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Testone G, Fernandes M, Carpi M, Lupo C, Mercuri NB, Liguori C. Obstructive sleep apnea may induce sleep-wake cycle dysregulation: An actigraphic study. J Sleep Res 2024:e14273. [PMID: 38888001 DOI: 10.1111/jsr.14273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 06/20/2024]
Abstract
Obstructive sleep apnea (OSA) causes sleep fragmentation and excessive daytime sleepiness (EDS). OSA has been hypothesised to impair the circadian sleep-wake rhythm, and this dysregulation may in turn exacerbate OSA-related diurnal symptoms. Hence, this study aimed to assess the sleep-wake rhythm through actigraphy, and its relationship with EDS in patients with untreated OSA. Patients with moderate-severe OSA (apnea-hypopnea index ≥15/h) and healthy controls (HC) underwent a 7-day actigraphic recording to evaluate the sleep-wake rhythm. Participants underwent a sleep medicine visit and completed the self-report questionnaires assessing EDS (Epworth sleepiness scale, ESS), sleep quality (Pittsburgh sleep quality index, PSQI), and chronotype (morningness-eveningness questionnaire, MEQ). This study included 48 OSA patients (72.9% males; mean age 56.48 ± 9.53 years), and 22 HC (45.5% males; mean age 53.73 ± 18.20 years). After controlling for MEQ scores, actigraphic recording showed that the OSA patients present a lower sleep time (p = 0.011) and sleep efficiency (p = 0.013), as well as a higher sleep latency (p = 0.047), and sleep fragmentation (p = 0.029) than the HC. Regarding the sleep-wake rhythm actigraphic parameters, the OSA patients showed a lower average activity during the most active 10-hour period (p = 0.036) and a lower day/night activity ratio (p = 0.007) than the HC. Patients with OSA also reported higher ESS (p = 0.005) and PSQI scores (p < 0.001), and a chronotype less of morning type (p = 0.027) than the HC. In conclusion, this study documented a reduced diurnal motor activity and lower day/night activity ratio in OSA patients than in controls. These findings suggest a dysregulation of the circadian sleep-wake rhythm in OSA, possibly related to both EDS and reduced daytime motor activity.
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Affiliation(s)
- Greta Testone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Matteo Carpi
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy
| | - Clementina Lupo
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy
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Allen N, Crock L, Chun T, Reinhard MJ. Investigating a clinically informed sleep disturbance threshold for physical and mental health among Gulf War Illness veterans. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae018. [PMID: 38616799 PMCID: PMC11015895 DOI: 10.1093/sleepadvances/zpae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/14/2024] [Indexed: 04/16/2024]
Abstract
Study Objectives This study (1) assessed sleep quality and health in Gulf War veterans (GWV) meeting the Gulf War Illness (GWI) criteria and (2) compared health associations for both those meeting a "clinically disturbed sleep" threshold, and those below, as determined by the Pittsburgh Sleep Quality Index (PSQI) cutoff for military populations (≥10) on measures of physical, mental, and cognitive health. Methods Participant data consisted of questionnaires and assessments completed prior to group assignment in a clinical trial. The sample consisted of 147 GWV, where 81.0% were males, and the median age was 53.4 years. Results The mean (SD) PSQI global score was 12.34 (4.00) with 61% of the sample qualifying as clinically disturbed sleepers according to the cutoff (global PSQI ≥ 10). GWI veterans with PSQI scores ≥10 did not differ from others in age (p = 0.20), sex (p = 0.19), or years of education (p = 0.87), but showed worse GW-related symptomology on the Gulf War Kansas questionnaire (p < 0.01), and poorer mental health on the Veterans Rand-36 (p < 0.01). Conclusions Disturbed sleep was associated with measures of pain, fatigue, and cognitive health. Our results suggest that a previously determined clinical threshold for clinically disturbed sleep is useful when examining the health status of the study population. Given that GWI is associated with elevated PSQI scores and a high frequency of disturbed sleep, cutoffs determining sleep health should be sensitive to population exposures and health history to improve interpretability.
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Affiliation(s)
- Nathaniel Allen
- Department of Veterans Affairs,War Related Illness and Injury Study Center (WRIISC), Washington, DC, USA
| | - Lucas Crock
- Department of Veterans Affairs,War Related Illness and Injury Study Center (WRIISC), Washington, DC, USA
| | - Timothy Chun
- Department of Veterans Affairs,War Related Illness and Injury Study Center (WRIISC), Washington, DC, USA
| | - Matthew J Reinhard
- Department of Veterans Affairs,War Related Illness and Injury Study Center (WRIISC), Washington, DC, USA
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC, USA
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3
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Ljubičić M, Šare S, Kolčić I. Sleep Quality and Evening Salivary Cortisol Levels in Association with the Psychological Resources of Parents of Children with Developmental Disorders and Type 1 Diabetes. J Autism Dev Disord 2024:10.1007/s10803-024-06269-7. [PMID: 38300504 DOI: 10.1007/s10803-024-06269-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Sleep deprivation can decrease parental well-being and degrade mental and physical health in parents of children with chronic illness. The aim of this study was to explore the associations of sleep quality, psychological stress perception, and evening salivary cortisol concentration with self-esteem, optimism and happiness in parents of children with type 1 diabetes and developmental disorders compared to parents of healthy, typically developing children. METHODS We studied 196 parents of children with chronic conditions, including autistic spectrum disorder (N = 33), cerebral palsy (N = 18), Down syndrome (N = 33), and diabetes mellitus type 1 (N = 40) and parents of healthy children (N = 72). We evaluated parental sleep quality, evening salivary cortisol levels, self-esteem, optimism and happiness. Multiple linear regression models were used to assess associations between variables. RESULTS Compared with those of the control group, the parents of children with autistic spectrum disorders had higher evening cortisol concentrations (β = 0.17; p = 0.038) and lower perceptions of happiness (β=-0.17; p = 0.017), while parents of children with type 1 diabetes had disrupted sleep quality (β = 0.25; p = 0.003). Optimism was negatively associated with the evening cortisol concentration (β=-0.18; p = 0.023) and sleep quality index (β=-0.20; p = 0.012). CONCLUSIONS Public health programs aimed at lifestyle habit improvement, respite care, and relaxation for parents of children with chronic conditions would be useful for improving parental sleep quality, self-esteem, optimism and happiness.
