Sleep disorders common during COVID-19 pandemic

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Re: Sleep disorders common during COVID-19 pandemic

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Increased evening screen time during Covid-19 lockdown negatively affects sleep quality

6/3/21


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


A new study in the journal Sleep finds that increased evening screen time during the Covid-19 lockdown negatively affects sleep quality.

During the lockdown period in Italy, daily internet traffic volume almost doubled compared to the same time in the previous year. Researchers here conducted a web-based survey of 2,123 Italian residents during the third and seventh week of Italy's first national lockdown. The survey ran in the third week of lockdown (March 25th - 28th, 2020) and evaluated sleep quality and insomnia symptoms, using the Pittsburgh Sleep Quality Index and the Insomnia Severity Index as means of measurement. The second assessment survey, in the seventh week of lockdown (April 21st - 27th, 2020), inquired about usage of electronic devices in the two hours before falling asleep, in addition to repeating the sleep questionnaires.

Of the participants surveyed, 92.9% reported an increase in their electronic device usage between the first and second surveys. These participants showed decreased sleep quality, an increase in insomnia symptoms, shorter total sleep times, and later bedtimes and rising times. Researchers found an increased prevalence of poor sleepers and respondents with moderate to severe insomnia symptoms only within this group of respondents.

Some 7.1% of participants reported a decrease in evening screen time between the first and second survey, and conversely reported improved sleep quality and fewer symptoms of insomnia. This subgroup also demonstrated a decrease in the prevalence of poor sleepers and moderate/severe insomnia symptoms. These respondents went to bed consistently earlier after four weeks of home confinement.

Survey respondents who reported no change in their screen time exposure likewise showed no variations in their sleep habits. Notably, this group of responders had the best sleep quality and fewest insomnia symptoms in the first survey results, suggesting that the lockdown exacerbated negative sleep conditions for people already suffering from poor sleep quality.

Dr. Federico Salfi, Ph.D. student and first author of the paper, says "The overuse of electronic devices in the hours before sleep was a deeply rooted habit in our society already before the pandemic emergency, in particular among young people. In our opinion, the current period of social distancing added fuel to the fire."

" The evidence of a strong relationship between screen habits and the time course of sleep disturbances during the lockdown period suggests that, now, more than never, raising public awareness about the risks of evening exposure to electronic devices could be crucial to preserve general sleep health. This applies to both the ongoing pandemic and the future, as electronic technologies will find more and more space in our daily routine."

- Prof. Michele Ferrara, Director, Laboratory of Sleep Psychophysiology and Cognitive Neuroscience, University of L'Aquila

Source:


Oxford University Press USA

Journal reference:

Salfi, F., et al. (2021) Changes of evening exposure to electronic devices during the COVID-19 lockdown affect the time course of sleep disturbances. Sleep. doi.org/10.1093/sleep/zsab080.
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Re: Sleep disorders common during COVID-19 pandemic

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Depression, anxiety and stress during pandemic linked with lower quality sleep

6/17/21


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


Many people likely lost sleep over COVID-19. A study of twins led by Washington State University researchers found that stress, anxiety and depression during the first few weeks of the pandemic were associated with less and lower quality sleep.

In a survey of more than 900 twins taken shortly after COVID-19 lockdown measures began, about half of the respondents reported no change in their sleep patterns, but around a third, 32.9%, reported decreased sleep. Another 29.8% reported sleeping more. In the analysis, the researchers found that any change in sleep was connected to self-reported mental health issues, though it was more strongly associated with decreased sleep.

"The results show that deviations from your typical sleep behavior may be associated with depression, anxiety and stress," said Siny Tsang, lead author on the study published in Frontiers in Neuroscience.

Tsang, a staff scientist with the WSU Elson S. Floyd College of Medicine, emphasized that this showed a connection, not a cause, but the study supports previous research that has found a two-way relationship between disrupted sleep patterns and poor mental health.

In other words, when people don't sleep well, they are more likely to feel stress, anxiety and depression, and when they are dealing with those same problems, they are more likely to sleep less--and sometimes more--than the typical six to nine hours a night.

This study analyzes survey responses collected between March 26 and April 5, 2020 from participants in the Washington State Twin Registry. Since then, the same group has answered three more waves of survey questions.

Researchers are particularly interested in studying twins, so they can investigate whether associations are mediated by genetic factors, shared environment, or both. The pandemic also offered an opportunity for a natural experiment to see how a stressful situation affects sleep amount and quality among individuals in the community, Tsang said.

The research relies on the self-reported perception of sleep length and quality, but the researcher said that when it comes to mental health, perception can matter more than the real amount of sleep.

