Insomnia and Mild Cognitive Impairment

The effect of yoga on insomnia and quality of life among nursing professionals during COVID-19: A pre-post-test interventional study

Background

The coronavirus disease 2019 (COVID-19) pandemic has taken a toll on the well-being and quality of life (QoL) of healthcare professionals, especially nurses. Insomnia, a common consequence of the pandemic, adds to the physical and mental strain on healthcare workers.

Aim

This study aimed to assess the impact of workplace yoga intervention on insomnia severity and QoL among female nursing and healthcare professionals during the pandemic.

Methods

A pre-post-interventional study was conducted among 173 nursing professionals working in a hospital setting. Baseline assessments collected age, body mass index (BMI), insomnia severity using the Insomnia Severity Index (ISI), and QoL using the World Health Organization Quality-of-Life Brief Version (WHOQOL-BREF). A 6-week workplace yoga intervention was conducted by trained professionals, followed by posttest assessments.

Results

Among 173 participants, 57 had insomnia. Participants without significant insomnia had higher QoL scores (P < 0.001). Following the yoga intervention, both subthreshold and moderate clinical insomnia groups experienced reduced insomnia severity (P < 0.001). Quality-of-life scores in the physical, psychological, and environmental domains improved significantly (P < 0.05).

Conclusion

Workplace yoga intervention appears to be a promising approach to alleviate insomnia and enhance QoL among female nursing and healthcare professionals during the COVID-19 pandemic. Implementing tailored workplace yoga programs can play a crucial role in promoting the well-being and resilience of healthcare workers, contributing to a positive work environment and improved patient care outcomes.

Exploring the Impact of Age of Onset of Mild Cognitive Impairment on the Profile of Cognitive and Psychiatric Symptoms

The present study aims to explore the differences in the manifestation of cognitive decline and psychiatric symptoms across the different ages of MCI onset: early onset (EOMCI: <65 years old), middle onset (MOMCI: 65-75 years old), and late onset (LOMCI: >75 years old). It was hypothesized that individuals with EOMCI will preserve their cognitive functions to a greater extent as compared to individuals with LOMCI, even after adjusting the cognitive performance for age and education through the use of published Greek norms. The level of cognitive decline concerning MOMCI was evaluated for extracting more precise conclusions regarding the impact of the age of onset on the patterns of MCI symptomatology. The analyses of data were conducted in a Greek population of individuals with MCI, who were consecutive visitors of the Outpatient Memory Clinic of Nestor Alzheimer's Centre in Athens, Greece. The sample consisted of 297 participants who fulfilled the following inclusion criteria: MCI diagnosis based on Petersen's criteria, Greek mother language, and absence of a psychiatric history or chronic and incurable organic disease. The overall results support the presence of a cognitive advantage of the EOMCI group compared to the LOMCI group. In the MOMCI group, cognitive performance displayed a tendency to remain intermediate compared to the other two groups. Nonetheless, significant differences were observed when this group was compared with the LOMCI group. The current findings indicate that the age of onset should be taken under consideration in the neuropsychological assessment of individuals with MCI. The specific parameters could have implications in terms of prognosis as well as the design and implementation of tailored interventions.

Is insomnia associated with self-reported health and life satisfaction in cardiac arrest survivors? A cross-sectional survey

Background

Insomnia symptoms seem to be common in cardiac arrest survivors but their associations with important outcomes such as self-reported health and life satisfaction have not previously been reported during the early post-event period. Therefore, the aim of the study was to investigate whether symptoms of insomnia are associated with self-reported health and life satisfaction in cardiac arrest survivors six months after the event.

Methods

This multicentre cross-sectional survey included cardiac arrest survivors ≥18 years. Participants were recruited six months after the event from five hospitals in southern Sweden, and completed a questionnaire including the Minimal Insomnia Symptom Scale, EQ-5D-5L, Health Index, Hospital Anxiety and Depression Scale, and Satisfaction With Life Scale. Data were analysed using the Mann-Whitney U test, linear regression, and ordinal logistic regression. The regression analyses were adjusted for demographic and medical factors.

Results

In total, 212 survivors, 76.4% males, with a mean age of 66.6 years (SD = 11.9) were included, and of those, 20% reported clinical insomnia. Insomnia was significantly associated with all aspects of self-reported health (p < 0.01) and life satisfaction (p < 0.001), except mobility (p = 0.093), self-care (p = 0.676), and usual activities (p = 0.073).

Conclusion

Insomnia plays a potentially important role for both health and life satisfaction in cardiac arrest survivors. Screening for sleep problems should be part of post cardiac arrest care and follow-up to identify those in need of further medical examination and treatment.

Comparative impact of yoga and ayurveda practice in insomnia: A randomized controlled trial

BACKGROUND

Insomnia is connected with a lifted hazard for neurocognitive dysfunction and psychiatric disarranges. Clinical observations of psychosomatic patients indicate that their distorted somatopsychic functioning necessitates their practice of yoga-like therapy. Sleep and its modifications and management have also been explained well in ayurveda. This study aimed to compare the effectiveness of Yoga and Nasya Karma on the sleep quality, stress, cognitive function, and quality of life of people suffering from acute insomnia.

MATERIAL AND METHODS

It was an open-label, randomized controlled trial. A total of 120 participants were randomly (computer-generated randomization) equally allocated to three groups, yoga group (G-1), ayurveda group (G-2), and control group (G-3). All the groups were assessed on the first day before the start of the yoga regime and the 48^th day. Participants in the study were included in the age group of 18 to 45 years, fulfilling DSM-V criteria for insomnia, physically fit for the yoga module, and Nasya procedure. Outcomes were measured by the Pittsburgh Sleep Quality Index (PSQI) questionnaire, Perceived Stress Scale (PSS), cognitive failure questionnaire, and WHO Quality of Life Scale-Brief (WHOQOL-Brief). Proportions and frequencies were described for categorical variables and compared using the Chi-square test. ANOVA (one-way) and post hoc analysis, Bonferroni test, were performed for multiple comparisons in groups at a significance level of P < 0.05 using SPSS (23 version).

