Insomnia Abstracts 10

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Influence of partial sleep deprivation on energy balance and insulin sensitivity in healthy women.
            (Bosy-Westphal et al., 2008) Download
BACKGROUND:  Voluntary sleep restriction is a lifestyle feature of modern societies that may contribute to obesity and diabetes. The aim of the study was to investigate the impact of partial sleep deprivation on the regulation of energy balance and insulin sensitivity. SUBJECTS AND METHODS:  In a controlled intervention, 14 healthy women (age 23-38 years, BMI 20.0-36.6 kg/m(2)) were investigated after 2 nights of >8 h sleep/night (T0), after 4 nights of consecutively increasing sleep curtailment (7 h sleep/night, 6 h sleep/night, 6 h sleep/night and 4 h sleep/night; T1) and after 2 nights of sleep recovery (>8 h sleep/night; T2). Resting and total energy expenditure (REE, TEE), glucose-induced thermogenesis (GIT), physical activity, energy intake, glucose tolerance and endocrine parameters were assessed. RESULTS:  After a decrease in sleep du-ration, energy intake (+20%), body weight (+0.4 kg), leptin/fat mass (+29%), free triiodothyronine (+19%), free thyroxine (+10%) and GIT (+34%) significantly increased (all p < 0.05). Mean REE, physical activity, TEE, oral glucose tolerance, and ghrelin levels remained unchanged at T1. The effect of sleep loss on GIT, fT3 and fT4 levels was inversely related to fat mass. CONCLUSION:  Short-term sleep deprivation increased energy intake and led to a net weight gain in women. The effect of sleep restriction on energy expenditure needs to be specifically addressed in future studies using reference methods for total energy expenditure.

Effects of a 3-week dehydroepiandrosterone administration on sleep, sex steroids and multiple 24-h hormonal profiles in postmenopausal women: a pilot study.
            (Caufriez et al., 2013) Download
OBJECTIVE:  Dehydroepiandrosterone (DHEA) administration is widely evocated as a 'fountain of youth', but previous studies have provided inconsistent results. We aimed to investigate in healthy postmenopausal women the effects of a 3-week oral DHEA administration on individual steroid levels, multiple 24-h hormonal profiles and sleep architecture. DESIGN:  Seven healthy nonobese postmenopausal women, off hormone replacement therapy for ≥2 months, were investigated in a randomized, crossover, double-blind, placebo-controlled study. For 3 weeks, subjects took daily at 2300 h a capsule of either 50 mg DHEA or placebo. Sleep was polygraphically recorded during the last two nights, and blood samples were drawn at 15-min intervals during the last 24 h. RESULTS:  Under DHEA, testosterone and estradiol levels were increased in all individuals. Individual increments were highly variable, not related to each other, and were not related to placebo values. However, the testosterone to estradiol ratio was markedly increased under DHEA. DHEA administration had little, if any, effect on thyroid function, GH secretion, prolactin, ACTH and cortisol profiles. DHEA effects on sleep appeared to be mediated by its conversion to androgens and oestrogens: sleep quality was enhanced by increments in testosterone and dampened by increments in estradiol levels. CONCLUSION:  As DHEA-induced elevations in testosterone and estradiol levels varied widely between individuals and were largely unpredictable, DHEA administration might not be the most appropriate approach to compensate for the reduction observed in androgen and oestrogen production in postmenopausal women. DHEA supplementation may result either in sleep stimulation or in inhibition, depending on the ratio between DHEA-induced increments in testosterone vs estradiol.

Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomized controlled trial.
            (Chang and Chen, 2016) Download
AIM:  The purpose of this study was to evaluate the effects of chamomile tea on sleep quality, fatigue and depression in postpartum women. BACKGROUND:  Sleep quality is a significant issue for postnatal women. Chamomile is widely used as a folk remedy for its presumed sedative-hypnotic effects. DESIGN:  A pretest-post-test randomized controlled trial was used. METHODS:  A total of 80 Taiwanese postnatal women with poor sleep quality (Postpartum Sleep Quality Scale; PSQS score ≧16) were recruited from November 2012-August 2013. They were systematically assigned, with a random start, to either the experimental group (n = 40) or the control group (n = 40). The participants in the experimental group were instructed to drink chamomile tea for a period of 2 weeks. The participants in the control group received regular postpartum care only. The PSQS, Edinburgh Postnatal Depression Scale, and Postpartum Fatigue Scale were used to assess outcomes. Two-sample t-tests were used to examine the mean differences in outcome variables between the two groups. RESULTS:  Compared with the control group, the experimental group demonstrated significantly lower scores of physical-symptoms-related sleep inefficiency (t = -2·482, P = 0·015) and the symptoms of depression (t = -2·372, P = 0·020). However, the scores for all three instruments were similar for both groups at 4-week post-test, suggesting that the positive effects of chamomile tea were limited to the immediate term. CONCLUSION:  Chamomile tea may be recommended to postpartum women as a supplementary approach to alleviating depression and sleep quality problems.


