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Palao-Loayza L, Yupanqui-Lorenzo DE, Arauco-Lozada T, Caycho-Rodríguez T, Seminario Ortiz HD, Lobos Rivera ME, Cardoza-Sernaqué MA, Pulido-Joo LA, Pulido-Capurro V, Cárcamo-Zepeda E, Mendoza-Sierra MI, Cuellar-Hernández MDL, Torres López A, Torales J, Barrios I. Cross-cultural validation of the Jenkins Sleep Scale in Spanish-speaking countries. J Health Psychol 2024:13591053241261349. [PMID: 39077835 DOI: 10.1177/13591053241261349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
The study aimed to validate the Jenkins Sleep Scale (JSS-4) in six Spanish-Speaking countries. A total of 1726 people participated and were distributed between men (32.4%) and women (67.6%). Confirmatory factor analysis confirmed the unidimensional structure and high reliability of the JSS-4 overall (α = 0.85, ω = 0.81) and within each country. The invariance analysis revealed that JSS-4 exhibited complete invariance across countries, thus establishing a robust foundation for inter-group comparisons. Interestingly, a comparative analysis revealed significant differences in the average levels of sleep difficulties, with particularly high rates in Spain and Chile. Item Response Theory (IRT) showed sufficient discrimination parameters for all items, and a correlation of 0.998 between Confirmatory Factor Analysis (CFA) and IRT highlighted the robustness and reliability of the results obtained. In summary, JSS-4 exhibits strong evidence of validity and consistency in measurement invariance across the six countries.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Julio Torales
- Universidad Nacional de Asunción, Paraguay
- Universidad Nacional de Caaguazú, Paraguay
- Universidad Sudamericana, Paraguay
| | - Iván Barrios
- Universidad Nacional de Asunción, Paraguay
- Universidad Sudamericana, Paraguay
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2
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Hiestand S, Waage S, Forthun I, Pallesen S, Bjorvatn B. Factors leading to excessive fatigue in nurses - a three-year follow-up study. BMC Nurs 2024; 23:446. [PMID: 38951772 PMCID: PMC11218166 DOI: 10.1186/s12912-024-02066-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/05/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Global nursing shortages necessitate the identification of mitigatable factors that may reduce nursing absence and turnover. Fatigue has been shown to be associated with these issues. This study aimed to identify factors leading to development of or recovery from excessive fatigue in nurses as these can offer actionable avenues for protecting nurses against fatigue or supporting fatigue recovery. METHODS A longitudinal study among nurses randomly sampled from the Norwegian Nurse's Organization. The Chalder Fatigue Questionnaire measured fatigue. Dichotomized scoring was used, with scores ≥ 4 considered excessive fatigue. The study included questions on shift work schedules, psychosocial work characteristics, sleep, body mass index, physical activity, caffeine, alcohol, mental health, etc. Two sets of logistic regression analysis were conducted (one for development of and one for recovery from excessive fatigue), evaluating how changes in work, lifestyle and health between baseline (2015) and follow-up (2018) affected first, odds of development of excessive fatigue and second, odds of recovery from excessive fatigue. RESULTS Among 1,311 included nurses, 21.6% maintained, 13.3% developed, and 18.0% recovered from excessive fatigue (2015-2018). Within work characteristics, increased psychological work demands were associated with development of excessive fatigue OR = 1.77 (CI = 1.11-2.82). Several work characteristics were associated with recovery from excessive fatigue, including decreased decision latitude (OR = 0.39; CI = 0.19-0.82) and increased coworker support (OR = 1.90; CI = 1.11-3.24). Shift work variables were not associated with fatigue outcomes. Amongst lifestyle factors, changes in sleep duration, obesity, and exercise were significant. Notably, developing inappropriate sleep duration (OR = 2.84; CI = 1.47-5.48) increased odds of developing excessive fatigue, while maintaining inappropriate sleep duration (< 6 h or > 8 h) (OR = 0.19; CI = 0.54-0.65) decreased odds of recovering. All assessed health conditions (depression, anxiety, insomnia, and shift work disorder) were related to development of (ORs 2.10-8.07) or recovery from (ORs 0.10-0.50) excessive fatigue. Depression, for example, increased odds of development of (OR = 8.07; CI = 2.35-27.66) and decreased odds of recovery (OR = 0.10; CI = 0.04-0.26) from excessive fatigue. CONCLUSIONS Changes in lifestyle factors, health conditions, and psychosocial work factors were associated with development of and recovery from excessive fatigue. Sleep and psychosocial work factors played important roles. We found no relationship with shift work schedules.
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Affiliation(s)
- Stand Hiestand
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, Bergen, 5020, Norway.
| | - Siri Waage
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, PO Box 1400, Bergen, 5021, Norway
- Department of Psychosocial Science, University of Bergen, PO Box 7807, Bergen, 5020, Norway
| | - Ingeborg Forthun
- Department of Disease Burden, Norwegian Institute of Public Health, Postboks 973 Sentrum, Bergen, 5808, Norway
| | - Ståle Pallesen
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, PO Box 1400, Bergen, 5021, Norway
- Department of Psychosocial Science, University of Bergen, PO Box 7807, Bergen, 5020, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, Bergen, 5020, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, PO Box 1400, Bergen, 5021, Norway
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Matthews JA, Sallis HM, Dyer ML, McConville R, Isotalus H, Attwood AS. Associations Between Self-Reported Sleep Quality, Fatigue Severity, Factors Associated With Successful Cessation, and Cessation Beliefs Among Regular Smokers. Nicotine Tob Res 2024; 26:835-842. [PMID: 37996095 PMCID: PMC11190051 DOI: 10.1093/ntr/ntad231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 10/17/2023] [Accepted: 11/20/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Smokers report poorer sleep than nonsmokers and sleep quality deteriorates further during cessation, increasing risk of smoking relapse. Better understanding of the relationship between sleep and relapse-related outcomes could inform novel approaches to smoking cessation support. The aim of this study was to investigate same-day associations of self-reported sleep quality and fatigue severity with factors associated with successful cessation and cessation beliefs, among regular smokers. METHODS This cross-sectional observational study (n = 412) collected self-reported sleep quality, fatigue severity, and factors associated with successful cessation and cessation beliefs among regular smokers via an online survey (60% male). RESULTS There was evidence of an association between sleep quality (SQ) and reduced 24-hour (β = -0.12, p = .05) and lifetime (β = -0.09, p = .04) abstinence self-efficacy. In addition, poorer SQ and higher fatigue severity (FS) were associated with increased smoking urges (SQ: β = 0.27, p < .001; FS: β = 0.32, p < .001), increased barriers to cessation (SQ: β = 0.19, p < .001; FS: β = 0.32, p < .001), and increased perceived risks to cessation (SQ: β = 0.18, p < .001; FS: β = 0.26, p < .001). Fatigue severity was weakly associated with increased perceived benefits to cessation (β = 0.12, p = .017). CONCLUSIONS Self-reported sleep quality and fatigue severity were associated with multiple factors associated with successful cessation and cessation beliefs. Further research is needed to extend these findings by using different methods to identify the temporal direction of associations and causality. IMPLICATIONS This study is the first to examine associations between sleep quality, fatigue severity, and factors associated with successful cessation and cessation beliefs. Findings show that both sleep quality and fatigue severity are associated with multiple factors associated with successful cessation and could be modifiable targets for future smoking cessation interventions. Furthermore, our data suggest that fatigue severity has an independent effect on multiple factors associated with successful cessation when accounting for sleep quality. This indicates that fatigue, independent of sleep quality, could be an important factor in a quit attempt.
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Affiliation(s)
- Joe A Matthews
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Electrical and Electronic Engineering, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Integrative Cancer Epidemiology Programme at the University of Bristol, Bristol, UK
| | - Hannah M Sallis
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- CAMH (Centre for Academic Mental Health), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Maddy L Dyer
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Ryan McConville
- Department Engineering and Mathematics, Ada Lovelace Building, University of Bristol, University Walk, Bristol, UK
| | - Hanna Isotalus
- Department of Electrical and Electronic Engineering, University of Bristol, Bristol, UK
| | - Angela S Attwood
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Integrative Cancer Epidemiology Programme at the University of Bristol, Bristol, UK
- Bristol Biomedical Research Centre at the University of Bristol, Bristol, UK
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Punj M, Neshat SS, Mateus AYL, Cheung J, Squire JD. Assessment of Sleep Disorders in Patients with CVID. J Clin Immunol 2024; 44:109. [PMID: 38676767 DOI: 10.1007/s10875-024-01711-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/14/2024] [Indexed: 04/29/2024]
Abstract
Inborn errors of immunity have been associated with reduced health-related quality of life and increased fatigue. Sleep disorders, which have been shown to contribute to fatigue and other health concerns, are prevalent in the general population, but there are limited studies evaluating these conditions in patients with common variable immunodeficiency (CVID). Our aim was to evaluate the prevalence of fatigue, sleep disturbances, and sleep-disordered breathing in adults with CVID. Patients completed 4 validated, self-administered questionnaires and a 1-night disposable home sleep apnea test. Our results demonstrated increased median Patient-Reported Outcomes Measurement Information System fatigue scores of 58.7 in patients with CVID in addition to clinically significant fatigue as measured by Fatigue Severity Scale score (median, 5.2) and overall poor sleep quality based on global Pittsburgh Sleep Quality Index score (median, 9.0). For CVID patients who completed the home sleep apnea test, 76.9% met criteria for sleep-disordered breathing with an Apnea-Hypopnea Index score of 5 or greater. The results of our study indicate that patients with CVID may have increased rates of undiagnosed sleep disorders that may contribute to increased fatigue and reduced health-related quality of life.
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Affiliation(s)
- Mantavya Punj
- Kadlec Regional Medical Center, Richland, Washington, USA
| | | | | | - Joseph Cheung
- Research Fellow in the Division of Pulmonary, Allergy, and Sleep Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Jacqueline D Squire
- Division of Pulmonary, Allergy, and Sleep Medicine, Mayo Clinic, Jacksonville, FL, USA.
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Anderson JFI. Heterogeneity of health-related quality of life after mild traumatic brain injury with systemic injury: a cluster analytic approach. Disabil Rehabil 2024:1-10. [PMID: 38655716 DOI: 10.1080/09638288.2024.2345278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 04/13/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Health-related quality of life (HRQoL) is a key component of evaluating outcome after mild traumatic brain injury (mTBI). As outcome is heterogeneous following mTBI, it is relevant to examine individual differences in HRQoL. This study investigated whether multiple homogenous subgroups could be meaningfully identified, 10 weeks after hospitalised mTBI with systemic injury, on the basis of HRQoL profiles. METHODS Ninety-one adults were assessed for HRQoL, pain, fatigue, sleep quality, psychological distress, cognition and post-concussion symptoms. RESULTS Cluster analyses revealed three separate subgroups based on physical, mental, social and energy HRQoL. One group (42%) demonstrated normative levels of HRQoL on all subdomains. The remaining two groups demonstrated significantly reduced HRQoL on all subdomains. These groups had equivalently poor mental, social and energy HRQoL, but the smallest group (27%) had significantly poorer physical HRQoL. Multinomial logistic regression revealed that pain significantly and independently predicted group membership for the particularly poor physical HRQoL group. Fatigue was the only significant independent predictor of group membership for the remaining group with reduced HRQoL. CONCLUSION These findings suggest more than 50% of hospitalised individuals with mTBI and systemic injury, have reduced HRQoL, 10 weeks after mTBI. Pain and fatigue warrant clinical attention in these individuals.IMPLICATIONS FOR REHABILITATIONMild traumatic brain injury is a common event that has been shown to be associated with persistently reduced health-related quality of life in approximately 50% of individuals 6 to 12 months after injury.Health-related quality of life likely varies between individuals after injuryRelative to the "normal" population, most individuals in this cohort of individuals with mTBI and systemic injury had reduced mental, social and energy quality of life 10 weeks after injury.Fatigue and pain are important factors in reduced health-related quality of life after mTBI with systemic injury.Further research is needed to determine whether these fatigue and pain issues are related to mTBI-factors, such as headache, and/or related to systemic injury factors, which are common in the mTBI population.
