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Rostampour M, Gharaylou Z, Rostampour A, Shahbodaghy F, Zarei M, Fadaei R, Khazaie H. Study of structural network connectivity using DTI tractography in insomnia disorder. Psychiatry Res Neuroimaging 2023; 336:111730. [PMID: 37944426 DOI: 10.1016/j.pscychresns.2023.111730] [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: 02/28/2023] [Revised: 10/01/2023] [Accepted: 10/10/2023] [Indexed: 11/12/2023]
Abstract
Most of tractography studies on insomnia disorder (ID) have reported decreased structural connectivity between cortical and subcortical structures. Tractography based on standard diffusion tensor imaging (DTI) can generate high number of false-positive streamlines connections between gray matter regions. In the present study, we employed the convex optimization modeling for microstructure informed tractography-2 (COMMIT2) to improve the accuracy of the reconstructed whole-brain connectome and filter implausible brain connections in 28 patients with ID and compared with 27 healthy controls. Then, we used NBS-predict (a prediction-based extension to the network-based statistic method) in the COMMIT2-weighted connectome. Our results revealed decreased structural connectivity between subregions of the left somatomotor, ventral attention, frontoparietal, dorsal attention and default mode networks in the insomnia group. Moreover, there is a negative correlation between sleep efficiency and structural connectivity within the left frontoparietal, visual, default mode network, limbic, dorsal attention, right dorsal attention as well as right default mode networks. By comparing with standard connectivity analysis, we showed that by removing of false-positive streamlines connections after COMMIT2 filtering, abnormal structural connectivity was reduced in patients with ID compared to controls. Our results demonstrate the importance of improving the accuracy of tractography for understanding structural connectivity networks in ID.
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Affiliation(s)
- Masoumeh Rostampour
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Ali Rostampour
- Department of Computer Engineering and Information Technology, Payame Noor University, Tehran, Iran
| | - Fatemeh Shahbodaghy
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Mojtaba Zarei
- Department of Neurology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Reza Fadaei
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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2
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Niemiec CP, Olafsen AH, Halvari H, Williams GC. Losing sleep over work: A self-determination theory view on need frustration, sleep disturbance, and mental ill health. Stress Health 2022; 38:790-803. [PMID: 35139261 DOI: 10.1002/smi.3134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/11/2022]
Abstract
Given the centrality of sleep and work in most individuals' lives, it is interesting to note that an empirical understanding of the association between what happens in the workplace and how well people sleep is in an early stage of development, at least relative to other topics that are of interest in the literature on stress and health. Using self-determination theory, the current study examined how maladaptive motivational processes at work relate to sleep disturbance and mental ill health. In line with hypotheses, the results of a cross-sectional analysis and analyses using data from two time points over 15 months revealed that employees are more likely to report sleep disturbance, anxiety, and depressive symptoms when they experience frustration of the basic psychological needs for autonomy, competence, and relatedness in the workplace. Additional results revealed an indirect effect of change in basic psychological need frustration on change in anxiety-but not on change in depressive symptoms-through change in sleep disturbance. Taken together, these findings add to the burgeoning literature on the maladaptive motivational origins of ill health and dysfunction in the workplace.
