{"title":"Cognitive Behavioral Therapy for Insomnia in Patients With Schizophrenia Without Prior Psychotic Symptom Aggravation: A Prospective Single-Arm Trial","authors":"Ji Seok Kim, Yujin Lee","doi":"10.33069/cim.2023.0024","DOIUrl":"https://doi.org/10.33069/cim.2023.0024","url":null,"abstract":"Objective: To determine the feasibility and efficacy of cognitive behavioral therapy for insomnia (CBT-I) in patients with schizophrenia without prior psychotic symptom aggravation.Methods: This prospective single-arm trial included 31 patients diagnosed with schizophrenia and insomnia who received CBT-I. We provided four weekly 60-min sessions of group or individual CBT-I. All patients completed several sleep-related scale assessments before and 2, 3, and 4 weeks after treatment: the Korean version of Pittsburgh Sleep Quality Index (PSQI-K), Insomnia Severity Index (ISI), Korean version of the Epworth Sleepiness Scale (K-ESS), Dysfunctional Beliefs and Attitudes about Sleep Scale-16 (DBAS-16), and sleep diary. The primary outcome was insomnia symptom changes over the treatment period, as indicated by the PSQI-K, ISI, sleep onset latency, and total sleep time from the sleep diary. The secondary outcome was improvement in maladaptive cognition associated with sleep, as indicated by the DBAS-16.Results: The total PSQI-K and ISI at each timepoint showed significant improvements over the CBT-I program period. The total K-ESS and DBAS-16 scores showed significant improvement over the treatment period. Sleep onset latency was significantly shortened; however, no significant changes were noted in the total sleep time and some PSQI-K subscales (sleep duration, use of sleep medication, and daytime dysfunction).Conclusion: Our findings suggest the efficacy of CBT-I in improving insomnia symptoms, dysfunctional beliefs, and attitudes toward sleep in patients with schizophrenia with relatively stable psychotic symptoms. Therefore, further large randomized controlled trials are warranted to provide precise estimates of the effects of CBT-I in this patient population.","PeriodicalId":479578,"journal":{"name":"Chronobiology in medicine (Online)","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Won Hee Seo, Eungu Kang, Young-Jun Rhie, Byoung Gook Loh
{"title":"Device-Measured Sleep Duration Age 9–11 Years Among Urban Korean Children","authors":"Won Hee Seo, Eungu Kang, Young-Jun Rhie, Byoung Gook Loh","doi":"10.33069/cim.2023.0019","DOIUrl":"https://doi.org/10.33069/cim.2023.0019","url":null,"abstract":"Objective: Sleep duration measurement methods are expensive and inconvenient. Smart bands or wearable activity trackers have offered objective and continuous tracking over several nights in real-world conditions. This study explored device-measured sleep duration in Korean children aged 9–11 years old. Methods: This cross-sectional study, conducted between October 2022 and March 2023, enrolled 72 participants aged 9–11 years and equipped with smart bands (Xiaomi Mi Smart Band 6) for several nights lasting more than 5 days, including weekends. Sleep duration and sleep onset time were obtained using the smart bands. Results: Seventy-one children (43 girls, 28 boys), with a mean age of 9.92±0.73 were included. Sleep durations on weekdays and weekends did not show a significant difference (8.55±0.66 h vs. 8.76±0.72 h). However, significant difference was observed in sleep onset time between weekdays and weekends (p<0.001). The sleep duration on weekdays and weekends declined with age. The sleep duration on weekdays and weekends was similar in each age group; however, the sleep onset time significantly differed for all age groups (p<0.05). Conclusion: This study suggests insufficient sleep duration among the children in this study. And digital device may be an effective and fast way to evaluate children without a sleep laboratory, and suggest the need for further research to understand their implications and develop more accurate measurement methods for understanding children’s sleep.","PeriodicalId":479578,"journal":{"name":"Chronobiology in medicine (Online)","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136345746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sleep Quality and Chronotype of Young Athletes Addicted to Smartphones During Ramadan Observance","authors":"Anas El-Jaziz, Said Lotfi","doi":"10.33069/cim.2023.0016","DOIUrl":"https://doi.org/10.33069/cim.2023.0016","url":null,"abstract":"Objective: Problematic smartphone use is associated with social, physical, and mental health issues, including chronotype and sleep patterns. During Ramadan intermittent fasting, these factors were more affected. However, no study explored problematic smartphone use and sleep patterns during Ramadan. Thus, the present study explored problematic smartphone use, sleep patterns, and chronotypes among athletic sample during Ramadan and assessed their