Chronic lack of rest and relaxation

The brain functional connectome is robustly altered by lack of sleep

Type of study: non-rct observational study

Number of citations: 109

Year: 2016

Authors: T. Kaufmann, T. Elvsåshagen, D. Alnæs, Nathalia Zak, Per Ø. Pedersen, L. Norbom, Sophia H. Quraishi, E. Tagliazucchi, H. Laufs, A. Bjørnerud, U. Malt, O. Andreassen, E. Roussos, E. Duff, Stephen M. Smith, I. Groote, L. Westlye

Journal: NeuroImage

Journal ranking: Q1

Key takeaways: Lack of sleep significantly alters the brain's functional connectome, affecting various resting-state networks and affecting overall brain functioning.

Plasticity and Susceptibility of Brain Morphometry Alterations to Insufficient Sleep

Type of study: non-rct observational study

Number of citations: 57

Year: 2018

Authors: Xi-jian Dai, Jian Jiang, Zhiqiang Zhang, Xiao Nie, Bi-Xia Liu, Li Pei, Hong-han Gong, Jianping Hu, G. Lu, Yang Zhan

Journal: Frontiers in Psychiatry

Journal ranking: Q1

Key takeaways: Acute sleep deprivation and chronic insomnia cause distinct morphological changes in brain morphology, which may contribute to attention and memory impairments after sleep loss.

Abstract: Background: Insufficient sleep is common in daily life and can lead to cognitive impairment. Sleep disturbance also exists in neuropsychiatric diseases. However, whether and how acute and chronic sleep loss affect brain morphology remain largely unknown. Methods: We used voxel-based morphology method to study the brain structural changes during sleep deprivation (SD) at six time points of rested wakefulness, 20, 24, 32, 36 h SD, and after one night sleep in 22 healthy subjects, and in 39 patients with chronic primary insomnia relative to 39 status-matched good sleepers. Attention network and spatial memory tests were performed at each SD time point in the SD Procedure. The longitudinal data were analyzed using one-way repeated measures ANOVA, and post-hoc analysis was used to determine the between-group differences. Results: Acute SD is associated with widespread gray matter volume (GMV) changes in the thalamus, cerebellum, insula and parietal cortex. Insomnia is associated with increased GMV in temporal cortex, insula and cerebellum. Acute SD is associated with brain atrophy and as SD hours prolong more areas show reduced GMV, and after one night sleep the brain atrophy is restored and replaced by increased GMV in brain areas. SD has accumulative negative effects on attention and working memory. Conclusions: Acute SD and insomnia exhibit distinct morphological changes of GMV. SD has accumulative negative effects on brain morphology and advanced cognitive function. The altered GMV may provide neurobiological basis for attention and memory impairments following sleep loss. Statement of significance Sleep is less frequently studied using imaging techniques than neurological and psychiatric disorders. Whether and how acute and chronic sleep loss affect brain morphology remain largely unknown. We used voxel-based morphology method to study brain structural changes in healthy subjects over multiple time points during sleep deprivation (SD) status and in patients with chronic insomnia. We found that prolonged acute SD together with one night sleep recovery exhibits accumulative atrophic effect and recovering plasticity on brain morphology, in line with behavioral changes on attentional tasks. Furthermore, acute SD and chronic insomnia exhibit distinct morphological changes of gray matter volume (GMV) but they also share overlapping GMV changes. The altered GMV may provide structural basis for attention and memory impairments following sleep loss.

Chronic sleep fragmentation shares similar pathogenesis with neurodegenerative diseases: Endosome‐autophagosome‐lysosome pathway dysfunction and microglia‐mediated neuroinflammation

Type of study:

Number of citations: 55

Year: 2019

Authors: Yi Xie, Li Ba, Min Wang, Saiyue Deng, Si-Miao Chen, Li-fang Huang, Min Zhang, Wei Wang, Fengfei Ding

Journal: CNS Neuroscience & Therapeutics

Journal ranking: Q1

Key takeaways: Chronic sleep insufficiency in young adult mice is linked to dysfunction of intracellular protein degradation pathways and microglia-mediated neuroinflammation, potentially contributing to neurodegeneration.

Abstract: Insufficient sleep has been found to result in varying degrees of cognitive impairment and emotional changes. Sleep was reported probably responsible for cleaning metabolic wastes in brain by increasing extracellular bulk flow. Herein, we propose that chronic sleep insufficiency in young adult wild‐type mice is also linked with dysfunction of intracellular protein degradation pathways and microglia‐mediated neuroinflammation, which are potentially important mechanisms in the initiation of neurodegeneration.

Chronic sleep restriction promotes brain inflammation and synapse loss, and potentiates memory impairment induced by amyloid-β oligomers in mice

Type of study: non-rct experimental

Number of citations: 98

Year: 2017

Authors: G. C. Kincheski, Isabela S. Valentim, J. Clarke, Danielle Cozachenco, Morgana Castelo-Branco, Angela M. Ramos-Lobo, V. Rumjanek, J. Donato, F. G. Felice, S. Ferreira

Journal: Brain, Behavior, and Immunity

Journal ranking: Q1

Key takeaways: Chronic sleep restriction increases brain vulnerability to amyloid- oligomers, leading to memory impairment and increased brain inflammation in mice.

Low-grade neuroinflammation due to chronic sleep deprivation results in anxiety and learning and memory impairments

Type of study: non-rct experimental

Number of citations: 113

Year: 2018

Authors: Shaffi Manchanda, Harpal Singh, T. Kaur, G. Kaur

Journal: Molecular and Cellular Biochemistry

Journal ranking: Q1

Key takeaways: Chronic sleep deprivation in rats leads to low-grade neuroinflammation, causing anxiety and memory impairments.

Abstract: Chronic sleep loss/fragmentation prevalent in the current 24/7 society is associated with irreversible consequences on health and overall wellbeing. Various studies have well documented the ill effects of acute sleep loss on cognitive functions of individuals; however, the underlying mechanism behind the chronic sleep loss is yet to be explored. The present study was aimed to investigate whether chronic sleep deprivation (CSD) triggers anxiety-like behaviour and memory decline in male Wistar rats. Rats were sleep deprived by placing them over slowly rotating drum (2 rpm) for 18 h (between 4 pm and 10 am) followed by 6 h of recovery sleep for 21 consecutive days. Post CSD regimen, rats were subjected to behavioural tests such as elevated plus maze (EPM), Novel Object Recognition (NOR) and Rotarod performance test and then sacrificed to remove brain for further molecular studies. The study demonstrated that CSD rats showed anxiogenic behaviour along with recognition memory decline compared to control rats. CSD rats further showed elevated levels of inflammatory cytokines (TNFα, IL-1β) along with activation of NFκB and AP1 transcription factors in hippocampus and piriform cortex (PC) regions of brain. These observations were also accompanied by enhanced expression of GFAP and Iba1 in the two brain regions. The data suggest that CSD triggered low-grade neuroinflammation which caused anxiogenic response and recognition memory impairment. The study provides preliminary leads to further explore the role of astrocytes/microglial cells and inflammatory cytokines in mediating these neurobehavioural consequences of chronic sleep loss and to develop effective interventions to combat them.

A night of sleep deprivation alters brain connectivity and affects specific executive functions

Type of study: non-rct experimental

Number of citations: 25

Year: 2021

Authors: M. Pesoli, R. Rucco, M. Liparoti, Anna Lardone, Giulia D’Aurizio, R. Minino, E. Troisi Lopez, Antonella Paccone, Carmine Granata, G. Curcio, G. Sorrentino, L. Mandolesi, P. Sorrentino

Journal: Neurological Sciences

Journal ranking: Q1

Key takeaways: 24 hours of sleep deprivation negatively affects attentional abilities and brain connectivity, but not switching abilities.

Abstract: Sleep is a fundamental physiological process necessary for efficient cognitive functioning especially in relation to memory consolidation and executive functions, such as attentional and switching abilities. The lack of sleep strongly alters the connectivity of some resting-state networks, such as default mode network and attentional network. In this study, by means of magnetoencephalography (MEG) and specific cognitive tasks, we investigated how brain topology and cognitive functioning are affected by 24 h of sleep deprivation (SD). Thirty-two young men underwent resting-state MEG recording and evaluated in letter cancellation task (LCT) and task switching (TS) before and after SD. Results showed a worsening in the accuracy and speed of execution in the LCT and a reduction of reaction times in the TS, evidencing thus a worsening of attentional but not of switching abilities. Moreover, we observed that 24 h of SD induced large-scale rearrangements in the functional network. These findings evidence that 24 h of SD is able to alter brain connectivity and selectively affects cognitive domains which are under the control of different brain networks.

Neural consequences of chronic sleep disruption

Type of study:

Number of citations: 55

Year: 2022

Authors: Zachary Zamore, S. Veasey

Journal: Trends in Neurosciences

Journal ranking: Q1

Key takeaways: Chronic sleep disruption can lead to protracted recovery of neurobehavioral performance, particularly sustained vigilance and episodic memory, with potential implications for aging and neurodegenerative disorders.

Chronic Sleep Deprivation Exacerbates Learning-Memory Disability and Alzheimer’s Disease-Like Pathologies in AβPPswe/PS1ΔE9 Mice

Type of study: non-rct experimental

Number of citations: 82

Year: 2016

Authors: Hongyan Qiu, Rujia Zhong, Hui Liu, Feng Zhang, Song Li, W. Le

Journal: Journal of Alzheimer's Disease

Journal ranking: Q1

Key takeaways: Chronic sleep deprivation impairs learning and memory, exacerbates Alzheimer's disease pathologies, and causes long-lasting neuronal damage in mice.

Abstract: Recently, there is an increasing concern over the association between sleep disorders and Alzheimer’s disease (AD). Clinical observations have reported that chronic sleep deprivation (SD) may serve as a risk factor for AD. However, the pathological evidence for this assumption is still lacking. In the present study, we examined the potential impacts of chronic SD on learning-memory and AD-related pathologies in AβPPswe/PS1 ΔE9 transgenic (TG) mice and their wild-type (WT) littermates. Results indicated that mice (both TG and WT) exposed to 2-month SD showed an altered amyloid-β protein precursor processing, an elevated level of phosphorylated tau protein, and impaired cognitive performance as compared to non-sleep deprivation (NSD) controls. Moreover, the SD-treated TG mice exhibited more amyloid-β1-42 production and developed more senile plaques in the cortex and hippocampus than NSD-treated TG mice. In addition, SD caused a striking neuronal mitochondrial damage, caspase cascade activation, and neuronal apoptosis in the hippocampus of both TG and WT mice. More importantly, all these behavioral, neuropathological, and biochemical changes induced by chronic SD were long lasting and were irreversible during a 3-month normal housing condition. Collectively, these results indicate that chronic SD impairs learning and memory, exacerbates AD pathologies, and aggravates the mitochondria-mediated neuronal apoptosis in a long-lasting manner. Our findings provide important experimental evidence to prove that chronic SD is a risk factor for AD.

