Papers by Girardin Jean-Louis
Sleep, 2018
phosphorylated tau) in AD patients than in the other three groups. Tau values were also higher in... more phosphorylated tau) in AD patients than in the other three groups. Tau values were also higher in those with FTD compared to those with DLB. Mean hypocretin level was 249.7 pg/mL (+/-56.3), without difference by diagnosis (F=0.36, p=0.79). Hypocretin was normal in 70 subjects (80.4%), low (<110 pg/mL) in a single patient with AD and intermediate (110-200 pg/mL) in 16 patients (3 with AD, 5 with DLB, 3 with FTD, and 5 controls). Hypocretin levels were significantly lower in those reporting intense, vivid dreams occurring at least sometimes (209.1 +/-28.3 vs 239.5 +/-47.8, p=0.01) and in those reporting nightmares at least sometimes (203.9 +/-29.8 vs 240.4 +/-46.1, p=0.05). Hypocretin and tau levels were correlated in men (r=0.34, p=0.2) but not in women (r=0.7, p=0.66). Conclusion: CSF hypocretin level is a biomarker for frequent dreams and nightmares in patients with dementing syndromes and elderly controls. This novel finding is consistent with hypocretin's role in REMstate control. Support (If Any): K23 NS083748 (LMT).
Sleep Medicine and Disorders: International Journal, 2018
Sleep plays a pivotal role in both physical and mental health. Sleep quality can be affected by m... more Sleep plays a pivotal role in both physical and mental health. Sleep quality can be affected by many socio demographic factors, such as race and/or ethnicity, as well as socio economic status (SES). Chronic sleep deprivation is associated with unhealthy behaviors such as alcohol abuse and also places individuals at risk for chronic diseases including obesity, cardiovasculardisease (CVD), depression, and/or anxiety. This review explores the common socio demographic factors and SES that can lead to sleep disturbances. Among these factors are shift work, poor dietary habits, smoking and alcohol abuse. Such factors need to be considered by health care providers in the clinical assessment and management plans of patients with sleep disorders.
Sleep, Apr 1, 2018
The new AHA/ACC guidelines define high blood pressure requiring lifestyle changes and treatment a... more The new AHA/ACC guidelines define high blood pressure requiring lifestyle changes and treatment at 130/80 mmHg, rather than 140/90 mmHg, allowing for earlier detection, prevention, and management of high blood pressure. This might enable better cardiovascular outcomes. Sleep and sleep duration, has been associated with cardiovascular outcomes. However, there is no literature that examines the relationship between sleep measures and the new high blood pressure guidelines. Methods: The National Health and Nutrition Examination Survey (NHANES) is a collection of cross-sectional surveys based on nationally representative samples of the US civilian non-institutionalized population, utilizing a stratified, multistage sampling design to recruit participants from households. Utilizing data from NHANES, high blood pressure was defined as systolic blood pressure >130 mmHg and diastolic blood pressure >80 mmHg as per the new guidelines. Self-reported sleep duration was determined from household interview questions with about sleep duration, less than usual sleep duration or more than usual amount of sleep. Statistical hypotheses were tested using chi-square tests and logistic regressions to estimate the likelihood of high blood pressure among adults with varying sleep groupings. Results: When high blood pressure is redefined by the new guidelines, there are varying differences in the percentage of individuals reporting less than usual amount of sleep in each category of increased blood pressure. Among individuals classified as having elevated blood pressure by the new guidelines, 63.4% of individuals reported having less than usual amount of sleep versus 62.2% based on the old guidelines. Among individuals classified as having Stage 1 hypertension by the new guidelines, 59.5% reported less than usual sleep versus 65.3% based on the old guidelines. For those classified as having Stage 2 hypertension based on the new guidelines, 64.5% of individuals reported less than usual sleep versus 60% based on the old guidelines. The new high blood pressure classifications allowed for significant differences in percentage of individuals reporting less than usual sleep by comparison with the old hypertension guidelines. Support (If Any): Grant K07AG052685.
