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Chu P, Ju YES, Hinze AM, Kim AH. Measures of Sleep in Rheumatologic Diseases: Sleep Quality Patient-Reported Outcomes in Rheumatologic Diseases. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:410-430. [PMID: 33091275 PMCID: PMC7586459 DOI: 10.1002/acr.24238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Philip Chu
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Yo-El S. Ju
- Sleep Medicine Center, Department of Neurology, Washington University School of Medicine, Saint Louis, MO
| | - Alicia M. Hinze
- Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Alfred H.J. Kim
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, Saint Louis, MO
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Bergia RE, Biskup I, Giacco R, Costabile G, Gray S, Wright A, Vitale M, Campbell WW, Landberg R, Riccardi G. The MEDGICarb-Study: Design of a multi-center randomized controlled trial to determine the differential health-promoting effects of low- and high-glycemic index Mediterranean-style eating patterns. Contemp Clin Trials Commun 2020; 19:100640. [PMID: 32885091 PMCID: PMC7451809 DOI: 10.1016/j.conctc.2020.100640] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/14/2020] [Accepted: 08/09/2020] [Indexed: 01/08/2023] Open
Abstract
Adults with central adiposity and other features of the metabolic syndrome have a markedly elevated risk of developing type 2 diabetes (T2D) and cardiovascular disease (CVD). A Mediterranean-style healthy eating pattern (MED-HEP) and consumption of foods with a lower glycemic index (GI) are potential dietary approaches to curb the T2D and CVD epidemic. However, experimental evidence of the effectiveness of MED-HEP and of the contribution of GI towards improving indices of glucose homeostasis, especially among non-diabetic people, are lacking. Therefore, we developed the MedGI-Carb trial, a multi-center (Italy, Sweden, and United States) intervention in adults with at least two components of the metabolic syndrome (elevated waist circumference + one other component) that aims to improve markers of glucose homeostasis through dietary modification. All participants were randomized to consume an isocaloric high- or low-GI MED-HEP for 12 weeks. We hypothesized that indexes of insulinemia (primary outcome: postprandial insulin and glucose after standardized breakfast and lunch; secondary outcomes: fasting plasma glucose and insulin, HbA1c, 24-h continuous glucose monitoring) would be improved more with the low-GI versus the high-GI MED-HEP. Additionally, we hypothesized that consumption of a MED-HEP would improve other markers of cardiometabolic health and well-being (fasting blood pressure, fasting lipid profile, sleep quality, satiety, global metabolic alterations in the plasma metabolome, changes in the gut microbiota, subjective health and well-being), with no difference between groups. Collectively, the design of MEDGI-Carb allows several different research questions to be explored. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03410719.
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Affiliation(s)
- Robert E Bergia
- Department of Nutrition Science, Purdue University, 700 West State St, West Lafayette, IN, 47907, USA
| | - Izabela Biskup
- Department of Biology and Biological Engineering, Food Science and Nutrition, Chalmers University of Technology, Gothenburg, Sweden
| | - Rosalba Giacco
- Diabetes, Nutrition and Metabolism Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.,Institute of Food Science, National Research Council, Avellino, Italy
| | - Giuseppina Costabile
- Diabetes, Nutrition and Metabolism Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Savanna Gray
- Department of Nutrition Science, Purdue University, 700 West State St, West Lafayette, IN, 47907, USA
| | - Amy Wright
- Department of Nutrition Science, Purdue University, 700 West State St, West Lafayette, IN, 47907, USA
| | - Marilena Vitale
- Diabetes, Nutrition and Metabolism Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, 700 West State St, West Lafayette, IN, 47907, USA
| | - Rikard Landberg
- Department of Biology and Biological Engineering, Food Science and Nutrition, Chalmers University of Technology, Gothenburg, Sweden
| | - Gabriele Riccardi
- Institute of Food Science, National Research Council, Avellino, Italy
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Kreutz C, Müller J, Schmidt ME, Steindorf K. Comparison of subjectively and objectively assessed sleep problems in breast cancer patients starting neoadjuvant chemotherapy. Support Care Cancer 2020; 29:1015-1023. [PMID: 32556623 PMCID: PMC7767899 DOI: 10.1007/s00520-020-05580-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/13/2020] [Indexed: 12/29/2022]
Abstract
Purpose To characterize sleep problems and to compare subjective and objective assessments in breast cancer patients starting neoadjuvant chemotherapy. Methods Sleep characteristics of 54 breast cancer patients starting neoadjuvant chemotherapy were analyzed. Subjective sleep characteristics were assessed with the Pittsburgh Sleep Quality Index (PSQI) and objective sleep measurements with an accelerometer (ActiGraph wGT3X-BT) worn on the wrist for 7 consecutive days. Results According to the common PSQI cut-off of 8, 10 (18.87%) of the patients were poor sleepers. ActiGraph measures did not mirror this classification as values for poor, and good sleepers did not differ significantly. Overall, Bland-Altman plots illustrated higher ActiGraph values for sleep efficiency and effective sleep time and lower values for sleep latency, compared with PSQI. For total sleep time, less disagreement between both measures was observed. Actigraphy was limited in precise identification of sleep begin and sleep latency but provided supplementary information about number and minutes of awakenings during the night. Conclusion Subjective and objective measurement methods differed substantially in various parameters, with limitations in both methods. A combination of both methods might be most promising. Trial Registration Clinicaltrials.gov: NCT02999074 Electronic supplementary material The online version of this article (10.1007/s00520-020-05580-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Charlotte Kreutz
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
- Faculty of Medicine Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany
| | - Jana Müller
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
- Institute of Sports and Sport Science, Heidelberg University, Im Neuenheimer Feld 700, 69120, Heidelberg, Germany
- Working Group Exercise Oncology, Division of Medical Oncology, Heidelberg University Hospital and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.
