Sonia Ancoli-Israel

University of California, San Diego | UCSD · Department of Psychiatry

Patients who have undergone hematopoietic stem cell transplant (HSCT) may experience cognitive impairment that can persist after treatment. Several studies have shown that bright light therapy may improve cognition, potentially due to its effects on the circadian system via brain regions that respond preferentially to light. In this double-blind ra...

Study objectives: Recent initiatives to discourage over-prescription of sleep medications have increased awareness of their potential adverse effects; however, it is unknown whether these efforts translated into a decline in use of these medications in the United States. We assessed recent national trends in the use of medications used for sleep d...

Introduction To identify actigraphy sleep health profiles in older men (Osteoporotic Fractures in Men Study; N=2,640) and women (Study of Osteoporotic Fractures; N=2.430), and to determine whether the identified profiles predict mortality. Methods We applied a novel and flexible clustering approach (Multiple Coalesced Generalized Hyperbolic mixtur...

Study objectives: Poor sleep, including short sleep duration, is common among caregivers of persons with dementia. However, it is unclear whether poor sleep is consistent across both self-reported and objective measures of sleep in caregivers. This study aimed to test the role of caregiving status (caregivers vs. non-caregivers) on the discrepancy...

Study objectives: Many people living with HIV (PLWH) have undiagnosed obstructive sleep apnea (OSA), which may contribute to commonly reported fatigue and the high cardiovascular disease burden in this population. Our objective was to assess the utility of traditional OSA screening tools (STOP-BANG, Berlin Questionnaire (BQ), and Epworth Sleepines...

Purpose To examine long-term cognitive effects of chemotherapy and identify predictors among women with breast cancer (WBC). Patients and methods Sixty-nine WBC scheduled to receive chemotherapy, and 64 matched-controls with no cancer, participated. Objective and subjective cognition, total sleep time, nap time, circadian activity rhythms (CAR), s...

Sleep disturbances are a key feature of bipolar disorder (BD), and poor sleep has been linked to mood symptoms. Recent use of ecological momentary assessment (EMA) has allowed for nuanced exploration of the sleep-mood link; though, the scale and directionality of this relationship is still unclear. Using EMA, actigraphy, and self-reported sleep mea...

Sleep difficulties, particularly symptoms of insomnia and circadian disruption, are among the primary complaints of gynecologic cancer survivors before, during, and after treatment. Moreover, difficulty sleeping has been linked to poorer health-related quality of life and elevated symptom burden in this population. Although leading behavioral sleep...

PurposeThe goal of this study was to examine whether daily increased morning light exposure would maintain or improve sleep and the circadian pattern of relatively more activity in the day and less during the night in women undergoing chemotherapy for breast cancer.Patients and Methods Participants were 39 women with newly diagnosed breast cancer,...

Study Objectives To identify actigraphy sleep health profiles in older men (Osteoporotic Fractures in Men Study; N=2,640) and women (Study of Osteoporotic Fractures; N=2.430), and to determine whether profile predicts mortality. Methods We applied a novel and flexible clustering approach (Multiple Coalesced Generalized Hyperbolic mixture modeling)...

Purpose Optimal cognitive performance might prevent vehicle accidents. Identifying time-related circadian and homeostatic parameters having an impact on cognitive performance of drivers may be crucial to optimize drivers’ performance. Methods In this prospective study conducted on bus drivers, two drivers alternated driving during a 24-h round tri...

Recent initiatives to discourage over-prescription of sleep medications have increased awareness of their potential adverse effects in older adults; however, it is unknown whether these efforts translated into a decline in use of these medications in the United States. We assessed recent national trends in the use of medications for sleep disorders...

Sleep and activity patterns have been linked to physical performance in older adults. Traditional parametric models of 24-hour activity rhythms fail to adequately capture specific diurnal sleep and wake patterns; functional principal components analysis (fPCA) is a non-parametric approach that addresses this limitation. Using fPCA, we modeled accel...

Actigraphy can objectively measure sleep in studies on Bipolar Disorder (BD) where subjective sleep ratings might be influenced by affect. Actigraphy data are complex necessitating data reduction approaches. We created a composite score of actigraphy sleep metrics (total sleep time [TST], wake after sleep onset [WASO], and percent sleep [PS]) in BD...

