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Sleep and Circadian Rhythms in Psychiatric Disorders

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 48670

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Dr. Pierre Alexis Geoffroy

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Department of Psychiatry and Addictive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat, 46 rue Henri Huchard, 75018 Paris, France
Interests: sleep; circadian rhythms; chronobiology; psychiatry; bipolar disorder; seasonal affective disorder; depression; suicide; addiction
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Dear Colleagues,

Sleep and circadian rhythm alterations benefit from increasing attention in psychiatric disorders, identified as core symptoms and interesting therapeutic targets, as, for instance, in bipolar disorders, depression, suicide, schizophrenia, autism spectrum disorders, anxiety disorders, post-traumatic stress disorder, attention-deficit hyperactivity disorder, and addictions. This rapidly growing field of interest has allowed one to better unravel the physiopathology of these disorders and to develop new therapeutic strategies. Indeed, international efforts are being made to identify sleep and circadian rhythm biomarkers during all phases of these disorders (prodromal, acute, and remitted phases). The identification of such biomarkers is paving the way to true precision medicine, with numerous chronotherapies and sleep interventions, such as such as bright-light therapy, dark therapy, melatonin, stimulant drugs, sleep privation, neuromodulation technics, cognitive behavioral therapy for insomnia, and interpersonal and social rhythm therapy.

On these grounds, this Special Issue of Journal of Clinical Medicine has the main objective to gather papers that can advance the field by better characterizing patients with psychiatric disorders thanks to sleep and circadian rhythm biomarkers, by better identifying sleep disorder comorbidities and associated clinical features, and by assessing chronotherapies and sleep interventions in these specific populations.

Original investigations, review articles, and short communications are especially welcome.

Dr. Pierre A. Geoffroy
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

sleep
circadian rhythms
chronobiology
psychiatry
bipolar disorder
seasonal affective disorder
depression
suicide
schizophrenia
addiction

Published Papers (13 papers)

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Research

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11 pages, 992 KiB

Open AccessArticle

Efficacy of a Smartphone-Based Virtual Companion to Treat Insomniac Complaints in the General Population: Sleep Diary Monitoring Versus an Internet Autonomous Intervention

by Pierre Philip, Lucile Dupuy, Patricia Sagaspe, Etienne de Sevin, Marc Auriacombe, Jacques Taillard, Jean-Arthur Micoulaud-Franchi and Charles M. Morin

J. Clin. Med. 2022, 11(15), 4387; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11154387 - 28 Jul 2022

Cited by 9 | Viewed by 3316

Abstract

(1) Background: Insomnia is the most prevalent sleep disorder worldwide and cognitive behavioral therapy is the front-line treatment. Digital health technologies have a role to play in screening and delivering interventions remotely and without the need for human intervention. The KANOPEE app, which provides a screening and behavioral intervention for insomnia symptoms through an interaction with a virtual agent, showed encouraging results in previous studies during and after the COVID-19 lockdown, but has not yet been evaluated in a controlled study. This study aims at comparing the benefits of KANOPEE, a smartphone application dealing with insomnia complaints, with another application proposing an electronic sleep diary named “My Sleep Diary”. The acceptance and potential benefits of these digital solutions are tested in real-life settings (i.e., without soliciting human medical resources) and in the general population. (2) Methods: Subjects were included if they downloaded one of the apps between December 2020 and October 2021, and were of legal age. Both apps were available on downloading platforms in France. Primary outcome was Insomnia Severity Index (ISI), and secondary outcomes were total sleep time (TST), sleep efficiency (SE) and wake time after sleep onset (WASO). (3) Results: A total of 535 users completed the intervention with KANOPEE and 489 users completed My Sleep Diary, both for 17 days. KANOPEE users improved their ISI score significantly more than sleep diary users (interaction Time*Group: F(2,2002) = 17.3, p < 0.001). Similar results were found for nocturnal sleep parameters (TST) (KANOPEE users gained 48 min of sleep after intervention, while My Sleep Diary users gained only 16 min of sleep), and particularly in the population with moderate to severe initial sleep complaints (F(4,1980) = 8.9, p < 0.001). Other sleep markers (SE and WASO) were significantly improved in the KANOPEE users compared to the sleep diary ones (p < 0.001). (4) Conclusions: KANOPEE provides significantly greater benefits than an electronic sleep diary regarding reduction of insomnia complaints and estimated nocturnal sleep characteristics in a self-selected sample of the general population. Population with the most severe initial ISI score (≥15) benefited the most from the KANOPEE App compared to filling up a simple sleep diary. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

