Knowledge Structure and Emerging Trends of Mild Cognitive Impairment with Dyssomnias in Recent 20 Years: A Bibliometric Analysis via CiteSpace and VOSviewer.

Background: Mild cognitive impairment (MCI), an intermediate stage between normal aging and dementia, has emerged as a prominent research area in geriatric care due to its heightened propensity for progressing toward dementia. Sleep plays a pivotal role in cognitive function, with dyssomnias not only exacerbating cognitive and affective symptoms associated with neurodegenerative diseases but also contributing to disease progression. Aim: This bibliometric analysis investigates the global research on MCI with dyssomnias over the past two decades, aiming to discern key findings, research domains, and emerging trends in this field. Methods: In this study, a bibliometric analysis was conducted using the search terms "MCI" and "sleep". Data were extracted from the Web of Science Core Collection database, and visualization and collaborative analysis were performed using CiteSpace and VOSviewer. Results: This study encompassed 546 publications from 2003 to 2023. The publication volume and citation rate consistently increased over time. Neurosciences, Clinical Neurology, and Geriatrics Gerontology emerged as the top three research fields. The Journal of Alzheimer's Disease had the highest publication count, while Sleep Medicine received the most citations. USA, China, and Italy led in publication output. Collaborative clusters among authors and institutions were identified, but cooperation between clusters was limited. Active cocited reference clusters included "obstructive sleep apnea", "possible mediating pathways", and "isolated rapid eye movement sleep behaviour disorder". The top frequently mentioned keywords, besides "MCI", were "Alzheimer's disease", "dementia", "risk factor", and "Parkinson's Disease". Notable keyword clusters spanned circadian rhythm, Parkinson's disease, MCI, dementia with Lewy body, subjective cognitive impairment, Lewy body disease, Alzheimer's disease, and dietary patterns. Conclusion: The field of MCI with dyssomnias is rapidly expanding, encompassing a wide range of neurodegenerative disorders and sleep disturbances. Current research endeavors are primarily focused on elucidating the underlying pathogenesis, predicting disease progression, and developing innovative treatment strategies for individuals affected by MCI with dyssomnias.

Sleep Health amongst Patients Attending Adult Neurology Clinic in Abakaliki, Nigeria.

BACKGROUND: Sleep health indicates how well an individual or population sleeps. Good sleep health is characterized by subjective satisfaction, sustained alertness during waking hours, appropriate timing, high efficiency, and adequate duration. Poor sleep health is associated with many short-term and long-term health consequences. There are limited data on the pattern of sleep health in Nigeria. Against this backdrop, we embarked on this study to determine the Pattern of Sleep Health among patients attending the Adult Neurology clinic in a Federal Teaching Hospital, in Abakaliki, Nigeria. METHODS: This is a cross-sectional observational hospital-based study undertaken at the Adult Neurology clinic of the Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria from July to September 2022. RESULTS: Out of the 267 patients recruited for the study, 19% had good sleep health with SATED scores of 8 to 10 while 81% had poor sleep health. The absence of alcohol abuse, cigarette smoking, and neurological diagnosis were statistically associated with poor sleep health with no sex and age predilection. The mean sleep duration was 7.5± 1.5 hours (male = 7.6 hours, female = 7.3 hours, 18- 64 years= 7.4 hours, ≥ 65 years =7.9 hours). Timing of sleep (mean= 0.97) was the least rated while sleep satisfaction (mean= 1.54) was the best-rated sleep dimension. CONCLUSION: Sleep health is very poor amongst patients attending the adult Neurology clinic at Abakaliki Nigeria and it is associated with smoking, absence of alcohol abuse, and neurological diagnosis. CONTEXTE: La santé du sommeil indique à quel point un individu ou une population dort. Une bonne santé du sommeil se caractérise par une satisfaction subjective, une vigilance soutenue pendant les heures d'éveil, un timing approprié, une efficacité élevée et une durée adéquate. Une mauvaise santé du sommeil est associée à de nombreuses conséquences sanitaires à court et à long terme. Il existe des données limitées sur le schéma de santé du sommeil au Nigéria. Dans ce contexte, nous avons entrepris cette étude pour déterminer le schéma de santé du sommeil parmi les patients fréquentant la clinique de neurologie pour adultes dans un hôpital d'enseignement fédéral à Abakaliki, Nigeria. MÉTHODES: Il s'agissait d'une étude observationnelle transversale réalisée à la clinique de neurologie pour adultes de l'hôpital universitaire fédéral Alex Ekwueme àAbakaliki, Nigeria, de juillet à septembre 2022. RÉSULTATS: Sur les 267 patients recrutés pour l'étude, 19 % avaient une bonne santé du sommeil avec des scores SATED de 8 à 10, tandis que 81 % avaient une mauvaise santé du sommeil. L'absence d'abus d'alcool, de tabagisme et de diagnostic neurologique était statistiquement associée à une mauvaise santé du sommeil, sans prédilection pour le sexe et l'âge. La durée moyenne du sommeil était de 7,5 ± 1,5 heures (homme = 7,6 heures, femme = 7,3 heures, 18-64 ans = 7,4 heures, ≥ 65 ans = 7,9 heures). Le timing du sommeil (moyenne = 0,97) était la dimension la moins bien notée, tandis que la satisfaction du sommeil (moyenne = 1,54) était la dimension la mieux notée. CONCLUSION: La santé du sommeil est très mauvaise chez les patients fréquentant la clinique de neurologie pour adultes à Abakaliki, au Nigéria, et elle est associée au tabagisme, à l'absence d'abus d'alcool et au diagnostic neurologique. Mots-clés: :Santé du sommeil, Clinique de neurologie,Abakaliki, Nigeria.

