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Baran B, Lee EE. Age-Related Changes in Sleep and Its Implications for Cognitive Decline in Aging Persons With Schizophrenia: A Critical Review. Schizophr Bull 2024:sbae059. [PMID: 38713085 DOI: 10.1093/schbul/sbae059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
BACKGROUND AND HYPOTHESIS Cognitive impairment is a core feature of schizophrenia that worsens with aging and interferes with quality of life. Recent work identifies sleep as an actionable target to alleviate cognitive deficits. Cardinal non-rapid eye movement (NREM) sleep oscillations such as sleep spindles and slow oscillations are critical for cognition. People living with schizophrenia (PLWS) and their first-degree relatives have a specific reduction in sleep spindles and an abnormality in their temporal coordination with slow oscillations that predict impaired memory consolidation. While NREM oscillatory activity is reduced in typical aging, it is not known how further disruption in these oscillations contributes to cognitive decline in older PLWS. Another understudied risk factor for cognitive deficits among older PLWS is obstructive sleep apnea (OSA) which may contribute to cognitive decline. STUDY DESIGN We conducted a narrative review to examine the published literature on aging, OSA, and NREM sleep oscillations in PLWS. STUDY RESULTS Spindles are propagated via thalamocortical feedback loops, and this circuitry shows abnormal hyperconnectivity in schizophrenia as revealed by structural and functional MRI studies. While the risk and severity of OSA increase with age, older PLWS are particularly vulnerable to OSA-related cognitive deficits because OSA is often underdiagnosed and undertreated, and OSA adds further damage to the circuitry that generates NREM sleep oscillations. CONCLUSIONS We highlight the critical need to study NREM sleep in older PWLS and propose that identifying and treating OSA in older PLWS will provide an avenue to potentially mitigate and prevent cognitive decline.
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Affiliation(s)
- Bengi Baran
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Ellen E Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Desert-Pacific Mental Illness Research Education and Clinical Center, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
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Johnson CE, Duncan MJ, Murphy MP. Sex and Sleep Disruption as Contributing Factors in Alzheimer's Disease. J Alzheimers Dis 2024; 97:31-74. [PMID: 38007653 PMCID: PMC10842753 DOI: 10.3233/jad-230527] [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] [Indexed: 11/27/2023]
Abstract
Alzheimer's disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
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Affiliation(s)
- Carrie E. Johnson
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
| | - Marilyn J. Duncan
- University of Kentucky, College of Medicine, Department of Neuroscience, Lexington, KY, USA
| | - M. Paul Murphy
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
- University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
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Breheny M, Ross I, Ladyman C, Signal L, Dew K, Gibson R. "It's Just [Complicated] Sleep": Discourses of Sleep and Aging in the Media. THE GERONTOLOGIST 2023; 63:1591-1601. [PMID: 37191628 PMCID: PMC10724049 DOI: 10.1093/geront/gnad058] [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: 01/15/2023] [Indexed: 05/17/2023] Open
Abstract
The media are influential in shaping beliefs and attitudes on aging and health-related behaviors. Sleep is increasingly recognized as a key pillar for healthy aging. However, the role of media representations of sleep is yet to be assessed with regard to discourses of aging. Texts from New Zealand's main free online news source were collated using key words "sleep" together with "aging," "older," "elderly," or "dementia" between 2018 and 2021. Contents of 38 articles were interpreted using critical discourse analysis. Discursive constructions described an inevitable decline of sleep with aging, including impacts of both physiological decline and life stage transitions; sleep's role as both a remedy and risk for ill health and disease; and the simplification of solutions for self-managing sleep juxtaposed alongside recognition of its complexity. The audience of these complex messages is left in the invidious position of both pursuing sleep practices to prevent age-related decline, whilst also being told that sleep degradation is inevitable. This research demonstrates the complexity of media messaging and the fraught options it offers: good sleep as both a reasonable achievement to strive for and as impossibly idealistic. Findings mirror two predominant health identities available to older people, as responsible for resisting aging or as falling into inevitable decline. This reveals additional expectations around appropriate time use and behaviors with aging. More nuanced messaging that goes beyond sleep as a resource for health and waking productivity is recommended. Acknowledging the complexity of sleep, aging, and society could be the starting point of such adaptation.
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Affiliation(s)
- Mary Breheny
- School of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Isabelle Ross
- Sleep/Wake Research Centre, School of Health Sciences, Massey University, Wellington, New Zealand
| | - Clare Ladyman
- Sleep/Wake Research Centre, School of Health Sciences, Massey University, Wellington, New Zealand
| | - Leigh Signal
- Sleep/Wake Research Centre, School of Health Sciences, Massey University, Wellington, New Zealand
| | - Kevin Dew
- School of Social and Cultural Studies, Victoria University of Wellington, Wellington, New Zealand
| | - Rosemary Gibson
- Sleep/Wake Research Centre, School of Health Sciences, Massey University, Wellington, New Zealand
- School of Psychology, Massey University, Palmerston North, New Zealand
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Cámara-Calmaestra R, Martínez-Amat A, Aibar-Almazán A, Hita-Contreras F, De Miguel-Hernando N, Rodríguez-Almagro D, Fábrega-Cuadros R, Achalandabaso-Ochoa A. Falls and Sleep Disorders in Spanish Alzheimer's Disease in Nursing Homes: An Observational Study. Healthcare (Basel) 2023; 11:2852. [PMID: 37957998 PMCID: PMC10649919 DOI: 10.3390/healthcare11212852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/18/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE The main objective of this study was to establish a relationship between the number of falls and sleep problems experienced by patients with Alzheimer's disease. MATERIALS AND METHODS This was a cross-sectional study. A total of 114 Spanish aged people with Alzheimer's disease institutionalized in nursing homes and 80 independent Spanish aged people without neurodegenerative diseases living at home were enrolled in this study and completed in-person interviews and digital questionnaires. RESULTS The mean age was 78.98 ± 8.59 years. Sleep disorders were related to continuous stress (p = 0.001; OR = 4.729) and a high frequency of falls (p = 0.001; OR = 2.145), while predictor variables associated with falls in patients with Alzheimer's disease were continuous medical visits (β = 0.319, p < 0.001), family history of dementia (β = 0.212; p = 0.014), and sleep disorders (β = 0.235; p = 0.007). Second, the analysis showed that moderate physical activity (p = 0.001; OR = 0.147), continuous medical visits (p < 0.001; OR = 0.621), and high level of study (p = 0.011; OR = 0.334) were protective factors against Alzheimer's, while older age (p = 0.035; OR = 1.087), type II Diabetes Mellitus (p = 0.042; OR = 3.973), number of falls (p = 0.021; OR = 1.409), and daily drug intake (p = 0.001; OR = 1.437) were risk factors for Alzheimer's. CONCLUSIONS Sleep disturbances are related to stress and falls in a sample of 114 Spanish AD aged people institutionalized in nursing homes, and the falls they experience are related to ongoing medical visits, a history of dementia, and sleep disturbances. Therefore, a bidirectional relationship was established between falls and sleep disorders in these patients. Moreover, this study showed that a greater frequency of falls and high daily drug intake could constitute novel risk factors for Alzheimer's disease, in addition to already known factors, such as age and type II Diabetes Mellitus, while being physically active and a high level of studies are protective factors against Alzheimer's disease.
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Affiliation(s)
- Rubén Cámara-Calmaestra
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain (R.F.-C.)
| | - Antonio Martínez-Amat
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain (R.F.-C.)
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain (R.F.-C.)
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain (R.F.-C.)
| | - Nerea De Miguel-Hernando
- Department of Surgery, Ophthalmology, Otolaryngology and Physiotherapy, University of Valladolid, 47002 Valladolid, Spain
| | | | - Raquel Fábrega-Cuadros
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain (R.F.-C.)
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Lücke AJ, Wrzus C, Gerstorf D, Kunzmann U, Katzorreck M, Hoppmann C, Schilling OK. Bidirectional Links of Daily Sleep Quality and Duration With Pain and Self-rated Health in Older Adults' Daily Lives. J Gerontol A Biol Sci Med Sci 2023; 78:1887-1896. [PMID: 36124664 DOI: 10.1093/gerona/glac192] [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: 07/04/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sleep and health perceptions, such as self-ratings of pain and health are closely linked. However, the temporal ordering of such associations is not well understood, and it remains unclear whether sleep quality and sleep duration show similar or differential associations with health perceptions. METHODS We used ecological momentary assessment data from 123 young-old (66-69 years, 47% women) and 47 old-old adults (84-90 years, 60% women). Across 7 consecutive days, participants reported their sleep quality and sleep duration each morning and rated their momentary pain and health 6 times per day. We applied dynamic structural equation models to examine bidirectional links of morning reports of sleep quality and duration with daily levels of self-rated pain and health. RESULTS In line with the hypotheses, results showed that when participants reported better sleep quality than what is typical for them, they reported less pain and better self-rated health on the day that followed. Longer sleep duration was not linked with subsequent pain or self-rated health. On days when people rated their health as better than usual, they reported better sleep quality but not longer sleep duration the following night. These associations were not moderated by age, gender, or chronic pain. CONCLUSION Findings suggest that in old age, sleep quality is more relevant for health perceptions than sleep duration. Associations between sleep quality and self-rated health seem to be bidirectional; daily pain was linked to prior but not subsequent sleep quality.
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Affiliation(s)
- Anna J Lücke
- Psychological Institute, Ruprecht Karls University Heidelberg, Heidelberg, Germany
| | - Cornelia Wrzus
- Psychological Institute, Ruprecht Karls University Heidelberg, Heidelberg, Germany
| | - Denis Gerstorf
- Department of Psychology, Humboldt University Berlin, Berlin, Germany
| | - Ute Kunzmann
- Institute of Psychology, University of Leipzig, Leipzig, Germany
| | | | - Christiane Hoppmann
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Oliver K Schilling
- Psychological Institute, Ruprecht Karls University Heidelberg, Heidelberg, Germany
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Delbari A, Ghavidel F, Bidkhori M, Saatchi M, Abolfathi Momtaz Y, Efati S, Hooshmand E. Evaluation of Sleep Quality and Related Factors in Community-Dwelling Adults: Ardakan Cohort Study on Aging (ACSA). J Res Health Sci 2023; 23:e00591. [PMID: 38315906 PMCID: PMC10660504 DOI: 10.34172/jrhs.2023.126] [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: 05/11/2023] [Revised: 06/18/2023] [Accepted: 08/29/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Sleep is a necessary physiological process that affects health. The current study aimed to evaluate sleep quality (SQ) and the related factors in Iranian community-dwelling adults. Study Design: A cross-sectional study. Method: Population-based cross-sectional data from the first wave of the Ardakan cohort study on aging (ACSA) were analyzed. The analytical sample consisted of 5197 community-dwelling adults aged≥50. All data were collected by trained staff. Pittsburgh Sleep Quality Index (PSQI) scores were used to measure SQ. Univariable and multivariable logistic regression were used to identify predictors of SQ. RESULTS The mean age of the participants was 62.22±7.7 years, and 51.8% were female. About threequarters of them (76.36%) were found to have poor SQ (PSQI score≥5). Multivariable logistic regression analysis revealed a relationship between SQ and gender, education, work, and financial level. Furthermore, SQ was found to be associated with self-reported health and physical activity. Regarding comorbidity, SQ had a significant relationship with cardiovascular diseases, musculoskeletal diseases, depression, and anxiety (P<0.05). CONCLUSION The prevalence of poor SQ was high in these community-dwelling adults in Iran. These findings highlight the importance of intervention programs for sleep hygiene education and screening for middle-aged and older adults.
