1. |
- Nilsonne, G., et al.
(author)
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Increased global FMRI signal variability after partial sleep deprivation : Findings from the Stockholm sleepy brain study
- 2017
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In: SLEEP. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 40, s. A40-A40
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Conference paper (peer-reviewed)abstract
- Introduction: Neural correlates of sleep deprivation are not fully understood and the difference between young and older adults in this regard has received little attention. We aimed to investigate the effect of partial sleep deprivation on resting state connectivity.Methods: 30 younger (20–30 years) and 23 older (65–75 years) healthy participants underwent MR imaging after normal sleep and partial sleep deprivation (3 h sleep). We acquired two runs of eyes-open resting state functional magnetic resonance images. Participants were monitored with eye-tracking to ensure their eyes remained open during scanning.Results: Global signal variability, defined as log-transformed standard deviation of average gray matter signal, was increased following partial sleep deprivation (0.16 [0.07, 0.24], p = 0.0004). In contrast to previous studies, we did not find that partial sleep deprivation inhibited connectivity in the default mode network, nor in other major networks investigated.Conclusion: Sleep deprivation caused increased global signal variability. This novel finding should be confirmed using independent data. Our finding of no difference in default mode connectivity in the sleep deprived state, could possibly be due to stricter monitoring of participants’ wakefulness compared to some earlier studies.
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- Akerstedt, Torbjörn, et al.
(author)
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Sleep homeostasis during repeated sleep restriction and recovery : support from EEG dynamics.
- 2009
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 32:2, s. 217-22
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Journal article (peer-reviewed)abstract
- STUDY OBJECTIVES: Sleep reduction normally causes a homeostatic response during subsequent recovery sleep, but this does not seem to be true for repeated partial sleep loss. The aim of the present study was to test the response to repeated partial sleep loss through detailed focus on spectral data and parts of sleep. DESIGN: The experiment involved 4 h of sleep across 5 days in the laboratory (partial sleep deprivation [PSD]), followed by 3 days of recovery sleep. PSD was achieved through a delayed bedtime. Nine individuals participated. To avoid "laboratory monotony," subjects were permitted to leave the lab for a few hours each day. MEASUREMENTS AND RESULTS: All sleep stages and the latencies to sleep and slow wave sleep (SWS) showed a significant reduction during PSD. However, SWS and TST (total sleep time) during the first half of sleep increased gradually across days with PSD. During the first recovery sleep, SWS was significantly increased, while stage 1 and latency to stage 3 were reduced. All were back to baseline on the second night of recovery sleep. Summed spectral power during the first 3.8 h of sleep showed a gradual and robust increase (50% above baseline) in the range 1.25-7.25 Hz across days with PSD up to first recovery sleep and then returned to baseline. CONCLUSIONS: SWS and summed power density in a broad low-frequency band respond to repeated partial sleep deprivation in a dose-response fashion during the first 4 h sleep, apparently reflecting a robust and stable homeostatic response to sleep loss.
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- Araghi, Marzieh Hosseini, et al.
(author)
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Effectiveness of Lifestyle Interventions on Obstructive Sleep Apnea (OSA) : Systematic Review and Meta-Analysis
- 2013
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In: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 36:10, s. 1553-1562
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Research review (peer-reviewed)abstract
- Background: Obstructive sleep apnea (OSA) is a common sleep disorder associated with several adverse health outcomes. Given the close association between OSA and obesity, lifestyle and dietary interventions are commonly recommended to patients, but the evidence for their impact on OSA has not been systematically examined. Objectives: To conduct a systematic review and meta-analysis to assess the impact of weight loss through diet and physical activity on measures of OSA: apnea-hypopnea index (AHI) and oxygen desaturation index of 4% (ODI4). Methods: A systematic search was performed to identify publications using Medline (1948-2011 week 40), EMBASE (from 1988-2011 week 40), and CINAHL (from 1982-2011 week 40). The inverse variance method was used to weight studies and the random effects model was used to analyze data. Results: Seven randomized controlled trials (519 participants) showed that weight reduction programs were associated with a decrease in AHI (-6.04 events/h [95% confidence interval -11.18, -0.90]) with substantial heterogeneity between studies (I-2 = 86%). Nine uncontrolled before-after studies (250 participants) showed a significant decrease in AHI (-12.26 events/h [95% confidence interval -18.51, -6.02]). Four uncontrolled before-after studies (97 participants) with ODI4 as outcome also showed a significant decrease in ODI4 (-18.91 episodes/h [95% confidence interval -23.40, -14.43]). Conclusions: Published evidence suggests that weight loss through lifestyle and dietary interventions results in improvements in obstructive sleep apnea parameters, but is insufficient to normalize them. The changes in obstructive sleep apnea parameters could, however, be clinically relevant in some patients by reducing obstructive sleep apnea severity. These promising preliminary results need confirmation through larger randomized studies including more intensive weight loss approaches.
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- Axelsson, John, et al.
(author)
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Banking Sleep and Biological Sleep Need
- 2015
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 38:12, s. 1843-1845
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Journal article (other academic/artistic)
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11. |
- Axelsson, John, et al.