RESULTS

A total of 112 participants were analyzed as per protocol analysis. All groups have observed significant mean differences for stress (<0.05) and sleep quality (<0.05). All five aspects of quality of life - general health (<0.05), physical health (<0.01), psychological health (<0.05), social health (<0.05), and environmental health (<0.05) - had a significant mean difference in all three groups. All three aspects of cognitive failure, forgetfulness (<0.05), distractibility (<0.05), and false triggers (<0.01) had a significant mean difference in scores for all three groups.

CONCLUSION

Yoga practice was effective, followed by ayurveda and the control group in reducing stress and improving sleep, cognitive function, and quality of life.

Real-Time Excitation of Slow Oscillations during Deep Sleep Using Acoustic Stimulation

Slow-wave synchronous acoustic stimulation is a promising research and therapeutic tool. It is essential to clearly understand the principles of the synchronization methods, to know their performances and limitations, and, most importantly, to have a clear picture of the effect of stimulation on slow-wave activity (SWA). This paper covers the mentioned and currently missing parts of knowledge that are essential for the appropriate development of the method itself and future applications. Artificially streamed real sleep EEG data were used to quantitatively compare the two currently used real-time methods: the phase-locking loop (PLL) and the fixed-step stimulus in our own implementation. The fixed-step stimulation method was concluded to be more reliable and practically applicable compared to the PLL method. The sleep experiment with chronic insomnia patients in our sleep laboratory was analyzed in order to precisely characterize the effect of sound stimulation during deep sleep. We found that there is a significant phase synchronization of delta waves, which were shown to be the most sensitive metric of the effect of acoustic stimulation compared to commonly used averaged signal and power analyses. This finding may change the understanding of the effect and function of the SWA stimulation described in the literature.

Revisiting the Role of Physicians in Assisted Living and Residential Care Settings

As the United States population ages, a higher share of adults is likely to use long-term services and supports. This change increases physicians' need for information about assisted living and residential care (AL/RC) settings, which provide supportive care and housing to older adults. Unlike skilled nursing facilities, states regulate AL/RC settings through varying licensure requirements enforced by state agencies, resulting in differences in the availability of medical and nursing services. Where some settings provide limited skilled nursing care, in others, residents rely on resident care coordinators, or their own physicians to oversee chronic conditions, medications, and treatments. The following narrative review describes key processes of care where physicians may interact with AL/RC operators, staff, and residents, including care planning, managing Alzheimer's disease and related conditions, medication management, and end-of-life planning. Communication and collaboration between physicians and AL/RC operators are a crucial component of care management.

The effectiveness of cognitive training on improving cognitive function and sleep quality in community-dwelling elderly in Iran

Background and aim

Given the ever-increasing of the older adults population and in order to achieve healthy and active ageing goals and improvement in the cognitive function and sleep quality in older adult, this study aimed to evaluate the effect of cognitive training program on improving cognitive function and ageing-related sleep quality in community-dwelling elderly in Iran, in 2018.

Methods

This was an experimental study. The sample comprised 420 older adults who were a member of the comprehensive health center in one of the southern cities of Iran. 164 had a cognitive problem and sleep disorder, of whom 108 were selected by the available method and based on inclusion criteria. Participants were randomly allocated to an experimental group (n=54) and a control group (n=54). Experimental group samples were undergoing the intervention for two months. Data were collected using MMSE questionnaire, Pittsburgh sleep quality, insomnia severity index and Clinical Dementia Rating Scale (CDR). Data were collected one month before-and-after the intervention. Data were analyzed using SPSS software.

Results

There was no significant difference between the mean score of cognitive function and sleep quality in both the intervention group and the control group before the intervention (p>0.05). At the post-test, the mean (SD) of elderly adults’ cognitive function in the intervention and control groups were 2.7 (1.3) and 3.44 (1.7), respectively (p=0.017). Moreover, the mean (SD) of sleep quality in older adults in the intervention and the control group was 6.76 (2.3) and 9.25 (2.36), respectively (p<0.001).

Conclusion

Given the obtained results in the current study the cognitive training promotes cognitive function and sleep quality in older adults. Therefore, since this program is effective, low-cost and applicable, it can be used to improve cognitive function and sleep disorder in the older adult population.

"Tipping point" concept analysis in the family caregiving context

AIM

Analyze the concept "tipping point" in the older adult family caregiving context to further knowledge about caregiving families, enhancing transdisciplinary theory, research, and practice.

BACKGROUND

While used commonly in some disciplines, how "tipping point" has been used in health care, generally, and in relation to caregiving families, specifically, is less clear. This project was conducted to offer conceptual clarity to tipping point.

DESIGN

Walker and Avant's framework.

DATA SOURCE

Searches of scholarly literature in PsycINFO, CINAHL, and PubMed using the search term "tipping point" in either title or abstract.

REVIEW METHODS

Definitions used were extracted; instances when the concept was implied but the actual term "tipping point" was not used and contexts where the term was used or implied were identified.

RESULTS

The composite definition of a caregiving tipping point is a seemingly abrupt, severe, and absolute change event involving either the older adult or caregiver(s), or both that indicates a breakdown in the status quo of the caregiving system.

CONCLUSIONS

Transdisciplinary research, care, and policy should treat caregiving families as complex systems, use longitudinal assessments, and include colloquial communication. Early detection of impending tipping points will provide family-centered decisional support and enhance families' quality of life and safety.