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4. The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study

Author

Barclay, Nicola L., primary, Pineda Moncusí, Marta, additional, Jödicke, Annika M., additional, Prieto-Alhambra, Daniel, additional, Raventós, Berta, additional, Newby, Danielle, additional, Delmestri, Antonella, additional, Man, Wai Yi, additional, Chen, Xihang, additional, and Català, Marti, additional

Published
2024
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6. Collateral effects of the COVID-19 pandemic on endocrine treatments for breast and prostate cancer in the UK: a cohort study.

Author

Barclay, Nicola L., Català, Marti, Jödicke, Annika M., Prieto-Alhambra, Daniel, Newby, Danielle, Delmestri, Antonella, Man, Wai Yi, Serrano, Àlvar Roselló, and Moncusí, Marta Pineda

Abstract

Background: The COVID-19 pandemic affected cancer screening, diagnosis and treatments. Many surgeries were substituted with bridging therapies during the initial lockdown, yet consideration of treatment side effects and their management was not a priority. Objectives: To examine how the changing social restrictions imposed by the pandemic affected incidence and trends of endocrine treatment prescriptions in newly diagnosed (incident) breast and prostate cancer patients and, secondarily, endocrine treatment-related outcomes (including bisphosphonate prescriptions, osteopenia and osteoporosis), in UK clinical practice from March 2020 to June 2022. Design: Population-based cohort study using UK primary care Clinical Practice Research Datalink GOLD database. Methods: There were 13,701 newly diagnosed breast cancer patients and 12,221 prostate cancer patients with ⩾1-year data availability since diagnosis between January 2017 and June 2022. Incidence rates (IR) and incidence rate ratios (IRR) were calculated across multiple time periods before and after lockdown to examine the impact of changing social restrictions on endocrine treatments and treatment-related outcomes, including osteopenia, osteoporosis and bisphosphonate prescriptions. Results: In breast cancer patients, aromatase inhibitor (AI) prescriptions increased during lockdown versus pre-pandemic [IRR: 1.22 (95% confidence interval (CI): 1.11–1.34)], followed by a decrease post-first lockdown [IRR: 0.79 (95% CI: 0.69–0.89)]. In prostate cancer patients, first-generation antiandrogen prescriptions increased versus pre-pandemic [IRR: 1.23 (95% CI: 1.08–1.4)]. For breast cancer patients on AIs, diagnoses of osteopenia, osteoporosis and bisphosphonate prescriptions were reduced across all lockdown periods versus pre-pandemic (IRR range: 0.31–0.62). Conclusion: During the first 2 years of the pandemic, newly diagnosed breast and prostate cancer patients were prescribed more endocrine treatments compared to pre-pandemic due to restrictions on hospital procedures replacing surgeries with bridging therapies. But breast cancer patients had fewer diagnoses of osteopenia and osteoporosis and bisphosphonate prescriptions. These patients should be followed up in the coming years for signs of bone thinning. Evidence of poorer management of treatment-related side effects will help assess resource allocation for patients at high risk for bone-related complications. Plain language summary: Effects of the COVID-19 pandemic on hormone treatments for breast and prostate cancer in the UK: implications for bone health The COVID-19 pandemic has had a big impact on health, going beyond just causing illness. One area it has influenced is how patients with breast cancer or prostate cancer are treated. Surgeries and radiotherapies were delayed from the first lockdown as hospitals reduced non-covid related procedures. Some patients with breast or prostate cancer were instead given some medications to help stop their cancers from growing until they were able to have surgery or radiotherapy. These medications (called endocrine treatments) have important side effects, such as conditions that affect the bones. Patients on these medications should be monitored by doctors for signs of bone thinning and should, in some cases, be given other medications to help stop this happening. This study used doctors' records from more than 5 million people to find out whether the pandemic affected the number of endocrine medications being prescribed in patients with breast or prostate cancer, and also looked at the number of these patients that were diagnosed with conditions that affect their bones and whether they were given medications that could protect their bone health. We found that during the first lockdown, patients with breast cancer or prostate cancer had more of some types of endocrine treatments compared to before the lockdown. However, they had fewer diagnoses of conditions related to bone health and fewer medications to protect their bones. It is possible that appointments and tests that are usually carried out to diagnose conditions relating to bone health were not performed in the months after the first lockdown, and so these conditions were underdiagnosed. The use of medications to protect their bones was also reduced, likely because this was not considered a priority during the pandemic. This highlights that such patients should be followed up in the coming years for signs of bone thinning, given the relatively poorer management of these side effects in these people after the pandemic. [ABSTRACT FROM AUTHOR]

Published
2024
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7. The Impact of the COVID-19 Pandemic on Incidence and Short-Term Survival for Common Solid Tumours in the United Kingdom: A Cohort Analysis.

