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Jensen SM, Friborg O, Mellgren SI, Müller KI, Bergvik S, Arntzen KA. Health-Related Quality of Life in FKRP-Related Limb-Girdle Muscular Dystrophy R9. J Neuromuscul Dis 2024; 11:59-74. [PMID: 37927270 PMCID: PMC10789334 DOI: 10.3233/jnd-221629] [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] [Accepted: 10/04/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Limb-girdle muscular dystrophy R9 (LGMDR9) is a chronic progressive hereditary muscle disease, related to the Fukutin Related Protein (FKRP) gene, that may cause major disabilities, cardiomyopathy, and ventilatory failure. Knowledge of how LGMDR9 affects health-related quality of life (HRQoL) is relevant in treatment and care. OBJECTIVE To investigate HRQoL in the Norwegian LGMDR9 population over 14 months and relation to fatigue and sleep quality. METHODS Participants (16+ years) of the Norwegian LGMDR9 cohort study completed two HRQoL measures, i.e., Individualized Neuromuscular Quality of Life questionnaire (INQoL) and the 36-item Short Form (SF-36) at baseline, 8, and 14 months and measures of fatigue and sleep quality at 9 months. RESULTS HRQoL response rate was 84/90 (75 c.826 C > A homozygotes and nine c.826 C > A compound heterozygotes). Compared to Norwegian normative data, all SF-36 domain scores were impaired (p≤0.006) except mental health in males (p = 0.05) and pain scores. During 14 months, perceived muscle weakness and the INQoL index (disease burden) worsened in c.826 C > A homozygotes. Compound heterozygotes reported more dysphagia and physical difficulties than homozygotes and showed a tendency towards worsening in weakness over time but some improvement on the INQoL index. Homozygous females reported generally poorer HRQoL and a higher burden than males. The INQoL index was related to perceived muscle weakness and fatigue, and fatigue to myalgia and mental distress. The prevalence of fatigue and poor sleep was 40% and 49%, respectively. CONCLUSIONS The 14-month follow-up period shows a worsening of perceived weakness and burden in c.826 C > A homozygotes, which can then be expected. The prevalence and impact of fatigue indicate a need for awareness and treatment of fatigue. Myalgia and mental distress are potential targets in the treatment of fatigue, which future studies need to establish. Sleep issues and gender-specific care needs also require attention in LGMDR9.
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Affiliation(s)
- Synnøve M. Jensen
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway (UNN), Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø –The Artic University of Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health Sciences, University of Tromsø –The Artic University of Norway, Tromsø, Norway
| | - Svein Ivar Mellgren
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway (UNN), Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø –The Artic University of Norway, Tromsø, Norway
| | - Kai Ivar Müller
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway (UNN), Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø –The Artic University of Norway, Tromsø, Norway
- Department of Neurology, Sørlandet Hospital Trust, Kristiansand, Norway
| | - Svein Bergvik
- Department of Psychology, Faculty of Health Sciences, University of Tromsø –The Artic University of Norway, Tromsø, Norway
| | - Kjell Arne Arntzen
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway (UNN), Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø –The Artic University of Norway, Tromsø, Norway
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Jang H, Lee S, Son Y, Seo S, Baek Y, Mun S, Kim H, Kim I, Kim J. Exploring Variations in Sleep Perception: Comparative Study of Chatbot Sleep Logs and Fitbit Sleep Data. JMIR Mhealth Uhealth 2023; 11:e49144. [PMID: 37988148 PMCID: PMC10698662 DOI: 10.2196/49144] [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: 05/24/2023] [Revised: 09/11/2023] [Accepted: 10/18/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Patient-generated health data are important in the management of several diseases. Although there are limitations, information can be obtained using a wearable device and time-related information such as exercise time or sleep time can also be obtained. Fitbits can be used to acquire sleep onset, sleep offset, total sleep time (TST), and wakefulness after sleep onset (WASO) data, although there are limitations regarding the depth of sleep and satisfaction; therefore, the patient's subjective response is still important information that cannot be replaced by wearable devices. OBJECTIVE To effectively use patient-generated health data related to time such as sleep, it is first necessary to understand the characteristics of the time response recorded by the user. Therefore, the aim of this study was to analyze the characteristics of individuals' time perception in comparison with wearable data. METHODS Sleep data were acquired for 2 weeks using a Fitbit. Participants' sleep records were collected daily through chatbot conversations while wearing the Fitbit, and the two sets of data were statistically compared. RESULTS In total, 736 people aged 30-59 years were recruited for this study, and the sleep data of 543 people who wore a Fitbit and responded to the chatbot for more than 7 days on the same day were analyzed. Research participants tended to respond to sleep-related times on the hour or in 30-minute increments, and each participant responded within the range of 60-90 minutes from the value measured by the Fitbit. On average for all participants, the chat responses and the Fitbit data were similar within a difference of approximately 15 minutes. Regarding sleep onset, the participant response was 8 minutes and 39 seconds (SD 58 minutes) later than that of the Fitbit data, whereas with respect to sleep offset, the response was 5 minutes and 38 seconds (SD 57 minutes) earlier. The participants' actual sleep time (AST) indicated in the chat was similar to that obtained by subtracting the WASO from the TST measured by the Fitbit. The AST was 13 minutes and 39 seconds (SD 87 minutes) longer than the time WASO was subtracted from the Fitbit TST. On days when the participants reported good sleep, they responded 19 (SD 90) minutes longer on the AST than the Fitbit data. However, for each sleep event, the probability that the participant's AST was within ±30 and ±60 minutes of the Fitbit TST-WASO was 50.7% and 74.3%, respectively. CONCLUSIONS The chatbot sleep response and Fitbit measured time were similar on average and the study participants had a slight tendency to perceive a relatively long sleep time if the quality of sleep was self-reported as good. However, on a participant-by-participant basis, it was difficult to predict participants' sleep duration responses with Fitbit data. Individual variations in sleep time perception significantly affect patient responses related to sleep, revealing the limitations of objective measures obtained through wearable devices.
