101
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Sleep disturbances increase the risk of dementia: A systematic review and meta-analysis. Sleep Med Rev 2018; 40:4-16. [PMID: 28890168 DOI: 10.1016/j.smrv.2017.06.010] [Citation(s) in RCA: 513] [Impact Index Per Article: 85.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/29/2017] [Accepted: 06/28/2017] [Indexed: 11/23/2022]
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102
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Gois ACB, Pernambuco LDA, Lima KCD. Factors associated with voice disorders among the elderly: a systematic review. Braz J Otorhinolaryngol 2018; 84:506-513. [PMID: 29331352 PMCID: PMC9449164 DOI: 10.1016/j.bjorl.2017.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/23/2017] [Accepted: 11/24/2017] [Indexed: 11/30/2022] Open
Abstract
Introduction During the aging process, natural modifications occur in the larynx and the structures involved in phonation which explain the specific characteristics found in the voices of elderly persons. When, at any moment, a voice fails and there is interference with communication, a voice disorder has occurred. This can generate disadvantages in communicative efficiency and have a negative impact on quality of life, compromising mechanisms of socialization, the maintenance of autonomy, and the sense of well-being. Nevertheless, there appears to be little clarity about which factors are associated with voice disorders in this population, especially from an epidemiological perspective. Objective The present study is a literature review to identify factors associated with voice disorders among the elderly described in population-based studies. Methods A systematic review of electronic databases was carried out. The methodological quality of the studies was analyzed with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The research was conducted independently by two researchers. Results Although two articles met the eligibility criteria, none fulfilled all the criteria for the evaluation of methodological quality. According to the two studies selected for this review, factors associated with voice disorders among the elderly included both physical and psychosocial aspects. However, the methodological discrepancies between the studies, particularly in relation to sample selection and the instruments used indicate great variability and compromise the reliability of the results. Conclusion Further prevalence studies and investigations of factors associated with voice disorders in the elderly from an epidemiological perspective, and which involve different cultures, should be carried out.
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103
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Abstract
Objective Obstructive sleep apnea (OSA) is assumed to influence the circadian blood pressure (BP) fluctuation, particularly causing nocturnal hypertension and changing the dipping pattern of nocturnal BP. This study aimed to clarify the triggers of the non-dipper pattern in nocturnal BP in Japanese patients with severe OSA (the apnea-hypopnea index ≥30/h). Methods Of 541 patients with OSA diagnosed using polysomnography (PSG) and ambulatory BP monitoring (ABPM), 163 patients <60 years of age (Younger group) and 101 patients ≥60 years of age (Older group) were stratified into the dipper or non-dipper pattern groups. Results A logistic regression analysis was performed using a non-dipper pattern as a dependent variable. A multivariate analysis demonstrated that the cumulative percentage of time at saturation below 90% was the only independent risk factor for the non-dipper and riser patterns in the Younger group (odds ratio, 1.022; 95% confidence interval, 1.001-1.044; p=0.035), whereas slow-wave sleep (odds ratio, 0.941; 95% confidence interval, 0.891-0.990; p=0.019) and the use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (odds ratio, 2.589; 95% confidence interval, 1.051-6.848; p=0.039) were risk factors in the Older group. Conclusion These findings suggested that the degree of desaturation in young OSA patients and sleep quality in old OSA patients might influence the dipping patterns in nocturnal BP.
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Affiliation(s)
- Hiromitsu Sekizuka
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
- Department of Internal Medicine, Fujitsu Clinic, Japan
| | - Naohiko Osada
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Yoshihiro J Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
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104
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Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics 2018; 18:155-165. [PMID: 29878472 DOI: 10.1111/psyg.12319] [Citation(s) in RCA: 251] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/27/2017] [Accepted: 01/15/2018] [Indexed: 12/24/2022]
Abstract
In contrast to newborns, who spend 16-20 h in sleep each day, adults need only about sleep daily. However, many elderly may struggle to obtain those 8 h in one block. In addition to changes in sleep duration, sleep patterns change as age progresses. Like the physical changes that occur during old age, an alteration in sleep pattern is also a part of the normal ageing process. As people age, they tend to have a harder time falling asleep and more trouble staying asleep. Older people spend more time in the lighter stages of sleep than in deep sleep. As the circadian mechanism in older people becomes less efficient, their sleep schedule is shifted forward. Even when they manage to obtain 7 or 8 h sleep, they wake up early, as they have gone to sleep quite early. The prevalence of sleep disorders is higher among older adults. Loud snoring, which is more common in the elderly, can be a symptom of obstructive sleep apnoea, which puts a person at risk for cardiovascular diseases, headaches, memory loss, and depression. Restless legs syndrome and periodic limb movement disorder that disrupt sleep are more prevalent in older persons. Other common medical problems of old age such as hypertension diabetes mellitus, renal failure, respiratory diseases such as asthma, immune disorders, gastroesophageal reflux disease, physical disability, dementia, pain, depression, and anxiety are all associated with sleep disturbances.
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Affiliation(s)
- Kamalesh K Gulia
- Division of Sleep Research, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Velayudhan Mohan Kumar
- Division of Sleep Research, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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105
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The bidirectional relationship between sleep duration and depression in community-dwelling middle-aged and elderly individuals: evidence from a longitudinal study. Sleep Med 2018; 52:221-229. [PMID: 29861378 DOI: 10.1016/j.sleep.2018.03.011] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/24/2018] [Accepted: 03/13/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND There are several studies that have focused on the relationship between sleep duration and depression, however, only a few prospective studies have centered on the bidirectional relationship between them. This four-year longitudinal study aimed to identify the association between sleep duration and depression in community-dwelling mid-age and elderly individuals. METHODS 10,704 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included for baseline and four-year follow up. Of these individuals, 7866 and 2956 were used to identify the effects of sleep duration on onset and recurrent depression respectively. 4504 individuals with normal sleep duration at baseline were included to examine the effects of depression on changes of sleep time. The 10-item version of the Centre for Epidemiological Studies Depression scale (CESD-10) was used to access depressive symptoms, as well sleep duration was self-reported. RESULTS Participants with short sleep duration (<5 and 5-6 h) had a higher risk of depression onset (OR 1.69 [1.36-2.11], 1.48 [1.19-1.84]) and recurrent depression (OR 1.44 [1.12-1.86], 1.32 [1.00-1.74]) compared to participants with normal sleep durations (7-8 h). Long sleep durations (>9 h) had no significant risks for depression. Males and the elderly (over 60 years-old) were more sensitive to short sleep durations and experienced a higher incidence of depression. Individuals with depression were more likely to have short sleep durations instead of long ones (RRR 1.20 [1.02-1.43]). CONCLUSIONS The present study identified the bidirectional relationship between sleep duration and depression. Short sleep durations were a risk factor for the onset and recurrent depression. Conversely, depression induced short sleep durations rather than excessive sleep durations. Future studies need to focus on identifying the mechanism between sleep duration and depression, and develop additional evidence-based cost-effective interventions to prevent depression and sleep problems.
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106
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Pang R, Guo R, Wu X, Hu F, Liu M, Zhang L, Wang Z, Li K. Altered Regional Homogeneity in Chronic Insomnia Disorder with or without Cognitive Impairment. AJNR Am J Neuroradiol 2018; 39:742-747. [PMID: 29496724 DOI: 10.3174/ajnr.a5587] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 12/29/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Many studies have shown that insomnia is an independent factor in cognitive impairment, but the involved neurobiological mechanisms remain unclear. We used regional homogeneity to explore the specific neurobiologic indicators of chronic insomnia disorder with mild cognitive impairment. MATERIALS AND METHODS Thirty-nine patients with insomnia were divided into a group with and without cognitive impairment; we also included a control group (n = 28). Abnormalities in brain functional activity were identified by comparing the regional homogeneity values for each brain region among the groups. RESULTS Subjective insomnia scores were negatively correlated with cognitive impairment after controlling for age, sex, and educational effects. Regions with significant differences in regional homogeneity values in the 3 groups were concentrated in the right medial prefrontal cortex, the right superior frontal gyrus, and the left superior occipital gyrus. Meanwhile, subjective insomnia scores were negatively correlated with the strength of the decreased regional homogeneity in the right medial prefrontal cortex. The increased regional homogeneity value in the right superior frontal gyrus was positively correlated with the Montreal Cognitive Assessment score in patients. CONCLUSIONS Our results indicate that decreased regional homogeneity values in the medial prefrontal cortex and increased regional homogeneity values in the cuneus may be important neurobiologic indicators of chronic insomnia disorder and accompanying cognitive impairment. Overall, our study described the regional homogeneity of the whole brain in chronic insomnia disorder with mild cognitive impairment and could be the basis for future studies.