Sleep, 2020
Introduction Daytime sleepiness impairs daily functioning and may be directly related to insuffic... more Introduction Daytime sleepiness impairs daily functioning and may be directly related to insufficient nighttime sleep. Previous studies have assessed disparities in sleep duration and quality, but community-level disparities in daytime sleepiness using validated measures are lacking. Methods Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study of N=1007 adults age 22-60. Daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). Predictors included age, sex, race/ethnicity, education, and social class (“Upper middle class or above,” “Middle class,” “Lower middle class,” “Poor,” or “Very Poor”). One-way ANOVAs evaluated group differences. Stepwise linear modeling evaluated ESS score relative to sociodemographic predictors. Final models included all variables entered together to evaluate independent effects. Finally, habitual sleep duration was entered as an additional covariate. Results ESS score was higher among racial/ethn...
Sleep, 2019
Sleep is related to socioeconomics and can impact health. This study evaluated whether foregoing ... more Sleep is related to socioeconomics and can impact health. This study evaluated whether foregoing medical care due to cost impacts sleep and plays a role in sleep disparities and the sleep-obesity relationship. Methods: Data were obtained from the 2017 Behavioral Risk Factor Surveillance System (N=39,267 from 7 states provided complete data on all variables). Sleep duration was assessed as hours/day. Participants were asked, "Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?" They were also asked for information about age, sex, race/ethnicity, education, income, employment, overall health, and access to health insurance. They were also asked for height/weight, which was used to compute body mass index (BMI). Results: Access to health insurance was not associated with habitual sleep duration. However, foregoing medical care was associated with less sleep on average (B=-0.26,95%CI[-0.35,-0.17],p<0.0005). There was an interaction with race/ethnicity, such that compared to non-Hispanic Whites, the effect was 115% larger among Blacks/African-Americans, 13% larger in Hispanics/Latinos, 101% larger and in the opposite direction for Asians, and non-significant for Multiracial. Race/ethnicity relationships to sleep duration were stratified by foregoing care. Among those who did not (90%), typical relationships were seen, with both high and low sleep duration being more likely among Blacks/African-Americans and other minority groups. Among those who did forego care (10%), these effects were dramatically reduced. Further, when sleep duration was evaluated as a predictor of obesity, this relationship was only seen among those who did not forego care. Foregoing medical care due to cost is an independent risk factor for insufficient sleep, irrespective of income, employment, and access to insurance. It disproportionately affects Blacks/African-Americans and may represent part of the reason why these disparities exist even after adjustment for most socioeconomic indices. Further, foregoing medical care may present such health risks that this subsumes the relationship between sleep and obesity.
Sleep, 2017
Supplement, 2017 B. Clinical Sleep Science VI. Normal Sleep, Sleep and Aging, Sleep and Gender hy... more Supplement, 2017 B. Clinical Sleep Science VI. Normal Sleep, Sleep and Aging, Sleep and Gender hypoxemia and PLMI the association between sleep efficiency and Digit Span Test Forwards remained significant (p=0.005), but was only borderline significant for the Digit Symbol score (p=0.06). There was no significant interaction between the presence of the APOE-ε4 allele and these associations. Reduced sleep efficiency is associated with poorer performance in processing speed, attention and short-term memory, and associations are evident even after considering sleep duration, overnight hypoxemia and periodic limb movements. These associations were not modified by APOE-ε4.
Journal of disease and global health
Increased legalization of marijuana has resulted in renewed interest in its effects on body weigh... more Increased legalization of marijuana has resulted in renewed interest in its effects on body weight and cardiometabolic risk. Conflicting data exist regarding marijuana effects on body weight, waist circumference as well as lipid profiles, blood pressure and cardiovascular disease. Furthermore, there is a dearth of data available on this effect in the black population. To assess the metabolic profile and cardiovascular risk factors as well as body weight and waist circumference among urban black marijuana users. A cross sectional study design involving 100 patients seen in a Family Practice clinic at University hospital of Brooklyn, NY, USA, over a period of 3 months from January 2014 to March 2014. Participants were administered a questionnaire regarding marijuana use, and other associated behaviors. Socio-demographic, laboratory, and clinical data were collected. We report measures of central tendencies, and dispersion for continuous variables and the frequency of distribution for ...
