lockdown, during which public life came to a standstill and many people experienced increased fl exibility regarding social schedules, led to improved individual sleep-wake timing and overall more sleep. At the same time, however, many people suffered from a decrease in sleep quality in this burdening and exceptional situation. Potential strategies to mitigate the adverse effects of the lockdown on sleep quality may include exposure to natural daylight and exercise.
Human untargeted metabolomics studies annotate only ~10% of molecular features. We introduce reference-data-driven analysis to match metabolomics tandem mass spectrometry (MS/MS) data against metadata-annotated source data as a pseudo-MS/MS reference library. Applying this approach to food source data, we show that it increases MS/MS spectral usage 5.1-fold over conventional structural MS/MS library matches and allows empirical assessment of dietary patterns from untargeted data.Complex sequence data from metagenomic (see Box 1 for definition of terms) or metatranscriptomic experiments require for interpretation both databases of curated genes and reference data, such as whole genomes or other sequence data with carefully curated metadata (developmental stage, tissue location, phenotype, etc.) [1][2][3][4] . Such reference data-driven (RDD) analysis increases understanding of complex communities by using matches between genes or transcripts of known and unknown origin. The RDD strategy is essential for the successful analysis of most metatranscriptomics or metagenomics data. By analogy, interpreting liquid chromatography-tandem mass spectromtery (LC-MS/MS)-based untargeted metabolomics data is performed by searching structural MS/MS libraries. However, leveraging reference data with curated and structured controlled vocabulary metadata to improve insights obtainable from untargeted MS/MS-based metabolomics is not yet done.RDD analysis uses not only annotated MS/MS-spectra but also all unannotated spectra. The gas chromatography-mass spectrometry (GC-MS) BinBase resource has made a step in the direction of RDD. With BinBase one can annotate if a spectrum match has been observed in a non-public GC-MS dataset. However, the metadata is not well controlled and lacks the ability to add contextualized metadata 5,6 . In addition, as we have previously demonstrated, using structural annotations, the source can be determined by literature mining 7 . However, owing to the above mentioned limitations and/ or inability to link related spectra in the case of metabolism, the above strategies to annotate unknowns cannot be used to systematically to interpret the source information at the dataset level. We therefore introduce the RDD approach for metabolomics (Fig. 1), followed by a use case demonstrating empirical food readouts from untargeted human data (Fig. 2).Untargeted MS/MS-based metabolomics experiments involve searching MS/MS structural libraries since the late 1970's 8,9 , or, more recently, for investigating the distribution of a MS/MS spectrum across public untargeted data 10 . Instead of only leveraging a single MS/MS spectrum to obtain an annotation, RDD metabolomics uses all MS/MS spectra from untargeted metabolomics files, which con-
Actigraphy is increasingly used in practice and research studies because of its relative low cost and decreased subject burden. How multiple nights of at-home actigraphy compare to one independent night of in-laboratory polysomnography (PSG) has not been examined in people with insomnia. Using event markers (MARK) to set time in bed (TIB) compared to automatic program analysis (AUTO) has not been systematically evaluated. Subjects (n = 30) meeting DSM-5 criteria for insomnia and in-laboratory PSG sleep efficiency (SE) of <85% were studied. Subjects were free of psychiatric, sleep or circadian disorders, other chronic conditions and medications that effect sleep. Subjects had an in-laboratory PSG, then were sent home for 7 nights with Philips Actiwatch Spectrum Plus. Data were analysed using Philips Actiware version 6. Using the mean of seven nights, TIB, total sleep time (TST), SE, sleep-onset latency (SOL) and wake after sleep onset (WASO) were examined. Compared to PSG, AUTO showed longer TIB and TST and less WASO. MARK only differed from PSG with decreased WASO. Differences between the PSG night and the following night at home were found, with better sleep on the first night home. Actigraphy in people with insomnia over seven nights is a valid indicator of sleep compared to an independent in-laboratory PSG. Event markers increased the validity of actigraphy, showing no difference in TIB, TST, SE and SOL. AUTO was representative of SE and SOL. Increased SE and TST without increased TIB suggests possible compensatory sleep the first at night home after in-laboratory PSG.
