Work-family conflict and sleep disturbance: the Malaysian working women study

PubMed Central

AAZAMI, Sanaz; MOZAFARI, Mosayeb; SHAMSUDDIN, Khadijah; AKMAL, Syaqirah

2015-01-01

This study aimed at assessing effect of the four dimensions of work-family conflicts (strain and time-based work interference into family and family interference into work) on sleep disturbance in Malaysian working women. This cross-sectional study was conducted among 325 Malaysian married working women. Multiple-stage simple random sampling method was used to recruit women from public service departments of Malaysia. Self-administrated questionnaires were used to measure the study variables and data were analyzed using SPSS version 21. We found that high level of the four dimensions of work-family conflicts significantly increase sleep disturbance. Our analyses also revealed an age-dependent effect of the work-family conflict on sleep disturbance. Women in their 20 to 30 yr old suffer from sleep disturbance due to high level of time-based and strain-based work-interference into family. However, the quality of sleep among women aged 30–39 were affected by strain-based family-interference into work. Finally, women older than 40 yr had significantly disturbed sleep due to strain-based work-interference into family as well as time-based family interference into work. Our findings showed that sleep quality of working women might be disturbed by experiencing high level of work-family conflict. However, the effects of inter-role conflicts on sleep varied among different age groups. PMID:26423332

Sleep and memory consolidation: motor performance and proactive interference effects in sequence learning.

PubMed

Borragán, Guillermo; Urbain, Charline; Schmitz, Rémy; Mary, Alison; Peigneux, Philippe

2015-04-01

That post-training sleep supports the consolidation of sequential motor skills remains debated. Performance improvement and sensitivity to proactive interference are both putative measures of long-term memory consolidation. We tested sleep-dependent memory consolidation for visuo-motor sequence learning using a proactive interference paradigm. Thirty-three young adults were trained on sequence A on Day 1, then had Regular Sleep (RS) or were Sleep Deprived (SD) on the night after learning. After two recovery nights, they were tested on the same sequence A, then had to learn a novel, potentially competing sequence B. We hypothesized that proactive interference effects on sequence B due to the prior learning of sequence A would be higher in the RS condition, considering that proactive interference is an indirect marker of the robustness of sequence A, which should be better consolidated over post-training sleep. Results highlighted sleep-dependent improvement for sequence A, with faster RTs overnight for RS participants only. Moreover, the beneficial impact of sleep was specific to the consolidation of motor but not sequential skills. Proactive interference effects on learning a new material at Day 4 were similar between RS and SD participants. These results suggest that post-training sleep contributes to optimizing motor but not sequential components of performance in visuo-motor sequence learning. Copyright © 2015 Elsevier Inc. All rights reserved.

Does Recall after Sleep-Dependent Memory Consolidation Reinstate Sensitivity to Retroactive Interference?

PubMed Central

Deliens, Gaétane; Schmitz, Rémy; Caudron, Isaline; Mary, Alison; Leproult, Rachel; Peigneux, Philippe

2013-01-01

Previous studies have shown that newly encoded memories are more resistant to retroactive interference when participants are allowed to sleep after learning the original material, suggesting a sleep-related strengthening of memories. In the present study, we investigated delayed, long-term effects of sleep vs. sleep deprivation (SD) on the first post-training night on memory consolidation and resistance to interference. On day 1, participants learned a list of unrelated word pairs (AB), either in the morning or in the evening, then spent the post-training night in a sleep or sleep deprivation condition, in a within-subject paradigm. On day 4, at the same time of day, they learned a novel list of word pairs (AC) in which 50% of the word pairs stemmed with the same word than in the AB list, resulting in retroactive interference. Participants had then to recall items from the AB list upon presentation of the “A” stem. Recall was marginally improved in the evening, as compared to the morning learning group. Most importantly, retroactive interference effects were found in the sleep evening group only, contrary to the hypothesis that sleep exerts a protective role against intrusion by novel but similar learning. We tentatively suggest that these results can be explained in the framework of the memory reconsolidation theory, stating that exposure to similar information sets back consolidated items in a labile form again sensitive to retroactive interference. In this context, sleep might not protect against interference but would promote an update of existing episodic memories while preventing saturation of the memory network due to the accumulation of dual traces. PMID:23874738

REM Sleep Enhancement of Probabilistic Classification Learning is Sensitive to Subsequent Interference

PubMed Central

Barsky, Murray M.; Tucker, Matthew A.; Stickgold, Robert

2015-01-01

During wakefulness the brain creates meaningful relationships between disparate stimuli in ways that escape conscious awareness. Processes active during sleep can strengthen these relationships, leading to more adaptive use of those stimuli when encountered during subsequent wake. Performance on the weather prediction task (WPT), a well-studied measure of implicit probabilistic learning, has been shown to improve significantly following a night of sleep, with stronger initial learning predicting more nocturnal REM sleep. We investigated this relationship further, studying the effect on WPT performance of a daytime nap containing REM sleep. We also added an interference condition after the nap/wake period as an additional probe of memory strength. Our results show that a nap significantly boosts WPT performance, and that this improvement is correlated with the amount of REM sleep obtained during the nap. When interference training is introduced following the nap, however, this REM-sleep benefit vanishes. In contrast, following an equal period of wake, performance is both unchanged from training and unaffected by interference training. Thus, while the true probabilistic relationships between WPT stimuli are strengthened by sleep, these changes are selectively susceptible to the destructive effects of retroactive interference, at least in the short term. PMID:25769506

Sleep Reactivity and Insomnia: Genetic and Environmental Influences

PubMed Central

Drake, Christopher L.; Friedman, Naomi P.; Wright, Kenneth P.; Roth, Thomas

2011-01-01

Study Objectives: Determine the genetic and environmental contributions to sleep reactivity and insomnia. Design: Population-based twin cohort. Participants: 1782 individual twins (988 monozygotic or MZ; 1,086 dizygotic or DZ), including 744 complete twin pairs (377 MZ and 367 DZ). Mean age was 22.5 ± 2.8 years; gender distribution was 59% women. Measurements: Sleep reactivity was measured using the Ford Insomnia Response to Stress Test (FIRST). The criterion for insomnia was having difficulty falling asleep, staying asleep, or nonrefreshing sleep “usually or always” for ≥ 1 month, with at least “somewhat” interference with daily functioning. Results: The prevalence of insomnia was 21%. Heritability estimates for sleep reactivity were 29% for females and 43% for males. The environmental variance for sleep reactivity was greater for females and entirely due to nonshared effects. Insomnia was 43% to 55% heritable for males and females, respectively; the sex difference was not significant. The genetic variances in insomnia and FIRST scores were correlated (r = 0.54 in females, r = 0.64 in males), as were the environmental variances (r = 0.32 in females, r = 0.37 in males). In terms of individual insomnia symptoms, difficulty staying asleep (25% to 35%) and nonrefreshing sleep (34% to 35%) showed relatively more genetic influences than difficulty falling asleep (0%). Conclusions: Sleep reactivity to stress has a substantial genetic component, as well as an environmental component. The finding that FIRST scores and insomnia symptoms share genetic influences is consistent with the hypothesis that sleep reactivity may be a genetic vulnerability for developing insomnia. Citation: Drake CL; Friedman NP; Wright KP; Roth T. Sleep reactivity and insomnia: genetic and environmental influences. SLEEP 2011;34(9):1179-1188. PMID:21886355

Consolidation through the looking-glass: sleep-dependent proactive interference on visuomotor adaptation in children.

PubMed

Urbain, Charline; Houyoux, Emeline; Albouy, Geneviève; Peigneux, Philippe

2014-02-01

Although a beneficial role of post-training sleep for declarative memory has been consistently evidenced in children, as in adults, available data suggest that procedural memory consolidation does not benefit from sleep in children. However, besides the absence of performance gains in children, sleep-dependent plasticity processes involved in procedural memory consolidation might be expressed through differential interference effects on the learning of novel but related procedural material. To test this hypothesis, 32 10-12-year-old children were trained on a motor rotation adaptation task. After either a sleep or a wake period, they were first retested on the same rotation applied at learning, thus assessing offline sleep-dependent changes in performance, then on the opposite (unlearned) rotation to assess sleep-dependent modulations in proactive interference coming from the consolidated visuomotor memory trace. Results show that children gradually improve performance over the learning session, showing effective adaptation to the imposed rotation. In line with previous findings, no sleep-dependent changes in performance were observed for the learned rotation. However, presentation of the opposite, unlearned deviation elicited significantly higher interference effects after post-training sleep than wakefulness in children. Considering that a definite feature of procedural motor memory and skill acquisition is the implementation of highly automatized motor behaviour, thus lacking flexibility, our results suggest a better integration and/or automation or motor adaptation skills after post-training sleep, eventually resulting in higher proactive interference effects on untrained material. © 2013 European Sleep Research Society.

Sleep Quality and Fatigue After A Stress Management Intervention For Women With Early-Stage Breast Cancer in Southern Florida

PubMed Central

Vargas, Sara; Antoni, Michael H.; Carver, Charles S.; Lechner, Suzanne C.; Wohlgemuth, William; Llabre, Maria; Blomberg, Bonnie B.; Glück, Stefan; DerHagopian, Robert P.

2015-01-01

Background Sleep disruption and fatigue are ubiquitous among cancer patients and is a source of stress that may compromise treatment outcomes. Previously we showed that a cognitive behavioral stress management (CBSM) intervention reduced anxiety and other stress-related processes in women undergoing primary treatment for breast cancer. Purpose This study examined secondary outcomes from a CBSM intervention trial for women with early-stage breast cancer to test if CBSM would improve sleep quality and fatigue among these patients at a single site in Southern Florida. CBSM-related effects have already been demonstrated for indicators of psychosocial adaptation (e.g., general and cancer-related anxiety). Methods Patients were randomized to CBSM (n = 120) or a one-day psychoeducation control group (n = 120). The Pittsburgh Sleep Quality Index (PSQI) and Fatigue Symptom Inventory were completed prior to randomization and 6 and 12 months after the baseline assignment. Results In latent growth analyses, women in CBSM reported greater improvements in PSQI sleep quality scores than controls, although there were no significant differences between conditions on PSQI total scores. Women in CBSM also reported greater reductions in fatigue-related daytime interference than controls, though there were no significant differences in changes in fatigue intensity. Changes in sleep quality were associated with changes in fatigue. Conclusions Future work may consider integrating sleep and fatigue content into stress management interventions for women with early-stage breast cancer. PMID:24318654

Validity, cut-points, and minimally important differences for two hot flash-related daily interference scales.

PubMed

Carpenter, Janet S; Bakoyannis, Giorgos; Otte, Julie L; Chen, Chen X; Rand, Kevin L; Woods, Nancy; Newton, Katherine; Joffe, Hadine; Manson, JoAnn E; Freeman, Ellen W; Guthrie, Katherine A

2017-08-01

To conduct psychometric analyses to condense the Hot Flash-Related Daily Interference Scale (HFRDIS) into a shorter form termed the Hot Flash Interference (HFI) scale; evaluate cut-points for both scales; and establish minimally important differences (MIDs) for both scales. We analyzed baseline and postrandomization patient-reported data pooled across three randomized trials aimed at reducing vasomotor symptoms (VMS) in 899 midlife women. Trials were conducted across five MsFLASH clinical sites between July 2009 and October 2012. We eliminated HFRDIS items based on experts' content validity ratings and confirmatory factor analysis, and evaluated cut-points and established MIDs by mapping HFRDIS and HFI to other measures. The three-item HFI (interference with sleep, mood, and concentration) demonstrated strong internal consistency (alphas of 0.830 and 0.856), showed good fit to the unidimensional "hot flash interference factor," and strong convergent validity with HFRDIS scores, diary VMS, and menopausal quality of life. For both scales, cut-points of mild (0-3.9), moderate (4-6.9), and severe (7-10) interference were associated with increasing diary VMS ratings, sleep, and anxiety. The average MID was 1.66 for the HFRDIS and 2.34 for the HFI. The HFI is a brief assessment of VMS interference and will be useful in busy clinics to standardize VMS assessment or in research studies where response burden may be an issue. The scale cut-points and MIDs should prove useful in targeting those most in need of treatment, monitoring treatment response, and interpreting existing and future research findings.

Interfering with theories of sleep and memory: sleep, declarative memory, and associative interference.

PubMed

Ellenbogen, Jeffrey M; Hulbert, Justin C; Stickgold, Robert; Dinges, David F; Thompson-Schill, Sharon L

2006-07-11

Mounting behavioral evidence in humans supports the claim that sleep leads to improvements in recently acquired, nondeclarative memories. Examples include motor-sequence learning; visual-discrimination learning; and perceptual learning of a synthetic language. In contrast, there are limited human data supporting a benefit of sleep for declarative (hippocampus-mediated) memory in humans (for review, see). This is particularly surprising given that animal models (e.g.,) and neuroimaging studies (e.g.,) predict that sleep facilitates hippocampus-based memory consolidation. We hypothesized that we could unmask the benefits of sleep by challenging the declarative memory system with competing information (interference). This is the first study to demonstrate that sleep protects declarative memories from subsequent associative interference, and it has important implications for understanding the neurobiology of memory consolidation.

The analgesic effect of therapeutic rTMS is not mediated or predicted by comorbid psychiatric or sleep disorders

PubMed Central

Lindholm, Pauliina; Lamusuo, Salla; Taiminen, Tero; Virtanen, Arja; Pertovaara, Antti; Forssell, Heli; Hagelberg, Nora; Jääskeläinen, Satu

2016-01-01

Abstract Background: Mechanisms underlying alleviation of neuropathic pain by repetitive transcranial magnetic stimulation (rTMS) of primary motor cortex (M1) and right secondary somatosensory cortex (S2) are only partly known. Patients with chronic neuropathic pain often have comorbidities like depression and sleep problems. Through functional connectivity, rTMS of M1 and S2 may activate dorsolateral prefrontal cortex, the target for treating depression with rTMS. Thus, the analgesic effect of rTMS could be mediated indirectly via improvement of psychiatric comorbidities or sleep. We examined whether rTMS has an independent analgesic effect or whether its clinical benefits depend on effects on mood or sleep. We also evaluated if comorbid psychiatric or sleep disorders predict the treatment outcome. Methods: Sixteen patients with chronic drug-resistant neuropathic orofacial pain participated in this randomized controlled crossover rTMS study. Patients’ psychiatric history was evaluated by a specialist in psychiatry. Intensity and interference of pain, mood, and the quality of sleep and life were evaluated at baseline and after 2 active (primary somatosensory cortex [S1]/M1 and S2) and placebo rTMS treatments. A logistic regression analysis was done to investigate predictors of treatment outcome. Results: The analgesic effect of the right S2 stimulation was not associated with improvement of psychiatric conditions or sleep, whereas S1/M1 stimulation improved sleep without significant analgesic effect (P = 0.013–0.046 in sleep scores). Psychiatric and sleep disorders were more common in patients than in the general population (P = 0.000–0.001 in sleep scores), but these comorbidities did not predict the rTMS treatment outcome. Conclusion: We conclude that rTMS to the right S2 does not exert its beneficial analgesic effects in chronic neuropathic orofacial pain via indirect improvement of comorbid psychiatric or sleep disorders. PMID:27858874

Positive Affect and Pain: Mediators of the Within-Day Relation Linking Sleep Quality to Activity Interference in Fibromyalgia

PubMed Central

Kothari, Dhwani J.; Davis, Mary C.; Yeung, Ellen W.; Tennen, Howard A.

2017-01-01

Fibromyalgia (FM) is a chronic pain condition often resulting in functional impairments. Nonrestorative sleep is a prominent symptom of FM that is related to disability, but the day-to-day mechanisms relating the prior night’s sleep quality to next day reports of disability have not been examined. The current study examined the within-day relations among early-morning reports of sleep quality last night, late-morning reports of pain and positive and negative affect, and end-of-day reports of activity interference. Specifically, we tested whether pain, positive affect, and negative affect mediated the association between sleep quality and subsequent activity interference. Data were drawn from electronic diary reports, collected from 220 FM patients for 21 consecutive days. The direct and mediated effects at the within-person level were estimated with Multilevel Structural Equation Modeling. Results showed that pain and positive affect mediated the relation between sleep quality and activity interference. Early-morning reports of poor sleep quality last night predicted elevated levels of pain and lower levels of positive affect at late-morning, which, in turn, predicted elevated end-of-day activity interference. Of note, positive affect was a stronger mediator than pain, and negative affect was not a significant mediator. In summary, the findings identify two parallel mechanisms, pain and positive affect, through which the prior night’s sleep quality predicts disability the next day in FM patients. Further, results highlight the potential utility of boosting positive affect following a poor night’s sleep as one means of preserving daily function in FM. PMID:25679472

Relationship between pain relief, reduction in pain-associated sleep interference, and overall impression of improvement in patients with postherpetic neuralgia treated with extended-release gabapentin.

PubMed

Mehta, Neel; Bucior, Iwona; Bujanover, Shay; Shah, Rajiv; Gulati, Amitabh

2016-04-01

Postherpetic neuralgia (PHN) interferes with patients' quality of life, and disturbed sleep is a prevalent complaint. Pain-associated sleep interference in turn enhances pain and/or reduces pain tolerance. Therefore, reducing sleep interference by pain, in addition to pain control, may improve patient care. To address this notion, we characterized relationships among changes in pain intensity, sleep interference, and overall impression of improvement in PHN patients treated with gastroretentive gabapentin (G-GR). Patients with PHN (n = 556) received G-GR 1,800 mg once-daily in two phase 3 and one phase 4 study. Visual Analog Scale (VAS) and Brief Pain Inventory (BPI) were completed at baseline and the end of study. Patients' Global Impression of Change (PGIC) was completed at the end of study. Regression analyses examined relationships between VAS, BPI sleep interference by pain, and PGIC. At the end of treatment, 53.7 and 63.2 % of patients reported a ≥ 30 % reduction in VAS and BPI pain-associated sleep interference (BPISI) respectively; 46.3 % reported feeling "Much" or "Very Much" improved on the PGIC. There were positive correlations between the percent reductions in VAS and BPISI; both correlated with PGIC improvements. Percent changes in VAS and BPISI were significant (p < 0.0001 and p = 0.0082, respectively), and were independent predictors of feeling "Much" or "Very Much" improved on the PGIC. Reductions in pain intensity and in BPISI were correlated, and both also correlated with overall impression of improvement for patients with PHN treated with G-GR. Both pain relief and improvement BPISI independently predicted improvement in PGIC. For optimal patient care, clinicians should consider reducing the impact of pain on quality of sleep as well as overall pain reduction. ClinicalTrials.gov numbers, NCT00335933 , NCT00636636 , NCT01426230.

Susceptibility to declarative memory interference is pronounced in primary insomnia.

PubMed

Griessenberger, Hermann; Heib, Dominik P J; Lechinger, Julia; Luketina, Nikolina; Petzka, Marit; Moeckel, Tina; Hoedlmoser, Kerstin; Schabus, Manuel

2013-01-01

Sleep has been shown to stabilize memory traces and to protect against competing interference in both the procedural and declarative memory domain. Here, we focused on an interference learning paradigm by testing patients with primary insomnia (N = 27) and healthy control subjects (N = 21). In two separate experimental nights with full polysomnography it was revealed that after morning interference procedural memory performance (using a finger tapping task) was not impaired in insomnia patients while declarative memory (word pair association) was decreased following interference. More specifically, we demonstrate robust associations of central sleep spindles (in N3) with motor memory susceptibility to interference as well as (cortically more widespread) fast spindle associations with declarative memory susceptibility. In general the results suggest that insufficient sleep quality does not necessarily show up in worse overnight consolidation in insomnia but may only become evident (in the declarative memory domain) when interference is imposed.

Cognitive effects of exogenous melatonin administration in elderly persons: a pilot study.

PubMed

Peck, Joel S; LeGoff, Daniel B; Ahmed, Iqbal; Goebert, Deborah

2004-01-01

Given that circadian rhythm disruption is associated with impairments in cognitive performance similar to those found in age-related cognitive decline, the authors investigated whether exogenous melatonin administration would improve cognitive functioning in healthy elderly subjects. This double-blind, placebo-controlled pilot study assigned 26 healthy elderly subjects to receive either melatonin 1 mg or placebo nightly for 4 weeks. Participants completed a sleep questionnaire and a battery of cognitive tests at baseline and at 4 weeks. Melatonin administration improved reported morning "restedness" and sleep latency after nocturnal awakening, and also improved scores on the California Verbal Learning Test-interference subtest. Melatonin administration at a dose of 1 mg nightly may be effective in improving certain aspects of cognitive functioning and subjective reports of sleep quality in elderly subjects. It may prove to be a useful therapeutic agent in the treatment of age-related cognitive decline.

Sleep disturbance in men receiving androgen deprivation therapy for prostate cancer: The role of hot flashes and nocturia.

PubMed

Gonzalez, Brian D; Small, Brent J; Cases, Mallory G; Williams, Noelle L; Fishman, Mayer N; Jacobsen, Paul B; Jim, Heather S L

2018-02-01

Patients with prostate cancer receiving androgen deprivation therapy (ADT) are at risk of sleep disturbance; however, to the authors' knowledge, the mechanisms by which ADT may affect sleep are not well understood. The current study compared objective and subjective sleep disturbance in ADT recipients and controls and examined whether sleep disturbance in ADT recipients is attributable to the influence of ADT on hot flashes and nocturia. Patients with prostate cancer were assessed before or within 1 month after the initiation of ADT as well as 6 months and 12 months later (78 patients). Patients with prostate cancer were treated with prostatectomy only (99 patients) and men with no history of cancer (108 men) were assessed at similar intervals. Participants self-reported their sleep disturbance (Insomnia Severity Index) and interference from hot flashes (Hot Flash Related Daily Interference Scale). One hundred participants also wore actigraphs for 3 days at the 6-month assessment to measure objective sleep disturbance and reported their nocturia frequency. ADT recipients reported worse sleep disturbance, higher rates of clinically significant sleep disturbance, and greater hot flash interference than controls (Ps≤.03). In cross-sectional analyses among those with actigraphy data, ADT recipients had greater objective sleep disturbance and more episodes of nocturia (Ps<.01). Cross-sectional mediation analyses demonstrated that the association between ADT and objectively and subjectively measured sleep disturbance was partly attributable to nocturia and hot flashes (Ps<.05). The results of the current study suggest that the association between ADT and sleep may be partly explained by nocturia and hot flash interference. Future studies should examine behavioral and pharmacologic interventions to address these symptoms among ADT recipients. Cancer 2018;124:499-506. © 2017 American Cancer Society. © 2017 American Cancer Society.

Effects of Sleep Deprivation on Color-Word, Emotional, and Specific Stroop Interference and on Self-Reported Anxiety

ERIC Educational Resources Information Center

Sagaspe, Patricia; Sanchez-Ortuno, Montserrat; Charles, Andre; Taillard, Jacques; Valtat, Cedric; Bioulac, Bernard; Philip, Pierre

2006-01-01

The aim of this study was principally to assess the impact of sleep deprivation on interference performance in short Stroop tasks (Color-Word, Emotional, and Specific) and on subjective anxiety. Subjective sleepiness and performance on a psychomotor sustained attention task were also investigated to validate our protocol of sleep deprivation.…

Sleep Tips: 7 Steps to Better Sleep

MedlinePlus

... turn every night. Consider simple tips for better sleep, from setting a sleep schedule to including physical activity in your daily ... factors that can interfere with a good night's sleep — from work stress and family responsibilities to unexpected ...

No effect of odor-induced memory reactivation during REM sleep on declarative memory stability

PubMed Central

Cordi, Maren J.; Diekelmann, Susanne; Born, Jan; Rasch, Björn

2014-01-01

Memory reactivations in hippocampal brain areas are critically involved in memory consolidation processes during sleep. In particular, specific firing patterns of hippocampal place cells observed during learning are replayed during subsequent sleep and rest in rodents. In humans, experimentally inducing hippocampal memory reactivations during slow-wave sleep (but not during wakefulness) benefits consolidation and immediately stabilizes declarative memories against future interference. Importantly, spontaneous hippocampal replay activity can also be observed during rapid eye movement (REM) sleep and some authors have suggested that replay during REM sleep is related to processes of memory consolidation. However, the functional role of reactivations during REM sleep for memory stability is still unclear. Here, we reactivated memories during REM sleep and examined its consequences for the stability of declarative memories. After 3 h of early, slow-wave sleep (SWS) rich sleep, 16 healthy young adults learned a 2-D object location task in the presence of a contextual odor. During subsequent REM sleep, participants were either re-exposed to the odor or to an odorless vehicle, in a counterbalanced within subject design. Reactivation was followed by an interference learning task to probe memory stability after awakening. We show that odor-induced memory reactivation during REM sleep does not stabilize memories against future interference. We propose that the beneficial effect of reactivation during sleep on memory stability might be critically linked to processes characterizing SWS including, e.g., slow oscillatory activity, sleep spindles, or low cholinergic tone, which are required for a successful redistribution of memories from medial temporal lobe regions to neocortical long-term stores. PMID:25225474

Chronic insufficient sleep and diet quality: Contributors to childhood obesity.

PubMed

Cespedes, Elizabeth M; Hu, Frank B; Redline, Susan; Rosner, Bernard; Gillman, Matthew W; Rifas-Shiman, Sheryl L; Taveras, Elsie M

2016-01-01

To examine associations of chronic insufficient sleep with diet and whether diet explains the sleep-adiposity relationship. In Project Viva, 1,046 parents reported children's sleep duration at 6 m and annually until midchildhood (7 y). The main exposure was a sleep curtailment score (6 m-7 y) ranging from 0 (maximal curtailment) to 13 (adequate sleep). In mid-childhood, parents reported children's diet; researchers measured height/weight. Multivariable linear regression assessed associations of sleep with diet (Youth Healthy Eating Index [YHEI]); sleep with BMI z-score adjusting for YHEI; and, secondarily, joint associations of sleep and YHEI with BMI. Mean (SD) sleep and YHEI scores were 10.21 (2.71) and 58.76 (10.37). Longer sleep duration was associated with higher YHEI in mid-childhood (0.59 points/unit sleep score; 95% CI: 0.32, 0.86). Although higher YHEI was associated with lower BMI z-score (-0.07 units/10-point increase; 95% CI: -0.13, -0.01), adjustment for YHEI did not attenuate sleep-BMI associations. Children with sleep and YHEI scores below the median (<11 and <60) had BMI z-scores 0.34 units higher (95% CI: 0.16, 0.51) than children with sleep and YHEI scores above the median. While parent-reported diet did not explain inverse associations of sleep with adiposity, both sufficient sleep and high-quality diets are important to obesity prevention. © 2015 The Obesity Society.

Semantic congruence reverses effects of sleep restriction on associative encoding.

PubMed

Alberca-Reina, Esther; Cantero, Jose L; Atienza, Mercedes

2014-04-01

Encoding and memory consolidation are influenced by factors such as sleep and congruency of newly learned information with prior knowledge (i.e., schema). However, only a few studies have examined the contribution of sleep to enhancement of schema-dependent memory. Based on previous studies showing that total sleep deprivation specifically impairs hippocampal encoding, and that coherent schemas reduce the hippocampal consolidation period after learning, we predict that sleep loss in the pre-training night will mainly affect schema-unrelated information whereas sleep restriction in the post-training night will have similar effects on schema-related and unrelated information. Here, we tested this hypothesis by presenting participants with face-face associations that could be semantically related or unrelated under different sleep conditions: normal sleep before and after training, and acute sleep restriction either before or after training. Memory was tested one day after training, just after introducing an interference task, and two days later, without any interference. Significant results were evident on the second retesting session. In particular, sleep restriction before training enhanced memory for semantically congruent events in detriment of memory for unrelated events, supporting the specific role of sleep in hippocampal memory encoding. Unexpectedly, sleep restriction after training enhanced memory for both related and unrelated events. Although this finding may suggest a poorer encoding during the interference task, this hypothesis should be specifically tested in future experiments. All together, the present results support a framework in which encoding processes seem to be more vulnerable to sleep loss than consolidation processes. Copyright © 2014 Elsevier Inc. All rights reserved.

Computer-Assisted Automated Scoring of Polysomnograms Using the Somnolyzer System.

PubMed

Punjabi, Naresh M; Shifa, Naima; Dorffner, Georg; Patil, Susheel; Pien, Grace; Aurora, Rashmi N

2015-10-01

Manual scoring of polysomnograms is a time-consuming and tedious process. To expedite the scoring of polysomnograms, several computerized algorithms for automated scoring have been developed. The overarching goal of this study was to determine the validity of the Somnolyzer system, an automated system for scoring polysomnograms. The analysis sample comprised of 97 sleep studies. Each polysomnogram was manually scored by certified technologists from four sleep laboratories and concurrently subjected to automated scoring by the Somnolyzer system. Agreement between manual and automated scoring was examined. Sleep staging and scoring of disordered breathing events was conducted using the 2007 American Academy of Sleep Medicine criteria. Clinical sleep laboratories. A high degree of agreement was noted between manual and automated scoring of the apnea-hypopnea index (AHI). The average correlation between the manually scored AHI across the four clinical sites was 0.92 (95% confidence interval: 0.90-0.93). Similarly, the average correlation between the manual and Somnolyzer-scored AHI values was 0.93 (95% confidence interval: 0.91-0.96). Thus, interscorer correlation between the manually scored results was no different than that derived from manual and automated scoring. Substantial concordance in the arousal index, total sleep time, and sleep efficiency between manual and automated scoring was also observed. In contrast, differences were noted between manually and automated scored percentages of sleep stages N1, N2, and N3. Automated analysis of polysomnograms using the Somnolyzer system provides results that are comparable to manual scoring for commonly used metrics in sleep medicine. Although differences exist between manual versus automated scoring for specific sleep stages, the level of agreement between manual and automated scoring is not significantly different than that between any two human scorers. In light of the burden associated with manual scoring, automated scoring platforms provide a viable complement of tools in the diagnostic armamentarium of sleep medicine. © 2015 Associated Professional Sleep Societies, LLC.

PROMIS®-29 v2.0 profile physical and mental health summary scores.

PubMed

Hays, Ron D; Spritzer, Karen L; Schalet, Benjamin D; Cella, David

2018-03-22

The PROMIS-29 v2.0 profile assesses pain intensity using a single 0-10 numeric rating item and seven health domains (physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance) using four items per domain. This paper describes the development of physical and mental health summary scores for the PROMIS-29 v2.0. We conducted factor analyses of PROMIS-29 scales on data collected from two internet panels (n = 3000 and 2000). Confirmatory factor analyses provided support for a physical health factor defined by physical function, pain (interference and intensity), and ability to participate in social roles and activities, and a mental health factor defined primarily by emotional distress (anxiety and depressive symptoms). Reliabilities for these two summary scores were 0.98 (physical health) and 0.97 (mental health). Correlations of the PROMIS-29 v2.0 physical and mental health summary scores with chronic conditions and other health-related quality of life measures were consistent with a priori hypotheses. This study develops and provides preliminary evidence supporting the reliability and validity of PROMIS-29 v2.0 physical and mental health summary scores that can be used in future studies to assess impacts of health care interventions and track changes in health over time. Further evaluation of these and alternative summary measures is recommended.

Sleep Hygiene and Sleep Quality of Third-Trimester Pregnant Women.

PubMed

Tsai, Shao-Yu; Lee, Chien-Nan; Wu, Wei-Wen; Landis, Carol A

2016-02-01

The purpose of this descriptive study was to examine the associations of sleep hygiene and actigraphy measures of sleep with self-reported sleep quality in 197 pregnant women in northern Taiwan. Third-trimester pregnant women completed the Sleep Hygiene Practice Scale (SHPS) and the Pittsburgh Sleep Quality Index (PSQI) as well as the Center for Epidemiologic Studies-Depression Scale (CES-D), and wore an actigraph for 7 consecutive days. Student's t-test was used to compare the SHPS scores and means as well as variability of actigraphy sleep variables between poor sleepers (i.e., PSQI global score >5) and good sleepers (i.e., PSQI global score ≤5). Compared to good sleepers, poor sleepers reported significantly worse sleep hygiene, with higher SHPS scores and higher sleep schedule, arousal-related behavior, and sleep environment subscale scores. Poor sleepers had significantly greater intra-individual variability of sleep onset latency, total nighttime sleep, and wake after sleep onset than good sleepers. In stepwise linear regression, older maternal age (p = .01), fewer employment hours per week (p = .01), higher CES-D total score (p < .01), and higher SHPS arousal-related behavior subscale scores (p < .01) predicted self-reported global sleep quality. Findings support avoiding physically, physiologically, emotionally, or cognitively arousing activities before bedtime as a target for sleep-hygiene intervention in women during pregnancy. © 2015 Wiley Periodicals, Inc.

Computer-Assisted Automated Scoring of Polysomnograms Using the Somnolyzer System

PubMed Central

Punjabi, Naresh M.; Shifa, Naima; Dorffner, Georg; Patil, Susheel; Pien, Grace; Aurora, Rashmi N.

2015-01-01

Study Objectives: Manual scoring of polysomnograms is a time-consuming and tedious process. To expedite the scoring of polysomnograms, several computerized algorithms for automated scoring have been developed. The overarching goal of this study was to determine the validity of the Somnolyzer system, an automated system for scoring polysomnograms. Design: The analysis sample comprised of 97 sleep studies. Each polysomnogram was manually scored by certified technologists from four sleep laboratories and concurrently subjected to automated scoring by the Somnolyzer system. Agreement between manual and automated scoring was examined. Sleep staging and scoring of disordered breathing events was conducted using the 2007 American Academy of Sleep Medicine criteria. Setting: Clinical sleep laboratories. Measurements and Results: A high degree of agreement was noted between manual and automated scoring of the apnea-hypopnea index (AHI). The average correlation between the manually scored AHI across the four clinical sites was 0.92 (95% confidence interval: 0.90–0.93). Similarly, the average correlation between the manual and Somnolyzer-scored AHI values was 0.93 (95% confidence interval: 0.91–0.96). Thus, interscorer correlation between the manually scored results was no different than that derived from manual and automated scoring. Substantial concordance in the arousal index, total sleep time, and sleep efficiency between manual and automated scoring was also observed. In contrast, differences were noted between manually and automated scored percentages of sleep stages N1, N2, and N3. Conclusion: Automated analysis of polysomnograms using the Somnolyzer system provides results that are comparable to manual scoring for commonly used metrics in sleep medicine. Although differences exist between manual versus automated scoring for specific sleep stages, the level of agreement between manual and automated scoring is not significantly different than that between any two human scorers. In light of the burden associated with manual scoring, automated scoring platforms provide a viable complement of tools in the diagnostic armamentarium of sleep medicine. Citation: Punjabi NM, Shifa N, Dorffner G, Patil S, Pien G, Aurora RN. Computer-assisted automated scoring of polysomnograms using the Somnolyzer system. SLEEP 2015;38(10):1555–1566. PMID:25902809

Effect of mandibular advancement device on sleep bruxism score and sleep quality.

PubMed

Solanki, Nehal; Singh, Balendra Pratap; Chand, Pooran; Siddharth, Ramashankar; Arya, Deeksha; Kumar, Lakshya; Tripathi, Suryakant; Jivanani, Hemant; Dubey, Abhishek

2017-01-01

The use of mandibular advancement devices (MADs) in the treatment of sleep bruxism is gaining widespread importance. However, the effects of MADs on sleep bruxism scores, sleep quality, and occlusal force are not clear. The purpose of this clinical study was to analyze the effect of MADs on sleep bruxism scores, sleep quality, and occlusal force. This uncontrolled before and after study enrolled 30 participants with sleep bruxism. Outcomes assessed were sleep quality, sleep bruxism scores (sleep bruxism bursts and sleep bruxism episodes/hour), and occlusal force before and after 15 and 30 days of using a MAD. Sleep bruxism scores were assessed by ambulatory polysomnography and sleep quality by using the Pittsburgh sleep quality index (PSQI). Occlusal force was recorded by using a digital gnathodynamometer in the first molar region on both sides. Statistical analysis was done by 1-factor repeated measures ANOVA (α=.05). Statistically significant reductions in sleep bruxism bursts/h, sleep bruxism episodes/h, and PSQI scores were found after 15 and 30 days of using a MAD (P<.001). Statistically significant reduction in occlusal force on both sides was found only after 15 days (P<.001) but not after 30 days of using a MAD (P=.292 on left side, and P=.575 on the right side). The study showed a short-term improvement in sleep bruxism scores, sleep quality, and reduction in occlusal force in sleep bruxism participants after using MADs. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Efficacy of Sleep Tool Education During Hospitalization: A Randomized Controlled Trial.

PubMed

Farrehi, Peter M; Clore, Kristen R; Scott, J Ryan; Vanini, Giancarlo; Clauw, Daniel J

2016-12-01

Patients are commonly provided tools in the hospital to overcome poor sleep. Whether education on use of sleep tools can impact health outcomes from a patient perspective is not known. We recruited 120 adults admitted to a nonintensive care unit cardiac-monitored floor. All patients received a set of sleep-enhancing tools (eye mask, ear plugs, and a white noise machine) and were randomized to receive direct education on use of and benefit of these sleep-enhancing tools (intervention), or an equal amount of time was spent discussing general benefits of sleep (control). Measurement of several symptom domains was assessed daily by health outcome survey responses, and change from baseline was assessed for differences between groups. Inpatient opioid use and length of stay were also measured. Participants randomized to receive the education intervention had a significantly greater decrease in fatigue scores over the 3 days, compared with controls (5.30 ± 6.93 vs 1.81 ± 6.96, t = 2.32, P = .028). There was a trend toward improvements in multiple other sleep-related domains, including sleep disturbance, sleep-related impairment, physical functioning, pain severity, or pain interference (all P >.140). There was no difference in length of stay between intervention and control groups (7.40 ± 7.29 vs 7.71 ± 6.06 days, P = .996). The change in number of opioid equivalents taken did not differ use between the groups (P = .688). In a randomized trial of education in the use of sleep-enhancing tools while hospitalized, patient fatigue was significantly improved, whereas several other patient-reported outcomes showed a trend toward improvements. Implementation of this very low-cost approach to improving sleep and well-being could substantially improve the patient care experience. Copyright © 2016 Elsevier Inc. All rights reserved.

Diaphragm pacing improves sleep in patients with amyotrophic lateral sclerosis.

PubMed

Gonzalez-Bermejo, Jesus; Morélot-Panzini, Capucine; Salachas, François; Redolfi, Stefania; Straus, Christian; Becquemin, Marie-Hélène; Arnulf, Isabelle; Pradat, Pierre-François; Bruneteau, Gaëlle; Ignagni, Anthony R; Diop, Moustapha; Onders, Raymond; Nelson, Teresa; Menegaux, Fabrice; Meininger, Vincent; Similowski, Thomas

2012-01-01

In amyotrophic lateral sclerosis (ALS) patients, respiratory insufficiency is a major burden. Diaphragm conditioning by electrical stimulation could interfere with lung function decline by promoting the development of type 1 muscle fibres. We describe an ancillary study to a prospective, non-randomized trial (NCT00420719) assessing the effects of diaphragm pacing on forced vital capacity (FVC). Sleep-related disturbances being early clues to diaphragmatic dysfunction, we postulated that they would provide a sensitive marker. Stimulators were implanted laparoscopically in the diaphragm close to the phrenic motor point in 18 ALS patients for daily conditioning. ALS functioning score (ALSFRS), FVC, sniff nasal inspiratory pressure (SNIP), and polysomnographic recordings (PSG, performed with the stimulator turned off) were assessed before implantation and after four months of conditioning (n = 14). Sleep efficiency improved (69 ± 15% to 75 ± 11%, p = 0.0394) with fewer arousals and micro-arousals. This occurred against a background of deterioration as ALSFRS-R, FVC, and SNIP declined. There was, however, no change in NIV status or the ALSFRS respiratory subscore, and the FVC decline was mostly due to impaired expiration. Supporting a better diaphragm function, apnoeas and hypopnoeas during REM sleep decreased. In conclusion, in these severe patients not expected to experience spontaneous improvements, diaphragm conditioning improved sleep and there were hints at diaphragm function changes.

Free Recall of Word Lists under Total Sleep Deprivation and after Recovery Sleep

PubMed Central

de Almeida Valverde Zanini, Gislaine; Tufik, Sérgio; Andersen, Monica Levy; da Silva, Raquel Cristina Martins; Bueno, Orlando Francisco Amodeo; Rodrigues, Camila Cruz; Pompéia, Sabine

2012-01-01

Study Objectives: One task that has been used to assess memory effects of prior total sleep deprivation (TSD) is the immediate free recall of word lists; however, results have been mixed. A possible explanation for this is task impurity, since recall of words from different serial positions reflects use of distinct types of memory (last words: short-term memory; first and intermediate words: episodic memory). Here we studied the effects of 2 nights of TSD on immediate free recall of semantically unrelated word lists considering the serial position curve. Design: Random allocation to a 2-night TSD protocol followed by one night of recovery sleep or to a control group. Setting: Study conducted under continuous behavioral monitoring. Participants: 24 young, healthy male volunteers. Intervention: 2 nights of total sleep deprivation (TSD) and one night of recovery sleep. Measurements and Results: Participants were shown five 15 unrelated word-lists at baseline, after one and 2 nights of TSD, and after one night of recovery sleep. We also investigated the development of recall strategies (learning) and susceptibility to interference from previous lists. No free recall impairment occurred during TSD, irrespective of serial position. Interference was unchanged. Both groups developed recall strategies, but task learning occurred earlier in controls and was evident in the TSD group only after sleep recovery. Conclusion: Prior TSD spared episodic memory, short-term phonological memory, and interference, allowed the development of recall strategies, but may have decreased the advantage of using these strategies, which returned to normal after recovery sleep. Citation: Zanini GAV; Tufik S; Andersen ML; da Silva RCM; Bueno OFA; Rodrigues CC; Pompéia S. Free recall of word lists under total sleep deprivation and after recovery sleep. SLEEP 2012;35(2):223-230. PMID:22294812

Longitudinal associations of sleep curtailment with metabolic risk in mid-childhood.

PubMed

Cespedes, Elizabeth M; Rifas-Shiman, Sheryl L; Redline, Susan; Gillman, Matthew W; Peña, Michelle-Marie; Taveras, Elsie M

2014-12-01

To examine associations of chronic insufficient sleep with mid-childhood cardiometabolic health. At 6 months and yearly from 1 to 7 years, mothers participating in the Project Viva cohort reported children's 24-h sleep duration. The main exposure was a sleep curtailment score, ranging from 0 (maximal curtailment) to 13 (never having curtailed sleep). The main outcome was a mid-childhood metabolic risk score, derived as the mean of five sex- and cohort-specific z scores for waist circumference, systolic blood pressure, HDL cholesterol (scaled inversely), and log-transformed triglycerides and HOMA-IR; higher scores indicate higher risk. The mean (SD) sleep score was 10.0 (2.8); 5.1% scored 0-4, 13.9% scored 5-7, 14.1% scored 8-9, 28.7% scored 10-11, and 38.3% scored 12-13. Mean (SD, range) metabolic risk score was -0.03 (0.6, -1.8 to 2.6). In multivariable models, the metabolic risk score difference for children with most versus least curtailed sleep was 0.29 units (95% confidence interval [CI]: 0.02, 0.57). Further adjustment for mid-childhood BMI z score attenuated this difference to 0.08 units (95% CI: -0.14, 0.30). Chronic insufficient sleep from infancy to school-age was associated with higher mid-childhood metabolic risk. This association was explained by sleep duration's influence on mid-childhood adiposity. © 2014 The Obesity Society.

Free recall of word lists under total sleep deprivation and after recovery sleep.

PubMed

de Almeida Valverde Zanini, Gislaine; Tufik, Sérgio; Andersen, Monica Levy; da Silva, Raquel Cristina Martins; Bueno, Orlando Francisco Amodeo; Rodrigues, Camila Cruz; Pompéia, Sabine

2012-02-01

One task that has been used to assess memory effects of prior total sleep deprivation (TSD) is the immediate free recall of word lists; however, results have been mixed. A possible explanation for this is task impurity, since recall of words from different serial positions reflects use of distinct types of memory (last words: short-term memory; first and intermediate words: episodic memory). Here we studied the effects of 2 nights of TSD on immediate free recall of semantically unrelated word lists considering the serial position curve. Random allocation to a 2-night TSD protocol followed by one night of recovery sleep or to a control group. Study conducted under continuous behavioral monitoring. 24 young, healthy male volunteers. 2 nights of total sleep deprivation (TSD) and one night of recovery sleep. Participants were shown five 15 unrelated word-lists at baseline, after one and 2 nights of TSD, and after one night of recovery sleep. We also investigated the development of recall strategies (learning) and susceptibility to interference from previous lists. No free recall impairment occurred during TSD, irrespective of serial position. Interference was unchanged. Both groups developed recall strategies, but task learning occurred earlier in controls and was evident in the TSD group only after sleep recovery. Prior TSD spared episodic memory, short-term phonological memory, and interference, allowed the development of recall strategies, but may have decreased the advantage of using these strategies, which returned to normal after recovery sleep.

An automated sleep-state classification algorithm for quantifying sleep timing and sleep-dependent dynamics of electroencephalographic and cerebral metabolic parameters

PubMed Central

Rempe, Michael J; Clegern, William C; Wisor, Jonathan P

2015-01-01

Introduction Rodent sleep research uses electroencephalography (EEG) and electromyography (EMG) to determine the sleep state of an animal at any given time. EEG and EMG signals, typically sampled at >100 Hz, are segmented arbitrarily into epochs of equal duration (usually 2–10 seconds), and each epoch is scored as wake, slow-wave sleep (SWS), or rapid-eye-movement sleep (REMS), on the basis of visual inspection. Automated state scoring can minimize the burden associated with state and thereby facilitate the use of shorter epoch durations. Methods We developed a semiautomated state-scoring procedure that uses a combination of principal component analysis and naïve Bayes classification, with the EEG and EMG as inputs. We validated this algorithm against human-scored sleep-state scoring of data from C57BL/6J and BALB/CJ mice. We then applied a general homeostatic model to characterize the state-dependent dynamics of sleep slow-wave activity and cerebral glycolytic flux, measured as lactate concentration. Results More than 89% of epochs scored as wake or SWS by the human were scored as the same state by the machine, whether scoring in 2-second or 10-second epochs. The majority of epochs scored as REMS by the human were also scored as REMS by the machine. However, of epochs scored as REMS by the human, more than 10% were scored as SWS by the machine and 18 (10-second epochs) to 28% (2-second epochs) were scored as wake. These biases were not strain-specific, as strain differences in sleep-state timing relative to the light/dark cycle, EEG power spectral profiles, and the homeostatic dynamics of both slow waves and lactate were detected equally effectively with the automated method or the manual scoring method. Error associated with mathematical modeling of temporal dynamics of both EEG slow-wave activity and cerebral lactate either did not differ significantly when state scoring was done with automated versus visual scoring, or was reduced with automated state scoring relative to manual classification. Conclusions Machine scoring is as effective as human scoring in detecting experimental effects in rodent sleep studies. Automated scoring is an efficient alternative to visual inspection in studies of strain differences in sleep and the temporal dynamics of sleep-related physiological parameters. PMID:26366107

Vasomotor and physical menopausal symptoms are associated with sleep quality.

PubMed

Kim, Min-Ju; Yim, Gyeyoon; Park, Hyun-Young

2018-01-01

Sleep disturbance is one of the common complaints in menopause. This study investigated the relationship between menopausal symptoms and sleep quality in middle-aged women. This cross-sectional observational study involved 634 women aged 44-56 years attending a healthcare center at Kangbuk Samsung Hospitals. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).Multiple linear regression analysis was performed to assess the associations between Menopause-specific Quality of Life (MENQOL) scores and PSQI scores and Menopause-specific Quality of Life (MENQOL)scores. The mean PSQI score was 3.6±2.3, and the rates of poor sleep quality(PSQI score > 5) in premenopausal, perimenopausal, and postmenopausal women were 14.4%, 18.2%, and 30.2%, respectively. Total PSQI score, specifically the sleep latency, habitual sleep efficiency and sleep disturbances scores, were significantly increased in postmenopausal women. Multiple linear regression analysis adjusted for age, BMI, hypertension, diabetes, smoking, marital status, family income, education, employment status, parity, physical activity, depression symptoms, perceived stress and menopausal status showed that higher PSQI score was positively correlated with higher vasomotor(ß = 0.240, P = 0.020)and physical(ß = 0.572, P<0.001) scores. Vasomotor and physical menopause symptoms was related to poor sleep quality. Effective management strategies aimed at reducing menopausal symptoms may improve sleep quality among women around the time of menopause.

The American Academy of Sleep Medicine Inter-scorer Reliability Program: Sleep Stage Scoring

PubMed Central

Rosenberg, Richard S.; Van Hout, Steven

2013-01-01

Study Objectives: The program provides a unique opportunity to compare a large number of scorers with varied levels of experience to determine sleep stage scoring agreement. The objective is to examine areas of disagreement to inform future revisions of the AASM Manual for the Scoring of Sleep and Associated Events. Methods: The sample included 9 record fragments, 1,800 epochs and more than 3,200,000 scoring decisions. More than 2,500 scorers, most with 3 or more years of experience, participated. The analysis determined agreement with the score chosen by the majority of scorers. Results: Sleep stage agreement averaged 82.6%. Agreement was highest for stage R sleep with stages N2 and W approaching the same level. Scoring agreement for stage N3 sleep was 67.4% and was lowest for stage N1 at 63.0%. Scorers had particular difficulty with the last epoch of stage W before sleep onset, the first epoch of stage N2 after stage N1 and the first epoch of stage R after stage N2. Discrimination between stages N2 and N3 was particularly difficult for scorers. Conclusions: These findings suggest that with current rules, inter-scorer agreement in a large group is approximately 83%, a level similar to that reported for agreement between expert scorers. Agreement in the scoring of stages N1 and N3 sleep was low. Modifications to the scoring rules to improve scoring during sleep stage transitions may result in improvement. Commentary: A commentary on this article appears in this issue on page 89. Citation: Rosenberg RS; Van Hout S. The American Academy of Sleep Medicine inter-scorer reliability program: sleep stage scoring. J Clin Sleep Med 2013;9(1):81–87. PMID:23319910

Association between sleep stages and hunger scores in 36 children.

PubMed

Arun, R; Pina, P; Rubin, D; Erichsen, D

2016-10-01

Childhood obesity is a growing health challenge. Recent studies show that children with late bedtime and late awakening are more obese independent of total sleep time. In adolescents and adults, a delayed sleep phase has been associated with higher caloric intake. Furthermore, an adult study showed a positive correlation between REM sleep and energy balance. This relationship has not been demonstrated in children. However, it may be important as a delayed sleep phase would increase the proportion of REM sleep. This study investigated the relationship between hunger score and sleep physiology in a paediatric population. Thirty-six patients referred for a polysomnogram for suspected obstructive sleep apnoea were enrolled in the study. Sleep stages were recorded as part of the polysomnogram. Hunger scores were obtained using a visual analogue scale. Mean age was 9.6 ± 3.5 years. Mean hunger scores were 2.07 ± 2.78. Hunger scores were positively correlated with percentage of total rapid eye movement (REM) sleep (r = 0.438, P < 0.01) and REM sleep duration in minutes (r = 0.471, P < 0.05). Percentage slow wave sleep (SWS) was negatively correlated with hunger score (r = -0.360, P < 0.05). There were no correlations between age, sex, body mass index percentiles, apnoea-hypopnoea index, total sleep time, sleep efficiency, sleep onset latency, stage 2 sleep duration and hunger scores. These findings suggest that delayed bedtime, which increases the proportion of REM sleep and decreases the proportion of SWS, results in higher hunger levels in children. © 2015 World Obesity.

Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity and frequency of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) symptoms in women.

PubMed

Milrad, Sara F; Hall, Daniel L; Jutagir, Devika R; Lattie, Emily G; Ironson, Gail H; Wohlgemuth, William; Nunez, Maria Vera; Garcia, Lina; Czaja, Sara J; Perdomo, Dolores M; Fletcher, Mary Ann; Klimas, Nancy; Antoni, Michael H

2017-02-15

Poor sleep quality has been linked to inflammatory processes and worse disease outcomes in the context of many chronic illnesses, but less is known in conditions such as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). This study examines the relationships between sleep quality, pro-inflammatory cytokines, and CFS/ME symptoms. Sixty women diagnosed with CFS/ME were assessed using the Pittsburgh Sleep Quality Index (PSQI), Fatigue Symptom Inventory (FSI) and Center for Disease Control and Prevention (CDC)-based CFS/ME symptom questionnaires. Circulating plasma pro-inflammatory cytokine levels were measured by ELISA. Multiple regression analyses examined associations between sleep, cytokines and symptoms, controlling for age, education, and body mass index. Poor sleep quality (PSQI global score) was associated with greater pro-inflammatory cytokine levels: interleukin-1β (IL-1β) (β=0.258, p=0.043), IL-6 (β=0.281, p=0.033), and tumor necrosis factor-alpha (TNF-α) (β=0.263, p=0.044). Worse sleep quality related to greater fatigue severity (β=0.395, p=0.003) and fatigue-related interference with daily activities (β=0.464, p<0.001), and more severe and frequent CDC-defined core CFS/ME symptoms (β=0.499, p<0.001, and β=0.556, p<0.001, respectively). Results underscore the importance of managing sleep-related difficulties in this patient population. Further research is needed to identify the etiology of sleep disruptions in CFS/ME and mechanistic factors linking sleep quality to symptom severity and inflammatory processes. Copyright © 2016 Elsevier B.V. All rights reserved.

The Relationship Between Sexual Function and Quality of Sleep in Caregiving Mothers of Sons with Duchenne Muscular Dystrophy

PubMed Central

Nozoe, Karen T; Hachul, Helena; Hirotsu, Camila; Polesel, Daniel N; Moreira, Gustavo A; Tufik, Sergio; Andersen, Monica L

2014-01-01

Introduction The task of the caregiver, especially a caregiving mother of a son with a chronic and fatal disease, may interfere with their quality of sleep, sexuality, and some hormone levels. Aim The aim of this study was to evaluate the sexual function and the quality of sleep of caregiving mothers of sons with Duchenne muscular dystrophy (DMD). Methods We evaluated 20 caregiving mothers of sons with DMD and 20 caregiving mothers of sons without any neuromuscular or chronic disease. All of them voluntarily responded to the evaluating questionnaires about their sexuality and their quality of sleep, and gave blood samples to evaluate their hormonal levels. Main Outcome Measures All mothers were evaluated using the questionnaire of Female Sexual Function Index (FSFI) and the Pittsburgh questionnaire (PSQI). The blood samples were tested to determine serum levels of testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, progesterone, adrenocorticotropic hormone, and cortisol. Results Caregiving mothers of sons with DMD had significantly lower scores in the FSFI questionnaire, suggesting a higher risk for sexual dysfunction. The PSQI demonstrated that these caregiving mothers present increased sleep latency, reduced sleep efficiency, daytime dysfunction, and poor sleep quality. Blood tests showed a rise in cortisol levels, which correlated with the compromised sexuality and quality of sleep. Conclusions This study indicates that caregiving mothers of sons with DMD show major risk for sexual dysfunction and a reduction in their quality of sleep mediated in part by the hormonal changes related to stress. Nozoe KT, Hachul H, Hirotsu C, Polesel DN, Moreira GA, Tufik S, and Andersen ML. The relationship between sexual function and quality of sleep in caregiving mothers of sons with Duchenne muscular dystrophy. Sex Med 2014;2:133–140. PMID:25356310

Examining Initial Sleep Onset in Primary Insomnia: A Case-Control Study Using 4-Second Epochs

PubMed Central

Moul, Douglas E.; Germain, Anne; Cashmere, J. David; Quigley, Michael; Miewald, Jean M.; Buysse, Daniel J.

2007-01-01

Study Objectives: To explore the sleep onset process in primary insomnia patients, new rules for scoring 4-second epochs were implemented to score sleep and artifacts during initial sleep onset. Conventional scorings in 20-second and 60-second epochs were also obtained. Methods: The start of the initial 60-second epoch of stage 1 was used to define “time zero” (t0). Sleep onset periods from 11 patients and 11 individually age- and sex-matched controls spanned from 5 minutes before t0 through 29 minutes after t0. Using the new rules, the periods were scored blind to group assignment. This t0 time-referenced the data analysis to one plausible midpoint in the sleep onset process. In parallel, latencies were time-referenced from good night time. Results: Reliability in scoring sleep and artifacts was adequate (kappa = 0.68 & 0.63, respectively, p <0.001). Group differences in sleep latencies were marginal in 60-second and 20-second scoring but significant with a definition of 4-second sleep latency. Patients had more 4-second epochs scored as awake (Mantel-Haenszel χ2 = 271, d.f. = 1, p <0.001) and containing artifact (M-H χ2 = 143, p <0.001). Patients took longer to achieve 30 continuous 4-second epochs of NREM sleep (Breslow χ2 = 4.03, d.f. = 1, p = 0.045) after t0. Patients accumulated sleep more slowly with all 3 scoring rules after t0. A slower rate of accumulating sleep after t0 was detected only with the 4-second scoring (p = 0.047). Conclusions: Evidence was present for momentary state-switching instabilities in the patients during the initial sleep onset process. Using rules for scoring small epochs may reveal such instabilities more readily than traditional scoring methods. Citation: Moul DE; Germain A; Cashmere D; Quigley M; Miewald JM; Buysse DJ. Examining initial sleep onset in primary insomnia: a case-control study using 4-second epochs. J Clin Sleep Med 2007;3(5):479-488. PMID:17803011

Effects of insomnia and sleep medication on health-related quality of life.

PubMed

Sasai, Taeko; Inoue, Yuichi; Komada, Yoko; Nomura, Takashi; Matsuura, Masato; Matsushima, Eisuke

2010-05-01

This study, using Short-Form 8 (SF-8), was undertaken to assess the effects of insomnia and sleep medication use on quality of life (QOL) in 2822 people (ages 20-97years) in a rural population. Factors associated with deterioration of the mental component summary (MCS) score and physical component summary (PCS) score were investigated. Questionnaires asked participants' basic information and included assessments using SF-8, the Pittsburgh Sleep Quality Index (PSQI), and a 12-item version of the Center for Epidemiological Studies Depression scale. Results of PSQI supported the classification of subjects as good sleepers, good sleepers using sleep medication, insomniacs, and insomniacs using sleep medication. Insomnia was associated with low scores of MCS and PCS. Nevertheless, sleep medication use was associated with low PCS scores only. Good sleepers using sleep medication had significantly higher MCS scores than either insomniacs or insomniacs using sleep medication, but lower scores than good sleepers. Similarly to insomniacs using sleep medication, good sleepers using sleep medication had significantly lower PCS scores than either good sleepers or insomniacs. Sleep medication was useful to improve mental QOL. That usage, however, might degrade the physical QOL, possibly because of the medication's adverse effects. Copyright 2010 Elsevier B.V. All rights reserved.

Reliability of the American Academy of Sleep Medicine Rules for Assessing Sleep Depth in Clinical Practice.

PubMed

Younes, Magdy; Kuna, Samuel T; Pack, Allan I; Walsh, James K; Kushida, Clete A; Staley, Bethany; Pien, Grace W

2018-02-15

The American Academy of Sleep Medicine has published manuals for scoring polysomnograms that recommend time spent in non-rapid eye movement sleep stages (stage N1, N2, and N3 sleep) be reported. Given the well-established large interrater variability in scoring stage N1 and N3 sleep, we determined the range of time in stage N1 and N3 sleep scored by a large number of technologists when compared to reasonably estimated true values. Polysomnograms of 70 females were scored by 10 highly trained sleep technologists, two each from five different academic sleep laboratories. Range and confidence interval (CI = difference between the 5th and 95th percentiles) of the 10 times spent in stage N1 and N3 sleep assigned in each polysomnogram were determined. Average values of times spent in stage N1 and N3 sleep generated by the 10 technologists in each polysomnogram were considered representative of the true values for the individual polysomnogram. Accuracy of different technologists in estimating delta wave duration was determined by comparing their scores to digitally determined durations. The CI range of the ten N1 scores was 4 to 39 percent of total sleep time (% TST) in different polysomnograms (mean CI ± standard deviation = 11.1 ± 7.1 % TST). Corresponding range for N3 was 1 to 28 % TST (14.4 ± 6.1 % TST). For stage N1 and N3 sleep, very low or very high values were reported for virtually all polysomnograms by different technologists. Technologists varied widely in their assignment of stage N3 sleep, scoring that stage when the digitally determined time of delta waves ranged from 3 to 17 seconds. Manual scoring of non-rapid eye movement sleep stages is highly unreliable among highly trained, experienced technologists. Measures of sleep continuity and depth that are reliable and clinically relevant should be a focus of clinical research. © 2018 American Academy of Sleep Medicine

Effects of oral versus transdermal menopausal hormone treatments on self-reported sleep domains and their association with vasomotor symptoms in recently menopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS).

PubMed

Cintron, Dahima; Lahr, Brian D; Bailey, Kent R; Santoro, Nanette; Lloyd, Robin; Manson, JoAnn E; Neal-Perry, Genevieve; Pal, Lubna; Taylor, Hugh S; Wharton, Whitney; Naftolin, Fredrick; Harman, S Mitchell; Miller, Virginia M

2018-02-01

This study determined whether two different formulations of hormone therapy (HT): oral conjugated equine estrogens (o-CEE; 0.45 mg/d, n = 209), transdermal 17β-estradiol (t-E2; 50 μg/d, n = 201) plus cyclic progesterone (Prometrium, 200 mg) or placebo (PBO, n = 243) affected sleep domains in participants of the Kronos Early Estrogen Prevention Study. Participants completed the Pittsburgh Sleep Quality Index at baseline and during the intervention at 6, 18, 36, and 48 months. Global sleep quality and individual sleep domain scores were compared between treatments using analysis of covariance, and correlated with vasomotor symptom (VMS) scores using Spearman correlation coefficients. Global Pittsburgh Sleep Quality Index scores (mean 6.3; 24% with score >8) were similar across groups at baseline and were reduced (improved sleep quality) by both HT (average change -1.27 [o-CEE] and -1.32 [t-E2]) when compared with PBO (-0.60; P = 0.001 [o-CEE vs PBO] and P = 0.002 [t-E2 vs PBO]). Domain scores for sleep satisfaction and latency improved with both HT. The domain score for sleep disturbances improved more with t-E2 than o-CEE or PBO. Global sleep scores significantly correlated with VMS severity (rs = 0.170, P < 0.001 for hot flashes; rs = 0.177, P < 0.001 for night sweats). Change in scores for all domains except sleep latency and sleep efficiency correlated with change in severity of VMS. Poor sleep quality is common in recently menopausal women. Sleep quality improved with both HT formulations. The relationship of VMS with domains of sleep suggests that assessing severity of symptoms and domains of sleep may help direct therapy to improve sleep for postmenopausal women.

Effects of oral versus transdermal menopausal hormone treatments on self-reported sleep domains and their association with vasomotor symptoms in recently menopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS)

PubMed Central

Cintron, Dahima; Lahr, Brian D.; Bailey, Kent R.; Santoro, Nanette; Lloyd, Robin; Manson, JoAnn E.; Neal-Perry, Genevieve; Pal, Lubna; Taylor, Hugh S.; Wharton, Whitney; Naftolin, Fredrick; Harman, S. Mitchell; Miller, Virginia M.

2018-01-01

Abstract Objective: This study determined whether two different formulations of hormone therapy (HT): oral conjugated equine estrogens (o-CEE; 0.45 mg/d, n = 209), transdermal 17β-estradiol (t-E2; 50 μg/d, n = 201) plus cyclic progesterone (Prometrium, 200 mg) or placebo (PBO, n = 243) affected sleep domains in participants of the Kronos Early Estrogen Prevention Study. Methods: Participants completed the Pittsburgh Sleep Quality Index at baseline and during the intervention at 6, 18, 36, and 48 months. Global sleep quality and individual sleep domain scores were compared between treatments using analysis of covariance, and correlated with vasomotor symptom (VMS) scores using Spearman correlation coefficients. Results: Global Pittsburgh Sleep Quality Index scores (mean 6.3; 24% with score >8) were similar across groups at baseline and were reduced (improved sleep quality) by both HT (average change −1.27 [o-CEE] and −1.32 [t-E2]) when compared with PBO (−0.60; P = 0.001 [o-CEE vs PBO] and P = 0.002 [t-E2 vs PBO]). Domain scores for sleep satisfaction and latency improved with both HT. The domain score for sleep disturbances improved more with t-E2 than o-CEE or PBO. Global sleep scores significantly correlated with VMS severity (rs = 0.170, P < 0.001 for hot flashes; rs = 0.177, P < 0.001 for night sweats). Change in scores for all domains except sleep latency and sleep efficiency correlated with change in severity of VMS. Conclusions: Poor sleep quality is common in recently menopausal women. Sleep quality improved with both HT formulations. The relationship of VMS with domains of sleep suggests that assessing severity of symptoms and domains of sleep may help direct therapy to improve sleep for postmenopausal women. PMID:28832429

Flight Crew Sleep in Long-Haul Aircraft Bunk Facilities: Survey Results

NASA Technical Reports Server (NTRS)

Rosekind, Mark R.; Miller, Donna L.; Gregory, Kevin B.; Dinges, David F.; Shafto, Michael G. (Technical Monitor)

1995-01-01

Modem long-haul aircraft can fly up to 16 continuous hours and provide a 24-hour, global capability. Extra (augmented) flight crew are available on long flights to allow planned rest periods, on a rotating basis, away from the flight deck in onboard crew rest facilities (2 bunks). A NASA/FAA study is under-way to examine the quantity and quality of sleep obtained in long-haul aircraft bunks and the factors that promote or interfere with that sleep. The first phase of the study involved a retrospective survey, followed by a second phase field study to collect standard polysomnographic data during inflight bunk sleep periods. A summary of the Phase I survey results are reported here. A multi-part 54-question retrospective survey was completed by 1,404 flight crew (37% return rate) at three different major US air carriers flying B747-100, 200, 400, and MD- 11 long-haul aircraft. The questions examined demographics, quantity and quality of sleep at home and in onboard bunks, factors that promote or interfere with sleep, and effects on subsequent performance and alertness. Flight crew reported a mean bunk sleep latency of 39.4 mins (SD=28.3 mins) (n=1,276) and a mean total sleep time of 2.2 hrs (SD=1.3 hrs) (n=603). (Different flight lengths could affect overall time available for sleep.) Crew rated 25 factors for their interference or promotion of bunk sleep. Figure I portrays the average ratings for each factor across all three carriers. A principal components analysis of the 25 factors revealed three areas that promoted bunk sleep: physiological (e.g., readiness for sleep), physical environment (e.g., bunk size, privacy), and personal comfort (e.g., blankets, pillows). Five areas were identified that interfered with sleep: environmental disturbance (e.g., background noise, turbulence), luminosity (e.g., lighting), personal disturbances (e.g., bathroom trips, random thoughts), environmental discomfort (e.g., low humidity, cold), and interpersonal disturbances (e.g., bunk partner).

Executive Functions are not Affected by 24 Hours of Sleep Deprivation: A Color-Word Stroop Task Study.

PubMed

Dixit, Abhinav; Mittal, Tushar

2015-01-01

Sleep is an important factor affecting cognitive performance. Sleep deprivation results in fatigue, lack of concentration, confusion and sleepiness along with anxiety, depression and irritability. Sleep deprivation can have serious consequences in professions like armed forces and medicine where quick decisions and actions need to be taken. Color-Word Stroop task is one of the reliable tests to assess attention and it analyzes the processing of information in two dimensions i.e., reading of words and naming of colour. The evidence regarding the effect of sleep deprivation on Stroop interference is conflicting. The present study evaluated the effect of 24 hours of sleep deprivation on reaction time and interference in Stroop task. The present study was done on 30 healthy male medical student volunteers in the age group of 18-25 years after taking their consent and clearance from Institute Ethics Committee. Recordings of Stroop task were at three times: baseline (between 7-9 am), after 12 hours (7-9 pm) and after 24 hours (7-9 am, next day). The subjects were allowed to perform normal daily activities. The study revealed a significant increase in reaction time after 24 hours of sleep deprivation in comparison to baseline and after 12 hours of sleep deprivation. There was no significant change in interference and facilitation after sleep deprivation in comparison to baseline. The number of errors also did not show any significant change after sleep deprivation. The study indicated that there was slowing of responses without change in executive functions after 24 hours of sleep deprivation. It is probable that 24 hours of sleep deprivation does not bring about change in areas of brain affecting executive functions in healthy individuals who have normal sleep cycle. The present study indicated that in professions like armed forces and medicine working 24 hours at a stretch can lead to decrease in motor responses without affecting information processing and judgment ability.

Comparison of actigraphy immobility rules with polysomnographic sleep onset latency in children and adolescents.

PubMed

Meltzer, Lisa J; Walsh, Colleen M; Peightal, Ashley A

2015-12-01

While actigraphy has gained popularity in pediatric sleep research, questions remain about the validity of actigraphy as an estimate of sleep-wake patterns. In particular, there is little consistency in the field in terms of scoring rules used to determine sleep onset latency. The purpose of this study was to evaluate different criteria of immobility as a measure of sleep onset latency in children and adolescents. Ninety-five youth (ages 3-17 years, 46 % male) wore both the Ambulatory Monitoring Inc. Motionlogger Sleep Watch (AMI) and the Philips Respironics Mini-Mitter Actiwatch-2 (PRMM) during overnight polysomnography in a pediatric sleep lab. We examined different sleep onset latency scoring rules (3, 5, 10, 15, and 20 min of immobility) using different algorithms (Sadeh and Cole-Kripke) and sensitivity settings (low, medium, high) for the devices. Comparisons were also made across age groups (preschoolers, school-aged, adolescents) and sleep disordered breathing status (no obstructive sleep apnea [OSA], mild OSA, clinically significant OSA). For the AMI device, shorter scoring rules performed best for children and longer scoring rules were better for adolescents, with shorter scoring rules best across sleep disordered breathing groups. For the PRMM device, medium to longer scoring rules performed best across age and sleep disordered breathing groups. Researchers are encouraged to determine the scoring rule that best fits their population of interest. Future studies are needed with larger samples of children and adolescents to further validate actigraphic immobility as a proxy for sleep onset latency.

A Rasch analysis of the Brief Pain Inventory Interference subscale reveals three dimensions and an age bias.

PubMed

Walton, David M; Beattie, Tyler; Putos, Joseph; MacDermid, Joy C

2016-06-01

The Brief Pain Inventory is composed of two quantifiable scales: pain severity and pain interference. The reported factor structure of the interference subscale is not consistent in the extant literature, with no clear choice between a single- or two-factor structure. Here, we report on the results of Rasch-based analysis of the interference subscale using a large population-based ambulatory patient database (the Quebec Pain Registry). Observational cohort. A total of 1,000 responses were randomly drawn from a total database of 5,654 for this analysis. Both the original 7-item and an expanded 10-item version (Tyler 2002) of the interference subscale were evaluated. Rasch analysis revealed significant misfit of both versions of the scale, with the original 7-item version outperforming the expanded 10-item version. Analysis of dimensionality revealed that both versions showed improved model fit when considered two subscales (affective and physical interference) with the item on sleep interference removed or considered separately. Additionally, significant uniform differential item functioning was identified for 6 of the 7 original items when the sample was stratified by age above or below 55 years. The interference subscale achieved adequate model fit when considered as two separate subscales with age as a mediator of response, while interpreting the sleep interference item separately. A transformation matrix revealed that in all cases, ordinal-level change at the extreme ends of the scale appears to be more meaningful than does a similar change at the midpoints. The Interference subscale of the BPI should be interpreted as two separate subscales (Affective Interference, Physical Interference) with the sleep item removed or interpreted separately for optimal fit to the Rasch model. Implications for research and clinical use are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Levels of Interference in Long and Short-Term Memory Differentially Modulate Non-REM and REM Sleep

PubMed Central

Fraize, Nicolas; Carponcy, Julien; Joseph, Mickaël Antoine; Comte, Jean-Christophe; Luppi, Pierre-Hervé; Libourel, Paul-Antoine; Salin, Paul-Antoine; Malleret, Gaël; Parmentier, Régis

2016-01-01

Study Objectives: It is commonly accepted that sleep is beneficial to memory processes, but it is still unclear if this benefit originates from improved memory consolidation or enhanced information processing. It has thus been proposed that sleep may also promote forgetting of undesirable and non-essential memories, a process required for optimization of cognitive resources. We tested the hypothesis that non-rapid eye movement sleep (NREMS) promotes forgetting of irrelevant information, more specifically when processing information in working memory (WM), while REM sleep (REMS) facilitates the consolidation of important information. Methods: We recorded sleep patterns of rats trained in a radial maze in three different tasks engaging either the long-term or short-term storage of information, as well as a gradual level of interference. Results: We observed a transient increase in REMS amount on the day the animal learned the rule of a long-term/reference memory task (RM), and, in contrast, a positive correlation between the performance of rats trained in a WM task involving an important processing of interference and the amount of NREMS or slow wave activity. Various oscillatory events were also differentially modulated by the type of training involved. Notably, NREMS spindles and REMS rapid theta increase with RM training, while sharp-wave ripples increase with all types of training. Conclusions: These results suggest that REMS, but also rapid oscillations occurring during NREMS would be specifically implicated in the long-term memory in RM, whereas NREMS and slow oscillations could be involved in the forgetting of irrelevant information required for WM. Citation: Fraize N, Carponcy J, Joseph MA, Comte JC, Luppi PH, Libourel PA, Salin PA, Malleret G, Parmentier R. Levels of interference in long and short-term memory differentially modulate non-REM and REM sleep. SLEEP 2016;39(12):2173–2188. PMID:27748246

Stability and Predictive Validity of the Parent-Child Sleep Interactions Scale: A Longitudinal Study Among Preschoolers.

PubMed

Barrios, Chelsey S; Jay, Samantha Y; Smith, Victoria C; Alfano, Candice A; Dougherty, Lea R

2018-01-01

Little research has examined the processes underlying children's persistent sleep problems and links with later psychopathology. The current study examined the stability of parent-child sleep interactions as assessed with the parent-reported Parent-Child Sleep Interactions Scale (PSIS) and examined whether sleep interactions in preschool-age children predict sleep problems and psychiatric symptoms later in childhood. Participants included 108 preschool-age children (50% female) and their parents. Parents completed the PSIS when children were 3-5 years (T1) and again when they were 6-9 years (T2). The PSIS includes three subscales-Sleep Reinforcement (reassurance of child sleep behaviors), Sleep Conflict (parent-child conflict at bedtime), Sleep Dependence (difficulty going to sleep without parent)-and a total score. Higher scores indicate more problematic bedtime interactions. Children's sleep problems and psychiatric symptoms at T1 and T2 were assessed with a clinical interview. PSIS scores were moderately stable from T1 to T2, and the factor structure of the PSIS remained relatively consistent over time. Higher total PSIS scores at T1 predicted increases in children's sleep problems at T2. Higher PSIS Sleep Conflict scores at T1 predicted increases in oppositional defiant disorder symptoms at T2. Children with more sleep problems and higher PSIS Sleep Reinforcement scores at T1 showed increases in attention deficit/hyperactivity disorder, depressive, and anxiety symptoms at T2. These findings provide evidence for the predictive validity of the PSIS and highlight the importance of early parent-child sleep interactions in the development of sleep and psychiatric symptoms in childhood. Parent-child sleep interactions may serve as a useful target for interventions.

Pain as a Predictor of Sleep Problems in Youth with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Tudor, Megan E.; Walsh, Caitlin E.; Mulder, Emile C.; Lerner, Matthew D.

2015-01-01

Evidence suggests that pain interferes with sleep in youth with developmental disabilities. This study examined the relationship between pain and sleep problems in a sample of youth with parent-reported autism spectrum disorder (N = 62). Mothers reported on standardized measures of pain and sleep problems. Youth demonstrated atypically high levels…

Aging worsens the effects of sleep deprivation on postural control.

PubMed

Robillard, Rébecca; Prince, François; Filipini, Daniel; Carrier, Julie

2011-01-01

Falls increase with age and cause significant injuries in the elderly. This study aimed to determine whether age modulates the interactions between sleep deprivation and postural control and to evaluate how attention influences these interactions in the elderly. Fifteen young (24±2.7 y.o.) and 15 older adults (64±3.2 y.o.) stood still on a force plate after a night of sleep and after total sleep deprivation. Center of pressure range and velocity were measured with eyes open and with eyes closed while participants performed an interference task, a control task, and no cognitive task. Sleep deprivation increased the antero-posterior range of center of pressure in both age groups and center of pressure speed in older participants only. In elderly participants, the destabilizing effects of sleep deprivation were more pronounced with eyes closed. The interference task did not alter postural control beyond the destabilization induced by sleep loss in older subjects. It was concluded that sleep loss has greater destabilizing effects on postural control in older than in younger participants, and may therefore increase the risk of falls in the elderly.

Aging Worsens the Effects of Sleep Deprivation on Postural Control

PubMed Central

Robillard, Rébecca; Prince, François; Filipini, Daniel; Carrier, Julie

2011-01-01

Falls increase with age and cause significant injuries in the elderly. This study aimed to determine whether age modulates the interactions between sleep deprivation and postural control and to evaluate how attention influences these interactions in the elderly. Fifteen young (24±2.7 y.o.) and 15 older adults (64±3.2 y.o.) stood still on a force plate after a night of sleep and after total sleep deprivation. Center of pressure range and velocity were measured with eyes open and with eyes closed while participants performed an interference task, a control task, and no cognitive task. Sleep deprivation increased the antero-posterior range of center of pressure in both age groups and center of pressure speed in older participants only. In elderly participants, the destabilizing effects of sleep deprivation were more pronounced with eyes closed. The interference task did not alter postural control beyond the destabilization induced by sleep loss in older subjects. It was concluded that sleep loss has greater destabilizing effects on postural control in older than in younger participants, and may therefore increase the risk of falls in the elderly. PMID:22163330

The AASM scoring manual: a critical appraisal.

PubMed

Grigg-Damberger, Madeleine M

2009-11-01

Summarize recently published studies and critiques evaluating the effects of the American Academy of Sleep Medicine (AASM) Sleep Scoring Manual. Only a few retrospective studies have been published evaluating the new AASM Scoring Manual. These have shown that when scoring polysomnograms (PSGs) using the AASM rules compared to previous standards and guidelines: increased amount and percentage of sleep time in Non-Rapid Eye Movement Sleep (NREM) 1 (N1) and N3 sleep, and decreased NREM 2 (N2) sleep; improved interscorer reliability when scoring sleep stages in adults; large differences in apnea-hypopnea indexes (AHIs) using different hypopnea scoring definitions; and PSGs scored using the 'recommended' hypopnea definition in the new manual identified no significant sleep disordered breathing in 40% of lean individuals with symptomatic OSA (AHI ≥5/h by 1999 'Chicago' criteria) and a favorable response to treatment. Two years have passed since the AASM Scoring Manual was published, garnering less criticism than was feared by those who developed it. The improvement in interscorer reliability using the Manual is heartening since this goal shaped many of the choices made. The alternative hypopnea rule should be endorsed as a recommended option. The AASM Scoring Manual provides a foundation upon which we all can build rules and methods that quantify the complexity of sleep and its disorders. Multicenter validation and refinement of the Manual is encouraged.

The Role of Inflammation in the Pain, Fatigue, and Sleep Disturbance Symptom Cluster in Advanced Cancer.

PubMed

Kwekkeboom, Kristine L; Tostrud, Lauren; Costanzo, Erin; Coe, Christopher L; Serlin, Ronald C; Ward, Sandra E; Zhang, Yingzi

2018-05-01

Symptom researchers have proposed a model of inflammatory cytokine activity and dysregulation in cancer to explain co-occurring symptoms including pain, fatigue, and sleep disturbance. We tested the hypothesis that psychological stress accentuates inflammation and that stress and inflammation contribute to one's experience of the pain, fatigue, and sleep disturbance symptom cluster (symptom cluster severity, symptom cluster distress) and its impact (symptom cluster interference with daily life, quality of life). We used baseline data from a symptom cluster management trial. Adult participants (N = 158) receiving chemotherapy for advanced cancer reported pain, fatigue, and sleep disturbance on enrollment. Before intervention, participants completed measures of demographics, perceived stress, symptom cluster severity, symptom cluster distress, symptom cluster interference with daily life, and quality of life and provided a blood sample for four inflammatory biomarkers (interleukin-1β, interleukin-6, tumor necrosis factor-α, and C-reactive protein). Stress was not directly related to any inflammatory biomarker. Stress and tumor necrosis factor-α were positively related to symptom cluster distress, although not symptom cluster severity. Tumor necrosis factor-α was indirectly related to symptom cluster interference with daily life, through its effect on symptom cluster distress. Stress was positively associated with symptom cluster interference with daily life and inversely with quality of life. Stress also had indirect effects on symptom cluster interference with daily life, through its effect on symptom cluster distress. The proposed inflammatory model of symptoms was partially supported. Investigators should test interventions that target stress as a contributing factor in co-occurring pain, fatigue, and sleep disturbance and explore other factors that may influence inflammatory biomarker levels within the context of an advanced cancer diagnosis and treatment. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Cancer-Related Fatigue in Cancer Survivorship.

PubMed

Ebede, Chidinma C; Jang, Yongchang; Escalante, Carmen P

2017-11-01

Cancer-related fatigue (CRF) significantly interferes with usual functioning because of the distressing sense of physical, emotional, and cognitive exhaustion. Assessment of CRF is important and should be performed during the initial cancer diagnosis, throughout cancer treatment, and after treatment using a fatigue scoring scale (mild-severe). The general approach to CRF management applies to cancer survivors at all fatigue levels and includes education, counseling, and other strategies. Nonpharmacologic interventions include psychosocial interventions, exercise, yoga, physically based therapy, dietary management, and sleep therapy. Pharmacologic interventions include psychostimulants. Antidepressants may also benefit when CRF is accompanied by depression. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of Actigraphy Immobility Rules with Polysomnographic Sleep Onset Latency in Children and Adolescents

PubMed Central

Meltzer, Lisa J.; Walsh, Colleen M.; Peightal, Ashley A.

2015-01-01

Purpose While actigraphy has gained popularity in pediatric sleep research, questions remain about the validity of actigraphy as an estimate of sleep-wake patterns. In particular, there is little consistency in the field in terms of scoring rules used to determine sleep onset latency. The purpose of this study was to evaluate different criteria of immobility as a measure of sleep onset latency in children and adolescents. Methods Ninety-five youth (ages 3-17 years, 46% male) wore both the Ambulatory-Monitoring Inc. Motionlogger Sleep Watch (AMI) and the Philips Respironics Mini-Mitter Actiwatch-2 (PRMM) during overnight polysomnography in a pediatric sleep lab. We examined different sleep onset latency scoring rules (3, 5, 10, 15, and 20 minutes of immobility) using different algorithms (Sadeh and Cole-Kripke) and sensitivity settings (Low, Medium, High) for the devices. Comparisons were also made across age groups (preschoolers, school-aged, adolescents) and sleep disordered breathing status (no obstructive sleep apnea [OSA], mild OSA, clinically significant OSA). Results For the AMI device, shorter scoring rules performed best for children and longer scoring rules were better for adolescents, with shorter scoring rules best across sleep disordered breathing groups. For the PRMM device, medium to longer scoring rules performed best across age and sleep disordered breathing groups. Conclusions Researchers are encouraged to determine the scoring rule that best fits their population of interest. Future studies are needed with larger samples of children and adolescents to further validate actigraphic immobility as a proxy for sleep onset latency. PMID:25687438

Smartphone addiction risk and daytime sleepiness in Korean adolescents.

PubMed

Chung, Jee Eun; Choi, Soo An; Kim, Ki Tai; Yee, Jeong; Kim, Joo Hee; Seong, Jin Won; Seong, Jong Mi; Kim, Ju Young; Lee, Kyung Eun; Gwak, Hye Sun

2018-04-06

Smartphone overuse can cause not only mobility problems in the wrists, fingers and neck but also interference with sleep habits. However, research on smartphone addiction and sleep disturbances is scarce. Therefore, we aimed to investigate daytime sleepiness in association with smartphone addiction risk in Korean adolescents. A cross-sectional survey method was used in this study. The Pediatric Daytime Sleepiness Scale was used to assess daytime sleepiness, and the Korean Smartphone Addiction Proneness Scale index was used to evaluate the degree of risk for smartphone addiction. The analyses were performed in 1796 adolescents using smartphones, including 820 boys and 976 girls. The at-risk smartphone users made up 15.1% of boys and 23.9% of girls. Our multivariate analyses demonstrated that students who were female, consumed alcohol, had lower academic performance, did not feel refreshed in the morning and initiated sleep after 12 am were at a significantly higher risk of smartphone addiction. The at-risk smartphone user group was independently associated with the upper quartile Pediatric Daytime Sleepiness Scale score in students with the following factors: Female gender, alcohol consumption, poor self-perceived health level, initiating sleep after 12 am, longer time taken to fall asleep and duration of night sleep less than 6 h. The quality of sleep in adolescence affects growth, emotional stability and learning skills. Therefore, the management of smartphone addiction seems to be essential for proper sleeping habits. There is a critical need to develop a means of preventing smartphone addiction on a social level. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

The relationship between sleep and cognitive function in patients with prediabetes and type 2 diabetes.

PubMed

Saetung, Sunee; Nimitphong, Hataikarn; Siwasaranond, Nantaporn; Sumritsopak, Rungtip; Jindahra, Panitha; Krairit, Orapitchaya; Thakkinstian, Ammarin; Anothaisintawee, Thunyarat; Reutrakul, Sirimon

2018-06-06

Diabetes is linked to cognitive impairment. Sleep plays a role in memory consolidation. Sleep disturbances, commonly found in patients with diabetes, were shown to be related to cognitive dysfunction. This study explored the role of sleep in cognitive function of patients with abnormal glucose tolerance. A total of 162 patients (81 type 2 diabetes and 81 prediabetes) participated. Sleep duration and sleep efficiency (an indicator of sleep quality) were obtained using 7-day actigraphy recordings. Obstructive sleep apnea (OSA) was screened using an overnight in-home monitor. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Three sub-scores of MoCA, visuoexecutive function, attention and delayed recall, were also analyzed. Mean age was 54.8 (10.2) years. OSA was diagnosed in 123 participants (76.9%). Mean sleep duration was 6.0 (1.0) h and sleep efficiency was 82.7 (8.1) %. Sleep duration and OSA severity were not related to MoCA scores. Higher sleep efficiency was associated with higher MoCA scores (p = 0.003), and having diabetes (vs. prediabetes) was associated with lower MoCA scores (p = 0.001). After adjusting covariates, both having diabetes (vs. prediabetes) (B = - 1.137, p = 0.002) and sleep efficiency (B = 0.085, p < 0.001) were independently associated with MoCA scores. In addition, diabetes (B = - 0.608, p < 0.001) and sleep efficiency (B = 0.038, p < 0.001) were associated with visuoexecutive function. Sleep parameters were not related to delayed recall or attention scores. Lower sleep efficiency is independently associated with lower cognitive function in patients with abnormal glucose tolerance. Whether sleep optimization may improve cognitive function in these patients should be explored.

Validation of a Wireless, Self-Application, Ambulatory Electroencephalographic Sleep Monitoring Device in Healthy Volunteers.

PubMed

Finan, Patrick H; Richards, Jessica M; Gamaldo, Charlene E; Han, Dingfen; Leoutsakos, Jeannie Marie; Salas, Rachel; Irwin, Michael R; Smith, Michael T

2016-11-15

To evaluate the validity of an ambulatory electroencephalographic (EEG) monitor for the estimation of sleep continuity and architecture in healthy adults. Healthy, good sleeping participants (n = 14) were fit with both an ambulatory EEG monitor (Sleep Profiler) and a full polysomnography (PSG) montage. EEG recordings were gathered from both devices on the same night, during which sleep was permitted uninterrupted for eight hours. The study was set in an inpatient clinical research suite. PSG and Sleep Profiler records were scored by a neurologist board certified in sleep medicine, blinded to record identification. Agreement between the scored PSG record, the physician-scored Sleep Profiler record, and the Sleep Profiler record scored by an automatic algorithm was evaluated for each sleep stage, with the PSG record serving as the reference. Results indicated strong percent agreement across stages. Kappa was strongest for Stage N3 and REM. Specificity was high for all stages; sensitivity was low for Wake and Stage N1, and high for Stage N2, Stage N3, and REM. Agreement indices improved for the manually scored Sleep Profiler record relative to the autoscore record. Overall, the Sleep Profiler yields an EEG record with comparable sleep architecture estimates to PSG. Future studies should evaluate agreement between devices with a clinical sample that has greater periods of wake in order to better understand utility of this device for estimating sleep continuity indices, such as sleep onset latency and wake after sleep onset. © 2016 American Academy of Sleep Medicine

Sleep, Health and Wellness at Work: A Scoping Review

PubMed Central

Garbarino, Sergio

2017-01-01

Many occupational factors may interfere with sleep. Sleep disturbances can, in turn, endanger the health and safety of workers. This rapid review of the literature identifies the main factors that alter the quantity and quality of sleep, indicates the effects these alterations have on the wellbeing of workers and suggests some health promotion measures. PMID:29113118

Accuracy of Automatic Polysomnography Scoring Using Frontal Electrodes

PubMed Central

Younes, Magdy; Younes, Mark; Giannouli, Eleni

2016-01-01

Study Objectives: The economic cost of performing sleep monitoring at home is a major deterrent to adding sleep data during home studies for investigation of sleep apnea and to investigating non-respiratory sleep complaints. Michele Sleep Scoring System (MSS) is a validated automatic system that utilizes central electroencephalography (EEG) derivations and requires minimal editing. We wished to determine if MSS' accuracy is maintained if frontal derivations are used instead. If confirmed, home sleep monitoring would not require home setup or lengthy manual scoring by technologists. Methods: One hundred two polysomnograms (PSGs) previously recorded from patients with assorted sleep disorders were scored using MSS once with central and once with frontal derivations. Total sleep time, sleep/stage R sleep onset latencies, awake time, time in different sleep stages, arousal/awakening index and apnea-hypopnea index were compared. In addition, odds ratio product (ORP), a continuous index of sleep depth/quality (Sleep 2015;38:641–54), was generated for every 30-sec epoch in each PSG and epoch-by-epoch comparison of ORP was performed. Results: Intraclass correlation coefficients (ICCs) ranged from 0.89 to 1.0 for the various sleep variables (0.96 ± 0.03). For epoch-by-epoch comparisons of ORP, ICC was > 0.85 in 96 PSGs. Lower values in the other six PSGs were related to signal artifacts in either derivation. ICC for whole-record average ORP was 0.98. Conclusions: MSS is as accurate with frontal as with central EEG derivations. The use of frontal electrodes along with MSS should make it possible to obtain high-quality sleep data without requiring home setup or lengthy scoring time by expert technologists. Citation: Younes M, Younes M, Giannouli E. Accuracy of automatic polysomnography scoring using frontal electrodes. J Clin Sleep Med 2016;12(5):735–746. PMID:26951417

Relationships between parental sleep quality, fatigue, cognitions about infant sleep, and parental depression pre and post-intervention for infant behavioral sleep problems.

PubMed

Hall, Wendy A; Moynihan, Melissa; Bhagat, Radhika; Wooldridge, Joanne

2017-04-04

Maternal and paternal depression has been associated with infants' behavioral sleep problems. Behavioral sleep interventions, which alter parental cognitions about infant sleep, have improved infant sleep problems. This study reports relationships between parental depression, fatigue, sleep quality, and cognitions about infant sleep pre and post-intervention for a behavioral sleep problem. This secondary analysis of data from Canadian parents (n = 455), with healthy infants aged 6-to-8-months exposed to a behavioral sleep intervention, examined baseline data and follow-up data from 18 or 24 weeks post intervention (group teaching or printed material) exposure. Parents reported on sleep quality, fatigue, depression, and cognitions about infant sleep. Data were analyzed using Pearson's r and stepwise regression analysis. Parents' fatigue, sleep quality, sleep cognitions, and depression scores were correlated at baseline and follow-up. At baseline, sleep quality (b = .52, 95% CI .19-.85), fatigue (b = .48, 95% CI .33-.63), doubt about managing infant sleep (b = .44, 95% CI .19-.69), and anger about infant sleep (b = .69, 95% CI .44-.94) were associated with mothers' depression. At baseline, fathers' depression related to sleep quality (b = .42, 95% CI .01-.83), fatigue (b = .47, 95% CI .32-.63), and doubt about managing infant sleep (b = .50, 95% CI .24-.76). At follow-up, mothers' depression was associated with sleep quality (b = .76, 95% CI .41-1.12), fatigue (b = .25, 95% CI .14-.37), doubt about managing infant sleep (b = .44, 95% CI .16-.73), sleep anger (b = .31, 95% CI .02-.59), and setting sleep limits (b = -.22, 95% CI -.41-[-.03]). At follow-up, fathers' depression related to sleep quality (b = .84, 95% CI .46-1.22), fatigue (b = .31, 95% CI .17-.45), sleep doubt (b = .34, 95% CI .05-.62), and setting sleep limits (b = .25, 95% CI .01-.49). Mothers' and fathers' cognitions about infant sleep demonstrate complex relationships with their depression scores. While mothers' setting sleep limit scores are associated with decreased depression scores, fathers' setting limits scores are associated with increased depression scores. Parental doubts about managing infant sleep and difficulties with setting sleep limits require attention in interventions.

Sleep assessment in a population-based study of chronic fatigue syndrome

PubMed Central

Unger, Elizabeth R; Nisenbaum, Rosane; Moldofsky, Harvey; Cesta, Angela; Sammut, Christopher; Reyes, Michele; Reeves, William C

2004-01-01

Background Chronic fatigue syndrome (CFS) is a disabling condition that affects approximately 800,000 adult Americans. The pathophysiology remains unknown and there are no diagnostic markers or characteristic physical signs or laboratory abnormalities. Most CFS patients complain of unrefreshing sleep and many of the postulated etiologies of CFS affect sleep. Conversely, many sleep disorders present similarly to CFS. Few studies characterizing sleep in unselected CFS subjects have been published and none have been performed in cases identified from population-based studies. Methods The study included 339 subjects (mean age 45.8 years, 77% female, 94.1% white) identified through telephone screen in a previously described population-based study of CFS in Wichita, Kansas. They completed questionnaires to assess fatigue and wellness and 2 self-administered sleep questionnaires. Scores for five of the six sleep factors (insomnia/hypersomnia, non-restorative sleep, excessive daytime somnolence, sleep apnea, and restlessness) in the Centre for Sleep and Chronobiology's Sleep Assessment Questionnaire© (SAQ©) were dichotomized based on threshold. The Epworth Sleepiness Scale score was used as a continuous variable. Results 81.4% of subjects had an abnormality in at least one SAQ© sleep factor. Subjects with sleep factor abnormalities had significantly lower wellness scores but statistically unchanged fatigue severity scores compared to those without SAQ© abnormality. CFS subjects had significantly increased risk of abnormal scores in the non-restorative (adjusted odds ratio [OR] = 28.1; 95% confidence interval [CI]= 7.4–107.0) and restlessness (OR = 16.0; 95% CI = 4.2–61.6) SAQ© factors compared to non-fatigued, but not for factors of sleep apnea or excessive daytime somnolence. This is consistent with studies finding that, while fatigued, CFS subjects are not sleepy. A strong correlation (0.78) of Epworth score was found only for the excessive daytime somnolence factor. Conclusions SAQ© factors describe sleep abnormalities associated with CFS and provide more information than the Epworth score. Validation of these promising results will require formal polysomnographic sleep studies. PMID:15096280

Association of sleep disturbances with cognitive impairment and depression in maintenance hemodialysis patients.