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Affiliation(s)
- Christopher P Niemiec
- University of Rochester, Rochester, New York, USA.,University of Stavanger, Stavanger, Norway
| | | | | | - Geoffrey C Williams
- University of Rochester, Rochester, New York, USA.,University of South-Eastern Norway, Hønefoss, Norway.,Billings Clinic, Billings, Montana, USA
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Menopausal Symptoms and Sleep Quality in Women Aged 40–65 Years. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2560053. [PMID: 35983252 PMCID: PMC9381266 DOI: 10.1155/2022/2560053] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/20/2022]
Abstract
The study examined the relationship between menopausal symptoms and sleep disturbances and the related influencing factors. Methods. We recruited women aged 40-65 years who attended the menopause clinic at Shanghai Jiao Tong University's Sixth People's Hospital from February 2011 to November 2019. The Menopause Rating Scale (MRS) was used to collect women's menopausal symptoms, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the subjects' sleep condition. We used logistic regression models to identify the relationship between menopausal symptoms and sleep quality. Results. A total of 1341 participants were recruited in this study. The most frequent three symptoms assessed by MRS were fatigue (72.9%), sleep disturbance (67%), and hot flashes with night sweats (65%). Participants' age was significantly associated with the severity of menopausal syndrome (P < 0.01). According to the PSQI sleep evaluation, 66.9 percent of participants had sleep disturbances (PSQI > 5). Logistic regression analysis revealed that women with mild, moderate, or severe menopausal syndrome had a 3-, 7-, and 17-fold increased chance of having sleep disturbances compared to women without menopausal syndrome. Conclusion. Women aged 40–65 years were found to have a significantly higher risk of menopausal syndrome and sleep disturbances.
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4
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Asymmetric alterations of white matter integrity in patients with insomnia disorder. Brain Imaging Behav 2021; 16:389-396. [PMID: 34427878 DOI: 10.1007/s11682-021-00512-w] [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] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
Despite the adverse consequences of insomnia disorder for both individuals and society, the underlying neurobiological processes are poorly understood. The purpose was to further understand the alterations of white matter tracts in patients with insomnia and their association with sleep variables and also to determine if diffusion tensor imaging measures would be a useful disease marker. Twenty-six patients with insomnia and 26 age-matched healthy volunteers underwent diffusion tensor imaging. We employed an automated probabilistic tractography analysis approach using TRActs Constrained by UnderLying Anatomy (TRACULA) to quantify diffusion measures in major white matter tracts. We found significantly increased fractional anisotropy in the right cingulum-angular bundle and uncinate fasciculus in patients group compared to controls. Moreover, the mean diffusivity and radial diffusivity were reduced in the right cingulum-angular bundle in patients group in comparison with controls. We also found significantly increased fractional anisotropy along the bilateral cingulum-angular bundle and right uncinate fasciculus in patients. Also, mean and radial diffusivity were reduced along the right cingulum-angular bundle in patients group compared to controls. There is a significant positive correlation between fractional anisotropy and Epworth Sleepiness Scale scores. Moreover, there are negative correlations between mean, radial and axial diffusivity and total sleep time and sleep efficiency and also positive correlations between mean, radial and axial diffusivity and duration of disease and Pittsburgh Sleep Quality Index scores. This study showed the importance of examining whole-tract and waypoint white matter integrity in insomnia disorder. We found asymmetric widespread white matter integrity changes in patients with insomnia.
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Bean CAL, Ciesla JA. Naturalistic Partial Sleep Deprivation Leads to Greater Next-Day Anxiety: The Moderating Role of Baseline Anxiety and Depression. Behav Ther 2021; 52:861-873. [PMID: 34134826 DOI: 10.1016/j.beth.2020.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 11/27/2022]
Abstract
The detrimental effects of insufficient sleep on emotional functioning have been well established. Total sleep deprivation usually leads to increased anxiety and depressive symptoms the following day. However, no study has yet examined the relationships between unmanipulated partial sleep deprivation and next-day symptoms of anxiety and depression in everyday life, which this study sought to characterize. Participants (N = 94) completed daily diary surveys twice per day for 2 weeks without instructions to alter their sleep in any way. Nights of spontaneous, naturally occurring partial sleep deprivation were followed by increased levels of self-reported symptoms of anxious arousal the next day, but were unrelated to next-day symptoms of anhedonic depression or general distress. The relationship between partial sleep deprivation and next-day anxious arousal was found to be moderated by both baseline depressive symptoms and anxiety such that individuals reporting higher levels of depression or anxiety at baseline showed relatively greater increases in symptoms of anxiety following partial sleep deprivation. These results suggest that partial sleep deprivation occurring in everyday life can lead to higher next-day levels of anxious arousal, a relationship that is particularly deleterious for individuals with higher overall levels of anxiety or depressive symptoms.
