Neurocognitive Game between Risk Factors, Sleep and Suicidal Behaviour

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Faustin Armel Etindele Sosso

Full Text Available Introduction: Sleep and lifestyles interact to allow the appropriate development of cerebral structures, and prevention of mood disorders. But just a hand of articles identified a precise relationship between these two above, and the probability to develop a suicidal behaviour. Objective: The aim of this study is to explore how the suicidal behaviour is associated in simultaneous with sleep components, psychological stress, depression, anxiety, well-being, addiction, and global health of participants; and if it is also influenced by the sociodemographic profile of each subject. Methods: The present study was led by a questionnaire incorporating McNair test, and an incorporated score to evaluate suicide tendencies. The questionnaire also included socio-demographic items and other questions to exhibit a profile of suicide tendency for each individual. Results: Our results showed that the stress levels and well-being are comparable according to gender. Specifically the results showed that lack of sleep combined with a low score to McNair test strongly affects the suicidal tendency, while score of memory and attention decreased. Conclusions: The suicidal behaviour is closely linked with sleep parameters which decreased accordingly, and the family's history of medication and suicidal behaviour.

Neurological impairments and sleep-wake behaviour among the mentally retarded.

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Lindblom, N; Heiskala, H; Kaski, M; Leinonen, L; Nevanlinna, A; Iivanainen, M; Laakso, M L

2001-12-01

The objective of the present study was to evaluate the relationship between the sleep-wake behaviour and neurological impairments among mentally retarded people. The sleep-wake behaviour of 293 mentally retarded subjects living in a rehabilitation center was studied by a standardized observation protocol carried out by trained staff members. The protocol consisted of brief check-ups of the subjects' sleep-wake status at 20-min intervals for five randomly chosen 24-h periods during 4 months. From the raw data five sleep-wake behaviour variables were formed. The data concerning the subject characteristics (age, body mass index (BMI), gender, degree of mental retardation, presence of locomotor disability, that of epilepsy, blindness or deafness and the usage of psychotropic medications) were collected from the medical records. Two main findings emerged: (1) severe locomotor disability, blindness and active epilepsy were found to be independent predictors of increased daytime sleep and increased number of wake-sleep transitions and (2) the subjects with a combination of two or all three of these impairments had a significantly more fragmented and abnormally distributed sleep than those with none or milder forms of these impairments. Age, BMI, degree of mental retardation and the studied medications played a minor role in the sleep disturbances of the study population. Finally, deafness was not found to be associated with any of the measured sleep-wake variables.

Rapid eye movement sleep behaviour disorder in patients with narcolepsy is associated with hypocretin-1 deficiency

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Knudsen, Stine; Gammeltoft, Steen; Jennum, Poul J

2010-01-01

Rapid eye movement sleep behaviour disorder is characterized by dream-enacting behaviour and impaired motor inhibition during rapid eye movement sleep. Rapid eye movement sleep behaviour disorder is commonly associated with neurodegenerative disorders, but also reported in narcolepsy with cataplexy....... Most narcolepsy with cataplexy patients lack the sleep-wake, and rapid eye movement sleep, motor-regulating hypocretin neurons in the lateral hypothalamus. In contrast, rapid eye movement sleep behaviour disorder and hypocretin deficiency are rare in narcolepsy without cataplexy. We hypothesized...... that rapid eye movement sleep behaviour disorder coexists with cataplexy in narcolepsy due to hypocretin deficiency. In our study, rapid eye movement sleep behaviour disorder was diagnosed by the International Classification of Sleep Disorders (2nd edition) criteria in 63 narcolepsy patients with or without...

Self-Monitoring vs. Implementation Intentions: a Comparison of Behaviour Change Techniques to Improve Sleep Hygiene and Sleep Outcomes in Students.

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Mairs, Lucinda; Mullan, Barbara

2015-10-01

This study seeks to investigate and compare the efficacy of self-monitoring and implementation intentions-two post-intentional behaviour change techniques-for improving sleep hygiene behaviours and sleep outcomes in university students. Seventy-two undergraduate students completed baseline measures of four sleep hygiene behaviours (making the sleep environment restful, avoiding going to bed hungry/thirsty, avoiding stress/anxiety-provoking activities near bed time and avoiding caffeine in the evening), as well as the Pittsburgh sleep quality index (PSQI) and the insomnia severity index (ISI). Participants were randomly assigned to an active-control diary-keeping, self-monitoring condition or completed implementation intentions for each behaviour. Post-intervention measurement was completed 2 weeks after baseline. Repeated measures analyses of variance found significant main effects of time for improvements in making the sleep environment restful and avoiding going to bed hungry or thirsty, as well as PSQI and ISI scores. Non-significant interactions suggested no group differences on any variable, except for increasing avoidance of stress and anxiety-provoking activities before bed time, for which only implementation intentions were found to be effective. Attrition was higher amongst self-monitoring participants. Both self-monitoring and implementation intentions appear to be promising behaviour change techniques for improving sleep hygiene and sleep. Future research should examine the acceptability of the two behaviour change techniques and the relationship with differential attrition, as well as effect size variations according to behaviour and technique. Researchers should investigate potential additive or interactive effects of the techniques, as they could be utilised in a complementary manner to target different processes in effecting behaviour change.

Prescriptions and proscriptions: moralising sleep medicines.

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Gabe, Jonathan; Coveney, Catherine M; Williams, Simon J

2016-05-01

The pharmaceuticalisation of sleep is a contentious issue. Sleep medicines get a 'bad press' due to their potential for dependence and other side effects, including studies reporting increased mortality risks for long-term users. Yet relatively little qualitative social science research has been conducted into how people understand and negotiate their use/non-use of sleep medicines in the context of their everyday lives. This paper draws on focus group data collected in the UK to elicit collective views on and experiences of prescription hypnotics across different social contexts. Respondents, we show, drew on a range of moral repertoires which allowed them to present themselves and their relationships with hypnotics in different ways. Six distinct repertoires about hypnotic use are identified in this regard: the 'deserving' patient, the 'responsible' user, the 'compliant' patient, the 'addict', the 'sinful' user and the 'noble' non user. These users and non-users are constructed drawing on cross-cutting themes of addiction and control, ambivalence and reflexivity. Such issues are in turn discussed in relation to recent sociological debates on the pharmaceuticalisation/de-pharmaceuticalisation of everyday life and the consumption of medicines in the UK today. © 2015 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

REM sleep respiratory behaviours mental content in narcoleptic lucid dreamers.

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Oudiette, Delphine; Dodet, Pauline; Ledard, Nahema; Artru, Emilie; Rachidi, Inès; Similowski, Thomas; Arnulf, Isabelle

2018-02-08

Breathing is irregular during rapid eye-movement (REM) sleep, whereas it is stable during non-REM sleep. Why this is so remains a mystery. We propose that irregular breathing has a cortical origin and reflects the mental content of dreams, which often accompany REM sleep. We tested 21 patients with narcolepsy who had the exceptional ability to lucid dream in REM sleep, a condition in which one is conscious of dreaming during the dream and can signal lucidity with an ocular code. Sleep and respiration were monitored during multiple naps. Participants were instructed to modify their dream scenario so that it involved vocalizations or an apnoea, -two behaviours that require a cortical control of ventilation when executed during wakefulness. Most participants (86%) were able to signal lucidity in at least one nap. In 50% of the lucid naps, we found a clear congruence between the dream report (e.g., diving under water) and the observed respiratory behaviour (e.g., central apnoea) and, in several cases, a preparatory breath before the respiratory behaviour. This suggests that the cortico-subcortical networks involved in voluntary respiratory movements are preserved during REM sleep and that breathing irregularities during this stage have a cortical/subcortical origin that reflects dream content.

Training issues pertaining to sleep medicine and child neurology.

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Kotagal, Suresh

2011-06-01

Co-morbid sleep disorders are quite common in Child Neurology. Formal training in the field of sleep medicine and routine attention to sleep-wake function in clinical practice enhances the ability of the child neurologist to deliver comprehensive care. Copyright © 2011 Elsevier Inc. All rights reserved.

Too Hot to Sleep? Sleep Behaviour and Surface Body Temperature of Wahlberg’s Epauletted Fruit Bat

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Downs, Colleen T.; Awuah, Adwoa; Jordaan, Maryna; Magagula, Londiwe; Mkhize, Truth; Paine, Christine; Raymond-Bourret, Esmaella; Hart, Lorinda A.

2015-01-01

The significance of sleep and factors that affect it have been well documented, however, in light of global climate change the effect of temperature on sleep patterns has only recently gained attention. Unlike many mammals, bats (order: Chiroptera) are nocturnal and little is known about their sleep and the effects of ambient temperature (Ta) on their sleep. Consequently we investigated seasonal temperature effects on sleep behaviour and surface body temperature of free-ranging Wahlberg’s epauletted fruit bat, Epomophorus wahlbergi, at a tree roost. Sleep behaviours of E. wahlbergi were recorded, including: sleep duration and sleep incidences (i.e. one eye open and both eyes closed). Sleep differed significantly across all the individuals in terms of sleep duration and sleep incidences. Individuals generally spent more time awake than sleeping. The percentage of each day bats spent asleep was significantly higher during winter (27.6%), compared with summer (15.6%). In summer, 20.7% of the sleeping bats used one eye open sleep, and this is possibly the first evidence of one-eye-sleep in non-marine mammals. Sleep duration decreased with extreme heat as bats spent significantly more time trying to cool by licking their fur, spreading their wings and panting. Skin temperatures of E. wahlbergi were significantly higher when Ta was ≥35°C and no bats slept at these high temperatures. Consequently extremely hot days negatively impact roosting fruit bats, as they were forced to be awake to cool themselves. This has implications for these bats given predicted climate change scenarios. PMID:25775371

Sleep medicine services in Saudi Arabia: The 2013 national survey

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Ahmed S Bahammam

2014-01-01

Conclusion: The sleep medicine services provided in the KSA have improved since the 2005 survey; however, these services are still below the level of service provided in developed countries. Organized efforts are needed to overcome the identified obstacles and challenges to the progress of sleep medicine in the KSA.

Sleep medicine education and knowledge among undergraduate dental students in Middle East universities.

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Talaat, Wael; AlRozzi, Balsam; Kawas, Sausan Al

2016-05-01

The aim of this study was to assess the undergraduate dental education in sleep medicine in Middle East universities as well as the students' knowledge in this field. A cross-sectional observational study was carried out during the period from September 2013 to April 2014.Two different questionnaires were used. A self-administered questionnaire and a cover letter were emailed and distributed to 51 randomly selected Middle East dental schools to gather information about their undergraduate sleep medicine education offered in the academic year 2012-2013.The second questionnaire was distributed to the fifth-year dental students in the 2nd Sharjah International Dental Student Conference in April 2014, to assess their knowledge on sleep medicine. A survey to assess knowledge of sleep medicine in medical education (Modified ASKME Survey) was used. Thirty-nine out of 51 (76%) responded to the first questionnaire. Out of the responding schools, only nine schools (23%) reported the inclusion of sleep medicine in their undergraduate curriculum. The total average hours dedicated to teaching sleep medicine in the responding dental schools was 1.2 hours. In the second questionnaire, 29.2% of the respondents were in the high score group, whereas 70.8% scored low in knowledge of sleep-related breathing disorders. Dental students in Middle East universities receive a weak level of sleep medicine education resulting in poor knowledge in this field.

Rapid eye movement sleep behaviour disorder in patients with narcolepsy is associated with hypocretin-1 deficiency

DEFF Research Database (Denmark)

Knudsen, Stine; Gammeltoft, Steen; Jennum, Poul J

2010-01-01

variables were analysed in relation to cataplexy and hypocretin deficiency with uni- and multivariate logistic/linear regression models, controlling for possible rapid eye movement sleep behaviour disorder biasing factors (age, gender, disease duration, previous anti-cataplexy medication). Only hypocretin......Rapid eye movement sleep behaviour disorder is characterized by dream-enacting behaviour and impaired motor inhibition during rapid eye movement sleep. Rapid eye movement sleep behaviour disorder is commonly associated with neurodegenerative disorders, but also reported in narcolepsy with cataplexy....... Most narcolepsy with cataplexy patients lack the sleep-wake, and rapid eye movement sleep, motor-regulating hypocretin neurons in the lateral hypothalamus. In contrast, rapid eye movement sleep behaviour disorder and hypocretin deficiency are rare in narcolepsy without cataplexy. We hypothesized...

Patent Medicine VendorsAND#8217; Clients: Medicine Use Behaviour

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Asa Auta

2012-12-01

Full Text Available AIM: To investigate some medicine use behaviour of Patent Medicine Vendors’ (PMVs clients including self medication practice and medication sharing behaviour. METHOD: A descriptive, cross-sectional survey was conducted in July 2011, on 361 undergraduate students of the University of Jos, Nigeria who visited PMVs within a month preceding the study. A pretested questionnaire was administered to participating students. Participants responded to questions on demography, and medicine use behaviour. Data were entered into the Statistical Package for Social Sciences (SPSS version 16 to generate descriptive statistics which were represented in percentages. RESULTS: The results showed that majority of the respondents (91.7% visited the PMVs for self-medication with the common classes of medicines procured by PMVs clients including analgesics (38.4%, antimalarials (22.2% and nutrition/blood preparations (14.1%. About 78.5% of the medicines sold to PMVs clients were in their original package and only 45.9% of clients reported checking the expiry date of their procured medicine prior to use. Medication sharing behaviour was common (60.2% among respondents. Although most respondents (70.2% said they had read a medicine information leaflet in the past, majority of them depended on unreliable sources such as friends/relatives (23.2%, media (10.8% and the internet (9.9% for medicine information. CONCLUSION: The study therefore demonstrated that PMV clients are those on self-medication practices and medication sharing behaviour is high among them. [TAF Prev Med Bull 2012; 11(6.000: 681-686

Behavioural sleep treatments and night time crying in infants: challenging the status quo.

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Blunden, Sarah L; Thompson, Kirrilly R; Dawson, Drew

2011-10-01

In Australia, as in many Westernised industrialised nations, the majority of families encourage infants to sleep alone or 'solo' from an early age. Sleeping solo can increase night time crying, which in turn disrupts sleep for both parent and infant. Night time waking and crying are frequently culturally constructed as behavioural sleep 'problems'. The pursuit of solo sleeping is thus achieved through 'behavioural sleep treatments' that teach an infant to sleep alone. Some behavioural extinction treatments necessitate a parent leaving an infant to cry for extended periods unattended, a practice reportedly difficult for parents. Despite parent's anxieties, and the potential (though little studied) stress to the infant, the pursuit of those behavioural sleep treatments are advocated by many psychologists and clinicians as acceptable and necessary interventions. This paper questions this necessity and critically reviews and debates these methods from biological, anthropological and cultural perspectives. Specifically, it considers Foucaultian, Leidloffian, attachment and behavioural perspectives. The central debate in this paper is if and why an infant's nocturnal cries should be ignored. It challenges the aetiology and acceptance of the status quo in the hope of revisiting the underlying belief that these methods are necessary. In doing so, the paper theorises the ways in which current sleep training techniques do or do not satisfy the needs of infants and their parents and questions the extent to which they can be reconciled. The paper posits an agenda for further research in the area that may facilitate the reconciliation of the needs of parents and those of their infants. Copyright © 2010 Elsevier Ltd. All rights reserved.

Sleep hygiene behaviours: an application of the theory of planned behaviour and the investigation of perceived autonomy support, past behaviour and response inhibition.

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Kor, Kenny; Mullan, Barbara Ann

2011-09-01

This study investigated the sleep hygiene behaviour of university students within the framework of the Theory of Planned Behaviour (TPB [Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.]), and examined the predictive validity of additional variables including perceived autonomy support, past behaviour and response inhibition. A total of 257 undergraduate students from an Australian university were administered two online questionnaires at two time points. At time 1, participants completed the TPB questionnaire and the Go/NoGo task as a measure of response inhibition. A week later at time 2, participants completed a questionnaire measuring the performance of sleep hygiene behaviours. Multiple and hierarchical regression analyses showed that the TPB model significantly predicted intention and behaviour. Although intention and perceived behavioural control were statistically significant in predicting behaviour, past behaviour and response inhibition accounted for more variance when added to the TPB model. Subjective norm was found to be the strongest predictor of intention implying the importance of normative influences in sleep hygiene behaviours. Response inhibition was the strongest predictor of behaviour, reinforcing the argument that the performance of health protective behaviours requires self-regulatory ability. Therefore, interventions should be targeted at enhancing self-regulatory capacity.

Parent-Reported Psychological and Sleep Problems in a Preschool-Aged Community Sample: Prevalence of Sleep Problems in Children with and without Emotional/Behavioural Problems

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Salater, Julie; Røhr, Marthe

2010-01-01

Objective : To examine (a) the prevalence of sleep problems among 4-year-olds in the general population, (b) the prevalence of sleep problems among children with emotional and/or behavioural problems, and (c) whether specific sleep problems are associated with particular emotional/behavioural problems. Method: Using The Preschool Age Psychiatric Assessment (PAPA) , data about sleep and emotional/behavioural problems was obtained from 727 parents of 4-year-olds, recruited for a large...

European guidelines for the certification of professionals in sleep medicine: report of the task force of the European Sleep Research Society.

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Pevernagie, Dirk; Stanley, Neil; Berg, Sören; Krieger, Jean; Amici, Roberto; Bassetti, Claudio; Billiard, Michel; Cirignotta, Fabio; Garcia-Borreguero, Diego; Tobler, Irene; Fischer, Jürgen

2009-03-01

In recent years, sleep medicine has evolved into a full-grown discipline, featuring a multidisciplinary approach to diagnosis and treatment of patients with sleep disorders. Sleep medicine cuts across the boundaries of different conventional disciplines and is therefore open to medical and non-medical professionals with different specialty backgrounds. The aim of the current paper is to introduce a qualification for those professionals whose main occupation is to practice sleep medicine in the setting of a sleep medicine centre. The drafting of guidelines dealing with requirements for such qualification was entrusted to a task force by the European Sleep Research Society. The guidelines are the result of a progressive consensus procedure in which standards were defined for education, training, and evaluation. The final step along this pathway is a theoretical and practical examination, providing proof of proficiency in the field of sleep medicine. This paper describes the object of specific competences, the scope of sleep medicine, and the qualification procedures that pertain to three professional categories: medical specialists, non-medical professionals with a university master degree (such as psychologists and biologists), and nurses and technologists. Indices of preceding practical experience and theoretical knowledge are presented in Appendices 1 and 2. These guidelines are a European standard. They may be adapted in the future according to new scientific insights. National certification programs that comply with these guidelines may be subject to homologation by the ESRS.

Can Sleep and Resting Behaviours Be Used as Indicators of Welfare in Shelter Dogs (Canis lupus familiaris?

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Sara C Owczarczak-Garstecka

Full Text Available Previous research on humans and animals suggests that the analysis of sleep patterns may reliably inform us about welfare status, but little research of this kind has been carried out for non-human animals in an applied context. This study explored the use of sleep and resting behaviour as indicators of welfare by describing the activity patterns of dogs (Canis lupus familiaris housed in rescue shelters, and comparing their sleep patterns to other behavioural and cognitive measures of welfare. Sleep and activity patterns were observed over five non-consecutive days in a population of 15 dogs. Subsequently, the characteristics of sleep and resting behaviour were described and the impact of activity on patterns of sleep and resting behaviour analysed. Shelter dogs slept for 2.8% of the day, 14.3% less than previously reported and experienced less sleep fragmentation at night (32 sleep bouts. There were no statistically significant relationships between behaviours exhibited during the day and sleep behaviour. A higher proportion of daytime resting behaviour was significantly associated with a positive judgement bias, less repetitive behaviour and increased time spent coded as 'relaxed' across days by shelter staff. These results suggest that, in the context of a busy shelter environment, the ability to rest more during the day could be a sign of improved welfare. Considering the non-linear relationship between sleep and welfare in humans, the relationship between sleep and behavioural indicators of welfare, including judgement bias, in shelter dogs may be more complex than this study could detect.

Total dietary sugar consumption does not influence sleep or behaviour in Australian children.

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Watson, Emily J; Coates, Alison M; Banks, Siobhan; Kohler, Mark

2018-06-01

This study aimed to compare sugar intake in Australian children with current guidelines and determine if total sugar consumption as a percentage of energy (sugar %E) exacerbates the relationship between sleep and behaviour. A sample of 287 children aged 8-12 years (boys 48.8%, age: 10.7 ± 1.3 years), and their parents/guardians completed a battery of questionnaires. Children completed a food frequency questionnaire, and parents completed demographic, sleep, and behaviour questionnaires. Average sugar intake was 134.9 ± 71.7 g per day (sugar %E 26.0 ± 7.0%), and only 55 (19%) participants did not exceed the recommended sugar intake limit. Correlations and logistical regressions indicated that sugar %E was not associated with sleep or behavioural domains (r range = -0.07-0.08; p range = .173-.979) nor contributed to the prediction of sleep behaviour problems (p range = .16-.80). Whilst a high proportion of children consumed above the recommended amount of daily total sugar, total sugar consumption was not related to behavioural or sleep problems, nor affected the relationship between these variables.

Watch out where you sleep: nocturnal sleeping behaviour of Bay Island lizards

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Nitya Prakash Mohanty

2016-04-01

Full Text Available Sleeping exposes lizards to predation. Therefore, sleeping strategies must be directed towards avoiding predation and might vary among syntopic species. We studied sleeping site characteristics of two syntopic, congeneric lizards—the Bay Island forest lizard, Coryphophylax subcristatus and the short-tailed Bay Island lizard, C. brevicaudus and evaluated inter-specific differences. We measured structural, microclimatic and potential predator avoidance at the sleeping perches of 386 C. subcristatus and 185 C. brevicaudus. Contrary to our expectation, we found similar perch use in both species. The lizards appeared to use narrow girth perch plants and accessed perches by moving both vertically and horizontally. Most lizards slept on leaves, with their heads directed towards the potential path of a predator approaching from the plant base. There was no inter-specific competition in the choices of sleeping perches. These choices indicate an anti-predator strategy involving both tactile and visual cues. This study provides insight into a rarely studied behaviour in reptiles and its adaptive significance.

Measurement of Quality to Improve Care in Sleep Medicine

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Morgenthaler, Timothy I.; Aronsky, Amy J.; Carden, Kelly A.; Chervin, Ronald D.; Thomas, Sherene M.; Watson, Nathaniel F.

2015-01-01

The Board of Directors of the American Academy of Sleep Medicine (AASM) commissioned a Task Force to develop quality measures as part of its strategic plan to promote high quality patient-centered care. Among many potential dimensions of quality, the AASM requested Workgroups to develop outcome and process measures to aid in evaluating the quality of care of five common sleep disorders: restless legs syndrome, insomnia, narcolepsy, obstructive sleep apnea in adults, and obstructive sleep apne...

Sleep apps: what role do they play in clinical medicine?

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Lorenz, Christopher P; Williams, Adrian J

2017-11-01

Today's smartphones boast more computing power than the Apollo Guidance Computer. Given the ubiquity and popularity of smartphones, are we already carrying around miniaturized sleep labs in our pockets? There is still a lack of validation studies for consumer sleep technologies in general and apps for monitoring sleep in particular. To overcome this gap, multidisciplinary teams are needed that focus on feasibility work at the intersection of software engineering, data science and clinical sleep medicine. To date, no smartphone app for monitoring sleep through movement sensors has been successfully validated against polysomnography, despite the role and validity of actigraphy in sleep medicine having been well established. Missing separation of concerns, not methodology, poses the key limiting factor: The two essential steps in the monitoring process, data collection and scoring, are chained together inside a black box due to the closed nature of consumer devices. This leaves researchers with little room for influence nor can they access raw data. Multidisciplinary teams that wield complete power over the sleep monitoring process are sorely needed.

Short Sleep Times Predict Obesity in Internal Medicine Clinic Patients

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Buscemi, Dolores; Kumar, Ashwani; Nugent, Rebecca; Nugent, Kenneth

2007-01-01

Study Objectives: Epidemiological studies have demonstrated an association between short sleep times and obesity as defined by body mass index (BMI). We wanted to determine whether this association occurs in patients with chronic medical diagnoses since the number of confounding factors is likely higher in patients than the general population. Methods: Two hundred patients attending internal medicine clinics completed a survey regarding sleep habits, lifestyle characteristics, and medical diagnoses. An independent surveyor collected the information on the questionnaires and reviewed the medical records. Height and weight were measured by clinic personnel. Data were analyzed with multivariate logistic regression. Results: Subjects with short sleep times (< 7 hours) had an increased likelihood of obesity as defined by a BMI ≥ 30 kg/m2 when compared to the reference group of (8, 9] hours (odds ratio 2.93; 95% confidence interval, 1.06–8.09). There was a U-shaped relationship between obesity and sleep time in women but not in men. Young age (18 to 49 years), not smoking, drinking alcohol, hypertension, diabetes, and sleep apnea were also associated with obesity in the overall model. Conclusions: This study demonstrates an association between short sleep times and obesity in undifferentiated patients attending an internal medicine clinic using models adjusting for age, lifestyle characteristics, and some medical diagnoses. The U-shaped relationship in women suggests that sleep patterns may have gender specific associations. These observations provide the background for therapeutic trials in weight loss in patients with established medical problems. Citation: Buscemi D; Kumar A; Nugent R; Nugent K. Short sleep times predict obesity in internal medicine clinic patients. J Clin Sleep Med 2007;3(7):681–688. PMID:18198800

Technical Developments and Clinical Use of Telemedicine in Sleep Medicine

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Marie Bruyneel

2016-12-01

Full Text Available The use of assistive technology and telemedicine is likely to continue to shape our medical practice in the future, notably in the field of sleep medicine, especially within developed countries. Currently, the number of people suffering from obstructive sleep apnea syndrome (OSAS is increasing. Telemedicine (TM can be used in a variety of ways in sleep medicine: telediagnostics, teleconsultation, teletherapy and telemonitoring of patients being treated with positive pressure devices. In this review, we aim to summarize the recent scientific progresses of these techniques and their potential clinical applications and give consideration to the remaining problems related to TM application.

Artificial light at night affects sleep behaviour differently in two closely related songbird species.

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Sun, Jiachen; Raap, Thomas; Pinxten, Rianne; Eens, Marcel

2017-12-01

Artificial light at night (ALAN) or light pollution is an increasing and worldwide problem. There is growing concern that because of the disruption of natural light cycles, ALAN may pose serious risks for wildlife. While ALAN has been shown to affect many aspects of animal behaviour and physiology, few studies have experimentally studied whether individuals of different species in the wild respond differently to ALAN. Here, we investigated the effect of ALAN on sleep behaviour in two closely related songbird species inhabiting the same study area and roosting/breeding in similar nest boxes. We experimentally exposed free-living great tits (Parus major) and blue tits (Cyanistes caeruleus) to artificial light inside their nest boxes and observed changes in their sleep behaviour compared to the previous night when the nest boxes were dark. In line with previous studies, sleep behaviour of both species did not differ under dark conditions. ALAN disrupted sleep in both great and blue tits. However, compared to blue tits, great tits showed more pronounced effects and more aspects of sleep were affected. Light exposed great tits entered the nest boxes and fell asleep later, woke up and exited the nest boxes earlier, and the total sleep amount and sleep percentage were reduced. By contrast, these changes in sleep behaviour were not found in light exposed blue tits. Our field experiment, using exactly the same light manipulation in both species, provides direct evidence that two closely related species respond differently to ALAN, while their sleep behaviour under dark conditions was similar. Our research suggests that findings for one species cannot necessarily be generalised to other species, even closely-related species. Furthermore, species-specific effects could have implications for community dynamics. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Use of medicines and lifestyles among Italian adolescents].

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Piccinini, Magda; Vieno, Alessio; Santinello, Massimo

2011-01-01

To determine the prevalence, among adolescents, of medicine use for headache, stomachache, difficulties in getting to sleep and nervousness, and to analyse its association with common lifestyles. Data were taken from the Health Behaviour in School-aged Children (HBSC), a transnational study coordinated by the WHO. The data are collected through a self-administered questionnaire for investigating health and health behaviours. 80 middle schools and 84 high schools were randomly selected from all Italian public and private schools. The questionnaire was filled out by a representative sample of 2667 (50.1% males) 13- and 15- year-old Italian students. Medicine use for headache, stomachache, difficulties in getting to sleep and nervousness, socio-economic status, physical fitness, breakfast, smoking and drunkenness. Females are more likely than boys to use medicines for headache (41.2% vs 30%) and stomachache (29%vs 16.2%), but there are no gender differences regarding medicines for difficulties in getting to sleep and nervousness, which are used less frequently. The prevalence of the use of medicines does not increase with age. The related behaviours are: for headache, breakfast, smoking and drunkenness; for stomachache, physical fitness, breakfast and smoking; for difficulties in getting to sleep and nervousness, drunkenness. The extensive use of medicines in adolescence and its association with some lifestyles suggest the importance to develop education programmes for adolescents.

Onset of impaired sleep as a predictor of change in health-related behaviours

DEFF Research Database (Denmark)

Clark, Alice Jessie; Salo, Paula; Lange, Theis

2015-01-01

BACKGROUND: Changes in health-related behaviour may be a key mechanism linking impaired sleep to poor health, but evidence on this is limited. In this study, we analysed observational data to determine whether onset of impaired sleep is followed by changes in health-related behaviours. METHODS: W...

Quality of life in patients with an idiopathic rapid eye movement sleep behaviour disorder in Korea.

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Kim, Keun Tae; Motamedi, Gholam K; Cho, Yong Won

2017-08-01

There have been few quality of life studies in patients with idiopathic rapid eye movement sleep behaviour disorder. We compared the quality of life in idiopathic rapid eye movement sleep behaviour disorder patients to healthy controls, patients with hypertension, type 2 diabetes mellitus without complication and idiopathic restless legs syndrome. Sixty patients with idiopathic rapid eye movement sleep behaviour disorder (24 female; mean age: 61.43 ± 8.99) were enrolled retrospectively. The diagnosis was established based on sleep history, overnight polysomnography, neurological examination and Mini-Mental State Examination to exclude secondary rapid eye movement sleep behavior disorder. All subjects completed questionnaires, including the Short Form 36-item Health Survey for quality of life. The total quality of life score in idiopathic rapid eye movement sleep behaviour disorder (70.63 ± 20.83) was lower than in the healthy control group (83.38 ± 7.96) but higher than in the hypertension (60.55 ± 24.82), diabetes mellitus (62.42 ± 19.37) and restless legs syndrome (61.77 ± 19.25) groups. The total score of idiopathic rapid eye movement sleep behaviour disorder patients had a negative correlation with the Pittsburg Sleep Quality Index (r = -0.498, P sleep behaviour disorder had a significant negative impact on quality of life, although this effect was less than that of other chronic disorders. This negative effect might be related to a depressive mood associated with the disease. © 2016 European Sleep Research Society.

Modifiable risk factors for prescription medicine sharing behaviours.

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Beyene, Kebede; Aspden, Trudi; McNeill, Rob; Sheridan, Janie

2018-04-06

Prescription medicine sharing has been defined as giving one's own medicine to someone else (lending) or taking someone else's medicine (borrowing). Medicines can be shared for non-medical purposes (recreational sharing or drug abuse) or for their intended therapeutic benefits (non-recreational sharing, e.g. sharing antibiotics to self-treat); the latter is the focus of this research. Limited research evidence is available about modifiable risk factors for non-recreational medicine sharing and addressing this issue was the main aim of this research. An online, cross-sectional survey design was used. The study population comprised a convenience sample of 233 adults, who were primarily recruited through patient support groups across New Zealand. Principal component analysis was used to develop scales assessing attitudes toward medicine lending and borrowing. Logistic regression was used to examine the relationship between explanatory (demographics, medical conditions, and attitudes towards medicine sharing) and outcome (medicine sharing behaviours) variables. Half of the study participants reported ever borrowing/lending medicines, and approximately a third of participants reported borrowing/lending in the past year. Modifiable risk factors associated with an increased risk of medicine borrowing behaviour were having more difficulty with accessing medicine ('access-related issue'), stronger 'emotional beliefs about borrowing', and greater 'concern about missing doses.' Greater 'concern for the wellbeing of others' and stronger 'beliefs about the benefits and safety of lending' were associated with an increased risk of medicine lending behaviour. Those with a higher 'perceived risk of harm' were less likely to borrow or lend medicines. This research expands the current knowledge of medicine sharing by examining underlying behavioural factors which predict sharing behaviours and that can be modified by interventions. This research suggests using multifaceted

Links between Sleep and Daytime Behaviour Problems in Children with Down Syndrome

Science.gov (United States)

Esbensen, A. J.; Hoffman, E. K.; Beebe, D. W.; Byars, K. C.; Epstein, J.

2018-01-01

Background: In the general population, sleep problems have an impact on daytime performance. Despite sleep problems being common among children with Down syndrome, the impact of sleep problems on daytime behaviours in school-age children with Down syndrome is an understudied topic. Our study examined the relationship between parent-reported and…

Reliability of the American Academy of Sleep Medicine Rules for Assessing Sleep Depth in Clinical Practice.

Science.gov (United States)

Younes, Magdy; Kuna, Samuel T; Pack, Allan I; Walsh, James K; Kushida, Clete A; Staley, Bethany; Pien, Grace W

2018-02-15

The American Academy of Sleep Medicine has published manuals for scoring polysomnograms that recommend time spent in non-rapid eye movement sleep stages (stage N1, N2, and N3 sleep) be reported. Given the well-established large interrater variability in scoring stage N1 and N3 sleep, we determined the range of time in stage N1 and N3 sleep scored by a large number of technologists when compared to reasonably estimated true values. Polysomnograms of 70 females were scored by 10 highly trained sleep technologists, two each from five different academic sleep laboratories. Range and confidence interval (CI = difference between the 5th and 95th percentiles) of the 10 times spent in stage N1 and N3 sleep assigned in each polysomnogram were determined. Average values of times spent in stage N1 and N3 sleep generated by the 10 technologists in each polysomnogram were considered representative of the true values for the individual polysomnogram. Accuracy of different technologists in estimating delta wave duration was determined by comparing their scores to digitally determined durations. The CI range of the ten N1 scores was 4 to 39 percent of total sleep time (% TST) in different polysomnograms (mean CI ± standard deviation = 11.1 ± 7.1 % TST). Corresponding range for N3 was 1 to 28 % TST (14.4 ± 6.1 % TST). For stage N1 and N3 sleep, very low or very high values were reported for virtually all polysomnograms by different technologists. Technologists varied widely in their assignment of stage N3 sleep, scoring that stage when the digitally determined time of delta waves ranged from 3 to 17 seconds. Manual scoring of non-rapid eye movement sleep stages is highly unreliable among highly trained, experienced technologists. Measures of sleep continuity and depth that are reliable and clinically relevant should be a focus of clinical research. © 2018 American Academy of Sleep Medicine

Change is the Only Constant in Life (and in Sleep Medicine).

Science.gov (United States)

Rosen, Ilene M

2018-05-29

Heraclitus, a philosopher who lived nearly 500 years before the common era, made the assertion that "Life is Flux," meaning that change is the only constant in life. Modern medicine, inclusive of the field of sleep medicine, has undergone dramatic changes over the last 10 years. For the American Academy of Sleep Medicine (AASM) specifically, the last year has been one of great change. Yes, change happens, but with great change comes even greater opportunity. As AASM president, I have been focused on staying abreast of the changes in our health care system while anticipating and preparing to adapt to challenges in our field. In June 2017, given all the changes in our health care delivery system, I challenged the AASM membership and our field to adapt our models of care to reduce the number of patients with undiagnosed and untreated obstructive sleep apnea (OSA) by 10% over 5 years. This article will provide a brief update describing how the AASM board of directors has responded to my challenge and capitalized on change in the areas of the physician pipeline, patient access, advocacy, new technology and strategic research. Change is inevitable and often beyond our control, but how we anticipate and respond to change is entirely within our power. As sleep specialists, it is our responsibility not only to respond to change so that we can deliver the best possible care for our patients, but also to be the leading voice for change so that we all achieve better health through optimal sleep. Copyright © 2018 American Academy of Sleep Medicine. All rights reserved.

Sleep and REM sleep behaviour disorder in Parkinson's disease with impulse control disorder.

Science.gov (United States)

Fantini, Maria Livia; Figorilli, Michela; Arnulf, Isabelle; Zibetti, Maurizio; Pereira, Bruno; Beudin, Patricia; Puligheddu, Monica; Cormier-Dequaire, Florence; Lacomblez, Lucette; Benchetrit, Eve; Corvol, Jean Christophe; Cicolin, Alessandro; Lopiano, Leonardo; Marques, Ana; Durif, Franck

2018-03-01

Because the association between rapid eye movement sleep behaviour disorder (RBD) and impulse control disorders (ICDs) in Parkinson's disease (PD) has been debated, we assessed the sleep characteristics and the frequency of RBD using video-polysomnography (v-PSG) in patients with PD with versus without ICDs. Eighty non-demented patients with PD consecutively identified during routine evaluation at three movement disorders centres were enrolled in a case-control study. Forty patients (22 men; mean age: 62.6±9.7 years, Hoehn & Yahr: 2.1±0.6) with one or more current ICDs were age-matched and sex-matched with 40 patients with no history of ICDs (22 men, mean age: 64.9±7.8 years, Hoehn & Yahr: 2.2±0.6). They underwent a detailed sleep interview followed by a full-night in-lab v-PSG. Sleep was scored blindly to ICDs condition and RBD diagnosis included a clinical complaint of enacted dreams and/or documented behaviour during rapid eye movement (REM) sleep, with the presence of quantified REM sleep without atonia (RSWA). Patients with ICDs had a higher arousal index and higher RSWA than those without ICDs (51.9%±28.2%vs 32.2±27.1%, p=0.004). In addition, RBD was more frequent in the ICD group (85%vs53%, p=0.0001). RBD was still associated with ICDs in a multivariate regression analysis including age of onset, PD duration and severity, treatment duration, levodopa-equivalent and dopamine agonist-equivalent daily doses and antidepressant use (OR: 4.9 (95% CI 1.3 to 18.5), p=0.02). This large, controlled series of patients with PD with ICDs assessed by v-PSG confirms the association between ICDs and RBD. Increased surveillance of symptoms of ICDs should be recommended in patients with PD with RBD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Immoral behaviour in medicine.

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Carmon, P; Tabak, N

1997-03-01

The purpose of this paper is to emphasize a social phenomenon that exists in Israel: immoral medicine. In recent years, nurses have been exposed to many instances of immoral medicine in hospitals. We want to protest about the demands for money from patients who are waiting for surgical intervention, arouse the medical community's conscience concerning these immoral activities, and improve professional and moral behaviour.

Big data in sleep medicine: prospects and pitfalls in phenotyping

Science.gov (United States)

Bianchi, Matt T; Russo, Kathryn; Gabbidon, Harriett; Smith, Tiaundra; Goparaju, Balaji; Westover, M Brandon

2017-01-01

Clinical polysomnography (PSG) databases are a rich resource in the era of “big data” analytics. We explore the uses and potential pitfalls of clinical data mining of PSG using statistical principles and analysis of clinical data from our sleep center. We performed retrospective analysis of self-reported and objective PSG data from adults who underwent overnight PSG (diagnostic tests, n=1835). Self-reported symptoms overlapped markedly between the two most common categories, insomnia and sleep apnea, with the majority reporting symptoms of both disorders. Standard clinical metrics routinely reported on objective data were analyzed for basic properties (missing values, distributions), pairwise correlations, and descriptive phenotyping. Of 41 continuous variables, including clinical and PSG derived, none passed testing for normality. Objective findings of sleep apnea and periodic limb movements were common, with 51% having an apnea–hypopnea index (AHI) >5 per hour and 25% having a leg movement index >15 per hour. Different visualization methods are shown for common variables to explore population distributions. Phenotyping methods based on clinical databases are discussed for sleep architecture, sleep apnea, and insomnia. Inferential pitfalls are discussed using the current dataset and case examples from the literature. The increasing availability of clinical databases for large-scale analytics holds important promise in sleep medicine, especially as it becomes increasingly important to demonstrate the utility of clinical testing methods in management of sleep disorders. Awareness of the strengths, as well as caution regarding the limitations, will maximize the productive use of big data analytics in sleep medicine. PMID:28243157

Do parents' support behaviours predict whether or not their children get sufficient sleep? A cross-sectional study.

Science.gov (United States)

Pyper, Evelyn; Harrington, Daniel; Manson, Heather

2017-05-24

Sleep is an essential component of healthy cognitive and physical development. Lack of sleep may put children at risk for a variety of mental and physical health outcomes, including overweight, obesity and related chronic diseases. Given that children's sleep duration has decreased in recent decades, there is a need to understand the determinants of child sleep, including the role of parental support behaviours. This study aims to determine the relative contribution of different types of parental support behaviours for predicting the likelihood that children meet recently established Canadian sleep guidelines. Data were collected using Computer Assisted Telephone Interviews (CATI) of parents or guardians with at least one child under the age of 18 living in Ontario, Canada. To align with sleep guidelines, parents included in this analysis had at least one child between 5 and 17 years of age (n = 1622). Two multivariable logistic regression models were built to predict whether or not parents reported their child was meeting sleep guidelines - one for weekday sleep and another for sleep on weekends. Independent variables included parent and child age and gender, motivational and regulatory parental support behaviours, and socio-demographic characteristics. On weekdays, enforcing rules about child bedtime was a significant positive predictor of children meeting sleep guidelines (OR: 1.59; 95% CI: 1.03-2.44); while encouraging the child to go to bed at a specific time was a significant negative predictor of child meeting sleep guidelines (OR: 0.29; 95% CI: 0.13-0.65). On weekends, none of the parental support behaviours contributed significantly to the predictions of child sleep. For both weekdays and weekends, the child's age group was an important predictor of children meeting sleep guidelines. The contribution of parental support behaviours to predictions of children meeting sleep guidelines varied with the type of support provided, and weekend versus weekday

Do parents’ support behaviours predict whether or not their children get sufficient sleep? A cross-sectional study

Directory of Open Access Journals (Sweden)

Evelyn Pyper

2017-05-01

Full Text Available Abstract Background Sleep is an essential component of healthy cognitive and physical development. Lack of sleep may put children at risk for a variety of mental and physical health outcomes, including overweight, obesity and related chronic diseases. Given that children’s sleep duration has decreased in recent decades, there is a need to understand the determinants of child sleep, including the role of parental support behaviours. This study aims to determine the relative contribution of different types of parental support behaviours for predicting the likelihood that children meet recently established Canadian sleep guidelines. Methods Data were collected using Computer Assisted Telephone Interviews (CATI of parents or guardians with at least one child under the age of 18 living in Ontario, Canada. To align with sleep guidelines, parents included in this analysis had at least one child between 5 and 17 years of age (n = 1622. Two multivariable logistic regression models were built to predict whether or not parents reported their child was meeting sleep guidelines – one for weekday sleep and another for sleep on weekends. Independent variables included parent and child age and gender, motivational and regulatory parental support behaviours, and socio-demographic characteristics. Results On weekdays, enforcing rules about child bedtime was a significant positive predictor of children meeting sleep guidelines (OR: 1.59; 95% CI: 1.03–2.44; while encouraging the child to go to bed at a specific time was a significant negative predictor of child meeting sleep guidelines (OR: 0.29; 95% CI: 0.13–0.65. On weekends, none of the parental support behaviours contributed significantly to the predictions of child sleep. For both weekdays and weekends, the child’s age group was an important predictor of children meeting sleep guidelines. Conclusions The contribution of parental support behaviours to predictions of children meeting sleep

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion.

Science.gov (United States)

Watson, Nathaniel F; Badr, M Safwan; Belenky, Gregory; Bliwise, Donald L; Buxton, Orfeu M; Buysse, Daniel; Dinges, David F; Gangwisch, James; Grandner, Michael A; Kushida, Clete; Malhotra, Raman K; Martin, Jennifer L; Patel, Sanjay R; Quan, Stuart F; Tasali, Esra

2015-08-01

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. © 2015 Associated Professional Sleep Societies, LLC.

Basal ganglia dysfunction in idiopathic REM sleep behaviour disorder parallels that in early Parkinson's disease.

Science.gov (United States)

Rolinski, Michal; Griffanti, Ludovica; Piccini, Paola; Roussakis, Andreas A; Szewczyk-Krolikowski, Konrad; Menke, Ricarda A; Quinnell, Timothy; Zaiwalla, Zenobia; Klein, Johannes C; Mackay, Clare E; Hu, Michele T M

2016-08-01

SEE POSTUMA DOI101093/AWW131 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Resting state functional magnetic resonance imaging dysfunction within the basal ganglia network is a feature of early Parkinson's disease and may be a diagnostic biomarker of basal ganglia dysfunction. Currently, it is unclear whether these changes are present in so-called idiopathic rapid eye movement sleep behaviour disorder, a condition associated with a high rate of future conversion to Parkinson's disease. In this study, we explore the utility of resting state functional magnetic resonance imaging to detect basal ganglia network dysfunction in rapid eye movement sleep behaviour disorder. We compare these data to a set of healthy control subjects, and to a set of patients with established early Parkinson's disease. Furthermore, we explore the relationship between resting state functional magnetic resonance imaging basal ganglia network dysfunction and loss of dopaminergic neurons assessed with dopamine transporter single photon emission computerized tomography, and perform morphometric analyses to assess grey matter loss. Twenty-six patients with polysomnographically-established rapid eye movement sleep behaviour disorder, 48 patients with Parkinson's disease and 23 healthy control subjects were included in this study. Resting state networks were isolated from task-free functional magnetic resonance imaging data using dual regression with a template derived from a separate cohort of 80 elderly healthy control participants. Resting state functional magnetic resonance imaging parameter estimates were extracted from the study subjects in the basal ganglia network. In addition, eight patients with rapid eye movement sleep behaviour disorder, 10 with Parkinson's disease and 10 control subjects received (123)I-ioflupane single photon emission computerized tomography. We tested for reduction of basal ganglia network connectivity, and for loss of tracer uptake in rapid eye movement sleep

Is it nutrients, food items, diet quality or eating behaviours that are responsible for the association of children's diet with sleep?

Science.gov (United States)

Khan, Mohammad K A; Faught, Erin L; Chu, Yen Li; Ekwaru, John P; Storey, Kate E; Veugelers, Paul J

2017-08-01

Both diet quality and sleep duration of children have declined in the past decades. Several studies have suggested that diet and sleep are associated; however, it is not established which aspects of the diet are responsible for this association. Is it nutrients, food items, diet quality or eating behaviours? We surveyed 2261 grade 5 children on their dietary intake and eating behaviours, and their parents on their sleep duration and sleep quality. We performed factor analysis to identify and quantify the essential factors among 57 nutrients, 132 food items and 19 eating behaviours. We considered these essential factors along with a diet quality score in multivariate regression analyses to assess their independent associations with sleep. Nutrients, food items and diet quality did not exhibit independent associations with sleep, whereas two groupings of eating behaviours did. 'Unhealthy eating habits and environments' was independently associated with sleep. For each standard deviation increase in their factor score, children had 6 min less sleep and were 12% less likely to have sleep of good quality. 'Snacking between meals and after supper' was independently associated with sleep quality. For each standard deviation increase in its factor score, children were 7% less likely to have good quality sleep. This study demonstrates that eating behaviours are responsible for the associations of diet with sleep among children. Health promotion programmes aiming to improve sleep should therefore focus on discouraging eating behaviours such as eating alone or in front of the TV, and snacking between meals and after supper. © 2016 European Sleep Research Society.

A dozen years of American Academy of Sleep Medicine (AASM) International Mini-Fellowship: program evaluation and future directions.

Science.gov (United States)

Ioachimescu, Octavian C; Wickwire, Emerson M; Harrington, John; Kristo, David; Arnedt, J Todd; Ramar, Kannan; Won, Christine; Billings, Martha E; DelRosso, Lourdes; Williams, Scott; Paruthi, Shalini; Morgenthaler, Timothy I

2014-03-15

Sleep medicine remains an underrepresented medical specialty worldwide, with significant geographic disparities with regard to training, number of available sleep specialists, sleep laboratory or clinic infrastructures, and evidence-based clinical practices. The American Academy of Sleep Medicine (AASM) is committed to facilitating the education of sleep medicine professionals to ensure high-quality, evidence-based clinical care and improve access to sleep centers around the world, particularly in developing countries. In 2002, the AASM launched an annual 4-week training program called Mini-Fellowship for International Scholars, designed to support the establishment of sleep medicine in developing countries. The participating fellows were generally chosen from areas that lacked a clinical infrastructure in this specialty and provided with training in AASM Accredited sleep centers. This manuscript presents an overview of the program, summarizes the outcomes, successes, and lessons learned during the first 12 years, and describes a set of programmatic changes for the near-future, as assembled and proposed by the AASM Education Committee and recently approved by the AASM Board of Directors. Ioachimescu OC; Wickwire EM; Harrington J; Kristo D; Arnedt JT; Ramar K; Won C; Billings ME; DelRosso L; Williams S; Paruthi S; Morgenthaler TI. A dozen years of American Academy of Sleep Medicine (AASM) international mini-fellowship: program evaluation and future directions.

Visual short-term memory deficits in REM sleep behaviour disorder mirror those in Parkinson's disease.