 

GABA tea helps sleep.
            (Cheng and Tsai, 2009) Download
Taking the advice of a relative, Mr. A began drinking a glass (about 250mL) of GABA tea before sleep. Mr. A re- ported no more interrupted sleep, early awakening, or back pain the next morning. He continued using GABA tea for 1 month, and the insomnia improved, without mention of any side-effects. After failure in treating insomnia with hypnotics, including BZDs and non-BZDs, Mr. A chose GABA tea (Green Heart Field Natural Tea Farm, Nantou, Taiwan).

Sleep and hormonal changes in aging.
            (Copinschi and Caufriez, 2013) Download
Age-related sleep and endocrinometabolic alterations frequently interact with each other. For many hormones, sleep curtailment in young healthy subjects results in alterations strikingly similar to those observed in healthy old subjects not submitted to sleep restriction. Thus, recurrent sleep restriction, which is currently experienced by a substantial and rapidly growing proportion of children and young adults, might contribute to accelerate the senescence of endocrine and metabolic function. The mechanisms of sleep-hormonal interactions, and therefore the endocrinometabolic consequences of age-related sleep alterations, which markedly differ from one hormone to another, are reviewed in this article.

Impact of sleep deprivation on insulin secretion, insulin sensitivity, and other hormonal regulations.
            (González-Ortiz and Martínez-Abundis, 2005) Download
Sleep deprivation, or sleep debt, is a very common condition in the lifestyles of many individuals. This condition has a profound effect on the endocrine system, leading to cardiovascular complications among other disturbances. Sleep deprivation decreases insulin sensitivity and is associated with metabolic control in diabetic patients. Other hormones such as cortisol, growth hormone, insulin-like growth factor-1, prolactin, leptin, thyroid hormone, and dehydroepiandrosterone sulfate, as well as the regulation pathways of these substances, are affected by the quantity and quality of sleep. Therefore, sleep loss has important implications in the prevention and treatment of the metabolic syndrome and other diseases.


 

Ornithine ingestion improved sleep disturbances but was not associated with correction of blood tryptophan ratio in Japanese Antarctica expedition members during summer.
            (Horiuchi et al., 2013) Download
Members of expeditions to Antarctica may show changes in biological and physiological parameters involved in lipid, glucose, and thyroid hormone metabolism as they adapt to the environment; however, alterations in amino acid (AA) levels and sleep among expedition members in Antarctica have yet to be fully elucidated. We hypothesized that there would be alterations of blood AA levels, and ornithine (Orn) ingestion would affect biological parameters and sleep in Japanese expedition members during the summer in Antarctica. Japanese Antarctica Research Expedition members (22 people) who stayed in Antarctica for 3 months from December 2010 were examined, and a randomized double-blind study of Orn ingestion (400 mg/d) for 4 weeks was performed. Sleep conditions were evaluated subjectively by the Oguri-Shirakawa-Azumi (brief version) questionnaire. The blood of Japanese Antarctica Research Expedition members in Antarctica showed higher creatine kinase, lactate dehydrogenase, and ammonia levels than that in Japan. On blood AA analysis, aspartate, Orn, and serine were significantly higher, and alanine and tryptophan (Trp) were significantly lower in Antarctica than in Japan. The Trp ratio, the value of Trp divided by the sum of phenylalanine, tyrosine, and branched-chain AAs, was significantly lower in Antarctica than in Japan. Although sleep deteriorated during the stay in Antarctica, Orn ingestion, to some extent, improved sleep compared with the placebo group in Antarctica, suggesting that Orn is effective for people with heavy physical workloads in places such as Antarctica.

