Massimiliano de Zambotti

Massimiliano de Zambotti
SRI International | SRI · Division of SRI Biosciences

PhD
Sleep technology R&D; characterization of insomnia disorder in adolescence; sleep CNS-ANS integration; women's health

About

137
Publications
18,361
Reads
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3,057
Citations
Citations since 2016
101 Research Items
2877 Citations
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Introduction
I am a sleep neuroscientist, expert in normal and pathological sleep. I am strongly devoted to the mission of advancing science, discovering and developing novel approaches and technologies to improve people’s health and well-being.
Additional affiliations
May 2011 - April 2012
University of Padova
Position
  • Neurofeedback in rehabilitation
January 2011 - April 2012
University of Padova
Position
  • Cardiovascular and autonomic activity in primary insomnia
September 2010 - May 2011
University of Padova
Position
  • Sleep in essential hypotension
Education
January 2008 - December 2010
University of Padova
Field of study
  • Biological Psychology (Neurosciences)
October 2005 - October 2007
University of Padova
Field of study
  • Cognitive-Behavioral Neurosciences
October 2003 - October 2005
University of Padova
Field of study
  • Cognitive Psychology

Publications

Publications (137)
Article
Full-text available
Background: Self-reported physical activity is often inaccurate. Wearable devices utilizing multiple sensors are now widespread. The aim of this study was to determine acceptability of Fitbit Charge HR for children and their families, and to determine best practices for processing its objective data. Methods: Data were collected via Fitbit Charge H...
Article
Chronic pain is a common and disabling condition in adolescents. Disturbed sleep is associated with many detrimental effects in adolescents with acute and chronic pain. While sleep and pain are known to share a reciprocal relationship, the sleep-pain relationship in adolescence warrants further contextualization within normally occurring maturation...
Article
Full-text available
Sleep facilitates hippocampal-dependent memories, supporting the acquisition and maintenance of internal representation of spatial relations within an environment. In humans, however, findings have been mixed regarding sleep's contribution to spatial memory and navigation, which may be due to task designs or outcome measurements. We developed the M...
Article
Full-text available
Objectives COVID-19 has infected millions of people worldwide, with growing evidence that individuals with a history of infection may continue to show persistent post-COVID symptoms (long COVID). The aim of this study was to investigate sleep health in an international sample of individuals who reported previously testing positive for COVID-19. De...
Article
Full-text available
To determine the persistent effects of the pandemic on mental health in young adults, we categorized depressive symptom trajectories and sought factors that promoted a reduction in depressive symptoms in high-risk individuals. Specifically, longitudinal analysis investigated changes in the risk for depression before and during the pandemic until De...
Article
Full-text available
Insomnia is the most common sleep disorder in adolescence, and frequently emerges during this vulnerable period of profound biobehavioral maturation. Insomnia tends to be chronic, and if left untreated, could be detrimental for the teenagers’ mental and physical health, social, and emotional development. However, there is a paucity of data about in...
Article
Full-text available
Objective: In this study, we describe the rationale, supported by preliminary data, for a novel, digital, immersive virtual reality (VR)-based mind-body approach, designed to reduce bedtime arousal in adolescents with insomnia. Methods: Fifty-two high-school students (16-20 years; 32 female) with (N = 18) and without (N = 34) DSM-5 insomnia symp...
Article
Introduction Adolescence is characterized by developmental changes in sleep timing and architecture as well as alcohol use initiation. While the effects of acute and chronic alcohol use on sleep in adults are well-documented, much less is known in adolescents. We used longitudinal data from the National Consortium on Alcohol and Neurodevelopment in...
Article
Introduction Emotional, more than neutral, experiences are preferentially consolidated during sleep. Fluctuating reproductive hormonal levels across the menstrual cycle are associated with changes in sleep features that are implicated in emotional memory consolidation. Yet, the interaction between menstrual cycle phases, sleep, and emotional memory...
Article
Introduction Insomnia in adolescence is a common and debilitating condition, and vulnerability to stress is known to play a major role its development. In this study, we investigated the effects of sleeping under stress in a sample of adolescents with and without clinically significant insomnia symptoms. The first night in the laboratory was used a...
Article
Full-text available
New sleep technologies have become pervasive in the consumer space, and are becoming highly common in research and clinical sleep settings. The rapid, widespread use of largely unregulated and unstandardized technology has enabled the quantification of many different facets of sleep health, driving scientific discovery. As sleep scientists, it is o...
Article
Full-text available
Background and objective: The ovulatory menstrual cycle is characterized by hormonal fluctuations that influence physiological systems and functioning. Multi-sensor wearable devices can be sensitive tools capturing cycle-related physiological features pertinent to women's health research. This study used the Oura ring to track changes in sleep and...
