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Uwishema O, Nazir A, Munyangaju I, Shariff S, Al Komi O, Chibueze N, Wojtara M. The pulse of sleep: novel interventions in understanding the sleep-cardiovascular connection: a literature review. Ann Med Surg (Lond) 2024; 86:5283-5291. [PMID: 39238992 PMCID: PMC11374239 DOI: 10.1097/ms9.0000000000002414] [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: 02/26/2024] [Accepted: 06/17/2024] [Indexed: 09/07/2024] Open
Abstract
Introduction Sleep disorders represent common complaints in different medical illnesses. They encompass a risk for diverse inflammatory, metabolic, and cardiovascular diseases. Sleep disorders include disorders of hypersomnolence, insomnia, parasomnias, sleep-related movement disorders, circadian rhythm sleep-wake-disorders, and sleep-related breathing disorders, each one of which was associated with increased cardiovascular disease risk in a different mechanism. In this review, the authors address the most recent research on the correlation between sleep and CVD. Methods The literature on sleep disorders and their potential links to various cardiovascular diseases was reviewed in narrative form. For the published papers up to June 2023, the authors searched the databases of PubMed and Google Scholar. Literature demonstrating the relationship between these illnesses, pathophysiological mechanisms, diagnosis, and various therapeutic approaches was included. Results Sleep disorders were significantly linked to heart rate variability, hypertension, and obesity, which can eventually result in cardiovascular consequences and affect mortality and morbidity. The disruption in sleep cycles, which can be noticed in different sleep disorders, can obviously result in blood pressure, heart rate, and other cardiac functions. The clinical assessment acts as the cornerstone in the diagnosis of different spectrums of sleep disorders. The management of sleep disorders ranges from cognitive-behavioral therapy to continuous positive airway pressure (CPAP). Conclusion Additional research on the topic is needed to pinpoint any potential links and pathological processes. To improve clinical treatment and preventive measures, further observational studies should emphasize the reliability of early diagnostic signs.
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Affiliation(s)
- Olivier Uwishema
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
| | - Abubakar Nazir
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Department of Medicine, King Edward Medical University, Pakistan
| | - Isabelle Munyangaju
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Barcelona Institute for Global Health - Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Sanobar Shariff
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Yerevan State Medical University, Yerevan, Armenia
| | - Omar Al Komi
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- College of Medicine, Sulaiman Al Rajhi Colleges, Bukayriah, Al-Qassim, Saudi Arabia
| | - Nweke Chibueze
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Department of Public Health, Innovations and Technologies in Disease Eradication and Control, School of Health Technology, Federal University of Technology Owerri, Imo State
- Department of Public Health, Edo State Ministry of Health, Benin City, Edo State, Nigeria
| | - Magda Wojtara
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
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Xing M, Zhang L, Li J, Li Z, Yu Q, Li W. Development and validation of a novel sleep health score in the sleep heart health study. Eur J Intern Med 2024; 127:112-118. [PMID: 38729786 DOI: 10.1016/j.ejim.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 04/14/2024] [Accepted: 05/03/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND There is a lack of consensus in evaluating multidimensional sleep health, especially concerning its implication for mortality. A validated multidimensional sleep health score is the foundation of effective interventions. METHODS We obtained data from 5706 participants in the Sleep Heart Health Study. First, random forest-recursive feature elimination algorithm was used to select potential predictive variables. Second, a sleep composite score was developed based on the regression coefficients from a Cox proportional hazards model evaluating the associations between selected sleep-related variables and mortality. Last, we validated the score by constructing Cox proportional hazards models to assess its association with mortality. RESULTS The mean age of participants was 63.2 years old, and 47.6% (2715/5706) were male. Six sleep variables, including average oxygen saturation (%), spindle density (C3), sleep efficiency (%), spindle density (C4), percentage of fast spindles (%) and percentage of rapid eye movement (%) were selected to construct this multidimensional sleep health score. The average sleep composite score in participants was 6.8 of 22 (lower is better). Participants with a one-point increase in sleep composite score had an 10% higher risk of death (hazard ratio = 1.10, 95% confidence interval: 1.08-1.12). CONCLUSIONS This study constructed and validated a novel multidimensional sleep health score to better predict death based on sleep, with significant associations between sleep composite score and all-cause mortality. Integrating questionnaire information and sleep microstructures, our sleep composite score is more appropriately applied for mortality risk stratification.
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Affiliation(s)
- Muqi Xing
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lingzhi Zhang
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiahui Li
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zihan Li
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qi Yu
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenyuan Li
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Carpi M, Fernandes M, Mercuri NB, Liguori C. Sleep Biomarkers for Predicting Cognitive Decline and Alzheimer's Disease: A Systematic Review of Longitudinal Studies. J Alzheimers Dis 2024; 97:121-143. [PMID: 38043016 DOI: 10.3233/jad-230933] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND Sleep disturbances are considered a hallmark of dementia, and strong evidence supports the association between alterations in sleep parameters and cognitive decline in patients with mild cognitive impairment and Alzheimer's disease (AD). OBJECTIVE This systematic review aims to summarize the existing evidence on the longitudinal association between sleep parameters and cognitive decline, with the goal of identifying potential sleep biomarkers of AD-related neurodegeneration. METHODS Literature search was conducted in PubMed, Web of Science, and Scopus databases from inception to 28 March 2023. Longitudinal studies investigating the association between baseline objectively-measured sleep parameters and cognitive decline were assessed for eligibility. RESULTS Seventeen studies were included in the qualitative synthesis. Sleep fragmentation, reduced sleep efficiency, reduced REM sleep, increased light sleep, and sleep-disordered breathing were identified as predictors of cognitive decline. Sleep duration exhibited a U-shaped relation with subsequent neurodegeneration. Additionally, several sleep microstructural parameters were associated with cognitive decline, although inconsistencies were observed across studies. CONCLUSIONS These findings suggest that sleep alterations hold promise as early biomarker of cognitive decline, but the current evidence is limited due to substantial methodological heterogeneity among studies. Further research is necessary to identify the most reliable sleep parameters for predicting cognitive impairment and AD, and to investigate interventions targeting sleep that can assist clinicians in the early recognition and treatment of cognitive decline. Standardized procedures for longitudinal studies evaluating sleep and cognition should be developed and the use of continuous sleep monitoring techniques, such as actigraphy or EEG headband, might be encouraged.
