Sleep disorders common during COVID-19 pandemic

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Study demonstrates link between housing insecurity and sleep outcomes

2/1/21


https://www.news-medical.net/news/20210 ... comes.aspx


People who are unable to make their rent or mortgage payments sleep less than than their peers who don't have such problems, and those who are forced to move because of financial problems sleep even less, according to a new RAND Corporation study.

The study, which followed 1,046 people receiving welfare in California over several years, is the first to analyze the relationship between housing insecurity and sleep outcomes after controlling for sleep duration and sleep quality measured prior to experiences with housing insecurity.

The study found that people who were unable to make a rent or mortgage payment slept on average 22 fewer minutes a night than their peers who were able to make their rent or mortgage payments.

People who were forced to move because they could not make their rent or mortgage payments slept on average 32 fewer minutes a night than their peers who were not forced to move. The findings are published online by the journal Sleep.

" This is the first study that demonstrates that housing insecurity represents a distinct impediment to healthy sleep duration and quality. The stability and condition of one's home environment are critically important for health and well-being."

- Robert Bozick, Study's Lead Author and Adjunct Researcher, RAND

The study analyzed information from the California Socioeconomic Survey, a longitudinal study conducted by RAND of participants in the state's welfare program, which is called CalWORKs.

The survey follows a random sample of 1,657 adults drawn from a population of 15,600 economically disadvantaged families who first enrolled in CalWORKs between 2011 and 2014 in one of six diverse counties: Alameda, Fresno, Los Angeles, Riverside, Sacramento and Stanislaus.

The new RAND study used information from a sample of 1,046 participants who participated in surveys during 2015-16 and 2017-18, and who answered questions about sleep duration, sleep quality and housing insecurity.

The reductions in sleep quality detailed by the study were small to moderate by conventional standards, but researchers say that sleep is cumulative such that slight reductions accrue over time. This accumulation in turn can create more pronounced sleep deficits.

"Considering the downstream health implications of housing insecurity is particularly timely given the economic fall-out from the coronavirus pandemic," said Bozick, who is a senior fellow at the Kinder Institute for Urban Research at Rice University. "National surveys show many Americans are having trouble making their housing payments, which may lead to greater reliance on social safety net programs like welfare in the near future."

Source:

RAND Corporation

Journal reference:

Bozick, R., et al. (2021) Housing insecurity and sleep among welfare recipients in California. Sleep. doi.org/10.1093/sleep/zsab005.
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Re: Sleep disorders common during COVID-19 pandemic

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Sleep keeps teens on track for good mental health

2/10/21

https://www.sciencedaily.com/releases/2 ... 091215.htm


As families settle back into a new school year, sleep experts at the University of South Australia are reminding parents about the importance of teenagers getting enough sleep, cautioning them that insufficient sleep can negatively affect their mental health.

In a new research paper, UniSA sleep experts Dr Alex Agostini and Dr Stephanie Centofanti confirm that sleep is intrinsically linked to mental health, but is commonly overlooked by health practitioners as a contributing factor.

Dr Agostini says it's imperative that parents and medical practitioners are aware of the bi-directional relationship between sleep and mental health, particularly across the teenage years.

"Getting enough sleep is important for all of us ¬¬- it helps our physical and mental health, boosts our immunity, and ensures we can function well on a daily basis," Dr Agostini¬ says.

"But for teenagers, sleep is especially critical because they're at an age where they're going through a whole range of physical, social, and developmental changes, all of which depend on enough sleep.

"Research shows that teenagers need at least eight hours of sleep each night. Without this, they're less able to deal with stressors, such as bullying or social pressures, and run the risk of developing behavioural problems, as well as anxiety and depression.

"If sleep drops to less than six hours a night, research shows that teens are twice as likely to engage in risky behaviours such as dangerous driving, marijuana, alcohol or tobacco use, risky sexual behaviour, and other aggressive or harmful activities."

In Australia, almost one in seven children and adolescents (aged 4-17 years) will experience a mental health disorder. The World Health Organization says that while half of all mental health conditions start by age 14, most cases go undetected and untreated.

Co-researcher, Dr Centofanti says while many factors contribute to later bedtimes for teenagers, technology is one of the greatest offenders.

"Teens spend a lot of time on devices, whether it's texting friends, playing games, or watching videos, using technology late into the night is one of the most common disruptors of good sleep. Overuse of technology can also contribute to mental health issues likely to increase anxiety," Dr Centofanti says.

