insomnia, would mediate, at least partly, the link between T. gondii infection and related behavioral dysregulation, then we would be able to identify significant associations between sleep disruption and T. gondii. The mechanisms for such an association may involve dopamine (DA) production by T. gondii, or collateral effects of immune activation necessary to keep T. gondii in check. Sleep questionnaires from 2031 Old Order Amish were analyzed in relationship to T. gondii-IgG antibodies measured by enzyme-linked immunosorbent assay (ELISA). Toxoplasma gondii seropositivity and serointensity were not associated with any of the sleep latency variables or Epworth Sleepiness Scale (ESS). A secondary analysis identified, after adjustment for age group, a statistical trend toward shorter sleep duration in seropositive men (p=0.07). In conclusion, it is unlikely that sleep disruption mediates links between T. gondii and mental illness or behavioral dysregulation. Trending gender differences in associations between T. gondii and shorter sleep need further investigation.

Download Full-text

Delayed Lactogenesis II is Associated With Lower Sleep Efficiency and Greater Variation in Nightly Sleep Duration in the Third Trimester

Journal of Human Lactation ◽

10.1177/0890334419830991 ◽

2019 ◽

Vol 35 (4) ◽

pp. 713-724

Author(s):

Theresa Casey ◽

Hui Sun ◽

Helen J. Burgess ◽

Jennifer Crodian ◽

Shelley Dowden ◽

...

Keyword(s):

Body Mass Index ◽

Blood Glucose ◽

Sleep Duration ◽

Body Mass ◽

Sleep Disturbances ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Efficiency ◽

Delayed Onset ◽

Wrist Actigraphy

Background: Metabolic and hormonal disturbances are associated with sleep disturbances and delayed onset of lactogenesis II. Research aims: The aim of this study was to measure sleep using wrist actigraphy during gestation weeks 22 and 32 to determine if sleep characteristics were associated with blood glucose, body mass index, gestational related disease, delayed onset of lactogenesis II, or work schedule. Methods: Demographic data were collected at study intake from primiparous women who wore a wrist actigraph during gestation weeks 22 ( n = 50) and 32 ( n = 44). Start and end sleep time, total nighttime sleep, sleep efficiency, wake after sleep onset, and sleep fragmentation were measured. Night to night variability was assessed with the root mean square of successive difference. Blood glucose levels, body mass index, and gestational disease data were abstracted from medical charts. Timing of lactogenesis II was determined by survey. Results: Between gestation week 22 and 32, sleep efficiency decreased and fragmentation increased ( p < .05). During gestation week 32, blood glucose was negatively correlated with sleep duration, and positively related to fragmentation ( p < .05). Women who experienced delayed lactogenesis II had lower sleep efficiency and greater fragmentation ( p < .05), and greater night-to-night variability in sleep start and end time, efficiency, and duration during gestation week 32 ( p < .05). Conclusion: Women with better sleep efficiency and more stable nightly sleep time are less likely to experience delayed onset of lactogenesis II. Interventions to improve sleep may improve maternal health and breastfeeding adequacy.

Download Full-text

0785 Associations Between Circadian Preference And Sleep-related Thoughts: Data From The 2015 Sleep In America Poll

SLEEP ◽

10.1093/sleep/zsaa056.781 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A298-A299

Author(s):

B Jeon ◽

F S Luyster ◽

E R Chasens

Keyword(s):