BMC Public Health, 2015
Background: The National Health Interview Survey (NHIS) was used to ascertain whether increases i... more Background: The National Health Interview Survey (NHIS) was used to ascertain whether increases in inadequate sleep differentially affected black and white Americans. We tested the hypothesis that prevalence estimates of inadequate sleep were consistently greater among blacks, and that temporal changes have affected these two strata differentially. Methods: NHIS is an ongoing cross-sectional study of non-institutionalized US adults (≥18 years) providing sociodemographic, health risk, and medical factors. Sleep duration was coded as very short sleep [VSS] (<5 h), short sleep [SS] (5-6 h), or long sleep [LS] (>8 h), referenced to 7-8 h sleepers. Analyses adjusted for NHIS' complex sampling design using SAS-callable SUDAAN. Results: Among whites, the prevalence of VSS increased by 53 % (1.5 % to 2.3 %) from 1977 to 2009 and the prevalence of SS increased by 32 % (19.3 % to 25.4 %); prevalence of LS decreased by 30 % (11.2 % to 7.8 %). Among blacks, the prevalence of VSS increased by 21 % (3.3 % to 4.0 %) and the prevalence of SS increased by 37 % (24.6 % to 33.7 %); prevalence of LS decreased by 42 % (16.1 % to 9.4 %). Adjusted multinomial regression analysis showed that odds of reporting inadequate sleep for whites were: VSS (OR = 1.40, 95 % CI = 1.13-1.74, p < 0.001), SS (OR = 1.34, 95 % CI = 1.25-1.44, p < 0.001), and LS (OR = 0.94, 95 % CI = 0.85-1.05, NS). For blacks, estimates were: VSS (OR = 0.83, 95 % CI = 0.60-1.40, NS), SS (OR = 1.21, 95 % CI = 1.05-1.50, p < 0.001), and LS (OR = 0.84, 95 % CI = 0.64-1.08, NS). Conclusions: Blacks and whites are characteristically different regarding the prevalence of inadequate sleep over the years. Temporal changes in estimates of inadequate sleep seem dependent upon individuals' race/ethnicity.
Sleep Medicine, 2016
Estimates suggest that by 2040 approximately half of the US population will consist of individual... more Estimates suggest that by 2040 approximately half of the US population will consist of individuals who self-identify as minority. Yet, there has not been a concerted effort to address important racial/ethnic disparities in various diseases and health conditions, as articulated in the Institute of Medicine's landmark report "Unequal Treatment" . According to the 1985 report from the US Secretary's Task Force on Black and Minority Health, several health equity objectives remain to be achieved. According to the report, despite the unprecedented explosion of scientific knowledge and the phenomenal capacity of medicine to diagnose, treat, and cure diseases, individuals of minority backgrounds (Blacks, Hispanics/Latinos, Native Americans, and Asians/Pacific Islanders) have not yet benefited fully or equitably from systems responsible for translating and using health sciences technology.
Nutrition Reviews, 2014
The popularity of energy drinks has increased rapidly in the past decade. One of the main reasons... more The popularity of energy drinks has increased rapidly in the past decade. One of the main reasons people use energy drinks is to counteract effects of insufficient sleep or sleepiness. Risks associated with energy drink use, including those related to sleep loss, may be disproportionately borne by racial minorities and those of lower socioeconomic status. In this review, a brief introduction to the issue of health disparities is provided, population-level disparities and inequalities in sleep are described, and the social-ecological model of sleep and health is presented. Social and demographic patterns of energy drink use are then presented, followed by discussion of the potential ways in which energy drink use may contribute to health disparities, including the following: 1) effects of excessive caffeine in energy drinks, 2) effects of energy drinks as sugar-sweetened beverages, 3) association between energy drinks and risk-taking behaviors when mixed with alcohol, 4) association between energy drink use and short sleep duration, and 5) role of energy drinks in cardiometabolic disease. The review concludes with a research agenda of critical unanswered questions.
Current Diabetes Reports, 2010
Current Diabetes Reports, 2010
The rampant diabetes pandemic over the last few decades has been associated with an increased ris... more The rampant diabetes pandemic over the last few decades has been associated with an increased rise in cardiovascular events and deaths. Risk factors such as obesity, family history of diabetes, decreased physical activity, and aging are among the most common in the development of diabetes. Emerging evidence in the last 10 years has suggested that sleep apnea is a novel risk factor in the development of diabetes. Associations between diabetes and sleep apnea are supported by both epidemiologic and clinical sleep apnea studies. In this report, we discuss epidemiologic and clinical evidence suggesting that sleep apnea is involved in the pathogenesis of altered glucose metabolism. In light of current evidence, sleep apnea treatment should be incorporated into existing pharmacotherapeutic regimens for optimal management of diabetes among diabetic patients with sleep apnea in order to reduce associated cardiovascular risk. Suggestions to improve practice guidelines in the management of diabetic patients with sleep apnea are provided.