Science.gov (United States)

Rolinski, Michal; Zokaei, Nahid; Baig, Fahd; Giehl, Kathrin; Quinnell, Timothy; Zaiwalla, Zenobia; Mackay, Clare E; Husain, Masud; Hu, Michele T M

2016-01-01

Individuals with REM sleep behaviour disorder are at significantly higher risk of developing Parkinson's disease. Here we examined visual short-term memory deficits--long associated with Parkinson's disease--in patients with REM sleep behaviour disorder without Parkinson's disease using a novel task that measures recall precision. Visual short-term memory for sequentially presented coloured bars of different orientation was assessed in 21 patients with polysomnography-proven idiopathic REM sleep behaviour disorder, 26 cases with early Parkinson's disease and 26 healthy controls. Three tasks using the same stimuli controlled for attentional filtering ability, sensorimotor and temporal decay factors. Both patients with REM sleep behaviour disorder and Parkinson's disease demonstrated a deficit in visual short-term memory, with recall precision significantly worse than in healthy controls with no deficit observed in any of the control tasks. Importantly, the pattern of memory deficit in both patient groups was specifically explained by an increase in random responses. These results demonstrate that it is possible to detect the signature of memory impairment associated with Parkinson's disease in individuals with REM sleep behaviour disorder, a condition associated with a high risk of developing Parkinson's disease. The pattern of visual short-term memory deficit potentially provides a cognitive marker of 'prodromal' Parkinson's disease that might be useful in tracking disease progression and for disease-modifying intervention trials. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain.

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

OpenAIRE

Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

2015-01-01

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep n...

Basal ganglia dysfunction in idiopathic REM sleep behaviour disorder parallels that in early Parkinson’s disease

Science.gov (United States)

Rolinski, Michal; Griffanti, Ludovica; Piccini, Paola; Roussakis, Andreas A.; Szewczyk-Krolikowski, Konrad; Menke, Ricarda A.; Quinnell, Timothy; Zaiwalla, Zenobia; Klein, Johannes C.; Mackay, Clare E.

2016-01-01

Abstract See Postuma (doi:10.1093/aww131) for a scientific commentary on this article. Resting state functional magnetic resonance imaging dysfunction within the basal ganglia network is a feature of early Parkinson’s disease and may be a diagnostic biomarker of basal ganglia dysfunction. Currently, it is unclear whether these changes are present in so-called idiopathic rapid eye movement sleep behaviour disorder, a condition associated with a high rate of future conversion to Parkinson’s disease. In this study, we explore the utility of resting state functional magnetic resonance imaging to detect basal ganglia network dysfunction in rapid eye movement sleep behaviour disorder. We compare these data to a set of healthy control subjects, and to a set of patients with established early Parkinson’s disease. Furthermore, we explore the relationship between resting state functional magnetic resonance imaging basal ganglia network dysfunction and loss of dopaminergic neurons assessed with dopamine transporter single photon emission computerized tomography, and perform morphometric analyses to assess grey matter loss. Twenty-six patients with polysomnographically-established rapid eye movement sleep behaviour disorder, 48 patients with Parkinson’s disease and 23 healthy control subjects were included in this study. Resting state networks were isolated from task-free functional magnetic resonance imaging data using dual regression with a template derived from a separate cohort of 80 elderly healthy control participants. Resting state functional magnetic resonance imaging parameter estimates were extracted from the study subjects in the basal ganglia network. In addition, eight patients with rapid eye movement sleep behaviour disorder, 10 with Parkinson’s disease and 10 control subjects received 123I-ioflupane single photon emission computerized tomography. We tested for reduction of basal ganglia network connectivity, and for loss of tracer uptake in rapid eye

Seasonal variation in physical activity, sedentary behaviour and sleep in a sample of UK adults.

Science.gov (United States)

O'Connell, Sophie E; Griffiths, Paula L; Clemes, Stacy A

2014-01-01

Physical activity (PA), sedentary behaviour (SB), sleep and diet have all been associated with increased risk for chronic disease. Seasonality is often overlooked as a determinant of these behaviours in adults. Currently, no study has simultaneously monitored these behaviours in UK adults to assess seasonal variation. The present study investigated whether PA, SB, sleep and diet differed over season in UK adults. Forty-six adults (72% female; age = 41.7 ± 14.4 years, BMI = 24.9 ± 4.4 kg/m(2)) completed four 7-day monitoring periods; one during each season of the year. The ActiGraph GT1M was used to monitor PA and SB. Daily sleep diaries monitored time spent in bed (TIB) and total sleep time (TST). The European Prospective Investigation of Cancer (EPIC) food frequency questionnaire (FFQ) assessed diet. Repeated measures ANOVAs were used to identify seasonal differences in behaviours. Light-intensity PA was significantly higher in summer and spring (p diet (p > 0.05). Findings support the concept that health promotion campaigns need to encourage year-round participation in light intensity PA, whilst limiting SB, particularly during the winter months.

Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion

OpenAIRE

Paruthi, Shalini; Brooks, Lee J.; D'Ambrosio, Carolyn; Hall, Wendy A.; Kotagal, Suresh; Lloyd, Robin M.; Malow, Beth A.; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F.; Rosen, Carol L.; Troester, Matthew M.; Wise, Merrill S.

2016-01-01

Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours pe...

Behavioural effects of dimethyl sulfoxide (DMSO): changes in sleep architecture in rats.

Science.gov (United States)

Cavas, María; Beltrán, David; Navarro, José F

2005-07-04

Dimethyl sulfoxide (DMSO) is an efficient solvent for water-insoluble compounds, widely used in biological studies and as a vehicle for drug therapy, but few data on its neurotoxic or behavioural effects is available. The aim of this work is to explore DMSO's effects upon sleep/wake states. Twenty male rats were sterotaxically prepared for polysomnography. Four concentrations of DMSO (5%, 10%, 15%, and 20%, in saline) were examined. DMSO or saline were administered intraperitoneally at the beginning of the light period. Three hours of polygraphic recording were evaluated for stages of vigilance after treatment. Sleep/wake parameters and EEG power spectral analyses during sleep were investigated. Results show no significant effect after 5% or 10% DMSO treatment. DMSO 15% increased mean episode duration of light slow wave sleep (SWS), decreasing mean episode duration of deep SWS and of quiet wake (QW). DMSO 20% increased light SWS enhancing number of episodes, while decreased deep SWS mean episode duration. EEG power spectra of sigma and delta activity were also affected by DMSO. Therefore, DMSO at 15% and 20% affects sleep architecture in rats, increasing light SWS and reducing deep SWS. Being aware of DMSO behavioural effects seems important since experimental artefacts caused by DMSO can lead to the erroneous interpretation of results.

Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion.

Science.gov (United States)

Paruthi, Shalini; Brooks, Lee J; D'Ambrosio, Carolyn; Hall, Wendy A; Kotagal, Suresh; Lloyd, Robin M; Malow, Beth A; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F; Rosen, Carol L; Troester, Matthew M; Wise, Merrill S

2016-11-15

Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. A commentary on this article apears in this issue on page 1439. © 2016 American Academy of Sleep Medicine

The treatment of insomnia through mass media, the results of a televised behavioural training programme

NARCIS (Netherlands)

Klip, EC

1997-01-01

An important trend in behavioural medicine is a psyche-educational approach to health problems. A training course aimed at the treatment of sleep disorders has been developed using the following basic principles: (1) a symptomatic approach, (2) emphasis on information on sleep and sleep disorders,

Influence of cilazapril on memory functions and sleep behaviour in comparison with metoprolol and placebo in healthy subjects.

Science.gov (United States)

Dietrich, B; Herrmann, W M

1989-01-01

1. In a controlled, randomized, double-blind study the influence of cilazapril and metoprolol on learning and memory functions and on sleep behaviour was investigated in healthy young volunteers under steady-state conditions. Twenty-three subjects were given either 2.5 mg cilazapril, 200 mg metoprolol, or placebo for 14 days in a latin square design separated by washout periods of 7 days. 2. To test memory functions different modalities--verbal, visual, numerical associative and two dimensional spatial memory were tested for recent anterograde recall, both short-term (less than 10 s) and middle-term (up to 15 min) were selected. The test had a content similar to that used in daily life situations. The sleep behaviour was tested both by objective (all night sleep EEG) and subjective measures. 3. Neither antihypertensive drug had an observable influence on memory performance at the dosages used under steady-state conditions. However, sleep was disturbed during metoprolol, while cilazapril could not be differentiated from placebo. The effects of metoprolol on sleep behaviour were observed in the objective and subjective measures. There was more frequent awakening during the night with the subjective complaint of difficulties in sleeping through. 4. From this study it is concluded that cilazapril has no major effect on memory functions and sleep behaviour. This is only true for the dosages given and under steady-state conditions.

REM sleep behaviour disorder is associated with lower fast and higher slow sleep spindle densities.

Science.gov (United States)

O'Reilly, Christian; Godin, Isabelle; Montplaisir, Jacques; Nielsen, Tore

2015-12-01

To investigate differences in sleep spindle properties and scalp topography between patients with rapid eye movement sleep behaviour disorder (RBD) and healthy controls, whole-night polysomnograms of 35 patients diagnosed with RBD and 35 healthy control subjects matched for age and sex were compared. Recordings included a 19-lead 10-20 electroencephalogram montage and standard electromyogram, electrooculogram, electrocardiogram and respiratory leads. Sleep spindles were automatically detected using a standard algorithm, and their characteristics (amplitude, duration, density, frequency and frequency slope) compared between groups. Topological analyses of group-discriminative features were conducted. Sleep spindles occurred at a significantly (e.g. t34 = -4.49; P = 0.00008 for C3) lower density (spindles ∙ min(-1) ) for RBD (mean ± SD: 1.61 ± 0.56 for C3) than for control (2.19 ± 0.61 for C3) participants. However, when distinguishing slow and fast spindles using thresholds individually adapted to the electroencephalogram spectrum of each participant, densities smaller (31-96%) for fast but larger (20-120%) for slow spindles were observed in RBD in all derivations. Maximal differences were in more posterior regions for slow spindles, but over the entire scalp for fast spindles. Results suggest that the density of sleep spindles is altered in patients with RBD and should therefore be investigated as a potential marker of future neurodegeneration in these patients. © 2015 European Sleep Research Society.

Analysis of automated quantification of motor activity in REM sleep behaviour disorder

DEFF Research Database (Denmark)

Frandsen, Rune; Nikolic, Miki; Zoetmulder, Marielle

2015-01-01

Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterized by dream enactment and REM sleep without atonia. Atonia is evaluated on the basis of visual criteria, but there is a need for more objective, quantitative measurements. We aimed to define and optimize a method for establishing...... baseline and all other parameters in automatic quantifying submental motor activity during REM sleep. We analysed the electromyographic activity of the submental muscle in polysomnographs of 29 patients with idiopathic RBD (iRBD), 29 controls and 43 Parkinson's (PD) patients. Six adjustable parameters...... were validated on PD patients. Automatic baseline estimation improved characterization of atonia during REM sleep, as it eliminates inter/intra-observer variability and can be standardized across diagnostic centres. We found an optimized method for quantifying motor activity during REM sleep...

Sleep Sleeping Patch

Institute of Scientific and Technical Information of China (English)

2008-01-01

The Sleep Sleeping Patch is a new kind of external patch based on modern sleep medicine research achievements, which uses the internationally advanced transdermal therapeutic system (TTS). The Sleep Sleeping Patch transmits natural sleep inducers such as peppermint and liquorice extracts and melatonin through the skin to induce sleep. Clinical research proves that the Sleep Sleeping Patch can effectively improve insomnia and the quality of sleep. Highly effective: With the modern TTS therapy,

The improvement of movement and speech during rapid eye movement sleep behaviour disorder in multiple system atrophy.

Science.gov (United States)

De Cock, Valérie Cochen; Debs, Rachel; Oudiette, Delphine; Leu, Smaranda; Radji, Fatai; Tiberge, Michel; Yu, Huan; Bayard, Sophie; Roze, Emmanuel; Vidailhet, Marie; Dauvilliers, Yves; Rascol, Olivier; Arnulf, Isabelle

2011-03-01

Multiple system atrophy is an atypical parkinsonism characterized by severe motor disabilities that are poorly levodopa responsive. Most patients develop rapid eye movement sleep behaviour disorder. Because parkinsonism is absent during rapid eye movement sleep behaviour disorder in patients with Parkinson's disease, we studied the movements of patients with multiple system atrophy during rapid eye movement sleep. Forty-nine non-demented patients with multiple system atrophy and 49 patients with idiopathic Parkinson's disease were interviewed along with their 98 bed partners using a structured questionnaire. They rated the quality of movements, vocal and facial expressions during rapid eye movement sleep behaviour disorder as better than, equal to or worse than the same activities in an awake state. Sleep and movements were monitored using video-polysomnography in 22/49 patients with multiple system atrophy and in 19/49 patients with Parkinson's disease. These recordings were analysed for the presence of parkinsonism and cerebellar syndrome during rapid eye movement sleep movements. Clinical rapid eye movement sleep behaviour disorder was observed in 43/49 (88%) patients with multiple system atrophy. Reports from the 31/43 bed partners who were able to evaluate movements during sleep indicate that 81% of the patients showed some form of improvement during rapid eye movement sleep behaviour disorder. These included improved movement (73% of patients: faster, 67%; stronger, 52%; and smoother, 26%), improved speech (59% of patients: louder, 55%; more intelligible, 17%; and better articulated, 36%) and normalized facial expression (50% of patients). The rate of improvement was higher in Parkinson's disease than in multiple system atrophy, but no further difference was observed between the two forms of multiple system atrophy (predominant parkinsonism versus cerebellar syndrome). Video-monitored movements during rapid eye movement sleep in patients with multiple system

Behavioural hyperventilation as a novel clinical condition associated with central sleep apnoea: a report of three cases.

Science.gov (United States)

Pevernagie, Dirk; Mariman, An; Vandenbussche, Nele; Tobback, Els; Overeem, Sebastiaan; Delesie, Liesbeth; Janssen, Hennie; Vogelaers, Dirk

2012-12-01

Central sleep apnoea (CSA) is a disorder characterised by repetitive episodes of decreased ventilation due to complete or partial reduction in the central neural outflow to the respiratory muscles. Hyperventilation plays a prime role in the pathogenesis of CSA. Chronic heart failure and dwelling at high altitude are classical conditions in which CSA is induced by hyperventilation. Hyperventilation syndrome (HVS) is a prevalent behavioural condition in which minute ventilation exceeds metabolic demands, resulting in haemodynamic and chemical changes that produce characteristic dysphoric symptoms. HVS is frequently caused by anxiety disorders and panic attacks. Until now, medical literature has focussed primarily on daytime symptoms of behavioural hyperventilation. It is currently unknown how this condition may affect sleep. Three cases are reported in which behavioural hyperventilation was associated with occurrence of significant central sleep apnoea, which was not present during normal tidal breathing in steady sleep. Therefore, behavioural hyperventilation should be added to the list of known clinical conditions associated with CSA. Copyright © 2012 Elsevier B.V. All rights reserved.

Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: randomised controlled trial.

Science.gov (United States)

Hiscock, Harriet; Sciberras, Emma; Mensah, Fiona; Gerner, Bibi; Efron, Daryl; Khano, Sonia; Oberklaid, Frank

2015-01-20

To examine whether behavioural strategies designed to improve children's sleep problems could also improve the symptoms, behaviour, daily functioning, and working memory of children with attention deficit hyperactivity disorder (ADHD) and the mental health of their parents. Randomised controlled trial. 21 general paediatric practices in Victoria, Australia. 244 children aged 5-12 years with ADHD attending the practices between 2010 and 2012. Sleep hygiene practices and standardised behavioural strategies delivered by trained psychologists or trainee paediatricians during two fortnightly consultations and a follow-up telephone call. Children in the control group received usual clinical care. At three and six months after randomisation: severity of ADHD symptoms (parent and teacher ADHD rating scale IV-primary outcome), sleep problems (parent reported severity, children's sleep habits questionnaire, actigraphy), behaviour (strengths and difficulties questionnaire), quality of life (pediatric quality of life inventory 4.0), daily functioning (daily parent rating of evening and morning behavior), working memory (working memory test battery for children, six months only), and parent mental health (depression anxiety stress scales). Intervention compared with control families reported a greater decrease in ADHD symptoms at three and six months (adjusted mean difference for change in symptom severity -2.9, 95% confidence interval -5.5 to -0.3, P=0.03, effect size -0.3, and -3.7, -6.1 to -1.2, P=0.004, effect size -0.4, respectively). Compared with control children, intervention children had fewer moderate-severe sleep problems at three months (56% v 30%; adjusted odds ratio 0.30, 95% confidence interval 0.16 to 0.59; Pfamilies reported greater improvements in all other child and family outcomes except parental mental health. Teachers reported improved behaviour of the children at three and six months. Working memory (backwards digit recall) was higher in the intervention

Sleep Quality and Factors Influencing Self-Reported Sleep Duration and Quality in the General Internal Medicine Inpatient Population.

Directory of Open Access Journals (Sweden)

Selina Dobing

Full Text Available Sleep quality in hospitalized Canadian General Internal Medicine patients is not well characterized. Our goals were to characterize hospital sleep quality in this population and identify potentially modifiable barriers to good sleep.GIM inpatients at a quaternary centre in Edmonton, Canada completed a survey, including the Verran-Snyder Halpern (VSH questionnaire, to characterize the previous night's sleep within 48 hours prior to discharge. A chart review was also completed to assess comorbidities, discharge diagnoses, and pharmaceutical sleep aid use.Patients reported significantly worse nighttime sleep duration in hospital compared with home (mean 5.5 versus 7.0 hours per night, p < 0.0001. Sleep quality was poor, as measured by the VSH disturbance (mean 371, effectiveness (190, and supplementation (115 subscales. Variables independently associated with poorer sleep duration in multivariable regression include prior diagnosis of sleep disorder and multi-patient occupancy rooms. Age, sex, admitting diagnosis, length of stay, frequency of vital checks, and use of sleep pharmaceuticals during the index hospitalization were not associated with sleep duration. The most frequently reported reasons for poor sleep included noise (59%, nursing interruptions (30%, uncomfortable beds (18%, bright lights (16%, unfamiliar surroundings (14%, and pain (9%.Sleep quality for GIM inpatients is significantly worse in hospital than at home. There is a need to test non-pharmacologic interventions to address the most frequently identified factors causing poor sleep hygiene for GIM inpatients.

Caffeine and sleep-deprivation mediated changes in open-field behaviours, stress response and antioxidant status in mice.

Science.gov (United States)

Onaolapo, J Olakunle; Onaolapo, Y Adejoke; Akanmu, A Moses; Olayiwola, Gbola

2016-01-01

Effects of daily caffeine consumption on open-field behaviours, serum corticosterone and brain antioxidant levels were investigated after six hours of total sleep-deprivation in prepubertal mice. We tested the hypothesis that daily caffeine consumption may significantly alter behaviour, stress and antioxidative response of prepubertal mice to an acute episode of total sleep-deprivation. Prepubertal Swiss mice of both sexes were assigned to two main groups of 120 each (subdivided into 6 groups of 10 each, based on sex), and administered vehicle or graded oral doses of caffeine (10, 20, 40, 80 and 120 mg/kg/day) for 14 days. On day 14, a main group was subjected to 6 h of total sleep-deprivation by 'gentle-handling'. Open-field behaviours were then assessed in both groups, after which animals were euthanized, and levels of corticosterone, superoxide dismutase and glutathione peroxidase assayed. Horizontal locomotion, rearing and grooming increased significantly, compared to control, with sleep-deprived (SD) mice showing stronger caffeine-driven responses at higher doses; and SD female mice showing sustained response to caffeine, compared to respective males. Plasma corticosterone increased with increasing doses of caffeine in both non sleep-deprived (NSD) and SD mice; although SD mice had higher corticosterone levels. Sleep-deprivation and/or higher doses of caffeine were associated with derangements in brain antioxidant levels. Repeated caffeine consumption and/or acute sleep-deprivation led to significant changes in pattern of open-field behaviour and stress/antioxidant response in mice. Responses seen in the study are probably due to modulatory effects of caffeine on the total body response to stressful stimuli.

Sleep, insomnia and its treatment – abrief review of current knowledge on thesubject withaspecial attention to herbal medicine

Directory of Open Access Journals (Sweden)

Izabela Grabska-Kobyłecka

2014-09-01

Full Text Available Sleep accounts for one third of human life. Its quality and duration affect our daily functioning, mood, concentration, perception and, to a large extent, the condition of our health. Approximately 10% of the world population suffer from insomnia. This can be incidental insomnia, i.e. lasting a few days, short-term insomnia, i.e. lasting up to a month, or chronic insomnia, which lasts over a month. People react to stress with insomnia. Acute and chronic stress often cause insomnia. Individuals who experience stress often have increased muscle tone, heart rate and blood pressure, which cause problems with falling asleep. In order to prevent insomnia lasting over 2 weeks from becoming a chronic condition, pharmacological treatment should be introduced and, as always in the case of sleep disturbances, the patient should be familiarised with the issue of sleep hygiene. Sleep medicines can be taken no longer than 2 weeks (benzodiazepine receptor agonists or 4 weeks (benzodiazepines due to the risk of dependency. In the treatment of insomnia such medicines can be taken only 2–3 times a week or 10 times a month. Preparations containing magnesium, calcium, L-tryptophan, melatonin and vitamin B6 can be used as support medication. Among herbs valerian, hop and lemon balm have confirmed therapeutic properties. Recently the soporific effect of tart cherry has been increasingly discussed. The efficacy of other plants used to treat insomnia is questionable. What seems effective, on the other hand, is cognitive-behavioural therapy, mindfulness meditation, acupressure, acupuncture and tai chi. Yoga and relaxing massage are also helpful in combating stress and therefore indirectly insomnia as well.

Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement.

Science.gov (United States)

Ramar, Kannan; Rosen, Ilene M; Kirsch, Douglas B; Chervin, Ronald D; Carden, Kelly A; Aurora, R Nisha; Kristo, David A; Malhotra, Raman K; Martin, Jennifer L; Olson, Eric J; Rosen, Carol L; Rowley, James A

2018-03-30

The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. Positive airway pressure (PAP) therapy remains the most effective treatment for OSA, although other treatment options continue to be explored. Limited evidence citing small pilot or proof of concept studies suggest that the synthetic medical cannabis extract dronabinol may improve respiratory stability and provide benefit to treat OSA. However, side effects such as somnolence related to treatment were reported in most patients, and the long-term effects on other sleep quality measures, tolerability, and safety are still unknown. Dronabinol is not approved by the United States Food and Drug Administration (FDA) for treatment of OSA, and medical cannabis and synthetic extracts other than dronabinol have not been studied in patients with OSA. The composition of cannabinoids within medical cannabis varies significantly and is not regulated. Synthetic medical cannabis may have differential effects, with variable efficacy and side effects in the treatment of OSA. Therefore, it is the position of the American Academy of Sleep Medicine (AASM) that medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of effectiveness, tolerability, and safety. OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs, and patients with OSA should discuss their treatment options with a licensed medical provider at an accredited sleep facility. Further research is needed to understand the functionality of medical cannabis extracts before recommending them as a treatment for OSA. Copyright © 2018 American Academy of Sleep Medicine. All rights reserved.

Caffeine and sleep-deprivation mediated changes in open-field behaviours, stress response and antioxidant status in mice

OpenAIRE

Onaolapo, J. Olakunle; Onaolapo, Y. Adejoke; Akanmu, A. Moses; Olayiwola, Gbola

2016-01-01

Objectives: Effects of daily caffeine consumption on open-field behaviours, serum corticosterone and brain antioxidant levels were investigated after six hours of total sleep-deprivation in prepubertal mice. We tested the hypothesis that daily caffeine consumption may significantly alter behaviour, stress and antioxidative response of prepubertal mice to an acute episode of total sleep-deprivation. Methods: Prepubertal Swiss mice of both sexes were assigned to two main groups of 120 each (...

Taking care of business: self-help and sleep medicine in american corporate culture.

Science.gov (United States)

Brown, Megan

2004-01-01

This article argues that corporate management in the United States has expanded its scope beyond office walls and encompasses many aspects of workers' daily lives. One new element of corporate training is the micromanagement of sleep; self-help books, newspaper reports, magazine articles, and consulting firms currently advise workers and supervisors on optimizing productivity by cultivating certain sleep habits. Although consultants and self-help books make specific recommendations about sleep, most medical research is inconclusive about sleep's benefits for human performance. Using the ideas of Michel Foucault and Gilles Deleuze as a philosophical backdrop, this article examines the complex and often contradictory links between self-help, medicine, and corporate governance.

The sleeping brain in Parkinson's disease: A focus on REM sleep behaviour disorder and related parasomnias for practicing neurologists.

Science.gov (United States)

Bhidayasiri, Roongroj; Sringean, Jirada; Rattanachaisit, Watchara; Truong, Daniel D

2017-03-15

Sleep disorders are identified as common non-motor symptoms of Parkinson's disease (PD) and recently this recognition has been expanded to include parasomnias, encompassing not only REM sleep behaviour disorder (RBD), but also other non-REM forms. RBD, a prototypical parasomnia in PD, exists even in the prodromal stage of the disease, and is characterized by the presence of dream enactment behaviours occurring alongside a loss of normal skeletal muscle atonia during REM sleep. In contrast, non-REM parasomnias are more frequently observed in the late stage PD. However, the development of these disorders often overlaps and it is not uncommon for PD patients to meet the criteria for more than one type of parasomnias, thus making a clinical distinction challenging for practicing neurologists who are not sleep specialists. Indeed, clinical recognition of the predominant form of parasomnia does not just depend on video-polysomnography, but also on an individual physician's clinical acumen in delineating pertinent clinical history to determine the most likely diagnosis and proceed accordingly. In this review article, we highlight the various forms of parasomnias that have been reported in PD, including, but not limited to, RBD, with a focus on clinical symptomatology and implications for clinical practice. In addition, we review the differences in PD-related parasomnias compared to those seen in general populations. With advances in sleep research and better technology for ambulatory home monitoring, it is likely that many unanswered questions on PD-related parasomnias will soon be resolved resulting in better management of this nocturnal challenge in PD. Copyright © 2017 Elsevier B.V. All rights reserved.

Position paper by Canadian dental sleep medicine professionals on the role of different health care professionals in managing obstructive sleep apnea and snoring with oral appliances.

Science.gov (United States)

Gauthier, Luc; Almeida, Fernanda; Arcache, Jean-Patrick; Ashton-McGregor, Catherine; Coté, David; Driver, Helen S; Ferguson, Kathleen A; Lavigne, Gilles J; Martin, Philippe; Masse, Jean-François; Morisson, Florence; Pancer, Jeffrey; Samuels, Charles Harry; Schachter, Maurice; Sériès, Frédéric; Sullivan, Glendon Edward

2012-01-01

The present Canadian position paper contains recommendations for the management by dentists of sleep-disordered breathing in adults with the use of oral appliances (OAs) as a treatment option for snoring and obstructive sleep apnea (OSA). The recommendations are based on literature reviews and expert panel consensus. OAs offer an effective, first-line treatment option for patients with mild to moderate OSA who prefer an OA to continuous positive airway pressure (CPAP) therapy, or for severe OSA patients who cannot tolerate CPAP, are inappropriate candidates for CPAP or who have failed CPAP treatment attempts. The purpose of the present position paper is to guide interdisciplinary teamwork (sleep physicians and sleep dentists) and to clarify the role of each professional in the management of OA therapy. The diagnosis of OSA should always be made by a physician, and OAs should be fitted by a qualified dentist who is trained and experienced in dental sleep medicine. Follow-up assessment by the referring physician and polysomnography or sleep studies are required to verify treatment efficacy. The present article emphasizes the need for a team approach to OA therapy and provides treatment guidelines for dentists trained in dental sleep medicine. Many of the dentists and sleep physicians who contributed to the preparation of the present article are members of the Canadian Sleep Society and the authors reached a consensus based on the current literature.

The challenge of identifying family medicine patients with obstructive sleep apnea: addressing the question of gender inequality.

Science.gov (United States)

Bailes, Sally; Fichten, Catherine S; Rizzo, Dorrie; Baltzan, Marc; Grad, Roland; Pavilanis, Alan; Creti, Laura; Amsel, Rhonda; Libman, Eva

2017-08-01

The purpose of this study was to examine the sleep characteristics, metabolic syndrome disease and likelihood of obstructive sleep apnea in a sample of older, family medicine patients previously unsuspected for sleep apnea. A total of 295 participants, minimum age 45, 58.7% women, were recruited from two family medicine clinics. None previously had been referred for sleep apnea testing. All participants completed a sleep symptom questionnaire and were offered an overnight polysomnography study, regardless of questionnaire results. 171 followed through with the sleep laboratory component of the study. Health data regarding metabolic syndrome disease (hypertension, hyperlipidemia, diabetes and obesity) were gathered by chart review. Overall, more women than men enrolled in the study and pursued laboratory testing. Of those who underwent polysomnography testing, 75% of the women and 85% of the men were diagnosed with sleep apnea based on an apnea/hypopnea index of 10 or greater. Women and men had similar polysomnography indices, the majority being in the moderate to severe ranges. In those with OSA diagnosis, gender differences in sleep symptom severity were not significant. We conclude that greater gender equality in sleep apnea rates can be achieved in family practice if sleep apnea assessments are widely offered to older patients. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Changing your sleep habits

Science.gov (United States)

... falling asleep; Sleep hygiene References American Academy of Sleep Medicine. Insomnia. Updated March 4, 2015. SleepEducation.org. sleepeducation. ... T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, PA: Elsevier; 2017:chap 86. ...

Athletes' precompetitive sleep behaviour and its relationship with subsequent precompetitive mood and performance.

Science.gov (United States)

Lastella, Michele; Lovell, Geoff Peter; Sargent, Charli

2014-01-01

This investigation examined precompetitive sleep behaviour of 103 athletes and how it relates to precompetitive mood and subsequent performance. Results revealed that on the night before competition athletes slept well under the recommended target of eight hours of sleep for healthy adults, with almost 70% of athletes experiencing poorer sleep than usual. It was found that anxiety, noise, the need to use the bathroom and early event times were amongst the most commonly reported causes of disrupted sleep in athletes on the night prior to competition. The negative moods of fatigue and tension were both significantly negatively correlated with precompetitive relative sleep quality (r = -0.28, P = 0.004, r = -0.21, P = 0.030, respectively) and total sleep time (r = -0.23, P = 0.023, r = -0.20, P = 0.044, respectively). Additionally, tension was positively correlated with number of awakenings (r = -0.20, P = 0.045). Vigour was seen to be significantly positively associated with relative sleep quality (r = 0.24, P=0.013). The relationships between relative sleep quality and fatigue, tension and vigour accounted for approximately 4 - 5% of the variance in mood scores. Disrupted sleep did not demonstrate any significant relationship with relative sporting performance. Conclusions from the present investigation are that athletes may be at particular risk of disrupted sleep on the night prior to competition, and this disruption can negatively relate to an athlete's precompetitive mood states.

Possible involvement of GABAergic mechanism in protective effect of melatonin against sleep deprivation-induced behaviour modification and oxidative damage in mice.

Science.gov (United States)

Kumar, Anil; Singh, Anant

2009-08-01

Sleep is an important physiological process responsible for the maintenance of physical, mental and emotional health of a living being. Sleep deprivation is considered risky for several pathological diseases such as anxiety and motor and cognitive dysfunctions. Sleep deprivation has recently been reported to cause oxidative damage. This study has been designed to explore the possible involvement of the GABAergic mechanism in protective effects of melatonin against 72-h sleep deprivation-induced behaviour modification and oxidative damage in mice. Mice were sleep-deprived for a period of 72 h using the grid over water suspended method. Animals were divided into groups of 6-8 animals each. Melatonin (5 and 10 mg/kg), flumazenil (0.5 mg/kg), picrotoxin (0.5 mg/kg) and muscimol (0.05 mg/kg) were administered for 5 days starting 2 days before 72-h sleep deprivation. Various behavioural tests (plus maze, zero maze, mirror chamber, actophotometer) and body weight assessment followed by oxidative stress parameters (malondialdehyde level, glutathione, catalase, nitrite and protein) were carried out. The 72-h sleep deprivation caused significant anxiety-like behaviour, weight loss, impaired locomotor activity and oxidative damage as compared with naïve (without sleep deprivation). Treatment with melatonin (5 mg/kg and 10 mg/kg, ip) significantly improved locomotor activity, weight loss and antianxiety effect as compared with control (sleep-deprived). Biochemically, melatonin treatment significantly restored reduced glutathione, catalase activity, attenuated lipid peroxidation and nitrite level as compared with control animals (72-h sleep-deprived). Flumazenil (0.5 mg/kg) and picrotoxin (0.5 mg/kg) pretreatments with a lower dose of melatonin (5 mg/kg) significantly antagonized the protective effect of melatonin. However, muscimol (0.05 mg/kg) pretreatment with melatonin (5 mg/kg, ip) potentiated the protective effect of melatonin which was significant as compared with their

Sleep and sleep disorders in Don Quixote.

Science.gov (United States)

Iranzo, Alex; Santamaria, Joan; de Riquer, Martín

2004-01-01

In Don Quijote de la Mancha, Miguel de Cervantes presents Don Quixote as an amazing character of the 17th century who suffers from delusions and illusions, believing himself to be a medieval knight errant. Besides this neuropsychiatric condition, Cervantes included masterful descriptions of several sleep disorders such as insomnia, sleep deprivation, disruptive loud snoring and rapid eye movement sleep behaviour disorder. In addition, he described the occurrence of physiological, vivid dreams and habitual, post-prandial sleepiness--the siesta. Cervantes' concept of sleep as a passive state where all cerebral activities are almost absent is in conflict with his description of abnormal behaviours during sleep and vivid, fantastic dreams. His concept of sleep was shared by his contemporary, Shakespeare, and could have been influenced by the reading of the classical Spanish book of psychiatry Examen de Ingenios (1575).

Infant sleep problems: The sleep characteristics of the "Don't Know" response.

Science.gov (United States)

Tsai, Shao-Yu; Lee, Chien-Chang; Chen, Li-Chiou; Tung, Yi-Ching

2018-01-01

To examine the sleep characteristics of infants with parentally reported sleep problems, with parentally reported no sleep problems and with parentally reported uncertain sleep conditions. Infant sleep problems are recognized as a major health issue worldwide. However, in our daily clinical practices, it is not uncommon for parents not to know whether their infant sleep is problematic. A prospective study conducted between 2012 - 2015 where 219 parents completed questionnaires and infants wore an actigraph monitor for 7 days. Multinomial logistic regression models were used to evaluate the actigraphic and parentally reported infant sleep behaviours between the groups. Thirty-two (14.61%) parents did not know whether their infant sleep was problematic and 118 (53.88%) parents considered their infant sleep a problem. Compared with infants without sleep problems, infants with uncertain sleep conditions had significantly increased odds of having shortened longest sleep duration according to parental report. A significant association was found for infants without sleep problems compared with those with sleep problems who had significantly more wake after sleep onset as measured by actigraphy, as well as reduced longest sleep duration according to parental report. Infants with uncertain sleep conditions have the same problematic sleep behaviours resembling those of children with reported sleep problems. Healthcare professionals should actively disseminate sleep knowledge to help parents interpret infant sleep behaviours and consider possible intervention strategies for improving parental sleep-related knowledge and infant sleep. © 2017 John Wiley & Sons Ltd.

Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review.

Science.gov (United States)

Morin, C M; Hauri, P J; Espie, C A; Spielman, A J; Buysse, D J; Bootzin, R R

1999-12-15

This paper reviews the evidence regarding the efficacy of nonpharmacological treatments for primary chronic insomnia. It is based on a review of 48 clinical trials and two meta-analyses conducted by a task force appointed by the American Academy of Sleep Medicine to develop practice parameters on non-drug therapies for the clinical management of insomnia. The findings indicate that nonpharmacological therapies produce reliable and durable changes in several sleep parameters of chronic insomnia sufferers. The data indicate that between 70% and 80% of patients treated with nonpharmacological interventions benefit from treatment. For the typical patient with persistent primary insomnia, treatment is likely to reduce the main target symptoms of sleep onset latency and/or wake time after sleep onset below or near the 30-min criterion initially used to define insomnia severity. Sleep duration is also increased by a modest 30 minutes and sleep quality and patient's satisfaction with sleep patterns are significantly enhanced. Sleep improvements achieved with these behavioral interventions are sustained for at least 6 months after treatment completion. However, there is no clear evidence that improved sleep leads to meaningful changes in daytime well-being or performance. Three treatments meet the American Psychological Association (APA) criteria for empirically-supported psychological treatments for insomnia: Stimulus control, progressive muscle relaxation, and paradoxical intention; and three additional treatments meet APA criteria for probably efficacious treatments: Sleep restriction, biofeedback, and multifaceted cognitive-behavior therapy. Additional outcome research is needed to examine the effectiveness of treatment when it is implemented in clinical settings (primary care, family practice), by non-sleep specialists, and with insomnia patients presenting medical or psychiatric comorbidity.

Sleep behaviors and attitudes among internal medicine housestaff in a U.S. university-based residency program.

Science.gov (United States)

Rosen, Ilene M; Bellini, Lisa M; Shea, Judy A

2004-05-01

Physicians-in-training are susceptible to fatigue given their prolonged duty hours. Sleep deprivation has been shown to alter perceptions of sleepiness and performance. This study examined the state of sleepiness and attitudes about sleep and performance of work- and non-work-related tasks among incoming and current housestaff; and how rotation, call cycle, and call status are related to acute and chronic sleep deprivation and perceptions of sleepiness. A survey instrument was administered in June 2001 to 53 incoming interns and 79 current housestaff at the University Pennsylvania School of Medicine, a university-based internal medicine residency program. All 132 participants (100%) completed the instrument. Acute sleep deprivation was experienced by 34% of the current housestaff and 64% of current housestaff were chronically sleep deprived. Current housestaff admitted to the possibility of dozing while performing various work-related tasks such as writing notes in charts (69%), reviewing medication lists (61%), interpreting labs (51%), and writing orders (46%). At least half of all respondents felt their patients received good care despite residents' sleepiness and as many believed sleep deprivation was a necessary part of training. Nearly half (48%) of current housestaff rotating on a ward service reported acute sleep deprivation, as did 81% of those who were postcall. Over two-thirds of the housestaff on wards and in the ICU reported chronic sleep deprivation. Subjective sleepiness did not vary much across rotations, call cycle, and call status. Chronic and acute sleep deprivation contribute to residents' fatigue. Education could be targeted at attitudes. Further investigation of factors contributing to chronic sleep deprivation in this population is warranted.

Conditions associated with REM sleep behaviour disorder: Description of a hospital series.

Science.gov (United States)

Abenza Abildúa, M J; Miralles Martinez, A; Arpa Gutiérrez, F J; Lores Gutiérrez, V; Algarra Lucas, C; Jimeno Montero, C; Sánchez García, B; Mata Álvarez-Santullano, M; Borrue Fernández, C; Cordero Martín, G; Gutiérrez Cueto, G; Torrecillas Narváez, M D; Thuissard Vasallo, I; Gómez Aceña, A

2017-02-16

REM sleep behaviour disorder (RBD) is characterised by violent behaviours (screaming, kicking, vivid dreams) during REM sleep. It has a prevalence of 1% to 2% of the general population and is especially frequent in men and the population older than 60. In the last decade, RBD has been suggested to be a prodrome of neurodegenerative disease. We analysed associated neurological diseases and responses to drug treatment in 33 patients with RBD treated in the multidisciplinary sleep disorders unit at Hospital Infanta Sofía. We conducted an observational descriptive retrospective analysis of patients diagnosed with RBD and treated in our multidisciplinary sleep disorders unit between October 2012 and December 2015. We recorded age, sex, associated diseases, and treatments administered to these patients. A total of 365 patients were attended at our unit, including 33 with RBD: 13 women (40%) and 20 men (60%). Mean age was 62.72 years. An associated disorder was identified in 48%, with the most common being mild cognitive impairment (69%). The percentage of patients with RBD and an associated disorder among patients older than 60 was 68%. Eighty-two percent of the patients required treatment. The most commonly used drug was clonazepam (76%), followed by melatonin (9%), gabapentin (6%), and trazodone (3%). In our series, 48% of the patients had an associated disorder. The likelihood of detecting an associated disorder increases with patients' age. The vast majority of patients required drug treatment due to symptom severity; the most frequently administered drug was clonazepam (76%). Copyright © 2017 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.

REM Behaviour Disorder Detection Associated with Neurodegerative Diseases

DEFF Research Database (Denmark)

Kempfner, Jacob; Sørensen, Gertrud Laura; Zoetmulder, Marielle

2010-01-01

Abnormal skeleton muscle activity during REM sleep is characterized as REM Behaviour Disorder (RBD), and may be an early marker for different neurodegenerative diseases. Early detection of RBD is therefore highly important, and in this ongoing study a semi-automatic method for RBD detection...... is proposed by analyzing the motor activity during sleep. Method: A total number of twelve patients have been involved in this study, six normal controls and six patients diagnosed with Parkinsons Disease (PD) with RBD. All subjects underwent at least one ambulant polysomnographic (PSG) recording. The sleep...... recordings were scored, according to the new sleep-scoring standard from the American Academy of Sleep Medicine, by two independent sleep specialists. A follow-up analysis of the scoring consensus between the two specialists has been conducted. Based on the agreement of the two manual scorings...

Sleep Problems

Science.gov (United States)

... For Consumers Consumer Information by Audience For Women Sleep Problems Share Tweet Linkedin Pin it More sharing ... 101 KB) En Español Medicines to Help You Sleep Tips for Better Sleep Basic Facts about Sleep ...

Impact of sleep disordered breathing on behaviour among elementary school-aged children: a cross-sectional analysis of a large community-based sample.

Science.gov (United States)

Smith, Dale L; Gozal, David; Hunter, Scott J; Philby, Mona F; Kaylegian, Jaeson; Kheirandish-Gozal, Leila

2016-12-01

Sleep disordered breathing (SDB) in children has been associated with inattention, impulsivity and hyperactivity, but the associations between SDB severity and the type and severity of behavioural disruption are unclear.1022 children aged 5-7 years old prospectively underwent sleep studies and behavioural assessments through completion of standardised instruments. Participants were subdivided into four categorical groups based on the apnoea-hypopnoea index (AHI; measured per hour of total sleep time (hTST)), i.e. Group 1: nonsnoring and AHI hTST -1 ; Group 2: habitual snoring and AHI hTST -1 ; Group 3: habitual snoring and AHI 1-5 hTST -1 ; and Group 4: habitual snoring and AHI >5 hTST -1 , followed by comparisons of behavioural functioning across the groups.All 10 behavioural variables differed significantly between Group 1 and all other groups. Post hoc comparisons indicated that Group 2 was the most impaired for most behavioural measures. Furthermore, differences between Group 2 and more severe sleep pathology conditions were rarely significant.This large community-based paediatric cohort confirms earlier findings highlighting a significant impact of SDB on behavioural regulation, with the greatest impact being already apparent among habitually snoring children. Thus, a likely low asymptote exists regarding SDB behavioural impact, such that further increases in severity do not measurably increase parent-rated difficulties with behavioural regulation relative to controls. Our findings do support the need for considering early intervention, particularly among those children manifesting a behavioural impact of SDB. Copyright ©ERS 2016.

The impact on sleep of a multidisciplinary cognitive behavioural pain management programme: a pilot study.

Science.gov (United States)

Cunningham, Jennifer M; Blake, Catherine; Power, Camillus K; O'Keeffe, Declan; Kelly, Valerie; Horan, Sheila; Spencer, Orla; Fullen, Brona M

2011-01-10

Reduced sleep quality is a common complaint among patients with chronic pain, with 50-80% of patients reporting sleep disturbance. Improvements in pain and quality of life measures have been achieved using a multidisciplinary cognitive behavioural therapy pain management programme (CBT-PMP) that aims to recondition attitudes to pain, and improve patients' self-management of their condition. Despite its high prevalence in patients with chronic pain, there is very limited objective evidence for the effect of this intervention on sleep quality. The primary research objective is to investigate the short-term effect of a multidisciplinary CBT-PMP on subjective (measured by Pittsburg Sleep Quality Index) and objective sleep quality (measured by Actigraphy) in patients with chronic pain by comparison with a control group. The secondary objectives will investigate changes in function and mood, and then explore the relationship between objective and subjective sleep quality and physical and psychological outcome measures. Patients who fulfil the inclusion criteria for attendance on the multidisciplinary CBT-PMP in the Adelaide and Meath Hospital, Tallaght, Dublin and are currently listed on the PMP waiting list will be invited to participate in this pilot study. Potential patients will be screened for sleep disturbance [determined by the Pittsburgh Sleep Quality Index (PSQI)]. Those patients with a sleep disturbance (PSQI >5) will be assigned to either the intervention group (immediate treatment), or control group (deferred treatment, i.e. the PMP they are listed for is more than six months away) based on where they appear on the waiting list. Baseline measures of sleep, function, and mood will be obtained using a combination of self-report questionnaires (the Hospital Anxiety and Depression Scale, the Short Form 36 health survey, the Pittsburgh Sleep Quality Index, the Tampa Scale for Kinesiophobia), and functional outcome measures. Sleep will be measured for seven days

Hallucinations and REM sleep behaviour disorder in Parkinson's disease: dream imagery intrusions and other hypotheses.

Science.gov (United States)

Manni, Raffaele; Terzaghi, Michele; Ratti, Pietro-Luca; Repetto, Alessandra; Zangaglia, Roberta; Pacchetti, Claudio

2011-12-01

REM sleep behaviour disorder (RBD) is a REM sleep-related parasomnia which may be considered a "dissociated state of wakefulness and sleep", given that conflicting elements of REM sleep (dreaming) and of wakefulness (sustained muscle tone and movements) coexist during the episodes, leading to motor and behavioural manifestations reminiscent of an enacted dream. RBD has been reported in association with α-synucleinopathies: around a third of patients with Parkinson's disease (PD) have full-blown RBD. Recent data indicate that PD patients with RBD are more prone to hallucinations than PD patients without this parasomnia. However it is still not clear why RBD in PD is associated with an increased prevalence of VHs. Data exist which suggest that visual hallucinations in PD may be the result of untimely intrusions of REM visual imagery into wakefulness. RBD, which is characterised by a REM sleep dissociation pattern, might be a condition that particularly favours such intrusions. However, other hypotheses may be advanced. In fact, deficits in attentional, executive, visuoperceptual and visuospatial abilities have been documented in RBD and found to occur far more frequently in PD with RBD than in PD without RBD. Neuropsychological deficits involving visual perception and attentional processes are thought to play an important role in the pathophysiology of VHs. On this basis, RBD in PD could be viewed as a contributory risk factor for VHs. Copyright © 2010 Elsevier Inc. All rights reserved.

SMART DOCS: A New Patient-Centered Outcomes and Coordinated-Care Management Approach for the Future Practice of Sleep Medicine

Science.gov (United States)

Kushida, Clete A.; Nichols, Deborah A.; Holmes, Tyson H.; Miller, Ric; Griffin, Kara; Cardell, Chia-Yu; Hyde, Pamela R.; Cohen, Elyse; Manber, Rachel; Walsh, James K.

2015-01-01

The practice of medicine is currently undergoing a transformation to become more efficient, cost-effective, and patient centered in its delivery of care. The aim of this article is to stimulate discussion within the sleep medicine community in addressing these needs by our approach as well as other approaches to sleep medicine care. The primary goals of the Sustainable Methods, Algorithms, and Research Tools for Delivering Optimal Care Study (SMART DOCS) are: (1) to introduce a new Patient-Centered Outcomes and Coordinated-Care Management (PCCM) approach for the future practice of sleep medicine, and (2) to test the PCCM approach against a Conventional Diagnostic and Treatment Outpatient Medical Care (CONV) approach in a randomized, two-arm, single-center, long-term, comparative effectiveness trial. The PCCM approach is integrated into a novel outpatient care delivery model for patients with sleep disorders that includes the latest technology, allowing providers to obtain more accurate and rapid diagnoses and to make evidence-based treatment recommendations, while simultaneously enabling patients to have access to personalized medical information and reports regarding their diagnosis and treatment so that they can make more informed health care decisions. Additionally, the PCCM approach facilitates better communication between patients, referring primary care physicians, sleep specialists, and allied health professionals so that providers can better assist patients in achieving their preferred outcomes. A total of 1,506 patients 18 y or older will be randomized to either the PCCM or CONV approach and will be followed for at least 1 y with endpoints of improved health care performance, better health, and cost control. Clinical Trials Registration: ClinicalTrials.gov Identifier: NCT02037438. Citation: Kushida CA, Nichols DA, Holmes TH, Miller R, Griffin K, Cardell CY, Hyde PR, Cohen E, Manber R, Walsh JK. SMART DOCS: a new patient-centered outcomes and coordinated

Disappearance of "phantom limb" and amputated arm usage during dreaming in REM sleep behaviour disorder.