PubMed

Rodriguez, Luke; Tighiouart, Hocine; Scott, Tammy; Lou, Kristina; Giang, Lena; Sorensen, Eric; Weiner, Daniel E; Sarnak, Mark J

2013-01-01

There are few data on the relationship of sleep with measures of cognitive function and symptoms of depression in dialysis patients. We evaluated the relationship of sleep with cognitive function and symptoms of depression in 168 hemodialysis patients, using multivariable linear and logistic regression. Sleep disturbances were assessed using the sleep subscale battery of the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) Health Experience Questionnaire. The cognitive battery assessed a broad range of functioning including global ability, verbal intelligence, supraspan learning, auditory retention, visual retention, attention/mental processing speed, visual construction/fluid reasoning and motor speed. Depressive symptoms were assessed using the Center for Epidemiological Studies of Depression (CESD) Scale, with depression indicated by a CESD score >16. Mean (SD) age of participants was 62 (17) years, 49% were women, 30% were African American and 33% had diabetes. There was no significant relationship between sleep score and performance on any neurocognitive test (p>0.13, for all multivariable analyses). The prevalence of depression increased from 16% in the highest quartile (best) of sleep score, to 31% in the lowest quartile (worst) of sleep score. In multivariable analyses, each 1 SD increase in sleep score was associated with a 2.18 (95% confidence interval, 1.07-3.29, p<0.001) lower CESD score. Results were consistent when considering individual components of both the CESD and sleep score. Disturbances in sleep are associated with symptoms of depression but not measures of cognitive function. Dialysis patients with disturbances in sleep should be screened for depression.

[Relationships of positive and negative affectivity to sleep quality in Japanese civil servants: 3-year follow-up study].

PubMed

Saeki, Urara; Nasermoaddeli, Ali; Sekine, Michikazu; Kagamimori, Sadanobu

2008-11-01

We conducted this longitudinal study to evaluate the relationships of positive and negative affectivity (Affect Balance Scale) to sleep quality among civil servants. For this study we evaluated 827 civil servants of T city in Toyama prefecture in the springs of 2001 (Baseline) and 2004 with complete information in both phases of the study. Based on the median score at each phase, we divided Affect Balance Scale (ABS) scores into high and low groups. We conducted logistic regression analysis to determine the odds ratios (OR) of 3-yr follow-up sleep quality by baseline and follow-up ABS scores. After adjusting for baseline sleep quality scores, age, sex, employment, job strain, and exercise habits, participants who had high ABS scores were more likely (OR: 3.13, 95% confidence interval (CI): 1.78-5.53) to have better sleep quality than those with low ABS scores at both phases. In addition, participants with low ABS scores at baseline and high ABS scores 3 yr later had better sleep quality (OR: 1.81, 95%CI: 1.02-3.20) than those with low ABS scores at both phases. These findings substantiate the relationships of positive and negative affectivity to sleep quality. Improving the affect balance condition as well as maintaining good affect balance condition may be important determinants of sleep quality in civil servants.

The Visual Scoring of Sleep in Infants 0 to 2 Months of Age.

PubMed

Grigg-Damberger, Madeleine M

2016-03-01

In March 2014, the American Academy of Sleep Medicine (AASM) Board of Directors requested the Scoring Manual Editorial Board develop rules, terminology, and technical specifications for scoring sleep/wake states in full-term infants from birth to 2 mo of age, cognizant of the 1971 Anders, Emde, and Parmelee Manual for Scoring Sleep in Newborns. On July 1, 2015, the AASM published rules for scoring sleep in infants, ages 0-2 mo. This evidence-based review summarizes the background information provided to the Scoring Manual Editorial Board to write these rules. The Anders Manual only provided criteria for coding physiological and behavioral state characteristics in polysomnograms (PSG) of infants, leaving specific sleep scoring criteria to the individual investigator. Other infant scoring criteria have been published, none widely accepted or used. The AASM Scoring Manual infant scoring criteria incorporate modern concepts, digital PSG recording techniques, practicalities, and compromises. Important tenets are: (1) sleep/wake should be scored in 30-sec epochs as either wakefulness (W), rapid eye movement, REM (R), nonrapid eye movement, NREM (N) and transitional (T) sleep; (2) an electroencephalographic (EEG) montage that permits adequate display of young infant EEG is: F3-M2, F4-M1, C3-M2, C4-M1, O1-M2, O2-M1; additionally, recording C3-Cz, Cz-C4 help detect early and asynchronous sleep spindles; (3) sleep onsets are more often R sleep until 2-3 mo postterm; (4) drowsiness is best characterized by visual observation (supplemented by later video review); (5) wide open eyes is the most crucial determinant of W; (6) regularity (or irregularity) of respiration is the single most useful PSG characteristic for scoring sleep stages at this age; (7) trace alternant (TA) is the only relatively distinctive EEG pattern, characteristic of N sleep, and usually disappears by 1 mo postterm replaced by high voltage slow (HVS); (8) sleep spindles first appear 44-48 w conceptional age (CA) and when present prompt scoring N; (9) score EEG activity in an epoch as "continuous" or "discontinuous" for inter-scorer reliability; (10) score R if four or more of the following conditions are present, including irregular respiration and rapid eye movement(s): (a) low chin EMG (for the majority of the epoch); (b) eyes closed with at least one rapid eye movement (concurrent with low chin tone); (c) irregular respiration; (d) mouthing, sucking, twitches, or brief head movements; and (e) EEG exhibits a continuous pattern without sleep spindles; (11) because rapid eye movements may not be seen on every page, epochs following an epoch of definite R in the absence of rapid eye movements may be scored if the EEG is continuous without TA or sleep spindles, chin muscle tone low for the majority of the epoch; and there is no intervening arousal; (12) Score N if four or more of the following conditions are present, including regular respiration, for the majority of the epoch: (a) eyes are closed with no eye movements; (b) chin EMG tone present; (c) regular respiration; and (d) EEG patterns of either TA, HVS, or sleep spindles are present; and (13) score T sleep if an epoch contains two or more discordant PSG state characteristics (either three NREM and two REM characteristics or two NREM and three REM characteristics). These criteria for ages 0-2 mo represent far more than baby steps. Like all the other AASM Manual rules and specifications none are fixed in stone, all open for debate, discussion and revision with the fundamental goal to provide standards for comparison of methods and results. A commentary on this article appears in this issue on page 291. © 2016 American Academy of Sleep Medicine.

Automatic Diagnosis of Obstructive Sleep Apnea/Hypopnea Events Using Respiratory Signals.

PubMed

Aydoğan, Osman; Öter, Ali; Güney, Kerim; Kıymık, M Kemal; Tuncel, Deniz

2016-12-01

Obstructive sleep apnea is a sleep disorder which may lead to various results. While some studies used real-time systems, there are also numerous studies which focus on diagnosing Obstructive Sleep Apnea via signals obtained by polysomnography from apnea patients who spend the night in sleep laboratory. The mean, frequency and power of signals obtained from patients are frequently used. Obstructive Sleep Apnea of 74 patients were scored in this study. A visual-scoring based algorithm and a morphological filter via Artificial Neural Networks were used in order to diagnose Obstructive Sleep Apnea. After total accuracy of scoring was calculated via both methods, it was compared with visual scoring performed by the doctor. The algorithm used in the diagnosis of obstructive sleep apnea reached an average accuracy of 88.33 %, while Artificial Neural Networks and morphological filter method reached a success of 87.28 %. Scoring success was analyzed after it was grouped based on apnea/hypopnea. It is considered that both methods enable doctors to reduce time and costs in the diagnosis of Obstructive Sleep Apnea as well as ease of use.

The Combined Effect of Sleep Duration and Quality on Mental Health Among Republic of Korea Armed Forces.

PubMed

Kim, Tae Kyung; Lee, Hee-Choon; Lee, Sang Gyu; Han, Kyu-Tae; Park, Eun-Cheol

2016-11-01

Sleep problems in the Republic of Korea Armed Forces have increased. This study analyzed the mental health impact of sleep duration and quality on personnel of the Republic of Korea Armed Forces. Data from the 2014 Military Health Survey were used. Degree of sleep duration and quality were measured by this self-reported questionnaire. Analysis of variance was carried out to compare Kessler Psychological Distress Scale 10 (K10) scores. Multiple logistic regression analysis identified associations between sleep duration, quality, and K10 scores. Among the personnel studied, 2.5% reported severe sleep difficulties. The average sleep duration was 6.83 ± 1.12 hours. Short sleep duration and sleep difficulty were associated with poorer K10 scores. Higher K10 scores among individuals with short sleep duration and low sleep quality were identified in the isolated military area group, the over 53 working hours/week group, and the enlisted soldier group. The factors listed were not by themselves associated with poorer mental health scores. Rather, specific workplaces and specific rank groups were more prone to poorer mental health. These results provide helpful information to minimize the negative psychological effects of sleep factors and to promote a sleep problem prevention and management policy. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Sleep and Native Language Interference Affect Non-Native Speech Sound Learning

PubMed Central

Earle, F. Sayako; Myers, Emily B.

2015-01-01

Adults learning a new language are faced with a significant challenge: non-native speech sounds that are perceptually similar to sounds in one’s native language can be very difficult to acquire. Sleep and native language interference, two factors that may help to explain this difficulty in acquisition, are addressed in three studies. Results of Experiment 1 showed that participants trained on a non-native contrast at night improved in discrimination 24 hours after training, while those trained in the morning showed no such improvement. Experiments 2 and 3 addressed the possibility that incidental exposure to perceptually similar native language speech sounds during the day interfered with maintenance in the morning group. Taken together, results show that the ultimate success of non-native speech sound learning depends not only on the similarity of learned sounds to the native language repertoire, but also to interference from native language sounds before sleep. PMID:26280264

Sleep and native language interference affect non-native speech sound learning.

PubMed

Earle, F Sayako; Myers, Emily B

2015-12-01

Adults learning a new language are faced with a significant challenge: non-native speech sounds that are perceptually similar to sounds in one's native language can be very difficult to acquire. Sleep and native language interference, 2 factors that may help to explain this difficulty in acquisition, are addressed in 3 studies. Results of Experiment 1 showed that participants trained on a non-native contrast at night improved in discrimination 24 hr after training, while those trained in the morning showed no such improvement. Experiments 2 and 3 addressed the possibility that incidental exposure to perceptually similar native language speech sounds during the day interfered with maintenance in the morning group. Taken together, results show that the ultimate success of non-native speech sound learning depends not only on the similarity of learned sounds to the native language repertoire, but also to interference from native language sounds before sleep. (c) 2015 APA, all rights reserved).

Automated sleep scoring and sleep apnea detection in children

NASA Astrophysics Data System (ADS)

Baraglia, David P.; Berryman, Matthew J.; Coussens, Scott W.; Pamula, Yvonne; Kennedy, Declan; Martin, A. James; Abbott, Derek

2005-12-01

This paper investigates the automated detection of a patient's breathing rate and heart rate from their skin conductivity as well as sleep stage scoring and breathing event detection from their EEG. The software developed for these tasks is tested on data sets obtained from the sleep disorders unit at the Adelaide Women's and Children's Hospital. The sleep scoring and breathing event detection tasks used neural networks to achieve signal classification. The Fourier transform and the Higuchi fractal dimension were used to extract features for input to the neural network. The filtered skin conductivity appeared visually to bear a similarity to the breathing and heart rate signal, but a more detailed evaluation showed the relation was not consistent. Sleep stage classification was achieved with and accuracy of around 65% with some stages being accurately scored and others poorly scored. The two breathing events hypopnea and apnea were scored with varying degrees of accuracy with the highest scores being around 75% and 30%.

Work-Family Conflict and Employee Sleep: Evidence from IT Workers in the Work, Family and Health Study.

PubMed

Buxton, Orfeu M; Lee, Soomi; Beverly, Chloe; Berkman, Lisa F; Moen, Phyllis; Kelly, Erin L; Hammer, Leslie B; Almeida, David M

2016-10-01

Work-family conflict is a threat to healthy sleep behaviors among employees. This study aimed to examine how Work-to-Family Conflict (demands from work that interfere with one's family/personal life; WTFC) and Family-to-Work Conflict (demands from family/personal life that interfere with work; FTWC) are associated with several dimensions of sleep among information technology workers. Employees at a U.S. IT firm (n = 799) provided self-reports of sleep sufficiency (feeling rested upon waking), sleep quality, and sleep maintenance insomnia symptoms (waking up in the middle of the night or early morning) in the last month. They also provided a week of actigraphy for nighttime sleep duration, napping, sleep timing, and a novel sleep inconsistency measure. Analyses adjusted for work conditions (job demands, decision authority, schedule control, and family-supportive supervisor behavior), and household and sociodemographic characteristics. Employees who experienced higher WTFC reported less sleep sufficiency, poorer sleep quality, and more insomnia symptoms. Higher WTFC also predicted shorter nighttime sleep duration, greater likelihood of napping, and longer nap duration. Furthermore, higher WTFC was linked to greater inconsistency of nighttime sleep duration and sleep clock times, whereas higher FTWC was associated with more rigidity of sleep timing mostly driven by wake time. Results highlight the unique associations of WTFC/FTWC with employee sleep independent of other work conditions and household and sociodemographic characteristics. Our novel methodological approach demonstrates differential associations of WTFC and FTWC with inconsistency of sleep timing. Given the strong associations between WTFC and poor sleep, future research should focus on reducing WTFC. © 2016 Associated Professional Sleep Societies, LLC.

Investigation on dysfunctional beliefs and attitudes about sleep in Chinese college students.

PubMed

Jin, Lairun; Zhou, Jun; Peng, Hui; Ding, Shushu; Yuan, Hui

2018-01-01

The aims of this study were to evaluate a subset of sleep-related cognitions and to examine whether dysfunctional beliefs and attitudes about sleep were associated with sleep quality in college students. A total of 1,333 college students were enrolled in this study by randomized cluster sampling. A brief version of Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16) was administered to college students at several colleges. Sleep quality was also assessed using the Pittsburgh Sleep Quality Index (PSQI). The DBAS-16 scores were analyzed across different demographic variables, corresponding subscales of 7-item PSQI, and relevant sleep behavior variables. A total of 343 participants were poor sleepers, while 990 were good sleepers, as defined by PSQI. The DBAS-16 scores were lower in poor sleepers than in good sleepers (46.32 ± 7.851 vs 49.87 ± 8.349, p < 0.001), and DBAS-16 scores were lower in females and nonmedical students when compared with those in males and medical students, respectively (48.20 ± 8.711 vs 49.73 ± 7.923, p = 0.001; 48.56 ± 8.406 vs 49.88 ± 8.208, p = 0.009, respectively). The total score for sleep quality, as measured by PSQI, was negatively correlated with the DBAS-16 total score ( r = -0.197, p < 0.01). There were significant differences in PSQI scores between individuals with attitudes and those without attitudes about sleep with respect to good sleep habits ( p < 0.001), self-relaxation ( p = 0.001), physical exercise ( p < 0.001), taking sleeping pills ( p = 0.004), and taking no action ( p < 0.001). Dysfunctional beliefs about sleep are associated with sleep quality and should be discouraged, especially for females and nonmedical college students.

[Sleep disorders associated with essential tremor and Parkinson's disease].

PubMed

Chen, Juping; Yao, Jianxin; Chen, Li; Miao, Hong; Mao, Chengjie; Liu, Chunfeng

2015-01-20

To evaluate the sleep quality and explore the manifestations of sleep disorders for 62 essential tremor (ET) patients, 60 normal controls and 62 Parkinson's disease (PD) patients. A total of 62 ET patients, 60 normal controls and 62 PD patients from June 2009 to December 2013 were recruited. All of them were outpatients at Second Affiliated Hospital, Soochow University and Hospital of Changshu Hospital of Traditional Chinese Medicine. Sleep was assessed with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). The global PSQI score was 4.7 ± 2.5 in controls, 6.0 ± 4.0 in ET cases and 7.4 ± 3. 7 in PD cases. PD cases had the highest PSQI score, followed by ET (intermediate) and lowest scores in controls (F = 9.022, P = 0.000). A poor quality of sleep was observed in normal controls (23/62, 38.3%) compared to ET cases (34/62, 54.8%) and PD cases (40/62, 64.5%) (χ² = 8.555, P = 0.014 when comparing all three groups and χ² = 1.206, P = 0.272 when ET vs PD). The ESS score increased from normal controls (4.4 ± 2.5) to ET cases (6.3 ± 4.8) and PD cases (8.2 ± 4.2). An ESS score ≥ 10 (an indicator of greater than normal levels of daytime sleepiness) was observed in 6 (10.0%) normal controls, compared to ET cases (16, 25.8%) and PD cases (20, 32.3%) (χ² = 9.047, P = 0.011 when comparing all three groups and χ² = 0.626, P = 0.429 when ET vs PD). For normal controls, ET and PD patients, the factor scores of subjective sleep were 0.6 ± 0.7, 0.8 ± 0.8 and 1.1 ± 0.7; the factor scores of quality sleep latency 0.6 ± 0.7, 0.9 ± 0.9 and 1.1 ± 1.0; the factor scores of sleep duration 0.6 ± 0.8, 0.7 ± 1.0 and 1.0 ± 0.9; the factor scores of sleep efficiency 0.6 ± 0.8, 0.9 ± 0.9 and 1.0 ± 1.0; the factor scores of sleep disturbances 1.2 ± 0.6, 1.2 ± 0.5 and 1.7 ± 0.7; the factor scores of daytime dysfunction 1.2 ± 1.0, 1.3 ± 1.0 and 2.0 ± 1.1 respectively. There were inter-group statistical differences in subjective sleep (F = 7.709, P = 0.001), quality sleep latency (F = 4.414, P = 0.013), sleep duration (F = 4.464, P = 0.013), sleep efficiency (F = 3.201, P = 0.043), sleep disturbances (F = 12.594, P = 0.000) and daytime dysfunction (F = 9.022, P = 0.000) . However, no inter-group statistical differences existed in use of sleeping medication (F = 1.200, P = 0.304). There were statistical differences in subjective sleep (P < 0.05), sleep efficiency (P < 0.05) and daytime dysfunction (P < 0.05) between ET and PD patients. Some sleep scores in ET are intermediate between those of PD cases and normal controls. And it suggests that a mild form of sleep dysregulation may be present in ET.

Restoring effective sleep tranquility (REST): A feasibility and pilot study.

PubMed

Eakman, Aaron M; Schmid, Arlene A; Henry, Kimberly L; Rolle, Natalie R; Schelly, Catherine; Pott, Christine E; Burns, Joshua E

2017-06-01

The purpose of this pilot study was to establish the feasibility of completing a future controlled trial of a multi-component cognitive behavioral therapy for insomnia program for military veterans with sleep disturbance. This was a single-arm feasibility and pilot study. Participants were United States post-9/11 veterans with service-connected injuries, university students, and had self-reported sleep disturbances. Restoring Effective Sleep Tranquility was a multi-component cognitive behavioral therapy for insomnia intervention consisting of seven sessions of group therapy and eight 1:1 sessions delivered by occupational therapists. Feasibility and pilot indicators were process, resources, management, and scientific, including pre-post-assessments of sleep difficulties, dysfunctional sleep beliefs, participation, and pain interference. Indicators were supportive of feasibility, including reduced sleep difficulties (for example Medical Outcomes Study Sleep Measure [ t  = 3.29, p  = .02]), reduced nightmares: t  = 2.79, p  = .03; fewer dysfunctional sleep beliefs: t  = 3.63, p  = .01, and greater ability to participate in social roles: t  = -2.86, p  = .03, along with trends towards improved satisfaction with participation and reduced pain interference. The Restoring Effective Sleep Tranquility program may reduce sleep difficulties and improve participation in US veterans with service-connected injuries, and evidence indicates a controlled trial would be feasible to deliver.

Restoring effective sleep tranquility (REST): A feasibility and pilot study

PubMed Central

Schmid, Arlene A; Henry, Kimberly L; Rolle, Natalie R; Schelly, Catherine; Pott, Christine E; Burns, Joshua E

2017-01-01

Introduction The purpose of this pilot study was to establish the feasibility of completing a future controlled trial of a multi-component cognitive behavioral therapy for insomnia program for military veterans with sleep disturbance. Method This was a single-arm feasibility and pilot study. Participants were United States post-9/11 veterans with service-connected injuries, university students, and had self-reported sleep disturbances. Restoring Effective Sleep Tranquility was a multi-component cognitive behavioral therapy for insomnia intervention consisting of seven sessions of group therapy and eight 1:1 sessions delivered by occupational therapists. Feasibility and pilot indicators were process, resources, management, and scientific, including pre–post-assessments of sleep difficulties, dysfunctional sleep beliefs, participation, and pain interference. Findings Indicators were supportive of feasibility, including reduced sleep difficulties (for example Medical Outcomes Study Sleep Measure [t = 3.29, p = .02]), reduced nightmares: t = 2.79, p = .03; fewer dysfunctional sleep beliefs: t = 3.63, p = .01, and greater ability to participate in social roles: t = –2.86, p = .03, along with trends towards improved satisfaction with participation and reduced pain interference. Conclusion The Restoring Effective Sleep Tranquility program may reduce sleep difficulties and improve participation in US veterans with service-connected injuries, and evidence indicates a controlled trial would be feasible to deliver. PMID:28626295

New assessment tools that measure sleep vital signs: the SleepMed Insomnia Index and the Sleep Matrix

PubMed Central

Bogan, Richard K; Turner, Jo Anne

2007-01-01

Insomnia is the leading sleep disorder in the US; however, diagnosis is often problematic. This pilot study assessed the clinical value of a novel diagnostic insomnia questionnaire. The SleepMed Insomnia Index (SMI) was administered to 543 consecutive patients and 50 normal control subjects during a pilot study. Mean SMI scores were assessed based on subsequent sleep-related diagnoses. The SMI scores for patients with sleep-related disorders were significantly higher than those for the control group (p < 0.001) and highest for the 90 patients comprising the insomnia group. Analysis of the SMI scores from the 90 insomnia patients indicates a high degree of reliability (Cronbach’s alpha: 0.7). These data support our clinical experience with this diagnostic tool which indicates a strong likelihood of disrupted nighttime sleep in patients with high SMI scores. Following further validation, the SMI may prove to be a valuable tool for evaluating sleep disorders, specifically as an aid in the diagnosis of insomnia. The Sleep Matrix is a visual tool that quantifies a sleep complaint by combining scores from the Epworth Sleepiness Scale (ESS) and the SMI. The SMI measures an insomnia component while the ESS is an accepted measure of daytime sleepiness. The Sleep Matrix visually displays the complexity of the sleep complaint in an effort to differentiate insomnia with differing etiologies from other sleep disorders and measure treatment outcomes. To pilot test the Sleep Matrix, the tool was administered to 90 patients with insomnia and to 22 normal controls. Plots from the insomnia patients were concentrated into the “insomnia zone” while scores from the normal controls were located in the “normal zone” located in the lower left quadrant. Additional research using the Sleep Matrix could provide data that the tool could be utilized to visually aid the clinician in the diagnosis of unknown sleep complaints. PMID:19300579

Levels of Interference in Long and Short-Term Memory Differentially Modulate Non-REM and REM Sleep.

PubMed

Fraize, Nicolas; Carponcy, Julien; Joseph, Mickaël Antoine; Comte, Jean-Christophe; Luppi, Pierre-Hervé; Libourel, Paul-Antoine; Salin, Paul-Antoine; Malleret, Gaël; Parmentier, Régis

2016-12-01

It is commonly accepted that sleep is beneficial to memory processes, but it is still unclear if this benefit originates from improved memory consolidation or enhanced information processing. It has thus been proposed that sleep may also promote forgetting of undesirable and non-essential memories, a process required for optimization of cognitive resources. We tested the hypothesis that non-rapid eye movement sleep (NREMS) promotes forgetting of irrelevant information, more specifically when processing information in working memory (WM), while REM sleep (REMS) facilitates the consolidation of important information. We recorded sleep patterns of rats trained in a radial maze in three different tasks engaging either the long-term or short-term storage of information, as well as a gradual level of interference. We observed a transient increase in REMS amount on the day the animal learned the rule of a long-term/reference memory task (RM), and, in contrast, a positive correlation between the performance of rats trained in a WM task involving an important processing of interference and the amount of NREMS or slow wave activity. Various oscillatory events were also differentially modulated by the type of training involved. Notably, NREMS spindles and REMS rapid theta increase with RM training, while sharp-wave ripples increase with all types of training. These results suggest that REMS, but also rapid oscillations occurring during NREMS would be specifically implicated in the long-term memory in RM, whereas NREMS and slow oscillations could be involved in the forgetting of irrelevant information required for WM. © 2016 Associated Professional Sleep Societies, LLC.

Respiratory Inductance Plethysmography Improved Diagnostic Sensitivity and Specificity of Obstructive Sleep Apnea.

PubMed

Kogan, Dmitriy; Jain, Arad; Kimbro, Shawn; Gutierrez, Guillermo; Jain, Vivek

2016-08-01

Respiratory inductance plethysmography (RIP) is a tool used during a polysomnogram (PSG), which serves as a surrogate of respiratory effort and can help detect inspiratory air-flow limitation. We hypothesize that RIP can improve the sensitivity and specificity of scoring hypopneas when compared with both the recommended and acceptable criteria of the American Academy of Sleep Medicine. We retrospectively analyzed a cohort of 12 subjects who had no obstructive sleep apnea (OSA) or mild OSA on PSG when scored by the American Academy of Sleep Medicine acceptable criteria for hypopneas but had high clinical suspicion for a diagnosis of OSA. These subjects were rescored using the American Academy of Sleep Medicine recommended criteria as well as RIP. Hypopnea was scored when there was a 50% decrease in the amplitude of the RIP sum channel (which combined input from chest and abdominal belts). OSA was diagnosed if the subjects had >5 respiratory events/h of sleep. The subject's response to CPAP was assessed by using a short questionnaire called the post-PSG sleep assessment. which evaluated subjective sleep quality. A positive response was considered an improvement in the post-PSG sleep assessment score after CPAP use. When scored using the American Academy of Sleep Medicine acceptable criteria, 10 subjects had a negative study, and 2 subjects had mild OSA for a sensitivity of 11% and specificity of 50%. When scored using the recommended criteria, 10 subjects had OSA, and 2 were negative, for a sensitivity of 78% and specificity of 70%. By RIP scoring, all 12 subjects had >5 respiratory events/h for a sensitivity of 100% and specificity of 75%. This small retrospective pilot study showed improved sensitivity and specificity when scoring hypopneas by RIP sum channel. Copyright © 2016 by Daedalus Enterprises.

Evidence for age-associated disinhibition of the wake drive provided by scoring principal components of the resting EEG spectrum in sleep-provoking conditions.

PubMed

Putilov, Arcady A; Donskaya, Olga G

2016-01-01

Age-associated changes in different bandwidths of the human electroencephalographic (EEG) spectrum are well documented, but their functional significance is poorly understood. This spectrum seems to represent summation of simultaneous influences of several sleep-wake regulatory processes. Scoring of its orthogonal (uncorrelated) principal components can help in separation of the brain signatures of these processes. In particular, the opposite age-associated changes were documented for scores on the two largest (1st and 2nd) principal components of the sleep EEG spectrum. A decrease of the first score and an increase of the second score can reflect, respectively, the weakening of the sleep drive and disinhibition of the opposing wake drive with age. In order to support the suggestion of age-associated disinhibition of the wake drive from the antagonistic influence of the sleep drive, we analyzed principal component scores of the resting EEG spectra obtained in sleep deprivation experiments with 81 healthy young adults aged between 19 and 26 and 40 healthy older adults aged between 45 and 66 years. At the second day of the sleep deprivation experiments, frontal scores on the 1st principal component of the EEG spectrum demonstrated an age-associated reduction of response to eyes closed relaxation. Scores on the 2nd principal component were either initially increased during wakefulness or less responsive to such sleep-provoking conditions (frontal and occipital scores, respectively). These results are in line with the suggestion of disinhibition of the wake drive with age. They provide an explanation of why older adults are less vulnerable to sleep deprivation than young adults.

The scoring of arousal in sleep: reliability, validity, and alternatives.

PubMed

Bonnet, Michael H; Doghramji, Karl; Roehrs, Timothy; Stepanski, Edward J; Sheldon, Stephen H; Walters, Arthur S; Wise, Merrill; Chesson, Andrew L

2007-03-15

The reliability and validity of EEG arousals and other types of arousal are reviewed. Brief arousals during sleep had been observed for many years, but the evolution of sleep medicine in the 1980s directed new attention to these events. Early studies at that time in animals and humans linked brief EEG arousals and associated fragmentation of sleep to daytime sleepiness and degraded performance. Increasing interest in scoring of EEG arousals led the ASDA to publish a scoring manual in 1992. The current review summarizes numerous studies that have examined scoring reliability for these EEG arousals. Validity of EEG arousals was explored by review of studies that empirically varied arousals and found deficits similar to those found after total sleep deprivation depending upon the rate and extent of sleep fragmentation. Additional data from patients with clinical sleep disorders prior to and after effective treatment has also shown a continuing relationship between reduction in pathology-related arousals and improved sleep and daytime function. Finally, many suggestions have been made to refine arousal scoring to include additional elements (e.g., CAP), change the time frame, or focus on other physiological responses such as heart rate or blood pressure changes. Evidence to support the reliability and validity of these measures is presented. It was concluded that the scoring of EEG arousals has added much to our understanding of the sleep process but that significant work on the neurophysiology of arousal needs to be done. Additional refinement of arousal scoring will provide improved insight into sleep pathology and recovery.

A Mixed Methods Examination of Sleep Throughout the Alcohol Recovery Process Grounded in the Social Cognitive Theory: The Role of Self-Efficacy and Craving.

PubMed

Brooks, Alyssa T; Krumlauf, Michael; Beck, Kenneth H; Fryer, Craig S; Yang, Li; Ramchandani, Vijay A; Wallen, Gwenyth R

2018-03-01

Sleep disturbances can accompany alcohol use disorders during various phases of the disease. This analysis utilized a mixed methods approach to assess whether sleep-related beliefs and/or behavior of individuals who are alcohol dependent were associated with sleep quality both pre- and postdischarge from a clinical research facility providing inpatient alcohol rehabilitation treatment. Individuals with higher self-efficacy for sleep (SE-S) reported better sleep quality at both time points. Individuals with fewer dysfunctional beliefs about sleep had poorer sleep quality at both time points. Individuals with higher unhealthy sleep-related safety behaviors had poorer sleep quality at both time points. In a linear regression model, only the difference in SE-S scores from pre- to postdischarge (β = -.396, p = .01) and the postdischarge Penn Alcohol Craving Score (β = .283, p = .019) significantly predicted the change in sleep quality. Thus, those whose SE-S scores increased and those with lower postdischarge craving scores were more likely to experience a decrease on Pittsburgh Sleep Quality Index scores from pre- to postdischarge even after controlling for covariates. References to behavior or personal factors were often discussed during the qualitative interviews in tandem with the environment. Participants reported both (1) self-medicating anxiety with alcohol and (2) self-medicating the inability to fall asleep with alcohol. Given the success of behavioral sleep interventions in various populations and the unique potential contributions of mixed methods approaches to examine sleep and alcohol use, assessing sleep-related cognitions and behaviors of individuals with severe alcohol use disorders may be important in understanding sleep quality and subsequent relapse.

Staging Sleep in Polysomnograms: Analysis of Inter-Scorer Variability

PubMed Central

Younes, Magdy; Raneri, Jill; Hanly, Patrick

2016-01-01

Study Objectives: To determine the reasons for inter-scorer variability in sleep staging of polysomnograms (PSGs). Methods: Fifty-six PSGs were scored (5-stage sleep scoring) by 2 experienced technologists, (first manual, M1). Months later, the technologists edited their own scoring (second manual, M2) based upon feedback from the investigators that highlighted differences between their scoring. The PSGs were then scored with an automatic system (Auto) and the technologists edited them, epoch-by-epoch (Edited-Auto). This resulted in 6 different manual scores for each PSG. Epochs were classified as scorer errors (one M1 score differed from the other 5 scores), scorer bias (all 3 scores of each technologist were similar, but differed from the other technologist) and equivocal (sleep scoring was inconsistent within and between technologists). Results: Percent agreement after M1 was 78.9% ± 9.0% and was unchanged after M2 (78.1% ± 9.7%) despite numerous edits (≈40/PSG) by the scorers. Agreement in Edited-Auto was higher (86.5% ± 6.4%, p < 1E−9). Scorer errors (< 2% of epochs) and scorer bias (3.5% ± 2.3% of epochs) together accounted for < 20% of M1 disagreements. A large number of epochs (92 ± 44/PSG) with scoring agreement in M1 were subsequently changed in M2 and/or Edited-Auto. Equivocal epochs, which showed scoring inconsistency, accounted for 28% ± 12% of all epochs, and up to 76% of all epochs in individual patients. Disagreements were largely between awake/NREM, N1/N2, and N2/N3 sleep. Conclusion: Inter-scorer variability is largely due to epochs that are difficult to classify. Availability of digitally identified events (e.g., spindles) or calculated variables (e.g., depth of sleep, delta wave duration) during scoring may greatly reduce scoring variability. Citation: Younes M, Raneri J, Hanly P. Staging sleep in polysomnograms: analysis of inter-scorer variability. J Clin Sleep Med 2016;12(6):885–894. PMID:27070243

Patient-reported sleep difficulty and cognitive function during the first year of dialysis.

PubMed

Kutner, Nancy G; Zhang, Rebecca; Huang, Yijian; Bliwise, Donald L

2008-01-01

Research in the general population indicates that sleep fragmentation is detrimental for cognitive function, but little attention has been given to this issue in dialysis patients. We hypothesized that patients with self-reported persistent sleep difficulty would have an increased risk of scoring lower on a cognitive function measure at follow-up compared to their score at baseline. Sleep difficulty and cognitive function were reported by a large national patient cohort near the start of dialysis and at a 9- to 12-month follow-up. Logistic regression was used to investigate the risk of scoring lower on a cognitive function measure at follow-up as a function of self-reported sleep difficulty, controlling for patients' sociodemographic, clinical and treatment characteristics, including depressed mood. At follow-up, cognitive function scores were lower among 35.8% of the cohort. Patients with self-reported persistent sleep difficulty had the lowest average cognitive function score. Men with reported persistent sleep difficulty, regardless of presence of depressed mood, had a significantly increased risk of a lower cognitive function score at follow-up. Women with reported persistent sleep difficulty as well as depressed mood had significantly increased risk of a lower cognitive function score. The potential impact of sleep difficulty and depressed mood on the cognitive function of dialysis patients emphasizes the importance of evaluating and treating these risks and highlights the value of continued research to improve our understanding and management of these issues.

Long-term Correction in Sleep Disturbance Is Sustained After Arthroscopic Rotator Cuff Repair.

PubMed

Horneff, John G; Tjoumakaris, Fotios; Wowkanech, Charles; Pepe, Matthew; Tucker, Bradford; Austin, Luke

2017-06-01

Sleep disturbance is a major complaint of patients with rotator cuff disease that often leads them to seek treatment. The authors previously reported a prospective analysis of patients who underwent rotator cuff repair and found that sleep disturbance significantly improved at 3 months after surgery. That improvement in sleep was maintained at 6 months. In the current study, the authors sought to gain medium-term data on this same population at greater than 2 years. The hypotheses were that improvement in sleep disturbance after arthroscopic rotator cuff repair is maintained at 2-year follow-up and that the continued use of narcotic pain medication has a negative effect on sleep quality at 2-year follow-up. Case series; Level of evidence, 4. The original cohort of patients was contacted at a minimum of 24 months after their surgery. Thirty-seven of the 56 patients (66%) involved in the original study were available. Patient outcomes were scored using the Pittsburgh Sleep Quality Index (PSQI), Simple Shoulder Test (SST), visual analog scale (VAS) for pain, and Single Assessment Numeric Evaluation (SANE). The newly obtained scores were compared with prior scores, which ranged from preoperatively to 6 months postoperatively. The statistically significant improvement of the PSQI score demonstrated in our prior analysis at 6 months postoperatively was maintained, with a mean PSQI score of 5.5 for the 37 patients followed beyond 24 months. Of those patients, 41% still had a PSQI score >5, indicative of sleep disturbance. However, even those patients in our study with a PSQI score >5, indicative of sleep disturbance, had an improved mean score of 9.3 at greater than 24 months compared with those patients with a PSQI score >5 at 6 months, who had a mean PSQI score of 11.5 ( P = .13). Both the SST and VAS scores displayed continued improvement at greater than 24 months, with both displaying moderate strength correlation to the PSQI score (VAS: Spearman rho = 0.479, P < .001; SST: Spearman rho = -0.505, P < .001). Regression models again demonstrated the continued use of narcotic pain medication correlating with poor sleep as the difference in the mean PSQI score between users and nonusers increased as postoperative time increased. At greater than 24 months after surgery, patients using narcotics had a mean PSQI score that was 7.4 points higher than narcotic nonusers (standard error [SE] = 1.93; P = .00017). At greater than 24 months, 41% of patients still demonstrated sleep disturbance, with both SST and VAS scores showing improvement. The prolonged use of narcotic medication negatively affects sleep, with a greater effect seen over time.

Reproducibility of a Standardized Actigraphy Scoring Algorithm for Sleep in a US Hispanic/Latino Population

PubMed Central

Patel, Sanjay R.; Weng, Jia; Rueschman, Michael; Dudley, Katherine A.; Loredo, Jose S.; Mossavar-Rahmani, Yasmin; Ramirez, Maricelle; Ramos, Alberto R.; Reid, Kathryn; Seiger, Ashley N.; Sotres-Alvarez, Daniela; Zee, Phyllis C.; Wang, Rui

2015-01-01

Study Objectives: While actigraphy is considered objective, the process of setting rest intervals to calculate sleep variables is subjective. We sought to evaluate the reproducibility of actigraphy-derived measures of sleep using a standardized algorithm for setting rest intervals. Design: Observational study. Setting: Community-based. Participants: A random sample of 50 adults aged 18–64 years free of severe sleep apnea participating in the Sueño sleep ancillary study to the Hispanic Community Health Study/Study of Latinos. Interventions: N/A. Measurements and Results: Participants underwent 7 days of continuous wrist actigraphy and completed daily sleep diaries. Studies were scored twice by each of two scorers. Rest intervals were set using a standardized hierarchical approach based on event marker, diary, light, and activity data. Sleep/wake status was then determined for each 30-sec epoch using a validated algorithm, and this was used to generate 11 variables: mean nightly sleep duration, nap duration, 24-h sleep duration, sleep latency, sleep maintenance efficiency, sleep fragmentation index, sleep onset time, sleep offset time, sleep midpoint time, standard deviation of sleep duration, and standard deviation of sleep midpoint. Intra-scorer intraclass correlation coefficients (ICCs) were high, ranging from 0.911 to 0.995 across all 11 variables. Similarly, inter-scorer ICCs were high, also ranging from 0.911 to 0.995, and mean inter-scorer differences were small. Bland-Altman plots did not reveal any systematic disagreement in scoring. Conclusions: With use of a standardized algorithm to set rest intervals, scoring of actigraphy for the purpose of generating a wide array of sleep variables is highly reproducible. Citation: Patel SR, Weng J, Rueschman M, Dudley KA, Loredo JS, Mossavar-Rahmani Y, Ramirez M, Ramos AR, Reid K, Seiger AN, Sotres-Alvarez D, Zee PC, Wang R. Reproducibility of a standardized actigraphy scoring algorithm for sleep in a US Hispanic/Latino population. SLEEP 2015;38(9):1497–1503. PMID:25845697

Sleep habits, food intake, and physical activity levels in normal and overweight and obese Malaysian children.

PubMed

Firouzi, Somayyeh; Poh, Bee Koon; Ismail, Mohd Noor; Sadeghilar, Aidin

2014-01-01

This study aimed to determine the association between sleep habits (including bedtime, wake up time, sleep duration, and sleep disorder score) and physical characteristics, physical activity level, and food pattern in overweight and obese versus normal weight children. Case control study. 164 Malaysian boys and girls aged 6-€“12 years. Anthropometric measurements included weight, height, waist circumference, and body fat percentage. Subjects divided into normal weight (n = 82) and overweight/obese (n = 82) group based on World Health Organization 2007 BMI-for-age criteria and were matched one by one based on ethnicity, gender, and age plus minus one year. Questionnaires related to sleep habits, physical activity, and food frequency were proxy-reported by parents. Sleep disorder score was measured by Children Sleep Habit Questionnaire. Sleep disorder score and carbohydrate intake (%) to total energy intake were significantly higher in overweight/obese group (p < 0.01 and p < 0.05, respectively). After adjusting for age and gender, sleep disorder score was correlated with BMI (r = 0.275, p < 0.001), weight (r = 0.253, p < 0.001), and WC (r = 0.293, p < 0.001). Based on adjusted odd ratio, children with shortest sleep duration were found to have 4.5 times higher odds of being overweight/obese (odd ratio: 4.536, 95% CI: 1.912-€“8.898) compared to children with normal sleep duration. The odds of being overweight/obese in children with sleep disorder score higher than 48 were 2.17 times more than children with sleep disorder score less than 48. Children who sleep lees than normal amount, had poor sleep quality, and consumed more carbohydrates were at higher risk of overweight/obesity. © 2014 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

The 2007 AASM Recommendations for EEG Electrode Placement in Polysomnography: Impact on Sleep and Cortical Arousal Scoring

PubMed Central

Ruehland, Warren R.; O'Donoghue, Fergal J.; Pierce, Robert J.; Thornton, Andrew T.; Singh, Parmjit; Copland, Janet M.; Stevens, Bronwyn; Rochford, Peter D.

2011-01-01

Study Objective: To examine the impact of using American Academy of Sleep Medicine (AASM) recommended EEG derivations (F4/M1, C4/M1, O2/M1) vs. a single derivation (C4/M1) in polysomnography (PSG) on the measurement of sleep and cortical arousals, including inter- and intra-observer variability. Design: Prospective, non-blinded, randomized comparison. Setting: Three Australian tertiary-care hospital clinical sleep laboratories. Patients or Participants: 30 PSGs from consecutive patients investigated for obstructive sleep apnea (OSA) during December 2007 and January 2008. Interventions: N/A Measurements and Results: To examine the impact of EEG derivations on PSG summary statistics, 3 scorers from different Australian clinical sleep laboratories each scored separate sets of 10 PSGs twice, once using 3 EEG derivations and once using 1 EEG derivation. To examine the impact on inter- and intra-scorer reliability, all 3 scorers scored a subset of 10 PSGs 4 times, twice using each method. All PSGs were de-identified and scored in random order according to the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Using 3 referential EEG derivations during PSG, as recommended in the AASM manual, instead of a single central EEG derivation, as originally suggested by Rechtschaffen and Kales (1968), resulted in a mean ± SE decrease in N1 sleep of 9.6 ± 3.9 min (P = 0.018) and an increase in N3 sleep of 10.6 ± 2.8 min (P = 0.001). No significant differences were observed for any other sleep or arousal scoring summary statistics; nor were any differences observed in inter-scorer or intra-scorer reliability for scoring sleep or cortical arousals. Conclusion: This study provides information for those changing practice to comply with the 2007 AASM recommendations for EEG placement in PSG, for those using portable devices that are unable to comply with the recommendations due to limited channel options, and for the development of future standards for PSG scoring and recording. As the use of multiple EEG derivations only led to small changes in the distribution of derived sleep stages and no significant differences in scoring reliability, this study calls into question the need to use multiple EEG derivations in clinical PSG as suggested in the AASM manual. Citation: Ruehland WR; O'Donoghue FJ; Pierce RJ; Thornton AT; Singh P; Copland JM; Stevens B; Rochford PD. The 2007 AASM recommendations for EEG electrode placement in polysomnography: impact on sleep and cortical arousal scoring. SLEEP 2011;34(1):73-81. PMID:21203376

[Sleep quality and occupational stress relationship analysis of 1413 train drivers in a railway bureau].

PubMed

Gu, G Z; Yu, S F; Zhou, W H; Wu, H; Kang, L; Chen, R

2017-07-20

Objective: To investigate sleep quality status of train drivers. Methods: By using cluster sampling method, a cross-sectional study was conducted in 1413 train drivers (including passenger train drivers 301, freight train drivers 683, passenger shunting train drivers 350, and high speed train drivers 79) from a railway bureau. The occupational stressors, strains, personalities and sleep quality were measured using occupational stress instruments and effort-reward imbalance questionnaire. Results: The train drivers of poor sleep quality was 48.34%. Sleep quality scores among different among different job category (job title) , exercise, smoking and drinking were statistical significance ( P <0.01) . Differences of sleep quality among different educational level, marry status, age, length of service groups weren't statistical significance ( P >0.05) . Correlation: analysis revealed that sleep quality score was related negatively to job satisfaction, reward, working stability, promotion opportunities, positive affectivity, esteem and self-esteem scores ( r : -0.454, -0.207, -0.329,-0.170, -0.291, -0.103, -0.139, P <0.01 or P <0.05) , positively to social support, effort, role conflict, conflict between groups, conflict in groups, responsibility for person, responsibility for thing, psychological needs, physiological needs, daily stress, negative affectivity, depressive symptoms scores ( r : 0.338, 0.524, 0.226, 0.094, 0.182, 0.210, 0.247, 0.190, 0.615, 0.550, 0.345, 0.570, P <0.01) . Nonparametric test found that train drivers of group with high sleep quality score reported higher scores for physiological need, psychological need, effort, role conflict, conflict between groups, social support, daily stress, depressive symptoms, responsibility for person, responsibility for thing, negative affectivity and coping scores than the group of lower sleep quality score ( P <0.01) . But reword, job satisfaction, positive affectivity, self-esteem working stability and Promotion opportunities scores were lower than the group of lower sleep quality score (P<0.01) . Multivariate logistic regression analysis revealed the risk for more physiological needs, more effort, more depressive symptoms and more daily stress for drivers occured the risk of poor sleep quality were more than two times as high as that of drivers with less physiological needs, less effort, less depressive symptoms and less daily stress ( OR =2.905~2.005) . Conclusions Different types of locomotive drivers get different level of sleep quality. Sleep quality was affected by occupational stress largely. Reducing the occupational stress may contribute to improve the sleep quality of train drivers.

Automated determination of wakefulness and sleep in rats based on non-invasively acquired measures of movement and respiratory activity

PubMed Central

Zeng, Tao; Mott, Christopher; Mollicone, Daniel; Sanford, Larry D.

2012-01-01

The current standard for monitoring sleep in rats requires labor intensive surgical procedures and the implantation of chronic electrodes which have the potential to impact behavior and sleep. With the goal of developing a non-invasive method to determine sleep and wakefulness, we constructed a non-contact monitoring system to measure movement and respiratory activity using signals acquired with pulse Doppler radar and from digitized video analysis. A set of 23 frequency and time-domain features were derived from these signals and were calculated in 10 s epochs. Based on these features, a classification method for automated scoring of wakefulness, non-rapid eye movement sleep (NREM) and REM in rats was developed using a support vector machine (SVM). We then assessed the utility of the automated scoring system in discriminating wakefulness and sleep by comparing the results to standard scoring of wakefulness and sleep based on concurrently recorded EEG and EMG. Agreement between SVM automated scoring based on selected features and visual scores based on EEG and EMG were approximately 91% for wakefulness, 84% for NREM and 70% for REM. The results indicate that automated scoring based on non-invasively acquired movement and respiratory activity will be useful for studies requiring discrimination of wakefulness and sleep. However, additional information or signals will be needed to improve discrimination of NREM and REM episodes within sleep. PMID:22178621

Psychoeducational Intervention for Symptom Management of Fatigue, Pain, and Sleep Disturbance Cluster Among Cancer Patients: A Pilot Quasi-Experimental Study.

PubMed

Nguyen, Ly Thuy; Alexander, Kimberly; Yates, Patsy

2018-06-01

To assess the feasibility of conducting a trial of a psychoeducational intervention involving the provision of tailored information and coaching to improve management of a cancer-related symptom cluster (fatigue, pain, and sleep disturbance) and reduce symptom cluster impacts on patient health outcomes in the Vietnamese context and to undertake a preliminary evaluation of the intervention. A parallel-group single-blind pilot quasi-experimental trial was conducted with 102 cancer patients in one Vietnamese hospital. The intervention group received one face-to-face session and two phone sessions delivered by a nurse one week apart, and the comparison group received usual care. Patient outcomes were measured at baseline before the chemotherapy cycle and immediately preceding the next chemotherapy cycle. Separate linear mixed models were used to evaluate the impact of the intervention on total symptom cluster severity, symptom scores, functional status, depressive symptoms, and health-related quality of life. The study design was feasible with a recruitment rate of 22.6% and attrition rate of 9.8%. Compared to the control group, the intervention group showed a significant reduction in symptom cluster severity, fatigue severity, fatigue interference, sleep disturbance, depression, and anxiety. Significant differences were not observed for pain severity, pain interference, functional status, and health-related quality of life. The intervention was acceptable to the study population, with a high attendance rate of 78% and adherence rate of 95.7%. On the basis of the present study findings, future randomized controlled trials are needed to test the effectiveness of a symptom cluster psychoeducational intervention in Vietnam. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Association Between Internet Use and Sleep Problems in Adolescents.

PubMed

Ekinci, Özalp; Çelik, Tanju; Savaş, Nazan; Toros, Fevziye

2014-06-01

Sleep problems are commonly encountered in adolescents. It has been shown that electronic media have a negative influence on the sleep quality and daytime functioning in adolescents. This study aims to investigate the association between internet use and sleep problems in adolescents. A total of 1212 adolescents were recruited to the study. Self-report study questionnaire included two main parts: Young's Internet Addiction Scale (IAS) and a semi-structured inquiry on sleep habits/problems. Of the study sample, 16% (n=198) reported their sleep quality as bad or very bad. One-fourth of the sample reported using internet everyday and 27% of them reported spending more than one hour when online. The mean IAS total score was 35.56±13.87. Adolescents with a higher IAS score reported getting to bed later in the night, needing more time to fall asleep and having an increased number of awakenings in the night than the adolescents with lower IAS score (p=.001). They were also found to have higher frequencies of several sleep problems including difficulty in initiating and sustaining sleep, difficulty in waking up and feelings of sleepiness in day. In addition, sleep quality of them was worse when compared to the adolescents with a lower IAS score (p=.001). Problematic sleep habits and sleep problems were found to be more frequent in adolescents with a higher IAS total score. Health care providers must be aware of the possible negative impact of excessive and uncontrolled internet use on adolescents' sleep habits.

Sleep habits and disturbances in Malaysian children with epilepsy.

PubMed

Ong, Lai Choo; Yang, Wai Wai; Wong, Sau Wei; alSiddiq, Feizel; Khu, Yi Soon

2010-03-01

To compare sleep habits and disturbances between Malaysian children with epilepsy and their siblings (age range 4-18 years) and to determine the factors associated with greater sleep disturbance. The Sleep Disturbance Scale for Children (SDSC) questionnaire was completed by the primary caregiver for 92 epileptic children (mean age 11.1 years, 50 male, 42 females) and their healthy siblings (mean age 11.1 years, 47 males, 45 females). Details of sleep arrangements and illness severity were obtained. Multiple regression analysis was used to determine factors associated with high Total SDSC scores in epileptic patients. Compared with their siblings, epileptic children had significantly higher total SDSC score (difference between means 8.7, 95% confidence interval (CI) 6.4-11.1) and subscale scores in disorders of initiating and maintaining sleep (3.9, 95% CI 2.8-5.2), sleep-wake transition disorders (2.1, 95% CI 1.3-2.9), sleep-disordered breathing (0.7, 95% CI 0.3-1.1) and disorders of excessive sleepiness (1.5, 95% CI 0.6-2.4). Epileptic children had a higher prevalence of co-sleeping (73.7% vs 31.5%) and on more nights per week (difference between means 3, 95% CI 2.0-3.9) than their siblings. Higher Epilepsy Illness Severity scores were associated with higher total SDSC scores (P= 0.02). Co-sleeping was highly prevalent in children with epilepsy, who also had more sleep disturbances (especially problems with initiating and maintaining sleep and sleep-wake transition disorders) than their siblings. Epilepsy severity contributed to the sleep disturbances. Evaluation of sleep problems should form part of the comprehensive care of children with severe epilepsy.

Determinants of Quality of Life in Lung Cancer Patients.

PubMed

Hung, Hsiu-Yu; Wu, Li-Min; Chen, Kang-Pan

2018-05-01

To examine the relationships of self-care, symptoms, and a variety of demographic factors to quality of life (QOL), and to identify determinants of QOL in lung cancer patients undergoing chemotherapy. A cross-sectional, correlational study. 159 patients with lung cancer undergoing chemotherapy were recruited from three southern hospitals in Taiwan. Four instruments were used: the Quality of Life Questionnaire Core 30-item (QLQ-C30), M.D. Anderson Symptom Inventory (MDASI), Memorial Symptom Assessment Scale-Short Form (MSAS-SF), and Self-Care Behavior Scale (SCBS). Lung cancer patients rated lower scores of self-care behaviors on food choice and nutrition maintenance, regular exercise and sleep, and medical compliance. Being younger, having spouses as main caregivers, having food choice and nutrition maintenance, and getting regular exercise and sleep were associated with better QOL. Degree of interference with life, age, food choice and nutrition maintenance, and psychological symptoms were found to predict functional QOL and accounted for 43% of total variance. The findings identified factors influencing QOL and provided evidence for designing an intervention to enhance QOL in lung cancer patients undergoing chemotherapy. The findings may be useful for guiding intervention development for early detection and management of symptom interference with daily living, and place greater focus on patient self-care to promote food choice and nutrition maintenance, especially in older patients and those whose caregivers are not their spouses. © 2018 Sigma Theta Tau International.

Prevalence of poor sleep quality, sleepiness and obstructive sleep apnoea risk factors in athletes.

PubMed

Swinbourne, Richard; Gill, Nicholas; Vaile, Joanna; Smart, Daniel

2016-10-01

Despite the perceived importance of sleep for athletes, little is known regarding athlete sleep quality, their prevalence of daytime sleepiness or risk factors for obstructive sleep apnoea (OSA) such as snoring and witnessed apnoeic episodes. The purpose of the present study was to characterise normative sleep quality among highly trained team sport athletes. 175 elite or highly trained rugby sevens, rugby union and cricket athletes completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Score (ESS) and Quality of Life questionnaires and an OSA risk factor screen. On average, athletes reported 7.9 ± 1.3 h of sleep per night. The average PSQI score was 5.9 ± 2.6, and 50% of athletes were found to be poor sleepers (PSQI > 5). Daytime sleepiness was prevalent throughout the population (average global score of 8.5) and clinically significant (ESS score of ≥10) in 28% of athletes. OSA may be an important clinical consideration within athletic populations, as a considerable number of athletes (38%) defined themselves as snorers and 8% reported having a witnessed apnoeic episode. The relationship between self-rated sleep quality and actual PSQI score was strong (Pearson correlation of 0.4 ± 0.1, 90% confidence limits). These findings suggest that this cohort of team sport athletes suffer a preponderance of poor sleep quality, with associated high levels of daytime sleepiness. Athletes should receive education about how to improve sleep wake schedules, extend total sleep time and improve sleep quality.

Racial/Ethnic and Socio-Contextual Correlates of Chronic Sleep Curtailment in Childhood

PubMed Central

Peña, Michelle-Marie; Rifas-Shiman, Sheryl L.; Gillman, Matthew W.; Redline, Susan; Taveras, Elsie M.

2016-01-01

Study Objectives: To examine the association between race/ethnicity and sleep curtailment from infancy to mid-childhood, and to determine the extent to which socioeconomic and contextual factors both explain racial/ethnic differences and are independently associated with sleep curtailment. Methods: We studied 1,288 children longitudinally in Project Viva, a pre-birth cohort study, from 6 months to 7 years of age. The main exposure was the child's race/ethnicity. The main outcome was a sleep curtailment score from 6 months to 7 years. The score ranged from 0–13, where 0 indicated maximal sleep curtailment and 13 indicated never having curtailed sleep. Results: The mean (standard deviation) sleep curtailment score was 10.2 (2.7) points. In adjusted models (β [95% CI]), black (−1.92, [−2.39, −1.45] points), Hispanic (−1.58, [−2.43, −0.72] points), and Asian (−1.71, [−2.55, −0.86] points) children had lower sleep scores than white children. Adjustment for sociodemographic covariates attenuated racial/ethnic differences in sleep scores for black (by 24%) and Hispanic children (by 32%) but strengthened the differences for Asian children by 14%. Further adjustment for environmental and behavioral variables did not substantially change these differences. Independently, low maternal education, living in households with incomes < $70,000, viewing more TV, and having a TV in the child's bedroom were associated with lower sleep scores. Conclusions: Chronic sleep curtailment from infancy to mid-childhood was more prevalent among black, Hispanic, and Asian children. These differences were partially but not entirely explained by socio-contextual variables. Independently, children from lower socioeconomic status and those with greater exposures to TV also had greater sleep curtailment. Citation: Peña MM, Rifas-Shiman SL, Gillman MW, Redline S, Taveras EM. Racial/ethnic and socio-contextual correlates of chronic sleep curtailment in childhood. SLEEP 2016;39(9):1653–1661. PMID:27306269

Sleep disorder among medical students: relationship to their academic performance.

PubMed

Abdulghani, Hamza M; Alrowais, Norah A; Bin-Saad, Norah S; Al-Subaie, Nourah M; Haji, Alhan M A; Alhaqwi, Ali I

2012-01-01

Medical students are exposed to a significant level of pressure due to academic demands. Their sleep pattern is characterized by insufficient sleep duration, delayed sleep onset, and occurrence of napping episodes during the day. To examine the prevalence of sleep disorder among medical students and investigate any relationship between sleep disorder and academic performance. This is a cross-sectional self-administered questionnaire-based study. The participants were medical students of the first, second, and third academic years. The Epworth Sleepiness Scale (ESS) was also included to identify sleep disorder and grade point average was recorded for academic performance. There were 491 responses with a response rate of 55%. The ESS score demonstrated that 36.6% of participants were considered to have abnormal sleep habits, with a statistically significant increase in female students (p = 0.000). Sleeping between 6-10 h per day was associated with normal ESS scores (p = 0.019) as well as the academic grades ≥ 3.75. Abnormal ESS scores were associated with lower academic achievement (p = 0.002). A high prevalence of sleep disorder was found in this group of students, specifically female students. Analysis of the relationship between sleep disorder and academic performance indicates a significant relationship between abnormal ESS scores, total sleeping hours, and academic performance.

Sleeping problems in mothers and fathers of patients suffering from congenital central hypoventilation syndrome.

PubMed

Paddeu, Erika Maria; Giganti, Fiorenza; Piumelli, Raffaele; De Masi, Salvatore; Filippi, Luca; Viggiano, Maria Pia; Donzelli, Gianpaolo

2015-09-01

Advanced medical technology has resulted in an increased survival rate of children suffering from congenital central hypoventilation syndrome. After hospitalization, these technology-dependent patients require special home care for assuring ventilator support and the monitoring of vital parameters mainly during sleep. The daily challenges associated with caring for these children can place primary caregivers under significant stress, especially at night. Our study aimed at investigating how this condition affects mothers and fathers by producing poor sleep quality, high-level diurnal sleepiness, anxiety, and depression. The study included parents of 23 subjects with congenital central hypoventilation syndrome and 23 healthy subjects. All parents filled out the Pittsburgh Sleep Quality Index (PSQI) questionnaire, Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory (BAI). A comparison between the two groups showed that parents of patients had poorer sleep quality, greater sleepiness, and higher BDI-II scores compared to that of parents of healthy subjects (respectively, PSQI score 6.5 vs 3.8, ESS score 6.2 vs 4.3, BDI-II score 8.4 vs 5.7). Specifically, mothers of patients showed poorer sleep quality and higher BDI-II scores compared to that of mothers of controls (respectively, PSQI score 7.5 vs 3.8, BDI-II score 9.3 vs 5.9), whereas fathers of patients showed greater levels of sleepiness with respect to fathers of healthy children (respectively, ESS score 6.8 vs 4.0). These differences emerged in parents of younger children. Congenital central hypoventilation syndrome impacts the family with different consequences for mothers and fathers. Indeed, while the patients' sleep is safeguarded, sleeping problems may occur in primary caregivers often associated with other psychological disorders. Specifically, this disease affects sleep quality and mood in the mothers and sleepiness levels in the fathers.

A feasibility study: Use of actigraph to monitor and follow-up sleep/wake patterns in individuals attending community pharmacy with sleeping disorders.

PubMed

Noor, Zaswiza Mohamad; Smith, Alesha J; Smith, Simon S; Nissen, Lisa M

2016-01-01

Community pharmacists are in a suitable position to give advice and provide appropriate services related to sleep disorders to individuals who are unable to easily access sleep clinics. An intervention with proper objective measure can be used by the pharmacist to assist in consultation. The study objectives are to evaluate: (1) The effectiveness of a community pharmacy-based intervention in managing sleep disorders and (2) the role of actigraph as an objective measure to monitor and follow-up individuals with sleeping disorders. The intervention care group (ICG) completed questionnaires to assess sleep scale scores (Epworth Sleepiness Scale [ESS] and Insomnia Severity Index [ISI]), wore a wrist actigraph, and completed a sleep diary. Sleep parameters (sleep efficiency in percentage [SE%], total sleep time, sleep onset latency, and number of nocturnal awakenings) from actigraphy sleep report were used for consultation and to validate sleep diary. The usual care group (UCG) completed similar questionnaires but received standard care. Pre- and post-mean scores for sleep scales and sleep parameters were compared between and within groups. A significant difference was observed when comparing pre- and post-mean scores for ISI in the ICG, but not for ESS. For SE%, an increase was found in the number of subjects rated as "good sleepers" at post-assessment in the ICG. ISI scores offer insights into the development of a community pharmacy-based intervention for sleeping disorders, particularly in those with symptoms of insomnia. It also demonstrates that actigraph could provide objective sleep/wake data to assist community pharmacists during the consultation.

Individual Differences in Response to Sleep Deprivation: Assessment of Fatigue Following Sleep Loss

NASA Technical Reports Server (NTRS)

Carskadon, Mary A.

1997-01-01

Previous work has indicated that a small but significant number of participants in sleep deprivation studies or in simulated shift work experiments manifests an exaggerated performance decrement when they reach a critical point in the experiment, usually near the trough of the circadian cycle or the middle of the night. Those who show this exaggerated response do not appear to differ from other non-nal volunteers in any substantial way according to usual screening criteria or baseline values. The present study aims to examine factors that may provide the basis for this extreme response. We propose that a preexisting sleep deficit-as manifested by low values on the Multiple Sleep Latency Test (MSLT)-may account for extreme responders. It has been shown that among normal volunteers screened for a variety of studies, approximately 20 to 25 percent show low (< 6 minutes) MSLT scores on a consistent basis, whereas a like proportion shows consistently high MSLT scores (> 13 minutes). Additionally, studies by this group have indicated that subjects with low MSLT scores may suffer from chronic insufficient sleep, as further substantiated by the finding that they have consistently higher nocturnal sleep efficiency and that their MSLT scores rise to normal values when sleep is extended. We hypothesize that the short MSLT subjects have a significant long-term sleep deficit that leads to a marked intolerance for sleep deprivation or shift work. We further suggest that this sleep debt may signify an increased sleep need in these individuals that is not met either due to personal preference or to societal pressures (or both). If this speculation is accurate, then we predict that the tolerance for sleep deprivation in such individuals can be increased by "pretreatment" with sleep extension. Thus, the present study is designed to test the following two hypotheses: (1) subjects with nominal sleep patterns who have low MSLT scores (e.g., Sleepy subjects) will show an exaggerated response (performance decrement) to sleep loss compared to subjects who have high MSLT scores (Alert subjects) on a nominal sleep schedule; (2) when permitted to extend sleep--thus discharging their sleep debt-the Sleepy subjects will show a sleep-loss response resembling that of the Alert subjects.

Individual Differences in Response to Sleep Deprivation: Assessment of Fatigue Following Sleep Loss

NASA Technical Reports Server (NTRS)

Carskadon, Mary A.

1997-01-01

Previous work has indicated that a small but significant number of participants in sleep deprivation studies or in simulated shift work experiments manifests an exaggerated performance decrement when they reach a critical point in the experiment, usually near the trough of the circadian cycle or the middle of the night. Those who show this exaggerated response do not appear to differ from other non-nal volunteers in any substantial way according to usual screening criteria or baseline values. The present study aims to examine factors that may provide the basis for this extreme response. We propose that a preexisting sleep deficit-as manifested by low values on the Multiple Sleep Latency Test (MSLT)-may account for extreme responders. Roth and colleagues (1993) have shown that among normal volunteers screened for a variety of studies, approximately 20 to 25 percent show low (< 6 minutes) MSLT scores on a consistent basis, whereas a like proportion shows consistently high MSLT scores (> 13 minutes). Additionally, studies by this group have indicated that subjects with low MSLT scores may suffer from chronic insufficient sleep (Roth et al., 1993), as further substantiated by the finding that they have consistently higher nocturnal sleep efficiency and that their MSLT scores rise to normal values when sleep is extended (Roehrs et al., 1996). We hypothesize that the short MSLT subjects have a significant long-term sleep deficit that leads to a marked intolerance for sleep deprivation or shift work. We further suggest that this sleep debt may signify an increased sleep need in these individuals that is not met either due to personal preference or to societal pressures (or both). If this speculation is accurate, then we predict that the tolerance for sleep deprivation in such individuals can be increased by "pretreatment" with sleep extension. Thus, the present study is designed to test the following two hypotheses: subjects with nominal sleep patterns who have low MSLT scores (e.g., Sleepy subjects) will show an exaggerated response (performance decrement) to sleep loss compared to subjects who have high MSLT scores (Alert subjects) on a nominal sleep schedule. when permitted to extend sleep-thus discharging their sleep debt-the Sleepy subjects will show a sleep-loss response resembling that of the Alert subjects.

Individual Differences in Response to Sleep Deprivation: Assessment of Fatigue Following Sleep Loss

NASA Technical Reports Server (NTRS)

Carskadon, Mary A.

1997-01-01

Previous work has indicated that a small but significant number of participants in sleep deprivation studies or in simulated shift work experiments manifests an exaggerated performance decrement when they reach a critical point in the experiment, usually near the trough of the circadian cycle or the middle of the night. Those who show this exaggerated response do not appear to differ from other normal volunteers in any substantial way according to usual screening criteria or baseline values. The present study aims to examine factors that may provide the basis for this extreme response. We propose that a preexisting sleep deficit-as manifested by low values on the Multiple Sleep Latency Test (MSLT)-may account for extreme responders. Roth and colleagues (1993) have shown that among normal volunteers screened for a variety of studies, approximately 20 to 25 percent show low (< or = 6 minutes) MSLT scores on a consistent basis, whereas a like proportion shows consistently high MSLT scores (> or = 13 minutes). Additionally, studies by this group have indicated that subjects with low MSLT scores may suffer from chronic insufficient sleep (Roth et al., 1993), as further substantiated by the finding that they have consistently higher nocturnal sleep efficiency and that their MSLT scores rise to normal values when sleep is extended (Roehrs et al., 1996). We hypothesize that the short MSLT subjects have a significant long-term sleep deficit that leads to a marked intolerance for sleep deprivation or shift work. We further suggest that this sleep debt may signify an increased sleep need in these individuals that is not met either due to personal preference or to societal pressures (or both). If this speculation is accurate, then we predict that the tolerance for sleep deprivation in such individuals can be increased by "pretreatment" with sleep extension. Thus, the present study is designed to test the following two hypotheses: subjects with nominal sleep patterns who have low MSLT scores (e.g., Sleepy subjects) will show an exaggerated response (performance decrement) to sleep loss compared to subjects who have high MSLT scores (Alert subjects) on a nominal sleep schedule. When permitted to extend sleep-thus discharging their sleep debt-the Sleepy subjects will show a sleep-loss response resembling that of the Alert subjects.

Morningness-eveningness interferes with perceived health, physical activity, diet and stress levels in working women: a cross-sectional study.

PubMed

Haraszti, Réka Ágnes; Purebl, Gyorgy; Salavecz, Gyongyver; Poole, Lydia; Dockray, Samantha; Steptoe, Andrew

2014-08-01

Sleep and health are closely interrelated and sleep quality is a well-known contributor to perceived health. However, effects of sleep-timing preference i.e. morningness-eveningness on health has yet to be revealed. In this study, we explored the relationship between morningness-eveningness and perceived health in a sample of female working professionals (N = 202). Sleep-timing preference was measured using the Composite Scale of Morningness. Perceived health was characterized by Center for Epidemiologic Studies Depression Scale, WHO Well-Being Scale-5 and Patient Health Questionnaire-15 scores. We also investigated possible mechanisms, including stress and health-impairing behaviours. In accordance with previous data, we found more depressive mood, lower well-being and poorer perceived health among evening types. To assess health-impairing behaviours we collected data on smoking habits, alcohol consumption, physical activity and diet. Among the possible mechanism variables, greater stress, less frequent physical activity and less healthy diet were associated with eveningness. Furthermore, stress diminished the strength of the association between morningness-eveningness and depressed mood. Physical activity attenuated the strength of the association between morningness-eveningness and well-being. No effects of alcohol consumption could be identified. Our data show that evening preference behaves as a health risk in terms of associating with poor perceived health. Our findings also suggest that this effect might be mediated by health behaviours and stress.

Sleep fragmentation: comparison of two definitions of short arousals during sleep in OSAS patients.

PubMed

Smurra, M V; Dury, M; Aubert, G; Rodenstein, D O; Liistro, G

2001-04-01

The measurement of arousals during sleep is useful to quantify sleep fragmentation. The criteria for electroencephalography (EEG) arousals defined by the American Sleep Disorders Association (ASDA) have recently been criticized because of lack of interobserver agreement. The authors have adopted a scoring method that associates the increase in chin electromyography (EMG) with the occurrence of an alpha-rhythm in all sleep stages (Université Catholique de Louvain (UCL) definition of arousals). The aim of the present study was to compare the two scoring definitions in terms of agreement and repeatability and the time taken for scoring in patients with obstructive sleep apnoea syndrome (OSAS) of varying severity. Two readers using both ASDA and UCL definitions scored twenty polysomnographies (PSGs) each on two occasions. The PSGs were chosen retrospectively to represent a wide range of arousal index (from 6-82) in OSAS patients. There was no difference in the arousal indices between readers and between scoring methods. The mean+/-SD difference between the two definitions (the bias) was 1.1+/-3.76 (95% confidence interval: -0.66-2.86). There was a strong linear relationship between the arousal index scored with the two definitions (r=0.981, p<0.001). Mean+/-SD scoring duration was significantly shorter for UCL than for ASDA definitions (18.5+/-5.4 versus 25.3+/-6.6 min, p<0.001). In conclusion, it has been found that in obstructive sleep apnoea syndrome patients, the American Sleep Disorders Association and Université Catholique de Louvain definitions were comparable in terms of agreement and repeatability.

Work-Family Conflict and Employee Sleep: Evidence from IT Workers in the Work, Family and Health Study

PubMed Central

Buxton, Orfeu M.; Lee, Soomi; Beverly, Chloe; Berkman, Lisa F.; Moen, Phyllis; Kelly, Erin L.; Hammer, Leslie B.; Almeida, David M.

2016-01-01

Study Objectives: Work-family conflict is a threat to healthy sleep behaviors among employees. This study aimed to examine how Work-to-Family Conflict (demands from work that interfere with one's family/personal life; WTFC) and Family-to-Work Conflict (demands from family/personal life that interfere with work; FTWC) are associated with several dimensions of sleep among information technology workers. Methods: Employees at a U.S. IT firm (n = 799) provided self-reports of sleep sufficiency (feeling rested upon waking), sleep quality, and sleep maintenance insomnia symptoms (waking up in the middle of the night or early morning) in the last month. They also provided a week of actigraphy for nighttime sleep duration, napping, sleep timing, and a novel sleep inconsistency measure. Analyses adjusted for work conditions (job demands, decision authority, schedule control, and family-supportive supervisor behavior), and household and sociodemographic characteristics. Results: Employees who experienced higher WTFC reported less sleep sufficiency, poorer sleep quality, and more insomnia symptoms. Higher WTFC also predicted shorter nighttime sleep duration, greater likelihood of napping, and longer nap duration. Furthermore, higher WTFC was linked to greater inconsistency of nighttime sleep duration and sleep clock times, whereas higher FTWC was associated with more rigidity of sleep timing mostly driven by wake time. Conclusions: Results highlight the unique associations of WTFC/FTWC with employee sleep independent of other work conditions and household and sociodemographic characteristics. Our novel methodological approach demonstrates differential associations of WTFC and FTWC with inconsistency of sleep timing. Given the strong associations between WTFC and poor sleep, future research should focus on reducing WTFC. Citation: Buxton OM, Lee S, Beverly C, Berkman LF, Moen P, Kelly EL, Hammer LB, Almeida DM. Work-family conflict and employee sleep: evidence from IT workers in the Work, Family and Health Study. SLEEP 2016;39(10):1871–1882. PMID:27568810

Children's Sleep and Academic Achievement: The Moderating Role of Effortful Control

ERIC Educational Resources Information Center

Diaz, Anjolii; Berger, Rebecca; Valiente, Carlos; Eisenberg, Nancy; VanSchyndel, Sarah K.; Tao, Chun; Spinrad, Tracy; Doane, Leah D.; Thompson, Marilyn S.; Silva, Kassondra M.; Southworth, Jody

2017-01-01

Poor sleep is thought to interfere with children's learning and academic achievement (AA). However, existing research and theory indicate there are factors that may mitigate the academic risk associated with poor sleep. The purpose of this study was to examine the moderating role of children's effortful control (EC) on the relation between sleep…

Dysfunctional overnight memory consolidation in ecstasy users.

PubMed

Smithies, Vanessa; Broadbear, Jillian; Verdejo-Garcia, Antonio; Conduit, Russell

2014-08-01

Sleep plays an important role in the consolidation and integration of memory in a process called overnight memory consolidation. Previous studies indicate that ecstasy users have marked and persistent neurocognitive and sleep-related impairments. We extend past research by examining overnight memory consolidation among regular ecstasy users (n=12) and drug naïve healthy controls (n=26). Memory recall of word pairs was evaluated before and after a period of sleep, with and without interference prior to testing. In addition, we assessed neurocognitive performances across tasks of learning, memory and executive functioning. Ecstasy users demonstrated impaired overnight memory consolidation, a finding that was more pronounced following associative interference. Additionally, ecstasy users demonstrated impairments on tasks recruiting frontostriatal and hippocampal neural circuitry, in the domains of proactive interference memory, long-term memory, encoding, working memory and complex planning. We suggest that ecstasy-associated dysfunction in fronto-temporal circuitry may underlie overnight consolidation memory impairments in regular ecstasy users. © The Author(s) 2014.

DeepSleepNet: A Model for Automatic Sleep Stage Scoring Based on Raw Single-Channel EEG.

PubMed

Supratak, Akara; Dong, Hao; Wu, Chao; Guo, Yike

2017-11-01

This paper proposes a deep learning model, named DeepSleepNet, for automatic sleep stage scoring based on raw single-channel EEG. Most of the existing methods rely on hand-engineered features, which require prior knowledge of sleep analysis. Only a few of them encode the temporal information, such as transition rules, which is important for identifying the next sleep stages, into the extracted features. In the proposed model, we utilize convolutional neural networks to extract time-invariant features, and bidirectional-long short-term memory to learn transition rules among sleep stages automatically from EEG epochs. We implement a two-step training algorithm to train our model efficiently. We evaluated our model using different single-channel EEGs (F4-EOG (left), Fpz-Cz, and Pz-Oz) from two public sleep data sets, that have different properties (e.g., sampling rate) and scoring standards (AASM and R&K). The results showed that our model achieved similar overall accuracy and macro F1-score (MASS: 86.2%-81.7, Sleep-EDF: 82.0%-76.9) compared with the state-of-the-art methods (MASS: 85.9%-80.5, Sleep-EDF: 78.9%-73.7) on both data sets. This demonstrated that, without changing the model architecture and the training algorithm, our model could automatically learn features for sleep stage scoring from different raw single-channel EEGs from different data sets without utilizing any hand-engineered features.

Diagnostic accuracy of sleep bruxism scoring in absence of audio-video recording: a pilot study.

PubMed

Carra, Maria Clotilde; Huynh, Nelly; Lavigne, Gilles J

2015-03-01

Based on the most recent polysomnographic (PSG) research diagnostic criteria, sleep bruxism is diagnosed when >2 rhythmic masticatory muscle activity (RMMA)/h of sleep are scored on the masseter and/or temporalis muscles. These criteria have not yet been validated for portable PSG systems. This pilot study aimed to assess the diagnostic accuracy of scoring sleep bruxism in absence of audio-video recordings. Ten subjects (mean age 24.7 ± 2.2) with a clinical diagnosis of sleep bruxism spent one night in the sleep laboratory. PSG were performed with a portable system (type 2) while audio-video was recorded. Sleep studies were scored by the same examiner three times: (1) without, (2) with, and (3) without audio-video in order to test the intra-scoring and intra-examiner reliability for RMMA scoring. The RMMA event-by-event concordance rate between scoring without audio-video and with audio-video was 68.3 %. Overall, the RMMA index was overestimated by 23.8 % without audio-video. However, the intra-class correlation coefficient (ICC) between scorings with and without audio-video was good (ICC = 0.91; p < 0.001); the intra-examiner reliability was high (ICC = 0.97; p < 0.001). The clinical diagnosis of sleep bruxism was confirmed in 8/10 subjects based on scoring without audio-video and in 6/10 subjects with audio-video. Although the absence of audio-video recording, the diagnostic accuracy of assessing RMMA with portable PSG systems appeared to remain good, supporting their use for both research and clinical purposes. However, the risk of moderate overestimation in absence of audio-video must be taken into account.

Good and poor sleepers among OSA patients: sleep quality and overnight polysomnography findings.

PubMed

Lusic Kalcina, Linda; Valic, Maja; Pecotic, Renata; Pavlinac Dodig, Ivana; Dogas, Zoran

2017-07-01

Previous studies aimed to determine if Pittsburgh sleep quality index (PSQI) is a valid screening instrument for obstructive sleep apnea, indicating its disadvantages. However, the rationale of PSQI use in sleep clinics is not the screening, but the assessment of sleep quality itself. Therefore, the aims of this study were to investigate the sleep quality in obstructive sleep apnea patients and to identify the cutoff point for differentiation of "good" and "poor" sleepers among them. We constructed the Croatian version of PSQI and assessed its psychometric properties. The protocol of the study included the assessment of sleep quality in 130 obstructive sleep apnea patients and 75 healthy control subjects. All subjects completed the Croatian version of the PSQI, and the patients underwent overnight polysomnography screening. Obstructive sleep apnea patients had higher values of the global PSQI component score, indicating lower sleep quality, compared to a healthy control group (p < 0.001). The psychometric properties of PSQI scores in the prediction of normal sleep efficiency indicate that the cutoff score of 9.5 differentiates patients in total sleep time (p <  0.001), REM duration (p = 0.014), sleep efficiency (p = 0.001), time spent awake during sleep (p = 0.006), after sleep (p = 0.024), and after sleep onset (p = 0.001). In OSA patients, a PSQI cutoff score of 9.5 differentiated good and poor sleepers significantly in total sleep time, REM duration, time spent awake during sleep, and WASO time. Current findings enhance the interpretability of PSQI results in a population of OSA patients.

Switch from oral pramipexole or ropinirole to rotigotine transdermal system in advanced Parkinson's disease: an open-label study.

PubMed

Chung, Sun Ju; Kim, Jong-Min; Kim, Jae Woo; Jeon, Beom Seok; Singh, Pritibha; Thierfelder, Stephan; Ikeda, Junji; Bauer, Lars

2015-05-01

Investigate safety, feasibility and efficacy of switching therapy in patients with advanced-stage Parkinson's disease (PD) inadequately controlled with pramipexole (≤ 3.5 mg/day) or ropinirole (≤ 14 mg/day) to rotigotine transdermal system (≤ 14 mg/24 h; dose adjustments ≤ 16 mg/24 h permitted). PD0009 (ClinicalTrials.gov: NCT01711866) was an open-label study in patients with advanced-stage PD receiving levodopa, and experiencing sleep disturbance or early-morning motor impairment. Pramipexole/ropinirole was switched to equivalent dose rotigotine overnight or in two stages. During the 4-week treatment period rotigotine dose adjustments were permitted (up to 16 mg/24 h). Primary variable: Clinical Global Impressions (CGI) item 4: side effects (assessing safety) at end of treatment. 79/87 (91%) patients completed the study; 2 (2%) withdrew due to adverse events (AEs). Most (84; 97%) had CGI item 4 score < 3 indicating switch did not interfere with functioning; three experienced drug-related AEs interfering with functioning (score = 3). 62% patients improved on Patient Global Impression of Change, assessing effectiveness. AEs occurring ≥ 5%: application site pruritus (10%), application site erythema (7%), dizziness (7%), dyskinesia (7%), erythema (6%), pruritus (6%). Unified Parkinson's Disease Rating Scale II and III, Parkinson's Disease Sleep Scale-2 and Pittsburgh Sleep Quality Index were unchanged. Numerical improvements in 'off' time, awakenings and nocturias were observed. Switch from pramipexole or ropinirole to rotigotine (up to 14 mg/24 h) was feasible and possibly associated with some benefit.

An epidemiological study to assess the prevalence of diabetic peripheral neuropathic pain among adults with diabetes attending private and institutional outpatient clinics in South Africa.

PubMed

Jacovides, Andrew; Bogoshi, Mampedi; Distiller, Larry A; Mahgoub, Ehab Y; Omar, Mahomed Ka; Tarek, Ismail A; Wajsbrot, Dalia B

2014-08-01

To determine the prevalence of diabetic peripheral neuropathic pain (DPNP) among South African adults with type 1 or type 2 diabetes. This cross-sectional study recruited patients with diabetes from 50 institutional/private clinics. DPNP was diagnosed using Douleur Neuropathique 4 (DN4) questionnaire (score ≥4). Health-related quality-of-life (HRQoL) and sleep were assessed with EQ-5D and Daily Sleep Interference Scale (DSIS), respectively. Prevalence of DPNP was 30.3% (n = 1046). Risk of DPNP was significantly increased in people aged 50-64 years (odds ratio [OR] 1.71, 95% confidence intervals [CI] 1.21, 2.41), with diabetes for ≥10 years (OR 1.55, 95% CI 1.15, 2.08), female patients (OR 1.58, 95% CI 1.18, 2.12), and black patients (OR 1.71, 95% CI 1.19, 2.46). Mean ± SD EQ-5D and DSIS scores were 0.84 ± 0.16 and 0.83 ± 1.90, respectively, in participants without DPNP versus 0.64 ± 0.25 and 3.62 ± 2.96, respectively, in those with DPNP. DPNP is widely prevalent in South Africa. Despite its negative impact on HRQoL and sleep, DPNP is inadequately treated. DN4 is an easy-to-use, validated questionnaire that can be used widely as a DPNP screening tool in clinical practice. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The 2007 AASM recommendations for EEG electrode placement in polysomnography: impact on sleep and cortical arousal scoring.

PubMed

Ruehland, Warren R; O'Donoghue, Fergal J; Pierce, Robert J; Thornton, Andrew T; Singh, Parmjit; Copland, Janet M; Stevens, Bronwyn; Rochford, Peter D

2011-01-01

To examine the impact of using American Academy of Sleep Medicine (AASM) recommended EEG derivations (F4/M1, C4/M1, O2/M1) vs. a single derivation (C4/M1) in polysomnography (PSG) on the measurement of sleep and cortical arousals, including inter- and intra-observer variability. Prospective, non-blinded, randomized comparison. Three Australian tertiary-care hospital clinical sleep laboratories. 30 PSGs from consecutive patients investigated for obstructive sleep apnea (OSA) during December 2007 and January 2008. N/A. To examine the impact of EEG derivations on PSG summary statistics, 3 scorers from different Australian clinical sleep laboratories each scored separate sets of 10 PSGs twice, once using 3 EEG derivations and once using 1 EEG derivation. To examine the impact on inter- and intra-scorer reliability, all 3 scorers scored a subset of 10 PSGs 4 times, twice using each method. All PSGs were de-identified and scored in random order according to the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Using 3 referential EEG derivations during PSG, as recommended in the AASM manual, instead of a single central EEG derivation, as originally suggested by Rechtschaffen and Kales (1968), resulted in a mean ± SE decrease in N1 sleep of 9.6 ± 3.9 min (P = 0.018) and an increase in N3 sleep of 10.6 ± 2.8 min (P = 0.001). No significant differences were observed for any other sleep or arousal scoring summary statistics; nor were any differences observed in inter-scorer or intra-scorer reliability for scoring sleep or cortical arousals. This study provides information for those changing practice to comply with the 2007 AASM recommendations for EEG placement in PSG, for those using portable devices that are unable to comply with the recommendations due to limited channel options, and for the development of future standards for PSG scoring and recording. As the use of multiple EEG derivations only led to small changes in the distribution of derived sleep stages and no significant differences in scoring reliability, this study calls into question the need to use multiple EEG derivations in clinical PSG as suggested in the AASM manual.

The importance of polysomnography in the evaluation of prolonged disorders of consciousness: sleep recordings more adequately correlate than stimulus-related evoked potentials with patients' clinical status.

PubMed

de Biase, Stefano; Gigli, Gian Luigi; Lorenzut, Simone; Bianconi, Claudio; Sfreddo, Patrizia; Rossato, Gianluca; Basaldella, Federica; Fuccaro, Matteo; Corica, Antonio; Tonon, Davide; Barbone, Fabio; Valente, Mariarosaria

2014-04-01

The aim of our study was to evaluate the importance of sleep recordings and stimulus-related evoked potentials (EPs) in patients with prolonged disorders of consciousness (DOCs) by correlating neurophysiologic variables with clinical evaluation obtained using specific standardized scales. There were 27 vegetative state (VS) and 5 minimally conscious state (MCS) patients who were evaluated from a clinical and neurophysiologic perspective. Clinical evaluation included the Coma Recovery Scale-Revised (CRS-R), Disability Rating Scale (DRS), and Glasgow Coma Scale (GCS). Neurophysiologic evaluation included 24-h polysomnography (PSG), somatosensory EPs (SEPs), brainstem auditory EPs (BAEPs), and visual EPs (VEPs). Patients with preservation of each single sleep element (sleep-wake cycle, sleep spindles, K-complexes, and rapid eye movement [REM] sleep) always showed better clinical scores compared to those who did not have preservation. Statistical significance was only achieved for REM sleep. In 7 patients PSG showed the presence of all considered sleep elements, and they had a CRS-R score of 8.29±1.38. In contrast, 25 patients who lacked one or more of the sleep elements had a CRS-R score of 4.84±1.46 (P<.05). Our multivariate analysis clarified that concurrent presence of sleep spindles and REM sleep were associated with a much higher CRS-R score (positive interaction, P<.0001). On the other hand, no significant associations were found between EPs and CRS-R scores. PSG recordings have proved to be a reliable tool in the neurophysiologic assessment of patients with prolonged DOCs, correlating more adequately than EPs with the clinical evaluation and the level of consciousness. The main contribution to higher clinical scores was determined by the concomitant presence of REM sleep and sleep spindles. PSG recordings may be considered inexpensive, noninvasive, and easy-to-perform examinations to provide supplementary information in patients with prolonged DOCs. Copyright © 2014 Elsevier B.V. All rights reserved.

Sleep disorders in patients with erectile dysfunction.

PubMed

Kalejaiye, Odunayo; Raheem, Amr Abdel; Moubasher, Amr; Capece, Marco; McNeillis, Sara; Muneer, Asif; Christopher, Andrew N; Garaffa, Giulio; Ralph, David J

2017-12-01

To assess the prevalence of obstructive sleep apnoea (OSA) in men presenting with erectile dysfunction (ED) at a single centre. All men attending a specialised andrology outpatient department with a new diagnosis of ED were included in this prospective study. All patients completed three questionnaires: the International Index of Erectile Function (IIEF) and two sleep questionnaires [the Obstructive Sleep Apnoea Screening questionnaire and the Insomnia Severity Index (ISI)]. Their ED management was subsequently undertaken in accordance with local and European guidelines. An OSA diagnosis was made based on a score of ≥3 on the Obstructive Sleep Apnoea Screening questionnaire and those patients were referred for specialist management. Between February and September 2016, 129 patients with ED completed the study questionnaires. In all, 71 patients (55%) had a score of ≥3 on the Obstructive Sleep Apnoea Screening questionnaire, indicating a need for specialist sleep referral. Men who scored ≥3 on the Obstructive Sleep Apnoea Screening questionnaire were significantly older (61.4 vs 46.5 years; P < 0.001) and had a significantly higher body mass index (29.4 vs 26.7 kg/m 2 ; P < 0.001) when compared to the control group (OSA score of <3). The sleep apnoea group (OSA score of ≥3) had significantly worse IIEF-ED scores (6.2 vs 9.1; P = 0.018) and ISI scores (7.9 vs 5.5; P = 0.061). Men presenting to the andrology clinic with ED are at significant risk of having undiagnosed sleep disorders. This has serious adverse health consequences, as well as being associated with potential dangers at work and travel. The patient compliance was high with 78% completing all three questionnaires. It is feasible to screen this population for sleep disturbance and this should be part of the ED assessment. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Understanding sleep problems in children with epilepsy: Associations with quality of life, Attention-Deficit Hyperactivity Disorder and maternal emotional symptoms.

PubMed

Ekinci, Ozalp; Isik, Uğur; Gunes, Serkan; Ekinci, Nuran

2016-08-01

This study aimed to (1) compare sleep problems between children and adolescents with epilepsy and non-epileptic controls, and (2) examine whether there is an association between sleep problems and quality of life, Attention-Deficit Hyperactivity Disorder (ADHD) and mothers' emotional symptoms. Fifty-three patients from a cohort of epilepsy (aged 7-18 years) and 28 controls with minor medical problems (aged 7-18 years) were included. Parents completed Children's Sleep Habits Questionnaire (CSHQ) and Kinder Lebensqualitätsfragebogen: Children's Quality of Life Questionnaire-revised (KINDL-R) for patients and controls. Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) parent and teacher forms were used to assess ADHD symptoms for patients. Mothers of the patients completed Beck Depression Inventory and State-Trait Anxiety Inventory (STAI). Neurology clinic charts were reviewed for the epilepsy-related variables. Children with epilepsy had a higher CSHQ Total score than the control group. Those with a CSHQ score >56 (which indicates moderate to severe sleep problems) had lower scores on KINDL-R. Parent-rated T-DSM-IV-S Total and Hyperactivity-Impulsivity scores, STAI trait and Beck scores were found to be higher in those with a CSHQ score >56. Significant positive correlations were found between CSHQ Total score and T-DSM-IV-S, STAI trait and Beck scores. Binary logistic regression analysis revealed that T-DSM-IV-S Total, Inattention and Hyperactivity-Impulsivity scores were significantly associated with a higher CSHQ Total score. None of the epilepsy-related variables were found to be related with the CSHQ Total score. Among children with epilepsy, sleep problems lead to a poor quality of life. The link between sleep problems and psychiatric symptoms must be conceptualized as a bilateral relationship. ADHD appears to be the strongest predictor of sleep problems. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Sleep disturbance and neurocognitive function during the recovery from a sport-related concussion in adolescents.

PubMed

Kostyun, Regina O; Milewski, Matthew D; Hafeez, Imran

2015-03-01

Sleep disturbances are a hallmark sign after a sport-related concussion (SRC). Poor sleep has been shown to adversely affect baseline neurocognitive test scores, but it is not comprehensively understood how neurocognitive function is affected by disrupted sleep during recovery from a concussion. To identify the correlation between adolescent athletes' neurocognitive function and their self-reported sleep quantity and sleep disturbance symptoms during recovery from SRC. Cross-sectional study; Level of evidence, 3. Immediate Post-Concussion Assessment and Cognition Testing (ImPACT) data were retrospectively collected for 545 adolescent athletes treated for SRC at a sports medicine concussion clinic. Patients were stratified into groups based on 2 criteria: self-reported sleep duration and self-reported sleep disturbance symptoms during postinjury ImPACT testing. Sleep duration was classified as short (<7 hours), intermediate (7-9 hours), and long (>9 hours). Sleep disturbance symptoms were self-reported as part of the Post-Concussion Symptom Scale (PCSS) as either sleeping less than normal, sleeping more than normal, or having trouble falling asleep. One-way analyses of variance were conducted to examine the effects that sleep duration as well as self-reported sleep disturbance symptoms had on composite scores. A total of 1067 ImPACT tests were analyzed: test 1, 545; test 2, 380; and test 3, 142. Sleeping fewer than 7 hours the night before testing correlated with higher PCSS scores (P < .001), whereas sleeping longer than 9 hours correlated with worse visual memory (P = .01), visual motor speed (P <.001), and reaction time (P = .04) composite scores. With regard to self-reported sleep disturbance symptoms, patients demonstrated worse composite scores during ImPACT testing when they self-reported sleeping more than normal (ImPACT test 1: verbal memory, P < .001; visual motor speed, P = .05; reaction time, P = .01; ImPACT test 2: verbal memory, P < .001; visual memory, P < .001; visual motor speed, P < .001; reaction time, P = .01). Adolescent patients recovering from SRC demonstrated higher (worse) PCSS scores (P < .001) when they sensed that their sleep had been disrupted. Adolescent patients who perceive that their sleep is somehow disrupted after SRC may report a greater number of concussion symptoms during their recovery. In addition, the study results suggest that sleeping more than normal may identify an individual who continues to be actively recovering from concussion, given the correlation between lower neurocognitive function and this self-reported symptom. © 2014 The Author(s).

The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain: A Prospective Open-label Study.

PubMed

Haroutounian, Simon; Ratz, Yael; Ginosar, Yehuda; Furmanov, Karina; Saifi, Fayez; Meidan, Ronit; Davidson, Elyad

2016-12-01

The objective of this prospective, open-label study was to determine the long-term effect of medicinal cannabis treatment on pain and functional outcomes in participants with treatment-resistant chronic pain. The primary outcome was the change in the pain symptom score on the S-TOPS (Treatment Outcomes in Pain Survey-Short Form) questionnaire at the 6-month follow-up in an intent-to-treat population. Secondary outcomes included the change in S-TOPS physical, social, and emotional disability scales, the pain severity, and pain interference on the Brief Pain Inventory, sleep problems, and the change in opioid consumption. A total of 274 participants were approved for treatment; complete baseline data were available for 206 (intent-to-treat), and complete follow-up data for 176 participants. At follow-up, the pain symptom score improved from median 83.3 (95% confidence interval [CI], 79.2-87.5) to 75.0 (95% CI, 70.8-79.2) (P<0.001). The pain severity score (7.50 [95% CI, 6.75-7.75] to 6.25 [95% CI, 5.75-6.75]) and the pain interference score (8.14 [95% CI, 7.28-8.43] to 6.71 [95% CI, 6.14-7.14]) improved (both P<0.001), together with most social and emotional disability scores. Opioid consumption at follow-up decreased by 44% (P<0.001). Serious adverse effects led to treatment discontinuation in 2 participants. The treatment of chronic pain with medicinal cannabis in this open-label, prospective cohort resulted in improved pain and functional outcomes, and a significant reduction in opioid use. Results suggest long-term benefit of cannabis treatment in this group of patients, but the study's noncontrolled nature should be considered when extrapolating the results.

Children's sleep disturbance scale in differentiating neurological disorders.

