On the influence of the day of the week on objective and self-rated sleep quality of adults

Background and objective: The extent to which adult sleep varies depending on the day of the week has not yet been systematically investigated with electroencephalography (EEG) data. Whether such effects exist and whether they are related to age, gender, and employment status was retrospectively analyzed based on data from an experimental double-blind cross-over study in which effects of electromagnetic fields of a cell phone base station on the sleep of a general rural population had been examined. Methods: The sleep of 397 adults (age 45.0 +/- 14.2 years, range 18-81 years; 50.9% women) from ten different rural German villages was recorded for 12 nights with ambulatory devices. Self-reported sleep quality was recorded in morning and evening protocols. Friedman tests were used for statistical analysis of the comparison between the days, and the Kruskal-Wallis and Mann-Whitney U tests were used for pairwise comparisons of independent parameters between groups. Results: For the present analysis, data from 335 participants were considered. Overall, the differences between nights were small and the quality of sleep was good. Three of the five objective and all six self-rated sleep parameters differed significantly between the days of the week. While the objective and the self-estimated total sleep time were longest on Sunday nights, the qualitatively poorest values occurred on Monday nights. People who worked fulltime had the longest sleep latencies on Sunday nights. Friday nights were rated the best. Conclusion: The objective and self-rated sleep quality varied relatively little in a rural adult population over the course of the week, being worst on Monday nights and best on Friday nights.Hintergrund und Ziel: Inwiefern Schlaf von Erwachsenen in Abhängigkeit vom Wochentag variiert, wurde bisher nicht systematisch mittels auf Elektroenzephalographie (EEG-)basierten Daten untersucht. Ob es solche Effekte gibt, und ob diese mit Alter, Geschlecht und Beschäftigungsstatus zusammenhängen, wurde auf der Basis von Daten einer experimentellen doppelblinden Cross-over-Studie, in der der Einfluss elektromagnetischer Felder einer Mobilfunkbasisstation auf den Schlaf einer ländlichen Allgemeinbevölkerung untersucht wurde, retrospektiv analysiert. Methoden: Der Schlaf von 397 Erwachsenen (Alter: 45,0± 14,2 Jahre, Spannbreite: 18–81 Jahre; 50,9% Frauen) aus 10 verschiedenen ländlichen deutschen Orten wurde über jeweils 12 Nächte mit ambulanten Geräten untersucht. Die selbst eingeschätzte Schlafqualität wurde mit Morgen- und Abendprotokollen erfasst. Für die statistische Analyse des Vergleichs zwischen den Tagen wurden Friedman-Tests verwendet, für paarweise Vergleiche unabhängiger Parameter kamen der Kruskal-Wallis-Test und der Mann-Whitney-U-Test zum Einsatz. Ergebnisse: Für die vorliegende Analyse wurden Daten von 335 Personen berücksichtigt. Die Unterschiede zwischen den Nächten waren sehr gering und die Schlafqualität sehr gut. Ein signifikanter Unterschied zwischen den Wochentagen bestand bei 3 der 5 objektiven und bei allen 6 subjektiven Schlafparametern. Während die objektive und die selbst geschätzte Gesamtschlafzeit in den Sonntagnächten am längsten waren, traten die qualitativ schlechtesten Werte in den Montagnächten auf. Personen, die einer Vollzeitbeschäftigung nachgingen, zeigten am Sonntagabend die längsten Einschlaflatenzen. Am besten bewertet wurden die Freitagnächte. Schlussfolgerungen: Die objektive und selbst bewertetete Schlafqualität variierte relativ geringfügig in einer erwachsenen ländlichen Population im Laufe der Woche und war in Montagnächten am schlechtesten und in Freitagnächten am besten

Effects of Supraphysiological Doses of Levothyroxine on Sleep in Healthy Subjects: A Prospective Polysomnography Study

