Decrease in Social Zeitgebers Is Associated With Worsened Delayed Sleep-Wake Phase Disorder: Findings During the Pandemic in Japan
BackgroundDelay in sleep-wake rhythms was observed in the general population during the coronavirus disease 2019 (COVID-19) pandemic. Patients with delayed sleep-wake phase disorder (DSWPD) may have also experienced exacerbation of symptoms, but no studies have investigated this topic. In this study...
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.898600/full |
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| author | Rei Otsuki Rei Otsuki Rei Otsuki Kentaro Matsui Kentaro Matsui Takuya Yoshiike Kentaro Nagao Kentaro Nagao Tomohiro Utsumi Tomohiro Utsumi Ayumi Tsuru Ayumi Tsuru Naoko Ayabe Naoko Ayabe Megumi Hazumi Megumi Hazumi Michio Fukumizu Michio Fukumizu Kenichi Kuriyama |
| author_facet | Rei Otsuki Rei Otsuki Rei Otsuki Kentaro Matsui Kentaro Matsui Takuya Yoshiike Kentaro Nagao Kentaro Nagao Tomohiro Utsumi Tomohiro Utsumi Ayumi Tsuru Ayumi Tsuru Naoko Ayabe Naoko Ayabe Megumi Hazumi Megumi Hazumi Michio Fukumizu Michio Fukumizu Kenichi Kuriyama |
| author_sort | Rei Otsuki |
| collection | DOAJ |
| description | BackgroundDelay in sleep-wake rhythms was observed in the general population during the coronavirus disease 2019 (COVID-19) pandemic. Patients with delayed sleep-wake phase disorder (DSWPD) may have also experienced exacerbation of symptoms, but no studies have investigated this topic. In this study, we aimed to retrospectively examine the changes in symptoms of outpatients with DSWPD both before and during the pandemic and to identify the factors associated with the exacerbation of sleep-wake rhythms.MethodsWe included outpatients with DSWPD aged 16 years or older who visited the outpatient clinic due to sleep disorders between January and September 2020. Decreased social zeitgebers was defined as a reduction of 50% or more in the frequency of commuting to school or work during the COVID-19 pandemic. The severity of DSWPD was assessed using the clinical global impressions - severity of illness (CGI-S) at two points: before and during the pandemic. We defined the worsened, unchanged, and improved groups as those whose CGI-S scores worsened by at least one point, remained unchanged, and improved by at least one point, respectively. Multivariate logistic regression analysis was performed to determine the factors associated with worsened DSWPD symptoms.ResultsSixty patients with DSWPD were eligible for this study. Even before the pandemic, patients who were unemployed or did not attend school tended to show more severe DSWPD symptoms. During the pandemic, 27 patients belonged to the worsened group; 28 patients, unchanged group; and 5 patients, improved group. Decreased social zeitgebers (odds ratio [OR] = 6.668, 95% confidence interval [CI]: 1.653–26.891, p < 0.05) and comorbid mood disorders (OR = 8.876, 95% CI: 1.714–45.974, p < 0.05) showed independent significant associations with the worsening of DSWPD symptoms.ConclusionsDuring the pandemic, the symptoms of DSWPD tended to worsen. The obtained findings emphasize the importance of social zeitgebers, suggesting the need for external motivation in DSWPD treatment. |
| first_indexed | 2024-03-13T01:26:28Z |
| format | Article |
| id | doaj.art-a6b43bd204d14fdfb625527c98352331 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-13T01:26:28Z |
| publishDate | 2022-06-01 |
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| series | Frontiers in Psychiatry |
| spelling | doaj.art-a6b43bd204d14fdfb625527c983523312023-07-04T14:31:25ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-06-011310.3389/fpsyt.2022.898600898600Decrease in Social Zeitgebers Is Associated With Worsened Delayed Sleep-Wake Phase Disorder: Findings During the Pandemic in JapanRei Otsuki0Rei Otsuki1Rei Otsuki2Kentaro Matsui3Kentaro Matsui4Takuya Yoshiike5Kentaro Nagao6Kentaro Nagao7Tomohiro Utsumi8Tomohiro Utsumi9Ayumi Tsuru10Ayumi Tsuru11Naoko Ayabe12Naoko Ayabe13Megumi Hazumi14Megumi Hazumi15Michio Fukumizu16Michio Fukumizu17Kenichi Kuriyama18Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, JapanDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, JapanDepartment of Psychiatry, Nihon University School of Medicine, Tokyo, JapanDepartment of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, JapanDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, JapanDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, JapanDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, JapanDepartment of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, JapanDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, JapanDepartment