Sleep and the gut microbiota in preschool aged children

Sleep plays a significant role in the mental and physical development of children. Emerging evidence in animals and human adults indicates a relationship between sleep and the gut microbiota; however, it is unclear whether the sleep of preschoolers during a key developmental period, associates with features of their gut microbiota. The objective of this study was to assess the relationship between sleep and gut microbiota in preschool aged children (4.37 ±0.48 years, n=143). Sleep measures included total nighttime sleep (TST), sleep efficiency (SE), and wake-time after sleep onset (WASO) assessed using actigraphy. Beta-diversity differences between children with low and high TST (p =0.048) suggest gut microbiota community differences. Particularly, relative abundance of Bifidobacterium was higher in the high TST group and Bacteroides, was higher in children who had higher SE and low WASO (LDA score >2). In contrast, some Lachnospiraceae members including Blautia and Coprococcus 1 were associated with shorter nighttime sleep duration and less efficiency, respectively. We also found a group of faecal metabolites, including specific neuroactive compounds and immunomodulating metabolites were associated with greater sleep efficiency and less time awake at night. Notably, tryptophan and its metabolizing products were higher in children who had higher SE or lower WASO (LDA score >2); concentration of propionate was higher in children with lower WASO (p =0.036). Overall, our results reveal a novel association between sleep and gut microbiota in preschool aged children. Longer nighttime sleep and greater sleep efficiency were associated with specific commensal bacteria that may regulate sleep through modulating neurotransmitter metabolism and the immune system.

Temporal relationships between device-derived sedentary behavior, physical activity, and sleep in early childhood

Study Objectives Understanding the ideal composition of a child’s day requires a better understanding of the relations between wake behaviors (sedentary behavior [SB], physical activity [PA]) and sleep. Here we examine between- and within-person temporal associations between daytime wake behaviors and overnight sleep in early childhood, an important age when healthy behaviors are initiated and 24-hour behaviors are largely determined by caregivers. Methods Daily, repeated measures of wake behavior and overnight sleep were assessed via wrist-worn actigraphy (mean=9 days/nights) in 240 children (50.8±9.8 months). Multilevel models with lagged effects were used to examine the temporal associations between wake and overnight sleep measures and adjusted for daily nap duration, age, sex, and socioeconomic status. Results Between-person associations for sleep outcomes were negative between MVPA and total activity for sleep efficiency (SE). Between-person associations for wake outcomes were positive between sleep duration and light PA, and negative between SE and both MVPA and total PA. When children obtained higher SE relative to their individual average, they were more likely to engage in less SB and greater MVPA and total PA the next day. Conclusions Generally, days with greater activity or sleep were not associated with greater subsequent sleep or PA. Most subsequent behaviors were not influenced by children achieving higher activity or sleep relative to their individual average levels, although higher sleep efficiency was beneficially associated with next day wake behaviors. Future analyses with young children should consider within-person associations and could investigate lagged effects beyond one day.

Characteristics of Obstructive Sleep Apnea Patients With Hypertension and Factors Associated With Autotitration Acceptance

In order to explore the characteristics and treatment status of obstructive sleep apnea (OSA) patients with hypertension, a retrospective study was conducted on 306 patients admitted from October 2018 to December 2019. According to the apnea hypopnea index (AHI), OSA patients with hypertension were divided into three groups. 69 cases were mild OSA (5 ≤ AHI < 15), 86 cases were moderate (15 ≤ AHI < 30), and 151 cases were severe (AHI ≥ 30). Compared with patients in the mild and moderate groups, the severe group had more male patients, with higher body mass index (BMI) and non-rapid eye movement stage 1 accounted for total sleep time (N1%), and lower non-rapid eye movement stage 2 accounted for total sleep time (N2%), average and minimum blood oxygen. Among all the patients, those who underwent the titration test accounted for 20.6% (63/306). Multivariate analysis showed that sleep efficiency (p < 0.001) and AHI (p < 0.001) were independent factors for patients to accept titration test. OSA patients with hypertension had a low acceptance of titration therapy. These people with higher sleep efficiency and AHI were more likely to receive autotitration.