" Even if your cell phone says you consistently sleep eight hours every day, you may feel that you slept less or slept poorly, and that may be linked to stressful or anxious feelings. It may not matter whether or not the actual number has changed. It's how you are feeling that is associated with your mental health."

- Siny Tsang, Study Lead Author, Washington State University

WSU researchers have also conducted twin-studies on COVID-19 lockdown effects on alcohol use and pandemic stress and exercise. These have all been initial studies taken at the early stages of the pandemic and associated social distancing measures. The scientists are still analyzing results of later surveys, but they are starting to see a common theme.

"A pattern that is consistent across these three studies is that people who reported change in physical exercise, alcohol use or sleep are more stressed, anxious and depressed than those who had said that they have had no change," Tsang said.

Source:


Washington State University

Journal reference:


Tsang, S., et al. (2021) Is COVID-19 Keeping us Up at Night? Stress, Anxiety, and Sleep Among Adult Twins. Frontiers in Neuroscience. doi.org/10.3389/fnins.2021.665777.
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Re: Sleep disorders common during COVID-19 pandemic

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Sleep-wake behavior predicts mental health resilience during COVID-19

6/25/21


https://www.news-medical.net/news/20210 ... ID-19.aspx


COVID-19 pandemic containment in the U.S. began in early 2020 with rigorous nonpharmaceutical interventions such as stay-at-home orders and remote-work directives. During this period, surveys and wearable data reported an increase in sleep duration and delayed sleep timing, as well as a spike in adverse mental health symptoms

Now, a group of researchers from the USA and Australia has collaborated on a study analyzing objective sleep-wake data and the effect of COVID-19 on the mental health of adults in the USA.

A pre-print version of the research paper is available on the medRxiv* server, while the article undergoes peer review.

Impaired sleep and mental health


The importance of sleep for mental health has long been established, with associations between impaired sleep, including sleep disturbances and insufficient sleep, and adverse mental and behavioral health symptoms. For some people, these symptoms include anxiety, depression, and substance abuse.

It was inescapable that COVID-19 would have adverse effects on mental health, owing to the isolated lifestyle and low social interaction associated with the pandemic.

In order to mitigate the spread of the virus and reduce the possibility of infection, lockdowns have been implemented globally as a stringent mitigation measure.

As a result, interdisciplinary research priorities focused on identifying optimal sleep-wake structures to support mental health in the wake of isolating effects with subsequent depressive and anxious states.

Survey data that analyzed the initial phase of COVID-19 had found links between poor quality, insufficient sleep, and having adverse mental and behavioral health symptoms.

The research published in the current pre-print has examined the objective sleep and mental health among 20,717 individuals residing in the United States through the use of a validated sleep wearable, both prior to COVID-19 as well as during the pandemic.

The researchers used a comprehensive list of variables for their sleep study which included, duration, sleep onset, sleep offset, consistency of sleep timing and wake after sleep onset.

The significance of sleep

The study's findings confirmed previous research studies on the quality of sleep and the state of mental health, with results demonstrating that there had been an increase in sleep duration within the pandemic and a delay in sleep timing.

The research, however, revealed new findings concerning the consistency of sleep timing. In the study, it was found that those with persistent sleep problems and low sleep consistency were more likely to experience adverse mental health.

Mental health resilience

Sleep duration of 6-7 hours is considered normal, however, when this number is below 6, anxiety and depression symptoms are more likely to occur. This is also the case for decreased consistency of sleep timing. Based on these results, it can be seen that sleep plays a significant role in mental health as well as what behavioral interventions can do to increase resilience during the pandemic for the people most affected.

The study suggested the COVID-19 directives such as remote working from home and a lack of social mixing had contributed to the isolation faced by individuals to a significant degree.

The differences in sleeping patterns found by the researchers during the pandemic have identified potential targets for risk factors for mental health problems.

Research has found that individuals who achieved the recommended sleep duration and consistency prior to the pandemic had greater mental health resilience since they were less affected by sleep decline during the pandemic and therefore were less likely to manifest mental and behavioral symptoms.

Limitations

The limitations of the research, which is included in the pre-print paper, include the participants being predominantly male, highly educated, employed, and had reported a higher than average household income. This can be seen as a bias for the study, which may prevent the research from being representative of the population.

The socio-economic implications of this can be significant with women, racial diversity and different wealth brackets being excluded. The biological and social differences in women may have caused varying implications on sleep; this can also be said for how different races and less economically stable individuals may have handled the pandemic, with lost jobs and lack of security during a challenging period of time. This may have further affected sleep patterns during the pandemic and enhanced mental and behavioral symptoms in these individuals.

