Sleep, Circadian Rhythms, and Risk Across Health Domains in Adolescents With an Evening Circadian Preference

Sleep and circadian rhythm changes during adolescence contribute to increased risk across emotional, behavioral, cognitive, social, and physical health domains. This study examines if sleep and dim light melatonin onset (DLMO) are related to greater risk in these 5 health domains. Participants were 163 (93 female, age = 14.7 years) adolescents with an evening circadian preference from a study funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Sleep and circadian measures included weekday total sleep time (TST), bedtime, and shut-eye time assessed via sleep diary, the Children's Morningness-Eveningness Preferences scale, and DLMO. Health domains included self-reported emotional, cognitive, behavioral, social, and physical health. Later DLMO was significantly associated with shorter weekday TST, later weekday bedtime, and later weekday shut-eye time, as well as lower risk in the behavioral domain. At the trend level, later DLMO was related to fewer physical health problems. Earlier DLMO combined with a later bedtime, later shut-eye time, or shorter TST predicted greater risk in the cognitive domain. Later DLMO and shorter TST or a later bedtime predicted worse physical health. DLMO timing was not related to the emotional or social domain. There is evidence that a discrepancy between sleep behaviors and the endogenous circadian rhythm may be related to risk in the cognitive domain for adolescents with an evening circadian preference. Preliminary evidence also indicated that a delayed DLMO and shorter TST or a later bedtime may be related to vulnerability to physical health risk

Proinflammatory Cytokines, Mood, and Sleep in Interepisode Bipolar Disorder and Insomnia

ObjectiveProinflammatory cytokines are associated with bipolar disorder (BD), but less is known about how cytokines function during the interepisode period. This study examined cytokines, mood symptoms, and sleep in individuals with interepisode BD with complaints of insomnia. We also investigated the effects of a BD-specific modification of cognitive behavior therapy for insomnia (CBTI-BP) on cytokine levels.MethodsTwenty-two adults with interepisode BD type I and insomnia were drawn from a subset of a National Institute of Mental Health funded study. Participants were randomly allocated to CBTI-BP (n = 11) or psychoeducation (n = 11). Participants completed a sleep diary, rated self-report measures of mania and depression, and provided samples assayed for interleukin (IL)-6 and tumor necrosis factor soluble receptor 2 (sTNF-R2).ResultsIL-6 was associated with mania symptoms (rs = 0.44, p = .041) and total sleep time (rs = -0.49, p = .026). IL-6 was related to depression symptoms at the trend level (rs = 0.43, p = .052). sTNF-R2 was not significantly related to mood or sleep measures. From pretreatment to posttreatment, CBTI-BP compared with psychoeducation was associated with a nonsignificant, large effect size decrease in IL-6 (z = -1.61, p = .13, d = -0.78) and a nonsignificant, small-medium effect size decrease in sTNF-R2 (z = -0.79, p = .44, d = -0.38).ConclusionsThese findings provide preliminary evidence that IL-6 is related to mania symptoms and shorter total sleep time in interepisode BD. A treatment that targets sleep in BD could potentially decrease IL-6 although replication is warranted

The Epidemiology of Insomnia and Sleep Duration Across Mental and Physical Health: The SHoT Study

Objective: Numerous epidemiological studies have been conducted to examine the prevalence and comorbidities of insomnia and document sleep duration, but a common limitation in many studies is the lack of use of agreed-upon definitions of insomnia, as well as insufficient statistical power to examine comorbid mental and physical disorders/conditions. Aim: To examine the prevalence of insomnia operationalized according to formal DSM-5 criteria and differences in mean sleep duration across a wide range of mental and physical disorders, examining men and women separately. Materials and Methods: Data stem from the SHoT study (Students’ Health and Wellbeing Study), a national survey of all college and university students in Norway. In all, 162,512 students aged 18–35 received an invitation to participate, of whom 50,054 students completed the internet-based survey (attendance rate: 30.8%). Insomnia was defined according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria and sleep duration was calculated separately for weekdays and weekends. Self-reported mental and physical disorders/conditions were assessed using a pre-defined list modified to fit this age group. Pearson chi-squared tests were used to examine the prevalence of insomnia across the various mental and physical disorders/conditions in men and women separately, and log-link binomial regression analysis were used to calculate effect-sizes, adjusting for age. Results: The prevalence of insomnia in both sexes was significantly higher across all mental disorders compared with a healthy reference group. Among females, the prevalence of insomnia ranged from 61.3% for comorbid depression (adj. RR = 2.49, 95% CI: 2.40) to 83.3% for comorbid schizophrenia (adj. RR = 3.37, 95% CI: 2.61–4.35). For males, the insomnia prevalence ranged from 32.3% for comorbid autism/Asperger (adj. RR = 2.02, 95% CI: 1.39–2.92) to 74.2% for comorbid eating disorder (adj. RR = 4.51, 95% CI: 3.87–5.27). The overall prevalence of insomnia was also significantly higher across most physical conditions compared with the healthy reference group, although generally lower compared to the mental disorders. For females, the insomnia prevalence ranged from 25% for comorbid multiple sclerosis (not significant) to 65.4% for comorbid chronic fatigue syndrome/ME (adj. RR = 2.66, 95% CI: 2.44–2.89). For males, the insomnia prevalence ranged from 20% for both comorbid cancer and diabetes (not significant) to 74.2% for comorbid fibromyalgia (adj. RR = 4.35, 95% CI: 2.96–6.39). Similar patterns were observed for sleep duration, with a significantly shorter sleep duration for across many physical disorders, but especially mental disorders. Conclusion: Insomnia and short sleep duration are strongly associated with a range of different disorders and conditions. Insomnia is most strongly associated with mental disorders, and physical conditions characterized by some level of psychological or psychosomatic properties.publishedVersio