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Affiliation(s)
- R Pang
- From the Departments of Radiology (R.P., M.L., Z.W., K.L.).,Department of Radiology (R.P., K.L.), Xuanwu Hospital, Capital Medical University, Beijing, China
| | | | - X Wu
- Acupuncture (X.W.), Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - F Hu
- Institute of Automation (F.H.), Chinese Academy of Sciences. Beijing, China.,School of Automation (F.H.), Harbin University of Science and Technology, Harbin, China
| | - M Liu
- From the Departments of Radiology (R.P., M.L., Z.W., K.L.)
| | | | - Z Wang
- From the Departments of Radiology (R.P., M.L., Z.W., K.L.)
| | - K Li
- From the Departments of Radiology (R.P., M.L., Z.W., K.L.) .,Department of Radiology (R.P., K.L.), Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics (K.L.), Beijing, China
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107
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Genetic variation in Aquaporin-4 moderates the relationship between sleep and brain Aβ-amyloid burden. Transl Psychiatry 2018; 8:47. [PMID: 29479071 PMCID: PMC5865132 DOI: 10.1038/s41398-018-0094-x] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 11/22/2017] [Accepted: 12/30/2017] [Indexed: 01/08/2023] Open
Abstract
The glymphatic system is postulated to be a mechanism of brain Aβ-amyloid clearance and to be most effective during sleep. Ablation of the astrocytic end-feet expressed water-channel protein, Aquaporin-4, in mice, results in impairment of this clearance mechanism and increased brain Aβ-amyloid deposition, suggesting that Aquaporin-4 plays a pivotal role in glymphatic function. Currently there is a paucity of literature regarding the impact of AQP4 genetic variation on sleep, brain Aβ-amyloid burden and their relationship to each other in humans. To address this a cross-sectional observational study was undertaken in cognitively normal older adults from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study. Genetic variants in AQP4 were investigated with respect to self-reported Pittsburgh Sleep Quality Index sleep parameters, positron emission tomography derived brain Aβ-amyloid burden and whether these genetic variants moderated the sleep-Aβ-amyloid burden relationship. One AQP4 variant, rs72878776, was associated with poorer overall sleep quality, while several SNPs moderated the effect of sleep latency (rs491148, rs9951307, rs7135406, rs3875089, rs151246) and duration (rs72878776, rs491148 and rs2339214) on brain Aβ-amyloid burden. This study suggests that AQP4 genetic variation moderates the relationship between sleep and brain Aβ-amyloid burden, which adds weight to the proposed glymphatic system being a potential Aβ-amyloid clearance mechanism and suggests that AQP4 genetic variation may impair this function. Further, AQP4 genetic variation should be considered when interpreting sleep-Aβ relationships.
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108
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Brown BJ, Robinson D, Jensen JF, Seedall RB, Hodgson J, Norton MC. Will Improving My Marriage Improve My Sleep? JOURNAL OF COUPLE & RELATIONSHIP THERAPY 2018. [DOI: 10.1080/15332691.2017.1417938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Braden J. Brown
- Department of Human Development and Family Science, East Carolina University, Greenville, NC/USA
| | - Dave Robinson
- Department of Family, Consumer, and Human Development, Utah State University, Logan, UT/USA
| | - Jakob F. Jensen
- Department of Human Development and Family Science, East Carolina University, Greenville, NC/USA
| | - Ryan B. Seedall
- Department of Family, Consumer, and Human Development, Utah State University, Logan, UT/USA
| | - Jennifer Hodgson
- Department of Human Development and Family Science, East Carolina University, Greenville, NC/USA
| | - Maria C. Norton
- Department of Family, Consumer, and Human Development, Utah State University, Logan, UT/USA
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Gibson R, Campbell A, Mather S, Neill A. From diagnosis to long-term management: the experiences of older New Zealanders with obstructive sleep apnoea. J Prim Health Care 2018; 10:140-149. [DOI: 10.1071/hc17072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
ABSTRACT INTRODUCTION In New Zealand (NZ), access to public sleep services is limited to people deemed with the highest need. The prevalence of obstructive sleep apnoea (OSA) increases with age, but the symptoms and the treatment pathway is expected to differ for older compared to younger patients. This study explored the experience of older people regarding diagnosis and treatment services for OSA in order to inform considerations required in primary health and sleep services. METHODS Patients who were initiated on Continuous Positive Airway Pressure (CPAP) therapy at the age of 65 years or older were invited to one of three 1.5-h focus group discussions. In total, 16 patients attended; nine were accompanied by their spouse or partner. Discussions were semi-structured and explored experiences with the OSA pathway, from diagnosis through to long-term management. RESULTS Thematic analysis highlights the key symptoms of OSA. Patients’ experiences with diagnostic and treatment services were generally positive. However, there was an overarching need for greater knowledge and follow up regarding OSA and CPAP therapy. Most patients were happy with CPAP treatment. Issues associated with long-term use, comfort and daily management were highlighted, and strategies used to overcome them discussed. DISCUSSION Focus groups reported similar experiences, positively endorsing the health value of OSA diagnosis and CPAP therapy. Mechanisms and resources are required at a primary healthcare level in order to raise awareness around sleep and aging, OSA and CPAP. This would aid earlier and more appropriate diagnosis and management of OSA and help overcome some of the gaps identified in this study.
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110
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Abstract
Hospitalization is a period of acute sleep deprivation for older adults owing to environmental, medical, and patient factors. Although hospitalized patients are in need of adequate rest and recovery during acute illness, older patients face unique risks owing to acute sleep loss during hospitalization. Sleep loss in the hospital is associated with worse health outcomes, including cardiometabolic derangements and an increased risk of delirium. Because older patients are at risk of polypharmacy and medication side effects, a variety of nonpharmacologic interventions are recommended first to improve sleep loss for hospitalized older adults.
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Affiliation(s)
- Nancy H Stewart
- Creighton University Medical Center, 7500 Mercy Road, Omaha, NE 68124, USA
| | - Vineet M Arora
- Department of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 2007 AMB W216, Chicago, IL 60637, USA.
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111
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Sonnesen L, Petersson A, Berg S, Svanholt P. Pharyngeal Airway Dimensions and Head Posture in Obstructive Sleep Apnea Patients with and without Morphological Deviations in the Upper Cervical Spine. J Oral Maxillofac Res 2017; 8:e4. [PMID: 29142656 PMCID: PMC5676314 DOI: 10.5037/jomr.2017.8304] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 09/26/2017] [Indexed: 11/16/2022]
Abstract
Objectives The aim of the study was to analyse differences in pharyngeal airway dimensions and head posture between obstructive sleep apnea patients with and without morphological deviations in the upper cervical spine and to analyse associations between pharyngeal airway dimensions and head posture in the total sample. Material and Methods The sample comprised 53 obstructive sleep apnea (OSA) patients of which 32.1% had upper spine morphological deviations. Accordingly two groups were defined: 17 OSA patients with morphological deviations in the upper spine and 36 without upper spine deviations. Pharyngeal airway dimensions in terms of distances, cross-sectional areas and volume and upper spine morphological deviations were evaluated on cone-beam computed tomography. Head posture was evaluated on two-dimensional generated lateral cephalograms. Differences were analysed and adjusted for age and gender by multiple linear regression analysis. Results OSA patients with upper spine morphological deviations had a significantly more backward and curved neck posture (OPT/HOR, P < 0.01; OPT/CVT, P < 0.05) compared to OSA patients without spine deviations. No significant differences were found in airway dimensions between patients with and without upper spine deviations. In the total group significant associations were found between head posture and pharyngeal airway distances and cross-sectional area at the nasal floor, epiglottis and hyoid bone level (P < 0.05, P < 0.01, P < 0.001). No significant association was found between head posture and airway volume. Conclusions The results may contribute to differentiate obstructive sleep apnea patients and thereby may prove valuable in diagnosis and treatment planning of obstructive sleep apnea patients.
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Affiliation(s)
- Liselotte Sonnesen
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of CopenhagenDenmark
| | - Arne Petersson
- Department of Oral and Maxillofacial Radiology, Malmö University, MalmöSweden
| | - Søren Berg
- Clinic for Infant and Adult Sleep Medicine, Lovisenberg Diakonale Sykehus, OsloNorway
| | - Palle Svanholt
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of CopenhagenDenmark
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112
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Broström A, Wahlin Å, Alehagen U, Ulander M, Johansson P. Sex-specific associations between self-reported sleep duration, depression, anxiety, fatigue and daytime sleepiness in an older community-dwelling population. Scand J Caring Sci 2017; 32:290-298. [DOI: 10.1111/scs.12461] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 02/27/2017] [Indexed: 02/03/2023]
Affiliation(s)
- Anders Broström
- Department of Clinical Neurophysiology; University Hospital; Linköping Sweden
- Department of Nursing; School of Health and Welfare; Jönköping University; Jönköping Sweden
| | - Åke Wahlin
- Institute of Gerontology; School of Health and Welfare; Jönköping University; Jönköping Sweden
| | - Urban Alehagen
- Department of Cardiology and Department of Medical and Health Sciences; Linköping University; Linköping Sweden
| | - Martin Ulander
- Department of Clinical Neurophysiology; University Hospital; Linköping Sweden
| | - Peter Johansson
- Department of Cardiology and Department of Medical and Health Sciences; Linköping University; Linköping Sweden
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113
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Kling JM, Manson JE, Naughton MJ, Temkit M, Sullivan SD, Gower EW, Hale L, Weitlauf JC, Nowakowski S, Crandall CJ. Association of sleep disturbance and sexual function in postmenopausal women. Menopause 2017; 24:604-612. [PMID: 28141665 PMCID: PMC5443696 DOI: 10.1097/gme.0000000000000824] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Sleep disturbance and sexual dysfunction are common in menopause; however, the nature of their association is unclear. The present study aimed to determine whether sleep characteristics were associated with sexual activity and sexual satisfaction. METHODS Sexual function in the last year and sleep characteristics (past 4 wk) were assessed by self-report at baseline for 93,668 women age 50 to 79 years enrolled in the Women's Health Initiative (WHI) Observational Study (OS). Insomnia was measured using the validated WHI Insomnia Rating Scale. Sleep-disordered breathing (SDB) risk was assessed using questions adapted from the Berlin Questionnaire. Using multivariate logistic regression, we examined cross-sectional associations between sleep measures and two indicators of sexual function: partnered sexual activity and sexual satisfaction within the last year. RESULTS Fifty-six percent overall reported being somewhat or very satisfied with their current sexual activity, and 52% reported partnered sexual activity within the last year. Insomnia prevalence was 31%. After multivariable adjustment, higher insomnia scores were associated with lower odds of sexual satisfaction (yes/no) (odds ratio [OR] 0.92, 95% CI, 0.87-0.96). Short sleep duration (<7-8 h) was associated with lower odds of partnered sexual activity (yes/no) (≤5 h, OR 0.88, 95% CI, 0.80-0.96) and less sexual satisfaction (≤5 h, OR 0.88, 95% CI, 0.81-0.95). CONCLUSIONS Shorter sleep durations and higher insomnia scores were associated with decreased sexual function, even after adjustment for potential confounders, suggesting the importance of sufficient, high-quality sleep for sexual function. Longitudinal investigation of sleep and its impact on sexual function postmenopause will clarify this relationship.