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Affiliation(s)
- Jacqueline F I Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia
- Senior Clinical Neuropsychologist, Psychology Department, The Alfred hospital, Commercial Rd, Melbourne, Australia
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Zhang X, Perry RJ. Metabolic underpinnings of cancer-related fatigue. Am J Physiol Endocrinol Metab 2024; 326:E290-E307. [PMID: 38294698 DOI: 10.1152/ajpendo.00378.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/01/2024]
Abstract
Cancer-related fatigue (CRF) is one of the most prevalent and detrimental complications of cancer. Emerging evidence suggests that obesity and insulin resistance are associated with CRF occurrence and severity in cancer patients and survivors. In this narrative review, we analyzed recent studies including both preclinical and clinical research on the relationship between obesity and/or insulin resistance and CRF. We also describe potential mechanisms for these relationships, though with the caveat that because the mechanisms underlying CRF are incompletely understood, the mechanisms mediating the association between obesity/insulin resistance and CRF are similarly incompletely delineated. The data suggest that, in addition to their effects to worsen CRF by directly promoting tumor growth and metastasis, obesity and insulin resistance may also contribute to CRF by inducing chronic inflammation, neuroendocrinological disturbance, and metabolic alterations. Furthermore, studies suggest that patients with obesity and insulin resistance experience more cancer-induced pain and are at more risk of emotional and behavioral disruptions correlated with CRF. However, other studies implied a potentially paradoxical impact of obesity and insulin resistance to reduce CRF symptoms. Despite the need for further investigation utilizing interventions to directly elucidate the mechanisms of cancer-related fatigue, current evidence demonstrates a correlation between obesity and/or insulin resistance and CRF, and suggests potential therapeutics for CRF by targeting obesity and/or obesity-related mediators.
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Affiliation(s)
- Xinyi Zhang
- Departments of Cellular & Molecular Physiology and Medicine (Endocrinology), Yale University School of Medicine, New Haven, Connecticut, United States
| | - Rachel J Perry
- Departments of Cellular & Molecular Physiology and Medicine (Endocrinology), Yale University School of Medicine, New Haven, Connecticut, United States
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7
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Yang Q, Wu Q, Zhan Q, Deng L, Ding Y, Wang F, Chen J, Xie L. Association between cytokines and fatigue in patients with type 1 narcolepsy. J Clin Neurosci 2024; 120:102-106. [PMID: 38237487 DOI: 10.1016/j.jocn.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/19/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Fatigue is a frequent complaint among patients with narcolepsy. Studies have shown that inflammatory cytokines are associated with fatigue in neurological disorders; however, this association has not been identified in patients with type 1 narcolepsy. The purpose of this study was to investigate the potential relationship between cytokines and fatigue in patients with type 1 narcolepsy. METHODS We investigated the association between 12 inflammatory cytokines and fatigue in 49 patients with type 1 narcolepsy. The Multidimensional Fatigue Inventory-20 was used to assess the fatigue severity. The associations of fatigue were identified using Spearman and Pearson correlation analyses. A linear regression analysis model was used to adjust the confounding factors and evaluate the associations of fatigue. RESULTS Correlation analysis showed that the plasma interleukin (IL)-2 level (r = 0.409, p = 0.004) was positively correlated with fatigue in patients with narcolepsy type 1. After adjusting for confounding factors, the linear regression model revealed a positive association between the IL-2 level (β = 1.148, p = 0.04) and fatigue in individuals diagnosed with type 1 narcolepsy. CONCLUSION IL-2 levels show a positive correlation with fatigue in type 1 narcolepsy, suggesting its potential role in the pathophysiology of fatigue.
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Affiliation(s)
- Qiao Yang
- Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Qiong Wu
- Department of Clinical Laboratory, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China; Jiangxi Province Key Laboratory of Laboratory Medicine, Nanchang, China; Jiangxi Provincial Clinical Research Center for Laboratory Medicine, Nanchang, China
| | - Qinqin Zhan
- Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China
| | - Liying Deng
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China; Jiangxi Key Laboratory of Neurological Tumors and Cerebrovascular Diseases, Nanchang, China; Jiangxi Health Commission Key Laboratory of Neurological Medicine, Nanchang, China; Institute of Neuroscience, Nanchang University, Nanchang, China
| | - Yongmin Ding
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China; Jiangxi Key Laboratory of Neurological Tumors and Cerebrovascular Diseases, Nanchang, China; Jiangxi Health Commission Key Laboratory of Neurological Medicine, Nanchang, China; Institute of Neuroscience, Nanchang University, Nanchang, China
| | - Fen Wang
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China; Jiangxi Key Laboratory of Neurological Tumors and Cerebrovascular Diseases, Nanchang, China; Jiangxi Health Commission Key Laboratory of Neurological Medicine, Nanchang, China; Institute of Neuroscience, Nanchang University, Nanchang, China
| | - Jin Chen
- Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
| | - Liang Xie
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China; Jiangxi Key Laboratory of Neurological Tumors and Cerebrovascular Diseases, Nanchang, China; Jiangxi Health Commission Key Laboratory of Neurological Medicine, Nanchang, China; Institute of Neuroscience, Nanchang University, Nanchang, China.
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8
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Chen P, Zhao YJ, An FR, Li XH, Lam MI, Lok KI, Wang YY, Li JX, Su Z, Cheung T, Ungvari GS, Ng CH, Zhang Q, Xiang YT. Prevalence of insomnia and its association with quality of life in caregivers of psychiatric inpatients during the COVID-19 pandemic: a network analysis. BMC Psychiatry 2023; 23:837. [PMID: 37964197 PMCID: PMC10644468 DOI: 10.1186/s12888-023-05194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/14/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Studies on sleep problems among caregivers of psychiatric patients, especially during the COVID-19 pandemic, are limited. This study examined the prevalence and correlates of insomnia symptoms (insomnia hereafter) among caregivers of psychiatric inpatients during the COVID-19 pandemic as well as the association with quality of life (QoL) from a network analysis perspective. METHODS A multi-center cross-sectional study was conducted on caregivers of inpatients across seven tertiary psychiatric hospitals and psychiatric units of general hospitals. Network analysis explored the structure of insomnia using the R program. The centrality index of "Expected influence" was used to identify central symptoms in the network, and the "flow" function was adopted to identify specific symptoms that were directly associated with QoL. RESULTS A total of 1,101 caregivers were included. The overall prevalence of insomnia was 18.9% (n = 208; 95% CI = 16.7-21.3%). Severe depressive (OR = 1.185; P < 0.001) and anxiety symptoms (OR = 1.099; P = 0.003), and severe fatigue (OR = 1.320; P < 0.001) were associated with more severe insomnia. The most central nodes included ISI2 ("Sleep maintenance"), ISI7 ("Distress caused by the sleep difficulties") and ISI1 ("Severity of sleep onset"), while "Sleep dissatisfaction" (ISI4), "Distress caused by the sleep difficulties" (ISI7) and "Interference with daytime functioning" (ISI5) had the strongest negative associations with QoL. CONCLUSION The insomnia prevalence was high among caregivers of psychiatric inpatients during the COVID-19 pandemic, particularly in those with depression, anxiety and fatigue. Considering the negative impact of insomnia on QoL, effective interventions that address insomnia and alteration of sleep dissatisfaction should be developed.
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Affiliation(s)
- Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Yan-Jie Zhao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Feng-Rong An
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Kiang Wu Nursing College of Macau, Macao SAR, China
| | - Ka-In Lok
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao SAR, China
| | - Yue-Ying Wang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Jia-Xin Li
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia.
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
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9
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Tereshko Y, Dal Bello S, Di Lorenzo C, Pittino A, Filippi F, Belgrado E, Lettieri C, Merlino G, Gigli GL, Valente M. The Effect of Three Different Ketogenic Diet Protocols on Migraine and Fatigue in Chronic and High-Frequency Episodic Migraine: A Pilot Study. Nutrients 2023; 15:4334. [PMID: 37892410 PMCID: PMC10609491 DOI: 10.3390/nu15204334] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
AIMS We aimed to evaluate the efficacy of three different ketogenic diets on migraine and fatigue in chronic and high-frequency episodic migraineurs. METHODS 76 patients with migraine were treated with the KD for at least three months. Three different KD protocols were used (2:1 KD, LGID, and VLCKD). We evaluated the fatigue severity scale (FSS), migraine frequency, migraine intensity, MIDAS, and HIT-6 at the baseline and 3-month follow-up, and we compared the results. We also correlated the mean FSS reduction with the mean migraine frequency, migraine intensity, BMI, fat mass, free-fat mass, MIDAS, and HIT-6 reduction. RESULTS FSS improved from 4.977 ± 1.779 to 3.911 ± 1.779 at the 3-month follow-up (p < 0.001). This improvement was significant in both high-frequency and chronic migraineurs. Moreover, the three KD protocols effectively improved migraine intensity, frequency, MIDAS, and HIT-6. There was a mild correlation between mean FSS reduction (p < 0.001), mean MIDAS (p = 0.001), and HIT-6 (p = 0.002) reduction. CONCLUSIONS The VLCKD, LGID, and 2:1 KD may improve migraine intensity, frequency, and fatigue in chronic and high-frequency episodic migraineurs.
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Affiliation(s)
- Yan Tereshko
- Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy (F.F.); (G.M.); (M.V.)
| | - Simone Dal Bello
- Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy (F.F.); (G.M.); (M.V.)
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, 04100 Latina, Italy
| | - Alice Pittino
- Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy (F.F.); (G.M.); (M.V.)
| | - Francesca Filippi
- Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy (F.F.); (G.M.); (M.V.)
| | - Enrico Belgrado
- Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy;
| | - Christian Lettieri
- Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy (F.F.); (G.M.); (M.V.)
| | - Giovanni Merlino
- Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy (F.F.); (G.M.); (M.V.)
| | - Gian Luigi Gigli
- Department of Medicine (DAME), University of Udine, Via Colugna 50, 33100 Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy (F.F.); (G.M.); (M.V.)
- Department of Medicine (DAME), University of Udine, Via Colugna 50, 33100 Udine, Italy
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van Berkel AC, Schiphof D, Waarsing JH, Runhaar J, van Ochten JM, Bindels PJ, Bierma-Zeinstra SM. Nocturnal pain and fatigue in middle-aged persons with hip symptoms suspected to be osteoarthritis, is there a link in 10-year follow-up of the CHECK study? OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100363. [PMID: 37214788 PMCID: PMC10192639 DOI: 10.1016/j.ocarto.2023.100363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/11/2023] [Indexed: 05/24/2023] Open
Abstract
Objective To explore the prevalence of nocturnal pain and fatigue in participants with hip symptoms suspected to be early osteoarthritis (OA) and to test the mediating effect of nocturnal pain on the association between hip OA pain and fatigue. Methods We included participants with hip pain but no knee pain at baseline, from the Cohort Hip and Cohort Knee (CHECK)-study. Severity of hip OA pain was determined using the Numeric-Rating-Scale-pain-score last week. Fatigue was assessed using the SF-36 Fatigue subscale. Nocturnal pain was determined using the WOMAC-question: "How much pain have you experienced in the last 48 h at night while in bed?". Hip OA pain, nocturnal pain and fatigue were measured repeatedly during 10-year follow-up. Path analysis were used per time point to determine the direct effect of OA pain on fatigue and the indirect effect through nocturnal pain. Results In 170 participants (female: 76%; mean age: 55.7 years; mean BMI: 25.5 kg/m2) the prevalence of nocturnal pain varied between 22 and 35% and the prevalence of fatigue ranged between 14 and 18%. Hip OA pain was associated with nocturnal pain and fatigue. The direct effect of hip OA pain on fatigue was significant at all-time points. No significant mediating effect of nocturnal pain was found. Conclusion In this cohort of participants suspected to have early hip OA, the prevalence of fatigue remained stable and the prevalence of nocturnal pain decreased slightly over 10-year follow-up. We did not find a mediating effect of nocturnal pain in the pathway between hip OA pain and fatigue.