Chronic Sleep Deprivation Altered the Expression of Memory-Related Genes and Caused Cognitive Memory Dysfunction in Mice

Type of study: non-rct experimental

Number of citations: 2

Year: 2024

Authors: Xiang Wang, Hanqing Chen, Tian Tang, Xiang Zhan, Shu Qin, Taijun Hang, Min Song

Journal: International Journal of Molecular Sciences

Journal ranking: Q1

Key takeaways: Chronic sleep deprivation in mice leads to cognitive memory dysfunction and alters memory-related gene expression, potentially contributing to sporadic Alzheimer's disease.

Abstract: Lack of sleep, whether acute or chronic, is quite common and negatively affects an individual’s memory and cognitive function. The question of whether chronic sleep deprivation (CSD) causes cognitive impairment to arise and progress is not well studied. To investigate the effects of CSD on memory and cognition, this study began by establishing a CSD mouse model. Behavioral experiments on animals revealed that CSD induced cognitive behavioral abnormalities reminiscent of Alzheimer’s disease. Western blot experiments further demonstrated a considerable increase in amyloid-β (Aβ) expression in the mouse brain following CSD. Meanwhile, the hub gene Prkcg was searched for in the cerebellum using RNA-seq and bioinformatics analysis. PKCγ (Prkcg) expression was significantly reduced, as demonstrated by RT-qPCR and Western blot validations. Additionally, CSD was associated with downregulated CREB expression, decreased expression of the endothelin-converting enzyme (ECE1), and increased phosphorylation of ERK1/2 downstream of PKCγ. These findings suggested that CSD down-regulated PKCγ expression, decreased ECE1 expression, impaired Aβ degradation, and affected the PKCγ/ERK/CREB pathway and the synthesis of memory-related proteins. Overall, this study highlighted how CSD modulated PKCγ-related metabolism, impacting Aβ clearance and the production of memory-related proteins. Such insights are crucial for understanding and preventing sporadic Alzheimer’s disease (sAD) associated with CSD.

Chronic sleep restriction increases soluble hippocampal Aβ-42 and impairs cognitive performance

Type of study: non-rct experimental

Number of citations: 16

Year: 2020

Authors: Kelly N Brice, C. Hagen, J. L. Peterman, J. Figg, P. Braden, M. Chumley, G. Boehm

Journal: Physiology & Behavior

Journal ranking: Q2

Key takeaways: Chronic sleep restriction impairs cognitive performance and increases hippocampal amyloid-beta levels, potentially contributing to Alzheimer's disease.

Neurological Disorders and Innovations in Targeted Drug Delivery

Type of study:

Number of citations: 0

Year: 2025

Authors: Tiwari Sandip Prasad, Sahu Mahendra Kumar

Journal: Journal of Clinical Neuroscience and Rehabilitation

Journal ranking: brak

Key takeaways: Sleep deprivation significantly impairs cognitive functions like memory, attention, and decision-making, emphasizing the importance of adequate rest for optimal brain health.

Abstract: Chronic stress is known to have significant effects on brain function and structure, particularly in regions such as the hippocampus, which plays a crucial role in memory and emotion regulation. This neuroscience study aimed to investigate the relationship between neuronal disorders, pathogenesis, and drug delivery techniques. Researchers utilized a combination of behavioral assessments, neuroimaging techniques, and molecular analyses to examine the impact of stress on the brain. Animal models were subjected to various stressors over time, with their brain activity monitored using EEG and MRI scans. Post-mortem analyses further assessed gene expression changes and neurogenesis within the hippocampus. Control groups were included to compare the effects of stress on brain function. The results demonstrated that sleep deprivation significantly impairs cognitive functions such as memory, attention, and decision-making. These findings emphasize the critical role of sleep in maintaining optimal brain health and cognitive performance, reinforcing the importance of adequate rest for overall neurological well-being.

Sleep Loss: What Does It Do to Our Brain and Body?

Type of study: literature review

Number of citations: 1

Year: 2020

Authors: V. Jha, Sushil K. Jha

Journal:

Journal ranking: brak

Key takeaways: Chronic sleep loss can impair neuronal functions, increase risk of hypertension, cardiovascular disease, and compromise the immune system, affecting the health of individuals of all ages.

Abstract: It is nowadays a common practice to “work without sleep and catch up later.” It is not a good idea to keep up with sleep deficit. In recent years, several reports have shown that the consequences of chronic sleep loss are not reversible. It may cause impairment in neuronal functions and neurodegeneration. The energy expenditure, risk of hypertension, cardiovascular disease increases, and the immune system diffuses into a compromised state during sleep deprivation. Sleep deprivation may cause the deposition of toxic metabolites usually produced during long hours of wakefulness. It may impair neurological functions and cause the death of brain cells. Sleep loss is affecting the health of children, adults, and elderly people. The brain shrinks, and the body becomes vulnerable to diseases. It affects the brain and neural development in children too. It is an irony that though its implications are gradually becoming clear, still it is turning out to be an epidemic in our modern society. Sleep loss can become a liability for the people having unusual lifestyles, working for long hours, in the night shift, and the subjects suffering from chronic sleep disorders. Here, we review some evidence to appraise the understanding of the known changes in our brain and body after prolonged sleep deprivation.

The impact of sleep and exercise on brain atrophy in mild cognitive impairment

Type of study: literature review

Number of citations: 0

Year: 2024

Authors: Maamoon Mian, J. Tahiri, Saadeddine Habbal, Fatima Aftan, P. H. Reddy

Journal: Mechanisms of Ageing and Development

Journal ranking: Q1

Key takeaways: Chronic sleep deprivation accelerates brain atrophy in mild cognitive impairment, while physical exercise preserves brain structure and supports cognitive resilience in aging populations.

Chronic sleep curtailment, even without extended (>16-h) wakefulness, degrades human vigilance performance

Type of study: rct

Number of citations: 66

Year: 2018

Authors: A. McHill, J. Hull, Wei Wang, C. Czeisler, E. Klerman

Journal: Proceedings of the National Academy of Sciences

Journal ranking: Q1

Key takeaways: Chronic short sleep duration impairs neurobehavioral performance and self-assessment of alertness, even without extended wakefulness.

Abstract: Significance Millions of individuals obtain insufficient sleep on a daily basis, which leads to impaired performance. Whether these decrements are caused by short sleep duration or extended wakefulness is unknown. In this study, healthy volunteers were randomized into either a chronically sleep-restricted or control protocol while living on a 20-h “day,” thus enabling short sleep without extended wakefulness. We demonstrate that chronic insufficient sleep, even without extended wakefulness, leads to neurobehavioral performance decrements at all times of the day, even when the circadian system is promoting arousal. These findings have implications for the understanding of basic physiology, the substantial population who chronically obtains insufficient sleep, and all of us who depend on sleep-restricted individuals working in safety-sensitive occupations. Millions of individuals routinely remain awake for more than 18 h daily, which causes performance decrements. It is unknown if these functional impairments are the result of that extended wakefulness or from the associated shortened sleep durations. We therefore examined changes in objective reaction time performance and subjective alertness in a 32-d inpatient protocol in which participants were scheduled to wakefulness durations below 16 h while on a 20-h “day,” with randomization into standard sleep:wake ratio (1:2) or chronic sleep restriction (CSR) ratio (1:3.3) conditions. This protocol allowed determination of the contribution of sleep deficiency independent of extended wakefulness, since individual episodes of wakefulness in the CSR condition were only 15.33 h in duration (less than the usual 16 h of wakefulness in a 24-h day) and sleep episodes were 4.67 h in duration each cycle. We found that chronic short sleep duration, even without extended wakefulness, doubled neurobehavioral reaction time performance and increased lapses of attention fivefold, yet did not uniformly decrease self-reported alertness. Further, these impairments in neurobehavioral performance were worsened during the circadian night and were not recovered during the circadian day, indicating that the deleterious effect from the homeostatic buildup of CSR is expressed even during the circadian promotion of daytime arousal. These findings reveal a fundamental aspect of human biology: Chronic insufficient sleep duration equivalent to 5.6 h of sleep opportunity per 24 h impairs neurobehavioral performance and self-assessment of alertness, even without extended wakefulness.

The impact from the aftermath of chronic stress on hippocampal structure and function: Is there a recovery?

Type of study:

Number of citations: 52

Year: 2018

Authors: J. B. Ortiz, C. Conrad

Journal: Frontiers in Neuroendocrinology

Journal ranking: Q1

Key takeaways: Chronic stress impairs hippocampal-mediated cognition, but after a 'post-stress rest period,' spatial memory deficits improve and CA3 apical dendritic arbors increase in complexity.

Progressive muscle relaxation increases slow‐wave sleep during a daytime nap

Type of study:

Number of citations: 11

Year: 2022

Authors: K. Simon, Elizabeth A. McDevitt, Rocco Ragano, S. Mednick

Journal: Journal of Sleep Research

Journal ranking: Q1

Key takeaways: Progressive muscle relaxation (PMR) before a nap increases slow-wave sleep and reduces rapid eye movement sleep, potentially improving sleep quality and reducing fatigue.

Abstract: Sleep is critical for health, cognition, and restorative processes, and yet, many experience chronic sleep restriction. Sleep interventions have been designed to enhance overnight sleep quality and physiology. Components of these interventions, like relaxation‐based progressive muscle relaxation (PMR), have been studied in isolation and have shown direct effects on sleep architecture, including increasing time in restorative, slow‐wave sleep (SWS). These relaxation methods have been understudied in naps, which are effective fatigue countermeasures that reduce deleterious effects of chronic sleep restriction. We hypothesised that PMR should boost SWS in a nap, as compared to an active control. We used a between‐subject design in which healthy young adults underwent PMR training or listened to Mozart music (control) prior to a 90‐min nap opportunity. We assessed changes in the amount and lateralisation of SWS, as evidence suggests left hemispheric lateralisation may be a proxy for recuperative sleep needs, and changes to state‐dependent anxiety and fatigue before and after the nap to assess intervention success. We found PMR participants spent ~10 min more in SWS, equivalent to 125% more time, than the control group, and concomitantly, significantly less time in rapid eye movement sleep. PMR participants also had greater right lateralised slow‐wave activity and delta activity compared to the control suggesting a more well‐rested brain profile during sleep. Further, pre‐sleep anxiety levels predicted nap architecture in the intervention group, suggesting benefits may be impacted by anxiety. The feasibility and accessibility of PMR prior to a nap make this an interesting research avenue to pursue with strong translational application.

Chronic sleep restriction causes a decrease in hippocampal volume in adolescent rats, which is not explained by changes in glucocorticoid levels or neurogenesis

Type of study: non-rct experimental

Number of citations: 98

Year: 2011

Authors: A. Novati, H. Hulshof, J. Koolhaas, P. Lucassen, P. Meerlo

Journal: Neuroscience

Journal ranking: Q2

Key takeaways: Chronic sleep restriction in adolescent rats leads to a decrease in hippocampal volume, potentially contributing to depression and sleep disorders.

THE EFFECTS OF EXERCISE ON BRAIN FUNCTIONAL CONNECTIVITY IN ADULTS AGED 55–65 EXPOSED TO EXPERIMENTAL BED REST

Type of study: rct

Number of citations: 0

Year: 2024

Authors: G. Balbim, C. Hsu, D. Tai, Simon Duchesne, Kenneth M. Madden, Teresa Liu-Ambrose

Journal: Innovation in Aging

Journal ranking: Q1

Key takeaways: Exercise during 14 days of experimental bed rest did not significantly affect brain resting-state connectivity in healthy middle-aged and older adults.