Self-reported sleep characteristics associated with dementia among rural-dwelling Chinese older adults: a population-based study

Background Sleep characteristics associated with dementia are poorly defined and whether their associations vary by demographics and APOE genotype among older adults are unclear. Methods This population-based cross-sectional study included 4742 participants (age ≥ 65 years, 57.1% women) living in rural China. Sleep parameters were measured using the self-rated questionnaires of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. Global cognitive function was assessed with the Mini-Mental State Examination (MMSE). Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, and the National Institute on Aging-Alzheimer’s Association criteria for Alzheimer’s disease (AD). Data were analysed using multiple logistic and general linear regression models. Results Dementia was diagnosed in 173 participants (115 with AD). Multivariable-adjusted odds ratio (OR) of dementia was 1.71 (95%CI, 1.07-2.72) for sleep duration ≤4 h/night (vs. > 6-8 h/night), 0.76 (0.49-1.18) for > 4-6 h/night, 1.63 (1.05-2.55) for > 8 h/night, 1.11 (1.03-1.20) for lower sleep efficiency (per 10% decrease), and 1.85 (1.19-2.89) for excessive daytime sleepiness. Very short sleep duration (≤4 h/night), lower sleep efficiency, and excessive daytime sleepiness were significantly associated with being diagnosed with AD (multivariable-adjusted OR range = 1.12-2.07; p < 0.05). The associations of sleep problems with dementia and AD were evident mainly among young-old adults (65-74 years) or APOE ε4 carriers. Among dementia-free participants, these sleep characteristics were significantly associated with a lower MMSE score. Conclusions Self-reported sleep problems in dementia are characterized by very short or long sleep duration, low sleep efficiency, and excessive daytime sleepiness, especially among young-old people and APOE ε4 carriers. Trial registration ChiCTR1800017758 (Aug 13, 2018).

Epilepsy and Sleep in the ATR-X Syndrome

Background This study explores the prevalence, clinical characteristics, and treatment of epilepsy and sleep disorders in α thalassemia mental retardation (ATR-X) syndrome. Design In this cross-sectional study, 37 participants with ATR-X syndrome aged 1.8 to 44 years were studied using a customized epilepsy questionnaire, review of electroencephalography (EEG) findings, the modified Sleep Questionnaire of Simonds and Parraga and 2-week sleep diary. Results Eleven participants had a clinical diagnosis of generalized epilepsy (29.7%). Seizure types were generalized tonic-clonic seizures, absences, and myoclonia. Interictal EEG recordings in participants with GTCS showed no epileptic discharges in 78%. Similarly, EEG recordings during myoclonia and absences often demonstrated no epileptic discharges. Sleep problems (difficulty falling or maintaining sleep, and early awakening) were reported in 70%. Participants with reported sleep problems went to bed earlier (p = 0.027) and had a lower sleep efficiency (p < 0.01) than participants without sleep problems, but as a group they both had a sufficient total sleep time (9 hours and 52 minutes vs. 10 hours and 55 minutes). Sixteen participants (43.2) used medication to improve sleep (predominantly melatonin n = 10), being effective in only two. Conclusion One-third of participants with ATR-X syndrome had a clinical diagnosis of epilepsy, but the absence of EEG abnormalities in suspected epileptic seizures questions this diagnosis in these patients. EEG recording during seizure like symptoms is warranted before making an epilepsy diagnosis. Seventy percent experienced sleep problems, although total sleep time was normal in most participants. Long bedtimes might have a negative influence on sleep efficiency.

Acupuncture Improves Certain Aspects of Sleep in Hematopoietic Stem Cell Transplantation Patients: a Randomized Controlled Trial

Background High-dose chemotherapy followed by hematopoietic stem cell transplantation (HSCT) is associated with a high symptom burden including decrease in sleep quality. We conducted a randomized sham-controlled trial (#NCT01811862) to study the effect of acupuncture on sleep quality during HSCT. Methods Adult multiple myeloma patients undergoing inpatient and outpatient autologous HSCT were randomized to receive either true or sham acupuncture once daily for 5 days starting the day after chemotherapy. Sleep onset, total sleep time, sleep efficiency percentage, and sleep-onset latency time were assessed using an Actigraphy Sleep Monitor. A multi-variate regression analysis was conducted to compare the average area-under-the-curve of five acupuncture intervention days for each sleep outcome between groups, adjusted by baseline score and inpatient or outpatient chemotherapy stratum. Results Over 32 months, 63 patients were enrolled. Participants undergoing true acupuncture experienced a significant improvement in sleep efficiency when compared to sham (-6.70, 95% CI -13.15, -0.25, p=0.042). Subgroup analysis showed that the improvement is more prominent in the inpatient setting (-9.62, 95% CI -18.76, -0.47, p=0.040). True acupuncture produced noticeable yet non-significant improvement in sleep-onset latency times. Between-group differences in other sleep related variables were not statistically significant. Conclusion Our data suggest that true acupuncture may improve certain aspects of sleep, including sleep efficiency and possibly sleep-onset latency, in multiple myeloma patients undergoing HSCT. By studying patient reported outcomes in future larger scale studies, acupuncture’s role in improving sleep quality during HSCT treatment can be further elucidated.