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Affiliation(s)
- Matteo Carpi
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Claudio Liguori
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Musty A, Lund JL, Yang YC, Niznik J, Shmuel S, Duchesneau ED. The association between wealth and sleep medication use in a nationally-representative sample of older Medicare beneficiaries. Pharmacoepidemiol Drug Saf 2024; 33:e5703. [PMID: 37743351 PMCID: PMC10841169 DOI: 10.1002/pds.5703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Sleep disorders are common among older adults, leading to high prevalence of over-the-counter and prescription sleep medication use. Socioeconomically disadvantaged individuals have higher prevalence of sleep disorders. Frequent use of sleep medications can increase the risk of falls. Little is known about the association between wealth and sleep medication use in older adults. METHODS We conducted a cross-sectional analysis using a nationwide sample of 7603 Medicare beneficiaries (65+ years) from Round 1 (2011) of the National Health and Aging Trends Study. We measured self-reported wealth as the sum of assets (retirement savings, stocks/bonds, checking/savings accounts, business assets, and home value) minus liabilities (mortgage, credit card, and medical debt). Self-reported sleep medication use in the past month was categorized as frequent (5-7 nights/week), sometimes (1-4 nights/week), or never (0 night/week). We estimated differences in the prevalence of sleep medication use by quintiles of wealth using crude and adjusted binomial regression models. Individuals missing sleep medication information were excluded. RESULTS Median wealth was $152 582 (IQR: $24 023-412 992). Sixteen percent reported frequent sleep medication use, 15% reported some use, and 70% reported no use. Frequent sleep medication use was more common in lower wealth quintiles (lowest: 20%, highest: 12%). Alternatively, some use was more common in higher wealth quintiles (lowest: 11%, highest: 18%). Results were similar after adjustment for demographic factors, anxiety, depression, and sleep disorders. CONCLUSIONS In this study, less wealthy older adults had higher prevalence of frequent sleep medication use. This may lead to dependency or increased fall risk in this vulnerable population.
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Affiliation(s)
- Allison Musty
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer L Lund
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yang Claire Yang
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Sociology, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Joshua Niznik
- Division of Geriatric Medicine and Center for Aging and Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Shahar Shmuel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Emilie D Duchesneau
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Ha B, Kim J, So WY, Kim S. Effects of Nonpharmacological Interventions on Sleep Quality and Insomnia in Perimenopausal and Postmenopausal Women: A Meta-Analysis. Healthcare (Basel) 2023; 11:327. [PMID: 36766902 PMCID: PMC9914174 DOI: 10.3390/healthcare11030327] [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: 12/06/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 01/24/2023] Open
Abstract
This study aimed to analyze the effects of nonpharmacological interventions on perimenopausal and postmenopausal women with sleep problems. Eight databases (MEDLINE/PubMed, Cochrane Library, EMBASE, CINAHL, and four Korean databases) were searched, from their inception through to 30 November 2021, for randomized controlled trials (RCTs) evaluating the effects of nonpharmacological interventions versus control conditions on sleep quality and insomnia in perimenopausal and postmenopausal women. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and the severity of insomnia was assessed using the Insomnia Severity Index (ISI). In the meta-analysis, corrected standardized mean differences (SMDs; Hedges' g) and 95% confidence intervals (CIs) were calculated as effect measures by applying the random effects model and inverse variant method. Fifteen trials met our inclusion criteria. Nonpharmacological interventions were found to have positive effects on sleep quality, measured with the PSQI (SMD = -1.32; 95% CI = -1.78 to -0.86; p < 0.001), and on the severity of insomnia, measured using the ISI (SMD = -1.11; 95% CI = -1.82 to -0.41; p = 0.002), compared with the control groups. Among perimenopausal and postmenopausal women with sleep problems, nonpharmacological interventions improved sleep quality and reduced the severity of insomnia.
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Affiliation(s)
- Beomman Ha
- Armed Forces Medical Command, Seongnam-si 13574, Republic of Korea
| | - Jisoon Kim
- Department of Nursing, Woosong University, Daejeon-si 34606, Republic of Korea
| | - Wi-Young So
- Sports Medicine Major, College of Humanities and Arts, Korea National University of Transportation, Chungju-si 27469, Republic of Korea
| | - Seonho Kim
- Department of Nursing Science, College of Medicine, Chungbuk National University, Cheongju-si 28644, Republic of Korea
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Amini M, Yousefi Z, Ghafori SS, Hassanzadeh G. Sleep deprivation and NLRP3 inflammasome: Is there a causal relationship? Front Neurosci 2022; 16:1018628. [PMID: 36620464 PMCID: PMC9815451 DOI: 10.3389/fnins.2022.1018628] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
In the modern era, sleep deprivation (SD) is one of the most common health problems that has a profound influence on an individual's quality of life and overall health. Studies have identified the possibility that lack of sleep can stimulate inflammatory responses. NLRP3 inflammasome, a key component of the innate immune responses, initiates inflammatory responses by enhancing proinflammatory cytokine release and caspase-1-mediated pyroptosis. In this study, NLRP3 modification, its proinflammatory role, and potential targeted therapies were reviewed with regard to SD-induced outcomes. A growing body of evidence has showed the importance of the mechanistic connections between NLRP3 and the detrimental consequences of SD, but there is a need for more clinically relevant data. In animal research, (i) some animals show differential vulnerability to the effects of SD compared to humans. (ii) Additionally, the effects of sleep differ depending on the SD technique employed and the length of SD. Moreover, paying attention to the crosstalk of all the driving factors of NLRP3 inflammasome activation such as inflammatory responses, autonomic control, oxidative stress, and endothelial function is highly recommended. In conclusion, targeting NLRP3 inflammasome or its downstream pathways for therapy could be complicated due to the reciprocal and complex relationship of SD with NLRP3 inflammasome activation. However, additional research is required to support such a causal claim.