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Affiliation(s)
| | - JoAnn E. Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michelle J. Naughton
- Division of Population Sciences, Department of Internal Medicine, Ohio State University, Columbus, Ohio
| | - M'hamed Temkit
- Division of Health Sciences Research, Mayo Clinic, Scottsdale, Arizona
| | - Shannon D Sullivan
- Division of Endocrinology, Medstar Washington Hospital Center and Georgetown University, Washington, D.C
| | - Emily W Gower
- Department of Epidemiology and Ophthalmology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, New York
| | - Julie C. Weitlauf
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California
| | - Sara Nowakowski
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Carolyn J. Crandall
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles,, California
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114
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The association between sleep duration and physical performance in Chinese community-dwelling elderly. PLoS One 2017; 12:e0174832. [PMID: 28358845 PMCID: PMC5373617 DOI: 10.1371/journal.pone.0174832] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 03/15/2017] [Indexed: 12/21/2022] Open
Abstract
Background Physical performance is an important healthy factor in elder people. Good living habits, which include sleep, can maintain physical strength and physical performance. The aim of the present study was to conduct a cross-sectional study to determine the association between total sleep duration and physical performance. Methods Our study population comprised residents of the township central hospital in the suburban of Tianjin, China. We measured muscle strength, walk speed and balance function by grip, 4-m walk test and timed up and go test (TUGT). We divided sleep duration into four groups <7h, 7-8h, >8-9h, >9h. Results A total 898 participants had completed data (392 men and 506 women, mean age 67.71 years). In man, adjusted sleep duration was associated with lower grip in > 9 h group, the mean value (95% CI) was 0.429 (0.409, 0.448), and longer TUGT time was also associated with long sleep duration, 10.46s (9.97 s, 10.95 s). In women, adjusted slower 4-m walk speed present an inverse U-shaped relation with sleep duration, by 0.93 m/s (0.86 m/s, 0.98 m/s), 0.97 m/s (0.96 m/s, 1.00 m/s), 0.97 m/s (0.95 m/s, 0.99 m/s) and 0.92 m/s (0.89 m/s, 0.96 m/s); longer TUGT time were associated with long sleep duration (> 9 h), by 11.23 s (10.70 s, 11.77 s). Conclusion In Chinese community-dwelling elderly, lower muscle strength and lower balance function were associated with long sleep duration in men. Slower walk speed and lower balance function were associated with long sleep duration in women.
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115
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Effects of Inhalation Aromatherapy on Symptoms of Sleep Disturbance in the Elderly with Dementia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:1902807. [PMID: 28400839 PMCID: PMC5376423 DOI: 10.1155/2017/1902807] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 02/20/2017] [Indexed: 11/18/2022]
Abstract
This study investigated the effects of inhalation aromatherapy on sleep disturbance in elderly individuals with dementia. In 19 subjects, normal sleep was observed for a 20-day control period, inhalation aromatherapy was then applied for a 20-day intervention period, and the control and intervention periods were compared. During the intervention period, essential oils were placed nightly on towels around the subjects' pillows. The measured sleep conditions were sleep latency, total sleep time, sleep efficacy, duration of the longest sustained sleep period, wake time after sleep onset, early morning awakening, total daytime sleep, and the Neuropsychiatric Inventory. Total sleep time was significantly longer in the intervention period than in the control period (p < 0.05). The duration of the longest sustained sleep period was significantly longer in the intervention period than in the control period (p < 0.05). Early morning awakening in the intervention period was significantly less compared to that in the control period (p < 0.05). Total daytime sleep could not be adequately measured and was omitted from the analysis. No significant differences in other sleep conditions were observed. These results indicated positive effects of inhalation aromatherapy on symptoms of sleep disturbance in elderly individuals with dementia.
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116
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Gui WJ, Li HJ, Guo YH, Peng P, Lei X, Yu J. Age-related differences in sleep-based memory consolidation: A meta-analysis. Neuropsychologia 2017; 97:46-55. [PMID: 28161367 DOI: 10.1016/j.neuropsychologia.2017.02.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/22/2017] [Accepted: 02/01/2017] [Indexed: 01/04/2023]
Abstract
A period of post-learning sleep benefits memory consolidation compared with an equal-length wake interval. However, whether this sleep-based memory consolidation changes as a function of age remains controversial. Here we report a meta-analysis that investigates the age differences in the sleep-based memory consolidation in two types of memory: declarative memory and procedural memory. The meta-analysis included 22 comparisons of the performance between young adults (N =640) and older adults (N =529) on behavioral tasks measuring sleep-based memory consolidation. Our results showed a significant overall sleep-based beneficial effect in young adults but not in older adults. However, further analyses suggested that the age differences were mainly manifested in sleep-based declarative memory consolidation but not in procedural memory consolidation. We discussed the possible underlying mechanisms for the age-related degradation in sleep-based memory consolidation. Further research is needed to determine the crucial components for sleep-related memory consolidation in older adults such as age-related changes in neurobiological and cardiovascular functions, which may play an important role in this context and have the potential to delineate the interrelationships between age-related changes in sleep and memory.
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Affiliation(s)
- Wen-Jun Gui
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Hui-Jie Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| | - Yu-Hua Guo
- MRC Cognition and Brain Sciences Unit, Cambridge CB2 7EF, United Kingdom; University of Cambridge, The Old Schools, Cambridge CB2 1TN, United Kingdom
| | - Peng Peng
- Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln NE 68583, USA
| | - Xu Lei
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Jing Yu
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
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Pettee Gabriel K, Sternfeld B, Shiroma EJ, Pérez A, Cheung J, Lee IM. Bidirectional associations of accelerometer-determined sedentary behavior and physical activity with reported time in bed: Women's Health Study. Sleep Health 2017; 3:49-55. [PMID: 28346151 PMCID: PMC5373487 DOI: 10.1016/j.sleh.2016.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/31/2016] [Accepted: 10/05/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To examine the day-to-day, bidirectional associations of accelerometer-derived sedentary behavior and physical activity (PA) with reported time in bed in a large cohort of older women. METHODS Data are from 10086 Women's Health Study participants (aged 71.6 years; SD, 5.7) who agreed to wear an accelerometer and complete a diary for 7 consecutive days. Generalized linear (multilevel) models with repeated measures were used to examine the adjusted associations of the following: (1) reported time in bed with next-day accelerometer-determined counts and time spent sedentary and in light- and moderate-to-vigorous-intensity PA (MVPA) and (2) accelerometer estimates with reported time in bed that night, expressed as short (<7 hours), optimal (7-9 hours), and long (>9 hours) sleep. RESULTS Across days, short sleep was associated with an average of 5500 (SE, 1352) higher accelerometer counts the following day but was also related to higher average sedentary (46.5 [SE, 1.5] minutes) and light-intensity PA (11.9 [SE, 1.2] minutes) than optimal sleep (all P<.001). Long sleep was associated with lower accelerometer counts, time spent sedentary and in light-intensity PA, and a reduced likelihood of engaging in ≥20 minutes of MVPA (all P<.001) than optimal sleep. Higher PA during the day (higher accelerometer counts and ≥20 minutes of accumulated MVPA) was associated with a reduced likelihood of reporting short or long sleep that night (all P<.001). CONCLUSIONS Findings support the bidirectional associations of accelerometer-determined sedentary behavior and PA with reported time in bed in older women. Future studies are needed to confirm findings with sleep actigraphy in older women.
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Affiliation(s)
- Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center in Houston, School of Public Health-Austin Campus, Austin, TX 78701.
