Insufficient Sleep and Vaccine Response

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Sleep and all that happens in the world of sleep have significant effects on our mind, body, and health. However, in the whirlwind of modern existence, we often cut corners on sleep.

In a recent study, researchers studied the profound impact of sleep on the effectiveness of vaccines. Understanding that vaccination is a critical strategy for controlling the pandemic of COVID-19, the researchers looked at how sleep, as a behavioral intervention, can boost vaccine response.

The researchers first screened and selected studies for their meta-analysis. They then found a consistent pattern: insufficient sleep duration of <6h, for 7 days around inoculation is significantly associated with a weakened antibody response to vaccination. Vaccines in the study included hepatitis A, hepatitis B, influenza A H1N1 and H3H2, and the effect size was positive, indicating that short sleep is associated with a lower level of antibodies or reduced protection status. These findings underscore the critical role that sleep plays in the choreography of our immune system.

Furthermore, the researchers explored how variations in sex hormone levels can affect the association. In the study “Acute sleep deprivation has no lasting effects on the human antibody titer response following a novel influenza A H1N1 virus vaccination” by Benedict et al., 2012, the association between short sleep periods and a decrease in antibody response was significantly significant. However, the association between insufficient sleep duration and weakened response to vaccination did not reach significance for women. Moreover, through forest plots of multiple studies, the effect size for men was determined to be 0.93 [0.54, 1.33]. On the other hand, the effect size for women is smaller, at 0.42 [-0.49, 1.32].

While the study calls for further research on the disparity between sex in the impact of sleep on our immune response – large-scale, well-controlled studies are urgently needed to define the window of time around vaccination when optimizing sleep duration is the most beneficial. In addition, the question remains, “how much sleep is enough sleep?”. While the National Sleep Foundation recommends 7 to 9 h of sleep for healthy adults and 7 to 8 h for adults over 65, the exact sleep duration for effective antibody response needs further study.

Overall, the study highlights the importance of adequate sleep for optimal vaccine effectiveness as we face ongoing concerns over Covid and new threats of flu strains. Moreover, sleep profoundly impacts our overall health, and habits must be prioritized for better health outcomes.

 

By: Helena Zhang, BS

Insufficient Sleep and Vaccine Response

The Healing Powers of Art

What Effect Can Physical Activity Have on Your Mental Health?

Journal References:

  1. Spiegel, K., et al. (2023) A meta-analysis of the associations between insufficient sleep duration and antibody response to vaccination. Current Biology. doi.org/10.1016/j.cub.2023.02.017.

The Healing Powers of Art

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What are the healing powers of art? And can art therapy be used to improve mental health?

From the animals dancing on the walls of Paleolithic caves to the Harlem Renaissance, the resonance of art in our world is loud and deeply felt. As we continue to carry histories and emotions, our propensity to turn to art has spanned across the desert of time.

While some believe that art can evoke emotions that go beyond words, others agree that art can captivate the soul, body, and mind. Recently, researchers studied the healing power of art. Through reviewing literature, they explored the effects of art therapy on mental health.[1]

Art therapy, which encompasses theater, dance, music, photography, drawing, painting, and crafts, is currently used in several recovery and treatment procedures. When art therapy became a formalized curriculum in 1940, our dependence on the arts for self-expression, healing, and communication became clear. Researchers found that art can improve mental health, slow cognitive decline, build self-esteem, and enhance one’s quality of life. Moreover, as a powerful, patient-centered tool, art can impart insight, decrease stress, heal trauma, increase memory and neurosensory capacities, and improve interpersonal relationships.

In a randomized control trial (RCT) by Ciasca et al., 60 stable, pharmacologically treated women with Major Depressive Disorder received either art therapy or care as usual. In the art therapy condition, therapists introduced artistic resources such as weaving, collage, clay modelling, drawing, and painting and guided participants in using them. Following the intervention, patients who received art therapy experienced less depression and anxiety symptoms than patients in the control condition. While these observations were consistent with other forms of nonpharmacological treatment, such as psychotherapy, the researchers found that during artistic output, emotions and feelings could be formulated and revaluated. Art as an outlet, allowed for new insights and forms of expression that led to less negative thoughts and feelings of sadness [2]. In another study, patients with Alzheimer’s disease who participated in art interventions experienced improved quality of life and self-actualization.

Currently, art therapy is used as a treatment modality for people with cancer, autism, HIV disease, Alzheimer’s disease, COVID-19, dementia, and Parkinson’s disease. The therapeutic and psychological impact of art is consistent. These findings demonstrate the healing power of art and the value it can bring to the lives of people who are managing medical and mental health disorders.