Sleep Disturbance ◽

Sleep Duration ◽

Sleep Disturbances ◽

Secondary Analysis ◽

Logistic Models ◽

Poor Sleep ◽

Sleep Habits ◽

Circadian Preference ◽

Physical Consequences ◽

The Impact

Abstract Introduction Evening types of sleep tend to have poorer sleep quality and sleep habits than morning types. Maladaptive beliefs or thoughts about sleep can affect one’s sleep and may differ between evening and morning types. We examined the association between the circadian preference and sleep-related thoughts in U.S adults. Methods A secondary analysis used survey data from the 2015 National Sleep Foundation’s Sleep in America Poll. Questions included normal bedtime and wake-up time for week/work days and weekend/non-work days. Circadian preference was determined by midpoint of sleep calculated as midpoint of sleep on weekends corrected for average nightly sleep duration. Participants were excluded if their sleep midpoint was from noon to midnight. Midpoint of sleep was divided into two groups using median split (“earlier” vs. “later”). Sleep-related thoughts were “worry about getting a good sleep”, “overwhelming thoughts about getting enough sleep”, “motivation to get sleep”, and “concern about serious physical consequences due to poor sleep”; responded often/always or extremely to somewhat for these items were coded as maladaptive. Logistic regression analysis controlling for socio-demographics, sleep duration, and sleep disturbance (PROMIS Scale; higher scores = greater sleep disturbance) was conducted to examine the relationships between midpoint of sleep and sleep-related thoughts. Results The sample (N = 1011) was primarily White (73.6%), male (50.9%), college educated (62.2%), married/partnered (67.6%) with a mean age of 51.65 ± 17.05 years. Mean midpoint of sleep in “earlier” type was 2:33AM and 5:29AM in “later” type. “Later” type had shorter sleep duration on weekdays and longer sleep duration on weekends than “earlier” type (p < .01), but average sleep duration was similar between two types. “Later” type had more “worry” and “overwhelming thoughts” (p < .05) about sleep. In logistic models, midpoint of sleep was significant only for “concern” (p = .02). Conclusion In this study, late chronotype was associated with increased sleep disturbances and greater variability in sleep duration. The relationship between the timing of sleep and thoughts about the impact of impaired sleep remains unclear and an area for further study with objective measures. Support

Download Full-text

0007 Daytime Sleep in Night Shift Workers: Quantifying the Role of Circadian Misalignment

SLEEP ◽

10.1093/sleep/zsaa056.006 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A3-A3

Author(s):

E Mann ◽

C Sagong ◽

A Cuamatzi Castelan ◽

M Singh ◽

T Roth ◽

...

Keyword(s):

Sleep Duration ◽

Sleep Disturbances ◽

Night Shift ◽

Sleep Onset ◽

Sleep Onset Latency ◽

Shift Workers ◽

Circadian Misalignment ◽

Daytime Sleep ◽

Falling Asleep ◽

Dim Light

Abstract Introduction Circadian misalignment is commonly cited as a culprit of daytime sleep disturbances in night shift workers; however, the specific impact and magnitude that circadian misalignment has on daytime sleep has not been well-characterized in larger samples of night shift workers. Methods Participants included fixed-night shift workers (n=52, ages 18–50) who completed an 8-hour daytime polysomnography (PSG) in the lab following a night shift. Measures of sleep disturbances included: difficulty falling asleep (sleep onset latency [SOL], latency to persistent sleep [LPS]), difficulty staying asleep (sleep efficiency [SE], wake after sleep onset [WASO]), and sleep duration (total sleep time [TST]). Melatonin samples were collected hourly for 24 hours under dim light (<10 lux) and used to determine dim light melatonin offset (DLMOff). Circadian misalignment (CM) was calculated as the time difference between bedtime and DLMOff (higher values represented sleeping after DLMOff), and correlated with PSG sleep variables. Results CM was significantly associated with difficulty staying asleep (WASO: r=0.48, p<0.001; SE: r=-0.45, p<0.001), and sleep duration (TST: r=-0.38, p<0.01). Specifically, every 3 hours of CM on average added 19.2 minutes of WASO and reduced TST by 15 minutes. In contrast, CM was not significantly correlated with sleep onset difficulties (SOL: r=-0.27; LPS: r=-0.02). Conclusion These data suggest that circadian misalignment in shift workers may be a better predictor of difficulties staying asleep and sleep duration during the day relative to difficulties falling asleep. Because longer work hours (10–12 hours) are common in night shift worker, it may be that sleep initiation difficulties associated with circadian misalignment is masked by elevated fatigue or an increased homeostatic drive from prolonged wakefulness. These results may help guide decisions about the magnitude of phase shifts required (e.g., with light therapy) for the desired improvement in daytime sleep. Support Support for this study was provided to PC by the NHLBI (K23HL138166)

Download Full-text

Associations of Sleep Characteristics With Cognitive Function and Decline Among Older Adults

