Cognitive Dysfunction in Insomnia Phenotypes: Further Evidence for Different Disorders

Study Objectives: To determine cognitive profiles in individuals with short sleep duration insomnia (SSDI) and normal sleep duration insomnia (NSDI; also, paradoxical insomnia), compared to healthy sleepers.Method: Polysomnographic (PSG) and neuropsychological data were analysed from 902 community-based Raine Study participants aged 22 ± 0.6 years of whom 124 met criteria for insomnia (53 with NSDI and 71 with or SSDI) and 246 were classified as healthy with normal sleep (i.e., without insomnia or other sleep disorders). Measurements of self- report (attention and memory) and laboratory-assessed (attention, episodic memory, working memory, learning, and psychomotor function) cognition and mood, and PSG-based sleep stages (% total sleep time; %TST) were compared between these 3 groups.Results: In comparison to the healthy sleeper group, both insomnia groups had poorer self-reported attention, memory, mood, and sleep, and poorer laboratory-assessed attention (inconsistency). The NSDI group had less consistent working memory reaction time than healthy-sleepers or those with SSDI. The SSDI group had more inconsistency in executive function (shifting), and showed greater %TST in stage N1 and N3, and less REM sleep than either healthy-sleepers or those with NSDI.Conclusions: Individuals with NSDI demonstrated greater working memory inconsistency, despite no laboratory assessed sleep problems, implicating early signs of pathophysiology other than disturbed sleep. Those with SSDI demonstrated different sleep architecture, poorer attention (inconsistency), and greater executive function (inconsistency) compared to healthy-sleepers and those with NSDI, implicating sleep disturbance in the disease process of this phenotype.

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Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation

Psychological Medicine ◽

10.1017/s0033291720000860 ◽

2020 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Michael R. Dolsen ◽

Aric A. Prather ◽

Femke Lamers ◽

Brenda W. J. H. Penninx

Keyword(s):

Suicidal Ideation ◽

Sleep Disturbance ◽

Sleep Duration ◽

Suicide Risk ◽

Suicide Attempts ◽

Self Report ◽

Short Sleep Duration ◽

Long Sleep ◽

Normal Sleep ◽

Insomnia Symptoms

Abstract Background Sleep disturbance has been consistently identified as an independent contributor to suicide risk. Inflammation has emerged as a potential mechanism linked to both sleep disturbance and suicide risk. This study tested associations between sleep duration, insomnia, and inflammation on suicidal ideation (SI) and history of a suicide attempt (SA). Methods Participants included 2329 adults with current or remitted depression and/or anxiety enrolled in the Netherlands Study of Depression and Anxiety. Sleep duration, insomnia, past week SI, and SA were assessed with self-report measures. Plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α were obtained. Results Short sleep duration (⩽6 h) compared to normal sleep duration (7–9 h) was associated with reporting a prior SA, adjusting for covariates [adjusted odds ratio (AOR) 1.68, 95% CI 1.13–2.51]. A higher likelihood of SI during the past week was observed for participants with long sleep duration (⩾10 h) compared to normal sleep duration (AOR 2.22, 95% CI 1.02–4.82), more insomnia symptoms (AOR 1.44, 95% CI 1.14–1.83), and higher IL-6 (AOR 1.31, 95% CI 1.02–1.68). Mediation analyses indicated that the association between long sleep duration and SI was partially explained by IL-6 (AOR 1.02, 95% CI 1.00–1.05). Conclusions These findings from a large sample of adults with depression and/or anxiety provide evidence that both short and long sleep duration, insomnia symptoms, and IL-6 are associated with the indicators of suicide risk. Furthermore, the association between long sleep duration and SI may operate through IL-6.