"Not only can technology use make us feel anxious and awake, but the blue light emitted from technology inhibits the production of the sleep hormone melatonin to delay the natural onset of sleep. This is problematic because teens already have a biological tendency to want to stay up late and sleep in.

"To make a real difference to teenage mental health, both parents and medical practitioners must understand how sleep can affect mental health in teenagers."

Story Source:

Materials provided by University of South Australia.

Journal Reference:

Alex Agostini, Stephanie Centofanti. Normal Sleep in Children and Adolescence. Child and Adolescent Psychiatric Clinics of North America, 2021; 30 (1): 1 DOI: 10.1016/j.chc.2020.08.011
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The science of siestas: New research reveals the genetic basis for daytime napping

2/10/21

https://www.sciencedaily.com/releases/2 ... 133305.htm


How often a person takes daytime naps, if at all, is partly regulated by their genes, according to new research led by investigators at Massachusetts General Hospital (MGH) and published in Nature Communications. In this study, the largest of its kind ever conducted, the MGH team collaborated with colleagues at the University of Murcia in Spain and several other institutions to identify dozens of gene regions that govern the tendency to take naps during the day. They also uncovered preliminary evidence linking napping habits to cardiometabolic health.

"Napping is somewhat controversial," says Hassan Saeed Dashti, PhD, RD, of the MGH Center for Genomic Medicine, co-lead author of the report with Iyas Daghlas, a medical student at Harvard Medical School (HMS). Dashti notes that some countries where daytime naps have long been part of the culture (such as Spain) now discourage the habit. Meanwhile, some companies in the United States now promote napping as a way to boost productivity. "It was important to try to disentangle the biological pathways that contribute to why we nap," says Dashti.

Previously, co-senior author Richa Saxena, PhD, principal investigator at the Saxena Lab at MGH, and her colleagues used massive databases of genetic and lifestyle information to study other aspects of sleep. Notably, the team has identified genes associated with sleep duration, insomnia, and the tendency to be an early riser or "night owl." To gain a better understanding of the genetics of napping, Saxena's team and co-senior author Marta Garaulet, PhD, of the department of Physiology at the University of Murcia, performed a genome-wide association study (GWAS), which involves rapid scanning of complete sets of DNA, or genomes, of a large number of people. The goal of a GWAS is to identify genetic variations that are associated with a specific disease or, in this case, habit.

For this study, the MGH researchers and their colleagues used data from the UK Biobank, which includes genetic information from 452,633 people. All participants were asked whether they nap during the day "never/rarely," "sometimes" or "usually." The GWAS identified 123 regions in the human genome that are associated with daytime napping. A subset of participants wore activity monitors called accelerometers, which provide data about daytime sedentary behavior, which can be an indicator of napping. This objective data indicated that the self-reports about napping were accurate. "That gave an extra layer of confidence that what we found is real and not an artifact," says Dashti.

Several other features of the study bolster its results. For example, the researchers independently replicated their findings in an analysis of the genomes of 541,333 people collected by 23andMe, the consumer genetic-testing company. Also, a significant number of the genes near or at regions identified by the GWAS are already known to play a role in sleep. One example is KSR2, a gene that the MGH team and collaborators had previously found plays a role in sleep regulation.

Digging deeper into the data, the team identified at least three potential mechanisms that promote napping:

Sleep propensity: Some people need more shut-eye than others.
Disrupted sleep: A daytime nap can help make up for poor quality slumber the night before.
Early morning awakening: People who rise early may "catch up" on sleep with a nap.

"This tells us that daytime napping is biologically driven and not just an environmental or behavioral choice," says Dashti. Some of these subtypes were linked to cardiometabolic health concerns, such as large waist circumference and elevated blood pressure, though more research on those associations is needed. "Future work may help to develop personalized recommendations for siesta," says Garaulet.

Furthermore, several gene variants linked to napping were already associated with signaling by a neuropeptide called orexin, which plays a role in wakefulness. "This pathway is known to be involved in rare sleep disorders like narcolepsy, but our findings show that smaller perturbations in the pathway can explain why some people nap more than others," says Daghlas.

Saxena is the Phyllis and Jerome Lyle Rappaport MGH Research Scholar at the Center for Genomic Medicine and an associate professor of Anesthesia at HMS.

