Browsing by Subject "DEPRIVATION"

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  • Alitalo, Okko; Saarreharju, Roosa; Henter, Ioline D.; Jr, Carlos A. Zarate; Kohtala, Samuel; Rantamäki, Tomi (2021)
    Depression is frequently associated with sleep problems, and clinical improvement often coincides with the normalization of sleep architecture and realignment of circadian rhythm. The effectiveness of treatments targeting sleep in depressed patients, such as sleep deprivation, further demonstrates the confluence of sleep and mood. Moreover, recent studies showing that the rapid-acting antidepressant ketamine influences processes related to sleep-wake neurobiology have led to novel hypotheses explaining rapid and sustained antidepressant effects. Despite the available evidence, studies addressing ketamine's antidepressant effects have focused on pharmacology and often overlooked the role of physiology. To explore this discrepancy in research on rapid acting antidepressants, we examined articles published between 2009-2019. A keyword search algorithm indicated that vast majority of the articles completely ignored sleep. Out of the 100 most frequently cited pre clinical and clinical research papers, 89 % and 71 %, respectively, did not mention sleep at all. Furthermore, only a handful of these articles disclosed key experimental variables, such as the times of treatment administration or behavioral testing, let alone considered the potential association between these variables and experimental observations. Notably, in preclinical studies, treatments were preferentially administered during the inactive period, which is the polar opposite of clinical practice and research. We discuss the potential impact of this practice on the results in the field. Our hope is that this perspective will serve as a wake-up call to (re)-examine rapid-acting antidepressant effects with more appreciation for the role of sleep and chronobiology.
  • Raaska, Hanna; Elovainio, Marko; Sinkkonen, Jari; Stolt, Suvi; Jalonen, Iina; Matomaki, Jaakko; Makipaa, Sanna; Lapinleimu, Helena (2013)
  • Lumme, Sonja; Manderbacka, Kristiina; Arffman, Martti; Karvonen, Sakari; Keskimaki, Ilmo (2020)
    Objectives To study the interplay between several indicators of social disadvantage and hospitalisations due to ambulatory care-sensitive conditions (ACSC) in 2011-2013. To evaluate whether the accumulation of preceding social disadvantage in one point of time or prolongation of social disadvantage had an effect on hospitalisations due to ACSCs. Four common indicators of disadvantage are examined: living alone, low level of education, poverty and unemployment. Design A population-based register study. Setting Nationwide individual-level register data on hospitalisations due to ACSCs for the years 2011-2013 and preceding data on social and socioeconomic factors for the years 2006-2010. Participants Finnish residents aged 45 or older on 1 January 2011. Outcome measure Hospitalisations due to ACSCs in 2011-2013. The effect of accumulation of preceding disadvantage in one point of time and its prolongation on ACSCs was studied using modified Poisson regression. Results People with preceding cumulative social disadvantage were more likely to be hospitalised due to ACSCs. The most hazardous combination was simultaneously living alone, low level of education and poverty among the middle-aged individuals (aged 45-64 years) and the elderly (over 64 years). Risk ratio (RR) of being hospitalised due to ACSC was 3.16 (95% CI 3.03-3.29) among middle-aged men and 3.54 (3.36-3.73) among middle-aged women compared with individuals without any of these risk factors when controlling for age and residential area. For the elderly, the RR was 1.61 (1.57-1.66) among men and 1.69 (1.64-1.74) among women. Conclusions To improve social equity in healthcare, it is important to recognise not only patients with cumulative disadvantage but also-as this study shows-patients with particular combinations of disadvantage who may be more susceptible. The identification of these vulnerable patient groups is also necessary to reduce the use of more expensive treatment in specialised healthcare.