Abstract: Abstract Bed rest can occur because of chronic conditions, injury, or hospitalization and initiate a downward spiral of deleterious changes in several body systems. Exercise is a countermeasure to many of these changes. However, its impact on middle-aged and older adults’ brain functional connectivity (FC) during bed rest remains unexplored. We examined the effects of exercise on brain resting-state FC in adults exposed to 14 days of experimental 6° head-down bed rest (HDBR). We conducted a non-blinded, parallel-group, randomized controlled trial with 23 healthy adults aged 55-65. Participants were randomized to either 14 days of HDBR (CON) or 14 days of HDBR with daily aerobic and strength exercise training (EX). At baseline and HDBR completion, participants underwent brain structural and resting-state functional magnetic resonance (MRI). Resting-state MRI preprocessing was performed using the FMRIPREP version 20.2.3. We extracted preprocessed resting-state time-series from a priori networks of interest based on Yeo’s 7-network parcellation. We conducted complete-case data analysis (NEX=11; NCON=8). Analysis of covariance explored EX effects on resting-state FC after controlling for baseline resting-state FC and baseline physical activity assessed by the Physical Activity Scale for the Elderly. Changes in EX resting-state FC within- and between- the Visual, Sensorimotor, Dorsal Attention, Ventral Attention, Fronto-Executive, Frontoparietal, and Default Mode Networks were not statistically significant compared with CON (all ps > 0.05). Exposure to 14 days of experimental HDBR or 14 days of daily aerobic and strength exercise training in HDBR did not elicit changes in brain resting-state FC of healthy middle-aged and older adults.

Brain functional connectivity dynamics at rest in the aftermath of affective and cognitive challenges

Type of study: non-rct experimental

Number of citations: 19

Year: 2020

Authors: Julian Gaviria, Gwladys Rey, T. Bolton, Jaime Delgado, D. Van de Ville, Patrik Vuilleumier

Journal: Human Brain Mapping

Journal ranking: Q1

Key takeaways: Emotional states influence brain activity at rest, with certain networks showing differential expression based on the emotional valence of the challenge.

Abstract: Carry‐over effects on brain states have been reported following emotional and cognitive events, persisting even during subsequent rest. Here, we investigated such effects by identifying recurring co‐activation patterns (CAPs) in neural networks at rest with functional magnetic resonance imaging (fMRI). We compared carry‐over effects on brain‐wide CAPs at rest and their modulation after both affective and cognitive challenges. Healthy participants underwent fMRI scanning during emotional induction with negative valence and performed cognitive control tasks, each followed by resting periods. Several CAPs, overlapping with the default‐mode (DMN), salience, dorsal attention, and social cognition networks were impacted by both the preceding events (movie or task) and the emotional valence of the experimental contexts (neutral or negative), with differential dynamic fluctuations over time. Temporal metrics of DMN‐related CAPs were altered after exposure to negative emotional content (compared to neutral) and predicted changes in subjective affect on self‐reported scores. In parallel, duration rates of another attention‐related CAP increased with greater task difficulty during the preceding cognitive control condition, specifically in the negative context. These findings provide new insights on the anatomical organization and temporal inertia of functional brain networks, whose expression is differentially shaped by emotional states, presumably mediating adaptive homeostatic processes subsequent to behaviorally challenging events.

Aberrant temporal and spatial brain activity during rest in patients with chronic pain

Type of study: non-rct observational study

Number of citations: 183

Year: 2010

Authors: S. Malinen, N. Vartiainen, Yevhen Hlushchuk, M. Koskinen, P. Ramkumar, N. Forss, E. Kalso, R. Hari

Journal: Proceedings of the National Academy of Sciences

Journal ranking: Q1

Key takeaways: Chronic pain patients exhibit altered brain activity in affective pain-processing areas, potentially related to altered autonomic nervous system activity.

Abstract: In the absence of external stimuli, human hemodynamic brain activity displays slow intrinsic variations. To find out whether such fluctuations would be altered by persistent pain, we asked 10 patients with unrelenting chronic pain of different etiologies and 10 sex- and age-matched control subjects to rest with eyes open during 3-T functional MRI. Independent component analysis was used to identify functionally coupled brain networks. Time courses of an independent component comprising the insular cortices of both hemispheres showed stronger spectral power at 0.12 to 0.25 Hz in patients than in control subjects, with the largest difference at 0.16 Hz. A similar but weaker effect was seen in the anterior cingulate cortex, whereas activity of the precuneus and early visual cortex, used as a control site, did not differ between the groups. In the patient group, seed point-based correlation analysis revealed altered spatial connectivity between insulae and anterior cingulate cortex. The results imply both temporally and spatially aberrant activity of the affective pain-processing areas in patients suffering from chronic pain. The accentuated 0.12- to 0.25-Hz fluctuations in the patient group might be related to altered activity of the autonomic nervous system.

Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials

Type of study: meta-analysis

Number of citations: 565

Year: 2021

Authors: A. Scott, Thomas Llewelyn Webb, Marrissa Martyn-St James, G. Rowse, S. Weich

Journal: Sleep Medicine Reviews

Journal ranking: Q1

Key takeaways: Improving sleep quality leads to significant improvements in mental health, including reduced depression, anxiety, and rumination, with greater sleep improvements resulting in better mental health outcomes.

Effect of Inadequate Sleep on Frequent Mental Distress

Type of study: non-rct observational study

Number of citations: 48

Year: 2021

Authors: Amanda J. Blackwelder, Mikhail Hoskins, L. Huber

Journal: Preventing Chronic Disease

Journal ranking: Q1

Key takeaways: Inadequate sleep, defined as 6 hours or less per night, is significantly associated with increased odds of frequent mental distress in US adults aged 18 to 64.

Abstract: Introduction One-third of US adults report sleeping less than the recommended amount, and approximately 20% live with a mental illness. The objective of our study was to examine the association between inadequate sleep and frequent mental distress in a population-based sample of US adults. Methods We conducted a cross-sectional study by using 2018 Behavioral Risk Factor Surveillance System (BRFSS) data that included 273,695 US adults aged 18 to 64. Inadequate sleep was defined as 6 hours or less in a given night, and frequent mental distress was defined as self-reporting 14 days of mental health status as “not good” within the last month. We used weighted logistic regression to calculate odds ratios (ORs) and 95% CIs. Results Thirteen percent of study participants experienced inadequate sleep, and 14.1% experienced frequent mental distress. Participants who averaged 6 hours or less of sleep per night were about 2.5 times more likely to have frequent mental distress when controlling for confounders (OR, 2.52; 95% CI, 2.32–2.73) than those who slept more than 6 hours. Conclusion Inadequate sleep was associated with significantly increased odds of frequent mental distress. Our findings suggest that further research is necessary to evaluate the temporal relationship between inadequate sleep and frequent mental distress.

Utilizing the Health Belief Model to move post-secondary students toward flourishing mental health

Type of study: non-rct observational study

Number of citations: 6

Year: 2020

Authors: Gray Zaidlin, Konrad T. Lisnyj, B. Dougherty, Natasha Cook, A. Papadopoulos

Journal: The Journal of Positive Psychology

Journal ranking: Q1

Key takeaways: Post-secondary students with average stress levels and three or more restful nights of sleep per week are more likely to flourish mental health, while those with symptoms of anxiety and depression, above or below average stress, and few restful sleep nights are more likely to languish.

Abstract: ABSTRACT Factors related to the ‘typical university experience,’ such as high levels of perceived stress and a lack of sleep, negatively affect student mental health. The present study analyzes mental health risk and protective factors from 2,472 respondents gathered through the National College Health Assessment-II survey to inform the development of a mental health program for post-secondary students at an institution in Southwestern Ontario, Canada. Students who reported symptoms or diagnoses of anxiety and depression, above or below average stress, and few nights of restful sleep were more likely to be languishing than moderately mentally healthy, while students who reported average levels of stress and three or more restful nights of sleep per week were more likely to be flourishing than moderately mentally healthy. This work draws on the Health Belief Model in developing effective wellness programs to help students move along the mental health continuum toward flourishing.

Editorial: Psychological sleep studies: new insights to support and integrate clinical practice within the healthcare system, volume II

Type of study:

Number of citations: 1

Year: 2024

Authors: M. Sforza, Luigi Ferini-Strambi, Christian Franceschini

Journal: Frontiers in Psychology

Journal ranking: Q2

Key takeaways: Integrating sleep health into mental healthcare strategies can improve patient quality of life and reduce psychological symptoms, particularly in vulnerable populations like university students.