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Affiliation(s)
- Marija Ljubičić
- Department of Health Studies, University of Zadar, Splitska 1, Zadar, 23000, Croatia.
| | - Sonja Šare
- Department of Health Studies, University of Zadar, Splitska 1, Zadar, 23000, Croatia
- Medical School Ante Kuzmanića Zadar, Franje Tuđmana 24G, Zadar, 23000, Croatia
| | - Ivana Kolčić
- Department of Public Health, School of Medicine, University of Split, Šoltanska 2, Split, 21000, Croatia
- Algebra LAB, Algebra University College, Gradišćanska ul. 24, Zagreb, 10000, Croatia
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Matsuda H, Mayers T, Maki N, Araki A, Eto S. Frailty and Diminished Human Relationships Are Associated with Poor Sleep Quality in Japanese Older Adults: A Cross-Sectional Study. Geriatrics (Basel) 2023; 8:91. [PMID: 37736891 PMCID: PMC10514848 DOI: 10.3390/geriatrics8050091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023] Open
Abstract
The purpose of this study was to examine the association between sleep quality, frailty, and human relationships in Japanese older adults (aged 65 years and above, excluding those certified as requiring long-term care). This cross-sectional study used a questionnaire survey to gather demographic information, data on frequency of conversation and conversation partners, and employed the following validated instruments: Kihon Checklist (KCL), a Japanese instrument used to determine the care needs and frailty of older adults; the Dysphagia Risk Assessment for Community-Dwelling Elderly (DRACE) scale; Japanese versions of Pittsburgh Sleep Quality Index (PSQI-J); the Geriatric Depression Scale-15 (GDS-15-J); and the University of California Los Angeles Scale (UCLA-J), an instrument to assess loneliness in older adults. The 500 respondents were divided into two groups based on sleep quality (PSQI-J): low sleep quality group (n = 167, 33.4%) and high sleep quality group (n = 333, 66.6%). Our analyses showed that the low sleep quality group had a KCL score of 5.55 ± 2.47, which indicated frailty. Binomial logistic regression analysis identified age, number of diseases under treatment, DRACE, GDS-15-J, and conversation frequency and discussion partner for important matters as factors (p < 0.05) associated with poor sleep quality. These factors could help enhance the detection of frailty and predictability of caregiving needs.
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Affiliation(s)
- Hitomi Matsuda
- Graduate School of Comprehensive Human Sciences, Department of Human Care Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
| | - Thomas Mayers
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
- Medical English Communications Center, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
| | - Naoki Maki
- Faculty of Rehabilitation, R Professional University of Rehabilitation, 2-12-31 Kawaguchi, Tsuchiura 300-0032, Ibaraki, Japan;
| | - Akihiro Araki
- Community Health Nursing Department, Oita University of Nursing and Health Sciences, 2944-9 Megusuno, Oita-City 870-1201, Oita, Japan;
| | - Sachie Eto
- Graduate School of Comprehensive Human Sciences, Department of Human Care Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
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Morris JL, Belcher SM, Jeon B, Godzik CM, Imes CC, Luyster F, Sereika SM, Scott PW, Chasens ER. Financial Hardship and its Associations with Perceived Sleep Quality in Participants with Type 2 Diabetes and Obstructive Sleep Apnea. Chronic Illn 2023; 19:197-207. [PMID: 34866430 PMCID: PMC10043926 DOI: 10.1177/17423953211065002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The purpose of this study was to explore social determinants of health (SDoH), and disease severity as predictors of sleep quality in persons with both Obstructive Sleep Apnea (OSA) and type 2 diabetes (T2D). METHODS Disease severity was measured by Apnea-Hypopnea Index [(AHI) ≥ 5] and HbA1c for glycemic control. SDoH included subjective and objective financial hardship, race, sex, marital status, education, and age. Sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI). RESULTS The sample (N = 209) was middle-aged (57.6 ± 10.0); 66% White and 34% African American; and 54% men and 46% women. Participants carried a high burden of disease (mean AHI = 20.7 ± 18.1, mean HbA1c = 7.9% ± 1.7%). Disease severity was not significantly associated with sleep quality (all p >.05). Worse sleep quality was associated with both worse subjective (b = -1.54, p = .015) and objective (b = 2.58, p <.001) financial hardship. Characteristics significantly associated with both subjective and objective financial hardship included being African American, female, ≤ 2 years post high school, and of younger ages (all p < .01).Discussion: Financial hardship is a more important predictor of sleep quality than disease severity, age, sex, race, marital status, and educational attainment, in patients with OSA and T2D.
