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Nutrients May 2024Seventy-one healthy subjects with sleep disturbances participated in a randomized, double-blind controlled trial in which dietary supplementation with an extract of... (Randomized Controlled Trial)
Randomized Controlled Trial
Seventy-one healthy subjects with sleep disturbances participated in a randomized, double-blind controlled trial in which dietary supplementation with an extract of (lemon verbena) ( = 33) or placebo ( = 38) was administered for 90 days. There were between-group differences in favor of the experimental group in the visual analogue scale (VAS) for sleep quality (6.5 ± 1.6 vs. 5.5 ± 2.1, = 0.021) as well as in the overall score (5.8 ± 2.4, = 0.008) and scores for sleep latency (1.6 ± 1.0 vs. 1.9 ± 0.7, = 0.027) and sleep efficiency (84.5 ± 12.8 vs. 79.8 ± 13.6, = 0.023) in the Pittsburgh Sleep Quality Index (PSQI). Sleep-related variables (latency, efficiency, wakefulness after sleep onset, awakenings) assessed by actigraphy also showed better scores in the experimental group ( = 0.001). Plasma nocturnal melatonin levels also increased significantly in the experimental group (199.7 ± 135.3 vs. 174.7 ± 115.4 pg/mL, = 0.048). Changes in anthropometric parameters and physical activity levels were not found. In summary, a dietary supplement of lemon verbena administered for 3 months was associated with a significant improvement in sleep quality as compared with placebo in a population of healthy subjects with sleep problems.
Topics: Humans; Double-Blind Method; Dietary Supplements; Male; Plant Extracts; Female; Adult; Sleep Quality; Middle Aged; Melatonin; Healthy Volunteers; Young Adult; Sleep; Sleep Wake Disorders
PubMed: 38794761
DOI: 10.3390/nu16101523 -
International Journal of Environmental... Apr 2024Sleep is often impaired in firefighters due to the psychologically and physiologically intense nature of their work and working shift schedules. Peanut butter is... (Randomized Controlled Trial)
Randomized Controlled Trial
Sleep is often impaired in firefighters due to the psychologically and physiologically intense nature of their work and working shift schedules. Peanut butter is affordable and a substantial source of monounsaturated fatty acids, which may aid sleep health. Thus, this study sought to determine if a daily serving of peanut butter consumed before bedtime for seven weeks altered sleep quality and quantity among full-time firefighters. Forty firefighters (peanut butter group = 20; control group = 20) participated in this eight-week randomized controlled trial. All participants completed a subjective questionnaire on mood, focus, and alertness twice daily and wore an Actigraph wristwatch to measure sleep variables, including latency, efficiency, time in bed, time asleep, wake after sleep onset, number of awakenings, and time spent awake. After a baseline week, the peanut butter group consumed two tablespoons of peanut butter two hours prior to bedtime for seven weeks. Compared to the control group, the peanut butter group did not demonstrate significant changes ( > 0.05) in sleep measures or subjective feelings of mood, focus, or alertness after consuming peanut butter for seven weeks. Therefore, peanut butter as a source of peanuts did not alter sleep quality or quantity in this group of firefighters.
Topics: Humans; Firefighters; Arachis; Male; Adult; Female; Sleep; Middle Aged
PubMed: 38791786
DOI: 10.3390/ijerph21050571 -
Brain Sciences Apr 2024Recent research suggests that cognitive deficits in individuals with psychotic disorders could be overestimated because poor cognitive test performance is partly...
Revisiting Cognitive Deficits in Outpatients with Psychotic Disorders: A Transdiagnostic Comparison of Cognitive Performance While Accounting for Putative Confounding Factors.
Recent research suggests that cognitive deficits in individuals with psychotic disorders could be overestimated because poor cognitive test performance is partly attributable to non-cognitive factors. To further test this, we included non-hospitalized individuals with psychotic disorders (PSY, = 38), individuals with attenuated psychotic symptoms ( = 40), individuals with obsessive-compulsive disorders ( = 39), and healthy controls ( = 38). Relevant cognitive domains were assessed using the MATRICS Consensus Cognitive Battery. Putative confounding non-cognitive factors-heart rate, self-reported stress, negative affect, performance-related beliefs, and actigraphy-derived sleep-were assessed before cognitive testing. A multivariate analysis of covariance was calculated to examine group differences in cognitive performance while controlling for non-cognitive factors. PSY showed decreased test performance in graphomotor speed, attention, and verbal tasks compared to the other groups, whereas non-verbal/visual-spatial tasks were unimpaired. After accounting for non-cognitive factors, group differences diminished in verbal learning, whereas differences in the other domains remained significant. Against our hypotheses, the present findings indicate that some cognitive deficits in PSY cannot be attributed to momentary confounding factors.