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Associations between sleep problems and ADHD symptoms among adolescents: findings from the Shandong Adolescent Behavior and Health Cohort (SABHC)

SLEEP ◽

10.1093/sleep/zsz294 ◽

2019 ◽

Vol 43 (6) ◽

Cited By ~ 3

Author(s):

Xianchen Liu ◽

Zhen-Zhen Liu ◽

Bao-Peng Liu ◽

Shi-Hua Sun ◽

Cun-Xian Jia

Keyword(s):

Sleep Duration ◽

Child Behavior Checklist ◽

Sleep Problems ◽

Adolescent Behavior ◽

Self Report ◽

Poor Sleep ◽

Adhd Symptoms ◽

Short Sleep Duration ◽

Hyperactivity Disorder

Abstract Study Objectives Sleep problems and symptoms of attention-deficit hyperactivity disorder (ADHD) in adolescence are common. Little is known about the prospective the prospective associations between sleep and subsequent ADHD symptoms in adolescents. This study examined the prospective associations between sleep problems and subsequent ADHD symptoms in a large sample of adolescents. Methods Participants included 7072 adolescents from the Shandong Adolescent Behavior and Health Cohort (SABHC) study in Shandong, China. Participants were initially assessed in November–December of 2015 and were reassessed 1-year later in 2016. Sleep duration, sleep problems, and psychosocial information were collected using a structured questionnaire. ADHD symptoms were measured by the Achenbach Child Behavior Checklist-Youth Self-Report. Results At baseline, 7.6% participants had clinically relevant ADHD symptoms, which were highly comorbid with sleep problems including insomnia symptoms, poor sleep quality, symptoms of restless legs syndrome (RLS), frequent snoring, and short sleep duration. Of the 6531 participants without clinically relevant ADHD symptoms at baseline, 4.5% reported clinically relevant ADHD symptoms at 1-year follow-up. After adolescent and family covariates were adjusted for, insomnia (OR = 2.09, 95% CI = 1.45–3.02), RLS (OR = 1.47, 95% CI = 1.02–2.11), and frequent snoring (OR = 2.30, 95% CI = 1.36–3.90) were all significantly associated with subsequent ADHD symptoms. Conclusion ADHD symptoms and sleep problems are highly comorbid. Insomnia, RLS and frequent snoring appear to be significant predictors of subsequent ADHD symptoms. Our study highlights the importance of assessing and managing sleep problems for prevention and clinical treatment of ADHD symptoms in adolescence.

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Sleep Duration Is Closely Associated with Suicidal Ideation and Suicide Attempt in Korean Adults: A Nationwide Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115594 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5594

Author(s):

Yujin Ko ◽

Jieun Moon ◽

Sangsoo Han

Keyword(s):

Suicidal Ideation ◽

Suicide Attempt ◽

Sleep Duration ◽

Suicide Attempts ◽

Sleep Problems ◽

Survey Methods ◽

Self Report ◽

Short Sleep Duration ◽

Sampling Weights ◽

Increased Risk

Introduction: Suicidal ideation and suicide attempts are major risk factors for suicidal death, and sleep problems are associated with an increased risk for mental disorders. We investigated the relationship between sleep duration and suicidal ideation and suicide attempts in a representative sample of the Korean general population from a nationwide survey. Methods: We analyzed data collected from the Korea National Health and Nutrition Examination Survey VI and VII (2013–2018). Suicidal ideation was identified via self-report, and we accessed suicide attempt history. Sleep duration was divided into three categories: short sleep duration (SSD) (≤5 h), normal sleep duration (NSD) (>5 and <9 h), and long sleep duration (LSD) (≥9 h). Sampling weights were applied to obtain estimates for the general Korean population. Results: Overall, 4015 (12.0%), 25,609 (76.5%), and 3857 (11.5%) participants were in the SSD, NSD, and LSD groups, respectively. Among these groups, 7.2%, 2.8%, and 3.3% reported suicidal ideation; while 1.2%, 0.4%, and 0.7% reported a history of suicide attempts. Multiple regression analyses revealed that SSD was significantly more strongly associated with suicidal ideation (adjusted odds ratio (AOR) 1.46, p < 0.001) and attempts (AOR 2.05, p = 0.003) than NSD. No association was found between LSD and suicidal ideation/attempts. Conclusion: Sleep duration is significantly associated with suicidal behavior, and SSD was particularly closely related with an increased risk for suicidal ideation and suicide attempt. Clinicians should carefully consider sleep duration in suicidal patients.