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Affiliation(s)
- Jonna L Morris
- 6614University of Pittsburgh, School of Nursing, 3500 Victoria Street, Pittsburgh PA, 1526
| | - Sarah M Belcher
- 6614University of Pittsburgh, School of Nursing, 3500 Victoria Street, Pittsburgh PA, 1526
| | - Bomin Jeon
- 6614University of Pittsburgh, School of Nursing, 3500 Victoria Street, Pittsburgh PA, 1526
| | - Cassandra M Godzik
- 583584Dartmouth-Hitchcock Medical Center
- Geisel School of Medicine at Dartmouth, Department of Psychiatry,46 Centerra Parkway, Lebanon, NH 03766
| | - Christopher C Imes
- 6614University of Pittsburgh, School of Nursing, 3500 Victoria Street, Pittsburgh PA, 1526
| | - Faith Luyster
- 6614University of Pittsburgh, School of Nursing, 3500 Victoria Street, Pittsburgh PA, 1526
| | - Susan M Sereika
- 6614University of Pittsburgh, School of Nursing, 3500 Victoria Street, Pittsburgh PA, 1526
| | - Paul W Scott
- 6614University of Pittsburgh, School of Nursing, 3500 Victoria Street, Pittsburgh PA, 1526
| | - Eileen R Chasens
- 6614University of Pittsburgh, School of Nursing, 3500 Victoria Street, Pittsburgh PA, 1526
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Ates H, Firat S, Buhari GK, Keren M, Cifci B, Erkekol FÖ. Relationships between quality of life, sleep problems, and sleep quality in patients with chronic idiopathic urticaria. J Cosmet Dermatol 2022; 21:4072-4079. [PMID: 35166020 DOI: 10.1111/jocd.14851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 01/30/2022] [Accepted: 02/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND In this study, we aimed to evaluate the sleep quality among chronic urticaria patients using the Chronic Urticaria Quality-of-Life Questionnaire (CU-Q2oL), sleep quality assessment tools, and polysomnography and to investigate any relationships between the obtained results. METHODS The study included 21 patients diagnosed with chronic spontaneous urticaria and 19 healthy controls. We recorded the patients' sleep quality data, including CU-Q2 oL, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and polysomnography results. RESULT Patients in the chronic urticaria group were more likely to have an ESS score of ≥10 (52.4% vs. 5.3%, p = 0.004) and an apnea-hypopnea index of ≥5 (44.4% vs. 5.3%, p = 0.017) compared to the control group. In the patient group, the CU-Q2 oL total score was positively correlated with sleep latency (r = 0.713, p = 0.004) and PSQI-C1 score (r = 0.726, p = 0.005), while it was negatively correlated with urticaria duration (r = -0.579, p = 0.015), apnea-hypopnea index (r = -0.607, p = 0.021), longest apnea duration (r = -0.583, p = 0.029), total number of respiratory events (r = -0.618, p = 0.018), and apnea count (r = -0.686, p = 0.007). CONCLUSION We conclude that sleep-related problems exist among a considerably large proportion of patients with chronic spontaneous urticaria.
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Affiliation(s)
- Hale Ates
- Department of Allergy and Immunology, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Selma Firat
- Sleep Disorders Center, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Gozde Koycu Buhari
- Department of Allergy and Immunology, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Metin Keren
- Department of Pulmonary Diseases, Süreyyapaşa Pulmonary Diseases Education and Research Hospital, Istanbul, Turkey
| | - Bulent Cifci
- Department of Chest Diseases, Medical School, Turkiye Yuksek Ihtisas University, Ankara, Turkey
| | - Ferda Öner Erkekol
- Department of Allergy and Immunology, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
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An Ultra-Short Measure of Excessive Daytime Sleepiness Is Related to Circadian Biological Rhythms: The French Psychometric Validation of the Barcelona Sleepiness Index. J Clin Med 2022; 11:jcm11133892. [PMID: 35807176 PMCID: PMC9267909 DOI: 10.3390/jcm11133892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/24/2022] Open
Abstract
The Barcelona Sleepiness Index (BSI) is an ultra-short instrument with several advantages for assessing excessive daytime sleepiness (EDS). The present study was performed to analyze the validity of the French version of the BSI in screening for EDS. We conducted a cross-sectional study on a population of students using an online questionnaire. The French version of the BSI was developed by a rigorous forward-backward translation process. We computed the discrimination properties of the BSI to predict EDS assessed by the Epworth Sleepiness Scale (ESS), as well as correlations with other sleep measures. In total, 662 students were enrolled in the study (mean age: 20.9 years, 76.0% women). The BSI score (mean = 1.5 ± 1.0) showed a strong correlation with the ESS score (r = 0.47, p < 10−4) and acceptable discrimination of EDS assessed by ESS score ≥ 11 (AUC = 0.742) with an optimal cutoff point of 2, as in the original study. The BSI score was significantly associated with sleep deprivation and social jetlag. Therefore, the French version of the BSI is a valid ultra-short instrument for EDS screening in individuals. In addition, the BSI score may be associated with both homeostatic and circadian processes. Further studies are needed to confirm these findings in general populations and in patients with sleep disorders.
