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Science (New York, N.Y.) Nov 2016Disruptions of normal circadian rhythms and sleep cycles are consequences of aging and can profoundly affect health. Accumulating evidence indicates that circadian and... (Review)
Review
Disruptions of normal circadian rhythms and sleep cycles are consequences of aging and can profoundly affect health. Accumulating evidence indicates that circadian and sleep disturbances, which have long been considered symptoms of many neurodegenerative conditions, may actually drive pathogenesis early in the course of these diseases. In this Review, we explore potential cellular and molecular mechanisms linking circadian dysfunction and sleep loss to neurodegenerative diseases, with a focus on Alzheimer's disease. We examine the interplay between central and peripheral circadian rhythms, circadian clock gene function, and sleep in maintaining brain homeostasis, and discuss therapeutic implications. The circadian clock and sleep can influence a number of key processes involved in neurodegeneration, suggesting that these systems might be manipulated to promote healthy brain aging.
Topics: Aging; Alzheimer Disease; Animals; Brain; Circadian Clocks; Circadian Rhythm; Dyssomnias; Humans; Mice; Sleep; Suprachiasmatic Nucleus
PubMed: 27885006
DOI: 10.1126/science.aah4968 -
Sleep Medicine Clinics Jun 2023Narcolepsy types 1 and 2 and idiopathic hypersomnia are primary Central Nervous System (CNS) disorders of hypersomnolence characterized by profound daytime sleepiness... (Review)
Review
Narcolepsy types 1 and 2 and idiopathic hypersomnia are primary Central Nervous System (CNS) disorders of hypersomnolence characterized by profound daytime sleepiness and/or excessive sleep need. Onset of symptoms begins typically in childhood or adolescence, and children can have unique presentations compared with adults. Narcolepsy type 1 is likely caused by immune-mediated loss of orexin (hypocretin) neurons in the hypothalamus; however, the causes of narcolepsy type 2 and idiopathic hypersomnia are unknown. Existing treatments improve daytime sleepiness and cataplexy but there is no cure for these disorders.
Topics: Adult; Adolescent; Child; Humans; Idiopathic Hypersomnia; Narcolepsy; Disorders of Excessive Somnolence
PubMed: 37120161
DOI: 10.1016/j.jsmc.2023.01.003 -
Sleep Dec 1991The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a...
The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.
Topics: Adult; Arousal; Circadian Rhythm; Disorders of Excessive Somnolence; Female; Humans; Male; Middle Aged; Narcolepsy; Psychometrics; Restless Legs Syndrome; Sleep Apnea Syndromes; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; Snoring; Wakefulness
PubMed: 1798888
DOI: 10.1093/sleep/14.6.540 -
Chest Sep 2021Delirium is a deleterious condition affecting up to 60% of patients in the surgical ICU (SICU). Few SICU-focused delirium interventions have been implemented, including... (Observational Study)
Observational Study
BACKGROUND
Delirium is a deleterious condition affecting up to 60% of patients in the surgical ICU (SICU). Few SICU-focused delirium interventions have been implemented, including those addressing sleep-wake disruption, a modifiable delirium risk factor common in critically ill patients.
RESEARCH QUESTION
What is the effect on delirium and sleep quality of a multicomponent nonpharmacologic intervention aimed at improving sleep-wake disruption in patients in the SICU setting?
STUDY DESIGN AND METHODS
Using a staggered pre-post design, we implemented a quality improvement intervention in two SICUs (general surgery or trauma and cardiovascular) in an academic medical center. After a preintervention (baseline) period, a multicomponent unit-wide nighttime (ie, efforts to minimize unnecessary sound and light, provision of earplugs and eye masks) and daytime (ie, raising blinds, promotion of physical activity) intervention bundle was implemented. A daily checklist was used to prompt staff to complete intervention bundle elements. Delirium was evaluated twice daily using the Confusion Assessment Method for the Intensive Care Unit. Patient sleep quality ratings were evaluated daily using the Richards-Campbell Sleep Questionnaire (RCSQ).