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Assimon MM, Flythe JE. Zolpidem Versus Trazodone Initiation and the Risk of Fall-Related Fractures among Individuals Receiving Maintenance Hemodialysis. Clin J Am Soc Nephrol 2021; 16:88-97. [PMID: 33355192 PMCID: PMC7792650 DOI: 10.2215/cjn.10070620] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 11/09/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Zolpidem, a nonbenzodiazepine hypnotic, and trazodone, a sedating antidepressant, are the most common medications used to treat insomnia in the United States. Both drugs have side effect profiles (e.g., drowsiness, dizziness, and cognitive and motor impairment) that can heighten the risk of falls and fractures. Despite widespread zolpidem and trazodone use, little is known about the comparative safety of these medications in patients receiving hemodialysis, a vulnerable population with an exceedingly high fracture rate. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Using data from the United States Renal Data System registry (2013-2016), we conducted a retrospective cohort study to investigate the association between the initiation of zolpidem versus trazodone therapy and the 30-day risk of hospitalized fall-related fractures among Medicare-enrolled patients receiving maintenance hemodialysis. We used an active comparator new-user design and estimated 30-day inverse probability of treatment-weighted hazard ratios and risk differences. We treated death as a competing event. RESULTS A total of 31,055 patients were included: 18,941 zolpidem initiators (61%) and 12,114 trazodone initiators (39%). During the 30-day follow-up period, 101 fall-related fractures occurred. Zolpidem versus trazodone initiation was associated with a higher risk of hospitalized fall-related fracture (weighted hazard ratio, 1.71; 95% confidence interval, 1.11 to 2.63; weighted risk difference, 0.17%; 95% confidence interval, 0.07% to 0.29%). This association was more pronounced among individuals prescribed higher zolpidem doses (hazard ratio, 1.85; 95% confidence interval, 1.10 to 3.01; and risk difference, 0.20%; 95% confidence interval, 0.04% to 0.38% for higher-dose zolpidem versus trazodone; and hazard ratio, 1.60; 95% confidence interval, 1.01 to 2.55 and risk difference, 0.14%; 95% confidence interval, 0.03% to 0.27% for lower-dose zolpidem versus trazodone). Sensitivity analyses using longer follow-up durations yielded similar results. CONCLUSIONS Among individuals receiving maintenance hemodialysis, zolpidem initiators had a higher risk of hospitalized fall-related fracture compared with trazodone initiators. PODCAST This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_12_18_CJN10070620_final.mp3.
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Affiliation(s)
- Magdalene M. Assimon
- Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina Kidney Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Jennifer E. Flythe
- Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina Kidney Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina,Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina
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7
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Bilsky SA, Friedman HP, Karlovich A, Smith M, Leen-Feldner EW. The interaction between sleep disturbances and anxiety sensitivity in relation to adolescent anger responses to parent adolescent conflict. J Adolesc 2020; 84:69-77. [PMID: 32871495 DOI: 10.1016/j.adolescence.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/09/2020] [Accepted: 08/19/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Sleep disturbances are common among adolescents and are associated with elevated anxiety, and difficulties managing affect. Familial conflict is associated with both anxiety sensitivity and adolescent sleep disturbances. No work to date has examined how adolescent sleep disturbances may interact with anxiety sensitivity in relation to adolescent affective responding to parent-adolescent conflict. The current study was designed to address this gap in the literature by examining how adolescent sleep disturbances, anxiety sensitivity, conflict elicited anger, and conflict avoidance are associated. METHOD Seventy-two American adolescents (n = 39 males) between the ages of 12 and 16 years (Mage = 13.84, SD = 1.38) completed a baseline assessment as well as a well-validated mother-adolescent laboratory-based conflict task. RESULTS For youth low in anxiety sensitivity, greater sleep disturbance related positively to conflict-elicited anger, which in turn predicted higher conflict avoidance. In contrast, this indirect effect was not significant for adolescents relatively higher in anxiety sensitivity. Instead, for these adolescents, increased sleep disturbances were associated with lower levels of conflict elicited anger. CONCLUSIONS Results suggest that the effects of sleep disturbances on conflict elicited anger may vary as a function of adolescent anxiety vulnerability. These findings highlight the importance of considering the unique effects of sleep disturbances on adolescent affect as a function of adolescent anxiety vulnerability.
