Linking Eating Habits & Sleep Patterns in Adolescents with Symptoms of Depression

Research Paper Title

Eating habits and sleep patterns of adolescents with depression symptoms in Mumbai, India.

Background

Adolescents with depression engage in unhealthy eating habits and irregular sleep patterns and are often at an increased risk for weight-related problems.

Improvement in these lifestyle behaviours may help to prevent depression, but knowledge about the associations between depression, sleep, eating habits and body weight among adolescents in India is limited.

Methods

This cross-sectional study investigated the prevalence of depression and its association with sleep patterns, eating habits and body weight status among a convenience sample of 527 adolescents, ages 10-17 years in Mumbai, India.

Participants completed a survey on sleep patterns such as sleep duration, daytime sleepiness and sleep problems and eating habits such as frequency of breakfast consumption, eating family meals and eating out.

Depression was assessed using the Patient Health Questionnaire modified for Adolescents (PHQ-A).

Anthropometric measurements were also taken.

Results

Within this sample, 25% had moderate to severe depression (PHQ-A ≥ 10) and 46% reported sleeping less than 6 h > thrice a week.

Adolescents with moderate to severe depression had significantly higher body mass index than those with minimal depression (26.2 ± 6.6 vs. 20.2 ± 4.8 kg/m2 ).

The odds of having clinically significant depression (PHQ-A ≥ 10) was 4.5 times higher in adolescents who had family meals ≤ once a week, 1.6 times higher among those who were sleeping <6 h and 2.3 times higher among participants having trouble falling to sleep more than thrice a week.

Conclusions

The findings indicated that a significant proportion of adolescents had depression symptoms; improving sleep and eating habits may present potential targets for interventions.

Reference

Moitra, P., Madan, J. & Shaikh, N.I. (2020) Eating habits and sleep patterns of adolescents with depression symptoms in Mumbai, India. Maternal & Child Nutrition. 16 Suppl 3(Suppl 3):e12998. doi: 10.1111/mcn.12998.

Sleep-Wake Disorders & DSM-5

Research Paper Title

Sleep-wake disorders and DSM-5.

Background

Most individuals with mental disorders complain about the problems they experience with sleeping and waking. It is becoming evident that careful diagnosis of sleep-wake disorders is of great importance for the prevention and treatment of mental disorders. Since the introduction of the DSM-IV, clinical scientific research has provided important new insights in this field.

Therefore the aim of this research was to find out whether the new classification of sleep-wake disorders in DSM-5 is likely to improve the diagnosis of disorders of this type.

Method

The researchers discuss the main changes in the DSM-5 classification of sleep- wake disorders, comparing the new version with the version in DSM-IV.

Results

Because considerable attention is being given to the symptom-orientated and dimensional approach, the classification of sleep-wake disorders in the DSM-5 is closer to current psychiatric practice and it does justice to the current scientific insights into the dimensional nature of psychiatric disorders.

Conclusions

The DSM-5 classification takes recent scientific insights into account and might help to improve the diagnosis of sleep-wake disorders in psychiatry.

Reference

van Bemmel, A.L. & Kerkhof, G.A. (2020) Sleep-wake disorders and DSM-5. Tijdschrift voor Psychiatrie. 56(3), pp.192-195.

Reviewing Sleep & Mental Disorders in Childhood & Adolescence

Research Paper Title

Review: Sleep and mental disorders in childhood and adolescence.

Background

Sleep problems and disorders are common in childhood and adolescence.

This review aims to throw light on the relationship between sleep problems and mental disorders in childhood and adolescence.

Sleep problems and disorders appear to be risk factors for mental disorders as comorbidities, as symptoms, and as effects of mental disorders.

Frequently, there is an interaction between sleep behaviour and psychopathology so that sleep problems contribute to the intensity and maintenance of mental disorders.

This bidirectional association is observed in early childhood as well as in school-aged children and in adolescents.

Many studies show that this association has a long-term nature beyond child development.

Both environmental and genetic factors seem to play a role in the development and maintenance of the relationship between sleep problems and mental disorders.

Various research articles show that treatment of mental disorders and treatment of sleep disorders influence each other in a positive way.