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Affiliation(s)
- Ahmad Delbari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh Ghavidel
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Bidkhori
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Department of Biostatistics and Epidemiology, School of Rehabilitation, University of Social Welfare and Rehabilitation Science, Tehran, Iran
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Yadollah Abolfathi Momtaz
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Sara Efati
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Elham Hooshmand
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Lin CY, Lin KP, Hsueh MC, Liao Y. Associations of accelerometer-measured sedentary behavior and physical activity with sleep in older adults. J Formos Med Assoc 2023:S0929-6646(23)00296-6. [PMID: 37586972 DOI: 10.1016/j.jfma.2023.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/03/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Few studies have examined the non-linear relationships of objectively-measured sedentary behavior and physical activity with insomnia symptoms in older adults. We investigated such relationships of sedentary and physically-active behaviors with total sleep time and nocturnal wakefulness. METHODS We recruited adults aged 60 years and above who have received health check-ups or been to geriatric outpatient services from a hospital setting. Sedentary and physically-active behaviors, total sleep time, and wakefulness time after sleep onset were measured by Actigraphy, and their relationships were estimated using generalized additive models. RESULTS The 157 older adults receiving health-related services slept 7.5 h (20.8 min awake) on average per day. Total sleep time was negatively associated with sedentary and physically-active behaviors. By contrast, a U-shape relationship was found between sedentary behavior and wakefulness time after sleep onset, with a turning point at a daily sedentary time of 10.9 h. CONCLUSION Longer high-intensity physical activity time was related to a shorter wakefulness time after sleep onset. By contrast, daily sedentary time longer than 10.9 h was related to shorter total sleep time but more nocturnal wakefulness time. Future nonpharmacological strategies for sleep improvement should consider the sedentary threshold.
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Affiliation(s)
- Chien-Yu Lin
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Kun-Pei Lin
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Yung Liao
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan; Graduate Institute of Sport, Leisure and Hospitality Management, College of Sports and Recreation, National Taiwan Normal University, Taipei, Taiwan
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8
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Muhammad T, Meher T, Siddiqui LA. Mediation of the association between multi-morbidity and sleep problems by pain and depressive symptoms among older adults: Evidence from the Longitudinal Aging Study in India, wave- 1. PLoS One 2023; 18:e0281500. [PMID: 36758012 PMCID: PMC9910705 DOI: 10.1371/journal.pone.0281500] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND There could be several possible mechanisms on how chronic conditions relate to sleep problems in older persons; for instance, pain and sleep have a strong link and depressive symptoms are similarly associated with sleep problems. The present study explored whether pain and depressive symptoms are mediators in the relationship between multi-morbidity and sleep problems among older adults. METHODS Study utilized data from the Longitudinal Aging Study in India (LASI) with a sample of 31,464 older adults age 60 years and above. Multivariable logistic regression along with mediation analysis using Karlson-Holm-Breen (KHB) method was conducted. RESULTS A proportion of 14.8% of the participants suffered from sleep problems, whereas, 22.5% and 8.7% of older adults had multi-morbidity and had depressive symptoms, respectively. Also, around 10.3% of older adults reported pain and received no medication for the relief of pain, whereas 29.3% of older adults reported pain and received some type of medication for the relief of pain. Older adults with multi-morbidity had higher odds of suffering from sleep problems [adjusted odds ratio (aOR):1.26, confidence interval (CI):1.10-1.45] than those who had no multi-morbidity. Older adults who reported pain but received no medication for the relief of pain [aOR: 1.90, CI: 1.64-2.22] or reported pain and received medication for the relief of pain [aOR: 1.82, CI:1.62-2.04] and those who had depressive symptoms [aOR: 2.21, CI:1.89-2.57%] had higher odds of suffering from sleep problems compared to those who did not report pain and had no depressive symptoms, respectively. Around 11.2% of the association of multi-morbidity with sleep problems was mediated by pain and 4.3% of such association was mediated by depressive symptoms. CONCLUSION Pain and depressive symptoms were found to mediate the association between multi-morbidity and sleep problems; therefore, reducing pain and depressive symptoms may be considered to improve sleep in older multi-morbid patients.
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Affiliation(s)
- T. Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
- * E-mail:
| | - Trupti Meher
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Laeek Ahemad Siddiqui
- Department of Bio-Statistics and Epidemiology, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Zan H, Yildiz A. Local Pattern Transformation-Based convolutional neural network for sleep stage scoring. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Dakhale BJ, Sharma M, Arif M, Asthana K, Bhurane AA, Kothari AG, Rajendra Acharya U. An automatic sleep-scoring system in elderly women with osteoporosis fractures using frequency localized finite orthogonal quadrature Fejer Korovkin kernels. Med Eng Phys 2023; 112:103956. [PMID: 36842776 DOI: 10.1016/j.medengphy.2023.103956] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/04/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023]
Abstract
Healthy sleep signifies a good physical and mental state of the body. However, factors such as inappropriate work schedules, medical complications, and others can make it difficult to get enough sleep, leading to various sleep disorders. The identification of these disorders requires sleep stage classification. Visual evaluation of sleep stages is time intensive, placing a significant strain on sleep experts and prone to human errors. As a result, it is crucial to develop machine learning algorithms to score sleep stages to acquire an accurate diagnosis. Hence, a new methodology for automated sleep stage classification is suggested using machine learning and filtering electroencephalogram (EEG) signals. The national sleep research resource's (NSRR) study of osteoporotic fractures (SOF) dataset comprising 453 subjects' polysomnograph (PSG) data is used in this study. Only two unipolar EEG derivations C4-A1 and C3-A2 are employed individually and jointly in this work. The EEG signals are decomposed into sub-bands using a frequency-localized finite orthogonal quadrature Fejer Korovkin wavelet filter bank. The wavelet-based entropy features are extracted from sub-bands. Subsequently, extracted features are classified using machine learning techniques. Our developed model obtained the highest classification accuracy of 81.3%, using an ensembled bagged trees classifier with a 10-fold cross-validation method and Cohen's Kappa coefficient of 0.72. The proposed model is accurate, dependable, and easy to implement and can be employed as an alternative to a PSG-based system at home with minimal resources. It is also ready to be tested on other EEG data to evaluate the sleep stages of healthy and unhealthy subjects.
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Affiliation(s)
- Bharti Jogi Dakhale
- Department of Electonics and Communication, Indian Institute of Information Technology Nagpur, Maharashtra, India.
| | - Manish Sharma
- Department of Electrical and Computer Science Engineering, Institute of Infrastructure, Technology, Research and Management (IITRAM), Ahmedabad, India.
| | - Mohammad Arif
- Department of Electrical and Computer Science Engineering, Institute of Infrastructure, Technology, Research and Management (IITRAM), Ahmedabad, India.
| | - Kushagra Asthana
- Department of Electrical and Computer Science Engineering, Institute of Infrastructure, Technology, Research and Management (IITRAM), Ahmedabad, India.
| | - Ankit A Bhurane
- Department of Electronics and Communication, Visvesvaraya National Institute of Technology Nagpur, Maharashtra, India.
| | - Ashwin G Kothari
- Department of Electronics and Communication, Visvesvaraya National Institute of Technology Nagpur, Maharashtra, India.
| | - U Rajendra Acharya
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore 639798, Singapore; Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan; Department of Biomedical Engineering, School of Science and Technology, Singapore 639798, Singapore.
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11
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Corbo I, Forte G, Favieri F, Casagrande M. Poor Sleep Quality in Aging: The Association with Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20031661. [PMID: 36767029 PMCID: PMC9914898 DOI: 10.3390/ijerph20031661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 05/13/2023]
Abstract
Sleep disturbances are common in the elderly. A primary sleep disorder can result from the physiological decline of aging; however, secondary sleep problems result from various causes involving physical and mental health. Since little is known about the relationships between sleep quality and mental health in aging, the present study aims to understand how different aspects generally associated with sleep (e.g., psychological and physiological factors, and sleep medication) may predict poor sleep quality in different stages of the lifespan. Therefore, we conducted several analyses (ANOVAs, Pearson correlations, and linear regressions) to test the hypotheses of the study. Accordingly, from a pool of 180 participants (elderly, middle-aged, and young adults), 143 individuals with poor sleep quality were selected. Different predictive patterns in the three groups emerged. Specifically, the use of sleep medication associated with worse sleep conditions is predicted by poor sleep quality in the elderly and by depression in young adults. In contrast, worsening sleep quality is predicted by depression in middle-aged adults. Previous studies focused on the transitions from good to poor sleep quality, while this is the first study to have examined the features of poor sleep quality in aging, highlighting different sleep patterns across the lifespan. This evidence should be considered from a preventive perspective.
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Affiliation(s)
- Ilaria Corbo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
- Correspondence: (I.C.); (M.C.)
| | - Giuseppe Forte
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy
| | - Francesca Favieri
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence: (I.C.); (M.C.)
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Cohen ZL, Eigenberger PM, Sharkey KM, Conroy ML, Wilkins KM. Insomnia and Other Sleep Disorders in Older Adults. Psychiatr Clin North Am 2022; 45:717-734. [PMID: 36396275 DOI: 10.1016/j.psc.2022.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sleep disruption is common in older adults and is associated with many poor health outcomes. It is vital for providers to understand insomnia and other sleep disorders in this population. This article outlines age-related changes in sleep, and medical, psychiatric, environmental, and psychosocial factors that may impact sleep. It addresses the evaluation of sleep symptoms and diagnosis of sleep disorders. It aims to examine the evidence for non-pharmacological and pharmacologic treatment options for insomnia while weighing factors particularly germane to the aging adult..
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Affiliation(s)
- Zachary L Cohen
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, Campus Box #7160, Chapel Hill, NC, 27599, USA.
| | - Paul M Eigenberger
- Yale University School of Medicine, 300 George Street, Suite #901, New Haven, CT, 06511, USA
| | - Katherine M Sharkey
- Department of Medicine, The Warren Alpert Medical School of Brown University, 233 Richmond Street, Suite 242, Providence, RI 02903, USA; Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, 233 Richmond Street, Suite 242, Providence, RI 02903, USA
| | - Michelle L Conroy
- Yale University School of Medicine, 300 George Street, Suite #901, New Haven, CT, 06511, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Kirsten M Wilkins
- Yale University School of Medicine, 300 George Street, Suite #901, New Haven, CT, 06511, USA; VA Connecticut Healthcare System, West Haven, CT, USA
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Bedford LE, Tang EHM, Dong W, Wong CKH, Tse ETY, Ng APP, Cheung BMY, Wu T, Yu EYT, Lam CLK. Who reports insufficient and disturbed sleep? Results from a representative population-based health survey in Hong Kong. BMJ Open 2022; 12:e058169. [PMID: 36115682 PMCID: PMC9486237 DOI: 10.1136/bmjopen-2021-058169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To highlight the prevalence of sleep problems and identify associated risk factors among a representative sample recruited from the general population of Hong Kong. DESIGN, SETTING AND PARTICIPANTS Participants included 12 022 individuals (aged 15 or above) who took part in the Population Health Survey 2014/15, a territory-wide survey conducted by the Department of Health of the Government of the Hong Kong Special Administrative Region. PRIMARY AND SECONDARY OUTCOME MEASURES Outcomes were the prevalence of (1) insufficient sleep (<6 hours sleep per day) and (2) any sleep disturbance (difficulty initiating sleep, intermittent awakenings, early awakening) ≥3 times per week in the past 30 days. Multivariable logistic regression identified associations between sleep problems and sociodemographic, clinical and lifestyle factors. RESULTS 9.7% of respondents reported insufficient sleep and 10.5% reported sleep disturbances ≥3 times a week. Female gender, monthly household income <$12 250 (Hong Kong dollar), lower education level, mental health condition and physical health condition were significantly associated with both insufficient and disturbed sleep (all p<0.05). Unemployment, homemaker, insufficient physical activity, current/former smoking status and harmful alcohol consumption were associated with sleep disturbances only (all p<0.01). CONCLUSIONS Sleep problems are highly prevalent in Hong Kong. As such problems are associated with a range of health conditions, it is important to facilitate improvements in sleep. Our results show that harmful alcohol consumption, insufficient physical activity and current smoking are modifiable risk factors for sleep disturbances. Public health campaigns should focus on these risk factors in order to promote a healthy lifestyle and ultimately reduce sleep disturbances. Targeted interventions for high-risk groups may also be warranted, particularly for those with doctor-diagnosed physical and mental health conditions.
