Sleep Med. 2019 Jun 8;63:142-150. doi: 10.1016/j.sleep.2019.05.016.
How does music aid sleep? literature review.
Dickson GT1, Schubert E2.
Author information
1
Empirical Musicology Laboratory, University of New South Wales, Sydney, 2052, Australia. Electronic address: GaelenThomasDickson@gmail.com.
2
Empirical Musicology Laboratory, University of New South Wales, Sydney, 2052, Australia.
Abstract
With the growth of interest in using music to treat insomnia, there is a need to collect and evaluate the literature. This paper reviews disparate literature and assesses the various kinds of assertions and hypotheses made by researchers about music's efficacy in assisting sleep. Six main researcher proposed reasons (RPR) for how music aids sleep were identified in the literature: (1) relaxation, where music encourages physiological or psychological relaxation; (2) distraction, where music acts as a focal point to distract from inner stressful thoughts; (3) entrainment, synchronization of biological rhythms to beat structures in music; (4) masking, obscuring noxious background noise with music; (5) enjoyment, listening to preferred, emotionally relatable or pleasant music; and (6) expectation, individuals cultural beliefs around music. We evaluated each RPR in terms of the evidence available in the extant literature. Masking RPR was identified as having support for improving sleep. Relaxation, distraction and enjoyment RPR had mixed levels of support. Expectation RPR had possible support. Entrainment had mixed possible support. The paper discusses interactions between RPRs, and a call is made to turn research attention to sequencing the RPRs and possible RPR mediators, with relaxation being a likely mediator of several RPRs.

Copyright © 2019 Elsevier B.V. All rights reserved.

KEYWORDS:
Insomnia; Literature-review; Mechanism; Music; Sleep; Therapy

PMID: 31655374 DOI: 10.1016/j.sleep.2019.05.016
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Select item 31655365
22.
Curr Opin Psychol. 2019 Sep 20;34:63-67. doi: 10.1016/j.copsyc.2019.09.004. [Epub ahead of print]
Sex differences in insomnia and risk for psychopathology in adolescence.
Marver JE1, McGlinchey EA2.
Author information
1
Fairleigh Dickinson University, School of Psychology, United States. Electronic address: marverj@student.fdu.edu.
2
Fairleigh Dickinson University, School of Psychology, United States; Columbia University Irving Medical Center/New York State Psychiatric Institute, Division of Child and Adolescent Psychiatry, United States.
Abstract
This review examines sex differences in sleep disturbance and risk for psychopathology, with a particular focus on the emergence of insomnia and risk for depression among adolescents. Possible explanations for the female preponderance of adolescent insomnia is discussed. The significance of the temporal relationship between adolescent insomnia and depression is discussed, as the extant literature suggests that insomnia tends to precede depression more than the inverse. Whether a causal relationship may exist between the two conditions and possible mechanisms underlying sex differences are highlighted along with important areas for future research.

Copyright © 2019 Elsevier Ltd. All rights reserved.

PMID: 31655365 DOI: 10.1016/j.copsyc.2019.09.004
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Select item 31655330
23.
Environ Res. 2019 Oct 19;180:108841. doi: 10.1016/j.envres.2019.108841. [Epub ahead of print]
Short-term exposures to particulate matter gamma radiation activities and biomarkers of systemic inflammation and endothelial activation in COPD patients.
Huang S1, Garshick E2, Vieira CLZ3, Grady ST4, Schwartz JD5, Coull BA6, Hart JE7, Laden F5, Koutrakis P3.
Author information
1
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: shhuang@hsph.harvard.edu.
2
Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
3
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
4
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Research and Development Service, VA Boston Healthcare System, Boston, MA, USA.
5
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
6
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
7
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Abstract
BACKGROUND:
We hypothesized that particulate matter (PM) gamma activity (gamma radiation associated with PM) is associated with systemic effects.

OBJECTIVE:
Examine short-term relationships between ambient and indoor exposures to PM gamma activities with systemic inflammation and endothelial activation in chronic obstructive pulmonary disease (COPD) patients.

METHODS:
In 85 COPD patients from Eastern Massachusetts, USA from 2012 to 2014, plasma C-reactive protein (CRP), interleukin-6 (IL-6), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured seasonally up to four times. We used US EPA RadNet data measuring ambient gamma radiation attached to PM adjusted for background radiation, and estimated in-home gamma radiation exposures using the ratio of in-home-to-ambient sulfur in PM2.5. Linear mixed-effects regression models were used to determine associations between moving averages of PM gamma activities through the week before phlebotomy with these biomarkers. We explored ambient and indoor PM2.5, black carbon (BC), and NO2 as confounders.

RESULTS:
Ambient and indoor PM gamma activities measured as energy spectra classes 3 through 9 were positively associated with CRP and IL-6. For example, averaged from phlebotomy day through previous 6 days, each IQR increase in indoor PM gamma activity for each spectra class, was associated with an CRP increase ranging from 7.45% (95%CI: 2.77, 12.4) to 13.4% (95%CI: 5.82, 21.4) and for ambient exposures were associated with an increase of 8.75% (95%CI: -0.57, 18.95) to 14.8% (95%CI: 4.5, 26.0). Indoor exposures were associated with IL-6 increase of 3.56% (95%CI: 0.31, 6.91) to 6.46% (95%CI:1.33, 11.85) and ambient exposures were associated with an increase of 0.03% (95%CI: -6.37, 6.87) to 3.50% (95%CI: -3.15, 10.61). There were no positive associations with sVCAM-1. Sensitivity analyses using two-pollutant models showed similar effects.

CONCLUSIONS:
Our results demonstrate that short-term exposures to environmental PM gamma radiation activities were associated with systemic inflammation in COPD patients.

Copyright © 2019. Published by Elsevier Inc.