(author)
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Sleepiness as motivation : a potential mechanism for how sleep deprivation affects behavior
- 2020
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 43:6
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Journal article (peer-reviewed)abstract
- STUDY OBJECTIVES: To determine how sleepiness and sleep deprivation drive the motivation to engage in different behaviors.METHODS: We studied the sleepiness of 123 participants who had been randomized to sleep deprivation or normal sleep, and their willingness to engage in a range of everyday behaviors.RESULTS: Self-reported sleepiness was a strong predictor of the motivation to engage in sleep-preparatory behaviors such as shutting one's eyes (OR=2.78, 95%CI: 2.19-3.52 for each step up on the Karolinska Sleepiness Scale) and resting (OR=3.20, CI: 2.46-4.16). Sleepiness was also related to the desire to be cared for by a loved one (OR=1.49, CI: 1.22-1.82), and preparedness to utilize monetary and energy resources to get to sleep. Conversely, increased sleepiness was associated with a decreased motivation for social and physical activities (e.g., be with friends OR=0.71, CI: 0.61-0.82; exercise OR=0.65, CI: 0.56-0.76). Sleep deprivation had similar effects as sleepiness on these behaviors. Neither sleepiness nor sleep deprivation had strong associations with hunger, thirst, or food preferences.CONCLUSIONS: Our findings indicate that sleepiness is a dynamic motivational drive that promotes sleep-preparatory behaviors and competes with other drives and desired outcomes. Consequently, sleepiness may be a central mechanism by which impaired alertness, e.g., due to insufficient sleep, contributes to poor quality of life and adverse health. We propose that sleepiness helps organize behaviors toward the specific goal of assuring sufficient sleep, in competition with other needs and incentives. A theoretical framework on sleepiness and its behavioral consequences are likely to improve our understanding of several disease mechanisms.
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12. |
- Baldanzi, Gabriel, et al.
(author)
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Evening chronotype is associated with elevated biomarkers of cardiometabolic risk in the EpiHealth cohort: a cross-sectional study
- 2022
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In: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 45:2
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Journal article (peer-reviewed)abstract
- Study objectives: Individuals with evening chronotype have a higher risk of cardiovascular and metabolic disorders, although the underlying mechanisms are not well understood. In a population- based cohort, we aimed to investigate the association between chronotype and 242 circulating proteins from three panels of established or candidate biomarkers of cardiometabolic processes. Methods: In 2,471 participants (49.7% men, mean age 61.2±8.4 SD years) from the EpiHealth cohort, circulating proteins were analyzed with a multiplex proximity extension technique. Participants self- reported their chronotype on a five-level scale from extreme morning to extreme evening chronotype. With the intermediate chronotype set as the reference, each protein was added as the dependent variable in a series of linear regression models adjusted for confounders. Next, the chronotype coefficients were jointly tested and the resulting p-values adjusted for multiple testing using false discovery rate (5%). For the associations identified, we then analyzed the marginal effect of each chronotype category. Results: We identified 17 proteins associated with chronotype. Evening chronotype was positively associated with proteins previously linked to insulin resistance and cardiovascular risk, namely retinoic acid receptor protein 2, fatty acid-binding protein adipocyte, tissue-type plasminogen activator, and plasminogen activator inhibitor 1 (PAI-1). Additionally, PAI-1 was inversely associated with the extreme morning chronotype. Conclusions: In this population-based study, proteins previously related with cardiometabolic risk were elevated in the evening chronotypes. These results may guide future research in the relation between chronotype and cardiometabolic disorders.
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13. |
- Basner, Mathias, et al.
(author)
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The effects on sleep play a critical role in the long-term health consequences of noise exposure
- 2024
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In: Sleep. - 0161-8105 .- 1550-9109. ; 47
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Journal article (other academic/artistic)abstract
- Sleep is a very dangerous state from an evolutionary perspective as we are unconscious and it takes time to arouse from sleep and react to threats in a meaningful way. Thus, it is not surprising that our full sensory array continues to monitor our environment during sleep, always ready to wake us up (although with different sensitivity depending on sleep stage). In fact, the multiple brief awakenings a healthy sleeper experiences during the night [1] can be thought of as “brief checks” into our sleep environment. As a long-range sensor, the auditory system plays a critical role in monitoring the environment during sleep. It analyzes not only sound levels but also sound content during sleep [2]. The thalamus has a gating function, shielding the cortex from sensory content deemed irrelevant, often associated with a K-complex in the electroencephalogram [3]. We do habituate to noise, but still react to individual noise events during sleep even after long exposure periods (i.e. years), albeit with lower probabilities. Compared to cortical arousals, autonomic arousals habituate to a much lesser degree with likely implications for long-term health consequences (see below) [4].
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14. |
- Benedict, Christian, et al.
(author)
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Acute sleep deprivation increases serum levels of neuron-specific enolase (NSE) and S100 calcium binding protein B (S-100B) in healthy young men.
- 2014
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In: Sleep. - : Oxford University Press (OUP). - 1550-9109 .- 0161-8105. ; 37:1, s. 195-8
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Journal article (peer-reviewed)abstract
- To investigate whether total sleep deprivation (TSD) affects circulating concentrations of neuron-specific enolase (NSE) and S100 calcium binding protein B (S-100B) in humans. These factors are usually found in the cytoplasm of neurons and glia cells. Increasing concentrations of these factors in blood may be therefore indicative for either neuronal damage, impaired blood brain barrier function, or both. In addition, amyloid β (Aβ) peptides 1-42 and 1-40 were measured in plasma to calculate their ratio. A reduced plasma ratio of Aβ peptides 1-42 to 1-40 is considered an indirect measure of increased deposition of Aβ 1-42 peptide in the brain.
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16. |
- Bengtsson, Caroline, et al.