Author

Barclay, Nicola L, Burkard, Theresa, Burn, Edward, Delmestri, Antonella, Dominguez, Andrea Miquel, Golozar, Asieh, Guarner-Argente, Carlos, Avilés-Jurado, Francesc Xavier, Man, Wai Yi, Serrano, Àlvar Roselló, Rosen, Andreas Weinberger, Tan, Eng Hooi, Tietzova, Ilona, Alhambra, Daniel Prieto, and Newby, Danielle

Subjects
STOMACH cancer, COVID-19 pandemic, ELECTRONIC health records, COLORECTAL cancer, MEDICAL research, BREAST, LUNGS
Abstract

Purpose: The COVID-19 pandemic profoundly affected healthcare systems and patients. There is a need to comprehend the collateral effects of the pandemic on non-communicable diseases. We examined the impact of the pandemic on short-term survival for common solid tumours, including breast, colorectal, head and neck, liver, lung, oesophageal, pancreatic, prostate, and stomach cancer in the UK. Methods: This was a population-based cohort study of electronic health records from the UK primary care Clinical Practice Research Datalink GOLD database. In sum, 12,259,744 eligible patients aged ≥ 18 years with ≥ 1 year's history identified from January 2000 to December 2022 were included. We estimated age-standardised incidence and short-term (one- and two-year) survival for several common cancers from 2000 to 2019 (in five-year strata) and compared these to 2020– 2022 using the Kaplan–Meier method. Results: Incidence decreased for most cancers in 2020 and recovered to different extents in 2021– 2022. Short-term survival improved for most cancers between 2000 and 2019, but then declined, albeit minimally, for those diagnosed in 2020– 2022. This was most pronounced for colorectal cancer, with one-year survival falling from 78.8% (95% CI 78%– 79.6%) in 2015– 2019 to 77% (95% CI 75.6– 78.3%) for those diagnosed in 2020– 2022. Conclusion: Short-term survival for many cancers was impacted, albeit minimally, by the pandemic in the UK, with reductions in survivorship from colorectal cancer equivalent to returning to the mortality seen in the first decade of the 2000s. While data on longer-term survival are needed to fully comprehend the impact of COVID-19 on cancer care, our findings illustrate the need for an urgent and substantial commitment from the UK National Health Service to address the existing backlog in cancer screening and diagnostic procedures to improve cancer care and mortality. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Genetic and environmental influences on sleep quality : quantitative and molecular genetic approaches to an understanding of individual differences

Author

Barclay, Nicola L.

Subjects
612, Psychology
Abstract

There are vast inter-individual differences in sleep quality in the general population – whilst some individuals sleep well with little or no sleep disturbance, others experience frequent sleep disturbances, problems which often manifest into chronic sleep disorders such as insomnia. The aim of this thesis is to explore factors accounting for these observed differences in sleep quality between individuals. Using data from a large-scale twin study this thesis uses behavioural genetic techniques to investigate genetic and environmental influences on sleep quality in a sample of 1,556 twins and siblings aged 18-27 years. The first four studies use quantitative genetic techniques to investigate 1) associations between components of sleep quality and the overlap in the genetic and environmental influences accounting for them; 2) specific non-shared environmental influences on global sleep quality; 3) the presence of gene-environment interplay between sleep quality and dependent negative life events; and 4) the association between sleep quality and diurnal preference, and the overlap in their aetiological influences. Most importantly, there was substantial genetic overlap between individual components of sleep quality (rA mostly ≥.50); sleep quality and diurnal preference (rD = .52[95% CI=.37-.70]); and sleep quality and dependent negative life events (rD = .63[.45-.83]) – the latter finding providing evidence of gene-environment correlation. In general, non-shared environmental overlap was small (rE mostly ≤.40). The final study used a candidate gene approach to investigate associations between sleep quality and diurnal preference with 5HTTLPR, PER3, and CLOCK 3111 – polymorphisms hypothesized to be implicated in sleep and/or the circadian system. An association was found between the ‘long’ allele of 5HTTLPR and poor sleep quality (β = -.34, p<.01). This thesis utilises the twin method in novel ways in the context of sleep research and advances knowledge of the genetic and environmental underpinnings of the variation in sleep quality in healthy young adults.

