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Canever JB, Zurman G, Vogel F, Sutil DV, Diz JBM, Danielewicz AL, Moreira BDS, Cimarosti HI, de Avelar NCP. Worldwide prevalence of sleep problems in community-dwelling older adults: A systematic review and meta-analysis. Sleep Med 2024; 119:118-134. [PMID: 38669835 DOI: 10.1016/j.sleep.2024.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/09/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024]
Abstract
The understanding of the prevalence of sleep problems in older adults can provide a broad and reliable perspective into the occurrence of such issues among older adults. This systematic review and meta-analysis aimed to estimate the worldwide prevalence of sleep problems in community-dwelling older adults. Studies that provide information on the prevalence of sleep problems in community-dwelling older adults (≥60 years) were screened between December 2022 and March 2023. A total of 20,379 studies were identified in database searches, from which 252 were included in this review. These studies covered the last 35 years (from 1988 to 2023) and pooled a sample of 995,544 participants from 36 countries. The most frequent sleep problem worldwide was obstructive sleep apnea (46.0%), followed by poor sleep quality (40.0%), other sleep problems (37.0%), insomnia (29.0%), and excessive daytime sleepiness (19.0%). No significant difference in the prevalence estimates of all sleep problems was observed between the sexes. This systematic review and meta-analysis showed a high prevalence of some sleep problems, mainly obstructive sleep apnea, poor sleep quality, and other sleep problems. Our estimates can be useful for managers and policymakers in planning healthcare strategies for sleep problems aimed at the older population.
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Affiliation(s)
- Jaquelini Betta Canever
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil; Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Gabriela Zurman
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Felipe Vogel
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Daiana Vieira Sutil
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Ana Lúcia Danielewicz
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health and Aging, Federal University of Minas Gerais and Oswaldo Cruz Foundation - Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Helena Iturvides Cimarosti
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil
| | - Núbia Carelli Pereira de Avelar
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Lee S, Quinn L, Fritschi C, Fink AM, Park C, Reutrakul S, Collins EG. Effects of daily sleep on physical activity after cardiac surgery. Heart Lung 2024; 65:47-53. [PMID: 38401358 DOI: 10.1016/j.hrtlng.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/06/2024] [Accepted: 02/18/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Maintaining physical activity is challenging after cardiac surgery. Postsurgical cardiac patients often experience sleep problems showing a reciprocal interaction with physical activity. As sleep and physical activity show day-to-day variations, their daily relationships need to be assessed. However, no studies have examined daily sleep-physical activity relationships in postsurgical cardiac patients. OBJECTIVES This study aimed to examine the effects of daily sleep factors on daily physical activity after cardiac surgery. METHODS Among 33 patients who underwent cardiac surgery at least 10 weeks earlier, 5 sleep and 4 physical activity variables were measured using a wrist-worn ActiGraph for 7 days. Mixed-effects models were applied for data analyses. RESULTS Most participants were male (57.6 %), non-Hispanic whites (63.6 %) who had coronary artery bypass graft surgery (54.6 %). Participants averaged 60.8 ± 10.1 years of age and 85.7 ± 91.2 months since surgery. They slept for an average of 385.6 ± 74.6 min (6.4 ± 1.2 h). Among sleep factors, greater number of awakenings (NOA) predicted lower next-day sedentary time. Higher sleep efficiency (SE) was associated with lower next-day sedentary time when not controlling for covariates. Among the psychosocial, demographic, and clinical covariates, higher comorbidity index was associated with fewer kcals expended, less daily moderate-to-vigorous physical activity, and more daily sedentary time. CONCLUSIONS Daily SE and NOA and individual health status, including comorbidity, should be assessed over time to support improvement of daily physical activity after cardiac surgery. Researchers should examine the relationship between NOA and next-day sedentary time with larger samples. Such research should address multiple psychosocial, demographic, and clinical factors and the potential mediating role of sleep.
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Affiliation(s)
- Sueyeon Lee
- Loyola University Chicago, Marcella Niehoff School of Nursing, 2160 S. 1st Ave., Maywood, IL 60153, USA.
| | - Lauretta Quinn
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Cynthia Fritschi
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Anne M Fink
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Chang Park
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Sirimon Reutrakul
- University of Illinois Chicago, Department of Medicine, 835 S. Wolcott, Chicago, IL 60612, USA
| | - Eileen G Collins
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
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Willinger CM, Waddell KJ, Arora V, Patel MS, Ryan Greysen S. Patient-reported sleep and physical function during and after hospitalization. Sleep Health 2024; 10:249-254. [PMID: 38151376 PMCID: PMC11045314 DOI: 10.1016/j.sleh.2023.12.001] [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: 06/20/2023] [Revised: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE Poor sleep is associated with morbidity and mortality in the community; however, the health impact of poor sleep during and after hospitalization is poorly characterized. Our purpose was to describe trends in patient-reported sleep and physical function during and after hospitalization and evaluate sleep as a predictor of function after discharge. METHODS This is a secondary analysis of trial data with 232 adults followed for 3months after hospital discharge. Main measures were patient-reported surveys on sleep (Pittsburgh Sleep Quality Index) and physical function (Katz Activities of Daily Living, Lawton Instrumental Activities of Daily Living, and Nagi Mobility Scale) were collected during hospitalization and at 1, 5, 9, and 13weeks postdischarge. RESULTS Patient-reported sleep declined significantly during hospitalization and remained worse for 3months postdischarge (median Pittsburgh Sleep Quality Index=8 vs. 6, p < .001). In parallel, mobility declined significantly from baseline and remained worse at each follow-up time (median Nagi score=2 vs. 0, p < .001). Instrumental activities of daily living similarly decreased during and after hospitalization, but basic activities of daily living were unaffected. In adjusted time-series logistic regression models, the odds of mobility impairment were 1.48 times higher for each 1-point increase in Pittsburgh Sleep Quality Index score over time (95% CI 1.27-1.71, p < .001). CONCLUSIONS Patient-reported sleep worsened during hospitalization, did not improve significantly for 3months after hospitalization, and poor sleep was a significant predictor of functional impairment over this time. Sleep dysfunction that begins with hospitalization may persist and prevent functional recovery after discharge. TRIAL REGISTRATION The primary study was registered at ClinicalTrials.gov NCT03321279.
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Affiliation(s)
| | - Kimberly J Waddell
- Center for Health Equity Research and Prevention, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Vineet Arora
- Department of Medicine, Section of Hospital Medicine, University of Chicago, Chicago, Illinois, USA
| | - Mitesh S Patel
- Office of Clinical Transformation, Ascension Health, St. Louis, Missouri, USA
| | - S Ryan Greysen
- Center for Health Equity Research and Prevention, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA; Department of Medicine, Section of Hospital Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Chen P, Lam MI, Si TL, Zhang L, Balbuena L, Su Z, Cheung T, Ungvari GS, Sha S, Xiang YT. The prevalence of poor sleep quality in the general population in China: a meta-analysis of epidemiological studies. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01764-5. [PMID: 38429554 DOI: 10.1007/s00406-024-01764-5] [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] [Received: 05/02/2023] [Accepted: 01/13/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND The high prevalence of poor sleep quality (PSQ) in the general population leads to negative health outcomes. Since estimates of PSQ prevalence in the Chinese general population vary widely, this meta-analysis aimed to refine these estimates and to identify moderating factors. METHODS A comprehensive literature search was undertaken in both international (PubMed, PsycINFO, Web of Science, and EMBASE) and Chinese (Wanfang, and the China National Knowledge Infrastructure databases) databases from inception to 23 November 2023. Studies were required to have used standard scales such as the Chinese version of the Pittsburgh Sleep Quality Index (PSQI). The pooled prevalence of PSQ and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup and meta-regression analyses were performed to identify sources of heterogeneity. RESULTS In 32 studies with a combined 376,824 participants, the pooled prevalence of PSQ was 19.0% (95% CI 15.8-22.8%; range 6.6-43.6%). Across 22 studies that reported PSQI data, the pooled mean score was 4.32 (95%CI 3.82-4.81; SD = 0.502). The pooled mean sleep duration across 8 studies was 7.62 (95% CI 7.23-8.00; SD = 0.194) hours. Subgroup analyses showed that lower education (Q = 4.12, P = 0.042), living in less developed regions (Q = 60.28, P < 0.001), and lower PSQI cutoff values (Q = 9.80, P = 0.007) were significantly associated with PSQ. Meta-regression analyses showed that study quality was inversely associated with estimated PSQ prevalence (β = - 0.442, P = 0.004). LIMITATIONS Although measures such as subgroup and meta-regression analyses were performed, substantial heterogeneity remained. Information related to sleep quality, such as comorbid physical diseases or psychiatric disorders, substance use, occupational types, and employment status, were not reported in most studies. CONCLUSION One in five people in the general population of China may have PSQ and people with lower education or living in western regions may be more susceptible.