PubMed: 38790425
DOI: 10.3390/brainsci14050446 -
Frontiers in Physiology 2024
PubMed: 38779322
DOI: 10.3389/fphys.2024.1419268 -
Sleep Medicine Jul 2024To examine cross-sectional and longitudinal associations of various types of dietary patterns with self-reported sleep quality and with actigraphy-estimated sleep...
OBJECTIVE
To examine cross-sectional and longitudinal associations of various types of dietary patterns with self-reported sleep quality and with actigraphy-estimated sleep parameters in the prospective, population-based Rotterdam Study.
METHODS
For each participant, scores for five different dietary patterns were derived based on food frequency questionnaires; two pre-defined scores developed to estimate adherence to the Dutch dietary guidelines and to the Mediterranean diet; and three data-driven scores indicating a prudent, unhealthy and typical Dutch diet. In 2589 participants (median age 56.9 years; 58 % female), self-rated sleep quality was assessed with the Pittsburgh Sleep Quality Index. In 533 participants, actigraphs were worn for an average of 6.8 days (SD: 0.7) to estimate total sleep time, sleep onset latency, wake after sleep onset, and sleep efficiency. Sleep parameters were measured at baseline and 3-6 years later. Multiple linear regression was used to assess cross-sectional and longitudinal associations.
RESULTS
No statistically significant associations between dietary patterns and total sleep time, sleep onset latency, wake after sleep onset, sleep efficiency and subjective sleep quality were observed in cross-sectional or longitudinal analyses. To illustrate, the effect estimate for sleep duration was 2.7 min per night (95 % CI -2.1, 7.5) per 5 point increase in Mediterranean diet score in the cross-sectional analyses. Furthermore, in longitudinal analyses, the effect estimate for sleep duration was -1.0 min per night (95 % CI -5.2, 3.1) per SD increase in the prudent diet.
CONCLUSIONS
Our results suggest that dietary patterns are not associated with sleep in this population-based cohort study.
TRIAL REGISTRATION
Netherlands National Trial Register and WHO International Clinical Trials Registry Platform (ICTRP; https://apps.who.int/trialsearch/) shared catalogue number NL6645/NTR6831. Registered November 13th, 2017.
Topics: Humans; Female; Male; Middle Aged; Sleep Quality; Cross-Sectional Studies; Actigraphy; Prospective Studies; Netherlands; Sleep; Diet; Diet, Mediterranean; Self Report; Surveys and Questionnaires; Aged; Longitudinal Studies; Cohort Studies; Feeding Behavior; Sleep Duration; Dietary Patterns
PubMed: 38761605
DOI: 10.1016/j.sleep.2024.05.017 -
Trials May 2024Prediabetes is a highly prevalent condition that heralds an increased risk of progression to type 2 diabetes, along with associated microvascular and macrovascular...
BACKGROUND
Prediabetes is a highly prevalent condition that heralds an increased risk of progression to type 2 diabetes, along with associated microvascular and macrovascular complications. The Diabetes Prevention Program (DPP) is an established effective intervention for diabetes prevention. However, participation in this 12-month lifestyle change program has historically been low. Digital DPPs have emerged as a scalable alternative, accessible asynchronously and recognized by the Centers for Disease Control and Prevention (CDC). Yet, most digital programs still incorporate human coaching, potentially limiting scalability. Furthermore, existing effectiveness results of digital DPPs are primarily derived from per protocol, longitudinal non-randomized studies, or comparisons to control groups that do not represent the standard of care DPP. The potential of an AI-powered DPP as an alternative to the DPP is yet to be investigated. We propose a randomized controlled trial (RCT) to directly compare these two approaches.
METHODS
This open-label, multicenter, non-inferiority RCT will compare the effectiveness of a fully automated AI-powered digital DPP (ai-DPP) with a standard of care human coach-based DPP (h-DPP). A total of 368 participants with elevated body mass index (BMI) and prediabetes will be randomized equally to the ai-DPP (smartphone app and Bluetooth-enabled body weight scale) or h-DPP (referral to a CDC recognized DPP). The primary endpoint, assessed at 12 months, is the achievement of the CDC's benchmark for type 2 diabetes risk reduction, defined as any of the following: at least 5% weight loss, at least 4% weight loss and at least 150 min per week on average of physical activity, or at least a 0.2-point reduction in hemoglobin A1C. Physical activity will be objectively measured using serial actigraphy at baseline and at 1-month intervals throughout the trial. Secondary endpoints, evaluated at 6 and 12 months, will include changes in A1C, weight, physical activity measures, program engagement, and cost-effectiveness. Participants include adults aged 18-75 years with laboratory confirmed prediabetes, a BMI of ≥ 25 kg/m (≥ 23 kg/m for Asians), English proficiency, and smartphone users. This U.S. study is conducted at Johns Hopkins Medicine in Baltimore, MD, and Reading Hospital (Tower Health) in Reading, PA.