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10 pages, 499 KiB

Open AccessArticle

An Ultra-Short Measure of Excessive Daytime Sleepiness Is Related to Circadian Biological Rhythms: The French Psychometric Validation of the Barcelona Sleepiness Index

by Julien Coelho, Régis Lopez, Jacques Taillard, Emmanuel D’Incau, Guillaume Fond, Pierre Philip and Jean-Arthur Micoulaud-Franchi

J. Clin. Med. 2022, 11(13), 3892; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11133892 - 04 Jul 2022

Cited by 2 | Viewed by 1694

Abstract

The Barcelona Sleepiness Index (BSI) is an ultra-short instrument with several advantages for assessing excessive daytime sleepiness (EDS). The present study was performed to analyze the validity of the French version of the BSI in screening for EDS. We conducted a cross-sectional study on a population of students using an online questionnaire. The French version of the BSI was developed by a rigorous forward-backward translation process. We computed the discrimination properties of the BSI to predict EDS assessed by the Epworth Sleepiness Scale (ESS), as well as correlations with other sleep measures. In total, 662 students were enrolled in the study (mean age: 20.9 years, 76.0% women). The BSI score (mean = 1.5 ± 1.0) showed a strong correlation with the ESS score (r = 0.47, p < 10⁻⁴) and acceptable discrimination of EDS assessed by ESS score ≥ 11 (AUC = 0.742) with an optimal cutoff point of 2, as in the original study. The BSI score was significantly associated with sleep deprivation and social jetlag. Therefore, the French version of the BSI is a valid ultra-short instrument for EDS screening in individuals. In addition, the BSI score may be associated with both homeostatic and circadian processes. Further studies are needed to confirm these findings in general populations and in patients with sleep disorders. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

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16 pages, 309 KiB

Open AccessArticle

Assessment of Insomnia Symptoms, Quality of Life, Daytime Sleepiness, and Psychoactive Substance Use among Polish Students: A Cross-Sectional Online Survey for Years 2016–2021 before and during COVID-19 Pandemic

by Mateusz Babicki, Patryk Piotrowski and Agnieszka Mastalerz-Migas

J. Clin. Med. 2022, 11(8), 2106; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11082106 - 09 Apr 2022

Cited by 9 | Viewed by 2550

Abstract

Sleep disorders are a serious health problem worldwide, and insomnia is their most common manifestation. An increasing number of people have insomnia every year, young adults, especially. Due to the importance that sleep has in almost every aspect of our lives, the need to monitor disturbances in circadian rhythms has arisen. Therefore, this study aimed to assess the prevalence of sleep disorders among Polish students, including their quality of life (QOL) and drug use patterns. The study also investigated associations between sleep, QoL, and drug use. The study was conducted in 2016–2021 based on the self-made sociodemographic questionnaire, as well as standardized psychometric tools: Athens Insomnia Scale (AIS), Epworth Sleepiness Scale (ESS), and Manchester Short Assessment of quality of life (MANSA). A total of 14,844 students participated in the study. The majority were women (80.7%), of which 3425 (23.1%) were medical students, with the most numerous representing medical and dental faculties, 1884 (57.2%). Before the COVID-19 pandemic, 52.1% of the surveys were collected; 54.1% of respondents had insomnia as indicated by the AIS scores, and 26.1% displayed sleepiness during the day. Female students, the first-year college students, more often suffered from sleep disorders. Drug use was widespread among Polish students, correlating with sleep assessment results and QoL. In conclusion, sleep disorders are a significant clinical problem among Polish students. Female and junior students’ years are more prone to sleep deprivation. Insufficient sleep can be associated with a lower QoL score and psychoactive substance use. The effects of the COVID-19 pandemic on sleep are not conclusive, because there was decreasing quality for longer sleep durations. In order to analyze these associations, there is a need for further in-depth study. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

