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Mattos MK, Bernacchi V, Shaffer KM, Gallagher V, Seo S, Jepson L, Manning C. Sleep and Caregiver Burden Among Caregivers of Persons Living With Dementia: A Scoping Review. Innov Aging 2024; 8:igae005. [PMID: 38420182 PMCID: PMC10901478 DOI: 10.1093/geroni/igae005] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Indexed: 03/02/2024] Open
Abstract
Background and Objectives Caregivers of persons with dementia report worse sleep when compared to the general population. The objective of this review was to synthesize evidence regarding the link between caregiver burden and dementia caregivers' sleep. Research Design and Methods We conducted a scoping review using a systematic search for pertinent literature in PubMed, CINAHL, and Web of Science through March 2022. Keywords included content areas of dementia, caregiver burden, and sleep. Inclusion criteria were informal caregivers of persons living with dementia, a measured relationship between informal dementia caregiver sleep and subjective caregiver burden variables, and original research. Non-English studies were excluded. Extracted data were organized in tables, compared, and synthesized. Results The search yielded 540 nonduplicate articles screened by title and abstract; 118 full-text articles were reviewed; 24 were included. Most studies were cross-sectional, with variable sample sizes. Dementia caregivers had significantly poorer overall perceived sleep than noncaregivers across 4 studies that examined self-reported sleep measures. Eighteen studies investigated the association between caregiver burden and self-reported sleep quality, with 14 reporting a significant positive association between caregiver burden and self-reported sleep quality, and 4 finding null results. Only 2 of the 4 studies reporting the association between caregiver burden and objective sleep parameters (ie, actigraphy and polysomnography) reported a significant positive association for at least one sleep subdomain. Discussion and Implications Although subjective sleep quality is commonly affected by dementia caregiving burden, there is a lack of corresponding evidence on the relationship between burden and objective sleep metrics. Healthcare providers should consider the dementia caregiver burden's impact on sleep and regularly assess caregivers' sleep difficulties. Future studies should focus on consistently measuring caregiver burden and sleep to promote dementia caregiver health and well-being.
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Affiliation(s)
- Meghan K Mattos
- Acute and Specialty Care Department, School of Nursing, University of Virginia, Charlottesville, Virginia, USA
- Division of Geriatrics, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Veronica Bernacchi
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Kelly M Shaffer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Virginia Gallagher
- Department of Neurology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Shinae Seo
- Acute and Specialty Care Department, School of Nursing, University of Virginia, Charlottesville, Virginia, USA
| | - Laura Jepson
- Acute and Specialty Care Department, School of Nursing, University of Virginia, Charlottesville, Virginia, USA
| | - Carol Manning
- Department of Neurology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
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Mattos M, Bernacchi V, Shaffer K, Gallagher V, Seo S, Manning C. SLEEP AND CAREGIVER BURDEN FOR CAREGIVERS OF PERSONS WITH DEMENTIA: A SCOPING REVIEW. Innov Aging 2022. [PMCID: PMC9767115 DOI: 10.1093/geroni/igac059.2917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Caregivers of persons with dementia report worse sleep when compared to the general population. This scoping review synthesizes evidence regarding the link between caregiver burden and dementia caregivers’ sleep. A systematic search was completed in PubMed, CINAHL, PsycINFO, and Web of Science for pertinent literature published through March 2022. Included original research articles studied informal adult caregivers of persons living with mild cognitive impairment or dementia, documented the relationship between subjective caregiver burden and caregiver sleep, and were written in English. Extracted data were organized in tables, compared, and synthesized. The search yielded 540 non-duplicate articles screened by title and abstract; 118 full-text articles were reviewed; of these, 26 were included. Most studies were cross-sectional, with variable sample sizes (range n=40–669). Sleep was operationalized across the 25 quantitative studies in terms of subjective quality (n=19) and objective sleep parameters using actigraphy (n=4), and polysomnography (n=2). Of studies reporting subjective sleep quality, 16 reported a significant positive association between caregiver burden (84%) with the remaining found null results. Half of the studies that used objective measures of sleep (actigraphy and polysomnography) found a positive association between sleep and caregiver burden, while the other half did not (n=3). Results suggest that, while subjective sleep quality is commonly impacted by dementia caregiving burden, there is a lack of corresponding evidence on the relationship between burden and objective sleep metrics. Caregiver burden was also not measured consistently across studies, and future studies should focus on consistent measurement of caregiver burden and determination of directionality.