PubMed

Cohen, Rony; Halevy, Ayelet; Shuper, Avinoam

2013-12-01

We use the Sleep Disturbance Scale for Children (SDSC) routinely as a tool for evaluating children's sleep quality in our pediatric neurology clinic. We analyzed at its ability to detect sleep disturbances distinctive to selected neurological disorders. One-hundred and eighty-six children (age range 2-18 years) who were evaluated by the SDSC questionnaire were divided into three groups according to their principal diagnosis: epilepsy, attention deficit hyperactivity disorder, or others. Their responses were analyzed. The average frequency of abnormal total sleep score was 26.9%. The most frequent sleep disorders were excessive somnolence (25.3%), initiating and maintaining sleep (24.7%), and arousal/nightmares (23.1%). There were no significant group differences for total scores or sleep disorder-specific scores; although a sleep-wake transition disorder was more frequent among children with epilepsy (31%). A literature search revealed that the frequency of abnormal total scores in several neurological disorders (e.g., epilepsy, cerebral palsy) ranges between 20% and 30%. The mechanism underlying sleep disturbances in many neurological disorders may be unrelated to that of the primary disease but rather originate from nonspecific or environmental factors (e.g., familial/social customs and habits, temperament, psychological parameters). Although the SDSC is noninformative for studying the effect of a specific neurological disorder on sleep, we still recommend its implementation for screening for sleep disturbances in children with neurological abnormalities. Copyright © 2013 Elsevier Inc. All rights reserved.

Changes in and predictors of pain characteristics in patients with head and neck cancer undergoing radiotherapy.

PubMed

Astrup, Guro Lindviksmoen; Rustøen, Tone; Miaskowski, Christine; Paul, Steven M; Bjordal, Kristin

2015-05-01

Pain is a common symptom in patients with head and neck cancer (HNC) that is associated with significant decrements in physical and psychological functioning. Only 4 studies have evaluated for changes in and predictors of different pain characteristics in these patients. In this longitudinal study of patients with HNC, changes in pain intensity (i.e., average pain, worst pain), pain interference with function, and pain relief were evaluated from the initiation of radiotherapy and through the following 6 months. Hierarchical linear modeling was used to evaluate for changes over time in these 4 pain characteristics, as well as to identify predictors of interindividual variability in each characteristic. Overall, pain intensity and interference with function scores were in the mild-to-moderate range, while pain relief scores were in the moderate range. The occurrence of pain, as well as scores for each pain characteristic, increased from the initiation to the completion of radiotherapy, followed by a gradual decrease to near pretreatment levels at 6 months. However, interindividual variability existed in patients' ratings of each pain characteristic. Predictors of more severe pain characteristic scores were more comorbidities, worse physical functioning, not having surgery before radiotherapy, difficulty swallowing, mouth sores, sleep disturbance, fatigue, more energy, and less social support. Patients with more depressive symptoms had better pain relief. Although some of the predictors cannot be modified (e.g., rrence of surgery), other predictors (e.g., symptoms) can be treated. Therefore, information about these predictors may result in decreased pain in patients with HNC.

Sleep Quality Assessment and Daytime Sleepiness of Liver Transplantation Candidates.

PubMed

Marques, D M; Teixeira, H R S; Lopes, A R F; Martins-Pedersoli, T A; Ziviani, L C; Mente, Ê D; Castro-E-Silva, O; Galvão, C M; Mendes, K S

2016-09-01

The goal of this study was to evaluate the sleep quality and daytime sleepiness of patients eligible for liver transplants. A cross-sectional prospective study was conducted on liver transplant candidates from a transplant center in the interior of São Paulo State. The Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires were applied to obtain demographic and clinical characteristics and to assess sleep quality and daytime sleepiness. The mean (±SD) score on the Epworth Sleepiness Scale of the 45 liver transplantation candidates was 7.00 ± 2.83 points, with 28.89% having scores >10 points, indicating excessive daytime sleepiness. The mean score on the Pittsburgh Sleep Quality Index was 6.64 ± 4.95 points, with 60% of the subjects showing impaired sleep quality, with scores >5 points. The average sleep duration was 07:16 h. Regarding sleep quality self-classification, 31.11% reported poor or very poor quality. It is noteworthy that 73.33% of patients had to go to the bathroom, 53.33% woke up in the middle of the night, and 40.00% reported pain related to sleeping difficulties. Comparison of subjects with good and poor sleep quality revealed a significant difference in time to sleep (P = .0002), sleep hours (P = .0003), and sleep quality self-classification (P = .000072). Liver transplant candidates have a compromised quality of sleep and excessive daytime sleepiness. In clinical practice, we recommend the evaluation and implementation of interventions aimed at improving the sleep and wakefulness cycle, contributing to a better quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

Gastrointestinal Dysfunctions as a Risk Factor for Sleep Disorders in Children with Idiopathic Autism Spectrum Disorder: A Retrospective Cohort Study

ERIC Educational Resources Information Center

McCue, Lena M.; Flick, Louise H.; Twyman, Kimberly A.; Xian, Hong

2017-01-01

Sleep disorders often co-occur with autism spectrum disorder. They further exacerbate autism spectrum disorder symptoms and interfere with children's and parental quality of life. This study examines whether gastrointestinal dysfunctions increase the odds of having sleep disorders in 610 children with idiopathic autism spectrum disorder, aged 2-18…

Characterizing sleep disorders of adults with tuberous sclerosis complex: a questionnaire-based study and review.

PubMed

van Eeghen, Agnies M; Numis, Adam I; Staley, Brigid A; Therrien, Samuel E; Thibert, Ronald L; Thiele, Elizabeth A

2011-01-01

An adult cohort with tuberous sclerosis complex was investigated for the prevalence of sleep disturbances and the relationship with seizure variables, medication, and psychological functioning. Information on 35 adults was gathered using four questionnaires: Epworth Sleepiness Scale (ESS), Sleep and Epilepsy Questionnaire (SEQ), Sleep Diagnosis List (SDL), and Adult Self-Report Scale (ASR). In addition, clinical, genetic and electrophysiological data were collected. Of 35 respondents, 25 had a history of epilepsy. A subjective sleep disorder was found in 31% of the cohort. Insomnia scores showed a significant positive correlation with obstructive sleep apnea syndrome and restless legs syndrome scores. Significant correlations were found between daytime sleepiness and scores on depression, antisocial behavior, and use of mental health medication. A subgroup using antiepileptic medication showed high correlations between daytime sleepiness, attention deficits, and anxiety scores. Copyright © 2010 Elsevier Inc. All rights reserved.

Confirmatory factor analysis of 2 versions of the Brief Pain Inventory in an ambulatory population indicates that sleep interference should be interpreted separately.

PubMed

Walton, David M; Putos, Joseph; Beattie, Tyler; MacDermid, Joy C

2016-07-01

The Brief Pain Inventory (BPI-SF) is a widely-used generic pain interference scale, however its factor structure remains unclear. An expanded 10-item version of the Interference subscale has been proposed, but the additional value of the 3 extra items has not been rigorously evaluated. The purpose of this study was to evaluate and contrast the factorial and concurrent validity of the original 7-item and 10-item versions of the BPI-SF in a large heterogeneous sample of patients with chronic pain. Exploratory and confirmatory factor analyses were conducted on independent subsets of the sample, and concurrent correlations with scales capturing similar constructs were evaluated. Two independent exploratory factor analyses (n=500 each) supported a single interference factor in both the 7- and 10-item versions, while confirmatory factor analysis (N=1000) suggested that a 2-factor structure (Physical and Affective) provided better fit. A 3-factor model, where sleep interference was the third factor, improved in model fit further. There was no significant difference in model fit between the 7- and 10-item versions. Concurrent associations with measures of general health, pain intensity and pain-related cognitions were all in the anticipated direction and magnitude and were not different by version of the BPI-SF. The addition of 3 extra items to the original 7-item Interference subscale of the BPI-SF did not improve psychometric properties. The combined results lead us to endorse a 3-factor structure (Physical, Affective, and Sleep Interference) as the more statistically and conceptually sound option. Copyright © 2016 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Sleep hygiene and its association with daytime sleepiness, depressive symptoms, and quality of life in patients with mild obstructive sleep apnea.

PubMed

Lee, Sang-Ahm; Paek, Joon-Hyun; Han, Su-Hyun

2015-12-15

To investigate the direct and indirect associations of sleep hygiene with daytime sleepiness, depressive symptoms, and quality of life (QoL), in newly diagnosed, untreated patients with mild obstructive sleep apnea (OSA). Data were collected from adults with mild OSA. The Sleep Hygiene Index (SHI), Sleep Problems Index-1 (SPI-1) of the Medical Outcomes Study-Sleep Scale, Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Medical Outcomes Study Short-Form Health survey (SF-36) were used to evaluate patients. To determine the indirect and direct associations between SHI and disease outcomes, the Sobel test and multiple linear regression analyses were used, respectively. When we evaluated the direct associations, we excluded 3 items of the original SHI which were more reflective of general health rather than sleep-specific habits and environments. In total, 260 patients with mild OSA participated in this study. The average age, AHI, and SHI scores were 49.1 years (SD 12.5), 9.3/h (SD 2.9), and 24.7 (SD 6.0), respectively. Here, ≥ 10% of participants indicated poor sleep hygiene behaviors on 7 of 13 items. Young age and men were associated with higher SHI scores (both p<0.01). The 13-item SHI scores were indirectly related to ESS, BDI, and SF-36 scores via SPI-1 (all p<0.05). The 10-item SHI scores were related to ESS (p=0.049) and SF-36 (p=0.001), but not to BDI, independently of SPI-1 or other confounding factors in mild OSA patients. Age, sex, AHI, and body mass index were not related to ESS, BDI, or total SF-36 scores. Sleep hygiene is indirectly related to daytime sleepiness, depressive symptoms, QoL via sleep quality and also related to daytime sleepiness and QoL independent of sleep quality in mild OSA patients. Copyright © 2015 Elsevier B.V. All rights reserved.

Influence of the right- versus left-sided sleeping position on the apnea-hypopnea index in patients with sleep apnea.

PubMed

Ozeke, Ozcan; Erturk, Ozcan; Gungor, Mutlu; Hızel, Serap Bılen; Aydın, Dilek; Celenk, Mehmet Kutlu; Dıncer, Hazim; Ilıcın, Gurler; Ozgen, Fuat; Ozer, Can

2012-09-01

Sleep and sleep position have a significant impact on physical, cardiac and mental health, and have been evaluated in numerous studies particularly in terms of lateral sleeping positions and their association with diseases. We retrospectively examined the relationship between the sleeping position and position-specific apnea-hypopnea index (AHI) in obstructive sleep apnea-hypopnea (OSA) patients. We assessed the sleeping body position and the body position-specific AHI score in patients who were referred for suspected OSA and underwent diagnostic nocturnal polysomnography. In order to eliminate inter-individual differences, only those who had a similar percentage of time spent in the LSSP and RSSP for each patient were enrolled. To provide this validity, only subjects that had a similar percentage of left and right lateral sleep time (±10%) were included in the analysis. A total of 864 patients had nocturnal diagnostic PSG. Of them, 131 patients met the inclusion criteria. The percent rate spent in the supine sleeping position (SSP) was 31.3 ± 18.7%, in the LSSP was 31.8 ± 10% and in the RSSP was 32.6 ± 10.8%. Whereas the SSP-specific AHI score was the highest with 60.4 ± 36.2/h among all the sleeping position-specific AHI scores (p < 0.001), the LSSP-specific AHI score was statistically higher than that for RSSP (30.2 ± 32.6/h vs. 23.6 ± 30.1/h; p < 0.001). When comparing individuals sub-grouped based on OSA severity, there was a statistically significant difference between the LSSP-specific AHI score and RSSP-specific AHI score in patients with severe (p = 0.002) and moderate (p = 0.026), but not mild (p = 0.130) OSA. We found that the sleeping position had a significant influence on apneic events and RSSP decreased the frequency of obstructive respiratory events in patients with moderate and severe disease.

Misclassification of OSA severity with automated scoring of home sleep recordings.

PubMed

Aurora, R Nisha; Swartz, Rachel; Punjabi, Naresh M

2015-03-01

The advent of home sleep testing has allowed for the development of an ambulatory care model for OSA that most health-care providers can easily deploy. Although automated algorithms that accompany home sleep monitors can identify and classify disordered breathing events, it is unclear whether manual scoring followed by expert review of home sleep recordings is of any value. Thus, this study examined the agreement between automated and manual scoring of home sleep recordings. Two type 3 monitors (ApneaLink Plus [ResMed] and Embletta [Embla Systems]) were examined in distinct study samples. Data from manual and automated scoring were available for 200 subjects. Two thresholds for oxygen desaturation (≥ 3% and ≥ 4%) were used to define disordered breathing events. Agreement between manual and automated scoring was examined using Pearson correlation coefficients and Bland-Altman analyses. Automated scoring consistently underscored disordered breathing events compared with manual scoring for both sleep monitors irrespective of whether a ≥ 3% or ≥ 4% oxygen desaturation threshold was used to define the apnea-hypopnea index (AHI). For the ApneaLink Plus monitor, Bland-Altman analyses revealed an average AHI difference between manual and automated scoring of 6.1 (95% CI, 4.9-7.3) and 4.6 (95% CI, 3.5-5.6) events/h for the ≥ 3% and ≥ 4% oxygen desaturation thresholds, respectively. Similarly for the Embletta monitor, the average difference between manual and automated scoring was 5.3 (95% CI, 3.2-7.3) and 8.4 (95% CI, 7.2-9.6) events/h, respectively. Although agreement between automated and manual scoring of home sleep recordings varies based on the device used, modest agreement was observed between the two approaches. However, manual review of home sleep test recordings can decrease the misclassification of OSA severity, particularly for those with mild disease. ClinicalTrials.gov; No.: NCT01503164; www.clinicaltrials.gov.

Misclassification of OSA Severity With Automated Scoring of Home Sleep Recordings

PubMed Central

Aurora, R. Nisha; Swartz, Rachel

2015-01-01

BACKGROUND: The advent of home sleep testing has allowed for the development of an ambulatory care model for OSA that most health-care providers can easily deploy. Although automated algorithms that accompany home sleep monitors can identify and classify disordered breathing events, it is unclear whether manual scoring followed by expert review of home sleep recordings is of any value. Thus, this study examined the agreement between automated and manual scoring of home sleep recordings. METHODS: Two type 3 monitors (ApneaLink Plus [ResMed] and Embletta [Embla Systems]) were examined in distinct study samples. Data from manual and automated scoring were available for 200 subjects. Two thresholds for oxygen desaturation (≥ 3% and ≥ 4%) were used to define disordered breathing events. Agreement between manual and automated scoring was examined using Pearson correlation coefficients and Bland-Altman analyses. RESULTS: Automated scoring consistently underscored disordered breathing events compared with manual scoring for both sleep monitors irrespective of whether a ≥ 3% or ≥ 4% oxygen desaturation threshold was used to define the apnea-hypopnea index (AHI). For the ApneaLink Plus monitor, Bland-Altman analyses revealed an average AHI difference between manual and automated scoring of 6.1 (95% CI, 4.9-7.3) and 4.6 (95% CI, 3.5-5.6) events/h for the ≥ 3% and ≥ 4% oxygen desaturation thresholds, respectively. Similarly for the Embletta monitor, the average difference between manual and automated scoring was 5.3 (95% CI, 3.2-7.3) and 8.4 (95% CI, 7.2-9.6) events/h, respectively. CONCLUSIONS: Although agreement between automated and manual scoring of home sleep recordings varies based on the device used, modest agreement was observed between the two approaches. However, manual review of home sleep test recordings can decrease the misclassification of OSA severity, particularly for those with mild disease. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01503164; www.clinicaltrials.gov PMID:25411804

Relationship Between Sleep Quality and Spiritual Well-Being/Religious Activities in Muslim Women with Breast Cancer.

PubMed

Khoramirad, Ashraf; Mousavi, Maryam; Dadkhahtehrani, Tahmineh; Pourmarzi, Davoud

2015-12-01

For determining relationship between quality of sleep and spiritual well-being/religious activities in Muslim women with breast cancer (WBC), we conducted a cross-sectional study on 80 WBC who presented at all chemotherapy clinics in Qom, Iran, in 2012. We used Pittsburgh Sleep Quality Index (PSQI), spiritual well-being scale (SWBS), and religious activities (RA) questionnaire. Global PSQI score and its seven components score were not significantly correlated with total score of SWBS and its two subscales. Global PSQI score was not significantly correlated with total score of RA questionnaire (P = 0.278), but its "sleep latency" (r = 0.235, P = 0.044) and "use of sleep medications" (r = 0.237, P = 0.040) components were significantly correlated with total score of RA. Global PSQI was significantly correlated with "I don't get much personal strength and support from my God," "I believe there is some real purpose for my life" questions in SWBS, and "Attendance in mosque or religious places" subscale of RA.

Polysomnography

MedlinePlus

... Test Whether the test is at a sleep study center or at home, you prepare the same way. Unless directed to do so by your doctor, do not take any sleep medicine and do not drink alcohol or caffeinated beverages before the test. They can interfere with your ...

So Tired: Predictive Utility of Baseline Sleep Screening in a Longitudinal Observational Survey Cohort of First-Year Residents.

PubMed

Zebrowski, Jonathan P; Pulliam, Samantha J; Denninger, John W; Berkowitz, Lori R

2018-06-01

Sleep impairment is highly prevalent among resident physicians and is associated with both adverse patient outcomes and poor resident mental and physical health. Risk factors for sleep problems during residency are less clear, and no screening model exists to identify residents at risk for sleep impairment. The objective of this study was to assess change in resident sleep during training and to evaluate utility of baseline sleep screening in predicting future sleep impairment. This is a prospective observational repeated-measures survey study. The participants comprised PGY-1 residents across multiple specialties at Partners HealthCare hospitals. Main measures used for this study were demographic queries and two validated scales: the Pittsburgh Sleep Quality Index (PSQI), measuring sleep quality, and the Epworth Sleepiness Scale (ESS), measuring excessive daytime sleepiness. Two hundred eighty-one PGY-1 residents completed surveys at residency orientation, and 153 (54%) completed matched surveys 9 months later. Mean nightly sleep time decreased from 7.6 to 6.5 hours (p < 0.001). Mean PSQI score increased from 3.6 to 5.2 (p < 0.001), and mean ESS score increased from 7.2 to 10.4 (p < 0.001). The proportion of residents exceeding the scales' clinical cutoffs increased over time from 15 to 40% on the PSQI (p < 0.001) and from 26 to 59% on the ESS (p < 0.001). Baseline normal sleep was not protective: 68% of residents with normal scores on both scales at baseline exceeded the clinical cutoff on at least one scale at follow-up. Greater age and fewer children increased follow-up PSQI score (p < 0.001) but not ESS score. During PGY-1 training, residents experience worsening sleep duration, quality of sleep, and daytime sleepiness. Residents with baseline impaired sleep tend to remain impaired. Moreover, many residents with baseline normal sleep experience sleep deterioration over time. Sleep screening at residency orientation may identify some, but not all, residents who will experience sleep impairment during training.

Temporal Relationships Between Napping and Nocturnal Sleep in Healthy Adolescents.

PubMed

Jakubowski, Karen P; Hall, Martica H; Lee, Laisze; Matthews, Karen A

2017-01-01

Many adolescents do not achieve the recommended 9 hr of sleep per night and report daytime napping, perhaps because it makes up for short nocturnal sleep. This article tests temporal relationships between daytime naps and nighttime sleep as measured by actigraphy and diary among 236 healthy high school students during one school week. Mixed model analyses adjusted for age, race, and gender demonstrated that shorter actigraphy-assessed nocturnal sleep duration predicted longer napping (measured by actigraphy and diary) the next day. Napping (by actigraphy and diary) predicted shorter nocturnal sleep duration and worse sleep efficiency that night measured by actigraphy. Diary-reported napping also predicted poorer self-reported sleep quality that night. Frequent napping may interfere with nocturnal sleep during adolescence.

Sleep quality and correlates of poor sleep in patients with rheumatoid arthritis.

PubMed

Løppenthin, K; Esbensen, B A; Jennum, P; Østergaard, M; Tolver, A; Thomsen, T; Midtgaard, J

2015-12-01

The objective of this study is to examine sleep quality and correlates of poor sleep in patients with rheumatoid arthritis (RA). Five hundred patients with RA were recruited from a rheumatology outpatient clinic and included in this cross-sectional study. Sleep quality and disturbances were assessed using the Pittsburgh Sleep Quality Index (PSQI). Other instruments included the Multidimensional Fatigue Inventory, the Epworth Sleepiness Scale, and the Health Assessment Questionnaire. Disease activity was assessed according to disease activity score DAS28-CRP-based. Complete scores on PSQI were obtained from 384 patients (77 %). In those, the prevalence of poor sleep (PSQI >5) was 61 %, and the mean global PSQI score was 7.54 (SD 4.17). A linear association was found between poor sleep and mental fatigue, reduced activity related to fatigue, physical fatigue, and general fatigue. Mental fatigue and general fatigue were independently associated with sleep quality, sleep latency, sleep duration, sleep efficiency, and daytime dysfunction. However, in the linear multivariate analysis, only general fatigue 1.06 (95 % CI 1.03-1.09) and mental fatigue 1.03 (95 % CI 1.01-1.05) were found to be significant correlates for reporting poor sleep. This study shows that a majority of patients with RA experience poor sleep and that general fatigue and mental fatigue are associated with poor sleep.

Electroencephalographic findings related with mild cognitive impairment in idiopathic rapid eye movement sleep behavior disorder.

PubMed

Sasai, Taeko; Matsuura, Masato; Inoue, Yuichi

2013-12-01

Mild cognitive impairment (MCI) and electroencephalographic (EEG) slowing have been reported as common findings of idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) and α-synucleinopathies. The objective of this study is to clarify the relation between MCI and physiological markers in iRBD. Cross-sectional study. Yoyogi Sleep Disorder Center. Thirty-one patients with iRBD including 17 younger patients with iRBD (younger than 70 y) and 17 control patients for the younger patients with iRBD. N/A. Montreal Cognitive Assessment (MoCA) and n-polysomnogram (PSG) were conducted of all participants. In patients with iRBD, the factors associated with MCI were explored among parameters of REM sleep without atonia (RWA), score of Sniffin' Sticks Test (threshold-discrimination-identification [TDI] score), RBD morbidity, and RBD severity evaluated with the Japanese version of the RBD questionnaire (RBDQ-JP). The younger iRBD group showed significantly lower alpha power during wake and lower MoCA score than the age-matched control group. MCI was detected in 13 of 17 patients (76.5%) on MoCA in this group. Among patients wtih iRBD, the MoCA score negatively correlated with age, proportion of slow wave sleep, TDI score, and EEG spectral power. Multiple regression analysis provided the following equation: MoCA score = 50.871-0.116*age -5.307*log (δ power during REM sleep) + 0.086*TDI score (R² = 0.598, P < 0.01). The standardized partial regression coefficients were -0.558 for age, -0.491 for log (δ power during REM sleep), and 0.357 for TDI score (F = 9.900, P < 0.001). Electroencephalographic slowing, especially during rapid eye movement sleep and olfactory dysfunction, was revealed to be associated with cognitive decline in idiopathic rapid eye movement sleep behavior disorder.

Actigraphy scoring for sleep outcome measures in chronic obstructive pulmonary disease.

PubMed

Kapella, Mary C; Vispute, Sachin; Zhu, Bingqian; Herdegen, James J

2017-09-01

Actigraphy is commonly used to measure sleep outcomes so that sleep can be measured conveniently at home over multiple nights. Actigraphy has been validated in people with sleep disturbances; however, the validity of scoring settings in people with chronic medical illnesses such as chronic obstructive pulmonary disease remains unclear. The purpose of this secondary analysis was to compare actigraphy-customized scoring settings with polysomnography (PSG) for the measurement of sleep outcomes in people with chronic obstructive pulmonary disease who have insomnia. Participants underwent overnight sleep assessment simultaneously by PSG and actigraphy at the University of Illinois of Chicago Sleep Science Center. Fifty participants (35 men and 15 women) with mild-to-severe chronic obstructive pulmonary disease and co-existing insomnia were included in the analysis. Sleep onset latency, total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE) were calculated independently from data derived from PSG and actigraphy. Actigraphy sleep outcome scores obtained at the default setting and several customized actigraphy settings were compared to the scored PSG results. Although no single setting was optimal for all sleep outcomes, the combination of 10 consecutive immobile minutes for sleep onset or end and an activity threshold of 10 worked well. Actigraphy overestimated TST and SE and underestimated WASO, but there was no difference in variance between PSG and actigraphy in TST and SE when the 10 × 10 combination was used. As the average TST and SE increased, the agreement between PSG and actigraphy appeared to increase, and as the average WASO decreased, the agreement between PSG and actigraphy appeared to increase. Results support the conclusion that the default actigraphy settings may not be optimal for people with chronic obstructive pulmonary disease and co-existing insomnia. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Sleep Quality Among Pharmacy Students

PubMed Central

Clark, Andraya; Woolley, Thomas W.; Saunders, Amy

2015-01-01

Objective. To determine the quality of sleep among pharmacy students in the didactic portion of the curriculum at one school of pharmacy. Methods. The study consisted of an anonymous, voluntary survey that included the Pittsburgh Sleep Quality Index (PSQI), a self-rated instrument that measures sleep habits for a month. Results. The survey was completed by 253 students. Students in the lower grade point average (GPA) category had higher scores on 2 of 7 components of the PSQI and on the global score. Poor sleep quality, indicated by a global PSQI score of greater than 5, was reported by 140 students. The rate of poor sleeping was higher among students in the lower GPA category. Conclusion. Poor sleep quality was pervasive among surveyed pharmacy students in the didactic portion of the pharmacy school curriculum, especially among those with lower GPAs. PMID:25741025

Polysomnographic Findings and Clinical Correlates in Huntington Disease: A Cross-Sectional Cohort Study

PubMed Central

Piano, Carla; Losurdo, Anna; Della Marca, Giacomo; Solito, Marcella; Calandra-Buonaura, Giovanna; Provini, Federica; Bentivoglio, Anna Rita; Cortelli, Pietro

2015-01-01

Study Objectives: To evaluate the sleep pattern and the motor activity during sleep in a cohort of patients affected by Huntington disease (HD). Design: Cross-sectional cohort study. Setting: Sleep laboratory. Patients: Thirty HD patients, 16 women and 14 men (mean age 57.3 ± 12.2 y); 30 matched healthy controls (mean age 56.5 ± 11.8 y). Interventions: Subjective sleep evaluation: Epworth Sleepiness Scale (ESS); Berlin's Questionnaire, interview for restless legs syndrome (RLS), questionnaire for REM sleep behavior disorder (RBD). Clinical evaluation: disease duration, clinical severity (unified Huntington disease motor rating scale [UHDMRS]), genetic tests. Laboratory-based full-night attended video-polysomnography (V-PSG). Measurements and Results: The duration of the disease was 9.4 ± 4.4 y, UHMDRS score was 55.5 ± 23.4, CAG repeats were 44.3 ± 4.1. Body mass index was 21.9 ± 4.0 kg/m2. No patients or caregivers reported poor sleep quality. Two patients reported symptoms of RLS. Eight patients had an ESS score ≥ 9. Eight patients had high risk of obstructive sleep apnea. At the RBD questionnaire, two patients had a pathological score. HD patients, compared to controls, showed shorter sleep, reduced sleep efficiency index, and increased arousals and awakenings. Four patients presented with sleep disordered breathing (SDB). Periodic limb movements (PLMs) during wake and sleep were observed in all patients. No episode of RBD was observed in the V-PSG recordings, and no patients showed rapid eye movement (REM) sleep without atonia. The disease duration correlated with ESS score (P < 0.02). UHMDRS correlated positively with the ESS score (P < 0.005), and negatively with the percentage of REM sleep. Conclusions: Patients with Huntington disease showed a severe sleep disruption and a high prevalence of periodic limb movements, but no evidence of sleep disordered breathing or REM sleep behavior disorder. Citation: Piano C, Losurdo A, Della Marca G, Solito M, Calandra-Buonaura G, Provini F, Bentivoglio AR, Cortelli P. Polysomnographic findings and clinical correlates in Huntington disease: a cross-sectional cohort study. SLEEP 2015;38(9):1489–1495. PMID:25845698

Endothelial function and sleep: associations of flow-mediated dilation with perceived sleep quality and rapid eye movement (REM) sleep.

PubMed

Cooper, Denise C; Ziegler, Michael G; Milic, Milos S; Ancoli-Israel, Sonia; Mills, Paul J; Loredo, José S; Von Känel, Roland; Dimsdale, Joel E

2014-02-01

Endothelial function typically precedes clinical manifestations of cardiovascular disease and provides a potential mechanism for the associations observed between cardiovascular disease and sleep quality. This study examined how subjective and objective indicators of sleep quality relate to endothelial function, as measured by brachial artery flow-mediated dilation (FMD). In a clinical research centre, 100 non-shift working adults (mean age: 36 years) completed FMD testing and the Pittsburgh Sleep Quality Index, along with a polysomnography assessment to obtain the following measures: slow wave sleep, percentage rapid eye movement (REM) sleep, REM sleep latency, total arousal index, total sleep time, wake after sleep onset, sleep efficiency and apnea-hypopnea index. Bivariate correlations and follow-up multiple regressions examined how FMD related to subjective (i.e., Pittsburgh Sleep Quality Index scores) and objective (i.e., polysomnography-derived) indicators of sleep quality. After FMD showed bivariate correlations with Pittsburgh Sleep Quality Index scores, percentage REM sleep and REM latency, further examination with separate regression models indicated that these associations remained significant after adjustments for sex, age, race, hypertension, body mass index, apnea-hypopnea index, smoking and income (Ps < 0.05). Specifically, as FMD decreased, scores on the Pittsburgh Sleep Quality Index increased (indicating decreased subjective sleep quality) and percentage REM sleep decreased, while REM sleep latency increased (Ps < 0.05). Poorer subjective sleep quality and adverse changes in REM sleep were associated with diminished vasodilation, which could link sleep disturbances to cardiovascular disease. © 2013 European Sleep Research Society.

Patients With Treatment-Resistant Insomnia Taking Nightly Prescription Medications for Sleep: A Retrospective Assessment of Diagnostic and Treatment Variables

PubMed Central

Ulibarri, Victor A.; Romero, Edward A.

2010-01-01

Background: Some chronic insomnia patients who take nightly prescription medication achieve less than optimal results. The US Food and Drug Administration (FDA) and the American Academy of Sleep Medicine (AASM) recommend reevaluation of this type of patient to assess for potential psychiatric or medical causes to explain this “failure for insomnia to remit.” Method: A retrospective chart review examined a consecutive series of chronic insomnia patients with persistent insomnia complaints despite current nightly use of prescription medication from May 2005 to February 2008. To assess the role of psychiatric influences on insomnia symptoms, our sample (N = 218) was divided into 2 subgroups: a group with a history of psychiatric complaints (psychiatric insomnia, n = 189) and a control group of no psychiatric complaints (insomnia, n = 29). Results: The average patient reported insomnia for a decade and took prescription medication for sleep for a mean of 4.5 years. Although 100% of the sample used nightly sleep drugs, only 20% believed medication was the best solution for their condition. As evaluated by self-report and polysomnography, these patients exhibited moderately severe insomnia across most measures. Only a few differences were noted between groups. Subjective perception of insomnia severity was worse in the psychiatric insomnia group, which also reported significantly more insomnia-related interference in daily functioning, symptoms of sleep maintenance insomnia, and a trend toward greater daytime fatigue. The mean Apnea-Hypopnea Index score was 19.5 events/hour, yielding an obstructive sleep apnea diagnosis in 75% of patients per conservative AASM nosology (79% in the insomnia group and 74% in the psychiatric insomnia group, P = .22). Conclusions: In this treatment-seeking sample of patients regularly taking sleep medications, residual insomnia was widespread, and patients with psychiatric insomnia may have perceived their condition as more problematic than a control group of insomnia patients without mental health complaints. Both groups exhibited high rates of objectively diagnosed obstructive sleep apnea, a medical condition associated with pervasive sleep fragmentation. These findings support FDA and AASM guidelines to reassess chronic insomnia patients who manifest residual symptoms despite nightly use of prescription medication for sleep. PMID:21085555

Actigraphic sleep measures and diet quality in the Hispanic Community Health Study/Study of Latinos Sueño ancillary study.

PubMed

Mossavar-Rahmani, Yasmin; Weng, Jia; Wang, Rui; Shaw, Pamela A; Jung, Molly; Sotres-Alvarez, Daniela; Castañeda, Sheila F; Gallo, Linda C; Gellman, Marc D; Qi, Qibin; Ramos, Alberto R; Reid, Kathryn J; Van Horn, Linda; Patel, Sanjay R

2017-12-01

Using a cross-sectional probability sample with actigraphy data and two 24-h dietary recalls, we quantified the association between sleep duration, continuity, variability and timing with the Alternative Healthy Eating Index-2010 diet quality score and its components in 2140 Hispanic Community Health Study/Study of Latinos participants. The Alternative Healthy Eating Index diet quality-2010 score ranges from 0 to 110, with higher scores indicating greater adherence to the dietary guidelines and lower risk from major chronic disease. None of the sleep measures was associated with total caloric intake as assessed using dietary recalls. However, both an increase in sleep duration and sleep efficiency were associated with healthier diet quality. Each standard deviation increase in sleep duration (1.05 h) and sleep efficiency (4.99%) was associated with a 0.30 point increase and 0.28 point increase, respectively, in the total Alternative Healthy Eating Index-2010 score. The component of Alternative Healthy Eating Index-2010 most strongly associated with longer sleep duration was increased nuts and legumes intake. The components of Alternative Healthy Eating Index-2010 most strongly associated with higher sleep efficiency were increased whole fruit intake and decreased sodium intake. Both longer sleep duration and higher sleep efficiency were significantly associated with better diet quality among US Hispanic/Latino adults. The dietary components most strongly associated with sleep duration and sleep efficiency differed, suggesting potentially independent mechanisms by which each aspect of sleep impacts dietary choices. Longitudinal research is needed to understand the directionality of these identified relationships and the generalizability of these data across other ethnic groups. © 2017 European Sleep Research Society.

Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia.

PubMed

Reid, Kathryn J; Baron, Kelly Glazer; Lu, Brandon; Naylor, Erik; Wolfe, Lisa; Zee, Phyllis C

2010-10-01

To assess the efficacy of moderate aerobic physical activity with sleep hygiene education to improve sleep, mood and quality of life in older adults with chronic insomnia. Seventeen sedentary adults aged >or=55 years with insomnia (mean age 61.6 [SD±4.3] years; 16 female) participated in a randomized controlled trial comparing 16 weeks of aerobic physical activity plus sleep hygiene to non-physical activity plus sleep hygiene. Eligibility included primary insomnia for at least 3 months, habitual sleep duration <6.5h and a Pittsburgh Sleep Quality Index (PSQI) score >5. Outcomes included sleep quality, mood and quality of life questionnaires (PSQI, Epworth Sleepiness Scale [ESS], Short-form 36 [SF-36], Center for Epidemiological Studies Depression Scale [CES-D]). The physical activity group improved in sleep quality on the global PSQI (p<.0001), sleep latency (p=.049), sleep duration (p=.04), daytime dysfunction (p=.027), and sleep efficiency (p=.036) PSQI sub-scores compared to the control group. The physical activity group also had reductions in depressive symptoms (p=.044), daytime sleepiness (p=.02) and improvements in vitality (p=.017) compared to baseline scores. Aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life in older adults with chronic insomnia.

Impact of Sleep Disorders, Quality of Life and Gastric Emptying in Distinct Subtypes of Functional Dyspepsia in Japan

PubMed Central

Yamawaki, Hiroshi; Shimpuku, Mayumi; Sato, Hitomi; Wakabayashi, Taiga; Maruki, Yuuta; Kodaka, Yasuhiro; Nagoya, Hiroyuki; Shindo, Tomotaka; Kawagoe, Tetsuro; Sakamoto, Choitsu

2014-01-01

Background/Aims The association between clinical symptoms, gastric emptying, quality of life and sleep disorders in distinct functional dyspepsia (FD) patients has not been studied yet in detail. Methods We enrolled 79 FD patients (postprandial distress syndrome [PDS], n = 65; epigastric pain syndrome [EPS], n = 47; EPS-PDS overlap, n = 33) and 44 healthy volunteers. Gastric motility was evaluated. We used Rome III criteria to evaluate clinical symptoms and State-Trait Anxiety Inventory (STAI) scores to determine anxiety status. Sleep disorder was evaluated using the Pittsburgh Sleep Quality Index scores. Results There were no significant differences in age, sex and Helicobacter pylori positivity between FD subtypes and healthy volunteers. The scores of Glasgow dyspepsia severity scores (GDSS), SF-8 and Pittsburgh Sleep Quality Index (PSQI) in distinct subtypes of FD patients were significantly different from those in healthy volunteers. However, there were not significant differences in these scores, Tmax and T1/2 among 3 subtypes of FD patients. PSQI score was significantly (P = 0.027, P = 0.002 and P = 0.039, respectively) associated with GDSS among EPS, PDS and EPS-PDS overlap patients. In addition, 8-item short form health survey (SF-8; Physical Component Score and Mental Component Score) was significantly associated with global PSQI score in PDS and EPS-PDS overlap patients. In contrast, SF-8 (Mental Component Score) only was significantly linked to global PSQI score in EPS patients. Conclusions Prevalences for sleep disorders, gastric motility and quality of life in 3 subtypes of FD patients were similar levels. In PDS and EPS-PDS overlap patients, SF-8 was significantly associated with global PSQI score. PMID:24466451

Stroop Color-Word Interference Test: Normative data for Spanish-speaking pediatric population.

PubMed

Rivera, D; Morlett-Paredes, A; Peñalver Guia, A I; Irías Escher, M J; Soto-Añari, M; Aguayo Arelis, A; Rute-Pérez, S; Rodríguez-Lorenzana, A; Rodríguez-Agudelo, Y; Albaladejo-Blázquez, N; García de la Cadena, C; Ibáñez-Alfonso, J A; Rodriguez-Irizarry, W; García-Guerrero, C E; Delgado-Mejía, I D; Padilla-López, A; Vergara-Moragues, E; Barrios Nevado, M D; Saracostti Schwartzman, M; Arango-Lasprilla, J C

2017-01-01

To generate normative data for the Stroop Word-Color Interference test in Spanish-speaking pediatric populations. The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the Stroop Word-Color Interference test as part of a larger neuropsychological battery. The Stroop Word, Stroop Color, Stroop Word-Color, and Stroop Interference scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. The final multiple linear regression models showed main effects for age on all scores, except on Stroop Interference for Guatemala, such that scores increased linearly as a function of age. Age2 affected Stroop Word scores for all countries, Stroop Color scores for Ecuador, Mexico, Peru, and Spain; Stroop Word-Color scores for Ecuador, Mexico, and Paraguay; and Stroop Interference scores for Cuba, Guatemala, and Spain. MLPE affected Stroop Word scores for Chile, Mexico, and Puerto Rico; Stroop Color scores for Mexico, Puerto Rico, and Spain; Stroop Word-Color scores for Ecuador, Guatemala, Mexico, Puerto Rico and Spain; and Stroop-Interference scores for Ecuador, Mexico, and Spain. Sex affected Stroop Word scores for Spain, Stroop Color scores for Mexico, and Stroop Interference for Honduras. This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the Stroop Word-Color Interference test in pediatric populations.

Sleep and fatigue in multiple sclerosis: A questionnaire-based, cross-sectional, cohort study.

PubMed

Nociti, Viviana; Losavio, Francesco Antonio; Gnoni, Valentina; Losurdo, Anna; Testani, Elisa; Vollono, Catello; Frisullo, Giovanni; Brunetti, Valerio; Mirabella, Massimiliano; Della Marca, Giacomo

2017-01-15

Fatigue and sleep disorders are frequently reported in patients affected by Multiple Sclerosis (MS) but the causes and the relationship are not yet fully understood. This study aimed at evaluating their prevalence, at determining the relationships between clinical findings of MS and the occurrence of sleep disorders and at investigating the relations between sleep disorders and fatigue. One hundred and two MS patients were enrolled in the study. They were analyzed on both their clinical features (type of MS, disease duration, clinical severity, type of treatment, presence of spinal demyelinating lesions) and specific scales scores (Expanded Disability Status Scale, Modified Fatigue Impact Scale - MFIS, Self-Administered Anxiety Scale - SAS, Beck's Depression Inventory - BDI, Pittsburgh Sleep Quality Index - PSQI, Epworth Sleepiness Scale - ESS, and the Berlin's questionnaire for Obstruction Sleep Apnea Syndrome - OSAS). Patients with poor sleep quality are more frequently fatigued (p=0.001), have higher MFIS global scores (p<0.001), higher prevalence of RLS symptoms (p=0.049), and show higher scores at BDI (p=0.017) and SAS (p≤0.001). Conversely patients with fatigue show older age (p=0.005), higher prevalence of sleepiness (p=0.021), higher prevalence of RLS symptoms (p=0.030), higher prevalence of poor sleep quality (p<0.001) with higher PSQI scores (p<0.001), higher scores on the BDI (p<0.001) and SAS (p≤0.001). This study shows that MS is associated with a high prevalence of sleep complaints, including subjectively poor sleep quality, excessive daytime sleepiness, RLS and symptoms of OSAS. Further, it demonstrated a strict relation between fatigue and sleep disorders. Finally, it underlines their relationship with anxiety and depression in MS patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Midlife sleep characteristics associated with late life cognitive function.

PubMed

Virta, Jyri J; Heikkilä, Kauko; Perola, Markus; Koskenvuo, Markku; Räihä, Ismo; Rinne, Juha O; Kaprio, Jaakko

2013-10-01

Previous studies with limited follow-up times have suggested that sleep-related traits are associated with an increased risk of incident dementia or cognitive decline. We investigated the association between midlife sleep characteristics and late life cognitive function. A follow-up study with a median follow-up time of 22.5 (range 15.8-25.7) years assessing the association between midlife sleep characteristics and later cognitive function. Questionnaire data from 1981 were used in the assessment of sleep characteristics, use of hypnotics, and covariates at baseline. Between 1999 and 2007, participants were assigned a linear cognitive score with a maximum score of 51 based on a telephone interview (mean score 38.3, SD 6.1). Linear regression analyses were controlled for age, sex, education, ApoE genotype, and follow-up time. 2,336 members of the Finnish Twin cohort who were at least 65 years of age. N/A. Baseline short (< 7 h/day) and long (> 8 h/day) sleepers had lower cognitive scores than participants sleeping 7-8 h/ day (β = -0.84, P = 0.014 and β = -1.66, P < 0.001, respectively). As compared to good sleep quality, poor or rather poor sleep quality was associated with a lower cognitive score (β = -1.00, P = 0.011). Also, the use of hypnotics ≥ 60 days per year was associated with poorer cognitive function (β = -1.92, P = 0.002). This is the first study indicating that midlife sleep length, sleep quality, and use of hypnotics are associated with late life cognitive function. Further confirmation is needed, but sleep-related characteristics may emerge as new risk factors for cognitive impairment.

Insufficient Sleep and Suicidality in Adolescents

PubMed Central

Lee, Yu Jin; Cho, Seong-Jin; Cho, In Hee; Kim, Seog Ju

2012-01-01

Study Objectives: To investigate the association between the behaviorally induced insufficient sleep and suicidality among adolescents. Design: A population-based, cross-sectional survey. Setting: General community. Participants: A sample of 8,530 students (grades 7-11) was recruited in the Republic of Korea. The participants were 8,010 students who completed all questionnaires. Intervention: N/A. Measurements: The survey included the Beck Scale for Suicidal Ideation (SSI), the Beck Depression Inventory (BDI), a modified Epworth Sleepiness Scale (ESS), and questionnaires about sleep (weekday/weekend sleep schedule/duration, insomnia and snoring). Results: Adolescents with behaviorally induced insufficient sleep syndrome (BISS) had higher SSI scores than those who slept ≥ 7 hours on weekdays, even after controlling for age, sex, and BDI score (F = 11.71, P < 0.001). After controlling for age and sex, longer weekend oversleep and shorter weekday sleep duration predicted a higher SSI score (β = 0.19, P < 0.001; β = 0.37, P < 0.001). The association between weekend oversleep and SSI score remained significant even after additionally controlling for BDI and ESS scores and presence of insomnia and snoring (β = 0.07, P < 0.01). Conclusion: BISS was found to be associated with increased suicidality. Weekend oversleep was associated with suicidality independently of depression, daytime sleepiness, snoring, and insomnia. The study findings suggest that chronic sleep restriction among adolescents may increase suicidal risk. Citation: Lee YJ; Cho SJ; Cho IH; Kim SJ. Insufficient sleep and suicidality in adolescents. SLEEP 2012;35(4):455-460. PMID:22467982

Comparison of manual sleep staging with automated neural network-based analysis in clinical practice.

PubMed

Caffarel, Jennifer; Gibson, G John; Harrison, J Phil; Griffiths, Clive J; Drinnan, Michael J

2006-03-01

We have compared sleep staging by an automated neural network (ANN) system, BioSleep (Oxford BioSignals) and a human scorer using the Rechtschaffen and Kales scoring system. Sleep study recordings from 114 patients with suspected obstructed sleep apnoea syndrome (OSA) were analysed by ANN and by a blinded human scorer. We also examined human scorer reliability by calculating the agreement between the index scorer and a second independent blinded scorer for 28 of the 114 studies. For each study, we built contingency tables on an epoch-by-epoch (30 s epochs) comparison basis. From these, we derived kappa (kappa) coefficients for different combinations of sleep stages. The overall agreement of automatic and manual scoring for the 114 studies for the classification {wake / light-sleep / deep-sleep / REM} was poor (median kappa = 0.305) and only a little better (kappa = 0.449) for the crude {wake / sleep} distinction. For the subgroup of 28 randomly selected studies, the overall agreement of automatic and manual scoring was again relatively low (kappa = 0.331 for {wake light-sleep / deep-sleep REM} and kappa = 0.505 for {wake / sleep}), whereas inter-scorer reliability was higher (kappa = -0.641 for {wake / light-sleep / deep-sleep / REM} and kappa = 0.737 for {wake / sleep}). We conclude that such an ANN-based analysis system is not sufficiently accurate for sleep study analyses using the R&K classification system.

Nocturnal Dynamics of Sleep-Wake Transitions in Patients With Narcolepsy.

PubMed

Zhang, Xiaozhe; Kantelhardt, Jan W; Dong, Xiao Song; Krefting, Dagmar; Li, Jing; Yan, Han; Pillmann, Frank; Fietze, Ingo; Penzel, Thomas; Zhao, Long; Han, Fang

2017-02-01

We investigate how characteristics of sleep-wake dynamics in humans are modified by narcolepsy, a clinical condition that is supposed to destabilize sleep-wake regulation. Subjects with and without cataplexy are considered separately. Differences in sleep scoring habits as a possible confounder have been examined. Four groups of subjects are considered: narcolepsy patients from China with (n = 88) and without (n = 15) cataplexy, healthy controls from China (n = 110) and from Europe (n = 187, 2 nights each). After sleep-stage scoring and calculation of sleep characteristic parameters, the distributions of wake-episode durations and sleep-episode durations are determined for each group and fitted by power laws (exponent α) and by exponentials (decay time τ). We find that wake duration distributions are consistent with power laws for healthy subjects (China: α = 0.88, Europe: α = 1.02). Wake durations in all groups of narcolepsy patients, however, follow the exponential law (τ = 6.2-8.1 min). All sleep duration distributions are best fitted by exponentials on long time scales (τ = 34-82 min). We conclude that narcolepsy mainly alters the control of wake-episode durations but not sleep-episode durations, irrespective of cataplexy. Observed distributions of shortest wake and sleep durations suggest that differences in scoring habits regarding the scoring of short-term sleep stages may notably influence the fitting parameters but do not affect the main conclusion. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

The relationship between lower urinary tract symptom severity and sleep disturbance in the CAMUS trial.

PubMed

Helfand, Brian T; McVary, Kevin T; Meleth, Sreelatha; Sharp, Victoria; Foster, Harris; Naslund, Michael; Williams, O Dale

2011-06-01

Bothersome lower urinary tract symptoms, including nocturia, significantly impact general health related quality of life in men, as does sleep disturbance. However, few groups have examined the relationship between urinary symptom severity and sleep disturbance. Men enrolled in a clinical trial of saw palmetto (Serenoa repens) were studied at baseline. Lower urinary tract symptom severity, as determined by the American Urological Association symptom index and quality of life scores, and the degree of sleep disturbance were determined by the Jenkins sleep scale. Analysis was done, adjusting for baseline characteristics, to identify predictors of severe sleep disturbance. A total of 366 men with a mean ± SD age of 60.9 ± 8.3 years who had moderate-severe lower urinary tract symptoms (mean American Urological Association symptom index score 14.58 ± 4.6 points) and a mean Jenkins sleep score of 7.3 ± 4.7 points were included in analysis. Overall there were significant associations between the American Urological Association symptom index score and sleep disturbance severity. Multivariate analysis revealed that obstructive and irritative symptoms were significantly associated with severe sleep disturbance. Further analysis showed that lower serum prostate specific antigen and post-void residual urine volume were also significantly associated with the degree of sleep disturbance. Lower urinary tract symptom severity is a risk factor for severe sleep disturbance in men. While nocturia was significantly associated with sleep disturbance, other lower urinary tract symptoms were also independent predictors of sleep dysfunction. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Sleep Problems are Associated with Development and Progression of Lower Urinary Tract Symptoms: Results from REDUCE.

PubMed

Branche, Brandee L; Howard, Lauren E; Moreira, Daniel M; Roehrborn, Claus; Castro-Santamaria, Ramiro; Andriole, Gerald L; Hopp, Martin L; Freedland, Stephen J

2018-02-01

Although lower urinary tract symptoms and sleep problems often develop together, to our knowledge it is unknown whether sleep disturbances are linked to lower urinary tract symptoms development and progression. As measured by the 6-item MOS-Sleep (Medical Outcomes Study Sleep Scale) survey we examined the relationship between sleep problems, and the development and progression of lower urinary tract symptoms in the REDUCE (Reduction by Dutasteride of Prostate Cancer Events) study. REDUCE was a randomized trial testing prostate cancer chemoprevention with dutasteride in men with prostate specific antigen 2.5 to 10 ng/ml and a negative biopsy. At baseline men completed MOS-Sleep and a scaled average was used to calculate the sleep score. Men were followed for 4 years and I-PSS (International Prostate Symptom Score) was completed at baseline and every 6 months. Asymptomatic men had I-PSS less than 8 while symptomatic men had I-PSS 8 or greater. In the placebo arm of 2,588 men not receiving α-blockers or 5α-reductase inhibitors at baseline we tested the association between sleep problems and lower urinary tract symptom development and progression using Cox models. During followup lower urinary tract symptoms developed in 209 of 1,452 asymptomatic men (14%) and 580 of 1,136 (51%) with lower urinary tract symptoms demonstrated progression. On multivariable analysis higher sleep scores were suggestively associated with increased lower urinary tract symptoms in asymptomatic men (quartile 4 vs 1 HR 1.41, 95% CI 0.92-2.17, p = 0.12) and with lower urinary tract symptom progression in symptomatic men (per 10 points of sleep score HR 1.06, 95% CI 1.01-1.12, p = 0.029). Among men with lower urinary tract symptoms worse sleep scores were associated with the progression of lower urinary tract symptoms and among asymptomatic men worse sleep scores were suggestively associated with the development of lower urinary tract symptoms. If confirmed, these data suggest that sleep problems may precede such symptoms. Whether treating sleep problems would improve lower urinary tract symptoms requires further testing. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The relationship of sleep problems to life quality and depression

PubMed Central

Sarıarslan, Hacı A.; Gulhan, Yıldırım B.; Unalan, Demet; Basturk, Mustafa; Delibas, Senol

2015-01-01

Objective: To identify the level of depression, the level of life quality, and the relationship between these, in patients applying to sleep centers for various sleep problems. Methods: This cross-sectional study included 229 patients who applied for polysomnography at sleeping centers under supervision of the Neurology and Chest Diseases Clinics of Kayseri Education and Research Hospital, Kayseri, Turkey between June and August 2013. The data collection tools were a socio-demographical data form, Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life Scale (WHOQOL-BREF). For statistical analyses, the Student t-test, Kruskal-Wallis-variant analysis, and chi-square tests were used. Significance level was considered as p<0.05. Results: In our study, patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom were observed to have significantly poorer sleep quality. While patients with any chronic disease had significantly higher scores for total PSQI and depression, their physical, mental, and social WHOQOL-BREF scores were significantly lower. The PSQI total scores, and depression scores of the smoking patients were significantly higher for physical, mental, and social WHOQOL-BREF fields. There was a positive correlation between PSQI scores and BDI scores while there was a negative correlation among BDI, PSQI, and WHOQOL-BREF life quality sub-scale scores. Conclusions: Sleep quality was significantly poorer in patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom. There was a significantly negative correlation among depression, sleep quality, and life quality, while there was a significantly positive correlation between life quality and depression. PMID:26166591

Sleep disturbances in children with epilepsy compared with their nearest-aged siblings.

PubMed

Wirrell, Elaine; Blackman, Marlene; Barlow, Karen; Mah, Jean; Hamiwka, Lorie

2005-11-01

The aim of the study was to compare sleep patterns in children with epilepsy with those of their non-epileptic siblings and to determine which epilepsy-specific factors predict greater sleep disturbance. We conducted a case-control study of 55 children with epilepsy (mean age 10y, range 4 to 16y; 27 males, 28 females) and their nearest-aged non-epileptic sibling (mean age 10y, range 4 to 18y; 26 males, 29 females). Epilepsy was idiopathic generalized in eight children (15%), symptomatic generalized in seven (13%), and focal in 40 (73%); the mean duration was 5 years 8 months. Parents or caregivers completed the Sleep Behavior Questionnaire (SBQ) and Child Behavior Checklist (CBCL) for patients and controls, and the Quality of Life in Childhood Epilepsy (QOLCE) for patients. Patients had a higher (more adverse) Total Sleep score (p<0.001) and scored worse than controls on nearly all subscales of the SBQ. In patients, higher Total Sleep scores were correlated with higher scores on the Withdrawn, Somatic complaints, Social problems, and Attention subscales of the CBCL, and significantly lower Total Quality of Life Scores. Refractory epilepsy, mental retardation, and remote symptomatic etiology predicted greater sleep problems in those with epilepsy. We conclude that children with epilepsy in this current study had significantly greater sleep problems than their non-epileptic siblings.

Minimizing Interrater Variability in Staging Sleep by Use of Computer-Derived Features

PubMed Central

Younes, Magdy; Hanly, Patrick J.

2016-01-01

Study Objectives: Inter-scorer variability in sleep staging of polysomnograms (PSGs) results primarily from difficulty in determining whether: (1) an electroencephalogram pattern of wakefulness spans > 15 sec in transitional epochs, (2) spindles or K complexes are present, and (3) duration of delta waves exceeds 6 sec in a 30-sec epoch. We hypothesized that providing digitally derived information about these variables to PSG scorers may reduce inter-scorer variability. Methods: Fifty-six PSGs were scored (five-stage) by two experienced technologists, (first manual, M1). Months later, the technologists edited their own scoring (second manual, M2). PSGs were then scored with an automatic system and the same two technologists and an additional experienced technologist edited them, epoch-by-epoch (Edited-Auto). This resulted in seven manual scores for each PSG. The two M2 scores were then independently modified using digitally obtained values for sleep depth and delta duration and digitally identified spindles and K complexes. Results: Percent agreement between scorers in M2 was 78.9 ± 9.0% before modification and 96.5 ± 2.6% after. Errors of this approach were defined as a change in a manual score to a stage that was not assigned by any scorer during the seven manual scoring sessions. Total errors averaged 7.1 ± 3.7% and 6.9 ± 3.8% of epochs for scorers 1 and 2, respectively, and there was excellent agreement between the modified score and the initial manual score of each technologist. Conclusions: Providing digitally obtained information about sleep depth, delta duration, spindles and K complexes during manual scoring can greatly reduce interrater variability in sleep staging by eliminating the guesswork in scoring epochs with equivocal features. Citation: Younes M, Hanly PJ. Minimizing interrater variability in staging sleep by use of computer-derived features. J Clin Sleep Med 2016;12(10):1347–1356. PMID:27448418

Timed Light Therapy for Sleep and Daytime Sleepiness Associated With Parkinson Disease: A Randomized Clinical Trial.

PubMed

Videnovic, Aleksandar; Klerman, Elizabeth B; Wang, Wei; Marconi, Angelica; Kuhta, Teresa; Zee, Phyllis C

2017-04-01

Impaired sleep and alertness are some of the most common nonmotor manifestations of Parkinson disease (PD) and currently have only limited treatment options. Light therapy (LT), a widely available treatment modality in sleep medicine, has not been systematically studied in the PD population. To determine the safety and efficacy of LT on excessive daytime sleepiness (EDS) associated with PD. This randomized, placebo-controlled, clinical intervention study was set in PD centers at Northwestern University and Rush University. Participants were 31 patients with PD receiving stable dopaminergic therapy with coexistent EDS, as assessed by an Epworth Sleepiness Scale score of 12 or greater, and without cognitive impairment or primary sleep disorder. Participants were randomized 1:1 to receive bright LT or dim-red LT (controlled condition) twice daily in 1-hour intervals for 14 days. This trial was conducted between March 1, 2007, and October 31, 2012. Data analysis of the intention-to-treat population was conducted from November 1, 2012, through April 30, 2016. The primary outcome measure was the change in the Epworth Sleepiness Scale score comparing the bright LT with the dim-red LT. Secondary outcome measures included the Pittsburgh Sleep Quality Index score, the Parkinson's Disease Sleep Scale score, the visual analog scale score for daytime sleepiness, and sleep log-derived and actigraphy-derived metrics. Among the 31 patients (13 males and 18 females; mean [SD] disease duration, 5.9 [3.6] years), bright LT resulted in significant improvements in EDS, as assessed by the Epworth Sleepiness Scale score (mean [SD], 15.81 [3.10] at baseline vs 11.19 [3.31] after the intervention). Both bright LT and dim-red LT were associated with improvements in sleep quality as captured by mean (SD) scores on the Pittsburg Sleep Quality Index (7.88 [4.11] at baseline vs 6.25 [4.27] after bright LT, and 8.87 [2.83] at baseline vs 7.33 [3.52] after dim-red LT) and the Parkinson's Disease Sleep Scale (97.24 [22.49] at baseline vs 106.98 [19.37] after bright LT, and 95.11 [19.86] at baseline vs 99.28 [16.94] after dim-red LT). Bright LT improved several self-reported mean (SD) sleep metrics, including sleep fragmentation (number of overnight awakenings, 1.51 [1.03] at baseline vs 0.92 [0.97] after the intervention), sleep quality (sleep diary score, 3.03 [1.01] at baseline vs 3.53 [0.91] after the intervention), and ease of falling asleep (sleep diary score, 2.32 [0.89] at baseline vs 1.83 [0.88] after the intervention). Light therapy was associated with increased daily physical activity as assessed by actigraphy (average activity [SD] counts, 165.01 [66.87] at baseline vs 194.59 [87.81] after the intervention). Light therapy was well tolerated and may be a feasible intervention for improving the sleep-wake cycles in patients with PD. Further studies are required to determine optimal parameters of LT for PD. clinicaltrials.gov Identifier: NCT01338649.

Internet-based survey of factors associated with subjective feeling of insomnia, depression, and low health-related quality of life among Japanese adults with sleep difficulty.

PubMed

Aritake, Sayaka; Asaoka, Shoichi; Kagimura, Tatsuo; Shimura, Akiyoshi; Futenma, Kunihiro; Komada, Yoko; Inoue, Yuichi

2015-04-01

This study was conducted to determine what symptom components or conditions of insomnia are related to subjective feelings of insomnia, low health-related quality of life (HRQOL), or depression. Data from 7,027 Japanese adults obtained using an Internet-based questionnaire survey was analyzed to examine associations between demographic variables and each sleep difficulty symptom item on the Pittsburgh Sleep Quality Index (PSQI) with the presence/absence of subjective insomnia and scores on the Short Form-8 (SF-8) and Center for Epidemiologic Studies Depression Scale (CES-D). Prevalence of subjective insomnia was 12.2% (n = 860). Discriminant function analysis revealed that item scores for sleep quality, sleep latency, and sleep medication use on the PSQI and CES-D showed relatively high discriminant function coefficients for identifying positivity for the subjective feeling of insomnia. Among respondents with subjective insomnia, a low SF-8 physical component summary score was associated with higher age, depressive state, and PSQI items for sleep difficulty and daytime dysfunction, whereas a low SF-8 mental component summary score was associated with depressive state, PSQI sleep latency, sleeping medication use, and daytime dysfunction. Depressive state was significantly associated with sleep latency, sleeping medication use, and daytime dysfunction. Among insomnia symptom components, disturbed sleep quality and sleep onset insomnia may be specifically associated with subjective feelings of the disorder. The existence of a depressive state could be significantly associated with not only subjective insomnia but also mental and physical QOL. Our results also suggest that different components of sleep difficulty, as measured by the PSQI, might be associated with mental and physical QOL and depressive status.

Effect of Melatonin Administration on Sleep Quality in Sulfur Mustard Exposed Patients with Sleep Disorders

PubMed Central

Mousavi, Seyyedeh Soghra; Shohrati, Majid; Vahedi, Ensieh; Abdollahpour-Alitappeh, Meghdad; Panahi, Yunes

2018-01-01

Sulfur mustard (SM) is a toxic agent that targets several tissues. It is the leading cause of persistent lung disease, progressive deterioration in lung function, and mortality among injured patients. Disturbed sleep and poor quality of sleep are common in SM-exposed patients with chronic respiratory problems. Melatonin is an alternative medication that has been widely used to treat poor sleep quality caused by several specific conditions. This study aimed to evaluate the efficacy of melatonin administration in improvement of sleep quality in SM-injured patients. In this randomized, double-blind and placebo-controlled trial study a total of 30 SM-exposed male patients were recruited. Patients received 3 mg melatonin (N = 15) or placebo (N = 15), orally in a single dose, 1 h before bedtime for 56 consecutive days. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI); daytime sleepiness was measured by Epworth Sleepiness Scale (ESS), and the risk of obstructive sleep apnea was determined by STOP-Bang questionnaire. Compared with placebo, melatonin administration significantly improved global PSQI score, particularly sleep latency (P = 0.03) and subjective sleep quality (P = 0.004). Mean of global PSQI score was declined significantly (P = 0.01) from 10.13 ± 3.44 to 6.66 ± 3.08 in melatonin group. No differences in ESS and STOP-Bang scores were observed between two groups. Melatonin was effective in improving global PSQI score and sleep latency, but not daytime sleepiness and obstructive sleep apnea in SM-exposed patients. Further long-term studies involving larger number of patients are needed before melatonin can be safely recommended for the management of sleep disturbances in these patients.

Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults.

PubMed

Lao, Xiang Qian; Liu, Xudong; Deng, Han-Bing; Chan, Ta-Chien; Ho, Kin Fai; Wang, Feng; Vermeulen, Roel; Tam, Tony; Wong, Martin C S; Tse, L A; Chang, Ly-Yun; Yeoh, Eng-Kiong

2018-01-15

There is limited information on the relationship between risk of cardiovascular disease and the joint effects of sleep quality and sleep duration, especially from large, prospective, cohort studies. This study is to prospectively investigate the joint effects of sleep quality and sleep duration on the development of coronary heart disease. This study examined 60,586 adults aged 40 years or older. A self-administered questionnaire was used to collect information on sleep quality and sleep duration as well as a wide range of potential confounders. Events of coronary heart disease were self-reported in subsequent medical examinations. Two types of Sleep Score (multiplicative and additive) were constructed to reflect the participants' sleep profiles, considering both sleep quality and sleep duration. The Cox regression model was used to estimate the hazard ratio (HR) and the 95% confidence interval (CI). A total of 2,740 participants (4.5%) reported new events of coronary heart disease at follow-up. For sleep duration, participants in the group of < 6 h/d was significantly associated with an increased risk of coronary heart disease (HR: 1.13, 95% CI: 1.04-1.23). However, the association in the participants with long sleep duration (> 8 h/d) did not reach statistical significance (HR: 1.11, 95% CI: 0.98-1.26). For sleep quality, both dreamy sleep (HR: 1.21, 95% CI: 1.10-1.32) and difficult to fall asleep/use of sleeping pills or drugs (HR: 1.40, 95% CI: 1.25-1.56) were associated with an increased risk of the disease. Participants in the lowest quartile of multiplicative Sleep Score (HR: 1.31, 95% CI: 1.16-1.47) and of additive sleep score (HR: 1.31, 95% CI: 1.16-1.47) were associated with increased risk of coronary heart disease compared with those in the highest quartile. Both short sleep duration and poor sleep quality are associated with the risk of coronary heart disease. The association for long sleep duration does not reach statistical significance. Lower Sleep Score (poorer sleep profile) increases the risk of coronary heart disease, suggesting the importance of considering sleep duration and sleep quality together when developing strategies to improve sleep for cardiovascular disease prevention. © 2018 American Academy of Sleep Medicine

Sleep disturbances in preschool age children with cerebral palsy: a questionnaire study.

PubMed

Romeo, Domenico M; Brogna, Claudia; Musto, Elisa; Baranello, Giovanni; Pagliano, Emanuela; Casalino, Tiziana; Ricci, Daniela; Mallardi, Maria; Sivo, Serena; Cota, Francesco; Battaglia, Domenica; Bruni, Oliviero; Mercuri, Eugenio

2014-09-01

The study aimed to analyze (i) the prevalence of sleep disorders in pre-school children with cerebral palsy (CP) using the Sleep Disturbance Scale for Children (SDSC), (ii) the possible association with motor, cognitive and behavioral problems, and (iii) the possible differences with typically developing children matched for age and gender. One-hundred children with CP (age range: 3-5 years, mean: 3.8 years) were assessed using the SDSC, the Gross Motor Function Classification System (GMFCS), the Wechsler Preschool and Primary Scale of Intelligence, and the Child Behaviour Check List (CBCL) to assess sleep, motor, cognitive, and behavioral problems, respectively. Further 100 healthy children matched for age and sex were assessed using the SDSC. An abnormal total sleep score was found in 13% of children with CP while 35% had an abnormal score on at least one SDSC factor. SDSC total score was significantly associated with pathological internalizing scores on CBCL and active epilepsy on multivariate analysis. CP group reported higher significant median scores on SDSC total, parasomnias, and difficulty in initiating and maintaining sleep factors. In pre-school children sleep disorders are more common in children with CP than in healthy control group and are often associated with epilepsy and behavioral problems. Copyright © 2014 Elsevier B.V. All rights reserved.

Insufficient sleep and suicidality in adolescents.

PubMed

Lee, Yu Jin; Cho, Seong-Jin; Cho, In Hee; Kim, Seog Ju

2012-04-01

To investigate the association between the behaviorally induced insufficient sleep and suicidality among adolescents. A population-based, cross-sectional survey. General community. A sample of 8,530 students (grades 7-11) was recruited in the Republic of Korea. The participants were 8,010 students who completed all questionnaires. N/A. The survey included the Beck Scale for Suicidal Ideation (SSI), the Beck Depression Inventory (BDI), a modified Epworth Sleepiness Scale (ESS), and questionnaires about sleep (weekday/weekend sleep schedule/duration, insomnia and snoring). Adolescents with behaviorally induced insufficient sleep syndrome (BISS) had higher SSI scores than those who slept ≥ 7 hours on weekdays, even after controlling for age, sex, and BDI score (F = 11.71, P < 0.001). After controlling for age and sex, longer weekend oversleep and shorter weekday sleep duration predicted a higher SSI score (β = 0.19, P < 0.001; β = 0.37, P < 0.001). The association between weekend oversleep and SSI score remained significant even after additionally controlling for BDI and ESS scores and presence of insomnia and snoring (β = 0.07, P < 0.01). BISS was found to be associated with increased suicidality. Weekend oversleep was associated with suicidality independently of depression, daytime sleepiness, snoring, and insomnia. The study findings suggest that chronic sleep restriction among adolescents may increase suicidal risk.

Using cannabis to help you sleep: heightened frequency of medical cannabis use among those with PTSD.

PubMed

Bonn-Miller, Marcel O; Babson, Kimberly A; Vandrey, Ryan

2014-03-01

The use of cannabis for medical purposes is proliferating in the U.S., and PTSD is an explicitly approved condition for accessing medical cannabis in 5 states. Prior research suggests that people with PTSD often use cannabis to help cope with their condition, and that doing so results in more frequent and problematic cannabis use patterns. Specific coping motivations, such as sleep improvement, among medical cannabis users, have not been examined. The present study evaluated specific coping use motivations, frequency of cannabis and alcohol use, and mental health among a convenience sample of patients (N=170) at a medical cannabis dispensary in California. Those with high PTSD scores were more likely to use cannabis to improve sleep, and for coping reasons more generally, compared with those with low PTSD scores. Cannabis use frequency was greater among those with high PTSD scores who used for sleep promoting purposes compared with those with low PTSD scores or those who did not use for sleep promoting purposes. Consistent with prior research, this study found increased rates of coping-oriented use of cannabis and greater frequency of cannabis use among medical users with high PTSD scores compared with low PTSD scores. In addition, sleep improvement appears to be a primary motivator for coping-oriented use. Additional research is needed to examine the health consequences of this pattern of cannabis use and whether alternative sleep promoting interventions (e.g. CBT-I) could reduce the reliance on cannabis for adequate sleep among those with PTSD. Published by Elsevier Ireland Ltd.

Sleep schedules and school performance in Indigenous Australian children.

PubMed

Blunden, Sarah; Magee, Chris; Attard, Kelly; Clarkson, Larissa; Caputi, Peter; Skinner, Timothy

2018-04-01

Sleep duration and sleep schedule variability have been related to negative health and well-being outcomes in children, but little is known about Australian Indigenous children. Data for children aged 7-9 years came from the Australian Longitudinal Study of Indigenous Children and the National Assessment Program-Literacy and Numeracy (NAPLAN). Latent class analysis determined sleep classes taking into account sleep duration, bedtimes, waketimes, and variability in bedtimes from weekdays to weekends. Regression models tested whether the sleep classes were cross-sectionally associated with grade 3 NAPLAN scores. Latent change score modeling then examined whether the sleep classes predicted changes in NAPLAN performance from grades 3 to 5. Five sleep schedule classes were identified: normative sleep, early risers, long sleep, variable sleep, and short sleep. Overall, long sleepers performed best, with those with reduced sleep (short sleepers and early risers) performing the worse on grammar, numeracy, and writing performance. Latent change score results also showed that long sleepers performed best in spelling and writing and short sleepers and typical sleepers performed the worst over time. In this sample of Australian Indigenous children, short sleep was associated with poorer school performance compared with long sleep, with this performance worsening over time for some performance indicators. Other sleep schedules (eg, early wake times and variable sleep) also had some relationships with school performance. As sleep scheduling is modifiable, this offers opportunity for improvement in sleep and thus performance outcomes for these and potentially all children. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

"Always Look on the Bright Side of Life!" - Higher Hypomania Scores Are Associated with Higher Mental Toughness, Increased Physical Activity, and Lower Symptoms of Depression and Lower Sleep Complaints.

PubMed

Jahangard, Leila; Rahmani, Anahita; Haghighi, Mohammad; Ahmadpanah, Mohammad; Sadeghi Bahmani, Dena; Soltanian, Ali R; Shirzadi, Shahriar; Bajoghli, Hafez; Gerber, Markus; Holsboer-Trachsler, Edith; Brand, Serge

2017-01-01

Background: In the present study, we explored the associations between hypomania, symptoms of depression, sleep complaints, physical activity and mental toughness. The latter construct has gained interest for its association with a broad variety of favorable behavior in both clinical and non-clinical samples. Subjects and Methods: The non-clinical sample consisted of 206 young adults ( M = 21.3 years; age range: 18-24 years; 57.3% males). They completed questionnaires covering hypomania, mental toughness, symptoms of depression, physical activity, and sleep quality. Results: Higher hypomania scores were associated with higher mental toughness, increased physical activity, lower symptoms of depression and lower sleep complaints. No gender differences were observed. Higher hypomania scores were predicted by higher scores of mental toughness subscales of control and challenge, and physical activity. Conclusion: The pattern of results suggests that among a non-clinical sample of young adults, self-rated hypomania scores were associated with higher scores on mental toughness and physical activity, along with lower depression and sleep complaints. The pattern of results further suggests that hypomania traits are associated with a broad range of favorable psychological, behavioral and sleep-related traits, at least among a non-clinical sample of young adults.

Sleep quality and quality of life in female shift-working nurses.

PubMed

Shao, Ming-Fen; Chou, Yu-Ching; Yeh, Mei-Yu; Tzeng, Wen-Chii

2010-07-01

This paper is a report of a study of the factors that influence sleep quality and quality of life among shift-working nurses and the relationship between their sleep quality and quality of life. Although shift-working nurses strive to adapt their life schedules to shift rotations, they tend to suffer from severe sleep disturbances and increased rates of cancer, cardiovascular diseases, digestive disease and irregular menstrual cycles. Poor sleep is also associated with medical errors and occupational injuries. A cross-sectional study was conducted in 2008 with a convenience sample of 435 female nurses from five regional hospitals in Taiwan. Data were collected on sleep quality and quality of life using the Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Instrument-BREF Taiwan version respectively. Data were analysed using descriptive statistics, independent t-tests, analysis of variance and Pearson correlations. The majority of female shift workers (57%) had global sleep-quality scores > or = 5, indicating poor sleep and all mean scores in four domains of the quality-of-life measure were statistically significantly lower than those of females in Taiwan's general population. Scores for poor sleep quality and quality of life were related to premenstrual dysphoria, occupational injury, illness and medication use. In addition, the associations between scores on the sleep-quality and quality-of-life scales were statistically significantly inversely correlated. Advice should be included in both undergraduate programmes and continuing education to help nurses to recognize and improve their own sleep quality and life quality managers should create a supportive environment to encourage shift-working nurses to engage in healthy behaviours.

Estimation of a Preference-Based Summary Score for the Patient-Reported Outcomes Measurement Information System: The PROMIS®-Preference (PROPr) Scoring System.

PubMed

Dewitt, Barry; Feeny, David; Fischhoff, Baruch; Cella, David; Hays, Ron D; Hess, Rachel; Pilkonis, Paul A; Revicki, Dennis A; Roberts, Mark S; Tsevat, Joel; Yu, Lan; Hanmer, Janel

2018-06-01

Health-related quality of life (HRQL) preference-based scores are used to assess the health of populations and patients and for cost-effectiveness analyses. The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS ® ) consists of patient-reported outcome measures developed using item response theory. PROMIS is in need of a direct preference-based scoring system for assigning values to health states. To produce societal preference-based scores for 7 PROMIS domains: Cognitive Function-Abilities, Depression, Fatigue, Pain Interference, Physical Function, Sleep Disturbance, and Ability to Participate in Social Roles and Activities. Online survey of a US nationally representative sample ( n = 983). Preferences for PROMIS health states were elicited with the standard gamble to obtain both single-attribute scoring functions for each of the 7 PROMIS domains and a multiplicative multiattribute utility (scoring) function. The 7 single-attribute scoring functions were fit using isotonic regression with linear interpolation. The multiplicative multiattribute summary function estimates utilities for PROMIS multiattribute health states on a scale where 0 is the utility of being dead and 1 the utility of "full health." The lowest possible score is -0.022 (for a state viewed as worse than dead), and the highest possible score is 1. The online survey systematically excludes some subgroups, such as the visually impaired and illiterate. A generic societal preference-based scoring system is now available for all studies using these 7 PROMIS health domains.

α(1)-adrenoceptor blocker naftopidil improves sleep disturbance with reduction in nocturnal urine volume.

PubMed

Yokoyama, Osamu; Aoki, Yoshitaka; Tsujimura, Akira; Takao, Tetsuya; Namiki, Mikio; Okuyama, Akihiko

2011-04-01

To examine the mechanism underlying improvements in nocturia by α(1)-blockers, we investigated whether the α(1)-blocker naftopidil acts on nocturia with sleep disturbance using a frequency/volume chart (FVC). A total of 56 male patients with lower urinary tract symptoms were enrolled. The inclusion criteria were as follows: eight or more points on the I-PSS; three or more points on the I-PSS score for nocturia; and prostate volume larger than 20 ml. Patients received 50 mg of naftopidil once daily for 4 weeks, and non-responders received 75 mg for another 4 weeks. All patients were examined, and their data entered into FVC for 2 days before and after administration of naftopidil. Quality of sleep was also evaluated using modified Pittsburgh sleep quality index (PSQI). Patients with sleep quality scores of three or four were assigned to sleep disturbance group (n = 33), while those with scores of less than three were assigned to non-disturbance group (n = 23). After administration of naftopidil, total I-PSS decreased and nocturia score decreased from 3.5 to 2.6 (P < 0.01). Total mean score of modified PSQI in sleep disturbance group became significantly lower after administration of naftopidil (from 16.9 to 14.0; P < 0.01). Naftopidil significantly decreased nocturnal urine volume, resulting in a decrease in the nocturnal polyuria index in both sleep disturbance and non-disturbance groups. These results suggest that α(1)-blockers have the ability to normalize sleep disorders. Naftopidil improved nocturnal polyuria regardless of the presence of sleep disturbance, meaning that it might directly reduce nocturnal urine production.

Performance of a New Portable Wireless Sleep Monitor

PubMed Central

Younes, Magdy; Soiferman, Marc; Thompson, Wayne; Giannouli, Eleni

2017-01-01

Study Objectives: To determine if signals generated by a new sleep monitor (Prodigy) are comparable to signals generated during in-laboratory polysomnography (PSG). Methods: Fifty-nine patients with various sleep disorders (25 with moderate/severe sleep apnea) were studied. Full PSG was performed using standard acquisition systems. Prodigy was attached to the forehead with four disposable snap electrodes. Four additional electrodes were attached to monitor eye movements and muscle activity, and to serve as reference (mastoid). One frontal EEG signal was outputted in real time from the monitor and stored in the PSG record along with the other PSG signals. PSG was scored for sleep variables manually, and monitor records were scored by a validated automatic system (MSS) (MSS-Prodigy). MSS-Prodigy was briefly edited following suggestions of an Editing Helper feature of MSS. Results: Technical failures resulted in one study being unusable and another with data for only 3 hours. Prodigy EEG signal stored in the PSG record was visually indistinguishable from the PSG-derived EEG signals. Important differences between manual scores and unedited MSS-Prodigy were seen in a few patients in some sleep variables (notably onset latencies and REM time). Editing Helper issued 2.1 ± 0.8 suggestions/file. Only these suggestions were pursued during editing. Intraclass correlation coefficients for manual vs. edited MSS-Prodigy were > 0.83 for all sleep variables except for stages N1 and N3 (0.57 and 0.58). Conclusions: When scored with MSS, and with only very minor editing, the monitor's results show excellent agreement with manual scoring of polysomnography data, even in patients with severe sleep disorders. Citation: Younes M, Soiferman M, Thompson W, Giannouli E. Performance of a new portable wireless sleep monitor. J Clin Sleep Med. 2017;13(2):245–258. PMID:27784419

Neonatal Sleep-Wake Analyses Predict 18-month Neurodevelopmental Outcomes.

PubMed

Shellhaas, Renée A; Burns, Joseph W; Hassan, Fauziya; Carlson, Martha D; Barks, John D E; Chervin, Ronald D

2017-11-01

The neurological examination of critically ill neonates is largely limited to reflexive behavior. The exam often ignores sleep-wake physiology that may reflect brain integrity and influence long-term outcomes. We assessed whether polysomnography and concurrent cerebral near-infrared spectroscopy (NIRS) might improve prediction of 18-month neurodevelopmental outcomes. Term newborns with suspected seizures underwent standardized neurologic examinations to generate Thompson scores and had 12-hour bedside polysomnography with concurrent cerebral NIRS. For each infant, the distribution of sleep-wake stages and electroencephalogram delta power were computed. NIRS-derived fractional tissue oxygen extraction (FTOE) was calculated across sleep-wake stages. At age 18-22 months, surviving participants were evaluated with Bayley Scales of Infant Development (Bayley-III), 3rd edition. Twenty-nine participants completed Bayley-III. Increased newborn time in quiet sleep predicted worse 18-month cognitive and motor scores (robust regression models, adjusted r2 = 0.22, p = .007, and 0.27, .004, respectively). Decreased 0.5-2 Hz electroencephalograph (EEG) power during quiet sleep predicted worse 18-month language and motor scores (adjusted r2 = 0.25, p = .0005, and 0.33, .001, respectively). Predictive values remained significant after adjustment for neonatal Thompson scores or exposure to phenobarbital. Similarly, an attenuated difference in FTOE, between neonatal wakefulness and quiet sleep, predicted worse 18-month cognitive, language, and motor scores in adjusted analyses (each p < .05). These prospective, longitudinal data suggest that inefficient neonatal sleep-as quantified by increased time in quiet sleep, lower electroencephalogram delta power during that stage, and muted differences in FTOE between quiet sleep and wakefulness-may improve prediction of adverse long-term outcomes for newborns with neurological dysfunction. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Social jetlag, chronotype, and body mass index in 14 to 17 year old adolescents

PubMed Central

Malone, Susan Kohl; Zemel, Babette; Compher, Charlene; Souders, Margaret; Chittams, Jesse; Thompson, Aleda Leis; Pack, Allan; Lipman, Terri H.

2016-01-01

The relationship between sleep duration and obesity in adolescents is inconclusive. This may stem from a more complex relationship between sleep and obesity than previously considered. Shifts towards evening preferences, later sleep-wake times, and irregular sleep-wake patterns are typical during adolescence but their relationship to body mass index has been relatively unexplored. This cross sectional study examined associations between sleep duration, midpoint of sleep, and social jetlag (estimated from seven days of continuous actigraphy monitoring) and morningness/eveningness with body mass indexes (BMI z scores) and waist to height ratios in 14 to 17 year old adolescents. Seventy participants were recruited from 9th and 10th grades at a public high school. Participant characteristics were as follows: 74% female, 75% post-pubertal, 36% Hispanic, 38% White, 22% Black, 4% Asian, and 64% free/reduced lunch participants with a mean age of 15.5 (SD, 0.7). Forty one percent of the participants were obese (BMI ≥ 95th percentile); 54% were abdominally obese (waist to height ratio ≥ 0.5). Multivariable general linear models were used to estimate the association between the independent variables (school night sleep duration, free night sleep duration, midpoint of sleep (corrected), social jetlag, and morningness/eveningness) and the dependent variables (BMI z scores and waist to height ratios). Social jetlag positively associated with BMI z scores (p < 0.01) and waist to height ratios (p = 0.01). Midpoint of sleep (corrected) positively associated with waist to height ratios (p = 0.01). After adjusting for social jetlag, school night sleep duration was not associated with waist to height ratios or BMI z scores. Morningness/eveningness did not moderate the association between sleep duration and BMI z scores. Findings from this study suggest that chronobiological approaches to preventing and treating obesity may be important for accelerating progress in reducing obesity rates in adolescents. PMID:27715325

The effects of sleep on episodic memory in older and younger adults.

PubMed

Aly, Mariam; Moscovitch, Morris

2010-04-01

Evidence on sleep-dependent benefits for episodic memory remains elusive. Furthermore we know little about age-related changes on the effects of sleep on episodic memory. The study we report is the first to compare the effects of sleep on episodic memories in younger and older adults. Memories of stories and personal events were assessed following a retention interval that included sleep and following an equal duration of wakefulness. Both older and younger adults have superior memory following sleep compared to following wakefulness for both types of material. Amount of forgetting of personal events was less during wakefulness in older adults than in younger adults, possibly due to spontaneous rehearsal. Amount of time spent sleeping correlated highly with sleep benefit in older adults, suggesting that quantity of total sleep, and/or time spent in some stages of sleep, are important contributors to age-related differences in memory consolidation or protection from interference during sleep.

Shorter sleep duration is associated with social impairment and comorbidities in ASD.

PubMed

Veatch, Olivia J; Sutcliffe, James S; Warren, Zachary E; Keenan, Brendan T; Potter, Melissa H; Malow, Beth A

2017-07-01

Sleep disturbance, particularly insomnia, is common in children with autism spectrum disorders (ASD). Furthermore, disturbed sleep affects core symptoms and other related comorbidities. Understanding the causes and consequences of sleep disturbances in children with ASD is an important step toward mitigating these symptoms. To better understand the connection between sleep duration and ASD severity, we analyzed ASD-related symptoms using the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), IQ scores, and parent reports of the average amount of time slept per night that were available in the medical histories of 2,714 children with ASD in the Simons Simplex Collection (SSC). The mean (SD) sleep duration was 555 minutes. Sleep duration and severity of core ASD symptoms were negatively correlated, and sleep duration and IQ scores were positively correlated. Regression results indicated that more severe social impairment, primarily a failure to develop peer relationships, is the core symptom most strongly associated with short sleep duration. Furthermore, increased severity for numerous maladaptive behaviors assessed on the Child Behavior Checklist, as well as reports of attention deficit disorder, depressive disorder, and obsessive compulsive disorder were associated with short sleep duration. Severity scores for social/communication impairment and restricted and repetitive behaviors (RRB) were increased, and IQ scores were decreased, for children reported to sleep ≤420 minutes per night (lower 5th percentile) compared to children sleeping ≥660 minutes (upper 95th percentile). Our results indicate that reduced amounts of sleep are related to more severe symptoms in children with ASD. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1221-1238. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

The use of PROMIS and the RAND VSQ9 in chiropractic patients receiving care with the Webster Technique.

PubMed

Alcantara, Joel; Ohm, Jeanne; Alcantara, Junjoe

2016-05-01

Our ongoing efforts to demonstrate effectiveness of care examined the quality of life (QoL) and patient satisfaction of chiropractic patients presenting for care in a PBRN. In addition to socio-demographic and clinical care information, we examined visit-specific satisfaction and QoL using the RAND VSQ and PROMIS-29, respectively. Our study population was comprised of 126 subjects (average age = 39.68; 97 females). The majority of respondents presented with musculoskeletal complaints with an average mean duration of 7.188 years. The mean PROMIS-25 mean T Scores were: depression (47.80); pain interference (53.49); fatigue (51.02); physical function (49.02); satisfaction with social role (52.10); anxiety (50.14); and sleep disturbance (49.88). The VSQ9 mean score was 93.4% indicating high satisfaction. Adults attending care in a chiropractic PBRN were able to successfully complete the PROMIS29 and VSQ9 instruments. Future longitudinal studies should quantify the minimal clinically important difference in mean T score changes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Psychometric Properties of the Adolescent Sleep Hygiene Scale (ASHS)

PubMed Central

Storfer-Isser, A; LeBourgeois, MK; Harsh, J; Tompsett, CJ; Redline, S

2013-01-01

Summary This study evaluated the psychometric properties of the Adolescent Sleep Hygiene Scale (ASHS), a self-report measure assessing sleep practices theoretically important for optimal sleep. Data were collected on a community sample of 514 adolescents (16-19 years; 17.7±0.4 years; 50% female) participating in the late adolescent examination of a longitudinal study on sleep and health. Self-reports of sleep hygiene and daytime sleepiness, caretaker-reports of behavior, and sleep-wake estimation on weekdays from wrist actigraphy were collected. Confirmatory factor analysis indicated the empirical and conceptually-based factor structure was similar for 6 of the 8 proposed sleep hygiene domains. Internal consistency of the revised scale (ASHSr) was α=0.84; subscale alphas were: physiological: α=0.60; behavioral arousal: α=0.62; cognitive/emotional: α=0.81; sleep environment: α=0.61; sleep stability: α=0.68; daytime sleep: α=0.78 α = 0.50. Sleep hygiene scores were positively associated with sleep duration (r=.16) and sleep efficiency (r=.12), and negatively correlated with daytime sleepiness (r=-.26). Results of extreme-groups analyses comparing ASHSr scores in the lowest and highest quintile provided further evidence for concurrent validity. Correlations between sleep hygiene scores and caretaker reports of school competence, internalizing, and externalizing behaviors provided support for convergent validity. These findings indicate that the ASHSr has satisfactory psychometric properties for a research instrument and is a useful research tool for assessing sleep hygiene in adolescents. PMID:23682620

Memory processing in great apes: the effect of time and sleep

PubMed Central

Martin-Ordas, Gema; Call, Josep

2011-01-01

Following encoding, memory remains temporarily vulnerable to disruption. Consolidation refers to offline time-dependent processes that continue after encoding and stabilize, transform or enhance the memory trace. Memory consolidation resulting from sleep has been reported for declarative and non-declarative memories in humans. We first investigated the temporal course of memory retrieval in chimpanzees, bonobos and orangutans. We found that the amount of retrieved information was time dependent: apes' performance degraded after 1 and 2 h, stabilized after 4 h, started to increase after 8 and 12 h and fully recovered after 24 h. Second, we show that although memories during wakefulness were highly vulnerable to interference from events similar to those witnessed during the original encoding event, an intervening period of sleep not only stabilized apes' memories into more permanent ones but also protected them against interference. PMID:21632621

An opportunistic theory of cellular and systems consolidation

PubMed Central

Mednick, Sara C.; Cai, Denise J.; Shuman, Tristan; Anagnostaras, Stephan; Wixted, John

2011-01-01

Memories are often classified as hippocampus-dependent or –independent, and sleep has been found to facilitate both, but in different ways. In this Opinion article, we explore the optimal neural state for cellular and systems consolidation of hippocampus-dependent memories that benefit from sleep. We suggest that these two kinds of consolidation, which are ordinarily treated separately, may overlap in time and jointly benefit from a period of reduced interference (during which no new memories are formed). Conditions that result in reduced interference include slow wave sleep (SWS), NMDA receptor antagonists, benzodiazepines, alcohol, and acetylcholine antagonists. We hypothesize that the consolidation of hippocampal-dependent memories may not depend on SWS per se. Instead, the brain opportunistically consolidates previously encoded memories whenever the hippocampus is not otherwise occupied by the task of encoding new memories. PMID:21742389

Memory processing in great apes: the effect of time and sleep.

PubMed

Martin-Ordas, Gema; Call, Josep

2011-12-23

Following encoding, memory remains temporarily vulnerable to disruption. Consolidation refers to offline time-dependent processes that continue after encoding and stabilize, transform or enhance the memory trace. Memory consolidation resulting from sleep has been reported for declarative and non-declarative memories in humans. We first investigated the temporal course of memory retrieval in chimpanzees, bonobos and orangutans. We found that the amount of retrieved information was time dependent: apes' performance degraded after 1 and 2 h, stabilized after 4 h, started to increase after 8 and 12 h and fully recovered after 24 h. Second, we show that although memories during wakefulness were highly vulnerable to interference from events similar to those witnessed during the original encoding event, an intervening period of sleep not only stabilized apes' memories into more permanent ones but also protected them against interference.

The relationships between migraine, depression, anxiety, stress, and sleep disturbances.

PubMed

Yalinay Dikmen, Pinar; Yavuz, Burcu Goksan; Aydinlar, Elif Ilgaz

2015-06-01

To assess the relationships between migraine, depression, anxiety, stress, and sleep problems. Psychiatric conditions and sleep disturbances are common in migraineurs. Depression, anxiety, stress, migraine, and sleep problems frequently coexist as comorbidities. Eighty-seven episodic migraineurs (62 females, 25 males; 32.8 ± 6.9) and 41 control subjects (25 females, 16 males; 31.5 ± 5.6) were prospectively enrolled for the study. The participants completed a sociodemographic data form and a migraine disability assessment scale (MIDAS), depression, anxiety, stress scale (DASS), and Pittsburg Sleep Quality Index (PSQI). In migraineurs, a significant positive correlation was found between PSQI total scores and MIDAS scores (migraine related disability for at least three consecutive months) (r = 0. 234, p = 0.04). Only 24.1 % of migraineus (n = 21) had minimal or no disability, 75.9 % of the patients (n = 66) had more than a little disability according to MIDAS scores. PSQI total scores were also correlated with pain intensity over a three month period (MIDAS B) (r = 0.221, p = 0.04). While PSQI scores were found significantly different between migraineurs and control subjects (5.5 ± 2.9 vs 4.5 ± 2.5; p = 0.04), the correlation of all the DASS subscale scores between the groups was not statistically significant. Our findings showed that episodic migraine was a risk factor on its own for sleep disturbances without comorbid depression, anxiety, and stress. Moreover, migraine-related disability and pain intensity in migraine attacks were related to poor sleep quality.

Sleep Characteristics and Carotid Atherosclerosis Among Midlife Women.

PubMed

Thurston, Rebecca C; Chang, Yuefang; von Känel, Roland; Barinas-Mitchell, Emma; Jennings, J Richard; Hall, Martica H; Santoro, Nanette; Buysse, Daniel J; Matthews, Karen A

2017-02-01

Midlife, which encompasses the menopause transition in women, can be a time of disrupted sleep and accelerated atherosclerosis accumulation. Short or poor sleep quality has been associated with cardiovascular disease (CVD) risk; few studies have investigated relations among midlife women. We tested whether shorter actigraphy sleep time or poorer subjective sleep quality was associated with carotid atherosclerosis among midlife women. Two hundred fifty-six peri- and postmenopausal women aged 40-60 years completed 3 days of wrist actigraphy, hot flash monitoring, questionnaires (Pittsburgh Sleep Quality Index [PSQI], Berlin), a blood draw, and carotid ultrasound [intima media thickness (IMT), plaque]. Associations of objective (actigraphy) and subjective (PSQI) sleep with IMT/plaque were tested in regression models (covariates: age, race, education, body mass index, blood pressure, lipids, insulin resistance, medications, snoring, depressive symptoms, sleep hot flashes, and estradiol). Shorter objective sleep time was associated with higher odds of carotid plaque (for each hour shorter sleep, plaque score ≥ 2, odds ratio (OR) [95% confidence interval, CI] = 1.58 [1.11-2.27], p = .01; plaque score = 1, OR [95% CI] = 0.95 [0.68-1.32], p = .75, vs. no plaque, multivariable). Poorer subjective sleep quality was associated with higher mean IMT [β, b (standard error, SE) = 0.004 (0.002), p = .03], maximal IMT [b (SE) = 0.009 (0.003), p = .005], and plaque [plaque score ≥ 2, OR (95% CI) = 1.23 (1.09-1.40), p = .001; score = 1, OR (95% CI) = 1.06 (0.93-1.21), p = .37, vs. no plaque] in multivariable models. Findings persisted additionally adjusting for sleep hot flashes and estradiol. Shorter actigraphy-assessed sleep time and poorer subjective sleep quality were associated with increased carotid atherosclerosis among midlife women. Associations persisted adjusting for CVD risk factors, hot flashes, and estradiol. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Assessment of physical and mental health in male university students with varying sleep habits.

PubMed

Matsumoto, Yuuki; Toyomasu, Kouji; Uchimura, Naohisa

2011-01-01

Healthy sleep habits entail not only sleeping for a sufficient period (quantity) but also regularity of the sleep cycle and getting sound sleep (quality). University students often have erratic schedules that cause irregular sleep patterns even though sleep durations remain relatively constant. This study compared the physical and mental health of 90 male university students with different sleep habits. We created sleep habit scales using the Tokyo Metropolitan Institute for Neuroscience life habits inventory (TMIN-LHI; Miyashita, 1994) by performing a factor analysis and classifying sleeping habits based on regularity, quality, and quantity. Four types of sleep habits were identified by cluster analysis; good sleep was characterized by regular and high quality sleep but of relatively short sleep duration; long sleep was regular and relatively long but of low quality; short sleep was of high quality but short and irregular, while poor sleep was irregular, of low quality, and relatively long. The good sleep group had a significantly lower average waist circumference, and lower systolic and diastolic blood pressure. The long and poor sleep groups, which both had low quality sleep, scored lower than the national standard on the mental component summary (MCS) calculated from the Social Functioning-36 (SF-36) short-form health survey. Furthermore, the average MCS score of the poor sleep group was significantly lower than that of any other sleep habit group. Subjects with poor sleep also scored lowest on the Self-rating Depression Scale (SDS). In addition, the short and poor sleep groups were prone to glucose or lipid metabolism disorders. Maintaining good physical and mental health without sound sleep and a regular sleep cycle is difficult, even if sleeping hours are kept constant. Therefore, we included the assessment of regularity and quality in addition to hours of sleep in order to develop appropriate sleep guidelines for improved physical and mental health.

