Genetic factors underlying insomnia and ovarian insufficiency.

Premature ovarian insufficiency (POI) is characterized by a loss of regular hormone production and egg release in women below the age of 40 years, which often leads to infertility, vaginal dryness and dysfunctional sleep. Acknowledging the common co-occurrence of insomnia and POI, we tested the overlap between POI and insomnia-associated genes, which were implicated in previous large-scale populational genetics efforts. Among the 27 overlapping genes, three pathways were found as enriched: DNA replication, homologous recombination and Fanconi anemia. We then describe biological mechanisms, which link these pathways to a dysfunctional regulation and response to oxidative stress. We propose that oxidative stress may correspond to one of the convergent cellular processes between ovarian malfunction and insomnia pathogenic etiology. This overlap might also be driven by cortisol release associated with dysregulated DNA repair mechanisms. Benefiting from the enormous advances in populational genetics studies, this study provides a novel outlook on the relationship between insomnia and POI. The shared genetic factors and critical biological nodes between these two comorbidities may lead to identification of putative pharmacological and therapeutical targets, which can leverage novel approaches to treat or alleviate their symptoms.

Sleep bruxism and its associations with insomnia and OSA in the general population of Sao Paulo.

Sleep bruxism (SB) is characterized by recurrent masticatory muscle activity during sleep with occasional tooth grinding. SB can be concomitant with sleep apnea although its association with insomnia is understudied. STUDY OBJECTIVE: Assess the strength of the associations between SB, insomnia and sleep apnea in a general population. METHODS: Data from the 2007 EPISONO general population study (n = 1042; Sao Paulo, Brazil) were reused for the present analyses. The data was collected from polysomnography (PSG) and from a questionnaire. SB could only be assessed as "possible" with self-report questionnaires, but as "definitive" with both self-reports and PSG. Logistic regression and decision tree analyses were performed. RESULTS: Logistic regression analyses revealed that being male, overweight, obese, having an apnea/hypopnea index (AHI) above 30 and insomnia syndrome are among risk factors for SB (prevalence ratio (PR): 1.5-3.3). A high AHI and insomnia syndrome had similar PRs, 2.7 and 2.8, respectively. Decision tree analysis showed that insomnia syndrome contributed to the predictive accuracy of SB self-report (88%). A similar estimate (91%) was observed with SB PSG data. Correspondence analysis illustrated three age profiles in participants: (1) good sleepers aged 20-35 years, (2) females aged 35-50 years with SB and concomitant insomnia syndrome, and (3) participants aged ≥ 50 years with obesity and sleep apnea. CONCLUSIONS: Insomnia is likely a condition associated with SB, especially in middle-age females, while sleep apnea seems age and gender dependent. Such overlap may influence the treatment decision to achieve best outcomes. CLINICAL TRIAL REGISTRATION: EPISONO study; Clinical trials.gov ID # NCT00596713.

Sleep-wake cycle of elite athletes prior to the Rio 2016 Olympic Games / Ciclo de vigilia-sueño de atletas de élite antes de los Juegos Olímpicos de Río 2016 / Ciclo de vigília-sono de atletas de elite antes dos Jogos Olímpicos Rio 2016

OBJECTIVE: To analyze chronotype, duration and quality of sleep among elite athletes, to compare differences in sleep variables between sex, and to compare differences between athletes of individual and team sports. METHOD: The sample included 70 Brazilian elite athletes of both sex (male=37; female=33) with a mean age 23.0 ± 4.0 years old. To measure sleep-wake cycle, athletes wore an actigraph on the wrist for 10 days. Moreover, athletes answered the chronotype questionnaire of Horne and Östberg. RESULTS: The most athletes are intermediate-type (n=55, 78.6%), with a mean of 07h:18min of sleep per night. The athletes demonstrated higher sleep fragmentation (39.26 ± 23.66 minutes) and higher sleep latency (30.88 ± 16.19 minutes) during pre-competition training days. Additionally, the athletes of individual sports demonstrated more fragmentation (p < 0.001) and less sleep efficiency (p < 0.001) compared athletes of team sports. However, there was no significant difference in all sleep variables between the male and female sex. CONCLUSION: The overall elite athletes presented poor sleep quality during the training periods prior to the Rio 2016 Olympic Games, and individual athletes showed higher fragmentation and poorer sleep efficiency compared to team athletes

