***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The present study was performed to determine whether high levels of trait-anger ( T-Anger ) are independently associated with  sleep disturbances  and quantitative and qualitative measurements of sleep in middle-aged adults . METHODS Enrolled in the study were 2404 men and 2291 women derived from the Korean Health and Genome Study ( KHGS ) , which is an ongoing population -based prospect i ve study . The Spielberger Trait Anger Scale was used to measure T-Anger . RESULTS Sleep disturbances , including difficulty in initiating and maintaining sleep ( DIS and DMS , respectively ) and early morning awakening ( EMA ) , significantly increased with increasing levels of T-Anger ( P<.05 by test for trend ) . Nonrestorative feelings in the morning and excessive daytime sleepiness were also strongly associated with higher levels of T-Anger . After adjusting for other potential risk factors , the high and /or moderate T-Anger showed 40 % to 70 % increases in the odds for sleep disturbances . CONCLUSION The present study provides evidence that high levels of T-Anger are independently associated with symptoms of disturbed sleep in middle-aged adult population Objectives . We explored the prospect i ve , microlevel relationship between nightly sleep quality ( SQ ) and the subsequent day 's stress on positive ( PA ) and negative affect ( NA ) as well as the moderating relationships between nightly SQ , subsequent stress , and subsequent PA on NA . We investigated whether age moderated these relationships . Method . We collected 56 days of sleep , stress , and affect data using daily diary question naires ( N = 552 ) . We used multilevel modeling to assess relationships at the between- and within-person levels . Results . Daily increases in SQ and decreases in stress interacted to predict higher daily PA and lower daily NA . Better SQ in older adults enhanced the benefits of PA  on the stress-NA relationship more during times of low stress , whereas better sleep in younger adults enhanced the benefits of PA  more during times of high stress . Between-person effects were stronger predictors of well-being outcomes than within-person variability . Discussion . The combination of good SQ and higher PA buffered the impact of stress on NA . The moderating impact of age suggests that sleep and stress play different roles across adulthood . Targeting intervention and prevention strategies to improve SQ and enhance PA could disrupt the detrimental relationship between daily stress and NA The aim of this pilot study was to quantify the impact of sleep deprivation on psychophysiological reactivity to emotional stimuli . Following an adaptation night of sleep in the lab , healthy young adults were r and omly assigned to either one night of total sleep deprivation or to a normal sleep control condition . The next afternoon , responses to positive , negative , and neutral picture stimuli were examined with pupillography , an indicator of cognitive and affective information processing . Only the sleep-deprived group displayed significantly larger pupil diameter while viewing negative pictures compared to positive or neutral pictures . The sleep-deprived group also showed anticipatory pupillary reactivity during blocks of negative pictures . These data suggest that sleep deprivation is associated with increased reactions to negative emotional information . Such responses may have important implication s for psychiatric disorders , which may be triggered or characterized by sleep disturbances The present study investigates whether interepisode mood regulation impairment contributes to disturbances in sleep onset latency ( SOL ) and rapid eye movement ( REM ) sleep .  Individuals with interepisode bipolar disorder ( n = 28 ) and healthy controls ( n = 28 ) slept in the laboratory for 2 baseline nights , a happy mood induction night , and a sad mood induction night . There was a significant interaction whereby on the happy mood induction night the bipolar group exhibited significantly longer SOL than did the control group , while there was no difference on the baseline nights . In addition , control participants exhibited shorter SOL on the happy mood induction night compared to the baseline nights , a finding that was not observed in the bipolar group . On the sad mood induction night , participants in both groups had shorter SOL and increased REM density when compared to the baseline nights . Bipolar participants exhibited heightened REM density compared to control participants on both nights . These results raise the possibility that regulation of positive stimuli may be a contributor to difficulties with SOL , while hyperactivity may be characteristic of REM sleep BACKGROUND Insomnia and major depressive disorder ( MDD ) can coexist . This study evaluated the effect of adding eszopiclone to fluoxetine . METHODS Patients who met DSM-IV criteria for both MDD and insomnia ( n = 545 ) received morning fluoxetine and were r and omized to nightly eszopiclone 3 mg ( ESZ+FLX ) or placebo ( PBO+FLX ) for 8 weeks . Subjective sleep and daytime function were assessed weekly . Depression