DISCUSSION
Prediabetes is a significant public health issue, necessitating scalable interventions for the millions affected. Our pragmatic clinical trial is unique in directly comparing a fully automated AI-powered approach without direct human coach interaction. If proven effective, it could be a scalable, cost-effective strategy. This trial will offer vital insights into both AI and human coach-based behavioral change strategies in real-world clinical settings.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05056376. Registered on September 24, 2021, https://clinicaltrials.gov/study/NCT05056376.
Topics: Humans; Diabetes Mellitus, Type 2; Prediabetic State; Artificial Intelligence; Mentoring; Randomized Controlled Trials as Topic; Multicenter Studies as Topic; Treatment Outcome; Risk Reduction Behavior; Time Factors; Adult; Male; Female; Middle Aged; Mobile Applications
PubMed: 38755706
DOI: 10.1186/s13063-024-08177-8 -
BMC Pregnancy and Childbirth May 2024The potential effect modification of sleep on the relationship between anxiety and elevated blood pressure (BP) in pregnancy is understudied. We evaluated the...
BACKGROUND
The potential effect modification of sleep on the relationship between anxiety and elevated blood pressure (BP) in pregnancy is understudied. We evaluated the relationship between anxiety, insomnia, and short sleep duration, as well as any interaction effects between these variables, on BP during pregnancy.
METHODS
This was a prospective pilot cohort of pregnant people between 23 to 36 weeks' gestation at a single institution between 2021 and 2022. Standardized questionnaires were used to measure clinical insomnia and anxiety. Objective sleep duration was measured using a wrist-worn actigraphy device. Primary outcomes were systolic (SBP), diastolic (DBP), and mean (MAP) non-invasive BP measurements. Separate sequential multivariable linear regression models fit with generalized estimating equations (GEE) were used to separately assess associations between anxiety (independent variable) and each BP parameter (dependent variables), after adjusting for potential confounders (Model 1). Additional analyses were conducted adding insomnia and the interaction between anxiety and insomnia as independent variables (Model 2), and adding short sleep duration and the interaction between anxiety and short sleep duration as independent variables (Model 3), to evaluate any moderating effects on BP parameters.
RESULTS
Among the 60 participants who completed the study, 15 (25%) screened positive for anxiety, 11 (18%) had subjective insomnia, and 34 (59%) had objective short sleep duration. In Model 1, increased anxiety was not associated with increases in any BP parameters. When subjective insomnia was included in Model 2, increased DBP and MAP was significantly associated with anxiety (DBP: β 6.1, p = 0.01, MAP: β 6.2 p < 0.01). When short sleep was included in Model 3, all BP parameters were significantly associated with anxiety (SBP: β 9.6, p = 0.01, DBP: β 8.1, p < 0.001, and MAP: β 8.8, p < 0.001). No moderating effects were detected between insomnia and anxiety (p interactions: SBP 0.80, DBP 0.60, MAP 0.32) or between short sleep duration and anxiety (p interactions: SBP 0.12, DBP 0.24, MAP 0.13) on BP.
CONCLUSIONS
When including either subjective insomnia or objective short sleep duration, pregnant people with anxiety had 5.1-9.6 mmHg higher SBP, 6.1-8.1 mmHg higher DBP, and 6.2-8.8 mmHg higher MAP than people without anxiety.
Topics: Humans; Female; Pregnancy; Pilot Projects; Prospective Studies; Adult; Anxiety; Blood Pressure; Sleep Initiation and Maintenance Disorders; Sleep; Pregnancy Complications; Surveys and Questionnaires; Actigraphy
PubMed: 38750438
DOI: 10.1186/s12884-024-06540-w -
MedRxiv : the Preprint Server For... Apr 2024Light is a salient environmental exposure, serving as the primary entraining cue for the circadian system and having other, non-circadian, effects on health. Gender...
