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Journal articles on the topic 'Intrinsic Sleep Disorders'
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Venn, P. J. H. "Intrinsic sleep disorders and anaesthesia." Current Anaesthesia & Critical Care 13, no. 1 (February 2002): 6–15. http://dx.doi.org/10.1054/cacc.2002.0376.
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Monk, T. "Intrinsic circadian rhythm sleep disorders." Sleep Medicine Reviews 3, no. 3 (September 1999): 177–78. http://dx.doi.org/10.1016/s1087-0792(99)90000-x.
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Richert, Allen C., and Alp Sinan Baran. "A Review of Common Sleep Disorders." CNS Spectrums 8, no. 2 (February 2003): 102–9. http://dx.doi.org/10.1017/s1092852900018320.
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AbstractWhat should clinicians know about sleep disorders? This article briefly introduces the reader to sleep medicine and succinctly reviews common sleep disorders. First, the authors describe the diagnostic tools unique to sleep medicine: the over-night polysomnogram and the multiple sleep latency test. Next, the authors review essential features of a subset of the sleep, described in the International Classification of Sleep Disorders-Revised, that sleep disorder specialists commonly evaluate, diagnose, and treat. The disorders reviewed include the intrinsic and circadian rhythm subsets of the dyssomnias group and the parasomnia group of sleep disorders. The authors identify the core signs and symptoms, polysomnogram findings, multiple sleep latency test findings, and treatment of these disorders.
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Mainieri, Greta, Giuseppe Loddo, and Federica Provini. "Disorders of Arousal: A Chronobiological Perspective." Clocks & Sleep 3, no. 1 (January 21, 2021): 53–65. http://dx.doi.org/10.3390/clockssleep3010004.
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Non-rapid eye movement (NREM) sleep parasomnias are characterized by motor and emotional behaviors emerging from incomplete arousals from NREM sleep and they are currently referred to as disorders of arousal (DoA). Three main clinical entities are recognized, namely confusional arousal, sleep terror and sleepwalking. DoA are largely present in pediatric populations, an age in which they are considered as transitory, unhabitual physiological events. The literature background in the last twenty years has extensively shown that DoA can persist in adulthood in predisposed individuals or even appear de novo in some cases. Even though some episodes may arise from stage 2 of sleep, most DoA occur during slow wave sleep (SWS), and particularly during the first two sleep cycles. The reasons for this timing are linked to the intrinsic structure of SWS and with the possible influence on this sleep phase of predisposing, priming and precipitating factors for DoA episodes. The objective of this paper is to review the intrinsic sleep-related features and chronobiological aspects affecting SWS, responsible for the occurrence of the majority of DoA episodes during the first part of the night.
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Campbell, S. "Etiology and treatment of intrinsic circadian rhythm sleep disorders." Sleep Medicine Reviews 3, no. 3 (September 1999): 179–200. http://dx.doi.org/10.1016/s1087-0792(99)90001-1.
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Kaplan, Robert. "Obstructive Sleep Apnoea and Depression — Diagnostic and Treatment Implications." Australian & New Zealand Journal of Psychiatry 26, no. 4 (December 1992): 586–91. http://dx.doi.org/10.3109/00048679209072093.
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Sleep apnoea (OSA), a common sleep disorder, is well recognised as a cause of morbidity including psychiatric disorders. There is increasing recognition of the link between OSA and depression. Sleep changes are intrinsic to depressive disorders, most notably disturbances of REM sleep; OSA causes predominantly REM sleep disturbances. The neuro-vegetative features of depression are similar or identical to the symptoms of OSA — an issue which has not achieved wide clinical recognition. A growing number of studies confirm the statistical link between the two conditions. The implications are twofold: OSA needs to be excluded in cases of chronic or resistant depression and treatment of OSA will make it easier to treat the primary depressive disorder. A new method of treatment for OSA, the Sullivan continuous positive airway pump (CPAP), raises the theoretical possibility of treating depression by this means as well.
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Wijnen, Herman, Catharine Boothroyd, Michael W. Young, and Adam Claridge-Chang. "Molecular genetics of timing in intrinsic circadian rhythm sleep disorders." Annals of Medicine 34, no. 5 (January 2002): 386–93. http://dx.doi.org/10.1080/078538902320772133.
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Blum, Nathan J., and William B. Carey. "Sleep Problems Among Infants and Young Children." Pediatrics In Review 17, no. 3 (March 1, 1996): 87–92. http://dx.doi.org/10.1542/pir.17.3.87.
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Parental concerns about their young children's sleep are among the most frequent behavior problems discussed with pediatricians. In view of this high prevalence, it is important to review the origins of these problems and emerging information about how best to manage them. Definition Sleep disorders among children can be classified as dyssomnias, parasomnias, and disruptions secondary to other conditions. The dyssomnias are disturbances in the amount or timing of the sleep. They include intrinsic sleep disorders such as narcolepsy and sleep apnea, interactional sleep disorders such as excessive night waking, and sleep phase disorders, when the time the parents assign for sleep and the child's period of needing it are not synchronous. Parasomnias, on the other hand, are abnormal behaviors that occur during sleep, such as night terrors, nightmares, sleep walking, and sleep talking. Sleep also can be disturbed as the result of various mental and physical conditions, including asthma, epilepsy, and anxiety disorders. The dyssomnias (sleep refusal and night waking) and parasomnias (night terrors and nightmares) of infancy and early childhood are the most common complaints of parents to pediatricians. Sometimes, however, parents may not seek help for these problems; at other times, they may be concerned by what actually is normal sleep behavior.
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Bruni, O., P. Fabrizi, S. Ottaviano, F. Cortesi, F. Giannotti, and V. Guidetti. "Prevalence of Sleep Disorders in Childhood and Adolescence with Headache." Cephalalgia 17, no. 4 (June 1997): 492–98. http://dx.doi.org/10.1046/j.1468-2982.1997.1704492.x.
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Although a relationship between headache and sleep disturbances has been reported in adults, only few data have been available in children. Accordingly, we performed a survey to determine the prevalence of sleep disturbances in children with migraine and tension-type headache. A questionnaire of history and clinical data and of sleep disturbances was given to parents of 283 headache subjects (164 with migraine and 119 with tension-type headache). Results were compared to a normative group comparable for age and sex of 893 normal healthy subjects. Migraine subjects showed a higher prevalence of sleep disturbances during infancy as well as 3-month colic. In both headache groups, more parents had sleep disturbances and there was a higher occurrence of co-sleeping and napping. A high frequency of sleep disturbances involving sleep quality, night awakening, nocturnal symptoms and daytime sleepiness was reported in headache children. No statistical differences were found in the prevalence of sleep disturbances between migraine and tension-type headache. However, the migraine group tended to have “disturbed sleep” more often with increased prevalence of nocturnal symptoms such as sleep breathing disorders and parasomnias. Our results give further support to an association between sleep and migraine that may have a common intrinsic origin.
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Emanuel, Hina, Amee Revana, Tue Te, and Kevin Kaplan. "830 Combined Phototherapy and Melatonin for treatment of Circadian Rhythm Disorder in a Patient with Cornelia de Lange Syndrome." Sleep 44, Supplement_2 (May 1, 2021): A323—A324. http://dx.doi.org/10.1093/sleep/zsab072.827.
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Abstract Introduction Cornelia de Lange syndrome (CdLS) is a rare genetic disorder characterized by variable physical, cognitive, and behavioral characteristics. Sleep disturbances have been frequently reported in CdLS including insomnia, sleep-disordered breathing, intrinsic sleep disorders, and circadian rhythm disorders (CRDs). The characterization and prevalence of CRDs in CdLS remain ill- defined. We report a case of a 13-year-old female with CdLS presenting with advanced sleep wake phase disorder (ASWPD). Report of case(s) A 13-year-old female with a past medical history of CdLS, developmental delay, bilateral cleft palate status post repair presents with inability to fall asleep at night and excessive daytime sleepiness.(EDS) Her sleep history consists of going to bed at 4 pm with no delayed sleep onset. She wakes at 2:30 am which has occurred since infancy. Mother reports the patient will remain awake from 2:30 am until she goes to school at 7:30 am. History is consistent with EDS and sleeping during the day while at school. Total sleep time of approximately 11–12 hours was reported in 24-hour period. History of obstructive sleep apnea, parasomnias, insomnia, restless leg syndrome, and psychotropic medications were not reported. Patient was treated with timed low dose melatonin therapy 0.5 mg at 4 pm and bright light therapy using 10,000 lux for 30 minutes at 7 am and 4 pm. Dim lights starting at 7:30 pm with structured scheduled sleep hygiene ensuring consistent bedtime at 9:30 pm. A consistent wake time at 7 am and no naps during the day was recommended. Follow up visits report successful response to therapy with attainment of desired sleep wake rhythm (bedtime at 9:30 pm and wake time at 7 am) and resolution of sleepiness during the day. Our patient was able to be weaned off of melatonin and light therapy and her circadian rhythm remained entrained. Conclusion Patients with disorder such as CdLS are at risk for circadian rhythm disorders. Our patient responded well to treatment with combined timed phototherapy and low dose melatonin therapy. Better knowledge and characterization of typology of CRDs in CdLS patients could permit a more specific therapeutic approach to sleep disorders in this population. Support (if any) None
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Swaminathan, Krithika, Elizabeth B. Klerman, and Andrew J. K. Phillips. "Are Individual Differences in Sleep and Circadian Timing Amplified by Use of Artificial Light Sources?" Journal of Biological Rhythms 32, no. 2 (April 2017): 165–76. http://dx.doi.org/10.1177/0748730417699310.