- Division of Physical Activity, Prevention and Cancer (C110), German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
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Mantua J, Bessey AF, Sowden WJ. Poor Subjective Sleep Quality Is Associated with Poor Occupational Outcomes in Elite Soldiers. Clocks Sleep 2020; 2:182-193. [PMID: 33089199 PMCID: PMC7445833 DOI: 10.3390/clockssleep2020015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/09/2020] [Indexed: 11/16/2022] Open
Abstract
We aimed to assess the relationship between subjective sleep quality and occupationally-relevant outcomes in military personnel. Participants were from an elite unit of US Army soldiers who worked extended (~30 h) shifts (with minimal recovery time between shifts) during 3-week work sessions. Questionnaires assessing subjective sleep quality during the month prior (Pittsburgh Sleep Quality Index [PSQI]) were administered at the beginning of the session. Occupational outcomes (emotional exhaustion, functional impairment, role overload, daytime sleepiness) were assessed on the final day of the session. Regression analyses were conducted to link sleep quality and occupational outcomes. The study sample participants had relatively poor sleep prior to the exercise (PSQI Global score average = 6.3 ± 3.1). Higher PSQI Global Scores prior to the work session longitudinally predicted daytime sleepiness (f2: 0.56) after the work session. PSQI component 7, which queries daytime dysfunction attributed to poor sleep quality, longitudinally predicted emotional exhaustion, functional impairment, and role overload (f2 range: 0.19-0.70). In conclusion, poor sleep quality-in aggregation with occupationally-mandated sleep loss-is predictive of poorer subsequent occupational outcomes. Future work should aim to increase sleep opportunities prior to occupationally-mandated sleep loss in order to build resilience when sleep loss is unavoidable.
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Affiliation(s)
- Janna Mantua
- Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (A.F.B.); (W.J.S.)
| | - Alexxa F Bessey
- Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (A.F.B.); (W.J.S.)
| | - Walter J Sowden
- Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (A.F.B.); (W.J.S.)
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Pedrozo-Pupo JC, Córdoba AP, Campo-Arias A. Estructura factorial y consistencia interna de la escala de somnolencia de Epworth. REVISTA DE LA FACULTAD DE MEDICINA 2020. [DOI: 10.15446/revfacmed.v68n2.73025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Introducción. En comparación con la polisomnografía (PSG), la escala de somnolencia de Epworth (ESE) tiene propiedades clinimétricas limitadas, por tanto es necesario revisar su estructura factorial.Objetivo. Revisar la estructura factorial (dimensionalidad) y la consistencia interna de la ESE en un grupo de pacientes a los que se les realizó PSG en Santa Marta, Colombia.Materiales y métodos. Se realizó una investigación para medir las propiedades clinimétricas de la ESE. La muestra estuvo compuesta por 684 adultos entre 18 y 64 años (media=43.2, desviación estándar=13.4) que habían completado los 8 ítems de dicha escala. 440 eran hombres y 244, mujeres. Para probar la estructura factorial se usó el análisis factorial confirmatorio (AFC) y para computar la consistencia interna, los coeficientes omega de McDonald y alfa de Cronbach.Resultados. La estructura de factores fue unidimensional y explicó el 42% de la varianza. En cuanto al AFC, los coeficientes de bondad de ajuste fueron insatisfactorios: χ²=146.47 (gl=20, p=0.001), RMSEA=0.096 (IC90%: 0.082-0.111), CFI=0.902, TLI=0.863 y SMSR=0.047. Los coeficientes omega de McDonald y alfa de Cronbach fueron ambos de 0.80 (IC95%: 0.78-0.82).Conclusiones. La ESE presentó una estructura unidimensional limitada, por lo que es necesario revisar el constructo de somnolencia excesiva o refinar su estructura factorial, pues es posible que con ello se obtengan mejores indicadores en comparación con el mejor criterio de referencia para diagnosticar somnolencia diurna excesiva.
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Smit CAJ, Berenpas F, de Groot S, Stolwijk-Swuste JM, Janssen TWJ. Feasibility of overnight electrical stimulation-induced muscle activation in people with a spinal cord injury. A Pilot study. Spinal Cord Ser Cases 2020; 6:5. [PMID: 31993216 PMCID: PMC6981179 DOI: 10.1038/s41394-019-0254-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 10/25/2019] [Accepted: 12/20/2019] [Indexed: 11/09/2022] Open
Abstract
Study Design We investigated whether overnight ES is a feasible method to activate gluteal, quadriceps, and hamstrings muscles in a two-week experiment. Electrical stimulation (ES) induced muscle contractions have proven positive effects on risk factors for developing pressure ulcers in people with a spinal cord injury (SCI). Therefore prolonged overnight ES-induced muscle activation is interesting, but has never been studied. Objective To study feasibility of ES-induced leg muscle activation. In eight participants with motor complete SCI gluteal, hamstrings and quadriceps muscles were activated with a 2-weeks overnight stimulation protocol, 8 h per night, using specially developed ES-shorts. Setting The Netherlands. Methods Muscle fatigue was determined with a muscle contraction sensor. Questionnaires on sleep quality (SQ) and the ES-shorts usability were taken. Results After 8 h of activation muscles still contracted, although fatigue occurred, and mean contraction size was lower at the end of a cycle (p = 0.03). SQ (0-100) after intervention was 75, and 66 after 4 weeks without overnight ES (p = 0.04) indicating ES improves sleep quality. The usability of the ES-shorts was good. Conclusions This study shows that overnight ES-induced muscle activation using ES-shorts in SCI is a new, feasible method that does not interfere with sleep. The nightly use of the ES-shorts might be considered as an important part of the daily routine in SCI.
