| 1. |
- Overton, Marieclaire, et al.
(författare)
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Sleep disturbances and change in multiple cognitive domains among older adults: a multicenter study of five Nordic cohorts
- 2024
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Ingår i: SLEEP. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 47:3
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives: We examined and compared cross-sectional and longitudinal associations between self-reported sleep disturbances and various cognitive domains in five separate Nordic European longitudinal aging studies (baseline N = 5631, mean age = 77.7, mean follow-up = 4.16 years).Methods: Comparable sleep parameters across studies included reduced sleep duration/quality, insomnia symptoms (sleep latency, waking up at night, and early awakenings), short and long sleep duration, and daytime napping. The cognitive domains were episodic memory, verbal fluency, perceptual speed, executive functioning, and global cognition (aggregated measure). A series of mixed linear models were run separately in each study and then compared to assess the level and rate of change in cognitive functioning across each sleep disturbance parameter. Models were adjusted for age, sex, education, hypnotic usage, depressive symptoms, lifestyle factors, cardiovascular, and metabolic conditions. By using a coordinated analytic approach, comparable construct-level measurements were generated, and results from identical statistical models were qualitatively compared across studies.Results: While the pattern of statistically significant results varied across studies, subjective sleep disturbances were consistently associated with worse cognition and steeper cognitive decline. Insomnia symptoms were associated with poorer episodic memory and participants sleeping less or more than 7-8 hours had a steeper decline in perceptual speed. In addition, daytime napping (>2 hours) was cross-sectionally and longitudinally associated with all examined cognitive domains. Most observed associations were study-specific (except for daytime napping), and a majority of association estimates remained significant after adjusting for covariates.Conclusion: This rigorous multicenter investigation further supports the importance of sleep disturbance, including insomnia, long and short sleep duration, and daytime napping on baseline cognitive functioning and rate of change among older adults. These sleep factors may be targeted in future lifestyle interventions to reduce cognitive decline.
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| 2. |
- Cai, Gui-Hong, et al.
(författare)
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Both weight at age 20 and weight gain have an impact on sleep disturbances later in life : Results of the EpiHealth study
- 2018
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 41:1
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives: Obesity is often associated with impaired sleep, whereas the impact of body mass index (BMI) at younger age and previous weight gain on sleep problems remains unknown. Methods: The present study utilized data from the Swedish EpiHealth cohort study. A total of 15845 participants (45–75 years) filled out an internet-based questionnaire. BMI was calculated from both measured data at study time and self-reported data at age 20 from the questionnaire. Results: Sleep-related symptoms were most common among obese individuals (BMI > 30 kg/m2). An association between weight gain and sleep problems was found and those with a low BMI at age 20 were most vulnerable to weight gain when it came to risk of sleep problems. Among those who were underweight (BMI < 18.5 kg/m2) at age 20, weight gain (kg/year) was associated with difficulties initiating sleep with an adjusted OR of 2.64 (95% CI: 1.51–4.62) after adjusting for age, sex, smoking, alcohol consumption, physical activity, education, and civil status. The corresponding adjusted OR’s among those who had been normal weight (BMI 18.5–24.99) and overweight (BMI 25–29.99 kg/m2) at age 20 were 1.89 (1.47–2.45) and 1.02 (0.48–2.13), respectively. Also difficulties maintaining sleep and snoring were most strongly related to weight gain among those who were underweight at age 20 with decreasing odds with increasing BMI at that age. Conclusions: Sleep problems are related to weight gain and obesity. The impact of weight is most pronounced among those who had a low BMI when young.
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| 4. |
- Engström, Maria, 1958-, et al.
(författare)
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Thalamic Activation in the Kleine-Levin Syndrome
- 2014
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Ingår i: Sleep. - United States : Associated Professional Sleep Societies, Llc. - 0161-8105 .- 1550-9109. ; 37:2, s. 379-386
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Tidskriftsartikel (refereegranskat)abstract
- STUDY OBJECTIVES:The objective of this study was to investigate if combined measures of activation in the thalamus and working memory capacity could guide the diagnosis of Kleine-Levin Syndrome (KLS). A second objective was to obtain more insight into the neurobiological causes of KLS.DESIGN:Matched group and consecutive recruitment.SETTING:University hospital neurology department and imaging center.PATIENTS OR PARTICIPANTS:Eighteen patients with KLS diagnosed according to the International Classification of Sleep Disorders and 26 healthy controls were included.INTERVENTIONS:N/A.MEASUREMENTS AND RESULTS:Working memory capacity was assessed by the listening span task. A version of this task (reading span) was presented to the participants during functional magnetic resonance imaging (fMRI). Activation in the thalamus was measured in a region of interest analysis. A combination of the working memory capacity and the thalamic activation measures resulted in 80% prediction accuracy, 81% sensitivity, and 78% specificity regarding the ability to separate KLS patients from healthy controls. The controls had an inverse relation between working memory capacity and thalamic activation; higher performing participants had lower thalamic activation (r = -0.41). KLS patients showed the opposite relationship; higher performing participants had a tendency to higher thalamic activation (r = -0.35).CONCLUSIONS:This study shows that functional neuroimaging of the thalamus combined with neuropsychological assessment of working memory function provides a means to guide diagnosis of Kleine-Levin Syndrome. Results in this study also indicate that imaging of brain function and evaluation of cognitive capacity can give insights into the neurobiological mechanisms of Kleine-Levin Syndrome.
