Alzheimer's disease with sleep insufficiency: a cross-sectional study on correlations among clinical characteristics, orexin, its receptors, and the blood-brain barrier
Guo P, Zhang WJ, Lian TH, Zhang WJ, He MY, Zhang YN, Huang Y, Ding DY, Guan HY, Li JH, Li DN, Luo DM, Zhang WJ, Yue H, Wang XM and Zhang W
Alzheimer's disease with sleep insufficiency: a cross-sectional study on correlations among clinical characteristics, orexin, its receptors, and the blood-brain barrier
Guo P, Zhang WJ, Lian TH, Zhang WJ, He MY, Zhang YN, Huang Y, Ding DY, Guan HY, Li JH, Li DN, Luo DM, Zhang WJ, Yue H, Wang XM and Zhang W
Previous studies have shown that reduced sleep duration, sleep fragmentation, and decreased sleep quality in patients with Alzheimer's disease are related to dysfunction in orexin signaling. At the same time, blood-brain barrier disruption is considered an early biomarker of Alzheimer's disease. However, currently no report has examined how changes in orexin signaling relate to changes in the blood-brain barrier of patients who have Alzheimer's disease with sleep insufficiency. This cross-sectional study included 50 patients with Alzheimer's disease who received treatment in 2019 at Beijing Tiantan Hospital. Patients were divided into two groups: those with insufficient sleep (sleep duration ≤ 6 hours, n = 19, age 61.58 ± 8.54 years, 10 men) and those with normal sleep durations (sleep duration > 6 hours, n = 31, age 63.19 ± 10.09 years, 18 men). Demographic variables were collected to evaluate cognitive function, neuropsychiatric symptoms, and activities of daily living. The levels of orexin, its receptor proteins, and several blood-brain barrier factors were measured in cerebrospinal fluid. Sleep insufficiency was associated with impaired overall cognitive function that spanned multiple cognitive domains. Furthermore, levels of orexin and its receptors were upregulated in the cerebrospinal fluid, and the blood-brain barrier was destroyed. Both these events precipitated each other and accelerated the progression of Alzheimer's disease. These findings describe the clinical characteristics and potential mechanism underlying Alzheimer's disease accompanied by sleep deprivation. Inhibiting the upregulation of elements within the orexin system or preventing the breakdown of the blood-brain barrier could thus be targets for treating Alzheimer's disease.
The association of dietary glycemic index and glycemic load with the risk of insomnia in the adult population
Farhadnejad H, Sadat S, Jahromi MK, Teymoori F, Tehrani AN, Mokhtari E, Teymouri H and Mirmiran P
The association of dietary glycemic index and glycemic load with the risk of insomnia in the adult population
Farhadnejad H, Sadat S, Jahromi MK, Teymoori F, Tehrani AN, Mokhtari E, Teymouri H and Mirmiran P
A dietary pattern with a high glycemic index (GI) and glycemic load (GL) can be a precursor to sleep disorders that link to many chronic diseases. We aimed to assess the association of dietary GI and GL with the risk of insomnia in Iranian adults.
Parental survey of the sleep patterns and screen time in US school children during the first 6 months of the COVID-19 pandemic
Hassinger AB, Monegro A and Perez G
Parental survey of the sleep patterns and screen time in US school children during the first 6 months of the COVID-19 pandemic
Hassinger AB, Monegro A and Perez G
This study compared sleep duration, screen exposure and sleep quality in school-aged children before COVID-19 to that during school closures and again when schools re-opened in fall 2020.
Cumulative Human Immunodeficiency Virus (HIV)-1 Viremia Is Associated With Increased Risk of Multimorbidity Among US Women With HIV, 1997-2019
Morton ZP, Christina Mehta C, Wang T, Palella FJ, Naggie S, Golub ET, Anastos K, French AL, Kassaye S, Taylor TN, Fischl MA, Adimora AA, Kempf MC, Tien PC, Ofotokun I, Sheth AN and Collins LF
Cumulative Human Immunodeficiency Virus (HIV)-1 Viremia Is Associated With Increased Risk of Multimorbidity Among US Women With HIV, 1997-2019
Morton ZP, Christina Mehta C, Wang T, Palella FJ, Naggie S, Golub ET, Anastos K, French AL, Kassaye S, Taylor TN, Fischl MA, Adimora AA, Kempf MC, Tien PC, Ofotokun I, Sheth AN and Collins LF
To evaluate the effect of cumulative human immunodeficiency virus (HIV)-1 viremia on aging-related multimorbidity among women with HIV (WWH), we analyzed data collected prospectively among women who achieved viral suppression after antiretroviral therapy (ART) initiation (1997-2019).