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Affiliation(s)
- Christof A. J. Smit
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
| | - Frank Berenpas
- MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands
| | - Sonja de Groot
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| | | | - Thomas W. J. Janssen
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
- MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands
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Izci-Balserak B, Zhu B, Gurubhagavatula I, Keenan BT, Pien GW. A Screening Algorithm for Obstructive Sleep Apnea in Pregnancy. Ann Am Thorac Soc 2019; 16:1286-1294. [PMID: 31162952 PMCID: PMC6812170 DOI: 10.1513/annalsats.201902-131oc] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/04/2019] [Indexed: 01/15/2023] Open
Abstract
Rationale: Obstructive sleep apnea (OSA) is common in pregnancy and associated with maternal and fetal complications. Early detection of OSA may have important implications for maternal-fetal well-being. A screening tool combining several methods of assessment may better predict OSA among pregnant women compared with tools that rely solely on self-reported information.Objectives: To develop a screening tool combining subjective and objective measures to predict OSA in pregnant women.Methods: This study is a secondary analysis using data collected from a completed cohort of pregnant women (n = 121 during the first and n = 87 during the third trimester). Participants underwent full polysomnography and completed the Multivariable Apnea Prediction Questionnaire. The Obstructive Sleep Apnea/Hypopnea Syndrome Score and Facco apnea predictive model were obtained. Logistic regression analysis and area under the curve (AUC) were used to identify models predicting OSA risk.Results: Participants' mean age was 27.4 ± 7.0 years. The prevalence of OSA during the first and third trimester was 10.7% and 24.1%, respectively. The final model predicting OSA risk consisted of body mass index, age, and presence of tongue enlargement. During the first trimester, the AUC was 0.86 (95% confidence interval [CI], 0.76-0.96). During the third trimester, the AUC was 0.87 (95% CI, 0.77-0.96). When the first-trimester data were used to predict third-trimester OSA risk, the AUC was 0.87 (95% CI, 0.77-0.97). This model had high sensitivity and specificity when used during both trimesters. The negative posttest probabilities (probability of OSA given a negative test result) ranged from 0.03 to 0.07.Conclusions: A new model consisting of body mass index, age, and presence of tongue enlargement provided accurate screening of OSA in pregnant women, particularly African-Americans. This tool can be easily and rapidly administered in busy clinical practices without depending on patients' awareness of experiencing apnea symptoms.
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Affiliation(s)
- Bilgay Izci-Balserak
- Department of Biobehavioral Health Sciences, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Bingqian Zhu
- Department of Biobehavioral Health Sciences, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Indira Gurubhagavatula
- Center for Sleep and Circadian Neurobiology and
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | | | - Grace W. Pien
- School of Medicine, John Hopkins University, Baltimore, Maryland
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Rice bran extract supplement improves sleep efficiency and sleep onset in adults with sleep disturbance: A randomized, double-blind, placebo-controlled, polysomnographic study. Sci Rep 2019; 9:12339. [PMID: 31451704 PMCID: PMC6710429 DOI: 10.1038/s41598-019-48743-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 08/07/2019] [Indexed: 11/30/2022] Open
Abstract
We previously reported that rice bran extract supplement (RBS) administration to mice decreased sleep latency and induced non-rapid eye movement (NREM) sleep via inhibition of the histamine H1 receptor. Based on this, we performed the first clinical trial to investigate whether RBS would be beneficial to subjects with disturbed sleep. We performed a randomized, double‐blinded, placebo‐controlled, 2-week study. Fifty subjects with sleep disturbance were enrolled and received either RBS (1,000 mg/day) or placebo. Polysomnography was performed, and Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale (ESS), and Fatigue Severity Scale were administered at the initiation and termination of the study. Compared with the placebo, RBS led to significant polysomnographic changes, including decreased sleep latency (adjusted, P = 0.047), increased total sleep time (P = 0.019), and improved sleep efficiency (P = 0.010). Additionally, the amount of stage 2 sleep significantly increased in the RBS group. When adjusted for caffeine intake, wakefulness after sleep onset, total wake time, and delta activity tended to decrease in the RBS group. RBS administration decreased ESS scores. There were no reported serious adverse events in both groups. RBS improved sleep in adults with sleep disturbance. Trial registration: WHO ICTRP, KCT0001893.
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More CE, Papp C, Harsanyi S, Gesztelyi R, Mikaczo A, Tajti G, Kardos L, Seres I, Lorincz H, Csapo K, Zsuga J. Altered irisin/BDNF axis parallels excessive daytime sleepiness in obstructive sleep apnea patients. Respir Res 2019; 20:67. [PMID: 30952206 PMCID: PMC6449996 DOI: 10.1186/s12931-019-1033-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 03/26/2019] [Indexed: 02/08/2023] Open
Abstract
STUDY OBJECTIVES Obstructive sleep apnea hypopnea syndrome (OSAHS) is a sleep-related breathing disorder, characterized by excessive daytime sleepiness (EDS), paralleled by intermittent collapse of the upper airway. EDS may be the symptom of OSAHS per se but may also be due to the alteration of central circadian regulation. Irisin is a putative myokine and has been shown to induce BDNF expression in several sites of the brain. BDNF is a key factor regulating photic entrainment and consequent circadian alignment and adaptation to the environment. Therefore, we hypothesized that EDS accompanying OSAHS is reflected by alteration of irisin/BDNF axis. METHODS Case history, routine laboratory parameters, serum irisin and BDNF levels, polysomnographic measures and Epworth Sleepiness Scale questionnaire (ESS) were performed in a cohort of OSAHS patients (n = 69). Simple and then multiple linear regression was used to evaluate data. RESULTS We found that EDS reflected by the ESS is associated with higher serum irisin and BDNF levels; β: 1.53; CI: 0.35, 6.15; p = 0.012 and β: 0.014; CI: 0.0.005, 0.023; p = 0.02, respectively. Furthermore, influence of irisin and BDNF was significant even if the model accounted for their interaction (p = 0.006 for the terms serum irisin, serum BDNF and their interaction). Furthermore, a concentration-dependent effect of both serum irisin and BDNF was evidenced with respect to their influence on the ESS. CONCLUSIONS These results suggest that the irisin-BDNF axis influences subjective daytime sleepiness in OSAS patients reflected by the ESS. These results further imply the possible disruption of the circadian regulation in OSAHS. Future interventional studies are needed to confirm this observation.
