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Temporal regulation of human circadian rhythms in body temperature, endocrines and habitual sleep–wake state. Abbreviations are core body temperature (CBT) and blood concentration of melatonin (Mel), growth hormone (GH), and cortisol (Corti). (A) In the normal relation among physiological timings and social time, people can maintain their sleepiness according to the bed-time (habitual sleep). (B) In external desynchronizations, physiological (internal) timings and the social 24-h clock are dissociated, that cause delayed sleep onset and lengthened sleepiness in daytimes. (C) Further desynchronizations in internal clocks make people on the slide, because the temporal relationships among sleep-related physiology and the habitual sleep–wake period in organisms are not kept constant.
Source publication
Considerable attention has been paid to individuals showing social maladjustment as well as withdrawal from social situations and activity, a state referred to as “Hikikomori” in Japanese. Recently, social maladjustment and Hikikomori states have also been noted to be highly prevalent among individuals with pervasive developmental disorders (PDDs),...
Citations
... Crepaldi (2019) tried to identify the stages that a hikikomori goes through before total isolation. What can be inferred is that the isolation resulting from hikikomori syndrome is not a choice dictated by a bad personal moment, but is a reasoned choice that the person matures over time and in full clarity: In the first stage, the person begins to feel the urge to isolate himself or herself, finds relief in isolation and feels uncomfortable with other people; in the middle stage, the person begins to consciously process the impulse to isolate, quits school or work, reverses the sleep-wake cycle (Takasu et al., 2011) and begins to spend most of their time in their own home (Okamura, 2016). ...
This paper intends to thoroughly examine the phenomenon called Hikikomori., which was initially studied in Japan in the late 1990s (Saito, 1998). Importantly, in recent years there has been a significant surge in current research efforts aimed at investigating the many aspects of this complex phenomenon.This article’s objective is to effectively organize and classify various articles discussing the Hikikomori phenomenon. It considers critical factors such as the type of researcher involved, the specific angle or focus of the article, and the disciplinary perspective underpinning it. By examining these elements, readers can gain a more comprehensive and nuanced understanding of this complex and often misunderstood phenomenon.To achieve our goal, we followed a structured process. Firstly, we extracted articles through Sciilit academic indexing platform. Then, we created an analysis form to enter the collected data. Finally, we analyzed the data using various techniques
... It is a reasoned choice that the person matures over time and in full clarity. In the first stage, the person begins to feel the urge to isolate himself or herself, finds relief in isolation and feels uncomfortable with other people; in the middle stage, the person begins to consciously process the impulse to isolate, quits school or work, reverses the sleep-wake cycle [3,20] and begins to spend most of their time in their own home [19]. ...
... Japan is considered the homeland of the Hikikomori phenomenon [24,25], and to date it remains the country with the largest number of isolated children. Data dating back to 2011, reported in a study by Takasu et al. [20], showed that about 200,000 people in Japan can be classified as Hikikomori (out of a population of about 120 million). One of the reasons that could be attributed to the phenomenon is certain Japanese cultural traits. ...
We can classify the Hikikomori phenomenon with the classification of “social pathology”: the Hikikomori phenomenon, and its spread in society, appear to be a real danger to the sustainability and resilience of the very society in which it occurs. This is because the social isolation of an individual, especially if young and non-independent, impacts the community of reference in human, economic and psychological terms. Therefore, an analysis that investigates the social aspects of the Hikikomori phenomenon cannot disregard the fact that it can be said to be sustainable in the community of reference within which it occurs. This, without wishing to produce a judgment on the merits of the social pathology, is relevant to assessing the capacity of that community to sustain its presence and spread and the human and social costs required to contain it. The research aims to explore the Hikikomori phenomenon in the context of Southern Italy, considering it as an emerging social vulnerability that impacts very deeply onto the sustainability of a social, economic and community systems such as the Campania region one. The following paper therefore presents empirical work conducted in southern Italy, in the Campania region. The methodology used is Mixed Methods, and the research design is Sequential Exploratory. The respondents were reached through the help of the association Hikikomori Italia.
... Social withdrawal not only affects the individual, but it also affects their loved ones and impacts the society (45). Studies have showed that individuals with who socially withdraw, besides having higher risks of health issues [e.g., cardiovascular diseases and stroke, (2); poor quality of sleep, (46)], place a huge burden on caregivers, leading to burnout from, specifically, family members (44). Our results suggested some possible factors behind Hikikomori tendencies, such as connection with friends, depression, and emotion expression suppression, which clinicians and social workers could perhaps tap into in mitigating social withdrawal tendencies as a probable antecedent of actual withdrawal behavior for those at risk of becoming a Hikikomori. ...