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Affiliation(s)
- Annemaria C. van Berkel
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jan H. Waarsing
- Department of Orthopaedics, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jos Runhaar
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - John M. van Ochten
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Patrick J.E. Bindels
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sita M.A. Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Orthopaedics, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
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11
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Ioannucci S, Chirokoff V, Dilharreguy B, Ozenne V, Chanraud S, Zénon A. Neural fatigue by passive induction: repeated stimulus exposure results in cognitive fatigue and altered representations in task-relevant networks. Commun Biol 2023; 6:142. [PMID: 36737639 PMCID: PMC9898557 DOI: 10.1038/s42003-023-04527-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 01/24/2023] [Indexed: 02/05/2023] Open
Abstract
Cognitive fatigue is defined by a reduced capacity to perform mental tasks. Despite its pervasiveness, the underlying neural mechanisms remain elusive. Specifically, it is unclear whether prolonged effort affects performance through alterations in over-worked task-relevant neuronal assemblies. Our paradigm based on repeated passive visual stimulation discerns fatigue effects from the influence of motivation, skill and boredom. We induced performance loss and observed parallel alterations in the neural blueprint of the task, by mirroring behavioral performance with multivariate neuroimaging techniques (MVPA) that afford a subject-specific approach. Crucially, functional areas that responded the most to repeated stimulation were also the most affected. Finally, univariate analysis revealed clusters displaying significant disruption within the extrastriate visual cortex. In sum, here we show that repeated stimulation impacts the implicated brain areas' activity and causes tangible behavioral repercussions, providing evidence that cognitive fatigue can result from local, functional, disruptions in the neural signal induced by protracted recruitment.
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Affiliation(s)
- Stefano Ioannucci
- Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA)-UMR 5287, CNRS, University of Bordeaux, Bordeaux, France. .,Visual and Cognitive Neuroscience Lab, University of Fribourg, Fribourg, Switzerland.
| | - Valentine Chirokoff
- grid.412041.20000 0001 2106 639XInstitut de Neurosciences Cognitives et Intégratives d’Aquitaine (INCIA)—UMR 5287, CNRS, University of Bordeaux, Bordeaux, France ,grid.440907.e0000 0004 1784 3645École Pratique des Hautes Études (EPHE), PSL Research University, Paris, France
| | - Bixente Dilharreguy
- grid.412041.20000 0001 2106 639XInstitut de Neurosciences Cognitives et Intégratives d’Aquitaine (INCIA)—UMR 5287, CNRS, University of Bordeaux, Bordeaux, France
| | - Valéry Ozenne
- grid.412041.20000 0001 2106 639XCentre de Résonance Magnétique des Systèmes Biologiques, UMR 5536, CNRS/Université de Bordeaux, Bordeaux, France
| | - Sandra Chanraud
- grid.412041.20000 0001 2106 639XInstitut de Neurosciences Cognitives et Intégratives d’Aquitaine (INCIA)—UMR 5287, CNRS, University of Bordeaux, Bordeaux, France ,grid.440907.e0000 0004 1784 3645École Pratique des Hautes Études (EPHE), PSL Research University, Paris, France
| | - Alexandre Zénon
- grid.412041.20000 0001 2106 639XInstitut de Neurosciences Cognitives et Intégratives d’Aquitaine (INCIA)—UMR 5287, CNRS, University of Bordeaux, Bordeaux, France
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12
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Anderson JFI, Jordan AS. Sex predicts post-concussion symptom reporting, independently of fatigue and subjective sleep disturbance, in premorbidly healthy adults after mild traumatic brain injury. Neuropsychol Rehabil 2023; 33:173-188. [PMID: 34724887 DOI: 10.1080/09602011.2021.1993274] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The relationship between sex and post-concussion symptom (PCS) reporting after mild traumatic brain injury (mTBI) is not well understood. Subjective sleep disturbance and fatigue impact PCS reporting after mTBI and show sex differences in the normal population. This study investigated whether sex had a relationship with PCS reporting after mTBI, independently of self-reported sleep disturbance and fatigue. Ninety-two premorbidly healthy adults in the post-acute period after mTBI completed the Rivermead Post-Concussion Symptoms Questionnaire, the Pittsburgh Sleep Quality Index, the Multidimensional Fatigue Inventory and measures of depression, anxiety and post-traumatic stress symptomatology. Females (n = 23) demonstrated higher levels of fatigue (p = .019) and greater psychological distress (p = .001) than males (n = 69), but equivalent levels of sleep disturbance (p = .946). Bootstrapping analyses were undertaken because PCS responses were not normally distributed. Female sex predicted greater PCS reporting (p = .001), independently of subjective sleep disturbance, fatigue, psychological distress and litigation status. The current findings support and extend previous work showing premorbidly healthy females are at higher risk of experiencing elevated PCS after mTBI than males in the post-acute period after mTBI. It may be beneficial for clinicians to be particularly sensitive to increased symptom reporting after mTBI in females, irrespective of sleep quality, fatigue or psychological status.
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Affiliation(s)
- Jacqueline F I Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.,Psychology Department, The Alfred Hospital, Prahran, Australia
| | - Amy S Jordan
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
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13
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Habibi Asgarabad M, Doos Ali Vand H, Salehi Yegaei P, Hooman F, Ahmadi R, Baglioni C, Moradi S. The contribution of transdiagnostic vulnerability factors in patients with chronic insomnia. Front Psychiatry 2023; 14:1162729. [PMID: 37077275 PMCID: PMC10106755 DOI: 10.3389/fpsyt.2023.1162729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/14/2023] [Indexed: 04/21/2023] Open
Abstract
Introduction Various transdiagnostic factors have been associated with insomnia severity. The current study aimed to predict insomnia severity based on a group of transdiagnostic factors including neuroticism, emotion regulation, perfectionism, psychological inflexibility, anxiety sensitivity, and repetitive negative thinking after controlling for depression/anxiety symptoms and demographic characteristics. Methods Two hundred patients with chronic insomnia disorder were recruited from a sleep disorder clinic. Participants completed the Insomnia Severity Index (ISI), Clinical Perfectionism Questionnaire (CPQ), Acceptance and Action Questionnaire-II (AAQ-II), Anxiety Sensitivity Index-3 (ASI-3), Repetitive Thinking Questionnaire (RTQ-10), Big Five Inventory (BFI-10), Emotion Regulation Questionnaire (ERQ), and Depression Anxiety Stress Scale (DASS-21). Results After controlling for the confounding variables (depression/anxiety symptoms and demographic characteristics), hierarchical multiple linear regression suggested the significant association of neuroticism (BFI), cognitive reappraisal (ERQ), personal standards (CPQ), evaluative concerns (CPQ), physical concerns (ASI), cognitive concerns (ASI), and repetitive negative thinking (RTQ) with insomnia severity. Discussion The findings support the role of transdiagnostic factors, especially physical concerns, repetitive negative thinking, and neuroticism in chronic insomnia. Future research using longitudinal designs is required to verify the causal status of transdiagnostic variables.
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Affiliation(s)
- Mojtaba Habibi Asgarabad
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Positive Youth Development Lab, Human Development & Family Sciences, Texas Tech University, Texas, TX, United States
- Center of Excellence in Cognitive Neuropsychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Hoda Doos Ali Vand
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pardis Salehi Yegaei
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
| | - Farzaneh Hooman
- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Reza Ahmadi
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
- Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Chiara Baglioni
- Human Sciences Department, University of Rome Guglielmo Marconi Rome, Rome, Italy
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Shahram Moradi
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Porsgrunn, Norway
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14
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Benkirane O, Delwiche B, Mairesse O, Peigneux P. Impact of Sleep Fragmentation on Cognition and Fatigue. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15485. [PMID: 36497559 PMCID: PMC9740245 DOI: 10.3390/ijerph192315485] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Abstract
Sleep continuity and efficacy are essential for optimal cognitive functions. How sleep fragmentation (SF) impairs cognitive functioning, and especially cognitive fatigue (CF), remains elusive. We investigated the impact of induced SF on CF through the TloadDback task, measuring interindividual variability in working memory capacity. Sixteen participants underwent an adaptation polysomnography night and three consecutive nights, once in a SF condition induced by non-awakening auditory stimulations, once under restorative sleep (RS) condition, counterbalanced within-subject. In both conditions, participants were administered memory, vigilance, inhibition and verbal fluency testing, and for CF the TloadDback, as well as sleep questionnaires and fatigue and sleepiness visual analog scales were administered. Subjective fatigue increased and sleep architecture was altered after SF (reduced sleep efficiency, percentage of N3 and REM, number of NREM and REM phases) despite similar total sleep time. At the behavioral level, only inhibition deteriorated after SF, and CF similarly evolved in RS and SF conditions. In line with prior research, we show that SF disrupts sleep architecture and exerts a deleterious impact on subjective fatigue and inhibition. However, young healthy participants appear able to compensate for CF induced by three consecutive SF nights. Further studies should investigate SF effects in extended and/or pathological disruption settings.
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Affiliation(s)
- Oumaïma Benkirane
- UR2NF—Neuropsychology and Functional Neuroimaging Research Unit, at CRCN—Centre for Research in Cognition and Neurosciences and UNI—ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
- Brugmann University Hospital, Sleep Laboratory & Unit for Chronobiology U78, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
| | - Bérénice Delwiche
- Brugmann University Hospital, Sleep Laboratory & Unit for Chronobiology U78, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
| | - Olivier Mairesse
- Brugmann University Hospital, Sleep Laboratory & Unit for Chronobiology U78, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
| | - Philippe Peigneux
- UR2NF—Neuropsychology and Functional Neuroimaging Research Unit, at CRCN—Centre for Research in Cognition and Neurosciences and UNI—ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
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15
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Eldridge-Smith ED, Manber R, Tsai S, Kushida C, Simmons B, Johnson R, Horberg R, Depew A, Abraibesh A, Simpson N, Strand M, Espie CA, Edinger JD. Stepped care management of insomnia co-occurring with sleep apnea: the AIR study protocol. Trials 2022; 23:806. [PMID: 36153634 PMCID: PMC9509569 DOI: 10.1186/s13063-022-06753-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) and insomnia are commonly co-occurring conditions that amplify morbidity and complicates the management of affected patients. Unfortunately, previous research provides limited guidance as to what constitutes the best and most practical management approach for this comorbid patient group. Some preliminary studies show that when cognitive behavioral insomnia therapy (CBT-I) is combined with standard OSA therapies for these patients, outcomes are improved. However, the dearth of trained providers capable of delivering CBT-I has long served as a pragmatic barrier to the widespread use of this therapy in clinical practice. The emergence of sophisticated online CBT-I (OCBT-I) programs could improve access, showing promising reductions in insomnia severity. Given its putative scalability and apparent efficacy, some have argued OCBT-I should represent a 1st-stage intervention in a broader stepped care model that allocates more intensive and less assessable therapist-delivered CBT-I (TCBT-I) only to those who show an inadequate response to lower intensity OCBT-I. However, the efficacy of OCBT-I as a 1st-stage therapy within a broader stepped care management strategy for insomnia comorbid with OSA has yet to be tested with comorbid OSA/insomnia patients. METHODS/DESIGN This dual-site randomized clinical trial will use a Sequential Multiple Assignment Randomized Trial (SMART) design to test a stepped care model relative to standard positive airway pressure (PAP) therapy and determine if (1) augmentation of PAP therapy with OCBT-I improves short-term outcomes of comorbid OSA/insomnia and (2) providing a higher intensity 2nd-stage CBT-I to patients who show sub-optimal short-term outcomes with OCBT-I+PAP improves short and longer-term outcomes. After completing baseline assessment, the comorbid OSA/insomnia patients enrolled will be randomized to a 1st-stage therapy that includes usual care PAP + OCBT-I or UC (usual care PAP + sleep hygiene education). Insomnia will be reassessed after 8 weeks. OCBT-I recipients who meet "remission" criteria (defined as an Insomnia Severity Index score < 10) will continue PAP but will not be offered any additional insomnia intervention and will complete study outcome measures again after an additional 8 weeks and at 3 and 6 month follow-ups. OCBT-I recipients classified as "unremitted" after 8 weeks of treatment will be re-randomized to a 2nd-stage treatment consisting of continued, extended access to OCBT-I or a switch to TCBT-I. Those receiving the 2nd-stage intervention as well as the UC group will be reassessed after another 8 weeks and at 3- and 6-month follow-up time points. The primary outcome will be insomnia remission. Secondary outcomes will include subjective and objective sleep data, including sleep time, sleep efficiency, fatigue ratings, PAP adherence, sleepiness ratings, sleep/wake functioning ratings, and objective daytime alertness. DISCUSSION This study will provide new information about optimal interventions for patients with comorbid OSA and insomnia to inform future clinical decision-making processes. TRIAL REGISTRATION ClinicalTrials.gov, NCT03109210 , registered on April 12, 2017, prospectively registered.