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Affiliation(s)
- Csaba E More
- Department of Psychiatry, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
| | - Csaba Papp
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
| | - Szilvia Harsanyi
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
| | - Angela Mikaczo
- Department of Pulmonology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
| | - Gabor Tajti
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
| | - Laszlo Kardos
- Institute of Clinical Pharmacology, Infectious Diseases and Allergology, Kenezy Gyula Teaching County Hospital and Outpatient Clinic, Bartok Bela ut 2-26, Debrecen, 4031, Hungary
| | - Ildiko Seres
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
| | - Hajnalka Lorincz
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary
| | - Krisztina Csapo
- Department of Neurology, Faculty of Medicine, University of Debrecen, Moricz Zsigmond krt. 22, Debrecen, 4032, Hungary
| | - Judit Zsuga
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary.
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Weisel KK, Zarski AC, Berger T, Krieger T, Schaub MP, Moser CT, Berking M, Dey M, Botella C, Baños R, Herrero R, Etchemendy E, Riper H, Cuijpers P, Bolinski F, Kleiboer A, Görlich D, Beecham J, Jacobi C, Ebert DD. Efficacy and cost-effectiveness of guided and unguided internet- and mobile-based indicated transdiagnostic prevention of depression and anxiety (ICare Prevent): A three-armed randomized controlled trial in four European countries. Internet Interv 2019; 16:52-64. [PMID: 30775265 PMCID: PMC6364519 DOI: 10.1016/j.invent.2018.04.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/09/2018] [Accepted: 04/11/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Depression and anxiety are highly prevalent and often co-occur. Several studies indicate the potential of disorder-specific psychological interventions for the prevention of each of these disorders. To treat comorbidity, transdiagnostic treatment concepts seem to be a promising approach, however, evidence for transdiagnostic concepts of prevention remains inconclusive. Internet- and mobile-based interventions (IMIs) may be an effective means to deliver psychological interventions on a large scale for the prevention of common mental disorders (CMDs) such as depression and anxiety. IMIs have been shown to be effective in treating CMDs, e.g. in reducing symptoms of depression and anxiety. However, there is a lack of studies examining the efficacy of interventions reducing the incidence of CMDs. Moreover, the comparative cost-effectiveness of guided versus unguided IMIs for the prevention of depression and anxiety has not been studied yet. Hence, this study aims at investigating the (cost-) effectiveness of guided and unguided internet- and mobile-based transdiagnostic individually tailored indicated prevention of depression and anxiety. METHODS A multi-country three-armed randomized controlled trial will be conducted to compare a guided and unguided intervention to treatment as usual (TAU). Both active conditions are based on the same intervention, ICare Prevent, and differ only with regard to guidance format. Altogether, 954 individuals with subclinical symptoms of depression (CES-D ≥ 16) and anxiety (GAD-7 ≥ 5) who do not have a full-blown disorder will be recruited in Germany, Switzerland, Spain and the Netherlands, and randomized to one of three conditions (guided intervention, unguided intervention, or TAU). The TAU arm will receive access to the training after a 12-month waiting period. The primary outcome will be time to CMD onset (any depression/anxiety disorder) within a follow-up period of 12 months after baseline. Secondary outcomes will include disorder-specific symptom severity (depression/anxiety) assessed by diagnostic raters blinded to intervention condition at post-intervention, self-reports, acceptability, health related quality of life, and psychosocial variables associated with developing a CMD. Assessments will take place at baseline, mid-intervention (5 weeks into the intervention), post-intervention (8 weeks after randomization) and follow-up (6 and 12 months after randomization). Data will be analyzed on an intention-to-treat basis and per protocol. Cost-effectiveness will be evaluated from a public health and a societal perspective, including both direct and indirect costs. DISCUSSION The present study will further enhance the evidence-base for transdiagnostic preventive interventions and provide valuable information about optimal trade-off between treatment outcome and costs. TRIAL REGISTRATION German Clinical Trial Registration (DRKS - http://www.drks.de/drks_web/): DRKS00011099.