The work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung, and Blood Institute, MGH Research Scholar Fund, Spanish Government of Investigation, Development and Innovation, the Autonomous Community of the Region of Murcia through the Seneca Foundation, Academy of Finland, Instrumentarium Science Foundation, Yrjö Jahnsson Foundation, and Medical Research Council.


Story Source:

Materials provided by Massachusetts General Hospital.

Journal Reference:

Hassan S. Dashti, Iyas Daghlas, Jacqueline M. Lane, Yunru Huang, Miriam S. Udler, Heming Wang, Hanna M. Ollila, Samuel E. Jones, Jaegil Kim, Andrew R. Wood, Michael N. Weedon, Stella Aslibekyan, Marta Garaulet, Richa Saxena. Genetic determinants of daytime napping and effects on cardiometabolic health. Nature Communications, 2021; 12 (1) DOI: 10.1038/s41467-020-20585-3
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Nightly sleep of five hours, less, may increase risk of dementia, death among older adults

Survey finds very short sleep duration in this population was associated with double the risk of dementia


2/11/21

https://www.sciencedaily.com/releases/2 ... 113840.htm


Sleep and health are inextricably connected. New research from investigators at Brigham and Women's Hospital explores the connection between sleep disturbances and deficiencies among older adults and risk of dementia and death, finding that risk of dementia was double among participants who reported getting less than five hours of sleep compared to those who reported 7-8 hours of sleep per night. The team also found associations between sleep disturbance and sleep deficiency with overall risk of death. Results are published in Aging.

"Our findings illuminate a connection between sleep deficiency and risk of dementia and confirm the importance of efforts to help older individuals obtain sufficient sleep each night," said lead author, Rebecca Robbins, PhD, of the Division of Sleep and Circadian Disorders.

To investigate the connection between quality and quantity of sleep and risk of dementia and death, Robbins and colleagues used nationally representative data collected from older adults participating in the National Health and Aging Trends Study (NHATS). NHATS is a longitudinal study of Medicare beneficiaries 65 years and older. Survey data from NHATS participants has been collected annually since 2011.

A sample of 2,610 participants answered sleep questionnaires in 2013 and 2014. The researchers examined participants' answers about several characteristics of sleep disturbance and deficiency, including alertness, nap frequency, how long it took participants to fall asleep, sleep quality (good/very good, fair, very poor/poor), sleep duration and snoring. They also collected information (from health care proxies as needed) about patient outcomes such as dementia and death from any cause for up to five years after the survey.

Overall, they found a strong relationship between several sleep disturbance and deficiency variables and incident dementia over time. Routinely taking 30 minutes or longer to fall asleep was associated with a 45 percent greater risk for incident dementia. Routinely experiencing a difficulty in maintaining alertness, routinely napping, reporting poor sleep quality, and sleeping five or fewer hours per night was also associated with increased risk of death.

"This prospective study reveals that sleep deficiency at baseline, when the average age of participants was 76 years old, was associated with double the risk of incident dementia and all-cause mortality over the next 4 to 5 years," said senior author, Charles Czeisler, MD, PhD, FRCP, FAPS, chief of the Division of Sleep and Circadian Disorders. "These data add to the evidence that sleep is important for brain health and highlight the need for further research on the efficacy of improving sleep and treating sleep disorders on the risk of Alzheimer's disease and mortality."

The authors call for further study of the causal relationship between sleep and dementia and death, as insights may lead to a new lens through which to view sleep among older adults.

"Our study demonstrates that very short sleep durations and poor-quality sleep in the elderly increase the risk of developing dementia and earlier death. There should be increased focus on obtaining healthy sleep in older adults," said second author Stuart Quan, MD, of the Division of Sleep and Circadian Disorders.

Funding for this work was provided by the National Institute for Occupational Safety and Health (R01OH011773); the NIH National Heart, Lung, and Blood Institute (K01HL150339 and R56HL151637), and the Brigham Research Institute Fund to Sustain Research Excellence.


Story Source:

Materials provided by Brigham and Women's Hospital.