The research undertaken has provided a comprehensive insight into the challenges faced by a group of individuals in the USA. This can be used for mental health interventions to direct these for the most vulnerable groups during the pandemic. This can assist further with aiding the ease out of the pandemic and how groups of individuals can be provided with mental health support during COVID-19.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:

Czeisler, M., Capodilupo, E., Weaver, M., Czeisler, C., Howard, M. and Rajaratnam, S., 2021. Prior sleep-wake behavior predicts mental health resilience among adults in the United States during the COVID-19 pandemic. https://www.medrxiv.org/content/10.1101 ... 21258983v1
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Re: Sleep disorders common during COVID-19 pandemic

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Insight into the impact of physical activity on sleep

7/8/21


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


Please could you introduce yourself and tell us what inspired your research into physical activity and sleep?


Hello, and thank you for having me. I am Emmanuel Stamatakis, I am a Professor of physical activity, lifestyle, and population health at the University of Sydney. I have been researching the health effects of physical activity and exercise for over 20 years, our new study represents the evolution of this research program, where we examine the interplay of physical activity and other aspects of lifestyle. It made a lot of sense to us to invest in sleep research as both physical activity and sleep are “time-dependent”, that is they both occupy parts of the same 24-hour cycle.

Both physical activity and sleep are critical for good health. Sadly, there are ongoing pandemics of physical inactivity and poor sleep in our society and this is causing huge disease burden and significant healthcare costs.

We also know that sleep and physical activity influence each other, for example, regular physical activity can improve sleep quality, and a good night’s sleep energizes people and makes them more likely to exercise. But we know very little about the combined health effects of these two key aspects of our lifestyle.

Research into the impact of different variables on our health is extremely important. Why is this especially important in light of the ongoing COVID-19 pandemic?

The COVID-19 pandemic has caused havoc in people’s lives across the globe; in relation to poor sleep and physical inactivity, it has made a bad situation worse. Lockdown restrictions, difficulties in accessing green space and getting outdoors, heightened anxiety and depression, all impact negatively both behaviors.

Understanding the combined health effects of sleep and physical activity may help us understand how to put together programs to help people both cope and thrive during the COVID-19 crisis.

How does physical inactivity and poor sleep increase your risk of cardiovascular disease and death?

Poor sleep and physical inactivity seem to work on the same cardiovascular and metabolic pathways. For example, short sleep and physical inactivity cause endocrine and metabolic dysfunction, increase systemic inflammation and cause stimulation of the sympathetic nervous system which comes with psychological as well as cardiovascular consequences.

Conversely, regular physical activity works on the same pathways as poor sleep but in the opposite direction e.g. regular physical activity improves metabolic function and reduces inflammation. This may partly explain our results; in other words, sufficient physical activity may help neutralize some of the health consequences of poor sleep.

Can you describe how you carried out your latest research into physical activity, sleep, and health?


This study was part of our UK Biobank research program and part of the PhD program of our student Bo-Huei-Huang, first author of the published paper. The UK Biobank recruited almost half a million adults aged 37-73 years back in 2006-2010, who were followed up 2020. At the end of the end of the follow up period we calculated death rates and classified cardiovascular and cancer-related causes of death of the 380,055 participants who were included in our study. Participants reported their leisure-time physical activity and five aspects of their sleep: sleep duration, insomnia, snoring, daytime sleepiness, and sleep chronotype.

We grouped people based on their sleep behavior into healthy, intermediate, or poor. We categorized people's level of physical activity based on [the World Health Organization (WHO) guidelines. People who met the upper bounds of the guidelines did 300 minutes of moderate-intensity physical activity a week, or 150 minutes of vigorous exercise, or a combination of both.

Those who met the lower bound did 150 minutes of moderate-intensity exercise a week, or 75 minutes of vigorous exercise, or a combination. We then calculated the death risk for each combination of physical activity and sleep, while taking statistically into account any characteristics the comparison groups differed.

What did you discover?

We found that physical inactivity seems to amplify the health risks of poor sleep patterns synergistically, i.e. the mortality risk from physical inactivity and poor sleep combined was much larger than the sum of the separate risk of poor sleep alone plus physical inactivity alone.

Conversely, being physically active (doing at least 150 minutes of moderate or 75 minutes of vigorous-intensity physical activity per week) seemed to counter most of the premature risks of poor sleep patterns.

What are some of the limitations associated with this observational study?

With observational studies, it is difficult to establish causality with very high certainty. However, we modeled the data and took statistical measures to minimize the chance that the associations we found were due to biases or confounding.

Another limitation is that we relied on questionnaire-based measurements of sleep and physical activity.

What advice would you give to people to help reduce their risk of cardiovascular disease and death?

