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Complex interaction of circadian and non-circadian effects of light on mood: Shedding new light on an old story
Stephenson KM, Schroder CM, Bertschy G, Bourgin P.
Department of Biological Rhythms, Institut des Neurosciences Cellulaires et Intégratives, CNRS-UPR 3212, Strasbourg, France; Department of Biological Sciences, Stanford University, Stanford, USA.
Sleep Med Rev. 2012 Jan 13. [Epub ahead of print]
Abstract
In addition to its role in vision, light exerts strong effects on behavior. Its powerful role in the modulation of mood is well established, yet remains poorly understood. Much research has focused on the effects of light on circadian rhythms and subsequent interaction with alertness and depression. The recent discovery of a third photoreceptor, melanopsin, expressed in a subset of retinal ganglion cells, allows major improvement of our understanding of how photic information is processed. Light affects behavior in two ways, either indirectly through the circadian timing system, or directly through mechanisms that are independent of the circadian system. These latter effects have barely been studied in regard to mood, but recent investigations on the direct effects of light on sleep and alertness suggest additional pathways through which light could influence mood. Based on our recent findings, we suggest that light, via melanopsin, may exert its antidepressant effect through a modulation of the homeostatic process of sleep. Further research is needed to understand how these mechanisms interplay and how they contribute to the photic regulation of mood. Such research could improve therapeutic management of affective disorders and influence the management of societal lighting conditions.© 2011. Published by Elsevier Ltd.
Stephenson KM, Schroder CM, Bertschy G, Bourgin P.
Department of Biological Rhythms, Institut des Neurosciences Cellulaires et Intégratives, CNRS-UPR 3212, Strasbourg, France; Department of Biological Sciences, Stanford University, Stanford, USA.
Sleep Med Rev. 2012 Jan 13. [Epub ahead of print]
Abstract
In addition to its role in vision, light exerts strong effects on behavior. Its powerful role in the modulation of mood is well established, yet remains poorly understood. Much research has focused on the effects of light on circadian rhythms and subsequent interaction with alertness and depression. The recent discovery of a third photoreceptor, melanopsin, expressed in a subset of retinal ganglion cells, allows major improvement of our understanding of how photic information is processed. -
Sleep disturbance is associated with cardiovascular and metabolic disorders.
Grandner MA, Jackson NJ, Pak VM, Gehrman PR.
Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA, USA Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
J Sleep Res. 2011 Dec 12. doi: 10.1111/j.1365-2869.2011.00990.x.
Existing research has demonstrated associations between sleep duration and obesity, diabetes, cardiovascular disease and mortality. Sleep disorders research has shown that sleep apnoea, insomnia and other sleep disorders confer risk for cardiometabolic disease, particularly in the presence of reduced sleep duration. The aim of the present study was to examine the associations between general sleep disturbance, operationalized as 'difficulty falling asleep, staying asleep, or sleeping too much' as measured in a large, nationally representative sample, and self-reported history of myocardial infarction, stroke, coronary artery disease, diabetes and obesity. Data from the Behavioral Risk Factor Surveillance System were analysed. Complete data were available for 138 201 individuals. A hierarchical logistic regression analysis examined associations before and after adjustment for demographic, socioeconomic, medical and psychological factors. After adjusting for demographic, socioeconomic and health risk factors, sleep duration was associated with obesity [odds ratio (OR) = 1.18, P < 0.0005), diabetes (OR = 1.18, P < 0.005), myocardial infarction (OR = 1.36, P < 0.0005), stroke (OR = 1.22, P < 0.05) and coronary artery disease (OR = 1.59, P < 0.0005). In fully adjusted models that included physical health, significant relationships remained for obesity (OR = 1.14, P < 0.0005), myocardial infarction (OR = 1.23, P < 0.005) and coronary artery disease (OR = 1.43, P < 0.0005). Sleep disturbance is a significant risk factor for obesity, diabetes, myocardial infarction, stroke and coronary artery disease, and effects for obesity, myocardial infarction and coronary artery disease are the most robust after adjustment. This study demonstrates that sleep disturbance is a novel risk factor that is potentially modifiable. Future research should determine whether sleep intervention could reduce the cardiometabolic consequences of sleep disturbance.
© 2011 European Sleep Research Society.
Grandner MA, Jackson NJ, Pak VM, Gehrman PR.
Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA, USA Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
J Sleep Res. 2011 Dec 12. doi: 10.1111/j.1365-2869.2011.00990.x.
