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Dala Pola D, Maia T, Moraes E, Ogochi L, Mesas A, Pitta F. Sarcopenia and sleep in individuals with chronic obstructive pulmonary disease. Sleep Breath 2024:10.1007/s11325-024-03126-w. [PMID: 39287720 DOI: 10.1007/s11325-024-03126-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/06/2024] [Accepted: 07/26/2024] [Indexed: 09/19/2024]
Abstract
OBJECTIVE To verify the relationship between sarcopenia and sleep in individuals with chronic obstructive pulmonary disease (COPD). METHODS Individuals with COPD were cross-sectionally assessed for lung function (spirometry), sleep (both subjectively [Pittsburgh Sleep Quality Index, PSQI] and objectively [Actiwatch sleep monitor]) and the presence of sarcopenia (handgrip strength by dynamometry). All tests were carried out in accordance with international standards. RESULTS Twenty-nine individuals with COPD were analyzed (16 women; 69 ± 7 years; BMI 27 ± 5 kg/m2; FEV1 59 ± 19% predicted). Upon division in groups according to the presence or absence of sarcopenia, individuals with sarcopenia (in comparison to those without sarcopenia) had shorter sleep time (81 [75-85] vs. 86 [81-90] %; p = 0.043), lower sleep efficiency (77 [69-83] vs. 85 [75-87] %; p = 0.038), longer time awake after sleep onset (92 [71-120] vs. 58 [47-83] minutes; p = 0.0012) and more marked sleep fragmentation, represented by a higher number of sleep blocks/night (46 [41-49] vs. 34 [26-48]; p = 0.018), higher number of awake blocks/night (45 [40-49] vs. 34 [26-48]; p = 0.018) and shorter duration of sleep blocks/night (9 [8-10] vs. 14 [8-58] minutes; p = 0.043). There was no statistical difference when comparing the PSQI variables between the groups. However, handgrip strength was negatively associated with PSQI components 2 [R= -0.51, p = 0.005] and 5 [R= -0.39, p = 0.037]. CONCLUSION Individuals with COPD and sarcopenia (as measured by handgrip strength) have worse objectively measured sleep outcomes. This was not the case regarding a self-reported perception of worse sleep quality, although there was weak-to-moderate association between handgrip strength and subjective sleep.
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Affiliation(s)
- Daniele Dala Pola
- Laboratory of Research in Respiratory Physiotherapy, Departament of Physioterapy, Universidade Estadual de Londrina - Av, Robert Koch, 60 - Vila Operária, Londrina, Paraná, 86038-350, Brasil
| | - Thaiuana Maia
- Laboratory of Research in Respiratory Physiotherapy, Departament of Physioterapy, Universidade Estadual de Londrina - Av, Robert Koch, 60 - Vila Operária, Londrina, Paraná, 86038-350, Brasil
| | - Elis Moraes
- Laboratory of Research in Respiratory Physiotherapy, Departament of Physioterapy, Universidade Estadual de Londrina - Av, Robert Koch, 60 - Vila Operária, Londrina, Paraná, 86038-350, Brasil
| | - Leticia Ogochi
- Laboratory of Research in Respiratory Physiotherapy, Departament of Physioterapy, Universidade Estadual de Londrina - Av, Robert Koch, 60 - Vila Operária, Londrina, Paraná, 86038-350, Brasil
| | - Arthur Mesas
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy, Departament of Physioterapy, Universidade Estadual de Londrina - Av, Robert Koch, 60 - Vila Operária, Londrina, Paraná, 86038-350, Brasil.
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2
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He L, Rabinowitz JA, An Y, Jackson C, Hellinger R, Wanigatunga S, Schrack J, Ferrucci L, Simonsick EM, Koehler K, Spira AP. Age and objectively measured sleep: investigating associations and interactions by sex and race in middle-aged and older adults. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae045. [PMID: 39076610 PMCID: PMC11285153 DOI: 10.1093/sleepadvances/zpae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 06/23/2024] [Indexed: 07/31/2024]
Abstract
Study Objectives Few studies of middle-aged and older adults have examined the association between age and sleep using objective sleep measures. We examined these associations in adults aged ≥40 years using wrist actigraphy, and investigated whether these associations differed by sex and race. Methods Participants were 468 cognitively normal adults aged ≥40 years enrolled in the Baltimore Longitudinal Study of Aging who completed wrist actigraphy. We used Generalized Least Squares Models to examine the associations of age with actigraphic sleep parameters, including total sleep time (TST), sleep efficiency, sleep onset latency, and wake after sleep onset (WASO). We conducted interaction and stratification analyses to test whether cross-sectional age-sleep associations were modified by sex and race. Results In analyses adjusting for sex, body mass index, and individual medical conditions, older age was associated with longer TST from ages 40-70 that plateaued after age 70. Older age also was associated with lower sleep efficiency, longer sleep onset latency, and greater WASO. In men only, after age 70, older age was associated with shorter TST, lower sleep efficiency, longer onset latency, and greater WASO. However, we did not observe any significant interactions of race with age. Conclusions Older age was associated with longer TST from ages 40 to 70 and with poorer sleep quality after age 40, and these relationships might vary by sex. Future studies with larger sample sizes are needed to investigate mechanisms that may account for sex differences in the observed age-sleep associations.