The challenge with poor sleep patterns is that they are, to a large extend, involuntary. While some aspects of sleep involve conscious decisions (e.g. what time we go to bed), some others are out of our control, e.g. nobody decides to have insomnia or daytime sleepiness. For sleep, my advice would be limited to ensuring adequate amounts of sleep, 7-8 hours for most people, and to avoid screens for a few hours prior to going to bed.

With physical activity, things are more within our control. For people who move very little in general, I would advise them to introduce small amounts of physical activity (10-15 minutes per day, for example) that can comfortably fit into their daily routine, and work towards 25-30 minutes per day overtime. Any activity is fine, as long as they enjoy it and can comfortably fit it in their daily routine in the long term; activities that get them at least slightly out of breath are best.

Physical activity improves sleep quality, so incorporating some regular activity in their daily routine not only they will offer people the direct cardiovascular health benefits of physical activity/exercise but may also help them normalize some aspects of their sleep. Which, in turn, may make them more energetic and motivated to exercise the day after.

Do you believe that with continued awareness into the health problems associated with poor sleep and physical inactivity, we could potentially reduce the number of people dying each year?

Public awareness is one part of the solution only, it will certainly help some and will save some lives. But awareness alone won’t solve the problem. Both physical inactivity and poor sleep are societal, political as well as individual health problems. To solve them fully we will have to seriously re-examine some basic assumptions that underpin our society, economy, relationship with technology, and even politics.

For example, the sharp rise in sleep problems has been partly caused by the anxieties the highly competitive dominant economic systems create and the rapid invasion of screen-based modern technology into our lives. Physical inactivity is an environmental and socioeconomic problem to a large extend. How can people be physically active if they live in car-dominated communities with no green space, where walking and cycling is too dangerous and exercise facilities are not accessible and/or unaffordable?

What more can governments and organizations do to help raise awareness for the risks associated with poor sleep and little physical activity?

Public health campaigns, such as online and print media campaigns, to promote physical activity and healthy sleep habits could be a great start, as part of a serious long-term strategy that will involve political and budgetary commitment.

Governments that are serious about these causes and the health of their citizens, in general, will need to form partnerships with many sectors and the civil society to come up with a long term strategy to e.g. improve active and public transportation, discourage the use of private cars, build more cycle lanes. Such “upstream” actions will help masses of people become more physically active without even directly trying to do so. In other words, increased physical activity will be a co-benefit of such measures.


The other thing that Governments can do is ensure that medical and other health professionals are equipped and well trained to provide physical activity and sleep behavior modification support to their patients. Most health professionals are not confident and/or skilled. Most medical schools, for example, do not even teach students the official physical activity guidelines.

On average, medical students have 4 hours of lectures on physical activity and diet across their degree, but over 100 hours of pharmacology and related content.

What do you think will they prescribe as practitioners to patients who suffer from lifestyle-related diseases?
What are the next steps in your research?

We are leading a large program of research involving collaborators from over 10 countries, the main aim of the program is to understand the combined effects of wearable sensor-measured physical activity, sedentary behavior, and sleep on cardiovascular health.

Where can readers find more information?

BJSM study: https://bjsm.bmj.com/content/early/2021 ... 021-104046

Some other highlights from this program of research:


https://pubmed.ncbi.nlm.nih.gov/33713846/
https://www.sciencedirect.com/science/a ... 352030339X
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Re: Sleep disorders common during COVID-19 pandemic

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Cerebral cortex may actually be responsible for sleep control

8/4/21


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


Why we sleep, and the processes behind sleep, are amongst the most interesting questions in modern neuroscience. Researchers at the University of Oxford have now uncovered a new target for sleep investigations within the mammalian brain - the cerebral cortex. The paper was published today in Nature Neuroscience.

The cerebral cortex makes up about 80% of the brain's volume and is responsible for many complex phenomena, including perception, thought, language, attention and memory. While activity in the cortex is normally used in sleep studies to record sleep/awake patterns, the latest study from Oxford has found that processes within the cortex itself may actually be responsible for sleep control, such as how long to sleep for and how deeply to sleep.

The study monitored brain activity in laboratory mice, which have fundamental brain similarities to humans in terms of anatomy and sleep mechanisms. Neurons in two areas of the cortex - neocortical layer 5 and a part of the hippocampus - were 'silenced' in the mice's brains. When the neurons in these areas of the brain were deactivated, the lab mice suddenly stayed awake for at least three hours longer every day. To put this into perspective, an average mouse lives for approximately two years, which means they gained three full months of 'awake' time in over their lifespans. In human terms, this would equate to about 10 years.

Though the mice were awake longer, their need for deep sleep did not appear to be affected. Normally, when mice (and humans) stay awake longer than usual and get more tired, we sleep more deeply to compensate. This study in lab mice found that they did not sleep any more deeply than usual. Their body clock did not appear to be affected at all by the extra waking hours in their days.

