Do periodic arm movements during sleep exist in healthy subjects? A polysomnographic study
Publication date:
September 2014
Source:Sleep Medicine, Volume 15, Issue 9
Author(s): David Gabelia , Thomas Mitterling , Birgit Högl , Gregor K. Wenning , Birgit Frauscher
Background
Despite several polysomnographic studies on periodic leg movements (PLM) in healthy sleep, data on the prevalence and characteristics of periodic arm movements (PAM) in normal subjects are lacking. We aimed to investigate PAM and their association with PLM during wakefulness and sleep in healthy subjects.
Methods
Ninety-one participants underwent video-polysomnography according to American Academy of Sleep Medicine 2007 criteria. In addition to standard electromyographic registration, data for both flexor digitorum superficialis muscles were recorded.
Results
Sixty-two subjects (68.1%) had a PAM index during wakefulness >5/h (median PAM index during wakefulness, 8.8/h; range, 0–77). Seven subjects (7.7%) had a PAM index >5/h during sleep (median PAM index during sleep, 0.7/h; range, 0–47.4). In 14% of cases, PAM during wakefulness were coincident with PLM during wakefulness. During sleep, this coincidence was not evident. The correlation between PAM and PLM was weak to moderate (during wakefulness: Spearman's
ρ
= 0.576,
P
< 0.001; during sleep: Spearman's
ρ
= 0.222,
P
= 0.036).
Conclusion
In healthy subjects, PAM occur predominantly during wakefulness with no apparent true periodicity. In contrast to classical PLM, some PAM may not present a true periodic phenomenon, but rather random voluntary movements meeting the wide range of periodicity criteria for PLM.
Sleep duration in chinese adolescents: biological, environmental, and behavioral predictors
Publication date:
Available online 22 August 2014
Source:Sleep Medicine
Author(s): Ting Chen , Zengqiang Wu , Zhifei Shen , Jun Zhang , Xiaoming Shen , Shenghui Li
Objective
To examine sleep-duration-related risk factors from multidimensional domains among Chinese adolescents.
Methods
A random sample of 4801 adolescents aged 11–20 years participated in a cross-sectional survey. A self-reported questionnaire was used to collect information about adolescents' sleep behaviors and possible related factors from eight domains.
Results
In all, 51.0% and 9.8% of adolescents did not achieve optimal sleep duration (defined as <8.0 h per day) on weekdays and on weekends, respectively. According to multivariate logistic regression models, after adjusting for all possible confounders, 17 factors were associated with sleep duration <8 h. Specifically, 13 factors from five domains were linked to physical and psychosocial condition, environment, and behaviors. These factors were overweight/obesity, chronic pain, bedtime anxiety/excitement/depression, bed/room sharing, school starting time earlier than 07:00, cram school learning, more time spent on homework on weekdays, television viewing ≥2 h/day, physical activity <1 h/day, irregular bedtime, and shorter sleep duration of father.
Conclusion
Biological and psychosocial conditions, sleep environments, school schedules, daily activity and behaviors, and parents' sleep habits significantly affect adolescents' sleep duration, indicating that the existing chronic sleep loss in adolescents could be, at least partly, intervened by improving adolescents' physical and psychosocial conditions, by controlling visual screen exposure, by regulating school schedules, by improving sleep hygiene and daytime behaviors, and by changing parents' sleep habits.
Auditory aura in nocturnal frontal lobe epilepsy: a red flag to suspect an extra-frontal epileptogenic zone
Publication date:
Available online 15 August 2014
Source:Sleep Medicine
Author(s): Lorenzo Ferri , Francesca Bisulli , Lino Nobili , Laura Tassi , Laura Lichetta , Barbara Mostacci , Carlotta Stipa , Greta Mainieri , Giorgia Bernabè , Federica Provini , Paolo Tinuper
Objective
To describe the anatomo-electro-clinical findings of patients with nocturnal hypermotor seizures (NHS) preceded by auditory symptoms, to evaluate the localizing value of auditory aura.