Journal Reference:

Rebecca Robbins, Stuart F. Quan, Matthew D. Weaver, Gregory Bormes, Laura K. Barger, Charles A. Czeisler. Examining sleep deficiency and disturbance and their risk for incident dementia and all-cause mortality in older adults across 5 years in the United States. Aging, 2021; DOI: 10.18632/aging.202591
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Regular caffeine consumption affects brain structure

2/16/21


https://www.sciencedaily.com/releases/2 ... 100137.htm


Coffee, cola or an energy drink: caffeine is the world's most widely consumed psychoactive substance. Researchers from the University of Basel have now shown in a study that regular caffeine intake can change the gray matter of the brain. However, the effect appears to be temporary.

No question -- caffeine helps most of us to feel more alert. However, it can disrupt our sleep if consumed in the evening. Sleep deprivation can in turn affect the gray matter of the brain, as previous studies have shown. So can regular caffeine consumption affect brain structure due to poor sleep? A research team led by Dr. Carolin Reichert and Professor Christian Cajochen of the University of Basel and UPK (the Psychiatric Hospital of the University of Basel) investigated this question in a study.

The result was surprising: the caffeine consumed as part of the study did not result in poor sleep. However, the researchers observed changes in the gray matter, as they report in the journal Cerebral Cortex. Gray matter refers to the parts of the central nervous system made up primarily of the cell bodies of nerve cells, while white matter mainly comprises the neural pathways, the long extensions of the nerve cells.

A group of 20 healthy young individuals, all of whom regularly drink coffee on a daily basis, took part in the study. They were given tablets to take over two 10-day periods, and were asked not to consume any other caffeine during this time. During one study period, they received tablets with caffeine; in the other, tablets with no active ingredient (placebo). At the end of each 10-day period, the researchers examined the volume of the subjects' gray matter by means of brain scans. They also investigated the participants' sleep quality in the sleep laboratory by recording the electrical activity of the brain (EEG).

Sleep unaffected, but not gray matter

Data comparison revealed that the participants' depth of sleep was equal, regardless of whether they had taken the caffeine or the placebo capsules. But they saw a significant difference in the gray matter, depending on whether the subject had received caffeine or the placebo. After 10 days of placebo -- i.e. "caffeine abstinence" -- the volume of gray matter was greater than following the same period of time with caffeine capsules.

The difference was particularly striking in the right medial temporal lobe, including the hippocampus, a region of the brain that is essential to memory consolidation. "Our results do not necessarily mean that caffeine consumption has a negative impact on the brain," emphasizes Reichert. "But daily caffeine consumption evidently affects our cognitive hardware, which in itself should give rise to further studies." She adds that in the past, the health effects of caffeine have been investigated primarily in patients, but there is also a need for research on healthy subjects.

Although caffeine appears to reduce the volume of gray matter, after just 10 days of coffee abstinence it had significantly regenerated in the test subjects. "The changes in brain morphology seem to be temporary, but systematic comparisons between coffee drinkers and those who usually consume little or no caffeine have so far been lacking," says Reichert.

Story Source:

Materials provided by University of Basel

Journal Reference:

Yu-Shiuan Lin, Janine Weibel, Hans-Peter Landolt, Francesco Santini, Martin Meyer, Julia Brunmair, Samuel M Meier-Menches, Christopher Gerner, Stefan Borgwardt, Christian Cajochen, Carolin Reichert. Daily Caffeine Intake Induces Concentration-Dependent Medial Temporal Plasticity in Humans: A Multimodal Double-Blind Randomized Controlled Trial. Cerebral Cortex, 2021; DOI: 10.1093/cercor/bhab005
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Irregular sleep schedules connected to bad moods and depression, study shows

The more variation in wake-up time and sleep time, the worse mood and more chance of depression symptoms in study of first-year medical residents

2/18/21


https://www.sciencedaily.com/releases/2 ... 094502.htm


An irregular sleep schedule can increase a person's risk of depression over the long term as much as getting fewer hours of sleep overall, or staying up late most nights, a new study suggests.

Even when it comes to just their mood the next day, people whose waking time varies from day to day may find themselves in as much of a foul mood as those who stayed up extra late the night before, or got up extra early that morning, the study shows.

The study, conducted by a team from Michigan Medicine, the University of Michigan's academic medical center, uses data from direct measurements of the sleep and mood of more than 2,100 early-career physicians over one year. It's published in npj Digital Medicine.

The interns, as they are called in their first year of residency training after medical school, all experienced the long intense work days and irregular work schedules that are the hallmark of this time in medical training. Those factors, changing from day to day, altered their ability to have regular sleep schedules.