Therefore, it is strongly advised to consider sleep problems in diagnosis and treatment but also in prevention of mental disorders.

Reference

Schnatschmidt, M. & Schlarb, A. (2020) Review: Sleep and mental disorders in childhood and adolescence. Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie. 46(5), pp.368-381. doi: 10.1024/1422-4917/a000605. Epub 2018 Jul 27.

Book: Sleep Medicine and Mental Health

Book Title:

Sleep Medicine and Mental Health – A Guide for Psychiatrists and Other Healthcare Professionals.

Author(s): Karim Sedky, Racha Nazir, and David Bennett (Editors).

Year: 2020.

Edition: First (1st).

Publisher: Springer.

Type(s): Hardcover and Kindle.

Synopsis:

Advances in sleep medicine research are improving our clinical work for individuals with sleep problems. The aim of this book is to educate psychiatrists and other mental health professionals about the importance of understanding sleep disorders, including their bidirectional relationship with psychiatric conditions.

This book consists of six major sections with seventeen chapters. It is led off by an introduction on the function of sleep, its neurophysiology, and types of sleep problems. Since insomnia represents a common and significant challenge for patients with psychiatric disorders, its clinical presentation and treatments are reviewed in the second section. Cognitive behavioural therapy for insomnia (CBT-I), mindfulness-based CBT, acceptance and commitment therapy (ACT), and the medication management of insomnia are reviewed.

A third section addresses sleep related breathing disorders. The pathology of sleep apnea, its treatments, and therapeutic modalities to address non-compliance with positive pressure ventilation are reviewed. Other sleep disorders such as hypersomnia, circadian rhythm disorders, movement disorders and parasomnias are discussed in the fourth section.

Since features of sleep disorders can vary by age, gender, and trauma history, a fifth section discusses the unique sleep problems associated with children, women, older adults, and veterans. The book concludes with a final section discussing how sleep disorders and psychiatric conditions overlap.

We hope this book highlights the importance of understanding and addressing comorbid sleep disorders among individuals with psychiatric conditions. We are confident that this book will be valuable in helping clinicians improve the management of sleep disorders in their clinical practice.

Are Alterations in Alpha Synchrony Discriminatory of PTSD?

Research Paper Title

Alterations in Sleep EEG Synchrony in Combat-Exposed Veterans With PTSD.

Background

The researchers assessed whether the synchrony between brain regions, analysed using electroencephalography (EEG) signals recorded during sleep, is altered in subjects with post-traumatic stress disorder (PTSD) and whether the results are reproducible across consecutive nights and sub-populations of the study.

Methods

Seventy-eight combat-exposed veteran men with (n = 31) and without (n = 47) PTSD completed two consecutive laboratory nights of high-density EEG recordings. They computed a measure of synchrony for each EEG channel-pair across three sleep stages [rapid eye movement (REM) and non-REM stages 2 and 3] and six frequency bands.

The researchers examined the median synchrony in nine region-of-interest (ROI) pairs consisting of six bilateral brain regions (left and right frontal, central, and parietal regions) for ten frequency-band and sleep-stage combinations.

To assess reproducibility, they used the first 47 consecutive subjects (18 with PTSD) for initial discovery and the remaining 31 subjects (13 with PTSD) for replication.

Results

In the discovery analysis, five alpha-band synchrony pairs during non-REM sleep were consistently larger in PTSD subjects compared to controls (effect sizes ranging from 0.52 to 1.44) across consecutive nights: two between the left-frontal and left-parietal ROIs, one between the left-central and left-parietal ROIs, and two across central and parietal bilateral ROIs.

These trends were preserved in the replication set.

Conclusions

PTSD subjects showed increased alpha-band synchrony during non-REM sleep in the left fronto-parietal, left centro-parietal, and inter-parietal brain regions.

Importantly, these trends were reproducible across consecutive nights and sub-populations. Thus, these alterations in alpha synchrony may be discriminatory of PTSD.

Reference

Laximinarayan, S., Wang, C., Ramakrishnan, S., Oyama, T., Cashmere, J.D., Germain, A. & Reifman, J. (2020) Alterations in Sleep EEG Synchrony in Combat-Exposed Veterans With PTSD. Sleep. doi: 10.1093/sleep/zsaa006. Online ahead of print.