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Sleep Duration is Closely Associated with Suicidal Ideation and Suicide Attempt in Korean Adults: A Nationwide Cross-sectional Study

10.21203/rs.3.rs-275335/v1 ◽

2021 ◽

Author(s):

Yujin Ko ◽

Ji Eun Moon ◽

Sangsoo Han

Keyword(s):

Suicidal Ideation ◽

Suicide Attempt ◽

Sleep Duration ◽

Suicide Attempts ◽

Sleep Problems ◽

Self Report ◽

Short Sleep Duration ◽

Sampling Weights ◽

Cross Sectional ◽

Increased Risk

Abstract Introduction: Suicidal ideation and suicide attempts are major risk factors for suicidal death, and sleep problems are associated with an increased risk for mental disorders. We investigated the relationship between sleep duration and suicidal ideation and suicide attempts in a representative sample of the Korean general population from a nationwide survey.Methods: We analyzed data collected from the Korea National Health and Nutrition Examination Survey VI and VII (2013–2018). Suicidal ideation was identified via self-report and we accessed suicide attempt history. Sleep duration was divided into three categories: short sleep duration (SSD) (≤5 h), normal sleep duration (NSD) (>5 and <9 h), and long sleep duration (LSD) (≥9 h). Sampling weights were applied to obtain estimates for the general Korean population.Results: Overall, 4015 (12.0%), 25,609 (76.5%), and 3857 (11.5%) participants were in the SSD, NSD, and LSD groups, respectively. Among these groups, 7.2%, 2.8%, and 3.3% reported suicidal ideation, 1.2%, 0.4%, and 0.7% reported a history of suicide attempts. Multiple regression analyses revealed that SSD was significantly more strongly associated with suicidal ideation (adjusted odds ratio [AOR] 1.46, p < 0.001) and attempts (AOR 2.05, p = 0.003) than NSD. No association was found between LSD and suicidal ideation/attempts. Conclusion: Sleep duration is significantly associated with suicidal behavior, and SSD was particularly closely related with an increased risk for suicidal ideation and suicide attempt. Clinicians should carefully consider sleep duration in suicidal patients.

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Relaksasi Benson Untuk Durasi Tidur Pasien Penyakit Jantung Koroner

Jurnal Endurance ◽

10.22216/jen.v3i3.2788 ◽

2018 ◽

Vol 3 (3) ◽

pp. 556

Author(s):

Mulyanti Roberto Muliantino ◽

Tuti Herawati ◽

Masfuri Masfuri

Keyword(s):

Cardiac Rehabilitation ◽

Sleep Duration ◽

Intervention Group ◽

Self Report ◽

Pharmacological Intervention ◽

Control Group ◽

P Value ◽

Short Sleep Duration ◽

Short Sleep ◽

Coronary Arterial Disease

Coronary Arterial Disease (CAD) is one of cardiovaskular disease that remain leading cause death and disability. Short sleep duration is the major symptoms in patients with CAD, during recovery period after cardiac events and during cardiac rehabilitation. Benson’s relaxation is one of relaxation as modalities therapy to increase sleep duration, however few studies related to this technique in planned intervention. This study was to measured the effectiveness of Benson’s relaxation in short sleep duration of CAD patients during cardiac rehabilitation. It was a quasi experimental pretest posttest control group design. This study included 29 respondens in Dr.M.Djamil Hospital were assigned to intervention group which receiving Benson’s relaxation technique (n=15) and control group with routine care (n=14). Benson’s relaxation technique was administered for 5 days 2 times a day, each 20 minutes to intervention group. Short sleep duration was measured using sleep diary (self report). The result indicated significant increasing in mean of sleep duration before and after Benson’s relaxation in intervention group (p value < 0,001). The study concluded that Benson’s relaxation technique is an effective non-pharmacological intervention to increase sleep duration in CAD patients. Penyakit jantung koroner menjadi masalah kardiovaskular yang mengakibatkan angka mortalitas yang tinggi. Durasi tidur pendek termasuk salah satu keluhan utama pasien penyakit jantung koroner pada masa recovery setelah serangan dan menjalani rehabilitasi fase 2. Relaksasi Benson merupakan teknik relaksasi sebagai terapi modalitas untuk mengurangi keluhan durasi tidur pendek, namum belum banyak penelitian terkait intervensi ini. Penelitian ini bertujuan untuk mengidentifikasi pengaruh relaksasi Benson terhadap durasi tidur pasien penyakit jantung koroner yang menjalani rehabilitasi fase 2. Penelitian ini menggunakan desain Quasi Eksperimen dengan pendekatan control group pretest posttest design pada 29 responden di RSUP. Dr.M.Djamil Padang yang dibagi dalam dua kelompok (kelompok intervensi dan kelompok kontrol). Hasil penelitian menunjukan ada perbedaan rerata durasi tidur yang signifikan antara sebelum dan setelah dilakukan intervensi relaksasi Benson pada kelompok intervensi (p value < 0,001). Simpulan hasil penelitian ini dapat menjadi salah satu terapi modalitas bagi perawat untuk mengatasi masalah durasi tidur pendek pada pasien penyakit jantung koroner.

