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Winkelman, John W.; Buxton, Orfeu M.; Jensen, J. Eric; Benson, Kathleen L.; O'Connor, Shawn P.; Wang, Wei; Renshaw, Perry F.
doi: 10.1093/sleep/31.11.1499pmid: 19014069
AbstractStudy Objectives:Both basic and clinical data suggest a potential significant role for GABA in the etiology and maintenance of primary insomnia (PI). Proton magnetic resonance spectroscopy (1H-MRS) can non-invasively determine GABA levels in human brain. Our objective was to assess GABA levels in unmedicated individuals with PI, using 1H-MRS.Design and Setting:Matched-groups, cross-sectional study conducted at two university-based hospitals.Participants:Sixteen non-medicated individuals (8 women) with PI (mean age = 37.3 +/− 8.1) and 16 (7 women) well-screened normal sleepers (mean age = 37.6 +/− 4.5).Methods and Measurements:PI was established with an unstructured clinical interview, a Structured Clinical Interview for DSM-IV (SCID), sleep diary, actigraphy and polysomnography (PSG). 1H-MRS data were collected on a Varian 4 Tesla magnetic resonance imaging/spectroscopy scanner. Global brain GABA levels were averaged from samples in the basal ganglia, thalamus, and temporal, parietal, and occipital white-matter and cortex.Results:Average brain GABA levels were nearly 30% lower in patients with PI (.18 +/− .06) compared to controls (.25 +/− .11). GABA levels were negatively correlated with wake after sleep onset (WASO) on two independent PSGs (r = −0.71, p = 0.0024 and −0.70, p = 0.0048).Conclusions:Our preliminary finding of a global reduction in GABA in non-medicated individuals with PI is the first demonstration of a neurochemical difference in the brains of those with PI compared to normal sleeping controls. 1H-MRS is a valuable tool to assess GABA in vivo, and may provide a means to shed further light on the neurobiology of insomnia.
Touchette, Évelyne; Petit, Dominique; Tremblay, Richard E.; Boivin, Michel; Falissard, Bruno; Genolini, Christophe; Montplaisir, Jacques Y.
doi: 10.1093/sleep/31.11.1507pmid: 19014070
AbstractObjective:To investigate whether longitudinal sleep duration patterns during early childhood is a risk factor of overweight or obesity at school entry while controlling for a variety of obesogenic environmental factors.Design, Setting, and Participants:This is a prospective cohort study (March-December 1998 to December 2004) of a representative sample of infants born in 1997-1998 in the Canadian province of Quebec. Body mass index (BMI) was measured at ages 2.5 and 6 years. Sleep duration was reported yearly from 2.5 to 6 years of age by their mothers. Prenatal, postnatal (5 and 29 months), and lifestyle (6 y) potentially confounding factors for excess weight were assessed by interviews, questionnaires and hospital records. A group-based semiparametric mixture model was used to estimate developmental patterns of sleep duration. The relationship between sleep duration patterns and BMI was tested using multivariate logistic regression models to control for potentially confounding factors on 1138 children.Results:Four sleep duration patterns were identified: short persistent (5.2%), short increasing (4.7%), 10-hour persistent (50.7%), and 11-hour persistent (39.4%). After controlling for potentially confounding factors, the risk for overweight or obesity was almost 4.2 times higher for short persistent sleepers (odds ratio [OR], 4.2; 95% confidence interval [CI], 1.6 to 11.1; P = 0.003) than for 11-hour persistent sleepers.Conclusions:Persistently short sleep duration (<10 h) during early childhood significantly increases the risk of excess weight or obesity in childhood, and appears to be independent of other obesogenic factors.
Yen, Cheng-Fang; Ko, Chih-Hung; Yen, Ju-Yu; Cheng, Chung-Ping
doi: 10.1093/sleep/31.11.1515pmid: 19014071
AbstractStudy Objectives:The aim of this study was to examine the correlates associated with short nocturnal sleep duration and subjective insomnia, including individual factors, family factors, peer factors, school factors, and the problematic use of high-tech devices among a large-scale representative population of Taiwanese adolescents.Design:Cross-sectional study.Setting:A total of 23 junior high and 29 senior high/vocational schools were randomly selected across southern Taiwan.Participants:Eight thousand four adolescent students.Interventions:N/A.Measurements and Results:The multidimensional correlates associated with short nocturnal sleep duration and subjective insomnia were examined using χ² automatic interaction detection analysis and logistic regression analysis models. The results indicated that an older age, self-reported depression, being in the third year of school, drinking coffee at night, and problematic Internet use were significantly associated with short nocturnal sleep duration in adolescents. Furthermore, self-reported depression, low school affinity, high family conflict, low connectedness to their peer group, and problematic Internet use were associated with subjective insomnia in adolescents.Conclusions:The results of this study indicate that a variety of individual, family, peer, and school factors were associated with short nocturnal sleep duration and subjective insomnia in adolescents. Furthermore, the correlates of short sleep duration were not identical to those of subjective insomnia. Parents and health professionals should be wary of sleep patterns among adolescents who have the identified correlates of short nocturnal sleep duration and subjective insomnia.
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