American Journal of Epidemiology ◽

10.1093/aje/kwz037 ◽

2019 ◽

Vol 188 (6) ◽

pp. 1066-1075 ◽

Cited By ~ 18

Author(s):

V Eloesa McSorley ◽

Yu Sun Bin ◽

Diane S Lauderdale

Keyword(s):

Standard Deviation ◽

Cognitive Function ◽

Cognitive Decline ◽

Sleep Duration ◽

Social Life ◽

Sleep Onset ◽

Sleep Disruption ◽

Cross Sectional ◽

Sleep Study ◽

Nationally Representative

Abstract Sleep laboratory studies find that restricted sleep duration leads to worse short-term cognition, especially memory. Observational studies find associations between self-reported sleep duration or quality and cognitive function. However self-reported sleep characteristics might not be highly accurate, and misreporting could relate to cognition. In the Sleep Study of the National Social Life, Health, and Aging Project (NSHAP), a nationally representative cohort of older US adults (2010–2015), we examined whether self-reported and actigraph-measured sleep are associated with cross-sectional cognitive function and 5-year cognitive decline. Cognition was measured with the survey adaptation of the multidimensional Montreal Cognitive Assessment (MoCA-SA). At baseline (n = 759), average MoCA-SA score was 14.1 (standard deviation, 3.6) points of a possible 20. In cross-sectional models, actigraphic sleep-disruption measures (wake after sleep onset, fragmentation, percentage sleep, and wake bouts) were associated with worse cognition. Sleep disruption measures were standardized, and estimates of association were similar (range, −0.37 to −0.59 MoCA-SA point per standard deviation of disruption). Actigraphic sleep-disruption measures were also associated with odds of 5-year cognitive decline (4 or more points), with wake after sleep onset having the strongest association (odds ratio = 1.43, 95% confidence interval: 1.04, 1.98). Longitudinal associations were generally stronger for men than for women. Self-reported sleep showed little association with cognitive function.

Download Full-text

0279 Fatigue and Pain Responses Across Repeated Exposure to Experimentally Induced Sleep Disturbance and Intermittent Recovery Sleep: Sex Differences

SLEEP ◽

10.1093/sleep/zsaa056.277 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A106-A106

Author(s):

M R Goldstein ◽

N S Simpson ◽

J K Devine ◽

R Dang ◽

C Connors ◽

...

Keyword(s):

Sex Differences ◽

Sleep Disturbances ◽

Light Exposure ◽

Sleep Onset ◽

Sleep Disruption ◽

Science Center ◽

Cold Pain ◽

Pressure Pain ◽

Recovery Sleep ◽

Pain Responses

Abstract Introduction Sleep disturbances are more common in women than in men, as are many chronic pain disorders characterized by inflammation and fatigue. This study investigated sex differences in fatigue and pain responses to sleep disruption and whether such responses recover with uninterrupted sleep. Methods 24 healthy young individuals (12 women; ages 18–42 yrs) participated in a study consisting of two counterbalanced 19-day experimental in-hospital stays, separated by two months. Following 3 baseline nights, participants were exposed to 3 nights of sleep disruption (SD) involving delayed sleep onset, hourly awakenings, and early-morning awakenings without return to sleep, followed by 1 night of recovery sleep. This 4-day cycle was repeated three times and finished with 3 additional nights of recovery sleep. Total sleep opportunity on SD nights was 4 hrs, and on recovery/sleep control (SC) nights was 8 hrs. Light exposure, ambient temperature, food and fluid intake, and physical activity were controlled. Self-reported fatigue and pain, pain sensitivity, and habituation were collected throughout. Data were analyzed with linear mixed models. Results For women but not men, fatigue in response to SD recovered incompletely starting after the 2nd sleep disruption-recovery cycle and remained elevated after the final 3 recovery nights in women (p<.05). Additionally, women became more sensitive to pressure pain in response to SD (p<.001) with incomplete return to baseline after the final 3 recovery nights. Whereas men habituated to cold pain across SC and even more so across SD (p=.045 Day, p=.021), women did not habituate. Conclusion These results indicate that incomplete recovery in both fatigue and pressure pain, alongside a lack of habituation to cold pain, in response to sleep disruption may explain the common co-occurrence of insomnia, fatigue, and pain observed as more prevalent in women. Support NIH/NINDS R01-NS091177; NIH/National Center for Research Resources UL1-RR02758 and M01-RR01032 to the Harvard Clinical and Translational Science Center.