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Affiliation(s)
- Sarah A Bilsky
- Department of Psychology, University of Mississippi, Oxford, MS, USA.
| | - Hannah P Friedman
- Department of Psychology, University of Mississippi, Oxford, MS, USA
| | - Ashley Karlovich
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Madeleine Smith
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Ellen W Leen-Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
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8
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Zhan Y, Liu Y, Liu H, Li M, Shen Y, Gui L, Zhang J, Luo Z, Tao X, Yu J. Factors associated with insomnia among Chinese front-line nurses fighting against COVID-19 in Wuhan: A cross-sectional survey. J Nurs Manag 2020; 28:1525-1535. [PMID: 32657449 PMCID: PMC7405094 DOI: 10.1111/jonm.13094] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/26/2020] [Accepted: 07/06/2020] [Indexed: 01/01/2023]
Abstract
Aim To investigate the prevalence of insomnia among front‐line nurses fighting against COVID‐19 in Wuhan, China, and analyse its influencing factors. Background Insomnia is an important factor that can affect the health and work quality of nurses. However, there is a lack of big‐sample studies exploring factors that affect the insomnia of nurses fighting against COVID‐19. Method This cross‐sectional study using the Ascension Insomnia Scale, Fatigue Scale‐14 and Perceived Stress Scale took place in March 2020. Participants were 1,794 front‐line nurses from four tertiary‐level general hospitals. Results The prevalence of insomnia among participants was 52.8%. Insomnia was predicted by gender, working experience, chronic diseases, midday nap duration, direct participation in the rescue of patients with COVID‐19, frequency of night shifts, professional psychological assistance during the pandemic, negative experiences (such as family, friends or colleagues being seriously ill or dying due to COVID‐19), the degree of fear of COVID‐19, fatigue and perceived stress. Conclusion The level of insomnia among participants was higher than the normal level. Interventions based on influencing factors should be implemented to ensure nurses’ sleep quality. Implications for Nursing Management An in‐depth understanding of the influencing factors of insomnia among front‐line nurses can help nurse managers develop solutions to improve front‐line nurses’ sleep quality, which will enhance the physical and mental conditions of nurses and promote the quality of care.
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Affiliation(s)
- Yuxin Zhan
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunfang Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huan Liu
- Department of Nursing, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu, China
| | - Mei Li
- Department of Intensive Care Unit, The Central Hospital of Wuhan Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Shen
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lingli Gui
- Nursing Department of Radiation and Medical Oncology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Jun Zhang
- Department of Pain, Affiliated Hospital of Jianghan University, Wuhan, China
| | - Zhihua Luo
- Neurosurgery Department, Wuhan NO. 1 Hospital, Wuhan, China
| | - Xiubin Tao
- Department of Nursing, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu, China
| | - Jiaohua Yu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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10
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Dobing S, Dey A, McAlister F, Ringrose J. Non-pharmacologic interventions to improve sleep of medicine inpatients: a controlled study. J Community Hosp Intern Med Perspect 2017; 7:287-295. [PMID: 29147469 PMCID: PMC5676797 DOI: 10.1080/20009666.2017.1379845] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/07/2017] [Indexed: 12/22/2022] Open
Abstract
Background: Sleep quality in hospitalized medicine patients is poor, with environmental factors among the most frequently cited reasons. Objective: We tested the efficacy of a non-pharmacologic intervention on the sleep quality of medicine inpatients. Design/Methods: A controlled study to evaluate our non-pharmacologic multidisciplinary ‘TUCK-in’ protocol (which includes timed lights-off periods, minimizing night-time noise, distribution of earplugs at bedtime, cued toileting before bedtime, and identification and reduction of modifiable interruptions) was deployed on two of five identical medicine wards. Randomization was at the level of the ward. The main outcome measure was self-reported duration of night-time sleep within 48 hours prior to discharge. Additional outcome measures included the Verran–Snyder-Halpern (VSH) Sleep Score and inpatient sleep pharmaceutical use. Results: Self-reported duration of night-time sleep (median 5.0 vs. 5.0 hours, p = 0.29) and daytime sleep (1.0 versus 0.5 hours, p = 0.43) did not differ between the 40 intervention patients and the 41 control patients (p = 0.13 on multivariate analysis). Cumulative VSH sleep disturbance (median 420 versus 359, p = 0.19), efficacy (median 169 versus 192, p = 0.29), or supplementation (median 97 versus 100, p = 0.51) scales were also not different between study arms. Conclusions: Although staff reported the protocol to be achievable and worthwhile, there were no significant differences in any of the outcomes between intervention and control patients.