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Affiliation(s)
- Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- Psychiatry Section, University of Notre Dame Australia, Fremantle, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Swain BK, Goswami S, Das CP, Panda BP. Soundscape of an eastern coastal city of India. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:107259-107280. [PMID: 37462869 DOI: 10.1007/s11356-023-28670-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/03/2023] [Indexed: 10/29/2023]
Abstract
The soundscape study of an eastern Indian coastal city (Puri) has been investigated. Acoustic data were collected at 36 sampling locations during two time intervals in and around Puri. A number of noise indices, namely, Lmin, Lmax, and Leq, were calculated to demonstrate the noise level of this city. Noise maps are generated using ARC-GIS to investigate the impact of road traffic noise on the soundscape of the city. The response of the public was appraised by a questionnaire. Due to variable traffic features, the equivalent noise level (Leq) as well as peak (L10) and background noise (L90) levels varied with location and time of the day. It was found that socio-demographic characteristics have no bearing on the amount of annoyance. However, a link was observed between age, hearing condition, and noise perception, as well as between gender and impacts of noise.
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Affiliation(s)
| | | | | | - Bibhu Prasad Panda
- Environmental Science Programme, ITER, S 'O' A University, Bhubaneswar, India
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Guo X, Qin Z, Meng C, Lv J, Hu Y, Fei J, Liang L, Li J, Yuan T, Mei S, Tong Q. Investigation of the Sleep Quality Among Hospitalized Cardiovascular Patients Using Regression Models and Qualitative Comparative Analysis. Clin Nurs Res 2023; 32:580-588. [PMID: 36633212 DOI: 10.1177/10547738221148150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This study aimed to explore the relationships between modifiable and non-modifiable factors that influence sleep quality in hospitalized patients with cardiovascular disease in China. This study design was cross-sectional and descriptive. This study involved a convenience sample of 242 patients hospitalized for cardiovascular issues. Hierarchical regression model and qualitative comparative analysis model were performed. Regression revealed that age and depression both had statistically significant effects on sleep quality. The combination of conditions with strongest predictive effect on sleep quality was male of younger age, high level of depression, high level of anxiety, and low level of social support. Other combinations with predictive power on sleep quality are as follows: (1) younger male patients (aged 47-63 years) with high level of anxiety, high level of social support, and low level of depression; (2) older male patients (aged 63-79 years) with high level of depression, high level of social support, and low levels of anxiety; and (3) older male patients with high level of anxiety and low level of social support. Nurses may promote primary and secondary prevention of cardiovascular health prior to hospitalization, through routine screening for depressive and anxious symptoms and assessment of the patient's social support network. It is unknown whether these findings are unique to hospitalized patients. Therefore, future work should assess the fit of the model to other more diverse groups of hospitalized patients.
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Affiliation(s)
- Xinmeng Guo
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Zeying Qin
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Cuicui Meng
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jianping Lv
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yueyang Hu
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Junsong Fei
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Leilei Liang
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jingyang Li
- First Hospital, Jilin University, Changchun, Jilin Province, China
| | - Tongshuang Yuan
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Songli Mei
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Qian Tong
- First Hospital, Jilin University, Changchun, Jilin Province, China
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Alghadir AH, Khan M, Alshehri MM, Alqahtani AS, Aldaihan M. In hypertensive individuals, sleep time and sleep efficiency did not affect the number of angina episodes: a cross-sectional study. Sci Rep 2022; 12:16290. [PMID: 36175431 PMCID: PMC9523051 DOI: 10.1038/s41598-022-20255-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 09/12/2022] [Indexed: 11/30/2022] Open
Abstract
Previous studies have reported adverse effects of short and long sleep duration on cardiovascular health. However, how sleep time and sleep efficiency affect angina have not been studied in hypertensive individuals. This study aimed to assess the relationship of sleep with angina. Using a cross-sectional design, data from 1563 hypertensive individuals were collected from the parent Sleep Heart Health Study (SHHS). Age, alcohol use, average diastolic blood pressure (ADBP), average systolic blood pressure (ASBP), cigarette use, sleep time, sleep efficiency, percent time in stage N3 of sleep, and body mass index (BMI) were used as covariates. Multiple linear regression, the Chi-Square test, and Pearson’s correlation coefficient were used for data analysis. Unadjusted sleep efficiency, sleep time, ADBP, and age were significant (p < 0.05) predictors of the number of angina episodes (Anginan). When the covariates were adjusted, only ADBP and ASBP were significant (p < 0.05) predictors of Anginan. Sleep efficiency, BMI, ADBP, sleep time, and age had a significant (p < 0.05) correlation with Anginan. In hypertensive individuals, sleep time and sleep efficiency did not affect Anginan when adjusted for covariates. ADBP and ASBP were found to be significant predictors of Anginan when the covariates were adjusted.
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Affiliation(s)
- Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Masood Khan
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | | | - Abdulfattah S Alqahtani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mishal Aldaihan
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Hu XM, Wei WT, Huang DY, Lin CD, Lu F, Li XM, Liao HS, Yu ZH, Weng XP, Wang SB, Hou CL, Jia FJ. Sleep patterns and potential risk factors for disturbed sleep quality in patients after surgery for infective endocarditis. J Cardiothorac Surg 2022; 17:121. [PMID: 35581652 PMCID: PMC9116038 DOI: 10.1186/s13019-022-01828-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background The current study aimed to investigate the sleep quality of patients after valve replacement surgery due to infective endocarditis and identify risk factors for disturbed sleep post hospitalisation. Methods Eighty patients were assessed postoperatively using subjective scale measures, the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale, and an objective measure, actigraphy. Scale measures were assessed approximately 2 weeks and 6 months after surgery. Actigraphy monitoring was performed for 2 consecutive weeks during hospitalisation. Logistic regression was used to identify risk factors for disturbed sleep. Results The study population (n = 80) had an average age of 42.8 ± 14.2 years, and 67.5% were male. The median sleep efficiency was 85.3% in week 1 and 86.8% in week 2. The frequency of awakenings was significantly higher in week 1 (20.0 times vs. 19.3 times, p = 0.017). The scale measures showed significant improvement in sleep by 6 months after surgery compared to that during hospitalisation. Multivariable logistic regression analysis suggested that the possible risk factors for disturbed sleep 6 months after surgery included age (OR = 1.479, 95%CI 1.140–1.920) and a few parameters of early postoperative disturbed sleep quality (PSQI: OR = 2.921, 95%CI 1.431–5.963; sleep efficiency: OR = 0.402, 95%CI 0.206–0.783; and average duration of awakenings: OR = 0.006, 95%CI 0.000–0.827). Conclusions Disturbed sleep quality was witnessed in postoperative patients during hospitalisation and up to 6 months after surgery. Over time, the patients’ sleep quality improved significantly. Age and a few early postoperative sleep quality variables were risk factors for disturbed sleep 6 months after surgery. Supplementary Information The online version contains supplementary material available at 10.1186/s13019-022-01828-4.
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Affiliation(s)
- Xiang-Ming Hu
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Wen-Ting Wei
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - De-Yi Huang
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Cai-Di Lin
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Fen Lu
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Xiao-Ming Li
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Huo-Sheng Liao
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Zhi-Hong Yu
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Xiao-Ping Weng
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 123 Huifu Road, Yuexiu District, Guangzhou, 510080, Guangdong Province, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 123 Huifu Road, Yuexiu District, Guangzhou, 510080, Guangdong Province, China
| | - Fu-Jun Jia
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China. .,Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 123 Huifu Road, Yuexiu District, Guangzhou, 510080, Guangdong Province, China.
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Hu X, Huang D, Lin C, Li X, Lu F, Wei W, Yu Z, Liao H, Huang F, Huang X, Jia F. Zolpidem improves patients' sleep quality after surgical treatment for infective endocarditis: a prospective observational study. Sleep Breath 2021; 26:1097-1105. [PMID: 34449017 DOI: 10.1007/s11325-021-02479-w] [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: 02/18/2021] [Revised: 08/09/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The objective of this study was to investigate the efficacy of zolpidem for improving post-operative sleep quality among patients with infective endocarditis (IE) and to identify the potential risk factors for impaired sleep quality at 6 months after surgery. METHODS Patients with IE who underwent surgical treatment were divided into two groups according to zolpidem usage. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to evaluate patients' sleep quality and daytime sleepiness at baseline, which was the second day after transferal, and at 6 months after surgery. Logistic regression was used to identify potential risk factors. RESULTS There were 32 patients in the zolpidem group and 42 in the control group. The PSQI and ESS scores at 6 months after surgery were significantly lower than those at baseline in both groups (P = 0.04). Additionally, 9 patients (28%) in the zolpidem group and 22 patients (52%) in the control group suffered poor sleep quality. Multivariate analysis identified age (odds ratio [OR] = 1.26, 95% confidence interval [CI]: 1.12-1.42), baseline PSQI score (OR = 2.66, 95%CI: 1.55-4.65), and no zolpidem usage (OR = 45.48, 95%CI: 3.01-691.23) as independent factors for poor sleep quality. CONCLUSIONS Poor sleep quality after IE surgery was prevalent among patients even 6 months after IE surgery. Age, baseline PSQI score and no zolpidem usage were independently associated with poor sleep quality. Therefore, zolpidem has the potential to be an effective part of a treatment arsenal for poor sleep quality after surgical treatment for IE.