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Affiliation(s)
- Laura Elizabeth Bedford
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Eric Ho Man Tang
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Weinan Dong
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong, Hong Kong
| | - Emily Tsui Yee Tse
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- Department of Family Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Amy Pui Pui Ng
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- Department of Family Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Bernard Man Yung Cheung
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Tingting Wu
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- Department of Family Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
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14
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Muhammad T, Gharge S, Meher T. The associations of BMI, chronic conditions and lifestyle factors with insomnia symptoms among older adults in India. PLoS One 2022; 17:e0274684. [PMID: 36108066 PMCID: PMC9477301 DOI: 10.1371/journal.pone.0274684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/02/2022] [Indexed: 11/26/2022] Open
Abstract
Background The aim of the study was to estimate the prevalence of insomnia symptoms and to examine the associations of body mass index (BMI), chronic diseases, and lifestyle factors with self-reported insomnia symptoms among older people in India. Methods We conducted a cross-sectional study using data from the baseline wave of the Longitudinal Ageing Study in India (LASI) that was collected during 2017–18. A sample of 31,358 older adults aged 60 and above was included in the analyses. Descriptive statistics and bivariate and multivariable analyses were performed to obtain the results. Results In this study, insomnia symptoms were reported by around 36 percent of older adults aged 60 and above. After controlling for socio-demographic factors, insomnia symptoms were positively associated with the risk of being underweight [AOR: 1.289, CI: 1.211–1.372] and negatively associated with obesity/overweight [AOR: 0.928, CI: 0.872–0.990] as compared to older adults with normal BMI. The odds of insomnia symptoms were higher among those who reported the following chronic conditions, i.e., hypertension [AOR:1.356, CI:1.278–1.438], diabetes [AOR:1.160, CI:1.074–1.254], chronic lung diseases [AOR:1.485, CI:1.351–1.632], bone-related diseases [AOR:1.561, CI:1.458–1.670] and any psychiatric disorders [AOR:1.761, CI:1.495–2.074]. In addition, older adults who were physically active [AOR: 0.850, CI:0.804–0.900] were less likely to report insomnia symptoms. Conclusions The study suggests a high prevalence of insomnia symptoms among the older population in India. Early identification of the signs of insomnia in older population is crucial, as is timely treatment for any kind of sleep problems. In addition, nutrition-based interventions and individual disease-specific management programs may help minimize the stressful situations in later life and develop a good night’s sleep for the older population.
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Affiliation(s)
- T. Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
- * E-mail: ,
| | - Shivani Gharge
- Department of Bio-Statistics & Epidemiology, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Trupti Meher
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
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15
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Dzierzewski JM, Perez E, Ravyts SG, Dautovich N. Sleep and Cognition: A Narrative Review Focused on Older Adults. Sleep Med Clin 2022; 17:205-222. [PMID: 35659074 DOI: 10.1016/j.jsmc.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Little is known regarding sleep's association with the traditional developmental course of late-life cognitive functioning. As the number of older adults increases worldwide, an enhanced understanding of age-related changes in sleep and cognition is necessary to slow decline and promote optimal aging. This review synthesizes the extant literature on sleep and cognitive function in healthy older adults, older adults with insomnia, and older adults with sleep apnea, incorporating information on the potential promising effects of treating poor sleep on cognitive outcomes in older adults. Unifying theories of the sleep-cognition association, possible mechanisms of action, and important unanswered questions are identified.
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Affiliation(s)
- Joseph M Dzierzewski
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Room 306, Box 842018, Richmond, VA 23284-2018, USA.
| | - Elliottnell Perez
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018, USA
| | - Scott G Ravyts
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018, USA
| | - Natalie Dautovich
- Department of Psychology, Virginia Commonwealth University, 800 West Franklin Street, Room 203, Box 842018, Richmond, VA 23284-2018, USA
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16
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Yu X, Wang N, Wang D, Ma Y, Liu H, Fu J, Xu C, Sun Y, Zhang Y. Consistency in the prevalence and associated factors of frailty determined by two instruments among hospitalised older adults: A cross-sectional study. J Clin Nurs 2022; 32:2813-2826. [PMID: 35650678 DOI: 10.1111/jocn.16386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 04/17/2022] [Accepted: 05/16/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To investigate the consistency in the prevalence and associated factors of frailty determined by the physical-originated Fatigue, Resistance, Ambulation, Illnesses and Loss of weight (FRAIL) scale and the multidimensional Tilburg Frailty Indicators (TFI) scale. BACKGROUND Accurate assessment of frailty and the identification of its associated factors could guide the development and implementation of holistic and individualised treatment plan. However, recommendations regarding the selection of frailty assessment tools are inconclusive. DESIGN This is a cross-sectional study, the reporting of which followed the STROBE guidelines. METHODS A total of 1220 older adults were recruited from a university affiliated tertiary hospital in Xi'an City, Northwest China, and administrated with a social-demographic and health-related information sheet, the FRAIL, the TFI, the Short-Form Mini-Nutritional Assessment, the Pittsburgh Sleep Quality Index and the 5-level EuroQol 5 dimensions questionnaire. Descriptive statistics and binary logistic regression analysis were used to investigate the prevalence of frailty and its associated factors. RESULTS The prevalence of physical-originated and multidimensional frailty was 55.2% and 77.6%, respectively. The consistency between the two scales was low. Taking the combined use of the two instruments as the reference, the TFI and FRAIL could identify 89.99% and 64.02% of the participants with frailty. Polypharmacy, health-related quality of life and sleep quality were found to be associated with both physical-originated and multidimensional frailty. Nutritional status and level of physical activity were additionally identified as the independent associated factors of multidimensional frailty. CONCLUSIONS The prevalence of frailty among hospitalised older adults is high. There is low consistency between the FRAIL and TFI in detecting frailty. The TFI exhibited higher sensitivity in detecting individuals with frailty and its associated factors. RELEVANCE TO CLINICAL PRACTICE The findings of this study supported a single use of the TFI for the assessment of frailty in the hospital setting.
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Affiliation(s)
- Xingfeng Yu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Nana Wang
- The Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Dan Wang
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China.,School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Yunmiao Ma
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Hongmei Liu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Jia Fu
- The Surgery Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Cuixiang Xu
- The Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, P. R. China.,Shaanxi Provincial Key Laboratory of Infection and Immune Diseases, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Yang Sun
- The Medical Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Yulian Zhang
- The Director's Office, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
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17
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Sleep health in later life: interviews exploring experiences, attitudes and behaviours of older people. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Sleep is vital for health and wellbeing across the lifecourse. Ethnic differences have been observed with regards to the prevalence and predictors of self-reported sleep problems. An understanding of sleep experiences with ageing and across ethnicities is required to better support older people. Open-ended interviews were conducted with 23 people living in Aotearoa/New Zealand aged 61–92 years (12 Māori and 11 non-Māori) concerning current sleep status, changes over their lifecourse and personal strategies for supporting good sleep. Participants typically expressed satisfaction with current sleep (usually pertaining to duration) or feelings that sleep was compromised (usually pertaining to waking function). Comparisons to a socially perceived ‘ideal’ sleep were common, with sleep transitions presented as a gradual and accepted part of ageing. Participants resisted medicalising sleep disruptions in older age. While participants were aware of ways to enhance their sleep, many acknowledged engaging in practices that undermined it. Unique insights from some Māori participants indicated that sleep disruptions were not so readily pathologised compared to Western views and that sleeplessness could provide opportunity for cultural or spiritual connection. Common narratives underpinning the themes were: ‘You don't need as much sleep when you're older’, ‘Sleep just fits in’ and ‘Having the time of my life’. Findings provide personal experiences and cultural interpretations relating to sleep and ageing. This provides the foundation for future participatory research to co-design sleep health messages which are meaningful for ageing well across ethnicities.
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18
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Lok R, Chawra D, Hon F, Ha M, Kaplan KA, Zeitzer JM. Objective underpinnings of self-reported sleep quality in middle-aged and older adults: the importance of N2 and wakefulness. Biol Psychol 2022; 170:108290. [PMID: 35192907 PMCID: PMC9038649 DOI: 10.1016/j.biopsycho.2022.108290] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/16/2022]
Abstract
STUDY OBJECTIVES The measurable aspects of brain function (polysomnography, PSG) that are correlated with sleep satisfaction are poorly understood. Using recent developments in automated sleep scoring, which remove the within- and between-rater error associated with human scoring, we examine whether PSG measures are associated with sleep satisfaction. DESIGN AND SETTING A single night of PSG data was compared to contemporaneously collected measures of sleep satisfaction with Random Forest regressions. Whole and partial night PSG data were scored using a novel machine learning algorithm. PARTICIPANTS Community-dwelling adults (N = 3165) who participated in the Sleep Heart Health Study. INTERVENTIONS None. MEASUREMENTS AND RESULTS Models explained 30% of sleep depth and 27% of sleep restfulness, with a similar top four predictors: minutes of N2 sleep, sleep efficiency, age, and minutes of wake after sleep onset (WASO). With increasing self-reported sleep quality, there was a progressive increase in N2 and decrease in WASO of similar magnitude, without systematic changes in N1, N3 or REM sleep. In comparing those with the best and worst self-reported sleep satisfaction, there was a range of approximately 30 min more N2, 30 min less WASO, an improvement of sleep efficiency of 7-8%, and an age span of 3-5 years. Examination of sleep most proximal to morning awakening revealed no greater explanatory power than the whole-night data set. CONCLUSIONS Higher N2 and concomitant lower wake is associated with improved sleep satisfaction. Interventions that specifically target these may be suitable for improving the self-reported sleep experience.
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Affiliation(s)
- Renske Lok
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Dwijen Chawra
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Flora Hon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA; College of Literature, Science, and The Arts, University of Michigan, Ann Arbor, MI 48109, USA
| | - Michelle Ha
- Department of Mathematics and Statistics, San Jose State University, San Jose, CA 95112, USA
| | - Katherine A Kaplan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA; Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA 94304, USA.
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19
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Zhang X, Chang L, Pan SD, Yan FX. Dexmedetomidine Improves Non-rapid Eye Movement Stage 2 Sleep in Children in the Intensive Care Unit on the First Night After Laparoscopic Surgery. Front Pediatr 2022; 10:871809. [PMID: 35573948 PMCID: PMC9091560 DOI: 10.3389/fped.2022.871809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/04/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Previous studies have reported that children who were admitted to the ICU experienced a significant decrease in sleep quality compared to home. We investigated the effects of dexmedetomidine as an adjunct to sufentanil on the sleep in children admitted to the ICU on the first night after major surgery. METHODS This is a prospective study From January to February 2022. Clinical trial number: ChiCTR2200055768, http://www.chictr.org.cn. Fifty-four children aged 1-10 years old children undergoing major laparoscopic surgery were recruited and randomly assigned to either the DEX group, in which intravenous dexmedetomidine (0.3 ug/kg/h) and sufentanil (0.04 ug/kg/h) were continuously infused intravenously for post-operative analgesia; or the SUF group, in which only sufentanil (0.04 ug/kg/h) was continuously infused. Patients were monitored with polysomnography (PSG) on the first night after surgery for 12 h. PSG, sleep architecture, physiologic variables and any types of side effects related to anesthesia and analgesia were recorded. The differences between the two groups were assessed using the chi-square and Wilcoxon rank-sum tests. RESULTS Fifty-four children completed data collection, of which thirty-four were 1-6 years old and twenty were aged >6 years. Compared to the SUF group, subjects in the DEX group aged 1-6 years displayed increased stage 2 sleep duration (P = 0.02) and light sleep duration (P = 0.02). Subjects aged >6 years in the DEX group also displayed increased stage 2 sleep duration (P = 0.035) and light sleep duration (P = 0.018), but decreased REM sleep percentage (P = 0). Additionally, the heart rate and blood pressure results differed between age groups, with the heart rates of subjects aged >6 years in DEX group decreasing at most time points compared to SUF group (P < 0.05). CONCLUSION Dexmedetomidine prolonged N2 sleep and light sleep duration in the pediatric ICU after surgery but had different effects on the heart rate and blood pressure of subjects in different age groups.