Abstract: Sleep health is essential for overall physical and mental well-being. Insufficient sleep, whether in terms of quantity or quality, significantly impacts an individual's quality of life and day-to-day functioning [1]. Consequences of sleep disorders like insomnia include impaired daytime cognition, reduced work productivity, an increased risk of accidents and injuries, and have been linked to psychiatric disorders, cardiovascular diseases, and other chronic health conditions. [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16].Sleep problems may compromise with the treatments that are currently being administered for a wide range of illnesses. When these disorders are addressed, they have the potential to enhance the patient's quality of life and adherence to therapy, as well as the intensity of the psychological symptoms that they are experiencing. It has been shown that there is a complicated association between sleep and mental health issues, such as anxiety, depression, and traumatic stress disorders. This interaction is considered to be bidirectional [2], [16], [17]. There is a growing demand in the clinical setting for psychologists who are skilled in evidence-based psychotherapy to become members of multidisciplinary health teams. These psychologists would be tasked with providing cognitive-behavioral intervention and support for patients suffering from insomnia [18], narcolepsy [19], [20], and adherence to treatment for obstructive sleep apnea [21].This volume brings together a collection of research that delves into different aspects of sleep health and its relationship with psychological well-being, offering new approaches to addressing these challenges in various populations. The findings provide critical implications for clinical practice, aiming to improve sleep health management across diverse healthcare settings.Luo et al. [22] investigate the mental health challenges, particularly anxiety and poor sleep, experienced by healthcare workers during the COVID-19 pandemic. Their study shows that Progressive Muscle Relaxation (PMR) significantly alleviates anxiety and improves sleep quality among practitioners in high-stress environments like mobile cabin hospitals. The intervention demonstrated a reduction in both anxiety and poor sleep indices, offering an accessible and effective solution to mitigate mental health strains during pandemicrelated crises.This study highlights the potential of PMR as a non-invasive, cost-effective intervention that could be readily implemented in healthcare systems to support the mental health of frontline workers. Given the global scale of the healthcare crisis, integrating such tools into standard healthcare practice could enhance workforce wellbeing and performance.In their study, O'Regan et al. [23] explore the patient journey in managing insomnia across Europe and Canada. By mapping the phases of insomnia management, from self-initiated behavioral changes to long-term reliance on prescription medications, the authors reveal a considerable gap in the alignment of healthcare provider strategies and patient needs. Their research uncovers key points where interventions can be improved, particularly in addressing patient expectations and enhancing education around sleep hygiene and nonpharmacological treatments.Overall, the findings show that patient education is crucial to remove the stigma surrounding insomnia, helping patients recognize that chronic insomnia is a primary disorder that requires appropriate medical management, and encouraging them to seek help earlier. Additionally, healthcare provider education and training on sleep disorders are essential to increase the perception of chronic insomnia as a serious primary medical condition and to fully understand its significant impact on patients' daily lives. Furthermore, the current situation, in which many patients must settle for 'manageable' insomnia, highlights a serious unmet need regarding the management and treatment of this condition. More comprehensive approaches are needed to ensure that patients receive effective care that goes beyond symptom management, addressing the root causes of their insomnia and improving their long-term health outcomes.Wale et al. [24] shed light on the high prevalence of insomnia among university students in Ethiopia. Their study identifies key predictors, including gender, age, mild anxiety symptoms, and excessive use of mobile devices before bedtime, which significantly contribute to poor sleep quality among students. The findings underscore the impact of lifestyle factors and mental health challenges on sleep patterns in young adults, a group particularly vulnerable to sleep disturbances due to academic stress and lifestyle transitions.The study calls for targeted interventions focusing on mental health support and promoting better sleep hygiene among university students. Educational institutions should integrate sleep health education into their wellness programs, emphasizing the importance of mental health and limiting late-night screen exposure.Zambelli et al. evaluate the feasibility of delivering CBT-I through telehealth to chronic pain patients suffering from insomnia [25]. The study shows that adapted CBT-I delivered via telehealth not only improved sleep quality but also alleviated symptoms of anxiety, and depression. The research highlights the growing role of telehealth in making effective sleep interventions more accessible, particularly for populations with mobility issues or those living in remote areas.Telehealth-based interventions offer a scalable and practical solution to reach populations with limited access to in-person therapy. As healthcare systems continue to embrace digital health solutions, telehealth-based CBT-I can play a pivotal role in addressing sleep disorders, particularly in the post-pandemic era where telehealth has become more prominent.While the studies presented in this volume offer important insights, several areas remain unexplored, signaling opportunities for future research. First, the long-term effectiveness of non-pharmacological interventions like PMR and CBT-I across diverse populations, including adolescents and the elderly, needs further investigation. Additionally, the impact of behavioral and lifestyle factors, such as mobile device use before bedtime, which has been shown to significantly influence sleep quality, particularly among younger populations, requires deeper examination.As telehealth becomes an increasingly central component of healthcare delivery, there is also a need to assess its broader efficacy across varying cultural contexts, socioeconomic groups, and medical conditions.Understanding how digital interventions like telehealth-delivered CBT-I can be optimized to meet the needs of different populations will be crucial for the equitable expansion of these services.The collection of research in this volume underscores the profound interconnectedness of sleep health and psychological well-being. From frontline healthcare workers grappling with anxiety during pandemics to chronic pain patients benefiting from telehealth-delivered CBT-I, these studies highlight the necessity of integrating sleep health into broader mental healthcare strategies. Sleep disorders, particularly insomnia, are often underdiagnosed and undertreated, despite their substantial repercussions on both individual and societal health.Psychologists play a crucial role in addressing sleep-related disorders, not only through therapeutic interventions such as CBT-I but also by promoting sleep hygiene and mental wellness as foundational elements of health. Academic training programs in psychology should emphasize the importance of sleep as a pillar of mental well-being, equipping future practitioners with the skills to recognize, address, and treat sleep disturbances as part of a comprehensive mental health approach.To advance a holistic approach, healthcare systems must prioritize early detection and treatment of sleep disorders, leveraging cross-disciplinary methods that integrate mental health, technology, and lifestyle interventions. This volume provides a robust foundation for understanding the significance of sleep in clinical practice, yet ongoing research and innovation will be essential to refine and expand these approaches, fostering a truly integrative model of mental healthcare that includes sleep as a central component.

Sustained sleep restriction reduces emotional and physical well-being

Type of study: rct

Number of citations: 408

Year: 2005

Authors: M. Haack, J. Mullington

Journal: Pain

Journal ranking: Q1

Key takeaways: Chronic insufficient sleep may contribute to the onset and amplification of pain by compromising optimism and psychosocial functioning.

A narrative review of the pathophysiology and impacts of insufficient and disrupted sleep.

Type of study: literature review

Number of citations: 6

Year: 2023

Authors: M. Steffey, Valery F. Scharf, M. Risselada, N. Buote, Dominique Griffon, Alexandra L Winter, H. Zamprogno

Journal: The Canadian veterinary journal = La revue veterinaire canadienne

Journal ranking: brak

Key takeaways: Insufficient sleep negatively impacts mental and physical health, and improving awareness of healthy sleep habits and the consequences of insufficient sleep is essential for promoting overall well-being.

Abstract: Background Despite substantial ramifications of insufficient sleep on mental and physical health and general well-being, many individuals are unaware of what constitutes sufficient sleep, or of the short- and long-term extent of sleep deficiency effects, including those that may not be perceived as fatigue. Objectives and procedures This review describes the physiology of sleep, defines healthy standards, reviews the pathophysiology and health hazards of acute and chronic sleep insufficiency, and offers concepts for improving individual sleep hygiene. Online databases were searched to extract literature pertaining to sleep, sleep insufficiency, fatigue, and health, with emphasis on literature published in the preceding 5 years. Results The detrimental effects of acute and chronic sleep loss vary in their range and impact. Individuals often obtain a substandard quantity of sleep, a problem that is poorly recognized by individuals and society. This lack of recognition perpetuates a culture in which sleep insufficiency is accepted, resulting in serious and substantial negative impacts on mental and physical health. Conclusion and clinical relevance Sleep management is one of the most fundamental and changeable aspects of personal health. Improving awareness of the important physiological roles of sleep, healthy sleep habits, and the consequence of insufficient sleep is essential in promoting general well-being and mental and physical health.

Comparison of rest‐break interventions during a mentally demanding task

Type of study:

Number of citations: 44

Year: 2018

Authors: G. Blasche, B. Szabo, M. Wagner-Menghin, C. Ekmekcioglu, Erwin Gollner

Journal: Stress and Health

Journal ranking: Q1

Key takeaways: During mentally demanding tasks, rest breaks involving physical activity or relaxation exercises can enhance well-being and reduce fatigue, with effects lasting up to 20 minutes.

Abstract: Abstract Research is scarce on ways to enhance the effect of rest breaks during mentally demanding tasks. The present study investigated the effectiveness of two rest‐break interventions on well‐being during an academic lecture. Sixty‐six students (53 females, mean age 22.5 years) enrolled in two different university classes of 4‐hr duration participated in the study. Two measures of well‐being (fatigue and vigor) were assessed immediately before, after, and 20 minutes after the break. A control condition without a break as well as an unstructured break was compared with breaks either encompassing physical activity or a relaxation exercise. Compared with the nonbreak condition, the unstructured rest break led to an increase in vigor, the exercise break as well as the relaxation break both to an increase in vigor and a decrease in fatigue at 20‐min post break. Compared with the unstructured break, exercise led to an (additional) increase in vigor and relaxation to an (additional) decrease in fatigue at 20‐min post break. Thus, the effects of rest breaks during mentally demanding tasks can be enhanced by engaging in physical activity or relaxation exercises, with effects lasting at least as long as 20 min into the continuation of the task.

The Effects of Job Demands on Nurses' Burnout and Presenteeism through Sleep Quality and Relaxation.

Type of study: non-rct observational study

Number of citations: 85

Year: 2019

Authors: Nicolas Gillet, Tiphaine Huyghebaert‐Zouaghi, C. Réveillère, P. Colombat, E. Fouquereau

Journal: Journal of clinical nursing

Journal ranking: Q1

Key takeaways: Emotional dissonance and workload negatively impact nurses' sleep quality and relaxation, leading to higher levels of presenteeism and emotional exhaustion.

Abstract: AIMS AND OBJECTIVES The main aim of this study was to investigate the indirect effects of emotional dissonance and workload on presenteeism and emotional exhaustion through sleep quality and relaxation. BACKGROUND Numerous investigations have found that job demands are related to employees' health and behaviors, but additional studies are needed among nurse samples. Specifically, little is known about the relationships between nurses' emotional dissonance and workload on one hand, and presenteeism and emotional exhaustion on the other hand. Moreover, research is needed to further explore the psychological mechanisms underlying these relationships. DESIGN We used a cross-sectional design. Our study was carried out between October 2015 and February 2016. Precisely, we asked nurses from various French healthcare centers to fill out a questionnaire survey. We ensured to meticulously follow the STROBE guidelines for cross-sectional research in designing and reporting this study. METHOD An empirical study with a sample of 378 nurses was conducted. RESULTS In line with our hypotheses, our findings revealed that emotional dissonance and workload were negatively linked to sleep quality and relaxation, which were, in turn, related to lower levels of presenteeism and emotional exhaustion. Workload and emotional dissonance were also directly and positively related to emotional exhaustion, while emotional dissonance was associated with higher levels of presenteeism. Finally, the indirect effects of emotional dissonance and workload on emotional exhaustion through sleep quality as well as the indirect effects of emotional dissonance on emotional exhaustion through relaxation were significant and positive. CONCLUSIONS Overall, our results provide insight into the effects of emotional dissonance and workload on presenteeism and emotional exhaustion through recovery processes. RELEVANCE TO CLINICAL PRACTICE The present findings have some practical implications for reducing nurses' emotional exhaustion and presenteeism. Specifically, managers and organizations should try to design and craft jobs to decrease the presence of negative work characteristics (i.e., workload and emotional dissonance). Our results also suggest that recovery processes may be important factors to focus on.

Factors affecting chronic lack of sleep among students. Methods of combating insomnia during university studies

Type of study:

Number of citations: 0

Year: 2024

Authors: O. Mokhunko, N. Havrylova

Journal: Scientific Journal of National Pedagogical Dragomanov University. Series 15. Scientific and pedagogical problems of physical culture (physical culture and sports)

Journal ranking: brak

Key takeaways: Chronic lack of sleep among students negatively impacts their health, academic performance, and overall well-being.

Abstract: Everyone can feel tired at times during the week, and the reasons for this are often quite obvious, including late nights, early starts, sleep disturbances or stress. But some students feel tired all the time, despite a good night's sleep. Constant tiredness and exhaustion are not normal and can be detrimental to mental and physical health. Lack of sleep due to stress is a serious problem among students. This condition has many negative consequences for health and academic performance. Consider the impact of stress on students' sleep and how it affects their lives. The impact of stress on students' sleep in its manifestation has the following effects: physiological effects of stress: increased cortisol levels, stress causes the release of cortisol, a stress hormone that makes it difficult to relax and fall asleep. The sympathetic nervous system also reacts, its activation due to stress leads to increased heart rate and increased readiness of the body for action, which prevents falling asleep. The psychological effects of stress are manifested by a state of worry and anxiety, stress is often accompanied by thoughts about problems and future tasks that prevent relaxation. Long-term stress can lead to depressive states, which negatively affect the quality of sleep. Social and behavioral factors are revealed through the academic load, high demands of learning, preparing for exams and performing tasks that increase the level of stress. Often, due to studies and social life, students neglect a regular sleep schedule, which worsens its quality and disrupts the daytime routine itself. There are major consequences of lack of sleep, which are manifested due to a decrease in immunity, chronic lack of sleep reduces the body's resistance to infections. There is a great risk of diseases. Lack of sleep is associated with an increased risk of cardiovascular disease, diabetes and obesity. Cognitive disorders are reflected in mental health. Lack of sleep impairs memory, concentration and learning ability. Emotional instability leads to lack of sleep, increases feelings of anxiety, depression and irritability. Academic success is also not on the sidelines: the effectiveness of learning is significantly reduced. Lack of sleep affects the ability to absorb new information and reduces productivity. Poor performance appears: Students who suffer from sleep deprivation often perform the worst in exams and in studies in general.