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Within the human population, there is large interindividual variability in the timing of sleep and circadian rhythms. This variability has been attributed to individual differences in sleep physiology, circadian physiology, and/or light exposure. Recent experimental evidence suggests that the latter is necessary to evoke large interindividual differences in sleep and circadian timing. We used a validated model of human sleep and circadian physiology to test the hypothesis that intrinsic differences in sleep and circadian timing are amplified by self-selected use of artificial light sources. We tested the model under 2 conditions motivated by an experimental study (Wright et al., 2013): (1) a “natural” light cycle, and (2) a “realistic” light cycle that included attenuation of light due to living indoors when natural light levels are high and use of electric light when natural light levels are low. Within these conditions, we determined the relationship between intrinsic circadian period (within the range of 23.7-24.6 h) and timing of sleep onset, sleep offset, and circadian rhythms. In addition, we simulated a work week, with fixed wake time for 5 days and free sleep times on weekends. Under both conditions, a longer intrinsic period resulted in later sleep and circadian timing. Compared to the natural condition, the realistic condition evoked more than double the variation in sleep timing across the physiological range of intrinsic circadian periods. Model predictions closely matched data from the experimental study. We found that if the intrinsic circadian period was long (>24.2 h) under the realistic condition, there was significant mismatch in sleep timing between weekdays and weekends, which is known as social jetlag. These findings indicate that individual tendencies to have very delayed schedules can be greatly amplified by self-selected modifications to the natural light/dark cycle. This has important implications for therapeutic treatment of advanced or delayed sleep phase disorders.
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Pierce, Mackenzie, Sunny A. Linnebur, Scott M. Pearson, and Danielle R. Fixen. "Optimal Melatonin Dose in Older Adults: A Clinical Review of the Literature." Senior Care Pharmacist 34, no. 7 (July 1, 2019): 419–31. http://dx.doi.org/10.4140/tcp.n.2019.419.
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OBJECTIVE: To review clinical studies evaluating melatonin doses and their effects on sleep in adults 65 years of age and older. DATA SOURCES: The MEDLINE databases were searched (1946 to October 10, 2018) using the following Medical Subject Heading terms: melatonin and: sleep initiation and maintenance disorders, dyssomnia, sleep wake disorders, insomnia, sleep disorders intrinsic, and sleep disorders circadian rhythm. Sources were limited to English and human data. STUDY SELECTION/DATA EXTRACTION: An initial search resulted in 144 publications, with 25 included in this review. Studies were selected for full review based on design, mean age of participants, use of exogenous melatonin, and reports on any sleep-related outcome. DATA SYNTHESIS: Because of the side effect profiles of most prescription and nonprescription sleep aids, safe and effective alternative therapies are necessary. Based on the current literature, no dose-related response to sleep improvement has been identified for melatonin in older adults. Variations in melatonin formulation and dosages, as well as available tools to measure sleep outcomes, make it challenging to compare studies. CONCLUSIONS: This review evaluated a variety of melatonin doses, 0.5 mg to 10 mg, and their effects on sleep in older adults. The results varied, with some studies finding no difference in sleep outcomes when compared with placebo, while other studies found statistically significant improvements in sleep outcomes. Doses of melatonin between 1 mg and 6 mg appear to be effective for improving sleep in older adults; however, further studies are needed to find the optimal minimum effective dose.
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Carrijo, Marilúcia, Sara S. Faria, Rodolfo P. Vieira, Renata K. da Palma, Renata S. R. Tomaz, Adriano L. Fonseca, Daniela R. P. Fonseca, et al. "Post-traumatic stress disorder, anxiety and depression in post-COVID19 patients: integrative review." Manual Therapy, Posturology & Rehabilitation Journal 20 (June 30, 2022): 1–10. http://dx.doi.org/10.17784/mtprehabjournal.2022.20.1240.
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Background: Global estimates point to high prevalence of neuropsychiatric disorders in individuals hospitalized for COVID-19. In Brazil, anxiety and depression rates resulting from SARS-CoV-2 infection range from 29.7% to 68%, respectively, being more prevalent in young women, with lower educational level, with comorbidities and psychological problems. previous. Objective: Identify possible causes, verify prevalence and identify risk factors for anxiety, depression and post-traumatic stress disorder (PTSD) in patients hospitalized for COVID-19. Methods: An integrative literature review was carried out involving retrospective and/or prospective cohort studies and population-based clinical trials published in the last three years. The main evidence on the relationship between neuropsychiatric disorders and intrinsic changes in neuroimmunomodulation parameters was also raised. Results: Twenty-one studies were included that addressed the presence of symptoms of PTSD, anxiety, depression, fatigue in sleep disorders in COVID19 survivors. Conclusion: With this literature review, it can be concluded that PTSD, anxiety, depression, fatigue and sleep disturbances are highly prevalent symptoms in COVID-19 survivors, being persistent for up to one-year post-infection.
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Chang, Kang Ming, and Sih Huei Chen. "Obstructive Sleep Apnea Identification by Heart Rate Features Derived from Intrinsic Mode Function." Applied Mechanics and Materials 284-287 (January 2013): 1691–97. http://dx.doi.org/10.4028/www.scientific.net/amm.284-287.1691.
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Obstructive sleep apnea (OSA) is one of the most important sleep disorders. The gold standard diagnosis of OSA is overnight PSG examination that is time-consuming and labor intensive. Overnight ECG signal was developed to examine OSA, with easy implementation and portable equipment. There were various ECG derived features used for OSA identification, in this study, intrinsic mode function (IMF) was developed. IMF is a byproduct of Hilbert-Huang transform. IMF decompose original signal into various sub components, due to its complexity. In this study, some novel IMF derived features were used to examine the OSA duration measured from ECG signal, compared with traditional HRV features.
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Lotufo-Neto, Francisco. "The Prevalence of Mental Disorders among Clergy in São Paulo, Brazil." Journal of Psychology and Theology 24, no. 4 (December 1996): 313–22. http://dx.doi.org/10.1177/009164719602400405.
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To investigate their mental disorders prevalence, the Self-Report Psychiatric Screening Questionnaire (SRQ-20) and the Religious Life Inventory were mailed to 750 religious ministers. From the 207 who answered, 40 were randomly chosen and invited to a diagnostic interview using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and an open interview using the Severity of Psychosocial Stressors Scale (DSM-III-R Axis IV). During the month before the interview, mental disorders prevalence was 12.5%, and 47% received a psychiatric diagnosis when the lifetime period was considered. Their main diagnoses were Depressive Disorders (16.4%), Sleep Disorders (12.9%) and Anxiety Disorders (9.4%). Intrinsic religious orientation was associated with positive mental health, and quest orientation scores were significantly higher in the group with a larger probability of mental disorder symptoms and diagnoses. Financial problems, problems with church members and with other pastors, leadership conflicts, marital difficulties, doctrinal problems in the church, and overwork were the main identified stressors.
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Nota, Alessandro, Laura Pittari, Martina Paggi, Silvio Abati, and Simona Tecco. "Correlation between Bruxism and Gastroesophageal Reflux Disorder and Their Effects on Tooth Wear. A Systematic Review." Journal of Clinical Medicine 11, no. 4 (February 19, 2022): 1107. http://dx.doi.org/10.3390/jcm11041107.
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Bruxism and gastroesophageal reflux (GERD) can lead to wear of the dental tissues. Wear has a mechanical or chemical origin, and it is of extrinsic or intrinsic type. Bruxism and GERD are two etiological factors of dental wear. The intrinsic mechanical wear (abfraction) of Bruxism and intrinsic chemical wear (erosion) of GERD are both involved in sleep disorders; indeed, they could have associations and act in synergy in dental wear. The purpose of this review was to find out the possible associations between bruxism and GERD and their effects on tooth wear. The research was conducted on PubMed and the Cochrane Library using the following Keywords/Mesh Terms: Tooth wear, Bruxism, Sleep Bruxism, Sleep Disorders, or GERD. Only systematic reviews and clinical studies performed exclusively on human subjects were included in the review. Initially, the research gave more than 630 results on dental wear, bruxism and GERD and after application of the inclusion criteria irrelevant studies were excluded, and 5 studies were finally included in this review. It was possible to observe the presence of some associations between the two problems (reflux and GERD) and hypothesize negative effects on tooth wear. This research revealed the presence of an interconnection between these three problems (reflux, GERD and tooth wear) that can further act in synergy by attacking the hard dental tissues both from a chemical (reflux) and mechanical (bruxism) point of view. The dentist could play a role of “sentinel” in a multidisciplinary team, intercepting these problems early in order to treat them in the most appropriate way. PROSPERO Registration Number: CRD42021234209.