Article
Objective: This case-control study examines if measures of subjective and objective (actigraphic) sleep difficulties mediate alterations in amygdalar connectivity in adolescents with migraine compared to healthy adolescents. Background: Adolescents with migraine have different functional connectivity of the amygdala compared to individuals witho...
Article
Objectives /Background. Insomnia in adolescence is common and debilitating yet it remains poorly understood. Here, we examine the complexity of clinical, behavioral, and psychosocial factors characterizing insomnia in adolescents. Methods Ninety-five adolescents (16-19 years) with (N=47, 31 female) and without (N=48, 28 female) insomnia symptoms p...
Article
Full-text available
Purpose Adolescence is characterized by dramatic physical, social, and emotional changes, making teens particularly vulnerable to the mental health effects of the COVID-19 pandemic. This longitudinal study identifies young adolescents who are most vulnerable to the psychological toll of the pandemic and provides insights to inform strategies to hel...
Article
Background The coronavirus disease 2019 (COVID-19) pandemic has significantly increased depression rates, particularly in emerging adults. The aim of this study was to examine longitudinal changes in depression risk before and during COVID-19 in a cohort of emerging adults in the U.S. and to determine whether prior drinking or sleep habits could pr...
Conference Paper
We aim to evaluate the feasibility and performance of a novel hot flash (HF) classification algorithm based on multisensor features integration using commercial wearable sensors. First, we processed feature sets from wrist-based multi-sensor data (photoplethysmography, motion, temperature, skin conductance and). Then, we classified (Decision Tree)...
Article
Full-text available
Enhancing the embodiment of artificial limbs—the individuals' feeling that a virtual or robotic limb is integrated in their own body scheme—is an impactful strategy for improving prosthetic technology acceptance and human-machine interaction. Most studies so far focused on visuo-tactile strategies to empower the embodiment processes. However, novel...
Article
Full-text available
Presentation attacks are falsified biometric traits presented on biometric systems to deceive them. While biometric systems can be tuned and modified to reliably detect known presentation attacks, their performance significantly degrades when encountering unknown presentation attacks. Here, we propose a new approach toward detecting unknown present...
Article
Study objectives: Restless legs syndrome (RLS) is a common neurological disorder characterized by an uncontrollable nocturnal urge to move the legs and often associated with chronic sleep disturbances. The most common treatments for RLS are medications that can have debilitating side-effects. Here, we evaluated a novel alternative modality of RLS...
Poster
Introduction Sleep modulates mood, with adequate, good-quality sleep associated with a more positive mood. Additionally, sleep is affected by the menstrual cycle in women, with better self-reported sleep quality during non-menses, compared with pre- and during menses. The present study examines the interaction between self-reported sleep quality an...
Poster
Introduction Adolescence is a transitional life-stage accompanied by large biopsychosocial changes and greater psychophysiological vulnerability. Global events like the COVID-19 pandemic may increase vulnerability to depression and anxiety in this population. Poor sleep is often associated with depression, and both sleep and mood have been shown to...
Poster
Introduction Insomnia is common in adolescence, particularly in older girls, with an overall prevalence comparable to major depression. Despite being associated with adverse outcomes such as an increased risk for substance dependence and suicidality, insomnia in adolescence is still under-recognized, under-diagnosed, and under-treated, and poorly d...
Poster
Introduction Estrogen and progesterone cycle through two main phases across a typical 28-day menstrual cycle: a perimense phase, when both hormones are low; and a non-perimenses phase, when both hormones are high. These fluctuations affect a range of daily activities, including sleep, mood, and physical feelings such as bloating. Here we aimed to p...
Poster
Introduction A woman’s menstrual cycle is characterized by hormonal changes that might affect sleep and therefore daily functionality. While some studies using self-reports have shown a lower sleep quality in the peri-menstruation phase, objective – in lab – studies have not found significant differences in sleep continuity during the menstrual cyc...
Preprint
Full-text available
Adolescents with migraine have different functional connectivity of the amygdala compared to individuals without migraine. Considering that sleep is often disturbed in those adolescents with migrane, this study examined if measures of subjective and objective (actigraphic) sleep difficulties mediate alterations in amygdalar connectivity in adolesce...
Article
We evaluated the performance of Fitbit Charge 3™ (FC3), a multi-sensor commercial sleep-tracker, for measuring sleep in adolescents against gold-standard laboratory polysomnography (PSG). Single-night PSG and FC3 sleep outcomes were compared in thirty-nine adolescents (22 girls; 16–19 years), 12 of whom presented with clinical/subclinical DSM-5 ins...
Chapter
Sleep and the autonomic nervous system (ANS) are intimately connected. The ANS is under the influence of circadian and sleep-dependent modulation. Forced desynchrony and constant routine protocols indicate strong circadian influences on heart rate (HR) and cardiac vagal activity, which fluctuate across 24 hours, with HR being lower, and vagal activ...