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Affiliation(s)
- Hyunchul Jang
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Siwoo Lee
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Yunhee Son
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sumin Seo
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Younghwa Baek
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sujeong Mun
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hoseok Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Icktae Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Junho Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Secondhand smoke is associated with poor sleep quality in self-reported never-smokers of Northwest China: a cross-sectional study. Sleep Breath 2021; 26:1417-1426. [PMID: 34674105 DOI: 10.1007/s11325-021-02505-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate the relationship between secondhand smoke (SHS) exposure and sleep quality in never-smokers of Northwest China. METHODS Never-smoking adults (≥ 15 years) from Xinjiang, Northwest China, were included in this cross-sectional survey between April and October 2019. SHS exposure in never-smokers was estimated using a structured questionnaire. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI), with PSQI score > 5 classified as poor sleep quality. Association of SHS exposure and frequency and duration of SHS exposure with poor sleep quality were analyzed by using a multivariate logistic regression after adjusting for potential confounding factors, including stratification by sex. RESULTS The mean age of participants was 48.0 years, and 77% were females. Of 21,198 never-smokers, 13% (n = 2703) reported SHS exposure and 35% (n = 7390) reported poor sleep quality. In multivariate logistic regression analysis, a significant association was observed between SHS exposure and poor sleep quality (adjusted odds ratio (OR), 1.36; 95% confidence interval (CI) 1.24-1.48). Subgroup analysis showed a negative association of SHS exposure with sleep quality in both sexes. However, a significant dose-response relationship of frequency and duration of SHS exposure per week with poor sleep quality was observed only in females. Consistent results were also observed in the aged ≥ 18 years. CONCLUSION Exposure to SHS is associated with poor sleep quality in never-smoking adults of Northwest China. A dose-response relationship between SHS exposure and poor sleep quality is found in women. Avoiding SHS exposure may have beneficial effects on sleep quality, especially for females.
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Savall A, Marcoux P, Charles R, Trombert B, Roche F, Berger M. Sleep quality and sleep disturbances among volunteer and professional French firefighters: FIRESLEEP study. Sleep Med 2021; 80:228-235. [PMID: 33610069 DOI: 10.1016/j.sleep.2021.01.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/22/2020] [Accepted: 01/26/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although insufficient sleep among firefighters reduces work efficiency and increases the risk of injury, little is known about the sleep quality of French firefighters in the Loire department. The aim of the FIRESLEEP study was to evaluate sleep quality and sleep disturbances among professional and voluntary French firefighters. METHODS A cross-sectional observational study was conducted between November 2018 and May 2019. Firefighters were invited to complete a questionnaire on a secure platform including clinical questions and validated questionnaires (Pittsburgh Sleep Quality Index [PSQI], Epworth sleepiness scale [ESS], Insomnia Severity Index [ISI] and the STOP-Bang score) during their periodic medical examination. RESULTS 193 firefighters were included in this study, of which 29% were of professional status and 71% were volunteer firefighters. Among them, 26.9% had poor sleep quality, 27.7% showed excessive daytime sleepiness (EDS), 18.8% reported moderate-to-severe symptoms of insomnia, and 1.6% had moderate-to-high risk of obstructive sleep apnea. Subgroup analysis revealed that professional firefighters had poorer sleep quality and higher sleep disturbances than volunteer firefighters. The independent risk factors associated with poor sleep quality were known sleep disorder, treated anxiety/depression, night calls, and insomnia symptoms. Moreover, the independent risk factors associated with EDS were short sleep duration, taking a nap, and insomnia symptoms; while older age was a protective factor for EDS. CONCLUSIONS Poor sleep quality and sleep disturbances are highly frequent in French firefighters and underdiagnosed. Prevention through education and systematic screening could limit the impact of sleep disturbances on firefighters' global health.
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Affiliation(s)
- Angélique Savall
- Department of Education and Research in General Practice, Saint-Etienne Jean Monnet University, Pôle Santé Nord, 42270 Saint Priest en Jarez, France; Clinical and Exercise Physiology, EA 4607 SNA EPIS, University Hospital and Jean Monnet University, PRES Lyon, 42023 Saint-Etienne, France.
| | - Pierre Marcoux
- Department of Education and Research in General Practice, Saint-Etienne Jean Monnet University, Pôle Santé Nord, 42270 Saint Priest en Jarez, France
| | - Rodolphe Charles
- Department of Education and Research in General Practice, Saint-Etienne Jean Monnet University, Pôle Santé Nord, 42270 Saint Priest en Jarez, France; Loire Departmental Fire and Emergency Service (DFES 42), 42007 Saint Etienne, France
| | - Béatrice Trombert
- Public Health, University Hospital, 42277 Saint-Priest-en-Jarez Cedex, France; Clinical and Exercise Physiology, EA 4607 SNA EPIS, University Hospital and Jean Monnet University, PRES Lyon, 42023 Saint-Etienne, France
| | - Frédéric Roche
- Clinical and Exercise Physiology, EA 4607 SNA EPIS, University Hospital and Jean Monnet University, PRES Lyon, 42023 Saint-Etienne, France
| | - Mathieu Berger
- Clinical and Exercise Physiology, EA 4607 SNA EPIS, University Hospital and Jean Monnet University, PRES Lyon, 42023 Saint-Etienne, France.
