Prevalence of Circadian Misalignment and Its Association with Depressive Symptoms in Delayed Sleep Phase Disorder.
Jade M. Murray,Jade M. Murray,Tracey L. Sletten,Tracey L. Sletten,Michelle Magee,Michelle Magee,Christopher J. Gordon,Nicole Lovato,Nicole Lovato,Delwyn J. Bartlett,Delwyn J. Bartlett,David J. Kennaway,Leon Lack,Leon Lack,Ronald R. Grunstein,Ronald R. Grunstein,Steven W. Lockley,Shantha M W Rajaratnam +17 more
TLDR
Almost half of patients clinically diagnosed with DSPD did not show misalignment between the circadian pacemaker and the DBT, suggesting that the reported difficulties initiating sleep at the D BT are unlikely to be explained by the (mis)timing of the circadian rhythm of sleep propensity.Abstract:
Study Objective: To examine the prevalence of circadian misalignment in clinically diagnosed delayed sleep phase disorder (DSPD) and to compare mood and daytime functioning in those with and without a circadian basis for the disorder. Methods: One hundred and eighty-two DSPD patients aged 16-64 years, engaged in regular employment or school, underwent sleep-wake monitoring in the home, followed by a sleep laboratory visit for assessment of salivary dim light melatonin onset (DLMO). Based on the DLMO assessments, patients were classified into two groups: circadian DSPD, defined as DLMO occurring at or after desired bedtime (DBT), or non-circadian DSPD, defined as DLMO occurring before DBT. Results: One hundred and three patients (57%) were classified as circadian DSPD and 79 (43%) as non-circadian DSPD. DLMO occurred 1.66 hours later in circadian DSPD compared to non-circadian DSPD (p < .001). Moderate-severe depressive symptoms (Beck Depression Inventory-II) were more prevalent in circadian DSPD (14.0%) than in non-circadian DSPD (3.8%; p < .05). Relative to non-circadian DSPD patients, circadian DSPD patients had 4.31 times increased odds of at least mild depressive symptoms (95% CI 1.75 to 10.64; p < .01). No group differences were found for daytime sleepiness or function, but DSPD symptoms were rated by clinicians to be more severe in those with circadian DSPD. Conclusions: Almost half of patients clinically diagnosed with DSPD did not show misalignment between the circadian pacemaker and the DBT, suggesting that the reported difficulties initiating sleep at the DBT are unlikely to be explained by the (mis)timing of the circadian rhythm of sleep propensity. Circadian misalignment in DSPD is associated with increased depressive symptoms and DSPD symptom severity.read more
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Rhythms of life: circadian disruption and brain disorders across the lifespan.
Ryan W. Logan,Colleen A. McClung +1 more
TL;DR: An overview of the relationship between the circadian system and brain disorders across various life stages is given and remaining questions that may direct future research towards a better understanding are identified.
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The Impact of Shift Work on Sleep, Alertness and Performance in Healthcare Workers.
Saranea Ganesan,Saranea Ganesan,Michelle Magee,Michelle Magee,Julia E. Stone,Julia E. Stone,Megan D Mulhall,Megan D Mulhall,Allison L Collins,Mark E Howard,Mark E Howard,Steven W. Lockley,Shantha M W Rajaratnam,Tracey L. Sletten,Tracey L. Sletten +14 more
TL;DR: Although healthcare workers perceive themselves to be less alert on the first night shift compared to subsequent night shifts, objective performance is equally impaired on subsequent nights.
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Chronotype and Mental Health: Recent Advances.
Briana J. Taylor,Brant P. Hasler +1 more
TL;DR: The literature on chronotype and mental illness has evolved to include associations with a broader range of psychiatric symptom profiles; explore underlying mechanisms; and expand on earlier research using objective measures and more sophisticated study designs.
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Circadian Rhythm Disturbances in Mood Disorders: Insights into the Role of the Suprachiasmatic Nucleus.
TL;DR: Clinical and preclinical studies are reviewed that provide evidence both for and against a causal role for the SCN in mood disorders, including genetic or environmental perturbations of SCN rhythms.
Journal ArticleDOI
Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: A double-blind, randomised clinical trial.
Tracey L. Sletten,Tracey L. Sletten,Michelle Magee,Michelle Magee,Jade M. Murray,Jade M. Murray,Christopher J. Gordon,Christopher J. Gordon,Christopher J. Gordon,Nicole Lovato,Nicole Lovato,David J. Kennaway,Stella May Gwini,Stella May Gwini,Delwyn J. Bartlett,Steven W. Lockley,Steven W. Lockley,Steven W. Lockley,Leon Lack,Ronald R. Grunstein,Ronald R. Grunstein,Ronald R. Grunstein,Shantha M W Rajaratnam,Shantha M W Rajaratnam,Shantha M W Rajaratnam +24 more
TL;DR: Melatonin treatment 1 h prior to DBT combined with behavioural sleep-wake scheduling was efficacious for improving objective and subjective measures of sleep disturbances and sleep-related impairments in DSWPD patients with delayed circadian phase relative to D BT.
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