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Affiliation(s)
- Xiangming Hu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong Province, China.,Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China
| | - Deyi Huang
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China
| | - Caidi Lin
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China
| | - Xiaoming Li
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China
| | - Fen Lu
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China
| | - Wenting Wei
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China
| | - Zhihong Yu
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China
| | - Huosheng Liao
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China
| | - Fang Huang
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China
| | - Xuezhen Huang
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong Province, China
| | - Fujun Jia
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong Province, China. .,Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, No. 123, Huifu Road, Yuexiu District, Guangzhou, 510080, Guangdong Province, China.
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10
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Affective relations of sleep in rehabilitation: cutting across social and biological divide to study how sleep comes to matter in rehabilitation. SOCIAL THEORY & HEALTH 2021. [DOI: 10.1057/s41285-020-00157-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sleep Quality after Coronary Artery Bypass Graft Surgery: Comparing Pulsatile and Nonpulsatile Pump Flow. THE JOURNAL OF EXTRA-CORPOREAL TECHNOLOGY 2020; 52:314-318. [PMID: 33343034 DOI: 10.1182/ject-2000024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/03/2020] [Indexed: 12/27/2022]
Abstract
Poor postoperative sleep quality is a common problem in patients undergoing coronary artery bypass graft surgery (CABG). The purpose of this study was to compare the effect of pulsatile and nonpulsatile pump flow on sleep quality of these patients. In this clinical trial, 52 patients undergoing on pump CABG surgery with the roller pump were randomly divided into two equal groups of 26 patients: group 1 using pulsatile pump flow and group 2 nonpulsatile pump flow while the heart was arrested. Sleep score of both groups was evaluated by Pittsburgh Sleep Quality Index questionnaire 2 days before operation and 1 month after operation, and they were compared with each other. Analysis was performed with SPSS software version 22 (SPSS for Windows Inc., Chicago, IL) using the independent t-test, chi-square test, and Fisher exact test. Both groups were the same in demographic characteristics and risk factors such as age, gender, diabetes mellitus, hypertension, hyperlipidemia, smoking, body mass index, and preoperative ejection fraction. Operation data showed no difference between two groups considering cardiopulmonary bypass time and cardiac arrest time. Preoperative sleep quality score of both groups had no significant difference (p = .84). One month postoperative sleep quality score of the pulsatile group was significantly better than that of the nonpulsatile group (p = .04). Using pulsatile flow cardiopulmonary bypass can effectively decrease postoperative sleep disorders in comparison to nonpulsatile flow.
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12
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Quantifying postoperative sleep loss associated with increased pain in children undergoing a modified Nuss operation. J Pediatr Surg 2020; 55:1846-1849. [PMID: 31982091 DOI: 10.1016/j.jpedsurg.2019.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/10/2019] [Accepted: 12/02/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE The presence of pain may interrupt sleep and impede normal postoperative recovery; however, no prior studies have quantified sleep loss due to pain in children undergoing inpatient surgery. Wearable accelerometers objectively measure sleep patterns in children. We aimed to quantify sleep loss associated with patient reported pain scores after a Modified Nuss operation. METHODS Ten patients undergoing Modified Nuss operations were recruited during their inpatient stay. Children wore an Actigraph GT3X-BT accelerometer postoperatively during their hospital stay. Hourly sleep minutes were recorded using the Actigraph between 10 pm and 6 am. Patient reported pain scores were abstracted from patient charts. Mixed linear regression models, adjusting for within-subject random effects, were estimated to quantify the association between hourly sleep minutes and patient reported pain scores. RESULTS Patients were 30% female, with an average age of 15.7 years (range 13-22). The majority (70%) of patients were white non-Hispanic. All patients received a patient controlled analgesic pump. Average postoperative length of stay was 4.8 days (range 4.0-6.0; SD = 0.8). A total of 240 sleep hours and associated pain scores were analyzed. Patients slept on average 48 min per hour. Mixed model analysis predicted that a 1-point increase in pain score was associated with 2.5 min per hour less sleep time. CONCLUSION Increases in patient-reported pain scores are associated with sleep loss after a Modified Nuss operation. Objectively quantifying sleep loss associated with postoperative pain using accelerometer data may help clinicians better understand their patient's level of pain control. Our findings provide the basis for future studies aimed at more accurately titrating pain medication to optimize sleep and speed up recovery. LEVEL OF EVIDENCE Case Series Without Comparison Group, Level IV.
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13
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Muthukrishnan A, Muralidharan TR, Subash J, Lathamangeswari C. Association of poor sleep quality with risk factors after coronary artery bypass graft surgery—A prospective cohort study. JOURNAL OF VASCULAR NURSING 2020; 38:83-92. [DOI: 10.1016/j.jvn.2020.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/22/2020] [Accepted: 02/05/2020] [Indexed: 10/24/2022]
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Le Grande MR, Beauchamp A, Driscoll A, Jackson AC. Prevalence of obstructive sleep apnoea in acute coronary syndrome patients: systematic review and meta-analysis. BMC Cardiovasc Disord 2020; 20:147. [PMID: 32209053 PMCID: PMC7092582 DOI: 10.1186/s12872-020-01430-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 03/12/2020] [Indexed: 12/26/2022] Open
Abstract
Background Obstructive Sleep Apnoea (OSA) has been recognised as a risk factor for cardiovascular diseases such as hypertension and cardiovascular events such as acute coronary syndrome (ACS). Since it is also known to reduce exercise tolerance, it is important to establish the prevalence of OSA in ACS patients, particularly in those who are commencing cardiac rehabilitation (CR) programs. Methods Using PRISMA guidelines a systematic search was conducted in order to identify studies that objectively measured (using polysomnography or portable monitoring) the prevalence of OSA in ACS patients following hospital admission. A data extraction table was used to summarise study characteristics and the quality of studies were independently assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool. Meta-analysis of the selected studies was conducted in order to estimate OSA prevalence as a function of the two main methods of measurement, the severity of OSA, and timing of the OSA assessment following ACS hospital admission. Results Pooled prevalence estimates of OSA using the “gold standard” polysomnography ranged from 22% for severe OSA to 70% for mild OSA, at any time after hospital admission. Similar prevalence estimates were obtained using portable monitoring, but interpretation of these results are limited by the significant heterogeneity observed among these studies. Conclusions Prevalence of OSA following ACS is high and likely to be problematic upon patient entry into CR programs. Routine screening for OSA upon program entry may be necessary to optimise effectiveness of CR for these patients.
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Affiliation(s)
- Michael R Le Grande
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia. .,Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia. .,Melbourne Centre for Behaviour Change, School of Psychological Sciences, The University of Melbourne, Parkville, VIC, 3052, Australia.
| | - Alison Beauchamp
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia.,Department of Medicine -Western Health, The University of Melbourne, Parkville, VIC, 3052, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), St.Albans, VIC, 3021, Australia.,School of Rural Health, Monash University, Newborough, VIC, 3825, Australia
| | - Andrea Driscoll
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia
| | - Alun C Jackson
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia.,Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia.,Centre on Behavioural Health, Hong Kong University, Pakfulam, Hong Kong
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15
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Ghorbani A, Hajizadeh F, Sheykhi MR, Mohammad Poor Asl A. The Effects of Deep-Breathing Exercises on Postoperative Sleep Duration and Quality in Patients Undergoing Coronary Artery Bypass Graft (CABG): a Randomized Clinical Trial. J Caring Sci 2018; 8:219-224. [PMID: 31915624 PMCID: PMC6942648 DOI: 10.15171/jcs.2019.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 10/22/2018] [Indexed: 12/19/2022] Open
Abstract
Introduction: Disordered sleep occurs frequently in patients who have undergone coronary bypass graft surgery, and it contributes to increased morbidity, mortality, and resource utilization. The present study aimed to determine the effects of deep-breathing exercises on postoperative sleep duration and quality in patients undergoing coronary artery bypass graft. Methods: This study was a clinical trial. The study sample included 64 patients who were coronary artery bypass graft hospitalized from January 2015 to April 2015 in Qazvin Booali-Sina hospital. The patients were selected by convenient sampling and then the participants were randomly allocated to the intervention and control groups. The baseline and postoperative (day 7) sleep duration and quality metrics were measured. The St Mary's Hospital Sleep Questionnaire was used to evaluate sleep quality in two groups. Results: Baseline night sleep duration was 5.72 (1.63) hours in the control group and 5.58 (1.07) hours in the intervention group. The initial findings showed that the mean of sleep quality score of patients in the intervention and control groups were 19.72 (2.68) and 18.22 (3.81) respectively. These measurements did not decline postoperatively in the intervention group while night sleep duration and quality declined in the control group. Deep breathing exercise program had a significant effect on sleep quality score in the intervention group compared to the control group. Conclusion: The results indicated that deep breathing exercises prevent decline in sleep quality postoperatively. It seems to be a safe method with no side effects for these patients. Furthermore, it is a simple method to implement and does not impose a high cost.