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Portacci A, Santomasi C, Di Lecce V, Barratta F, De Candia ML, Resta O, Carpagnano GE. Predictive tools for nocturnal respiratory failure in patients with moderate and severe OSAS. Sleep Breath 2022; 27:611-620. [DOI: 10.1007/s11325-022-02666-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/25/2022] [Accepted: 06/09/2022] [Indexed: 11/28/2022]
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Baugh A, Buhr RG, Quibrera P, Barjaktarevic I, Barr RG, Bowler R, Han MK, Kaufman JD, Koch AL, Krishnan J, Labaki W, Martinez FJ, Mkorombindo T, Namen A, Ortega V, Paine R, Peters SP, Schotland H, Sundar K, Zeidler MR, Hansel NN, Woodruff PG, Thakur N. Risk of COPD exacerbation is increased by poor sleep quality and modified by social adversity. Sleep 2022; 45:6602021. [PMID: 35665826 PMCID: PMC9366643 DOI: 10.1093/sleep/zsac107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/19/2022] [Indexed: 02/03/2023] Open
Abstract
STUDY OBJECTIVES Sleep is an important dimension in the care of chronic obstructive pulmonary disease (COPD), but its relevance to exacerbations is unclear. We wanted to assess whether sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) is associated with an increased risk of COPD exacerbations and does this differ by socio-environmental exposures. METHODS We included 1647 current and former smokers with spirometrically confirmed COPD from the SPIROMICS cohort. We assessed incidence rate ratios for exacerbation using zero-inflated negative binomial regression adjusting for demographics, medical comorbidities, and multiple metrics of disease severity, including respiratory medications, airflow obstruction, and symptom burden. Our final model adjusted for socio-environmental exposures using the Area Deprivation Index, a composite measure of contemporary neighborhood quality, and Adversity-Opportunity Index, a composite measure of individual-level historic and current socioeconomic indicators. We used a pre-determined threshold of 20% missingness to undertake multiple imputation by chained equations. As sensitivity analyses, we repeated models in those with complete data and after controlling for prior exacerbations. As an exploratory analysis, we considered an interaction between socio-environmental condition and sleep quality. RESULTS After adjustment for all co-variates, increasing PSQI scores (range 0-21) were associated with a 5% increased risk for exacerbation per point (p = .001) in the imputed dataset. Sensitivity analyses using complete cases and after controlling for prior exacerbation history were similar. Exploratory analysis suggested less effect among those who lived in poor-quality neighborhoods (p-for-interaction = .035). CONCLUSIONS Poor sleep quality may contribute to future exacerbations among patients with COPD. This represents one target for improving disease control. CLINICAL TRIAL REGISTRATION Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). ClinicalTrials.gov Identifier# NCT01969344. Registry URL: https://clinicaltrials.gov/ct2/show/.
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Affiliation(s)
- Aaron Baugh
- Corresponding author. Aaron Baugh, University of California, San Francisco, Box 0111, 505 Parnassus Ave, San Francisco, CA 94143, USA. E-mail:
| | - Russell G Buhr
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Pedro Quibrera
- Collaborative Studies Coordination Center, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Igor Barjaktarevic
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - R Graham Barr
- Department of Medicine, Columbia University, New York, NY, USA
| | - Russell Bowler
- Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Meilan King Han
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Joel D Kaufman
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Abigail L Koch
- Department of Medicine, Veterans Administration Miami Healthcare, Miami, FL, USA
| | - Jerry Krishnan
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Wassim Labaki
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Andrew Namen
- Department of Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Victor Ortega
- Department of Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Robert Paine
- Department of Medicine, University of Utah, Salt Lake City, UA, USA
| | - Stephen P Peters
- Department of Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Helena Schotland
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Krishna Sundar
- Department of Medicine, University of Utah, Salt Lake City, UA, USA
| | - Michelle R Zeidler
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Nadia N Hansel
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Prescott G Woodruff
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Neeta Thakur
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Jerković A, Mikac U, Matijaca M, Košta V, Ćurković Katić A, Dolić K, Vujović I, Šoda J, Đogaš Z, Pavelin S, Rogić Vidaković M. Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in Patients with Multiple Sclerosis: Factor Structure, Reliability, Correlates, and Discrimination. J Clin Med 2022; 11:jcm11072037. [PMID: 35407644 PMCID: PMC8999563 DOI: 10.3390/jcm11072037] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 12/15/2022] Open
Abstract
Sleep disturbances and poor sleep are a common complaint in the population with multiple sclerosis (MS) disease. The most commonly reported scale is the Pittsburgh Sleep Quality Index (PSQI), measuring seven components of sleep quality. Yet, till today, the PSQI instrument has not been validated in people with multiple sclerosis (pwMS). The objective of our study was to add precision in sleep quality assessment by investigating the psychometric properties of PSQI (factor structure, reliability, validity based on relations with other variables, cut-off scores) in pwMS. The cross-sectional study included data on a total of 87 patients with MS and 216 control subjects. Demographic information, education level, and MS-related variables were ascertained. Psychometric properties were examined by estimating the validity, including factor structure, metric invariance, and relations with other MS- and non-MS-related variables, reliability, and discrimination ability of the PSQI. The Croatian version of the PSQI had a two-factor structure which demonstrated loading and partial intercept invariance between pwMS and the control group. The global score and both subscales had high internal consistencies (McDonald's omega and Cronbach's alpha coefficients) in pwMS and showed expected relations with demographic and MS-related variables. PwMS differed significantly in the PSQI global score from the control groups, although receiver operating characteristics (ROC) curve analysis did not indicate a clear cut-off point. The PSQI is a reliable and valid scale and can be applied in clinical settings for assessing sleep quality in pwMS.