Download Full-text

Sleep in children and adolescents with juvenile idiopathic arthritis: a systematic review and meta-analysis of case-control studies

SLEEP ◽

10.1093/sleep/zsab233 ◽

2021 ◽

Author(s):

Oussama Saidi ◽

Emmanuelle Rochette ◽

Pierre Bourdier ◽

Sébastien Ratel ◽

Etienne Merlin ◽

...

Keyword(s):

Systematic Review ◽

Juvenile Idiopathic Arthritis ◽

Sleep Duration ◽

Sleep Disturbances ◽

Meta Analysis ◽

Sleep Onset ◽

Sleep Onset Latency ◽

Inclusion Criteria ◽

Case Control Studies ◽

Qualitative Synthesis

Abstract Study Objectives Juvenile idiopathic arthritis (JIA) is one of the most common pediatric rheumatic disease. However, sleep alteration associated with this auto-immune disease remain unclear. We aimed in this systematic review and meta-analysis to compare sleep duration, quality, and architecture in JIA subjects with those in their healthy peers. Methods Systematic search performed in PubMed, EMBase, Cochrane, and PsycINFO databases included 19 studies in the qualitative synthesis of which 10 met the inclusion criteria for the meta-analysis. Results Pooled results from subjective methods indicated pronounced sleep disturbances and complaints in youth with JIA compared with their healthy counterparts. This was further confirmed by Increased difficulty maintaining sleep (wake after sleep onset; SMD: −0.69; CI: −1.29; −0.09, p =0.02) and a tendency to increased difficulty initiating sleep (sleep onset latency; SMD: −0.29; CI: −0.60; 0.03, p =0.07). There were no remarkable differences in sleep duration or sleep architecture between JIA patients and healthy controls. High heterogeneity was found for several outcomes. This could be explained by the different methods used as well as associated sleep disorders, medication and comorbidities. Conclusions Although included studies were methodologically diverse, the summarized results of our review and meta-analysis bring evidence that children with JIA present more fragmented sleep compared to healthy peers. Thereby, the implementation of strategies to manage and improve sleep in this population are needed and might have a beneficial effect on the symptoms and functions of JIA.

Download Full-text

The Role of Sleep Duration and Sleep Problems During Childhood in the Development of ADHD in Adolescence: Findings From a Population-Based Birth Cohort

Journal of Attention Disorders ◽

10.1177/1087054719879500 ◽

2019 ◽

Vol 24 (4) ◽

pp. 590-600 ◽

Cited By ~ 1

Author(s):

Marina Xavier Carpena ◽

Tiago N. Munhoz ◽

Mariana Otero Xavier ◽

Luis Augusto Rohde ◽

Iná S. Santos ◽

...

Keyword(s):

Mental Disorders ◽

Birth Cohort ◽

Sleep Duration ◽

Sleep Disturbances ◽

Sleep Problems ◽

Secondary Analysis ◽

Well Being ◽

Population Based ◽

Early Markers

Objective: We aimed to investigate the association between sleep in early life and ADHD in adolescence. As a secondary analysis, we tested whether the associations may be specific to ADHD. Method: Data from 3,467 participants of the 2004 Pelotas Birth Cohort were used. Information on their sleep duration and problems was collected at 12, 24, and 48 months of age. ADHD diagnosis and hyperactivity/inattention problems were assessed with the Development and Well-Being Assessment (DAWBA) and the Strengths and Difficulties Questionnaire (SDQ) among participants at 11 years of age. Results: Difficulty going to sleep at 24 months, nightmares at 24 months and at 48 months, and restless sleep at 48 months were consistently associated with ADHD as well as with other mental disorders. Conclusion: The results suggest that sleep disturbances may be more important ADHD predictors than sleep duration or sleep duration trajectories. However, it may also be considered early markers of other mental disorders.