14 pages, 300 KiB

Open AccessArticle

Chronotype Profile, Stress, Depression Level, and Temporomandibular Symptoms in Students with Type D Personality

by Magdalena Gębska, Bartosz Dalewski, Łukasz Pałka, Łukasz Kołodziej and Ewa Sobolewska

J. Clin. Med. 2022, 11(7), 1886; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11071886 - 28 Mar 2022

Cited by 9 | Viewed by 2369

Abstract

Background: Despite a growing interest in the types of human circadian activity, different chronotypes and personality-related issues have been rarely studied. It has already been emphasized that ‘stress personality’ is considered a risk factor for certain psychosomatic diseases and may be a temporomandibular disorders (TMDs) predictor. Therefore, an attempt has been made to analyze the chronotypes, stress levels, stress factors, and the occurrence of depression and TMDs in students with type D personalities. People with this personality trait tend to experience negative emotions more—depression, anxiety, anger, or hostility—yet may have a negative image of themselves and report somatic complaints. Aim: The aim of this study was to analyze the importance of the chronotype profile for the level of stress perceived, as well as for the occurrence of depression and TMDs in people with type D personalities. Material and Methods: The study has been conducted on a group of 220 physical therapy students. The study group G1 consisted of 110 participants with type D personalities, the control group G2 consisted of the same number of participants without the stress personality. All participants have been analyzed for the chronotype (MEQ), stress perception (PSS10), the occurrence of depression (Beck scale-BDI), the occurrence of TMDs symptoms and have completed the stress factor assessment questionnaire during the study, followed by DS14 questionnaire—a tool for assessing the prevalence of type D personality. Results: In students with type D personalities (G1), the definitely evening and evening chronotypes have been significantly more predominant than in the control group (G2). A significantly higher number of stressors and TMDs symptoms have been observed in the respondents from the G1 group than in the control group (<0.001). Univariate logistic regression analysis showed that type D personality was strongly associated with a more frequent occurrence of all TMD symptoms. Additionally, a significant influence of the evening chronotype on the occurrence of type D personality was observed. Among the potential confounding variables, female gender and a mild and moderate degree of depression have an impact on the occurrence of type D personality (p < 0.05). In the multivariate model, adjusted with the above-mentioned factors, an increased risk of the type D personality trait was found. Conclusion: The evening chronotype and type D personality may imply greater feelings of stress, greater depression, and more frequent symptoms of TMDs in young adults. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

12 pages, 695 KiB

Open AccessArticle

Sleep and Depressive Symptoms in the Morningness/Eveningness-Suicidal Ideation Relationship Depend on School Shift in Mexican Adolescents

by Arturo Arrona-Palacios, Juan F. Díaz-Morales, Zaida Parra-Robledo and Ana Adan