RESULTS
Six hundred forty-six SICU admissions (332 baseline, 314 intervention) were analyzed. Median age was 61 years (interquartile range, 49-70 years); 35% of the cohort were women and 83% were White. During the intervention period, patients experienced fewer days of delirium (proportion ± SD of ICU days, 15 ± 27%) as compared with the preintervention period (20 ± 31%; P = .022), with an adjusted pre-post decrease of 4.9% (95% CI, 0.5%-9.2%; P = .03). Overall RCSQ-perceived sleep quality ratings did not change, but the RCSQ noise subscore increased (9.5% [95% CI, 1.1%-17.5%; P = .02).
INTERPRETATION
Our multicomponent intervention was associated with a significant reduction in the proportion of days patients experienced delirium, reinforcing the feasibility and effectiveness of a nonpharmacologic sleep-wake bundle to reduce delirium in critically ill patients in the SICU.
TRIAL REGISTRY
ClinicalTrials.gov; No.: NCT03313115; URL: www.clinicaltrials.gov.
Topics: Cardiology Service, Hospital; Critical Care; Critical Illness; Delirium; Dyssomnias; Female; Humans; Intensive Care Units; Light Pollution; Male; Middle Aged; Noise; Outcome and Process Assessment, Health Care; Patient Care Bundles; Protective Devices; Quality Improvement; Sleep Quality; Sleep Wake Disorders
PubMed: 33773988
DOI: 10.1016/j.chest.2021.03.030 -
Sleep Medicine Reviews Feb 2023Repetitive transcranial magnetic stimulation (rTMS) is a widely used non-invasive neuromodulatory technique. When applied in sleep medicine, the main hypothesis... (Review)
Review
Repetitive transcranial magnetic stimulation (rTMS) is a widely used non-invasive neuromodulatory technique. When applied in sleep medicine, the main hypothesis explaining its effects concerns the modulation of synaptic plasticity and the strength of connections between the brain areas involved in sleep disorders. Recently, there has been a significant increase in the publication of rTMS studies in primary sleep disorders. A multi-database-based search converges on the evidence that rTMS is safe and feasible in chronic insomnia, obstructive sleep apnea syndrome (OSAS), restless legs syndrome (RLS), and sleep deprivation-related cognitive deficits, whereas limited or no data are available for narcolepsy, sleep bruxism, and REM sleep behavior disorder. Regarding efficacy, the stimulation of the dorsolateral prefrontal cortex bilaterally, right parietal cortex, and dominant primary motor cortex (M1) in insomnia, as well as the stimulation of M1 leg area bilaterally, left primary somatosensory cortex, and left M1 in RLS reduced subjective symptoms and severity scale scores, with effects lasting for up to weeks; conversely, no relevant effect was observed in OSAS and narcolepsy. Nevertheless, several limitations especially regarding the stimulation protocols need to be considered. This review should be viewed as a step towards the further contribution of individually tailored neuromodulatory techniques for sleep disorders.
Topics: Humans; Transcranial Magnetic Stimulation; Brain; Restless Legs Syndrome; Sleep Apnea, Obstructive; Sleep Initiation and Maintenance Disorders; Narcolepsy; Sleep Wake Disorders
PubMed: 36563570
DOI: 10.1016/j.smrv.2022.101735 -
Sleep Medicine Reviews Aug 2015The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific... (Review)
Review
The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) improve sleep? Is there still a use for sleep hygiene? Global public health concern over sleep has increased demand for sleep promotion strategies accessible to the population. However, the extent to which sleep hygiene strategies apply outside clinical settings is not well known. The present review sought to evaluate the empirical evidence for sleep hygiene recommendations regarding exercise, stress management, noise, sleep timing, and avoidance of caffeine, nicotine, alcohol, and daytime napping, with a particular emphasis on their public health utility. Thus, our review is not intended to be exhaustive regarding the clinical application of these techniques, but rather to focus on broader applications. Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population. Suggestions for clarification of sleep hygiene recommendations and considerations for the use of sleep hygiene in nonclinical populations are discussed.