Science.gov (United States)

Vetrugno, Roberto; Arnulf, Isabelle; Montagna, Pasquale

2009-01-01

Limb amputation is followed, in approximately 90% of patients, by "phantom limb" sensations during wakefulness. When amputated patients dream, however, the phantom limb may be present all the time, part of the time, intermittently or not at all. Such dreaming experiences in amputees have usually been obtained only retrospectively in the morning and, moreover, dreaming is normally associated with muscular atonia so the motor counterpart of the phantom limb experience cannot be observed directly. REM sleep behaviour disorder (RBD), in which muscle atonia is absent during REM sleep and patients act out their dreams, allows a more direct analysis of the "phantom limb" phenomena and their modifications during sleep.

SMART DOCS: a new patient-centered outcomes and coordinated-care management approach for the future practice of sleep medicine.

Science.gov (United States)

Kushida, Clete A; Nichols, Deborah A; Holmes, Tyson H; Miller, Ric; Griffin, Kara; Cardell, Chia-Yu; Hyde, Pamela R; Cohen, Elyse; Manber, Rachel; Walsh, James K

2015-02-01

The practice of medicine is currently undergoing a transformation to become more efficient, cost-effective, and patient centered in its delivery of care. The aim of this article is to stimulate discussion within the sleep medicine community in addressing these needs by our approach as well as other approaches to sleep medicine care. The primary goals of the Sustainable Methods, Algorithms, and Research Tools for Delivering Optimal Care Study (SMART DOCS) are: (1) to introduce a new Patient-Centered Outcomes and Coordinated-Care Management (PCCM) approach for the future practice of sleep medicine, and (2) to test the PCCM approach against a Conventional Diagnostic and Treatment Outpatient Medical Care (CONV) approach in a randomized, two-arm, single-center, long-term, comparative effectiveness trial. The PCCM approach is integrated into a novel outpatient care delivery model for patients with sleep disorders that includes the latest technology, allowing providers to obtain more accurate and rapid diagnoses and to make evidence-based treatment recommendations, while simultaneously enabling patients to have access to personalized medical information and reports regarding their diagnosis and treatment so that they can make more informed health care decisions. Additionally, the PCCM approach facilitates better communication between patients, referring primary care physicians, sleep specialists, and allied health professionals so that providers can better assist patients in achieving their preferred outcomes. A total of 1,506 patients 18 y or older will be randomized to either the PCCM or CONV approach and will be followed for at least 1 y with endpoints of improved health care performance, better health, and cost control. http://www.clinicaltrials.gov, NCT02037438. © 2015 Associated Professional Sleep Societies, LLC.

Driver education: Enhancing knowledge of sleep, fatigue and risky behaviour to improve decision making in young drivers.

Science.gov (United States)

Alvaro, Pasquale K; Burnett, Nicole M; Kennedy, Gerard A; Min, William Yu Xun; McMahon, Marcus; Barnes, Maree; Jackson, Melinda; Howard, Mark E

2018-03-01

This study assessed the impact of an education program on knowledge of sleepiness and driving behaviour in young adult drivers and their performance and behaviour during simulated night driving. Thirty-four participants (18-26 years old) were randomized to receive either a four-week education program about sleep and driving or a control condition. A series of questionnaires were administered to assess knowledge of factors affecting sleep and driving before and after the four-week education program. Participants also completed a two hour driving simulator task at 1am after 17 h of extended wakefulness to assess the impact on driving behaviour. There was an increase in circadian rhythm knowledge in the intervention group following the education program. Self-reported risky behaviour increased in the control group with no changes in other aspects of sleep knowledge. There were no significant differences in proportion of intervention and control participants who had microsleeps (p ≤ .096), stopped driving due to sleepiness (p = .107), recorded objective episodes of drowsiness (p = .455), and crashed (p = .761), although there was a trend towards more control participants having microsleeps and stopping driving. Those in the intervention group reported higher subjective sleepiness at the end of the drive [M = 6.25, SD = 3.83, t(31) = 2.15, p = .05] and were more likely to indicate that they would stop driving [M = 3.08, SD = 1.16, t(31) = 2.24, p = .04]. The education program improved some aspects of driver knowledge about sleep and safety. The results also suggested that the education program lead to an increased awareness of sleepiness. Education about sleep and driving could reduce the risk of drowsy driving and associated road trauma in young drivers, but requires evaluation in a broader sample with assessment of real world driving outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sleep stage distribution in persons with mild traumatic brain injury: a polysomnographic study according to American Academy of Sleep Medicine standards.

Science.gov (United States)

Mollayeva, Tatyana; Colantonio, Angela; Cassidy, J David; Vernich, Lee; Moineddin, Rahim; Shapiro, Colin M

2017-06-01

Sleep stage disruption in persons with mild traumatic brain injury (mTBI) has received little research attention. We examined deviations in sleep stage distribution in persons with mTBI relative to population age- and sex-specific normative data and the relationships between such deviations and brain injury-related, medical/psychiatric, and extrinsic factors. We conducted a cross-sectional polysomnographic investigation in 40 participants diagnosed with mTBI (mean age 47.54 ± 11.30 years; 56% males). At the time of investigation, participants underwent comprehensive clinical and neuroimaging examinations and one full-night polysomnographic study. We used the 2012 American Academy of Sleep Medicine recommendations for recording, scoring, and summarizing sleep stages. We compared participants' sleep stage data with normative data stratified by age and sex to yield z-scores for deviations from available population norms and then employed stepwise multiple regression analyses to determine the factors associated with the identified significant deviations. In patients with mTBI, the mean duration of nocturnal wakefulness was higher and consolidated sleep stage N2 and REM were lower than normal (p sleep stage duration. No sex differences were observed in the mean proportion of non-REM or REM sleep. We observed longer relative nocturnal wakefulness and shorter relative N2 and REM sleep in patients with mTBI, and these outcomes were associated with potentially modifiable variables. Addressing disruptions in sleep architecture in patients with mTBI could improve their health status. Copyright © 2017 Elsevier B.V. All rights reserved.

The impact on sleep of a multidisciplinary cognitive behavioural pain management programme: a pilot study

Directory of Open Access Journals (Sweden)

Horan Sheila

2011-01-01

Full Text Available Abstract Background Reduced sleep quality is a common complaint among patients with chronic pain, with 50-80% of patients reporting sleep disturbance. Improvements in pain and quality of life measures have been achieved using a multidisciplinary cognitive behavioural therapy pain management programme (CBT-PMP that aims to recondition attitudes to pain, and improve patients' self-management of their condition. Despite its high prevalence in patients with chronic pain, there is very limited objective evidence for the effect of this intervention on sleep quality. The primary research objective is to investigate the short-term effect of a multidisciplinary CBT-PMP on subjective (measured by Pittsburg Sleep Quality Index and objective sleep quality (measured by Actigraphy in patients with chronic pain by comparison with a control group. The secondary objectives will investigate changes in function and mood, and then explore the relationship between objective and subjective sleep quality and physical and psychological outcome measures. Methods/Design Patients who fulfil the inclusion criteria for attendance on the multidisciplinary CBT-PMP in the Adelaide and Meath Hospital, Tallaght, Dublin and are currently listed on the PMP waiting list will be invited to participate in this pilot study. Potential patients will be screened for sleep disturbance [determined by the Pittsburgh Sleep Quality Index (PSQI]. Those patients with a sleep disturbance (PSQI >5 will be assigned to either the intervention group (immediate treatment, or control group (deferred treatment, i.e. the PMP they are listed for is more than six months away based on where they appear on the waiting list. Baseline measures of sleep, function, and mood will be obtained using a combination of self-report questionnaires (the Hospital Anxiety and Depression Scale, the Short Form 36 health survey, the Pittsburgh Sleep Quality Index, the Tampa Scale for Kinesiophobia, and functional outcome

Autogenic Training as a behavioural approach to insomnia: a prospective cohort study.

Science.gov (United States)

Bowden, Ann; Lorenc, Ava; Robinson, Nicola

2012-04-01

Insomnia is commonly associated with chronic health problems. Behavioural and cognitive factors often perpetuate a vicious cycle of anxiety and sleep disturbance, leading to long-term insomnia. National Institute for Health and Clinical Excellence currently recommends behavioural approaches before prescribing hypnotics. Behavioural approaches aim to treat underlying causes, but are not widely available. Research usually includes patients diagnosed with insomnia rather than secondary, co-morbid sleep- related problems. To examine the effectiveness of autogenic training (AT) as a non-drug approach to sleep-related problems associated with chronic ill health. Prospective pre- and post-treatment cohort study. AT centre, Royal London Hospital for Integrated Medicine, University College London Hospitals NHS Foundation Trust. All patients referred for AT from April 2007 to April 2008 were invited to participate. Participants received standard 8-week training, with no specific focus on sleep. Sleep questionnaires were administered at four time points, 'Measure Your Medical Outcome Profile' (MYMOP) and Hospital Anxiety and Depression Scale, before and after treatment. Results before and after treatment were compared. Camden and Islington Community Local Research and Ethics Committee approved the study. The AT course was completed by 153 participants, of whom 73% were identified as having a sleep-related problem. Improvements in sleep patterns included: sleep onset latency (P = 0.049), falling asleep quicker after night waking (P training. AT may provide an approach to insomnia that could be incorporated into primary care.

Isolated sleep paralysis

Science.gov (United States)

... T, Dement WC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 103. ... Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant ...

Sleep in childhood and adolescence: age-specific sleep characteristics, common sleep disturbances and associated difficulties.

Science.gov (United States)

Barclay, Nicola L; Gregory, Alice M

2014-01-01

Sleep changes throughout the lifespan, with particularly salient alterations occurring during the first few years of life, as well as during the transition from childhood to adolescence. Such changes are partly the result of brain maturation; complex changes in the organisation of the circadian system; as well as changes in daily routine, environmental demands and responsibilities. Despite the automaticity of sleep, given that it is governed by a host of complex mechanisms, there are times when sleep becomes disturbed. Sleep disturbances in childhood are common and may stem from behavioural difficulties or abnormalities in physiological processes-and, in some cases manifest into diagnosable sleep disorders. As well as occurring exclusively, childhood sleep disturbances often co-occur with other difficulties. The purpose of this chapter is to outline the neurobiology of typical sleep/wake processes, and describe changes in sleep physiology and architecture from birth to adulthood. Furthermore, common childhood sleep disorders are described as are their associations with other traits, including all of the syndromes presented in this handbook: ASDs, ADHD, schizophrenia and emotional/behavioural difficulties. Throughout, we attempt to explain possible mechanisms underlying these disorders and their associations.

Teen Sleep: Why Is Your Teen So Tired?

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... A consensus statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine. 2016;12:785. Teens, young adults and sleep. American Academy of Sleep Medicine. http://www.aasmnet.org/. Accessed June 29, 2017. ...

REM sleep behaviour disorder: prodromal and mechanistic insights for Parkinson's disease.

Science.gov (United States)

Tekriwal, Anand; Kern, Drew S; Tsai, Jean; Ince, Nuri F; Wu, Jianping; Thompson, John A; Abosch, Aviva

2017-05-01

Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterised by complex motor enactment of dreams and is a potential prodromal marker of Parkinson's disease (PD). Of note, patients with PD observed during RBD episodes exhibit improved motor function, relative to baseline states during wake periods. Here, we review recent epidemiological and mechanistic findings supporting the prodromal value of RBD for PD, incorporating clinical and electrophysiological studies. Explanations for the improved motor function during RBD episodes are evaluated in light of recent publications. In addition, we present preliminary findings describing changes in the activity of the basal ganglia across the sleep-wake cycle that contribute to our understanding of RBD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Self-reported recurrent pain and medicine use behaviours among 15-year olds

DEFF Research Database (Denmark)

Gobina, I; Villberg, J; Villerusa, A

2015-01-01

-old adolescents internationally; (2) to investigate the association between recurrent pain and medicine use behaviours among boys and girls; and (3) to evaluate the consistency of these associations across countries. METHODS: The World Health Organization (WHO) collaborative international Health Behaviour......BACKGROUND: There is considerable variation in adolescent pain prevalence across epidemiological studies, with limited information on pain-related behaviours among adolescents, including medicine use. The aims of this study were (1) to examine the prevalence of recurrent pain among 15-year...... in School-aged Children 2009/2010 study collects data about self-reported aches and medicine use from 36,762 15-year-old adolescents from 22 countries/regions in Europe and the United States. Multi-level multivariate logistic regression, stratified by gender, was used to analyse the association between...

Sleep Bruxism in Respiratory Medicine Practice.

Science.gov (United States)

Mayer, Pierre; Heinzer, Raphael; Lavigne, Gilles

2016-01-01

Sleep bruxism (SB) consists of involuntary episodic and repetitive jaw muscle activity characterized by occasional tooth grinding or jaw clenching during sleep. Prevalence decreases from 20% to 14% in childhood to 8% to 3% in adulthood. Although the causes and mechanisms of idiopathic primary SB are unknown, putative candidates include psychologic risk factors (eg, anxiety, stress due to life events, hypervigilance) and sleep physiologic reactivity (eg, sleep arousals with autonomic activity, breathing events). Although certain neurotransmitters (serotonin, dopamine, noradrenalin, histamine) have been proposed to play an indirect role in SB, their exact contribution to rhythmic masticatory muscle activity (RMMA) (the electromyography marker of SB) genesis remains undetermined. No specific gene is associated with SB; familial environmental influence plays a significant role. To date, no single explanation can account for the SB mechanism. Secondary SB with sleep comorbidities that should be clinically assessed are insomnia, periodic limb movements during sleep, sleep-disordered breathing (eg, apnea-hypopnea), gastroesophageal reflux disease, and neurologic disorders (eg, sleep epilepsy, rapid eye movement behavior disorder). SB is currently quantified by scoring RMMA recordings in parallel with brain, respiratory, and heart activity recordings in a sleep laboratory or home setting. RMMA confirmation with audio-video recordings is recommended for better diagnostic accuracy in the presence of neurologic conditions. Management strategies (diagnostic tests, treatment) should be tailored to the patient's phenotype and comorbidities. In the presence of sleep-disordered breathing, a mandibular advancement appliance or CPAP treatment is preferred over single occlusal splint therapy on the upper jaw. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Mid-Treatment Sleep Duration Predicts Clinically Significant Knee Osteoarthritis Pain reduction at 6 months: Effects From a Behavioral Sleep Medicine Clinical Trial.

Science.gov (United States)

Salwen, Jessica K; Smith, Michael T; Finan, Patrick H

2017-02-01

To determine the relative influence of sleep continuity (sleep efficiency, sleep onset latency, total sleep time [TST], and wake after sleep onset) on clinical pain outcomes within a trial of cognitive behavioral therapy for insomnia (CBT-I) for patients with comorbid knee osteoarthritis and insomnia. Secondary analyses were performed on data from 74 patients with comorbid insomnia and knee osteoarthritis who completed a randomized clinical trial of 8-session multicomponent CBT-I versus an active behavioral desensitization control condition (BD), including a 6-month follow-up assessment. Data used herein include daily diaries of sleep parameters, actigraphy data, and self-report questionnaires administered at specific time points. Patients who reported at least 30% improvement in self-reported pain from baseline to 6-month follow-up were considered responders (N = 31). Pain responders and nonresponders did not differ significantly at baseline across any sleep continuity measures. At mid-treatment, only TST predicted pain response via t tests and logistic regression, whereas other measures of sleep continuity were nonsignificant. Recursive partitioning analyses identified a minimum cut-point of 382 min of TST achieved at mid-treatment in order to best predict pain improvements 6-month posttreatment. Actigraphy results followed the same pattern as daily diary-based results. Clinically significant pain reductions in response to both CBT-I and BD were optimally predicted by achieving approximately 6.5 hr sleep duration by mid-treatment. Thus, tailoring interventions to increase TST early in treatment may be an effective strategy to promote long-term pain reductions. More comprehensive research on components of behavioral sleep medicine treatments that contribute to pain response is warranted. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Does self-efficacy mediate the relationship between transformational leadership behaviours and healthcare workers' sleep quality? A longitudinal study.

Science.gov (United States)

Munir, Fehmidah; Nielsen, Karina

2009-09-01

This paper is a report of a study conducted to investigate the longitudinal relationship between transformational leadership behaviours and employees' sleep quality, and the mediating effects of self-efficacy. Although there is evidence for the influential role of transformational leadership on health outcomes, researchers have used either attitude outcomes (e.g. job satisfaction) or softer health measures, such as general well-being. Specific measures of well-being such as sleep quality have not been used, despite its association with working conditions. A longitudinal design was used to collect data from Danish healthcare workers at time 1 in 2005 (n = 447) and 18 months later at time 2 in 2007 (n = 274). Structural equation modelling was used to investigate the relationships between transformational leadership, self-efficacy and sleep quality at both time points independently (cross-sectionally) and longitudinally. For all constructs, time 2 measures were influenced by the baseline level. Direct relationships between transformational leadership and sleep quality were found. This relationship was negative cross-sectionally at both time points, but positive between baseline and follow-up. The relationship between leadership and employees' sleep quality was not mediated by employees' self-efficacy. Our results indicate that training managers in transformational leadership behaviours may have a positive impact on healthcare workers' health over time. However, more research is needed to examine the mechanisms by which transformational leadership brings about improved sleep quality; self-efficacy was not found to be the explanation.

Balanced: a randomised trial examining the efficacy of two self-monitoring methods for an app-based multi-behaviour intervention to improve physical activity, sitting and sleep in adults

Directory of Open Access Journals (Sweden)

Mitch J. Duncan

2016-07-01

Full Text Available Abstract Background Many adults are insufficiently physically active, have prolonged sedentary behaviour and report poor sleep. These behaviours can be improved by interventions that include education, goal setting, self-monitoring, and feedback strategies. Few interventions have explicitly targeted these behaviours simultaneously or examined the relative efficacy of different self-monitoring methods. Methods/Design This study aims to compare the efficacy of two self-monitoring methods in an app-based multi-behaviour intervention to improve objectively measured physical activity, sedentary, and sleep behaviours, in a 9 week 2–arm randomised trial. Participants will be adults (n = 64 who report being physically inactive, sitting >8 h/day and frequent insufficient sleep (≥14 days out of last 30. The “Balanced” intervention is delivered via a smartphone ‘app’, and includes education materials (guidelines, strategies to promote change in behaviour, goal setting, self-monitoring and feedback support. Participants will be randomly allocated to either a device-entered or user-entered self-monitoring method. The device-entered group will be provided with a activity tracker to self-monitor behaviours. The user-entered group will recall and manually record behaviours. Assessments will be conducted at 0, 3, 6, and 9 weeks. Physical activity, sedentary behaviour and sleep-wake behaviours will be measured using the wrist worn Geneactiv accelerometer. Linear mixed models will be used to examine differences between groups and over time using an alpha of 0.01. Discussion This study will evaluate an app-based multi-behavioural intervention to improve physical activity, sedentary behaviour and sleep; and the relative efficacy of two different approaches to self-monitoring these behaviours. Outcomes will provide information to inform future interventions and self-monitoring targeting these behaviours. Trial registration ACTRN12615000182594

Balanced: a randomised trial examining the efficacy of two self-monitoring methods for an app-based multi-behaviour intervention to improve physical activity, sitting and sleep in adults.

Science.gov (United States)

Duncan, Mitch J; Vandelanotte, Corneel; Trost, Stewart G; Rebar, Amanda L; Rogers, Naomi; Burton, Nicola W; Murawski, Beatrice; Rayward, Anna; Fenton, Sasha; Brown, Wendy J

2016-07-30

Many adults are insufficiently physically active, have prolonged sedentary behaviour and report poor sleep. These behaviours can be improved by interventions that include education, goal setting, self-monitoring, and feedback strategies. Few interventions have explicitly targeted these behaviours simultaneously or examined the relative efficacy of different self-monitoring methods. This study aims to compare the efficacy of two self-monitoring methods in an app-based multi-behaviour intervention to improve objectively measured physical activity, sedentary, and sleep behaviours, in a 9 week 2-arm randomised trial. Participants will be adults (n = 64) who report being physically inactive, sitting >8 h/day and frequent insufficient sleep (≥14 days out of last 30). The "Balanced" intervention is delivered via a smartphone 'app', and includes education materials (guidelines, strategies to promote change in behaviour), goal setting, self-monitoring and feedback support. Participants will be randomly allocated to either a device-entered or user-entered self-monitoring method. The device-entered group will be provided with a activity tracker to self-monitor behaviours. The user-entered group will recall and manually record behaviours. Assessments will be conducted at 0, 3, 6, and 9 weeks. Physical activity, sedentary behaviour and sleep-wake behaviours will be measured using the wrist worn Geneactiv accelerometer. Linear mixed models will be used to examine differences between groups and over time using an alpha of 0.01. This study will evaluate an app-based multi-behavioural intervention to improve physical activity, sedentary behaviour and sleep; and the relative efficacy of two different approaches to self-monitoring these behaviours. Outcomes will provide information to inform future interventions and self-monitoring targeting these behaviours. ACTRN12615000182594 (Australian New Zealand Clinical Trials Registry. Registry URL: www.anzctr.org.au ; registered

[Sleep habits, sleep quality and sleep medicine use of the Swiss population result].

Science.gov (United States)

Tinguely, Gilberte; Landolt, Hans-Peter; Cajochen, Christian

2014-11-01

A survey in a representative sample of the Swiss population revealed an average sleep duration of 7.5 hours on workdays and of 8.5 hours on free days, which reflected a more than half an hour (38 min) shorter sleep duration than 28 years ago. The mean time in bed was between 22:41 and 06:37 on workdays and between 23:29 and 08:27 on free days. On workdays as well as on free days the bedtime was delayed by 47 minutes in comparison to a similar survey 28 years ago. By contrast, the mean rise times on workdays and free days did not change. The sleep duration required to feel refreshed was indicated with 7 hours, which was 41 minutes less than 28 years ago. Roughly 90 % of the interviewees answered that they felt healthy, and 75 % described their sleep as good or very good compared to 79 % 28 years ago. The most frequent reasons stated for bad sleep were personal problems and strain at the workplace. The effect of bad quality sleep on every day functioning was considered as essential by 65 % of the respondents compared to 69 % 28 years ago. The use of medication to improve sleep was declared by 2.8 % (2.7 % 28 years ago), most often benzodiazepines, but also Valerian products and so-called z-drugs. In comparison with similar surveys in other countries (France, Great Britain and USA), Swiss residents slept roughly half an hour longer, but these other countries alike showed a sizable shortening of their habitual sleep duration over the last decades.

Sleep and its disorders in translational medicine.

Science.gov (United States)

Paterson, Louise M; Nutt, David J; Wilson, Sue J

2011-09-01

The study of sleep is a useful approach to studying the brain in psychiatric disorders and in investigating the effects of psychotropic drugs. Sleep physiology lends itself well to pharmacological and physiological manipulation, as it has the advantage of a functional output, the electroencephalograph, which is common to all mammals, and can be measured in freely moving (or naturally sleeping) animals under controlled laboratory conditions or in a naturalistic home environment. The complexity of sleep architecture varies between species but all share features which are comparable. In addition, sleep architecture is sensitive to changes in brain neurotransmitters such as serotonin, so cross-species sleep measurement can be combined with pharmacological manipulation to investigate the receptor mechanisms controlling sleep-wake regulation and sleep architecture in response to known and novel agents. Translational approaches such as these have improved our understanding of sleep circuitry and facilitated the development of new treatments for sleep disorders, particularly insomnia. This review provides examples of how research findings within the sleep field have been translated between animal models, healthy volunteers and patient populations with particular focus on the serotonergic system.

Delaying Middle School and High School Start Times Promotes Student Health and Performance: An American Academy of Sleep Medicine Position Statement.

Science.gov (United States)

Watson, Nathaniel F; Martin, Jennifer L; Wise, Merrill S; Carden, Kelly A; Kirsch, Douglas B; Kristo, David A; Malhotra, Raman K; Olson, Eric J; Ramar, Kannan; Rosen, Ilene M; Rowley, James A; Weaver, Terri E; Chervin, Ronald D

2017-04-15

During adolescence, internal circadian rhythms and biological sleep drive change to result in later sleep and wake times. As a result of these changes, early middle school and high school start times curtail sleep, hamper a student's preparedness to learn, negatively impact physical and mental health, and impair driving safety. Furthermore, a growing body of evidence shows that delaying school start times positively impacts student achievement, health, and safety. Public awareness of the hazards of early school start times and the benefits of later start times are largely unappreciated. As a result, the American Academy of Sleep Medicine is calling on communities, school boards, and educational institutions to implement start times of 8:30 AM or later for middle schools and high schools to ensure that every student arrives at school healthy, awake, alert, and ready to learn. © 2017 American Academy of Sleep Medicine

Extrastriatal monoaminergic dysfunction and enhanced microglial activation in idiopathic rapid eye movement sleep behaviour disorder

DEFF Research Database (Denmark)

Stokholm, Morten Gersel; Iranzo, Alex; Østergaard, Karen

2018-01-01

BACKGROUND: The majority of patients diagnosed with idiopathic rapid eye movement sleep behaviour disorder (iRBD) progress over time to a Lewy-type α-synucleinopathy such as Parkinson's disease or dementia with Lewy bodies. This in vivo molecular imaging study aimed to investigate if extrastriatal...

Shining evolutionary light on human sleep and sleep disorders.

Science.gov (United States)

Nunn, Charles L; Samson, David R; Krystal, Andrew D

2016-01-01

Sleep is essential to cognitive function and health in humans, yet the ultimate reasons for sleep-i.e. 'why' sleep evolved-remain mysterious. We integrate findings from human sleep studies, the ethnographic record, and the ecology and evolution of mammalian sleep to better understand sleep along the human lineage and in the modern world. Compared to other primates, sleep in great apes has undergone substantial evolutionary change, with all great apes building a sleeping platform or 'nest'. Further evolutionary change characterizes human sleep, with humans having the shortest sleep duration, yet the highest proportion of rapid eye movement sleep among primates. These changes likely reflect that our ancestors experienced fitness benefits from being active for a greater portion of the 24-h cycle than other primates, potentially related to advantages arising from learning, socializing and defending against predators and hostile conspecifics. Perspectives from evolutionary medicine have implications for understanding sleep disorders; we consider these perspectives in the context of insomnia, narcolepsy, seasonal affective disorder, circadian rhythm disorders and sleep apnea. We also identify how human sleep today differs from sleep through most of human evolution, and the implications of these changes for global health and health disparities. More generally, our review highlights the importance of phylogenetic comparisons in understanding human health, including well-known links between sleep, cognitive performance and health in humans. © The Author(s) 2016. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

Find a Sleep Center Near You

Science.gov (United States)

... to become accredited by the American Academy of Sleep Medicine, sleep centers must comply with the AASM Standards ... the gold standard for patient care in the sleep medicine field. These requirements incorporate the latest advances in ...

Creatine supplementation reduces sleep need and homeostatic sleep pressure in rats.

Science.gov (United States)

Dworak, Markus; Kim, Tae; Mccarley, Robert W; Basheer, Radhika

2017-06-01

Sleep has been postulated to promote brain energy restoration. It is as yet unknown if increasing the energy availability within the brain reduces sleep need. The guanidine amino acid creatine (Cr) is a well-known energy booster in cellular energy homeostasis. Oral Cr-monohydrate supplementation (CS) increases exercise performance and has been shown to have substantial effects on cognitive performance, neuroprotection and circadian rhythms. The effect of CS on cellular high-energy molecules and sleep-wake behaviour is unclear. Here, we examined the sleep-wake behaviour and brain energy metabolism before and after 4-week-long oral administration of CS in the rat. CS decreased total sleep time and non-rapid eye movement (NREM) sleep significantly during the light (inactive) but not during the dark (active) period. NREM sleep and NREM delta activity were decreased significantly in CS rats after 6 h of sleep deprivation. Biochemical analysis of brain energy metabolites showed a tendency to increase in phosphocreatine after CS, while cellular adenosine triphosphate (ATP) level decreased. Microdialysis analysis showed that the sleep deprivation-induced increase in extracellular adenosine was attenuated after CS. These results suggest that CS reduces sleep need and homeostatic sleep pressure in rats, thereby indicating its potential in the treatment of sleep-related disorders. © 2017 European Sleep Research Society.

Rhythmicity in mice selected for extremes in stress reactivity: behavioural, endocrine and sleep changes resembling endophenotypes of major depression.

Directory of Open Access Journals (Sweden)

Chadi Touma

Full Text Available Dysregulation of the hypothalamic-pituitary-adrenal (HPA axis, including hyper- or hypo-activity of the stress hormone system, plays a critical role in the pathophysiology of mood disorders such as major depression (MD. Further biological hallmarks of MD are disturbances in circadian rhythms and sleep architecture. Applying a translational approach, an animal model has recently been developed, focusing on the deviation in sensitivity to stressful encounters. This so-called 'stress reactivity' (SR mouse model consists of three separate breeding lines selected for either high (HR, intermediate (IR, or low (LR corticosterone increase in response to stressors.In order to contribute to the validation of the SR mouse model, our study combined the analysis of behavioural and HPA axis rhythmicity with sleep-EEG recordings in the HR/IR/LR mouse lines. We found that hyper-responsiveness to stressors was associated with psychomotor alterations (increased locomotor activity and exploration towards the end of the resting period, resembling symptoms like restlessness, sleep continuity disturbances and early awakenings that are commonly observed in melancholic depression. Additionally, HR mice also showed neuroendocrine abnormalities similar to symptoms of MD patients such as reduced amplitude of the circadian glucocorticoid rhythm and elevated trough levels. The sleep-EEG analyses, furthermore, revealed changes in rapid eye movement (REM and non-REM sleep as well as slow wave activity, indicative of reduced sleep efficacy and REM sleep disinhibition in HR mice.Thus, we could show that by selectively breeding mice for extremes in stress reactivity, clinically relevant endophenotypes of MD can be modelled. Given the importance of rhythmicity and sleep disturbances as biomarkers of MD, both animal and clinical studies on the interaction of behavioural, neuroendocrine and sleep parameters may reveal molecular pathways that ultimately lead to the discovery of new

Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine.

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Russo, Ethan B; Guy, Geoffrey W; Robson, Philip J

2007-08-01

Cannabis sativa L. has been utilized for treatment of pain and sleep disorders since ancient times. This review examines modern studies on effects of Delta9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on sleep. It goes on to report new information on the effects on sleep in the context of medical treatment of neuropathic pain and symptoms of multiple sclerosis, employing standardized oromucosal cannabis-based medicines containing primarily THC, CBD, or a 1 : 1 combination of the two (Sativex). Sleep-laboratory results indicate a mild activating effect of CBD, and slight residual sedation with THC-predominant extracts. Experience to date with Sativex in numerous Phase I-III studies in 2000 subjects with 1000 patient years of exposure demonstrate marked improvement in subjective sleep parameters in patients with a wide variety of pain conditions including multiple sclerosis, peripheral neuropathic pain, intractable cancer pain, and rheumatoid arthritis, with an acceptable adverse event profile. No tolerance to the benefit of Sativex on pain or sleep, nor need for dosage increases have been noted in safety extension studies of up to four years, wherein 40-50% of subjects attained good or very good sleep quality, a key source of disability in chronic pain syndromes that may contribute to patients' quality of life.

Getting a Diagnosis for Sleep Apnea

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... of Internal Medicine and the American Board of Sleep Medicine . You should feel free to ask any doctor ... centers are accredited by the American Academy of Sleep Medicine and you can find them listed here . Others ...

Pillow use: the behaviour of cervical pain, sleep quality and pillow comfort in side sleepers.

Science.gov (United States)

Gordon, Susan J; Grimmer-Somers, Karen; Trott, Patricia

2009-12-01

A random allocation single blind block design pillow field study was undertaken to investigate the behaviour of cervico-thoracic spine pain in relation to pillow use. Participants (N=106) who reported preference for side sleep position with one pillow were recruited via a telephone survey and newspaper advertisement. They recorded sleep quality and pillow comfort ratings, frequency of retiring and waking cervical pain and duration of waking cervical pain while sleeping for a week on their usual pillow, polyester, foam, feather and rubber pillows of regular shape and a foam contour pillow. Analysis was undertaken comparing sleep quality, pillow comfort, waking and temporal cervical pain reports, between the usual pillow and the trial pillows, between pillows of differing content and foam pillows of differing shape. This study provides evidence to support recommendation of rubber pillows in the management of waking cervical pain, and to improve sleep quality and pillow comfort. The rubber pillow performed better than subjects' own pillow in most instances. Subjects' own pillow performed similarly to foam and polyester pillows, and there is no evidence that the use of a foam contour pillow has advantages over the regular shaped pillows. Feather pillows should not be recommended.

MiDas: automatic extraction of a common domain of discourse in sleep medicine for multi-center data integration.

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Sahoo, Satya S; Ogbuji, Chimezie; Luo, Lingyun; Dong, Xiao; Cui, Licong; Redline, Susan S; Zhang, Guo-Qiang

2011-01-01

Clinical studies often use data dictionaries with controlled sets of terms to facilitate data collection, limited interoperability and sharing at a local site. Multi-center retrospective clinical studies require that these data dictionaries, originating from individual participating centers, be harmonized in preparation for the integration of the corresponding clinical research data. Domain ontologies are often used to facilitate multi-center data integration by modeling terms from data dictionaries in a logic-based language, but interoperability among domain ontologies (using automated techniques) is an unresolved issue. Although many upper-level reference ontologies have been proposed to address this challenge, our experience in integrating multi-center sleep medicine data highlights the need for an upper level ontology that models a common set of terms at multiple-levels of abstraction, which is not covered by the existing upper-level ontologies. We introduce a methodology underpinned by a Minimal Domain of Discourse (MiDas) algorithm to automatically extract a minimal common domain of discourse (upper-domain ontology) from an existing domain ontology. Using the Multi-Modality, Multi-Resource Environment for Physiological and Clinical Research (Physio-MIMI) multi-center project in sleep medicine as a use case, we demonstrate the use of MiDas in extracting a minimal domain of discourse for sleep medicine, from Physio-MIMI's Sleep Domain Ontology (SDO). We then extend the resulting domain of discourse with terms from the data dictionary of the Sleep Heart and Health Study (SHHS) to validate MiDas. To illustrate the wider applicability of MiDas, we automatically extract the respective domains of discourse from 6 sample domain ontologies from the National Center for Biomedical Ontologies (NCBO) and the OBO Foundry.

ACETAZOLAMIDE IS A MEDICINE FOR THE MEDICATED CORRECTION OF THE SLEEP APNEA AND HYPOPNEA SYNDROME AMONG CHILDREN AND ADULTS

Directory of Open Access Journals (Sweden)

O.V. Bykova

2006-01-01

Full Text Available Sleep apnea and hypopnea syndrome is a life bendangering sleep dis order among both adults and children. The prevalence of the sleep apnea and hypopnea syndrome both in adult and pediatric population may be evaluated only approximately, as not all of the patients, suffering from this pathology, may call some adequate complaints, which, in their turn, help diagnose the disease. For example, only obstructive sleep apnea syndrome according to the data of British epidemiologists is met among the adults at the frequency rate, which can be compared with the prevalence of the bronchial asthma. Since metabolic acidosis caused by the carbonic anhydrase inhibitor of acetazolamide stimulates the ventilation of lungs, the researchers have set forth a supposition that the application of this medicine can be efficient to treat the respiratory disturbances in sleep. There is wide application of acetazolamide for the medicated correction of sleep apnea and hypopnea syndrome of the central genesis among both adults and children. When using acetazolamide for the long term therapy of respiratory disturbances among adult patients, the main issue is the probable growth of tolerance towards the carbonic anhydrase inhibitor along with the continuous longbterm application of the medicine. In pediatry, quite on the contrary, the sleep apnea and hypopnea syndrome is usually a transit problem of the early infancy and it does not require any longbterm drug therapy, which defines specifically high perspectives of the efficient and safe application of acetazolamide for the medicated correction of respiratory disturbances in sleep precisely within this category of patients.Key words: apnea, hypopnea, sleep disorder, acetazolamide, children.

Schizophrenia, Sleep and Acupuncture

NARCIS (Netherlands)

Bosch, M.P.C.; Noort, M.W.M.L. van den

2008-01-01

This book is an introduction for professionals in Western medicine and for acupuncturists on the use of acupuncture in treatment of schizophrenia and sleep disorders. Acupuncture has long been used in Traditional Chinese Medicine (TCM) in mental health and sleep disorders. This book aims to build a

Sleep in Children and Adolescents with Angelman Syndrome: Association with Parent Sleep and Stress

Science.gov (United States)

Goldman, S. E.; Bichell, T. J.; Surdyka, K.; Malow, B. A.

2012-01-01

Background: Sleep concerns are common in children with Angelman syndrome, with 20-80% of individuals having a decreased sleep need and/or abnormal sleep-wake cycles. The impact of these sleep behaviours on parental sleep and stress is not known. Method: Through the use of standardised questionnaires, wrist actigraphy and polysomnography, we…

Sleep Forensics: a critical review of the literature and brief comments on the Brazilian legal situation

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Raimundo Nonato Delgado-Rodrigues

2014-02-01

Full Text Available Sleep medicine is a relatively new field among Medical Sciences. Its legal aspects are still obscure, either for lack of knowledge of the biological mechanisms underlying violent behaviour during sleep or the virtual absence of clear legal and uniformly accepted guidelines as to whether to punish or treat those disorders. An updated review of the pertinent literature was performed to determine the most prevalent pathological conditions involving violence and sleep and to identify their most common precipitating factors, attempting to provide some technical support to aid Brazilian medical-experts or assistants in preparing substantial and scientific-based reports in a legal environment.

Behavioural aspects surrounding medicine purchases from pharmacies in Australia

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Emmerton L

2008-09-01

Full Text Available Objective: This study aimed to produce current data regarding behavioural aspects of non-prescription (over-the-counter medicine purchases, in light of changes in the pharmaceutical market and increasing provision of professional services in pharmacies.Methods: Data were collected in 15 community pharmacies in South-East Queensland, Australia, over 540 hours in five days in August, 2006. The method, previously validated, involved documentation of both observational and interview data. Fifteen trained researchers were stationed in a selected pharmacy each to unobtrusively observe all eligible sales of non-prescription medicines, and, where possible, interview the purchasers post-sale. Non-response was supplemented by observational data and recall by the salesperson. The data included details of the purchase and purchasing behaviour, while new questions addressed issues of topical importance, including customers’ privacy concerns. A selection of the analyses is reported here.Results: In total, 3470 purchases were documented (135-479 per pharmacy, with customers of 67.5% of purchases (74.7% excluding an outlier pharmacy participating in the survey. Customers averaged 1.2 non-prescription medicines per transaction. Two-thirds (67.2% of customers were female, and 38.8% of the customers were aged 31-45 years. Analgesics and respiratory medicines accounted for two-thirds of the sales data (33.4% and 32.4%, respectively. Intended-brand purchases comprised 71% of purchases (2004/2824; in-store substitution then occurred in 8.8% of these cases, mainly following recommendations by pharmacy staff. Medicines intended for self-use comprised 62.9% of purchases (1752/2785. First-time purchases (30.8%, 799/2594 were more commonly influenced by pharmacy staff than by advertising.Conclusions: This study used validated methods adapted to a changing marketplace, thus providing data that both confirm and add to knowledge surrounding medicine purchases. Despite the

Subjective sleep complaints indicate objective sleep problems in psychosomatic patients: a prospective polysomnographic study

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Linden M

2016-08-01

Full Text Available Michael Linden,1,2 Marie Dietz,1 Christian Veauthier,3 Ingo Fietze3 1Research Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, 2Department of Psychosomatic Medicine, Rehabilitation Centre Seehof, Teltow, 3Interdisciplinary Center of Sleep Medicine, Charité University Medicine Berlin, Berlin, Germany Objective: To elucidate the relationship between subjective complaints and polysomnographical parameters in psychosomatic patients.Method: A convenience sample of patients from a psychosomatic inpatient unit were classified according to the Pittsburgh Sleep Quality Index (PSQI as very poor sleepers (PSQI >10, n=80 and good sleepers (PSQI <6, n=19. They then underwent a polysomnography and in the morning rated their previous night’s sleep using a published protocol (Deutschen Gesellschaft für Schlafforschung und Schlafmedizin morning protocol [MP].Results: In the polysomnography, significant differences were found between very poor and good sleepers according to the PSQI with respect to sleep efficiency and time awake after sleep onset. When comparing objective PSG and subjective MP, the polysomnographical sleep onset latency was significantly positively correlated with the corresponding parameters of the MP: the subjective sleep onset latency in minutes and the subjective evaluation of sleep onset latency (very short, short, normal, long, very long were positively correlated with the sleep latency measured by polysomnography. The polysomnographical time awake after sleep onset (in minutes was positively correlated with the subjective time awake after sleep onset (in minutes, evaluation of time awake after sleep onset (seldom, normal often, and subjective restfulness. The polysomnographical total sleep time (TST was positively correlated with the subjective TST. Conversely, the polysomnographical TST was negatively correlated with the evaluation of TST (high polysomnographical TST was correlated with the subjective

Sleep homeostasis, habits and habituation.

Science.gov (United States)

Vyazovskiy, Vladyslav V; Walton, Mark E; Peirson, Stuart N; Bannerman, David M

2017-06-01

The importance of sleep for behavioural performance during waking is long-established, but the underlying reasons and mechanisms remain elusive. Waking and sleep are associated with changes in the levels of GluA1 AMPAR subunit in synaptic membranes, while studies using genetically-modified mice have identified an important role for GluA1-dependent synaptic plasticity in a non-associative form of memory that underlies short-term habituation to recently experienced stimuli. Here we posit that sleep may play a role in dishabituation, which restores attentional capacity and maximises the readiness of the animal for learning and goal-directed behaviour during subsequent wakefulness. Furthermore we suggest that sleep disturbance may fundamentally change the nature of behaviour, making it more model-free and habitual as a result of reduced attentional capacity. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Are You Getting Enough Sleep?

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... Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843–844. Features Media ...

Recent temporal trends in sleep duration, domain-specific sedentary behaviour and physical activity. A survey among 25-79-year-old Danish adults.

Science.gov (United States)

Aadahl, Mette; Andreasen, Anne Helms; Hammer-Helmich, Lene; Buhelt, Lone; Jørgensen, Torben; Glümer, Charlotte

2013-11-01

Prevalence of sedentary behaviour is high in many countries, but little is known about temporal trends in sitting time. To examine temporal changes in sleep and domain-specific sedentary behaviour and moderate to vigorous leisure time physical activity (MVPA). Two cross-sectional population-based surveys of 25-79-year-old inhabitants were conducted in The Capital Region of Denmark in 2007 (N = 69.800, response rate 52.3%) and 2010 (N = 77.517, response rate 54.8%). Information on sedentary behaviour and physical activity was obtained from self-report questionnaire and sociodemographic information from central registers. Data were weighted for survey design and for non-response and were analysed by multiple regression analyses. In 2007, the entire survey population reported a mean daily sleeping duration of 7.4 hours, leisure time sitting of 3.4 hours per day, occupational sitting of 4.4 hours per day, MVPA of 0.87 hours per day and a total 24-hour energy expenditure of 40.12 METs per day. In 2010, duration of sleep was unaltered (p = 0.1), sedentary leisure time and sedentary work time had increased by 12.6 minutes (p work and during leisure time, but also on leisure time MVPA. As duration of sleep is unaltered findings suggest that low intensity physical activity may be displaced in everyday life.

Rapid eye movement sleep behavior disorder

DEFF Research Database (Denmark)

Zoetmulder, Marielle; Jennum, Poul

2009-01-01

Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterized by loss of REM sleep and related electromyographic atonia with marked muscular activity and dream enactment behaviour. RBD is seen in 0.5% of the population. It occurs in an idiopathic form and secondarily to medical...

Caffeine and sleep-deprivation mediated changes in open-field behaviours, stress response and antioxidant status in mice

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J. Olakunle Onaolapo

2016-07-01

Conclusion: Repeated caffeine consumption and/or acute sleep-deprivation led to significant changes in pattern of open-field behaviour and stress/antioxidant response in mice. Responses seen in the study are probably due to modulatory effects of caffeine on the total body response to stressful stimuli.

Interactions between sleep disorders and oral diseases.

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Huynh, N T; Emami, E; Helman, J I; Chervin, R D

2014-04-01

Dental sleep medicine is a rapidly growing field that is in close and direct interaction with sleep medicine and comprises many aspects of human health. As a result, dentists who encounter sleep health and sleep disorders may work with clinicians from many other disciplines and specialties. The main sleep and oral health issues that are covered in this review are obstructive sleep apnea, chronic mouth breathing, sleep-related gastroesophageal reflux, and sleep bruxism. In addition, edentulism and its impact on sleep disorders are discussed. Improving sleep quality and sleep characteristics, oral health, and oral function involves both pathophysiology and disease management. The multiple interactions between oral health and sleep underscore the need for an interdisciplinary clinical team to manage oral health-related sleep disorders that are commonly seen in dental practice. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Association between REM sleep behaviour disorder and impulse control disorder in patients with Parkinson's disease.

Science.gov (United States)

Bellosta Diago, E; Lopez Del Val, L J; Santos Lasaosa, S; López Garcia, E; Viloria Alebesque, A

2017-10-01

The relationship between impulse control disorder (ICD) and REM sleep behaviour disorder (RBD) has not yet been clarified, and the literature reports contradictory results. Our purpose is to analyse the association between these 2 disorders and their presence in patients under dopaminergic treatment. A total of 73 patients diagnosed with Parkinson's disease and treated with a single dopamine agonist were included in the study after undergoing clinical assessment and completing the single-question screen for REM sleep behaviour disorder and the short version of the questionnaire for impulsive-compulsive behaviours in Parkinson's disease. Mean age was 68.88 ± 7.758 years. Twenty-six patients (35.6%) were classified as probable-RBD. This group showed a significant association with ICD (P=.001) and had a higher prevalence of non-tremor akinetic rigid syndrome and longer duration of treatment with levodopa and dopamine agonists than the group without probable-RBD. We found a significant correlation between the use of oral dopamine agonists and ICD. Likewise, patients treated with oral dopamine agonists demonstrated a greater tendency toward presenting probable-RBD than patients taking dopamine agonists by other routes; the difference was non-significant. The present study confirms the association between RBD and a higher risk of developing symptoms of ICD in Parkinson's disease. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep.

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Tremblay, Mark S; Chaput, Jean-Philippe; Adamo, Kristi B; Aubert, Salomé; Barnes, Joel D; Choquette, Louise; Duggan, Mary; Faulkner, Guy; Goldfield, Gary S; Gray, Casey E; Gruber, Reut; Janson, Katherine; Janssen, Ian; Janssen, Xanne; Jaramillo Garcia, Alejandra; Kuzik, Nicholas; LeBlanc, Claire; MacLean, Joanna; Okely, Anthony D; Poitras, Veronica J; Rayner, Mary-Ellen; Reilly, John J; Sampson, Margaret; Spence, John C; Timmons, Brian W; Carson, Valerie

2017-11-20

The Canadian Society for Exercise Physiology convened representatives of national organizations, research experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children of the early years embrace the natural and intuitive integration of movement behaviours across the whole day (24-h period). The development process was guided by the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Four systematic reviews (physical activity, sedentary behaviour, sleep, combined behaviours) examining the relationships within and among movement behaviours and several health indicators were completed and interpreted by a Guideline Development Panel. The systematic reviews that were conducted to inform the development of the guidelines, and the framework that was applied to develop the recommendations, followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Complementary compositional analyses were performed using data from the Canadian Health Measures Survey to examine the relationships between movement behaviours and indicators of adiposity. A review of the evidence on the cost effectiveness and resource use associated with the implementation of the proposed guidelines was also undertaken. A stakeholder survey (n = 546), 10 key informant interviews, and 14 focus groups (n = 92 participants) were completed to gather feedback on draft guidelines and their dissemination. The guidelines provide evidence-informed recommendations as to the combinations of light-, moderate- and vigorous-intensity physical activity, sedentary behaviours, and sleep that infants (guidelines. These guidelines represent a sensible evolution of public health guidelines whereby optimal health is

Sleep from an islamic perspective

OpenAIRE

Ahmed S BaHammam

2011-01-01

Sleep medicine is a relatively new scientific specialty. Sleep is an important topic in Islamic literature, and the Quran and Hadith discuss types of sleep, the importance of sleep, and good sleep practices. Islam considers sleep as one of the signs of the greatness of All?h (God) and encourages followers to explore this important sign. The Quran describes different types of sleep, and these correspond with sleep stages identified by modern science. The Quran discusses the beneficial effects ...

Obstructive sleep apnea - adults

Science.gov (United States)

... SM. Obstructive sleep apnea: clinical features, evaluation, and principles of management. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, ...

Light pollution disrupts sleep in free-living animals.

Science.gov (United States)

Raap, Thomas; Pinxten, Rianne; Eens, Marcel

2015-09-04

Artificial lighting can alter individual behaviour, with often drastic and potentially negative effects on biological rhythms, daily activity and reproduction. Whether this is caused by a disruption of sleep, an important widespread behaviour enabling animals to recover from daily stress, is unclear. We tested the hypothesis that light pollution disrupts sleep by recording individual sleep behaviour of great tits, Parus major, that were roosting in dark nest-boxes and were exposed to light-emitting diode light the following night. Their behaviour was compared to that of control birds sleeping in dark nest-boxes on both nights. Artificial lighting caused experimental birds to wake up earlier, sleep less (-5%) and spent less time in the nest-box as they left their nest-box earlier in the morning. Experimental birds did not enter the nest-box or fall asleep later than controls. Although individuals in lit nest-boxes did not wake up more often nor decreased the length of their sleep bouts, females spent a greater proportion of the night awake. Our study provides the first direct proof that light pollution has a significant impact on sleep in free-living animals, in particular in the morning, and highlights a mechanism for potential effects of light pollution on fitness.