KEYWORDS:
Chronic obstructive pulmonary disease (COPD); Gamma radiation; Particulate matter (PM); Particulate matter gamma radiation activities; Systemic inflammatory biomarkers

PMID: 31655330 DOI: 10.1016/j.envres.2019.108841
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Select item 31655325
24.
Sleep Med. 2019 Jun 14;64:43-47. doi: 10.1016/j.sleep.2019.06.006. [Epub ahead of print]
Obstructive sleep apnea in patients with chronic rhinosinusitis with nasal polyps: a cross-sectional study.
Migueis DP1, Lacerda GCB2, Lopes MC3, Azevedo-Soster LMSF3, Thuler LCS4, Lemes LNA5, Araujo-Melo MH2.
Author information
1
Gafree and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Brazil. Electronic address: debpetrungaro@gmail.com.
2
Gafree and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Brazil.
3
University of Sao Paulo, Brazil.
4
National Cancer Institute, Brazil.
5
Rio de Janeiro State University, Brazil.
Abstract
INTRODUCTION:
Adults with chronic rhinosinusitis with nasal polyps (CRSwNP) often suffer from sleep disruption and sleep apnea. As the apneic profile of CRSwNP may differ from obstructive sleep apnea (OSA) classic patients without nasal polyps (NP), it may prove useful to define a new profile for OSA screening in these patients. The aim of the current study was to compare baseline characteristics and apneic profile of OSA patients with CRSwNP to OSA patients without NP.

MATERIALS AND METHODS:
Thirty-one apneic patients with CRSwNP and 62 apneic cases without NP were included in our study. Both groups underwent nasal endoscopy, Epworth Sleepiness Scale (ESS) evaluation, and overnight polysomnography (PSG). We additionally accessed anthropometric characteristics such as snoring, tiredness, observed apnea, high blood pressure, body mass index (BMI), age, neck circumference, male gender, and OSA risk via the STOP-Bang questionnaire.

RESULTS:
Although the patients were matched according to age and gender, the median BMI and STOP-Bang score were significantly higher in patients with OSA than in those with OSA and CRSwNP. Notably, the median ESS showed low somnolence and a low median apnea-hypopnea index in patients with CRSwNP, despite the fact that the lowest median oxygen saturation was not significantly different between groups.

CONCLUSIONS:
Anthropometric characteristics in individuals with apnea caused by CRSwNP were significantly different from those in individuals with typical. This finding will improve screening and treatment of apneic patients CRSwNP.

Copyright © 2019 Elsevier B.V. All rights reserved.

KEYWORDS:
Adults; Nasal polyps; Obstructive sleep apnea; Rhinosinusitis; STOP-Bang

PMID: 31655325 DOI: 10.1016/j.sleep.2019.06.006
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Select item 31655324
25.
Sleep Med. 2019 Jun 14;64:37-42. doi: 10.1016/j.sleep.2019.06.005. [Epub ahead of print]
Nocturnal dialysis improves sleep apnea more than daytime dialysis: a meta-analysis of crossover studies.
Lavoie MR1, Patel JA2, Camacho M3.
Author information
1
Madigan Army Medical Center, Department of Medicine, 9040A Jackson Ave, Joint Base Lewis-McChord, WA, 98431, USA. Electronic address: mattrlavoie@gmail.com.
2
Madigan Army Medical Center, Department of Otolaryngology, 9040A Jackson Ave, Joint Base Lewis-McChord, WA, 98431, USA.
3
Tripler Army Medical Center, Division of Otolaryngology-Head and Neck Surgery, 1 Jarrett White Rd, Tripler AMC, HI, 96859, USA. Electronic address: drcamachoent@yahoo.com.
Abstract
PURPOSE:
To systematically review the literature for articles evaluating differences in polysomnography (PSG) data when patients are on primarily daytime hemodialysis (conventional hemodialysis or continuous ambulatory peritoneal dialysis) versus nocturnal hemodialysis (nocturnal hemodialysis or nocturnal peritoneal dialysis). Then to perform a meta-analysis on the available PSG data, specifically evaluating differences in apnea hypopnea index (AHI) and mean saturation of oxygen (SpO2) between these two groups.

METHODS:
Two authors systematically searched MEDLINE/Pubmed, Scopus, EMBASE, CINAHL, and Cochrane. Searches were performed through December 6, 2018.

RESULTS:
A total of four adult crossover studies (91 patients, age 50.4 ± 12.4, BMI 25.1 ± 5.3) reported PSG data. The daytime hemodialysis (DHD) and nocturnal hemodialysis (NHD) AHI decreased from 24.6 ± 18.2 to 12.6 ± 11.8 (events/hour) with a mean difference of -11.9 [95% CI -13.47, -10.37], Z score of 15.07 (P < 0.00001). The standardized mean difference was -1.35 [95% CI -2.70, 0.01]. Two studies reported mean SpO2 changes during PSG. The DHD and NHD SpO2 increased from 92.7 ± 2.4 to 94.7 ± 2.2 with a mean difference of 2.26 [95% CI -0.18, 4.71], Z score 1.82 (P = 0.07).

CONCLUSION:
In the current literature, nocturnal hemodialysis improves AHI more than daytime hemodialysis. A trend towards improvement in mean SpO2 with nocturnal dialysis was noted, but did not reach statistical significance. Consideration can be given for transitioning patients who have end stage renal disease and sleep apnea from daytime to nocturnal hemodialysis as an adjunct to other treatment modalities.

Published by Elsevier B.V.

KEYWORDS:
Apnea hypopnea index; Fluid shift; Nocturnal hemodialysis; Sleep apnea

PMID: 31655324 DOI: 10.1016/j.sleep.2019.06.005
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Select item 31655323
26.
Sleep Med. 2019 Jun 22;64:30-36. doi: 10.1016/j.sleep.2019.06.008. [Epub ahead of print]
Night-time cardiac autonomic modulation as a function of sleep-wake stages is modified in otherwise healthy overweight adolescents.
Chamorro R1, Algarín C2, Rojas O2, Garrido M2, Durán-Agüero S2, Causa L3, Held C3, Lozoff B4, Ferri R5, Peirano P6.
Author information
1
Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile; Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile.
2
Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.
3
Electrical Engineering Department, Faculty of Physical and Mathematical Sciences, University of Chile, Santiago, Chile.
4
Center for Human Growth and Development, and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA.
5
Sleep Research Centre, Oasi Research Institute - IRCCS, Troina, Italy.
6
Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile. Electronic address: ppeirano@inta.uchile.cl.
Abstract
OBJECTIVE:
Even though sympathetic dominance during the daytime period is well known, currently, scarce data exist on autonomic nervous system (ANS) regulation during sleep in pediatric obesity. We aimed to evaluate sleep cardiac ANS regulation in normal-weight (NW) and overweight and obese (OW) adolescents.

