-One workweek of mild sleep restriction adversely impacts sleepiness, performance, and proinflammatory cytokines. Many individuals try to overcome these adverse effects by extending their sleep on weekends. To assess whether extended recovery sleep reverses the effects of mild sleep restriction on sleepiness/alertness, inflammation, and stress hormones, 30 healthy young men and women (mean age Ϯ SD, 24.7 Ϯ 3.5 yr; mean body mass index Ϯ SD, 23.6 Ϯ 2.4 kg/m 2 ) participated in a sleep laboratory experiment of 13 nights [4 baseline nights (8 h/night), followed by 6 sleep restriction nights (6 h/night) and 3 recovery nights (10 h/night)]. Twenty-four-hour profiles of circulating IL-6 and cortisol, objective and subjective daytime sleepiness (Multiple Sleep Latency Test and Stanford Sleepiness Scale), and performance (Psychomotor Vigilance Task) were assessed on days 4 (baseline), 10 (after 1 wk of sleep restriction), and 13 (after 2 nights of recovery sleep). Serial 24-h IL-6 plasma levels increased significantly during sleep restriction and returned to baseline after recovery sleep. Serial 24-h cortisol levels during restriction did not change compared with baseline, but after recovery they were significantly lower. Subjective and objective sleepiness increased significantly after restriction and returned to baseline after recovery. In contrast, performance deteriorated significantly after restriction and did not improve after recovery. Extended recovery sleep over the weekend reverses the impact of one work week of mild sleep restriction on daytime sleepiness, fatigue, and IL-6 levels, reduces cortisol levels, but does not correct performance deficits. The long-term effects of a repeated sleep restriction/sleep recovery weekly cycle in humans remain unknown. recovery sleep; sleep restriction; alertness; cortisol; Il-6 IN MODERN SOCIETIES, increasing work demands and lifestyle changes have resulted in adults sleeping considerably less than the seven hours per night considered to be the average sleep time necessary to sustain optimal daytime functioning (8, 23). Experimental studies in healthy young adults have consistently demonstrated that chronic sleep restriction results in a number of abnormal physiological changes, including increased inflammatory markers (15,22,39) and impaired blood glucose regulation (33), which may be the mechanisms through which chronic sleep curtailment may affect health and longevity. A recent U.S. National Sleep Foundation survey showed that about 25% of the population do not get enough sleep during the weekdays due to the work demands, whereas about 40% sleep longer during the weekend trying to "catch up" for the shorter weekdays' sleep duration (23). Although it is commonly believed that sleep loss accumulated during the week can be compensated for by extending sleep over the weekend, it is not known whether recovery sleep adequately reverses the adverse effects of sleep loss. Most studies on the effects of recovery sleep after short-term sleep restriction are focused on psychomotor...

In obese males obstructive sleep apnoea (OSA) is associated with inflammation and insulin resistance; however, findings are confounded by adipose tissue, a hormone-and cytokine-secreting organ. Our goal was to examine whether in a relatively nonobese population, OSA is associated with sleepiness and inflammation/insulin resistance, and to assess the effects of a 2-month placebo-controlled continuous positive airway pressure (CPAP) use.77 subjects, 38 middle-aged males and post-menopausal females with OSA and 39 male and female controls, were studied in the sleep laboratory for 4 nights. Measures of sleepiness (objective and subjective), performance, serial 24-h blood samples for interleukin (IL)-6, tumour necrosis factor receptor (TNFR)-1, leptin and adiponectin, and single samples for high-sensitivity C-reactive protein (hsCRP), fasting glucose and insulin levels were obtained.Apnoeic males were significantly sleepier and had significantly higher hsCRP, IL-6, leptin and insulin resistance than controls. Apnoeic females had significantly higher hsCRP; however, objective sleepiness, IL-6, TNFR-1, insulin resistance (Homeostatic Model Assessment index), leptin and adiponectin were similar to controls. CPAP improved subjective sleepiness, but no changes were observed in any of the biomarkers.In conclusion, OSA is associated with sleepiness, inflammation and insulin resistance, even in nonobese males, and this association is stronger in males than in females. Short-term CPAP does not improve the inflammatory/metabolic aberrations in OSA. @ERSpublications OSA is associated with sleepiness and inflammation/insulin resistance in nonobese males and females

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We compared the number of M > 2 earthquakes in an area, including the island of Crete, Greece, to the number of admissions to the Psychiatric Inpatient Unit of the University of Crete (IPU/UoC), during the period 2008-2010. We found that when earthquakes with M ! 6.4 occurred in the region examined, the number of monthly admissions to the Acute Care Unit of the IPU/UoC, N AA , reached lowest values, whereas this number increased when the monthly number N E of small (M < 3) earthquakes increased. We also found a positive correlation between the total number of monthly admissions N A and N E (r ¼ 0.601/P ¼ 0.001). When a daily resolution analysis was performed for the month with the highest value of N E , we found that an abrupt increase in the number of small earthquakes was followed by an increase in the number of admissions after $2 days (during that month, from a total of 71 patients, 38/10 people were diagnosed with schizophrenia/bipolar disorder). We hypothesize that seismic activity might be a significant contributing factor influencing the frequency of admissions of psychotic disorders in Crete in the period 2008-2010 and that the beneficial/adverse effects are related to the anomalous electric field/extra low frequency-ultra low frequency emissions.

