Relationships among types of activity engagement and insomnia symptoms among older adults

Comparing the experiences of cancer survivors living with sleep disturbances between differing levels of psychological distress: a qualitative study

BACKGROUND

Psychological distress often co-occurs with sleep disturbances; but the specific mechanisms linking the two remain unclear. A qualitative study explored perceptions and factors associated with sleep disturbances in cancer survivors between patients with varying levels of psychological distress.

METHODS

Thirty-three Cantonese speaking mixed type cancer survivors were recruited from a community cancer care program. Participants that scored > 5 on the Pittsburgh Sleep Quality Index and had non-clinical or borderline to clinical levels of psychological distress underwent semi-structured interviews. Interviews were analyzed using grounded theory.

RESULTS

Common triggers of sleep disturbances included unresolved treatment side-effects, intrusive thoughts about cancer and fear of cancer recurrence or progression, poor sleep hygiene and a lack of routine. Those with higher levels of distress exhibited more worry about recovery after cancer. Further, they engaged in thought suppression and experienced meta-worry about negative emotions and worry of poor sleep impacting recovery and cancer progression. They commonly exhibited high sleep reactivity and were observed to have limited social support. In contrast, those with low distress adopted better adaptive mechanisms, including a changed commitment to prioritizing health and positive reappraisal of their recovery progress. Self-distraction was used to cope with sleep disturbances and they had fewer expectations of good sleep quality.

CONCLUSIONS

Findings provided insights into the suitability of interventions for patients with sleep disturbances. Interventions targeting maladaptive emotion-focused coping may be more effective in addressing sleep disturbances in cancer survivors with higher distress. Interventions adopting a stepped-care approach may be advantageous in managing sleep disturbances by catering for varying levels of distress.

Worldwide prevalence of sleep problems in community-dwelling older adults: A systematic review and meta-analysis

The understanding of the prevalence of sleep problems in older adults can provide a broad and reliable perspective into the occurrence of such issues among older adults. This systematic review and meta-analysis aimed to estimate the worldwide prevalence of sleep problems in community-dwelling older adults. Studies that provide information on the prevalence of sleep problems in community-dwelling older adults (≥60 years) were screened between December 2022 and March 2023. A total of 20,379 studies were identified in database searches, from which 252 were included in this review. These studies covered the last 35 years (from 1988 to 2023) and pooled a sample of 995,544 participants from 36 countries. The most frequent sleep problem worldwide was obstructive sleep apnea (46.0%), followed by poor sleep quality (40.0%), other sleep problems (37.0%), insomnia (29.0%), and excessive daytime sleepiness (19.0%). No significant difference in the prevalence estimates of all sleep problems was observed between the sexes. This systematic review and meta-analysis showed a high prevalence of some sleep problems, mainly obstructive sleep apnea, poor sleep quality, and other sleep problems. Our estimates can be useful for managers and policymakers in planning healthcare strategies for sleep problems aimed at the older population.

Effect of Huo Li Su Oral Solution Combined with Zopiclone in the Treatment of Insomnia Symptoms

Objective

Insomnia is a common symptom in subhealthy states. In patients, long-term insomnia symptoms can lead to decreased immune function, even mental depression, thus seriously affecting quality of life. Therefore, this study aims to observe the therapeutic effect of huo li su (HLS) oral solution combined with zopiclone in the treatment of insomnia to find suitable drugs for treatment.

Methods

A total of 161 patients with insomnia from January 2017 to March 2022 were selected in this retrospective cohort study. The patients were divided into the observation (82 cases, receiving HLS oral solution and zopiclone) and control (79 cases, receiving zopiclone alone) groups in accordance with therapeutic drug administration. The differences in the scores of the 2 groups on the Sleep Disorder Scale (SDRS), Pittsburgh Sleep Quality Index (PSQI), Fatigue Inventory 14 (FS-14), and traditional Chinese medicine (TCM) syndromes before and after treatment were compared.

Results

No significant differences in age, gender, disease duration, body mass index (BMI), and other general data were found between the 2 groups (P > .05). The TCM syndrome, PSQI, FS-14, and SDRS scores before treatment of the 2 groups were not significantly different (P < .05). After 4 weeks of treatment, the TCM syndrome, PSQI, FS-14, and SDRS scores of the observation group were significantly lower than those of the control group.

Conclusion

HLS oral solution combined with zopiclone can effectively improve insomnia symptoms and is superior to zopiclone alone.

Couples' Cognition, Intimacy, and Activity Engagement: An Actor-Partner Interdependence Model Analysis

OBJECTIVES

This study examines the actor and partner effects of cognition on activity engagement and the potential mediating role of intimate relationship in older couple dyadic context.

METHODS

Data for this study were obtained from heterosexual couples who participated in the 2020 wave of the Health and Retirement Study. Constructing a dyadic model of couples' cognitions, activity engagement, and intimacy using structural equation modeling to analyze the relationship between variables and mediating effects.

RESULTS

At the actor level, cognition was positively correlated with their activity participation. At the partner level, wives' cognition and husbands' activity engagement were positively correlated. Husband's cognitive score affect wife's subjective feelings about intimacy. The mediation effect of Wife's intimacy on the relationship between husband's cognition and wife's activity engagement was significant.

CONCLUSIONS

In older couples, cognition influences activity engagement at a binary level, and this association is influenced by the level of intimacy. Improving intimacy can help increase activity engagement in older couples, which in turn promotes health. Clinical Implications Maintaining cognition helps older people enjoy good marriage and participation in activities. For women, the closer the partnership, the higher the frequency of participating in various activities.

