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Younes A, Point C, Wacquier B, Lanquart JP, Hein M. Excessive Daytime Sleepiness in Hypertensive Patients: The Role of Major Depressive Disorder. Diagnostics (Basel) 2024; 14:1854. [PMID: 39272639 PMCID: PMC11394253 DOI: 10.3390/diagnostics14171854] [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: 07/30/2024] [Revised: 08/19/2024] [Accepted: 08/23/2024] [Indexed: 09/15/2024] Open
Abstract
There is a special relationship between major depressive disorder and excessive daytime sleepiness. However, given the negative impact of excessive daytime sleepiness on life quality and cardiovascular outcome in hypertensive patients, the objective of this study was to investigate the potential role played by major depressive disorder in the occurrence of this complaint for this particular subpopulation. Data from 1404 hypertensive patients recruited from the Sleep Unit's polysomnographic recordings database were analyzed. A score >10 on the Epworth Sleepiness Scale was used to define excessive daytime sleepiness in this study. Logistic regression analyses were performed to investigate the risk of excessive daytime sleepiness associated with major depressive disorder in hypertensive patients. Excessive daytime sleepiness was frequent (40.0%) in our sample of hypertensive patients. After adjustments for major confounding factors, multivariate logistic regression analyses demonstrated that unlike remitted major depressive disorder, only current major depressive disorder was associated with a higher risk of excessive daytime sleepiness in hypertensive patients. Given this potential implication of current major depressive disorder in the occurrence of excessive daytime sleepiness for hypertensive patients, it is therefore essential to achieve the complete remission of this psychiatric disorder to avoid negative consequences associated with this complaint in this particular subpopulation.
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Affiliation(s)
- Alexandre Younes
- Faculté de Médecine, Université Libre de Bruxelles, ULB, 1070 Bruxelles, Belgium
| | - Camille Point
- Hôpital Universitaire de Bruxelles, Service de Psychiatrie et Laboratoire du Sommeil, Université Libre de Bruxelles, ULB, 1070 Bruxelles, Belgium
| | - Benjamin Wacquier
- Hôpital Universitaire de Bruxelles, Service de Psychiatrie et Laboratoire du Sommeil, Université Libre de Bruxelles, ULB, 1070 Bruxelles, Belgium
| | - Jean-Pol Lanquart
- Hôpital Universitaire de Bruxelles, Service de Psychiatrie et Laboratoire du Sommeil, Université Libre de Bruxelles, ULB, 1070 Bruxelles, Belgium
| | - Matthieu Hein
- Hôpital Universitaire de Bruxelles, Service de Psychiatrie et Laboratoire du Sommeil, Université Libre de Bruxelles, ULB, 1070 Bruxelles, Belgium
- Laboratoire de Psychologie Médicale et Addictologie (ULB312), Université Libre de Bruxelles, ULB, 1020 Bruxelles, Belgium
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Woods TJ, Kaambwa B. An empirical comparison of sleep-specific versus generic quality of life instruments among Australians with sleep disorders. Qual Life Res 2024; 33:2261-2274. [PMID: 38913275 PMCID: PMC11286652 DOI: 10.1007/s11136-024-03686-0] [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] [Accepted: 05/08/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE In Australian adults diagnosed with a sleep disorder(s), this cross-sectional study compares the empirical relationships between two generic QoL instruments, the EuroQoL 5-dimension 5-level (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A), and three sleep-specific metrics, the Epworth Sleepiness Scale (ESS), 10-item Functional Outcomes of Sleep Questionnaire (FOSQ-10), and Pittsburgh Sleep Quality Index (PSQI). METHODS Convergent and divergent validity between item/dimension scores was examined using Kendall's Tau-B correlation, with correlations below 0.30 considered weak, between 0.30 and 0.50 moderate and those above 0.50 strong (indicating that instruments were measuring similar constructs). Exploratory factor analysis (EFA) was conducted to identify shared underlying constructs. RESULTS A total of 1509 participants (aged 18-86 years) were included in the analysis. Convergent validity between dimensions/items of different instruments was weak to moderate. A 5-factor EFA solution, representing 'daytime dysfunction', 'fatigue', 'wellbeing', 'physical health', and 'perceived sleep quality', was simplest with close fit and fewest cross-loadings. Each instrument's dimensions/items primarily loaded onto their own factor, except for the EQ-5D-5L and PSQI. Nearly two-thirds of salient loadings were of excellent magnitude (0.72 to 0.91). CONCLUSION Moderate overlap between the constructs assessed by generic and sleep-specific instruments indicates that neither can fully capture the complexity of QoL alone in general disordered sleep populations. Therefore, both are required within economic evaluations. A combination of the EQ-5D-5L and, depending on context, ESS or PSQI offers the broadest measurement of QoL in evaluating sleep health interventions.
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Affiliation(s)
- Taylor-Jade Woods
- Health Economics Unit, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
| | - Billingsley Kaambwa
- Health Economics Unit, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
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Giloyan A, Harutyunyan T, Babayan A, Petrosyan V. Factors associated with health-related quality of life among people with visual impairments living in nursing homes in Armenia: a cross-sectional study. Disabil Rehabil 2024; 46:3355-3362. [PMID: 37578136 DOI: 10.1080/09638288.2023.2247328] [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: 01/26/2023] [Revised: 07/03/2023] [Accepted: 08/09/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE The study aimed to examine the effect of visual impairment (VI), eye diseases, and other risk factors on health-related quality of life (HRQoL) in nursing home residents in Armenia. METHODS This cross-sectional study administered an interviewer-administered structured questionnaire to collect information about socio-demographics, chronic diseases, HRQoL, smoking, receiving and giving instrumental/emotional social support, and sleeping disorders among 313 nursing home residents. An ophthalmic examination of the participants was conducted. RESULTS The mean age was 72.5 years, ranging from 45.5 to 91.4. Women constituted 50% of the sample. The prevalence of normal vision by presenting visual acuity with available correction was 55.3%, while VI and blindness were present in 40.8% and 3.9%, respectively. Uncorrected refractive error (URE) was found in 20% of participants. The mean HRQoL score was 51.3, ranging from 7.9 to 95.0. In the adjusted analysis, having at least one chronic non-communicable disease, sleeping disorders, eye diseases, URE, VI, blindness, and giving instrumental social support were associated with HRQoL. CONCLUSIONS Regular eye care services could improve the eye health and HRQoL of nursing home residents. Interventions addressing vision loss and chronic non-communicable diseases could enhance the functioning and overall well-being of the target population.
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Affiliation(s)
- Aida Giloyan
- Garo Meghrigian Institute for Preventive Ophthalmology, Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Tsovinar Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Ani Babayan
- Garo Meghrigian Institute for Preventive Ophthalmology, Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
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McPhillips MV, Petrovsky DV, Lorenz R, Lee J, George T, Smyth A, Bubu OM, Brewster GS. Treatment Modalities for Insomnia in Adults Aged 55 and Older: A Systematic Review of Literature from 2018 to 2023. CURRENT SLEEP MEDICINE REPORTS 2024; 10:232-256. [PMID: 39156226 PMCID: PMC11328977 DOI: 10.1007/s40675-024-00285-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 08/20/2024]
Abstract
Purpose of Review Insomnia is the most common sleep disorder experienced by older adults. There is a wide range of pharmacological and non-pharmacological treatment options in existing literature. The purpose of this systematic review was to synthesize randomized controlled trials of insomnia treatment modalities for adults aged 55 and older over the last 5 years. We searched four databases, and after screening, there were 34 full-text manuscripts that met the inclusion/exclusion criteria. Recent Findings We found non-pharmacological interventions, including exercise and behavioral/psychoeducational therapies, remain effective and favorable. Complementary and alternative therapies ranged across studies and warrant further testing in larger, more diverse samples. Dual orexin receptor antagonist medications were tested in a few studies with positive benefits for sleep and minimal side effects. Finally, measures of insomnia/sleep disturbance outcomes varied among the studies, with the Pittsburgh Sleep Quality Index being used most frequently. Summary Non-pharmacological interventions for insomnia in older adults are effective, and some newer medications may be safer, with less side effects, at managing insomnia in this population.
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Affiliation(s)
| | - Darina V. Petrovsky
- Health Care Policy, and Aging Research, School of Nursing, Institute for Health, Rutgers University, New Brunswick, USA
| | | | - Jiwon Lee
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, USA
| | - Tessy George
- Georgia Baptist College of Nursing, Mercer University, Macon, USA
| | - Aisling Smyth
- School of Nursing and Midwifery, University of Notre Dame Australia, Fremantle, USA
- Centre for Research in Aged Care, Edith Cowan University, Joondalup, Australia
| | - Omonigho Michael Bubu
- Departments of Psychiatry, NYU Grossman School of Medicine, Population Health & Neurology, New York, NY, USA
| | - Glenna S. Brewster
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Room 256, Atlanta, GA 30322, USA
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Chen L, Li R, Yang L, Gao H, Li W, Wei Y, Pang L. Effect of holographic Guasha on sleep quality of older adults with hypertension in the community: A prospective study. Medicine (Baltimore) 2024; 103:e38233. [PMID: 38788017 PMCID: PMC11124766 DOI: 10.1097/md.0000000000038233] [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: 08/09/2023] [Accepted: 04/24/2024] [Indexed: 05/26/2024] Open
Abstract
To explore the effect of holographic Guasha therapy on the Pittsburg Sleep Quality Index (PSQI) and Hamilton Anxiety Rating Scale (HAMA) in older adults with hypertension living in the community. This prospective study was conducted from July 2019 to December 2020. Older adults with hypertension (systolic pressure ≥ 140 mm Hg, diastolic pressure ≥ 90 mm Hg) were divided into the control and Guasha groups. The PSQI and HAMA were assessed before and after 4 weeks of intervention. 62 patients were enrolled, with 31/group (Guasha: 72.4 ± 6.9 years, 23.0 ± 3.1 kg/m2; control: 71.4 ± 6.3 years; 22.9 ± 2.9 kg/m2). The total PSQI score did not decrease in the control group after 4 weeks (from 14.8 ± 1.2 to 14.8 ± 1.8, P = .498) but decreased in the Guasha group (from 14.9 ± 1.1 to 6.8 ± 3.5, P < .001). All PSQI subscores decreased in the Guasha group after 4 weeks of Guasha intervention (all P < .05), except for the use of sleep medication, since the use of such drugs was an exclusion criterion. The HAMA index scores did not change in the control or Guasha group (both P > .05). Holographic Guasha appears to achieve better sleep outcomes than conventional treatment in improving the sleep quality of older adults with hypertension living in the community. The participants were not randomly assigned to the treatments, and the results should be confirmed in a formal trial.
