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The Effect of A Whey-Protein and Galacto-Oligosaccharides Based Product on Parameters of Sleep Quality, Stress, and Gut Microbiota in Apparently Healthy Adults with Moderate Sleep Disturbances: A Randomized Controlled Cross-Over Study.
Schaafsma, A, Mallee, L, van den Belt, M, Floris, E, Kortman, G, Veldman, J, van den Ende, D, Kardinaal, A
Nutrients. 2021;(7)
Abstract
People experiencing sleep problems may benefit from nutrients supporting serotonin metabolism and stress reduction. We studied the effect of a dairy-based product (DP) containing protein, galacto-oligosaccharides, vitamins and minerals, on sleep quality, stress, and gut-microbiota. In a cross-over RCT (three weeks intervention; three weeks washout), adults (n = 70; 30-50 y) with sleep disturbances (Pittsburgh Sleep Quality Index (PSQI) ≥ 9) consumed products 1 h before bed-time. Sleep quality (PSQI) was measured weekly, stress at base- and end-line (Depression Anxiety Stress Scale and saliva cortisol). Fecal samples were collected in the 1st intervention period only. Compared to placebo (skimmed milk), PSQI was only lower at day 14 in the 2nd intervention period in intention-to-treat (ITT) (p = 0.017; n = 69) and per-protocol (PP) (p = 0.038; n = 64) analyses. Post-hoc analysis (modified-PP: n=47, with baseline PSQI ≥ 9, and endline day 14), however, showed a decrease in PSQI (-1.60 ± 2.53; p = 0.034). Early morning saliva cortisol decreased versus placebo (p = 0.045). Relative abundance of Bifidobacterium increased (p = 0.02). Redundancy analysis showed an inverse relationship between baseline microbiota composition and baseline PSQI (p = 0.046). Thus, although DP did not improve sleep quality in ITT and PP populations, it did in the modPP. DP reduced salivary cortisol and stimulated Bifidobacterium, which possibly is important for sleep improvement.
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The Effect of Parenteral or Oral Iron Supplementation on Fatigue, Sleep, Quality of Life and Restless Legs Syndrome in Iron-Deficient Blood Donors: A Secondary Analysis of the IronWoMan RCT.
Macher, S, Herster, C, Holter, M, Moritz, M, Matzhold, EM, Stojakovic, T, Pieber, TR, Schlenke, P, Drexler, C, Amrein, K
Nutrients. 2020;(5)
Abstract
UNLABELLED Background: Besides anemia, iron deficiency may cause more subtle symptoms, including the restless legs syndrome (RLS), the chronic fatigue syndrome (CFS) or sleeping disorders. Objective: The aim of this pre-planned secondary analysis of the IronWoMan randomized controlled trial (RCT) was to compare the frequency and severity of symptoms associated with iron deficiency before and after (intravenous or oral) iron supplementation in iron deficient blood donors. METHODS/DESIGN Prospective, randomized, controlled, single-centre trial. (ClinicalTrials.gov: NCT01787526). SETTING Tertiary care center in Graz, Austria. PARTICIPANTS 176 (138 female and 38 male) whole-blood and platelet apheresis donors aged ≥ 18 and ≤ 65 years with iron deficiency (ferritin ≤ 30ng/mL at the time of blood donation). INTERVENTIONS Intravenous iron (1 g ferric carboxymaltose, n = 86) or oral iron supplementation (10 g iron fumarate, 100 capsules, n = 90). MEASUREMENTS Clinical symptoms were evaluated by a survey before iron therapy (visit 0, V0) and after 8-12 weeks (visit 1, V1), including questions about symptoms of restless legs syndrome (RLS), chronic fatigue syndrome (CFS), sleeping disorders, quality of life and symptoms like headaches, dyspnoea, dizziness, palpitations, pica and trophic changes in fingernails or hair. RESULTS We found a significant improvement in the severity of symptoms for RLS, fatigue and sleep quality (p < 0.001). Furthermore, a significant decrease in headaches, dyspnoea, dizziness and palpitations was reported (p < 0.05). There was no difference between the type of iron supplementation (intravenous versus oral) and clinical outcome data. CONCLUSION Iron supplementation in iron-deficient blood donors may be an effective strategy to improve symptoms related to iron deficiency and the wellbeing of blood donors.