relationship.Methods: Fifty athlete students (18.44±0.79 years) were voluntarily involved in this prospective cohort study. The Pittsburgh Sleep Quality Index (PSQI) and the Morningness-Eveningness Questionnaire (MEQ) were used to collect information on sleep quality and circadian preferences, respectively, before one week of Ramadan (baseline). Then, the participants repeated the Pittsburgh Sleep Quality Index (PSQI) and completed the Arabic version of the Smartphone Addiction Scale short version (SAS-sv) at the end of Ramadan.Results: Of the 50 patients, 38% of the participants demonstrated problematic smartphone use. Ramadan showed no significant impact on sleep quality. Problematic smartphone use was not associated with sleep quality or chronotype. Nevertheless, it was negatively correlated with chronotype.Conclusion: High prevalence of smartphones and sleep quality was reported during Ramadan. The associations between sleep quality and problematic smartphone use were not confirmed. However, there is a negative relationship between chronotype and problematic smartphone use. The study suggests more focus on how athlete students can exploit physical exercise as a healthy alternative to keep control of excessive use of smartphones.","PeriodicalId":479578,"journal":{"name":"Chronobiology in medicine (Online)","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Circadian Fluctuations of Cognitive and Psychomotor Performance in Medical Students: The Role of Daytime and Chronotype Patterns","authors":"Ikram Sabaoui, Said Lotfi, Mohammed Talbi","doi":"10.33069/cim.2023.0018","DOIUrl":"https://doi.org/10.33069/cim.2023.0018","url":null,"abstract":"Objective: Our research aimed to explore the impact of chronotype and time of day on the cognitive and psychomotor performance of medical students around 25 years old. The study provides evidence that an individual’s circadian rhythm affects their daily performance and cognitive processes.Methods: To measure selective attention and inhibition, we utilized the Stroop test, while three subtests from the fourth edition of Wechsler Adult Intelligence Scale (WAIS-IV) were employed to measure simple attention and working memory. In addition, the Leed psychomotor tester was utilized to measure perception and motor reaction time, and the morningness-eveningness questionnaire was administered to investigate students’ chronotype. Statistical analysis were based on many tests depending on the correlation types. We mainly used ANOVA repeated measures, Bonferroni post-hoc test, ANOVA I, chi-square, and Pearson correlation tests.Results: Our findings suggest that students exhibit decreased selective attention (F=128.842b, p<0.01, η<sup>2</sup>=0.868, 95% CI=2.744–16.998) and weakened inhibition during the late afternoon (6 p.m.) when the largest margin of error was committed (1.56±2.90) compared to 10 a.m. (0.82±1.72), leading to increased difficulty resisting interference; except that the size effect was small (η<sup>2</sup>>0.13). Simple attention reaches its peak in the morning around 10 a.m., while memory performance and auditory modality of working memory reach their peaks at 10 a.m. and the end of the afternoon (6 p.m.), respectively.Conclusion: Our study underscores the importance of taking wake time and body temperature into account when examining task performance. Overall, the study highlights the importance of considering circadian rhythm and chronotype when designing academic and athletic schedules.","PeriodicalId":479578,"journal":{"name":"Chronobiology in medicine (Online)","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Revolutionizing Sleep Health: The Promise and Challenges of Digital Phenotyping","authors":"Chul-Hyun Cho","doi":"10.33069/cim.2023.0020","DOIUrl":"https://doi.org/10.33069/cim.2023.0020","url":null,"abstract":"Sleep disorders, a critical issue in global health, affect millions worldwide. Disorders ranging from insomnia to sleep apnea profoundly impact individual well-being and societal productivity [1]. While traditional diagnostic and therapeutic methods like polysomnography and cognitive-behavioral therapy for insomnia are effective, they are also labor-intensive, less patient-centered, and expensive. The emergence of digital phenotyping, using data from personal digital devices such as smartphones and wearables, heralds a promising new direction in sleep medicine [2]. Digital phenotyping offers several advantages over traditional methods. It allows continuous, active, and passive data collection in a patient’s natural environment, capturing a nuanced and comprehensive image of daily sleep patterns. These insights illuminate the interplay between sleep, lifestyle, behavior, health, and overall well-being [2]. Digital phenotyping is also cost-effective, negating the need for expensive equipment or hospitalization, facilitating early identification of high-risk individuals for