of Psychiatry, The Jikei University School of Medicine, Tokyo, JapanDepartment of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, JapanDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, JapanDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, JapanDepartment of Regional Studies and Humanities, Faculty of Education and Human Studies, Akita University, Akita, JapanDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, JapanDepartment of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, JapanDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, JapanSegawa Memorial Neurological Clinic for Children, Tokyo, JapanDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, JapanBackgroundDelay in sleep-wake rhythms was observed in the general population during the coronavirus disease 2019 (COVID-19) pandemic. Patients with delayed sleep-wake phase disorder (DSWPD) may have also experienced exacerbation of symptoms, but no studies have investigated this topic. In this study, we aimed to retrospectively examine the changes in symptoms of outpatients with DSWPD both before and during the pandemic and to identify the factors associated with the exacerbation of sleep-wake rhythms.MethodsWe included outpatients with DSWPD aged 16 years or older who visited the outpatient clinic due to sleep disorders between January and September 2020. Decreased social zeitgebers was defined as a reduction of 50% or more in the frequency of commuting to school or work during the COVID-19 pandemic. The severity of DSWPD was assessed using the clinical global impressions - severity of illness (CGI-S) at two points: before and during the pandemic. We defined the worsened, unchanged, and improved groups as those whose CGI-S scores worsened by at least one point, remained unchanged, and improved by at least one point, respectively. Multivariate logistic regression analysis was performed to determine the factors associated with worsened DSWPD symptoms.ResultsSixty patients with DSWPD were eligible for this study. Even before the pandemic, patients who were unemployed or did not attend school tended to show more severe DSWPD symptoms. During the pandemic, 27 patients belonged to the worsened group; 28 patients, unchanged group; and 5 patients, improved group. Decreased social zeitgebers (odds ratio [OR] = 6.668, 95% confidence interval [CI]: 1.653–26.891, p < 0.05) and comorbid mood disorders (OR = 8.876, 95% CI: 1.714–45.974, p < 0.05) showed independent significant associations with the worsening of DSWPD symptoms.ConclusionsDuring the pandemic, the symptoms of DSWPD tended to worsen. The obtained findings emphasize the importance of social zeitgebers, suggesting the need for external motivation in DSWPD treatment.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.898600/fulldelayed sleep-wake phase disordercoronavirus disease 2019COVID-19state of emergencyJapansocial zeitgeber |
| spellingShingle | Rei Otsuki Rei Otsuki Rei Otsuki Kentaro Matsui Kentaro Matsui Takuya Yoshiike Kentaro Nagao Kentaro Nagao Tomohiro Utsumi Tomohiro Utsumi Ayumi Tsuru Ayumi Tsuru Naoko Ayabe Naoko Ayabe Megumi Hazumi Megumi Hazumi Michio Fukumizu Michio Fukumizu Kenichi Kuriyama Decrease in Social Zeitgebers Is Associated With Worsened Delayed Sleep-Wake Phase Disorder: Findings During the Pandemic in Japan Frontiers in Psychiatry delayed sleep-wake phase disorder coronavirus disease 2019 COVID-19 state of emergency Japan social zeitgeber |
| title | Decrease in Social Zeitgebers Is Associated With Worsened Delayed Sleep-Wake Phase Disorder: Findings During the Pandemic in Japan |
| title_full | Decrease in Social Zeitgebers Is Associated With Worsened Delayed Sleep-Wake Phase Disorder: Findings During the Pandemic in Japan |
| title_fullStr | Decrease in Social Zeitgebers Is Associated With Worsened Delayed Sleep-Wake Phase Disorder: Findings During the Pandemic in Japan |
| title_full_unstemmed | Decrease in Social Zeitgebers Is Associated With Worsened Delayed Sleep-Wake Phase Disorder: Findings During the Pandemic in Japan |
| title_short | Decrease in Social Zeitgebers Is Associated With Worsened Delayed Sleep-Wake Phase Disorder: Findings During the Pandemic in Japan |
| title_sort | decrease in social zeitgebers is associated with worsened delayed sleep wake phase disorder findings during the pandemic in japan |
| topic | delayed sleep-wake phase disorder coronavirus disease 2019 COVID-19 state of emergency Japan social zeitgeber |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.898600/full |
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