Mediating Role of PERMA Wellbeing in the Relationship between Insomnia and Psychological Distress among Nursing College Students

BACKGROUND

Psychological distress is an important mental health problem in college students. Insomnia may be a major factor contributing to psychological distress. This study aimed to explore the indirect relationship between insomnia and psychological distress through the five PERMA wellbeing variables (i.e., positive emotions, engagement, relationships, meaning in life, and achievement) among nursing college students.

METHODS

A cross-sectional study was conducted in China using an online survey design. Mediation analyses were examined using the PROCESS macro version 4.1 for SPSS 27.0. A total of 1741 nursing college students completed the online survey.

RESULTS

Insomnia was positively associated with psychological distress (p < 0.01, r = 0.673), while negative associations were detected between PERMA wellbeing variables and insomnia (p < 0.01, r range = -0.176 and -0.272), as well as psychological distress (p < 0.01, r range = -0.196 and -0.386). The association between insomnia and psychological distress was partially mediated by the participants' positive emotions (indirect effect = 0.137, SE = 0.024, 95% CI boot = [0.094, 0.188]), engagement (indirect effect = -0.033, SE = 0.010, 95% CI boot = [-0.054, -0.017]), and meaning in life (indirect effect = 0.027, SE = 0.014, 95% CI boot = [0.001, 0.055]) but not their relationships or achievement of the PERMA wellbeing variables.

CONCLUSIONS

The findings of this study suggest that the PERMA wellbeing variables, especially positive emotions, engagement, and meaning in life, could be potential mechanisms by which insomnia is associated with psychological distress. The mediating roles of PERMA wellbeing variables between insomnia and psychological distress could be incorporated into the health management of university administrations to promote the health and wellbeing of nursing college students.

The association between loneliness and sleep quality among older adults: A systematic review and meta-analysis

OBJECTIVE

To systematically review studies and explore the association between loneliness and sleep quality among older adults.

METHODS

A comprehensive literature search was conducted in 8 databases from their inception to February 28, 2022. Studies that investigated the association between loneliness and sleep quality among older people were obtained. Comprehensive Meta-analysis was used to meta-analyze data in the included studies.

RESULTS

In total, 16 studies with 23,485 participants were included in this review, and 6 of these studies were included in the meta-analysis. The meta-analysis showed that older adults who were lonely were significantly more likely to suffer from low sleep quality than their counterparts without loneliness (pooled OR = 1.750, 95% CI: 1.511-2.026, p < 0.01).

CONCLUSIONS

Loneliness is associated with poor sleep quality among older adults. Loneliness reduction measures should be considered as one of the essential elements in sleep management programs for older people with low sleep quality.

Promoting sleep in low-income older adults with disabilities: Comparing CAPABLE with a social engagement control

Sleep plays a vital role in older adults' health. The Community Aging in Place-Advancing Better Living for Elders (CAPABLE) trial, conducted in Maryland between 2012 and 2016, is a 5-month biobehavioral environmental intervention study to reduce functional disabilities in 300 low-income older adults. Individual and environmental factors impacting sleep were addressed in CAPABLE. This secondary data analysis was to test the preliminary effect of CAPABLE on actigraph-measured sleep, compared with a social engagement control in 73 CAPABLE participants with pretest-posttest actigraph data. Participants in this analysis were aged 75.8±7.5 years; 86.3% of them were females and 84.9% were Black/African Americans. Both CAPABLE intervention and social engagement control improved sleep efficiency and reduced sleep onset latency. The effect of CAPABLE on sleep was comparable to social engagement. These findings underline the importance of promoting physical function and maintaining social activity for sleep in low-income older adults with disabilities.

Types of social activities associated with fewer insomnia symptoms and the mediating role of loneliness in older adults

BACKGROUND

A positive association has been known to exist between social activity engagements and fewer insomnia symptoms in later life. However, little is known about which social activities are associated with insomnia symptoms. Investigating mediating factors in this relationship may contribute to developing effective strategies for the reduction of sleep complaints in older adults. This study aimed to examine the mediating role of loneliness on the relationship between engagement in different social activities and insomnia symptoms.

METHODS

We used secondary data from the 2018 Health and Retirement Study. The study sample included 3236 older adults who responded to a survey on social activity engagement, insomnia symptoms, and loneliness. After adjusting for covariates, simple mediation analyses were performed with bootstrapping to identify the mediating role.

RESULTS

Among the several types of social activities, higher levels of engagement in educational courses and community arts group had a significant and direct relationship with fewer insomnia symptoms in older adults. Mediation analyses confirmed the mediating role of loneliness in the relationship between these specific social activity engagements and insomnia symptoms.

CONCLUSION

These findings provide new evidence for associations among social activity, loneliness, and insomnia symptoms in older adults.

Physical, Cognitive and Social Rehabilitation in Relation to Sleep Quality and Cognitive Functions in the Elderly

The aim of the study was to assess cognitive functions and sleep quality after a 3-month holistic intervention including physical, social and cognitive rehabilitation in patients 65+. Twenty-nine people participated in the study. The study was divided into two stages. In the first stage, a self-administered questionnaire consisting of sociodemographic questions was used, and cognitive functions were assessed using the Rey-Osterrieth complex figure test, Addenbrooke's Cognitive Examination III (ACE III) test, Montreal Cognitive Function Assessment Scale (MoCA) and digit repetition test. All patients were also assessed for sleep quality using the Athens Insomnia Scale (AIS). After three months, the patients were assessed for cognitive functions and sleep quality, which was the second stage of the study. Analysis of the results obtained by patients in the study showed a statistically significant improvement in sleep quality and cognitive function. Rehabilitation activities, including physical training, cognitive exercises and occupational therapy, reduce the severity of mild cognitive disorders and reduce insomnia.