" Our finding that the cortex is part of the sleep-regulating system opens new perspectives for sleep medicine. It might be possible to use already-established non-invasive brain stimulation techniques to alter cortical activity and thereby moderate sleep for therapeutic purpose, such as for the treatment of sleep disorders."

- Dr Lukas Krone, Department of Physiology, Anatomy and Genetics, University of Oxford, and lead author on the study

Professor Vladyslav Vyazovskiy, Head of Sleep, Brain and Behaviour Laboratory in the Department of Physiology, Anatomy and Genetics and a member of Sleep and Circadian Neuroscience Institute (SCNi), a co-corresponding author on the paper, said: 'The cortex is a highly complex structure, both anatomically and functionally, and is therefore difficult to study; and this is why we think its role in sleep control was previously overlooked. The effects on sleep of cortical silencing offers a novel and fresh perspective on the mechanisms of sleep control, and has the strong potential to transform the field of sleep neurobiology.'

Professor Zoltán Molnár, Head of Cerebral Cortical Development and Evolution Laboratory in the Department of Physiology, Anatomy and Genetics and co-corresponding author on the paper said: 'Much effort and funding over the last decades has been spent on clarifying the role of subcortical structures in sleep regulation and the cerebral cortex was not the focus of attention. When we first performed our 'silencing' study on different cortical projection neurons, I expected such phenotype from another neuronal population and not from layer 5 and hippocampus. For me, the discovery of its effect on the mice's sleep was a great surprise.'

While this study is an important first step, more work needs to be done. 'We hope that many other research groups will now be investigating how exactly the cortex contributes to sleep regulations,' said Dr Krone. 'A multidisciplinary approach will help us to fully understand the cellular mechanisms and neuronal circuits through which the cortex regulates sleep.'

Source:

University of Oxford
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New mothers’ sleep loss linked to accelerated aging

Too little sleep in first six months after birth can add 3 to 7 years to women’s ‘biological age,’ UCLA scientists report


https://www.sciencedaily.com/releases/2 ... 115519.htm

Date:
August 5, 2021
Source:
University of California - Los Angeles
Summary:
When new mothers complain that all those sleepless nights caring for their newborns are taking years off their life, they just might be right. A year after giving birth, the 'biological age' of mothers who slept less than seven hours a night at the six-month mark was three to seven years older than those who logged seven hours or more, the scientists report.

When new mothers complain that all those sleepless nights caring for their newborns are taking years off their life, they just might be right, UCLA research published this summer in the journal Sleep Health suggests.

Scientists studied 33 mothers during their pregnancies and the first year of their babies' lives, analyzing the women's DNA from blood samples to determine their "biological age," which can differ from chronological age. They found that a year after giving birth, the biological age of mothers who slept less than seven hours a night at the six-month mark was three to seven years older than those who logged seven hours or more.

Mothers who slept less than seven hours also had shorter telomeres in their white blood cells. These small pieces of DNA at the ends of chromosomes act as protective caps, like the plastic tips on the ends of shoelaces. Shortened telomeres have been linked to a higher risk of cancers, cardiovascular and other diseases, and earlier death.

"The early months of postpartum sleep deprivation could have a lasting effect on physical health," said the study's first author, Judith Carroll, UCLA's George F. Solomon Professor of Psychobiology. "We know from a large body of research that sleeping less than seven hours a night is detrimental to health and increases the risk of age-related diseases."

While participants' nightly sleep ranged from five to nine hours, more than half were getting less than seven hours, both six months and one year after giving birth, the researchers report.

"We found that with every hour of additional sleep, the mother's biological age was younger," said Carroll, a member of the Cousins Center for Psychoneuroimmunology at UCLA's Jane and Terry Semel Institute for Neuroscience and Human Behavior. "I, and many other sleep scientists, consider sleep health to be just as vital to overall health as diet and exercise."

Carroll urged new mothers take advantage of opportunities to get a little extra sleep, like taking naps during the day when their baby is asleep, accepting offers of assistance from family and friends, and, when possible, asking their partner to help with the baby during the night or early morning. "Taking care of your sleep needs will help you and your baby in the long run," she said.

Co-author Christine Dunkel Schetter, a distinguished professor of psychology and psychiatry at UCLA, said the study results "and other findings on maternal postpartum mental health provide impetus for better supporting mothers of young infants so that they can get sufficient sleep -- possibly through parental leave so that both parents can bear some of the burden of care, and through programs for families and fathers."

Dunkel Schetter added that while accelerated biological aging linked to sleep loss may increase women's health risks, it doesn't automatically cause harm to their bodies. "We don't want the message to be that mothers are permanently damaged by infant care and loss of sleep," she emphasized. "We don't know if these effects are long lasting."