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Affiliation(s)
- Linchen He
- Department of Community and Population Health, Lehigh University, Bethlehem, PA, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Yang An
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Chandra Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
- Division of Intramural Research, Department of Health and Human Services, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Ryan Hellinger
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sarah Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Kirsten Koehler
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
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Subjective and objective sleep quality does not predict behavioural episodic foresight in younger or older adults. Sci Rep 2023; 13:1056. [PMID: 36658258 PMCID: PMC9852464 DOI: 10.1038/s41598-023-28183-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
Episodic foresight refers to one's capacity to use imagined scenarios to guide future-directed behaviors. It is important in facilitating complex activities of daily living, such as managing finances. Broader literature shows that older adults perform more poorly on tests of episodic foresight relative to their younger counterparts. At the same time, age-related changes in sleep often contribute to age-related decline in other cognitive abilities known to support episodic foresight, such as memory. No study to date has tested whether sleep quality is associated with episodic foresight when it is measured behaviorally; or whether this relationship is moderated by age. To address this, in the present study healthy younger (n = 39) and older (n = 41) adults were asked to wear an actigraphy watch and self-report their sleep quality for seven nights. Participants then completed the virtual-week foresight task-a behavioral assessment of episodic foresight. Neither objective or subjective sleep quality predicted episodic foresight outcomes, and this was not moderated by age group. Bayesian analyses provided evidence in favour of the null hypotheses. These results suggest that sleep quality (at least in healthy adult populations) may not be linked to episodic foresight.
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Pola DCD, Hirata RP, Schneider LP, Bertoche MP, Furlanetto KC, Mesas AE, Pitta F. Sleep-onset time variability and sleep characteristics on weekday and weekend nights in patients with COPD. JORNAL BRASILEIRO DE PNEUMOLOGIA : PUBLICACAO OFICIAL DA SOCIEDADE BRASILEIRA DE PNEUMOLOGIA E TISILOGIA 2022; 48:e20210412. [PMID: 36074407 PMCID: PMC9496202 DOI: 10.36416/1806-3756/e20210412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 05/29/2022] [Indexed: 11/18/2022]
Abstract
Objective: To evaluate sleep-onset time variability, as well as sleep characteristics on weekday and weekend nights, in individuals with moderate-to-severe COPD. Methods: Sleep was objectively assessed by an activity/sleep monitor for seven consecutive nights in individuals with COPD. For analysis, individuals were divided into two groups according to sleep-onset time variability results, characterized by intrasubject standard deviation of sleep-onset time (SOTV) ≥ 60 min or < 60 min. Results: The sample comprised 55 individuals (28 males; mean age = 66 ± 8 years; and median FEV1 % of predicted = 55 [38-62]). When compared with the SOTV<60min group (n = 24), the SOTV≥60min group (n = 31) presented shorter total sleep time (5.1 ± 1.3 h vs. 6.0 ± 1.3 h; p = 0.006), lower sleep efficiency (73 ± 12% vs. 65 ± 13%; p = 0.030), longer wake time after sleep onset (155 ± 66 min vs. 115 ± 52 min; p = 0.023), longer duration of wake bouts (19 [16-28] min vs. 16 [13-22] min; p = 0.025), and higher number of steps at night (143 [104-213] vs. 80 [59-135]; p = 0.002). In general, sleep characteristics were poor regardless of the day of the week, the only significant difference being that the participants woke up about 30 min later on weekends than on weekdays (p = 0.013). Conclusions: Sleep-onset time varied over 1 h in a standard week in the majority of individuals with COPD in this sample, and a more irregular sleep onset indicated poor sleep quality both on weekdays and weekends. Sleep hygiene guidance could benefit these individuals if it is integrated with their health care.
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Affiliation(s)
- Daniele Caroline Dala Pola
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil
| | - Raquel Pastrello Hirata
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil
| | - Lorena Paltanin Schneider
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil
| | - Mariana Pereira Bertoche
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil
| | - Karina Couto Furlanetto
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil.,. Centro de Pesquisa em Ciências da Saúde, Universidade Pitágoras-Universidade Norte do Paraná - UNOPAR - Londrina (PR) Brasil
| | - Arthur Eumann Mesas
- . Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil.,. Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Fabio Pitta
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil
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Cleland J, Gates LJ, Waiter GD, Ho VB, Schuwirth L, Durning S. Even a little sleepiness influences neural activation and clinical reasoning in novices. Health Sci Rep 2021; 4:e406. [PMID: 34761123 PMCID: PMC8566838 DOI: 10.1002/hsr2.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND AND AIMS Sleepiness influences alertness and cognitive functioning and impacts many aspects of medical care, including clinical reasoning. However, dual processing theory suggests that sleepiness will impact clinical reasoning differently in different individual, depending on their level of experience with the given condition. Our aim, therefore, was to examine the association between clinical reasoning, neuroanatomical activation, and sleepiness in senior medical students. METHODS Our methodology replicated an earlier study but with novices rather than board-certified physicians. Eighteen final-year medical students answered validated multiple-choice questions (MCQs) during an fMRI scan. Each MCQ was projected in three phases: reading, answering, and reflection (modified think aloud). Echo-planar imaging (EPI) scans gave a time series that reflected blood oxygenation level dependent (BOLD) signal in each location (voxel) within the brain. Sleep data were collected via self-report (Epworth Sleepiness Scale) and actigraphy. These data were correlated with answer accuracy using Pearson correlation. RESULTS Analysis revealed an increased BOLD signal in the right dorsomedial prefrontal cortex (P < .05) during reflection (Phase 3) associated with increased self-reported sleepiness (ESS) immediately before scanning. Covariate analysis also revealed that increased BOLD signal in the right supramarginal gyrus (P < .05) when reflecting (Phase 3) was associated with increased correct answer response time. Both patterns indicate effortful analytic (System 2) reasoning. CONCLUSION Our findings that novices use System 2 thinking for clinical reasoning and even a little (perceived) sleepiness influences their clinical reasoning ability to suggest that the parameters for safe working may be different for novices (eg, junior doctors) and experienced physicians.
