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Piekarski D, Sullivan EV, Pfefferbaum A, Zahr NM. Poor subjective sleep predicts compromised quality of life but not cognitive impairment in abstinent individuals with Alcohol Use Disorder. Alcohol 2022; 103:37-43. [PMID: 35870739 DOI: 10.1016/j.alcohol.2022.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 11/01/2022]
Abstract
How disrupted sleep contributes to cognitive dysfunction over the dynamic course of Alcohol Use Disorder (AUD) is an emerging topic of investigation. Here, the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate subjective sleep in 90 individuals with AUD sober for an average of 3 months and in 50 healthy controls. Relative to controls, AUD individuals had higher global PSQI scores (worse sleep), higher scores on the Beck Depression Inventory (BDI), worse Quality of Life (QoL) indicators, and poorer performance on cognitive composite tests (executive functioning, attention and working memory, visual and verbal learning or memory). Among AUD individuals, a higher PSQI score correlated with a higher BDI scores and worse QoL, but not with cognitive scales. Also noted in the AUD group were higher global PSQI scores in individuals also diagnosed with major depressive (MDD) or generalized anxiety (GAD) disorders. Together, the 4 variables explained 29.8% of the variance in AUD PSQI scores. In women with AUD, the 4 factors explained 39.3% of the variance in PSQI scores; in AUD men, the 4 measures explained 19.9% of the variance: MDD was salient in women, QoL in men with AUD suggesting differential factors associate with poor sleep in men and women with AUD even with sustained alcohol abstinence. Here, global PSQI scores were related to clinical diagnoses and life functioning but failed to predict cognitive performance in abstinent AUD individuals.
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Affiliation(s)
- David Piekarski
- Neuroscience Program SRI International 333 Ravenswood Ave. Menlo Park, CA 94025
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine 401 Quarry Rd. Stanford, CA 94305
| | - Adolf Pfefferbaum
- Neuroscience Program SRI International 333 Ravenswood Ave. Menlo Park, CA 94025
| | - Natalie M Zahr
- Neuroscience Program SRI International 333 Ravenswood Ave. Menlo Park, CA 94025; Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine 401 Quarry Rd. Stanford, CA 94305.
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2
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Hu CP, Zhao YH, Zhao XD, Zhu BG, Qin HY. Correlation between sleep characteristics and cognitive decline in the elderly people: A cross-sectional study in China. Int J Clin Pract 2021; 75:e14225. [PMID: 33871134 DOI: 10.1111/ijcp.14225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 03/29/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022] Open
Abstract
STUDY OBJECTIVES In this study, we conducted a cross-sectional analysis of the sleep characteristics in the elderly Chinese people to comprehensively investigate the association between sleep and cognitive function in the elderly people. We aimed to evaluate the most important demographic factors, conventional physiological indices and living habits that may influence sleep. METHODS We surveyed 2901 elderly people (age ≥60 years old) face-to-face from 1 July to 31 December 2017, who were recruited from 17 communities of the Pudong New Area (Shanghai, China) by probability proportional to size. The Pittsburgh sleep quality index (PSQI) scale was used to describe the sleep features of each participant. Cognitive assessment was performed using the mini-mental state examination (MMSE) scale, Montreal cognitive assessment (MoCA) and the clinical dementia rating (CDR) scale. Those factors which potentially influence sleep and consequentially may impact cognition in the elderly people were evaluated, and the correlations of sleep characteristics and cognitive function were explored by the linear regression analysis. RESULTS Altogether, there were 1287 (44.4%) people taking part in the investigation. Sleep quality was significantly correlated with MMSE and MoCA total scores. Healthy sleep (especially enough sleep) was correlated with better cognitive functions. Besides recognised relative factors (such as age, sex and living alone), the number of children was found to be a strong risk factor of poor sleep. Anxiety before sleep and light/noise interference significantly damaged sleep while an exercise routine was associated with better sleep. Moderate levels of reading, watching TV and household work were correlated with superior sleep quality. CONCLUSION In conclusion, sleep characteristics correlate with cognitive decline in the elderly people, and they can be influenced by multiple demographic factors and living habits. To improve sleep quality, it may be important to change sleep environment, to be relax, to increase physical exercise and recreational activities moderately.
