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Torimoto K, Gotoh D, Nakai Y, Miyake M, Fujimoto K. Electroencephalography-based investigation of the effects of oral desmopressin on improving slow-wave sleep time in nocturnal polyuria patients (the DISTINCT study): A single-arm, open-label, single-assignment trial. Neurourol Urodyn 2024; 43:1559-1565. [PMID: 38606623 DOI: 10.1002/nau.25476] [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: 03/05/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
Abstract
AIMS To investigate changes in subjective and objective sleep quality after desmopressin administration in patients with nocturia due to nocturnal polyuria (NP) using electroencephalography (EEG) and the Pittsburgh sleep quality index (PSQI). METHODS Twenty male patients (≥65 years old) with NP participated in this study. The inclusion criteria were nocturnal frequency ≥ 2, NP index (NPi) ≥ 0.33, first uninterrupted sleep period (FUSP) ≤ 2.5 h, serum sodium concentration ≥ 135 mEq/L, and estimated glomerular filtration rate ≥ 50 mL/min/1.73 m2. Participants were given 50 μg of desmopressin to be taken orally once daily before bed. The primary endpoint was the change in the duration of slow-wave sleep (nonrapid eye movement sleep stages 3 and 4), as evaluated by EEG 28 days from the baseline. The visual analog scale (VAS) was used as an additional indicator of sleep quality. RESULTS Analysis of data from 15 participants (median age: 74.0 [70.5, 76.0] years) revealed that from before to after desmopressin administration, significant decreases occurred in the median nocturnal frequency (3.0 [2.0, 4.0] to 1.5 [1.0, 2.0]) and NPi (0.445 [0.380, 0.475] to 0.360 [0.250, 0.430]). Furthermore, FUSP was significantly prolonged from 120.0 (94.0, 150.0) min to 210.0 (203.8, 311.3) min. Although the VAS scores improved, slow-wave sleep duration and the PSQI global score showed no significant differences (68.50 [47.50, 75.50] and 48.00 [38.00, 66.50]; 5.0 [5.0, 10.0] and 7.0 [5.0, 9.0] min, respectively). CONCLUSION Oral administration of 50 μg desmopressin improved nocturnal frequency and FUSP in older individuals with NP but did not significantly enhance sleep quality. In older adults, decreased nighttime urinary frequency may enhance quality of life; however, its influence on objective sleep quality may be limited.
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Affiliation(s)
- Kazumasa Torimoto
- Department of Urology, Nara Medical University Hospital, Kashihara, Japan
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University Hospital, Kashihara, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University Hospital, Kashihara, Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University Hospital, Kashihara, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University Hospital, Kashihara, Japan
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Huang JY, Liao PL, Chang HP, Su PH. Association of Sleep Patterns and Respiratory Disturbance Index with Physiological Parameters in Pediatric Patients with Self-Perceived Short Stature. Diagnostics (Basel) 2024; 14:1675. [PMID: 39125551 PMCID: PMC11311679 DOI: 10.3390/diagnostics14151675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/10/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE To investigate the relationships of sleep patterns and respiratory disturbance index (RDI) with key physiological parameters (height, body mass index (BMI), bone age (BA), and IGF-1 levels) in children aged 6 to 16 years with self-perceived short stature. METHODS For this cross-sectional study, conducted from October 2019 to November 2021, 238 children aged 6 to 16 years with self-perceived short stature were enrolled. The primary outcomes of sleep patterns and the RDI were non-invasively collected at home using the LARGAN Health AI-Tech Sleep Apnea and Sleep Quality Examination System, which operates based on polygraphy. Additionally, various physiological parameters, including height, BMI, bone age, and IGF-1 levels, were measured to assess their associations with sleep patterns and RDI. RESULTS Significant age-related reductions were observed in both the total and deep sleep durations. Children aged 6-9 years averaged 8.5 ± 1.0 h of total sleep, which decreased to 8.1 ± 1.1 h in ages 10-11 and further to 7.5 ± 0.9 h in ages 12-16 (p < 0.0001). Deep sleep followed a similar pattern, decreasing from 4.4 ± 1.1 h in the youngest group to 3.3 ± 1.0 h in the oldest (p < 0.0001). Notably, girls experienced significantly longer deep sleep than boys, averaging 4.0 ± 1.2 h compared to 3.6 ± 1.2 h (p = 0.0153). In a multivariable regression analysis, age (beta = 4.89, p < 0.0001) and RDI (beta = -0.54, p = 0.0022) were significantly associated with body height. Age and deep sleep duration (beta = -0.02, p = 0.0371) were significantly associated with BMI. CONCLUSIONS The results demonstrate significant age-related decreases in the total and deep sleep duration among children with self-perceived short stature, along with a notable association between RDI and body height and an association between deep sleep duration and BMI. These findings suggest that sleep disturbances in pediatric endocrine patients are intricately linked with physiological growth parameters. The identified correlations underline the importance of monitoring sleep patterns in this demographic to better understand the impact of endocrine disorders on developmental health. Further research is needed to explore interventions that could alleviate these sleep disturbances, thereby potentially improving outcomes for the affected children.
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Affiliation(s)
- Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (J.-Y.H.); (P.-L.L.)
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Pei-Lun Liao
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (J.-Y.H.); (P.-L.L.)
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Hua-Pin Chang
- Department of Nursing, Asia University, Taichung 41354, Taiwan
| | - Pen-Hua Su
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
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Delbari A, Ahmadi F, Zar A, Zandvakili A, Sadeghipour HR, Sims J. Living in urban or rural environments affect the sleep quality of the elderly in Bushehr (Southern Iran): emphasizing the active and inactive of the elderly. BMC Public Health 2024; 24:1340. [PMID: 38760757 PMCID: PMC11102227 DOI: 10.1186/s12889-024-18747-9] [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: 11/01/2023] [Accepted: 04/30/2024] [Indexed: 05/19/2024] Open
Abstract
INTRODUCTION Sleep disorders have a significant negative impact on mental and physical health, especially among the elderly. Various factors can affect the sleep quality of elderly people. The aim of this research to investigate the effect of urban and rural environments on the sleep quality of elderly people with emphasis on physical activity. METHOD Four hundred and thirty-nine elderly people (226 city residents and 213 village residents) in urban and rural areas of Bushehr (Southern Iran), volunteered to participate in the present study. Information was collected via the General information questionnaire and Petersburg Sleep Questionnaire. RESULT The results showed that active elderly women (p < 0.001), and total active elderly (male + female) (p < 0.001) living in urban areas compared to inactive elderly and also in rural areas active elderly women (p < 0.001), active elderly men (p < 0.001) and total active elderly (male + female) (p < 0.001) had better overall sleep quality in compared to inactive elderly. Also, elderly men (p < 0.001) and the total elderly (male + female) (p < 0.001) living in urban areas had better sleep quality than the elderly in rural areas. CONCLUSION Based on the findings, it can be concluded that the way of life (being active) as well as the living environment can affect the sleep quality of elderly people, so that active elderly people and also elderly people living in urban environments had better sleep quality.
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Affiliation(s)
- Ahmad Delbari
- Research Center on Aging, University of social Welfare and Rehabilitation Sciense, Tehran, Iran
| | - Fatemeh Ahmadi
- Research Center of Persian Gulf Sports, Nutrition and Health, School of Literature and Humanities, Persian Gulf University, Boushehr, Iran
- Department of Sport Science, School of Literature and Humanities, Persian Gulf University, Boushehr, Iran
| | - Abdossaleh Zar
- Research Center of Persian Gulf Sports, Nutrition and Health, School of Literature and Humanities, Persian Gulf University, Boushehr, Iran.