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Affiliation(s)
- Kiona K. Weisel
- Department of Clinical Psychology and Psychotherapy, Nägelsbachstraße 25a, Germany
| | - Anna-Carlotta Zarski
- Department of Clinical Psychology and Psychotherapy, Nägelsbachstraße 25a, Germany
- Leuphana University, Innovation Incubator, Division Health Trainings Online, Lüneburg, Germany
| | - Thomas Berger
- University of Bern, Department of Clinical Psychology and Psychotherapy, Bern, Switzerland
| | - Tobias Krieger
- University of Bern, Department of Clinical Psychology and Psychotherapy, Bern, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction ISGF, Associated to the University of Zurich, Zurich, Switzerland
| | - Christian T. Moser
- University of Bern, Department of Clinical Psychology and Psychotherapy, Bern, Switzerland
| | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, Nägelsbachstraße 25a, Germany
| | - Michelle Dey
- Swiss Research Institute for Public Health and Addiction ISGF, Associated to the University of Zurich, Zurich, Switzerland
| | - Cristina Botella
- Jaume I University, Castellón, Spain
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
| | - Rosa Baños
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- University of Valencia, Valencia, Spain
| | - Rocio Herrero
- Jaume I University, Castellón, Spain
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
| | - Ernestina Etchemendy
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- University of Zaragoza, Teruel, Spain
| | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Felix Bolinski
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Annet Kleiboer
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Dennis Görlich
- Westfälische Wilhelms-Universität Münster, Institute of Biostatistics and Clinical Research, Münster, Germany
| | - Jennifer Beecham
- Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science, London, United Kingdom
| | - Corinna Jacobi
- Department of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
| | - David D. Ebert
- Department of Clinical Psychology and Psychotherapy, Nägelsbachstraße 25a, Germany
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Al-Ameri LT, Mohsin TS, Abdul Wahid AT. Sleep Disorders Following Mild and Moderate Traumatic Brain Injury. Brain Sci 2019; 9:brainsci9010010. [PMID: 30641953 PMCID: PMC6356283 DOI: 10.3390/brainsci9010010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/04/2019] [Accepted: 01/10/2019] [Indexed: 01/23/2023] Open
Abstract
(1) Background: Sleeping disorders are frequently reported following traumatic brain injury (TBI). Different forms of sleeping disorders have been reported, such as sleepiness, insomnia, changes in sleeping latency, and others. (2) Methods: A case-control study with 62 patients who were victims of mild or moderate TBI with previous admissions to Iraqi tertiary neurosurgical centers were enrolled as the first group, and 158 patients with no history of trauma were considered as the control. All were 18 years of age or older, and the severity of the trauma and sleep disorders was assessed. The Pittsburgh sleep quality index was used to assess sleep disorders with average need for sleep per day and average sleep latency were assessed in both groups. Chi-square and t-test calculations were used to compare different variables. (3) Results: 39 patients (24.7%) of the controlled group experienced sleeping disorders compared to TBI group with 45 patients (72.6%), P-value < 0.00001. A total of 42 patients were diagnosed on admission as having a mild degree of TBI (mean GCS 13.22 ± 1.76) and 20 patients were diagnosed with moderate TBI (mean GCS11.05 ± 1.14. 27). A total of 27 (46.28%) patients with mild severity TBI and 18 patients (90%) of moderate severity were considered to experience sleeping disorders, P-value 0.0339. Each of the mild and moderate TBI subgroups show a P-value < 0.00001 compared to the control group. Average sleep hours needed per day for TBI and the control were 8.02 ± 1.04 h and 7.26 ± 0.58 h, respectively, P-value < 0.00001. Average sleep latency for the TBI and the control groups were 13.32 ± 3.16 min and 13.93 ± 3.07 min respectively, P-value 0.065. (4) Conclusion: Sleep disturbances are more common following mild and moderate TBI three months after the injury with more hours needed for sleep per day and no significant difference in sleep latency. Sleep disturbances increase in frequency with the increase in the severity of TBI.
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Weisel KK, Zarski AC, Berger T, Schaub MP, Krieger T, Moser CT, Berking M, Ebert DD. Transdiagnostic Tailored Internet- and Mobile-Based Guided Treatment for Major Depressive Disorder and Comorbid Anxiety: Study Protocol of a Randomized Controlled Trial. Front Psychiatry 2018; 9:274. [PMID: 30022954 PMCID: PMC6039558 DOI: 10.3389/fpsyt.2018.00274] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/05/2018] [Indexed: 12/30/2022] Open
Abstract
Introduction: Depression is highly prevalent and often accompanied by comorbid anxiety disorder. Internet-based interventions have shown to be one effective treatment modality; however, comorbidities are often not targeted. Transdiagnostic tailored internet-and mobile-based interventions (IMIs) might be promising to overcome such issues. Aim: This study aims to evaluate the efficacy, moderators, and cost-effectiveness of a transdiagnostic tailored internet- and mobile-based guided intervention for depression and comorbid anxiety in individuals with major depressive disorder (MDD). Method: Two-hundred participants with MDD will be randomly assigned to an 8-week guided self-help internet intervention (IC) or a 6-month wait-list control group (WLC). Participants of the IC will receive weekly content-focused feedback on module completion as well as monitored adherence reminders from an eCoach. The primary outcome is clinician-rated depression severity (QIDS-C) at post-assessment assessed by diagnostic raters blind to study condition. Secondary outcomes include, e.g., change in diagnostic status (MDD and anxiety disorders), remission and response rates, disorder symptom severity, health related quality of life, incongruence related to needs and values, and behavioral activation. Assessments will take place at baseline (T1), post-assessment (T2), 6-month follow-up (T3), and 12-month follow-up in the IC. Data will be analyzed on an intention-to-treat basis and per protocol. A large number of a priori defined moderators of treatment outcome will be assessed at baseline and tested in predicting treatment outcome. Cost-effectiveness will be evaluated from a societal perspective. Discussion: The present study will provide evidence on the efficacy, potential cost-effectiveness, and moderators of a transdiagnostic tailored guided internet- and mobile-based treatment protocol. TRIAL REGISTRATION German Register of Clinical Studies DRKS00011690 (https://www.drks.de/drks_web/).