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Affiliation(s)
| | - Rachel Manber
- Stanford University, 401 Quarry Road, Stanford, CA 94305 USA
| | - Sheila Tsai
- National Jewish Health, 1400 Jackson St, Denver, CO 80206 USA
| | - Clete Kushida
- Stanford University, 450 Broadway Street, Redwood City, CA USA
| | - Bryan Simmons
- National Jewish Health, 1400 Jackson St, Denver, CO 80206 USA
| | - Rachel Johnson
- National Jewish Health, 1400 Jackson St, Denver, CO 80206 USA
| | - Roxane Horberg
- National Jewish Health, 1400 Jackson St, Denver, CO 80206 USA
| | - Ann Depew
- National Jewish Health, 1400 Jackson St, Denver, CO 80206 USA
| | - Aysha Abraibesh
- Stanford University, 401 Quarry Road, Stanford, CA 94305 USA
| | - Norah Simpson
- Stanford University, 401 Quarry Road, Stanford, CA 94305 USA
| | - Matthew Strand
- National Jewish Health, 1400 Jackson St, Denver, CO 80206 USA
| | - Colin A. Espie
- Big Health, 461 Bush St #200, San Francisco, CA 94108 USA
- University of Oxford, Oxford, OX1 2JD UK
| | - Jack D. Edinger
- National Jewish Health, 1400 Jackson St, Denver, CO 80206 USA
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16
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Ahmed S, Alam S, Alsabri M. Health-Related Quality of Life in Pediatric Inflammatory Bowel Disease Patients: A Narrative Review. Cureus 2022; 14:e29282. [PMID: 36277571 PMCID: PMC9578282 DOI: 10.7759/cureus.29282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 12/02/2022] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic autoimmune condition that can have a wide range of symptoms among pediatric patients. Although clinical symptoms like hematochezia, diarrhea, and abdominal pain are commonly addressed, health-related quality of life (HRQOL) is often overlooked in patients with IBD and pediatric patients with chronic disease in general. Examining HRQOL can help improve patient outcomes, but it has been studied sparingly. In this review, we aim to compare HRQOL between pediatric patients suffering from IBD and healthy children, as well as those suffering from other illnesses. We searched through peer-reviewed primary literature related to IBD and HRQOL and selected 10 articles from the PubMed database to be reviewed. Our inclusion criteria included articles published after the year 2000 in English, primary studies, and those that corresponded to the aim of this review. Case reports and secondary and tertiary articles were excluded from our review. We found that patients with IBD reported worse HRQOL in terms of overall health and in various subdomains, including physical health and fatigue, compared to their healthy counterparts. However, children with IBD demonstrated a comparable HRQOL with children suffering from functional abdominal pain (FAP) and obesity. Additionally, children with IBD displayed a greater HRQOL than pediatric patients with gastroesophageal reflux disease (GERD) and chronic constipation. In addressing the aim of this review, we found that children with IBD had a lower HRQOL when compared to healthy children, but a comparable or greater HRQOL than other sick children. Some factors associated with a reduced HRQOL include disease activity, age, fatigue, gender, psychological variables, and associated symptoms. Going forward, HRQOL should be considered by practitioners when caring for pediatric IBD patients in a clinical setting as it can help improve patient care. More studies need to be conducted to further explore HRQOL in pediatric patients. This can help implement early psychosocial interventions in children to reduce the disease burden.
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17
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Chepke C, Jain R, Rosenberg R, Moline M, Yardley J, Pinner K, Kumar D, Perdomo C, Filippov G, Atkins N, Malhotra M. Improvement in fatigue and sleep measures with the dual orexin receptor antagonist lemborexant in adults with insomnia disorder. Postgrad Med 2022; 134:316-325. [DOI: 10.1080/00325481.2022.2049553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Craig Chepke
- Excel Psychiatric Associates, PA, Huntersville, NC, USA
| | - Rakesh Jain
- Texas Tech University School of Medicine – Permian Basin, Midland, TX, USA
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18
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Ditmer M, Gabryelska A, Turkiewicz S, Białasiewicz P, Małecka-Wojciesko E, Sochal M. Sleep Problems in Chronic Inflammatory Diseases: Prevalence, Treatment, and New Perspectives: A Narrative Review. J Clin Med 2021; 11:67. [PMID: 35011807 PMCID: PMC8745687 DOI: 10.3390/jcm11010067] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/15/2021] [Accepted: 12/19/2021] [Indexed: 12/12/2022] Open
Abstract
Epidemiological studies have shown that individuals with sleep problems are at a greater risk of developing immune and chronic inflammatory diseases. As sleep disorders and low sleep quality in the general population are frequent ailments, it seems important to recognize them as serious public health problems. The exact relation between immunity and sleep remains elusive; however, it might be suspected that it is shaped by others stress and alterations of the circadian rhythm (commonly caused by for example shift work). As studies show, drugs used in the therapy of chronic inflammatory diseases, such as steroids or monoclonal antibodies, also influence sleep in more complex ways than those resulting from attenuation of the disease symptoms. Interestingly, the relation between sleep and immunity appears to be bidirectional; that is, sleep may influence the course of immune diseases, such as inflammatory bowel disease. Thus, proper diagnosis and treatment of sleep disorders are vital to the patient's immune status and, in effect, health. This review examines the epidemiology of sleep disorders and immune diseases, the associations between them, and their current treatment and novel perspectives in therapy.
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Affiliation(s)
- Marta Ditmer
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (M.D.); (A.G.); (S.T.); (P.B.)
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (M.D.); (A.G.); (S.T.); (P.B.)
| | - Szymon Turkiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (M.D.); (A.G.); (S.T.); (P.B.)
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (M.D.); (A.G.); (S.T.); (P.B.)
| | - Ewa Małecka-Wojciesko
- Department of Digestive Tract Diseases, Medical University of Lodz, 92-215 Lodz, Poland;
| | - Marcin Sochal
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (M.D.); (A.G.); (S.T.); (P.B.)
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19
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Shadlow JO, Kell PA, Toledo TA, Huber FA, Kuhn BL, Lannon EW, Hellman N, Sturycz CA, Ross EN, Rhudy JL. Sleep Buffers the Effect of Discrimination on Cardiometabolic Allostatic Load in Native Americans: Results from the Oklahoma Study of Native American Pain Risk. J Racial Ethn Health Disparities 2021; 9:1632-1647. [PMID: 34319571 DOI: 10.1007/s40615-021-01103-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/18/2021] [Accepted: 07/02/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Compared to other racial/ethnic groups, Native Americans (NAs) are more likely to develop health conditions associated with allostatic load (stress-related wear-and-tear). Psychosocial factors (i.e., adverse life events, discrimination, psychological distress) often promote stress and may help explain greater allostatic load in NAs. Moreover, previous research suggests sleep may either mediate or moderate the effects of some psychosocial stressors, like discrimination, on allostatic load. The current study investigated the relationship between adverse life events, discrimination, psychological stress, sleep, and cardiometabolic load. METHODS Using a sample of 302 healthy, chronic pain-free NAs and non-Hispanic White (NHW) participants, bootstrapped mediation analyses were conducted to determine whether the relationship between NA race/ethnicity and cardiometabolic allostatic load (composite score of body mass index, mean arterial pressure, and heart rate variability) was mediated by psychosocial stressors. Models also assessed whether sleep disturbance served as an additional mediator or a moderator to the effects. RESULTS Consistent with prior research, we found that NAs experienced greater discrimination, adverse life events (potentially traumatic events), and cardiometabolic allostatic load than NHWs. Further, discrimination was associated with increased psychological stress for NAs, but this did not explain why NAs experience higher cardiometabolic allostatic load. A moderating effect of sleep on discrimination was found, such that discrimination partially contributed to the relationship between NA race/ethnicity and cardiometabolic allostatic load, but only for participants reporting greater sleep disturbance. Implications These findings highlight that good sleep can buffer the effect of psychosocial stress on cardiometabolic allostatic load in Native Americans.
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Affiliation(s)
- Joanna O Shadlow
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA.
| | - Parker A Kell
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Tyler A Toledo
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Felicitas A Huber
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Bethany L Kuhn
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Edward W Lannon
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Natalie Hellman
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Cassandra A Sturycz
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Erin N Ross
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Jamie L Rhudy
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
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20
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Liu J, Glenn AL, Cui N, Raine A. Longitudinal bidirectional association between sleep and behavior problems at age 6 and 11 years. Sleep Med 2021; 83:290-298. [PMID: 34091178 PMCID: PMC10117417 DOI: 10.1016/j.sleep.2021.04.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Although a growing number of longitudinal studies have found that sleep problems precede behavior problems, few have examined potential bidirectional relationships longitudinally. The present study examined prospective associations between sleep problems and internalizing, externalizing, and attention problems over the course of childhood. METHODS Participants included 775 children from the China Jintan Cohort Study. Sleep problems were rated by mothers at ages six and 11.5, as well as self-reported by children at age 11.5. Behavior problems were rated by mothers and teachers at ages six and 11.5, and self-reported by children at age 11.5. RESULTS At age six, 15.0% of children were reported to have sleep problems as rated by mothers. At age 11, this prevalence was 12% as rated by mothers and 20% as rated by youth. Bidirectional relationships between sleep problems and behavior problems were observed. Mother-reported sleep problems at age six were predictive of self-reported internalizing and attention problems at age 11.5, even after controlling for baseline behavioral problems. At age six, teacher-reported externalizing, internalizing, and attention problems, and mother-rated internalizing and externalizing problems were all related to sleep problems at age 11.5, even after controlling for baseline sleep problems. Other sociodemographic covariates including child sex, age, and parental education were controlled for. CONCLUSIONS Findings provide further support for the reciprocal relationship between sleep problems and behavior problems. Early interventions that target both types of problems may be especially effective in preventing this aggravating health-behavior cycle.
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Affiliation(s)
- Jianghong Liu
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
| | - Andrea L Glenn
- University of Alabama, Center for Youth Development and Intervention, Department of Psychology, Tuscaloosa, AL, USA
| | - Naixue Cui
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA; Shandong University School of Nursing and Rehabilitation, Jinan, Shandong Province, China
| | - Adrian Raine
- University of Pennsylvania, Departments of Criminology, Psychiatry, and Psychology, Philadelphia, PA, USA
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21
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Harris AL, Carmona NE, Moss TG, Carney CE. Testing the contiguity of the sleep and fatigue relationship: a daily diary study. Sleep 2021; 44:6007511. [PMID: 33245330 DOI: 10.1093/sleep/zsaa252] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/22/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES There is mixed evidence for the relationship between poor sleep and daytime fatigue, and some have suggested that fatigue is simply caused by lack of sleep. Although retrospective measures of insomnia and fatigue tend to correlate, other studies fail to demonstrate a link between objectively disturbed sleep and fatigue. The current study prospectively explored the relationship between sleep and fatigue among those with and without insomnia disorder. METHODS Participants meeting Research Diagnostic Criteria for insomnia disorder (n = 33) or normal sleepers (n = 32) completed the Consensus Sleep Diary (CSD) and daily fatigue ratings for 2 weeks. Baseline questionnaires evaluated cognitive factors including unhelpful beliefs about sleep and rumination about fatigue. Hierarchical linear modeling tested the within- and between-participant relationships between sleep quality, total sleep time, and daily fatigue ratings. Mediation analyses tested if cognitive factors mediated the relationship between insomnia and fatigue. RESULTS Self-reported nightly sleep quality significantly predicted subsequent daily fatigue ratings. Total sleep time was a significant predictor of fatigue within, but not between, participants. Unhelpful sleep beliefs and rumination about fatigue mediated the relationship between insomnia and fatigue reporting. CONCLUSIONS The results suggest that perception of sleep plays an important role in predicting reports of daytime fatigue. These findings could be used in treatment to help shift the focus away from total sleep times, and instead, focus on challenging maladaptive sleep-related cognitions to change fatigue perception.