A self-help book is better than sleep hygiene advice for insomnia: a randomized controlled comparative study.

PubMed

Bjorvatn, Bjørn; Fiske, Eldbjørg; Pallesen, Ståle

2011-12-01

The objective was to compare the effects of two types of written material for insomnia in a randomized trial with follow-up after three months. Insomniacs were recruited through newspaper advertisements to a web-based survey with validated questionnaires about sleep, anxiety, depression, and use of sleep medications. A self-help book focusing on cognitive behavioral therapy for insomnia was compared to standard sleep hygiene advice; 77 and 78 participants were randomized to self-help book or sleep hygiene advice, respectively. The response rate was 81.9%. The self-help book gave significantly better scores on the sleep questionnaires compared to sleep hygiene advice. The proportion using sleep medications was reduced in the self-help book group, whereas it was increased in the sleep hygiene group. Compared to pre-treatment, the self-help book improved scores on the sleep (effect sizes 0.61-0.62) and depression (effect size 0.18) scales, whereas the sleep hygiene advice improved scores on some sleep scales (effect sizes 0.24-0.28), but worsened another (effect size -0.36). In addition, sleep hygiene advice increased the number of days per week where they took sleep medications (effect size -0.50). To conclude, in this randomized controlled trial, the self-help book improved sleep and reduced the proportion using sleep medications compared to sleep hygiene advice. The self-help book is an efficient low-threshold intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice are given as a single treatment. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

Interrater reliability for sleep scoring according to the Rechtschaffen & Kales and the new AASM standard.

PubMed

Danker-Hopfe, Heidi; Anderer, Peter; Zeitlhofer, Josef; Boeck, Marion; Dorn, Hans; Gruber, Georg; Heller, Esther; Loretz, Erna; Moser, Doris; Parapatics, Silvia; Saletu, Bernd; Schmidt, Andrea; Dorffner, Georg

2009-03-01

Interrater variability of sleep stage scorings has an essential impact not only on the reading of polysomnographic sleep studies (PSGs) for clinical trials but also on the evaluation of patients' sleep. With the introduction of a new standard for sleep stage scorings (AASM standard) there is a need for studies on interrater reliability (IRR). The SIESTA database resulting from an EU-funded project provides a large number of studies (n = 72; 56 healthy controls and 16 subjects with different sleep disorders, mean age +/- SD: 57.7 +/- 18.7, 34 females) for which scorings according to both standards (AASM and R&K) were done. Differences in IRR were analysed at two levels: (1) based on quantitative sleep parameter by means of intraclass correlations; and (2) based on an epoch-by-epoch comparison by means of Cohen's kappa and Fleiss' kappa. The overall agreement was for the AASM standard 82.0% (Cohen's kappa = 0.76) and for the R&K standard 80.6% (Cohen's kappa = 0.68). Agreements increased from R&K to AASM for all sleep stages, except N2. The results of this study underline that the modification of the scoring rules improve IRR as a result of the integration of occipital, central and frontal leads on the one hand, but decline IRR on the other hand specifically for N2, due to the new rule that cortical arousals with or without concurrent increase in submental electromyogram are critical events for the end of N2.

Sleep problems in pediatric epilepsy and ADHD: The impact of comorbidity.

PubMed

Ekinci, Ozalp; Okuyaz, Çetin; Gunes, Serkan; Ekinci, Nuran; Kalınlı, Merve; Tan, Muhammet Emin; Teke, Halenur; Direk, Meltem Çobanoğulları; Erdoğan, Semra

2017-06-01

Attention-deficit hyperactivity disorder (ADHD) is a frequent comorbidity in pediatric epilepsy. Although sleep problems are commonly reported in both children with primary ADHD and epilepsy, those with epilepsy-ADHD comorbidity have not been well studied. This study aimed to compare sleep problems among three groups of children: 1) children with epilepsy, 2) children with epilepsy and ADHD (epilepsy-ADHD), and 3) children with primary ADHD. 53 children with epilepsy, 35 children with epilepsy-ADHD, and 52 children with primary ADHD completed the Children's Sleep Habits Questionnaire (CSHQ). Neurology clinic charts were reviewed for the epilepsy-related variables. ADHD subtypes were diagnosed according to the DSM-IV. Children with epilepsy-ADHD had the highest CSHQ total scores, while children with primary ADHD had higher scores than those with epilepsy. Besides the total score, epilepsy-ADHD group differed from the primary ADHD and epilepsy groups with higher CSHQ subscores on sleep onset delay and sleep anxiety. The frequency of moderate-severe sleep problems (CSHQ>56) was 62.9% in children with epilepsy-ADHD, while it was 40.4% and 26.4% in children with primary ADHD and epilepsy, respectively. CSHQ total scores were not different between ADHD subtypes in both children with epilepsy-ADHD and those with primary ADHD. None of the epilepsy-related variables were found to be associated with CSHQ scores. Epilepsy-ADHD is associated with a significantly poor sleep quality which is beyond that of primary ADHD and epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.

Cross-sectional study of randomly selected 18-year-old students showed that body mass index was only associated with sleep duration in girls.

PubMed

Kjartansdottir, Ingibjorg; Arngrimsson, Sigurbjorn A; Bjarnason, Ragnar; Olafsdottir, Anna S

2018-06-01

This study investigated the associations, by sex, between sleep and adiposity, dietary habits, cardiorespiratory fitness and metabolic risk in 18-year-old students. We carried out a cross-sectional study of 199 randomly chosen, healthy 18-year-old students (53% girls) in Iceland's capital region. The data collection took place in the winter months of 2012 to 2015. The anthropometric measurements were body mass index, waist circumference and body fat percentage. Sleep duration and dietary habits were self-reported. Cardiorespiratory fitness was measured on a stationary bicycle. A subsample of 152 participants gave blood samples. A quarter of the adolescents failed to reach the minimum recommended sleep duration of seven hours per night on weekdays. In girls, the average sleep score was associated with body mass index and waist circumference, after adjusting for cardiorespiratory fitness and unhealthy eating scores. In boys, the average sleep score was not associated with anthropometric measurements, but cardiorespiratory fitness was an independent predictor (p < 0.001). No associations were found between average sleep scores and metabolic profiles in either sex. Sleep duration and adiposity only appeared to be associated in girls and were independent of cardiorespiratory fitness and unhealthy eating. Sleep duration was not related to metabolic risk. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Clustering-based energy-saving algorithm in ultra-dense network

NASA Astrophysics Data System (ADS)

Huang, Junwei; Zhou, Pengguang; Teng, Deyang; Zhang, Renchi; Xu, Hao

2017-06-01

In Ultra-dense Networks (UDN), dense deployment of low power small base stations will cause serious small cells interference and a large amount of energy consumption. The purpose of this paper is to explore the method of reducing small cells interference and energy saving system in UDN, and we innovatively propose a sleep-waking-active (SWA) scheme. The scheme decreases the user outage causing by failure to detect users’ service requests, shortens the opening time of active base stations directly switching to sleep mode; we further proposes a Vertex Surrounding Clustering(VSC) algorithm, which first colours the small cells with the most strongest interference and next extends to the adjacent small cells. VSC algorithm can use the least colour to stain the small cell, reduce the number of iterations and promote the efficiency of colouring. The simulation results show that SWA scheme can effectively improve the system Energy Efficiency (EE), the VSC algorithm can reduce the small cells interference and optimize the users’ Spectrum Efficiency (SE) and throughput.

[Randomized Controlled Clinical Trials of Eye-acupuncture Therapy for Patients with Post-stroke Insomnia].

PubMed

Liu, Lu-Yang; Wang, Peng-Qin

2017-02-25

To observe the therapeutic effect of eye-acupuncture therapy for post-stroke insomnia. Sixty patients (45-70 years in age) with post-stroke insomnia were randomized into eye-acupuncture group and routine acupuncture (body acupuncture) group (30 cases in each). Patients of the eye-acupuncture group were treated by acupuncture stimulation of bilateral Shangjiao (Upper-energizer) and Xin (Heart) regions and those of the routine acupuncture group treated by acupuncture stimulation of Baihui (GV 20), Sishencong (EX-HN 1), Anmian (EX-HN 16), etc. After Deqi , the filiform needles were retained for 20 min, and the treatment in both groups was conducted once a day, with 15 days being one therapeutic course and 2 courses altogether. The Pittsburgh Sleep Quality Index (PSQI) including the subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and total PSQI score was used to evaluate the overall sleep quality. The clinical efficacy was assessed according to the "Guiding Principles of Clinical Trials for New Drugs of Traditional Chinese Medicine" formulated by Chinese Ministry of Health. Following the treatment, of the two 30 cases in the eye-and routine acupuncture groups, 21 and 9 experienced a marked improvement in their symptoms, 8 and 17 were effective, and 1 and 4 invalid, with the effective rate being 96.7% and 86.7%, respectively. The PSQI scores of the subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and the total PSQI score were all significantly decreased in comparison with pre-treatment in each group ( P <0.01). The therapeutic effect of the eye-acupuncture was markedly superior to those of routine acupuncture in reducing sleep latency, sleep disturbances and daytime dysfunction ( P <0.05), but without significant differences between the two groups in the effective rate, sleep quality, sleep duration, sleep efficiency and total PSQI score ( P >0.05). Both eye-acupuncture and routine acupunture are effective in the treatment of post-stroke insomnia, and the eye-acupuncture is better than routine acupuncture in reducing sleep latency, improving sleep disturbances and daytime dysfunction.

Sleep disorders in children with cerebral palsy: neurodevelopmental and behavioral correlates.

PubMed

Romeo, Domenico M; Brogna, Claudia; Quintiliani, Michela; Baranello, Giovanni; Pagliano, Emanuela; Casalino, Tiziana; Sacco, Annalisa; Ricci, Daniela; Mallardi, Maria; Musto, Elisa; Sivo, Serena; Cota, Francesco; Battaglia, Domenica; Bruni, Oliviero; Mercuri, Eugenio

2014-02-01

We aimed to estimate the frequency of sleep disorders in children with cerebral palsy (CP) using the Sleep Disturbance Scale for Children (SDSC) and to evaluate the relations between sleep disorders and motor, cognitive, and behavioral problems. One hundred and sixty-five children with CP ages 6-16 years (mean age, 11years) were assessed using the SDSC, the Gross Motor Function Classification System (GMFCS), the Wechsler Intelligence Scale for Children and the Child Behavior Check List (CBCL) to assess sleep, motor, cognitive, and behavioral problems, respectively. An abnormal total sleep score was found in 19% of children with CP; more than 40% of children had an abnormal score on at least one SDSC factor. The SDSC total score was significantly associated (P<.01) with mental retardation, epilepsy, CBCL scores, and level 5 on the GMFCS. Our results confirm that sleep disorders are common in children with cerebral palsy. The relationship between motor and cognitive behavior and epilepsy should be further explored to better understand how these factors influence one another to identify effective treatments and to improve the well-being of the child. Copyright © 2014 Elsevier B.V. All rights reserved.

Variability in recording and scoring of respiratory events during sleep in Europe: a need for uniform standards.

PubMed

Arnardottir, Erna S; Verbraecken, Johan; Gonçalves, Marta; Gjerstad, Michaela D; Grote, Ludger; Puertas, Francisco Javier; Mihaicuta, Stefan; McNicholas, Walter T; Parrino, Liborio

2016-04-01

Uniform standards for the recording and scoring of respiratory events during sleep are lacking in Europe, although many centres follow the published recommendations of the American Academy of Sleep Medicine. The aim of this study was to assess the practice for the diagnosis of sleep-disordered breathing throughout Europe. A specially developed questionnaire was sent to representatives of the 31 national sleep societies in the Assembly of National Sleep Societies of the European Sleep Research Society, and a total of 29 countries completed the questionnaire. Polysomnography was considered the primary diagnostic method for sleep apnea diagnosis in 10 (34.5%), whereas polygraphy was used primarily in six (20.7%) European countries. In the remaining 13 countries (44.8%), no preferred methodology was used. Fifteen countries (51.7%) had developed some type of national uniform standards, but these standards varied significantly in terms of scoring criteria, device specifications and quality assurance procedures between countries. Only five countries (17.2%) had published these standards. Most respondents supported the development of uniform recording and scoring criteria for Europe, which might be based partly on the existing American Academy of Sleep Medicine rules, but also take into account differences in European practice when compared to North America. This survey highlights the current varying approaches to the assessment of patients with sleep-disordered breathing throughout Europe and supports the need for the development of practice parameters in the assessment of such patients that would be suited to European clinical practice. © 2015 European Sleep Research Society.

Psychometric properties of the Adolescent Sleep Hygiene Scale.

PubMed

Storfer-Isser, Amy; Lebourgeois, Monique K; Harsh, John; Tompsett, Carolyn J; Redline, Susan

2013-12-01

This study evaluated the psychometric properties of the Adolescent Sleep Hygiene Scale (ASHS), a self-report measure assessing sleep practices theoretically important for optimal sleep. Data were collected on a community sample of 514 adolescents (16-19; 17.7 ± 0.4 years; 50% female) participating in the late adolescent examination of a longitudinal study on sleep and health. Sleep hygiene and daytime sleepiness were obtained from adolescent reports, behavior from caretaker reports, and sleep-wake estimation on weekdays from wrist actigraphy. Confirmatory factor analysis indicated the empirical and conceptually based factor structure were similar for six of the eight proposed sleep hygiene domains. Internal consistency of the revised scale (ASHSr) was α = 0.84; subscale alphas were: physiological: α = 0.60; behavioural arousal: α = 0.62; cognitive/emotional: α = 0.81; sleep environment: α = 0.61; sleep stability: α = 0.68; daytime sleep: α = 0.78. Sleep hygiene scores were associated positively with sleep duration (r = 0.16) and sleep efficiency (r = 0.12) and negatively with daytime sleepiness (r = -0.26). Results of extreme-groups analyses comparing ASHSr scores in the lowest and highest quintile provided further evidence for concurrent validity. Correlations between sleep hygiene scores and caretaker reports of school competence, internalizing and externalizing behaviours provided support for convergent validity. These findings indicate that the ASHSr has satisfactory psychometric properties for a research instrument and is a useful research tool for assessing sleep hygiene in adolescents. © 2013 European Sleep Research Society.

Intensive care unit depth of sleep: proof of concept of a simple electroencephalography index in the non-sedated

PubMed Central

2014-01-01

Introduction Intensive care unit (ICU) patients are known to experience severely disturbed sleep, with possible detrimental effects on short- and long- term outcomes. Investigation into the exact causes and effects of disturbed sleep has been hampered by cumbersome and time consuming methods of measuring and staging sleep. We introduce a novel method for ICU depth of sleep analysis, the ICU depth of sleep index (IDOS index), using single channel electroencephalography (EEG) and apply it to outpatient recordings. A proof of concept is shown in non-sedated ICU patients. Methods Polysomnographic (PSG) recordings of five ICU patients and 15 healthy outpatients were analyzed using the IDOS index, based on the ratio between gamma and delta band power. Manual selection of thresholds was used to classify data as either wake, sleep or slow wave sleep (SWS). This classification was compared to visual sleep scoring by Rechtschaffen & Kales criteria in normal outpatient recordings and ICU recordings to illustrate face validity of the IDOS index. Results When reduced to two or three classes, the scoring of sleep by IDOS index and manual scoring show high agreement for normal sleep recordings. The obtained overall agreements, as quantified by the kappa coefficient, were 0.84 for sleep/wake classification and 0.82 for classification into three classes (wake, non-SWS and SWS). Sensitivity and specificity were highest for the wake state (93% and 93%, respectively) and lowest for SWS (82% and 76%, respectively). For ICU recordings, agreement was similar to agreement between visual scorers previously reported in literature. Conclusions Besides the most satisfying visual resemblance with manually scored normal PSG recordings, the established face-validity of the IDOS index as an estimator of depth of sleep was excellent. This technique enables real-time, automated, single channel visualization of depth of sleep, facilitating the monitoring of sleep in the ICU. PMID:24716479

One night of sleep is insufficient to achieve sleep-to-forget emotional decontextualisation processes.

PubMed

Deliens, Gaétane; Peigneux, Philippe

2014-01-01

Neutral memories unbind from their emotional acquisition context when sleep is allowed the night after learning and testing takes place after two additional nights of sleep. However, mood-dependent memory (MDM) effects are not abolished after a restricted sleep episode mostly featuring non rapid-eye-movement (NREM) or rapid-eye-movement (REM) sleep. Here, we tested whether (1) one night of sleep featuring several NREM-REM sleep cycles is sufficient to suppress MDM effects and (2) a neutral mood is a sufficiently contrasting state to induce MDM effects, i.e. interfere with the recall of information learned in happy or sad states. Results disclosed MDM effects both in the post-learning sleep and wake conditions, with better recall in congruent than incongruent emotional contexts. Our findings suggest that the emotional unbinding needs several consecutive nights of sleep to be complete, and that even subtle mood changes are sufficient to produce MDM effects.

Understanding and managing sleep disruption in children with fetal alcohol spectrum disorder.

PubMed

Hanlon-Dearman, Ana; Chen, Maida Lynn; Olson, Heather Carmichael

2018-04-01

Accumulating evidence has revealed high rates of sleep disruption among children with fetal alcohol spectrum disorder (FASD). Multiple animal and clinical studies have found a clear association between sleep problems and prenatal alcohol exposure, and recent research is beginning to characterize the types and extent of sleep disruption in FASD. Nevertheless, sleep disruption in children with FASD often goes unrecognized or is treated without referring to an evidence base. Children's disrupted sleep interferes with parental sleep and increases caregiver burden, which is of particular importance for families raising children with FASD, a group with very high levels of caregiving stress. The literature supporting an association between sleep problems and deficits in emotional, behavioral, and cognitive function in children is compelling, but needs further investigation in children with FASD. This paper will review the current state of knowledge on sleep in FASD and recommend a rational approach to sleep interventions for affected children and their families.

The sleep needs of adolescents.

PubMed

Kelman, B B

1999-08-01

The amount of sleep affects the way adolescents perform, feel, think, learn, and remember. Significant physiological and social changes have profound effects on adolescents' sleeping patterns. Lack of sleep increases the possibility of increased daytime sleepiness, which may result in a tragic automobile or work accident. Other consequences of sleep deprivation include poor school performance, heightened risk of drug and alcohol use, increased irritability, and aggressive behavior, all of which can interfere with relationships with classmates, parents, and teachers. The purpose of this paper is to explore the literature concerning what is known about why adolescents need more sleep and why adolescents do not obtain enough sleep. Nursing interventions targeting adolescents, parents, teachers, schools, and employers are included. If adolescents understand and learn to improve their sleep patterns while they are young, they may have improved sleep habits in adulthood. Teaching adolescents about the importance of sleep is an important task for school nurses.

Sleep Patterns and Academic Performance During Preparation for College Entrance Exam in Chinese Adolescents.

PubMed

Wang, Guanghai; Ren, Fen; Liu, Zhijun; Xu, Guangxing; Jiang, Fan; Skora, Elizabeth; Lewin, Daniel S

2016-04-01

Deficient sleep is linked to detrimental outcomes in health and school performance for adolescents. This study characterized sleep patterns in Chinese adolescents preparing for the College Entrance Exam (CEE) and evaluated the association between sleep patterns, self-rated academic performance, and the CEE scores. A sample of 481 Chinese adolescents in 12th grade (ages 16-19 years) completed questionnaires about sleep patterns, academic performance, academic stress, and sociodemographic factors 4-6 weeks before the CEE in June 2013. The CEE scores for each student also were obtained. A total of 21% of the students had bedtimes after 12:00 am, 78.3% had sleep latency longer than 30 minutes, 14.6% had wake time earlier than 6:00 am, and the vast majority (94.4%) had sleep duration less than 8 hours. After adjusting for selected confounders such as academic stress, prolonged sleep latency was associated with poorer self-reported academic performance, and late bedtime was associated with higher CEE score. Our findings highlight the complex association between sleep and academic performance. Assessing and monitoring sleep patterns in adolescents during periods of high academic demand and stress may yield important recommendations for their health and safety as well as establishing optimal sleep and study habits. © 2016, American School Health Association.

Higher sleep reactivity and insomnia mutually aggravate depressive symptoms: a cross-sectional epidemiological study in Japan.

PubMed

Nakajima, Shun; Komada, Yoko; Sasai-Sakuma, Taeko; Okajima, Isa; Harada, Yutaka; Watanabe, Kazue; Inoue, Yuichi

2017-05-01

Sleep reactivity assessed using the Ford Insomnia Response to Stress Test (FIRST) is associated with depression. This study clarified stress reactivity and insomnia effects on depressive symptoms. A cross-sectional questionnaire survey was administered to 2645 participating government employees (35.4% female, mean age 42.8 years) during health checks conducted at Tottori prefecture, Japan, in June 2012. Questionnaire items included: demographic information; the FIRST; the Pittsburgh Sleep Quality Index (PSQI); and a 12-item version of the Center for Epidemiological Studies Depression scale (CES-D). The study defined CES-D scores of ≥12 points as positive for depression, PSQI scores of ≥5.5 points as positive for insomnia symptoms, and FIRST scores of ≥19 points as indicating higher sleep reactivity. Multivariate logistic regression analysis revealed insomnia (adjusted OR = 3.40), higher sleep reactivity (adjusted OR = 1.78), presence of disease currently being treated (adjusted OR = 1.84), and being female (adjusted OR = 1.53) as independently associated with depression. Participants with insomnia and a high FIRST score showed higher CES-D scores than those with insomnia alone and those with high FIRST without insomnia (all p < 0.01). Sleep reactivity might be associated with depression, independent of insomnia. Elevated sleep reactivity and insomnia symptoms are thought to aggravate depressive symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

Open-Source Logic-Based Automated Sleep Scoring Software using Electrophysiological Recordings in Rats

PubMed Central

Gross, Brooks A.; Walsh, Christine M.; Turakhia, Apurva A.; Booth, Victoria; Mashour, George; Poe, Gina R.

2009-01-01

Manual state scoring of physiological recordings in sleep studies is time-consuming, resulting in a data backlog, research delays and increased personnel costs. We developed MATLAB-based software to automate scoring of sleep/waking states in rats, potentially extendable to other animals, from a variety of recording systems. The software contains two programs, Sleep Scorer and Auto-Scorer, for manual and automated scoring. Auto-Scorer is a logic-based program that displays power spectral densities of an electromyographic signal and σ, δ, and θ frequency bands of an electroencephalographic signal, along with the δ/θ ratio and σ ×θ, for every epoch. The user defines thresholds from the training file state definitions which the Auto-Scorer uses with logic to discriminate the state of every epoch in the file. Auto-Scorer was evaluated by comparing its output to manually scored files from 6 rats under 2 experimental conditions by 3 users. Each user generated a training file, set thresholds, and autoscored the 12 files into 4 states (waking, non-REM, transition-to-REM, and REM sleep) in ¼ the time required to manually score the file. Overall performance comparisons between Auto-Scorer and manual scoring resulted in a mean agreement of 80.24 +/− 7.87%, comparable to the average agreement among 3 manual scorers (83.03 +/− 4.00%). There was no significant difference between user-user and user-Auto-Scorer agreement ratios. These results support the use of our open-source Auto-Scorer, coupled with user review, to rapidly and accurately score sleep/waking states from rat recordings. PMID:19615408

Color of intra-ocular lens and cataract type are prognostic determinants of health indices after visual and photoreceptive restoration by surgery.

PubMed

Ayaki, Masahiko; Negishi, Kazuno; Suzukamo, Yoshimi; Tsubota, Kazuo

2015-04-01

This study compared post-operative quality of life and sleep according to the type of cataract opacity and color of the implanted intra-ocular lens (IOL). This is a cohort study and participants were 206 patients (average age 74.1 years) undergoing cataract surgery with the implantation of a clear ultra-violet (UV)-blocking IOL (C) or a yellow blue-light-blocking IOL (Y). Participants were evaluated using the National Eye Institute Visual Function Questionnaire (VFQ-25) and Pittsburgh Sleep Quality Index (PSQI) before surgery and 2 and 7 months after surgery. Changes in sub-scale scores of VFQ-25 and PSQI were compared. Sub-scale analyses for improvement after surgery revealed significant differences in ocular pain scores on the VFQ-25 (Y>C; the higher the score, the better the outcome). Furthermore, there were significant differences between the two IOLs in terms of the sleep latency score (C>Y) and sleep disturbances score (C>Y). A posterior sub-capsular cataract was significantly correlated with improvements in ocular pain and sleep latency scores. These effects were successfully represented by the change in scores rather than absolute post-operative scores because individual standard of response may often change after intervention, recognized as a response shift phenomenon in patient-reported outcome study. Regarding seasonal differences, patients who had surgery in summer exhibited relatively better sleep quality than those who had surgery in winter. Analysis of sub-scales of health indices demonstrated characteristic prognoses for each IOL and cataract type. Cataract surgery may potentially contribute to systemic health in older adults.

Unsupervised Online Classifier in Sleep Scoring for Sleep Deprivation Studies

PubMed Central

Libourel, Paul-Antoine; Corneyllie, Alexandra; Luppi, Pierre-Hervé; Chouvet, Guy; Gervasoni, Damien

2015-01-01

Study Objective: This study was designed to evaluate an unsupervised adaptive algorithm for real-time detection of sleep and wake states in rodents. Design: We designed a Bayesian classifier that automatically extracts electroencephalogram (EEG) and electromyogram (EMG) features and categorizes non-overlapping 5-s epochs into one of the three major sleep and wake states without any human supervision. This sleep-scoring algorithm is coupled online with a new device to perform selective paradoxical sleep deprivation (PSD). Settings: Controlled laboratory settings for chronic polygraphic sleep recordings and selective PSD. Participants: Ten adult Sprague-Dawley rats instrumented for chronic polysomnographic recordings Measurements: The performance of the algorithm is evaluated by comparison with the score obtained by a human expert reader. Online detection of PS is then validated with a PSD protocol with duration of 72 hours. Results: Our algorithm gave a high concordance with human scoring with an average κ coefficient > 70%. Notably, the specificity to detect PS reached 92%. Selective PSD using real-time detection of PS strongly reduced PS amounts, leaving only brief PS bouts necessary for the detection of PS in EEG and EMG signals (4.7 ± 0.7% over 72 h, versus 8.9 ± 0.5% in baseline), and was followed by a significant PS rebound (23.3 ± 3.3% over 150 minutes). Conclusions: Our fully unsupervised data-driven algorithm overcomes some limitations of the other automated methods such as the selection of representative descriptors or threshold settings. When used online and coupled with our sleep deprivation device, it represents a better option for selective PSD than other methods like the tedious gentle handling or the platform method. Citation: Libourel PA, Corneyllie A, Luppi PH, Chouvet G, Gervasoni D. Unsupervised online classifier in sleep scoring for sleep deprivation studies. SLEEP 2015;38(5):815–828. PMID:25325478

“Always Look on the Bright Side of Life!” – Higher Hypomania Scores Are Associated with Higher Mental Toughness, Increased Physical Activity, and Lower Symptoms of Depression and Lower Sleep Complaints

PubMed Central

Jahangard, Leila; Rahmani, Anahita; Haghighi, Mohammad; Ahmadpanah, Mohammad; Sadeghi Bahmani, Dena; Soltanian, Ali R.; Shirzadi, Shahriar; Bajoghli, Hafez; Gerber, Markus; Holsboer-Trachsler, Edith; Brand, Serge

2017-01-01

Background: In the present study, we explored the associations between hypomania, symptoms of depression, sleep complaints, physical activity and mental toughness. The latter construct has gained interest for its association with a broad variety of favorable behavior in both clinical and non-clinical samples. Subjects and Methods: The non-clinical sample consisted of 206 young adults (M = 21.3 years; age range: 18–24 years; 57.3% males). They completed questionnaires covering hypomania, mental toughness, symptoms of depression, physical activity, and sleep quality. Results: Higher hypomania scores were associated with higher mental toughness, increased physical activity, lower symptoms of depression and lower sleep complaints. No gender differences were observed. Higher hypomania scores were predicted by higher scores of mental toughness subscales of control and challenge, and physical activity. Conclusion: The pattern of results suggests that among a non-clinical sample of young adults, self-rated hypomania scores were associated with higher scores on mental toughness and physical activity, along with lower depression and sleep complaints. The pattern of results further suggests that hypomania traits are associated with a broad range of favorable psychological, behavioral and sleep-related traits, at least among a non-clinical sample of young adults. PMID:29312026

Measurement of narcolepsy symptoms: The Narcolepsy Severity Scale.

PubMed

Dauvilliers, Yves; Beziat, Severine; Pesenti, Carole; Lopez, Regis; Barateau, Lucie; Carlander, Bertrand; Luca, Gianina; Tafti, Mehdi; Morin, Charles M; Billiard, Michel; Jaussent, Isabelle

2017-04-04

To validate the Narcolepsy Severity Scale (NSS), a brief clinical instrument to evaluate the severity and consequences of symptoms in patients with narcolepsy type 1 (NT1). A 15-item scale to assess the frequency and severity of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, and disrupted nighttime sleep was developed and validated by sleep experts with patients' feedback. Seventy untreated and 146 treated adult patients with NT1 were evaluated and completed the NSS in a single reference sleep center. The NSS psychometric properties, score changes with treatment, and convergent validity with other clinical parameters were assessed. The NSS showed good psychometric properties with significant item-total score correlations. The factor analysis indicated a 3-factor solution with good reliability, expressed by satisfactory Cronbach α values. The NSS total score temporal stability was good. Significant NSS score differences were observed between untreated and treated patients (dependent sample, 41 patients before and after sleep therapy; independent sample, 29 drug-free and 105 treated patients). Scores were lower in the treated populations (10-point difference between groups), without ceiling effect. Significant correlations were found among NSS total score and daytime sleepiness (Epworth Sleepiness Scale, Mean Sleep Latency Test), depressive symptoms, and health-related quality of life. The NSS can be considered a reliable and valid clinical tool for the quantification of narcolepsy symptoms to monitor and optimize narcolepsy management. © 2017 American Academy of Neurology.

A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients

PubMed Central

Sherman, Christy A.; Mist, Scott D.; Carson, James W.; Bennett, Robert M.; Li, Fuzhong

2017-01-01

Previous researchers have found that 10-form Tai chi yields symptomatic benefit in patients with fibromyalgia (FM). The purpose of this study was to further investigate earlier findings and add a focus on functional mobility. We conducted a parallel-group randomized controlled trial FM-modified 8-form Yang-style Tai chi program compared to an education control. Participants met in small groups twice weekly for 90 min over 12 weeks. The primary endpoint was symptom reduction and improvement in self-report physical function, as measured by the Fibromyalgia Impact Questionnaire (FIQ), from baseline to 12 weeks. Secondary endpoints included pain severity and interference (Brief Pain Inventory (BPI), sleep (Pittsburg sleep Inventory), self-efficacy, and functional mobility. Of the 101 randomly assigned subjects (mean age 54 years, 93 % female), those in the Tai chi condition compared with the education condition demonstrated clinically and statistically significant improvements in FIQ scores (16.5 vs. 3.1, p=0.0002), BPI pain severity (1.2 vs. 0.4, p=0.0008), BPI pain interference (2.1 vs. 0.6, p=0.0000), sleep (2.0 vs. −0.03, p=0.0003), and self-efficacy for pain control (9.2 vs. −1.5, p=0.0001). Functional mobility variables including timed get up and go (−.9 vs. −.3, p=0.0001), static balance (7.5 vs. −0.3, p= 0.0001), and dynamic balance (1.6 vs. 0.3, p=0.0001) were significantly improved with Tai chi compared with education control. No adverse events were noted. Twelve weeks of Tai chi, practice twice weekly, provided worthwhile improvement in common FM symptoms including pain and physical function including mobility. Tai chi appears to be a safe and an acceptable exercise modality that may be useful as adjunctive therapy in the management of FM patients. (ClinicalTrials.gov Identifier, NCT01311427) PMID:22581278

A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients.

PubMed

Jones, Kim D; Sherman, Christy A; Mist, Scott D; Carson, James W; Bennett, Robert M; Li, Fuzhong

2012-08-01

Previous researchers have found that 10-form Tai chi yields symptomatic benefit in patients with fibromyalgia (FM). The purpose of this study was to further investigate earlier findings and add a focus on functional mobility. We conducted a parallel-group randomized controlled trial FM-modified 8-form Yang-style Tai chi program compared to an education control. Participants met in small groups twice weekly for 90 min over 12 weeks. The primary endpoint was symptom reduction and improvement in self-report physical function, as measured by the Fibromyalgia Impact Questionnaire (FIQ), from baseline to 12 weeks. Secondary endpoints included pain severity and interference (Brief Pain Inventory (BPI), sleep (Pittsburg sleep Inventory), self-efficacy, and functional mobility. Of the 101 randomly assigned subjects (mean age 54 years, 93 % female), those in the Tai chi condition compared with the education condition demonstrated clinically and statistically significant improvements in FIQ scores (16.5 vs. 3.1, p = 0.0002), BPI pain severity (1.2 vs. 0.4, p = 0.0008), BPI pain interference (2.1 vs. 0.6, p = 0.0000), sleep (2.0 vs. -0.03, p = 0.0003), and self-efficacy for pain control (9.2 vs. -1.5, p = 0.0001). Functional mobility variables including timed get up and go (-.9 vs. -.3, p = 0.0001), static balance (7.5 vs. -0.3, p    0.0001), and dynamic balance (1.6 vs. 0.3, p = 0.0001) were significantly improved with Tai chi compared with education control. No adverse events were noted. Twelve weeks of Tai chi, practice twice weekly, provided worthwhile improvement in common FM symptoms including pain and physical function including mobility. Tai chi appears to be a safe and an acceptable exercise modality that may be useful as adjunctive therapy in the management of FM patients. (ClinicalTrials.gov Identifier, NCT01311427).

Effects of sleep timing, sleep quality and sleep duration on school achievement in adolescents.

PubMed

Tonetti, Lorenzo; Fabbri, Marco; Filardi, Marco; Martoni, Monica; Natale, Vincenzo

2015-08-01

The aim of this study was to examine the effects of sleep timing, quality and duration on school achievement in adolescents. Thirty-six Italian students (mean age: 18.14 ± 0.49 years) attending their last year of high school participated in the study. They completed the Morningness-Eveningness Questionnaire for Children and Adolescents (MEQ-CA). This was used to determine their ideal sleep timing by computing the total score, with higher scores corresponding to a greater tendency toward morningness. In addition, students underwent two non-consecutive weeks of actigraphy in one-month period to objectively assess: habitual sleep timing through the midpoint of sleep (MS); habitual sleep quality through the parameter of sleep efficiency (SE); and habitual sleep duration through the parameter of total sleep time (TST). Participants also completed the Mini Sleep Questionnaire, which allowed us to assess perceived sleep quality, at the end of each actigraphic-recording week. School performance was assessed using the grades obtained by students in their school leaving exams taken at the end of the school year. A significant positive correlation was observed between SE and exam grades, as well as MEQ-CA scores and grades. Multiple regression analysis showed that only SE was significantly and positively related to the final grade. Examining objective and ecological measures, SE (indicator of sleep quality) had the strongest effect on school achievement in adolescents. Copyright © 2015 Elsevier B.V. All rights reserved.

Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS): reliability, initial validity and normative scores in higher education students.

PubMed

Allen Gomes, Ana; Ruivo Marques, Daniel; Meia-Via, Ana Maria; Meia-Via, Mariana; Tavares, José; Fernandes da Silva, Carlos; Pinto de Azevedo, Maria Helena

2015-04-01

Based on successive samples totaling more than 5000 higher education students, we scrutinized the reliability, structure, initial validity and normative scores of a brief self-report seven-item scale to screen for the continuum of nighttime insomnia complaints/perceived sleep quality, used by our team for more than a decade, henceforth labeled the Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS). In study/sample 1 (n = 1654), the items were developed based on part of a larger survey on higher education sleep-wake patterns. The test-retest study was conducted in an independent small group (n = 33) with a 2-8 week gap. In study/sample 2 (n = 360), focused mainly on validity, the BaSIQS was completed together with the Pittsburgh Sleep Quality Index (PSQI). In study 3, a large recent sample of students from universities all over the country (n = 2995) answered the BaSIQS items, based on which normative scores were determined, and an additional question on perceived sleep problems in order to further analyze the scale's validity. Regarding reliability, Cronbach alpha coefficients were systematically higher than 0.7, and the test-retest correlation coefficient was greater than 0.8. Structure analyses revealed consistently satisfactory two-factor and single-factor solutions. Concerning validity analyses, BaSIQS scores were significantly correlated with PSQI component scores and overall score (r = 0.652 corresponding to a large association); mean scores were significantly higher in those students classifying themselves as having sleep problems (p < 0.0001, d = 0.99 corresponding to a large effect size). In conclusion, the BaSIQS is very easy to administer, and appears to be a reliable and valid scale in higher education students. It might be a convenient short tool in research and applied settings to rapidly assess sleep quality or screen for insomnia complaints, and it may be easily used in other populations with minor adaptations.

Restless Legs Syndrome and Poor Sleep Quality in Obese Children and Adolescents

PubMed

Baran, Rıza Taner; Atar, Müge; Pirgon, Özgür; Filiz, Serkan; Filiz, Meral

2018-06-01

Adult epidemiological studies suggest that the rate of Restless Legs syndrome (RLS) in the general population may range from 5% to 15%. The aim of this study was to investigate the frequency of RLS in a community sample of obese adolescents aged 10-16 years and to assess the association with sleep quality and health-related glucose metabolism markers. The study group comprised 144 obese and overweight children aged 10-16 yearsand the control group consisted of 66 age-matched healthy children. The RLS Questionnaire devised by the International RLS Study and the Pittsburgh Sleep Quality Index (PSQI), where a score >5 indicates poor sleep quality, was used to assess sleep quality. Mean body mass index (BMI) of the overweight/obese and control groups were 30.5±0.5 and 18.7±0.2, respectively. The frequency of RLS was higher in the obese group (21.7%) than the overweight (3.4%) and control (1.5%) (p<0.001) groups. The frequency of a poor PSQI score was significantly higher (p<0.001) in the obese group (37.3%) than the control group (24.2%). The obese with RLS group also had poorer sleep quality scores than the non-RLS obese group. Many symptoms of sleep disruption were more common in obese patients with RLS and RLS was independently correlated with a high PSQI score [odds ratio (OR): 2.25, confidence interval (Cl): 0.96-5.28, p<0.001)] and an increased BMI z-score (OR: 8.87, Cl: 2.04-38.61, p<0.001). RLS is common in obese children and may be associated with altered sleep quality. Obese children with RLS need to be assessed since they may need support to improve their sleep quality.

Sustained attention to response task (SART) shows impaired vigilance in a spectrum of disorders of excessive daytime sleepiness.

PubMed

Van Schie, Mojca K M; Thijs, Roland D; Fronczek, Rolf; Middelkoop, Huub A M; Lammers, Gert Jan; Van Dijk, J Gert

2012-08-01

The sustained attention to response task comprises withholding key presses to one in nine of 225 target stimuli; it proved to be a sensitive measure of vigilance in a small group of narcoleptics. We studied sustained attention to response task results in 96 patients from a tertiary narcolepsy referral centre. Diagnoses according to ICSD-2 criteria were narcolepsy with (n=42) and without cataplexy (n=5), idiopathic hypersomnia without long sleep time (n=37), and obstructive sleep apnoea syndrome (n=12). The sustained attention to response task was administered prior to each of five multiple sleep latency test sessions. Analysis concerned error rates, mean reaction time, reaction time variability and post-error slowing, as well as the correlation of sustained attention to response task results with mean latency of the multiple sleep latency test and possible time of day influences. Median sustained attention to response task error scores ranged from 8.4 to 11.1, and mean reaction times from 332 to 366ms. Sustained attention to response task error score and mean reaction time did not differ significantly between patient groups. Sustained attention to response task error score did not correlate with multiple sleep latency test sleep latency. Reaction time was more variable as the error score was higher. Sustained attention to response task error score was highest for the first session. We conclude that a high sustained attention to response task error rate reflects vigilance impairment in excessive daytime sleepiness irrespective of its cause. The sustained attention to response task and the multiple sleep latency test reflect different aspects of sleep/wakefulness and are complementary. © 2011 European Sleep Research Society.

Restless Legs Syndrome and Poor Sleep Quality in Obese Children and Adolescents

PubMed Central

Baran, Rıza Taner; Atar, Müge; Pirgon, Özgür; Filiz, Serkan; Filiz, Meral

2018-01-01

Objective: Adult epidemiological studies suggest that the rate of Restless Legs syndrome (RLS) in the general population may range from 5% to 15%. The aim of this study was to investigate the frequency of RLS in a community sample of obese adolescents aged 10-16 years and to assess the association with sleep quality and health-related glucose metabolism markers. Methods: The study group comprised 144 obese and overweight children aged 10-16 yearsand the control group consisted of 66 age-matched healthy children. The RLS Questionnaire devised by the International RLS Study and the Pittsburgh Sleep Quality Index (PSQI), where a score >5 indicates poor sleep quality, was used to assess sleep quality. Results: Mean body mass index (BMI) of the overweight/obese and control groups were 30.5±0.5 and 18.7±0.2, respectively. The frequency of RLS was higher in the obese group (21.7%) than the overweight (3.4%) and control (1.5%) (p<0.001) groups. The frequency of a poor PSQI score was significantly higher (p<0.001) in the obese group (37.3%) than the control group (24.2%). The obese with RLS group also had poorer sleep quality scores than the non-RLS obese group. Many symptoms of sleep disruption were more common in obese patients with RLS and RLS was independently correlated with a high PSQI score [odds ratio (OR): 2.25, confidence interval (Cl): 0.96-5.28, p<0.001)] and an increased BMI z-score (OR: 8.87, Cl: 2.04-38.61, p<0.001). Conclusion: RLS is common in obese children and may be associated with altered sleep quality. Obese children with RLS need to be assessed since they may need support to improve their sleep quality. PMID:29175807

Self-Reported Perceptions of Sleep Quality and Resilience Among Dance Students.

PubMed

Arbinaga, F

2018-04-01

This study examined relationships between self-perceived sleep quality and resilience among 116 dance students (Mean age = 21.6 years; SD = 4.348). who self-reported sleep quality with the Pittsburgh Sleep Quality Index (PSQI) and personal resilience with the Resilience Scale (RS). Most participants (59.5%) reported poor sleep quality on the PSQI, with 62.9% of the women and 42.1% of the men ( p = .092) scoring higher than five points on this instrument. On the RS, a large majority of the participants (75%) obtained scores less than 147, indicating low resilience, with no significant gender differences observed. Those reporting poor sleep quality (PSQI scores > 5) obtained lower resilience scores (RS < 147) than those reporting good sleep quality (PSQI scores ≤ 5; p = .025), and participants with poorer sleep quality were at higher risk of low resilience (Odds Ratio = 3.273) relative to those with good sleep quality ( p = .006). Those with shorter duration sleep (claiming they slept <7 hours/night) were also at higher risk for low resilience (Odds Ratio = 3.266), relative to those with longer duration sleep (>7 hours/night). These findings can help students and dance professionals improve their performance and face pressures inherent in dance practice. Follow-up research should verify these findings in varied populations with objective sleep measures and observational data from multiple respondents.

Interaction of sleep quality and psychosocial stress on obesity in African Americans: the Cardiovascular Health Epidemiology Study (CHES).

PubMed

Bidulescu, Aurelian; Din-Dzietham, Rebecca; Coverson, Dorothy L; Chen, Zhimin; Meng, Yuan-Xiang; Buxbaum, Sarah G; Gibbons, Gary H; Welch, Verna L

2010-09-28

Compared with whites, sleep disturbance and sleep deprivation appear more prevalent in African Americans (AA). Long-term sleep deprivation may increase the risk of obesity through multiple metabolic and endocrine alterations. Previous studies have reported contradictory results on the association between habitual sleep duration and obesity. Accordingly, we aimed to assess whether sleep quality and duration are inversely associated with body mass index (BMI) and obesity and test whether these associations are modified by psychosocial stress, known to influence sleep quality. A sample of 1,515 AA residents of metropolitan Atlanta, aged 30-65 years, was recruited by a random-digit-dialing method in 2007-08. The outcome obesity was defined by BMI (kg/m²) continuously and categorically (BMI ≥ 30 versus BMI < 30). Global sleep quality (GSQ) score was computed as the sum of response values for the seven components of the Pittsburgh Sleep Quality Index (PSQI) scale. GSQ score was defined as a continuous variable (range 0-21) and as tertiles. The general perceived stress (GPS), derived from the validated Cohen scale, was categorized into tertiles to test the interaction. Chi-square tests, correlation coefficients and weighted multiple linear and logistic regression were used to assess the associations of GSQ, GPS and obesity. The mean (standard deviation) age was 47.5 (17.0) years, and 1,096 (72%) were women. GSQ score categorized into tertiles was associated with BMI. Among women, after multivariable adjustment that included age, gender, physical activity, smoking status, education, total family income, financial stress and history of hypertension, hypercholesterolemia, diabetes and myocardial infarction, obesity was associated with sleep quality as assessed by GSQ continuous score, [odds ratio, OR (95% C.I.): 1.08 (1.03 - 1.12)], and with a worse sleep disturbance subcomponent score [OR (95% C.I.): 1.48 (1.16 - 1.89)]. Among all participants, stress modified the association between obesity and sleep quality; there was an increased likelihood of obesity in the medium stress category, OR (95% C.I.): 1.09 (1.02 - 1.17). Sleep quality was associated with obesity in women. The association of sleep quality with obesity was modified by perceived stress. Our results indicate the need for simultaneous assessment of sleep and stress.

The relationship between mood and sleep in different female reproductive states.

PubMed

Toffol, Elena; Kalleinen, Nea; Urrila, Anna Sofia; Himanen, Sari-Leena; Porkka-Heiskanen, Tarja; Partonen, Timo; Polo-Kantola, Päivi

2014-06-16

Sleep is disrupted in depressed subjects, but it also deteriorates with age and possibly with the transition to menopause. The nature of interaction between mood, sleep, age and reproductive state is not well-defined. The aim of this study was to evaluate the relationship between mood and sleep among healthy women in different reproductive states. We analyzed data from 11 younger (20-26 years), 21 perimenopausal (43-51 years) and 29 postmenopausal (58-71 years) healthy women who participated in a study on menopause, sleep and cognition. The 21-item Beck Depression Inventory (BDI) was administered to assess mood. Subjective sleep quality was assessed with the Basic Nordic Sleep Questionnaire (BNSQ). Objective sleep was measured with all-night polysomnography (PSG) recordings. Perimenopausal and younger women were examined during the first days of their menstrual cycle at the follicular phase. Among younger women, less arousals associated with higher BDI total scores (p = 0.026), and higher SWS percentages with more dissatisfaction (p = 0.001) and depressive-somatic symptoms (p = 0.025), but with less depressive-emotional symptoms (p = 0.001). In specific, less awakenings either from REM sleep or SWS, respectively, associated with more punishment (p = 0.005; p = 0.036), more dissatisfaction (p < 0.001; p = 0.001) and more depressive-somatic symptoms (p = 0.001; p = 0.009), but with less depressive-emotional symptoms (p = 0.002; p = 0.003). In perimenopausal women, higher BNSQ insomnia scores (p = 0.005), lower sleep efficiencies (p = 0.022) and shorter total sleep times (p = 0.024) associated with higher BDI scores, longer sleep latencies with more depressive-somatic symptoms (p = 0.032) and longer REM latencies with more dissatisfaction (p = 0.017). In postmenopausal women, higher REM percentages associated with higher BDI total scores (p = 0.019) and more depressive-somatic symptoms (p = 0.005), and longer SWS latencies with more depressive-somatic symptoms (p = 0.030). Depressive symptoms measured with the total BDI scores associated with sleep impairment in both perimenopausal and postmenopausal women. In younger women, specific BDI factors revealed minor associations, suggesting that the type of sleep impairment can vary in relation to different depressive features. Our data indicate that associations between sleep and depressed mood may change in conjunction with hormonal milestones.

Trajectory of sleep disturbances in patients undergoing lung cancer surgery: a prospective study.

PubMed

Halle, Ingrid Helene; Westgaard, Therese Krystad; Wahba, Alexander; Oksholm, Trine; Rustøen, Tone; Gjeilo, Kari Hanne

2017-08-01

Patients with lung cancer report sleep difficulties to be frequent and bothersome symptoms. This study describes the trajectory of sleep from before and up to 12 months after surgery for lung cancer. Further, it investigates possible associations between sleep disturbance, demographic and clinical characteristics before surgery. This study is part of a longitudinal multicentre study. Sleep disturbance was measured by The General Sleep Disturbance Scale (GSDS) that investigates frequencies of sleep difficulties (21 items) and a total sum score ≥43 indicates a clinically meaningful level of sleep disturbance (score range 0-147). Linear mixed models were used to study changes in sleep from baseline to 1, 5, 9 and 12 months after surgery. The percentage of patients (n = 264) reporting sleep disturbances was 60.9% at baseline, 68.5% at Month 1, 55.4% at Month 5, 51.3% at Month 9 and 49.7% at Month 12. The increase to and decrease from Month 1 was the only significant alteration in the occurrence of sleep disturbance. The patients reported most problems within the subscales sleep quantity, early awakenings and sleep quality. Factors associated with sleep disturbance were lower age, use of pain medication and psychotropic medication and higher comorbidity score. Lung cancer patients sleep poorly, before as well as after surgery. There is a need to address sleeping disturbance routinely in clinical practice and screening for sleeping problems is indicated. Further studies are warranted concerning factors that contribute to sleep disturbance and how they best can be treated. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Pilot study of a mindfulness-based, multi-component, in-school group sleep intervention in adolescent girls.

PubMed

Bei, Bei; Byrne, Michelle L; Ivens, Clare; Waloszek, Joanna; Woods, Michael J; Dudgeon, Paul; Murray, Greg; Nicholas, Christian L; Trinder, John; Allen, Nicholas B

2013-05-01

Existing literature links poor sleep and anxiety symptoms in adolescents. This pilot study aimed to develop a practical method through which a program to improve sleep could reach adolescents in need and to examine the feasibility of a mindfulness-based, multi-component group sleep intervention using sleep and anxiety as outcome measures. Sixty-two grade 9 students (aged 13-15) at a girls' school were screened with the Pittsburgh Sleep Quality Index (PSQI) and Spence Children's Anxiety Scale (SCAS). Ten participants with self-reported poor sleep were enrolled into a six-session program based on Bootzin & Stevens, with added stress/anxiety-specific components. Sessions covered key aspects of basic mindfulness concepts and practice, sleep hygiene, sleep scheduling, evening/daytime habits, stimulus control, skills for bedtime worries and healthy attitudes to sleep. Treatment changes were measured by pre-post scores on the PSQI, SCAS and 7-day actigraphy-measured sleep. The program demonstrated high acceptability, with a completion rate of 90%. Based on effect-size analysis, participants showed significant improvement on objective sleep onset latency (SOL), sleep efficiency and total sleep time; actigraphy data also showed significantly earlier bedtime, rise time and smaller day-to-day bedtime variation. Post-intervention global PSQI scores were significantly lower than that of pre-intervention, with significant improvement in subjective SOL, sleep quality and sleep-related daytime dysfunction. There were small improvements on some subscales of the SCAS, but change on its total score was minimal. A mindfulness-based, multi-component, in-school group sleep intervention following brief screening is feasible, and has the potential to improve sleep. Its impact on anxiety needs further investigation. © 2012 Wiley Publishing Asia Pty Ltd.

Burnout and Sleep Quality: A Cross-Sectional Questionnaire-Based Study of Medical and Non-Medical Students in India

PubMed Central

Thawani, Rajat; Goel, Ashish

2015-01-01

Introduction It is well documented that on entering college, students experience a multitude of changes in sleep habits. Very few studies have been conducted that explore sleep quality in Indian undergraduate students; fewer still study the effects of burnout in the same population. Medical students, in particular, are believed to be more stressed, sleep deprived, and burnt out than their non-medical peers. Methods A cross-sectional study was conducted to study sleep disturbances and burnout in a sample of 214 Indian undergraduate students (112 medical, 102 non-medical). The instruments used to measure the sleep quality and burnout were the PSQI (Pittsburgh Sleep Quality Index) and OLBI (Oldenburg Burnout Inventory), respectively. Differences between continuous variables were analysed using Wilcox Mann Whitney U-tests. Bivariate Spearman’s rho correlations were done to identify correlations between the individual burnout components and the PSQI sleep quality components. Results Of the students surveyed, 62.6% were found to be poor sleepers with an average score of 6.45 ± 2.85. It was seen that 20% of the students (n = 43) slept less than five hours a day. Medical students, in particular, were found to have more poor sleep (72.9%) than their non-medical peers (51.9%; p < 0.001). Of the sampled women, 65.8% were poor sleepers, as compared to 62.1% of the sampled men, but the difference was not statistically significant. The average scores of the burnout dimensions were 2.43 ± 0.57 for exhaustion and 2.32 ± 0.53 for disengagement. Both exhaustion and disengagement correlated with PSQI sleep scores (Rho 0.21, p 0.001) and (Rho = 0.18, p = 0.008), respectively. The exhaustion dimension of burnout was higher in medical students (2.46 ± 0.55) than in non-medical students (2.38 ± 0.59), but was seen to correlate more with the PSQI sleep score in the non-medical group (Rho = 0.62, p < 0.001). The PSQI scores showed a weak but significant correlation with academic year (rho = -0.19, p = 0.004). Unlike the sleep scores, the burnout dimensions did not correlate well with the academic year. Conclusions Burnout and sleep quality are both uncommonly studied topics in India. Fostering a healthier and more proactive approach to tackling burnout and poor sleep quality may help unearth culture specific causes for some of the results we have demonstrated. PMID:26623216

Burnout and Sleep Quality: A Cross-Sectional Questionnaire-Based Study of Medical and Non-Medical Students in India.

PubMed

Shad, Rohan; Thawani, Rajat; Goel, Ashish

2015-10-21

Introduction It is well documented that on entering college, students experience a multitude of changes in sleep habits. Very few studies have been conducted that explore sleep quality in Indian undergraduate students; fewer still study the effects of burnout in the same population. Medical students, in particular, are believed to be more stressed, sleep deprived, and burnt out than their non-medical peers. Methods A cross-sectional study was conducted to study sleep disturbances and burnout in a sample of 214 Indian undergraduate students (112 medical, 102 non-medical). The instruments used to measure the sleep quality and burnout were the PSQI (Pittsburgh Sleep Quality Index) and OLBI (Oldenburg Burnout Inventory), respectively. Differences between continuous variables were analysed using Wilcox Mann Whitney U-tests. Bivariate Spearman's rho correlations were done to identify correlations between the individual burnout components and the PSQI sleep quality components. Results Of the students surveyed, 62.6% were found to be poor sleepers with an average score of 6.45 ± 2.85. It was seen that 20% of the students (n = 43) slept less than five hours a day. Medical students, in particular, were found to have more poor sleep (72.9%) than their non-medical peers (51.9%; p < 0.001). Of the sampled women, 65.8% were poor sleepers, as compared to 62.1% of the sampled men, but the difference was not statistically significant. The average scores of the burnout dimensions were 2.43 ± 0.57 for exhaustion and 2.32 ± 0.53 for disengagement. Both exhaustion and disengagement correlated with PSQI sleep scores (Rho 0.21, p 0.001) and (Rho = 0.18, p = 0.008), respectively. The exhaustion dimension of burnout was higher in medical students (2.46 ± 0.55) than in non-medical students (2.38 ± 0.59), but was seen to correlate more with the PSQI sleep score in the non-medical group (Rho = 0.62, p < 0.001). The PSQI scores showed a weak but significant correlation with academic year (rho = -0.19, p = 0.004). Unlike the sleep scores, the burnout dimensions did not correlate well with the academic year. Conclusions Burnout and sleep quality are both uncommonly studied topics in India. Fostering a healthier and more proactive approach to tackling burnout and poor sleep quality may help unearth culture specific causes for some of the results we have demonstrated.

Prevalence of sleep problems in Japanese preschoolers in a medium-sized city: Community-based survey using the Children's Sleep Habits Questionnaire.

PubMed

Takahashi, Michio; Adachi, Masaki; Yasuda, Sayura; Osato-Kaneda, Ayako; Saito, Manabu; Kuribayashi, Michito; Nakamura, Kazuhiko

2017-06-01

Although the mean score of the Children's Sleep Habits Questionnaire (CSHQ) differs between countries, there are no normative data for the CSHQ of Japanese preschoolers based on a community sample. The aims of this study were therefore to present normative data for the CSHQ and determine the prevalence and characteristics of sleep problems in Japanese preschoolers. Parents or the primary caregiver of 482 preschoolers aged 4-5 years completed the CSHQ and the Strength and Difficulties Questionnaire. Approximately 80% of preschoolers scored above the cut-off for sleep disturbance on the CSHQ. In addition, co-sleeping was prevalent in Japanese preschoolers but the habit of co-sleeping contributed little to behavioral and emotional problems. Sleep problems appear to be prevalent in Japanese preschoolers based on the CSHQ, and could be associated with the Japanese sleep habit of co-sleeping. © 2017 Japan Pediatric Society.

Negative affect and sleep disturbance may be associated with response to epidural steroid injections for spine-related pain.

PubMed

Karp, Jordan F; Yu, Lan; Friedly, Janna; Amtmann, Dagmar; Pilkonis, Paul A

2014-02-01

To describe whether negative affect and sleep impairment are associated with the clinical effect of epidural steroid injections (ESIs) for low back pain. Observational study; patients were evaluated before ESI and 1 and 3 months after ESI. Spine center and related treatment sites. Participants (N=158) seeking treatment for low back pain with or without radiculopathy. ESI for low back pain with or without radiculopathy. We assessed the dependent (global pain severity for back and leg pain, pain behavior, pain interference) and independent variables (depression, sleep disturbance, and covariates of back pain response) with the Patient-Reported Outcome Measurement Information System (PROMIS) and legacy measures. Outcome was assessed cross-sectionally using multiple regression and longitudinally with path analysis. After 1 month, sleep disturbance was the only predictor for the global ratings of improvement in back pain (R(2)=16.8%) and leg pain (R(2)=11.4%). The proportions of variance explained by sleep disturbance and negative affect for all dependent variables were greater at 3 months than 1 month. Mediation analysis was significant for negative affect for the 3-month outcomes on PROMIS pain behavior (β=.87, P<.01) and pain interference (β=.37, P<.01). There was no evidence of mediation by sleep disturbance for any outcome. Negative affect and sleep disturbance are associated with worse outcomes after ESI. Further research is needed to determine if treatment of negative affect and sleep disturbance prior to or concurrently with ESI will improve outcomes. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Relationships of Sleep Duration With Weight-Related Behaviors of U.S. College Students.

PubMed

Quick, Virginia; Byrd-Bredbenner, Carol; Shoff, Suzanne; White, Adrienne A; Lohse, Barbara; Horacek, Tanya; Colby, Sarah; Brown, Onikia; Kidd, Tandalayo; Greene, Geoffrey

2016-01-01

This study describes sleep behaviors of U.S. college students (N = 1,252; 18-24 years old; 59% female) and examines associations of sleep duration with weight-related behaviors. More than one quarter of participants slept < 7 hr/night and had mean Pittsburgh Sleep Quality Index (PSQI) scores indicating poor sleep quality. There were significant differences for all PSQI scales among sleep duration categories, < 7 hr (n = 344), 7-8 hr (n = 449), ≥ 8 hr (n = 459) sleep/night. Compared to those who slept ≥ 8 hr, those who slept < 8 hr had significantly more negative eating attitudes (2% higher), poorer internal regulation of food (4% lower), and greater binge eating (4% higher) scores. Findings advocate for health care professionals to evaluate sleep behaviors of college students during office visits and promote good sleep behaviors.

Impact of herpes zoster and post-herpetic neuralgia on patients’ quality of life: a patient-reported outcomes survey

PubMed Central

Edte, Alexander; Schmitt, Sonja; Lukas, Kati

2010-01-01

Background The impact of herpes zoster (HZ) and post-herpetic neuralgia (PHN) on patients’ quality of life (QoL) is currently poorly documented. Subjects and methods Telephone interviews in Germany identified patients ≥50 years old with painful HZ diagnosed during the previous 5 years. Bespoke questions evaluated previous HZ episodes. Results Of 11,009 respondents, 280 met the screening criteria, and 32 (11%) developed PHN. PHN was associated with significantly worse outcomes than HZ (all P < 0.05). Mean pain scores associated with PHN and HZ, respectively, were 7.1 and 6.2 (average) and 8.2 and 7.0 (worst). Many patients with PHN (91%) and HZ (73%) experienced problems with daily activities, including work, studies, housework, family and leisure activities. Mean pain interference scores in patients with PHN versus HZ were highest for sleep (6.5 versus 4.9), normal work (6.1 versus 4.4) and mood (5.9 versus 4.4). Most employed interviewees with PHN (70%) and HZ (64%) stopped work during the disease. Pain and QoL outcomes were not significantly different between all patients versus those diagnosed during the previous 12 months or between patients aged 50–59 years versus ≥60 years. Conclusions HZ causes substantial pain, which seriously interferes with many aspects of daily life, particularly in patients with PHN. PMID:21124645

Noise levels and their effects on Shuttle crewmembers' performance: Operational concerns

NASA Technical Reports Server (NTRS)

Koros, Anton S.; Adam, Susan C.; Wheelwright, Charles D.

1993-01-01

When excessive, noise can result in sleep interference, fatigue, interference with verbal communication, and hearing damage. Shuttle crewmembers are exposed to noise throughout their mission. The contribution of noise to decrements in crew performance over these extended exposure durations was the focus of this study. On the STS-40/SLS-1, mission noise levels were evaluated through the use of a sound level meter and a crew questionnaire. Crewmembers noted that sleep, concentration, and relaxation were negatively impacted by high noise levels. Speech Interference Levels (SIL's), calculated from the sound level measurements, suggested that crewmembers were required to raise their voice in order to be heard. No difficulty detecting caution and warning alarms was noted. The higher than desirable noise levels in Spacelab were attributed to flight specific payloads for which acoustic waivers were granted. It is recommended that current noise levels be reduced in Spacelab and the Orbiter Middeck especially as longer missions are planned for the buildup of Space Station Freedom. Levels of NC 50 are recommended in areas where speech communication is required and NC 40 in sleep areas. These levels are in accordance with the NASA Man-Systems Integration Standards. Measurements proposed for subsequent orbiter missions are discussed.

Assessment of sleep quality and correlates in a large cohort of Colombian women around menopause.

PubMed

Monterrosa-Castro, Alvaro; Marrugo-Flórez, Martha; Romero-Pérez, Ivette; Fernández-Alonso, Ana M; Chedraui, Peter; Pérez-López, Faustino R

2013-04-01

The aim of this study was to determine the relationship between self-reported sleep quality, menopausal symptom intensity, and correlates (including ethnicity) among middle-aged women. The present cross-sectional study involved 1,078 Colombian women aged 40 to 59 years who completed the Pittsburgh Sleep Quality Index (PSQI), the Menopause Rating Scale (MRS), and a general questionnaire exploring sociodemographic data. The median [interquartile range] age of the whole sample was 49.0 [9.0] years. Among the participants, 45.4% were postmenopausal, 57.2% had increased body mass index values, 13.9% were black, 20.7% had hypertension, 74.1% had a stable partner, and 3.8% used hormone therapy. The prevalence of poor sleep quality was 57.1% (PSQI global score ≥5). Significant correlations between PSQI global scores and MRS total and subscale scores were found. Multiple linear regression analysis found that higher PSQI scores (poorer quality of sleep) correlated with higher MRS psychological and somatic subscale scores (more severe symptoms), smoking habit, and hypertension. Menopause status and black ethnicity were excluded from the final regression model. Despite study limitations, poor sleep quality is highly prevalent in this large middle-aged Colombian female sample and is related to menopausal symptom severity, tobacco use, and presence of hypertension.

Empiric Auto-Titrating CPAP in People with Suspected Obstructive Sleep Apnea

PubMed Central

Drummond, Fitzgerald; Doelken, Peter; Ahmed, Qanta A.; Gilbert, Gregory E.; Strange, Charlie; Herpel, Laura; Frye, Michael D.

2010-01-01

Objective: Efficient diagnosis and treatment of obstructive sleep apnea (OSA) can be difficult because of time delays imposed by clinic visits and serial overnight polysomnography. In some cases, it may be desirable to initiate treatment for suspected OSA prior to polysomnography. Our objective was to compare the improvement of daytime sleepiness and sleep-related quality of life of patients with high clinical likelihood of having OSA who were randomly assigned to receive empiric auto-titrating continuous positive airway pressure (CPAP) while awaiting polysomnogram versus current usual care. Methods: Serial patients referred for overnight polysomnography who had high clinical likelihood of having OSA were randomly assigned to usual care or immediate initiation of auto-titrating CPAP. Epworth Sleepiness Scale (ESS) scores and the Functional Outcomes of Sleep Questionnaire (FOSQ) scores were obtained at baseline, 1 month after randomization, and again after initiation of fixed CPAP in control subjects and after the sleep study in auto-CPAP patients. Results: One hundred nine patients were randomized. Baseline demographics, daytime sleepiness, and sleep-related quality of life scores were similar between groups. One-month ESS and FOSQ scores were improved in the group empirically treated with auto-titrating CPAP. ESS scores improved in the first month by a mean of −3.2 (confidence interval −1.6 to −4.8, p < 0.001) and FOSQ scores improved by a mean of 1.5, (confidence interval 0.5 to 2.7, p = 0.02), whereas scores in the usual-care group did not change (p = NS). Following therapy directed by overnight polysomnography in the control group, there were no differences in ESS or FOSQ between the groups. No adverse events were observed. Conclusion: Empiric auto-CPAP resulted in symptomatic improvement of daytime sleepiness and sleep-related quality of life in a cohort of patients awaiting polysomnography who had a high pretest probability of having OSA. Additional studies are needed to evaluate the applicability of empiric treatment to other populations. Citation: Drummond F; Doelken P; Ahmed QA; Gilbert GE; Strange C; Herpel L; Frye MD. Empiric auto-titrating CPAP in people with suspected obstructive sleep apnea. J Clin Sleep Med 2010;6(2):140-145. PMID:20411690

Association between depressive symptoms and morningness-eveningness, sleep duration and rotating shift work in Japanese nurses.

PubMed

Togo, Fumiharu; Yoshizaki, Takahiro; Komatsu, Taiki

2017-01-01

Higher depressive symptoms have been reported in rotating shift workers compared with day workers. Depressive symptoms in adults who do not engage in night work have also been shown to be associated with chronotype and sleep duration. This study examines associations between depressive symptoms, morningness-eveningness (i.e. the degree to which people prefer to be active in the morning or the evening), sleep duration and rotating shift work. Japanese nurses (1252 day workers and 1780 rotating shift workers, aged 20-59) were studied using a self-administered questionnaire. The questionnaire covered depressive symptoms, morningness-eveningness, sleep habits and demographic characteristics of the participants. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to determine the levels of depressive symptoms. A Japanese version of the Morningness-Eveningness Questionnaire (MEQ) was used to measure morningness-eveningness. The CES-D score of shift workers was significantly (p < 0.05) higher than that of day workers. The MEQ score was significantly (p < 0.05) lower (i.e. greater eveningness) in shift workers than in day workers. Sleep duration on the day shift was significantly (p < 0.05) shorter in shift workers than in day workers. Simple linear regression revealed that the MEQ score, sleep duration on the day shift and current work shift (i.e. rotating shift work) were significantly (p < 0.05) associated with the CES-D score. Multivariate linear regression indicated that greater eveningness and shorter sleep duration were independently associated with higher CES-D scores, while rotating shift work was not. These associations between the MEQ score, the sleep duration and the CES-D score were also confirmed in both day workers and shift workers when the groups were analyzed separately. These results suggest that greater eveningness and shorter sleep duration on the day shift were independently associated with higher levels of depressive symptoms, which may explain associations between rotating shift workers and depressive symptoms. These findings have important implications for the development of novel strategies for preventing poor mental health in day workers and rotating shift workers.

Patterns of pain and interference in patients with painful bone metastases: a brief pain inventory validation study.

PubMed

Wu, Jackson S Y; Beaton, Dorcas; Smith, Peter M; Hagen, Neil A

2010-02-01

Bone metastases are prevalent, painful, and carry a poorer prognosis for pain control compared with other cancer pain syndromes. Standard tools to measure pain have not been validated in this patient population, and particular subgroups with more challenging symptoms have yet to be identified and studied. The objectives of this study were 1) to validate the psychometric properties of the Brief Pain Inventory (BPI) and its Pain and Interference subscales in patients with clinically significant metastatic bone pain requiring palliative radiotherapy and 2) to examine differences in BPI subscales among predefined subgroups of bone metastases patients. A total of 258 patients evaluated and treated through a rapid access radiation therapy clinic between July 2002, and November 2006, were included in the analysis. High internal consistency of the BPI subscales of Pain, Activity interference, and Affect interference was demonstrated by Cronbach's alpha between 0.81 and 0.89. Removing sleep interference improved model fit in confirmatory factor analysis. The BPI revealed an alarming pattern in patients with lower body metastases, who reported substantial interference of activity even though pain levels were mild or moderate. Such patients may require prompt clinical attention to better meet their needs. Finally, the allocation of interference from sleep within the BPI framework, in our population of pain patients, requires further study. Copyright 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Relationships Among Daytime Napping and Fatigue, Sleep Quality, and Quality of Life in Cancer Patients.

PubMed

Sun, Jia-Ling; Lin, Chia-Chin

2016-01-01

The relationships among napping and sleep quality, fatigue, and quality of life (QOL) in cancer patients are not clearly understood. The aim of the study was to determine whether daytime napping is associated with nighttime sleep, fatigue, and QOL in cancer patients. In total, 187 cancer patients were recruited. Daytime napping, nighttime self-reported sleep, fatigue, and QOL were assessed using a questionnaire. Objective sleep parameters were collected using a wrist actigraph. According to waking-after-sleep-onset measurements, patients who napped during the day experienced poorer nighttime sleep than did patients who did not (t = -2.44, P = .02). Daytime napping duration was significantly negatively correlated with QOL. Patients who napped after 4 PM had poorer sleep quality (t = -1.93, P = .05) and a poorer Short-Form Health Survey mental component score (t = 2.06, P = .04) than did patients who did not. Fatigue, daytime napping duration, and sleep quality were significant predictors of the mental component score and physical component score, accounting for 45.7% and 39.3% of the variance, respectively. Daytime napping duration was negatively associated with QOL. Napping should be avoided after 4 PM. Daytime napping affects the QOL of cancer patients. Future research can determine the role of napping in the sleep hygiene of cancer patients.

Sleep Duration and School Readiness of Chinese Preschool Children.

PubMed

Tso, Winnie; Rao, Nirmala; Jiang, Fan; Li, Albert Martin; Lee, So-Lun; Ho, Frederick Ka-Wing; Li, Sophia Ling; Ip, Patrick

2016-02-01

To examine the average sleep duration in Chinese preschoolers and to investigate the association between sleep duration and school readiness. This is a cross-sectional study that included 553 Chinese children (mean age = 5.46 years) from 20 preschools in 2 districts of Hong Kong. Average daily sleep duration in the last week was reported by parents and school readiness as measured by the teacher-rated Chinese Early Development Instrument (CEDI). Most Chinese preschoolers had 9-10 hours of sleep per day. Only 11% of preschoolers had the recommended 11-12 hours of sleep per day. This group was associated with more "very ready" CEDI domains. Sleep deprivation (≤7 hours per day) was associated with a lower CEDI total score, lower scores in the emotional maturity and language/cognitive domain, and prosocial behaviors subdomain but a greater score in the hyperactivity/inattention subdomain. Children with a lower family socioeconomic index, lower maternal education level, infrequent parent-child interactions, and who used electronic devices for more than 3 hours per day had shortened sleep durations. Optimal sleep duration was associated with better school readiness in preschool children, whereas sleep deprivation was associated with lower school readiness, more hyperactivity and inattention, and less prosocial behavior. Copyright © 2016 Elsevier Inc. All rights reserved.

Is it nutrients, food items, diet quality or eating behaviours that are responsible for the association of children's diet with sleep?

PubMed

Khan, Mohammad K A; Faught, Erin L; Chu, Yen Li; Ekwaru, John P; Storey, Kate E; Veugelers, Paul J

2017-08-01

Both diet quality and sleep duration of children have declined in the past decades. Several studies have suggested that diet and sleep are associated; however, it is not established which aspects of the diet are responsible for this association. Is it nutrients, food items, diet quality or eating behaviours? We surveyed 2261 grade 5 children on their dietary intake and eating behaviours, and their parents on their sleep duration and sleep quality. We performed factor analysis to identify and quantify the essential factors among 57 nutrients, 132 food items and 19 eating behaviours. We considered these essential factors along with a diet quality score in multivariate regression analyses to assess their independent associations with sleep. Nutrients, food items and diet quality did not exhibit independent associations with sleep, whereas two groupings of eating behaviours did. 'Unhealthy eating habits and environments' was independently associated with sleep. For each standard deviation increase in their factor score, children had 6 min less sleep and were 12% less likely to have sleep of good quality. 'Snacking between meals and after supper' was independently associated with sleep quality. For each standard deviation increase in its factor score, children were 7% less likely to have good quality sleep. This study demonstrates that eating behaviours are responsible for the associations of diet with sleep among children. Health promotion programmes aiming to improve sleep should therefore focus on discouraging eating behaviours such as eating alone or in front of the TV, and snacking between meals and after supper. © 2016 European Sleep Research Society.

Randomized controlled trial on the effects of a combined sleep hygiene education and behavioral approach program on sleep quality in workers with insomnia.

PubMed

Kaku, Akiko; Nishinoue, Nao; Takano, Tomoki; Eto, Risa; Kato, Noritada; Ono, Yutaka; Tanaka, Katsutoshi

2012-01-01

To evaluate the effects of a combined sleep hygiene education and behavioral approach program on sleep quality in workers with insomnia, we conducted a randomized controlled trial at a design engineering unit in Japan. Employees evaluated for insomnia by the Athens Insomnia Scale (≥6 points) were divided into an intervention and control group. The intervention group received a short-term intervention (30 min) program that included sleep hygiene education and behavioral approaches (relaxation training, stimulus control, and sleep restriction) performed by occupational health professionals. We calculated differences in change in Pittsburgh Sleep Quality Index (PSQI) scores between the two groups from baseline to three months after the start of intervention after adjusting for gender, age, job title, job category, average number of hours of overtime during the study period, marital status, smoking habit, average number of days of alcohol consumption per week, exercise habits, K6 score, and baseline PSQI score. Results showed that the average PSQI score decreased by 1.0 in the intervention group but increased by 0.9 in the control group. Additionally, the difference in variation between the two groups was 1.9 (95% confidence interval: 0.6 to 3.4), which was significant. Taken together, these results indicate that the intervention program significantly improved the sleep quality of workers with insomnia.

Sleep disturbance and correlates in menopausal women in Shanghai.

PubMed

Sun, Dongmei; Shao, Hongfang; Li, Changbin; Tao, Minfang

2014-03-01

The aim of this study was to investigate the sleep disturbance and its correlates in Chinese middle-aged women. A total of 2046 Chinese women 40-60 years of age were recruited in this cross-sectional descriptive study. The subjects were surveyed using the Pittsburgh Sleep Quality Index (PSQI), the modified Kupperman Index (KI), and a general questionnaire to obtain sociodemographic data. Data were analyzed using SPSS 20.0 software. In this study, the mean (standard deviation) age of the participants was 51.69 (6.54) years and the mean PSQI score was 6.88 (3.20). The prevalence of sleep disturbance was 33.2% (a PSQI global score ≥8). The prevalence of sleep disturbance was higher in women with a menopausal status (from 34.8% in premenopausal women to 40.9% in postmenopausal women, P < .001) and in women with an increased age (from 21.7% in women 40-44 years of age to 41.8% in women 55-60 years of age, P < .001). Vasomotor symptoms (classical menopausal symptoms, VMS) were associated with sleep disturbance. An increase in the severity of menopausal symptoms (higher total KI scores) was observed in women who experienced sleep disturbance. A logistic regression analysis revealed that menopausal status, vasomotor symptoms, modified KI scores, a history of disease, and older age (≥ 50 years) were significant risk factors for sleep disturbance. Sleep disturbance was highly prevalent in this large sample of middle-aged Chinese women. Therefore, clinicians should pay more attention to sleep problems in middle-aged Chinese women and measures should be taken to improve the quality of sleep in these women. Copyright © 2013 Elsevier Inc. All rights reserved.

Prevalence and impacts of poor sleep on quality of life and associated factors of good sleepers in a sample of older Chinese adults.

PubMed

Lo, Catherine M H; Lee, Paul H

2012-06-18

Sleep disturbance is a complex health problem in ageing global populations decreasing quality of life among many older people. Geographic, cultural, and ethnic differences in sleep patterns have been documented within and between Western and Asian populations. The aim of this study was to explore sleep problems among Hong Kong seniors by examining the prevalence of poor sleep quality, the relationship between sleep quality and health-related quality of life, and associated factors of good sleepers in different age groups. This cross-sectional study used convenience sampling and gathered data during face-to-face interviews. Older community-dwelling individuals (n = 301) were recruited in community centres in 2010. The Pittsburgh Sleep Quality Index and Medical Outcomes Study Short Form-36 were used to measure sleep quality and health-related quality of life. The Medical Outcomes Study Short Form-36 domain scores were compared between good and bad sleepers and between long and short sleepers using Hotelling's T-Square test. SF-36 domain scores were placed into a logistic regression model that controlled for significant demographic variables (gender, educational level, perceived health). Most (77.7%) participants were poor sleepers. Participants who had global Pittsburgh Sleep Quality Index scores <5 and slept ≥5.5 h/night had better health-related quality of life. Vitality, emotional role, physical functioning, and bodily pain domain scores were associated factors of good sleepers in different age groups. This study found a strong negative association between sleep deprivation (poor quality, short duration) and health-related quality of life. Associated factors for good sleep quality in later life differ among age groups in relation to universal age-related changes, and should be addressed by social policies and health-care programmes.

Quick returns and night work as predictors of sleep quality, fatigue, work-family balance and satisfaction with work hours.

PubMed

Dahlgren, Anna; Tucker, Philip; Gustavsson, Petter; Rudman, Ann

2016-01-01

Quick returns (intervals of <11 h between the end of one shift and the start of the next) are associated with short sleeps and fatigue on the subsequent shift. Recent evidence suggests that shift workers regard quick returns as being more problematic than night work. The current study explored quick returns and night work in terms of their impact on sleep, unwinding, recovery, exhaustion, satisfaction with work hours and work-family interference. Data from the 2006 cohort of Swedish nursing students within the national Longitudinal Analysis of Nursing Education (LANE) study were analysed (N = 1459). Respondents completed a questionnaire prior to graduation (response rate 69.2%) and 3 years after graduation (65.9%). The analyses examined associations between frequency of quick returns and night work and measures taken in year three, while adjusting for confounding factors (in year three and prior graduation). Frequency of quick returns was a significant predictor of poor sleep quality, short sleeps, unwinding, exhaustion, satisfaction with work hours and work-to-family interference, with higher frequency predicting more negative outcomes. Quick returns did not predict recovery after rest days. Frequency of night work did not predict any of the outcomes. In conclusion, quick returns were an important determinant of sleep, recovery and wellbeing, whereas night work did not show such an association.

Pregabalin beneficial effects on sleep quality or health-related quality of life are poorly correlated with reduction on pain intensity after an 8-week treatment course.

PubMed

Perez-Lloret, Santiago; Rojas, Gloria Meza; Menoni, Maria Celia; Ruiz, Gabriela; Velásquez, Carolina; Rodriguez, Hernán; Rey, María Verónica; Cardinali, And Daniel P

2012-01-01

Pregabalin (PGB) has been shown to improve sleep quality and health-related quality of life (HRQoL) as well as pain intensity in patients with neuropathic pain. The objective of the study was to explore the magnitude of the correlations between changes in pain intensity, sleep quality, and HRQoL after PGB treatment. One hundred thirty-eight patients with neuropathic pain of any origin and without an adequate response to analgesics received an 8-week treatment course of PGB in an open-label fashion. Pain intensity, sleep quality, and HRQoL outcomes were evaluated at baseline and at week 8 by means of an 11-point (0-10) numerical rating scale (NRS), the Pittsburgh Sleep Quality Index (PSQI), and the EuroQol health-state visuoanalogic scale (EQ-5D VAS) score, respectively. At week 8, mean PGB dose was 166.7 ± 7.8 mg/d. Pain intensity NRS score, PSQI total score, and EQ-5D VAS score were improved by 66.5% ± 1.9%, 40.0% ± 3.6%, and 26.4% ± 4.7% (all P < 0.01), respectively. Correlations between percent change from baseline in pain NRS score and PSQI total score or EQ-5D VAS scores were r = 0.36 (P < 0.01, R = 0.11) and r = -0.20 (P < 0.02, R = 0.05), respectively. A multivariate logistic regression analysis disclosed that PSQI score change below the median (ie, a better outcome) was related to higher EQ-5D VAS score change (odds ratio, 2.15; 95% confidence interval, 1.09-4.25), whereas pain intensity NRS score change below the median was not (odds ratio, 1.58; 95% confidence interval,0.78-3.23). In our study, PGB-related improvements in sleep quality and HRQoL were marginally related to reductions in pain intensity in patients with neuropathic pain. Improvement in sleep quality was a significant predictor of better HRQoL, whereas pain intensity reduction was not.

Sleep alterations and iron deficiency anemia in infancy

PubMed Central

Peirano, Patricio D.; Algarín, Cecilia R.; Chamorro, Rodrigo A.; Reyes, Sussanne C.; Durán, Samuel A.; Garrido, Marcelo I.; Lozoff, Betsy

2013-01-01

Iron-deficiency anemia (IDA) continues to be the most common single nutrient deficiency in the world. An estimated 20-25% of the world’s infants have IDA, with at least as many having iron deficiency without anemia. Infants are at particular risk due to rapid growth and limited dietary sources of iron. We found that infants with IDA showed different motor activity patterning in all sleep-waking states and several differences in sleep states organization. Sleep alterations were still apparent years after correction of anemia with iron treatment in the absence of subsequent IDA. We suggest that altered sleep patterns may represent an underlying mechanism that interferes with optimal brain functioning during sleep and wakefulness in former IDA children. PMID:20620103

Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults

PubMed Central

Lao, Xiang Qian; Liu, Xudong; Deng, Han-Bing; Chan, Ta-Chien; Ho, Kin Fai; Wang, Feng; Vermeulen, Roel; Tam, Tony; Wong, Martin C.S.; Tse, L.A.; Chang, Ly-yun; Yeoh, Eng-Kiong

2018-01-01

Study Objectives: There is limited information on the relationship between risk of cardiovascular disease and the joint effects of sleep quality and sleep duration, especially from large, prospective, cohort studies. This study is to prospectively investigate the joint effects of sleep quality and sleep duration on the development of coronary heart disease. Methods: This study examined 60,586 adults aged 40 years or older. A self-administered questionnaire was used to collect information on sleep quality and sleep duration as well as a wide range of potential confounders. Events of coronary heart disease were self-reported in subsequent medical examinations. Two types of Sleep Score (multiplicative and additive) were constructed to reflect the participants' sleep profiles, considering both sleep quality and sleep duration. The Cox regression model was used to estimate the hazard ratio (HR) and the 95% confidence interval (CI). Results: A total of 2,740 participants (4.5%) reported new events of coronary heart disease at follow-up. For sleep duration, participants in the group of < 6 h/d was significantly associated with an increased risk of coronary heart disease (HR: 1.13, 95% CI: 1.04–1.23). However, the association in the participants with long sleep duration (> 8 h/d) did not reach statistical significance (HR: 1.11, 95% CI: 0.98–1.26). For sleep quality, both dreamy sleep (HR: 1.21, 95% CI: 1.10–1.32) and difficult to fall asleep/use of sleeping pills or drugs (HR: 1.40, 95% CI: 1.25–1.56) were associated with an increased risk of the disease. Participants in the lowest quartile of multiplicative Sleep Score (HR: 1.31, 95% CI: 1.16–1.47) and of additive sleep score (HR: 1.31, 95% CI: 1.16–1.47) were associated with increased risk of coronary heart disease compared with those in the highest quartile. Conclusions: Both short sleep duration and poor sleep quality are associated with the risk of coronary heart disease. The association for long sleep duration does not reach statistical significance. Lower Sleep Score (poorer sleep profile) increases the risk of coronary heart disease, suggesting the importance of considering sleep duration and sleep quality together when developing strategies to improve sleep for cardiovascular disease prevention. Citation: Lao XQ, Liu X, Deng HB, Chan TC, Ho KF, Wang F, Vermeulen R, Tam T, Wong MC, Tse LA, Chang LY, Yeoh EK. Sleep quality, sleep duration, and the risk of coronary heart disease: a prospective cohort study with 60,586 adults. J Clin Sleep Med. 2018;14(1):109–117. PMID:29198294

Menopause is associated with self-reported poor sleep quality in women without vasomotor symptoms.

PubMed

Hung, Hao-Chang; Lu, Feng-Hwa; Ou, Horng-Yih; Wu, Jin-Shang; Yang, Yi-Ching; Chang, Chih-Jen

2014-08-01

The aim of this study was to investigate the relationship between menopause and self-reported sleep quality in Chinese women without vasomotor symptoms. Cross-sectional data were collected from a decoded database of the National Cheng Kung University Hospital. Menopause was defined as absence of menses for at least 12 months or a history of hysterectomy and oophorectomy. Self-reported sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A higher global PSQI score indicates poorer self-reported sleep quality, and a global PSQI score greater than 5 differentiates poor sleepers from good sleepers. Of the 1,088 women recruited, 353 (32.4%) were in postmenopause status. Postmenopausal women had higher mean (SD) global PSQI scores (8.0 [3.3] vs. 6.1 [2.2], P < 0.001) and a greater prevalence of poor sleepers (73.1% vs. 60.8%, P < 0.001) compared with premenopausal women. Multivariate linear regression analysis showed that menopause (β = 1.532; 95% CI, 1.135 to 1.949; P < 0.001) and snoring (β = 0.764; 95% CI, 0.299 to 1.228; P = 0.001) were positively associated with global PSQI scores, whereas long sleep duration (β = -0.791; 95% CI, -1.113 to -0.468; P < 0.001) was negatively associated with global PSQI scores. Multivariate logistic regression analyses showed that menopause (odds ratio, 1.453; 95% CI, 1.030 to 2.051; P < 0.05), long sleep duration (odds ratio, 0.545; 95% CI, 0.418 to 0.710; P < 0.001), and snoring (odds ratio, 2.022; 95% CI, 1.312 to 3.116; P = 0.001) were independent predictors of poor sleepers. Postmenopausal women without vasomotor symptoms have significantly higher global PSQI scores and a higher risk of being poor sleepers than premenopausal women. In addition, menopause and snoring are associated with an increased risk of poor self-reported sleep quality independently of cardiometabolic factors and lifestyle, whereas long sleep duration is associated with a decreased risk of poor self-reported sleep quality.

All Fatigue is Not Created Equal: The Association of Fatigue and Its Subtypes on Pain Interference in Orofacial Pain.

PubMed

Boggero, Ian A; Rojas-Ramirez, Marcia V; Carlson, Charles R

2017-03-01

Fatigue is known to be a pathway through which depression, psychological distress, pain intensity, and sleep disturbance influence pain interference, but the independent effects of fatigue on pain interference after controlling for these variables remains unknown. In addition, no study to date has tested whether fatigue subtypes of general fatigue, mental fatigue, emotional fatigue, physical fatigue, or vigor differentially predict pain interference. The current study tested these associations using archival medical data of 2133 chronic orofacial pain patients, who completed a battery of psychological questionnaires at the time of their first appointment at an orofacial pain clinic. Hierarchical linear regression analysis revealed that after controlling for depression, psychological distress, sleep disturbance, pain intensity, and demographic variables, fatigue predicted higher pain interference (B=0.70, SE=0.17, P<0.001, η=0.01). Physical fatigue (B=1.70, SE=0.48, P<0.001, η=0.01) and vigor (B=-3.24, SE=0.47, P<0.001, η=0.03) were independently associated with pain interference after controlling for the aforementioned variables. The findings suggest that fatigue is an important independent predictor of pain interference and not merely a mediator. These findings also suggest that not all fatigue is created equal. Interventions aimed at reducing pain interference should target specific fatigue symptoms of physical fatigue and vigor. Future research investigating the independent associations of fatigue subtypes on pain outcomes may help clarify the nature of the interrelationships between pain and fatigue.

Evaluation of Automated and Semi-Automated Scoring of Polysomnographic Recordings from a Clinical Trial Using Zolpidem in the Treatment of Insomnia

PubMed Central

Svetnik, Vladimir; Ma, Junshui; Soper, Keith A.; Doran, Scott; Renger, John J.; Deacon, Steve; Koblan, Ken S.

2007-01-01

Objective: To evaluate the performance of 2 automated systems, Morpheus and Somnolyzer24X7, with various levels of human review/editing, in scoring polysomnographic (PSG) recordings from a clinical trial using zolpidem in a model of transient insomnia. Methods: 164 all-night PSG recordings from 82 subjects collected during 2 nights of sleep, one under placebo and one under zolpidem (10 mg) treatment were used. For each recording, 6 different methods were used to provide sleep stage scores based on Rechtschaffen & Kales criteria: 1) full manual scoring, 2) automated scoring by Morpheus 3) automated scoring by Somnolyzer24X7, 4) automated scoring by Morpheus with full manual review, 5) automated scoring by Morpheus with partial manual review, 6) automated scoring by Somnolyzer24X7 with partial manual review. Ten traditional clinical efficacy measures of sleep initiation, maintenance, and architecture were calculated. Results: Pair-wise epoch-by-epoch agreements between fully automated and manual scores were in the range of intersite manual scoring agreements reported in the literature (70%-72%). Pair-wise epoch-by-epoch agreements between automated scores manually reviewed were higher (73%-76%). The direction and statistical significance of treatment effect sizes using traditional efficacy endpoints were essentially the same whichever method was used. As the degree of manual review increased, the magnitude of the effect size approached those estimated with fully manual scoring. Conclusion: Automated or semi-automated sleep PSG scoring offers valuable alternatives to costly, time consuming, and intrasite and intersite variable manual scoring, especially in large multicenter clinical trials. Reduction in scoring variability may also reduce the sample size of a clinical trial. Citation: Svetnik V; Ma J; Soper KA; Doran S; Renger JJ; Deacon S; Koblan KS. Evaluation of automated and semi-automated scoring of polysomnographic recordings from a clinical trial using zolpidem in the treatment of insomnia. SLEEP 2007;30(11):1562-1574. PMID:18041489

Sleep disturbances as predictors of prolonged exposure therapy effectiveness among veterans with PTSD.

PubMed

Sexton, Minden B; Avallone, Kimberly M; Smith, Erin R; Porter, Katherine E; Ashrafioun, Lisham; Todd Arnedt, J; Rauch, Sheila A M

2017-10-01

Sleep disturbances (SD) are pronounced in Veterans with posttraumatic stress disorder (PTSD). In clinical trials, SD have been shown to limit the effectiveness of evidence-based treatments for non-PTSD disorders. The purpose of this study was to investigate the relationships between pretreatment SD and the effectiveness of Prolonged Exposure (PE) therapy for Veterans with PTSD. Twenty-one Veterans completed the Pittsburgh Sleep Quality Index (PSQI) and the Clinician Administered PTSD Scale upon presenting to a PTSD specialty clinic. Veterans completed the PTSD Symptom Checklist-Civilian (PCL-C) at the initiation of PE and biweekly thereafter for the duration of treatment (96 total assessments). Correlations and hierarchical linear modeling were utilized to examine the potential impact of baseline sleep variables on the slope and magnitude of treatment outcomes. Higher PSQI total scores, and higher sleep latency and sleep medication use subscale scores were associated with higher PCL-C scores at baseline. Veterans evidenced significant reductions in PTSD symptoms during the course of the treatment study. Total PSQI scores and composites were not associated with reduced effectiveness of PE treatment or the slope of PTSD symptom changes. Sleep disturbances do not preclude Veterans from benefits derived from engagement in this gold standard PTSD intervention. Published by Elsevier B.V.

[Clinical observation of sleeping disorder in children with encephalopathy treated with acupuncture at head points and seed-pressure at ear points].

PubMed

Lai, Shugui; Wu, Qiang; Chen, Lanfang; Huang, Qianru; Zhang, Xuejun

2015-07-01

To compare the difference of clinical efficacy on sleeping disorder in the children with encephalopathy between the combined therapy of acupuncture at head points and seed-pressure at ear points and the simple acupuncture at head points. Thirty cases of sleeping disorder induced by encephalopathy werei randomized into an observation group and a control group, 15 cases in each one. In the observation group, the combined therapy of acupuncture at head points and seed-pressure at ear points was adopted. The head points in cluded Sishencong (EX-HN 1), Shenting (GV 24) and Benshen (GB 13). The ear points were the positive reactive sites in the cymba and cavum conchae. In the control group, acupuncture was applied simply to the acupoints on the head. The treatment was given once on every Tuesday and Friday a week separately, 30 min each time. Totally, 16 treatments were required. Children's sleeping habit questionnaire (CSHQ) was used to observe the sleep improvements and the efficacy in the patients of the two groups. In the observation group, the results of sleep resistance, sleep anxiety, night sleep wake, parasomnias, sleep dyspnea, daytime somnolence and the total score after treatment were all improved apparently as compared with those before treatment (all P<0. 05). In the control group, the results of night sleep wake, parasomnias, daytime somnolence and the total score after treatment were improved apparently than those before treatment (all P<0. 05). In the observation group, the results of sleep resistance, sleep dyspnea and the total score after treatment were better than those in the control group (all P<0. 05) and the scores of sleep anxiety and daytime somnolence in the control group were better than those in the observation group after treatment (both P<0. 05). The combined therapy of acupuncture at head points and seed-pressure at the positive reactive sites in the cymba and cavum conchae achieves the superior efficacy on sleep resistance and sleep dyspnea as compared with the simple acupuncture. The efficacy of simple acupuncture is more satisfactory on sleep anxiety and daytime somnolence.

Children with developmental dyslexia showed greater sleep disturbances than controls, including problems initiating and maintaining sleep.

