Limited population-based data from children are available to investigate the associations between insomnia and sleep duration in relationship to impaired cardiac autonomic modulation (CAM). Therefore, the objective of...Limited population-based data from children are available to investigate the associations between insomnia and sleep duration in relationship to impaired cardiac autonomic modulation (CAM). Therefore, the objective of this study is to examine the cross-sectional associations between insomnia symptoms, sleep duration, and CAM in a population-based sample of children. All 616 children were randomly selected from Central Pennsylvania to participate in a one-night polysomnography (PSG) study in a sleep laboratory. The Pediatric Behavior Scale was used to assess parent-reported insomnia. Sleep duration was assessed objectively by PSG. CAM was measured by heart rate variability (HRV) analysis of 9-hour-beat-to-beat RR intervals. Multivariate linear regression models were used to assess the association between insomnia, sleep duration and HRV. The mean (SD) age was 9.2 (1.7) years, with 25.5% non-white and 48.9% male. After adjusting for age, race, gender, BMI percentile, %REM sleep, apnea-hypopnea-index, sleep latency, and sleep efficiency, the means(SE) of HRV indices were lower in children with insomnia than in children without: 6.56 (0.07) vs. 6.78 (0.04) m2 on logHF, respectively;and 6.47 (0.06) vs. 6.61 (0.03) m2 on logLF, respectively (all P < 0.05). There is a trend towards a significant lower time domain HRV indices, faster HR, and higher LF/HF ratio in children with insomnia symptoms. There is a similar pattern of association between shorter objective sleep duration and HRV. Insomnia symptoms and shorter objective sleep duration are associated with lower HRV and higher HR and LF/HF ratio, indicative of disturbance of CAM towards more sympathetic and lower parasympathetic modulation. These data provide supporting evidence of physiological activation associated with insomnia and short sleep duration even in very young children.展开更多
Mobile phone addiction is a growing concern among college students, with significant implications for their mental health. This study examines the complex relationship between mobile phone addiction and its impact on ...Mobile phone addiction is a growing concern among college students, with significant implications for their mental health. This study examines the complex relationship between mobile phone addiction and its impact on college students’ insomnia, symptoms of depression, and anxiety. A sample of 399 college students from traditional Chinese medicine colleges in Guangxi, China, completed the Mobile Phone Addiction Tendency Scale questionnaire. Among them, 155 students with high Mobile Phone Addiction Tendency scores were selected for the correlation study. The analysis revealed a strong association between mobile phone addiction and insomnia. Furthermore, mobile phone addiction was significantly associated with symptoms of depression, including feelings of sadness, worthlessness, and hopelessness, as well as heightened anxiety symptoms, such as excessive worry and restlessness. These findings emphasized the importance of targeted interventions and preventive measures to address the negative impact of mobile phone addiction on college students’ mental health.展开更多
Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(...Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(OSA),also occurs frequently in PTSD,and emerging research indicates OSA fuels chronic insomnia.Scant research has investigated the impact of OSA treatment on insomnia outcomes(Insomnia Severity Index,ISI)in trauma survivors.Methods:OSA patients with moderately severe posttraumatic stress symptoms were studied in a retrospective chart review.Ninety-six patients who failed CPAP therapy due to expiratory pressure intolerance or complex sleep apnea or both underwent manual titration with advanced PAP modes[autobilevel(ABPAP);adaptive servo-ventilation(ASV)],which were subsequently prescribed.PAP use measured by objective data downloads divided the sample into three groups:compliant regular users(C-RU):n=68;subthreshold users(SC-RU):n=12;and noncompliant users(NC-MU):n=16.The average follow-up was 11.89±12.22 months.Baseline and posttreatment ISI scores were analyzed to assess residual insomnia symptoms as well as cure rates.Results:The C-RU group showed significant improvements in insomnia with very large effects compared to those in the NC-MU reference group(P=0.019).Insomnia severity significantly decreased in all three groups with large effects(C-RU,P=0.001;SC-RU,P=0.027;NC-MU,P=0.007).Hours of weekly PAP use and insomnia severity were inversely correlated(P=0.001,r=–0.321).However,residual insomnia symptoms based on established ISI cut-offs were quite common,even among the C-RU group.Post hoc analysis showed that several categories of sedating medications reported at baseline(hypnotics,anti-epileptic,opiates)as well as actual use of any sedating medication(prescription or nonprescription)were associated with smaller insomnia improvements than those in patients not using any sedating agents.Conclusions:In a retrospective,nonrandomized analysis of a select sample of sleep clinic patients with OSA and PTSD symptoms,advanced PAP therapy was associated with significant improvement in insomnia severity for both compliant and partial users.However,residual insomnia symptoms persisted,indicating that PAP therapy provides only limited treatment.RCTs are warranted to assess the effect of ABPAP and ASV modes of therapy on adherence and sleep outcomes,and their potential impact on posttraumatic stress symptoms.Treatment arms that combine PAP with CBT-I would be expected to yield the greatest potency.展开更多