(author)
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Chronic rhinosinusitis impairs sleep quality : results of the GA(2)LEN study
- 2017
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In: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 40:1
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Journal article (peer-reviewed)abstract
- STUDY OBJECTIVES: To analyse the prevalence of sleep problems in subjects with CRS and to determine whether the disease severity of CRS affects sleep quality.METHODS: Questionnaires were sent to a random sample of 45 000 adults in four Swedish cities. Questions on CRS, asthma, allergic rhinitis, co-morbidities, tobacco use, educational level and physical activity were included. CRS was defined according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) epidemiological criteria. The disease severity of CRS was defined by the number of reported CRS symptoms. Sleep quality was assessed using the Basic Nordic Sleep Questionnaire.RESULTS: Of the 26 647 subjects, 2249 (8.4%) had CRS. Reported sleep problems were 50-90% more common among subjects with CRS compared with those without or the total population. The prevalence of reported sleep problems increased in conjunction with the severity of CRS. After adjusting for gender, BMI, age, tobacco use, asthma, somatic diseases, physical activity level and educational level, participants with four symptoms of CRS (compared with subjects without CRS symptoms) displayed a higher risk of snoring (adj. OR (95% CI): 3.13 (2.22-4.41)), difficulties inducing sleep (3.98 (2.94-5.40)), difficulties maintaining sleep (3.44 (2.55-4.64)), early morning awakening (4.71 (3.47-6.38)) and excessive daytime sleepiness (4.56 (3.36-6.18)). The addition of persistent allergic rhinitis to CRS further increased the risk of sleep problems.CONCLUSIONS: Sleep problems are highly prevalent among subjects with CRS. The disease severity of CRS negatively affects sleep quality.
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17. |
- Bjornsdottir, Erla, et al.
(author)
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Symptoms of Insomnia among Patients with Obstructive Sleep Apnea Before and After Two Years of Positive Airway Pressure Treatment
- 2013
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 36:12, s. 1901-1909
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Journal article (peer-reviewed)abstract
- Study Objectives: To assess the changes of insomnia symptoms among patients with obstructive sleep apnea (OSA) from starting treatment with positive airway pressure (PAP) to a 2-y follow-up. Design: Longitudinal cohort study. Setting: Landspitali-The National University Hospital of Iceland. Participants: There were 705 adults with OSA who were assessed prior to and 2 y after starting PAP treatment. Intervention: PAP treatment for OSA. Measurements and Results: All patients underwent a medical examination along with a type 3 sleep study and answered questionnaires on health and sleep before and 2 y after starting PAP treatment. The change in prevalence of insomnia symptoms by subtype was assessed by questionnaire and compared between individuals who were using or not using PAP at follow-up. Symptoms of middle insomnia were most common at baseline and improved significantly among patients using PAP (from 59.4% to 30.7%, P < 0.001). Symptoms of initial insomnia tended to persist regardless of PAP treatment, and symptoms of late insomnia were more likely to improve among patients not using PAP. Patients with symptoms of initial and late insomnia at baseline were less likely to adhere to PAP (odds ratio [OR] 0.56, P = 0.007, and OR 0.53, P < 0.001, respectively). Conclusion: Positive airway pressure treatment significantly reduced symptoms of middle insomnia. Symptoms of initial and late insomnia, however, tended to persist regardless of positive airway pressure treatment and had a negative effect on adherence. Targeted treatment for insomnia may be beneficial for patients with obstructive sleep apnea comorbid with insomnia and has the potential to positively affect adherence to positive airway pressure.
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19. |
- Blom, Kerstin, et al.
(author)
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Internet Treatment Addressing either Insomnia or Depression, for Patients with both Diagnoses : A Randomized Trial
- 2015
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 38:2, s. 267-277
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Journal article (peer-reviewed)abstract
- Study Objectives: To compare treatment effects when patients with insomnia and depression receive treatment for either insomnia or depression. Design: A 9-w randomized controlled trial with 6- and 12-mo follow-up. Setting: Internet Psychiatry Clinic, Stockholm, Sweden. Participants: Forty-three adults in whom comorbid insomnia and depression were diagnosed, recruited via media and assessed by psychiatrists. Interventions: Guided Internet-delivered cognitive behavior therapy (ICBT) for either insomnia or depression. Measurements and Results: Primary outcome measures were symptom self-rating scales (Insomnia Severity Index [ISI] and the Montgomery Asberg Depression Rating Scale [MADRS-S]), assessed before and after treatment with follow-up after 6 and 12 mo. The participants' use of sleep medication and need for further treatment after completion of ICBT was also investigated. The insomnia treatment was more effective than the depression treatment in reducing insomnia severity during treatment (P = 0.05), and equally effective in reducing depression severity. Group differences in insomnia severity were maintained during the 12-mo follow-up period. Post treatment, participants receiving treatment for insomnia had significantly less self-rated need for further insomnia treatment (P < 0.001) and used less sleep medication (P < 0.05) than participants receiving treatment for depression. The need for depression treatment was similar in both groups. Conclusions: In this study, Internet-delivered treatment with cognitive behavior therapy (ICBT) for insomnia was more effective than ICBT for depression for patients with both diagnoses. This indicates, in line with previous research, that insomnia when comorbid with depression is not merely a symptom of depression, but needs specific treatment.
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20. |
- Blom, Kerstin, et al.
