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İşcan Ayyildiz N, Bingöl N. The effects of web-based animation-supported progressive relaxation exercises applied to individuals with epilepsy on fatigue and sleep quality: A randomized controlled study. Epilepsy Behav 2024; 154:109734. [PMID: 38554645 DOI: 10.1016/j.yebeh.2024.109734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/09/2024] [Accepted: 03/03/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE The study was conducted to determine the effects of Progressive Relaxation Exercise, supported by mobile-based animation, on fatigue and sleep quality of individuals with epilepsy. MATERIAL-METHOD The study was conducted in a randomized controlled design with a pretest-posttest model on epileptic individuals who applied to Giresun University, Faculty of Medicine, Neurology Outpatient Clinic between February and December 2022. By using power analysis, the sample of the study was determined as 60 epilepsy patients (30 in the Control Group, 30 in the Experimental Group). The data were collected by face-to-face interview technique with the Personal Information Form, Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS). Frequencies, percentages, arithmetic mean, standard deviations, Pearson Correlation Analysis, Paired t-Test, Student's t-Test, and Chi-Square Test were used in the evaluation of the study data. RESULTS When the Control Group's mean scores in the pre-test and post-tests, which were performed with an interval of 6 weeks, were compared, a statistically significant difference was detected between the FSS and PSQI scores (p>0.05). The mean Fatigue Severity Scale score was found to be 5.24 ± 0.69 before the Progressive Relaxation Exercises and 3.82 ± 0.77 after the exercises. The mean scores of the individuals on the Fatigue Severity Scale after the relaxation exercises were found to be lower at a statistically significant level than the mean scores before the relaxation exercises (p<0.001). The differences between subjective sleep quality (p<0.001), sleep latency (p<0.001), daytime dysfunction (p<0.001), and total sleep quality (p<0.001) score averages after the Progressive Relaxation Exercises were statistically significant compared to the pre-exercises status. When the post-test scores of the participants in the Experimental Group was examined, significant, moderate, and positive differences were detected between the FSS and Total PSQI scores (r: 0.373-p: 0.042), Subjective Sleep Quality (r: 0.487-p: 0.006), which is one of the sub-dimensions of PSQI, Sleeping Pill Use (r: 0.531-p: 0.003), and Daytime Dysfunction (r: 0.461-p: 0.01) scores. CONCLUSION It was determined that individuals with epilepsy experience fatigue and deterioration in sleep quality and there is a reciprocal relationship between the severity of fatigue and sleep quality in these individuals. Progressive Relaxation Exercises applied with the animation-supported web-based mobile intervention technique reduce the fatigue levels of individuals and increase sleep quality.
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Affiliation(s)
| | - Nuray Bingöl
- Department of Medical Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey.
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Crowther ME, Saunders WJ, Sletten TL, Drummond SPA, Bei B. Tailoring cognitive behavioural therapy for insomnia across contexts, conditions, and individuals: What do we know, where do we go? J Sleep Res 2023; 32:e14023. [PMID: 37641983 DOI: 10.1111/jsr.14023] [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: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
Cognitive behavioural therapy for insomnia (CBT-I) is considered the front-line treatment for insomnia. Despite the demonstrated effectiveness of CBT-I, it is necessary to consider how CBT-I may be tailored to different individuals. The purpose of the present review is to provide a summary of literature on tailoring CBT-I to different individuals and provide directions for future research. This review focused on the following domains of adaptation: (i) tailoring CBT-I components to individuals with comorbid mental or physical health conditions such as comorbid depression and pain; (ii) adapting CBT-I delivery for different contexts in which individuals exist, such as inpatient, educational, and different social/cultural settings, (iii) adapting CBT-I to specific individuals via case-formulation in clinical settings. We highlight current gaps in the exploration of tailored CBT-I, including a lack of research methodology to evaluate tailored interventions, a need for the integration of ongoing individualised assessment to inform treatment, and the necessary involvement of consumers and stakeholders throughout the research and treatment development process. Together, this review showed abundant adaptations in CBT-I already exist in the literature. Future research is needed in understanding when and how to apply adaptations in CBT-I and evaluate the benefits of these adaptations.
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Affiliation(s)
- Meagan E Crowther
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - William J Saunders
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Tracey L Sletten
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Bei Bei
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
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Li M, Li F. Assessment of college students' mental health status based on temporal perception and hybrid clustering algorithm under the impact of public health events. PeerJ Comput Sci 2023; 9:e1586. [PMID: 37810345 PMCID: PMC10557517 DOI: 10.7717/peerj-cs.1586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/21/2023] [Indexed: 10/10/2023]
Abstract
The dynamic landscape of public health occurrences presents a formidable challenge to the emotional well-being of college students, necessitating a precise appraisal of their mental health (MH) status. A pivotal metric in this realm is the Mental Health Assessment Index, a prevalent gauge utilized to ascertain an individual's psychological well-being. However, prevailing indices predominantly stem from a physical vantage point, neglecting the intricate psychological dimensions. In pursuit of a judicious evaluation of college students' mental health within the crucible of public health vicissitudes, we have pioneered an innovative metric, underscored by temporal perception, in concert with a hybrid clustering algorithm. This augmentation stands poised to enrich the extant psychological assessment index framework. Our approach hinges on the transmutation of temporal perception into a quantifiable measure, harmoniously interwoven with established evaluative metrics, thereby forging a novel composite evaluation metric. This composite metric serves as the fulcrum upon which we have conceived a pioneering clustering algorithm, seamlessly fusing the fireworks algorithm with K-means clustering. The strategic integration of the fireworks algorithm addresses a noteworthy vulnerability inherent to K-means-its susceptibility to converging onto local optima. Empirical validation of our paradigm attests to its efficacy. The proposed hybrid clustering algorithm aptly captures the dynamic nuances characterizing college students' mental health trajectories. Across diverse assessment stages, our model consistently attains an accuracy threshold surpassing 90%, thus outshining existing evaluation techniques in both precision and simplicity. In summation, this innovative amalgamation presents a formidable stride toward an augmented understanding of college students' mental well-being during times of fluctuating public health dynamics.
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Affiliation(s)
- Mao Li
- Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China
| | - Fanfan Li
- Student Affairs Department, Huanggang Normal University, Huanggang, Hubei, China
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4
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Wang S, Lan Y, Liu Z, Xu S, Wu X. Effects of different interventions on insomnia in adults: Systematic review and network meta-analysis. J Psychiatr Res 2023; 165:140-149. [PMID: 37499485 DOI: 10.1016/j.jpsychires.2023.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 05/04/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE Insomnia is a common sleep disorder. There are many clinical-intervention methods for treating this condition, but thus far, the most effective method has not been determined. METHODS We conducted a network meta-analysis by including random evidence of insomnia improvement in people over 18 years old, without other physical diseases. From January 1, 1990 to June 15, 2022, we searched multiple electronic databases for randomized controlled trials of different insomnia-related, clinical-intervention methods. R software was used to analyze 10 indices, in order to evaluate the effect of sleep improvement. Primary outcomes comprised Pittsburgh sleep quality-index (PSQI) scores and insomnia severity-index (ISI) scores. RESULTS Finally, 122 randomized controlled trials were included in our study. For the PSQI scores, we found the sequence of intervention measures by effect to be as follows: electroacupuncture, acupuncture, repetitive transcranial magnetic stimulation (rTMS), essential oils, herbal medicine, traditional Western medicine, Tai Chi and Baduanjin, music, supplements, cognitive behavioral therapy for insomnia (CBT-I), and exercise. The results for ISI were similar to those for PSQI, but with slight differences. CONCLUSION Our research results indicate that various measures have a certain effect on improving sleep, among which the effect of instruments is more prominent. The curative effect of placebo groups was better than that of blank control groups. There is essentially no statistical difference in detailed classification within the same intervention category.
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Affiliation(s)
- Shuwen Wang
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yueyan Lan
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Zixiu Liu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Shuang Xu
- Library of China Medical University, Shenyang, Liaoning Province, China
| | - Xiaomei Wu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China.
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Shriane AE, Russell AMT, Ferguson SA, Rigney G, Vincent GE. Sleep hygiene in paramedics: What do they know, and what do they do? Sleep Health 2023; 9:240-248. [PMID: 36681619 DOI: 10.1016/j.sleh.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 10/19/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Shift workers routinely obtain inadequate sleep, which has major health and well-being consequences. Sleep hygiene describes a range of behaviors, lifestyle and environmental factors that can support optimal sleep. To date, limited research has examined sleep hygiene in shift workers. This study aimed to 1) assess the knowledge and understanding of sleep hygiene amongst shift working paramedics, as well as the perceived impact on sleep, and 2) investigate paramedics engagement with sleep hygiene practices. STUDY DESIGN Participants completed an online, cross-sectional survey. PARTICIPANTS Queensland Ambulance Service paramedics (n = 184) who work shift work. MEASURES The online survey included questions from the Standard Shiftwork Index and Sleep Hygiene Index. RESULTS Most participants reported little or no understanding or knowledge of "sleep hygiene" as a concept. Participants reported that sleep scheduling and bedroom environment (temperature, light, and noise) were the most impactful on sleep. Few participants reported nicotine and alcohol consumption, or daytime napping, whereas caffeine consumption and mentally-stimulating bedtime activities were more common. Participants who were young, single, and worked all shift types (day, afternoon, and night) as part of their regular rosters, demonstrated less knowledge regarding sleep hygiene, and were more likely to be exhibiting poor sleep hygiene engagement. CONCLUSIONS Paramedics demonstrated a limited level of understanding of sleep hygiene as a concept, and varied knowledge about the impacts of individual sleep hygiene factors. Further, paramedics demonstrated varied engagement with individual sleep hygiene practices. Future research should focus on the development of sleep hygiene interventions to optimize sleep in paramedics.