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Affiliation(s)
- Ling Chen
- Nursing College, Guangxi University of Chinese Medicine, Nanning, China
| | - Ruilin Li
- Nursing College, Guangxi University of Chinese Medicine, Nanning, China
| | - Lianzhao Yang
- Nursing College, Guangxi University of Chinese Medicine, Nanning, China
| | - Hui Gao
- Nursing College, Guangxi University of Chinese Medicine, Nanning, China
| | - Wen Li
- Nursing Faculty, Shanghai Donghai Vocational and Technical College, Shanghai, China
| | - Yujuan Wei
- Gynecology Department 1, Nanning Maternity and Child Health Hospital, Nanning, China
| | - Lingling Pang
- Beihu Nanmian Community Health Service Center, Ruikang Hospital Affiliated to the Guangxi University of Chinese Medicine, Nanning, China
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Kaambwa B, Woods TJ, Natsky A, Bulamu N, Mpundu-Kaambwa C, Loffler KA, Sweetman A, Catcheside PG, Reynolds AC, Adams R, Eckert DJ. Content Comparison of Quality-of-Life Instruments Used in Economic Evaluations of Sleep Disorder Interventions: A Systematic Review. PHARMACOECONOMICS 2024; 42:507-526. [PMID: 38340220 PMCID: PMC11039546 DOI: 10.1007/s40273-023-01349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND Assessment of quality of life (QoL) in people living with sleep disorders using questionnaires is necessary to compare intervention benefits. Knowledge of the content and concepts covered by specific QoL instruments is essential to determine which instruments are best suited for conducting economic evaluations of sleep-related interventions. OBJECTIVES This review aims to identify the QoL instruments that have been applied in economic evaluations of sleep disorder interventions and compare their conceptual overlap and content coverage using the framework of the International Classification of Functioning, Disability and Health (ICF). METHODS A systematic review of full economic evaluations in sleep published in peer-reviewed journals from conception to 30 May, 2023 was conducted. MEDLINE, PsychInfo, ProQuest, Cochrane, Scopus, CINAHL, Web of Science and Emcare were searched for eligible studies. Studies incorporating either generic or sleep-specific QoL instruments as the primary or secondary measures of effectiveness within a full economic evaluation were included. Quality appraisal against the JBI Critical Appraisal Checklist for Economic Evaluations and EURONHEED checklists and mapping of QoL items to ICF categories were performed by two reviewers, with a third helping settle any potential differences. RESULTS Sixteen instruments were identified as having been used in sleep health economic evaluations. The EQ-5D-3L, Epworth Sleepiness Scale, and Insomnia Severity Index were the most widely used, but the latter two are predominantly diagnostic tools and not specifically designed to guide economic evaluations. Other instruments with broader ICF content coverage have been least used, and these include the Sleep Apnea Quality of Life Index, Functional Outcomes of Sleep Questionnaire, 15 Dimensions, Short-Form 6 Dimensions, 12-item Short Form Survey, 36-item Short Form Survey and the GRID Hamilton Rating Scale for Depression. CONCLUSIONS This study provides an overview of current QoL instruments used in economic evaluations of sleep with respect to their content coverage. A combination of generic and sleep-specific instruments with broader ICF content coverage is recommended for such evaluations.
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Affiliation(s)
- Billingsley Kaambwa
- Health Economics Unit, College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, SA, 5042, Australia.
| | - Taylor-Jade Woods
- Health Economics Unit, College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, SA, 5042, Australia
| | - Andrea Natsky
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Norma Bulamu
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Christine Mpundu-Kaambwa
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Kelly A Loffler
- Health Data and Clinical Trials, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
| | - Alexander Sweetman
- Flinders Health and Medical Research Institute (Sleep Health)/formerly Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Peter G Catcheside
- Flinders Health and Medical Research Institute (Sleep Health)/formerly Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health)/formerly Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Robert Adams
- Flinders Health and Medical Research Institute (Sleep Health)/formerly Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Danny J Eckert
- Flinders Health and Medical Research Institute (Sleep Health)/formerly Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia
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Sutil DV, Moreira BDS, Canever JB, Cândido LM, Danielewicz AL, Lima-Costa MF, Avelar NCPD. Association between self-perception of the neighborhood environment and sleep problems in older Brazilian adults: findings from ELSI-Brazil. CAD SAUDE PUBLICA 2024; 40:e00141623. [PMID: 38695455 PMCID: PMC11057486 DOI: 10.1590/0102-311xen141623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 05/06/2024] Open
Abstract
This study aimed to investigate associations between neighborhood perception and sleep problems in older Brazilian adults. A cross-sectional study was conducted with 5,719 community-dwelling older adults (≥ 60 years) from the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021). The outcomes were self-reported sleep problems: poor sleep quality, daytime sleepiness, primary insomnia complaints, difficulty staying asleep, and waking up at dawn. The exposure variables were questions about the perception of participants about the physical and social environment of the neighborhood. Logistic regression was used in data analysis. Garbage, rubbish, or tall grass on the streets and the desire to move were associated with higher odds of poor sleep quality. Concern about falling due to damaged sidewalks, concern about having difficulties taking transportation, and concern about having difficulties crossing the street were associated with higher odds of all sleep problems. Sound/noise of buses and cars was associated with higher odds of some sleep problems. Perceiving the neighborhood as a good place to live was associated with lower odds of daytime sleepiness and primary insomnia complaints. Trusting most people in the neighborhood and perceiving that kids and younger people treat adults with respect were associated with lower odds of daytime sleepiness, primary insomnia complaints, and waking up at dawn. Being a good place for kids to play and raise teenagers was associated with lower odds of daytime sleepiness. These results can assist public administrators in creating urban planning policies aimed at improving neighborhood environments as a means of health promotion.
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Affiliation(s)
| | - Bruno de Souza Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | | | | | | | - Maria Fernanda Lima-Costa
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Programa de Pós-graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Ma H, Zhao M, Liu Y, Wei P. Network analysis of depression and anxiety symptoms and their associations with life satisfaction among Chinese hypertensive older adults: a cross-sectional study. Front Public Health 2024; 12:1370359. [PMID: 38562253 PMCID: PMC10983850 DOI: 10.3389/fpubh.2024.1370359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Background Hypertension is one of the most prevalent chronic diseases among the older adult population in China and older adults with hypertension are more susceptible to mental health problems. This study aimed to explore the network structure of depression and anxiety, and their association with life satisfaction (LS) in older adults with hypertension. Methods A total of 4,993 hypertensive individuals aged 60 and above were selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2017-2018). The design of the CLHLS study was approved by the Campus Institutional Review Board of Duke University (Pro00062871) and the Biomedical Ethics Committee of Peking University (IRB00001052-13,074). The Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and the Generalized Anxiety Disorder Scale-7 (GAD-7) were used to assess depressive and anxiety symptoms. Central and bridge symptoms were identified via "Expected Influence" and "Bridge Expected Influence", respectively. Network stability was assessed using the case-dropping bootstrap technique. Results Network analysis identified CESD3 (Feeling blue/depressed), GAD4 (Trouble relaxing), and GAD2 (Uncontrollable worry) as the most influential central symptoms in the network of depression and anxiety. Concurrently, GAD1 (Nervousness or anxiety), CESD10 (Sleep disturbances), and CESD1 (Feeling bothered) stand as critical bridge symptoms between depression and anxiety disorders. Moreover, CESD7 (Lack of happiness) exhibited the strongest negative correlation with LS in Chinese hypertensive older adults. Conclusion This exploratory study represents the first investigation to examine the mutual relationship between depressive and anxiety symptoms among Chinese hypertensive older adults. Interventions addressing targeting bridge symptoms have the potential to alleviate depressive and anxiety symptoms. Furthermore, improving happiness, hope, and sleep quality in this population may mitigate the adverse effects of depression and anxiety on LS.
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Affiliation(s)
| | | | | | - Pingmin Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
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Ma Z, Geng H, Yang H, Meng G, Gu Y, Wu H, Zhang S, Zhang J, Wang X, Huang T, Niu K. Adherence to a healthy sleep pattern and risk of urologic cancers: A large prospective cohort study. Prev Med 2024; 179:107844. [PMID: 38176446 DOI: 10.1016/j.ypmed.2023.107844] [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: 07/29/2023] [Revised: 11/28/2023] [Accepted: 12/28/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE A variety of unhealthy sleep behaviors have been shown to be associated with an increased risk of urologic cancers. However, little is known about the association between the overall sleep patterns and urologic cancers. To prospectively investigate the associations between a healthy sleep pattern and the risks of urologic cancers, including bladder cancer (BCa) and renal cell carcinoma (RCC). METHODS In this prospective cohort study, 377,144 participants free of cancer at baseline were recruited from the UK Biobank. Data on sleep behaviors were collected through questionnaires at recruitment. The incident urologic cancer cases were determined through linkage to national cancer and death registries. We established a healthy sleep score according to five sleep traits (sleep duration, chronotype, insomnia, snoring, and daytime sleepiness). Cox proportional hazard regression models were used to calculate the adjusted hazard ratios and 95% confidence intervals to assess the relationship between the healthy sleep score and the risk of urologic cancers. RESULTS During a median of ≥9 years of follow-up, we identified 1986 incident urologic cancer cases, including 1272 BCa cases and 706 RCC cases. Compared with the participants with a poor sleep pattern (score of 0-2), the multivariable-adjusted hazard ratio and 95% confidence interval were 0.85 (0.75 to 0.96) for urologic cancers, 0.80 (0.68 to 0.93) for BCa, and 0.91 (0.74, 1.12) for RCC, respectively, for those with the healthier sleep pattern (score of 4-5). CONCLUSION Our results indicate that a healthy sleep pattern is associated with lower risks of urologic cancers.
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Affiliation(s)
- Zheng Ma
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hao Geng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Honghao Yang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Juanjuan Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
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Dichter MN, Dörner J, Wilfling D, Berg A, Klatt T, Möhler R, Haastert B, Meyer G, Halek M, Köpke S. Intervention for sleep problems in nursing home residents with dementia: a cluster-randomized study. Int Psychogeriatr 2024:1-14. [PMID: 38186227 DOI: 10.1017/s1041610223004489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To reduce sleep problems in people living with dementia using a multi-component intervention. DESIGN Cluster-randomized controlled study with two parallel groups and a follow-up of 16 weeks. SETTING Using external concealed randomization, 24 nursing homes (NH) were allocated either to the intervention group (IG, 12 clusters, 126 participants) or the control group (12 clusters, 116 participants). PARTICIPANTS Participants were eligible if they had dementia or severe cognitive impairment, at least two sleep problems, and residence of at least two weeks in a NH. INTERVENTION The 16-week intervention consists of six components: (1) assessment of sleep-promoting activities and environmental factors in NHs, (2) implementation of two "sleep nurses," (3) basic education, (4) advanced education for staff, (5) workshops to develop sleep-promoting concepts, and (6) written information and education materials. The control group (CG) received standard care. MEASUREMENTS Primary outcome was ≥ two sleep problems after 16 weeks assessed with the Sleep Disorders Inventory (SDI). RESULTS Twenty-two clusters (IG = 10, CG = 12) with 191 participants completed the study. At baseline, 90% of people living with dementia in the IG and 93% in the CG had at least two sleep problems. After 16 weeks, rates were 59.3% (IG) vs 83.8% (CG), respectively, a difference of -24.5% (95% CI, -46.3% - -2.7%; cluster-adjusted odds ratio 0.281; 95% CI 0.087-0.909). Secondary outcomes showed a significant difference only for SDI scores after eight and 16 weeks. CONCLUSIONS The MoNoPol-Sleep intervention reduced sleep problems of people living with dementia in NH compared to standard care.