The Association Between Self-Reported Screen Time, Social Media Addiction, and Sleep Among Norwegian University Students

The aim of this study was to assess the relationship between daily screen time and sleep, evening screen time and sleep, and between social media addiction and sleep in a student population. This cross-sectional study is based on data from a national survey of all college and university students in Norway (the SHoT2018 study; n = 49,051). The sleep outcomes were sleep duration, sleep onset latency, sleep efficiency, and insomnia operationalized according to formal DSM-5 criteria. The results show a strong negative association between time spent on screen-based devices and sleep quality and quantity, and where screen use in bed had more consistent negative associations with sleep. Furthermore, there were higher rates of insomnia among those with higher levels of addiction, and curvilinear relationships with sleep duration, sleep onset latency, and sleep efficiency. Those with higher levels of addiction also had more evening screen time. The findings suggest that screen use plays an important role in students' sleep quantity and quality, where evening screen time has a stronger relationship with sleep compared to total daily screen time. The results also suggest a role of social media addiction, and addictive social media use may be a target for intervention in order to reduce evening screen time.

Sleep Characteristics According to Gender and Age Measured by Wrist Actigraphy

The sleep/wake rhythm is one of the most important biological rhythms. Quality and duration of sleep change during lifetime. The aim of our study was to determine differences in sleep efficiency, movement, and fragmentation during sleep period between genders and according to age. Sleep period was monitored by wrist actigraphy under home-based conditions. Seventy-four healthy participants—47 women and 27 men participated in the study. The participants were divided by age into groups younger than 40 years and 40 years and older. Women showed lower sleep fragmentation and mobility during sleep compared to men. Younger women showed a higher actual sleep and sleep efficiency compared to older women and younger men. Younger men compared to older men had a significantly lower actual sleep, lower sleep efficiency and significantly more sleep and wake bouts. Our results confirmed differences in sleep parameters between genders and according to age. The best sleep quality was detected in young women, but gender differences were not apparent in elderly participants, suggesting the impact of sex hormones on sleep.

Sleep Disturbances Are Associated With Depressive Symptoms in a Chinese Population: The Rugao Longevity and Aging Cohort

Objective: To investigate the cross-sectional and longitudinal relationships between sleep disturbances and depressive symptoms in older Chinese adults.Methods: This study included baseline and 3.5-year follow-up data of 1,631 Chinese men and women aged 70 years or older from the aging arm of the Rugao Longevity and Aging Study. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS). Sleep disturbances were assessed by using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression models were used to estimate the odds ratios (ORs) of the associations.Results: In the cross-sectional analysis, individuals with greater total PSQI scores exhibited significantly higher risk of “depressive symptoms” (OR: 1.31, 95% CI: 1.21–1.41) and “some depressive symptoms” (OR: 1.22, 95% CI: 1.17–1.28). Specifically, higher scores on the sleep efficiency PSQI subscale were associated with greater odds for “depressive symptoms” (OR: 1.54, 95% CI: 1.30–1.84) and “some depressive symptoms” (OR: 1.42, 95% CI: 1.29–1.57). Our longitudinal analyses indicated an association between greater PSQI total scores at baseline and greater odds of having “some depressive symptoms” at follow-up (OR: 1.07, 95% CI: 1.00–1.14). Additionally, higher scores on the sleep efficiency PSQI subscale had an association with higher odds for “some depressive symptoms” (OR: 1.21, 95% CI: 1.04–1.41).Conclusions: Poor self-reported global sleep quality and sleep efficiency PSQI subscale scores were associated with levels of depressive symptoms in an older Chinese population, indicating that global sleep quality and sleep efficiency may be risk factors for depression and can possibly predict the levels of depressive symptoms.

Stronger Associations Between Sleep and Mental Health in Adults with Autism: A UK Biobank Study

This study examined sleep and its cognitive and affective correlates in adults with and without autism spectrum disorder (ASD), utilizing UK Biobank data. There were no group differences in subjective sleep duration [n = 220 ASD; n = 2200 general population (GP)]. Accelerometer measures of sleep duration or nighttime activity did not differ by group, but sleep efficiency was marginally lower in ASD (n = 83 ASD; n = 824 GP). Sleep efficiency was associated with wellbeing and mental health, and pathways between accelerometer sleep measures and wellbeing and mental health were significantly stronger for adults with ASD (who also reported substantially poorer wellbeing and > 5 × likelihood of experiencing mental distress). These findings highlight the need to monitor sleep to maintain good mental health in adult ASD.