(author)
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Three-Year Follow-Up Comparing Cognitive Behavioral Therapy for Depression to Cognitive Behavioral Therapy for Insomnia, for Patients With Both Diagnoses
- 2017
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In: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 40:8
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Journal article (peer-reviewed)abstract
- This 3-year follow-up compared insomnia treatment to depression treatment for patients with both diagnoses. Forty-three participants were randomized to either treatment, in the form of Internet-delivered therapist-guided cognitive behavior therapy (CBT), and 37 (86%) participants provided primary outcome data at the 3-year follow-up. After 3 years, reductions on depression severity were similar in both groups (between-group effect size, d = 0.33, p =.45), while the insomnia treatment had superior effects on insomnia severity (d = 0.66, p <.05). Overall, insomnia treatment was thus more beneficial than depression treatment. The implication for practitioners, supported by previous research, is that patients with co-occurring depression and insomnia should be offered CBT for insomnia, in addition to medication or psychological treatment for depression.
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21. |
- Blom, Kerstin, et al.
(author)
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Three-Year Follow-Up of Insomnia and Hypnotics after Controlled Internet Treatment for Insomnia
- 2016
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In: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 39:6, s. 1267-1274
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Journal article (peer-reviewed)abstract
- Study Objectives: To investigate the long-term effects of therapist-guided Internet-based insomnia treatment on insomnia severity and sleep medication use, compared with active control. Methods: This study was an 8 week randomized controlled trial with follow-up posttreatment and at 6, 12, and 36 months, set at the Internet Psychiatry Clinic, Stockholm, Sweden. Participants were 148 media-recruited nondepressed adults with insomnia. Interventions were Guided Internet-based cognitive behavioral therapy for insomnia (ICBT-i) or active control treatment (ICBT-ctrl). Primary outcome was insomnia severity, measured with the Insomnia Severity Index. Secondary outcomes were sleep medication use and use of other treatments. Results: The large pretreatment to posttreatment improvements in insomnia severity of the ICBT-i group were maintained during follow-up. ICBT-ctrl exhibited significantly less improvement posttreatment (between-Cohen d = 0.85), but after 12 and 36 months, there was no longer a significant difference. The within-group effect sizes from pretreatment to the 36-months follow-up were 1.6 (ICBT-i) and 1.7 (ICBT-ctrl), and 74% of the interviewed participants no longer had insomnia diagnosis after 36 mo. ICBT-ctrl used significantly more sleep medication (P = 0.017) and underwent significantly more other insomnia treatments (P < 0.001) during the follow-up period. Conclusions: The large improvements in the ICBT-i group were maintained after 36 months, corroborating that CBT for insomnia has long-term effects. After 36 months, the groups did not differ in insomnia severity, but ICBT-ctrl had used more sleep medication and undergone more other additional insomnia treatments during the follow-up period.
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23. |
- Bothelius, Kristoffer, 1973-, et al.
(author)
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Measuring Acceptance of Sleep Difficulties : The Development of the Sleep Problem Acceptance Questionnaire
- 2015
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 38:11, s. 1815-1822
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Journal article (peer-reviewed)abstract
- Study Objectives: Acceptance may be an important therapeutic process in sleep medicine, but valid psychometric instruments measuring acceptance related to sleep difficulties are lacking. The purpose of this study was to develop a measure of acceptance in insomnia, and to examine its factor structure as well as construct validity. Design: In a cross-sectional design, a principal component analysis for item reduction was conducted on a first sample (A) and a confirmatory factor analysis on a second sample (B). Construct validity was tested on a combined sample (C). Setting: Questionnaire items were derived from a measure of acceptance in chronic pain, and data were gathered through screening or available from pretreatment assessments in four insomnia treatment trials, administered online, via bibliotherapy and in primary care. Participants: Adults with insomnia: 372 in sample A and 215 in sample B. Sample C (n = 820) included sample A and B with another 233 participants added. Measures: Construct validity was assessed through relations with established acceptance and sleep scales. Results: The principal component analysis presented a two-factor solution with eight items, explaining 65.9% of the total variance. The confirmatory factor analysis supported the solution. Acceptance of sleep problems was more closely related to subjective symptoms and consequences of insomnia than to diary description of sleep, or to acceptance of general private events. Conclusions: The Sleep Problem Acceptance Questionnaire (SPAQ), containing the subscales "Activity Engagement" and "Willingness", is a valid tool to assess acceptance of insomnia.
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24. |
- Cai, Gui-Hong, et al.
(author)
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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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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 41:1
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Journal article (peer-reviewed)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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26. |
- Cedernaes, Jonathan, et al.
(author)
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Short Sleep Makes Declarative Memories Vulnerable to Stress in Humans
- 2015
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 38:12, s. 1861-1868
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Journal article (peer-reviewed)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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27. |
- Chandola, Tarani, et al.
(author)
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The effect of short sleep duration on coronary heart disease risk is greatest among those with sleep disturbance : a prospective study from the Whitehall II cohort.