Published
2011

11. The Impact of the UK COVID-19 Lockdown on the Screening, Diagnostics and Incidence of Breast, Colorectal, Lung and Prostate Cancer in the UK: a Population-Based Cohort Study

Author

Barclay, Nicola L, primary, Pineda-Moncusi, Marta L, additional, Jodicke, Annika M., additional, Prieto-Alhambra, Daniel, additional, Raventos, Berta, additional, Newby, Danielle, additional, Delmestri, Antonella, additional, Man, Wai Yi, additional, Chen, Xihang, additional, and Catala, Marti, additional

Published
2023
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13. The interaction between polygenic risk and environmental influences: A direct test of the 3P model of insomnia in adolescents.

Author

Madrid‐Valero, Juan J., Barclay, Nicola L., and Gregory, Alice M.

Subjects
*LIFE change events, *DNA, *TWINS, *REGRESSION analysis, *GENETIC testing, *SEX distribution, *RISK assessment, *COMPARATIVE studies, *DESCRIPTIVE statistics, *QUESTIONNAIRES, *DISEASE susceptibility, *RESEARCH funding, *INSOMNIA, *PREDICTION models, *PHENOTYPES, *LONGITUDINAL method, *DISEASE risk factors, *ADOLESCENCE
Abstract

Background: Stress is a universal phenomenon and one of the most common precipitants of insomnia. However, not everyone develops insomnia after experiencing a stressful life event. This study aims to test aspects of Spielman's '3P model of insomnia' (during adolescence) by exploring the extent to which: (a) insomnia symptoms are predicted by polygenic scores (PGS); (b) life events predict insomnia symptoms; (c) the interaction between PGS and life events contribute to the prediction of insomnia symptoms; (d) gene–environment interaction effects remain after controlling for sex. Methods: The sample comprised 4,629 twins aged 16 from the Twin Early Development Study who reported on their insomnia symptoms and life events. PGS for insomnia were calculated. In order to test the main hypothesis of this study (a significant interaction between PGS and negative life events), we fitted a series of mixed effect regressions. Results: The best fit was provided by the model including sex, PGS for insomnia, negative life events, and their interactions (AIC = 26,158.7). Our results show that the association between insomnia symptoms and negative life events is stronger for those with a higher genetic risk for insomnia. Conclusions: This work sheds light on the complex relationship between genetic and environmental factors implicated for insomnia. This study has tested for the first time the interaction between genetic predisposition (PGS) for insomnia and environmental stressors (negative life events) in adolescents. This work represents a direct test of components of Spielman's 3P model for insomnia which is supported by our results. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Problematic technology use and sleep quality in young adulthood: novel insights from a nationally representative twin study

Author

Universidad de Alicante. Departamento de Psicología de la Salud, Madrid-Valero, Juan J., Matthews, Timothy, Barclay, Nicola L., Odgers, Candice L., Moffitt, Terrie E., Caspi, Avshalom, Arseneault, Louise, Gregory, Alice M., Universidad de Alicante. Departamento de Psicología de la Salud, Madrid-Valero, Juan J., Matthews, Timothy, Barclay, Nicola L., Odgers, Candice L., Moffitt, Terrie E., Caspi, Avshalom, Arseneault, Louise, and Gregory, Alice M.