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Affiliation(s)
- Jennifer Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological UniversitySingaporeSingapore
| | - Laura J. Gates
- Institute of Education for Medical and Dental Sciences, University of AberdeenAberdeenUK
| | - Gordon D. Waiter
- Aberdeen Biomedical Imaging Centre, University of AberdeenAberdeenUK
| | - Vincent B. Ho
- Department of Radiology and Radiological SciencesUniformed Services University of the Health SciencesBethesdaMarylandUSA
| | - Lambert Schuwirth
- College of Medicine and Public Health, Flinders UniversityAdelaideAustralia
| | - Steven Durning
- Department of MedicineUniformed Services University of the Health SciencesBethesdaMarylandUSA
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Lurie A, Roche N. Obstructive Sleep Apnea in Patients with Chronic Obstructive Pulmonary Disease: Facts and Perspectives. COPD 2021; 18:700-712. [PMID: 34595967 DOI: 10.1080/15412555.2021.1950663] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The co-occurrence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) in the same patient, named the overlap syndrome (OS), was first described in 1985. Although the American Thoracic Society underlined the limited knowledge of OS, stated research priorities for this condition, and recommended a "screening" strategy to identify OSA in COPD patients with chronic stable hypercapnia, research studies on OS remain scarce. This review aims to summarize the current knowledge and perspectives related to OSA in COPD patients. OS prevalence is 1.0-3.6% in the general population, 3-66% in COPD patients, and 7-55% in OSA patients. OS patients may have worse sleep quality than those with OSA or COPD alone. Scoring hypopneas may be difficult in COPD patients; desaturation episodes may have origins in these patients, namely upper airway obstruction, hypoventilation during paradoxical sleep, ventilation/perfusion mismatches, and obesity. The apnea-hypopnea index is similar in OSA and OS patients. Desaturations may be greater and more prolonged in OS patients than in patients with COPD or OSA alone. Low body mass index, hyperinflation, and less collapsible airways reduce the risk of OSA in COPD patients. OSA is a risk factor for pulmonary hypertension in COPD patients. Whether OS increases mortality and morbidity risks compared to COPD or OSA alone remains to be confirmed. No guidelines currently recommend specific approaches to the treatment of OSA in patients with COPD.
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Affiliation(s)
- Alain Lurie
- Clinique Ambroise Paré, Laboratoire du sommeil, Neuilly-sur-Seine, France.,Hôpital Cochin (AP-HP Centre), Pneumologie, Paris, France
| | - Nicolas Roche
- Hôpital Cochin (AP-HP Centre), Pneumologie, Université de Paris (Descartes), UMR 1016, Institut Cochin, Paris, France
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Evans MA, Buysse DJ, Marsland AL, Wright AGC, Foust J, Carroll LW, Kohli N, Mehra R, Jasper A, Srinivasan S, Hall MH. Meta-analysis of age and actigraphy assessed sleep characteristics across the lifespan. Sleep 2021; 44:6211192. [PMID: 33823052 DOI: 10.1093/sleep/zsab088] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/11/2021] [Indexed: 12/17/2022] Open
Abstract
STUDY OBJECTIVES Sleep quantity and continuity vary across the lifespan. Actigraphy is a reliable and widely-used behavioral measure of sleep in research and personal health monitoring. This meta-analysis provides a novel examination of whether age (in years) is associated with actigraphy-assessed sleep across the lifespan. METHODS A systematic search of PubMed, Embase.com, Cochrane CENTRAL, and PsycINFO using "actigraphy" and "sleep" terms provided 7,079 titles/abstracts; studies of individuals with known psychiatric or medical comorbidities were excluded. Ninety-one articles (N = 23,365) provided data for six meta-analyses examining sleep duration (k = 89), sleep efficiency (k = 58), bedtime (k = 19) and waketime (k = 9) for individuals ages 6-21, and bedtime (k = 7) and waketime (k = 7) for individuals ages 22 and older. RESULTS At older ages, sleep duration was shorter (r = -0.12) and sleep efficiency was lower (r = -0.05). Older age was associated with later bedtime (r = 0.37) and wake-up time (r = 0.24) from ages 6-21, whereas older age was associated with earlier bedtime (r = -0.66) and wake-up time (r = -0.59) for ages 22 and above. The strength of these associations was modified by study continent, but not by any other moderator. CONCLUSIONS Age was negatively associated with actigraphy-assessed sleep duration and efficiency, but the effects were small in magnitude. On the other hand, large associations were observed between age and sleep timing, despite a smaller literature and the absence of analyzable data for ages 30-60. Changes in sleep timing, rather than changes in sleep duration or continuity, may better characterize the effects of age on human sleep.