Dietary amino acid intake and sleep duration are additively involved in future cognitive decline in Japanese adults aged 60 years or over: a community-based longitudinal study.

BACKGROUND: Sleep duration and amino acid intake are independently associated with cognitive decline. This study aimed to determine the longitudinal association between sleep duration and cognitive impairment incidence and to examine the involvement of diet, particularly amino acid intake, in these associations in community dwellers. METHODS: In this longitudinal study in a community-based setting, we analyzed data from 623 adults aged 60-83 years without cognitive impairment at baseline. Sleep duration was assessed using a self-report questionnaire. Amino acid intake was assessed using 3-day dietary records. Cognitive impairment was defined as a Mini-Mental State Examination score ≤ 27. Participants were classified into short-, moderate-, and long-sleep groups according to baseline sleep duration (≤ 6, 7-8, and > 8 h, respectively). Using moderate sleep as a reference, odds ratios (ORs) and 95% confidence intervals (CIs) of short- and long-sleep for cognitive-impairment incidence were estimated using the generalized estimating equation. Participants were classified according to sex-stratified quartiles (Q) of 19 amino acid intake: Q1 and Q2-Q4 were low- and middle to high-intake groups, respectively. Using middle- to high-intake as a reference, ORs and 95% CIs of low intake for cognitive impairment incidence were estimated using the generalized estimating equation in each sleep-duration group. Follow-up period, sex, age, body mass index, depressive symptoms, education, smoking status, employment status, sleep aids use, physical activity, medical history, and Mini-Mental State Examination score at baseline were covariates. RESULTS: Mean follow-up period was 6.9 ± 2.1 years. Adjusted ORs (95% CIs) for cognitive impairment in short- and long-sleep groups were 0.81 (0.49-1.35, P = 0.423) and 1.41 (1.05-1.87, P = 0.020), respectively. Particularly in long sleepers (i.e., > 8 h), cognitive impairment was significantly associated with low cystine, proline, and serine intake [adjusted ORs (95% CIs) for cognitive impairment were 2.17 (1.15-4.11, P = 0.017), 1.86 (1.07-3.23, P = 0.027), and 2.21 (1.14-4.29, P = 0.019), respectively]. CONCLUSIONS: Community-dwelling adults aged ≥ 60 years who sleep longer are more likely to have cognitive decline, and attention should be paid to the low cystine, proline, and serine intake.

Prevalence of central sleep apnea in people with tetraplegic spinal cord injury: a retrospective analysis of research and clinical data.

