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Zhang H, Rong H, Xiong S, Chen X, Lin Z. Intervention effect of electroacupuncture therapy on drug reducing and discontinuation of insomnia patients with long-term excessive use of zolpidem. Explore (NY) 2024; 20:328-333. [PMID: 37775407 DOI: 10.1016/j.explore.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/25/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE To explore therapeutic interventions after drug withdrawal reduction for insomnia patients who used zolpidem excessively for a long time. METHODS A total of 86 patients with simple insomnia were randomly rolled into treatment (Tre) group (electroacupuncture therapy under low-dose zolpidem+relaxation treatment intervention, n=40) and control (Ctrl) group (low-dose zolpidem+relaxation treatment intervention, n=40), all of which received treatment and intervention for four weeks. RESULTS As a result, after the dosage of zolpidem was gradually reduced, the deep sleep time of patients in the two groups was reduced in the first stage. However, with the prolongation of treatment time, the reduction trend of the two groups was gradually alleviated, but no great difference was found between groups (P>0.05). In the second stage of treatment, the deep sleep time of patients in the two groups gradually recovered and increased, and that in Tre group was greater than that in Ctrl group, and the upward trend was significant but differed slightly between groups (P>0.05). After treatment, the insomnia severity index (ISI) scores of the two groups gradually decreased, and that in Tre group was drastically inferior to those of Ctrl group on days 14 and 28 after treatment (both Ps<0.05). CONCLUSIONS In summary, electroacupuncture therapy can effectively alleviate the effect of zolpidem on sleep quality in patients with insomnia after drug discontinuation and promote the recovery of deep sleep time in patients, thereby alleviating the side effects and drug dependence of patients.
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Affiliation(s)
- Haixiao Zhang
- Department of Neurology, Hangzhou Red Cross Hospital, Hangzhou 310011, Zhejiang Province, China
| | - Haiqing Rong
- Specialty of Acupuncture and Moxibustion in the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Sangsang Xiong
- Specialty of Acupuncture and Moxibustion in the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Xilong Chen
- Specialty of Acupuncture and Moxibustion in the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Zhichuan Lin
- Department of Neurology, Hainan General Hospital, Haikou 570000, Hainan Province, China.
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Warren JR, Link RC, Cheng AL, Sinclair MK, Sorensen AA. Carpal tunnel syndrome and sleep, a systematic review and meta-analysis. Hand Surg Rehabil 2024:101698. [PMID: 38641062 DOI: 10.1016/j.hansur.2024.101698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND The most common symptom and reason patients seek treatment for carpal tunnel syndrome is lack of sleep. Our purpose was to determine how much sleep-related symptoms of carpal tunnel syndrome improve after carpal tunnel release using validated patient-reported outcome measures (PROMs) and objective sleep data as primary measures of interest. METHODS A PRISMA-guided literature search was conducted using Ovid MEDLINE, PubMed, Cochrane, and ClinicalTrials.gov. Only interventional clinical trials that examined primary outcome measures of interest were included. Patient-reported outcome measures underwent meta-analysis to determine how much scores improved following carpal tunnel release. RESULTS The Pittsburgh Sleep Quality Index improved significantly after carpal tunnel release, by 4.43 points and 6.02 points at 1-3 and 6-12 months postoperatively, respectively, and continued to improve up to 2 years. Improvement on the Insomnia Severity Index after carpal tunnel release was also significant, with improvement up to 1 year postoperatively, by 8.54 points and 9.05 points at 1-3 and 6-12 months, respectively. Insomnia Severity Index scores improved significantly after splinting as well. CONCLUSIONS The present meta-analysis determined to what extent patients can expect their sleep to improve after operative and non-operative intervention, as measured by various patient-reported outcome measures that assess sleep. The Pittsburgh Sleep Quality Index and Insomnia Severity Index correlated very well between studies and across hundreds of patients with carpal tunnel syndrome. Data are lacking to define the minimal clinically important difference and assess whether patients achieve a minimal clinically important difference for sleep questionnaires; more information on this topic is needed. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Jonathan R Warren
- Department of Orthopaedic Surgery, University of Missouri Kansas City, 2301 Holmes St. Kansas City, MO 64063, USA.