Study Objectives: To address the question of how representative subjects studied in hypnotic clinical trials are of the broader insomnia population, this study assessed initial contact rates and reasons for inclusion and exclusion during recruitment to an efficacy trial and to a safety trial of Food & Drug Administration (FDA) approved hypnotics. Methods: Otherwise heathy persons meeting Diagnostic Statistical Manual, Fourth Edition, Revised (DSM-IVR) criteria for insomnia were recruited. In one study, persons 32-65 yrs, were invited to a 12 month trial of nightly use of zolpidem or placebo. In the other persons 21-64 yrs with driver’s licenses were recruited to test the effects of a hypnotic on live on-the-road driving ability. In both studies screening was conducted through an initial telephone interview followed by a clinic visit. Results: In the United States (US) study 13% (n=410) of 3180 initial contacts and in the Netherlands (NL) study 67% (n=53) of the 79 initial contacts proceeded to the clinic visit. Of those at clinic 25% of US and 37% of NL participants failed to meet additional insomnia criteria. Mental health exclusions accounted for 24% of US and 23% of NL participants and medical problems accounted for 23% of US and 9% NL exclusions. Finally 20% of US and 26% of NL participants were excluded for drug use/abuse histories. After all screening 4% of the initial US contacts and 0% of the NL contacts entered the study. Conclusions: These data suggest persons entering insomnia hypnotic clinical trials are a highly selected sample that is unlikely to be representative of the broad insomnia population or the population of potential medication users.
Study Objectives: The chronic pain disorder, fibromyalgia, is associated with sleep disturbance, typically sleep maintenance. No studies have evaluated the effect of sleep medication on pain sensitivity in this population. Suvorexant, an orexin antagonist approved for treatment of insomnia, was evaluated for effects on both sleep and the pain of fibromyalgia. Methods: Women age 21 to 65 years with fibromyalgia and comorbid insomnia (n = 10) were treated, double-blind, for 9 nights each with suvorexant, 20 mg and placebo in counterbalanced order. All were in good psychiatric and stable physical health and met American College of Rheumatology 2010 criteria for fibromyalgia and Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition criteria for insomnia. Screening 8-hour polysomnography (PSG) was used to rule out other sleep disorders. On nights 8 and 9 of each treatment 8-hour PSG were collected and on days 1 and 8 pain sensitivity was assessed at 1100 and 1500 hours by measuring finger withdrawal latency (FWL) to a radiant heat stimulus at 5 randomly presented intensity levels. Results: Suvorexant versus placebo increased total sleep time (7.2 versus 6.7 hours, P <.05) and reduced wake after sleep onset (37 versus 67 minutes, P <.04) with no night effects or interaction. Latency to persistent sleep and sleep stage measures were not altered. FWL on both AM and PM tests varied as a function of intensity (P <.001). Average FWL (over 5 intensities and both days) was increased relative to placebo on both the AM (13.9 versus 13.1 seconds) and PM tests (15.8 versus 14.1 seconds, P < .03) following suvorexant the previous night. Conclusions: Suvorexant 20 mg in patients with fibromyalgia, improved sleep time and reduced next-day pain sensitivity on assessments of FWL to a radiant heat stimulus. Clinical Trial Registry: Registry: ClinicalTrials.gov; Name: A double-blind cross-over, study to compare the hypnotic, daytime sleepiness/fatigue, and pain effects of nighttime administration of suvorexant 20 mg versus placebo in patients with fibromyalgia and comorbid insomnia; Identifier: NCT02684136;
SummaryThe human metabolome has remained largely unknown, with most studies annotating ∼10% of features. In nucleic acid sequencing, annotating transcripts by source has proven essential for understanding gene function. Here we generalize this concept to stool, plasma, urine and other human metabolomes, discovering that food-based annotations increase the interpreted fraction of molecular features 7-fold, providing a general framework for expanding the interpretability of human metabolomic “dark matter.”
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