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Climent-Sanz C, Gea-Sánchez M, Fernández-Lago H, Mateos-García JT, Rubí-Carnacea F, Briones-Vozmediano E. Sleeping is a nightmare: A qualitative study on the experience and management of poor sleep quality in women with fibromyalgia. J Adv Nurs 2021; 77:4549-4562. [PMID: 34268797 DOI: 10.1111/jan.14977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/01/2021] [Accepted: 06/27/2021] [Indexed: 12/15/2022]
Abstract
AIM This study aimed to explore the experience and management of poor sleep quality in Spanish women with fibromyalgia (FM). DESIGN This was a qualitative study based on one-to-one interviews. METHODS Twenty-one adult women diagnosed with FM were recruited from the community between January and March 2020. Data were collected through in-depth semistructured one-to-one interviews, using an interview guide of open questions about the experience and management of poor sleep quality, and were analyzed with thematic qualitative analysis. The symptom management theory was used as a biopsychosocial conceptual framework. RESULTS The results were organized into two themes: (a) experience of poor sleep quality and (b) management strategies for poor sleep quality. Poor sleep quality was found to be a severe symptom of FM that negatively impacts pain, fatigue, stiffness, mental health, and quality of life. The participants perceived pharmacological treatment to be the main approach of health care professionals for improving sleep, and most did not want this form of treatment. Self-management strategies lack clear beneficial effects on sleep quality. CONCLUSION Women with FM recognize that they need to receive more information from nurses and allied professions about sleep in the context of FM and how to effectively manage poor sleep quality. IMPACT This study contributes to a better understanding of how women with FM experience and manage poor sleep quality. More information about management strategies for poor sleep quality from nurses and other health care professionals is needed in women with FM. The results of this study can be applied by nurses and health care professionals, including sleep educators, in the treatment of this patient group.
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Affiliation(s)
- Carolina Climent-Sanz
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup d'Estudis Societat, Salut, Educació i Cultura, GESEC, Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, Lleida, Spain
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup d'Estudis Societat, Salut, Educació i Cultura, GESEC, Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, Lleida, Spain.,Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain
| | - Helena Fernández-Lago
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, Lleida, Spain
| | - José Tomás Mateos-García
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, Lleida, Spain
| | - Francesc Rubí-Carnacea
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup d'Estudis Societat, Salut, Educació i Cultura, GESEC, Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, Lleida, Spain
| | - Erica Briones-Vozmediano
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup d'Estudis Societat, Salut, Educació i Cultura, GESEC, Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, Lleida, Spain
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Hermans LWA, Regis M, Fonseca P, Overeem S, Leufkens TRM, Vermeeren A, van Gilst MM. Assessing sleep-wake survival dynamics in relation to sleep quality in a placebo-controlled pharmacological intervention study with people with insomnia and healthy controls. Psychopharmacology (Berl) 2021; 238:83-94. [PMID: 32939597 PMCID: PMC7794103 DOI: 10.1007/s00213-020-05660-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/07/2020] [Indexed: 12/21/2022]
Abstract
RATIONALE The mechanisms underlying impaired sleep quality in insomnia are not fully known, but an important role for sleep fragmentation has been proposed. OBJECTIVES The aim of this study is to explore potential mechanisms of sleep fragmentation influencing alterations of perceived sleep quality. METHODS We analyzed polysomnography (PSG) recordings from a double-blind crossover study with zopiclone 7.5 mg and placebo, in elderly participants with insomnia complaints and age-matched healthy controls. We compared survival dynamics of sleep and wake across group and treatment. Subsequently, we used a previously proposed model to estimate the amount of sleep onset latency (SOL) misperception from PSG-defined sleep fragmentation. Self-reported and model-estimated amount of SOL misperception were compared across group and treatment, as well as model prediction errors. RESULTS In the zopiclone night, the average segment length of NREM sleep was increased (group F = 1.16, p = 0.32; treatment F = 8.89, p < 0.01; group x treatment F = 0.44, p = 0.65), while the segment length of wake was decreased (group F = 1.48, p = 0.23; treatment F = 11.49, p < 0.01; group x treatment F = 0.36, p = 0.70). The self-reported and model-estimated amount of SOL misperception were lower during the zopiclone night (self-reported group F = 6.08, p < 0.01, treatment F = 10.8, p < 0.01, group x treatment F = 2.49, p = 0.09; model-estimated F = 1.70, p = 0.19, treatment F = 16.1, p < 0.001, group x treatment F = 0.60, p = 0.55). The prediction error was not altered (group F = 1.62, p = 0.20; treatment F = 0.20, p = 0.65; group x treatment F = 1.01, p = 0.37). CONCLUSIONS Impaired subjective sleep quality is associated with decreased NREM stability, together with increased stability of wake. Furthermore, we conclude that zopiclone-induced changes in SOL misperception can be largely attributed to predictable changes of sleep architecture.