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612
| | - Eric J Shiroma
- Division of Preventive Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA; National Institute on Aging, National Institutes of Health, Bethesda, MD
| | - Adriana Pérez
- Department of Biostatistics, University of Texas Health Science Center in Houston, School of Public Health-Austin Campus, Austin, TX 78701
| | - Joseph Cheung
- Stanford Center for Sleep Sciences and Medicine, Stanford University; Palo Alto, CA 94304
| | - I-Min Lee
- Division of Preventive Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
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Singh SS, Deb A, Sutradhar S. Dexamethasone modulates melatonin MT2 receptor expression in splenic tissue and humoral immune response in mice. BIOL RHYTHM RES 2016. [DOI: 10.1080/09291016.2016.1268330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Shiv Shankar Singh
- Molecular Endocrinology Research Lab, Department of Zoology, Tripura University, Suryamaninagar, India
| | - Anindita Deb
- Molecular Endocrinology Research Lab, Department of Zoology, Tripura University, Suryamaninagar, India
| | - Sangita Sutradhar
- Molecular Endocrinology Research Lab, Department of Zoology, Tripura University, Suryamaninagar, India
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Kim JH, Park EC, Lee KS, Lee Y, Shim S, Kim J, Chon D, Lee SG. Association of sleep duration with rheumatoid arthritis in Korean adults: analysis of seven years of aggregated data from the Korea National Health and Nutrition Examination Survey (KNHANES). BMJ Open 2016; 6:e011420. [PMID: 27965246 PMCID: PMC5168660 DOI: 10.1136/bmjopen-2016-011420] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 10/13/2016] [Accepted: 10/18/2016] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To investigate the association between rheumatoid arthritis (RA) and self-reported sleep duration. SETTING The present study analysed 7 years of aggregated cross-sectional data (2007-2013) from the Korea National Health and Nutrition Examination Surveys (KNHANES). PARTICIPANTS A total of 37 979 individuals were selected for the analyses. INTERVENTIONS RA. PRIMARY AND SECONDARY OUTCOME MEASURES Sleep duration. RESULTS After adjusting for confounding factors, the odds of short-duration sleepers (≤6 hours/day) and long-duration sleepers (≥9 hours/day) for RA were 1.23-fold (95% CI 1.101 to 1.51) and 1.27-fold (95% CI 0.85 to 1.88) higher, respectively, than those for persons with sleep duration of 7-8 hours/day. A subgroup analysis according to the extent of pain in RA revealed that the strong relationship between RA and sleep disturbances was observed in those with high pain from RA (OR: 1.28 CI 1.04 to 1.58). CONCLUSIONS Individuals with RA may be at a higher risk for sleep disturbances compared with individuals without RA. Therefore, the provision of comprehensive care for patients with RA by healthcare professionals should include assessments of sleep duration and patients with RA should be encouraged to report sleep problems.
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Affiliation(s)
- Jae-Hyun Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Kwang Soo Lee
- Department of Health Administration, College of Health Sciences, Yonsei University, Wonju, South Korea
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Sungkeun Shim
- Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Jinhee Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Doukyoung Chon
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Sang-Gue Lee
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Hospital management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
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Asken BM, Sullan MJ, Snyder AR, Houck ZM, Bryant VE, Hizel LP, McLaren ME, Dede DE, Jaffee MS, DeKosky ST, Bauer RM. Factors Influencing Clinical Correlates of Chronic Traumatic Encephalopathy (CTE): a Review. Neuropsychol Rev 2016; 26:340-363. [PMID: 27561662 PMCID: PMC5507554 DOI: 10.1007/s11065-016-9327-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 08/08/2016] [Indexed: 12/14/2022]
Abstract
Chronic traumatic encephalopathy (CTE) is a neuropathologically defined disease reportedly linked to a history of repetitive brain trauma. As such, retired collision sport athletes are likely at heightened risk for developing CTE. Researchers have described distinct pathological features of CTE as well a wide range of clinical symptom presentations, recently termed traumatic encephalopathy syndrome (TES). These clinical symptoms are highly variable, non-specific to individuals described as having CTE pathology in case reports, and are often associated with many other factors. This review describes the cognitive, emotional, and behavioral changes associated with 1) developmental and demographic factors, 2) neurodevelopmental disorders, 3) normal aging, 4) adjusting to retirement, 5) drug and alcohol abuse, 6) surgeries and anesthesia, and 7) sleep difficulties, as well as the relationship between these factors and risk for developing dementia-related neurodegenerative disease. We discuss why some professional athletes may be particularly susceptible to many of these effects and the importance of choosing appropriate controls groups when designing research protocols. We conclude that these factors should be considered as modifiers predominantly of the clinical outcomes associated with repetitive brain trauma within a broader biopsychosocial framework when interpreting and attributing symptom development, though also note potential effects on neuropathological outcomes. Importantly, this could have significant treatment implications for improving quality of life.
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Affiliation(s)
- Breton M Asken
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
| | - Molly J Sullan
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Aliyah R Snyder
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Zachary M Houck
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Vaughn E Bryant
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Loren P Hizel
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Molly E McLaren
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Duane E Dede
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Michael S Jaffee
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Steven T DeKosky
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Russell M Bauer
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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The association between benzodiazepine use and sleep quality in residential aged care facilities: a cross-sectional study. BMC Geriatr 2016; 16:196. [PMID: 27888835 PMCID: PMC5124287 DOI: 10.1186/s12877-016-0363-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 11/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Benzodiazepines are commonly prescribed in residential aged care facilities (RACFs) for their sedative and anxiolytic effects. The objective of this study was to investigate the association between benzodiazepine use and sleep quality in residents of RACFs. METHODS A cross-sectional study involving 383 participants was conducted in six Australian RACFs. Night-time sleep quality, day-time drowsiness and day-time napping behavior were assessed using a validated questionnaire. Logistic regression was used to compute adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the association between benzodiazepine use and sleep quality. Covariates included pain, dementia severity, depression, insomnia and other sedative use. RESULTS Of the 383 residents (mean age 87.5 years, 77.5% female), 96(25.1%) used a benzodiazepine on a regular basis. Residents who used long-acting benzodiazepines on a regular basis had higher night-time sleep quality than non-users (AOR = 4.00, 95%CI 1.06 - 15.15). Residents who used short-acting benzodiazepines on a PRN only basis had longer daytime napping times than non-users (AOR = 1.77, 95%CI 1.01 - 3.08). No benzodiazepine category was associated with day-time drowsiness. CONCLUSIONS The association between benzodiazepine use and sleep quality is dependent on the half-life and prescribing pattern of the benzodiazepine. Short-acting PRN benzodiazepines were associated with lower night time sleep quality and longer day-time napping compared to long-acting regular benzodiazepines. Longitudinal studies are needed to determine whether these findings reflect channeling of short-acting agents to residents at higher risk of sleep disorders.
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Gamaldo AA, Beydoun MA, Beydoun HA, Liang H, Salas RE, Zonderman AB, Gamaldo CE, Eid SM. Sleep Disturbances among Older Adults in the United States, 2002-2012: Nationwide Inpatient Rates, Predictors, and Outcomes. Front Aging Neurosci 2016; 8:266. [PMID: 27895576 PMCID: PMC5109617 DOI: 10.3389/fnagi.2016.00266] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 10/24/2016] [Indexed: 01/08/2023] Open
Abstract
Objective/Background: We examined the rates, predictors, and outcomes [mortality risk (MR), length of stay (LOS), and total charges (TC)] of sleep disturbances in older hospitalized patients. Patients/Methods: Using the U.S. Nationwide Inpatient Sample database (2002–2012), older patients (≥60 years) were selected and rates of insomnia, obstructive sleep apnea (OSA) and other sleep disturbances (OSD) were estimated using ICD-9CM. TC, adjusted for inflation, was of primary interest, while MR and LOS were secondary outcomes. Multivariable regression analyses were conducted. Results: Of 35,258,031 older adults, 263,865 (0.75%) had insomnia, 750,851 (2.13%) OSA and 21,814 (0.06%) OSD. Insomnia rates increased significantly (0.27% in 2002 to 1.29 in 2012, P-trend < 0.001), with a similar trend observed for OSA (1.47 in 2006 to 5.01 in 2012, P-trend < 0.001). TC (2012 $) for insomnia-related hospital admission increased over time from $22,250 in 2002 to $31,527 in 2012, and increased similarly for OSA and OSD; while LOS and MR both decreased. Women with any sleep disturbance had lower MR and TC than men, while Whites had consistently higher odds of insomnia, OSA, and OSD than older Blacks and Hispanics. Co-morbidities such as depression, cardiovascular risk factors, and neurological disorders steadily increased over time in patients with sleep disturbances. Conclusion: TC increased over time in patients with sleep disturbances while LOS and MR decreased. Further, research should focus on identifying the mechanisms that explain the association between increasing sleep disturbance rates and expenditures within hospital settings and the potential hospital expenditures of unrecognized sleep disturbances in the elderly.
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Affiliation(s)
- Alyssa A Gamaldo
- School of Aging Studies, University of South FloridaTampa, FL, USA; Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRPBaltimore, MD, USA; Human Development and Family Studies, Penn State UniversityState College, PA, USA
| | - May A Beydoun
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP Baltimore, MD, USA
| | - Hind A Beydoun
- Department of Medicine, Johns Hopkins University School of Medicine Baltimore, MD, USA
| | - Hailun Liang
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health Baltimore, MD, USA
| | - Rachel E Salas
- Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA
| | - Alan B Zonderman
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP Baltimore, MD, USA
| | - Charlene E Gamaldo
- Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA
| | - Shaker M Eid
- Department of Medicine, Johns Hopkins University School of Medicine Baltimore, MD, USA
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Low-dose Dexmedetomidine Improves Sleep Quality Pattern in Elderly Patients after Noncardiac Surgery in the Intensive Care Unit. Anesthesiology 2016; 125:979-991. [DOI: 10.1097/aln.0000000000001325] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Abstract
Background
Patients admitted to the intensive care unit (ICU) after surgery often develop sleep disturbances. The authors tested the hypothesis that low-dose dexmedetomidine infusion could improve sleep architecture in nonmechanically ventilated elderly patients in the ICU after surgery.
Methods
This was a pilot, randomized controlled trial. Seventy-six patients age 65 yr or older who were admitted to the ICU after noncardiac surgery and did not require mechanical ventilation were randomized to receive dexmedetomidine (continuous infusion at a rate of 0.1 μg kg−1 h−1; n = 38) or placebo (n = 38) for 15 h, i.e., from 5:00 pm on the day of surgery until 8:00 am on the first day after surgery. Polysomnogram was monitored during the period of study-drug infusion. The primary endpoint was the percentage of stage 2 non–rapid eye movement (stage N2) sleep.