The new paper is based on data gathered by tracking the interns' sleep and other activity through commercial devices worn on their wrists, and asking them to report their daily mood on a smartphone app and take quarterly tests for signs of depression.

Those whose devices showed they had variable sleep schedules were more likely to score higher on standardized depression symptom questionnaires, and to have lower daily mood ratings. Those who regularly stayed up late, or got the fewest hours of sleep, also scored higher on depression symptoms and lower on daily mood. The findings add to what's already known about the association between sleep, daily mood and long-term risk of depression.

"The advanced wearable technology allows us to study the behavioral and physiological factors of mental health, including sleep, at a much larger scale and more accurately than before, opening up an exciting field for us to explore," says Yu Fang, M.S.E., lead author of the new paper and a research specialist at the Michigan Neuroscience Institute. "Our findings aim not only to guide self-management on sleep habits but also to inform institutional scheduling structures."

Fang is part of the team from the Intern Health Study, led by Srijan Sen, M.D., Ph.D., that has been studying the mood and depression risk of first-year medical residents for more than a decade. The study collected an average of two weeks of data from before the doctors' intern years began, and an average of nearly four months of monitoring through their intern year.

For the new paper, the team worked with Cathy Goldstein, M.D., M.S., an associate professor of neurology and physician in the Sleep Disorders Center at Michigan Medicine.

She notes that wearable devices that estimate sleep are now being used by millions of people, including the Fitbit devices used in the study, other activity trackers, and smart watches.

"These devices, for the first time, allow us to record sleep over extensive time periods without effort on behalf of the user," says Goldstein. "We still have questions surrounding the accuracy of the sleep predictions consumer trackers make, though initial work suggests similar performance to clinical and research grade actigraphy devices which are cleared by the FDA."

Sen, who holds the Eisenberg Professorship in Depression and Neurosciences and is a professor of neuroscience and psychiatry, notes that the new findings build on what his team's work has already shown about high risk of depression among new physicians, and other underlying factors that as associated with a heightened risk.

"These findings highlight sleep consistency as an underappreciated factor to target in depression and wellness," he says. "The work also underscores the potential of wearable devices in understanding important constructs relevant to health that we previously could not study at scale."

The team notes that the relatively young group of people in the study -- with an average age of 27, and holding both college and medical degrees -- are not representative of the broader population. However, because all of them experience similar workloads and schedules, they are a good group to test hypotheses in. The researchers hope that other groups will study other populations using similar devices and approaches, to see if the findings about variation in sleep schedule hold up for them.

Fang, for instance, notes that the parents of young children might be another important group to study. "I also wish my 1-year-old could learn about these findings and only wake me up at 8:21 a.m. every day," she jokes.

Story Source:

Materials provided by Michigan Medicine - University of Michigan.

Journal Reference:

Yu Fang, Daniel B. Forger, Elena Frank, Srijan Sen & Cathy Goldstein. Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians. npj Digital Medicine, 2021 DOI: 10.1038/s41746-021-00400-z
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Sleep is vital to associating emotion with memory, study finds

2/22/21


https://www.sciencedaily.com/releases/2 ... 164216.htm


When you slip into sleep, it's easy to imagine that your brain shuts down, but University of Michigan research suggests that groups of neurons activated during prior learning keep humming, tattooing memories into your brain.

U-M researchers have been studying how memories associated with a specific sensory event are formed and stored in mice. In a study conducted prior to the coronavirus pandemic and recently published in Nature Communications, the researchers examined how a fearful memory formed in relation to a specific visual stimulus.

They found that not only did the neurons activated by the visual stimulus keep more active during subsequent sleep, sleep is vital to their ability to connect the fear memory to the sensory event.

Previous research has shown that regions of the brain that are highly active during intensive learning tend to show more activity during subsequent sleep. But what was unclear was whether this "reactivation" of memories during sleep needs to occur in order to fully store the memory of newly learned material.

"Part of what we wanted to understand was whether there is communication between parts of the brain that are mediating the fear memory and the specific neurons mediating the sensory memory that the fear is being tied to. How do they talk together, and must they do so during sleep? We would really like to know what's facilitating that process of making a new association, like a particular set of neurons, or a particular stage of sleep," said Sara Aton, senior author of the study and a professor in the U-M Department of Molecular, Cellular and Developmental Biology. "But for the longest time, there was really no way to test this experimentally."