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Affiliation(s)
- Azam Ghorbani
- Department of Community Health Nursing, Metabolic Diseases Research Center, Nursing and Midwifery Faculty, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Hajizadeh
- Department of Community Health Nursing, Nursing and Midwifery Faculty, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Reza Sheykhi
- Department of Community Health Nursing, Nursing and Midwifery Faculty, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Asghar Mohammad Poor Asl
- Department of Epidemiology & Biostatistics, Health Services Management Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Tan X, van Egmond L, Partinen M, Lange T, Benedict C. A narrative review of interventions for improving sleep and reducing circadian disruption in medical inpatients. Sleep Med 2018; 59:42-50. [PMID: 30415906 DOI: 10.1016/j.sleep.2018.08.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 08/07/2018] [Accepted: 08/14/2018] [Indexed: 12/28/2022]
Abstract
Sleep and circadian disruptions are frequently observed in patients across hospital wards. This is alarming, since impaired nocturnal sleep and disruption of a normal circadian rhythm can compromise health and disturb processes involved in recovery from illness (eg, immune functions). With this in mind, the present narrative review discusses how patient characteristics (sleep disorders, anxiety, stress, chronotype, and disease), hospital routines (pain management, timing of medication, nocturnal vital sign monitoring, and physical inactivity), and hospital environment (light and noise) may all contribute to sleep disturbances and circadian misalignment in patients. We also propose hospital-based strategies that may help reduce sleep and circadian disruptions in patients admitted to the hospital.
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Affiliation(s)
- Xiao Tan
- Department of Neuroscience, Sleep Research Laboratory, Uppsala University, Uppsala, Sweden.
| | - Lieve van Egmond
- Department of Neuroscience, Sleep Research Laboratory, Uppsala University, Uppsala, Sweden
| | - Markku Partinen
- Department of Neurological Sciences, University of Helsinki, Helsinki, Finland; VitalMed Research Center, Helsinki Sleep Clinic, Helsinki, Finland
| | - Tanja Lange
- Department of Rheumatology & Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - Christian Benedict
- Department of Neuroscience, Sleep Research Laboratory, Uppsala University, Uppsala, Sweden.
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17
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Conrad N, Karlik J, Lewandowski Holley A, Wilson AC, Koh J. A Narrative Review: Actigraphy as an Objective Assessment of Perioperative Sleep and Activity in Pediatric Patients. CHILDREN-BASEL 2017; 4:children4040026. [PMID: 28420221 PMCID: PMC5406685 DOI: 10.3390/children4040026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 04/10/2017] [Indexed: 12/27/2022]
Abstract
Sleep is an important component of pediatric health and is crucial for cognitive development. Actigraphy is a validated, objective tool to capture sleep and movement data that is increasingly being used in the perioperative context. The aim of this review is to present recent pediatric studies that utilized actigraphy in the perioperative period, highlight gaps in the literature, and provide recommendations for future research. A literature search was completed using OVID and PubMed databases and articles were selected for inclusion based on relevance to the topic. The literature search resulted in 13 papers that utilized actigraphic measures. Results of the review demonstrated that actigraphy has been used to identify predictors and risk factors for poor postoperative sleep, examine associations among perioperative pain and sleep patterns, and assess activity and energy expenditure in both inpatient and outpatient settings. We propose expansion of actigraphy research to include assessment of sleep via actigraphy to: predict functional recovery in pediatric populations, to study postoperative sleep in high-risk pediatric patients, to test the efficacy of perioperative interventions, and to assess outcomes in special populations for which self-report data on sleep and activity is difficult to obtain.
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Affiliation(s)
- Nicole Conrad
- Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University (OHSU), Portland, OR 97239, USA.
| | - Joelle Karlik
- Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University (OHSU), Portland, OR 97239, USA.
| | - Amy Lewandowski Holley
- Department of Pediatrics, Oregon Health and Science University (OHSU), Portland, OR 97329, USA.
| | - Anna C Wilson
- Department of Pediatrics, Oregon Health and Science University (OHSU), Portland, OR 97329, USA.
| | - Jeffrey Koh
- Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University (OHSU), Portland, OR 97239, USA.
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18
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Is insufficient sleep duration associated with suicidal behavior in Korean adolescents? Sleep Biol Rhythms 2017. [DOI: 10.1007/s41105-016-0087-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Kamdar BB, Combs MP, Colantuoni E, King LM, Niessen T, Neufeld KJ, Collop NA, Needham DM. The association of sleep quality, delirium, and sedation status with daily participation in physical therapy in the ICU. Crit Care 2016; 19:261. [PMID: 27538536 PMCID: PMC4990875 DOI: 10.1186/s13054-016-1433-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 07/22/2016] [Indexed: 11/16/2022] Open
Abstract
Background Poor sleep is common in the ICU setting and may represent a modifiable risk factor for patient participation in ICU-based physical therapy (PT) interventions. This study evaluates the association of perceived sleep quality, delirium, sedation, and other clinically important patient and ICU factors with participation in physical therapy (PT) interventions. Method This was a secondary analysis of a prospective observational study of sleep in a single academic medical ICU (MICU). Perceived sleep quality was assessed using the Richards-Campbell Sleep Questionnaire (RCSQ) and delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU). Other covariates included demographics, pre-hospitalization ambulation status, ICU admission diagnosis, daily mechanical ventilation status, and daily administration of benzodiazepines and opioids via bolus and continuous infusion. Associations with participation in PT interventions were assessed among patients eligible for PT using a multinomial Markov model with robust variance estimates. Results Overall, 327 consecutive MICU patients completed ≥1 assessment of perceived sleep quality. After adjusting for all covariates, daily assessment of perceived sleep quality was not associated with transitioning to participate in PT the following day (relative risk ratio [RRR] 1.02, 95 % CI 0.96–1.07, p = 0.55). However, the following factors had significant negative associations with participating in subsequent PT interventions: delirium (RRR 0.58, 95 % CI 0.41–0.76, p <0.001), opioid boluses (RRR 0.68, 95 % CI 0.47–0.99, p = 0.04), and continuous sedation infusions (RRR 0.58, 95 % CI 0.40–0.85, p = 0.01). Additionally, in patients with delirium, benzodiazepine boluses further reduced participation in subsequent PT interventions (RRR 0.25, 95 % CI 0.13–0.50, p <0.001). Conclusions Perceived sleep quality was not associated with participation in PT interventions the following day. However, continuous sedation infusions, opioid boluses, and delirium, particularly when occurring with administration of benzodiazepine boluses, were negatively associated with subsequent PT interventions and represent important modifiable factors for increasing participation in ICU-based PT interventions.
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Affiliation(s)
- Biren B Kamdar
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at the University of California, 10833 Le Conte Ave., Room 37-131 CHS, Los Angeles, CA, 90095, USA.
| | - Michael P Combs
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, 90095, USA
| | - Elizabeth Colantuoni
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, 21205, USA.,Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Lauren M King
- Department of Palliative Medicine, Wellspan Health, York Hospital, York, PA, 17403, USA
| | - Timothy Niessen
- Department of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Karin J Neufeld
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, 21205, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Nancy A Collop
- Emory Sleep Disorders Center, Wesley Woods Health Center, Emory University, Atlanta, GA, 30322, USA
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, 21205, USA.,Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA.,Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, 21205, USA
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20
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DuBose JR, Hadi K. Improving inpatient environments to support patient sleep. Int J Qual Health Care 2016; 28:540-553. [DOI: 10.1093/intqhc/mzw079] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 06/17/2016] [Accepted: 06/21/2016] [Indexed: 02/04/2023] Open
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21
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Bauldoff GS, Ryan-Wenger NA, Diaz PT. Wrist Actigraphy Validation of Exercise Movement in COPD. West J Nurs Res 2016; 29:789-802. [PMID: 17636244 DOI: 10.1177/0193945906297371] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A wrist actigraph is a device used in sleep research studies to measure whole body movements. The purpose of this study was to evaluate the feasibility, sensitivity, and validity of wrist actigraphy during pulmonary rehabilitation (PR) upper-extremity exercise in chronic obstructive pulmonary disease (COPD) patients. In this study, 20 patients wore Octagonal Basic Motionlogger® actigraphs during two 90-minute PR sessions while the investigator recorded details of the subject's upper-extremity movements. Concurrent validity with supervised exercise records was supported for upper-extremity endurance (UEE) intensity at baseline ( r = .885, p < .001) and 1 week ( r = .935, p < .001). Criterion validity was supported for UEE ( r = .56, p = .01) and combined lower- and upper-extremity resistance ( r = .72, p < .01) compared with rank-ordered type of exercise. Wrist actigraphy is shown to be a feasible, sensitive, and valid instrument to measure upper-extremity movement during PR in COPD patients.
