Sleep Disorder During the Third Wave of COVID-19 Pandemic among Malaysian Adults

Background: The outbreak of coronavirus posits deleterious consequences on global healthcare system while affecting human life in every aspect. Despite various measures undertaken to limit the socio-economic effect of coronavirus, various challenges remain pervasive, and one such challenge is mental health, particularly sleep disorders. Therefore, this study examines the prevalence and determinants of sleep disorders among Malaysian adults.Methods: An online survey was conducted from 11 January to May 2021. Structured questionnaire link using Google form was sent to the adults through E-mail in Malaysia. The study utilized Holland Sleep Disorder Questionnaire (HSDQ) to screen out the various sleep disorders, namely; Insomnia, Parasomnia, Circadian Rhythm Sleep Disorder (CRSD), Hypersomnia, Restless Legs Syndrome (RLS/PLMD), and Sleep-disordered Breathing (SDB). Percentage distribution and logistic regression analysis were used as study tools.Results: Around 70% of the surveyed population had one or another sleep disorder. One-third reported RLS/PLMD (34.8%) and CRSD (33.9%). More than one-fourth of the adults reported Insomnia (29.7%) and Hypersomnia (25.8%). Increased risk of sleep disorders was found to be associated with being unemployed (OR=2.4, C.I.=1.17-4.89). The risk of insomnia and hypersomnia was higher among female adults (OR=1.6, C.I.=1.11-2.3) and unemployed adults (OR=2.4, C.I.=1.23-5.04), respectively.Conclusion: Immediate interventions to prevent aggravation of sleep disorders should be promoted. It is recommended to bring forth psychiatric and psychological support to those suffering from various sleep disorders in the ongoing coronavirus pandemic. Government shall impart counselling through various online channels consisting of psychologists and sleep experts to improve the quality of sleep.

Effect of jet lag on brain white matter functional connectivity

Background A long-haul flight across more than five time zones may produce a circadian rhythm sleep disorder known as jet lag. Little is known about the effect of jet lag on white matter (WM) functional connectivity (FC). Objective The present study is to investigate changes in WM FC in subjects due to recovery from jet lag after flying across six time zones. Methods Here, resting-state functional magnetic resonance imaging was performed in 23 participants within 24 hours of flying and again 50 days later. Gray matter (GM) and WM networks were identified by k-means clustering. WM FC and functional covariance connectivity (FCC) were analyzed. Next, a sliding window method was used to establish dynamic WM FC. WM static and dynamic FC and FCC were compared between when participants had initially completed their journey and 50 days later. Emotion was assessed using the Positive and Negative Affect Schedule and the State Anxiety Inventory. Results All participants were confirmed to have jet lag symptoms by the Columbian Jet Lag Scale. The static FC strengthes of cingulate network (WM7)- sensorimotor network and ventral frontal network- visual network were lower after the long-haul flight compared with recovery. Corresponding results were obtained for the dynamic FC analysis. The analysis of FCC revealed weakened connections between the WM7 and several other brain networks, especially the precentral/postcentral network. Moreover, a negative correlation was found between emotion scores and the FC between the WM7 and sensorimotor related regions. Conclusions The results of this study provide further evidence for the existence of WM networks and show that jet lag is associated with alterations in static and dynamic WM FC and FCC, especially in sensorimotor networks. Jet lag is a complex problem that not only is related to sleep rhythm but also influences emotion.

Association of Expression Levels of Clock Genes and Autophagy-Related Genes under Abnormal Light/Dark Cycle Stimulation in NAFLD Mice

Background: Environmental disorders of the circadian rhythms can lead to metabolism-related diseases or exacerbate pathological conditions. Non-alcoholic fatty liver disease (NAFLD) has emerged with a growing occurrence. In the present study, we attempted to indicate whether circadian clock may influence lipid deposition and the expression levels of autophagy-related genes in liver of mice. Methods: High-fat diet and abnormal light/dark cycles were employed to induce a mouse model of NAFLD with circadian rhythm sleep disorder. Herein, liver samples were obtained at ZT0, ZT4, ZT8, ZT12, ZT16, and ZT20 time-point to detect the rhythmic expressions of circadian genes, autophagy-related genes, and Rev-erbα. Results: Abnormal exposure to light aggravated lipid deposition in liver of mice and exacerbated disorders related to 24-h expression levels of clock genes, autophagy-related genes, and Rev-erbα. Besides, Rev-erbα could transcriptionally control the expression levels of autophagy-related genes. Conclusions: The long-term high-fat diet combined with abnormal light/dark cycle stimulation aggravated the development of NAFLD and disturbed the expressions levels of autophagy-related genes. An abnormal circadian expression may lead to NAFLD aggression. Besides, the abnormal expression levels of clock genes may create an association between circadian rhythm sleep disorder and autophagy.