J. Clin. Med. 2021, 10(20), 4681; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10204681 - 13 Oct 2021

Cited by 6 | Viewed by 1743

Abstract

The aim was to analyze the morningness/eveningness (M/E) effect on suicidal ideation through sleep and depressive symptoms mediators with school shift (i.e., morning and afternoon) as moderator. In this study, 586 Mexican adolescents, with a mean age of 16.31 ± 0.92, from a public high school in a double-shift school system (298 from the morning shift and 288 from the afternoon shift) participated. Measurements of sleep, morningness/eveningness (circadian preference), depressive symptomology, and suicidal ideation were completed. Adolescents in the afternoon shift reported a later rise time, bedtime, greater time in bed sleep length, and less social jet lag than in the morning shift. Considering the moderated-mediated analysis, circadian preference and suicidal ideation were mediated by both depressive symptoms and school day’s sleep length in the morning shift. In the afternoon shift, no mediation effect was significant. When weekend sleep length was considered in the model, only depressive symptoms had a mediating effect between circadian preference and suicidal ideation in the morning shift; no significant mediating effect was found on the afternoon shift. The results suggest that an afternoon school schedule may act as a protective factor for the adolescent’s mental health and may represent a viable option for future interventions. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

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16 pages, 765 KiB

Open AccessArticle

Validity and Usage of the Seasonal Pattern Assessment Questionnaire (SPAQ) in a French Population of Patients with Depression, Bipolar Disorders and Controls

by Eve Reynaud, Fabrice Berna, Emmanuel Haffen, Luisa Weiner, Julia Maruani, Michel Lejoyeux, Carmen M. Schroder, Patrice Bourgin and Pierre A. Geoffroy

J. Clin. Med. 2021, 10(9), 1897; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10091897 - 27 Apr 2021

Cited by 9 | Viewed by 3336

Abstract

The Seasonal Pattern Assessment Questionnaire (SPAQ), by Rosenthal et al. (1984), is by far the most used questionnaire to evaluate seasonal effects on mood and behavior. It includes a general seasonality score (GSS), composed of 6 items, from which cutoffs have been established to screen for seasonal affective disorder (SAD). However, it has never been validated in French and associations with circadian rhythm and symptoms of depression and bipolarity remain unclear. In this study, including 165 subjects (95 controls and 70 patients with depression or bipolar disorder), we confirmed the validity of the French version of the SPAQ, with a two-factor structure (a psychological factor: energy, mood, social activity and sleep length; and a food factor: weight and appetite) and a good fit was observed by all indicators. Mood and social activity dimensions were significantly affected by seasons in the depressed/bipolar group and a stronger global seasonality score (GSS) was associated with more severe phenotypes of depression and mania. Subjects meeting SAD and subsyndromal-SAD criteria also showed a delayed circadian rhythm compared to controls. Simple tools, such as the SPAQ, can aid the identification of significant seasonal changes and have direct implications on therapeutics including the use of bright light therapy in order to enhance personalized treatments, but also to prevent adverse seasonal effects. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

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9 pages, 258 KiB

Open AccessArticle

Prevalence of Circadian Rhythm Sleep-Wake Disorder in Outpatients with Schizophrenia and Its Association with Psychopathological Characteristics and Psychosocial Functioning

by Kentaro Matsui, Ken Inada, Kenichi Kuriyama, Takuya Yoshiike, Kentaro Nagao, Hidehiro Oshibuchi, Rie Akaho and Katsuji Nishimura

J. Clin. Med. 2021, 10(7), 1513; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10071513 - 05 Apr 2021

Cited by 5 | Viewed by 2108

Abstract

The prevalence of circadian rhythm sleep-wake disorder (CRSWD) among patients with schizophrenia is not clear. The effect of comorbid CRSWD on such patients has also not been fully evaluated yet. Outpatients with schizophrenia in the maintenance phase who visited Tokyo Women’s Medical University Hospital between April 2018 and March 2019 participated in this study. The Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impressions–Severity Illness Scale (CGI-S), Global Assessment of Functioning (GAF), World Health Organization Disability Assessment Schedule II, Insomnia Severity Index (ISI), and Morningness–Eveningness Questionnaire (MEQ) were administered, and the patient responses with and without CRSWD were compared. Of the 105 patients with schizophrenia, 19 (18.1%) had CRSWD. There were trends toward higher BPRS and lower GAF scores in the CRSWD group than in the non-CRSWD group, although these did not reach statistical significance following a false discovery rate correction. Among the BPRS subitems, the anxiety scores were significantly higher in the CRSWD group than in the non-CRSWD group (p < 0.01). CRSWD was highly prevalent among patients with schizophrenia in the maintenance phase. Comorbidities of CRSWD may affect psychopathological characteristics and psychosocial functioning. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