'This aisle is closed': Using epigenetics to determine biological age

The study used the latest scientific methods of analyzing changes in DNA to assess biological aging -- also known as epigenetic aging, Dunkel Schetter said. DNA provides the code for making proteins, which carry out many functions in the cells of our body, and epigenetics focuses on whether regions of this code are "open" or "closed."

"You can think of DNA as a grocery store," Carroll said, "with lots of basic ingredients to build a meal. If there is a spill in one aisle, it may be closed, and you can't get an item from that aisle, which might prevent you from making a recipe. When access to DNA code is 'closed,' then those genes that code for specific proteins cannot be expressed and are therefore turned off."

Because specific sites within DNA are turned on or off with aging, the process acts as a sort of clock, Carroll said, allowing scientists to estimate individuals' biological age. The greater an individual's biological, or epigenetic, age, the greater their risk of disease and earlier death.

The study's cohort -- which included women who ranged in age from 23 to 45 six months after giving birth -- is not a large representative sample of women, the authors said, and more studies are needed to better understand the long-term impact of sleep loss on new mothers, what other factors might contribute to sleep loss and whether the biological aging effects are permanent or reversible.

Carroll and Dunkel Schetter reported last year that a mother's stress prior to giving birth may accelerate her child's biological aging, which is a form of "intergenerational transfer of health risk," Dunkel Schetter said.

Co-authors of the new study included researchers from the department of psychology, the department of psychiatry and biobehavioral sciences, and the department of human genetics and biostatistics at UCLA and from the psychology department at the University of Colorado at Colorado Springs.

Funding sources for the study included the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Aging, both part of the National Institutes of Health.

Journal Reference:


Judith E. Carroll, Kharah M. Ross, Steve Horvath, Michele Okun, Calvin Hobel, Kelly E. Rentscher, Mary Coussons-Read, Christine Dunkel Schetter. Postpartum sleep loss and accelerated epigenetic aging. Sleep Health, 2021; 7 (3): 362 DOI: 10.1016/j.sleh.2021.02.002
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Re: Sleep disorders common during COVID-19 pandemic

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Scrap the nap: Study shows short naps don’t relieve sleep deprivation

8/12/21


https://www.sciencedaily.com/releases/2 ... 123122.htm


A nap during the day won't restore a sleepless night, says the latest study from Michigan State University's Sleep and Learning Lab.

"We are interested in understanding cognitive deficits associated with sleep deprivation. In this study, we wanted to know if a short nap during the deprivation period would mitigate these deficits," said Kimberly Fenn, associate professor of MSU, study author and director of MSU's Sleep and Learning Lab. "We found that short naps of 30 or 60 minutes did not show any measurable effects."

The study was published in the journal Sleep and is among the first to measure the effectiveness of shorter naps -- which are often all people have time to fit into their busy schedules.

"While short naps didn't show measurable effects on relieving the effects of sleep deprivation, we found that the amount of slow-wave sleep that participants obtained during the nap was related to reduced impairments associated with sleep deprivation," Fenn said.

Slow-wave sleep, or SWS, is the deepest and most restorative stage of sleep. It is marked by high amplitude, low frequency brain waves and is the sleep stage when your body is most relaxed; your muscles are at ease, and your heart rate and respiration are at their slowest.

"SWS is the most important stage of sleep," Fenn said. "When someone goes without sleep for a period of time, even just during the day, they build up a need for sleep; in particular, they build up a need for SWS. When individuals go to sleep each night, they will soon enter into SWS and spend a substantial amount of time in this stage."

Fenn's research team -- including MSU colleague Erik Altmann, professor of psychology, and Michelle Stepan, a recent MSU alumna currently working at the University of Pittsburgh -- recruited 275 college-aged participants for the study.

The participants completed cognitive tasks when arriving at MSU's Sleep and Learning Lab in the evening and were then randomly assigned to three groups: The first was sent home to sleep; the second stayed at the lab overnight and had the opportunity to take either a 30 or a 60 minute nap; and the third did not nap at all in the deprivation condition.

The next morning, participants reconvened in the lab to repeat the cognitive tasks, which measured attention and placekeeping, or the ability to complete a series of steps in a specific order without skipping or repeating them -- even after being interrupted.

"The group that stayed overnight and took short naps still suffered from the effects of sleep deprivation and made significantly more errors on the tasks than their counterparts who went home and obtained a full night of sleep," Fenn said. "However, every 10-minute increase in SWS reduced errors after interruptions by about 4%."