testing, and reducing unnecessary healthcare expenditure. Recent studies have validated the use of digital phenotyping in sleep medicine, revealing that sleep patterns derived from smartphones or wearable devices closely correlate with actigraphy, a noninvasive method for monitoring rest/activity cycles [3,4]. Techniques introduced to measure aspects such as sleep stages and sleep apnea events using only smartphone data demonstrate that digital phenotyping may facilitate screening for sleep disorders [5]. Additionally, conditions like mood disorders, closely linked to sleep-wake rhythms, can be assessed or predicted based on digital Revolutionizing Sleep Health: The Promise and Challenges of Digital Phenotyping","PeriodicalId":479578,"journal":{"name":"Chronobiology in medicine (Online)","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Young-Min Park, So-Jin Lee, Jin-Seong Lee, Kyoung-Sae Na, Seung-Gul Kang, Bun-Hee Lee, Ho-Kyoung Yoon, Eui-Joong Kim
{"title":"Efficacy and Safety of Prolonged-Release Melatonin for Primary Insomnia in Elderly Patients","authors":"Young-Min Park, So-Jin Lee, Jin-Seong Lee, Kyoung-Sae Na, Seung-Gul Kang, Bun-Hee Lee, Ho-Kyoung Yoon, Eui-Joong Kim","doi":"10.33069/cim.2023.0021","DOIUrl":"https://doi.org/10.33069/cim.2023.0021","url":null,"abstract":"Objective: Insomnia, a prevalent sleep disorder affecting the elderly, necessitates effective and safe treatment options. This study explores the potential of the prolonged-release melatonin (Circadin<sup>®</sup>) addressing insomnia in elderly patients.Methods: The 8-week prospective observational study involved 115 participants, assessing sleep parameters using the Pittsburgh Sleep Quality Index (PSQI) and WHO-5 Well-being Index. The prolonged-release melatonin (2 mg) was administered nightly, and assessments were conducted at baseline, 4 weeks, and 8 weeks.Results: Both per protocol and last observation carried forward (LOCF) analyses consistently revealed significant improvements in sleep latency, total sleep time, sleep efficiency, and overall well-being. Notably, sleep latency decreased after 4 and 8 weeks, while total sleep time and sleep efficiency increased, reflecting longer and more restful sleep. The WHO-5 Well-being Index exhibited noticeable enhancement. Adverse events, including dizziness and heartburn, were manageable. Despite a high dropout rate, this drug’s potential as an efficacious and safe treatment option for elderly insomnia patients was evident, aligned with prior research.Conclusion: The prolonged-release formulation’s resemblance to the natural circadian rhythm of melatonin release offers advantages over conventional medications. This study contributes to understanding the prolonged-release melatonin’s promise as a valuable therapeutic alternative, encouraging further investigation into its longterm effects and optimal implementation.","PeriodicalId":479578,"journal":{"name":"Chronobiology in medicine (Online)","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of a Single Episode of Different Intensity of White Light Pulse at Night on Masking Response in the Diurnal Mammal, Funambulus pennantii","authors":"Vivek Verma, Priyoneel Basu, Muniyandi Singaravel","doi":"10.33069/cim.2023.0015","DOIUrl":"https://doi.org/10.33069/cim.2023.0015","url":null,"abstract":"Objective: Light affects mammalian circadian rhythms through entrainment and masking. Photic masking increases locomotor activity in diurnal species (positive masking) while reducing activity in nocturnal species (negative masking). Fewer studies have investigated masking in diurnal rodents. We investigated the masking response in a diurnal rodent, <i>Funambulus pennantii</i> when subjected to white light pulses of different intensities at night between zeitgeber time (ZT) 12 and ZT 15.Methods: Adult male squirrels, <i>F. pennantii</i> (n=10/group, three groups) were placed in individual cages with running wheels under standard 12:12 h light-dark (LD) conditions. Recording of the locomotor activity rhythm was carried out using a ClockLab setup. Following a week of stable entrainment to the LD cycle, the animals of each group were given a sham exposure. After 10 days, animals of group I, II, and III were exposed to 3-h white light pulses of 100 lux, 10 lux, and 1 lux, respectively, between ZT 12 and ZT 15. Following the exposure, the animals were allowed to run undisturbed for 7 days.Results: Compared to the shamexposed group, exposure to 3-h 1 lux, 10 lux, and 100 lux artificial light pulses at night caused positive masking, stimulating wheel running in an intensity-dependent manner. Additionally, nighttime light pulses of 100 lux and 10 lux reduced onset accuracy, reduced the amplitude of the rhythm, and also altered the phase angle relationship to light.Conclusion: The positive masking caused by light exposure at night in diurnal squirrels is intensity-dependent up to at least 100 lux and is associated with a dampening of circadian rhythms.","PeriodicalId":479578,"journal":{"name":"Chronobiology in medicine (Online)","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Novita Gemalasari Liman, Sunu Budhi Raharjo, Ina Susianti Timan, Franciscus D. Suyatna, Salim Harris, Joedo Prihartono, Kristiana Siste, Bambang Budi Siswanto