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Affiliation(s)
- Lieke W. A. Hermans
- Department of Electrical Engineering, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands
| | - Marta Regis
- Department of Mathematics and Computer Science, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands
| | - Pedro Fonseca
- Department of Electrical Engineering, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands ,Philips Research, High Tech Campus 34, Eindhoven, The Netherlands
| | - Sebastiaan Overeem
- Department of Electrical Engineering, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands ,Sleep Medicine Center Kempenhaeghe, Sterkselseweg 65, Heeze, The Netherlands
| | | | - Annemiek Vermeeren
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, Maastricht, The Netherlands
| | - Merel M. van Gilst
- Department of Electrical Engineering, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands ,Sleep Medicine Center Kempenhaeghe, Sterkselseweg 65, Heeze, The Netherlands
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Barateau L, Lopez R, Chenini S, Rassu AL, Scholz S, Lotierzo M, Cristol JP, Jaussent I, Dauvilliers Y. Association of CSF orexin-A levels and nocturnal sleep stability in patients with hypersomnolence. Neurology 2020; 95:e2900-e2911. [DOI: 10.1212/wnl.0000000000010743] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/25/2020] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo evaluate the associations between CSF orexin-A (ORX) levels and markers of nocturnal sleep stability, assessed by polysomnography.MethodsNocturnal polysomnography data and ORX levels of 300 drug-free participants (55% men, 29.9±15.5 years, ORX level 155.1±153.7 pg/mL) with hypersomnolence were collected. Several markers of nocturnal sleep stability were analyzed: sleep and wake bouts and sleep/wake transitions. Groups were categorized according to ORX levels, in 2 categories (deficient ≤110; >110), in tertiles (≤26, 26–254, >254), and compared using logistic regression models. Results were adjusted for age, sex, and body mass index.ResultsWe found higher number of wake bouts (43 vs 25, p < 0.0001), sleep bouts (43 vs 25.5, p < 0.0001), and index of sleep bouts/hour of sleep time, but lower index of wake bouts/hour of wake time (41.4 vs 50.6, p < 0.0001), in patients with ORX deficiency. The percentage of wake bouts <30 seconds was lower (51.3% vs 60.8%, p < 0.001) and of wake bouts ≥1 minutes 30 seconds higher (7.7% vs 6.7%, p = 0.02) when ORX deficient. The percentage of sleep bouts ≤14 minutes was higher (2–5 minutes: 23.7% vs 16.1%, p < 0.0001), and of long sleep bouts lower (>32 minutes 30 seconds: 7.3% vs 18.3%, p < 0.0001), when ORX deficient. These findings were confirmed when groups were categorized according to ORX tertiles, with a dose–response effect of ORX levels in post hoc comparisons, and in adjusted models.InterpretationThis study shows an association between ORX levels and nocturnal sleep stabilization in patients with hypersomnolence. Sleep and wake bouts are reliable markers of nighttime sleep stability that correlate with CSF ORX levels in a dose-dependent manner.