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Affiliation(s)
- Meghan Mattos
- University of Virginia, School of Nursing, Charlottesville, Virginia, United States
| | - Veronica Bernacchi
- Penn State College of Medicine, State College, Pennsylvania, United States
| | - Kelly Shaffer
- University of Virginia, Charlottesville, Virginia, United States
| | | | - Shinae Seo
- University of Virginia, School of Nursing, Charlottesville, Virginia, United States
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Chen Y, Herrold AA, Gallagher V, Martinovich Z, Bari S, Vike NL, Vesci B, Mjaanes J, McCloskey LR, Reilly JL, Breiter HC. Preliminary Report: Localized Cerebral Blood Flow Mediates the Relationship between Progesterone and Perceived Stress Symptoms among Female Collegiate Club Athletes after Mild Traumatic Brain Injury. J Neurotrauma 2021; 38:1809-1820. [PMID: 33470158 PMCID: PMC8336258 DOI: 10.1089/neu.2020.7217] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Female athletes are under-studied in the field of concussion research, despite evidence of higher injury prevalence and longer recovery time. Hormonal fluctuations caused by the natural menstrual cycle (MC) or hormonal contraceptive (HC) use impact both post-injury symptoms and neuroimaging findings, but the relationships among hormone, symptoms, and brain-based measures have not been jointly considered in concussion studies. In this preliminary study, we compared cerebral blood flow (CBF) measured with arterial spin labeling between concussed female club athletes 3-10 days after mild traumatic brain injury (mTBI) and demographic, HC/MC matched controls (CON). We tested whether CBF statistically mediates the relationship between progesterone serum levels and post-injury symptoms, which may support a hypothesis for progesterone's role in neuroprotection. We found a significant three-way relationship among progesterone, CBF, and perceived stress score (PSS) in the left middle temporal gyrus for the mTBI group. Higher progesterone was associated with lower (more normative) PSS, as well as higher (more normative) CBF. CBF mediates 100% of the relationship between progesterone and PSS (Sobel p value = 0.017). These findings support a hypothesis for progesterone having a neuroprotective role after concussion and highlight the importance of controlling for the effects of sex hormones in future concussion studies.
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Affiliation(s)
- Yufen Chen
- Center for Translational Imaging, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Virginia Gallagher
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Zoran Martinovich
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sumra Bari
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nicole L. Vike
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brian Vesci
- Northwestern Health Services Sports Medicine, Northwestern University, Evanston, Illinois, USA
| | - Jeffrey Mjaanes
- Northwestern Health Services Sports Medicine, Northwestern University, Evanston, Illinois, USA
| | - Leanne R. McCloskey
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - James L. Reilly
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Hans C. Breiter
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Laboratory of Neuroimaging and Genetics, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Gallagher V, Vesci B, Mjaanes J, Breiter H, Chen Y, Herrold A, Reilly J. Eye movement performance and clinical outcomes among female athletes post-concussion. Brain Inj 2020; 34:1674-1684. [PMID: 33103479 DOI: 10.1080/02699052.2020.1830173] [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] [Indexed: 10/23/2022]
Abstract
BACKGROUND Most post-concussion eye movement (EM) research involves predominantly male samples. We evaluated pro- (PRO; reflexive shift of visual attention to target) and anti- (ANTI; executive control of visual attention away from target) computer-based saccade task performance among female, collegiate athletes with recent concussion (CON) versus healthy-control athletes (HC). We evaluated the relationship between EM performance and post-concussion outcomes. We hypothesized ANTI performance would differ among CON and HC due to greater executive control demands, and that EM performance (both tasks) would be associated with clinical outcomes in CON. METHODS 16 CON (assessed 4-10 days post-injury [M = 6.87, SD = 2.15 days]) and 16 age-matched HC athletes were recruited. General linear mixed modeling and Pearson's correlations were used. RESULTS On ANTI, CON demonstrated higher error rate [F(1,2863) = 12.650, p<.001] and shorter latency on error trials [F(1,469) = 5.976, p=.015] relative to HC. Multiple EM measures were associated with clinical outcomes: PRO duration predicted days to symptom remission (r=.44, p <.05); ANTI error rate was associated with symptom burden on the day of testing (r=.27, p <.05). CONCLUSION This study demonstrates promising utility of EM measures to detect cognitive control and sensorimotor effects of concussion among female athletes and their use as a prognostic indicators of recovery.