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Affiliation(s)
- Alexandra E Shriane
- Central Queensland University, School of Health, Medical and Applied Sciences, Rockhampton, Queensland, Australia; Queensland Ambulance Service, Brisbane, Queensland, Australia.
| | - Alex M T Russell
- Central Queensland University, School of Health, Medical and Applied Sciences, Rockhampton, Queensland, Australia
| | - Sally A Ferguson
- Central Queensland University, School of Health, Medical and Applied Sciences, Rockhampton, Queensland, Australia
| | - Gabrielle Rigney
- Central Queensland University, School of Health, Medical and Applied Sciences, Rockhampton, Queensland, Australia
| | - Grace E Vincent
- Central Queensland University, School of Health, Medical and Applied Sciences, Rockhampton, Queensland, Australia
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Whale K, Gooberman-Hill R. Development of a novel intervention to improve sleep and pain in patients undergoing total knee replacement. Trials 2022; 23:625. [PMID: 35918742 PMCID: PMC9344446 DOI: 10.1186/s13063-022-06584-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 07/22/2022] [Indexed: 11/18/2022] Open
Abstract
Background Up to 20% of patients experience long-term pain and dissatisfaction after total knee replacement, with a negative impact on their quality of life. New approaches are needed to reduce the proportion of people to go on to experience chronic post-surgical pain. Sleep and pain are bidirectionally linked with poor sleep linked to greater pain. Interventions to improve sleep among people undergoing knee replacement offer a promising avenue. Health beliefs and barriers to engagement were explored using behaviour change theory. This study followed stages 1–4 of the Medical Research Council’s guidance for complex intervention development to develop a novel intervention aimed at improving sleep in pre-operative knee replacement patients. Methods Pre-operative focus groups and post-operative telephone interviews were conducted with knee replacement patients. Before surgery, focus groups explored sleep experiences and views about existing sleep interventions (cognitive behavioural therapy for insomnia, exercise, relaxation, mindfulness, sleep hygiene) and barriers to engagement. After surgery, telephone interviews explored any changes in sleep and views about intervention appropriateness. Data were audio-recorded, transcribed, anonymised, and analysed using framework analysis. Results Overall, 23 patients took part, 17 patients attended pre-operative focus groups, seven took part in a post-operative telephone interview, and one took part in a focus group and interview. Key sleep issues identified were problems getting to sleep, frequent waking during the night, and problems getting back to sleep after night waking. The main reason for these issues was knee pain and discomfort and a busy mind. Participants felt that the sleep interventions were generally acceptable with no general preference for one intervention over the others. Views of delivery mode varied in relation to digital move and group or one-to-one approaches. Conclusion Existing sleep interventions were found to be acceptable to knee replacement patients. Key barriers to engagement related to participants’ health beliefs. Addressing beliefs about the relationship between sleep and pain and enhancing understanding of the bidirectional/cyclical relationship could benefit engagement and motivation. Individuals may also require support to break the fear and avoidance cycle of pain and coping. A future intervention should ensure that patients’ preferences for sleep interventions and delivery mode can be accommodated in a real-world context.
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Affiliation(s)
- K Whale
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Level 1, Southmead Hospital, Bristol, BS10 5NB, UK. .,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.
| | - R Gooberman-Hill
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Level 1, Southmead Hospital, Bristol, BS10 5NB, UK.,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
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7
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Kodsi A, Bullock B, Kennedy GA, Tirlea L. Psychological Interventions to Improve Sleep in Young Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Behav Sleep Med 2022; 20:125-142. [PMID: 33554644 DOI: 10.1080/15402002.2021.1876062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The effects of impaired sleep on the wellbeing of young adults are profound, and the adverse outcomes for mental health are well documented in the research literature. OBJECTIVE This systematic review and meta-analysis aimed to identify, summarize, and synthesize the available evidence from randomized-controlled trials (RCTs) investigating psychological interventions aimed at improving sleep and related secondary outcomes such as anxiety and depression in healthy young adults. METHOD Nine electronic databases (Cochrane Central Registry of Controlled Trials [CENTRAL], PubMed, Scopus, PsycNET, CINHAL, INFORMIT, Web of Science [Science and Social Citation Index], OpenSigle and EMBASE) were searched, returning 54 full-text papers for assessment, with 13 studies meeting inclusion criteria for the meta-analysis. RESULTS A random effects meta-analysis showed that the combined effect of all interventions was moderate (ES = -0.53, 95% CIs [- 0.69, -0.36], p < .01), reflecting the efficacy of psychological interventions at improving sleep scores at post-intervention. Subgroup analyses of individual interventions showed that cognitive-behavioral interventions improved sleep (ES = -0.67, 95% CIs [-0.77, -0.57], p < .01) and secondary outcomes for anxiety (ES = -0.35, 95% CIs [-0.56, -0.15], p < .01) and depression (ES = -0.41, 95% CIs [-0.70, -0.13], p < .01) at post-intervention. CONCLUSION The results of the current review support the implementation of cognitive and behavioral interventions for sleep among young adults experiencing both sleep and comorbid mental health problems.
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Affiliation(s)
- Ali Kodsi
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Ben Bullock
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Gerard A Kennedy
- School of Health and Life Sciences, Federation University, Ballarat, Australia.,School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Loredana Tirlea
- Department of Health and Biomedical Sciences, Swinburne University of Technology, Melbourne, Australia
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8
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Combertaldi SL, Ort A, Cordi M, Fahr A, Rasch B. Pre-sleep social media use does not strongly disturb sleep: a sleep laboratory study in healthy young participants. Sleep Med 2021; 87:191-202. [PMID: 34627122 DOI: 10.1016/j.sleep.2021.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/17/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Sleep is critical for our mental health and optimal cognitive functioning. Social media use is increasingly common and suspected to disturb sleep due to increasing bedtime arousal. However, most studies rely on self-reported sleep. METHODS We tested the effects of 30 min social media use on arousal and subsequent sleep in the sleep laboratory in 32 healthy young volunteers. Effects of blue-light were excluded in this study. We compared it to 30 min progressive muscle relaxation (PMR) and neutral sleep in a within-subject design. RESULTS Thirty minutes of social media use immediately before sleep did not significantly increase arousal and did neither disturb objective nor subjective sleep. After social media use, participants only spent less time in sleep stage N2. In contrast, PMR had the expected positive effects on pre-sleep arousal level indicated by reduced heart rate. In addition, PMR improved sleep efficiency, reduced sleep onset latency, and shortened the time to reach slow-wave sleep compared to a neutral night. Oscillatory power in the slow-wave activity and spindle bands remained unaffected. CONCLUSION Social media use before sleep (controlling for effects of blue-light) had little effect on bedtime arousal and sleep quality than what was previously expected. The most notable effect appears to be the additional time spent engaging in social media use at bedtime, potentially keeping people from going to sleep. As wake up-time is mostly determined externally, due to school or working hours, limiting personal media use at bedtime-and especially in bed-is recommended to get sufficient hours of sleep.
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Affiliation(s)
| | - Alexander Ort
- University of Lucerne, Department of Health Sciences and Medicine, Lucerne, Switzerland
| | - Maren Cordi
- University of Fribourg, Department of Psychology, Fribourg, Switzerland
| | - Andreas Fahr
- University of Fribourg, Department of Communication and Media Research, Fribourg, Switzerland
| | - Björn Rasch
- University of Fribourg, Department of Psychology, Fribourg, Switzerland.
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Edinger JD, Arnedt JT, Bertisch SM, Carney CE, Harrington JJ, Lichstein KL, Sateia MJ, Troxel WM, Zhou ES, Kazmi U, Heald JL, Martin JL. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med 2021; 17:263-298. [PMID: 33164741 DOI: 10.5664/jcsm.8988] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The purpose of this systematic review is to provide supporting evidence for a clinical practice guideline on the use of behavioral and psychological treatments for chronic insomnia disorder in adult populations. METHODS The American Academy of Sleep Medicine commissioned a task force of 9 experts in sleep medicine and sleep psychology. A systematic review was conducted to identify randomized controlled trials that addressed behavioral and psychological interventions for the treatment of chronic insomnia disorder in adults. Statistical analyses were performed to determine if the treatments produced clinically significant improvements in a range of critical and important outcomes. Finally, the Grading of Recommendations Assessment, Development, and Evaluation process was used to evaluate the evidence for making specific treatment recommendations. RESULTS The literature search identified 1,244 studies; 124 studies met the inclusion criteria, and 89 studies provided data suitable for statistical analyses. Evidence for the following interventions is presented in this review: cognitive-behavioral therapy for insomnia, brief therapies for insomnia, stimulus control, sleep restriction therapy, relaxation training, sleep hygiene, biofeedback, paradoxical intention, intensive sleep retraining, and mindfulness. This review provides a detailed summary of the evidence along with the quality of evidence, the balance of benefits vs harms, patient values and preferences, and resource use considerations.