- Department of Sport Science, School of Literature and Humanities, Persian Gulf University, Boushehr, Iran.
| | - Atousa Zandvakili
- Research Center of Persian Gulf Sports, Nutrition and Health, School of Literature and Humanities, Persian Gulf University, Boushehr, Iran
| | - Hamid Reza Sadeghipour
- Research Center of Persian Gulf Sports, Nutrition and Health, School of Literature and Humanities, Persian Gulf University, Boushehr, Iran
- Department of Sport Science, School of Literature and Humanities, Persian Gulf University, Boushehr, Iran
| | - Jamie Sims
- Department of Sport, Health Sciences, and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
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Del-Valle-Soto C, López-Pimentel JC, Vázquez-Castillo J, Nolazco-Flores JA, Velázquez R, Varela-Aldás J, Visconti P. A Comprehensive Review of Behavior Change Techniques in Wearables and IoT: Implications for Health and Well-Being. SENSORS (BASEL, SWITZERLAND) 2024; 24:2429. [PMID: 38676044 PMCID: PMC11054424 DOI: 10.3390/s24082429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
This research paper delves into the effectiveness and impact of behavior change techniques fostered by information technologies, particularly wearables and Internet of Things (IoT) devices, within the realms of engineering and computer science. By conducting a comprehensive review of the relevant literature sourced from the Scopus database, this study aims to elucidate the mechanisms and strategies employed by these technologies to facilitate behavior change and their potential benefits to individuals and society. Through statistical measurements and related works, our work explores the trends over a span of two decades, from 2000 to 2023, to understand the evolving landscape of behavior change techniques in wearable and IoT technologies. A specific focus is placed on a case study examining the application of behavior change techniques (BCTs) for monitoring vital signs using wearables, underscoring the relevance and urgency of further investigation in this critical intersection of technology and human behavior. The findings shed light on the promising role of wearables and IoT devices for promoting positive behavior modifications and improving individuals' overall well-being and highlighting the need for continued research and development in this area to harness the full potential of technology for societal benefit.
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Affiliation(s)
- Carolina Del-Valle-Soto
- Facultad de Ingeniería, Universidad Panamericana, Álvaro del Portillo 49, Zapopan 45010, Mexico;
| | | | - Javier Vázquez-Castillo
- Department of Informatics and Networking, Universidad Autónoma del Estado de Quintana Roo, Chetumal 77019, Mexico;
| | | | - Ramiro Velázquez
- Facultad de Ingeniería, Universidad Panamericana, Aguascalientes 20296, Mexico;
| | - José Varela-Aldás
- Centro de Investigaciones de Ciencias Humanas y de la Educación—CICHE, Universidad Indoamérica, Ambato 180103, Ecuador;
| | - Paolo Visconti
- Department of Innovation Engineering, University of Salento, 73100 Lecce, Italy;
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Bezgin S, Özkaya Y, Akbaş Y, Elbasan B. An investigation of computer-game addiction, physical activity level, quality of life and sleep of children with a sibling with a chronic condition. Child Care Health Dev 2024; 50:e13228. [PMID: 38265131 DOI: 10.1111/cch.13228] [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: 06/02/2023] [Revised: 11/28/2023] [Accepted: 12/24/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND It is known that chronic condition also affects siblings without chronic illness. Healthy siblings of children with a chronic condition and aged 9-14 years and healthy children with a sibling without chronic illness and their parents were included in the study. AIM The aim of our study was to examine the internet-game addiction, physical activity, quality of life and sleep in children with a sibling with chronic condition and compare them with their peers with a healthy sibling. METHODS Computer game addiction, physical activity, sleep quality and quality of life were evaluated respectively by Computer Game Addiction Scale for Children, Child Physical Activity Questionnaire, Children's Sleep Disorder Scale and Children's Quality of Life Scale. RESULTS While the mean age of 75 children with chronically ill siblings was 10.65 ± 1.59 years, the mean age of 75 healthy children with healthy siblings was 10.46 ± 2.09 years. It was observed that children with a sibling with a chronic condition were more tend to computer-game addiction, had lower sleep quality, lower quality of life in terms of school functionality and psychosocial health compared to children with a healthy sibling (p < 0.05). CONCLUSIONS It was revealed that in families with children with a chronic condition, siblings with no health problems should also be evaluated in psychosocial terms and supported by appropriate approaches, such as to increase the level of physical activity.
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Affiliation(s)
- Sabiha Bezgin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey
| | - Yunus Özkaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey
| | - Yılmaz Akbaş
- Faculty of Medicine, Department of Child Neurology, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey
| | - Bülent Elbasan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Inoue Y, Nishida M, Kubota N, Koebis M, Taninaga T, Muramoto K, Ishikawa K, Moline M. Comparison of the treatment effectiveness between lemborexant and zolpidem tartrate extended-release for insomnia disorder subtypes defined based on polysomnographic findings. J Clin Sleep Med 2023; 19:519-528. [PMID: 36472134 PMCID: PMC9978424 DOI: 10.5664/jcsm.10378] [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] [Received: 07/25/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022]
Abstract
STUDY OBJECTIVES Patients with chronic insomnia may respond differently to therapeutic modalities. This study examined differences in response of individuals with 2 insomnia phenotypes-short sleep duration (I-SSD; < 6 hours) and normal sleep duration (I-NSD; ≥ 6 hours) determined by polysomnography-to treatment with lemborexant and zolpidem tartrate extended-release 6.25 mg (zolpidem ER), compared with placebo. METHODS Study E2006-G000-304 (Study 304; SUNRISE-1; NCT02783729) was a global, randomized, double-blind, placebo, and active comparator-controlled, parallel-group study comparing lemborexant 5 and 10 mg in individuals aged ≥ 55 years with insomnia disorder. In this analysis, changes in subjective (self-reported) variables based on sleep diaries and objective variables based on polysomnographs were assessed after 1-month administration of study drugs. Data from participants with I-SSD and I-NSD were compared. RESULTS In the I-SSD subgroup, both lemborexant doses provided significant benefit for sleep-onset latency (SOL), total sleep time (TST), and wake after sleep onset (WASO) vs placebo; zolpidem ER also provided significant benefit for TST and WASO, but not SOL, on both measures vs placebo. In the I-NSD subgroup, lemborexant and zolpidem ER provided significant benefit for TST and WASO vs placebo objectively but not subjectively; both doses of lemborexant provided significant benefit for SOL vs placebo subjectively, but not objectively. CONCLUSIONS Both drugs, but lemborexant more consistently, showed subjective and objective benefits compared with placebo in participants with insomnia with objective short sleep duration. However, neither lemborexant nor zolpidem provided consistent benefits for participants with normal sleep duration on sleep-onset and sleep maintenance variables. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Study of the Efficacy and Safety of Lemborexant in Subjects 55 Years and Older With Insomnia Disorder (SUNRISE 1); URL: https://clinicaltrials.gov/ct2/show/record/NCT02783729; Identifier: NCT02783729. CITATION Inoue Y, Nishida M, Kubota N, et al. Comparison of the treatment effectiveness between lemborexant and zolpidem tartrate extended-release for insomnia disorder subtypes defined based on polysomnographic findings. J Clin Sleep Med. 2023;19(3):519-528.