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Wang Y, Li Y, Liu X, Liu R, Mao Z, Tu R, Zhang H, Zhang X, Qian X, Jiang J, Qiao D, Luo Z, Dong X, Liu X, Wang C. Gender-specific prevalence of poor sleep quality and related factors in a Chinese rural population: the Henan Rural Cohort Study. Sleep Med 2019; 54:134-141. [DOI: 10.1016/j.sleep.2018.10.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 12/21/2022]
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Examination of the Relationship Between Elective Surgical Patients' Methods for Coping With Stress and Sleeping Status the Night Before an Operation. J Perianesth Nurs 2018; 33:855-864. [DOI: 10.1016/j.jopan.2017.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/04/2017] [Accepted: 08/10/2017] [Indexed: 11/30/2022]
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Hammersen F, Lewin P, Gebauer J, Kreitschmann-Andermahr I, Brabant G, Katalinic A, Waldmann A. Sleep quality and health-related quality of life among long-term survivors of (non-) Hodgkin lymphoma in Germany. PLoS One 2017; 12:e0187673. [PMID: 29107959 PMCID: PMC5673196 DOI: 10.1371/journal.pone.0187673] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/24/2017] [Indexed: 12/12/2022] Open
Abstract
This study investigated sleep quality and health-related quality of life (HRQOL) among long-term survivors of Hodgkin (HL) and non-Hodgkin lymphoma (NHL). The aim was to explore the impact of personal and health-related factors on sleep quality as well as associations between sleep quality and HRQOL. For the postal survey, participants with a minimum age of 18 years initially treated between 1998 and 2008 were recruited via the population-based cancer registry in Schleswig-Holstein, Northern Germany. Questionnaires included amongst others the Pittsburg Sleep Quality Index (PSQI) and the 36-Item Short Form Health Survey (SF-36v1). Descriptive and comparative statistics were performed. Additionally, a regression analysis was conducted to identify predictors of sleep quality. In total, we recruited 515 participants (398 NHL, 117 HL) with a mean age of 63.1 years. Approximately half of the survivors were classified as good sleepers. HRQOL scores differed between good and poor sleepers with lower scores in poor sleepers. In a prediction model, self-reported depression, exhaustion, higher age, inability to work, endocrinological disorders and female gender classified as predictors of sleep quality. This study highlights the impact of sleep quality on HRQOL in long-term survivors of NHL and HL. Thus, sleep quality should be routinely assessed during follow-up of cancer survivors with special attention to patients with potential risk factors.
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Affiliation(s)
- Friederike Hammersen
- Institute for Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
- * E-mail:
| | - Philip Lewin
- Institute for Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Judith Gebauer
- Experimental and Clinical Endocrinology Department of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
| | | | - Georg Brabant
- Experimental and Clinical Endocrinology Department of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
- Institute for Cancer Epidemiology e.V., University of Luebeck, Luebeck, Germany
| | - Annika Waldmann
- Institute for Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
- Hamburg Cancer Registry, Hamburg, Germany
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Tang J, Liao Y, Kelly BC, Xie L, Xiang YT, Qi C, Pan C, Hao W, Liu T, Zhang F, Chen X. Gender and Regional Differences in Sleep Quality and Insomnia: A General Population-based Study in Hunan Province of China. Sci Rep 2017; 7:43690. [PMID: 28262807 PMCID: PMC5337959 DOI: 10.1038/srep43690] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 01/30/2017] [Indexed: 01/23/2023] Open
Abstract
Insomnia and the inability to sleep affect people's health and well-being. However, its systematic estimates of prevalence and distribution in the general population in China are still lacking. A population-based cluster sampling survey was conducted in the rural and urban areas of Hunan, China. Subjects (n = 26,851) were sampled from the general population, with a follow-up using the Pittsburgh Sleep Quality Index (PSQI) for interview to assess quality of sleep and Insomnia (PSQI score >5). While the overall prevalence of insomnia was 26.6%, and little difference was found between males (26.3%) and females (27.0%); the mean PSQI score was 4.26 (±2.67), and significant higher in females (4.32 ± 2.70) than males (4.21 ± 2.64, p = 0.003). Individuals in the rural areas tended to report a higher PSQI score (4.45 ± 2.81) than urban residents did (4.18 ± 2.60) (p < 0.001) and the estimates of prevalence of insomnia was 29.4% in the rural areas, significant higher than 25.5% in the urban areas (p < 0.001). Multiple logistic regression analysis showed that female gender, older age, higher level of education, being unmarried, living in the rural area, cigarette smoking and alcohol drinking were associated with insomnia. Our study may provide important information for general and mental health research.
