Sleep regularity is associated with sleep-wake and circadian timing, and mediates daytime function in Delayed Sleep-Wake Phase Disorder.
Adult
Australia
/ epidemiology
Biological Variation, Population
/ physiology
Case-Control Studies
Central Nervous System Depressants
/ metabolism
Circadian Rhythm
/ physiology
Female
Humans
Latent Class Analysis
Male
Melatonin
/ metabolism
Mood Disorders
/ psychology
Severity of Illness Index
Sleep
/ drug effects
Sleep Disorders, Circadian Rhythm
/ physiopathology
Sleep Initiation and Maintenance Disorders
/ complications
Sleep Wake Disorders
/ physiopathology
Circadian rhythm sleep disorder
DSWPD
Structural equation modeling
Variability
Journal
Sleep medicine
ISSN: 1878-5506
Titre abrégé: Sleep Med
Pays: Netherlands
ID NLM: 100898759
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
20
08
2018
revised:
07
02
2019
accepted:
12
03
2019
pubmed:
28
5
2019
medline:
15
7
2020
entrez:
28
5
2019
Statut:
ppublish
Résumé
In healthy populations, irregular sleep patterns are associated with delayed sleep and poor functional/mood outcomes. Currently, it is unknown whether irregular sleep contributes to poor functional/mood outcomes in individuals with Delayed Sleep-Wake Phase Disorder (DSWPD). In 170 patients with DSWPD, we collected sleep-wake patterns, dim light melatonin onset (DLMO), and functional/mood outcomes. The Sleep Regularity Index (SRI) and other sleep timing metrics were computed. Correlations of SRI were computed with phase angle (difference between DLMO and desired bedtime), sleep timing and quality variables, daytime function, sleep-related daytime impairment, mood, and insomnia symptom severity. Path analyses assessed whether SRI or total sleep time mediated the associations between sleep onset time and phase angle with daytime functioning, sleep-related impairment, and mood outcomes. Higher SRI was associated with earlier sleep and longer total sleep time, but did not relate to sleep quality, daytime function, or mood outcomes. Path analysis showed that phase angle was directly associated with all outcome variables, whereas sleep onset time was not directly associated with any. SRI mediated the effects of sleep onset time and phase angle on daytime function. Total sleep time mediated the effects of sleep onset time and phase angle on sleep-related impairment. Individuals with DSWPD who have more delayed sleep and a greater phase angle also have more irregular sleep. This suggests that it is not delayed sleep timing per se that drives poor functional outcomes in DSWPD, but rather the timing of sleep relative to circadian phase and resultant irregular sleep patterns.
Sections du résumé
BACKGROUND
In healthy populations, irregular sleep patterns are associated with delayed sleep and poor functional/mood outcomes. Currently, it is unknown whether irregular sleep contributes to poor functional/mood outcomes in individuals with Delayed Sleep-Wake Phase Disorder (DSWPD).
METHODS
In 170 patients with DSWPD, we collected sleep-wake patterns, dim light melatonin onset (DLMO), and functional/mood outcomes. The Sleep Regularity Index (SRI) and other sleep timing metrics were computed. Correlations of SRI were computed with phase angle (difference between DLMO and desired bedtime), sleep timing and quality variables, daytime function, sleep-related daytime impairment, mood, and insomnia symptom severity. Path analyses assessed whether SRI or total sleep time mediated the associations between sleep onset time and phase angle with daytime functioning, sleep-related impairment, and mood outcomes.
RESULTS
Higher SRI was associated with earlier sleep and longer total sleep time, but did not relate to sleep quality, daytime function, or mood outcomes. Path analysis showed that phase angle was directly associated with all outcome variables, whereas sleep onset time was not directly associated with any. SRI mediated the effects of sleep onset time and phase angle on daytime function. Total sleep time mediated the effects of sleep onset time and phase angle on sleep-related impairment.
CONCLUSION
Individuals with DSWPD who have more delayed sleep and a greater phase angle also have more irregular sleep. This suggests that it is not delayed sleep timing per se that drives poor functional outcomes in DSWPD, but rather the timing of sleep relative to circadian phase and resultant irregular sleep patterns.
Identifiants
pubmed: 31132578
pii: S1389-9457(18)30490-8
doi: 10.1016/j.sleep.2019.03.009
pii:
doi:
Substances chimiques
Central Nervous System Depressants
0
Melatonin
JL5DK93RCL
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
93-101Investigateurs
E Armstrong
(E)
K Chohan
(K)
Y Djavadkhani
(Y)
K Dodds
(K)
S Gunaratnam
(S)
M Hardy
(M)
S Joosten
(S)
J Lee
(J)
G Micic
(G)
B Raman
(B)
E Roese
(E)
M Salkeld
(M)
E Verberne
(E)
K Wong
(K)
B Yee
(B)
A Yeo
(A)
K Yu
(K)
Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.