Inflammation, Oxidative Stress, and Antioxidants Contribute to Selected Sleep Quality and Cardiometabolic Health Relationships: A Cross-Sectional Study.
            (Kanagasabai and Ardern, 2015) Download
Sleep is vital for cardiometabolic health, but a societal shift toward poor sleep is a prominent feature of many modern cultures. Concurrently, factors such as diet and lifestyle have also changed and may mediate the relationship between sleep quality and cardiometabolic health. Objectives were to explore (1) the interrelationship and (2) mediating effect of inflammation, oxidative stress, and antioxidants on sleep quality and cardiometabolic health. Cross-sectional data from the US National Health and Nutritional Examination Survey 2005-06 (≥20 y; N = 2,072) was used. Cardiometabolic health was defined as per the Joint Interim Statement; overall sleep quality was determined from six sleep habits and categorized as good, fair, poor, and very poor. Fair quality sleepers had optimal inflammation, oxidative stress, and antioxidant levels. Inflammation was above the current clinical reference range across all sleep quality categories, while oxidative stress was only within the clinical reference range for fair sleep quality. Selected sleep quality-cardiometabolic health relationships were mediated by inflammation, oxidative stress, and antioxidants and were moderated by sex. Our results provide initial evidence of a potential role for inflammation, oxidative stress, and antioxidants in the pathway between poor sleep quality-cardiometabolic decline. Further prospective research is needed to confirm our results.

Stress hormones, sleep deprivation and cognition in older adults.
            (Maggio et al., 2013) Download
Cognition can be deteriorated in older persons because of several potential mechanisms including the hormonal changes occurring with age. Stress events cause modification in hormonal balance with acute and chronic changes such as increase in cortisol and thyroid hormones, and simultaneous alterations in dehydroepiandrosterone sulphate, testosterone and insulin like growth factor-1 levels. The ability to cope with stress and regain previous healthy status, also called resiliency, is particularly impaired in older persons Thus, stressful conditions and hormonal dysregulation might concur to the onset of cognitive impairment in this population. In this review we address the relationship between stress hormones and cognitive function in older persons focusing on the role of one of the main stress factors, such as sleep deprivation (SD). We extracted and cross-checked data from 2000 to 2013 March and selected 112 full-text articles assessed for eligibility. In particular we considered 68 studies regarding the contribution of hormonal pathway to cognition in older adults, and 44 regarding hormones and SD both in rats and humans. We investigated how the activation of a stress-pattern response, like the one evoked from SD, can influence cognitive development and worsen cognitive status in the elderly. We will show the limited number of studies targeting the effects of SD and the consequent changes in stress hormones on cognitive function in this age group. We conclude that the current literature is not strong enough to give definitive answers on the role of stress hormonal pathway to the development of cognitive impairment in older individuals.

Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation.
            (Mullington et al., 2009) Download
That insufficient sleep is associated with poor attention and performance deficits is becoming widely recognized. Fewer people are aware that chronic sleep complaints in epidemiologic studies have also been associated with an increase in overall mortality and morbidity. This article summarizes findings of known effects of insufficient sleep on cardiovascular risk factors including blood pressure, glucose metabolism, hormonal regulation, and inflammation with particular emphasis on experimental sleep loss, using models of total and partial sleep deprivation, in healthy individuals who normally sleep in the range of 7 to 8 hours and have no sleep disorders. These studies show that insufficient sleep alters established cardiovascular risk factors in a direction that is known to increase the risk of cardiac morbidity.

 

Sleep, rhythms and women's mood. Part I. Menstrual cycle, pregnancy and postpartum.
            (Parry et al., 2006a) Download
This review summarizes studies of sleep and other biological rhythms during the menstrual cycle, pregnancy and the postpartum period, focusing, where feasible, on studies in women who met DSM-IV (Diagnostic and Statistical Manual for Mental Disorders, 4th edition) criteria for a depressive disorder compared with healthy controls. The aim was to review supporting evidence for the hypothesis that disruption of the normal temporal relationship between sleep and other biological rhythms such as melatonin, core body temperature, cortisol, thyroid stimulating hormone (TSH) or prolactin occurring during times of reproductive hormonal change precipitates depressive disorders in predisposed women. Treatment strategies, designed to correct these altered phase (timing) or amplitude abnormalities, thereby improve mood. Although there may be some common features to premenstrual, pregnancy and postpartum depressive disorders (e.g. elevated prolactin levels), a specific profile of sleep and biological rhythms distinguishes healthy from depressed women during each reproductive epoch. Further work is needed to characterize more fully the particular abnormalities associated with each reproductive state to identify common versus distinctive features for each diagnostic group. This information could serve as the basis for developing more targeted treatment strategies.