| | - R Clayton Link
- Department of Orthopaedic Surgery, University of Missouri Kansas City, 2301 Holmes St. Kansas City, MO 64063, USA
| | - An-Lin Cheng
- Department of Orthopaedic Surgery, University of Missouri Kansas City, 2301 Holmes St. Kansas City, MO 64063, USA
| | - Micah K Sinclair
- Department of Orthopaedic Surgery, University of California Davis, 4860 Y St #1700, Sacramento, CA 95817, USA
| | - Amelia A Sorensen
- Department of Orthopaedic Surgery, University of Missouri Kansas City, 2301 Holmes St. Kansas City, MO 64063, USA
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Wang S, Jülich ST, Lei X. Latent profile of the insomnia severity index: A longitudinal study. Sleep Med 2024; 115:202-209. [PMID: 38368737 DOI: 10.1016/j.sleep.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/01/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024]
Abstract
STUDY OBJECTIVES To identify the distinct classification of insomnia symptoms and to explore their association with sleep problems and depression. METHODS Latent profile analysis was used to examine patterns of insomnia symptoms in two samples. Discovery and replication samples comprised 1043 (Mean age at baseline = 18.95 ± 0.93 years, 62.2% females) and 729 (Mean age at baseline = 18.71 ± 1.02 years, 66.4% females) college students, respectively. Participants completed measures of sleep problems (insomnia symptoms, sleep quality, susceptibility to insomnia, perceived consequences of insomnia, dream recall frequency, and percentage of recurring nightmares) and other psychological variables (rumination and depression). Binary logistic regression was used to analyze the effects of different types of insomnia symptoms at baseline on sleep problems and depression two years later. RESULTS Four classes of insomnia symptoms were identified, and classified as "non-insomnia" (class 1, 45.7%), "mild subjective symptoms but severe subjective feelings" (class 2, 23.9%), "severe subjective symptoms but mild subjective feelings" (class 3, 22.0%), and "high insomnia risk" (class 4, 8.4%), respectively. Compared with the group classified as non-insomnia group, other classifications significantly predicted insomnia two years later, only class 4 significantly predicted depression, and class 3 significantly predicted susceptibility to insomnia, after adjusting gender, insomnia, depression, and susceptibility to insomnia at baseline. CONCLUSIONS The findings highlighted the importance of identifying the patterns of insomnia symptoms, and the need for tailored intervention to improve sleep problems. Additionally, when screening for insomnia symptoms, simplified screening using Insomnia Severity Index (ISI) dimensions or items should be considered.
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Affiliation(s)
- Shuo Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, 400715, China
| | - Simon Theodor Jülich
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, 400715, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, 400715, China.
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Wu D, Wang X, Lin S, Xu G, Tian J, Ma X. Predicting insomnia severity using structure-function coupling in female chronic insomnia patients. Behav Brain Res 2023; 441:114283. [PMID: 36621579 DOI: 10.1016/j.bbr.2023.114283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/13/2022] [Accepted: 01/02/2023] [Indexed: 01/07/2023]
Abstract
Functional connectivity between brain regions is constrained by the underlying structural pathways. However, how this structure-function coupling is disrupted in female patients with insomnia disorder is unclear. This study examines if the whole-brain pattern of structure-function coupling could be used to predict unseen female patients' insomnia severity index. Resting-state functional MRI and diffusion-weighted imaging were performed in 82 female participants with chronic insomnia. Structure-function coupling was computed using the Spearman rank correlations between structural and functional connectivity profiles. Using relevance vector regression approach and 10-fold cross-validation, we predicted the individuals' insomnia severity index using the pattern of whole-brain structure-function coupling. Finally, we extracted the contribution of each regional coupling to the prediction model. The pattern of structure-function coupling could be used to significantly predict unseen individuals' insomnia severity index scores (r = 0.29, permutation P < 0.001; mean absolute error (MAE) = 4.59, permutation P < 0.001). Moreover, the brain regions with high functional hierarchy, including regions in the default mode network, mainly displayed negative contribution weights, while the regions with lower functional hierarchy, including occipital regions and the precentral gyrus, mainly displayed positive contribution weights. This is the first study to demonstrate an association between structure-function coupling and the insomnia severity index in females with insomnia disorder. Importantly, our data suggest that insomnia severity is associated with a reduction in structure-function coupling in higher-order brain regions and an increase in structure-function coupling in lower-order brain regions.