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Affiliation(s)
- Marissa A Evans
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anna L Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jill Foust
- Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lucas W Carroll
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Naina Kohli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rishabh Mehra
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Adam Jasper
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Swathi Srinivasan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Spina G, Casale P, Albert PS, Alison J, Garcia-Aymerich J, Clarenbach CF, Costello RW, Hernandes NA, Leuppi JD, Mesquita R, Singh SJ, Smeenk FWJM, Tal-Singer R, Wouters EFM, Spruit MA, den Brinker AC. Nighttime features derived from topic models for classification of patients with COPD. Comput Biol Med 2021; 132:104322. [PMID: 33780868 DOI: 10.1016/j.compbiomed.2021.104322] [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: 08/14/2020] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
Nighttime symptoms are important indicators of impairment for many diseases and particularly for respiratory diseases such as chronic obstructive pulmonary disease (COPD). The use of wearable sensors to assess sleep in COPD has mainly been limited to the monitoring of limb motions or the duration and continuity of sleep. In this paper we present an approach to concisely describe sleep patterns in subjects with and without COPD. The methodology converts multimodal sleep data into a text representation and uses topic modeling to identify patterns across the dataset composed of more than 6000 assessed nights. This approach enables the discovery of higher level features resembling unique sleep characteristics that are then used to discriminate between healthy subjects and those with COPD and to evaluate patients' disease severity and dyspnea level. Compared to standard features, the discovered latent structures in nighttime data seem to capture important aspects of subjects sleeping behavior related to the effects of COPD and dyspnea.
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Affiliation(s)
- Gabriele Spina
- HumanTotalCare, Data Science Department, Utrecht, the Netherlands.
| | - Pierluigi Casale
- Jheronimous Academy of Data Science, 'S-Hertogenbosch, the Netherlands
| | - Paul S Albert
- School of Ageing and Chronic Disease, University Hospital Aintree, Liverpool, United Kingdom
| | - Jennifer Alison
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Judith Garcia-Aymerich
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain and Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Richard W Costello
- Department of Respiratory Medicine, Royal College of Surgeons, Dublin, Ireland
| | - Nidia A Hernandes
- Laboratory of Research in Respiratory Physiotherapy, Dept. of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | - Jörg D Leuppi
- University Department of Medicine, Cantonal Hospital Baselland and University of Basel, Basel, Switzerland
| | - Rafael Mesquita
- Department of Research and Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn and MUMC+ Dept. of Respiratory Medicine, Maastricht University Medical Center+, the Netherlands
| | - Sally J Singh
- NIHR Leicester Respiratory Biomedical Research Centre, Dept of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Frank W J M Smeenk
- Dept. of Respiratory Medicine, Catharina Hospital, Eindhoven, the Netherlands
| | | | - Emiel F M Wouters
- Department of Research and Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn and MUMC+ Dept. of Respiratory Medicine, Maastricht University Medical Center+, the Netherlands
| | - Martijn A Spruit
- Department of Research and Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn and MUMC+ Dept. of Respiratory Medicine, Maastricht University Medical Center+, the Netherlands; REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium, and NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
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9
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Syed N, Road JD, Ryerson CJ, Guenette JA. Evaluation of the Vibe Actigraph in Patients With Chronic Obstructive Pulmonary Disease: A Pilot Study. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2020; 8:2700708. [PMID: 32879810 PMCID: PMC7458158 DOI: 10.1109/jtehm.2020.3018399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 07/10/2020] [Accepted: 08/05/2020] [Indexed: 12/22/2022]
Abstract
STUDY OBJECTIVE To validate the Vibe actigraph in assessing sleep-wake patterns compared to polysomnography (PSG) in patients with COPD. METHODS Nine stable COPD patients wore actigraphs while undergoing PSG. The correlation between total sleep time (TST), total sleep period (TSP), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency was determined for corresponding measurements from the actigraph and PSG. Sensitivity, specificity, and positive and negative predictive values were calculated for the actigraph, considering PSG the gold standard. Levels of agreement between the variables of PSG and the actigraph were estimated using Bland-Altman plots. RESULTS A strong and statistically significant correlation was noted between PSG and the actigraph in detecting movement during sleep [mean activity score (counts)], TST and TSP (all rs = 0.83; p = 0.005). The median agreement of sleep and wake counts between PSG and the actigraph was 73% and the Cohen's Kappa value was 0.66. The medians of sensitivity and specificity of the actigraph for detecting sleep versus PSG were 84 and 66%, respectively. The median positive and negative predictive values of the actigraph were 74 and 72%, respectively. CONCLUSIONS This study demonstrated that, under controlled laboratory conditions, the Vibe actigraph in its default settings is a promising tool for the detection of sleep-wake parameters in a small number of ambulatory patients with COPD. Clinical Impact: The actigraph used in this pilot study suggests that these devices could provide clinically relevant information in COPD to better understand the relationship between sleep and health in this population.
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Affiliation(s)
- Nafeez Syed
- Centre for Heart Lung InnovationProvidence Health Care Research Institute, The University of British Columbia, St. Paul's HospitalVancouverBCV6Z 1Y6Canada.,Department of Physical TherapyThe University of British ColumbiaVancouverBCV6T 1Z4Canada.,Department of PhysiotherapyManipal College of Health ProfessionalsManipal Academy of Higher EducationManipal576 104India
| | - Jeremy D Road
- Division of Respiratory MedicineDepartment of MedicineThe University of British ColumbiaVancouverBCV6T 1Z4Canada
| | - Christopher J Ryerson
- Centre for Heart Lung InnovationProvidence Health Care Research Institute, The University of British Columbia, St. Paul's HospitalVancouverBCV6Z 1Y6Canada.,Division of Respiratory MedicineDepartment of MedicineThe University of British ColumbiaVancouverBCV6T 1Z4Canada
| | - Jordan A Guenette
- Centre for Heart Lung InnovationProvidence Health Care Research Institute, The University of British Columbia, St. Paul's HospitalVancouverBCV6Z 1Y6Canada.,Department of Physical TherapyThe University of British ColumbiaVancouverBCV6T 1Z4Canada.,Division of Respiratory MedicineDepartment of MedicineThe University of British ColumbiaVancouverBCV6T 1Z4Canada
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10
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Luyster FS, Wang J, Sciurba FC, Bon J. Longitudinal associations between sleep disturbance and disease severity in patients with COPD. SLEEP SCIENCE AND PRACTICE 2020. [DOI: 10.1186/s41606-020-00046-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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11
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Sleep disturbance and next-day physical activity in COPD patients. Geriatr Nurs 2020; 41:872-877. [PMID: 32586622 DOI: 10.1016/j.gerinurse.2020.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 11/23/2022]
Abstract
Physical inactivity and sleep disturbance are more problematic in patients with chronic obstructive pulmonary disease (COPD) than in healthy individuals. The purpose of the study was to identify impacts of nighttime sleep on next-day physical activity in COPD patients. The study included 52 COPD patients reporting disturbed sleep. Sleep and physical activity were measured using an accelerometer for 5 days. Increased sleep latency was associated with less next-day physical activity during the afternoon (4-6 p.m.). Greater waking duration/times were associated with less next-morning (6-8 a.m.) physical activity. Greater total sleep time was associated with less next-morning (12-9 a.m.) physical activity, and greater sleep efficiency was associated with less next-morning (1-3 a.m.) and more next-evening (6-7 p.m.) physical activity. Results suggest that sleep disturbance had varying influences on next-day hourly physical activity. These results support the potential value of sleep management in promoting physical activity in COPD patients.
