The onset of sleep disturbances and their associations with anxiety after acute high-altitude exposure at 3700 m

Bian, Shizhu; Zhang, Laiping; Jin, Jun; Zhang, Jihang; Li, Qian-ning; Yu, Jie; Chen, Jianfei; Yu, Shanshan; Zhao, Xinshu; Qin, Jun; Huang, Lan

doi:10.1038/s41398-019-0510-x

Cited by 21 publications

(20 citation statements)

References 28 publications

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“…A negative correlation between the efficiency of sleep and depression was also observed. Bian et al ( 43 ) showed that SDB developed at HA was positively correlated with anxiety, and the synthesis of amines, substance P, catecholamines, and nitric oxide was affected due to breathing disruption during sleep, which is related to mood disturbances, anxiety, and stress. Reviewing previous literature, reactions, attention, and mood are significantly impaired during the first 1 to 2 weeks after an individual ascends to a high altitude.…”

Section: Discussionmentioning

confidence: 99%

Sleep, short-term memory, and mood states of volunteers with increasing altitude

Wang

et al. 2022

Front. Psychiatry

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PurposeThis study sought to identify the changes and potential association between sleep characteristics and short-term memory, and mood states among volunteers at different altitudes and times.MethodA total of 26 healthy volunteers were recruited from the PLA General Hospital, and we conducted a longitudinal prospective survey for over 1 year from November 2019 to April 2021. First, we collected demographic data, sleep parameters by overnight polysomnography (PSG), short-term memory by digit span test, and mood states by completing a questionnaire with a brief profile of mood states among participants in the plain (53 m). Then, we continuously followed them up to collect data in the 3rd month at an altitude of 1,650 m (on the 3rd month of the 1-year survey period), the 3rd month at an altitude of 4,000 m (on the 6th month of the 1-year survey period), and the 9th month at an altitude of 4,000 m (on the 12th month of the 1-year survey period). Multiple linear regression analysis was used to construct models between sleep parameters and short-term memory, and mood states.ResultsThe prevalence of sleep apnea syndrome (SAS) significantly increased with rising elevation (P < 0.01). The apnea-hypopnea index (AHI), the mean apnea time (MAT), the longest apnea time (LAT), and the duration of time with SaO2 < 90% (TSA90) were increased (P < 0.05), and the mean pulse oxygen saturation (MSpO2), the lowest pulse oxygen saturation (LSpO2), and heart rate were significantly decreased with increasing altitude (P < 0.05). Digit span scores were decreased with increasing altitude (P < 0.001). A negative mood was more severe and a positive mood increasingly faded with rising elevation (P < 0.001). Additionally, linear correlation analysis showed that higher AHI, LAT, and MAT were strongly associated with a greater decline in short-term memory (in the 3rd and 9th month at an altitude of 4,000 m, respectively: rs = −0.897, −0.901; rs = −0.691, −0.749; rs = −0.732, −0.794, P < 0.001), and also were strongly associated with more severe negative mood (in the 3rd month at altitudes of 1,650 m and 4,000 m, respectively: rs = 0.655, 0.715, 0.724; rs = 0.771, 0.638, 0.737, P < 0.000625). Multiple linear regression pointed out that AHI was a significant predictor of negative mood among people at different altitudes (in the 3rd month at an altitude of 1,650 m: TMD = 33.161 + 6.495*AHI; in the 3rd month at an altitude of 4,000 m: TMD = 74.247 + 1.589*AHI, P < 0.05).ConclusionSAS developed easily in high altitudes, most often in CSA (central sleep apnea, CSA). The sleep, short-term memory, and negative mood were significantly more damaged with elevation in volunteers. Sleep parameters were closely associated with short-term memory and mood states in volunteers at high altitudes; the higher the sleep parameters (AHI, LAT, and MAT) scores, the more significant the mood disorders and the more obvious impairment of short-term memory. AHI was a critical predictor of the negative mood of volunteers at different altitudes. This study provides evidence that could help with the prevention and control of sleep disorder, cognitive disorder, and negative mood among populations with high altitudes.

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Section: Discussionmentioning

confidence: 99%

Sleep, short-term memory, and mood states of volunteers with increasing altitude

Wang

et al. 2022

Front. Psychiatry

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“…With very few exceptions ( Szymczak et al, 2009 ; Johnson et al, 2010 ; Frost et al, 2021 ), sleep studies conducted at altitude have included primarily men ( Pattyn et al, 1985 ; Bolmont et al, 2000 ; Stadelmann et al, 2013 ; Fernandez Tellez et al, 2014 ; Rojc et al, 2014 ; Morrison et al, 2017 ; Bian et al, 2019 ; Mairesse et al, 2019 ). This is remarkable, as it is clear that sex does lead to significant differences in the outcomes of psychophysiological research ( Mark et al, 2014 ).…”

Section: Discussionmentioning

confidence: 99%

“…Many normobaric hypoxic ( Rojc et al, 2014 ; Morrison et al, 2017 ) and hypobaric hypoxic field ( Reite et al, 1975 ; Bloch et al, 1985 ; Pattyn et al, 1985 ; Szymczak et al, 2009 ; Johnson et al, 2010 ; Stadelmann et al, 2013 ; Fernandez Tellez et al, 2014 ; Bian et al, 2019 ; Mairesse et al, 2019 ) and laboratory ( Anholm et al, 1992 ; Houston, 1997 ; Richalet, 2010 ) studies have focused on the analysis of sleep at altitude, confirming that with increasing altitude there is also an increased level of sleep disturbance. Regarding the combination of hypoxia and bed rest (BR) far less research has been performed ( Rojc et al, 2014 ; Morrison et al, 2017 ; Gennser et al, 2018 ).…”

Section: Introductionmentioning

confidence: 94%

Adult Female Sleep During Hypoxic Bed Rest

Cutsem

Pattyn²,

Maîresse³

et al. 2022

Front. Neurosci.