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| 6. |
- Cedernaes, Jonathan, et al.
(författare)
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Short Sleep Makes Declarative Memories Vulnerable to Stress in Humans
- 2015
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 38:12, s. 1861-1868
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Tidskriftsartikel (refereegranskat)abstract
- Study Objective: This study sought to investigate the role of nocturnal sleep duration for the retrieval of oversleep consolidated memories, both prior to and after being cognitively stressed for similar to 30 minutes the next morning. Design: Participants learned object locations (declarative memory task comprising 15 card pairs) and a finger tapping sequence (procedural memory task comprising 5 digits) in the evening. After learning, participants either had a sleep opportunity of 8 hours (between similar to 23:00 and similar to 07:00, full sleep condition) or they could sleep between similar to 03:00 and similar to 07:00 (short sleep condition). Retrieval of both memory tasks was tested in the morning after each sleep condition, both before (similar to 08:30) and after being stressed (similar to 09:50). Setting: Sleep laboratory. Participants: 15 healthy young men. Results: The analyses demonstrated that oversleep memory changes did not differ between sleep conditions. However, in their short sleep condition, following stress hallmarked by increased subjective stress feelings, the men were unable to maintain their pre-stress performance on the declarative memory task, whereas their performance on the procedural memory task remained unchanged. While men felt comparably subjectively stressed by the stress intervention, overall no differences between pre- and post-stress recalls were observed following a full night of sleep. Conclusions: The findings suggest that 8-h sleep duration, within the range recommended by the US National Sleep Foundation, may not only help consolidate newly learned procedural and declarative memories, but also ensure full access to both during periods of subjective stress.
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| 7. |
- Clark, Alice, et al.
(författare)
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Sleep Impairment and Prognosis of Acute Myocardial Infarction : A Prospective Cohort Study
- 2014
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 37:5, s. 851-U215
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives: Impaired sleep is an established risk factor for the development of cardiovascular disease, whereas less is known about how impaired sleep affects cardiovascular prognosis. The aim of this study is to determine how different aspects of impaired sleep affect the risk of case fatality and subsequent cardiovascular events following first-time acute myocardial infarction (AMI). Design: Prospective cohort study. Setting: The Stockholm Heart Epidemiology Program, Sweden. Participants: There were 2,246 first-time AMI cases. Measurements and Results: Sleep impairment was assessed by the Karolina Sleep Questionnaire, which covers various indices of impaired sleep: disturbed sleep, impaired awakening, daytime sleepiness, and nightmares. Case fatality, defined as death within 28 days of initial AMI, and new cardiovascular events within up to 10 y of follow-up were identified through national registries. In women, disturbed sleep showed a consistently higher risk of long-term cardiovascular events: AMI (hazard ratio [HR] = 1.69; 95% confidence interval [CI] 0.95-3.00), stroke (HR = 2.61; 95% CI: 1.19-5.76), and heart failure (HR = 2.43; 95% CI: 1.18-4.97), whereas no clear effect of impaired sleep on case fatality was found in women. In men, a strong effect on case fatality (odds ratio = 3.27; 95% CI: 1.76-6.06) was observed in regard to impaired awakening; however, no consistent effect of impaired sleep was seen on long-term cardiovascular prognosis. Conclusion: Results suggest sex-specific effects of impaired sleep that differ by short-and long-term prognosis. Sleep complaints are frequent, easily recognizable, and potentially manageable. Evaluation of sleep complaints may, even if they represent prognostic markers rather than risk factors, provide additional information in clinical risk assessment that could benefit secondary cardiovascular prevention.
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| 8. |
- Cordoza, Makayla, et al.