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Affiliation(s)
- Andrea L Harris
- Department of Psychology, Ryerson University, Toronto, Canada
| | | | - Taryn G Moss
- Department of Psychology, Ryerson University, Toronto, Canada
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22
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Anderson JFI, Jordan AS. An observational study of the association between sleep disturbance, fatigue and cognition in the post-acute period after mild traumatic brain injury in prospectively studied premorbidly healthy adults. Neuropsychol Rehabil 2020; 31:1444-1465. [PMID: 32558623 DOI: 10.1080/09602011.2020.1781665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The literature examining the relationship between sleep disturbance, fatigue, and cognition in premorbidly healthy civilian adults after mTBI is very limited. The current study aimed to investigate the relationships of sleep disturbance and fatigue with cognition while controlling for psychological distress and age. Using a prospective observational design, we assessed 60 premorbidly healthy individuals approximately 8 weeks after mTBI. Participants were assessed with the Pittsburgh Sleep Quality Index and the Multidimensional Fatigue Inventory as well as measures of speed of information processing, attention, memory, and executive function; depression and anxiety were also assessed. Findings revealed associations between sleep disturbance and cognition (r2 = .586, p < .001) as well as between fatigue and cognition (r2 = .390, p < .01), independent of the impact of psychological status and age. Associations were evident in the domains of processing speed, attention, and memory, but were most consistently apparent on measures of executive function. Greater sleep disturbance was most consistently associated with poorer cognitive function. Unexpectedly, higher levels of fatigue were associated with better cognitive function, which may be explained by the coping hypothesis. Given sleep interventions have been shown to improve sleep disturbance, these findings suggest that sleep intervention may also result in improved cognition after mTBI.
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Affiliation(s)
- Jacqueline F I Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.,Senior Clinical Neuropsychologist, Psychology Department, The Alfred Hospital, Prahran, Australia
| | - Amy S Jordan
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
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23
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Crain TL, Brossoit RM, Robles-Saenz F, Tran M. Fighting fatigue: A conceptual model of driver sleep in the gig economy. Sleep Health 2020; 6:358-365. [PMID: 32205095 DOI: 10.1016/j.sleh.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 01/23/2020] [Accepted: 02/03/2020] [Indexed: 01/09/2023]
Abstract
The purpose of this paper was to integrate the sleep science, occupational health, and organizational psychology literature to develop a conceptual model of driver sleep and fatigue in the gig economy. We develop an integrative framework, which proposes that aspects of the on-demand driving context influence driver sleep health and fatigue. Driver outcomes include safety incidents, injuries, health, job attitudes, interpersonal behavior, and performance. In addition, moderators, such as driver demographics and health conditions, can interact with aspects of the driver context. A number of practical implications are provided, addressing the ways in which occupational health researchers, online labor platform companies, and drivers can improve sleep health. This is the first paper to provide a broad understanding of how scientists, through both research and practice, can help improve sleep, a primary issue in the ridesharing industry.
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Affiliation(s)
- Tori L Crain
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523-1876.
| | - Rebecca M Brossoit
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523-1876
| | - Faviola Robles-Saenz
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523-1876
| | - Molly Tran
- Department of Nursing and Health Sciences, Elmhurst College, 190 Prospect Avenue, Elmhurst, IL 60126
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24
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Rhee J, Benden ME. Stand-Biased Desk Intervention on Sleep Quality of High School Students: A Pilot Study Using Tri-Axial Accelerometery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010037. [PMID: 31861545 PMCID: PMC6981534 DOI: 10.3390/ijerph17010037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 11/16/2022]
Abstract
Prolonged sitting is related to a sedentary inactive lifestyle and related to obesity and many metabolic problems caused by inactivity. The problem gets more serious for people who spent most of their work time in a seated position like students or office workers. In this study, we provided standing desk and stool to the local public high school and observed the changes in their behavior in terms of physical activity using tri-axial accelerometer before and after intervention. Previously published study using the same dataset under the larger project reported increased physical activity during school hours. In this study, we extracted more diverse features directly from the raw data instead of using data processed by the software that manufacturer provided. Hence, we were able to analyze the same features (sedentary, physically active time) as well as sleep-related variables. Of the interest, sleep is another important feature that can tell us about participants’ health conditions. Even if the intervention contributed to updating their behavioral patterns, the result might be nullified in the long run if their sleep pattern was compromised. The quantity and quality of sleep was not changed after the intervention. Therefore, the efficacy of standing desks has been confirmed again.
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25
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Factors associated with fatigue in patients with insomnia. J Psychiatr Res 2019; 117:24-30. [PMID: 31272015 DOI: 10.1016/j.jpsychires.2019.06.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/28/2019] [Accepted: 06/28/2019] [Indexed: 01/08/2023]
Abstract
Although fatigue is common in insomnia, the clinical associates of fatigue in patients with insomnia are largely unknown. We aimed to investigate the clinical associates of fatigue in patients with insomnia. Patients visiting the Stanford Sleep Medicine Center completed the Insomnia Severity Index (ISI), Insomnia Symptom Questionnaire (ISQ), the Fatigue Severity Scale (FSS), the Epworth Sleepiness Scale (ESS), and the Patient Health Questionnaire (PHQ-9). Among 6367 patients, 2024 were diagnosed with insomnia (age 43.06 ± 15.19 years; 1110 women and 914 men) according to the ISI and the ISQ. Insomnia patients with severe fatigue (n = 1306) showed higher insomnia symptoms, daytime sleepiness, depression and longer habitual sleep duration than those without severe fatigue (n = 718). Higher insomnia symptoms, daytime sleepiness and depressive symptoms, and longer habitual sleep duration, independently predicted higher fatigue scores. Among insomnia patients with daytime sleepiness (ESS≥10), only habitual sleep duration and depression predicted fatigue scores. The interaction between insomnia severity and daytime sleepiness significantly predicted the severity of fatigue. Depression was a significant mediator between insomnia and fatigue. For 598 insomnia patients undergoing overnight polysomnography (PSG), no significant correlations were found between fatigue and any PSG parameters. The current study suggests that managing insomnia or depression may reduce the fatigue of insomnia patients, whereas arbitrary efforts to prolong sleep duration may worsen their fatigue.
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26
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Marklund M, Braem MJA, Verbraecken J. Update on oral appliance therapy. Eur Respir Rev 2019; 28:190083. [PMID: 31554705 PMCID: PMC9488498 DOI: 10.1183/16000617.0083-2019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 08/14/2019] [Indexed: 12/26/2022] Open
Abstract
Oral appliances are increasingly recommended for selected patients with obstructive sleep apnoea (OSA) and those who do not tolerate nor prefer continuous positive airway pressure. The most commonly used oral appliance advances the lower jaw during sleep, the so-called mandibular advancement device (MAD). Patients seek treatment because of disturbing snoring, daytime symptoms, apnoeas that disturb sleep and the longer term consequences with regard to cardiovascular risks. MADs reduce the apnoea-hypopnoea index, although to various degrees among patients. Effects on daytime sleepiness have been observed mainly among the more severe OSA patients. Blood pressure may be reduced in MAD-treated OSA patients. There is, however, uncertainty about which patients will respond to this therapy in terms of apnoea reductions, decreased sleepiness and other symptoms, and reduced risk for future impaired health. The occurrence of side-effects also remains difficult to predict at present. The majority of sleep apnoea patients suffer from various comorbidities in terms of cardiovascular diseases, type 2 diabetes and depression. The most recent findings indicate that phenotyping of patients, considering various aspects of this multifaceted disease, will shed more light on the indications for MADs in patients with nightly sleep breathing disturbances. This review summarises the most recent knowledge about MAD treatment.
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Affiliation(s)
- Marie Marklund
- Dept of Odontology, Medical Faculty, Umeå University, Umeå, Sweden
| | - Marc J A Braem
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Dept of Special Dentistry Care, Antwerp University Hospital, Antwerp, Belgium
| | - Johan Verbraecken
- LEMP, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Antwerp, Belgium
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27
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McCallum SM, Batterham PJ, Calear AL, Sunderland M, Carragher N, Kazan D. Associations of fatigue and sleep disturbance with nine common mental disorders. J Psychosom Res 2019; 123:109727. [PMID: 31376877 DOI: 10.1016/j.jpsychores.2019.05.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/17/2019] [Accepted: 05/18/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the contribution of nine mental/substance use disorders to fatigue and sleep disturbance. METHODS 3620 Australians aged 18 years or older recruited from the general community via Facebook during January-February 2016 completed an online survey assessing demographic characteristics, diagnosed medical conditions and nine mental disorders. Outcome measures were Patient Reported Outcomes Measurement Information System (PROMIS®) fatigue and PROMIS sleep disturbance. RESULTS Overall, 56% of the sample met criteria for at least one mental disorder. Linear regression models of sleep disturbance revealed all mental disorders except obsessive compulsive disorder (β = 0.038) had independent associations with sleep disturbance, with generalised anxiety disorder (GAD) (β = 0.173), major depressive disorder (MDD) (β = 0.117) and post-traumatic stress disorder (PTSD) (β = 0.111) making the greatest contribution. Inclusion of fatigue in the model attenuated the effects of panic disorder, MDD and attention-deficit hyperactive disorder (ADHD) to non-significance. For the outcome of fatigue, GAD (β = 0.223), MDD (β = 0.176) and PTSD (β = 0.147) made the greatest contributions, although all disorders had significant independent relationships. After adjusting for sleep disturbance, all mental disorders continued to make a significant contribution except for alcohol use disorder and substance use disorder. CONCLUSION Sleep disturbance and fatigue have independent associations with many mental disorders after correcting for comorbidity and known confounds. The disorders providing the greatest contribution to sleep disturbance and fatigue were GAD and MDD. Sleep disturbance and fatigue may be appropriate transdiagnostic targets for improving symptoms and global functioning for people with mental disorders.
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Affiliation(s)
- Sonia M McCallum
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia.
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Faculty of Health and Medicine, The University of Sydney, Sydney, Australia
| | - Natacha Carragher
- Department of Mental Health and Substance Abuse, World Health Organisation Headquarters, Geneva, Switzerland; Office of Medical Education, University of New South Wales, Sydney, Australia
| | - Dominique Kazan
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
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28
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Kazemeini E, Braem MJ, Moorkens G, Balina S, Kastoer C, Op de Beeck S, Vanderveken OM, Dieltjens M. Scoring of Hypersomnolence and Fatigue in Patients With Obstructive Sleep Apnea Treated With a Titratable Custom-Made Mandibular Advancement Device. J Clin Sleep Med 2019; 15:623-628. [PMID: 30952225 DOI: 10.5664/jcsm.7728] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/09/2019] [Indexed: 01/04/2023]
Abstract
STUDY OBJECTIVES The objective of this study was to measure fatigue and hypersomnolence in patients with obstructive sleep apnea (OSA) treated with a mandibular advancement device (MAD), using Epworth Sleepiness Scale (ESS) for hypersomnolence and Checklist Individual Strength questionnaire (CIS20R) for fatigue. METHODS This was a single-center, prospective cohort study. A total of 58 patients with OSA filled out ESS and CIS20R questionnaires at baseline and after 3 months of MAD treatment. A total of 39 full datasets were collected. Statistical analysis for reliability of the questionnaires, comparison between baseline and 3-month follow-up, correlation between the changes in the values of the two questionnaires, and changes in apnea-hypopnea index (AHI) were performed. RESULTS CIS20R showed excellent reliability in this patient group at baseline and 3-month follow-up (Cronbach α = .97), ESS showed a marginally good reliability (Cronbach α = .82). The CIS20R (82/140) expressed high levels of fatigue at baseline, and ESS showed a normal level of daytime sleepiness. AHI, ESS, and CIS20R were significantly reduced under MAD treatment. A significant correlation between ESS and CIS20R was observed. No significant correlation between any of the questionnaires and the change in AHI was found. CONCLUSIONS The CIS20R questionnaire results showed a high level of fatigue in the patients with OSA, and the questionnaire can be used to evaluate changes in fatigue due to MAD treatment after 3 months. The ESS failed to show similar characteristics. Therefore, a combination of ESS for hypersomnolence with CIS20R for fatigue is proposed for the follow-up of patients with OSA treated with MAD.