Sleep in the domestic hen (Gallus domesticus).

Science.gov (United States)

van Luijtelaar, E L; van der Grinten, C P; Blokhuis, H J; Coenen, A M

1987-01-01

Electrophysiological recordings were made of five closely observed hens, all permanently implanted with both EEG and EMG electrodes. Five behavioural postures were distinguished and percentages of wakefulness, sleep and presumably paradoxical sleep (PS) were determined during the third and sixth hour of the dark period. Substantial agreement was generally found between behaviour and sleep with the exception of sitting or standing motionless with at least one eye open. During two thirds of this behavioural posture, the EEG showed large amplitude slow waves undistinguishable from slow wave sleep. Characteristics of PS were determined: periods were short, whereas its percentage increased during the night. Furthermore, EMG atonia was never found. An all night recording was made, and delta activity (2-5 Hz) was filtered and plotted against time for three of the hens. A significant decrease in delta activity across the night was found. Differences and similarities between sleep in hens and in mammals are discussed. Although large similarities exist it is concluded that some properties of birds' sleep make it unique and are a challenge for further study.

Sleep hygiene among veterinary medical students.

Science.gov (United States)

Royal, Kenneth D; Hunt, Suzanne A; Borst, Luke B; Gerard, Mathew

2018-01-01

The objective of this study was to better understand veterinary medical students' sleep hygiene and identify the extent to which sleep hygiene behaviors may result in consequences (either positive or negative) for students. A total of 187 doctor of veterinary medicine (DVM) program students at a large College of Veterinary Medicine in the United States. The Epworth Sleep Scale and Daytime Sleepiness Scale were administered to 393 students enrolled in the DVM program. About 55.1% of students reported sleep per night, 28.9% reported having trouble sleeping, and 50.3% reported feeling sleepy all day. With respect to sleep quality, 5.3% described it as excellent, 52.4% as good, 34.2% as fair, and 8.0% as poor. A significant percentage of veterinary medical students exhibit poor sleep hygiene habits that may be detrimental to both their health and academic endeavors.

Problems sleeping during pregnancy

Science.gov (United States)

... T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, PA: Elsevier; 2017:chap 156. Ibrahim S, Foldvary-Shaefer N. Sleep disorders in pregnancy: implications, evaluation, and treatment. Neurologic ...

Eczema and sleep and its relationship to daytime functioning in children.

Science.gov (United States)

Camfferman, Danny; Kennedy, John D; Gold, Michael; Martin, Alfred J; Lushington, Kurt

2010-12-01

Chronic childhood eczema has significant morbidity characterised by physical discomfort, emotional distress, reduced child and family quality-of-life and, of particular note, disturbed sleep characterised by frequent and prolonged arousals. Sleep disturbance affects up to 60% of children with eczema, increasing to 83% during exacerbation. Even when in clinical remission, children with eczema demonstrate more sleep disturbance than healthy children. Notably, disturbed sleep in otherwise healthy children is associated with behavioural and neurocognitive deficits. Preliminary evidence suggests that disturbed sleep in children with eczema is also associated with behavioural deficits while the impact on neuropsychological functioning remains unexplored. In conclusion, a disease which affects up to 20% of children in some countries and may produce long-term behavioural and neurocognitive deficits merits further evaluation using standardised tests of sleep, behaviour and neurocognition. Copyright © 2010 Elsevier Ltd. All rights reserved.

Exploring sleep disorders in patients with chronic kidney disease

Directory of Open Access Journals (Sweden)

Nigam G

2018-01-01

Full Text Available Gaurav Nigam,1 Macario Camacho,2 Edward T Chang,2 Muhammad Riaz3 1Division of Sleep Medicine, Clay County Hospital, Flora, IL, 2Division of Otolaryngology, Sleep Surgery and Sleep Medicine, Tripler Army Medical Center, Honolulu, HI, 3Division of Sleep Medicine, Astria Health Center, Grandview, WA, USA Abstract: Kidney disorders have been associated with a variety of sleep-related disorders. Therefore, researchers are placing greater emphasis on finding the role of chronic kidney disease (CKD in the development of obstructive sleep apnea and restless legs syndrome. Unfortunately, the presence of other sleep-related disorders with CKDs and non-CKDs has not been investigated with the same clinical rigor. Recent studies have revealed that myriad of sleep disorders are associated with CKDs. Furthermore, there are a few non-CKD-related disorders that are associated with sleep disorders. In this narrative review, we provide a balanced view of the spectrum of sleep disorders (as identified in International Classification of Sleep disorders-3 related to different types of renal disorders prominently including but not exclusively limited to CKD. Keywords: kidney disease, sleep disorders, obstructive sleep apnea, parasomnias, restless legs syndrome, chronic kidney disease, insomnia

Role of sleep quality in the metabolic syndrome

Directory of Open Access Journals (Sweden)

Koren D

2016-08-01

Full Text Available Dorit Koren,1,2 Magdalena Dumin,1 David Gozal2,3 1Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, Department of Medicine, 2Section of Pediatric Sleep Medicine, 3Section of Pulmonology, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA Abstract: Emerging evidence has assigned an important role to sleep as a modulator of metabolic homeostasis. The impact of variations in sleep duration, sleep-disordered breathing, and chronotype to cardiometabolic function encompasses a wide array of perturbations spanning from obesity, insulin resistance, type 2 diabetes, the metabolic syndrome, and cardiovascular disease risk and mortality in both adults and children. Here, we critically and extensively review the published literature on such important issues and provide a comprehensive overview of the most salient pathophysiologic pathways underlying the links between sleep, sleep disorders, and cardiometabolic functioning. Keywords: sleep apnea, circadian clock, insulin resistance, obesity, cardiovascular risk

Sleep walking

Science.gov (United States)

... Sleepwalking. In: Chokroverty S, Thomas RJ, eds. Atlas of Sleep Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2014:380- ... of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare ... NIH MedlinePlus Magazine Read more ...

Can a Brief Educational Intervention Improve Parents' Knowledge of Healthy Children's Sleep? A Pilot-Test

Science.gov (United States)

Jones, Caroline H. D.; Owens, Judith A.; Pham, Brian

2013-01-01

Objective: Insufficient and poor quality sleep is prevalent in children, and is a significant public health concern due to the negative consequences for health. Certain sleep-related behaviours are associated with improved sleep, and sleep behaviours are amenable to efforts targeted towards behaviour change. Parental educational interventions have…

Impact of Protected Sleep Period for Internal Medicine Interns on Overnight Call on Depression, Burnout, and Empathy

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Shea, Judy A.; Bellini, Lisa M.; Dinges, David F.; Curtis, Meredith L.; Tao, Yuanyuan; Zhu, Jingsan; Small, Dylan S.; Basner, Mathias; Norton, Laurie; Novak, Cristina; Dine, C. Jessica; Rosen, Ilene M.; Volpp, Kevin G.

2014-01-01

Background Patient safety and sleep experts advocate a protected sleep period for residents. Objective We examined whether interns scheduled for a protected sleep period during overnight call would have better end-of-rotation assessments of burnout, depression, and empathy scores compared with interns without protected sleep periods and whether the amount of sleep obtained during on call predicted end-of-rotation assessments. Methods We conducted a randomized, controlled trial with internal medicine interns at the Philadelphia Veterans Affairs Medical Center (PVAMC) and the Hospital of the University of Pennsylvania (HUP) in academic year 2009–2010. Four-week blocks were randomly assigned to either overnight call permitted under the 2003 duty hour standards or a protected sleep period from 12:30 am to 5:30 am. Participants wore wrist actigraphs. At the beginning and end of the rotations, they completed the Beck Depression Inventory (BDI-II), Maslach Burnout Inventory (MBI-HSS), and Interpersonal Reactivity Index (IRI). Results A total of 106 interns participated. There were no significant differences between groups in end-of-rotation BDI-II, MBI-HSS, or IRI scores at either location (P > .05). Amount of sleep while on call significantly predicted lower MBI-Emotional Exhaustion (P < .003), MBI-Depersonalization (P < .003), and IRI-Personal Distress (P < .006) at PVAMC, and higher IRI-Perspective Taking (P < .008) at HUP. Conclusions A protected sleep period produced few consistent improvements in depression, burnout, or empathy, although depression was already low at baseline. Possibly the amount of protected time was too small to affect these emotional states or sleep may not be directly related to these scores. PMID:24949128

Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline

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Sateia, Michael J.; Buysse, Daniel J.; Krystal, Andrew D.; Neubauer, David N.; Heald, Jonathan L.

2017-01-01

Introduction: The purpose of this guideline is to establish clinical practice recommendations for the pharmacologic treatment of chronic insomnia in adults, when such treatment is clinically indicated. Unlike previous meta-analyses, which focused on broad classes of drugs, this guideline focuses on individual drugs commonly used to treat insomnia. It includes drugs that are FDA-approved for the treatment of insomnia, as well as several drugs commonly used to treat insomnia without an FDA indication for this condition. This guideline should be used in conjunction with other AASM guidelines on the evaluation and treatment of chronic insomnia in adults. Methods: The American Academy of Sleep Medicine commissioned a task force of four experts in sleep medicine. A systematic review was conducted to identify randomized controlled trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, and patient values and preferences. Literature reviews are provided for those pharmacologic agents for which sufficient evidence was available to establish recommendations. The AASM Board of Directors approved the final recommendations. Recommendations: The following recommendations are intended as a guideline for clinicians in choosing a specific pharmacological agent for treatment of chronic insomnia in adults, when such treatment is indicated. Under GRADE, a STRONG recommendation is one that clinicians should, under most circumstances, follow. A WEAK recommendation reflects a lower degree of certainty in the outcome and appropriateness of the patient-care strategy for all patients, but should not be construed as an indication of ineffectiveness. GRADE recommendation strengths do not refer to the magnitude of treatment effects in a particular patient, but rather, to the strength of

Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline.

Science.gov (United States)

Sateia, Michael J; Buysse, Daniel J; Krystal, Andrew D; Neubauer, David N; Heald, Jonathan L

2017-02-15

The purpose of this guideline is to establish clinical practice recommendations for the pharmacologic treatment of chronic insomnia in adults, when such treatment is clinically indicated. Unlike previous meta-analyses, which focused on broad classes of drugs, this guideline focuses on individual drugs commonly used to treat insomnia. It includes drugs that are FDA-approved for the treatment of insomnia, as well as several drugs commonly used to treat insomnia without an FDA indication for this condition. This guideline should be used in conjunction with other AASM guidelines on the evaluation and treatment of chronic insomnia in adults. The American Academy of Sleep Medicine commissioned a task force of four experts in sleep medicine. A systematic review was conducted to identify randomized controlled trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, and patient values and preferences. Literature reviews are provided for those pharmacologic agents for which sufficient evidence was available to establish recommendations. The AASM Board of Directors approved the final recommendations. The following recommendations are intended as a guideline for clinicians in choosing a specific pharmacological agent for treatment of chronic insomnia in adults, when such treatment is indicated. Under GRADE, a STRONG recommendation is one that clinicians should, under most circumstances, follow. A WEAK recommendation reflects a lower degree of certainty in the outcome and appropriateness of the patient-care strategy for all patients, but should not be construed as an indication of ineffectiveness. GRADE recommendation strengths do not refer to the magnitude of treatment effects in a particular patient, but rather, to the strength of evidence in published data. Downgrading

The spectrum of REM sleep-related episodes in children with type 1 narcolepsy.

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Antelmi, Elena; Pizza, Fabio; Vandi, Stefano; Neccia, Giulia; Ferri, Raffaele; Bruni, Oliviero; Filardi, Marco; Cantalupo, Gaetano; Liguori, Rocco; Plazzi, Giuseppe

2017-06-01

Type 1 narcolepsy is a central hypersomnia due to the loss of hypocretin-producing neurons and characterized by cataplexy, excessive daytime sleepiness, sleep paralysis, hypnagogic hallucinations and disturbed nocturnal sleep. In children, close to the disease onset, type 1 narcolepsy has peculiar clinical features with severe cataplexy and a complex admixture of movement disorders occurring while awake. Motor dyscontrol during sleep has never been systematically investigated. Suspecting that abnormal motor control might affect also sleep, we systematically analysed motor events recorded by means of video polysomnography in 40 children with type 1 narcolepsy (20 females; mean age 11.8 ± 2.6 years) and compared these data with those recorded in 22 age- and sex-matched healthy controls. Motor events were classified as elementary movements, if brief and non-purposeful and complex behaviours, if simulating purposeful behaviours. Complex behaviours occurring during REM sleep were further classified as 'classically-defined' and 'pantomime-like' REM sleep behaviour disorder episodes, based on their duration and on their pattern (i.e. brief and vivid-energetic in the first case, longer and with subcontinuous gesturing mimicking daily life activity in the second case). Elementary movements emerging either from non-REM or REM sleep were present in both groups, even if those emerging from REM sleep were more numerous in the group of patients. Conversely, complex behaviours could be detected only in children with type 1 narcolepsy and were observed in 13 patients, with six having 'classically-defined' REM sleep behaviour disorder episodes and seven having 'pantomime-like' REM sleep behaviour disorder episodes. Complex behaviours during REM sleep tended to recur in a stereotyped fashion for several times during the night, up to be almost continuous. Patients displaying a more severe motor dyscontrol during REM sleep had also more severe motor disorder during daytime (i

Dispensing good sleep health behaviours not pills--a cluster-randomized controlled trial to test the feasibility and efficacy of pharmacist-provided brief behavioural treatment for insomnia.

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Fuller, Joanne M; Wong, Keith K; Hoyos, Camilla; Krass, Ines; Saini, Bandana

2016-02-01

Behavioural therapies are recommended as the first-line treatment of insomnia; however, sedatives and hypnotics constitute the main treatment modality used in primary care. Community pharmacies provide a unique conduit for identifying and providing appropriate treatment for those with insomnia either purchasing prescription sedatives or seeking over-the-counter treatments. A feasibility study using a cluster-randomized controlled trial, testing the efficacy of trained pharmacists providing behavioural interventions such as stimulus control and sleep restriction to patients with insomnia, in improving insomnia severity was conducted. The intervention involved three pharmacy visits (baseline, 1 and 3 months follow-up). The control group received usual care and information sheets on insomnia. The primary outcome was the Insomnia Severity Index. Twelve community pharmacists (five control, seven intervention) in New South Wales, Australia were recruited and trained. These pharmacists, in turn, recruited 46 patients (22 control, 24 intervention (mean age 53.7 ± 18.4, 72% females) and delivered a brief behavioural therapy intervention. The overall decrease in Insomnia Severity Index from baseline to the 3-month follow-up in the intervention group, n = 17 (7.6 ± 4.3 points), was significantly greater than for the control group, n = 19 (2.9 ± 8.8 points) (mean difference 4.6, 95% confidence interval: 0.005-9.2, P = 0.05). However, when the effect of clustering was taken into account using a mixed-effects model, the estimated difference in Insomnia Severity Index (change from baseline to visit 3) between the intervention and control groups was not significant (group difference in Insomnia Severity Index change = 3.78, 95% confidence interval: -0.81 to 8.37, P = 0.11; intracluster correlation = 0.18). The study highlights the use of a novel venue to deliver brief behavioural therapies for insomnia using trained non-psychologist health professionals. Although, when cluster

Role of a behavioural therapy involving psychodrama for the treatment of sleep disorders in paediatric primary care.

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Stagnara, Jean; Lemoine, Patrick

2017-07-28

Sleep disorders are common in young children. Our objective was to describe a psychodrama using puppets and to assess the interest of this approach for the treatment of sleep disorders in ambulatory paediatric patients. This retrospective, observational, monocentre study was carried between 1st January 2014 and 31st December 2015. Children aged 12 months to 6 years with a sleep disorder confirmed according to the International Classification of Sleep Disorders-2 were recruited. The parents were questioned separately about their child's sleep rhythm and the family's quality of life (QoL). The child sitting on their parent's knee and, using puppets to represent the family members, the paediatrician reproduced the scenario that took place at home and demonstrated what should be changed. The parents were contacted by telephone 1-2 weeks after the therapy to determine whether the child's sleep patterns had improved. The primary endpoint was resolution of the sleep disorder. Thirty-eight children (mean age 27.2 ± 14.0 months; mean duration of sleep disorder 12.7 ± 9.5 months) were assessed. The most common sleep disorders were difficulties in falling asleep at evening bed-time (76.3%) and night-time wakening (76.3%). The main triggering factors were the birth of a sibling (30.8%) or an illness (30.8%). In the majority (52.2%) of families who were convinced that the psychodrama would work, an immediate and complete resolution of the sleep disorder was obtained within 3 days of the consultation. QoL improved in the majority of families after the consultation (QoL was average in 68.4% of families before the consultation vs. good in 84.2% after the consultation). Psychodrama was effective at bringing about an immediate and complete resolution of sleep disorders in children. This confirms the findings of other reports that show that behavioural therapy is effective in this context. This method could be adapted effectively by individual practitioners, enabling children to

Management of sleep disorders in neurodevelopmental disorders and genetic syndromes.

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Heussler, Helen S

2016-03-01

Sleep disorders in individuals with developmental difficulties continue to be a significant challenge for families, carers, and therapists with a major impact on individuals and carers alike. This review is designed to update the reader on recent developments in this area. A systematic search identified a variety of studies illustrating advances in the regulation of circadian rhythm and sleep disturbance in neurodevelopmental disorders. Specific advances are likely to lead in some disorders to targeted therapies. There is strong evidence that behavioural and sleep hygiene measures should be first line therapy; however, studies are still limited in this area. Nonpharmacological measures such as exercise, sensory interventions, and behavioural are reported. Behavioural regulation and sleep hygiene demonstrate the best evidence for improved sleep parameters in individuals with neurodisability. Although the mainstay of management of children with sleep problems and neurodevelopmental disability is similar to that of typically developing children, there is emerging evidence of behavioural strategies being successful in large-scale trials and the promise of more targeted therapies for more specific resistant disorders.

Effects of Homeopathic Medicines on Polysomnographic Sleep of Young Adults with Histories of Coffee-Related Insomnia

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Bell, Iris R.; Howerter, Amy; Jackson, Nicholas; Aickin, Mikel; Baldwin, Carol M.; Bootzin, Richard R.

2010-01-01

Background Homeopathy, a common form of alternative medicine worldwide, relies on subjective patient reports for diagnosis and treatment. Polysomnography offers a modern methodology for evaluating the objective effects of taking homeopathic remedies that clinicians claim exert effects on sleep quality in susceptible individuals. Animal studies have previously shown changes in non rapid eye movement sleep with certain homeopathic remedies. Methods Young adults of both sexes (ages 18–31) with above-average scores on standardized personality scales for either cynical hostility or anxiety sensitivity (but not both), and a history of coffee-induced insomnia, participated in the month-long study. At-home polysomnographic recordings were obtained on successive pairs of nights once per week for a total of eight recordings (nights 1, 2, 8, 9, 15, 16, 22, 23). Subjects (N=54) received placebo pellets on night 8 (single-blind) and verum pellets on night 22 (double-blind) in 30c doses of one of two homeopathic remedies, Nux Vomica or Coffea Cruda. Subjects completed daily morning sleep diaries and weekly Pittsburgh Sleep Quality Index scales, as well as Profile of Mood States Scales at bedtime on polysomnography nights. Results Verum remedies significantly increased PSG total sleep time and NREM, as well as awakenings and stage changes. Changes in actigraphic and self-rated scale effects were not significant. Conclusions The study demonstrated the feasibility of using in-home all-night sleep recordings to study homeopathic remedy effects. Findings are similar though not identical to those reported in animals with the same remedies. Possible mechanisms include initial disruption of the nonlinear dynamics of sleep patterns by the verum remedies. PMID:20673648

Sleep Health: Can We Define It? Does It Matter?

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Buysse, Daniel J.

2014-01-01

Good sleep is essential to good health. Yet for most of its history, sleep medicine has focused on the definition, identification, and treatment of sleep problems. Sleep health is a term that is infrequently used and even less frequently defined. It is time for us to change this. Indeed, pressures in the research, clinical, and regulatory environments require that we do so. The health of populations is increasingly defined by positive attributes such as wellness, performance, and adaptation, and not merely by the absence of disease. Sleep health can be defined in such terms. Empirical data demonstrate several dimensions of sleep that are related to health outcomes, and that can be measured with self-report and objective methods. One suggested definition of sleep health and a description of self-report items for measuring it are provided as examples. The concept of sleep health synergizes with other health care agendas, such as empowering individuals and communities, improving population health, and reducing health care costs. Promoting sleep health also offers the field of sleep medicine new research and clinical opportunities. In this sense, defining sleep health is vital not only to the health of populations and individuals, but also to the health of sleep medicine itself. Citation: Buysse DJ. Sleep health: can we define it? Does it matter? SLEEP 2014;37(1):9-17. PMID:24470692

Hypertension and obstructive sleep apnea

Directory of Open Access Journals (Sweden)

Phillips CL

2013-05-01

Full Text Available Craig L Phillips,1–3 Denise M O'Driscoll4,51Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia; 2National Health and Medical Research Council Center for Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; 3Discipline of Sleep Medicine, Sydney Medical School, University of Sydney, Sydney, Australia; 4Monash Lung and Sleep, Monash Medical Centre, Monash University, Melbourne, Australia; 5Department of Medicine, Southern Clinical School, Monash University, Melbourne, AustraliaAbstract: Obstructive sleep apnea (OSA is increasingly being recognized as a major health burden with strong focus on the associated cardiovascular risk. Studies from the last two decades have provided strong evidence for a causal role of OSA in the development of systemic hypertension. The acute physiological changes that occur during apnea promote nocturnal hypertension and may lead to the development of sustained daytime hypertension via the pathways of sympathetic activation, inflammation, oxidative stress, and endothelial dysfunction. This review will focus on the acute hemodynamic disturbances and associated intermittent hypoxia that characterize OSA and the potential pathophysiological mechanisms responsible for the development of hypertension in OSA. In addition the epidemiology of OSA and hypertension, as well as the role of treatment of OSA, in improving blood pressure control will be examined.Keywords: obstructive sleep apnea, hypertension, intermittent hypoxia, ambulatory blood pressure, sympathetic activation

Using the Behaviour Change Wheel to explore potential strategies for minimising harms from non-recreational prescription medicine sharing.

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Beyene, Kebede; Aspden, Trudi; Sheridan, Janie

2018-04-05

Non-recreational sharing of prescribed medicines can have positive outcomes under some circumstances, but can also result in negative health outcomes. This paper describes a theoretically underpinned and systematic approach to exploring potential interventions to reduce harm. Individual, semi-structured, face-to-face interviews were conducted with purposively sampled pharmacists (n = 8), doctors (n = 4), nurses (n = 6) and patients (n = 17) from Auckland, New Zealand. Thematic analysis of suggested interventions was undertaken, and these were linked to relevant intervention functions of the Behaviour Change Wheel (BCW). Analysis of previously defined factors influencing sharing were mapped onto the "Capability, Opportunity, Motivation - Behaviour" (COM-B) model of the BCW. COM-B analysis of the factors influencing sharing behaviour revealed: (i) 'Capability'-related factors, such as patient misconceptions about the safety of certain medicines, forgetting to refill or to carry around own medicines, and lack of knowledge about safe disposal of leftover/unused medicines; (ii) 'Opportunity'-related factors included lack of access to health facilities, lack of time to see a doctor, linguistic and cultural barriers, lack of information from healthcare providers about risks of sharing, and having leftover/unused medicines, and (iii) 'Motivation'-related factors included altruism, illness denial, embarrassment about seeing a doctor, not carrying around own medicines, habit, and fear of negative health consequences from missing a few doses of medicines. Five intervention functions of the BCW appear to be the most likely candidates for targeting the factors which relate to medicine sharing. These are education, persuasion, enablement, environmental restructuring and restriction. A variety of personal and external factors which influence sharing behaviours were identified, and the BCW provided a means by which theoretically underpinned interventions to reduce

Study protocol: the sleeping sound with attention-deficit/hyperactivity disorder project.

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Sciberras, Emma; Efron, Daryl; Gerner, Bibi; Davey, Margot; Mensah, Fiona; Oberklaid, Frank; Hiscock, Harriet

2010-12-30

Up to 70% of children with Attention-Deficit/Hyperactivity Disorder (ADHD) experience sleep problems including difficulties initiating and maintaining sleep. Sleep problems in children with ADHD can result in poorer child functioning, impacting on school attendance, daily functioning and behaviour, as well as parental mental health and work attendance. The Sleeping Sound with ADHD trial aims to investigate the efficacy of a behavioural sleep program in treating sleep problems experienced by children with ADHD. We have demonstrated the feasibility and the acceptability of this treatment program in a pilot study. This randomised controlled trial (RCT) is being conducted with 198 children (aged between 5 to 12 years) with ADHD and moderate to severe sleep problems. Children are recruited from public and private paediatric practices across the state of Victoria, Australia. Upon receiving informed written consent, families are randomised to receive either the behavioural sleep intervention or usual care. The intervention consists of two individual, face-to-face consultations and a follow-up phone call with a trained clinician (trainee consultant paediatrician or psychologist), focusing on the assessment and management of child sleep problems. The primary outcome is parent- and teacher-reported ADHD symptoms (ADHD Rating Scale IV). Secondary outcomes are child sleep (actigraphy and parent report), behaviour, daily functioning, school attendance and working memory, as well as parent mental health and work attendance. We are also assessing the impact of children's psychiatric comorbidity (measured using a structured diagnostic interview) on treatment outcome. To our knowledge, this is the first RCT of a behavioural intervention aiming to treat sleep problems in children with ADHD. If effective, this program will provide a feasible non-pharmacological and acceptable intervention improving child sleep and ADHD symptoms in this patient group. Current Controlled Trials ISRCTN

Sleep less and bite more: sleep disorders associated with occlusal loads during sleep.

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Kato, Takafumi; Yamaguchi, Taihiko; Okura, Kazuo; Abe, Susumu; Lavigne, Gilles J

2013-04-01

Occlusal overload during sleep is a significant clinical issue that has negative impacts on the maintenance of teeth and the longevity of dental prostheses. Sleep is usually viewed as an 'out-of-functional' mode for masticatory muscles. However, orodental structures and prostheses are not free from occlusal loads during sleep since masticatory muscles can be activated at a low level within normal sleep continuity. Thus, an increase in masticatory muscle contractions, by whatever the cause, can be associated with a risk of increased occlusal loads during sleep. Among such conditions, sleep bruxism (SB) is a type of sleep-related movement disorders with potential load challenge to the tooth and orofacial structures. Patients with SB usually report frequent tooth grinding noises during sleep and there is a consecutive increase in number and strength of rhythmic masticatory muscle activity (RMMA). Other types of masticatory muscle contractions can be non-specifically activated during sleep, such as brief contractions with tooth tapping, sleep talking, non-rhythmic contractions related to non-specific body movements, etc.; these occur more frequently in sleep disorders. Studies have shown that clinical signs and symptoms of SB can be found in patients with sleep disorders. In addition, sleep becomes compromised with aging process, and a prevalence of most sleep disorders is high in the elderly populations, in which prosthodontic rehabilitations are more required. Therefore, the recognition and understanding of the role of sleep disorders can provide a comprehensive vision for prosthodontic rehabilitations when prosthodontists manage complex orodental cases needing interdisciplinary collaborations between dentistry and sleep medicine. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years: An Integration of Physical Activity, Sedentary Behaviour, and Sleep

Directory of Open Access Journals (Sweden)

Mark S. Tremblay

2017-11-01

Full Text Available Abstract Background The Canadian Society for Exercise Physiology convened representatives of national organizations, research experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children of the early years embrace the natural and intuitive integration of movement behaviours across the whole day (24-h period. Methods The development process was guided by the Appraisal of Guidelines for Research and Evaluation (AGREE II instrument. Four systematic reviews (physical activity, sedentary behaviour, sleep, combined behaviours examining the relationships within and among movement behaviours and several health indicators were completed and interpreted by a Guideline Development Panel. The systematic reviews that were conducted to inform the development of the guidelines, and the framework that was applied to develop the recommendations, followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE methodology. Complementary compositional analyses were performed using data from the Canadian Health Measures Survey to examine the relationships between movement behaviours and indicators of adiposity. A review of the evidence on the cost effectiveness and resource use associated with the implementation of the proposed guidelines was also undertaken. A stakeholder survey (n = 546, 10 key informant interviews, and 14 focus groups (n = 92 participants were completed to gather feedback on draft guidelines and their dissemination. Results The guidelines provide evidence-informed recommendations as to the combinations of light-, moderate- and vigorous-intensity physical activity, sedentary behaviours, and sleep that infants (<1 year, toddlers (1–2 years and preschoolers (3–4�

Female impulsive aggression: a sleep research perspective.

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Lindberg, Nina; Tani, Pekka; Putkonen, Hanna; Sailas, Eila; Takala, Pirjo; Eronen, Markku; Virkkunen, Matti

2009-01-01

The rate of violent crimes among girls and women appears to be increasing. One in every five female prisoners has been reported to have antisocial personality disorder. However, it has been quite unclear whether the impulsive, aggressive behaviour among women is affected by the same biological mechanisms as among men. Psychiatric sleep research has attempted to identify diagnostically sensitive and specific sleep patterns associated with particular disorders. Most psychiatric disorders are typically characterized by a severe sleep disturbance associated with decreased amounts of slow wave sleep (SWS), the physiologically significant, refreshing part of sleep. Among men with antisocial behaviour with severe aggression, on the contrary, increased SWS has been reported, reflecting either specific brain pathology or a delay in the normal development of human sleep patterns. In our preliminary study among medication-free, detoxified female homicidal offenders with antisocial personality disorder, the same profound abnormality in sleep architecture was found. From the perspective of sleep research, the biological correlates of severe impulsive aggression seem to share similar features in both sexes.

A pilot study of a novel smartphone application for the estimation of sleep onset.

Science.gov (United States)

Scott, Hannah; Lack, Leon; Lovato, Nicole

2018-02-01

The aim of the study was to investigate the accuracy of Sleep On Cue: a novel iPhone application that uses behavioural responses to auditory stimuli to estimate sleep onset. Twelve young adults underwent polysomnography recording while simultaneously using Sleep On Cue. Participants completed as many sleep-onset trials as possible within a 2-h period following their normal bedtime. On each trial, participants were awoken by the app following behavioural sleep onset. Then, after a short break of wakefulness, commenced the next trial. There was a high degree of correspondence between polysomnography-determined sleep onset and Sleep On Cue behavioural sleep onset, r = 0.79, P Sleep On Cue overestimated sleep-onset latency by 3.17 min (SD = 3.04). When polysomnography sleep onset was defined as the beginning of N2 sleep, the discrepancy was reduced considerably (M = 0.81, SD = 1.96). The discrepancy between polysomnography and Sleep On Cue varied between individuals, which was potentially due to variations in auditory stimulus intensity. Further research is required to determine whether modifications to the stimulus intensity and behavioural response could improve the accuracy of the app. Nonetheless, Sleep On Cue is a viable option for estimating sleep onset and may be used to administer Intensive Sleep Retraining or facilitate power naps in the home environment. © 2017 European Sleep Research Society.

Improving physical activity, sedentary behaviour and sleep in COPD : Perspectives of people with COPD and experts via a Delphi approach

NARCIS (Netherlands)

Lewthwaite, Hayley; Effing, Tanja W.; Lenferink, Anke; Olds, Tim; Williams, Marie T.

2018-01-01

Background. Little is known about how to achieve enduring improvements in physical activity (PA), sedentary behaviour (SB) and sleep for people with chronic obstructive pulmonary disease (COPD). This study aimed to: (1) identify what people with COPD from South Australia and the Netherlands, and

[The NHG guideline 'Sleep problems and sleeping pills'].

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Damen-van Beek, Zamire; Lucassen, Peter L B J; Gorgels, Wim; Smelt, Antonette F H; Knuistingh Neven, Arie; Bouma, Margriet

2015-01-01

The Dutch College of General Practitioners' (NHG) guideline 'Sleep problems and sleeping pills' provides recommendations for the diagnosis and treatment of the most prevalent sleep problems and for the management of chronic users of sleeping pills. The preferred approach for sleeplessness is not to prescribe medication but to give information and behavioural advice. Practice assistants of the Dutch Association of Mental Health and Addiction Care are also expected to be able to undertake this management. The GP may consider prescribing sleeping pills for a short period only in cases of severe insomnia with considerable distress. Chronic users of sleeping pills should be advised by the GP to stop using them or to reduce the dose gradually (controlled dose reduction). The GP may refer patients with suspected obstructive sleep apnoea (OSA) to a pulmonary or ear, nose and throat specialist or neurologist for further diagnosis depending on the regional arrangements. The GP may then consider the cardiovascular risk factors commonly present with OSA. In patients with restless legs syndrome (RLS) who continue to experience major distress despite being given advice without the prescription of medication, the GP may consider prescribing a dopamine agonist.

Are there associations between sleep bruxism, chronic stress, and sleep quality?

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Ohlmann, Brigitte; Bömicke, Wolfgang; Habibi, Yasamin; Rammelsberg, Peter; Schmitter, Marc

2018-07-01

The purpose of this study was to identify associations between definite sleep bruxism, as defined by the American academy of sleep medicine, and chronic stress and sleep quality. Sleep bruxism was determined by use of questionnaires, assessment of clinical symptoms, and recording of electromyographic and electrocardiographic data (recorded by the Bruxoff ® device). The study included 67 participants. Of these, 38 were identified as bruxers and 29 as non-bruxers. The 38 bruxers were further classified as 17 moderate and 21 intense bruxers. Self-reported stress and self-reported sleep quality were determined by use of the validated questionnaires "Trier Inventory for the Assessment of Chronic Stress" (TICS) and the "Pittsburgh Sleep Quality Index" (PSQI). No statistically significant association was found between sleep bruxism and self-reported stress or sleep quality. However, a significant association between specific items of chronic stress and poor sleep quality was identified. The results of this study indicate an association between subjective sleep quality and subjective chronic stress, irrespective of the presence or absence of sleep bruxism. Chronic stress and sleep quality do not seem to be associated with sleep bruxism. (clinical trial no. NCT03039985). Copyright © 2018 Elsevier Ltd. All rights reserved.

Sleep-related Issues for Recovery and Performance in Athletes.

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Kölling, Sarah; Duffield, Rob; Erlacher, Daniel; Venter, Ranel; Halson, Shona L

2018-04-13

The body of research that reports the relevance of sleep in high-performance sports is growing steadily. While the identification of sleep cycles and diagnosis of sleep disorders is limited to lab-based assessment via polysomnography, the development of activity-based devices estimating sleep patterns provides greater insight into the sleep behaviour of athletes in ecological settings. Overall, small sleep quantity and/or poor quality appears to exist in many athletic populations, though this may be related to training and competition context. Typical sleep-affecting factors are the scheduling of training sessions and competitions as well as impaired sleep-onset as a result of increased arousal prior to competition or due to the use of electronic devices before bedtime. Further challenges are travel demands which may be accompanied by jet-lag symptoms and disruption of sleep habits. Promotion of sleep may be approached via behavioural strategies, such as sleep hygiene, extending night-time sleep or daytime napping. Pharmacological interventions should be limited to clinically-induced treatments as evidence among healthy and athletic populations is lacking. To optimise and manage sleep in athletes, it is recommended to implement routine sleep monitoring on an individual basis.

Train hard, sleep well? Perceived training load, sleep quantity and sleep stage distribution in elite level athletes.

Science.gov (United States)

Knufinke, Melanie; Nieuwenhuys, Arne; Geurts, Sabine A E; Møst, Els I S; Maase, Kamiel; Moen, Maarten H; Coenen, Anton M L; Kompier, Michiel A J

2018-04-01

Sleep is essential for recovery and performance in elite athletes. While it is generally assumed that exercise benefits sleep, high training load may jeopardize sleep and hence limit adequate recovery. To examine this, the current study assessed objective sleep quantity and sleep stage distributions in elite athletes and calculated their association with perceived training load. Mixed-methods. Perceived training load, actigraphy and one-channel EEG recordings were collected among 98 elite athletes during 7 consecutive days of regular training. Actigraphy revealed total sleep durations of 7:50±1:08h, sleep onset latencies of 13±15min, wake after sleep onset of 33±17min and sleep efficiencies of 88±5%. Distribution of sleep stages indicated 51±9% light sleep, 21±8% deep sleep, and 27±7% REM sleep. On average, perceived training load was 5.40±2.50 (scale 1-10), showing large daily variability. Mixed-effects models revealed no alteration in sleep quantity or sleep stage distributions as a function of day-to-day variation in preceding training load (all p's>.05). Results indicate healthy sleep durations, but elevated wake after sleep onset, suggesting a potential need for sleep optimization. Large proportions of deep sleep potentially reflect an elevated recovery need. With sleep quantity and sleep stage distributions remaining irresponsive to variations in perceived training load, it is questionable whether athletes' current sleep provides sufficient recovery after strenuous exercise. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Sleep: A Health Imperative

Science.gov (United States)

Luyster, Faith S.; Strollo, Patrick J.; Zee, Phyllis C.; Walsh, James K.

2012-01-01

Chronic sleep deficiency, defined as a state of inadequate or mistimed sleep, is a growing and underappreciated determinant of health status. Sleep deprivation contributes to a number of molecular, immune, and neural changes that play a role in disease development, independent of primary sleep disorders. These changes in biological processes in response to chronic sleep deficiency may serve as etiological factors for the development and exacerbation of cardiovascular and metabolic diseases and, ultimately, a shortened lifespan. Sleep deprivation also results in significant impairments in cognitive and motor performance which increase the risk of motor vehicle crashes and work-related injuries and fatal accidents. The American Academy of Sleep Medicine and the Sleep Research Society have developed this statement to communicate to national health stakeholders the current knowledge which ties sufficient sleep and circadian alignment in adults to health. Citation: Luyster FS; Strollo PJ; Zee PC; Walsh JK. Sleep: a health imperative. SLEEP 2012;35(6):727-734. PMID:22654183

Herbal medicine for management of the behavioural and psychological symptoms of dementia (BPSD): A systematic review and meta-analysis.

Science.gov (United States)

Hyde, Anna J; May, Brian H; Dong, Lin; Feng, Mei; Liu, Shaonan; Guo, Xinfeng; Zhang, Anthony Lin; Lu, Chuanjian; Xue, Charlie Changli

2017-02-01

Management of the behavioural and psychological symptoms of dementia remains a challenge worldwide. Herbal medicines may play a role in the development of new interventions. To determine effects of herbal medicines for management of the behavioural and psychological symptoms of dementia, meta-analysis was conducted of 31 controlled trials (3613 participants). Frequently tested herbal medicines were the Ginkgo biloba leaf extract EGb 761 (seven studies) and the multi-ingredient formula Yokukansan (eight studies). Sixteen studies tested other herbal medicines. Improvements were detected in Neuropsychiatric Inventory scores in EGb 761 groups compared to placebo (MD -3.46 [-5.94, -0.98]; I 2 = 93%; n = 1757) and Yokukansan groups compared to no treatment (SMD -0.53 [-0.86, -0.21]; I 2 = 0%; n = 150). Cognitive scores were improved in EGb 761 groups while Yokukansan did not appear to affect cognitive function. Of the other herbal medicines, there were improvements in the behavioural and psychological symptoms of dementia and cognitive outcomes in two of four placebo-controlled studies. EGb 761 and Yokukansan appeared safe and well tolerated. Adverse effects and dropouts were not reported consistently for the other herbal medicines. Weaknesses of these included short durations, small sample sizes, lack of blinding and other risks of bias. Well-designed studies are needed to further investigate the reported effects of these interventions on the behavioural and psychological symptoms of dementia.

Subjective-objective sleep discrepancy among older adults: associations with insomnia diagnosis and insomnia treatment.

Science.gov (United States)

Kay, Daniel B; Buysse, Daniel J; Germain, Anne; Hall, Martica; Monk, Timothy H

2015-02-01

Discrepancy between subjective and objective measures of sleep is associated with insomnia and increasing age. Cognitive behavioural therapy for insomnia improves sleep quality and decreases subjective-objective sleep discrepancy. This study describes differences between older adults with insomnia and controls in sleep discrepancy, and tests the hypothesis that reduced sleep discrepancy following cognitive behavioural therapy for insomnia correlates with the magnitude of symptom improvement reported by older adults with insomnia. Participants were 63 adults >60 years of age with insomnia, and 51 controls. At baseline, participants completed sleep diaries for 7 days while wearing wrist actigraphs. After receiving cognitive behavioural therapy for insomnia, insomnia patients repeated this sleep assessment. Sleep discrepancy variables were calculated by subtracting actigraphic sleep onset latency and wake after sleep onset from respective self-reported estimates, pre- and post-treatment. Mean level and night-to-night variability in sleep discrepancy were investigated. Baseline sleep discrepancies were compared between groups. Pre-post-treatment changes in Insomnia Severity Index score and sleep discrepancy variables were investigated within older adults with insomnia. Sleep discrepancy was significantly greater and more variable across nights in older adults with insomnia than controls, P ≤ 0.001 for all. Treatment with cognitive behavioural therapy for insomnia was associated with significant reduction in the Insomnia Severity Index score that correlated with changes in mean level and night-to-night variability in wake after sleep onset discrepancy, P insomnia. © 2014 European Sleep Research Society.

Sleep patterns and insomnia among portuguese adolescents: a cross-sectional study

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Odete Amaral

2014-11-01

Conclusions: There are high prevalence of inadequate sleep patterns, insufficient sleep and insomnia among Portuguese adolescents. Insufficient sleep is associated with sleep patterns and social and behavioural factors. These results add to our knowledge of adolescent sleep worldwide.

Legal Aspects of Sleep Medicine in the 21st Century.

Science.gov (United States)

Venkateshiah, Saiprakash B; Hoque, Romy; Collop, Nancy A

2018-05-08

Multiple manifestations of sleep disorders may interact with the law making it important to increase awareness of such interactions among clinicians. Patients with excessive sleepiness may have civil (and in some states criminal) liability if they fall asleep while driving and cause a motor vehicle accident. Employers may be held vicariously liable due to the actions of sleepy employees. Hence awareness of causes of excessive sleepiness such as sleep deprivation and OSA is increasing among trucking, railroad, and other safety sensitive occupations. Interestingly, litigation related to perioperative complications due to Obstructive Sleep Apnea (OSA) is more frequent than non-operative issues such as a failure to diagnose OSA. Parasomnia associated sleep-related violence (SRV) represents a challenge to clinicians, as they may be asked to consider parasomnia as a possible contributing, mitigating, or exculpatory factor in criminal proceedings. Clinicians should also familiarize with the legal and regulatory aspects of running an independent sleep laboratory. Sleep telemedicine practice using 21 st century technology has opened novel and unique challenges to existing laws. In this review, we shall cover the most common interactions between sleep disorders and the law including the challenges of excessive sleepiness and driving; other legal issues involving patients with obstructive sleep apnea (OSA); and the liabilities associated with parasomnia disorder. We shall also cover some practical legal aspects involving independent sleep laboratories and the field of sleep telemedicine. Published by Elsevier Inc.

The sleeping patterns of Head Start children and the influence on developmental outcomes.

Science.gov (United States)

Schlieber, M; Han, J

2018-05-01

Sleep has a significant influence on children's development. The objective of this study was to investigate Head Start children's sleeping patterns and the impact on cognitive and behavioural outcomes. Using the 2009 cohort of the Head Start Family and Child Experiences Survey (N = 2,868), information on sleeping patterns was assessed through parent interviews. Cognitive outcomes were assessed using direct assessments (Peabody Picture Vocabulary Test-IV, the Expressive One-Word Picture Vocabulary Test, and Subtests of the Woodcock-Johnson III) in addition to teacher report. Behavioural outcomes were assessed through parent and teacher reports. A multiple regression analysis was performed for each outcome variable. Descriptive findings showed that 89% of children had a regular bedtime at least 4 days per week and that the average amount of sleep per night was 10.41 hr. White mothers were more likely than other racial groups to adhere to a consistent bedtime, and maternal employment predicted less hour of sleep per night. Multiple regression analyses revealed that disrupted sleep had a negative influence on cognitive outcomes, especially in areas of mathematical problem solving, receptive language, teacher-reported literacy behaviours, and approaches to learning. Disrupted sleep was associated with the risk of misbehaviour by increasing teacher and parent ratings on aggressive behaviours, hyperactivity, and withdrawing in addition to decreased scores on overall social skills. Having an inconsistent bedtime negatively predicted expressive vocabulary and teacher-reported literacy behaviours. The findings of this study support the influential role of sleep on children's development. Sleeping through the night and having a consistent bedtime were found to be predictive of many areas of cognitive and behavioural development. Head Start staff can provide the supports to increase parental knowledge on appropriate child sleep practices. © 2017 John Wiley & Sons Ltd.

The Biology of REM Sleep

Science.gov (United States)

Peever, John; Fuller, Patrick M.

2018-01-01

Considerable advances in our understanding of the mechanisms and functions of rapid-eye-movement (REM) sleep have occurred over the past decade. Much of this progress can be attributed to the development of new neuroscience tools that have enabled high-precision interrogation of brain circuitry linked with REM sleep control, in turn revealing how REM sleep mechanisms themselves impact processes such as sensorimotor function. This review is intended to update the general scientific community about the recent mechanistic, functional and conceptual developments in our current understanding of REM sleep biology and pathobiology. Specifically, this review outlines the historical origins of the discovery of REM sleep, the diversity of REM sleep expression across and within species, the potential functions of REM sleep (e.g., memory consolidation), the neural circuits that control REM sleep, and how dysfunction of REM sleep mechanisms underlie debilitating sleep disorders such as REM sleep behaviour disorder and narcolepsy. PMID:26766231

In a randomized case-control trial with 10-years olds suffering from attention deficit/hyperactivity disorder (ADHD) sleep and psychological functioning improved during a 12-week sleep-training program.

Science.gov (United States)

Keshavarzi, Zahra; Bajoghli, Hafez; Mohamadi, Mohammad Reza; Salmanian, Maryam; Kirov, Roumen; Gerber, Markus; Holsboer-Trachsler, Edith; Brand, Serge

2014-12-01

We tested the hypothesis that sleep training would improve emotional, social and behavioural functioning in children with attention-deficit/hyperactivity disorder (ADHD) compared to children with ADHD without such intervention and to healthy controls. Forty children with ADHD were randomly assigned to intervention and control conditions. Parents of 20 children with ADHD were instructed and thoroughly supervised in improving their children's sleep schedules and sleep behaviour. Parents of the other 20 children with ADHD and parents of 20 healthy children received general information about sleep hygiene. At baseline and 12 weeks later, parents and children completed questionnaires related to children's sleep and psychological functioning. Relative to the control groups, children in the intervention group improved sleep quantitatively and qualitatively (F values intervention group children reported improvements in mood, emotions, and relationships (F values ADHD in regulating and supervising children's sleep schedules leads to positive changes in the emotions, behaviour and social lives of these children.

ENN-ICS - quality assurance and online evaluation of a multilingual learning management system for sleep medicine

Directory of Open Access Journals (Sweden)

Knobl, Brigitte

2006-11-01

Full Text Available With the development and implementation of a multilingual interactive communication system the e-health project ENN-ICS, funded by the European Union, aims at the improvement of health care in Europe. The field of application is sleep physiology and sleep medicine. ENN-ICS Centre offers direct access to medical information for multiple users, i.e. health authorities, health care professionals, patients and citizen. Using XML technologies the new web based network integrates advanced e-learning and e-publishing methods for the training of healthcare professionals. Editorial and distributive processes are supported by customized central editorial, content management and learning management systems (CMS, LMS. ENN-ICS e-health services are evaluated by selected user groups in North, Middle and Southern Europe using reliable and scientifically accepted validation instruments. The compliance with essential quality requirements and criteria is tested and verified by using adapted online questionnaires based on the DISCERN questionnaire for evaluating patient information, on the HON principles for evaluating health-related websites and on the GMDS catalogue of quality criteria for electronic publications in medicine. The system architecture and its exemplary applications can be used as a model for future e-health services dealing with neurological and other medical topics.

Family medicine residents' practice intentions: Theory of planned behaviour evaluation.

Science.gov (United States)

Grierson, Lawrence E M; Fowler, Nancy; Kwan, Matthew Y W

2015-11-01

To assess residents' practice intentions since the introduction of the College of Family Physicians of Canada's Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. A survey based on Ajzen's theory of planned behaviour was administered on 2 occasions. McMaster University in Hamilton, Ont. Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. The survey was modeled so as to measure the respondents' intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents' intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University.

Melanopsin Regulates Both Sleep-Promoting and Arousal-Promoting Responses to Light.