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Affiliation(s)
- Jack D Edinger
- National Jewish Health, Denver, Colorado.,Duke University Medical Center, Durham, North Carolina
| | - J Todd Arnedt
- Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Suzanne M Bertisch
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | | | - Eric S Zhou
- Harvard Medical School, Dana-Farber Cancer Institute, Boston Children's Hospital, Boston, Massachusetts
| | - Uzma Kazmi
- American Academy of Sleep Medicine, Darien, Illinois
| | | | - Jennifer L Martin
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California.,VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, Los Angeles, California
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10
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Harris AL, Carmona NE, Moss TG, Carney CE. Testing the contiguity of the sleep and fatigue relationship: a daily diary study. Sleep 2021; 44:6007511. [PMID: 33245330 DOI: 10.1093/sleep/zsaa252] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/22/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES There is mixed evidence for the relationship between poor sleep and daytime fatigue, and some have suggested that fatigue is simply caused by lack of sleep. Although retrospective measures of insomnia and fatigue tend to correlate, other studies fail to demonstrate a link between objectively disturbed sleep and fatigue. The current study prospectively explored the relationship between sleep and fatigue among those with and without insomnia disorder. METHODS Participants meeting Research Diagnostic Criteria for insomnia disorder (n = 33) or normal sleepers (n = 32) completed the Consensus Sleep Diary (CSD) and daily fatigue ratings for 2 weeks. Baseline questionnaires evaluated cognitive factors including unhelpful beliefs about sleep and rumination about fatigue. Hierarchical linear modeling tested the within- and between-participant relationships between sleep quality, total sleep time, and daily fatigue ratings. Mediation analyses tested if cognitive factors mediated the relationship between insomnia and fatigue. RESULTS Self-reported nightly sleep quality significantly predicted subsequent daily fatigue ratings. Total sleep time was a significant predictor of fatigue within, but not between, participants. Unhelpful sleep beliefs and rumination about fatigue mediated the relationship between insomnia and fatigue reporting. CONCLUSIONS The results suggest that perception of sleep plays an important role in predicting reports of daytime fatigue. These findings could be used in treatment to help shift the focus away from total sleep times, and instead, focus on challenging maladaptive sleep-related cognitions to change fatigue perception.
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Affiliation(s)
- Andrea L Harris
- Department of Psychology, Ryerson University, Toronto, Canada
| | | | - Taryn G Moss
- Department of Psychology, Ryerson University, Toronto, Canada
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11
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Saruhanjan K, Zarski AC, Bauer T, Baumeister H, Cuijpers P, Spiegelhalder K, Auerbach RP, Kessler RC, Bruffaerts R, Karyotaki E, Berking M, Ebert DD. Psychological interventions to improve sleep in college students: A meta-analysis of randomized controlled trials. J Sleep Res 2020; 30:e13097. [PMID: 32672865 DOI: 10.1111/jsr.13097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 05/04/2020] [Accepted: 05/10/2020] [Indexed: 11/30/2022]
Abstract
Sleep disturbances and insomnia are common in college students, and reduce their quality of life and academic performance. The aim of this meta-analysis was to evaluate the efficacy of psychological interventions aimed at improving sleep in college students. A meta-analysis was conducted with 10 randomized controlled trials with passive control conditions (N = 2,408). The overall mean effect size (Hedges' g) of all sleep-related outcomes within each trial was moderate to large (g = 0.61; 95% confidence interval: 0.41-0.81; numbers-needed-to-treat = 3). Effect sizes for global measures of sleep disturbances were g = 0.79; 95% confidence interval: 0.52-1.06; and for sleep-onset latency g = 0.65; 95% confidence interval: 0.36-0.94. The follow-up analyses revealed an effect size of g = 0.56; 95% confidence interval: 0.45-0.66 for the combined sleep-related outcomes based on three studies. No significant covariates were identified. These results should be interpreted cautiously due to an overall substantial risk of bias, and in particular with regard to blinding of participants and personnel. Nevertheless, they provide evidence that psychological interventions for improving sleep are efficacious among college students. Further research should explore long-term effects and potential moderators of treatment efficacy in college students.
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Affiliation(s)
- Karina Saruhanjan
- Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Anna-Carlotta Zarski
- Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Tobias Bauer
- Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Harald Baumeister
- Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eirini Karyotaki
- Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Matthias Berking
- Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - David Daniel Ebert
- Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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12
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Shriane AE, Russell AMT, Ferguson SA, Rigney G, Vincent GE. Sleep hygiene in paramedics: What do they know and what do they do? Sleep Health 2020; 6:321-329. [PMID: 32507492 DOI: 10.1016/j.sleh.2020.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 04/04/2020] [Accepted: 04/05/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Shift workers routinely obtain inadequate sleep, which has major health and wellbeing consequences. Sleep hygiene describes a range of behaviours, lifestyle and environmental factors that can support optimal sleep. To date, limited research has examined sleep hygiene in shift workers. This study aimed to 1) assess the knowledge and understanding of sleep hygiene amongst shift working paramedics, as well as its perceived impact on sleep, and 2) investigate paramedics' engagement with sleep hygiene practices. STUDY DESIGN Participants completed an online, cross-sectional survey. PARTICIPANTS Queensland Ambulance Service paramedics (n = 184) who engage in shift work. MEASURES The online survey included questions from the Standard Shiftwork Index and Sleep Hygiene Index. RESULTS Most participants reported little or no understanding or knowledge of 'sleep hygiene' as a concept. Participants reported that sleep scheduling and bedroom environment (temperature, light, and noise) were the most impactful on sleep. Few participants reported nicotine and alcohol consumption, or daytime napping, whereas caffeine consumption and mentally-stimulating bedtime activities were more common. Participants who were young, single, and worked varying shift types (day, afternoon, and night) as part of their regular rosters demonstrated less knowledge regarding sleep hygiene, and were more likely to be exhibiting poor sleep hygiene engagement. CONCLUSIONS Paramedics demonstrated a limited level of understanding of sleep hygiene as a concept, and varied knowledge about the impacts of individual sleep hygiene factors. Further, paramedics demonstrated varied engagement with individual sleep hygiene practices. Future research should focus on the development of sleep hygiene interventions to optimise sleep in paramedics.
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Affiliation(s)
- Alexandra E Shriane
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, 44 Greenhill Road, Rockhampton, Wayville, Queensland 5034, Australia; Queensland Ambulance Service, Brisbane, Queensland, Australia.
| | - Alex M T Russell
- Experimental Gambling Research Laboratory, School and Health, Medical and Applied Sciences, Central Queensland University, Sydney, New South Wales, Australia
| | - Sally A Ferguson
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, 44 Greenhill Road, Rockhampton, Wayville, Queensland 5034, Australia
| | - Gabrielle Rigney
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, 44 Greenhill Road, Rockhampton, Wayville, Queensland 5034, Australia
| | - Grace E Vincent
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, 44 Greenhill Road, Rockhampton, Wayville, Queensland 5034, Australia
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Combertaldi SL, Rasch B. Healthy Sleepers Can Worsen Their Sleep by Wanting to Do so: The Effects of Intention on Objective and Subjective Sleep Parameters. Nat Sci Sleep 2020; 12:981-997. [PMID: 33204201 PMCID: PMC7667149 DOI: 10.2147/nss.s270376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/05/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Sleep is regulated by homeostatic and circadian factors. In addition, psychological factors have a strong modulatory impact on our sleep, but the exact underlying mechanisms are still largely unknown. Here, we examined the role of intentions on subjective and objective sleep parameters. Young healthy sleepers were instructed to voluntarily either worsen or improve their sleep. We predicted that participants would be capable of worsening, but not improving, their sleep compared to a regular sleep condition. In addition, we predicted that the instruction to alter sleep would lead to a higher discrepancy between subjective and objective sleep variables. PARTICIPANTS AND METHODS Twenty-two healthy students participated in one adaptation and three experimental nights. Polysomnography and subjective sleep parameters were measured during all four nights. Participants were instructed to sleep regularly ("neutral"), better ("good") or worse ("bad") than normal, in a counterbalanced order. RESULTS The instruction to sleep "bad" increased objective sleep onset latency and the number of awakings during the night. The effects were stronger on subjective sleep variables, resulting in a higher sleep misperception in the "bad" condition as compared to the other two conditions. The instruction to sleep "good" did not improve sleep nor did it affect sleep misperception. CONCLUSION We conclude that intention is sufficient to impair (but not improve) subjective and objective sleep quality and to increase sleep misperception in healthy young sleepers. Our results have important implications for the understanding of the impact of psychological factors on our sleep.