Methods
Our database of 165 patients with nocturnal frontal lobe epilepsy (NFLE) diagnosis confirmed by videopolysomnography (VPSG) was reviewed, selecting those who reported an auditory aura as the initial ictal symptom in at least two NHS during their lifetime.
Results
Eleven patients were selected (seven males, four females). According to the anatomo-electro-clinical data, three groups were identified. Group 1 [defined epileptogenic zone (EZ)]: three subjects were studied with stereo-EEG. The EZ lay in the left superior temporal gyrus in two cases, whereas in the third case seizures arose from a dysplastic lesion located in the left temporal lobe. One of these three patients underwent left Heschl's gyrus resection, and is currently seizure-free. Group 2 (presumed EZ): three cases in which a presumed EZ was identified; in the left temporal lobe in two cases and in the left temporal lobe extending to the insula in one subject. Group 3 (uncertain EZ): five cases had anatomo-electro-clinical correlations discordant.
Conclusions
This work suggests that auditory aura may be a helpful anamnestic feature suggesting an extra-frontal seizure origin. This finding could guide secondary investigations to improve diagnostic definition and selection of candidates for surgical treatment.
Restless legs syndrome/Willis–Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria – history, rationale, description, and significance
Publication date:
August 2014
Source:Sleep Medicine, Volume 15, Issue 8
Author(s): Richard P. Allen , Daniel L. Picchietti , Diego Garcia-Borreguero , William G. Ondo , Arthur S. Walters , John W. Winkelman , Marco Zucconi , Raffaele Ferri , Claudia Trenkwalder , Hochang B. Lee
Background
In 2003, following a workshop at the National Institutes of Health, the International Restless Legs Syndrome Study Group (IRLSSG) developed updated diagnostic criteria for restless legs syndrome/Willis–Ekbom disease (RLS/WED). These criteria were integral to major advances in research, notably in epidemiology, biology, and treatment of RLS/WED. However, extensive review of accumulating literature based on the 2003 NIH/IRLSSG criteria led to efforts to improve the diagnostic criteria further.
Methods
The clinical standards workshop, sponsored by the WED Foundation and IRLSSG in 2008, started a four-year process for updating the diagnostic criteria. That process included a rigorous review of research advances and input from clinical experts across multiple disciplines. After broad consensus was attained, the criteria were formally approved by the IRLSSG executive committee and membership.
Results
Major changes are: (i) addition of a fifth essential criterion, differential diagnosis, to improve specificity by requiring that RLS/WED symptoms not be confused with similar symptoms from other conditions; (ii) addition of a specifier to delineate clinically significant RLS/WED; (iii) addition of course specifiers to classify RLS/WED as chronic-persistent or intermittent; and (iv) merging of the pediatric with the adult diagnostic criteria. Also discussed are supportive features and clinical aspects that are important in the diagnostic evaluation.
Conclusions
The IRLSSG consensus criteria for RLS/WED represent an international, interdisciplinary, and collaborative effort intended to improve clinical practice and promote further research.
Predictors of shorter sleep in early childhood
Publication date:
May 2014
Source:Sleep Medicine, Volume 15, Issue 5
Author(s): Laura McDonald , Jane Wardle , Clare H. Llewellyn , Cornelia H.M. van Jaarsveld , Abigail Fisher
Objective
The aim of this study was to identify socio-demographic and home environmental predictors of shorter sleep in early childhood, and to examine whether effects were mediated by the timing of bedtime or wake time.
Methods
Participants were from Gemini, a British birth cohort of twins, and included 1702 children; one randomly selected from each twin pair. Parents reported night-time sleep duration at an average age of 15.8
months (range 14–27
months) using a modified version of the Brief Infant Sleep Questionnaire. Multiple logistic regression models were used to identify predictors of shorter sleep for this study.