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Violetta Pilorz

2016-06-01

Full Text Available Light plays a critical role in the regulation of numerous aspects of physiology and behaviour, including the entrainment of circadian rhythms and the regulation of sleep. These responses involve melanopsin (OPN4-expressing photosensitive retinal ganglion cells (pRGCs in addition to rods and cones. Nocturnal light exposure in rodents has been shown to result in rapid sleep induction, in which melanopsin plays a key role. However, studies have also shown that light exposure can result in elevated corticosterone, a response that is not compatible with sleep. To investigate these contradictory findings and to dissect the relative contribution of pRGCs and rods/cones, we assessed the effects of light of different wavelengths on behaviourally defined sleep. Here, we show that blue light (470 nm causes behavioural arousal, elevating corticosterone and delaying sleep onset. By contrast, green light (530 nm produces rapid sleep induction. Compared to wildtype mice, these responses are altered in melanopsin-deficient mice (Opn4-/-, resulting in enhanced sleep in response to blue light but delayed sleep induction in response to green or white light. We go on to show that blue light evokes higher Fos induction in the SCN compared to the sleep-promoting ventrolateral preoptic area (VLPO, whereas green light produced greater responses in the VLPO. Collectively, our data demonstrates that nocturnal light exposure can have either an arousal- or sleep-promoting effect, and that these responses are melanopsin-mediated via different neural pathways with different spectral sensitivities. These findings raise important questions relating to how artificial light may alter behaviour in both the work and domestic setting.

Sleep regulation and insomnia

NARCIS (Netherlands)

van Someren, E.J.W.; Cluydts, R.; Pfaff, D.W.

2013-01-01

For years, the subject of sleep failed to generate much interest from either the field of medicine or that of psychology - a curious fact, as a 60-year-old has spent some 20 years out of those 60 sleeping. In fact, up until the age of approximately three years, a child spends more time asleep than

Drivers' perceived legitimacy of enforcement practices for sleep-related crashes: What are the associated factors?

Science.gov (United States)

Watling, Christopher N

2018-02-01

The purpose of traffic law enforcement is to deter risky driving behaviours. The aim of this study was to examine the individual factors of demographic, personality constructs, and attitudes for their association with perceived legitimacy of traffic law enforcement of sleep-related crashes. In total, 293 drivers completed a survey that assessed perceived legitimacy of enforcement and attitudes towards sleepy driving, as well as individual factors of demographic, personality and risk taking factors. The results demonstrate that younger drivers, drivers with higher levels of extraversion, and those with tolerant attitudes towards sleepy driving were less likely to agree that it is legitimate to charge someone if they crash due to sleepiness. The attitudes towards sleepy driving variable had the largest association with perceived legitimacy. Thus, the factors associated with perceived legitimacy of traffic law enforcement of sleep-related crashes are multifaceted. Overall, the findings have relevance with attitudinal and behaviour change programs, particularly with younger drivers. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Sleep Disorders and Their Management in Children With Ehlers-Danlos Syndrome Referred to Sleep Clinics.

Science.gov (United States)

Domany, Keren Armoni; Hantragool, Sumalee; Smith, David F; Xu, Yuanfang; Hossain, Monir; Simakajornboon, Narong

2018-04-15

The nature of sleep disorders in children with Ehlers-Danlos syndrome (EDS) is unknown. We aimed to describe the type, the management, and the short-term outcome of sleep disorders in children with EDS referred to sleep clinics. This is a retrospective review of medical records and polysomnography tests of children with EDS younger than 18 years who were referred to the sleep clinic. Demographic information and medical history were collected, and polysomnography tests were reviewed. Questionnaires completed during previous clinic visits, including the Pediatrics Sleep Questionnaire (PSQ), Epworth Sleepiness Scale (ESS), and Pediatric Quality of Life Inventory (PedsQL), were also evaluated. Sixty-five patients with EDS-hypermobility type were included. The mean age was 13.15 ± 3.9 years. There were 68% of patients who were female, and 91% of patients were Caucasian. The mean follow-up period was 1.14 ± 1.55 years. Common sleep diagnoses included insomnia (n = 14, 22%), obstructive sleep apnea (OSA) (n = 17, 26%), periodic limb movement disorder (PLMD) (n = 11, 17%), and hypersomnia (n = 10, 15%). In addition, 65% required pharmacologic treatment and 29% were referred to behavioral sleep medicine. For OSA, two patients required continuous positive airway pressure. A significant improvement was observed in the PSQ, ESS, and PedsQL scores during follow-up visits after treatment (n = 34; P = .0004, 0.03, and 0.01, respectively). There is a high prevalence of sleep disorders, including OSA, insomnia, PLMD, and hypersomnia in children with EDS referred to sleep clinics. Specific management can improve quality of life and questionnaire scores of this patient population. Our study emphasizes the importance of screening for sleep disorders in children with EDS. © 2018 American Academy of Sleep Medicine.

Circadian rhythm and sleep influences on digestive physiology and disorders

OpenAIRE

Vaughn, Bradley; Rotolo,Sean; Roth,Heidi

2014-01-01

Bradley V Vaughn, Sean Rotolo, Heidi L Roth Division of Sleep Medicine, Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, USA Abstract: Circadian rhythms and sleep influence a variety of physiological functions, including the digestive system. The digestive system also has intrinsic rhythms that interact dynamically with circadian rhythms. New advances in understanding the interaction of these rhythms and sleep provide the prospect of evaluating their...

Traditional medicine for the rich and knowledgeable: challenging assumptions about treatment-seeking behaviour in rural and peri-urban Nepal

Science.gov (United States)

Thorsen, Rikke Stamp; Pouliot, Mariève

2016-01-01

Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household survey data collected from 571 households in three rural and peri-urban sites in Nepal in 2012. Questions encompassed household socioeconomic characteristics, illness characteristics, and treatment-seeking behaviour. Treatment choice was investigated through bivariate analyses. Results show that traditional medicine, and especially self-treatment with medicinal plants, prevail as treatment options in both rural and peri-urban populations. Contrarily to what is commonly assumed, high income is an important determinant of use of traditional medicine. Likewise, knowledge of medicinal plants, age, education, gender and illness chronicity were also significant determinants. The importance of self-treatment with medicinal plants should inform the development of health policy tailored to people’s treatment-seeking behaviour. PMID:26130610

Effect of a medicinal plant (Passiflora incarnata L) on sleep.

Science.gov (United States)

Guerrero, Fructuoso Ayala; Medina, Graciela Mexicano

2017-01-01

Extracts of the plant Passiflora incarnata L. (Passifloraceae) were administered intraperitoneally in order to test its effects on sleep. Experiments were carried out on chronically implanted male adult wistar rats to obtain cerebral (EEG), ocular (EOG) and muscular (EMG) activities throughout their states of vigilance. Polygraphic recordings were taken during 9 continuous hours before and after the extract administration (500 mg/kg). Passiflora incarnata induced a significant increment in the total sleep time ( p sleep (SWS). Concomitantly, a significant decrement in wakefulness (W) was observed ( p sleep showed a decreasing tendency, since both its frequency and mean duration were reduced. The extracts obtained from Passiflora incarnata can be considered as appropriated sleep inducers.

Rapid eye movement sleep behavior disorder--diagnostik, årsager og behandling

DEFF Research Database (Denmark)

Zoetmulder, Marielle; Jennum, Poul Jørgen

2009-01-01

Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterized by loss of REM sleep and related electromyographic atonia with marked muscular activity and dream enactment behaviour. RBD is seen in 0.5% of the population. It occurs in an idiopathic form and secondarily to medical...

Pinellia ternata (Thunb.) Makino Preparation promotes sleep by increasing REM sleep.

Science.gov (United States)

Lin, Sisi; Nie, Bo; Yao, Guihong; Yang, Hui; Ye, Ren; Yuan, Zhengzhong

2018-05-15

Pinellia ternata (Thunb.) Makino Preparation (PTP) is widely used to treat insomnia in traditional Chinese medicine; however, its specific role is not clear. In this study, PTP was prepared at three concentrations. For locomotor activity tests, mice were treated with PTP and evaluated for 14 days. For polygraph recordings, mice were treated for 14 days and recorded after treatment. The main chemical constituents in PTP were identified by Ultra performance liquid chromatography/quadrupole time spectrometry (UPLC/Q-TOF-MS). The results showed that 0.9 g/mL PTP significantly reduced locomotor activity. The effect was related to the time of treatment. PTP reduced wakefulness and increased sleep in mice. Furthermore, PTP promoted sleep by increasing the number of REM sleep episodes with a duration of 64-128s and increasing the number of transitions from NREM sleep to REM sleep and from REM sleep to wakefulness. A total of 17 compounds were identified.

CHILD SLEEP ONTOGENY AND APPLICATION OF THE STANDARDIZED QUESTIONNAIRE FOR THE EVALUATION OF CHILD BEHAVIOUR DURING SLEEP

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I. A. Kelmanson

2017-01-01

Full Text Available The questions of the ontogeny of a child’s sleep, starting with the stage of fetation, are considered. Data on the formation of certain fetal conditions that are analogues of fast and slow sleep in the postnatal period are given. The most important neurobiological preconditions for the formation of the child’s behavioral states are discussed, beginning with the neonatal period and until adolescence. Information on the specifics of the formation of periods of sleep and waking in infants, born in the outcome of premature birth, is presented. Changes in the bioelectrical activity of the brain in various states of the child at different stages of ontogeny are considered. The rationale for the risk of forming certain variants of sleep disorders in children of different age groups is given. The Russian-language version of the standardized questionnaire Child’s Sleep Habits Questionnaire (CSHQ, designed to detect sleep disorders in preschool and school-age children on the basis of parents’ questionnaires, is developed. 

Sleep patterns of Japanese preschool children and their parents: implications for co-sleeping.

Science.gov (United States)

Iwata, Sachiko; Iwata, Osuke; Matsuishi, Toyojiro

2013-06-01

The aim of this study was to investigate the direct relationship of sleep schedule and sleep quality variables between healthy preschool children and their parents, focusing on the influence of the difference in bedtime between each other. Forty-seven Japanese 5-year-old children and their primary parent were studied. The parents completed questionnaires including the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. The children wore an actigraph for one week. Although sleep patterns of children were generally independent of their parents, late sleep end time and bedtime of children were associated with parents' late sleep end time on weekends. For 87% of children and parents who shared a bedroom, sleep quality was negatively affected by a shorter difference in bedtimes between child and parent, but not by co-sleeping. Sleep behaviours of parents can influence those of their children. For parents and children who share a bedroom, the timing of bedtime rather than co-sleeping may be a key factor in modulating sleep patterns. Trying to get children asleep and subsequently falling asleep at a similar time may disturb parents' sleep quality, which may subsequently affect that of their children. ©2013 Foundation Acta Paediatrica. Published by Blackwell Publishing Ltd.

Sleep facilitates long-term face adaptation.

Science.gov (United States)

Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

2013-10-22

Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as 'storage'. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation--which are usually not considered to play a relevant role in mnemonic processes--with learning and memory, and at the same time reveal a new function of sleep in cognition.

Rapid eye movement sleep behavior disorder--diagnostik, årsager og behandling

DEFF Research Database (Denmark)

Zoetmulder, Marielle; Jennum, Poul Jørgen

2009-01-01

Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterized by loss of REM sleep and related electromyographic atonia with marked muscular activity and dream enactment behaviour. RBD is seen in 0.5% of the population. It occurs in an idiopathic form and secondarily to medical and neu...

Putting Children’s Sleep Problems to Bed: Using Behavior Change Theory to Increase the Success of Children’s Sleep Education Programs and Contribute to Healthy Development

Directory of Open Access Journals (Sweden)

Sarah Blunden

2016-07-01

Full Text Available Sleep is critical for the healthy development of children, yet most children simply don’t get enough. Whilst school based sleep education programs have been developed for parents and their children, they have had mixed success. We consider how existing school-based sleep education programs can be improved by applying a broader model to behaviour change theory. We find that the mixed success of school-based sleep education programs may be due to a plausible but misleading assumption that simply increasing information about the importance of sleep and the risks of insufficient and/or inefficient sleep, will necessarily result in improved sleep behaviours. We identify the potential benefits of using a more inclusive behavior change theory in the development of sleep education programs with a particular need for theories that incorporate the multiple biological, environmental and social impacts on children’s sleep. Bronfenbrenner’s Bioecological model is presented to illustrate how one such inclusive behavior change theory could significantly improve the success of sleep education programs and ultimately support the healthy development of children.

Psychometric properties of the Adolescent Sleep Hygiene Scale.

Science.gov (United States)

Storfer-Isser, Amy; Lebourgeois, Monique K; Harsh, John; Tompsett, Carolyn J; Redline, Susan

2013-12-01

This study evaluated the psychometric properties of the Adolescent Sleep Hygiene Scale (ASHS), a self-report measure assessing sleep practices theoretically important for optimal sleep. Data were collected on a community sample of 514 adolescents (16-19; 17.7 ± 0.4 years; 50% female) participating in the late adolescent examination of a longitudinal study on sleep and health. Sleep hygiene and daytime sleepiness were obtained from adolescent reports, behavior from caretaker reports, and sleep-wake estimation on weekdays from wrist actigraphy. Confirmatory factor analysis indicated the empirical and conceptually based factor structure were similar for six of the eight proposed sleep hygiene domains. Internal consistency of the revised scale (ASHSr) was α = 0.84; subscale alphas were: physiological: α = 0.60; behavioural arousal: α = 0.62; cognitive/emotional: α = 0.81; sleep environment: α = 0.61; sleep stability: α = 0.68; daytime sleep: α = 0.78. Sleep hygiene scores were associated positively with sleep duration (r = 0.16) and sleep efficiency (r = 0.12) and negatively with daytime sleepiness (r = -0.26). Results of extreme-groups analyses comparing ASHSr scores in the lowest and highest quintile provided further evidence for concurrent validity. Correlations between sleep hygiene scores and caretaker reports of school competence, internalizing and externalizing behaviours provided support for convergent validity. These findings indicate that the ASHSr has satisfactory psychometric properties for a research instrument and is a useful research tool for assessing sleep hygiene in adolescents. © 2013 European Sleep Research Society.

Towards the development of day one competences in veterinary behaviour medicine: survey of veterinary professionals experience in companion animal practice in Ireland.

Science.gov (United States)

Golden, Olwen; Hanlon, Alison J

2018-01-01

Veterinary behaviour medicine should be a foundation subject of the veterinary curriculum because of its wide scope of applications to veterinary practice. Private practitioners are likely to be the primary source of information on animal behaviour for most pet owners, however studies indicate that behavioural issues are not frequently discussed during companion animal consultations and many practitioners lack confidence in dealing with behavioural problems, likely due to poor coverage of this subject in veterinary education.There is a need to identify learning outcomes to support day one competences in veterinary behaviour medicine and these should be informed by practice-based evidence. This study aimed to investigate the nature and frequency of behavioural queries experienced by veterinary professionals in Ireland, the provision of behavioural services at companion animal practices, behaviour referral practices and challenges associated with providing a behaviour service. Two online surveys were developed, one for private veterinary practitioners (PVP) and one for veterinary nurses (VN). Invitations to participate were distributed using contact details from the Premises Accreditation Scheme database on the Veterinary Council of Ireland website. Thirty-eight PVPs and 69 VNs completed the survey. Results indicated that less than half of companion animal practices offer behavioural consults and under a third of practices provide training and socialization events. Over half of the practices surveyed have referred cases to a behavioural specialist.The majority of respondents encountered behavioural queries weekly. Ninety-eight percent reported receiving queries regarding dog behaviour. Toilet training and unruly behaviour were two issues encountered frequently. Behavioural issues in cats were also common. House soiling and destructive behaviour were the problems most frequently encountered by respondents.The two most commonly cited barriers to providing behavioural

Predictors of poor sleep quality among Lebanese university students: association between evening typology, lifestyle behaviors, and sleep habits

OpenAIRE

Kabrita, Colette S; Hajjar-Muça, Theresa A; Duffy, Jeanne F

2014-01-01

Colette S Kabrita,1 Theresa A Hajjar-Muça,2 Jeanne F Duffy31Department of Sciences, 2Department of Mathematics and Statistics, Faculty of Natural and Applied Sciences, Notre Dame University – Louaize, Zouk Mosbeh, Lebanon; 3Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USAAbstract: Adequate, good night sleep is fundamental to well-being and is known to be influenced by myriad biological and en...

Sleep/Wake Patterns and Parental Perceptions of Sleep in Children Born Preterm.

Science.gov (United States)

Biggs, Sarah N; Meltzer, Lisa J; Tapia, Ignacio E; Traylor, Joel; Nixon, Gillian M; Horne, Rosemary S C; Doyle, Lex W; Asztalos, Elizabeth; Mindell, Jodi A; Marcus, Carole L

2016-05-15

To compare sleep/wake patterns in children born preterm in Australia vs Canada and determine cultural differences in the relationship between parental perception of sleep and actual sleep behaviors. Australian and Canadian children born preterm were recruited from the Caffeine for Apnea of Prematurity trial (n = 188, 5-12 y) and underwent 14 days actigraphy monitoring. Parents completed the National Sleep Foundation 2004 Sleep in America questionnaire. Cross-cultural differences in sleep characteristics assessed by actigraphy and parent-reported questionnaire were examined. Correlational analyses determined the associations between parental perceptions of child sleep need and sleep behavior. Actigraphy showed preterm children obtained, on average, 8 h sleep/night, one hour less than population recommendations for their age. There was no difference in total sleep time (TST) between Australian and Canadian cohorts; however, bed and wake times were earlier in Australian children. Bedtimes and TST varied by 60 minutes from night to night in both cohorts. Parent-reported child TST on the National Sleep Foundation questionnaire was 90 minutes longer than recorded by actigraphy. Both bedtime and TST on weekdays and weekends were related to parental perception of child sleep need in the Australian cohort. Only TST on weekdays was related to parental perception of child sleep need in the Canadian cohort. This study suggests that short sleep duration and irregular sleep schedules are common in children born preterm. Cultural differences in the association between parental perception of child sleep need and actual sleep behaviors provide important targets for future sleep health education. © 2016 American Academy of Sleep Medicine.

Association between sleep duration and overweight: the importance of parenting.

NARCIS (Netherlands)

de Jong, E.; Stocks, T.; Visscher, T.L.S.; Hira Sing, R.A.; Seidell, J.C.; Renders, C.M.

2012-01-01

Objective:Sleep duration has been related to overweight in children, but determinants of sleep duration are unclear. The aims were to investigate the association between sleep duration and childhood overweight adjusted for family characteristics and unhealthy behaviours, to explore determinants of

Parental professional help-seeking for infant sleep.

Science.gov (United States)

Hsu, Pei-Wen; Wu, Wei-Wen; Tung, Yi-Ching; Thomas, Karen A; Tsai, Shao-Yu

2017-12-01

To explore the perceptions and experiences of parental professional help-seeking for infant sleep and sleep-related concerns. Infant sleep is a frequent concern for parents. However, very little is known about the reasons parents seek, do not seek or delay seeking professional attention about their concerns related to infant sleep. A qualitative study design was used. Twenty audio-taped interviews with parents of healthy 12-month-old infants were conducted at a university-affiliated hospital or parents' homes depending on where parents felt more comfortable discussing their personal views and medical help-seeking experiences. Thematic content analysis was performed to determine specific patterns and similarities within and between interview data. Three main themes developed from the interviews were as follows: (i) uncertainty about infant sleep; (ii) I can handle infant sleep; and (iii) I am not satisfied with the professional services provided for infant sleep. Overall, parents knew little about or misunderstood infant sleep behaviours. Lack of proper information and knowledge about infant sleep influenced parents' motivation for professional help-seeking and help-receiving. Parents who have consulted a healthcare professional but received unsatisfactory responses, such as an ambivalent attitude or insufficient assessment, reported being less motivated or unwilling to seek medical help again. Our study demonstrates the complexity of parental professional help-seeking and receiving for infant sleep. Findings suggest that parents perceive a wide range of barriers that influence the likelihood that they will seek professional advice for infant sleep. Reducing knowledge barriers and providing adequate attention at all well-infant visits would facilitate parental use of healthcare services to manage problematic infant sleep behaviours. © 2017 John Wiley & Sons Ltd.

Changes in the association between health complaint frequency and medicine use among adolescents in Scotland between 1998 and 2010

DEFF Research Database (Denmark)

Levin, Kate Ann; Whitehead, Ross; Andersen, Anette

2015-01-01

and understand the mechanisms behind these changes METHODS: Data from the 1998, 2006 and 2010 Scotland Health Behaviour in School-aged Children Survey were modelled using multilevel logistic regression, modelling medicine use for: headache, stomachache, sleeping difficulties and nervousness, as well...... as a combined medicine use measure. Models adjusted for year and frequency of health complaints to measure trends in medicine use, and an interaction term to measure the relationship between medicine use and health complaint frequency. RESULTS: Medicine use reduced between 1998 and 2010. Hownever having...... the majority of the reduction was observed between 1998 and 2006 for all five outcomes. Adjustment for health complaint frequency only explained some of this reduction. When an interaction term was added between year and health complaint frequency this was significant for boys' medicine use, suggesting...

Migrant differences in adolescents’ medicine use for common health problems

DEFF Research Database (Denmark)

Cantarero Arevalo, Lourdes; Andersen, Anette; Holstein, Bjørn Evald

2014-01-01

the odds to 1.93 (1.32-2.81) for descendants and to 1.30 (0.81-2.07) for immigrants. When simultaneously controlling for the clustering effect of school, feeling safe at school and specific symptoms, the risk of using medicine for stomach-ache was still higher for descendant boys 1.90 (1...... differences in adolescents’ medicine use for common health problems, and if feeling safe at school, as a non-exposure to discrimination, explained these differences. Methods: Data derived from the 2006 Danish contribution to the World Health Organization collaborative study Health Behaviour in School......-aged Children (HBSC). Medicine use for headache, stomach-ache, difficulties getting to sleep and nervousness and feeling safe at school were self-reported. The population included boys and girls from ages 11 to 15 who were enrolled in the cross-sectional study. Included were 8480 ethnic Danes, 508 descendants...

Effect of a medicinal plant (Passiflora incarnata L on sleep

Directory of Open Access Journals (Sweden)

Fructuoso Ayala Guerrero

Full Text Available INTRODUCTION: Extracts of the plant Passiflora incarnata L. (Passifloraceae were administered intraperitoneally in order to test its effects on sleep. METHOD: Experiments were carried out on chronically implanted male adult wistar rats to obtain cerebral (EEG, ocular (EOG and muscular (EMG activities throughout their states of vigilance. Polygraphic recordings were taken during 9 continuous hours before and after the extract administration (500 mg/kg. RESULTS: Passiflora incarnata induced a significant increment in the total sleep time (p<0.05. This increment was due to an increase in the time spent by animals in slow wave sleep (SWS. Concomitantly, a significant decrement in wakefulness (W was observed (p<0.05. In contrast, time spent in rapid eye movement (REM sleep showed a decreasing tendency, since both its frequency and mean duration were reduced. CONCLUSIONS: The extracts obtained from Passiflora incarnata can be considered as appropriated sleep inducers.

Problem behaviours and parenting in preschool children with cystic fibrosis.

Science.gov (United States)

Ward, C; Massie, J; Glazner, J; Sheehan, J; Canterford, L; Armstrong, D; Jaffe, A; Hiscock, H

2009-05-01

Problems with sleep, eating and adherence to therapy may adversely affect health outcomes in children with cystic fibrosis (CF). Data on the prevalence of such problems, associated parenting styles and caregiver mental health are limited. To determine: (a) the prevalence of sleep, mealtime, therapy adherence and externalising and internalising behavioural problems in preschool children with CF; (b) the prevalence of caregiver mental health problems and poor sleep quality; and (c) associations between child behavioural problems and parenting styles. This was a cross sectional survey of caregivers of children aged 6 months to 5 years attending CF outpatient clinics at Royal Children's Hospital (Melbourne), Monash Medical Centre (Melbourne) and Sydney Children's Hospital. Main outcome measures were child externalising and internalising behaviours, sleep, eating and adherence with therapy; the predictor was parenting styles (harsh, inconsistent, overprotective). 117 of 139 families participated. Problems were common with child sleep (small 31.6%; moderate/large problem: 21.9%), eating (32.4%) and adherence with physiotherapy (50.4%). Compared to normative data, sleep and mealtime problems were more prevalent. Caregivers reported high rates of symptoms indicating depression (33.3%), anxiety (16.4%) and stress (34.2%). Harsh parenting was associated with internalising behaviours (adjusted OR 3.9, 95% CI 1.16 to 13.17, p = 0.03). Problems with sleeping, eating and physiotherapy adherence were common in preschool children with CF. Caregivers reported high rates of symptoms indicative of mental health problems. Harsh parenting was associated with internalising problems. An intervention targeting child problem behaviours and parental mental health would be appropriate for CF families.

New technology to assess sleep apnea: wearables, smartphones, and accessories

Science.gov (United States)

Penzel, Thomas; Schöbel, Christoph; Fietze, Ingo

2018-01-01

Sleep medicine has been an expanding discipline during the last few decades. The prevalence of sleep disorders is increasing, and sleep centers are expanding in hospitals and in the private care environment to meet the demands. Sleep medicine has evidence-based guidelines for the diagnosis and treatment of sleep disorders. However, the number of sleep centers and caregivers in this area is not sufficient. Many new methods for recording sleep and diagnosing sleep disorders have been developed. Many sleep disorders are chronic conditions and require continuous treatment and monitoring of therapy success. Cost-efficient technologies for the initial diagnosis and for follow-up monitoring of treatment are important. It is precisely here that telemedicine technologies can meet the demands of diagnosis and therapy follow-up studies. Wireless recording of sleep and related biosignals allows diagnostic tools and therapy follow-up to be widely and remotely available. Moreover, sleep research requires new technologies to investigate underlying mechanisms in the regulation of sleep in order to better understand the pathophysiology of sleep disorders. Home recording and non-obtrusive recording over extended periods of time with telemedicine methods support this research. Telemedicine allows recording with little subject interference under normal and experimental life conditions. PMID:29707207

Are qualitative and quantitative sleep problems associated with delinquency when controlling for psychopathic features and parental supervision?

Science.gov (United States)

Backman, Heidi; Laajasalo, Taina; Saukkonen, Suvi; Salmi, Venla; Kivivuori, Janne; Aronen, Eeva T

2015-10-01

The aim of this study was to explore the relationship between sleep, including both qualitative and quantitative aspects, and delinquent behaviour while controlling for psychopathic features of adolescents and parental supervision at bedtime. We analysed data from a nationally representative sample of 4855 Finnish adolescents (mean age 15.3 years, 51% females). Sleep problems, hours of sleep and delinquency were evaluated via self-report. Psychopathic features were measured with the Antisocial Process Screening Device - Self-Report. In negative binomial regressions, gender and sleep-related variables acted as predictors for both property and violent crime after controlling for psychopathic features and parental supervision at bedtime. The results suggest that both sleep problems (at least three times per week, at least for a year) and an insufficient amount of sleep (less than 7 h) are associated with property crime and violent behaviour, and the relationship is not explained by gender, degree of parental supervision at bedtime or co-occurring psychopathic features. These results suggest that sleep difficulties and insufficient amount of sleep are associated with delinquent behaviour in adolescents. The significance of addressing sleep-related problems, both qualitative and quantitative, among adolescents is thus highlighted. Implications for a prevention technique of delinquent behaviour are discussed. © 2015 European Sleep Research Society.

Behavioural screening of zebrafish using neuroactive traditional Chinese medicine prescriptions and biological targets

Science.gov (United States)

Wang, Ya-Nan; Hou, Yuan-Yuan; Sun, Ming-Zhu; Zhang, Chun-Yang; Bai, Gang; Zhao, Xin; Feng, Xi-Zeng

2014-06-01

The mechanism of the therapeutic action of antidepressants remains uncertain in traditional Chinese medicine (TCM). In this study, we selected 7 classical TCM prescriptions and utilised an automatic video-tracking system to monitor the rest/wake behaviour of larval zebrafish at 4 days post-fertilisation (dpf) for 48 hours. We found that the curative effects of the prescriptions were dose-dependent. K-means clustering was performed according to the shared behavioural phenotypes of the zebrafish. The results revealed that the rest/wake behavioural profiles induced by the same class of prescriptions were similar. A correlation analysis was conducted between the TCM prescriptions and the known compounds. The results showed that the TCM prescriptions correlated well with some well-known compounds. Therefore, we predicted that they may share a similar mechanism of action. This paper describes the first study to combine TCM research with zebrafish rest/wake behaviour in vivo and presents a powerful approach for the discovery of the mechanism of action of TCM prescriptions.

Sleep Disorders: Insomnia.

Science.gov (United States)

Burman, Deepa

2017-09-01

Insomnia is the most common type of sleep disorder in the family medicine population. It is defined as a persistent difficulty initiating or maintaining sleep, or a report of nonrestorative sleep, accompanied by related daytime impairment. Insomnia is a significant public health problem because of its high prevalence and management challenges. There is increasing evidence of a strong association between insomnia and various medical and psychiatric comorbidities. Diagnosis of insomnia and treatment planning rely on a thorough sleep history to address contributing and precipitating factors as well as maladaptive behaviors resulting in poor sleep. Using a sleep diary or sleep log is more accurate than patient recall to determine sleep patterns. A sleep study is not routinely indicated for evaluation of insomnia. Cognitive behavioral therapy for insomnia (CBT-I) is the mainstay of treatment and is a safe and effective approach. The key challenge of CBT-I is the lack of clinicians to implement it. The newer generation nonbenzodiazepines (eg, zolpidem, zaleplon) are used as first-line pharmacotherapy for chronic insomnia. Newer drugs active on targets other than the gamma-aminobutyric acid receptor are now available, but clear treatment guidelines are needed. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

No objectively measured sleep disturbances in children with attention-deficit/hyperactivity disorder.

Science.gov (United States)

Bergwerff, Catharina E; Luman, Marjolein; Oosterlaan, Jaap

2016-10-01

The main goal of this study was to gain more insight into sleep disturbances in children with attention-deficit/hyperactivity disorder, using objective measures of sleep quality and quantity. The evidence for sleep problems in children with attention-deficit/hyperactivity disorder thus far is inconsistent, which might be explained by confounding influences of comorbid internalizing and externalizing problems and low socio-economic status. We therefore investigated the mediating and moderating role of these factors in the association between attention-deficit/hyperactivity disorder and sleep problems. To control for the effects of stimulant medication use, all participants were tested free of medication. Sixty-three children with attention-deficit/hyperactivity disorder and 61 typically developing children, aged 6-13 years, participated. Sleep was monitored for one to three school nights using actigraphy. Parent and teacher questionnaires assessed symptoms of attention-deficit/hyperactivity disorder, internalizing behaviour, oppositional defiant disorder and conduct disorder. Results showed no differences between the attention-deficit/hyperactivity disorder and typically developing group in any sleep parameter. Within the attention-deficit/hyperactivity disorder group, severity of attention-deficit/hyperactivity disorder symptoms was not related to sleep quality or quantity. Moderation analyses in the attention-deficit/hyperactivity disorder group showed an interaction effect between attention-deficit/hyperactivity disorder symptoms and internalizing and externalizing behaviour on total sleep time, time in bed and average sleep bout duration. The results of our study suggest that having attention-deficit/hyperactivity disorder is not a risk factor for sleep problems. Internalizing and externalizing behaviour moderate the association between attention-deficit/hyperactivity disorder and sleep, indicating a complex interplay between psychiatric symptoms and sleep. �

Patients' intention to consume prescribed and non-prescribed medicines: A study based on the theory of planned behaviour in selected European countries.

Science.gov (United States)

Kamekis, A; Bertsias, A; Moschandreas, J; Petelos, E; Papadakaki, M; Tsiantou, V; Saridaki, A; Symvoulakis, E K; Souliotis, K; Papadakis, N; Faresjö, T; Faresjö, A; Martinez, L; Agius, D; Uncu, Y; Sengezer, T; Samoutis, G; Vlcek, J; Abasaeed, A; Merkouris, B; Lionis, C

2018-02-01

Polypharmacy has a significant impact on patients' health with overall expenditure on over-the-counter (OTC) medicines representing a substantial burden in terms of cost of treatment. The aim of this study, which was conducted within the framework of a European Project funded by the European Union under the Seventh Framework Programme and was entitled OTC-SOCIOMED, was to report on possible determinants of patient behaviour regarding the consumption of medicines, and particularly OTCs, in the context of primary care. A multicentre, cross-sectional study was designed and implemented in well-defined primary healthcare settings in Cyprus, the Czech Republic, France, Greece, Malta and Turkey. Patients completed a questionnaire constructed on the basis of the theory of planned behaviour (TPB), which was administered via face-to-face interviews. The percentage of patients who had consumed prescribed medicines over a 6-month period was consistently high, ranging from 79% in the Czech Republic and 82% in Turkey to 97% in Malta and 100% in Cyprus. Reported non-prescribed medicine consumption ranged from 33% in Turkey to 92% in the Czech Republic and 97% in Cyprus. TPB behavioural antecedents explained 43% of the variability of patients' intention to consume medicines in Malta and 24% in Greece, but only 3% in Turkey. Subjective norm was a significant predictor of the intention to consume medicines in all three countries (Greece, Malta and Turkey), whereas attitude towards consumption was a significant predictor of the expectation to consume medicines, if needed. This study shows that parameters such as patients' beliefs and influence from family and friends could be determining factors in explaining the high rates of medicine consumption. Factors that affect patients' behavioural intention towards medicine consumption may assist in the formulation of evidence-based policy proposals and inform initiatives and interventions aimed at increasing the appropriate use of medicines

Continual Screening of Patients Using mHealth: The Rolling Score Concept Applied to Sleep Medicine.

Science.gov (United States)

Zluga, Claudio; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

2016-01-01

Continual monitoring of patients utilizing mHealth-based telemonitoring applications are more and more used for individual management of patients. A new approach in risk assessment called Rolling Score Concept uses standardized questionnaires for continual scoring of individuals' health state through electronic patient reported outcome (ePRO). Using self-rated questionnaires and adding a specific Time Schedule to each question result in a movement of the questionnaires' scores over time, the Rolling Score. A text-processing pipeline was implemented with KNIME analytics platform to extract a Score Mapping Rule Set for three standardized screening questionnaires in the field of sleep medicine. A feasibility study was performed in 10 healthy volunteers equipped with a mHealth application on a smartphone and a sleep tracker. Results show that the proposed Rolling Score Concept is feasible and deviations of scores are in a reasonable range (< 7%), sustaining the new approach. However, further studies are required for verification. In addition, parameter quantification could avoid incorrect subjective evaluation by substitution of questions with sensor data.

Increased risk of impulse control symptoms in Parkinson's disease with REM sleep behaviour disorder.

Science.gov (United States)

Fantini, M L; Macedo, L; Zibetti, M; Sarchioto, M; Vidal, T; Pereira, B; Marques, A; Debilly, B; Derost, P; Ulla, M; Vitello, N; Cicolin, A; Lopiano, L; Durif, F

2015-02-01

To assess the frequency of symptoms of impulse control disorders (ICD, namely pathological gambling, compulsive sexual behaviour, compulsive eating and compulsive shopping) and related behaviours (hobbyism, punding, walkabout and dopamine dysregulation syndrome) in patients with Parkinson's disease (PD) with and without probable rapid eye movement, sleep behaviour disorder (pRBD). Two hundred and sixteen consecutive PD patients, attending two university-based movement disorders clinics, were screened for p-RBD using the RBD Single Question and the RBD Screening Questionnaire (RBDSQ). Current ICDs and related behaviours symptoms were assessed with the Questionnaire for Impulsive-Compulsive Disorders in PD (QUIP)-short form. PD-pRBD patients (n=106/216;49%) had a longer PD duration, a higher Hoehn & Yahr score, a greater levodopa-equivalent daily dose (LEDD), but no difference in dopamine agonist use, compared to PD-without pRBD. A higher proportion of one or more current ICDs and related behaviours symptoms was reported in PD-pRBD compared to PD-without RBD (53% vs28%; p=0.0002). In a multivariate regression analysis accounting for gender, age of onset, PD duration, PD severity, depression score and total and dopaminergic agonist-LEDD, RBD was associated to a relative risk of 1.84 for any ICD or related behaviours symptoms (p=0.01), and to a risk of 2.59 for any ICD symptoms only (p=0.001). Furthermore, PD-pRBD had a more than fourfold risk for symptoms of pathological gambling (relative risk (RR): 4.87; p=0.049) compared to PD-without pRBD. The present study indicates that RBD is associated with an increased risk of developing symptoms of ICDs in PD. Identifying RBD in PD may help clinicians to choose the best therapeutic strategy. AU1023 Institutional Ethics Committee. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Automatic sleep scoring in normals and in individuals with neurodegenerative disorders according to new international sleep scoring criteria

DEFF Research Database (Denmark)

Jensen, Peter S.; Sørensen, Helge Bjarup Dissing; Jennum, P. J.

2010-01-01

Medicine (AASM). Methods: A biomedical signal processing algorithm was developed, allowing for automatic sleep depth quantification of routine polysomnographic (PSG) recordings through feature extraction, supervised probabilistic Bayesian classification, and heuristic rule-based smoothing. The performance......Introduction: Reliable polysomnographic classification is the basis for evaluation of sleep disorders in neurological diseases. Aim: To develop a fully automatic sleep scoring algorithm on the basis of a reproduction of new international sleep scoring criteria from the American Academy of Sleep....... Conclusion: The developed algorithm was capable of scoring normal sleep with an accuracy around the manual inter-scorer reliability, it failed in accurately scoring abnormal sleep as encountered for the PD/MSA patients, which is due to the abnormal micro- and macrostructure pattern in these patients....

Sleep from an Islamic perspective.

Science.gov (United States)

Bahammam, Ahmed S

2011-10-01

Sleep medicine is a relatively new scientific specialty. Sleep is an important topic in Islamic literature, and the Quran and Hadith discuss types of sleep, the importance of sleep, and good sleep practices. Islam considers sleep as one of the signs of the greatness of Allνh (God) and encourages followers to explore this important sign. The Quran describes different types of sleep, and these correspond with sleep stages identified by modern science. The Quran discusses the beneficial effects of sleep and emphasizes the importance of maintaining a pattern of light and darkness. A mid-day nap is an important practice for Muslims, and the Prophet Muhammad peace be upon him (pbuh) promoted naps as beneficial. In accordance with the practice and instructions of Muhammad (pbuh), Muslims have certain sleep habits and these sleep habits correspond to some of the sleep hygiene rules identified by modern science. Details during sleep include sleep position, like encouraging sleep on the right side and discouraging sleep in the prone position. Dream interpretation is an established science in the Islamic literature and Islamic scholars have made significant contributions to theories of dream interpretation. We suggest that sleep scientists examine religious literature in general and Islamic literature in particular, to understand the views, behaviors, and practices of ancient people about the sleep and sleep disorders. Such studies may help to answer some unresolved questions in sleep science or lead to new areas of inquiry.

Sleep from an islamic perspective

Directory of Open Access Journals (Sweden)

Ahmed S BaHammam

2011-01-01

Full Text Available Sleep medicine is a relatively new scientific specialty. Sleep is an important topic in Islamic literature, and the Quran and Hadith discuss types of sleep, the importance of sleep, and good sleep practices. Islam considers sleep as one of the signs of the greatness of Allβh (God and encourages followers to explore this important sign. The Quran describes different types of sleep, and these correspond with sleep stages identified by modern science. The Quran discusses the beneficial effects of sleep and emphasizes the importance of maintaining a pattern of light and darkness. A mid-day nap is an important practice for Muslims, and the Prophet Muhammad peace be upon him (pbuh promoted naps as beneficial. In accordance with the practice and instructions of Muhammad (pbuh, Muslims have certain sleep habits and these sleep habits correspond to some of the sleep hygiene rules identified by modern science. Details during sleep include sleep position, like encouraging sleep on the right side and discouraging sleep in the prone position. Dream interpretation is an established science in the Islamic literature and Islamic scholars have made significant contributions to theories of dream interpretation. We suggest that sleep scientists examine religious literature in general and Islamic literature in particular, to understand the views, behaviors, and practices of ancient people about the sleep and sleep disorders. Such studies may help to answer some unresolved questions in sleep science or lead to new areas of inquiry.

Habitual sleep durations and subjective sleep quality predict white matter differences in the human brain

Directory of Open Access Journals (Sweden)

Sakh Khalsa

2017-06-01

Full Text Available Self-imposed short sleep durations are increasingly commonplace in society, and have considerable health and performance implications for individuals. Reduced sleep duration over multiple nights has similar behavioural effects to those observed following acute total sleep deprivation, suggesting that lack of sleep affects brain function cumulatively. A link between habitual sleep patterns and functional connectivity has previously been observed, and the effect of sleep duration on the brain's intrinsic functional architecture may provide a link between sleep status and cognition. However, it is currently not known whether differences in habitual sleep patterns across individuals are related to changes in the brain's white matter, which underlies structural connectivity. In the present study we use diffusion–weighted imaging and a group comparison application of tract based spatial statistics (TBSS to investigate changes to fractional anisotropy (FA and mean diffusivity (MD in relation to sleep duration and quality, hypothesising that white matter metrics would be positively associated with sleep duration and quality. Diffusion weighted imaging data was acquired from a final cohort of 33 (23–29 years, 10 female, mean 25.4 years participants. Sleep patterns were assessed for a 14 day period using wrist actigraphs and sleep diaries, and subjective sleep quality with the Pittsburgh Sleep Quality Index (PSQI. Median splits based on total sleep time and PSQI were used to create groups of shorter/longer and poorer/better sleepers, whose imaging data was compared using TBSS followed by post-hoc correlation analysis in regions identified as significantly different between the groups. There were significant positive correlations between sleep duration and FA in the left orbito-frontal region and the right superior corona radiata, and significant negative correlations between sleep duration and MD in right orbito-frontal white matter and the right

Automatic Sleep Scoring in Normals and in Individuals with Neurodegenerative Disorders According to New International Sleep Scoring Criteria

DEFF Research Database (Denmark)

Jensen, Peter S.; Sørensen, Helge Bjarup Dissing; Leonthin, Helle

2010-01-01

The aim of this study was to develop a fully automatic sleep scoring algorithm on the basis of a reproduction of new international sleep scoring criteria from the American Academy of Sleep Medicine. A biomedical signal processing algorithm was developed, allowing for automatic sleep depth....... Based on an observed reliability of the manual scorer of 92.5% (Cohen's Kappa: 0.87) in the normal group and 85.3% (Cohen's Kappa: 0.73) in the abnormal group, this study concluded that although the developed algorithm was capable of scoring normal sleep with an accuracy around the manual interscorer...... reliability, it failed in accurately scoring abnormal sleep as encountered for the Parkinson disease/multiple system atrophy patients....

Automatic sleep scoring in normals and in individuals with neurodegenerative disorders according to new international sleep scoring criteria

DEFF Research Database (Denmark)

Jensen, Peter S; Sorensen, Helge B D; Jennum, Poul

2010-01-01

The aim of this study was to develop a fully automatic sleep scoring algorithm on the basis of a reproduction of new international sleep scoring criteria from the American Academy of Sleep Medicine. A biomedical signal processing algorithm was developed, allowing for automatic sleep depth....... Based on an observed reliability of the manual scorer of 92.5% (Cohen's Kappa: 0.87) in the normal group and 85.3% (Cohen's Kappa: 0.73) in the abnormal group, this study concluded that although the developed algorithm was capable of scoring normal sleep with an accuracy around the manual interscorer...... reliability, it failed in accurately scoring abnormal sleep as encountered for the Parkinson disease/multiple system atrophy patients....

A systematic review of school-based eHealth interventions targeting alcohol use, smoking, physical inactivity, diet, sedentary behaviour and sleep among adolescents: a review protocol.

Science.gov (United States)

Champion, Katrina E; Newton, Nicola C; Spring, Bonnie; Wafford, Q Eileen; Parmenter, Belinda J; Teesson, Maree

2017-12-06

Six key behavioural risk factors (risky alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and unhealthy sleep patterns) have been identified as strong determinants of chronic disease, such as cardiovascular disease, diabetes and cancers. School-based interventions targeting these multiple health risk behaviours among adolescents have the potential to halt the trajectory towards later disease, whilst online and mobile technology interventions offer advantages in terms of student engagement, reach and scalability. Despite this, the efficacy of eHealth school-based interventions targeting these six health risk behaviours among adolescents has not been evaluated. The proposed systematic review aims to address this by determining the nature and efficacy of existing eHealth school-based interventions targeting multiple health risk behaviours among adolescents. A systematic search of the MEDLINE, Embase, PsycINFO and Cochrane Library databases will be conducted to identify eligible published papers. Eligible studies will be randomised controlled trials, including cluster randomised controlled trials, of interventions targeting two or more of the following lifestyle risk behaviours: alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and sleep. Eligible studies will be those evaluating interventions delivered in a secondary school setting among participants 11-18 years of age, via an eHealth platform (Internet, computers of mobile technology). Two reviewers will independently screen studies for eligibility, extract data and assess the risk of bias. Study outcomes will be summarised in a narrative synthesis, and meta-analyses will be conducted where it is appropriate to combine studies. It is anticipated that the results from this review will serve to inform the development of future eHealth multiple health behaviour interventions for adolescents by identifying common characteristics of effective programs and highlighting

Sleep in amphibians and reptiles: a review and a preliminary analysis of evolutionary patterns.

Science.gov (United States)

Libourel, Paul-Antoine; Herrel, Anthony

2016-08-01

Despite the ubiquitous nature of sleep, its functions remain a mystery. In an attempt to address this, many researchers have studied behavioural and electrophysiological phenomena associated with sleep in a diversity of animals. The great majority of vertebrates and invertebrates display a phase of immobility that could be considered as a sort of sleep. Terrestrial mammals and birds, both homeotherms, show two sleep states with distinct behavioural and electrophysiological features. However, whether these features have evolved independently in each clade or were inherited from a common ancestor remains unknown. Unfortunately, amphibians and reptiles, key taxa in understanding the evolution of sleep given their position at the base of the tetrapod and amniote tree, respectively, remain poorly studied in the context of sleep. This review presents an overview of what is known about sleep in amphibians and reptiles and uses the existing data to provide a preliminary analysis of the evolution of behavioural and electrophysiological features of sleep in amphibians and reptiles. We also discuss the problems associated with analysing existing data, as well as the difficulty in inferring homologies of sleep stages based on limited data in the context of an essentially mammalian-centric definition of sleep. Finally, we highlight the importance of developing comparative approaches to sleep research that may benefit from the great diversity of species with different ecologies and morphologies in order to understand the evolution and functions of sleep. © 2015 Cambridge Philosophical Society.

Medieval Islamic scholarship and writings on sleep and dreams.

Science.gov (United States)

BaHammam, Ahmed S; Almeneessier, Aljohara S; Pandi-Perumal, Seithikurippu R

2018-01-01

Islamic civilization between the 7 th and the 15 th centuries made great contributions to the development of science and medicine, and discoveries made during this time formed the basis for the emergence of the European Renaissance. Muslims view sleep as one of the great signs of Allāh , and a number of Muslim scholars studied and wrote on sleep and dreams. However, Muslim scholars' contributions to this topic have not been adequately represented in modern scholarship. Islamic scholars did far more than simply act as the preservers of the antiquity and Greek knowledge, but rather laid significant foundation, translation, interpretation, and transference of knowledge and experience, and have contributed original works in many fields of science and medicine including sleep. This brief article introduces some of the writings by Muslim scholars and philosophers about the importance of sleep, some sleep disorders, and dreams.

Medieval Islamic scholarship and writings on sleep and dreams

Directory of Open Access Journals (Sweden)

Ahmed S BaHammam

2018-01-01

Full Text Available Islamic civilization between the 7th and the 15th centuries made great contributions to the development of science and medicine, and discoveries made during this time formed the basis for the emergence of the European Renaissance. Muslims view sleep as one of the great signs of Allāh, and a number of Muslim scholars studied and wrote on sleep and dreams. However, Muslim scholars' contributions to this topic have not been adequately represented in modern scholarship. Islamic scholars did far more than simply act as the preservers of the antiquity and Greek knowledge, but rather laid significant foundation, translation, interpretation, and transference of knowledge and experience, and have contributed original works in many fields of science and medicine including sleep. This brief article introduces some of the writings by Muslim scholars and philosophers about the importance of sleep, some sleep disorders, and dreams.

Sleep problems and obstructive sleep apnea in children with down syndrome, an overwiew.