STUDY OBJECTIVES: Over 80% of people with tetraplegia have sleep-disordered breathing (SDB), but whether this is predominantly obstructive or central is unclear. This study aimed to estimate the prevalence of central sleep apnea (CSA) in tetraplegia and the contributions of central, obstructive, and hypopnea respiratory events to SDB summary indices in tetraplegia. METHODS: Research and clinical data from 606 individuals with tetraplegia and full overnight polysomnography were collated. The proportions of different respiratory event types were calculated; overall and for mild, moderate, and severe disease. The prevalence of Predominant CSA (Central Apnea Index [CAI] ≥ 5 and more central than obstructive apneas) and Any CSA (CAI ≥ 5) was estimated. Prevalence of sleep-related hypoventilation (SRH) was estimated in a clinical sub-cohort. RESULTS: Respiratory events were primarily hypopneas (71%), followed by obstructive (23%), central (4%), and mixed apneas (2%). As severity increased, the relative contribution of hypopneas and central apneas decreased, while that of obstructive apneas increased. The prevalence of Predominant CSA and Any CSA were 4.3% (26/606) and 8.4% (51/606) respectively. Being male, on opiates and having a high tetraplegic spinal cord injury were associated with CSA. SRH was identified in 26% (26/113) of the clinical sub-cohort. CONCLUSIONS: This is the largest study to characterize SDB in tetraplegia. It provides strong evidence that obstructive sleep apnea is the predominant SDB type; 9-18 times more prevalent than CSA. The prevalence of CSA was estimated to be 4%-8%, significantly lower than previously reported.

The association between long-term exposure to outdoor artificial light at night and poor sleep quality among Chinese veterans: A multi-city study.

BACKGROUND: A handful of previous studies have reported the association between exposure to outdoor artificial light at night (ALAN) and sleep problems. However, evidence for such association is limited in low- and middle-income countries. This study aimed to examine the association between outdoor ALAN exposure and sleep quality in veterans across different regions of China. METHODS: Within the network of the Chinese Veteran Clinical Research Platform, we selected 7258 participants from 277 veteran communities in 18 cities across China during December 2009 and December 2011, using a multi-stage stratified cluster sampling strategy. Face-to-face interviews with the participants were conducted by trained investigators. We used the Pittsburgh Sleep Quality Index (PSQI) to assess participants' sleep quality. We defined poor sleep quality as a PSQI global score >7. The 3-year average exposure to outdoor ALAN prior to the baseline interview was calculated using satellite imagery data, according to participants' geolocation information. The association of ALAN exposure with sleep quality was examined using the mixed-effects logistic regression models with natural cubic splines. RESULTS: The exposure-response curve for sleep quality associated with ALAN exposure was nonlinear, with a threshold value of 49.20 nW/cm2/sr for the 3-year average exposure to outdoor ALAN prior to the baseline interview. Higher ALAN exposure above the threshold was associated with increased risk of poor sleep quality. After adjusting for potential confounders, the odds ratios (and 95%CI, 95% confidence intervals) were 1.15 (0.97, 1.36) and 1.45 (1.17, 1.78) at the 75th and 95th percentiles of ALAN against the threshold. The association of ALAN exposure with poor sleep quality was more pronounced in veterans with depression than those without. Higher OR of poor sleep quality at the 75th percentile of ALAN against the threshold was observed in veterans with depression than those without [2.09 (1.16, 3.76) vs. 1.09 (0.92, 1.30)]. CONCLUSIONS: Long-term exposure to outdoor ALAN was associated with higher risk of poor sleep quality in Chinese veterans. Effective outdoor ALAN management may help to reduce the burden of sleep disorders in Chinese veterans.

Does ethnic-racial socialization matter? A within-person analysis of racial discrimination and sleep health among Black and Latinx emerging adults.

OBJECTIVES: Emerging work suggests that racism-related stressors may contribute to adverse sleep health, yet little is known about how culturally relevant resources may influence the relationship between racism-related stressors and adverse sleep health. The aim of this study was to examine associations between weekly reports of racial hassles and young adults' sleep health (i.e., sleep onset latency, total sleep time, sleep quality) and to determine whether various forms of parental ethnic-racial socialization would moderate these associations. METHODS: Participants were 141 college students (Mage = 20.7 years, standard deviation (SD) = 1.22, 70% female) who identified as either Black (n = 88; 62.4%) or Latinx (n = 53; 37.6%). Participants completed an initial 1.5-hour assessment in the laboratory and 4 weekly sleep diary surveys (assessed sleep health and depressive symptoms). RESULTS: Weekly racial hassles are related to greater sleep onset latency, decreased total sleep time, and poorer sleep quality. The promotion of mistrust and cultural socialization significantly moderated associations between weekly racial hassles and sleep onset latency and total sleep time, respectively. CONCLUSIONS: These results provide supportive evidence that parental ethnic-racial socialization practices, a preemptive cultural resource, may be an understudied mechanism in sleep health research. Future research is needed to clarify the role of parental ethnic-racial socialization in promoting sleep health equity among youth and young adults.