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Affiliation(s)
- Jinsong Tang
- Department of Psychiatry &Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders &National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, 139 Renmin (M) Rd, Changsha, Hunan 410011, P. R. China.,Department of Psychiatry and Biobehavioral Sciences, UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Yanhui Liao
- Department of Psychiatry &Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders &National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, 139 Renmin (M) Rd, Changsha, Hunan 410011, P. R. China.,Department of Psychiatry and Biobehavioral Sciences, UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Brian C Kelly
- Department of Sociology &Center for Research on Young People's Health (CRYPH), Purdue University, 700 W State Street, West Lafayette, IN 47907, USA
| | - Liqin Xie
- Changsha Social Work College, 22 Xiangzhang Rd, Yuhua, Changsha, Hunan, 410116, P. R. China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Avenida da Universidade, 3/F, Building E12, Macau SAR, Taipa, P. R. China
| | - Chang Qi
- Department of Psychiatry &Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders &National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, 139 Renmin (M) Rd, Changsha, Hunan 410011, P. R. China
| | - Chen Pan
- Clinical Psychology Department, the Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | - Wei Hao
- Department of Psychiatry &Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders &National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, 139 Renmin (M) Rd, Changsha, Hunan 410011, P. R. China
| | - Tieqiao Liu
- Department of Psychiatry &Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders &National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, 139 Renmin (M) Rd, Changsha, Hunan 410011, P. R. China
| | - Fengyu Zhang
- Department of Psychiatry &Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders &National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, 139 Renmin (M) Rd, Changsha, Hunan 410011, P. R. China
| | - Xiaogang Chen
- Department of Psychiatry &Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders &National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, 139 Renmin (M) Rd, Changsha, Hunan 410011, P. R. China
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Assessment of Sleep Quality and Effects of Relaxation Exercise on Sleep Quality in Patients Hospitalized in Internal Medicine Services in a University Hospital: The Effect of Relaxation Exercises in Patients Hospitalized. Holist Nurs Pract 2017; 30:155-65. [PMID: 27078810 DOI: 10.1097/hnp.0000000000000147] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study aims to assess sleep quality and determine the effects of relaxation exercise on sleep quality in patients hospitalized in internal medicine services. In total, 47 patients comprised the control group and did not engage in the exercise intervention--the progressive muscle relaxation exercise, whereas 235 patients were assigned to the intervention group (N = 282). In this study, Description Questionnaire Form and the Pittsburg Sleep Quality Index (PSQI) were used. Most patients (73.8%) had poor sleep quality. The mean pre- and postexercise PSQI scores of the patients in the interventional group were 8.7 ± 4.0 and 6.1 ± 3.3, respectively. The mean pre- and postexercise PSQI scores of the control patients were 6.6 ± 3.5 and 5.6 ± 2.7, respectively. According to this study, the exercises significantly enhanced the quality of sleep. Patients should be encouraged by nurses to perform relaxation exercises.
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Sithey G, Wen LM, Kelly P, Li M. Association between Sleep Duration and Self-Reported Health Status: Findings from the Bhutan's Gross National Happiness Study. J Clin Sleep Med 2017; 13:33-38. [PMID: 27707437 DOI: 10.5664/jcsm.6382] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 08/25/2016] [Indexed: 01/06/2023]
Abstract
STUDY OBJECTIVES Short and long sleep durations have been found to be associated with chronic conditions like diabetes mellitus, hypertension and cardiovascular disease. However, most studies were conducted in developed countries and the results were inconsistent. The aim of this study is to investigate the association between sleep duration and self-reported health status in a developing country setting. METHODS We conducted secondary data analysis of the 2010 Gross National Happiness study of Bhutan, which was a nationwide cross sectional study with representative samples from rural and urban areas. The study included 6476 participants aged 15-98 y. The main outcome variable of interest was self-reported health status. Sleep duration was categorized as ≤ 6 h, 7 h, 8 h, 9 h, 10 h, and ≥ 11 h. Multiple logistic regressions were conducted to investigate the association between sleep duration and self-reported health status. RESULTS The mean sleep duration was 8.5 (± 1.65) h. Only 9% of the respondents slept for 7 h; 6% were short sleepers (≤ 6 h) and 84% were long sleepers (21%, 8 h; 28%, 9 h; 22%, 10 h; 13%, ≥ 11 h). We found that both short (≤ 6 h) and long sleep duration (≥ 11 h) were independently associated with poor self-reported health status. CONCLUSIONS This study found that people with shorter and longer sleep durations were more likely to report poorer health status.