文摘Limited population-based data from children are available to investigate the associations between insomnia and sleep duration in relationship to impaired cardiac autonomic modulation (CAM). Therefore, the objective of this study is to examine the cross-sectional associations between insomnia symptoms, sleep duration, and CAM in a population-based sample of children. All 616 children were randomly selected from Central Pennsylvania to participate in a one-night polysomnography (PSG) study in a sleep laboratory. The Pediatric Behavior Scale was used to assess parent-reported insomnia. Sleep duration was assessed objectively by PSG. CAM was measured by heart rate variability (HRV) analysis of 9-hour-beat-to-beat RR intervals. Multivariate linear regression models were used to assess the association between insomnia, sleep duration and HRV. The mean (SD) age was 9.2 (1.7) years, with 25.5% non-white and 48.9% male. After adjusting for age, race, gender, BMI percentile, %REM sleep, apnea-hypopnea-index, sleep latency, and sleep efficiency, the means(SE) of HRV indices were lower in children with insomnia than in children without: 6.56 (0.07) vs. 6.78 (0.04) m2 on logHF, respectively;and 6.47 (0.06) vs. 6.61 (0.03) m2 on logLF, respectively (all P < 0.05). There is a trend towards a significant lower time domain HRV indices, faster HR, and higher LF/HF ratio in children with insomnia symptoms. There is a similar pattern of association between shorter objective sleep duration and HRV. Insomnia symptoms and shorter objective sleep duration are associated with lower HRV and higher HR and LF/HF ratio, indicative of disturbance of CAM towards more sympathetic and lower parasympathetic modulation. These data provide supporting evidence of physiological activation associated with insomnia and short sleep duration even in very young children.
文摘Mobile phone addiction is a growing concern among college students, with significant implications for their mental health. This study examines the complex relationship between mobile phone addiction and its impact on college students’ insomnia, symptoms of depression, and anxiety. A sample of 399 college students from traditional Chinese medicine colleges in Guangxi, China, completed the Mobile Phone Addiction Tendency Scale questionnaire. Among them, 155 students with high Mobile Phone Addiction Tendency scores were selected for the correlation study. The analysis revealed a strong association between mobile phone addiction and insomnia. Furthermore, mobile phone addiction was significantly associated with symptoms of depression, including feelings of sadness, worthlessness, and hopelessness, as well as heightened anxiety symptoms, such as excessive worry and restlessness. These findings emphasized the importance of targeted interventions and preventive measures to address the negative impact of mobile phone addiction on college students’ mental health.
基金small private donations to the Sleep&Human Health Institute.
文摘Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(OSA),also occurs frequently in PTSD,and emerging research indicates OSA fuels chronic insomnia.Scant research has investigated the impact of OSA treatment on insomnia outcomes(Insomnia Severity Index,ISI)in trauma survivors.Methods:OSA patients with moderately severe posttraumatic stress symptoms were studied in a retrospective chart review.Ninety-six patients who failed CPAP therapy due to expiratory pressure intolerance or complex sleep apnea or both underwent manual titration with advanced PAP modes[autobilevel(ABPAP);adaptive servo-ventilation(ASV)],which were subsequently prescribed.PAP use measured by objective data downloads divided the sample into three groups:compliant regular users(C-RU):n=68;subthreshold users(SC-RU):n=12;and noncompliant users(NC-MU):n=16.The average follow-up was 11.89±12.22 months.Baseline and posttreatment ISI scores were analyzed to assess residual insomnia symptoms as well as cure rates.Results:The C-RU group showed significant improvements in insomnia with very large effects compared to those in the NC-MU reference group(P=0.019).Insomnia severity significantly decreased in all three groups with large effects(C-RU,P=0.001;SC-RU,P=0.027;NC-MU,P=0.007).Hours of weekly PAP use and insomnia severity were inversely correlated(P=0.001,r=–0.321).However,residual insomnia symptoms based on established ISI cut-offs were quite common,even among the C-RU group.Post hoc analysis showed that several categories of sedating medications reported at baseline(hypnotics,anti-epileptic,opiates)as well as actual use of any sedating medication(prescription or nonprescription)were associated with smaller insomnia improvements than those in patients not using any sedating agents.Conclusions:In a retrospective,nonrandomized analysis of a select sample of sleep clinic patients with OSA and PTSD symptoms,advanced PAP therapy was associated with significant improvement in insomnia severity for both compliant and partial users.However,residual insomnia symptoms persisted,indicating that PAP therapy provides only limited treatment.RCTs are warranted to assess the effect of ABPAP and ASV modes of therapy on adherence and sleep outcomes,and their potential impact on posttraumatic stress symptoms.Treatment arms that combine PAP with CBT-I would be expected to yield the greatest potency.