PubMed

Carotenuto, M; Esposito, M; Cortese, S; Laino, D; Verrotti, A

2016-09-01

Although there have been frequent clinical reports about sleep disturbances in children with learning disabilities, no data are available about the prevalence of sleep disturbances in children with developmental dyslexia (DD). This study evaluated sleep disturbances in children with DD referred to a hospital clinic and compared their scores with healthy controls. We consecutively enrolled 147 children (66% male) aged 10.26 ± 2.63 years who were referred by clinical paediatricians to the Clinic for Child and Adolescent Neuropsychiatry at the Second University of Naples with DD and 766 children without DD (60% male) aged 10.49 ± 2.39 years recruited from schools in the same urban area. Sleep disturbances were assessed with the Sleep Disturbances Scale for Children (SDSC), which was filled out by the children's main carers. Compared with the controls, the children with DD showed significantly higher rates of above threshold scores on the total SDSC score (p < 0.001) and on the subscales for disorders in initiating and maintaining sleep (p < 0.001), sleep breathing disorders (p < 0.001) and disorders of arousal (p < 0.001). Sleep disorders were significantly more frequent in children with DD than in healthy controls. A possible relationship between dyslexia and sleep disorders may have relevant clinical implications. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Sleep disturbance linked to suicidal ideation in postural orthostatic tachycardia syndrome

PubMed Central

Pederson, Cathy Lynn; Blettner Brook, Jill

2017-01-01

Objective We investigated the prevalence of suicidal ideation in relationship with symptoms of sleep disruption in people with postural orthostatic tachycardia syndrome (POTS). Methods Online surveys (including the Pittsburgh Sleep Quality Index and the Suicide Behaviors Questionnaire – Revised) were completed by 705 POTS patients and 170 non-POTS controls. Results Poor sleep quality was reported in 98.4% of POTS patients with a calculated subjective sleep efficiency of 65.4%. The POTS group’s sleep efficiency was significantly lower (t[873]= −11.32; p<0.001) and sleep disturbances because of pain were significantly higher (t[873]=15.36; p<0.001) than controls. Chi-square testing showed a larger proportion of individuals at high-risk for suicide among POTS patients than controls (c2 [1, n=875]=55.6; p<0.001). Multiple linear regression analysis showed that sleep scores (β=0.23, p<0.001), age (β=–0.03, p<0.001), and illness with POTS (β=0.68, p=0.05) were significantly associated with suicide ideation scores (F[4, 870]=38.34, p<0.001). This model explained 15% of variance (R2=0.15) in suicidal ideation scores. Conclusion Patients with POTS may suffer from increased sleep disturbance and suicidal ideation compared with the general population. Treatment to improve sleep efficiency and sleep quality is an important step toward better quality of life for POTS patients. PMID:28442939

Accurate discrimination of the wake-sleep states of mice using non-invasive whole-body plethysmography.

PubMed

Bastianini, Stefano; Alvente, Sara; Berteotti, Chiara; Lo Martire, Viviana; Silvani, Alessandro; Swoap, Steven J; Valli, Alice; Zoccoli, Giovanna; Cohen, Gary

2017-01-31

A major limitation in the study of sleep breathing disorders in mouse models of pathology is the need to combine whole-body plethysmography (WBP) to measure respiration with electroencephalography/electromyography (EEG/EMG) to discriminate wake-sleep states. However, murine wake-sleep states may be discriminated from breathing and body movements registered by the WBP signal alone. Our goal was to compare the EEG/EMG-based and the WBP-based scoring of wake-sleep states of mice, and provide formal guidelines for the latter. EEG, EMG, blood pressure and WBP signals were simultaneously recorded from 20 mice. Wake-sleep states were scored based either on EEG/EMG or on WBP signals and sleep-dependent respiratory and cardiovascular estimates were calculated. We found that the overall agreement between the 2 methods was 90%, with a high Cohen's Kappa index (0.82). The inter-rater agreement between 2 experts and between 1 expert and 1 naïve sleep investigators gave similar results. Sleep-dependent respiratory and cardiovascular estimates did not depend on the scoring method. We show that non-invasive discrimination of the wake-sleep states of mice based on visual inspection of the WBP signal is accurate, reliable and reproducible. This work may set the stage for non-invasive high-throughput experiments evaluating sleep and breathing patterns on mouse models of pathophysiology.

Performance evaluation of an automated single-channel sleep–wake detection algorithm

PubMed Central

Kaplan, Richard F; Wang, Ying; Loparo, Kenneth A; Kelly, Monica R; Bootzin, Richard R

2014-01-01

Background A need exists, from both a clinical and a research standpoint, for objective sleep measurement systems that are both easy to use and can accurately assess sleep and wake. This study evaluates the output of an automated sleep–wake detection algorithm (Z-ALG) used in the Zmachine (a portable, single-channel, electroencephalographic [EEG] acquisition and analysis system) against laboratory polysomnography (PSG) using a consensus of expert visual scorers. Methods Overnight laboratory PSG studies from 99 subjects (52 females/47 males, 18–60 years, median age 32.7 years), including both normal sleepers and those with a variety of sleep disorders, were assessed. PSG data obtained from the differential mastoids (A1–A2) were assessed by Z-ALG, which determines sleep versus wake every 30 seconds using low-frequency, intermediate-frequency, and high-frequency and time domain EEG features. PSG data were independently scored by two to four certified PSG technologists, using standard Rechtschaffen and Kales guidelines, and these score files were combined on an epoch-by-epoch basis, using a majority voting rule, to generate a single score file per subject to compare against the Z-ALG output. Both epoch-by-epoch and standard sleep indices (eg, total sleep time, sleep efficiency, latency to persistent sleep, and wake after sleep onset) were compared between the Z-ALG output and the technologist consensus score files. Results Overall, the sensitivity and specificity for detecting sleep using the Z-ALG as compared to the technologist consensus are 95.5% and 92.5%, respectively, across all subjects, and the positive predictive value and the negative predictive value for detecting sleep are 98.0% and 84.2%, respectively. Overall κ agreement is 0.85 (approaching the level of agreement observed among sleep technologists). These results persist when the sleep disorder subgroups are analyzed separately. Conclusion This study demonstrates that the Z-ALG automated sleep–wake detection algorithm, using the single A1–A2 EEG channel, has a level of accuracy that is similar to PSG technologists in the scoring of sleep and wake, thereby making it suitable for a variety of in-home monitoring applications, such as in conjunction with the Zmachine system. PMID:25342922

Ayurvedic doshas as predictors of sleep quality.

PubMed

Telles, Shirley; Pathak, Shivangi; Kumar, Ankur; Mishra, Prabhat; Balkrishna, Acharya

2015-05-17

The 3 Ayurvedic constitutional types or Doshas--vata, pitta, and kapha--are responsible for homeostasis and health. The doshas determine various functions, including sleep. According to the Ayurvedic texts, sleep is caused by increased kapha and insomnia by increased vata or pitta, which may follow physical or mental exertion, or disease. The present study was carried out to determine whether this relationship could be found using contemporary standardized questionnaires. In this cross-sectional single-group study, 995 persons participated (646 males; group average age ±S.D., 49.1±15.2 years). Participants were attending a 1-week residential yoga program in northern India. Participants were assessed for dosha scores using a Tridosha questionnaire and the quality of sleep in the preceding week was self-rated using a sleep rating questionnaire. Multiple linear regression analyses were used to determine if each dosha acted as a predictor of quality and quantity of sleep. Vata scores significantly predicted the time taken to fall asleep [p<0.01], and the feeling of being rested in the morning [p<0.001]; with higher vata scores being associated with a longer time to fall asleep and a lesser feeling of being rested in the morning. Kapha scores significantly predicted day-time somnolence [p<0.05] and the duration of day-time naps in minutes [p<0.05], with higher kapha scores being associated with longer day-time naps. The results suggest that the doshas can influence the quality and quantity of sleep.

Scores on morningness-eveningness and sleep habits of Korean students, Japanese students, and Japanese workers.

PubMed

Park, Y M; Matsumoto, K; Seo, Y J; Shinkoda, H; Park, K P

1997-08-01

The Morningness-Eveningness Questionnaire and Life Habits Inventory were given to three groups of the same mean age: 533 Korean students, 468 Japanese students, and 311 Japanese workers. The distributions of scores on the questionnaire for these three groups are normal; however the Japanese students' distribution was slightly skewed towards the Evening type. The self-reported waking times and bedtimes for the three groups were late in the order of Morning, Intermediate, and Evening types. It is noteworthy, however, that the Korean students woke earlier than the Japanese students, and the workers always went to bed and woke earlier than the students. For the groups the variations in bedtime, waking time, and length of sleep were large, the sleep latency was long, and mood of the participants upon waking was bad in the order of the Morning. Intermediate, and Evening types. The scores of the Korean students were distributed more highly in the Morning type than were the Japanese students', but the students' sleep habits in both countries were quite similar. The subjects categorized as Evening types had more irregular sleep habits than those of the Morning type. In comparison with the student groups, Japanese workers of the same mean age had higher scores and slightly different sleep habits. The change in sleep habits could be seen as a result of the demands of employment, and the probable basis for difference in scores.

Quality of sleep and health-related quality of life in renal transplant recipients.

PubMed

Liu, Hong-Xia; Lin, Jun; Lin, Xiao-Hong; Wallace, Linda; Teng, Sha; Zhang, Shu-Ping; Hao, Yu-Fang

2015-01-01

The purpose of this study was to examine the sleep quality and health-related quality of life (HRQOL) in patients after renal transplantation and to explore the relationship between the quality of sleep and the HRQOL. Sleep disorders are still an important clinical problem after renal transplantation. Previous studies mainly focused on patients' sleep quality before kidney transplant. More studies are needed to document sleep quality after renal transplantation. A cross-sectional design was used in this study. A convenience sample of renal transplant recipients was recruited at an outpatient transplant clinic of a general hospital in Beijing, China. The Pittsburgh Sleep Quality Index (PSQI) was used to measure quality of sleep. The Medical Outcomes Study 36-item Short Form (MOS SF-36) was used to measure health-related quality of life. The average PSQI score of the 204 renal transplant recipients was 5.81±3.52, significantly lower than the norm. Fifty (24.5%) recipients were classified as having poor sleep quality (global PSQI > 7). The mean scores of renal transplant recipients for SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) were 47.57±6.71 and 48.26±9.66 respectively. Compared with residents in Sichuan province, recipients' scores for SF-36 dimensions were statistically lower except the dimension of mental health. SF-36 scores of poor sleepers (PSQI > 7) were significantly lower than the good sleepers (PSQI ≤ 7) in both the MCS and PCS. Significant differences exist between the groups in physical function, bodily pain, vitality, and mental health dimensions. Sleep quality and HRQOL of patients after renal transplantation were lower than the norm. Poor sleep is associated with lower HRQOL. Health professionals need to pay attention to sleep quality and HRQOL in renal transplant recipients and take appropriate measures to improve patients' sleep quality and HRQOL.

Water as a complex system: its role in ligand diffusion, general anesthesia, and sleep.

PubMed

Kier, Lemont B

2007-10-01

The work and inspiration of Robert Rosen is stated and expressed in personal tones. The concept of passages through water (H2O) near protein surfaces is reviewed in terms of its influence on ligand diffusion to an effector. This is offered as a target for interference by a non-specific general anesthetic agent. In view of the similarities between this anesthetic state and sleep, this mechanism is proposed to be operative for the sleep/wake states. Based on this mechanism and other factors, nitrogen (N2) is proposed as an exogenous sleep factor.

Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study.

PubMed

Lucassen, Eliane A; de Mutsert, Renée; le Cessie, Saskia; Appelman-Dijkstra, Natasha M; Rosendaal, Frits R; van Heemst, Diana; den Heijer, Martin; Biermasz, Nienke R

2017-01-01

Sleep deprivation has detrimental metabolic consequences. Osteopenia and sarcopenia usually occur together and increase risk of fractures and disease. Results from studies linking sleep parameters to osteopenia or sarcopenia are scarce and inconsistent. To examine the associations of sleep parameters with osteopenia and sarcopenia, considering the influence of sex and menopause. Cross-sectional analysis of 915 participants (45-65 years, 56% women, BMI 26 (range: 18-56) kg/m2) in the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study. Sleep duration, quality, and timing were assessed with the Pittsburgh Sleep Quality Index (PSQI); bone mineral density and relative appendicular muscle mass were measured by DXA scans. Linear and logistic regressions were performed to associate sleep parameters to bone mineral density, relative appendicular muscle mass, osteopenia (t-score between -1 and -2.5) and sarcopenia (1 SD below average muscle mass). After adjustment for confounding factors, one unit increase in PSQI score (OR and 95% CI, 1.09, 1.03-1.14), declined self-rated sleep quality (1.76, 1.03-3.01), sleep latency (1.18, 1.06-1.31), and a one hour later sleep timing (1.51, 1.08-2.11), but not sleep duration (1.05, 0.90-1.23), were associated with osteopenia. PSQI score (1.10, 1.02-1.19) was also associated with sarcopenia; OR's of sleep latency and later mid-sleep time with sarcopenia were 1.14 (0.99-1.31) and 1.54 (0.91-2.61), respectively. Associations were somewhat stronger in women and varied per menopausal status. These results suggest that decreased sleep quality and a later sleep timing are risk factors for osteopenia and sarcopenia in middle aged individuals.

Genetic and environmental influences on sleep quality in middle-aged men: a twin study.

PubMed

Genderson, Margo R; Rana, Brinda K; Panizzon, Matthew S; Grant, Michael D; Toomey, Rosemary; Jacobson, Kristen C; Xian, Hong; Cronin-Golomb, Alice; Franz, Carol E; Kremen, William S; Lyons, Michael J

2013-10-01

Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (mean age = 55.4 years; range 51-60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 [SD = 3.6; range 0-20]. Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep-a dichotomous measure based on the cut-off of global PSQI>5-was 31%, with no contribution of the common environment. Heritability of six of the seven PSQI component scores (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, and daytime dysfunction) ranged from 0.15 to 0.31, whereas no genetic influences contributed to the use of sleeping medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step towards examination of the genetic relationship between sleep and other facets of aging. © 2013 European Sleep Research Society.

Association between work role stressors and sleep quality.

PubMed

Iwasaki, S; Deguchi, Y; Inoue, K

2018-05-17

Work-related stressors are associated with low sleep quality. However, few studies have reported an association between role stressors and sleep quality. To elucidate the association between role stressors (including role conflict and ambiguity) and sleep quality. Cross-sectional study of daytime workers whose sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Work-related stressors, including role stressors, were assessed using the Generic Job Stress Questionnaire (GJSQ). The association between sleep quality and work-related stressors was investigated by logistic regression analysis. A total of 243 participants completed questionnaires were received (response rate 71%); 86 participants reported poor sleep quality, based on a global PSQI score ≥6. Multivariable logistic regression analysis revealed that higher role ambiguity was associated with global PSQI scores ≥6, and that role conflict was significantly associated with sleep problems, including sleep disturbance and daytime dysfunction. These results suggest that high role stress is associated with low sleep quality, and that this association should be considered an important determinant of the health of workers.

Sleep, Fatigue, and Problems with Cognitive Function in Adults Living with HIV

PubMed Central

Gay, Caryl L.; Lee, Kathryn A.

2015-01-01

Up to 50% of people living with HIV have some neurocognitive impairment. We examined associations of sleep and fatigue with self-reported cognitive problems in 268 adults living with HIV. Multivariate regression was used to examine associations between cognitive problems, self-reported sleep quality, actigraphy-measured total sleep time and wake after sleep onset, and fatigue severity. Poorer self-reported sleep quality (p < .001), short or long total sleep time (< 7 or > 8 vs. 7–8 hours, p = .015), and greater fatigue (p < .001) were associated with lower self-reported cognitive function scores after controlling for demographic and clinical characteristics. However, objective measure of wake after sleep onset was unrelated to self-reported cognitive function scores. Findings suggest that assessing and treating poor sleep and complaints about fatigue would be areas for intervention that could have a greater impact on improving cognition function than interventions that only target cognitive problems. PMID:26547298

Sleep Problems and Their Relationship to Maladaptive Behavior Severity in Psychiatrically Hospitalized Children with Autism Spectrum Disorder (ASD).

PubMed

Sannar, Elise M; Palka, Tamara; Beresford, Carol; Peura, Christine; Kaplan, Desmond; Verdi, Mary; Siegel, Matthew; Kaplan, Shir; Grados, Marco

2017-10-30

We examined the relationship between sleep duration and awakenings to Aberrant Behavior Checklist-Community (ABC-C) and Autism Diagnostic Observation Schedule (ADOS-2) scores in hospitalized youth with ASD and behavioral disturbance. Participants included 106 patients with a stay of at least 10 nights. Sleep in the hospital was recorded by staff observation. Higher scores on the ABC-C (irritability, stereotypy, and hyperactivity subscales) at admission were significantly associated with fewer minutes slept during the last five nights of hospitalization. There was no association between total awakenings and ABC-C scores or ADOS-2 comparison scores. Improved understanding of the relationship between sleep quality and maladaptive behavior in this challenging cohort of patients with ASD is vital to the definition and design of future effective interventions.

Sleep patterns, work, and strain among young students in hospitality and tourism.

PubMed

Brand, Serge; Hermann, Bernadette; Muheim, Flavio; Beck, Johannes; Holsboer-Trachsler, Edith

2008-07-01

Good and sufficient sleep is crucial for a good quality of life. We investigated the associations between sleep patterns, work, and strain among students of hospitality and tourism. 92 students completed psychological and sleep-related questionnaires, and a sleep/work log for one week. Sleeping hours were inversely correlated with working hours. Decreased sleep quality was associated with increased scores of strain, depression and anxiety. Participants with increased working hours were 3.2 times more likely to report heightened insomnia scores than those with lower weekly working hours. Working on weekends was associated with increased strain with family life and peers. In hospitality and tourism, the employees' 'personal costs' for a 24/7 service may be underestimated; unfavourable work schedules are linked with decreased sleep quality, symptoms of depression, anxiety, and with social problems.

Sleep Patterns in Adults with a Diagnosis of High-Functioning Autism Spectrum Disorder

PubMed Central

Baker, Emma K.; Richdale, Amanda L.

2015-01-01

Study Objectives: To examine sleep patterns and sleep problems and their relationship with daytime functioning in adults with a diagnosis of an autism spectrum disorder and no comorbid intellectual disability (high-functioning autism spectrum disorder [HFASD]) compared to neurotypical (NT) adults. Design: Cross-sectional. Setting: Home-based study. Participants: 36 adults with HFASD and 36 age-, intelligence quotient- and sex-matched NT adults. Measurements: Participants completed an online questionnaire battery including the Pittsburgh Sleep Quality Index (PSQI), a 14-d sleep wake diary and 14-d actigraphy data collection. Results: Adults with HFASD had significantly more general sleep disturbances and higher scores on the PSQI, longer sleep onset latencies (actigraphy), and poorer sleep efficiency (diary) and these results remained significant after accounting for the False Discovery Rate. Those adults with HFASD who did not have a comorbid diagnosis of anxiety/depression had significantly shorter total sleep time (diary and actigraphy) compared to NT adults. Compared to NT adults, the HFASD group self-reported significantly poorer refreshment scores upon waking in the morning and higher scores on the daytime dysfunction due to sleepiness subscale of the PSQI. Conclusions: These findings support the notion that problems related to sleep, in particular insomnia, continue into adulthood in individuals with high-functioning autism spectrum disorder. Citation: Baker EK, Richdale AL. Sleep patterns in adults with a diagnosis of high-functioning autism spectrum disorder. SLEEP 2015;38(11):1765–1774. PMID:26237770

Assessment of sleep in pediatric cancer patients.

PubMed

İnce, Dilek; Demirağ, Bengü; Karapınar, Tuba Hilkay; Oymak, Yeşim; Ay, Yılmaz; Kaygusuz, Arife; Töret, Ersin; Vergin, Canan

2017-01-01

İnce D, Demirağ B, Karapınar TH, Oymak Y, Ay Y, Kaygusuz A, Töret E, Vergin C. Assessment of sleep in pediatric cancer patients. Turk J Pediatr 2017; 59: 379-386. The purpose of the study is to describe sleep habits, assess the prevalence of sleep disturbances in pediatric cancer patients and healthy controls, and to compare sleep patterns, sleep problems. One hundred-thirty-five patients and 190 healthy controls were evaluated. Healthy children matched for age, sex, economic status, parental education and family structure constituted the control group. Sleep was evaluated by using the Children`s Sleep Habits Questionnaire (CSHQ). Sleep problems were detected in half of patients. There were no significant differences in total sleep score and subscale scores between patients and controls. Solely the wake-time was found significantly different between patients and controls. Although our results indicated that neither childhood cancer survivors nor patients with cancer during treatment period had more sleep problems than their healthy peers, sleep problems were not uncommon in whole study group. This study underlines the need to screen, assess and manage sleep problems in children with diagnosis of cancer.

Comparison of dexmedetomidine and propofol used for drug-induced sleep endoscopy in patients with obstructive sleep apnea syndrome.

PubMed

Kuyrukluyıldız, Ufuk; Binici, Orhan; Onk, Didem; Ayhan Celik, Serap; Torun, Mumtaz Taner; Unver, Edhem; Ozcicek, Adalet; Alagol, Aysin

2015-01-01

Backround: Surgical operations are alternative treatments in persons with Obstructive Sleep Apnea Syndrome who cannot tolerate continuous positive airway pressure therapy. Drug-Induced Sleep Endoscopy is a method with which somnolence is pharmacologically induced and collapse is evaluated through nasal endoscopy in patients with Obstructive Sleep Apnea Syndrome. We aimed to evaluate efficiency of dexmedetomidine or propofol used for sedation in patients undergoing drug-induced sleep endoscopy. A total of 40 patients aged between 18 and 65 years old in the ASA STATUS I-II group were included in the study. After premedicatıon wıth midazolam 0.05 mg/kg intravenously, patients were randomly divided into two groups and administered intravenous (iv) propofol with the loading dose of 0.7 mg/kg for 10 minutes, followed 0.5 mg/kg/h infusion (Group P); or dexmedetomidine with the loading dose of 1 mcg/kg for 10 minutes, followed by 0.3 mcg/kg/h infusion (Group D). Haemodynamic and respiratuary parameters, Bispectral index score, Ramsey sedation score, time to achieve sufficient sedation, surgeon's and patients' satisfaction, postoperative Aldrete score and side effects were recorded. Time to achieve sufficient sedation, Bispectral index scores at 5, 10 and 15th. minutes intraoperatively, first Aldrete score in the recovery room, SpO2 values and respiratory rates all over the surgical procedure and in the recovery room were found lower in Group P (P<0.05). Bispectral index scores, mean arterial pressure and heart rate in the recovery room were significantly lower in Group D (P<0.05). Dexmedetomidine may be preferred as a safer agent with respecting to respiratory function compared with propofol in obstructive sleep apnea patients who known to be susceptible to hypoxia and hypercarbia.

The Value of Sleep on Athletic Performance, Injury, and Recovery in the Young Athlete.

PubMed

Copenhaver, Elizabeth A; Diamond, Alex B

2017-03-01

Adequate sleep can easily become compromised as student-athletes try to balance the multiple demands on their time. People with sleep deficiency are at increased risk for acute illnesses, traumatic sports injuries, and development of chronic diseases. Training sessions or competitions during extremely early or late hours can interfere with circadian and homeostatic rhythms. Adjusting the training schedule to improve sleep duration has a significantly positive impact on several aspects of athletic performance. Pediatricians should increase the time dedicated in well-child visits for sleep hygiene and evaluate for sleep disorders at all ages. Parents, coaching staff, teachers, and pediatricians should advocate for improved education on the importance of sleep during adolescence. Future sleep research specific to adolescent athletes can further delineate requirements specific to sport, gender, training times, and surrounding competitions. [Pediatr Ann. 2017;46(3):e106-e111.]. Copyright 2017, SLACK Incorporated.

Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis

PubMed Central

Parker, Kathy P; Kutner, Nancy G; Bliwise, Donald L; Bailey, James L; Rye, David B

2003-01-01

Background Although considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients receiving hemodialysis (HD). However, in spite of the high prevalence of sleep complaints and disorders in this population, the relationship between these problems and quality of life remains to be well characterized. Thus, we studied a sample of stable HD patients to explore relationships between quality of life and both subjective and objective measures of nocturnal sleep and daytime sleepiness Methods The sample included forty-six HD patients, 24 men and 22 women, with a mean age of 51.6 (10.8) years. Subjects underwent one night of polysomnography followed the next morning by a Multiple Sleep Latency Test (MSLT), an objective measure of daytime sleepiness. Subjects also completed: 1) a brief nocturnal sleep questionnaire; 2) the Epworth Sleepiness Scale; and, 3) the Quality of Life Index (QLI, Dialysis Version) which provides an overall QLI score and four subscale scores for Health & Functioning (H&F), Social & Economic (S&E), Psychological & Spiritual (P&S), and Family (F). (The range of scores is 0 to 30 with higher scores indicating better quality of life.) Results The mean (standard deviation; SD) of the overall QLI was 22.8 (4.0). The mean (SD) of the four subscales were as follows: H&F – 21.1 (4.7); S&E – 22.0 (4.8); P&S – 24.5 (4.4); and, F – 26.8 (3.5). H&F (rs = -0.326, p = 0.013) and F (rs = -0.248, p = 0.048) subscale scores were negatively correlated with periodic limb movement index but not other polysomnographic measures. The H&F subscale score were positively correlated with nocturnal sleep latency (rs = 0.248, p = 0.048) while the H&F (rs = 0.278, p = 0.030) and total QLI (rs = 0.263, p = 0.038) scores were positively associated with MSLT scores. Both of these latter findings indicate that higher life quality is associated with lower sleepiness levels. ESS scores were unrelated to overall QLI scores or the subscale scores. Subjective reports of difficulty falling asleep and waking up too early were significantly correlated with all four subscale scores and overall QLI. Feeling rested in the morning was positively associated with S&E, P&S, and Total QLI scores. Conclusion Selected measures of both poor nocturnal sleep and increased daytime sleepiness are associated with decreased quality of life in HD patients, underscoring the importance of recognizing and treating these patients' sleep problems. PMID:14633280

Sleep Quality in Medical Students; the Impact of Over-Use of Mobile Cell-Phone and Social Networks.

PubMed

Mohammadbeigi, Abolfazl; Absari, Rozita; Valizadeh, Farzaneh; Saadati, Mohammadreza; Sharifimoghadam, Soroush; Ahmadi, Ali; Mokhtari, Mohsen; Ansari, Hossein

2016-01-01

Poor sleep quality is closely associated with lifestyle habits including use of mobile cell-phones.This study aimed to identify the relationship between sleep quality due to abuse in mobile cell-phones and engagement in social networks. This cross-sectional study was conducted on 380 undergraduate students selected by proportional stratified sampling in Qom, Iran in 2015. Data were collected by two standard questionnaire including Cell-Phone Over-Use Scale (COS) and Pittsburgh sleep quality questionnaire beside the status of usage in cell-phone social networks. T-test, chi-square, Pearson correlation coefficient and multivariate logistic regression were used in data analysis. The mean age of participants was 21.8 ±3.2 yr, 69.1% were female, and 11.7% were married. The mean of COS and sleep quality scores were 48.18 ±17.5 and 5.38 ±2.31, respectively. The prevalence of over-use of cell phone was 10.7% (CI 0.95; 8.8%, 12.6%) and the prevalence of poor sleep quality was 61.7% (CI 0.95; 57.1%, 66.3%). The mean of all aspects and total score of sleep quality showed a direct significant association by cell-phone addiction score except sleep duration score that was inversely. Based on multivariate analysis affected to cell-phone addiction, being male gender and studying in general physician level are the most important predictors of poor sleep quality. Over use of internet and social networks via smart phones is related to poor sleep quality and quantity. Predefined sport programs, educational, cultural, and interesting entertainment are the essential needs for all medical students. These interventions are more important especially for male students who have longer educational.

The effect of vitamin D supplement on the score and quality of sleep in 20-50 year-old people with sleep disorders compared with control group.

PubMed

Majid, Mohammad Shahi; Ahmad, Hosseini Seyed; Bizhan, Helli; Mohammad Hosein, Haghighi Zade; Mohammad, Abolfathi

2017-05-05

Sleep quality may be directly related with vitamin D serum level. Some studies found that people with lower vitamin D serum level experienced a lower sleep quality. Consequently, this study aimed at determining the effect of vitamin D supplements on sleep score and quality in 20-50 year-old people with sleep disorders. This double blind, clinical trial was performed in November 2015-February 2016 on 89 people with sleep disorders based on Petersburg's Sleep Index. Patient samples were divided randomly into two groups: intervention and placebo. At the end of the study, the data on 89 subjects (44 in intervention group and 45 people in placebo group) were examined. Intervention group received a 50 000-unit vitamin D supplement, one in a fortnight for 8 weeks. Meanwhile, placebo group received placebo. Before and after intervention, Petersburg's Sleep Quality Questionnaire, International Physical Activity Questionnaire, general information questionnaire, sun exposure, vitamin D serum level and 3-day food record questionnaire were assessed and recorded for all participants. To analyze data, t-test, chi square, ANCOVA, U-Mann-Whitney and Wilcoxon statistical tests were used. Based on the results of the present study, at the end of the study sleep score (PSQI) reduced significantly in vitamin recipients as compared with placebo recipients (P < 0.05). This difference was significant even after modifying confounding variables (P < 0.05). This study shows that the use of vitamin D supplement improves sleep quality, reduces sleep latency, raises sleep duration and improves subjective sleep quality in people of 20-50 year-old with sleep disorder.

The Impact of Sleep-Related Attentional Bias on Polysomnographically Measured Sleep in Primary Insomnia

PubMed Central

Spiegelhalder, Kai; Kyle, Simon D.; Feige, Bernd; Prem, Martin; Nissen, Christoph; Espie, Colin A.; Riemann, Dieter

2010-01-01

Study Objectives: Although sleep-related attentional bias has been shown to be evident in primary insomnia, the association with objectively measured sleep has not been investigated. In the present study, we used polysomnography (PSG) to fill this void. Design: Patients with primary insomnia and healthy controls were studied using a visual dot probe task (VDP) and an emotional Stroop task (EST). Additionally, polysomnography was carried out in a sub-sample (n = 22) of patients in the subsequent night. Setting: Department of Psychiatry and Psychotherapy of the University of Freiburg Medical Center. Participants: Thirty patients with primary insomnia and 30 matched healthy controls. Interventions: N/A Measurements and Results: Patients with primary insomnia demonstrated a significant sleep-related attentional bias compared to controls in the EST but no significant group effects were found for the VDP. VDP attentional bias scores were positively correlated with measures of sleep pressure, including total sleep time, sleep efficiency, and the amount of slow wave sleep. EST attentional bias scores were not correlated with subsequent PSG parameters, and we did not observe a correlation between attentional bias scores on the two tasks. Conclusions: The unexpected relationship between increased attentional bias, in the VDP task, and improved markers of sleep duration and continuity, may be indicative of a homeostatic craving for sleep in those with high attentional bias. This awaits further testing in multiple night studies, to shed light on the mechanisms and implications of sleep-related attentional bias. Citation: Spiegelhalder K; Kyle SD; Feige B; Prem M; Nissen C; Espie CA; Riemann D. The impact of sleep-related attentional bias on polysomnographically measured sleep in primary insomnia. SLEEP 2010;33(1):107-112. PMID:20120627

The protective effects of acute cardiovascular exercise on the interference of procedural memory.

PubMed

Jo, J S; Chen, J; Riechman, S; Roig, M; Wright, D L

2018-04-10

Numerous studies have reported a positive impact of acute exercise for procedural skill memory. Previous work has revealed this effect, but these findings are confounded by a potential contribution of a night of sleep to the reported exercise-mediated reduction in interference. Thus, it remains unclear if exposure to a brief bout of exercise can provide protection to a newly acquired motor memory. The primary objective of the present study was to examine if a single bout of moderate-intensity cardiovascular exercise after practice of a novel motor sequence reduces the susceptibility to retroactive interference. To address this shortcoming, 17 individuals in a control condition practiced a novel motor sequence that was followed by test after a 6-h wake-filled interval. A separate group of 17 individuals experienced practice with an interfering motor sequence 45 min after practice with the original sequence and were then administered test trials 6 h later. One additional group of 12 participants was exposed to an acute bout of exercise immediately after practice with the original motor sequence but prior to practice with the interfering motor sequence and the subsequent test. In comparison with the control condition, increased response times were revealed during the 6-h test for the individuals that were exposed to interference. The introduction of an acute bout of exercise between the practice of the two motor sequences produced a reduction in interference from practice with the second task at the time of test, however, this effect was not statistically significant. These data reinforce the hypothesis that while there may be a contribution from exercise to post-practice consolidation of procedural skills which is independent of sleep, sleep may interact with exercise to strengthen the effects of the latter on procedural memory.

Clinical Hypnosis in the Treatment of Post-Menopausal Hot Flashes: A Randomized Controlled Trial

PubMed Central

Elkins, Gary R.; Fisher, William I.; Johnson, Aimee K.; Carpenter, Janet S.; Keith, Timothy Z.

2012-01-01

Objective The use of estrogen and progesterone to manage vasomotor symptoms (i.e., hot flashes, night sweats) has declined due to concerns over their risks and there is an increased interest in alternate, effective, and low-risk treatments. This study reports the results of a randomized, controlled trial of clinical hypnosis in treating vasomotor symptoms among post-menopausal women. Methods Randomized, single-blind, controlled, clinical trial involving 187 post-menopausal women reporting a minimum of seven hot flashes per day, or at least 50 hot flashes a week at baseline between December 2008 and April 2012. Eligible participants received five weekly sessions of either clinical hypnosis or structured-attention control. Primary outcomes were hot flash frequency (subjectively and physiologically recorded) and hot flash score assessed by daily diaries at weeks 2–6, and 12. Secondary outcomes included measures of hot flash related daily interference, sleep quality and treatment satisfaction. Results In a modified intent-to-treat analysis that included all randomized participants that provided data, reported subjective hot flash frequency from baseline to week 12 showed a mean reduction of 55.82 hot flashes for the clinical hypnosis intervention (74.16%), versus a 12.89 hot flash reduction (17.13%) for the control (p<.001, 95% CI, 36.15–49.67). Mean reduction in hot flash score was 18.83 (80.32%) for the clinical hypnosis intervention as compared to 3.53 (15.38%) for the control (p<.001, 95% CI, 12.60–17.54). At 12 week follow-up, the mean reduction in physiologically monitored hot flashes was 5.92 (56.86%) for clinical hypnosis and .88 (9.94%) for the control (p<.001, 95% CI, 2.00–5.46). Secondary outcomes were significantly improved compared to control at 12 week follow-up in hot flash related interference (p<.001, 95% CI, 2.74–4.02), sleep quality (p<.001, 95% CI, 3.65–5.84), and treatment satisfaction (p<.001, 95% CI, 7.79–8.59). Conclusion Compared to a structured attention control, clinical hypnosis resulted in significant reductions in self-reported and physiologically measured hot flashes as well as hot flash scores in post-menopausal women. PMID:23435026

Relationships between menopausal and mood symptoms and EEG sleep measures in a multi-ethnic sample of middle-aged women: the SWAN sleep study.

PubMed

Kravitz, Howard M; Avery, Elizabeth; Sowers, Maryfran; Bromberger, Joyce T; Owens, Jane F; Matthews, Karen A; Hall, Martica; Zheng, Huiyong; Gold, Ellen B; Buysse, Daniel J

2011-09-01

Examine associations of vasomotor and mood symptoms with visually scored and computer-generated measures of EEG sleep. Cross-sectional analysis. Community-based in-home polysomnography (PSG). 343 African American, Caucasian, and Chinese women; ages 48-58 years; pre-, peri- or post-menopausal; participating in the Study of Women's Health Across the Nation Sleep Study (SWAN Sleep Study). None. Measures included PSG-assessed sleep duration, continuity, and architecture, delta sleep ratio (DSR) computed from automated counts of delta wave activity, daily diary-assessed vasomotor symptoms (VMS), questionnaires to collect mood (depression, anxiety) symptoms, medication, and lifestyle information, and menopausal status using bleeding criteria. Sleep outcomes were modeled using linear regression. Nocturnal VMS were associated with longer sleep time. Higher anxiety symptom scores were associated with longer sleep latency and lower sleep efficiency, but only in women reporting nocturnal VMS. Contrary to expectations, VMS and mood symptoms were unrelated to either DSR or REM latency. Vasomotor symptoms moderated associations of anxiety with EEG sleep measures of sleep latency and sleep efficiency and was associated with longer sleep duration in this multi-ethnic sample of midlife women.

Sleep and Circadian Rhythms in Spousally Bereaved Seniors

PubMed Central

Monk, Timothy H.; Begley, Amy E.; Billy, Bart D.; Fletcher, Mary E.; Germain, Anne; Mazumdar, Sati; Moul, Douglas E.; Shear, M. Katherine; Thompson, Wesley K.; Zarotney, Joette R.

2009-01-01

A laboratory study of sleep and circadian rhythms was undertaken in 28 spousally bereaved seniors (≥60 yrs) at least four months after the loss event. Measures taken included two nights of polysomnography (second night used), ∼36 h of continuous core body temperature monitoring, and four assessments of mood and alertness throughout a day. Preceding the laboratory study, two-week diaries were completed, allowing the assessment of lifestyle regularity using the 17-item Social Rhythm Metric (SRM) and the timing of sleep using the Pittsburgh Sleep Diary (PghSD). Also completed were questionnaires assessing level of grief (Texas Revised Inventory of Grief [TRIG] and Index of Complicated Grief [ICG]), subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI]), morningness-eveningness (Composite Scale of Morningness [CSM]), and clinical interview yielding a Hamilton Depression Rating Scale (HDRS) score. Grief was still present, as indicated by an average TRIG score of about 60. On average, the bereaved seniors habitually slept between ∼23:00 and ∼06:40 h, achieving ∼6 h of sleep with a sleep efficiency of ∼80%. They took about 30 min to fall asleep, and had their first REM episode after 75 min. About 20% of their sleep was in Stage REM, and about 3% in Stages 3 or 4 (slow wave sleep). Their mean PSQI score was 6.4. Their circadian temperature rhythms showed the usual classic shape with a trough at ∼01:00 h, a fairly steep rise through the morning hours, and a more gradual rise to mid-evening, with an amplitude of ∼0.8°C. In terms of lifestyle regularity, the mean regularity (SRM) score was 3.65 (slightly lower than that usually seen in seniors). Mood and alertness showed time-of-day variation with peak alertness in the late morning and peak mood in the afternoon. Correlations between outcome sleep/circadian variables and level of grief (TRIG score) were calculated; there was a slight trend for higher grief to be associated with less time spent asleep (p = 0.07) and reduced alertness at 20:00 h (p = 0.05). Depression score was not correlated with TRIG score (p > 0.20). When subjects were divided into groups by the nature of their late spouse's death (expected/after a long-term chronic illness [n = 18] versus unexpected [n = 10]), no differences emerged in any of the variables. In conclusion, when studied at least four months after the loss event, there appears to be some sleep disruption in spousally bereaved seniors. However, this disruption does not appear to be due to bereavement-related disruptions in the circadian system. PMID:18293151

Quality of Life, Psychological Burden, and Sleep Quality in Patients With Brain Metastasis Undergoing Whole Brain Radiation Therapy.

PubMed

Teke, Fatma; Bucaktepe, Pakize; Kıbrıslı, Erkan; Demir, Melike; Ibiloglu, Aslıhan; Inal, Ali

2016-10-01

Patients with brain metastasis (BM) usually suffer from poor quality of life (QOL), anxiety, depression, and sleep disorders in their reduced lifespan. The aim of this study was to evaluate QOL, anxiety, depression, and sleep characteristics in patients with BM at the beginning and end of whole brain radiation therapy (WBRT) and three months after treatment. Thirty-three patients undergoing WBRT for BM were featured in this study. The authors used the Karnofsky Performance Status (KPS) scale to measure performance status, the Hospital Anxiety and Depression Scale (HADS) to evaluate anxiety and depression, the SF-36® to evaluate health-related QOL, and the Pittsburgh Sleep Quality Index to evaluate sleep disorders at the start of WBRT, the end of WBRT, and three months after WBRT. Statistically significant improvements were noted in KPS scores from baseline evaluation to the end of WBRT and to three months after WBRT. No significant differences were observed in SF-36 and HADS scores between the start and the end of WBRT. Anxiety scores were negatively correlated with survival at the end of WBRT. Overall survival was better in those who reported better sleep. WBRT improves KPS scores and does not worsen sleep quality or mood, even in patients with poor performance status. When changes in mood and sleep quality are observed, survival and QOL may improve in patients with BM; consequently, nurses should be responsive to these changes.

Predictors of poor sleep quality among head and neck cancer patients.

PubMed

Shuman, Andrew G; Duffy, Sonia A; Ronis, David L; Garetz, Susan L; McLean, Scott A; Fowler, Karen E; Terrell, Jeffrey E

2010-06-01

The objective of this study was to determine the predictors of sleep quality among head and neck cancer patients 1 year after diagnosis. This was a prospective, multisite cohort study of head and neck cancer patients (N = 457). Patients were surveyed at baseline and 1 year after diagnosis. Chart audits were also conducted. The dependent variable was a self-assessed sleep score 1 year after diagnosis. The independent variables were a 1 year pain score, xerostomia, treatment received (radiation, chemotherapy, and/or surgery), presence of a feeding tube and/or tracheotomy, tumor site and stage, comorbidities, depression, smoking, problem drinking, age, and sex. Both baseline (67.1) and 1-year postdiagnosis (69.3) sleep scores were slightly lower than population means (72). Multivariate analyses showed that pain, xerostomia, depression, presence of a tracheotomy tube, comorbidities, and younger age were statistically significant predictors of poor sleep 1 year after diagnosis of head and neck cancer (P < .05). Smoking, problem drinking, and female sex were marginally significant (P < .09). Type of treatment (surgery, radiation and/or chemotherapy), primary tumor site, and cancer stage were not significantly associated with 1-year sleep scores. Many factors adversely affecting sleep in head and neck cancer patients are potentially modifiable and appear to contribute to decreased quality of life. Strategies to reduce pain, xerostomia, depression, smoking, and problem drinking may be warranted, not only for their own inherent value, but also for improvement of sleep and the enhancement of quality of life.

The relationship between mood and sleep in different female reproductive states

PubMed Central

2014-01-01

Background Sleep is disrupted in depressed subjects, but it also deteriorates with age and possibly with the transition to menopause. The nature of interaction between mood, sleep, age and reproductive state is not well-defined. The aim of this study was to evaluate the relationship between mood and sleep among healthy women in different reproductive states. Methods We analyzed data from 11 younger (20–26 years), 21 perimenopausal (43–51 years) and 29 postmenopausal (58–71 years) healthy women who participated in a study on menopause, sleep and cognition. The 21-item Beck Depression Inventory (BDI) was administered to assess mood. Subjective sleep quality was assessed with the Basic Nordic Sleep Questionnaire (BNSQ). Objective sleep was measured with all-night polysomnography (PSG) recordings. Perimenopausal and younger women were examined during the first days of their menstrual cycle at the follicular phase. Results Among younger women, less arousals associated with higher BDI total scores (p = 0.026), and higher SWS percentages with more dissatisfaction (p = 0.001) and depressive-somatic symptoms (p = 0.025), but with less depressive-emotional symptoms (p = 0.001). In specific, less awakenings either from REM sleep or SWS, respectively, associated with more punishment (p = 0.005; p = 0.036), more dissatisfaction (p < 0.001; p = 0.001) and more depressive-somatic symptoms (p = 0.001; p = 0.009), but with less depressive-emotional symptoms (p = 0.002; p = 0.003). In perimenopausal women, higher BNSQ insomnia scores (p = 0.005), lower sleep efficiencies (p = 0.022) and shorter total sleep times (p = 0.024) associated with higher BDI scores, longer sleep latencies with more depressive-somatic symptoms (p = 0.032) and longer REM latencies with more dissatisfaction (p = 0.017). In postmenopausal women, higher REM percentages associated with higher BDI total scores (p = 0.019) and more depressive-somatic symptoms (p = 0.005), and longer SWS latencies with more depressive-somatic symptoms (p = 0.030). Conclusions Depressive symptoms measured with the total BDI scores associated with sleep impairment in both perimenopausal and postmenopausal women. In younger women, specific BDI factors revealed minor associations, suggesting that the type of sleep impairment can vary in relation to different depressive features. Our data indicate that associations between sleep and depressed mood may change in conjunction with hormonal milestones. PMID:24935559

Empiric auto-titrating CPAP in people with suspected obstructive sleep apnea.

PubMed

Drummond, Fitzgerald; Doelken, Peter; Ahmed, Qanta A; Gilbert, Gregory E; Strange, Charlie; Herpel, Laura; Frye, Michael D

2010-04-15

Efficient diagnosis and treatment of obstructive sleep apnea (OSA) can be difficult because of time delays imposed by clinic visits and serial overnight polysomnography. In some cases, it may be desirable to initiate treatment for suspected OSA prior to polysomnography. Our objective was to compare the improvement of daytime sleepiness and sleep-related quality of life of patients with high clinical likelihood of having OSA who were randomly assigned to receive empiric auto-titrating continuous positive airway pressure (CPAP) while awaiting polysomnogram versus current usual care. Serial patients referred for overnight polysomnography who had high clinical likelihood of having OSA were randomly assigned to usual care or immediate initiation of auto-titrating CPAP. Epworth Sleepiness Scale (ESS) scores and the Functional Outcomes of Sleep Questionnaire (FOSQ) scores were obtained at baseline, 1 month after randomization, and again after initiation of fixed CPAP in control subjects and after the sleep study in auto-CPAP patients. One hundred nine patients were randomized. Baseline demographics, daytime sleepiness, and sleep-related quality of life scores were similar between groups. One-month ESS and FOSQ scores were improved in the group empirically treated with auto-titrating CPAP. ESS scores improved in the first month by a mean of -3.2 (confidence interval -1.6 to -4.8, p < 0.001) and FOSQ scores improved by a mean of 1.5, (confidence interval 0.5 to 2.7, p = 0.02), whereas scores in the usual-care group did not change (p = NS). Following therapy directed by overnight polysomnography in the control group, there were no differences in ESS or FOSQ between the groups. No adverse events were observed. Empiric auto-CPAP resulted in symptomatic improvement of daytime sleepiness and sleep-related quality of life in a cohort of patients awaiting polysomnography who had a high pretest probability of having OSA. Additional studies are needed to evaluate the applicability of empiric treatment to other populations.

Effect of Tai Ji Quan training on self-reported sleep quality in elderly Chinese women with knee osteoarthritis: a randomized controlled trail.

PubMed

Lü, Jiaojiao; Huang, Lingyan; Wu, Xie; Fu, Weijie; Liu, Yu

2017-05-01

The purpose of this study was to explore the effects of a 24-week Tai Ji Quan training program on sleep quality, quality of life, and physical performance among elderly Chinese women with knee osteoarthritis (OA). A 24-week randomized, controlled trial of 46 elderly women with knee OA. Participants were randomly assigned to either a Tai Ji Quan group (n = 23) or a control group (n = 23). Participants in the Tai Ji Quan group completed training sessions three times per week, while those in the control group had bi-weekly educational classes. The primary outcome was total score of the Pittsburgh Sleep Quality of Index (PSQI). Secondary outcomes were: seven subscales of the PSQI; sleep latency; total sleep time; sleep efficiency; physical component summary (PCS) and mental component summary (MCS) of the 36-item Short Form Health Survey (SF-36); Berg Balance Scale (BBS); and Timed Up and Go (TUG). Compared with the control group, participants in the Tai Ji Quan group had significantly improved primary outcome (global PSQI score, p = 0.006) and secondary outcomes, including three PSQI sub-scores (sleep latency, p = 0.031; sleep duration, p = 0.043; daytime dysfunction, p = 0.007), total sleep time (p = 0.033), and SF-36 PCS (p = 0.006). The Tai Ji Quan group also had significant improvements compared with baseline in three PSQI sub-scores (sleep latency, p = 0.031; habitual sleep efficiency, p = 0.049; sleep disturbance, p = 0.016), sleep latency (p = 0.003), BBS (p = 0.001), and TUG (p = 0.006). Tai Ji Quan training is an effective treatment approach to improve sleep quality and quality of life in elderly Chinese women with knee OA. Chinese Clinical Trial Registry (June 16, 2013): ChiCTR-TRC-13003264. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of the central sleep apnea in asymptomatic children with Chiari 1 malformation: an open question.

PubMed

Zaffanello, Marco; Sala, Francesco; Sacchetto, Luca; Gasperi, Emma; Piacentini, Giorgio

2017-05-01

Type I is the most common Chiari malformation in children. In this condition, the lower part of the cerebellum, but not the brain stem, extends into the foramen magnum at the base of the skull leading to intermittent brain hypertension. In symptomatic children, central sleep apneas are shown in polysomnography evaluation. A central apnea index of 1/h or more is considered abnormal, but >5/h is clearly considered pathological. Therefore, central sleep apnea evaluation in pediatric age may show great age-related variability. We present three patients who were assessed by polysomnography with two different scores for central sleep apneas published in the literature: the method by Scholle (2011) and the American Academy of Sleep Medicine scoring system (2012). We speculated that the Scholle scoring system can be more helpful in assessing children with asymptomatic Chiari 1 malformation for a closer follow-up. More studies are needed.

Ayurvedic Doshas as Predictors of Sleep Quality

PubMed Central

Telles, Shirley; Pathak, Shivangi; Kumar, Ankur; Mishra, Prabhat; Balkrishna, Acharya

2015-01-01

Background The 3 Ayurvedic constitutional types or Doshas – vata, pitta, and kapha – are responsible for homeostasis and health. The doshas determine various functions, including sleep. According to the Ayurvedic texts, sleep is caused by increased kapha and insomnia by increased vata or pitta, which may follow physical or mental exertion, or disease. The present study was carried out to determine whether this relationship could be found using contemporary standardized questionnaires. Material/Methods In this cross-sectional single-group study, 995 persons participated (646 males; group average age ±S.D., 49.1±15.2 years). Participants were attending a 1-week residential yoga program in northern India. Participants were assessed for dosha scores using a Tridosha questionnaire and the quality of sleep in the preceding week was self-rated using a sleep rating questionnaire. Results Multiple linear regression analyses were used to determine if each dosha acted as a predictor of quality and quantity of sleep. Vata scores significantly predicted the time taken to fall asleep [p<0.01], and the feeling of being rested in the morning [p<0.001]; with higher vata scores being associated with a longer time to fall asleep and a lesser feeling of being rested in the morning. Kapha scores significantly predicted day-time somnolence [p<0.05] and the duration of day-time naps in minutes [p<0.05], with higher kapha scores being associated with longer day-time naps. Conclusions The results suggest that the doshas can influence the quality and quantity of sleep. PMID:25982247

Impact of medications on cognitive function in obstructive sleep apnea syndrome.

PubMed

Lal, Chitra; Siddiqi, Nasar; Kumbhare, Suchit; Strange, Charlie

2015-09-01

Medications can impact cognitive function. Obstructive sleep apnea syndrome (OSAS) is associated with cognitive impairment. There is currently a paucity of data evaluating the impact of medications on sleep architecture and cognition in untreated OSAS. Our objective was to evaluate the impact of obstructive sleep apnea syndrome (OSAS) and medications on cognition by a screening questionnaire called the Mail-In Cognitive Function Screening Instrument (MCFSI). We conducted a retrospective chart review on consecutive adults (age > 18 years) with OSAS seen in Medical University of South Carolina Sleep Clinic between January 1, 2012 and May 8, 2013, for whom the Mail-In Cognitive Function Screening Instrument (MCFSI) score was available and who were not on continuous positive airway pressure (CPAP). The correlation between different medications, sleep study variables, and MCFSI scores was studied. Univariate analysis revealed that many medications had significant correlations with MCFSI scores, including antidepressants (p = 0.05), antipsychotics (p = 0.01), anxiolytics (p = 0.005), statins (p = 0.077) and narcotics (p = 0.006). The mean percentage of rapid eye movement (REM) sleep (p = 0.04) and Epworth Sleepiness Scale (p = 0.01) were also significantly correlated with MCFSI scores. Multivariate analysis revealed that Epworth Sleepiness Scale and use of antipsychotics, narcotics, and anxiolytics correlated with higher MCFSI scores (worse cognition) and conversely that statin use was associated with improved cognition. Medications have a significant impact on cognitive function in OSAS. Thus, medication use should be considered in future studies of cognitive function in patients with OSAS.

Automatic sleep classification using a data-driven topic model reveals latent sleep states.

PubMed

Koch, Henriette; Christensen, Julie A E; Frandsen, Rune; Zoetmulder, Marielle; Arvastson, Lars; Christensen, Soren R; Jennum, Poul; Sorensen, Helge B D

2014-09-30

The golden standard for sleep classification uses manual scoring of polysomnography despite points of criticism such as oversimplification, low inter-rater reliability and the standard being designed on young and healthy subjects. To meet the criticism and reveal the latent sleep states, this study developed a general and automatic sleep classifier using a data-driven approach. Spectral EEG and EOG measures and eye correlation in 1s windows were calculated and each sleep epoch was expressed as a mixture of probabilities of latent sleep states by using the topic model Latent Dirichlet Allocation. Model application was tested on control subjects and patients with periodic leg movements (PLM) representing a non-neurodegenerative group, and patients with idiopathic REM sleep behavior disorder (iRBD) and Parkinson's Disease (PD) representing a neurodegenerative group. The model was optimized using 50 subjects and validated on 76 subjects. The optimized sleep model used six topics, and the topic probabilities changed smoothly during transitions. According to the manual scorings, the model scored an overall subject-specific accuracy of 68.3 ± 7.44 (% μ ± σ) and group specific accuracies of 69.0 ± 4.62 (control), 70.1 ± 5.10 (PLM), 67.2 ± 8.30 (iRBD) and 67.7 ± 9.07 (PD). Statistics of the latent sleep state content showed accordances to the sleep stages defined in the golden standard. However, this study indicates that sleep contains six diverse latent sleep states and that state transitions are continuous processes. The model is generally applicable and may contribute to the research in neurodegenerative diseases and sleep disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

Genetic and Environmental Influences on Sleep Quality in Middle-Aged Men: A Twin Study

PubMed Central

Genderson, Margo R.; Rana, Brinda K.; Panizzon, Matthew S.; Grant, Michael D.; Toomey, Rosemary; Jacobson, Kristen C.; Xian, Hong; Cronin-Golomb, Alice; Franz, Carol E.; Kremen, William S.; Lyons, Michael J.

2013-01-01

SUMMARY Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (VETSA)(mean age=55.4 years; range 51–60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 (SD=3.6; range 0–20). Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep—a dichotomous measure based on the cut-off of global PSQI>5--was 31% with no contribution of the common environment. Heritability of six of the seven PSQI component scores (Subjective Sleep Quality, Sleep Latency, Sleep Duration, Habitual Sleep Efficiency, Sleep Disturbances, and Daytime Dysfunction) ranged from .15 to .31, where as no genetic influences contributed to Use of Sleeping Medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step toward examination of the genetic relationship between sleep and other facets of aging. PMID:23509903

Rotigotine transdermal system as add-on to oral dopamine agonist in advanced Parkinson's disease: an open-label study.

PubMed

Kim, Jong-Min; Chung, Sun Ju; Kim, Jae Woo; Jeon, Beom Seok; Singh, Pritibha; Thierfelder, Stephan; Ikeda, Junji; Bauer, Lars

2015-02-28

Achieving optimal symptom control with minimal side effects is a major goal in clinical practice. Dual-agent dopamine receptor agonist (DA) therapy in Parkinson's disease (PD) may represent a promising approach to treatment, as the combination of different pharmacokinetic/pharmacological profiles may result in a lesser need for high dosages and, accordingly, may be well tolerated. The objective of the current study was to investigate safety and efficacy of rotigotine transdermal system as add-on to oral DA in patients with advanced PD inadequately controlled with levodopa and low-dose oral DA. PD0015 was an open-label, multinational study in patients with advanced-PD and sleep disturbance or early-morning motor impairment. Patients were titrated to optimal dose rotigotine (≤8 mg/24 h) over 1-4 weeks and maintained for 4-7 weeks (8-week treatment). Dosage of levodopa and oral DA (pramipexole ≤1.5 mg/day, ropinirole ≤6.0 mg/day) was stable. Primary variable was Clinical Global Impressions (CGI) item 4: side effects, assessing safety. Other variables included adverse events (AEs), Patient Global Impressions of Change (PGIC), Unified Parkinson's Disease Rating Scale (UPDRS) II and III, Parkinson's Disease Sleep Scale (PDSS-2), Pittsburgh Sleep Quality Index (PSQI), and "off" time. Of 90 patients who received rotigotine, 79 (88%) completed the study; 5 (6%) withdrew due to AEs. Most (83/89; 93%) had a CGI-4 score <3 indicating that rotigotine add-on therapy did not interfere with functioning; 6 (7%) experienced drug-related AEs that interfered with functioning (score ≥3). AEs occurring in ≥5% were application site pruritus (13%), dizziness (10%), orthostatic hypotension (10%), nausea (8%), dyskinesia (8%), and nasopharyngitis (6%). Numerical improvements in motor function (UPDRS III), activities of daily living (UPDRS II), sleep disturbances (PDSS-2, PSQI), and reduction in "off" time were observed. The majority (71/88; 81%) improved on PGIC. Addition of rotigotine transdermal system to low-dose oral DA in patients with advanced-PD was feasible and may be associated with clinical benefit. ClinicalTrials.gov identifier NCT01723904 . Trial registration date: November 6, 2012.

Effect of Escitalopram on Hot Flash Interference: A Randomized, Controlled Trial

PubMed Central

Carpenter, Janet S.; Guthrie, Katherine A.; Larson, Joseph C.; Freeman, Ellen W.; Joffe, Hadine; Reed, Susan D.; Ensrud, Kristine E.; LaCroix, Andrea Z.

2012-01-01

Objectives To estimate the effect of escitalopram 10–20 mg/day versus placebo for reducing hot flash interference in daily life and understand correlates and predictors of reductions in hot flash interference, a key measure of quality of life. Design Multi-site, randomized, double-blind, placebo-controlled clinical trial. Patients 205 midlife women (46% African-American) who met criteria participated. Setting MsFLASH clinical sites in Boston, Indianapolis, Oakland, and Philadelphia. Intervention After baseline, women were randomized to 1 pill of escitalopram 10 mg/day (n=104) or placebo (n=101) with follow-up at 4- and 8-weeks. At week 4, those not achieving 50% fewer hot flashes were increased to 2 pills daily (20 mg/day or 2 placebo pills). Main outcome measures The Hot Flash Related Daily Interference Scale; Correlates were variables from hot flash diaries; Predictors were baseline demographics, clinical variables, depression, anxiety, sleep quality, and hot flashes. Results Compared to placebo, escitalopram significantly reduced hot flash interference by 6.0 points at week 4 and 3.4 points at week 8 more than placebo (p=0.012). Reductions in hot flash interference correlated with changes in hot flash diary variables. However, baseline variables did not significantly predict reductions in hot flash interference. Conclusions Escitalopram 10–20mg/day for 8 weeks improves women’s quality of life and this benefit did not vary by demographic, clinical, mood, sleep, or hot flash variables. PMID:22480818

Comparison of Motor Activity and Sleep in Patients with Complex Partial Seizures on Levetiracetam Treatment and a Group of Healthy Subjects

PubMed Central

Yilmaz, Hikmet

2007-01-01

Purpose: Levetiracetam-treated patients commonly report daytime drowsiness, fatique, asthenia and decreasing of motor activity. However the origin of these reported side effects are still debated, we aimed to clarify effect of levetiracetam on sleep. Therefore this prospective study was conducted to evaluate the effects of levetiracetam on motor activity, amount and continuity of sleep and napping. Methods: Various tests were performed on twenty two patients treated with levetiracetam (10 monotherapy, 12 add-on therapy) at least three days before the initiation of treatment, and consecutively for five to eight days at the third week of treatment. These tests included sleep logs, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Modified Maintenance of Wakefulness Test and actimetric measurements. In order to evaluate the sleep behavior of these patients the following sleep parameters were estimated: bedtime, wake-up time, sleep-onset time, sleep-offset time, sleep latency, total sleep time, wake time after sleep onset, fragmentation index, total activity score, nap episodes, total nap duration and sleep efficiency. Twenty members of staff from our hospital (Doctor, nurse, secretary, civil servant etc.) were evaluated as control subjects in the study. Results: After three-week treatment with levetiracetam (in particular with add-on therapy), Epworth Sleepiness Scale scores, napping episodes and total nap durations increased and sleep latencies decreased. While durations of Modified Maintenance of Wakefulness Test and total activity scores decreased. However the total sleep time and the sleep efficiency did not show any difference from the pre-treatment values. Conclusions: Our results suggest that levetiracetam leads to drowsiness by decreasing the daily motor activity and increasing the naps; however this agent does not have any major effects on total sleep time and sleep efficiency during night. Actimetric analyses give information about continuity of sleep and sleep/wake states however does not give satisfactory information about architecture of sleep. In order to determine the effects of levetiracetam on the sleep architecture we need similiar protocol studies by full night polysomnography. PMID:17726245

Sleep Patterns, Sleep Disturbances, and Associated Factors Among Chinese Urban Kindergarten Children.

PubMed

Liu, Zhijun; Wang, Guanghai; Geng, Li; Luo, Junna; Li, Ningxiu; Owens, Judith

2016-01-01

This study aimed to characterize sleep patterns and disturbances among Chinese urban kindergarten children and examine potentially associated factors. Caregivers of 513 children (47.96% male) aged 3-6 years (mean age = 4.46, SD = 0.9) completed the Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ). Almost 80% (78.8%) of the children scored above the original CSHQ cutoff point for global sleep disturbance. Regression analysis indicated that child's age, and the presence of emotional problems, hyperactivity and peer problems, cosleeping, and interparental inconsistency of attitudes toward child rearing accounted for significant variance in the CSHQ total score (R(2) = 22%). These findings indicate that there is an apparently high prevalence of sleep disturbances in Chinese urban kindergarten children; and sleep disturbances are associated with both child-related and parenting practice variables.

Subjective sleep disturbance in Chinese adults with epilepsy: Associations with affective symptoms.

PubMed

Shen, Yeru; Zhang, Mengmeng; Wang, Yu; Wang, Lanlan; Xu, Xiangjun; Xiao, Gairong; Chen, Jing; Zhang, Ting; Zhou, Nong

2017-09-01

As well as being a very common neurological disease worldwide, epilepsy significantly impairs patients' emotional, behavioral, and cognitive functioning. Sleep disturbances are the most frequent complaint in patients with epilepsy. The present study assesses the impact of a range of affective symptoms on subjective sleep quality and sleep disturbances in Chinese adults with epilepsy. Adults with epilepsy who visited our epilepsy clinic from July 2015 to March 2016 were enrolled in our study. Both patients and healthy controls completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Mini-mental State Examination (MMSE). Subjective sleep quality and sleep disturbances were examined with regard to self-reported symptoms of depression and anxiety, seizure-related factors, and demographic factors. The PSQI scores and ISI scores of patients were significantly higher (indicating lower quality sleep and more serious insomnia) than those of the control group. Symptoms associated with depression and anxiety were independently related to impaired subjective sleep quality and insomnia. Affective symptoms explained more of the variance in PSQI scores and ISI scores than did seizure-related or demographic variables. In addition, these variables also seemed to be less powerful contributing factors to subjective sleep quality and insomnia than affective symptoms, several seizure-related factors, such as seizure control, partial seizures and duration of epilepsy, which are also significantly associated with subjective sleep quality and insomnia. In addition, use of lamotrigine (LTG) was also associated with insomnia and use of clonazepam (CZP) and phenobarbital (PB) with daytime sleepiness in patients with epilepsy. Chinese adults with epilepsy have poorer self-reported subjective sleep quality and a higher prevalence of insomnia than the control group. Depressive- and anxiety-related symptoms independently exert an adverse effect on the subjective sleep quality and insomnia of patients. In addition, seizure control, partial seizures, and the duration of epilepsy affect the quality of sleep and insomnia in patients, but seem less powerful predictors of sleep quality and insomnia than affective symptoms. Early identification and treatment of affective symptoms is of great importance in improving the sleep quality and insomnia of patients with epilepsy. Copyright © 2017 Elsevier B.V. All rights reserved.

Nocturia × disturbed sleep: a review.

PubMed

Furtado, Daniele; Hachul, Helena; Andersen, Monica L; Castro, Rodrigo A; Girão, Manoel B; Tufik, Sergio

2012-03-01

In this article, we provide a concise review of the literature on nocturia and its interference with sleep and, consequently, on quality of life. There are few studies addressing the possible influences of nocturia on sleep disruption. Nocturia is a potential contributor to sleep disorders because affected individuals experience nonrestorative sleep due to frequent interruptions. We also attempted to determine whether individuals with nocturia wake to urinate or, alternately, urinate because they are awake. This review attempts to outline this specific association by examining the possible interactions with other medical conditions and the pathophysiology and prevalence. Most studies have observed a higher prevalence among women; however, the impact on quality of life is higher in men. Nocturia is not necessarily associated with natural aging. The exploration of these topics provides information to clarify the implications of nocturia on sleep, sleep disruption, and other related consequences. Additional evidence is still required to address the question of whether nocturia leads to disordered sleep or whether disordered sleep leads to nocturia.

Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

NASA Technical Reports Server (NTRS)

Evans-Flynn, Erin; Gregory, Kevin; Arsintescu, Lucia; Whitmire, Alexandra; Leveton, Lauren B.; Vessey, William

2015-01-01

Sleep loss, circadian desynchronization, and work overload occur to some extent for ground and flight crews, prior to and during spaceflight missions. Ground evidence indicates that such risk factors may lead to performance decrements and adverse health outcomes, which could potentially compromise mission objectives. Efforts are needed to identify the environmental and mission conditions that interfere with sleep and circadian alignment, as well as individual differences in vulnerability and resiliency to sleep loss and circadian desynchronization. Specifically, this report highlights a collection of new evidence to better characterize the risk and reveals new gaps in this risk.

One Night of Sleep Deprivation Affects Reaction Time, but Not Interference or Facilitation in a Stroop Task

ERIC Educational Resources Information Center

Cain, Sean W.; Silva, Edward J.; Chang, Anne-Marie; Ronda, Joseph M.; Duffy, Jeanne F.

2011-01-01

The Stroop color-naming task is one of the most widely studied tasks involving the inhibition of a prepotent response, regarded as an executive function. Several studies have examined performance on versions of the Stroop task under conditions of acute sleep deprivation. Though these studies revealed effects on Stroop performance, the results…

Unsupervised online classifier in sleep scoring for sleep deprivation studies.

PubMed

Libourel, Paul-Antoine; Corneyllie, Alexandra; Luppi, Pierre-Hervé; Chouvet, Guy; Gervasoni, Damien

2015-05-01

This study was designed to evaluate an unsupervised adaptive algorithm for real-time detection of sleep and wake states in rodents. We designed a Bayesian classifier that automatically extracts electroencephalogram (EEG) and electromyogram (EMG) features and categorizes non-overlapping 5-s epochs into one of the three major sleep and wake states without any human supervision. This sleep-scoring algorithm is coupled online with a new device to perform selective paradoxical sleep deprivation (PSD). Controlled laboratory settings for chronic polygraphic sleep recordings and selective PSD. Ten adult Sprague-Dawley rats instrumented for chronic polysomnographic recordings. The performance of the algorithm is evaluated by comparison with the score obtained by a human expert reader. Online detection of PS is then validated with a PSD protocol with duration of 72 hours. Our algorithm gave a high concordance with human scoring with an average κ coefficient > 70%. Notably, the specificity to detect PS reached 92%. Selective PSD using real-time detection of PS strongly reduced PS amounts, leaving only brief PS bouts necessary for the detection of PS in EEG and EMG signals (4.7 ± 0.7% over 72 h, versus 8.9 ± 0.5% in baseline), and was followed by a significant PS rebound (23.3 ± 3.3% over 150 minutes). Our fully unsupervised data-driven algorithm overcomes some limitations of the other automated methods such as the selection of representative descriptors or threshold settings. When used online and coupled with our sleep deprivation device, it represents a better option for selective PSD than other methods like the tedious gentle handling or the platform method. © 2015 Associated Professional Sleep Societies, LLC.

Improvement of sleep architecture parameters in cirrhotic patients with recurrent hepatic encephalopathy with the use of rifaximin.

PubMed

Bruyneel, Marie; Sersté, Thomas; Libert, Walter; van den Broecke, Sandra; Ameye, Lieveke; Dachy, Bernard; Mulkay, Jean-Pierre; Moreno, Christophe; Gustot, Thierry

2017-03-01

Sleep disorders are frequently reported in patients with cirrhosis and hepatic encephalopathy (HE). This study assessed the effect of rifaximin on sleep architecture parameters in patients with recurrent HE. This sequential, prospective, and exploratory study involved all patients with cirrhosis and recurrent HE admitted between June 2014 and September 2015. HE was assessed according to the West-Haven Classification. Patients underwent 24-h polysomnography (PSG) and 7-day actigraphy. Rapid eye movement (REM) sleep was considered to be an indicator of good sleep quality. Patients completed questionnaires assessing the quality of sleep and sleepiness. After a 28-day course of rifaximin, the same assessment was repeated. Fifteen patients were included (nine men, mean age: 57±11 years). Child-Pugh scores ranged from B7 to C15. Before rifaximin, the mean HE score was 2.7±0.7. Data from PSG analysis indicated long total sleep time (TST): 571±288 min, and limited REM sleep: 2.5% TST (0-19). Seven-day actigraphy showed an impaired number of steps: 1690/24 h (176-6945). Questionnaires indicated that patients experienced impaired sleep quality and excessive daytime sleepiness. After rifaximin, HE scores decreased to 1.7±0.6 (P<0.001). REM sleep increased to 8.5% TST (0-25) (P=0.003). No changes were observed for TST, number of steps, and on questionnaires. Patients with recurrent HE suffer from poor sleep quality and excessive daytime sleepiness. On 24-h PSG, rifaximin improves objective sleep architecture parameters with no changes in the subjective quality of sleep and sleepiness.

Motor Interference Does Not Impair the Memory Consolidation of Imagined Movements

ERIC Educational Resources Information Center

Debarnot, Ursula; Maley, Laura; De Rossi, Danilo; Guillot, Aymeric

2010-01-01

The present study aimed to investigate whether an interference task might impact the sleep-dependent consolidation process of a mentally learned sequence of movements. Thirty-two participants were subjected to a first training session through motor imagery (MI) or physical practice (PP) of a finger sequence learning task. After 2 h, half of the…

Effects of low sleep quality on sexual function, in women with fibromyalgia.

PubMed

Amasyali, A S; Taştaban, E; Amasyali, S Y; Turan, Y; Kazan, E; Sari, E; Erol, B; Cengiz, M; Erol, H

2016-01-01

Sexual dysfunction is a common experience in women with fibromyalgia. However, the physiopathology of this association is unclear. We aimed to evaluate whether sleep disturbance has an influence on sexual function in women with fibromyalgia. Fifty-four sexually active premenopausal women with fibromyalgia were enrolled in the study. The following questionnaires were used: the Female Sexual Function Index (FSFI), the Pittsburgh Sleep Quality Index (PSQI), the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Depression Inventory (BDI). Appropriate statistical analyses were used by using SPSS 18. The mean FSFI score was 25.344 ± 6.52 and showed no correlation with age, body mass index, BDI or duration of fibromyalgia. However, a positive correlation between sexual dysfunction and low sleep quality was found (r=0.43; P=0.001). In addition, the median FSFI score was 29.2 (27.2-32.4) in patients with higher sleep quality (PSQI⩽5), whereas it was 21.4 (18.9-25.3) in patients with lower sleep quality (PSQI>5) (P<0.001). There was a positive correlation between sexual dysfunction and symptoms of fibromyalgia as indicated by a higher FIQ score (r=0.37; P=0.006). Sexual dysfunction in female patients with fibromyalgia may be due to low sleep quality. Treatment of the sleep disorder may improve female sexual function.

Shorter sleep duration is associated with reduced cognitive development at two years of age.

PubMed

Smithson, Lisa; Baird, Tieghan; Tamana, Sukhpreet K; Lau, Amanda; Mariasine, Jennifer; Chikuma, Joyce; Lefebvre, Diana L; Subbarao, Padmaja; Becker, Allan B; Turvey, Stuart E; Sears, Malcolm R; Beal, Deryk S; Pei, Jacqueline; Mandhane, Piush J

2018-04-30

Both short sleep duration and sleep-disordered breathing (SDB) are associated with poor neurocognitive development. However, the co-contributions of short sleep duration and SDB on neurodevelopment in pre-school children are relatively unknown. We assessed both sleep duration and SDB by quarterly questionnaire from three months to two years of age among Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort participants. Group-based modeling determined trajectories of total, daytime, and nighttime sleep duration and SDB. Linear regression was used to assess the impact of sleep duration and SDB trajectories on cognitive (primary outcome) and language (secondary) development at two years of age as assessed by the Bayley Scale of Infant Development (BSID-III) (mean 100; standard deviation of 15). Of the 822 CHILD Edmonton participants, 703 (86%) were still enrolled at two years of age with 593 having BSID-III data at two years of age. Trajectory analysis identified four total sleep durations phenotypes [short sleepers (17.9%), decline to short sleepers (21.1%), intermediate sleepers (36.9%) and long sleepers (24.1%)]. Compared to children with intermediate sleep durations, short sleepers had a 5.2-point lower cognitive development score at two years of age [standard error (SE) 1.7; p = 0.002]. Nocturnal sleep duration, compared to daytime sleep duration had the greatest effect on cognitive development. We also identified three SDB symptom trajectories [early-onset SDB (15.7%), late-onset SDB (14.2%), and persistent SDB (5.3%)] and 79.5% of children had no SDB symptoms. Children with persistent SDB also had a 5.3-point lower language score (SE 2.7; p = 0.05) compared to children with no SDB. SDB trajectories were not associated with cognitive development. In a population-representative birth cohort study, both short sleep duration and SDB were associated with adverse neurodevelopment at two years of age. Children with short nighttime sleep duration had lowered cognitive and language scores and children with persistent SDB also had lower language scores. Copyright © 2018 Elsevier B.V. All rights reserved.

Sleep habits and road traffic accident risk for Iranian occupational drivers.

PubMed

Ebrahimi, Mohammad Hossein; Sadeghi, Masoumeh; Dehghani, Mohsen; Niiat, Khosro Sadegh

2015-01-01

The aim of this study is to assess the sleep quality and sleep disorders (prevalence of obstructive sleep apnea and sleepiness) among occupational drivers in Iran and to determine which demographic factors and occupational habits are linked to road traffic accidents. In this analytic cross-sectional study 556 occupational road drivers from Shahroud city (in the northeast of Iran) participated, upon a prior verbal informed consent, during 2013-2014. The Pittsburgh Sleep Quality Index (PSQI) standard questionnaire that scored on 7 point scale, the 8-item Epworth Sleepiness Scale (ESS) questionnaire and the 8-question STOP-Bang questionnaire along with demographic information and occupational data were used. To explore the independent factors associated with odds of poor sleep quality and road accident, multiple logistic regression models were used. Prevalence of previous road accidents, sleepiness while driving, and obstructive sleep apnea scored ≥ 3 in the study, and drivers accounted for 23.8%, 29%, and 24.8%, respectively. The global mean score of sleep quality and excessive sleepiness score were 5.2 and 4.8, respectively. The main factors related to the odds of poor sleep quality were snoring (odds ratio (OR) = 2.34; 95% confidence interval (CI): 1.15-4.77), smoking (OR = 2.12; 95% CI: 1.15-3.97), and driving times in a day (OR = 1.12; 95% CI: 1.03-1.21). The Epworth Sleepiness Scale (OR = 1.13; 95% CI: 1.07-1.23) and suffering from apnea (OR = 4.89; 95% CI: 1.07-23.83) were the best predictors for odds (increased risk) of road accidents. A considerable proportion of Iranian drivers had records of road accidents; poor sleep quality, sleepiness while driving, and sleep disorder breathing (obstructive sleep apnea - OSA). Snoring, smoking, driving time in a day, excessive sleepiness, and presumably apnea increase the odds of poor sleep quality and road traffic accident for Iranian occupational drivers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

New technology to assess sleep apnea: wearables, smartphones, and accessories

PubMed Central

Penzel, Thomas; Schöbel, Christoph; Fietze, Ingo

2018-01-01

Sleep medicine has been an expanding discipline during the last few decades. The prevalence of sleep disorders is increasing, and sleep centers are expanding in hospitals and in the private care environment to meet the demands. Sleep medicine has evidence-based guidelines for the diagnosis and treatment of sleep disorders. However, the number of sleep centers and caregivers in this area is not sufficient. Many new methods for recording sleep and diagnosing sleep disorders have been developed. Many sleep disorders are chronic conditions and require continuous treatment and monitoring of therapy success. Cost-efficient technologies for the initial diagnosis and for follow-up monitoring of treatment are important. It is precisely here that telemedicine technologies can meet the demands of diagnosis and therapy follow-up studies. Wireless recording of sleep and related biosignals allows diagnostic tools and therapy follow-up to be widely and remotely available. Moreover, sleep research requires new technologies to investigate underlying mechanisms in the regulation of sleep in order to better understand the pathophysiology of sleep disorders. Home recording and non-obtrusive recording over extended periods of time with telemedicine methods support this research. Telemedicine allows recording with little subject interference under normal and experimental life conditions. PMID:29707207

Shorter sleep duration and better sleep quality are associated with greater tissue density in the brain.

PubMed

Takeuchi, Hikaru; Taki, Yasuyuki; Nouchi, Rui; Yokoyama, Ryoichi; Kotozaki, Yuka; Nakagawa, Seishu; Sekiguchi, Atsushi; Iizuka, Kunio; Yamamoto, Yuki; Hanawa, Sugiko; Araki, Tsuyoshi; Miyauchi, Carlos Makoto; Shinada, Takamitsu; Sakaki, Kohei; Nozawa, Takayuki; Ikeda, Shigeyuki; Yokota, Susumu; Daniele, Magistro; Sassa, Yuko; Kawashima, Ryuta

2018-04-11

Poor sleep quality is associated with unfavorable psychological measurements, whereas sleep duration has complex relationships with such measurements. The aim of this study was to identify the associations between microstructural properties of the brain and sleep duration/sleep quality in a young adult. The associations between mean diffusivity (MD), a measure of diffusion tensor imaging (DTI), and sleep duration/sleep quality were investigated in a study cohort of 1201 normal young adults. Positive correlations between sleep duration and MD of widespread areas of the brain, including the prefrontal cortex (PFC) and the dopaminergic systems, were identified. Negative correlations between sleep quality and MD of the widespread areas of the brain, including the PFC and the right hippocampus, were also detected. Lower MD has been previously associated with more neural tissues in the brain. Further, shorter sleep duration was associated with greater persistence and executive functioning (lower Stroop interference), whereas good sleep quality was associated with states and traits relevant to positive affects. These results suggest that bad sleep quality and longer sleep duration were associated with aberrant neurocognitive measurements in the brain in healthy young adults.

Subjective Assessment of Sleep in Huntington Disease: Reliability of Sleep Questionnaires Compared to Polysomnography.

PubMed

Piano, Carla; Della Marca, Giacomo; Losurdo, Anna; Imperatori, Claudio; Solito, Marcella; Calandra-Buonaura, Giovanna; Provini, Federica; Cortelli, Pietro; Bentivoglio, Anna Rita

2017-01-01

The aim of the study was to evaluate the clinical reliability of subjective sleep evaluation, based on sleep and psychometric questionnaires, by comparing the results with those obtained with laboratory-based video-polysomnography (V-PSG). Thirty consecutive Huntington disease (HD) patients were enrolled. Subjective evaluation of sleep included the Pittsburgh Sleep Quality Index (PSQI), the sleep questionnaire for HD (HDQ), the Epworth Sleepiness Scale, the Bologna questionnaire for sleepiness (BQ), the Berlin questionnaire, and the RBD questionnaire; the International Restless Legs Syndrome Study Group scale was administered to patients with positive screening. The psychometric evaluation included the Zung Anxiety Scale, the short form of the Beck Depression Inventory, and the Maudsley Obsessive-Compulsive Inventory. All patients underwent V-PSG. In sleepiness evaluation, the Epworth score was above the cutoff in 6 subjects, and the BQ detected a "high risk" of sleepiness in 7 cases. The results were concordant in 24 and discordant in 5 cases. In the evaluation of sleep quality, the PSQI score was above the cutoff in 18 subjects. According to the HDQ, 10 subjects were poor sleepers. The results were concordant with the PSQI in 20 subjects. All comparisons between scale scores and PSG results showed poor or totally absent concordance between subjective and objective measures. The subjective evaluation of sleep in HD patients shows a poor correlation with PSG results. © 2017 S. Karger AG, Basel.

Weekend catch-up sleep is independently associated with suicide attempts and self-injury in Korean adolescents.

PubMed

Kang, Seung-Gul; Lee, Yu Jin; Kim, Seog Ju; Lim, Weonjeong; Lee, Heon-Jeong; Park, Young-Min; Cho, In Hee; Cho, Seong-Jin; Hong, Jin Pyo

2014-02-01

The current study aims to determine the associations of insufficient sleep with suicide attempts and self-injury in a large, school-based Korean adolescent sample. A sample of 4553 middle- and high-school students (grades 7-10) was recruited in this study. Finally, 4145 students completed self-report questionnaires including items on sleep duration (weekday/weekend), self-injury, suicide attempts during the past year, the Suicidal Ideation Questionnaire (SIQ), and the Beck Depression Inventory (BDI). A multiple linear regression model showed that higher SIQ scores were associated with longer weekend catch-up sleep duration (p=0.009), higher BDI score (p<0.001), and longer time spent in a private educational institute (p=0.025). The multiple logistic regression analysis revealed that longer weekend catch-up sleep duration (p=0.011), higher BDI score (p<0.001), longer time spent in a private educational institute (p=0.046), and poorer academic record (p=0.029) were associated with suicide attempt and self-injury during the past year. The present results suggest that weekend catch-up sleep duration--which is an indicator of insufficient weekday sleep--might be associated with suicide attempts and self-injury in Korean adolescents. © 2014.

Preoperative and post-operative sleep quality evaluation in rotator cuff tear patients.

PubMed

Serbest, Sancar; Tiftikçi, Uğur; Askın, Aydogan; Yaman, Ferda; Alpua, Murat

2017-07-01

The aim of this study was to examine the potential relationship between subjective sleep quality and degree of pain in patients with rotator cuff repair. Thirty-one patients who underwent rotator cuff repair prospectively completed the Pittsburgh Sleep Quality Index, the Western Ontario Rotator Cuff Index, and the Constant and Murley shoulder scores before surgery and at 6 months after surgery. Preoperative demographic, clinical, and radiologic parameters were also evaluated. The study analysed 31 patients with a median age of 61 years. There was a significant difference preoperatively versus post-operatively in terms of all PSQI global scores and subdivisions (p < 0.001). A statistically significant improvement was determined by the Western Ontario Rotator Cuff Scale and the Constant and Murley shoulder scores (p ˂ 0.001). Sleep disorders are commonly seen in patients with rotator cuff tear, and after repair, there is an increase in the quality of sleep with a parallel improvement in shoulder functions. However, no statistically significant correlation was determined between arthroscopic procedures and the size of the tear and sleep quality. It is suggested that rotator cuff tear repair improves the quality of sleep and the quality of life. IV.

Baseline neurocognitive testing in sports-related concussions: the importance of a prior night's sleep.

PubMed

McClure, D Jake; Zuckerman, Scott L; Kutscher, Scott J; Gregory, Andrew J; Solomon, Gary S

2014-02-01

The management of sports-related concussions (SRCs) utilizes serial neurocognitive assessments and self-reported symptom inventories to assess recovery and safety for return to play (RTP). Because postconcussive RTP goals include symptom resolution and a return to neurocognitive baseline levels, clinical decisions rest in part on understanding modifiers of this baseline. Several studies have reported age and sex to influence baseline neurocognitive performance, but few have assessed the potential effect of sleep. We chose to investigate the effect of reported sleep duration on baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) performance and the number of patient-reported symptoms. We hypothesized that athletes receiving less sleep before baseline testing would perform worse on neurocognitive metrics and report more symptoms. Cross-sectional study; Level of evidence, 3. We retrospectively reviewed 3686 nonconcussed athletes (2371 male, 1315 female; 3305 high school, 381 college) with baseline symptom and ImPACT neurocognitive scores. Patients were stratified into 3 groups based on self-reported sleep duration the night before testing: (1) short, <7 hours; (2) intermediate, 7-9 hours; and (3) long, ≥9 hours. A multivariate analysis of covariance (MANCOVA) with an α level of .05 was used to assess the influence of sleep duration on baseline ImPACT performance. A univariate ANCOVA was performed to investigate the influence of sleep on total self-reported symptoms. When controlling for age and sex as covariates, the MANCOVA revealed significant group differences on ImPACT reaction time, verbal memory, and visual memory scores but not visual-motor (processing) speed scores. An ANCOVA also revealed significant group differences in total reported symptoms. For baseline symptoms and ImPACT scores, subsequent pairwise comparisons revealed these associations to be most significant when comparing the short and intermediate sleep groups. Our results indicate that athletes sleeping fewer than 7 hours before baseline testing perform worse on 3 of 4 ImPACT scores and report more symptoms. Because SRC management and RTP decisions hinge on the comparison with a reliable baseline evaluation, clinicians should consider sleep duration before baseline neurocognitive testing as a potential factor in the assessment of athletes' recovery.

Predictors of Poor Sleep Quality Among Head and Neck Cancer Patients

PubMed Central

Shuman, Andrew G.; Duffy, Sonia A.; Ronis, David L.; Garetz, Susan L.; McLean, Scott A.; Fowler, Karen E.; Terrell, Jeffrey E.

2013-01-01

Objectives/Hypothesis The objective of this study was to determine the predictors of sleep quality among head and neck cancer patients 1 year after diagnosis. Study Design This was a prospective, multisite cohort study of head and neck cancer patients (N = 457). Methods Patients were surveyed at baseline and 1 year after diagnosis. Chart audits were also conducted. The dependent variable was a self-assessed sleep score 1 year after diagnosis. The independent variables were a 1 year pain score, xerostomia, treatment received (radiation, chemotherapy, and/or surgery), presence of a feeding tube and/or tracheotomy, tumor site and stage, comorbidities, depression, smoking, problem drinking, age, and sex. Results Both baseline (67.1) and 1-year post-diagnosis (69.3) sleep scores were slightly lower than population means (72). Multivariate analyses showed that pain, xerostomia, depression, presence of a tracheotomy tube, comorbidities, and younger age were statistically significant predictors of poor sleep 1 year after diagnosis of head and neck cancer (P < .05). Smoking, problem drinking, and female sex were marginally significant (P < .09). Type of treatment (surgery, radiation and/or chemotherapy), primary tumor site, and cancer stage were not significantly associated with 1-year sleep scores. Conclusions Many factors adversely affecting sleep in head and neck cancer patients are potentially modifiable and appear to contribute to decreased quality of life. Strategies to reduce pain, xerostomia, depression, smoking, and problem drinking may be warranted, not only for their own inherent value, but also for improvement of sleep and the enhancement of quality of life. PMID:20513034

Sleep quality in fibromyalgia and rheumatoid arthritis: associations with pain, fatigue, depression, and disease activity.

PubMed

Ulus, Y; Akyol, Y; Tander, B; Durmus, D; Bilgici, A; Kuru, O

2011-01-01

The aim of this study was to compare the sleep quality in patients with rheumatoid arthritis (RA) and fibromyalgia syndrome (FMS); and to evaluate the relationship between sleep quality and pain, fatigue, depression, and disease activity in patients with RA and FMS. Forty RA, 40 FMS and 40 healthy controls were enrolled in the study. Disease activity and disease duration were reported in patients. Pain by visual analogue scale (VAS), fatigue by Multidimensional Assesment of Fatigue (MAF), depression by Beck Depression Index (BDI), and sleep quality by Pittsburgh Sleep Quality Index (PSQI) were gathered in all participants. All participants were aged between 20 and 65 years, with a mean age of 42.97±10.75 years. There was no significant difference with respect to demographic characteristics among the three study groups. Patients reported more depression than controls, but BDI scores were similar in FMS and RA patients. VAS pain scores and MAF scores were significantly different in the three groups (p<0.001). FMS and RA patients had poor sleep quality (p<0.001). FMS patients had daytime dysfunction due to sleep disorder and had worse habitual sleep efficiency than RA patients (p<0.05). In patients, positive correlations were found between PSQI and clinic assessment variables except disease duration. FMS and RA may have poor sleep quality when compared to subjects without rheumatologic disorders. The quality of sleep can be impaired by pain, fatigue, depression, and disease activity in such patients.

Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study

PubMed Central

de Mutsert, Renée; le Cessie, Saskia; Appelman-Dijkstra, Natasha M.; Rosendaal, Frits R.; van Heemst, Diana; den Heijer, Martin; Biermasz, Nienke R.

2017-01-01

Context Sleep deprivation has detrimental metabolic consequences. Osteopenia and sarcopenia usually occur together and increase risk of fractures and disease. Results from studies linking sleep parameters to osteopenia or sarcopenia are scarce and inconsistent. Objective To examine the associations of sleep parameters with osteopenia and sarcopenia, considering the influence of sex and menopause. Design, setting and participants Cross-sectional analysis of 915 participants (45–65 years, 56% women, BMI 26 (range: 18–56) kg/m2) in the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study. Sleep duration, quality, and timing were assessed with the Pittsburgh Sleep Quality Index (PSQI); bone mineral density and relative appendicular muscle mass were measured by DXA scans. Linear and logistic regressions were performed to associate sleep parameters to bone mineral density, relative appendicular muscle mass, osteopenia (t-score between -1 and -2.5) and sarcopenia (1 SD below average muscle mass). Results After adjustment for confounding factors, one unit increase in PSQI score (OR and 95% CI, 1.09, 1.03–1.14), declined self-rated sleep quality (1.76, 1.03–3.01), sleep latency (1.18, 1.06–1.31), and a one hour later sleep timing (1.51, 1.08–2.11), but not sleep duration (1.05, 0.90–1.23), were associated with osteopenia. PSQI score (1.10, 1.02–1.19) was also associated with sarcopenia; OR’s of sleep latency and later mid-sleep time with sarcopenia were 1.14 (0.99–1.31) and 1.54 (0.91–2.61), respectively. Associations were somewhat stronger in women and varied per menopausal status. Conclusions These results suggest that decreased sleep quality and a later sleep timing are risk factors for osteopenia and sarcopenia in middle aged individuals. PMID:28459884

Hip pain while using lower extremity joints and sleep disturbances in elderly white women: results from a cross-sectional analysis.

PubMed

Parimi, Neeta; Blackwell, Terri; Stone, Katie L; Lui, Li-Yung; Ancoli-Israel, Sonia; Tranah, Gregory J; Hillier, Teresa A; Nevitt, Michael E; Lane, Nancy E

2012-07-01

To evaluate sleep quality in women with hip pain due to daily activities involving the lower extremity joints. We evaluated the association of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) hip pain severity score with objective sleep measures obtained by wrist actigraphy in 2,225 white women ≥ 65 years of age enrolled in the Study of Osteoporotic Fractures. Women had an increased odds of spending ≥ 90 minutes awake after sleep onset (odds ratio [OR] 1.28, 95% confidence interval [95% CI] 1.11-1.50) for every 5-point increase in hip pain score after adjustment for all covariates. Hip pain when sitting or lying was the strongest predictor of sleep fragmentation (OR 2.0, 95% CI 1.47-2.73); however, standing pain was associated with a higher number of awake minutes in bed scored from sleep onset to the end of the last sleep episode, independent of pain while in bed (OR 1.41, 95% CI 1.07-2.01). Sleep disturbances increased significantly after the first 2 hours of sleep in women with severe hip pain compared to those without hip pain (mean ± SD 1.4 ± 0.47 minutes per hour of sleep; P < 0.003). Similar associations were observed for long wake episodes >5 minutes. There were no associations between daytime napping, sleep latency, sleep efficiency, and total sleep minutes and WOMAC hip pain. Fragmented sleep was greater in women with hip pain compared to those without hip pain; however, fragmented sleep in women with severe hip pain compared to those without hip pain was unchanged until after the first 2 hours of sleep. Further investigations into pain medications wearing off over time or the prolonged periods of inactivity decreasing the pain threshold are warranted. Copyright © 2012 by the American College of Rheumatology.

Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students.

PubMed

Demirci, Kadir; Akgönül, Mehmet; Akpinar, Abdullah

2015-06-01

The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. In total, 319 university students (203 females and 116 males; mean age = 20.5 ± 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n = 71, 22.3%), a low smartphone use group (n = 121, 37.9%), and a high smartphone use group (n = 127, 39.8%). All participants were evaluated using the Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory; moreover, participants other than those in the smartphone non-user group were also assessed with the Smartphone Addiction Scale. The findings revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores. The results indicate that depression, anxiety, and sleep quality may be associated with smartphone overuse. Such overuse may lead to depression and/or anxiety, which can in turn result in sleep problems. University students with high depression and anxiety scores should be carefully monitored for smartphone addiction.

Relationship of Smartphone Use Severity with Sleep Quality, Depression, and Anxiety in University Students

PubMed Central

Demi̇rci̇, Kadi̇r; Akgönül, Mehmet; Akpinar, Abdullah

2015-01-01

Background and Aims The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. Methods In total, 319 university students (203 females and 116 males; mean age = 20.5 ± 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n = 71, 22.3%), a low smartphone use group (n = 121, 37.9%), and a high smartphone use group (n = 127, 39.8%). All participants were evaluated using the Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory; moreover, participants other than those in the smartphone non-user group were also assessed with the Smartphone Addiction Scale. Results The findings revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores. Conclusion The results indicate that depression, anxiety, and sleep quality may be associated with smartphone overuse. Such overuse may lead to depression and/or anxiety, which can in turn result in sleep problems. University students with high depression and anxiety scores should be carefully monitored for smartphone addiction. PMID:26132913

[Treatment of insomnia with shujing massage therapy: a randomized controlled trial].

PubMed

Tang, Hongliang; Chen, Zhao; Pang, Jun; Mo, Qiaoming

2015-08-01

To compare the differences in the clinical efficacy on insomnia between shujing massage therapy and medication with estazolam. Eighty patients of insomnia were randomized into a shujing mass age therapy group (40 cases) and a medication group (40 cases). In the shujing massage therapy group, the spreading massage manipulation was applied along the running course of the gallbladder meridian of foot-shaoyang on the temporal area. The pressing and kneading manipulation was done at Yangbai (GB 14), Benshen (GB 13), Toulinqi (GB 15), Zhengying (GB 17), Chengling (GB 18), Shuaigu (GB 8), and Fengchi (GB 20), etc, 1 min at each acupoint. In the medication group, 1 mg estazolam was taken orally half an hour before sleep. The treatment was given once every day in the two groups. After the continuous treatment for 1 month, every dimensional score and the total score in the Pittsburgh sleep quality index scale (PSQI) and the clinical efficacy were evaluated between the two groups. After the intervention, the each item score of PSQI was improved as compared with that before treatment in the patients of the two groups (all P<0. 05). The differences in sleep time and the time for falling into sleep were not significant between the two groups (both P>0. 05). In the shujing massage therapy group, the scores of sleep quality, sleep efficiency, sleep disturbance and daytime dysfunction, as well as the total score were all lower than those in the medication group (all P<0. 05). The total effective rate was 92. 1% (35/38) in the shujing massage group and was 84. 2% (32/38) in the medication group, indicating the significant difference (P<0. 05). Shujing massage therapy achieves the superior efficacy on insomnia compared with the oral administration of estazolam.

Maintenance of Wakefulness Test scores and driving performance in sleep disorder patients and controls.

PubMed

Philip, Pierre; Chaufton, Cyril; Taillard, Jacques; Sagaspe, Patricia; Léger, Damien; Raimondi, Monika; Vakulin, Andrew; Capelli, Aurore

2013-08-01

Sleepiness at the wheel is a risk factor for traffic accidents. Past studies have demonstrated the validity of the Maintenance of Wakefulness Test (MWT) scores as a predictor of driving impairment in untreated patients with obstructive sleep apnea syndrome (OSAS), but there is limited information on the validity of the maintenance of wakefulness test by MWT in predicting driving impairment in patients with hypersomnias of central origin (narcolepsy or idiopathic hypersomnia). The aim of this study was to compare the MWT scores with driving performance in sleep disorder patients and controls. 19 patients suffering from hypersomnias of central origin (9 narcoleptics and 10 idiopathic hypersomnia), 17 OSAS patients and 14 healthy controls performed a MWT (4×40-minute trials) and a 40-minute driving session on a real car driving simulator. Participants were divided into 4 groups defined by their MWT sleep latency scores. The groups were pathological (sleep latency 0-19 min), intermediate (20-33 min), alert (34-40 min) and control (>34 min). The main driving performance outcome was the number of inappropriate line crossings (ILCs) during the 40 minute drive test. Patients with pathological MWT sleep latency scores (0-19 min) displayed statistically significantly more ILC than patients from the intermediate, alert and control groups (F (3, 46)=7.47, p<0.001). Pathological sleep latencies on the MWT predicted driving impairment in patients suffering from hypersomnias of central origin as well as in OSAS patients. MWT is an objective measure of daytime sleepiness that appears to be useful in estimating the driving performance in sleepy patients. Copyright © 2013 Elsevier B.V. All rights reserved.