Results
Using a cut-off of <11
h a night, shorter sleep was reported in 14.1% of children. Lower maternal education, non-white ethnic background, being male, low birth weight, living in a home with >1 older child and watching >1
h of TV in the evening were independently associated with shorter sleep. Mediation analyses showed that associations between education, ethnicity, evening TV viewing and sleep were driven predominantly by later bedtimes, while sex differences were driven predominantly by earlier wake times in boys.
Conclusion
In this sample, multiple environmental factors were associated with shorter sleep in young children, with several operating predominantly through later bedtime. An emphasis on the importance of an early and consistent bedtime could help promote healthy sleep and reduce inequalities in child health.
Factor structure of the Chinese version of the Pittsburgh Sleep Quality Index in breast cancer patients
Publication date:
May 2014
Source:Sleep Medicine, Volume 15, Issue 5
Author(s): Rainbow T.H. Ho , Ted C.T. Fong
Objective
The Pittsburgh Sleep Quality Index (PSQI) is used extensively to assess subjective sleep disturbance in cancer populations. Although previous studies on the PSQI suggested a better fit for a two- or three-factor model than the original one-factor model, none accounted for the indicator-specific effect between sleep duration and habitual sleep efficiency. This study evaluated the PSQI’s dimensionality and its convergent validity with cancer-related psychopathological states in female breast cancer patients.
Methods
The PSQI was administered to 197 women with breast cancer. Confirmatory factor analysis examined the relative fit of one-, two-, three-, and revised one-factor models. The PSQI’s convergent validity was evaluated via bivariate correlations between the PSQI factor scores and measures of anxiety, depression, fatigue, pain, and quality of life.
Results
Confirmatory factor analyses showed an adequate fit for the revised one-factor model with the PSQI global score as the overall index of sleep disturbance. Although the revised one- and two-factor solutions showed statistically equivalent model fits, the one-factor model was selected due to utility reasons. The severity of sleep dysfunction that the PSQI global score represented was positively correlated with anxiety, depression, fatigue, pain, and reduced quality of life.
Conclusion
The results support the PSQI’s original unidimensional structure, demonstrating that the PSQI global score is a valid and parsimonious measure for assessing and screening sleep dysfunction in cancer patients.
Self-reported sleep patterns in a British population cohort
Publication date:
March 2014
Source:Sleep Medicine, Volume 15, Issue 3
Author(s): Yue Leng , Nick W.J. Wainwright , Francesco P. Cappuccio , Paul G. Surtees , Robert Luben , Nick Wareham , Carol Brayne , Kay-Tee Khaw
Objectives
Sleep patterns have been linked to various health outcomes, but sleep patterns in the British population have not been extensively reported. We aimed to describe the sleep characteristics reported by the European Prospective Investigation of Cancer (EPIC)-Norfolk participants, with a particular emphasis on the comparison of measures of sleep quantity.
Methods
From 2006 to 2007, a total of 8480 participants aged 45–90
years reported sleep timing, nighttime sleep duration, and sleep difficulties. Time in bed (TIB) was calculated from the difference between rise time and bedtime, and sleep proportion was defined as the ratio of sleep duration and TIB.
Results
On average, the reported TIB was more than 1.5
h longer than sleep durations. Compared to men, women spent 15
min longer in bed, but they slept for 11
min less and reported more sleep difficulties. In multivariate analysis sleep duration and TIB varied with socioeconomic factors, but sleep proportion was consistently lower among women, nonworkers, and older individuals, as well as those who were widowed, separated, or divorced; those who reported sleep difficulties and more frequently used sleep medication; and those who had lower education, poorer general health, or a major depressive disorder (MDD).
Conclusions
Self-reported sleep duration and TIB have different meanings and implications for health. Sleep proportion may be a useful indicator of sleep patterns in the general population.
Prevalence of insomnia symptoms in a general population sample of young children and preadolescents: gender effects
Publication date:
January 2014
Source:Sleep Medicine, Volume 15, Issue 1
Author(s): Susan L. Calhoun , Julio Fernandez-Mendoza , Alexandros N. Vgontzas , Duanping Liao , Edward O. Bixler
Objective
Our population-based study examined the prevalence of insomnia symptoms and its sociodemographic, subjective, and polysomnographic (PSG) sleep risk factors in young and preadolescent children.