Sleep, rhythms and women's mood. Part II. Menopause.
            (Parry et al., 2006b) Download
This review summarizes studies of sleep and other biological rhythms in menopausal women with major depression compared with healthy control subjects. Where feasible, we focused on studies in women who met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for a major depressive episode (MDE) compared with matched normal control subjects and the Staging System for Reproductive Aging in Women (STRAW) criteria. The aim was to review supporting evidence for the hypothesis that a disruption of the normal temporal relationship between sleep and other biological rhythms, such as melatonin, cortisol, thyroid stimulating hormone (TSH) or prolactin, occur during the menopausal transition. As a result, depressive disorders occur in predisposed women. Treatment strategies, designed to correct these altered phase (timing) or amplitude abnormalities, thereby improve mood. Although there may be some common features to menopausal depression compared with other depressive disorders related to the reproductive cycle (e.g. premenstrual dysphoric disorder or postpartum major depression), such as increased morning melatonin secretion, a specific profile of sleep and biological rhythms may distinguish healthy from depressed women during menopause. Further work is needed to characterize more fully the particular abnormalities associated with well-defined menopausal depression in order to develop treatment strategies targeted more specifically to pathogenesis.

Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study.
            (Rotem and Kaplan, 2007) Download
OBJECTIVE:  To determine the efficacy and safety of the herbal formula Phyto-Female Complex (SupHerb, Netanya, Israel; ingredients: standardized extracts of black cohosh, dong quai, milk thistle, red clover, American ginseng, chaste-tree berry) for the relief of menopausal symptoms. METHODS:  A randomized, double-blind, placebo-controlled trial in 50 healthy pre and postmenopausal women, aged 44-65 years, to whom oral Phyto-Female Complex or matched placebo was prescribed twice daily for 3 months. A structured questionnaire on the frequency and intensity of menopausal symptoms was administered weekly from one week before throughout the 3-month treatment period, followed by biochemical tests, breast check, and transvaginal ultrasonography. RESULTS:  The women receiving Phyto-Female Complex reported a significantly superior mean reduction in menopausal symptoms than the placebo group. The effect of treatment improvements in menopausal symptoms increased over time; by 3 months there was a 73% decrease in hot flushes and a 69% reduction of night sweats, accompanied by a decrease in their intensity and a significant benefit in terms of sleep quality. Hot flushes ceased completely in 47% of women in the study group compared with only 19% in the placebo group. There were no changes in findings on vaginal ultrasonography or levels of relevant hormones (estradiol, follicle-stimulating hormone), liver enzymes or thyroid-stimulating hormone in either group. CONCLUSION:  Phyto-Female Complex is safe and effective for the relief of hot flushes and sleep disturbances in pre- and postmenopausal women, at least for 3 months' use.

Ghrelin in mental health, sleep, memory.
            (Steiger et al., 2011) Download
Ghrelin acts as a neuropeptide. It participates in sleep-wake regulation. After systemic ghrelin treatment nonREM sleep is promoted in male humans and mice. This effect is influenced by gender, time of administration and depression. Ghrelin does not modulate sleep in healthy women and during the early morning in male subjects. In depressed women REM sleep is diminished after ghrelin. In elderly men and depressed men sleep promotion by ghrelin was preserved. In rats after central ghrelin feeding and wakefulness increased. The nocturnal secretion pattern of cortisol, GH, LH, FSH and hypothalamo-pituitary-thyroid hormones are influenced by ghrelin. Furthermore ghrelin appears to be related to memory and to be involved in the pathophysiology of CNS disorders, particularly depression.

 