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Dijk, Derk-Jan, and Steven W. Lockley. "Invited Review: Integration of human sleep-wake regulation and circadian rhythmicity." Journal of Applied Physiology 92, no. 2 (February 1, 2002): 852–62. http://dx.doi.org/10.1152/japplphysiol.00924.2001.
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The human sleep-wake cycle is generated by a circadian process, originating from the suprachiasmatic nuclei, in interaction with a separate oscillatory process: the sleep homeostat. The sleep-wake cycle is normally timed to occur at a specific phase relative to the external cycle of light-dark exposure. It is also timed at a specific phase relative to internal circadian rhythms, such as the pineal melatonin rhythm, the circadian sleep-wake propensity rhythm, and the rhythm of responsiveness of the circadian pacemaker to light. Variations in these internal and external phase relationships, such as those that occur in blindness, aging, morning and evening, and advanced and delayed sleep-phase syndrome, lead to sleep disruptions and complaints. Changes in ocular circadian photoreception, interindividual variation in the near-24-h intrinsic period of the circadian pacemaker, and sleep homeostasis can contribute to variations in external and internal phase. Recent findings on the physiological and molecular-genetic correlates of circadian sleep disorders suggest that the timing of the sleep-wake cycle and circadian rhythms is closely integrated but is, in part, regulated differentially.
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Auger, R. Robert, Helen J. Burgess, Jonathan S. Emens, Ludmila V. Deriy, Sherene M. Thomas, and Katherine M. Sharkey. "Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders: Advanced Sleep-Wake Phase Disorder (ASWPD), Delayed Sleep-Wake Phase Disorder (DSWPD), Non-24-Hour Sleep-Wake Rhythm Disorder (N24SWD), and Irregular Sleep-Wake Rhythm Disorder (ISWRD). An Update for 2015." Journal of Clinical Sleep Medicine 11, no. 10 (October 15, 2015): 1199–236. http://dx.doi.org/10.5664/jcsm.5100.
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Faulkner, Sophie M., Penny E. Bee, Nicholas Meyer, Derk-Jan Dijk, and Richard J. Drake. "Light therapies to improve sleep in intrinsic circadian rhythm sleep disorders and neuro-psychiatric illness: A systematic review and meta-analysis." Sleep Medicine Reviews 46 (August 2019): 108–23. http://dx.doi.org/10.1016/j.smrv.2019.04.012.
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Faulkner, Sophie M., Derk-Jan Dijk, Richard J. Drake, and Penny E. Bee. "Adherence and acceptability of light therapies to improve sleep in intrinsic circadian rhythm sleep disorders and neuropsychiatric illness: a systematic review." Sleep Health 6, no. 5 (October 2020): 690–701. http://dx.doi.org/10.1016/j.sleh.2020.01.014.
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Ruff, Robert L., and Kayla Blake. "Pathophysiological links between traumatic brain injury and post-traumatic headaches." F1000Research 5 (August 31, 2016): 2116. http://dx.doi.org/10.12688/f1000research.9017.1.
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This article reviews possible ways that traumatic brain injury (TBI) can induce migraine-type post-traumatic headaches (PTHs) in children, adults, civilians, and military personnel. Several cerebral alterations resulting from TBI can foster the development of PTH, including neuroinflammation that can activate neural systems associated with migraine. TBI can also compromise the intrinsic pain modulation system and this would increase the level of perceived pain associated with PTH. Depression and anxiety disorders, especially post-traumatic stress disorder (PTSD), are associated with TBI and these psychological conditions can directly intensify PTH. Additionally, depression and PTSD alter sleep and this will increase headache severity and foster the genesis of PTH. This article also reviews the anatomic loci of injury associated with TBI and notes the overlap between areas of injury associated with TBI and PTSD.
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Milanaccio, Claudia, Sonia Di Profio, Sara De Giuseppe, Antonia Ramaglia, Antonio Verrico, Marco Crocco, Gianluca Piccolo, Camilla Satragno, Veronica Biassoni, and Maria Luisa Garrè. "DIPG-27. Behavioral disturbances as underestimated presenting symptoms in children with Diffuse Intrinsic Pontine Glioma (DIPG)." Neuro-Oncology 24, Supplement_1 (June 1, 2022): i24. http://dx.doi.org/10.1093/neuonc/noac079.084.
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Abstract PURPOSE: to describe how often behavioral and emotional changes occur at diagnosis in children with DIPG, or precede it. METHODS: the anamnesis, clinical history, psychological evaluation, and onset symptoms of all cases of DIPG diagnosed at Gaslini Institute between January 2010 and December 2020 were reviewed. RESULTS: 20 DIPGs were diagnosed, 7 males, with a median age of 7,6 years (range 2,4-16,2). All patients presented typical neurological symptoms: 16 had cranial nerves palsy, 12 ataxia, 8 dysarthria, 5 dysphagia, 5 hemiparesis, 5 headache, and 2 obstructive hydrocephalus. Behavioral disorders were found in 14 cases, with several manifestations and in various association: irritability and aggressive behavior in 6, ideomotor slowdown and apathy in 5, emotional dysregulation in 4, mood deflection in 3, sleep disturbances (i.e. nightmares, insomnia, and somniloquy) in 3, marked behavioral changes, school phobia and separation anxiety in 2, depersonalization crisis and phobia of waterdrops in the eyes in 2 patients each. In 6 cases behavioral disturbances were the presenting symptom, appearing one to twelve months earlier than the classic neurological deficits. In all patients, behavioral symptoms improved during Radiotherapy. CONCLUSIONS: behavioral disturbances, although well-known and described in the literature, are not commonly reported among the onset symptoms of DIPG, thus being probably underestimated. Their pathogenesis can be explained by neurophysiology: the brainstem contains reciprocal cerebro-ponto-cerebellar connections whose disruption compromises their modulatory function on affective and cognitive behavior. Furthermore, the reticular formation contains aggregates of neurons regulating several complex functions including the state of alertness (e.g. sleep and wakefulness), the perception of pain, and cognitive functions (e.g. attention, mood, and memory). A careful anamnestic and medical history together with a detailed psychological assessment should be always performed in all DIPGs at diagnosis, in order to bring out those underlying behavioral disorders which could benefit from early neuropsycological support.
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Ragni, B., S. De Stasio, T. Grimaldi Capitello, R. Giampaolo, and S. Gentile. "Parental postpartum affective disorders as a risk factor for infant bedtime resistance." European Psychiatry 64, S1 (April 2021): S555—S556. http://dx.doi.org/10.1192/j.eurpsy.2021.1482.
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IntroductionInfant intrinsic factors, parental mental health, and parenting functioning could influence infant sleep development (Camerota et al., 2019). The current study was designed to advance understanding of parental mental health in influencing bedtime resistance in infants aging 8-12 months.ObjectivesThe main aim of the present study was to examine the role of parental postpartum affective disorders, infants’ temperament and paternal involvement at bedtime in predicting infants’ bedtime resistance (e.g. fussing, crying or protesting).Methods60 Italian families of infants (34 boys and 26 girls) aging from 8 to 12months (M =10.73, SD = 2.54) participated in this study. Parents completed Brief Infant Sleep Questionnaire (Sadeh et al., 2009), Perinatal Assessment of Paternal and Maternal Affectivity (Baldoni et al., 2018), QUIT for infants’ temperament (Axia, 2002) and an ad-hoc questionnaire for fathers’ involvement. Two multiple linear regressions (MR), one for fathers and one for mothers, and relative weight analyses (RWA) were conducted.ResultsInfants’ involvement in constant bedtime routines (reported by fathers: β = −.35, p < .05; mothers: β = −.31, p < .05) and paternal involvement at bedtime (fathers: β = −.45, p < .01; mothers: β = −.27, p < .05) represented protective factors for infants’ bedtime difficulties. Paternal affective disorders, accounted for 17.2% of the explained variance for mothers’ and 12.5% for fathers’ reports of infant bedtime difficulties, more than did maternal postpartum affective disorders.ConclusionsFindings support that parental mental health can interfere with infants’ bedtime resistance.
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Ioannou, Petros, Magdalini Velegraki, Stella Soundoulounaki, Achilleas Gikas, and Diamantis P. Kofteridis. "An Unexpected Cause of Bradycardia in a Patient with Bacterial Meningitis." Case Reports in Medicine 2017 (2017): 1–3. http://dx.doi.org/10.1155/2017/4297372.