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Affiliation(s)
- Ana Jerković
- Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, School of Medicine, University of Split, 21000 Split, Croatia; (A.J.); (Z.Đ.)
| | - Una Mikac
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, 10000 Zagreb, Croatia;
| | - Meri Matijaca
- Department of Neurology, University Hospital of Split, 21000 Split, Croatia; (M.M.); (V.K.); (A.Ć.K.); (S.P.)
| | - Vana Košta
- Department of Neurology, University Hospital of Split, 21000 Split, Croatia; (M.M.); (V.K.); (A.Ć.K.); (S.P.)
| | - Ana Ćurković Katić
- Department of Neurology, University Hospital of Split, 21000 Split, Croatia; (M.M.); (V.K.); (A.Ć.K.); (S.P.)
| | - Krešimir Dolić
- Department of Radiology, University Hospital of Split, 21000 Split, Croatia;
| | - Igor Vujović
- Department of Marine Electrical Engineering and Information Technologies, Faculty of Maritime Studies, University of Split, 21000 Split, Croatia; (I.V.); (J.Š.)
| | - Joško Šoda
- Department of Marine Electrical Engineering and Information Technologies, Faculty of Maritime Studies, University of Split, 21000 Split, Croatia; (I.V.); (J.Š.)
| | - Zoran Đogaš
- Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, School of Medicine, University of Split, 21000 Split, Croatia; (A.J.); (Z.Đ.)
- Sleep Medical Center, University of Split, 21000 Split, Croatia
| | - Sanda Pavelin
- Department of Neurology, University Hospital of Split, 21000 Split, Croatia; (M.M.); (V.K.); (A.Ć.K.); (S.P.)
| | - Maja Rogić Vidaković
- Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, School of Medicine, University of Split, 21000 Split, Croatia; (A.J.); (Z.Đ.)
- Correspondence: (M.R.V.); Tel.: +385-(0)21-557-876 or +385-(0)98-508-210; Fax: +358-(0)-21-557-955
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11
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Glymphatic system dysfunction in obstructive sleep apnea evidenced by DTI-ALPS. Sleep Med 2021; 89:176-181. [PMID: 35030357 DOI: 10.1016/j.sleep.2021.12.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/13/2021] [Accepted: 12/20/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This study aimed to evaluate the glymphatic system function in patients with obstructive sleep apnea (OSA) compared to healthy controls using diffusion tensor imaging (DTI) with the perivascular space (DTI-ALPS) method. Our hypothesis is that patients with OSA may have glymphatic system dysfunction, which is correlated with OSA severity. METHODS We enrolled 24 patients with OSA and 24 healthy controls. All participants underwent DTI magnetic resonance imaging (MRI) using the same 3T MRI scanner, and we calculated the DTI-ALPS index from the DTI. We evaluated the differences in the DTI-ALPS index between patients with OSA and healthy controls. In addition, we conducted a correlation analysis between the DTI-ALPS index and clinical characteristics. RESULTS The DTI-ALPS index was significantly different between the groups. The DTI-ALPS in patients with OSA was significantly lower than in healthy controls (1.30450 vs. 1.61600, p = 0.0006). Furthermore, the DTI-ALPS index was significantly negatively correlated with the apnea-hypopnea index in sleep stage N (r = -0.427, p = 0.042) and oxygen desaturation index during sleep N (r = -0.497, p = 0.036). CONCLUSION We successfully demonstrated glymphatic system dysfunction in patients with OSA. In addition, glymphatic system dysfunction is well correlated with OSA severity, especially during sleep stage N. Thus, these findings can explain the effects of OSA on increased risk of developing dementia and highlight the importance of OSA treatment.
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Kurtovic A, Hnojcik A. Early bird catches the worm? The relation between school schedule, sleep quality, and depression in Croatian adolescents. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ana Kurtovic
- Department of Psychology Faculty of Humanities and Social Sciences in Osijek Osijek Croatia
| | - Adrijana Hnojcik
- Department of Psychology Faculty of Humanities and Social Sciences in Osijek Osijek Croatia
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13
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Peter-Derex L, Berthomier C, Taillard J, Berthomier P, Bouet R, Mattout J, Brandewinder M, Bastuji H. Automatic analysis of single-channel sleep EEG in a large spectrum of sleep disorders. J Clin Sleep Med 2021; 17:393-402. [PMID: 33089777 DOI: 10.5664/jcsm.8864] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
STUDY OBJECTIVES To assess the performance of the single-channel automatic sleep staging (AS) software ASEEGA in adult patients diagnosed with various sleep disorders. METHODS Sleep recordings were included of 95 patients (38 women, 40.5 ± 13.7 years) diagnosed with insomnia (n = 23), idiopathic hypersomnia (n = 24), narcolepsy (n = 24), and obstructive sleep apnea (n = 24). Visual staging (VS) was performed by two experts (VS1 and VS2) according to the American Academy of Sleep Medicine rules. AS was based on the analysis of a single electroencephalogram channel (Cz-Pz), without any information from electro-oculography nor electromyography. The epoch-by-epoch agreement (concordance and Conger's coefficient [κ]) was compared pairwise (VS1-VS2, AS-VS1, AS-VS2) and between AS and consensual VS. Sleep parameters were also compared. RESULTS The pairwise agreements were: between AS and VS1, 78.6% (κ = 0.70); AS and VS2, 75.0% (0.65); and VS1 and VS2, 79.5% (0.72). Agreement between AS and consensual VS was 85.6% (0.80), with the following distribution: insomnia 85.5% (0.80), narcolepsy 83.8% (0.78), idiopathic hypersomnia 86.1% (0.68), and obstructive sleep disorder 87.2% (0.82). A significant low-amplitude scorer effect was observed for most sleep parameters, not always driven by the same scorer. Hypnograms obtained with AS and VS exhibited very close sleep organization, except for 80% of rapid eye movement sleep onset in the group diagnosed with narcolepsy missed by AS. CONCLUSIONS Agreement between AS and VS in sleep disorders is comparable to that reported in healthy individuals and to interexpert agreement in patients. ASEEGA could therefore be considered as a complementary sleep stage scoring tool in clinical practice, after improvement of rapid eye movement sleep onset detection.