Abstract

Study Objectives: Digital technology use is associated with poor sleep quality in adolescence and young adulthood although research findings have been mixed. No studies have addressed the association between the two using a genetically informative twin design which could extend our understanding of the etiology of this relationship. This study aimed to test: (1) the association between adolescents’ perceived problematic use of digital technology and poor sleep quality, (2) whether the association between problematic use of technology and poor sleep quality remains after controlling for familial factors, and (3) genetic and environmental influences on the association between problematic use of technology and poor sleep quality. Methods: Participants were 2232 study members (18-year-old twins) of the Environmental Risk (E-Risk) Longitudinal Twin Study. The sample was 48.9% male, 90% white, and 55.6% monozygotic. We conducted regression and twin difference analyses and fitted twin models. Results: Twin differences for problematic use of technology were associated with differences for poor sleep quality in the whole sample (p < 0.001; B = 0.15) and also when we limited the analyses to identical twins only (p < 0.001; B = 0.21). We observed a substantial genetic correlation between problematic use of technology and sleep quality (rA = 0.31), whereas the environmental correlation was lower (rE = 0.16). Conclusions: Adolescent reported problematic use of digital technology is associated with poor sleep quality—even after controlling for familial factors including genetic confounds. Our results suggest that the association between adolescents’ sleep and problematic digital technology use is not accounted for by shared genetic liability or familial factors but could reflect a causal association. This robust association needs to be examined in future research designed to test causal associations.

Published
2023

16. The interaction between polygenic risk and environmental influences: A direct test of the 3P model of insomnia in adolescents

Author

Universidad de Alicante. Departamento de Psicología de la Salud, Madrid-Valero, Juan J., Barclay, Nicola L., Gregory, Alice M., Universidad de Alicante. Departamento de Psicología de la Salud, Madrid-Valero, Juan J., Barclay, Nicola L., and Gregory, Alice M.

Abstract

Background: Stress is a universal phenomenon and one of the most common precipitants of insomnia. However, not everyone develops insomnia after experiencing a stressful life event. This study aims to test aspects of Spielman's ‘3P model of insomnia’ (during adolescence) by exploring the extent to which: (a) insomnia symptoms are predicted by polygenic scores (PGS); (b) life events predict insomnia symptoms; (c) the interaction between PGS and life events contribute to the prediction of insomnia symptoms; (d) gene–environment interaction effects remain after controlling for sex. Methods: The sample comprised 4,629 twins aged 16 from the Twin Early Development Study who reported on their insomnia symptoms and life events. PGS for insomnia were calculated. In order to test the main hypothesis of this study (a significant interaction between PGS and negative life events), we fitted a series of mixed effect regressions. Results: The best fit was provided by the model including sex, PGS for insomnia, negative life events, and their interactions (AIC = 26,158.7). Our results show that the association between insomnia symptoms and negative life events is stronger for those with a higher genetic risk for insomnia. Conclusions: This work sheds light on the complex relationship between genetic and environmental factors implicated for insomnia. This study has tested for the first time the interaction between genetic predisposition (PGS) for insomnia and environmental stressors (negative life events) in adolescents. This work represents a direct test of components of Spielman's 3P model for insomnia which is supported by our results.

Published
2023

19. The interaction between polygenic risk and environmental influences on sleep quality and insomnia

Author

Barclay, Nicola L, Gregory, Alice, and Madrid-Valero, Juan J

Subjects
FOS: Psychology, Biological Psychology, Life Sciences, Psychology, Social and Behavioral Sciences
Abstract

Sleep is a fundamental state, important for health, well-being and longevity. Yet consistently poor/ insufficient sleep or symptoms of insomnia affect as many as a third of the adult population worldwide. In order to reduce the impact of insomnia and poor sleep quality, it is first of interest to understand their aetiology. Numerous behavioural genetic studies have indicated that insomnia and sleep quality are under partial genetic control (accounting for between 31%-44% of the variance according to recent meta-analyses). However, attempts to elucidate the genetic pathways involved have been slower than anticipated, and replete with inconsistencies. There have been non-replications of initially promising genetic variants involved in insomnia-related phenotypes for many reasons. For example, the effects of individual genes are small; and/or that genetic factors interact with the environment to exert their effects on insomnia-related phenotypes. With regards this latter point, there have been a handful of studies highlighting a probable role for gene-environment interaction (GxE) in insomnia-related phenotypes, but this field is also replete with inconsistencies. This is likely due to 1) the selection of individual genetic variants in isolation, rather than the consideration of a broader array of genetic effects, in interaction with the environment; 2) different ways of conceptualising ‘environmental risk’; 3) different ways of conceptualising insomnia; and/or 4) direct (genetic) and indirect (GxE) effects being moderated by other factors such as sex. One way to overcome this first point is to examine the contribution of Polygenic Risk Scores (PRS). PRS use GWAS data to create a summarised effect of multiple genetic variants acting upon a phenotype. PRS can then be used in regression analyses to examine associations with the trait in question, as well as in models exploring possible gene-environment interaction. An understanding of the extent of gene-environment interaction influencing insomnia will enable us to identify who may be at risk for insomnia, and who may benefit from preventative interventions. Thus, the overall aim of this research is to understand more about the role of gene-environment interaction (GxE) in the aetiology of insomnia, and the possibility of sex-specific GxE effects.