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Affiliation(s)
- Martin Nikolaus Dichter
- Institute of Nursing Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jonas Dörner
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Denise Wilfling
- Institute of Social Medicine and Epidemiology, Nursing Research Group, University of Lübeck, Lübeck, Germany
| | - Almuth Berg
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Medical Faculty, Halle (Saale), Germany
| | - Thomas Klatt
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Medical Faculty, Halle (Saale), Germany
| | - Ralph Möhler
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Gabriele Meyer
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Medical Faculty, Halle (Saale), Germany
| | - Margareta Halek
- School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Sascha Köpke
- Institute of Nursing Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Okyere J, Ayebeng C, Owusu BA, Dickson KS. Fruits and vegetable consumption, and its association with hypertension among women in Ghana: a cross-sectional study. Public Health Nutr 2023; 27:e19. [PMID: 38148174 PMCID: PMC10830364 DOI: 10.1017/s1368980023002896] [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: 02/06/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE This study aimed to examine the association between fruit and vegetable consumption (FVC) and the risk of hypertension among women in Ghana. DESIGN Data from the 2014 Ghana Demographic and Health Survey were used. Bivariate and multivariate logistic regression analyses were performed using Stata version 14. The study reports the adjusted OR (AOR) and CI. SETTING Ghana. PARTICIPANTS A total sample of 4168 women was used in the analysis. RESULTS Among women who met the WHO's recommended intake of FVC, 13·1 % had hypertension. The intake of the recommended servings of fruit and vegetables was not significantly associated with hypertension. However, the likelihood of being hypertensive was significantly associated with increasing age (AOR = 6·1; 95 % CI = 4·29, 8·73), being married (AOR = 1·7; 95 % CI = 1·14, 2·57) or formerly married (AOR = 2·3; 95 % CI = 1·44, 3·70), and being overweight (AOR = 1·6; 95 % CI = 1·24, 2·07) or obese (AOR = 2·4; 95 % CI = 1·82, 3·20). CONCLUSION The study concludes that there is no significant association between FVC and hypertension risk among women in Ghana. While this study did not find a significant association between FVC and hypertension risk among women in Ghana, it underscores the point that other multifaceted factors influence hypertension risk. As such, public health campaigns should emphasise a balanced and holistic approach to promoting cardiovascular health, including factors beyond FVC. The findings also highlight the need to target high-risk populations (i.e. older women, married and formerly married women, and overweight or obese women) with hypertension prevention education and related interventions.
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Affiliation(s)
- Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, University Post Office, PMB, Ghana
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, University Post Office, PMB, Ghana
| | - Bernard Afriyie Owusu
- Department of Population and Health, University of Cape Coast, Cape Coast, University Post Office, PMB, Ghana
| | - Kwamena Sekyi Dickson
- Department of Population and Health, University of Cape Coast, Cape Coast, University Post Office, PMB, Ghana
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12
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Almansouri Y, Alsuwatt A, Alzahrani M, Alsuwat MS, Alamrai R, Alsuwat WS, Almansouri BH, Al Bahis AF. Excessive Daytime Sleepiness in Patients With Hypertension: A Systematic Review. Cureus 2023; 15:e50716. [PMID: 38234944 PMCID: PMC10792344 DOI: 10.7759/cureus.50716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2023] [Indexed: 01/19/2024] Open
Abstract
We must remember that there are many subclinical cases of obstructive sleep apnea (OSA), even if the patient or family members typically become aware of it through symptoms such as snoring and excessive daytime sleepiness (EDS). EDS is a common symptom among hypertensive patients. This interesting and remarkable systematic review aims to comprehensively survey the current literature on the prevalence and association of EDS among hypertensive patients. PubMed, SCOPUS, Web of Science, and Science Direct were systematically searched for relevant literature. Rayyan QRCI (Rayyan Systems Inc., Cambridge, MA) was employed throughout this comprehensive process. This review included nine studies with a total of 58,517 patients, and 34,398 (58.8%) were males. EDS prevalence among hypertensive patients ranged from 12.1% to 88.3%. This review stated that individuals with hypertension (HTN) had EDS that was worse than that of patients with normotension. In one of the studies included in this analysis, sympathovagal imbalance was noted alongside EDS and HTN. Older age, primary education, being overweight, working, obesity, depression, and having had the condition for longer are all associated with EDS in HTN patients.
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Li T, Li J, Ke X. Exploring the relationship between mental health and dialect use among Chinese older adults: a moderated mediation estimation. Front Psychol 2023; 14:1177984. [PMID: 37575424 PMCID: PMC10416436 DOI: 10.3389/fpsyg.2023.1177984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Background Mental health, conceptualized as psychological status that includes rational cognition, emotional stability, and interpersonal harmony, is highly relevant to the expected health and well-being of all humans. China is facing the dual risk of increased aging and mental health disorders in older adults, while the established studies have rarely focused on the influence of dialect on the mental health of Chinese older adults. The present study aims to capture the relationship between dialect and mental health in Chinese older adults. Methods We use cross-sectional data from the nationally representative China Family Panel Studies, which encompasses the dialect use, mental health, and other socioeconomic features of 4,420 respondents. We construct a moderated mediation model that uses dialects and mental health as the independent and dependent variables and income inequality and subjective well-being as the mediator and moderator to reveal the relationship between dialect and mental health in Chinese older adults. Results (1) Dialects are shown to have a negative influence on the mental health of older adults in the current study (coefficient = -0.354, 95% CI = [-0.608, -0.097]). (2) Income inequality positively mediates the correlation between dialects and mental health (coefficient = 0.019, 95% CI = [0.010, 0.045]). (3) Subjective well-being negatively moderates the potential mechanism between dialects and mental health (coefficient = -0.126, 95% CI = [-0.284, -0.010]). Conclusion The use of dialects is associated with worse mental health outcomes in Chinese older adults, while this negative influence is positively mediated by income inequality and negatively moderated by subjective well-being, simultaneously. This study contributes to the knowledge enrichment of government workers, older adults with mental disorders, medical staff, and other stakeholders.
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Affiliation(s)
- Tianxin Li
- Department of Literature, Shaanxi Normal University, Xi'an, China
| | - Jin Li
- International School of Chinese Studies, Shaanxi Normal University, Xi'an, China
| | - Xigang Ke
- Department of Literature, Shaanxi Normal University, Xi'an, China
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14
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Bakavoly ME, Sajjadi M, Ghasemi R, Ajamzibad H. Comparison of the Impacts of Benson Relaxation Technique and Foot Reflexology Massage on Sleep Quality of Patients with Systolic Heart Failure: A Randomized Clinical Trial. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:448-454. [PMID: 37694200 PMCID: PMC10484392 DOI: 10.4103/ijnmr.ijnmr_332_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/11/2022] [Accepted: 12/28/2022] [Indexed: 09/12/2023]
Abstract
Background Cardiovascular diseases can affect sleep quality. The use of non-pharmacological methods to improve the sleep quality of heart failure patients is essential. Therefore, this study compared the effects of the Benson relaxation technique and foot reflexology massage on sleep quality of those patients. Materials and Methods In this clinical trial study, 93 patients with systolic heart failure referred to Javad Al-Aeme heart clinic in Torbat Heydarieh were selected with purposive sampling method and divided into the foot reflexology massage, Benson relaxation technique, and control groups using the balanced blocking randomization method. The Benson relaxation technique and the foot reflexology massage were performed for 20 and 30 minutes three days per week for four weeks, respectively. The control group only received routine care. Sleep quality was measured by the Pittsburgh sleep quality index and then compared among the groups before and after the intervention. The data were analyzed using ANOVA, Tukey's post hoc tests, paired t test, and Chi-square at the significant level of p < 0.05. Results After interventions, the mean (SD) quality of sleep significantly increased in both intervention groups (Reflexology: pre-intervention 10.80 (3.40), post-intervention 6.60 (3.10), Benson relaxation: pre-intervention 15.50 (2.40) post-intervention 12 (2.60), compared to the control group (pre-intervention 10.50 (1.90) post-intervention 9.40(1.70) (p < 0.001). There was no significant difference between the two intervention groups (p = 0.53). Conclusions The interventions improved the quality of sleep in patients with systolic heart failure. Therefore, these methods can be used as a suitable complementary treatment to improve the quality of sleep by nurses and midwives.
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Affiliation(s)
- Masoumeh Emami Bakavoly
- Nursing Student, Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Moosa Sajjadi
- Department of Medical Surgical Nursing, Faculty of Nursing School, Nursing Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Reza Ghasemi
- Department of Cardiology, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Hosein Ajamzibad
- Department of Nursing and Aging, Faculty of Nursing School, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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15
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Boyle JT, Rosenfield B, Di Tomasso RA, Moye J, Bamonti PM, Grandner M, Vargas I, Perlis M. Sleep Continuity, Sleep Related Daytime Dysfunction, and Problem Endorsement: Do These Vary Concordantly by Age? Behav Sleep Med 2023; 21:436-447. [PMID: 36170023 PMCID: PMC10043048 DOI: 10.1080/15402002.2022.2124994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Sleep continuity (i.e., ability to initiate and/or maintain sleep) worsens with age. It is unclear whether problem endorsement and/or daytime dysfunction show similar age-related trends. Accordingly, a large archival dataset was used to examine age differences in sleep continuity, problem endorsement, and sleep related daytime dysfunction. METHOD Participants were categorized as: Young Adults (18-29 years); Adults (30-44 years); Middle Aged Adults (45-64 years); and Older Adults (65-89 years). Young Adults, Adults, and Middle Aged Adults were 1:1 matched with Older Adults (n = 233) on the basis of gender, race, ethnicity, and BMI. MANOVA, ANOVAs, and chi-square analysis were performed to assess for age-related differences. RESULTS In a sample of 932 adults with self-reported sleep continuity disturbance (i.e., insomnia), sleep continuity was significantly worse in older age groups. This effect was limited to middle and late insomnia with middle aged and older adults waking up with greater frequency and for longer durations of time during the night and in the early morning than younger cohorts. Problem endorsement largely increased across age groups (except for sleep latency) but reports of overall sleep-related daytime dysfunction showed no difference by age. CONCLUSION When evaluating sleep continuity disturbance, assessing whether the patient identifies their sleep continuity disturbance as a problem and whether it affects their daytime function can be informative, particularly in older adults. It may serve to reveal (case-by-case) when there are discordances between incidence/severity of illness and problem endorsement/daytime dysfunction. Such information may better inform if treatment should be initiated.