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Affiliation(s)
- Gyambo Sithey
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia
| | - Li Ming Wen
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia.,Health Promotion Unit, Sydney Local Health District, New South Wales, Australia
| | - Patrick Kelly
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia
| | - Mu Li
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia
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Sakhelashvili I, Eliozishvili M, Basishvili T, Datunashvili M, Oniani N, Cervena K, Darchia N. Sleep-wake patterns and sleep quality in urban Georgia. Transl Neurosci 2016; 7:62-70. [PMID: 28123823 PMCID: PMC5234514 DOI: 10.1515/tnsci-2016-0010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/23/2016] [Indexed: 11/20/2022] Open
Abstract
Objectives Sleep problems represent a worldwide health concern but their prevalence and impacts are unknown in most non-European/North American countries. This study aimed to evaluate sleep-wake patterns, sleep quality and potential correlates of poor sleep in a sample of the urban Georgian population. Methods Analyses are based on 395 volunteers (267 females, 128 males, aged 20-60 years) of the Georgia Somnus Study. Subjects completed the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory-Short Form. Sociodemographic information and self-reported height and weight were collected. Results 43% of subjects had poor sleep quality (PSQI > 5). Further, 41% had low sleep efficiency, 27.6% slept 6 hours or less, 32.4% went to bed after midnight, 27.6% snored, 10.6% were taking sleep medication, and 26.8% had sleep maintenance problems as occurring three or more times a week. The latest bedtime, rise time, and gender effect on these variables were found in the age group 20-29 years. PSQI global score showed a significant age but not gender difference. The economic status and the depression score were two significant predictors of sleep quality. Conclusions Poor sleep quality has a high prevalence and is strongly linked to the economic status. Study findings call for a global assessment of sleep problems in countries where sleep disturbances represent an insufficiently recognized public health issue.
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Affiliation(s)
- Irine Sakhelashvili
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| | - Marine Eliozishvili
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| | - Tamar Basishvili
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| | - Maia Datunashvili
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| | - Nikoloz Oniani
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| | - Katerina Cervena
- Sleep Medicine Center, Division of Pneumology, University Hospital of Geneva, Geneva, Switzerland
| | - Nato Darchia
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
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Hinz A, Glaesmer H, Brähler E, Löffler M, Engel C, Enzenbach C, Hegerl U, Sander C. Sleep quality in the general population: psychometric properties of the Pittsburgh Sleep Quality Index, derived from a German community sample of 9284 people. Sleep Med 2016; 30:57-63. [PMID: 28215264 DOI: 10.1016/j.sleep.2016.03.008] [Citation(s) in RCA: 234] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/03/2016] [Accepted: 03/14/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The Pittsburgh Sleep Quality Index (PSQI) is frequently used to assess sleep problems in patients. The aim of this study was to provide reference values for this questionnaire, to test psychometric properties, and to analyze associations with psychological, sociodemographic, and behavioral factors. METHODS A German community sample comprising 9284 adult residents (aged 18-80 years) was surveyed using the PSQI and several other questionnaires. RESULTS According to the generally accepted cut-off (PSQI > 5), 36% of the general population slept badly. Females reported significantly more sleep problems than males (mean scores: M = 5.5 vs. M = 4.4, respectively; effect size d = 0.35), but there was no linear association between age and sleep quality. Sleep problems were correlated with fatigue, quality of life (physical as well as mental), physical complaints, anxiety, and lack of optimism. Sleep quality was also strongly associated with socioeconomic status, professional situation (poorest sleep quality in unemployed people), and obesity. In addition to the results of the PSQI total score, mean scores of specific components of sleep quality were presented (sleep latency, sleep duration, and use of sleep medication). CONCLUSION The PSQI proved to be a suitable instrument for measuring sleep quality. Gender differences, psychological factors, and obesity should be taken into account when groups of patients are compared with respect to sleep problems.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany; Clinic for Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Cornelia Enzenbach
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry, University of Leipzig, Leipzig, Germany
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Morning headaches, daytime functioning and sleep problems – a population-based controlled study. Wien Klin Wochenschr 2010; 122:579-83. [DOI: 10.1007/s00508-010-1464-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 09/07/2010] [Indexed: 11/25/2022]
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Patel NP, Grandner MA, Xie D, Branas CC, Gooneratne N. "Sleep disparity" in the population: poor sleep quality is strongly associated with poverty and ethnicity. BMC Public Health 2010; 10:475. [PMID: 20701789 PMCID: PMC2927542 DOI: 10.1186/1471-2458-10-475] [Citation(s) in RCA: 245] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 08/11/2010] [Indexed: 01/17/2023] Open
Abstract
Background Little is known about the social determinants of sleep attainment. This study examines the relationship of race/ethnicity, socio-economic status (SES) and other factors upon sleep quality. Methods A cross-sectional survey of 9,714 randomly selected subjects was used to explore sleep quality obtained by self-report, in relation to socioeconomic factors including poverty, employment status, and education level. The primary outcome was poor sleep quality. Data were collected by the Philadelphia Health Management Corporation. Results Significant differences were observed in the outcome for race/ethnicity (African-American and Latino versus White: unadjusted OR = 1.59, 95% CI 1.24-2.05 and OR = 1.65, 95% CI 1.37-1.98, respectively) and income (below poverty threshold, unadjusted OR = 2.84, 95%CI 2.41-3.35). In multivariable modeling, health indicators significantly influenced sleep quality most prominently in poor individuals. After adjusting for socioeconomic factors (education, employment) and health indicators, the association of income and poor sleep quality diminished, but still persisted in poor Whites while it was no longer significant in poor African-Americans (adjusted OR = 1.95, 95% CI 1.47-2.58 versus OR = 1.16, 95% CI 0.87-1.54, respectively). Post-college education (adjusted OR = 0.47, 95% CI 0.31-0.71) protected against poor sleep. Conclusions A "sleep disparity" exists in the study population: poor sleep quality is strongly associated with poverty and race. Factors such as employment, education and health status, amongst others, significantly mediated this effect only in poor subjects, suggesting a differential vulnerability to these factors in poor relative to non-poor individuals in the context of sleep quality. Consideration of this could help optimize targeted interventions in certain groups and subsequently reduce the adverse societal effects of poor sleep.