Results
Complete polysomnogram recordings were obtained in 61 patients (30 in the placebo group and 31 in the dexmedetomidine group). Dexmedetomidine infusion increased the percentage of stage N2 sleep from median 15.8% (interquartile range, 1.3 to 62.8) with placebo to 43.5% (16.6 to 80.2) with dexmedetomidine (difference, 14.7%; 95% CI, 0.0 to 31.9; P = 0.048); it also prolonged the total sleep time, decreased the percentage of stage N1 sleep, increased the sleep efficiency, and improved the subjective sleep quality. Dexmedetomidine increased the incidence of hypotension without significant intervention.
Conclusions
In nonmechanically ventilated elderly patients who were admitted to the ICU after noncardiac surgery, the prophylactic low-dose dexmedetomidine infusion may improve overall sleep quality.
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Moon C, Yoon JY, Bratzke LC. The Role of Heart Failure, Daytime Sleepiness, and Disturbed Sleep on Cognition. West J Nurs Res 2016; 39:473-491. [PMID: 27784834 DOI: 10.1177/0193945916675587] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Disturbed sleep and daytime sleepiness may interfere with possible direct relationships between heart failure (HF) and cognition, yet there is limited research investigating this relationship. We aimed to investigate possible mediating roles of disturbed sleep and daytime sleepiness on the relationship between HF and selected cognitive domains among individuals with and without HF. In a cross-sectional design study, we examined the data of 841 older adults with and without HF from the Aging, Demographics, and Memory Study (ADAMS). We found individuals with HF were likely to have a higher degree of disturbed sleep and daytime sleepiness. Both disturbed sleep and daytime sleepiness were significant predictors of cognition. We found that only daytime sleepiness mediated the relationship between the presence of HF and cognitive domains, such as in attention, memory, and executive function after controlling for covariates. Interventions to improve daytime sleepiness among individuals with HF may also help improving cognition.
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Affiliation(s)
- Chooza Moon
- 1 University of Wisconsin-Madison, Madison, WI, USA
| | - Ju Young Yoon
- 2 College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
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Backhaus W, Kempe S, Hummel FC. The effect of sleep on motor learning in the aging and stroke population - a systematic review. Restor Neurol Neurosci 2016; 34:153-64. [PMID: 26835597 DOI: 10.3233/rnn-150521] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is extensive evidence for positive effects of sleep on motor learning in young individuals; however, the effects of sleep on motor learning in people with stroke and in healthy older individuals are not well understood. The aim of this systematic review was to quantify the association between sleep and procedural memory performance - a marker for motor learning - in healthy older people and people with stroke. After searches in PubMed, Medline and Embase fourteen studies, including 44 subjects after stroke and 339 healthy older participants were included. Overall, sleep was found to enhance motor performance in people after stroke in comparison to an equivalent time of wakefulness. In addition, although evidence is limited, sleep only enhanced motor performance in people after stroke and not in age-matched healthy older adults. In older adults the effect of a sleep intervention did - in general - not differ from equivalent periods of wakefulness. Tasks with whole hand or whole body movements could show significant changes. The results suggest a delayed retention effect after longer breaks including sleep, hinting towards a changed learning strategy as a result of aging. Current evidence for sleep dependent learning in people after stroke is promising, however sparse.
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Abstract
Introduction A recent increase in studies suggests a role of age-related sleep changes in executive functions (EF). However, this relationship remains unclear and mixed results have emerged. Objective To investigate how age-related sleep changes may play an important role in the extent to which healthy older adults exhibit decline in EF. Methods A systematic strategy was employed to identify the available literature on age-related sleep changes and EF. Results: Of the 465 studies identified, 26 were included. Results suggest that multiple sleep parameters differ in the way they benefit or impair EF. Parameters such as greater wake after sleep onset and lower sleep efficiency, in addition to circadian fragmentation of sleep, showed more consistent results and are potentially correlated with worsening in EF measures. However, other results seem inconclusive. Conclusion These findings were discussed based on the prefrontal circuitry vulnerability model, in which sleep has been identified as a beneficial factor for prefrontal cortex functioning and hence for EF, which relies mostly on this brain area and its related networks.
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Affiliation(s)
| | - Katie Moraes de Almondes
- Associate Professor at the Department of Psychology and on the Postgraduate Program in Psychology, Federal University of Rio Grande do Norte, Natal RN, Brazil
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Mood, stress and longevity: convergence on ANK3. Mol Psychiatry 2016; 21:1037-49. [PMID: 27217151 PMCID: PMC9798616 DOI: 10.1038/mp.2016.65] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/10/2016] [Accepted: 03/14/2016] [Indexed: 01/01/2023]
Abstract
Antidepressants have been shown to improve longevity in C. elegans. It is plausible that orthologs of genes involved in mood regulation and stress response are involved in such an effect. We sought to understand the underlying biology. First, we analyzed the transcriptome from worms treated with the antidepressant mianserin, previously identified in a large-scale unbiased drug screen as promoting increased lifespan in worms. We identified the most robust treatment-related changes in gene expression, and identified the corresponding human orthologs. Our analysis uncovered a series of genes and biological pathways that may be at the interface between antidepressant effects and longevity, notably pathways involved in drug metabolism/degradation (nicotine and melatonin). Second, we examined which of these genes overlap with genes which may be involved in depressive symptoms in an aging non-psychiatric human population (n=3577), discovered using a genome-wide association study (GWAS) approach in a design with extremes of distribution of phenotype. Third, we used a convergent functional genomics (CFG) approach to prioritize these genes for relevance to mood disorders and stress. The top gene identified was ANK3. To validate our findings, we conducted genetic and gene-expression studies, in C. elegans and in humans. We studied C. elegans inactivating mutants for ANK3/unc-44, and show that they survive longer than wild-type, particularly in older worms, independently of mianserin treatment. We also show that some ANK3/unc-44 expression is necessary for the effects of mianserin on prolonging lifespan and survival in the face of oxidative stress, particularly in younger worms. Wild-type ANK3/unc-44 increases in expression with age in C. elegans, and is maintained at lower youthful levels by mianserin treatment. These lower levels may be optimal in terms of longevity, offering a favorable balance between sufficient oxidative stress resistance in younger worms and survival effects in older worms. Thus, ANK3/unc-44 may represent an example of antagonistic pleiotropy, in which low-expression level in young animals are beneficial, but the age-associated increase becomes detrimental. Inactivating mutations in ANK3/unc-44 reverse this effect and cause detrimental effects in young animals (sensitivity to oxidative stress) and beneficial effect in old animals (increased survival). In humans, we studied if the most significant single nucleotide polymorphism (SNP) for depressive symptoms in ANK3 from our GWAS has a relationship to lifespan, and show a trend towards longer lifespan in individuals with the risk allele for depressive symptoms in men (odds ratio (OR) 1.41, P=0.031) but not in women (OR 1.08, P=0.33). We also examined whether ANK3, by itself or in a panel with other top CFG-prioritized genes, acts as a blood gene-expression biomarker for biological age, in two independent cohorts, one of live psychiatric patients (n=737), and one of suicide completers from the coroner's office (n=45). We show significantly lower levels of ANK3 expression in chronologically younger individuals than in middle age individuals, with a diminution of that effect in suicide completers, who presumably have been exposed to more severe and acute negative mood and stress. Of note, ANK3 was previously reported to be overexpressed in fibroblasts from patients with Hutchinson-Gilford progeria syndrome, a form of accelerated aging. Taken together, these studies uncover ANK3 and other genes in our dataset as biological links between mood, stress and longevity/aging, that may be biomarkers as well as targets for preventive or therapeutic interventions. Drug repurposing bioinformatics analyses identified the relatively innocuous omega-3 fatty acid DHA (docosahexaenoic acid), piracetam, quercetin, vitamin D and resveratrol as potential longevity promoting compounds, along with a series of existing drugs, such as estrogen-like compounds, antidiabetics and sirolimus/rapamycin. Intriguingly, some of our top candidate genes for mood and stress-modulated longevity were changed in expression in opposite direction in previous studies in the Alzheimer disease. Additionally, a whole series of others were changed in expression in opposite direction in our previous studies on suicide, suggesting the possibility of a "life switch" actively controlled by mood and stress.
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Altınyazar V, Kiylioglu N. Insomnia and dementia: is agomelatine treatment helpful? Case report and review of the literature. Ther Adv Psychopharmacol 2016; 6:263-8. [PMID: 27536345 PMCID: PMC4971602 DOI: 10.1177/2045125316646064] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The treatment of sleep disorders in Alzheimer's disease (AD) may be quite challenging in elderly patients because of drug side effects or interactions and comorbid local or systemic diseases. Here, we report a patient with AD, who was suffering from severe insomnia and depression. We ordered agomelatine for the treatment of insomnia in this patient, and it was quite helpful not only for insomnia but also for depression and for the cognitive symptoms related with dementia. Our aim was to share these observations for similar patients.