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Associations between different components of executive control in childhood and sleep problems in early adolescence: A longitudinal study

Journal of Health Psychology ◽

10.1177/1359105318801065 ◽

2018 ◽

Vol 25 (13-14) ◽

pp. 2440-2452 ◽

Cited By ~ 1

Author(s):

Cara C Tomaso ◽

Jennifer Mize Nelson ◽

Kimberly Andrews Espy ◽

Timothy D Nelson

Keyword(s):

Working Memory ◽

Early Adolescence ◽

Executive Control ◽

Daytime Sleepiness ◽

Inverse Relationship ◽

Sleep Problems ◽

Interference Suppression ◽

Self Report ◽

Poor Sleep ◽

The Impact

Research has examined the impact of poor sleep on executive control and related abilities, but the inverse relationship has received less attention. Youth completed objective executive control tasks in childhood ( N = 208; Mage = 10.03; 50.5% girls) and self-report measures of sleep–wake problems and daytime sleepiness in early adolescence ( Mage = 12.00). Poorer interference suppression and flexible shifting abilities both predicted sleep–wake problems, but response inhibition and working memory did not. For daytime sleepiness, interference suppression was the only significant predictor among executive control components. Socioeconomic status did not moderate any of these associations. Findings have implications for targeting specific executive control abilities in childhood to improve sleep outcomes later in development.

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Abstract P335: Associations of Sleep Duration and Sleep Quality With Physical Performance in Older Adults --The Chicago Healthy Aging Study (CHAS)

Circulation ◽

10.1161/circ.137.suppl_1.p335 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

ThanhHuyen T Vu ◽

Kathryn J Reid ◽

Martha L Daviglus ◽

Daniel B Garside ◽

Kiang Liu ◽

...

Keyword(s):

Sleep Disturbance ◽

Sleep Duration ◽

Physical Performance ◽

Gait Speed ◽

Healthy Aging ◽

Handgrip Strength ◽

Short Sleep Duration ◽

Aging Study ◽

Normal Sleep ◽

And Performance

Background: Sleep duration (too short or too long) is associated with lower physical performance. However, the association of sleep duration and physical performance, taking into account the quality of sleep (e.g., sleep disturbance) in older populations, has not been thoroughly investigated. Methods: Using data from the Chicago Healthy Aging study conducted in 2007-10, we investigated a cross-sectional association of a combination of sleep duration and sleep disturbance with muscle strength (hand grip), and performance [4m gait speed and Short Physical Performance Battery (SPPB)]. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep duration [categorized as short (≤ 6 hours), normal (7-8 hours), and long (≥ 9 hours)] and sleep disturbance (defined as either cannot fall asleep within 30 minutes or waking up in the middle of the night or early morning three or more times per week). (See Table and Table Footnote for definitions of sleep duration and disturbance, and physical performance categories). Multivariable logistic regression analysis was used. Results: The study sample consists of 952 men and 350 women, ages 65-84 (mean age 71) in 2007-10; 9% were African American.12.6 % had SPPB score ≤ 8, 6.8 % had gait speed on 4 meter course < 0.8 m/s, and 23.4 % had low sex-BMI specific handgrip strength. As compared to the group with normal sleep duration (7-8 hours) without sleep disturbance, adjusted odds (95% confidence interval) of low gait speed <0.8 m/s in those with short sleep duration (≤ 6 hours) and sleep disturbance was much higher [2.00 (1.06-3.75)]. Similarly, the odds of low sex-BMI specific handgrip strength was about 2 times higher in those with long duration of sleep (≥ 9 hours), compared to those with normal sleep duration without sleep disturbance. No association was found for Short Physical Performance Battery (see Table). Conclusion: In older age, short sleep duration with poor quality as well as excessive sleep duration were associated with the greater likelihood of having low muscle strength and performance.