PATIENTS/METHODS:
In this study, 60 healthy adolescents (15.7 ± 0.7 years) belonging to a birth cohort since infancy were classified based on body mass index percentiles criteria as: OW (N = 27) or NW (N = 33). Sleep was evaluated by polysomnography (PSG) during two consecutive in-lab overnight sessions. Non-rapid eye movement (non-REM) sleep stages (stages 1, 2, and slow-wave sleep [SWS]), rapid eye movement (REM) sleep, and wakefulness (Wake) were scored. R-waves were detected automatically in the electrocardiographic (ECG) signal. An all-night heart rate variability analysis was conducted in the ECG signal, with several time- and frequency-domain measures calculated for each sleep-wake stage. Sleep time was divided into thirds (T1, T2, T3). The analysis was performed using a mixed-effects linear regression model.

RESULTS:
Sleep organization was comparable except for reduced REM sleep percentage in the OW group (p < 0.04). Shorter R-R intervals were found for all sleep stages in the OW group; time-domain measured standard deviation of all R-R intervals (RRSD) was lower during stage 2, SWS and REM sleep (all p < 0.05). The square root of the mean of the sum of the squares of differences between adjacent R-R intervals (RMSSD) was also lower only during wake after sleep onset (WASO) in T1 and T3 (p < 0.05). The OW group had increased very low- and low-frequency (LF) power during WASO (in T1 and T2), and LF power during stage 2 and REM sleep (in T2). During WASO in the OW group, high-frequency (HF) power was lower (in T1 and T2), and LF/HF ratio was higher (in T2, p < 0.007).

CONCLUSIONS:
Several sleep-stage-dependent changes in cardiac autonomic regulation characterized the OW group. As sleep-related ANS balance was disturbed in the absence of concomitant metabolic alterations in this sample of otherwise healthy OW adolescents, their relevance for pediatric obesity should be further explored throughout development.

Copyright © 2019 Elsevier B.V. All rights reserved.

KEYWORDS:
Adolescents; Autonomic regulation; Heart rate variability; Obesity; Overweight; Sleep

PMID: 31655323 DOI: 10.1016/j.sleep.2019.06.008
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Select item 31655322
27.
Sleep Med. 2019 Jun 26;64:3-11. doi: 10.1016/j.sleep.2019.05.019. [Epub ahead of print]
Effect of continuous positive airway pressure on respiratory drive in patients with obstructive sleep apnea.
Radovanovic D1, Rizzi M1, Airoldi A1, Mantero M2, Di Marco F3, Raccanelli R4, Santus P5.
Author information
1
Division of Respiratory Diseases, Luigi Sacco University Hospital, Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Milan, Italy.
2
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; Internal Medicine Department, Respiratory Unit and Regional Adult Cystic Fibrosis Center, IRCCS Fondazione Cá Granda Ospedale Policlinico, Milan, Italy.
3
Dipartimento di Scienze della Salute, Università degli Studi di Milano, Respiratory Unit, ASST - Ospedale Papa Giovanni XXIII, Bergamo, Italy.
4
Cardiorespiratory Rehabilitation Medicine, IRCCS ICS Maugeri SPA SB, Milan, Italy.
5
Division of Respiratory Diseases, Luigi Sacco University Hospital, Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Milan, Italy. Electronic address: pierachille.santus@unimi.it.
Abstract
OBJECTIVE:
Patients with obstructive sleep apnea (OSA) have an altered control of breathing during wakefulness. Thus far, whether and how treatment with continuous positive airway pressure (CPAP) may restore these abnormalities has been poorly understood. The aim of this study was to investigate the long-term effects of CPAP on the breathing pattern, ventilatory drive (VDr), and chemoreceptor sensitivity in OSA patients.

PATIENTS AND METHODS:
This was a prospective, observational study, carried out in an academic sleep outpatient clinic. A total of 62 patients with OSA (mean age [SD], 51 [11] years) underwent polysomnography (PSG), breathing pattern assessment, mouth occlusion pressure, ventilatory response to hypoxemia (Ve/SaO2), and hypercapnia (Ve/PETCO2) before and after CPAP titration and during 12-month follow-up. A total of 48 age-matched healthy subjects served as controls. Patients with good (≥6 h/night) and poor (<6 h/night) compliance with CPAP were also compared.

RESULTS:
At baseline, VDr as well as thoracic and inspiratory impedances were greater in patients with OSA compared with controls and were reduced by CPAP treatment, starting from the night of titration (P < 0.01), especially in patients with good compliance with CPAP. Baseline Ve/SaO2 was higher in OSA patients (P < 0.05) and was progressively normalized during CPAP treatment (P < 0.001). The pathophysiological changes were mainly due to a reduction in tidal volume. The remaining breathing pattern parameters were unaltered by CPAP treatment and were similar between groups.

CONCLUSION:
In OSA patients, the mechanics of breathing are inefficient because of an imbalance of the VDr. Regular CPAP treatment improves the efficiency of the respiratory system and normalizes the hypoxemic stimulus.

Copyright © 2019 Elsevier B.V. All rights reserved.

KEYWORDS:
CPAP; Inspiratory impedance; Respiratory drive; Sleep apnea; Thoracic impedance; Ventilatory response

