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Urbanová L, Vaníček O, Červená K, Bartoš A, Evansová K. The impact of sleep education, light intervention and relaxation on sleep and mood in the elderly. Chronobiol Int 2024; 41:567-576. [PMID: 38602470 DOI: 10.1080/07420528.2024.2337007] [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: 06/21/2023] [Accepted: 03/25/2024] [Indexed: 04/12/2024]
Abstract
Sleep and light education (SLE) combined with relaxation is a potential method of addressing sleep and affective problems in older people. 47 participants took part in a four-week sleep education program. SLE was conducted once a week for 60-90 minutes. Participants were instructed on sleep and light hygiene, sleep processes, and practiced relaxation techniques. Participants were wearing actigraphs for 6 weeks, completed daily sleep diaries, and wore blue light-blocking glasses 120 minutes before bedtime. Measures included scores of the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISS), Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI) and actigraphy measurements of sleep latency, sleep efficiency, and sleep fragmentation. Sleep quality increased after SLE based on the subjective assessment and in the objective measurement with actigraphy. PSQI scores were statistically reduced indicating better sleep. Scores after the intervention significantly decreased in ESS and ISS. Sleep latency significantly decreased, whereas sleep efficiency and fragmentation index (%), did not improve. Mood significantly improved after SLE, with lower scores on the BDI-II and STAI. SLE combined with relaxation proved to be an effective method to reduce sleep problems and the incidence of depressive and anxiety symptoms.
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Affiliation(s)
- Lucie Urbanová
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ondřej Vaníček
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
- Center for Sexual Health and Interventions, National Institute of Mental Health, Klecany, Czech Republic
| | - Kateřina Červená
- Sleep and Chronobiology Research Centre, National Institute of Mental Health, Klecany, Czech Republic
- Department of Molecular Biology, Umeå University, Umeå, Sweden
| | - Aleš Bartoš
- Department of Neurology, University Hospital Kralovske Vinohrady, Prague, Czech Republic
- 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Katarína Evansová
- Sleep and Chronobiology Research Centre, National Institute of Mental Health, Klecany, Czech Republic
- 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
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Millar BM, Parsons JT, Redline S, Duncan DT. What's Sleep Got to Do with It?: Sleep Health and Sexual Risk-Taking Among Men Who have Sex with Men. AIDS Behav 2019; 23:572-579. [PMID: 30267366 DOI: 10.1007/s10461-018-2288-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Emerging evidence links poor sleep health with a range of adverse health behaviors, including condomless anal intercourse (CAI) among men who have sex with men (MSM). We tested associations between a range of sleep health indicators and sex outcomes in an online sample of 559 MSM in Paris France, recruited from a geosocial-networking phone application. Participants reported on sleep quality, sleep duration, problems falling asleep, and problems staying awake during wake-time activities, and four sex outcomes: numbers of receptive, insertive, and total CAI partners in the past three months, and use of substances before or during sex. In bivariate analyses, all four sleep variables were associated with the three CAI outcomes, whereas poor sleep quality and problems falling asleep were positively associated with using substances before or during sex. Most of these associations remained significant when adjusting for various socio-demographic and behavioral covariates. These findings highlight the importance of addressing sleep health to prevent HIV risk among MSM.
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Affiliation(s)
- Brett M Millar
- Center for HIV Educational Studies & Training (CHEST), Hunter College, City University of New York (CUNY), 142 West 36th St, 9th Floor, New York, NY, 10018, USA.
| | - Jeffrey T Parsons
- Center for HIV Educational Studies & Training (CHEST), Hunter College, City University of New York (CUNY), 142 West 36th St, 9th Floor, New York, NY, 10018, USA
- Department of Psychology, Hunter College, CUNY, New York, NY, USA
- Health Psychology and Clinical Science Training Area, Graduate Center, CUNY, New York, NY, USA
| | - Susan Redline
- Department of Medicine, Harvard Medical School, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Dustin T Duncan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
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Millar BM, Starks TJ, Rendina HJ, Parsons JT. Three Reasons to Consider the Role of Tiredness in Sexual Risk-Taking Among Gay and Bisexual Men. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:383-395. [PMID: 30128984 PMCID: PMC6349479 DOI: 10.1007/s10508-018-1258-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 06/07/2018] [Accepted: 06/08/2018] [Indexed: 06/08/2023]
Abstract
Numerous factors have been shown to increase sexual risk-taking-especially among gay and bisexual men (GBM), who remain disproportionately affected by HIV and STIs. We present three lines of evidence that highlight the need to consider a previously under-explored situational factor in sexual risk-taking: tiredness. While tiredness has been shown, in sleep science literature, to impair cognition, emotional functioning, and decision-making in a wide range of behaviors, it has yet to be considered in-depth as a risk factor in sexual behavior. Counter to the common-sense assumption that being tired should impede the performance of active, effortful behaviors such as sex, we propose that tiredness may actually increase sexual risk-taking. Analyzing data from an online survey of 1113 HIV-negative GBM, we found that sex with casual partners most commonly occurred at night, especially among younger GBM and those with an evening chronotype, and that sex without condoms more often occurred at or later than one's usual time of feeling tired (as was reported by 44.2% of men) than did sex with condoms (reported by 36.6%). We also found that tiredness can increase sexual desire in many GBM (endorsed by 29.9%), and increases the likelihood of engaging in receptive positioning in anal sex (endorsed by almost 40% of men with a versatile sexual positioning identity). These findings highlight the importance of considering tiredness as a situational risk factor in sexual health-especially among younger GBM-and of counting sex among the behaviors that can be adversely impacted by poor or overdue sleep.