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Affiliation(s)
- Laure Peter-Derex
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Lyon, France.,Lyon Neuroscience Research Center, CNRS 5292 INSERM U1028, Lyon, France.,Lyon 1 University, Lyon, France
| | | | - Jacques Taillard
- CNRS, Bordeaux University, USR 3413 SANPSY Sleep, Addiction and Neuropsychiatry, Bordeaux, France
| | | | - Romain Bouet
- Lyon Neuroscience Research Center, CNRS 5292 INSERM U1028, Lyon, France
| | - Jérémie Mattout
- Lyon Neuroscience Research Center, CNRS 5292 INSERM U1028, Lyon, France
| | | | - Hélène Bastuji
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Lyon, France.,Lyon Neuroscience Research Center, CNRS 5292 INSERM U1028, Lyon, France.,Functional Neurology and Epilepsy Unit, Neurological Hospital, Hospices Civils de Lyon, Bron, France
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The Effects of Sleep Quality on Dream and Waking Emotions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020431. [PMID: 33430454 PMCID: PMC7827529 DOI: 10.3390/ijerph18020431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/31/2022]
Abstract
Despite the increasing interest in sleep and dream-related processes of emotion regulation, their reflection into waking and dream emotional experience remains unclear. We have previously described a discontinuity between wakefulness and dreaming, with a prevalence of positive emotions in wakefulness and negative emotions during sleep. Here we aim to investigate whether this profile may be affected by poor sleep quality. Twenty-three ‘Good Sleepers’ (GS) and 27 ‘Poor Sleepers’ (PS), identified through the Pittsburgh Sleep Quality Index (PSQI) cut-off score, completed three forms of the modified Differential Emotions Scale, assessing, respectively, the frequency of 22 emotions over the past 2 weeks, their intensity during dreaming and during the previous day. The ANOVA revealed a different pattern of emotionality between groups: GS showed high positive emotionality in wakefulness (both past 2 weeks and 24 h) with a significant shift to negative emotionality in dreams, while PS showed evenly distributed emotional valence across all three conditions. No significant regression model emerged between waking and dream affect. In the frame of recent hypotheses on the role of dreaming in emotion regulation, our findings suggest that the different day/night expression of emotions between groups depends on a relative impairment of sleep-related processes of affect regulation in poor sleepers. Moreover, these results highlight the importance of including sleep quality assessments in future dream studies.
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Daga D, Singh M, Nahar P, Mathur H, Babel A, Daga A. A comparative study of alternative therapies and mandibular advancement device in the management of obstructive sleep apnea. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2021. [DOI: 10.4103/jiaomr.jiaomr_182_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Kim JJ, Hwang IC. Weekend catch-up sleep is associated with reduced metabolic derangements in Korean adults. Neurol Sci 2020; 42:735-737. [PMID: 33044669 DOI: 10.1007/s10072-020-04805-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 10/06/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Deficits in sleep are associated with metabolic derangements, but the effect of sleep supplementation on metabolic derangements remains to be elucidated. This study aimed to investigate whether weekend catch-up sleep is associated with metabolic derangements in Korean adults. METHODS A total of 10,749 individuals over 40 years old were identified from the 2016-2017 Korea National Health and Nutrition Examination Survey. Data on demographics, health behaviors, self-reported sleep duration, and physician-diagnosed metabolic diseases were used in this analysis. The odds ratio for each metabolic derangement was determined via stepwise multivariable logistic regression models. RESULTS Short weekday sleep and insufficient weekend catch-up sleep were independently associated with an increased risk for all metabolic derangements, except hypertension. Individuals who did not make up sleep on the weekend were more likely to be obese and have type 2 diabetes or hypercholesterolemia.
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Affiliation(s)
- Jin Joo Kim
- Department of Emergency Medicine, Incheon Medical Center, Incheon, Republic of Korea
| | - In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea.