Science.gov (United States)

Maris, Mieke; Verhulst, Stijn; Wojciechowski, Marek; Van de Heyning, Paul; Boudewyns, An

2016-03-01

Children with Down syndrome (DS) have a high prevalence of sleep problems, including behavioural sleep disturbances and obstructive sleep apnea. Sleep problems are associated with a wide range of adverse health effects. Since children with DS are already known to have many comorbidities, they are particularly susceptible for the negative impact of sleep problems. Aim of this study is (1) to evaluate the prevalence of sleep problems in children with DS, (2) compare the prevalence of sleep problems in children with DS with a community sample of typical developing school-aged children, and (3) to correlate the existence of sleep problems in children with DS and OSA. Children enrolled at the multidisciplinary Down team of the University Hospital Antwerp and seen at the ENT department were eligible for this study. The prevalence of sleep problems was evaluated by the use of the Child Sleep Habits Questionnaire (CSHQ) and a full overnight polysomnography was performed to screen for obstructive sleep apnea. Parents of fifty-four children with DS, aged 7.5 years (5.4-11.6), completed the CSHQ and an overall prevalence of sleep problems was found in 74.1%. In 57.1% of the children OSA was diagnosed with a median obstructive apnea-hypopnea index (oAHI) 7.25/h (5.7-9.8). Overall sleep problems were not age-or gender related, however boys suffer more from daytime sleepiness. Symptoms of sleep disordered breathing correlate with parasomnias, a longer sleep duration and more daytime sleepiness. No correlation was found between sleep problems and underlying OSA. Children with Down syndrome have a significantly higher prevalence of sleep problems, compared to normal developing healthy school-aged children. We didn't find any correlation between the parental report of sleep problems and underlying OSA, or OSA severity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The effect of aromatherapy with Rosa damascena essential oil on sleep quality in children

OpenAIRE

A.S. Keyhanmehr; M. Movahhed; S. Sahranavard; L. Gachkar; M. Hamdieh; Sh. Afsharpaiman*; H. Nikfarjad

2018-01-01

Background and objectives: Sleep disorder is one of the main problems in children. Poor sleep quality can lead to adverse effects on their growth and development. Aromatherapy is a kind of method for improving sleep. In Iranian traditional medicine, inhaling Rosa damascena has been recommended for treating sleep disorder. Due to the side effects of chemical drugs and trend to alternative medicine due to less complication, the aim of this study was to investigate the effect of aromatherapy wit...

Behavioural and Cognitive-Behavioural Treatments of Parasomnias

Directory of Open Access Journals (Sweden)

Andrea Galbiati

2015-01-01

Full Text Available Parasomnias are unpleasant or undesirable behaviours or experiences that occur predominantly during or within close proximity to sleep. Pharmacological treatments of parasomnias are available, but their efficacy is established only for few disorders. Furthermore, most of these disorders tend spontaneously to remit with development. Nonpharmacological treatments therefore represent valid therapeutic choices. This paper reviews behavioural and cognitive-behavioural managements employed for parasomnias. Referring to the ICSD-3 nosology we consider, respectively, NREM parasomnias, REM parasomnias, and other parasomnias. Although the efficacy of some of these treatments is proved, in other cases their clinical evidence cannot be provided because of the small size of the samples. Due to the rarity of some parasomnias, further multicentric researches are needed in order to offer a more complete account of behavioural and cognitive-behavioural treatments efficacy.

Behavioural phenotypes of the mucopolysaccharide disorders: a systematic literature review of cognitive, motor, social, linguistic and behavioural presentation in the MPS disorders.

Science.gov (United States)

Cross, E M; Hare, D J

2013-03-01

The mucopolysaccharide disorders (MPS) are a group of recessively inherited metabolic disorders resulting in progressive physical and cognitive decline. MEDLINE, PsycINFO and Embase databases were searched, alongside manual screening, to identify relevant literature. Papers were included in the review if they were published in a peer reviewed journal and conducted empirical research into cognitive, motor, social or linguistic development or behaviour in one or more MPS disorders. Twenty-five papers were reviewed. Two papers used methodology of a sufficiently high standard to demonstrate a behavioural phenotype; both found sleep disturbance to be part of the phenotype of MPS III. Fearfulness and sleep disturbance were frequently observed in people with MPS I and II. Cognitive and motor impairment and decline, and challenging behaviour were highly prevalent in the severe form of MPS II. Cognitive decline and severe behavioural problems relating to aggression, hyperactivity, orality, unusual affect and temper tantrums were seen in MPS III. Sleep disturbance is part of the behavioural phenotype of MPS III, and challenging behaviour is highly prevalent in MPS II and MPS III, therefore the efficacy of behavioural interventions for these populations should be investigated. Further research into the behaviour and adaptive skills of children with MPS III and MPS IV is required.

Sleep in intensive care unit

DEFF Research Database (Denmark)

Boyko, Yuliya; Jennum, Poul; Nikolic, Miki

2017-01-01

PURPOSE: To determine if improving intensive care unit (ICU) environment would enhance sleep quality, assessed by polysomnography (PSG), in critically ill mechanically ventilated patients. MATERIALS AND METHODS: Randomized controlled trial, crossover design. The night intervention "quiet routine...... Medicine) sleep scoring criteria were insufficient for the assessment of polysomnograms. Modified classification for sleep scoring in critically ill patients, suggested by Watson et al. (Crit Care Med 2013;41:1958-1967), was used. RESULTS: Sound level analysis showed insignificant effect...... patients. We were not able to further reduce the already existing low noise levels in the ICU and did not find any association between the environmental intervention and the presence of normal sleep characteristics in the PSG....

Circadian rhythm and sleep influences on digestive physiology and disorders

Directory of Open Access Journals (Sweden)

Vaughn BV

2014-09-01

Full Text Available Bradley V Vaughn, Sean Rotolo, Heidi L Roth Division of Sleep Medicine, Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, USA Abstract: Circadian rhythms and sleep influence a variety of physiological functions, including the digestive system. The digestive system also has intrinsic rhythms that interact dynamically with circadian rhythms. New advances in understanding the interaction of these rhythms and sleep provide the prospect of evaluating their role in normal physiology and the link of their disruption to pathological conditions. Recent work has demonstrated that sleep and circadian factors influence appetite, nutrient absorption, and metabolism. Disruption of sleep and circadian rhythms may increase vulnerability to digestive disorders, including reflux, ulcers, inflammatory bowel issues, irritable bowel disease, and gastrointestinal cancer. As our knowledge of the link between circadian timing and gastrointestinal physiology grows, so do our opportunities to provide promising diagnostic and therapeutic approaches for gastrointestinal disorders. Keywords: digestion, digestive diseases, gastrointestinal reflux, sleep, circadian rhythm 

Clinical predictors of central sleep apnea evoked by positive airway pressure titration

OpenAIRE

Bianchi, Matt; Gannon,Karen; Lovell,Kathy; Merlino,Margaret; Mojica,James; Moro,Marilyn

2016-01-01

Marilyn Moro,1 Karen Gannon,1 Kathy Lovell,1 Margaret Merlino,1 James Mojica,2 Matt T Bianchi,1,3 1Neurology Department, 2Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA; 3Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA Purpose: Treatment-emergent central sleep apnea (TECSA), also called complex apnea, occurs in 5%–15% of sleep apnea patients during positive airway pressure (PAP) therapy, but the clinical predictors are not w...

Sleep-wake disturbances after traumatic brain injury.

Science.gov (United States)

Ouellet, Marie-Christine; Beaulieu-Bonneau, Simon; Morin, Charles M

2015-07-01

Sleep-wake disturbances are extremely common after a traumatic brain injury (TBI). The most common disturbances are insomnia (difficulties falling or staying asleep), increased sleep need, and excessive daytime sleepiness that can be due to the TBI or other sleep disorders associated with TBI, such as sleep-related breathing disorder or post-traumatic hypersomnia. Sleep-wake disturbances can have a major effect on functional outcomes and on the recovery process after TBI. These negative effects can exacerbate other common sequelae of TBI-such as fatigue, pain, cognitive impairments, and psychological disorders (eg, depression and anxiety). Sleep-wake disturbances associated with TBI warrant treatment. Although evidence specific to patients with TBI is still scarce, cognitive-behavioural therapy and medication could prove helpful to alleviate sleep-wake disturbances in patients with a TBI. Copyright © 2015 Elsevier Ltd. All rights reserved.

Role of norepinephrine in the regulation of rapid eye movement sleep

Indian Academy of Sciences (India)

Sleep and wakefulness are instinctive behaviours that are present across the animal species. Rapid eye movement (REM) sleep is a unique biological phenomenon expressed during sleep. It evolved about 300 million years ago and is noticed in the more evolved animal species. Although it has been objectively identified ...

Dream Content in Patients With Sleep Apnea: A Prospective Sleep Laboratory Study.

Science.gov (United States)

Di Pauli, Franziska; Stefani, Ambra; Holzknecht, Evi; Brandauer, Elisabeth; Mitterling, Thomas; Holzinger, Brigitte; Högl, Birgit

2018-01-15

Few studies have addressed dreaming in patients with sleep apnea. We hypothesized that respiratory events and subsequent oxygen desaturation act as an important physiological trigger and may thus influence dream content in patients with a sleep-related breathing disorder. Seventy-six patients (28 women, mean age 54 years, range 20-82) who underwent polysomnography because of suspected sleep apnea participated in this study. Dream reports and dream questionnaires were collected immediately after first morning awakening, at 5:30 AM, at the sleep laboratory. Dream content analysis with respect to possible respiratory-related content was performed. Patients were stratified into primary snoring, mild, moderate, and severe sleep apnea groups. In 63 patients sleep apnea was diagnosed (mild n = 31, 49.2%, moderate n = 13, 20.6%, severe n = 19, 30.2%), and 13 subjects in whom a sleep-related breathing disorder was not confirmed were included as a control group with primary snoring. There was no significant difference in respiratory-related dream topics between patients and controls. Also, no influence of respiratory parameters measured during polysomnography on dream content was detectable. We failed to detect a difference in dream content between patients with sleep apnea and controls. Further studies are required to determine whether these results indicate that the incorporation of respiratory events into dreams is absent in patients with sleep apnea or represents a bias due to the collection of dream content in the early morning hours. © 2018 American Academy of Sleep Medicine

Medications for Sleep Schedule Adjustments in Athletes.

Science.gov (United States)

Baird, Matthew B; Asif, Irfan M

Sleep schedule adjustments are common requirements of modern-day athletes. Many nonpharmacologic and pharmacologic strategies exist to facilitate circadian rhythm shifts to maximize alertness and performance during competition. This review summarizes the evidence for commonly used pharmacologic agents and presents recommendations for the sports medicine provider. MEDLINE searches were performed using the following keywords: sleep aids, circadian rhythm adjustment, athletes and sleep, caffeine and sports, melatonin and athletes, and sleep aids and sports. Pertinent articles were extracted and discussed. Clinical review. Level 2. There are very few available studies investigating pharmacologic sleep aids in athletes. Data from studies involving shift workers and airline personnel are more abundant and were used to formulate recommendations and conclusions. Melatonin, caffeine, and nonbenzodiazepine sleep aids have a role in facilitating sleep schedule changes in athletes and maximizing sports performance through sleep enhancement.

Growth and development of children with a special focus on sleep.

Science.gov (United States)

Danker-Hopfe, Heidi

2011-12-01

The first two decades of life are characterised complex biological processes involving growth and maturation as well as differentiation. The Central Nervous System (CNS) where among others internal and external stimuli are integrated and responses of the body are prepared starts to evolve quite early during ontogenesis. One of the complex behaviours, which are regulated by the brain, is the sleep-wake cycle. The discussion of age-related changes in sleep comprises changes at the physiological level (e.g. changes in the frequency and amplitude of EEG signal, as well as development and distribution of sleep stages), changes in the corresponding behaviour (e.g. changes in the absolute amount of sleep and its distribution in 24h perspective), and finally the subjective perception of sleep and sleep as a measure of well-being. Studies on the impact of a specific factor on sleep during childhood and adolescence have to consider chronological and biological age as well as sex as relevant biological parameters. Even when these factors are controlled for large interindividual differences persist, that is why prospective instead of cross-sectional approaches should be used whenever possible. Furthermore, it has to be distinguished between sleep assessed at the level of brain functioning (i.e. by polysomnography), which gives information on effects at the physiological level and at the level of self-assessment, which focuses on behaviour. Both, sleep at the subjective as well as at the objective level, can to a considerable degree be affected by life style factors, which hence have to be considered as potential confounders. Copyright © 2011 Elsevier Ltd. All rights reserved.

Sleep and obsessive-compulsive disorder (OCD).

Science.gov (United States)

Paterson, Jessica L; Reynolds, Amy C; Ferguson, Sally A; Dawson, Drew

2013-12-01

Obsessive-compulsive disorder (OCD) is a chronic mental illness that can have a debilitating effect on daily functioning. A body of research reveals altered sleep behaviour in OCD sufferers; however, findings are inconsistent and there is no consensus on the nature of this relationship. Understanding sleep disturbance in OCD is of critical importance given the known negative consequences of disturbed sleep for mood and emotional wellbeing. A systematic literature search was conducted of five databases for studies assessing sleep in adults diagnosed with OCD. Fourteen studies met inclusion criteria and qualitative data analysis methods were used to identify common themes. There was some evidence of reduced total sleep time and sleep efficiency in OCD patients. Many of the sleep disturbances noted were characteristic of depression. However, some OCD sufferers displayed delayed sleep onset and offset and an increased prevalence of delayed sleep phase disorder (DSPD). Severe OCD symptoms were consistently associated with greater sleep disturbance. While the sleep of OCD patients has not been a major focus to date, the existing literature suggests that addressing sleep disturbance in OCD patients may ensure a holistic approach to treatment, enhance treatment efficacy, mitigate relapse and protect against the onset of co-morbid psychiatric illnesses. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Sleep disturbance in older ICU patients

Directory of Open Access Journals (Sweden)

Sterniczuk R

2014-06-01

Full Text Available Roxanne Sterniczuk,1–3 Benjamin Rusak,1,2 Kenneth Rockwood31Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, 2Department of Psychiatry, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, NS, 3Division of Geriatric Medicine, Department of Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, NS, CanadaAbstract: Maintaining a stable and adequate sleeping pattern is associated with good health and disease prevention. As a restorative process, sleep is important for supporting immune function and aiding the body in healing and recovery. Aging is associated with characteristic changes to sleep quantity and quality, which make it more difficult to adjust sleep–wake rhythms to changing environmental conditions. Sleep disturbance and abnormal sleep–wake cycles are commonly reported in seriously ill older patients in the intensive care unit (ICU. A combination of intrinsic and extrinsic factors appears to contribute to these disruptions. Little is known regarding the effect that sleep disturbance has on health status in the oldest of old (80+, a group, who with diminishing physiological reserve and increasing prevalence of frailty, is at a greater risk of adverse health outcomes, such as cognitive decline and mortality. Here we review how sleep is altered in the ICU, with particular attention to older patients, especially those aged ≥80 years. Further work is required to understand what impact sleep disturbance has on frailty levels and poor outcomes in older critically ill patients.Keywords: intensive care unit, sleep–wake rhythm, aging, frailty

Herbal medicine use behaviour in Australian adults who experience anxiety: a descriptive study.

Science.gov (United States)

McIntyre, Erica; Saliba, Anthony J; Wiener, Karl K; Sarris, Jerome

2016-02-11

Anxiety disorders are the most prevalent mental health condition in Australia. In addition, there are many people who experience problematic anxiety symptoms who do not receive an anxiety disorder diagnosis but require treatment. As herbal medicine use is popular in Australia, and little is known about how adults experiencing anxiety are using these medicines, this study aimed to identify how Australian adults who experience anxiety are using herbal medicines. An online cross-sectional descriptive study was conducted using purposive convenience sampling to recruit Australian adults who have experienced anxiety symptoms and have used herbal medicines (N = 400). Descriptive statistics, chi-square test of contingency, analysis of variance, and simple logistic regression was used to analyse the data. Eighty two percent of participants experienced anxiety symptoms in the previous 12 months, with 47% reporting having previously been diagnosed with an anxiety disorder. In addition, 72.8% had used herbal medicines specifically for anxiety symptoms in their lifetime, while 55.3% had used prescribed pharmaceuticals, with 27.5% having used herbal medicines concurrently with prescribed pharmaceuticals. The Internet and family and friends were the most frequently used sources of information about herbal medicines. Forty eight percent of participants did not disclose their herbal medicine use to their doctor. Herbal medicines are being used by adults with anxiety and are commonly self-prescribed for anxiety symptoms. Health practitioners who are experts in herbal medicine prescribing are consulted infrequently. In addition, herbal medicine use is often not disclosed to health practitioners. These behaviours are concerning as people may not be receiving the most suitable treatments, and their use of herbal medicines may even be dangerous. It is critical we develop a better understanding of why people are using these medicines, and how we can develop improved health literacy

[Healthy sleep: evidence and guidelines for action. Official document of the Spanish Sleep Society].

Science.gov (United States)

Merino-Andreu, M; Alvarez-Ruiz de Larrinaga, A; Madrid-Perez, J A; Martinez-Martinez, M A; Puertas-Cuesta, F J; Asencio-Guerra, A J; Romero Santo-Tomas, O; Jurado-Luque, M J; Segarra-Isern, F J; Canet-Sanz, T; Gimenez-Rodriguez, P; Teran-Santos, J; Alonso-Alvarez, M L; Garcia-Borreguero Diaz-Varela, D; Barriuso-Esteban, B

2016-10-03

One of the main objectives of the Spanish Sleep Society is to promote healthy sleep in both the general population and in health professionals. This document aims to conduct a review of the current scientific literature on sleep habits that can serve as the basis on which to establish a set of general recommendations, regarding healthy sleep, for use by the general population in Spain as well as to identify the main challenges faced by research into sleep habits. The document has been developed by a multidisciplinary team made up of members of the Spanish Sleep Society who are experts in paediatric sleep medicine, clinical neurophysiology, pulmonology, neurology, chronobiology, physiology and psychology. The existing scientific literature dealing with sleep habits in the general population was reviewed, and the following aspects were addressed: the current state of sleep habits in the Spanish population; a generic review of the optimum number of hours of sleep; the impact of the environmental setting (noise, temperature, illumination, etc.), hours of sleep, diet and sport, together with several specific sections for children and teenagers, shift-workers and drivers of different vehicles. The conclusions from all the aspects addressed in this document have resulted in a set of final general recommendations that will serve as a guide for the general population and health professionals. Likewise, the principal environmental challenges and future lines of research are also discussed.

Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances. American Sleep Disorders Association.

Science.gov (United States)

1995-07-01

These clinical guidelines, which have been reviewed and approved by the Board of Directors of the American Sleep Disorders Association (ASDA), provide recommendations for the practice of sleep medicine in North American with regards to the use of oral appliances for the treatment of snoring and obstructive sleep apnea. Oral appliances have been developed for the treatment of snoring and have been applied to the treatment of obstructive sleep apnea, a syndrome associated with morbidity. Based on a review of the relevant scientific literature, the Standards of Practice Committee of the ASDA has developed guidelines describing the use of oral appliances for the treatment of snoring and obstructive sleep apnea in adults.

The Future of Sleep Technology: Report from an American Association of Sleep Technologists Summit Meeting

Science.gov (United States)

Brooks, Rita; Trimble, Melinda

2014-01-01

The American Association of Sleep Technologists (AAST) Board of Directors hosted a Sleep Technology Summit on September 21, 2013 with the goals of identifying changes in the delivery of diagnostic and treatment services to sleep disorders patients, predicting the impact on sleep technologists, identifying new roles for sleep technologists, and determining appropriate education to prepare technologists for the future. A carefully chosen panel of speakers focused on the business skills necessary to provide care cost effectively and the clinical skills that will be essential for the technologist of the future to help care for patients with sleep disorders. A group of selected leaders, educators, and industry professionals reviewed the current state of affairs and examined opportunities to sustain the profession and define the role of the sleep technologist of the future. Facilitated group discussions of these critical topics followed each session. There was a clear consensus that regulatory and economic pressures are changing the way sleep disorders patients are diagnosed and treated. Private insurers are requiring pre-authorization for laboratory sleep studies and are incentivizing home sleep testing for most patients suspected of obstructive sleep apnea. Reimbursement for home testing will be lower than for laboratory testing, and further reductions in overall reimbursement are anticipated. These factors will almost certainly reduce the need for technologists to perform laboratory diagnostic studies and pressure sleep centers to reduce payrolls. Remaining laboratory patients will have more complicated sleep disorders, have more comorbidity, and require a higher level of care than most of the patients currently tested in sleep centers. Testing these patients will require technologists with a higher level of training, experience, and sophistication. A second area of consensus was that the focus in medicine is changing from diagnosis to outcomes. New models of

Nuclear medicine in psychiatry

International Nuclear Information System (INIS)

Lass, P.; Slawek, P.

2007-01-01

In the same way that the symptoms between different diseases in psychiatry overlap, functional brain research frequently shows the same pattern of changes across diagnostic borders; on the other hand, many the other tests, e.g. psychological tests, present the same problem as mentioned above; therefore: The psychiatrist seldom applies to an NM specialist to obtain a diagnosis; instead, a nuclear medicine report will rather confirm, or less frequently exclude, the psychiatrist's diagnosis. Ideally, psychiatric patients should be rescanned after the treatment, and changes in perfusion and/or metabolism discussed between psychiatrist and NM specialist. As shown above, there are few practical applications of nuclear medicine due to low specificity and low spatial resolution, although in the aspect of functional imaging it is still superior to CT/MRI, even in their functional modalities. On the other hand, its investigational potential is still growing, as there is no imaging technique in sight which could replace metabolic and receptor studies, and also because the scope of functional imaging in psychiatric diseases is spreading from its traditional applications, like dementia or depression, towards many poorly investigated fields e.g. hypnosis, suicidal behaviour or sleep disorders. (author)

Fiber and Saturated Fat Are Associated with Sleep Arousals and Slow Wave Sleep.

Science.gov (United States)

St-Onge, Marie-Pierre; Roberts, Amy; Shechter, Ari; Choudhury, Arindam Roy

2016-01-01

Sleep restriction alters food intake, but less is known about how dietary patterns affect sleep. Current goals were to determine whether: (1) sleep is different after consumption of a controlled diet vs. an ad libitum diet, and (2) dietary intake during ad libitum feeding is related to nocturnal sleep. Twenty-six normal weight adults (30-45 y), habitually sleeping 7-9 h/night, participated in a randomized-crossover inpatient study with 2 phases of 5 nights: short (4 h in bed) or habitual (9 h in bed) sleep. Only data from the habitual sleep phase were used for the present analyses. During the first 4 days, participants consumed a controlled diet; on day 5, food intake was self-selected. Linear regression was used to determine relations between daytime food intake and nighttime sleep on day 5. Sleep duration did not differ after 3 days of controlled feeding vs. a day of ad libitum intake. However, sleep after ad libitum eating had less slow wave sleep (SWS, P = 0.0430) and longer onset latency (P = 0.0085). Greater fiber intake predicted less stage 1 (P = 0.0198) and more SWS (P = 0.0286). Percent of energy from saturated fat predicted less SWS (P = 0.0422). Higher percent of energy from sugar and other carbohydrates not considered sugar or fiber was associated with arousals (P = 0.0320 and 0.0481, respectively). Low fiber and high saturated fat and sugar intake is associated with lighter, less restorative sleep with more arousals. Diet could be useful in the management of sleep disorders but this needs to be tested. http://www.clinicaltrials.gov, #NCT00935402. © 2016 American Academy of Sleep Medicine.

Predictors of poor sleep quality among Lebanese university students: association between evening typology, lifestyle behaviors, and sleep habits

Directory of Open Access Journals (Sweden)

Kabrita CS

2014-01-01

Full Text Available Colette S Kabrita,1 Theresa A Hajjar-Muça,2 Jeanne F Duffy31Department of Sciences, 2Department of Mathematics and Statistics, Faculty of Natural and Applied Sciences, Notre Dame University – Louaize, Zouk Mosbeh, Lebanon; 3Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USAAbstract: Adequate, good night sleep is fundamental to well-being and is known to be influenced by myriad biological and environmental factors. Given the unavailability of sleep data about Lebanon, the cultural shifts and socioeconomic pressures that have affected many aspects of society, particularly for students and working adults, as well as our understanding of sleep in university students in other countries, we conducted a national study to assess sleep quality and factors contributing to sleep and general health in a culture-specific context. A self-filled questionnaire, inquiring about sociodemographics, health-risk behaviors, personal health, and evaluating sleep quality and chronotype using standard scales was completed by 540 students at private and public universities in Lebanon. Overall, they reported sleeping 7.95±1.34 hours per night, although 12.3% reported sleeping <6.5 hours and more than half scored in the poor-sleeper category on the Pittsburgh Sleep Quality Index (PSQI. Sleep timing differed markedly between weekdays and weekends, with bedtimes and wake-up times delayed by 1.51 and 2.43 hours, respectively, on weekends. While most scored in the "neither type" category on the Morningness–Eveningness Questionnaire (MEQ, 24.5% were evening types and 7.3% were morning types. MEQ score was significantly correlated with smoking behavior and daily study onset, as well as with PSQI score, with eveningness associated with greater number of cigarettes, later study times, and poor sleep. We conclude that the prevalence of poor sleep quality among Lebanese university students is associated

Smoking behaviour, knowledge and attitudes among Family Medicine physicians and nurses in Bosnia and Herzegovina

Directory of Open Access Journals (Sweden)

Broers Teresa

2004-06-01

Full Text Available Abstract Background Smoking rates among the general population in Bosnia and Herzegovina are extremely high, and national campaigns to lower smoking rates have not yet begun. As part of future activities of the Queen's University Family Medicine Development Program in the Balkans Region, technical assistance may be provided to Bosnia and Herzegovina to develop of national tobacco control strategies. This assistance may focus on training doctors and nurses on smoking cessation strategies with a view to helping their patients to stop smoking. Given this important role that health professionals have, data is needed on smoking rates as well as on smoking behaviour among doctors and nurses in Bosnia and Herzegovina. This study therefore seeks to determine the smoking rates and behaviour of family medicine physicians and nurses in Bosnia and Herzegovina and to determine how well prepared they feel with respect to counselling their patients on smoking cessation strategies. Methods The WHO Global Health Professional Survey, a self-administered questionnaire, was distributed to physicians and nurses in 19 Family Medicine Teaching Centres in Bosnia and Herzegovina in June 2002. Smoking rates and behaviour, as well as information on knowledge and attitudes regarding smoking were determined for both physicians and nurses. Results Of the 273 physicians and nurses currently working in Family Medicine Teaching Centres, 209 (77% completed the questionnaire. Approximately 45% of those surveyed currently smoke, where 51% of nurses smoked, compared to 40% of physicians. With respect to knowledge and attitudes, all respondents agreed that smoking is harmful to one's health. However, "ever" smokers, compared to "never" smokers, were less likely to agree that health professionals who smoke were less likely to advise patients to quit smoking than non-smoking health professionals. Less than half of physicians and nurses had received formal training in smoking

Smoking behaviour, knowledge and attitudes among Family Medicine physicians and nurses in Bosnia and Herzegovina.

Science.gov (United States)

Hodgetts, Geoffrey; Broers, Teresa; Godwin, Marshall

2004-06-11

Smoking rates among the general population in Bosnia and Herzegovina are extremely high, and national campaigns to lower smoking rates have not yet begun. As part of future activities of the Queen's University Family Medicine Development Program in the Balkans Region, technical assistance may be provided to Bosnia and Herzegovina to develop of national tobacco control strategies. This assistance may focus on training doctors and nurses on smoking cessation strategies with a view to helping their patients to stop smoking. Given this important role that health professionals have, data is needed on smoking rates as well as on smoking behaviour among doctors and nurses in Bosnia and Herzegovina. This study therefore seeks to determine the smoking rates and behaviour of family medicine physicians and nurses in Bosnia and Herzegovina and to determine how well prepared they feel with respect to counselling their patients on smoking cessation strategies. The WHO Global Health Professional Survey, a self-administered questionnaire, was distributed to physicians and nurses in 19 Family Medicine Teaching Centres in Bosnia and Herzegovina in June 2002. Smoking rates and behaviour, as well as information on knowledge and attitudes regarding smoking were determined for both physicians and nurses. Of the 273 physicians and nurses currently working in Family Medicine Teaching Centres, 209 (77%) completed the questionnaire. Approximately 45% of those surveyed currently smoke, where 51% of nurses smoked, compared to 40% of physicians. With respect to knowledge and attitudes, all respondents agreed that smoking is harmful to one's health. However, "ever" smokers, compared to "never" smokers, were less likely to agree that health professionals who smoke were less likely to advise patients to quit smoking than non-smoking health professionals. Less than half of physicians and nurses had received formal training in smoking cessations strategies, but about two thirds of health

Sleep patterns and predictors of disturbed sleep in a large population of college students.

Science.gov (United States)

Lund, Hannah G; Reider, Brian D; Whiting, Annie B; Prichard, J Roxanne

2010-02-01

To characterize sleep patterns and predictors of poor sleep quality in a large population of college students. This study extends the 2006 National Sleep Foundation examination of sleep in early adolescence by examining sleep in older adolescents. One thousand one hundred twenty-five students aged 17 to 24 years from an urban Midwestern university completed a cross-sectional online survey about sleep habits that included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, the Horne-Ostberg Morningness-Eveningness Scale, the Profile of Mood States, the Subjective Units of Distress Scale, and questions about academic performance, physical health, and psychoactive drug use. Students reported disturbed sleep; over 60% were categorized as poor-quality sleepers by the PSQI, bedtimes and risetimes were delayed during weekends, and students reported frequently taking prescription, over the counter, and recreational psychoactive drugs to alter sleep/wakefulness. Students classified as poor-quality sleepers reported significantly more problems with physical and psychological health than did good-quality sleepers. Students overwhelmingly stated that emotional and academic stress negatively impacted sleep. Multiple regression analyses revealed that tension and stress accounted for 24% of the variance in the PSQI score, whereas exercise, alcohol and caffeine consumption, and consistency of sleep schedule were not significant predictors of sleep quality. These results demonstrate that insufficient sleep and irregular sleep-wake patterns, which have been extensively documented in younger adolescents, are also present at alarming levels in the college student population. Given the close relationships between sleep quality and physical and mental health, intervention programs for sleep disturbance in this population should be considered. Copyright 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.

Cannabis species and cannabinoid concentration preference among sleep-disturbed medicinal cannabis users.

Science.gov (United States)

Belendiuk, Katherine A; Babson, Kimberly A; Vandrey, Ryan; Bonn-Miller, Marcel O

2015-11-01

Individuals report using cannabis for the promotion of sleep, and the effects of cannabis on sleep may vary by cannabis species. Little research has documented preferences for particular cannabis types or cannabinoid concentrations as a function of use for sleep disturbances. 163 adults purchasing medical cannabis for a physical or mental health condition at a cannabis dispensary were recruited. They provided self-report of (a) whether cannabis use was intended to help with sleep problems (e.g. insomnia, nightmares), (b) sleep quality (PSQI), (c) cannabis use (including preferred type), and (d) symptoms of DSM-5 cannabis dependence. 81 participants reported using cannabis for the management of insomnia and 14 participants reported using cannabis to reduce nightmares. Individuals using cannabis to manage nightmares preferred sativa to indica strains (Fisher's exact test (2) = 6.83, p < 0.05), and sativa users were less likely to endorse DSM-5 cannabis dependence compared with those who preferred indica strains (χ(2)(2) = 4.09, p < 0.05). Individuals with current insomnia (t(9) = 3.30, p < 0.01) and greater sleep latency (F(3,6) = 46.7, p < 0.001) were more likely to report using strains of cannabis with significantly higher concentrations of CBD. Individuals who reported at least weekly use of hypnotic medications used cannabis with lower THC concentrations compared to those who used sleep medications less frequently than weekly (t(17) = 2.40, p < 0.05). Associations between sleep characteristics and the type of cannabis used were observed in this convenience sample of individuals using cannabis for the management of sleep disturbances. Controlled prospective studies are needed to better characterize the impact that specific components of cannabis have on sleep. Copyright © 2015. Published by Elsevier Ltd.

Sleep problems and suicide associated with mood instability in the Adult Psychiatric Morbidity Survey, 2007

Science.gov (United States)

McDonald, Keltie C; Saunders, Kate EA; Geddes, John R

2018-01-01

Objective Mood instability is common in the general population. Mood instability is a precursor to mental illness and associated with a range of negative health outcomes. Sleep disturbance appears to be closely linked with mood instability. This study assesses the association between mood instability and sleep disturbance and the link with suicidal ideation and behaviour in a general population sample in England. Method The Adult Psychiatric Morbidity Survey, 2007 collected detailed information about mental health symptoms and correlates in a representative sample of adult household residents living in England (n = 7303). Mood instability was assessed using the Structured Clinical Interview for DSM-IV Axis-II. Sleep problems were defined as sleeping more than usual or less than usual during the past month. Other dependent variables included medication use and suicidal ideation and behaviour (response rate 57%). Generalized linear modelling was used to estimate the prevalence of mood instability and sleep problems. Logistic regression was used to estimate odds ratios. All estimates were weighted. Results The prevalence of mood instability was 14.7% (95% confidence interval [13.6%, 15.7%]). Sleep problems occurred in 69.8% (95% confidence interval: [66.6%, 73.1%]) of those with mood instability versus 37.6% (95% confidence interval: [36.2%, 39.1%]) of those without mood instability. The use of sedating and non-sedating medications did not influence the association. Sleep problems were significantly associated with suicidal ideation and behaviour even after adjusting for mood instability. Conclusion Sleep problems are highly prevalent in the general population, particularly among those with mood instability. Sleep problems are strongly associated with suicidal ideation and behaviour. Treatments that target risk and maintenance factors that transcend diagnostic boundaries, such as therapies that target sleep disturbance, may be particularly valuable for preventing and

Perspectives on Sleep, Sleep Problems, and Their Treatment, in People with Serious Mental Illnesses: A Systematic Review.

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Sophie Faulkner

Full Text Available Sleep problems are common in people with serious mental illness, and impact negatively on functioning and wellbeing. To understand the development of sleep problems, their maintenance, and their treatment, an in depth understanding of patient perspectives is crucial. A systematic literature review was conducted using Medline, AMED, PsychInfo, Embase and CINAHL. Qualitative and quantitative studies were included if they explored or measured patient perspectives on sleep, sleep problems or sleep treatments in people with serious mental illness. Of the 2,067 hits, only 22 met review inclusion criteria, and high quality evidence was sparse. The limited findings suggested sleep was seen as highly interlinked with mental health. Evaluations of treatments varied, however perceived efficacy and personalisation of treatments were valued. Some evidence suggested patient priorities and conceptualisations regarding sleep may diverge from those of validated screening tools developed in general population and sleep medicine samples. More rigorous research is needed to support adaptation and development of interventions and outcome measures for use in specialist mental health settings. Qualitative studies exploring the experience of sleep disturbance in particular diagnostic groups and contexts are urgently required, as are patient perspectives on sleep interventions.

Social Experiences in Infancy and Early Childhood Co-Sleeping

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Hayes, Marie J.; Fukumizu, Michio; Troese, Marcia; Sallinen, Bethany A.; Gilles, Allyson A.

2007-01-01

Infancy and early childhood sleep-wake behaviours from current and retrospective parental reports were used to explore the relationship between sleeping arrangements and parent-child nighttime interactions at both time points. Children (N = 45) from educated, middle-class families, mostly breastfed in infancy, composed a convenience sample that…

Always Tired? You May Have Sleep Apnea

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... Medicine, an oral appliance is worn only during sleep and fits like a sports mouth guard or an orthodontic retainer. It supports the jaw in a forward position to help maintain an open upper airway. There are no drugs that are approved by the FDA to treat sleep apnea. Ronald Farkas, M.D., Ph.D., at ...

Medical image of the week: sleep bruxism

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Bartell J

2015-03-01

Full Text Available No abstract available. Article truncated at 150 words. A 42 year-old man with a past medical history of insomnia, post-traumatic stress disorder, depression and both migraine and tension headaches was referred for an overnight sleep study. He had presented to the sleep clinic with symptoms of obstructive sleep apnea. Medications included sumatriptan, amitryptiline, sertraline, and trazodone. His sleep study showed: sleep efficiency of 58.2%, apnea-hypopnea index of 33 events per hour, and arousal index of 14.5/hr. Periodic limb movement index was 29.2/hr. The time spent in the sleep stages included N1 (3.6%, N2 (72.5%, N3 (12.9%, and REM (10.9%. Figure 1 is representative of the several brief waveforms seen on his EEG and chin EMG. Sleep bruxism (SB is a type of sleep-related movement disorder that is characterized by involuntary masticatory muscle contraction resulting in grinding and clenching of the teeth and typically associated with arousals from sleep (1,2. The American academy of sleep medicine (AASM criteria for ...

Social class variation in medicine use among adolescents

DEFF Research Database (Denmark)

Holstein, Bjørn E; Hansen, Ebba Holme; Due, Pernille

2004-01-01

BACKGROUND: Little is known about social determinants of adolescents' medicine use. The objective was to analyse the association between the family's social class and adolescents' use of medicine for headache, stomachache, difficulties in getting to sleep, and nervousness. METHODS: Cross......, participation rate 88%, n=5,205. RESULTS: Logistic regression analyses showed that medicine use for all four symptoms increased by decreasing social class, controlled for age and prevalence of the specific symptom for which the medicine was taken. Adjusted OR (95% CI) for medicine use among students from lower...... social classes were: medicine for headache 1.35 (1.11-1.65), medicine for stomachache 1.41 (1.08-1.84), medicine for difficulties in getting to sleep 2.00 (1.30-3.08), and medicine for nervousness 3.22 (1.87-5.56). CONCLUSION: Symptom-adjusted medicine use in a representative sample of Danish adolescents...

Starting a sleep center.

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Epstein, Lawrence J; Valentine, Paul S

2010-05-01

The demand for sleep medicine services has grown tremendously during the last decade and will likely continue. To date, growth in demand has been met by growth in the number of new sleep centers. The need for more new centers will be dependent on market drivers that include increasing regulatory requirements, personnel shortages, integration of home sleep testing, changes in reimbursement, a shift in emphasis from diagnostics to treatment, and an increased consumer focus on sleep. The decision to open a new center should be based on understanding the market dynamics, completing a market analysis, and developing a business plan. The business plan should include an overview of the facility, a personnel and organizational structure, an evaluation of the business environment, a financial plan, a description of services provided, and a strategy for obtaining, managing, and extending a referral base. Implementation of the business plan and successful operation require ongoing planning and monitoring of operational parameters. The need for new sleep centers will likely continue, but the shifting market dynamics indicate a greater need for understanding the marketplace and careful planning.

Prevalence of sleep disturbance in chronic pain.

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Karaman, S; Karaman, T; Dogru, S; Onder, Y; Citil, R; Bulut, Y E; Tapar, H; Sahin, A; Arici, S; Kaya, Z; Suren, M

2014-01-01

Sleep is a vital function for human beings, which can be affected by several factors. Chronic pain is one of these factors where it is the most frequent cause for seeking medical care in combination with insomnia. The aim of this study is to examine the prevalence and relationship between sleep disturbance and chronic pain. After approval, a total of 85 Family Medicine Units from over 170 in Tokat were randomly selected using a 50% sampling. A sample of 2635 subjects, over the age of 19 years, who were registered with the selected Family Medicine Units, were assessed due to gender, age group, and the urban/rural population size of Tokat using the stratified sampling method. The sample size distribution was calculated as 1515 urban subjects, 1120 rural subjects; 1345 female subjects, 1290 male subjects; 1123 subjects between 20-39 years of age, 1103 subjects between the ages of 40-64, and 409 subjects over 64 years of age. After sampling, subjects were invited to participate in the study via an invitation letter, and agreeing individuals were taken to the Family Medicine Unit for face-to-face meetings. Written, informed consent was obtained, along with demographic data. The presence of chronic pain was recorded. According to the presence of chronic pain, all subjects were separated into two groups as Group Chronic Pain and Group Non-Chronic Pain. The visual analog scale for pain intensity, and Pittsburgh Sleep Quality Index for sleep quality, were performed with all subjects. A multiple linear regression model was used to assess the predictors of sleep quality. Analyses were conducted using the Statistical Package for Social Sciences program (SPSS Inc., Chicago, IL, USA), version 20.0. The statistical significance for all analyses was set at p 5. A moderate positive correlation was found between the global Pittsburgh Sleep Quality Index and Visual Analog Scale scores (r = 0.310, p < 0.01). A multiple linear regression analysis showed that age, gender, income, Visual

Relationship of symptoms with sleep-stage abnormalities in obstructive sleep apnea-hypopnea syndrome

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Md Basunia

2016-09-01

Full Text Available Background: Patients with obstructive sleep apnea-hypopnea syndrome (OSAHS present with a variety of sleep-related symptoms. In polysomnography, sleep architecture is almost always abnormal, but it is not known which of the sleep-stage abnormalities are related to symptoms. Finding key sleep-stage abnormality that cause symptoms may be of therapeutic importance to alleviate symptoms. So far the mainstay of treatment is continuous positive airway pressure (CPAP/bi-level positive airway pressure (BIPAP therapy, but many patients are non-compliant to it. Correcting the sleep-stage abnormality that cause symptoms by pharmacotherapy may become an important adjunct to CPAP/BIPAP therapy. Methods: A cross-sectional study. Adult subjects who attended a sleep laboratory for diagnostic polysomnography for a period of 1 month were recruited consecutively. OSAHS was diagnosed using American Academy of Sleep Medicine criteria. Subjects filled a questionnaire for symptoms prior to polysomnography. Results: Thirty subjects, of whom 83.3% were obese, met diagnostic criteria, with males constituting 46.7% and females constituting 53%. Mean age was 53.40±11.60 years. Sleep architecture comprised N1 19.50±19.00%, N2 53.93±13.39%, N3 3.90±19.50%, and rapid eye movement 8.92±6.21%. Excessive fatigue or sleepiness, waking up tired, falling asleep during the day, trouble paying attention, snoring and insomnia were significantly related to decreased N3 sleep. Conclusions: Most of the symptoms in OSAHS in adults are related to decreased stage N3 sleep. If confirmed by larger controlled studies, correcting N3 sleep deficiency by pharmacotherapy may become an important adjunct to CPAP/BIPAP therapy to alleviate symptoms.

Melatonin Decreases Daytime Challenging Behaviour in Persons with Intellectual Disability and Chronic Insomnia

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Braam, W.; Didden, R.; Maas, A. P. H. M.; Korzilius, H.; Smits, M. G.; Curfs, L. M. G.

2010-01-01

Background: Persons with intellectual disability (ID) and sleep problems exhibit more daytime challenging behaviours than persons with ID without sleep problems. Several anecdotal reports suggest that melatonin is not only effective in the treatment of insomnia, but also decreases daytime challenging behaviour. However, the effect of melatonin…

Sleep problems and daytime problem behaviours in children with intellectual disablity

NARCIS (Netherlands)

Didden, H.C.M.; Korzilius, H.P.L.M.; Aperloo, B. van; Overloon, C. van; Vries, M. de

2002-01-01

BACKGROUND: Sleep problems are common among children with intellectual disability (ID). METHOD: The present study assessed the prevalence of severe sleep problems in a sample of children (n=286) with mild to profound ID who lived at home with their parents(s) in the Netherlands. It also

Brain Networks are Independently Modulated by Donepezil, Sleep, and Sleep Deprivation.

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Wirsich, Jonathan; Rey, Marc; Guye, Maxime; Bénar, Christian; Lanteaume, Laura; Ridley, Ben; Confort-Gouny, Sylviane; Cassé-Perrot, Catherine; Soulier, Elisabeth; Viout, Patrick; Rouby, Franck; Lefebvre, Marie-Noëlle; Audebert, Christine; Truillet, Romain; Jouve, Elisabeth; Payoux, Pierre; Bartrés-Faz, David; Bordet, Régis; Richardson, Jill C; Babiloni, Claudio; Rossini, Paolo Maria; Micallef, Joelle; Blin, Olivier; Ranjeva, Jean-Philippe

2018-05-01

Resting-state connectivity has been widely studied in the healthy and pathological brain. Less well-characterized are the brain networks altered during pharmacological interventions and their possible interaction with vigilance. In the hopes of finding new biomarkers which can be used to identify cortical activity and cognitive processes linked to the effects of drugs to treat neurodegenerative diseases such as Alzheimer's disease, the analysis of networks altered by medication would be particularly interesting. Eleven healthy subjects were recruited in the context of the European Innovative Medicines Initiative 'PharmaCog'. Each underwent five sessions of simultaneous EEG-fMRI in order to investigate the effects of donepezil and memantine before and after sleep deprivation (SD). The SD approach has been previously proposed as a model for cognitive impairment in healthy subjects. By applying network based statistics (NBS), we observed altered brain networks significantly linked to donepezil intake and sleep deprivation. Taking into account the sleep stages extracted from the EEG data we revealed that a network linked to sleep is interacting with sleep deprivation but not with medication intake. We successfully extracted the functional resting-state networks modified by donepezil intake, sleep and SD. We observed donepezil induced whole brain connectivity alterations forming a network separated from the changes induced by sleep and SD, a result which shows the utility of this approach to check for the validity of pharmacological resting-state analysis of the tested medications without the need of taking into account the subject specific vigilance.

Sleep duration and sleep quality are associated differently with alterations of glucose homeostasis.

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Byberg, S; Hansen, A-L S; Christensen, D L; Vistisen, D; Aadahl, M; Linneberg, A; Witte, D R

2012-09-01

Studies suggest that inadequate sleep duration and poor sleep quality increase the risk of impaired glucose regulation and diabetes. However, associations with specific markers of glucose homeostasis are less well explained. The objective of this study was to explore possible associations of sleep duration and sleep quality with markers of glucose homeostasis and glucose tolerance status in a healthy population-based study sample. The study comprised 771 participants from the Danish, population-based cross-sectional 'Health2008' study. Sleep duration and sleep quality were measured by self-report. Markers of glucose homeostasis were derived from a 3-point oral glucose tolerance test and included fasting plasma glucose, 2-h plasma glucose, HbA(1c), two measures of insulin sensitivity (the insulin sensitivity index(0,120) and homeostasis model assessment of insulin sensitivity), the homeostasis model assessment of β-cell function and glucose tolerance status. Associations of sleep duration and sleep quality with markers of glucose homeostasis and tolerance were analysed by multiple linear and logistic regression. A 1-h increment in sleep duration was associated with a 0.3 mmol/mol (0.3%) decrement in HbA(1c) and a 25% reduction in the risk of having impaired glucose regulation. Further, a 1-point increment in sleep quality was associated with a 2% increase in both the insulin sensitivity index(0,120) and homeostasis model assessment of insulin sensitivity, as well as a 1% decrease in homeostasis model assessment of β-cell function. In the present study, shorter sleep duration was mainly associated with later alterations in glucose homeostasis, whereas poorer sleep quality was mainly associated with earlier alterations in glucose homeostasis. Thus, adopting healthy sleep habits may benefit glucose metabolism in healthy populations. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

The relationship between sleep habits and academic performance in dental students in Croatia.

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Valic, M; Pecotic, R; Lusic, L; Peros, K; Pribudic, Z; Dogas, Z

2014-11-01

It is well accepted that sleep and lifestyle habits affect academic success in students. However, sleep patterns and sleep problems amongst dental students have been insufficiently addressed in the literature. The purpose of this study was to evaluate sleep habits of dental students and the relationship between sleep habits and academic performance. A self-administered questionnaire on sleep habits, academic performance and lifestyle was administered. The participants were 447 dental students from Split University Dental Medicine School and Zagreb University Dental Medicine School from the six academic years. The subjects were classified into two groups based on academic success (high-performing vs. low-performing students) for comparison of sleep and lifestyle habits. Amongst the whole group of students, average bedtime and wake time during weekday was significantly earlier compared with weekend. Main findings indicate that students with high academic performance had earlier bedtimes during weekdays and weekends, earlier wake times during weekends and shorter sleep latency compared with low academic performing students. Self-reported academic performance of dental students in Croatia is associated with timing of sleep and wakefulness, rather than with total sleep time duration. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Increased Motor Activity During REM Sleep Is Linked with Dopamine Function in Idiopathic REM Sleep Behaviour Disorder and Parkinson Disease

DEFF Research Database (Denmark)

Zoetmulder, Marielle; Nikolic, Miki; Biernat, Heidi

2016-01-01

STUDY OBJECTIVES: Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by impaired motor inhibition during REM sleep, and dream-enacting behavior. RBD is especially associated with α-synucleinopathies, such as Parkinson disease (PD). Follow-up studies have shown...... in the putamen. In PD patients, EMG-activity was correlated to anti-Parkinson medication. CONCLUSIONS: Our results support the hypothesis that increased EMG-activity during REM sleep is at least partly linked to the nigrostriatal dopamine system in iRBD, and with dopamine function in PD....... the relation between this system and electromyographic (EMG) activity during sleep. The objective of this study was to investigate the relationship between the nigrostriatal dopamine system and muscle activity during sleep in iRBD and PD. METHODS: 10 iRBD patients, 10 PD patients with PD, 10 PD patients...

Parental rating of sleep in children with attention deficit/hyperactivity disorder

DEFF Research Database (Denmark)

Hvolby, Allan; Jørgensen, Jan; Bilenberg, Niels

2009-01-01

OBJECTIVE: Sleep problems have often been associated with attention deficit/hyperactivity disorder (ADHD). Parents of those with ADHD and children with ADHD report sleep difficulties more frequently than healthy children and their parents. The primary objective of this paper is to describe sleep...... regarding numbers of awakenings per night and total sleep time per night. Comorbid oppositional defiant disorder appeared not to have an added effect on problematic behaviour around bedtime. CONCLUSION: Parents of children with ADHD report that their children do not sleep properly more often than other...

Sleep apnea diagnosis varies with the hypopnea criteria applied

DEFF Research Database (Denmark)

Ponsaing, Laura B; Iversen, Helle K; Jennum, Poul

2016-01-01

PURPOSE: We aimed to evaluate the three hypopnea criteria, A and B from 2007 and the revised from 2012, proposed by the American Academy of Sleep Medicine (AASM) for scoring sleep-related breathing disorders (SRBDs) in patients with acute stroke or transient ischemic attack (TIA). METHODS...