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PurposeHypobaric hypoxic habitats are currently being touted as a potential solution to minimise decompression procedures in preparation for extra vehicular activities during future space missions. Since astronauts will live in hypoxic environments for the duration of such missions, the present study sought to elucidate the separate and combined effects of inactivity [simulated with the experimental bed rest (BR) model] and hypoxia on sleep characteristics in women.MethodsTwelve women (Age = 27 ± 3 year) took part in three 10-day interventions, in a repeated measures cross-over counterbalanced design: (1) normobaric normoxic BR (NBR), (2) normobaric hypoxic BR (HBR; simulated altitude of 4,000 m), and (3) normobaric hypoxic ambulatory (HAMB; 4,000 m) confinement, during which sleep was assessed on night 1 and night 10 with polysomnography. In addition, one baseline sleep assessment was performed. This baseline assessment, although lacking a confinement aspect, was included statistically as a fourth comparison (i.e., pseudo normobaric normoxic ambulatory; pNAMB) in the present study.ResultsHypoxia decreased sleep efficiency (p = 0.019), increased N1% sleep (p = 0.030), decreased N3 sleep duration (p = 0.003), and increased apnea hypopnea index (p < 0.001). BR impaired sleep maintenance, efficiency, and architecture [e.g., N2% sleep increased (p = 0.033)]. Specifically, for N3% sleep, the effects of partial pressure of oxygen and activity interacted. Hypoxia decreased N3% sleep both when active (pNAMB vs HAMB; p < 0.001) and inactive (NBR vs HBR; p = 0.021), however, this decrease was attenuated in the inactive state (–3.8%) compared to the active state (–10.2%).ConclusionA 10-day exposure to hypoxia and BR negatively impacted sleep on multiple levels as in macrostructure, microstructure and respiratory functioning. Interestingly, hypoxia appeared to have less adverse effects on sleep macrostructure while the participants were inactive (bed ridden) compared to when ambulatory. Data were missing to some extent (i.e., 20.8%). Therefore, multiple imputation was used, and our results should be considered as exploratory.

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“…The English version of the scale was compiled by Zung in 1971 21 and localised by Chinese scholars in 1981, making it appropriate to use in the Chinese population; 22 it has since been widely used. [23][24][25] This scale contains a total of 20 items measured on a 4-point Likert scale, ranging from 1 (none or a little of the time) to 4 (good all of the time). The standard score for the scale was obtained by multiplying the original score of 20 items by 1.25.…”

Section: Self-rating Anxiety Scale (Sas)mentioning

confidence: 99%

Mediating role of coping styles on anxiety in healthcare workers victim of violence: a cross-sectional survey in China hospitals

Wang

Shi

et al. 2021

BMJ Open

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ObjectiveThe purposes of this study were to evaluate the rate of workplace violence in county hospitals in China and its impact on healthcare workers and to explore the relationship between hospital violence, coping styles and anxiety to provide effective procedures for reducing anxiety among healthcare workers.MethodsThe study used stratified sampling to select 1200 healthcare workers from 30 county hospitals in China to conduct a questionnaire survey. Of these, 1030 were valid questionnaires, and the effective response rate was 85.83%. We collected demographic characteristics of our participants and administered the following scales to them: Workplace Violence, Trait Coping Style, Self-rating Anxiety. Data were statistically analysed.ResultsThe results showed that 67.28% of healthcare workers in county hospitals in China had experienced workplace violence in the previous 12 months, with prevalent verbal violence (66.12%) followed by physical violence (15.24%). Workplace violence in hospitals was negatively related to positive coping (r=−0.091, p<0.01) but positively related to negative coping (r=0.114, p<0.001) and anxiety (r=0.298, p<0.001). Positive and negative coping was negatively (r=−0.085, p<0.01) and positively (r=0.254, p<0.001) associated with anxiety respectively. Positive and negative coping influenced both hospital workplace violence and anxiety in healthcare workers who were victims of violence. Compared with positive coping, the mediating effect of negative coping was stronger (95% CI −0.177 to –0.006).ConclusionsThe incidence of workplace violence among healthcare workers in county-level hospitals in China is relatively high, and there is a correlation between hospital violence, coping styles and anxiety. Positive and negative coping play a mediating role in the impact of hospital violence on healthcare workers’ anxiety. Therefore, hospital administrators should actively promote healthcare workers’ transition to positive coping strategies and minimise the negative impact of anxiety on them.

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The onset of sleep disturbances and their associations with anxiety after acute high-altitude exposure at 3700 m

Cited by 21 publications

References 28 publications

Sleep, short-term memory, and mood states of volunteers with increasing altitude

Sleep, short-term memory, and mood states of volunteers with increasing altitude

Adult Female Sleep During Hypoxic Bed Rest

Mediating role of coping styles on anxiety in healthcare workers victim of violence: a cross-sectional survey in China hospitals

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