These numbers may seem small but when considering the types of errors that are likely to occur in sleep-deprived operators -- like those of surgeons, police officers or truck drivers -- a 4% decrease in errors could potentially save lives, Fenn said.

"Individuals who obtained more SWS tended to show reduced errors on both tasks. However, they still showed worse performance than the participants who slept," she said.

Fenn hopes that the findings underscore the importance of prioritizing sleep and that naps -- even if they include SWS -- cannot replace a full night of sleep.

Journal Reference:

Michelle E Stepan, Erik M Altmann, Kimberly M Fenn. Slow-wave sleep during a brief nap is related to reduced cognitive deficits during sleep deprivation. Sleep, 2021; DOI: 10.1093/sleep/zsab152
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FDA approves a new indication for chronic sleep disorder treatment

8/12/21


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


The U.S. Food and Drug Administration today approved a new indication for Xywav for idiopathic hypersomnia (IH) in adults. IH is an uncommon chronic sleep disorder that causes people to be excessively sleepy during the day even after a good night's sleep. Xywav (calcium, magnesium, potassium, and sodium oxybates) oral solution is already approved for the treatment of cataplexy or excessive daytime sleepiness in patients seven years or older with narcolepsy.

"A novel indication for Xywav is significant as the FDA has never granted an approval for idiopathic hypersomnia. Idiopathic hypersomnia is a life-long condition, and the approval of Xywav will be instrumental in providing treatment for symptoms such as excessive sleepiness and difficulty waking, and in effectively managing this debilitating disorder."

- Eric Bastings, M.D., Deputy Director of the Office of Neuroscience in the FDA's Center for Drug Evaluation and Research

The effectiveness of Xywav was evaluated in a double-blind placebo-controlled randomized-withdrawal study in 154 adult patients (ages 19 to 75 years) with IH. In the clinical study, patients who were randomized to switch from Xywav to placebo experienced worsening on measures of sleepiness and symptoms of IH compared to patients randomized to continue treatment with Xywav.

In the clinical trial for IH, the most common adverse events as a result of the treatment observed in the study included nausea (21.4%), headache (16.2%), dizziness (11.7%), anxiety (10.4%) and vomiting (10.4%).

Xywav has a boxed warning for central nervous system depression and abuse and misuse. The active moiety of Xywav is oxybate, also known as gamma-hydroxybutyrate (GHB), a Schedule I controlled substance. Abuse or misuse of illicit GHB has been associated with serious side effects including seizures, trouble breathing, changes in alertness, coma, and death. Clinically significant respiratory depression and reduced level of alertness has occurred in adult patients taking sodium oxybate.

Because of the potential risks associated with Xywav, it is subject to strict safety controls on prescribing and dispensing under a program called a Risk Evaluation and Mitigation Strategy (REMS).

Specifically, under the Xywav REMS, it can be prescribed only by a certified prescriber, and dispensed only to an enrolled patient by a certified pharmacy. Only a certified pharmacy that ships directly to patients can dispense Xywav. Xywav will not be available in retail pharmacies.

The FDA granted this application Fast Track and Priority Review designations. Xywav also received Orphan Drug designation, which provides incentives to assist and encourage the development of drugs for rare diseases. The FDA granted the approval of Xywav to Jazz Pharmaceuticals plc.

Source:

U.S. Food and Drug Administration
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Re: Sleep disorders common during COVID-19 pandemic

Post by trader32176 »

Brain refreshing: Why the dreaming phase matters

https://www.sciencedaily.com/releases/2 ... 113638.htm

Date:

August 25, 2021
Source:
University of Tsukuba
Summary:

Researchers have found that blood flow in the brain capillaries, which is important for oxygen/nutrient delivery and waste removal, was increased during rapid eye movement sleep in mice. Adenosine A2a receptors might be at least partially responsible for this increased blood flow. These findings bring new hope for understanding the function of sleep and developing treatments for neurodegenerative diseases that involve the buildup of waste products in the brain, such as Alzheimer's disease.

Scientists have long wondered why almost all animals sleep, despite the disadvantages to survival of being unconscious. Now, researchers led by a team from the University of Tsukuba have found new evidence of brain refreshing that takes place during a specific phase of sleep: rapid eye movement (REM) sleep, which is when you tend to dream a lot.

Previous studies have measured differences in blood flow in the brain between REM sleep, non-REM sleep, and wakefulness using various methods, with conflicting results. In their latest work, the Tsukuba-led team used a technique to directly visualize the movement of red blood cells in the brain capillaries (where nutrients and waste products are exchanged between brain cells and blood) of mice during awake and asleep states.

"We used a dye to make the brain blood vessels visible under fluorescent light, using a technique known as two-photon microscopy," says senior author of the study Professor Yu Hayashi. "In this way, we could directly observe the red blood cells in capillaries of the neocortex in non-anesthetized mice."