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Affiliation(s)
- Selina Ladina Combertaldi
- Division of Cognitive Biopsychology and Methods, Department of Psychology, University of Fribourg, Fribourg, FR, Switzerland
| | - Björn Rasch
- Division of Cognitive Biopsychology and Methods, Department of Psychology, University of Fribourg, Fribourg, FR, Switzerland
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Longitudinally Measured Changes in Somnolence Severity With a Visual Analog Scale in a Randomized Lithium Versus Quetiapine-IR Study in Bipolar Disorder. J Clin Psychopharmacol 2019; 39:249-253. [PMID: 30932950 DOI: 10.1097/jcp.0000000000001031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to use a visual analog scale (VAS) longitudinally measuring somnolence severity in patients with bipolar disorder. METHODS A data set of patients with bipolar spectrum disorders who were randomized to lithium or quetiapine-IR for 16 weeks was used. The somnolence severity was measured with a VAS from 0 to 100 (VAS based), and somnolence frequency was recorded according to incident report (incidence based) at each visit. The rates of VAS-based and incidence-based somnolence and changes in somnolence severity from baseline to the end of study were compared between the lithium and quetiapine groups. Longitudinal changes in somnolence severity were analyzed with linear regression analysis. RESULTS Of 42 patients randomized, only 3 scored 0 on the VAS at baseline. The rates of incidence-based and VAS-based somnolence were similar in the lithium and quetiapine-IR groups. The VAS change scores from baseline to each visit varied in both groups with significant decreases at weeks 6 and 12 in the quetiapine-IR group only. The decrease at week 6 in the quetiapine-IR group was significantly different from that in the lithium group. Patterns of changes in somnolence severity were inconsistent in both groups. A significant interaction between time course and the decrease in VAS scores was observed in the quetiapine-IR group, but not in the lithium group. CONCLUSIONS Baseline somnolence was highly prevalent in patients with bipolar disorder. The change in somnolence severity was different between lithium-treated and quetiapine-treated patients. Quantifying somnolence longitudinally is important in clinical trials and practice.
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Bang YR, Jeon HJ, Yoon IY. Modest Effects of Low-frequency Electrical Stimulation on Patients with Chronic Insomnia in an Open Trial. SLEEP MEDICINE RESEARCH 2019. [DOI: 10.17241/smr.2019.00346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Heart rate variability biofeedback and other psychophysiological procedures as important elements in psychotherapy. Int J Psychophysiol 2018; 131:89-95. [DOI: 10.1016/j.ijpsycho.2017.09.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 12/21/2022]
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Rehman IU, Chia DWB, Ahmed R, Khan NA, Rahman AU, Munib S, Lee LH, Chan KG, Khan TM. A randomized controlled trial for effectiveness of zolpidem versus acupressure on sleep in hemodialysis patients having chronic kidney disease-associated pruritus. Medicine (Baltimore) 2018; 97:e10764. [PMID: 30075491 PMCID: PMC6081075 DOI: 10.1097/md.0000000000010764] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Pruritus adds to the complications of chronic kidney disease (CKD) patient and a well-recognized complication among the CKD patients. Majority of the patients on hemodialysis experience a generalized pruritus and patients reported being moderately to extremely disturbed by at least one of the sleep-related condition. This study aim to investigate the effectiveness of zolpidem 10 mg and acupressure therapy on foot acupoints to improve the sleep quality and overall quality of life among hemodialysis patients suffering from CKD-associated pruritus. METHODS A multicentered, open-label, parallel group, prospective randomized controlled trial among patients suffering from CKD-associated pruritus with sleep disturbance, after randomization into control, and intervention group to be held at North West General Hospital and Research Center Peshawar, Pakistan and Institute of Kidney Diseases Peshawar, Pakistan. RESULTS The primary outcome is to investigate the effectiveness of zolpidem 10 mg and acupressure therapy on foot acupoints to improve the sleep quality and overall quality of life among hemodialysis patients suffering from CKD-associated pruritus. After baseline assessment by Urdu version of 5D itch scale and Urdu version of Pittsburgh Sleep Quality Index (PSQI) and Urdu EQ-5D 3L, the intervention group will be given zolpidem 10 mg oral tablets and control group with acupressure on both foots on KI-1 acupoints for total of 6 minutes. Assessment will be done at weeks 4 and 8 from baseline by using Urdu version of 5D itch scale and Urdu version of PSQI and Urdu EQ-5D 3L, whereas safety profiling of zolpidem 10 mg tablet at week 6 from baseline and acupressure acceptability at week 6 from baseline. Analysis of covariance will be used to examine the differences in treatment effects between the intervention and control groups. CONCLUSION Improvement of sleep quality and quality of life among patients with CKD-associated pruritus requires great importance. This study aims to improve the quality of sleep and quality of life among patients with hemodialysis suffering from CKD-associated pruritus.
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Affiliation(s)
- Inayat Ur Rehman
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Selangor Darul Ehsan, Malaysia
- Department of Pharmacy, Abdul Wali Khan University, Mardan
| | - David Wu Bin Chia
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Selangor Darul Ehsan, Malaysia
| | - Raheel Ahmed
- Department of Nephrology, Institute of Kidney Diseases
| | - Nisar Ahmad Khan
- Department of Nephrology, North West General Hospital and Research Center, Peshawar, Pakistan
| | - Aziz Ur Rahman
- Department of Urology, North West General Hospital and Research Center, Peshawar, Pakistan
| | - Syed Munib
- Department of Nephrology, Institute of Kidney Diseases
| | - Learn Han Lee
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Selangor Darul Ehsan, Malaysia
- Biomedical Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Bandar Sunway, Selangor Darul Ehsan, Malaysia
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
| | - Kok Gan Chan
- International Genome Centre, Jiangsu University, Zhenjiang, China
- ISB (Genetics), Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Tahir Mehmood Khan
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Selangor Darul Ehsan, Malaysia
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Science, Outfall Campus, Civil Lines, Lahore, Pakistan
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Özkan SA, Rathfisch G. The effect of relaxation exercises on sleep quality in pregnant women in the third trimester: A randomized controlled trial. Complement Ther Clin Pract 2018; 32:79-84. [PMID: 30057064 DOI: 10.1016/j.ctcp.2018.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 05/25/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To assess the effects of relaxation exercises on subjective sleep quality of in third-trimester pregnant women. MATERIALS AND METHODS The pretest posttest randomized controlled trial recruited 84 pregnant women in the third trimester. Following random assignment of subjects, the treatment group (n = 46) performed relaxation exercises for four weeks and the control group (n = 46) received standart cares. At baseline and after the intervention sleep quality was assessed. Data obtained were analyzed in SPSS. RESULTS The mean score of the global Pittsburgh Sleep Quality Index was 7.12 ± 3.66. It was determined that relaxation exercises improved some sleep quality subscales including subjective sleep quality, sleep latency, sleep duration and habitual sleep efficiency, sleep disturbances, daytime dysfunction and global sleep quality. The difference between the two groups was found to be statistically significant (p < 0.05). CONCLUSION A four -week compact disc guide relaxation exercises program can be effective in improving sleep quality.
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Affiliation(s)
| | - Gülay Rathfisch
- Istanbul University, Florence Nightingale Nursing Faculty, Department of Women's Health and Diseases Nursing, Abide-i Hurriyet Street Florence Nightingale Nursing Faculty, 34381, Sisli, Istanbul, Turkey.
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van Straten A, van der Zweerde T, Kleiboer A, Cuijpers P, Morin CM, Lancee J. Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. Sleep Med Rev 2018; 38:3-16. [DOI: 10.1016/j.smrv.2017.02.001] [Citation(s) in RCA: 296] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 01/11/2017] [Accepted: 02/01/2017] [Indexed: 11/30/2022]
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Abstract
This article concerns the interpretation and construction of measurements for single observational units, including the creation of scales or indexes to improve the quality of the measurements. The focus is on the individual as the observational unit in psychology, but to present a broader perspective related measurement issues in official statistics are also discussed. It is concluded that when individual measurements are to be interpreted, measurement precision must be given priority and taken into account in the research design. Unfortunately, most measures in psychology are not highly reliable, and examples are given demonstrating that such measures do not normally allow the researcher to make inferences about single individuals. Methods for testing questionnaires in a cognitive laboratory that have been developed within survey research can provide useful tools to increase both reliability and validity of single questions/items.
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Abstract
Difficulty initiating and/or maintaining sleep is a common issue. Patients experiencing insomnia symptoms frequently self-treat their symptoms with sleep medications. However, there remains concern regarding the short- and long-term health impacts of sleep medications. This article discusses the evidence supporting integrative approaches to insomnia treatment, including cognitive-behavioral therapy and mind-body therapies (mindfulness meditation, yoga, tai chi), as well as emerging data for use of other less well supported approaches (dietary supplements, acupuncture).