  • Elovainio, Marko; Kuula, Liisa; Halonen, Risto; Pesonen, Anu-Katriina (2020)
    Background: Very late sleep rhythms are risks for social adjustment problems in adolescence. Using ecological momentary assessment data, we quantified and visualized temporal and contemporaneous within-persons dynamical relations of sleepiness and emotions in adolescents with and without late sleep rhythms. Methods: We analyzed a temporal network via multilevel vector autoregression (mlVAR) modeling and a contemporaneous network through the partial associations between the residuals of temporal and the between-subject multilevel models. We tested whether these networks were different between those with a late circadian rhythm [concurrent delayed sleep phase (DSP) N = 172, 37% boys, 63% girls] and those without (N = 143, 22% boys, 78% girls). Results: In adolescents without DSP, the temporal networks showed continuity only for low mood from the previous to the following time point. In adolescents with DSP, there were more predictable patterns of emotions. Feelings of depression led to a decrease of positive emotions and increase of irritation and anxiety. The contemporaneous networks showed clusters of positive and negative emotions in both groups and sleepiness decreased the experience of positive emotions concurrently. Limitations: DSP in our current study was based only on one out of three diagnostic criteria of the full disorder (DSM-5) and it was assessed only once. Conclusions: These findings indicate that the dynamic organization of emotions and sleepiness is different in adolescents with and without DSP. DSP adolescents have more predictable and maladaptive emotional patterns during the day. Results provide new insight about why individuals with DSP are at a heightened risk for decreased emotional adjustment.
  • Cooke, Marie; Ritmala-Castren, Marita; Dwan, Toni; Mitchell, Marion (2020)
    Background Pharmacological interventions for sleep (analgesic, sedative and hypnotic agents) can both disrupt and induce sleep and have many negative side effects within the intensive care population. The use of complementary and alternative medicine therapies to assist with sleep has been studied but given the variety of modalities and methodological limitations no reliable conclusions have been drawn. Objective To synthesise research findings regarding the effectiveness of using complementary and alternative medicine interventions within the domains of mind and body practices (relaxation techniques, acupuncture) and natural biologically based products (herbs, vitamins, minerals, probiotics) on sleep quality and quantity in adult intensive care patients. Review method used Systematic review Data sources Five databases were searched in August 2018 and updated in February 2019 and 2020. Review methods: Searches were limited to peer reviewed randomised controlled trials, published in English involving adult populations in intensive care units. Interventions were related to the complementary and alternative medicine domains of mind and body practices and natural products. Included studies were assessed using Cochrane's risk of bias tool. Results Seventeen studies were included. The interventions used varied: 4 investigated melatonin; 4 music +/- another therapy; 3 acupressure; 2 aromatherapy and 1 each for relaxation and imagery, reflexology, bright light exposure and inspiratory muscle training. Measurement of sleep quantity and quality was also varied: 5 studies used objective measures such as Polysomnography and Bispectral index with the remaining using subjective patient or clinician assessment (for example, Richards-Campbell Sleep Questionnaire, Pittsburgh Sleep Quality Index, observation). Given the different interventions, outcomes and measures used in the studies a meta-analysis was not possible. Generally, the results support the use of complementary and alternative medicine for assisting with sleep with 11 out of 17 trials reporting significant results for the interventions examined. Conclusions Complementary and alternative medicine interventions, in particular, melatonin and music, have shown promise for improving sleep in adults with critically conditions; however, further research that addresses the limitations of small sample sizes and improved techniques for measuring sleep is needed.
  • Ämmälä, Antti-Jussi; Urrila, Anna-Sofia; Lahtinen, Aleksandra; Santangeli, Olena; Hakkarainen, Antti; Kantojärvi, Katri; Castaneda, Anu E.; Lundbom, Nina; Marttunen, Mauri; Paunio, Tiina (2019)
    Objectives: This study aimed to test the hypothesis that sleep and depression have independent effects on brain development and plasticity in adolescents, and that these changes are reflected in changes in the epigenome. Methods: Participants were 17 medication-free adolescent boys (age 16.05 +/- 0.80 years, mean +/- standard deviation (SD); eight cases with depression and sleep symptoms, nine healthy controls). Sleep was assessed by polysomnography recordings and the Pediatric Daytime Sleepiness Scale (PDSS) and Athens Insomnia Scale (AIS). Participants underwent a clinical evaluation. DNA methylation of blood leukocytes was measured by Illumina 450K array, and Ingenuity Pathway analysis was applied to identify the most significant pathways with differentially methylated positions (DMPs). Secondary analysis of the identified loci included linear correlations between methylation and the subjectively rated scales of sleep, depression and sleep microarchitecture. Results: Due to small sample size, we found no genome-wide significant differences in methylation between cases and controls. However, pathway analysis identified the synaptic long-term depression (LTD) canonical pathway (p = 0.00045) when the best 500 DMPs from the original case-control design were included. A flattened dissipation of slow wave sleep, tiredness and depression severity values correlated with five of 10 sites from the LTD pathway (IGF1R, PLAG16, PLA2R1, PPP2C5 and ERK12) in the secondary analysis when the case-control status was controlled for. Conclusion: Among adolescents, depressive disorder with sleep symptoms is associated with a distinctive epigenetic pattern of DNA methylation in blood leukocytes. The enrichment of DMPs on genes related to synaptic LTD emphasizes the role of sleep in synaptic plasticity and the widespread physiological consequences of disturbed sleep. (C) 2019 Elsevier B.V. All rights reserved.