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Affiliation(s)
- Cheng-Ping Hu
- Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Yun-Han Zhao
- Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Xu-Dong Zhao
- Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Bing-Gen Zhu
- Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Hong-Yun Qin
- Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
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3
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Lu L, Wang SB, Rao W, Zhang Q, Ungvari GS, Ng CH, Kou C, Jia FJ, Xiang YT. The Prevalence of Sleep Disturbances and Sleep Quality in Older Chinese Adults: A Comprehensive Meta-Analysis. Behav Sleep Med 2019; 17:683-697. [PMID: 29851516 DOI: 10.1080/15402002.2018.1469492] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: This is a meta-analysis of the pooled prevalence of insomnia-specific sleep disturbances (sleep disturbances thereafter) and sleep quality in older Chinese adults. Method: Both English (PubMed, Embase and PsycINFO) and Chinese (Chinese National Knowledge Infrastructure [CNKI], WanFang and SinoMed) databases were systematically searched. Data extraction and quality assessment were independently performed by two investigators. Random-effects model was performed to pool the prevalence of sleep disturbances and sleep quality. Subgroup and meta-regression analyses were performed to explore the source of heterogeneity. Funnel plots, Egger's regression model, and Begg's test were used to assess publication bias. Results: A total of 47 studies were included. The pooled prevalence of sleep disturbances was 35.9% (95% CI: 30.6%-41.2%). Older adults in rural areas had higher prevalence of sleep disturbances than their counterparts in urban areas. Sleep quality was measured by the Pittsburgh Sleep Quality Assessment (PSQI) in all studies with available data. In the 27 studies with available data, the pooled mean PSQI total score was 6.64 (95% CI: 6.14-7.13). There was no significant difference between genders and between rural and urban areas. Compared to men, women had higher mean scores in sleep latency (Q = 23.62, p < 0.001), sleep efficiency (Q = 12.08, p = 0.001), and use of sleep-promoting medications (Q = 4.07, p = 0.044). Conclusion: Sleep disturbances are common in older Chinese adults, particularly in older women.
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Affiliation(s)
- Li Lu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau , Macao SAR , China
| | - Shi-Bin Wang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau , Macao SAR , China.,Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences , Guangzhou, China
| | - Wenwang Rao
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau , Macao SAR , China.,Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun , China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders, China & Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University , Beijing , China
| | - Gabor S Ungvari
- University Notre Dame Australia, Graylands Hospital , Perth , Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne , Melbourne , Australia
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun , China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences , Guangzhou, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau , Macao SAR , China
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Park SY, Oh MK, Lee BS, Kim HG, Lee WJ, Lee JH, Lim JT, Kim JY. The Effects of Alcohol on Quality of Sleep. Korean J Fam Med 2015; 36:294-9. [PMID: 26634095 PMCID: PMC4666864 DOI: 10.4082/kjfm.2015.36.6.294] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 09/24/2015] [Accepted: 09/30/2015] [Indexed: 12/14/2022] Open
Abstract
Background Alcohol is traditionally known to have a relaxing effect. However, persons who consume alcohol in excessive amounts suffer from poor sleep quality and patients with alcohol use disorders commonly report insomnia. In this study, we aimed to evaluate the effects of alcohol use on sleep quality. Methods A questionnaire-based cross-sectional survey was conducted with 234 men and 159 women who had visited a general hospital. We used structured questionnaires, including Alcohol Use Disorder Identification Test-Korean revised version (AUDIT-KR) and the Pittsburgh Sleep Quality Index-Korean version (PSQI-K). We analyzed the association between scores for all subcategories of the PSQI-K and the AUDIT-KR and then analyzed the correlation between AUDIT-KR and global PSQI-K scores. Results The global PSQI-K score for men was positively correlated with the AUDIT-KR score (P=0.008) after adjusting for age, chronic disease, tobacco use, exercise, depression, and anxiety. The AUDIT-KR score was significantly associated with subjective sleep quality (P=0.005), sleep duration (P=0.047), and sleep disturbance (P=0.048); it was not associated with sleep latency, sleep efficiency, or daytime dysfunction. Sleep disturbances due to snoring were significantly associated with total AUDIT-KR score (P=0.008). There was no correlation between the global PSQI-K and AUDIT-KR scores for women (P=0.333). However, daytime dysfunction showed a significant association with total AUDIT-KR score (P=0.048). Conclusion Men with higher AUDIT-KR scores tended to suffer from poor sleep quality. AUDIT-KR scores showed significant correlations with subjective sleep quality, sleep duration, and sleep disturbances in men.