Now, researchers have the tools to genetically tag cells that are activated by an experience during a specific window of time. Focusing on a specific set of neurons in the primary visual cortex, Aton and the study's lead author, graduate student Brittany Clawson, created a visual memory test. They showed a group of mice a neutral image, and expressed genes in the visual cortex neurons activated by the image.

To verify that these neurons registered the neutral image, Aton and her team tested whether they could instigate the memory of the image stimulus by selectively activating the neurons without showing them the image. When they activated the neurons and paired that activation with a mild foot shock, they found that their subjects would subsequently be afraid of visual stimuli that looked similar to the image those cells encode. They found the reverse also to be true: after pairing the visual stimulus with a foot shock, their subjects would subsequently respond with fear to reactivating the neurons.

"Basically, the precept of the visual stimulus and the precept of this completely artificial activation of the neurons generated the same response," Aton said.

The researchers found that when they disrupted sleep after they showed the subjects an image and had given them a mild foot shock, there was no fear associated with the visual stimulus. Those with unmanipulated sleep learned to fear the specific visual stimulus that had been paired with the foot shock.

"We found that these mice actually became afraid of every visual stimulus we showed them," Aton said. "From the time they go to the chamber where the visual stimuli are presented, they seem to know there's a reason to feel fear, but they don't know what specifically they're afraid of."

This likely shows that, in order for them to make an accurate fear association with a visual stimulus, they have to have sleep-associated reactivation of the neurons encoding that stimulus in the sensory cortex, according to Aton. This allows a memory specific to that visual cue to be generated.The researchers think that at the same time, that sensory cortical area must communicate with other brain structures, to marry the sensory aspect of the memory to the emotional aspect.

Aton says their findings could have implications for how anxiety and post-traumatic stress disorder are understood.

"To me this is kind of a clue that says, if you're linking fear to some very specific event during sleep, sleep disruption may affect this process. In the absence of sleep, the brain seems to manage processing the fact that you are afraid, but you may be unable to link that to what specifically you should be afraid of," Aton said. "That specification process may be one that goes awry with PTSD or generalized anxiety."

Story Source:

Materials provided by University of Michigan.

Journal Reference:

Brittany C. Clawson, Emily J. Pickup, Amy Ensing, Laura Geneseo, James Shaver, John Gonzalez-Amoretti, Meiling Zhao, A. Kane York, Femke Roig Kuhn, Kevin Swift, Jessy D. Martinez, Lijing Wang, Sha Jiang, Sara J. Aton. Causal role for sleep-dependent reactivation of learning-activated sensory ensembles for fear memory consolidation. Nature Communications, 2021; 12 (1) DOI: 10.1038/s41467-021-21471-2
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Effective treatment for insomnia delivered in a few short phone calls

2/23/21


https://www.sciencedaily.com/releases/2 ... 135603.htm


Insomnia -- trouble falling asleep, staying asleep or waking up too early -- is a common condition in older adults. Sleeplessness can be exacerbated by osteoarthritis, the most common form of arthritis causing joint pain. While there are effective therapies for treating insomnia in older adults, many people cannot get the treatment they need because they live in areas with limited access to health care, either in person or over the internet.

With telephones nearly universal among the elderly, however, researchers at the University of Washington and Kaiser Permanente Washington Health Research Institute sought to determine if therapy using only a phone connection could be used to dramatically improve access to insomnia treatment.

In a study involving patients in the Kaiser Permanente Washington system -- the Osteoarthritis and Therapy for Sleep, or OATS study, published Feb. 22 in JAMA Internal Medicine -- the researchers found that effective treatment for insomnia can be delivered in a few short phone calls. The phone-delivered therapy, which consisted of guided training and education to combat insomnia, also helped reduce fatigue as well as pain associated with osteoarthritis.

"It's very exciting," said Susan M. McCurry, lead author and research professor in the UW School of Nursing, "because when people have insomnia, it's miserable. Our study has shown that this treatment can be delivered over the phone, and its effects are sustainable for up to a year."

Importantly, added McCurry, who is also an affiliate investigator at Kaiser Permanente, the study results also mean people living in rural or other areas with limited access to the internet and health care, especially sleep clinics, could potentially be reached and helped.

"When people can get relief from their sleep problems," she said, "they're going to function better during the day. They're going to emotionally feel better, be less irritable and think more clearly."