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22
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Millstein RA, Celano CM, Beale EE, Beach SR, Suarez L, Belcher AM, Januzzi JL, Huffman JC. The effects of optimism and gratitude on adherence, functioning and mental health following an acute coronary syndrome. Gen Hosp Psychiatry 2016; 43:17-22. [PMID: 27796252 PMCID: PMC6894170 DOI: 10.1016/j.genhosppsych.2016.08.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/22/2016] [Accepted: 08/25/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This study examined the effects of optimism and gratitude on self-reported health behavior adherence, physical functioning and emotional well-being after an acute coronary syndrome (ACS). METHODS Among 156 patients, we examined associations between optimism and gratitude measured 2 weeks post-ACS and 6-month outcomes: adherence to medical recommendations, mental and physical health-related quality of life (HRQoL), physical functioning, depressive symptoms and anxiety. Multivariable linear regression models were used, controlling for increasing levels of adjustment. RESULTS Optimism [β=.11, standard error (S.E.)=.05, P=.038] and gratitude (β=.10, S.E.=.05, P=.027) at 2 weeks were associated with subsequent self-reported adherence to medical recommendations (diet, exercise, medication adherence, stress reduction) at 6 months in fully adjusted models. Two-week optimism and gratitude were associated with improvements in mental HRQoL (optimism: β=.44, S.E.=.13, P=.001; gratitude: β=.33, S.E.=.12, P=.005) and reductions in symptoms of depression (optimism: β=-.11, S.E.=.05, P=.039; gratitude: β=-.10, S.E.=.05, P=.028) and anxiety (optimism: β=-.15, S.E.=.05, P=.004; gratitude: β=-.10, S.E.=.05, P=.034) at 6 months. CONCLUSION Optimism and gratitude at 2 weeks post-ACS were associated with higher self-reported adherence and improved emotional well-being 6 months later, independent of negative emotional states. Optimism and gratitude may help recovery from an ACS. Interventions promoting these positive constructs could help improve adherence and well-being.
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Affiliation(s)
- Rachel A. Millstein
- Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA,Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA,Corresponding author at: Massachusetts General Hospital, 55 Fruit Street/Warren 1220, Boston, MA 02114, USA. Tel.: +1 617 724 2047; fax: +1 617 724 9150. (R.A. Millstein)
| | - Christopher M. Celano
- Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA,Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
| | | | - Scott R. Beach
- Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA,Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
| | - Laura Suarez
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
| | - Arianna M. Belcher
- Department of Medicine, Division of Cardiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
| | - James L. Januzzi
- Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA,Department of Medicine, Division of Cardiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
| | - Jeff C. Huffman
- Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA,Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
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Relationship Between Accelerometer-Measured Activity and Self-Reported or Performance-Based Function in Older Adults with Severe Aortic Stenosis. CURRENT GERIATRICS REPORTS 2015; 4:377-384. [PMID: 27668146 DOI: 10.1007/s13670-015-0152-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In older adults with aortic stenosis, we evaluated whether accelerometer-measured physical activity provides distinct clinical information apart from self-reported surveys or performance-based function tests. We employed wrist-mounted accelerometry in 52 subjects with severe aortic stenosis prior to transcatheter aortic valve replacement (TAVR). Daily daytime activity was estimated using the maximum 10 h of daily accelerometer-measured activity (M10) reported in activity counts. Subjects completed baseline surveys (New York Heart Association (NYHA), Short Form 12 (SF12), Kansas City Cardiomyopathy Questionnaire (KCCQ), EuroQol-5D (EQ-5D), Revised Life Orientation Test (LOT-R), Life Space, Detailed Activity Form) and performance-based function tests (Short Physical Performance Battery, 6-min walk test distance, grip strength) to estimate functional status. Simple and multiple linear regression models were used to evaluate the relationship between accelerometer-measured activity and survey data and performance-based function tests. Among all baseline surveys and performance-based function tests, the only statistically significant univariable relationships identified were weak, negative associations between M10 and SF-12 Mental Composite Score (R2=0.1970, P=0.04) and between M10 and grip strength (R2=0.1568, P=0.004). Neither multiple linear regression of overall survey data (R2=0.6159, P=0.23) nor performance-based function tests (R2=0.1743, P=0.10) correlated with M10. Self-reported surveys and performance-based function tests are not meaningfully correlated with daytime accelerometer-measured activity. The results of our study suggest that accelerometer-measured physical activity provides distinct clinical information apart from self-reported surveys or performance-based function tests.
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Yang PL, Huang GS, Tsai CS, Lou MF. Sleep Quality and Emotional Correlates in Taiwanese Coronary Artery Bypass Graft Patients 1 Week and 1 Month after Hospital Discharge: A Repeated Descriptive Correlational Study. PLoS One 2015; 10:e0136431. [PMID: 26291524 PMCID: PMC4546334 DOI: 10.1371/journal.pone.0136431] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/03/2015] [Indexed: 12/16/2022] Open
Abstract
Background Poor sleep quality is a common health problem for coronary artery bypass graft patients, however few studies have evaluated sleep quality during the period immediately following hospital discharge. Purpose The aim of this study was to investigate changes in sleep quality and emotional correlates in coronary artery bypass graft patients in Taiwan at 1 week and 1 month after hospital discharge. Methods We used a descriptive correlational design for this study. One week after discharge, 87 patients who had undergone coronary artery bypass surgery completed two structured questionnaires: the Pittsburgh Sleep Quality Index and the Hospital Anxiety and Depression Scale. Three weeks later (1 month after discharge) the patients completed the surveys again. Pearson correlations, t-tests, ANOVA and linear multiple regression analysis were used to analyze the data. Results A majority of the participants had poor sleep quality at 1 week (82.8%) and 1 month (66.7%) post-hospitalization, based on the global score of the Pittsburgh Sleep Quality Index. Despite poor sleep quality at both time-points the sleep quality at 1 month was significantly better than at 1-week post hospitalization. Poorer sleep quality correlated with older age, poorer heart function, anxiety and depression. The majority of participants had normal levels of anxiety at 1 week (69.0%) and 1 month (88.5%) as measured by the Hospital Anxiety and Depression Scale. However, some level of depression was seen at 1 week (78.1%) and 1 month (59.7%). Depression was a significant predictor of sleep quality at 1 week; at 1 month after hospital discharge both anxiety and depression were significant predictors of sleep quality. Conclusion Sleep quality, anxiety and depression all significantly improved 1 month after hospital discharge. However, more than half of the participants continued to have poor sleep quality and some level of depression. Health care personnel should be encouraged to assess sleep and emotional status in patients after coronary artery bypass surgery and offer them appropriate management strategies to improve sleep and reduce anxiety and depression.
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Affiliation(s)
- Pei-Lin Yang
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Guey-Shiun Huang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Sung Tsai
- Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Meei-Fang Lou
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- * E-mail:
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25
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Beveridge C, Knutson K, Spampinato L, Flores A, Meltzer DO, Van Cauter E, Arora VM. Daytime Physical Activity and Sleep in Hospitalized Older Adults: Association with Demographic Characteristics and Disease Severity. J Am Geriatr Soc 2015; 63:1391-400. [PMID: 26131982 DOI: 10.1111/jgs.13520] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess objectively measured daytime physical activity and sleep duration and efficiency in hospitalized older adults and explore associations with demographic characteristics and disease severity. DESIGN Prospective cohort study. SETTING University of Chicago Medical Center general medicine wards. PARTICIPANTS Community-dwelling inpatients aged 50 and older (N = 120) MEASUREMENTS: Physical activity and sleep were measured using wrist accelerometers. Information on Charlson Comorbidity Index and length of stay was collected from charts. Random-effects linear regression analysis was used to examine the association between in-hospital sleep and physical activity. RESULTS From March 2010 to May 2013, 120 participants wore wrist actigraphy monitors for at least 2 nights and 1 intervening day. Median activity level over the waking period was 77 counts/min (interquartile range 51-121 counts/min), an activity level that approximately corresponds to sitting while watching television (65 counts/min). Mean sleep duration the night before the activity interval was 289 ± 157 minutes, and mean sleep efficiency the night before the activity interval was 65.2 ± 26.9%. Mean activity counts/min were lowest for the oldest participants (oldest quartile 62, 95% confidence interval (CI) = 50-75; youngest quartile 121, 95% CI = 98-145, trend test P < .001) and those with highest Charlson Comorbidity Index (highest tertile 71, 95% CI = 60-83; lowest tertile 125, 95% CI = 104-147, trend test P = .01). Controlling for severity of illness and demographic characteristics, activity declined by 3 counts/min (95% CI = -5.65 to -0.43, P = .02) for each additional hour of inpatient sleep. CONCLUSION Older, sicker adults are less physically active during hospitalization. In contrast to studies in the community, inpatients who slept more were not more active. This may highlight that need for sleep is greater in the hospital than in the community.