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Affiliation(s)
- Soon-Yeob Park
- Department of Family Medicine, Gangneung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, Korea
| | - Mi-Kyeong Oh
- Department of Family Medicine, Gangneung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, Korea
| | - Bum-Soon Lee
- Department of Family Medicine, Gangneung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, Korea
| | - Haa-Gyoung Kim
- Department of Family Medicine, Gangneung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, Korea
| | - Won-Joon Lee
- Department of Family Medicine, Gangneung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, Korea
| | - Ji-Ho Lee
- Department of Family Medicine, Gangneung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, Korea
| | - Jun-Tae Lim
- Department of Family Medicine, Gangneung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, Korea
| | - Jin-Young Kim
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
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Chen CH, Chang YC, Hsieh YH, Chen YC, Huang YC, Kuo HW. The association between drinking habits and family relationships in 3 villages of indigenous Taiwanese. Asia Pac J Public Health 2015; 27:NP2721-31. [PMID: 22815308 DOI: 10.1177/1010539512452754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although the vast majority of indigenous peoples in Taiwan consume alcohol, little is known about the relationship between alcoholic behavior and family relationships. A total of 471 residents from 3 villages in Alishan township in Taiwan were interviewed using a questionnaire that asked for demographic information and included the Family Function Scale and questions regarding the individual's consumption of alcohol. It was found that 50% of the participants drink alcohol, and 71% of their family members consume alcohol; 47% of the respondents indicated excessive alcohol consumption (ie, were heavy drinkers). When individuals are knowledgeable about alcohol-related health issues, their families generally function better (odds ratio = 2.56; 95% confidence interval = 1.38-4.74; P < .01). Those who were moderate and heavy drinkers were 2.5 and 3.0 times, respectively, more likely to have poor family relationships than those who were light drinkers. It is necessary to promote the reduction of alcohol consumption among indigenous peoples.
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Affiliation(s)
| | | | | | | | | | - Hsien-Wen Kuo
- China Medical University and Yang Ming University, Taipei, Taiwan
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6
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Tang J, Liao Y, He H, Deng Q, Zhang G, Qi C, Cui H, Jiao B, Yang M, Feng Z, Chen X, Hao W, Liu T. Sleeping problems in Chinese illicit drug dependent subjects. BMC Psychiatry 2015; 15:28. [PMID: 25884573 PMCID: PMC4337091 DOI: 10.1186/s12888-015-0409-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 02/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Illicit drug use/dependence has been recognized as a major problem. Clinical studies demonstrate that poor sleep quality is associated with increased frequency of drug use and relapse. However, few studies have addressed the issue of sleep quality among illicit drug dependent subjects. METHODS This cross-sectional study explored sleep quality in drug dependent subjects in China. We studied 2178 illicit drug dependent subjects from drug rehabilitation centres in Changsha and 2236 non-drug-using subjects, all of whom completed the self-report Pittsburgh Sleep Quality Index (PSQI). RESULTS We found that the prevalence of sleep disturbance was much higher in drug users (68.5%, PSQI >5; specifically, 80.24% in heroin users, 54.16% in methamphetamine users and 81.98% in ketamine users with PSQI >5) than non-users (26.4%, PSQI >5). Drug users had approximately twice the sleep latency than nondrug users (37.7 minutes V.S 18.4 minutes). Although drug users and non-users reported similar sleep duration (about 7.4 hours), drug users showed poorer subjective sleep quality and habitual sleep efficiency. They reported more sleep disturbance and need for sleep medications, more daytime dysfunction and poorer subjective sleep quality compared with nondrug users. The total PSQI score positively correlated with the duration of drug use (rp = 0.164, p < 0.001). We also found a link between sleep problems and cigarette smoking, alcohol drinking, and duration of drug use. CONCLUSIONS Poor sleep quality is common among illicit drug dependent subjects. Long-term substance users had more sleep problems. Future research aiming at quantifying the benefits of treatment interventions should not neglect the influence of sleep problems. Gaining more insight into the impact of sleep quality on the addiction treatment could also help to target future intervention measures more effectively.