Medical comorbidity of sleep disorders.

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Dikeos, Dimitris; Georgantopoulos, Georgios

2011-07-01

Recently published literature indicates that sleep disorders present with medical comorbidities quite frequently. The coexistence of a sleep disorder with a medical disorder has a substantial impact for both the patient and the health system. Insomnia and hypersomnia are highly comorbid with medical conditions, such as chronic pain and diabetes, as well as with various cardiovascular, respiratory, gastrointestinal, urinary and neurological disorders. Restless legs syndrome and periodic leg movement syndrome have been associated with iron deficiency, kidney disease, diabetes, and neurological, autoimmune, cardiovascular and respiratory disorders. Rapid eye movement behaviour disorder has been described as an early manifestation of serious central nervous system diseases; thus, close neurological monitoring of patients referring with this complaint is indicated. Identification and management of any sleep disorder in medical patients is important for optimizing the course and prognosis. Of equal importance is the search for undetected medical disorder in patients presenting with sleep disorders.

Association between sleep duration and overweight: the importance of parenting.

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de Jong, E; Stocks, T; Visscher, T L S; HiraSing, R A; Seidell, J C; Renders, C M

2012-10-01

Sleep duration has been related to overweight in children, but determinants of sleep duration are unclear. The aims were to investigate the association between sleep duration and childhood overweight adjusted for family characteristics and unhealthy behaviours, to explore determinants of sleep duration and to determine with sleep competing activities. A cross-sectional study was carried out in 2006 among 4072 children aged 4-13 years in the city of Zwolle, The Netherlands. In these children, data were available on measured height, weight and waist circumference, and from a parental questionnaire, on socio-demographic characteristics, child's sleep duration, nutrition, physical activity and sedentary behaviour. Associations were studied in 2011 using logistic and linear regression analyses, adjusted for potential confounders. Short sleep duration was associated with overweight for 4-8-year-old boys (odds ratio (OR):3.10; 95% confidence interval (CI):1.15-8.40), 9-13-year-old boys (OR:4.96; 95% CI:1.35-18.16) and 9-13-year-old girls (OR:4.86; 95% CI:1.59-14.88). Among 4-8-year-old girls no statistically significant association was found. Determinants for short sleep duration were viewing television during a meal, permission to have candy without asking, not being active with their caregiver and a late bedtime. For all children, short sleep duration was strongly associated with more television viewing and computer use. Association between sleep duration and overweight is not explained by socio-demographic variables, drinking sugared drinks and eating snacks. Parents have a key role in stimulating optimal sleep duration. Improving parenting skills and knowledge to offer children more structure, and possibly with that, increase sleeping hours, may be promising in prevention of overweight.

Sleep Misperception in Chronic Insomnia Patients with Obstructive Sleep Apnea Syndrome: Implications for Clinical Assessment.

Science.gov (United States)

Choi, Su Jung; Suh, Sooyeon; Ong, Jason; Joo, Eun Yeon

2016-11-15

To investigate whether sleep perception (SP), defined by the ratio of subjective and objective total sleep time, and habitual sleep time in various sleep disorders may be based on comorbid insomnia status. We enrolled 420 patients (age 20-79 y) who underwent polysomnography (PSG). They were divided into three groups based on chief complaints: chronic insomnia (CI, n = 69), patients with both obstructive sleep apnea and insomnia (OSA-I, n = 49) or OSA only (OSA, n = 149). Healthy volunteers were also recruited (normal controls [NC], n = 80). We compared differences in PSG parameters and habitual sleep duration and investigated the discrepancy between objective and subjective total sleep time (TST) and sleep latency among four groups. Subjective TST was defined as sleep time perceived by participants the next morning of PSG. SP for TST was highest in the OSA group (median 92.9%), and lowest in the CI group (80.3%). SP of the NC group (91.4%) was higher than the CI, but there was no difference between OSA-I and OSA groups. OSA-I had higher depressive mood compared to the OSA group (p insomnia and arousal index of PSG. Insomnia patients with (OSA-I) or without OSA (CI) reported the smallest discrepancy between habitual sleep duration and objective TST. Patients with OSA with or without insomnia have different PSG profiles, which suggests that objective measures of sleep are an important consideration for differentiating subtypes of insomnia and tailoring proper treatment. A commentary on this articles appears in this issue on page 1437. © 2016 American Academy of Sleep Medicine

Impact of Impulse Control Disorders on Sleep-Wake Regulation in Parkinson’s Disease

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Atbin Djamshidian

2015-01-01

Full Text Available Sleep disturbances are common in patients with Parkinson’s disease (PD and are even more prevalent in patients with behavioural addictions, such as pathological gambling, compulsive sexual behaviour, compulsive buying, binge eating, punding, and the compulsive use of dopamine replacement therapy. An overview of the relationship between these impulse control disorders and sleep disturbances is given and potential underlying mechanisms and treatment strategies are covered.

Sleep disturbances after fast-track hip and knee arthroplasty

DEFF Research Database (Denmark)

Krenk, L; Jennum, P; Kehlet, H

2012-01-01

BACKGROUND: /st>Major surgery is followed by pronounced sleep disturbances after traditional perioperative care potentially leading to prolonged recovery. The aim was to evaluate the rapid eye movement (REM) sleep duration and sleep architecture before and after fast-track hip and knee replacement......, and on the fourth postoperative night at home. Sleep staging was performed according to the American Academy of Sleep Medicine manual. Opioid use, pain, and inflammatory response (C-reactive protein) were also evaluated. RESULTS: /st>The mean LOS was 1.5 (1-2) days. The mean REM sleep time decreased from a mean...... on the fourth postoperative night. There was no association between opioid use, pain scores, and inflammatory response with a disturbed sleep pattern. CONCLUSIONS: /st>Despite ultra-short LOS and provision of spinal anaesthesia with multimodal opioid-sparing analgesia, REM sleep was almost eliminated...

Sleep-wake patterns in patients with cirrhosis: all you need to know on a single sheet. A simple sleep questionnaire for clinical use.

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Montagnese, Sara; Middleton, Benita; Skene, Debra J; Morgan, Marsha Y

2009-10-01

Sleep-wake abnormalities are common in patients with cirrhosis but their evaluation is time consuming and laborious. The aim of this study was to assess the validity of a simple Sleep Timing and Sleep Quality Screening questionnaire (STSQS) against an established sleep quality questionnaire and daily sleep diaries. The study population comprised 87 patients with cirrhosis and 19 healthy volunteers. All participants completed the STSQS (sleep quality score range 1-9) and the Pittsburgh Sleep Quality Index (PSQI; total score range: 0-21; scores >5 identify 'poor' sleepers); a subgroup of 35 patients and 12 healthy volunteers also kept daily sleep diaries for 2 weeks. Patients slept significantly less well than the healthy volunteers (total PSQI score: 8.4+/-4.9 vs. 4.6+/-2.5, p4: sensitivity 75%, specificity 93%; patients: STSQS sleep quality >3: sensitivity 83%, specificity 70%). The STSQS provided estimates of habitual sleep timing variables which did not significantly differ from the average data recorded in the sleep diaries, although more variability was observed in the patients. The STSQS provides acceptable estimates of sleep quality and sleep timing and could be used to identify patients with cirrhosis whose sleep behaviour might require further assessment.

Rapid eye movement sleep behavior disorder--diagnostik, årsager og behandling

DEFF Research Database (Denmark)

Zoetmulder, Marielle; Jennum, Poul Jørgen

2009-01-01

Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterized by loss of REM sleep and related electromyographic atonia with marked muscular activity and dream enactment behaviour. RBD is seen in 0.5% of the population. It occurs in an idiopathic form and secondarily to medical...... and neurological disease. RBD is related to brainstem pathology. Furthermore, it is increasingly recognized that RBD is frequently related to Parkinsonian disorders and narcolepsy. This article reviews recent knowledge about RBD with focus on the diagnostic process and management....

Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders: Advanced Sleep-Wake Phase Disorder (ASWPD), Delayed Sleep-Wake Phase Disorder (DSWPD), Non-24-Hour Sleep-Wake Rhythm Disorder (N24SWD), and Irregular Sleep-Wake Rhythm Disorder (ISWRD). An Update for 2015

Science.gov (United States)

Auger, R. Robert; Burgess, Helen J.; Emens, Jonathan S.; Deriy, Ludmila V.; Thomas, Sherene M.; Sharkey, Katherine M.

2015-01-01

A systematic literature review and meta-analyses (where appropriate) were performed and the GRADE approach was used to update the previous American Academy of Sleep Medicine Practice Parameters on the treatment of intrinsic circadian rhythm sleep-wake disorders. Available data allowed for positive endorsement (at a second-tier degree of confidence) of strategically timed melatonin (for the treatment of DSWPD, blind adults with N24SWD, and children/ adolescents with ISWRD and comorbid neurological disorders), and light therapy with or without accompanying behavioral interventions (adults with ASWPD, children/adolescents with DSWPD, and elderly with dementia). Recommendations against the use of melatonin and discrete sleep-promoting medications are provided for demented elderly patients, at a second- and first-tier degree of confidence, respectively. No recommendations were provided for remaining treatments/ populations, due to either insufficient or absent data. Areas where further research is needed are discussed. Citation: Auger RR, Burgess HJ, Emens JS, Deriy LV, Thomas SM, Sharkey KM. Clinical practice guideline for the treatment of intrinsic circadian rhythm sleep-wake disorders: advanced sleep-wake phase disorder (ASWPD), delayed sleep-wake phase disorder (DSWPD), non-24-hour sleep-wake rhythm disorder (N24SWD), and irregular sleep-wake rhythm disorder (ISWRD). An update for 2015. J Clin Sleep Med 2015;11(10):1199–1236. PMID:26414986

Long-term impact of earthquakes on sleep quality.

Science.gov (United States)

Tempesta, Daniela; Curcio, Giuseppe; De Gennaro, Luigi; Ferrara, Michele

2013-01-01

We investigated the impact of the 6.3 magnitude 2009 L'Aquila (Italy) earthquake on standardized self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and frequency of disruptive nocturnal behaviours (Pittsburgh Sleep Quality Index-Addendum, PSQI-A) two years after the natural disaster. Self-reported sleep quality was assessed in 665 L'Aquila citizens exposed to the earthquake compared with a different sample (n = 754) of L'Aquila citizens tested 24 months before the earthquake. In addition, sleep quality and disruptive nocturnal behaviours (DNB) of people exposed to the traumatic experience were compared with people that in the same period lived in different areas ranging between 40 and 115 km from the earthquake epicenter (n = 3574). The comparison between L'Aquila citizens before and after the earthquake showed a significant deterioration of sleep quality after the exposure to the trauma. In addition, two years after the earthquake L'Aquila citizens showed the highest PSQI scores and the highest incidence of DNB compared to subjects living in the surroundings. Interestingly, above-the-threshold PSQI scores were found in the participants living within 70 km from the epicenter, while trauma-related DNBs were found in people living in a range of 40 km. Multiple regressions confirmed that proximity to the epicenter is predictive of sleep disturbances and DNB, also suggesting a possible mediating effect of depression on PSQI scores. The psychological effects of an earthquake may be much more pervasive and long-lasting of its building destruction, lasting for years and involving a much larger population. A reduced sleep quality and an increased frequency of DNB after two years may be a risk factor for the development of depression and posttraumatic stress disorder.

Canadian Sleep Society/Canadian Thoracic Society position paper on the use of portable monitoring for the diagnosis of obstructive sleep apnea/hypopnea in adults

Directory of Open Access Journals (Sweden)

Adam Blackman

2010-01-01

Full Text Available The present position paper on the use of portable monitoring (PM as a diagnostic tool for obstructive sleep apnea/hypopnea (OSAH in adults was based on consensus and expert opinion regarding best practice standards from stakeholders across Canada. These recommendations were prepared to guide appropriate clinical use of this new technology and to ensure that quality assurance standards are adhered to. Clinical guidelines for the use of PM for the diagnosis and management of OSAH as an alternative to in-laboratory polysomnography published by the American Academy of Sleep Medicine Portable Monitoring Task Force were used to tailor our recommendations to address the following: indications; methodology including physician involvement, physician and technical staff qualifications, and follow-up requirements; technical considerations; quality assurance; and conflict of interest guidelines. When used appropriately under the supervision of a physician with training in sleep medicine, and in conjunction with a comprehensive sleep evaluation, PM may expedite treatment when there is a high clinical suspicion of OSAH.

The Epidemiology of Sleep Quality, Sleep Patterns, Consumption of Caffeinated Beverages, and Khat Use among Ethiopian College Students.

Science.gov (United States)

Lemma, Seblewengel; Patel, Sheila V; Tarekegn, Yared A; Tadesse, Mahlet G; Berhane, Yemane; Gelaye, Bizu; Williams, Michelle A

2012-01-01

Objective. To evaluate sleep habits, sleep patterns, and sleep quality among Ethiopian college students; and to examine associations of poor sleep quality with consumption of caffeinated beverages and other stimulants. Methods. A total of 2,230 undergraduate students completed a self-administered comprehensive questionnaire which gathered information about sleep complaints, sociodemographic and lifestyle characteristics,and theuse of caffeinated beverages and khat. We used multivariable logistic regression procedures to estimate odds ratios for the associations of poor sleep quality with sociodemographic and behavioral factors. Results. Overall 52.7% of students were classified as having poor sleep quality (51.8% among males and 56.9% among females). In adjusted multivariate analyses, caffeine consumption (OR = 1.55; 95% CI: 1.25-1.92), cigarette smoking (OR = 1.68; 95% CI: 1.06-2.63), and khat use (OR = 1.72, 95% CI: 1.09-2.71) were all associated with increased odds of long-sleep latency (>30 minutes). Cigarette smoking (OR = 1.74; 95% CI: 1.11-2.73) and khat consumption (OR = 1.91; 95% CI: 1.22-3.00) were also significantly associated with poor sleep efficiency (sleep medicine. Conclusion. Findings from the present study demonstrate the high prevalence of poor sleep quality and its association with stimulant use among college students. Preventive and educational programs for students should include modules that emphasize the importance of sleep and associated risk factors.

Assessing the sleeping habits of patients in a sleep disorder centre: a review of sleep diary accuracy

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Lawrence, Geoffrey

2018-01-01

Background Excessive daytime sleepiness (EDS) is a complaint common to many aspects of medicine. There are primary and secondary causes for EDS, with secondary causes including a large number of common conditions. Primary causes, such as narcolepsy, are much rarer. When assessing for primary hypersomnia, restricted or fragmented sleep must be ruled out. This process involves assessment of sleeping habits using a sleep diary and/or actigraphy. Clinicians are suspicious of the accuracy with which patients use the former. This review aims to evaluate the accuracy of a sleep diary study against the ‘objective gold standard’ actigraphy report. Methods Data from 35 patients at a Sleep Disorder Centre who underwent both a sleep diary and actigraphy study for suspected primary hypersomnia in 2016 was collected. Mean values of four variables were calculated: ‘time of lights out’, ‘time to fall asleep’, ‘time of waking’ and ‘sleep time’. The ‘similarity’ was assessed. This was a term defined in three different ways: if sleep diary values are accurate to within 20, 30 and 60 min respectively. Percentage ‘similarity’, mean time differences and standard deviations (SDs) were calculated for each variable. A paired t-test was also performed to assess the significance of the time differences between the two modalities. Results Least accurate was ‘sleep time’, with 14.7%, 23.5% and 58.8% of patients within 20, 30 and 60 min of the actigraphy respectively. Mean time difference for this variable was 66 min (versus 33, 15 and 22). ‘Time to fall asleep’ was most accurate, with 76.5%, 82.4% and 100% ‘similarity’ respectively. Conclusions The clinically acceptable accuracy has no universal definition, so clinicians must use experience and reasoning to determine this level to interpret this data. The review suggests that some variables are entered with high accuracy, and the diary is low cost and adds subjective information that cannot be gathered

The effect of aromatherapy with Rosa damascena essential oil on sleep quality in children

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A.S. Keyhanmehr

2018-01-01

Full Text Available Background and objectives: Sleep disorder is one of the main problems in children. Poor sleep quality can lead to adverse effects on their growth and development. Aromatherapy is a kind of method for improving sleep. In Iranian traditional medicine, inhaling Rosa damascena has been recommended for treating sleep disorder. Due to the side effects of chemical drugs and trend to alternative medicine due to less complication, the aim of this study was to investigate the effect of aromatherapy with Rosa damascena essential oil on sleep quality in children. Methods: This study was an experimental before and after study that conducted in 30 children with sleep disorder. Children inhaled 5 drops of Rosa damascena essential oil on a cotton ball before sleep for 20 min (2 weeks. Before and after intervention, BEARS questionnaire was asked. Wilcoxon signed-rank test was used for comparisons by SPSS software. Results: The results of this study showed that resistance to sleep, difficulty waking in the morning, nightmare and waking up during the night in children decreased (p

Assessment of Sleep Quantity and Sleep Disturbances During Recovery From Sports-Related Concussion in Youth Athletes.

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Murdaugh, Donna L; Ono, Kim E; Reisner, Andrew; Burns, Thomas G

2018-05-01

To determine the relation between sleep quantity and sleep disturbances on symptoms and neurocognitive ability during the acute phase (sports-related concussion (SRC; >21d). Prospective inception cohort study. General community setting of regional middle and high schools. A sample (N=971) including youth athletes with SRC (n=528) and controls (n=443) (age, 10-18y). Not applicable. Athletes completed the Immediate Post-Concussion Assessment and Cognitive Testing battery. Partial correlation analyses and independent t tests were conducted to assess sleep quantity the night before testing. Multivariate analysis of covariance was used to assess sleep disturbances and their interaction with age. Less sleep quantity was correlated with greater report of cognitive (P=.001) and neuropsychological (P=.024) symptoms specific to prolonged recovery from SRC. Sleep disturbances significantly affect each migraine, cognitive, and neuropsychological symptoms (Psleep disturbances and age (P=.04) at >21 days post-SRC. Findings emphasize that the continued presence of low sleep quantity and sleep disturbances in youth athletes with SRC should be a specific indicator to health professionals that these athletes are at an increased risk of protracted recovery. Further research should identify additional factors that may interact with sleep to increase the risk of protracted recovery. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

New technology to assess sleep apnea: wearables, smartphones, and accessories [version 1; referees: 2 approved

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Thomas Penzel

2018-03-01

Full Text Available Sleep medicine has been an expanding discipline during the last few decades. The prevalence of sleep disorders is increasing, and sleep centers are expanding in hospitals and in the private care environment to meet the demands. Sleep medicine has evidence-based guidelines for the diagnosis and treatment of sleep disorders. However, the number of sleep centers and caregivers in this area is not sufficient. Many new methods for recording sleep and diagnosing sleep disorders have been developed. Many sleep disorders are chronic conditions and require continuous treatment and monitoring of therapy success. Cost-efficient technologies for the initial diagnosis and for follow-up monitoring of treatment are important. It is precisely here that telemedicine technologies can meet the demands of diagnosis and therapy follow-up studies. Wireless recording of sleep and related biosignals allows diagnostic tools and therapy follow-up to be widely and remotely available. Moreover, sleep research requires new technologies to investigate underlying mechanisms in the regulation of sleep in order to better understand the pathophysiology of sleep disorders. Home recording and non-obtrusive recording over extended periods of time with telemedicine methods support this research. Telemedicine allows recording with little subject interference under normal and experimental life conditions.

Simplified sleep restriction for insomnia in general practice: a randomised controlled trial.

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Falloon, Karen; Elley, C Raina; Fernando, Antonio; Lee, Arier C; Arroll, Bruce

2015-08-01

Insomnia is common in primary care. Cognitive behavioural therapy for insomnia (CBT-I) is effective but requires more time than is available in the general practice consultation. Sleep restriction is one behavioural component of CBT-I. To assess whether simplified sleep restriction (SSR) can be effective in improving sleep in primary insomnia. Randomised controlled trial of patients in urban general practice settings in Auckland, New Zealand. Adults with persistent primary insomnia and no mental health or significant comorbidity were eligible. Intervention patients received SSR instructions and sleep hygiene advice. Control patients received sleep hygiene advice alone. Primary outcomes included change in sleep quality at 6 months measured by the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and sleep efficiency (SE%). The proportion of participants reaching a predefined 'insomnia remission' treatment response was calculated. Ninety-seven patients were randomised and 94 (97%) completed the study. At 6-month follow-up, SSR participants had improved PSQI scores (6.2 versus 8.4, Pinsomnia, the adjusted odds ratio for insomnia remission was 2.7 (95% CI = 1.1 to 6.5). There were no significant differences in other outcomes or adverse effects. SSR is an effective brief intervention in adults with primary insomnia and no comorbidities, suitable for use in general practice. © British Journal of General Practice 2015.

Obstructive sleep apnea: a clinical review

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M. Marvisi

2013-05-01

Full Text Available BACKGROUND Since the original classification of the obstructive nature of obstructive sleep apnea syndrome (OSAS in 1965, much has been learned about the disorder. In 1990 respiratory disturbances during sleep have come to be recognized as extremely common disorders with important clinical consequences. DISCUSSION It is a condition with high prevalence of obesity as a major risk factor. Premenopausal women are relatively protected from the disorder: its prevalence in women rises after menopause. Although OSAS is a risk factor for excessive daytime sleepiness, there is developing evidence that it is also a risk factor for hypertension, acute cardiovascular events, and insulin resistance. Definitive diagnosis still depends on in-laboratory polysomnography. This involves recording of multiple variables during sleep, including electroencephalogram. There is a considerable interest in the role of unattended home sleep-monitoring and some evidence of its usefulness has yet to be established. The first line of therapy is nasal continuous positive airway pressure (CPAP. Data into the efficacy of CPAP in severe OSAS have come from randomized, placebo-controlled clinical trials the endpoints of which being sleepiness, quality of life, and 24-h ambulatory blood pressure. Data are currently less convincing for treatment outcomes in mild to moderate OSAS, and new clinical trails to assess outcomes in this group are underway. CONCLUSION The field of sleep medicine has now firmly entered the mainstream of clinical practice, substantial progress has been made, and OSAS has increasingly emerged as a major public health concern. The Internal Medicine specialist has to recognize this clinical entity.

INTEGRATED DIAGNOSTICS AND CORRECTION OF SLEEP DISORDERS IN CHILDREN

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S. A. Nemkova

2015-01-01

Full Text Available The article is devoted to the actual problem of modern pediatrics and neurology ― a comprehensive diagnosis and correction of sleep disorders in children. Detail the features of the clinical manifestations of sleep disorders in childhood (insomnia and parasomnia, great attention is paid to sleep apnea syndrome as a risk factor for somatic and psychopathological disorders in children. Highlight the current capabilities of complex instrumental diagnosis of sleep disorders with the use of highly effective methods of polysomnography and pulse oximetry. The actual dimensions as non-drug and drug treatment of sleep disorders in children, taking into account the pathogenetic features of their occurrence. From the standpoint of evidence-based medicine demonstrate efficient methods of herbal medicine, developed on the basis of traditional Chinese recipes, as well as modern nootropics and magnesium preparations. It is shown that sleep disorders in children not only lead to a deterioration of emotional mood, cognitive function, health and school performance, but also are associated with increasing risk of somatic disorders, which determines the need for timely diagnosis and comprehensive differentiated medical and psychological data correction of pathological conditions, taking into account the neurophysiological and biochemical mechanisms of their development, as well as polymorphism of clinical manifestations, in order to increase the effectiveness of treatment and quality of life of patients.  

Sleep habits and patterns among medical students.

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Bahammam, Ahmed S; Al-Khairy, Omar K; Al-Taweel, Ahmed A

2005-04-01

This study was designed to assess sleep patterns among male medical students at different academic levels. Participants in this study were healthy male medical students in the first (L1), second (L2) and third (L3) academic levels of the College of Medicine, King Saud University, Riyadh, Saudi Arabia. The study was conducted during November 2001. A self-administered questionnaire was distributed to students to assess age, academic level, registered credit hours, sleep-wake schedule, naps, quality of sleep, total sleep time at night, possible factors affecting bedtime, and daytime sleepiness using the Epworth Sleepiness Scale (ESS). The final analysis included 129 students. Total sleep time at night + nap of the whole group was 5.9 +/- 1.6 hours. Twenty-nine students (22.4%) were defined to have excessive daytime sleepiness (EDS) based on ESS score of >10. Also, 83.3% of students reported napping during the daytime more than twice per week. Analysis of the sleep pattern of male medical students revealed that this group is sleep deprived, which in turn may affect their academic performance.

Sleep complaints in middle-aged women and men: the contribution of working conditions and work-family conflicts.

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Lallukka, Tea; Rahkonen, Ossi; Lahelma, Eero; Arber, Sara

2010-09-01

This study aimed to examine how physical working conditions, psychosocial working conditions and work-family conflicts are associated with sleep complaints, and whether health behaviours explain these associations. We used pooled postal questionnaire surveys collected in 2001-2002 among 40-60-year-old employees of the City of Helsinki (n = 5819, response rate 66%). Participants were classified as having sleep complaints if they reported sleep complaints at least once a week on average (24% of women and 20% of men). Independent variables included environmental work exposures, physical workload, computer work, Karasek's job strain and work-family conflicts. Age, marital status, occupational class, work arrangements, health behaviours and obesity were adjusted for. Most working conditions were associated strongly with sleep complaints after adjustment for age only. After adjustment for work-family conflicts, the associations somewhat attenuated. Work-family conflicts were also associated strongly with women's [odds ratio (OR) 5.90; confidence interval (CI) 4.16-8.38] and men's sleep (OR 2.56; CI 1.34-4.87). The associations remained robust even after controlling for unhealthy behaviours, obesity, health status, depression and medications. Physically strenuous working conditions, psychosocial job strain and work-family conflicts may increase sleep complaints. Efforts to support employees to cope with psychosocial stress and reach a better balance between paid work and family life might reduce sleep complaints. Sleep complaints need to be taken into account in worksite health promotion and occupational health care in order to reduce the burden of poor sleep.

Drosophila male sex peptide inhibits siesta sleep and promotes locomotor activity in the post-mated female.

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Isaac, R Elwyn; Li, Chenxi; Leedale, Amy E; Shirras, Alan D

2010-01-07

Quiescence, or a sleep-like state, is a common and important feature of the daily lives of animals from both invertebrate and vertebrate taxa, suggesting that sleep appeared early in animal evolution. Recently, Drosophila melanogaster has been shown to be a relevant and powerful model for the genetic analysis of sleep behaviour. The sleep architecture of D. melanogaster is sexually dimorphic, with females sleeping much less than males during day-time, presumably because reproductive success requires greater foraging activity by the female as well as the search for egg-laying sites. However, this loss of sleep and increase in locomotor activity will heighten the risk for the female from environmental and predator hazards. In this study, we show that virgin females can minimize this risk by behaving like males, with an extended afternoon 'siesta'. Copulation results in the female losing 70 per cent of day-time sleep and becoming more active. This behaviour lasts for at least 8 days after copulation and is abolished if the mating males lack sex peptide (SP), normally present in the seminal fluid. Our results suggest that SP is the molecular switch that promotes wakefulness in the post-mated female, a change of behaviour compatible with increased foraging and egg-laying activity. The stress resulting from SP-dependent sleep deprivation might be an important contribution to the toxic side-effects of male accessory gland products that are known to reduce lifespan in post-mated females.

The Epidemiology of Sleep Quality, Sleep Patterns, Consumption of Caffeinated Beverages, and Khat Use among Ethiopian College Students

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Seblewengel Lemma

2012-01-01

Full Text Available Objective. To evaluate sleep habits, sleep patterns, and sleep quality among Ethiopian college students; and to examine associations of poor sleep quality with consumption of caffeinated beverages and other stimulants. Methods. A total of 2,230 undergraduate students completed a self-administered comprehensive questionnaire which gathered information about sleep complaints, sociodemographic and lifestyle characteristics,and theuse of caffeinated beverages and khat. We used multivariable logistic regression procedures to estimate odds ratios for the associations of poor sleep quality with sociodemographic and behavioral factors. Results. Overall 52.7% of students were classified as having poor sleep quality (51.8% among males and 56.9% among females. In adjusted multivariate analyses, caffeine consumption (OR=1.55; 95% CI: 1.25–1.92, cigarette smoking (OR=1.68; 95% CI: 1.06–2.63, and khat use (OR=1.72, 95% CI: 1.09–2.71 were all associated with increased odds of long-sleep latency (>30 minutes. Cigarette smoking (OR=1.74; 95% CI: 1.11–2.73 and khat consumption (OR=1.91; 95% CI: 1.22–3.00 were also significantly associated with poor sleep efficiency (<85%, as well as with increased use of sleep medicine. Conclusion. Findings from the present study demonstrate the high prevalence of poor sleep quality and its association with stimulant use among college students. Preventive and educational programs for students should include modules that emphasize the importance of sleep and associated risk factors.

Obstructive sleep apnoea syndrome in children

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Anna Włodarska

2016-09-01

Full Text Available Sleep-related breathing disorders in children are a clinical problem which is more and more often diagnosed by doctors nowadays. They can be the basis for diagnosing obstructive sleep apnoea syndrome that causes a number of complications: lowering the quality of life, behavioural problems, complications involving cardiovascular system. The incidence of obstructive sleep apnoea syndrome in the paediatric population is estimated to be at the level of 2%. The symptoms of obstructive sleep apnoea syndrome can be divided into daytime and night ones. Night symptoms in children include: snoring, apnoea, breathing with open mouth (both during the day and at night, dry tongue and mouth during sleep, agitated sleep in unnatural positions. Among daytime symptoms of obstructive sleep apnoea syndrome there are: irritability, aggressiveness, hyperactivity, attention deficit disorder, delayed development and growth pattern (mainly failure to thrive, learning problems, morning headaches. Parents often do not connect the night and daytime symptoms with the possible development of obstructive sleep apnoea syndrome in their children. The main predisposing factor of obstructive sleep apnoea syndrome in children is adenotonsillar hypertrophy. Effective and in most cases preferred treatment for the management of obstructive sleep apnoea syndrome in children is adenotonsillectomy. Polysomnography and polygraphy are diagnostic tools helpful in the study of sleep-related disorders. The objective of this study was to systematise the knowledge on the epidemiology, aetiology, clinical image and prevention of obstructive sleep apnoea syndrome in children.

Sleep Quality and Academic Performance Among Medical College Students

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Ameer Kadhim Al-Humairi

2018-01-01

Full Text Available Background:Sleep plays a very important role in a human health. Poor sleep quality remains as a frequent feature of student life. Quantity and quality of sleep in addition to average sleep time are strongly linked with students’ learning abilities and academic performance. Subjects and method:The study was a descriptive cross-sectional study conducted to assess sleep quality among medical college students – University of Babylon using Pittsburgh Sleep Quality Index (PSQI. This study was done during April 2016. Results:Mean age of students was (20.63 ± 0.65. Majority was female. According to PSQI(60.4% of students were poor sleeper. Significant association between quality of sleep and academic performance was found in our study, (72.9% of those fail in one or more subjects have poor sleep quality. Conclusion: Poor sleep quality was regarded as an important problem among medical college students. Majority of students (60.4% was poor sleepers. Our study shows significant relation between sleep quality and academic performance among students of Babylon University –College of Medicine.

Medicine Use among Warsaw Ninth-Grade Students

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Pisarska, Agnieszka; Ostaszewski, Krzysztof

2011-01-01

Aim: This study examined the prevalence of medicine use for headache, stomachache, difficulties in getting to sleep, nervousness, depression and lack of energy among 15- to 16-year-old students; the relationship between medicine use and students' health status; and the relationship between medicine and nicotine, illegal drug, and alcohol use.…

Are sleep disturbances preclinical markers of Parkinson’s disease?

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Brito dos Santos, Altair; Kohlmeier, Kristi Anne; Barreto, George

2015-01-01

REM sleep behaviour and currently several other disturbances have gained importance as potential markers, such as excessive daytime sleepiness, restless legs syndrome and new evidence also points to changes in circadian rhythms. Here we present a brief review of the major evidence indicating......Parkinson’s disease (PD) is a neurobehavioral disorder characterized by motor symptoms and signs, and non-motor abnormalities such as olfactory dysfunction, pain, sleep disorders and cognitive impairment. Amongst these alterations, sleep disturbances play an important role in the pathology......, but presence of disturbed sleep is not currently considered in diagnosis. However, sleeping problems may precede by many years the classic motor abnormalities of PD and should be clinically evaluated as a potential marker before disease onset. The first disturbance reported with this potential was the disorder...

Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer

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Palesh O

2012-12-01

Full Text Available Oxana Palesh,1 Luke Peppone,2 Pasquale F Innominato,3–5 Michelle Janelsins,2 Monica Jeong,1 Lisa Sprod,7 Josee Savard,6 Max Rotatori,1 Shelli Kesler,1 Melinda Telli,1 Karen Mustian21Stanford University School of Medicine, Stanford, CA, USA; 2University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; 3INSERM, UMRS 776, Biological Rhythms and Cancers, Villejuif, France; 4Faculty of Medicine, Universite Paris Sud, le Kremlin-Bicêtre, France; 5APHP, Chronotherapy Unit, Department of Oncology, Paul Brousse Hospital, Villejuif, France; 6Laval University, Quebec, Canada; 7University of North Carolina, Wilmington, NC, USAAbstract: Sleep problems are highly prevalent in cancer patients undergoing chemotherapy. This article reviews existing evidence on etiology, associated symptoms, and management of sleep problems associated with chemotherapy treatment during cancer. It also discusses limitations and methodological issues of current research. The existing literature suggests that subjectively and objectively measured sleep problems are the highest during the chemotherapy phase of cancer treatments. A possibly involved mechanism reviewed here includes the rise in the circulating proinflammatory cytokines and the associated disruption in circadian rhythm in the development and maintenance of sleep dysregulation in cancer patients during chemotherapy. Various approaches to the management of sleep problems during chemotherapy are discussed with behavioral intervention showing promise. Exercise, including yoga, also appear to be effective and safe at least for subclinical levels of sleep problems in cancer patients. Numerous challenges are associated with conducting research on sleep in cancer patients during chemotherapy treatments and they are discussed in this review. Dedicated intervention trials, methodologically sound and sufficiently powered, are needed to test current and novel treatments of sleep problems in cancer patients

Computer use, sleep duration and health symptoms

DEFF Research Database (Denmark)

Nuutinen, Teija; Roos, Eva; Ray, Carola

2014-01-01

OBJECTIVES: This study investigated whether computer use is associated with health symptoms through sleep duration among 15-year olds in Finland, France and Denmark. METHODS: We used data from the WHO cross-national Health Behaviour in School-aged Children study collected in Finland, France...... and Denmark in 2010, including data on 5,402 adolescents (mean age 15.61 (SD 0.37), girls 53 %). Symptoms assessed included feeling low, irritability/bad temper, nervousness, headache, stomachache, backache, and feeling dizzy. We used structural equation modeling to explore the mediating effect of sleep...... duration on the association between computer use and symptom load. RESULTS: Adolescents slept approximately 8 h a night and computer use was approximately 2 h a day. Computer use was associated with shorter sleep duration and higher symptom load. Sleep duration partly mediated the association between...

CDKL5 deficiency entails sleep apneas in mice.

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Lo Martire, Viviana; Alvente, Sara; Bastianini, Stefano; Berteotti, Chiara; Silvani, Alessandro; Valli, Alice; Viggiano, Rocchina; Ciani, Elisabetta; Zoccoli, Giovanna

2017-08-01

A recently discovered neurodevelopmental disorder caused by the mutation of the cyclin-dependent kinase-like 5 gene (CDKL5) entails complex autistic-like behaviours similar to Rett syndrome, but its impact upon physiological functions remains largely unexplored. Sleep-disordered breathing is common and potentially life-threatening in patients with Rett syndrome; however, evidence is limited in children with CDKL5 disorder, and is lacking altogether in adults. The aim of this study was to test whether the breathing pattern during sleep differs between adult Cdkl5 knockout (Cdkl5-KO) and wild-type (WT) mice. Using whole-body plethysmography, sleep and breathing were recorded non-invasively for 8 h during the light period. Sleep apneas occurred more frequently in Cdkl5-KO than in WT mice. A receiver operating characteristic (ROC) analysis discriminated Cdkl5-KO significantly from WT mice based on sleep apnea occurrence. These data demonstrate that sleep apneas are a core feature of CDKL5 disorder and a respiratory biomarker of CDKL5 deficiency in mice, and suggest that sleep-disordered breathing should be evaluated routinely in CDKL5 patients. © 2017 European Sleep Research Society.

Consumer sleep monitors: is there a baby in the bathwater?

OpenAIRE

Bianchi, Matt; Russo,Kathryn; Goparaju,Balaji

2015-01-01

Kathryn Russo,1 Balaji Goparaju,1 Matt T Bianchi1,2 1Department of Neurology, Massachusetts General Hospital, 2Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA Abstract: The rapid expansion of consumer sleep devices is outpacing the validation data necessary to assess the potential use of these devices in clinical and research settings. Common sleep monitoring devices utilize a variety of sensors to track movement as well as cardiac and respiratory physiology. The variety ...

Obstructive sleep apnea as a risk factor for type 2 diabetes mellitus

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Rajan P

2015-10-01

Full Text Available Preethi Rajan, Harly Greenberg Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY, USA Abstract: Obstructive sleep apnea (OSA is independently associated with cardiovascular and cardiometabolic risk in several large epidemiologic studies. OSA leads to several physiologic disturbances such as intermittent hypoxia, sleep fragmentation, and increase in autonomic tone. These disturbances have been associated with insulin resistance and type 2 diabetes mellitus (T2DM in animal and human studies. Studies also suggest a bidirectional relationship between OSA and T2DM whereby T2DM itself might contribute to the features of OSA. Moreover, successful treatment of OSA may reduce these risks, although this is controversial. The purpose of this article is to review 1 the links and bidirectional associations between OSA and T2DM; 2 the pathogenic mechanisms that might link these two disease states; 3 the role of continuous positive airway pressure therapy in improving glucose tolerance, sensitivity, and resistance; and 4 the implications for clinical practice. Keywords: Insulin resistance, metabolic syndrome, sleep disordered breathing, intermittent hypoxia

The role of environmental factors on sleep patterns and school performance in adolescents

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Dagmara eDimitriou

2015-12-01

Full Text Available Background. Modern life, with its many distractions, is seeing sleep quantity and quality decline during adolescence. This is a concern as research persuasively demonstrates the negative impact of reduced sleep on academic achievement, both in terms of learning and behaviour.Aims. This study examined the relationship between sleep and school functioning in adolescence, with a focus on environmental factors that might mediate this relationship.Sample and method. Forty-seven adolescents took part. Sleep was measured using the School Sleep Habits Survey and a sleep diary. School records of year grade point averages provided a measure of academic achievement. Raven’s Standard Progressive Matrices gave a measure of general cognitive processing. Environmental sleep factors falling into three groups, namely, stimulant consumption, media use and exercise, were measured using a self-report questionnaire. Results. An average of 7.08 hours of sleep was reported. Correlations revealed that Total sleep time (TST and bedtimes on weekdays were strongly associated with academic achievement. Morning/eveningness and sleep/wake behaviour problems had a strong relationship with performance on the Ravens. Stimulant consumption and media use before bed revealed strong relationships with TST and bedtimes on weekdays. Crucially, mediation analyses confirmed that both caffeine consumption and electronic media use before bedtime were negatively associated with academic performance, via the mediating pathway by affecting sleep. Exercise was not associated with any of the sleep variables, but was associated with better academic performance.Conclusion. The current findings highlight that, now more than ever, parents, schools and policy makers must be aware of the negative effects of caffeinated substances marketed to students, and electronic media use on their sleep habits. Our findings suggest that targeting caffeine consumption and electronic media use before bed may

Efficacy and Safety of the Traditional Herbal Medicine, Gamiguibi-tang, in Patients With Cancer-Related Sleep Disturbance: A Prospective, Randomized, Wait-List-Controlled, Pilot Study.

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Lee, Jee Young; Oh, Hye Kyung; Ryu, Han Sung; Yoon, Sung Soo; Eo, Wankyu; Yoon, Seong Woo

2018-06-01

Sleep disturbance is the second most bothersome symptom in patients with cancer, and it can significantly impair their quality of life. The aim of this study was to investigate the efficacy and safety of the traditional herbal medicine Gamiguibi-tang (GGBT) in patients with cancer-related sleep disturbance. We conducted a prospective, randomized, wait-list-controlled, open-label pilot clinical trial on cancer-related sleep disturbance. Patients with cancer experiencing poor sleep quality with a Pittsburgh Sleep Quality Index of at least 6 were randomly assigned to the GGBT and wait-list groups to receive GGBT and conventional care, respectively, for 2 weeks. The primary endpoint was the Insomnia Severity Index (ISI) score. Fatigue, depression, and cognitive impairment were assessed as the secondary endpoints by using the Brief Fatigue Inventory (BFI), Beck Depression Inventory (BDI), and Montreal Cognitive Assessment (MoCA). Thirty participants who met the eligibility criteria were enrolled. Sleep disturbance assessed using the ISI improved significantly more in the GGBT group than in the wait-list group (-5.5 ± 4.4 vs 0.1 ± 1.1, P < .001). Fatigue level determined using the BFI also improved significantly more in the GGBT group than in the wait-list group (-0.8 ± 0.8 vs 0.0 ± 0.3, P = .002). The BDI and MoCA scores showed no significant changes. Adverse events were reported in two patients in the GGBT group and consisted of mild dyspepsia and mild edema. GGBT may be a potential treatment option for cancer-related sleep disturbance. Further research is needed to investigate the efficacy and safety of GGBT.

Medicine use for headache in adolescence predicts medicine use for headache in young adulthood

DEFF Research Database (Denmark)

Andersen, Anette; Holstein, Bjørn E; Due, Pernille

2009-01-01

BACKGROUND: Health risk behaviours such as smoking and binge drinking track from adolescence to adulthood. Medicine use is associated with smoking and binge drinking among adolescents. Whether medicine-use behaviour tracks from adolescence to adulthood is unknown. AIM: To examine tracking...... from adolescence into adulthood....

Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults.

Science.gov (United States)

Lao, Xiang Qian; Liu, Xudong; Deng, Han-Bing; Chan, Ta-Chien; Ho, Kin Fai; Wang, Feng; Vermeulen, Roel; Tam, Tony; Wong, Martin C S; Tse, L A; Chang, Ly-Yun; Yeoh, Eng-Kiong

2018-01-15

improve sleep for cardiovascular disease prevention. © 2018 American Academy of Sleep Medicine

Medicolegal aspects of complex behaviours arising from the sleep period: a review and guide for the practising sleep physician.

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Morrison, Ian; Rumbold, John M M; Riha, Renata L

2014-06-01

This review is aimed at summarizing the current state of knowledge regarding parasomnias, which have been implicated in medicolegal cases as well as providing guidance to those working within common-law jurisdictions regarding the technical aspects of the law. Sleepwalking and sexsomnia as a defence are being raised more frequently in criminal cases and there has been public debate on their validity. Unfortunately, expert evidence on forensic sleep disorders continues to be heavily opinion-based with the potential for miscarriages of justice seen in recent highly publicized cases. There is an apparent inertia in research into violent sleep disorders. We review the current state of forensic sleep science in the United Kingdom (UK) and abroad and discuss the need to formulate guidelines based on available evidence. We also highlight the pressing necessity for more research in this area as well as the need to reform the law, which is the subject of a recent Criminal Law Commission report in the United Kingdom. In time, this will facilitate the efficient, proportionate, and just disposal of violence arising from sleep, thus benefitting both society and the individual sufferer. Copyright © 2013 Elsevier Ltd. All rights reserved.

Impact of sleep on executive functioning in school-age children with Down syndrome.

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Esbensen, A J; Hoffman, E K

2018-06-01

Sleep problems have an impact on executive functioning in the general population. While children with Down syndrome (DS) are at high risk for sleep problems, the impact of these sleep problems on executive functioning in school-age children with DS is less well documented. Our study examined the relationship between parent-reported and actigraphy-measured sleep duration and sleep quality with parent and teacher reports and neuropsychology assessments of executive functioning among school-age children with DS. Thirty school-age children with DS wore an actigraph watch for a week at home at night. Their parent completed ratings of the child's sleep during that same week. Children completed a neuropsychology assessment of their inhibitory control, ability to shift and working memory. Their parents and teachers completed rating scales to assess these same constructs of executive functioning. Parent reports of restless sleep behaviours on the Children's Sleep Habits Questionnaire (CSHQ), but not actigraph-measured sleep period or efficiency, were predictive of parent reports of concerns with inhibitory control, shifting and working memory, and of teacher reports of inhibitory control. No measure of sleep was predictive of executive functioning as measured by the neuropsychology assessment. The study findings corroborate the preliminary literature that parent-reported sleep problems are related to executive functioning in school-age children with DS, particularly in the area of inhibitory control across home and school. These findings have implications for understanding contributing factors to academic performance and school behaviour in school-age children with DS. © 2018 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Sleep disorders associated with primary mitochondrial diseases.

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Ramezani, Ryan J; Stacpoole, Peter W

2014-11-15

Primary mitochondrial diseases are caused by heritable or spontaneous mutations in nuclear DNA or mitochondrial DNA. Such pathological mutations are relatively common in humans and may lead to neurological and neuromuscular complication that could compromise normal sleep behavior. To gain insight into the potential impact of primary mitochondrial disease and sleep pathology, we reviewed the relevant English language literature in which abnormal sleep was reported in association with a mitochondrial disease. We examined publication reported in Web of Science and PubMed from February 1976 through January 2014, and identified 54 patients with a proven or suspected primary mitochondrial disorder who were evaluated for sleep disturbances. Both nuclear DNA and mitochondrial DNA mutations were associated with abnormal sleep patterns. Most subjects who underwent polysomnography had central sleep apnea, and only 5 patients had obstructive sleep apnea. Twenty-four patients showed decreased ventilatory drive in response to hypoxia and/ or hyperapnea that was not considered due to weakness of the intrinsic muscles of respiration. Sleep pathology may be an underreported complication of primary mitochondrial diseases. The probable underlying mechanism is cellular energy failure causing both central neurological and peripheral neuromuscular degenerative changes that commonly present as central sleep apnea and poor ventilatory response to hyperapnea. Increased recognition of the genetics and clinical manifestations of mitochondrial diseases by sleep researchers and clinicians is important in the evaluation and treatment of all patients with sleep disturbances. Prospective population-based studies are required to determine the true prevalence of mitochondrial energy failure in subjects with sleep disorders, and conversely, of individuals with primary mitochondrial diseases and sleep pathology. © 2014 American Academy of Sleep Medicine.

Availability and affordability of essential medicines: exploring the health seeking behaviours and health service utilisation for children under-5 years living in squatter settlement of Karachi, Pakistan.

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Shafiq, Yasir; Shaikh, Babar Tasneem; Kumar, Ramesh

2011-01-01

Child health outcomes in the poor communities are largely affected by the non-availability of essential medicines at government health facilities and non-affordability of prescribed medicines at private retail pharmacies. This phenomenon largely defines health seeking behaviours and health service utilisation patterns of the families of the children. Using observational visits, we examined the shelf-availability of medicines for children less than 5 years of age at a rural health centre and conducted focus group discussions with the mothers to explore the effects of non-availability and non-affordability of medicines. We also validated all information by interviewing the health care providers of the area. We found that erratic and insufficient supply of essential medicines at the government health facility and a limited purchasing power to buy medicines from a retail pharmacy, led to considerable 'financial burden' on the poor people, non-compliance with the treatment, health care seeking from informal health providers and healer shopping. This trend has a serious repercussion on the health seeking behaviours and of course the health outcomes, especially among children. On the users' side, health education and health promotion campaign must be instituted to explain the adverse effects on child health ensure appropriate health care seeking behaviours. For the supply side, the health care authorities must ensure the availability of essential medicines for the children at the government facilities. Local community representatives must be involved in the matters related to medicines stock management at the facility.

Sleep-Related Erections Throughout the Ages

NARCIS (Netherlands)

van Driel, Mels F.

Introduction. The occurrence of sleep-related erections (SREs) has been known since antiquity. Aim. To highlight historical, theological, and sexual medicine-related aspects of SREs throughout the ages. Methods. Review of old medical books on male sexual functioning and review of scientific medical

[Sleep disturbances in Parkinson's disease: characteristics, evaluation and therapeutic approaches].

Science.gov (United States)

Faludi, Béla; Janszky, József; Komoly, Sámuel; Kovács, Norbert

2015-07-05

Parkinson's disease is a well known representent of the movement disorder group of neurological disorders. The diagnosis of Parkinson's disease is based on specific symptoms and signs of movement abnormalities. In addition to classic motor symptoms, Parkinson's disease has characteristic non-motor features, and some of these emerges the classic signs. The authors discuss characteristics and therapeutic interventions in Parkinson's disease related sleep disturbances. The authors reviewed and summarised literature data on sleep disorders in Parkinson's disease published in the PubMed database up to January 2015. Sleep problems are important non-motor complains (insomnia, hypersomnia, REM behaviour disorder, sleep apnea and restless legs syndrome). The neurodegenerative process of the brain-stem, the effect of symptoms of Parkinson's disease on sleep and concomitant sleep disorders constitute the background of the patient's complains. Appropriate diagnosis and therapy of the consequential or concomitant sleep disorders in Parkinson's disease will help to improve the patient's quality of life.