Topics: Dyssomnias; Health Promotion; Humans; Public Health; Sleep; Sleep Medicine Specialty
PubMed: 25454674
DOI: 10.1016/j.smrv.2014.10.001 -
Nutrients Aug 2016Caffeine is commonly consumed to help offset fatigue, however, it can have several negative effects on sleep quality and quantity. The aim of this study was to determine...
Caffeine is commonly consumed to help offset fatigue, however, it can have several negative effects on sleep quality and quantity. The aim of this study was to determine the relationship between caffeine consumption and sleep quality in adults using a newly validated caffeine food frequency questionnaire (C-FFQ). In this cross sectional study, 80 adults (M ± SD: 38.9 ± 19.3 years) attended the University of South Australia to complete a C-FFQ and the Pittsburgh Sleep Quality Index (PSQI). Caffeine consumption remained stable across age groups while the source of caffeine varied. Higher total caffeine consumption was associated with decreased time in bed, as an estimate of sleep time (r = -0.229, p = 0.041), but other PSQI variables were not. Participants who reported poor sleep (PSQI global score ≥ 5) consumed 192.1 ± 122.5 mg (M ± SD) of caffeine which was significantly more than those who reported good sleep quality (PSQI global score < 5; 125.2 ± 62.6 mg; p = 0.008). The C-FFQ was found to be a quick but detailed way to collect population based caffeine consumption data. The data suggests that shorter sleep is associated with greater caffeine consumption, and that consumption is greater in adults with reduced sleep quality.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Caffeine; Carbonated Beverages; Coffee; Cross-Sectional Studies; Dyssomnias; Feeding Behavior; Female; Humans; Male; Middle Aged; Quality of Life; Self Report; Severity of Illness Index; Sleep Initiation and Maintenance Disorders; South Australia; Tea; Time Factors; Young Adult
PubMed: 27527212
DOI: 10.3390/nu8080479 -
Journal of Behavioral Medicine Jun 2006The Sleep Hygiene Index was developed to assess the practice of sleep hygiene behaviors. The Sleep Hygiene Index was delivered to 632 subjects and a subset of the...
The Sleep Hygiene Index was developed to assess the practice of sleep hygiene behaviors. The Sleep Hygiene Index was delivered to 632 subjects and a subset of the subjects participated in a readministration of the instrument. Test-retest reliability analyses suggested that sleep hygiene behaviors are relatively stable over time for a nonclinical population. Results confirmed that sleep hygiene is strongly related to sleep quality and modestly related to perceptions of daytime sleepiness. As predicted, support of the sleep hygiene construct was also provided by strong correlations with the associated features of a diagnosis of inadequate sleep hygiene. The Sleep Hygiene Index, a much shorter sleep hygiene instrument than previously published, demonstrated comparable psychometric properties with additional evidence of validity and a clear item selection rationale.
Topics: Adult; Disorders of Excessive Somnolence; Dyssomnias; Female; Humans; Male; Reproducibility of Results; Severity of Illness Index; Surveys and Questionnaires
PubMed: 16557353
DOI: 10.1007/s10865-006-9047-6 -
Pediatrics May 2007Our aim for this study was to determine the prevalence of dyssomnias and various parasomnias in early childhood and to describe their temporal evolution, gender... (Comparative Study)
Comparative Study
OBJECTIVES
Our aim for this study was to determine the prevalence of dyssomnias and various parasomnias in early childhood and to describe their temporal evolution, gender differences, and correlates.