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Affiliation(s)
- Claire Beveridge
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Kristen Knutson
- Department of Medicine, University of Chicago, Chicago, Illinois.,Sleep, Metabolism, and Health Center, University of Chicago, Chicago, Illinois
| | - Lisa Spampinato
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Andrea Flores
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - David O Meltzer
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Eve Van Cauter
- Department of Medicine, University of Chicago, Chicago, Illinois.,Sleep, Metabolism, and Health Center, University of Chicago, Chicago, Illinois
| | - Vineet M Arora
- Department of Medicine, University of Chicago, Chicago, Illinois.,Sleep, Metabolism, and Health Center, University of Chicago, Chicago, Illinois
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Preoperative sleep complaints are associated with poor physical recovery in the months following cardiac surgery. Ann Behav Med 2015; 47:347-57. [PMID: 24272231 DOI: 10.1007/s12160-013-9557-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Sleep disturbance is associated with poorer outcomes in cardiac patients, but little is known about the independent role of sleep quality in coronary artery bypass graft (CABG) patients. PURPOSE This study aims to examine the relationship between preoperative sleep complaints and post-operative emotional and physical recovery in CABG surgery patients, independently of demographic, clinical and mood factors. METHODS Two hundred thirty CABG patients (aged 67.81 ± 9.07 years) completed measures of self-reported sleep complaints before surgery and health-related quality of life (HRQoL), physical symptoms and pain 2 months after surgery. RESULTS Greater sleep complaints prior to surgery were associated with greater physical symptoms, poorer physical HRQoL and greater sensory pain after surgery (p < 0.05), but not with affective pain or mental HRQoL. Preoperative mood was not able to explain these associations. CONCLUSIONS Sleep complaints may be implicated in physical recovery from CABG surgery but further work is needed to understand the role of causal pathways.
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Madsen MT, Rosenberg J, Gögenur I. Actigraphy for measurement of sleep and sleep-wake rhythms in relation to surgery. J Clin Sleep Med 2013; 9:387-94. [PMID: 23585756 DOI: 10.5664/jcsm.2598] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Patients undergoing surgery have severe sleep and sleep-wake rhythm disturbances resulting in increased morbidity. Actigraphy is a tool that can be used to quantify these disturbances. The aim of this manuscript was to present the literature where actigraphy has been used to measure sleep and sleep-wake rhythms in relation to surgery. METHODS A systematic review was performed in 3 databases (Medline, Embase, and Psycinfo), including all literature until July 2012. RESULTS Thirty-two studies were included in the review. Actigraphy could demonstrate that total sleep time and sleep efficiency was reduced after surgery and number of awakenings was increased in patients undergoing major surgery. Disturbances were less severe in patients undergoing minor surgery. Actigraphy could be used to differentiate between delirious and non-delirious patients after major surgery. Actigraphy measurements could determine a differential effect of surgery based on the patient's age. The effect of pharmacological interventions (chronobiotics and hypnotics) in surgical patients could also be demonstrated by actigraphy. CONCLUSION Actigraphy can be used to measure sleep and sleep-wake rhythms in patients undergoing surgery.
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Affiliation(s)
- Michael T Madsen
- Department of Surgical Gastroenterology, University of Copenhagen, Herlev Hospital, Herlev, Denmark.
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Yasuhara Y, Kobayashi H, Tanioka T, Fujikawa E, Fujinaga H, Kongsuwan W, Locsin RC. Sleep conditions and quality of life among patients with ischemic heart disease after elective percutaneous coronary intervention. Health (London) 2013. [DOI: 10.4236/health.2013.53a072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Berg SK, Higgins M, Reilly CM, Langberg JJ, Dunbar SB. Sleep quality and sleepiness in persons with implantable cardioverter defibrillators: outcome from a clinical randomized longitudinal trial. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 35:431-43. [PMID: 22303998 DOI: 10.1111/j.1540-8159.2011.03328.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients receiving an implantable cardioverter defibrillator (ICD) report various types and degree of sleep disruptions, but little is known regarding their characteristics, duration, and associated factors. The purposes of this study were: (1) to describe the effect of a psychoeducational intervention on sleep quality and daytime sleepiness, (2) to describe patterns of sleep over time, and (3) to identify predictors of poor sleep in an ICD population. METHODS A randomized longitudinal intervention trial was designed to test the effects of a psychoeducational intervention, which included a sleep education and counseling session in patients receiving their initial ICD. Patients (n=236; 75% men; mean age 58.4 [±11.2] from the PsychoEducationAl Intervention for ICD PatiEnts (PEACE) trial comprised the study population. Variables related to sleep were measured by the Pittsburgh Sleep Quality Inventory (PSQI) and Epworth Sleepiness Scale (ESS). RESULTS No psychoeducational intervention effects on sleep outcomes were observed. However, 67.2% of the patients reported poor sleep quality at baseline, and 56.8% had low sleep quality at 6 months based on PSQI scores>5; one-third (32.6%) were excessively sleepy based on ESS scores≥10 at 6 months. Anxiety, depression, physical function, pain intensity, and pain severity were all highly correlated to each other across time. Female gender was a significant covariate for the PSQI. New York Heart Association (NYHA) class was a significant covariate for sleepiness (Epworth). CONCLUSIONS Low sleep quality and daytime sleepiness are found at time of insertion and over time in patients with ICD. Female gender, higher NYHA class, as well as two latent factors encompassing increased anxiety, depressive symptoms, and decreased physical function and increased pain, were significant predictors of poor sleep quality and sleepiness over time. These data help identify those at higher risk for sleep problems after ICD.
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Garaulet M, Ortega FB, Ruiz JR, Rey-López JP, Béghin L, Manios Y, Cuenca-García M, Plada M, Diethelm K, Kafatos A, Molnár D, Al-Tahan J, Moreno LA. Short sleep duration is associated with increased obesity markers in European adolescents: effect of physical activity and dietary habits. The HELENA study. Int J Obes (Lond) 2011; 35:1308-17. [PMID: 21792170 DOI: 10.1038/ijo.2011.149] [Citation(s) in RCA: 272] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adequate sleep is a critical factor for adolescent's health and health-related behaviors. OBJECTIVE (a) to describe sleep duration in European adolescents from nine countries, (b) to assess the association of short sleep duration with excess adiposity and (c) to elucidate if physical activity (PA), sedentary behaviors and/or inadequate food habits underlie this association. DESIGN A sample of 3311 adolescents (1748 girls) aged 12.5-17.49 years from 10 European cities in Austria, Belgium, France, Germany, Greece, Hungary, Italy, Spain and Sweden was assessed in the Healthy Lifestyle in Europe by Nutrition in Adolescence Study between 2006 and 2008. We measured anthropometric data, sleep duration, PA (accelerometers and questionnaire), television watching and food habits (Food Frequency Questionnaire). RESULTS Average duration of daily sleep was 8 h. Shorter sleepers showed higher values of BMI, body fat, waist and hip circumferences and fat mass index (P<0.05), particularly in females. Adolescents who slept <8 h per day were more sedentary, as assessed by accelerometry, and spent more time watching TV (P<0.05). The proportion of adolescents who eat adequate amounts of fruits, vegetables and fish was lower in shorter sleepers than in adolescents who slept ≥8 h per day, and so was the probability of having adequate food habits (P<0.05). Correlation analysis indicated that short sleep is associated with higher obesity parameters. CONCLUSIONS In European adolescents, short sleep duration is associated with higher adiposity markers, particularly in female adolescents. This association seems to be related to both sides of the energy balance equation due to a combination of increased food intake and more sedentary habits.
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Affiliation(s)
- M Garaulet
- Department of Physiology, University of Murcia, Campus de Espinardo s/n, Murcia, Spain.
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Sveinsdóttir H, Ingadóttir B. Predictors of psychological distress in patients at home following cardiac surgery: an explorative panel study. Eur J Cardiovasc Nurs 2011; 11:339-48. [DOI: 10.1016/j.ejcnurse.2011.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Herdís Sveinsdóttir
- Faculty of Nursing, University of Iceland, Eirberg Eiríksgötu 34, 101 Reykjavík, Iceland
| | - Brynja Ingadóttir
- Faculty of Nursing, University of Iceland, Eirberg Eiríksgötu 34, 101 Reykjavík, Iceland
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Abbott AA, Barnason S, Zimmerman L. Symptom burden clusters and their impact on psychosocial functioning following coronary artery bypass surgery. J Cardiovasc Nurs 2010; 25:301-10. [PMID: 20539164 PMCID: PMC2885049 DOI: 10.1097/jcn.0b013e3181cfbb46] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although there is extensive literature on symptoms experienced by patients after coronary artery bypass surgery (CABS), there is a paucity of data on symptom clusters and their impact on functional outcomes. The purpose of these descriptive, secondary analyses was to identify and describe cluster subgroups of 226 elderly CABS patients at discharge and to examine the cluster's impact on psychosocial functioning over time (baseline, 6 weeks, and 3 months) using the 36-item Medical Outcome Study Short Form subscales. Cluster analysis revealed a 3-cluster solution with low, low-moderate, and moderate symptom burden clusters. Significant differences were detected for Duke Activity Status Index (F(2,223) = 5.12, P = .007), Barnason Efficacy Expectation Scale (F(2,223) = 9.60, P < .0001), Hospital Anxiety and Depression Scale (F(2,219) = 15.14, P < .0001), and New York Heart Association classification (chi = 17.44, P = .008). Significant differences were noted on all variables between the low and moderate symptom burden clusters with differences between the low-moderate and moderate clusters for only the Barnason Efficacy Expectation Scale and the Hospital Anxiety and Depression Scale. Those in the moderate symptom burden cluster had more symptoms, anxiety, and depression along with lower self-efficacy and physiological functioning than those in the other 2 clusters. There was no interaction or simple main effects for the role-emotional or social subscales as measured by the 36-item Medical Outcome Study Short Form. There was no significant interaction for mental functioning by time and cluster (F(4,641) = .30, P = .88); however, there was a simple main effect for cluster (F(2,641) = 4.11, P = .02). Follow-up analysis indicated significant differences between the low and low-moderate clusters, indicating that those with low symptom burden had significantly better mental health functioning than those with moderate symptom burden. Findings provide a foundation of knowledge on symptom clusters in CABS populations and may be useful to clinicians to identify patients at risk for slowed or delayed recovery and for early intervention.