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Affiliation(s)
- Mohammad Amini
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Yousefi
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sayed Soran Ghafori
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Hassanzadeh
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran,*Correspondence: Gholamreza Hassanzadeh,
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Gordon NP, Yao JH, Brickner LA, Lo JC. Prevalence of sleep-related problems and risks in a community-dwelling older adult population: a cross-sectional survey-based study. BMC Public Health 2022; 22:2045. [PMID: 36348296 PMCID: PMC9644466 DOI: 10.1186/s12889-022-14443-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022] Open
Abstract
Background Despite evidence of adverse health consequences of inadequate restorative sleep for older adults, assessment of sleep quantity, quality, and use of sleep aids is not routinely done. We aimed to characterize sleep problems, sleep risks, and advice received about sleep in a community-dwelling older adult population, overall and in subgroups with health conditions and functional difficulties. Methods This cross-sectional study used weighted self-report data for 5074 Kaiser Permanente Northern California members aged 65-79y who responded to a 2017 or 2020 Member Health Survey. We estimated usual amount of sleep (< 6, 6 to < 7, ≥7 hours) and prevalence of sleep problems (frequent insomnia, frequent daytime fatigue, poor quality sleep, and potential sleep apnea (OSA) symptoms (frequent very loud snoring, apnea episodes)) for older adults overall, by self-rated health, and in subgroups reporting hypertension, diabetes, heart disease, frequent problems with balance/walking, and frequent memory problems. We also estimated percentages who regularly used sleep aids and had discussed sleep adequacy with a healthcare professional in the past year. Results Approximately 30% of older adults usually got less than the recommended ≥7 hours sleep per day, and 9% experienced frequent daytime fatigue, 13% frequent insomnia, 18% frequent insomnia/poor quality sleep, and 8% potential OSA symptoms. Prevalence of frequent insomnia was higher among women than men (16% vs. 11%). Higher percentages of those in fair/poor health and those with frequent balance/walking and memory problems reported sleeping < 6 hours per day and having all four types of sleep problems. Nearly 20% of all older adults (22% of women vs. 17% of men) and 45% of those with frequent insomnia (no sex difference) reported regular sleep aid use. Only 10% of older adults reported discussing sleep with a healthcare professional whereas > 20% reported discussing diet and exercise. Conclusions Large percentages of older adults experience sleep problems or get less sleep than recommended for optimal sleep health. Older patients should routinely be assessed on multiple components of sleep health (sleep hygiene, quantity, quality, problems, and sleep aid use) and educated about sleep hygiene and the importance of getting adequate restorative sleep for their overall health and wellbeing.
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Protocol for single case experimental design for yoga and sleep quality and inflammation: A two-hit model of sleep intervention. Contemp Clin Trials Commun 2022; 30:101028. [DOI: 10.1016/j.conctc.2022.101028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/07/2022] [Accepted: 10/26/2022] [Indexed: 11/05/2022] Open
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Cai ZZ, Lin R, Wang XX, Yan YJ, Li H. Effects of mindfulness in patients with mild cognitive impairment with insomnia: A double-blind randomized controlled trial. Geriatr Nurs 2022; 47:239-246. [PMID: 36027785 DOI: 10.1016/j.gerinurse.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Current research on the effects of mindfulness therapy on MCI and insomnia has been inconsistent. It is still a hot topic of research and discussion. This study aimed to improve the sleep quality, cognition, and mental state of patients with mild cognitive impairment (MCI) with insomnia. METHODS A double-blind randomized controlled trial was conducted. Seventy-five patients who met the eligibility criteria were randomly assigned to the mindfulness (n = 38) or health education (n = 37) treatment group. The primary outcomes were sleep, measured by the Pittsburgh Sleep Quality Inventory, and cognition, measured by The Montreal Cognitive Assessment and Mini-Mental State Examination. Secondary outcomes included insomnia, measured by the Insomnia Severity Index, depression, anxiety, and perceived stress. EEG signals were collected at rest with eyes closed in the mindfulness state. The power spectrum was analyzed from these data. RESULTS Cognitive function and sleep quality were significantly improved in the mindfulness group (95% confidence interval 0.04 - 0.05, 0.03 - 0.04, -5.58 - -1.55, respectively). Anxiety and perceived stress scores were significantly lower than those in the control group (95% confidence interval 0.002 - 0.004, 0.009 - 0.013, respectively). The power spectrum differences in δ, θ, β, and γ bands were significant between the rest and mindfulness states (P < .05). Good safety was achieved in both groups with no deaths or serious adverse events. CONCLUSION Mindfulness improved sleep quality, cognitive function, and mentality of patients. Mindfulness practice caused deep relaxation in the brain and changes in electrical frequency bands associated with attention and cognitive tasks. Mindfulness learning can be performed successfully for individuals with MCI. Additionally, it is suitable for adoption in nursing homes.
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Affiliation(s)
- Zhen-Zhen Cai
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Rong Lin
- Post-Doctoral Research Center, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiao-Xia Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Yuan-Jiao Yan
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hong Li
- School of Nursing, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; Department of Nursing, Fujian Provincial Hospital, Fuzhou, China.