Purpose: To evaluate the short- and long-term effects of light therapy on fatigue (primary outcome) and sleep quality, depression, anxiety, quality of life, and circadian rhythms (secondary outcomes) in survivors of (non-)Hodgkin lymphoma presenting with chronic cancer-related fatigue. Methods: We randomly assigned 166 survivors (mean survival 1...

Altered 24-hour rest-activity rhythms may be associated with cognitive impairment in older adults, but evidence from prospective studies is limited. Non-parametric methods were used to assess actigraphy-based activity patterns in 2,496 older men. Incident cognitive impairment was assessed four times over 12 years using the Modified Mini Mental Stat...

Study objectives: To evaluate the clinical utility of actigraphy as compared to sleep questionnaires prior to the Multiple Sleep Latency Test (MSLT) in a sleep disorders clinic population. Methods: Twenty-eight clinically referred participants (mean age 42.3±18.8) completed the study protocol. On day 1, participants completed questionnaires: Epw...

BACKGROUND Sleep disturbances are associated with risk of cognitive decline but it is not clear if treating disturbed sleep mitigates decline. We examined differences in cognitive trajectories before and after sleep treatment initiation. METHODS Data came from the 2006-2014 Health and Retirement Study. At each of five waves, participants were admi...

BACKGROUND Wrist-worn actigraphy can objectively measure sleep, and has advantages over self-report, particularly for people with Bipolar Disorder (BD) for whom self-reports might be influenced by affect. Clinically useful data reduction approaches are needed to explore these complex data. METHODS We created a composite score of sleep metrics in B...

Study Objectives Disrupted daily rhythms are associated with mild cognitive impairment (MCI) and dementia. The specific nature of how rhythms and cognition are related, however, is unknown. We hypothesized characteristics from a nonparametric estimate of circadian rest-activity rhythm patterns would be associated to the development of MCI or dement...

Chronic increases in pro-inflammatory cytokines in older adults, known as inflammaging, is an important risk factor for morbidity and mortality in the aging population. It has been suggested that circadian disruption may play a role in chronic inflammation, but there has been limited study that investigated the overall profile of 24-hour rest-activ...

Background: The increasing prevalence of Alzheimer's disease (AD) and lack of effective medications has led to a need to identify modifiable risk factors as targets for interventions. Objective: In this cross-sectional study, we sought to determine whether worse sleep quality is associated with increased pathological tau, and whether this relati...

Premature mortality and increased physical comorbidity associated with bipolar disorder (BD) may be related to accelerated biological aging. Sleep disturbances and inflammation may be key mechanisms underlying accelerated aging in adults with BD. To our knowledge, these relationships have not been examined rigorously. This cross-sectional study inc...

Study objectives: Depression is prevalent among patients with sleep disorders, and studies show associations between suicidal ideation and insufficient sleep. Using retrospective clinic records, we examined positive depression screening rates among adolescent sleep clinic patients relative to other subspecialty clinic patients. We also examined re...

Objective: Disruption of rest-activity rhythms is cross-sectionally associated with metabolic disorders, including type 2 diabetes, yet it remains unclear whether it predicts impaired glucose metabolism and homeostasis. The aim of this study is to examine the cross-sectional and prospective associations between rest-activity rhythm characteristics...

Importance Rapid eye movement (REM) sleep has been linked with health outcomes, but little is known about the relationship between REM sleep and mortality. Objective To investigate whether REM sleep is associated with greater risk of mortality in 2 independent cohorts and to explore whether another sleep stage could be driving the findings. Desig...

Importance Disruption in circadian activity rhythms is very common in older adults, particularly among those with neurodegenerative diseases, including Parkinson disease (PD). However, whether circadian disruption could be a prodrome for PD is unclear. Objective To determine the association between rest-activity rhythm (RAR) and risk of incident P...

Background The increasing prevalence of Alzheimer’s Disease (AD) and lack of effective medications has led to a need to identify modifiable risk factors as targets for interventions. In this cross-sectional study, we sought to determine whether worse sleep quality is associated with increased pathological tau, and whether this relationship is affec...

Introduction Disruption in circadian activity rhythms are very common in older adults, particularly among those with neurodegenerative diseases. However, the longitudinal association between circadian disruption and subsequent risk of developing neurodegenerative diseases, including Parkinson’s disease (PD), is unclear. Methods We examined rest-ac...

Introduction Despite growing use of home sleep testing for the diagnosis of obstructive sleep apnea (OSA), there are significant barriers including limited availability, high cost, and complex wires making it difficult for patients to use on their own. The objective of this study was to evaluate a new flexible, thin, and wireless adhesive patch (pr...