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Affiliation(s)
- Dongyan Wu
- Department of Neurology, China-Japan Friendship Hospital, Beijing, PR China
| | - Xinzhi Wang
- Department of Radiology, Guangdong Second Provincial General Hospital, Guangzhou, PR China
| | - Shiqi Lin
- Department of Radiology, Guangdong Second Provincial General Hospital, Guangzhou, PR China
| | - Guang Xu
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, PR China
| | - Junzhang Tian
- Department of Radiology, Guangdong Second Provincial General Hospital, Guangzhou, PR China
| | - Xiaofen Ma
- Department of Radiology, Guangdong Second Provincial General Hospital, Guangzhou, PR China.
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Jahrami HA, Fekih-Romdhane F, Saif ZQ, Alhaj OA, AlRasheed MM, Pandi-Perumal SR, BaHammam AS, Vitiello MV. Sleep dissatisfaction is a potential marker for nomophobia in adults. Sleep Med 2022; 98:152-157. [PMID: 35868112 DOI: 10.1016/j.sleep.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/16/2022] [Accepted: 07/01/2022] [Indexed: 12/22/2022]
Abstract
INTRODUCTION NOMOPHOBIA is a term used to describe an anxiety disorder in which people fear being disconnected from their mobile phones. Strong associations between nomophobia and insomnia have previously been documented. However, there is no clear explanation for this relationship between the two disorders. The present study was designed to first determine the diagnostic precision of the Insomnia Severity Index (ISI) various components in detecting or classifying nomophobia; and second, examine the diagnostic performance of the identified ISI components in classifying nomophobia. METHODS From a previous study 549 participants completed demographic information, the Nomophobia Questionnaire (NMP-Q), and the ISI. The sample was divided into two parts so that each part represented the original sample, using a 40% (n = 209) allocation for sample 1 and 60% (n = 340) for sample 2. To determine common components between nomophobia and insomnia, an exploratory factor analysis was performed using sample 1 to determine the diagnostic precision of the ISI's various components in detecting or classifying nomophobia. A test of the ISI and a cut-off value (ISI-4 ≥2) was then conducted on Sample 2 to determine whether they would accurately identify significant nomophobia. RESULTS Sleep dissatisfaction was a common component of insomnia and nomophobia. Sleep dissatisfaction had excellent diagnostic accuracy in detecting individuals with nomophobia (sensitivity 75.13%, specificity 100%, Youden' index 0.75, area under curve 0.88). CONCLUSION Questioning patients sleep dissatisfaction may serve as a marker for both nomophobia and insomnia, both of which may demand more comprehensive evaluation.
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Affiliation(s)
- Haitham A Jahrami
- Ministry of Health, Bahrain; College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain.
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Psychiatry Department "Ibn Omrane", Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | | | - Omar A Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Science, University of Petra, Amman, Jordan
| | - Maha M AlRasheed
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; Princess Nora bint Abdul Rahman University, Riyadh, Saudi Arabia
| | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., College Street, Toronto, Canada; Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Ahmed S BaHammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Saudi Arabia; The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | - Michael V Vitiello
- Psychiatry & Behavioral Sciences, Gerontology & Geriatric Medicine, and Biobehavioral Nursing, University of Washington, Seattle, WA, 98195-6560, United States
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Kohli S, Diwan S, Kumar A, Kohli S, Aggarwal S, Sood A, Sachdeva HC, Usha G. Depression, Anxiety, Stress, and Insomnia amongst COVID Warriors across Several Hospitals after Second Wave: Have We Acclimatized? A Cross-sectional Survey. Indian J Crit Care Med 2022; 26:825-832. [PMID: 36864854 PMCID: PMC9973192 DOI: 10.5005/jp-journals-10071-24238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Coronavirus disease-2019 (COVID-19) pandemic has been a cause of significant mental health disturbances in medical health personnel. However, 18 months into the pandemic, healthcare workers (HCWs) have become accustomed to the heightened stress and anxiety that comes with caring for COVID patients. Through this study, we aim to measure depression, anxiety, stress, and insomnia in doctors with the help of validated scales. Materials and methods This was a cross-sectional study with an online survey design conducted among doctors from major hospitals in New Delhi. The questionnaire included participant demographics, including designation, specialty, marital status, and living arrangements. This was followed by questions from the validated depression, anxiety, stress scale (DASS-21), and insomnia severity index (ISI). Depression, anxiety, stress, and insomnia scores were calculated for each participant, and the data were analyzed statistically. Results The mean scores of the whole study population showed no depression, moderate anxiety, mild stress, and subthreshold insomnia. Female doctors exhibited more psychological issues (mild depression and stress, moderate anxiety, but only subthreshold insomnia) as compared to males (mild anxiety, but no depression, stress, and insomnia). Junior doctors also had higher depression, anxiety, and stress scores than senior doctors. Similarly, single doctors, those living alone, and those not having kids had higher DASS and insomnia scores. Discussion HCWs have been under tremendous mental stress during this pandemic which is influenced by multiple factors. Female sex, junior doctors, working on the frontline, not being in a relationship, and living alone may be some of the factors recognized in our study and corroborated by many authors, which may increase the chances of depression, anxiety, and stress in them. HCWs need regular counseling, time off for rejuvenation, and social support to overcome this hurdle. How to cite this article Kohli S, Diwan S, Kumar A, Kohli S, Aggarwal S, Sood A, et al. Depression, Anxiety, Stress, and Insomnia amongst COVID Warriors across Several Hospitals after Second Wave: Have We Acclimatized? A Cross-sectional Survey. Indian J Crit Care Med 2022;26(7):825-832.