Methods
We performed a cross-sectional study of 700 children, ages 5–12 years who underwent a 9-h PSG and parent-completed sleep and development questionnaires (Penn State Child Cohort). Insomnia symptoms were defined as parent report of difficulty falling or staying asleep and sleep-disordered breathing (SDB) as an apnea hypopnea index of ⩾1.
Results
The prevalence of insomnia symptoms was 19.3% and did not significantly change (20.2%) when children with SDB were excluded. A significant interaction between gender and age revealed that the prevalence of insomnia symptoms was highest in girls ages 11 to 12 years (30.6%). This gender difference was not associated with significant differences between girls and boys ages 11–12
years in anxiety and depressive symptoms. In contrast girls ages 11–12
years with insomnia symptoms, but not boys of the same group, demonstrated clinically significant PSG sleep disturbances compared to those without insomnia symptoms.
Conclusions
These data suggest that one out of five young children and preadolescents of the general population have insomnia symptoms. Importantly, the prevalence of insomnia symptoms peaks in girls ages 11 to 12 years and is associated with objective sleep disturbances which may be related to hormonal changes associated with the onset of puberty rather than anxiety and depression.
Restless legs syndrome (Willis–Ekbom disease) and growing pains: are they the same thing? A side-by-side comparison of the diagnostic criteria for both and recommendations for future research
Publication date:
December 2013
Source:Sleep Medicine, Volume 14, Issue 12
Author(s): Arthur S. Walters , David Gabelia , Birgit Frauscher
There has been no previous side-by-side comparison of the diagnostic criteria for restless legs syndrome (RLS) (Willis–Ekbom disease) and growing pains. In our review, we explore this comparison emphasizing overlaps and disconnects, summarize recent literature exploring the relationship between the 2 entities, and make suggestions for future research.
There is considerable overlap in the diagnostic criteria for childhood RLS and growing pains. The literature also indicates that RLS and growing pains more commonly occur together than one would expect based on chance alone, and the family histories of RLS and growing pains often are overlapping. Leg rubbing to obtain relief from leg discomfort is common to both disorders, though walking to obtain relief seems unique to RLS. Childhood RLS also has been reported to be painful in up to 45% of cases.
The development of standard diagnostic criteria is necessary to move forward in the field of growing pains research. A quantitative and validated rating scale for growing pains severity already exists. Because of the clinical and genetic similarity between RLS and growing pains, studies that parallel those previously performed in RLS patients are recommended for growing pains patients. For example, a genome wide association study in growing pains patients of all possible genes with particular attention to those identified as related to RLS and a therapeutic trial of medications known to be effective in RLS would be welcome. Abnormalities in vitamin D metabolism also may be common to both disorders.
Pediatric restless legs syndrome diagnostic criteria: an update by the International Restless Legs Syndrome Study Group
Publication date:
December 2013
Source:Sleep Medicine, Volume 14, Issue 12
Author(s): Daniel L. Picchietti , Oliviero Bruni , Al de Weerd , Jeffrey S. Durmer , Suresh Kotagal , Judith A. Owens , Narong Simakajornboon
Background
Specific diagnostic criteria for pediatric restless legs syndrome (RLS) were published in 2003 following a workshop at the National Institutes of Health. Due to substantial new research and revision of the adult RLS diagnostic criteria, a task force was chosen by the International Restless Legs Syndrome Study Group (IRLSSG) to consider updates to the pediatric diagnostic criteria.
Methods
A committee of seven pediatric RLS experts developed a set of 15 consensus questions to review, conducted a comprehensive literature search, and extensively discussed potential revisions. The committee recommendations were approved by the IRLSSG executive committee and reviewed by the IRLSSG membership.