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Comparing Sleep Quality in Patients Before and After Kidney Transplantation.
Hasanzamani, B, Pourranjbar, E, Rezaei Ardani, A
Iranian journal of kidney diseases. 2020;(2):139-144
Abstract
INTRODUCTION The purpose of the present study was to identify the prevalence of sleep disturbances in ESRD, and to compare the sleep quality before and after kidney transplantation. METHODS A semi-experimental study was performed on 40 participants with ESRD from September 2017 to September 2018 in Mashhad, Iran. Participants were in the waiting list of kidney transplantation, aged 18-years-old or more, had no history of any major psychological problems. They were excluded from the study if new medical condition or psychiatric disorder was initiated throughout the study. Patients' medical information including the duration of dialysis and laboratory data was extracted from medical records. Their sleep quality was assessed with the Pittsburgh sleep quality index (PSQI) within1-month prior the kidney transplantation and at the 3rd and 6th months after it. Collected data was analyzed using SPSS-16. P < .05 considered as significant. RESULTS The frequency of poor sleepers was 37.5%, 37.5%, and 20.0%; before the kidney transplantation, 3 months and 6 months after the surgery; respectively. The average sleep quality score decreased significantly 6-month post-operation compared to pre-transplant phase (P < 0.05). We found a significant relationship between the gender and quality of sleep before transplant surgery, whereas no correlation was found between sleep quality and the age, type or duration of dialysis, serum phosphorus or hemoglobin level, and the cause of kidney failure (P < .05, > .05, > .05, > .05, > .05, > .05, and > .05; respectively). CONCLUSION Kidney transplantation has a positive effect on patients' sleep quality after 6 months.
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Effect of Lifestyle Factors on Outcomes in Patients With Inflammatory Bowel Diseases.
Rozich, JJ, Holmer, A, Singh, S
The American journal of gastroenterology. 2020;(6):832-840
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Abstract
Various lifestyle factors including physical activity and obesity, stress, sleep, and smoking may modify the risk of developing inflammatory bowel diseases (IBDs). In patients with established IBD, these lifestyle factors may significantly impact the natural history and clinical outcomes. Recreational exercise decreases the risk of flare and fatigue in patients with IBD. In contrast, obesity increases the risk of relapse and is associated with higher anxiety, depression, fatigue, and pain and higher health care utilization. Obesity also modifies pharmacokinetics of biologic agents unfavorably and is associated with a higher risk of treatment failure. Sleep disturbance is highly prevalent in patients with IBD, independent of disease activity, and increases the risk of relapse and chronic fatigue. Similarly, stress, particularly perceived stress rather than major life events, may trigger symptomatic flare in patients with IBD, although its impact on inflammation is unclear. Cigarette smoking is associated with unfavorable outcomes including the risk of corticosteroid dependence, surgery, and disease progression in patients with Crohn's disease; in contrast, smoking does not significantly impact outcomes in patients with ulcerative colitis, although some studies suggest that it may be associated with a lower risk of flare. The effect of alcohol and cannabis use in patients with IBD is inconsistent, with some studies suggesting that cannabis may decrease chronic pain in patients with IBD, without a significant effect of biological remission. Although these lifestyle factors are potentially modifiable, only a few interventional studies have been conducted. Trials of structured exercise and psychological therapy including mindfulness-based therapies such as meditation and yoga and gut-directed hypnotherapy have not consistently demonstrated benefit in clinical and/or endoscopic disease activity in IBD, although may improve overall quality of life.
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Footbath as a safe, simple, and non-pharmacological method to improve sleep quality of menopausal women.