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Shuteye Time Compared With Bedtime: Misclassification of Sleep in Adolescent Females

Journal for the Measurement of Physical Behaviour ◽

10.1123/jmpb.2020-0042 ◽

2021 ◽

pp. 1-6

Author(s):

Jillian J. Haszard ◽

Tessa Scott ◽

Claire Smith ◽

Meredith C. Peddie

Keyword(s):

Sleep Duration ◽

Sedentary Time ◽

Vegetable Intake ◽

Healthy Lifestyle ◽

Self Report ◽

Short Sleep Duration ◽

Physical Activity Guidelines ◽

Substantial Error ◽

The Relationship ◽

Sedentary Activities

Short sleep duration is associated with poorer outcomes for adolescents; however, sleep duration is often assessed (either by questionnaire or device) using self-reported bedtime (i.e., the time a person goes to bed). With sedentary activities, such as screen time, being common presleep in-bed behaviors, the use of “bedtime” may introduce error to the estimates of sleep duration. It has been proposed that self-reported “shuteye time” (i.e., the time a person starts trying to go to sleep) is used instead of bedtime. This study aimed to compare the bedtimes and shuteye times of a sample of 15- to 18-year-old female adolescents recruited from 13 high schools across New Zealand. The influence on sleep duration estimates and associations with healthy lifestyle habits was also examined. Sleep data were collected from 136 participants using actigraphy and self-report. On average, 52 min (95% confidence interval [43, 60] min) of sedentary time was misclassified as sleep when bedtime was used instead of shuteye time with actigraph data. Mean bedtimes on weekdays and weekends were 9:56 p.m. (SD = 58 min) and 10:40 p.m. (SD = 77 min), respectively. The relationship between bedtime and shuteye time was not linear—indicating that bedtime cannot be used as a proxy for shuteye time. Earlier shuteye times were more strongly associated with meeting fruit and vegetable intake and sleep and physical activity guidelines than earlier bedtimes. Using bedtime instead of shuteye time to estimate sleep duration may introduce substantial error to estimates of both sleep and sedentary time.

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Abstract P545: Insufficient Sleep and Nitric Oxide-Mediated Endothelium-Dependent Vasodilation in Adults With Elevated Blood Pressure

Circulation ◽

10.1161/circ.141.suppl_1.p545 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Kelly A Stockelman ◽

Anthony R Bain ◽

Dana M Withrow ◽

Tracey A Larson ◽

Elizabeth M Boland ◽

...

Keyword(s):

Oxidative Stress ◽

Nitric Oxide ◽

Blood Pressure ◽

Sleep Duration ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Short Sleep Duration ◽