- 2010
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In: Sleep. - 0161-8105 .- 1550-9109. ; 33:6, s. 739-44
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Journal article (peer-reviewed)abstract
- STUDY OBJECTIVES: Short sleep duration is associated with increased CHD (coronary heart disease) mortality and morbidity, although some evidence suggests that sleep disturbance is just as important. We investigated whether a combination of short sleep duration and sleep disturbance is associated with a higher risk of CHD than their additive effects. SETTING: The Whitehall II study. PATIENTS OR PARTICIPANTS: The Whitehall II study recruited 10,308 participants from 20 civil service departments in London, England. Participants were between the ages of 35 and 55 years at baseline (1985-1988) and were followed up for an average of 15 years. INTERVENTIONS: N/A. MEASUREMENTS: Sleep hours and sleep disturbance (from the General Heath Questionnaire-30) were obtained from the baseline survey. CHD events included fatal CHD deaths or incident nonfatal myocardial infarction or angina (ICD-9 codes 410-414 or ICD-10 120-25). RESULTS: Short sleep duration and sleep disturbance were both associated with increased hazards for CHD in women as well as in men, although, after we adjusted for confounders, only those reporting sleep disturbance had a raised risk. There was some evidence for an interaction between sleep duration and sleep disturbance. Participants with short sleep duration and restless disturbed nights had the highest hazard ratios (HR) of CHD (relative risk:1.55, 95% confidence interval:1.33-1.81). Among participants who did not report any sleep disturbance, there was little evidence that short sleep hours increased CHD risk. CONCLUSION: The effect of short sleep (< or = 6 hours) on increasing CHD risk is greatest among those who reported some sleep disturbance. However, among participants who did not report any sleep disturbance, there was little evidence that short sleep hours increased CHD risk.
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28. |
- Clark, Alice, et al.
(author)
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Sleep Impairment and Prognosis of Acute Myocardial Infarction : A Prospective Cohort Study
- 2014
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 37:5, s. 851-U215
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Journal article (peer-reviewed)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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29. |
- Collet, T. H., et al.
(author)
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The Sleep/Wake Cycle is Directly Modulated by Changes in Energy Balance
- 2016
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 39:9, s. 1691-1700
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Journal article (peer-reviewed)abstract
- Study Objectives: The rise in obesity has been paralleled by a decline in sleep duration in epidemiological studies. However, the potential mechanisms linking energy balance and the sleep/wake cycle are not well understood. We aimed to examine the effects of manipulating energy balance on the sleep/wake cycle. Methods: Twelve healthy normal weight men were housed in a clinical research facility and studied at three time points: baseline, after energy balance was disrupted by 2 days of caloric restriction to 10% of energy requirements, and after energy balance was restored by 2 days of ad libitum/free feeding. Sleep architecture, duration of sleep stages, and sleep-associated respiratory parameters were measured by polysomnography. Results: Two days of caloric restriction significantly increased the duration of deep (stage 4) sleep (16.8% to 21.7% of total sleep time; P = 0.03); an effect which was entirely reversed upon free feeding (P = 0.01). Although the apnea-hypopnea index stayed within the reference range (< 5 events per hour), it decreased significantly from caloric restriction to free feeding (P = 0.03). Caloric restriction was associated with a marked fall in leptin (P < 0.001) and insulin levels (P = 0.002). The fall in orexin levels from baseline to caloric restriction correlated positively with duration of stage 4 sleep (Spearman rho = 0.83, P = 0.01) and negatively with the number of awakenings in caloric restriction (Spearman rho = -0.79, P = 0.01). Conclusions: We demonstrate that changes in energy homeostasis directly and reversibly impact on the sleep/wake cycle. These findings provide a mechanistic framework for investigating the association between sleep duration and obesity risk.
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30. |
- Cordoza, Makayla, et al.
(author)
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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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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109.
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Conference paper (other academic/artistic)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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31. |
- Cucchiara, F, et al.
(author)
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Electrophysiological features of sleep in children with Kir4.1 channel mutations and Autism-Epilepsy phenotype: a preliminary study
- 2020
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In: Sleep. - : Oxford University Press (OUP). - 1550-9109 .- 0161-8105. ; 43:4
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Journal article (peer-reviewed)abstract
- Study ObjectivesRecently, a role for gain-of-function (GoF) mutations of the astrocytic potassium channel Kir4.1 (KCNJ10 gene) has been proposed in subjects with Autism–Epilepsy phenotype (AEP). Epilepsy and autism spectrum disorder (ASD) are common and complexly related to sleep disorders. We tested whether well characterized mutations in KCNJ10 could result in specific sleep electrophysiological features, paving the way to the discovery of a potentially relevant biomarker for Kir4.1-related disorders.MethodsFor this case–control study, we recruited seven children with ASD either comorbid or not with epilepsy and/or EEG paroxysmal abnormalities (AEP) carrying GoF mutations of KCNJ10 and seven children with similar phenotypes but wild-type for the same gene, comparing period-amplitude features of slow waves detected by fronto-central bipolar EEG derivations (F3-C3, F4-C4, and Fz-Cz) during daytime naps.ResultsChildren with Kir4.1 mutations displayed longer slow waves periods than controls, in Fz-Cz (mean period = 112,617 ms ± SE = 0.465 in mutated versus mean period = 105,249 ms ± SE = 0.375 in controls, p < 0.001). An analog result was found in F3-C3 (mean period = 125,706 ms ± SE = 0.397 in mutated versus mean period = 120,872 ms ± SE = 0.472 in controls, p < 0.001) and F4-C4 (mean period = 127,914 ms ± SE = 0.557 in mutated versus mean period = 118,174 ms ± SE = 0.442 in controls, p < 0.001).ConclusionThis preliminary finding suggests that period-amplitude slow wave features are modified in subjects carrying Kir4.1 GoF mutations. Potential clinical applications of this finding are discussed.
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32. |
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33. |
- Davidson, Per, et al.