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Hippocampal oscillatory dynamics and sleep atonia are altered in an animal model of fibromyalgia: Implications in the search for biomarkers. J Comp Neurol 2020; 528:1367-1391. [DOI: 10.1002/cne.24829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 11/07/2022]
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Comparison of sleep structure in patients with fibromyalgia and healthy controls. Sleep Breath 2020; 24:1591-1598. [PMID: 32100235 DOI: 10.1007/s11325-020-02036-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 02/02/2020] [Accepted: 02/10/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Sleep disturbances such as nonrestorative sleep and nighttime awakenings play a crucial role in fibromyalgia (FMS). Pain and sleep disturbances show a bidirectional relationship which affect outcomes in FMS. This study aims to compare sleep structures between patients with fibromyalgia and healthy controls. METHODS We evaluated subjective and objective sleep structures of 33 patients with fibromyalgia and 34 healthy controls using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and polysomnography. Student's T test, chi-square, discriminant analysis, the Kruskal-Wallis, and Mann-Whitney U test were used for statistical analysis. RESULTS Patients with FMS reported poorer sleep quality than controls (p = 0.003). Polysomnography data showed patients with FMS exhibited a greater number of awakenings (p = 0.01), more arousals (p = 0.00), higher arousal index (p = 0.00), greater apnea hypopnea index (p = 0.03), and less N1 sleep (p = 0.02) than healthy controls. The discriminant analysis revealed that number of arousals, arousal index, and N1 sleep were able to distinguish patients with FMS from healthy controls with 78.5% accuracy. Twelve of the 33 patients with FMS were diagnosed with obstructive sleep apnea syndrome (OSAS). When we excluded patients with OSAS, a statistically significant difference was maintained. CONCLUSIONS Our findings may explain the deterioration of subjective sleep, symptoms as unrefreshing sleep, fatigue, and pain in patients with FMS. Despite similar clinical manifestations, patients with FMS should be evaluated for OSAS due to treatment differences. The role of sleep alterations in the clinical manifestation and severity of FMS suggest that effective treatments to improve sleep quality may lead to more effective management of FMS.
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Marchi L, Marzetti F, Orrù G, Lemmetti S, Miccoli M, Ciacchini R, Hitchcott PK, Bazzicchi L, Gemignani A, Conversano C. Alexithymia and Psychological Distress in Patients With Fibromyalgia and Rheumatic Disease. Front Psychol 2019; 10:1735. [PMID: 31417462 PMCID: PMC6685004 DOI: 10.3389/fpsyg.2019.01735] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/12/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is a chronic rheumatologic disease characterized by widespread musculoskeletal pain and other psychopathological symptoms which have a negative impact on patients' quality of life. FMS is frequently associated with alexithymia, a multidimensional construct characterized by difficulty in identifying feelings (DIF) and verbally communicating them difficulty describing feelings (DDF) and an externally oriented cognitive thinking style (EOT). The aim of the present study was to investigate the relationship between alexithymia, anxious and depressive symptoms and pain perception, in patients with FMS and other rheumatic diseases (RD). METHODS The sample consisted of 127 participants (M = 25, F = 102; mean age: 51.97; SD: 11.14), of which 48 with FMS, 41 with RD and 38 healthy control group (HC). All groups underwent to a test battery investigating anxiety and depressive symptoms (HADS), pain (VAS; QUID-S/-A) and alexithymia (TAS-20). RESULTS A high prevalence of alexithymia (TAS ≥ 61) was found in FMS (47.9%) and RD (41.5%) patients, compared to the HC group (2.6%). FMS patients showed significant higher scores than HC on DIF, DDF, EOT, anxiety and depression. The clinical sample, FMS and RD groups combined (n = 89), alexithymic patients (AL, n = 40) exhibited higher scores in pain and psychological distress compared to non-alexithymic patients (N-AL, n = 34). Regression analysis found no relationship between alexithymia and pain in AL, meanwhile pain intensity was predicted by anxiety in N-AL. CONCLUSION While increasing clinical symptoms (pain intensity and experience, alexithymia, anxiety, and depression) in patients with fibromyalgia or rheumatic diseases, correlations were found on the one side, between alexithymia and psychological distress, on the other side, between pain experience and intensity. Meanwhile, when symptoms of psychological distress and alexithymia were subthreshold, correlations with pain experience and intensity became stronger.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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8
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Sleep disturbances and sleep disorders in adults living with chronic pain: a meta-analysis. Sleep Med 2018; 52:198-210. [DOI: 10.1016/j.sleep.2018.05.023] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/01/2018] [Accepted: 05/24/2018] [Indexed: 11/23/2022]
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9
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Shaver JL, Iacovides S. Sleep in Women with Chronic Pain and Autoimmune Conditions: A Narrative Review. Sleep Med Clin 2018; 13:375-394. [PMID: 30098754 DOI: 10.1016/j.jsmc.2018.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic pain and sleep disturbances are intricately intertwined. This narrative review provides comments on observations related to pain, stress-immunity, and sleep. Sleep evidence is reviewed from studies of select conditions involving pain (ie, functional somatic syndromes and autoimmune) that are predominant in women. Chronic pain and poor sleep encompass persistent stress-immune activation with systemic inflammation, cellular oxidative stress, and sick behavior indicators that increase morbidity and threaten quality of life. In painful conditions, sleep impairments are nearly ubiquitous, and exaggerated combined effects should not be underestimated or ignored, nor should crucial implications for clinical practice and research.