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Prospective Association between Multimorbidity and Falls and Its Mediators: Findings from the Irish Longitudinal Study on Ageing. J Clin Med 2022; 11:jcm11154470. [PMID: 35956086 PMCID: PMC9370027 DOI: 10.3390/jcm11154470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/23/2022] [Accepted: 07/28/2022] [Indexed: 11/21/2022] Open
Abstract
This study including older adults from Ireland aimed to analyze the prospective association between multimorbidity and falls and to identify the mediators in this relationship. The present study used data from two consecutive waves of the Irish Longitudinal Study on Ageing (TILDA) survey. Multimorbidity was assessed at Wave 1 (2009–2011) and was defined as the presence of at least two chronic conditions. Falls occurring at Wave 2 (2012–2013) were self-reported. Mediating variables considered were polypharmacy, cognitive impairment, sleep problems, pain, low handgrip strength, difficulty in activities of daily living (ADL), obesity, and underweight. Multivariable binary logistic regression and mediation analysis using the Karlson Holm Breen method were conducted. This study included 6900 adults aged ≥50 years (51.6% women; mean [SD] age 63.1 [8.9] years). Compared to no chronic conditions at baseline, there was a positive and significant association between multimorbidity and falls at follow-up, with ORs ranging from 1.32 (95% CI = 1.06–1.64) for 2 conditions to 1.92 (95% CI = 1.54–2.38) for ≥4 conditions. Pain (23.5%), polypharmacy (13.3%), and difficulty in ADL (10.7%) explained the largest proportion of the multimorbidity-fall relationship. Multimorbidity increased risk for incident falls in older adults from Ireland. Interventions should be implemented to reduce fall risk in people with multimorbidity, especially targeting the identified mediators.
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Effectiveness of cognitive behaviour therapy (CBT) to improve the sleep quality of the elderly in hospital. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns4.6320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Quality of sleep is very important for everyone both healthy and sick, Efforts to provide sleeping pills have also not been effective because of the elderly do not want to report or treat sleep problems experienced so that the quality of sleep becomes poor. One of the therapies that can be done to improve the quality of sleep in the elderly, using Cognitive Behaviour Theraphy (CBT) therapy. Method research design is quasi experimental design pre and post test design with Control group and interventions in the form of CBT therapy to elderly clients. The study was conducted using two groups, the intervention group was given CBT therapeutic interventions and the control group was only given general care. The study subjects got CBT therapy for 2 days (dose 2 X 1 day @ 20-30 minutes). Measurement of sleep quality was carried out 2 times for 4 days in the study subjects using the Indonesian version of the ISI instrument.
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Sella E, Toffalini E, Canini L, Borella E. Non-pharmacological interventions targeting sleep quality in older adults: a systematic review and meta-analysis. Aging Ment Health 2022; 27:847-861. [PMID: 35352595 DOI: 10.1080/13607863.2022.2056879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives: This review aimed to examine the available evidence about non-pharmacological interventions (NPIs) aimed at improving sleep quality in older adults without insomnia or dementia.Methods: Studies on NPIs targeting older adults' sleep were searched in the PsycInfo, PubMed and Scopus databases, with no restriction on publication year up to September 2021. Studies on NPIs for older adults with no diagnosed sleep disorders were included, while those on pharmacological therapies and/or concerning pathological samples were excluded. The risk of bias was assessed using tools based on Joanna Briggs' criteria. The data extracted were meta-analyzed using random effects models for subgroups of NPIs.Results: Of the 1,893 records identified, 31 studies on NPIs (N = 2,224; range of mean ages: 60-78 years) were analyzed. All NPIs improved self-reported sleep quality, albeit to a different extent (physical activity: d=.97 - 95% CI=.62, 1.32-; psychological/psychoeducational, or NPIs that combined more than one sleep-targeting activity: d range: .21 to .97). Only the NPIs based on physical activity improved objectively-measured sleep, d=.31 (.04, .57). The methodological quality of most studies was limited.Conclusion: The most often used NPIs targeting sleep rely on physical activity and sensory stimulation with promising results on sleep quality for the former. More data are needed on psychological/psychoeducational NPIs and combined interventions in order to test their effectiveness. The methodological weaknesses of the available studies suggest they their findings should be interpreted with caution.
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Affiliation(s)
- Enrico Sella
- Department of General Psychology, University of Padova, Padova, Italy
| | - Enrico Toffalini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Luca Canini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Erika Borella
- Department of General Psychology, University of Padova, Padova, Italy
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Kuhn T, Heisz J. Cardiorespiratory Fitness May Protect Memory for Poorer Sleepers. Front Psychol 2022; 13:793875. [PMID: 35250729 PMCID: PMC8892568 DOI: 10.3389/fpsyg.2022.793875] [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: 10/12/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Physical activity has been shown to protect executive functions against the deleterious effects of poorer sleep among older adults (OA); however, it is unknown whether memory is protected too, and if this relationship differs by age. The present study investigated the relationship between cardiorespiratory fitness, sleep, and memory in both older and young adults (YA). METHODS This observational study recruited 26 OA (70.7 ± 2.8 years) and 35 YA (21.0 ± 3.1 years). Participants completed the Rockport 1-mile walk test to evaluate cardiorespiratory fitness. Participants wore an actigraph for 1 week to measure habitual sleep and returned for a second visit to perform the memory tests. The interaction between cardiorespiratory fitness and sleep to predict memory was assessed separately in OA and YA. RESULTS In OA, cardiorespiratory fitness significantly moderated the relationship between memory and sleep quality, specifically number of nighttime awakenings, sleep efficiency, and wake after sleep onset. Further analyses reveal that a high number of nighttime awakenings and low sleep efficiency significantly predicted worse memory performance in the low fit OA, but high fit OA. Notably, every nighttime awakening was associated with a nearly 4% decrease in memory in low fit OA, but not high fit OA. Wake after sleep onset did not significantly predict memory in either fitness group. No interaction was found when looking at sleep duration or self-report sleep quality in OA and no significant interactions were observed between fitness, sleep, and memory in YA. CONCLUSION Overall, the results suggest that cardiorespiratory fitness may act as a protective buffer for memory in OA with poor sleep quality. These same was not true for YA suggesting that the protective effects of cardiorespiratory fitness on sleep-related memory impairments may be age specific.