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Affiliation(s)
- Santvana Kohli
- Department of Anesthesia and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sahil Diwan
- Department of Anesthesia and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Ajay Kumar
- Department of Anesthesia and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sanchaita Kohli
- Department of Maxillofacial Surgery, CK Birla Hospital, New Delhi, India
| | - Shipra Aggarwal
- Department of Anesthesia and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India,Shipra Aggarwal, Department of Anesthesia and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India, Phone: +91 9811420866, e-mail:
| | - Aakar Sood
- Department of Maxillofacial Surgery, CK Birla Hospital, New Delhi, India
| | - Harish Chander Sachdeva
- Department of Anesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - G Usha
- Department of Anesthesia and Critical Care Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Kraepelien M, Blom K, Forsell E, Hentati Isacsson N, Bjurner P, Morin CM, Jernelöv S, Kaldo V. A very brief self-report scale for measuring insomnia severity using two items from the Insomnia Severity Index - development and validation in a clinical population. Sleep Med 2021; 81:365-374. [PMID: 33813233 DOI: 10.1016/j.sleep.2021.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To develop a very brief scale with selected items from the Insomnia Severity Index (ISI), and to investigate the psychometric properties of the proposed scale in a psychiatric sample. METHODS Patient data from seven Cognitive Behavioral Therapy (CBT) for insomnia trials and from regular care were used in psychometric analyses (N = 280-15 653). The samples included patients screening (N = 6936) or receiving treatment (N = 1725) for insomnia and other psychiatric conditions. Six criteria relating to component structure, sensitivity to change and clinical representativeness were used to select items. Psychometric analyses for the proposed very brief scale were performed. RESULTS One item representing satisfaction/dissatisfaction with current sleep pattern and one item representing interferences with daily functioning, were selected to create the 2-item ISI version. Correlations with the full scale were high at screening, pre and post, and for change (0.82-0.94). Categorical omega was ⍵C = 0.86. With a cut-off of 6 points, the scale could detect Insomnia Disorder with a sensitivity of 84% and a specificity of 76%, which was close to the full ISI showing 86% and 80% respectively. CONCLUSIONS The systematic psychometric evaluation based on a large sample from different contexts makes the proposed 2-item ISI version (ISI-2) a strong candidate for a very brief scale measuring insomnia, both for detecting cases and for measuring change during CBT with an overall high discriminative validity. ISI-2 is especially useful in clinical settings or population studies where there is a need to measure more than one condition at a time without overburdening patients. CLINICAL TRIALS Trials used in this analysis: ClinicalTrials.gov identifier: NCT01105052 (https://www.clinicaltrials.gov/ct2/show/NCT01105052) (sample b), ClinicalTrials.gov identifier: NCT01256099 (https://clinicaltrials.gov/ct2/show/NCT01256099) (sample c and d), German clinical trial (DRKS), registration ID: DRKS00008745 (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00008745) (sample e), ClinicalTrials.gov identifier: NCT01663844 (https://clinicaltrials.gov/ct2/show/NCT01663844) (sample f and g), ClinicalTrials.gov Identifier: NCT02743338 (https://clinicaltrials.gov/ct2/show/NCT02743338) (sample h).