Introduction
Once a localized Japanese phenomenon, Hikikomori-type social withdrawal has since been observed globally in increasing numbers. However, there is a lack of research about Hikikomori in Singapore. Consequently, local variations of Hikikomori may differ from past research in Japan. Drawing on associations found in international and Japanese Hikikomori research, we explored some variables relevant and generalizable to the Singaporean context. Specifically, we examined the relationships between (1) Hikikomori risk factors, (2) social withdrawal tendencies, (3) depression and anxiety, (4) connections with family and friends, and (5) employment status.
Methods
In a cross-sectional survey study (N = 416; Mage = 24.90, SDage = 4.79; females = 236, males = 177, undisclosed = 3), participants were provided a Qualtrics link and asked to complete a questionnaire comprising the NHR scale, LSNS-6, DASS-21, ERQ, and HQ-25.
Results
We found that (a) Hikikomori risk factors positively correlated with social withdrawal tendencies and depression and anxiety but negatively correlated with support from family and friends, (b) high Hikikomori risk factors predicted high social withdrawal tendencies, (c) support from friends (one of the psychosocial factors) predicted social withdrawal tendencies together with the Hikikomori risk factors, and (d) social withdrawal tendencies moderated the relationship between Hikikomori risk factors and depression among the emerging adults in Singapore.
Conclusion
The current research findings serve as a basis for future Hikikomori research in Singapore.
... With emergence consumer devices such as Microsoft R Kinect TM re-purposed for sports science, the cost of technology has become less of an issue [14]. Recently interesting developments in wearable compressive garment-based sensor platforms [286] and novel sensors/actuators developed for extended reality (XR) [383, 854] and soft robots applications [738] are enabling the design of future non-invasive and cost-eective continuous performance monitoring solutions for strength training.The development in sensor technology and its ease of use might rene the denitions of the test-ing (done infrequently) vs monitoring (done often) variables used by some S&C coaches[667].Some of the measures such as blood sampling and dual-energy X-ray absorptiometry (DXA) currently seen as testing measures might become monitoring measures with the introduction of low-SWE for the (real-time) quantication of musculotendon stiness [419, 467], cartoon of smart insoles for quantifying center-of-pressure (CoP) and the tripod loading , force plates for measuring ground reaction forces [245], EMG for measuring activation [257] (myoelectric activity more exactly[841]), sweat-based biochemical sensing for detecting metabolic and neuromuscular fatigue from ammonia and lactate levels[697], core body temperature for circadian phase[788] and muscle temperature measurements for training preparedness, subjective rating of eort through RPE logging (https://www.reactivetrainingsystems.com/), cognitive load from electrical (EEG) ...
In strength training, personalised strength training (autoregulation) approaches have been used to individualise exercise programs with monitoring an for dynamic adjustment based on their responses to training. While this transition from tradition-based training to evidence-based training framework has been an improvement in training practices, we argue that the future of strength training will also incorporate deep learning models powered by data. We refer to this data-driven framework as precision strength training inspired by the similar modeling frameworks used in precision medicine. In contrast to current personalised training in which the acquired athlete data is often subject to human expert decision-making, we are anticipating the rise of human-in-the-loop systems with an augmented coach who will be doing decisions collaboratively with the machine. Similar to other precision frameworks, such as precision health, we envision such a future to take decades to be realised and we focus here on practical short-term targets on a way to long-term realisation. In this chapter, we will review the measurement technology needed for continuous data acquisition from an individual during training/physical activity, how to acquire these datasets for the development of such systems and, how a proof-of-concept system could be developed for powerlifting training with applicability to general strength and conditioning (S&C) and physical rehabilitation purposes. Additionally, we will evaluate how the user experience (UX) of the system feedback and visualisation could be designed.
... The protracted confinement in a bedroom would not be conducive to the usual domestic cycle of adequate and regular sleep, causing poor sleep quality [1,6]. A recent review has discussed the similarities between hikikomori status and pervasive developmental disorders, which suggested the associations of physical problems such as headaches, neck, back and muscle pains, and gastrointestinal problems with the irregular sleep-wake rhythms of hikikomori [7]. Indeed, from the bio-psychosocial point of view, as supported by empirical evidences, the harmful impacts of social withdrawal and sedentary lifestyle on both physical and mental health have long been established. ...
... Numerous studies [9][10][11] have reported that the existence of psychiatric co-morbidity was common within 1-2 years following the onset of a hikikomori life, and that the problem often became worse during the time that the individual leads such a life. In Japan, the lifetime prevalence of mental disorders in hikikomori was almost double of the non-hikikomori population, whereas the risk of mood disorders was six-times higher among hikikomori [7]. Although the etiology remains largely unknown, many researchers believed that this is a personalized phenomenon and culturally driven. ...