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Affiliation(s)
- Selina Dobing
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Anita Dey
- Department of Medicine, University of Alberta, Edmonton, Canada
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Sakamoto R, Okumiya K, Norboo T, Tsering N, Yamaguchi T, Nose M, Takeda S, Tsukihara T, Ishikawa M, Nakajima S, Wada T, Fujisawa M, Imai H, Ishimoto Y, Kimura Y, Fukutomi E, Chen W, Otsuka K, Matsubayashi K. Sleep quality among elderly high-altitude dwellers in Ladakh. Psychiatry Res 2017; 249:51-57. [PMID: 28063399 DOI: 10.1016/j.psychres.2016.12.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/09/2016] [Accepted: 12/27/2016] [Indexed: 11/26/2022]
Abstract
It has been already known that people who temporarily stay at high altitude may develop insomnia as a symptom of acute mountain sickness. However, much less is known about people living at high altitude. The aim of this study was to determine the effect of high altitude environment on sleep quality for the elderly who have been living at high altitude for their whole lives. A cross-sectional study was conducted in Domkhar valley at altitudes of 2800-4200m, Ladakh. Sleep quality was assessed using Insomnia Severity Index (ISI). Measurement items include body mass index, blood pressure, blood sugar, hemoglobin, timed Up and Go test, oxygen saturation during wakefulness, respiratory function test, Oxford Knee Score (OKS), and Geriatric Depression Scale (GDS), and so on. The participants were Ladakhi older adults aged 60 years or over (n=112) in Domkhar valley. The participation rate was 65.1% (male: female=47:65, mean age: 71.3 years and 67.9 years, respectively). The prevalence of the high score of ISI (8 or more) was 15.2% (17 out of 112). Altitude of residence was significantly correlated with ISI. Stepwise multiple regression analysis showed that OKS and altitude of residence were significantly related with ISI.
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Affiliation(s)
- Ryota Sakamoto
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan; Research Institute for Humanity and Nature, Kyoto, Japan.