PMID: 31655322 DOI: 10.1016/j.sleep.2019.05.019
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Select item 31655321
28.
Sleep Med. 2019 Jun 15;64:23-29. doi: 10.1016/j.sleep.2019.05.020. [Epub ahead of print]
Sleep disordered breathing in Silver-Russell syndrome patients: a new outcome.
Giabicani É1, Boulé M2, Aubertin G3, Galliani E4, Brioude F5, Dubern B6, Netchine I5.
Author information
1
Sorbonne Université, INSERM, UMR_S 938 Centre de Recherche Saint Antoine, APHP, Hôpital Armand Trousseau, Explorations Fonctionnelles Endocriniennes, Paris, France. Electronic address: eloise.giabicani@aphp.fr.
2
APHP, Hôpital Armand Trousseau, Explorations Fonctionnelles Respiratoires et du Sommeil, Paris, France.
3
APHP, Hôpital Armand Trousseau, Service de Pneumologie Pédiatrique, Centre de Références des Maladies Respiratoires Rares de l'Enfant, Paris, France; Centre de Pneumologie de l'Enfant, Ramsay Générale de Santé, Clinique Chirurgicale, Boulogne-Billancourt, France.
4
AP-HP, Hôpital Necker Enfants Malades, Chirurgie Maxillo-Faciale et Chirurgie Plastique, Paris, France.
5
Sorbonne Université, INSERM, UMR_S 938 Centre de Recherche Saint Antoine, APHP, Hôpital Armand Trousseau, Explorations Fonctionnelles Endocriniennes, Paris, France.
6
APHP, Hôpital Armand Trousseau, Service de Nutrition et de Gastroentérologie Pédiatriques, Paris, France; Sorbonne Université, INSERM, Nutriomics, Paris, France.
Abstract
OBJECTIVE:
Imprinting disorders (ID), such as Prader-Willi syndrome (PWS), are associated with sleep-disordered breathing (SDB). No data are available for Silver-Russell syndrome (SRS), another ID that shares clinical features with PWS, although many patients describe excessive daytime sleepiness, disturbed sleep, and snoring. The aim of this study was to characterize sleep in children with SRS and to evaluate the impact of recombinant growth hormone (rGH) therapy.

METHODS:
We performed a retrospective analysis of sleep recordings in 40 patients with molecularly proven SRS (methylation anomaly in 11p15 [n = 32] or maternal uniparental disomy of chromosome 7 [n = 16]). Sleep recordings were either by means of polygraphy or polysomnography (PSG) (n = 16). A total of 34 patients received rGH therapy.

RESULTS:
We collected 61 sleep recordings. The mean apnea-hypopnea index (AHI) was 3.4 events/h (0-12.4), with a mean central AHI of 0.5 events/h (0-2.4). SDB was identified in 73.8% (n = 45) of the recordings and was severe in 4.9%. SDB was present in 86.4% of patients before rGH therapy and was severe in 13.6%. AHI worsened for 5 of 12 patients with sleep recordings before and after rGH therapy initiation, reaching mild impairment. The mean rGH dose was 32.3 μg/kg/(12.9-51.4), with a mean insulin-like growth factor 1 plasma level of 1.7 SDS (-1.9 to 6.6).

CONCLUSION:
Most patients with SRS present with SDB with an obstructive profile, possibly explained by narrowing of the airways and lymphoid organ hypertrophy. We recommend systematic ear-nose-throat evaluation of SRS patients and PSG if there are clinical anomalies, preferably before initiating rGH therapy, to monitor and adapt the management of patients with SDB.

Copyright © 2019 Elsevier B.V. All rights reserved.

KEYWORDS:
Growth hormone; Silver-Russell syndrome; Sleep apnea syndrome; Sleep disordered breathing; Sleep recording

PMID: 31655321 DOI: 10.1016/j.sleep.2019.05.020
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Select item 31655320
29.
Sleep Med. 2019 Jun 22;64:15-22. doi: 10.1016/j.sleep.2019.05.022. [Epub ahead of print]
The impact of delayed sleep phase disorder on adolescents and their family.
Montie K1, Quaedackers L2, Perlitius V2, van der Horst E2, Vandenbussche N2, Overeem S3, Pillen S4.
Author information
1
Sleep Medicine Center, Kempenhaeghe, Heeze, the Netherlands; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
2
Sleep Medicine Center, Kempenhaeghe, Heeze, the Netherlands.
3
Sleep Medicine Center, Kempenhaeghe, Heeze, the Netherlands; Department of Industrial Design, Technical University Eindhoven, Eindhoven, the Netherlands; Dept. of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
4
Sleep Medicine Center, Kempenhaeghe, Heeze, the Netherlands; Department of Industrial Design, Technical University Eindhoven, Eindhoven, the Netherlands. Electronic address: PillenS@kempenhaeghe.nl.
Abstract
INTRODUCTION:
We investigated the impact of delayed sleep phase disorder (DSPD) on the daily lives of adolescents and their families.

METHOD:
In this qualitative study, six adolescents with DSPD, and six parents were given in-depth interviews. Using thematic analysis, we merged open codes into themes that reflected the impact of the disorder.

RESULT:
We identified five themes: (1) Impact on the adolescents' school and social life: describing the negative influence of DSPD on school performance and friendships. (2) Impact on the parents, feeling guilty and powerless: showing the consequences of many unsuccessful attempts to improve the situation, with a lack of understanding from their social support system. (3) Impact on the family, conflicts, and misunderstanding: describing the negative influence on other family members, family relationships, and home atmosphere. (4) Impact on the parents, being weary of everything: describing the effect on the parents' mood and social life. (5) Factors mediating the severity of impact, of which personal characteristics and school support seemed most important. Themes 2 to 4 were highly interrelated.

CONCLUSIONS:
Adolescent DSPD not only affects cognitive functioning and mental health but has a much broader impact, also affecting social life, family life, and parental well-being. This information provides new potential points of engagement for therapy, guidance, and support for these families. Greater awareness and recognition of the impact of DSPD is needed on the part of physicians as well as the general population, to increase support and reduce misunderstanding of these adolescents and their parents.

Copyright © 2019 Elsevier B.V. All rights reserved.

KEYWORDS:
Adolescents; Delayed sleep phase syndrome; Family; Impact; School; Social functioning