Effects of progressive muscle relaxation training with music therapy on sleep and anger of patients at Community Mental Health Center.

Type of study:

Number of citations: 23

Year: 2021

Authors: Sema İçel, Ceyda Başoğul

Journal: Complementary therapies in clinical practice

Journal ranking: Q1

Key takeaways: Progressive muscle relaxation training and music therapy effectively reduce anger and improve sleep quality in chronic psychiatric patients.

Sleep loss and sleepiness: current issues.

Type of study:

Number of citations: 142

Year: 2008

Authors: T. Balkin, T. Rupp, D. Picchioni, N. Wesensten

Journal: Chest

Journal ranking: Q1

Key takeaways: Sleep loss impairs mental abilities and contributes to obesity, with individuals habituating to chronic partial sleep loss and slow recovery, highlighting the need for improved sleep regulation and public health policies.

Abstract: Awareness of the consequences of sleep loss and its implications for public health and safety is increasing. Sleep loss has been shown to generally impair the entire spectrum of mental abilities, ranging from simple psychomotor performance to executive mental functions. Sleep loss may also impact metabolism in a manner that contributes to obesity and its attendant health consequences. Although objective measures of alertness and performance remain degraded, individuals subjectively habituate to chronic partial sleep loss (eg, sleep restriction), and recovery from this type of sleep loss is slow, factors that may help to explain the observation that many individuals in the general population are chronically sleep restricted. Individual differences in habitual sleep duration appear to be a trait-like characteristic that is determined by several factors, including genetic polymorphisms.

Feeling tired versus feeling relaxed: Two faces of low physiological arousal

Type of study: meta-analysis

Number of citations: 5

Year: 2024

Authors: Sarah Steghaus, Christian H. Poth

Journal: PLOS ONE

Journal ranking: Q1

Key takeaways: Subjective sleepiness and relaxation are anti-correlated pre-intervention, reflecting distinct underlying constructs, but this negative correlation may not be consistently found post-intervention.

Abstract: Human well-being and functioning depend on two fundamental mental states: Relaxation and sleepiness. Relaxation and sleepiness are both assumed to be states of low physiological arousal and negatively correlated. However, it is still unclear how consistent this negative relationship is across different settings and whether it changes before and after an intervention. Here we investigated this intricate relationship between subjective momentary sleepiness and relaxation states by meta-analytically analyzing several data sets from studies using the Relaxation State Questionnaire. We discovered that subjective sleepiness and relaxation were in fact anti-correlated pre-intervention. This anti-correlation provides a quantitative dissociation between sleepiness and relaxation. Thus, even though sleepiness and relaxation both implicate a low arousal level, the two mental states are subjectively experienced in a qualitatively different fashion, and thus reflect distinct underlying constructs. For the post-intervention relationship, this negative correlation could not be consistently found. This indicates that there are aspects of the experimental setting or intervention that introduce changes in the dynamics of the relationship of the two constructs.

Occupational burnout and chronic fatigue in the work of academic teachers–moderating role of selected health behaviours

Type of study: non-rct observational study

Number of citations: 11

Year: 2023

Authors: Agnieszka Springer, Karolina Oleksa-Marewska, A. Basińska-Zych, I. Werner, S. Białowąs

Journal: PLOS ONE

Journal ranking: Q1

Key takeaways: Academic teachers' stress from demanding work environments is strongly linked to occupational burnout and chronic fatigue, with stress-coping strategies and limited sleep only slightly moderating this relationship.

Abstract: Increasing and changing demands for academic teachers worldwide are leading to different consequences, some of which are negative, such as physical and mental health impairment. With the job demands-resources model and the transactional model of occupational stress adopted as a theoretical framework, a cross-sectional study among Polish academic teachers was conducted. The aim of the study is to identify the role of vital personal resources understood as selected health-promoting behaviours, such as (1) stress-coping strategies, (2) sleep hygiene, and (3) using annual vacation leave, in the process of the regeneration. In a cross-sectional survey, the following variables have been assessed: 1) work-related stress using the Psychosocial Risk Scale, 2) occupational burnout using the Oldenburg Burnout Inventory (OLBI), 3) chronic fatigue using the Polish adaptation of the Checklist Individual Strength (CIS), and selected health behaviours of academic teachers 4) stress-coping strategies with the help of the Polish version of Mini-COPE and 5) rest: the amount of sleep and vacation days devoted to rest using a short questionnaire designed by the authors. The sample (N = 340) was comprised of academic teachers employed at Polish higher education institutions who have experienced changes in the work environment in recent years. We conducted a multiple regression analysis to determine the relationships among stress, burnout, and chronic fatigue, looking at coping strategies and rest as a moderator. The results indicate that there is a strong relationship between stress resulting from an excessively demanding work environment on the one hand and occupational burnout and chronic fatigue on the other. At the same time, selected health behaviours of academic teachers only slightly moderate the analyzed relationship. Avoidance strategies strengthen the relationship between stress and its negative consequences, while rest and—to a limited extent—the amount of sleep only slightly contribute to weakening the analyzed relationship.

Brief Rest Practices for Caregivers

Type of study:

Number of citations: 1

Year: 2025

Authors: J. Waldrop, Cammie Presler

Journal: The Journal for Nurse Practitioners

Journal ranking: Q2

Key takeaways: Brief rest practices like yoga, conscious breathing, and meditation can significantly improve mental health, reduce stress, and enhance cognitive functions for caregivers.

Sleep, Rest, and Relaxation in Improving Wellness

Type of study:

Number of citations: 0

Year: 2020

Authors: Ashley Ngor, W. Ishak

Journal:

Journal ranking: brak

Key takeaways: Sleep, rest, and relaxation are essential factors in maintaining and improving overall wellness, with inadequate sleep linked to increased risks of mortality, cardiovascular disease, and depression.

Abstract: Sleep, rest, and relaxation are often undervalued factors that contribute to the maintenance and improvement of wellness. Sleep cycles and their given durations have been clinically proven to influence essential aspects of human life: cardiovascular health, metabolic health, mental health, immunologic health, human performance, and mortality, to name a few [1]. Inadequate sleep has known associations with increased risks of mortality, cardiovascular disease, cerebrovascular disease, obesity, diabetes, cancer, and depression. Rest, in the context of this chapter, is not necessarily synonymous with sleep – for instance, sleep can still occur without rest and its improvements on overall functioning [2]. Relaxation often corresponds to feelings of peace, comfort, body laxity, mental laxity, and positive emotions. Relaxation as a wellness tool can take a variety of forms, such as abdominal breathing and progressive muscle relaxation techniques [3].

Induction of altered states of consciousness during Floatation-REST is associated with the dissolution of body boundaries and the distortion of subjective time

Type of study: rct

Number of citations: 9

Year: 2024

Authors: Helena Hruby, Stefan Schmidt, Justin S. Feinstein, Marc Wittmann

Journal: Scientific Reports

Journal ranking: Q1

Key takeaways: Floatation-REST induces altered states of consciousness, leading to more relaxed, less anxious, and less tired feelings, with body boundaries dissolving and subjective time distorted.

A systematic review of Flotation-Restricted Environmental Stimulation Therapy (REST)

Type of study: systematic review

Number of citations: 1

Year: 2023

Authors: E. Lashgari, E. G. Chen, J. Gregory, U. Maoz

Journal:

Journal ranking: brak

Key takeaways: Flotation-REST positively impacts pain, athletic performance, stress, mental well-being, and clinical anxiety, but has limited effects on sleep-related disorders and smoking cessation.

Abstract: Background: Restricted Environmental Stimulation Therapy (REST) is a therapeutic technique that involves immersing an individual in an environment with minimal sensory input or stimulation. The goal of REST is to induce a state of relaxation that is deeper than what can be achieved through other forms of relaxation techniques. Research suggests that REST can help reduce anxiety, alleviate chronic pain, improve sleep, and enhance creativity and cognitive function. Flotation-REST is a popular type of REST that utilizes an enclosed tank filled with buoyant saltwater to facilitate relaxation. Methods: We used PRISMA to survey the flotation-REST literature from 1960 to 2023. From each paper, we extracted information regarding the participant sample, application of flotation-REST, experimental design, treatment delivery method, questionnaires and tools, and study results. Results: We propose that the application of flotation-REST can be divided into nine main categories: pain, athletic performance, physiology, stress, consciousness, psychology, creativity, clinical anxiety, sleep, smoking cessation, and other miscellaneous applications. In general, flotation-REST was found to bring about positive effects on pain, athletic performance, stress, mental well-being, and clinical anxiety, while having limited to no effect on sleep-related disorders and smoking cessation. Conclusion: This paper provides a comprehensive overview of the current research on flotation-REST, highlights ongoing limitations in the literature, and outlines potential areas for future research. While flotation-REST appears to induce various benefits for physical and mental well-being, particularly when it comes to managing states like pain and stress, more research is needed to better understand the mechanisms underlying these effects and to identify optimal treatment protocols for different populations.

The Effect of Relaxation Techniques on Anxiety, Fatigue and Sleep Quality of Parents of Children with Leukemia under Chemotherapy in South East Iran

Type of study: rct

Number of citations: 29

Year: 2019

Authors: B. Pouraboli, Zeynab Poodineh, Y. Jahani

Journal: Asian Pacific Journal of Cancer Prevention : APJCP

Journal ranking: Q3

Key takeaways: Relaxation techniques significantly reduce anxiety, fatigue, and improve sleep quality in parents of children with leukemia under chemotherapy in South East Iran.