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12
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Zeidler MR, Martin JL, Kleerup EC, Schneider H, Mitchell MN, Hansel NN, Sundar K, Schotland H, Basner RC, Wells JM, Krishnan JA, Criner GJ, Cristenson S, Krachman S, Badr MS. Sleep disruption as a predictor of quality of life among patients in the subpopulations and intermediate outcome measures in COPD study (SPIROMICS). Sleep 2019. [PMID: 29534240 DOI: 10.1093/sleep/zsy044] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Study Objectives Sleep quality is poor among patients with chronic obstructive pulmonary disease (COPD), and studies show that sleep disturbance is associated with low overall quality of life in this population. We evaluated the impact of patient-reported sleep quality and sleep apnea risk on disease-specific and overall quality of life within patients with COPD enrolled in the SPIROMICS study, after accounting for demographics and COPD disease severity. Methods Baseline data from 1341 participants [892 mild/moderate COPD (FEV1 ≥ 50% predicted); 449 severe COPD (FEV1 < 50%)] were used to perform three nested (blocks) regression models to predict quality of life (Short Form-12 mental and physical components and St. George's Respiratory Questionnaire). Dependent measures used for the nested regressions included the following: Block1: demographics and smoking history; Block 2: disease severity (forced expiratory volume 1 s; 6 min walk test); Block 3: risk for obstructive sleep apnea (OSA; Berlin questionnaire); and Block 4: sleep quality (Pittsburgh Sleep Quality Index [PSQI]). Results Over half of participants with COPD reported poor sleep quality (Mean PSQI 6.4 ± 3.9; 50% with high risk score on the Berlin questionnaire). In all three nested regression models, sleep quality (Block 4) was a significant predictor of poor quality of life, over and above variables included in blocks 1-3. Conclusions Poor sleep quality represents a potentially modifiable risk factor for poor quality of life in patients with COPD, over and above demographics and smoking history, disease severity, and risk for OSA. Improving sleep quality may be an important target for clinical interventions. Clinical Trial SPIROMICS. Clinical Trial URL http://www2.cscc.unc.edu/spiromics/. Clinical Trial Registration ClinicalTrials.gov NCT01969344.
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Affiliation(s)
- Michelle R Zeidler
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA.,Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Jennifer L Martin
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA.,VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, Los Angeles, CA
| | - Eric C Kleerup
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA
| | | | - Michael N Mitchell
- VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, Los Angeles, CA
| | - Nadia N Hansel
- School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Krishna Sundar
- Department of Medicine, University of Utah, Salt Lake City, UT
| | | | - Robert C Basner
- Department of Medicine, Columbia University, New York City, NY
| | - J Michael Wells
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | | | - Gerard J Criner
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | | | - Samuel Krachman
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - M Safwan Badr
- School of Medicine, Wayne State University, Detroit, MI
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13
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Nunes DM, Gonçalves BSB, Tardelli Peixoto CA, De Bruin VMS, Louzada FM, De Bruin PFC. Circadian rest-activity rhythm in chronic obstructive pulmonary disease. Chronobiol Int 2017; 34:1315-1319. [PMID: 29053034 DOI: 10.1080/07420528.2017.1352594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To characterize circadian rest-activity rhythm in COPD, 26 cases (66.9 ± 8.5y) and 15 controls (63.0 ± 10.7y) were assessed by actimetry. Rhythm fragmentation was measured by intradaily variability (IV), while synchronization to the 24-h light-dark cycle was measured by interdaily stability (IS). The average activity during the least active 5-h period (L5) and the average activity during the most active 10-h period (M10) were used to calculate the relative amplitude mean [RAm = (M10-L5)/(M10+L5)]. COPD patients presented higher IVm (0.242 ± 0.097 vs 0.182 ± 0.063) and L5 (36.849 ± 18.239 vs 19.888 ± 12.268) and lower RAm (0.696 ± 0.134 vs 0.833 ± 0.093) than controls. Future studies on the effects of chronotherapy measures in COPD are warranted.