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Affiliation(s)
- Nirav P Patel
- Center for Sleep and Respiratory Neurobiology, University of Pennsylvania, Philadelphia, PA, USA
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15
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Zeitlhofer J, Seidel S, Klösch G, Moser D, Anderer P, Machatschke I, Bolitschek J, Fugger B, Holzinger B, Kerbl R, Lehofer M, Mallin W, Pavelka R, Popovic R, Saletu A, Saletu B, Högl B. Die Schlafgewohnheiten der Österreicher. SOMNOLOGIE 2010. [DOI: 10.1007/s11818-010-0452-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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16
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17
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Influence of Abusive Vocal Habits, Hydration, Mastication, and Sleep in the Occurrence of Vocal Symptoms in Teachers. J Voice 2010; 24:86-92. [DOI: 10.1016/j.jvoice.2008.06.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Accepted: 06/04/2008] [Indexed: 11/23/2022]
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18
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Physicians appeals on the dangers of mobile communication--what is the evidence? Assessment of public health data. Int J Hyg Environ Health 2009; 212:576-87. [PMID: 19736044 DOI: 10.1016/j.ijheh.2009.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Revised: 07/13/2009] [Accepted: 07/19/2009] [Indexed: 12/22/2022]
Abstract
In October 2002 German physicians appealed to persons in the field of health care, politicians and the public with "great concern" ("Freiburger Appell", "Appeal of Freiburg") claiming "soaring incidences of symptoms and diseases in the general population" to be causally related to the "commence of radio (wave) burden", i.e. due to mobile radio technology. This first example was followed by several further appeals published nationally and Europe-wide up until today. The aim of the present paper is an evaluation of the scientific literature and databases to check incidence and prevalence of symptoms and diseases stated in the appeals to have "dramatically increased" or to have appeared in "greater frequency" in adults. If the allegations were true a clear time-trend should show up since the start of widely-used mobile communication technology. The following health conditions were considered: Alzheimer's disease, dementia, sleep disturbances, tinnitus, cerebrovascular disease, ischemic heart-diseases, headache, migraine. Data on the incidence of these conditions were assessed from 1993 through at least 2005. For this, a systematic search by keywords was performed in the online-database of the National Library of Medicine (pubmed) and other national and international (European and US) databases. For none of the considered symptoms or diseases a "dramatic increase" was found to have occurred since 1993. Because of the different diagnoses and terms used in the studies, direct comparability is somewhat difficult. Indeed, with the data available no time related increases and surely no "dramatic increase" can be identified, even if the limited comparability is considered. This analysis strongly suggests that the allegations of the quoted appeals are not supported by public health data.
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Riemerth A, Kunze U, Groman E. Nocturnal sleep-disturbing nicotine craving and accomplishment with a smoking cessation program. Wien Med Wochenschr 2009; 159:47-52. [DOI: 10.1007/s10354-008-0640-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2007] [Accepted: 02/04/2008] [Indexed: 10/21/2022]
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Müller MR, Guimarães SS. Impacto dos transtornos do sono sobre o funcionamento diário e a qualidade de vida. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2007. [DOI: 10.1590/s0103-166x2007000400011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Os distúrbios do sono provocam conseqüências adversas na vida das pessoas por diminuir seu funcionamento diário, aumentar a propensão a distúrbios psiquiátricos, déficits cognitivos, surgimento e agravamento de problemas de saúde, riscos de acidentes de tráfego, absenteísmo no trabalho, e por comprometer a qualidade de vida. Este estudo foi realizado com o objetivo de revisar a literatura especializada sobre as características dos distúrbios de sono mais freqüentes na população geral e suas implicações sobre os comportamentos, a rotina diária e a qualidade de vida das pessoas portadoras dessa condição. Os estudos revisados mostram que os distúrbios do sono desencadeiam conseqüências adversas à saúde e ao bem-estar dos indivíduos, afetando o trabalho, a cognição, os relacionamentos e o funcionamento diário, com diferentes desdobramentos a curto, médio e longo prazo.
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Mystakidou K, Parpa E, Tsilika E, Pathiaki M, Patiraki E, Galanos A, Vlahos L. Sleep quality in advanced cancer patients. J Psychosom Res 2007; 62:527-33. [PMID: 17467407 DOI: 10.1016/j.jpsychores.2006.11.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2006] [Revised: 11/09/2006] [Accepted: 11/14/2006] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the sleep quality of advanced cancer patients and its relationship with pain, depression, and hopelessness. METHODS The participants were 102 advanced cancer patients who were on palliative treatment. Patients completed a sleep quality instrument, the Pittsburgh Sleep Quality Index (PSQI); a pain assessment tool, the Greek Brief Pain Inventory; a self-report measure of depression, the Beck Depression Inventory; and, finally, the Beck Hopelessness Scale. RESULTS Multiple regression analyses (forward method) have shown that hopelessness (P=.003), "interference of pain with mood" (P<.0005), and strong opioids (P=.010) seemed to influence patients' sleep quality (PSOI). In an additional regression analysis (enter method), the PSQI is significantly related to opioids (P=.013), hopelessness (P=.035), and "interference of pain with mood" (P=.004). CONCLUSION Hopelessness, pain treatment, and "interference of pain with mood" may influence the quality of sleep in advanced stages of cancer.