Sleep disturbance and anxiety symptoms among asymptomatic COVID-19 carriers in Shanghai, China: the mediating role of entrapment and defeat.

BACKGROUND: The COVID-19 pandemic increases the risk of psychological problems, especially for the infected population. Sleep disturbance and feelings of defeat and entrapment are well-documented risk factors of anxiety symptoms. Exploring the psychological mechanism of the development of anxiety symptoms is essential for effective prevention. This study aimed to examine the mediating effects of entrapment and defeat in the association between sleep disturbance and anxiety symptoms among asymptomatic COVID-19 carriers in Shanghai, China. METHODS: A cross-sectional study was conducted from March to April, 2022. Participants were 1,283 asymptomatic COVID-19 carriers enrolled from the Ruijin Jiahe Fangcang Shelter Hospital, Shanghai (59.6% male; mean age = 39.6 years). Questionnaire measures of sleep disturbance, entrapment, defeat, anxiety symptoms, and background characteristics were obtained. A mediation model was constructed to test the mediating effects of entrapment and defeat in the association between sleep disturbance and anxiety symptoms. RESULTS: The prevalence rates of sleep disturbance and anxiety symptoms were 34.3% and 18.8%. Sleep disturbance was positively associated with anxiety symptoms (OR [95%CI] = 5.013 [3.721-6.753]). The relationship between sleep disturbance and anxiety symptoms (total effect: Std. Estimate = 0.509) was partially mediated by entrapment (indirect effect: Std. Estimate = 0.129) and defeat (indirect effect: Std. Estimate = 0.126). The mediating effect of entrapment and defeat accounted for 50.3% of the association between sleep disturbance and anxiety symptoms. CONCLUSION: Sleep disturbance and anxiety symptoms were prevalent among asymptomatic COVID-19 carriers. Entrapment and defeat mediate the association between sleep disturbance and anxiety symptoms. More attention is needed to monitoring sleep conditions and feelings of defeat and entrapment to reduce the risk of anxiety.

Sleep-related problems as a mediator in the association between depression and work-family conflict in middle-aged female workers: A population-based study.

AIM: To investigate the mediating effect of sleep-related problems on the relationship between depression and work-family conflicts (WFCs) among middle-aged female workers. DESIGN: Secondary analysis of cross-sectional study. METHODS: Overall, 15,718 female workers aged 40-65 years from the Sixth Korean Working Conditions Survey (KWCS) were included. Depression was assessed using the WHO-5 wellbeing index; sleep-related problems and WFCs were measured with five items on a Likert scale. The mediating effect of sleep-related problems between depression and WFCs was analysed using model 4 of Hayes PROCESS macro for SPSS. RESULTS: There was a significant positive correlation between depression and both sleep-related problems (r = 0.225, p < 0.001) and WFCs (r = 0.124, p < 0.001). Depression also had a significant effect on sleep-related problems (ß = 0.221, p < 0.001) and WFCs (ß=0.061, p < 0.001). Sleep-related problems had a significant effect on WFCs (ß = 0.282, p < 0.001). The indirect effect of depression on WFCs by mediating sleep-related problems was ß = 0.062 (95% bootstrap confidence interval = 0.057-0.068). The study also confirmed the significance of the mediating effect of sleep-related problems in the relationship between depression and WFCs.

Effect of house dust mite allergen on sleep parameters and sleep quality.

PURPOSE: The role of nasal problems such as allergic rhinitis in the development of obstructive sleep apnea (OSA) is controversial. The purpose of this study was to analyze the effects of house dust mite (HDM) allergen on sleep-related problems. METHODS: In a retrospective study patients were classified according to the house dust mite (HDM)-related specific immunoglobulin E (IgE) level into a low HDM-IgE group (group A) and a high HDM-IgE group (group B). Polysomnographic indices, OSA severity, and self-administered questionnaire results were compared between groups. Correlational analysis was used to identify associations between specific IgE values and sleep parameters related to respiratory events. RESULTS: A total of 327 patients were enrolled. N1 stage ratio, apnea index, and apnea-hypopnea index were significantly higher in group B (P = 0.010, 0.003, and 0.002 respectively) than in group A. N2 stage ratio, and lowest and mean oxygen saturation were significantly lower in group B (P = 0.001, 0.001, and < 0.001 respectively). After propensity score matching, the apnea index and lowest and mean oxygen saturation remained significantly different (P = 0.005, 0.005, and 0.001 respectively). Patients in group B were more likely to have severe OSA and worse subjective sleep quality. In correlational analysis, lowest and mean oxygen saturation were significantly negatively correlated with specific IgE values. CONCLUSION: A high HDM-specific IgE level was associated with the occurrence of respiratory events and oxygen desaturation during sleep, and with the presence of severe OSA, as well as poorer subjective sleep quality.