Sleep problems and depressive symptoms in toddlers and 8-year-old children: A longitudinal study

Sleep and depression are interlinked throughout the lifespan, but very few studies have examined the directionality of the sleep–depression link in children. The aim of the current study was to prospectively examine the bidirectional association between sleep problems and internalizing problems and depressive symptoms in toddlers and children aged 1.5 and 8 years. Data stem from the large ongoing population‐based longitudinal study, the Norwegian Mother, Father and Child Cohort Study, recruited from October 1999 to July 2009. A total of 35,075 children were included. Information on sleep duration, nocturnal awakenings and internalizing problems (Child Behaviour Checklist) was provided by the mothers at 1.5 years, whereas data on sleep duration and depressive symptoms (Short Mood and Feelings Questionnaire) were provided by the mothers when the children were 8 years old. Odds ratios (ORs) were calculated using logistic regression analyses. After accounting for previous internalizing problems, short sleep duration (≤10 hr) and frequent (≥3) nightly awakenings at 1.5 years predicted the development of depressive symptoms at 8 years of age (adjusted OR = 1.28; 95% confidence interval [CI] 1.08–1.51, and adjusted OR = 1.27, 95% CI 1.08–1.50, respectively). Also, internalizing problems at 1.5 years predicted onset of later short sleep duration (adjusted OR = 1.83, 95% CI 1.32–2.54) after accounting for early sleep problems. This prospective study demonstrated a bidirectional association between sleep and internalizing/depressive symptoms from toddlerhood to middle childhood. Intervention studies are needed to examine whether targeting either of these problems at this early age may prevent onset of the other.publishedVersio

Internet use and its impact on internalizing disorder symptoms and sleep in adolescents with an evening circadian preference.

Study objectivesThis study sought to examine the relationship between internet use, sleep, and internalizing disorder symptoms in adolescents with an evening circadian preference.MethodsOne hundred seventy-two adolescents aged 10-18 years with an evening circadian preference completed a week of sleep diaries and questionnaires about internet use and internalizing disorder symptoms.ResultsAdolescents reported internet use for 3.81 hours on weekdays and 5.44 hours on weekends, with > 90% having access to both a computer with internet and a personal cell phone. A majority of adolescents used the internet from 4-8 pm (71%) and from 9-11 pm (62%). Common online activities included listening to music (77%), watching videos (64%), communicating with others (64%), and doing homework (58%). Late-night internet use (9-11 pm) was associated with more internalizing disorder symptoms. Middle-of-the-night internet use (midnight-5 am) was associated with a later bedtime, shorter total sleep time, and more internalizing disorder symptoms. Adolescents used the internet to fulfill social needs, to avoid or combat boredom, or for maladaptive activities. Using the internet for social interaction or avoidance/boredom was associated with higher internalizing disorder symptoms. Using the internet for maladaptive reasons was associated with more late-night and middle-of-the-night use.ConclusionsAdolescent internet use late at night and in the middle of the night is common. Internet use may be motivated by desires for social connection, by boredom/avoidance, or for maladaptive behaviors. Because middle-of-the-night internet use was associated with higher internalizing disorder symptoms and worse sleep, it presents as a potential target for intervention.CitationAsarnow LD, Gasperetti CE, Gumport NB, Harvey AG. Internet use and its impact on internalizing disorder symptoms and sleep in adolescents with an evening circadian preference. J Clin Sleep Med. 2021;17(10):2019-2027

Fully differential cross sections for electron-impact excitation-ionization of aligned D2

We examine fully differential cross sections for 176 eV electron-impact dissociative excitation-ionization of orientated D2 for transitions to final ion states 2sσg, 2pσu, and 2pπu. In previous work [Phys. Rev. A 88, 062705 (2013)PLRAAN1050-294710.110

Sleep the Night Before and After a Treatment Session: A Critical Ingredient for Treatment Adherence?