Published
2023
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28. Experienced Demand Does Not Affect Subsequent Sleep and the Cortisol Awakening Response

Author

Elder, Greg J, Wetherell, Mark A, Pollet, Thomas V, Barclay, Nicola L, and Ellis, Jason G

Subjects
stress, polysomnography, Nature and Science of Sleep, anticipation, cortisol, sleep, Original Research
Abstract

Greg J Elder,1 Mark A Wetherell,2 Thomas V Pollet,2 Nicola L Barclay,3 Jason G Ellis1 1Northumbria Sleep Research Laboratory, Northumbria University, Newcastle Upon Tyne, UK; 2Department of Psychology, Northumbria University, Newcastle Upon Tyne, UK; 3Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UKCorrespondence: Greg J ElderNorthumbria Sleep Research Laboratory, Northumbria University, Newcastle Upon Tyne NE1 8ST, UKTel +44 191 227 3241Email g.elder@northumbria.ac.ukPurpose: Stress is associated with subjective and objective sleep disturbances; however, it is not known whether stress disrupts sleep and relevant physiological markers of stress immediately after it is experienced. The present study examined whether demand, in the form of cognitive tasks, disrupted sleep and the cortisol awakening response (CAR), depending on whether it was experienced or just anticipated.Participants and Methods: Subjective and objective sleep was measured in 22 healthy adults on three nights (Nights 0– 2) in a sleep laboratory using sleep diaries and polysomnography. Saliva samples were obtained at awakening, +15, +30, +45 and +60 minutes on each subsequent day (Day 1– 3) and CAR measurement indices were derived: awakening cortisol levels, the mean increase in cortisol levels (MnInc) and total cortisol secretion (AUCG). On Night 1, participants were informed that they were required to complete a series of demanding cognitive tasks within the sleep laboratory during the following day. Participants completed the tasks as expected or unexpectedly performed sedentary activities.Results: Compared to the no-demand group, the demand group displayed significantly higher levels of state anxiety immediately completing the first task. There were no subsequent differences between the demand and no-demand groups in Night 2 subjective sleep continuity, objective sleep continuity or architecture, or on any Day 3 CAR measure.Conclusion: These results indicate that sleep and the CAR are not differentially affected depending on whether or not an anticipated stressor is then experienced. This provides further evidence to indicate that the CAR is a marker of anticipation and not recovery. In order to disrupt sleep, a stressor may need to be personally relevant or of a prolonged duration or intensity.Keywords: stress, cortisol, polysomnography, sleep, anticipation

Published
2020

32. The natural history of insomnia: predisposing, precipitating, coping and perpetuating factors\ud over the early developmental course of insomnia

Author

Ellis, Jason G., Perlis, Michael L., Espie, Colin A., Grandner, Michael A., Bastien, Célyne H., Barclay, Nicola L., Altena, Ellemarije, and Gardani, Maria

