A Randomized, Double-Blind, Placebo-Controlled Trial of a Polyphenol Botanical Blend on Sleep and Daytime Functioning

Despite the high prevalence of subclinical sleep disturbances, existing treatments are either potent prescription medications or over-the-counter supplements with minimal scientific support and numerous side effects. However, preliminary evidence shows that polyphenols such as rosmarinic acid and epigallocatechin gallate can support healthy sleep without significant side effects. Therefore, the present study examined whether a polyphenol botanical blend (PBB) could improve sleep and/or daytime functioning in individuals with subclinical sleep disturbances. A total of 89 individuals completed a double-blind, randomized trial of daily treatment with PBB (n = 43) or placebo (n = 46) 30 min before bed for 30 days. Participants were monitored for changes in sleep (by sleep diary and an activity tracker), mood, and neurocognitive functioning. After 30 days, PBB improved diary sleep quality (p = 0.008) and reduced insomnia severity (p = 0.044) when compared to placebo. No other changes in sleep outcomes were observed. Additionally, PBB did not impair neurocognitive functioning, and some improvement was noted in vigilant attention, working memory, and risk assessment. Among individuals with subclinical sleep disturbances, PBB improved sleep quality, insomnia severity, and neurocognitive functioning over placebo. These findings indicate that polyphenol compounds may be useful for improving certain aspects of sleep without compromising neurocognitive functioning

Global error analysis and inertial manifold reduction

Four types of global error for initial value problems are considered in a common framework. They include classical forward error analysis and shadowing error analysis together with extensions of both to include rescaling of time. To determine the amplificatioh of the local error that bounds the global error we present a linear analysis similar in spirit to condition number estimation for linear systems of equations. We combine these ideas with techniques for dimension reduction of differential equations via a boundary value formulation of numerical inertial manifold reduction. These global error concepts are exercised to illustrate their utility on the Lorenz equations and inertial manifold reductions of the Kuramoto-Sivashinsky equation. (C) 2016 Elsevier B.V. All rights reserved

Phase 3, Randomized, 20-Month Study of the Efficacy and Safety of Bimatoprost Implant in Patients with Open-Angle Glaucoma and Ocular Hypertension (ARTEMIS 2)

Objective- To evaluate the intraocular pressure (IOP)-lowering efficacy and safety of 10 and 15 µg bimatoprost implant in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). Methods- This randomized, 20-month, multicenter, masked, parallel-group, phase 3 trial enrolled 528 patients with OAG or OHT and an open iridocorneal angle inferiorly in the study eye. Study eyes were administered 10 or 15 µg bimatoprost implant on day 1, week 16, and week 32, or twice-daily topical timolol maleate 0.5%. Primary endpoints were IOP and IOP change from baseline through week 12. Safety measures included treatment-emergent adverse events (TEAEs) and corneal endothelial cell density (CECD). Results- Both 10 and 15 µg bimatoprost implant met the primary endpoint of noninferiority to timolol in IOP lowering through 12 weeks. Mean IOP reductions from baseline ranged from 6.2–7.4, 6.5–7.8, and 6.1–6.7 mmHg through week 12 in the 10 µg implant, 15 µg implant, and timolol groups, respectively. IOP lowering was similar after the second and third implant administrations. Probabilities of requiring no IOP-lowering treatment for 1 year after the third administration were 77.5% (10 µg implant) and 79.0% (15 µg implant). The most common TEAE was conjunctival hyperemia, typically temporally associated with the administration procedure. Corneal TEAEs of interest (primarily corneal endothelial cell loss, corneal edema, and corneal touch) were more frequent with the 15 than the 10 µg implant and generally were reported after repeated administrations. Loss in mean CECD from baseline to month 20 was ~ 5% in 10 µg implant-treated eyes and ~ 1% in topical timolol-treated eyes. Visual field progression (change in the mean deviation from baseline) was reduced in the 10 µg implant group compared with the timolol group. Conclusions- The results corroborated the previous phase 3 study of the bimatoprost implant. The bimatoprost implant met the primary endpoint and effectively lowered IOP. The majority of patients required no additional treatment for 12 months after the third administration. The benefit-risk assessment favored the 10 over the 15 µg implant. Studies evaluating other administration regimens with reduced risk of corneal events are ongoing. The bimatoprost implant has the potential to improve adherence and reduce treatment burden in glaucoma

Refractory Insomnia in an Adolescent with Total Blindness

We present a totally blind adolescent with refractory insomnia due to a combination of Non-24 hour sleep-wake disorder and restless leg syndrome that was successfully treated with tasimelteon, iron replacement, and gabapentin. To our knowledge, this is the first published report of treatment of N24 with tasimelteon in an adolescent. In addition, this case highlights the importance of recognizing and treating multifactorial causes of insomnia.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Obstructive Sleep Apnea in Jacobsen Syndrome