12 pages, 1777 KiB

Open AccessArticle

The Revised Mood Rhythm Instrument: A Large Multicultural Psychometric Study

by Melissa Alves Braga de Oliveira, Euclides José de Mendonça Filho, Alicia Carissimi, Luciene Lima dos Santos Garay, Marina Scop, Denise Ruschel Bandeira, Felipe Gutiérrez Carvalho, Salina Mathur, Kristina Epifano, Ana Adan, Benicio N. Frey and Maria Paz Hidalgo

J. Clin. Med. 2021, 10(3), 388; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10030388 - 20 Jan 2021

Cited by 3 | Viewed by 2162

Abstract

Background: Recent studies with the mood rhythm instrument (MRhI) have shown that the presence of recurrent daily peaks in specific mood symptoms are significantly associated with increased risk of psychiatric disorders. Using a large sample collected in Brazil, Spain, and Canada, we aimed to analyze which MRhI items maintained good psychometric properties across cultures. As a secondary aim, we used network analysis to visualize the strength of the association between the MRhI items. Methods: Adults (n = 1275) between 18–60 years old from Spain (n = 458), Brazil (n = 415), and Canada (n = 401) completed the MRhI and the self-reporting questionnaire (SRQ-20). Psychometric analyses followed three steps: Factor analysis, item response theory, and network analysis. Results: The factor analysis indicated the retention of three factors that grouped the MRhI items into cognitive, somatic, and affective domains. The item response theory analysis suggested the exclusion of items that displayed a significant divergence in difficulty measures between countries. Finally, the network analysis revealed a structure where sleepiness plays a central role in connecting the three domains. These psychometric analyses enabled a psychometric-based refinement of the MRhI, where the 11 items with good properties across cultures were kept in a shorter, revised MRhI version (MRhI-r). Limitations: Participants were mainly university students and, as we did not conduct a formal clinical assessment, any potential correlations (beyond the validated SRQ) cannot be ascertained. Conclusions: The MRhI-r is a novel tool to investigate self-perceived rhythmicity of mood-related symptoms and behaviors, with good psychometric properties across multiple cultures. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

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19 pages, 887 KiB

Open AccessArticle

Disturbances of Continuous Sleep and Circadian Rhythms Account for Behavioral Difficulties in Children with Autism Spectrum Disorder

by Enise Yavuz-Kodat, Eve Reynaud, Marie-Maude Geoffray, Nadège Limousin, Patricia Franco, Frédérique Bonnet-Brilhault, Patrice Bourgin and Carmen M. Schroder

J. Clin. Med. 2020, 9(6), 1978; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9061978 - 24 Jun 2020

Cited by 18 | Viewed by 3578

Abstract

Sleep disorders are among the most common comorbidities in children with Autism Spectrum Disorder (ASD), and subjectively defined sleep disturbances have been related to ASD symptom severity. However, no study has investigated the differential impact of objectively measured sleep and circadian rhythm disturbances on behavioral difficulties in this population. Fifty-two children with ASD aged 3–10 years underwent assessments of sleep and circadian rest–activity rhythms objectively with actigraphy and subjectively with the Children’s Sleep Habits Questionnaire. Behavioral difficulties were assessed using the ABC-C. Group comparison analyses were used to compare sleep and circadian rhythm parameters of children with higher and lower behavioral difficulties and dominance analysis to rank predictors and address multicollinearity. Children with high irritability had a shorter continuous sleep period compared to those with lower irritability (−60 min, p = 0.04), as well as those with high stereotypic behaviors compared to children with less stereotypies (−75 min, p = 0.006). Objective circadian and sleep disturbances accounted together for, respectively, 17%, 18% and 36% of the variance in social withdrawal, irritability and stereotypic behaviors. The identification of both sleep and circadian rhythm disturbances as explanatory factors for behavioral difficulties warrants their inclusion in the existing behavioral management strategies for children with ASD. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