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Affiliation(s)
- Kiona K. Weisel
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Anna-Carlotta Zarski
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Psychology, Leuphana University of Lüneburg, Lüneburg, Germany
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction ISGF, University of Zurich, Zurich, Switzerland
| | - Tobias Krieger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christian T. Moser
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - David D. Ebert
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Stanić I, Smoljo T, Barun B, Habek M. Influence of resistance exercise on autonomic nervous system and sleep. MEDICINSKI PODMLADAK 2018. [DOI: 10.5937/mp69-18103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Forner-Cordero A, Umemura GS, Furtado F, Gonçalves BDSB. Comparison of sleep quality assessed by actigraphy and questionnaires to healthy subjects. ACTA ACUST UNITED AC 2018; 11:141-145. [PMID: 30455845 PMCID: PMC6201524 DOI: 10.5935/1984-0063.20180027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sleep quality analysis is crucial for human health and it is related to duration, rhythm and quality. The goal of this study is to analyze objective assessment of the sleep-wake cycles with actigraphy, subjective questionnaires and their relationship with sleep quality indices. A wearable actigraph registered the sleep habits of 41 healthy subjects for 9 days. Afterwards, the subjects filled two questionnaires about sleep quality (Pittsburgh Sleep Quality Index) and sleepiness (Epworth Sleepiness Scale). The subjects were divided into two groups based on cut-off scores and the actigraphy parameters were compared between groups. Group 1 in ESS and PSQI categorization had less diurnal sleepiness and better sleep quality, respectively, than Group 2. Measurements of regularity (IS), fragmentation (IV), active phase amplitude (M10), rest amplitude (L5), and relative amplitude (RA) were compared between groups. Group 2 had higher L5 values. Parameter L5 (lowest of 5 consecutive hours of activity) was concluded to be relevant to identify the sleep conditions of the subjects.
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Affiliation(s)
| | | | - Fabianne Furtado
- University of São Paulo, Biomechatronics Lab. (EPUSP) - São Paulo - SP - Brazil.,Federal Institute of Education, Science and Technology of Southeast of Minas Gerais, Physical Therapy - Barbacena - MG - Brazil
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15
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Good and poor sleepers among OSA patients: sleep quality and overnight polysomnography findings. Neurol Sci 2017; 38:1299-1306. [PMID: 28474149 DOI: 10.1007/s10072-017-2978-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
Previous studies aimed to determine if Pittsburgh sleep quality index (PSQI) is a valid screening instrument for obstructive sleep apnea, indicating its disadvantages. However, the rationale of PSQI use in sleep clinics is not the screening, but the assessment of sleep quality itself. Therefore, the aims of this study were to investigate the sleep quality in obstructive sleep apnea patients and to identify the cutoff point for differentiation of "good" and "poor" sleepers among them. We constructed the Croatian version of PSQI and assessed its psychometric properties. The protocol of the study included the assessment of sleep quality in 130 obstructive sleep apnea patients and 75 healthy control subjects. All subjects completed the Croatian version of the PSQI, and the patients underwent overnight polysomnography screening. Obstructive sleep apnea patients had higher values of the global PSQI component score, indicating lower sleep quality, compared to a healthy control group (p < 0.001). The psychometric properties of PSQI scores in the prediction of normal sleep efficiency indicate that the cutoff score of 9.5 differentiates patients in total sleep time (p < 0.001), REM duration (p = 0.014), sleep efficiency (p = 0.001), time spent awake during sleep (p = 0.006), after sleep (p = 0.024), and after sleep onset (p = 0.001). In OSA patients, a PSQI cutoff score of 9.5 differentiated good and poor sleepers significantly in total sleep time, REM duration, time spent awake during sleep, and WASO time. Current findings enhance the interpretability of PSQI results in a population of OSA patients.
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da Cunha Silva Santiago L, Batista RMF, Lyra MJ, Farah BQ, Pedrosa RP, Falcão APST, de Araújo RC, Dos Santos MAM. The role played by gender and age on poor sleep quality among institutionalized adolescents. Sleep Breath 2017; 21:197-202. [PMID: 28102484 DOI: 10.1007/s11325-017-1463-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/19/2016] [Accepted: 01/11/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to analyze the prevalence and association between sleep quality with gender and age and to examine the relation between age and the components of the PSQI in institutionalized adolescents. METHODS High school internal students of both genders, aged between 14 and 19 years old, were analyzed. After a full clinical evaluation, the Pittsburg Sleep Quality Index Score was obtained from all participants. RESULTS We studied 210 participants [male: 15. 7 ± 1.2 years; BMI: 21.7 ± 2.6 kg/m2; female: 15.7 ± 1. 2 years; BMI: 21.9 ± 4.5 kg/m2]. Poor sleep quality was present in 137 (65.3%) participants and was predominant among girls than boys (PSQI = 76.3 vs 55.8%; p < 0.001), respectively. There were positive correlations between PSQI components with age in boys (sleep latency: R = 0.23; p = 0.02; sleep duration: R = 0.28; p < 0.01 and overall sleep quality: R = 0.21; p = 0.03), but not among girls. CONCLUSION Institutionalized girls have worse sleep quality than boys and positive correlations between sleep quality components with age were only present among boys.
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Affiliation(s)
| | | | - Maria Julia Lyra
- Program in Adolescent Health, University of Pernambuco (UPE), Recife, PE, Brazil
| | - Breno Quintella Farah
- Associate Graduate Program in Physical Education, University of Pernambuco, Recife, Brazil
- Group Research in Health and Sport, ASCES College, Caruaru, Brazil
| | - Rodrigo Pinto Pedrosa
- Sleep and Heart Laboratory, Pronto Socorro Cardiologic de Pernambuco (PROCAPE), University of Pernambuco, Recife, Brazil
- Hospital Metropolitano Sul Dom Helder Câmara IMIP Hospitalar, Cabo de Santo Agostinho, Brazil
| | | | - Rodrigo Cappato de Araújo
- Program in Adolescent Health, University of Pernambuco (UPE), Recife, PE, Brazil
- Associate Graduate Program in Physical Education, University of Pernambuco, Recife, Brazil
| | - Marcos André Moura Dos Santos
- Program in Adolescent Health, University of Pernambuco (UPE), Recife, PE, Brazil.
- Associate Graduate Program in Physical Education, University of Pernambuco, Recife, Brazil.
- Physical Education School, University of Pernambuco, Arnóbio Marques street, 310. Santo Amaro, Recife, PE, 50100-130, Brazil.