Can Adverse Childhood Experiences have an Affect on Mental Health Outcomes through Disrupted Sleep?

Research Paper Title

Sleep disturbance mediates the association of adverse childhood experiences with mental health symptoms and functional impairment in US soldiers.

Background

Adverse childhood experiences (ACEs) can have long-term impacts on a person’s mental health, which extend into adulthood.

There is a high prevalence of ACEs among service members.

Further, service members also report frequently experiencing disrupted sleep.

Methods

The researchers hypothesised that disrupted sleep may serve a mechanistic function connecting ACEs to functional impairment and poorer mental health.

Results

In a cross-sectional sample (n = 759), the researchers found evidence for an indirect effect of ACEs on mental health outcomes through disrupted sleep.

In a different sample using two time-points (n = 410), they found evidence for an indirect effect of ACEs on changes in mental health outcomes and functional impairment during a reset period, through changes in disrupted sleep during the same period.

Conclusions

Implications, limitations and future research directions are discussed.

Reference

Conway, M.A., Cabrera, O.A., Clarke-Walper, K., Dretsch, M.N., Holzinger, J.B., Riviere, L.A. & Quartana, P.J. (2020) Sleep disturbance mediates the association of adverse childhood experiences with mental health symptoms and functional impairment in US soldiers. Journal of Sleep Research. e13026. doi: 10.1111/jsr.13026. [Epub ahead of print].

Is there a Link between Sleeplessness and Alzheimer’s?

Just one sleepless night raises levels of a protein linked to Alzheimer’s disease in the blood of young men (Benedict et al., 2020).

This suggests getting into good sleep habits at an early age may help ward off the illness.

People with Alzheimer’s have clumps of two sticky proteins –
beta-amyloid and tau – in their brains. Previous work has found that one night of sleep deprivation raises beta-amyloid levels in our brains, but less is known about tau.

Jonathan Cedernaes at Uppsala University in Sweden and his team
recruited 15 healthy young men. They measured tau levels in the
men’s blood after a full night’s sleep and after a night of no sleep.

After the sleepless night, tau levels in blood rose by 17%. After
the good night, the rise was 2%.

While it is a small study that looked only at men, the finding adds to growing evidence that people with poor sleep are more likely to develop Alzheimer’s decades later, says Cedernaes.

More research is needed to confirm that sleep deprivation increases tau in the brain, since blood levels are not necessarily indicative of amounts in the brain, says Cedernaes. And higher blood levels of tau after sleep deprivation could be a sign that the brain is clearing out the protein rather than accumulating it, he says.

The role tau plays in Alzheimer’s is unclear – it may be a side effect, not a cause. Similarly, while lack of sleep has been linked to Alzheimer’s disease, it is possible that this is an early sign of
the condition, rather than a contributing factor.

References

Benedict, C., Blennow, K., Zetterberg, H. & Cedarnaes, J. (2020) Effects of acute sleep loss on diurnal plasma dynamics of CNS health biomarkers in young men. Neurology. 94(11). DOI: https://doi.org/10.1212/WNL.0000000000008866.

Klein, A. (2020) Alzheimer’s Protein Rise Without Sleep. New Scientist. 18 January 2020, pp.17.

Is There a Link between Elevated Spindle Oscillatory Frequency in PTSD & Sleep Continuity?

Research Paper Title

Increased Oscillatory Frequency of Sleep Spindles in Combat-Exposed Veteran Men with Post-Traumatic Stress Disorder.

Background

Sleep disturbances are core symptoms of post-traumatic stress disorder (PTSD), but reliable sleep markers of PTSD have yet to be identified.

Sleep spindles are important brain waves associated with sleep protection and sleep-dependent memory consolidation.

The present study tested whether sleep spindles are altered in individuals with PTSD and whether the findings are reproducible across nights and sub-samples of the study.

Methods

Seventy-eight combat-exposed veteran men with (n = 31) and without (n = 47) PTSD completed two consecutive nights of high-density EEG recordings in a laboratory.

The researchers identified slow (10-13 Hz) and fast (13-16 Hz) sleep spindles during N2 and N3 sleep stages and performed topographical analyses of spindle parameters (amplitude, duration, oscillatory frequency, and density) on both nights.