Background: A prospective cohort study was conducted to follow-up on 104 participants on their changes of social, psychological and physical health as exposed to the hikikomori lifestyle. Methods: Participants were interviewed at baseline, 6 months and 12 months by administering a set of questionnaires and anthropometric measurements. Results: All three health domains of hikikomori were significantly improved over the follow-up period as evidenced by: (1) increased social network scores from 2.79 ± 1.80 to 3.09 ± 1.87, (2) decreased perceived stress scores from 21.18 ± 5.87 to 20.11 ± 5.79, and (3) reduced blood pressure levels from 118/75 to 115/71 and waist-to-hip ratios. Almost half of the participants have recovered from hikikomori by returning to the workforce in society; however, the health improvements were dominant in those that remained as hikikomori and were associated with the gradual swapping of exercise practices from light to moderate level strength. Conclusions: With intended exposure to social worker engagement, physical assessments of the cohort study triggered the social workers to encourage participants to do more exercises, which in turn enhanced their awareness of health modification towards a better health. Engagement of social workers could be considered as part of the intended exposure for all participants, which suggested social work intervention was effective in helping hikikomori recovery.
... The protracted confinement in bedroom could be hard to lead the usual domestic cycle of adequate and regular sleep causing poor sleep quality [1,3]. A recent review has discussed the similarities between hikikomori status and pervasive developmental disorders, which suggested the associations of physical problems such as headaches, neck, back and muscle pains, and gastrointestinal problems with the irregular sleep-wake rhythm of hikikomori [4]. Indeed, from the bio-psychosocial point of view, as supported by empirical evidences, the harmful impacts of socially withdrawn and sedentary lifestyle on both physical and mental health have long been established. ...
Background: A prospective study was conducted to follow-up how the living lifestyle of hikikomori could change the social, mental and physical health profile. Methods: A cohort consisted of 104 young people living as Hikikomori were interviewed at baseline, 6 months and 12 months by using the same set of questionnaires and anthropometric measurements. Results: Besides the high attrition of 30% in wave 2 and 25% in wave 3, almost half of the participants have recovered from hikikomori by returning to the workforce in society. The three domains of health profile of hikikomori were significantly improved over the follow-up period by: 1) increasing the social network scores from 2.791.80 to 3.091.87, 2) decreasing the perceived stress scores from 21.185.87 to 20.115.79, and 3) reducing blood pressure levels from 118/75 to 115/71 and waist-to-hip ratios. Those variables were also predictable by lifestyle living with the hikikomori according to the Generalized Estimating Equation analysis, whereas the participants of current study had increased the practice of moderate-intensity exercises. Conclusion: Social work intervention was effective in helping the recovery of hikikomori while physical assessments followed by encouragement from social workers to do more exercises might enhance their awareness in health modification towards a better health.
... Excessive energy intake and insufficient physical activities could be a major cause of weight gains by time, which eventually leads to obesity [57,58]. Furthermore, the poor sleeping quality of current participants was consistent with previous report that hikikomori tended to sleep at extremely late night hours or during the day [59]. Very frequent and prolonged use of computers and electronic devices at home as the top activities amongst the hikikomori cases could be associated with poor sleep quality, which coincided with the strong association between sleep quality and daytime function with the use of technologies [60,61]. ...
... Clinical significance of human circadian rhythms was reviewed [63], which has highlighted the negative impacts of disrupted sleeping cycle on cardiovascular regulation associated with BP levels. Another study discussed how irregular sleep-wake rhythm of hikikomori could be associated with physical problems such as headaches, neck, back, or muscle pain, and gastrointestinal problems [59]. However, such physical parameters have not been measured in the current study, and are deemed to be further investigated. ...
A cross-sectional study was designed to understand the impacts of "hikikomori" lifestyle on physical health. A total of 104 eligible hikikomori cases were recruited from the social services network of Hong Kong with a mean age of 19.02 ± 3.62 (ranged 13-31) year-old, and had completed the set of questionnaires and a series of anthropometric and physical health measurements. Despite SF36 score of 84.0 indicated good physical functioning in general, participants were lived sedentarily with high incidence of hypertension at 15.4% and prehypertension at 31.7%. Occurrence of hypertension and prehypertension in cases living as hikikomori >6 months were 3 times and 1.5 times higher than those newly onset cases, respectively. The blood pressure levels were correlated with age and all obesity index parameters measured including waist circumference and body mass index. Results also observed a shift of body weight from underweight to overweight and obesity along the hikikomori duration. Half of the hypertensive cases involved the elevation of systolic blood pressure, which suggested higher odds of cardiovascular complications. In conclusion, the hikikomori lifestyle could be a risk behavior that may harm the younger generation physically by promoting obesity and hypertension and probably other chronic illnesses.