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Sinus bradycardia which is a sinus rhythm with a resting heart rate of less than 60 bpm is caused by intrinsic cardiac disorders like sick sinus syndrome or inferior myocardial infarction, metabolic and environmental causes (such as hypothyroidism and electrolyte disorders), medications (such as beta-blockers and amiodarone), infection (such as myocarditis), increased intracranial pressure, and toxic exposure, while it can sometimes be a normal phenomenon, especially during sleep, in athletes, and during pregnancy. Symptomatic sinus bradycardia should warrant a thorough work-up in order to identify any reversible causes; otherwise, placement of a permanent pacemaker could be needed. We present the case of a patient who was admitted due to confusion and fever and was found to have pneumococcal meningitis and bacteremia, and during his hospital stay he developed symptomatic sinus bradycardia that was of intractable cause and persistent. Placement of a permanent pacemaker was chosen until the night staff of the hospital discovered by chance the neglected cause of his bradycardia.
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Jain, Samay, Seo-Young Park, and Diane Comer. "Patterns of Motor and Non-Motor Features in Medication-Naïve Parkinsonism." Neuroepidemiology 45, no. 1 (2015): 59–69. http://dx.doi.org/10.1159/000437228.
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Background: Parkinsonism is defined by motor features (tremor, bradykinesia, rigidity, and postural instability). Accompanying non-motor features (e.g. cognitive, autonomic, sleep disturbances) are underrecognized and undertreated. We hypothesized that clinical patterns occurring in early, medication-naïve Parkinsonism are distinguished by features such as tremor, sleep, autonomic, and cognitive dysfunction. Methods: Clinical and neuroimaging data were obtained in the Parkinson's Progression Marker Initiative. Group comparisons of Parkinsonism with dopaminergic deficits (PDD) (n = 388), controls (n = 196), and Parkinsonism with scans without evidence of dopaminergic deficits (n = 64) were done with ANOVA, chi-square, and post-hoc pairwise tests. To examine clinical patterns within the PDD group, k-means clustering was performed with non-motor or motor features, or both. Results: Among PDD, 4 non-motor patterns (% of PDD) (impulsive (14.9%), sleep-autonomic (22.9%), cognitive-olfactory (18.0%), and mild (44.1%)), 4 motor patterns (tremor plus bradykinesia (56.2%), tremor without bradykinesia (16.2%), postural instability (6.7%) and no tremor (20.9%)) and 5 combined motor/non-motor patterns (tremor with bradykinesia (42.3%), tremor without bradykinesia (15.5%), no tremor and mild non-motor features (17.0%), postural instability with sleep-autonomic disturbances (6.7%) and oldest onset cognitive-olfactory (18.6%)) were observed. Conclusions: To our knowledge, this is the first description of non-motor clinical patterns in early, medication-naïve Parkinsonism, suggesting that such features are intrinsic to Parkinsonian disorders.
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Muzyka, Mariya, Luca Tagliafico, Gianluca Serafini, Ilaria Baiardini, Fulvio Braido, Alessio Nencioni, and Fiammetta Monacelli. "Neuropsychiatric Disorders and Frailty in Older Adults over the Spectrum of Cancer: A Narrative Review." Cancers 14, no. 1 (January 5, 2022): 258. http://dx.doi.org/10.3390/cancers14010258.
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Background: The interplay between different neuropsychiatric conditions, beyond dementia, in the presence of a diagnosis of cancer in older adults may mediate patients’ fitness and cancer-related outcomes. Here, we aimed to investigate the presence of depression, sleep disturbances, anxiety, attitude, motivation, and support in older adults receiving a diagnosis of cancer and the dimension of frailty in order to understand the magnitude of the problem. Methods: This review provides an update of the state of the art based on references from searches of PubMed between 2000 and June 2021. Results: The evidence obtained underscored the tight association between frailty and unfavorable clinical outcomes in older adults with cancer. Given the intrinsic correlation of neuropsychiatric disorders with frailty in the realm of cancer survivorship, the evidence showed they might have a correlation with unfavorable clinical outcomes, late-life geriatric syndromes and higher degree of frailty. Conclusions: The identification of common vulnerabilities among neuropsychiatric disorders, frailty, and cancer may hold promise to unmask similar shared pathways, potentially intercepting targeted new interventions over the spectrum of cancer with the delivery of better pathways of care for older adults with cancer.
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Suzuki, Keisuke, Masayuki Miyamoto, Tomoyuki Miyamoto, and Koichi Hirata. "Restless Legs Syndrome and Leg Motor Restlessness in Parkinson’s Disease." Parkinson's Disease 2015 (2015): 1–9. http://dx.doi.org/10.1155/2015/490938.
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Sleep disturbances are important nonmotor symptoms in Parkinson’s disease (PD) that are associated with a negative impact on quality of life. Restless legs syndrome (RLS), which is characterized by an urge to move the legs accompanied by abnormal leg sensations, can coexist with PD, although the pathophysiology of these disorders appears to be different. RLS and PD both respond favorably to dopaminergic treatment, and several investigators have reported a significant relationship between RLS and PD. Sensory symptoms, pain, motor restlessness, akathisia, and the wearing-off phenomenon observed in PD should be differentiated from RLS. RLS in PD may be confounded by chronic dopaminergic treatment; thus, more studies are needed to investigate RLS in drug-naïve patients with PD. Recently, leg motor restlessness (LMR), which is characterized by an urge to move the legs that does not fulfill the diagnostic criteria for RLS, has been reported to be observed more frequently in de novo patients with PD than in age-matched healthy controls, suggesting that LMR may be a part of sensorimotor symptoms intrinsic to PD. In this paper, we provide an overview of RLS, LMR, and PD and of the relationships among these disorders.
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Lino, Renata Rodrigues Garcia, Maria Solange Gosik, Maria Filomena Xavier Mendes, Isabella Sebusiani Duarte Takeuti, Silvia Grosso Esher, Danielle Barbas, Giselle Iannarella Lacerda, et al. "Homeopathy and emotional disorders in children during covidian-19 pandemic." International Journal of High Dilution Research - ISSN 1982-6206 20, no. 1 (March 28, 2021): 11–12. http://dx.doi.org/10.51910/ijhdr.v20i1.1084.
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Background The period of social isolation, due to the Covid-19 Pandemic, impacted the children's social and family life in different ways. The whole family's feelings and emotions are intertwined, and everyone is involved in a broad awareness. Children, having a more developed intuitive awareness, receive all this in the form of subliminal inputs. At the moment, there is a concern regarding behavioral disorders in children and the risk of medicalization. The systemic view of Homeopathy can contribute to understanding this context. Aims: To contextualize the pediatric emotional disorders resulting from Pandemic in Carillo Júnior's view of Classic Systemic Homeopathy and list possible homeopathic medicines. Methodology: Bibliographic survey about emotional disorders in children during the Pandemic period. A theoretical review of the concept of disease in the view of classic systemic homeopathy and selection of drugs based on the method of repertorization of signs and symptoms. Results and discussion: The classification of diseases based on the Carillo Jr Complex Systems Model is based on the concept of prevalence between intrinsic and extrinsic factors. Through this model, we can understand what is being received by children as subliminal "inputs" since they do not assess the irrational conscience. Individual resilience and vulnerability will determine how they respond. Emotional and behavior disorders: distraction, irritability, fear, agitation, anxiety, poor sleep, nightmares. Main suggested drugs: Belladona, Chamomilla, Aconitum nappelus, Argentum nitricum, Gelsemium, Tarentula hispanica, Stramonium, Ignatia amara, Aurum metalicum, Cypripedium, Coffea cruda. Conclusion: The imposed social isolation leads to an excess of external inputs on the pediatric population, and the difficulty in processing them can lead to the emergence of emotional disorders. Therefore, as a cognitive therapy that acts on the self-regulation of the organism, homeopathy is an excellent, beneficial, and assertive tool.
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Manella, Gal, Rona Aviram, Nityanand Bolshette, Sapir Muvkadi, Marina Golik, David F. Smith, and Gad Asher. "Hypoxia induces a time- and tissue-specific response that elicits intertissue circadian clock misalignment." Proceedings of the National Academy of Sciences 117, no. 1 (December 17, 2019): 779–86. http://dx.doi.org/10.1073/pnas.1914112117.
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The occurrence and sequelae of disorders that lead to hypoxic spells such as asthma, chronic obstructive pulmonary disease, and obstructive sleep apnea (OSA) exhibit daily variance. This prompted us to examine the interaction between the hypoxic response and the circadian clock in vivo. We found that the global transcriptional response to acute hypoxia is tissue-specific and time-of-day–dependent. In particular, clock components differentially responded at the transcriptional and posttranscriptional level, and these responses depended on an intact circadian clock. Importantly, exposure to hypoxia phase-shifted clocks in a tissue-dependent manner led to intertissue circadian clock misalignment. This differential response relied on the intrinsic properties of each tissue and could be recapitulated ex vivo. Notably, circadian misalignment was also elicited by intermittent hypoxia, a widely used model for OSA. Given that phase coherence between circadian clocks is considered favorable, we propose that hypoxia leads to circadian misalignment, contributing to the pathophysiology of OSA and potentially other diseases that involve hypoxia.