(author)
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A daytime nap does not increase pattern separation ability
- 2019
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In: Sleep. - 0161-8105 .- 1550-9109. ; 42:1, s. 42-42
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Journal article (peer-reviewed)abstract
- IntroductionA large body of studies has showed that the ability to learn new information is impaired when we are sleep deprived. Pattern separation (PS), the ability to form distinct memories for events that are highly similar and share overlapping features, has also previously been found to be impaired by sleep deprivation. In the present study, we examined if a daytime nap would increase PS performance.Methods108 young healthy participants came to the lab in the morning and completed the Mnemonic Similarity Task (MST). This task starts with an encoding phase where participants view images of common everyday objects and are asked to classify them as indoor or outdoor objects. During a subsequent memory test, participants view three different kinds of objects; ‘old’ objects that were also present during the encoding phase, ‘new’ objects that have not been seen before, and ‘lure’ objects that are similar to, but not exactly the same as, objects viewed during encoding. The task of the participants during the re-test is to say if the objects presented are ‘old’, ‘new’ or ‘similar’. This test gives two different outcome measures: General Recognition (GR) - the ability to separate old objects from new ones, and PS - the ability to separate similar objects from old ones. After this task, participants were randomly allocated to either a sleep or a wake group. The sleep group had a two-hour nap opportunity and the wake group spent an equal amount of time resting. After this delay interval, participants completed the MST for a second time with a new set of images.ResultsResults revealed no support for sleep in increasing either GR or PS ability. Within the sleep group, there were no correlations between changes in PS ability and time spent in any sleep stage.ConclusionPrevious studies that have found a role of sleep for PS ability has done so using larger manipulation of sleep. Based on the present study however, just a short daytime nap does not seem to have any effect on PS ability.
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34. |
- Davidson, Per, et al.
(author)
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A daytime nap does not increase pattern separation ability
- 2019
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In: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 42:1, s. 42-42
-
Journal article (peer-reviewed)abstract
- Introduction A large body of studies has showed that the ability to learn new information is impaired when we are sleep deprived. Pattern separation (PS), the ability to form distinct memories for events that are highly similar and share overlapping features, has also previously been found to be impaired by sleep deprivation. In the present study, we examined if a daytime nap would increase PS performance. Methods 108 young healthy participants came to the lab in the morning and completed the Mnemonic Similarity Task (MST). This task starts with an encoding phase where participants view images of common everyday objects and are asked to classify them as indoor or outdoor objects. During a subsequent memory test, participants view three different kinds of objects; ‘old’ objects that were also present during the encoding phase, ‘new’ objects that have not been seen before, and ‘lure’ objects that are similar to, but not exactly the same as, objects viewed during encoding. The task of the participants during the re-test is to say if the objects presented are ‘old’, ‘new’ or ‘similar’. This test gives two different outcome measures: General Recognition (GR) - the ability to separate old objects from new ones, and PS - the ability to separate similar objects from old ones. After this task, participants were randomly allocated to either a sleep or a wake group. The sleep group had a two-hour nap opportunity and the wake group spent an equal amount of time resting. After this delay interval, participants completed the MST for a second time with a new set of images. Results Results revealed no support for sleep in increasing either GR or PS ability. Within the sleep group, there were no correlations between changes in PS ability and time spent in any sleep stage. Conclusion Previous studies that have found a role of sleep for PS ability has done so using larger manipulation of sleep. Based on the present study however, just a short daytime nap does not seem to have any effect on PS ability.
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35. |
- Davidson, Per, et al.
(author)
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The effect of sleep on intrusive memories in daily life : a systematic review and meta-analysis of trauma film experiments
- 2023
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In: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 46:2
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Journal article (peer-reviewed)abstract
- Study objectives: To synthesize the literature on the effect of sleep versus wake on the frequency and distress of intrusive memories in everyday life after watching film clips with distressing content as a proxy for traumatic experiences.Methods: We conducted a systematic review by searching PubMed and PsychInfo. The last search was conducted on January 31 st 2022. We included experimental studies comparing sleep and wake groups on intrusions using ecological diary methods, whereas studies lacking a wake control condition or relying solely on intrusion-triggering tasks or retrospective questionnaires were excluded. Meta-analyses were performed to evaluate the results. Risks of biases were assessed following the Cochrane guidelines.Results: Across 7 effect sizes from 6 independent studies, sleep (n = 192), as compared to wake (n=175), significantly reduced the number of intrusive memories (Hedges' g = -0.26, p = .04, 95% CI [-0.50, -0.01]), but not the distress associated with them (Hedges' g = -0.14, p = .25, 95% CI [-0.38, 0.10]).Conclusions: Although the results suggest that sleep reduces the number of intrusions, there is a strong need for high-powered pre-registered studies to confirm this effect. Risks of biases in the reviewed work include the selection of the reported results, measurement of the outcome, and failure to adhere to the intervention. Limits with the current meta-analysis include the few number of studies, only including English-language studies, and the fact that it was not pre-registered.
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36. |
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37. |
- Edell-Gustafsson, Ulla, et al.
(author)
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Sleep-activity profile and quality of life in patients with stable coronary disease
- 2003
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In: Sleep. - Westchester, IL, United States : Associated Professional Sleep Societies, Llc. - 0161-8105 .- 1550-9109. ; 26:Abstract supplement, s. A357-A357
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Journal article (other academic/artistic)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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38. |
- Engström, Maria, 1958-, et al.
(author)
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Thalamic Activation in the Kleine-Levin Syndrome
- 2014
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In: Sleep. - United States : Associated Professional Sleep Societies, Llc. - 0161-8105 .- 1550-9109. ; 37:2, s. 379-386
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Journal article (peer-reviewed)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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39. |
- Fjell, Anders M., et al.