PMID: 31655320 DOI: 10.1016/j.sleep.2019.05.022
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Select item 31655319
30.
Sleep Med. 2019 Jun 21;64:12-14. doi: 10.1016/j.sleep.2019.06.007. [Epub ahead of print]
Overnight oxygen desaturation index in sickle cell disease: prediction of sleep apnea.
Ayache M1, Rosen CL2, Chiang A3, Little JA3, Strohl KP4.
Author information
1
Division of Pulmonary, Critical Care and Sleep Medicine, Metrohealth Medical Center, United States. Electronic address: mayache1@metrohealth.org.
2
Division of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center, United States; Division of Pediatric Pulmonary and Sleep Medicine, Rainbow Babies and Children's Hospital, United States.
3
Division of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center, United States.
4
Division of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center, United States; Division of Pulmonary, Critical Care and Sleep Medicine, Louis Stokes Veterans Affair Medical Center, United States.
PMID: 31655319 DOI: 10.1016/j.sleep.2019.06.007
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Select item 31655318
31.
Sleep Med. 2019 Jun 22;64:1-2. doi: 10.1016/j.sleep.2019.06.009. [Epub ahead of print]
Comorbid episodes of primary bruxism and bruxism as an epileptic activity-related motor event.
Bušková J1, Košťálová J2, Miletínová E3, Bušek P4.
Author information
1
National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic. Electronic address: vankjit@seznam.cz.
2
National Institute of Mental Health, Klecany, Czech Republic.
3
National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic.
4
Department of Neurology, Centre of Clinical Neurosciences, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
PMID: 31655318 DOI: 10.1016/j.sleep.2019.06.009
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Select item 31655279
32.
Pharmacol Rep. 2019 Jul 16;71(6):1147-1150. doi: 10.1016/j.pharep.2019.06.018. [Epub ahead of print]
Orexin 2 receptor is involved in orexin A-induced hyperlocomotion in rats.
Maehara S1, Furukawa J2, Ota T2.
Author information
1
Pharmacology, Research Center, Mochida Pharmaceutical Co., Ltd., 722 Uenohara, Jimba, Gotemba, Shizuoka 412-8524, Japan. Electronic address: shunsuke.maehara@mochida.co.jp.
2
Pharmacology, Research Center, Mochida Pharmaceutical Co., Ltd., 722 Uenohara, Jimba, Gotemba, Shizuoka 412-8524, Japan.
Abstract
BACKGROUND:
The orexin system regulates various functions, including sleep/wake cycles, feeding, and cognition. Orexin A and orexin B are endogenous neuropeptides for both orexin 1 (OX1) and orexin 2 (OX2) receptors. Orexin A has a potent agonistic activity for both the receptors and is known to increase locomotor activity in rats. However, it has not been elucidated how each receptor contributes to orexin A-induced hyperlocomotion.

METHODS:
We examined the effects of an OX1 receptor antagonist, SB 334867, and an OX2 receptor antagonist, EMPA, as well as an OX1 and OX2 receptor antagonist on hyperlocomotion caused by intracerebroventricular administration of orexin A or an OX2 receptor agonist, ADL-OXB ([Ala11,d-Leu15]-orexin B), in rats.

RESULTS:
EMPA (100 mg/kg, ip) but not SB 334867 (3-10 mg/kg, ip) showed antagonistic effects on ADL-OXB-induced hyperlocomotion without affecting the spontaneous locomotor activity. Both EMPA (100 mg/kg, ip) and the OX1 and OX2 receptor antagonist (3-30 mg/kg, po) antagonized orexin A-induced hyperlocomotion, while SB 334867 (3‒-10 mg/kg, ip) showed no effects.

CONCLUSIONS:
Our results suggest that orexin A-induced hyperlocomotion is mainly mediated by the activation of the OX2 receptor.

Copyright © 2019 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier B.V. All rights reserved.

KEYWORDS:
Locomotor activity; OX(1) receptor; OX(2) receptor; Orexin A

PMID: 31655279 DOI: 10.1016/j.pharep.2019.06.018
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Select item 31654892
33.
J Pediatr Nurs. 2019 Oct 22;49:67-71. doi: 10.1016/j.pedn.2019.09.018. [Epub ahead of print]
Opioid seeking behaviors and diversion in hospitalized pediatric patients: A case series.
McNeely HL1.
Author information
1
Children's Hospital Colorado, Anschutz Campus, 13123 E. 16th Ave., Box 450, Aurora, CO 80045, United States of America. Electronic address: Heidi.Mcneely@childrenscolorado.org.
Abstract
All nurses have a responsibility for monitoring their patients for signs of substance misuse or substance use disorder. Adolescents and young adults are at risk for substance use. Prescription medications may be used by adolescents for non-medical reasons such as to feel high, to assist with sleep, to avoid negative feelings or thoughts or to avoid withdrawal symptoms after chronic use. Some adolescents with legally prescribed medications have been asked to divert those medications by giving them to someone else. Drug diversion by employees is often reported in healthcare settings, but diversion of medications done by patients is far less commonly reported. This paper is a report of two patients with complex medical issues and chronic pain who diverted opioid medications while hospitalized. Hiring clinical staff, such as nurses, working in Drug Diversion Prevention positions will provide knowledge and expertise to facilitate investigations and to help reduce risks for diversion in healthcare settings. In addition, nurses with concerns about patient diversion should discuss these concerns with the care team. Organizational leaders need to support their teams by providing education and resources so staff feel comfortable addressing these challenging situations.

Copyright © 2019 Elsevier Inc. All rights reserved.

PMID: 31654892 DOI: 10.1016/j.pedn.2019.09.018
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Select item 31654856
34.
J Pharm Biomed Anal. 2019 Oct 13;178:112919. doi: 10.1016/j.jpba.2019.112919. [Epub ahead of print]
Simultaneous determination of donepezil, 6-O-desmethyl donepezil and spinosin in beagle dog plasma using liquid chromatography‒tandem mass spectrometry and its application to a drug-drug interaction study.
Lee CB1, Min JS1, Chae SU1, Kim HM2, Jang JH2, Jung IH3, Zheng YF4, Ryu JH5, Bae SK6.
Author information
1
College of Pharmacy and Integrated Research Institute of Pharmaceutical Sciences, The Catholic University of Korea, Bucheon 14662, Republic of Korea.
2
Daehwa Pharmaceutical Co., Ltd., Seongnam 13488, Republic of Korea.
3
Daehwa Pharmaceutical Co., Ltd., Seongnam 13488, Republic of Korea; Department of Life and Nanopharmaceutical Sciences, Kyung Hee University, Seoul 02447, Republic of Korea.
4
Department of Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210000, China.
5
Department of Life and Nanopharmaceutical Sciences, Kyung Hee University, Seoul 02447, Republic of Korea.
6
College of Pharmacy and Integrated Research Institute of Pharmaceutical Sciences, The Catholic University of Korea, Bucheon 14662, Republic of Korea. Electronic address: baesk@catholic.ac.kr.
Abstract
Spinosin, which is traditionally used for sedation and sleep disorders, has recently shown potential effects in alleviating memory loss. As spinosin is the main bioactive component in a standardized dried 50% ethanol extract of the seeds of Zizyphus jujuba var. spinosa, a Phase IIb clinical trial is ongoing, in Korea for the combination of the above extract formulated in a tablet (DHP1401 tablet) with donepezil hydrochloride (Aricept® tablet) in patients with mild to moderate Alzheimer's disease. Therefore, to promote safety and efficacy evaluations, a reliable method for the simultaneous detection and analysis of the two drugs is needed. Toward this end, in this study, we established and validated a rapid and sensitive LC-MS/MS method for the simultaneous determination of donepezil, its pharmacologically active metabolite 6-O-desmethyl donepezil, and spinosin in beagle dog plasma (50 μL). After optimization of the system, we used methanol for simple protein precipitation. Chromatographic separation was performed using a Phenomenex Luna C18 column (100 × 2.0 mm, 3 μm) with a mobile phase consisting of 0.1% formic acid in acetonitrile-0.1% formic acid in distilled water (2:8, v/v) at a flow rate of 0.65 mL/min. All analytes were detected and quantified in selected reaction monitoring mode. All calibration curves showed good linearity (r ≥ 0.9965) over the concentration range of 0.02-20, 0.02-10, and 0.5-250 ng/mL for donepezil, for 6-O-desmethyl donepezil, and spinosin, respectively. This validated method was then successfully applied to a pharmacokinetic study in beagle dogs with no evidence for potential drug-drug interactions between DHP1401 and donepezil hydrochloride. This information and optimized assay can be useful for the anticipated co-administration of these two drugs in clinical settings.