By: Helena Zhang, BS

Insufficient Sleep and Vaccine Response

The Healing Powers of Art

What Effect Can Physical Activity Have on Your Mental Health?

Journal References:

  1. Shukla A, Choudhari SG, Gaidhane AM, Quazi Syed Z. Role of Art Therapy in the Promotion of Mental Health: A Critical Review. Cureus. 2022 Aug 15;14(8):e28026. doi: 10.7759/cureus.28026. PMID: 36134083; PMCID: PMC9472646.
  2. Ciasca EC, Ferreira RC, Santana CLA, Forlenza OV, Dos Santos GD, Brum PS, Nunes PV. Art therapy as an adjuvant treatment for depression in elderly women: a randomized controlled trial. Braz J Psychiatry. 2018 Jul-Sep;40(3):256-263. doi: 10.1590/1516-4446-2017-2250. Epub 2018 Feb 1. PMID: 29412335; PMCID: PMC6899401.

What Effect Can Physical Activity Have on Your Mental Health?

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How do you cope during times of stress? And what do you turn to when you’re up against difficulties?

In 2022, researchers investigated a possible outlet – physical activity (PA).To study the relationship between physical activity and mental health, the researchers synthesized evidence on the effects of physical activity on symptoms of depression, anxiety, and psychological distress.

Across 97 reviews with over 100000 participants, physical activity was found to have benefits across all clinical populations, with larger benefits for people with depression, HIV and kidney disease, in pregnant and postpartum women, and in healthy individuals. On the other hand, usual care without physical activity, only had medium effects on depression. All forms of physical activity were beneficial, however moderate to high-intensity physical activity was associated with an even greater improvement in symptoms. The study found that different modes of physical activity have different psychological effects. While resistance exercise had the largest effects on depression, yoga and other mind-body exercises were most effective for reducing anxiety.

Moreover, the study highlights the neuromuscular mechanisms through which physical activity improves depression. Physical activity can lead to an increased expression of neurotrophic factors, greater availability of serotonin and norepinephrine, and reduced systemic inflammation. These mechanisms may prevent as well as treat mental health disorders. 

A key strength of this study is the umbrella review it uses to evaluate the effects of all types of PA on depression, anxiety and psychological distress in all adult populations. The study calls for more research and clinical actions. More research is needed to evaluate the different factors that can influence this relationship between physical activity and mental health, such as the exact type, duration, and intensity of physical activity, and the individual characteristics at play, such as age, sex, and socioeconomic status. Do team sports generate different effects than solo training? 

And as for actions, it is critical for healthcare professionals to consider physical activity in treatment plans.  In our world today, one in two people will experience a mental health disorder in their lifetime. While the annual global costs of mental health disorders have been estimated at $2.5 trillion, hundreds of millions of people face the debilitating effects of depression and anxiety in their day-to-day lives. Therefore, lifestyle management approaches, such as exercise, sleep, and diet, need to be incorporated with psychotherapy or pharmacotherapy treatment to achieve best outcomes. 

The study shows that lifestyle changes can alter lives: to improve the mental health outcomes of people around the world, it is time that we turn towards the great benefits of physical activity.

By: Helena Zhang, BS

Insufficient Sleep and Vaccine Response

The Healing Powers of Art

What Effect Can Physical Activity Have on Your Mental Health?

Journal References:

  1. Singh B, Olds T, Curtis R, Dumuid D, Virgara R, Watson A, Szeto K, O’Connor E, Ferguson T, Eglitis E, Miatke A, Simpson CE, Maher C. Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. Br J Sports Med. 2023 Feb 16:bjsports-2022-106195. doi: 10.1136/bjsports-2022-106195. Epub ahead of print. PMID: 36796860.

A Metareview of Lifestyle Psychiatry

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Recent research has elucidated the role of these lifestyle factors – diet, sleep, and exercise, on our minds. Upon finding a link between various mental disorders to these factors, Firth et al., conducted a review and analysis of the top-tier evidence to examine how physical activity, sleep, dietary patterns and tobacco smoking can impact the development and treatment of a variety of different mental disorders.

Broadly, they found evidence that physical activity is helpful for both the prevention and treatment of a variety of mental health disorders and is one of the most extensively researched “lifestyle factors”. They also found that tobacco smoking was a significant risk factor that contributed to people developing mental illness. Poor sleep was also a modifiable risk factor in both the development and worsening of mental health disorders and symptoms, and in the research, a complex two-way relationship between sleep and mental health symptoms is highlighted. More evidence is needed to establish the role of dietary patterns in mental health.