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Affiliation(s)
- Eric S Zhou
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
| | - Paula Gardiner
- Boston Medical Center, Boston University School of Medicine, 1 Boston Medical Center Place, Boston, MA 02218, USA
| | - Suzanne M Bertisch
- Division of Pulmonary, Critical Care, and Sleep Medicine, Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
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Friedrich A, Schlarb AA. Let's talk about sleep: a systematic review of psychological interventions to improve sleep in college students. J Sleep Res 2017; 27:4-22. [DOI: 10.1111/jsr.12568] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 04/24/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Anja Friedrich
- Faculty of Psychology and Sport Science; Bielefeld University; Bielefeld Germany
| | - Angelika A. Schlarb
- Faculty of Psychology and Sport Science; Bielefeld University; Bielefeld Germany
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The SIESTA Trial: A Randomized Study Investigating the Efficacy, Safety, and Tolerability of Acupressure versus Sham Therapy for Improving Sleep Quality in Patients with End-Stage Kidney Disease on Hemodialysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:7570352. [PMID: 28316636 PMCID: PMC5339536 DOI: 10.1155/2017/7570352] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 01/26/2017] [Indexed: 12/20/2022]
Abstract
Objectives. To compare the effectiveness of real acupressure versus sham acupressure therapy in improving sleep quality in patients receiving hemodialysis (HD) or hemodiafiltration (HDF). Methods. A multicenter, single-blind, randomized controlled trial was conducted in two Australian dialysis units located in Princess Alexandra Hospital and Logan Hospital, respectively. Forty-two subjects with self-reported poor sleep quality were randomly assigned to real (n = 21) or sham (n = 21) acupressure therapy delivered thrice weekly for four consecutive weeks during routine dialysis sessions. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) score measured at week four adjusted for baseline PSQI measurements. Secondary outcomes were quality of life (QOL) (SF-8), adverse events, and patient acceptability (treatment acceptability questionnaire, TAQ). Results. The two groups were comparable on global PSQI scores (difference 0.19, 95% confidence interval [CI] −1.32 to 1.70) and on the subscale scores. Similar results were observed for QOL both in the mental (difference −3.88, 95% CI −8.63 to 0.87) and the physical scores (difference 2.45, 95% CI −1.69 to 6.58). There were no treatment-related adverse events and acupressure was perceived favorably by participants. Conclusion. Acupressure is a safe, well-tolerated, and highly acceptable therapy in adult hemodialysis patients in a Western healthcare setting with uncertain implications for therapeutic efficacy.
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Kloss JD, Nash CO, Walsh CM, Culnan E, Horsey S, Sexton-Radek K. A "Sleep 101" Program for College Students Improves Sleep Hygiene Knowledge and Reduces Maladaptive Beliefs about Sleep. Behav Med 2016; 42:48-56. [PMID: 25268924 DOI: 10.1080/08964289.2014.969186] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Sensitizing young adults about sleep hygiene knowledge and helpful sleep attitudes may have the potential to instill long-lasting healthy sleep practices. Towards these ends, evaluation of psychoeducational program "Sleep 101" tailored to college students was undertaken. Following two weeks of sleep-log recordings, participants were randomly assigned to a Sleep 101 (experimental) condition or a sleep monitoring (control) condition. The Sleep 101 condition was comprised of two 90-minute workshops aimed to educate students about healthy sleep practices, helpful thoughts about sleep, and ways to improve sleep. The sleep monitoring group received a sleep hygiene handout and completed sleep logs for the study duration. Sleep 101 participants endorsed fewer maladaptive beliefs and attitudes about sleep, increased sleep hygiene knowledge, and reduced sleep onset latency compared to the sleep monitoring participants. Brief psychoeducational courses may be a cost-effective way to alleviate current, and/or prevent future, sleep problems in young adults.
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Adler E, Dhruva A, Moran PJ, Daubenmier J, Acree M, Epel ES, Bacchetti P, Prather AA, Mason A, Hecht FM. Impact of a Mindfulness-Based Weight-Loss Intervention on Sleep Quality Among Adults with Obesity: Data from the SHINE Randomized Controlled Trial. J Altern Complement Med 2016; 23:188-195. [PMID: 28029852 DOI: 10.1089/acm.2016.0141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Sleep disturbance is a common problem among adults with obesity. Mindfulness interventions have been shown to improve sleep quality in various populations but have not been investigated in adults with obesity. The aim of this study was to compare the effects of a mindfulness-based weight-loss intervention with an active control on self-reported sleep quality among adults with obesity. METHOD This study was a secondary analysis of a randomized controlled trial and included 194 adults with a body mass index in the range 30-45 kg/m2. The treatment intervention included mindfulness-based eating and stress-management practices, and the active control intervention included training in progressive muscle relaxation (PMR). Both groups received identical diet and exercise guidelines in 17 group sessions conducted over 5.5 months that were matched for time, attention, and social support. The primary outcome of this analysis was between-group change in self-reported sleep quality, which was assessed using the Pittsburgh Sleep Quality Index (PSQI) global score at baseline and at 6, 12, and 18 months. RESULTS Between-group differences in mean PSQI change scores in the mindfulness group (n = 100) compared to the control group (n = 94) were -0.27 (-0.68, 1.22; p = 0.58) at 6 months, -0.57 (-0.35, 1.50; p = 0.22) at 12 months, and -0.50 (-0.53, 1.53; p = 0.34) at 18 months, all in the direction of more sleep improvement in the mindfulness group but none reaching statistical significance. In the mindfulness group, average weekly minutes of meditation practice time was associated with improved sleep quality from baseline to 6 months. CONCLUSIONS No statistically significant evidence was found that a weight-loss program that incorporates mindfulness improves self-reported sleep quality compared to a control diet/exercise intervention that included PMR. Within the mindfulness group, average weekly minutes of mindfulness practice was associated with improved sleep quality.
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Affiliation(s)
- Elizabeth Adler
- 1 UCSF Osher Center for Integrative Medicine, San Francisco, CA
| | - Anand Dhruva
- 1 UCSF Osher Center for Integrative Medicine, San Francisco, CA.,2 Department of Medicine, UCSF Osher Center for Integrative Medicine , San Francisco, CA
| | | | | | - Michael Acree
- 1 UCSF Osher Center for Integrative Medicine, San Francisco, CA
| | - Elissa S Epel
- 1 UCSF Osher Center for Integrative Medicine, San Francisco, CA
| | - Peter Bacchetti
- 3 Department of Epidemiology and Biostatistics, UCSF Osher Center for Integrative Medicine , San Francisco, CA
| | - Aric A Prather
- 4 Department of Psychiatry, UCSF Osher Center for Integrative Medicine , San Francisco, CA
| | - Ashley Mason
- 1 UCSF Osher Center for Integrative Medicine, San Francisco, CA
| | - Frederick M Hecht
- 1 UCSF Osher Center for Integrative Medicine, San Francisco, CA.,2 Department of Medicine, UCSF Osher Center for Integrative Medicine , San Francisco, CA
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McGowan SK, Behar E, Luhmann M. Examining the Relationship Between Worry and Sleep: A Daily Process Approach. Behav Ther 2016; 47:460-73. [PMID: 27423163 DOI: 10.1016/j.beth.2015.12.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 12/16/2015] [Accepted: 12/17/2015] [Indexed: 11/19/2022]
Abstract
There is growing evidence suggesting that worry and sleep are intimately linked. However, the relationship between these two phenomena over the course of a day remains largely unstudied. It is possible that (a) worry predicts sleep disturbance that night, (b) sleep disturbance predicts worry the following day, or (c) there is a bidirectional relationship between worry and sleep disturbance. The present study examined the daily relationship between worry (both during the day and immediately prior to sleep onset) and sleep in 50 high trait worriers who were randomly assigned to one of two interventions aimed at reducing worry as part of a larger study. A daily process approach was utilized wherein participants completed daily reports of sleep and worry during a 7-day baseline period followed by a 14-day intervention period. Results of repeated measures multilevel modeling analyses indicated that worry experienced on a particular day predicted increased sleep disturbance that night during both the baseline and intervention weeks. However, there was no evidence of a bidirectional relationship as sleep characteristics did not predict worry the following day. Additionally, the type of intervention that participants engaged in did not affect the daily relationship between worry and sleep. Results of the present study are consistent with the cognitive model of insomnia (Harvey, 2002) and highlight the importance of addressing and treating worry among individuals with high trait worry and sleep disturbance.
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Affiliation(s)
| | | | - Maike Luhmann
- University of Illinois at Chicago; University of Cologne
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Milojevich HM, Lukowski AF. Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits. PLoS One 2016; 11:e0156372. [PMID: 27280714 PMCID: PMC4900547 DOI: 10.1371/journal.pone.0156372] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 05/13/2016] [Indexed: 11/18/2022] Open
Abstract
Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning.