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Affiliation(s)
- Elahe Kazemeini
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium.,Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Marc J Braem
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium.,Department of Special Dentistry Care, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Greta Moorkens
- Department of Internal Medicine, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Sowjanya Balina
- Department of Special Dentistry Care, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Chloé Kastoer
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium.,Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Sara Op de Beeck
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium.,Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Olivier M Vanderveken
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium.,Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium.,Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Marijke Dieltjens
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium.,Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium.,Department of Special Dentistry Care, Antwerp University Hospital, Edegem, Antwerp, Belgium
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29
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Bazazan A, Dianat I, Feizollahi N, Mombeini Z, Shirazi AM, Castellucci HI. Effect of a posture correction-based intervention on musculoskeletal symptoms and fatigue among control room operators. APPLIED ERGONOMICS 2019; 76:12-19. [PMID: 30642516 DOI: 10.1016/j.apergo.2018.11.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 07/07/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
This study was conducted to examine the effect of a posture correction-based intervention (with a biofeedback device) on the occurrence of musculoskeletal symptoms (MSS) and fatigue among control room operators in a petrochemical plant in Iran. A total of 188 office workers (91 in the case group and 97 in the control group) participated at baseline as well as at 6- and 12-month follow-up. A questionnaire survey (including the Nordic Musculoskeletal Questionnaire and Multidimensional Fatigue Inventory) and direct observations of working postures by using the Rapid Upper Limb Assessment (RULA) method were used. The occurrence of MSS in the shoulders, upper back, neck, and low back areas, as well as the mental and physical dimensions of fatigue were found to be the most common problems. The results showed considerable improvements in working postures (in the neck, trunk, and RULA grand scores) and the occurrence of MSS (particularly in the neck, shoulders, and upper back and low back areas) and fatigue (in particular the mental and physical aspects) after the intervention. The overall mean RULA grand score for the case group was significantly decreased after the intervention (mean scores of 5.1, 4.4, and 4.6 at pre-intervention, post-intervention 1, and post-intervention 2, respectively). A total of 81 operators (89.0%) reported some kind of MSS at baseline, which were reduced to 75 operators (82.4%) and 77 operators (84.6%) at post-interventions 1 and 2, respectively. Significant differences were also found between the pre- and post-intervention scores for the physical fatigue (mean of 12.19, 10.16, and 9.99 at pre-intervention, post-intervention 1, and post-intervention 2, respectively) and mental fatigue (mean of 14.03, 12.05, and 12.16 at pre-intervention, post-intervention 1, and post-intervention 2, respectively) dimensions. The findings confirm the effectiveness of this low-cost, simple, and easy-to-use ergonomic intervention.
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Affiliation(s)
- Ahmad Bazazan
- Department of Occupational Health and Ergonomics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Iman Dianat
- Department of Occupational Health and Ergonomics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Nafiseh Feizollahi
- Department of Electronic, Faculty of Electrical Engineering, Islamic Azad University, Tehran South Branch, Tehran, Iran.
| | - Zohreh Mombeini
- Department of Health Safety and Environment (HSE), Razi Petrochemical Complex, Mahshahr, Iran.
| | - Alireza Mohammad Shirazi
- Department of Orthotics and Prosthetics, Faculty of Rehabilitation, Iran University of Medical Science, Tehran, Iran.
| | - Héctor Ignacio Castellucci
- Centro de Estudio del Trabajo y Factores Humanos, Escuela de Kinesiología, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile.
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30
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Kagee A, Coetzee B, Toit SD, Loades ME. Psychosocial predictors of quality of life among South Africa adolescents receiving antiretroviral therapy. Qual Life Res 2019; 28:57-65. [PMID: 30244360 PMCID: PMC6754750 DOI: 10.1007/s11136-018-2010-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE Minimal research has been conducted to understand how fatigue influences quality of life (QOL) among adolescents living with HIV. The purpose of the study was to examine the relationship between fatigue, sleep disturbance, depression, anxiety, pain and QOL among adolescents receiving antiretroviral therapy (ART). METHODS Using a cross-sectional survey design, we studied 134 South African adolescents receiving an ART at community clinics. RESULTS Participants in general reported low levels of fatigue, insomnia, distress and pain and non-problematic levels of QOL. In the regression model, the linear combination of these variables explained 49% of the variance in QOL, a large effect size. Insomnia, anxiety, and depression significantly predicted QOL but surprisingly fatigue and pain did not. CONCLUSIONS Many members of the sample experienced non-clinical levels of sleep disturbance, fatigue and psychosocial distress. Similarly, QOL was within the normal range. These findings are surprising as the commonly held assumption is that adolescents living with HIV, especially those of poorer socio-economic backgrounds, would experience lower QOL than the norm. Even though scores on the instruments measuring these variables fell in the non-clinical range, they were still robustly predictive of poor QOL. Future research may address the relationship between self-reported adherence and QOL, possibly by examining the role of viral load as a mediating variable. Further research may also focus on non-adherent adolescents to understand the ways in which fatigue and other factors such as school functioning and social interaction influence QOL.
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Affiliation(s)
- A Kagee
- Department of Psychology, Stellenbosch University, Matieland, Private Bag X1, Stellenbosch, South Africa.
| | - B Coetzee
- Department of Psychology, Stellenbosch University, Matieland, Private Bag X1, Stellenbosch, South Africa
| | - S Du Toit
- Department of Psychology, Stellenbosch University, Matieland, Private Bag X1, Stellenbosch, South Africa
| | - M E Loades
- Department of Psychology, University of Bath, Bath, BA2 7AY, UK
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31
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Kim D, Shin DS, Lee SC, Chang HJ, Hwangbo Y, You S, Jang T, Yang KI. Sleep Status and the Risk Factor of Drowsy-Related Accidents in Commercial Motor Vehicle Drivers. SLEEP MEDICINE RESEARCH 2018. [DOI: 10.17241/smr.2018.00283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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32
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Herron K, Farquharson L, Wroe A, Sterr A. Development and Evaluation of a Cognitive Behavioural Intervention for Chronic Post-Stroke Insomnia. Behav Cogn Psychother 2018; 46:641-660. [PMID: 29478417 DOI: 10.1017/s1352465818000061] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cognitive behavioural therapy for insomnia (CBTI) has been successfully applied to those with chronic illness. However, despite the high prevalence of post-stroke insomnia, the applicability of CBTI for this population has not been substantially researched or routinely used in clinical practice. AIMS The present study developed a 'CBTI+' protocol for those with post-stroke insomnia and tested its efficacy. The protocol also incorporated additional management strategies that considered the consequences of stroke. METHOD A single-case experimental design was used with five community-dwelling individuals with post-stroke insomnia. Daily sleep diaries were collected over 11 weeks, including a 2-week baseline, 7-week intervention and 2-week follow-up. The Insomnia Severity Index, Dysfunctional Attitudes and Beliefs About Sleep Scale, Epworth Sleepiness Scale, Fatigue Severity Scale and Stroke Impact Scale were administered pre- and post-treatment, as well as at 2-week follow-up. RESULTS At post-treatment, three participants no longer met diagnostic criteria for insomnia and all participants showed improvements on two or more sleep parameters, including sleep duration and sleep onset latency. Three participants showed a reduction in daytime sleepiness, increased quality of life and reduction in unhelpful beliefs about sleep. CONCLUSIONS This study provides initial evidence that CBTI+ is a feasible and acceptable intervention for post-stroke insomnia. Furthermore, it indicates that sleep difficulties in community-dwelling stroke populations are at least partly maintained by unhelpful beliefs and behaviours. The development and delivery of the CBTI+ protocol has important clinical implications for managing post-stroke insomnia and highlights directions for future research.
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Affiliation(s)
- Katie Herron
- Pain Management Centre,National Hospital For Neurology and Neurosurgery,University College London Hospitals,London,UK
| | - Lorna Farquharson
- Department of Psychology,Royal Holloway,University of London,Surrey,UK
| | - Abigail Wroe
- Clinical Health Psychology Service,Berkshire Healthcare NHS Foundation Trust,Reading,UK
| | - Annette Sterr
- School of Psychology,University of Surrey,Guildford,Surrey,UK
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Job A, Cardinal F, Michel H, Klein C, Ressiot E, Gauthier J. Tinnitus and Associated Handicaps in the French Mountain Artillery: Assessment by the Tinnitus Handicap Inventory. Mil Med 2018; 183:e302-e306. [PMID: 29590475 DOI: 10.1093/milmed/usy042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/19/2017] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Tinnitus and associated handicap related to acoustic trauma sequelae have never been assessed in the French artillery. Although impulsive noise exposure to firearms and canons are thought to increase prevalence of tinnitus among soldiers, recent studies demonstrating this fact are missing. MATERIALS AND METHODS Here, a representative sample of 389 soldiers from an operational mountain artillery regiment was surveyed. Soldiers personally concerned by tinnitus were invited to fill in a questionnaire. We assessed tinnitus and the associated handicap using a French translation of the Tinnitus Handicap Inventory (THI). Questions about attention/concentration problems, impaired speech hearing and understanding, sleep disorders, social and familial tension, irritability, depression, and tiredness as linked to tinnitus were the core of the questionnaire. RESULTS Soldiers that completed the THI (n = 73, 19%) had a mean THI score of 18 ± 17, this mean score corresponded to a mild handicap. At this grade, tinnitus should be easily masked and should not interfere with daily activities. The percentage of soldiers concerned by tinnitus was slightly higher in the older age class, but there was no significant difference of THI scores between the different age classes. The most reported handicaps were attention/concentration problems, impaired speech hearing, and understanding. Among the THI fillers, eight soldiers (11%) had THI scores >36, indicating a moderate to severe handicap. CONCLUSION Despite a mild tinnitus handicap, the percentage of people concerned by tinnitus in this regiment is higher (19%) than that in the estimated percentage of general population of European countries (about 10%). It should be of interest to replicate this type of study from other regiments and from other countries. Education and good fitting of hearing protection for prevention of acoustic trauma sequelae should still be encouraged.
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Affiliation(s)
- Agnès Job
- IRBA eq. territoire Grenoble, French Biomedical Research Institute of the Armed Forces, BP 73, Brétigny-sur-Orge, France
| | - Fabien Cardinal
- CMA des Alpes, Medical Center of the Army, Quartier Reynies, Varces, France
| | - Hugues Michel
- CMA des Alpes, Medical Center of the Army, Quartier Reynies, Varces, France
| | - Céline Klein
- CMA des Alpes, Medical Center of the Army, Quartier Reynies, Varces, France
| | - Elodie Ressiot
- HIA Desgenettes, Military Hospital, ENT Unit, 108 Boulevard Pinel, Lyon 3, France
| | - Jérome Gauthier
- HIA Desgenettes, Military Hospital, ENT Unit, 108 Boulevard Pinel, Lyon 3, France
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Matsangas P, Shattuck NL. Discriminating Between Fatigue and Sleepiness in the Naval Operational Environment. Behav Sleep Med 2018; 16:427-436. [PMID: 27662510 DOI: 10.1080/15402002.2016.1228645] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess the similarities and differences between reported levels of fatigue and sleepiness as a consequence of working at sea. PARTICIPANTS 767 crewmembers of a U.S. Navy ship. METHODS Retrospective analysis of a survey to include questions about demographics, caffeine consumption, sleep adequacy, the Epworth Sleepiness Scale (ESS), and the Fatigue Severity Scale (FSS). RESULTS ESS scores (8.41 ± 4.66) indicated that 32% of the participants had excessive daytime sleepiness (ESS score > 10), while approximately 7% had an ESS score of 16 or more. FSS scores (average FSS = 3.01 ± 1.37) indicated that 28% of the participants had elevated fatigue (FSS score ≥ 4). Even though ESS and FSS scores were correlated (r = 0.39), their association explained only 15% of the variability observed. In terms of behavioral and lifestyle patterns, crewmembers with elevated fatigue (FSS ≥ 4) reported getting less exercise than those reporting less fatigue. Individuals with excessive sleepiness (ESS > 10) reported higher caffeine consumption. Crewmembers with elevated fatigue and comorbid sleepiness (FSS ≥ 4 and ESS > 10) reported receiving less sleep than other crew members. CONCLUSIONS These results suggest that subjective fatigue and subjective sleepiness, as measured by the FSS and ESS scales, are distinct constructs and both are consequences of working at sea. The scores on the two scales correlate differentially with behavioral and lifestyle patterns of the crewmembers.