... Excessive energy intake and insufficient physical activities could be a major cause of weight gains by time, which eventually leads to obesity [57,58]. Furthermore, the poor sleeping quality of current participants was consistent with previous report that hikikomori tended to sleep at extremely late night hours or during the day [59]. Very frequent and prolonged use of computers and electronic devices at home as the top activities amongst the hikikomori cases could be associated with poor sleep quality, which coincided with the strong association between sleep quality and daytime function with the use of technologies [60,61]. ...
... Clinical significance of human circadian rhythms was reviewed [63], which has highlighted the negative impacts of disrupted sleeping cycle on cardiovascular regulation associated with BP levels. Another study discussed how irregular sleep-wake rhythm of hikikomori could be associated with physical problems such as headaches, neck, back, or muscle pain, and gastrointestinal problems [59]. However, such physical parameters have not been measured in the current study, and are deemed to be further investigated. ...
To understand the health impacts of “hikikomori” lifestyle and to establish its first comprehensive health profile, a cross-sectional study was designed to measure how well the cases of hikikomori youths of Hong Kong were living, in terms of social, mental and physical aspects. This study involved 104 eligible participants at age 19.02 year-old who had completed the set of questionnaires and a series of anthropometric and physical health measurements. Despite SF36 score of 84.0 indicated good physical functioning in general, participants were lived sedentarily with high incidence of hypertension at 15.4% and prehypertension at 31.7%. Occurrence of hypertension in cases living as hikikomori >6 months was 3-times higher than those newly onset cases. The blood pressure levels were correlated with age and all obesity index parameters measured including waist circumference and body mass index. Half of the hypertensive cases involved the elevation of systolic blood pressure, which suggested higher odds of cardiovascular complications. Participants were mentally stable living with moderate levels of perceived stress and state anxiety, but borderline clinical depression. In conclusion, the hikikomori lifestyle could be a risk behavior that may harm the younger generation physically by promoting obesity and hypertension and probably other chronic illnesses.
... Sleep is one of the most important human biological processes which have deep effects on mental and physical health. [15] In Iran, 80% of those employed in the health and treatment system are nurses. [16] Studies have indicated that night-shift nurses suffer from sleepiness and making errors twice as much as day-shift nurses. ...
Introduction:
Sleep is affected by circadian cycle and its features. Amplitude and stability of circadian rhythm are important parameters of circadian cycle. This study aims to examine the relationship between amplitude and stability of circadian rhythm with sleep quality and sleepiness.
Method:
In this cross-sectional research, 315 shift nurses and health care worker of educational hospitals of Kerman University of Medical Sciences (KUMS), Iran, were selected using random sampling method. Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Circadian Type Inventory (CTI) were used to collect the required data.
Results:
In this study, 83.2% suffered from poor sleep and one half had moderate and excessive sleepiness. The results showed that flexibility in circadian rhythm stability, job stress and sleepiness are among the factors affecting quality sleep in shift workers.
Discussion:
Those whose circadian rhythm amplitude was languid suffered more from sleepiness and those whose circadian stability was flexible had a better sleep. The variables including circadian rhythm stability (FR) and amplitude (LV) can act as predictive indices in order to employ people in shift work system so that sleepiness and drop in quality sleep are prevented.
Aim and background
Sleep quality has a significant impact on children's overall health and is associated with oral diseases. This study aimed to investigate the relationship between dental caries, periodontal status, and sleep patterns in 8–12-year-old children.
Materials and methods
This cross-sectional study was conducted on 120 children aged 8–12 years. The children's sleep habits questionnaire (CSHQ) was employed to evaluate sleep status. Another questionnaire was used to collect data on lifestyle habits. Dental caries status was evaluated using the decayed, missing, and filled teeth (DMFT) and International Caries Detection and Assessment System (ICDAS) indices. Periodontal status was assessed through the plaque index (PI), probing depth (PD), gingival index (GI), and periodontal screening and recording (PSR). The association between oral health and sleep patterns was evaluated using Spearman's coefficient correlation, independent t-test, and the Chi-squared test.
Results
The ICDAS mean was significantly higher in children with improper sleep patterns (p = 0.032). However, there was no statistically significant relationship between DMFT and sleep patterns (p = 0.346). The GI, PD, and PSR mean were significantly higher in the inappropriate sleep pattern group. There was a significant relationship between children's sleep patterns and GI, PD, and PSR indices (p = 0.033, p = 0.020, p = 0.028, respectively). However, there was no significant association between PI and sleep patterns (p = 0.277).
Conclusion
Children's sleep patterns were associated with dental caries and periodontal status. Adequate sleep is required to prevent oral diseases such as dental caries and periodontal diseases.
Clinical significance
According to this study, it is recommended that children should be encouraged to get adequate sleep by their parents and dentists.
How to cite this article
Mehdipour A, Abbasi R, Keykha E, et al. The Association between Dental Caries, Periodontal Status, and Sleep Patterns in Children. Int J Clin Pediatr Dent 2024;17(8):925–932.