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Yadav, Roopesh Kumar, Sudhanshu Mishra, and Deepti Jain. "Methylcobalamine (Vitamin B12): Water Soluble Vitamin with Various Pharmacological Aspect." Journal of Drug Delivery and Therapeutics 11, no. 1 (January 15, 2021): 130–37. http://dx.doi.org/10.22270/jddt.v11i1.4488.
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Vitamin B12 is a water-soluble vitamin that plays a key role in the brain's proper functioning and nervous system, in blood flow, and in reducing weakness and tiredness. In their food, most people get adequate vitamin B12, but in some health conditions (e.g. inadequate sleep, stomach/intestinal disorders, inflammation, cancer), there could be a shortage. If left unchecked, severe Vitamin B12 deficiency results in anemia and nerve damage. Vitamin B12 deficiency is typically treated using parenteral and oral dosage formulations, but absorption and compliance problems are involved with these routes of administration. Most significantly, the function of this missing intrinsic factor has been shown to assist in vitamin B12 absorption and a deficiency known as pernicious anaemia. Vitamin B12 is only partially absorbed when delivered by mouth to patients with pernicious anemia, but hematologically re-absorbed in patients with pernicious anemia. Parenteral administration of the extrinsic element will treat pernicious anaemia satisfactorily. There are several roles and advantages of vitamin B 12 in the human body with therapeutic effects also.
Keywords: Water Soluble Vitamins, Methylcobalamine, Vitamin B12, Pernicious Anaemia.
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Chung, Iau-Quen, Jen-Te Yu, and Wei-Chi Hu. "Estimating Heart Rate and Respiratory Rate from a Single Lead Electrocardiogram Using Ensemble Empirical Mode Decomposition and Spectral Data Fusion." Sensors 21, no. 4 (February 8, 2021): 1184. http://dx.doi.org/10.3390/s21041184.
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Cardiopulmonary monitoring is important and useful for diagnosing and managing multiple conditions, such as stress and sleep disorders. Wearable ambulatory systems can provide continuous, comfortable, and inexpensive means for monitoring; it always has been a research subject in recent years. Being simple and cost-effective, electrocardiogram-based commercial products can be found in the market that provides cardiac diagnostic information for assessment, including heart rate measurement and atrial fibrillation identification. Based on a data-driven and self-adaptive approach, this study aims to estimate heart rate and respiratory rate simultaneously from one lead electrocardiogram signal. In contrast to ensemble empirical mode decomposition with principle component analysis, performed in the time domain, our method uses spectral data fusion, together with intrinsic mode functions using ensemble empirical mode decomposition obtains a more accurate heart rate and respiratory rate. Equipped with a rule-based selection of defined frequency levels for respiratory rate (RR) estimation, the proposed method obtains (0.92, 1.32) beat per minute for the heart rate and (2.20, 2.92) breath per minute for the respiratory rate as their mean absolute error and root mean square error, respectively outperforming other existing methods.
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Chiavaroli, Annalisa, Simonetta Cristina Di Simone, Alessandra Acquaviva, Nilofar, Maria Loreta Libero, Luigi Brunetti, Lucia Recinella, et al. "Neuromodulatory and Protective Effects Induced by the Association of Herbal Extracts from Valeriana officinalis, Ziziphus jujuba, and Humulus lupulus with Melatonin: An Innovative Formulation for Counteracting Sleep Disorders." Processes 10, no. 8 (August 14, 2022): 1609. http://dx.doi.org/10.3390/pr10081609.
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Background: The use of herbal extracts could represent an advantageous approach for treating sleeping disorders, especially in mild-to-moderate conditions, before the onset of a specific therapy with first-line drugs. Specifically, the focus was posed about the use of extracts from Valeriana officinalis, Ziziphus jujuba, and Humulus lupulus. Multiple studies demonstrated the efficacy of these medicinal plants to positively manage insomnia symptoms. Additionally, their efficacy in the treatment of sleeping disorders could also be improved by their pharmacological association. In the present study, extracts from Valeriana officinalis, Ziziphus jujuba, Humulus lupulus, melatonin, and their pharmacological association, Vagonotte® MEL, were studied for potential application in the treatment of insomnia. Methods: The extracts and melatonin were tested on hypothalamic neurons and tissue for evaluating biocompatibility and protective and neuromodulatory effects. The neuromodulatory effects were evaluated as orexin A gene expression and serotonin steady state level, in the hypothalamus. Results: The extracts and melatonin, although with evident differences, were effective as antioxidant and anti-inflammatory agents; additionally, they were also able to reduce the hypothalamic gene expression of orexin A and the steady state level of serotonin, playing master roles in wakefulness. It is noteworthy that the formulation displayed all the effects of the single ingredients, without any sign of toxicity and pharmacological interference in the hypothalamus. Conclusions: Concluding, the present study explored the biological effects of melatonin and herbal extracts with phytotherapy interest in V. officinalis, Z. jujuba, and H. lupulus. The study demonstrated their intrinsic scavenging/reducing activity, together with protective and neuromodulatory effects in the hypothalamus, with a significant reduction of both orexin A gene expression and serotonin steady state level. Additionally, the study also considered their pharmacological association, which displayed an overall pharmacological spectrum mirroring, including all the effects of the single ingredients, without showing any sign of toxicity in the brain and interference between the extracts and melatonin.
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Van Drunen, Rachel, and Kristin Eckel-Mahan. "Circadian Rhythms of the Hypothalamus: From Function to Physiology." Clocks & Sleep 3, no. 1 (February 25, 2021): 189–226. http://dx.doi.org/10.3390/clockssleep3010012.
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The nearly ubiquitous expression of endogenous 24 h oscillations known as circadian rhythms regulate the timing of physiological functions in the body. These intrinsic rhythms are sensitive to external cues, known as zeitgebers, which entrain the internal biological processes to the daily environmental changes in light, temperature, and food availability. Light directly entrains the master clock, the suprachiasmatic nucleus (SCN) which lies in the hypothalamus of the brain and is responsible for synchronizing internal rhythms. However, recent evidence underscores the importance of other hypothalamic nuclei in regulating several essential rhythmic biological functions. These extra-SCN hypothalamic nuclei also express circadian rhythms, suggesting distinct regions that oscillate either semi-autonomously or independent of SCN innervation. Concurrently, the extra-SCN hypothalamic nuclei are also sensitized to fluctuations in nutrient and hormonal signals. Thus, food intake acts as another powerful entrainer for the hypothalamic oscillators’ mediation of energy homeostasis. Ablation studies and genetic mouse models with perturbed extra-SCN hypothalamic nuclei function reveal their critical downstream involvement in an array of functions including metabolism, thermogenesis, food consumption, thirst, mood and sleep. Large epidemiological studies of individuals whose internal circadian cycle is chronically disrupted reveal that disruption of our internal clock is associated with an increased risk of obesity and several neurological diseases and disorders. In this review, we discuss the profound role of the extra-SCN hypothalamic nuclei in rhythmically regulating and coordinating body wide functions.
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Jin, Xiao-Tao, Ningren Cui, Weiwei Zhong, Xin Jin, Zhongying Wu, and Chun Jiang. "Pre- and postsynaptic modulations of hypoglossal motoneurons by α-adrenoceptor activation in wild-type and Mecp2−/Y mice." American Journal of Physiology-Cell Physiology 305, no. 10 (November 15, 2013): C1080—C1090. http://dx.doi.org/10.1152/ajpcell.00109.2013.
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Hypoglossal motoneurons (HNs) control tongue movement and play a role in maintenance of upper airway patency. Defects in these neurons may contribute to the development of sleep apnea and other cranial motor disorders including Rett syndrome (RTT). HNs are modulated by norepinephrine (NE) through α-adrenoceptors. Although postsynaptic mechanisms are known to play a role in this effect, how NE modulates the synaptic transmissions of HNs remains poorly understood. More importantly, the NE system is defective in RTT, while how the defect affects HNs is unknown. Believing that information of NE modulation of HNs may help the understanding of RTT and the design of new therapeutical interventions to motor defects in the disease, we performed these studies in which glycinergic inhibitory postsynaptic currents and intrinsic membrane properties were examined in wild-type and Mecp2 −/Y mice, a mouse of model of RTT. We found that activation of α1-adrenoceptor facilitated glycinergic synaptic transmission and excited HNs. These effects were mediated by both pre- and postsynaptic mechanisms. The latter effect involved an inhibition of barium-sensitive G protein-dependent K+ currents. The pre- and postsynaptic modulations of the HNs by α1-adrenoceptors were not only retained in Mecp2-null mice but also markedly enhanced, which appears to be a compensatory mechanism for the deficiencies in NE and GABAergic synaptic transmission. The existence of the endogenous compensatory mechanism is an encouraging finding, as it may allow therapeutical modalities to alleviate motoneuronal defects in RTT.
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Brgoch, Jakoah, and Shruti Hariyani. "(Invited) Advancing Human-Centric Lighting." ECS Meeting Abstracts MA2022-02, no. 51 (October 9, 2022): 1958. http://dx.doi.org/10.1149/ma2022-02511958mtgabs.