Article
Introduction Insomnia disorder is a common sleep disorder and frequently emerges in the context of menopause, being associated with menopause-specific factors such as hot flashes and other psychosocial variables. Increased vulnerability to stress may also contribute to the development of insomnia in midlife women. Here, we aimed to investigate whet...
Chapter
Consumer sleep technology (CST) is at the core of the ongoing Internet of Things digital health revolution, with about one-third of the US population reporting regular use of CST wearables to track sleep, physical activity, and other health-related indicators. Wearables provides a low-cost and technologically advanced approach to measure sleep over...
Article
Objective/Background This pilot study explored the efficacy of a novel forehead cooling device for perceived sleep difficulties and hot flashes in menopausal-age women. Participants 20 women (55.1 ± 4.2 years; 19 post-menopausal) with insomnia symptoms and self-reported two or more hot flashes per day. Methods Participants completed daily assessm...
Patent
A restorative health and wellness system that provides an immersive environment is provided herein. In some embodiments, the system includes one or more sensors configured to measure physiological properties of an individual and/or the properties of the individual's surroundings, one or more actuators configured to create the immersive environment...
Article
Full-text available
Purpose: This study sought to assess the performance of the Fitbit Charge HR, a consumer-level multi-sensor activity tracker, to measure physical activity and sleep in children. Methods: 59 healthy boys and girls aged 9-11 years old wore a Fitbit Charge HR, and accuracy of physical activity measures were evaluated relative to research-grade meas...
Article
Sleep-tracking devices, particularly within the consumer sleep technology (CST) space, are increasingly used in both research and clinical settings, providing new opportunities for large-scale data collection in highly ecological conditions. Due to the fast pace of the CST industry combined with the lack of a standardized framework to evaluate the...
Article
Study objectives To investigate the dose-dependent impact of moderate alcohol intake on sleep-related cardiovascular (CV) function, in adult men and women. Methods Twenty-six healthy adults (30-60y; 11 women) underwent three nights of laboratory polysomnographic (PSG) recordings in which different doses of alcohol (low: 1 standard drink for women...
Article
Objectives Starting in adolescence, female sex is a strong risk factor for the development of insomnia. Reasons for this are unclear but could involve altered stress reactivity and/or autonomic nervous system (ANS) dysregulation, which are strongly associated with the pathophysiology of insomnia. We investigated sex differences in the effect of str...
Article
Introduction Many women experience sleep difficulties in the approach to menopause and post-menopause, with about 25% experiencing severe symptoms that impact daytime functioning and quality of life. Hot flashes contribute to these sleep difficulties, being associated with nocturnal awakenings, poorer sleep quality, and chronic insomnia. New non-ph...
Article
Introduction Sleep disturbances frequently emerge during adolescence amongst profound, normative, sleep maturation and biopsychosocial changes. Factors like stress, worry or rumination may make falling asleep and maintaining sleep more difficult. Here, we evaluate the efficacy of a novel intervention based on virtual reality (VR) and slow breathing...
Poster
Introduction Commercial wearable devices have shown the capability of collecting and processing multisensor information (motion, cardiac activity), claiming to be able to measure sleep-wake patterns and differentiate sleep stages. While using these devices, users should be aware of their accuracy, sources of measurement error and contextual factors...
Article
Introduction Restless Legs Syndrome (RLS) is a sensorimotor neurological condition characterized by an uncontrollable urge to move the legs that interferes with falling and staying asleep. For the over 5 million Americans with clinically significant RLS, these symptoms occur multiple nights per week, significantly impair quality of life, increase t...
Chapter
There are sex differences in human sleep behavior, whether assessed by self-report or with polysomnographic (PSG) and electroencephalographic (EEG) measures. Women report more sleep problems and a poorer sleep quality, and are at greater risk for developing insomnia disorder, than men across a wide age range. Men and women also interpret sleep qual...
Article
Sleep is crucial for the proper functioning of bodily systems and for cognitive and emotional processing. Evidence indicates that sleep is vital for health, well-being, mood, and performance. Consumer sleep technologies (CSTs), such as multisensory wearable devices, have brought attention to sleep and there is growing interest in using CSTs in rese...
Article
Purpose: The aim of the study was to investigate associations between sleep disturbances and mental health in adolescents. Methods: Data are from a national sample of 11,670 U.S. participants (5,594 females, aged 9 -10 years, 63.5% white) in the Adolescent Brain Cognitive Development study. Initial longitudinal analyses were conducted for a subset...
Article
Study Objectives To investigate the pre-sleep psychophysiological state and the arousal deactivation process across the sleep onset (SO) transition in adolescents. Methods Data were collected from a laboratory overnight recording in 102 healthy adolescents (48 girls, 12-20 years old). Measures included pre-sleep self-reported cognitive/somatic aro...