ObjectiveSleep prepares key neural structures for next-day learning, and sleep obtained after learning promotes subsequent memory consolidation supporting long-term retention. This study examined whether sleep the night before and after a therapy session predicts aspects of treatment adherence.MethodAs part of a randomized clinical trial, 188 adults (62.7% female, mean age = 47.5, 80.5% Caucasian) with persistent insomnia received cognitive-behavioral therapy for insomnia. Patients completed a sleep diary before and after treatment sessions. Minutes spent awake during the night (total wake time; TWT) and total sleep time (TST) were used as measures of sleep disturbance. At each treatment session, therapists rated participant understanding of the session and homework compliance from the previous session.ResultsCompared to longer TWT, before session shorter TWT was associated with increased treatment understanding the next day. After session shorter TWT was also associated with increased understanding, but not homework compliance the subsequent session compared to participants with longer TWT. Similar results were obtained for TST.ConclusionsImproving sleep may benefit patient adherence to treatment. Sleep may influence processes related to initial learning and subsequent consolidation of treatment information. Future studies should examine whether improved sleep within other psychiatric disorders is also an ingredient to the successful outcome of psychosocial interventions. (PsycINFO Database Recor

Experimental and theoretical cross sections for molecular-frame electron-impact excitation-ionization of D 2

We present both experimental and theoretical results for the dissociative ionization of D2 molecules induced by electron impact. Cross sections are determined in the molecular frame and are fully differential in the energies and emission angles of the di

Suicide attempts and non-suicidal self-harm among university students: prevalence study

Background: Suicide attempts and non-suicidal self-harm (NSSH) are major public health concerns that affect millions of young people worldwide. Consequently, there is a strong need for up-to-date epidemiological data in this population. Aims: To provide prevalence and trend estimates of suicidal thoughts and behaviours and NSSH thoughts and behaviour in university students. Method: Data are from a 2018 national health survey for higher education in Norway. A total of 50 054 full-time students (69.1% women) aged 18–35 years participated (response rate 31%). Suicidal ideation, suicide attempts and NSSH were assessed with three items drawn from the Adult Psychiatric Morbidity Survey, and thoughts of NSSH were assessed with one item from the Child and Adolescent Self-Harm in Europe study. Results: Lifetime suicidal thoughts were reported by 21.0%, and 7.2% reported having such thoughts within the past year. In total, 4.2% reported a suicide attempt, of whom 0.4% reported attempting suicide within the past year. The prevalence of lifetime NSSH behaviour and thoughts was 19.6% and 22.6%, respectively. All four suicidal behaviour and NSSH variables were more common among students who were single, living alone and with a low annual income, as well as among immigrants. There was an increase in suicidal thoughts from 2010 (7.7%) to 2018 (11.4%), which was evident in both men and women. Conclusions: The observed high and increasing prevalence of suicidal thoughts and NSSH among college and university students is alarming, underscoring the need for further research, preferably registry-linked studies, to confirm whether the reported prevalence is representative of the student population as a whole

Insomnia disorder

Insomnia disorder affects a large proportion of the population on a situational, recurrent or chronic basis and is among the most common complaints in medical practice. The disorder is predominantly characterized by dissatisfaction with sleep duration or quality and difficulties initiating or maintaining sleep, along with substantial distress and impairments of daytime functioning. It can present as the chief complaint or, more often, co-occurs with other medical or psychiatric disorders, such as pain and depression. Persistent insomnia has been linked with adverse long-term health outcomes, including diminished quality of life and physical and psychological morbidity. Despite its high prevalence and burden, the aetiology and pathophysiology of insomnia is poorly understood. In the past decade, important changes in classification and diagnostic paradigms have instigated a move from a purely symptom-based conceptualization to the recognition of insomnia as a disorder in its own right. These changes have been paralleled by key advances in therapy, with generic pharmacological and psychological interventions being increasingly replaced by approaches that have sleep-specific and insomnia-specific therapeutic targets. Psychological and pharmacological therapies effectively reduce the time it takes to fall asleep and the time spent awake after sleep onset, and produce a modest increase in total sleep time; these are outcomes that correlate with improvements in daytime functioning. Despite this progress, several challenges remain, including the need to improve our knowledge of the mechanisms that underlie insomnia and to develop more cost-effective, efficient and accessible therapies