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Affiliation(s)
- Kyriaki Mystakidou
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, Athens, Greece.
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Prause W, Saletu B, Tribl GG, Rieder A, Rosenberger A, Bolitschek J, Holzinger B, Kapfhammer G, Katschnig H, Kunze M, Popovic R, Graetzhofer E, Zeitlhofer J. Effects of socio-demographic variables on health-related quality of life determined by the quality of life index--German version. Hum Psychopharmacol 2005; 20:359-65. [PMID: 15981308 DOI: 10.1002/hup.699] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
STUDY OBJECTIVE The purpose of this study was to determine subjective health-related quality of life (HRQoL) in a sample of the Austrian population over 14 years of age in order to evaluate the effect of socio-demographic variables on HRQoL. DESIGN/SETTING HRQoL was determined by means of the quality of life index-German version (QLI-Ge). The influence of socio-demographic variables on HRQoL was assessed by statistical analysis using the Kruskal-Wallis test and an analysis of variance. PARTICIPANTS A random-quota procedure was used to get balanced representation from regions and demographic groups of the Austrian population. The sample consisted of 1049 participants, 493 men and 556 women. MAIN RESULTS Age was found to influence the QLI-Ge total score (index score) and most individual items, with increasing age resulting in a decrease in HRQoL. Differences between the sexes were observed in three dimensions: males scored higher in 'physical well-being', 'psychological well-being' and 'occupational functioning'. Marital status impacted most items with married persons showing better values than divorced persons or singles. Profession had only a minor effect on HRQoL, the level of education showed no influence at all. CONCLUSIONS The socio-demographic variables age, sex and objective living conditions had a major influence on subjectively rated HRQoL, whereas profession and education were found to play a minor role in this context. It is recommended that in the interpretation of studies assessing HRQoL the above-mentioned objective factors be considered. This will be of particular importance when determining the effect of a pharmacotherapy on HRQoL in patients.
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Affiliation(s)
- W Prause
- Department of Psychiatry, Medical University of Vienna, Austria.
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Abstract
AIMS AND OBJECTIVES The objective of this study was to evaluate and compare sleep quality of the hospitalized patients and matched healthy controls. BACKGROUND Although the functions of sleep are not clearly understood, it is generally accepted that it is necessary for the maintenance of good health. Hospitalized patients' sleep may not be refreshing or restorative. The reasons for this can be categorized into three groups: environmental, physiological and psychological. DESIGN AND METHODS This research was conducted at the Cumhuriyet University Hospital in Turkey. One hundred and fifty hospitalized patients (psychiatry = 50; orthopaedic + general surgery + cardiovascular surgery + urology = 50; internal medicine + chest diseases + infectious diseases + physical therapy and rehabilitation = 50) and 50 healthy controls constituted the sample. The researchers administered to the patient and control groups Sociodemographic Information Form and the Pittsburgh Sleep Quality Index. We compared sociodemographic and illness variables with sleep characteristics. The following statistical analyses were used in order to evaluate the data: variance analysis, Tukey HSD test, Student's t-test, Kruskall-Wallis test. RESULTS We found that patients in psychiatric ward experienced worse sleep quality than the other patients, worse in female patients than male patients, and worse sleep characteristics in patients than controls. CONCLUSIONS Health professionals must be educated about sleep and must provide intervention when needed. Relevance to clinical practice. The enhancing of sleep quality accelerates to the recovery from illness.
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Affiliation(s)
- Orhan Dogan
- Director of Department of Psychiatry, School of Medicine, Cumhuriyet University, Sivas, Turkey.
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Soldatos CR, Allaert FA, Ohta T, Dikeos DG. How do individuals sleep around the world? Results from a single-day survey in ten countries. Sleep Med 2005; 6:5-13. [PMID: 15680289 DOI: 10.1016/j.sleep.2004.10.006] [Citation(s) in RCA: 206] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2004] [Revised: 10/11/2004] [Accepted: 10/14/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND PURPOSE To describe between-country differences in both the prevalence and type of sleep disorders seen across the globe, and to provide information on how impaired sleep impacts daytime functioning. PATIENTS AND METHODS The study is a large-scale, global cross-sectional survey conducted on International Sleep Well Day (March 21), 2002. A standardized questionnaire was used in 10 countries under the guidance of local survey managers. In addition, the Athens Insomnia Scale (AIS) and the Epworth Sleepiness Scale (ESS) were completed. Subjects included in the study were adults from 10 countries representing different continents with clear variations in lifestyle. RESULTS The total number of questionnaires collected was 35,327. Overall, 24% of subjects reported that they did not sleep well. According to self-assessments using the AIS, 31.6% of subjects had 'insomnia', while another 17.5% could be considered as having 'sub-threshold insomnia'. According to ESS scores, 11.6% of subjects were found to be 'very sleepy' or 'dangerously sleepy' during the day. CONCLUSIONS Although there seem to be important global variations in the prevalence of insomnia, its symptoms and their management, about one in four individuals do not think they sleep well. Moreover, self-reported sleep problems could be underestimated in the general population. Overall, there is a need for increased awareness of the importance of disturbed sleep and the improved detection and management of sleep disorders.