Light is a salient environmental exposure, serving as the primary entraining cue for the circadian system and having other, non-circadian, effects on health. Gender differences in light exposure patterns could contribute to gender differences in health outcomes and would have important implications for sleep and circadian research. Gender differences in real-world light exposure (measured over a week with wrist-worn ActiGraph GT3X+ devices) were investigated in cross- sectional data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). Measures of time above light threshold (TALT), individual photoperiod (IP), first and last timing of light (FTL and LTL, respectively), and mean light timing revised (MLiTR) at different light intensity thresholds were derived. Gender differences in light exposure were tested using two-sample t-tests, Watson's two-sample test of homogeneity, and linear regression models. Exploratory analyses to investigate work and physical activity-related factors in relation to bright light exposure were also conducted. A total of 11,318 NHANES participants (age range: 3-80+, 52.2% women) with 6 days of valid actigraphy and light data were included in the analysis. The findings suggest that for every 60 minutes of bright light (≥1,000 lux) that men receive, women receive 39.6 minutes. Men spend approximately 52% more time in bright light than women and this gender difference begins in childhood. The IP of bright light exposure is also longer for men, with earlier first and later last timing of bright light exposure compared to women. These gender differences were robust across ages and between race and ethnicity groups. While further research is needed, these gender differences in light exposure may be due to gender differences in indoor vs. outdoor activities. Future studies of gender differences in response to light exposure should consider light exposure history in study design and analysis. The results of this study may inform future health disparities research and support the importance of the study of light as an important environmental exposure and component of the human exposome.
PubMed: 38746463
DOI: 10.1101/2024.04.28.24306495 -
Sleep Advances : a Journal of the Sleep... 2024Evidence suggests that adolescents and adults with a later chronotype have poorer sleep habits and are more susceptible to unhealthy behaviors, but little is known about...
STUDY OBJECTIVES
Evidence suggests that adolescents and adults with a later chronotype have poorer sleep habits and are more susceptible to unhealthy behaviors, but little is known about these associations in younger children. The objective of the study was to (1) identify and compare individual chronotype tendencies among preschool-aged children and (2) investigate associations of sleep dimensions and chronotype with diet.
METHODS
Participants were 636 3-6 years old (mean ± SD age: 4.74 ± 0.89 years, 49% girls) preschoolers from the cross-sectional Increased Health and Well-Being in Preschoolers (DAGIS) study in Finland. Sleep duration, sleep variability (in duration and midpoint), social jetlag, and midsleep on weekends adjusted for sleep debt (MSWEadj) were measured with 7-day actigraphy. Morning, intermediate, and evening chronotype tendencies were defined based on the lowest and highest 10th percentile cutoffs of MSWEadj. Food, energy, and macronutrient intake were assessed from 3-day records. Associations between sleep dimensions and diet were assessed with regression models.
RESULTS
MSWEadj was 1:13 ± 14 minutes for morning ( = 64), 2:25 ± 28 minutes for intermediate ( = 560), and 3:38 ± 15 minutes for evening ( = 64) chronotype tendency. Children with an evening chronotype tendency had greater social jetlag and sleep variability. Having an evening chronotype tendency was associated with higher added sugar, higher sugary food consumption, and lower vegetable consumption compared to intermediate tendency types. A later chronotype (MSWEadj) was associated with higher sugary food consumption, as well as lower vegetable and fiber intake. Sleep duration, social jetlag, and sleep variability were not associated with diet.
CONCLUSIONS
Several less healthy sleep and diet behaviors were observed among children with later chronotypes. Future public health interventions aimed towards children would benefit from taking into account chronotype.
PubMed: 38737796
DOI: 10.1093/sleepadvances/zpae026 -
PloS One 2024This study aimed to determine whether filtering out walking-related actigraphy data improves the reliability and accuracy of real-world upper extremity activity... (Randomized Controlled Trial)
Randomized Controlled Trial
This study aimed to determine whether filtering out walking-related actigraphy data improves the reliability and accuracy of real-world upper extremity activity assessment in children with unilateral cerebral palsy. Twenty-two children aged 4-12 years diagnosed with unilateral cerebral palsy were included in this study, which was drawn from a two-phase randomized controlled trial conducted from July 2021 to December 2022. Data were collected from a tertiary hospital in Seoul, Republic of Korea. Participants were monitored using tri-axial accelerometers on both wrists across three time points (namely, T0, T1, and T2) over 3 days; interventions were used between each time point. Concurrently, an in-laboratory study focusing on walking and bimanual tasks was conducted with four participants. Data filtration resulted in a reduction of 8.20% in total data entry. With respect to reliability assessment, the intra-class correlation coefficients indicated enhanced consistency after filtration, with increased values for both the affected and less-affected sides. Before filtration, the magnitude counts for both sides showed varying tendencies, depending on the time points; however, they presented a consistent and stable trend after filtration. The findings of this research underscore the importance of accurately interpreting actigraphy measurements in children with unilateral cerebral palsy for targeted upper limb intervention by filtering walking-induced data.
Topics: Humans; Cerebral Palsy; Actigraphy; Child; Walking; Male; Female; Child, Preschool; Reproducibility of Results; Republic of Korea
PubMed: 38722902
DOI: 10.1371/journal.pone.0303090