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Gervais C, Hjeij D, Fernández-Puerta L, Arbour C. Non-pharmacological interventions for sleep disruptions and fatigue after traumatic brain injury: a scoping review. Brain Inj 2024; 38:403-416. [PMID: 38402580 DOI: 10.1080/02699052.2024.2318599] [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: 04/28/2022] [Accepted: 02/09/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE The aim of this study was to conduct a scoping review to determine the nature, variety, and volume of empirical evidence on nonpharmacological interventions for sleep disturbances with potential implications for fatigue in adults sustaining a traumatic brain injury (TBI). METHODS A systematic literature search was conducted across four databases to identify primary studies testing a single non-pharmacological intervention or a combination of non-pharmacological interventions for sleep disturbances and fatigue in community-dwelling adults with TBI. RESULTS Sixteen studies were reviewed addressing six non-pharmacological interventions for sleep disruptions and fatigue after TBI including light therapy, cognitive-behavioral therapy, warm footbath application, shiatsu, and sleep hygiene protocol. Non-pharmacological interventions involving light or cognitive-behavioral therapy were reported in 75% of the studies. Actigraphy-based estimation of total sleep time and subjective level of fatigue were frequent outcomes. CONCLUSION While this scoping review has utility in describing existing non-pharmacological approaches to manage sleep and fatigue after TBI, the findings suggest that interventions are often developed without considering TBI individuals' source of motivation and the need for support in self-administration. Future studies may achieve greater sustainability by considering the evolving needs of TBI patients and their families and the drivers and barriers that might influence non-pharmacological intervention use at home.
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Affiliation(s)
- Charles Gervais
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Danny Hjeij
- Faculty of Nursing, Université de Montréal, Montreal, Canada
| | | | - Caroline Arbour
- Faculty of Nursing, Université de Montréal, Montreal, Canada
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Elliott JE, Tinsley CE, Reynolds C, Olson RJ, Weymann KB, Au-Yeung WTM, Wilkerson A, Kaye JA, Lim MM. Tunable White Light for Elders (TWLITE): A Protocol Demonstrating Feasibility and Acceptability for Deployment, Remote Data Collection, and Analysis of a Home-Based Lighting Intervention in Older Adults. SENSORS 2022; 22:s22145372. [PMID: 35891052 PMCID: PMC9320387 DOI: 10.3390/s22145372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/25/2022] [Accepted: 07/11/2022] [Indexed: 12/10/2022]
Abstract
Sleep disturbances are common in older adults and may contribute to disease progression in certain populations (e.g., Alzheimer's disease). Light therapy is a simple and cost-effective intervention to improve sleep. Primary barriers to light therapy are: (1) poor acceptability of the use of devices, and (2) inflexibility of current devices to deliver beyond a fixed light spectrum and throughout the entirety of the day. However, dynamic, tunable lighting integrated into the native home lighting system can potentially overcome these limitations. Herein, we describe our protocol to implement a whole-home tunable lighting system installed throughout the homes of healthy older adults already enrolled in an existing study with embedded home assessment platforms (Oregon Center for Aging & Technology-ORCATECH). Within ORCATECH, continuous data on room location, activity, sleep, and general health parameters are collected at a minute-to-minute resolution over years of participation. This single-arm longitudinal protocol collected participants' light usage in addition to ORCATECH outcome measures over a several month period before and after light installation. The protocol was implemented with four subjects living in three ORCATECH homes. Technical/usability challenges and feasibility/acceptability outcomes were explored. The successful implementation of our protocol supports the feasibility of implementing and integrating tunable whole-home lighting systems into an automated home-based assessment platform for continuous data collection of outcome variables, including long-term sleep measures. Challenges and iterative approaches are discussed. This protocol will inform the implementation of future clinical intervention trials using light therapy in patients at risk for developing Alzheimer's disease and related conditions.
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Affiliation(s)
- Jonathan E. Elliott
- VA Portland Health Care System, Research Service, Portland, OR 97239, USA; (J.E.E.); (C.E.T.); (R.J.O.)
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (C.R.); (W.-T.M.A.-Y.); (J.A.K.)
| | - Carolyn E. Tinsley
- VA Portland Health Care System, Research Service, Portland, OR 97239, USA; (J.E.E.); (C.E.T.); (R.J.O.)
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, USA
| | - Christina Reynolds
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (C.R.); (W.-T.M.A.-Y.); (J.A.K.)
| | - Randall J. Olson
- VA Portland Health Care System, Research Service, Portland, OR 97239, USA; (J.E.E.); (C.E.T.); (R.J.O.)
| | | | - Wan-Tai M. Au-Yeung
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (C.R.); (W.-T.M.A.-Y.); (J.A.K.)
| | | | - Jeffrey A. Kaye
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (C.R.); (W.-T.M.A.-Y.); (J.A.K.)
| | - Miranda M. Lim
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (C.R.); (W.-T.M.A.-Y.); (J.A.K.)
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, USA
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR 97239, USA
- Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, OR 97239, USA
- VA Portland Health Care System, Mental Illness Research Education and Clinical Center, Neurology, National Center for Rehabilitative Auditory Research, Portland, OR 97239, USA
- Correspondence: ; Tel.: +1-503-220-8262 (ext. 57404)
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Healthy Dwelling: Design of Biophilic Interior Environments Fostering Self-Care Practices for People Living with Migraines, Chronic Pain, and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042248. [PMID: 35206441 PMCID: PMC8871637 DOI: 10.3390/ijerph19042248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/22/2022]
Abstract
The benefits of biophilic interior design have been recognized by healthcare facilities, but residential environments receive relatively less attention with respect to improving the health of people living with chronic diseases. Recent “stay-at-home” restrictions due to the COVID-19 pandemic further emphasized the importance of creating interior spaces that directly and indirectly support physical and mental health. In this viewpoint article, we discuss opportunities for combining biophilic interventions with interior design, fostering disease-specific self-care. We provide examples of designing residential spaces integrating biophilic interventions, light therapy, relaxation opportunities, mindfulness meditation, listening to music, physical activities, aromatherapy, and quality sleep. These modalities can provide the clinical benefits of reducing migraine headaches and chronic pain, as well as improving depressive symptoms. The disease-specific interior environment can be incorporated into residential homes, workplaces, assisted-living residences, hospitals and hospital at home programs. This work aims to promote a cross-disciplinary dialogue towards combining biophilic design and advances in lifestyle medicine to create therapeutic interior environments and to improve healthcare outcomes.
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