Existing research has demonstrated associations between sleep duration and obesity, diabetes, cardiovascular disease and mortality. Sleep disorders research has shown that sleep apnoea, insomnia and other sleep disorders confer risk for cardiometabolic disease, particularly in the presence of reduced sleep duration.
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Factors relating to insomnia during the menopausal transition as evaluated by the Insomnia Severity Index.
Arakane M, Castillo C, Rosero MF, Peñafiel R, Pérez-López FR, Chedraui P.
Departamento de Docencia e Investigación, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
Maturitas. 2011 Jun;69(2):157-61. Epub 2011 Mar 27.
BACKGROUND:
Although the menopause associates to poor sleep quality, insomnia severity data in the menopausal transition is scarce or lacking.
OBJECTIVE:
To assess insomnia prevalence, severity and related factors in mid-aged women.
METHODS:
In this cross-sectional study 340 women (40 to 59 years) completed the Insomnia Severity Index (ISI) and a general questionnaire containing personal/partner data. Hot flush presence and intensity was also assessed with the Menopause Rating Scale (MRS).
RESULTS:
Median age of the sample was 48.0 years, with 63.5% having lower education and 52.9% being postmenopausal. At the moment of the survey 7.1% were on hormone therapy, 8.2% on phytoestrogens and 2.1% on psychotropic drugs. A 63.8% were abdominally obese (waist circumference > 88 cm) and 65.5% sedentary. According to item 1 of the MRS, 60.9% presented hot flushes, graded in 17.4% as severe-very severe. Regarding the partner (n=255), erectile dysfunction was present in 23.9%, premature ejaculation 37.6%, 35.3% abused alcohol and 42.4% were faithful. The ISI tool displayed a high internal consistency (alpha Cronbach coefficient=0.87), identifying 41.5% of women with some degree of insomnia (Total ISI score ≥8) further categorized as sub-threshold or mild (32.0%), moderate (7.4%) and severe (2.1%). Multiple linear regression analysis obtained two best fit models predicting total ISI scores, one not including and one including partner data. In the first model, hot flush severity, psychotropic use and sedentarism displayed significant positive correlations with total ISI scores. In the second, hot flush intensity, psychotropic drug use and male erectile dysfunction positively correlated whereas partner faithfulness inversely with ISI scores.
CONCLUSION:
In this mid-aged series insomnia severity was related to female and partner factors; several of which are susceptible of intervention.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Arakane M, Castillo C, Rosero MF, Peñafiel R, Pérez-López FR, Chedraui P.
Departamento de Docencia e Investigación, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
Maturitas. 2011 Jun;69(2):157-61. Epub 2011 Mar 27.
BACKGROUND:
Although the menopause associates to poor sleep quality, insomnia severity data in the menopausal transition is scarce or lacking.
OBJECTIVE:
To assess insomnia prevalence, severity and related factors in mid-aged women.
METHODS:
In this cross-sectional study 340 women (40 to 59 years) completed the Insomnia Severity Index (ISI) and a general questionnaire containing personal/partner data. Hot flush presence and intensity was also assessed with the Menopause Rating Scale (MRS).
RESULTS:
Median age of the sample was 48. -
Opioids, sleep, and sleep-disordered breathing.
Zutler M, Holty JE.
Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA. moshe.zutler@ucsf.edu
Curr Pharm Des. 2011;17(15):1443-9.
Abstract
Opioid medications are increasingly used to treat chronic pain. Opioid-associated respiratory depression, and their potential to cause nocturnal apneas, is increasingly recognized as a major contributor to nocturnal hypoxemia and sleep-disordered breathing. Given the widespread use of opioids, understanding their mechanism of action and their potential to cause adverse effects particularly during sleep is critical. This article reviews the salient features of the physiologic control of respiration and sleep, and the role opioids play in altering that regulation. Additionally, we summarize the evidence regarding the association between opioid use and sleep-disordered breathing and explore treatment modalities for opioid-associated nocturnal respiratory depression and apneas.
Zutler M, Holty JE.
Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA. moshe.zutler@ucsf.edu
Curr Pharm Des. 2011;17(15):1443-9.
Abstract
Opioid medications are increasingly used to treat chronic pain. Opioid-associated respiratory depression, and their potential to cause nocturnal apneas, is increasingly recognized as a major contributor to nocturnal hypoxemia and sleep-disordered breathing. Given the widespread use of opioids, understanding their mechanism of action and their potential to cause adverse effects particularly during sleep is critical. This article reviews the salient features of the physiologic control of respiration and sleep, and the role opioids play in altering that regulation. -
Volume of the amygdala is reduced in patients with narcolepsy - a structural MRI study.