Aghamohammadi, V, Salmani, R, Ivanbagha, R, Effati Daryani, F, Nasiri, K
Research in nursing & health. 2020;(6):621-628
Abstract
Due to the adverse effects of medication we decided to provide a safe, economic, and easy intervention to decrease sleep problems in menopausal women. This trial aimed to determine the effect of footbath on sleep disturbance in postmenopausal women. One hundred menopausal women were randomly stratified using a permuted block randomization procedure by Random Allocation Software, and assigned to one of two study groups: control (without intervention, n = 50) and intervention (footbath, n = 50). The footbath group was asked to lie their feet into the warm water for 20 min in a container with a depth of 10 cm one hour before the usual sleeping time for 6 weeks. To assess sleep quality, we used the Pittsburgh sleep quality index (PSQI). To evaluate severity of menopause symptoms, the Greene scale was applied. Before the intervention, 96% of the subjects in the footbath group and 94% in the control group were poor sleepers. The results of analysis of covariance showed significant improvement in sleep quality and decrease in severity of menopause signs in the footbath group compared to the control group. At the baseline, there was a statistically significant correlation between the severity of menopause signs and the global score of PSQI in all study individuals (p ≤ .001, r = .464). The present study findings showed that footbath intervention enhanced sleep quality in menopausal women. Thus, footbath as a safe, simple, and non-pharmacological application can improve quality of life in postmenopausal women and inhibit problems due to inadequate sleep quality.
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The Effect of Aromatherapy on Sleep and Quality of Life in Menopausal Women with Sleeping Problems: A Non-Randomized, Placebo-Controlled Trial.
Gürler, M, Kızılırmak, A, Baser, M
Complementary medicine research. 2020;(6):421-430
Abstract
INTRODUCTION Menopause is the termination of menstruation and fertility. Women commonly experience sleeping problems during the menopausal period. Aromatherapy is among the complementary therapies used to remedy sleeping problems. METHODS This study aims to investigate the effects of lavender oil on sleep and quality of life of menopausal women through steam inhalation. This study was quasi-experimental with pre-test/post-test placebo control groups. It was conducted with 57 women, 27 of whom were subject to aromatherapy and 30 to a placebo. Data were collected using the Questionnaire Form, the Pittsburgh Sleep Quality Index (PSQI) and the Menopause-Specific Quality of Life Questionnaire (MENQOL). RESULTS For the intervention group, the PSQI median scores after the administration of aromatherapy were found to be significantly lower than those before the administration (p < 0.001) and those of the placebo group (p < 0.001). Similarly, for the intervention group, the total median MENQOL scores after the administration of the aromatherapy were found to be significantly lower than the scores prior to the administration (p < 0.001) as well as the scores of the placebo group (p < 0.001). CONCLUSION It was found that aromatherapy involving lavender-scented steam inhalation increased sleep quality and quality of life in women with sleep deprivation problems during menopause.
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Influence of sitting behaviors on sleep disturbance and memory impairment in breast cancer survivors.
Ehlers, DK, Fanning, J, Sunderlage, A, Severson, J, Kramer, AF, McAuley, E
Cancer medicine. 2020;(10):3417-3424
Abstract
BACKGROUND The purpose was to prospectively examine the effects of sedentary behaviors on subjective memory impairment in breast cancer survivors (BCS) and the extent to which sleep disturbances mediated this pathway. METHODS BCS (N = 380; Mage = 57.38 ± 9.25 years) completed questionnaires assessing demographics, health history, sitting behaviors, sleep disturbance, subjective memory impairment, and moderate-to-vigorous physical activity (MVPA) at baseline and 6-month follow-up. A subsample (N = 300) wore an accelerometer to objectively estimate sedentary time and MVPA. Structural equation modeling was used to test direct and indirect effects of self-reported and objectively estimated sedentary behaviors on memory impairment (through sleep disturbance) across time. Models were adjusted for demographic, clinical, and MVPA covariates. RESULTS At baseline, more total daily sitting (γ = 0.23), occupational sitting (γ = 0.11), television viewing (γ = 0.15), and computer use (γ = 0.22) were associated with greater sleep disturbance, which was associated with greater memory impairment (γ = -0.22). Indirect effects of self-reported sitting on memory were significant. At follow-up, increased total daily sitting (γ = 0.08) and computer use (γ = 0.14) predicted increased sleep disturbance, which predicted increased memory impairment (γ = -0.09). The indirect path from increased computer use to memory impairment was significant (β = -0.01). In the accelerometer subsample, greater daily sedentary time at baseline was associated with less sleep disturbance (γ = -0.14) and memory impairment (indirect effect: β = 0.03). CONCLUSIONS Findings provide early evidence that sedentary contexts may differentially influence sleep disturbance and memory impairment in BCS. Computer use and television viewing may pose the strongest risks to cognitive health. Disparate findings between objective and subjective sedentary measures warrant further research.