Disrupted sleep is prevalent in both mood and thyroid disorders. Given the emerging use of thyroid hormones in the treatment of mood disorders, we investigated the effects of supraphysiological doses of levothyroxine (L-T4) on sleep. In an open-label design, 13 healthy subjects received up to 500 μg/day for an eight-week period. A baseline night was polysomnographically recorded (PSG) followed by PSG under the maximum tolerated dose of L-T4. All subjects developed hyperthyroxinemia. The heart rate and respiration rate increased significantly with treatment; a significant increase in body temperature was observed in men but not in women. Surprisingly, treatment with supraphysiological doses of L-T4 did not cause significant effects on sleep architecture. However, the increase in body movements and REM density was close to reaching statistical significance. Here, we report on the sleep data, thyroid hormone levels, and physiological parameters during sleep. We conclude that experimentally induced hyperthyroidism does not profoundly change the sleep structure in healthy individuals underlining the good tolerability of treatment with supraphysiological doses of L-T4 in patients with mood disorders

REM sleep in acutely traumatized individuals and interventions for the secondary prevention of post-traumatic stress disorder

Increasing evidence supports a close link between REM sleep and the consolidation of emotionally toned memories such as traumatic experiences. In order to investigate the role of sleep for the development of symptoms related to traumatic experiences, beyond experimental models in the laboratory, sleep of acutely traumatised individuals may be examined on the first night after trauma. This might allow us to identify EEG variables predicting the development of posttraumatic stress disorder (PTSD) symptoms, and guide the way to novel sleep interventions to prevent PTSD. Based on our experience, patients' acceptance of polysomnography in the first hours after treatment in an emergency room poses obstacles to such a strategy. Wearable, self-applicable sleep recorders might be an option for the investigation of sleep in the aftermath of trauma. They would considerably decrease the perceived burden for patients and thus increase the likelihood of successful patient recruitment. As one potential sleep intervention, sleep deprivation directly after trauma has been suggested to reduce the consolidation of traumatic memories and hence act as a secondary preventive measure. However, experimental data from sleep deprivation studies in healthy volunteers with the trauma film paradigm have been inconclusive regarding the beneficial or detrimental effects of sleep on traumatic memory processing. Depending on further insights into the role of sleep in traumatic memory consolidation through observational and experimental studies, several options for therapeutic sleep interventions are conceivable: besides behavioural sleep deprivation, selective REM sleep suppression or enhancement by a pharmacological intervention into the serotonergic, noradrenergic or cholinergic systems might provide novel therapeutic options. While REM-modulating drugs have been used with some success for the prevention of PTSD after trauma, they have never been tried before the first night of sleep. In conclusion, more experimental and observational research is needed before sleep interventions are performed in actual trauma victim

Restless Legs Syndrome Prevalence and Clinical Correlates Among Psychiatric Inpatients: A Multicenter Study.

Background There are only limited reports on the prevalence of restless legs syndrome (RLS) in patients with psychiatric disorders. The present study aimed to evaluate the prevalence and clinical correlates in psychiatric inpatients in Germany and Switzerland. Methods This is a multicenter cross-sectional study of psychiatric inpatients with an age above 18 years that were diagnosed and evaluated face-to-face using the International RLS Study Group criteria (IRLSSG) and the International RLS severity scale (IRLS). In addition to sociodemographic and biometric data, sleep quality and mood were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), and the Patient Health Questionnaire (PHQ-9). In addition to univariate statistics used to describe and statistically analyze differences in variables of interest between patients with and without RLS, a logistic model was employed to identify predictors for the occurrence of RLS. Results The prevalence of RLS in a sample of 317 psychiatric inpatients was 16.4%, and 76.9% of these were diagnosed with RLS for the first time. RLS severity was moderate to severe (IRLS ± SD: 20.3 ± 8.4). The prevalences in women (p = 0.0036) and in first-degree relatives with RLS (p = 0.0108) as well as the body mass index (BMI, p = 0.0161) were significantly higher among patients with RLS, while alcohol consumption was significantly lower in the RLS group. With the exception of atypical antipsychotics, treatment with psychotropic drugs was not associated with RLS symptoms. Regarding subjective sleep quality and mood, scores of the PSQI (p = 0.0007), ISI (p = 0.0003), and ESS (p = 0.0005) were higher in patients with RLS, while PHQ-9 scores were not different. A logistic regression analysis identified gender (OR 2.67; 95% CI [1.25; 5.72]), first-degree relatives with RLS (OR 3.29; 95% CI [1.11; 9.73], ESS score (OR 1.09; 95% CI [1.01; 1.17]), and rare alcohol consumption (OR 0.45; 95% CI [0.22; 0.94] as predictors for RLS. Conclusions Clinically significant RLS had a high prevalence in psychiatric patients. RLS was associated with higher BMI, impaired sleep quality, and lower alcohol consumption. A systematic assessment of restless legs symptoms might contribute to improve the treatment of psychiatric patients