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17
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Berg LM, Ankjell TKS, Sun YQ, Trovik TA, Rikardsen OG, Sjögren A, Moen K, Hellem S, Bugten V. Health-Related Quality of Life and Sleep Quality after 12 Months of Treatment in Nonsevere Obstructive Sleep Apnea: A Randomized Clinical Trial with Continuous Positive Airway Pressure and Mandibular Advancement Splints. Int J Otolaryngol 2020; 2020:2856460. [PMID: 32665778 PMCID: PMC7349617 DOI: 10.1155/2020/2856460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/06/2020] [Accepted: 06/13/2020] [Indexed: 12/16/2022] Open
Abstract
In this randomized controlled trial, patients with nonsevere obstructive sleep apnea (OSA) were treated with continuous positive airway pressure (CPAP) or a twin block mandibular advancement splint (MAS). The primary objective was to compare how CPAP and MAS treatments change the health-related quality of life (HRQoL) and self-reported sleep quality of patients after 12 months of treatment. In total, 104 patients were recruited: 55 were allocated to the CPAP treatment group and 49 to the MAS treatment group. We used the SF36 questionnaire to evaluate HRQoL and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. All patients were included in the intention-to-treat analyses. These analyses showed improvements in the SF36 physical component score (from 48.8 ± 7.6 at baseline to 50.5 ± 8.0 at follow-up, p=0.03) in the CPAP treatment group and in the mental component score (from 44.9 ± 12.1 to 49.3 ± 9.2, p=0.009) in the MAS treatment group. The PSQI global score improved in both the CPAP (from 7.7 ± 3.5 to 6.6 ± 2.9, p=0.006) and the MAS (8.0 ± 3.1 to 6.1 ± 2.6, p < 0.001) treatment groups. No difference was found between the treatment groups in any of the SF36 scores or PSQI global score at the final follow-up (p > 0.05) in any analysis. The improvement in the SF36 vitality domain moderately correlated to the improvement in the PSQI global score in both groups (CPAP: |r|=0.47, p < 0.001; MAS: |r|=0.36, p=0.01). In the MAS treatment group, we also found a weak correlation between improvements in the SF36 mental component score and PSQI global score (|r|=0.28, p=0.05). In conclusion, CPAP and MAS treatments lead to similar improvements in the HRQoL and self-reported sleep quality in nonsevere OSA. Improvements in aspects of HRQoL seem to be moderately correlated to the self-reported sleep quality in both CPAP and MAS treatments.
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Affiliation(s)
- Lars M. Berg
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Torun K. S. Ankjell
- ENT Department, University Hospital in Northern Norway, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Yi-Qian Sun
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Tordis A. Trovik
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Oddveig G. Rikardsen
- ENT Department, University Hospital in Northern Norway, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anders Sjögren
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ketil Moen
- ENT Department, Section for Oral and Maxillofacial Surgery, Arendal Hospital, Arendal, Norway
| | - Sølve Hellem
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Vegard Bugten
- Department of Otorhinolaryngology, Head and Neck Surgery, St. Olav's University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
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Lins-Filho OL, Pedrosa RP, Gomes JML, Dantas Moraes SL, Vasconcelos BCE, Lemos CAA, Pellizzer EP. Effect of exercise training on subjective parameters in patients with obstructive sleep apnea: a systematic review and meta-analysis. Sleep Med 2020; 69:1-7. [PMID: 32045849 DOI: 10.1016/j.sleep.2019.12.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/12/2019] [Accepted: 12/23/2019] [Indexed: 12/14/2022]
Abstract
Obstructive sleep apnea (OSA) has many effects on subjective parameters of the disease, such as reduction in quality of life (QoL), sleep quality (SQ), and increases in daytime sleepiness. Studies have reported the beneficial effect of exercise training on OSA severity; however, whether it improves subjective parameters remains unclear. The purpose of the present review was to investigate the effect of exercise training on QoL, daytime sleepiness, and SQ in adults with OSA by summarizing the results of clinical trials. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in PROSPERO. A systematic review of the PubMed, Scopus, and Cochrane (CENTRAL) databases was conducted. Risk of bias analysis was performed using the Cochrane tool, and Review Manager version 5.2 (R Foundation for Statistical Computing, Vienna, Austria) was used to perform the meta-analysis. Of the 1573 studies initially retrieved, 8 relevant studies with 228 participants were included in the analysis. The studies presented moderate risk of bias. Exercise training significantly improved QoL (mean difference, 12.9 [95% confidence interval (CI) 6.4 to 19.5]) and SQ (mean difference, -2.0 [95% CI -3.6 to -0.5]), and reduced daytime sleepiness (mean difference, -3.7 [95% CI -6.1 to -1.2]), and OSA severity (mean difference, -11.4 [95% CI -13.4 to -9.4 events/h]). Thus, physical exercise training was effective in improving subjective parameters and reducing the severity of OSA. Additional randomized clinical trials, however, should be performed to confirm these findings.
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Affiliation(s)
- Ozeas L Lins-Filho
- PhD Student of Health Sciences - Pernambuco University, (UPE), Recife, Pernambuco, Brazil.
| | - Rodrigo Pinto Pedrosa
- Professor of Health Sciences - Pernambuco University, (UPE), Recife, Pernambuco, Brazil
| | - Jessica M L Gomes
- PhD Student of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Sandra L Dantas Moraes
- Professor of Department of Oral and Maxillofacial Surgery, School of Dentistry, Pernambuco University (UPE), Camaragibe, Pernambuco, Brazil
| | | | | | - Eduardo Piza Pellizzer
- Professor of Departament of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
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Dunleavy G, Bajpai R, Comiran Tonon A, Chua AP, Cheung KL, Soh CK, Christopoulos G, de Vries H, Car J. Examining the Factor Structure of the Pittsburgh Sleep Quality Index in a Multi-Ethnic Working Population in Singapore. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4590. [PMID: 31756941 PMCID: PMC6926964 DOI: 10.3390/ijerph16234590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/11/2019] [Accepted: 11/13/2019] [Indexed: 11/21/2022]
Abstract
The Pittsburgh Sleep Quality Index (PSQI) is a widely used measure for assessing sleep impairment. Although it was developed as a unidimensional instrument, there is much debate that it contains multidimensional latent constructs. This study aims to investigate the dimensionality of the underlying factor structure of the PSQI in a multi-ethnic working population in Singapore. The PSQI was administered on three occasions (baseline, 3 months and 12 months) to full-time employees participating in a workplace cohort study. Exploratory factor analysis (EFA) investigated the latent factor structure of the scale at each timepoint. Confirmatory factor analysis (CFA) evaluated the model identified by EFA, and additionally evaluated it against a single factor and a three-factor model. The EFA identified a two-factor model with similar internal consistency and goodness-of-fit across each timepoint. In the CFA, the two- and three-factor models were both superior to the unidimensional model. The two- and three-factor models of the PSQI were reliable, consistent and provided similar goodness-of-fit over time, and both models were superior to the unidimensional measure. We recommend using the two-factor model to assess sleep characteristics in working populations in Singapore, given that it performs as well as the three-factor model and is simpler compared to the latter.