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Affiliation(s)
- Vesile Altınyazar
- Department of Psychiatry, Medical Faculty, Adnan Menderes University, Aydin, 09100, Turkey
| | - Nefati Kiylioglu
- Department of Neurology, Medical Faculty, Adnan Menderes University, Aydin, 09100, Turkey
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Alakuijala A, Salmi T. Predicting Obstructive Sleep Apnea with Periodic Snoring Sound Recorded at Home. J Clin Sleep Med 2016; 12:953-8. [PMID: 27092701 DOI: 10.5664/jcsm.5922] [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: 09/04/2015] [Accepted: 03/07/2016] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The cost-effectiveness of diagnosing obstructive sleep apnea (OSA) could be improved by using a preliminary screening method among subjects with no suspicion of other sleep disorders. We aimed to evaluate the diagnostic value of periodic snoring sound recorded at home. METHODS We included 211 subjects, aged 18-83 (130 men), who were referred to our laboratory for suspicion of OSA, and had a technically successful overnight polygraphy, measured with the Nox T3 Sleep Monitor (Nox Medical, Iceland) with a built-in microphone. We analyzed the percentage of periodic snoring during the home sleep apnea study. RESULTS Apnea-hypopnea index (AHI) ranged from 0.1 to 116 events/h and the percentage of periodic snoring from 1% to 97%. We found a strong positive correlation (r = 0.727, p < 0.001) between periodic snoring and AHI. The correlation was slightly stronger among female, younger, and obese subjects. The best threshold value of the periodic snoring for predicting an AHI > 15 events/h with as high sensitivity as possible was found to be 15%. There, sensitivity was 93.3%, specificity 35.1%, and negative predictive value 75.0%. CONCLUSIONS According to our results, it is possible to set a periodic snoring threshold (15% or more) for the subject to advance to further sleep studies. Together with medical history and prior to more expensive studies, measuring periodic snoring at home is a simple and useful method for predicting the probability of OSA, in particular among women who are often unaware of their apnea-related snoring.
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Affiliation(s)
- Anniina Alakuijala
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, Helsinki University Hospital, Finland.,Department of Neurological Sciences, University of Helsinki, Helsinki, Finland
| | - Tapani Salmi
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, Helsinki University Hospital, Finland.,Department of Neurological Sciences, University of Helsinki, Helsinki, Finland
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Cardinali DP, Golombek DA, Rosenstein RE, Brusco LI, Vigo DE. Assessing the efficacy of melatonin to curtail benzodiazepine/Z drug abuse. Pharmacol Res 2016; 109:12-23. [DOI: 10.1016/j.phrs.2015.08.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 08/17/2015] [Accepted: 08/19/2015] [Indexed: 12/15/2022]
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131
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Farajzadeh M, Hosseini M, Mohtashami J, Chaibakhsh S, Zagheri Tafreshi M, Ghanei Gheshlagh R. The Association Between Obstructive Sleep Apnea and Depression in Older Adults. Nurs Midwifery Stud 2016; 5:e32585. [PMID: 27579333 PMCID: PMC5002089 DOI: 10.17795/nmsjournal32585] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 01/07/2016] [Accepted: 01/07/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Depression is the most frequent psychiatric disorder among the elderly. Obstructive sleep apnea (OSA) is a chronic and prevalent disease that has an ambiguous role in triggering depression. Several researches with contradictory findings have been performed about the association between OSA and depression. OBJECTIVES This study aimed to investigate the association between OSA and depression among elderly. PATIENTS AND METHODS A total of 350 home residing elderly took part in this case-control study. The participants were selected using clustering method. All cases were divided into two groups of depressed and non-depressed using the geriatric depression scale (GDS). Then they were matched in age, gender, education and body mass index (BMI). Berlin questionnaire (BQ) was used to diagnose OSA. Data analysis was performed using Mann-Whitney U test, t-test, Chi-square and Fisher's exact tests and odds ratio. RESULTS Totally, 60.6 % of depressed group and 18.9 % of non-depressed group were in high risk for OSA. A significant association was found between OSA and depression (P < 0.001, OR = 6.61, CI 95 % = 4.1 - 10.7). In addition, a significant association was found between gender and OSA (P = 0.008). CONCLUSIONS OSA was associated with depression among the elderly patients. Given the high prevalence of OSA in older adults, implementation of screening methods is necessary to identify people at high risk of OSA.
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Affiliation(s)
- Mohammad Farajzadeh
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Imam Khomeini Hospital of Saqqez, Kurdistan University of Medical Sciences, Sanandaj, IR Iran
| | - Meimanat Hosseini
- Department of Community Health Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Jamileh Mohtashami
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Samira Chaibakhsh
- Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mansoureh Zagheri Tafreshi
- Management Department, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Brown BM, Rainey-Smith SR, Villemagne VL, Weinborn M, Bucks RS, Sohrabi HR, Laws SM, Taddei K, Macaulay SL, Ames D, Fowler C, Maruff P, Masters CL, Rowe CC, Martins RN. The Relationship between Sleep Quality and Brain Amyloid Burden. Sleep 2016; 39:1063-8. [PMID: 27091528 DOI: 10.5665/sleep.5756] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 12/24/2015] [Indexed: 01/30/2023] Open
Abstract
STUDY OBJECTIVES To evaluate the association between self-reported sleep quality and levels of brain β-amyloid (Aβ) burden, and to determine the effect of the apolipoprotein E (APOE) ε4 allele on any associations found. METHODS This study is a cross-sectional analysis of 184 cognitively healthy men and women aged over 60 y. We measured sleep quality factors: specifically, sleep duration, latency (time taken to fall asleep), disturbances, efficiency, daytime dysfunction, and overall sleep quality, using the Pittsburgh Sleep Quality Index. All participants underwent Aβ positron emission tomography imaging for the quantification of brain Aβ burden and were APOE genotyped. Linear regression analyses were used to evaluate the relationship between sleep quality factors and brain Aβ burden, adjusting for age, body mass index, cardiovascular disease, and symptoms of depression, with APOE ε4 carriage entered as a moderator. RESULTS Of the sleep factors, longer sleep latency was associated with higher levels of brain Aβ (B = 0.003 [standard error = 0.001], P = 0.02). APOE ε4 allele (carrier/noncarrier) did not moderate the relationship between sleep latency and brain Aβ burden. CONCLUSIONS Our findings suggest a relationship between brain Aβ burden and sleep latency, independent of APOE ε4 genotype.
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Affiliation(s)
- Belinda M Brown
- School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia.,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Hospital, Nedlands, Western Australia
| | - Stephanie R Rainey-Smith
- School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia.,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Hospital, Nedlands, Western Australia
| | - Victor L Villemagne
- Austin Health, Department of Nuclear Medicine and Centre for PET, Heidelberg, Victoria, Australia
| | - Michael Weinborn
- School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia.,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Hospital, Nedlands, Western Australia.,School of Psychology, University of Western Australia, Crawley, Western Australia
| | - Romola S Bucks
- School of Psychology, University of Western Australia, Crawley, Western Australia
| | - Hamid R Sohrabi
- School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia.,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Hospital, Nedlands, Western Australia
| | - Simon M Laws
- School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia.,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Hospital, Nedlands, Western Australia
| | - Kevin Taddei
- School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia.,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Hospital, Nedlands, Western Australia
| | | | - David Ames
- Department of Psychiatry, University of Melbourne, Victoria, Australia.,National Ageing Research Institute, Parkville, Victoria, Australia
| | - Christopher Fowler
- Florey Institute for Neurosciences and Mental Health, University of Melbourne, Victoria, Australia
| | - Paul Maruff
- Florey Institute for Neurosciences and Mental Health, University of Melbourne, Victoria, Australia.,Cogstate Ltd., Melbourne, Victoria, Australia
| | - Colin L Masters
- Florey Institute for Neurosciences and Mental Health, University of Melbourne, Victoria, Australia
| | - Christopher C Rowe
- Austin Health, Department of Nuclear Medicine and Centre for PET, Heidelberg, Victoria, Australia
| | - Ralph N Martins
- School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia.,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Hospital, Nedlands, Western Australia.,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Nedlands, Western Australia
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McFeeters S, Pront L, Cuthbertson L, King L. Massage, a complementary therapy effectively promoting the health and well-being of older people in residential care settings: a review of the literature. Int J Older People Nurs 2016; 11:266-283. [PMID: 26875503 DOI: 10.1111/opn.12115] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 01/04/2016] [Indexed: 11/26/2022]
Abstract
AIMS To explore the potential benefits of massage within daily routine care of the older person in residential care settings. BACKGROUND Globally, the proportion of people over 65 years is rapidly rising. Increased longevity means older people may experience a rise in physiological and psychological health problems. These issues potentially place an increased demand for quality long-term care for the older person. Complementary approaches such as massage appear to be needed in quality residential care. DESIGN A critical literature review was undertaken. METHODS A literature review pertaining to massage in the older resident was conducted using a range of online databases. Fourteen studies dated 1993-2012 met the inclusion criteria and were critically evaluated as suitable resources for this review. RESULTS Evidence suggests massage may be advantageous from client and nursing perspectives. Clients' perceive massage to positively influence factors such as pain, sleep, emotional status and psychosocial health. Evidence also demonstrates massage to benefit the client and organisation by reducing the necessity for restraint and pharmacological intervention. Massage may be incorporated into care provision and adopted by care providers and family members as an additional strategy to enhance quality of life for older people. CONCLUSION Massage offers a practical activity that can be used to enhance the health and well-being of the older person in residential care. IMPLICATIONS FOR PRACTICE Massage offers benefit for promoting health and well-being of the older person along with potential increased engagement of family in care provision. Integration of massage into daily care activities of the older person requires ongoing promotion and implementation.