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Affiliation(s)
- Martin Kraepelien
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Kerstin Blom
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Erik Forsell
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Nils Hentati Isacsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Pontus Bjurner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Charles M Morin
- School of Psychology and Centre de recherche CERVO, Université Laval, Quebec City, Canada
| | - Susanna Jernelöv
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Viktor Kaldo
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
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Löwing K, Gyllensvärd M, Tedroff K. Exploring sleep problems in young children with cerebral palsy - A population-based study. Eur J Paediatr Neurol 2020; 28:186-192. [PMID: 32669213 DOI: 10.1016/j.ejpn.2020.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/01/2020] [Accepted: 06/15/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To describe and explore sleep problems in a population-based cohort of young children with cerebral palsy (CP) in Stockholm, Sweden. METHODS All children with CP, aged 5-10 years, and living in the Northern Karolinska University Hospital's catchment area were invited to participate in a cross-sectional study. Medical records obtained in the previous two-year period were reviewed, and a pre-planned parental telephone interview that included five structured questions and the Insomnia Severity Index (ISI) was conducted. RESULTS In total, 118 children, with a mean age of 7.4 years (SD 1.5), were included. Bilateral CP was present in 45%, unilateral in 37%, dyskinetic in 15%, and ataxic CP in 3%. Parents of 81% of the children participated in the interview. They reported sleep problems in 41% of their children, and in 80% of these children, night-time sleep was negatively affected by pain. Differences between the ISI total score in relation to CP subtypes (p < 0.025) and levels in GMFCS-E&R (p < 0.001) were detected, with increasing sleep problems for children with dyskinetic CP and children in GMFCS-E&R V. Sleep problems affected by pain were associated to the total score at ISI (rs = 0.83, p < 0.001, n = 95). CONCLUSION The results identified that sleep problems were present in more than 40% of children with CP. Sleep problems were more frequently and extensively present in children with dyskinetic CP and children in GMFCS-E&R level V. Sleep problems were associated with the presence of pain and, in particular, in the most severely affected children.
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Affiliation(s)
- Kristina Löwing
- Department of Women's & Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
| | - Mirja Gyllensvärd
- Department of Women's & Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Tedroff
- Department of Women's & Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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9
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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GHAFARZADEH J, SADEGHNIIAT-HAGHIGHI K, SADEGHPOUR O, AKBARPOUR S, AMINI-BEHBAHANI F. Investigating the Prevalence of Sleep Disorder and the Impact of Sweet Almond on the Quality of Sleep in Students of Tehran, Iran. Iran J Public Health 2019; 48:1149-1154. [PMID: 31341858 PMCID: PMC6635337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Insomnia is an important problem in medical sciences students and has implications for their educational progress. The current study aimed to estimate the prevalence of sleep disorders and investigating the impact of sweet almond on quality of sleep in students of the Tehran University of Medical Sciences (TUMS), Tehran, Iran who live in dormitories. METHODS This is a before-after study conducted in 2017. At first, using the ISI questionnaire prevalence of sleep disorders was determined. Sweet almond was the study intervention. Each day, 10 almonds were given to 446 students for 14 d. At the end of the second week, again ISI questionnaire was filled. SPSS was used to analyze data. The McNemar, Wilcoxson Signed Ranks, and Repeated Measures tests were used. RESULTS Out of 442 participants, 217 (49.1%) were female. Before intervention, 343 (77.6%) had insomnia and 99 (22.4%) had normal sleep. After intervention, 306 (69.2%) had insomnia and 136 (30.8%) had normal sleep. Having sweet almond for two weeks is associated with reducing insomnia (P<0.05). Investigating the almond impact in different categories also showed that it has a reducing impact on severe, mild, weak and normal sleep categories (P<0.05). CONCLUSION Sweet almond has impacts on quality of sleep of those students of the TUMS that are living in dormitories. Intervention programs to improve quality of sleep are necessary and with regard to the high prevalence of insomnia, students must be protected, guided and consulted.