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12 pages, 1009 KiB

Open AccessArticle

Sleep in the Supine Position During Pregnancy is Associated with Fetal Cerebral Redistribution

by Nicole Robertson, Satomi Okano and Sailesh Kumar

J. Clin. Med. 2020, 9(6), 1773; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9061773 - 07 Jun 2020

Cited by 2 | Viewed by 4134

Abstract

The supine sleep position in late pregnancy is a major risk factor for stillbirth, with a population attributable risk of 5.8% and one in four pregnant women reportedly sleeping in a supine position. Although the mechanisms linking the supine sleep position and late stillbirth remain unclear, there is evidence that it exacerbates pre-existing maternal sleep disordered breathing, which is another known risk factor for adverse perinatal outcomes. Given that maternal sleep position is a potentially modifiable risk factor, the aim of this study was to characterize and correlate uteroplacental and fetal hemodynamics, including cardiac function, in a cohort of women with apparently uncomplicated pregnancies with their nocturnal sleep position. This was a prospective observational cohort study at an Australian tertiary obstetric hospital. Women were asked to complete a series of questions related to their sleep position in late pregnancy after 35 weeks of completed gestation. They also underwent an ultrasound assessment where Doppler indices of various fetoplacental vessels and fetal cardiac function were measured. Regional cerebral perfusion was also assessed. Pregnancy outcome data was extracted from the electronic hospital database for analysis. A total of 274 women were included in the final analysis. Of these, 78.1% (214/274) reported no supine sleep, and 21.9% (60/274) reported going to sleep in a supine position. The middle cerebral artery, anterior cerebral artery, and vertebral artery pulsatility indices were all significantly lower in the supine sleep cohort, as was the cerebroplacental ratio. There were no significant differences in the mode or indication for delivery or in serious neonatal outcomes, including 5-min Apgar score < 7, acidosis, and neonatal intensive care unit admission between cohorts. Women in the supine cohort were more likely to have an infant with a BW > 90th centile (p = 0.04). This data demonstrates fetal brain sparing in association with the maternal supine sleep position in a low-risk population. This data contributes to the growing body of literature attempting to elucidate the etiological pathways responsible for the association of late stillbirth with the maternal supine sleep position. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

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Review

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20 pages, 1339 KiB

Open AccessEditor’s ChoiceReview

Multi-Level Processes and Retina–Brain Pathways of Photic Regulation of Mood

by Julia Maruani and Pierre A. Geoffroy

J. Clin. Med. 2022, 11(2), 448; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11020448 - 16 Jan 2022

Cited by 18 | Viewed by 5240

Abstract

Light exerts powerful biological effects on mood regulation. Whereas the source of photic information affecting mood is well established at least via intrinsically photosensitive retinal ganglion cells (ipRGCs) secreting the melanopsin photopigment, the precise circuits that mediate the impact of light on depressive behaviors are not well understood. This review proposes two distinct retina–brain pathways of light effects on mood: (i) a suprachiasmatic nucleus (SCN)-dependent pathway with light effect on mood via the synchronization of biological rhythms, and (ii) a SCN-independent pathway with light effects on mood through modulation of the homeostatic process of sleep, alertness and emotion regulation: (1) light directly inhibits brain areas promoting sleep such as the ventrolateral preoptic nucleus (VLPO), and activates numerous brain areas involved in alertness such as, monoaminergic areas, thalamic regions and hypothalamic regions including orexin areas; (2) moreover, light seems to modulate mood through orexin-, serotonin- and dopamine-dependent pathways; (3) in addition, light activates brain emotional processing areas including the amygdala, the nucleus accumbens, the perihabenular nucleus, the left hippocampus and pathways such as the retina–ventral lateral geniculate nucleus and intergeniculate leaflet–lateral habenula pathway. This work synthetizes new insights into the neural basis required for light influence mood Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