Results
The pediatric RLS diagnostic criteria were simplified and integrated with the newly revised adult RLS criteria. Specific recommendations were developed for pediatric application of the criteria, including consideration of typical words used by children to describe their symptoms. Pediatric aspects of differential diagnosis, comorbidity, and clinical significance were then defined. In addition, the research criteria for probable and possible pediatric RLS were updated and criteria for a related condition, periodic limb movement disorder (PLMD), were clarified.
Conclusions
Revised diagnostic criteria for pediatric RLS have been developed, which are intended to improve clinical practice and promote further research.
Response to intravenous iron in patients with iron deficiency anemia (IDA) and restless leg syndrome (willis ekbom disease)
Publication date:
Available online 10 September 2014
Source:Sleep Medicine
Author(s): Tahir Mehmood , Michael Auerbach , Christopher J Earley , Richard P Allen
Objectives
Iron-deficit anemia (IDA) engenders restless legs syndrome (RLS, aka Willis Ekbom disease). Intravenous (IV) iron can rapidly reverse IDA and would be expected to similarly reverse RLS caused by IDA. This is the first consecutive case series evaluating effects of intravenous (IV) iron therapy on RLS occurring with IDA (RLS-IDA)
Methods
RLS-IDA patients were evaluated before and 7 – 12 months after a 1000mg IV infusion of Low molecular weight iron dextran (INFeD@) using validated questionnaires and standardized telephone interview. Patients were classified as responder versus non-responder for RLS improvement.
Results
Follow-up data were obtained on 42 (70%) of 60 consecutive RLS-IDA patients. RLS symptoms were reduced in 76% (32/42) with 47% (20/42) showing an extended response lasting more than 6 months. The response did not relate to age or gender, but tended to be less for African-Americans than Whites (40% (2/5) vs. 81% (30/37), p=0.078). White responders vs. non-responder had higher hemoglobin after treatment (12.1 vs. 11.3 g/dL, p=0.03).
Conclusions
RLS-IDA is reduced after IV iron in most cases, but the 24% failing to respond was higher than expected. The non-responders all showed below normal hemoglobin levels (<12.5 g/dl) suggesting a failure of adequate treatment of the iron deficiency. Intravenous iron treatment of the RLS with IDA likely requires ensuring more than minimally adequate body iron stores to support iron delivery to the brain. This may require for some a dose higher than the customary 1000 mg IV iron used for treatment of either IDA or RLS alone.
Impaired sleep and allostatic load: cross-sectional results from the danish copenhagen aging and midlife biobank
Publication date:
Available online 10 September 2014
Source:Sleep Medicine
Author(s): Alice Jessie Clark , Nadya Dich , Theis Lange , Poul Jennum , Åse Marie Hansen , Rikke Lund , Naja Hulvej Rod
Objective
Understanding the mechanisms linking sleep impairment to morbidity and mortality is important for future prevention, but these mechanisms are far from elucidated. We aimed to determine the relation between impaired sleep, both in terms of duration and disturbed sleep, and allostatic load (AL), which is a measure of systemic wear and tear of multiple body systems, as well as with individual risk markers within the cardiac, metabolic, anthropometric, and immune system.
Methods
A cross-sectional population-based study of 5226 men and women from the Danish Copenhagen Aging and Midlife Biobank with comprehensive information on sleep duration, disturbed sleep, objective measures of an extensive range of biological risk markers, and physical conditions.
Results
Long sleep (mean difference 0.23; 95% confidence interval, 0.13, 0.32) and disturbed sleep (0.14; 0.06, 0.22) were associated with higher AL as well as with high-risk levels of risk markers from the anthropometric, metabolic, and immune system. Sub-analyses suggested that the association between disturbed sleep and AL might be explained by underlying disorders. Whereas there was no association between short sleep and AL, the combination of short and disturbed sleep was associated with higher AL (0.19; 0.08, 0.30) and high-risk levels of immune system markers.