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Affiliation(s)
- Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
- Japan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan
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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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Álvarez-Bueno C, Mesas AE, Reina-Gutierrez S, Saz-Lara A, Jimenez-Lopez E, Martinez-Vizcaino V. Napping and cognitive decline: a systematic review and meta-analysis of observational studies. BMC Geriatr 2022; 22:756. [PMID: 36109701 PMCID: PMC9479293 DOI: 10.1186/s12877-022-03436-2] [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: 11/24/2021] [Accepted: 08/31/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND No clear evidence is available for the influence of napping on cognitive function in older adults. This systematic review and meta-analysis aimed to elucidate the cross-sectional and longitudinal relationships between napping and cognitive function (global cognition and memory) and to explore whether some individual characteristics and sleep characteristics can modify this relationship. METHODS We systematically searched Medline (via PubMed), Web of Science, and Scopus. DerSimonian and Lair and Hartung-Knapp-Sidik-Jonkman random effects methods were used to compute pooled estimates of odds ratios (ORs) and their respective 95% confidence intervals (95% CIs) for the association of global cognition and memory with napping. The mean age, the night sleep time (hours), and the percentage of women, no nappers, and people in the less night-time sleep duration category were used for meta-regressions. RESULTS Twenty-five studies were included in this systematic review and meta-analysis, 18 cross-sectional and seven longitudinal studies, including 95,719 participants older than 60 years. The pooled ORs from the cross-sectional analyses were 1.03 (95% CI: 1.01 to 1.06) for global cognition and 1.06 (95%: 0.90 to 1.26) for memory. The pooled ORs from the longitudinal analyses were 1.00 (95% 0.85 to 1.18) for global cognition and 1.08 (95% 0.98 to 1.19) for memory. These associations were not modified by individual or sleep characteristics. CONCLUSION Our data confirm the absence of association between napping and global cognition and memory regardless of the characteristics of the population. This information might be considered when providing lifestyle recommendations to adults with and without cognitive complaints.
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Affiliation(s)
- Celia Álvarez-Bueno
- grid.8048.40000 0001 2194 2329Universidad de Castilla-La Mancha, Health and Social Care Research Center, 16071 Cuenca, Spain ,grid.441660.10000 0004 0418 6711Universidad Politécnica Y Artística del Paraguay, Asunción, 001518 Paraguay
| | - Arthur Eumann Mesas
- grid.8048.40000 0001 2194 2329Universidad de Castilla-La Mancha, Health and Social Care Research Center, 16071 Cuenca, Spain ,grid.411400.00000 0001 2193 3537Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Parana, Brasil
| | - Sara Reina-Gutierrez
- grid.8048.40000 0001 2194 2329Universidad de Castilla-La Mancha, Health and Social Care Research Center, 16071 Cuenca, Spain
| | - Alicia Saz-Lara
- grid.8048.40000 0001 2194 2329Universidad de Castilla-La Mancha, Health and Social Care Research Center, 16071 Cuenca, Spain
| | - Estela Jimenez-Lopez
- Department of Psychiatry Hospital, Virgen de La Luz, Cuenca, Spain ,grid.469673.90000 0004 5901 7501CIBERSAM (Biomedical Research, Networking Centre in Mental Health), Barcelona, Spain
| | - Vicente Martinez-Vizcaino
- grid.8048.40000 0001 2194 2329Universidad de Castilla-La Mancha, Health and Social Care Research Center, 16071 Cuenca, Spain ,grid.441837.d0000 0001 0765 9762Faculty of Health Sciences, Universidad Autónoma de Chile, 1670 Talca, Chile
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Obesity and Voiding Parameters in a Community-Based Population of Okinawa, Japan: Kumejima Digital Health Project (KDHP). Metabolites 2022; 12:metabo12050468. [PMID: 35629972 PMCID: PMC9145398 DOI: 10.3390/metabo12050468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Evidence has accumulated regarding the etiology of lower urinary tract symptoms associated with obesity and metabolic syndrome. Therefore, the present study aimed to identify which subjectively and objectively measured voiding parameters were associated with obesity in a community-based population. (2) Methods: Voiding parameters on a self-administered questionnaire and a digital self-health monitoring system for urine excretion (s-HMSU) were compared between participants with and without obesity, defined as a body mass index ≥ 25 kg/m2 (n = 30 and 29, respectively), from a community in Okinawa, Japan. Logistic regression analysis was employed to calculate the odds ratios of abnormalities in voiding parameters for the obese group, with the non-obese group serving as a reference. (3) Results: The obese group had odds ratios of 5.17 (95% confidence interval: 1.33−20.0) for shortened hours of undisturbed sleep (<302 min) by s-HMSU and 7.65 (1.88−31.1) for nighttime urinary frequency by a questionnaire after adjusting for age and sex. In addition, the obese group had an adjusted odds ratio of 2.27 (0.76−6.78) for decreased maximum bladder capacity (<212 mL) by s-HMSU. (4) Conclusion: the results of the present study suggest that nocturia and shortened hours of undisturbed sleep are signs of obesity.
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Ong ZL, Chaturvedi N, Tillin T, Dale C, Garfield V. Association between sleep quality and type 2 diabetes at 20-year follow-up in the Southall and Brent REvisited (SABRE) cohort: a triethnic analysis. J Epidemiol Community Health 2021; 75:1117-1122. [PMID: 34117111 PMCID: PMC8515117 DOI: 10.1136/jech-2020-215796] [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: 10/14/2020] [Revised: 04/17/2021] [Accepted: 05/06/2021] [Indexed: 11/04/2022]
Abstract
Background The risk of developing type 2 diabetes associated with poor sleep quality is comparable to other lifestyle factors (eg, overweight, physical inactivity). In the UK, these risk factors could not explain the two to three-fold excess risks in South-Asian and African-Caribbean men compared with Europeans. This study investigates (1) the association between mid-life sleep quality and later-life type 2 diabetes risk and (2) the potential modifying effect of ethnicity. Methods The Southall and Brent REvisited cohort is composed of Europeans, South-Asians and African-Caribbeans (median follow-up 19 years). Complete-case analysis was performed on 2189 participants without diabetes at baseline (age=51.7±7 SD). Competing risks regressions were used to estimate the HRs of developing diabetes associated with self-reported baseline sleep (difficulty falling asleep, early morning waking, waking up tired, snoring and a composite sleep score), adjusting for confounders. Modifying effects of ethnicity were analysed by conducting interaction tests and ethnicity-stratified analyses. Results There were 484 occurrences of incident type 2 diabetes (22%). Overall, there were no associations between sleep exposures and diabetes risk. Interaction tests suggested a possible modifying effect for South-Asians compared with Europeans for snoring only (p=0.056). The ethnicity-stratified analysis found an association with snoring among South-Asians (HR 1.41, 95% CI 1.08 to 1.85), comparing those who snored often/always versus occasionally/never. There were no elevated risks for the other sleep exposures. Conclusion The association between snoring and type 2 diabetes appeared to be modified by ethnicity, and was strongest in South-Asians.
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Affiliation(s)
- Zhen Ling Ong
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Nishi Chaturvedi
- MRC Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
| | - Therese Tillin
- MRC Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
| | - Caroline Dale
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK.,Institute of Health Informatics, University College London, London, UK
| | - Victoria Garfield
- MRC Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
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Mason D, Ronald A, Ambler A, Caspi A, Houts R, Poulton R, Ramrakha S, Wertz J, Moffitt TE, Happé F. Autistic traits are associated with faster pace of aging: Evidence from the Dunedin study at age 45. Autism Res 2021; 14:1684-1694. [PMID: 34042279 DOI: 10.1002/aur.2534] [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: 12/11/2020] [Revised: 03/31/2021] [Accepted: 05/03/2021] [Indexed: 01/25/2023]
Abstract
Growing evidence indicates that the defining characteristics of autism spectrum disorder (ASD) are distributed throughout the general population; hence, understanding the correlates of aging in people with high autistic traits could shed light on ASD and aging. 915 members of the Dunedin longitudinal birth cohort completed a measure of autistic traits at age 45. A composite measure of the "pace of aging" was derived by tracking the decline in 19 biomarkers across ages 26, 32, 38, and 45 years. Facial age was also assessed. Reports of perceived health were collected from participants themselves, informants, and interviewers. Higher self-reported autistic traits significantly correlated with a faster pace of aging, older facial age, and poorer self-, informant-, and interviewer-rated health. After control for sex, SES and IQ, autistic traits were significantly associated with each variable: pace of aging (β = 0.09), facial age (β = 0.08), self- (β = -0.15), informant (β = -0.12), and interviewer-rated (β = -0.17) health. Autistic traits measured at age 45 are associated with faster aging. Participants with high autistic traits appear to be more vulnerable to poor health outcomes, as previously reported for those clinically diagnosed with ASD. Therefore, autistic traits may have important health implications. Replicating these findings in samples of autistic people is needed to identify the mechanism of their effect on aging and physical health to improve outcomes for those with ASD diagnoses or high autistic traits. LAY SUMMARY: The role that autistic traits have in relation to health outcomes has not been investigated. We looked at how physical health and aging (measured with self-reported questions and decline in multiple biological measures) were related to autistic traits (measured with a questionnaire, at age 45). We found that higher autistic traits were associated with poorer reports of physical health, and a faster pace of aging. This suggests that both those with autism and those with higher autistic traits may be more likely to experience poorer health outcomes.