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Affiliation(s)
- Julia T. Boyle
- Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine (PCOM), Philadelphia, Pennsylvania, USA
- Department of Psychology, VA Boston Healthcare System, Boston, Massachusetts, USA
- New England Geriatric Research Education and Clinical Center (GRECC), Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Bradley Rosenfield
- Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine (PCOM), Philadelphia, Pennsylvania, USA
| | - Robert A. Di Tomasso
- Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine (PCOM), Philadelphia, Pennsylvania, USA
| | - Jennifer Moye
- Department of Psychology, VA Boston Healthcare System, Boston, Massachusetts, USA
- New England Geriatric Research Education and Clinical Center (GRECC), Boston, Massachusetts, USA
- School of Medicine, Boston University, Boston, Massachusetts, USA
- Department of Psychology, Harvard Medical School, Boston, Massachusetts, USA
| | - Patricia M. Bamonti
- Department of Psychology, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, Arizona, USA
| | - Ivan Vargas
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - Michael Perlis
- Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Chronobiology and Sleep Institute, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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16
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Nutakor JA, Zhou L, Larnyo E, Gavu AK, Chohan IM, Addai-Dansoh S, Tripura D. The Relationship Between Social Capital and Sleep Duration Among Older Adults in Ghana: A Cross-Sectional Study. Int J Public Health 2023; 68:1605876. [PMID: 37457843 PMCID: PMC10338686 DOI: 10.3389/ijph.2023.1605876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Objective: This study aims to investigate the connection between social capital and sleep duration among older adults in Ghana, as limited research has been conducted to explore this relationship. Methods: This study utilized Wave 2 data from a sample of Ghanaian older adults from the World Health Organization Study on Global AGEing and Adult Health (SAGE). Self-reported data on social capital and sleep duration were compiled. Using ordered logistic regression, the relationship between social capital and sleep duration was examined. Results: Older adults who did not participate in social activities showed the strongest association with the risk of short sleep (p < 0.05). Our study found that older adults who sleep for shorter periods tend to report better sleep quality. There was no correlation between medium and long sleep durations and social capital. Conclusion: This study underscores the importance of more research to truly understand the complex connections between older adults' social participation, sleep, and health. It also has important implications for the promotion of good sleep in aging populations.
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Affiliation(s)
| | - Lulin Zhou
- School of Management, Jiangsu University, Zhenjiang, China
| | - Ebenezer Larnyo
- Center for Black Studies Research, University of California, Santa Barbara, CA, United States
| | - Alexander Kwame Gavu
- Department of Educational Administration, College of Education, University of Saskatchewan, Saskatoon, SK, Canada
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17
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Draelants L, Point C, Wacquier B, Lanquart JP, Loas G, Hein M. 10-Year Risk for Cardiovascular Disease Associated with COMISA (Co-Morbid Insomnia and Sleep Apnea) in Hypertensive Subjects. Life (Basel) 2023; 13:1379. [PMID: 37374161 PMCID: PMC10303626 DOI: 10.3390/life13061379] [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: 05/04/2023] [Revised: 06/05/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Due to the few studies available, this study aimed to investigate the 10-year risk for cardiovascular disease (CVD) associated with COMISA (co-morbid insomnia and sleep apnea) in hypertensive subjects. Clinical data of 1009 hypertensive subjects extracted from the Sleep Laboratory database were analyzed. Framingham Risk Score ≥ 10% was used as a cut-off to identify hypertensive subjects with high 10-year risk for CVD. The association between 10-year risk for CVD and COMISA was investigated using logistic regression analyses. 65.3% of hypertensive subjects from our sample presented a high 10-year risk for CVD. After controlling for major confounding factors, multivariate logistic regression analyses demonstrated that unlike its components present separately, COMISA was significantly associated with high 10-year risk for CVD in hypertensive subjects (OR 1.88, 95% CI 1.01-3.51). In this study, we have demonstrated that the negative synergy between obstructive sleep apnea syndrome and insomnia disorder seems to play a central role in the 10-year risk for CVD in hypertensive subjects, which seems to indicate that the establishment of a systematic research and an adapted treatment of COMISA could open new perspectives to promote a better cardiovascular outcome in this specific subgroup of patients.
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Affiliation(s)
| | | | | | | | | | - Matthieu Hein
- Hôpital Universitaire de Bruxelles, Service de Psychiatrie et Laboratoire du Sommeil, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium; (L.D.); (C.P.); (B.W.); (J.-P.L.); (G.L.)
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18
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Yao Q, Jiang K, Lin F, Zhu T, Khan NH, Jiang E. Pathophysiological Association of Alzheimer's Disease and Hypertension: A Clinical Concern for Elderly Population. Clin Interv Aging 2023; 18:713-728. [PMID: 37181536 PMCID: PMC10167960 DOI: 10.2147/cia.s400527] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/22/2023] [Indexed: 05/16/2023] Open
Abstract
Alzheimer's disease (AD), the most common cause of dementia and the fifth leading cause of death in the adult population has a complex pathophysiological link with hypertension (HTN). A growing volume of published literature on a parallel elevation of blood pressure (BP), amyloid plaques, and neurofibrillary tangles formation in post-middle of human brain cells has developed new, widely accepting foundations on this association. In particular, HTN in elderly life mediates cerebral blood flow dysfunction, neuronal dysfunction, and significant decline in cognitive impairment, primarily in the late-life populace, governing the onset of AD. Thus, HTN is an established risk factor for AD. Considering the impact of AD, 1.89 million deaths annually, and the failure of palliative therapies to cure AD, the scientific research community is looking to adopt integrated approaches to target early modified risk factors like HTN to reduce AD burden. The current review highlights the significance and impact of HTN-based prevention in lowering the AD burden in the elderly by providing a comprehensive overview of the physiological relationship between AD and HTN with an in-detail explanation of the role and applications of pathological biomarkers in this clinical association. The review will gain worth in presenting new insights and providing inclusive discussion on the correlation between HTN and cognitive impairment. It will increase across a wider scientific audience to expand understanding of this pathophysiological association.
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Affiliation(s)
- Qianqian Yao
- Institute of Nursing and Health, Henan University, Kaifeng, People’s Republic of China
| | - Kexin Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, People’s Republic of China
| | - Fei Lin
- School of Medicine, Shangqiu Institute of Technology, Shangqiu, People’s Republic of China
| | - Tao Zhu
- Department of Geriatrics, Kaifeng Traditional Chinese Medicine Hospital, Kaifeng, People’s Republic of China
| | - Nazeer Hussain Khan
- Institute of Nursing and Health, Henan University, Kaifeng, People’s Republic of China
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, People’s Republic of China
| | - Enshe Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, People’s Republic of China
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, People’s Republic of China
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19
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Gyasi RM, Abass K, Segbefia AY, Afriyie K, Asamoah E, Boampong MS, Adam AM, Owusu-Dabo E. A two-mediator serial mediation chain of the association between social isolation and impaired sleep in old age. Sci Rep 2022; 12:22458. [PMID: 36577767 PMCID: PMC9797554 DOI: 10.1038/s41598-022-26840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
Poor sleep is a long-term public health issue that has become increasingly prevalent among socially isolated older adults. However, research on the mechanisms explaining the link between social isolation and impaired sleep (IS) remains limited, particularly in low- and middle-income countries. This study explored the serial mediating effects of loneliness and mental distress on the association of social isolation with IS among Ghanaian older adults. We analyzed data from 1201 adults aged ≥ 50 from Ghana's AgeHeaPsyWel-HeaSeeB study (mean age = 66.14, SD = 11.85, age range = 50-111; women = 63.28%). Measures included the UCLA 3-item Loneliness Scale, modified Berkman-Syme Social Network Index, Sleep Quality Scale, and Mental Distress Questionnaire. We used bootstrapping techniques from Hayes' PROCESS macro program to estimate the hypothesized serial mediation. Social isolation was significantly associated with IS (β = 0.242, p < 0.001). Crucially, social isolation indirectly predicted IS via three significant mediating pathways. Loneliness accounted for 17.6% (β = 0.054, CI = 0.096, 0.016), mental distress accounted for 6.5% (β = 0.020, 95% CI = 0.004, 0.040), and loneliness and mental distress accounted for 32.2% (β = 0.099, 95% CI = 0.065, 0.138) of the overall effect. The total mediating effect was 56.4%. These findings suggest that the social isolation-sleep link is respectively and serially explained by loneliness and mental distress. Social integrative interventions for sleep quality in old age should target mental and emotional well-being.
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Affiliation(s)
- Razak M Gyasi
- Aging and Development Program, African Population and Health Research Center (APHRC), Manga Close, Off-Kirawa Road, P. O. Box 10787-00100, Nairobi, Kenya.
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
| | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alexander Yao Segbefia
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwadwo Afriyie
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward Asamoah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mary Sefa Boampong
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anokye M Adam
- Department of Finance, School of Business, University of Cape Coast, Cape Coast, Ghana
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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20
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Tang D, Zhou Y, Long C, Tang S. The Association of Midday Napping With Hypertension Among Chinese Adults Older Than 45 Years: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e38782. [PMID: 36279195 PMCID: PMC9727692 DOI: 10.2196/38782] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Hypertension is one of the main public health issues around worldwide, and midday napping is a popular habit. The association between the two remains to be explored. OBJECTIVE The goal of the research was to explore the association of midday napping with hypertension. METHODS This study separately selected 11,439, 12,689, and 9464 Chinese respondents aged over 45 years from the China Health and Retirement Longitudinal Study 2011, 2015, and 2018 data sets. Binary logistic regression was used to explore the association of midday napping with hypertension, and the 3-step method was used to test the mediation effect of BMI. RESULTS Among all respondents, the prevalence rates of hypertension were 24.6% (2818/11439) in 2011, 21.1% (2683/12689) in 2015, and 22.1% (2092/9464) in 2018. Midday napping was positively correlated with hypertension. In 2011 and 2015, napping 60 to 90 minutes had the greatest odds ratios [OR] (OR2011 1.705, OR2015 1.494). In 2018, the biggest OR came from the group napping 30 to 60 minutes (OR 1.223), and ORs of different napping durations decreased from 2011 to 2018. In addition, BMI had a partial mediation effect in 2015 and 2018. CONCLUSIONS Midday napping is a potential risk factor for hypertension with BMI acting as a mediator. To prevent hypertension, avoiding prolonged duration of midday napping and taking action to maintain a normal BMI level are recommended.
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Affiliation(s)
- Dongfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute for Hospital Management, Tsinghua University, Shenzhen, China
| | - Yiheng Zhou
- College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Chengxu Long
- Department of Global Health and Social Medicine, King's College London, London, United Kingdom
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, China
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21
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Tsaras K, Tsiantoula M, Papagiannis D, Papathanasiou IV, Chatzi M, Kelesi M, Kaba E, Fradelos EC. The Effect of Depressive and Insomnia Symptoms in Quality of Life among Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13704. [PMID: 36294280 PMCID: PMC9603389 DOI: 10.3390/ijerph192013704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to investigate the effects of depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms on the quality of life among community-dwelling older adults in an urban area of central Greece. A cross-sectional study was conducted on 200 older adults (aged ≥ 60) collected from five Open Care Centers for Elderly People of the Municipality of Larissa, Greece. Data were obtained through a questionnaire that included demographic, socioeconomic, and health-related characteristics; the World Health Organization Quality of Life (WHOQoL)-Bref questionnaire; the Geriatric Depression Scale; and the Athens Insomnia Scale. The prevalences of depression, insomnia, and comorbid depression and insomnia were 28% (95% confidence interval (95% CI): 21.8-34.2%), 40.5% (95% CI: 33.7-47.3%), and 19% (95% CI: 13.5-24.5%), respectively. The mean WHOQoL-Bref score for all domains was approximately 14.50, with the highest mean value observed for psychological health (14.79 ± 2.60), followed by the physical health (14.49 ± 2.66), social relationships (14.39 ± 2.03), and environmental domains (14.32 ± 1.90). All WHOQoL-Bref domains were negatively correlated with depression and insomnia. Older adults with depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms had lower scores in all quality of life dimensions compared with those without.