Online insomnia treatment-a review

Spiegelhalder K, Acker J, Baumeister H, et al. Digitale Behandlungsangebote für Insomnie – eine Übersichtsarbeit. SOMNOLOGIE. 2020;24(4):106-114.Zusammenfassung Digital angebotene psychologische Interventionen gegen Schlafstörungen sind aktuell ein sehr intensiv bearbeitetes Forschungsthema. In dieser Übersichtsarbeit werden Originalarbeiten und Metaanalysen zu diesem Thema zusammengefasst. Hierbei zeigt sich, dass die internetbasierte kognitive Verhaltenstherapie für Insomnie (KVT-I) bei Erwachsenen durchweg sehr effektiv ist mit allenfalls leicht geringeren Effektstärken als die gleiche Behandlung mit physischer Präsenz von Therapeuten und Patienten. Behandlungseffekte zeigen sich dabei auch für sekundäre Outcome-Parameter wie Depressivität, Angst, Fatigue und Lebensqualität. Hingegen lassen die Forschung zur Wirksamkeit der internetbasierten KVT‑I bei Erwachsenen mit komorbiden psychischen Störungen oder körperlichen Erkrankungen sowie die Forschung zur Frage, wieviel Therapeutenkontakt in die Behandlung integriert werden sollte, anscheinend noch keine abschließenden Antworten zu. In diesen Bereichen scheint weitere Forschung notwendig zu sein scheint.Digitally provided psychological interventions for sleep disorders are currently a very intensively researched topic. In this review, original work and meta-analyses are summarized. Thus, it was shown that internet-based cognitive behavioral therapy for insomnia (CBT-I) in adults is consistently very effective, with only slightly reduced effects compared with the same treatment with the physical presence of therapists and patients. Treatment effects are also shown for secondary outcome parameters such as depression, anxiety, fatigue, and quality of life. On the other hand, research on the effectiveness of internet-based CGT-I in adults with comorbid mental disorders or physical illnesses, and on the issue of how much contact with therapists should be integrated into treatment, does not seem to provide any conclusive answers. Further research seems to be needed in these areas

Nocturnal Brain Activity Differs with Age and Sex: Comparisons of Sleep EEG Power Spectra Between Young and Elderly Men, and Between 60–80-Year-Old Men and Women

Purpose: Quantification of nocturnal EEG activity has emerged as a promising extension to the conventional sleep evaluation approach. To date, studies focusing on quantitative sleep EEG data in relation to age and sex have revealed considerable variation across lifespan and differences between men and women. However, sleep EEG power values from elderly individuals are still rare. The present secondary analysis aimed to fill this gap. Participants and Methods: Sleep EEG data of 30 healthy elderly males (mean age +/- SD: 69.1 +/- 5.5 years), 30 healthy elderly females (67.8 +/- 5.7 years), and of 30 healthy young males (25.6 +/- 2.4 years) have been collected in three different studies with the same experimental design. Each individual contributed three polysomnographic recordings without any intervention to the analysis. Sleep recordings were performed and evaluated according to the standard of the American Academy of Sleep Medicine. Sleep EEG signals were derived from 19 electrode sites. Sleep-stage specific global and regional EEG power were compared between samples using a permutation-based statistic in combination with the threshold-free cluster enhancement method. Results: The present results showed pronounced differences in sleep EEG power between older men and women. The nocturnal EEG activity of older women was generally larger than that of older men, confirming previously reported variations with sex in younger individuals. Aging was reflected by differences in EEG power between young and elderly men for lower frequencies and for the sleep spindle frequency range, again consistent with prior studies. Conclusion: The findings of this investigation complement those of earlier studies. They add to the understanding of nocturnal brain activity manifestation in senior adulthood and show how it differs with age in males. Unfortunately, the lack of information on young women prevents a similar insight for females