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The concept of human-centric lighting stems from the evolution of sunlight’s intensity and color temperature throughout the course of a day. This natural progression of bright cold-white light during the middle of the day to a softer warm-white light in the evening stimulates intrinsic photosensitive retinal ganglion cells that control our circadian rhythm. The blue-hue of daylight activates these cells to produce dopamine and cortisol while suppressing melatonin, the sleep hormone, to keep humans awake and alert. The current generation of energy-efficient LED lights reproduce daylight by converting a blue-emitting LED into a broad-spectrum white light using inorganic phosphors. Unfortunately, the resulting intense blue-hue generated by cheap LED bulbs and the underlying blue light from even the most expensive bulbs have been shown to cause macular degeneration, cataract formation, mood disorders, and circadian disruption, resulting in insomnia and fatigue. This talk will investigate the production of a ‘human-centric’ light that minimizes blue light by using a violet LED chip and inorganic phosphors. We report a new phosphor, Na2MgPO4F:Eu2+, which can be readily excited by violet light to produce a bright blue emission. This material possesses all the necessary requirements for LED lighting, including a high quantum yield, thermally robust emission, and impressive chemical stability. Incorporating this material into a prototype device demonstrates our ability produce a warm-white light with a higher color rendering index than a commercially purchased LED light bulb while significantly reducing the blue component.
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Marino, V., A. Pasca, F. Galante, M. Fabrazzo, E. L. DI Caprio, F. Riccio, S. Fasano, F. Ciccia, and R. Tirri. "AB1198 PREVALENCE AND PSYCHOPATHOLOGICAL CHARACTERISTICS OF ANXIETY AND DEPRESSIVE SYMPTOMS IN FIBROMYALGIA PATIENTS." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1714.1–1714. http://dx.doi.org/10.1136/annrheumdis-2022-eular.1147.
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BackgroundSeveral studies reported higher depression and anxiety rates in fibromyalgia (FM) patients compared to the general population. Furthermore, dysfunctional coping strategieshave been pointed to as intrinsic parts of the pathogenesis of FM.ObjectivesOur study aimed to verify the prevalence of anxiety and depressive symptoms and explore their correlation with physical symptoms as fatigue, sleep, and widespread pain in a cohort of patients diagnosed with FM. We also aimed to determine whether dysfunctional coping strategies might increase the depression and anxiety burden, besides worsening the core symptoms of FM.MethodsWe analyzed a cohort of 105 patients (median age of 53 years 6 M, 99 F) with a diagnosis of FM according to the ACR 2016 criteria. The participants were consecutively recruited from the Fibromyalgia clinic of the University of Campania “Luigi Vanvitelli”. All patients underwent a psychiatric evaluation. We assessed widespread pain by the Widespread Pain Index (WPI) and the presence of fatigue by the Symptom Severity score (SS). Sleep disorders were investigated through Pittsburgh Sleep Quality Index (PSQI). We analyzed mental alterations by Hamilton Depression and Anxiety Rating Scales (HAM-D, HAM-A), and coping strategies by Coping Orientation to Problems Experienced (COPE) Inventory.The Statistical Package for Social Sciences (SPSS) 22.0 was used; the level of significance was set at p < 0.05.ResultsAll patients showed fatigue and widespread pain (100%); sleep disturbances were found in 90.5% of patients and overlapped with all sleep phases. The prevalence of anxiety associated with depression was 75.2%. We found isolated anxiety in 14.3% and isolated depression in 4.8% of patients. We further evidenced a different degree of depression: mild (50.7%), moderate (24.3%), and severe (6.5%). All patients showed depressed mood only if questioned (low tendency to spontaneous verbalization). COPE analysis showed no significant differences in the use of the three coping strategies (Problem-focused, emotion-focused, avoidance-focused). Pearson’s correlation analysis highlighted a negative relationship between problem-focused strategies and the severity of anxiety (r = -0.31, p = .001) and depression (r = -0.32, p = .001). Our analysis also highlighted a positive correlation between fatigue, sleep disturbances, widespread pain, and both anxiety and depression. The analysis of the characteristics of anxiety and depressive symptoms showed a scarce tendency to spontaneous verbalization of depressed mood and ideas of guilt, mostly limited to family relationships, and a sense of ineffectiveness conditioned by the physical symptoms of the disease. Most patients showed psychomotor agitation, psychic and somatic anxiety, poor insight. The analysis of coping strategies adopted showed a negative correlation between problem-focused strategies and anxiety-depressive symptoms, suggesting that such strategies are less frequent in FM patients with comorbid anxiety and depressive symptoms.ConclusionOur study confirms the high prevalence of anxiety and depressive symptoms in FM patients. A positive correlation between the pivotal symptoms and anxiety and depressive symptoms may suggest, without implying a cause-and-effect relationship, that psychiatric intervention should be considered along with rheumatologic treatment, to improve both physical symptoms and quality of life. Potentiating problem-focused coping strategies may represent a target to improve anxiety and depressive symptoms.References[1]Wolfe et al Revisions to the 2010/2011 FM diagnostic criteria. Semin Arth. Rheum. 2016Table 1.Correlation analysis between coping strategies and HAM-D and HAM-A total scoresHAM-DHAM- AProblem-focused Coping- 0,32**- 0,31**Avoidant Coping0,800,92Emotion Coping0,140,13**p<0.01Disclosure of InterestsNone declared
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Smieszek, S. P. "0018 Whole Genome Sequencing Study Identifies Novel Variants Associated with Intrinsic Circadian Period in Humans." Sleep 43, Supplement_1 (April 2020): A7—A8. http://dx.doi.org/10.1093/sleep/zsaa056.017.
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Abstract Introduction Non-24 is a circadian rhythm disorder in which the master body clock runs either slightly earlier or, more commonly in the disorder, longer than 24 hours. Methods We conducted the first whole genome sequencing study of a non-24 population of 174 individuals that we identified as being totally blind with Non-24 Disorder. We have directly tested the association between SNPs and circadian period length (tau) (n=69). Linear regression corrected for PCs and covariates identified a strong signal in HCN1, Brain Cyclic Nucleotide-Gated Channel 1, HCN1. Results HCN1 channel is responsible for the feedback on the rods regulating the dynamic range of light reactivity under dim or intermediate light conditions. Minor allele rs72762058 associated with longer tau, a difference of 12 minutes, and mean tau of 24.71. In Drosophila there is only one HCN channel encoding gene, DmIh. Interestingly, DmIh mutant flies display alterations in the rest:activity pattern, and altered circadian rhythms, specifically, arrhythmic behavior or a shorter period in constant darkness. We report a variant that associated with longer tau. In addition, we identify others variants that strongly associate with tau, such as a missense variant (rs16989535), (minor allele associated with longer tau), within DEPDC5, GATOR Complex Protein). Subjects carrying the rare allele have a period > 25.2. DEPDC5 is part of GATOR1 complex, together with NPRL2 and NPRL3acts to inhibit the mTORC1 pathway. The GATOR1 seizure phenotype consists mostly of focal seizures, often sleep-related and drug-resistant and is associated with focal cortical dysplasia (20%). mTOR signaling is part of the photic entrainment pathway in the SCN, it regulates autonomous clock properties in a variety of circadian oscillators. Light-induced mTORC1 activation appears to be important for photic entrainment of the SCN clock, as rapamycin modulates light-induced phase shifts of wheel-running and body temperature rhythms in mice. Conclusion We identify variants in HCN1 and DEPDC5 implicated in significantly longer tau. Knowledge of the circadian clock and period length is not only essential for understanding of the basic clockwork mechanisms but also could provide insights into mechanistic links between circadian dysfunctions and human diseases such as epilepsy. Support Vanda Pharmaceuticals
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Bullock, Gabrielle L., and Ulrich Schall. "Dyssomnia in Children Diagnosed with Attention Deficit Hyperactivity Disorder: A Critical Review." Australian & New Zealand Journal of Psychiatry 39, no. 5 (May 2005): 373–77. http://dx.doi.org/10.1080/j.1440-1614.2005.01584.x.
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Objective: Studies prior to 1999 reported prevalent sleep disturbances in children diagnosed with attention deficit hyperactivity disorder (ADHD). However, these reports were largely inconclusive and inconsistent in their findings, hence the current review based on studies published thereafter. Method: An online research of the National Library of Medicine and the Cochrane Library was conducted using the terms ‘attention deficit hyperactivity disorder’, ‘sleep’, ‘human’, and ‘English language’. Results: Sixteen articles met the search criteria with 10 reporting objective measures of sleep characteristics (i.e. polysomnography, actigraphy, and/or video recording). These studies confirm an increase of rapid eye movement (REM) sleep latency and a proportional decrease of REM sleep in children diagnosed with ADHD. Stimulant treatment appears to have little effect on sleep quality while parent's reports of poor sleep in their ADHD-diagnosed offspring was largely inconsistent with the objective measures. Conclusions: The review demonstrated a link between disturbances in sleep architecture and ADHD. Whether this is of an intrinsic or extrinsic cause remains debateable, as both behavioural (parental reporting) and physiological (objective differences in sleep architecture) factors are indicated. The effect of stimulant medication on sleep also requires further research, as current evidence is limited by study design.