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Affiliation(s)
| | - Leeanne Pront
- School of Nursing & Midwifery, Flinders University, Adelaide, SA, Australia
| | - Lesley Cuthbertson
- School of Nursing & Midwifery, Flinders University, Adelaide, SA, Australia
| | - Lindy King
- School of Nursing & Midwifery, Flinders University, Adelaide, SA, Australia
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Babkina OV, Poluektov MG, Levin OS. Heterogeneity of excessive daytime sleepiness in Parkinson’s disease. Zh Nevrol Psikhiatr Im S S Korsakova 2016; 116:60-70. [DOI: 10.17116/jnevro20161166260-70] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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135
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Niu J, Han H, Wang Y, Wang L, Gao X, Liao S. Sleep quality and cognitive decline in a community of older adults in Daqing City, China. Sleep Med 2016; 17:69-74. [DOI: 10.1016/j.sleep.2015.07.033] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 06/25/2015] [Accepted: 07/27/2015] [Indexed: 01/28/2023]
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Abstract
Sleep disturbances are a common presenting symptom of older-age adults to their physicians. This article explores normal changes in sleep pattern with aging and primary sleep disorders in the elderly. Behavioral factors and primary psychiatric disorders affecting sleep in this population are reviewed. Further discussion examines sleep changes associated with 2 common forms of neurocognitive disorder: Alzheimer disease and Lewy Body Dementia. Common medical illnesses in the elderly are discussed in relation to sleep symptoms. Nonpharmacological and pharmacologic treatment strategies are summarized, with emphasis placed on risk of side effects in older adults. Future targets are considered.
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Affiliation(s)
- Kristina F Zdanys
- Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - David C Steffens
- Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA
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137
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Ray S, Datana S, Jayan B, Jain A. Cervical vertebral anomalies in patients with obstructive sleep apnea. APOS TRENDS IN ORTHODONTICS 2015. [DOI: 10.4103/2321-1407.169974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective
The aim of this study was to find an association between the patients with obstructive sleep apnea (OSA) and with cervical vertebral anomalies and any further correlation between various anomalies with varying severities of OSA.
Materials and Methods
The sample consisted lateral cephalograms of 70 subjects who were diagnosed with OSA and 70 other orthodontic patients who were selected as a control group. The lateral radiographs of both cases and controls were traced and findings were recorded.
Results
In total, 21.42% of subjects in the OSA group and 8.57% in the control group were affected with cervical vertebrae anomalies. The statistical analysis reveals that the number of subjects affected with cervical vertebrae anomalies in OSA group is highly significant. A number of cases of fusion were higher than posterior arch deficiency in OSA group and equal in the control group. However, in both the groups, the number of cases with two vertebrae fusion was higher. Further, the higher number of two vertebrae fusion cases in OSA group was found to be statistically significant. The findings of one-way ANOVA for OSA cases reveals the number of cases affected with cervical vertebrae anomalies were statistically highly significant (P < 0.01) in severe cases of OSA.
Conclusion
Patients of cervical vertebral anomalies may be at higher risk of developing OSA, and the possibility of the presence of cervical vertebral anomalies may increase with the increase in the severity of OSA. The most common vertebral anomaly was found to be two vertebral fusions.
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Affiliation(s)
- Saugat Ray
- Department of Orthodontics and Dentofacial Orthopedics, FDC, Fort, Mumbai, Maharashtra, India
| | - Sanjeev Datana
- Department of Orthodontics and Dentofacial Orthopedics, R&R, Delhi Cant., New Delhi, India
| | | | - Amit Jain
- Department of Orthodontics and Dentofacial Orthopedics, CMDC, Pune, Maharashtra, India
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139
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Yen CF, Ko CH, Chang YP, Yu CY, Huang MF, Yeh YC, Lin JJ, Chen CS. Dependence, misuse, and beliefs regarding use of hypnotics by elderly psychiatric patients taking zolpidem, estazolam, or flunitrazepam. Asia Pac Psychiatry 2015; 7:298-305. [PMID: 25296384 DOI: 10.1111/appy.12147] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 07/24/2014] [Indexed: 11/27/2022]
Abstract
INTRODUCTION To examine the prevalence rates and correlates of dependence on, misuse of, and beliefs regarding use of hypnotics in elderly psychiatric patients with long-term use of zolpidem, estazolam, or flunitrazepam. METHODS A total of 139 psychiatric outpatients 65 or more years of age who used zolpidem, estazolam, or flunitrazepam for at least 3 months were studied. The levels of hypnotic dependence and beliefs regarding hypnotic use (necessity and concern) were assessed. Three patterns of hypnotic misuse in the past 1 month were also explored. The correlates of high dependence, misuse, and unfavorable attitude and high concern toward hypnotic use were examined using logistic regression analyses. RESULTS A total of 28.8%, 7.9%, 12.2%, and 22.3% of participants reported high dependence on, misuse of, unfavorable attitude toward, and high concern toward hypnotic use, respectively. Males were more likely to report unfavorable attitude toward hypnotic use than females. Elders with significant depression were more likely to report high concern toward hypnotic use than those without significant depression. Elders with high concern toward hypnotic use were more likely to report high dependence on hypnotics than those with low concern. Elders with significant depression and taking zolpidem were more likely to misuse hypnotics than those without significant depression and taking estazolam or flunitrazepam, respectively. DISCUSSION Clinicians should monitor the possibility of dependence on and misuse of hypnotics among elderly psychiatric patients who had the correlates identified in this study.
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Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, Buffalo, NY, USA
| | - Cheng-Ying Yu
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Mei-Feng Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chun Yeh
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jin-Jia Lin
- Department of Psychiatry, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Psychiatry, Chi-Mei Hospital, Liuying Campus, Tainan, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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140
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Golombek DA, Pandi-Perumal SR, Brown GM, Cardinali DP. Some implications of melatonin use in chronopharmacology of insomnia. Eur J Pharmacol 2015; 762:42-8. [DOI: 10.1016/j.ejphar.2015.05.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 04/10/2015] [Accepted: 05/11/2015] [Indexed: 12/20/2022]
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141
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Calev H, Spampinato LM, Press VG, Meltzer DO, Arora VM. Prevalence of impaired memory in hospitalized adults and associations with in-hospital sleep loss. J Hosp Med 2015; 10:439-45. [PMID: 25872763 PMCID: PMC4490972 DOI: 10.1002/jhm.2364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/10/2015] [Accepted: 03/21/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Effective inpatient teaching requires intact patient memory, but studies suggest hospitalized adults may have memory deficits. Sleep loss among inpatients could contribute to memory impairment. OBJECTIVE To assess memory in older hospitalized adults, and to test the association between sleep quantity, sleep quality, and memory, in order to identify a possible contributor to memory deficits in these patients. DESIGN Prospective cohort study. SETTING General medicine and hematology/oncology inpatient wards. PATIENTS Fifty-nine hospitalized adults at least 50 years of age with no diagnosed sleep disorder. MEASUREMENTS Immediate memory and memory after a 24-hour delay were assessed using a word recall and word recognition task from the University of Southern California Repeatable Episodic Memory Test. A vignette-based memory task was piloted as an alternative test more closely resembling discharge instructions. Sleep duration and efficiency overnight in the hospital were measured using actigraphy. RESULTS Mean immediate recall was 3.8 words out of 15 (standard deviation = 2.1). Forty-nine percent of subjects had poor memory, defined as immediate recall score of 3 or lower. Median immediate recognition was 11 words out of 15 (interquartile range [IQR] = 9-13). Median delayed recall score was 1 word, and median delayed recognition was 10 words (IQR = 8-12). In-hospital sleep duration and efficiency were not significantly associated with memory. The medical vignette score was correlated with immediate recall (r = 0.49, P < 0.01). CONCLUSIONS About half of the inpatients studied had poor memory while in the hospital, signaling that hospitalization might not be an ideal teachable moment. In-hospital sleep was not associated with memory scores.
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Affiliation(s)
- Hila Calev
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | | | - Valerie G Press
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - David O Meltzer
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Vineet M Arora
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
- Department of Medicine, University of Chicago, Chicago, Illinois
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142
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Abstract
Sleep disorders are a pervasive problem throughout all patient populations but represent an especially important health problem for the elderly. Alterations in sleep architecture that occur as a part of normal aging will contribute to sleep problems as we grow older. Other contributing factors-including comorbid medical conditions, changes in lifestyle and schedule, altered circadian rhythm, among a host of others-can have detrimental effects on the health of the elderly. Coupled with a number of sleep disorders that either emerge or exacerbate with age, the effects of poor sleep often result in an overall worsening of quality of life. Treatment options can be unique in this population and often more difficult due to the effects of normal aging, as well as polypharmacy and possible medication interactions. The following article will focus on the common sleep disorders that can besiege this population, symptoms to aid in diagnosis, and specific treatment options to help improve quality of life in the elderly.
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Affiliation(s)
- Kevin Gleason
- Department of Psychiatry and Health Behavior, Medical College of Georgia, 997 St. Sebastian Way, Augusta, GA, 30912, USA,
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143
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Tardy M, Gonthier R, Barthelemy JC, Roche F, Crawford-Achour E. Subjective sleep and cognitive complaints in 65 year old subjects: a significant association. The PROOF cohort. J Nutr Health Aging 2015; 19:424-30. [PMID: 25809806 DOI: 10.1007/s12603-014-0547-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The prevalence of subjective sleep and cognitive complaints increases with age. The purpose of this study was to investigate the link between subjective cognitive and sleep complaints in a population aged 65. DESIGN AND SETTING analysis of a cohort of 1011 subjects aged 65 years old at time of inclusion. METHODS Older people underwent a cognitive tests battery and a nocturnal polygraphy recording. Subjective cognitive difficulties were scored on the McNair and Kahn Scale. Subjective sleep complaints were evaluated according to the St. Mary's Hospital Sleep Questionnaire and the Epworth Sleepiness Scale score. RESULTS In a 65 years old population, an association between subjective cognitive difficulties and poor sleep quality was observed. This remained significant after adjustment on gender, depression score, anxiety, educational level, medication intake, Apnea/Hypopnea index, Body Mass Index and Mini-Mental State Examination (OR = 2.1; p = 0.0002). Similar significant association was demonstrated between subjective cognitive difficulties and daytime sleepiness (OR = 2.6; p = 0.0007). CONCLUSION There was a significant association between subjective cognitive and sleep complaints, and daytime sleepiness in our population of older people.
