Most QEEG bandwidths and HRV during sleep show high short-term stability in good sleepers and patients with insomnia alike. One night of data is, thus, sufficient to derive reliable estimates of these outcomes in studies focused on group differences or correlates of QEEG and/or HRV. In contrast, one night of data is unlikely to generate reliable estimates of PSG-assessed sleep duration, continuity or architecture, with the exception of slow wave sleep.
Chronic stress is prospectively associated with sleep disturbance in midlife women, even after adjusting for acute stressors at the time of the sleep study and other factors known to disrupt sleep. These results are consistent with current models of stress that emphasize the cumulative effect of stressors on health over time.
Endotoxemia is an important risk factor for development of acute laminitis in horses during hospitalization for medical or surgical conditions. Early recognition of endotoxemia, or the potential for it to develop in certain disease states, and initiation of treatment directed at endotoxemia or its consequences may help prevent laminitis in horses during hospitalization.
Childhood trauma may affect sleep health in adulthood. These findings align with the growing body of evidence linking childhood trauma to adverse health outcomes later in life.
The cortisol awakening response (CAR) is a burst of cortisol in response to awakening from sleep that is superimposed on the circadian rhythm of cortisol. Determination of the CAR is contingent on the timing of sample collection: A delay between waking and collection of the first sample may affect the rise of the CAR, and could explain equivocal findings reported in the literature. We evaluated the impact of a delay between wake time and collection of waking cortisol samples on the CAR. Two methods were used to identify wake time: polysomnography (PSG) and self-report (S-R). Participants (total n = 207, mean age 74.0 ± 7.2 yrs) included bereaved older adults (n = 35), caregivers (n =50), patients with insomnia and co-morbid medical disorders (n = 68), and the healthy older adults (n = 54). We used ANOVA to test if a delay > 15 minutes affected the CAR. We also fitted cubic spline models to assess expected cortisol levels, the expected CAR, and the expected decrease in CAR. Wake times measured by PSG and S-R did not differ significantly. Large delays were observed (for both PSG and S-R) between wake time and collection of the waking cortisol sample (24.8 ± 32.2 min for PSG and 28.3 ± 49.2 min for S-R). Both statistical methods indicated that a delay > 15 minutes between wake time and first cortisol sample collection significantly affected the CAR (p's < .005); later collection times were associated with smaller CAR values. Later collection times and reduced CAR values may affect the interpretation of clinical associations. Our data also show that S-R assessments of wake time perform equally well to PSG for evaluating adherence with CAR sampling procedures.
Summary
While insomnia is a well‐established risk factor for the initial onset, recurrence or relapse of affective disorders, the specific characteristics of insomnia that confer risk remain unclear. Patients with insomnia with an evening chronotype may be one particularly high‐risk group, perhaps due to alterations in positive affect and its related affective circuitry. We explored this possibility by comparing diurnal patterns of positive affect and the activity of positive affect‐related brain regions in morning‐ and evening‐types with insomnia. We assessed diurnal variation in brain activity via the relative regional cerebral metabolic rate of glucose uptake by using [18F]fluorodeoxyglucose‐positron emission tomography during morning and evening wakefulness. We focused on regions in the medial prefrontal cortex and striatum, which have been consistently linked with positive affect and reward processing. As predicted, chronotypes differed in their daily patterns in both self‐reported positive affect and associated brain regions. Evening‐types displayed diurnal patterns of positive affect characterized by phase delay and smaller amplitude compared with those of morning‐types with insomnia. In parallel, evening‐types showed a reduced degree of diurnal variation in the metabolism of both the medial prefrontal cortex and the striatum, as well as lower overall metabolism in these regions across both morning and evening wakefulness. Taken together, these preliminary findings suggest that alterations in the diurnal activity of positive affect‐related neural structures may underlie differences in the phase and amplitude of self‐reported positive affect between morning and evening chronotypes, and may constitute one mechanism for increased risk of mood disorders among evening‐type insomniacs.
Extended hours of sales and consumption of alcohol were associated with increased risk of homicides. Strong restrictions on alcohol availability could reduce the incidence of interpersonal violence events in communities where homicides are high.
No studies have evaluated the dynamic, time-varying, relationship between delta electroencephalographic (EEG) sleep and high frequency heart rate variability (HF-HRV) in women. Delta EEG and HF-HRV were measured during sleep in 197 midlife women (Mage =52.1, SD =2.2). Delta EEG-HF-HRV correlations in Non-Rapid Eye Movement (NREM) sleep were modeled as whole night averages and as continuous functions of time. The whole-night delta EEG-HF-HRV correlation was positive. Strongest correlations were observed during the first NREM sleep period preceding and following peak delta power. Time-varying correlations between delta EEG-HF-HRV were stronger in participants with sleep-disordered breathing and self-reported insomnia compared to healthy controls. The dynamic interplay between sleep and autonomic activity can be modeled across the night to examine within- and between-participant differences including individuals with and without sleep disorders.
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