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Affiliation(s)
- Amy A Abbott
- Creighton University School of Nursing, Omaha, Nebraska 68178, USA.
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Leegaard M, Rustøen T, Fagermoen MS. Interference of Postoperative Pain on Women's Daily Life after Early Discharge from Cardiac Surgery. Pain Manag Nurs 2010; 11:99-107. [DOI: 10.1016/j.pmn.2009.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2008] [Revised: 02/23/2009] [Accepted: 04/19/2009] [Indexed: 12/12/2022]
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Caldwell BA, Redeker NS. Sleep patterns and psychological distress in women living in an inner city. Res Nurs Health 2009; 32:177-90. [PMID: 19086035 DOI: 10.1002/nur.20308] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Psychological distress, including symptoms of anxiety, depression, and psychological trauma, is common in women living in inner cities and can be associated with disturbed sleep. The purposes of the study of 115 women were to examine: (a) objective and subjective sleep patterns; (b) extent of psychological distress; and (c) the relationship between objective and subjective sleep patterns and psychological distress. Wrist actigraphs were worn. High levels of life stress, sleep pattern disturbance, and psychological distress were common. Self-reported sleep patterns, but not objective sleep pattern variables, explained 12.5% to 44% of the variance in psychological distress, suggesting the importance of screening for sleep and psychological distress. These findings suggest that interventions focusing on sleep or psychological distress may reduce symptoms.
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Affiliation(s)
- Barbara A Caldwell
- School of Nursing, University of Medicine and Dentistry of New Jersey, 65 Bergen Street, Newark, NJ, USA
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Gardner G, Collins C, Osborne S, Henderson A, Eastwood M. Creating a therapeutic environment: a non-randomised controlled trial of a quiet time intervention for patients in acute care. Int J Nurs Stud 2009; 46:778-86. [PMID: 19167711 DOI: 10.1016/j.ijnurstu.2008.12.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Revised: 10/22/2008] [Accepted: 12/18/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Noise is a significant barrier to sleep for acute care hospital patients, and sleep has been shown to be therapeutic for health, healing and recovery. Scheduled quiet time interventions to promote inpatient rest and sleep have been successfully trialled in critical care but not in acute care settings. OBJECTIVES The study aim was to evaluate a scheduled quiet time intervention in an acute care setting. The study measured the effect of a scheduled quiet time on noise levels, inpatients' rest and sleep behaviour, and wellbeing. The study also examined the impact of the intervention on patients', visitors' and health professionals' satisfaction, and organisational functioning. DESIGN The study was a multi-centred non-randomised parallel group trial. SETTINGS The research was conducted in the acute orthopaedic wards of two major urban public hospitals in Brisbane, Australia. PARTICIPANTS All patients admitted to the two wards in the 5-month period of the study were invited to participate, with a final sample of 299 participants recruited. This sample produced an effect size of 0.89 for an increase in the number of patients asleep during the quiet time. METHODS Demographic data were collected to enable comparison between groups. Data for noise level, sleep status, sleepiness and wellbeing were collected using previously validated instruments: a Castle Model((c)) 824 digital sound level indicator; a three point sleep status scale; the Epworth Sleepiness Scale; and the SF12 V2 questionnaire. The staff, patient and visitor surveys on the experimental ward were adapted from published instruments. RESULTS Significant differences were found between the two groups in mean decibel level and numbers of patients awake and asleep. The difference in mean measured noise levels between the two environments corresponded to a 'perceived' difference of 2 to 1. There were significant correlations between average decibel level and number of patients awake and asleep in the experimental group, and between average decibel level and number of patients awake in the control group. Overall, patients, visitors and health professionals were satisfied with the quiet time intervention. CONCLUSIONS The findings show that a quiet time intervention on an acute care hospital ward can affect noise level and patient sleep/wake patterns during the intervention period. The overall strongly positive response from surveys suggests that scheduled quiet time would be a positively perceived intervention with therapeutic benefit.
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Affiliation(s)
- Glenn Gardner
- Centre for Clinical Nursing, Royal Brisbane & Women's Hospital & Queensland University of Technology, Brisbane, Australia.
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Zaros MC, Ceolim MF. Sleep/wake cycle of women submitted to elective gynecological surgery with a one-day hospital stay. Rev Lat Am Enfermagem 2008; 16:838-43. [DOI: 10.1590/s0104-11692008000500007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Accepted: 08/08/2008] [Indexed: 11/21/2022] Open
Abstract
The aim of this descriptive study was to compare preoperative and post-operative sleep/wake cycle (SWC) patterns of 22 women undergoing elective surgery, with up to one day of hospitalization. The study was approved by the local Review Board. Voluntary women (average age 39 ± 9) filled out a Sleep Journal for 23 consecutive days, before and after the surgery (46 days total). Data were analyzed with Wilcoxon's matched-pairs test. The findings showed slight and transitory SWC changes (increased latency, reduced efficiency and later wake-up time) after the surgery. Nevertheless, sleep quality was improved and there was a fast return to the SWC patterns observed before the intervention, perhaps due to the early exposition to daily routine, e.g. the environmental clues that are important to rhythmic synchronization.
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Leegaard M, Nåden D, Fagermoen MS. Postoperative pain and self-management: women’s experiences after cardiac surgery. J Adv Nurs 2008; 63:476-85. [DOI: 10.1111/j.1365-2648.2008.04727.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Disturbances in sleep associated with sleep deprivation, disorders in circadian rhythms, and sleep-disordered breathing are common in critical care settings and may have a significant impact on physiologic, behavioral, and functional outcomes, as well as patient satisfaction and utilization of healthcare resources. Despite growth in awareness of the potential importance of sleep in the critical setting over the past 30 years, many questions about the nature of sleep, the predictors and consequences of sleep disturbance, and the efficacy of sleep promotion interventions in critically ill patients remain unanswered. Most of the studies of sleep in critical care settings have used small, nonrandom samples and descriptive or explanatory designs; many have not considered multifactorial explanatory variables; and clinical trials are rare. These gaps in quantity and quality of research findings are barriers to the delivery of evidence-based sleep promotion interventions and may be partially explained by conceptual and methodological challenges associated primarily with the nature of sleep measurement and characteristics of critically ill patients and the critical care environment. This article will explore these concerns and propose strategies to deal with them. Research exemplars from the literature will be used to illustrate key points.
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Yilmaz H, Iskesen I. Objective and Subjective Characteristics of Sleep after Coronary Artery Bypass Graft Surgery in the Early Period: A Prospective Study with Healthy Subjects. Heart Surg Forum 2007; 10:E16-20. [PMID: 17162394 DOI: 10.1532/hsf98.20061128] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The purpose of this study was to investigate changes in sleep characteristics by examining both subjective tests and objective parameters such as actigraphic sleep analysis in patients who underwent coronary artery bypass graft surgery (CABG). PATIENTS AND METHODS Forty-five patients who underwent CABG operations and did not have any sleep disturbance were examined. They were evaluated by subjective and objective sleep parameters at the beginning of the examination and on the fifth postoperative day. Forty healthy subjects who did not undergo the operation were also evaluated. RESULTS The Pittsburgh Index and Epworth values in the postoperative group were significantly higher, but Maintenance of Wakefulness Test lengths were significantly shorter than in the preoperative and control groups. Sleep latency, napping episodes, total napping periods, and fragmentation index values of the postoperative group were significantly higher, but sleep efficiency values were significantly lower than in the preoperative and control groups. CONCLUSION The cause of sleeplessness after CABG surgery may be the temporary deterioration of circulation in the centers of the brain stem and hypothalamus, which control sleep and awakening. It can be proposed that the improvement of the circulation in these centers a couple of months after the operation help to regain sleep control, and thus sleep disturbances disappear.
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Affiliation(s)
- Hikmet Yilmaz
- Department of Neurology, Celal Bayar University School of Medicine, Manisa, Turkey.