Download Full-text

622 Bedtime, Sleep Duration, and Sleep Quality as Predictors of Externalizing Symptoms in Children in Foster Care

SLEEP ◽

10.1093/sleep/zsab072.620 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A244-A244

Author(s):

Priscilla Rigos ◽

Josephine Kim ◽

Josefina Muñoz Nogales ◽

Madeline Valentine ◽

Jinu KIm ◽

...

Keyword(s):

Foster Care ◽

Sleep Quality ◽

Sleep Duration ◽

Sleep Disturbances ◽

Sleep Onset ◽

Externalizing Symptoms ◽

The United States ◽

Parent Rating ◽

Behavioral Issues ◽

Children In Foster Care

Abstract Introduction A strong association between sleep disturbances and externalizing symptoms has been found among school-aged children. In particular, there is a known association between sleep disturbances, irritability, emotional dysregulation, and hyperactivity (e.g., Coto et al., 2018). Limited research, however, has examined this association in a high-risk population of children, such as those in foster care who are at increased risk for sleep disturbances due to heightened exposure to trauma. Thus, the following study sought to assess the association between sleep quality and externalizing symptoms in a population of children in foster care. Methods Caregivers with children ages 4–11 were sampled from private Facebook community foster care groups across the United States (n = 410). Caregivers were provided a link to a survey powered by Qualtrics where they were asked to report on the children under their care’s weekday bedtime, overall sleep quality (e.g., “Please rate your child’s overall sleep quality over the last two weeks”), and sleep onset (e.g. “On weekdays, how long does it usually take for your child to fall asleep?”). Child behavioral issues were assessed via the Eyberg Child Behavior Inventory (ECBI) Parent Rating Form. Results A linear regression model was utilized to assess if child weekday bedtime, weekday total sleep duration, and overall sleep quality were unique predictors of externalizing symptoms when controlling for age. Results suggest that weekday sleep duration and bedtime were not significant unique predictors of child behavioral issues, though were significantly and positively correlated at the bivariate level (p=.02, p=.04). Sleep onset and overall sleep quality, irrespective of child age, were found to be significant unique predictors of child behavioral issues and accounted for 1% and 11% of the total variance, respectively. Conclusion Results suggest that delayed sleep onset and poorer sleep quality were predictive of increased behavioral issues for children in foster care. Findings persisted when controlling for age, which suggests that children in foster care experiencing sleep disturbances may benefit from more behaviorally focused sleep interventions to improve externalizing behaviors and increase sleep health. Support (if any):

Download Full-text

727 Impact of Washington State COVID-19 Lockdown on Sleep

SLEEP ◽

10.1093/sleep/zsab072.724 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A283-A284

Author(s):

Mary Peterson ◽

Kirsie Lundholm ◽

Lillian Skeiky ◽

Hans Van Dongen ◽

Devon Hansen

Keyword(s):