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Affiliation(s)
- Panagiotis Matsangas
- a Operations Research Department, Naval Postgraduate School , Monterey , California
| | - Nita Lewis Shattuck
- a Operations Research Department, Naval Postgraduate School , Monterey , California
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Fatigue following Paediatric Acquired Brain Injury and its Impact on Functional Outcomes: A Systematic Review. Neuropsychol Rev 2018; 28:73-87. [PMID: 29552735 DOI: 10.1007/s11065-018-9370-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 02/15/2018] [Indexed: 10/17/2022]
Abstract
Fatigue is a commonly reported sequela following an acquired brain injury (ABI), and can have a negative impact on many areas of a child's life. However, there is minimal research that focuses on fatigue specifically, and so factors such as its occurrence, duration, and impact on functioning remain uncertain. This systematic review aims to provide a comprehensive summary of the research to date, bringing together a number of studies with a focus on paediatric ABI and fatigue. Terms were searched in relevant databases (PsycInfo, Medline, CINAHL), and articles were included or excluded based on specified criteria. Of the 1177 papers identified in the original search, a total of 9 papers met inclusion criteria, and were categorised as traumatic brain injury (TBI; n = 4), meningitis and meningococcal disease (n = 2), brain tumours (n = 2), and mixed ABI group (n = 1). Key findings suggest that fatigue is a problem encountered by a significant proportion of patients in all the studies reviewed, and often occurred regardless of the cause; fatigue was also associated with poor academic achievement, limited physical activity, and social and emotional problems. Injuries of greater severity were associated with higher levels of fatigue and worse outcomes. Several management options were suggested, though their efficacy was not reported. Future research is required with a suggested focus on using multiple time points to better understand the trajectories of fatigue following childhood ABI, and to build an evidence base to determine which management options are most suitable.
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Åkerstedt T, Discacciati A, Miley-Åkerstedt A, Westerlund H. Aging and the Change in Fatigue and Sleep - A Longitudinal Study Across 8 Years in Three Age Groups. Front Psychol 2018; 9:234. [PMID: 29568279 PMCID: PMC5852064 DOI: 10.3389/fpsyg.2018.00234] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 02/12/2018] [Indexed: 11/16/2022] Open
Abstract
Fatigue is prevalent in the population and usually linked to sleep problems, and both are related to age. However, previous studies have been cross-sectional. The purpose of the present study was to investigate the trajectories of sleep and fatigue across 8 years of aging in a large group (N > 8.000) of individuals. A second purpose was to investigate whether fatigue trajectories would differ between age groups, and whether different trajectories of fatigue would be reflected in a corresponding difference in trajectories for sleep variables. Results from mixed model analyses showed that fatigue decreased across 8 years in all age groups, while sleep problems increased, non-restorative sleep decreased, weekend sleep duration decreased, and weekday sleep duration showed different patterns depending on age. Furthermore, the larger the decrease in fatigue, the larger was the increase in sleep duration across years, the lower was the increase of sleep problems, and the larger was the decrease of non-restorative sleep. The results suggest that aging has positive effects on fatigue and sleep and that these changes are linked.
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Affiliation(s)
- Torbjörn Åkerstedt
- Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden.,Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Andrea Discacciati
- Department of Environmental Medicine, Karolinska Institute, Solna, Sweden
| | | | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
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Nigro CA, Dibur E, Borsini E, Malnis S, Ernst G, Bledel I, González S, Arce A, Nogueira F. The influence of gender on symptoms associated with obstructive sleep apnea. Sleep Breath 2018; 22:683-693. [PMID: 29392572 DOI: 10.1007/s11325-017-1612-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 11/05/2017] [Accepted: 12/19/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND It has been reported that the clinical expression of obstructive sleep apnea (OSA) may differ in women and men. OBJECTIVE The objective of this study was to evaluate the influence of gender on reported OSA-related symptoms in a large clinical population of patients. METHODS The database from the sleep laboratory of a tertiary care center was examined. Adult patients who had undergone a diagnostic polysomnography and completed the Berlin questionnaire, a sleep questionnaire, and the Epworth sleepiness scale were selected. Multiple logistic regression analysis was performed to assess the relationship between OSA-associated symptoms and different potential explanatory variables. RESULTS The study sample included 1084 patients, median age was 53 years, 46.5% (504) were women, 72.7% (788) had OSA (apnea/hypopnea index ≥ 5), and 31.2% were obese. After adjusting for age, body mass index, and apnea/hypopnea index, men were more likely to report snoring (OR 4.06, p < 0.001), habitual or loud snoring (OR 2.34, p < 0.001; 2.14, p < 0.001, respectively) and apneas (OR 2.44, p < 0.001), than women. After controlling for multiple variables, female gender was an independent predictive factor for reported tiredness (OR 0.57, p 0.001), sleep onset insomnia (OR 0.59, p 0.0035), and morning headaches (OR 0.32, p < 0.001). Reports of excessive daytime sleepiness, nocturia, midnight insomnia, and subjective cognitive complaints were not significantly associated with gender. CONCLUSION Women with OSA were more likely to report tiredness, initial insomnia, and morning headaches, and less likely to complain of typical OSA symptoms (snoring, apneas) than men.
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Affiliation(s)
| | - Eduardo Dibur
- Sleep Laboratory, Pneumonology Unit, Hospital Alemán, Buenos Aires, Argentina
| | - Eduardo Borsini
- Sleep Laboratory, Pneumonology Unit, Hospital Británico, Buenos Aires, Argentina
| | - Silvana Malnis
- Sleep Laboratory, Pneumonology Unit, Hospital Alemán, Buenos Aires, Argentina
| | - Glenda Ernst
- Sleep Laboratory, Pneumonology Unit, Hospital Británico, Buenos Aires, Argentina
| | - Ignacio Bledel
- Sleep Laboratory, Pneumonology Unit, Hospital Alemán, Buenos Aires, Argentina
| | - Sergio González
- Sleep Laboratory, Pneumonology Unit, Hospital Alemán, Buenos Aires, Argentina
| | - Anabella Arce
- Sleep Laboratory, Pneumonology Unit, Hospital Alemán, Buenos Aires, Argentina
| | - Facundo Nogueira
- Sleep Laboratory, Pneumonology Unit, Hospital de Clínicas, Buenos Aires, Argentina
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Naiman R. Insomnia. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tomar S, Sharma A, Jain A, Sinha VD, Gupta ID. Study of Fatigue and Associated Factors in Traumatic Brain Injury and Its Correlation with Insomnia and Depression. Asian J Neurosurg 2018; 13:1061-1065. [PMID: 30459868 PMCID: PMC6208265 DOI: 10.4103/ajns.ajns_89_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: Fatigue has been cited as a common problem associated with traumatic brain injury. A positive association of fatigue has been suggested with insomnia and depression which are also considered to be significantly associated with traumatic brain injury. Aims and Objectives: The present study in post-traumatic brain injury patients is planned to assess the prevalence of fatigue, depression and insomnia, the correlation of fatigue with depression and insomnia and the risk factors associated with fatigue. Material and Methodology: Total 100 patients were recruited in the present study. Interview was focused on assessment of severity of traumatic brain injury, fatigue, insomnia and depression using Glasgow Coma Scale, Fatigue Severity Scale, Insomnia Severity Index and Patients Health Questionnaire(PHQ-9) respectively. Results: Prevalence of depression was found 84% while that of fatigue and insomnia was 50% and 49% respectively. All patients with fatigue had depression whereas those patients without fatigue were also found to have depression (68%) and this correlation was found statistically significant. Similarly, insomnia was reported in 70% of patients who were fatigued against 28% of patients with no fatigue. This was also found statistically significant (P <0.0002). Conclusion: Fatigue in common in post TBI patients. Insomnia and depression are closely associated with fatigue. Clinical and research investigations of fatigue in post-traumatic brain injury should include concomitant screening for treatable depressive symptoms and sleep disorders.
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Affiliation(s)
- Sachin Tomar
- Department of Neurosurgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Achal Sharma
- Department of Neurosurgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Akhilesh Jain
- Department of Psychiatry, ESIC Model Hospital, Jaipur, Rajasthan, India
| | - Virendra Deo Sinha
- Department of Neurosurgery, SMS Medical College, Jaipur, Rajasthan, India
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Tang HY(J, McCurry SM, Pike KC, Von Korff M, Vitiello MV. Differential predictors of nighttime and daytime sleep complaints in older adults with comorbid insomnia and osteoarthritis pain. J Psychosom Res 2017; 100:22-28. [PMID: 28789789 PMCID: PMC5599170 DOI: 10.1016/j.jpsychores.2017.06.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Osteoarthritis (OA) is extremely common in older adults, affecting 50% of people aged 65 or older, and more than half of older adults with OA complain of significantly disturbed sleep. This study compared predictors of nighttime sleep complaints and daytime sleep-related consequences as measured by the Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) in older adults with comorbid OA pain and insomnia. METHODS A secondary analysis of baseline data from a large longitudinal randomized controlled trial. Multivariate regression analyses were performed to test two sets of predictive models. RESULTS 367 older adults (mean age 72.9±8.2years; female 78.5%) with OA and insomnia were included in this analysis. In Model 1, fatigue and depression predicted daytime sleep-related consequences for both ISI and PSQI. When measures of sleep and pain beliefs/attitudes were added (Model 2), fatigue, and sleep and pain beliefs/attitudes predicted nighttime sleep complaints for both ISI and PSQI; depression was no longer a significant predictor of ISI daytime consequences, but remained in the model for PSQI daytime consequences. CONCLUSIONS This study found both similarities and differences in factors predicting nighttime sleep complaints and daytime sleep-related consequences. Individual beliefs/attitudes about sleep and pain were stronger predictors of sleep difficulties than were depression and pain. Fatigue was the strongest and most consistent predictor associated with both nighttime sleep complaints and daytime sleep-related consequences regardless of the scale used to measure these concepts.