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Rohl B, Collins K, Morgan S, Cosentino S, Huey ED, Louis ED. Daytime sleepiness and nighttime sleep quality across the full spectrum of cognitive presentations in essential tremor. J Neurol Sci 2016; 371:24-31. [PMID: 27871441 PMCID: PMC5467974 DOI: 10.1016/j.jns.2016.10.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/06/2016] [Accepted: 10/06/2016] [Indexed: 12/17/2022]
Abstract
There is increasing evidence that essential tremor (ET) is a complex and heterogeneous disorder with nonmotor features including cognitive deficits and sleep problems. We are unaware of a study that has examined sleep deficits in ET across the full spectrum of cognitive presentations. Cross-sectional (baseline) data on self-reported nighttime sleep dysfunction and excessive daytime sleepiness were collected using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) in 96 ET cases enrolled in a prospective study. Cases underwent a comprehensive neuropsychological assessment, and were classified as ET with normal cognition (ET-NC), ET with mild cognitive impairment (ET-MCI), and ET with dementia (ET-D). PSQI scores did not significantly differ across the three ET cognitive groups (p=0.22). ESS scores were highest (more daytime sleepiness) in the ET-MCI group, followed by the ET-D and ET-NC groups, respectively (p=0.016). We examined sleep dysfunction across the cognitive spectrum in ET. We demonstrate for the first time that excessive daytime sleepiness is greater in ET-MCI than ET-NC. Unpredicted low ESS scores in the dementia group raises two possibilities: a self-report bias related to cognitive impairment and/or the possibility that currently undefined pathological heterogeneity in ET may map onto multiple presentations of non-motor deficits.
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Affiliation(s)
- Brittany Rohl
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, 15 York Street, New Haven, CT 06510, USA
| | - Kathleen Collins
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, 15 York Street, New Haven, CT 06510, USA
| | - Sarah Morgan
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, 15 York Street, New Haven, CT 06510, USA
| | - Stephanie Cosentino
- Department of Neurology, College of Physicians and Surgeons, Columbia University, 710 West 168th Street, New York, NY 10032,USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 710 West 168th Street, New York, NY 10032, USA
| | - Edward D Huey
- Department of Neurology, College of Physicians and Surgeons, Columbia University, 710 West 168th Street, New York, NY 10032,USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 710 West 168th Street, New York, NY 10032, USA; Division of Geriatric Psychiatry, Department of Psychiatry, College of Physicians and Surgeons, New York Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Elan D Louis
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, 15 York Street, New Haven, CT 06510, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, 333 Cedar Street, New Haven, CT 06510, USA; Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA.
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Shao IH, Wu CC, Hsu HS, Chang SC, Wang HH, Chuang HC, Tam YY. The effect of nocturia on sleep quality and daytime function in patients with lower urinary tract symptoms: a cross-sectional study. Clin Interv Aging 2016; 11:879-85. [PMID: 27418814 PMCID: PMC4933563 DOI: 10.2147/cia.s104634] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Nocturia has been proven to have a negative impact on the quality of life and sleep quality in general elderly population. However, there are limited studies on the quantitative effect of nocturia on sleep quality and daytime dysfunction, specifically in patients with lower urinary tract symptoms. Patients and methods During March 1, 2015 to December 31, 2015, a total of 728 patients who visited our urology department due to voiding dysfunction and experienced nocturia at least once per night were enrolled. Three questionnaires were administered to them after obtaining their written consents. Pittsburgh Sleep Quality Index (PSQI) questionnaire, Epworth Sleepiness Scale (ESS) questionnaire, and International Prostate Symptom Score (IPSS) questionnaire were applied to evaluate their sleep quality, daytime dysfunction, and voiding problems, respectively. Statistical analysis of the impact of nocturia on sleep quality and daytime dysfunction was performed. Results The mean age of patients was 61 years, with a male-to-female ratio of 2.7. The mean nocturia number was 3.03. The IPSS, PSQI, and ESS scores were 17.56, 8.35, and 8.22, respectively. The nocturia number increased with age and was significantly correlated to ESS score (daytime dysfunction) and PSQI total score (sleep quality) in overall group. Among subgroups divided by age and sex, there was a significant correlation between nocturia number and daytime dysfunction in male patients or patients younger than 65 years. Conclusion In patients with lower urinary tract symptoms, nocturia number increased with age and was significantly correlated with poor sleep quality. Nocturia plays an important role in patients younger than 65 years in daytime dysfunction.
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Affiliation(s)
- I-Hung Shao
- Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County
| | - Chia-Chen Wu
- Department of Otorhinolaryngology - Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan
| | - Hueih-Shing Hsu
- Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County
| | - Shyh-Chyi Chang
- Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County
| | - Hsu-Hsiang Wang
- Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County
| | - Heng-Chang Chuang
- Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County
| | - Yuan-Yun Tam
- Department of Otorhinolaryngology - Head and Neck Surgery, Lotung Poh-Ai Hospital, Yilan County, Taiwan, Republic of China
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Association between Self-Reported Bruxism and Sleeping Patterns among Dental Students in Saudi Arabia: A Cross-Sectional Study. Int J Dent 2016; 2016:4327081. [PMID: 27034672 PMCID: PMC4789476 DOI: 10.1155/2016/4327081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 12/13/2015] [Accepted: 01/31/2016] [Indexed: 11/17/2022] Open
Abstract
Objectives. The aim of this cross-sectional study was to identify sleeping patterns among dental students and their association with self-reported bruxism in Riyadh Colleges of Dentistry and Pharmacy (RCsDP). Methods. A cross-sectional study was performed including 549 students (67 men and 482 women). A structured questionnaire was adopted from The PSQI (The Pittsburgh Sleep Questionnaire Index) used for data collection. It included questions which are categorized into sleeping habits, sleep-related symptoms, and additional questions concerning bruxism. This questionnaire was randomly distributed among all college preclinical and postclinical students. Sleep bruxism diagnosis was based on self-reported data. The data were analyzed using Chi-square tests through SPSS software for Windows. Results. Statistical analyses revealed significant correlations between self-reported bruxism and sleeping habits including sleep initiation (χ2 = 22.6, p = 0.000), continuous sleep until morning (χ2 = 19.2, p = 0.001), nighttime sleep duration (χ2 = 20.2, p = 0.000), and length of daytime naps (χ2 = 28.35, p = 0.000). There was an association between self-reported bruxism and sleeping-related symptoms including awakening early in the morning before the usual time without a cause (χ2 = 16.52, p = 0.000) and increased nightmares (χ2 = 13.7, p = 0.001). Conclusions. Poor sleeping pattern was an important factor among dental students, who reported sleep bruxism.