Subjects
mental disorders, nervous system diseases
Abstract

While there is an extensive literature on predisposing, precipitating, coping and perpetuating factors in those with chronic insomnia, very little work has been undertaken to evaluate these factors over the early developmental course of insomnia. The present aim was to determine whether several hypothesized factors in each domain (predisposing, precipitating, coping and perpetuating), assessed during an episode of acute insomnia, are related to its persistence or remission to normal sleep. Participants comprised n = 140 people with acute insomnia and n = 737 normal sleepers recruited from the general public. Participants completed measures assessing predisposing characteristics (personality traits, arousal predisposition and insomnia vulnerability), precipitating events and outcomes (life events, perceived stress, anxiety and depression), coping styles (thought control strategies and coping styles) and perpetuating factors (sleep preoccupation, pre-sleep arousal, dysfunctional beliefs and fatigue). Additionally, insomnia status (from acute insomnia at baseline to its persistence or natural remission) was assessed one month later (n = 129). Baseline differences between normal sleepers and individuals with acute insomnia were observed in each domain with increasing age, lower openness to experience and conscientiousness, higher insomnia severity, levels of anxiety and affective sleep preoccupation significantly predicting acute insomnia status. Further, a previous episode of insomnia, higher depression scores and affective sleep preoccupation scores significantly predicted its persistence, as opposed to its natural remission. Results are discussed with reference to the conceptualization of insomnia and how the findings may influence the design of preventative interventions to circumvent the transition from acute to chronic insomnia.

Published
2021

33. The Heritability of Insomnia: A Meta-Analysis of Twin Studies

Author

Barclay, Nicola L, Kocevska, Desi, Bramer, Wichor M, Van Someren, Eus J W, Gehrman, Philip, Barclay, Nicola L, Kocevska, Desi, Bramer, Wichor M, Van Someren, Eus J W, and Gehrman, Philip

Abstract

Twin studies of insomnia exhibit heterogeneity in estimates of heritability. This heterogeneity is likely due to sex differences, age of the sample, the reporter, and the definition of insomnia. The aim of the present study was to systematically search the literature for twin studies investigating insomnia disorder and insomnia symptoms and to meta-analyse the estimates of heritability derived from these studies to generate an overall estimate of heritability. We further examined whether heritability was moderated by sex, age, reporter and insomnia symptom. A systematic literature search of 5 online databases was completed on January 24th 2020. Two authors independently screened 5,644 abstracts, and 160 complete papers for the inclusion criteria of twin studies from the general population reporting heritability statistics on insomnia or insomnia symptoms, written in English, reporting data from independent studies. We ultimately included 12 papers in the meta-analysis. The meta-analysis focussed on twin intra-class correlations for monozygotic and dizygotic twins. Based on these intra-class correlations, the meta-analytic estimate of heritability was estimated at 40%. Moderator analyses demonstrated stronger heritability in females than males; and for parent-reported insomnia symptoms compared to self-reported insomnia symptoms. There were no other significant moderator effects, though this is likely due to the small number of studies that were comparable across levels of the moderators. Our meta-analysis provides a robust estimate of the heritability of insomnia which can inform future research aiming to uncover molecular genetic factors involved in insomnia vulnerability.

Published
2021

34. The heritability of insomnia:A meta-analysis of twin studies

Author

Barclay, Nicola L., Kocevska, Desi, Bramer, Wichor M., Van Someren, Eus J.W., Gehrman, Philip, Barclay, Nicola L., Kocevska, Desi, Bramer, Wichor M., Van Someren, Eus J.W., and Gehrman, Philip

Abstract

Twin studies of insomnia exhibit heterogeneity in estimates of heritability. This heterogeneity is likely because of sex differences, age of the sample, the reporter and the definition of insomnia. The aim of the present study was to systematically search the literature for twin studies investigating insomnia disorder and insomnia symptoms and to meta-analyse the estimates of heritability derived from these studies to generate an overall estimate of heritability. We further examined whether heritability was moderated by sex, age, reporter and insomnia symptom. A systematic literature search of five online databases was completed on 24 January 2020. Two authors independently screened 5644 abstracts, and 160 complete papers for the inclusion criteria of twin studies from the general population reporting heritability statistics on insomnia or insomnia symptoms, written in English, reporting data from independent studies. We ultimately included 12 papers in the meta-analysis. The meta-analysis focussed on twin intra-class correlations for monozygotic and dizygotic twins. Based on these intra-class correlations, the meta-analytic estimate of heritability was estimated at 40%. Moderator analyses showed stronger heritability in females than males; and for parent-reported insomnia symptoms compared with self-reported insomnia symptoms. There were no other significant moderator effects, although this is likely because of the small number of studies that were comparable across levels of the moderators. Our meta-analysis provides a robust estimate of the heritability of insomnia, which can inform future research aiming to uncover molecular genetic factors involved in insomnia vulnerability.