Phenotypic heterogeneity in 22q11.2 deletion syndrome: Copy Number Variants as genetic modifiers for congenital heart disease in a Brazilian cohort
Zamariolli M, Dantas AG, Nunes N, Moysés-Oliveira M, Sgardioli IC, Soares DCQ, Gil-Da-Silva-Lopes VL, Kim CA and Melaragno MI
Phenotypic heterogeneity in 22q11.2 deletion syndrome: Copy Number Variants as genetic modifiers for congenital heart disease in a Brazilian cohort
Zamariolli M, Dantas AG, Nunes N, Moysés-Oliveira M, Sgardioli IC, Soares DCQ, Gil-Da-Silva-Lopes VL, Kim CA and Melaragno MI
The clinical heterogeneity in 22q11.2 deletion syndrome (22q11.2DS) underlies complex genetic mechanisms including variants in other regions of the genome, known as genetic modifiers. Congenital heart disease (CHD) is one of the most relevant phenotypes in the syndrome and copy number variants (CNVs) outside the 22q11.2 region could play a role in its variable expressivity. Since those described loci account for a small proportion of the variability, the CNV analysis in new cohorts from different ancestry-based populations constitutes a valuable resource to identify a wider range of modifiers. We performed SNP-array in 117 Brazilian patients with 22q11.2DS, with and without CHD, and leveraged genome-wide CNV analysis. After quality control, we selected 50 CNVs in 38 patients for downstream analysis. CNVs' genetic content and implicated biological pathways were compared between patients with and without CHD. CNV-affected genes in patients with CHD were enriched for several functional terms related to ubiquitination, transcription factor binding sites and miRNA targets, highlighting the complexity of the phenotype's expressivity. Cardiac-related genes were identified in both groups of patients suggesting that increasing risk and protective mechanisms could be involved. These genes and enriched pathways could indicate new modifiers to the cardiac phenotype in 22q11.2DS patients.
Pain, Sleep Disturbance and Smoking Among Patients with Covid-19 Presenting to the Emergency Department
Eskici İlgin V, Yayla A, Karaman Özlü Z, Özlü İ, Toraman RL and Toraman MM
Pain, Sleep Disturbance and Smoking Among Patients with Covid-19 Presenting to the Emergency Department
Eskici İlgin V, Yayla A, Karaman Özlü Z, Özlü İ, Toraman RL and Toraman MM
AİM: The study aimed to determine the pain, sleep disturbance, and smoking among patients with Covid-19 who were presented to emergency departments.
Contribution of risk and resilience factors to anxiety trajectories during the early stages of the COVID-19 pandemic: A longitudinal study
Shilton T, Mancini AD, Perlstein S, DiDomenico GE, Visoki E, Greenberg DM, Brown LA, Gur RC, Gur RE, Waller RE and Barzilay R
Contribution of risk and resilience factors to anxiety trajectories during the early stages of the COVID-19 pandemic: A longitudinal study
Shilton T, Mancini AD, Perlstein S, DiDomenico GE, Visoki E, Greenberg DM, Brown LA, Gur RC, Gur RE, Waller RE and Barzilay R
The COVID-19 pandemic, and the response of governments to mitigate the pandemic's spread, resulted in exceptional circumstances that comprised a major global stressor, with broad implications for mental health. We aimed to delineate anxiety trajectories over three time-points in the first 6 months of the pandemic and identify baseline risk and resilience factors that predicted anxiety trajectories. Within weeks of the pandemic onset, we established a website (covid19resilience.org), and enrolled 1,362 participants (n=1064 from US; n=222 from Israel) who provided longitudinal data between April-September 2020. We used latent growth mixture modeling to identify anxiety trajectories and ran multivariate regression models to compare characteristics between trajectory classes. A four-class model best fit the data, including a resilient trajectory (stable low anxiety) the most common (n=961, 75.08%), and chronic anxiety (n=149, 11.64%), recovery (n=96, 7.50%) and delayed anxiety (n=74, 5.78%) trajectories. Resilient participants were older, not living alone, with higher income, more education, and reported fewer COVID-19 worries and better sleep quality. Higher resilience factors' scores, specifically greater emotion regulation and lower conflict relationships, also uniquely distinguished the resilient trajectory. Results are consistent with the pre-pandemic resilience literature suggesting that most individuals show stable mental health in the face of stressful events. Findings can inform preventative interventions for improved mental health. This article is protected by copyright. All rights reserved.