Conclusion
Our study suggests small but significant differences in the distribution of allostatic load, a pre-clinical indicator of disease risk and premature death, for people with impaired relative to normal sleep. Impaired sleep may be a risk factor for developing disease and be a risk marker for underlying ill health or sleep disorders.
Time for screening?
Publication date:
Available online 10 September 2014
Source:Sleep Medicine
Author(s): Winfried Randerath
Sleep apnea and retinal signs in cardiovascular disease: the multi-ethnic study of atherosclerosis
Publication date:
Available online 10 September 2014
Source:Sleep Medicine
Author(s): Merwyn Chew , Jing Xie , Ronald Klein , Barbara Klein , Mary Frances Cotch , Susan Redline , Tien Yin Wong , Ning Cheung
Objective
To examine the relationship between sleep apnea, retinal vascular caliber and retinopathy and their impact on cardiovascular disease (CVD) risk.
Methods
A multi-ethnic cohort of 5803 participants was examined based on standardized grading of retinal vascular caliber and retinopathy from digital fundus photographs, self-reported physician-diagnosed sleep apnea (PDSA) and incident cardiovascular events.
Results
In women, PDSA was associated with narrower arterioles [regression coefficient (β), –5.80; 95% confidence interval (CI), –8.65, –2.95] after adjusting for cardiometabolic risk factors. The incident rate ratio (IRR) of CVD was also associated with narrower arterioles (
IRR for highest versus lowest tertile,
1.95; 95% CI, 1.11, 3.45). In men, PDSA was not associated with arteriolar caliber. However, incident CVD was associated with narrower arterioles (IRR, 1.71; 95% CI, 1.13, 2.59), wider venules (1.70; 1.12, 2.56) and PDSA (2.16; 1.17, 4.02). The IRR of CVD in men with PDSA increased minimally to 2.17 (1.17, 4.03) after adjustment for retinal arteriolar and venular caliber. Combining women and men, the IRR of CVD was 3.38 (1.77, 6.43) in those with both PDSA and narrower retinal arterioles.
Conclusion
Sleep apnea was associated with narrower retinal arterioles in women but not in men. However, sleep apnea was also associated with incident CVD in men. These findings suggest potential gender differences in susceptibility to microvascular disease in association with sleep apnea.
Sleep restoration is associated with reduced plasma c-reactive protein and depression symptoms in military personnel with sleep disturbance after deployment
Publication date:
Available online 10 September 2014
Source:Sleep Medicine
Author(s): Morgan Heinzelmann , Hyunhwa Lee , Hannah Rak , Whitney Livingston , Taura Barr , Tristin Baxter , Lindsay Scattergood-Keepper , Vincent Mysliwiec , Jessica Gill
Background
Deployed military personnel are vulnerable to chronic sleep disturbance, which is highly comorbid with post-traumatic stress disorder (PTSD) and depression, as well as declines in health-related quality of life (HRQOL). Inflammation is associated with HRQOL declines and sleep-related comorbidities; however, the impact of sleep changes on comorbid symptoms and inflammation in this population is unknown.
Methods
In this observational study, we examined the relationship between reported sleep changes and concentrations of inflammatory biomarkers, interleukin 6 (IL-6) and C-reactive protein (CRP), in peripheral blood. The sample was dichotomized into two groups: (1) decrease in Pittsburgh Sleep Quality Index (PSQI; restorative sleep) and (2) no change or increase in PSQI (no change). Mixed between-within subjects analysis of variance tests were used to determine group differences on changes of inflammation and comorbid symptoms.
Results
In our sample of 66 recently deployed military personnel with insomnia, 34 participants reported restorative sleep whereas 32 reported no sleep changes. The two groups did not differ on demographic or clinical characteristics, with the exception of PTSD at baseline. The restorative sleep group had significant reductions in CRP concentrations and depression symptoms, as well as reduced fatigue and improvements in emotional well-being, social functioning, and physical functioning at follow-up.