Abstract: Introduction: Cancer can cause emotional stress in parents, which has a negative impact on the quality of their life. Also, anxiety and psychological stress have a negative effect on the health of parents, and fatigue causes a sense of weakness and reduces the capacity for mental and physical activity, and insomnia, as well as stress and inability to perform their occupational and social functions. This study aimed to determine the effect of relaxation techniques on anxiety, fatigue, and sleep quality of parents of children with leukemia under chemotherapy in South East Iran in 2015. Methods: This is a randomized controlled trial study. The study population included parents of children with leukemia undergoing chemotherapy who were admitted to a teaching hospital in South East Iran. One hundred twenty parents were randomly assigned to control and intervention groups, and the experimental group was provided with Benson relaxation technique. Data collection tool included a demographic questionnaire, state-trait anxiety inventory, Brief Fatigue Inventory, and sleep quality inventory. Data analysis was done by SPSS 16 and paired t-test, Wilcoxon, Mann-Whitney, regression, One - Way ANOVA and Pearson tests were performed, and p ≤ 0.05 was statistically significant. Results: The mean score of state anxiety in the intervention group was 60.86 ± 8.95 and 35.95 ± 4.61 before and after the intervention, respectively. The mean score of trait anxiety was 56.56 ± 4.75 and 34.45 ± 4.95. The mean score of the fatigue was 73.83 ± 14.63 and 43.71 ± 11. 06, and the mean score of the quality of sleep was 13.5 ± 6.05 and 5.7 ± 3.43 before and after the intervention respectively. There was a statistically significant difference among state-trait anxiety, fatigue, and sleep quality in intervention and control groups after the intervention. There was a statistically significant negative correlation between fatigue and age, but there was no statistically significant relationship among the mean fatigue, weight, the number of sons and daughters, education, occupation, gender, place of residence and income (p> 0.05). There was no statistically significant relationship among the quality of sleep of parents, education, gender, and place of residence, but there was a statistically significant relationship between state anxiety and education (p≤0.05). Conclusion: The results can predispose family-centered nursing care to support more the parents of children with cancer in the face of the stress of illness. Developing programs for training muscle relaxation techniques will improve family functioning and mental health.

Interventions for improving sleep quality in people with chronic kidney disease.

Type of study: meta-analysis

Number of citations: 47

Year: 2017

Authors: P. Natale, M. Ruospo, V. Saglimbene, S. Palmer, G. Strippoli

Journal: The Cochrane database of systematic reviews

Journal ranking: Q1

Key takeaways: Relaxation techniques show uncertain effects on sleep quality and depression, while exercise may decrease fatigue and depression in people with chronic kidney disease.

Abstract: BACKGROUND Sleep disorders are commonly experienced by people with chronic kidney disease (CKD). Several approaches for improving sleep quality are used in clinical practice including relaxation techniques, exercise, acupressure, and medication. OBJECTIVES To assess the effectiveness and associated adverse events of interventions designed to improve sleep quality among adults and children with CKD including people with end-stage kidney disease (ESKD) treated with dialysis or kidney transplantation. SEARCH METHODS We searched the Cochrane Kidney and Transplant Register of Studies up to 8 October 2018 with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. SELECTION CRITERIA We included randomised controlled trials (RCTs) or quasi-randomised RCTs of any intervention in which investigators reported effects on sleep quality. Two authors independently screened titles and abstracts of identified records. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risk of bias for included studies. The primary outcomes were sleep quality, sleep onset latency, sleep duration, sleep interruption, and sleep efficiency. Risks of bias were assessed using the Cochrane tool. Evidence certainty was assessed using the GRADE approach. We calculated treatment estimates as risk ratios (RR) for dichotomous outcomes or mean difference (MD) or standardised MD (SMD) for continuous outcomes to account for heterogeneity in measures of sleep quality. MAIN RESULTS Sixty-seven studies involving 3427 participants met the eligibility criteria. Thirty-six studies involving 2239 participants were included in meta-analyses. Follow-up for clinical outcomes ranged between 0.3 and 52.8 weeks (median 5 weeks). Interventions included relaxation techniques, exercise, acupressure, cognitive-behavioural therapy (CBT), educational interventions, benzodiazepine treatment, dopaminergic agonists, telephone support, melatonin, reflexology, light therapy, different forms of peritoneal dialysis, music, aromatherapy, and massage. Incomplete reporting of key methodological details resulted in uncertain risk of bias in many studies.In very low certainty evidence relaxation techniques had uncertain effects on sleep quality and duration, health-related quality of life (HRQoL), depression, anxiety, and fatigue. Studies were not designed to evaluate the effects of relaxation on sleep latency or hospitalisation. Exercise had uncertain effects on sleep quality (SMD -1.10, 95% CI -2.26 to 0.05; I2 = 90%; 5 studies, 165 participants; very low certainty evidence). Exercise probably decreased depression (MD -9.05, 95% CI -13.72 to -4.39; I2 = 0%; 2 studies, 46 participants; moderate certainty evidence) and fatigue (SMD -0.68, 95% CI -1.07 to -0.29; I2 = 0%; 2 studies, 107 participants; moderate certainty evidence). Compared with no acupressure, acupressure had uncertain effects on sleep quality (Pittsburgh Sleep Quality Index (PSQI) scale 0 - 21) (MD -1.27, 95% CI -2.13 to -0.40; I2 = 89%; 6 studies, 367 participants: very low certainty evidence). Acupressure probably slightly improved sleep latency (scale 0 - 3) (MD -0.59, 95% CI -0.92 to -0.27; I2 = 0%; 3 studies, 173 participants; moderate certainty evidence) and sleep time (scale 0 - 3) (MD -0.60, 95% CI -1.12 to -0.09; I2 = 68%; 3 studies, 173 participants; moderate certainty evidence), although effects on sleep disturbance were uncertain as the evidence certainty was very low (scale 0 - 3) (MD -0.49, 95% CI -1.16 to 0.19; I2 = 97%). In moderate certainty evidence, acupressure probably decrease fatigue (MD -1.07, 95% CI -1.67 to -0.48; I2 = 0%; 2 studies, 137 participants). Acupressure had uncertain effects on depression (MD -3.65, 95% CI -7.63 to 0.33; I2 = 27%; 2 studies, 137 participants; very low certainty evidence) while studies were not designed to evaluate the effect of acupressure on HRQoL, anxiety, or hospitalisation. It was uncertain whether acupressure compared with sham acupressure improved sleep quality (PSQI scale 0 to 21) because the certainty of the evidence was very low (MD -2.25, 95% CI -6.33 to 1.82; I2 = 96%; 2 studies, 129 participants), but total sleep time may have been improved (SMD -0.34, 95% CI -0.73 to 0.04; I2 = 0%; 2 studies, 107 participants; low certainty evidence). 2 =2 =There were no studies designed to directly examine and/or correlate efficacy of any interventions aimed at improving sleep that may have been attempted for the spectrum of sleep disordered breathing. No studies reported treatment effects for children. Adverse effects of therapies were very uncertain. AUTHORS' CONCLUSIONS The evidence base for improving sleep quality and related outcomes for adults and children with CKD is sparse. Relaxation techniques and exercise had uncertain effects on sleep outcomes. Acupressure may improve sleep latency and duration, although these findings are based on few studies. The effects of acupressure were not confirmed in studies in which sham acupressure was used as the control. Given the very low certainly evidence, future research will very likely change the evidence base. Based on the importance of symptom management to patients, caregivers and clinicians, future studies of sleep interventions among people with CKD should be a priority.

Roles of sleep deprivation in cardiovascular dysfunctions

Type of study:

Number of citations: 73

Year: 2019

Authors: Haiqiong Liu, Aihua Chen

Journal: Life Sciences

Journal ranking: Q1

Key takeaways: Sleep deprivation increases cardiovascular dysfunctions and is linked to multiple diseases, but the underlying mechanisms remain unclear.

Sleep and cardiovascular disease

Type of study: literature review

Number of citations: 15

Year: 2023

Authors: Michelle A. Miller, Nathan E. Howarth

Journal: Emerging Topics in Life Sciences

Journal ranking: Q1

Key takeaways: Poor sleep and sleep disorders increase the risk of cardiovascular diseases, such as hypertension, diabetes, and obesity, and lifestyle interventions focusing on sleep can help manage these risk factors.

Abstract: This review centres around the recent evidence in examining the intersection of sleep and cardiovascular disease (CVD). Sleep in this review will be further subdivided to consider both sleep quantity and quality along and will also consider some of the more common sleep disorders, such as insomnia and obstructive sleep apnoea, in the context of CVD. Sleep disorders have been further explored in several specific populations which are both at risk of sleep disorders and CVD. Secondly, the review will present some of the risk factors for CVD that are affected by sleep and sleep disorders which include hypertension, diabetes, and obesity. It will also examine the potential underlying mechanisms including inflammation, appetite control, endocrine, and genetic processes that are affected by sleep and sleep disorders leading to increased risk of CVD development. In addition, we will consider the observed bi-directional relationships between sleep and cardiovascular risk factors. For example, obesity, a risk factor for CVD can be affected by sleep, but in turn can increase the risk of certain sleep disorder development which disrupts sleep, leading to further risk of obesity development and increased CVD risk. Finally, the review will explore emerging evidence around lifestyle interventions that have included a sleep component and how it impacts the management of CVD risk factor. The need for increased awareness of the health effects of poor sleep and sleep disorders will be discussed alongside the need for policy intervention to improve sleep to facilitate better health and well-being.

Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation.

Type of study:

Number of citations: 765

Year: 2009

Authors: J. Mullington, M. Haack, M. Toth, J. Serrador, H. Meier-Ewert

Journal: Progress in cardiovascular diseases

Journal ranking: Q1

Key takeaways: Insufficient sleep alters cardiovascular risk factors, increasing the risk of cardiac morbidity and mortality.

Implications of Long Sleep Duration on Cardiovascular Health: A Systematic Review

Type of study: systematic review

Number of citations: 1

Year: 2025

Authors: Christian Sanchez Corredera, Pranav S Tadepalli, Julian Scaccia, Adiraj S Sibia, Harvey N Mayrovitz

Journal: Cureus

Journal ranking: brak

Key takeaways: Long sleep duration is associated with increased risks of cardiovascular diseases, such as coronary artery disease, stroke, hypertension, and MI, with inflammatory markers as potential mediators.

Abstract: Sleep duration is an important determinant of cardiovascular health, yet the adverse effects of long sleep duration remain underexplored. While short sleep has well-documented associations with increased cardiovascular risk, emerging evidence highlights a U-shaped relationship, with excessive sleep also linked to adverse outcomes. This systematic review evaluates the association between prolonged sleep duration and cardiovascular health outcomes, including coronary artery disease (CAD), stroke, myocardial infarction (MI), hypertension, heart failure (HF), and atherosclerosis. A systematic search of PubMed, Embase, and Web of Science identified 38 studies published between 2008 and 2024 that investigated the relationship between sleep duration and cardiovascular health. Prolonged sleep duration was consistently associated with increased risks of CAD, stroke (ischemic and hemorrhagic), hypertension, and MI. Elevated inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6), emerged as potential mediators alongside demographic and lifestyle factors, including age, gender, and socioeconomic status. Long sleep duration may serve as a modifiable risk factor for cardiovascular diseases. Incorporating sleep assessments into cardiovascular risk evaluations could inform prevention strategies, and further research is needed to elucidate mechanisms and develop targeted interventions.

Sleep Loss Influences the Interconnected Brain-Body Regulation of Cardiovascular Function in Humans

Type of study: non-rct experimental

Number of citations: 6

Year: 2022

Authors: Adam J. Krause, R. Vallat, E. B. Simon, M. Walker

Journal: Psychosomatic Medicine

Journal ranking: Q1

Key takeaways: Sleep loss increases blood pressure by impacting central brain control of vascular tone, rather than directly affecting heart rate.