METHODS
This research is part of a longitudinal study of child development. A randomized, 3-level, stratified survey design was used to study a representative sample of infants who were born in 1997-1998 in the province of Quebec (Canada). When the children were 2.5 years of age, 1997 families agreed to be interviewed. The presence of dyssomnias or parasomnias was obtained from a self-administered questionnaire that was completed by the mother at each round of measures.
RESULTS
The percentage of children with frequent night wakings decreased steadily from 36.3% at age 2.5 to 13.2% at age 6. Similarly, the percentage of children who had difficulty falling asleep at night decreased significantly from 16.0% at ages 3.5 and 4 to 10% at age 5 and to 7.4% at age 6. The overall prevalence of each parasomnia for the period studied was as follows: somnambulism, 14.5%; sleep terrors, 39.8%; somniloquy, 84.4%; enuresis, 25.0%; bruxism, 45.6%; and rhythmic movements, 9.2%. Persistent somnambulism at age 6 was significantly correlated with sleep terrors and somniloquy. Persistent sleep terrors at age 6 were also correlated with somniloquy. Finally, persistent sleep terrors at age 6 were correlated with frequent night wakings. Separation anxiety was associated with persistent night wakings and with somnambulism, bruxism, sleep terrors, and somniloquy.
CONCLUSIONS
There is a high prevalence of night wakings and sleep-onset difficulties in preschool children. Parasomnias are highly prevalent in early childhood and are associated with separation anxiety. However, they have little impact on sleep duration.
Topics: Child; Child, Preschool; Cohort Studies; Data Collection; Dyssomnias; Female; Humans; Longitudinal Studies; Male; Parasomnias; Sex Characteristics
PubMed: 17438080
DOI: 10.1542/peds.2006-2132 -
Behavioural Neurology 2024Mild cognitive impairment (MCI), an intermediate stage between normal aging and dementia, has emerged as a prominent research area in geriatric care due to its... (Review)
Review
BACKGROUND
Mild cognitive impairment (MCI), an intermediate stage between normal aging and dementia, has emerged as a prominent research area in geriatric care due to its heightened propensity for progressing toward dementia. Sleep plays a pivotal role in cognitive function, with dyssomnias not only exacerbating cognitive and affective symptoms associated with neurodegenerative diseases but also contributing to disease progression.
AIM
This bibliometric analysis investigates the global research on MCI with dyssomnias over the past two decades, aiming to discern key findings, research domains, and emerging trends in this field.
METHODS
In this study, a bibliometric analysis was conducted using the search terms "MCI" and "sleep". Data were extracted from the Web of Science Core Collection database, and visualization and collaborative analysis were performed using CiteSpace and VOSviewer.
RESULTS
This study encompassed 546 publications from 2003 to 2023. The publication volume and citation rate consistently increased over time. Neurosciences, Clinical Neurology, and Geriatrics Gerontology emerged as the top three research fields. The had the highest publication count, while received the most citations. USA, China, and Italy led in publication output. Collaborative clusters among authors and institutions were identified, but cooperation between clusters was limited. Active cocited reference clusters included "obstructive sleep apnea", "possible mediating pathways", and "isolated rapid eye movement sleep behaviour disorder". The top frequently mentioned keywords, besides "MCI", were "Alzheimer's disease", "dementia", "risk factor", and "Parkinson's Disease". Notable keyword clusters spanned circadian rhythm, Parkinson's disease, MCI, dementia with Lewy body, subjective cognitive impairment, Lewy body disease, Alzheimer's disease, and dietary patterns.
CONCLUSION
The field of MCI with dyssomnias is rapidly expanding, encompassing a wide range of neurodegenerative disorders and sleep disturbances. Current research endeavors are primarily focused on elucidating the underlying pathogenesis, predicting disease progression, and developing innovative treatment strategies for individuals affected by MCI with dyssomnias.
Topics: Humans; Aged; Alzheimer Disease; Cognitive Dysfunction; Disease Progression; Bibliometrics; Dyssomnias
PubMed: 38223295
DOI: 10.1155/2024/6622212