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Affiliation(s)
- Hsin-Yi (Jean) Tang
- Department of Psychosocial and Community Health, University of Washington, Seattle, WA
| | - Susan M. McCurry
- Department of Psychosocial and Community Health, University of Washington, Seattle, WA
| | - Kenneth C. Pike
- Department of Psychosocial and Community Health, University of Washington, Seattle, WA
| | | | - Michael V. Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
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Kim SA, Koo BB, Kim DE, Hwangbo Y, Yang KI. Factors affecting fatigue severity in patients with obstructive sleep apnea. CLINICAL RESPIRATORY JOURNAL 2017; 11:1045-1051. [DOI: 10.1111/crj.12682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 06/30/2017] [Accepted: 07/25/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Soo A Kim
- Department of Physical Medicine and Rehabilitation; Soonchunhyang University College of Medicine, Cheonan Hospital; Cheonan South Korea
| | - Brian B Koo
- Department of Neurology; Yale University School of Medicine; New Haven Connecticut
| | - Do Eui Kim
- Sleep Disorders Center; Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital; Cheonan South Korea
| | - Young Hwangbo
- Department of Preventive Medicine; Soonchunhyang University College of Medicine; Cheonan South Korea
| | - Kwang Ik Yang
- Sleep Disorders Center; Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital; Cheonan South Korea
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Cameron K, Williamson P, Short MA, Gradisar M. Validation of the Flinders Fatigue Scale as a measure of daytime fatigue. Sleep Med 2017; 30:105-112. [DOI: 10.1016/j.sleep.2016.11.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/22/2016] [Accepted: 11/25/2016] [Indexed: 11/24/2022]
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Akram U, Ellis JG, Myachykov A, Barclay NL. Preferential attention towards the eye-region amongst individuals with insomnia. J Sleep Res 2016; 26:84-91. [PMID: 27624588 DOI: 10.1111/jsr.12456] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 08/14/2016] [Indexed: 11/29/2022]
Abstract
People with insomnia often perceive their own facial appearance as more tired compared with the appearance of others. Evidence also highlights the eye-region in projecting tiredness cues to perceivers, and tiredness judgements often rely on preferential attention towards this region. Using a novel eye-tracking paradigm, this study examined: (i) whether individuals with insomnia display preferential attention towards the eye-region, relative to nose and mouth regions, whilst observing faces compared with normal-sleepers; and (ii) whether an attentional bias towards the eye-region amongst individuals with insomnia is self-specific or general in nature. Twenty individuals with DSM-5 Insomnia Disorder and 20 normal-sleepers viewed 48 neutral facial photographs (24 of themselves, 24 of other people) for periods of 4000 ms. Eye movements were recorded using eye-tracking, and first fixation onset, first fixation duration and total gaze duration were examined for three interest-regions (eyes, nose, mouth). Significant group × interest-region interactions indicated that, regardless of the face presented, participants with insomnia were quicker to attend to, and spent more time observing, the eye-region relative to the nose and mouth regions compared with normal-sleepers. However, no group × face × interest-region interactions were established. Thus, whilst individuals with insomnia displayed preferential attention towards the eye-region in general, this effect was not accentuated during self-perception. Insomnia appears to be characterized by a general, rather than self-specific, attentional bias towards the eye-region. These findings contribute to our understanding of face perception in insomnia, and provide tentative support for cognitive models of insomnia demonstrating that individuals with insomnia monitor faces in general, with a specific focus around the eye-region, for cues associated with tiredness.
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Affiliation(s)
- Umair Akram
- Northumbria Centre for Sleep Research, Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK
| | - Jason G Ellis
- Northumbria Centre for Sleep Research, Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK
| | - Andriy Myachykov
- Northumbria Centre for Sleep Research, Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK
| | - Nicola L Barclay
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
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Lerdal A, Wahl A, Rustøen T, Hanestad BR, Moum T. Fatigue in the general population: A translation and test of the psychometric properties of the Norwegian version of the fatigue severity scale. Scand J Public Health 2016; 33:123-30. [PMID: 15823973 DOI: 10.1080/14034940410028406] [Citation(s) in RCA: 247] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: A study was undertaken to test the psychometric properties of the Fatigue Severity Scale (FSS), and to explore the relationship between fatigue and sociodemographic variables in the general population. Method: A national representative sample of 1893 respondents was randomly selected from a pool of 4,000 Norwegians aged 19—81 years. A mailed questionnaire that included the FSS was used to measure fatigue severity. Results: The FSS showed satisfactory internal consistency (Cronbach's alpha 0.88). The prevalence of high fatigue (FSS score>=5) was 23.1% in the total sample. More women (26.2%) than men (19.8%) experienced high fatigue (p=0.004). Respondents with chronic illness (more than six months) reported a higher mean (M=4.69, SD=1.35) than the rest of the sample (M=3.67, SD=1.17) (p<0.001). An inverse correlation was found between fatigue and level of formal education (r=0.20, p<0.001). Conclusion: The psychometric properties of the Norwegian version of FSS were satisfactory. To avoid over-diagnosing people for high level of fatigue, the threshold for high fatigue probably should be 5 on the FSS scale instead of 4 as had been suggested originally, but further validation of the cut-off point is needed.
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Affiliation(s)
- Anners Lerdal
- Department of Behavioral Science in Medicine, University of Oslo, Norway
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Abstract
Insomnia is often comorbid with obstructive sleep apnea. It reduces positive airway pressure (PAP) therapy acceptance and adherence. Comorbid patients show greater daytime impairments and poorer health outcomes. The insomnia often goes undiagnosed, undertreated, or untreated. Pharmacotherapy is not recommended for long-term treatment. Although care should be taken administering behavioral therapies to patients with elevated sleepiness, cognitive behavior therapy for insomnia (CBTi) is an effective and durable nondrug therapy that reduces symptoms and may increase the effectiveness of PAP therapy. Sleep clinics should be alert to comorbid insomnia and provide adequate diagnostic tools and clinicians with CBTi expertise.
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Ouellet MC, Savard J, Morin CM. Book Review: Insomnia following Traumatic Brain Injury: A Review. Neurorehabil Neural Repair 2016; 18:187-98. [DOI: 10.1177/1545968304271405] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sleep disturbances after a traumatic brain injury (TBI) have received very little scientific attention despite the fact that several studies indicate that they may occur in 30% to 70% of patients. For individuals with TBI, problems falling asleep or maintaining sleep can exacerbate other symptoms such as pain, cognitive deficits, fatigue, or irritability. Sleep disturbances can thus compromise the rehabilitation process and the ability to return to work. This article reviews the evidence on the epidemiology, etiology, and treatment of insomnia in the context of TBI and proposes areas for future research. Prevalence estimates of insomnia complaints in TBI patients are summarized. Potential etiological factors (i.e., lesions to the nervous system, anxiety) and possible consequences of insomnia (i.e., fatigue, cognitive problems) in the context of TBI are discussed. Finally, pharmacological and psychological treatments previously shown effective to treat insomnia in healthy individuals are discussed as valuable treatment options for TBI patients. Increased knowledge about the high prevalence, diagnosis, and potential etiological factors of insomnia following TBI may promote a better identification, evaluation, and treatment of sleeping difficulties in this population.
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Affiliation(s)
- Marie-Christine Ouellet
- École de Psychologie, Centre d’Étude des Troubles du Sommeil, Université Laval, Québec, Canada,
| | - Josée Savard
- École de Psychologie, Centre d’Étude des Troubles du Sommeil, Université Laval, Québec, Canada
| | - Charles M. Morin
- École de Psychologie, Centre d’Étude des Troubles du Sommeil, Université Laval, Québec, Canada
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Sleep Quality and Vigilance Differ Among Inpatient Nurses Based on the Unit Setting and Shift Worked. J Patient Saf 2016; 11:215-20. [PMID: 24522213 DOI: 10.1097/pts.0000000000000089] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Sleepiness in nurses has been shown to impact patient care and safety. The objectives of this study are to measure sleep quality, sleepiness, fatigue, and vigilance in inpatient nurses and to assess how setting (intensive care unit versus the general floor) and shift worked (day versus night) affect these measures. METHODS Nurses from both the ICU and floor were included in the study. Participants completed questionnaires assessing self-reported sleep quality (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Stanford Sleepiness Scale and Epworth Sleepiness Scale, ESS), and fatigue (Fatigue Severity Scale, FSS). Vigilance was measured by means of the psychomotor vigilance test (PVT), before and after a 12-hour duty shift. RESULTS The ESS was abnormal in 22% of all nurses, the FSS was abnormal in 33%, and the global PSQI was abnormal in 63%. More ICU nurses than floor nurses reported abnormal sleep quality (component 5) on the PSQI. Sleep medication use (PSQI component 6) was higher in night shift nurses. The FSS was greater in night shift nurses. On preshift PVT testing, day-shift nurses overall provided faster mean reaction time (RT) than night-shift nurses. ICU nurses working the day shift made more than twice as many total errors and false starts than day shift floor nurses. Floor nurses demonstrated a significant decrease from preshift to postshift in the mean of the fastest 10% RT. CONCLUSIONS Our data indicate that a significant number of inpatient nurses have impaired sleep quality, excessive sleepiness, and abnormal fatigue, which may place them at a greater risk of making medical errors and harming patients; these problems are especially pronounced in night shift workers. PVT results were inconsistent, but floor and day shift nurses performed better on some tasks than ICU and night shift nurses.
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Akram U, Ellis JG, Myachykov A, Barclay NL. Misperception of tiredness in young adults with insomnia. J Sleep Res 2016; 25:466-74. [DOI: 10.1111/jsr.12395] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 01/09/2016] [Indexed: 01/22/2023]
Affiliation(s)
- Umair Akram
- Northumbria Centre for Sleep Research; Northumbria University; Newcastle UK
| | - Jason G. Ellis
- Northumbria Centre for Sleep Research; Northumbria University; Newcastle UK
| | - Andriy Myachykov
- Northumbria Centre for Sleep Research; Northumbria University; Newcastle UK
| | - Nicola L. Barclay
- Northumbria Centre for Sleep Research; Northumbria University; Newcastle UK
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Rizou I, De Gucht V, Papavasiliou A, Maes S. The contribution of illness perceptions to fatigue and sleep problems in youngsters with epilepsy. Eur J Paediatr Neurol 2016; 20:93-9. [PMID: 26497901 DOI: 10.1016/j.ejpn.2015.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/10/2015] [Accepted: 10/04/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE The present study aims to explore the extent to which gender, epilepsy severity and illness perceptions predict fatigue and sleep problems in youngsters with epilepsy. METHOD Structured interviews were conducted in 100 young patients (Mage = 13,9, SD = 2.21; 41% girls) and data were analyzed by means of multiple hierarchical regression analyses. RESULTS Most patients (91%) were well controlled by anti-epileptics; 3% had infrequent seizures and 6% were pharmacoresistant. At a multivariate level it appeared that youngsters with epilepsy who believe that they have less personal control over their illness and who feel that the illness has a high emotional impact on their lives reported higher levels of fatigue. In addition, more sleep problems were reported by youngsters who think they have less personal control over the disease, who believe that treatment controls epilepsy and report that the disease has a high emotional impact on their lives. CONCLUSION Given the importance of illness perceptions, it is suggested that they are targets for future interventions that aim to reduce fatigue and sleep problems in youngsters with epilepsy.
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Affiliation(s)
- Ioanna Rizou
- Child Psychiatry Department, Mental Health Center of General Hospital of Athens "G. Gennimatas", Athens, Greece.
| | - Veronique De Gucht
- Health, Medical and Neuropsychology Department, Leiden University, Leiden, The Netherlands.
| | | | - Stan Maes
- Health, Medical and Neuropsychology Department, Leiden University, Leiden, The Netherlands.
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McCrae CS, Roth AJ, Ford J, Crew EC, Conti JB, Berry RB, Sears SF. Sleep, Psychosocial Functioning, and Device-Specific Adjustment in Patients with Implantable Cardioverter Defibrillators (ICDs). Behav Sleep Med 2016; 14:49-66. [PMID: 25174823 PMCID: PMC4345140 DOI: 10.1080/15402002.2014.941064] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Rates of sleep disorders and associated adjustment were examined in patients with implantable cardioverter defibrillators (ICDs; n = 42; Mage = 61.57, SD = 12.60). One night of ambulatory polysomnography, 14 days of sleep diaries, and questionnaires (mood, sleepiness, fatigue, device acceptance) were administered. Controlling for ischemia, MANCOVA examined adjustment by sleep diagnosis. Apnea was most common (28.6%), followed by Insomnia (16.7%) and Comorbid Insomnia/Apnea (11.9%). Patients with insomnia reported poorer mood, greater sleepiness, and lower device acceptance than good sleepers; they also demonstrated poorer mood and less ICD device acceptance than patients with sleep apnea. Patients with comorbid insomnia/apnea also exhibited poorer mood and less ICD device acceptance than good sleepers; however, comorbid patients did not significantly differ from insomnia or apnea patients on any measure. Those with disordered sleep (regardless of type) reported greater fatigue than good sleepers. Assessment (and treatment) of difficulties with sleep, mood, fatigue, and device acceptance may be important for the comprehensive clinical management of ICD patients. Further research appears warranted.
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Affiliation(s)
- Christina S. McCrae
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Alicia J. Roth
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Jessica Ford
- Psychology and Cardiovascular Sciences, East Carolina University, Greenville, NC
| | - Earl C. Crew
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Jamie B. Conti
- College of Medicine, University of Florida, Gainesville, FL
| | | | - Samuel F. Sears
- Psychology and Cardiovascular Sciences, East Carolina University, Greenville, NC
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