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Affiliation(s)
- Deuzilane Muniz Nunes
- a Department of Pharmacy , Universidade Federal do Vale do São Francisco , Petrolina , Pernambuco , Brazil
| | - Bruno S B Gonçalves
- b School of Arts, Sciences and Humanities , Universidade de São Paulo , São Paulo , Brazil
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14
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Spina G, Spruit MA, Alison J, Benzo RP, Calverley PMA, Clarenbach CF, Costello RW, Donaire-Gonzalez D, Dürr S, Garcia-Aymerich J, van Gestel AJR, Gramm M, Hernandes NA, Hill K, Hopkinson NS, Jarreta D, Kohler M, Kirsten AM, Leuppi JD, Magnussen H, Maltais F, Man WDC, McKeough ZJ, Mesquita R, Miedinger D, Pitta F, Singh SJ, Smeenk FWJM, Tal-Singer R, Vagaggini B, Waschki B, Watz H, Wouters EFM, Zogg S, den Brinker AC. Analysis of nocturnal actigraphic sleep measures in patients with COPD and their association with daytime physical activity. Thorax 2017; 72:694-701. [PMID: 28082529 DOI: 10.1136/thoraxjnl-2016-208900] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 11/15/2016] [Accepted: 12/07/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Sleep disturbances are common in patients with chronic obstructive pulmonary disease (COPD) with a considerable negative impact on their quality of life. However, factors associated with measures of sleep in daily life have not been investigated before nor has the association between sleep and the ability to engage in physical activity on a day-to-day basis been studied. AIMS To provide insight into the relationship between actigraphic sleep measures and disease severity, exertional dyspnoea, gender and parts of the week; and to investigate the association between sleep measures and next day physical activity. METHODS Data were analysed from 932 patients with COPD (66% male, 66.4±8.3 years, FEV1% predicted=50.8±20.5). Participants had sleep and physical activity continuously monitored using a multisensor activity monitor for a median of 6 days. Linear mixed effects models were applied to investigate the factors associated with sleep impairment and the association between nocturnal sleep and patients' subsequent daytime physical activity. RESULTS Actigraphic estimates of sleep impairment were greater in patients with worse airflow limitation and worse exertional dyspnoea. Patients with better sleep measures (ie, non-fragmented sleep, sleeping bouts ≥225 min, sleep efficiency ≥91% and time spent awake after sleep onset <57 min) spent significantly more time in light (p<0.01) and moderate-to-vigorous physical activity (p<0.01). CONCLUSIONS There is a relationship between measures of sleep in patients with COPD and the amount of activity they undertake during the waking day. Identifying groups with specific sleep characteristics may be useful information when designing physical activity-enhancing interventions.
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Affiliation(s)
- Gabriele Spina
- Department of Signal Processing Systems, Technische Universiteit Eindhoven, Eindhoven, The Netherlands.,Data Science Group, Philips Research, Eindhoven, The Netherlands
| | - Martijn A Spruit
- Department of Research and Education, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.,REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Jennifer Alison
- Clinical and Rehabilitation Sciences, The University of Sydney, Sydney, New South Wales, Australia.,Physiotherapy Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Roberto P Benzo
- Mindful Breathing Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | - Peter M A Calverley
- School of Ageing and Chronic Disease, University Hospital Aintree, Liverpool, UK
| | | | | | - David Donaire-Gonzalez
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Selina Dürr
- Medical University Clinic, Cantonal Hospital Baselland, Liestal and Medical Faculty, University of Basel, Basel, Switzerland
| | - Judith Garcia-Aymerich
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Marco Gramm
- Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Centre for Lung Research, Grosshansdorf, Germany
| | - Nidia A Hernandes
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Washington, Australia
| | - Nicholas S Hopkinson
- NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, London, UK
| | | | - Malcolm Kohler
- Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland
| | - Anne M Kirsten
- Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Centre for Lung Research, Grosshansdorf, Germany
| | - Jörg D Leuppi
- Medical University Clinic, Cantonal Hospital Baselland, Liestal and Medical Faculty, University of Basel, Basel, Switzerland
| | - Helgo Magnussen
- Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Centre for Lung Research, Grosshansdorf, Germany
| | - François Maltais
- Centre de recherche, Institut Universitaire de cardiologie et de pneumologie de Québec, 2725 Chemin Ste-Foy Québec, Université Laval, Québec, Canada
| | - William D-C Man
- NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, London, UK
| | - Zoe J McKeough
- Clinical and Rehabilitation Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Rafael Mesquita
- Department of Research and Education, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
| | - David Miedinger
- Medical University Clinic, Cantonal Hospital Baselland, Liestal and Medical Faculty, University of Basel, Basel, Switzerland
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | - Sally J Singh
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Frank W J M Smeenk
- Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | | | - Barbara Vagaggini
- Cardio-Thoracic and Vascular Department, University of Pisa, Pisa, Italy
| | - Benjamin Waschki
- Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Centre for Lung Research, Grosshansdorf, Germany
| | - Henrik Watz
- Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Centre for Lung Research, Grosshansdorf, Germany
| | - Emiel F M Wouters
- Department of Research and Education, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
| | - Stefanie Zogg
- Medical University Clinic, Cantonal Hospital Baselland, Liestal and Medical Faculty, University of Basel, Basel, Switzerland
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Durning SJ, Kelly W, Costanzo ME, Artino AR, Vleuten CVD, Beckman TJ, Roy MJ, Holmboe ES, Wittich CM, Schuwirth L. Relationship of Neuroimaging to Typical Sleep Times During a Clinical Reasoning Task: A Pilot Study. Mil Med 2015; 180:129-35. [DOI: 10.7205/milmed-d-14-00572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
ABSTRACT
Background: Sleep deprivation and fatigue have been associated with medical errors, clinical performance decrements, and reduced quality of life for both practicing physicians and medical students. Greater understanding of the impact of sleep quantity on clinical reasoning could improve patient care. The purpose of our pilot study was to examine relationships between clinical reasoning (assessed by functional magnetic resonance imaging) and sleep time (measured in different ways by actigraphy) while answering multiple-choice questions (MCQs) from licensing agencies. Methods: Residents and faculty were administered a clinical reasoning exercise (MCQs from licensing bodies) during functional magnetic resonance imaging. Usual sleep patterns were sampled with actigraphy. Covariate analysis was used to examine the relationship between sleep duration (mean sleep, minimum sleep, maximum sleep) and brain activity during clinical reasoning (solving MCQs from licensing bodies). Results: The mean sleep time over the duration of monitoring for the group was 7.19 hours (SD 0.66) with a range of 6.1 to 8.1 hours (internal medicine faculty 7.1 hours, SD 0.41; internal medicine residents 7.27 hours, SD 0.92). There was a negative relationship between activation in the prefrontal cortex and minimum sleep time while reflecting on MCQs. Conclusion: Our findings provide evidence that the quantity of sleep can modulate brain activity while completing a clinically meaningful task that should be confirmed in larger studies. Our findings suggest that the construct of sleepiness may be more complex than appreciated by many and that the most important of these sleep measures in terms of outcomes remains to be determined.