Effect of Rosa damascene aromatherapy on sleep quality in cardiac patients: a randomized controlled trial.

PubMed

Hajibagheri, Ali; Babaii, Atye; Adib-Hajbaghery, Mohsen

2014-08-01

Sleep disorders are common among patients hospitalized in coronary care unit (CCU). This study aimed to investigate the effect of Rosa damascene aromatherapy on sleep quality of patients hospitalized in CCU. In this randomized controlled trial, 60 patients who met the inclusion criteria were conveniently sampled and randomly allocated to the experimental and control groups. Patients in the control group received routine care. In the experimental group, patients received routine care and Rosa damascene aromatherapy for three subsequent nights. In the both groups the sleep quality was assessed using the Pittsburgh Sleep Quality Index. After the study, the mean scores of five domains of Pittsburg Sleep Quality Index as well as the mean of total score of the index in the experimental group were significantly lower than the control group. Rosa damascene aromatherapy can significantly improve the sleep quality of patients hospitalized in CCUs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assessment of Itakura Distance as a valuable feature for computer-aided classification of sleep stages.

PubMed

Ebrahimi, F; Mikaili, M; Estrada, E; Nazeran, H

2007-01-01

Staging and detection of various states of sleep derived from EEG and other biomedical signals have proven to be very helpful in diagnosis, prognosis and remedy of various sleep related disorders. The time consuming and costly process of visual scoring of sleep stages by a specialist has always motivated researchers to develop an automatic sleep scoring system and the first step toward achieving this task is finding discriminating characteristics (or features) for each stage. A vast variety of these features and methods have been investigated in the sleep literature with different degrees of success. In this study, we investigated the performance of a newly introduced measure: the Itakura Distance (ID), as a similarity measure between EEG and EOG signals. This work demonstrated and further confirmed the outcomes of our previous research that the Itakura Distance serves as a valuable similarity measure to differentiate between different sleep stages.

Mister Sandman, bring me good marks! On the relationship between sleep quality and academic achievement.

PubMed

Baert, Stijn; Omey, Eddy; Verhaest, Dieter; Vermeir, Aurélie

2015-04-01

There is growing evidence that health factors affect tertiary education success in a causal way. This study assesses the effect of sleep quality on academic achievement at university. To this end, we surveyed 804 students about their sleep quality by means of the Pittsburgh Sleep Quality Index (PSQI) before the start of their first exam period in December 2013 at Ghent University. PSQI scores were merged with course marks in this exam period. Instrumenting PSQI scores by sleep quality during secondary education, we find that increasing total sleep quality with one standard deviation leads to 4.85 percentage point higher course marks. Based on this finding, we suggest that higher education providers might be incentivised to invest part of their resources for social facilities in professional support for students with sleep and other health problems. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sleep and eating in childhood: a potential behavioral mechanism underlying the relationship between poor sleep and obesity.

PubMed

Burt, Julia; Dube, Laurette; Thibault, Louise; Gruber, Reut

2014-01-01

The goal of our study was to examine the associations between sleep and eating behaviors. Specifically, we examined associations between sleep duration and continuity with behaviors that promote eating regardless of true physiologic hunger state including emotional (food intake in response to emotional distress) external (eating in response to the sight or smell of food), and restrained eating (a paradoxical behavior; food intake is initially reduced to lose or maintain body weight, but followed by increased consumption and binge eating). Fifty-six children (29 boys; 27 girls) ages 5 to 12 years participated in the study. Mean age was 7.7±1.9 years, and average body mass index (BMI) was within the healthy range (17.8±4.3 kg/m(2)). Sleep duration, continuity and schedule were assessed using actigraphy and self-reports. The Child Dutch Eating Behavior Questionnaire-modified version (DEBQ-M) was used to examine levels of emotional, external and restrained eating in the children. Associations between the sleep and eating behaviors were examined using partial correlations and multiple regression analyses. External eating score was negatively associated with sleep duration; emotional eating score was associated with lower levels of sleep continuity; and restrained eating score were associated with a later sleep start and later bedtime. Short sleep duration and poor sleep continuity were associated with higher levels of eating behaviors shown to be associated with increased food intake. Therefore, sleep loss may be associated with diminished self-regulation of appetite in children, increasing the risk for overeating and obesity. Copyright © 2013 Elsevier B.V. All rights reserved.

Trajectories of sleep disturbance and daytime sleepiness in women before and after surgery for breast cancer.

PubMed

Van Onselen, Christina; Paul, Steven M; Lee, Kathryn; Dunn, Laura; Aouizerat, Bradley E; West, Claudia; Dodd, Marylin; Cooper, Bruce; Miaskowski, Christine

2013-02-01

Sleep disturbance is a problem for oncology patients. To evaluate how sleep disturbance and daytime sleepiness (DS) changed from before to six months following surgery and whether certain characteristics predicted initial levels and/or the trajectories of these parameters. Patients (n=396) were enrolled prior to surgery and completed monthly assessments for six months following surgery. The General Sleep Disturbance Scale was used to assess sleep disturbance and DS. Using hierarchical linear modeling, demographic, clinical, symptom, and psychosocial adjustment characteristics were evaluated as predictors of initial levels and trajectories of sleep disturbance and DS. All seven General Sleep Disturbance Scale scores were above the cutoff for clinically meaningful levels of sleep disturbance. Lower performance status; higher comorbidity, attentional fatigue, and physical fatigue; and more severe hot flashes predicted higher preoperative levels of sleep disturbance. Higher levels of education predicted higher sleep disturbance scores over time. Higher levels of depressive symptoms predicted higher preoperative levels of sleep disturbance, which declined over time. Lower performance status; higher body mass index; higher fear of future diagnostic tests; not having had sentinel lymph node biopsy; having had an axillary lymph node dissection; and higher depression, physical fatigue, and attentional fatigue predicted higher DS prior to surgery. Higher levels of education, not working for pay, and not having undergone neo-adjuvant chemotherapy predicted higher DS scores over time. Sleep disturbance is a persistent problem for patients with breast cancer. The effects of interventions that can address modifiable risk factors need to be evaluated. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Comparison of dexmedetomidine and propofol used for drug-induced sleep endoscopy in patients with obstructive sleep apnea syndrome

PubMed Central

Kuyrukluyıldız, Ufuk; Binici, Orhan; Onk, Didem; Ayhan Celik, Serap; Torun, Mumtaz Taner; Unver, Edhem; Ozcicek, Adalet; Alagol, Aysin

2015-01-01

Backround: Surgical operations are alternative treatments in persons with Obstructive Sleep Apnea Syndrome who cannot tolerate continuous positive airway pressure therapy. Drug-Induced Sleep Endoscopy is a method with which somnolence is pharmacologically induced and collapse is evaluated through nasal endoscopy in patients with Obstructive Sleep Apnea Syndrome. Aims: We aimed to evaluate efficiency of dexmedetomidine or propofol used for sedation in patients undergoing drug-induced sleep endoscopy. Methods: A total of 40 patients aged between 18 and 65 years old in the ASA STATUS I-II group were included in the study. After premedicatıon wıth midazolam 0.05 mg/kg intravenously, patients were randomly divided into two groups and administered intravenous (iv) propofol with the loading dose of 0.7 mg/kg for 10 minutes, followed 0.5 mg/kg/h infusion (Group P); or dexmedetomidine with the loading dose of 1 mcg/kg for 10 minutes, followed by 0.3 mcg/kg/h infusion (Group D). Haemodynamic and respiratuary parameters, Bispectral index score, Ramsey sedation score, time to achieve sufficient sedation, surgeon’s and patients’ satisfaction, postoperative Aldrete score and side effects were recorded. Results: Time to achieve sufficient sedation, Bispectral index scores at 5, 10 and 15th. minutes intraoperatively, first Aldrete score in the recovery room, SpO2 values and respiratory rates all over the surgical procedure and in the recovery room were found lower in Group P (P<0.05). Bispectral index scores, mean arterial pressure and heart rate in the recovery room were significantly lower in Group D (P<0.05). Conclusion: Dexmedetomidine may be preferred as a safer agent with respecting to respiratory function compared with propofol in obstructive sleep apnea patients who known to be susceptible to hypoxia and hypercarbia. PMID:26131153

The Accuracy, Night-to-Night Variability, and Stability of Frontopolar Sleep Electroencephalography Biomarkers

PubMed Central

Levendowski, Daniel J.; Ferini-Strambi, Luigi; Gamaldo, Charlene; Cetel, Mindy; Rosenberg, Robert; Westbrook, Philip R.

2017-01-01

Study Objectives: To assess the validity of sleep architecture and sleep continuity biomarkers obtained from a portable, multichannel forehead electroencephalography (EEG) recorder. Methods: Forty-seven subjects simultaneously underwent polysomnography (PSG) while wearing a multichannel frontopolar EEG recording device (Sleep Profiler). The PSG recordings independently staged by 5 registered polysomnographic technologists were compared for agreement with the autoscored sleep EEG before and after expert review. To assess the night-to-night variability and first night bias, 2 nights of self-applied, in-home EEG recordings obtained from a clinical cohort of 63 patients were used (41% with a diagnosis of insomnia/depression, 35% with insomnia/obstructive sleep apnea, and 17.5% with all three). The between-night stability of abnormal sleep biomarkers was determined by comparing each night's data to normative reference values. Results: The mean overall interscorer agreements between the 5 technologists were 75.9%, and the mean kappa score was 0.70. After visual review, the mean kappa score between the autostaging and five raters was 0.67, and staging agreed with a majority of scorers in at least 80% of the epochs for all stages except stage N1. Sleep spindles, autonomic activation, and stage N3 exhibited the least between-night variability (P < .0001) and strongest between-night stability. Antihypertensive medications were found to have a significant effect on sleep quality biomarkers (P < .02). Conclusions: A strong agreement was observed between the automated sleep staging and human-scored PSG. One night's recording appeared sufficient to characterize abnormal slow wave sleep, sleep spindle activity, and heart rate variability in patients, but a 2-night average improved the assessment of all other sleep biomarkers. Commentary: Two commentaries on this article appear in this issue on pages 771 and 773. Citation: Levendowski DJ, Ferini-Strambi L, Gamaldo C, Cetel M, Rosenberg R, Westbrook PR. The accuracy, night-to-night variability, and stability of frontopolar sleep electroencephalography biomarkers. J Clin Sleep Med. 2017;13(6):791–803. PMID:28454598

Melatonin in perimenopausal and postmenopausal women: associations with mood, sleep, climacteric symptoms, and quality of life.

PubMed

Toffol, Elena; Kalleinen, Nea; Haukka, Jari; Vakkuri, Olli; Partonen, Timo; Polo-Kantola, Päivi

2014-05-01

Melatonin synthesis and secretion are partly modulated by estrogen and progesterone. Changes in melatonin concentrations, possibly related to the menopausal transition, may be associated with climacteric mood, sleep, and vasomotor symptoms. The aims of this study were to compare the serum concentrations of melatonin in perimenopausal and postmenopausal women and to evaluate melatonin's influence on mood, sleep, vasomotor symptoms, and quality of life. We analyzed the data of 17 healthy perimenopausal women (aged 43-51 y) and 18 healthy postmenopausal women (aged 58-71 y) who participated in a prospective study. On study night (9:00 pm-9:00 am), serum melatonin was sampled at 20-minute (9:00 pm-12:00 midnight; 6:00-9:00 am) and 1-hour (12:00 midnight-6:00 am) intervals. Questionnaires were used to assess depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory), insomnia and sleepiness (Basic Nordic Sleep Questionnaire [BNSQ]), subjective sleep quality, vasomotor symptoms, and quality of life (EuroQoL). Postmenopausal women had lower nighttime serum melatonin concentrations than perimenopausal women. The duration of melatonin secretion tended to be shorter in postmenopause, whereas melatonin peak time did not differ. Mean melatonin concentrations and exposure levels did not correlate with follicle-stimulating hormone level, estradiol level, body mass index, Beck Depression Inventory score, State-Trait Anxiety Inventory score, BNSQ insomnia score, BNSQ sleepiness score, subjective sleep score, climacteric vasomotor score, or quality of life. In perimenopause, the later is the melatonin peak, the higher is the level of anxiety (P = 0.022), and the longer is the melatonin secretion, the better is the quality of life (P < 0.001). Longitudinal research is needed to better understand the possible contributory role of menopause in lower melatonin levels.

Can body temperature dysregulation explain the co-occurrence between overweight/obesity, sleep impairment, late-night eating, and a sedentary lifestyle?

PubMed

Brown, Rhonda F; Thorsteinsson, Einar B; Smithson, Michael; Birmingham, C Laird; Aljarallah, Hessah; Nolan, Christopher

2017-12-01

Overweight/obesity, sleep disturbance, night eating, and a sedentary lifestyle are common co-occurring problems. There is a tendency for them to co-occur together more often than they occur alone. In some cases, there is clarity as to the time course and evolution of the phenomena. However, specific mechanism(s) that are proposed to explain a single co-occurrence cannot fully explain the more generalized tendency to develop concurrent symptoms and/or disorders after developing one of the phenomena. Nor is there a clinical theory with any utility in explaining the development of co-occurring symptoms, disorders and behaviour and the mechanism(s) by which they occur. Thus, we propose a specific mechanism-dysregulation of core body temperature (CBT) that interferes with sleep onset-to explain the development of the concurrences. A detailed review of the literature related to CBT and the phenomena that can alter CBT or are altered by CBT is provided. Overweight/obesity, sleep disturbance and certain behaviour (e.g. late-night eating, sedentarism) were linked to elevated CBT, especially an elevated nocturnal CBT. A number of existing therapies including drugs (e.g. antidepressants), behavioural therapies (e.g. sleep restriction therapy) and bright light therapy can also reduce CBT. An elevation in nocturnal CBT that interferes with sleep onset can parsimoniously explain the development and perpetuation of common co-occurring symptoms, disorders and behaviour including overweight/obesity, sleep disturbance, late-night eating, and sedentarism. Nonetheless, a significant correlation between CBT and the above symptoms, disorders and behaviour does not necessarily imply causation. Thus, statistical and methodological issues of relevance to this enquiry are discussed including the likely presence of autocorrelation. Level V, narrative review.

Sleep directly following learning benefits consolidation of spatial associative memory.

PubMed

Talamini, Lucia M; Nieuwenhuis, Ingrid L C; Takashima, Atsuko; Jensen, Ole

2008-04-01

The last decade has brought forth convincing evidence for a role of sleep in non-declarative memory. A similar function of sleep in episodic memory is supported by various correlational studies, but direct evidence is limited. Here we show that cued recall of face-location associations is significantly higher following a 12-h retention interval containing sleep than following an equally long period of waking. Furthermore, retention is significantly higher over a 24-h sleep-wake interval than over an equally long wake-sleep interval. This difference occurs because retention during sleep was significantly better when sleep followed learning directly, rather than after a day of waking. These data demonstrate a beneficial effect of sleep on memory that cannot be explained solely as a consequence of reduced interference. Rather, our findings suggest a competitive consolidation process, in which the fate of a memory depends, at least in part, on its relative stability at sleep onset: Strong memories tend to be preserved, while weaker memories erode still further. An important aspect of memory consolidation may thus result from the removal of irrelevant memory "debris."

Sleep on your memory traces: How sleep effects can be explained by Act-In, a functional memory model.

PubMed

Cherdieu, Mélaine; Versace, Rémy; Rey, Amandine E; Vallet, Guillaume T; Mazza, Stéphanie

2018-06-01

Numerous studies have explored the effect of sleep on memory. It is well known that a period of sleep, compared to a similar period of wakefulness, protects memories from interference, improves performance, and might also reorganize memory traces in a way that encourages creativity and rule extraction. It is assumed that these benefits come from the reactivation of brain networks, mainly involving the hippocampal structure, as well as from their synchronization with neocortical networks during sleep, thereby underpinning sleep-dependent memory consolidation and reorganization. However, this memory reorganization is difficult to explain within classical memory models. The present paper aims to describe whether the influence of sleep on memory could be explained using a multiple trace memory model that is consistent with the concept of embodied cognition: the Act-In (activation-integration) memory model. We propose an original approach to the results observed in sleep research on the basis of two simple mechanisms, namely activation and integration. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparing the Effects of Reflexology and Footbath on Sleep Quality in the Elderly: A Controlled Clinical Trial

PubMed Central

Valizadeh, Leila; Seyyedrasooli, Alehe; Zamanazadeh, Vahid; Nasiri, Khadijeh

2015-01-01

Background: Sleep disorders are common mental disorders reported among the elderly in all countries, and with nonpharmacological interventions, they could be helped to improve their sleep quality. Objectives: The aim of this study was to compare the effects of two interventions, foot reflexology and foot bath, on sleep quality in elderly people. Patients and Methods: This three-group randomized clinical trial (two experimental groups and a control group) was conducted on 69 elderly men. The two experimental groups had reflexology (n = 23) and foot bath (n = 23) interventions for 6 weeks. The reflexology intervention was done in the mornings, once a week for ten minutes on each foot. The participants in the foot bath group were asked to soak their feet in 41°C to 42°C water one hour before sleeping. The pittsburgh sleep quality index (PSQI) was completed before and after the intervention through an interview process. Results: The results showed that the PSQI scores after intervention compared to before it in the reflexology and foot bath groups were statistically significant (P = 0.01 , P = 0.001); however, in the control group did not show a statistically significant difference (P = 0.14). In addition, the total score changes among the three groups were statistically significant (P = 0.01). Comparing the score changes of quality of sleep between the reflexology and foot bath groups showed that there was no significant difference in none of the components and the total score (P = 0.09). The two interventions had the same impact on the quality of sleep. Conclusions: It is suggested that the training of nonpharmacological methods to improve sleep quality such as reflexology and foot bath be included in the elderly health programs. In addition, it is recommended that the impact of these interventions on subjective sleep quality using polysomnographic recordings be explored in future research. PMID:26734475

Comparing the Effects of Reflexology and Footbath on Sleep Quality in the Elderly: A Controlled Clinical Trial.

PubMed

Valizadeh, Leila; Seyyedrasooli, Alehe; Zamanazadeh, Vahid; Nasiri, Khadijeh

2015-11-01

Sleep disorders are common mental disorders reported among the elderly in all countries, and with nonpharmacological interventions, they could be helped to improve their sleep quality. The aim of this study was to compare the effects of two interventions, foot reflexology and foot bath, on sleep quality in elderly people. This three-group randomized clinical trial (two experimental groups and a control group) was conducted on 69 elderly men. The two experimental groups had reflexology (n = 23) and foot bath (n = 23) interventions for 6 weeks. The reflexology intervention was done in the mornings, once a week for ten minutes on each foot. The participants in the foot bath group were asked to soak their feet in 41°C to 42°C water one hour before sleeping. The pittsburgh sleep quality index (PSQI) was completed before and after the intervention through an interview process. The results showed that the PSQI scores after intervention compared to before it in the reflexology and foot bath groups were statistically significant (P = 0.01 , P = 0.001); however, in the control group did not show a statistically significant difference (P = 0.14). In addition, the total score changes among the three groups were statistically significant (P = 0.01). Comparing the score changes of quality of sleep between the reflexology and foot bath groups showed that there was no significant difference in none of the components and the total score (P = 0.09). The two interventions had the same impact on the quality of sleep. It is suggested that the training of nonpharmacological methods to improve sleep quality such as reflexology and foot bath be included in the elderly health programs. In addition, it is recommended that the impact of these interventions on subjective sleep quality using polysomnographic recordings be explored in future research.

Prospective Study of Insufficient Sleep and Neurobehavioral Functioning Among School-Age Children.

PubMed

Taveras, Elsie M; Rifas-Shiman, Sheryl L; Bub, Kristen L; Gillman, Matthew W; Oken, Emily

2017-08-01

To examine associations between insufficient sleep and neurobehavioral functioning in childhood as reported by mothers and teachers. Participants were 1046 children in a prebirth cohort study. Main exposures were insufficient sleep durations at 3 time points: 6 months to 2 years, defined as sleep <11 h/d, 11 to <12 h/d (vs ≥12); 3 to 4 years, defined as sleep <10 h/d, 10 to <11 h/d (vs ≥11); and 5 to 7 years, sleep <9 h/d, 9 to <10 h/d (vs ≥10). Outcomes at age 7 years were executive function, behavior, and social-emotional functioning, assessed using the Behavioral Rating Inventory of Executive Function (BRIEF) and the Strengths and Difficulties Questionnaire (SDQ). Higher scores indicate poorer functioning. Mothers and teachers completed both instruments independently. At age 7 years, mean (SD) mother and teacher report of the BRIEF global executive composite scale were 48.3 (7.9) and 50.7 (9.4) points, respectively, and of the SDQ total difficulties score was 6.5 (4.7) and 6.2 (5.7). In multivariable models, children who slept <10 h/d at 3 to 4 years had worse maternal-reported scores for the BRIEF (2.11 points; 95% confidence interval, 0.17-4.05) and SDQ (1.91 points; 95% confidence interval, 0.78-3.05) than those with age-appropriate sleep. Children who slept <9 h/d at 5 to 7 years also had worse scores. At both ages, associations with teacher-reported results were consistent with those of mothers. Infants who slept 11 to <12 h/d had higher teacher- but not mother-reported scores. Insufficient sleep in the preschool and early school years is associated with poorer mother- and teacher-reported neurobehavioral processes in midchildhood. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Underperception of Naps in Older Adults Referred for a Sleep Assessment: An Insomnia Trait and a Cognitive Problem?

PubMed

Nguyen-Michel, Vi-Huong; Lévy, Pierre-P; Pallanca, Olivier; Kinugawa, Kiyoka; Banica-Wolters, Raluca; Sebban, Claude; Mariani, Jean; Fournier, Emmanuel; Arnulf, Isabelle

2015-10-01

To examine the frequency and determinants of underperception of naps in older adults referred for a sleep assessment. Prospective study. Outpatient geriatric sleep clinic. Individuals aged 60 and older referred for insomnia complaints or suspected sleep apnea (N = 135). Tests included clinical interview, sleepiness scale, anxiety and depression scale, Insomnia Severity Index (ISI), Mini-Mental State Examination (MMSE), and overnight polysomnography, followed by multiple sleep latency tests. At the end of each of four nap opportunities, participants answered whether they had slept during the test. Nap underperception was defined as two or more unperceived naps. Of the 105 participants who napped at least twice, 42 (40%) did not perceive at least two naps. These participants had lower MMSE scores (P = .01) and were more likely to be taking benzodiazepines (P = .008) than the 63 participants who did not underperceive their naps but had similar demographic characteristics, sleep diagnoses, depression and anxiety scores, and polysomnography measures. Both groups had similarly short mean daytime sleep latencies (9.7 ± 4.5 minutes and 9.8 ± 3.7 minutes), but participants who underperceived their naps scored lower on the Epworth Sleepiness Scale (5.6 ± 4.0, vs 9.6 ± 4.8, P < .001). An ISI of 11 or greater, a MMSE score of 26 or less, and a sleepiness score of 8 or less were each independently associated with underperception of naps. The combination of these three factors yielded a positive predictive value of 93% and a negative predictive value of 71% for nap underperception. Older adults referred for sleep consultation with cognitive impairment and greater insomnia symptoms frequently underperceive naps, leading them to underestimate their level of sleepiness. In such cases, objective measures of daytime sleepiness would be better than the Epworth Sleepiness Scale. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Naive scoring of human sleep based on a hidden Markov model of the electroencephalogram.

PubMed

Yaghouby, Farid; Modur, Pradeep; Sunderam, Sridhar

2014-01-01

Clinical sleep scoring involves tedious visual review of overnight polysomnograms by a human expert. Many attempts have been made to automate the process by training computer algorithms such as support vector machines and hidden Markov models (HMMs) to replicate human scoring. Such supervised classifiers are typically trained on scored data and then validated on scored out-of-sample data. Here we describe a methodology based on HMMs for scoring an overnight sleep recording without the benefit of a trained initial model. The number of states in the data is not known a priori and is optimized using a Bayes information criterion. When tested on a 22-subject database, this unsupervised classifier agreed well with human scores (mean of Cohen's kappa > 0.7). The HMM also outperformed other unsupervised classifiers (Gaussian mixture models, k-means, and linkage trees), that are capable of naive classification but do not model dynamics, by a significant margin (p < 0.05).

Effect of brief sleep hygiene education for workers of an information technology company.

PubMed

Kakinuma, Mitsuru; Takahashi, Masaya; Kato, Noritada; Aratake, Yutaka; Watanabe, Mayumi; Ishikawa, Yumi; Kojima, Reiko; Shibaoka, Michi; Tanaka, Katsutoshi

2010-01-01

To investigate the effects of sleep hygiene education for workers of an information technology (IT) company, we conducted a controlled clinical trial providing 581 workers one-hour sleep hygiene education. The contents of the sleep hygiene education program were a review of sleep habits, provide sleep hygiene education, and the establishment of sleep habit goals. A self-report questionnaire was used to measure outcomes including the Pittsburgh Sleep Quality Index (PSQI), Karolinska Sleepiness Scale (KSS), Checklist Individual Strength (CIS), Center for Epidemiologic Studies for Depression (CES-D), and mean sleep duration on weekdays before and 4 wk after the intervention. A total of 391 participants were included in the analysis, with 214 participants in the sleep hygiene education group and 177 in the waiting list group. KSS score at 2 P.M. decreased by 0.42 points in the sleep hygiene education group, but increased by 0.08 points in the waiting list group, showing a significant effect size of 0.50 (95%CI, -0.97 to -0.04, p<0.05). PSQI score also improved, but the inter-group difference was not statically significant. The present study provides preliminary evidence that brief sleep hygiene education may improve afternoon sleepiness at work, but not sleep at night for IT workers.

Cardiometabolic risk is associated with the severity of sleep-disordered breathing in children with obesity.

PubMed

Isacco, Laurie; Roche, Johanna; Quinart, Sylvain; Thivel, David; Gillet, Valérie; Nègre, Véronique; Mougin, Fabienne

2017-03-01

The alarming progression of pediatric obesity is associated with the development of sleep-disordered breathing (SDB), and both exhibit similar adverse cardiometabolic health outcomes. Physical activity level (PAL) may counteract sleep and metabolic disturbances. The present study investigates i) the association between the metabolic syndrome in childhood obesity and SDB, ii) the impact of SDB severity on cardiometabolic risk scores and PAL in children with obesity. Maturation status (Tanner stages), anthropometric (height, weight, body mass index, waist circumference, body adiposity index) and cardiometabolic characteristics (systolic and diastolic blood pressure, lipid and glycemic profiles) were assessed in 83 obese children (mean±SD, age: 10.7±2.7years). PAL and SDB were investigated with a step test and interviews, and an overnight sleep monitor, respectively. The presence or absence of metabolic syndrome (MS) was established and continuous cardiometabolic risk scores were calculated (MetScore BMI and MetScore WC ). Obese children with (61.4%) and without (38.6%) MS present similar SDB. SDB severity is associated with increased insulin concentrations, MetScore BMI and MetScore WC (p<0.05) in obese children. There is no association between SDB and PAL. In a context where no consensus exists for SDB diagnosis in children, our results suggest the influence of SDB severity on cardiometabolic risk factors. Further studies are needed to explore the association between PAL and both metabolic and sleep alterations in obese children. Copyright © 2016 Elsevier Inc. All rights reserved.

Forecasting Behavior in Smart Homes Based on Sleep and Wake Patterns

PubMed Central

Williams, Jennifer A.; Cook, Diane J.

2017-01-01

Background The goal of this research is to use smart home technology to assist people who are recovering from injuries or coping with disabilities to live independently. Objective We introduce an algorithm to model and forecast wake and sleep behaviors that are exhibited by the participant. Furthermore, we propose that sleep behavior is impacted by and can be modeled from wake behavior, and vice versa. Methods This paper describes the Behavior Forecasting (BF) algorithm. BF consists of 1) defining numeric values that reflect sleep and wake behavior, 2) forecasting wake and sleep values from past behavior, 3) analyzing the effect of wake behavior on sleep and vice versa, and 4) improving prediction performance by using both wake and sleep scores. Results The BF method was evaluated with data collected from 20 smart homes. We found that regardless of the forecasting method utilized, wake behavior and sleep behavior can be modeled with a minimum accuracy of 84%. Additionally, normalizing the wake and sleep scores drastically improves the accuracy to 99%. Conclusions The results show that we can effectively model wake and sleep behaviors in a smart environment. Furthermore, wake behaviors can be predicted from sleep behaviors and vice versa. PMID:27689555

Forecasting behavior in smart homes based on sleep and wake patterns.

PubMed

Williams, Jennifer A; Cook, Diane J

2017-01-01

The goal of this research is to use smart home technology to assist people who are recovering from injuries or coping with disabilities to live independently. We introduce an algorithm to model and forecast wake and sleep behaviors that are exhibited by the participant. Furthermore, we propose that sleep behavior is impacted by and can be modeled from wake behavior, and vice versa. This paper describes the Behavior Forecasting (BF) algorithm. BF consists of 1) defining numeric values that reflect sleep and wake behavior, 2) forecasting wake and sleep values from past behavior, 3) analyzing the effect of wake behavior on sleep and vice versa, and 4) improving prediction performance by using both wake and sleep scores. The BF method was evaluated with data collected from 20 smart homes. We found that regardless of the forecasting method utilized, wake behavior and sleep behavior can be modeled with a minimum accuracy of 84%. Additionally, normalizing the wake and sleep scores drastically improves the accuracy to 99%. The results show that we can effectively model wake and sleep behaviors in a smart environment. Furthermore, wake behaviors can be predicted from sleep behaviors and vice versa.

Poor sleep quality predicts decreased cognitive function independently of chronic mountain sickness score in young soldiers with polycythemia stationed in Tibet.

PubMed

Kong, Fan-Yi; Li, Qiang; Liu, Shi-Xiang

2011-01-01

Little is known about the association between poor sleep and cognitive function in people with polycythemia at high altitude. The aim of this study was to survey the sleep quality of individuals with polycythemia at high altitude and determine its association with cognitive abilities. We surveyed 230 soldiers stationed in Tibet (all men; mean age 21-52±4.30 yr) at altitudes ranging from 3658 to 3996 m. All participants were given a blood tests for hemoglobin level and a questionnaire survey of cognitive function. Polycythemia was defined as excessive erythrocytosis (Hb≥21 g/dL in men or ≥19 g/dL in women). Poor sleepers were defined as having a global Pittsburgh Sleep Quality Index score (PSQI)>5. Cognitive abilities were determined by the Chinese revision of the Wechsler Adult Intelligence Scale and the Benton Visual Retention Test. Multiple linear regression analysis was used to determine the association between the PSQI and cognitive function. Logistic regression analysis was performed to determine the independent effect of sleep quality on cognitive function. The global PSQI score of enrolled participants was 8.14±3.79. Seventy-five (32.6%) soldiers were diagnosed with polycythemia. The proportion of poor sleepers was 1.45 times greater in those with polycythemia compared with those without polycythemia [95% (confidence interval) CI 1.82-2.56], and they had a statistically significant lower score for cognitive function. Multiple linear regression analysis showed that the global PSQI score was negatively associated with IQ (β=0.11, 95% CI -0.16 to -0.05) and digit symbol scores (β=0.66, 95% CI -0.86 to -0.44). Poor sleep quality was determined to be an independent predictor of impaired IQ [odds ratio (OR) 1.59, 95% CI 1.30-1.95] and digit symbol score (OR 1.18, 95% CI 1.07-1.31) in logistic regression analysis. The present study showed that for young soldiers with polycythemia at high altitude impaired subjective sleep quality was an independent predictor of decreased cognitive function, especially IQ and verbal short-term memory.

Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity.

PubMed

Hansen, Berit Hjelde; Alfstad, Kristin Å; van Roy, Betty; Henning, Oliver; Lossius, Morten I

2016-09-01

Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

Do later wake times and increased sleep duration of 12th graders result in more studying, higher grades, and improved SAT/ACT test scores?

PubMed

Cole, James S

2016-09-01

The aim of this study was to investigate the relationship between sleep duration, wake time, and hours studying on high school grades and performance on the Scholastic Aptitude Test (SAT)/ American College Testing (ACT) college entrance exams. Data were collected from 13,071 recently graduated high school seniors who were entering college in the fall of 2014. A column proportions z test with a Bonferroni adjustment was used to analyze proportional differences. Analysis of covariance (ANCOVA) was used to examine mean group differences. Students who woke up prior to 6 a.m. and got less than 8 h of sleep (27 %) were significantly more likely to report studying 11 or more hours per week (30 %), almost double the rate compared to students who got more than 8 h of sleep and woke up the latest (16 %). Post hoc results revealed students who woke up at 7 a.m. or later reported significantly higher high school grades than all other groups (p < 0.001), with the exception of those students who woke up between 6:01 a.m. and 7:00 a.m. and got eight or more hours of sleep. The highest reported SAT/ACT scores were from the group that woke up after 7 a.m. but got less than 8 h sleep (M = 1099.5). Their scores were significantly higher than all other groups. This study provides additional evidence that increased sleep and later wake time are associated with increased high school grades. However, this study also found that students who sleep the longest also reported less studying and lower SAT/ACT scores.

Prevalence of impaired memory in hospitalized adults and associations with in-hospital sleep loss.

PubMed

Calev, Hila; Spampinato, Lisa M; Press, Valerie G; Meltzer, David O; Arora, Vineet M

2015-07-01

Effective inpatient teaching requires intact patient memory, but studies suggest hospitalized adults may have memory deficits. Sleep loss among inpatients could contribute to memory impairment. To assess memory in older hospitalized adults, and to test the association between sleep quantity, sleep quality, and memory, in order to identify a possible contributor to memory deficits in these patients. Prospective cohort study. General medicine and hematology/oncology inpatient wards. Fifty-nine hospitalized adults at least 50 years of age with no diagnosed sleep disorder. Immediate memory and memory after a 24-hour delay were assessed using a word recall and word recognition task from the University of Southern California Repeatable Episodic Memory Test. A vignette-based memory task was piloted as an alternative test more closely resembling discharge instructions. Sleep duration and efficiency overnight in the hospital were measured using actigraphy. Mean immediate recall was 3.8 words out of 15 (standard deviation = 2.1). Forty-nine percent of subjects had poor memory, defined as immediate recall score of 3 or lower. Median immediate recognition was 11 words out of 15 (interquartile range [IQR] = 9-13). Median delayed recall score was 1 word, and median delayed recognition was 10 words (IQR = 8-12). In-hospital sleep duration and efficiency were not significantly associated with memory. The medical vignette score was correlated with immediate recall (r = 0.49, P < 0.01). About half of the inpatients studied had poor memory while in the hospital, signaling that hospitalization might not be an ideal teachable moment. In-hospital sleep was not associated with memory scores. © 2015 Society of Hospital Medicine.

The effect of nocturia on sleep quality and daytime function in patients with lower urinary tract symptoms: a cross-sectional study.

PubMed

Shao, I-Hung; Wu, Chia-Chen; Hsu, Hueih-Shing; Chang, Shyh-Chyi; Wang, Hsu-Hsiang; Chuang, Heng-Chang; Tam, Yuan-Yun

2016-01-01

Nocturia has been proven to have a negative impact on the quality of life and sleep quality in general elderly population. However, there are limited studies on the quantitative effect of nocturia on sleep quality and daytime dysfunction, specifically in patients with lower urinary tract symptoms. During March 1, 2015 to December 31, 2015, a total of 728 patients who visited our urology department due to voiding dysfunction and experienced nocturia at least once per night were enrolled. Three questionnaires were administered to them after obtaining their written consents. Pittsburgh Sleep Quality Index (PSQI) questionnaire, Epworth Sleepiness Scale (ESS) questionnaire, and International Prostate Symptom Score (IPSS) questionnaire were applied to evaluate their sleep quality, daytime dysfunction, and voiding problems, respectively. Statistical analysis of the impact of nocturia on sleep quality and daytime dysfunction was performed. The mean age of patients was 61 years, with a male-to-female ratio of 2.7. The mean nocturia number was 3.03. The IPSS, PSQI, and ESS scores were 17.56, 8.35, and 8.22, respectively. The nocturia number increased with age and was significantly correlated to ESS score (daytime dysfunction) and PSQI total score (sleep quality) in overall group. Among subgroups divided by age and sex, there was a significant correlation between nocturia number and daytime dysfunction in male patients or patients younger than 65 years. In patients with lower urinary tract symptoms, nocturia number increased with age and was significantly correlated with poor sleep quality. Nocturia plays an important role in patients younger than 65 years in daytime dysfunction.

Prevalence of Impaired Memory in Hospitalized Adults and Associations with In-Hospital Sleep Loss

PubMed Central

Calev, Hila; Spampinato, Lisa M; Press, Valerie G; Meltzer, David O; Arora, Vineet M

2015-01-01

Background Effective inpatient teaching requires intact patient memory, but studies suggest hospitalized adults may have memory deficits. Sleep loss among inpatients could contribute to memory impairment. Objective To assess memory in older hospitalized adults, and to test the association between sleep quantity, sleep quality and memory, in order to identify a possible contributor to memory deficits in these patients. Design Prospective cohort study Setting General medicine and hematology/oncology inpatient wards Patients 59 hospitalized adults at least 50 years of age with no diagnosed sleep disorder. Measurements Immediate memory and memory after a 24-hour delay were assessed using a word recall and word recognition task from the University of Southern California Repeatable Episodic Memory Test (USC-REMT). A vignette-based memory task was piloted as an alternative test more closely resembling discharge instructions. Sleep duration and efficiency overnight in the hospital were measured using actigraphy. Results Mean immediate recall was 3.8 words out of 15 (SD=2.1). Forty-nine percent of subjects had poor memory, defined as immediate recall score of 3 or lower. Median immediate recognition was 11 words out of 15 (IQR=9, 13). Median delayed recall score was 1 word and median delayed recognition was 10 words (IQR= 8–12). In-hospital sleep duration and efficiency were not significantly associated with memory. The medical vignette score was correlated with immediate recall (r=0.49, p<0.01) Conclusions About half of inpatients studied had poor memory while in the hospital, signaling that hospitalization might not be an ideal teachable moment. In-hospital sleep was not associated with memory scores. PMID:25872763

Time to improvement of pain and sleep quality in clinical trials of pregabalin for the treatment of fibromyalgia.

PubMed

Arnold, Lesley M; Emir, Birol; Pauer, Lynne; Resnick, Malca; Clair, Andrew

2015-01-01

To determine the time to immediate and sustained clinical improvement in pain and sleep quality with pregabalin in patients with fibromyalgia. A post hoc analysis of four 8- to 14-week phase 2-3, placebo-controlled trials of fixed-dose pregabalin (150-600 mg/day) for fibromyalgia, comprising 12 pregabalin and four placebo treatment arms. A total of 2,747 patients with fibromyalgia, aged 18-82 years. Pain and sleep quality scores, recorded daily on 11-point numeric rating scales (NRSs), were analyzed to determine time to immediate improvement with pregabalin, defined as the first of ≥2 consecutive days when the mean NRS score was significantly lower for pregabalin vs placebo in those treatment arms with a significant improvement at endpoint, and time to sustained clinical improvement with pregabalin, defined as a ≥1-point reduction of the baseline NRS score of patient responders who had a ≥30% improvement on the pain NRS, sleep NRS, or Fibromyalgia Impact Questionnaire (FIQ) from baseline to endpoint, or who reported "much improved" or "very much improved" on the Patient Global Impression of Change (PGIC) at endpoint. Significant improvements in pain and sleep quality scores at endpoint vs placebo were seen in 8/12 and 11/12 pregabalin treatment arms, respectively (P < 0.05). In these arms, time to immediate improvements in pain or sleep occurred by day 1 or 2. Time to sustained clinical improvement occurred significantly earlier in pain, sleep, PGIC, and FIQ responders (P < 0.02) with pregabalin vs placebo. Both immediate and sustained clinical improvements in pain and sleep quality occurred faster with pregabalin vs placebo. Wiley Periodicals, Inc.

Psychometric properties of the children's sleep habits questionnaire in children with autism spectrum disorder.

PubMed

Johnson, Cynthia R; DeMand, Alexandra; Lecavalier, Luc; Smith, Tristram; Aman, Michael; Foldes, Emily; Scahill, Lawrence

2016-04-01

Sleep disturbances in autism spectrum disorder (ASD) are very common. Psychometrically sound instruments are essential to assess these disturbances. Children's Sleep Habit Questionnaire (CSHQ) is a widely used measure in ASD. The purpose of this study was to explore the psychometric properties of the CSHQ in a sample of children with ASD. Parents/caregivers of 310 children (mean age: 4.7) with ASD completed the CSHQ at study enrollment. Correlations between intelligence quotient (IQ) scores and the original CSHQ scales were calculated. Item endorsement frequencies and percentages were also calculated. A principal component analysis (PCA) was performed, and internal consistency was assessed for the newly extracted components. Correlations between IQ scores and CSHQ subscales and total scores ranged from .015 to .001 suggesting a weak, if any, association. Item endorsement frequencies were high for bedtime resistance items, but lower for parasomnia and sleep-disordered breathing items. A PCA suggested that a five-component solution best fits the data. Internal consistency of the newly extracted five components ranged α = .87-.50. Item endorsement frequencies were highest for bedtime resistance items. A PCA suggested a five-component solution. Three of the five components (Sleep Routine Problems, Insufficient Sleep, and Sleep-onset Association Problems) were types of sleep disturbances commonly reported in ASD, but the other two components (Parasomnia/Sleep-disordered Breathing and Sleep Anxiety) were less clear. Internal consistencies ranged from mediocre to good. Further development of this measure for use in children with ASD is encouraged. Copyright © 2016 Elsevier B.V. All rights reserved.

Influence of sleep deprivation on learning among surgical house staff and medical students.

PubMed

Browne, B J; Van Susteren, T; Onsager, D R; Simpson, D; Salaymeh, B; Condon, R E

1994-05-01

Sleep deprivation as a result of in-house night call may alter capacity to learn. Surgical residents and medical students, in both sleep-deprived and rested states, read surgical journal articles and later answered questions regarding their content as a measure of ability to learn while participating in scheduled night call. Medical students (n = 35) and residents (n = 21) rotating on surgical services kept logs of hours slept during a 4-week study period. Subjects read six selected articles at separate early morning sittings during weeks 1 and 3. A multiple choice test was given 1 week after each session to assess short-term recall, and all tests were given again 3 months later to assess retention of information over the longer term. Scores were compared with the sleep data. Subjective measures of fatigue and motivation elicited from subjects also were evaluated. Sleep deprivation (4 hours or less uninterrupted sleep per night) resulted in increased fatigue and decreased motivation among medical students and residents (p < 0.05, t test). Objective scores on tests administered 1 week and 3 months after reading did not show an effect attributable to sleep deprivation (p > 0.05, t test). Sleep deprivation leads to subjective feelings of increased fatigue and decreased motivation. Residents and medical students, however, whether sleep deprived or not, obtain comparable scores on objective tests measuring both short-term and long-term retention of newly learned material. The ability to learn medically relevant information does not appear to be significantly altered by the degree of sleep deprivation associated with clinical rotations on surgical services.

Examining maladaptive beliefs about sleep across insomnia patient groups

PubMed Central

Carney, Colleen E.; Edinger, Jack D.; Morin, Charles M.; Manber, Rachel; Rybarczyk, Bruce; Stepanski, Edward J.; Wright, Helen; Lack, Leon

2009-01-01

Objectives: Unhelpful beliefs about sleep have been linked to insomnia, and increasing one's cognitive flexibility about sleep has been linked to post-treatment sleep improvement. This study evaluated if levels of such beliefs differ across insomnia groups, and whether there are particular beliefs that differ for specific insomnia subtypes. Methods: Participants (N = 1384) were people with insomnia and good sleepers ranging from 18 to 89 years old (M = 42.6, SD = 19.4). Data from previous studies at five insomnia clinical sites were pooled to examine responses on the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16) across differing insomnia groups. Results: Group analyses revealed that those from community-based insomnia clinics and those who are hypnotic-dependent generally had the highest levels of unhelpful sleep-related beliefs. With the exception of beliefs about sleep needs (wherein only community sleep clinic patients had high scores relative to good sleepers), all insomnia groups had higher scores on the DBAS-16 than good sleepers. A validity analysis suggested that a DBAS-16 index score > 3.8 was the level of unhelpful beliefs associated with clinically significant insomnia, although a slightly lower cutoff may be useful to identify an unhelpful degree of sleep-related beliefs in highly screened PI and medical patient groups. Conclusions: This study offers descriptive data for the use of the DBAS-16 across insomnia subgroups, which will help the user understand what degree of maladaptive sleep beliefs are most strongly associated with clinically significant levels of insomnia. Results also may have implications for cognitive targeting during treatment for particular insomnia groups. PMID:20004301

Effect of levothyroxine on prolonged nocturnal sleep time and excessive daytime somnolence in patients with idiopathic hypersomnia.

PubMed

Shinno, Hideto; Ishikawa, Ichiro; Yamanaka, Mami; Usui, Ai; Danjo, Sonoko; Inami, Yasushi; Horiguchi, Jun; Nakamura, Yu

2011-06-01

This study aims to examine the effect of levothyroxine, a thyroid hormone, on a prolonged nocturnal sleep and excessive daytime somnolence (EDS) in patients with idiopathic hypersomnia. In a prospective, open-label study, nine patients were enrolled. All subjects met criteria for idiopathic hypersomnia with long sleep time defined by the International Classification of Sleep Disorders, 2nd edition (ICSD-2). Subjects with sleep apnea syndrome, obesity or hypothyroidism were excluded. Sleep architecture and subjective daytime somnolence were estimated by polysomnography (PSG) and Epworth Sleepiness Scale (ESS), respectively. After baseline examinations, levothyroxine (25μg/day) was orally administered every day. Mean total sleep time, ESS score at baseline were compared with those after treatment (2, 4 and 8 weeks). Mean age of participants was 23.8±13.7 years old. At baseline, mean total sleep time (hours) and ESS score were 12.9±0.3 and 17.8±1.4, respectively. Mean total sleep times after treatment were 9.1±0.7 and 8.5±1.0h at 4 and 8 treatment weeks, respectively. Mean ESS scores were 8.8±2.3 and 7.4±2.8 at 4 and 8 treatment weeks, respectively. One patient dropped out at the 2nd week due to poor effect. No adverse effects were noted. After treatment with levothyroxine for over 4 weeks, prolonged sleep time and EDS were improved. Levothyroxine was effective for hypersomnia and well tolerated. Copyright © 2011 Elsevier B.V. All rights reserved.

Quality of Life in Patients With Chronic Rhinosinusitis and Sleep Dysfunction Undergoing Endoscopic Sinus Surgery: A Pilot Investigation of Comorbid Obstructive Sleep Apnea.

PubMed

Alt, Jeremiah A; DeConde, Adam S; Mace, Jess C; Steele, Toby O; Orlandi, Richard R; Smith, Timothy L

2015-10-01

Patients with chronic rhinosinusitis (CRS) have reduced sleep quality linked to their overall well-being and disease-specific quality of life (QOL). Other primary sleep disorders also affect QOL. To determine the impact of comorbid obstructive sleep apnea (OSA) on CRS disease-specific QOL and sleep dysfunction in patients with CRS following functional endoscopic sinus surgery. Prospective multisite cohort study conducted between October 2011 and November 2014 at academic, tertiary referral centers with a population-based sample of 405 adults. Functional endoscopic sinus surgery for medically refractory symptoms of CRS. Primary outcome measures consisted of preoperative and postoperative scores operationalized by the Rhinosinusitis Disability Index (RSDI) survey, the 22-item Sinonasal Outcome Test (SNOT-22), and the Pittsburgh Sleep Quality Index (PSQI). Obstructive sleep apnea was the primary, independent risk factor. Of 405 participants, 60 (15%) had comorbid OSA. A total of 285 (70%) participants provided preoperative and postoperative survey responses, with a mean (SD) of 13.7 (5.3) months of follow-up. Significant postoperative improvement (P < .05) was reported across all mean disease-specific QOL measures for both participants with and without comorbid OSA. Participants without OSA reported significant greater improvement in unadjusted mean (SD) RSDI global scores (−25.0 [23.3] vs. −16.5 [22.1]; P = .03), RSDI physical (−10.7 [9.2] vs. −7.3 [9.1]; P = .03) and functional (−8.4 [8.7] vs. −5.1 [7.5]; P = .03) subdomain scores, and SNOT-22 rhinologic symptom domain scores (−9.1 [7.7] vs. −5.7 [6.9]; P = .008). Participants without OSA also reported greater improvements on mean (SD) PSQI global (−1.9 [4.0] vs. −0.5 [3.7]; P = .03), sleep quality (−0.4 [0.8] vs. −0.03 [0.7]; P = .02), and sleep disturbance (−0.4 [0.7] vs. −0.1 [0.7]; P = .03) scores. The majority of these associations were found to be durable after adjustment for alternate independent cofactors using stepwise linear regression modeling. Patients with CRS and comorbid OSA have poor QOL with substantial disease-specific QOL improvements following surgery. Patients who present with CRS should be assessed for primary sleep disorders and, if identified, should be treated concurrently for both CRS and OSA to improve sleep dysfunction to optimize surgical outcomes. clinicaltrials.gov Identifier: NCT01332136.

Impact of coexisting irritable bowel syndrome and non-erosive reflux disease on postprandial abdominal fullness and sleep disorders in functional dyspepsia.

PubMed

Futagami, Seiji; Yamawaki, Hiroshi; Shimpuku, Mayumi; Izumi, Nikki; Wakabayashi, Taiga; Kodaka, Yasuhiro; Nagoya, Hiroyuki; Shindo, Tomotaka; Kawagoe, Tetsuro; Sakamoto, Choitsu

2013-01-01

The association between clinical symptoms and sleep disorders in functional dyspepsia (FD)-overlap syndrome has not been studied in detail. The subjects were 139 patients with FD, 14 with irritable bowel syndrome (IBS), 12 with nonerosive reflux disease (NERD), and 41 healthy volunteers. Gastric motility was evaluated with the (13)C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Sleep disorders were evaluated with Pittsburgh Sleep Quality Index (PSQI) scores. There were no significant differences in age, body-mass index, alcohol intake, and smoking rate between patients with FD alone and those with FD-overlap syndrome. The postprandial abdominal fullness score in patients with FD-NERD-IBS was significantly greater than that in patients with FD-NERD overlap syndrome (p<0.001) or FD alone (p<0.001). The score for the feeling of hunger in patients with FD-NERD-IBS was significantly greater than that in patients with FD alone (p=0.0025), FD-NERD overlap syndrome (p=0.0088), or FD-IBS overlap syndrome (p=0.0057). The heartburn score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone (p=0.0035) or FD-IBS overlap syndrome (p=0.0026). The Tmax in patients with FD-overlap syndrome or FD alone was significantly higher than that in healthy volunteers. The Pittsburgh Sleep Quality Index score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone. Symptom scores, such as those for postprandial abdominal fullness, heartburn, and the feeling of hunger, in patients with FD-overlap syndromes are significantly greater than those in patients with FD alone. Further studies are necessary to clarify whether various symptoms are related to sleep disorders in patients with FD-NERD-IBS overlap syndrome.

A Contribution for the Automatic Sleep Classification Based on the Itakura-Saito Spectral Distance

NASA Astrophysics Data System (ADS)

Cardoso, Eduardo; Batista, Arnaldo; Rodrigues, Rui; Ortigueira, Manuel; Bárbara, Cristina; Martinho, Cristina; Rato, Raul

Sleep staging is a crucial step before the scoring the sleep apnoea, in subjects that are tested for this condition. These patients undergo a whole night polysomnography recording that includes EEG, EOG, ECG, EMG and respiratory signals. Sleep staging refers to the quantification of its depth. Despite the commercial sleep software being able to stage the sleep, there is a general lack of confidence amongst health practitioners of these machine results. Generally the sleep scoring is done over the visual inspection of the overnight patient EEG recording, which takes the attention of an expert medical practitioner over a couple of hours. This contributes to a waiting list of two years for patients of the Portuguese Health Service. In this work we have used a spectral comparison method called Itakura distance to be able to make a distinction between sleepy and awake epochs in a night EEG recording, therefore automatically doing the staging. We have used the data from 20 patients of Hospital Pulido Valente, which had been previously visually expert scored. Our technique results were promising, in a way that Itakura distance can, by itself, distinguish with a good degree of certainty the N2, N3 and awake states. Pre-processing stages for artefact reduction and baseline removal using Wavelets were applied.

The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis.

PubMed

Mollayeva, Tatyana; Thurairajah, Pravheen; Burton, Kirsteen; Mollayeva, Shirin; Shapiro, Colin M; Colantonio, Angela

2016-02-01

This review appraises the process of development and the measurement properties of the Pittsburgh sleep quality index (PSQI), gauging its potential as a screening tool for sleep dysfunction in non-clinical and clinical samples; it also compares non-clinical and clinical populations in terms of PSQI scores. MEDLINE, Embase, PsycINFO, and HAPI databases were searched. Critical appraisal of studies of measurement properties was performed using COSMIN. Of 37 reviewed studies, 22 examined construct validity, 19 - known-group validity, 15 - internal consistency, and three - test-retest reliability. Study quality ranged from poor to excellent, with the majority designated fair. Internal consistency, based on Cronbach's alpha, was good. Discrepancies were observed in factor analytic studies. In non-clinical and clinical samples with known differences in sleep quality, the PSQI global scores and all subscale scores, with the exception of sleep disturbance, differed significantly. The best evidence synthesis for the PSQI showed strong reliability and validity, and moderate structural validity in a variety of samples, suggesting the tool fulfills its intended utility. A taxonometric analysis can contribute to better understanding of sleep dysfunction as either a dichotomous or continuous construct. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sleep Extension Improves Neurocognitive Functions in Chronically Sleep-Deprived Obese Individuals

PubMed Central

Lucassen, Eliane A.; Piaggi, Paolo; Dsurney, John; de Jonge, Lilian; Zhao, Xiong-ce; Mattingly, Megan S.; Ramer, Angela; Gershengorn, Janet; Csako, Gyorgy; Cizza, Giovanni

2014-01-01

Background Sleep deprivation and obesity, are associated with neurocognitive impairments. Effects of sleep deprivation and obesity on cognition are unknown, and the cognitive long-term effects of improvement of sleep have not been prospectively assessed in short sleeping, obese individuals. Objective To characterize neurocognitive functions and assess its reversibility. Design Prospective cohort study. Setting Tertiary Referral Research Clinical Center. Patients A cohort of 121 short-sleeping (<6.5 h/night) obese (BMI 30–55 kg/m2) men and pre-menopausal women. Intervention Sleep extension (468±88 days) with life-style modifications. Measurements Neurocognitive functions, sleep quality and sleep duration. Results At baseline, 44% of the individuals had an impaired global deficit score (t-score 0–39). Impaired global deficit score was associated with worse subjective sleep quality (p = 0.02), and lower urinary dopamine levels (p = 0.001). Memory was impaired in 33%; attention in 35%; motor skills in 42%; and executive function in 51% of individuals. At the final evaluation (N = 74), subjective sleep quality improved by 24% (p<0.001), self-reported sleep duration increased by 11% by questionnaires (p<0.001) and by 4% by diaries (p = 0.04), and daytime sleepiness tended to improve (p = 0.10). Global cognitive function and attention improved by 7% and 10%, respectively (both p = 0.001), and memory and executive functions tended to improve (p = 0.07 and p = 0.06). Serum cortisol increased by 17% (p = 0.02). In a multivariate mixed model, subjective sleep quality and sleep efficiency, urinary free cortisol and dopamine and plasma total ghrelin accounted for 1/5 of the variability in global cognitive function. Limitations Drop-out rate. Conclusions Chronically sleep-deprived obese individuals exhibit substantial neurocognitive deficits that are partially reversible upon improvement of sleep in a non-pharmacological way. These findings have clinical implications for large segments of the US population. Trail registration www.ClinicalTrials.gov NCT00261898. NIDDK protocol 06-DK-0036 PMID:24482677

Automated identification of sleep states from EEG signals by means of ensemble empirical mode decomposition and random under sampling boosting.

PubMed

Hassan, Ahnaf Rashik; Bhuiyan, Mohammed Imamul Hassan

2017-03-01

Automatic sleep staging is essential for alleviating the burden of the physicians of analyzing a large volume of data by visual inspection. It is also a precondition for making an automated sleep monitoring system feasible. Further, computerized sleep scoring will expedite large-scale data analysis in sleep research. Nevertheless, most of the existing works on sleep staging are either multichannel or multiple physiological signal based which are uncomfortable for the user and hinder the feasibility of an in-home sleep monitoring device. So, a successful and reliable computer-assisted sleep staging scheme is yet to emerge. In this work, we propose a single channel EEG based algorithm for computerized sleep scoring. In the proposed algorithm, we decompose EEG signal segments using Ensemble Empirical Mode Decomposition (EEMD) and extract various statistical moment based features. The effectiveness of EEMD and statistical features are investigated. Statistical analysis is performed for feature selection. A newly proposed classification technique, namely - Random under sampling boosting (RUSBoost) is introduced for sleep stage classification. This is the first implementation of EEMD in conjunction with RUSBoost to the best of the authors' knowledge. The proposed feature extraction scheme's performance is investigated for various choices of classification models. The algorithmic performance of our scheme is evaluated against contemporary works in the literature. The performance of the proposed method is comparable or better than that of the state-of-the-art ones. The proposed algorithm gives 88.07%, 83.49%, 92.66%, 94.23%, and 98.15% for 6-state to 2-state classification of sleep stages on Sleep-EDF database. Our experimental outcomes reveal that RUSBoost outperforms other classification models for the feature extraction framework presented in this work. Besides, the algorithm proposed in this work demonstrates high detection accuracy for the sleep states S1 and REM. Statistical moment based features in the EEMD domain distinguish the sleep states successfully and efficaciously. The automated sleep scoring scheme propounded herein can eradicate the onus of the clinicians, contribute to the device implementation of a sleep monitoring system, and benefit sleep research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Sleep Quality in University Students with Premenstrual Dysphoric Disorder

PubMed Central

KHAZAIE, Habibolah; GHADAMI, Mohammad Rasoul; KHALEDI-PAVEH, Behnam; CHEHRI, Azita; NASOURI, Marzieh

2016-01-01

Background Up to 8% of women in their reproductive years are affected by Premenstral Dysphoric Disorder (PMDD). Sleep disturbances such as insomnia or hypersomnia are one of the DSM-IV-TR’s defining criteria for the diagnosis of PMDD and are found in about 70% of women with the disorder. However, studies are lacking that specifically address the effects of PMDD on quality of sleep. Aim This study was designed to evaluate the prevalence of Premenstrual DysphoricDisorder (PMDD) and its impact on sleep quality in female university students. Methods We developed an 18-item PMDD scale based on The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to diagnose PMDD in female university studentswho ranged in age from 18 to 30 years and had regular menstrual cycles.Participants were categorized into a PMDD group or a No/PMDD group and sleep quality was compared between the two groups. The evaluation tool used to measure sleep quality was the Pittsburgh Sleep Quality Index (PSQI). Results The prevalence of PMDD in female universitystudents was 25.5%. Analysis of the PSQI demonstrated that 80.5% of those in PMDD group had a PSQI that scored >5; however, only 56.4% in the No/PMDD grouphad a PSQI that scored >5 (χ2=12.459, p<0.001). The mean PSQI score was 8.2(3.4) in the PMDD group and was 6.5(3.1) in the No/PMDD group (t=3.648, p<0.001). Conclusions Female university students who experience PMDD are deeply affected by sleep problems. Lower sleep quality, daytime dysfunction, and sleep disturbance are common sleep problems among female university students with PMDD. PMID:28638182

Depressive symptoms are associated with daytime sleepiness and subjective sleep quality in dementia with Lewy bodies.

PubMed

Elder, Greg J; Colloby, Sean J; Lett, Debra J; O'Brien, John T; Anderson, Kirstie N; Burn, David J; McKeith, Ian G; Taylor, John-Paul

2016-07-01

Sleep problems and depression are common symptoms in dementia with Lewy bodies (DLB), where patients typically experience subjectively poor sleep quality, fatigue and excessive daytime sleepiness. However, whilst sleep disturbances have been linked to depression, this relationship has not received much attention in DLB. The present cross-sectional study addresses this by examining whether depressive symptoms are specifically associated with subjective sleep quality and daytime sleepiness in DLB, and by examining other contributory factors. DLB patients (n = 32) completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and the 15-item Geriatric Depression Scale (GDS-15). Motor and cognitive functioning was also assessed. Pearson correlations were used to assess the relationship between GDS-15, ESS and PSQI scores. GDS-15 scores were positively associated with both ESS (r = 0.51, p < 0.01) and PSQI (r = 0.59, p < 0.001) scores. Subjective poor sleep and daytime sleepiness were associated with depressive symptoms in DLB. Given the cross-sectional nature of the present study, the directionality of this relationship cannot be determined, although this association did not appear to be mediated by sleep quality or daytime sleepiness. Nevertheless, these findings have clinical relevance; daytime sleepiness or poor sleep quality might indicate depression in DLB, and subsequent work should examine whether the treatment of depression can reduce excessive daytime sleepiness and improve sleep quality in DLB patients. Alternatively, more rigorous screening for sleep problems in DLB might assist the treatment of depression. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.

Characterization of REM sleep without atonia in patients with narcolepsy and idiopathic hypersomnia using AASM scoring manual criteria.

PubMed

DelRosso, Lourdes M; Chesson, Andrew L; Hoque, Romy

2013-07-15

The AASM Manual for the Scoring of Sleep and Associated Events (Manual) has provided standardized definitions for tonic and phasic REM sleep without atonia (RSWA). This study used Manual criteria to characterize REM sleep in patients with narcolepsy and idiopathic hypersomnia (IH). A retrospective review of PSG data from ICSD-2 defined patients with narcolepsy or IH, performed by two board certified sleep medicine physicians. Data compiled included REM sleep epochs and the presence in REM sleep of epochs scored as sustained muscle activity (tonic), and excessive transient muscle activity (phasic) as defined by Manual criteria. PSG data from 8 narcolepsy patients (mean age: 27.5 years; age range: 11-55) showed mean ± standard deviation values for: total REM sleep epochs 205 ± 46.1; RSWA/ phasic epochs 56.1 ± 25.4; and RSWA/tonic epochs 15.0 ± 10.7. PSG data from 8 IH patients (mean age: 33.1 years; age range: 20-57) showed mean ± standard deviation values of total REM sleep epochs 163.8 ± 67.9; RSWA/phasic epochs 6.2 ± 3.5; and RSWA/tonic epochs 0.2 ± 0.4. Comparison revealed intergroup differences in phasic REM sleep (p < 0.01) and tonic REM sleep (p < 0.01) were significantly increased in narcoleptics compared to IH. Our retrospective analysis showed that RSWA phasic activity and RSWA tonic activity are significantly increased in patients meeting ICSD-2 criteria for narcolepsy compared to patients meeting ICSD-2 criteria for IH. This robust difference, with further validation, could be useful as electrophysiological criteria differentiating the two disorders and understanding the physiological differences.

Poor sleep quality and insufficient sleep of a collegiate student-athlete population.

PubMed

Mah, Cheri D; Kezirian, Eric J; Marcello, Brandon M; Dement, William C

2018-06-01

Poor and inadequate sleep negatively impact cognitive and physical functioning and may also affect sports performance. The study aim is to examine sleep quality, sleep duration, and daytime sleepiness in collegiate student-athletes across a wide range of sports. Questionnaire. University setting. 628 athletes across 29 varsity teams at Stanford University. Athletes completed a questionnaire inquiring about sleep quality via a modified Pittsburgh Sleep Quality Index (PSQI), sleep duration, and daytime sleepiness via Epworth Sleepiness Scale. Sleep quality on campus and while traveling for competition was rated on a 10-point scale. Collegiate athletes were classified as poor sleepers (PSQI 5.38 ± 2.45), and 42.4% of athletes experience poor sleep quality (reporting PSQI global scores >5). Athletes reported lower sleep quality on campus than when traveling for competition (7.1 vs 7.6, P< .001). Inadequate sleep was demonstrated by 39.1% of athletes that regularly obtain <7 hours of sleep on weekdays. Fifty-one percent of athletes reported high levels of daytime sleepiness with Epworth scores ≥10. Teen student-athletes in the first and second year of college reported the highest mean levels of daytime sleepiness. Greater total sleep time was associated with daytime functioning including lower frequency of difficulty waking up for practice or class (P< .001) and lower frequency of trouble staying awake during daily activities (P< .001). Collegiate athletes frequently experience poor sleep quality, regularly obtain insufficient sleep, and commonly exhibit daytime sleepiness. Copyright © 2018 National Sleep Foundation. All rights reserved.

Shift Work and Sleep: Medical Implications and Management

PubMed Central

Jehan, Shazia; Zizi, Ferdinand; Pandi-Perumal, Seithikurippu R; Myers, Alyson K; Auguste, Evan; Jean-Louis, Girardin; McFarlane, Samy I

2018-01-01

The primary occupation of a worker can play an important role in achieving good sleep, as well as good physical and mental health. Shift Work Sleep Disorder (SWSD) is a condition that results from working atypical shifts (i.e. other than the typical 9 am to 5 pm schedule). Individuals who manifest SWSD usually complaint of trouble sleeping, excessive sleepiness and fatigue which interfere with overall functioning. Misalignment of circadian timing system results in undesirable health consequences. Among shift workers, good sleep is essential for efficient functioning. Disturbed sleep is associated with anxiety, depression, poor physical and mental health and eventually, leads to impaired quality of life. The economic burden of undiagnosed, under-and untreated shift work is high. The healthcare workers and policymakers can play a pivotal role in dealing with this issue by educating the public and providing them with adequate privileges to perform their work. PMID:29517053

Continual Screening of Patients Using mHealth: The Rolling Score Concept Applied to Sleep Medicine.

PubMed

Zluga, Claudio; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

2016-01-01

Continual monitoring of patients utilizing mHealth-based telemonitoring applications are more and more used for individual management of patients. A new approach in risk assessment called Rolling Score Concept uses standardized questionnaires for continual scoring of individuals' health state through electronic patient reported outcome (ePRO). Using self-rated questionnaires and adding a specific Time Schedule to each question result in a movement of the questionnaires' scores over time, the Rolling Score. A text-processing pipeline was implemented with KNIME analytics platform to extract a Score Mapping Rule Set for three standardized screening questionnaires in the field of sleep medicine. A feasibility study was performed in 10 healthy volunteers equipped with a mHealth application on a smartphone and a sleep tracker. Results show that the proposed Rolling Score Concept is feasible and deviations of scores are in a reasonable range (< 7%), sustaining the new approach. However, further studies are required for verification. In addition, parameter quantification could avoid incorrect subjective evaluation by substitution of questions with sensor data.

Strokes and their relationship with sleep and sleep disorders.

PubMed

Ferre, A; Ribó, M; Rodríguez-Luna, D; Romero, O; Sampol, G; Molina, C A; Álvarez-Sabin, J

2013-03-01

In the current population, strokes are one of the most important causes of morbidity and mortality, to which new risk factors are increasingly being attributed. Of late, there is increased interest in the relationship between sleep disorders and strokes as regards risk and prognosis. This article presents the changes in sleep architecture and brain activity in stroke patients, as well as the interaction between stroke and sleep disorders, including those which may also influence the outcome and recovery from strokes. The different treatments discussed in the literature are also reviewed, as correct treatment of such sleep disorders may not only improve quality of life and reduce after-effects, but can also increase life expectancy. Sleep disorders are becoming increasingly associated with stroke. In addition to being a risk factor, they can also interfere in the outcome and recovery of stroke patients. This article aims to present an exhaustive and current review on strokes and their relationship with sleep alterations and sleep disorders. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Disability associated with low back pain in Mulago Hospital, Kampala Uganda.

PubMed

Galukande, M; Muwazi, S; Mugisa, B D

2006-09-01

Low back pain is sufficiently disabling and a common cause of disability particularly during the productive middle years of adult life. Disability implies interference with daily activities. To assess and document the disability associated with low back pain in terms of sick leave days, interference with daily activities and some pain characteristics. This study was carried out in the Orthopaedic out patient clinic of Mulago Hospital, a tertiary national referral hospital in Kampala, Uganda. It was a descriptive cross sectional study over a period of seven months. 204 patients with mechanical back pain were enrolled in the study, after screening all consecutive new adult patients referred with low back pain as the major complaint. A validated modified Oswestry instrument was used to collect data. Nine daily activities: sleep, sex, lifting, traveling, social and recreational activities, dressing, sitting, walking and running activities were investigated. Data was analyzed using SPSS for windows version 10. Mean and Standard deviations were used to summarize continuous variables. P value was considered statistically significant if it was equal or less than 0.05. 87% of the respondents reported a mean of 14 days off work during the 4 weeks prior to the interview because of back problems. The mean duration of a current low back pain episode was 5 months. All activities were interfered with; with lifting as the most affected with a mean score of 4.5, walking and running was 3.6, standing was 3.3, sex life was 2.9, traveling was 2.9, sitting was 2.7, social and recreational activities was 2.7, getting dressed was 2.1 and sleeping was 1.8. Our results confirm that low back pain is a significant cause of disability affecting the productive middle years of adult life and causes significant disruption of daily activities including sleep and sex. The cost of lost work time, compensation and treatment for our setting is a knowledge gap that should be filled by further study. There is need for a community-based study to ascertain extent of the problem in at a wider population level.

[SLEEP QUALITY, EXCESSIVE DAYTIME SLEEPINESS AND INSOMNIA IN CHILEAN PARALYMPIC ATHLETES].

PubMed

Durán Agüero, Samuel; Arroyo Jofre, Patricio; Varas Standen, Camila; Herrera-Valenzuela, Tomas; Moya Cantillana, Cristobal; Pereira Robledo, Rodolfo; Valdés-Badilla, Pablo

2015-12-01

the sleep takes part in diverse biological and physiological functions, associating his restriction, with minor performance in the sport, nevertheless the quantity and quality of sleep is not known in paralympic athletes. to determine the sleep quality, insomnia and excessive daytime sleepiness in Chilean paralympic athletes. descriptive transverse Study, the sample included 33 paralympic athletes (24.2% women), those who were practicing swimming, tennis of table, football 5, powerlifting and tennis chair. The studied variables measured up across two surveys of dream: the Questionnaire of Insomnia and the Pittsburgh Sleep Quality Index. the paralympic athletes sleep were 6.9 } 1.4 hours, 27.7% presents daytime sleepiness, 69.6 % insomnia (Survey of insomnia =7), whereas 78.7 % exhibits a bad sleep quality. The age showed a positive correlation with latency to the sleep (r=0.417 *), the insomnia with latency to the sleep (r=0.462 **), the Pittsburg score was correlated negatively by the sleep duration (r =-0.323) and latency to the sleep is correlated positively by the Pittsburgh score (r=0.603 **). the chilean paralympic athletes, present a low sleep quality, insomnia and excessive daytime sleepiness, situation that might influence negatively the sports performance. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

The effects of partial sleep restriction and altered sleep timing on olfactory performance.

PubMed

McNeil, J; Forest, G; Hintze, L J; Brunet, J-F; Doucet, É

2017-12-01

Olfaction can increase the drive to eat and may partially explain the consistent increases in energy intake (EI) following sleep restriction. We investigated the effects of 50% sleep restriction with altered sleep timing on olfactory performance. We also evaluated whether changes (Δ) in olfactory performance were associated with Δ24 h EI. Twelve men and six women (age: 23±4 years; BMI: 23±3 kg/m 2 ) completed three randomized cross-over conditions: habitual sleep duration, 50% sleep restriction with advanced wake-time, and 50% sleep restriction with delayed bedtime. Sleep was measured in-laboratory (polysomnography). Olfactory performance ('sniffin sticks') and 24 h EI (food menu) were evaluated the next day. A trend for a significant condition*sex interaction was noted for threshold-discrimination-identification (TDI) scores (P=0.09); TDI scores were lowest in women and highest in men, following sleep restriction with advanced wake-time. Δolfactory performance were not associated with Δ24 h EI. The impact of sleep restriction on olfactory performance may differ between sexes. Changes in olfactory performance were not associated with changes in 24 h EI. Studies investigating prolonged effects of sleep loss on the relationship between olfactory performance with EI are needed.

Presence and persistence of sleep-related symptoms and suicidal ideation in psychiatric inpatients.

PubMed

Nadorff, Michael R; Ellis, Thomas E; Allen, Jon G; Winer, E Samuel; Herrera, Steve

2014-01-01

Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment. To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve. The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination. Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission. These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.

Association between Sleep Duration and Intelligence Scores in Healthy Children

ERIC Educational Resources Information Center

Geiger, Anja; Achermann, Peter; Jenni, Oskar G.

2010-01-01

We examined the association between sleep behavior and cognitive functioning in 60 healthy children between 7 and 11 years of age under nonexperimental conditions. Intellectual abilities were assessed by the Wechsler Intelligence Scale for Children (4th edition) and sleep variables by questionnaires, actigraphy, and sleep diaries. Correlation…

Pilot study on the effects of a 1-day sleep education program: influence on sleep of stopping alcohol intake at bedtime.

PubMed

Morita, Emi; Miyazaki, Soichiro; Okawa, Masako

2012-08-01

The aim of this pilot study was to evaluate whether sleep was improved by a 1-day sleep education program in an occupational setting and whether stopping alcohol intake at bedtime might influence sleep. Subjects were 40 high school employees. The sleep education program lasted 4.5 hours and consisted of sleep science information, and sleep hygiene education including the risk of sleep related breathing disorder resulting from alcohol intake. Sleep conditions were evaluated by self-administered questionnaires at baseline and approximately 1 month later. The mean the Epworth Sleepiness Scale (ESS) score was significantly decreased by 1.2 points (P = 0.04), while the mean sleep duration was significantly decreased by 10 minutes (P = 0.02). Shortened sleep duration coincided with a decrease in sleepiness. This may indicate an improvement in sleep quality. The percentage of habitual alcohol intake at bedtime was significantly decreased (from 38.5% (15/39) to 20.5% (8/39), P = 0.04). Subjects who stopped alcohol intake at bedtime (n = 8) received the most benefit, with decreased scores of ESS and Insomnia Severity Index (ISI), although the reductions were not significant. This education program offers the possibility of improving sleep conditions among the general population, especially in those who cease habitual alcohol intake at bedtime. Further larger, randomized, controlled studies are warranted.

Gender Differences in Sleep Disruption and Fatigue on Quality of Life Among Persons with Ostomies

PubMed Central

Baldwin, Carol M.; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C.; Herrinton, Lisa J.; McMullen, Carmit; Krouse, Robert S.

2009-01-01

Study Objectives: The aim of this study is to examine differences in sleep disruption and fatigue of men and women colorectal cancer (CRC) survivors with intestinal ostomies and associated health-related quality of life (HR-QOL). Methods: Participants in this cross-sectional study of long-term (> 5 years) CRC survivors received care at Kaiser Permanente. Measures included the City of Hope QOL Ostomy questionnaire with narrative comments for ostomy-related “greatest challenges.” The Short Form-36 Version 2 (SF-36v2) health survey provided physical (PCS) and mental composite scale (MCS) scores to examine generic HR-QOL. The “sleep disruption” and “fatigue” items from the ostomy questionnaire (scale from 0 to 10 with higher scores indicating better HR-QOL) were dependent variables, while independent variables included age, ethnicity, education, partnered status, body mass index, and time since surgery. Data were analyzed using chi-square for nominal variables, Student t-tests for continuous variables, and logistic regression with significance set at p < 0.05. Results: On the ostomy-specific measure, women (n = 118) compared to men (n = 168) reported more sleep disruption (p < 0.01), adjusted for age, and greater levels of fatigue (p < 0.01), adjusted for time since surgery. Women's PCS and MCS scores indicated poorer HR-QOL compared to men, and differences were clinically meaningful. Qualitative narrative comments suggested that sleep disruption could stem from ostomy-associated fear of or actual leakage during sleep. Conclusion: Although women CRC survivors with ostomies report more sleep disruption and fatigue, which is reflected in their reduced physical and mental health scores on the SF-36v2 compared to men with ostomies, their stated reasons for disrupted sleep are similar to their male counterparts. These findings can provide a foundation for gender-relevant ostomy interventions to improve sleep and HR-QOL in this patient population. Citation: Baldwin CM; Grant M; Wendel C; Hornbrook MC; Herrinton LJ; McMullen C; Krouse RS. Gender Differences in Sleep Disruption and Fatigue on Quality of Life Among Persons with Ostomies. J Clin Sleep Med 2009;5(4):335-343. PMID:19968011

Reliability and validity of a brief sleep questionnaire for children in Japan.

PubMed

Okada, Masakazu; Kitamura, Shingo; Iwadare, Yoshitaka; Tachimori, Hisateru; Kamei, Yuichi; Higuchi, Shigekazu; Mishima, Kazuo

2017-09-15

There is a dearth of sleep questionnaires with few items and confirmed reliability and validity that can be used for the early detection of sleep problems in children. The aim of this study was to develop a questionnaire with few items and assess its reliability and validity in both children at high risk of sleep disorders and a community population. Data for analysis were derived from two populations targeted by the Children's Sleep Habits Questionnaire (CSHQ): 178 children attending elementary school and 432 children who visited a pediatric psychiatric hospital (aged 6-12 years). The new questionnaire was constructed as a subset of the CSHQ. The newly developed short version of the sleep questionnaire for children (19 items) had an acceptable internal consistency (0.65). Using the cutoff value of the CSHQ, the total score of the new questionnaire was confirmed to have discriminant validity (27.2 ± 3.9 vs. 22.0 ± 2.1, p < 0.001) and yielded a sensitivity of 0.83 and specificity of 0.78 by receiver operator characteristic curve analysis. Total score of the new questionnaire was significantly correlated with total score (r = 0.81, p < 0.001) and each subscale score (r = 0.29-0.65, p < 0.001) of the CSHQ. The new questionnaire demonstrated an adequate reliability and validity in both high-risk children and a community population, as well as similar screening ability to the CSHQ. It could thus be a convenient instrument to detect sleep problems in children.

Reliability of scoring arousals in normal children and children with obstructive sleep apnea syndrome.

PubMed

Wong, Tat Kong; Galster, Patricia; Lau, Tai Shing; Lutz, Janita M; Marcus, Carole L

2004-09-15

Scoring of arousals in children is based on an extension of adult criteria, as defined by the American Sleep Disorders Association (ASDA). By this, a minimum duration of 3 seconds is required. A few recent studies utilized modified criteria for the study of children, with durations as short as 1 second. However, the validity and reliability of scoring these shorter arousals have never been verified. Based on studies in adults, we hypothesized that interscorer agreement for scoring arousals shorter than 3 seconds was poor. Retrospective review of polysomnograms by 2 experienced sleep practitioners who independently scored arousals according to the ASDA 3-second criteria and modified duration criteria of 1 and 2 seconds. Academic hospital. 20 polysomnographic studies from children aged 3 to 8 years with mild to severe obstructive sleep apnea syndrome, and 16 polysomnographic studies from normal children. None. The intraclass correlation coefficient for scoring ASDA arousals was 0.90 (95% confidence interval: 0.81-0.95), indicating excellent interscorer agreement. The intraclass correlation coefficient for scoring modified 1-second and 2-second arousals were 0.35 (95% confidence interval: 0.02-0.61) and 0.42 (95% confidence interval: 0.12-0.65) respectively, indicating poor to fair interscorer agreement. Furthermore, modified 1-second and 2-second arousals accounted for less than 15% of all arousals scored. We conclude that there is much poorer interscorer agreement for scoring arousals shorter than 3 seconds, when compared to the standard ASDA criteria. We propose that scoring of arousals in children should follow the standard ASDA criteria.

Sleep medicine education and knowledge among medical students in selected Saudi Medical Schools

PubMed Central

2013-01-01

Background Limited information is available regarding sleep medicine education worldwide. Nevertheless, medical education has been blamed for the under-recognition of sleep disorders among physicians. This study was designed to assess the knowledge of Saudi undergraduate medical students about sleep and sleep disorders and the prevalence of education on sleep medicine in medical schools as well as to identify the obstacles to providing such education. Methods We surveyed medical schools that were established more than 10 years ago, asking fourth- and fifth-year medical students (men and women) to participate. Seven medical schools were selected. To assess knowledge on sleep and sleep disorders, we used the Assessment of Sleep Knowledge in Medical Education (ASKME) Survey, which is a validated 30-item questionnaire. The participants were separated into two groups: those who scored ≥60% and those who scored <60%. To assess the number of teaching hours dedicated to sleep medicine in the undergraduate curricula, the organizers of the major courses on sleep disorders were contacted to obtain the curricula for those courses and to determine the obstacles to education. Results A total of 348 students completed the survey (54.9% male). Among the participants, 27.7% had a specific interest in sleep medicine. More than 80% of the study sample had rated their knowledge in sleep medicine as below average. Only 4.6% of the respondents correctly answered ≥60% of the questions. There was no difference in the scores of the respondents with regard to university, gender, grade-point average (GPA) or student academic levels. Only five universities provided data on sleep medicine education. The time spent teaching sleep medicine in the surveyed medical schools ranged from 0-8 hours with a mean of 2.6 ±2.6 hours. Identified obstacles included the following: (1) sleep medicine has a lower priority in the curriculum (53%) and (2) time constraints do not allow the incorporation of sleep medicine topics in the curriculum (47%). Conclusions Medical students in the surveyed institutions possess poor knowledge regarding sleep medicine, which reflects the weak level of education in this field of medicine. To improve the recognition of sleep disorders among practicing physicians, medical schools must provide adequate sleep medicine education. PMID:24070217

The effect of preinjury sleep difficulties on neurocognitive impairment and symptoms after sport-related concussion.

PubMed

Sufrinko, Alicia; Pearce, Kelly; Elbin, R J; Covassin, Tracey; Johnson, Eric; Collins, Michael; Kontos, Anthony P

2015-04-01

Researchers have reported that sleep duration is positively related to baseline neurocognitive performance. However, researchers have yet to examine the effect of preinjury sleep difficulties on postconcussion impairments. To compare neurocognitive impairment and symptoms of athletes with preinjury sleep difficulties to those without after a sport-related concussion (SRC). Cohort study; Level of evidence, 3. The sample included 348 adolescent and adult athletes (age, mean ± SD, 17.43 ± 2.34 years) with a diagnosed SRC. The sample was divided into 2 groups: (1) 34 (10%) participants with preinjury sleep difficulties (sleeping less as well as having trouble falling asleep; SLEEP SX) and (2) 231 (66%) participants without preinjury sleep difficulties (CONTROL). The remaining 84 (24%) participants with minimal sleep difficulties (1 symptom) were excluded. Participants completed the Immediate Postconcussion Assessment and Cognitive Test (ImPACT) and Postconcussion Symptom Scale (PCSS) at baseline and 3 postinjury intervals (2, 5-7, and 10-14 days after injury). A series of repeated-measures analyses of covariance with Bonferroni correction, controlling for baseline non-sleep-related symptoms, were conducted to compare postinjury neurocognitive performance between groups. Follow-up exploratory t tests examined between-group differences at each time interval. A series of analyses of variance were used to examine total PCSS score, sleep-related, and non-sleep-related symptoms across time intervals between groups. Groups differed significantly in PCSS scores across postinjury intervals for reaction time (P < .001), with the preinjury SLEEP SX group performing worse than controls at 5-7 days (mean ± SD, 0.70 ± 0.32 [SLEEP SX], 0.60 ± 0.14 [CONTROL]) and 10-14 days (0.61 ± 0.17 [SLEEP SX]; 0.57 ± 0.10 [CONTROL]) after injury. Groups also differed significantly on verbal memory performance (P = .04), with the SLEEP SX (68.21 ± 18.64) group performing worse than the CONTROL group (76.76 ± 14.50) 2 days after injury. The SLEEP SX group reported higher total symptom (P = .02) and sleep-related symptom (P = .02) scores across postinjury time intervals. Preinjury sleep difficulties may exacerbate neurocognitive impairment and symptoms after concussion. The findings may help clinicians identify athletes who are at risk for worse impairments after a concussion due to preinjury sleep difficulties. © 2015 The Author(s).

Sleep medicine education and knowledge among medical students in selected Saudi Medical Schools.

PubMed

Almohaya, Abdulellah; Qrmli, Abdulaziz; Almagal, Naeif; Alamri, Khaled; Bahammam, Salman; Al-Enizi, Mashhour; Alanazi, Atif; Almeneessier, Aljohara S; Sharif, Munir M; Bahammam, Ahmed S

2013-09-27

Limited information is available regarding sleep medicine education worldwide. Nevertheless, medical education has been blamed for the under-recognition of sleep disorders among physicians. This study was designed to assess the knowledge of Saudi undergraduate medical students about sleep and sleep disorders and the prevalence of education on sleep medicine in medical schools as well as to identify the obstacles to providing such education. We surveyed medical schools that were established more than 10 years ago, asking fourth- and fifth-year medical students (men and women) to participate. Seven medical schools were selected. To assess knowledge on sleep and sleep disorders, we used the Assessment of Sleep Knowledge in Medical Education (ASKME) Survey, which is a validated 30-item questionnaire. The participants were separated into two groups: those who scored ≥60% and those who scored <60%. To assess the number of teaching hours dedicated to sleep medicine in the undergraduate curricula, the organizers of the major courses on sleep disorders were contacted to obtain the curricula for those courses and to determine the obstacles to education. A total of 348 students completed the survey (54.9% male). Among the participants, 27.7% had a specific interest in sleep medicine. More than 80% of the study sample had rated their knowledge in sleep medicine as below average. Only 4.6% of the respondents correctly answered ≥60% of the questions. There was no difference in the scores of the respondents with regard to university, gender, grade-point average (GPA) or student academic levels. Only five universities provided data on sleep medicine education. The time spent teaching sleep medicine in the surveyed medical schools ranged from 0-8 hours with a mean of 2.6 ±2.6 hours. Identified obstacles included the following: (1) sleep medicine has a lower priority in the curriculum (53%) and (2) time constraints do not allow the incorporation of sleep medicine topics in the curriculum (47%). Medical students in the surveyed institutions possess poor knowledge regarding sleep medicine, which reflects the weak level of education in this field of medicine. To improve the recognition of sleep disorders among practicing physicians, medical schools must provide adequate sleep medicine education.

Are there any seasonal changes of cognitive impairment, depression, sleep disorders and quality of life in hemodialysis patients?

PubMed

Afsar, Baris; Kirkpantur, Alper

2013-01-01

Cognitive impairment, depression, sleep disorders and impaired quality of life are very common in hemodialysis (HD) patients. However, whether there are any seasonal changes of cognitive impairment, depression, sleep disorders and quality of life in HD patients is not known. The laboratory parameters, depressive symptoms, health-related quality of life, sleep quality (SQ) and cognitive function, were measured twice. A total of 66 HD patients were enrolled. Pre-dialysis systolic blood pressure (BP) and pre-dialysis diastolic BP were higher, whereas predialysis creatinine and sodium were lower in January compared to July. Among domains of Short Form 36 (SF-36), physical functioning, role-physical limitation, general health perception, vitality, role emotional, Physical Component Summary Score (PCS) were higher, whereas Beck Depression Inventory (BDI) score was lower in July compared to January. Stepwise linear regression analysis revealed that only change in albumin and smoking status were related with seasonal change of BDI scores. Additionally only change in Mental Component Summary score of SF-36 were related with change in PCS score of SF-36 scores. Depressive symptoms and quality of life but not SQ and cognitive function showed seasonal variability in HD patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Using Linear Equating to Map PROMIS(®) Global Health Items and the PROMIS-29 V2.0 Profile Measure to the Health Utilities Index Mark 3.

PubMed

Hays, Ron D; Revicki, Dennis A; Feeny, David; Fayers, Peter; Spritzer, Karen L; Cella, David

2016-10-01

Preference-based health-related quality of life (HR-QOL) scores are useful as outcome measures in clinical studies, for monitoring the health of populations, and for estimating quality-adjusted life-years. This was a secondary analysis of data collected in an internet survey as part of the Patient-Reported Outcomes Measurement Information System (PROMIS(®)) project. To estimate Health Utilities Index Mark 3 (HUI-3) preference scores, we used the ten PROMIS(®) global health items, the PROMIS-29 V2.0 single pain intensity item and seven multi-item scales (physical functioning, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, sleep disturbance), and the PROMIS-29 V2.0 items. Linear regression analyses were used to identify significant predictors, followed by simple linear equating to avoid regression to the mean. The regression models explained 48 % (global health items), 61 % (PROMIS-29 V2.0 scales), and 64 % (PROMIS-29 V2.0 items) of the variance in the HUI-3 preference score. Linear equated scores were similar to observed scores, although differences tended to be larger for older study participants. HUI-3 preference scores can be estimated from the PROMIS(®) global health items or PROMIS-29 V2.0. The estimated HUI-3 scores from the PROMIS(®) health measures can be used for economic applications and as a measure of overall HR-QOL in research.

Polysomnographic Study of Sleep in Survivors of Breast Cancer

PubMed Central

Reinsel, Ruth A.; Starr, Tatiana D.; O'Sullivan, Barbara; Passik, Steven D.; Kavey, Neil B.

2015-01-01

Study Objective: Insomnia is a frequent complaint in breast cancer patients during and after treatment. Breast cancer survivors, 1–10 years posttreatment, underwent in-lab polysomnography (PSG) to objectively define the insomnia in those patients with such a complaint. Methods: Twenty-six breast cancer survivors (aged 39–80, mean 54.0 months posttreatment) spent 2 nights in the sleep laboratory. Sleep on Night 2 was scored for sleep stages, sleep onset latency, REM sleep onset latency, wake time, apneas and hypopneas, periodic limb movements and arousals. Subjects were allocated into 2 groups by their scores on the Pittsburgh Sleep Quality Index (PSQI): no/ mild sleep disturbance (PSQI score ≤ 9, n = 15) or moderate/ severe sleep disturbance (PSQI ≥ 10, n = 11). Results: Standard PSG/EEG parameters failed to differentiate insomniacs from non-insomniacs. The single variable that distinguished the insomnia group was periodic limb movements in sleep (PLMS). PLMS were significantly correlated (r ≅ 0.7, p < 0.02) with subjective report of insomnia on PSQI and insomnia severity index. Log[Number of PLMS] was higher in the moderate/severe insomnia group (p = 0.008). Five of 11 patients in the moderate/severe insomnia group had a PLMS index ≥ 15, compared to only one of 15 patients in the none/mild insomnia group (p = 0.02). Menopausal symptoms and use of caffeine, hypnotics, and antidepressants were unrelated to insomnia severity or PLMS. Conclusions: PLMS was the sole PSG variable that separated breast cancer survivors with moderate/severe insomnia from those with no/mild sleep disturbance. Further study of the incidence and significance of PLMS in breast cancer survivors with the complaint of insomnia is merited. Citation: Reinsel RA, Starr TD, O'Sullivan B, Passik SD, Kavey NB. Polysomnographic study of sleep in survivors of breast cancer. J Clin Sleep Med 2015;11(12):1361–1370. PMID:26194735

Working hours and sleep duration in midlife as determinants of health-related quality of life among older businessmen.

PubMed

von Bonsdorff, Mikaela Birgitta; Strandberg, Arto; von Bonsdorff, Monika; Törmäkangas, Timo; Pitkälä, Kaisu H; Strandberg, Timo E

2017-01-25

Long working hours and short sleep duration are associated with a range of adverse health consequences. However, the combined effect of these two exposures on health-related quality of life (HRQoL) has not been investigated. We studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3,490). Data on clinical variables, self-rated health (SRH), working hours and sleep duration in 1974, and RAND-36 (SF-36) HRQoL survey in the year 2000 were available for 1,527 men. Follow-up time was 26 years. By combining working hours and sleep duration, four categories were formed: (i) normal work (≤50 hours/week) and normal sleep (>47 hours/week); (ii) long work (>50 hours/week) and normal sleep; (iii) normal work and short sleep (≤47 hours/week); and (iv) long work and short sleep. The association with RAND-36 domains was examined using multiple linear regression models adjusted for age, smoking and SRH. Compared to those with normal work and sleep in midlife, men with long work and short sleep had poorer RAND-36 scores for physical functioning, vitality and general health, and those with long work and normal sleep had poorer scores for physical functioning in old age. Adjustment for midlife smoking and SRH attenuated the associations, but the one for long work and short sleep and physical functioning remained significant (difference in mean physical functioning score −4.58, 95% confidence interval −9.00 to −0.15). Businessmen who had long working hours coupled with short sleep duration in midlife had poorer physical health in old age. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Acute versus chronic partial sleep deprivation in middle-aged people: differential effect on performance and sleepiness.

PubMed

Philip, Pierre; Sagaspe, Patricia; Prague, Mélanie; Tassi, Patricia; Capelli, Aurore; Bioulac, Bernard; Commenges, Daniel; Taillard, Jacques

2012-07-01

To evaluate the effects of acute sleep deprivation and chronic sleep restriction on vigilance, performance, and self-perception of sleepiness. Habitual night followed by 1 night of total sleep loss (acute sleep deprivation) or 5 consecutive nights of 4 hr of sleep (chronic sleep restriction) and recovery night. Eighteen healthy middle-aged male participants (age [(± standard deviation] = 49.7 ± 2.6 yr, range 46-55 yr). Multiple sleep latency test trials, Karolinska Sleepiness Scale scores, simple reaction time test (lapses and 10% fastest reaction times), and nocturnal polysomnography data were recorded. Objective and subjective sleepiness increased immediately in response to sleep restriction. Sleep latencies after the second and third nights of sleep restriction reached levels equivalent to those observed after acute sleep deprivation, whereas Karolinska Sleepiness Scale scores did not reach these levels. Lapse occurrence increased after the second day of sleep restriction and reached levels equivalent to those observed after acute sleep deprivation. A statistical model revealed that sleepiness and lapses did not progressively worsen across days of sleep restriction. Ten percent fastest reaction times (i.e., optimal alertness) were not affected by acute or chronic sleep deprivation. Recovery to baseline levels of alertness and performance occurred after 8-hr recovery night. In middle-aged study participants, sleep restriction induced a high increase in sleep propensity but adaptation to chronic sleep restriction occurred beyond day 3 of restriction. This sleepiness attenuation was underestimated by the participants. One recovery night restores daytime sleepiness and cognitive performance deficits induced by acute or chronic sleep deprivation. Philip P; Sagaspe P; Prague M; Tassi P; Capelli A; Bioulac B; Commenges D; Taillard J. Acute versus chronic partial sleep deprivation in middle-aged people: differential effect on performance and sleepiness. SLEEP 2012;35(7):997-1002.

Association between combined lifestyle factors and non-restorative sleep in Japan: a cross-sectional study based on a Japanese health database.