The researchers also measured electrical activity in the brain to identify REM sleep, non-REM sleep, and wakefulness, and looked for differences in blood flow between these phases.

"We were surprised by the results," explains Professor Hayashi. "There was a massive flow of red blood cells through the brain capillaries during REM sleep, but no difference between non-REM sleep and the awake state, showing that REM sleep is a unique state"

The research team then disrupted the mice's sleep, resulting in "rebound" REM sleep -- a stronger form of REM sleep to compensate for the earlier disruption. Blood flow in the brain was further increased during rebound REM sleep, suggesting an association between blood flow and REM sleep strength. However, when the researchers repeated the same experiments in mice without adenosine A2a receptors (the receptors whose blockade makes you feel more awake after drinking coffee), there was less of an increase in blood flow during REM sleep, even during rebound REM sleep.

"These results suggest that adenosine A2a receptors may be responsible for at least some of the changes in blood flow in the brain during REM sleep," says Professor Hayashi.

Given that reduced blood flow in the brain and decreased REM sleep are correlated with the development of Alzheimer's disease, which involves the buildup of waste products in the brain, it may be interesting to address whether increased blood flow in the brain capillaries during REM sleep is important for waste removal from the brain. This study lays preliminary groundwork for future investigations into the role of adenosine A2a receptors in this process, which could ultimately lead to the development of new treatments for conditions such as Alzheimer's disease.

Journal Reference:

Chia-Jung Tsai, Takeshi Nagata, Chih-Yao Liu, Takaya Suganuma, Takeshi Kanda, Takehiro Miyazaki, Kai Liu, Tsuyoshi Saitoh, Hiroshi Nagase, Michael Lazarus, Kaspar E. Vogt, Masashi Yanagisawa, Yu Hayashi. Cerebral capillary blood flow upsurge during REM sleep is mediated by A2a receptors. Cell Reports, 2021; 36 (7): 109558 DOI: 10.1016/j.celrep.2021.109558
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Re: Sleep disorders common during COVID-19 pandemic

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Study provides clearer understanding of how migraines affect sleep patterns

9/23/21


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


Adults and children with migraines may get less quality, REM sleep time than people who don't have migraines. That's according to a meta-analysis published in the September 22, 2021, online issue of Neurology®, the medical journal of the American Academy of Neurology. Children with migraines were also found to get less total sleep time than their healthy peers but took less time to fall asleep.

Rapid Eye Movement (REM) sleep is the stage of sleep that involves the most brain activity and vivid dreams. It is important for learning and memory function.

"Do migraines cause poor sleep quality or does poor sleep quality cause migraines?" said meta-analysis author Jan Hoffmann, MD, PhD, of King's College London in the United Kingdom and a member of the American Academy of Neurology. "We wanted to analyze recent research to get a clearer picture of how migraines affect people's sleep patterns and the severity of their headaches. That way, clinicians can better support people with migraines and deliver more effective sleep treatments."

For the meta-analysis, researchers included 32 studies, involving 10,243 people. Participants completed a questionnaire to rate their own sleep quality. It asked about sleep habits, including how long it takes to fall asleep, total sleep time and the use of sleep aids. Higher scores indicate worse sleep quality.

For many of the studies, people took part in an overnight sleep lab used to diagnose sleep disorders. This sleep study records brain waves, the oxygen level in the blood, heart rate and eye movement.

Researchers found that adults with migraines overall had higher average scores on the questionnaire than people without migraines, with a moderate amount of the difference due to the migraines. The difference was even greater in people with chronic migraines.

When researchers looked at sleep studies, they found adults and children with migraines had less REM sleep as a percentage of their total sleep time than their healthy counterparts.

When looking at children with migraines, researchers found they had less total sleep time, more wake time, and shorter time for sleep onset than children without migraines. Hoffmann said it's possible children with migraines may fall asleep more quickly than their peers because they may be sleep deprived.

" Our analysis provides a clearer understanding of migraines and how they affect sleep patterns and illustrates the impact these patterns might have on a person's ability to get a good night's sleep."

- Jan Hoffmann, MD, PhD, King's College London

The meta-analysis does not prove a causal relationship between sleep and migraines.

A limitation of the meta-analysis is that medications that affect sleep cycles were not taken into account.

The meta-analysis was supported by the Medical Research Council and the Migraine Trust in the U.K.

Source:

American Academy of Neurology

Journal reference:


Stanyer, E.C., et al. (2021) Subjective Sleep Quality and Sleep Architecture in Patients With Migraine: A Meta-analysis. Neurology. doi.org/10.1212/WNL.0000000000012701.
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