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Affiliation(s)
- Joan L Shaver
- Biobehavioral Health Science Division, University of Arizona College of Nursing, 1305 North Martin Avenue, Tucson, AZ 85721, USA.
| | - Stella Iacovides
- Faculty of Health Sciences, Brain Function Research Group, School of Physiology, University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa
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10
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The Role of Sex in Sleep Deprivation Related Changes of Nociception and Conditioned Pain Modulation. Neuroscience 2018; 387:191-200. [DOI: 10.1016/j.neuroscience.2017.09.044] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 09/11/2017] [Accepted: 09/24/2017] [Indexed: 11/19/2022]
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11
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Çetin B, Güleç H, Toktaş HE, Ulutaş Ö, Yılmaz SG, İsbir T. Objective measures of sleep in fibromyalgia syndrome: Relationship to clinical, psychiatric, and immunological variables. Psychiatry Res 2018; 263:125-129. [PMID: 29549784 DOI: 10.1016/j.psychres.2018.02.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 02/28/2018] [Accepted: 02/28/2018] [Indexed: 11/13/2022]
Abstract
We aimed to investigate the changes in the objective and subjective sleep variables during painful episodes of fibromyalgia and post-episode period, and to evaluate the impact of the sleep variables on the current clinical, psychological, and immunologic parameters. Thirty-one consecutive patients who were referred to the Erenköy Physical Therapy and Rehabilitation Polyclinic with a diagnosis of fibromyalgia were evaluated before and in the sixth week of the acute pain treatment. The sleep variables were measured by polysomnography, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale. The clinical and psychiatric assessment of patients was performed by using Fibromyalgia Impact Questionnaire; Patient Health Questionnaire-Somatic, Anxiety, and Depressive Symptoms; and Visual Analog Scale. Serum pro-inflammatory molecules were measured to evaluate the immunological status. The pain treatment significantly affected subjective sleep variables, psychiatric variables, clinical variables, and IL-6 levels. The subjective sleep parameters, clinical and psychiatric variables, and IL-6 levels were improved with pain treatment in fibromyalgia. The objective sleep variables, IL-1 and TNF-alpha levels were not significantly improved with the pain treatment, and they were not related to clinical presentation of patients with fibromyalgia. Subjective variability of sleep contributes to the clinical presentation, suggesting that the objective structure is trait-specific with IL-1 and TNF-alpha.
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Affiliation(s)
- Buğra Çetin
- Department of Psychiatry, School of Medicine, University of Maltepe, Istanbul, Turkey.
| | - Hüseyin Güleç
- Department of Psychiatry, Erenköy Psychiatric and Neurological Diseases Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | | | - Özgür Ulutaş
- Department of Physical Therapy and Rehabilitation, Erenköy Physical Therapy and Rehabilitation Hospital, Istanbul, Turkey
| | - Seda Güleç Yılmaz
- Department of Molecular Medicine, School of Medicine, University of Yeditepe, Istanbul, Turkey
| | - Turgay İsbir
- Department of Medical Biology, School of Medicine, University of Yeditepe, Istanbul, Turkey
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12
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Wei Y, Colombo MA, Ramautar JR, Blanken TF, van der Werf YD, Spiegelhalder K, Feige B, Riemann D, Van Someren EJW. Sleep Stage Transition Dynamics Reveal Specific Stage 2 Vulnerability in Insomnia. Sleep 2018; 40:3926054. [PMID: 28934523 DOI: 10.1093/sleep/zsx117] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Study Objectives Objective sleep impairments in insomnia disorder (ID) are insufficiently understood. The present study evaluated whether whole-night sleep stage dynamics derived from polysomnography (PSG) differ between people with ID and matched controls and whether sleep stage dynamic features discriminate them better than conventional sleep parameters. Methods Eighty-eight participants aged 21-70 years, including 46 with ID and 42 age- and sex-matched controls without sleep complaints, were recruited through www.sleepregistry.nl and completed two nights of laboratory PSG. Data of 100 people with ID and 100 age- and sex-matched controls from a previously reported study were used to validate the generalizability of findings. The second night was used to obtain, in addition to conventional sleep parameters, probabilities of transitions between stages and bout duration distributions of each stage. Group differences were evaluated with nonparametric tests. Results People with ID showed higher empirical probabilities to transition from stage N2 to the lighter sleep stage N1 or wakefulness and a faster decaying stage N2 bout survival function. The increased transition probability from stage N2 to stage N1 discriminated people with ID better than any of their deviations in conventional sleep parameters, including less total sleep time, less sleep efficiency, more stage N1, and more wake after sleep onset. Moreover, adding this transition probability significantly improved the discriminating power of a multiple logistic regression model based on conventional sleep parameters. Conclusions Quantification of sleep stage dynamics revealed a particular vulnerability of stage N2 in insomnia. The feature characterizes insomnia better than-and independently of-any conventional sleep parameter.