Abstract: ABSTRACT Objective Poor sleep is associated with hypertension, a major risk factor for cardiovascular disease. However, the mechanism(s) through which sleep loss affects cardiovascular health remains largely unknown, including the brain and body systems that regulate vascular function. Methods Sixty-six healthy adults participated in a repeated-measures, crossover, experimental study involving assessments of cardiovascular function and brain connectivity after a night of sleep and a night of sleep deprivation. Results First, sleep deprivation significantly increased blood pressure—both systolic and diastolic. Interestingly, this change was independent of any increase in heart rate, inferring a vasculature-specific rather than direct cardiac pathway. Second, sleep loss compromised functional brain connectivity within the vascular control network, specifically the insula, anterior cingulate, amygdala, and ventral and medial prefrontal cortices. Third, sleep loss–related changes in brain connectivity and vascular tone were not independent, but significantly interdependent, with changes within the vascular control brain network predicting the sleep-loss shift toward hypertension. Conclusions These findings establish an embodied framework in which sleep loss confers increased risk of cardiovascular disease through an impact upon central brain control of vascular tone, rather than a direct impact on accelerated heart rate itself.

Effect of sleep and fatigue on cardiovascular performance in young, healthy subjects

Type of study: non-rct observational study

Number of citations: 6

Year: 2022

Authors: L. Castelli, D. Walzik, N. Joisten, M. Watson, A. Montaruli, M. Oberste, E. Roveda, P. Zimmer

Journal: Physiology & Behavior

Journal ranking: Q2

Key takeaways: Chronic inadequate sleep quality negatively impacts cardiovascular performance in males, while fatigue is more significant in females.

Orexin, Sleep, Sympathetic Neural Activity, and Cardiovascular Function

Type of study: literature review

Number of citations: 10

Year: 2022

Authors: Jeremy A. Bigalke, Z. Shan, J. Carter

Journal: Hypertension

Journal ranking: Q1

Key takeaways: Poor sleep quality is linked to impaired sympathetic nervous system function, which may impact cardiovascular health.

Abstract: Inadequate sleep duration and quality are associated with reduced cardiovascular health and increased mortality. Experimental evidence points to the sympathetic nervous system as a key mediator in the observed relationship between poor sleep and cardiovascular dysfunction. However, brain mechanisms underpinning the impaired sympathetic function associated with poor sleep remain unclear. Recent evidence suggests the central orexin system, particularly orexins A and B and their receptors, have a key regulatory role for sleep in animal and human models. While orexin system activity has been observed to significantly impact sympathetic regulation in animals, the extension of these findings to humans has been difficult due to an inability to directly assess orexin system activity in humans. However, direct measures of sympathetic activity in populations with narcolepsy and chronic insomnia, 2 sleep disorders associated with deficient and excessive orexin neural activity, have allowed indirect assessment of the relationships between orexin, sleep, and sympathetic regulation. Further, the recent pharmaceutical development of dual orexin receptor antagonists for use in clinical insomnia populations offers an unprecedented opportunity to examine the mechanistic role of orexin in sleep and cardiovascular health in humans. The current review assesses the role of orexin in both sleep and sympathetic regulation from a translational perspective, spanning animal and human studies. The review concludes with future research directions necessary to fully elucidate the mechanistic role for orexin in sleep and sympathetic regulation in humans.

Effects of chronic sleep deprivation on autonomic activity by examining heart rate variability, plasma catecholamine, and intracellular magnesium levels.

Type of study: non-rct experimental

Number of citations: 98

Year: 2004

Authors: B. Takase, T. Akima, K. Satomura, F. Ohsuzu, T. Mastui, M. Ishihara, A. Kurita

Journal: Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie

Journal ranking: Q1

Key takeaways: Chronic sleep deprivation leads to an autonomic imbalance and decreases intracellular magnesium levels, potentially contributing to cardiovascular events.

One night on-call: sleep deprivation affects cardiac autonomic control and inflammation in physicians.

Type of study: non-rct experimental

Number of citations: 112

Year: 2013

Authors: E. Tobaldini, C. Cogliati, E. Fiorelli, V. Nunziata, M. Wu, M. Prado, M. Bevilacqua, D. Trabattoni, A. Porta, N. Montano

Journal: European journal of internal medicine

Journal ranking: Q1

Key takeaways: One night of sleep deprivation in young physicians affects cardiovascular autonomic response and immune modulation, independently of the activation of the hypothalamic-pituitary axis.

Exploring the Link Between Sleep Patterns and Early Cardiovascular Disease Markers in Young Adults with Chronic Anxiety.

Type of study: non-rct observational study

Number of citations: 0

Year: 2025

Authors: Jacob W Richardson, Emily A Buck, Jennifer B Weggen, Brad T. Bakken, Brandon J. Fitzpatrick, Raven G. Campbell, Ryan Garten

Journal: American journal of physiology. Regulatory, integrative and comparative physiology

Journal ranking: Q2

Key takeaways: Irregular sleep patterns in young adults with chronic anxiety are linked to higher oxidative stress, lower brachial artery function, and poorer blood pressure control, key precursors of cardiovascular disease.

Abstract: Purpose: Chronic anxiety is commonly associated with poor sleep patterns, which may contribute to an increased risk of cardiovascular disease (CVD) through mechanisms like oxidative stress, vascular dysfunction, and poor blood pressure control. As sleep disturbances, particularly poor sleep quality and/or regularity, have been independently linked to CVD development, this study explored whether sleep quality/regularity in young adults with chronic anxiety are associated with early indicators of CVD risk, specifically oxidative stress, vascular function, and blood pressure control. Methods: Twenty-eight young (24±4 years) participants with a prior clinical diagnosis of generalized anxiety disorder (GAD) or elevated GAD symptoms (GAD7>10) had their sleep quality (total sleep time (TST) and sleep efficiency (SE)) and regularity (via TST/SE standard deviations (SD)) assessed for seven consecutive days. Various precursors to CVD development such as oxidative stress, brachial artery function, microvascular function, and blood pressure control (exercise pressor responses and cardiovagal baroreflex sensitivity (cBRS)), were also evaluated. Pearson's correlations were utilized to determine potential relationships between sleep quality/regularity and CVD precursors. Results: Both sleep irregularity variables (SE-SD (r=0.61; p<0.01) and TST-SD (r=0.39; p=0.04)), but neither of the sleep quality variables, were positively correlated with oxidative stress. TST-SD alone was significantly associated with lower brachial artery function (r=-0.44; p=0.02) and cBRS (r=0.43; p=0.02), with TST-SD median splits further highlighting these differences. Conclusions: The study found that irregular TST in individuals with chronic anxiety was significantly associated with higher oxidative stress, lower brachial artery function, and blunted blood pressure control (lower cBRS), key precursors of CVD.

Restfulness from sleep and subsequent cardiovascular disease in the general population

Type of study: non-rct observational study

Number of citations: 16

Year: 2020

Authors: H. Kaneko, H. Itoh, H. Kiriyama, T. Kamon, K. Fujiu, K. Morita, N. Michihata, T. Jo, N. Takeda, H. Morita, H. Yasunaga, I. Komuro

Journal: Scientific Reports

Journal ranking: Q1

Key takeaways: Good restfulness from sleep may be associated with a lower risk of cardiovascular diseases, particularly in younger, female individuals.

Influence of poor sleep on cardiovascular disease-free life expectancy: a multi-resource-based population cohort study

Type of study: non-rct observational study

Number of citations: 14

Year: 2022

Authors: Bo-Huei Huang, B. del Pozo Cruz, A. Teixeira-Pinto, P. Cistulli, E. Stamatakis

Journal: BMC Medicine

Journal ranking: Q1

Key takeaways: Poor sleep is negatively associated with cardiovascular disease-free life expectancy, especially in individuals with sleep-related breathing disorders.

Abstract: Abstract Background The complexity of sleep hinders the formulation of sleep guidelines. Recent studies suggest that different unhealthy sleep characteristics jointly increase the risks for cardiovascular disease (CVD). This study aimed to estimate the differences in CVD-free life expectancy between people with different sleep profiles. Methods We included 308,683 middle-aged adults from the UK Biobank among whom 140,181 had primary care data linkage. We used an established composite sleep score comprising self-reported chronotype, duration, insomnia complaints, snoring, and daytime sleepiness to derive three sleep categories: poor, intermediate, and healthy. We also identified three clinical sleep disorders captured by primary care and inpatient records within 2 years before enrollment in the cohort: insomnia, sleep-related breathing disorders, and other sleep disorders. We estimated sex-specific CVD-free life expectancy with three-state Markov models conditioning on survival at age 40 across different sleep profiles and clinical disorders. Results We observed a gradual loss in CVD-free life expectancy toward poor sleep such as, compared with healthy sleepers, poor sleepers lost 1.80 [95% CI 0.96–2.75] and 2.31 [1.46–3.29] CVD-free years in females and males, respectively, while intermediate sleepers lost 0.48 [0.41–0.55] and 0.55 [0.49–0.61] years. Among men, those with clinical insomnia or sleep-related breathing disorders lost CVD-free life by 3.84 [0.61–8.59] or 6.73 [5.31–8.48] years, respectively. Among women, sleep-related breathing disorders or other sleep disorders were associated with 7.32 [5.33–10.34] or 1.43 [0.20–3.29] years lost, respectively. Conclusions Both self-reported and doctor-diagnosed poor sleep are negatively associated with CVD-free life, especially pronounced in participants with sleep-related breathing disorders.

Regular Aerobic Exercise Counteracts Endothelial Vasomotor Dysfunction Associated With Insufficient Sleep.

Type of study: non-rct experimental

Number of citations: 21

Year: 2021

Authors: Kelly A. Stockelman, Anthony R Bain, Caitlin A. Dow, K. Diehl, Jared J. Greiner, B. Stauffer, C. Desouza

Journal: American journal of physiology. Heart and circulatory physiology

Journal ranking: Q1

Key takeaways: Regular aerobic exercise can counteract endothelial vasomotor dysfunction associated with insufficient sleep, improving blood flow and reducing cardiovascular risk in middle-aged adults.

Abstract: Insufficient sleep is associated with endothelial vasomotor dysfunction and increased cardiovascular risk. Regular aerobic exercise is an effective lifestyle strategy for improving endothelial function and, in turn, reducing cardiovascular risk. We tested the hypotheses that regular aerobic exercise would: 1) improve endothelial vasodilation; and 2) decrease ET-1-mediated vasoconstrictor tone in middle-aged adults who chronically sleep <7 h/night. Thirty-six healthy, middle-aged adults were studied: 16 with normal sleep duration (age: 57±2 yr; sleep duration: 7.4±0.1 h/night) and 20 with short sleep duration (56±1 yr; 6.2±0.1 h/night). The 20 short sleepers completed a 3-month aerobic exercise training intervention. Forearm blood flow was determined (via plethysmography) in response to intra-arterial acetylcholine (ACh), BQ-123 (ETAreceptor antagonist), ACh+BQ-123 and sodium nitroprusside. Forearm blood flow responses to ACh were lower (20%; P<0.05) in the short (from 4.2±0.2 to 10.5±0.6 mL/100 mL tissue/min) vs normal (4.2±0.2 to 12.7±0.6 mL/100 mL tissue/min) sleepers. In response to BQ-123, the short sleep group had a significantly greater increase in resting forearm blood flow than the normal sleep group (~25% vs ~8%). ACh+BQ-123 resulted in a significant (~25%) increase in the ACh-vasodilation in the short sleep group only. After exercise training, although nightly sleep duration was unchanged (6.4±0.1 h/night), ACh-mediated vasodilation was significantly higher (~20%), ET-1-mediated vasoconstriction was significantly lower (~80%) and the vasodilator response to ACh was not increased with ETAreceptor blockade. Regular aerobic exercise, independent of changes in nightly sleep duration, can counteract insufficient sleep-related endothelial vasomotor dysfunction.