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Affiliation(s)
- M Tardy
- Dr Emilie Crawford-Achour, Hôpital La Charité, Rue Pointe Cadet, 42055 Saint Etienne, Cedex, Mail : , Tel: 0033(0)477127098, Fax: 0033(0)477127083
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144
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dos Santos Silva M, Bazzana CM, de Souza AL, Ramos LR, Tufik S, Lucchesi LM, Lopes GS. Relationship between perceived sleep and polysomnography in older adult patients. Sleep Sci 2015; 8:75-81. [PMID: 26483948 PMCID: PMC4608903 DOI: 10.1016/j.slsci.2015.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 04/20/2015] [Accepted: 04/30/2015] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND AND AIMS Aging is a multifactorial process that elicits changes in the duration and quality of sleep. Polysomnography is considered to be the standard examination for the analysis of sleep and consists of the simultaneous recording of selected physiological variables during sleep. OBJECTIVE The objective of this study was to use polysomnography to compare sleep reported by senior citizens. METHODS We selected 40 patients, both male and female, with ages ranging from 64 to 89 years from the Center for the Study of Aging at the Federal University of São Paulo. Patients answered questions about sleep on the Comprehensive Geriatric Assessment and underwent polysomnography. RESULTS The results were compared, and agreement between perceived sleep and polysomnography was found in several areas. There was an association between difficulty sleeping and sleep onset latency (p=0.015), waking up at night with sleep onset latency (p=0.005), total sleep time with daytime sleepiness (0.005) and snoring (0.027), sleep efficiency with sleepiness (0.004), snoring (0.033) and pause in breathing (p=0.024), awakenings with snoring (p=0.012) and sleep apnea with pauses in breathing (p=0.001). CONCLUSION These results suggest that the older adult population have a good perception of their sleep. The questionnaires aimed at this population should be used as an alternative to polysomnography.
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Affiliation(s)
- Mayra dos Santos Silva
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Altay Lino de Souza
- Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luiz Roberto Ramos
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Tufik
- Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Lígia M. Lucchesi
- Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Guiomar Silva Lopes
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, Brazil
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145
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Singh SS, Laskar P, Acharjee S. Age- and sex-dependent effect of exogenous melatonin on expression pattern of melatonin receptor (MT1 and MT2) proteins in spleen of mice. BIOL RHYTHM RES 2015. [DOI: 10.1080/09291016.2015.1020198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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146
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Bennett SL, Goubran R, Knoefel F. The detection of breathing behavior using Eulerian-enhanced thermal video. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2015:7474-7477. [PMID: 26738020 DOI: 10.1109/embc.2015.7320120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The current gold standard for detecting and distinguishing between types of sleep apnea is expensive and invasive. This paper aims to examine the potential of inexpensive and unobtrusive thermal cameras in the identification and distinction between types of sleep apnea. A thermal camera was used to gather video of a subject performing regular nasal breathing, nasal hyperventilation and an additional trial simulating one type of sleep apnea. Simultaneously, a respiratory inductance plethysmography (RIP) band gathered respiratory data. Thermal video of all three trials were subjected to Eulerian Video Magnification; a procedure developed at MIT for enhancing subtle color variations in video data. Post magnification, nasal regions of interest were defined and mean region intensities were found for each frame of each trial. These signals were compared to determine the best performing region and compared to RIP data to validate breathing behavior. While some regions performed better, all region intensity signals depicted correct breathing behavior. The mean intensity signals for normal breathing and hyperventilation were correct and correlated well with RIP data. Furthermore, the RIP data resulting from the sleep apnea simulation clearly depicted chest movement while the corresponding mean intensity signal depicted lack of cyclical air flow. These results indicate that a subject's breathing behavior can be captured using thermal video and suggest that, with further development and additional equipment, thermal video can be used to detect and distinguish between types of sleep apnea.
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147
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Ayoub AI, Attia M, El Kady HM, Ashour A. Insomnia among community dwelling elderly in Alexandria, Egypt. J Egypt Public Health Assoc 2014; 89:136-142. [PMID: 25534178 DOI: 10.1097/01.epx.0000456621.42258.79] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Insomnia is a common problem in the elderly population. Poor sleep quality is associated with decreased memory and concentration, increased risk of falls, cognitive decline, and higher rate of mortality. Inadequate sleep hygiene such as irregular sleep schedules, use of stimulants, and daytime naps may predispose to insomnia. AIM The aim of this study was to determine the prevalence of insomnia among community dwelling elderly in Alexandria and to assess some of the risk factors and comorbid conditions related to insomnia. PARTICIPANTS AND METHODS This is a cross-sectional study conducted among 380 elderly people taken from different clubs in Alexandria using a predesigned structured interview questionnaire. Data on sociodemographic characteristics, medical history, and personal and sleeping habits were collected. The Insomnia Severity Index was used to assess insomnia and the Depression Anxiety Stress Scale was used to measure depression, anxiety, and stress. RESULTS One-third (33.4%) of the elderly suffered from insomnia. On logistic regression, the most independent factors that were significantly associated with insomnia were number of chronic diseases [odds ratio (OR)=7.25 for having ≥5 diseases], being female (OR=2.37), anxiety (OR=1.91), watching television in bed before sleeping (OR=1.90), depression (OR=1.74), nocturia (OR=1.13), and daily sunlight exposure (OR=0.57). CONCLUSION AND RECOMMENDATIONS Insomnia is a common problem among the elderly in Alexandria. Female sex, chronic diseases, mental health problems, and bad sleep hygiene practice increase the risk for insomnia. Improving knowledge among the elderly about the prevalence and risk factors of insomnia could help the development of effective public health prevention and intervention programs for better sleep quality.
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Affiliation(s)
- Abla I Ayoub
- aGeriatric Health Specialty bMental Health Specialty, Family Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Costa AR, Fontes F, Pereira S, Gonçalves M, Azevedo A, Lunet N. Impact of breast cancer treatments on sleep disturbances - A systematic review. Breast 2014; 23:697-709. [PMID: 25307946 DOI: 10.1016/j.breast.2014.09.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 08/06/2014] [Accepted: 09/10/2014] [Indexed: 10/24/2022] Open
Abstract
Sleep disturbances are highly prevalent in women with breast cancer; side effects of cancer treatment may worsen pre-existing sleep problems and have been pointed to as important determinants of their incidence. Therefore, we aimed to assess the association between different types of breast cancer treatment and sleep disturbances, through a systematic review. Medline (using PubMed), CINAHL Plus with full text, PsycINFO and Cochrane Central Register of Controlled Trials (Central) were searched from inception to January 2014. Studies that evaluated samples of women with breast cancer, assessed sleep disturbances with standardized sleep-specific measures, and provided data for different cancer treatments were eligible. A total of 12 studies met the inclusion criteria. Three studies evaluated insomnia, five studies assessed sleep quality, two provide data on general sleep disturbances and two analysed specific sleep parameters. Women submitted to chemotherapy, or radiotherapy, tended to report higher levels of sleep disturbances. More heterogeneous findings were observed regarding the effect of surgical treatment and hormonal therapy. However, a sound assessment of the impact of these treatments was hampered by differences across studies regarding the outcomes assessed, reporting bias and the fact that most studies did not control for the effect of potential confounders. The present review highlights the potential relation between breast cancer treatments and sleep disturbances, particularly of chemotherapy, though more robust evidence is needed for a proper understanding of these associations.
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Affiliation(s)
- Ana Rute Costa
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
| | - Filipa Fontes
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
| | - Susana Pereira
- EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal; Department of Neurology, Portuguese Oncology Institute, Porto, Portugal
| | - Marta Gonçalves
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal; Department of Psychiatry and Sleep Medicine Center, CUF Porto Hospital, Porto, Portugal
| | - Ana Azevedo
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
| | - Nuno Lunet
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; EPIUnit - Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal.
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Acosta-Peña E, Camacho-Abrego I, Melgarejo-Gutiérrez M, Flores G, Drucker-Colín R, García-García F. Sleep deprivation induces differential morphological changes in the hippocampus and prefrontal cortex in young and old rats. Synapse 2014; 69:15-25. [PMID: 25179486 DOI: 10.1002/syn.21779] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 06/17/2014] [Accepted: 08/18/2014] [Indexed: 11/11/2022]
Abstract
Sleep is a fundamental state necessary for maintenance of physical and neurological homeostasis throughout life. Several studies regarding the functions of sleep have been focused on effects of sleep deprivation on synaptic plasticity at a molecular and electrophysiological level, and only a few studies have studied sleep function from a structural perspective. Moreover, during normal aging, sleep architecture displays some changes that could affect normal development in the elderly. In this study, using a Golgi-Cox staining followed by Sholl analysis, we evaluate the effects of 24 h of total sleep deprivation on neuronal morphology of pyramidal neurons from Layer III of the prefrontal cortex (PFC) and the dorsal hippocampal CA1 region from male Wistar rats at two different ages (3 and 22 months). We found no differences in total dendritic length and branching length in both analyzed regions after sleep deprivation. Spine density was reduced in the CA1 of young-adults, and interestingly, sleep deprivation increased spine density in PFC of aged animals. Taken together, our results show that 24 h of total sleep deprivation have different effects on synaptic plasticity and could play a beneficial role in cognition during aging.
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Affiliation(s)
- Eva Acosta-Peña
- Department of Biomedicine, Health Sciences Institute, Veracruzana University, Luis Castelazo-Ayala s/n, Industrial-Animas, Xalapa, Veracruz, 91190, México
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