Purpose: Many congenital disorders are associated with an elevated risk of obstructive sleep apnea due to craniofacial abnormalities, hypotonia, and obesity. We describe a male with an 11q deletion (Jacobsen syndrome) with obstructive sleep apnea. Report of Case: The patient was diagnosed with severe obstructive sleep apnea, but was unable to adhere to positive airway pressure therapy due to mask discomfort. Discussion: Obstructive sleep apnea is common in many congenital disorders. Implications for cognitive functioning, as well as the potential for cognitive improvements following treatment are discussed. Screening polysomnography may be indicated in patients with Jacobsen syndrome given their high likelihood of obstructive sleep apnea.12 month embargo; published: 21 April 2019This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Spectrophotometric properties of commercially available blue blockers across multiple lighting conditions

Lenses that filter short-wavelength (“blue”) light are commercially marketed to improve sleep and circadian health. Despite their widespread use, minimal data are available regarding their comparative efficacy in curtailing blue light exposure while maintaining visibility. Fifty commercial lenses were evaluated using five light sources: a blue LED array, a computer tablet display, an incandescent lamp, a fluorescent overhead luminaire, and sunlight. Absolute irradiance was measured at baseline and for each lens across the visual spectrum (380–780 nm), which allowed calculation of percent transmission. Transmission specificity was also calculated to determine whether light transmission was predominantly circadian-proficient (455–560 nm) or non-proficient (380–454 nm and 561–780 nm). Lenses were grouped by tint and metrics were compared between groups. Red-tinted lenses exhibited the lowest transmission of circadian-proficient light, while reflective blue lenses had the highest transmission. Orange-tinted lenses transmitted similar circadian-proficient light as red-tinted lenses but transmitted more non-circadian-proficient light, resulting in higher transmission specificity. Orange-tinted lenses had the highest transmission specificity while limiting biologically active light exposure in ordinary lighting conditions. Glasses incorporating these lenses currently have the greatest potential to support circadian sleep-wake rhythms.12 month embargo; published online: 04 January 2022This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Insomnia and the Interpersonal Theory of suicide among civilians, service members, and veterans

Background: Insomnia is associated with suicide risk in civilian and military populations. Thwarted belongingness is proposed as a mediator of this relationship under the Interpersonal Theory of Suicide (IPTS). The present study explored how insomnia relates to suicidal ideation in conjunction with thwarted belongingness among civilians, Service members, and Veterans. Methods. Data from the Military Suicide Research Consortium for N = 6556 individuals (6316 with non-missing suicidal ideation status) were divided into 4 subgroups: civilians, never deployed Service members, previously deployed Service members, and Veterans. Robust Poisson models evaluated the associations between insomnia severity/subtype and current suicidal ideation, with bootstrap mediation models assessing thwarted belongingness as a mediator. Results. A 5-point increase in insomnia severity was associated with a 38% increased risk for current suicidal ideation among civilians, a 56% greater risk among never deployed Service members, an 83% greater risk among previously deployed Service members, and a 37% greater risk among Veterans. Moreover, active Service members showed greater associations between difficulty falling asleep and staying asleep with suicidal ideation than civilians. These associations were independent of covariates and only mediated by thwarted belongingness among Veterans. Conclusions. The relationship between insomnia and suicide is not purely explained by thwarted belongingness except among Veterans. Future research should explore additional psychological and neurobiological mechanisms connecting insomnia and suicidality.US Department of Defense12 month embargo; available online: 27 September 2022This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Repetitive Behavior With Objects in Infants Developing Autism Predicts Diagnosis and Later Social Behavior as Early as 9 Months

We evaluated repetitive behavior with objects in infants at risk for autism spectrum disorder (ASD) from 9 to 36 months of age, and associations between early repetitive behavior and social engagement. Infant siblings of children with ASD (high-risk) or typical development (low-risk) were administered a task eliciting repetitive object use at 9, 12, 15, 18, 24, and 36 months of age. Infants (n = 147) were classified into 1 of 3 outcome groups at 36 months: Low-Risk Non-ASD (n = 58), High-Risk Non-ASD (n = 72), and ASD (n = 17). Behavior was coded from video for frequencies of unusual visual inspection, spinning, and rotating behaviors. Differences in unusual visual inspection were most prominent, consistent, and present earliest: At 9 months, the ASD group engaged in this behavior more frequently than both other groups, persisting through 36 months. Differences in frequencies of spinning and rotating were later-appearing, more time-limited, and/or related to familial ASD risk rather than ultimate diagnosis. Sensitivity and specificity estimates for the presence of unusual visual inspection at 9 months of age were in the moderate range (.60 and .68, respectively) for ASD versus Low-Risk Non-ASD comparisons, generally increasing over time. Unusual visual inspection at 9 months predicted 12-month social behavior controlling for 9-month social behavior, but not vice versa, with no evidence of moderation by ASD diagnosis. In summary, unusual visual inspection of objects is present and stable by 9 months of age in infants developing ASD and predicts reduced social engagement three-months later. Close monitoring of this behavior may aid early detection. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Racial/ethnic minorities have greater declines in sleep duration with higher risk of cardiometabolic disease: An analysis of the U.S. National Health Interview Survey