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Affiliation(s)
- Jinsong Tang
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China.
| | - Yanhui Liao
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China.
| | - Haoyu He
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China.
| | - Qijian Deng
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China.
| | - Guanbai Zhang
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China. .,Yunnan Institute for Drug Abuse, Kunming, Yunnan, China.
| | - Chang Qi
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China.
| | - Hangtao Cui
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China. .,Department of Psychiatry, Hunan Brain Hospital, Changsha, Hunan, China.
| | - Bin Jiao
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China. .,Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China.
| | - Mei Yang
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China. .,School of Public Health, Central South University, Changsha, Hunan, China.
| | - Zhijuan Feng
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China.
| | - Xiaogang Chen
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China.
| | - Wei Hao
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China.
| | - Tieqiao Liu
- Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha, Hunan, 410011, P. R. China. .,National Technology of Institute of Psychiatry, Central South University, Changsha, Hunan, China. .,The State Key Laboratory of Medical Genetics, Central South University, Changsha, Hunan, China.
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Current status of sleep quality in Taiwan: a nationwide walk-in survey. Ann Gen Psychiatry 2015; 14:36. [PMID: 26535047 PMCID: PMC4630925 DOI: 10.1186/s12991-015-0078-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 10/20/2015] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Sleep disorder plays an important role in the overall health care system, because it can be co-morbid with many other physical or mental disorders. In this study, we conducted a screening survey to determine the current status of sleep quality in the general population of Taiwan. METHODS During the period 1 March 2010 to 30 April 2013, we collaborated with the Fo-Guang Shan Compassion Foundation's Mentality Protection Center (MPC) branches to conduct 53 walk-in screenings at the 59 branches distributed throughout Taiwan. We used the Pittsburgh Sleep Quality Index (PSQI) to assess multiple dimensions of sleep over a 1-month period after identifying the participants' age, sex, and residence location. The participants were identified to have poor sleep quality if their PSQI-T total score was greater than five. RESULTS In total, 760 participants, 195 from northern, 289 from central, 228 from southern, and 48 from eastern Taiwan with an average age of 54.2 years (SD 14.7) were recruited. We found that 46.6 % of all participants had poor sleep quality and that there were significantly different proportions among the four areas. Besides, 11.6 % of all participants and 21.8 % of individuals with poor sleep quality had used sedatives/hypnotics to help them fall asleep in the past 4 weeks, and the proportion was highest in the eastern area. CONCLUSIONS This survey suggested that the ratio of poor sleep quality in Taiwan is progressively increasing compared to the previous studies. In addition, there were significantly different proportions of individuals with poor sleep quality and hypnotics' uses among the four areas.
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Hsu YW, Ho CH, Wang JJ, Hsieh KY, Weng SF, Wu MP. Longitudinal trends of the healthcare-seeking prevalence and incidence of insomnia in Taiwan: an 8-year nationally representative study. Sleep Med 2013; 14:843-9. [PMID: 23856295 DOI: 10.1016/j.sleep.2013.02.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 02/05/2013] [Accepted: 02/25/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We used insurance claims of a nationally representative population-based cohort to assess the longitudinal healthcare-seeking prevalence and incidence of insomnia. METHODS Participants were identified from National Health Insurance enrollees in Taiwan during 2002 to 2009. Individuals with insomnia were identified using The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic and procedure codes of 780.52, 307.41, and 307.42. RESULTS In 2009 the prevalence of insomnia was 5.4% for women and 3.0% for men; the incidence of insomnia was 1.6% for women and 1.3% for men. Patients who were women (odds ratio [OR]), 1.82; 95% confidence interval [CI], 1.79-1.86), who were older (50-64 years: OR, 23.25; 95% CI, 21.07-25.64; ≥ 65 years: OR, 24.70; 95% CI, 22.40-27.24), and who were in the middle socioeconomic status (SES) group (OR, 1.19; 95% CI, 1.16-1.21) were more likely to have insomnia. An inverse U-shaped woman-to-man ratio trend for the insomnia prevalence was found, and this ratio reached a peak around the menopausal transitional period. CONCLUSIONS The persistence of healthcare-seeking behaviors with insomnia was more common in women. Our findings underscore the need to initiate treatment at an early stage as opposed to waiting for the spontaneous resolution of insomnia. Future research needs to identify causes of the persistence of insomnia and to develop proper interventions to reduce its rising prevalence. More active approaches toward preventive strategies for insomnia are needed, especially for women who are at higher risk for insomnia.