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23 pages, 968 KiB

Open AccessReview

Nightmares in Patients with Major Depressive Disorder, Bipolar Disorder, and Psychotic Disorders: A Systematic Review

by Marine Ambar Akkaoui, Michel Lejoyeux, Marie-Pia d’Ortho and Pierre A. Geoffroy

J. Clin. Med. 2020, 9(12), 3990; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9123990 - 09 Dec 2020

Cited by 19 | Viewed by 4232

Abstract

Chronic nightmares are very common in psychiatric disorders, affecting up to 70% of patients with personality or post-traumatic stress disorders. In other psychiatric disorders, the relationships with nightmares are poorly known. This review aimed to clarify the relationship between nightmares and both mood and psychotic disorders. We performed a systematic literature search using the PubMed, Cochrane Library and PsycINFO databases until December 2019, to identify studies of patients suffering from either a mood disorder or a psychotic disorder associated with nightmares. From the 1145 articles screened, 24 were retained, including 9 studies with patients with mood disorders, 11 studies with patients with psychotic disorders and 4 studies with either psychotic or mood disorders. Nightmares were more frequent in individuals with mood or psychotic disorders than in healthy controls (more than two-fold). Patients with frequent nightmares had higher suicidality scores and had more frequently a history of suicide attempt. The distress associated with nightmares, rather than the frequency of nightmares, was associated with the severity of the psychiatric disorder. Further studies assessing whether nightmare treatment not only improves patient–sleep perception but also improves underlying psychiatric diseases are needed. In conclusion, nightmares are overrepresented in mood and psychotic disorders, with the frequency associated with suicidal behaviors and the distress associated with the psychiatric disorder severity. These findings emphasize major clinical and therapeutic implications. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

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25 pages, 4204 KiB

Open AccessReview

A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Evaluating the Evidence Base of Melatonin, Light Exposure, Exercise, and Complementary and Alternative Medicine for Patients with Insomnia Disorder

by Chiara Baglioni, Zarina Bostanova, Valeria Bacaro, Fee Benz, Elisabeth Hertenstein, Kai Spiegelhalder, Gerta Rücker, Lukas Frase, Dieter Riemann and Bernd Feige

J. Clin. Med. 2020, 9(6), 1949; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9061949 - 22 Jun 2020

Cited by 41 | Viewed by 10540

Abstract

Insomnia is a prevalent disorder and it leads to relevant impairment in health-related quality of life. Recent clinical guidelines pointed out that Cognitive-Behavior Therapy for Insomnia (CBT-I) should be considered as first-line intervention. Nevertheless, many other interventions are commonly used by patients or have been proposed as effective for insomnia. These include melatonin, light exposure, exercise, and complementary and alternative medicine. Evaluation of comparable effectiveness of these interventions with first-line intervention for insomnia is however still lacking. We conducted a systematic review and network meta-analysis on the effects of these interventions. PubMed, PsycInfo, PsycArticles, MEDLINE, and CINAHL were systematically searched and 40 studies were included in the systematic review, while 36 were entered into the meta-analysis. Eight network meta-analyses were conducted. Findings support effectiveness of melatonin in improving sleep-onset difficulties and of meditative movement therapies for self-report sleep efficiency and severity of the insomnia disorder. Some support was observed for exercise, hypnotherapy, and transcranial magnetic resonance, but the number of studies for these interventions is still too small. None of the considered interventions received superior evidence to CBT-I, which should be more widely disseminated in primary care. Full article

(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)

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