Introduction Sleep disorders and sleep characteristics have been linked to higher risk of mortality. Despite the emerging evidence of a sleep-mortality association, the relationship between sleep architecture and mortality aren’t well understood. We hypothesize that reduced REM is associated with increased mortality risk. Methods The Osteoporotic...

Study Objectives To estimate the association of self-reported poor sleep in multiple dimensions with health care costs in older men. Methods Participants were 1413 men (mean [SD] age 76.5 [5.7] years) enrolled in both the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) study and Medicare Fee-for-Service. Poor sleep was characterized at the b...

Study objectives: The primary objective of this study was to compare circadian activity rhythms (CARs) of adolescents within five years of completing cancer treatment (survivors) and healthy adolescent controls. Secondary objectives were to explore differences in the relationship of CARs and fatigue between survivors and controls, and between earl...

Background This study examined whether biological mechanisms linking dementia caregiving with an increased risk of coronary heart disease can be modified by psychosocial interventions and which caregivers might benefit the most from an intervention. Methods Spousal dementia caregivers were randomized to 12-week treatment with either a behavioral a...

Purpose Robust circadian rhythms are increasingly recognized as essential to good health. Adult cancer patients with dysregulated circadian activity rhythms (CAR) experience greater fatigue, lower responsiveness to chemotherapy, and shorter time to relapse. There is scant research describing circadian rhythms and associated outcomes in children wit...

Purpose Sleep disturbance and cancer-related fatigue (CRF) are among the most commonly reported symptoms associated with breast cancer and its treatment. This study identified symptom cluster groups of breast cancer patients based on multidimensional assessment of sleep disturbance and CRF prior to and during chemotherapy. Methods Participants wer...

Study objectives: Determine the association of poor multidimensional sleep health with health-care costs and utilization. Methods: We linked 1,459 community-dwelling women (mean age 83.6 years) participating in the Study of Osteoporotic Fractures Year 16 visit (2002-2004) with their Medicare claims. Five dimensions of sleep health (satisfaction,...

In older adults, desynchronized circadian rhythms have been associated with medical illness, including Alzheimer Disease. Activity, which can be easily measured using actigraphy over consecutive 24-hour periods, is a valid marker of entrained sleep phase and correlates with entrained endogenous circadian phase. We compare results of both parametric...

Sleep disturbances and physical inactivity have been associated with chronic inflammation, an important risk factor for cognitive decline in the aging population. However most previous studies focused on the cross-sectional relationships between sleep and physical activity and inflammation. In the Outcomes of Sleep Disorders in Older Men (MrOS Slee...

Associations between subjective maternal bonding recalled from the first 16 years of life and current sleep indices were investigated in a clinical sample of 34 adults with major depressive disorder and 36 normal controls (n = 70) using the self-report parental bonding instrument and wrist actigraphy. Results of multiple linear regression analyses...

Study Objectives Both periodic limb movements during sleep (PLMS) and arousals are associated with sympathetic nervous system activation and may be arrhythmogenic. We hypothesize a temporal relationship exists between individual PLMS, particularly with arousal, and nonsustained ventricular tachycardia (NSVT) events. Methods A bidirectional time-st...

Local and national governments around the world are currently considering the elimination of the annual switch to and from Daylight Saving Time (DST). As an international organization of scientists dedicated to studying circadian and other biological rhythms, the Society for Research on Biological Rhythms (SRBR) engaged experts in the field to writ...

Introduction: Little is known about the longitudinal association between napping and cognitive impairment in older adults. Methods: We used wrist actigraphy to measure naps in 2751 community-dwelling older men. Cognition was assessed repeatedly over 12 years, and clinically significant cognitive impairment was determined by physician diagnosis,...

Objectives To determine whether a sleep intervention compared with standard of care (SOC) was successful in preserving nighttime sleep in children with central nervous system cancers hospitalized for high‐dose chemotherapy (HDCT) and autologous stem cell rescue, and to explore associations between sleep and fatigue during treatment. Methods An unb...

Objective: Older adults are among the most frequent users of emergency departments (EDs). Non-specific symptoms such as fatigue and widespread pain are among the most common symptoms in patients admitted at the ED. Interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) are inflammation biomarkers associated with chronic stress (i.e., dementi...