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Affiliation(s)
- Steven J. Durning
- Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda MD 20814
| | - William Kelly
- Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda MD 20814
| | - Michelle E. Costanzo
- Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda MD 20814
| | - Anthony R. Artino
- Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda MD 20814
| | - Cees van der Vleuten
- Department of Educational Development and Research, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Thomas J. Beckman
- Department of Internal Medicine, Division of General Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55905
| | - Michael J. Roy
- Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda MD 20814
| | - Eric S. Holmboe
- American Board of Internal Medicine, 510 Walnut Street Suite 1700 Philadelphia, PA 19106–3699
| | - Christopher M. Wittich
- Department of Internal Medicine, Division of General Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55905
| | - Lambert Schuwirth
- School of Medicine, Flinders University, GPO Box 2100, Adelaide 5001, South Australia
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16
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Hartman JE, Prinzen J, van Lummel RC, Ten Hacken NHT. Frequent sputum production is associated with disturbed night's rest and impaired sleep quality in patients with COPD. Sleep Breath 2015; 19:1125-33. [PMID: 25737300 PMCID: PMC4662951 DOI: 10.1007/s11325-014-1111-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 12/01/2014] [Accepted: 12/23/2014] [Indexed: 11/29/2022]
Abstract
Purpose In this study, we measured night’s rest parameters measured with an accelerometer and sleep quality in mild to very severe patients with COPD. Furthermore, our aim was to investigate the association between night’s rest parameters and clinical variables and the association between sleep quality and quality of life or health status. Methods Mild to very severe COPD patients were recruited from general practitioners and outpatient clinics of general hospitals to participate in a cross-sectional study on physical activity in patients with COPD. A total of 103 patients (mean age 65 years, 67 % male) wore the accelerometer during night’s rest for at least four nights and were included in the analyses. Results No significant associations were found between objectively measured body movements during night’s rest or subjective sleep quality and lung function, dyspnoea severity, body composition and physical activity during the day. Patients with frequent sputum production during the day had a higher number of sitting transitions during the night (5.3 vs 4.3 sitting transitions) and more frequently got out of bed compared to patients who hardly ever produced sputum during the day (1.0 vs 0.8 times per night). Furthermore, these patients also reported worse sleep quality (Pittsburgh sleep quality index (PSQI) score 4 vs 3). Conclusions Our results indicate that objectively measured body movements during night’s rest like body postures and transitions are not related to sleep quality in patients with COPD. We did find an association between frequent sputum production and disturbances during night’s rest and sleep quality. Future studies should investigate whether the treatment of mucus hypersecretion leads to improved night’s rest.
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Affiliation(s)
- J E Hartman
- Department of Pulmonary Diseases AA11, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
- GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - J Prinzen
- McRoberts, Den Haag, The Netherlands
| | | | - N H T Ten Hacken
- Department of Pulmonary Diseases AA11, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands
- GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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17
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Garrow AP, Yorke J, Khan N, Vestbo J, Singh D, Tyson S. Systematic literature review of patient-reported outcome measures used in assessment and measurement of sleep disorders in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2015; 10:293-307. [PMID: 25709424 PMCID: PMC4330032 DOI: 10.2147/copd.s68093] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Sleep problems are common in patients with chronic obstructive pulmonary disease (COPD), but the validity of patient-reported outcome measures (PROMs) that measure sleep dysfunction has not been evaluated. We have reviewed the literature to identify disease-specific and non-disease-specific sleep PROMs that have been validated for use in COPD patients. The review also examined the psychometric properties of identified sleep outcome measures and extracted point and variability estimates of sleep instruments used in COPD studies. METHODS The online EMBASE, MEDLINE, PsycINFO, and SCOPUS databases for all years to May 2014 were used to source articles for the review. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Criteria from the Medical Outcomes Trust Scientific Advisory Committee guidelines were used to evaluate the psychometric properties of all sleep PROMs identified. RESULTS One COPD-specific and six non-COPD-specific sleep outcome measures were identified and 44 papers met the review selection criteria. We only identified one instrument, the COPD and Asthma Sleep Impact Scale, which was developed specifically for use in COPD populations. Ninety percent of the identified studies used one of two non-disease-specific sleep scales, ie, the Pittsburgh Sleep Quality Index and/or the Epworth Sleep Scale, although neither has been tested for reliability or validity in people with COPD. CONCLUSION The results highlight a need for existing non-disease-specific instruments to be validated in COPD populations and also a need for new disease-specific measures to assess the impact of sleep problems in COPD.