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Affiliation(s)
- Tara Kuhn
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Jennifer Heisz
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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14
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Aschbrenner KA, Naslund JA, Salwen-Deremer JK, Browne J, Bartels SJ, Wolfe RS, Xie H, Mueser KT. Sleep quality and its relationship to mental health, physical health and health behaviours among young adults with serious mental illness enrolled in a lifestyle intervention trial. Early Interv Psychiatry 2022; 16:106-110. [PMID: 33594828 PMCID: PMC10047807 DOI: 10.1111/eip.13129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/22/2021] [Accepted: 01/31/2021] [Indexed: 01/28/2023]
Abstract
AIM To characterize subjective sleep quality and examine its associations with mental health, physical health and health behaviours in a transdiagnostic sample of young adults with serious mental illness (SMI) enrolled in a lifestyle intervention trial. METHODS Baseline data from a lifestyle intervention trial with young adults (ages 18-35 years) with SMI included the Pittsburgh Sleep Quality Index (PSQI), mental health, physical health and health behaviour outcomes. Descriptive statistics and multiple linear regression were used in analyses. RESULTS Of 150 participants, 76% were categorized with poor sleep quality. Depressive symptoms were significantly associated with sleep quality (β = .438, p < .001); however, no association was found with physical health and health behaviours. CONCLUSIONS Young adults with SMI enrolled in lifestyle interventions may benefit from treatment that addresses sleep as part of a comprehensive approach to health promotion with attention to the role of depressive symptoms in sleep quality.
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Affiliation(s)
- Kelly A Aschbrenner
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - Jessica K Salwen-Deremer
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.,Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Julia Browne
- Geriatric Research, Education, and Clinical Center, Durham VA Health Care System, Durham, North Carolina
| | - Stephen J Bartels
- Department of Medicine, Massachusetts General Hospital, Mongan Institute, Boston, Massachusetts
| | - Rosemarie S Wolfe
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Haiyi Xie
- Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Kim T Mueser
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.,Department of Occupational Therapy, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts.,Department of Psychological & Brain Sciences, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts
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15
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Hjort Telhede E, Arvidsson S, Karlsson S. Nursing staff's experiences of how weighted blankets influence resident's in nursing homes expressions of health. Int J Qual Stud Health Well-being 2021; 17:2009203. [PMID: 34904541 PMCID: PMC8740773 DOI: 10.1080/17482631.2021.2009203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose The most common treatment for resident’s health problems is pharmacological. Little research has been done on how an intervention with a non-pharmacological method, such as a weighted blanket, Through the nursing staff view, we can learn how weighted blankets influence resident’s health in nursing homes. The aim of this study was to explore nursing staff’s experiences of how an intervention with weighted blankets influenced resident’s expressions of health. Methods The study had a descriptive qualitative design with semi-structured interviews with 20 nursing staff working in nursing homes, and an inductive content analysis was applied. Results The nursing staff expressed that the weighted blanket positively influenced resident’s health in the areas of sleep, physical activity, and psychological behaviour. The weighted blanket made them fall asleep faster, sleep was uninterrupted andthey felt more rested in the morning. The nursing staff observed an increased level of activity as the resident became more energetic . The nursing staff also experienced reduced negative psychological behaviours like anxiety and worrying. Conclusion This study indicated that the weighted blanket changed the health expression of resident in several crucial areas. Deep pressure treatment indicates an alternative health-improved treatment for resident in nursing homes.
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Affiliation(s)
| | - Susann Arvidsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Staffan Karlsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.,Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
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16
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Finucane E, O'Brien A, Treweek S, Newell J, Das K, Chapman S, Wicks P, Galvin S, Healy P, Biesty L, Gillies K, Noel-Storr A, Gardner H, O'Reilly MF, Devane D. Does reading a book in bed make a difference to sleep in comparison to not reading a book in bed? The People's Trial-an online, pragmatic, randomised trial. Trials 2021; 22:873. [PMID: 34996514 PMCID: PMC8740874 DOI: 10.1186/s13063-021-05831-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The best way of comparing healthcare treatments is through a randomised trial. In a randomised trial, we compare something (a treatment or intervention) to something else, often another treatment. Who gets what is decided at random, meaning everyone has an equal chance of getting any of the treatments. This means any differences found can be put down to the treatment received rather than other things, such as where people live, or health conditions they might have. The People's Trial aimed to help the public better understand randomised trials by inviting them to design and carry out a trial. The question chosen by the public for The People's Trial was: 'Does reading a book in bed make a difference to sleep, in comparison to not reading a book in bed?' This paper describes that trial, called 'The Reading Trial'. METHODS The Reading Trial was an online, randomised trial. Members of the public were invited to take part through social media campaigns. People were asked to either read a book in bed before going to sleep (intervention group) or not read a book in bed before going to sleep (control group). We asked everyone to do this for 7 days, after which they measured their sleep quality. RESULTS During December 2019, a total of 991 people took part in The Reading Trial, half (496 (50%)) in the intervention group and half (495 (50%)) in the control group. Not everyone finished the trial: 127 (25.6%) people in the intervention group and 90 (18.18%) people in the control group. Of those providing data, 156/369 (42%) people in the intervention group felt their sleep improved, compared to 112/405 (28%) of those in the control group, a difference of 14%. When we consider how certain we are of this finding, we estimate that, in The Reading Trial, sleep improved for between 8 and 22% more people in the intervention group compared to the control group. CONCLUSIONS Reading a book in bed before going to sleep improved sleep quality, compared to not reading a book in bed. TRIAL REGISTRATION ClinicalTrials.gov NCT04185818. Registered on 4 December 2019.