was assessed with the 17-item Hamilton Rating Scale for Depression ( HAM-D-17 ) and the Clinical Global Impression Improvement ( CGI-I ) and Severity items ( CGI-S ) . RESULTS Patients in the ESZ+FLX group had significantly decreased sleep latency , wake time after sleep onset ( WASO ) , increased total sleep time ( TST ) , sleep quality , and depth of sleep at all double-blind time points ( all p < .05 ) . Eszopiclone co-therapy also result ed in : significantly greater changes in HAM-D-17 scores at Week 4 ( p = .01 ) with progressive improvement at Week 8 ( p = .002 ) ; significantly improved CGI-I and CGI-S scores at all time points beyond Week 1 ( p < .05 ) ; and significantly more responders ( 59 % vs. 48 % ; p = .009 ) and remitters ( 42 % vs. 33 % ; p = .03 ) at Week 8 . Treatment was well tolerated , with similar adverse event and dropout rates . CONCLUSIONS In this study , eszopiclone/fluoxetine co-therapy was relatively well tolerated and associated with rapid , substantial , and sustained sleep improvement , a faster onset of antidepressant response on the basis of CGI , and a greater magnitude of the antidepressant effect STUDY OBJECTIVES ( 1 ) To describe the prevalence and prospect i ve course of insomnia in a representative young-adult sample and ( 2 ) to describe the cross-sectional and longitudinal associations between insomnia and depression . DESIGN Longitudinal cohort study . SETTING Community of Zurich , Switzerl and . PARTICIPANTS Representative stratified population sample . INTERVENTIONS None . MEASUREMENTS AND RESULTS The Zurich Study prospect ively assessed psychiatric , physical , and sleep symptoms in a community sample of young adults ( n=591 ) with 6 interviews spanning 20 years . We distinguished 4 duration -based subtypes of insomnia : 1-month insomnia associated with significant distress , 2- to 3-week insomnia , recurrent brief insomnia , and occasional brief insomnia . The annual prevalence of 1-month insomnia increased gradually over time , with a cumulative prevalence rate of 20 % and a greater than 2-fold risk among women . In 40 % of subjects , insomnia developed into more chronic forms over time . Insomnia either with or without comorbid depression was highly stable over time . Insomnia lasting 2 weeks or longer predicted major depressive episodes and major depressive disorder at subsequent interviews ; 17 % to 50 % of subjects with insomnia lasting 2 weeks or longer developed a major depressive episode in a later interview . " Pure " insomnia and " pure " depression were not longitudinally related to each other , whereas insomnia comorbid with depression was longitudinally related to both . CONCLUSIONS This longitudinal study confirms the persistent nature of insomnia and the increased risk of subsequent depression  among individuals with insomnia . The data support a spectrum of insomnia ( defined by duration and frequency ) comorbid with , rather than secondary to , depression Although previous research has suggested that presleep negative cognitive activities are associated with poor  sleep quality , there is little evidence regarding the association between negative thoughts and sleep in real-life setting s. The present study used experience sampling and long-term sleep monitoring with actigraphy to investigate the relationships among negative repetitive thought , mood , and sleep problems . During a 1-week sampling period , 43 undergraduate students recorded their thought content and mood eight times a day at semir and om intervals . In addition to these subjective reports , participants wore actigraphs on their wrists in order to measure sleep parameters . Analyses using multilevel modeling showed that repetitive thought in the evening was significantly associated with longer sleep-onset latency , decreased sleep efficiency , and reduced total sleep time . Furthermore , impaired sleep quality was significantly associated with reduced positive affect the next morning , and decreased positive affect was indirectly associated with increased repetitive thought in the evening . These findings suggest the existence of a self-reinforcing cycle involving repetitive thought , mood , and impaired sleep quality , highlighting the importance of cognitive and emotional factors in enhancement and maintenance of good- quality sleep BACKGROUND  Sleep and mood disturbances in women have often been linked to the menstrual cycle , implying an ovarian hormonal causation . However , most studies in this area have used self-reported menstrual cycle phase rather than direct measurement of ovarian hormone concentrations . Further , many studies have focused primarily on peri- and postmenopausal population s reporting clinical sleep difficulty . In this study , we examined the associations among sleep quality , mood , and ovarian hormone concentration in a r and om sample of community-dwelling , non clinical women of reproductive age . METHODS Our sample consisted of 19 non-help-seeking women aged 18 - 43 years , each contributing an average of 39.5 nights of data . Over the 42 days of the study , we collected self-reported and actigraphic sleep- quality data , concentrations of urinary estrogen and progesterone metabolites  ( estrone-3-glucuronide ( E1 G ) and  pregnanediol-3-glucuronide  [ PdG ] , respectively ) , and daily mood ratings .  