  • Rönö, K.; Masalin, S.; Kautiainen, H.; Gissler, M.; Raina, M.; Eriksson, J. G.; Laine, M. K. (2019)
    Aims Findings concerning the impact of socio-economic status on the risk of gestational diabetes mellitus (GDM) are inconclusive and little is known about the simultaneous impact of income and educational attainment on the risk of GDM. This study aims to assess the impact of maternal prepregnancy income in combination with traditional GDM risk factors on the incidence of GDM in primiparous women. Methods This is an observational cohort study including 5962 Finnish women aged >= 20 years from the city of Vantaa, Finland, who delivered for the first time between 2009 and 2015, excluding women with pre-existing diabetes mellitus. The Finnish Medical Birth Register, Finnish Tax Administration, Statistics Finland, Social Insurance Institution of Finland and patient healthcare records provided data for the study. We divided the study population according to five maternal income levels and four educational attainment levels. Results Incidence of GDM decreased with increasing income level in primiparous women (P <0.001 for linearity, adjusted for smoking, age, BMI and cohabiting status). In an adjusted two-way model, the relationship was significant for both income (P = 0.007) and education (P = 0.039), but there was no interaction between income and education (P = 0.52). Conclusions There was an inverse relationship between both maternal prepregnancy taxable income and educational attainment, and the risk of GDM in primiparous Finnish women.
  • Jokela, Markus (2020)
    Neighborhood characteristics have been associated with psychological distress, but it is uncertain whether these associations are causal. The current article reviews data from interventions and quasi-experimental studies that have addressed the question of causality of neighborhood associations. Overall, data from neighborhood interventions, longitudinal studies, and twin studies have provided only limited and inconsistent evidence to support causal interpretation of neighborhood associations with psychological distress: very few findings have been replicated across different samples, and many associations have been observed only with some of the multiple measures included the studies. Studies that examine the effects of neighborhood change on people's wellbeing are needed to improve causal inference and policy relevance of neighborhood studies.
  • Tietäväinen, Aino; Kuvaldina, Maria; Haeggström, Edward (2018)
    Sleep deprivation may cause accidents, and it has deteriorating effects on health. A measurement of postural steadiness by a portable and affordable Nintendo Wii Fit balance board can be used to quantify a person's alertness. At work, people are under the influence of their environment-often other peopledthat may affect their alertness. This work investigates whether sleep deprivation among people is "contagious," as quantified by sway measures. We measured 21 volunteers' postural steadiness while alert and sleep deprived. During the measurements, a screen placed in front of the participants showed a footage of either alert or sleep-deprived faces. We found a significant difference between the day time and night time steadiness, but found no effect resulting from watching footage of sleep-deprived people. This finding shows that a posturographic sleepiness tester quantifies physiological sleep deprivation, and is insensitive to the influence of social factors. (C) 2017 Occupational Safety and Health Research Institute, Published by Elsevier Korea LLC.