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Affiliation(s)
- Konstantinos Tsaras
- Public Health & Vaccines Laboratory, Faculty of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Maria Tsiantoula
- Department of Welfare, Municipality of Larissa, 41222 Larissa, Greece
| | - Dimitrios Papagiannis
- Public Health & Vaccines Laboratory, Faculty of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Ioanna V. Papathanasiou
- Community Nursing Laboratory, Faculty of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Maria Chatzi
- Department of Infections, University Hospital of Larissa, 41110 Larissa, Greece
| | - Martha Kelesi
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Evridiki Kaba
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Evangelos C. Fradelos
- Community Nursing Laboratory, Faculty of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
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Pequeno NPF, Cabral NLDA, Oliveira ÂGRC, Crispim SP, Rocha C, Marchioni DM, Lima SCVC, Lyra CDO. Chronic diseases and emotional disorders are associated with low perception of quality of life in food insecurity/security. Front Public Health 2022; 10:893601. [PMID: 35923966 PMCID: PMC9340216 DOI: 10.3389/fpubh.2022.893601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Understanding individual perception of Quality of Life (QoL) can help combat social and health inequalities. We aimed to identify factors associated with Low Perceived Quality of Life (LPQoL) in 295 adults and older adults with food security and food insecurity, in the city of Natal, Brazil. A cross-sectional study was conducted from June to December 2019, with collection of data on socioeconomic demographic status, lifestyle information, non-communicable diseases (NCDs) and risk factors, emotional disorders, food (in) security and quality of life. To assess food insecurity, the Brazilian Scale of Food Insecurity—EBIA was used, and the WHOQOL-Bref questionnaire was used to assess quality of life. Poisson's Regression was used to verify associations between variables and LPQoL, stratifying the sample into food secure (FS) and food insecure (FI) groups. In the FI group, being overweight, older adult, having no partner, drinking alcoholic beverages twice a week or more, and not having daily availability of water were associated with LPQoL, and in the FS group, having diabetes, monthly family income in the 1st and 2nd tertiles, and never having studied was associated with LPQoL. Reporting emotional disorders and sleeping < 7 h/day were associated with LPQoL in both FI and FS groups. LPQoL was associated with the occurrence of NCDs and risk factors, and emotional disorders, regardless of the food security measure. However, the lack of adequate access to water highlights the social vulnerability of the FI group.
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Affiliation(s)
- Nila Patrícia Freire Pequeno
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
- *Correspondence: Nila Patrícia Freire Pequeno
| | - Natália Louise de Araújo Cabral
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Federal Institute of Education, Science and Technology of Sertão Pernambucano, Petrolina, Brazil
| | | | | | - Cecília Rocha
- School of Nutrition, Centre for Studies in Food Security, Ryerson University, Toronto, ON, Canada
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Clélia de Oliveira Lyra
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
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Sleep quality and associated factors among adult hypertensive patients attending a chronic follow up care clinic in northwest Amhara regional state referral hospitals, Northwest Ethiopia. PLoS One 2022; 17:e0271072. [PMID: 35797273 PMCID: PMC9262207 DOI: 10.1371/journal.pone.0271072] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/21/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction
Sleep plays an essential role in every individual’s life since it contributes greatly to their well-being and health. Poor sleep quality is one of the most common consequences of hypertension (HTN), which is a leading public health problem. In Ethiopia, it is the main health concern among hypertension patients. Thus, in the study area, there is limited information regarding the investigation of sleep quality among hypertension patients. Therefore, this study aimed to assess sleep quality and associated factors among adult hypertensive patients attending a chronic follow up care clinic in northwest Amhara regional state referral hospitals, Northwest Ethiopia.
Methods
An institution-based cross-sectional study was conducted among adult HTN patients from March 15/2021 to May 15/2021 in Northwest Amhara Regional State Referral Hospitals. A systematic random sampling method was used to select the study participants. A face-to-face interviewer-administered questionnaire with chart review was used. The Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality was used in this study. A binary logistic regression was used to see the association between dependent and independent variables. Variables having a p-value < 0.05 with a 95% CI were considered statistically significant in the multivariable logistic regression analysis.
Results
In this study, 563 hypertensive patients were included, with a response rate of 96.9%. The overall prevalence of poor sleep quality was 37.7% (95% CI: 33.4%–41.6%). Female gender (AOR = 2.55, 95% CI: 1.55–4.18), age ≥ 65 years (AOR = 4.07, 95% CI: 2.07–7.97), overweight (BMI) ≥ 25 kg/m2 (AOR = 1.68, 95% CI: 1.06–2.65), WHO stage II hypertension (AOR = 1.78, 95% CI:1.01–3.12), poor physical activity (AOR = 2.39, 95% CI:1.41–4.05), participants who had depression (AOR = 2.03,95% CI:1.24–3.34) and participants who had anxiety (AOR = 1.89, 95% CI: 1.16–3.03) were factors associated with poor sleep quality.
Conclusions
In this study, more than one-third of the study participants had poor sleep quality. Female gender, age ≥ 65 years, overweight (BMI) ≥ 25 kg/m2, stage II hypertension, physical inactivity, depression, and anxiety were all associated with poor sleep quality. Managing depression and anxiety disorders, encouraging physical activity, and providing health education about weight loss are all necessary for HTN patients.
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Self-reported sleep-disordered breathing and insomnia in association with hypertension: a community-based study in Eastern China. Blood Press Monit 2022; 27:320-326. [PMID: 35866504 DOI: 10.1097/mbp.0000000000000609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We aimed to explore the associations of self-reported sleep-disordered breathing (SDB) and insomnia with hypertension based on a community-based survey among adults in Suzhou, Eastern China. METHODS The Suzhou Food Consumption and Health Survey was conducted from 2018 to 2019. A multistage random sampling method was used to recruit potential participants. Associations of SDB and insomnia with hypertension were examined by multivariable logistic regression models with adjustment for covariates. In addition, sensitivity analysis was used to reinforce our findings. RESULTS A total of 2728 participants were included in the final analysis. SDB (OR, 1.83; 95% CI, 1.44-2.34; P < 0.001) and insomnia (OR, 1.31; 95% CI, 1.04-1.65; P < 0.001) were significantly associated with prevalent hypertension after multivariable adjustments. In the subgroup analysis by age groups and sex, the association between SDB and hypertension persisted in all groups, whereas the association between insomnia and hypertension remained significant in males and different age groups. In addition, SDB was positively correlated with DBP. Notably, participants with comorbid SDB and insomnia had the highest risk for hypertension (OR, 1.95; 95% CI, 1.40-2.72; P < 0.001). CONCLUSION Both SDB and insomnia were associated with the prevalence of hypertension among the Chinese adults, whereas the comorbid conditions conveyed the highest risk for hypertension. Our findings provide a new insight for the potential pathogenesis of hypertension and a prevention strategy of hypertension among community adults.
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Campbell R, Chabot I, Rousseau B, Bridge D, Nicol G, Meier G. Understanding the unmet needs in insomnia treatment: a systematic literature review of real-world evidence. Int J Neurosci 2021:1-15. [PMID: 34668828 DOI: 10.1080/00207454.2021.1995383] [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: 10/20/2022]
Abstract
STUDY OBJECTIVE The objective of this study was to define and characterize the unmet needs in the pharmacological management of insomnia. METHODS A systematic literature review was conducted to identify relevant literature reporting real-world evidence in insomnia, published from January 2009 to April 2020. Pharmacological treatments - both prescription (benzodiazepines, 'Z-drugs' and suvorexant) and off-label (antidepressants, antipsychotics, and antihistamines) - were considered. RESULTS Overall, 108 publications describing the humanistic (n = 59) and economic burden (n = 20) of insomnia, off-label treatment patterns (n = 28) and factors influencing treatment adherence or persistence (n = 8) were identified. A high prevalence of comorbid conditions was reported in patients with insomnia resulting in significantly lower health-related QoL compared to those with insomnia or a comorbidity alone. Current treatment options were associated with adverse events, including reduced sleep quality and next-day somnolence. An increased risk of accidents/injuries was also associated with insomnia and its treatment. Furthermore, safety concerns and perceived lack of efficacy for approved treatments have led to frequent off-label prescribing, despite a lack of clinical evidence of risk/benefit ratios. Safety concerns associated with benzodiazepines include risk of dependence, leading to prolonged treatment persistence and exacerbated adverse events, making them unsuitable for use in patients with chronic insomnia. Finally, the substantial economic burden of insomnia was evident, with reduced work productivity demonstrated in patients with insomnia compared to the general population. CONCLUSIONS This review highlights a clear unmet need for insomnia therapies that improve sleep quality without resulting in next-day impairment and/or dependence.
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Affiliation(s)
- Renee Campbell
- Formerly at Global Value and Access, Eisai, New York, USA
| | - Isabelle Chabot
- Faculty of Pharmacy, University of Montreal, Montreal, Canada
| | - Ben Rousseau
- Adelphi Values PROVE, Adelphi Mill, Bollington, UK
| | - Daisy Bridge
- Adelphi Values PROVE, Adelphi Mill, Bollington, UK
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Peng YT, Hsu YH, Chou MY, Chu CS, Su CS, Liang CK, Wang YC, Yang T, Chen LK, Lin YT. Factors associated with insomnia in older adult outpatients vary by gender: a cross-sectional study. BMC Geriatr 2021; 21:681. [PMID: 34876057 PMCID: PMC8650339 DOI: 10.1186/s12877-021-02643-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/18/2021] [Indexed: 01/17/2023] Open
Abstract
Background Insomnia is a common sleep disturbance in older adults and is associated with many poor health outcomes. This study aimed to explore factors associated with insomnia in older adult outpatient clinics, and to further analyze the influence of gender on factors associated with insomnia. Methods This cross-sectional study was conducted in the outpatient clinics of a tertiary hospital in Southern Taiwan from July to September 2018. A total of 400 consecutive subjects aged 60 years or older were recruited. Insomnia was defined as a score of ≥6 points on the Athens Insomnia Scale (AIS). Socio-demographics, health behaviors and clinical data were collected by face-to-face interview. Multivariable logistic regression was adopted for statistical analysis of the entire sample and stratified by gender. Results Participants’ mean age was 74.74 ± 8.54 years, and the majority (93%) had more than one chronic disease. The prevalence of insomnia accounted for 30% (120/400) of all subjects, with males 22.9% (46/201) and females 37.2% (74/199). Gender, appetite, exercise, depressive symptoms, and sleep-related conditions such as short sleep duration, sleeping pills usage, medium-high risk of obstructive sleep apnea (OSA) and restless leg syndrome (RLS) were factors associated with insomnia in older adults. Exercise, sleeping pills usage, and RLS were independently associated with insomnia only in men, while appetite and medium-high risk of OSA were associated with insomnia in women only. In addition, after further adjusting for covariates, prevalence of the insomnia-related symptoms such as sleep induction, total sleep duration, sleep quality and sleepiness during the day was significantly higher in females than in males. Conclusions Insomnia symptoms are highly prevalent among older adults, predominantly females. Significant differences are found between genders in factors associated with insomnia and insomnia-related symptoms. Understanding gender differences may help clinicians to modify associated factors when managing older adults with insomnia.