Published
2021

35. The heritability of insomnia: A meta-analysis of twin studies

Author

Barclay, Nicola L., Kocevska, Desi, Bramer, Wichor M., Van Someren, Eus J.W., Gehrman, Philip, Barclay, Nicola L., Kocevska, Desi, Bramer, Wichor M., Van Someren, Eus J.W., and Gehrman, Philip

Abstract

Twin studies of insomnia exhibit heterogeneity in estimates of heritability. This heterogeneity is likely because of sex differences, age of the sample, the reporter and the definition of insomnia. The aim of the present study was to systematically search the literature for twin studies investigating insomnia disorder and insomnia symptoms and to meta-analyse the estimates of heritability derived from these studies to generate an overall estimate of heritability. We further examined whether heritability was moderated by sex, age, reporter and insomnia symptom. A systematic literature search of five online databases was completed on 24 January 2020. Two authors independently screened 5644 abstracts, and 160 complete papers for the inclusion criteria of twin studies from the general population reporting heritability statistics on insomnia or insomnia symptoms, written in English, reporting data from independent studies. We ultimately included 12 papers in the meta-analysis. The meta-analysis focussed on twin intra-class correlations for monozygotic and dizygotic twins. Based on these intra-class correlations, the meta-analytic estimate of heritability was estimated at 40%. Moderator analyses showed stronger heritability in females than males; and for parent-reported insomnia symptoms compared with self-reported insomnia symptoms. There were no other significant moderator effects, although this is likely because of the small number of studies that were comparable across levels of the moderators. Our meta-analysis provides a robust estimate of the heritability of insomnia, which can inform future research aiming to uncover molecular genetic factors involved in insomnia vulnerability.

Published
2021
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38. Experienced Demand Does Not Affect Subsequent Sleep and the Cortisol Awakening Response

Author

Elder,Greg J, Wetherell,Mark A, Pollet,Thomas V, Barclay,Nicola L, Ellis,Jason G, Elder,Greg J, Wetherell,Mark A, Pollet,Thomas V, Barclay,Nicola L, and Ellis,Jason G

Abstract

Greg J Elder,1 Mark A Wetherell,2 Thomas V Pollet,2 Nicola L Barclay,3 Jason G Ellis1 1Northumbria Sleep Research Laboratory, Northumbria University, Newcastle Upon Tyne, UK; 2Department of Psychology, Northumbria University, Newcastle Upon Tyne, UK; 3Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UKCorrespondence: Greg J ElderNorthumbria Sleep Research Laboratory, Northumbria University, Newcastle Upon Tyne NE1 8ST, UKTel +44 191 227 3241Email g.elder@northumbria.ac.ukPurpose: Stress is associated with subjective and objective sleep disturbances; however, it is not known whether stress disrupts sleep and relevant physiological markers of stress immediately after it is experienced. The present study examined whether demand, in the form of cognitive tasks, disrupted sleep and the cortisol awakening response (CAR), depending on whether it was experienced or just anticipated.Participants and Methods: Subjective and objective sleep was measured in 22 healthy adults on three nights (Nights 0– 2) in a sleep laboratory using sleep diaries and polysomnography. Saliva samples were obtained at awakening, +15, +30, +45 and +60 minutes on each subsequent day (Day 1– 3) and CAR measurement indices were derived: awakening cortisol levels, the mean increase in cortisol levels (MnInc) and total cortisol secretion (AUCG). On Night 1, participants were informed that they were required to complete a series of demanding cognitive tasks within the sleep laboratory during the following day. Participants completed the tasks as expected or unexpectedly performed sedentary activities.Results: Compared to the no-demand group, the demand group displayed significantly higher levels of state anxiety immediately completing the first task. There were no subsequent differences between the demand and no-demand groups in Night 2 subjective sleep continuity, objective sleep continuity or architecture, or on

Published
2020

48. Association between symptoms of sleep apnea and problem behaviors in young adult twins and siblings.

Author

Madrid-Valero, Juan J., Barclay, Nicola L., Rowe, Richard, Perach, Rotem, Buysse, Daniel J., Ordoñana, Juan R., Eley, Thalia C., and Gregory, Alice M.