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Affiliation(s)
- Xian Zhang
- Department of Anesthesiology, Capital Institute of Pediatrics Affiliated Children's Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Li Chang
- Department of Respiratory Medicine, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing, China
| | - Shou-Dong Pan
- Department of Anesthesiology, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing, China
| | - Fu-Xia Yan
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
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20
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Lee S, Chung JH, Kim JH. Association Between Sleep Quality and Falls: A Nationwide Population-Based Study from South Korea. Int J Gen Med 2021; 14:7423-7433. [PMID: 34744453 PMCID: PMC8566001 DOI: 10.2147/ijgm.s331103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 10/05/2021] [Indexed: 01/06/2023] Open
Abstract
Purpose There are few large studies evaluating the association between sleep quality and the risk of falls. We aimed to determine the independent effect of poor sleep quality on an increased risk of falls using a large-sample dataset. Methods We conducted a retrospective, cross-sectional study using population-based data from the 2018 Korean Community Health Survey on 201,700 participants. Sociodemographic, mental health-related, and physical health-related variables as well as sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) were compared between 2499 fallers who have experienced at least one fall during the past 12 months and 199,201 non-fallers. Multivariable logistic regression was performed to identify sleep quality variables significantly associated with an increased risk of falls. Results Fallers had poorer sleep quality (PSQI score >5) and higher scores for global PSQI and individual PSQI components than did non-fallers (all p < 0.001). Multivariable logistic regression adjusted for potential confounders including socioeconomic, physical health-related, and mental health-related variables showed that an increased risk of falls was associated with poor sleep quality (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.19–1.42). Subgroup analyses by age revealed that poor sleep quality was significantly associated with an increased risk of falls in all three adult age groups. Multivariable logistic regression using the seven PSQI components revealed that an increased risk of falls was associated with short sleep duration (OR 1.14, CI 1.09–1.20), increased sleep disturbances (OR 1.30, CI 1.16–1.46), and increased daytime dysfunctions (OR 1.21, CI 1.08–1.13). Conclusion Poor sleep quality caused by short sleep duration may be a principal risk factor of falls in adult populations. Increased sleep disturbances and daytime dysfunctions may also contribute to an increased risk of falls. Our results have clinical and public health perspectives that increasing sleep duration and reducing daytime dysfunctions and sleep disturbances could mitigate unintentional falls.
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Affiliation(s)
- Sujin Lee
- Department of Neurology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Ji Hyun Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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21
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Han C, An J, Chan P. The influence of probable rapid eye movement sleep behavior disorder and sleep insufficiency on fall risk in a community-dwelling elderly population. BMC Geriatr 2021; 21:606. [PMID: 34702166 PMCID: PMC8549138 DOI: 10.1186/s12877-021-02513-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/29/2021] [Indexed: 12/01/2022] Open
Abstract
Background The objective was to investigate the individual effect and potential interactions of probable rapid eye movement sleep behavior disorder (pRBD) and sleep insufficiency on fall risk among a Chinese elderly population. Methods Community-dwelling population aged 55 years or above were recruited from the Beijing Longitudinal Study on Aging II cohort from 2010 to 2011. Odds ratio (ORs) and 95% confidence intervals (CIs) were estimated using multivariate logistic regression models. Multiplicative and additive interactions between pRBD and sleep insufficiency were examined using likelihood ratio tests and relative excess risk due to interaction (RERI), respectively. Results Among 6891 included participants, 479 experienced at least once fall. pRBD and sleep insufficiency were both independently associated with elevated fall risk. Compared to the elderly without pRBD or sleep insufficiency, pRBD and sleep insufficiency was each associated with a 2.57-fold (OR = 2.57, 95%CI: 1.46–4.31) and 1.45-fold (OR = 1.45, 95%CI: 1.11–1.88) risk of falls individually, while their coexistence was associated with a less-than-additive 17% (OR = 1.17, 95%CI: 0.43–2.63) increased risk of falls. The combination of these two factors demonstrated evidence of a negative interaction on both multiplicative (ratio of ORs = 0.31, 95%CI: 0.10, 0.86) and additive (RERI = − 1.85, 95%CI: − 3.61, − 0.09) scale. Conclusions Our study has provided robust evidence for the adverse effect of pRBD and sleep insufficiency, as well as their negative interaction on increasing fall risk in a Chinese elderly population. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02513-2.
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Affiliation(s)
- Chao Han
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Jing An
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Piu Chan
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China. .,Department of Neurobiology, Neurology and Geriatrics, Clinical Center for Parkinson's Disease, Key Laboratories for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Advanced Innovative Center for Human Brain Protection, Beijing Institute of Geriatrics, Parkinson Disease Center of Beijing Institute for Brain Disorders, Xuanwu Hospital of Capital Medical University, 45 Changchun Road, Beijing, 100053, China.
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22
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Tang Y, Wang S, Yi Q, Xia Y, Geng B. Sleep pattern and bone mineral density: a cross-sectional study of National Health and Nutrition Examination Survey (NHANES) 2017-2018. Arch Osteoporos 2021; 16:157. [PMID: 34689259 DOI: 10.1007/s11657-021-01025-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/11/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED This research is a cross-sectional study based on the participants aged 50 years and older from National Health and Nutrition Examination Survey (NHANES) database. Poor sleep patterns were associated with lower bone mineral density (BMD) and a higher risk of osteoporosis, especially among older individuals or females. INTRODUCTION Accumulated evidence demonstrates that sleep duration, which is one aspect of sleep pattern, is associated with the risk of osteoporosis. However, the related studies on the association between sleep patterns and the risk of osteoporosis were limited. Therefore, this research aims to investigate the association of sleep patterns with BMD and the risk of osteoporosis among individuals aged 50 years and older. METHODS Participants aged ≥ 50 years from the NHANES database were included in the present study. The diagnosis of osteoporosis was based on the results of BMD testing. Moreover, all the participants were divided into different sleep pattern groups according to nocturnal sleep duration and bedtime. In addition, this study used multivariate linear regression models to evaluate the association between sleep patterns and BMD and exploited multiple logistic regression models to investigate the odds ratios (ORs) for osteoporosis. RESULTS Finally, 1,865 individuals (non-osteoporosis: N = 1,713; osteoporosis: N = 152) aged over 50 years old with complete data were analyzed. The results of multivariate linear regression models showed that individuals with normal sleep duration/later bedtime or long sleep duration/later bedtime had lower femoral BMD than those with normal sleep duration/usual bedtime. Moreover, subjects with long sleep duration/later bedtime had a higher risk of osteoporosis compared with those with normal sleep duration/usual bedtime. In addition, subgroup analyses revealed the association of sleep patterns with BMD and the risk of osteoporosis appeared to be more pronounced among individuals aged ≥ 65 years or females. CONCLUSION This study demonstrated that sleep patterns are associated with BMD and the risk of osteoporosis. Poor sleep patterns contribute to decreased bone mass and the increased risk of osteoporosis. Therefore, a healthy sleep pattern is favorable for the prevention of osteoporosis.
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Affiliation(s)
- Yuchen Tang
- Department of Orthopaedics, Lanzhou University Second Hospital, Cuiyingmen, Lanzhou, Gansu, #82, China.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.,Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Shenghong Wang
- Department of Orthopaedics, Lanzhou University Second Hospital, Cuiyingmen, Lanzhou, Gansu, #82, China.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.,Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Qiong Yi
- Department of Orthopaedics, Lanzhou University Second Hospital, Cuiyingmen, Lanzhou, Gansu, #82, China.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.,Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Yayi Xia
- Department of Orthopaedics, Lanzhou University Second Hospital, Cuiyingmen, Lanzhou, Gansu, #82, China.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.,Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Bin Geng
- Department of Orthopaedics, Lanzhou University Second Hospital, Cuiyingmen, Lanzhou, Gansu, #82, China. .,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China. .,Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China.
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23
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Currow DC, Davis W, Connolly A, Krishnan A, Wong A, Webster A, Barnes-Harris MM, Daveson B, Ekström M. Sleeping-related distress in a palliative care population: A national, prospective, consecutive cohort. Palliat Med 2021; 35:1663-1670. [PMID: 33726609 DOI: 10.1177/0269216321998558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Sleep, a multi-dimensional experience, is essential for optimal physical and mental wellbeing. Poor sleep is associated with worse wellbeing but data are scarce from multi-site studies on sleeping-related distress in palliative care populations. AIM To evaluate patient-reported distress related to sleep and explore key demographic and symptom distress related to pain, breathing or fatigue. DESIGN Australian national, consecutive cohort study with prospectively collected point-of-care data using symptoms from the Symptom Assessment Scale (SAS). SETTING/PARTICIPANTS People (n = 118,117; 475,298 phases of care) who died while being seen by specialist palliative care services (n = 152) 2013-2019. Settings: inpatient (direct care, consultative); community (outpatient clinics, home, residential aged care). RESULTS Moderate/severe levels of sleeping-related distress were reported in 11.9% of assessments, more frequently by males (12.7% vs 10.9% females); people aged <50 years (16.2% vs 11.5%); and people with cancer (12.3% vs 10.0% for other diagnoses). Sleeping-related distress peaked with mid-range Australia-modified Karnofsky Performance Status scores (40-60).Strong associations existed between pain-, breathing- and fatigue-related distress in people who identified moderate/severe sleeping-related distress, adjusted for age, sex and functional status. Those reporting moderate/severe sleeping-related distress were also more likely to experience severe pain-related distress (adjusted odds ratios [OR] 6.6; 95% confidence interval (CI) 6.3, 6.9); breathing-related distress (OR 6.2; 95% CI 5.8, 6.6); and fatigue-related distress (OR 10.4; 95% CI 9.99-10.8). CONCLUSIONS This large, representative study of palliative care patients shows high prevalence of sleeping-related distress, with strong associations shown to distress from other symptoms including pain, breathlessness and fatigue.
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Affiliation(s)
- David C Currow
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
| | - Walter Davis
- Walt Centre for Applied Statistics in Health, Australian Health Services Research Institute, NSW, Australia
| | - Alanna Connolly
- Palliative Care Outcomes Collaboration (PCOC), Australian Health Services Research Institute (AHSRI), University of Wollongong, NSW, Australia Alana
| | - Anu Krishnan
- Palliative Care, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Aaron Wong
- Department of Palliative Care, Austin Health, Heidelberg, VIC, Australia
- Department of Palliative Care, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Andrew Webster
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Matilda Mm Barnes-Harris
- York Teaching Hospital NHS Foundation Trust, York, UK
- Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
| | - Barb Daveson
- Palliative Care Outcomes Collaboration (PCOC), Australian Health Services Research Institute (AHSRI), University of Wollongong, NSW, Australia Alana
| | - Magnus Ekström
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Faculty of Medicine, Lund University, Lund, Sweden
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Sobczak AM, Bohaterewicz B, Fafrowicz M, Zyrkowska A, Golonka N, Domagalik A, Beldzik E, Oginska H, Rekas M, Bronicki D, Romanowska-Dixon B, Bolsega-Pacud J, Karwowski W, Farahani F, Marek T. Brain Functional Network Architecture Reorganization and Alterations of Positive and Negative Affect, Experiencing Pleasure and Daytime Sleepiness in Cataract Patients after Intraocular Lenses Implantation. Brain Sci 2021; 11:brainsci11101275. [PMID: 34679340 PMCID: PMC8533692 DOI: 10.3390/brainsci11101275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Cataracts are associated with progressive blindness, and despite the decline in prevalence in recent years, it remains a major global health problem. Cataract extraction is reported to influence not only perception, attention and memory but also daytime sleepiness, ability to experience pleasure and positive and negative affect. However, when it comes to the latter, the magnitude and prevalence of this effect still remains uncertain. The current study aims to evaluate the hemodynamic basis of daytime sleepiness, ability to experience pleasure and positive and negative affect in cataract patients after the intraocular lens (IOL) implantation. Methods: Thirty-four cataract patients underwent resting-state functional magnetic resonance imaging evaluation before and after cataract extraction and intraocular lens implantation. Both global and local graph metrics were calculated in order to investigate the hemodynamic basis of excessive sleepiness (ESS), experiencing pleasure (SHAPS) as well as positive and negative affect (PANAS) in cataract patients. Results: Eigenvector centrality and clustering coefficient alterations associated with cataract extraction are significantly correlated with excessive sleepiness, experiencing pleasure as well as positive and negative affect. Conclusions: The current study reveals the hemodynamic basis of sleepiness, pleasure and affect in patients after cataract extraction and intraocular lens implantation. The aforementioned mechanism constitutes a proof for changes in functional network activity associated with postoperative vision improvement.