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Affiliation(s)
- Yu-Ting Peng
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan, Republic of China.,Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ying-Hsin Hsu
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan, Republic of China.,Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Meiho University, Pingtung, Taiwan
| | - Ming-Yueh Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan, Republic of China.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Geriatric Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
| | - Che-Sheng Chu
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan, Republic of China.,Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chen-San Su
- Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan, Republic of China. .,Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. .,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Department of Geriatric Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.
| | - Yu-Chun Wang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan, Republic of China
| | - Tsan Yang
- Department of Health Business Administration, Meiho University, Pingtung, Taiwan
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Geriatric Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.,Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan, Republic of China.,Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Pharmacy, Tajen University, Pingtung, Taiwan
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Jain N, Pathania M, Bahurupi Y. Assessment of Sleep Quality and Quality of Life in Hypertensive Subjects at a Tertiary Care Hospital in Uttarakhand, India. Int J Prev Med 2021; 12:158. [PMID: 35070191 PMCID: PMC8724674 DOI: 10.4103/ijpvm.ijpvm_465_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/21/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Hypertension is a leading risk factor for cardiovascular diseases with prevalence of 33% in urban and 25% in rural population in India. Studies have suggested that hypertension significantly affects the sleep quality and quality of life of subjects. Therefore, this study aimed to establish a correlation between sleep quality, quality of life, and hypertension in Uttarakhand. METHODS This observational cross-sectional study was carried out on hypertensive subjects at a tertiary care hospital in Uttarakhand following ethics approval. After taking consent from participants, blood pressure and anthropometric measurements were recorded. Then, their sleep quality and quality of life was assessed using Pittsburgh sleep quality index (PSQI) and WHO-QOL BREF questionnaire respectively. Statistical analysis was then carried out to correlate these parameters. RESULTS 168 participants were recruited for this study, with 43.5% males and 56.5% females. It was found that 77.4% of these subjects were having poor sleep quality with the mean global PSQI score as 7.90 ± 3.713. These subjects assessed their Quality of life to be worst in physical domain (12.68 ± 3.13), followed by psychological, social relationship domain and environment domain. A significant association was found between sleep quality and different stages of hypertension (P value = 0.039) but quality of life and stages of hypertension have no significant association (P value > 0.05). CONCLUSIONS Sleep quality, quality of life and blood pressure are correlated. So, clinicians should also focus on improving their patient's sleep quality and quality of life besides pharmacological treatment.
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Affiliation(s)
- Neha Jain
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Monika Pathania
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India,Address for correspondence: Dr. Monika Pathania, Department of Medicine, AIIMS Rishikesh, Uttarakhand, India. E-mail:
| | - Yogesh Bahurupi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Isaac F, Toukhsati SR, Di Benedetto M, Kennedy GA. A Systematic Review of the Impact of Wildfires on Sleep Disturbances. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910152. [PMID: 34639453 PMCID: PMC8508521 DOI: 10.3390/ijerph181910152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/21/2022]
Abstract
Wildfires present a serious risk to humans as well as to the environment. Wildfires cause loss of lives, economic losses, expose people to personal as well as collective trauma, and compromise the mental health of survivors. Sleep disturbances are highly prevalent following a traumatic event; however, their prevalence is not well established amongst those confronted by natural disasters such as wildfires. The aim of this systematic review is to synthesise the empirical findings pertaining to wildfires and the prevalence of sleep disturbances in the general community affected by this natural disaster. We searched EBSCO, PsychINFO, Medline, SpringerLink, CINAHL Complete, EMBASE, PubMed, Scopus and Cochrane Library between January 2012 and March 2021. Five studies met the inclusion criteria. Findings from this systematic review suggest that sleep disturbances, assessed one to ten months following the fires, are highly prevalent in wildfire survivors, with insomnia (ranging between 63–72.5%) and nightmares (ranging between 33.3–46.5%), being the most prevalent sleep disturbances reported in this cohort. Results also highlight the significant associations between sleep disturbances and post-traumatic symptoms following the trauma of wildfires. There is a possible link between sleep disturbance prevalence, severity of, and proximity to fires.
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Affiliation(s)
- Fadia Isaac
- School of Science, Psychology and Sport, Federation University, Ballarat, VIC 3350, Australia; (S.R.T.); (G.A.K.)
- Correspondence: ; Tel.: +61-3-5327-6651
| | - Samia R. Toukhsati
- School of Science, Psychology and Sport, Federation University, Ballarat, VIC 3350, Australia; (S.R.T.); (G.A.K.)
| | | | - Gerard A. Kennedy
- School of Science, Psychology and Sport, Federation University, Ballarat, VIC 3350, Australia; (S.R.T.); (G.A.K.)
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3083, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, VIC 3084, Australia
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Melo VHD, Sousa RALD, Improta-Caria AC, Nunes MAP. Physical activity and quality of life in adults and elderly individuals with lower limb amputation. Rev Assoc Med Bras (1992) 2021; 67:985-990. [PMID: 34817511 DOI: 10.1590/1806-9282.20210382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/30/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the levels of physical activity (PA) and quality of life (QOL) in adults and elderly individuals with lower limb amputation (LLA). METHODS This was a cross-sectional observational study. Participants completed three surveys as follows: a demographic survey, the International Physical Activity Questionnaire, and the World Health Organization Quality of Life. Thirty-six individuals with lower limb amputation were separated into two different groups as follows: Adults-lower limb amputation (n=12), composed of individuals with lower limb amputation who aged from 18-59 years, and Elderly-lower limb amputation (n=24), composed of individuals with lower limb amputation who aged 60 years and above. Statistical differences were determined as p<0.05. RESULTS Age and number of individuals with a low level of functional independency were higher in the Elderly-lower limb amputation group (p<0.05). The International Physical Activity Questionnaire scores were reduced in the Elderly-lower limb amputation group (p<0.05). The Pearson's correlation test between low metabolic equivalent task (MET), time since amputation, and family income presented positive significant results in the Elderly-lower limb amputation (p<0.05). Adults-lower limb amputation just presents a positive significant correlation with the low family income (p<0.05). CONCLUSION Elderly individuals with lower limb amputation are more susceptible to present negative health outcomes than adults with lower limb amputation.
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Affiliation(s)
| | | | - Alex Cleber Improta-Caria
- Universidade Federal da Bahia, School of Medicine, Programa de Pós-Graduação em Medicina e Saúde - Salvador (BA), Brazil
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Effect of exercise on sleep and cardiopulmonary parameters in patients with pulmonary artery hypertension. Sleep Breath 2021; 25:1953-1960. [PMID: 33604801 DOI: 10.1007/s11325-020-02286-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/18/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) is considered to be a rare progressive disease resulting from restricted flow through the pulmonary arterial circulation resulting ultimately in right-sided heart failure. Most patients with PAH suffer from sleep disorders, reduced aerobic fitness, and mortality risk despite optimized medical treatment. This study investigated the effect of 12 weeks of aerobic training on sleep quality, sleep efficiency, right ventricular systolic pressure (RVSP), and aerobic fitness in patients with PAH. METHODS Thirty patients with PAH were randomized to two equal groups, training group (A) and control group (B). The Pittsburg sleep quality index (PSQI) questionnaire and a wrist-worn actigraph were used for the assessment of sleep quality and sleep efficiency respectively. RVSP was measured using echocardiography. Cardiopulmonary exercise testing (CPET) assessed maximal heart rate and VO2max. All were measured before and after the study period for both groups. Exercise training was conducted on a bicycle ergometer as an individually-tailored moderate-intensity aerobic training session (60 to 70% of the maximal heart rate reached during the initial exercise test) for 30 to 45 min/day, 3 sessions/week for 12 weeks (36 sessions). RESULTS Sleep scores and RVSP showed significant reductions and VO2max-representing the aerobic fitness-showed a significant increase in the group (A) compared with group (B). CONCLUSION These results suggest that aerobic training has a positive effect on three risk factors for mortality in patients with PAH, namely sleep quality, decline in exercise capacity, and right ventricular remodeling. CLINICAL TRIALS REGISTRATION Clinical trial registered in ClinicalTrials.gov , ID: NCT04337671.
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Dichter MN, Berg A, Hylla J, Eggers D, Wilfling D, Möhler R, Haastert B, Meyer G, Halek M, Köpke S. Evaluation of a multi-component, non-pharmacological intervention to prevent and reduce sleep disturbances in people with dementia living in nursing homes (MoNoPol-sleep): study protocol for a cluster-randomized exploratory trial. BMC Geriatr 2021; 21:40. [PMID: 33430785 PMCID: PMC7802225 DOI: 10.1186/s12877-020-01997-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sleep problems are highly prevalent in people with dementia. Nevertheless, there is no "gold standard" intervention to prevent or reduce sleep problems in people with dementia. Existing interventions are characterized by a pronounced heterogeneity as well as insufficient knowledge about the possibilities and challenges of implementation. The aim of this study is to pilot and evaluate the effectiveness of a newly developed complex intervention to prevent and reduce sleep problems in people with dementia living in nursing homes. METHODS This study is a parallel group cluster-randomized controlled trial. The intervention consists of six components: (1) the assessment of established sleep-promoting interventions and an appropriate environment in the participating nursing homes, (2) the implementation of two "sleep nurses" as change agents per nursing home, (3) a basic education course for nursing staff: "Sleep problems in dementia", (4) an advanced education course for nursing staff: "Tailored problem-solving" (two workshops), (5) workshops: "Development of an institutional sleep-promoting concept" (two workshops with nursing management and sleep nurses) and (6) written information and education material (e.g. brochure and "One Minute Wonder" poster). The intervention will be performed over a period of 16 weeks and compared with usual care in the control group. Overall, 24 nursing homes in North, East and West Germany will be included and randomized in a 1:1 ratio. The primary outcome is the prevalence of sleep problems in people with dementia living in nursing homes. Secondary outcomes are quality of life, quality of sleep, daytime sleepiness and agitated behavior of people with dementia, as well as safety parameters like psychotropic medication, falls and physical restraints. The outcomes will be assessed using a mix of instruments based on self- and proxy-rating. A cost analysis and a process evaluation will be performed in conjunction with the study. CONCLUSIONS It is expected that the intervention will reduce the prevalence of sleep problems in people with dementia, thus not only improving the quality of life for people with dementia, but also relieving the burden on nursing staff caused by sleep problems. TRIAL REGISTRATION Current controlled trials: ISRCTN36015309 . Date of registration: 06/11/2020.
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Affiliation(s)
- Martin N Dichter
- Institute of Nursing Science, University Hospital of Cologne, Gleuler Straße 176-178, D-50935, Cologne, Germany.
- Neurodegenerative Diseases (DZNE), Witten, Stockumer Straße 12, 58453, Witten, Germany.