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Affiliation(s)
- Yishul Wei
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Michele A Colombo
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.,Bernstein Center Freiburg and Faculty of Biology, University of Freiburg, Freiburg, Germany.,Centre for Chronobiology, Psychiatric Hospital of the University of Basel (UPK), Basel, Switzerland
| | - Jennifer R Ramautar
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Tessa F Blanken
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.,Departments of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University and Medical Center, Amsterdam, The Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.,Departments of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University and Medical Center, Amsterdam, The Netherlands
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Svetnik V, Snyder ES, Tao P, Scammell TE, Roth T, Lines C, Herring WJ. Insight Into Reduction of Wakefulness by Suvorexant in Patients With Insomnia: Analysis of Wake Bouts. Sleep 2017; 41:4587975. [PMID: 29112763 DOI: 10.1093/sleep/zsx178] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | - Thomas E Scammell
- Beth Israel Deaconess Medical Center, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Thomas Roth
- Henry Ford Hospital Sleep Center, Detroit, MI
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Heymann RE, Paiva ES, Martinez JE, Helfenstein M, Rezende MC, Provenza JR, Ranzolin A, Assis MRD, Feldman DP, Ribeiro LS, Souza EJR. New guidelines for the diagnosis of fibromyalgia. REVISTA BRASILEIRA DE REUMATOLOGIA 2017; 57 Suppl 2:467-476. [PMID: 28800969 DOI: 10.1016/j.rbre.2017.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 05/23/2017] [Accepted: 05/25/2017] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To establish guidelines based on scientific evidence for the diagnosis of fibromyalgia. MATERIAL AND METHODS Evidence collection was performed based on 9 questions regarding the diagnosis of fibromyalgia, structured using the Patient, Intervention or Indicator, Comparison and Outcome (P.I.C.O.), with searches in the main, primary databases of scientific information. After defining the potential studies to support the recommendations, they were graded according to evidence and degree of recommendation.
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Affiliation(s)
- Roberto E Heymann
- Sociedade Brasileira de Reumatologia, Brazil; Universidade Federal do Estado de São Paulo, São Paulo, SP, Brazil.
| | - Eduardo S Paiva
- Sociedade Brasileira de Reumatologia, Brazil; Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - José Eduardo Martinez
- Sociedade Brasileira de Reumatologia, Brazil; Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brazil
| | - Milton Helfenstein
- Sociedade Brasileira de Reumatologia, Brazil; Universidade Federal do Estado de São Paulo, São Paulo, SP, Brazil
| | - Marcelo C Rezende
- Sociedade Brasileira de Reumatologia, Brazil; Santa Casa de Campo Grande, Campo Grande, MS, Brazil
| | - Jose Roberto Provenza
- Sociedade Brasileira de Reumatologia, Brazil; Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil
| | - Aline Ranzolin
- Sociedade Brasileira de Reumatologia, Brazil; Hospital das Clínicas de Pernambuco, Recife, PE, Brazil
| | - Marcos Renato de Assis
- Sociedade Brasileira de Reumatologia, Brazil; Faculdade de Medicina de Marília, Marília, SP, Brazil
| | - Daniel P Feldman
- Sociedade Brasileira de Reumatologia, Brazil; Universidade Federal do Estado de São Paulo, São Paulo, SP, Brazil
| | - Luiz Severiano Ribeiro
- Sociedade Brasileira de Reumatologia, Brazil; Hospital do Servidor Público de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Eduardo J R Souza
- Sociedade Brasileira de Reumatologia, Brazil; Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
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15
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Heymann RE, Paiva ES, Martinez JE, Helfenstein M, Rezende MC, Provenza JR, Ranzolin A, Assis MRD, Feldman DP, Ribeiro LS, Souza EJ. Novas diretrizes para o diagnóstico da fibromialgia. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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