Recent research has examined associations between inflammation and mental health, and has increasingly focused on utilising younger samples to characterise the temporal relationship between inflammatory responses and the emergence of other symptoms. These studies have typically used blood to measure inflammation, although rates of detection for many inflammatory markers appear to be low. Saliva is a safe and low-cost alternative, and adult research has shown that levels of some salivary markers correlate well with those in serum. However, no research has examined this association in young people. This study examined 16 inflammatory markers in serum and saliva in 17 depressed adolescents and 18 healthy controls, aged 13-18 years. In general, detection rates were higher in saliva compared to in serum. When non-detectable levels were excluded, serum levels of C-reactive protein (CRP) correlated with salivary CRP (r=0.424, p=0.015), and this correlation appeared to only exist for those individuals with high levels of serum CRP (r=0.599, p=0.014). However, when non-detectable levels were included as zero, salivary levels of CRP, interleukin (IL)-2, IL-12p70, and interferon (IFN)-γ correlated with their serum counterparts. No significant clinical group differences in any acute phase proteins or cytokines were present. This study suggests that saliva can be used to measure inflammation in studies with adolescent participants, especially CRP, as it appears to correlate with systemic inflammation for those individuals who are expected to have high levels of inflammation. Implications for future directions in research on salivary inflammatory markers are discussed.
The findings validate the single-factor scoring structure of the PSQI in an adolescent sample and highlight important covariation between poor sleep duration, efficiency, and latency in this age group. Further validation studies are required to determine an appropriate PSQI clinical cut-off score for adolescents.
Objective: Sleep problems are a major risk factor for the emergence of mental health problems in adolescence. The aim of this study was to investigate the post intervention effects of a cognitive–behavioral/mindfulness-based group sleep intervention on sleep and mental health among at-risk adolescents. Method: A randomized controlled trial (RCT) was conducted across High schools in Melbourne, Australia. One hundred forty-four adolescents (aged 12–17 years) with high levels of anxiety and sleeping difficulties, but without past or current depressive disorder, were randomized into either a sleep improvement intervention or an active control ‘study skills’ intervention. Both programs consisted of 7 90-min-long group sessions delivered over 7 weeks. One hundred twenty-three participants began the interventions (female = 60%; mean age = 14.48, SD = 0.95), with 60 in the sleep condition and 63 in the control condition. All participants were required to complete a battery of mood and sleep questionnaires, 7 days of wrist actigraphy (an objective measure of sleep), and sleep diary entry at pre- and-post intervention. Results: The sleep intervention condition was associated with significantly greater improvements in subjective sleep (global sleep quality [with a medium effect size], sleep onset latency, daytime sleepiness [with small effect sizes]), objective sleep (sleep onset latency [with a medium effect size]), and anxiety (with a small effect size) compared with the control intervention condition. Conclusion: The SENSE study provides evidence that a multicomponent group sleep intervention that includes cognitive–behavioral and mindfulness-based therapies can reduce sleep initiation problems and related daytime dysfunction, along with concomitant anxiety symptoms, among at-risk adolescents.
Aim Existing literature links poor sleep and anxiety symptoms in adolescents. This pilot study aimed to develop a practical method through which a program to improve sleep could reach adolescents in need and to examine the feasibility of a mindfulness‐based, multi‐component group sleep intervention using sleep and anxiety as outcome measures. Methods Sixty‐two grade 9 students (aged 13–15) at a girls’ school were screened with the Pittsburgh Sleep Quality Index (PSQI) and Spence Children's Anxiety Scale (SCAS). Ten participants with self‐reported poor sleep were enrolled into a six‐session program based on Bootzin & Stevens, with added stress/anxiety‐specific components. Sessions covered key aspects of basic mindfulness concepts and practice, sleep hygiene, sleep scheduling, evening/daytime habits, stimulus control, skills for bedtime worries and healthy attitudes to sleep. Treatment changes were measured by pre‐post scores on the PSQI, SCAS and 7‐day actigraphy‐measured sleep. Results The program demonstrated high acceptability, with a completion rate of 90%. Based on effect‐size analysis, participants showed significant improvement on objective sleep onset latency (SOL), sleep efficiency and total sleep time; actigraphy data also showed significantly earlier bedtime, rise time and smaller day‐to‐day bedtime variation. Post‐intervention global PSQI scores were significantly lower than that of pre‐intervention, with significant improvement in subjective SOL, sleep quality and sleep‐related daytime dysfunction. There were small improvements on some subscales of the SCAS, but change on its total score was minimal. Conclusions A mindfulness‐based, multi‐component, in‐school group sleep intervention following brief screening is feasible, and has the potential to improve sleep. Its impact on anxiety needs further investigation.
Normal sleep has a profound effect on the cardiovascular system, reducing cardiovascular activity throughout non-rapid eye movement sleep; changes that are modified and augmented by circadian system influence. There is also evidence that sleep-initiated changes in autonomic balance may in turn modify the development of sleep within a night, particularly the development of slow wave sleep. It is assumed that the cardiovascular changes that accompany sleep reflect a functional aspect of sleep, although the precise functional role has not been agreed upon. Nevertheless, there is good evidence that the cardiovascular changes that occur during normal sleep are beneficial for the cardiovascular system. Arousals from sleep, which are common even in normal sleep, are associated with a surge in activity in cardiorespiratory systems, with marked effects on the sleep-related pattern of cardiovascular activity when they occur frequently. Despite the importance of this aspect of sleep, controversy remains as to both the nature of the activation response and the circumstances under which it is elicited. The concept that sleep-related changes in cardiovascular activity are beneficial leads to the corollary that sleep disturbance would result in adverse cardiovascular consequences. While there is strong empirical evidence for such a relationship, it remains unclear whether this is a direct effect or, as has been suggested recently, the effect of disturbed sleep is mediated via stress-related modification of neuroendocrine systems.
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