| | - Kiyohito Okumiya
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan; Research Institute for Humanity and Nature, Kyoto, Japan
| | | | | | | | - Mitsuhiro Nose
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Shinya Takeda
- Graduate School of Asian and African Area Studies, Kyoto University, Kyoto, Japan
| | - Toshihiro Tsukihara
- Faculty of Education and Regional Studies, University of Fukui, Fukui, Japan
| | - Motonao Ishikawa
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Tokyo, Japan
| | - Shun Nakajima
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Tokyo, Japan
| | - Taizo Wada
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Michiko Fujisawa
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Hissei Imai
- Department of Field Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Yasuko Ishimoto
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Yumi Kimura
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Eriko Fukutomi
- Department of Field Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Wenling Chen
- Department of Field Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Kuniaki Otsuka
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Tokyo, Japan
| | - Kozo Matsubayashi
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan; Department of Field Medicine, School of Public Health, Kyoto University, Kyoto, Japan
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12
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Dobing S, Frolova N, McAlister F, Ringrose J. Sleep Quality and Factors Influencing Self-Reported Sleep Duration and Quality in the General Internal Medicine Inpatient Population. PLoS One 2016; 11:e0156735. [PMID: 27280292 PMCID: PMC4900612 DOI: 10.1371/journal.pone.0156735] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 04/27/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Sleep quality in hospitalized Canadian General Internal Medicine patients is not well characterized. Our goals were to characterize hospital sleep quality in this population and identify potentially modifiable barriers to good sleep. METHODS GIM inpatients at a quaternary centre in Edmonton, Canada completed a survey, including the Verran-Snyder Halpern (VSH) questionnaire, to characterize the previous night's sleep within 48 hours prior to discharge. A chart review was also completed to assess comorbidities, discharge diagnoses, and pharmaceutical sleep aid use. RESULTS Patients reported significantly worse nighttime sleep duration in hospital compared with home (mean 5.5 versus 7.0 hours per night, p < 0.0001). Sleep quality was poor, as measured by the VSH disturbance (mean 371), effectiveness (190), and supplementation (115) subscales. Variables independently associated with poorer sleep duration in multivariable regression include prior diagnosis of sleep disorder and multi-patient occupancy rooms. Age, sex, admitting diagnosis, length of stay, frequency of vital checks, and use of sleep pharmaceuticals during the index hospitalization were not associated with sleep duration. The most frequently reported reasons for poor sleep included noise (59%), nursing interruptions (30%), uncomfortable beds (18%), bright lights (16%), unfamiliar surroundings (14%), and pain (9%). CONCLUSIONS Sleep quality for GIM inpatients is significantly worse in hospital than at home. There is a need to test non-pharmacologic interventions to address the most frequently identified factors causing poor sleep hygiene for GIM inpatients.
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Affiliation(s)
- Selina Dobing
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Natalia Frolova
- Division of General Internal Medicine, University of Alberta, Edmonton, Canada
| | - Finlay McAlister
- Division of General Internal Medicine, University of Alberta, Edmonton, Canada
| | - Jennifer Ringrose
- Division of General Internal Medicine, University of Alberta, Edmonton, Canada
- * E-mail:
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13
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Horsley KJ, Rouleau CR, Garland SN, Samuels C, Aggarwal SG, Stone JA, Arena R, Campbell TS. Insomnia symptoms and heart rate recovery among patients in cardiac rehabilitation. J Behav Med 2016; 39:642-51. [PMID: 26944765 DOI: 10.1007/s10865-016-9725-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 02/04/2016] [Indexed: 01/26/2023]
Abstract
Insomnia symptoms (i.e., difficulty falling asleep, difficulty staying asleep, and early morning awakenings) are common among people with cardiovascular disease, and have been linked to adverse cardiovascular health outcomes. Reduced parasympathetic tone is one pathway through which risk may be conferred. The purpose of this study was to evaluate whether insomnia symptoms are associated with lower parasympathetic tone in cardiac rehabilitation patients with suspected insomnia. Participants (N = 121) completed a self-report measure of insomnia severity. 1-min heart rate recovery (HRR), an index of parasympathetic tone, was obtained during a maximal exercise test. Difficulty falling asleep, but not difficulty staying asleep or early awakenings, was associated with attenuated 1-min HRR. When analyses were restricted to participants with moderate and severe insomnia severity (n = 51), the strength of this association increased. In a sample of cardiac rehabilitation patients with insomnia, only the symptom of difficulty falling asleep was associated with lower parasympathetic tone, suggesting that individual insomnia symptoms may show specificity in their associations with physiological mechanisms.