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Affiliation(s)
- David Mason
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck University of London, London, United Kingdom
| | - Antony Ambler
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.,Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.,Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Center for Genomic and Computational Biology, Duke University, Durham, North Carolina, USA.,PROMENTA Center, University of Oslo, Oslo, Norway
| | - Renate Houts
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Jasmin Wertz
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Terrie E Moffitt
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.,Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Center for Genomic and Computational Biology, Duke University, Durham, North Carolina, USA.,PROMENTA Center, University of Oslo, Oslo, Norway
| | - Francesca Happé
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
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Park J, Park CH, Jun SE, Lee EJ, Kang SW, Kim N. Effects of biofeedback-based sleep improvement program on urinary symptoms and sleep patterns of elderly Korean women with overactive bladder syndrome. BMC Urol 2019; 19:109. [PMID: 31703581 PMCID: PMC6839159 DOI: 10.1186/s12894-019-0540-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 10/20/2019] [Indexed: 11/29/2022] Open
Abstract
Background The prevalence of overactive bladder syndrome (OAB) increases with age. Sleep disturbances in elderly individuals with OAB is a common problem. The purpose of this study was to examine the effects of a biofeedback-based sleep improvement (BBSI) program on urinary symptoms and sleep patterns in elderly Korean women with OAB. Methods A non-equivalent control group pre−/post-test design was used. Elderly women with OAB were assigned to an intervention group (n = 20) or a control group (n = 18). The BBSI program was implemented in the intervention group for 12 weeks, while two educational sessions of general sleep hygiene and lifestyle modification were provided to the control group. Using SPSS 23.0, the data were analyzed by descriptive analysis using the chi-square test, Fisher’s exact test, Mann-Whitney test, and Wilcoxon test. Results After the 12-week BBSI program, significant improvements were found in the intervention group’s the square root of the mean squared differences of successive R-R intervals (p = 0.025), low frequency/high frequency ratio (p = 0.006), and epinephrine (p = 0.039). We also observed a significant difference in urinary symptoms, sleep efficiency, wake after sleep onset, number of awakenings, and number of awakenings within 3 h after sleep onset (p < 0.001, p = 0.004, p = 0.001, p = 0.001, and p = 0.048, respectively). However, no significant changes were found in these variables in the control group. Conclusions The BBSI program effectively improved urinary symptoms and sleep patterns of elderly Korean women with OAB. Further longitudinal research is required to investigate the sustainability and effects of the BBSI program. Trial registration KCT0003882. Date of registration: 02/05/2019. Retrospectively registered.
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Affiliation(s)
- Jooyeon Park
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Choal Hee Park
- Department of Urology, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Sang-Eun Jun
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Eun-Ju Lee
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Seung Wan Kang
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Nahyun Kim
- College of Nursing, Keimyung University, Daegu, Republic of Korea.
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Tyagi S, Perera S, Clarkson BD, Tadic SD, Resnick NM. Nocturnal Excretion in Healthy Older Women and Rationale for a Safer Approach to Sleep Disruption. J Am Geriatr Soc 2019; 67:2610-2614. [PMID: 31437310 DOI: 10.1111/jgs.16144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/23/2019] [Accepted: 07/27/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Insomnia, especially difficulty maintaining sleep, is prevalent among older adults and increases the incidence of falls and fractures. Moreover, the drugs used to treat it exacerbate the risk. Yet current therapies fail to address one of its most common causes in older adults: nocturia and its primary contributor, nocturnal polyuria (NP), especially among the majority of individuals without lower urinary tract symptoms (LUTS). Therefore, we examined the factors associated with nocturia in two groups of such older women and the impact of nocturia on sleep. DESIGN Secondary analysis of two observational studies of bladder function in carefully evaluated healthy older women. SETTING Academic medical center. PARTICIPANTS A total of 39 women without LUTS who had adequate fluid intake (ie, >1200 mL urine output/24 h recorded on their diary), normal videourodynamic testing, and normal daytime frequency (≤7 voids). MEASUREMENTS Voided volumes and sleep duration obtained from subjects' 3-day voiding diary, and sleep quality from the Center for Epidemiologic Studies Depression Scale. Nighttime excretion of more than 33% of 24-hour urine volume was considered NP. RESULTS Overall, 21 of these healthy subjects (54%) awakened at least once nightly to void, and 19 (90%) of them had NP. Compared with those without nocturia, participants with nocturia had shorter duration of the first uninterrupted sleep period (182 ± 100 vs 250 ± 60 min; P = .03), and they reported worse sleep quality. Two factors contributed independently to nocturia: (1) a larger proportion of 24-hour urine output at night (43.4 ± 7.4% vs 25.4 ± 5.5%; P = <.001) and (2) smaller bladder capacity (484 ± 157 mL vs 608 ± 167 mL; P = .02). CONCLUSIONS Nocturia, NP, and reduced bladder capacity are very common even in healthy older women without LUTS and are associated with impaired sleep. Thus applying currently available modalities to address both NP and reduced bladder capacity may effectively treat sleep disruption without incurring the complications of sedative-hypnotics. J Am Geriatr Soc 67:2610-2614, 2019.
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Affiliation(s)
- Shachi Tyagi
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Subashan Perera
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Becky D Clarkson
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Stasa D Tadic
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Neil M Resnick
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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14
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Bliwise DL, Wagg A, Sand PK. Nocturia: A Highly Prevalent Disorder With Multifaceted Consequences. Urology 2019; 133S:3-13. [PMID: 31310770 DOI: 10.1016/j.urology.2019.07.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 05/31/2019] [Accepted: 07/05/2019] [Indexed: 12/26/2022]
Abstract
Nocturia is a bothersome, multifactorial condition with many underlying causes and contributing factors. Nocturnal polyuria (NP; overproduction of urine at night) is a frequent component. The prevalence of nocturia increases with age; specific estimates of prevalence are influenced by frequency thresholds used to define it. There is a tendency toward higher prevalence in young women than young men, which is reversed in later life. The association between frequency of nocturnal voiding and sleep disruption is well-documented. Nocturia correlates strongly with shorter sleep during the first part (2-4 hours) of the night, during which the first nocturnal void often occurs. A short time to first void after sleep onset (often referred to as "first uninterrupted sleep period") is associated with increased daytime dysfunction and decreased sleep quality and/or sleep efficiency. Adverse health consequences related to nocturia include poor sleep, depression, reduced quality of life, and increased risk of morbidity, mortality, falls, and fractures; studies have been able to establish a causal role for nocturia in only some of these. The potential impact of nocturia on health increases with age. By age 80, 80% of people will rise at least once per night to void. Despite its associated bother, nocturia is often accepted as a natural consequence of aging and many people do not seek help. Women, in particular, may be reluctant to report nocturia. This article reviews the prevalence of nocturia, possible impact on sleep, mortality and morbidity, and falls, and its importance in the elderly/frail population and women.
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Affiliation(s)
| | - Adrian Wagg
- University of Alberta, Edmonton, Alberta, Canada
| | - Peter K Sand
- NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Chicago, IL
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15
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Abstract
Cardiovascular disease is a negative health outcome of obstructive sleep apnea (OSA). Risk factors associated with OSA development include low physical activity (PA), high body mass index (BMI), and increasing age (>50 years), and weight loss is usually recommended as treatment. This cross-sectional study examined the association between PA, BMI, and OSA severity in manual workers. Fifty-five participants (23 females and 32 males; mean age 55.2 years), were examined for OSA and completed a PA and anthropometric assessment. On average, OSA severity was mild, PA levels were moderate, and 32% of the sample was classified as obese. PA was negatively associated with OSA severity, but BMI strongly independently predicted OSA severity, with no evidence of mediation. As both PA and BMI were significantly associated with OSA in older manual workers, increasing PA should also be a focus of treatment for OSA.