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Affiliation(s)
- Adam P Garrow
- University of Manchester Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, Manchester, UK
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Janelle Yorke
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Naimat Khan
- University of Manchester Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, Manchester, UK
| | - Jørgen Vestbo
- The University of Manchester Academic Health Science Centre, University Hospital South Manchester NHS Foundation Trust, Manchester, UK
| | - Dave Singh
- University of Manchester Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, Manchester, UK
| | - Sarah Tyson
- University of Manchester Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, Manchester, UK
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19
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Hunt T, Madigan S, Williams MT, Olds TS. Use of time in people with chronic obstructive pulmonary disease--a systematic review. Int J Chron Obstruct Pulmon Dis 2014; 9:1377-88. [PMID: 25548519 PMCID: PMC4271726 DOI: 10.2147/copd.s74298] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
“Physical inactivity” and “sedentary lifestyles” are phrases often used when describing lifestyles of people with chronic obstructive pulmonary disease (COPD). Evidence suggests activity types, independent of energy expenditure, influence health outcomes, so understanding patterns of time use is important, particularly in chronic disease. We aimed to identify reports of time use in people with COPD. Predefined search strategies were used with six electronic databases to identify individual activity reports (including frequencies and/or durations) in which community-dwelling people with COPD engaged. Eligible studies were assessed independently against predefined criteria and data were extracted by two reviewers. Data synthesis was achieved by aggregating activity reports into activity domains (sports/exercise, screen time, transport, quiet time, self-care, sociocultural, work/study, chores, and sleep). Twenty-six publications reported 37 specific daily activities. People with COPD were found to spend extended periods in sedentary behaviors (eg, standing [194 min/day]; sitting [359 min/day]; lying [88 min/day]), have limited engagement in physical activity (eg, walking [51 min/day]; exercising [1.2 episodes per week {ep/w}, 13 min/day]), have high health care needs (medical appointments [1.0 ep/w]), and experience difficulties associated with activities of daily living (eg, showering [2.5 ep/w, 60 minutes per episode]; preparing meals [4.7 ep/w]). Little data could be found describing how people with COPD use their time, and data synthesis was problematic because of variations in methodologies, population differences, and research emphases. Identified data largely referred to posture and were skewed according to country, assessment methods, and disease severity. Comparisons with age-matched population data showed people with COPD spent less time engaged in personal-care activities (self-care and sleeping) and chores than people in similar age groups. The incorporation of time-use outcomes in future research designs should be encouraged. Ideally, these tools should use consistent frameworks and comparable outcome measures in order to provide clearer descriptions of time use in chronic disease.
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Affiliation(s)
- Toby Hunt
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, School of Health Sciences, University of South Australia, City East Campus, Adelaide, SA, Australia ; Respiratory Clinical Research Unit, Repatriation General Hospital, Daw Park, SA, Australia
| | - Sarah Madigan
- Respiratory Clinical Research Unit, Repatriation General Hospital, Daw Park, SA, Australia
| | - Marie T Williams
- School of Population Health, University of South Australia, City East Campus, Adelaide, SA, Australia
| | - Tim S Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, School of Health Sciences, University of South Australia, City East Campus, Adelaide, SA, Australia
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Azuma M, Chin K, Yoshimura C, Takegami M, Takahashi KI, Sumi K, Nakamura T, Nakayama-Ashida Y, Minami I, Horita S, Oka Y, Oga T, Wakamura T, Fukuhara SI, Mishima M, Kadotani H. Associations among Chronic Obstructive Pulmonary Disease and Sleep-Disordered Breathing in an Urban Male Working Population in Japan. Respiration 2014; 88:234-43. [DOI: 10.1159/000366064] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 07/22/2014] [Indexed: 11/19/2022] Open
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Johansson A, Svanborg E, Edéll-Gustafsson U. Sleep-wake activity rhythm and health-related quality of life among patients with coronary artery disease and in a population-based sample--an actigraphy and questionnaire study. Int J Nurs Pract 2013; 19:390-401. [PMID: 23915408 DOI: 10.1111/ijn.12080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The aim of this study was to explore whether there are gender differences in sleep and health-related quality of life in patients with coronary artery disease (CAD) and a matched population-based sample and to see how subjectively rated sleep is associated with actigraphy. Secondly, to explore whether factors that predict patients' sleep quality could be identified. Fifty-seven patients with stable CAD and 47 participants from a population-based sample were included. All participants completed the Uppsala Sleep Inventory (USI), the Epworth Sleepiness Scale and the SF-36. Actigraphy recordings and a sleep diary were performed for seven 24-h periods. Multiple stepwise regression analysis showed that sleep duration, sleep onset latency, nocturnal awakenings, vitality (SF-36) and body mass index explained 60% of the sleep quality outcome (USI). Sleep duration, sleep efficiency and fragmentation index assessed with actigraphy and sleep diary accounted for 36% of the sleep quality outcome (diary). The result can form the basis for a non-pharmacological, self-care programme supported and led by nurses.
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Affiliation(s)
- Anna Johansson
- Department of Cardiology, Skaraborgs Hospital, Skövde, Sweden.
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22
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Restless legs syndrome, sleep impairment, and fatigue in chronic obstructive pulmonary disease. Sleep Med 2012; 13:842-7. [DOI: 10.1016/j.sleep.2012.03.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Revised: 02/28/2012] [Accepted: 03/29/2012] [Indexed: 11/17/2022]
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