Insufficient Sleep ◽

Short Sleep ◽

Normal Sleep

Elevated blood pressure (BP ≥130/80 mmHg) is associated with increased risk for myocardial infarction, heart failure, stroke and vascular disease. Insufficient nightly sleep (<7 h/night) has been linked not only to the etiology of elevated blood pressure but is a prevalent, often ignored, comorbidity. Indeed, short sleep duration is now considered to be a plausible risk factor for elevated blood pressure and a harbinger of increased cardiovascular risk. A high prevalence of insufficient nightly sleep has been reported in adults with elevated blood pressure. The influence of insufficient sleep on endothelial vasodilator function in adults with elevated blood pressure is unknown. We tested the hypotheses that chronic insufficient sleep is associated with diminished nitric oxide (NO)-mediated endothelium-dependent vasodilation in adults with elevated blood pressure. Moreover, the insufficient sleep-related reduction in endothelial vasodilator function is due, at least in part to increased oxidative stress. Thirty-five middle-aged and older adults with elevated blood pressure were studied: 15 with normal nightly sleep duration (11M/4F; age: 58±2 yr; BP: 136/82±1/2 mmHg; sleep: 7.6±0.2 h/night) and 20 with short nightly sleep duration (14M/6F; 58±1 yr; BP: 138/84±1/1 mmHg; sleep: 6.0±0.1 h/night). Forearm blood flow (FBF) responses to intra-arterial infusion of acetylcholine (ACh), in the absence and presence of the endothelial NO synthase inhibitor N G -monomethyl-L-arginine (L-NMMA) and the antioxidant vitamin C were determined by venous occlusion plethysmography. The FBF response to ACh was significantly lower (~20%) in the short sleep (from 3.8±0.2 to 11.0±0.6 ml/100 ml tissue/min) compared with the normal sleep duration group (from 4.2±0.2 to 13.6±0.6 ml/100 ml tissue/min). L-NMMA significantly reduced (~25%) the FBF response to ACh in the normal sleep but not the short sleep group. Vitamin C markedly increased (~35%; P<0.05) the vasodilator response to ACh in short sleepers only. In summary, habitual short sleep duration worsens NO-mediated endothelium-dependent vasodilation in adults with elevated blood pressure. Furthermore, the sleep-related diminishment in endothelial vasodilator function is due, in part, to increased oxidative stress.

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Depressive symptoms and sleep problems as risk factors for heart disease: a prospective community study

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796019000441 ◽

2019 ◽

Vol 29 ◽

Cited By ~ 2

Author(s):

S. S. Deschênes ◽

R. J. Burns ◽

E. Graham ◽

N. Schmitz

Keyword(s):

Risk Factors ◽

Heart Disease ◽

Depressive Symptoms ◽

Sleep Disorders ◽

Sleep Duration ◽

Sleep Problems ◽

Self Report ◽

World Health ◽

Diagnostic Codes ◽

Long Sleep

Abstract Aims The goals of the present study were to examine the associations between depressive symptoms, sleep problems and the risk of developing heart disease in a Canadian community sample. Methods Baseline data were from the CARTaGENE study, a community health survey of adults aged 40–69 years in Quebec, Canada. Incidence of heart disease was examined in N = 33 455 participants by linking survey data with administrative health insurance data. Incident heart disease was identified using the World Health Organization's International Classification of Diseases, 9th or 10th edition (ICD-9 and ICD-10) diagnostic codes for heart disease. Sleep problems were assessed with diagnostic codes for sleep disorders within the 2 years preceding the baseline assessment. Average sleep duration was assessed by self-report. Depressive symptoms were assessed with the nine-item Patient Health Questionnaire. Results In total, 2448 (7.3%) participants developed heart disease over an average follow-up period of 4.6 years. Compared to those without depressive symptoms and with no sleep disorders, those with elevated depressive symptoms and a sleep disorder (HR = 2.60, 95% CI 1.83–3.69), those with depressive symptoms alone (HR = 1.40, 95% CI 1.25–1.57) and those with sleep disorders alone (HR = 1.33, 95% CI 1.03–1.73) were more likely to develop heart disease. Test of additive interaction suggested a synergistic interaction between depressive symptoms and sleep disorders (synergy index = 2.17 [95% CI 1.01–4.64]). When sleep duration was considered, those with long sleep duration and elevated depressive symptoms were more likely to develop heart disease than those with long sleep alone (HR = 1.77, 95% CI 1.37–2.28; and HR = 1.16, 95% CI 0.99–1.36, respectively). Conclusions Depression and diagnosed sleep disorders or long sleep duration are independent risk factors for heart disease and are associated with a stronger risk of heart disease when occurring together.

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