- School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany.
| | - Almuth Berg
- Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, 06112, Halle (Saale), Germany
| | - Jonas Hylla
- Neurodegenerative Diseases (DZNE), Witten, Stockumer Straße 12, 58453, Witten, Germany
- School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany
| | - Daniela Eggers
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Denise Wilfling
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Ralph Möhler
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
- School of Public health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
| | | | - Gabriele Meyer
- Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, 06112, Halle (Saale), Germany
| | - Margareta Halek
- Neurodegenerative Diseases (DZNE), Witten, Stockumer Straße 12, 58453, Witten, Germany
- School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany
| | - Sascha Köpke
- Institute of Nursing Science, University Hospital of Cologne, Gleuler Straße 176-178, D-50935, Cologne, Germany
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
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Jankowska-Polańska B, Polański J, Dudek K, Sławuta A, Mazur G, Gajek J. The Role of Sleep Disturbance, Depression and Anxiety in Frail Patients with AF-Gender Differences. J Clin Med 2020; 10:E11. [PMID: 33374533 PMCID: PMC7793100 DOI: 10.3390/jcm10010011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 01/20/2023] Open
Abstract
The aim of the study was to assess the link between anxiety and depression and frailty syndrome (FS) in patients with atrial fibrillation (AF) with regard to gender differences. MATERIAL AND METHODS The study was conducted on 158 patients with AF (mean age 70.4 ± 7.6). The study used the hospital anxiety and depression scale (HADS-M), the Athens insomnia scale (AIS) and the Edmonton frailty scale to assess and compare anxiety, depression, and sleep disturbance between frail and non-frail patients with AF. RESULTS FS was diagnosed in 53.2% of patients. A comparative analysis showed a statistically significantly higher severity level of anxiety (12.0 ± 2.6 vs. 8.4 ± 2.5, p < 0.001) and depression (12.5 ± 2.5 vs. 7.2 ± 3.3, p < 0.001) in frail patients compared to non-frail patients. The analysis of the level of anxiety, depression and FS did not show any significant differences between the studied women and men. However, statistically, significant differences were observed when FS occurred, regardless of gender. Anxiety disorders were observed in 75.5% of patients with FS and in 16.7% without frailty, whereas depressive disorders were observed in 73.6% of frail patients and in 4.2% without frailty. In an analysis of the impact of cumulative variables on the level of frailty, the risk of FS in patients with anxiety/depression and sleep disturbance is almost 500 times higher compared to patients without anxiety/depression and sleep disturbance. The risk of frailty in patients with sleep disturbance only is thirteen times higher than in the reference group, i.e., in patients without depression/anxiety and sleep disturbances. CONCLUSIONS Patients with AF and FS show deeper anxiety, depression and sleep disturbances. Gender does not influence the risk of frailty in AF patients. Frailty in patients with AF is associated with a higher risk of depression, sleep disturbances and anxiety.
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Affiliation(s)
| | - Jacek Polański
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wrocław Medical University, 50-367 Wroclaw, Poland; (J.P.); (A.S.); (G.M.)
| | - Krzysztof Dudek
- Faculty of Mechanical Engineering, Technical University of Wroclaw, 50-370 Wrocław, Poland;
| | - Agnieszka Sławuta
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wrocław Medical University, 50-367 Wroclaw, Poland; (J.P.); (A.S.); (G.M.)
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wrocław Medical University, 50-367 Wroclaw, Poland; (J.P.); (A.S.); (G.M.)
| | - Jacek Gajek
- Department of Emergency Medical Service, Wroclaw Medical University, 50-367 Wrocław, Poland;
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Zhang Y, Han P, Yin N, Huang Y, Li C, Lian H, Yang D. The Effects of Long-Term Tai-Chi Practice on Blood Pressure Under Normal Conditions. Am J Med Sci 2020; 361:598-606. [PMID: 33775428 DOI: 10.1016/j.amjms.2020.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/23/2020] [Accepted: 11/07/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Tai-Chi is a popular form of mind-body activity that is suitable for people of all ages. Accumulating evidence have shown that Tai-Chi can help ameliorate cardiovascular diseases. However, the benefits of long-term practice of Tai-Chi on blood pressure control remains unclear. A total of 898 villagers of Chenjiagou were enrolled in this study based on certain inclusion and exclusion criteria. METHODS All basic information and clinical data were collected by physicians. The effects of Tai-Chi on the systolic blood pressure (SBP), diastolic blood pressure (DBP) and mental status of participants were analyzed. The average practice time of Tai-Chi in the Tai-Chi group was 28.53 years (median 29 years, range 2-69 years). RESULTS The results showed that SBP and DBP were significantly lower in the Tai-Chi group, compared with the control group and the stop group. Meanwhile, the long-term practice of Tai-Chi significantly improved the body mass index (BMI) (P=0.021). Stepwise regression results demonstrated that Tai-Chi practice, age and BMI could significantly affect blood pressure, with adjusted R2 of 0.218 and 0.159 for SBP and DBP, respectively. In addition, Tai-chi is associated with a lower rate of hypertension after age 40. However, compared with the control group, participants who practiced Tai-Chi for a short time, then stopped, showed no significant improvement in the above-mentioned measurements. CONCLUSIONS The long-term practice of Tai-Chi was associated with better blood pressure, at least partly through the improvement of BMI and mental state. However, the short-term practice of Tai-Chi may not provide significant benefits on blood pressure in the long term.
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Affiliation(s)
- Yueli Zhang
- Department of Clinical Pharmacy, Zhengzhou Central Hospital, Zhengzhou, China
| | - Pengli Han
- Translational Medicine Center, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Ningwei Yin
- Department of General Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Yongliang Huang
- Department of Cardiovascular Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Cien Li
- Department of Cardiovascular Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - HongKai Lian
- Department of Orthopedics, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Dongwei Yang
- Department of Cardiovascular Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
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Hu Z, Zhu X, Kaminga AC, Zhu T, Nie Y, Xu H. Association between poor sleep quality and depression symptoms among the elderly in nursing homes in Hunan province, China: a cross-sectional study. BMJ Open 2020; 10:e036401. [PMID: 32665347 PMCID: PMC7359068 DOI: 10.1136/bmjopen-2019-036401] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES To examine the association between the prevalence of poor sleep quality and depression symptoms among the elderly in the nursing homes of Hunan province in China. DESIGN, SETTING AND PARTICIPANTS This was a cross-sectional study investigating 817 elderly people from 24 nursing homes in China's Hunan province. MAIN OUTCOME MEASURES Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) such that poor sleep quality was defined as PSQI Score >5. In addition, depression symptoms were assessed using the Geriatric Depression Scale (GDS). Linear regression models and binary logistic regression models were used to analyse the relationship between the prevalence of poor sleep quality and depression symptoms. RESULTS The mean PSQI Score was 8.5±4.9, and the prevalence of poor sleep quality was 67.3%. Additionally, the mean GDS Score was 9.8±7.5, and the prevalence of depression symptoms was 36.0%. Elderly people with poor sleep quality had increased GDS Score (mean difference=2.54, 95% CI 1.66 to 3.42) and increased risk of depression symptoms (OR=3.19, 95% CI 2.04 to 4.98) after controlling for demographics, chronic disease history, lifestyle behaviours, social support, activities of daily living and negative life events. CONCLUSIONS The prevalence of poor sleep quality was relatively high, and this was associated with increased depression symptoms. Therefore, poor sleep quality could be speculated as a marker of current depression symptoms in the elderly.
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Affiliation(s)
- Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health,Central South University, Changsha, Hunan, China
| | - Xidi Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health,Central South University, Changsha, Hunan, China
| | - Atipatsa Chiwanda Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
| | - Tingting Zhu
- Department of Scientific Research Management, Shanghai Health Development Research Center, Shanghai, China
| | - Yu Nie
- Educational Administration Office, The Second Xiangya Hospital, Changsha, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health,Central South University, Changsha, Hunan, China
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Hashimoto Y, Sakai R, Ikeda K, Fukui M. Association between sleep disorder and quality of life in patients with type 2 diabetes: a cross-sectional study. BMC Endocr Disord 2020; 20:98. [PMID: 32605640 PMCID: PMC7325681 DOI: 10.1186/s12902-020-00579-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/16/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND We investigated the association between sleep symptoms, which cause sleep disorder, and quality of life (QoL) among people with type 2 diabetes (T2D). METHODS In this cross-sectional study of 342 people with T2D, the Japan National Health and Wellness Survey (NHWS) database 2016 were used. We treated the respondents who reported experiencing any of the sleep symptoms as having sleep disorders. To examine health-related QoL (HRQoL), we used the physical component summary (PCS) and the mental component summary (MCS) from the 36-Item short-form and the EuroQol 5 Dimension (EQ-5D) survey instruments. Overall activity impairment was used for assessment of the effect on the individual's ability to perform regular daily activities. We used t-test and one-way ANOVA test for comparison QoL scores between the participants with and without sleep disorders. RESULTS 66.4% of the participants with T2D reported having a sleep disorder. The PCS, MCS, EQ-5D, and overall activity impairment of people with sleep disorder was significantly poorer than those of the people without. Specific sleep symptoms, such as waking up to go to the bathroom, daytime sleepiness, and waking up too early (before the alarm clock), had high prevalence (35.4, 27.8 and 20.2%). The participants who experienced waking up to go to the bathroom or daytime sleepiness demonstrated significantly poorer QoL on all scores related to QoL, but those who experienced waking up too early only demonstrated significantly poorer QoL on the EQ-5D. CONCLUSIONS Two-thirds of people with T2D in this study suffer from sleep disorders. The people who experience waking up to go to the bathroom or daytime sleepiness had significantly poorer QoL than those without these symptoms. Thus, sleep disorders, especially the symptoms of waking up to go to the bathroom or daytime sleepiness, might be the treatment targets for QOL of people with T2DM.
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Affiliation(s)
- Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Ryosuke Sakai
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kenichiro Ikeda
- Product Branding, Product Marketing Department, Kowa Company, Ltd., Tokyo, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
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Zhu X, Hu Z, Nie Y, Zhu T, Chiwanda Kaminga A, Yu Y, Xu H. The prevalence of poor sleep quality and associated risk factors among Chinese elderly adults in nursing homes: A cross-sectional study. PLoS One 2020; 15:e0232834. [PMID: 32413064 PMCID: PMC7228093 DOI: 10.1371/journal.pone.0232834] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 04/22/2020] [Indexed: 11/25/2022] Open
Abstract
Background Sleep problems have become the most common complaints among the elderly. There are a few studies that explored the prevalence of poor sleep quality and its associated factors among the elderly in nursing homes. Therefore, this study aimed to examine the prevalence of poor sleep quality and its associated factors among the Chinese elderly in nursing homes. Methods A total of 817 elderly residents, from 24 nursing homes, were included in this cross-sectional study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and poor sleep quality was defined as PSQI >5. Multiple binary logistic regression was used to estimate the strength of the association between risk factors and poor sleep quality in terms of adjusted odds ratios (AORs) and their 95% confidence intervals (CIs), and interactions of risk factors for poor sleep quality were also examined. Results The prevalence of poor sleep quality was 67.3% (95% CI: 64.0, 70.5%) among the Chinese elderly in nursing homes. Multiple binary logistic regression results showed that participants with the following characteristics had an increased risk of poor sleep quality after adjustments for other confounders: being 70–79 years old (AOR: 1.78, 95% CI: 1.08, 2.92) or 80 years old and above (AOR: 2.67, 95% CI: 1.68, 4.24); having one to two kinds of chronic diseases (AOR: 2.05, 95% CI: 1.39, 3.01) or three or more kinds of chronic diseases (AOR: 2.35, 95% CI: 1.39, 4.00); depression symptoms (AOR: 1.08, 95% CI: 1.04, 1.11), anxiety symptoms (AOR: 1.11, 95% CI: 1.05, 1.18), and social support(AOR: 0.97, 95% CI: 0.95, 0.99). Additive interactions were detected between age and anxiety symptoms (AOR: 8.34, 95% CI: 4.43, 15.69); between chronic disease and anxiety symptoms (AOR: 8.61, 95% CI; 4.28, 17.31); and between social support and anxiety symptoms (AOR: 6.43, 95% CI: 3.22, 12.86). Conclusions The prevalence of poor sleep quality among the elderly in nursing homes is relatively high. Besides, anxiety symptoms has additive interactions with age, chronic disease and social support for poor sleep quality. These findings have significant implications for interventions that aim to improve sleep quality among elderly residents in nursing homes.