•Since 2010, daily sleep duration in the U.S. has decreased 1 min per year.•This decline was significantly greater among Mexican-Hispanic individuals.•Shorter sleep duration is linked to higher risk of cardiometabolic diseases.•Risk of cardiometabolic disease from sleep loss was greater among minority groups. Habitual insufficient sleep may contribute to cardiometabolic disease in the United States, particularly among racial and ethnic minorities. However, there is mixed evidence on secular trends in U.S. sleep duration. Cross-sectional data from 413,417 individuals were acquired from the National Health Interview Survey from 2005–2018. Variables included self-reported sleep duration as well as lifetime diagnosis of hypertension, coronary heart disease, diabetes, and pre-diabetes, and obesity. Population-weighted robust Poisson models estimated annual trends in sleep duration and the prevalence risk ratios (PRR) of cardiometabolic disease as a function of sleep duration. Population-based survey. Daily sleep duration decreased -0.62 min ([-0.71, 0.54], p < 0.01) annually from 2005–2018. However, this decline began only after 2010, when sleep duration fell by 1.04 min ([-1.21, -0.86], p < 0.01) each year. This trend varied by race (two-way ANOVA, p = 0.02), such that Mexican Hispanic individuals saw a greater decline (-1.83 [-2.37, -1.30] min per year, p < 0.01) than whites (-0.83 [-1.02, -0.64] min per year, p < 0.01). Additionally, a 1-h loss in daily sleep duration was linked to 4% greater prevalence of hypertension (PRR: 1.04, [1.04, 1.05]), 3% greater prevalence of diabetes (PRR: 1.03 [1.01, 1.05]), and 8% greater prevalence of obesity (PRR: 1.08 [1.07, 1.09]) after adjusting for age, sex, employment, marital status, and survey year. There is a secular decline in U.S. daily sleep duration that is greater among Mexican Hispanic individuals. Moreover, reduced sleep duration is associated with more prevalent cardiometabolic disease

Social Jetlag and Other Aspects of Sleep Are Linked to Non-Suicidal Self-Injury Among College Students

Introduction: Disrupted sleep is associated with non-suicidal self-injury (NSSI) in young adults, but many specific features of sleep continuity and timing have yet to be examined. Additionally, the psychological mechanisms linking sleep to NSSI are unclear. The present study evaluated 14 sleep variables as classifiers of lifetime or recent NSSI and examined potential confounding and mediating factors. Methods: A sample of 885 college students provided measures of sleep continuity (e.g., duration, timing, fragmentation), nightmares, insomnia, and perceived sleep control. Lifetime and past 3-month NSSI were measured using a self-report version of the Columbia Suicide Severity Ratings Scale. Bidirectional stepwise regression identified significant sleep classifiers and subsequent models examined their associations with NSSI after adjusting for covariates and through potential psychological mediators. Results: Only absolute social jetlag was associated with recent NSSI, even after adjusting for covariates, such that each additional hour difference between weekday and weekend sleep schedules was associated with a 17% greater risk of recent NSSI. Nightmares, weekend sleep efficiency, and perceived sleep control were associated with lifetime NSSI, although only weekend sleep efficiency remained associated after adjusting for covariates. Bootstrap mediations identified negative urgency as a partial mediator for recent and lifetime NSSI, and lack of premeditation and perceived burdensomeness as partial mediators for lifetime NSSI. Conclusions: The timing and consistency of young adults’ sleep schedules may be of greater importance to NSSI among college students than insomnia or insufficient sleep. Future studies of sleep and NSSI should include these measures as potential risk factors. HIGHLIGHTS Differences between weekday/weekend sleep timing are linked to recent NSSI. Negative urgency partially mediates poor sleep on recent and lifetime NSSI. Sleep shares a multifaceted relationship with NSSI risk in college students.12 month embargo; published online: 07 April 2022This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]