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16
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Baldini T, Loddo G, Sessagesimi E, Mignani F, Cirignotta F, Mondini S, Licchetta L, Bisulli F, Tinuper P, Provini F. Clinical Features and Pathophysiology of Disorders of Arousal in Adults: A Window Into the Sleeping Brain. Front Neurol 2019; 10:526. [PMID: 31164861 PMCID: PMC6534078 DOI: 10.3389/fneur.2019.00526] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/02/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Disorders of Arousal (DoA) are NREM parasomnias that have been typically regarded as self-limited childhood manifestations. It is now clear that DoA can persist in adults, often presenting with distinctive characteristics. So far, few studies have described the clinical course and characteristics of DoA in adulthood, therefore a large part of their semiology is ignored. The aim of this study is to describe the clinical manifestations of DoA in an adult population and to provide a pathophysiological interpretation of their features. Methods: We screened our database for all 1,600 adult (≥15 years) patients with sleep-related motor behaviors between 1995 and 2016. We identified 45 patients with typical DoA episodes, of whom a complete history, neurological examination and diagnostic video-polysomnography (VPSG) were available. All patients provided a detailed description of their episodes (with particular regards to semiology, frequency, and association with stressful life events) in different life periods. VPSG recordings were reviewed and DoA episodes were identified and assigned to three different categories according to their complexity. Results: Our population was composed of 45 adult patients ranging between 15 and 76 years. Sleepwalking was reported by 86% of patients, possibly associated with complex interactions with the environment and violent behaviors in 53% of cases; distressing mental contents were reported by 64%. Recall of the episodes was reported in 77% of patients. Non-restorative sleep was reported in 46% of patients. Stress was a potential episode trigger in 80% of patients. VPSG recordings documented 334 DoA episodes. According to our classification of motor patterns, 282 episodes (84%) were Simple Arousal Movements (SAMs), 34 (10%) Rapid Arousal Movements (RAMs) and 18 (5%) Complex Arousal Movements (CAMs). Discussion: Our study confirms that DoA in adulthood present with distinctive characteristics, such as non-restorative sleep, violence and complex, or bizarre behaviors. Alternative classifications of DoA based on motor patterns could be useful to characterize DoA episodes in adults, as different motor patterns often coexist in the same individual and minor episodes are more common but generally underreported by patients. Prospective studies are needed for a definitive characterization of DoA in adulthood throughout the life course.
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Affiliation(s)
- Tommaso Baldini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Loddo
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Elisa Sessagesimi
- Radiology Unit, Experimental, Diagnostic and Specialty Medicine, University Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Francesco Mignani
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Fabio Cirignotta
- Unit of Neurology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Susanna Mondini
- Unit of Neurology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Laura Licchetta
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Francesca Bisulli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Paolo Tinuper
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Federica Provini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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17
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Xue Z, Lin Y, Jiang Y, Wei N, Bi J. The evaluation of nocturia in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia and the analysis of the curative effect after medical or placebo therapy for nocturia: a randomized placebo-controlled study. BMC Urol 2018; 18:115. [PMID: 30545338 PMCID: PMC6293598 DOI: 10.1186/s12894-018-0426-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/26/2018] [Indexed: 11/22/2022] Open
Abstract
Background To study nocturia in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) after medical or placebo treatment. Methods Patients with LUTS suggestive of BPH from several community clinics were included. Patients completed the International Prostate Symptom Score (I-PSS) questionnaire and a 3-day voiding diary. Urinalysis, prostate-specific antigen (PSA) measurement, and prostate ultrasonography were performed. Nocturnal polyuria (NP) was defined as a nocturnal urine fraction exceeding one third of the daily urine output in elderly men. A total of 148 outpatients were randomized to drug treatment (tamsulosin) or placebo treatment. After 8 weeks of treatment, they were re-evaluated using a 3-day voiding diary, PSA measurement, prostate volume (PV), I-PSS, etc. Results The average I-PSS score was 20.3, storage symptom score was 11.7, voiding symptom score was 8.6, quality of life (QoL) score was 3.7, PV was 40.4 ± 19.4 ml, and nocturnal urine volume (NUV) was 845.7 ± 339.0 ml. The mean frequency of nocturia was 2.3 ± 1.1 per day, and 94% of the patients had a nocturia frequency of more than two times per day. Of these patients, 76.5% had NP. A significant correlation was found between NUV and the amount of water intake at night and 4 h before sleep (r = 0.419,P = 0.002; r = 0.302,P = 0.031). Eighty patients were randomized to drug treatment (tamsulosin) and 68 patients were randomized to placebo treatment. The I-PSS score was 16.8 ± 4.9 to 19.3 ± 5.0 (p = 0.002), the storage symptom score was 10.3 ± 3.4 to 10.7 ± 3.4 (p = 0.007), and the voiding symptom score was 7.5 ± 2.4 to 8.6 ± 2.3 (p = 0.003). The frequency of daytime urination was 7.5 ± 2.6 to 8.1 ± 2.6 (p = 0.002), maximum urine volume (ml) was 372.8 ± 103.3 to 302.8 ± 119.3 (p = 0.007), and morning urine volume (ml) was 280.5 ± 111.7 to 259.5 ± 100.7 (p = 0.003). However, the frequency of nocturia score was 2.8 ± 0.7 to 3.0 ± 0.6 (p = 0.306) and the nocturnal urine volume (ml) was 800.7 ± 323.0 to 845.7 ± 303.5 (p = 0.056), which did not change significantly. There were significant differences between the NP and non-NP groups in the duration of LUTS, first voided urine volume, daytime urination frequency, and the amount of water intake at night and 4 h before sleep. Conclusions Among the symptoms of LUTS, the improvement rates for nocturia were the lowest after medical treatment for BPH. The α-blockers did not improve nocturia, which was a common symptom accompanying LUTS suggestive of BPH. Our results showed that the prevalence of NP was 76.5% and that NP was significantly related to the amount of water intake during the evening and before sleep. Trial registration ISRCTN registry, Trial registration number (TRN): ISRCTN85509614, Date of registration: 30/10/2018. This trial was registered retrospectively.