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Affiliation(s)
- Brett M Millar
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA
| | - Tyrel J Starks
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA
| | - H Jonathon Rendina
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA
| | - Jeffrey T Parsons
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA.
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA.
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA.
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Kemple M, O'Toole S, O'Toole C. Sleep quality in patients with chronic illness. J Clin Nurs 2016; 25:3363-3372. [PMID: 27378192 DOI: 10.1111/jocn.13462] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 12/17/2022]
Abstract
AIMS AND OBJECTIVES To explore sleep quality in patients with chronic illness in primary care. BACKGROUND Many people suffer from chronic illness with the numbers increasing. One common issue arises from problems that people have with their quality of sleep: a largely under-researched topic. This study exploring poor quality sleep allowed patients to describe their daily struggles with poor sleep in their own lives. This allowed the development of a deeper understanding of what it means to sleep poorly and find out how participants cope with not sleeping well. DESIGN A qualitative approach enabling a deep exploration of patient's experiences of sleep quality was used. Interviews were conducted with a purposive sample of nine participants from a primary care clinic. Analysis utilised an interpretative approach. RESULTS Data analysed produced four recurrent themes that were grouped into two categories. First, themes that identified the recognition by participants that 'something was wrong' were abrupt beginning and impact on their life. Second, themes that identified that the participants considered there was 'nothing wrong' were I am fine and I just carry on. CONCLUSION Data revealed that poor quality sleep can have a profound effect on quality of life. Participants lived without good quality sleep for years. They had come to accept two seemingly irreconcilable ideas that not being able to sleep is an enduring problem with a distinct starting point, and paradoxically, this is not a problem that deserves much professional attention. RELEVANCE TO CLINICAL PRACTICE Important original data were generated on the impact of poor quality sleep indicating that chronically disturbed sleep can increase the disease burden on patients with chronic illness. The results of this study suggest healthcare professionals need to understand how sleep quality issues impact on patient's experience of chronic illness. Data from this study will help nurses and other health professionals to deepen their understanding of the profound impact of poor quality sleep on patients with chronic illness. A programme of education highlighting the important role of sleep quality in chronic illness is suggested by the issues raised in this study. Nurses are ideally placed to assess sleep quality in patients and tailor intervention to positively affect the quality of life for this group.
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Affiliation(s)
- Mary Kemple
- School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Sinead O'Toole
- School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Conor O'Toole
- Slievemore General Practice, Slivemore Cliniccal, Stillorgan, Co. Dublin, Ireland
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Kline CE. The bidirectional relationship between exercise and sleep: Implications for exercise adherence and sleep improvement. Am J Lifestyle Med 2014; 8:375-379. [PMID: 25729341 DOI: 10.1177/1559827614544437] [Citation(s) in RCA: 200] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Exercise has long been associated with better sleep, and evidence is accumulating on the efficacy of exercise as a nonpharmacologic treatment option for disturbed sleep. Recent research, however, has noted that poor sleep may contribute to low physical activity levels, emphasizing a robust bidirectional relationship between exercise and sleep. This article will briefly review the evidence supporting the use of exercise as a nonpharmacologic treatment for sleep disturbance, outline future research that is needed to establish the viability of exercise as a behavioral sleep treatment, describe recent research that has emphasized the potential influence of poor sleep on daytime activity levels, and discuss whether improving sleep may facilitate adoption and/or better adherence to a physically active lifestyle. With poor sleep and physical inactivity each recognized as key public health priorities, additional research into the bidirectional relationship between exercise and sleep has significant implications for facilitating greater exercise adherence and improving sleep in society.
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