{"title":"Differential Profiles of Cortisol, Components of Autonomic Nervous System, and Self-Rated Health in Premature Ventricular Contraction: An Observational Study of Three Circadian Types","authors":"Novita Gemalasari Liman, Sunu Budhi Raharjo, Ina Susianti Timan, Franciscus D. Suyatna, Salim Harris, Joedo Prihartono, Kristiana Siste, Bambang Budi Siswanto","doi":"10.33069/cim.2023.0017","DOIUrl":"https://doi.org/10.33069/cim.2023.0017","url":null,"abstract":"Objective: Premature ventricular contraction (PVC) exhibits one of the three circadian patterns, namely fast-type, slow-type, and independent-type. This study aimed to investigate whether the cortisol-marker of hypothalamic-pituitary-adrenal axis, autonomic nervous system activity, and perceptive self-rated health are associated with the three PVC circadian types.Methods: This cross-sectional observational study recruited 65 idiopathic PVC subjects (23 fast-, 20 slow-, and 22 independent-type) as well as 5 control subjects. Each subject underwent a 24- hour Holter to examine PVC burden and heart rate variability, collected saliva for cortisol and norepinephrine level measurement at 6–7 am, 10–11 am, and 10–11 pm, and recorded their self-rated health scales. Furthermore, univariate and multiple linear regression were conducted to investigate the associations between the independent variables and PVC burden.Results: The average PVC burden was 15.7%, 8.5%, and 13.6% in fast-, slow-, and independent-type idiopathic PVCs, respectively. Multiple linear regression showed that the high burden of fast-type idiopathic PVC was associated with higher cortisol levels and lower parasympathetic nervous system tone. The high burden of slow-type idiopathic PVC was associated with lower cortisol levels and lower sympathetic nervous system tone. Meanwhile, in independent-type idiopathic PVC, the high burden was associated with higher cortisol levels and sympathetic nervous system tone as well as lower self-rated health scales.Conclusion: Each PVC circadian type is uniquely related to hypothalamic-pituitary-adrenal axis, autonomic nervous system, and selfrated health. Assessment of PVC circadian type needs to be carried out routinely considering the differences in the underlying associated factors.","PeriodicalId":479578,"journal":{"name":"Chronobiology in medicine (Online)","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Intricate Interplay Between Dementia and Hypnotics","authors":"Young-Min Park","doi":"10.33069/cim.2023.0013","DOIUrl":"https://doi.org/10.33069/cim.2023.0013","url":null,"abstract":"The connection between the use of hypnotics and dementia has sparked significant interest and controversy in the medical community. This perspective aims to provide a succinct overview of the current understanding of this intricate relationship. Some studies have indicated a potential association between long-term use of specific hypnotics, such as benzodiazepines and Z-drugs, and an increased risk of dementia [1,2]. Consequently, concerns have arisen regarding potential cognitive impairment associated with these medications [3]. However, findings pertaining to the dose-response relationship have been inconsistent, and the precise mechanism by which hypnotics may heighten dementia risk remains unclear. Proposed mechanisms include disruptions in sleep architecture, impaired memory consolidation, heightened susceptibility to falls and resultant brain trauma, and direct neurotoxic effects of certain medications [4]. Nevertheless, several factors warrant contemplation in this context. Firstly, publication bias should be considered, as researchers may have a propensity to publish positive findings, and the topic of hypnotics-induced dementia may be subject to such biases due to its sensational nature [5]. Secondly, although Taiwanese studies with large sample sizes are frequently cited in relation to hypnotics and dementia, caution is advised as these studies rely on medical insurance data and may have limitations [6]. Thirdly, meta-analyses showing positive results have encompassed heterogeneous subjects [7]. Moreover, while depression has been controlled in most positive studies, more than half of the studies did not control for anxiety [8]. Additionally, most studies have explored the The Intricate Interplay Between Dementia and Hypnotics","PeriodicalId":479578,"journal":{"name":"Chronobiology in medicine (Online)","volume":"523 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136016018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}