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Affiliation(s)
- Zhigang Xue
- Department of Urology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.,Department of Urology, Beijing Huairou Hospital, Beijing, 101400, China
| | - Yunhua Lin
- Department of Urology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Yongguang Jiang
- Department of Urology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
| | - Nengbao Wei
- Department of Urology, Beijing Huairou Hospital, Beijing, 101400, China
| | - Jinwen Bi
- Department of Urology, Beijing Huairou Hospital, Beijing, 101400, China
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18
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The Effect of Aromatherapy on Sleep Quality of Elderly People Residing in a Nursing Home. Holist Nurs Pract 2018; 32:8-16. [DOI: 10.1097/hnp.0000000000000244] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Gadie A, Shafto M, Leng Y, Kievit RA. How are age-related differences in sleep quality associated with health outcomes? An epidemiological investigation in a UK cohort of 2406 adults. BMJ Open 2017; 7:e014920. [PMID: 28760786 PMCID: PMC5642766 DOI: 10.1136/bmjopen-2016-014920] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To examine age-related differences in self-reported sleep quality and their associations with health outcomes across four domains: physical health, cognitive health, mental health and neural health. SETTING Cambridge Centre for Ageing and Neuroscience (Cam-CAN) is a cohort study in East Anglia/England, which collected self-reported health and lifestyle questions as well as a range of objective measures from healthy adults. PARTICIPANTS 2406 healthy adults (age 18-98) answered questions about their sleep quality (Pittsburgh Sleep Quality Index (PSQI)) and measures of physical, cognitive, mental and neural health. A subset of 641 individuals provided measures of brain structure. MAIN OUTCOME MEASURES PSQI scores of sleep and scores across tests within the four domains of health. Latent class analysis (LCA) is used to identify sleep types across the lifespan. Bayesian regressions quantify the presence, and absence, of relationships between sleep quality and health measures. RESULTS Better self-reported sleep is generally associated with better health outcomes, strongly so for mental health, moderately for cognitive and physical health, but not for sleep quality and neural health. LCA identified four sleep types: 'good sleepers' (68.1%, most frequent in middle age), 'inefficient sleepers' (14.01%, most frequent in old age), 'delayed sleepers' (9.28%, most frequent in young adults) and 'poor sleepers' (8.5%, most frequent in old age). There is little evidence for interactions between sleep quality and age on health outcomes. Finally, we observe U-shaped associations between sleep duration and mental health (depression and anxiety) as well as self-reported general health, such that both short and long sleep were associated with poorer outcomes. CONCLUSIONS Lifespan changes in sleep quality are multifaceted and not captured well by summary measures, but instead should be viewed as as partially independent symptoms that vary in prevalence across the lifespan. Better self-reported sleep is associated with better health outcomes, and the strength of these associations differs across health domains. Notably, we do not observe associations between self-reported sleep quality and white matter.
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Affiliation(s)
- Andrew Gadie
- MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Meredith Shafto
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Yue Leng
- Department of Psychiatry, University of California, San Francisco, California, USA
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20
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Sleep-Promoting Effects and Possible Mechanisms of Action Associated with a Standardized Rice Bran Supplement. Nutrients 2017; 9:nu9050512. [PMID: 28524102 PMCID: PMC5452242 DOI: 10.3390/nu9050512] [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: 04/14/2017] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 12/13/2022] Open
Abstract
Natural sleep aids are becoming more popular due to the widespread occurrence of sleep disorders. The objective of this study was to assess the sleep-promoting effects of rice bran—a product that is considered as a functional ingredient. To evaluate the sleep-promoting effects of a standardized rice bran supplement (RBS), we employed a pentobarbital-induced sleep test and conducted analyses of sleep architecture. In addition, the effect of RBS on a caffeine-induced sleep disturbance was investigated. Oral administration of RBS (500 and 1000 mg/kg) produced a significant decrease in sleep latency and increase in sleep duration in pentobarbital-induced sleep in mice. Moreover, both RBS (1000 mg/kg) and doxepin hydrochloride (histamine H1 receptor antagonist, 30 mg/kg) counteracted a caffeine-induced sleep disturbance in mice. In terms of sleep phases, RBS (500 mg/kg) promoted non-rapid eye movement sleep for the first 3 h following its administration. Lastly, we unveiled a possible mechanism for RBS action as the hypnotic effect of RBS was blocked by a histamine H1 receptor agonist. The present study revealed sleep-promoting effects of RBS using various animal assays. Such effects seem to be mediated through the histaminergic system. Our findings suggest that RBS may be a promising natural aid for relieving sleep problems.
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21
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Kim J, Lee J, Shin M. Sleep stage classification based on noise-reduced fractal property of heart rate variability. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.procs.2017.10.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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22
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Mendoza-Meléndez M, Jimenez-Correa U, Gallegos-Cari A, Ayala-Guerrero F, Jiménez-Anguiano A. Prevalence of sleep disorders, daytime sleepiness and clinical symptomatology in older adults. REVISTA MÉDICA DEL HOSPITAL GENERAL DE MÉXICO 2016. [DOI: 10.1016/j.hgmx.2016.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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23
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Oelke M, Adler E, Marschall-Kehrel D, Herrmann TRW, Berges R. Nocturia: state of the art and critical analysis of current assessment and treatment strategies. World J Urol 2015; 32:1109-17. [PMID: 25216925 DOI: 10.1007/s00345-014-1396-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This editorial of the topic issue of the World Journal of Urology provides a state of the art on nocturia which includes descriptions of the terminology, epidemiology, health-related quality of life, medical and financial consequences, pathophysiology, assessment tools and treatment strategies of nocturia. This summary also includes a flowchart on the pathophysiology of nocturia with illustration of the various causes of reduced bladder capacity, increased fluid intake or increased diuresis; a flowchart with the key findings of frequency-volume charts to determine the underlying pathophysiology; and a flowchart on the treatment of the various causes of nocturia. The editorial critically discusses current assessment and treatment strategies in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) and nocturia. The outcome of nocturia remains hidden in drug trials of patients with LUTS/BPH because nocturia-specific measures were not included. The authors recommend using frequency-volume charts, measurement of the hours of undisturbed sleep, and nocturia-specific quality of life questionnaires (e.g., ICIQ-N or N-Qol) in all future studies in patients with LUTS/BPH and nocturia.
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Affiliation(s)
- Matthias Oelke
- Department of Urology, OE 6240, Hannover Medical School, 30625, Hannover, Germany,
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Aktaruzzaman M, Migliorini M, Tenhunen M, Himanen SL, Bianchi AM, Sassi R. The addition of entropy-based regularity parameters improves sleep stage classification based on heart rate variability. Med Biol Eng Comput 2015; 53:415-25. [DOI: 10.1007/s11517-015-1249-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 02/02/2015] [Indexed: 11/29/2022]
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25
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Marklund H, Spångberg A, Edéll-Gustafsson U. Sleep and partner-specific quality of life in partners of men with lower urinary tract symptoms compared with partners of men from the general population. Scand J Urol 2014; 49:321-8. [PMID: 25515951 DOI: 10.3109/21681805.2014.990052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aims of this study were to examine differences between partners of men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO) and partners of men from the population regarding sleep and two aspects of quality of life, partner-specific quality of life and health-related quality of life (HRQoL), and to identify factors related to the partner-specific quality of life and the parameter sleep efficiency. MATERIALS AND METHODS The design was descriptive and comparative. The subjects were partners of men with LUTS suggestive of BPO (n = 126) and partners of randomly selected men from the general population (n = 131). Self-administered questionnaires about demography, comorbidity, sleep, sexuality, partner-specific quality of life and HRQoL were used. RESULTS Partners of men with LUTS suggestive of BPO were significantly more affected in all variables measuring partner-specific quality of life compared with partners from the population. The most impaired aspects were compassion and worry about an operation or cancer. In logistic regression, the only explanatory factors were having a partner belonging to the LUTS group for impaired partner-specific quality of life and having a bed partner for high sleep efficiency. There were no significant differences between the two groups regarding the quantity and quality of sleep or the HRQoL. CONCLUSIONS The partner-specific quality of life was impaired in partners of men with LUTS suggestive of BPO. Sleep and HRQoL did not differ between partners of men with LUTS and partners from the population.
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Affiliation(s)
- Helén Marklund
- Department of Social and Welfare Studies, Division HAV, Health, Activity, Care, Faculty of Health Sciences
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26
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Moccellin AS, Rett MT, Driusso P. Incontinência urinária na gestação: implicações na qualidade de vida. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2014. [DOI: 10.1590/s1519-38292014000200004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivos: comparar a qualidade de vida de gestantes com e sem perda urinaria, identificando os principais fatores que interferem negativamente na qualidade de vida durante essa fase de vida da mulher. Métodos: foram incluídas 15 gestantes com queixa de perda urinaria e presença de sintomas miccionais e 25 gestantes sem queixa miccional, avaliadas em dois momentos, na 24-28" e 34-36" semana gestacional. As avaliações consistiram na aplicação de dois questionários de qualidade de vida (King Health Questionnaire e o World Health Organization Quality of Life). Os dados foram tabulados no Excel e analisados estatisticamente no programa Statistica. Adotou-se um nível de significância de 5%. Resultados: as gestantes sem sintomas miccionais apresentaram melhor qualidade de vida em relação àquelas com sintomas miccionais nos domínios físico, social e ambiental. Para as gestantes com sintomas miccionais ocorreu piora dos escores dos domínios percepção geral de saúde e impacto da incontinência entre a 1" e 2" avaliação. Conclusões: a perda urinária reduz a qualidade de vida das gestantes. Outros fatores como o suporte social e emoções também podem ter impactos negativos na qualidade de vida durante a gestação.