Association of job stress, FK506 binding protein 51 (FKBP5) gene polymorphisms and their interaction with sleep disturbance.

Background: Sleep disturbance is an outcome of multiple factors including environmental and genetic influences. Job stress, a complex environmental factor, likely affects sleep quality, significantly reducing the quality of life of workers. Additionally, FK506 binding protein 51 (FKBP5) may be a pathogenic factor for sleep disturbance as it regulates hypothalamic-pituitary-adrenal (HPA) axis activity, where HPA axis has been found to be involved in the regulation mechanism of sleep and stress response. Objectives: The main aim of this study was to investigate the association between job stress and FKBP5 gene polymorphism as well as their interaction with sleep disturbance in Chinese workers; to date, these relationships have not been explored. Methods: This is a cross-sectional study. A total of 675 railway workers (53.8% male) completed a short Effort-Reward Imbalance questionnaire and the Pittsburgh Sleep Quality Index. The SNaPshot single nucleotide polymorphism (SNP) assay was carried out by screening for FKBP5 SNPs in every participant. Generalized multifactor dimensionality reduction (GMDR) was used to identify the strongest G×E interaction combination. Results: The findings showed that job stress was significantly associated with sleep disturbance; specifically, scores on the PSQI subscales (sleep disturbance, sleep medication, and daytime dysfunction) exhibited significant differences between the two job stress groups (X2 = 18.10, p = 0.01). Additionally, the FKBP5 SNP rs1360780-TT (adjusted odds ratio [AOR] = 4.98, 95% confidence interval [CI] = 2.80-8.84) and rs3800373-CC genotype (AOR = 2.06, CI = 1.10-3.86) were associated with an increased risk of sleep disturbance. Job stress and rs1360780 and rs3800373 variants showed a high-dimensional interaction with sleep disturbance as determined by the GMDR model. Conclusion: The FKBP5 gene may increase susceptibility to job stress and result in sleep disturbance, especially in the presence of negative work-related events. These findings contribute to the field of sleep disturbance prevention and treatment.

Animal models of human insomnia.

Insomnia disorder (chronic sleep continuity disturbance) is a debilitating condition affecting 5%-10% of the adult population worldwide. To date, researchers have attempted to model insomnia in animals through breeding strategies that create pathologically short-sleeping individuals or with drugs and environmental contexts that directly impose sleeplessness. While these approaches have been invaluable for identifying insomnia susceptibility genes and mapping the neural networks that underpin sleep-wake regulation, they fail to capture concurrently several of the core clinical diagnostic features of insomnia disorder in humans, where sleep continuity disturbance is self-perpetuating, occurs despite adequate sleep opportunity, and is often not accompanied by significant changes in sleep duration or architecture. In the present review, we discuss these issues and then outline ways animal models can be used to develop approaches that are more ecologically valid in their recapitulation of chronic insomnia's natural aetiology and pathophysiology. Conditioning of self-generated sleep loss with these methods promises to create a better understanding of the neuroadaptations that maintain insomnia, including potentially within the infralimbic cortex, a substrate at the crossroads of threat habituation and sleep.

Longitudinal Sleep Study in Pregnancy: Cohort Profile and Prevalence and Risk Factors for Sleep Symptoms in the First Trimester.