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Affiliation(s)
- Gerard Dunleavy
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore 308232, Singapore; (R.B.); (J.C.)
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6022 MD Maastricht, The Netherlands;
| | - Ram Bajpai
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore 308232, Singapore; (R.B.); (J.C.)
- Research Institute for Primary Care and Health Sciences, Keele University, David Weatherall Building, Staffordshire ST5 5BG, UK
| | - André Comiran Tonon
- Laboratório de Cronobiologia e Sono, Porto Alegre Clínicas Hospital (HCPA), R. Ramiro Barcelos, 2350—Santa Cecilia, Porto Alegre 90035-007, RS, Brazil;
- Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande Do Sul (UFRGS), Av. Paulo Gama, 110—Farroupilha, Porto Alegre 90040-060, RS, Brazil
| | - Ai Ping Chua
- Department of Medicine, Jurong Health Campus, National University Health System, 1 Jurong East Street 21, Singapore 609606, Singapore;
| | - Kei Long Cheung
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, Middlesex, London UB8 3PH, UK;
| | - Chee-Kiong Soh
- School of Civil and Environmental Engineering, College of Engineering, Nanyang Technological University Singapore, 50 Nanyang Avenue, Singapore 639798, Singapore;
| | - Georgios Christopoulos
- Division of Leadership, Management and Organisation, Nanyang Business School, College of Business, Nanyang Technological University Singapore, 50 Nanyang Avenue, Singapore 639798, Singapore;
| | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6022 MD Maastricht, The Netherlands;
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore 308232, Singapore; (R.B.); (J.C.)
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London SW7 2AZ, UK
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IoT-Based Home Monitoring: Supporting Practitioners' Assessment by Behavioral Analysis. SENSORS 2019; 19:s19143238. [PMID: 31340542 PMCID: PMC6679511 DOI: 10.3390/s19143238] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 11/18/2022]
Abstract
This paper introduces technical solutions devised to support the Deployment Site - Regione Emilia Romagna (DS-RER) of the ACTIVAGE project. The ACTIVAGE project aims at promoting IoT (Internet of Things)-based solutions for Active and Healthy ageing. DS-RER focuses on improving continuity of care for older adults (65+) suffering from aftereffects of a stroke event. A Wireless Sensor Kit based on Wi-Fi connectivity was suitably engineered and realized to monitor behavioral aspects, possibly relevant to health and wellbeing assessment. This includes bed/rests patterns, toilet usage, room presence and many others. Besides hardware design and validation, cloud-based analytics services are introduced, suitable for automatic extraction of relevant information (trends and anomalies) from raw sensor data streams. The approach is general and applicable to a wider range of use cases; however, for readability’s sake, two simple cases are analyzed, related to bed and toilet usage patterns. In particular, a regression framework is introduced, suitable for detecting trends (long and short-term) and labeling anomalies. A methodology for assessing multi-modal daily behavioral profiles is introduced, based on unsupervised clustering techniques. The proposed framework has been successfully deployed at several real-users’ homes, allowing for its functional validation. Clinical effectiveness will be assessed instead through a Randomized Control Trial study, currently being carried out.
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Erfassung von tatsächlichem Schlafverhalten und Beschwerdesymptomatik mittels Selbstrating-Diagnostikfragebogen – eine Validierung anhand von Schlaftagebüchern. SOMNOLOGIE 2019. [DOI: 10.1007/s11818-018-0189-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Multi-angles of smoking and mild cognitive impairment: is the association mediated by sleep duration? Neurol Sci 2019; 40:1019-1027. [PMID: 30778881 DOI: 10.1007/s10072-019-03750-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/02/2019] [Indexed: 01/09/2023]
Abstract
Although the association between cigarette smoking and risk of mild cognitive impairment (MCI) is controversial, most recent studies have shown that this influence is negative. However, it is unknown how multiple factors of smoking affect MCI, and the mechanisms of different smoking factors are not yet clarified. This study will examine the impact of various angles of smoking on MCI and the potential mediating effects of sleep duration on smoking MCI association in the elderly. In the case group, 109 elderly people who met the inclusion criteria were selected, and 123 were selected in the control group. Participant characteristics include sleep duration and a detailed lifetime history of smoking. After adjusting the relevant covariates, higher odds of MCI occurrence were found in ex-smokers/current smokers; moderate/heavy smokers; smokers for 30-44, 45-59 and more than 60 years; smokers with cumulative smoking duration of 30-44 or more than 60 years and smokers with cumulative dose smoking intensity of 200-399 or 400-599 cigarettes monthly. Elderly subjects who had quit smoking for 21 years or longer were found to have lower odds of MCI occurrence. The indirect effects of smoking on MCI via sleep duration were statistically significant, as the ratio of indirect effect to total effect ranged from 0.14 to 0.29. Smoking affects cognitive function through multi-angles of smoking and influences the cognitive function partly via the duration of sleep.
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