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Yokoyama O, Hiro S, Hotta S, Mogami S, Yamagami H. Efficacy of Fesoterodine on Nocturia and Quality of Sleep in Asian Patients With Overactive Bladder. Urology 2014; 83:750-5. [DOI: 10.1016/j.urology.2013.12.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 11/13/2013] [Accepted: 12/03/2013] [Indexed: 11/30/2022]
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Şenol V, Soyuer F, Argün M. Quality of life of elderly nursing home residents and its correlates in Kayseri. A descriptive-analytical design: A cross-sectional study. Health (London) 2013. [DOI: 10.4236/health.2013.52029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Osman NI, Chapple CR, Wein AJ. Nocturia: current concepts and future perspectives. Acta Physiol (Oxf) 2013; 207:53-65. [PMID: 23033860 DOI: 10.1111/apha.12013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 03/26/2012] [Accepted: 09/10/2012] [Indexed: 01/16/2023]
Abstract
Nocturia is a prevalent highly bothersome urinary symptom that may significantly detriment the health and well-being of sufferers. It is characterized by waking at night to void, each void preceded and followed by sleep, hence leading to fragmentation of sleep and day-time tiredness. This may result in reduced productivity in the workplace, which contributes to the significant burden to the wider society that nocturia incurs. Nocturia was traditionally viewed as one of the many urinary tract symptoms that occur due to lower urinary tract dysfunction. However, recently it has been recognized that due to its multi-factorial aetio-pathogenesis, nocturia should be viewed as distinct clinical condition in its own right. Careful assessment of the nocturic patient is essential so that treatment strategies are guided by the likely causes. Much research is currently being undertaken into the underlying causes and the optimal management approaches. This review will explore the contemporary status of research on nocturia with a focus on the current and newly available pharmacotherapies.
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Affiliation(s)
- N. I. Osman
- Department of Urology; Sheffield Teaching Hospitals NHS Foundation Trust; Royal Hallamshire Hospital; Sheffield; UK
| | - C. R. Chapple
- Department of Urology; Sheffield Teaching Hospitals NHS Foundation Trust; Royal Hallamshire Hospital; Sheffield; UK
| | - A. J. Wein
- Division of Urology; University of Pennsylvania School of Medicine; Philadelphia; PA; USA
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Bal K, Ayik S, Issi Y, Bolukbasi A, Akhan G. Sleep analysis of patients with nocturia and benign prostatic obstruction. Urology 2012; 80:383-8. [PMID: 22698463 DOI: 10.1016/j.urology.2011.12.067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Revised: 12/15/2011] [Accepted: 12/22/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To analyze the timing of nocturia during sleep and its effect on sleep quality using the polysomnography (PSG) findings from patients with benign prostatic obstruction. METHODS From August 2009 to August 2010, 20 patients diagnosed with benign prostatic obstruction were enrolled in the present study. The sleep evaluation was performed by PSG. The Epworth index was used to evaluate the sleepiness of the patients. The effect of nocturia on sleep quality is evaluated by sleep efficacy, total sleep time, and rapid eye movement sleep duration, calculated from the hypnograms derived from the polysomnograms. RESULTS The mean age, total International Prostate Symptom Score, nocturia frequency on International Prostate Symptom Score, and frequency of nocturia recorded during PSG was 60.4 ± 8.5 years (range 44-74), 19.3 ± 4.9 (range 10-28), 3.5 ± 1.05 (range 2-5), and 1.35 ± 1.2 (range 0-4), respectively. In 6 patients (30%), the Epworth sleepiness score was pathologic (score >8). Nocturia correlated positively with increased daytime sleepiness, however it did not correlate with sleep efficacy or total sleep time. These parameters were affected by the apnea-hypopnea index, the major determinant of obstructive sleep apnea. Of the 20 patients, 14 (70%) experienced nocturia during PSG, and in these patients, we recorded 23 nocturia episodes that mostly occurred in the superficial sleep stage (16 [70%] of 23). Only 7 nocturia episodes (30%) occurred in the deep sleep stage. The sleep quality of patients with deep sleep nocturia did not differ from that of patients with superficial sleep nocturia. CONCLUSION The results of our study have shown that nocturia predominantly occurs during the superficial sleep or rapid eye movement stage and is related to increased daytime sleepiness in patients with benign prostatic obstruction. The timing and frequency of nocturia had no significant affect on sleep quality; however, the presence of obstructive sleep apnea negatively interfered with these parameters.
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Affiliation(s)
- Kaan Bal
- Department of Urology, Izmir Ataturk Research and Training Hospital, Izmir, Turkey.
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Tacchino G, Mariani S, Migliorini M, Bianchi AM. Optimization of time-variant autoregressive models for tracking REM-non REM transitions during sleep. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2012:2236-2239. [PMID: 23366368 DOI: 10.1109/embc.2012.6346407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The aim of this study was the optimization of Time-Variant Autoregressive Models (TVAM) for tracking REM-non REM transitions during sleep, through the analysis of spectral indexes extracted from tachograms. A first improvement of TVAM was achieved by choosing the best typology of forgetting factor in the analysis of a tachogram obtained during a sitting-to-standing test; then, a method for improving robustness of AR recursive identification with respect to outliers was selected by analyzing a tachogram with an ectopic beat. A variable forgetting factor according to the Fortescue method and a specific condition on the prediction error for recursive AR identification gave the best performances. The optimized TVAM was then employed in the analysis of tachograms derived from ECGs recorded during a whole night, through a sensorized T-shirt, from 9 healthy subjects. The spectral indexes (power of tachogram in the LF and HF bands, LF/HF ratio and the absolute value of the spectrum pole in the HF band) were computed from the estimated AR parameters on a beat-to-beat basis. A two groups T-test aimed at comparing values assumed by each spectral index in REM and non-REM sleep epochs was performed. Significant statistical differences (p-value < 0.05) were found in three of the four spectral indexes computed. In conclusion, the combination of the Fortescue variant and of the robustness method based on the prediction error in the TVAM seems to be helpful in the differentiation between REM and non-REM sleep stages.
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Affiliation(s)
- Giulia Tacchino
- Politecnico di Milano, Dept. of Biomedical Engineering, Milan, Italy.
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Weiss JP, Wein AJ, van Kerrebroeck P, Dmochowski R, Fitzgerald M, Tikkinen KAO, Abrams P. Nocturia: new directions. Neurourol Urodyn 2011; 30:700-3. [PMID: 21661016 DOI: 10.1002/nau.21125] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Nocturia Think Tank (TT) met during the 2010 meeting of the International Consultation on Incontinence-Research Society to discuss present knowledge and future directions in care and research of this prominent component of the spectrum of lower urinary tract symptoms. Questions raised included whether nocturia should be re-defined as a function of its bother, effects on quality of life, and economic impact upon society. At issue is the need to delineate the determinants of successful nocturia management. The multifactorial nature of nocturia requires that progress in its treatment will be dependent upon the cooperative investigation on the part of urologists, urogynecologists, geriatricians, epidemiologists, medical economists and pharma. Areas for future avenues of research were outlined at the conclusion of the meeting.