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Yilmaz H, Iskesen I. Follow-up With Objective and Subjective Tests of the Sleep Characteristics of Patients After Cardiac Surgery. Circ J 2007; 71:1506-10. [PMID: 17895541 DOI: 10.1253/circj.71.1506] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the changes in sleep characteristics in patients who underwent coronary artery bypass grafting (CABG) surgery, using both subjective and objective tests in the early (preoperative) and late (postoperative) periods. METHODS AND RESULTS Forty-five patients who underwent CABG and did not previously have any sleep disturbance were evaluated by subjective and objective sleep parameters during a consecutive 3-5-day preoperative examination, during a consecutive 5-8-day period in the 1st postoperative week, and during consecutive 5-8-day periods in the 1st and 2nd postoperative months. The Pittsburgh Index and Epworth Sleepiness Scale values, sleep latency, napping episodes, total napping period, duration of wakefulness after sleep onset and fragmentation index values were significantly increased; however, Maintenance of Wakefulness Test lengths, total sleep time and sleep efficiency were significantly decreased in the 1st postoperative week. All of these were the same in the 1st postoperative month and differences were not statistically different from the preoperative period. None of the sleep parameters in the 2nd postoperative month differed from the values obtained in the preoperative period. CONCLUSION The cause of sleeplessness after CABG surgery may be temporary deterioration of circulation in the centers of the brain stem and hypothalamus that control sleep and awakening. Improvement of the circulation in these centers a few months after the operation helps to regain sleep control, and thus sleep disturbances disappear.
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Affiliation(s)
- Hikmet Yilmaz
- Department of Neurology, Celal Bayar University School of Medicine, Manisa, Turkey
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Abstract
Probe recognition tasks have shown the effects of sleep deprivation following a full night of sleep loss. The current study investigated shorter durations of deprivation by testing 11 subjects for accuracy and response time every 2 hr. from 10 p.m. through 8 a.m. We replicated Elkin and Murray's auditory single-probe recognition task using the number triplets and added two visual tasks with number and shape triplets. Series of six stimuli were each followed by a probe, which was presented after 2.5 sec. as a short delay or 20 sec. as a long delay. Accuracy performance showed a significant decrease for the long delay beginning after 4 a.m. for the two visual tasks. Response times were significantly slower for the visual shapes task using the short delay. Visual tasks, especially shapes, may be more prone to disruption by sleep deprivation, given the visual information load and the briefness of iconic memory.
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Affiliation(s)
- Desiree J Raidy
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX 75962, USA
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Chen MY, Wang EK, Jeng YJ. Adequate sleep among adolescents is positively associated with health status and health-related behaviors. BMC Public Health 2006; 6:59. [PMID: 16524482 PMCID: PMC1447528 DOI: 10.1186/1471-2458-6-59] [Citation(s) in RCA: 173] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2005] [Accepted: 03/08/2006] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Amount of sleep is an important indicator of health and well-being in children and adolescents. Adequate sleep (AS: adequate sleep is defined as 6-8 hours per night regularly) is a critical factor in adolescent health and health-related behaviors. The present study was based on a health promotion project previously conducted on adolescents in Tao-Yuan County, Taiwan. The aim was to examine the relationship between AS during schooldays and excessive body weight, frequency of visiting doctors and health-related behaviors among Taiwanese adolescents. METHODS A cross-sectional study design, categorical and multivariate data analyses were used. The hypotheses investigated were: high frequency of AS is positively associated with lack of obesity and less frequent visits to doctors; and high frequency AS is positively associated with health-related behavior. RESULTS A total of 656 boys (53.2%) and girls (46.8%), ranging in age from 13-18 years were studied between January and June 2004. Three hundred and fifty seven subjects (54%) reported that they slept less than the suggested 6-8 hours on schooldays. A significant negative association was found between low sleep and of the following health-related behaviors: (1) life appreciation; (2) taking responsibility for health; (3) adopting healthy diet; (4) effective stress management; (5) regular exercise; and (6) total AHP score. High frequency AS was associated with low frequencies of obesity after potential confounding factors were controlled. Junior high school adolescents reported significantly higher frequencies of AS than high school participants. Gender, family structure, home location and frequency of television watching or computer use were not significantly associated with AS. CONCLUSION These findings support the proposition that AS is associated with good health status and high-frequency adoption of health-related behavior. Furthermore, these findings suggest that inadequate sleep may be a screening indicator for an unhealthy lifestyle and poor health status. The results might be useful for future research into the development of intervention strategies to assist adolescents who are not receiving enough hours of sleep.
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Affiliation(s)
- Mei-Yen Chen
- Nursing Department, Chang Gung Institute of Technology, Wen-Hwa 1Road, Kwei-Shan, Taoyuan, Taiwan
| | - Edward K Wang
- Neurology Department, Tao-Yuan Veteran Hospital, Kwei-Shan, Taoyuan, Taiwan
| | - Yi-Jong Jeng
- Nursing Department, Chang Gung Institute of Technology, Wen-Hwa 1Road, Kwei-Shan, Taoyuan, Taiwan
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Caldwell-Andrews AA, Kain ZN. Psychological predictors of postoperative sleep in children undergoing outpatient surgery. Paediatr Anaesth 2006; 16:144-51. [PMID: 16430410 DOI: 10.1111/j.1460-9592.2005.01706.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purpose of this study was to examine psychological predictors of postoperative sleep in children undergoing outpatient surgery. METHODS We used hierarchical multivariate regression to examine the impact of demographic and personality variables such as parental worry/anxiety [NEO-personality inventory, revised (NEO-PI-R) Neuroticism], parental coping style (Miller Behavioral Style Scale), children's aggressive behavior [child behavior checklist (CBCL) externalizing], and children's temperament (emotionality, activity, sociability, and impulsivity) on postoperative sleep in 52 consecutive, healthy, children undergoing outpatient surgery. Sleep was assessed using actigraphy, a valid, reliable and objective measure of sleep quality. All perioperative protocols were strictly controlled and standardized. RESULTS We found that 22% of the children experienced difficulty with postoperative sleep as defined by actigraphy. A hierarchical multiple regression model that was constructed to identify predictors of postoperative sleep efficiency in children accounted for 82% of the variance (R = 0.906, F = 19.42, P = 0.0001). Significant predictors in this model included preoperative sleep patterns (60%), postoperative pain (8.2%), parental anxiety/worry (NEO-PI-R Neuroticism scale; 9%), and children's aggressive behavior (CBCL externalizing; 5%). CONCLUSIONS We conclude that psychological factors such as parental anxiety/worry and children's aggressive behavior are predictive of children's postoperative sleep above and beyond the influence of preoperative sleep patterns and postoperative pain.
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Affiliation(s)
- Alison A Caldwell-Andrews
- The Center for the Advancement of Perioperative Health, Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510, USA.
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Redeker NS, Hilkert R. Sleep and Quality of Life in Stable Heart Failure. J Card Fail 2005; 11:700-4. [PMID: 16360966 DOI: 10.1016/j.cardfail.2005.07.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2005] [Revised: 07/06/2005] [Accepted: 07/11/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Functional performance and mental health are significant quality of life concerns for heart failure (HF) patients. Poor sleep also appears to be common. We examined the extent to which sleep was associated with functional performance and mental health among persons who had stable systolic HF. METHODS AND RESULTS Sixty-one patients with stable systolic HF wore wrist actigraphs to record nocturnal sleep and daily activity for 3 days while living at home, performed 6-minute walks (6MWT), and completed the Pittsburgh Sleep Quality Index and the Medical Outcomes Study SF-36 questionnaire. Self-reported sleep quality and actigraph-recorded wake time and wake bout time explained 9% to 20% of the variance in the functional performance variables (daytime activity level, 6MWT, self-reported physical function), and mental health, after controlling for age, gender, comorbidity, and New York Heart Association class. Time in bed was negatively associated with functional performance. There were no statistically significant relationships between sleep duration and functional performance. CONCLUSIONS Self-reported sleep quality and sleep continuity (sleep that is undisturbed by nocturnal awakenings) are associated with functional performance and mental health in stable systolic HF patients. Effective treatment of sleep problems may contribute to improvement in quality of life.
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Affiliation(s)
- Nancy S Redeker
- University of Medicine & Dentistry of New Jersey, School of Nursing, Newark, New Jersey 07101-1709, USA
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Redeker NS, Ruggiero J, Hedges C. Patterns and predictors of sleep pattern disturbance after cardiac surgery. Res Nurs Health 2004; 27:217-24. [PMID: 15264261 DOI: 10.1002/nur.20023] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purposes of this study were to examine changes in sleep patterns after cardiac surgery and the contributions of preoperative sleep to postoperative sleep. Seventy-two cardiac surgery patients wore wrist actigraphs for 3 days during the preoperative period (T1) and the 1st (T2), 4th (T3), and 8th (T4) postoperative weeks. They completed the Pittsburgh Sleep Quality Index at T1, T3, and T4. Sleep was most disturbed during the 1st postoperative week and improved at T3 and T4. Overall, sleep pattern disturbance was higher at T3 and T4 than at T1. Age, gender, preoperative New York Heart Association Functional Class, and preoperative sleep variables explained 20%-50% of the variance in sleep at T2, T3, and T4. Sleep disturbance is present preoperatively and continues during the postoperative period.
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Affiliation(s)
- Nancy S Redeker
- University of Medicine & Dentistry of New Jersey, School of Nursing, 65 Bergen Street, Room 1122, Newark, NJ 07101-1709, USA
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