Sleep Disturbances ◽

Sleep Onset ◽

Washington State ◽

Self Report ◽

Sleep Disruption ◽

Before And After ◽

Report Data ◽

Delayed Sleep ◽

Self Report Data ◽

At Home

Abstract Introduction The COVID-19 pandemic caused a global disruption to daily routines. Studies using surveys and sleep-related applications on mobile devices suggest that the pandemic has contributed to increases in sleep disruption or onset of new sleep disturbances. We present results from a naturalistic at-home study in which objective sleep measurements were made using both a wrist actigraph (Actiwatch-2, Philips Respironics) and a non-contact monitoring device (SleepScore Max, SleepScore Labs), comparing sleep measurements obtained immediately before and after the start of the first mandatory COVID-19 stay-at-home order in Washington State. Methods As part of a larger study, nine Washington State residents (ages 22–48, 5 female, 4 male; 6 insomniacs, 3 normal sleeper) were enrolled in a 10-week at-home sleep monitoring study, which involved 1 week of actigraphy, 8 weeks of non-contact monitoring (data available for 6 subjects), and 1 week of actigraphy. During the study, the Washington State governor issued a stay-at-home order, effective March 15, 2020. We compared sleep measurements obtained before this date (mean ± SD: 25.0 ± 15.0 nights) and after this date (25.2 ± 13.9 nights) using mixed-effects ANOVA. Results Non-contact monitoring measurements indicated that after the start of the lockdown, participants woke up later by 63.2 ± 12.1 min (mean ± SE; F[1,299]=27.40, p<0.001) without significant change in bedtime (F[1,299]=0.29, p=0.59). Sleep latency lengthened by 4.0 ± 2.3 min (F[1,295]=4.92, p=0.027), and there were increases in number of awakenings (F[1,295]=6.22, p=0.013) and wake after sleep onset (F[1,295]=12.58, p<0.001). Actigraphy data complemented these results, showing delayed sleep onset by 53.4 ± 15.1 min (F[1,101]=12.46, p<0.001) and delayed final awakening by 104.3 ± 19.6 min (F[1,101]=28.43, p<0.001), with longer sleep duration (F[1,101]=6.06, p=0.016), increased number of awakenings (F[1,101]=13.00, p<0.001), and a trend for increased intermittent wakefulness (F[1,101]=3.88, p=0.052) post-lockdown. Conclusion In this sample, we found evidence of increased sleep disruption following the first Washington State stay-at-home order related to COVID-19. Our findings are consistent with previous studies based on self-report data, which observed later wake times and decreases in sleep quality post-lockdown. Support (if any) NIH grant KL2TR002317. Non-contact monitoring devices provided by SleepScore Labs.

Download Full-text

The Influence of Sleep on Glycated Hemoglobin in Pregnancy With Gestational Diabetes

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.890 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A436-A437

Author(s):

Cristina Sampaio Facanha ◽

Veralice S De Bruin ◽

Fernando Henrique A Lopes ◽

Magno M P Faria ◽

Paula S Machado ◽

...

Keyword(s):

Gestational Diabetes ◽

Sleep Quality ◽

Sleep Duration ◽

Sleep Disturbances ◽

Glycated Hemoglobin ◽

Sleep Onset ◽

Diabetic Patients ◽

Poor Sleep ◽

Wake Time ◽

Sleep Log

Abstract Background: Sleep disturbances have been associated with poor glycemic control in differential clinical settings. Both short and long sleep duration, influence insulin resistance and blood glucose in diabetic patients. Pregnancy is an additional risk for reduced sleep quality and quantity, and the presence of hyperglycemia, as a complicating factor, has being increasingly frequent. Different measures of sleep evaluation, both objectively and subjectively, can provide additional information about the influence of sleep in metabolic control in Gestational Diabetes Mellitus (GDM). Objective: To investigate the influence of sleep quality and objective sleep measures on glycated hemoglobin (HBA1C) in patients with GDM. Methodology: This is a cross-sectional study examining patients with GDM from 2nd to 3rd trimester of pregnancy. Clinical data and behavior questionnaires were collected by a face-to-face interview. Self-Rated Sleep Quality was evaluated by Pittsburgh Sleep Quality Index- (PSQI). In order to improve the accuracy of the information, a 14-day sleep log was obtained, and objective sleep measurements were registered by actigraphic record (5 to 7 days). Results: Overall, GDM patients (N=311), aged from 20 to 46 y (33.1±5.6) were evaluated. Sleep duration ≤6 hours/night was found in 43.4%, and 63.9% reported poor sleep quality (PSQI>5). Sleep duration measured by actigraphy was correlated with sleep duration registered by sleep log (r=.45, p=.04), and with PSQI (r=-.33, p=.002). Sleep quality and sleep duration registered by either actigraphy or sleep log were not correlated with Hba1c. Amongst all, Hba1c varied from 4.3 to 7.0 mg/dL (5.9 ±.53). Sleep fragmentation, measured by the length of time patient spends awake after sleep onset (WASO) was correlated withHba1c level in patients with GDM (r=.41, p=0.04). Conclusion: Sleep duration obtained from the sleep log was a reliable measure correlating with objective sleep parameters registered by actigraphy and with sleep quality. In GDM patients, increased wake time after sleep onset was correlated with higher Hba1c.

Download Full-text