Baseline characteristics of the North American prodromal Synucleinopathy cohort
Elliott JE, Lim MM, Keil AT, Postuma RB, Pelletier A, Gagnon JF, St Louis EK, Forsberg LK, Fields JA, Huddleston DE, Bliwise DL, Avidan AY, Howell MJ, Schenck CH, McLeland J, Criswell SR, Videnovic A, During EH, Miglis MG, Shprecher DR, Lee-Iannotti JK, Boeve BF, Ju YS and
Baseline characteristics of the North American prodromal Synucleinopathy cohort
Elliott JE, Lim MM, Keil AT, Postuma RB, Pelletier A, Gagnon JF, St Louis EK, Forsberg LK, Fields JA, Huddleston DE, Bliwise DL, Avidan AY, Howell MJ, Schenck CH, McLeland J, Criswell SR, Videnovic A, During EH, Miglis MG, Shprecher DR, Lee-Iannotti JK, Boeve BF, Ju YS and
Rapid eye movement (REM) sleep behavior disorder (RBD) is widely considered a prodromal synucleinopathy, as most with RBD develop overt synucleinopathy within ~10 years. Accordingly, RBD offers an opportunity to test potential treatments at the earliest stages of synucleinopathy. The North American Prodromal Synucleinopathy (NAPS) Consortium has created a multisite RBD participant, primarily clinic-based cohort to better understand characteristics at diagnosis, and in future work, identify predictors of phenoconversion, develop synucleinopathy biomarkers, and enable early stage clinical trial enrollment.
Bronchial Asthma Exacerbation in the Emergency Department in a Saudi Pediatric Population: An Insight From a Tertiary Hospital in Riyadh, Saudi Arabia
Alfurayh MA, Alturaymi MA, Sharahili A, Bin Dayel MA, Al Eissa AI and Alilaj MO
Bronchial Asthma Exacerbation in the Emergency Department in a Saudi Pediatric Population: An Insight From a Tertiary Hospital in Riyadh, Saudi Arabia
Alfurayh MA, Alturaymi MA, Sharahili A, Bin Dayel MA, Al Eissa AI and Alilaj MO
Background Severe uncontrolled asthma in the pediatric population is a complicated disease and is considered a major challenge for pediatricians. Severe bronchial asthma in the pediatric population is related to significant morbidity and mortality. Children with complicated asthma are at a higher risk for unfavorable outcomes, including medication-associated adverse effects, severe life-threatening exacerbations, and poor quality of life. Methodology A cohort study was conducted at National Guard Health Affairs Hospital in Riyadh, Saudi Arabia. Data were collected using the chart review method utilizing a data collection sheet. A total of 363 charts of children aged one month to 14 years who visited the emergency room (ER) due to asthma exacerbation at NGHA were reviewed, from January 2016 to May 2022, to extract the variables. Variables included demographic data, comorbidities, and asthma-related variables which included the number of asthma exacerbations, hospital admission, ER visit, medication use (non-steroidal anti-inflammatory drugs and steroids), and the presence of allergic rhinitis and eczema. Results A total of 363 patients were analyzed, with 229 (63.1%) males and 134 (36.9%) females. The mean age was 4.9 years (SD = 3.5 years). Overall, 8.5% of patients had congenital heart disease, 4.1% had gastroesophageal reflux disease, 2.2% had diabetes mellitus, 1.9% had obstructive sleep apnea, and 0.6% had hypertension. Most patients presented with a cough at 88.2% (n = 320), followed by shortness of breath at 59% (n = 214) and fever at 46% (n = 167). Male asthmatics visited ER more than females. Forty-four patients were admitted to the hospital. Inhaled steroids were associated with fewer emergency department visits and night symptoms. Most asthmatic patients presented in the winter and fall seasons. Conclusions Asthma is a common pediatric respiratory disease that could be a burden if not controlled well. Unfortunately, the frequency of hospital admissions and pediatric ER visits due to asthma exacerbation is increasing. Comorbidities such as obesity and gastroesophageal reflux disease play a significant role in asthma control.
Insomnia Is Not a Normal Part of Aging: The Challenges of Safely and Effectively Managing Insomnia in Older People
Espeso N and Wick JY
Insomnia Is Not a Normal Part of Aging: The Challenges of Safely and Effectively Managing Insomnia in Older People
Espeso N and Wick JY
Almost everyone has sleep problems from time to time, and often, simple nonpharmacologic interventions can improve sleep hygiene. When nonpharmacologic interventions fail, patients often request and may even require treatment with hypnotics. Insomnia is a heterogeneous disorder. Patients with insomnia may have trouble falling asleep, staying asleep, or waking too early. Sleep disturbances are especially common in older people because of changes in sleep architecture. Though this population may benefit from hypnotics to improve sleep, these drugs increase the risk of polypharmacy, drug interactions, and adverse drug effects, such as falls and cognitive impairment. Pharmacists must consider patient-specific factors to ensure older patients who require hypnotics receive an appropriate drug for an appropriate duration.