Brabec J, Rulseh A, Horinek D, Pala A, Guerreiro H, Buskova J, Petrovicky P, Nemcova V, Krasensky J, Seidl Z, Nimsky C, Sonka K.
Institute of Anatomy, First Faculty of Medicine, Charles University in Prague, Czech Republic. ksonka@lf1.cuni.cz.
Neuro Endocrinol Lett. 2011 Sep 3;32(5):652-656.
Abstract
OBJECTIVE:
Based on the clinical observation that patients suffering from narcolepsy with cataplexy (NC) have cataplectic attacks when they experience positive emotions, it is therefore hypothesised that the abnormal processing of external emotional input through the limbic system, or motor dysregulation induced by emotions, takes place during these episodes. To date, imaging studies have failed to reveal consistent brain abnormalities in NC patients.
METHODS:
Considering the discrepancies in reported structural or functional abnormalities of the hypothalamus, amygdala, and nucleus accumbens, we used the MRI volumetry to determine the volumes of the amygdala and nucleus accumbens in a group of eleven patients with NC (5 males and 6 females, mean age 41.7 years ± 17.7). This data was compared to an equal number of examinations in healthy volunteers matched for age and gender.
RESULTS:
We found a decrease in the amygdalar volume of NC patients in both raw (p<0.001) and relative (p<0.01) data sets. The difference in amygdalar volume between healthy volunteers and NC patients was about 17%. In contrast to the amygdala, we did not find any differences in the volumes of nucleus accumbens.
CONCLUSION:
In the present MRI volumetric study, we found bilateral gray matter loss in the amygdala only.
Brabec J, Rulseh A, Horinek D, Pala A, Guerreiro H, Buskova J, Petrovicky P, Nemcova V, Krasensky J, Seidl Z, Nimsky C, Sonka K.
Institute of Anatomy, First Faculty of Medicine, Charles University in Prague, Czech Republic. ksonka@lf1.cuni.cz.
Neuro Endocrinol Lett. 2011 Sep 3;32(5):652-656.
Abstract
OBJECTIVE:
Based on the clinical observation that patients suffering from narcolepsy with cataplexy (NC) have cataplectic attacks when they experience positive emotions, it is therefore hypothesised that the abnormal processing of external emotional input through the limbic system, or motor dysregulation induced by emotions, takes place during these episodes. To date, imaging studies have failed to reveal consistent brain abnormalities in NC patients. -
Evaluating sleep characteristics in intensive care unit and non-intensive care unit physicians.
Ok G, Yilmaz H, Tok D, Erbüyün K, Coban S, Dinç G.
Department of Anaesthesiology and Reanimation, Celal Bayar University Medical Faculty, Manisa, Turkey. gulayokmd@hotmail.com
Anaesth Intensive Care. 2011 Nov;39(6):1071-5.
Abstract
Healthcare workers' cognitive performances and alertness are highly vulnerable to sleep loss and circadian rhythms. The purpose of this study was to investigate the changes in sleep characteristics of intensive care unit (ICU) and non-ICU physicians. Actigraphic sleep parameters, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Hamilton Depression Rating Scale were evaluated for ICU and non-ICU physicians on the day before shift-work and on three consecutive days after shift-work. Total sleep time, sleep latency, wakefulness after sleep onset, total activity score, movement fragmentation index, sleep efficiency, daytime naps and total nap duration were also calculated by actigraph. In the ICU physicians, the mean Pittsburgh Sleep Quality Index score was significantly higher than the non-ICU physicians (P = 0.001), however mean Epworth Sleepiness Scale scores were not found significantly different between the two groups. None of the scores for objective sleep parameters were statistically different between the groups when evaluated before and after shift-work (P > 0.05). However in both ICU and non-ICU physicians, sleep latency was observed to be decreased within the three consecutive-day period after shift-work with respect to basal values (P < 0.001). Total sleep time, total activity score and sleep efficiency scores prior to shift-work were significantly different from shift-work and the three consecutive-days after shift-work, in both groups. Working in the ICU does not have an impact on objective sleep characteristics of physicians in this study. Large cohort studies are required to determine long-term health concerns of shift-working physicians.
Ok G, Yilmaz H, Tok D, Erbüyün K, Coban S, Dinç G.
Department of Anaesthesiology and Reanimation, Celal Bayar University Medical Faculty, Manisa, Turkey. gulayokmd@hotmail.com
Anaesth Intensive Care. 2011 Nov;39(6):1071-5.