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Affiliation(s)
- Elaine Finucane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland. .,Health Research Board-Trials Methodology Research Network, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland. .,Evidence Synthesis Ireland, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.
| | - Ann O'Brien
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Health Research Board-Trials Methodology Research Network, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,J.E. Cairnes School of Business & Economics, National University of Ireland Galway, Galway, Ireland
| | - Shaun Treweek
- Health Services Research Unit, Health Sciences Building, University of Aberdeen, Forester Hill, Aberdeen, AB25 2ZD, UK
| | - John Newell
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Kishor Das
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Sarah Chapman
- Cochrane UK, hosted by Oxford University Hospitals NHS Foundation Trust, and funded by the National Institute for Health Research, London, UK
| | - Paul Wicks
- Wicks Digital Health, Lichfield, England, UK
| | - Sandra Galvin
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Health Research Board-Trials Methodology Research Network, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Patricia Healy
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Linda Biesty
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Katie Gillies
- Health Services Research Unit, Health Sciences Building, University of Aberdeen, Forester Hill, Aberdeen, AB25 2ZD, UK
| | - Anna Noel-Storr
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Heidi Gardner
- Health Services Research Unit, Health Sciences Building, University of Aberdeen, Forester Hill, Aberdeen, AB25 2ZD, UK
| | - Mary Frances O'Reilly
- Formerly - Nursing and Midwifery Planning and Development Unit, West Mid-West, Merlin Park University Hospital, Galway, Ireland
| | - Declan Devane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Health Research Board-Trials Methodology Research Network, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Evidence Synthesis Ireland, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Cochrane Ireland, National University of Ireland Galway, Galway, Ireland
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17
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Harper L, Ooms A, Tuffrey Wijne I. The impact of nutrition on sleep in people with an intellectual disability: An integrative literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1393-1407. [PMID: 34212459 DOI: 10.1111/jar.12911] [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: 12/05/2020] [Revised: 04/25/2021] [Accepted: 05/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with intellectual disabilities are more likely to experience sleep problems. Sleep can impact on health and well-being; therefore, evidence-based interventions are required to improve sleep in this population. METHOD An integrative literature review was conducted on the impact of nutrition on sleep in people with intellectual disabilities. Following screening of papers (n = 289), 14 papers met the inclusion criteria. RESULTS Themes related to nutrition and improved overall well-being, use of nutritional supplements, specific foods, links to health comorbidities and food fussiness. CONCLUSION This is the first comprehensive review completed on nutritional interventions to improve sleep in people with intellectual disabilities. Dietary patterns may be an important factor to improving the quality and quantity of sleep. However, the current literature regarding the benefit of improved nutrition on sleep in people with an intellectual disability needs to be interpreted with caution.
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Affiliation(s)
- Lynette Harper
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Ann Ooms
- Kingston University and St Georges University, London, UK
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18
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López PL, Torrente FM, Comandé D, Ailan D, Fernandez Nievas SE, Robertson L, Ciapponi A. Remote non-pharmacologic interventions for sleep problems in adults during the COVID-19 pandemic. Hippokratia 2021. [DOI: 10.1002/14651858.cd015051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Pablo Luis López
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT); CONICET, INECO Foundation, Favaloro University; Buenos Aires Argentina
| | - Fernando Manuel Torrente
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT); CONICET, INECO Foundation, Favaloro University; Buenos Aires Argentina
| | - Daniel Comandé
- Argentine Cochrane Centre; Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET); Buenos Aires Argentina
| | - Delfina Ailan
- Psychiatry and Cognitive Psychotherapy; Institute of Cognitive Neurology (INECO); Buenos Aires Argentina
| | - Simon E Fernandez Nievas
- Quality and Patient Safety; Institute for Clinical Effectiveness and Health Policy; Buenos Aires Argentina
| | - Lindsay Robertson
- Cochrane Common Mental Disorders; University of York; York UK
- Centre for Reviews and Dissemination; University of York; York UK
| | - Agustín Ciapponi
- Argentine Cochrane Centre; Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET); Buenos Aires Argentina
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19
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Wirth MD, Jessup A, Turner-McGrievy G, Shivappa N, Hurley TG, Hébert JR. Changes in dietary inflammatory potential predict changes in sleep quality metrics, but not sleep duration. Sleep 2021; 43:5837028. [PMID: 32406919 DOI: 10.1093/sleep/zsaa093] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/16/2020] [Indexed: 01/29/2023] Open
Abstract
STUDY OBJECTIVES Non-pharmacological sleep interventions may improve sleep profiles without the side-effects observed with many pharmacological sleep aids. The objective of this research was to examine the association between sleep and inflammation and to examine how changes in dietary inflammatory potential influence changes in sleep. METHODS The Inflammation Management Intervention Study (IMAGINE), which was a dietary intervention designed to lower inflammation, provided access to 24-h dietary recalls (24HR), objectively measured sleep using SensewearTM armbands, and a range of self-reported demographics, health histories, lifestyle behaviors, psychosocial metrics, anthropometric measurements, and inflammatory biomarkers. Dietary Inflammatory Index® (DII®) scores were calculated from three unannounced 24HR-derived estimated intakes of whole foods and micro and macronutrients over a 2-week period at baseline and post-intervention (i.e. month 3). Statistical analyses primarily utilized linear regression. RESULTS At baseline, for every 1-min increase in sleep onset latency, tumor necrosis factor-α increased by 0.015 pg/mL (±0.008, p = 0.05). Every one-percentage increase in sleep efficiency was associated with decreased C-reactive protein (CRP) of -0.088 mg/L (±0.032, p = 0.01). Every 1-min increase in wake-after-sleep-onset (WASO) increased both CRP and interleukin-6. Compared to participants with pro-inflammatory DII changes over 3 months, those with anti-inflammatory changes decreased WASO (0 vs. -25 min, respectively, p < 0.01) and improved sleep efficiency (-2.1% vs. +2.6%, respectively, p = 0.04). CONCLUSIONS Non-pharmacological treatments, such as anti-inflammatory diets, may improve sleep in some adults. Future research involving dietary treatments to improve sleep should not only focus on the general population, but also in those commonly experiencing co-morbid sleep complaints. CLINICAL TRIAL INFORMATION NCT02382458.