PubMed

Wakasugi, Minako; Kazama, Junichiro James; Narita, Ichiei; Iseki, Kunitoshi; Moriyama, Toshiki; Yamagata, Kunihiro; Fujimoto, Shouichi; Tsuruya, Kazuhiko; Asahi, Koichi; Konta, Tsuneo; Kimura, Kenjiro; Kondo, Masahide; Kurahashi, Issei; Ohashi, Yasuo; Watanabe, Tsuyoshi

2014-01-01

Although lifestyle factors such as cigarette smoking, excessive drinking, obesity, low or no exercise, and unhealthy dietary habits have each been associated with inadequate sleep, little is known about their combined effect. The aim of this study was to quantify the overall impact of lifestyle-related factors on non-restorative sleep in the general Japanese population. A cross-sectional study of 243,767 participants (men, 39.8%) was performed using the Specific Health Check and Guidance System in Japan. A healthy lifestyle score was calculated by adding up the number of low-risk lifestyle factors for each participant. Low risk was defined as (1) not smoking, (2) body mass index<25 kg/m², (3) moderate or less alcohol consumption, (4) regular exercise, and (5) better eating patterns. Logistic regression analysis was used to examine the relationship between the score and the prevalence of non-restorative sleep, which was determined from questionnaire responses. Among 97,062 men (mean age, 63.9 years) and 146,705 women (mean age, 63.7 years), 18,678 (19.2%) and 38,539 (26.3%) reported non-restorative sleep, respectively. The prevalence of non-restorative sleep decreased with age for both sexes. Compared to participants with a healthy lifestyle score of 5 (most healthy), those with a score of 0 (least healthy) had a higher prevalence of non-restorative sleep (odds ratio, 1.59 [95% confidence interval, 1.29-1.97] for men and 2.88 [1.74-4.76] for women), independently of hypertension, hypercholesterolemia, diabetes, and chronic kidney disease. The main limitation of the study was the cross-sectional design, which limited causal inferences for the identified associations. A combination of several unhealthy lifestyle factors was associated with non-restorative sleep among the general Japanese population. Further studies are needed to establish whether general lifestyle modification improves restorative sleep.

Eating behavior by sleep duration in the Hispanic Community Health Study/Study of Latinos.

PubMed

Mossavar-Rahmani, Yasmin; Jung, Molly; Patel, Sanjay R; Sotres-Alvarez, Daniela; Arens, Raanan; Ramos, Alberto; Redline, Susan; Rock, Cheryl L; Van Horn, Linda

2015-12-01

Sleep is an important pillar of health and a modifiable risk factor for diabetes, stroke and obesity. Little is known of diet and sleep patterns of Hispanics/Latinos in the US. Here we examine eating behavior as a function of sleep duration in a sub-sample of 11,888 participants from the Hispanic Community Health Study/Study of Latinos, a community-based cohort study of Hispanics aged 18-74 years in four US cities. Using a cross-sectional probability sample with self-report data on habitual sleep duration and up to two 24-h dietary recalls, we quantified the Alternative Healthy Eating Index (AHEI-2010) score, a measure of diet quality, and intake of selected nutrients related to cardiovascular health. Linear regression models were fit to estimate least-square means of usual nutrient intake of saturated fats, potassium density, fiber, calcium, caffeine and the AHEI-2010 score by sleep duration adjusting for age, sex, Hispanic/Latino background, income, employment status, education, depressive symptomology, and years lived in the US. Distribution of calories over the day and association with sleep duration and BMI were also examined. Short sleepers (≤6 h) had significantly lower intake of potassium, fiber and calcium and long sleepers (≥9 h) had significantly lower intake of caffeine compared to others sleepers after adjusting for covariates. However no difference in the AHEI-2010 score was seen by sleep duration. Significantly more long sleepers, compared to intermediate and short sleepers, reported having ≥30% total daily calories before bedtime. Not consuming a snack or meal within 3 h before bedtime was associated with higher AHEI-2010 scores. These findings identify novel differences in dietary patterns by sleep duration in a Hispanic/Latino cohort in the U.S. CLINICALTRIALS. NCT02060344. Copyright © 2015 Elsevier Ltd. All rights reserved.

Gender differences in sleep disruption and fatigue on quality of life among persons with ostomies.

PubMed

Baldwin, Carol M; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C; Herrinton, Lisa J; McMullen, Carmit; Krouse, Robert S

2009-08-15

The aim of this study is to examine differences in sleep disruption and fatigue of men and women colorectal cancer (CRC) survivors with intestinal ostomies and associated health-related quality of life (HR-QOL). Participants in this cross-sectional study of long-term (> 5 years) CRC survivors received care at Kaiser Permanente. Measures included the City of Hope QOL Ostomy questionnaire with narrative comments for ostomy-related "greatest challenges." The Short Form-36 Version 2 (SF-36v2) health survey provided physical (PCS) and mental composite scale (MCS) scores to examine generic HR-QOL. The "sleep disruption" and "fatigue" items from the ostomy questionnaire (scale from 0 to 10 with higher scores indicating better HR-QOL) were dependent variables, while independent variables included age, ethnicity, education, partnered status, body mass index, and time since surgery. Data were analyzed using chi-square for nominal variables, Student t-tests for continuous variables, and logistic regression with significance set at p < 0.05. On the ostomy-specific measure, women (n = 118) compared to men (n = 168) reported more sleep disruption (p < 0.01), adjusted for age, and greater levels of fatigue (p < 0.01), adjusted for time since surgery. Women's PCS and MCS scores indicated poorer HR-QOL compared to men, and differences were clinically meaningful. Qualitative narrative comments suggested that sleep disruption could stem from ostomy-associated fear of or actual leakage during sleep. Although women CRC survivors with ostomies report more sleep disruption and fatigue, which is reflected in their reduced physical and mental health scores on the SF-36v2 compared to men with ostomies, their stated reasons for disrupted sleep are similar to their male counterparts. These findings can provide a foundation for gender-relevant ostomy interventions to improve sleep and HR-QOL in this patient population.

Children’s Sleep and Academic Achievement: The Moderating Role of Effortful Control

PubMed Central

Diaz, Anjolii; Berger, Rebecca; Valiente, Carlos; Eisenberg, Nancy; VanSchyndel, Sarah; Tao, Chun; Spinrad, Tracy L.; Doane, Leah D.; Thompson, Marilyn S.; Silva, Kassondra M.; Southworth, Jody

2016-01-01

Poor sleep is thought to interfere with children’s learning and academic achievement (AA). However, existing research and theory indicate there are factors that may mitigate the academic risk associated with poor sleep. The purpose of this study was to examine the moderating role of children’s effortful control (EC) on the relation between sleep and AA in young children. One hundred and three 4.5- to 7-year-olds (M = 5.98 years, SD = 0.61) wore a wrist-based actigraph for five continuous weekday nights. Teachers and coders reported on children’s EC. EC was also assessed with a computer-based task at school. Additionally, we obtained a standardized measure of children’s AA. There was a positive main effect of sleep efficiency to AA. Several relations between sleep and AA were moderated by EC and examination of the simple slopes indicated that the negative relation between sleep and AA was only significant at low levels of EC. PMID:28255190

Sleep of 1- and 2-year-old children in intensive care.

PubMed

Corser, N C

1996-01-01

Physiologic and psychologic changes associated with sleep disturbance decrease the ability of a critically ill child to adapt to hospitalization and thus hamper recovery. Research demonstrates that intensive care settings interfere with sleep of adults, but little is known about the impact of these settings on children's sleep. An exploratory field study was conducted to describe the sleep-wake patterns of 1- and 2-year-old children in intensive care, identify intensive care environmental stimuli associated with sleep and waking states, compare the intensive care sleep-wake pattern to the pre-illness sleep-wake pattern, and determine the time required for children to return to their pre-illness sleep-wake pattern. Twelve children aged 13 to 35 months composed the sample for the study. Pre-illness and postdischarge sleep patterns, sleep patterns during a 12-hour night in the pediatric intensive care unit (PICU), and external and internal environmental stimuli were measured. Prior to hospitalization, subjects demonstrated sleep similar to that documented in healthy children. Children in the PICU experienced a significant loss of sleep, frequent awakenings, and a virtual rapid eye movement (REM) sleep deprivation. External environmental stimuli of light, noise, and caregiver activity were negatively correlated with sleep state. Pain and treatment with benzodiazepines were associated with sleep acquisition. Sleep changes persisted after discharge from the PICU and the hospital. Total sleep time recovered more rapidly than nighttime awakening. Parents perceived that their child's sleep remained different longer than total sleep time and night awakening values demonstrated.

Examining Dark Triad traits in relation to sleep disturbances, anxiety sensitivity and intolerance of uncertainty in young adults.

PubMed

Sabouri, Sarah; Gerber, Markus; Lemola, Sakari; Becker, Stephen P; Shamsi, Mahin; Shakouri, Zeinab; Sadeghi Bahmani, Dena; Kalak, Nadeem; Holsboer-Trachsler, Edith; Brand, Serge

2016-07-01

The Dark Triad (DT) describes a set of three closely related personality traits, Machiavellianism, narcissism, and psychopathy. The aim of this study was to examine the associations between DT traits, sleep disturbances, anxiety sensitivity and intolerance of uncertainty. A total of 341 adults (M=29years) completed a series of questionnaires related to the DT traits, sleep disturbances, anxiety sensitivity, and intolerance of uncertainty. A higher DT total score was associated with increased sleep disturbances, and higher scores for anxiety sensitivity and intolerance of uncertainty. In regression analyses Machiavellianism and psychopathy were predictors of sleep disturbances, anxiety sensitivity, and intolerance of uncertainty. Results indicate that specific DT traits, namely Machiavellianism and psychopathy, are associated with sleep disturbances, anxiety sensitivity and intolerance of uncertainty in young adults. Copyright © 2016 Elsevier Inc. All rights reserved.

Subjective-objective sleep discrepancy among older adults: associations with insomnia diagnosis and insomnia treatment.

PubMed

Kay, Daniel B; Buysse, Daniel J; Germain, Anne; Hall, Martica; Monk, Timothy H

2015-02-01

Discrepancy between subjective and objective measures of sleep is associated with insomnia and increasing age. Cognitive behavioural therapy for insomnia improves sleep quality and decreases subjective-objective sleep discrepancy. This study describes differences between older adults with insomnia and controls in sleep discrepancy, and tests the hypothesis that reduced sleep discrepancy following cognitive behavioural therapy for insomnia correlates with the magnitude of symptom improvement reported by older adults with insomnia. Participants were 63 adults >60 years of age with insomnia, and 51 controls. At baseline, participants completed sleep diaries for 7 days while wearing wrist actigraphs. After receiving cognitive behavioural therapy for insomnia, insomnia patients repeated this sleep assessment. Sleep discrepancy variables were calculated by subtracting actigraphic sleep onset latency and wake after sleep onset from respective self-reported estimates, pre- and post-treatment. Mean level and night-to-night variability in sleep discrepancy were investigated. Baseline sleep discrepancies were compared between groups. Pre-post-treatment changes in Insomnia Severity Index score and sleep discrepancy variables were investigated within older adults with insomnia. Sleep discrepancy was significantly greater and more variable across nights in older adults with insomnia than controls, P ≤ 0.001 for all. Treatment with cognitive behavioural therapy for insomnia was associated with significant reduction in the Insomnia Severity Index score that correlated with changes in mean level and night-to-night variability in wake after sleep onset discrepancy, P < 0.001 for all. Study of sleep discrepancy patterns may guide more targeted treatments for late-life insomnia. © 2014 European Sleep Research Society.

Neurological, psychological and polygraphic findings in sleep drunkenness.

PubMed

Roth, B; Nevsímalová, S; Ságová, V; Paroubková, D; Horáková, A

1981-01-01

Eight patients suffering from idiopathic hypersomnia with sleep drunkenness were given neurological, psychological and polygraphic investigations, and that after 4, 8 and 12 hours of nocturnal sleep. Also examined and tested were 8 controls - after 4, 8 and 0 hours of sleep during the preceding night. The patients and the controls were awakened and tested in the afternoon hours 30-45 minutes after they had fallen asleep. Under those circumstances the state of sleep drunkenness was observed in the patients in 19 instances, but only once in the controls. While experiencing sleep drunkenness the subjects were found to have prominent cerebellar signs, proprioceptive hypo- or even areflexia, signs of vestibular and, rarely, pyramidal tract involvement. Psychological tests scores and scores for the fine and gross motricity tests were substantially worse in sleep drunkenness than in wakefulness. Sleep drunkenness manifested itself in the polygraphic recordings by signs of microsleep. Pathological predisposition to the development of sleep drunkenness in hypersomniacs was found to be the most significant factor responsible for the occurrence of this state. Attention is drawn to the analogy between states of sleep drunkenness and automatic behaviour in narcoleptics and hypersomniacs as a common feature of both states. The authors believe that sleep drunkenness in idiopathic hypersomnia develops as a result of chronic relative sleep deprivation in those patients whose sleep requirements are greater than conditions of normal life can permit.

Cognitive Effects of Adenotonsillectomy for Obstructive Sleep Apnea.

PubMed

Taylor, H Gerry; Bowen, Susan R; Beebe, Dean W; Hodges, Elise; Amin, Raouf; Arens, Raanan; Chervin, Ronald D; Garetz, Susan L; Katz, Eliot S; Moore, Reneé H; Morales, Knashawn H; Muzumdar, Hiren; Paruthi, Shalini; Rosen, Carol L; Sadhwani, Anjali; Thomas, Nina Hattiangadi; Ware, Janice; Marcus, Carole L; Ellenberg, Susan S; Redline, Susan; Giordani, Bruno

2016-08-01

Research reveals mixed evidence for the effects of adenotonsillectomy (AT) on cognitive tests in children with obstructive sleep apnea syndrome (OSAS). The primary aim of the study was to investigate effects of AT on cognitive test scores in the randomized Childhood Adenotonsillectomy Trial. Children ages 5 to 9 years with OSAS without prolonged oxyhemoglobin desaturation were randomly assigned to watchful waiting with supportive care (n = 227) or early AT (eAT, n = 226). Neuropsychological tests were administered before the intervention and 7 months after the intervention. Mixed model analysis compared the groups on changes in test scores across follow-up, and regression analysis examined associations of these changes in the eAT group with changes in sleep measures. Mean test scores were within the average range for both groups. Scores improved significantly (P < .05) more across follow-up for the eAT group than for the watchful waiting group. These differences were found only on measures of nonverbal reasoning, fine motor skills, and selective attention and had small effects sizes (Cohen's d, 0.20-0.24). As additional evidence for AT-related effects on scores, gains in test scores for the eAT group were associated with improvements in sleep measures. Small and selective effects of AT were observed on cognitive tests in children with OSAS without prolonged desaturation. Relative to evidence from Childhood Adenotonsillectomy Trial for larger effects of surgery on sleep, behavior, and quality of life, AT may have limited benefits in reversing any cognitive effects of OSAS, or these benefits may require more extended follow-up to become manifest. Copyright © 2016 by the American Academy of Pediatrics.

Cognitive Effects of Adenotonsillectomy for Obstructive Sleep Apnea

PubMed Central

Bowen, Susan R.; Beebe, Dean W.; Hodges, Elise; Amin, Raouf; Arens, Raanan; Chervin, Ronald D.; Garetz, Susan L.; Katz, Eliot S.; Moore, Reneé H.; Morales, Knashawn H.; Muzumdar, Hiren; Paruthi, Shalini; Rosen, Carol L.; Sadhwani, Anjali; Thomas, Nina Hattiangadi; Ware, Janice; Marcus, Carole L.; Ellenberg, Susan S.; Redline, Susan; Giordani, Bruno

2016-01-01

OBJECTIVE: Research reveals mixed evidence for the effects of adenotonsillectomy (AT) on cognitive tests in children with obstructive sleep apnea syndrome (OSAS). The primary aim of the study was to investigate effects of AT on cognitive test scores in the randomized Childhood Adenotonsillectomy Trial. METHODS: Children ages 5 to 9 years with OSAS without prolonged oxyhemoglobin desaturation were randomly assigned to watchful waiting with supportive care (n = 227) or early AT (eAT, n = 226). Neuropsychological tests were administered before the intervention and 7 months after the intervention. Mixed model analysis compared the groups on changes in test scores across follow-up, and regression analysis examined associations of these changes in the eAT group with changes in sleep measures. RESULTS: Mean test scores were within the average range for both groups. Scores improved significantly (P < .05) more across follow-up for the eAT group than for the watchful waiting group. These differences were found only on measures of nonverbal reasoning, fine motor skills, and selective attention and had small effects sizes (Cohen’s d, 0.20–0.24). As additional evidence for AT-related effects on scores, gains in test scores for the eAT group were associated with improvements in sleep measures. CONCLUSIONS: Small and selective effects of AT were observed on cognitive tests in children with OSAS without prolonged desaturation. Relative to evidence from Childhood Adenotonsillectomy Trial for larger effects of surgery on sleep, behavior, and quality of life, AT may have limited benefits in reversing any cognitive effects of OSAS, or these benefits may require more extended follow-up to become manifest. PMID:27464674

Vedolizumab Therapy Is Associated with an Improvement in Sleep Quality and Mood in Inflammatory Bowel Diseases

PubMed Central

Stevens, Betsy W.; Borren, Nynke Z.; Velonias, Gabriella; Conway, Grace; Cleland, Thom; Andrews, Elizabeth; Khalili, Hamed; Garber, John G.; Xavier, Ramnik J.; Yajnik, Vijay

2016-01-01

Introduction Poor sleep, depression, and anxiety are common in patients with inflammatory bowel diseases (IBD) and associated with increased risk of relapse and poor outcomes. The effectiveness of therapies in improving such psychosocial outcomes is unclear but is an important question to examine with increasing selectivity of therapeutic agents. Methods This prospective cohort enrolled patients with moderate-to-severe CD or UC starting biologic therapy with vedolizumab or anti-tumor necrosis factor α agents (anti-TNF). Sleep quality, depression, and anxiety were measured using validated short-form NIH PROMIS questionnaires assessing sleep and mood quality over the past 7 days. Disease activity was assessed using validated indices. Improvement in sleep and mood scores from baseline was assessed, and regression models were used to identify determinants of sleep quality. Results Our study included 160 patients with IBD (49 anti-TNF, 111 Vedolizumab) among whom half were women and the mean age was 40.2 years. In the combined cohort, we observed a statistically significant and meaningful decrease in mean scores from baseline (52.8) by week 6 (49.8, p = 0.002). Among vedolizumab users, sleep T-score improved from baseline (53.6) by week 6 (50.7) and persisted through week 54 (46.5, p = 0.009). Parallel reductions in depression and anxiety were also noted (p < 0.05 by week 6). We observed no difference in improvement in sleep, depression, and anxiety between vedolizumab and anti-TNF use at week 6. Conclusions Both vedolizumab and anti-TNF biologic therapies were associated with improvement in sleep and mood quality in IBD. PMID:27796768

Associations among gastroesophageal reflux disease, psychological stress, and sleep disturbances in Japanese adults.

PubMed

Okuyama, Masatsugu; Takaishi, Osamu; Nakahara, Kenichi; Iwakura, Narika; Hasegawa, Tomoki; Oyama, Maizumi; Inoue, Ayumi; Ishizu, Hirotaka; Satoh, Hiroshi; Fujiwara, Yasuhiro

2017-01-01

Gastroesophageal reflux disease (GERD) and psychological stress are associated with sleep disturbances. The aim of the present study was to examine the prevalence of sleep disturbances, anxiety, and depression by GERD subtypes and to identify factors associated with sleep disturbances in general population. A total of 2002 Japanese subjects, who underwent annual health checkups, were enrolled and asked to fill out a questionnaire, including the frequency scale for the symptoms of GERD (FSSG), Athens Insomnia Scale (AIS), Rome III questionnaire, and Hospital Anxiety and Depression Scale (HADS). GERD was divided into asymptomatic erosive reflux disease (a-ERD), symptomatic ERD (s-ERD), and non-erosive reflux disease (NERD), according to the presence or absence of esophageal mucosal injury on endoscopy, and the FSSG scores. Sleep disturbances were diagnosed in subjects with AIS score ≥6. Prevalence of sleep disturbances was significantly higher in GERD subjects than in controls (35.9 and 14.7%, respectively), especially, in the NERD group (45.1%). Sleep duration was significantly shorter in the s-ERD group compared with other groups. Subjects in the NERD and s-ERD groups showed higher HADS scores, resulting in higher incidences of anxiety and depression than those in the control and a-ERD groups. Reflux symptoms, anxiety, depression, and coexisting functional dyspepsia, but not the presence of esophageal mucosal injury, were associated with an increased odds ratio for sleep disturbances. There were significant positive associations among reflux symptoms, psychological stress, and sleep disturbance in Japanese adults. Further studies investigating the efficacy of therapy are needed.

Effectiveness of Group Cognitive Behavioral Therapy for Insomnia (CBT-I) in a Primary Care Setting.

PubMed

Davidson, Judith R; Dawson, Samantha; Krsmanovic, Adrijana

2017-05-02

Primary care is where many patients with insomnia first ask for professional help. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia. Although CBT-I's efficacy is well established, its effectiveness in real-life primary care has seldom been investigated. We examined the effectiveness of CBT-I as routinely delivered in a Canadian primary care setting. The patients were 70 women and 11 men (mean age = 57.0 years, SD = 12.3); 83% had medical comorbidity. For the first 81 patients who took the six-session group program we compared initial and postprogram sleep diaries, sleep medication use, Insomnia Severity Index (ISI), the Hospital Anxiety and Depression Scale (HADS), and visits to the family physician. Sleep onset latency, wake after sleep onset, total sleep time, sleep efficiency, and ISI scores improved significantly (p < .001). Mood ratings also improved (p < .001). Use of sleep medication decreased (p < .001). Effect sizes were medium to large. Eighty-eight percent of patients no longer had clinically significant insomnia (ISI score ≤ 14) by the last session; 61% showed at least "moderate" improvement (ISI score reduction > 7). Wait-list data from 42 patients showed minimal sleep and mood improvements with the passage of time. Number of visits to the family physician six months postprogram decreased, although not significantly (p = .108). The CBT-I program was associated with improvement on all sleep and mood measures. Effect sizes were similar to, or larger than, those found in randomized controlled trials, demonstrating the real-world effectiveness of CBT-I in an interdisciplinary primary care setting.

Sleep Patterns and Academic Performance during Preparation for College Entrance Exam in Chinese Adolescents

ERIC Educational Resources Information Center

Wang, Guanghai; Ren, Fen; Liu, Zhijun; Xu, Guangxing; Jiang, Fan; Skora, Elizabeth; Lewin, Daniel S.

2016-01-01

Background: Deficient sleep is linked to detrimental outcomes in health and school performance for adolescents. This study characterized sleep patterns in Chinese adolescents preparing for the College Entrance Exam (CEE) and evaluated the association between sleep patterns, self-rated academic performance, and the CEE scores. Methods: A sample of…

Impact of Protected Sleep Period for Internal Medicine Interns on Overnight Call on Depression, Burnout, and Empathy

PubMed Central

Shea, Judy A.; Bellini, Lisa M.; Dinges, David F.; Curtis, Meredith L.; Tao, Yuanyuan; Zhu, Jingsan; Small, Dylan S.; Basner, Mathias; Norton, Laurie; Novak, Cristina; Dine, C. Jessica; Rosen, Ilene M.; Volpp, Kevin G.

2014-01-01

Background Patient safety and sleep experts advocate a protected sleep period for residents. Objective We examined whether interns scheduled for a protected sleep period during overnight call would have better end-of-rotation assessments of burnout, depression, and empathy scores compared with interns without protected sleep periods and whether the amount of sleep obtained during on call predicted end-of-rotation assessments. Methods We conducted a randomized, controlled trial with internal medicine interns at the Philadelphia Veterans Affairs Medical Center (PVAMC) and the Hospital of the University of Pennsylvania (HUP) in academic year 2009–2010. Four-week blocks were randomly assigned to either overnight call permitted under the 2003 duty hour standards or a protected sleep period from 12:30 am to 5:30 am. Participants wore wrist actigraphs. At the beginning and end of the rotations, they completed the Beck Depression Inventory (BDI-II), Maslach Burnout Inventory (MBI-HSS), and Interpersonal Reactivity Index (IRI). Results A total of 106 interns participated. There were no significant differences between groups in end-of-rotation BDI-II, MBI-HSS, or IRI scores at either location (P > .05). Amount of sleep while on call significantly predicted lower MBI-Emotional Exhaustion (P < .003), MBI-Depersonalization (P < .003), and IRI-Personal Distress (P < .006) at PVAMC, and higher IRI-Perspective Taking (P < .008) at HUP. Conclusions A protected sleep period produced few consistent improvements in depression, burnout, or empathy, although depression was already low at baseline. Possibly the amount of protected time was too small to affect these emotional states or sleep may not be directly related to these scores. PMID:24949128

Effects of an irregular bedtime schedule on sleep quality, daytime sleepiness, and fatigue among university students in Taiwan.

PubMed

Kang, Jiunn-Horng; Chen, Shih-Ching

2009-07-19

An irregular bedtime schedule is a prevalent problem in young adults, and could be a factor detrimentally affecting sleep quality. The goal of the present study was to explore the association between an irregular bedtime schedule and sleep quality, daytime sleepiness, and fatigue among undergraduate students in Taiwan. A total of 160 students underwent a semi-structured interview and completed a survey comprising 4 parts: Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), and a rating of irregular bedtime frequency. Participants were grouped into 3 groups in terms of irregular bedtime frequency: low, intermediate, or high according to their 2-week sleep log. To screen for psychological disorders or distress that may have affected responses on the sleep assessment measures, the Chinese health questionnaire-12 (CHQ-12) was also administered. We found an increase in bedtime schedule irregularity to be significantly associated with a decrease in average sleep time per day (Spearman r = -0.22, p = 0.05). Multivariate regression analysis revealed that irregular bedtime frequency and average sleep time per day were correlated with PSQI scores, but not with ESS or FSS scores. A significant positive correlation between irregular bedtime frequency and PSQI scores was evident in the intermediate (partial r = 0.18, p = 0.02) and high (partial r = 0.15, p = 0.05) frequency groups as compared to low frequency group. The results of our study suggest a high prevalence of both an irregular bedtime schedule and insufficient sleep among university students in Taiwan. Students with an irregular bedtime schedule may experience poor sleep quality. We suggest further research that explores the mechanisms involved in an irregular bedtime schedule and the effectiveness of interventions for improving this condition.

Sleep spindles and intelligence in early childhood-developmental and trait-dependent aspects.

PubMed

Ujma, Péter P; Sándor, Piroska; Szakadát, Sára; Gombos, Ferenc; Bódizs, Róbert

2016-12-01

Sleep spindles act as a powerful marker of individual differences in cognitive ability. Sleep spindle parameters correlate with both age-related changes in cognitive abilities and with the age-independent concept of IQ. While some studies have specifically demonstrated the relationship between sleep spindles and intelligence in young children, our previous work in older subjects revealed sex differences in the sleep spindle correlates of IQ, which was never investigated in small children before. We investigated the relationship between age, Raven Colored Progressive Matrices (CPM) scores and sleep spindles in 28 young children (age 4-8 years, 15 girls). We specifically investigated sex differences in the psychometric correlates of sleep spindles. We also aimed to separate the correlates of sleep spindles that are because of age-related maturation from other effects that reflect an age-independent relationship between sleep spindles and general intelligence. Our results revealed a modest positive correlation between fast spindle amplitude and age. Raven CPM scores positively correlated with both slow and fast spindle amplitude, but this effect remained a tendency in males and vanished after correcting for the effects of age. Age-corrected correlations between Raven CPM scores and both slow and fast spindle amplitude were only significant in females. Overall, our results show that in male children sleep spindles are a maturational marker, but in female children they indicate trait-like intelligence, in line with previous studies in adolescent and adult subjects. Thalamocortical white matter connectivity may be the underlying mechanism behind both higher spindle amplitude and higher intelligence in female, but not male subjects. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Temporal lobe epilepsy is a predisposing factor for sleep apnea: A questionnaire study in video-EEG monitoring unit.

PubMed

Yildiz, F Gokcem; Tezer, F Irsel; Saygi, Serap

2015-07-01

The interaction between epilepsy and sleep is known. It has been shown that patients with epilepsy have more sleep problems than the general population. However, there is no recent study that compares the frequency of sleep disorders in groups with medically refractory temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE). The main purpose of this study was to investigate the occurrence of sleep disorders in two subtypes of epilepsy by using sleep questionnaire forms. One hundred and eighty-nine patients, out of 215 who were monitored for refractory epilepsy and were followed by the video-EEG monitoring unit, were divided into a group with TLE and a group with ETLE. The medical outcome study-sleep scale (MOS-SS), Epworth sleepiness scale (ESS), and sleep apnea scale of the sleep disorders questionnaire (SD-SDQ) were completed after admission to the video-EEG monitoring unit. The total scores in the group with TLE and group with ETLE were compared. Of the patients, TLE was diagnosed in 101 (53.4%) (45 females), and ETLE was diagnosed in 88 (46.6%) (44 females). Comparison of MOS-SS and Epworth sleepiness scale scores in the two subgroups did not reveal significant differences. In the group with TLE, SD-SDQ scores were significantly higher compared to that in the group with ETLE. Patients with temporal lobe epilepsy have higher risk of obstructive sleep apnea (OSA) according to their reported symptoms. Detection of OSA in patients with epilepsy by using questionnaire forms may decrease the risk of ictal or postictal respiratory-related 'Sudden Unexpected Death in Epilepsy'. Copyright © 2015 Elsevier Inc. All rights reserved.

Reduced Rapid Eye Movement Density in Parkinson Disease: A Polysomnography-Based Case-Control Study.

PubMed

Schroeder, Lynn A; Rufra, Olivier; Sauvageot, Nicolas; Fays, François; Pieri, Vannina; Diederich, Nico J

2016-12-01

To explore rapid eye movement density (RD) in patients with idiopathic Parkinson disease (IPD) and to investigate its usefulness as surrogate marker of excessive daytime sleepiness, a frequent complaint in IPD patients. Retrospective polysomnography study on 81 subjects without dementia: 29 patients with early stage IPD (disease duration ≤ 3 y), 21 patients with middle- stage IPD (disease duration > 3 and < 8 y) and 31 healthy controls (HC). Rapid eye movement (REM) sleep was defined as any REM episode with > 3 min of continuous REM sleep. RD was defined as number of ocular movements per minute of REM sleep. Patients with early stage IPD and HC fulfilled the PD-specific sleepiness questionnaires Parkinson's Disease Sleep Scale (PDSS) and the Nonmotor Symptoms Questionnaire for Parkinson's disease (NMSQuest). RD was lower in patients with IPD than in HC. The difference was most significant between patients with middle stage IPD and HC (P = 0.001), and most prominent for the third REM episode, again when comparing patients with middle stage IPD and HC (P = 0.03). RD was independent from sex, age, and other sleep parameters. In early stage IPD, RD correlated with the PDSS score (r = -0.63, P = 0.001) and the sleep-related questions of the NMSQuest score (r = 0.48, P = 0.017). REM density is reduced in patients with IPD and correlates with subjective scores on sleep impairment. As an indicator of persistent high sleep pressure, reduced RD in IPD is eligible as a biomarker of excessive daytime sleepiness in IPD. It possibly reflects direct involvement of the brainstem REM generation sites by the disease process. RD is a promising new tool for sleep research in IPD. © 2016 Associated Professional Sleep Societies, LLC.

Prevalence of Sleep Disorders and Their Impacts on Occupational Performance: A Comparison between Shift Workers and Nonshift Workers

PubMed Central

Yazdi, Zohreh; Sadeghniiat-Haghighi, Khosro; Loukzadeh, Ziba; Elmizadeh, Khadijeh; Abbasi, Mahnaz

2014-01-01

The consequences of sleep deprivation and sleepiness have been noted as the most important health problem in our modern society among shift workers. The objective of this study was to investigate the prevalence of sleep disorders and their possible effects on work performance in two groups of Iranian shift workers and nonshift workers. This study was designed as a cross-sectional study. The data were collected by PSQI, Berlin questionnaire, Epworth Sleepiness Scale, Insomnia Severity Index, and RLS Questionnaire. Occupational impact of different sleep disorders was detected by Occupational Impact of Sleep Disorder questionnaire. These questionnaires were filled in by 210 shift workers and 204 nonshift workers. There was no significant difference in the age, BMI, marital status, and years of employment in the two groups. Shift workers scored significantly higher in the OISD. The prevalence of insomnia, poor sleep quality, and daytime sleepiness was significantly higher in shift workers. Correlations between OISD scores and insomnia, sleep quality, and daytime sleepiness were significant. We concluded that sleep disorders should receive more attention as a robust indicator of work limitation. PMID:24977041

Cognitive Expectancies for Hypnotic Use among Older Adult Veterans with Chronic Insomnia.

PubMed

Fung, Constance H; Martin, Jennifer L; Josephson, Karen; Fiorentino, Lavinia; Dzierzewski, Joseph M; Jouldjian, Stella; Song, Yeonsu; Rodriguez Tapia, Juan Carlos; Mitchell, Michael N; Alessi, Cathy A

2018-01-01

To examine relationships between cognitive expectancies about sleep and hypnotics and use of medications commonly used for insomnia (hypnotics). We analyzed baseline data from older veterans who met diagnostic criteria for insomnia and were enrolled in a trial comparing CBTI delivered by a supervised, sleep educator to an attention control condition (N = 159; 97% male, mean age 72 years). We classified individuals as hypnotic users (N = 23) vs. non-users (N = 135) based upon medication diaries. Associations between hypnotic status and Dysfunctional Beliefs and Attitudes about Sleep-16 (DBAS) total score (0-10, higher = worse) and two DBAS medication item scores (Item 1: "…better off taking a sleeping pill rather than having a poor night's sleep;" Item 2: "Medication… probably the only solution to sleeplessness"; 0-10, higher = worse) were examined in logistic regression models. Higher scores on the DBAS medication items (both odds ratios = 1.3; p-values < .001) were significantly associated with hypnotic use. DBAS-16 total score was not associated with hypnotic use. Cognitive expectancy (dysfunctional beliefs) about hypnotics was associated with hypnotic use in older adults with chronic insomnia disorder. Strategies that specifically target dysfunctional beliefs about hypnotics are needed and may impact hypnotic use in older adults.

Seizures in the elderly: Impact on mental status, mood and sleep

PubMed Central

Haut, Sheryl R.; Katz, Mindy; Masur, Jonathan; Lipton, Richard B.

2009-01-01

Co-morbidities of epilepsy have not been well explored in the elderly. Herein, we examined mental status, mood, and sleep in elderly patients with epilepsy, compared to age and gender matched community controls without epilepsy from the Einstein Aging Study. Testing included a mental status test, the Blessed Information Memory and Concentration (BIMC) test; Prime-MD Patient Health Questionnaire (PHQ) Depression and Anxiety Modules; and Medical Outcomes Study Sleep Scale. Persons with epilepsy (n=31) had higher mean BIMC scores than controls (n=31, BIMC 6.3 vs.1.2; p<0.0001). Mean PHQ Depression scores were higher for cases than controls indicating more depressive symptoms (4.2 vs. 0.8; p=0.006); six cases (18%) and no controls met screening criteria for depression. Mean PHQ Anxiety scores were also higher for cases than controls (3.7 vs. 0.0; p=0.001). Cases demonstrated poorer sleep scores in the categories of somnolence (p=0.009) and shortness of breath/headache (p=0.021). Thus, co-morbidities of epilepsy in this elderly population included decreased mental status, a higher prevalence of depression and anxiety, and poorer sleep health when compared to age mates without epilepsy. Mental status impairment was not related to anti-epileptic medication or mood disturbance. Further investigation will explore these associations prospectively. PMID:19189862

Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus.

PubMed

Cai, Shirong; Tan, Sara; Gluckman, Peter D; Godfrey, Keith M; Saw, Seang-Mei; Teoh, Oon Hoe; Chong, Yap-Seng; Meaney, Michael J; Kramer, Michael S; Gooley, Joshua J

2017-02-01

To examine the influence of maternal sleep quality and nocturnal sleep duration on risk of gestational diabetes mellitus (GDM) in a multiethnic Asian population. A cohort of 686 women (376 Chinese, 186 Malay, and 124 Indian) with a singleton pregnancy attended a clinic visit at 26-28 weeks of gestation as part of the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort study. Self-reported sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). GDM was diagnosed based on a 75-g oral glucose tolerance test administered after an overnight fast (1999 WHO criteria). Multiple logistic regression was used to model separately the associations of poor sleep quality (PSQI score > 5) and short nocturnal sleep duration (<6 h) with GDM, adjusting for age, ethnicity, maternal education, body mass index, previous history of GDM, and anxiety (State-Trait Anxiety Inventory score). In the cohort 296 women (43.1%) had poor sleep quality and 77 women (11.2%) were categorized as short sleepers; 131 women (19.1%) were diagnosed with GDM. Poor sleep quality and short nocturnal sleep duration were independently associated with increased risk of GDM (poor sleep, adjusted odds ratio [OR] = 1.75, 95% confidence interval [CI] 1.11 to 2.76; short sleep, adjusted OR = 1.96, 95% CI 1.05 to 3.66). During pregnancy, Asian women with poor sleep quality or short nocturnal sleep duration exhibited abnormal glucose regulation. Treating sleep problems and improving sleep behavior in pregnancy could potentially reduce the risk and burden of GDM. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Sleep deprivation selectively disrupts top-down adaptation to cognitive conflict in the Stroop test.

PubMed

Gevers, Wim; Deliens, Gaetane; Hoffmann, Sophie; Notebaert, Wim; Peigneux, Philippe

2015-12-01

Sleep deprivation is known to exert detrimental effects on various cognitive domains, including attention, vigilance and working memory. Seemingly at odds with these findings, prior studies repeatedly failed to evidence an impact of prior sleep deprivation on cognitive interference in the Stroop test, a hallmark paradigm in the study of cognitive control abilities. The present study investigated further the effect of sleep deprivation on cognitive control using an adapted version of the Stroop test that allows to segregate top-down (attentional reconfiguration on incongruent items) and bottom-up (facilitated processing after repetitions in responses and/or features of stimuli) components of performance. Participants underwent a regular night of sleep or a night of total sleep deprivation before cognitive testing. Results disclosed that sleep deprivation selectively impairs top-down adaptation mechanisms: cognitive control no longer increased upon detection of response conflict at the preceding trial. In parallel, bottom-up abilities were found unaffected by sleep deprivation: beneficial effects of stimulus and response repetitions persisted. Changes in vigilance states due to sleep deprivation selectively impact on cognitive control in the Stroop test by affecting top-down, but not bottom-up, mechanisms that guide adaptive behaviours. © 2015 European Sleep Research Society.

Impact of television on the quality of sleep in preschool children.

PubMed

Brockmann, Pablo E; Diaz, Blanca; Damiani, Felipe; Villarroel, Luis; Núñez, Felipe; Bruni, Oliviero

2016-04-01

We aimed to investigate the impact of different habits concerning television (TV) use and the time of day in which TV is watched on the sleep quality of young children. Parents of 100 healthy children (58% boys, mean age of 2.7 ± 1.5 years) attending a routine health check completed the Sleep Disturbance Scale for Children (SDSC) and a questionnaire concerning TV and electronic media use. Children were divided into those with a normal (SDSC-) or abnormal (SDSC+) questionnaire score. TV viewing habits were compared between groups. The total sleep time and total TV viewing time were not different between groups. A TV set was inside each child's bedroom in 51% of participants. Children with a TV in their bedroom showed significantly higher scores in the "sleep terrors," "nightmares," "sleep talking," and "tired when waking up" responses of the SDSC (P = 0.02, 0.01, 0.01, and 0.01, respectively). Children with a TV in their room had an odds ratio (95% confidence interval) of 3.29 (1.08-9.99) for having an abnormal SDSC. Evening TV viewers had significantly higher SDSC scores compared with those who watched TV earlier during the day (P = 0.04). The presence of a TV set in the child's bedroom was associated with significant reductions in the quality of young children's sleep. Evening exposure to TV was associated with significantly worse sleep quality. Copyright © 2015 Elsevier B.V. All rights reserved.

Stress-free automatic sleep deprivation using air puffs

PubMed Central

Gross, Brooks A.; Vanderheyden, William M.; Urpa, Lea M.; Davis, Devon E.; Fitzpatrick, Christopher J.; Prabhu, Kaustubh; Poe, Gina R.

2015-01-01

Background Sleep deprivation via gentle handling is time-consuming and personnel-intensive. New Method We present here an automated sleep deprivation system via air puffs. Implanted EMG and EEG electrodes were used to assess sleep/waking states in six male Sprague-Dawley rats. Blood samples were collected from an implanted intravenous catheter every 4 hours during the 12-hour light cycle on baseline, 8 hours of sleep deprivation via air puffs, and 8 hours of sleep deprivation by gentle handling days. Results The automated system was capable of scoring sleep and waking states as accurately as our offline version (~90% for sleep) and with sufficient speed to trigger a feedback response within an acceptable amount of time (1.76 s). Manual state scoring confirmed normal sleep on the baseline day and sleep deprivation on the two manipulation days (68% decrease in non-REM, 63% decrease in REM, and 74% increase in waking). No significant differences in levels of ACTH and corticosterone (stress hormones indicative of HPA axis activity) were found at any time point between baseline sleep and sleep deprivation via air puffs. Comparison with Existing Method There were no significant differences in ACTH or corticosterone concentrations between sleep deprivation by air puffs and gentle handling over the 8-hour period. Conclusions Our system accurately detects sleep and delivers air puffs to acutely deprive rats of sleep with sufficient temporal resolution during the critical 4-5 h post learning sleep-dependent memory consolidation period. The system is stress-free and a viable alternative to existing sleep deprivation techniques. PMID:26014662

Stress-free automatic sleep deprivation using air puffs.

PubMed

Gross, Brooks A; Vanderheyden, William M; Urpa, Lea M; Davis, Devon E; Fitzpatrick, Christopher J; Prabhu, Kaustubh; Poe, Gina R

2015-08-15

Sleep deprivation via gentle handling is time-consuming and personnel-intensive. We present here an automated sleep deprivation system via air puffs. Implanted EMG and EEG electrodes were used to assess sleep/waking states in six male Sprague-Dawley rats. Blood samples were collected from an implanted intravenous catheter every 4h during the 12-h light cycle on baseline, 8h of sleep deprivation via air puffs, and 8h of sleep deprivation by gentle handling days. The automated system was capable of scoring sleep and waking states as accurately as our offline version (∼90% for sleep) and with sufficient speed to trigger a feedback response within an acceptable amount of time (1.76s). Manual state scoring confirmed normal sleep on the baseline day and sleep deprivation on the two manipulation days (68% decrease in non-REM, 63% decrease in REM, and 74% increase in waking). No significant differences in levels of ACTH and corticosterone (stress hormones indicative of HPA axis activity) were found at any time point between baseline sleep and sleep deprivation via air puffs. There were no significant differences in ACTH or corticosterone concentrations between sleep deprivation by air puffs and gentle handling over the 8-h period. Our system accurately detects sleep and delivers air puffs to acutely deprive rats of sleep with sufficient temporal resolution during the critical 4-5h post learning sleep-dependent memory consolidation period. The system is stress-free and a viable alternative to existing sleep deprivation techniques. Copyright © 2015 Elsevier B.V. All rights reserved.

Variations in sleep characteristics and sleep-related impairment in at-risk college drinkers: a latent profile analysis.

PubMed

DeMartini, Kelly S; Fucito, Lisa M

2014-10-01

Sleep disturbance and heavy drinking increase risk of negative consequences in college students. Limited research exists on how they act synergistically, and the overall nature of sleep and sleep-related impairment in college student drinkers is poorly understood. A latent profile analysis was conducted on the sleep characteristics and daytime sleep-related consequences of college student drinkers who were at-risk based on Alcohol Use Disorders Identification Test-Consumption scores. Participants (N = 312, mean age = 18.90 (0.97) years) consumed a mean (SD) of 20.93 (13.04) drinks per week. Scores on the 10 items of the Sleep/Wake Behavior Problems Scale (SWPS) were the class indicators. Four classes best described the sleep and sleep-related consequences of at-risk college drinkers. Classes represented different gradients and types of sleep patterns and sleep-related impairment; nearly half the sample reported late bedtimes and daytime consequences of insufficient sleep. Subsequent validation analyses indicated that these classes were directly correspondent with severity of alcohol consumption, alcohol-related consequences illicit substance use, and perceived health. These findings indicate the presence of significant heterogeneity in college drinkers' sleep patterns and experiences of sleep-related impairment. Class differences significantly impact the level of alcohol and drug use and the consequences members experience. Greater alcohol use and sleep/wake problems are associated with increased risk for negative consequences for certain classes. These results suggest that college drinking interventions could benefit from the incorporation of sleep-related content and the value in adding brief alcohol assessments and interventions to other college health treatments.

Sleep Disorders in Adult Sickle Cell Patients

PubMed Central

Sharma, Sunil; Efird, Jimmy T.; Knupp, Charles; Kadali, Renuka; Liles, Darla; Shiue, Kristin; Boettger, Peter; Quan, Stuart F.

2015-01-01

Study Objectives: While sleep apnea has been studied in children with sickle cell disease (SCD), little is known about sleep disorders in adult sickle cell patients. The objective of this study was to evaluate sleep disordered breathing and its polysomnographic characteristics in adult patients with sickle cell disease. Methods: The analysis cohort included 32 consecutive adult SCD patients who underwent a comprehensive sleep evaluation and overnight polysomnography in an accredited sleep center after reporting symptoms suggesting disordered sleep or an Epworth Sleepiness Scale score ≥ 10. Epworth score, sleep parameters, comorbid conditions, and narcotic use were reviewed and compared in patients with and without sleep disordered breathing. SCD complication rates in the two groups also were compared. Results: In adult SCD patients who underwent overnight polysomnography, we report a high prevalence (44%) of sleep disordered breathing. Disease severity was mild to moderate (mean apnea-hypopnea index = 17/h (95% CI: 10–24/h). Concomitant sleep disorders, including insomnia complaints (57%) and delayed sleep-phase syndrome (57%), also were common in this population. In this limited cohort, we did not find increased SCD complications associated with sleep disordered breathing in adult patients with sickle cell disease. Conclusions: A high burden of sleep disordered breathing and other sleep-related complaints were identified in the adult sickle cell population. Our results provide important information on this unique population. Citation: Sharma S, Efird JT, Knupp C, Kadali R, Liles D, Shiue K, Boettger P, Quan SF. Sleep disorders in adult sickle cell patients. J Clin Sleep Med 2015;11(3):219–223. PMID:25515282

Evaluation of latent links between irritable bowel syndrome and sleep quality

PubMed Central

Bellini, Massimo; Gemignani, Angelo; Gambaccini, Dario; Toti, Simona; Menicucci, Danilo; Stasi, Cristina; Costa, Francesco; Mumolo, Maria Gloria; Ricchiuti, Angelo; Bedini, Remo; de Bortoli, Nicola; Marchi, Santino

2011-01-01

AIM: To examine the links between quality of sleep and the severity of intestinal symptoms in irritable bowel syndrome (IBS). METHODS: One hundred and forty-two outpatients (110 female, 32 male) who met the Rome III criteria for IBS with no psychiatric comorbidity were consecutively enrolled in this study. Data on age, body mass index (BMI), and a set of life-habit variables were recorded, and IBS symptoms and sleep quality were evaluated using the questionnaires IBS Symptom Severity Score (IBS-SSS) and Pittsburgh Sleep Quality Index (PSQI). The association between severity of IBS and sleep disturbances was evaluated by comparing the global IBS-SSS and PSQI score (Pearson’s correlation and Fisher’s exact test) and then analyzing the individual items of the IBS-SSS and PSQI questionnaires by a unitary bowel-sleep model based on item response theory (IRT). RESULTS: IBS-SSS ranged from mild to severe (120-470). The global PSQI score ranged from 1 to 17 (median 5), and 60 patients were found to be poor sleepers (PSQI > 5). The correlation between the global IBS-SSS and PSQI score indicated a weak association (r = 0.2 and 95% CI: -0.03 to 0.35, P < 0.05), which becomes stronger using our unitary model. Indeed, the IBS and sleep disturbances severities, estimated as latent variables, resulted significantly high intra-subject correlation (posterior mean of r = 0.45 and 95% CI: 0.17 to 0.70, P < 0.05). Moreover, the correlations between patient features (age, sex, BMI, daily coffee and alcohol intake) and IBS and sleep disturbances were also analyzed through our unitary model. Age was a significant regressor, with patients ≤ 50 years old showing more severe bowel disturbances (posterior mean = -0.38, P < 0.05) and less severe sleep disturbances (posterior mean = 0.49, P < 0.05) than older patients. Higher daily coffee intake was correlated with a lower severity of bowel disturbances (posterior mean = -0.31, P < 0.05). Sex (female) and daily alcohol intake (modest) were correlated with less severe sleep disturbances. CONCLUSION: The unitary bowel-sleep model based on IRT revealed a strong positive correlation between the severity of IBS symptoms and sleep disturbances. PMID:22171143

Clinical and polysomnographic predictors of laryngopharyngeal reflux in obstructive sleep apnea syndrome.

PubMed

Caparroz, Fábio Azevedo; Campanholo, Milena de Almeida Torres; Regina, Caroline Gomez; Park, Sung Woo; Haddad, Leonardo; Gregório, Luís Carlos; Haddad, Fernanda Louise Martinho

2018-04-14

Obstructive sleep apnea syndrome and laryngopharyngeal reflux are diseases with a high prevalence in the overall population; however, it remains unclear whether they are diseases with the same risk factors present in the same populations or if there is any association between them. To evaluate and determine the prevalence of laryngopharyngeal reflux in patients with moderate and severe obstructive apnea syndrome and also to determine its predictive factors. Historical cohort, cross-sectional study of patients aged 18-70 years, referred to a tertiary service Otorhinolaryngology outpatient clinic with a polysomnographic diagnosis of moderate or severe obstructive sleep apnea syndrome. The reflux symptom index questionnaire and the reflux finding score at indirect videolaryngoscopy were applied to the assessed population, considering the inclusion and exclusion criteria. Fifty-six patients were evaluated, of which 64.3% had a positive laryngopharyngeal reflux (positive reflux symptom index and/or positive endolaryngeal reflux finding score). Body mass index was a predictor of reflux presence in this group of patients with moderate to severe obstructive sleep apnea syndrome. In patients with positive score for endoscopic findings and reflux symptom index (12.3%), there was a trend toward significance for a higher mean apnea-hypopnea index and a higher percentage of sleep time with oxyhemoglobin saturation below 90% (p=0.05). The prevalence of laryngopharyngeal reflux was higher in this group of patients with moderate to severe obstructive sleep apnea syndrome, and the body mass index was a predictor of laryngopharyngeal reflux in these patients. There was a trend toward greater oxyhemoglobin desaturation in patients with a positive score for reflux symptoms index (RSI) and reflux finding score (RFS). Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. All rights reserved.

Congruence between Polysomnography Obstructive Sleep Apnea and the Pediatric Sleep Questionnaire: Fatigue and Health-Related Quality of Life in Juvenile Idiopathic Arthritis

PubMed Central

Ward, Teresa M.; Chen, Maida Lynn; Landis, Carol A.; Ringold, Sarah; Beebe, Dean W.; Pike, Kenneth C.; Wallace, Carol A.

2016-01-01

Purpose To examine the congruence between polysomnography obstructive apnea hypopnea index (OAHI) and parent reported obstructive sleep apnea (OSA) symptoms in 6-to-11 year-old children with juvenile idiopathic arthritis (JIA) and controls; and to compare fatigue and quality of life in JIA and control children based on OAHI and OSA symptoms. Methods Sixty-eight children with JIA and 75 controls and a parent participated. Children underwent one night of polysomnography in a sleep laboratory. Parents completed the sleep-related breathing disorders scale - Pediatric Sleep Questionnaire (PSQ), and both children and parents completed the Pediatric Quality of Life Generic Core Scale and the Multidimensional Fatigue scale. Results In JIA, 86% who met the OAHI clinical criteria for OSA (≥ 1.5) were above the PSQ OSA symptom cut-off score with a sensitivity of 0.86 and a specificity of 0.28. In the control group, 63% who met the OAHI clinical criteria for OSA, were above the PSQ OSA symptom cut-off score, with a sensitivity of 0.63 and a specificity of 0.42. All children above both the clinical criteria for OAHI and OSA symptom cut-off score had the most impaired quality of life and greater fatigue compared to those below both the clinical criteria for OAHI and the OSA symptom cut-off score. Conclusion Children who meet clinical criteria for OSA and also scored high on a parent reported screening tool for OSA symptoms had the most impaired quality of life and more fatigue. The PSQ has potential to identify children at risk for OSA. PMID:27987106

Dietary Carbohydrate and Nocturnal Sleep Duration in Relation to Children's BMI: Findings from the IDEFICS Study in Eight European Countries.

PubMed

Hunsberger, Monica; Mehlig, Kirsten; Börnhorst, Claudia; Hebestreit, Antje; Moreno, Luis; Veidebaum, Toomas; Kourides, Yiannis; Siani, Alfonso; Molnar, Dénes; Sioen, Isabelle; Lissner, Lauren

2015-12-08

Previous research has found an association between being overweight and short sleep duration. We hypothesized that this association could be modified by a high carbohydrate (HC) diet and that the timing and type (starch or sugar) of intake may be an important factor in this context. Participants in the prospective, eight-country European study IDEFICS were recruited from September 2007 to June 2008, when they were aged two to nine years. Data on lifestyle, dietary intake and anthropometry were collected on two occasions. This study included 5944 children at baseline and 4301 at two-year follow-up. For each meal occasion (morning, midday, and evening), starch in grams and sugar in grams were divided by total energy intake (EI), and quartiles calculated. HC-starch and HC-sugar intake categories were defined as the highest quartile for each meal occasion. In a mutually adjusted linear regression model, short sleep duration as well as HC-starch in the morning were positively associated with body mass index (BMI) z-scores at baseline. HC-starch at midday was positively associated with body mass index (BMI) z-scores in children with short sleep duration, and negatively associated with BMI z-scores in those with normal sleep. After adjustment for baseline BMI z-scores, associations between total HC from starch or sugar and high BMI z-scores at two-year follow-up did not persist. Our observations offer a perspective on optimal timing for macronutrient consumption, which is known to be influenced by circadian rhythms. Reduced carbohydrate intake, especially during morning and midday meals, and following nocturnal sleep duration recommendations are two modifiable factors that may protect children from being overweight in the future.

Maternal anxiety, depression and sleep disorders before and during pregnancy, and preschool ADHD symptoms in the NINFEA birth cohort study.

PubMed

Vizzini, L; Popovic, M; Zugna, D; Vitiello, B; Trevisan, M; Pizzi, C; Rusconi, F; Gagliardi, L; Merletti, F; Richiardi, L

2018-04-18

Maternal mental disorders have been associated with the risk of attention-deficit/hyperactivity disorder (ADHD) in children. Within the context of a mother-child cohort, we examined whether maternal anxiety, depression and sleep disorders are associated with pre-school ADHD symptoms. The study included 3634 singletons from the Italian NINFEA (Nascita e INFanzia: gli Effetti dell'Ambiente') cohort. Maternal doctor-diagnosed anxiety, depression and sleep disorders before and during pregnancy were assessed from the questionnaires completed during pregnancy and 6 months after delivery. Mothers rated child ADHD symptoms at 4 years of age, according to the Diagnostic and Statistical Manual of Mental Disorders. Hyperactive-impulsive (ADHD-H), inattentive (ADHD-I) and total ADHD scores were analysed in the models adjusted for child's gender, first-born status, maternal age, education, alcohol consumption and smoking during pregnancy. The total ADHD score at age 4 was associated with maternal lifetime anxiety (17.1% percentage difference in score compared with never; 95% CI 7.3-27.9%), sleep disorders (35.7%; 95% CI 10.7-66.5%) and depression (17.5%; 95% CI 3.2-33.8%). Similar positive associations were observed also for ADHD-H and ADHD-I traits, with slightly attenuated associations between maternal sleep disorders and child ADHD-I score, and maternal depression and both ADHD scores. All the estimates were enhanced when the disorders were active during pregnancy and attenuated for disorders active only during the pre-pregnancy period. Maternal anxiety, depression and sleep disorders are associated with a relative increase in the number of ADHD-H, ADHD-I and total ADHD symptoms in preschoolers.

Effect of Adenotonsillectomy on Parent-Reported Sleepiness in Children with Obstructive Sleep Apnea.

PubMed

Paruthi, Shalini; Buchanan, Paula; Weng, Jia; Chervin, Ronald D; Mitchell, Ronald B; Dore-Stites, Dawn; Sadhwani, Anjali; Katz, Eliot S; Bent, John; Rosen, Carol L; Redline, Susan; Marcus, Carole L

2016-11-01

To describe parental reports of sleepiness and sleep duration in children with polysomnography (PSG)-confirmed obstructive sleep apnea (OSA) randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC) in the ChildHood Adenotonsillectomy Trial (CHAT). We hypothesized children with OSA would have a larger improvement in sleepiness 6 mo following eAT compared to WWSC. Parents of children aged 5.0-9.9 y completed the Epworth Sleepiness Scale modified for children (mESS) and the Pediatric Sleep Questionnaire-Sleepiness Subscale (PSQ-SS). PSG was performed at baseline and at 7-mo endpoint. Children underwent early adenotonsillectomy or WWSC. The mESS and PSQ-SS classified 24% and 53% of the sample as excessively sleepy, respectively. At baseline, mean mESS score was 7.4 ± 5.0 (SD) and mean PSQ-SS score was 0.44 ± 0.30. Sleepiness scores were higher in African American children; children with shorter sleep duration; older children; and overweight children. At endpoint, mean mESS score decreased by 2.0 ± 4.2 in the eAT group versus 0.3 ± 4.0 in the WWSC group (P < 0.0001); mean PSQ-SS score decreased 0.29 ± 0.40 in eAT versus 0.08 ± 0.40 in the WWSC group (P < 0.0001). Despite higher baseline sleepiness, African American children experienced similar improvement with adenotonsillectomy than other children. Improvement in sleepiness was weakly associated with improved apnea-hypopnea index or oxygen desaturation indices, but not with change in other polysomnographic measures. Sleepiness assessed by parent report was prevalent; improved more after eAT than after WWSC; and was not strongly predicted by sleep disturbances identified by PSG. Childhood Adenotonsillectomy Study for Children with OSA (CHAT). ClinicalTrials.gov Identifier #NCT00560859. © 2016 Associated Professional Sleep Societies, LLC.

Impact of shift work on sleep and daytime performance among health care professionals.

PubMed

Alshahrani, Sultan M; Baqays, Abdulsalam A; Alenazi, Abdelelah A; AlAngari, Abdulaziz M; AlHadi, Ahmad N

2017-08-01

To evaluate sleep quality and daytime sleepiness in health care professionals who are performing shift work. Methods: This cross-sectional study was conducted on 510 health care professionals at Prince Sultan Military Medical City and King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia between December 2015 and April 2016. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Participants were divided into 2 groups: shift workers and non-shift workers. Results: We compared both groups regarding the effect of shift work on the total score of PSQI and ESS. We found that the PSQI global score (p less than 0.001) and the total ESS score (p=0.003) were significantly higher in shift work health care professionals.  Conclusion: Shift work among health care professionals is associated with poor sleep quality but not excessive daytime sleepiness. Health care professionals performing shift work have PSQI and ESS scores slightly higher than non-shift work health professionals.

Sleep characteristics as predictor variables of stress systems markers in insomnia disorder.

PubMed

Floam, Samantha; Simpson, Norah; Nemeth, Emese; Scott-Sutherland, Jennifer; Gautam, Shiva; Haack, Monika

2015-06-01

This study investigates the extent to which sleep characteristics serve as predictor variables for inflammatory, hypothalamic-pituitary-adrenal and autonomic systems markers. Twenty-nine participants with a diagnosis of insomnia disorder based on the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (age 25.3 ± 1.6 years, insomnia duration 6.6 ± 0.8 years) and 19 healthy control sleepers (age 25.4 ± 1.4 years) underwent a 2-week at-home evaluation keeping a sleep diary and wearing an actigraph, followed by a visit to the Research Center to measure blood pressure, and collect blood and urine samples. The actigraphy- and diary-based variables of sleep duration, sleep-onset latency, wake after sleep onset and sleep fragmentation/number of night-time awakenings were averaged and entered as dependent variables in regression analyses. Composite scores were calculated for the autonomic (blood pressure, norepinephrine), inflammatory (monocyte counts, interleukin-6, C-reactive protein) and hypothalamic-pituitary-adrenal systems (cortisol), and used as predictor variables in regression models. Compared with controls, individuals with insomnia had a shorter sleep duration (P < 0.05), and a higher hypothalamic-pituitary-adrenal and inflammatory composite score (P < 0.05). The higher inflammatory score was mainly due to higher circulating monocytes (P < 0.05), rather than differences in interleukin-6 or C-reactive protein. In persistent insomnia disorder, cortisol is upregulated and associated with actigraphy- and diary-based wake after sleep onset, suggesting that wake after sleep onset may serve as a marker to identify individuals at increased risks for disorders associated with a hyperactive hypothalamic-pituitary-adrenal system. The absence of autonomic and pro-inflammatory changes (interleukin-6, C-reactive protein), despite a substantial decrease in actigraphic sleep duration, may relate to a higher resilience to the adverse biological consequences of insomnia in this young age group. © 2014 European Sleep Research Society.

How Do Sleep-Related Health Problems Affect Functional Status According to Sex?

PubMed Central

Boccabella, Allegra; Malouf, John

2017-01-01

Study Objectives: To measure differences in functional status between men and women presenting with sleep-related health problems. Methods: A retrospective clinical audit of 744 Australian patients across 7 private general practices between April 2013 and January 2015 was conducted. Patients completed an electronic survey as part of their routine consultation, which included the Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep Questionnaire 10 (FOSQ-10), and other questions relating to the effect of their sleep problem. The proportion of males and females with ESS and FOSQ-10 scores associated with disorders of daytime sleepiness and burden of symptoms due to sleepiness, respectively, were compared, as well as reported differences between the sexes in memory, concentration, issues with relationships, feeling depressed, and trouble sleeping. Results: On presentation, females were more likely to have sleeping disorders associated with daytime sleepiness (median ESS score of 9 for females versus 8 for males, P = .038; proportion ESS > 9 was 49.0% for females versus 36.9% for males, P = .003). Women were also more likely to report an increased burden of symptoms due to sleepiness compared to men, as shown by lower FOSQ-10 scores (P < .001). Secondary outcome measures showed that females were more likely to feel excessively tired and depressed, have difficulties with memory and concentration, and have trouble sleeping at night. Snoring kept partners awake in roughly the same proportion of males and females, and a larger proportion of the partners of males were forced out of the room. Conclusions: Sleep-related health issues both manifest in and affect the lives of males and females differently. Sleep health professionals should recognize these differences on all levels of disease prevention and health promotion from patient education, to diagnosis and management to improve quality of life for those with sleep-related health problems. Citation: Boccabella A, Malouf J. How do sleep-related health problems affect functional status according to sex? J Clin Sleep Med. 2017;13(5):685–692. PMID:28260591

Does Race-Ethnicity Moderate the Relationship between CPAP Adherence and Functional Outcomes of Sleep in US Veterans with Obstructive Sleep Apnea Syndrome?

PubMed Central

Wallace, Douglas M.; Wohlgemuth, William K.

2014-01-01

Background: Little is known about the association of race-ethnicity and the relationship of continuous positive airway pressure (CPAP) adherence with functional outcomes of sleep in American samples with obstructive sleep apnea syndrome (OSAS). This retrospective study examines whether race-ethnicity moderates the relationship between CPAP adherence and functional outcomes of sleep in OSAS. Methods: Over 4 months, consecutive OSAS patients had CPAP data downloads and completed questionnaires (demographics, Functional Outcomes of Sleep Questionnaire [FOSQ], Epworth Sleepiness Scale [ESS], Insomnia Severity Index [ISI]) at the Miami VA sleep center. Medical diagnoses and polysomnography data were obtained from medical record. CPAP adherence was measured as mean daily hours of use. Hierarchical regression modeling was used to explore the differential impact of race-ethnicity and CPAP adherence on functional outcomes of sleep. Results: Two hundred twenty-seven veterans (93% male, age 59 ± 11 years) were included; 142 (63%) participants self-reported as white or Hispanic, and 85 participants (37%) as black. Hierarchical regression analyses failed to show main effects for race-ethnicity or CPAP use and FOSQ scores; however, the interaction of race-ethnicity with CPAP adherence was significantly associated with the total FOSQ (p = 0.04), Social (p = 0.02), and Intimacy (p = 0.01) subscale scores. For blacks, in adjusted analyses, CPAP adherence was positively associated with Social and Intimacy FOSQ subscales; however, no significant relationship was noted between CPAP use and FOSQ scores in whites/Hispanics. Conclusions: Race-ethnicity may moderate the relationship between CPAP adherence and some functional outcomes of sleep; however, further studies are needed. Citation: Wallace DM, Wohlgemuth WK. Does race-ethnicity moderate the relationship between CPAP adherence and functional outcomes of sleep in US veterans with obstructive sleep apnea syndrome? J Clin Sleep Med 2014;10(10):1083-1091. PMID:25317089

Sleep and memory. I: The influence of different sleep stages on memory.

PubMed

Rotenberg, V S

1992-01-01

A new approach to the sleep stages role in memory is discussed in the context of the two opposite patterns of behavior-search activity and renunciation of search. Search activity is activity designed to change the situation (or the subjects attitudes to it) in the absence of a definite forecast of the results of such activity, but with the constant consideration of these results at all stages of activity. Search activity increases general adaptability and body resistance while renunciation of search decreases adaptability and requires REM sleep for its compensation. Unprepared learning, which is often accompanied by failures on the first steps of learning, is suggested to produce renunciation of search, which decreases learning ability, suppress retention, and increase REM sleep requirement. A prolonged REM sleep deprivation before training causes learned helplessness and disturbs the learning process, while short REM sleep deprivation cause the "rebound" of the compensatory search activity that interferes with passive avoidance. REM sleep deprivation performed after a training session can increase distress caused by a training procedure, with the subsequent negative outcome on retention.

The effect of sleep deprivation on leadership behaviour in military officers: an experimental study.

PubMed

Olsen, Olav Kjellevold; Pallesen, Ståle; Torsheim, Torbjørn; Espevik, Roar

2016-12-01

While several studies show that leaders frequently lack sleep, little is known about how this influences leadership behaviour. The present study encompasses an experiment that investigated how three main types of leadership behaviour: transformational (four sub-facets); transactional (two sub-facets); and passive-avoidant (two sub-facets) leadership differed across a rested and a long-term, partially sleep-deprived condition. A total of 16 military naval officers participated. In both conditions, the leaders managed a team of three subordinates in a navy navigation simulator, instructed to complete a specific mission (A or B). Both sleep state (rested or sleep deprived) and mission were counterbalanced. Leadership behaviour was video recorded and subsequently rated on the three leadership behaviours. Overall, the scores on transformational leadership (and on two of four sub-facets) and transactional leadership (on both sub-facets) decreased from the rested to sleep-deprived condition, whereas scores on passive-avoidant leadership overall (and on both sub-facets) increased from the rested to sleep-deprived condition. This study underscores the importance of including sleep as a potentially important determinant when assessing leadership effectiveness. © 2016 European Sleep Research Society.

Daytime somnolence in adult sleepwalkers.

PubMed

Desautels, Alex; Zadra, Antonio; Labelle, Marc-Antoine; Dauvilliers, Yves; Petit, Dominique; Montplaisir, Jacques

2013-11-01

Sleepwalkers often complain of excessive daytime somnolence (EDS). Our retrospective study aimed to document the presence of EDS in a substantial sample of sleepwalkers and to explore the contribution of other sleep disorders, nocturnal sleep disruption, and sleep depth to the alteration of their daytime vigilance. Seventy adult sleepwalkers and 70 control subjects completed the Epworth Sleepiness Scale (ESS). Sleepwalkers also were studied for one night in the sleep laboratory. We compared the sleep profiles of 32 somnolent vs 38 nonsomnolent sleepwalkers and investigated the relationship between ESS scores and sleep-related variables. No differences were found in polysomnographic (PSG) parameters. Slow-wave activity (SWA) also was similar in the two subgroups. Sleepwalkers' ESS scores were not correlated with their body mass index (BMI) or periodic limb movements during sleep (PLMS) index, but they tended to be negatively correlated with indices of respiratory events. The EDS reported by adult sleepwalkers does not appear to be explained by the presence of concomitant sleep disorders or PSG signs of nocturnal sleep disruption. These results raise the possibility that EDS is part of the sleepwalking phenotype and that it is linked to its underlying pathophysiology. Copyright © 2013 Elsevier B.V. All rights reserved.

The Effects of Aromatherapy Massage on Sleep Quality of Nurses on Monthly Rotating Night Shifts

PubMed Central

Lin, Chao-Ling

2017-01-01

The goal of this study is to examine the effects of aromatherapy massage on sleep quality of nurses with monthly rotating night shifts. Subjects were enrolled at a medical center in central Taiwan with overall score ≥ 5 of Pittsburgh Sleep Quality Index (PSQI) and randomly assigned to the treatment or control groups. They were validated by pretests during their first graveyard shift in the trial period and the sleep quality information was collected by using the PSQI and sleep detectors. During the second graveyard shift, the treatment group received aromatherapy massage and the control group rested in the same aromatherapy room after work. All subjects filled out the PSQI surveys and the sleep quality information was collected during massage or resting and the following night. We found that the total PSQI was significantly decreased in the treatment group following the aromatherapy massage. Specifically, the components such as subjective sleep quality, sleep disturbance, and daytime dysfunction were significantly decreased. However, there were no significant changes of average PSQI scores between the two groups before and after intervention. Taken together, our study suggested that aromatherapy massage could improve sleep quality of nurses with monthly rotating night shift. PMID:28761497

The Effects of Aromatherapy Massage on Sleep Quality of Nurses on Monthly Rotating Night Shifts.

PubMed

Chang, Ying-Ying; Lin, Chao-Ling; Chang, Li-Yin

2017-01-01

The goal of this study is to examine the effects of aromatherapy massage on sleep quality of nurses with monthly rotating night shifts. Subjects were enrolled at a medical center in central Taiwan with overall score ≥ 5 of Pittsburgh Sleep Quality Index (PSQI) and randomly assigned to the treatment or control groups. They were validated by pretests during their first graveyard shift in the trial period and the sleep quality information was collected by using the PSQI and sleep detectors. During the second graveyard shift, the treatment group received aromatherapy massage and the control group rested in the same aromatherapy room after work. All subjects filled out the PSQI surveys and the sleep quality information was collected during massage or resting and the following night. We found that the total PSQI was significantly decreased in the treatment group following the aromatherapy massage. Specifically, the components such as subjective sleep quality, sleep disturbance, and daytime dysfunction were significantly decreased. However, there were no significant changes of average PSQI scores between the two groups before and after intervention. Taken together, our study suggested that aromatherapy massage could improve sleep quality of nurses with monthly rotating night shift.

Effects of industrial wind turbine noise on sleep and health.

PubMed

Nissenbaum, Michael A; Aramini, Jeffery J; Hanning, Christopher D

2012-01-01

Industrial wind turbines (IWTs) are a new source of noise in previously quiet rural environments. Environmental noise is a public health concern, of which sleep disruption is a major factor. To compare sleep and general health outcomes between participants living close to IWTs and those living further away from them, participants living between 375 and 1400 m (n = 38) and 3.3 and 6.6 km (n = 41) from IWTs were enrolled in a stratified cross-sectional study involving two rural sites. Validated questionnaires were used to collect information on sleep quality (Pittsburgh Sleep Quality Index - PSQI), daytime sleepiness (Epworth Sleepiness Score - ESS), and general health (SF36v2), together with psychiatric disorders, attitude, and demographics. Descriptive and multivariate analyses were performed to investigate the effect of the main exposure variable of interest (distance to the nearest IWT) on various health outcome measures. Participants living within 1.4 km of an IWT had worse sleep, were sleepier during the day, and had worse SF36 Mental Component Scores compared to those living further than 1.4 km away. Significant dose-response relationships between PSQI, ESS, SF36 Mental Component Score, and log-distance to the nearest IWT were identified after controlling for gender, age, and household clustering. The adverse event reports of sleep disturbance and ill health by those living close to IWTs are supported.

Comparison of inhibition in two timed reaction tasks: the color and emotion Stroop tasks.

PubMed

Cothran, D Lisa; Larsen, Randy

2008-07-01

The authors examined the cross-task consistency of the ability to inhibit the processing of irrelevant information. They compared interference scores on 2 widely used inhibition tasks and found that color word Stroop interference scores correlated with emotion word Stroop interference scores. An examination of physiological reactivity showed that, in general, the color Stroop was more arousing than was the emotion Stroop, most likely due to increased response conflict.

Measuring leg movements during sleep using accelerometry: comparison with EMG and piezo-electric scored events.

PubMed

Terrill, Philip I; Leong, Matthew; Barton, Katrina; Freakley, Craig; Downey, Carl; Vanniekerk, Mark; Jorgensen, Greg; Douglas, James

2013-01-01

Periodic Limb Movements during Sleep (PLMS) can cause significant disturbance to sleep, resulting in daytime sleepiness and reduced quality of life. In conventional clinical practice, PLMS are measured using overnight electromyogram (EMG) of the tibialis anterior muscle, although historically they have also been measured using piezo-electric gauges placed over the muscle. However, PLMS counts (PLM index) do not correlate well with clinical symptomology. In this study, we propose that because EMG and piezo derived signals measure muscle activation rather than actual movement, they may count events with no appreciable movement of the limb and therefore no contribution to sleep disturbance. The aim of this study is thus to determine the percentage of clinically scored limb movements which are not associated with movement of the great toe measured using accelerometry. 9 participants were studied simultaneously with an overnight diagnostic polysomnogram (including EMG and piezo instrumentation of the right leg) and high temporal resolution accelerometry of the right great toe. Limb movements were scored, and peak acceleration during each scored movement was quantified. Across the participant population, 54.9% (range: 26.7-76.3) and 39.0% (range: 4.8-69.6) of limb movements scored using piezo and EMG instrumentation respectively, were not associated with toe movement measured with accelerometry. If sleep disturbance is the consequence of the limb movements, these results may explain why conventional piezo or EMG derived PLMI is poorly correlated with clinical symptomology.

Effect of Adenotonsillectomy on Parent-Reported Sleepiness in Children with Obstructive Sleep Apnea

PubMed Central

Paruthi, Shalini; Buchanan, Paula; Weng, Jia; Chervin, Ronald D.; Mitchell, Ronald B.; Dore-Stites, Dawn; Sadhwani, Anjali; Katz, Eliot S.; Bent, John; Rosen, Carol L.; Redline, Susan; Marcus, Carole L.

2016-01-01

Study Objectives: To describe parental reports of sleepiness and sleep duration in children with polysomnography (PSG)-confirmed obstructive sleep apnea (OSA) randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC) in the ChildHood Adenotonsillectomy Trial (CHAT). We hypothesized children with OSA would have a larger improvement in sleepiness 6 mo following eAT compared to WWSC. Methods: Parents of children aged 5.0–9.9 y completed the Epworth Sleepiness Scale modified for children (mESS) and the Pediatric Sleep Questionnaire-Sleepiness Subscale (PSQ-SS). PSG was performed at baseline and at 7-mo endpoint. Children underwent early adenotonsillectomy or WWSC. Results: The mESS and PSQ-SS classified 24% and 53% of the sample as excessively sleepy, respectively. At baseline, mean mESS score was 7.4 ± 5.0 (SD) and mean PSQ-SS score was 0.44 ± 0.30. Sleepiness scores were higher in African American children; children with shorter sleep duration; older children; and overweight children. At endpoint, mean mESS score decreased by 2.0 ± 4.2 in the eAT group versus 0.3 ± 4.0 in the WWSC group (P < 0.0001); mean PSQ-SS score decreased 0.29 ± 0.40 in eAT versus 0.08 ± 0.40 in the WWSC group (P < 0.0001). Despite higher baseline sleepiness, African American children experienced similar improvement with adenotonsillectomy than other children. Improvement in sleepiness was weakly associated with improved apnea-hypopnea index or oxygen desaturation indices, but not with change in other polysomnographic measures. Conclusions: Sleepiness assessed by parent report was prevalent; improved more after eAT than after WWSC; and was not strongly predicted by sleep disturbances identified by PSG. Clinical Trial Registration: Childhood Adenotonsillectomy Study for Children with OSA (CHAT). ClinicalTrials.gov Identifier #NCT00560859. Citation: Paruthi S, Buchanan P, Weng J, Chervin RD, Mitchell RB, Dore-Stites D, Sadhwani A, Katz ES, Bent J, Rosen CL, Redline S, Marcus CL. Effect of adenotonsillectomy on parent-reported sleepiness in children with obstructive sleep apnea. SLEEP 2016;39(11):2005–2012. PMID:27568804

Effect of auricular acupressure for postpartum insomnia: an uncontrolled clinical trial.

PubMed

Ko, Yi-Li; Lin, Shih-Chi; Lin, Pi-Chu

2016-02-01

This study examined the effects of auricular acupressure therapy on women with postpartum insomnia. Postpartum women generally have poor sleep quality because of frequent night-time breastfeeding during the first month after giving birth. A one-group pretest/post-test quasi-experiment was conducted. A convenience sampling method was used to recruit participants at a postpartum centre (doing-the-month centre) in Northern Taiwan, from January 2014-July 2014. Thirty women with postpartum insomnia received auricular acupressure therapy on one auricular point (Shenmen point pressing) four times a day for 14 days. The Chinese version of the Pittsburgh Sleep Quality Index was used to assess sleep quality before and after the 14-day treatment. After the 14-day auricular acupressure treatment, the Pittsburgh Sleep Quality Index total scores of the women decreased from 8·7 (pretest) to 5·57 (post-test, 36% reduction). Scores on the subscales of the Pittsburgh Sleep Quality Index, including sleep quality, sleep latency, sleep duration and sleep disturbance, also statistically improved (p < 0·05). Hormone changes and frequent breastfeeding were identified as characteristics that may exacerbate poor sleep quality of postpartum women, for whom the auricular acupressure intervention may effectively improve sleep quality. Auricular acupressure can be an alternative complementary therapy to aid postpartum women with insomnia in improving sleep quality. © 2015 John Wiley & Sons Ltd.

Sleep disorders in spinocerebellar ataxia type 2 patients.

PubMed

Velázquez-Pérez, Luis; Voss, Ursula; Rodríguez-Labrada, Roberto; Auburger, Georg; Canales Ochoa, Nalia; Sánchez Cruz, Gilberto; Galicia Polo, Lourdes; Haro Valencia, Reyes; Aguilera Rodríguez, Raúl; Medrano Montero, Jacqueline; Laffita Mesa, Jose M; Tuin, Inka

2011-01-01

Sleep disturbances are common features in spinocerebellar ataxias (SCAs). Nevertheless, sleep data on SCA2 come from scarce studies including few patients, limiting the evaluation of the prevalence and determinants of sleep disorders. To assess the frequency and possible determinants of sleep disorders in the large and homogeneous SCA2 Cuban population. Thirty-two SCA2 patients and their age- and sex-matched controls were studied by video-polysomnography and sleep interviews. The most striking video-polysomnography features were rapid eye movement (REM) sleep pathology and periodic leg movements (PLMs). REM sleep abnormalities included a consistent reduction of the REM sleep percentage and REM density as well as an increase in REM sleep without atonia (RWA). REM sleep and REM density decreases were closely related to the increase in ataxia scores, whereas the RWA percentage was influenced by the cytosine-adenine-guanine (CAG) repeats. PLMs were observed in 37.5% of cases. The PLM index showed a significant association with the ataxia score and disease duration but not with CAG repeats. REM sleep pathology and PLMs are closely related to SCA2 severity, suggesting their usefulness as disease progression markers. The RWA percentage is influenced by the CAG repeats and might thus be a sensitive parameter for reflecting polyglutamine toxicity. Finally, as PLMs are sensible to drug treatment, they represents a new therapeutic target for the symptomatic treatment of SCA2. Copyright © 2011 S. Karger AG, Basel.

No Acute Effects of Cannabidiol on the Sleep-Wake Cycle of Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study

PubMed Central

Linares, Ila M. P.; Guimaraes, Francisco S.; Eckeli, Alan; Crippa, Ana C. S.; Zuardi, Antonio W.; Souza, Jose D. S.; Hallak, Jaime E.; Crippa, José A. S.

2018-01-01

Cannabidiol (CBD) is a component of Cannabis sativa that has a broad spectrum of potential therapeutic effects in neuropsychiatric and other disorders. However, few studies have investigated the possible interference of CBD on the sleep-wake cycle. The aim of the present study was to evaluate the effect of a clinically anxiolytic dose of CBD on the sleep-wake cycle of healthy subjects in a crossover, double-blind design. Twenty-seven healthy volunteers that fulfilled the eligibility criteria were selected and allocated to receive either CBD (300 mg) or placebo in the first night in a double-blind randomized design (one volunteer withdrew from the study). In the second night, the same procedure was performed using the substance that had not been administered in the previous occasion. CBD or placebo were administered 30 min before the start of polysomnography recordings that lasted 8 h. Cognitive and subjective measures were performed immediately after polysomnography to assess possible residual effects of CBD. The drug did not induce any significant effect (p > 0.05). Different from anxiolytic and antidepressant drugs such as benzodiazepines and selective serotonin reuptake inhibitors, acute administration of an anxiolytic dose of CBD does not seem to interfere with the sleep cycle of healthy volunteers. The present findings support the proposal that CBD do not alter normal sleep architecture. Future studies should address the effects of CBD on the sleep-wake cycle of patient populations as well as in clinical trials with larger samples and chronic use of different doses of CBD. Such studies are desirable and opportune. PMID:29674967

Modulation of the Muscle Activity During Sleep in Cervical Dystonia.

PubMed

Antelmi, Elena; Ferri, Raffaele; Provini, Federica; Scaglione, Cesa M L; Mignani, Francesco; Rundo, Francesco; Vandi, Stefano; Fabbri, Margherita; Pizza, Fabio; Plazzi, Giuseppe; Martinelli, Paolo; Liguori, Rocco

2017-07-01

Impaired sleep has been reported as an important nonmotor feature in dystonia, but so far, self-reported complaints have never been compared with nocturnal video-polysomnographic (PSG) recording, which is the gold standard to assess sleep-related disorders. Twenty patients with idiopathic isolated cervical dystonia and 22 healthy controls (HC) underwent extensive clinical investigations, neurological examination, and questionnaire screening for excessive daytime sleepiness and sleep-related disorders. A full-night video PSG was performed in both patients and HC. An ad hoc montage, adding electromyographic leads over the muscle affected with dystonia, was used. When compared to controls, patients showed significantly increased pathological values on the scale assessing self-reported complaints of impaired nocturnal sleep. Higher scores of impaired nocturnal sleep did not correlate with any clinical descriptors but for a weak correlation with higher scores on the scale for depression. On video-PSG, patients had significantly affected sleep architecture (with decreased sleep efficiency and increased sleep latency). Activity over cervical muscles disappears during all the sleep stages, reaching significantly decreased values when compared to controls both in nonrapid eye movements and rapid eye movements sleep. Patients with cervical dystonia reported poor sleep quality and showed impaired sleep architecture. These features however cannot be related to the persistence of muscle activity over the cervical muscles, which disappears in all the sleep stages, reaching significantly decreased values when compared to HC. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Learning machines and sleeping brains: Automatic sleep stage classification using decision-tree multi-class support vector machines.

PubMed

Lajnef, Tarek; Chaibi, Sahbi; Ruby, Perrine; Aguera, Pierre-Emmanuel; Eichenlaub, Jean-Baptiste; Samet, Mounir; Kachouri, Abdennaceur; Jerbi, Karim

2015-07-30

Sleep staging is a critical step in a range of electrophysiological signal processing pipelines used in clinical routine as well as in sleep research. Although the results currently achievable with automatic sleep staging methods are promising, there is need for improvement, especially given the time-consuming and tedious nature of visual sleep scoring. Here we propose a sleep staging framework that consists of a multi-class support vector machine (SVM) classification based on a decision tree approach. The performance of the method was evaluated using polysomnographic data from 15 subjects (electroencephalogram (EEG), electrooculogram (EOG) and electromyogram (EMG) recordings). The decision tree, or dendrogram, was obtained using a hierarchical clustering technique and a wide range of time and frequency-domain features were extracted. Feature selection was carried out using forward sequential selection and classification was evaluated using k-fold cross-validation. The dendrogram-based SVM (DSVM) achieved mean specificity, sensitivity and overall accuracy of 0.92, 0.74 and 0.88 respectively, compared to expert visual scoring. Restricting DSVM classification to data where both experts' scoring was consistent (76.73% of the data) led to a mean specificity, sensitivity and overall accuracy of 0.94, 0.82 and 0.92 respectively. The DSVM framework outperforms classification with more standard multi-class "one-against-all" SVM and linear-discriminant analysis. The promising results of the proposed methodology suggest that it may be a valuable alternative to existing automatic methods and that it could accelerate visual scoring by providing a robust starting hypnogram that can be further fine-tuned by expert inspection. Copyright © 2015 Elsevier B.V. All rights reserved.

Validation of the Korean Version of the Scales for Outcomes in Parkinson's Disease-Sleep

PubMed Central

2017-01-01

Background Sleep problems commonly occur in patients with Parkinson's disease (PD), and are associated with a lower quality of life. The aim of the current study was to translate the English version of the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-S) into the Korean version of SCOPA-S (K-SCOPA-S), and to evaluate its reliability and validity for use by Korean-speaking patients with PD. Methods In total, 136 patients with PD from 27 movement disorder centres of university-affiliated hospitals in Korea were enrolled in this study. They were assessed using SCOPA, Hoehn and Yahr Scale (HYS), Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Sleep Scale 2nd version (PDSS-2), Non-motor Symptoms Scale (NMSS), Montgomery Asberg Depression Scale (MADS), 39-item Parkinson's Disease Questionnaire (PDQ39), Neurogenic Orthostatic Hypotension Questionnaire (NOHQ), and Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (RBDQ). The test-retest reliability was assessed over a time interval of 10–14 days. Results The internal consistency (Cronbach's α-coefficients) of K-SCOPA-S was 0.88 for nighttime sleep (NS) and 0.75 for daytime sleepiness (DS). Test-retest reliability was 0.88 and 0.85 for the NS and DS, respectively. There was a moderate correlation between the NS sub-score and PDSS-2 total score. The NS and DS sub-scores of K-SCOPA-S were correlated with motor scale such as HYS, and non-motor scales such as UPDRS I, UPDRS II, MADS, NMSS, PDQ39, and NOHQ while the DS sub-score was with RBDQ. Conclusion The K-SCOPA-S exhibited good reliability and validity for the assessment of sleep problems in the Korean patients with PD. PMID:29215823

Validation of the Korean Version of the Scales for Outcomes in Parkinson's Disease-Sleep.

PubMed

Sung, Young Hee; Kim, Hee Jin; Koh, Seong Beom; Kim, Joong Seok; Kim, Sang Jin; Cheon, Sang Myung; Cho, Jin Whan; Kim, Yoon Joong; Ma, Hyeo Il; Park, Mee Young; Baik, Jong Sam; Lee, Phil Hyu; Chung, Sun Ju; Kim, Jong Min; Song, In Uk; Kim, Han Joon; Kim, Ji Young; Kwon, Do Young; Lee, Jae Hyeok; Lee, Jee Young; Kim, Ji Seon; Yun, Ji Young; Hong, Jin Yong; Kim, Mi Jung; Youn, Jinyoung; Kim, Ji Sun; Oh, Eung Seok; Yang, Hui Jun; Yoon, Won Tae; You, Sooyeoun; Kwon, Kyum Yil; Park, Hyung Eun; Lee, Su Yun; Kim, Younsoo; Kim, Hee Tae; Ahn, Tae Beom

2018-01-08

Sleep problems commonly occur in patients with Parkinson's disease (PD), and are associated with a lower quality of life. The aim of the current study was to translate the English version of the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-S) into the Korean version of SCOPA-S (K-SCOPA-S), and to evaluate its reliability and validity for use by Korean-speaking patients with PD. In total, 136 patients with PD from 27 movement disorder centres of university-affiliated hospitals in Korea were enrolled in this study. They were assessed using SCOPA, Hoehn and Yahr Scale (HYS), Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Sleep Scale 2nd version (PDSS-2), Non-motor Symptoms Scale (NMSS), Montgomery Asberg Depression Scale (MADS), 39-item Parkinson's Disease Questionnaire (PDQ39), Neurogenic Orthostatic Hypotension Questionnaire (NOHQ), and Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (RBDQ). The test-retest reliability was assessed over a time interval of 10-14 days. The internal consistency (Cronbach's α-coefficients) of K-SCOPA-S was 0.88 for nighttime sleep (NS) and 0.75 for daytime sleepiness (DS). Test-retest reliability was 0.88 and 0.85 for the NS and DS, respectively. There was a moderate correlation between the NS sub-score and PDSS-2 total score. The NS and DS sub-scores of K-SCOPA-S were correlated with motor scale such as HYS, and non-motor scales such as UPDRS I, UPDRS II, MADS, NMSS, PDQ39, and NOHQ while the DS sub-score was with RBDQ. The K-SCOPA-S exhibited good reliability and validity for the assessment of sleep problems in the Korean patients with PD. © 2018 The Korean Academy of Medical Sciences.

The Pittsburgh Sleep Quality Index: validation of the Urdu translation.

PubMed

Hashmi, Ali Madeeh; Khawaja, Imran Shuja; Butt, Zeeshan; Umair, Muhammad; Naqvi, Suhaib Haider; Jawad-Ul-Haq

2014-02-01

To translate and validate the Pittsburgh Sleep Quality Index (PSQI), a standardized self-administered questionnaire for the assessment of subjective sleep quality into the Urdu language. Validation study. Mayo Hospital, Lahore, from March to April 2012. The PSQI was translated into Urdu following standard guidelines. The final Urdu version (PSQI-U) was administered to 200 healthy volunteers comprising medical students, nursing staff and doctors. Inter-item correlation was assessed by calculating Cronbach alpha. Correlation of component scores with global score was assessed by calculating Spearman correlation coefficient. Correlation between global PSQI-U scores at baseline with global scores for each PSQI-U and PSQI-E at 4-week interval was evaluated by calculating Spearman correlation coefficient. Moreover, scores on individual items of the scale at baseline were compared with respective scores after 4-week by t-test. One hundred and eighty five (185) participants completed the PSQI-U at baseline. The Cronbach alpha for PSQI-U was 0.56. Scores on individual components of the PSQI-U and composite scores were all highly correlated with each other (all p-values < 0.01). Composite scores for PSQI-U at baseline and PSQI-E at 4-week interval were also highly correlated with each other (Spearman correlation coefficient 0.74, p-value < 0.01) indicating good linguistic interchangeability. Composite scores for PSQI-U at baseline and at 4-week interval were positively correlated with each other (Spearman correlation coefficient 0.70, p < 0.01) indicating good test-retest reliability. The PSQI-U is a valid and reliable instrument for the assessment of sleep quality. It shows good linguistic interchangeability and test-retest reliability in comparison to the original English version when applied to individuals who speak the Urdu language. The PSQI-U can be a tool either for clinical management or research.

Functional Interference Clusters in Cancer Patients With Bone Metastases: A Secondary Analysis of RTOG 9714

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chow, Edward, E-mail: Edward.Chow@sunnybrook.c; James, Jennifer; Barsevick, Andrea

Purpose: To explore the relationships (clusters) among the functional interference items in the Brief Pain Inventory (BPI) in patients with bone metastases. Methods: Patients enrolled in the Radiation Therapy Oncology Group (RTOG) 9714 bone metastases study were eligible. Patients were assessed at baseline and 4, 8, and 12 weeks after randomization for the palliative radiotherapy with the BPI, which consists of seven functional items: general activity, mood, walking ability, normal work, relations with others, sleep, and enjoyment of life. Principal component analysis with varimax rotation was used to determine the clusters between the functional items at baseline and the follow-up.more » Cronbach's alpha was used to determine the consistency and reliability of each cluster at baseline and follow-up. Results: There were 448 male and 461 female patients, with a median age of 67 years. There were two functional interference clusters at baseline, which accounted for 71% of the total variance. The first cluster (physical interference) included normal work and walking ability, which accounted for 58% of the total variance. The second cluster (psychosocial interference) included relations with others and sleep, which accounted for 13% of the total variance. The Cronbach's alpha statistics were 0.83 and 0.80, respectively. The functional clusters changed at week 12 in responders but persisted through week 12 in nonresponders. Conclusion: Palliative radiotherapy is effective in reducing bone pain. Functional interference component clusters exist in patients treated for bone metastases. These clusters changed over time in this study, possibly attributable to treatment. Further research is needed to examine these effects.« less

Pain and chronic mild traumatic brain injury in the US military population: a Chronic Effects of Neurotrauma Consortium study.

PubMed

Hoot, Michelle R; Levin, Harvey S; Smith, Austin N; Goldberg, Gary; Wilde, Elisabeth A; Walker, William C; Eapen, Blessen C; Nolen, T; Pugh, N L

2018-06-08

To describe the association between mild traumatic brain injury (mTBI) and pain intensity and pain interference outcomes while accounting for potential confounders and mediators including environmental factors and comorbidities in a cohort of US Veterans of the Iraq and Afghanistan wars. Cross-sectional snapshot of baseline data from a prospective, longitudinal study. Effects of mTBI on pain intensity and pain interference were compared between participants with or without mTBI exposure. Data were analysed using covariate-adjusted regression analyses as well as structural equation modelling (SEM) methods to assess the robustness of findings across different modelling assumptions. As results of the two approaches were consistent with respect to the overall association between mTBI exposure and pain, the results focus primarily on the SEM findings. The mTBI exposed group reported significantly greater indices of post-traumatic stress disorder (PTSD), depression, anxiety and sleep disturbance. After accounting for other factors, mTBI exposure was significantly, but indirectly associated with the pain interference and pain intensity outcomes. mTBI is strongly associated with pain intensity and pain interference in this sample. However, the effect appears to be mediated by other common mTBI comorbidities: PTSD, depression, anxiety and sleep disturbance.

The impact of junior doctors' worktime arrangements on their fatigue and well-being.

PubMed

Tucker, Philip; Brown, Menna; Dahlgren, Anna; Davies, Gwyneth; Ebden, Philip; Folkard, Simon; Hutchings, Hayley; Akerstedt, Torbjörn

2010-11-01

Many doctors report working excessively demanding schedules that comply with the European Working Time Directive (EWTD). We compared groups of junior doctors working on different schedules in order to identify which features of schedule design most negatively affected their fatigue and well-being in recent weeks. Completed by 336 doctors, the questionnaires focused on the respondents' personal circumstances, work situation, work schedules, sleep, and perceptions of fatigue, work-life balance and psychological strain. Working 7 consecutive nights was associated with greater accumulated fatigue and greater work-life interference, compared with working just 3 or 4 nights. Having only 1 rest day after working nights was associated with increased fatigue. Working a weekend on-call between 2 consecutive working weeks was associated with increased work-life interference. Working frequent on-calls (either on weekends or during the week) was associated with increased work-life interference and psychological strain. Inter-shift intervals of <10 hours were associated with shorter periods of sleep and increased fatigue. The number of hours worked per week was positively associated with work-life interference and fatigue on night shifts. The current findings identify parameters, in addition to those specified in the EWTD, for designing schedules that limit their impact on doctors' fatigue and well-being.

Consistently high sports/exercise activity is associated with better sleep quality, continuity and depth in midlife women: the SWAN sleep study.