Abstract
Healthcare workers' cognitive performances and alertness are highly vulnerable to sleep loss and circadian rhythms. The purpose of this study was to investigate the changes in sleep characteristics of intensive care unit (ICU) and non-ICU physicians. Actigraphic sleep parameters, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Hamilton Depression Rating Scale were evaluated for ICU and non-ICU physicians on the day before shift-work and on three consecutive days after shift-work. -
Adherence to continuous positive airway pressure therapy in obstructive sleep apnea syndrome: effect of visual education.
Basoglu OK, Midilli M, Midilli R, Bilgen C.
Department of Chest Diseases, Ege University Medical School, 35100, Bornova, Izmir, Turkey, ozen.basoglu@ege.edu.tr.
Sleep Breath. 2011 Dec 14.
Abstract
BACKGROUND:
Continuous positive airway pressure (CPAP) therapy is the most effective treatment in obstructive sleep apnea syndrome (OSAS) although it is known that adherence to therapy is limited. The aims of this study were to evaluate the effect of visual education on CPAP adherence and to identify the factors affecting adherence.
METHODS:
Out of 133 consecutive newly diagnosed moderate-to-severe OSAS patients, 66 were informed about OSAS and CPAP therapy and received visual education by videotape (video group), whereas only information was given to 67 of them (control group). The patients were followed up in the 1st, 3rd, and 6th months.
RESULTS:
After 6-month follow-up, adherence rate to CPAP therapy was 71.2% in the video group and 56.7% in the control group (p = 0.08). OSAS symptoms, such as witnessed apnea, morning headache, night sweating, dry mouth, and Epworth sleepiness score (ESS), were ameliorated more significantly in the video group (p < 0.05). In order to assess predictors of adherence, 85 patients using CPAP effectively were compared to 48 nonadherent patients; significant improvement in OSAS symptoms and ESS was observed in the adherent patients (p < 0.05). ESS was negatively correlated with the duration of CPAP use (r = -0.524, p < 0.0001). Adverse effects such as mask intolerance, choking, noise, and nasal congestion were related to poorer adherence (p < 0.01).
CONCLUSIONS:
It is shown that adherence rate to CPAP therapy might be improved by visual education although the difference was not significant. Besides, patients with better adherence to CPAP treatment report the greatest improvement in OSAS symptoms and daytime sleepiness, and adverse effects are significantly related to poorer adherence.
Basoglu OK, Midilli M, Midilli R, Bilgen C.
Department of Chest Diseases, Ege University Medical School, 35100, Bornova, Izmir, Turkey, ozen.basoglu@ege.edu.tr.
Sleep Breath. 2011 Dec 14.
Abstract
BACKGROUND:
Continuous positive airway pressure (CPAP) therapy is the most effective treatment in obstructive sleep apnea syndrome (OSAS) although it is known that adherence to therapy is limited. The aims of this study were to evaluate the effect of visual education on CPAP adherence and to identify the factors affecting adherence.
METHODS:
Out of 133 consecutive newly diagnosed moderate-to-severe OSAS patients, 66 were informed about OSAS and CPAP therapy and received visual education by videotape (video group), whereas only information was given to 67 of them (control group). The patients were followed up in the 1st, 3rd, and 6th months. -
Sleep problems, depression, substance use, social bonding, and quality of life in professional firefighters.
Carey MG, Al-Zaiti SS, Dean GE, Sessanna L, Finnell DS.
School of Nursing, University at Buffalo, Buffalo, NY 14214, USA. mgcarey@buffalo.edu
J Occup Environ Med. 2011 Aug;53(8):928-33.
Abstract
OBJECTIVE:
Little attention has been given to factors contributing to firefighters' psychosomatic well-being. The purpose of this descriptive study was to examine such contributing factors in a sample of professional firefighters.
METHODS:
Measures assessing sleep, depression, substance use, social bonding, and quality of life were examined in 112 firefighters.
RESULTS:
Overall, many firefighters reported sleep deprivation (59%), binge drinking behavior (58%), poor mental well-being (21%), current nicotine use (20%), hazardous drinking behavior (14%), depression (11%), poor physical well-being (8%), caffeine overuse (5%), or poor social bonding (4%).
CONCLUSIONS:
Small-to-medium correlations were identified between sleep deprivation, depression, physical/mental well-being, and drinking behaviors. High-risk behaviors that impact psychosomatic well-being are prevalent in professional firefighters, which require environmental and individual-based health promotion interventions. The inter-correlation relationships between such behaviors, therefore, need to be explored in further details.