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Affiliation(s)
- Michael D Wirth
- College of Nursing, University of South Carolina, Columbia, SC.,Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC.,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Connecting Health Innovations, LLC, Columbia, SC
| | - Angela Jessup
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC.,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Connecting Health Innovations, LLC, Columbia, SC
| | - Thomas G Hurley
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - James R Hébert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC.,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Connecting Health Innovations, LLC, Columbia, SC
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20
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Abstract
Abstract
The amount of financial debt held by older adults has grown substantially over the past two decades in Europe. This study examines the association of objective and subjective debt burden with social and emotional loneliness among 1,606 older adults in the Netherlands. Objective debt burden is based on financial terms, such as debt-to-income ratio; whereas subjective debt burden measures the psychological distress caused by financial debt. Data are from the 2015/2016 wave of the Longitudinal Aging Study Amsterdam. First, we use means-comparison tests to examine whether older adults who experience social and emotional loneliness differ from older adults who do not experience loneliness regarding their subjective and objective debt burdens. Subsequently, using linear regression models we address two questions: whether social loneliness and emotional loneliness are associated with objective and subjective debt burden; and whether social participation, social network size, anxiety and depression mediate these relationships. We find that subjective debt burden (i.e. the worry related to debt) is a significant predictor of social loneliness, above and beyond the role of social and psychological measures. Objective debt burden, in contrast, is unrelated to social and emotional loneliness. Social participation, social network size, anxiety and depression do not mediate the debt-burden-to-loneliness relationships. The results point to the importance of subjective debt burden in understanding social loneliness and designing interventions.
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21
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Mishra K, Misra N, Chaube N. Expressive arts therapy for subjective happiness and loneliness feelings in institutionalized elderly women: A pilot study. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2021. [DOI: 10.1080/21507686.2021.1876116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Komal Mishra
- Clinical Psychology, Institute of Behavioural Science, Gujarat Forensic Sciences University, Gandhinagar, INDIA
| | - Nishi Misra
- Defence Institute of Psychological Research (DIPR, Ministry of Defence, Timarpur, INDIA
| | - Nandita Chaube
- School of Behavioural Science, National Forensic Sciences University, Gandhinagar, INDIA
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22
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Zaidel C, Musich S, Karl J, Kraemer S, Yeh CS. Psychosocial Factors Associated with Sleep Quality and Duration Among Older Adults with Chronic Pain. Popul Health Manag 2021; 24:101-109. [PMID: 32049579 PMCID: PMC7875123 DOI: 10.1089/pop.2019.0165] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Sleep complaints are common among older adults with chronic pain. Because of the risk of significant side effects, sleep medications are not recommended as first-line treatments. Little is known about the association between positive psychosocial factors and sleep, but further awareness could support non-drug strategies to minimize poor sleep. The purpose of this study was to (1) determine the prevalence of self-reported poor sleep quality and short/long sleep duration in a population of older adults with chronic pain, and (2) examine the associations of negative risk factors, sleep-inducing medications, and positive psychosocial characteristics on sleep outcomes in this population. This study analyzed survey responses from 4201 adults ages ≥65 years with diagnosed back pain, osteoarthritis, and/or rheumatoid arthritis, and at least 1 year of continuous medical and drug plan enrollment. The most commonly reported sleep outcome was short sleep duration (39%), followed by poor sleep quality (22%), and long sleep duration (9%). Based on pharmaceutical claims, prescriptions for opioids (59%) or benzodiazepines (22%) were common. Perceived stress, depression, and pain or sleep prescription medications were independently associated with poor sleep quality and short or long sleep durations. The positive psychosocial factors of higher resilience and more diverse social networks were independently associated with good sleep quality and optimal sleep duration. These results underscore the importance of social and coping factors to sleep, which may provide new opportunities to improve sleep and well-being in older adults with chronic pain.
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Affiliation(s)
| | - Shirley Musich
- Research for Aging Populations, Optum, Ann Arbor, Michigan, USA
| | - Jaycee Karl
- Research for Aging Populations, Optum, Ann Arbor, Michigan, USA
| | - Sandra Kraemer
- UnitedHealthcare Medicare and Retirement, Minneapolis, Minnesota, USA
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23
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Han S, Hu Y, Pei Y, Zhu Z, Qi X, Wu B. Sleep satisfaction and cognitive complaints in Chinese middle-aged and older persons living with HIV: the mediating role of anxiety and fatigue. AIDS Care 2021; 33:929-937. [PMID: 33487030 DOI: 10.1080/09540121.2020.1844861] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Middle-aged and older persons living with HIV (PLWH) suffer from sleep distress and cognitive disorders due to HIV infection and aging. We aim to explore the relationship between sleep satisfaction and cognitive complaints, and the mediating role of anxiety and fatigue in this relationship among middle-aged and older PLWH. We used data from a multicenter cross-sectional study in China (Shanghai, Kunming, Nanning, Hengyang, and Changning) conducted in 2017. The data analysis included 435 PLWH aged 45 years and over. Multiple linear regression models showed that worse sleep satisfaction was significantly associated with lower cognitive complaints after controlling for anxiety, fatigue, demographic variables, and clinical variables (β = -0.246, p < 0.01). Both anxiety and fatigue were significant partial mediators in the relationship between sleep satisfaction and cognitive complaints. The serial multiple mediation models of sleep satisfaction-anxiety (M1)-fatigue (M2)-cognitive complaints were supported and the alternative model of sleep satisfaction-fatigue (M2)-anxiety (M1)-cognitive complaints were both supported. Our study indicates that it is important to improve sleep quality to promote cognitive function among Chinese middle-aged and older PLWH. Prevention and treatment programs for sleep satisfaction and cognitive function should include the assessment and reduction of fatigue and anxiety.