Conclusions
Military personnel who report sleep restoration after deployment have reduced concentrations of CRP, decreased severity of depression, and improved HRQOL. These findings suggest that treatment for sleep disturbances may be associated with improvements in mental and physical health, thereby supporting continued study in this line of research.
The children's report of sleep patterns: validity and reliability of the sleep hygiene index and sleep disturbances scale in adolescents
Publication date:
Available online 6 September 2014
Source:Sleep Medicine
Author(s): Lisa J. Meltzer , Chasity Brimeyer , Kathryn Russell , Kristin T. Avis , Sarah Biggs , Amy C. Reynolds , Valerie McLaughlin Crabtree
Objective
Sleep is critical for adolescent health and well-being. However, there are a limited number of validated self-report measures of sleep for adolescents, and no well-validated measures of sleep that can be used across middle childhood and adolescence. The Children's Report of Sleep Patterns (CRSP) has already been validated in children ages 8-12 years. The purpose of this study was to examine the psychometric properties of the CRSP as a multidimensional, self-report sleep measure for adolescents.
Methods
Participants included 570 adolescents aged 13 – 18 years, 60% female, recruited from pediatricians' offices, sleep clinics, children's hospitals, schools, and the general population. A multi-method, multi-reporter approach was used to validate the CRSP. Along with the CRSP, a subset of the sample completed the Adolescent Sleep Hygiene Scale (ASHS), with a different subset of adolescents undergoing polysomnography.
Results
The CRSP demonstrated good reliability and validity. Group differences on the CRSP were found for adolescents presenting to a sleep or medical clinic (vs. community sample), for older adolescents (vs. younger adolescents), those who regularly napped (vs. infrequently napped), and those with poor sleep quality (vs. good sleep quality). Self-reported sleep quality in adolescents was also associated with higher apnea-hypopnea index scores from polysomnography. Finally, the CRSP Sleep Hygiene Indices were significantly correlated with indices of the ASHS.
Conclusions
The CRSP is a valid and reliable measure of adolescent sleep hygiene and sleep disturbances. With a parallel version for middle childhood (8-12 years), the CRSP likely provides clinicians and researchers the ability to measure self-reported sleep across development.
The effects of chronotype, sleep schedule and light/dark pattern exposures on circadian phase
Publication date:
Available online 3 September 2014
Source:Sleep Medicine
Author(s): Mariana G. Figueiro , Barbara Plitnick , Mark S. Rea
Background
Chronotype characterizes individual differences in sleep/wake rhythm timing, which also impact light exposure patterns. The present study investigated whether early and late chronotypes respond differently to controlled advancing and delaying light exposure patterns while on a fixed, advanced sleep/wake schedule.
Methods
In a mixed design, 23 participants (11 late chronotypes; 12 early chronotypes) twice completed a 2-week, advanced sleep/wake protocol, once with an advancing light exposure pattern, once with a delaying light exposure pattern. In the advancing light exposure pattern, participants received short-wavelength light in the morning and short-wavelength restricting orange-tinted glasses in the evening. In the delaying light exposure pattern, participants received short-wavelength restricting orange-tinted glasses in the morning and short-wavelength light in the evening. Light/dark exposures were measured with the Daysimeter. Salivary dim light melatonin onset (DLMO) was also measured.
Results
Compared to baseline week, DLMO was significantly delayed after the delaying light intervention and significantly advanced after the advancing light intervention in both groups. There was no significant difference in how the two chronotype groups responded to the light intervention.
Conclusions
The present results demonstrate that circadian phase changes resulting from lighting interventions are consistent with those predicted by previously published phase response curves (PRC) for both early and late chronotypes.