  • Ternman, Emma; Nilsson, Emma; Nielsen, Per Peetz; Pastell, Matti; Hänninen, Laura; Agenäs, Sigrid (2019)
    ABSTRACT The importance of rest and sleep is well established; we know, for example, that lack of sleep impairs immune function in rats and increases pain sensitivity in humans. However, little is known about sleep in dairy cows, but a lack of rest and sleep is discussed as a possible welfare problem in cattle. A first step toward a better understanding of sleep in dairy cows is to quantify the time cows spend awake and asleep in different stages of lactation. Using electrophysiological recordings on 7 occasions in wk −2, 2, 7, 13, 22, 37, and 45 in relation to calving, we investigated changes in rapid eye movement (REM) sleep time as well as non-rapid eye movement (NREM) sleep, drowsing, awake, and rumination in 19 dairy cows of the Swedish Red breed kept in single pens with ad libitum access to feed and water. The recordings on wk −2 and 45 were conducted during the dry period, and all others during lactation. The PROC MIXED procedure in SAS (SAS Institute Inc., Cary, NC) was used to test for significant differences in REM, NREM, drowsing, awake, and rumination between the different stages of lactation cycle. Pairwise comparisons between all recording occasions showed that total REM sleep duration was shorter for cows in wk 2 relative to calving compared with wk −2, and the number of REM sleep bouts were fewer in wk 2 compared with wk −2. The REM sleep was recorded during both the day (0500–2100 h) and night (2100–0500 h), but predominantly performed at night compared with daytime, and the bout duration was longer during nighttime compared with daytime. A tendency was observed for time spent in NREM sleep to be shorter in wk 2 relative to calving compared with wk −2. The duration spent drowsing was shorter for cows in wk 2 and 13 relative to calving compared with wk −2. We found no effect of stage of lactation cycle on the duration of awake or ruminating. Our study is the first to assess sleep distribution during a lactation cycle, and our results show that stage of lactation is important to consider when moving forward with sleep investigations in dairy cows. The shortest REM sleep duration was found for cows 2 wk after calving and longest 2 wk before calving, and the difference was due a higher number of REM sleep bouts in the recording 2 wk before calving. The REM sleep and rumination predominantly occurred at night but were recorded during both day and night.
  • Manderbacka, Kristiina; Arffman, Martti; Satokangas, Markku; Keskimäki, Ilmo (2019)
    Objectives A persistent finding in research concerning healthcare and hospital use in Western countries has been regional variation in the medical practices. The aim of the current study was to examine trends in the regional variation of avoidable hospitalisations, that is, hospitalisations due to conditions treatable in ambulatory care in Finland in 1996–2013 and the influence of different healthcare levels on them.Setting Use of hospital inpatient care in 1996–2013 among the total population in Finland.Participants Altogether 1 931 012 hospital inpatient care episodes among all persons residing in Finland identified from administrative registers in Finland in 1996−2013 and alive in 1 January 1996.Outcome measures We examined hospitalisations due to avoidable causes including vaccine-preventable hospitalisations, hospitalisations due to complications of chronic conditions and acute conditions treatable in ambulatory care. We calculated annual age-adjusted rates per 10 000 person-years. Multilevel models were used for studying time trends in regional variation.Results There was a steep decline in avoidable hospitalisation rates during the study period. The decline occurred almost exclusively in hospitalisations due to chronic conditions, which diminished by about 60%. The overall correlation between hospital district intercepts and slopes in time was −0.46 (p&lt;0.05) among men and −0.20 (ns) among women. Statistically highly significant diminishing variation was found in hospitalisations due to chronic conditions among both men (−0.90) and women (−0.91). The variation was mainly distributed to the hospital district level.Conclusions The results suggest that chronic conditions are managed better in primary care in the whole country than before. Further research is needed on whether this is the case or whether this has more to do with supply of hospital care.
  • Urrila, Anna S.; Artiges, Eric; Massicotte, Jessica; Miranda, Ruben; Vulser, Helene; Bezivin-Frere, Pauline; Lapidaire, Winok; Lemaitre, Herve; Penttilae, Jani; Conrod, Patricia J.; Garavan, Hugh; Martinot, Marie-Laure Paillere; Martinot, Jean-Luc; IMAGEN Consortium (2017)
    Here we report the first and most robust evidence about how sleep habits are associated with regional brain grey matter volumes and school grade average in early adolescence. Shorter time in bed during weekdays, and later weekend sleeping hours correlate with smaller brain grey matter volumes in frontal, anterior cingulate, and precuneus cortex regions. Poor school grade average associates with later weekend bedtime and smaller grey matter volumes in medial brain regions. The medial prefrontal anterior cingulate cortex appears most tightly related to the adolescents' variations in sleep habits, as its volume correlates inversely with both weekend bedtime and wake up time, and also with poor school performance. These findings suggest that sleep habits, notably during the weekends, have an alarming link with both the structure of the adolescent brain and school performance, and thus highlight the need for informed interventions.
  • Halonen, Jaana I.; Vahtera, Jussi; Oksanen, Tuula; Pentti, Jaana; Virtanen, Marianna; Jokela, Markus; Diez-Roux, Ana V.; Kivimäki, Mika (2013)