(author)
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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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In: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 43:5
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Journal article (peer-reviewed)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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40. |
- Franklin, Karl A, et al.
(author)
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Effects and side-effects of surgery for snoring and obstructive sleep apnea--a systematic review
- 2009
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In: Sleep. - : The Associated Professional Sleep Societies, LLC. - 0161-8105 .- 1550-9109. ; 32:1, s. 27-36
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Journal article (peer-reviewed)abstract
- Only a small number of randomized controlled trials with a limited number of patients assessing some surgical modalities for snoring or sleep apnea are available. These studies do not provide any evidence of effect from laser-assisted uvulopalatoplasty or radiofrequency ablation on daytime sleepiness, apnea reduction, quality of life or snoring. We call for research of randomized, controlled trials of surgery other than uvulopalatopharyngoplasty and uvulopalatoplasty, as they are related to a high risk of long-term side-effects, especially difficulty swallowing.
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41. |
- Friberg, Danielle, et al.
(author)
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Sibling risk of pediatric obstructive sleep apnea syndrome and adenotonsillar hypertrophy.
- 2009
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 32:8, s. 1077-1083
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Journal article (peer-reviewed)abstract
- Objectives:To estimate sibling risk of hospitalization for children with sleep disordered breathing (SDB), diagnosed with (1) obstructive sleep apnea syndrome (OSAS), or (2) adenotonsillar hypertrophy in the total Swedish population.Design, Setting, and Participants:Using the MigMed database at the Karolinska Institute, we divided the population of Sweden aged 0–18 years into sibling groups based on a shared mother and father and presence of a primary hospital diagnosis of OSAS or adenotonsillar hypertrophy for each individual born between 1978 and 1986, during the follow-up period 1997–2004. Individuals with at least one affected sibling were identified and the incidence rates were computed, using standardized incidence ratios (SIRs) with 95% confidence intervals (CIs). Reference groups were boys and girls with unaffected siblings of 2 or more.Results:After accounting for socioeconomic status, age, and geographic region, boys with at least one sibling with OSAS had an increased risk of having OSAS (SIR, 33.2; 95% CI, 16.5–64.8), and in girls the SIR was 40.5 (19.4–81.4). For hypertrophy of the tonsils or hypertrophy of the adenoids and tonsils the corresponding SIRs were 4.53 (3.0–6.8) for boys and 4.94 (3.3–7.4) for girls.Conclusions:The study indicate an increased sibling risk of sleep disordered breathing in children, which may be due to heritable genes and/or shared environment such as increased awareness among family members or referring doctors. Caregivers should ask parents if siblings have similar symptoms, and thus offer them early treatment.
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42. |
- Germeys, Lynn, et al.
(author)
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Divergent concurrent and lagged effects of the reciprocal relation between work-nonwork interactions and sleep disturbance
- 2019
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 42:3
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Journal article (peer-reviewed)abstract
- Study ObjectivesWork-nonwork interactions and sleep disturbances are found to be important predictors of well-being and job performance outcomes. However, little is known about the mutual interrelations of the interactions between life domains and disturbed sleep over short and long periods of time.MethodsIn total, 4079 representative individuals of the Swedish working population completed three subsequent waves of surveys with a time interval of 2 years (i.e. longitudinal design).ResultsConcurrent, cross-lagged, and reverse directionality effects were simultaneously examined using autoregressive longitudinal path analysis. Contemporarily, interference between work and nonwork increased sleep disturbances, whereas work-nonwork enhancement decreased sleep disturbances. From one time point to the other, work-nonwork interference negatively related to sleep disturbances, and work-nonwork enhancement was mostly no longer (or positively) related to sleep disturbances. Over time sleep disturbances, in turn, predicted more interference and less enhancement between both life domains.ConclusionsThe results highlight that problematic work-nonwork interactions (i.e. high work-nonwork interference and low work-nonwork enhancement) disturb an individual's sleep in the short term (i.e. cross-sectional). Furthermore, the results suggest that individuals adapt to negative work-nonwork interactions over time, but that sleep disturbances impair an individual's work-nonwork interactions 2 years later.
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43. |
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44. |
- Grydeland, Håkon, et al.
(author)
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Self-reported sleep relates to microstructural hippocampal decline in beta-amyloid positive Adults beyond genetic risk
- 2021
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In: Sleep. - : Oxford University Press. - 0161-8105 .- 1550-9109. ; 44:11
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Journal article (peer-reviewed)abstract
- Study Objectives: A critical role linking sleep with memory decay and beta-amyloid (A beta) accumulation, two markers of Alzheimer's disease (AD) pathology, may be played by hippocampal integrity. We tested the hypotheses that worse self-reported sleep relates to decline in memory and intra-hippocampal microstructure, including in the presence of A beta.Methods: Two-hundred and forty-three cognitively healthy participants, aged 19-81 years, completed the Pittsburgh Sleep Quality Index once, and two diffusion tensor imaging sessions, on average 3 years apart, allowing measures of decline in intra-hippocampal microstructure as indexed by increased mean diffusivity. We measured memory decay at each imaging session using verbal delayed recall. One session of positron emission tomography, in 108 participants above 44 years of age, yielded 23 A beta positive. Genotyping enabled control for APOE epsilon 4 status, and polygenic scores for sleep and AD, respectively.Results: Worse global sleep quality and sleep efficiency related to more rapid reduction of hippocampal microstructure over time. Focusing on efficiency (the percentage of time in bed at night spent asleep), the relation was stronger in presence of A beta accumulation, and hippocampal integrity decline mediated the relation with memory decay. The results were not explained by genetic risk for sleep efficiency or AD.Conclusions: Worse sleep efficiency related to decline in hippocampal microstructure, especially in the presence of A beta accumulation, and A beta might link poor sleep and memory decay. As genetic risk did not account for the associations, poor sleep efficiency might constitute a risk marker for AD, although the driving causal mechanisms remain unknown.