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Health risk behaviours and allostatic load: A systematic review.
Suvarna, B, Suvarna, A, Phillips, R, Juster, RP, McDermott, B, Sarnyai, Z
Neuroscience and biobehavioral reviews. 2020;:694-711
Abstract
Health risk behaviours (HRB) across the lifespan have been associated with higher cumulative physiological burden as measured by allostatic load (AL). This study examines the contribution of HRB and their effects on multisystem biological risk associated with morbidity and early mortality. We systematically reviewed the literature to assess the links between HRB and AL. Twenty-six eligible human studies were included in our assessment of the current literature investigating the association of different HRB that included overeating/obesity, alcohol, smoking, drug use, physical inactivity and sleep impairments in relation to AL. We found that 50 % of obesity and substance abuse, 75 % of sleep and 62.5 % of combined HRB studies showed a significant association with AL. Lifestyle coping behaviours therefore have a significant contribution to AL. This study is among the first to explore multiple domains of HRB in relation to AL. Further research should focus on evaluating lifestyle factors that adapt HRB as a strategy to cope with chronic stress to help decrease AL and resulting long-term negative health consequences.
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The lullaby of the sun: the role of vitamin D in sleep disturbance.
Muscogiuri, G, Barrea, L, Scannapieco, M, Di Somma, C, Scacchi, M, Aimaretti, G, Savastano, S, Colao, A, Marzullo, P
Sleep medicine. 2019;:262-265
Abstract
Vitamin D is a pro-hormone belonging to the category of the fat-soluble group of vitamins; it is obtained more from solar exposure and in smaller quantities through feeding. Although vitamin D has traditionally been shown to be involved in calcium homeostasis and bone health, recent studies have found a positive association between vitamin D and sleep. In particular, clinical studies in humans indicate that low levels of vitamin D are correlated with poor quality and short sleep duration. The mechanism by which this association is explained is still unclear. However, vitamin D receptors have been found in the brain regions involved in sleep regulation, and vitamin D appears to be involved in regulating the sleep-wake cycle. The current review summarizes the available evidence regarding the association between vitamin D and sleep, focusing on both clinical and preclinical studies.
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Pharmacotherapeutic management of sleep disorders in children with neurodevelopmental disorders.
Bruni, O, Angriman, M, Melegari, MG, Ferri, R
Expert opinion on pharmacotherapy. 2019;(18):2257-2271
Abstract
Introduction: Sleep disturbances are highly prevalent in children with neurodevelopmental disabilities. Without appropriate treatment, sleep disorders can become chronic and last for many years. However, there are no sleep medications approved by the United States Food and Drug Administration and only one has been approved by the European Medicines Agency for pediatric insomnia; thus, most medications are prescribed off-label.Areas covered: In this narrative review, the authors highlight and summarize the most common drugs and supplements used for the treatment of sleep problems in children with neurodevelopmental disabilities. Recommendations are formulated regarding the use of melatonin and melatonin receptor agonists, sedating antidepressants, antipsychotics, antihistamines, gabapentin, clonidine and orexin receptor antagonists, and benzodiazepines and hypnotic benzodiazepine receptor agonists.Expert opinion: The choice of pharmacological agents and their dosage should be individualized taking into consideration multiple factors, including the severity and type of sleep problem and the associated neurological pathology. Melatonin is widely used and safe in children with neurodevelopmental conditions. Gabapentin, clonidine, trazodone, and mirtazapine hold promise but require further study. Supplements (iron, vitamin D, and 5-hydroxytryptophan) might be helpful. Due to the lack of clinical data, there is still uncertainty concerning dosing regimens and tolerability.