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Moline, M., Y. Inoue, N. Kubota, K. Pinner, C. Perdomo, and J. Yardley. "0486 Impact of Intrinsic Factors on Efficacy of Lemborexant: Subgroup Analyses of SUNRISE-2." Sleep 43, Supplement_1 (April 2020): A186—A187. http://dx.doi.org/10.1093/sleep/zsaa056.483.
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Abstract Introduction Lemborexant (LEM), a dual orexin receptor antagonist, demonstrated significant benefits vs placebo on patient-reported sleep outcomes in adults age ≥18y in SUNRISE-2 (NCT02952820; E2006-G000-303). The impact of intrinsic factors (sex, race, and region) on LEM efficacy outcomes was assessed. Methods SUNRISE-2 was a randomized, double-blind, global phase 3 study in adults age ≥18y with insomnia disorder (Full Analysis Set, n=949). Subjects received placebo (n=318) or LEM (5mg [LEM5], n=316; 10mg [LEM10]; n=315) for 6 months. At 6 months, placebo subjects were rerandomized to LEM for another 6 months (not reported here); LEM subjects remained on their assigned dose. Sleep diary-based (subjective) sleep onset latency (sSOL) and wake after sleep onset (sWASO) were assessed for prespecified patient subgroups including: sex (male [n=302], female [n=647]), race (white [n=679], black [n=76], Asian [n=178]), and region (North America [n=302], Europe/New Zealand [n=483], Asia [n=164]). Analyses were not controlled for multiplicity. Results LEM5 and LEM10 provided numerically greater median reductions (improvement) from baseline in sSOL vs placebo at 6 months in across all subgroups examined. Also, LEM5 and LEM10 led to mean reductions (improvement) from baseline at 6 months in sWASO for all subgroups. While several subgroups had small numbers of subjects, changes from baseline in sSOL and sWASO were in the direction of improvement in the majority of subgroups. Pharmacokinetic analyses showed no important differences in exposure by these factors. Conclusion LEM treatment demonstrated efficacy in improving sSOL and sWASO across patient subgroups, supporting common dosing instructions for both sexes and all races. Support Eisai Inc.
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McLay, Laurie, Sarah G. Hansen, Amarie Carnett, Karyn G. France, and Neville M. Blampied. "Attributions, causal beliefs, and help-seeking behavior of parents of children with autism spectrum disorder and sleep problems." Autism 24, no. 7 (June 6, 2020): 1829–40. http://dx.doi.org/10.1177/1362361320924216.
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Sleep problems in children with autism spectrum disorder are prevalent and persistent but also treatable. Little is known about how and why parents of such children seek help for sleep disturbance. Via an online survey ( n = 244 respondents), we gathered information about parents’ attributions about children’s sleep problems and beliefs about causes and on sources of information about, and their decisions regarding, help-seeking. Eighty-two percent of parents reported seeking some kind of help for their child’s sleep disturbance, and the average parent had tried six different treatment strategies, most commonly medical. Alignment of parents’ treatment choices with empirical evidence about treatment efficacy was poor, but belief in effectiveness was closely related to frequency of use of a treatment. In a Principal Components Analysis, parental attributions loaded on two factors: one which suggests the sleep problems are viewed as intrinsic to autism and stable (factor one) and the other as located within the child, stable, and treatment resistant (factor two). These findings have important implications for parental education and clinical practice in the treatment of sleep problems in children with autism spectrum disorder. Lay abstract Sleep problems are commonly reported among parents of children with autism spectrum disorder (ASD). Without effective treatment, such problems are unlikely to resolve. To date, we know very little about how and why parents of children with ASD seek help for sleep disturbance. Via an online survey, we gathered information about how parents make sense of their children’s sleep problems, beliefs about their causes, sources of information, and help-seeking behavior. The analysis of responses from 244 parents revealed that parents commonly view sleep problems (a) as a consequence of their child’s ASD, and unlikely to change over time (stable), and (b) as located within the child (intrinsic), stable over time, and difficult to treat. Despite this, parents also rated sleep problems as being important to treat. Eighty-two percent of parents surveyed reported seeking some kind of help for their child’s sleep disturbance, and the average parent had tried six different treatment strategies, most commonly medical approaches (e.g. melatonin). The alignment between parents’ treatment choices and those strategies that are supported by research was poor, but belief in the effectiveness of treatments was closely related to how often the treatment was used. These findings have important implications for parental education and clinical practice in the treatment of sleep problems in children with ASD.
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Antelmi, Elena, Fabio Pizza, Christian Franceschini, Raffaele Ferri, and Giuseppe Plazzi. "REM sleep behavior disorder in narcolepsy: A secondary form or an intrinsic feature?" Sleep Medicine Reviews 50 (April 2020): 101254. http://dx.doi.org/10.1016/j.smrv.2019.101254.
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Juszczak, Aleksandra Maria, Robert Czarnomysy, Jakub Władysław Strawa, Marijana Zovko Končić, Krzysztof Bielawski, and Michał Tomczyk. "In Vitro Anticancer Potential of Jasione montana and Its Main Components against Human Amelanotic Melanoma Cells." International Journal of Molecular Sciences 22, no. 7 (March 25, 2021): 3345. http://dx.doi.org/10.3390/ijms22073345.
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Jasione montana L. (Campanulaceae) is used in traditional Belarusian herbal medicine for sleep disorders in children, but the chemical composition and biological activity have not been investigated. In this study, the activities of J. montana extracts, their fractions and main compounds were evaluated in amelanotic melanoma C32 (CRL-1585) cells and normal fibroblasts (PCS-201-012). The extracts and fractions were analyzed using liquid chromatography–photodiode array detection–electrospray ionization–mass spectrometry (LC–PDA–ESI–MS/TOF) to characterize 25 compounds. Further, three major and known constituents, luteolin (22) and its derivatives such as 7-O-glucoside (12) and 7-O-sambubioside (9) were isolated and identified. The cytotoxic activities against fibroblasts and the amelanotic melanoma cell line were determined using the fixable viability stain (FVS) assay. The influence of diethyl ether (Et2O) fraction (JM4) and 22 on apoptosis induction was investigated using an annexin V binding assay. The obtained results showed significant cytotoxicity of JM4 and 22 with IC50 values of 119.7 ± 3.2 and 95.1 ± 7.2 μg/mL, respectively. The proapoptotic potential after 22 treatment in the C32 human amelanotic melanoma cell line was comparable to that of vinblastine sulfate (VLB), detecting 29.2 ± 3.0% apoptotic cells. Moreover, 22 displayed less necrotic potential against melanoma cells than VLB. In addition, the influences of JM4 and 22 on the dysfunction of the mitochondrial membrane potential (MMP), cell cycle and activity of caspases 3, 8, 9, and 10 were established. The effects of JM4 on MMP change (74.5 ± 3.0% of the cells showed a reduced MMP) corresponded to the results obtained from the annexin V binding assay and activation of caspase-9. JM4 and 22 displayed a significant impact on caspase-9 (40.9 ± 2.4% of the cells contained active caspase-9 after JM4 treatment and 16.6 ± 0.8% after incubation with 22) and the intrinsic (mitochondrial) apoptotic pathway. Moreover, studies have shown that JM4 and 22 affect the activation of external apoptosis pathways by inducing the caspase-8 and caspase-10 cascades. Thus, activation of caspase-3 and DNA damage via external and internal apoptotic pathways were observed after treatment with JM4 and 22. The obtained results suggest that J. montana extracts could be developed as new topical preparations with potential anticancer properties due to their promising cytotoxic and proapoptotic potential.
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Kitamura, Shingo, Akiko Hida, Minori Enomoto, Makiko Watanabe, Yasuko Katayose, Kentaro Nozaki, Sayaka Aritake, et al. "Intrinsic Circadian Period of Sighted Patients with Circadian Rhythm Sleep Disorder, Free-Running Type." Biological Psychiatry 73, no. 1 (January 2013): 63–69. http://dx.doi.org/10.1016/j.biopsych.2012.06.027.
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Janockova, Jana, Rafael Dolezal, Eugenie Nepovimova, Tereza Kobrlova, Marketa Benkova, Kamil Kuca, Jan Konecny, et al. "Investigation of New Orexin 2 Receptor Modulators Using In Silico and In Vitro Methods." Molecules 23, no. 11 (November 9, 2018): 2926. http://dx.doi.org/10.3390/molecules23112926.