Article
Accurate assessment of sleep can be fundamental for monitoring, managing and evaluating treatment outcomes within diseases. A proliferation of consumer activity trackers gives easy access to objective sleep. We evaluated the performance of a commercial device (Fitbit Alta HR) relative to a research‐grade actigraph (Actiwatch Spectrum Pro) in measur...
Article
The ‘International Biomarkers Workshop on Wearables in Sleep and Circadian Science’ was held at the 2018 SLEEP Meeting of the Associated Professional Sleep Societies. The workshop brought together experts in consumer sleep technologies and medical devices, sleep and circadian physiology, clinical translational research, and clinical practice. The g...
Article
Consumer activity trackers claiming to measure sleep/wake patterns are ubiquitous within clinical and consumer settings. However, validation of these devices in sleep disorder populations are lacking. We examined 1 night of sleep in 42 individuals with insomnia (mean = 49.14 ± 17.54 years) using polysomnography, a wrist actigraph (Actiwatch Spectru...
Article
Full-text available
Hyperarousal is a critical component of insomnia, particularly at bedtime when individuals are trying to fall asleep. The current study evaluated the effect of a novel, acute behavioral experimental manipulation (combined immersive audio-visual relaxation and biofeedback) in reducing bedtime physiological hyperarousal in women with insomnia symptom...
Article
There is evidence for impairment in both central nervous system (CNS) and autonomic nervous system (ANS) function with prolonged alcohol use. While these impairments persist into abstinence, partial recovery of function has been demonstrated in both systems during sleep. To investigate potential ANS dysfunction associated with cortical CNS response...
Article
Hot flashes (HFs) are a hallmark of menopause in midlife women. They are beyond bothersome symptoms, having a profound impact on quality of life and wellbeing, and are a potential marker of cardiovascular (CV) disease risk. Here, we investigated the impact on CV functioning of single nocturnal HFs, considering whether or not they were accompanied b...
Conference Paper
Full-text available
Sleep is characterized by dynamic coupling between central (CNS) and peripheral autonomic (ANS) nervous systems. However, further research is needed to better understand the multiple interactions occurring among electroencephalographic (EEG) features and respiratory and cardiovascular (CV) outputs modulated by the ANS during sleep. Here, we develop...
Conference Paper
Full-text available
Impedance cardiography (ICG) is a noninvasive technique for evaluation of cardiac hemodynamic parameters such as cardiac output and pre-ejection period. However, the sensitivity of the technique to motion artifact, electrode displacement, and cardiovascular pathologies can severely impact the accuracy of hemodynamic parameter estimates. In this pap...
Conference Paper
Full-text available
Introduction Elevated bedtime psychophysiological activation interferes with the way people fall asleep and sleep. The falling asleep is an overlooked phenomenon, particularly relevant in the pathophysiology of insomnia. Insomnia disorder shows a profound sex difference in its prevalence, which emerges during adolescence. Greater vulnerability to i...
Conference Paper
Full-text available
Introduction As children approach adolescence, they are at increased risk for mental health disorders, particularly girls. Sleep disturbances may contribute to this increased risk. Here, we investigated associations between sleep and mental health in a nationally-representative sample of 4521 US children (2146 female, aged 9-10 years) in the Adoles...
Conference Paper
Full-text available
Introduction Women are more vulnerable than men to the development of insomnia disorder, with the sex difference emerging during adolescence. Underlying physiological mechanisms are unknown, although upregulation of the autonomic nervous system (ANS) during sleep is strongly implicated in the pathophysiology of insomnia and may be critical in its d...
Conference Paper
Full-text available
Introduction Insomnia is a common complaint, being present in about a third of the adult population, with a greater prevalence in women. Insomnia is characterized by difficulties initiating and maintaining sleep, often attributed to an underlying state of psychological and physiological hyperarousal. Hyperarousal is particularly magnified in insomn...
Conference Paper
Full-text available
Introduction Hot flashes (HFs) are a common symptom of menopause, occurring across the day and night in up to 80% of women, and persisting for a median duration of 7.4 years. Women with HFs are more likely to have disrupted sleep and insomnia disorder, and night-time HFs account for a significant proportion of total wakefulness after sleep onset in...
Article
Full-text available
The pre‐ejection period (PEP) is a valid index of myocardial contractility and beta‐adrenergic sympathetic control of the heart defined as the time between electrical systole (ECG Q wave) to the initial opening of the aortic valve, estimated as the B point on the impedance cardiogram (ICG). B‐point detection accuracy can be severely impacted if ICG...
Article
Objective: Sleep changes substantially during adolescence; however, our understanding of age-related differences in specific electroencephalographic waveforms during this developmental period is limited. Method: Sigma power, spindle characteristics and cognitive data were calculated for fast (~13Hz) central and slow (~11Hz) frontal sleep spindles...