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Affiliation(s)
- Anna Maria Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
- Correspondence: (A.M.S.); (B.B.)
| | - Bartosz Bohaterewicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Department of Psychology of Individual Differences, Psychological Diagnosis, and Psychometrics, Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland
- Correspondence: (A.M.S.); (B.B.)
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Aleksandra Zyrkowska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
| | - Natalia Golonka
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
| | - Aleksandra Domagalik
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Ewa Beldzik
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Halszka Oginska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Marek Rekas
- Ophthalmology Department, Military Institute of Medicine, 04-349 Warsaw, Poland; (M.R.); (D.B.)
| | - Dominik Bronicki
- Ophthalmology Department, Military Institute of Medicine, 04-349 Warsaw, Poland; (M.R.); (D.B.)
| | - Bozena Romanowska-Dixon
- Department of Ophthalmology and Ocular Oncology, Medical College, Jagiellonian University, 31-008 Kraków, Poland; (B.R.-D.); (J.B.-P.)
| | - Joanna Bolsega-Pacud
- Department of Ophthalmology and Ocular Oncology, Medical College, Jagiellonian University, 31-008 Kraków, Poland; (B.R.-D.); (J.B.-P.)
| | - Waldemar Karwowski
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA; (W.K.); (F.F.)
| | - Farzad Farahani
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA; (W.K.); (F.F.)
- Biostatistics Department, John Hopkins University, Baltimore, MD 21218, USA
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
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Armat MR, Mortazavi H, Akbari H, Ebrahimzadeh Z. The effect of footbath on the quality of sleep in older adults: A pilot study. Geriatr Nurs 2021; 42:1178-1183. [PMID: 34419870 DOI: 10.1016/j.gerinurse.2021.07.008] [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: 04/27/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/19/2022]
Abstract
This pilot study was a randomized controlled trial that aimed to investigate the effect of the warm footbath on the sleep quality of Iranian older adults. Males and females aged over 60 were randomly divided into three groups (footbath group with water at 40°C, footbath group with water at 37°C, and one control group) using the permutation block method. Repeated measures design was used to compare the groups after week two and week four to study the effects of footbath on sleep quality. Footbath with water at 40°C and 37°C caused significant improvement in the participants' sleep quality. No significant difference was found between the participants' sleep quality treated with water at 40°C and 37°C. Future studies with larger samples are recommended for assessing the effectiveness of warm footbath in enhancing sleep quality in older adults.
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Affiliation(s)
- Mohamad Reza Armat
- Geriatric Care Research Center, Department of Medical-Surgical Nursing, School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hamed Mortazavi
- Geriatric Care Research Center, Department of Medical-Surgical Nursing, School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hadi Akbari
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Zohreh Ebrahimzadeh
- Research Committee for Students, School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran.
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Bai J, Cheng C. The relationship between health-promoting behaviors, menopause syndrome, and sleep quality in Chinese middle-aged nurses: A cross-sectional study. Jpn J Nurs Sci 2021; 19:e12443. [PMID: 34235867 DOI: 10.1111/jjns.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/26/2021] [Accepted: 06/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nursing staff are on the front line of providing healthcare that addresses patients' needs. Sleep quality is highly related to work performance and quality of life among nurses. AIMS This study aimed to examine the influence of sociodemographic variables, menopause syndrome, and health-promoting behaviors on sleep quality in a sample of middle-aged nurses in China. METHODS A cross-sectional design was employed. A consecutive sample of 424 nurses was recruited from a university-affiliated hospital in Bengbu, China. Self-reported, structured questionnaires, including sociodemographic surveys, the Kupperman Menopausal Index, the Health Promoting Lifestyle Profile II, and the Pittsburgh Sleep Quality Index, were administered between October 2018 and July 2019. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS Study participants had a mean sleep quality level of 5.30 points (SD = 3.16), indicating potential sleep problems. The results of regression models showed that menopause syndrome and spiritual growth were important predictors of sleep quality for premenopause, perimenopause, and postmenopause groups. CONCLUSION Middle-aged nurses with more severe menopause syndrome and less spiritual growth might experience worse sleep quality. RELEVANCE TO CLINICAL PRACTICE This study highlights important factors influencing the level of sleep quality in Chinese middle-aged nurses. Identifying the factors that are associated with sleep quality may help with the development of proper interventions.
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Affiliation(s)
- Jie Bai
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Cheng Cheng
- School of Nursing, Shanghai Medical College, Fudan University, Shanghai, China
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Abstract
This study aimed to understand how marital status and marital transitions were related to sleep quality in mid to late life and whether these findings differed by gender. Data from 2,872 participants 50-74 years old from the ORANJ BOWLSM, a longitudinal panel study in New Jersey, were used. Marital status and sleep quality were examined in two waves that were approximately 10 years apart. Individuals in a significant romantic relationship and women had worse sleep quality than those in other marital status groups and men. Compared to individuals who remained married, individuals who remained divorced or widowed or who became widowed had better sleep quality, whereas those who became divorced had worse sleep quality; individuals who transitioned into marriage had better sleep quality than those who remained divorced or widowed. Marital status and gender appear important for at least some indices of sleep quality, an important predictor of late-life health.
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Affiliation(s)
- Kristin J August
- Department of Psychology and Health Sciences Center, Rutgers University, Camden, NJ, USA
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Elías MN, Munro CL, Liang Z, Padilla Fortunatti CF, Calero K, Ji M. Nighttime Sleep Duration Is Associated With Length of Stay Outcomes Among Older Adult Survivors of Critical Illness. Dimens Crit Care Nurs 2021; 39:145-154. [PMID: 32251163 PMCID: PMC11110929 DOI: 10.1097/dcc.0000000000000411] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Older adults who required mechanical ventilation while in an intensive care unit (ICU) require adequate sleep throughout recovery from critical illness. Poor post-ICU sleep quality may contribute to worsening impairments in physical, cognitive, or psychological status after critical illness, known as post-ICU syndrome. Previous research has evaluated post-ICU sleep with qualitative or mixed methods (eg, interviews, questionnaires). We proposed measurement of sleep with actigraphy. We hypothesized that nighttime sleep is associated with length of stay (LOS). OBJECTIVES The aims of this study were to describe sleep quality of previously mechanically ventilated older adults recently transferred out of ICU and explore relationships between sleep duration and LOS outcomes. METHODS We enrolled 30 older adults, 65 years and older, within 24 to 48 hours after ICU discharge. We collected actigraphy data on post-ICU sleep duration (total sleep time [TST]) and sleep fragmentation (wake time after sleep onset) over 2 consecutive nights. We explored associations between TST and LOS (in days) outcomes using multivariate regression. RESULTS Subjects' mean TST was 7.55 ± 2.52 hours, and mean wake time after sleep onset was 2.26 ± 0.17 hours. In exploratory regression analyses, longer ICU LOS (β = 0.543, P < .001) and longer length of mechanical ventilation (β = 0.420, P = .028) were associated with greater post-ICU TST, after adjusting for potential confounding factors. Total sleep time was prospectively associated with total hospital LOS (β = 0.535, P < .001). DISCUSSION Older ICU survivors demonstrate greater sleep duration and worse sleep fragmentation. Poor sleep may contribute to longer LOS, secondary to post-ICU syndrome and sequelae. We recommend nursing interventions to promote sleep consolidation throughout transitions of care in the acute post-ICU recovery period.
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Affiliation(s)
- Maya N Elías
- Maya N. Elías, PhD, MA, RN, is postdoctoral research fellow, School of Nursing & Health Studies, University of Miami, Coral Gables, Florida. Cindy L. Munro, PhD, ANP-BC, FAAN, FAANP, FAAAS, is dean and professor, School of Nursing & Health Studies, University of Miami, Coral Gables, Florida. Zhan Liang, PhD, MSN, RN, is assistant professor, School of Nursing & Health Studies, University of Miami, Coral Gables, Florida. Cristobal F. Padilla Fortunatti, MSN, is PhD student, School of Nursing & Health Studies, University of Miami, Coral Gables, Florida; and assistant clinical professor, School of Nursing, Pontificia Universidad Catolica de Chile, Santiago, Chile. Karel Calero, MD, is assistant professor, Department of Pulmonary, Critical Care & Sleep Medicine, College of Medicine, University of South Florida, Tampa, Florida. Ming Ji, PhD, is professor, College of Nursing, University of South Florida, Tampa, Florida
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Liu R, Shao W, Lai JK, Zhou L, Ren M, Sun N. Identification of comprehensive geriatric assessment-based risk factors for insomnia in elderly Chinese hospitalized patients. Aging Med (Milton) 2021; 4:26-34. [PMID: 33738377 PMCID: PMC7954828 DOI: 10.1002/agm2.12146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Insomnia is a common problem in older persons and is associated with poor prognosis from a functional or clinical perspective. The purpose of this study was to investigate the prevalence of insomnia and identify comprehensive geriatric assessment (CGA) based clinical factors associated with insomnia in elderly hospitalized patients. METHODS Standardized face-to-face interviews were conducted and CGA data were collected from 356 Chinese hospitalized patients aged 60 years or older. Insomnia was defined as self-reported sleep poor quality according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-Ⅴ). Multivariate logistic regression analysis was applied to assess the association between patient clinical factors together with domains within the CGA and insomnia. RESULTS Among the 365 patients, insomnia was found in 48.31% of the participants. Difficulty in initiating sleep (DIS), early morning awakening (EMA), difficulty in maintaining sleep (DMS), and snoring were found in 33.99%, 9.55%, 13.48%, and 1.69% of patients, respectively. Significant associations were found between insomnia and several covariates: female gender (P = 0.034), depression (P = 0.001), activities of daily living (ADL) (P = 0.034), instrumental activities of daily living (IADL; P = 0.009), falling (P = 0.003), chronic pain (P = 0.001), and poor nutritional status (P = 0.038). According to the results of the adjustment multivariate logistic regression analysis, female sex (odds ratio [OR] = 2.057, confidence interval [CI] = 1.179-3.588, P = 0.011), depression (OR = 1.889, CI = 1.080-3.304, P = 0.026), and chronic pain (OR = 1.779, CI = 1.103-2.868, P = 0.018) were significant independently predictors associated with insomnia. CONCLUSIONS Our study revealed that female sex, depression, and chronic pain were independently predictors of insomnia in hospitalized patients. Early identification of elderly patients with these risk factors using the CGA may improve the quality of life and treatment outcomes.