To assess reproducibility, we used the first 47 consecutive participants (18 with PTSD) for initial discovery and the remaining 31 participants (13 with PTSD) for replication assessment.

Results

In the discovery analysis, compared to non-PTSD participants, PTSD participants exhibited:

  1. Higher slow-spindle oscillatory frequency over the antero-frontal regions on both nights; and
  2. Higher fast-spindle oscillatory frequency over the centro-parietal regions on the second night.

The first finding was preserved in the replication analysis.

The researchers found no significant group differences in the amplitude, duration, or density of slow or fast spindles.

Conclusions

The elevated spindle oscillatory frequency in PTSD may indicate a deficient sensory-gating mechanism responsible for preserving sleep continuity.

The findings, if independently validated, may assist in the development of sleep-focused PTSD diagnostics and interventions.

Reference

Wang, C., Laxminarayan, S., Ramakrishnan, S., Dovzhenok, A., Cashmere, J.D., Germain, A. & Reifman, J. (2020) Increased Oscillatory Frequency of Sleep Spindles in Combat-Exposed Veteran Men with Post-Traumatic Stress Disorder. Sleep. pii: zsaa064. doi: 10.1093/sleep/zsaa064. [Epub ahead of print].

Could an Elevated Spindle Oscillatory Frequency in PTSD Indicate a Deficient Sensory-gating Mechanism is Responsible For Preserving Sleep Continuity?

Research Paper Title

Increased Oscillatory Frequency of Sleep Spindles in Combat-Exposed Veteran Men with Post-Traumatic Stress Disorder.

Background

Sleep disturbances are core symptoms of post-traumatic stress disorder (PTSD), but reliable sleep markers of PTSD have yet to be identified.

Sleep spindles are important brain waves associated with sleep protection and sleep-dependent memory consolidation.

The present study tested whether sleep spindles are altered in individuals with PTSD and whether the findings are reproducible across nights and sub-samples of the study.

Methods

Seventy-eight combat-exposed veteran men with (n = 31) and without (n = 47) PTSD completed two consecutive nights of high-density EEG recordings in a laboratory.

The researchers identified slow (10-13 Hz) and fast (13-16 Hz) sleep spindles during N2 and N3 sleep stages and performed topographical analyses of spindle parameters (amplitude, duration, oscillatory frequency, and density) on both nights.

To assess reproducibility, they used the first 47 consecutive participants (18 with PTSD) for initial discovery and the remaining 31 participants (13 with PTSD) for replication assessment.

Results

In the discovery analysis, compared to non-PTSD participants, PTSD participants exhibited 1) higher slow-spindle oscillatory frequency over the antero-frontal regions on both nights and 2) higher fast-spindle oscillatory frequency over the centro-parietal regions on the second night.

The first finding was preserved in the replication analysis.

The researchers found no significant group differences in the amplitude, duration, or density of slow or fast spindles.

Conclusions

The elevated spindle oscillatory frequency in PTSD may indicate a deficient sensory-gating mechanism responsible for preserving sleep continuity.

The findings, if independently validated, may assist in the development of sleep-focused PTSD diagnostics and interventions.

Reference

Wang, C., Laxminarayan, S., Ramakrishnan, S., Dovzhenok, A., Cashmere, J.D., Germain, A. & Reifman, J. (2020) Increased Oscillatory Frequency of Sleep Spindles in Combat-Exposed Veteran Men with Post-Traumatic Stress Disorder. Sleep. pii: zsaa064. doi: 10.1093/sleep/zsaa064. [Epub ahead of print].

Sleeplessness & Anxiety, Get Some NREM

While a sleepless night can result in a 30% rise in anxiety levels, deep sleep could actually be a remedy against anxiety according to researchers at the University of California.

The researchers found that when the brain is in deep sleep (aka non-rapid eye movement or NREM) it has a calming effect on individuals with anxiety disorders.

MRI scans and other methods were used to measure brain activity in participants.

The results revealed that sleeplessness shuts down the brain’s medial prefrontal cortex – this helps to keep emotions in check.

However, a full night of slumber helps to restore prefrontal changes.