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Affiliation(s)
- Virginia Gallagher
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA
| | - Brian Vesci
- Department of Sports Medicine, Northwestern University , Evanston, Illinois, USA
| | - Jeffrey Mjaanes
- Department of Sports Medicine, Northwestern University , Evanston, Illinois, USA
| | - Hans Breiter
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA.,Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA
| | - Yufen Chen
- Center for Translational Imaging, Department of Radiology, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA
| | - Amy Herrold
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA.,Research Health Scientist, Edward Hines, Jr. VA Hospital , Hines IL, Oregon, USA
| | - James Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, Illinois, USA
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Gallagher V, Kramer N, Abbott K, Alexander J, Breiter H, Herrold A, Lindley T, Mjaanes J, Reilly J. The Effects of Sex Differences and Hormonal Contraception on Outcomes after Collegiate Sports-Related Concussion. J Neurotrauma 2018; 35:1242-1247. [PMID: 29336208 DOI: 10.1089/neu.2017.5453] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is conflicting evidence regarding whether females are more adversely affected after concussion than males. Further, recent research suggests that hormonal contraceptive (HC) use may affect symptom severity and duration post-concussion. The objective of this study was to examine the effects of sex and HC use on outcomes following concussion among collegiate varsity athletes. We hypothesized that females would have longer length of recovery (LOR), and that peak symptom severity would be associated with longer LOR in both males and females. Among females, we hypothesized that non-HC users would have longer LOR and higher peak symptom severity than HC users. Ninety collegiate student-athletes were included in this study (40 males, 50 females; 24 HC users, 25 non-HC users). Demographic, injury, and recovery information was abstracted via retrospective record review. LOR was defined as days between injury and clearance for full return to play by team physician. Peak symptom severity score (Sport Concussion Assessment Tool [SCAT] 2 or 3) was used in analyses. Study results revealed that males had shorter LOR than females (F[1, 86] = 5.021, p < 0.05, d = 0.49), but had comparable symptom severity scores. Symptom severity was strongly related to LOR for males (r = 0.513, p < 0.01) but not females (r = -0.003, p > 0.05). Among females, non-HC users demonstrated higher symptom severity than HC users (F[1,47] = 5.142, p < 0.05, d = 0.70). No significant differences between female HC users and non-HC users on LOR were observed. This study provides evidence for differential concussion outcomes between male and female collegiate athletes and between HC users and nonusers among females.
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Affiliation(s)
- Virginia Gallagher
- 1 Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University , Chicago, Illinois
| | - Natalie Kramer
- 2 Health Service, Northwestern University , Evanston, Illinois
| | - Kristin Abbott
- 2 Health Service, Northwestern University , Evanston, Illinois
| | - John Alexander
- 2 Health Service, Northwestern University , Evanston, Illinois
| | - Hans Breiter
- 1 Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University , Chicago, Illinois
| | - Amy Herrold
- 1 Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University , Chicago, Illinois.,3 Edward Hines, Jr. Veterans Administration Hospital , Hines, Illinois
| | - Tory Lindley
- 2 Health Service, Northwestern University , Evanston, Illinois
| | - Jeffrey Mjaanes
- 2 Health Service, Northwestern University , Evanston, Illinois
| | - James Reilly
- 1 Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University , Chicago, Illinois
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Gallagher C, Gallagher V, Sleeman D. A study of the effectiveness of peripheral alcohol injection in trigeminal neuralgia and a review of patient attitudes to this treatment. Ir Med J 2005; 98:149-50. [PMID: 16010786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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Abstract
The aims of this study were to estimate the average maximum mouth opening and range of mouth opening in a representative sample of the Irish adult population, to compare mouth opening in patients with and without signs or symptoms of temporomandibular joint (TMJ) dysfunction syndrome and to investigate the association between mouth opening and stature among populations. As part of the Irish National Survey of Adult Oral Health, maximum mouth opening was measured and questionnaire data collected for 1513 adults, aged 16-99 years. The average maximum mouth opening was 43 mm for males and 41 mm for females. Mouth opening was found to reduce with age, independent of gender. No link was found between reduced mouth opening and TMJ dysfunction or between mouth opening and stature in populations.
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Affiliation(s)
- C Gallagher
- Department of Dental Surgery, University Dental School and Hospital, Wilton, Cork, Ireland.
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Gallagher V, Gallagher C, Sleeman D. Surgically assisted rapid palatal expansion for management of transverse maxillary deficiency. J Ir Dent Assoc 2002; 48:18-21. [PMID: 15861591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Surgically assisted rapid palatal expansion (SA-RPE) is a combined orthodontic and surgical procedure which facilitates an increase in transverse maxillary width in skeletally mature adults. Many different techniques have been described. In 1992 Pogrel and associates described a conservative method of widening the maxilla. This procedure consisted of bilateral zygomatic buttress and midpalatal osteotomies combined with the use of a tooth-borne device postoperatively. Other moreradical SA-RPE procedures have been described in which more extensive osteotomies have been performed. Experience of SA-RPE using the simplified technique described by Pogrel et al is describe.
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Affiliation(s)
- V Gallagher
- Department of Dental Surgery, University Dental School & Hospital, Cork
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Doyle GD, O'Dwyer WF, Carmody M, Gallagher V. Quantitative and qualitative changes in plasma amino nitrogen and amino acids during haemodialysis. Ir J Med Sci 1970; 3:475-82. [PMID: 5483044 DOI: 10.1007/bf02958989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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