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Affiliation(s)
- Ya-Wen Hsu
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
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Corte C, Rongmuang D, Farchaus Stein K. Nursing knowledge about alcohol use and alcohol problems in women: a review of the literature. J Am Psychiatr Nurses Assoc 2010; 16:252-61. [PMID: 21659277 PMCID: PMC5002222 DOI: 10.1177/1078390310378042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this article, the authors review the nursing empirical literature on alcohol and women's health published over the past 5 years (2005-2010). A total of 36 data-based articles authored by nurse investigators met eligibility criteria and were included in this review. Most were single studies by individual nurse investigators; few studies reflected ongoing programs of research related to alcohol and women's health. Studies were categorized into four main groups, including (a) determinants of alcohol use and alcohol problems; (b) patterns of use, assessment of alcohol use, and comorbidity; (c) consequences of alcohol use; and (d) the effects of treatment or specific interventions and the contributions of nursing research to the knowledge base of each group are summarized. The authors then propose a research agenda for nursing that addresses the most pressing issues related to alcohol use and alcohol problems in women.
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Affiliation(s)
- Colleen Corte
- University of Illinois at Chicago, Chicago, IL, USA,
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10
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Abstract
SummaryAlcohol use is common in older adults and is associated with numerous health and social problems. Recent evidence suggests that in addition to level of alcohol consumption, drinking pattern may also be important. Moderate alcohol intake may confer some cardiac benefits, while heavy episodic drinking seems particularly problematic. Detecting alcohol misuse in older adults is difficult since clinical acumen is often poor, screening questionnaires have serious limitations and laboratory tests are not diagnostic. Brief alcohol interventions to reduce alcohol consumption appear useful in younger populations, but are less studied in older adults. While there is increasing research into the issue of alcohol use among older adults, clinicians and policy-makers must rely on limited evidence when making clinical decisions.
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Brower KJ, Perron BE. Sleep disturbance as a universal risk factor for relapse in addictions to psychoactive substances. Med Hypotheses 2009; 74:928-33. [PMID: 19910125 DOI: 10.1016/j.mehy.2009.10.020] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Accepted: 10/10/2009] [Indexed: 11/16/2022]
Abstract
Relapse to uncontrolled use of a psychoactive substance is arguably the single most defining characteristic of an addiction. Relapse following addiction treatment is very common with serious consequences to individuals, families, and the public system of care, making predictors of relapse a highly significant area of study. Before the turn of the century, most of the addiction treatment outcome literature focused on psychosocial predictors of relapse. More recently, investigating biological predictors of relapse specifically and treatment outcome broadly has gained momentum. This line of research has linked sleep disturbances to the risk of relapse among persons who are recovering from an alcohol addiction. Given common neurobiological and psychosocial processes in sleep and addictive behaviors, we hypothesize that the link between sleep disturbance and relapse risk observed among alcohol addiction generalizes to all other types of psychoactive substances. This hypothesis has the potential for helping develop more effective and targeted treatment approaches for persons with addiction. As initial support for the hypothesis, this paper reviews evidence on common neurobiological processes among various types of psychoactive substances that suggests sleep is a universal risk factor for relapse. A conceptual framework is also presented to articulate causal mechanisms. The paper concludes with implications for research and practice.
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Affiliation(s)
- Kirk J Brower
- University of Michigan, Department of Psychiatry, SPC 5740, Ann Arbor, MI 48109-2700, USA.
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