(författare)
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Feelings of Emotional Exhaustion and Depersonalization Predict Self-Report of Trouble Sleeping for Nurses Working in Hospital Environments
- 2019
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction American nurses report sleeping an average of 6.8 hours per night on workdays, which is less than the recommended 7-9 hours. Burnout, which is comprised of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA), is common among nurses and may contribute to insufficient sleep quantity and sleep disruption. We aimed to investigate if burnout, measured using the Maslach Burnout Inventory (MBI), predicted self-report of trouble sleeping for nurses working in the hospital. Methods This is a secondary report of a prospective crossover trial of nurses assigned to either 6 weeks of daily work-breaks in an outdoor hospital garden or 6 weeks of indoor-only breaks. After a 1-week washout period, break assignments were switched for an additional 6 weeks. Nurses completed the MBI at the beginning and end of each 6-week period. Each workday, nurses completed a visual analog scale reporting no trouble sleeping to much trouble sleeping immediately following a break. For this analysis, we used initial MBI subscale score (EE, DP, PA) as a predictor of mean trouble sleeping over the subsequent 6-week period regardless of break location using generalized estimating equations. Results A total of 29 nurses (27 females, mean age 42.8 years) participated. Most (n=20) worked dayshift, and 9 worked night shift. Initial MBI subscale score, regardless of break location, was predictive of mean self-report of trouble sleeping over the subsequent 6-week period for EE (p<0.001) and DP (p=0.004), but not for PA (p=0.48). When divided by break assignment (indoor-only vs garden), results were similar for EE (indoor p<0.001; garden p<0.001), DP (indoor p<0.001; garden p<0.001), and PA (indoor p=0.20; garden p=0.49). Conclusion The MBI subscales of EE and DP were predictive of self-report of trouble sleeping for nurses in this study. Further research using objective measures of sleep are needed to confirm and extend these preliminary observations. Support (If Any) Funding for this research was provided by the TKF Foundation as part of the National Open Spaces Sacred Places Initiative.
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| 9. |
- Edell-Gustafsson, Ulla, et al.
(författare)
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Sleep-activity profile and quality of life in patients with stable coronary disease
- 2003
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Ingår i: Sleep. - Westchester, IL, United States : Associated Professional Sleep Societies, Llc. - 0161-8105 .- 1550-9109. ; 26:Abstract supplement, s. A357-A357
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Previous studies have examined the relationship between initiation sleep difficulties and quality of life. However, when reviewing the literature in this area we found no reports of a relationship between evening physical activity and health related quality of life in patients with coronary disease. This study was designed to investigate assumed sleep, circadian rhythm, evening physical activity and health related quality of life.Methods: Twenty-six men and 21 women, mean age 64.0 (SD 8.9) years and 63 (SD 9.3) years, respectively, with stable angina pectoris were included. For assessment of health related quality of life the patients completed the SF36 questionnaire. The data were compared with those for men and women in the general Swedish population. Physical activity was continuously recorded at home, using actigraphy with an integral light recorder (Model AW-L, Cambridge Neurotechnology Ltd, UK) in 1-minute epochs during one week. The data were downloaded by Actiwatch Reader and imported to the Actiwatch software for Windows 98.Results: Average time of going to bed was 22.37, sleep latency 27 minutes, assumed sleep duration 7.59 hr, time in bed 8.56 hr and sleep efficiency 79.2%. No differences were found during the seven nights. Nonparametric analysis of the circadian rhythm showed that 39 of 47 patients had the lowest 5-hour count activity onset at 00.00 p.m. and 41of 47 patients had the maximal 10 hr count onset 08.00 a.m. or later. Sleep analysis indicated reduced activity in the evening (p.m. 06.00-09.00). Some actigraphic parameters of the evening activity associated significantly with circadian rhythm parameters. Compared to the general Swedish population, the patients ́ health related quality of life waspoor. Linear stepwise regression analysis showed that reduced activity 3 evenings/week significantly explained health related quality of life in32.3% of role function outcome, due to physical causes (p=0.0001) and in 24.7% (p<0.01) of social function, whereas reduced activity 2 evenings/week explained 20% (p<0.01) of body pain.Conclusions: These data indicate that sleep-activity profile is associated with health related quality of life in patients with stable angina pectoris.
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| 10. |
- Fjell, Anders M., et al.
(författare)
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Self-reported sleep relates to hippocampal atrophy across the adult lifespan : results from the Lifebrain consortium
- 2020
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Ingår i: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 43:5
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Poor sleep is associated with multiple age-related neurodegenerative and neuropsychiatric conditions. The hippocampus plays a special role in sleep and sleep-dependent cognition, and accelerated hippocampal atrophy is typically seen with higher age. Hence, it is critical to establish how the relationship between sleep and hippocampal volume loss unfolds across the adult lifespan.Methods: Self-reported sleep measures and MRI-derived hippocampal volumes were obtained from 3105 cognitively normal participants (18–90 years) from major European brain studies in the Lifebrain consortium. Hippocampal volume change was estimated from 5116 MRIs from 1299 participants for whom longitudinal MRIs were available, followed up to 11 years with a mean interval of 3.3 years. Cross-sectional analyses were repeated in a sample of 21,390 participants from the UK Biobank.Results: No cross-sectional sleep—hippocampal volume relationships were found. However, worse sleep quality, efficiency, problems, and daytime tiredness were related to greater hippocampal volume loss over time, with high scorers showing 0.22% greater annual loss than low scorers. The relationship between sleep and hippocampal atrophy did not vary across age. Simulations showed that the observed longitudinal effects were too small to be detected as age-interactions in the cross-sectional analyses.Conclusions: Worse self-reported sleep is associated with higher rates of hippocampal volume decline across the adult lifespan. This suggests that sleep is relevant to understand individual differences in hippocampal atrophy, but limited effect sizes call for cautious interpretation.
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