Carey MG, Al-Zaiti SS, Dean GE, Sessanna L, Finnell DS.
School of Nursing, University at Buffalo, Buffalo, NY 14214, USA. mgcarey@buffalo.edu
J Occup Environ Med. 2011 Aug;53(8):928-33.
Abstract
OBJECTIVE:
Little attention has been given to factors contributing to firefighters' psychosomatic well-being. The purpose of this descriptive study was to examine such contributing factors in a sample of professional firefighters.
METHODS:
Measures assessing sleep, depression, substance use, social bonding, and quality of life were examined in 112 firefighters.
RESULTS:
Overall, many firefighters reported sleep deprivation (59%), binge drinking behavior (58%), poor mental well-being (21%), current nicotine use (20%), hazardous drinking behavior (14%), depression (11%), poor physical well-being (8%), caffeine overuse (5%), or poor social bonding (4%). -
Benefits of napping on night shifts.
McMillan DE, Fallis WM.
Faculty of nursing, University of Manitoba, Winnipeg, Canada.
Nurs Times. 2011 Nov 8-14;107(44):12-3.
Many nurses deliver care when they are fatigued and sleep deprived, which may place them and patients at risk. A qualitative study found restorative napping on breaks during night shifts helped to improve energy, mood, decision-making and vigilance. This article looks at the benefits night napping can offer nurses doing shift work.
McMillan DE, Fallis WM.
Faculty of nursing, University of Manitoba, Winnipeg, Canada.
Nurs Times. 2011 Nov 8-14;107(44):12-3.
Many nurses deliver care when they are fatigued and sleep deprived, which may place them and patients at risk. A qualitative study found restorative napping on breaks during night shifts helped to improve energy, mood, decision-making and vigilance. This article looks at the benefits night napping can offer nurses doing shift work.
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Diagnostic tools for REM sleep behavior disorder.
Neikrug AB, Ancoli-Israel S.
SDSU/UCSD Joint Doctoral Program in Clinical Psychology, Department of Psychiatry, University of California San Diego, United States.
Sleep Med Rev. 2011 Dec 12.
BACKGROUND:
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by loss of muscle atonia during REM sleep that results in motor behaviors. Diagnosis of RBD involves a clinical interview in which history of dream enactment behaviors is elicited and a subsequent overnight polysomnography (PSG) evaluation to assess for REM sleep without atonia (RWA) and/or observe motor behaviors during REM sleep. Therefore, the nature of RBD diagnosis involves both subjective and objective measurements that attempt to qualify and quantify the different diagnostic sub-criteria.
OBJECTIVES:
The primary aim of the current study was to identify and summarize the available clinical measurements that have been used for RBD assessment.
METHODS:
Two major online databases (MEDLINE and PsycInfo) were searched for articles developing, validating, or evaluating psychometric properties of the RBD diagnostic criteria or methods used for diagnosis. Studies of adult subjects (18 years or more) that included sufficient psychometric data for validation were included.
RESULTS:
Fifty-eight studies were found to meet review criteria. The objective measurements for assessment of RBD reviewed included visual electromyographic (EMG) scoring methods, computerized EMG scoring methods, cardiac (123)I-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy, actigraphy, behavioral classification and video analysis. Subjective measurements of RBD included interviews and questionnaires.
CONCLUSION:
Sleep history may be sufficient for diagnosis of RBD in some populations. However, PSG is necessary for a definitive diagnosis. EMG scoring methods vary in definition used and there is no single accepted approach to scoring muscle activity. Additional validation studies are required for establishing cutoff scores for the different methods. Questionnaires were shown to be appropriate screening tools, yet further validation in different populations is necessary.Copyright © 2011 Elsevier Ltd. All rights reserved.
Neikrug AB, Ancoli-Israel S.
SDSU/UCSD Joint Doctoral Program in Clinical Psychology, Department of Psychiatry, University of California San Diego, United States.
Sleep Med Rev. 2011 Dec 12.
BACKGROUND:
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by loss of muscle atonia during REM sleep that results in motor behaviors. Diagnosis of RBD involves a clinical interview in which history of dream enactment behaviors is elicited and a subsequent overnight polysomnography (PSG) evaluation to assess for REM sleep without atonia (RWA) and/or observe motor behaviors during REM sleep. Therefore, the nature of RBD diagnosis involves both subjective and objective measurements that attempt to qualify and quantify the different diagnostic sub-criteria.