OBJETIVO: Analizar el cronotipo, la duración y la calidad del sueño entre los atletas de élite, comparar las diferencias en las variables de sueño entre los sexos y comparar las diferencias entre los atletas de los deportes individuales y de equipo. MÉTODO: La muestra incluyó a 70 atletas de élite brasileños de ambos sexos (hombre = 37; mujer = 33) con una edad media de 23.0 ± 4.0 años. Para medir lo ciclo de vigilia-sueño, los atletas usaron un actígrafo en la muñeca durante 10 días. Además, los atletas respondieron el cuestionario cronotipo de Horne y Östberg. RESULTADOS: La mayoría de los atletas son de tipo intermedio (n = 55, 78.6%), con una media de 07h: 18min de sueño por noche. Los atletas demostraron una mayor fragmentación del sueño (39.26 ± 23.66 minutos) y una mayor latencia del sueño (30.88 ± 16.19 minutos) durante los días de entrenamiento previo a la competencia. Además, los atletas de deportes individuales demostraron más fragmentación (p <0.001) y menos eficiencia del sueño (p <0.001) en comparación con los atletas de deportes de equipo. Sin embargo, no hubo diferencias significativas en todas las variables de sueño entre el sexo masculino y el femenino. CONCLUSIÓN: Los atletas de élite en general presentaron mala calidad del sueño durante los períodos de entrenamiento previos a los Juegos Olímpicos de Río 2016, y los atletas individuales mostraron una mayor fragmentación y una menor eficiencia del sueño en comparación con los atletas del equipo

OBJETIVO: Analisar o cronotipo, a duração e a qualidade do sono de atletas de elite, comparar as diferenças nas variáveis do sono entre os sexos e as diferenças entre atletas de esportes individuais e coletivos. MÉTODO: A amostra incluiu 70 atletas de elite brasileiros de ambos os sexos (masculino = 37; feminino = 33) com idade média de 23.0 ± 4.0 anos. Para mensurar o ciclo vigília-sono, os atletas usaram um actígrafo no punho por 10 dias. Além disso, os atletas responderam ao questionário de cronotipo de Horne e Östberg. RESULTADOS: A maioria dos atletas é do tipo intermediário (n = 55, 78.6%), com média de 07h:18min de sono por noite. Os atletas demonstraram maior fragmentação do sono (39.26 ± 23.66 minutos) e maior latência do sono (30.88 ± 16.19 minutos) durante os dias de treinamento pré-competição. Além disso, os atletas de esportes individuais demonstraram maior fragmentação (p <0.001) e menor eficiência do sono (p <0.001) em comparação aos atletas de esportes coletivos. No entanto, não houve diferença significativa em todas as variáveis de sono entre os sexos masculino e feminino. CONCLUSÃO: Os atletas de elite em geral apresentaram baixa qualidade do sono durante os períodos de treinamento antes dos Jogos Olímpicos Rio 2016, e os atletas de esportes individuais apresentaram maior fragmentação e menor eficiência do sono em comparação aos atletas de esportivos coletivos

Sleep disturbance and atopic dermatitis: A bidirectional relationship?

Atopic dermatitis (AD) is one of the most common pediatric dermatologic disorders and is associated with an increased risk of recurrent bacterial and viral cutaneous infections, such as impetigo, the most common bacterial infection in children. AD may impair patient quality of life in a number of ways, one of which is its impact on sleep. The way that the condition affects sleep has not yet been fully elucidated; it is clear that the symptoms of the disease such as pruritus and scratching can affect sleep but other factors, such as changes in the immunological system related to the disease can also have an effect. We argue that this relationship may be bi-directional, with changes to the skin barrier (barrier dysfunction, alterations in its microbiome and oxidative stress) and immunological function caused by the condition impairing sleep and leading to imbalanced inflammatory pathways that exacerbate AD and other associated conditions such as impetigo. We highlight the need for further studies to investigate this correlation between AD and sleep to make the role of this relationship clearer.

Impact of insomnia on pain in postmenopausal women.

BACKGROUND: Sleep disturbances and pain are assumed to be reciprocally linked. Insomnia and pain are central symptoms of the postmenopausal period and are closely related. Insomnia affects quality of life, increases pain sensitivity, the risk of pain-related disability, and other health problems. OBJECTIVE: To investigate whether insomnia influences aspects of pain (pain intensity and the effect of pain on daily function) in postmenopausal women, and to evaluate the objective sleep pattern of insomniacs with pain. METHODS: Fifty-seven women completed questionnaires about insomnia, climacteric symptoms, and pain. Polysomnography data were collected as well as their medical history. Patients were allocated into three groups: control, subthreshold insomnia, and insomnia. Pain intensity, climacteric symptoms and objective sleep pattern were compared between groups. RESULTS: Postmenopausal women with insomnia had statistically significant higher pain interference in their activities (e.g. relationships with other people, enjoyment of life and sleep) than controls, and had more severe climacteric symptoms. There were no statistically significant differences in pain intensity and objective sleep pattern between groups. CONCLUSIONS: Insomnia status affected climacteric symptoms and pain interference, but not pain intensity in postmenopausal women. Women with insomnia had higher rates of climacteric symptoms than those without insomnia or those with subthreshold insomnia. No changes in objective sleep pattern were found.