Introduction The onset of the COVID-19 pandemic disrupted and changed sleep as well as elevated stress levels worldwide. Previous research has demonstrated a bidirectional relationship between stress and sleep, in that stress contributes to poorer sleep and poor sleep leads to higher stress. It is hypothesized that perseverative cognition (i.e., worry, racing thoughts) is a key cognitive mechanism in this relationship. The goal of our study was to examine the relationships between stress and sleep during a major global stressor, testing key cognitive and behavioral factors that may influence this relationship. Methods Adults aged 18 and above were recruited to complete a text-message survey twice per day for 3 weeks over a 4-month period. Sleep duration and efficiency during the previous night and evening/overnight perseverative cognition was measured in the morning survey, daily stress levels were measured in the evening survey. Physical activity was measured by the International Physical Activity Questionnaire (IPAQ). Results were analyzed using mixed effects models controlling for age, gender and race/ethnicity. Results Participants included 191 adults (91 F, mean age= 43, SD= 16 years). Results demonstrate that stress ratings were associated with higher sleep duration (p= 0.04) but perseverative cognition was associated with lower sleep duration and efficiency (p values <0.001). Participants who were more physically active had higher sleep duration (p=0.02) and efficiency (p< 0.001). Sleep did not predict next-day stress. Conclusion Results demonstrate that perseverative cognition is a key factor in the daily relationships between stress during the day and sleep at night. Higher physical activity was related to better sleep. These results indicate that interventions to reduce perseverative cognition may improve sleep during times of stress, including reducing the sleep-disrupting effects of the COVID-19 pandemic. Support (If Any) University of Utah i3 COVID-19 pilot grant, UL1TR002538
<div>AbstractPurpose:<p>Chemotherapy for childhood acute lymphoblastic leukemia (ALL) can cause late-appearing side effects in survivors that affect multiple organs, including the heart and brain. However, the complex ALL treatment regimen makes it difficult to isolate the causes of these side effects and impossible to separate the contributions of individual chemotherapy agents by clinical observation. Using a mouse model, we therefore assessed each of eight representative, systemically-administered ALL chemotherapy agents for their impact on postnatal brain development and heart function.</p>Experimental Design:<p>Mice were treated systemically with a single chemotherapy agent at an infant equivalent age, then allowed to age to early adulthood (9 weeks). Cardiac structure and function were assessed using <i>in vivo</i> high-frequency ultrasound, and brain anatomy was assessed using high-resolution volumetric <i>ex vivo</i> MRI. In addition, longitudinal <i>in vivo</i> MRI was used to determine the time course of developmental change after vincristine treatment.</p>Results:<p>Vincristine, doxorubicin, and methotrexate were observed to produce the greatest deficiencies in brain development as determined by volumes measured on MRI, whereas doxorubicin, methotrexate, and l-asparaginase altered heart structure or function. Longitudinal studies of vincristine revealed widespread volume loss immediately following treatment and impaired growth over time in several brain regions.</p>Conclusions:<p>Multiple ALL chemotherapy agents can affect postnatal brain development or heart function. This study provides a ranking of agents based on potential toxicity, and thus highlights a subset likely to cause side effects in early adulthood for further study.</p></div>
<div>AbstractPurpose:<p>Chemotherapy for childhood acute lymphoblastic leukemia (ALL) can cause late-appearing side effects in survivors that affect multiple organs, including the heart and brain. However, the complex ALL treatment regimen makes it difficult to isolate the causes of these side effects and impossible to separate the contributions of individual chemotherapy agents by clinical observation. Using a mouse model, we therefore assessed each of eight representative, systemically-administered ALL chemotherapy agents for their impact on postnatal brain development and heart function.</p>Experimental Design:<p>Mice were treated systemically with a single chemotherapy agent at an infant equivalent age, then allowed to age to early adulthood (9 weeks). Cardiac structure and function were assessed using <i>in vivo</i> high-frequency ultrasound, and brain anatomy was assessed using high-resolution volumetric <i>ex vivo</i> MRI. In addition, longitudinal <i>in vivo</i> MRI was used to determine the time course of developmental change after vincristine treatment.</p>Results:<p>Vincristine, doxorubicin, and methotrexate were observed to produce the greatest deficiencies in brain development as determined by volumes measured on MRI, whereas doxorubicin, methotrexate, and l-asparaginase altered heart structure or function. Longitudinal studies of vincristine revealed widespread volume loss immediately following treatment and impaired growth over time in several brain regions.</p>Conclusions:<p>Multiple ALL chemotherapy agents can affect postnatal brain development or heart function. This study provides a ranking of agents based on potential toxicity, and thus highlights a subset likely to cause side effects in early adulthood for further study.</p></div>
<p>Additional figures and tables</p>
<p>Additional figures and tables</p>
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