Prevalence of abnormal sleep duration and excessive daytime sleepiness in pregnancy and the role of socio-demographic factors: comparing pregnant women with women in the general population
Publication date:
Available online 3 September 2014
Source:Sleep Medicine
Author(s): T. Leigh Signal , Sarah-Jane Paine , Bronwyn Sweeney , Monique Priston , Diane Muller , Alexander Smith , Kathryn A. Lee , Mark Huthwaite , Papaarangi Reid , Philippa Gander
Objectives
Compare the prevalence of self-reported abnormal sleep duration and excessive daytime sleepiness in pregnancy among Māori (indigenous New Zealanders) and non-Māori women versus the general population, and examine the influence of socio-demographic factors.
Methods
Self-reported total sleep time (TST) in 24-hrs, Epworth Sleepiness Scale scores and socio-demographic information was obtained from nullipara and multipara women aged 20-46 yrs at 35-37 weeks pregnant (358 Māori and 717 non-Māori), and women in the general population (381 Māori and 577 non-Māori).
Results
After controlling for ethnicity, age, socio-economic status, and employment status, pregnant women average 30 min less TST than women in the general population. The distribution of TST was also greater for pregnant women, who were 3 times more likely to be short sleepers (≤6h) and 1.9 times more likely to be long sleepers (>9h). In addition, pregnant women were 1.8 times more likely to report excessive daytime sleepiness (EDS). Pregnant women >30 years of age experienced greater age-related declines in TST. Identifying as Māori, being unemployed, and working at night increased the likelihood of reporting abnormal sleep duration across all women. EDS was also more likely for Māori women and women who worked at night.
Conclusions
Pregnancy increases the prevalence of abnormal sleep duration and EDS, which are also higher among Māori than non- Māori women and those who do night work. Health professionals responsible for the care of pregnant women need to be well-educated about the importance of sleep and discuss sleep issues with the women they care for.
Cardiorespiratory abnormalities during epileptic seizures
Publication date:
Available online 3 September 2014
Source:Sleep Medicine
Author(s): Sanjeev V. Kothare , Kanwaljit Singh
Sudden Unexpected Death in Epilepsy Patients (SUDEP) is a leading cause of death in young and otherwise healthy patients with epilepsy, and sudden death is at-least 20 times more common in epilepsy patients as compared to patients without epilepsy. A significant proportion of patients with epilepsy experience cardiac and respiratory complications during seizures. These cardiorespiratory complications are suspected to be significant risk factor for SUDEP. Sleep physicians are increasingly involved in the care of epilepsy patients and a recognition of these changes in relation to seizures whilst a patient is under their care may improve their awareness of these potentially life-threating complications that may occur during sleep studies. This paper details these cardiopulmonary changes that take place in relation to epileptic seizures and how these changes may relate to occurrence of SUDEP.
Delayed sleep timing is associated with low levels of free-living physical activity in normal sleeping adults
Publication date:
Available online 2 September 2014
Source:Sleep Medicine
Author(s): Ari Shechter , Marie-Pierre St-Onge
Objective and Background
We and others have reported that experimentally-induced short sleep does not affect resting metabolic rate and leads to increased laboratory-measured 24-h energy expenditure. Here, we aimed to determine if sleep timing and/or quality are related to physical activity (PA) levels.
Methods
Measures of PA via waist-actigraphy, sleep diary, and sleep quality questionnaires were collected over a 7-18 d period in 22 adults (mean age ± SD: 35.8±4.6 y, and mean body mass index ± SD: 23.8±1.1 kg/m2) who were on their habitual sleep-wake and activity schedules.
Results
During the recording period, mean (± SD) bed- and wake-times were 00:17±1:07 h (range: 22:02-02:07 h) and 08:20±1:14 h (range: 06:30-10:11 h), respectively. After controlling for sleep duration, later bedtime, wake-time,and midpoint of sleep were associated with less time spent in moderate-to-vigorous PA (p=0.013, p=0.005, and p=0.007, respectively), and increased time in sedentary PA (p=0.016, p=0.013, and p=0.013, respectively).
Conclusions
Current results suggest that even relatively small alterations in sleep timing may influence PA. However, causality cannot be inferred from this cross-sectional study. Clinical intervention studies should be conducted to assess the relationship between sleep timing and energy balance.