Influence of sleep deprivation and circadian misalignment on cortisol, inflammatory markers, and cytokine balance.
            (Wright et al., 2015) Download
Cortisol and inflammatory proteins are released into the blood in response to stressors and chronic elevations of blood cortisol and inflammatory proteins may contribute to ongoing disease processes and could be useful biomarkers of disease. How chronic circadian misalignment influences cortisol and inflammatory proteins, however, is largely unknown and this was the focus of the current study. Specifically, we examined the influence of weeks of chronic circadian misalignment on cortisol, stress ratings, and pro- and anti-inflammatory proteins in humans. We also compared the effects of acute total sleep deprivation and chronic circadian misalignment on cortisol levels. Healthy, drug free females and males (N=17) aged 20-41 participated. After 3weeks of maintaining consistent sleep-wake schedules at home, six laboratory baseline days and nights, a 40-h constant routine (CR, total sleep deprivation) to examine circadian rhythms for melatonin and cortisol, participants were scheduled to a 25-day laboratory entrainment protocol that resulted in sleep and circadian disruption for eight of the participants. A second constant routine was conducted to reassess melatonin and cortisol rhythms on days 34-35. Plasma cortisol levels were also measured during sampling windows every week and trapezoidal area under the curve (AUC) was used to estimate 24-h cortisol levels. Inflammatory proteins were assessed at baseline and near the end of the entrainment protocol. Acute total sleep deprivation significantly increased cortisol levels (p<0.0001), whereas chronic circadian misalignment significantly reduced cortisol levels (p<0.05). Participants who exhibited normal circadian phase relationships with the wakefulness-sleep schedule showed little change in cortisol levels. Stress ratings increased during acute sleep deprivation (p<0.0001), whereas stress ratings remained low across weeks of study for both the misaligned and synchronized control group. Circadian misalignment significantly increased plasma tumor necrosis factor-alpha (TNF-α), interleukin 10 (IL-10) and C-reactive protein (CRP) (p<0.05). Little change was observed for the TNF-α/IL-10 ratio during circadian misalignment, whereas the TNF-α/IL-10 ratio and CRP levels decreased in the synchronized control group across weeks of circadian entrainment. The current findings demonstrate that total sleep deprivation and chronic circadian misalignment modulate cortisol levels and that chronic circadian misalignment increases plasma concentrations of pro- and anti-inflammatory proteins.

 


References

Bosy-Westphal, A, et al. (2008), ‘Influence of partial sleep deprivation on energy balance and insulin sensitivity in healthy women.’, Obes Facts, 1 (5), 266-73. PubMed: 20054188
Caufriez, A, et al. (2013), ‘Effects of a 3-week dehydroepiandrosterone administration on sleep, sex steroids and multiple 24-h hormonal profiles in postmenopausal women: a pilot study.’, Clin Endocrinol (Oxf), 79 (5), 716-24. PubMed: 23488643
Chang, SM and CH Chen (2016), ‘Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomized controlled trial.’, J Adv Nurs, 72 (2), 306-15. PubMed: 26483209
Cheng, TC and JF Tsai (2009), ‘GABA tea helps sleep.’, J Altern Complement Med, 15 (7), 697-98. PubMed: 19534613
Copinschi, G and A Caufriez (2013), ‘Sleep and hormonal changes in aging.’, Endocrinol Metab Clin North Am, 42 (2), 371-89. PubMed: 23702407
González-Ortiz, M and E Martínez-Abundis (2005), ‘Impact of sleep deprivation on insulin secretion, insulin sensitivity, and other hormonal regulations.’, Metab Syndr Relat Disord, 3 (1), 3-7. PubMed: 18370703
Horiuchi, M, et al. (2013), ‘Ornithine ingestion improved sleep disturbances but was not associated with correction of blood tryptophan ratio in Japanese Antarctica expedition members during summer.’, Nutr Res, 33 (7), 557-64. PubMed: 23827130
Kanagasabai, T and CI Ardern (2015), ‘Inflammation, Oxidative Stress, and Antioxidants Contribute to Selected Sleep Quality and Cardiometabolic Health Relationships: A Cross-Sectional Study.’, Mediators Inflamm, 2015 824589. PubMed: 26568665
Maggio, M, et al. (2013), ‘Stress hormones, sleep deprivation and cognition in older adults.’, Maturitas, 76 (1), 22-44. PubMed: 23849175
Mullington, JM, et al. (2009), ‘Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation.’, Prog Cardiovasc Dis, 51 (4), 294-302. PubMed: 19110131
Parry, BL, et al. (2006a), ‘Sleep, rhythms and women’s mood. Part I. Menstrual cycle, pregnancy and postpartum.’, Sleep Med Rev, 10 (2), 129-44. PubMed: 16460973
Parry, BL, et al. (2006b), ‘Sleep, rhythms and women’s mood. Part II. Menopause.’, Sleep Med Rev, 10 (3), 197-208. PubMed: 16618548
Rotem, C and B Kaplan (2007), ‘Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study.’, Gynecol Endocrinol, 23 (2), 117-22. PubMed: 17454163
Steiger, A, et al. (2011), ‘Ghrelin in mental health, sleep, memory.’, Mol Cell Endocrinol, 340 (1), 88-96. PubMed: 21349316
Wright, KP, et al. (2015), ‘Influence of sleep deprivation and circadian misalignment on cortisol, inflammatory markers, and cytokine balance.’, Brain Behav Immun, 47 24-34. PubMed: 25640603