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45. |
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46. |
- Hedström, Anna Karin, et al.
(author)
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Insomnia in the context of short sleep increases suicide risk
- 2021
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 44:4
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Journal article (peer-reviewed)abstract
- Study objectives: The relationship between insomnia and suicide risk is not completely understood. We aimed to investigate the influence of insomnia on suicide risk, taking both sleep duration and depression into consideration.Methods: The present study is based on a Swedish prospective cohort study of 38,786 participants with a mean follow-up time of 19.2 years. Cox proportional hazards models with attained age as time-scale were used to estimate hazard ratios (HRs) of death by suicide with 95% confidence intervals (CI) for participants categorized by frequency of insomnia symptoms. Causal mediation analysis was performed to assess to what extent the relationship between insomnia and suicide risk is mediated by depression.Results: Insomnia was only associated with suicide risk among short sleepers, whereas no significant association was observed among those who slept 7 h/night or more. The total effect of insomnia in the context of short sleep on suicide risk, expressed on the HR scale, was 2.85 (95% CI 1.42-5.74). The direct effect was 2.25 (95% CI 1.12-4.54) and the indirect effect, mediated by depression, was 1.27 (95% CI 1.05-1.53). Of the total effect, 32% was mediated by depression. The association between insomnia and suicide risk became more pronounced with decreasing depressive symptoms (p value for trend <0.05).Conclusions: Insomnia in the context of short sleep increases suicide risk, both directly and indirectly by affecting the risk of depression. Abnormalities of sleep duration and insomnia symptoms should be evaluated when assessing suicide risk.
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47. |
- Hense, Sabrina, et al.
(author)
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Sleep duration and overweight in European children: is the association modified by geographic region?
- 2011
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In: AMER ACAD SLEEP MEDICINE. - : AMER ACAD SLEEP MEDICINE. - 0161-8105 .- 1550-9109. ; 34:7, s. 885-890
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Journal article (peer-reviewed)abstract
- To investigate differences and a possible effect modification by geographical region in the association between sleep duration and overweight. Cross-sectional. Primary schools and preschools in 8 European countries. 7867 children aged 2 to 9 years. Not applicable. Nocturnal sleep duration was assessed as part of a parental 24-h recall. Height and weight were measured by standardized procedures across centers. Data on personal, social, environmental and behavioral factors were collected using a standardized parental questionnaire. Sleep duration differed (P < 0.001) between European regions and normal vs. overweight children. A dose-dependent inverse association between sleep duration and overweight could be seen, with crude odds ratios ranging from 1.73 (99% CI 1.33; 2.25) for sleeping between 10 and 11 h to 3.81 (99% CI 2.85; 5.09) for sleeping less than 9 h (reference category > 11 h). This persisted after adjustment, but remained significant only for sleeping less than 9 h per night (north: OR = 1.70; 99% CI 1.13; 2.58 vs. south: OR = 2.84; 99% CI 1.57; 5.12) if stratified by region. No effect modification by region could be found, but adjustment for region accounted for changes in the effect estimate for sleeping less than 9 h (OR = 2.22; 99% CI 1.64; 3.02). The association was stronger in school children than in preschool children. Geographic region and related aspects-even if they do not seem to modify the association between sleep and overweight-should in any case be taken in consideration as a confounding factor on this association.
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48. |
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50. |
- Holding, Benjamin C., et al.
(author)
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Multimodal Emotion Recognition Is Resilient to Insufficient Sleep : Results From Cross-Sectional and Experimental Studies
- 2017
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In: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 40:11
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Journal article (peer-reviewed)abstract
- Objectives: Insufficient sleep has been associated with impaired recognition of facial emotions. However, previous studies have found inconsistent results, potentially stemming from the type of static picture task used. We therefore examined whether insufficient sleep was associated with decreased emotion recognition ability in two separate studies using a dynamic multimodal task.Methods: Study 1 used a cross-sectional design consisting of 291 participants with questionnaire measures assessing sleep duration and self-reported sleep quality for the previous night. Study 2 used an experimental design involving 181 participants where individuals were quasi-randomized into either a sleep-deprivation (N = 90) or a sleep-control (N = 91) condition. All participants from both studies were tested on the same forced-choice multimodal test of emotion recognition to assess the accuracy of emotion categorization.Results: Sleep duration, self-reported sleep quality (study 1), and sleep deprivation (study 2) did not predict overall emotion recognition accuracy or speed. Similarly, the responses to each of the twelve emotions tested showed no evidence of impaired recognition ability, apart from one positive association suggesting that greater self-reported sleep quality could predict more accurate recognition of disgust (study 1).Conclusions: The studies presented here involve considerably larger samples than previous studies and the results support the null hypotheses. Therefore, we suggest that the ability to accurately categorize the emotions of others is not associated with short-term sleep duration or sleep quality and is resilient to acute periods of insufficient sleep.
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