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Affiliation(s)
- Shuyu Han
- School of Nursing, Fudan University, Shanghai, People's Republic of China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, People's Republic of China.,Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, People's Republic of China
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, People's Republic of China.,Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, People's Republic of China
| | - Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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24
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Sleep Disturbance in Older Patients in the Emergency Department: Prevalence, Predictors and Associated Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193577. [PMID: 31557801 PMCID: PMC6801409 DOI: 10.3390/ijerph16193577] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/21/2019] [Accepted: 09/22/2019] [Indexed: 12/22/2022]
Abstract
Impaired sleep is common in hospital. Despite this, little is known about sleep disturbance among older adults attending Emergency Departments (ED), particularly overnight-boarders, those admitted but housed overnight while awaiting a bed. Consecutive, medically-stable patients aged ≥70, admitted through a university hospital ED were evaluated for overnight sleep quality (Richards Campbell Sleep Questionnaire/RCSQ) and baseline sleep (Pittsburgh Sleep Quality Index/PSQI). Additional variables included frailty, functional and cognitive status, trolley location, time in ED and night-time noise levels. Over four-weeks, 152 patients, mean age 80 (± 6.8) years were included; 61% were male. Most (68%) were ED boarders (n = 104) and 43% were frail. The majority (72%) reported impaired sleep quality at baseline (PSQI ≥ 5) and 13% (20/152) had clinical insomnia. The median time spent in ED for boarders was 23 h (Interquartile ± 13). After adjusting for confounders, median RCSQ scores were significantly poorer for ED boarders compared with non-boarders: 22 (± 45) versus 71 (± 34), respectively, (p = 0.003). There was no significant difference in one-year mortality (p = 0.08) length of stay (LOS) (p = 0.84), 30-day (p = 0.73) or 90-day (p = 0.64) readmission rates between boarders and non-boarders. Sleep disturbance is highly prevalent among older adults admitted through ED. ED boarders experienced significantly poorer sleep, without this impacting upon mortality, LOS or re-admission rates.
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25
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Dening KH. Differentiating between dementia, delirium and depression in older people. Nurs Stand 2019; 35:43-50. [PMID: 31762251 DOI: 10.7748/ns.2019.e11361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2019] [Indexed: 06/10/2023]
Abstract
Older people can find hospital stays challenging and distressing. When their presenting symptoms make it challenging for healthcare professionals to differentiate between dementia, delirium and depression, their experience may be increasingly distressing, and can result in delays in diagnosis and treatment, as well as an increased risk of morbidity. This article considers each of the conditions of dementia, delirium and depression, their presenting features and how nurses can differentiate between them to enable comprehensive assessment, diagnosis and treatment in older people.
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26
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Varma P, Jackson ML, Meaklim H. Dreaming of the good old days: sleep in older adults. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2019. [DOI: 10.1002/jppr.1578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Prerna Varma
- Casual Academic and PhD Candidate RMIT Sleep Laboratory, Discipline of Psychology, School of Biomedical and Health Sciences RMIT University Melbourne Australia
- Co‐Chair Insomnia and Sleep Health Council for the Australasian Sleep Association Blacktown Australia
| | - Melinda L. Jackson
- Senior Lecturer, Turner Institute for Brain and Mental Health School of Psychological Sciences, Monash University Clayton/Melbourne Australia
- Co‐Chair Chronobiology Council for the Australasian Sleep Association Blacktown Australia
| | - Hailey Meaklim
- Casual Academic and PhD Candidate RMIT Sleep Laboratory, Discipline of Psychology, School of Biomedical and Health Sciences RMIT University Melbourne Australia
- Co‐Chair Insomnia and Sleep Health Council for the Australasian Sleep Association Blacktown Australia
- Sleep Centre, Department of Respiratory and Sleep Medicine St Vincent’s Hospital Melbourne Australia
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27
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Reynolds AC, Adams RJ. Treatment of sleep disturbance in older adults. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2019. [DOI: 10.1002/jppr.1565] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Amy C. Reynolds
- The Appleton Institute CQUniversity Australia Adelaide Australia
- School of Health Medical and Applied Sciences CQUniversity Adelaide Australia
| | - Robert J. Adams
- Adelaide Institute for Sleep Health Flinders University Adelaide Australia
- Respiratory and Sleep Service Southern Adelaide Local Health Network Adelaide Australia
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28
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Psychological Interventions for Late-life Insomnia: Current and Emerging Science. CURRENT SLEEP MEDICINE REPORTS 2018; 4:268-277. [PMID: 31106115 DOI: 10.1007/s40675-018-0129-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose of Review Late-life insomnia is a serious medical condition associated with many untoward consequences. The high prevalence of late-life insomnia, along with the concomitant risks inherent in the use of hypnotic medications in older adults necessitates non-pharmacological (i.e., psychological) treatment options. We aim to summarize and evaluate the state-of-the-science of psychological treatment options for late-life insomnia. Recent Findings Cumulative scientific evidence suggests the efficacy of psychological treatment of late-life insomnia. During the previous decade, trials of psychological treatments for insomnia have begun to test various modifications to treatments that have the potential to improve access for older adults, along with expanding their focus to include individuals with comorbid conditions that are common to older adults. While these modifications represent positive advances in the science of treatment for late-life insomnia, the evidence is still largely explanatory/efficacious in nature. Summary Psychological strategies represent the best approaches for the treatment of late-life insomnia. Future investigations would be wise to progressively move towards increasingly pragmatic/effectiveness investigations, adding to the literature base regarding the treatment of late-life insomnia under usual/real-world conditions as opposed to ideal/artificial conditions.
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