Sleep disorders could influence pregnancy outcomes but evidence for longitudinal associations is scarce. We established a prospective cohort of women to determine incident sleep issues and their adverse health outcomes during pregnancy and beyond, and present here the baseline cohort profile. Antenatal women in gestational weeks 8-12 were recruited (n = 535) and followed-up in each trimester and at 5-6 weeks postpartum (no attrition). Sleep symptoms and disorders were measured using STOP-Bang and Berlin questionnaires and Pittsburgh Sleep Quality Index. Incident health outcomes were extracted from clinical records. At the time of recruitment, habitual snoring was present in 13.8% of participants; "excessive sleepiness during the day" (EDS) in 42.8%; short (<7 h) sleep duration in 46.4%; "having trouble sleeping" in 15.3%; and "poor subjective sleep quality" in 8.6%. Habitual snoring was strongly associated with irregular menstrual periods for one year preceding pregnancy (p = 0.014) and higher BMI (p < 0.001). Higher age was associated with less "trouble sleeping" (OR 0.9, p = 0.033) and longer sleep duration was associated with better "subjective sleep quality" (OR 0.8, p = 0.005). Sleep issues were highly prevalent at baseline and associated with age, irregular menstruation, and obesity. This cohort will provide a robust platform to investigate incident sleep disorders during pregnancy and their effects on adverse pregnancy outcomes and long-term health of women and their offspring.

Racial and Ethnic Trajectories of Sleep Disturbances: Variations by Age and Cohort.

BACKGROUND: The racial and ethnic differences in trajectories of sleep disturbances in later life are crucial for addressing health disparities, but are not well understood. This study examines (a) how trajectories of sleep disturbances vary by race and ethnicity and birth cohort and (b) whether social and health risk factors explain such variations. METHODS: The study uses longitudinal data from the 2002-2018 Health and Retirement Study (N = 21 963) and the multilevel growth curve model to assess trajectories of sleep disturbances and their variations across 6 cohorts of White, Black, and Hispanic older adults. Sleep disturbances are measured using a modified Jenkins Sleep Scale. RESULTS: Without controls, sleep disturbances increased with aging for all racial and ethnic groups, but more rapidly among minorities, particularly younger cohorts of Hispanic older adults. When controlling for social and health risks, sleep disturbances did not change with aging for Whites and Blacks and increased for younger cohorts of Hispanics. Cohort effects were observed among White older adults, with higher sleep disturbances in younger cohorts. Importantly, the racial and ethnic disparities in age and cohort effects were not fully explained by social and health risks. Of the symptoms, the most salient racial and ethnic disparities were found in "waking up at night" and "not feeling rested." CONCLUSIONS: Findings reveal several differences by race and ethnicity and birth cohort in trajectories of sleep disturbances. Efforts should be made to improve sleep health for older adults as they age, especially for younger cohorts of Blacks and Hispanics.

Translation, Cross-Cultural Adaptation and Preliminary Validation of a French Version of the Trauma-Related Nightmare Survey (TRNS-FR) in a PTSD Veteran Population.

INTRODUCTION: In the military population, trauma-related nightmares (TRNs) are highly associated with deployments and combat-related events. Trauma-related nightmares are also correlated with severity, treatment resistance, and chronicity of Post-Traumatic Stress Disorder (PTSD). However, to date, no specific measure of TRNs has been validated for use in the French language. This study aimed to translate and culturally adapt the English version of the Trauma-Related Nightmare Survey into French and to evaluate the psychometric properties of the translation on veterans. MATERIALS AND METHODS: After the translation and cultural adaptation process, we evaluated the reliability and validity of the French version of the questionnaire (TRNS-FR) in a population of veterans suffering from PTSD with nightmare complaints (n = 56 patients for test-retest and n = 60 for internal consistency), recruited from five French military hospitals. RESULTS: Analyses demonstrated that TRNS-FR has good test-retest reliability (r = 0.59) and good internal consistency with PTSD symptoms, insomnia symptoms, and subjective sleep parameters assessed at home. This questionnaire provides a rapid and comprehensive assessment of sleep disturbance and a specific description of TRNs in the population of veterans with severe PTSD. Our results allowed us to propose a valid and reliable French adaptation of the questionnaire. CONCLUSION: Because sleep disturbances and TRNs require specific therapeutic management, the psychometric qualities of TRNS-FR make it a tool of choice for assessing TRNs in future clinical research settings.

The impact of stress and lifestyle factors on short-term sickness absence in a large Danish industrial company.