0396 Prevalence of Delayed Sleep Phase Syndrome (DPSP) Among Omani People

Introduction Delayed sleep phase syndrome (DSPS) is a circadian rhythm sleep disorder with a definition of delayed night sleep by two or more hours beyond the socially acceptable or conventional bedtime. The general reported prevalence of DSPS is 7% to 16%. However, there is no previous study which assess DSPS prevalence in Oman or nearby regions. This study aimed to assess the prevalence of DSPS among Omani population and to establish a connection between demographics and DSPS. Methods This community-based study included 186 subjects aged from 18 to 64 who had one week of actigraphy records along with their demographical data in Sultan Qaboos University hospital. Results Among the 186, 19 (10.2%) subjects were identified of having DSPS in weekdays, and 15 (11.4%) subjects have DSPS in weekends. The results indicated that marital status had significant relation (P=0.02) more with unmarried group (62.50%, N=10). No significant relationship was found between DSPS and age, gender, BMI, education and employment status in either weekdays or weekends (P>0.05) Conclusion A consistent rates of DSPS was found among Omanis which are 10.2% in weekdays and 11.4% in weekends. Also, DSPS have significantly higher rates among unmarried subjects in weekdays. Further studies in DSPS are needed to assess risk factors and possible health impacts. Support The research Council of Oman

Contingency Contracting Untuk Menurunkan Perilaku Tertidur Di Kelas Pada Anak Sleep Disorder

Normal sleep patterns are very important for academic achievement and life of each child. This study aims to know the effect of Contingency Contracting to reduce sleep behavior in class and improve sleep patterns in children with Circadian-Rhythm Sleep Disorder. The study subjects were A, a boy aged 11 years, with ADHD-PI diagnosed with Circadian-Rhythm Sleep Disorder Delayed Sleep Phase Type. The design of this study uses multiple-baseline-across-behaviors design. Contingency contracting interventions are carried out using prompt techniques, fading, and economic tokens. The recording instrument used is sleep diary and behavior frequency recording sheet. The results of the study show that behavioral modification intervention programs carried out with contingency contracting have been shown to effectively reduce sleep behavor in the classroom in the morning and improve the pattern of nighttime sleep in children with Circadian-Rhythm Sleep Disorder.Keywords: sleep-disorder; circadian-rhythm; behavior modification; contingency contracting; prompt  AbstrakPola tidur yang normal sangatlah penting bagi prestasi akademik dan kehidupan setiap anak. Penelitian ini bertujuan melihat pengaruh Contingency Contracting untuk menurunkan perilaku tertidur di kelas dan memperbaiki pola waktu tidur pada anak dengan Circadian-Rhythm Sleep Disorder. Subjek penelitian adalah A, anak laki-laki usia 11 tahun, dengan ADHD-PI didiagnosa mengalami Circadian-Rhythm Sleep Disorder Delayed Sleep Phase Type. Desain penelitian ini menggunakan multiple-baseline-across-behaviors design. Intervensi contingency contracting dilakukan menggunakan teknik prompt, fading, dan token ekonomi. Instrumen pencatatan yang digunakan adalah sleep diary dan lembar pencatatan frekuensi perilaku. Hasil dari penelitian menunjukkan program intervensi modifikasi perilaku yang dilakukan dengan contingency contracting terbukti efektif menurunkan perilaku tertidur di kelas pada pagi hari maupun memperbaiki pola waktu tidur malam hari pada anak dengan Circadian-Rhythm Sleep Disorder.Kata Kunci: sleep-disorder; circadian-rhythm; modifikasi perilaku; contingency contracting; prompt

Conceptualizing Digital Addiction as Glutamine Inhibition and Glutamate Acceleration (GIGA)

This chapter carries out two investigations into digital addiction using the brain productivity measure of knol. It is asserted that digital addiction is caused by two medical conditions linked to the well-known concept of flow and lesser known concept of involvement. These conditions are serotonergic-dopaminergic asynchronicity (SDA) and glutamine inhibition and glutamate acceleration (GIGA). In online environments SDA affects befriending, defriending and kudos and GIGA affects workfulness and smart-device overuse to produce increased wakefulness, causing conditions like Circadian rhythm sleep disorder. In other words, if a person is over-stimulated or under-stimulated, their use of digital technologies, such as at night, will increase. The results show improved sleep and reduced device use during the night when the L-Glutamine is consumed, but effects the following day were not always positive. L-5-Hydroxytryptophan had some effect in reducing ‘mental gaze' caused by glutamate and dopamine, but could not be seen as effective as an SSRI.