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Choueiry N, Salamoun T, Jabbour H, El Osta N, Hajj A, Rabbaa Khabbaz L. Insomnia and Relationship with Anxiety in University Students: A Cross-Sectional Designed Study. PLoS One 2016; 11:e0149643. [PMID: 26900686 PMCID: PMC4762701 DOI: 10.1371/journal.pone.0149643] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 02/03/2016] [Indexed: 12/12/2022] Open
Abstract
Purpose Sleep disorders (SDs) are now recognized as a public health concern with considerable psychiatric and societal consequences specifically on the academic life of students. The aims of this study were to assess SDs in a group of university students in Lebanon and to examine the relationship between SDs and anxiety. Methods An observational cross-sectional study was conducted at Saint-Joseph University, Lebanon, during the academic year 2013–2014. Four questionnaires were face-to-face administered to 462 students after obtaining their written consent: Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Generalized Anxiety Disorder 7-item scale (GAD-7). Results The prevalence of clinically significant insomnia was 10.6% (95% CI: 7.8–13.4%), more frequent in first year students. ISI mean score was 10.06 (SD = 3.76). 37.1% of the participants were poor sleepers. Excessive daytime sleepiness (EDS) and poor sleep were significantly more frequent among participants with clinical insomnia (p = 0.031 and 0.001 respectively). Clinically significant anxiety was more frequent in students suffering from clinical insomnia (p = 0.006) and in poor sleepers (p = 0.003). 50.8% of the participants with clinically significant anxiety presented EDS versus 30.9% of those with no clinically significant anxiety (p<0.0001). Conclusions The magnitude of SDs in this sample of Lebanese university students demonstrate the importance of examining sleep health in this population. Moreover, the link between SD and anxiety reminds us of the importance of treating anxiety as soon as detected and not simply targeting the reduction of sleep problems.
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Affiliation(s)
- Nour Choueiry
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Tracy Salamoun
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Hicham Jabbour
- Department of Anesthesia and Critical Care, Hôtel-Dieu de France Hospital, Saint-Joseph University of Beirut, Beirut, Lebanon
- Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Nada El Osta
- Department of Public Health, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Department of Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Aline Hajj
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de qualité des médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Lydia Rabbaa Khabbaz
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de qualité des médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
- * E-mail:
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Poor Sleep in Multiple Sclerosis Correlates with Beck Depression Inventory Values, but Not with Polysomnographic Data. SLEEP DISORDERS 2016; 2016:8378423. [PMID: 26885399 PMCID: PMC4739473 DOI: 10.1155/2016/8378423] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 12/20/2015] [Accepted: 12/22/2015] [Indexed: 11/21/2022]
Abstract
Objectives. Pittsburgh Sleep Quality Index (PSQI) values correlate with depression, but studies investigating the relationship between PSQI values and polysomnographic (PSG) data showed inconsistent findings. Methods. Sixty-five consecutive patients with multiple sclerosis (MS) were retrospectively classified as “good sleepers” (GS) (PSQI ≤ 5) and “poor sleepers” (PS) (PSQI > 5). The PSG data and the values of the Visual Analog Scale (VAS) of fatigue, Modified Fatigue Impact Scale (MFIS), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), and the Beck Depression Inventory (BDI) were compared. Results. No significant differences were found either for PSG data or for ESS, MFIS, and FSS values; but PS showed significantly increased BDI and VAS values. Conclusions. Poor sleep is associated with increased depression and fatigue scale values.
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Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a common diagnosis in clinical practice. Excessive daytime sleepiness may be a warning for possible OSA. OBJECTIVES To assess the prevalence of excessive daytime sleepiness as measured by the Epworth Sleepiness Scale (ESS) in a rural community population; potential risk factors for OSA were also assessed. METHODS In 2010, a baseline respiratory health questionnaire within the Saskatchewan Rural Health Study was mailed to 11,982 households in Saskatchewan. A total of 7597 adults within the 4624 (42%) respondent households completed the ESS questionnaire. Participants were categorized according to normal or high (>10) ESS scores. Data obtained included respiratory symptoms, doctor-diagnosed sleep apnea, snoring, hypertension, smoking and demographics. Body mass index was calculated. Multivariable logistic regression analysis examined associations between high ESS scores and possible risk factors. Generalized estimating equations accounted for the two-tiered sampling procedure of the study design. RESULTS The mean age of respondents was 55.0 years and 49.2% were male. The prevalence of ESS>10 and 'doctor diagnosed' OSA were 15.9% and 6.0%, respectively. Approximately 23% of respondents reported loud snoring and 30% had a body mass index >30 kg⁄m2. Of those with 'doctor-diagnosed' OSA, 37.7% reported ESS>10 (P<0.0001) and 47.7% reported loud snoring (P<0.0001). Risk of having an ESS>10 score increased with age, male sex, obesity, lower socioeconomic status, marriage, loud snoring and doctor-diagnosed sinus trouble. CONCLUSIONS High levels of excessive daytime sleepiness in this particular rural population are common and men >55 years of age are at highest risk. Examination of reasons for residual sleepiness and snoring in persons with and without sleep apnea is warranted.
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