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Affiliation(s)
- Rong Liu
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
| | - Wenchao Shao
- Department of CardiologyUnion Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Jonathan King‐Lam Lai
- Storr Liver Center, Westmead Institute for Medical ResearchUniversity of Sydney and Westmead HospitalSydneyNew South WalesAustralia
| | - Lingshan Zhou
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
| | - Man Ren
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
| | - Nianzhe Sun
- The First Clinical Medicine School of Lanzhou UniversityLanzhouChina
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Effects of menopause on sleep quality and sleep disorders: Canadian Longitudinal Study on Aging. ACTA ACUST UNITED AC 2021; 27:295-304. [PMID: 31851117 DOI: 10.1097/gme.0000000000001462] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Sleep complaints are common during the menopause transition. However, it is difficult to disentangle changes in sleep related to aging from those directly due to menopause. We compared sleep disorders in 45 to 60-year-old women in a large population-based study, according to menopausal status. METHODS Women aged between 45 and 60 years who self-reported menopausal status were selected from the Canadian Longitudinal Study of Aging, excluding those with prior hysterectomy. Participants completed assessments for overall sleep satisfaction, hours of daily sleep, sleep-onset insomnia, sleep-maintenance insomnia, daytime somnolence, rapid eye movement sleep behavior disorder (RBD), restless leg syndrome (RLS), and obstructive sleep apnea (OSA). Each sleep variable was compared between postmenopausal and pre/perimenopausal women using multivariate regression, adjusting for potential confounders. RESULTS Among 6,179 women included, 3,713 (60.1%; age 55.7 ± 3.3 years) were postmenopausal and 2,466 (39.9%) were pre/perimenopausal (age 49.80 ± 3.1 years). Compared with pre/perimenopausal women, postmenopausal women were more often reported requiring ≥30 minutes to fall asleep (20.4% vs 15.5%; adjusted odds ratio [AOR] 1.24, 95% confidence interval [CI] 1.00-1.53) and were more likely to meet criteria for possible sleep-onset insomnia disorder (10.8% vs 7.3%; AOR 1.51, 95% CI 1.07-2.12). Postmenopausal women were also more likely to screen positive for OSA (14.6% vs 10.4%; AOR 1.48, 95% CI 1.14-1.92). The two groups did not differ on sleep dissatisfaction (32.4% vs 29%), daytime somnolence disorder (1.6% vs 1.3%), sleep-maintenance insomnia disorder (17% vs 14.5%), RLS (23.5% vs 20.9%), or RBD (3.9% vs 4.0%). CONCLUSIONS Menopause is associated with increased sleep-onset insomnia. Postmenopausal women also are more likely to screen positive for OSA. However, menopausal status is not associated with sleep maintenance, somnolence, or RLS, and RBD. : Video Summary:http://links.lww.com/MENO/A501.
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M Abd El-Kader S, H Al-Jiffri O. Aerobic exercise affects sleep, psychological wellbeing and immune system parameters among subjects with chronic primary insomnia. Afr Health Sci 2020; 20:1761-1769. [PMID: 34394237 PMCID: PMC8351861 DOI: 10.4314/ahs.v20i4.29] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chronic primary insomnia is characterized by long-term difficulties in maintaining and initiating sleep, too early waking up, poor mood, fatigue, impaired concentration and poor quality of life. Exercise training is recommended to prevent and alleviate sleep disorders. OBJECTIVE The aim of the study was to investigate the influence of aerobic exercise training on quality of sleep, psychological wellbeing and immune system among subjects with chronic primary insomnia. MATERIAL AND METHODS Eighty previously sedentary subjects with chronic primary insomnia subjects enrolled in this study, their age ranged from 35-56 years. All participants were randomly assigned to supervised aerobic exercise intervention group (group A, n=40) or control group (group B, n=40). Polysomnographic recordings for sleep quality assessment, Beck Depression Inventory (BDI), Profile of Mood States(POMS), Rosenberg Self-Esteem Scale (RSES), number of CD3+, CD4+, CD8+ T cells count and CD4/CD8 ratio were measured before and at the end of the study after six months. RESULTS There was a significant increase in the total sleep duration, sleep efficiency and sleep onset latency in group(A) after six months of aerobic exercise training, while, wake time after sleep onset and rapid eye movement (REM) latency significantly reduced after six months of aerobic training compared with values obtained prior to aerobic exercise training. Also, the mean values of BDI, POMS, CD3 count, CD4 count and CD8 count decreased significantly and the mean value of RSES significantly increased in group (A) after the aerobic exercise training, while the results of the control group were not significant. Moreover, there were significant differences between both groups at the end of the study. CONCLUSION Exercise training can be considered as a non-pharmacological modalty for modifying sleep quality, psychological wellbeing and immune system among subjects with chronic primary insomnia.
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Desjardins S, Lapierre S, Vasiliadis HM, Hudon C. Evaluation of the Effects of an Intervention Intended to Optimize the Sleep Environment Among the Elderly: An Exploratory Study. Clin Interv Aging 2020; 15:2117-2127. [PMID: 33204077 PMCID: PMC7665518 DOI: 10.2147/cia.s277252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/07/2020] [Indexed: 12/29/2022] Open
Abstract
Purpose The objective of this exploratory study was to evaluate the effects of a brief intervention intended to optimize the sleep environment in older people living in the community and to examine the way these effects change over time. Methods The sample was made up of 44 participants (19 men and 25 women) aged 65-85 years, with a mean age of 71.4. The intervention consisted in a group training session that covered the reasons for and ways to ("why" and "how") optimize a sleep environment. It comprises six themes: air quality and odors, luminosity, noises and sounds, comfort of the mattress, comfort of the pillow, and temperature. Participants completed a set of questionnaires before the intervention, and one month and four months later. Results Four months after the intervention, the replies to the questionnaires showed that the participants experienced reduced severity of insomnia, sleep latency and anxiety. The subjective quality of the participants' sleep along with their sleep efficacy also increased significantly during the same period. Conclusion A brief intervention intended to optimize the sleep environment appears promising as an addition or alternative to the two other sleep improvement options generally offered to older people: medication and cognitive behavioral therapy.
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Affiliation(s)
- Sophie Desjardins
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Sylvie Lapierre
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
| | - Carol Hudon
- School of Psychology, Université Laval, Québec, Québec, Canada
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Dey A, Majumdar P, Saha A, Sahu S. COVID-19 pandemic lockdown-induced altered sleep/wake circadian rhythm, health complaints and stress among traffic police personnel in India. Chronobiol Int 2020; 38:140-148. [PMID: 33043698 DOI: 10.1080/07420528.2020.1831524] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
COVID-19 is a highly contagious disease caused by Severe Acute Respiratory Syndrome coronavirus-2, capable of high human transmission. To protect against the COVID-19 pandemic, the World Health Organization proposed intervening guidance that included movement restrictions, isolation, restriction of national and international travel or movement, and full or partial closure of organizations and institutions. Police personnel play a vital role in safeguarding the spread of COVID-19; thus, potentially causing severe stress due to increased consignment and direct exposure to infection during duty. The study aimed to determine the effect of the added stress of the COVID-19 pandemic and population lockdown on the sleep/wake 24 h rhythm of traffic police. A concise online questionnaire survey was conducted among the traffic police personnel of India. Collected data were analyzed statistically. Disorientation of working schedule, fear of being vulnerable to disease, pressure of maintaining law, and orders during lockdown increased stress level. The survey identified discontinuation of sleep, shift of mid-sleep time, increase in depression, plus stress and anxiety among traffic police personnel that affected their chronobiological milieu. Proper awareness of adequate health and safety measures, use of personnel protection equipment, regular conversation with family members, and meditation can help reduce stress during this pandemic situation.
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Affiliation(s)
- Arindam Dey
- Environmental and Occupational Physiology Laboratory, Department of Physiology, Sister Nibedita Government General Degree College for Girl , Kolkata, India.,Ergonomics and Occupational Physiology Laboratory, Department of Physiology, University of Kalyani , Nadia, West Bengal, India
| | - Piya Majumdar
- Ergonomics and Occupational Physiology Laboratory, Department of Physiology, University of Kalyani , Nadia, West Bengal, India
| | - Atanu Saha
- Environmental and Occupational Physiology Laboratory, Department of Physiology, Sister Nibedita Government General Degree College for Girl , Kolkata, India
| | - Subhashis Sahu
- Ergonomics and Occupational Physiology Laboratory, Department of Physiology, University of Kalyani , Nadia, West Bengal, India
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Abstract
At the core of human thought, for the majority of individuals in the developed nations at least, there is the tacit assumption that as a species we are unfettered by the demands imposed by our biology and that we can do what we want, at whatever time we choose, whereas in reality every aspect of our physiology and behaviour is constrained by a 24 h beat arising from deep within our evolution. Our daily circadian rhythms and sleep/wake cycle allow us to function optimally in a dynamic world, adjusting our biology to the demands imposed by the day/night cycle. The themes developed in this review focus upon the growing realization that we ignore the circadian and sleep systems at our peril, and this paper considers the mechanisms that generate and regulate circadian and sleep systems; what happens mechanistically when these systems collapse as a result of societal pressures and disease; how sleep disruption and stress are linked; why sleep disruption and mental illness invariably occur together; and how individuals and employers can attempt to mitigate some of the problems associated with working against our internal temporal biology. While some of the health costs of sleep disruption can be reduced, in the short-term at least, there will always be significant negative consequences associated with shift work and sleep loss. With this in mind, society needs to address this issue and decide when the consequences of sleep disruption are justified in the workplace.
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Affiliation(s)
- Russell G. Foster
- Sleep and Circadian Neuroscience Institute (SCNi) and Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, OMPI, Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, UK
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35
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Borges CR, Poyares D, Piovezan R, Nitrini R, Brucki S. Alzheimer's disease and sleep disturbances: a review. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 77:815-824. [PMID: 31826138 DOI: 10.1590/0004-282x20190149] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/23/2019] [Indexed: 01/19/2023]
Abstract
The association between Alzheimer's disease (AD) and sleep disturbances has received increasing scientific attention in the last decades. However, little is known about the impact of sleep and its disturbances on the development of preclinical AD stages, such as mild cognitive impairment. This review describes the evolution of knowledge about the potential bidirectional relationships between AD and sleep disturbances exploring recent large prospective studies and meta-analyses and studies of the possible mechanisms through which sleep and the neurodegenerative process could be associated. The review also makes a comprehensive exploration of the sleep characteristics of older people, ranging from cognitively normal individuals, through patients with mild cognitive impairment, up to the those with dementia with AD.
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Affiliation(s)
- Conrado Regis Borges
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brasil
| | - Dalva Poyares
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Instituto do Sono, São Paulo SP, Brasil
| | - Ronaldo Piovezan
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Instituto do Sono, São Paulo SP, Brasil
| | - Ricardo Nitrini
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brasil
| | - Sonia Brucki
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brasil
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36
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van Sluijs R, Wilhelm E, Rondei Q, Omlin X, Crivelli F, Straumann D, Jäger L, Riener R, Achermann P. Gentle rocking movements during sleep in the elderly. J Sleep Res 2020; 29:e12989. [PMID: 32061115 PMCID: PMC7757236 DOI: 10.1111/jsr.12989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 11/30/2022]
Abstract
Vestibular stimulation in the form of rocking movements could be a promising non‐pharmacological intervention for populations with reduced sleep quality, such as the elderly. We hypothesized that rocking movements influence sleep by promoting comfort. We assessed whether gentle rocking movements can facilitate the transition from wake to sleep, increase sleep spindle density and promote deep sleep in elderly people. We assessed self‐reported comfort using a pilot protocol including translational movements and movements along a pendulum trajectory with peak linear accelerations between 0.10 and 0.20 m/s2. We provided whole‐night stimulation using the settings rated most comfortable during the pilot study (movements along a pendulum trajectory with peak linear acceleration of 0.15 m/s2). Sleep measures (polysomnography) of two baseline and two movement nights were compared. In our sample (n = 19; eight female; mean age: 66.7 years, standard deviation: 3 years), vestibular stimulation using preferred stimulation settings did not improve sleep. A reduction of delta power was observed, suggesting reduced sleep depth during rocking movements. Sleep fragmentation was similar in both conditions. We did not observe a sleep‐promoting effect using settings optimized to be comfortable. This finding could imply that comfort is not the underlying mechanism. At frequencies below 0.3 Hz, the otoliths cannot distinguish tilt from translation. Translational movement trajectories, such as used in previous studies reporting positive effects of rocking, could have caused sensory confusion due to a mismatch between vestibular and other sensory information. We propose that this sensory confusion might be essential to the sleep‐promoting effect of rocking movements described in other studies.