The study tracked 327 people over 60 years old with moderate to severe insomnia from 2016 to 2018. The patients were interviewed six times for 20 to 30 minutes over an eight-week period. Roughly half of the patients received materials and guided training called cognitive behavioral therapy for insomnia. CBT-I is a proven and effective strategy used as the first line of treatment for insomnia.

The remaining patients were in a control group, which received education-only phone calls that did not include the CBT-I therapy. The control group was important, McCurry said, to make sure the positive effects of the phone calls weren't due to "the fact that you have someone who's smart and pleasant calling you every week."

The key task of the therapy sessions was to guide patients through routines, information and self-monitoring in order to get their homeostatic sleep drive, which is the internal drive to sleep that is dissipated during the night and builds up during the day, and circadian rhythms, the complex and innate cycles of biochemical, physiological and behavioral processes, working together so that the patient will sleep at night and be wakeful during the daytime.

The phone-based therapy also helped patients reduce anxiety related to sleeplessness.

"People can become conditioned to knowing that when they get into bed, they're going to have a bad night. The bed becomes an anxious place for them to be," McCurry said. "We help them develop cognitive tools that can give their mind something else to do other than worry about what tomorrow is going to be like if they don't get a good night's sleep."

While earlier phone-based studies using similar techniques improved sleep, these studies were limited by their small number of participants and included only patients of specialty insomnia clinics. The OATS study was the first large trial of a statewide population of older adults with chronic osteoarthritis who were randomly assigned to either the treatment or a control group.

"Although osteoarthritis-related insomnia is a very common condition among older adults, it can be a challenge to find and enroll people with this condition in a clinical trial. Our ability to work with Kaiser Permanente Washington's extensive electronic health records data made it possible to identify and recruit more than 300 patients across Washington state over age 60 with moderate to severe osteoarthritis pain and insomnia," said Kai Yeung, co-author and assistant scientific investigator at Kaiser Permanente Washington Health Research Institute.

The study authors concluded that the phone-based treatment benefits for insomnia were "large, robust" and sustained for a year, even for patients with more severe insomnia and pain symptoms. The study also found a reduction of those pain symptoms, although the pain reductions did not last a full year.

While the study results can give hope to those suffering from insomnia and osteoporosis-related pain, the study authors said patients may not yet have access to a phone-based system of treatment. However, they can still talk to their medical care provider to learn what treatment options are available to them now.

"The bottom line is nobody should be sleeping poorly," said Michael V Vitiello, co-author and professor of psychiatry and behavioral sciences at University of Washington School of Medicine. "We have ways to fix sleep problems. Older adults don't need to suffer. We can make them better."

Story Source:

Materials provided by University of Washington.

Journal Reference:

Susan M. McCurry, Weiwei Zhu, Michael Von Korff, Robert Wellman, Charles M. Morin, Manu Thakral, Kai Yeung, Michael V. Vitiello. Effect of Telephone Cognitive Behavioral Therapy for Insomnia in Older Adults With Osteoarthritis Pain. JAMA Internal Medicine, 2021; DOI: 10.1001/jamainternmed.2020.9049
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Rest during holidays has a restorative effect on DNA changes in shift workers with sleep disorder

2/22/21


https://www.news-medical.net/news/20210 ... order.aspx


Long-term sleep deprivation is detrimental to health, increasing the risk of psychiatric and somatic disorders, such as depression and cardiovascular diseases. And yet, little is known about the molecular biological mechanisms set in motion by sleep deprivation which underlie related adverse health effects.

In a recently published study, the University of Helsinki, the Finnish Institute for Health and Welfare, the Finnish Institute of Occupational Health and the Finnair airline investigated dynamic changes to DNA methylation in shift workers. DNA methylation denotes epigenetic regulation that modifies gene function and regulates gene activity without changing the sequence of bases in the DNA.

Short-term genetic changes caused by DNA methylation are not well known. While methylation is connected with our surroundings, more research is needed on how the environment affects epigenetic regulation and gene function.

The recently published study provides researchers with new information on both DNA methylation and the biological processes that have an impact on a sleep disorder related to shift work (shift work disorder, or SWD).

The study was published in the esteemed Scientific Reports publication series.

Changes to DNA methylation can mediate infections caused by sleep deprivation


A total of 32 shift workers participated in the study, of whom 21 suffered from shift work disorder and 11 were in the control group. Dynamic changes to DNA methylation were investigated through a genome-wide analysis during work and after a holiday period.