Copyright © 2019 Elsevier B.V. All rights reserved.

KEYWORDS:
6-O-desmethyl donepezil; Beagle dog plasma; Donepezil; Drug-drug interaction; LC‒MS/MS; Spinosin

PMID: 31654856 DOI: 10.1016/j.jpba.2019.112919
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Select item 31654830
35.
Comp Biochem Physiol C Toxicol Pharmacol. 2019 Oct 22:108641. doi: 10.1016/j.cbpc.2019.108641. [Epub ahead of print]
Antioxidant response to cadmium exposure in primary skeletal muscle cells isolated from humans and elephant seals.
Del Águila-Vargas AC1, Vázquez-Medina JP2, Crocker DE3, Méndez-Rodriguez LC1, Gaxiola-Robles R4, de Anda-Montañez JA1, Ramirez-Jirano LJ5, Lugo-Lugo O1, Zenteno-Savín T6.
Author information
1
Centro de Investigaciones Biológicas del Noroeste (CIBNOR), S.C., Instituto Politécnico Nacional 195, Col. Playa Palo de Santa Rita Sur, La Paz, Baja California Sur C.P. 23096, Mexico.
2
University of California Berkley, Department of Integrative Biology, 3040 Valley Life Sciences Building #3140, Berkeley, CA 94720, USA.
3
Sonoma State University, Department of Biology, 1801 E. Cotati Ave., Rohnert Park, CA 94928, USA.
4
Centro de Investigaciones Biológicas del Noroeste (CIBNOR), S.C., Instituto Politécnico Nacional 195, Col. Playa Palo de Santa Rita Sur, La Paz, Baja California Sur C.P. 23096, Mexico; Hospital General de Zona No.1, Instituto Mexicano del Seguro Social, 5 de Febrero y Héroes de la Independencia, Col. Centro, La Paz, Baja California Sur C.P. 23000. Mexico.
5
Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Sierra Mojada 800. Col. Independencia, Guadalajara, Jalisco, C.P. 44340, Mexico.
6
Centro de Investigaciones Biológicas del Noroeste (CIBNOR), S.C., Instituto Politécnico Nacional 195, Col. Playa Palo de Santa Rita Sur, La Paz, Baja California Sur C.P. 23096, Mexico. Electronic address: tzenteno04@cibnor.mx.
Abstract
Cadmium (Cd) occurs naturally; however, its concentration can increase with anthropogenic activities. Excess Cd increases reactive oxygen species (ROS) production and oxidative damage, which can lead to pathological conditions. Marine mammals accumulate Cd in the liver and the kidney; yet, there are no reports of Cd-associated tissue damage in whales, seals or dolphins. Response to Cd exposure (0-5.0 μM CdCl2 for 1-12 h) was analyzed and compared in primary skeletal muscle cells isolated from northern elephant seals (Mirounga angustirostris) and humans (Homo sapiens). Antioxidant enzyme activities (glutathione S-transferase, glutathione reductase, glutathione peroxidase), glutathione concentration, and protein carbonyl levels (an indicator of oxidative damage) were quantified. Glutathione levels were higher in northern elephant seal than in human cells. Protein carbonyl content in cells exposed to Cd was lower and had a smaller variability range in elephant seals than in humans. Generalized linear models (GLIM) identified Cd exposure and antioxidant defenses as significant contributors to protein carbonyl variability in human but not in elephant seal cells. These results suggest that the previously observed differences in circulating and tissue glutathione levels between marine and terrestrial mammals are maintained under cell culture conditions and that northern elephant seal and human muscle cells respond differently to Cd exposure. The results also suggest that the observed differences could potentially be associated with the protective mechanisms that allow northern elephant seals to tolerate extreme conditions that result in increased ROS generation (e.g. diving, sleep apnea, fasting) with no oxidative damage.

Copyright © 2019. Published by Elsevier Inc.