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Affiliation(s)
- Helen M Milojevich
- Department of Psychology and Social Behavior, University of California-Irvine, Irvine, CA, United States of America
| | - Angela F Lukowski
- Department of Psychology and Social Behavior, University of California-Irvine, Irvine, CA, United States of America
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Bramoweth AD, Renqvist JG, Germain A, Buysse DJ, Gentili A, Kochersberger G, Rodriguez E, Rossi MI, Weiner DK. Deconstructing Chronic Low Back Pain in the Older Adult—Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment: Part VII: Insomnia. PAIN MEDICINE 2016; 17:851-63. [DOI: 10.1093/pm/pnw063] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Adam D Bramoweth
- Mental Illness Research, Education & Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jenna G Renqvist
- Mental Illness Research, Education & Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Anne Germain
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Angela Gentili
- Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
- Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Gary Kochersberger
- VA Medical Center, Canandaigua, New York, USA
- Division of Geriatrics, University of Rochester, Rochester, New York, USA
| | - Eric Rodriguez
- Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Michelle I Rossi
- Geriatric Research, Education and Clinical Center (GRECC), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Debra K Weiner
- Geriatric Research, Education and Clinical Center (GRECC), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Clinical and Translational Science Institute—University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA, USA
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Akgün Şahin Z, Dayapoğlu N. Effect of progressive relaxation exercises on fatigue and sleep quality in patients with chronic obstructive lung disease (COPD). Complement Ther Clin Pract 2015; 21:277-81. [DOI: 10.1016/j.ctcp.2015.10.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 10/06/2015] [Accepted: 10/15/2015] [Indexed: 11/26/2022]
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Hall MH, Kline CE, Nowakowski S. Insomnia and sleep apnea in midlife women: prevalence and consequences to health and functioning. F1000PRIME REPORTS 2015; 7:63. [PMID: 26097736 PMCID: PMC4447062 DOI: 10.12703/p7-63] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Sleep disturbance is common during the menopausal transition, with numerous downstream consequences to health and functioning, including reduced quality of life, impaired mental health, and increased physical health morbidity. Insomnia affects approximately 50% of midlife women and is characterized by nocturnal symptoms of difficulties initiating or maintaining sleep (or both) and daytime symptoms that impair occupational, social, or other components of functioning. In addition, approximately 20% of midlife women develop sleep-disordered breathing during the menopausal transition. This commentary summarizes the prevalence, risk factors, and treatment options for each of these sleep disorders in midlife women, with specific focus on first-line treatments for insomnia (cognitive behavioral therapy for insomnia) and sleep-disordered breathing (continuous positive airway pressure) and unique considerations for treating sleep disorders in midlife women. Future directions are also discussed.
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Affiliation(s)
- Martica H. Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine3811 O'Hara Street, Pittsburgh, PA 15213USA
| | - Christopher E. Kline
- Department of Psychiatry, University of Pittsburgh School of Medicine3811 O'Hara Street, Pittsburgh, PA 15213USA
| | - Sara Nowakowski
- Department of Obstetrics and Gynecology, University of Texas Medical Branch301 University Boulevard, Galveston, TX 77555-0587USA
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Phillips KD, Gunther ME. Sleep and HIV Disease. Sleep Med 2015. [DOI: 10.1007/978-1-4939-2089-1_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Med Rev 2014; 22:23-36. [PMID: 25454674 DOI: 10.1016/j.smrv.2014.10.001] [Citation(s) in RCA: 424] [Impact Index Per Article: 42.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 08/01/2014] [Accepted: 10/03/2014] [Indexed: 02/03/2023]
Abstract
The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) improve sleep? Is there still a use for sleep hygiene? Global public health concern over sleep has increased demand for sleep promotion strategies accessible to the population. However, the extent to which sleep hygiene strategies apply outside clinical settings is not well known. The present review sought to evaluate the empirical evidence for sleep hygiene recommendations regarding exercise, stress management, noise, sleep timing, and avoidance of caffeine, nicotine, alcohol, and daytime napping, with a particular emphasis on their public health utility. Thus, our review is not intended to be exhaustive regarding the clinical application of these techniques, but rather to focus on broader applications. Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population. Suggestions for clarification of sleep hygiene recommendations and considerations for the use of sleep hygiene in nonclinical populations are discussed.
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Harvey AG, Bélanger L, Talbot L, Eidelman P, Beaulieu-Bonneau S, Fortier-Brochu É, Ivers H, Lamy M, Hein K, Soehner AM, Mérette C, Morin CM. Comparative efficacy of behavior therapy, cognitive therapy, and cognitive behavior therapy for chronic insomnia: a randomized controlled trial. J Consult Clin Psychol 2014; 82:670-83. [PMID: 24865869 PMCID: PMC4185428 DOI: 10.1037/a0036606] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine the unique contribution of behavior therapy (BT) and cognitive therapy (CT) relative to the full cognitive behavior therapy (CBT) for persistent insomnia. METHOD Participants were 188 adults (117 women; M age = 47.4 years, SD = 12.6) with persistent insomnia (average of 14.5 years duration). They were randomized to 8 weekly, individual sessions consisting of BT (n = 63), CT (n = 65), or CBT (n = 60). RESULTS Full CBT was associated with greatest improvements, the improvements associated with BT were faster but not as sustained and the improvements associated with CT were slower and sustained. The proportion of treatment responders was significantly higher in the CBT (67.3%) and BT (67.4%) relative to CT (42.4%) groups at post treatment, while 6 months later CT made significant further gains (62.3%), BT had significant loss (44.4%), and CBT retained its initial response (67.6%). Remission rates followed a similar trajectory, with higher remission rates at post treatment in CBT (57.3%) relative to CT (30.8%), with BT falling in between (39.4%); CT made further gains from post treatment to follow up (30.9% to 51.6%). All 3 therapies produced improvements of daytime functioning at both post treatment and follow up, with few differential changes across groups. CONCLUSIONS Full CBT is the treatment of choice. Both BT and CT are effective, with a more rapid effect for BT and a delayed action for CT. These different trajectories of changes provide unique insights into the process of behavior change via behavioral versus cognitive routes.
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Affiliation(s)
| | - Lynda Bélanger
- University of California, Berkeley, USA
- Université Laval, Québec, Canada
| | - Lisa Talbot
- University of California, Berkeley, USA
- Université Laval, Québec, Canada
| | - Polina Eidelman
- University of California, Berkeley, USA
- Université Laval, Québec, Canada
| | | | | | - Hans Ivers
- University of California, Berkeley, USA
- Université Laval, Québec, Canada
| | - Manon Lamy
- University of California, Berkeley, USA
- Université Laval, Québec, Canada
| | - Kerrie Hein
- University of California, Berkeley, USA
- Université Laval, Québec, Canada
| | | | - Chantal Mérette
- University of California, Berkeley, USA
- Université Laval, Québec, Canada
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Taylor DJ, Zimmerman MR, Gardner CE, Williams JM, Grieser EA, Tatum JI, Bramoweth AD, Francetich JM, Ruggero C. A pilot randomized controlled trial of the effects of cognitive-behavioral therapy for insomnia on sleep and daytime functioning in college students. Behav Ther 2014; 45:376-89. [PMID: 24680232 DOI: 10.1016/j.beth.2013.12.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 12/17/2013] [Accepted: 12/23/2013] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to pilot test if cognitive behavioral therapy for insomnia (CBT-I) is an effective intervention for insomnia and daytime functioning in college students. College students' developmental stage and lifestyle are significantly different than the general adult population, yet there have been no studies of CBT-I in this age group. Thirty-four college students (ages 18-27; M=19.71, SD=2.10) were randomly assigned to and completed either six sessions of CBT-I or a 6-week wait list control (WLC). All participants completed 1-week sleep diaries and actigraphy, as well as sleep and daytime functioning questionnaires at baseline and posttreatment. The treatment group repeated all measures at 3-month follow-up. Students who received CBT-I showed greater baseline to posttreatment improvements in sleep efficiency, sleep onset latency, number of awakenings, time awake after sleep onset, sleep quality, insomnia severity, dysfunctional beliefs about sleep, general fatigue, and global sleep quality than the WLC group. These improvements were durable at 3-month follow-up. Ninety-four percent of participants in the CBT-I condition completed at least 4 sessions of treatment. Significantly more participants in the CBT-I group than the WLC group responded (68.8% vs 7.7%, respectively) and remitted (68.8% vs 15.4%, respectively). CBT-I is an effective treatment for insomnia in college students. This study found that treatment responses were similar to results from studies in the general population. The treatment appeared to be well tolerated based on very low attrition rates.