Sleep disordered breathing (SDB)-related overnight hypoxemia is associated with cardiometabolic disease and other comorbidities. Understanding the genetic bases for variations in nocturnal hypoxemia may help understand mechanisms influencing oxygenation and SDB-related mortality. We conducted genome-wide association tests across 10 cohorts and 4 po...

Minimum oxygen saturation discovery cohorts manhattan and QQ plots. Top: African-Americans; Middle: European-Americans; Bottom: Multi-ethnic (2 or more populations for each variant). (PDF)

Average oxygen saturation regional plot (European ancestry males, 10q22). (PDF)

Average oxygen saturation regional plot (European ancestry males, 5q21). (PDF)

Minimum oxygen saturation regional plot (Combined discovery/replication African-American ancestry, 6q25). (PDF)

Minimum oxygen saturation regional plot (Combined discovery/replication European ancestry, 17p13). (PDF)

Multi-variate MTAG (p < 10 x 10–6) results. MTAG analysis was performed on European ancestry samples using our summary statistics for the three traits simultaneously. Lead results (p < 1 x 10–6) are shown. (XLS)

MetaXcan gene-level results for lung in European-Americans. Lead results (p < 0.05) are shown. Note that Ensembl IDs obtained from MetaXcan are occasionally unavailable. (XLS)

MetaXcan gene-level results for skeletal muscle in European-Americans. Lead results (p < 0.05) are shown. Note that Ensembl IDs obtained from MetaXcan are occasionally unavailable. (XLS)

MetaXcan gene-level results for DGN whole blood in European-Americans. Lead results (p < 0.05) are shown. Note that Ensembl IDs obtained from MetaXcan are occasionally unavailable. (XLS)

GIGSEA transcription factor binding site enrichment in whole blood analyses. MetaXcan gene-level results for DGN whole blood (S19 Table, all p-values) were used as input. Transcription factor binding sites are curated by the Molecular Signatures Database (http://software.broadinstitute.org/gsea/msigdb/index.jsp). (XLS)

Multi-ethnic discovery cohorts minimum oxygen saturation miami plots. Top: Females; Bottom: Males. (PDF)

Average oxygen saturation regional plot (European ancestry males, 12q14). (PDF)

Average oxygen saturation regional plot (European ancestry males, 2p21). (PDF)

Average oxygen saturation regional plot (Combined discovery/replication African-American ancestry, 22q11). (PDF)

Minimum oxygen saturation regional plot (Combined discovery/replication European ancestry, 2p12). (PDF)

Phenotype and covariate correlations. Spearman correlations between phenotypes and covariates across all discovery cohorts and ethnic groups are shown. Correlations with the spirometry measures FEV1 and FVC are also shown. Correlations were pooled using Fisher Z-transformations weighted by sample size. 95% confidence intervals are listed in parenth...

Lead loci results for other phenotypes. Each lead SNP from the “Original Phenotype” and “Original Model” columns was analyzed using equivalent individuals and models for different phenotypes. Available sample size will vary depending on the availability of the phenotype. AHI values are taken from Chen, Cade, et al. (submitted) “Locus Class” indicat...

Lead loci results adjusted for additional covariates. Lead variants were re-analyzed with standard models and additional covariates as listed. As these covariates were not collected in all cohorts and individuals, the analysis were also performed with the same individuals for direct comparisons (matched N control columns). (XLS)

Top locus SNP (p < 1 x 10–6) Blueprint and Vermunt epigenetic evidence. Blueprint cell lines are a non-cancerous sub-set of largely blood cells. Vermunt brain region samples were not assayed for promoter regions. “Locus Class” indicates “Discovery/Replication” for main analyses or “Combined meta-analysis” for regions not clearing initial discovery...

GIGSEA micro RNA enrichment in whole blood analyses. MetaXcan gene-level results for DGN whole blood (S19 Table, all p-values) were used as input. MicroRNAs are curated by the Molecular Signatures Database (http://software.broadinstitute.org/gsea/msigdb/index.jsp). (XLS)

Per90 discovery cohorts manhattan and QQ plots. Top: African-Americans; Middle: European-Americans; Bottom: Multi-ethnic (2 or more populations for each variant). (PDF)

Multi-ethnic discovery cohorts Per90 saturation miami plots. Top: Females; Bottom: Males. (PDF)

Average oxygen saturation regional plot (European ancestry, 10q22). The supplemental regional plot order corresponds to the order found in S2, S3 and S4 Tables, minus the associations shown in Figs 1 and 2. (PDF)