With these findings, the researchers have made recommendations for the integration and delivery of lifestyle interventions in healthcare settings at a broad scale to help people improve their mental health. A few important steps to optimizing mental health and cognitive performance include taking adequate time for exercise, creating an environment conducive to quality sleep, not smoking tobacco, and fueling your mind and body with healthy, whole foods. 

By: Douglas Noordsy, MD and Vanika Chawla, MD

 

Insufficient Sleep and Vaccine Response

The Healing Powers of Art

What Effect Can Physical Activity Have on Your Mental Health?

Journal References:

  1. Reference: Firth J, Solmi M, Wootton RE, et al. A meta-review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry. 2020;19(3):360-380. doi:10.1002/wps.20773

A Strong Sense of Life Purpose is Associated With Better Quality of Life

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Purposeful living is a self-organizing life aim to stimulate goals, promote healthy behaviors and give meaning to life. Many of us are most likely agree that having a sense of purpose in life is associated with overall both physical and mental health quality of life. Needs a scientific proof to this? This article showed a very interesting association of life purpose with all-cause mortality in older adults. The study analyzed a total of 6,985 individuals between 50-60 year. Hazard ratio, 2.43; 95% CI, 1.57-3.75, comparing those in the lowest life purpose category with those in the highest life purpose category. There were also significant association between life purpose and specific cause mortality attributed to heart, circulatory and blood conditions. There are several possible mechanisms through which life purpose might potentially be associated with mortality such decreased expression of proinflammatory genes in purposeful living (studied by Fredrickson et al), lower cortisol and proinflammatory cytokines in purposeful living (studied by Ryff et all), elevated inflammatory markers such as CRP and inflammatory cytokines such as IL-6 in those without low to no purposeful living (studied by Harris et, Reuben et al and De Martinis et al).

By: Rusly Harsono, MD, Head, Lifestyle Medicine Social Engagement

 

Insufficient Sleep and Vaccine Response

The Healing Powers of Art

What Effect Can Physical Activity Have on Your Mental Health?

Journal Reference:

  1. Alimujiang A, Wiensch A, Boss J, Fleischer NL, Mondul AM, McLean K, Mukherjee B, Pearce CL. Association Between Life Purpose and Mortality Among US Adults Older Than 50 Years. JAMA Netw Open. 2019 May 3;2(5):e194270. doi: 10.1001/jamanetworkopen.2019.4270. PMID: 31125099; PMCID: PMC6632139.

Dysfunctional Breathing Patterns Have Been Associated With Several Musculoskeletal Conditions

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Have you ever thought twice about the way you breath?

Properly diaphragmatic breathing results from using our primary respiratory muscles (the diaphragm and external intercostals), causing expansion of the abdomen. However, many rely on accessory respiratory muscles in the upper chest and shoulders rather than the diaphragm – which result in dysfunctional breathing patterns. Dysfunctional breathing patterns have been associated with musculoskeletal conditions such as low back pain, chronic neck pain, and chronic ankle instability. And on the contrary, diaphragmatic breathing patterns correlate with improved postural and core stability, reduction musculoskeletal injuries and in physiological stress.

The prevalence of dysfunctional breathing has been reported as between 29 and 74% in asthmatics, and 62-73% in physically active, healthy adults. In athletes, the prevalence of dysfunctional breathing patterns is not known, nor is it known whether dysfunctional breathing in athletes confers a greater injury risk.

A study was performed in a Japanese population on a wide variety of athletes in competitive sports ranging from elementary school athletes to professional athletes (maximum age 25). It demonstrates that the prevalence of dysfunctional breathing was extremely high (90.6%) in athletes.  The authors hypothesized that the higher proportion of dysfunctional breathing in athletes may be due to greater physiological and psychological stress due to the demands of competitive sport, but this remains to be further studied. There are a few drawbacks of this study. Of note, these athletes were only assessed in the standing position, which may increase the proportion of dysfunctional breathers due to the increased respiratory demand (as compared to supine and sitting). Prior studies have suggested assessing breathing in multiple positions. Also of note, this study does NOT determine the clinical significance of dysfunctional breathing patterns – i.e. we do not know if these breathing patterns actually confer a greater risk of injury.

However, this is an interesting study that draws attention to an area where further research is needed – and is one which reminds us to think again about the way we breath:

  1. Place one hand on your chest and one on your abdomen
  2. Inhale slowly through your nose and focus on expanding your abdomen rather than your chest
  3. Exhale slowly

By: Sarah DeParis, MD and Helena Zhang, BS

 

Insufficient Sleep and Vaccine Response

The Healing Powers of Art

What Effect Can Physical Activity Have on Your Mental Health?