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Shekleton JA, Flynn-Evans EE, Miller B, Epstein LJ, Kirsch D, Brogna LA, Burke LM, Bremer E, Murray JM, Gehrman P, Lockley SW, Rajaratnam SMW. Neurobehavioral performance impairment in insomnia: relationships with self-reported sleep and daytime functioning. Sleep 2014; 37:107-16. [PMID: 24470700 DOI: 10.5665/sleep.3318] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
STUDY OBJECTIVES Despite the high prevalence of insomnia, daytime consequences of the disorder are poorly characterized. This study aimed to identify neurobehavioral impairments associated with insomnia, and to investigate relationships between these impairments and subjective ratings of sleep and daytime dysfunction. DESIGN Cross-sectional, multicenter study. SETTING Three sleep laboratories in the USA and Australia. PATIENTS Seventy-six individuals who met the Research Diagnostic Criteria (RDC) for Primary Insomnia, Psychophysiological Insomnia, Paradoxical Insomnia, and/or Idiopathic Childhood Insomnia (44F, 35.8 ± 12.0 years [mean ± SD]) and 20 healthy controls (14F, 34.8 ± 12.1 years). INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Participants completed a 7-day sleep-wake diary, questionnaires assessing daytime dysfunction, and a neurobehavioral test battery every 60-180 minutes during an afternoon/evening sleep laboratory visit. Included were tasks assessing sustained and switching attention, working memory, subjective sleepiness, and effort. Switching attention and working memory were significantly worse in insomnia patients than controls, while no differences were found for simple or complex sustained attention tasks. Poorer sustained attention in the control, but not the insomnia group, was significantly associated with increased subjective sleepiness. In insomnia patients, poorer sustained attention performance was associated with reduced health-related quality of life and increased insomnia severity. CONCLUSIONS We found that insomnia patients exhibit deficits in higher level neurobehavioral functioning, but not in basic attention. The findings indicate that neurobehavioral deficits in insomnia are due to neurobiological alterations, rather than sleepiness resulting from chronic sleep deficiency.
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Affiliation(s)
- Julia A Shekleton
- Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA ; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA ; School of Psychology and Psychiatry, Monash University, Melbourne, Australia
| | - Erin E Flynn-Evans
- Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA ; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA
| | - Belinda Miller
- Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Australia ; Central Clinical School, Monash University, Melbourne, Australia
| | - Lawrence J Epstein
- Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA ; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA ; Sleep HealthCenters, Brighton, MA
| | - Douglas Kirsch
- Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA ; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA ; Sleep HealthCenters, Brighton, MA
| | - Lauren A Brogna
- Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Liza M Burke
- Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Erin Bremer
- Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Jade M Murray
- School of Psychology and Psychiatry, Monash University, Melbourne, Australia
| | - Philip Gehrman
- Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Steven W Lockley
- Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA ; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA ; School of Psychology and Psychiatry, Monash University, Melbourne, Australia
| | - Shantha M W Rajaratnam
- Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA ; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA ; School of Psychology and Psychiatry, Monash University, Melbourne, Australia
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[Psychological factors and sleep in the lifeworld nursing home from the nursing home residents' perspective. A qualitative study]. Z Gerontol Geriatr 2013; 47:221-7. [PMID: 24271140 DOI: 10.1007/s00391-013-0534-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Sleep disorders are common among nursing home residents. However, the possible involvement of psychological factors has been given little attention up until now. We investigated nursing home residents' perspective on psychological factors and sleep disorders within the nursing home environment. MATERIALS AND METHODS We conducted a qualitative interview study comprising episodic interviews with 30 nursing home residents in five different nursing homes. The data was analysed by thematic coding. RESULTS Nursing home residents require peace of mind in order to sleep well. Ruminations and thoughts disturb inner peace and are, in turn, caused by psychological factors. Of particular relevance is the end-of-life situation of the residents. Nursing home residents possess only limited strategies to relax and achieve inner peace. CONCLUSION Psychosocial factors play a central role in sleep disturbances among nursing home residents. Nurses and physicians who treat nursing home residents with sleep disorders should consider the possible psychosocial causes. Counselling and treatment should be given on an individual basis, for example by educating in relaxation techniques.
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Efficacy of acupuncture for primary insomnia: a randomized controlled clinical trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:163850. [PMID: 24159338 PMCID: PMC3789397 DOI: 10.1155/2013/163850] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 08/12/2013] [Indexed: 01/09/2023]
Abstract
Objectives. To investigate the six-week influence of acupuncture on sleep quality and daytime functioning in primary insomnia. Methods. The study was a double-dummy, single-blinded, randomized, placebo-controlled clinical trial. A total of 180 patients with primary insomnia were randomly assigned to 3 groups: verum group underwent verum acupuncture plus placebo; estazolam group underwent estazolam plus sham acupuncture; sham group underwent sham acupuncture plus placebo. The outcome was measured by Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the 36-item short-form health survey (SF-36). Results. The three groups showed significant improvement compared with the pretreatment baseline. Compared with the other two groups, the verum group reported improved sleep quality (SQ) and vitality (VT), decreased daytime dysfunction (DD) and sleepiness (ESS score). The differences were kept from the treatment period to the end of the trial. Discussion. Verum acupuncture appeared to be more effective in increasing sleep quality and daytime functioning than sham acupuncture and estazolam. Trial Registration. The trial is registeded with ClinicalTrials.gov ISRCTN12585433.
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Taylor DJ, Bramoweth AD, Grieser EA, Tatum JI, Roane BM. Epidemiology of insomnia in college students: relationship with mental health, quality of life, and substance use difficulties. Behav Ther 2013; 44:339-48. [PMID: 23768662 DOI: 10.1016/j.beth.2012.12.001] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 12/04/2012] [Accepted: 12/06/2012] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to evaluate the prevalence and correlates of insomnia using rigorous diagnostic criteria and a comprehensive assessment battery. In a large sample (N=1,074) of college students (mean age 20.39years), participants were asked to complete a week-long sleep diary and comprehensive questionnaire packet assessing recommended daytime functioning domains (i.e., fatigue, quality of life, depression, anxiety, stress, academic performance, substance use) during the academic year. A significant portion of this sample of college students met proposed DSM-5 criteria for chronic insomnia (9.5%). The chronic insomnia group reported significantly worse sleep, fatigue, depression, anxiety, stress, and quality of life, and greater hypnotic and stimulant use for sleep problems. There were no differences between groups on excessive daytime sleepiness, academic performance, or substance use. This was a rigorous and comprehensive assessment of the prevalence and psychosocial correlates of insomnia. Insomnia is a significant problem in college students and should be regularly assessed. More research is also needed to guide treatment in this population.
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Affiliation(s)
- Daniel J Taylor
- University of North Texas, Department of Psychology, Denton, TX 76203-5017, USA.
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Yang CM, Lin SC, Cheng CP. Transient insomnia versus chronic insomnia: a comparison study of sleep-related psychological/behavioral characteristics. J Clin Psychol 2013; 69:1094-107. [PMID: 23797824 DOI: 10.1002/jclp.22000] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Vulnerability to transient insomnia is regarded as a predisposing factor for chronic insomnia. However, most individuals with transient insomnia do not develop chronic insomnia. The current study investigated the differential contributing factors for these two conditions to further the understanding of this phenomenon. METHOD Chronic insomnia patients and normal sleepers with high and low vulnerability to transient insomnia completed measures of pre-sleep arousal, dysfunctional sleep beliefs, and sleep-related safety behaviors. RESULTS Both cognitive and somatic pre-sleep arousals were identified as significant predictors for transient insomnia. Dysfunctional beliefs regarding worry about insomnia and cognitive arousal were predictors for chronic insomnia. Sleep-related safety behavior, although correlated with insomnia severity, was not a significant predictor for both conditions. CONCLUSIONS Dysfunctional beliefs associated with worry and losing control over sleep are the most critical factors in differentiating chronic insomnia from transient insomnia. These factors should be addressed to help prevent individuals with high sleep vulnerability from developing chronic sleep disturbance.
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Samanta J, Dhiman RK, Khatri A, Thumburu KK, Grover S, Duseja A, Chawla Y. Correlation between degree and quality of sleep disturbance and the level of neuropsychiatric impairment in patients with liver cirrhosis. Metab Brain Dis 2013; 28:249-59. [PMID: 23494591 DOI: 10.1007/s11011-013-9393-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 02/22/2013] [Indexed: 12/11/2022]
Abstract
Sleep disturbances are common in patients of cirrhosis and has a significant effect on their health related quality of life (HRQOL). Thus far, no study has demonstrated a systematically studied significant correlation between the sleep disturbance observed and the neuropsychiatric impairment status of patients of cirrhosis. On the basis of PHES, we divided 100 cirrhotics into those having minimal hepatic encephalopathy (MHE) (PHES≤-5) and those not (NMHE). Now, in these MHE (n=46) and NMHE (n=54) patients, sleep disturbance was measured with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) and HRQOL with SF-36(v2) questionnaire. Sixty (60 %) patients were found to be 'poor sleepers' (PSQI>5) while 38 (38 %) patients had excessive daytime sleepiness (ESS≥11). Univariate and multivariate analyses showed MHE has significant effect among 'poor sleepers' (P<0.0001) as well as on those with EDS (P<0.0001). Significant correlation existed between PHES and both the sleep parameters of PSQI (r = -0.518, P <0.0001) as well as ESS (r = -0.383, P <0.0001), implying independently strong correlation between poor cognition and the presence of night time sleep disturbance and excessive daytime sleepiness among cirrhotics. Significant correlation existed between PSQI and ESS and the various scales and component scores of SF-36(v2) signifying the negative impact of sleep disturbance on the HRQOL. In conclusion, both night time sleep disturbance and excessive daytime sleepiness have significant relation with the neuropsychiatric impairment in patients of cirrhosis and are significantly associated with the observed impairment in HRQOL.