KEYWORDS:
Glutathione; Marine mammals; Oxidative stress; Primary cells; Tissue culture; Trace elements

PMID: 31654830 DOI: 10.1016/j.cbpc.2019.108641
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Select item 31654682
36.
Physiol Behav. 2019 Oct 22:112703. doi: 10.1016/j.physbeh.2019.112703. [Epub ahead of print]
Effects of CDP-choline Administration on Learning and Memory in REM Sleep-Deprived Rats.
Cakir A1, Ocalan B1, Koc C2, Suyen GG3, Cansev M2, Kahveci N4.
Author information
1
Bursa Uludag University School of Medicine, Department of Physiology, Bursa, Turkey.
2
Bursa Uludag Univ School of Medicine, Department of Pharmacology, Bursa, Turkey.
3
Acibadem Mehmet Ali Aydinlar University School of Medicine, Department of Physiology, Istanbul, Turkey.
4
Bursa Uludag University School of Medicine, Department of Physiology, Bursa, Turkey. Electronic address: nevka@uludag.edu.tr.
Abstract
Cytidine 5-diphosphocholine (CDP-choline) administration has been shown to improve learning and memory deficits in different models of brain disorders. In this study, effects of CDP-choline on the well known negative effects of Rapid Eye Movements (REM) sleep deprivation on learning and memory were investigated. Sleep deprivation was induced by placing adult male Wistar albino rats on 6.5 cm diameter platforms individually for 96 hours according to flower pot method. Learning and memory performances were evaluated using Morris Water Maze (MWM) test during the same period of time. Saline or CDP-choline (100 µmol/kg, 300 µmol/kg or 600 µmol/kg) was administered intraperitoneally 30 minutes prior to the onset of MWM experiments. On completion of behavioral tests, rats were decapitated and hippocampi were assayed for total and phosphorylated Ca2+/calmodulin-dependent protein kinase II (tCaMKII and pCaMKII, respectively) and total antioxidant capacity. We observed that while REM sleep deprivation had no effect on learning, it diminished the memory function, which was associated with decreased levels of pCaMKII and total antioxidant capacity in the hippocampus. CDP-choline treatment blocked the impairment in memory function of sleep-deprived rats and, increased pCaMKII levels and total antioxidant capacity. These data suggest that CDP-choline reduces REM sleep deprivation-induced impairment in memory, at least in part, by counteracting the disturbances in biochemical and molecular biological parameters.

Copyright © 2019. Published by Elsevier Inc.

KEYWORDS:
CDP-choline; Camkll; Learning and memory; Morris water maze; REM sleep deprivation; total antioxidant Capacity

PMID: 31654682 DOI: 10.1016/j.physbeh.2019.112703
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Select item 31654677
37.
Gen Comp Endocrinol. 2019 Oct 22:113304. doi: 10.1016/j.ygcen.2019.113304. [Epub ahead of print]
Involvement of orexin A in nocturnal melatonin secretion into the cerebrospinal fluid and the blood plasma in seasonal sheep.
Kirsz K1, Szczęsna M2, Biernat W3, Molik E4, Zięba DA5.
Author information
1
University of Agriculture in Krakow, Department of Animal Biotechnology, 1B Rędzina Street, 31-248 Krakow, Poland. Electronic address: k.kirsz.ur@gmail.com.
2
University of Agriculture in Krakow, Department of Animal Biotechnology, 1B Rędzina Street, 31-248 Krakow, Poland. Electronic address: malgorzata.szczesna@urk.edu.pl.
3
University of Agriculture in Krakow, Department of Animal Biotechnology, 1B Rędzina Street, 31-248 Krakow, Poland. Electronic address: weronikaa.biernat@gmail.com.
4
University of Agriculture in Krakow, Department of Animal Biotechnology, 1B Rędzina Street, 31-248 Krakow, Poland. Electronic address: e.molik@urk.edu.pl.
5
University of Agriculture in Krakow, Department of Animal Biotechnology, 1B Rędzina Street, 31-248 Krakow, Poland. Electronic address: rzzieba@cyf-kr.edu.pl.
Abstract
In sheep, differences in orexin A (OXA) gene expression and activity are related to changes in energy demand and seasonal reproduction. However, the mechanism by which and the key place where the OXA signal is integrated with photoperiod, whose main biochemical expression is melatonin (MEL), remain unknown. We examined the effects of cisterna magna injections of OXA (0.3 μg/kg body weight) on nocturnal cerebrospinal fluid (CSF) and plasma MEL concentrations; mRNA and protein expression of two rate-limiting enzymes for MEL biosynthesis, tryptophan 5-hydroxylase-1 (TPH1) and arylalkylamine-N-acetyltransferase (AA-NAT); and OXA receptor (OX1R, OX2R) expression in the pineal gland (PG) obtained from twenty ewes during the short-day (SD) and long-day (LD) seasons. OXA increased (P<0.001) CSF and plasma MEL concentrations regardless of the season. Plasma MEL was positively correlated (P<0.001) with CSF MEL in the OXA-treated sheep in both seasons. OXA had no effect (P>0.05) on TPH1 transcript or protein level but upregulated (P<0.05) AA-NAT mRNA and protein expression in both seasons. OXA enhanced (P<0.05) OX1R mRNA level only during the LD season. Our results show that the endocrine activity of the ovine PG is regulated by day length and non-photic signals via hypothalamic OXA. These results are important for understanding the work of the biological clock and recognizing mechanisms responsible for the adaptation of seasonal animals to the changing external environment conditions. OXA and MEL are both involved in the regulation of the sleep-wakefulness system, therefore our results can be used in the study on the circadian rhythm disorders in humans (e.g. jet lag, insomnia, seasonal depression).

Copyright © 2019. Published by Elsevier Inc.

KEYWORDS:
arylalkylamine-N-acetyltransferase; melatonin; orexin A; orexin receptors; sheep; tryptophan 5-hydroxylase-1

PMID: 31654677 DOI: 10.1016/j.ygcen.2019.113304
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Select item 31654658
38.
Pharmacol Ther. 2019 Oct 22:107427. doi: 10.1016/j.pharmthera.2019.107427. [Epub ahead of print]
Research and development of κ opioid receptor agonists and δ opioid receptor agonists.
Nagase H1, Saitoh A2.
Author information
1
International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. Electronic address: nagase.hiroshi.gt@u.tsukuba.ac.jp.
2
Laboratory of Pharmacology, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, 278-8510, Japan.
Abstract
Delta opioid delta receptor (DOP) agonists were expected to be analgesics and many researchers tried to develop the SNC80 derivatives. However, the derivatives were dropped at the stage of early clinical trials because of undesirable side effects and weak analgesia. On the other hand, DOP agonists have been proposed as attractive candidates for the novel psychotropic drugs. We recently succeeded in synthesizing a novel selective DOP agonist KNT-127. KNT-127 produced neither catalepsy nor convulsive effects. We have demonstrated that KNT-127 has potent anxiolytic-like effect in rat models of innate anxiety. This anxiolytic-like effect was independent from known adverse effect of benzodiazepine, such as memory impairment, motor coordination deficits, and ethanol interactions. We have also demonstrated that KNT-127 showed potent and rapid antidepressant-like effects in rat models of depression. This antidepressant-like effect was independent from known adverse effect of selective serotonin reuptake inhibitor (SSRI), such as digestive symptoms. Therefore, we propose that DOP should be considered as an attractive target for the development of novel psychotropic drugs, without producing the adverse effects associated with benzodiazepine anxiolytics and SSRI antidepressants. Very recently, we developed another delta agonist NC-2800 with a different structure. NC-2800 is now in the preclinical stage using the CiCLE fund supported by AMED (Japanese Agency for Medical Research and Development).