Sleep Medicine, 2009
Background-Measures of attachment style are often used to appraise social and emotional health. I... more Background-Measures of attachment style are often used to appraise social and emotional health. In developmental literature, the concept of attachment is used to explain relationships between children and their adult caregivers. While both attachment styles and sleep patterns are conceived as developmentally organized systems, very few studies have explored the link between the two. The present study examined whether attachment styles and sleep measures are associated among older adults. Methods-Relationships between attachment styles (i.e., secure, fearful, preoccupied, and dismissive) and subjective sleep measures were assessed utilizing data from 70 older participants (mean age: 68 ± 6 years; Blacks: 59% and Whites: 41%) in a community-based study assessing subjective health characteristics. After obtaining informed consent, each participant provided demographic and socioeconomic data, as well as relevant medical and subjective data. Results-Independent of participants' demographic and subjective factors, significant correlations were found between the preoccupied attachment dimension and sleep measures. Specifically, individuals scoring high on the preoccupied attachment dimension were more likely to report daytime napping (r p = 0.31, p < 0.01) and to use sleep-inducing medications (r p = 0.37, p < 0.05). No significant correlations were found among sleep measures and the secure, dismissive, and fearful dimensions. Conclusions-Important relations have been observed between specific attachment styles and subjective sleep factors in our data. Although only one dimension (preoccupied) demonstrated statistical significance, a trend was observed, suggesting possible associations between the secure attachment style dimension and subjective sleep measures. Future studies are needed to broaden our understanding of the relationship between attachment styles and sleep patterns.
Journal of Circadian Rhythms, 2008
The absence of circadian zeitgebers in the social environment causes circadian misalignment, whic... more The absence of circadian zeitgebers in the social environment causes circadian misalignment, which is often associated with sleep disturbances. Circadian misalignment, defined as a mismatch between the sleep-wake cycle and the timing of the circadian system, can occur either because of inadequate exposure to the light-dark cycle, the most important synchronizer of the circadian system, or reduction in light transmission resulting from ophthalmic diseases (e.g., senile miosis, cataract, diabetic retinopathy, macular degeneration, retinitis pigmentosa, and glaucoma). We propose that glaucoma may be the primary ocular disease that directly compromises photic input to the circadian time-keeping system because of inherent ganglion cell death. Glaucomatous damage to the ganglion cell layer might be particularly harmful to melanopsin. According to histologic and circadian data, a subset of intrinsically photoresponsive retinal ganglion cells, expressing melanopsin and cryptochromes, entrain the endogenous circadian system via transduction of photic input to the thalamus, projecting either to the suprachiasmatic nucleus or the lateral geniculate nucleus. Glaucoma provides a unique opportunity to explore whether in fact light transmission to the circadian system is compromised as a result of ganglion cell loss.
Expert Review of Cardiovascular Therapy, 2010
The American Journal of Medicine, 2012
Background-Effect of race/ethnicity on the risk of diabetes associated with sleep duration has no... more Background-Effect of race/ethnicity on the risk of diabetes associated with sleep duration has not been systematically investigated. This study assessed whether blacks reporting short (≤ 5 hours) or long (≥ 9 hours) sleep durations were at greater risk for diabetes than their white counterparts. In addition, this study also examined whether the influence of race/ethnicity on associations between abnormal sleep durations and the presence of diabetes were independent of individuals' sociodemographic and medical characteristics. Methods-A total of 29,818 Americans (age range: 18-85 years) enrolled in the 2005 National Health Interview Survey (NHIS), cross-sectional household interview survey, provided complete data for this analysis. Results-Of the sample, 85% self-ascribed their ethnicity as white and 15% as black. The average age was 47.4; 56% were female. Results of univariate regression analysis adjusted for medical comorbidities showed that black and white participants who reported short sleep duration (≤ 5 hours) were more likely to have diabetes than individuals who reported sleeping 6 to 8 hours [OR = 1.66; OR = 1.87, respectively]. Similarly, black and white participants reporting long sleep duration (≥ 9 hours) had a greater likelihood to report diabetes compared with those with sleeping 6 to 8 hours [OR = 1.68; OR = 2.33, respectively]. Significant interactions of short and long sleep with black and white race were observed. Compared with white participants, greater diabetes risk was associated with being black short or long sleepers. The present findings suggest that American the black short and long sleepers may be at greater risk for diabetes, independently of their sociodemographic profile or the presence of
SLEEP
Introduction Short sleep (< 7 hours of sleep/24 hr. period) duration is associated with unheal... more Introduction Short sleep (< 7 hours of sleep/24 hr. period) duration is associated with unhealthy cholesterol levels, a significant cardiovascular risk marker. Precious epidemiological studies indicate that Hispanics are at increased risk for hypercholesteremia. However, little is known about whether sleep duration contributes to high cholesterol levels, among Hispanics. We sought to investigate the following: 1) Examine whether sleep duration predicts cholesterol levels; 2) Examine whether this relationship differs in Hispanics in comparison to non-Hispanics. Methods This study was based on the 2020 National Health Interview Survey. Cholesterol, the outcome, is defined as whether an individual had high cholesterol during the last 12 months. Sleep quantity was categorized as follows: short sleep (< 7 hours), healthy sleep (7-8 hours), and long sleep (≥9 hours). For stratified analyses, we investigated whether the relationship between sleep duration and cholesterol differed bet...