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Affiliation(s)
- Jafar GHAFARZADEH
- Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Omid SADEGHPOUR
- Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Samaneh AKBARPOUR
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad AMINI-BEHBAHANI
- Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran,Corresponding Author:
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Raikes AC, Athey A, Alfonso-Miller P, Killgore WDS, Grandner MA. Insomnia and daytime sleepiness: risk factors for sports-related concussion. Sleep Med 2019; 58:66-74. [PMID: 31132574 DOI: 10.1016/j.sleep.2019.03.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE/BACKGROUND Poor quality and inadequate sleep are associated with impaired cognitive, motor, and behavioral components of sport performance and increased injury risk. While prior work identifies sports-related concussions as predisposing factors for poor sleep, the role of sleep as a sports-related concussion risk factor is unknown. The purpose of this study was to quantify the effect of poor sleep quality and insomnia symptoms on future sports-related concussion risk. PATIENTS/METHODS In this study, 190 NCAA Division-1 athletes completed a survey battery, including the Insomnia Severity Index (ISI) and National Health and Nutrition Examination Survey (NHANES) Sleep module. Univariate risk ratios for future sports-related concussions were computed with ISI and NHANES sleepiness scores as independent predictors. An additional multiple logistic regression model including sport, sports-related concussion history, and significant univariate predictors jointly assessed the odds of sustaining a concussion. RESULTS Clinically moderate-to-severe insomnia severity (RR = 3.13, 95% CI: 1.320-7.424, p = 0.015) and excessive daytime sleepiness two or more times per month (RR = 2.856, 95% CI: 0.681-11.977, p = 0.037) increased concussion risk. These variables remained significant and comparable in magnitude in a multivariate model adjusted for sport participation. CONCLUSION Insomnia and daytime sleepiness are independently associated with increased sports-related concussion risk. More completely identifying bidirectional relationships between concussions and sleep requires further research. Clinicians and athletes should be cognizant of this relationship and take proactive measures - including assessing and treating sleep-disordered breathing, limiting insomnia risk factors, improving sleep hygiene, and developing daytime sleepiness management strategies - to reduce sports-related concussion risk and support overall athletic performance.
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Affiliation(s)
- Adam C Raikes
- Social, Cognitive, and Affective Neuroscience (SCAN) Lab, University of Arizona, Tucson, AZ, United States.
| | - Amy Athey
- Department of Athletics, University of Arizona, Tucson, AZ, United States
| | | | - William D S Killgore
- Social, Cognitive, and Affective Neuroscience (SCAN) Lab, University of Arizona, Tucson, AZ, United States
| | - Michael A Grandner
- Sleep and Health Research Program, University of Arizona, Tucson, AZ, United States
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Seow LSE, Abdin E, Chang S, Chong SA, Subramaniam M. Identifying the best sleep measure to screen clinical insomnia in a psychiatric population. Sleep Med 2017; 41:86-93. [PMID: 29425582 DOI: 10.1016/j.sleep.2017.09.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/29/2017] [Accepted: 09/13/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Insomnia symptoms are highly prevalent among patients with psychiatric disorders, and this mandates the need to identify the best self-administered sleep measure to screen for clinical insomnia among them. METHODS A total of 400 psychiatric outpatients completed the Pittsburgh Sleep Quality Index, Insomnia Severity Index (ISI), Epworth Sleepiness Scale, Flinders Fatigue Scale, Functional Outcomes of Sleep Questionnaire, and Dysfunctional Beliefs and Attitudes about Sleep Scale in a cross-sectional study. The sensitivity, specificity, positive, and negative predictive values of these six sleep scales were assessed and compared in relation to both ICD-10 and DSM-5 insomnia disorder status established using the interviewer-administered Brief Insomnia Questionnaire. RESULTS Receiver operator characteristic curves with the area under the curve (AUC) revealed the ISI to be the most accurate measure to discriminate cases and non-cases on both ICD-10 (AUC = 0.88, 95% CI = 0.84-0.92) and DSM-5 (AUC = 0.82, 95% CI = 0.78-0.86) criteria with "good" accuracy. The cut-off scores of ≥14 and ≥ 11 for the ISI provided optimal sensitivity and specificity for the detection of ICD-10 and DSM-5 insomnia, respectively. DISCUSSION With the new calling from DSM-5 to treat sleep symptoms in the presence of a co-existing mental condition, early detection of psychiatric patients with clinically significantly insomnia using a simple but accurate self-report sleep measure becomes important. Our study suggests that the ISI could be used as a potential screening tool for comorbid insomnia disorder in patients with mental disorders.