IntroductionDeinstitutionalization in Crete and the closure of the only Psychiatric Hospital in 2006, has resulted in a significant shift of treatment options that were available for chronic psychiatric patients. Specifically, psychiatric care shifted from long-term or even lifetime hospitalization, to short-term hospitalization and community-based treatment.ObjectiveTo examine the residential/occupational status of the patients discharged from the Psychiatric Hospital after its closure and the profile of residence, psychiatric profile and sociodemographic data of inpatients of the Psychiatric Department of the University Hospital of Crete (PD/UHC).AimTo explore the burden of family members living in the same home with chronic psychiatric patients.MethodWe examined the residence status of the patients discharged from the Psychiatric Hospital. Furthermore, we examined the psychiatric profile and sociodemographic data from 400 inpatients that were admitted between Nov 2011 and August 2012 in the PD/UHC. We analyzed the data by using frequencies.ResultsAmong Psychiatric Hospital residents, 72% returned home after its closure, while 2.5% were referred to community services. Among psychiatric inpatients, 82,9% return home after discharge. From a subset of 212 patients, 64% live with their own/paternal families, while 24.5% live alone, and 63% of patients living with family/relatives, remain unemployed/on welfare.ConclusionsPsychiatric reform and inadequate community-based psychiatric services, has resulted in an increasing family burden, since most psychiatric patients remain unemployed, under the care of their family. There is a need for development of community-based services to provide care and assistance to chronic patients and their families.

IntroductionSuicide attempts/thoughts are common among psychiatric inpatients and they are burden for the individual, the family and the health system. According to published reports, suicidality in Greece has increased significantly, because of the current economic crisis.ObjectiveExamine the profile of psychiatric inpatients of the Psychiatric Department of the University Hospital of Crete(PD/UHC), presenting with suicide attempts/ thoughts.AimIdentify risk factors associated with attempted suicide or suicidal thoughts.MethodsOne hundred forty four out of 444 (33%) inpatients admitted in the PD/UHC between Nov 2011- Aug 2012 presented suicidal attempts/thoughts. Data were analyzed using the Pearson's chi-square test and multivariable regression models.ResultsMajor Depression, substance abuse, female gender and having a spouse were associated with suicidality in the entire group. Because there was an interaction between gender and having children, the analysis was stratified by gender. Risk factors for suicidality in men were having children (OR=2.26) and shorter time since onset of illness (OR= 0.96), and in women having a spouse (OR=2.47). Low income and unemployment were not significant predictors of suicidality.ConclusionsMajor Depression, substance abuse, female gender, family status and recent onset of illness appear to be risk factors associated with suicidality in psychiatric inpatients. Unemployment/low income, did not correlate with suicidality. Our findings do not support the popular belief of increased suicidality due to the current economic crisis. Finally, there is a need for further understanding of how family, its dynamics and potential stressors associated with it, may influence suicidality.

Introduction:Twenty percent of psychiatric inpatients have co-morbid substance abuse/dependence and their management is challening.Objectives:To investigate co-morbidity and patterns of substance use among inpatients in a general psychiatric unit.Aim:To examine specific patterns and risk factors associated with substances/alcohol in psychiatric inpatients.Methods:Participants included 487 inpatients consecutively admitted to the Psychiatric Unit, University Hospital of Crete between Nov 2011- Jun 2013. Data were analyzed using the Pearson's chi-square test and multiple regression.Results:Our sample, mean age 42.7±14.5yrs, consisted of 57.9% males, whereas 51.9% were admitted involuntarily. In addition, 60.3% were unemployed, 24.3% had a spouse and 38.1% had no previous psychiatric hospitalizations. Furthermore, 354 (72.8%) used no substances, while 16.1% used alcohol, 12.3% cannabis, 3.8% opioids, 2.5% cocaine, and 5.5% anxiolytics. Mean age of those abusing alcohol was 41.8yrs, cannabis 34.1yrs, opioids and cocaine 31.6yrs and anxiolytics 36.9yrs. In patients with Major Depression, alcohol (21.1%) and anxiolytics (9.8%) were the most prevalent, whereas, in patients with psychotic disorders and bipolar disorders, alcohol (9.8% and 5.8% respectively) and cannabis (11.9% and 15.2%) were the most frequent. Unemployment, and involuntary admission weren’t significant risk factors for alcohol/substance use.Conclusions:Substance/alcohol abuse/dependence is present in 1/3 of our psychiatric population with alcohol, cannabis and anxiolytics the most commonly used. Alcohol was more frequent in older patients with depression, whereas cannabis was more frequent in younger patients with psychotic/bipolar disorder. Development of dual diagnosis centers, very scarce in Greece, are needed for the management of psychiatric patients with substance co-morbidity.

Introduction:The psychological consequences on the caregivers taking care of mentally ill patients are well known; however, little evidence exists as to whether taking care of a mentally ill patient affects the physical health of the caregiver.Objective:To examine the effect of caregiving on emotional and physical health.Aim:To study the association between caregiving for mentally ill and physical illness.Methods:One hundred twenty-eight caregivers, relatives of patients suffering from schizophrenia or bipolar disorder, who were hospitalized consecutively during the past three years (2011–2013), and 117 controls completed over telephone a structured questionnaire. Eligible patients were all those with duration of illness more than 5 yrs. Data included demographics and detailed information about past or present mental and/or physical illness. Data were analyzed using the Pearson's chi-square test and multivariate binary regression controlling for BMI, age, sex, and smoking.Results:Significant correlation was found between caregiving and anxiety (OR=4,1, p<0,0001), depression (OR=3,5 p=0,03), sleep disturbances (OR=2,6, p=0,05), arthritis (OR=2,5, p=0,03), rheumatopathy (OR=2,8, p=0.09) and allergies (OR=2,5, p=0,09). The association of caregiving with allergies/ arthritis was independent of anxiety and depression. No correlation was found with diabetes, hypertension and cardiovascular disease.Conclusion:The stress of taking care of a mentally ill patient appears to affect physical health, specifically increasing the risk for autoimmune disorders (allergy, arthritis), independently of anxiety, depression and sleep disturbances.