Journal Reference:

  1. Shimozawa, Yuka1; Kurihara, Toshiyuki2; Kusagawa, Yuki3; Hori, Miyuki3; Numasawa, Shun4; Sugiyama, Takashi1; Tanaka, Takahiro3; Suga, Tadashi2; Terada, Ryoko S.5; Isaka, Tadao1; Terada, Masafumi1. Point Prevalence of the Biomechanical Dimension of Dysfunctional Breathing Patterns Among Competitive Athletes. Journal of Strength and Conditioning Research: May 24, 2022 10.1519/JSC.0000000000004253 doi: 10.1519/JSC.0000000000004253

 

A Mindfulness Program May Be Just as Effective as Medication at Reducing Anxiety

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A recent study called Treatments for Anxiety: Meditation and Escitalopram (TAME) compared an 8-week standardized evidence-based mindfulness-based intervention (mindfulness-based stress reduction, MBSR) with medication for the treatment of anxiety disorders. The study included over 200 adults with a diagnosed anxiety disorder that were assigned to either 8 weeks of the weekly MBSR course or taking a medication for anxiety called escitalopram. The MBSR course involved weekly 2.5 hour classes, 45-minuter daily home exercises, and a day-long weekend retreat during the fourth or sixth week. The classes and home exercises involved mindfulness meditation, body scans (directing attention to one part of the body at a time to increase inward awareness), and mindful movements such as stretching.  At the end of the 8 weeks, the results showed that the mindfulness program was just as effective at reducing anxiety as medication. 

By: Vanika Chawla, MD

 

Insufficient Sleep and Vaccine Response

The Healing Powers of Art

What Effect Can Physical Activity Have on Your Mental Health?

Journal Reference:

  1. Hoge EA, Bui E, Mete M, Dutton MA, Baker AW, Simon NM. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial. JAMA Psychiatry. 2023;80(1):13–21. doi:10.1001/jamapsychiatry.2022.3679
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Study Suggests the Benefits of Prebiotic Supplements Were Dependent on Dietary Fiber Intake

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This small proof-of-concept study found something for further exploration: the high dietary fiber vs low dietary fiber interaction with different prebiotic supplements. The  study found that the supplements only affected those who weren’t taking in dietary fiber, thus taking prebiotic supplements may be ineffective if you already consume the recommended amounts of dietary fiber. The study included a very wide age range so the findings shouldn’t be printed on t-short quite yet, however it brings to light an interesting interaction. Ironically it’s often the people who already have a healthy diet that lean towards supplement intake even though they don’t need it!

By: Marily Oppezzo, PhD, MS, Head of Lifestyle Medicine Nutrition Pillar

 

Insufficient Sleep and Vaccine Response

The Healing Powers of Art

What Effect Can Physical Activity Have on Your Mental Health?

Journal Reference:

  1. Holmes ZC, Villa MM, Durand HK, Jiang S, Dallow EP, Petrone BL, Silverman JD, Lin PH, David LA. Microbiota responses to different prebiotics are conserved within individuals and associated with habitual fiber intake. Microbiome. 2022 Jul 29;10(1):114. doi: 10.1186/s40168-022-01307-x. PMID: 35902900; PMCID: PMC9336045.

 

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Lifestyle May Be More Important Than Age in Determining Risk of Cognitive Decline

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A great part of who were are is composed of the memories we have. With a growing interest in preventing the loss of memories, researchers have turned to preventative approaches – to address lack of disease-modifying treatment for dementia. 

A recent study found that lifestyle may be more important than age in determining risk of dementia and cognitive health. The study included data from over 22,000 participants between the ages of 18 – 89  and found that, for all ages, lifestyle is a more important risk factor for cognitive decline than age.The risk factors that were examined range from early life factors to late-life factors. They include low education, traumatic brain injury, hypertension, smoking, diabetes, and depression. 

In the study, participants with no risk factors for dementia had similar brain health to people 10-20 years younger than them! Additionally, the study found that each risk factor for dementia reduced cognitive abilities by the equivalent of 3 years of aging, and each additional risk factor added to this decline. 

For the risk factors that are modifiable with nutrition, exercise, and stress management, this study suggests it is never too early to start caring for your brain health. Maintaining healthy lifestyle habits can prevent the loss of memory and shape the life you live.

By: Helena Zhang, BS & Maya Shetty, BS

Journal Reference:

  1. LaPlume AA, McKetton L, Levine B, Troyer AK, Anderson ND. The adverse effect of modifiable dementia risk factors on cognition amplifies across the adult lifespan. Alzheimers Dement (Amst). 2022 Jul 13;14(1):e12337. doi: 10.1002/dad2.12337. PMID: 35845262; PMCID: PMC9277708.