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Lojanapiwat B, Permpongkosol S. The efficacy and safety of oral Tamsulosin controlled absorption system (OCAS) for the treatment of lower urinary tract symptoms due to bladder outlet obstruction associated with benign prostatic hyperplasia: an open-label preliminary study. Int Braz J Urol 2011; 37:468-76. [DOI: 10.1590/s1677-55382011000400005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2010] [Indexed: 11/21/2022] Open
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Weiss JP, Blaivas JG, Bliwise DL, Dmochowski RR, Dubeau CE, Lowe FC, Petrou SP, Van Kerrebroeck PEV, Rosen RC, Wein AJ. The evaluation and treatment of nocturia: a consensus statement. BJU Int 2011; 108:6-21. [PMID: 21676145 DOI: 10.1111/j.1464-410x.2011.10175.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Jeffrey P Weiss
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, NY, USA.
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Udo Y, Nakao M, Honjo H, Ukimura O, Kawauchi A, Kitakoji H, Miki T. Analysis of nocturia with 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration: concept for effective treatment modality. BJU Int 2010; 107:791-798. [DOI: 10.1111/j.1464-410x.2010.09581.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Marklund H, Spångberg A, Edéll-Gustafsson U. Sleep and health-related quality of life in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction compared to the general population and patients with inguinal hernia. ACTA ACUST UNITED AC 2010; 44:304-14. [DOI: 10.3109/00365599.2010.488246] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Helén Marklund
- Department of Clinical and Experimental Medicine, University Hospital, Linköping, Sweden
- Department of Medicine and Health, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Anders Spångberg
- Department of Clinical and Experimental Medicine, University Hospital, Linköping, Sweden
| | - Ulla Edéll-Gustafsson
- Department of Medicine and Health, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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Multinomial logistic estimation of Markov-chain models for modeling sleep architecture in primary insomnia patients. J Pharmacokinet Pharmacodyn 2010; 37:137-55. [PMID: 20052524 DOI: 10.1007/s10928-009-9148-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Accepted: 12/16/2009] [Indexed: 10/20/2022]
Abstract
Hypnotic drug development calls for a better understanding of sleep physiology in order to improve and differentiate novel medicines for the treatment of sleep disorders. On this basis, a proper evaluation of polysomnographic data collected in clinical trials conducted to explore clinical efficacy of novel hypnotic compounds should include the assessment of sleep architecture and its drug-induced changes. This work presents a non-linear mixed-effect Markov-chain model based on multinomial logistic functions which characterize the time course of transition probabilities between sleep stages in insomniac patients treated with placebo. Polysomnography measurements were obtained from patients during one night treatment. A population approach was used to describe the time course of sleep stages (awake stage, stage 1, stage 2, slow-wave sleep and REM sleep) using a Markov-chain model. The relationship between time and individual transition probabilities between sleep stages was modelled through piecewise linear multinomial logistic functions. The identification of the model produced a good adherence of mean post-hoc estimates to the observed transition frequencies. Parameters were generally well estimated in terms of CV, shrinkage and distribution of empirical Bayes estimates around the typical values. The posterior predictive check analysis showed good consistency between model-predicted and observed sleep parameters. In conclusion, the Markov-chain model based on multinomial logistic functions provided an accurate description of the time course of sleep stages together with an assessment of the probabilities of transition between different stages.
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Malakouti SK, Foroughan M, Nojomi M, Ghalebandi MF, Zandi T. Sleep patterns, sleep disturbances and sleepiness in retired Iranian elders. Int J Geriatr Psychiatry 2009; 24:1201-8. [PMID: 19343736 DOI: 10.1002/gps.2246] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Complaints of sleep disturbance increase with age and many studies have reported on the relationship of sleep problems to the greater use of health services, physical and mental morbidity, functional decline, and all causes of mortality. This study aimed to examine sleep patterns and sleep disturbances in Iranian elders and correlate their sleep quality to their health status. METHODS Four hundred men and women, aged 60 years or older, were interviewed by trained interviewers regarding their physical and mental health status. The Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale (ESS), and a General Health Questionnaire (GHQ) were then administered to each participant. The data gathered were analyzed using chi(2)-test, t-test, and one-way analysis of variance and logistic regression. RESULTS The results indicated that the majority of participants (82.6%) suffered from poor sleep quality and approximately one-third (29.2%) experienced sleepiness during the daytime. Difficulty falling asleep (p < or = 0.001) and maintaining sleep (p < or = 0.01) and the feeling of being too hot at night (p < or = 0.005) were significantly more prevalent in women, but men suffered more from leg twitching (p < or = 0.01). Being female (OR = 2.52), and having GHQ scores of more than 11 (OR = 4.14) increased the risk of poor sleep quality considerably. CONCLUSION Promoting sleep hygiene education of elders in primary health care services are recommended.
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Affiliation(s)
- Seyed Kazem Malakouti
- Department of Psychiatry, Mental Health Research Centre, Iran University of Medical Sciences, Tehran, Iran.
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Bing MH, Moller LA, Jennum P, Mortensen S, Lose G. Pathophysiological Aspects of Nocturia in a Danish Population of Men and Women Age 60 to 80 Years. J Urol 2007; 178:552-7. [PMID: 17570415 DOI: 10.1016/j.juro.2007.03.141] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2006] [Indexed: 11/22/2022]
Abstract
PURPOSE We applied the International Continence Society Guidelines and categorized men and women with nocturia 2 or more times a night in pathophysiological groups based on selected lower urinary tract symptoms, clinical examination, frequency volume charts and urodynamics, and categorized the most likely pathophysiological causes of nocturia. MATERIALS AND METHODS Participants were randomly selected among respondents in a population study of 4,000 individuals 60 to 80 years old living in Copenhagen County. Nocturia was assessed using the new and validated Nocturia, Nocturnal Enuresis, and Sleep-interruption Questionnaire. Nocturic (2 or more voids) or control (less than 1 void) status was assessed by a 3-day frequency volume chart. Participants were interviewed regarding lower urinary tract symptoms, and physical examination was performed. Nocturia pathophysiology was divided in 4 groups according to frequency volume chart variables, that is nocturnal polyuria, low bladder capacity, nocturnal polyuria and low bladder capacity in combination, and polyuria. Spontaneous flow rate and post-void residual urine were determined, and invasive urodynamic examination was performed in patients. RESULTS Of 1,111 eligible individuals 75 patients and 75 controls were included. More patients vs controls had daytime frequency, urgency and urge incontinence. However, the difference was not significant in men. Nocturnal polyuria was the only pathophysiological finding that differed significantly in prevalence between patients and controls. The most prevalent urodynamic finding in patients was detrusor overactivity incontinence (26%) in women and detrusor overactivity (64%) in men. CONCLUSIONS Urgency in women, and symptoms suggestive of bladder outlet obstruction in men were the major complaints. Frequency volume charts demonstrated that 55% of patients had nocturnal polyuria which was significantly more than controls. From frequency volume chart variables alone we could categorize 84% of the patients. When symptoms and urodynamic examination were added to the assessment, the most likely cause of nocturia was categorized in 96% of participants.
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Affiliation(s)
- M H Bing
- Department of Obstetrics and Gynecology, Glostrup County Hospital, University of Copenhagen, Glostrup, Denmark.
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CHARTIER-KASTLER EMMANUEL, CHAPPLE CHRISTOPHERR. LUTS/BPH in clinical practice: the importance of nocturia and quality of sleep. BJU Int 2006. [DOI: 10.1111/j.1464-410x.2006.06493.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chapple CR, Batista JE, Berges R, Chartier-Kastler E, Tubaro A, Van Kerrebroeck P, Stoevelaar H. The Impact of Nocturia in Patients with LUTS/BPH: Need for New Recommendations. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.eursup.2005.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chartier-Kastler E, Tubaro A. The Measurement of Nocturia and Its Impact on Quality of Sleep and Quality of Life in LUTS/BPH. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.eursup.2005.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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The Impact of Tamsulosin Oral Controlled Absorption System (OCAS) on Nocturia and the Quality of Sleep: Preliminary Results of a Pilot Study. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.eursup.2004.12.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abrams P. Nocturia: the major problem in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO). ACTA ACUST UNITED AC 2005. [DOI: 10.1016/s1569-9056(05)80002-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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