Copyright © 2019 Elsevier Inc. All rights reserved.

KEYWORDS:
Antidepressant; Anxiolytic; KNT-127; SNC80; TAN-67; δ-opioid agonists

PMID: 31654658 DOI: 10.1016/j.pharmthera.2019.107427
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Select item 31654653
39.
Pharmacol Biochem Behav. 2019 Oct 22:172794. doi: 10.1016/j.pbb.2019.172794. [Epub ahead of print]
TAK-925, an orexin 2 receptor-selective agonist, shows robust wake-promoting effects in mice.
Yukitake H1, Fujimoto T1, Ishikawa T1, Suzuki A1, Shimizu Y1, Rikimaru K1, Ito M1, Suzuki M1, Kimura H2.
Author information
1
Neuroscience Drug Discovery Unit, Research, Takeda Pharmaceutical Company Limited, Fujisawa, Japan.
2
Neuroscience Drug Discovery Unit, Research, Takeda Pharmaceutical Company Limited, Fujisawa, Japan. Electronic address: haruhide.kimura@takeda.com.
Abstract
Orexin-producing neurons in the lateral hypothalamus are a critical regulator of sleep/wake states, and their loss is associated with narcolepsy type 1 (NT1). Orexin peptides act on two G protein-coupled receptors: orexin 1 receptor (OX1R) and orexin 2 receptor (OX2R). OX2R knockout (KO) mice, but not OX1R KO mice, showed clear narcolepsy-like phenotypes, including fragmented sleep-wake cycles. Moreover, OX2R selective antagonists have been shown to induce sleepiness in mice, and activation of OX2R has been reported to increase wakefulness. In this study, we characterized in vitro and in vivo profiles of a novel highly selective OX2R agonist, TAK-925 [methyl (2R,3S)-3-[(methylsulfonyl)amino]-2-{[(cis-4-phenylcyclohexyl)oxy]methyl}piperidine-1-carboxylate]. TAK-925 activated human recombinant OX2R with 50% effective concentration value of 5.5 nM, and showed >5000-fold selectivity over OX1R in calcium mobilization assays. TAK-925 induced OX2R-downstream signals similar to those displayed by orexin peptides in Chinese hamster ovary cells stably expressing human OX2R. In an electrophysiological study, TAK-925 activated physiological OX2R on histaminergic neurons in the mouse tuberomammillary nucleus (TMN). Subcutaneous (SC) administration of TAK-925 also modulated neuronal activity in various brain regions, including TMN, as measured by an immunohistochemical analysis using an anti-c-fos antibody. TAK-925 (SC) increased wakefulness in wild-type mice, but not in OX2R KO mice, during their sleep phase, demonstrating that a highly selective OX2R agonist can increase wakefulness in mice via OX2R activation. TAK-925 may have therapeutic potential to reduce hypersomnia in multiple disorders including NT1.

Copyright © 2019. Published by Elsevier Inc.

KEYWORDS:
Hypersomnia; Narcolepsy; Orexin; Orexin 2 receptor; Orexin 2 receptor agonist; TAK-925

PMID: 31654653 DOI: 10.1016/j.pbb.2019.172794
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Select item 31654575
40.
Psychooncology. 2019 Oct 26. doi: 10.1002/pon.5242. [Epub ahead of print]
A call to action for expanded sleep research in pediatric oncology: A position paper on behalf of the International Psycho-Oncology Society Pediatrics Special Interest Group.
Daniel LC1, van Litsenburg RRL2, Rogers VE3, Zhou ES4, Ellis SJ5,6, Wakefield CE5,6, Stremler R7, Walter L8, Crabtree VM9; International Psycho-Oncology Society Pediatrics Special Interest Group.
Author information
1
Rutgers University Camden, NJ.
2
Princess Máxima Center for Pediatric Oncology Utrecht and Amsterdam UMC, VU University Medical Center Amsterdam, Netherlands.
3
University of Maryland Baltimore School of Nursing, MD.
4
Dana-Farber Cancer Institute, Harvard Medical School, MA.
5
School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia.
6
Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia.
7
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, and The Hospital for Sick Children, Toronto, ON, CA.
8
The Ritchie Centre, Hudson Institute of Medical Research and the Department of Paediatrics, Monash University, Melbourne, VIC, Australia.
9
St. Jude Children's Research Hospital, Memphis, TN.
Abstract
Sleep and circadian rhythms are closely related to physical and psychosocial well-being. However, sleep and circadian rhythm disruptions are often overlooked in children with cancer, as they are frequently considered temporary side effects of therapy that resolve when treatment ends. Yet, evidence from adult oncology suggests a bidirectional relationship wherein cancer and its treatment disrupt sleep and circadian rhythms, which are associated with negative health outcomes such as poor immune functioning and lower survival rates. A growing body of research demonstrates that sleep problems are prevalent among children with cancer and can persist into survivorship. However, medical and psychosocial outcomes of poor sleep and circadian rhythmicity have not been explored in this context. It is essential to increase our understanding because sleep and circadian rhythms are vital components of health and quality of life. In children without cancer, sleep and circadian disturbances respond well to intervention, suggesting that they may also be modifiable in children with cancer. We present this paper as a call to: 1) Incorporate sleep/circadian rhythm assessment into pediatric cancer clinical trials; 2) Address gaps in understanding the bidirectional relationship between sleep/circadian rhythms and health throughout the cancer trajectory; and 3) Integrate sleep and circadian science into oncologic treatment.

This article is protected by copyright. All rights reserved.

KEYWORDS:
circadian rhythms; pediatric cancer; sleep; sleep disorders. actigraphy

PMID: 31654575 DOI: 10.1002/pon.5242