Objectives: Work-related stress and certain lifestyles have been associated with sickness absence among employees. We analysed relations between stress and lifestyles (as risk factors) and short-term sickness absence among employees of a large Danish industrial company. Moreover, we analysed the impact of risk factors on short-term sickness absence. Methods: A self-administered questionnaire was completed by 7753 employees (67% response rate). Relations between risk factors (dyssomnia, low physical activity, alcohol, smoking, unhealthy food habits, overweight and stress) and short-term sickness absence were analysed by calculating etiologic fractions and binary logistic regression. Relations between the number of risk factors and short-term sickness absence were also analysed. Finally, the cost of short-term sickness absence from risk factors was estimated to illustrate the potential savings in avoided loss of productivity that could be gained from intervention programmes. Results: Stress, overweight, smoking and dyssomnia are significantly related to short-term sickness absence. Etiologic fractions revealed that these factors were associated with between 29.8% and 37.8% of short-term sickness absence. The number of risk factors was also related to the risk and length of sickness absence. Conclusions: This study identified risk factors that could be addressed by intervention programmes to reduce short-term sickness absence. Based on the results, focus on the risk factors that account for most short-term sickness absence and reduction of the number of risk factors could potentially reduce short-term sickness absence. A 30% reduction is equivalent to an avoidance of a loss of productivity of 4.5%, corresponding to €9.4 million per year.

Longitudinal associations between parent, child, family factors and dyssomnias in children from birth to 8 years: The CIKEO study.

BACKGROUND: Dyssomnias, are the most common parent-reported sleep complaints in young children. The present study investigated the prevalence, one-year development (incidence and persistence) of dyssomnia in early childhood, and the parent, child, and family factors associated with dyssomnia. METHODS: Longitudinal data of 700 children aged 0-8, gathered in the CIKEO cohort study in the Netherlands were analyzed. Dyssomnias were defined as the presence of night awakenings ≥3 times per night or sleep-onset latency of >30 min. Least absolute shrinkage and selection operator (LASSO) was used to identify the parental, child, and family factors associated with the incidence and persistence of dyssomnias in children. RESULTS: The mean age of the children (47 % girls) was 3.2 ± 1.9 years at baseline and 4.4 ± 1.8 years at follow-up. The prevalence of dyssomnias was 13.3 % and 15.4 % at baseline and follow-up, respectively. The incidence and persistence rates of dyssomnias at follow-up were 12.0 % and 37.6 %, respectively. New incidence of insomnia was associated with being a girl, having medical conditions, experiencing stressful life events, and lower parenting self-efficacy at baseline (P < 0.05). Higher levels of parental psychological distress were associated with the persistence of dyssomnias in children (P < 0.05). CONCLUSIONS: Dyssomnias are common with a moderate persistent rate in young children. Several parental, child, and family factors in relation to the incidence and persistence of dyssomnias were identified. Preventive programs and interventions targeting modifiable factors, particularly parental psychological distress, parenting self-efficacy, and resilience to stressful life events, might benefit child sleep.

Impaired peri-olfactory cerebrospinal fluid clearance is associated with ageing, cognitive decline and dyssomnia.

BACKGROUND: Animal experiments have demonstrated the dependency of cerebrospinal fluid clearance function on age and sleep, which partially underlay the cognitive decline in the elderly. However, human evidence is lacking, which could be mainly attributed to the limited methods of cerebrospinal fluid clearance function assessment. METHOD: Serial T1-weighted and T2-fluid attenuated inversion recovery imaging were performed in 92 patients before and at multiple time points including 4.5 h, 15 h and 39 h after intrathecal injection of contrast agent to visualize the putative meningeal lymphatic pathway, peri-olfactory nerve pathway, and peri-optic nerve pathway. We defined the clearance function as the percentage change in signal unit ratio of critical locations in these pathways from baseline to 39 h after intrathecal injection, and further analysed their relationships with age, sleep, and cognitive function. FINDINGS: Cerebrospinal fluid clearance through the putative meningeal lymphatic and perineural pathways were clearly visualized. The clearance function of putative meningeal lymphatic and perineural pathways were impaired with ageing (all P < 0.05). The clearance function through peri-olfactory nerve pathway in inferior turbinate was positively correlated with sleep quality and cognitive function (both P < 0.05), and mediated the association of sleep quality with cognitive function (percent change in ß [bootstrap 95% CI]: 33% [-0.220, -0.007]). INTERPRETATION: The impaired clearance through putative peri-olfactory nerve pathway may explain the cognitive decline in patients with sleep disturbance. The study shows a promising method to assess cerebrospinal fluid clearance function of putative peri-neural pathways via dynamic magnetic resonance imaging with intrathecal injection of contrast agent. FUNDING: This work was supported by the National Natural Science Foundation of China (81971101, 82171276 and 82101365).