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Affiliation(s)
- Xidi Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yu Nie
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Tingting Zhu
- Department of Scientific Research Management, Shanghai Health Development Research Center, Shanghai, China
| | - Atipatsa Chiwanda Kaminga
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yunhan Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- * E-mail:
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Kretchy IA, Boima V, Agyabeng K, Koduah A, Appiah B. Psycho-behavioural factors associated with medication adherence among male out-patients with hypertension in a Ghanaian hospital. PLoS One 2020; 15:e0227874. [PMID: 31995606 PMCID: PMC6988959 DOI: 10.1371/journal.pone.0227874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/01/2020] [Indexed: 11/18/2022] Open
Abstract
Medication adherence is a key health outcome that reflects the health and general well-being of patients with hypertension. Challenges with adherence are common and associated with clinical, behavioural and psychosocial factors. This study sought to provide data on the extent of medication adherence among male patients with hypertension and their biopsychosocial predictors. Patient and clinical characteristics, psychological distress, insomnia and sexual dysfunction were hypothesized to predict outcomes of medication adherence. Utilizing quantitative data from a hospital-based cross-sectional study from 358 male out-patients with hypertension attending a tertiary hospital in Ghana, medication adherence was associated with age, marital status, educational level, income, duration of diagnosis, number of medications taken and sexual dysfunction. These findings support the need for biopsychosocial interventions aiming at promoting adherence while taking these factors into consideration for the benefit of improving the health and general well-being of male patients with hypertension.
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Affiliation(s)
- Irene A. Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Vincent Boima
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Ghana
- * E-mail: ,
| | - Kofi Agyabeng
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Augustina Koduah
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Bernard Appiah
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M Health Science Center, TAMU, College Station, Texas, United States of America
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Cybulski M, Cybulski Ł, Cwalina U, Kowalczuk K, Krajewska-Kułak E. Mental Health of the Participants of the Third Age University Program: A Cross-Sectional Study. Front Psychiatry 2020; 11:656. [PMID: 32754065 PMCID: PMC7365889 DOI: 10.3389/fpsyt.2020.00656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/24/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Population aging is a progressive demographic phenomenon observed in all countries worldwide. The progressive global process of population aging poses many threats, especially in the context of the mental health of the elderly. Third Age Universities are an essential preventive measure shown to improve the quality of life and psychological wellbeing of the elderly. OBJECTIVES The aim of this study was to analyze the mental status of older persons attending Third Age Universities in Poland, with particular emphasis on sociodemographic sources of variance in psychological indices. METHODS The study included a group of the Third Age University program participants from Poland. A total of 247 persons were enrolled, among them 215 women and 32 men. The study was carried out as a diagnostic survey, using the following validated psychometric scales: The Mood Disorder Questionnaire (MDQ), Geriatric Depression Scale (GDS), General Health Questionnaire-28 (GHQ-28), The Athens Insomnia Scale (AIS), Courtauld Emotional Control Scale (CECS), State-Trait Anxiety Inventory (STAI) and SMAST-G-Short Michigan Alcoholism Screening Test-Geriatric Version. RESULTS The vast majority of the respondents did not screen positively for possible bipolar disorder. However, more than 90% of the participants presented with the symptoms of mild depression, and more than one-third had manifestations of non-psychotic mental morbidity. Nearly half of the respondents had complaints associated with insomnia, and in more than one-fourth, SMAST-G score raised suspicion of problem alcohol drinking. Retired participants were shown to present with significantly higher levels of anger control than the occupationally active respondents. Respondents with poor economic status had significantly higher levels of symptoms for non-psychotic mental disorders. Men significantly more often than women showed symptoms raising suspicion of alcohol-related problems. DISCUSSION In conclusion, the study group was characterized primarily by the mild depressive and anxiety symptoms. The mental health of the Polish participants of the Third Age University program was significantly modulated by their socio-occupational and marital status, and financial condition. The study showed that persons with likely problem alcohol drinking differed from other respondents in terms of the occurrence of possible bipolar disorder, depression, and non-psychotic symptoms of mental disorders, state and trait anxiety levels and anger control. There is a need for further research in the field of mental health status in the Third Age Universities seniors to determine the prevalence of these phenomena on a national scale.
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Affiliation(s)
- Mateusz Cybulski
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Łukasz Cybulski
- Faculty of Social Sciences, University of Warmia and Mazury, Olsztyn, Poland
| | - Urszula Cwalina
- Department of Statistics and Medical Informatics, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Krystyna Kowalczuk
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Elżbieta Krajewska-Kułak
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
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Preoperative sleep quality affects postoperative pain and function after total joint arthroplasty: a prospective cohort study. J Orthop Surg Res 2019; 14:378. [PMID: 31752947 PMCID: PMC6868862 DOI: 10.1186/s13018-019-1446-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/31/2019] [Indexed: 02/05/2023] Open
Abstract
Background The relationship between preoperative sleep quality and postoperative clinical outcomes after total joint arthroplasty (TJA) is unclear. We performed a prospective cohort study to determine whether preoperative sleep quality was correlated with postoperative outcomes after TJA. Methods In this prospective cohort study, 994 patients underwent TJA. Preoperative sleep measures included scores on the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and a ten-point sleep quality scale. The primary study outcome measured was the visual analog scale (VAS) pain score to 12 weeks postoperation. The consumption of analgesic rescue drugs (oxycodone and parecoxib) and postoperative length of stay (LOS) were recorded. We also measured functional parameters, including range of motion (ROM), Knee Society Score (KSS), and Harris hip score (HHS). Results The mean age for total knee and hip arthroplasties was 64.28 and 54.85 years, respectively. The PSQI scores were significantly correlated with nocturnal and active pain scores and ROM and functional scores from postoperative day 1 (POD1) to POD3. In addition, significant correlation was noted between the correlation between the active pain scores and ESS scores in the TKA group at postoperative 3 months. The consumption of analgesics after joint arthroplasty was significantly correlated with the PSQI scores. Moreover, significant correlations were noted between the sleep parameters and postoperative length of hospital stay (LOS). Conclusion Preoperative sleep parameters were correlated with clinical outcomes (i.e., pain, ROM, function, and LOS) after TJA. Clinicians should assess the sleep quality and improve it before TJA.
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Abstract
Purpose of Review To evaluate and summarize recent research articles pertaining to insomnia in older adults that can guide healthcare providers on factors to consider when assessing and managing insomnia. Recent Findings Up to 75% of older adults experience symptoms of insomnia. Insomnia is associated with socioeconomic status, racial and ethnic classification, family relationships, medical and mental health disorders, cognitive function, and dementia. Although one-fifth of older adults are still prescribed sleep medications, cognitive behavioral therapy for insomnia is the first line treatment for insomnia, resulting in short-term and long-term benefits. Summary To manage insomnia safely and effectively, healthcare providers need to consistently assess for insomnia during baseline and annual assessments, evaluate medical and social factors associated with insomnia, minimize the use of sleep medications, and provide referrals to and/or collaborate with providers who perform cognitive behavioral therapy for insomnia. Insomnia screening is important as it facilitates early intervention with behavioral management, reduces the potential for pharmacological management, which increases fall risk in older adults, and enables further assessment and early identification of outcomes such as cognitive impairment.
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Cybulski M, Cybulski L, Krajewska-Kulak E, Orzechowska M, Cwalina U, Kowalczuk K. Sleep disorders among educationally active elderly people in Bialystok, Poland: a cross-sectional study. BMC Geriatr 2019; 19:225. [PMID: 31426755 PMCID: PMC6701151 DOI: 10.1186/s12877-019-1248-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 08/13/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Sleep disorders in an ageing society constitute a significant public health problem. It is estimated that approximately 50% of people aged 55 years and older have trouble sleeping, including initiating and maintaining sleep. The aim of this study was to determine the prevalence of sleep disorders in a group of educationally active elderly people living in Bialystok, Poland. METHODS The study included a total of 182 people - residents of Bialystok - aged 60 or older; 146 women (80.22%) and 36 men (19.78%). The study used three standardized psychometric scales: The Athens Insomnia Scale (AIS), The Epworth Sleepiness Scale (ESS) and The Insomnia Severity Index (ISI). RESULTS More than half of the respondents scored 6 or more points on the AIS, which is considered a value that indicates a high probability of insomnia symptom occurrence. A similar percentage of respondents obtained a point value on the ISI indicating the presence of insomnia. The vast majority of respondents scored below 11 points on the ESS, which means no symptoms of excessive sleepiness. There was a significant correlation between the results of the above scales in the examined group in total and also by sex. CONCLUSIONS Sleep disorders, particularly insomnia, constitute a significant social and health problem in the group of educationally active elderly people living in Bialystok. In light of the obtained study results, it is recommended to conduct and improve existing health education programs aimed at the elderly regarding sleep disorders to improve the quality of their sleep, and thus quality of life, and raise the awareness of the elderly about the importance of sleep in everyday life. There is a need for further research in the field of sleep disorders in the elderly to determine the prevalence of these disorders on a national scale.
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Affiliation(s)
- Mateusz Cybulski
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 7a M. Sklodowskiej-Curie str., 15-096, Bialystok, Poland.
| | - Lukasz Cybulski
- National security student, Faculty of Social Sciences, University of Warmia and Mazury in Olsztyn, 14 Zolnierska str., 10-561, Olsztyn, Poland
| | - Elzbieta Krajewska-Kulak
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 7a M. Sklodowskiej-Curie str., 15-096, Bialystok, Poland
| | - Magda Orzechowska
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 7a M. Sklodowskiej-Curie str., 15-096, Bialystok, Poland
| | - Urszula Cwalina
- Department of Statistics and Medical Informatics, Faculty of Health Sciences, Medical University of Bialystok, 37 Szpitalna str., 15-295, Bialystok, Poland
| | - Krystyna Kowalczuk
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 7a M. Sklodowskiej-Curie str., 15-096, Bialystok, Poland
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