PubMed

Kline, Christopher E; Irish, Leah A; Krafty, Robert T; Sternfeld, Barbara; Kravitz, Howard M; Buysse, Daniel J; Bromberger, Joyce T; Dugan, Sheila A; Hall, Martica H

2013-09-01

To examine relationships between different physical activity (PA) domains and sleep, and the influence of consistent PA on sleep, in midlife women. Cross-sectional. Community-based. 339 women in the Study of Women's Health Across the Nation Sleep Study (52.1 ± 2.1 y). None. Sleep was examined using questionnaires, diaries and in-home polysomnography (PSG). PA was assessed in three domains (Active Living, Household/Caregiving, Sports/Exercise) using the Kaiser Physical Activity Survey (KPAS) up to 4 times over 6 years preceding the sleep assessments. The association between recent PA and sleep was evaluated using KPAS scores immediately preceding the sleep assessments. The association between the historical PA pattern and sleep was examined by categorizing PA in each KPAS domain according to its pattern over the 6 years preceding sleep assessments (consistently low, inconsistent/consistently moderate, or consistently high). Greater recent Sports/Exercise activity was associated with better sleep quality (diary "restedness" [P < 0.01]), greater sleep continuity (diary sleep efficiency [SE; P = 0.02]) and depth (higher NREM delta electroencephalographic [EEG] power [P = 0.04], lower NREM beta EEG power [P < 0.05]), and lower odds of insomnia diagnosis (P < 0.05). Consistently high Sports/Exercise activity was also associated with better Pittsburgh Sleep Quality Index scores (P = 0.02) and higher PSG-assessed SE (P < 0.01). Few associations between sleep and Active Living or Household/Caregiving activity (either recent or historical pattern) were noted. Consistently high levels of recreational physical activity, but not lifestyle- or household-related activity, are associated with better sleep in midlife women. Increasing recreational physical activity early in midlife may protect against sleep disturbance in this population.

The Impact of a Randomized Sleep Education Intervention for College Students.

PubMed

Hershner, Shelley; O'Brien, Louise M

2018-03-15

Sleep deprivation can impair attention, mood, and performance; however, few effective sleep education programs are available. The aim of this study was to assess the effect of a sleep education website, Sleep to Stay Awake (sleeptostayawake.org), on sleep behaviors of college students. College students (age 18 years or older) attending a public Midwestern university were randomized to control or intervention groups. All subjects completed baseline surveys that included demographics, Pittsburgh Sleep Quality Index, Patient Health Questionnaire, sleep knowledge, and measures of sleepiness and circadian rhythm. The intervention group then undertook the online intervention. Surveys were repeated at 1 week and at 8 weeks. Students who participated included 295 controls and 254 intervention subjects. The mean age was 21.9 ± 4.1 years and 41.7% were male. Survey results at 8 weeks showed that more intervention subjects reported improved sleep behaviors (50.3% versus 39.5%, P = .04). Intervention subjects were more likely to stop electronics use earlier (odds ratio [95% confidence interval] = 1.5 [1.0-2.4]), keep a more regular sleep schedule (1.6 [1.06-2.4]), have an earlier weekday rise time (2.4 [1.3-4.4]), and have a lower likelihood of insufficient sleep prior to examinations (0.46 [0.28-0.76]). The intervention group had improvement in mean sleep quality (odds ratio = 5.8 versus 6.6, P < .001) and depression scores (odds ratio = 4.6 versus 5.6, P = .03). No significant differences were found in the other measures. A brief and personalized online sleep education intervention improved sleep behaviors, sleep quality, and depressions scores. This novel approach to address sleep deprivation, poor sleep habits, and mood among college students may offer an effective and inexpensive remedy. © 2018 American Academy of Sleep Medicine.

Specific headache factors predict sleep disturbances among youth with migraine.

PubMed

Heyer, Geoffrey L; Rose, Sean C; Merison, Kelsey; Perkins, Sara Q; Lee, Jo Ellen M

2014-10-01

There is a paucity of pediatric data addressing the complex relationship between primary headaches and sleep disturbances. Our study objective was to explore headache-related factors that predict sleep disturbance and to compare sleep complaints with other forms of headache-related disability among youth with migraines. A prospective cohort study was conducted in patients 10-18 years old with migraine or probable migraine and without daily sleep complaints. The patients completed a 90-day internet-based headache diary. On headache days, patients rated headache intensity, answered Pediatric Migraine Disability Assessment-based questions modified for daily scoring, and reported sleep disturbances that resulted as a direct effect of proximate headaches. Fifty-two patients generated 4680 diary entries, 984 patients (21%) involved headaches. Headache intensity (P = 0.009) and timing of headache onset (P < 0.001) were predictive of sleep disturbances. Three Pediatric Migraine Disability Assessment-based items were also associated with sleep disturbances: partial school-day absence (P = 0.04), recreational activities prevented (P < 0.001), and decreased functioning during recreational activities (P < 0.001). Sleep disturbances correlated positively and significantly with daily headache disability scores (rpb = 0.35; P < 0.01). We conclude that specific headache factors predict sleep disturbances among youth with primary headaches. Copyright © 2014 Elsevier Inc. All rights reserved.

Infant sleep and feeding patterns are associated with maternal sleep, stress, and depressed mood in women with a history of major depressive disorder (MDD).

PubMed

Sharkey, Katherine M; Iko, Ijeoma N; Machan, Jason T; Thompson-Westra, Johanna; Pearlstein, Teri B

2016-04-01

Our goal was to examine associations of infant sleep and feeding patterns with maternal sleep and mood among women at risk for postpartum depression. Participants were 30 women (age ± SD = 28.3 ± 5.1 years) with a history of MDD (but not in a mood episode at enrollment) who completed daily sleep diaries, wore wrist actigraphs to estimate sleep, and had their mood assessed with the Hamilton Depression Rating Scale (HAM-D-17) during four separate weeks of the perinatal period (33 weeks pregnancy and weeks 2, 6, and 16 postpartum). They logged their infants' sleep and feeding behaviors daily and reported postnatal stress on the Childcare Stress Inventory (CSI) at week 16. Mothers' actigraphically estimated sleep showed associations with infant sleep and feeding patterns only at postpartum week 2. Shorter duration of the longest infant-sleep bout was associated with shorter maternal sleep duration (p = .02) and lower sleep efficiency (p = .04), and maternal sleep efficiency was negatively associated with the number of infant-sleep bouts (p = .008) and duration of infant feeding (p = .008). Neither infant sleep nor feeding was associated with maternal sleep at 6 or 16 weeks, but more disturbed infant sleep and more frequent feeding at 6 weeks were associated with higher HAM-D scores at 6 and 16 weeks and higher CSI scores. Sleep in the mother-infant dyad is most tightly linked in the early postpartum weeks, but mothers continue to experience disturbed sleep and infant sleep and feeding behaviors continue to be associated with mothers' depressive symptoms and stress ratings as long as 16 weeks postpartum. These data imply that interventions designed to improve maternal sleep and postpartum mood should include both mothers and infants because improving infant sleep alone is not likely to improve maternal sleep, and poor infant sleep is linked to postpartum depression and stress.

Infant Sleep and Feeding Patterns are Associated with Maternal Sleep, Stress, and Depressed Mood in Women with a History of Major Depressive Disorder

PubMed Central

Sharkey, Katherine M.; Iko, Ijeoma N.; Machan, Jason T.; Thompson-Westra, Johanna; Pearlstein, Teri B.

2015-01-01

Purpose Our goal was to examine associations of infant sleep and feeding patterns with maternal sleep and mood among women at risk for postpartum depression. Methods Participants were 30 women (age±SD = 28.3±5.1 years) with a history of MDD (but not in a mood episode at enrollment) who completed daily sleep diaries, wore wrist actigraphs to estimate sleep, and had mood assessed with the Hamilton Depression Rating Scale (HAM-D-17) during 4 separate weeks of the perinatal period (33 weeks pregnancy and weeks 2, 6, and 16 postpartum). They logged their infants’ sleep and feeding behaviors daily and reported postnatal stress on the Childcare Stress Inventory (CSI) at week 16. Results Mothers’ actigraphically-estimated sleep showed associations with infant sleep and feeding patterns only at postpartum week 2. Shorter duration of the longest infant sleep bout was associated with shorter maternal sleep duration (p=.02) and lower sleep efficiency (p=.04), and maternal sleep efficiency was negatively associated with number of infant sleep bouts (p =.008) and duration of infant feeding (p =.008). Neither infant sleep nor feeding was associated with maternal sleep at 6 or 16 weeks, but more disturbed infant sleep and more frequent feeding at 6 weeks were associated with higher HAM-D scores at 6 and 16 weeks and higher CSI scores. Conclusions Sleep in the mother-infant dyad is most tightly linked in the early postpartum weeks, but mothers continue to experience disturbed sleep and infant sleep and feeding behaviors continue to be associated with mothers’ depressive symptoms and stress ratings as long as 16 weeks postpartum. These data imply that interventions designed to improve maternal sleep and postpartum mood should include both mothers and infants, because improving infant sleep alone is not likely to improve maternal sleep and poor infant sleep is linked to postpartum depression and stress. PMID:26228760

Translation, cultural adaptation, and validation of the Sleep Apnea Quality of Life Index (SAQLI) in Persian-speaking patients with obstructive sleep apnea.

PubMed

Rahavi-Ezabadi, Sara; Amali, Amin; Sadeghniiat-Haghighi, Khosro; Montazeri, Ali; Nedjat, Saharnaz

2016-05-01

The aim of this study was the translation, cross-cultural adaptation, and validation of the Sleep Apnea Quality of Life Index (SAQLI) in Persian-speaking patients with obstructive sleep apnea (OSA). Ninety-six patients with OSA completed a series of questionnaires including SAQLI, Epworth Sleepiness Scale (ESS),10-item Functional Outcomes of Sleep Questionnaire (FOSQ-10), and Medical Outcome Survey Short form 12 (SF-12) for assessment of reliability, validity, and responsiveness of Persian version of SAQLI. The Persian version of SAQLI had a very good internal consistency and also demonstrated good test-retest reliability. Concurrent validity was confirmed by significant correlations with ESS, FOSQ-10 and SF-12 subscale scores. Comparison of SAQLI scores in groups of patients categorized by ESS showed the high discriminative power of this instrument. However, there was no significant difference in the SAQLI scores of patients with mild, moderate, and severe sleep apnea. The results of sensitivity to change verified that the SAQLI was able to detect changes after continuous positive airway pressure (CPAP) treatment. The findings of this study indicate that the Persian version of SAQLI is a reliable, valid, and responsive measure for evaluation of quality of life in patients with OSA.

Cardiovascular Stress Reactivity and Carotid Intima-Media Thickness: The Buffering Role of Slow-Wave Sleep.

PubMed

Brindle, Ryan C; Duggan, Katherine A; Cribbet, Matthew R; Kline, Christopher E; Krafty, Robert T; Thayer, Julian F; Mulukutla, Suresh R; Hall, Martica H

2018-04-01

Exaggerated cardiovascular reactivity to acute psychological stress has been associated with increased carotid intima-media thickness (IMT). However, interstudy variability in this relationship suggests the presence of moderating factors. The current study aimed to test the hypothesis that poor nocturnal sleep, defined as short total sleep time or low slow-wave sleep, would moderate the relationship between cardiovascular reactivity and IMT. Participants (N = 99, 65.7% female, age = 59.3 ± 9.3 years) completed a two-night laboratory sleep study and cardiovascular examination where sleep and IMT were measured. The multisource interference task was used to induce acute psychological stress, while systolic and diastolic blood pressure and heart rate were monitored. Moderation was tested using the PROCESS framework in SPSS. Slow-wave sleep significantly moderated the relationship between all cardiovascular stress reactivity variables and IMT (all pinteraction ≤ .048, all ΔRinteraction ≥ .027). Greater stress reactivity was associated with higher IMT values in the low slow-wave sleep group and lower IMT values in the high slow-wave sleep group. No moderating effects of total sleep time were observed. The results provide evidence that nocturnal slow-wave sleep moderates the relationship between cardiovascular stress reactivity and IMT and may buffer the effect of daytime stress-related disease processes.

Sleep patterns and sleep-related complaints of Brazilian interstate bus drivers.

PubMed

Mello, M T; Santana, M G; Souza, L M; Oliveira, P C; Ventura, M L; Stampi, C; Tufik, S

2000-01-01

Sleep-related complaints have become a highlight for physicians as well as public health administrators. Studies of sleep patterns and sleep-related complaints of shift workers have been useful in minimizing reduction in the quality of life due to the warping of the sleep-wake cycle. The objective of the present study was to assess patterns of sleep, sleep-related complaints as well as physical activity and scoring rates for depression and anxiety in interstate bus drivers. Data were obtained with a sleep questionnaire, with the Beck inventory for depression, and the State-Trait Anxiety Inventory (STAI). A total of 400 interstate bus drivers from the northern, southern, central-western and south-eastern regions of Brazil were interviewed. Sixty percent of the subjects interviewed presented at least one sleep-related complaint, 16% admitted to have dozed at the wheel while on duty, and 41% stated that they exercised on a regular basis. Other sleep disturbance complaints reported were: sleep latency 29'17"; physical fatigue, 59.8%; mental fatigue, 45.4%; sleepiness, 25.8%; irritability, 20.6%; insomnia, 37.5%, respiratory disturbances, 19. 25% and snoring, 20.75%. Scores for anxiety and depression were not in the pathological range. The present data reinforce the view that bus drivers are generally discontent with shift work and its effects on sleep. Consequently, it is very important to establish an appropriate work schedule for drivers, besides implementing photo-therapy and physical activities in order to minimize sleepiness when driving.

Idiopathic hypersomnia with and without long sleep time: a controlled series of 75 patients.

PubMed

Vernet, Cyrille; Arnulf, Isabelle

2009-06-01

To characterize the clinical, psychological, and sleep pattern of idiopathic hypersomnia with and without long sleep time, and provide normative values for 24-hour polysomnography. University Hospital. Controlled, prospective cohort. 75 consecutive patients (aged 34 +/- 12 y) with idiopathic hypersomnia and 30 healthy matched controls. Patients and controls underwent during 48 hours a face-to-face interview, questionnaires, human leukocyte antigen genotype, a night polysomnography and multiple sleep latency test (MSLT), followed by 24-h ad libitum sleep monitoring. Hypersomniacs had more fatigue, higher anxiety and depression scores, and more frequent hypnagogic hallucinations (24%), sleep paralysis (28%), sleep drunkenness (36%), and unrefreshing naps (46%) than controls. They were more frequently evening types. DQB1*0602 genotype was similarly found in hypersomniacs (24.2%) and controls (19.2%). Hypersomniacs had more frequent slow wave sleep after 06:00 than controls. During 24-h polysomnography, the 95% confidence interval for total sleep time was 493-558 min in controls, versus 672-718 min in hypersomniacs. There were 40 hypersomniacs with and 35 hypersomniacs without long ( > 600 min) sleep time. The hypersomniacs with long sleep time were younger (29 +/- 10 vs 40 +/- 13 y, P = 0.0002), slimmer (body mass index: 26 +/- 5 vs 23 +/- 4 kg/m2; P = 0.005), and had lower Horne-Ostberg scores and higher sleep efficiencies than those without long sleep time. MSLT latencies were normal (> 8 min) in 71% hypersomniacs with long sleep time. Hypersomnia, especially with long sleep time, is frequently associated with evening chronotype and young age. It is inadequately diagnosed using MSLT.

How Sleep Activates Epileptic Networks?

PubMed Central

Halász, Peter

2013-01-01

Background. The relationship between sleep and epilepsy has been long ago studied, and several excellent reviews are available. However, recent development in sleep research, the network concept in epilepsy, and the recognition of high frequency oscillations in epilepsy and more new results may put this matter in a new light. Aim. The review address the multifold interrelationships between sleep and epilepsy networks and with networks of cognitive functions. Material and Methods. The work is a conceptual update of the available clinical data and relevant studies. Results and Conclusions. Studies exploring dynamic microstructure of sleep have found important gating mechanisms for epileptic activation. As a general rule interictal epileptic manifestations seem to be linked to the slow oscillations of sleep and especially to the reactive delta bouts characterized by A1 subtype in the CAP system. Important link between epilepsy and sleep is the interference of epileptiform discharges with the plastic functions in NREM sleep. This is the main reason of cognitive impairment in different forms of early epileptic encephalopathies affecting the brain in a special developmental window. The impairment of cognitive functions via sleep is present especially in epileptic networks involving the thalamocortical system and the hippocampocortical memory encoding system. PMID:24159386

Poor Sleep Is Related to Lower Emotional Competence Among Adolescents.

PubMed

Brand, Serge; Kirov, Roumen; Kalak, Nadeem; Gerber, Markus; Schmidt, Norman B; Lemola, Sakari; Correll, Christoph U; Holsboer-Trachsler, Edith

2016-01-01

The aim of the present study was to explore the association between subjective insomnia and self-reported emotional competence in areas such as regulating and perceiving one's own emotions and empathy, in a sample of adolescents. Gender differences were also explored. 366 adolescents in 10th to 12th grade (mean age: M = 16.9 years) took part in this cross-sectional study. They completed questionnaires related to emotional competencies, empathy, and sleep. Higher scores for insomnia were associated with lower scores for some aspects of emotional competence and empathy. Compared to males, females generally had higher scores for emotional competence. Poor sleep as subjectively experienced among adolescents is associated with specific impairments in emotional competence and empathy. Gender-related patterns were also observed.

Effects of cognitive behavioral therapy in patients with depressive disorder and comorbid insomnia: A propensity score-matched outcome study.

PubMed

Hsu, Hui-Min; Chou, Kuei-Ru; Lin, Kuan-Chia; Chen, Kuan-Yu; Su, Shu-Fang; Chung, Min-Huey

2015-10-01

We evaluated the effects of cognitive behavioral therapy for insomnia (CBT-I) in inpatients with a diagnosis of depression and comorbid insomnia. This study used a prospective, parallel-group design. The experimental group received CBT-I for no more than 90 min once weekly for 6 weeks and the control group only have health education manuals for insomnia. The following questionnaires were administered at baseline: the Hamilton Rating Scale for Depression (HAM-D), Dysfunctional Beliefs and Attitudes about Sleep (DBAS), Presleep Arousal Scale (PSAS), Sleep Hygiene Practice (SHP), and Pittsburgh Sleep Quality Index. The questionnaires were readministered after the completion of the 6-wk CBT-I intervention and 1 month following the completion of CBT-I, to determine the effects of the CBT-I intervention over time. The analysis of Generalized Estimation Equations was identified the difference between the experimental group and the control group by controlling for the variables in BZD dose and propensity score of gender, age, and the scores for the DBAS-16, PSAS, SHPS, and HAM-D. Consequently, the significant difference in the PSQI scores was observed at the 1-month follow-up assessment however, no significant intergroup difference in the PSQI scores was found at the completion of the CBT-I intervention between two groups. As a conclusion, we found that overall sleep quality significantly improved in patients who received CBT-I after we controlled for the BZD dose and propensity score, which suggests that CBT-I may represent a useful clinical strategy for improving sleep quality in patients with depression and comorbid insomnia. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sleep disordered breathing in chronic spinal cord injury.

PubMed

Sankari, Abdulghani; Bascom, Amy; Oomman, Sowmini; Badr, M Safwan

2014-01-15

Spinal cord injury (SCI) is associated with 2-5 times greater prevalence of sleep disordered breathing (SDB) than the general population. The contribution of SCI on sleep and breathing at different levels of injury using two scoring methods has not been assessed. The objectives of this study were to characterize the sleep disturbances in the SCI population and the associated physiological abnormalities using quantitative polysomnography and to determine the contribution of SCI level on the SDB mechanism. We studied 26 consecutive patients with SCI (8 females; age 42.5 ± 15.5 years; BMI 25.9 ± 4.9 kg/m2; 15 cervical and 11 thoracic levels) by spirometry, a battery of questionnaires and by attended polysomnography with flow and pharyngeal pressure measurements. Inclusion criteria for SCI: chronic SCI (> 6 months post injury), level T6 and above and not on mechanical ventilation. Ventilation, end-tidal CO2 (PETCO2), variability in minute ventilation (VI-CV) and upper airway resistance (RUA) were monitored during wakefulness and NREM sleep in all subjects. Each subject completed brief history and exam, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin questionnaire (BQ) and fatigue severity scale (FSS). Sleep studies were scored twice, first using standard 2007 American Academy of Sleep Medicine (AASM) criteria and second using new 2012 recommended AASM criteria. Mean PSQI was increased to 10.3 ± 3.7 in SCI patients and 92% had poor sleep quality. Mean ESS was increased 10.4 ± 4.4 in SCI patients and excessive daytime sleepiness (ESS ≥ 10) was present in 59% of the patients. Daytime fatigue (FSS > 20) was reported in 96% of SCI, while only 46% had high-risk score of SDB on BQ. Forced vital capacity (FVC) in SCI was reduced to 70.5% predicted in supine compared to 78.5% predicted in upright positions (p < 0.05). Likewise forced expiratory volume in first second (FEV1) was 64.9% predicted in supine compared to 74.7% predicted in upright positions (p < 0.05). Mean AHI in SCI patients was 29.3 ± 25.0 vs. 20.0 ± 22.8 events/h using the new and conventional AASM scoring criteria, respectively (p < 0.001). SCI patients had SDB (AHI > 5 events/h) in 77% of the cases using the new AASM scoring criteria compared to 65% using standard conventional criteria (p < 0.05). In cervical SCI, VI decreased from 7.2 ± 1.6 to 5.5 ± 1.3 L/min, whereas PETCO2 and VI-CV, increased during sleep compared to thoracic SCI. The majority of SCI survivors have symptomatic SDB and poor sleep that may be missed if not carefully assessed. Decreased VI and increased PETCO2 during sleep in patients with cervical SCI relative to thoracic SCI suggests that sleep related hypoventilation may contribute to the pathogenesis SDB in patients with chronic cervical SCI.

Sleep, anxiety and fatigue in family members of patients admitted to the intensive care unit: a questionnaire study.

PubMed

Day, Alex; Haj-Bakri, Samer; Lubchansky, Stephanie; Mehta, Sangeeta

2013-05-24

Family members of critically ill patients often experience increased incidence of physical and mental health issues. One of the first ways family members suffer is by losing sleep. The purpose of this study is to understand sleep quality, levels of fatigue and anxiety, and factors contributing to poor sleep in adult family members of critically ill patients. A questionnaire was designed to evaluate sleep, fatigue and anxiety during the intensive care unit (ICU) admission. We incorporated three validated instruments: General Sleep Disturbance Scale (GSDS), Beck Anxiety Index (BAI) and Lee Fatigue Scale (NRS-F). Adult family members of patients in ICU for more than 24 hours were approached for questionnaire completion. Patient demographics were recorded. The study population consisted of 94 respondents, (49.1 ± 12.9 years, 52.7% male); 43.6% were children and 21.3% were spouses of ICU patients. Sleep quality was rated as poor/very poor by 43.5% of respondents, and good/very good by 15.2%. The most common factors contributing to poor sleep were anxiety (43.6%), tension (28.7%) and fear (24.5%). Respondents' most common suggestions to improve sleep were more information regarding the patient's health (24.5%) and relaxation techniques (21.3%). Mean GSDS score was 38.2 ± 19.3, with 58.1% of respondents experiencing moderate to severe sleep disturbance. Mean BAI was 12.3 ± 10.2, with 20.7% of respondents experiencing moderate to severe anxiety. Mean NRS-F was 3.8 ± 2.5, with 57.6% of respondents experiencing moderate to high fatigue. Family members who spent one or more nights in the hospital had significantly higher GSDS, BAI and NRS-F scores. The patient's Acute Physiology and Chronic Health Evaluation (APACHE) II score at survey completion correlated significantly with family members' GSDS, BAI and NRS-F. The majority of family members of ICU patients experience moderate to severe sleep disturbance and fatigue, and mild anxiety.

How Do Sleep-Related Health Problems Affect Functional Status According to Sex?

PubMed

Boccabella, Allegra; Malouf, John

2017-05-15

To measure differences in functional status between men and women presenting with sleep-related health problems. A retrospective clinical audit of 744 Australian patients across 7 private general practices between April 2013 and January 2015 was conducted. Patients completed an electronic survey as part of their routine consultation, which included the Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep Questionnaire 10 (FOSQ-10), and other questions relating to the effect of their sleep problem. The proportion of males and females with ESS and FOSQ-10 scores associated with disorders of daytime sleepiness and burden of symptoms due to sleepiness, respectively, were compared, as well as reported differences between the sexes in memory, concentration, issues with relationships, feeling depressed, and trouble sleeping. On presentation, females were more likely to have sleeping disorders associated with daytime sleepiness (median ESS score of 9 for females versus 8 for males, P = .038; proportion ESS > 9 was 49.0% for females versus 36.9% for males, P = .003). Women were also more likely to report an increased burden of symptoms due to sleepiness compared to men, as shown by lower FOSQ-10 scores ( P < .001). Secondary outcome measures showed that females were more likely to feel excessively tired and depressed, have difficulties with memory and concentration, and have trouble sleeping at night. Snoring kept partners awake in roughly the same proportion of males and females, and a larger proportion of the partners of males were forced out of the room. Sleep-related health issues both manifest in and affect the lives of males and females differently. Sleep health professionals should recognize these differences on all levels of disease prevention and health promotion from patient education, to diagnosis and management to improve quality of life for those with sleep-related health problems. © 2017 American Academy of Sleep Medicine

Prevalence, symptomatic features, and factors associated with sleep disturbance/insomnia in Japanese patients with type-2 diabetes.

PubMed

Narisawa, Hajime; Komada, Yoko; Miwa, Takashi; Shikuma, Junpei; Sakurai, Mamoru; Odawara, Masato; Inoue, Yuichi

2017-01-01

To clarify the prevalence and symptomatic characteristics of sleep disturbance/insomnia among type-2 diabetes mellitus (DM) Japanese patients. A cross-sectional survey of Japanese patients with the disorder was conducted. Participants consisted of 622 type-2 DM patients (mean 56.1±9.56 years) and 622 sex- and age-matched controls. Participants' scores in the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J), the Japanese version of the 12-item Center for Epidemiologic Studies Depression Scale (CES-D), the Medical Outcomes Study 8-item Short Form Health Survey (SF-8), and the glycated hemoglobin A1c (HbA1c) of type-2 DM patients were analyzed. There were 253 poor sleepers (43.9%) in the type-2 DM group as a result of dichotomization with the PSQI-J cutoff total score of 5.5. The type-2 DM group recorded a higher mean PSQI-J total score ( P <0.01) and manifested poorer sleep maintenance. Poor sleepers in both groups had lower mental component summary from SF-8 (MCS), physical component summary from SF-8 (PCS), and CES-D than good sleepers, and good sleepers in both groups had higher MCS, PCS, and CES-D than poor sleepers. Higher body mass index, presence of smoking habit, and living alone were significantly associated with sleep disturbance/insomnia symptoms, but HbA1c was not associated with sleep disturbance/insomnia in the type-2 DM group. Individuals affected with type-2 DM are likely to experience sleep problems, characterized by disturbance in sleep maintenance. Sleep disturbance/insomnia symptoms in DM patients might considerably reduce health-related quality of life.

Association between sleep and residential environments in the summertime in Japan.

PubMed

Kayaba, Momoko; Ihara, Tomohiko; Kusaka, Hiroyuki; Iizuka, Satoru; Miyamoto, Kenji; Honda, Yasushi

2014-05-01

We aimed to identify the effect of environmental factors on sleep in the summertime in Japan. A self-reported questionnaire survey was conducted in Japan. Age of participants ranged from 20 to 70 years. The mean Pittsburgh Sleep Quality Index (PSQI) score was 4.9 (±2.7), and 123 (35.0%) participants had scores of >5. According to the results of multivariate logistic regression analysis, the adjusted odds ratio (aOR) for PSQI scores of >5 without installation of air conditioner was 1.8 (95% confidence interval [CI], 1.0-3.3; P<.05), use of a light bulb was 3.7 (95% CI, 1.1-12.6; P<.05), and noise was 2.1 (95% CI, 1.1-4.1; P<.05) after controlling for several confounding variables. Difficulty initiating sleep (DIS) was associated with installation of an air conditioner (1 [reference] to 3 [aOR, 2.5 {95% CI, 1.2-5.1}] and 4 [aOR, 2.8 {95% CI, 1.1-7.1}]) and noise (1 [reference] to 3 [aOR, 2.4 {95% CI, 1.0-5.9}] and 4 [aOR, 8.8 {95% CI, 3.1-25.0}]). Difficulty maintaining sleep (DMS) was associated with installation of a fan (1 [reference] to 2 [aOR, 0.4 {95% CI, 0.2-0.8}] and noise (1 [reference] to 3 [aOR, 2.3 {95% CI, 1.0-5.3}]) after controlling for several confounding variables. Our finding using analysis of the association between residential environments and subjective sleep statuses, which determined that the installation of an air conditioner and lighting equipment might affect sleep, may be useful to discuss sleep environments and improve sleep quality. Copyright © 2014 Elsevier B.V. All rights reserved.

Long-Term Impact of Earthquakes on Sleep Quality

PubMed Central

Tempesta, Daniela; Curcio, Giuseppe; De Gennaro, Luigi; Ferrara, Michele

2013-01-01

Purpose We investigated the impact of the 6.3 magnitude 2009 L’Aquila (Italy) earthquake on standardized self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and frequency of disruptive nocturnal behaviours (Pittsburgh Sleep Quality Index-Addendum, PSQI-A) two years after the natural disaster. Methods Self-reported sleep quality was assessed in 665 L’Aquila citizens exposed to the earthquake compared with a different sample (n = 754) of L'Aquila citizens tested 24 months before the earthquake. In addition, sleep quality and disruptive nocturnal behaviours (DNB) of people exposed to the traumatic experience were compared with people that in the same period lived in different areas ranging between 40 and 115 km from the earthquake epicenter (n = 3574). Results The comparison between L’Aquila citizens before and after the earthquake showed a significant deterioration of sleep quality after the exposure to the trauma. In addition, two years after the earthquake L'Aquila citizens showed the highest PSQI scores and the highest incidence of DNB compared to subjects living in the surroundings. Interestingly, above-the-threshold PSQI scores were found in the participants living within 70 km from the epicenter, while trauma-related DNBs were found in people living in a range of 40 km. Multiple regressions confirmed that proximity to the epicenter is predictive of sleep disturbances and DNB, also suggesting a possible mediating effect of depression on PSQI scores. Conclusions The psychological effects of an earthquake may be much more pervasive and long-lasting of its building destruction, lasting for years and involving a much larger population. A reduced sleep quality and an increased frequency of DNB after two years may be a risk factor for the development of depression and posttraumatic stress disorder. PMID:23418478

Long-term impact of earthquakes on sleep quality.

PubMed

Tempesta, Daniela; Curcio, Giuseppe; De Gennaro, Luigi; Ferrara, Michele

2013-01-01

We investigated the impact of the 6.3 magnitude 2009 L'Aquila (Italy) earthquake on standardized self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and frequency of disruptive nocturnal behaviours (Pittsburgh Sleep Quality Index-Addendum, PSQI-A) two years after the natural disaster. Self-reported sleep quality was assessed in 665 L'Aquila citizens exposed to the earthquake compared with a different sample (n = 754) of L'Aquila citizens tested 24 months before the earthquake. In addition, sleep quality and disruptive nocturnal behaviours (DNB) of people exposed to the traumatic experience were compared with people that in the same period lived in different areas ranging between 40 and 115 km from the earthquake epicenter (n = 3574). The comparison between L'Aquila citizens before and after the earthquake showed a significant deterioration of sleep quality after the exposure to the trauma. In addition, two years after the earthquake L'Aquila citizens showed the highest PSQI scores and the highest incidence of DNB compared to subjects living in the surroundings. Interestingly, above-the-threshold PSQI scores were found in the participants living within 70 km from the epicenter, while trauma-related DNBs were found in people living in a range of 40 km. Multiple regressions confirmed that proximity to the epicenter is predictive of sleep disturbances and DNB, also suggesting a possible mediating effect of depression on PSQI scores. The psychological effects of an earthquake may be much more pervasive and long-lasting of its building destruction, lasting for years and involving a much larger population. A reduced sleep quality and an increased frequency of DNB after two years may be a risk factor for the development of depression and posttraumatic stress disorder.

Vedolizumab Therapy Is Associated with an Improvement in Sleep Quality and Mood in Inflammatory Bowel Diseases.

PubMed

Stevens, Betsy W; Borren, Nynke Z; Velonias, Gabriella; Conway, Grace; Cleland, Thom; Andrews, Elizabeth; Khalili, Hamed; Garber, John G; Xavier, Ramnik J; Yajnik, Vijay; Ananthakrishnan, Ashwin N

2017-01-01

Poor sleep, depression, and anxiety are common in patients with inflammatory bowel diseases (IBD) and associated with increased risk of relapse and poor outcomes. The effectiveness of therapies in improving such psychosocial outcomes is unclear but is an important question to examine with increasing selectivity of therapeutic agents. This prospective cohort enrolled patients with moderate-to-severe CD or UC starting biologic therapy with vedolizumab or anti-tumor necrosis factor α agents (anti-TNF). Sleep quality, depression, and anxiety were measured using validated short-form NIH PROMIS questionnaires assessing sleep and mood quality over the past 7 days. Disease activity was assessed using validated indices. Improvement in sleep and mood scores from baseline was assessed, and regression models were used to identify determinants of sleep quality. Our study included 160 patients with IBD (49 anti-TNF, 111 Vedolizumab) among whom half were women and the mean age was 40.2 years. In the combined cohort, we observed a statistically significant and meaningful decrease in mean scores from baseline (52.8) by week 6 (49.8, p = 0.002). Among vedolizumab users, sleep T-score improved from baseline (53.6) by week 6 (50.7) and persisted through week 54 (46.5, p = 0.009). Parallel reductions in depression and anxiety were also noted (p < 0.05 by week 6). We observed no difference in improvement in sleep, depression, and anxiety between vedolizumab and anti-TNF use at week 6. Both vedolizumab and anti-TNF biologic therapies were associated with improvement in sleep and mood quality in IBD.

Influence of sleep disturbance, fatigue, vitality on oral health and academic performance in indian dental students

PubMed Central

ASAWA, KAILASH; SEN, NANDINI; BHAT, NAGESH; TAK, MRIDULA; SULTANE, PRATIBHA; MANDAL, ARITRA

2017-01-01

Background Oral health and academic performance are important contributing factors for a student’s professional life. Countless factors affect both, among which sleep, vitality and fatigue are less explored areas that also have a strong impact. Objective The objective of the study was to assess the association of sleep disturbances, fatigue and vitality with self reported oral health status, oral hygiene habits and academic performance of dental students of Udaipur. Methods A descriptive cross-sectional study was conducted among undergraduate and postgraduate dental students of Udaipur. Self-administered structured questionnaire was used to assess the psychological factors, vitality, sleep quality, fatigue, self reported oral health status, habits and academic performance. Analysis of variance and stepwise multiple linear regression were utilized for statistical analysis with 95% confidence level and 5% level of significance. Results Of the 230 participants, 180 (78.3%) were undergraduates and 50 (21.7%) were postgraduates. Among them, females showed higher scores in disturbed sleep index (2.69±2.14) as compared to males (2.45±1.91). Respondents who had “Poor” dental health, scored more in disturbed sleep index (3.15±1.64) and fatigue scale (20.00±4.88). Subjects who flossed “everyday”, were found to have good sleep and more energy (p=0.01) and those who assessed themselves as excellent students scored more in the Vitality Scale (p=0.01) and less in the Sleep index (p=0.01). Conclusion The present study confirms that disturbed sleep, aliveness and fatigue, all are interlinked with each other and are imperative factors having the potential to alter the oral health status, habits and academics of dental students. PMID:28781530

Sleep disturbances and cognitive decline in the Northern Manhattan Study

PubMed Central

Ramos, Alberto R.; Gardener, Hannah; Rundek, Tatjana; Elkind, Mitchell S.V.; Boden-Albala, Bernadette; Dong, Chuanhui; Cheung, Ying Kuen; Stern, Yaakov; Sacco, Ralph L.

2016-01-01

Objective: To examine frequent snoring, sleepiness, and sleep duration with baseline and longitudinal performance on neuropsychological (NP) battery. Methods: The analysis consists of 711 participants of the Northern Manhattan Study (NOMAS) with sleep data and NP assessment (age 63 ± 8 years, 62% women, 18% white, 17% black, 67% Hispanic) and 687 with repeat NP testing (at a mean of 6 ± 2 years). The main exposures were snoring, sleepiness, and sleep duration obtained during annual follow-up. Using factor analysis–derived domain-specific Z scores for episodic memory, language, executive function, and processing speed, we constructed multivariable regression models to evaluate sleep symptoms with baseline NP performance and change in performance in each NP domain. Results: In the cross-sectional analysis, adjusting for demographics and the NOMAS vascular risk score, participants with frequent snoring had worse executive function (β = −12; p = 0.04) and processing speed (β = −13; p = 0.02), but no difference in with episodic memory or language. Those with severe daytime sleepiness (β = −26; p = 0.009) had worse executive function, but no changes in the other NP domains. There was no cross-sectional association between sleep duration and NP performance. Frequent snoring (β = −29; p = 0.0007), severe daytime sleepiness (β = −29; p = 0.05), and long sleep duration (β = −29; p = 0.04) predicted decline in executive function, adjusting for demographic characteristics and NOMAS vascular risk score. Sleep symptoms did not explain change in episodic memory, language, or processing speed. Conclusions: In this race-ethnically diverse community-based cohort, sleep symptoms led to worse cognitive performance and predicted decline in executive function. PMID:27590286

Gender, Headaches, and Sleep Health in High School Students.

PubMed

Ming, Xue; Radhakrishnan, Varsha; Kang, Lilia; Pecor, Keith

2016-09-01

The effects of gender, headaches, and their interaction on sleep health (sleep duration, sleep onset and continuity, and indications of hypersomnolence) have not been well studied. For American adolescents, we contrasted sleep health variables between males (n = 378) and females (n = 372) and between individuals with chronic headaches (n = 102 females and 60 males) and without chronic headaches (n = 270 females and 318 males) using data from surveys. Not all measures of sleep health differed between groups, but the following patterns were observed for the measures that did differ. Females reported shorter sleep durations on school nights (p = 0.001), increased likelihood of sleepiness on school days (p < 0.05), and higher hypersomnolence scores compared with males (p = 0.005). Individuals with headaches reported shorter sleep durations on weekends (p = 0.009) and higher hypersomnolence scores (p = 0.009) than individuals without headaches. Interestingly, females with headaches reported worse sleep health than females without headaches for multiple measures. Males with headaches did not differ from males without headaches, except for greater waking at night (p = 0.04). These results are consistent with other studies of gender-based differences in sleep health and emphasize the importance of recognizing the risk of headache in female adolescents and treating that condition to prevent additional sleep health issues.

Genetic Correlation Analysis Suggests Association between Increased Self-Reported Sleep Duration in Adults and Schizophrenia and Type 2 Diabetes.

PubMed

Byrne, Enda M; Gehrman, Philip R; Trzaskowski, Maciej; Tiemeier, Henning; Pack, Allan I

2016-10-01

We sought to examine how much of the heritability of self-report sleep duration is tagged by common genetic variation in populations of European ancestry and to test if the common variants contributing to sleep duration are also associated with other diseases and traits. We utilized linkage disequilibrium (LD)-score regression to estimate the heritability tagged by common single nucleotide polymorphisms (SNPs) in the CHARGE consortium genome-wide association study (GWAS) of self-report sleep duration. We also used bivariate LD-score regression to investigate the genetic correlation of sleep duration with other publicly available GWAS datasets. We show that 6% (SE = 1%) of the variance in self-report sleep duration in the CHARGE study is tagged by common SNPs in European populations. Furthermore, we find evidence of a positive genetic correlation (rG) between sleep duration and type 2 diabetes (rG = 0.26, P = 0.02), and between sleep duration and schizophrenia (rG = 0.19, P = 0.01). Our results show that increased sample sizes will identify more common variants for self-report sleep duration; however, the heritability tagged is small when compared to other traits and diseases. These results also suggest that those who carry variants that increase risk to type 2 diabetes and schizophrenia are more likely to report longer sleep duration. © 2016 Associated Professional Sleep Societies, LLC.

Oxidative stress, cancer, and sleep deprivation: is there a logical link in this association?

PubMed

Noguti, Juliana; Andersen, Monica Levy; Cirelli, Chiara; Ribeiro, Daniel Araki

2013-09-01

Sleep disorders are associated with various human pathologies and interfere with biological processes essential for health and quality of life. On the other hand, cancer is one of the most common diseases worldwide with an average of 1,500 deaths per day in the USA. Is there a factor common to both sleep disorders and cancer that serves to link these conditions? It is a normal process for cellular metabolism to produce reactive oxidant series (ROS). However, when the production of ROS overcomes the antioxidant capacity of the cell to eliminate these products, the resulting state is called oxidative stress. Oxidative DNA damage may participate in ROS-induced carcinogenesis. Moreover, ROS are also produced in the sleep deprivation process. The aim of this article is to review pathways and mechanisms that may point to oxidative stress as a link between sleep deprivation and cancer.

'Football is good for your sleep': favorable sleep patterns and psychological functioning of adolescent male intense football players compared to controls.

PubMed

Brand, Serge; Beck, Johannes; Gerber, Markus; Hatzinger, Martin; Holsboer-Trachsler, Edith

2009-11-01

It is commonly assumed that physical activity exerts a favorable impact on sleep, although scientific evidence is lacking. This study investigated the impact of football sports on the sleep patterns of 36 male chronic and intense football players and 34 controls. Participants completed a sleep log for seven consecutive days. Compared to controls, football players reported shorter sleep onset latency, fewer awakenings, higher scores of sleep quality and a lower variability of sleep from weekdays to weekends. The findings suggest that football sports activity is positively associated with both quantitative and qualitative dimensions of sleep.

A Preliminary Investigation of Accelerometer-Derived Sleep and Physical Activity Following Sport-Related Concussion.

PubMed

Sufrinko, Alicia M; Howie, Erin K; Elbin, R J; Collins, Michael W; Kontos, Anthony P

2018-03-29

Describe changes in postconcussion activity levels and sleep throughout recovery in a sample of pediatric sport-related concussion (SRC) patients, and examine the predictive value of accelerometer-derived activity and sleep on subsequent clinical outcomes at a follow-up clinic visit. Outpatient concussion clinic. Twenty athletes aged 12 to 19 years with diagnosed SRC. Prospective study including visit 1 (<72 hours postinjury) and visit 2 (6-18 days postinjury). Linear regressions used to predict scores (ie, neurocognitive, vestibular/oculomotor) at visit 2 from accelerometer-derived data collected 0 to 6 days postinjury. Linear mixed models evaluated changes in activity and sleep across recovery. Symptom, neurocognitive, and vestibular/oculomotor scores; sleep and activity data (Actigraph GT3x+) RESULTS:: The maximum intensity of physical activity increased (P = .009) and time in bed decreased throughout recovery (P = .026). Several physical activity metrics from 0 to 6 days postinjury were predictive of worse vestibular/oculomotor scores at visit 2 (P < .05). Metrics indicative of poor sleep 0 to 6 days postinjury were associated with worse reaction time at visit 2 (P < .05). This exploratory study suggests physical activity and sleep change from the acute to subacute postinjury time period in adolescent SRC patients. In our small sample, excess physical activity and poor sleep the first week postinjury may be associated with worse outcomes at follow-up in the subacute stage of recovery. This study further supported the feasibility of research utilizing wearable technology in concussion patients, and future research in a large, diverse sample of concussion patients examined at concise time intervals postinjury is needed.

Impact of working hours on sleep and mental health.

PubMed

Afonso, P; Fonseca, M; Pires, J F

2017-07-01

The number of hours people are required to work has a pervasive influence on both physical and mental health. Excessive working hours can also negatively affect sleep quality. The impact at work of mental health problems can have serious consequences for individuals' as well as for organizations' productivity. To evaluate differences in sleep quality and anxiety and depression symptoms between longer working hours group (LWHG) and regular working hours group (RWHG). To examine factors influencing weekly working hours, sleep quality and anxiety and depressive symptoms. Participants were divided into two groups, RWHG and LWHG, based on working hours, with a cut-off of 48 h per week. We used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression symptoms and the Pittsburgh Sleep Quality Index (PSQI) to measure the quality and patterns of sleep. The response rate was 23%. Among the 429 study participants, those in the LWHG group (n = 256, 53%) had significantly more depressive and anxiety symptoms and worse sleep quality than those in RWHG (n = 223, 47%). Working time was significantly positively correlated with higher corporate position and HADS scores. Moreover, HADS scores were positively correlated with PSQI scores and negatively correlated with age. This study suggests that longer working hours are associated with poorer mental health status and increasing levels of anxiety and depression symptoms. There was a positive correlation between these symptoms and sleep disturbances. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Acute Versus Chronic Partial Sleep Deprivation in Middle-Aged People: Differential Effect on Performance and Sleepiness

PubMed Central

Philip, Pierre; Sagaspe, Patricia; Prague, Mélanie; Tassi, Patricia; Capelli, Aurore; Bioulac, Bernard; Commenges, Daniel; Taillard, Jacques

2012-01-01

Study Objective: To evaluate the effects of acute sleep deprivation and chronic sleep restriction on vigilance, performance, and self-perception of sleepiness. Design: Habitual night followed by 1 night of total sleep loss (acute sleep deprivation) or 5 consecutive nights of 4 hr of sleep (chronic sleep restriction) and recovery night. Participants: Eighteen healthy middle-aged male participants (age [(± standard deviation] = 49.7 ± 2.6 yr, range 46-55 yr). Measurements: Multiple sleep latency test trials, Karolinska Sleepiness Scale scores, simple reaction time test (lapses and 10% fastest reaction times), and nocturnal polysomnography data were recorded. Results: Objective and subjective sleepiness increased immediately in response to sleep restriction. Sleep latencies after the second and third nights of sleep restriction reached levels equivalent to those observed after acute sleep deprivation, whereas Karolinska Sleepiness Scale scores did not reach these levels. Lapse occurrence increased after the second day of sleep restriction and reached levels equivalent to those observed after acute sleep deprivation. A statistical model revealed that sleepiness and lapses did not progressively worsen across days of sleep restriction. Ten percent fastest reaction times (i.e., optimal alertness) were not affected by acute or chronic sleep deprivation. Recovery to baseline levels of alertness and performance occurred after 8-hr recovery night. Conclusions: In middle-aged study participants, sleep restriction induced a high increase in sleep propensity but adaptation to chronic sleep restriction occurred beyond day 3 of restriction. This sleepiness attenuation was underestimated by the participants. One recovery night restores daytime sleepiness and cognitive performance deficits induced by acute or chronic sleep deprivation. Citation: Philip P; Sagaspe P; Prague M; Tassi P; Capelli A; Bioulac B; Commenges D; Taillard J. Acute versus chronic partial sleep deprivation in middle-aged people: differential effect on performance and sleepiness. SLEEP 2012;35(7):997–1002. PMID:22754046

SLEEP AND GAMBLING SEVERITY IN A COMMUNITY SAMPLE OF GAMBLERS

PubMed Central

Parhami, Iman; Siani, Aaron; Rosenthal, Richard J.; Lin, Stephanie; Collard, Michael; Fong, Timothy W.

2012-01-01

Although sleep has been extensively studied in substance related disorders, it has yet to be examined as thoroughly in gambling-related disorders. The purpose of this study is to examine the relationship between gambling severity and sleep disturbances in a sample of non-treatment seeking gamblers (N = 96) using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Mean ESS scores for recreational, problem, and pathological gamblers were 4.13, 5.81, and 8.69, respectively, with a significant difference between pathological gamblers and both problem (P = .007) and recreational gamblers (P < .001). Mean PSQI scores for recreational, problem, and pathological gamblers were 3.35, 5.30, and 5.44, respectively, with a significant difference in sleep quality between recreational and problem gamblers (P = .018), as well as recreational and pathological gamblers (P = .008). As the first study to use objective sleep measures, these findings will not only increase awareness of this relationship, but also provide a foundation on which others can investigate the benefits of screening and adjunct treatment for sleep disorders in the gambling population. PMID:22356670

Stress, Sleep and Depressive Symptoms in Active Duty Military Personnel.

PubMed

Chou, Han-Wei; Tzeng, Wen-Chii; Chou, Yu-Ching; Yeh, Hui-Wen; Chang, Hsin-An; Kao, Yu-Chen; Huang, San-Yuan; Yeh, Chin-Bin; Chiang, Wei-Shan; Tzeng, Nian-Sheng

2016-08-01

The military is a unique occupational group and, because of this, military personnel face different kinds of stress than civilian populations. Sleep problems are an example. The purpose of this study was to investigate the relationship between sleep problems, depression level and coping strategies among military personnel. In this cross-sectional study, military personnel completed the Beck Depression Inventory, the Pittsburgh Sleep Quality Index and the Jalowiec Coping Scale. An evaluation of the test scores showed that officers had better sleep quality and fewer depressive symptoms than enlisted personnel. Military personnel with higher educational levels and less physical illness also had fewer depressive symptoms. Officers and noncommissioned officers preferred problem-focused strategies. Those with higher Beck Depression Inventory and Pittsburgh Sleep Quality Index scores and those who drank alcohol frequently preferred affective-focused strategies. Our results revealed that sleep quality, physical illness and alcohol consumption were associated with the mental health of military personnel. Treating these factors may improve the mental health of military personnel and enhance effective coping strategies. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Hours of sleep in adolescents and its association with anxiety, emotional concerns, and suicidal ideation.

PubMed

Sarchiapone, Marco; Mandelli, Laura; Carli, Vladimir; Iosue, Miriam; Wasserman, Camilla; Hadlaczky, Gergö; Hoven, Christina W; Apter, Alan; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Haring, Christian; Kaess, Michael; Keeley, Helen; Keresztény, Agnes; Kahn, Jean-Pierre; Postuvan, Vita; Mars, Urša; Saiz, Pilar A; Varnik, Peter; Sisask, Merike; Wasserman, Danuta

2014-02-01

Anxiety and concerns in daily life may result in sleep problems and consistent evidence suggests that inadequate sleep has several negative consequences on cognitive performance, physical activity, and health. The aim of our study was to evaluate the association between mean hours of sleep per night, psychologic distress, and behavioral concerns. A cross-sectional analysis of the correlation between the number of hours of sleep per night and the Zung Self-rating Anxiety Scale (Z-SAS), the Paykel Suicidal Scale (PSS), and the Strengths and Difficulties Questionnaire (SDQ), was performed on 11,788 pupils (mean age±standard deviation [SD], 14.9±0.9; 55.8% girls) from 11 different European countries enrolled in the SEYLE (Saving and Empowering Young Lives in Europe) project. The mean number of reported hours of sleep per night during school days was 7.7 (SD, ±1.3), with moderate differences across countries (r=0.06; P<.001). A reduced number of sleeping hours (less than the average) was more common in girls (β=0.10 controlling for age) and older pupils (β=0.10 controlling for sex). Reduced sleep was found to be associated with increased scores on SDQ subscales of emotional (β=-0.13) and peer-related problems (β=-0.06), conduct (β=-0.07), total SDQ score (β=-0.07), anxiety (Z-SAS scores, β=-10), and suicidal ideation (PSS, β=-0.16). In a multivariate model including all significant variables, older age, emotional and peer-related problems, and suicidal ideation were the variables most strongly associated with reduced sleep hours, though female gender, conduct problems measured by the SDQ, and anxiety only showed modest effects (β=0.03-0.04). Our study supports evidence that reduced hours of sleep are associated with potentially severe mental health problems in adolescents. Because sleep problems are common among adolescents partly due to maturational processes and changes in sleep patterns, parents, other adults, and adolescents should pay more attention to their sleep patterns and implement interventions, if needed. Copyright © 2013 Elsevier B.V. All rights reserved.

Sleep debt and depression in female college students.

PubMed

Regestein, Quentin; Natarajan, Viji; Pavlova, Milena; Kawasaki, Susan; Gleason, Ray; Koff, Elissa

2010-03-30

The objective of the study was to evaluate relationships between sleep habits and depressive symptoms. Pilot study data were collected about sleep schedules, related factors and depression in female college students to find whether their sleep schedules correlate with affective symptoms. In the subsequent main study, similar information was collected under more controlled conditions. Depression was measured using the CES-D (Center for Epidemiologic Studies Depression Scale) and HAM-D-3 (modified Hamilton Depression Rating Scale). Response rates were 31.3% of eligible students for the pilot survey and 71.6% for the main study. Both studies showed that about 20% of students reported weekday sleep debts of greater than 2 h and about 28% reported significantly greater sleep debt and had significantly higher depression scores (P<0.0001) than other students. Melancholic symptoms indicated by high CES-D scores (>24), were observed in 24% of students. Sleep problems explained 13% of the variance for both the CESD scale and the HAM-D-3 scale. Among female college students, those who report a sleep debt of at least 2 h or significant daytime sleepiness have a higher risk of reporting melancholic symptoms than others. Copyright 2008 Elsevier Ltd. All rights reserved.

A study on the sleep quality of incoming university students.

PubMed

Cheng, Shu Hui; Shih, Chi-Chen; Lee, I Hui; Hou, Yi-Wen; Chen, Kao Chin; Chen, Kow-Tong; Yang, Yen Kuang; Yang, Yi Ching

2012-05-30

This study was designed to examine the prevalence and the risk factors of poor sleep quality in 4318 incoming university students in Taiwan. The test battery comprised a self-administered structured questionnaire, including items related to personal medical history and lifestyle habits, the Measurement of Support Functions (MSF), Pittsburgh Sleep Quality Index (PSQI), Chinese Internet Addiction Scale-Revision (CIAS-R), neuroticism subscale of the Maudsley Personality Inventory (MPI), and the 12-item Chinese Health Questionnaire (CHQ-12). Of the total study population, 2360 students (54.7%) were classified into the poor sleep quality group, as defined by a PSQI score ≥6. Based on the results of multivariate logistic regression analysis, poor sleep quality was significantly associated with undergraduate students, female gender, skipping breakfast, tea drinking, a higher tendency toward internet addition, poor social support, higher neuroticism, and higher CHQ scores. Poor sleep quality is prevalent among incoming university students in Taiwan, and more work is needed on the identification of the factors influencing poor sleep, and in providing systematic education in the importance of sleep and time management skills to university students. Copyright © 2012 Elsevier Ltd. All rights reserved.

Validating Actigraphy as a Measure of Sleep for Preschool Children

PubMed Central

Bélanger, Marie-Ève; Bernier, Annie; Paquet, Jean; Simard, Valérie; Carrier, Julie

2013-01-01

Study Objectives: The algorithms used to derive sleep variables from actigraphy were developed with adults. Because children change position during sleep more often than adults, algorithms may detect wakefulness when the child is actually sleeping (false negative). This study compares the validity of three algorithms for detecting sleep with actigraphy by comparing them to PSG in preschoolers. The putative influence of device location (wrist or ankle) is also examined. Methods: Twelve children aged 2 to 5 years simultaneously wore an actigraph on an ankle and a wrist (Actiwatch-L, Mini-Mitter/Respironics) during a night of PSG recording at home. Three algorithms were tested: one recommended for adults and two designed to decrease false negative detection of sleep in children. Results: Actigraphy generally showed good sensitivity (> 95%; PSG sleep detection) but low specificity (± 50%; PSG wake detection). Intraclass correlations between PSG and actigraphy variables were strong (> 0.80) for sleep latency, sleep duration, and sleep efficiency, but weak for number of awakenings (< 0.40). The two algorithms designed for children enhanced the validity of actigraphy in preschoolers and increased the proportion of actigraphy-scored wake epochs scored that were also PSG-identified as wake. Sleep variables derived from the ankle and wrist were not statistically different. Conclusion: Despite the weak detection of wakefulness, Acti-watch-L appears to be a useful instrument for assessing sleep in preschoolers when used with an adapted algorithm. Citation: Bélanger M; Bernier A; Paquet J; Simard V; Julie Carrier J. Validating actigraphy as a measure of sleep for pre-school children. J Clin Sleep Med 2013;9(7):701-706. PMID:23853565

Deadlines at work and sleep quality. Cross-sectional and longitudinal findings among Danish knowledge workers.

PubMed

Rugulies, Reiner; Martin, Marie H T; Garde, Anne Helene; Persson, Roger; Albertsen, Karen

2012-03-01

Exposure to deadlines at work is increasing in several countries and may affect health. We aimed to investigate cross-sectional and longitudinal associations between frequency of difficult deadlines at work and sleep quality. Study participants were knowledge workers, drawn from a representative sample of Danish employees who responded to a baseline questionnaire in 2006 (n = 363) and a follow-up questionnaire in 2007 (n = 302). Frequency of difficult deadlines was measured by self-report and categorized into low, intermediate, and high. Sleep quality was measured with a Total Sleep Quality Score and two indexes (Awakening Index and Disturbed Sleep Index) derived from the Karolinska Sleep Questionnaire. Analyses on the association between frequency of deadlines and sleep quality scores were conducted with multiple linear regression models, adjusted for potential confounders. In addition, we used multiple logistic regression models to analyze whether frequency of deadlines at baseline predicted caseness of sleep problems at follow-up among participants free of sleep problems at baseline. Frequent deadlines were cross-sectionally and longitudinally associated with poorer sleep quality on all three sleep quality measures. Associations in the longitudinal analyses were greatly attenuated when we adjusted for baseline sleep quality. The logistic regression analyses showed that frequent deadlines at baseline were associated with elevated odds ratios for caseness of sleep problems at follow-up, however, confidence intervals were wide in these analyses. Frequent deadlines at work were associated with poorer sleep quality among Danish knowledge workers. We recommend investigating the relation between deadlines and health endpoints in large-scale epidemiologic studies. Copyright © 2011 Wiley Periodicals, Inc.

Sleep timing is associated with diet and physical activity levels in 9-11-year-old children from Dunedin, New Zealand: the PEDALS study.

PubMed

Harrex, Harriet A L; Skeaff, Sheila A; Black, Katherine E; Davison, Brittany K; Haszard, Jillian J; Meredith-Jones, Kim; Quigg, Robin; Saeedi, Pouya; Stoner, Lee; Wong, Jyh E; Skidmore, Paula M L

2017-11-20

It is well documented that short sleep duration is associated with excess body weight and poor food intake in children. It has been suggested that sleep timing behaviour may also be an important predictor of weight and other related behaviours, independent of sleep duration; however, there is a lack of research investigating these relationships. The present study investigated sleep timing in association with diet and physical activity levels in 439 children aged 9-11 years old from New Zealand. Sleep and physical activity data were collected using accelerometry, and food choice using a short food-frequency questionnaire. Participants were classified into one of four sleep timing behaviour categories using the median split for sleep-onset and -offset times. Differences between sleep timing groups for weekly consumption frequency of selected food groups, dietary pattern scores and minutes of moderate-to-vigorous physical activity were examined. Children in the late sleep/late wake category had a lower 'Fruit & Vegetables' pattern score [mean difference (95% CI): -0.3 (-0.5, -0.1)], a lower consumption frequency of fruit and vegetables [mean weekly difference (95% CI): -2.9 (-4.9, -0.9)] and a higher consumption frequency of sweetened beverages [mean weekly difference (95% CI): 1.8 (0.2, 3.3)] compared with those in the early sleep/early wake category. Additionally, children in the late sleep/late wake category accumulated fewer minutes of moderate-to-vigorous physical activity per day compared with those in the early sleep/early wake category [mean difference (95% CI): -9.4 (-15.3, -3.5)]. These findings indicate that sleep timing, even after controlling for sleep duration, was associated with both food consumption and physical activity. © 2017 European Sleep Research Society.

Sleep Trajectories of Women Undergoing Elective Cesarean Section: Effects on Body Weight and Psychological Well-Being.

PubMed

Tzeng, Ya-Ling; Chen, Shu-Ling; Chen, Chuen-Fei; Wang, Fong-Chen; Kuo, Shu-Yu

2015-01-01

After cesarean section (CS), women may be at great risk for sleep disturbance, but little is known about temporal changes in their sleep patterns and characteristics. We had two aims: 1) to identify distinct classes of sleep-disturbance trajectories in women considering elective CS from third-trimester pregnancy to 6 months post-CS and 2) to examine associations of sleep trajectories with body mass index (BMI), depressive symptoms, and fatigue scores. We analyzed data from a prospective cohort study of 139 Taiwanese pregnant women who elected CS. Sleep components were assessed using the Pittsburgh Sleep Quality Index in third-trimester pregnancy, 1 day, 1 week, 1 month, and 6 months post-CS. Data were collected on depressive symptoms, fatigue symptoms, and BMI. Sleep-quality trajectories were identified by group-based trajectory modeling. We identified three distinct trajectories: stable poor sleep (50 women, 36.0%), progressively worse sleep (67 women, 48.2%), and persistently poor sleep (22 women, 15.8%). Poor sleep was significantly associated with pre-pregnancy BMI and more baseline (third-trimester pregnancy) depressive and fatigue symptoms. At 6 months post-CS, women classified as progressively worse or persistently poor sleepers showed a trend toward higher BMI (p<0.03), more depressive symptoms (p<0.001), and higher fatigue scores (p<0.001) than those with stable poor sleep. Women had three distinct sleep-disturbance trajectories before and after elective CS. These poor-sleep courses were associated with BMI and psychological well-being. Our findings suggest a need to continuously assess sleep quality among women considering elective CS and up to 6 months post-CS.

Children benefit differently from night- and day-time sleep in motor learning.

PubMed

Yan, Jin H

2017-08-01

Motor skill acquisition occurs while practicing (on-line) and when asleep or awake (off-line). However, developmental questions still remain about whether children of various ages benefit similarly or differentially from night- and day-time sleeping. The likely circadian effects (time-of-day) and the possible between-test-interference (order effects) associated with children's off-line motor learning are currently unknown. Therefore, this study examines the contributions of over-night sleeping and mid-day napping to procedural skill learning. One hundred and eight children were instructed to practice a finger sequence task using computer keyboards. After an equivalent 11-h interval in one of the three states (sleep, nap, wakefulness), children performed the same sequence in retention tests and a novel sequence in transfer tests. Changes in the movement time and sequence accuracy were evaluated between ages (6-7, 8-9, 10-11years) during practice, and from skill training to retrievals across three states. Results suggest that night-time sleeping and day-time napping improved the tapping speed, especially for the 6-year-olds. The circadian factor did not affect off-line motor learning in children. The interference between the two counter-balanced retrieval tests was not found for the off-line motor learning. This research offers possible evidence about the age-related motor learning characteristics in children and a potential means for enhancing developmental motor skills. The dynamics between age, experience, memory formation, and the theoretical implications of motor skill acquisition are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

Sleep assessment by patients and nurses in the intensive care: An exploratory descriptive study.

PubMed

Aitken, Leanne M; Elliott, Rosalind; Mitchell, Marion; Davis, Chelsea; Macfarlane, Bonnie; Ullman, Amanda; Wetzig, Krista; Datt, Ashika; McKinley, Sharon

2017-03-01

Sleep disruption is common in intensive care unit (ICU) patients, with reports indicating reduced quality and quantity of sleep in many patients. There is growing evidence that sleep in this setting may be improved. To describe ICU patients' self-report assessment of sleep, examine the relationship between patients' self-reported sleep and their reported sleep by the bedside nurse, and describe the strategies suggested by patients to promote sleep. An exploratory descriptive study was undertaken with communicative adult patients consecutively recruited in 2014-2015. Patients reported sleep using the Richards-Campbell Sleep Questionnaire (score range 0-100mm; higher score indicates better sleep quality), with nursing assessment of sleep documented across a five level ordinal variable. Patients were asked daily to describe strategies that helped or hindered their sleep. Ethical approval for the study was gained. Descriptive statistical analysis was performed [median (interquartile range)]; relationships were tested using Spearman's rank correlation and differences assessed using the Kruskal-Wallis test; p<0.05 was considered significant. Participants (n=151) were recruited [age: 60 (46-71) years; ICU length of stay 4 (2-9) days] with 356 self-reports of sleep. Median perceived sleep quality was 46 (26-65) mm. A moderate relationship existed between patients' self-assessment and nurses' assessment of sleep (Spearman's rank correlation coefficient 0.39-0.50; p<0.001). Strategies identified by patients to improve sleep included adequate pain relief and sedative medication, a peaceful and comfortable environment and physical interventions, e.g. clustering care, ear plugs. Patients reported on their sleep a median of 2 (1-3) days during their ICU stay, suggesting that routine use of self-report was feasible. These reports revealed low sleep quality. Patients reported multiple facilitators and barriers for sleep, with environmental and patient comfort factors being most common. Interventions that target these factors to improve patient sleep should be implemented. Copyright © 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Short sleep duration and irregular bedtime are associated with increased behavioral problems among Japanese preschool-age children.

PubMed

Komada, Yoko; Abe, Takashi; Okajima, Isa; Asaoka, Shoichi; Matsuura, Noriko; Usui, Akira; Shirakawa, Shuichiro; Inoue, Yuichi

2011-06-01

Sleep problems are known to be risk factors for subsequent emotional and behavioral difficulties in childhood and adolescence. To date, there has been no study investigating the relationships between sleep habits and behavioral problems in a large nonclinical sample of preschool age children. The aim of this study was to examine these relationships and factors associated with the sleep habits of preschool age (2 to 5 year old) children. Their mothers (n = 1,746) completed a multiple-choice questionnaire about the sleep habits and behavior problems of their children, as well as their own sleep habits and working hours at Tokyo metropolitan public nursery schools. The short sleep duration group showed significantly higher aggressive scores than the long sleep duration group among 2- to 3-year-old children, and the irregular bedtime group showed significantly higher aggressive and attention problem scores than the regular bedtime group among 4- to 5-year-old children. Univariate and multivariate logistic regression analyses revealed that children's late bedtime was associated with their mother's late waking-up time, and late schedule of both the mother's leaving and returning home. This study recognized an association between behavioral problems and poor sleep habits among preschool-age children. It is important for children to sleep regularly and adequately in order to decrease their behavior problems. In conclusion, appropriate management of children's sleep by their mothers is necessary for promoting sleep-related health of children.

Assessment of sleep quality in benign paroxysmal positional vertigo recurrence.

PubMed

Wang, Yun; Fei Xia, Fei; Wang, Wei; Hu, Wenli

2018-06-08

Despite the availability of highly effective treatments, there is a significant recurrence rate of benign paroxysmal positional vertigo (BPPV). This study is aimed to quantitatively measure sleep quality in BPPV patients and correlate it with the recurrence of BPPV. In this longitudinal cohort study, the clinical records of 67 elderly or middle-aged adult patients who were diagnosed with BPPV at Neurology Clinic, Beijing Chaoyang Hospital affiliated to Capital Medical University between 2013 and 2014. The "Recurrent" and "Non-recurrent" BPPV were respectively defined. Primary data collection included the medical history, blood test and Pittsburgh sleep quality index measurement. Among the total 67 patients after successful treatment, recurrent BPPV is observed in 37.31% patients (n = 25) within 2 years. Among all 11 variables analyzed between recurrent and non-recurrent groups, only the Pittsburgh Sleep Quality Index (PSQI) scores showed significant difference (P < 0.001). In details, these differences were also measured in five individual sleep items, including the subjective assessment of sleep quality, sleep latency, sleep duration, the use of sleep-aid medication and daytime dysfunctions (all P < 0.05). Regression analysis showed patients with higher PSQI score (lower sleep quality) had higher risk of BPPV recurrence (OR = 1.17, 95% CI: 1.04-1.32, P= 0.0082). The sleep quality in patients with BPPV recurrence is significantly poorer compared to non-recurrent patients. Our result suggested sleep quality as measured by PSQI is an independent risk factor of BPPV recurrence.

The role of emotional eating and stress in the influence of short sleep on food consumption.

PubMed

Dweck, Julia S; Jenkins, Steve M; Nolan, Laurence J

2014-01-01

Short sleep duration is associated with elevated body mass index (BMI) and increased energy consumption. The present studies were conducted to determine what role emotional eating and stress might play in these relationships. The first was an exploratory questionnaire study in which sleep quality and duration were measured in conjunction with the Dutch Eating Behavior Questionnaire in 184 women. Emotional and external eating scores were significantly higher in those who reported poor sleep quality (but were not related to sleep duration). In a second study of 64 women who were provided with snacks in the laboratory under stressed and control conditions, elevated food consumption was observed in those who scored high on emotional eating and who reported short sleep (a significant stress × emotional eating × sleep duration interaction) but not in those who reported poor sleep quality. No effects were found in liking or wanting of food and few effects were found on appetite. BMI was not related to sleep duration or sleep quality in either study. The results suggest that the relationship between short sleep and elevated food consumption exists in those who are prone to emotional eating. An external stressor elevated consumption in normal sleepers to the level observed in short sleepers, however, it did not significantly elevate consumption in short sleepers. Future examinations of the effects of sleep duration and quality on food consumption should examine emotional eating status. Copyright © 2013 Elsevier Ltd. All rights reserved.

Afternoon serum-melatonin in sleep disordered breathing.

PubMed

Ulfberg, J; Micic, S; Strøm, J

1998-08-01

To study afternoon serum-melatonin values in patients with sleep disordered breathing. Melatonin has a strong circadian rhythm with high values during the night-time and low values in the afternoon. Sleep disordered breathing may change the circadian rhythm of melatonin which may have diagnostic implications. The Sleep Laboratory, The Department of Internal Medicine, Avesta Hospital, Sweden, and the Department of Anaesthesiology, Glostrup University Hospital, Copenhagen, Denmark. We examined 60 consecutive patients admitted for sleep disordered breathing and 10 healthy non snoring controls. The patients underwent a sleep apnoea screening test having a specificity of 100% for the obstructive sleep apnoea syndrome (OSAS) using a combination of static charge sensitive bed and oximetry. Obstructive sleep apnoea syndrome was found in 49 patients, eight patients had borderline sleep disordered breathing (BSDB) and three patients were excluded due to interfering disease. Patients and controls had an afternoon determination of serum-melatonin. The Epworth Sleepiness Scale was used to score day-time sleepiness. In comparison with normal controls patients suffering from OSAS had significantly higher serum-melatonin levels in the afternoon. However, as a diagnostic test for OSAS in patients with sleep disordered breathing serum-melatonin showed a low sensitivity but a high specificity. The results indicate that breathing disorders during sleep in general affect pineal function. Sleep disordered breathing seems to disturb pineal function. Determination of afternoon serum-melatonin alone or together with a scoring of daytime sleepiness does not identify OSAS-patients in a heterogeneous population of patients complaining of heavy snoring and excessive daytime sleepiness.

Interictal spiking increases with sleep depth in temporal lobe epilepsy.

PubMed

Malow, B A; Lin, X; Kushwaha, R; Aldrich, M S

1998-12-01

To test the hypothesis that deepening sleep activates focal interictal epileptiform discharges (IEDs), we performed EEG-polysomnography in 21 subjects with medically refractory temporal lobe epilepsy. At the time of study, subjects were seizure-free for > or =24 h and were taking stable doses of antiepileptic medications (AEDs). Sleep depth was measured by log delta power (LDP). Visual sleep scoring and visual detection of IEDs also were performed. Logistic-regression analyses of IED occurrence in relation to LDP were carried out for two groups of subjects, nine with frequent IEDs (group 1) and 12 with rare IEDs (group 2). The LDP differentiated visually scored non-rapid eye movement (NREM) sleep stages (p = 0.0001). The IEDs were most frequent in NREM stages 3/4 and least frequent in REM sleep. Within NREM sleep, in both groups, IEDs were more frequent at higher levels of LDP (p < 0.05). In group 1, after accounting for the level of LDP, IEDs were more frequent (a) on the ascending limb of LDP and with more rapid increases in LDP (p = 0.007), (b) in NREM than in REM sleep (p = 0.002), and (c) closer to sleep onset (p < 0.0001). Fewer than 1% of IEDs occurred within 10 s of an EEG arousal. Processes underlying the deepening of NREM sleep, including progressive hyperpolarization in thalamocortical projection neurons, may contribute to IED activation in partial epilepsy. Time from sleep onset and NREM versus REM sleep also influence IED occurrence.

YouTube as a source of information for obstructive sleep apnea.

PubMed

Singh, Sameer K; Liu, Stanley; Capasso, Robson; Kern, Robert C; Gouveia, Christopher J

Assess the quality of information on obstructive sleep apnea (OSA) presented on YouTube for patients. "Obstructive sleep apnea" was entered into the YouTube search. Two independent reviewers categorized and analyzed videos utilizing a customized scoring-system along with search position, likes, and views. Forty-eight videos were analyzed. Most were educational (52.1%). Educational and news videos had significantly higher scores, but had no significant differences in search position, likes/day, or views/day. Most videos mentioned positive airway pressure (65%), and nearly half (44%) mentioned mandibular devices in the management of OSA. Few videos discussed surgery (13%) or otolaryngology (15%). YouTube is a promising source of information for OSA patients. Educational and news videos are of highest quality. General quality measures like search position, views, and likes are not correlated with formally scored value. Sleep surgery and otolaryngologists are minimally mentioned, representing an opportunity for improvement. Copyright © 2018 Elsevier Inc. All rights reserved.

Brief Behavioral Sleep Intervention for Adolescents: An Effectiveness Study.

PubMed

Paavonen, E Juulia; Huurre, Taina; Tilli, Maija; Kiviruusu, Olli; Partonen, Timo

2016-01-01

Sleep disturbances are common among adolescents, but there are no brief interventions to treat them. The objective of this study was to evaluate the effectiveness of a brief semistructured, individually delivered sleep intervention to ameliorate adolescents' sleeping difficulties and lengthen sleep duration. All students aged 16-18 years in a high school were screened for sleeping difficulties and 36 students with the highest sleep problem scores were invited to the intervention. Postintervention improvements were observed on self-reported and actiwatch-registered sleep duration, self-reported sleep quality and sleep latency, perceived stress and anxiety (all p values < 0.001). However, objectively measured sleep efficiency and sleep latency did not change (p > 0.05). A brief individual sleep intervention can be effective in lengthening sleep duration and improving subjective sleep quality and well-being among adolescents.

Sleep quality and health service utilization in Chinese general population: a cross-sectional study in Dongguan, China.

PubMed

Zhang, Hui-Shan; Mai, Yan-Bing; Li, Wei-Da; Xi, Wen-Tao; Wang, Jin-Ming; Lei, Yi-Xiong; Wang, Pei-Xi

The aims of this study were to explore the Pittsburgh Sleep Quality Index (PSQI) and health service utilization in Chinese general population, to investigate the association between PSQI and health service utilization and to identify the independent contributions of social demographic variables, health related factors and PSQI to health service utilization. In a cross-sectional community-based health survey using a multi-instrument questionnaire, 4067 subjects (≥15 years old) were studied. The Chinese version of the PSQI was used to assess sleep quality. Health service utilization was measured by recent two-week physician visit and annual hospitalization rates. Higher PSQI scores were associated with more frequent health service utilization. Higher scores in subjective sleep quality were associated with higher rate of recent two-week physician visit (adjusted OR = 1.24 per SD increase, P = 0.015). Higher scores in habitual sleep efficiency (adjusted OR = 1.24 per SD increase, P = 0.038) and sleep disturbances (adjusted OR = 2.09 per SD increase, P < 0.001) were associated with more frequent annual hospitalization. The independent influence of PSQI on the risk of recent two-week physician visit was 0.7%, and that of annual hospitalization 31.4%. Poorer sleep quality predicted more frequent health service utilization. The independent contribution of PSQI on health service utilization was smaller than social demographic variables. Copyright © 2016. Published by Elsevier B.V.

Patients with insomnia and subthreshold depression show marked worsening of insomnia after discontinuation of sleep promoting medication.

PubMed

Wichniak, Adam; Wierzbicka, Aleksandra; Jernajczyk, Wojciech

2011-08-15

To investigate whether the outcome of treatment with trazodone CR in primary insomnia differs between patients with and without subthreshold depression. 14 patients (9 females, mean age 57.3 ± 13.3) with primary insomnia and increased Beck Depression Inventory (BDI) scores (>10) and 15 sex- and age-matched patients with primary insomnia and low BDI scores (≤ 10) were treated with trazodone CR 25-150 mg/d for 3 months and followed for 1 month after discontinuation of the medication. The Athens Insomnia Scale (AIS), Sheehan Disability Scale (SDS), and Clinical Global Impression scale (CGI) were completed at baseline, after each month of treatment and after the first week of run-out phase. Additional assessment tools comprised sleep diaries, the Leeds Sleep Evaluation Questionnaire (LSEQ) and actigraphic recordings. Subjective sleep time increased by 61.5 ± 72.3 min in the group with low BDI and 60.0 ± 59.4 min in the group with increased BDI at the end of the treatment phase. The significant improvements were also observed in the AIS, CGI, LSEQ and SDS. During the run-out phase the improvement was sustained in patients with low BDI, while AIS scores, sleep latency and total sleep time deteriorated in patients with increased BDI. Patients with subthreshold depression, even if the depressive symptoms do not fulfill the time criteria for depressive episode, show marked worsening of insomnia after discontinuation of sleep promoting medication. Copyright © 2011 Elsevier Inc. All rights reserved.

Eat, sleep, work, play: associations of weight status and health-related behaviors among young adult college students.

PubMed

Quick, Virginia; Byrd-Bredbenner, Carol; White, Adrienne A; Brown, Onikia; Colby, Sarah; Shoff, Suzanne; Lohse, Barbara; Horacek, Tanya; Kidd, Tanda; Greene, Geoffrey

2014-01-01

To examine relationships of sleep, eating, and exercise behaviors; work time pressures; and sociodemographic characteristics by weight status (healthy weight [body mass index or BMI < 25] vs. overweight [BMI ≥ 25]) of young adults. Cross-sectional. Nine U.S. universities. Enrolled college students (N = 1252; 18-24 years; 80% white; 59% female). Survey included the Pittsburgh Sleep Quality Index (PSQI), Three-Factor Eating Questionnaire (TFEQ), Satter Eating Competence Inventory (ecSI), National Cancer Institute Fruit/Vegetable Screener, International Physical Activity Questionnaire, Work Time Pressure items, and sociodemographic characteristics. Chi-square and t-tests determined significant bivariate associations of sociodemographics, sleep behaviors, eating behaviors, physical activity behavior, and work time pressures with weight status (i.e., healthy vs. overweight/obese). Statistically significant bivariate associations with weight status were then entered into a multivariate logistic regression model that estimated associations with being overweight/obese. Sex (female), race (nonwhite), older age, higher Global PSQI score, lower ecSI total score, and higher TFEQ Emotional Eating Scale score were significantly (p < .05) associated with overweight/obesity in bivariate analyses. Multivariate logistic regression analysis showed that sex (female; odds ratio [OR] = 2.05, confidence interval [CI] = 1.54-2.74), older age (OR = 1.35, CI = 1.21-1.50), higher Global PSQI score (OR = 1.07, CI = 1.01-1.13), and lower ecSI score (OR = .96, CI = .94-.98), were significantly (p < .05) associated with overweight/obesity. Findings suggest that obesity prevention interventions for college students should include an education component to emphasize the importance of overall sleep quality and improving eating competence.

Electro-oculography-based detection of sleep-wake in sleep apnea patients.

PubMed

Virkkala, Jussi; Toppila, Jussi; Maasilta, Paula; Bachour, Adel

2015-09-01

Recently, we have developed a simple method that uses two electro-oculography (EOG) electrodes for the automatic scoring of sleep-wake in normal subjects. In this study, we investigated the usefulness of this method on 284 consecutive patients referred for a suspicion of sleep apnea who underwent a polysomnography (PSG). We applied the AASM 2007 scoring rules. A simple automatic sleep-wake classification algorithm based on 18-45 Hz beta power was applied to the calculated bipolar EOG channel and was compared to standard polysomnography. Epoch by epoch agreement was evaluated. Eighteen patients were excluded due to poor EOG quality. One hundred fifty-eight males and 108 females were studied, their mean age was 48 (range 17-89) years, apnea-hypopnea index 13 (range 0-96) /h, BMI 29 (range 17-52) kg/m(2), and sleep efficiency 78 (range 0-98) %. The mean agreement in sleep-wake states between EOG and PSG was 85% and the Cohen's kappa was 0.56. Overall epoch-by-epoch agreement was 85%, and the Cohen's kappa was 0.57 with positive predictive value of 91% and negative predictive value of 65%. The EOG method can be applied to patients referred for suspicion of sleep apnea to indicate the sleep-wake state.

Chronic widespread musculoskeletal pain in patients with obstructive sleep apnea syndrome and the relationship between sleep disorder and pain level, quality of life, and disability.

PubMed

Aytekin, Ebru; Demir, Saliha Eroglu; Komut, Ece Akyol; Okur, Sibel Caglar; Burnaz, Ozer; Caglar, Nil Sayiner; Demiryontar, Dilay Yilmaz

2015-09-01

[Purpose] The aim of this study was to ascertain the prevalence of chronic widespread musculoskeletal pain in patients with obstructive sleep apnea syndrome and to assess the relationship between sleep disorder and pain, quality of life, and disability. [Subjects and Methods] Seventy-four patients were included in the study and classified as having mild, moderate, or severe obstructive sleep apnea. Chronic widespread pain, quality of life, and disability were evaluated. [Results] Forty-one patients (55.4%) had chronic widespread pain. Female patients had a higher incidence of chronic pain, and female patients with chronic pain had higher body mass indexes, pain levels, and disability scores than did male patients. Physical component scores of female patients with chronic pain were lower than those of male patients. No correlation was observed between the degree of sleep disorder and severity of pain, pain duration, disability, or quality of life in obstructive sleep apnea patients with pain. [Conclusion] This study showed a 55.4% prevalence of chronic widespread pain in patients with obstructive sleep apnea and a greater risk of chronic pain in female than in male patients. Female patients with obstructive sleep apnea and chronic pain have higher pain and disability levels and a lower quality of life.

Effects of music listening on stress, anxiety, and sleep quality for sleep-disturbed pregnant women.

PubMed

Liu, Yu-Hsiang; Lee, ChihChen Sophia; Yu, Chen-Hsiang; Chen, Chung-Hey

2016-01-01

Prenatal sleep disturbance has been associated with undesirable birthing outcomes. To determine the effectiveness of listening to music at home in improving sleep quality, 121 Taiwanese pregnant women with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score > 5) were systematically assigned, with a random start to music listening (n = 61) or control (n = 60) group. Participants in the music listening group self-regulated listening to music in addition to receiving general prenatal care similar to that in the control group for 2 weeks. The PSQI and State-Anxiety Inventory were used to assess outcomes. ANCOVA analyses were used with the pretest scores as covariates and showed significant improvement in sleep quality, stress, and anxiety in the music listening group compared with the control group. The most frequently used music genre by participants in the experimental group was lullabies, followed by classical music and crystal baby music. This study supported the theory that 2-week music listening interventions may reduce stress, anxiety, and yield better sleep quality for sleep-disturbed pregnant women. The analysis of participants' journals also implied that the expectant mothers' choices of musical genres may correlate more with perceived prenatal benefits or the desire to interact with their unborn child.

Caffeine Consumption and Sleep Quality in Australian Adults

PubMed Central

Watson, Emily J.; Coates, Alison M.; Kohler, Mark; Banks, Siobhan

2016-01-01

Caffeine is commonly consumed to help offset fatigue, however, it can have several negative effects on sleep quality and quantity. The aim of this study was to determine the relationship between caffeine consumption and sleep quality in adults using a newly validated caffeine food frequency questionnaire (C-FFQ). In this cross sectional study, 80 adults (M ± SD: 38.9 ± 19.3 years) attended the University of South Australia to complete a C-FFQ and the Pittsburgh Sleep Quality Index (PSQI). Caffeine consumption remained stable across age groups while the source of caffeine varied. Higher total caffeine consumption was associated with decreased time in bed, as an estimate of sleep time (r = −0.229, p = 0.041), but other PSQI variables were not. Participants who reported poor sleep (PSQI global score ≥ 5) consumed 192.1 ± 122.5 mg (M ± SD) of caffeine which was significantly more than those who reported good sleep quality (PSQI global score < 5; 125.2 ± 62.6 mg; p = 0.008). The C-FFQ was found to be a quick but detailed way to collect population based caffeine consumption data. The data suggests that shorter sleep is associated with greater caffeine consumption, and that consumption is greater in adults with reduced sleep quality. PMID:27527212

Determining the relationship between sleep architecture, seizure variables and memory in patients with focal epilepsy.

PubMed

Miller, Laurie A; Ricci, Monica; van Schalkwijk, Frank J; Mohamed, Armin; van der Werf, Ysbrand D

2016-06-01

Sleep has been shown to be important to memory. Both sleep and memory have been found to be abnormal in patients with epilepsy. In this study, we explored the effects that nocturnal epileptiform discharges and the presence of a hippocampal lesion have on sleep patterns and memory. Twenty-five patients with focal epilepsy who underwent a 24-hr ambulatory EEG also completed the Everyday Memory Questionnaire (EMQ). The EEG record was scored for length of time spent in the various sleep stages, time spent awake after sleep onset, and rapid eye movement (REM) latency. Of these sleep variables, only REM latency differed when the epilepsy patients were divided on the bases of either presence/absence of nocturnal discharges or presence/absence of a hippocampal lesion. In both cases, presence of the abnormality was associated with longer latency. Furthermore, longer REM latency was found to be a better predictor of EMQ score than either number of discharges or presence of a hippocampal lesion. Longer REM latency was associated with a smaller percentage of time spent in slow-wave sleep in the early part of the night and may serve as a particularly sensitive marker to disturbances in sleep architecture. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Individual Differences in Digit Span, Susceptibility to Proactive Interference, and Aptitude/Achievement Test Scores.

ERIC Educational Resources Information Center

Dempster, Frank N.; Cooney, John B.

1982-01-01

Individual differences in digit span, susceptibility to proactive interference, and various aptitude/achievement test scores were investigated in two experiments with college students. Results indicated that digit span was strongly correlated with aptitude/achievement scores, but did not indicate that susceptibility to proactive interference…

The GABA(A) receptor RDL acts in peptidergic PDF neurons to promote sleep in Drosophila.

PubMed

Chung, Brian Y; Kilman, Valerie L; Keath, J Russel; Pitman, Jena L; Allada, Ravi

2009-03-10

Sleep is regulated by a circadian clock that times sleep and wake to specific times of day and a homeostat that drives sleep as a function of prior wakefulness. To analyze the role of the circadian clock, we have used the fruit fly Drosophila. Flies display the core behavioral features of sleep, including relative immobility, elevated arousal thresholds, and homeostatic regulation. We assessed sleep-wake modulation by a core set of circadian pacemaker neurons that express the neuropeptide PDF. We find that disruption of PDF function increases sleep during the late night in light:dark and the first subjective day of constant darkness. Flies deploy genetic and neurotransmitter pathways to regulate sleep that are similar to those of their mammalian counterparts, including GABA. We find that RNA interference-mediated knockdown of the GABA(A) receptor gene, Resistant to dieldrin (Rdl), in PDF neurons reduces sleep, consistent with a role for GABA in inhibiting PDF neuron function. Patch-clamp electrophysiology reveals GABA-activated picrotoxin-sensitive chloride currents on PDF+ neurons. In addition, RDL is detectable most strongly on the large subset of PDF+ pacemaker neurons. These results suggest that GABAergic inhibition of arousal-promoting PDF neurons is an important mode of sleep-wake regulation in vivo.

Sleep patterns and disorders among university students in Lebanon.

PubMed

Assaad, Shafika; Costanian, Christy; Haddad, Georges; Tannous, Fida

2014-01-01

Insufficient sleep is a significant public health issue with adverse medical consequences. Sleep disturbances are common among university students and have an effect on this group's overall health and functioning. The aim of this study was to investigate sleep habits and disorders in a population of university students across Lebanon. This was a cross-sectional study carried out in 2012 among 735 students aged 18-25 yrs. old, enrolled at six universities across Lebanon. The Pittsburg Sleep Quality Index (PSQI) was used to assess sleep quality and habits. Less than half of the total study population (47.3%) were good sleepers (PSQI<5). Upon bivariate analysis, males experienced more sleep difficulties than females (57.8% vs. 40.8%). The majority (60%) of males vs. 40% of females had trouble performing daily activities more than once per week (P=0.02). Results of the multivariate analysis revealed that reporting poor sleep quality was strongly associated with daytime dysfunction and sleep- enhancing medication use especially more than once per week. This is the first study to describe the nature of sleep problems among university students in Lebanon. This study suggests that sleep problems among Lebanese college students were common and such problems may interfere with daily performance. Findings from this study have important implications for programs intended to improve academic performance by targeting sleep habits of students.

[The effectiveness of therapeutic touch on pain, depression and sleep in patients with chronic pain: clinical trial].

PubMed

Marta, Ilda Estefani Ribeiro; Baldan, Sueli Santiago; Berton, Ani Fabiana; Pavam, Michele; da Silva, Maria Júlia Paes

2010-12-01

This research aimed to check the effectiveness of Therapeutic Touch on decreased pain intensity, depression self-assessment scores and improved sleep quality. A clinical before-after trial is presented. The study was carried out at a Basic Health Unit in Fernandópolis, SP-Brazil, involving 30 elderly patients with chronic non-oncologic pain who received 8 sessions of Therapeutic Touch in accordance with the Krieger-Kunz method. The Visual Analogue Scale for pain was applied before and after each session, and Beck Depression Inventory and the Pittsburgh Sleep Quality Index before the first and after the last session. Data analysis showed a significant decrease (p < 0.05) in pain intensity, depression self-assessment scores and the sleep quality index. It is concluded that the Therapeutic Touch was effective to decrease pain intensity and depressive attitudes and symptoms, as well as to improve sleep quality.

Sleep Hygiene and Recovery Strategies in Elite Soccer Players.

PubMed

Nédélec, Mathieu; Halson, Shona; Delecroix, Barthélémy; Abaidia, Abd-Elbasset; Ahmaidi, Said; Dupont, Gregory

2015-11-01

In elite soccer, players are frequently exposed to various situations and conditions that can interfere with sleep (e.g., playing night matches interspersed with 3 days; performing activities demanding high levels of concentration close to bedtime; use of products containing caffeine or alcohol in the period preceding bedtime; regular daytime napping throughout the week; variable wake-up times or bedtime), potentially leading to sleep deprivation. We outline simple, practical, and pharmaceutical-free sleep strategies that are coordinated to the constraints of elite soccer in order to promote sleep. Sleep deprivation is best alleviated by sleep extension; however, sleep hygiene strategies (i.e., consistent sleep pattern, appropriate napping, and active daytime behaviors) can be utilized to promote restorative sleep. Light has a profound impact on sleep, and sleep hygiene strategies that support the natural environmental light-dark cycle (i.e., red-light treatment prior to sleep, dawn-simulation therapy prior to waking) and prevent cycle disruption (i.e., filtering short wavelengths prior to sleep) may be beneficial to elite soccer players. Under conditions of inordinate stress, techniques such as brainwave entrainment and meditation are promising sleep-promoting strategies, but future studies are required to ascertain the applicability of these techniques to elite soccer players. Consuming high-electrolyte fluids such as milk, high-glycemic index carbohydrates, some forms of protein immediately prior to sleep, as well as tart cherry juice concentrate and tryptophan may promote rehydration, substrate stores replenishment, muscle-damage repair and/or restorative sleep. The influence of cold water immersion performed close to bedtime on subsequent sleep is still debated. Conversely, the potential detrimental effects of sleeping medication must be recognized. Sleep initiation is influenced by numerous factors, reinforcing the need for future research to identify such factors. Efficient and individualized sleep hygiene strategies may consequently be proposed.

Oropharyngeal examination to predict sleep apnea severity.

PubMed

Barceló, Xavier; Mirapeix, Rosa M; Bugés, Jordi; Cobos, Albert; Domingo, Christian

2011-10-01

To evaluate the usefulness of the examination of the upper airway, paying special attention to the Friedman tongue position (FTP), to confirm obstructive sleep apnea syndrome (OSAS) and its severity. Prospective, single-center, cross-sectional study. Sleep disorders unit of a community hospital. A total of 301 consecutive patients admitted to the sleep disorders unit due to suspicion of OSAS. Assessments included body mass index calculated as weight in kilograms divided by height in meters squared (BMI); neck perimeter measurement; oropharyngeal examination; fiberendoscopy; rhinomanometry; and a sleep study. Apnea-hypopnoea index (AHI), FTP, the uvula size, and certain complementary examinations (sex, age, BMI, cervical perimeter, nasal flow) whose importance has not been clearly established, and to explore their potential value as predictors of the AHI. Findings included the following: the mean (SD) age of the patients was 51 (12) years; 71.1% were male; the mean (SD) BMI was 29.8 (4.6); and the mean (SD) cervical perimeter, 40.5 (3.7) cm. In 94.0% of the patients the AHI value was at least 5.0/hour. Patients with FTP scores of 2 and 3 accounted for 74.1% of the whole cohort: 14.3% had an FTP score of 1, and only 11.6% had a score of 4. Of the 6.0% of cases with a normal AHI, 16 patients were classified as having FTP scores of 1, and 2 as having a score of 2. Tonsil size score (P = .005), uvula score (P = .003), BMI (P < .001), cervical perimeter (P < .001), nasal flow at 150 Pa (P = .02), and age (P = .007) were related to OSAS severity. Curiously, AHI in patients who had undergone tonsillectomy was higher than in the TS1 group (tonsils inside the tonsillar fossa) and quite similar to the TS 2 group (tonsils that extend beyond the tonsillar pillars). In the multiple regression model, only the FTP score showed a relevant relationship to OSAS severity. First, since the FTP score is almost the only parameter related to OSAS severity, a simple oropharyngeal examination can provide key information on this issue. Second, tonsillectomy does not seem to protect against development of OSAS.

A comparison of passive and active estimates of sleep in a cohort with schizophrenia.

PubMed

Staples, Patrick; Torous, John; Barnett, Ian; Carlson, Kenzie; Sandoval, Luis; Keshavan, Matcheri; Onnela, Jukka-Pekka

2017-10-16

Sleep abnormalities are considered an important feature of schizophrenia, yet convenient and reliable sleep monitoring remains a challenge. Smartphones offer a novel solution to capture both self-reported and objective measures of sleep in schizophrenia. In this three-month observational study, 17 subjects with a diagnosis of schizophrenia currently in treatment downloaded Beiwe, a platform for digital phenotyping, on their personal Apple or Android smartphones. Subjects were given tri-weekly ecological momentary assessments (EMAs) on their own smartphones, and passive data including accelerometer, GPS, screen use, and anonymized call and text message logs was continuously collected. We compare the in-clinic assessment of sleep quality, assessed with the Pittsburgh Sleep Questionnaire Inventory (PSQI), to EMAs, as well as sleep estimates based on passively collected accelerometer data. EMAs and passive data classified 85% (11/13) of subjects as exhibiting high or low sleep quality compared to the in-clinic assessments among subjects who completed at least one in-person PSQI. Phone-based accelerometer data used to infer sleep duration was moderately correlated with subject self-assessment of sleep duration (r = 0.69, 95% CI 0.23-0.90). Active and passive phone data predicts concurrent PSQI scores for all subjects with mean average error of 0.75 and future PSQI scores with a mean average error of 1.9, with scores ranging from 0-14. These results suggest sleep monitoring via personal smartphones is feasible for subjects with schizophrenia in a scalable and affordable manner. SMARTPHONES CAN TRACK SCHIZOPHRENIA-RELATED SLEEP ABNORMALITIES: Smartphones may one-day offer accessible, clinically-useful insights into schizophrenia patients' sleep quality. Despite the clinical relevance of sleep to disease severity, monitoring technologies still evade convenience and reliability. In search of a preferential method, a group of Harvard University researchers led by Patrick Staples investigated the validity of data collected via patients' own mobile phones. The team, with a cohort of 17 schizophrenia patients, compared the quality of data produced by smartphone sensors and smartphone-delivered questionnaires to that of an in-clinic evaluation. The results significantly showed that smartphone monitoring could generate information that approached the accuracy of in-clinic assessments. The team noted some areas for improvement; however, this study provides convincing justifications for further research into this non-invasive, low-cost, scalable method to monitor the sleep quality of schizophrenic patients.