Sleep restoration is associated with reduced plasma C-reactive protein and depression symptoms in military personnel with sleep disturbance after deployment.

BACKGROUND: Deployed military personnel are vulnerable to chronic sleep disturbance, which is highly comorbid with post-traumatic stress disorder (PTSD) and depression, as well as declines in health-related quality of life (HRQOL). Inflammation is associated with HRQOL declines and sleep-related comorbidities; however, the impact of sleep changes on comorbid symptoms and inflammation in this population is unknown. METHODS: In this observational study, we examined the relationship between reported sleep changes and concentrations of inflammatory biomarkers, interleukin 6 (IL-6), and C-reactive protein (CRP) in peripheral blood. The sample was dichotomized into two groups: (1) decrease in Pittsburgh Sleep Quality Index (PSQI; restorative sleep) and (2) no change or increase in PSQI (no change). Mixed between-within subjects analysis of variance tests were used to determine group differences on changes of inflammation and comorbid symptoms. RESULTS: In our sample of 66 recently deployed military personnel with insomnia, 34 participants reported restorative sleep whereas 32 reported no sleep changes. The two groups did not differ in demographic or clinical characteristics, with the exception of PTSD diagnosis at baseline. The restorative sleep group had significant reductions in CRP concentrations and depression symptoms, as well as reduced fatigue and improvements in emotional well-being, social functioning, and physical functioning at follow-up. CONCLUSIONS: Military personnel who report sleep restoration after deployment have reduced CRP concentrations, decreased severity of depression, and improved HRQOL. These findings suggest that treatment for sleep disturbances may be associated with improvements in mental and physical health, thereby supporting continued study in this line of research.

Evaluation of a Test Battery to Assess Perception of Music in Children With Cochlear Implants.

IMPORTANCE: A number of studies have investigated music perception in adult cochlear implant (CI) users. However, little is known about how pediatric CI users perceive and process music, in part because suitable methods for assessing music perception in this population are lacking. Therefore, we developed the Music in Children With Cochlear Implants (MCCI) battery to assess music perception in pediatric CI users younger than 9 years. OBJECTIVE: To pilot test the MCCI on a group of pediatric CI users to determine its feasibility for measuring music perception and to compare performance of CI users with that of normal-hearing (NH) control participants. DESIGN, SETTING, AND PARTICIPANTS: The pilot test was conducted in an academic tertiary care center. The MCCI evaluated rhythm, pitch, melody, harmony, and timbre perception. For each section, 10 pediatric CI users and 10 NH controls were presented with a pair of stimuli that possibly varied along a single musical element (eg, rhythm). Participants were required to indicate whether the stimuli in the pair were the same or different. INTERVENTIONS: Administration of the MCCI. MAIN OUTCOMES AND MEASURES: Percentage correct on each section of the MCCI and the aggregate score of all sections by group. RESULTS: The MCCI provided a basic characterization of musical perceptual abilities. In the aggregate, NH controls significantly outperformed CI users in music perception (mean [SD] accuracy for CI users vs NH controls: rhythm, 73% [20%] vs 78% [20%]; pitch, 84% [12%] vs 91% [13%]; melody, 65% [16%] vs 75% [18%]; harmony, 74% [13%] vs 75% [14%]; and timbre, 80% [17%] vs 90% [12%]; repeated-measures analysis of variance, F1,17 = 9.3; P < .01). Despite obtaining lower accuracies than NH controls, however, the CI users achieved above-chance accuracy in all sections of the MCCI (1-sample t test, P < .01), including pitch-based sections that are traditionally difficult for CI users. These results suggest that CI users can make use of temporal and spectral cues to discriminate between musical stimuli, although not to the extent of their NH peers. CONCLUSIONS AND RELEVANCE: The MCCI provided an efficient and user-friendly assessment of music perception in pediatric CI users. This test battery may serve as a valuable tool to evaluate music perceptual abilities of pediatric CI users and measure the effects of interventions.