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Affiliation(s)
- Rachel van Sluijs
- Department of Health Science and Technology, Sensory-Motor Systems Laboratory, Institute of Robotic and Intelligent Systems, Swiss Federal Institute of Technology, Zurich, Switzerland.,Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
| | - Elisabeth Wilhelm
- Department of Health Science and Technology, Sensory-Motor Systems Laboratory, Institute of Robotic and Intelligent Systems, Swiss Federal Institute of Technology, Zurich, Switzerland.,Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
| | - Quincy Rondei
- Department of Health Science and Technology, Sensory-Motor Systems Laboratory, Institute of Robotic and Intelligent Systems, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Ximena Omlin
- Department of Health Science and Technology, Sensory-Motor Systems Laboratory, Institute of Robotic and Intelligent Systems, Swiss Federal Institute of Technology, Zurich, Switzerland.,Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
| | - Francesco Crivelli
- Department of Health Science and Technology, Sensory-Motor Systems Laboratory, Institute of Robotic and Intelligent Systems, Swiss Federal Institute of Technology, Zurich, Switzerland
| | | | - Lukas Jäger
- Department of Health Science and Technology, Sensory-Motor Systems Laboratory, Institute of Robotic and Intelligent Systems, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Robert Riener
- Department of Health Science and Technology, Sensory-Motor Systems Laboratory, Institute of Robotic and Intelligent Systems, Swiss Federal Institute of Technology, Zurich, Switzerland.,Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland.,Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Peter Achermann
- Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, The KEY Institute for Brain Mind Research, University Hospital of Psychiatry, Zurich, Switzerland.,Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
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Simoes Maria M, Büla C, Santos-Eggimann B, Krief H, Heinzer R, Seematter-Bagnoud L. Sleep characteristics and self-rated health in older persons. Eur Geriatr Med 2019; 11:131-138. [PMID: 32297231 DOI: 10.1007/s41999-019-00262-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/05/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE It remains unclear, how much older persons' sleep problems are due to age-related changes in sleep architecture and pattern, or whether they are a consequence of health problems. This work aimed to examine the association between sleep characteristics and self-rated health, taking into account potential confounders. METHODS Data about sleep, including sleep efficiency (ratio of sleep duration to the amount of time spent in bed, considered as good if > 85%), as well as health-rated characteristics were self-reported by community-dwelling persons enrolled in the Lausanne cohort 65+ study (n = 2712, age 66-75 years). Participants' subjective health was categorized as good versus poor. The cross-sectional association between good self-rated health and sleep characteristics was examined in bivariate and multivariate analysis. RESULTS The majority of participants (68.4%) rated their health as good. Compared to the participants with poor-rated health, they more often reported a good sleep efficiency (59.5% vs 45.0%, p < 0.001) and less often reported napping (41.6% vs 54.0%, p < 0.001) as well as using sleep medication (12.7% vs 31.8%, p < 0.001). After adjustment for comorbidity, depressive symptoms and cognitive difficulties, a positive association persisted between good sleep efficiency and good self-rated health (adjOR: 1.35, 95% CI 1.10-1.66). Regular napping remained negatively associated to feel healthy (adjOR: 0.65, 95% CI 0.53-0.79). CONCLUSION Sleep efficiency is positively associated with subjective health, whereas napping and use of sleep medication are negatively associated to rating own health as good. These associations need to be further investigated in longitudinal analyses to better understand causality.
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Affiliation(s)
- Mariana Simoes Maria
- Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Centre, Mont-Paisible 16, 1011, Lausanne, Switzerland.,Faculty of Biology and Medicine, Lausanne University, Lausanne, Switzerland
| | - Christophe Büla
- Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Centre, Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Brigitte Santos-Eggimann
- Health Services Unit, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Hélène Krief
- Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Centre, Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Raphaël Heinzer
- Center for Investigation and Research in Sleep (CIRS), University of Lausanne Hospital Centre, Lausanne, Switzerland
| | - Laurence Seematter-Bagnoud
- Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Centre, Mont-Paisible 16, 1011, Lausanne, Switzerland. .,Health Services Unit, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
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38
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Menon RN, Radhakrishnan A, Sreedharan SE, Sarma PS, Kumari RS, Kesavadas C, Sasi D, Lekha VS, Justus S, Unnikrishnan JP. Do quantified sleep architecture abnormalities underlie cognitive disturbances in amnestic mild cognitive impairment? J Clin Neurosci 2019; 67:85-92. [PMID: 31221582 DOI: 10.1016/j.jocn.2019.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/10/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
Abstract
The study was designed to gauge association between occult sleep-related breathing disturbances and sleep architecture changes on cognitive trajectories in subjects with amnestic mild cognitive impairment (aMCI) relative to cognitively normal healthy controls, phenotyped by neuroimaging. Subjects with aMCI and normal cognition were prospectively recruited. Following standardized neuropsychological and sleep questionnaire assessment they underwent a single overnight polysomnography (PSG); multimodality MRI was used to ascertain age-corrected radiological differences between the 2 groups. The aMCI cohort was followed up longitudinally with serial cognitive assessments for the next 3 years. Thirty seven subjects with aMCI and 24 control subjects consented for evaluation. Although occult moderate to severe obstructive sleep apnea (OSA) was more prevalent in aMCI (43.6%) as opposed to controls (22.7%); higher median apnea-hypopnea index (AHI = 11.5) and total apnea-hypopnea time (26.6 min) were also noted in aMCI relative to controls (6.6 and 11.4 min respectively), the differences were not statistically significant. In the aMCI group, better sleep efficiency, longer duration of REM sleep correlated with higher associative learning, free-recall/recognition memory performance. Higher AHI had negative correlation with visual memory scores. However longitudinal cognitive trends in the aMCI group over 3 years reflected relative stability (only 5% progressed to AD) notwithstanding imaging differences from controls and appeared to be independent of sleep parameters. The study concluded that despite associations between sleep efficiency, REM sleep and sleep-related breathing variables with neuropsychological test-scores in aMCI, these appear to be comorbidities rather than causative factors for the degree of cognitive impairment or its longitudinal trajectory.
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Affiliation(s)
- Ramshekhar N Menon
- Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
| | - Ashalatha Radhakrishnan
- Comprehensive Care Centre for Sleep Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - Sapna Erat Sreedharan
- Comprehensive Care Centre for Sleep Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - P Sankara Sarma
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - R Sheela Kumari
- Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - C Kesavadas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - Deepak Sasi
- Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - V S Lekha
- Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - Sunitha Justus
- Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - J P Unnikrishnan
- Comprehensive Care Centre for Sleep Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
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Abd El-Kader SM, Al-Jiffri OH. Aerobic exercise modulates cytokine profile and sleep quality in elderly. Afr Health Sci 2019; 19:2198-2207. [PMID: 31656505 PMCID: PMC6794533 DOI: 10.4314/ahs.v19i2.45] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Sleep disturbance is a major problem for older adults which can be exacerbated by increased inflammation as aging is associated with increased circulating pro-inflammatory and lower anti-inflammatory cytokines. There is a need to develop alternative medicine techniques to help improve sleep quality in the elderly. Objective To investigate the effects of aerobic exercise training on the sleep quality and inflammatory cytokines in elderly subjects. Material and methods Forty previously sedentary elderly subjects participated in this study, their age ranged from 61- 67 years. All subjects were randomly assigned to supervised aerobic exercise intervention group (group A, n=25) or control group (group B, n=25). Polysomnographic recordings for sleep quality assessment, interleukin- 6 (IL-6), tumor necrosis factor- alpha (TNF-α) and interleukin-10 (IL-10) were measured before and after 6 months at the end of the study. Results There was a significant increase in total sleep duration, sleep efficiency and sleep onset latency in group(A) after 6 months of aerobic exercise training, while, wake time after sleep onset and rapid eye movement (REM) latency significantly reduced after 6 months of aerobic training compared with values obtained prior to aerobic exercise training. Also, the mean values of TNF- α and IL-6 decreased significantly and the mean value of IL-10 significantly increased in group (A) after the aerobic exercise training, however the results of the control group were not significant. Moreover, there were significant differences between both groups at the end of the study. Conclusion Exercise training can be considered as a non-pharmacological modality for modifying sleep quality and inflammation among elderly.
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Affiliation(s)
- Shehab M Abd El-Kader
- Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama H Al-Jiffri
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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40
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Gagnon JF, Lafrenière A, Rauchs G, Petit D, Carrier J. Sleep in Normal Aging, Alzheimer's Disease, and Mild Cognitive Impairment. HANDBOOK OF SLEEP RESEARCH 2019. [DOI: 10.1016/b978-0-12-813743-7.00045-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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41
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Occupational Health and Sleep Issues in Underserved Populations. PHYSICIAN ASSISTANT CLINICS 2019. [DOI: 10.1016/j.cpha.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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42
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Sleep and Intensive Care Unit–Acquired Weakness in Critically Ill Older Adults. Dimens Crit Care Nurs 2019; 38:20-28. [DOI: 10.1097/dcc.0000000000000335] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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43
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Sella E, Cellini N, Miola L, Sarlo M, Borella E. The Influence of Metacognitive Beliefs on Sleeping Difficulties in Older Adults. Appl Psychol Health Well Being 2018; 11:20-41. [DOI: 10.1111/aphw.12140] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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44
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Ludwin BM, Bamonti P, Mulligan EA. Program Evaluation of Group-based Cognitive Behavioral Therapy for Insomnia: a Focus on Treatment Adherence and Outcomes in Older Adults with Co-morbidities. Clin Gerontol 2018; 41:487-497. [PMID: 29252112 DOI: 10.1080/07317115.2017.1399190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To describe a program evaluation of the interrelationship of adherence and treatment outcomes in a sample of veteran older adults with co-morbidities who participated in group-based cognitive behavioral therapy for insomnia. METHODS Retrospective data extraction was performed for 14 older adults. Adherence measures and sleep outcomes were measured with sleep diaries and Insomnia Severity Index. Demographic and clinical information was extracted through chart review. RESULTS Adherence with prescribed time in bed, daily sleep diaries, and maintaining consistent time out of bed and time in bed was generally high. There were moderate, though not significant, improvements in consistency of time in bed and time out of bed over time. Adherence was not significantly associated with sleep outcomes despite improvements in most sleep outcomes. CONCLUSIONS The non-significant relationship between sleep outcomes and adherence may reflect the moderating influence of co-morbidities or may suggest a threshold effect beyond which stricter adherence has a limited impact on outcomes. CLINICAL IMPLICATIONS Development of multi-method adherence measures across all treatment components will be important to understand the influence of adherence on treatment outcomes as monitoring adherence to time in bed and time out of bed had limited utility for understanding treatment outcomes in our sample.
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Affiliation(s)
- Brian M Ludwin
- a VA Boston Healthcare System , Brockton , Massachusetts, USA
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45
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Patel D, Steinberg J, Patel P. Insomnia in the Elderly: A Review. J Clin Sleep Med 2018; 14:1017-1024. [PMID: 29852897 PMCID: PMC5991956 DOI: 10.5664/jcsm.7172] [Citation(s) in RCA: 268] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 02/03/2018] [Accepted: 02/15/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Insomnia remains one of the most common sleep disorders encountered in the geriatric clinic population, frequently characterized by the subjective complaint of difficulty falling or maintaining sleep, or nonrestorative sleep, producing significant daytime symptoms including difficulty concentrating and mood disturbances. METHODS A search of the literature was conducted to review the epidemiology, definition, and age-related changes in sleep, as well as factors contributing to late-life insomnia and scales utilized for the assessment of insomnia in older people. The aim is to summarize recent diagnostic guidelines and both nonpharmacological and pharmacological strategies for the management of insomnia in the older population. RESULTS Insomnia remains a clinical diagnosis. There are several demographic, psychosocial, biologic, and behavioral factors that can contribute to late-life insomnia. Older adults are at higher risk for the medical and psychiatric effects of insomnia. CONCLUSIONS The most important aspect in evaluation of insomnia is detailed history taking and thorough physical examination. Nonpharmacological treatment options have favorable and enduring benefits compared to pharmacological therapy.