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The neuropeptides, orexin A and orexin B (also known as hypocretins), are produced in hypothalamic neurons and belong to ligands for orphan G protein-coupled receptors. Generally, the primary role of orexins is to act as excitatory neurotransmitters and regulate the sleep process. Lack of orexins may lead to sleep disorder narcolepsy in mice, dogs, and humans. Narcolepsy is a neurological disorder of alertness characterized by a decrease of ability to manage sleep-wake cycles, excessive daytime sleepiness, and other symptoms, such as cataplexy, vivid hallucinations, and paralysis. Thus, the discovery of orexin receptors, modulators, and their causal implication in narcolepsy is the most important advance in sleep-research. The presented work is focused on the evaluation of compounds L1–L11 selected by structure-based virtual screening for their ability to modulate orexin receptor type 2 (OX2R) in comparison with standard agonist orexin-A together with their blood-brain barrier permeability and cytotoxicity. We can conclude that the studied compounds possess an affinity towards the OX2R. However, the compounds do not have intrinsic activity and act as the antagonists of this receptor. It was shown that L4 was the most potent antagonistic ligand to orexin A and displayed an IC50 of 2.2 µM, offering some promise mainly for the treatment of insomnia.
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Kram Mendelsohn, A., C. Daffre, K. I. Oliver, J. Seo, N. B. Lasko, and E. F. Pace-Schott. "1071 Subjective Measures Of Hyperarousal Predict Subjective Longitudinal And Retrospective Measures Of Sleep Quality In Individuals Exposed To Trauma." Sleep 43, Supplement_1 (April 2020): A408. http://dx.doi.org/10.1093/sleep/zsaa056.1067.
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Abstract Introduction Hyperarousal and disturbed sleep are intrinsic symptoms of posttraumatic stress disorder (PTSD). We explored whether self-reported indices of hyperarousal predict longitudinally measured objective, subjective, and retrospective evaluations of sleep quality in trauma-exposed individuals. Methods Individuals exposed to a DSM-5 PTSD Criterion-A traumatic event within the past two years (N=130, 91 females), aged 18-40 (mean 24.43, SD 5.30), 51.54% of whom met DSM-5 criteria for PTSD, completed 14 days of actigraphy and sleep diaries. Participants also completed the PTSD Checklist for DSM-5 (PCL-5), the Clinician-Administered PTSD Scale (CAPS-5), published Hyperarousal (HAS) and Hypervigilance (HVQ) scales, and the Pittsburgh Sleep Quality Index (PSQI) (N=108-125 for different scales). Mean total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE) and sleep midpoint were calculated from actigraphy and subjective SOL, SE, number of awakenings, and time spent awake from diaries. Simple regressions were used to predict associations of the PCL-5, HAS, and HVQ scores with measures of sleep quality. Results Hyperarousal indices predicted diary but not actigraphy measures of sleep quality. Longer diary-reported SOL was predicted by higher scores for: PCL-5 total score (R=0.290, p=0.001), PCL-5 hyperarousal items without the sleep item (R=0.261, p=0.004), and HAS without sleep items (R=0.220, p=0.016). Diary-reported number of awakenings and wake time after sleep onset were predicted by higher HAS scores without the sleep question: (R=0.373, p<0.001; r=0.352, p<0.001). Similarly, all hyperarousal indices significantly predicted PSQI global score (PCL-5: R=0.482, p<0.001; PCL-5 hyperarousal: R=0.389, p<0.001; HVQ: R=0.214, p=0.017; HAS without sleep question: R=0.415, p<0.001). Conclusion Self-reported hyperarousal measures predict subjective longitudinal (especially SOL) and retrospective measures, but not objective measurements of sleep quality. Similar discrepancies between self-reported and objective measures of sleep quality have been reported in patients with insomnia disorder. Cognitive-behavioral therapy for insomnia may be especially effective in treating post-traumatic sleep disturbances. Support R01MH109638
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Pace, Marta, Ilaria Colombi, Matteo Falappa, Andrea Freschi, Mojtaba Bandarabadi, Andrea Armirotti, Blanco María Encarnación, et al. "Loss of Snord116 alters cortical neuronal activity in mice: a preclinical investigation of Prader–Willi syndrome." Human Molecular Genetics 29, no. 12 (May 18, 2020): 2051–64. http://dx.doi.org/10.1093/hmg/ddaa084.
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Abstract Prader–Willi syndrome (PWS) is a neurodevelopmental disorder that is characterized by metabolic alteration and sleep abnormalities mostly related to rapid eye movement (REM) sleep disturbances. The disease is caused by genomic imprinting defects that are inherited through the paternal line. Among the genes located in the PWS region on chromosome 15 (15q11-q13), small nucleolar RNA 116 (Snord116) has been previously associated with intrusions of REM sleep into wakefulness in humans and mice. Here, we further explore sleep regulation of PWS by reporting a study with PWScrm+/p− mouse line, which carries a paternal deletion of Snord116. We focused our study on both macrostructural electrophysiological components of sleep, distributed among REMs and nonrapid eye movements. Of note, here, we study a novel electroencephalography (EEG) graphoelements of sleep for mouse studies, the well-known spindles. EEG biomarkers are often linked to the functional properties of cortical neurons and can be instrumental in translational studies. Thus, to better understand specific properties, we isolated and characterized the intrinsic activity of cortical neurons using in vitro microelectrode array. Our results confirm that the loss of Snord116 gene in mice influences specific properties of REM sleep, such as theta rhythms and, for the first time, the organization of REM episodes throughout sleep–wake cycles. Moreover, the analysis of sleep spindles present novel specific phenotype in PWS mice, indicating that a new catalog of sleep biomarkers can be informative in preclinical studies of PWS.
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Kitajima, Tsuyoshi. "Non–24-hour sleep-wake rhythm disorder not driven by central circadian clock dysregulation: is it not “intrinsic”?" Journal of Clinical Sleep Medicine 18, no. 3 (March 2022): 957. http://dx.doi.org/10.5664/jcsm.9770.
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Li, Guanglu, Zhichun Chen, Liche Zhou, Mengsha Yao, Ningdi Luo, Wenyan Kang, Shengdi Chen, and Jun Liu. "Abnormal intrinsic brain activity of the putamen is correlated with dopamine deficiency in idiopathic rapid eye movement sleep behavior disorder." Sleep Medicine 75 (November 2020): 73–80. http://dx.doi.org/10.1016/j.sleep.2019.09.015.
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Sibarani, Joseph Partogi. "Seorang Pria 21 Tahun dengan Urin Berwarna Gelap." Nommensen Journal of Medicine 5, no. 1 (August 20, 2019): 19–23. http://dx.doi.org/10.36655/njm.v5i1.82.
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First published by Strubing in 1882, Paroxysmal Nocturnal Hemoglobinuria (PNH) is a chronic acquired disorder characterized by the occurrence of intravascular hemolysis and hemoglobinuria which commonly occurs when patients sleep at night, caused by cellular abnormalities due to somatic mutations that cause intrinsic damage on the red blood cell membrane, making it more susceptible to complement lysis. The incidence of PNH varies greatly in various populations and is more common in Southeast Asia. In general, the incidence is estimated to be 1 -1.5 cases / million population. This case is more common in young adults, but can also be found in children and parents. In general the clinical picture of PNH includes symptoms of anemia, hemoglobinia, signs of bleeding, and gastrointestinal complaints. Diagnosis can be determined through blood, urine, bone marrow and cytogenetic examination. We reported the case of a 21-year-old man with complaints of pale face, easy fatigue and tea colored urine in the morning. After several laboratory tests and aspiration of the bone marrow, PNH diagnosis is made. Glucocorticoids used as therapy, and patients are discharged with clinical improvement.
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Keller, Arielle S., Tali M. Ball, and Leanne M. Williams. "Deep phenotyping of attention impairments and the ‘Inattention Biotype’ in Major Depressive Disorder." Psychological Medicine 50, no. 13 (September 3, 2019): 2203–12. http://dx.doi.org/10.1017/s0033291719002290.
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AbstractBackgroundAttention impairment is an under-investigated feature and diagnostic criterion of Major Depressive Disorder (MDD) that is associated with poorer outcomes. Despite increasing knowledge regarding mechanisms of attention in healthy adults, we lack a detailed characterization of attention impairments and their neural signatures in MDD.MethodsHere, we focus on selective attention and advance a deep multi-modal characterization of these impairments in MDD, using data acquired from n = 1008 patients and n = 336 age- and sex-matched healthy controls. Selective attention impairments were operationalized and anchored in a behavioral performance measure, assessed within a battery of cognitive tests. We sought to establish the accompanying neural signature using independent measures of functional magnetic resonance imaging (15% of the sample) and electroencephalographic recordings of oscillatory neural activity.ResultsGreater impairment on the behavioral measure of selective attention was associated with intrinsic hypo-connectivity of the fronto-parietal attention network. Not only was this relationship specific to the fronto-parietal network unlike other large-scale networks; this hypo-connectivity was also specific to selective attention performance unlike other measures of cognition. Selective attention impairment was also associated with lower posterior alpha (8–13 Hz) power at rest and was related to more severe negative bias (frequent misidentifications of neutral faces as sad and lingering attention on sad faces), relevant to clinical features of negative attributions and brooding. Selective attention impairments were independent of overall depression severity and of worrying or sleep problems.ConclusionsThese results provide a foundation for the clinical translational development of objective markers and targeted therapeutics for attention impairment in MDD.