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Affiliation(s)
| | - Codie R Rouleau
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Sheila N Garland
- Department of Psychology, Memorial University, St. John's, NL, Canada
| | - Charles Samuels
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Sandeep G Aggarwal
- TotalCardiology™ Rehabilitation, Calgary, AB, Canada.,Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada
| | - James A Stone
- TotalCardiology™ Rehabilitation, Calgary, AB, Canada.,Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, Calgary, AB, Canada.
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14
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Roehrs T, Gumenyuk V, Drake C, Roth T. Physiological correlates of insomnia. Curr Top Behav Neurosci 2014; 21:277-90. [PMID: 24920447 DOI: 10.1007/7854_2014_324] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Insomnia is a prevalent sleep disorder that is typically comorbid with medical, psychiatric, and other sleep disorders. Yet, it is a disorder with its own course and morbidity that can persist if untreated. This chapter describes the physiological correlates of insomnia expressed during sleep and during the daytime. Together, the data from nighttime and daytime electrophysiology, event-related brain potential recording, neuroimaging studies, sympathetic nervous system, and HPA axis monitoring all suggest that insomnia is a 24 h disorder of hyperarousal.
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Affiliation(s)
- Timothy Roehrs
- Sleep Disorders & Research Center, Henry Ford Hospital, Detroit, MI, USA,
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Espuña-Pons M, Blasco P, Pérez M, Díaz-Cuervo H. [Association between nocturia, subjective satisfaction with sleep and insomnia in patients with overactive bladder]. Med Clin (Barc) 2010; 135:357-9. [PMID: 20627322 DOI: 10.1016/j.medcli.2010.02.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 02/03/2010] [Accepted: 02/04/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVES In this study the relationship between nocturia and subjective sleep satisfaction (SSS) was analysed, aiming at establishing if nocturia could be used as a relevant predictive parameter for insomnia assessment. PATIENTS AND METHODS Epidemiologic and observational study of 1454 patients with overactive bladder. The bivariate association of sleep-, clinical- and personal parameters with SSS, assessed by a specific questionnaire, was analyzed. A multiple regression model was defined for SSS prediction. RESULTS Insomnia, hypersomnia, nocturia, Charlson Index, sex and age were associated with SSS in a bivariate analysis. Nocturia, hypersomnia and insomnia severity were independent predictive parameters of SSS and explained 33% of its variance. CONCLUSIONS Nocturia is an important predictive parameter of SSS.
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Affiliation(s)
- Montserrat Espuña-Pons
- Institut Clinic de Ginecología y Obstetricia (ICGON), Hospital Clinic, Barcelona, Spain.
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SCHMIDT RALPHE, RICHTER MICHAEL, GENDOLLA GUIDOHE, VAN DER LINDEN MARTIAL. Young poor sleepers mobilize extra effort in an easy memory task: evidence from cardiovascular measures. J Sleep Res 2010; 19:487-95. [DOI: 10.1111/j.1365-2869.2010.00834.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Babson KA, Feldner MT, Trainor CD, Smith RC. An experimental investigation of the effects of acute sleep deprivation on panic-relevant biological challenge responding. Behav Ther 2009; 40:239-50. [PMID: 19647525 DOI: 10.1016/j.beth.2008.06.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Revised: 06/19/2008] [Accepted: 06/20/2008] [Indexed: 10/21/2022]
Abstract
Prospective research indicates sleep deprivation potentiates anxiety development, yet relatively little research has examined the effects of sleep deprivation in terms of specific types of anxiety. The current study tested the association between acute sleep deprivation and panic-relevant biological challenge responding among nonclinical participants. One hundred and two participants were randomly assigned to either an experimental (acute sleep deprivation) or control (no sleep deprivation) group. The day prior to and following the experimental (sleep) manipulation, participants completed a 5-minute 10% carbon dioxide-enriched air laboratory-based biological challenge. As predicted, sleep deprivation increased anxious and fearful responding to the challenge. Findings suggest sleep deprivation may be an important factor to consider in models of panic development. There are several areas in this general domain that warrant additional investigation.
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