Sleep, 2020
Introduction Previous studies have shown that, in the laboratory, sleep deprivation leads to unhe... more Introduction Previous studies have shown that, in the laboratory, sleep deprivation leads to unhealthy eating patterns. In real-world samples, lack of sleep is associated with obesity. Few real-world studies of sleep and food intake patterns exist, especially from nationally-representative samples. Methods Data from the 2015–2016 National Health and Nutrition Examination Survey (NHANES) were used. NHANES is a national-representative survey collected by the CDC. N=6,291 participants provided data about dietary behaviors and sleep timing. Dietary behaviors included the number of meals not made at home in the past 7 days (NOTHOME), number of fast food/pizza meals in the past 7 days (FASTFOOD), number of pre-made meals in the past 30 days (PREMADE), and number of frozen meals in the past 30 days (FROZEN). Linear regression models examined these as outcomes and predictors including bedtime (minutes), waketime (minutes), sleep duration (hours), and daytime tiredness/fatigue (never, rarely...
Sleep, 2020
Introduction In Israel, those with Arabic as compared to Jewish ethnicity, exhibit poorer health ... more Introduction In Israel, those with Arabic as compared to Jewish ethnicity, exhibit poorer health and motor vehicle safety behaviors. Their ethnic differences in sleep duration and quality may modulate their vulnerabilities to these behaviors. Methods 7,230 Israeli individuals (N=5,880 Jewish and N=1350 Arabic) responded to the 2017 Israeli Bureau of Statistics population-based survey of households. Variables were self-reported. Outcomes included sleepiness, sleep medications, functional impairment, drowsy driving, overall health, 1-year health change, and obesity. Predictors included categorical sleep duration (<=5, 6, 7, 8 [reference], or >=9 hours) and sleep disturbance in the past month (none [reference], mild [1/week], moderate [2-3/week], or severe [>3/week]). Covariates included age, sex, and financial status. Ethnicity (Jewish/Arabic) was treated as a predictor of sleep and behavioral outcomes. Results When compared to normal (8-hour) sleepers, Jewish as compared to ...
Journal of Medical Internet Research, 2020
Background Population estimates of sleep duration and quality are inconsistent because they rely ... more Background Population estimates of sleep duration and quality are inconsistent because they rely primarily on self-reported data. Passive and ubiquitous digital tracking and wearable devices may provide more accurate estimates of sleep duration and quality. Objective This study aimed to identify trends in sleep duration and quality in New York City based on 2 million nights of data from users of a popular mobile sleep app. Methods We examined sleep duration and quality using 2,161,067 nights of data captured from 2015 to 2018 by Sleep Cycle, a popular sleep-tracking app. In this analysis, we explored differences in sleep parameters based on demographic factors, including age and sex. We used graphical matrix representations of data (heat maps) and geospatial analyses to compare sleep duration (in hours) and sleep quality (based on time in bed, deep sleep time, sleep consistency, and number of times fully awake), considering potential effects of day of the week and seasonality. Resul...
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Papers by Girardin Jean-Louis