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Affiliation(s)
| | | | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Rubio-Arias JÁ, Marín-Cascales E, Ramos-Campo DJ, Hernandez AV, Pérez-López FR. Effect of exercise on sleep quality and insomnia in middle-aged women: A systematic review and meta-analysis of randomized controlled trials. Maturitas 2017; 100:49-56. [PMID: 28539176 DOI: 10.1016/j.maturitas.2017.04.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 04/03/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We assessed the effects of programmed exercise (PE) on sleep quality and insomnia in middle-aged women (MAW). METHODS Searches were conducted in five databases from inception through December 15, 2016 for randomized controlled trials (RCTs) evaluating the effects of PE versus a non-exercising control condition on sleep quality, sleep disturbance and/or insomnia in MAW. Interventions had to last at least 8 weeks. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and insomnia with the Insomnia Severity Index (ISI). Random effects models were used for meta-analyses. The effects on outcomes were expressed as mean differences (MDs) and their 95% confidence intervals (CI). RESULTS Five publications reported data from four RCTs on PE effects during 12-16 weeks on sleep quality (n=4 studies reporting PSQI results) and/or insomnia (n=3 studies reporting ISI results), including 660 MAW. Low-moderate levels of exercise significantly lowered the PSQI score (MD=-1.34; 95% CI -2.67, 0.00; p=0.05) compared with controls. In a subgroup analysis, moderate PE (aerobic exercise) had a positive effect on sleep quality (PSQI score MD=-1.85; 95% CI -3.62, -0.07; p=0.04), while low levels of physical activity (yoga) did not have a significant effect (MD-0.46, 95% CI -1.79, 0.88, p=0.50). In three studies (two studies of yoga, one study of aerobic exercise), there was a non-significant reduction in the severity of insomnia measured with the ISI score (MD -1.44, 95% CI -3.28, 0. 44, p=0.13) compared with controls. Heterogeneity of effects among studies was moderate to high. CONCLUSION In middle-aged women, programmed exercise improved sleep quality but had no significant effect on the severity of insomnia.
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Affiliation(s)
- Jacobo Á Rubio-Arias
- Department of Physical Activity and Sports Sciences, Faculty of Sports and Research Center for High Performance Sport, Catholic University of Murcia (UCAM), Murcia, Spain
| | - Elena Marín-Cascales
- Department of Physical Activity and Sports Sciences, Faculty of Sports and Research Center for High Performance Sport, Catholic University of Murcia (UCAM), Murcia, Spain
| | - Domingo J Ramos-Campo
- Department of Physical Activity and Sports Sciences, Faculty of Sports and Research Center for High Performance Sport, Catholic University of Murcia (UCAM), Murcia, Spain
| | - Adrian V Hernandez
- School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima 9, Peru,University of Connecticut/Hartford Hospital Evidence-based Practice Center, 80 Seymour St, Hartford, CT 06102, USA
| | - Faustino R Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine and Lozano-Blesa University Hospital, Domingo Miral s/n, Zaragoza 50009, Spain.
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Veqar Z, Moiz JA, Hussain ME. Psychometric Analysis of the Pittsburgh Insomnia Rating Scale among University Population of Poor Sleepers in India. N Am J Med Sci 2014; 6:161-7. [PMID: 24843848 PMCID: PMC4024582 DOI: 10.4103/1947-2714.131238] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: Pittsburgh insomnia rating scale is a 65 item self administered open source questionnaire. The scale is widely used in clinical practice but its psychometric properties are not well established. Therefore keeping in mind this lacuna the current study was designed for university population of poor sleepers in India. Aims: The purpose of this study was to establish the Pittsburgh sleep Quality Index test- retest reliability, validity and internal consistency of Pittsburgh insomnia rating scale. Materials and Methods: Twenty five subjects were randomly chosen from the screened population of poor sleepers. Pittsburgh insomnia rating scale, Pittsburgh sleep quality index and Insomnia severity index were administered on test day. Retest was administered after one week. Results: Eight males and seventeen females with mean age 24 + 7.04 were recruited. The test retest reliability for Pittsburgh insomnia rating scale total score showed excellent reliability (ICC2,1-0.93). The results also show that the total score is moderately correlated with Pittsburgh sleep Quality Index (r-0.31) and moderately correlated with Insomnia severity index (r-0.49). Internal consistency for the test was excellent (Cronbach's alpha- 0.930) Conclusion: The study findings suggest that Pittsburgh insomnia rating scale has excellent internal consistency, test-retest reliability and good validity for university population of poor sleepers in India. It is an important first line of assessment scale for screening of sleep problems.
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Affiliation(s)
- Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A central university), New Delhi, India
| | - Jamal Ali Moiz
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A central university), New Delhi, India
| | - Mohammed Ejaz Hussain
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A central university), New Delhi, India
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