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Affiliation(s)
- Dhaval Patel
- Department of Geriatrics, Wayne State University School of Medicine, Detroit, Michigan
| | - Joel Steinberg
- Department of Geriatrics, Wayne State University School of Medicine, Detroit, Michigan
| | - Pragnesh Patel
- Department of Geriatrics, Wayne State University School of Medicine, Detroit, Michigan
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Rawtaer I, Mahendran R, Chan HY, Lei F, Kua EH. A nonpharmacological approach to improve sleep quality in older adults. Asia Pac Psychiatry 2018; 10:e12301. [PMID: 28994200 DOI: 10.1111/appy.12301] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 08/30/2017] [Accepted: 09/12/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Poor sleep quality is highly prevalent among older adults and is associated with poor quality of life, cognitive and physical decline, depression, and increased mortality. Medication options commonly used are not ideal, and alternative treatment strategies are needed. We evaluate a community-based psychosocial intervention program and its effect on sleep quality in older adults. METHOD Elderly participants aged 60 and above were included. Those with Geriatric Depression Scale and Geriatric Anxiety Inventory scores above 5 and 10, respectively, were excluded. The community program included tai chi exercise, art therapy, mindfulness awareness practice, and music reminiscence therapy. Pittsburgh Sleep Quality Index, Geriatric Depression Scale, and Geriatric Anxiety Inventory were administered at baseline and at 1 year. RESULTS A hundred and eighty-nine subjects (44 men, 145 women; mean age = 69 years, SD = 5.7, range = 60-89) participated. The proportion of participants with good sleep quality had increased from 58.2% to 64.6%. Sleep disturbance was significantly reduced (baseline, 1.04; postintervention, 0.76; mean difference 0.28; P < .01); men experienced greater improvement (P < .001). Improvements were independent of changes in depressive and anxiety symptoms. CONCLUSION Participation in this community program led to positive effects on sleep disturbances after a year. Psychosocial interventions have potential as a nondrug intervention approach for sleep problems, and further research is needed to understand its mediating mechanisms.
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Affiliation(s)
- Iris Rawtaer
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University Hospital, Singapore.,Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Hui Yu Chan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Feng Lei
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, National University Hospital, Singapore.,Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Thichumpa W, Howteerakul N, Suwannapong N, Tantrakul V. Sleep quality and associated factors among the elderly living in rural Chiang Rai, northern Thailand. Epidemiol Health 2018; 40:e2018018. [PMID: 29807410 PMCID: PMC6060346 DOI: 10.4178/epih.e2018018] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/14/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES This study aimed to characterize the prevalence of poor sleep quality and to identify associated factors among community-dwelling elderly individuals in northern Thailand. METHODS A cross-sectional study was conducted among 266 randomly selected elderly people in a sub-district in rural Chiang Rai Province, northern Thailand. The participants were interviewed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI). RESULTS Roughly 44.0% of the participants had poor sleep quality (PSQI score, >5), 9.4% used sleep medication, 27.1% had poor family relationships, and 12.0% had mild depression. Multiple logistic regression analysis indicated that being female (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.10 to 3.02), a higher education level (OR, 3.03; 95% CI, 1.34 to 6.86 for primary school; OR, 2.48; 95% CI, 1.31 to 5.44 for higher than primary school), mild depression (OR, 2.65; 95% CI, 1.11 to 6.36), and poor family relationships (OR, 3.65; 95% CI, 1.98 to 6.75) were significantly associated with poor sleep quality. CONCLUSIONS The prevalence of poor sleep quality among the elderly was moderately high. Healthcare providers should regularly conduct screenings for sleep quality and depression; provide sleep health education; and conduct interventions to encourage participating in family activities, resolving conflicts, sharing ideas, and making compromises within the family.
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Affiliation(s)
- Weerakorn Thichumpa
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Nopporn Howteerakul
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Nawarat Suwannapong
- Department of Public Health Administration, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Visasiri Tantrakul
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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48
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Jang KH, Lee JH, Kim SJ, Kwon HJ. Characteristics of napping in community-dwelling insomnia patients. Sleep Med 2018; 45:49-54. [PMID: 29680428 DOI: 10.1016/j.sleep.2017.12.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/13/2017] [Accepted: 12/30/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We aimed to determine napping characteristics of community-dwelling patients with insomnia disorder (ID) compared to characteristics of normal controls (NC), and to examine the effect of napping on nocturnal sleep. METHODS Adult volunteers who were more than 18 years old were recruited from three rural public health centers in Korea. Data from actigraphy recording and a sleep diary filled out for seven days were obtained. Finally, 115 ID patients and 80 NC subjects were included in this study. Parameters and timing of nocturnal sleep and nap were compared between the ID and NC groups. Two-way analysis of covariance (ANCOVA) was performed to determine the effect of ID diagnosis and napping on sleep parameters. RESULTS Sleep efficiency (SE) in the ID group was significantly lower (p = 0.010), and wake time after sleep onset (WASO) was significantly greater (p = 0.023), compared to the NC group. There was no significant difference in nocturnal sleep or nap timing between the two groups. Nap frequency in the ID group was significantly higher than that in the NC group (p = 0.025). Although ID diagnosis and napping had no independent effect on fragmentation index, their interaction had a significant effect on fragmentation index (p = 0.021). Nap frequency was positively correlated with PSQI score (r = 0.166, p = 0.033). CONCLUSION Insomnia patients showed no significant difference in nap timing or nap duration compared to NC subjects. However, insomnia patients showed higher nap frequency. Frequent napping was associated with poorer subjective sleep quality. Therefore, although napping might not have a negative impact on nocturnal sleep maintenance in NC subjects, it did have an effect on nocturnal sleep in insomnia patients.
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Affiliation(s)
- Kwang Ho Jang
- Department of Psychiatry, Chuncheon National Hospital, Chuncheon, South Korea
| | - Jung Hie Lee
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Psychiatry, Kangwon National University Hospital, Chuncheon, South Korea.
| | - Seong Jae Kim
- Department of Psychiatry, Doeun Hospital, Jincheon, South Korea
| | - Hyo Jeong Kwon
- Department of Psychiatry, Kangwon National University Hospital, Chuncheon, South Korea
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Brandão GS, Camelier FWR, Sampaio AAC, Brandão GS, Silva AS, Gomes GSBF, Donner CF, Oliveira LVF, Camelier AA. Association of sleep quality with excessive daytime somnolence and quality of life of elderlies of community. Multidiscip Respir Med 2018; 13:8. [PMID: 29568522 PMCID: PMC5853141 DOI: 10.1186/s40248-018-0120-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 02/25/2018] [Indexed: 01/07/2023] Open
Abstract
Background The progressive increase in the elderly population contributes to the fact that studies on human aging have important attention of health professionals and government agents, since they present a great challenge regarding public health. Our objective is to characterize the profile of older people with poor sleep quality and analyze possible associations with excessive daytime somnolence, quality of life and functional mobility. Methods This is a cross-sectional descriptive study, involving elderlies of the community, with the questionnaires Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, WHOQOL-OLD and application of the Timed Up and Go test - TUG. Descriptive statistics, Student’s t test for paired samples and Pearson’s correlation coefficient (p ≤ 0.05) were used. Results We recruited 131 elderly people, predominantly female (87%); mean age 68 ± 7 years, low per capita income (84.8% ≤ 2 minimum wage), low education (86.3% ≤ 3 years of study), and mostly staying with relatives (67.9%), married (39.7%) or amassed (35.9%). Seventy-one percent of the sample is above normal weight, 90.1% of women have an abdominal circumference ≥ 80 cm and a high prevalence of chronic and psychosocial diseases was identified in the self-report, and the risk of obstructive sleep apnea in 38.2%. The mean PSQI, Epworth Sleepiness Scale, WHOQOL-OLD and TUG were equal to, respectively, 11.2 ± 3.2; 8.32 ± 2.2; 84.8 ± 10.2 and 8.97 ± 2. An association of sleep quality with excessive daytime somnolence and quality of life, while not with functional mobility, was observed. Conclusion The results of the present study allowed to identify a sleep quality associated with excessive daytime somnolence and quality of life and also to characterize the profile of elders with poor sleep quality.
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Affiliation(s)
- Glauber Sá Brandão
- Postgraduate Program in Medicine and Human Health, School of Medicine and Public Health in Bahia, Salvador, BA Brazil.,Department of Education (DEDC-VII), University of the State of Bahia - UNEB, Rodovia Lomanto Júnior, BR 407, Km127, Senhor do Bonfim, BA CEP 48970-000 Brazil
| | | | - Antônia Adonis Callou Sampaio
- Department of Education (DEDC-VII), University of the State of Bahia - UNEB, Rodovia Lomanto Júnior, BR 407, Km127, Senhor do Bonfim, BA CEP 48970-000 Brazil
| | | | - Anderson Soares Silva
- 5Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University (UNINOVE), Sao Paulo, SP Brazil
| | - Glaucia Sá Brandão Freitas Gomes
- Department of Education (DEDC-VII), University of the State of Bahia - UNEB, Rodovia Lomanto Júnior, BR 407, Km127, Senhor do Bonfim, BA CEP 48970-000 Brazil
| | - Claudio F Donner
- Mondo Medico, Multidisciplinary & Rehabilitation Outpatient Clinic, Borgomanero, NO Italy
| | | | - Aquiles Assunção Camelier
- Postgraduate Program in Medicine and Human Health, School of Medicine and Public Health in Bahia, Salvador, BA Brazil.,Department of Life Sciences (DCV), University of the State of Bahia - UNEB, Salvador, BA Brazil
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Pushpanathan ME, Loftus AM, Gasson N, Thomas MG, Timms CF, Olaithe M, Bucks RS. Beyond factor analysis: Multidimensionality and the Parkinson's Disease Sleep Scale-Revised. PLoS One 2018; 13:e0192394. [PMID: 29432463 PMCID: PMC5809063 DOI: 10.1371/journal.pone.0192394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 01/23/2018] [Indexed: 01/27/2023] Open
Abstract
Many studies have sought to describe the relationship between sleep disturbance and cognition in Parkinson’s disease (PD). The Parkinson’s Disease Sleep Scale (PDSS) and its variants (the Parkinson’s disease Sleep Scale-Revised; PDSS-R, and the Parkinson’s Disease Sleep Scale-2; PDSS-2) quantify a range of symptoms impacting sleep in only 15 items. However, data from these scales may be problematic as included items have considerable conceptual breadth, and there may be overlap in the constructs assessed. Multidimensional measurement models, accounting for the tendency for items to measure multiple constructs, may be useful more accurately to model variance than traditional confirmatory factor analysis. In the present study, we tested the hypothesis that a multidimensional model (a bifactor model) is more appropriate than traditional factor analysis for data generated by these types of scales, using data collected using the PDSS-R as an exemplar. 166 participants diagnosed with idiopathic PD participated in this study. Using PDSS-R data, we compared three models: a unidimensional model; a 3-factor model consisting of sub-factors measuring insomnia, motor symptoms and obstructive sleep apnoea (OSA) and REM sleep behaviour disorder (RBD) symptoms; and, a confirmatory bifactor model with both a general factor and the same three sub-factors. Only the confirmatory bifactor model achieved satisfactory model fit, suggesting that PDSS-R data are multidimensional. There were differential associations between factor scores and patient characteristics, suggesting that some PDSS-R items, but not others, are influenced by mood and personality in addition to sleep symptoms. Multidimensional measurement models may also be a helpful tool in the PDSS and the PDSS-2 scales and may improve the sensitivity of these instruments.
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Affiliation(s)
- Maria E. Pushpanathan
- School of Psychological Sciences, The University of Western Australia, Crawley, Western Australia, Australia
- * E-mail:
| | - Andrea M. Loftus
- School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia
| | - Natalie Gasson
- School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia
| | - Meghan G. Thomas
- School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Caitlin F. Timms
- School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia
| | - Michelle Olaithe
- School of Psychological Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Romola S. Bucks
- School of Psychological Sciences, The University of Western Australia, Crawley, Western Australia, Australia
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