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Affiliation(s)
- Constantin R Soldatos
- Sleep Research Unit, Department of Psychiatry, University of Athens, Vas Sofias 72, Athens 11528, Athens, Greece.
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Saletu M, Esberger-Chowdhury M, Zeitlhofer J, Deecke L. Diagnostik und Therapie des Restless-Legs-Syndroms in der Arztpraxis. Wien Klin Wochenschr 2004; 116:552-60. [PMID: 15471183 DOI: 10.1007/bf03217709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a movement and sleep disorder with leg dysesthesias with a high prevalence (9-18% in Austria). AIM OF THE STUDY Determination of frequency, diagnosis and therapy of RLS in general practitioner and specialist offices. METHODS Telephone survey of a random sample of 120 general practitioners, 100 neurologists and 80 specialists in internal medicine. RESULTS 69% of the whole sample of doctors reported seeing 1 to 10 RLS patients, but in proportion to the prevalence of these two conditions fewer cases of RLS than of Parkinson's disease are treated. In all three groups of doctors, 84% consider the 4 key symptoms (urge to move the legs accompanied or caused by dysesthesia; worsening of symptoms at rest or inactivity; relief by activity; worsening of symptoms in the evening/at night) the most important diagnostic criteria for RLS, followed by a complaint of disturbed sleep (75%), daytime tiredness (43%) and dopaminergic responsiveness in a therapeutic trial (29%). 83% of general practitioners and 86% of medical specialists refer their RLS patients to a neurologist, 19% to a polysomnographic examination. 75% of doctors decide for pharmacological treatment of RLS, 18% for psychotherapy, 15% for household remedies. 54% of all doctors (70% of the neurologists, 68% of the GPs, 48% of the medical specialists) prescribe dopamine agonists. L-Dopa is used by 49% (61% of the neurologists, 42% of the GPs, 44% of the medical specialists). 17% prescribe GABAergic drugs, 6% opiates. 51% would be highly interested in obtaining a drug specifically registered for the treatment of RLS. CONCLUSION RLS is not as well known as Parkinson's disease. Thus providing doctors with relevant information and further education programs on this subject seems desirable. In Austrian doctors' offices the diagnosis of RLS is usually obtained clinically on the basis of the 4 key symptoms. Patients suffering from insomnia of multifactorial pathogenesis should be referred to an outpatient clinic for sleep disorders with an associated sleep laboratory. Especially neurologists and GPs consider dopamine agonists the treatment of first choice, closely followed by L-Dopa.
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Affiliation(s)
- Michael Saletu
- Universitätsklinik für Neurologie, Abteilung für Klinische Neurologie, Wien, Osterreich.
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Saletu-Zyhlarz G, Anderer P, Gruber G, Mandl M, Gruber D, Metka M, Huber J, Oettel M, Gräser T, Abu-Bakr MH, Grätzhofer E, Saletu B. Insomnia related to postmenopausal syndrome and hormone replacement therapy: sleep laboratory studies on baseline differences between patients and controls and double-blind, placebo-controlled investigations on the effects of a novel estrogen-progestogen combination (Climodien, Lafamme) versus estrogen alone. J Sleep Res 2003; 12:239-54. [PMID: 12941063 DOI: 10.1046/j.1365-2869.2003.00356.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Differences in sleep and awakening quality between 51 insomniac postmenopausal syndrome patients and normal controls were evaluated. In a subsequent double-blind, placebo-controlled, comparative, randomized, three-arm trial (Climodien 2/3 = estradiol valerate 2 mg + the progestogen dienogest 3 mg = regimen A, estradiol valerate 2 mg = regimen EV, and placebo = regimen P), the effects of 2 months of hormone replacement therapy were investigated, followed by a 2-month open-label phase in which all patients received Climodien 2/2 (EV 2 mg + dienogest 2 mg = regimen A*). Polysomnography at baseline demonstrated significantly deteriorated sleep initiation and maintenance, increased S1 and decreased S2 in patients. Subjective sleep and awakening quality, well-being, morning drive, wakefulness, memory and reaction time performance were deteriorated too. Treatment with both regimen A and regimen EV induced a moderate, although nonsignificant, improvement in the primary efficacy variable wakefulness during the total sleep period compared with baseline, while under placebo no changes occurred. Secondary efficacy variables concerning sleep initiation and maintenance, and sleep architecture showed similar findings. The apnea and apnea-hypopnea indices improved significantly under regimen A, compared with both baseline and placebo. Subjective sleep and awakening quality improved significantly after regimen A and EV compared with baseline, with the drug-induced changes being superior to those induced by placebo. In the open-label phase, subjective sleep quality improved further, significantly in the former regimen A group. Awakening quality, somatic complaints and morning thymopsyche did not yield any significant findings. Concerning morning noopsychic performance, memory improved significantly after regimen A compared with baseline, fine motor activity after regimen EV. Reaction time performance increased with all three compounds. In conclusion, Climodien significantly improved subjective sleep quality, the apnea and apnea-hypopnea indices of insomniac postmenopausal syndrome patients, while it only marginally improved variables concerning objective sleep and awakening quality.
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