Linear-mixed models were used to estimate associations , clustering longitudinal observations by the participant . RESULTS We found a significant positive association between Sleep Efficiency and E1 G , and a significant negative association between Sleep Efficiency and PdG. Otherwise , the self-reported and actigraphic sleep measures were not associated with ovarian hormone concentrations . Self-reported sleep was strongly associated with mood , whereas actigraphic sleep was associated with only two of the 11 individual mood items , " Feeling on Top of Things " and " Difficulty Coping . " CONCLUSIONS In this community sample of women of reproductive age , ovarian hormones play little , if any , role in day-to-day sleep quality . Our findings additionally highlight the different associations that self-reported and actigraphic sleep show with hormones and mood Rapid eye movement ( REM ) sleep and dreaming may be implicated in cross-night adaptation to emotionally negative events . To evaluate the impact of REM sleep deprivation ( REMD ) and the presence of dream emotions on a possible emotional adaptation ( EA ) function , 35 healthy subjects r and omly assigned to REMD ( n = 17 ; mean age 26.4 + /- 4.3 years ) and control ( n = 18 ; mean age 23.7 + /- 4.4 years ) groups underwent a partial REMD and control nights in the laboratory , respectively . In the evening preceding and morning following REMD , subjects rated neutral and negative pictures on scales of valence and arousal and EA scores were calculated . Subjects also rated dream emotions using the same scales and a 10-item emotions list . REMD was relatively successful in decreasing REM% on the experimental night , although a mean split procedure was applied to better differentiate subjects high and low in REM% . High and low groups differed - but in a direction contrary to expectations . Subjects high in REMD% showed greater adaptation to negative pictures on arousal ratings than did those low in REMD% ( P < 0.05 ) , even after statistically controlling sleep efficiency and awakening times . Subjects above the median on EA(valence ) had less intense overall dream negativity ( P < 0.005 ) and dream sadness ( P < 0.004 ) than subjects below the median . A correlation between the emotional intensities of the morning dream and the morning picture ratings supports a possible emotional carry-over effect . REM sleep may enhance morning reactivity to negative emotional stimuli . Further , REM sleep and dreaming may be implicated in different dimensions of cross-night adaptation to negative emotions The present study investigated the daily fluctuation of ruminative thinking and its individual differences by using the experience sampling method .  Participants recorded their thought contents and negative affect eight times a day for a week at semir and om intervals . High-trait ruminators showed high levels of self-focus , unpleasantness , and uncontrollability in their thoughts over the sampling course . These variables were interacted to predict the levels of concurrent negative affect : Self-focus was strongly associated with increased levels of negative affect when the thought was highly unpleasant and uncontrollable . A composite measure of rumination , including self-focus , unpleasantness , and uncontrollability , exhibited diurnal variation , which was assimilated by a quadratic function of time of day . However , there were differences in the estimated parameters of diurnal trajectories between high and low levels of depression , which indicated that individuals with higher levels of depression are more likely to engage in rumination in the evening , not in the morning , than those with lower levels of depression . These findings suggest that rumination in the evening would play an important role in the exacerbation and maintenance of depression The current study investigated how night-to-night variations in sleep duration relate to affective well-being the next morning as well as how the relationship varies for people of different ages . Using an Experience Sampling approach , 397 participants aged 12 to 88 years reported their  sleep duration and their momentary affect on 9 mornings , on average . Associations between sleep duration during the previous night and morning affect differed depending on the participants ' age . For ad 
    Output:
    
Electronic data bases ( EMBASE , PsycINFO , PubMed , and SCOPUS ) were search ed for studies using experience sampling methodology to investigate daily associations between sleep and mood in naturalistic environments in healthy and clinical sample s. Findings of the included studies supported the notion of a reciprocal relationship between subjective sleep variables ( sleep quality , sleep duration and sleep latency ) and daytime affective states over the short term , and highlight the potential clinical importance of daily sleep disturbance in the prediction and prevention of the development of psychopathology in the future