Subjects
*SELF-evaluation, *TWINS, *BEHAVIOR disorders, *SLEEP apnea syndromes, *MENTAL depression, *AFFECTIVE disorders, *ANXIETY, *ENVIRONMENTAL exposure, *SYMPTOMS
Abstract

Background: Sleep apnea is one of the most common sleep disorders and it is related to multiple negative health consequences. Previous studies have shown that sleep apnea is influenced by genetic factors. However, studies have not investigated the genetic and environmental influences of symptoms of sleep apnea in young adults. Furthermore, the underpinnings of the relationship between apnea symptoms and internalizing/externalizing problems are unknown. The objectives of this study were to estimate the magnitude of: (1) genetic and environmental influences on self-reported apnea symptoms; (2) the relationship between self-reported apnea symptoms and internalizing/externalizing traits; (3) genetic and environmental influences on the associations between self-reported apnea symptoms, internalizing behaviors and externalizing behaviors. Methods: In a twin/sibling study, univariate and multivariate models were fitted to estimate both individual variance and sources of covariance between symptoms of sleep apnea and internalizing/externalizing behaviors. Results: Our results show that genetic influences account for 40% of the variance in sleep apnea symptoms. Moreover, there are modest associations between depression, anxiety and externalizing behaviors with apnea symptoms (ranging from r = 0.22–0.29). However, the origins of these associations differ. For example, whereas most of the covariation between symptoms of depression and sleep apnea can be explained by genes (95%), there was a larger role for the environment (53%) in the association between symptoms of anxiety and sleep apnea. Conclusions: Genetic factors explain a significant proportion of variance in symptoms of apnea and most of the covariance with depression. [ABSTRACT FROM AUTHOR]

Published
2021
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50. Externalizing Behaviors and Callous-Unemotional Traits:Different Associations With Sleep Quality

Author

Denis, Dan, Akhtar, Reece, Holding, Benjamin C., Murray, Christina, Panatti, Jennifer, Claridge, Gordon, Sadeh, Avi, Barclay, Nicola L., O'Leary, Rachael, Maughan, Barbara, McAdams, Tom A., Rowe, Richard, Eley, Thalia C., Viding, Essi, and Gregory, Alice M.

Subjects
sleep, psychopathology, antisocial, externalizing, actigraphy, callous-unemotional
Abstract

Study Objectives: Sleep quality is associated with different aspects of psychopathology, but relatively little research has examined links between sleep quality and externalizing behaviors or callous-unemotional traits. We examined: (1) whether an association exists between sleep quality and externalizing behaviors; (2) whether anxiety mediates this association; (3) whether callous-unemotional traits are associated with sleep quality.Methods: Data from two studies were used. Study 1 involved 1556 participants of the G1219 study aged 18-27 years (62% female). Questionnaire measures assessed sleep quality, anxiety, externalizing behaviors, and callous-unemotional traits. Study 2 involved 338 participants aged 18-66 years (65% female). Questionnaires measured sleep quality, externalizing behaviors, and callous-unemotional traits. In order to assess objective sleep quality, actigraphic data were also recorded for a week from a subsample of study 2 participants (n = 43).Results: In study 1, poorer sleep quality was associated with greater externalizing behaviors. This association was partially mediated by anxiety and moderated by levels of callous-unemotional traits. There was no significant relationship between sleep quality and callous-unemotional traits. In study 2, poorer sleep quality, as assessed via self-reported but not objective measures, was associated with higher levels of externalizing behaviors. Furthermore, in study 2, better sleep quality (indicated in both questionnaires and actigraphy measures: lower mean activity, and greater sleep efficiency) was associated with higher levels of callous-unemotional traits.Conclusions: Self-reports of poorer sleep quality are associated with externalizing behaviors, and this association is partially mediated by anxiety. Callous-unemotional traits are not associated with poor sleep and may even be related to better sleep quality. This is an exceptional finding given that poor sleep quality appears to be a characteristic of most psychopathology.

Published
2017
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