Effectiveness of relaxation techniques for stress management and quality of life improvement in cardiovascular disease and hypertensive patients: a systematic review.

Type of study: systematic review

Number of citations: 0

Year: 2025

Authors: Andrea Calderone, Giulia Marafioti, Desirée Latella, Francesco Corallo, Piercataldo D'Aleo, Angelo Quartarone, Rocco Salvatore Calabrò

Journal: Psychology, health & medicine

Journal ranking: Q2

Key takeaways: Relaxation techniques, such as progressive muscle relaxation and diaphragmatic breathing, effectively reduce stress and improve quality of life in patients with cardiovascular disease and hypertension.

Abstract: BACKGROUND AND OBJECTIVES Cardiovascular diseases (CVD) and hypertension are leading causes of morbidity and mortality worldwide, significantly affecting quality of life (QoL). Stress, anxiety, and poor psychological well-being often exacerbate these conditions, creating a vicious cycle. Relaxation techniques, including progressive muscle relaxation (PMR) and diaphragmatic breathing, assist in contracting and relaxing muscle groups to aid individuals in identifying and reducing physical tension and foster relaxation due to increased parasympathetic nerve activity, resulting in emotional tranquility. This systematic review explores the efficacy of relaxation techniques in reducing stress and improving QoL in patients with CVD and hypertension. MATERIALS AND METHODS The review adhered to PRISMA guidelines, searching five major databases (PubMed, EBSCOhost, Web of Science, PsychINFO, and Scopus) with a search time range from 2014 to 2024. This review has been registered on Open OSF (n) 6HYG9. RESULTS The results from several studies highlight the positive effects of relaxation techniques on both cardiovascular health and psychological well-being. Various methods, such as PMR, breathing exercises, and biofeedback, significantly reduced blood pressure (BP), anxiety, and stress levels in hypertensive and cardiovascular patients. Additionally, interventions like Benson's relaxation and jaw relaxation demonstrated improvements in patient QoL and cardiovascular health outcomes, underscoring the potential benefits of integrating relaxation techniques into treatment programs for heart-related conditions. CONCLUSIONS By targeting both the physiological and psychological aspects of the patient's well-being, these methods contribute to improved BP regulation, reduced heart rate, and alleviation of anxiety and stress symptoms. When incorporated into cardiac rehabilitation programs, these techniques have shown positive effects on emotional well-being and overall QoL, making them a valuable tool for patients recovering from cardiovascular events or managing chronic CVD. More robust, high-quality studies are needed to refine the optimal methods, duration, and frequency of these interventions.

Increasing systemic chronic inflammation mediated the association between poor sleep during pregnancy and gestational cardiovascular health.

Type of study: non-rct observational study

Number of citations: 2

Year: 2023

Authors: Shuang-shuang Ma, P. Li, Deqin Li, Meiting Zhou, Lei Li, Wan-jun Yin, Peng Wang, Yimo Zhang, Daomin Zhu, P. Zhu

Journal: Sleep health

Journal ranking: Q1

Key takeaways: Poor sleep during pregnancy, particularly late chronotype and snoring, may worsen cardiovascular health by increasing systemic chronic inflammation.

Heart rate variability related to effort at work.

Type of study: non-rct observational study

Number of citations: 113

Year: 2011

Authors: A. Uusitalo, T. Mets, K. Martinmäki, S. Mauno, U. Kinnunen, H. Rusko

Journal: Applied ergonomics

Journal ranking: Q1

Key takeaways: Higher work effort is associated with lower daytime heart rate variability and relaxation time, indicating chronic work stress and daily emotions at work.

Abstract 28: Regular Aerobic Exercise Counteracts Endothelial Vasomotor Dysfunction Associated With Insufficient Sleep

Type of study: non-rct experimental

Number of citations: 0

Year: 2020

Authors: Kelly A. Stockelman, Anthony R Bain, Caitlin A. Dow, Jared J. Greiner, B. Stauffer, C. Desouza

Journal: Circulation

Journal ranking: Q1

Key takeaways: Regular aerobic exercise can counteract the negative impact of insufficient sleep on endothelial vasomotor regulation, improving blood flow and reducing cardiovascular risk in middle-aged adults.

Abstract: Insufficient sleep, defined as chronic short sleep duration (<7 h/night), is an independent risk factor for cardiovascular disease (CVD). We have previously demonstrated that insufficient sleep is associated with reduced endothelium-dependent vasodilation and enhanced endothelin (ET)-1-mediated vasoconstrictor tone. Impaired endothelial vasomotor regulation is thought to contribute mechanistically to the increased risk of atherosclerotic vascular disease incurred with chronic insufficient sleep. Regular aerobic exercise is an effective lifestyle strategy for improving endothelial function and, in turn reducing cardiovascular risk. It is currently unknown if regular aerobic exercise can counteract the negative impact of insufficient sleep on endothelial vasomotor regulation. We tested the hypotheses that regular aerobic exercise would: 1) improve endothelial vasodilation; and 2) decrease ET-1-mediated vasoconstrictor tone in middle-aged adults who chronically sleep less than 7 h/night. We studied 36 healthy, middle-aged adults: 16 with normal sleep duration (10M/6F; age: 57±2 yr; sleep duration: 7.4±0.1 h/night) and 20 with short sleep duration (11M/9F; 56±1 yr; sleep duration: 6.2±0.1 h/night). The 20 short sleepers completed a 3-month aerobic exercise training intervention. Forearm blood flow (FBF; plethysmography) was determined in response to intra-arterial doses of acetylcholine (ACh), sodium nitroprusside (SNP), BQ-123 (ET A receptor antagonist) and ACh + BQ-123 in both groups and after the exercise intervention in the short sleepers. As expected, forearm vasodilator responses to ACh were lower (20%; P<0.05) in the short (from 4.2±0.2 to 10.5±0.6 mL/100 mL tissue/min) vs normal (4.2±0.2 to 12.7±0.6 mL/100 mL tissue/min) sleepers. FBF responses to SNP were comparable between the groups. In response to BQ-123, short sleep group had a greater increase in resting FBF than normal sleep group (~25% vs ~8%; P< 0.05). ACh+BQ-123 resulted in an ~25% increase in the ACh-vasodilation in the short sleep group only. After exercise training, although nightly sleep duration was not affected (6.4±0.1 h/night), ACh-mediated vasodilation was ~20% higher (P<0.05), ET-1-mediated vasoconstriction was ~90% lower (P<0.05) and vasodilator response to ACh was not significantly increased with ET A receptor blockade. These results indicate that regular aerobic exercise can reverse the negative influence of insufficient sleep on endothelial vasomotor function, independent of changes in nightly sleep duration.

Sympathetic cardiovascular control during orthostatic stress and isometric exercise in adolescent chronic fatigue syndrome

Type of study: non-rct observational study

Number of citations: 64

Year: 2008

Authors: V. B. Wyller, V. B. Wyller, J. Saul, L. Walløe, E. Thaulow

Journal: European Journal of Applied Physiology

Journal ranking: Q1

Key takeaways: Adolescents with chronic fatigue syndrome exhibit increased sympathetic activity at rest, with exaggerated cardiovascular responses to orthostatic stress, but attenuated responses during isometric exercise during orthostatic stress.

Abstract: The chronic fatigue syndrome (CFS) has been shown to be associated with orthostatic intolerance and cardiovascular dysregulation. We investigated the cardiovascular responses to combined orthostatic stress and isometric exercise in adolescents with CFS. We included a consecutive sample of 15 adolescents 12–18 years old with CFS diagnosed according to a thorough and standardized set of investigations, and a volunteer sample of 56 healthy control subjects of equal sex and age distribution. Heart rate, systolic, mean and diastolic blood pressure, stroke index, and total peripheral resistance index were non-invasively recorded during lower body negative pressure (LBNP) combined with two consecutive periods of handgrip. In addition, we measured baseline plasma catecholamines, and recorded symptoms. At rest, CFS patients had higher heart rate, diastolic blood pressure, plasma norepinephrine (P < 0.01), mean blood pressure and plasma epinephrine (P < 0.05) than controls. During LBNP, CFS patients had a greater increase in heart rate, diastolic blood pressure, mean blood pressure (P < 0.05) and total peripheral resistance index (n.s.) than controls. During handgrip, CFS patients had a smaller increase in heart rate, diastolic blood pressure (P < 0.05), mean blood pressure and total peripheral resistance index (n.s.) than controls. Our results indicate that adolescents with CFS have increased sympathetic activity at rest with exaggerated cardiovascular response to orthostatic stress, but attenuated cardiovascular response when performing isometric exercise during orthostatic stress. This suggests that CFS might be causally related to sympathetic dysfunction.

Exercise and heart failure: A statement from the American Heart Association Committee on exercise, rehabilitation, and prevention.

Type of study:

Number of citations: 1005

Year: 2003

Authors: I. Piña, C. Apstein, G. Balady, R. Belardinelli, B. Chaitman, B. Duscha, B. Fletcher, J. Fleg, J. Myers, M. J. Sullivan

Journal: Circulation

Journal ranking: Q1

Key takeaways: Exercise training can improve exercise tolerance and reduce exercise intolerance in patients with heart failure due to systolic dysfunction.

Abstract: Heart failure (HF) may be defined as the inability of the heart to meet the demands of the tissues, which results in symptoms of fatigue or dyspnea on exertion progressing to dyspnea at rest. The inability to perform exercise without discomfort may be one of the first symptoms experienced by patients with HF and is often the principal reason for seeking medical care. Therefore, exercise intolerance is inextricably linked to the diagnosis of HF. It might be expected that a tight relationship would exist between indices of resting ventricular function and exercise capacity. Data indicate, however, that indices of resting ventricular function (such as ejection fraction [EF]) are only weakly correlated to exercise tolerance.1 Exercise intolerance is defined as the reduced ability to perform activities that involve dynamic movement of large skeletal muscles because of symptoms of dyspnea or fatigue. Many investigators have sought mechanisms to explain the source of exercise intolerance. The aims of this position statement are to review (1) factors that affect exercise tolerance, with specific emphasis on chronic HF due to systolic dysfunction; (2) data that support the role of exercise training in chronic systolic HF, including the risks and benefits; (3) data on exercise training in patients with HF due to diastolic dysfunction; and finally (4) the subgroups of patients with HF for which data are lacking, and (5) the subgroups of patients who should not be included in exercise training programs. We anticipate this report will stimulate appropriate use of exercise training in patients with HF when indicated and encourage further studies in those areas in which data are lacking. ### Cardiovascular The capacity for performing aerobic exercise depends on the ability of the heart to augment its output to the exercising muscles and the ability of these muscles to utilize oxygen from the delivered …