Changes to DNA methylation which affected gene function were identified in study subjects suffering from a sleep disorder caused by shift work. The findings demonstrated that rest and recovery during holiday periods also resulted in the restoration of DNA methylation in cases where changes had been observed during the work period.

The study proved the dynamic nature of DNA methylation, which was particularly emphasized in the activity of NMDA glutamate receptors. The strongest evidence was gained from the GRIN2C receptor: the methylation level of a specific CpG base pair in the regulatory region was lower during the work period in subjects suffering from shift work disorder. However, this change was reversed after the holiday period.


" Based on the results, we can deduce that changes to the DNA methylation of white blood cells are associated with shift work disorder. These changes, such as low methylation levels observed during the work period, are probably linked to sleep deprivation and related inflammatory consequences which DNA changes may mediate."

- Alexandra Lahtinen, MSc, Doctoral Student, University of Helsinki

"Sufficient rest and recovery are important for everyone, but especially important for people with a background of long-term sleep deprivation due to, for example, living habits or irregular working conditions. Having said that, it's positive that the subjects recovered from at least some of the changes related to shift work disorder observed in the study," says Professor Tiina Paunio from the University of Helsinki and the Finnish Institute for Health and Welfare, who was the principal investigator of the study.

Source:

University of Helsinki

Journal reference:

Lahtinen, A., et al. (2021) Differential DNA methylation in recovery from shift work disorder. Scientific Reports. doi.org/10.1038/s41598-021-82627-0.
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Re: Sleep disorders common during COVID-19 pandemic

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Research identifies impact of teenage screen use

3/5/21


https://www.sciencedaily.com/releases/2 ... 113449.htm


Two thirds of children use more than one screen at the same time after school, in the evenings and at weekends as part of increasingly sedentary lifestyles, according to new research at the University of Leicester.

An NIHR study of more than 800 adolescent girls between the ages of 11 and 14 identified worrying trends between screen use and lower physical activity -- including higher BMI -- as well as less sleep.

The use of concurrent screens (termed 'screen stacking') grew over the course of the week -- with 59% of adolescents using two or more screens after school, 65% in the evenings, and 68% at weekends.

Some teens reporting using as many as four screens at one time.

But further analysis showed the use of any screen was still detrimental to the indicators of health and wellbeing. More than 90% owned or had access to a smart phone and using this after school had a knock on effect on their sleep.

Researchers from the Leicester Diabetes Centre at the University measured physical activity and sleep using accelerometers worn on participants' wrists, while those involved in the study self-reported the number of screens they were using at the same time -- such as scrolling on a mobile phone while also watching TV -- as well as perceptions of self-esteem and physical self-worth.

Dr Deirdre Harrington, Lecturer in Physical Activity for Health led the study during her time at Leicester and now works in the School of Psychological Sciences and Health at the University of Strathclyde. She said:

"Intuitively, we believe there must be negative effects on teenagers of using too many screens at the same time. Our data show it isn't as simple as that.

"This research was done before the COVID-19 lockdown, where much more of our day is spent in front of a screen. More than ever the effects of this on adolescents need to be known -- there are positives too, no doubt.

"These adolescents wore an accelerometer 24 hours a day for a week allowing us to capture their daily routines and even estimate their sleep. Uniquely, they also reported how many screens they used at the same time which is not well known."

Melanie Davies, Professor of Diabetes Medicine at the University of Leicester and Co-Director of the Leicester Diabetes Centre based at Leicester General Hospital, said:

"Sadly, this study reminds us that we are in danger of creating a new generation of sedentary children. Increased sedentary time is closely linked to type 2 diabetes, which is increasing in younger age groups.

"The number of young people with type 2 diabetes has gone up by 50% in just five years."

The study was supported by the National Institute for Public Health Research programme as well as the NIHR Leicester Biomedical Research Centre, and the NIHR Applied Research and Care (ARC) East Midlands.

Story Source:


Materials provided by University of Leicester.

Journal Reference:

Deirdre M. Harrington, Ekaterini Ioannidou, Melanie J. Davies, Charlotte L. Edwardson, Trish Gorely, Alex V. Rowlands, Lauren B. Sherar, Amanda E. Staiano. Concurrent screen use and cross‐sectional association with lifestyle behaviours and psychosocial health in adolescent females. Acta Paediatrica, 2021; DOI: 10.1111/apa.15806
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