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Affiliation(s)
- Jayanta Samanta
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Kyle SD, Crawford MR, Morgan K, Spiegelhalder K, Clark AA, Espie CA. The Glasgow Sleep Impact Index (GSII): a novel patient-centred measure for assessing sleep-related quality of life impairment in Insomnia Disorder. Sleep Med 2013; 14:493-501. [PMID: 23347908 DOI: 10.1016/j.sleep.2012.10.023] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 09/13/2012] [Accepted: 10/29/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Daytime dysfunction and quality of life impairment are important and salient consequences of poor sleep in those with insomnia. Existing measurement approaches to functional impact tend to rely on non-specific generic tools, non-validated scales, or ad hoc single scale items. Here we report the development and validation of the Glasgow Sleep Impact Index (GSII), a novel self-report measure which asks patients to generate, and assess, three domains of impairment unique to their own individual context. These three patient-generated areas of impairment are ranked in order of concern (1-3; i.e. 1=the most concerning impairment), and then rated on a visual analogue scale with respect to impact in the past two weeks. Patients re-rate these specified areas of impairment, post-intervention, permitting both individual and group-level analyses. METHODS One-hundred and eight patients (71% female; Mean age=45 yrs) meeting Research Diagnostic Criteria for Insomnia Disorder completed the GSII, resulting in the generation of 324 areas (ranks) of sleep-related daytime and quality of life impairment. Fifty-five patients also completed the GSII pre- and post-sleep restriction therapy. The following psychometric properties were assessed: content validity of generated domains; relationship between ranks of impairment; and sensitivity to change post-behavioural intervention. RESULTS Content analysis of generated domains support recent DSM-5 proposals for specification of daytime consequences of insomnia; with the most commonly cited areas reflecting impairments in energy/motivation, work performance, cognitive functioning, emotional regulation, health/well-being, social functioning and relationship/family functioning. Preliminary results with 108 patients indicate the GSII to have excellent face and construct validity. The GSII was found to be sensitive to change, post-behavioural treatment (p<0.001; Cohen's d≥0.85 for all three ranks of impairment), and improvements were associated with reductions in insomnia severity in both correlational (range of r=0.28-0.56) and responder versus non-responder analyses (all p<0.05). CONCLUSIONS The development of the GSII represents a novel attempt to capture and measure sleep-related quality of life impairment in a valid and meaningful way. Further psychometric and clinical evaluation is suggested.
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Affiliation(s)
- Simon D Kyle
- University of Glasgow Sleep Centre, Institute of Neuroscience & Psychology, University of Glasgow, Scotland, United Kingdom.
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Schwartz DR, Carney CE. Mediators of cognitive-behavioral therapy for insomnia: A review of randomized controlled trials and secondary analysis studies. Clin Psychol Rev 2012; 32:664-75. [DOI: 10.1016/j.cpr.2012.06.006] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 05/02/2012] [Accepted: 06/25/2012] [Indexed: 11/29/2022]
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Excessive daytime sleepiness assessed by the Epworth Sleepiness Scale and its association with health related quality of life: a population-based study in China. BMC Public Health 2012; 12:849. [PMID: 23039935 PMCID: PMC3524046 DOI: 10.1186/1471-2458-12-849] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Accepted: 09/27/2012] [Indexed: 11/30/2022] Open
Abstract
Background Excessive daytime sleepiness (EDS) is a common condition worldwide that has many negative effects on people who were afflicted with it, especially on their health-related quality of life (HRQOL). The Epworth Sleepiness Scale (ESS) is a commonly used method for evaluating EDS in English-speaking countries. This paper reported the prevalence of subjective EDS in China as assessed by the Mandarin version of the ESS; tested the scale’s response rate, reliability and validity; and investigated the relationship between ESS scores and HRQOL. Methods A population-based sample of 3600 residents was selected randomly in five cities in China. The demographic information was collected, subjective EDS was assessed by the Mandarin version of the ESS (ESS scores >10), and HRQOL was evaluated by the Mandarin version of the 36-item Short Form Health Survey (SF-36). Results The Mandarin version of ESS had very few missing responses, and the average response rate of its eight items was 97.92%. The split-half reliability coefficient and Cronbach’s α coefficient were 0.81 and 0.80, respectively. One factor was identified by factor analysis with an eigenvalue of 2.78. The ESS scores showed positive skewness in the selected sample, with a median (Q1, Q3) of 6 (3, 0). 644 (22.16%) respondents reported subjective EDS, and all of the scores of the eight dimensions of the SF-36 were negatively correlated with ESS scores. Conclusions The Mandarin version of ESS is an acceptable, reliable, and valid tool for measuring EDS. In addition, subjective EDS is common in China, based on the ESS results, and impairs HRQOL.
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Dayapoğlu N, Tan M. Evaluation of the effect of progressive relaxation exercises on fatigue and sleep quality in patients with multiple sclerosis. J Altern Complement Med 2012; 18:983-7. [PMID: 22967281 PMCID: PMC3469207 DOI: 10.1089/acm.2011.0390] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Fatigue and sleep problems are very commonly observed in patients with multiple sclerosis (MS). The Progressive Muscle Relaxation Technique (PMRT), used as one of the alternative methods in recent years, is reported to have benefits such as facilitating sleep and reducing sensitivity against fatigue. This research was conducted to investigate the effect of PMRT on fatigue and sleep quality in patients with MS. SETTING AND DESIGN This research was performed as a single-group pretest/post-test pretrial model. The research was conducted between March 2008 and December 2009 in the neurology polyclinic. MATERIALS AND METHODS The study was conducted with 32 patients who met the research criteria and agreed to participate in the study. A Personal Information Form was used as a data collection tool, Fatigue Severity Scale was used for measuring fatigue, and the Pittsburgh Sleep Quality Index was used for evaluating the sleep quality. PMRT was applied to the sample group once a day for 6 weeks. STATISTICAL ANALYSIS Percentage, paired t-test, and Pearson's correlation analysis were used in the assessment of data. RESULTS It was determined that PMRT decreased patients' fatigue level and improved their sleep quality, and this difference was observed to be statistically significant. Moreover, patients' fatigue level increased as their sleep quality decreased. CONCLUSIONS This study supports the effect of PMRT on fatigue and sleep quality in patients with MS, and it is recommended that further studies be conducted on this subject in the future.
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Affiliation(s)
- Nuray Dayapoğlu
- Department of Internal Diseases Nursing, Faculty of Health Science, Atatürk University, Erzurum, Turkey.
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Taibi DM, Vitiello MV. Yoga for osteoarthritis: nursing and research considerations. J Gerontol Nurs 2012; 38:26-35; quiz 36-7. [PMID: 22715961 DOI: 10.3928/00989134-20120608-04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 01/11/2012] [Indexed: 11/20/2022]
Abstract
Osteoarthritis (OA) is a leading cause of pain and disability worldwide. Current treatment guidelines recommend nonpharmacological approaches such as yoga for firstline treatment of OA. Yoga is a promising mind-body practice that includes physical postures, breathing practices, and meditative mental focus. This article presents the current evidence, as well as a proposed conceptual model for future research. Current research on yoga for OA is scant but promising, showing some evidence of reduced pain, sleep disturbance, and disability. The conceptual model described here proposes musculoskeletal effects (strengthening, flexibility, relaxation), reduction of autonomic arousal, and therapeutic cognitive patterns (distraction, mindfulness) as potentially important mechanisms of yoga. This article also describes considerations for patients and health care providers when evaluating the potential usefulness and safety of yoga programs: yoga style, instructor qualifications, and amount of time spent in yoga practice.
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Affiliation(s)
- Diana M Taibi
- Departments of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
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Gottschalk C, Scheuermann P, Wiater A. Schlafstörungen im Kindesalter. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2011; 54:1303-10. [DOI: 10.1007/s00103-011-1377-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mayer G. [Frequently occurring sleep disorders]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2011; 54:1284-95. [PMID: 22116478 DOI: 10.1007/s00103-011-1376-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Some sleep disorders are frequently found in the general population. The most common include restless legs syndrome, insomnia, and sleep apnea. These sleep disorders are well classified and can easily be diagnosed and treated. Since they are risk factors for cardiovascular and psychiatric disorders, early diagnosis and treatment are essential to prevent these sequelae. The impairments caused by these sleep disorders (e.g., due to daytime sleepiness, sleep disruption, or cognitive deficits) can result in a significant reduction in a person's quality of life. The diagnostic and therapeutic recommendations were taken from the S3 guideline "Nonrestorative sleep/sleep disorders" by the German Sleep Society. The levels of evidence were given according to the recommendations of the Oxford Centre for Evidence-based Medicine.
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Affiliation(s)
- G Mayer
- Hephata-Klinik Schwalmstadt-Treysa, Schwalmstadt-Treysa,Germany.
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Comorbid insomnia in sleep-related breathing disorders: an under-recognized association. Sleep Breath 2011; 16:295-304. [DOI: 10.1007/s11325-011-0513-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 03/08/2011] [Accepted: 03/11/2011] [Indexed: 10/18/2022]
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