Sleep Deprivation and Time-Based Prospective Memory.

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Esposito, Maria José; Occhionero, Miranda; Cicogna, PierCarla

2015-11-01

To evaluate the effect of sleep deprivation on time-based prospective memory performance, that is, realizing delayed intentions at an appropriate time in the future (e.g., to take a medicine in 30 minutes). Between-subjects experimental design. The experimental group underwent 24 h of total sleep deprivation, and the control group had a regular sleep-wake cycle. Participants were tested at 08:00. Laboratory. Fifty healthy young adults (mean age 22 ± 2.1, 31 female). 24 h of total sleep deprivation. Participants were monitored by wrist actigraphy for 3 days before the experimental session. The following cognitive tasks were administered: one time-based prospective memory task and 3 reasoning tasks as ongoing activity. Objective and subjective vigilance was assessed by the psychomotor vigilance task and a visual analog scale, respectively. To measure the time-based prospective memory task we assessed compliance and clock checking behavior (time monitoring). Sleep deprivation negatively affected time-based prospective memory compliance (P sleep deprivation on human behavior, particularly the ability to perform an intended action after a few minutes. Sleep deprivation strongly compromises time-based prospective memory compliance but does not affect time check frequency. Sleep deprivation may impair the mechanism that allows the integration of information related to time monitoring with the prospective intention. © 2015 Associated Professional Sleep Societies, LLC.

Sleep timing is more important than sleep length or quality for medical school performance.

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Genzel, L; Ahrberg, K; Roselli, C; Niedermaier, S; Steiger, A; Dresler, M; Roenneberg, T

2013-07-01

Overwhelming evidence supports the importance of sleep for memory consolidation. Medical students are often deprived of sufficient sleep due to large amounts of clinical duties and university load, we therefore investigated how study and sleep habits influence university performance. We performed a questionnaire-based study with 31 medical students of the University of Munich (second and third clinical semesters; surgery and internal medicine). The students kept a diary (in 30-min bins) on their daily schedules (times when they studied by themselves, attended classes, slept, worked on their thesis, or worked to earn money). The project design involved three 2-wk periods (A: during the semester; B: directly before the exam period--pre-exam; C: during the subsequent semester break). Besides the diaries, students completed once questionnaires about their sleep quality (Pittsburgh Sleep Quality Index [PSQI]), their chronotype (Munich Chronotype Questionnaire [MCTQ]), and their academic history (previous grades, including the previously achieved preclinical board exam [PBE]). Analysis revealed significant correlations between the actual sleep behavior during the semester (MS(diary); mid-sleep point averaged from the sleep diaries) during the pre-exam period and the achieved grade (p = 0.002) as well as between the grades of the currently taken exam and the PBE (p = 0.002). A regression analysis with MS(diary) pre-exam and PBE as predictors in a model explained 42.7% of the variance of the exam grade (effect size 0.745). Interestingly, MS(diary)--especially during the pre-exam period-was the strongest predictor for the currently achieved grade, along with the preclinical board exam as a covariate, whereas the chronotype did not significantly influence the exam grade.

Insomnia in Iranian Traditional Medicine

OpenAIRE

Feyzabadi, Zohre; Jafari, Farhad; Feizabadi, Parvin Sadat; Ashayeri, Hassan; Esfahani, Mohammad Mahdi; Badiee Aval, Shapour

2014-01-01

Context: Insomnia is one of the most prevalent sleep disorders characterized by sleep difficulty that impairs daily functioning and reduces quality of life. The burden of medical, psychiatric, interpersonal, and societal consequences of insomnia expresses the importance of diagnosing and treatment of insomnia. The aim of study was to investigate causes of insomnia from the viewpoint of Iranian traditional medicine. Evidence Acquisition: In this review study, we searched insomnia in a few of t...

Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnoea syndrome: a randomised, placebo-controlled trial on self-reported symptoms of common sleep disorders and sleep-related problems.

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Nikolopoulou, M; Byraki, A; Ahlberg, J; Heymans, M W; Hamburger, H L; De Lange, J; Lobbezoo, F; Aarab, G

2017-06-01

Obstructive sleep apnoea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomised placebo-controlled trial, sixty-four OSAS patients (52·0 ± 9·6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design. All participants filled out the validated Dutch Sleep Disorders Questionnaire (SDQ) twice: one before treatment and one after six months of treatment. With 88 questions, thirteen scales were constructed, representing common sleep disorders and sleep-related problems. Linear mixed model analyses were performed to study differences between the groups for the different SDQ scales over time. The MAD group showed significant improvements over time in symptoms corresponding with 'insomnia', 'excessive daytime sleepiness', 'psychiatric sleep disorder', 'periodic limb movements', 'sleep apnoea', 'sleep paralysis', 'daytime dysfunction', 'hypnagogic hallucinations/dreaming', 'restless sleep', 'negative conditioning' and 'automatic behaviour' (range of P values: 0·000-0·014). These improvements in symptoms were, however, not significantly different from the improvements in symptoms observed in the nCPAP and placebo groups (range of P values: 0·090-0·897). It can be concluded that there is no significant difference between MAD and nCPAP in their positive effects on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. These beneficial effects may be a result of placebo effects. © 2017 John Wiley & Sons Ltd.

Sleep variability and fatigue in adolescents: Associations with school-related features.

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Matos, M G; Gaspar, T; Tomé, G; Paiva, T

2016-10-01

This study aims to evaluate the influences of sleep duration and sleep variability (SleepV), upon adolescents' school-related situations. The Health Behaviour in School-Aged Children (HBSC) survey is based on a self-completed questionnaire. The participants were 3164 pupils (53.7% girls), attending the 8th and 10th grades, 14.9 years old, and were inquired about subjective sleep duration during the week and weekends, SleepV, fatigue, difficulties in sleep initiation, school achievement, feelings towards schools, pressure with school work and skipping classes. Multiple regression models used, as dependent variables: (a) school achievement, (b) disliking school, (c) pressure with school work and (d) skipping classes, using as independent variables, each of the remaining school-related variables, fatigue, total sleep duration and difficulties in sleep initiation. The average sleep duration in the week and during weekdays was lower than recommended for these age groups, and almost half of students had high SleepV between weekdays and weekends. A logistic model revealed that the absence of SleepV was associated with lower perception of school work pressure, less frequent skipping classes, more infrequent fatigue and more infrequent difficulties in sleep initiation. Poor sleep quality, SleepV and insufficient sleep duration affected negatively school-related variables. © 2015 International Union of Psychological Science.

The hypocretin/orexin system in sleep disorders: preclinical insights and clinical progress

Directory of Open Access Journals (Sweden)

Chow M

2016-03-01

Full Text Available Matthew Chow, Michelle CaoDepartment of Psychiatry and Behavioral Sciences, Division of Sleep Medicine, Stanford University School of Medicine, Stanford, CA, USAAbstract: Much of the understanding of the hypocretin/orexin (HCRT/OX system in sleep–wake regulation came from narcolepsy–cataplexy research. The neuropeptides hypocretin-1 and -2/orexin-A and -B (HCRT-1 and -2/OX-A and -B, respectively, as we know, are intimately involved in the regulation wakefulness. The HCRT/OX system regulates sleep–wake control through complex interactions between monoaminergic/cholinergic (wake-promoting and gamma-aminobutyric acid-ergic (sleep-promoting neuronal systems. Deficiency of HCRT/OX results in loss of sleep–wake control or stability with consequent unstable transitions between wakefulness to nonrapid eye movement and rapid eye movement sleep. This manifests clinically as abnormal daytime sleepiness with sleep attacks and cataplexy. Research on the development of HCRT/OX agonists and antagonists for the treatment of sleep disorders has dramatically increased with the US Food and Drug Administration approval of the first-in-class dual HCRT/OX receptor antagonist for the treatment of insomnia. This review focuses on the origin, mechanisms of HCRT/OX receptors, clinical progress, and applications for the treatment of sleep disorders.Keywords: hypocretin, orexin, narcolepsy, insomnia, orexin antagonist, orexin agonist

Is There a Clinical Role For Smartphone Sleep Apps? Comparison of Sleep Cycle Detection by a Smartphone Application to Polysomnography.

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Bhat, Sushanth; Ferraris, Ambra; Gupta, Divya; Mozafarian, Mona; DeBari, Vincent A; Gushway-Henry, Neola; Gowda, Satish P; Polos, Peter G; Rubinstein, Mitchell; Seidu, Huzaifa; Chokroverty, Sudhansu

2015-07-15

Several inexpensive, readily available smartphone apps that claim to monitor sleep are popular among patients. However, their accuracy is unknown, which limits their widespread clinical use. We therefore conducted this study to evaluate the validity of parameters reported by one such app, the Sleep Time app (Azumio, Inc., Palo Alto, CA, USA) for iPhones. Twenty volunteers with no previously diagnosed sleep disorders underwent in-laboratory polysomnography (PSG) while simultaneously using the app. Parameters reported by the app were then compared to those obtained by PSG. In addition, an epoch-by-epoch analysis was performed by dividing the PSG and app graph into 15-min epochs. There was no correlation between PSG and app sleep efficiency (r = -0.127, p = 0.592), light sleep percentage (r = 0.024, p = 0.921), deep sleep percentage (r = 0.181, p = 0.444) or sleep latency (rs = 0.384, p = 0.094). The app slightly and nonsignificantly overestimated sleep efficiency by 0.12% (95% confidence interval [CI] -4.9 to 5.1%, p = 0.962), significantly underestimated light sleep by 27.9% (95% CI 19.4-36.4%, p sleep by 11.1% (CI 4.7-17.4%, p = 0.008) and significantly overestimated sleep latency by 15.6 min (CI 9.7-21.6, p sleep-wake detection (85.9%). The app had high sensitivity but poor specificity in detecting sleep (89.9% and 50%, respectively). Our study shows that the absolute parameters and sleep staging reported by the Sleep Time app (Azumio, Inc.) for iPhones correlate poorly with PSG. Further studies comparing app sleep-wake detection to actigraphy may help elucidate its potential clinical utility. A commentary on this article appears in this issue on page 695. © 2015 American Academy of Sleep Medicine.

Afternoon serum-melatonin in sleep disordered breathing.

Science.gov (United States)

Ulfberg, J; Micic, S; Strøm, J

1998-08-01

To study afternoon serum-melatonin values in patients with sleep disordered breathing. Melatonin has a strong circadian rhythm with high values during the night-time and low values in the afternoon. Sleep disordered breathing may change the circadian rhythm of melatonin which may have diagnostic implications. The Sleep Laboratory, The Department of Internal Medicine, Avesta Hospital, Sweden, and the Department of Anaesthesiology, Glostrup University Hospital, Copenhagen, Denmark. We examined 60 consecutive patients admitted for sleep disordered breathing and 10 healthy non snoring controls. The patients underwent a sleep apnoea screening test having a specificity of 100% for the obstructive sleep apnoea syndrome (OSAS) using a combination of static charge sensitive bed and oximetry. Obstructive sleep apnoea syndrome was found in 49 patients, eight patients had borderline sleep disordered breathing (BSDB) and three patients were excluded due to interfering disease. Patients and controls had an afternoon determination of serum-melatonin. The Epworth Sleepiness Scale was used to score day-time sleepiness. In comparison with normal controls patients suffering from OSAS had significantly higher serum-melatonin levels in the afternoon. However, as a diagnostic test for OSAS in patients with sleep disordered breathing serum-melatonin showed a low sensitivity but a high specificity. The results indicate that breathing disorders during sleep in general affect pineal function. Sleep disordered breathing seems to disturb pineal function. Determination of afternoon serum-melatonin alone or together with a scoring of daytime sleepiness does not identify OSAS-patients in a heterogeneous population of patients complaining of heavy snoring and excessive daytime sleepiness.

Leadership Primer for Current and Aspiring Pulmonary, Critical Care, and Sleep Medicine Academic Division Chiefs.

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Nguyen, H Bryant; Thomson, Carey C; Kaminski, Naftali; Schnapp, Lynn M; Madison, J Mark; Glenny, Robb W; Dixon, Anne E

2018-02-27

An academic medical career traditionally revolves around patient care, teaching, and scholarly projects. Thus, when an opportunity for a leadership role arises, such as Division Chief, the new leader is often unprepared with little or no formal leadership training. In this article, academic leaders of the Association of Pulmonary, Critical Care and Sleep Division Directors reviewed several leadership concepts adapted from the business sector and applied years of their experience to aid new division chiefs with their first day on the job. The first 90 days are highlighted to include accomplishing the early wins, performing a division Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, establishing division rapport, redefining the division infrastructure, avoiding conflicts, and managing their relationship with the department chair. The five levels of leadership applicable to academic medicine are discussed: position, permission, production, people, and pinnacle. Finally, emotional intelligence and behavior styles crucial to leadership success are reviewed.

The role of environmental factors on sleep patterns and school performance in adolescents

OpenAIRE

Dagmara eDimitriou; Dagmara eDimitriou; Frances eLe Cornu Knight; Frances eLe Cornu Knight; Patrick eMilton; Patrick eMilton

2015-01-01

Background. Modern life, with its many distractions, is seeing sleep quantity and quality decline during adolescence. This is a concern as research persuasively demonstrates the negative impact of reduced sleep on academic achievement, both in terms of learning and behaviour.Aims. This study examined the relationship between sleep and school functioning in adolescence, with a focus on environmental factors that might mediate this relationship.Sample and method. Forty-seven adolescents took pa...

Synchronizing Education to Adolescent Biology: "Let Teens Sleep, Start School Later"

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Kelley, Paul; Lockley, Steven W.; Foster, Russell G.; Kelley, Jonathan

2015-01-01

Arne Duncan, US Secretary of State for Education, tweeted in 2013: "let teens sleep, start school later". This paper examines early starts and their negative consequences in the light of key research in the last 30 years in sleep medicine and circadian neuroscience. An overview of the circadian timing system in adolescence leading to…

Does Elite Sport Degrade Sleep Quality? A Systematic Review

OpenAIRE

Gupta, Luke; Morgan, Kevin; Gilchrist, Sarah

2016-01-01

Background Information on sleep quality and insomnia symptomatology among elite athletes remains poorly systematised in the sports science and medicine literature. The extent to which performance in elite sport represents a risk for chronic insomnia is unknown. Objectives The purpose of this systematic review was to profile the objective and experienced characteristics of sleep among elite athletes, and to consider relationships between elite sport and insomnia symptomatology. Methods Studies...

Novel method for detection of Sleep Apnoea using respiration signals

DEFF Research Database (Denmark)

Nielsen, Kristine Carmes; Kempfner, Lykke; Sørensen, Helge Bjarup Dissing

2014-01-01

desaturations > 3%, extracted from the thorax and abdomen respiration effort belts, and the oxyhemoglobin saturation (SaO2), fed to an Elastic Net classifier and validated according to American Academy of Sleep Medicine (AASM) using the patients' AHI value. The method was applied to 109 patient recordings......Polysomnography (PSG) studies are considered the “gold standard” for the diagnosis of Sleep Apnoea (SA). Identifying cessations of breathing from long-lasting PSG recordings manually is a labour-intensive and time-consuming task for sleep specialist, associated with inter-scorer variability...

Screening midlife women for sleep problems: why, how, and who should get a referral?

Science.gov (United States)

Lee, Kathryn A; Anderson, Debra J

2015-07-01

Advancements in sleep medicine have been escalating ever since research began appearing in the 1950s. As with most early clinical trials, women were excluded from participation. Even if researchers included women or addressed sex differences by age, reproductive stage was seldom considered. Recently, there has been an exponential increase in research on sleep in midlife and older women. This Practice Pearl briefly reviews the importance of adequate sleep, clinical assessment for sleep disorders, and guidelines for practice.

The Clinical Validation of the Athlete Sleep Screening Questionnaire: an Instrument to Identify Athletes that Need Further Sleep Assessment.

Science.gov (United States)

Bender, Amy M; Lawson, Doug; Werthner, Penny; Samuels, Charles H

2018-06-04

Previous research has established that general sleep screening questionnaires are not valid and reliable in an athlete population. The Athlete Sleep Screening Questionnaire (ASSQ) was developed to address this need. While the initial validation of the ASSQ has been established, the clinical validity of the ASSQ has yet to be determined. The main objective of the current study was to evaluate the clinical validity of the ASSQ. Canadian National Team athletes (N = 199; mean age 24.0 ± 4.2 years, 62% females; from 23 sports) completed the ASSQ. A subset of athletes (N = 46) were randomized to the clinical validation sub-study which required subjects to complete an ASSQ at times 2 and 3 and to have a clinical sleep interview by a sleep medicine physician (SMP) who rated each subjects' category of clinical sleep problem and provided recommendations to improve sleep. To assess clinical validity, the SMP category of clinical sleep problem was compared to the ASSQ. The internal consistency (Cronbach's alpha = 0.74) and test-retest reliability (r = 0.86) of the ASSQ were acceptable. The ASSQ demonstrated good agreement with the SMP (Cohen's kappa = 0.84) which yielded a diagnostic sensitivity of 81%, specificity of 93%, positive predictive value of 87%, and negative predictive value of 90%. There were 25.1% of athletes identified to have clinically relevant sleep disturbances that required further clinical sleep assessment. Sleep improved from time 1 at baseline to after the recommendations at time 3. Sleep screening athletes with the ASSQ provides a method of accurately determining which athletes would benefit from preventative measures and which athletes suffer from clinically significant sleep problems. The process of sleep screening athletes and providing recommendations improves sleep and offers a clinical intervention output that is simple and efficient for teams and athletes to implement.

Smartphone viewing distance and sleep: an experimental study utilizing motion capture technology

Directory of Open Access Journals (Sweden)

Yoshimura M

2017-03-01

Full Text Available Michitaka Yoshimura,1,* Momoko Kitazawa,1–3,* Yasuhiro Maeda,2 Masaru Mimura,4 Kazuo Tsubota,1 Taishiro Kishimoto,4,5 1Department of Ophthalmology, Keio University School of Medicine, Tokyo, 2RIKEN Center for Advanced Photonics, Wako, Saitama, 3Department of Nursing, Aino University Junior College, 4Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; 5Department of Psychiatry, Hofstra Northwell School of Medicine, NY, USA *These authors contributed equally to this work Abstract: There are studies reporting the negative impact of smartphone utilization on sleep. It is considered that reduction of melatonin secretion under the blue light exposure from smartphone displays is one of the causes. The viewing distance may cause sleep disturbance, because the viewing distance determines the screen illuminance and/or asthenopia. However, to date, there has been no study closely investigating the impact of viewing distance on sleep; therefore, we sought to determine the relationship between smartphone viewing distance and subjective sleep status. Twenty-three nursing students (mean age ± standard deviation of 19.7±3.1 years participated in the study. Subjective sleep status was assessed using the Pittsburgh Sleep Quality Index, morningness–eveningness questionnaire, and the Epworth sleepiness scale. We used the distance between the head and the hand while holding a smartphone to measure the viewing distance while using smartphones in sitting and lying positions. The distance was calculated using the three-dimensional coordinates obtained by a noncontact motion-sensing device. The viewing distance of smartphones in the sitting position ranged from 13.3 to 32.9 cm among participants. In the lying position, it ranged from 9.9 to 21.3cm. The viewing distance was longer in the sitting position than in the lying position (mean ± standard deviation: 20.3±4.7 vs 16.4±2.7, respectively, P<0.01. We found that the short viewing

Dream Recall Frequencies and Dream Content in Wilson's Disease with and without REM Sleep Behaviour Disorder: A Neurooneirologic Study.

Science.gov (United States)

Tribl, Gotthard G; Trindade, Mateus C; Schredl, Michael; Pires, Joana; Reinhard, Iris; Bittencourt, Thais; Lorenzi-Filho, Geraldo; Alves, Rosana Cardoso; de Andrade, Daniel Ciampi; Fonoff, Erich T; Bor-Seng-Shu, Edson; Machado, Alexandre A; Teixeira, Manoel J; Barbosa, Egberto R

2016-01-01

Objective. Violent dream content and its acting out during rapid eye movement sleep are considered distinctive for rapid eye movement sleep behaviour disorder (RBD). This study reports first quantitative data on dreaming in a cohort of patients with treated Wilson's disease (WD) and in patients with WD with RBD. Methods. Retrospective questionnaires on different dimensions of dreaming and a prospective two-week home dream diary with self-rating of emotions and blinded, categorical rating of content by an external judge. Results. WD patients showed a significantly lower dream word count and very few other differences in dream characteristics compared to age- and sex-matched healthy controls. Compared to WD patients without RBD, patients with WD and RBD reported significantly higher nightmare frequencies and more dreams with violent or aggressive content retrospectively; their prospectively collected dream reports contained significantly more negative emotions and aggression. Conclusions. The reduction in dream length might reflect specific cognitive deficits in WD. The lack of differences regarding dream content might be explained by the established successful WD treatment. RBD in WD had a strong impact on dreaming. In accordance with the current definition of RBD, violent, aggressive dream content seems to be a characteristic of RBD also in WD.

Quantifying Leg Movement Activity During Sleep.

Science.gov (United States)

Ferri, Raffaele; Fulda, Stephany

2016-12-01

Currently, 2 sets of similar rules for recording and scoring leg movement (LM) exist, including periodic LM during sleep (PLMS) and periodic LM during wakefulness. The former were published in 2006 by a task force of the International Restless Legs Syndrome Study Group, and the second in 2007 by the American Academy of Sleep Medicine. This article reviews the basic recording methods, scoring rules, and computer-based programs for PLMS. Less frequent LM activities, such as alternating leg muscle activation, hypnagogic foot tremor, high-frequency LMs, and excessive fragmentary myoclonus are briefly described. Copyright © 2016 Elsevier Inc. All rights reserved.

Can body temperature dysregulation explain the co-occurrence between overweight/obesity, sleep impairment, late-night eating, and a sedentary lifestyle?

Science.gov (United States)

Brown, Rhonda F; Thorsteinsson, Einar B; Smithson, Michael; Birmingham, C Laird; Aljarallah, Hessah; Nolan, Christopher

2017-12-01

Overweight/obesity, sleep disturbance, night eating, and a sedentary lifestyle are common co-occurring problems. There is a tendency for them to co-occur together more often than they occur alone. In some cases, there is clarity as to the time course and evolution of the phenomena. However, specific mechanism(s) that are proposed to explain a single co-occurrence cannot fully explain the more generalized tendency to develop concurrent symptoms and/or disorders after developing one of the phenomena. Nor is there a clinical theory with any utility in explaining the development of co-occurring symptoms, disorders and behaviour and the mechanism(s) by which they occur. Thus, we propose a specific mechanism-dysregulation of core body temperature (CBT) that interferes with sleep onset-to explain the development of the concurrences. A detailed review of the literature related to CBT and the phenomena that can alter CBT or are altered by CBT is provided. Overweight/obesity, sleep disturbance and certain behaviour (e.g. late-night eating, sedentarism) were linked to elevated CBT, especially an elevated nocturnal CBT. A number of existing therapies including drugs (e.g. antidepressants), behavioural therapies (e.g. sleep restriction therapy) and bright light therapy can also reduce CBT. An elevation in nocturnal CBT that interferes with sleep onset can parsimoniously explain the development and perpetuation of common co-occurring symptoms, disorders and behaviour including overweight/obesity, sleep disturbance, late-night eating, and sedentarism. Nonetheless, a significant correlation between CBT and the above symptoms, disorders and behaviour does not necessarily imply causation. Thus, statistical and methodological issues of relevance to this enquiry are discussed including the likely presence of autocorrelation. Level V, narrative review.

Complex sleep apnea syndrome

Directory of Open Access Journals (Sweden)

Wang J

2013-07-01

Full Text Available Juan Wang,1,* Yan Wang,1,* Jing Feng,1,2 Bao-yuan Chen,1 Jie Cao1 1Respiratory Department of Tianjin Medical University General Hospital, Tianjin, People's Republic of China; 2Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC, USA *The first two authors contributed equally to this work Abstract: Complex sleep apnea syndrome (CompSAS is a distinct form of sleep-disordered breathing characterized as central sleep apnea (CSA, and presents in obstructive sleep apnea (OSA patients during initial treatment with a continuous positive airway pressure (CPAP device. The mechanisms of why CompSAS occurs are not well understood, though we have a high loop gain theory that may help to explain it. It is still controversial regarding the prevalence and the clinical significance of CompSAS. Patients with CompSAS have clinical features similar to OSA, but they do exhibit breathing patterns like CSA. In most CompSAS cases, CSA events during initial CPAP titration are transient and they may disappear after continued CPAP use for 4–8 weeks or even longer. However, the poor initial experience of CompSAS patients with CPAP may not be avoided, and nonadherence with continued therapy may often result. Treatment options like adaptive servo-ventilation are available now that may rapidly resolve the disorder and relieve the symptoms of this disease with the potential of increasing early adherence to therapy. But these approaches are associated with more expensive and complicated devices. In this review, the definition, potential plausible mechanisms, clinical characteristics, and treatment approaches of CompSAS will be summarized. Keywords: complex sleep apnea syndrome, obstructive sleep apnea, central sleep apnea, apnea threshold, continuous positive airway pressure, adaptive servo-ventilation

Postoperative Sleep Disturbances after Zolpidem Treatment in Fast-Track Hip and Knee Replacement

DEFF Research Database (Denmark)

Krenk, Lene; Jennum, Poul; Kehlet, Henrik

2014-01-01

STUDY OBJECTIVES: Previous studies have demonstrated pronounced reduction of REM sleep on the first nights following major surgery which may influence pain, analgesic use, and recovery. This placebo-controlled, randomized, double-blind study set out to evaluate the effect of zolpidem on sleep....... Polysomnography measures were performed for 2 nights, 1 night at home prior to surgery and on the first night after surgery, when the patient received placebo or zolpidem 10 mg. Analgesic use, pain levels, and subjective measures of fatigue and sleep quality were recorded. Analysis of sleep data was performed...... according to the American Academy of Sleep Medicine manual. RESULTS: Objective sleep data did not show a significant difference between groups in any of the sleep stages. However, subjective data on sleep quality and fatigue showed significantly less fatigue and better sleep quality in the zolpidem group (p...

Thermal-Signature-Based Sleep Analysis Sensor

Directory of Open Access Journals (Sweden)

Ali Seba

2017-10-01

Full Text Available This paper addresses the development of a new technique in the sleep analysis domain. Sleep is defined as a periodic physiological state during which vigilance is suspended and reactivity to external stimulations diminished. We sleep on average between six and nine hours per night and our sleep is composed of four to six cycles of about 90 min each. Each of these cycles is composed of a succession of several stages of sleep that vary in depth. Analysis of sleep is usually done via polysomnography. This examination consists of recording, among other things, electrical cerebral activity by electroencephalography (EEG, ocular movements by electrooculography (EOG, and chin muscle tone by electromyography (EMG. Recordings are made mostly in a hospital, more specifically in a service for monitoring the pathologies related to sleep. The readings are then interpreted manually by an expert to generate a hypnogram, a curve showing the succession of sleep stages during the night in 30s epochs. The proposed method is based on the follow-up of the thermal signature that makes it possible to classify the activity into three classes: “awakening,” “calm sleep,” and “restless sleep”. The contribution of this non-invasive method is part of the screening of sleep disorders, to be validated by a more complete analysis of the sleep. The measure provided by this new system, based on temperature monitoring (patient and ambient, aims to be integrated into the tele-medicine platform developed within the framework of the Smart-EEG project by the SYEL–SYstèmes ELectroniques team. Analysis of the data collected during the first surveys carried out with this method showed a correlation between thermal signature and activity during sleep. The advantage of this method lies in its simplicity and the possibility of carrying out measurements of activity during sleep and without direct contact with the patient at home or hospitals.

Associations of quality of sleep with lifestyle factors and profile of studies among Lithuanian students.

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Preišegolavičiūtė, Evelina; Leskauskas, Darius; Adomaitienė, Virginija

2010-01-01

The objective of the study was to analyze associations among quality of sleep, profile of the studies, and lifestyle factors among the students of three different study profiles (medicine, economics, and law). A total of 405 randomly selected students from the first and fourth years of studies from 4 different universities in Lithuania answered the standardized questionnaires consisting of two parts: 1) the Pittsburgh Sleep Quality Index (PSQI) for subjective evaluation of sleep quality; 2) the questionnaire about sleep and lifestyle habits and impact of poor sleep on the quality of life developed by the researchers. More than half (59.4%) of the students scored higher than 5 on the PSQI, which allowed suspecting sleep disorders. A significant difference in the frequency of poor sleepers was found regarding the profile of studies (Pstudents. There was a significant correlation between quality of sleep and subjective evaluation of quality of life (Pstudents experienced the highest impact of poor sleep on the quality of life (P=0.008). Students studying before going to sleep, spending more time studying, and having less leisure time had worse quality of sleep (Pstudents of medicine. The incidence of sleep problems is high among students in Lithuania, reaching 59.4%. Medical students have worse quality of sleep and worse impact of poor sleep on the quality of life compared to students of law and economics. A significant difference was found between medical students and their peers in other profiles of studies regarding their attitudes and habits related to studies: medical students spent more time for studying, were more anxious about studies and less satisfied with the results, studied more often before going to sleep.

Sleep-apnea risk and subclinical atherosclerosis in early-middle-aged retired National Football League players

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Luyster FS

2017-02-01

Full Text Available Faith S Luyster,1 Reginald E Dunn,2 Diane S Lauderdale,3 Mercedes R Carnethon,4 Andrew M Tucker,5 Robert A Vogel,6 Andrew E Lincoln,2 Kristen L Knutson,7 Elliot J Pellman,8–10 Patrick J Strollo Jr11 1School of Nursing, University of Pittsburgh, Pittsburgh, PA, 2Sports Medicine Research Center, MedStar Health Research Institute, Baltimore, MD, 3Department of Public Health Sciences, University of Chicago, 4Department of Preventive Medicine, Northwestern University, Chicago, IL, 5MedStar Sports Medicine, MedStar Union Memorial Hospital, Baltimore, MD, 6Cardiology Section, Department of Veterans Affairs Medical Center, Denver, CO, 7Department of Medicine, University of Chicago, Chicago, IL, 8ProHealth Care Associates, Lake Success, 9Department of Medicine, 10Department of Orthopedics, Mount Sinai School of Medicine, New York, NY, 11Department of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA Purpose: Limited data from former National Football League (NFL players suggest that obstructive sleep apnea (OSA may be highly prevalent after retirement. It remains unclear whether the high prevalence of OSA in retired players is comparable to nonathletes. This retrospective analysis compared sleep apnea (SA risk in retired NFL players to a community cohort (CARDIA Sleep study, and examined associations between SA risk and cardiovascular risk factors, including subclinical atherosclerosis.Materials and methods: Retired NFL players (n=122 were matched to CARDIA Sleep participants by age ±2 years (range 37–55 years, body mass index ±2 kg/m2, race, and male sex. Participants underwent electron-beam computed tomography to measure coronary artery calcium (CAC and completed the Berlin Questionnaire to determine SA risk. The presence of CAC was defined as an Agatston score >0.Results: Retired NFL players had a greater prevalence of high SA risk than the matched CARDIA Sleep participants (27% vs 11

In Search of a Safe Natural Sleep Aid.

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Rao, Theertham P; Ozeki, Motoko; Juneja, Lekh R

2015-01-01

Sleep deprivation is associated with an elevated risk of various diseases and leads to a poor quality of life and negative socioeconomic consequences. Sleep inducers such as drugs and herbal medicines may often lead to dependence and other side effects. L-Theanine (γ-glutamylethylamide), an amino acid naturally found abundant in tea leaves, has anxiolytic effects via the induction of α brain waves without additive and other side effects associated with conventional sleep inducers. Anxiolysis is required for the initiation of high-quality sleep. In this study, we review the mechanism(s), safety, and efficacy of L-theanine. Collectively, sleep studies based on an actigraph, the obstructive sleep apnea (OSA) sleep inventory questionnaire, wakeup after sleep onset (WASO) and automatic nervous system (ANS) assessment, sympathetic and parasympathetic nerve activities, and a pediatric sleep questionnaire (PSQ) suggest that the administration of 200 mg of L-theanine before bed may support improved sleep quality not by sedation but through anxiolysis. Because L-theanine does not induce daytime drowsiness, it may be useful at any time of the day. The no observable adverse effect level (NOAEL) for the oral administration of L-theanine was determined to be above 2000 mg/kg bw/day. KEY TEACHING POINTS: Sleep deprivation-associated morbidity is an increasing public health concern posing a substantial socioeconomic burden. Chronic sleep disorders may seriously affect quality of life and may be etiological factors in a number of chronic diseases such as depression, obesity, diabetes, and cardiovascular diseases. Most sleep inducers are sedatives and are often associated with addiction and other side effects. L-Theanine promotes relaxation without drowsiness. Unlike conventional sleep inducers, L-theanine is not a sedative but promotes good quality of sleep through anxiolysis. This review suggests that L-theanine is a safe natural sleep aid.

Sleep quality and functional gastrointestinal disorders. A psychological issue.

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Bouchoucha, Michel; Mary, Florence; Bon, Cyriaque; Bejou, Bakhtiar; Airinei, Gheorghe; Benamouzig, Robert

2018-02-01

Sleep disorders are often associated with functional gastrointestinal disorders (FGIDs). This study aims to evaluate the association of sleep disorders with specific FGIDs and to assess the related importance of psychological disorders. We included 1009 consecutive patients with FGIDs (70.9% females). The patients completed a Rome III questionnaire and after a psychological evaluation on anxiety and depression they were classified according to their sleep disorders using a 7-point grading scale: Groups 1-3, drowsiness (severe, moderate, mild); Group 4, no change; Groups 5-7, insomnia (mild, moderate, severe). Multinomial logistic regression using sleep group as a dependent variable with no sleep change as reference and body mass index, FGIDs, anxiety and depression as independent variables were used for statistical analysis. Altogether 667 (66.1%) patients reported changes in sleep disorders, of whom 487 (48.3%) had decreased sleep and 180 (17.8%) had increased sleep while 342 (33.9%) reported no change. Depression was lower in patients with no change in sleep pattern and increased with the severity of their sleep disorder (P proctalgia fugax. Sleep disorders are associated with FGIDs, especially in the presence of depressive symptoms. © 2018 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

iFlit: an ambient display to induce cognitive dissonance and behaviour change

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R. Maimone

2014-03-01

Full Text Available In this paper, we explore how persuasive ambient displays could induce cognitive dissonance to promote positive behaviour change among graduate students. We developed iFlit –an interactive and collective ambient display that enables a group of students to reflect on their burnout level, and sleeping and activity habits. iFlit shows a garden with birds representing students monitored behaviour. Birds move according to users’ activity level, and the garden’s background changes according to each user’s sleeping habits. Users match peers perceived burnout, and sleep and activity habits to induce cognitive dissonance. We argue such displays are more efficient than personal devices to empower individuals’ self-reflection due their capabilities for enabling a playful interaction with their personal data.

Symptoms of Common Mental Disorders and Adverse Health Behaviours in Male Professional Soccer Players

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Gouttebarge Vincent

2015-12-01

Full Text Available To present time, scientific knowledge about symptoms of common mental disorders and adverse health behaviours among professional soccer players is lacking. Consequently, the aim of the study was to determine the prevalence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance and adverse health behaviours (adverse alcohol behaviour, smoking, adverse nutrition behaviour among professional soccer players, and to explore their associations with potential stressors (severe injury, surgery, life events and career dissatisfaction. Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among male professional players. Using validated questionnaires to assess symptoms of common mental disorders and adverse health behaviours as well as stressors, an electronic questionnaire was set up and distributed by players’ unions in 11 countries from three continents. Prevalence of symptoms of common mental disorders and adverse health behaviours among professional soccer players ranged from 4% for smoking and 9% for adverse alcohol behaviour to 38% for anxiety/depression and 58% for adverse nutrition behaviour. Significant associations were found for a higher number of severe injuries with distress, anxiety/depression, sleeping disturbance and adverse alcohol behaviour, an increased number of life events with distress, sleeping disturbance, adverse alcohol behaviour and smoking, as well as an elevated level of career dissatisfaction with distress, anxiety/depression and adverse nutrition behaviour. Statistically significant correlations (p<0.01 were found for severe injuries and career dissatisfaction with most symptoms of common mental disorders. High prevalence of symptoms of common mental disorders and adverse health behaviours was found among professional players, confirming a previous pilot-study in a similar study population.

REM sleep at its core—Circuits, neurotransmitters and pathophysiology

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John ePeever

2015-05-01

Full Text Available REM sleep is generated and maintained by the interaction of a variety of neurotransmitter systems in the brainstem, forebrain and hypothalamus. Within these circuits lies a core region that is active during REM sleep, known as the subcoeruleus nucleus (SubC or sublaterodorsal nucleus. It is hypothesized that glutamatergic SubC neurons regulate REM sleep and its defining features such as muscle paralysis and cortical activation. REM sleep paralysis is initiated when glutamatergic SubC activate neurons in the ventral medial medulla (VMM, which causes release of GABA and glycine onto skeletal motoneurons. REM sleep timing is controlled by activity of GABAergic neurons in the ventrolateral periaqueductal gray (vlPAG and dorsal paragigantocellular reticular nucleus (DPGi as well as melanin-concentrating hormone (MCH neurons in the hypothalamus and cholinergic cells in the laterodorsal (LDT and pedunculo-pontine tegmentum (PPT in the brainstem. Determining how these circuits interact with the SubC is important because breakdown in their communication is hypothesized to underlie cataplexy/narcolepsy and REM sleep behaviour disorder (RBD. This review synthesizes our current understanding of mechanisms generating healthy REM sleep and how dysfunction of these circuits contributes to common REM sleep disorders such as cataplexy/narcolepsy and RBD.

Impact of obstructive sleep apnea on blood pressure in patients with hypertension

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Gurubhagavatula I

2011-12-01

Full Text Available Barry Fields1, Indira Gurubhagavatula1–31Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, 2Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, 3Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USAAbstract: Hypertension is the most significant risk factor for death worldwide. Approximately 30%–40% of affected individuals have coexisting obstructive sleep apnea (OSA, a disorder resulting from the upper airway’s inability to remain patent during sleep. A causal relationship between OSA and hypertension has been demonstrated. Blunting or elimination of normal blood pressure (BP dipping during sleep is commonly seen in OSA patients, with corresponding increases in daytime BP. This dipping is clinically salient, because it is associated with the end-organ damage seen with chronic hypertension, such as cardiovascular, renal, and cerebrovascular disease. African-Americans are at greatest risk for non-dipping and end-organ damage. Rapidly fluctuating changes in sympathetic tone, intrathoracic pressure, oxyhemoglobin saturation, and carbon dioxide levels are all thought to play a role in acute and chronic BP elevation. Individuals with preexisting hypertension are most susceptible to OSA’s BP-raising effects. First-line therapy for OSA includes continuous positive airway pressure (CPAP delivered via a mask interface. Patients who show the greatest BP declines while using CPAP are more likely to be those who have at least moderate OSA, adhere to therapy, have preexisting hypertension, and whose blood vessels retain reversibility in disease-related remodeling. Given the heavy burden OSA-related hypertension places on the healthcare system, prevention, early detection, and prompt intervention should be the goals for all affected individuals.Keywords: obstructive sleep apnea (OSA, hypertension, nocturnal dipping, continuous positive airway pressure (CPAP

Does Elite Sport Degrade Sleep Quality? A Systematic Review.

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Gupta, Luke; Morgan, Kevin; Gilchrist, Sarah

2017-07-01

Information on sleep quality and insomnia symptomatology among elite athletes remains poorly systematised in the sports science and medicine literature. The extent to which performance in elite sport represents a risk for chronic insomnia is unknown. The purpose of this systematic review was to profile the objective and experienced characteristics of sleep among elite athletes, and to consider relationships between elite sport and insomnia symptomatology. Studies relating to sleep involving participants described on a pre-defined continuum of 'eliteness' were located through a systematic search of four research databases: SPORTDiscus, PubMed, Science Direct and Google Scholar, up to April 2016. Once extracted, studies were categorised as (1) those mainly describing sleep structure/patterns, (2) those mainly describing sleep quality and insomnia symptomatology and (3) those exploring associations between aspects of elite sport and sleep outcomes. The search returned 1676 records. Following screening against set criteria, a total of 37 studies were identified. The quality of evidence reviewed was generally low. Pooled sleep quality data revealed high levels of sleep complaints in elite athletes. Three risk factors for sleep disturbance were broadly identified: (1) training, (2) travel and (3) competition. While acknowledging the limited number of high-quality evidence reviewed, athletes show a high overall prevalence of insomnia symptoms characterised by longer sleep latencies, greater sleep fragmentation, non-restorative sleep, and excessive daytime fatigue. These symptoms show marked inter-sport differences. Two underlying mechanisms are implicated in the mediation of sport-related insomnia symptoms: pre-sleep cognitive arousal and sleep restriction.

Seasonal aspects of sleep in the Djungarian hamster

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Deboer Tom

2003-05-01

Full Text Available Abstract Background Changes in photoperiod and ambient temperature trigger seasonal adaptations in the physiology and behaviour of many species, including the Djungarian hamster. Exposure of the hamsters to a short photoperiod and low ambient temperature leads to a reduction of the polyphasic distribution of sleep and waking over the light and dark period. In contrast, a long photoperiod enhances the daily sleep-wake amplitude leading to a decline of slow-wave activity in NREM sleep within the light period. It is unknown whether these changes can be attributed specifically to photoperiod and/or ambient temperature, or whether endogenous components are contributing factors. The influence of endogenous factors was investigated by recording sleep in Djungarian hamsters invariably maintained at a low ambient temperature and fully adapted to a short photoperiod. The second recording was performed when they had returned to summer physiology, despite the maintenance of the 'winter' conditions. Results Clear winter-summer differences were seen in sleep distribution, while total sleep time was unchanged. A significantly higher light-dark cycle modulation in NREM sleep, REM sleep and waking was observed in hamsters in the summer physiological state compared to those in the winter state. Moreover, only in summer, REM sleep episodes were longer and waking bouts were shorter during the light period compared to the dark period. EEG power in the slow-wave range (0.75–4.0 Hz in both NREM sleep and REM sleep was higher in animals in the summer physiological state than in those in the 'winter' state. In winter SWA in NREM sleep was evenly distributed over the 24 h, while in summer it decreased during the light period and increased during the dark period. Conclusion Endogenous changes in the organism underlie the differences in sleep-wake redistribution we have observed previously in hamsters recorded in a short and long photoperiod.

Obstructive Sleep Apnoea Syndrome and Weight Loss: Review

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Douglas C. Cowan

2012-01-01

Full Text Available Obstructive sleep apnoea (OSA syndrome is common, and obesity is a major risk factor. Increased peripharyngeal and central adiposity result in increased pharyngeal collapsibility, through increased mechanical loading around the upper airway, reduced tracheal traction on the pharynx, and reduced neuromuscular activity, particularly during sleep. Significant and sustained weight loss, if achieved, is likely to be a useful therapeutic option in the management of OSA and may be attempted by behavioural, pharmacological, and surgical approaches. Behavioural therapy programs that focus on aspects such as dietary intervention, exercise prescription patients and general lifestyle counselling have been tested. Bariatric surgery is an option in the severely obese when nonsurgical measures have failed, and laparoscopic adjustable gastric banding and Roux-en-Y gastric bypass are the most commonly employed techniques in the United Kingdom. Most evidence for efficacy of surgery comes from cohort studies. The role of sibutramine in OSA in the obese patients has been investigated, however, there are concerns regarding associated cardiovascular risk. In this paper the links between obesity and OSA are discussed, and the recent studies evaluating the behavioural, pharmacological and surgical approaches to weight loss in OSA are reviewed.

Understanding sleep disturbance in athletes prior to important competitions.

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Juliff, Laura E; Halson, Shona L; Peiffer, Jeremiah J

2015-01-01

Anecdotally many athletes report worse sleep in the nights prior to important competitions. Despite sleep being acknowledged as an important factor for optimal athletic performance and overall health, little is understood about athlete sleep around competition. The aims of this study were to identify sleep complaints of athletes prior to competitions and determine whether complaints were confined to competition periods. Cross-sectional study. A sample of 283 elite Australian athletes (129 male, 157 female, age 24±5 y) completed two questionnaires; Competitive Sport and Sleep questionnaire and the Pittsburgh Sleep Quality Index. 64.0% of athletes indicated worse sleep on at least one occasion in the nights prior to an important competition over the past 12 months. The main sleep problem specified by athletes was problems falling asleep (82.1%) with the main reasons responsible for poor sleep indicated as thoughts about the competition (83.5%) and nervousness (43.8%). Overall 59.1% of team sport athletes reported having no strategy to overcome poor sleep compared with individual athletes (32.7%, p=0.002) who utilised relaxation and reading as strategies. Individual sport athletes had increased likelihood of poor sleep as they aged. The poor sleep reported by athletes prior to competition was situational rather than a global sleep problem. Poor sleep is common prior to major competitions in Australian athletes, yet most athletes are unaware of strategies to overcome the poor sleep experienced. It is essential coaches and scientists monitor and educate both individual and team sport athletes to facilitate sleep prior to important competitions. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Use of blood biomarkers to screen for obstructive sleep apnea

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Fleming WE

2018-06-01

Full Text Available Wesley Elon Fleming,1 Jon-Erik C Holty,2 Richard K Bogan,3 Dennis Hwang,4 Aliya S Ferouz-Colborn,4 Rohit Budhiraja,5 Susan Redline,5 Edith Mensah-Osman,6 Nadir Ishag Osman,6 Qing Li,7 Armaghan Azad,1 Susann Podolak,1 Michael K Samoszuk,8 Amabelle B Cruz,8 Yang Bai,8 Jiuliu Lu,8 John S Riley,8 Paula C Southwick8 1Sleep Center Orange County, Irvine, CA, USA; 2Stanford Medical School, VA Palo Alto Health Care System, Pulmonary, Critical Care and Sleep Medicine Section, Palo Alto, CA, USA; 3SleepMed Inc., Bogan Sleep Consultants, LLC, Columbia, SC, USA; 4Sleep Medicine Department, Southern California Permanente Medical Group, Kaiser Permanente, Fontana Medical Center, Fontana, CA, USA; 5Division of Sleep Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA; 6EENA Comprehensive Neurology and Sleep Center, Boynton Beach, FL, USA; 7South Bend Medical Foundation, New Technology and Test Development, South Bend, IN, USA; 8Clinical Research Department, Beckman Coulter, Inc., Brea, CA, USAPurpose: Obstructive sleep apnea (OSA is a highly prevalent disorder associated with increased risk for cardiovascular disease, diabetes, and other chronic conditions. Unfortunately, up to 90% of individuals with OSA remain without a diagnosis or therapy. We assess the relationship between OSA and blood biomarkers, and test the hypothesis that combinations of markers provide a characteristic OSA signature with diagnostic screening value. This validation study was conducted in an independent cohort in order to replicate findings from a prior feasibility study.Patients and methods: This multicenter prospective study consecutively enrolled adult male subjects with clinically suspected OSA. All subjects underwent overnight sleep studies. An asymptomatic control group was also obtained. Five biomarkers were tested: glycated hemoglobin (HbA1c, C-reactive protein (CRP, uric acid, erythropoietin (EPO, and interleukin-6 (IL-6.Results: The study

Does selection for short sleep duration explain human vulnerability to Alzheimer's disease?

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Nesse, Randolph M; Finch, Caleb E; Nunn, Charles L

2017-01-16

Compared with other primates, humans sleep less and have a much higher prevalence of Alzheimer 's disease (AD) pathology. This article reviews evidence relevant to the hypothesis that natural selection for shorter sleep time in humans has compromised the efficacy of physiological mechanisms that protect against AD during sleep. In particular, the glymphatic system drains interstitial fluid from the brain, removing extra-cellular amyloid beta (eAβ) twice as fast during sleep. In addition, melatonin - a peptide hormone that increases markedly during sleep - is an effective antioxidant that inhibits the polymerization of soluble eAβ into insoluble amyloid fibrils that are associated with AD. Sleep deprivation increases plaque formation and AD, which itself disrupts sleep, potentially creating a positive feedback cycle. These and other physiological benefits of sleep may be compromised by short sleep durations. Our hypothesis highlights possible long-term side effects of medications that reduce sleep, and may lead to potential new strategies for preventing and treating AD. © The Author(s) 2017. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

Sleep and circadian rhythm disruption in neuropsychiatric illness.

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Jagannath, Aarti; Peirson, Stuart N; Foster, Russell G

2013-10-01

Sleep and circadian rhythm disruption (SCRD) is a common feature in many neuropsychiatric diseases including schizophrenia, bipolar disorder and depression. Although the precise mechanisms remain unclear, recent evidence suggests that this comorbidity is not simply a product of medication or an absence of social routine, but instead reflects commonly affected underlying pathways and mechanisms. For example, several genes intimately involved in the generation and regulation of circadian rhythms and sleep have been linked to psychiatric illness. Further, several genes linked to mental illness have recently been shown to also play a role in normal sleep and circadian behaviour. Here we describe some of the emerging common mechanisms that link circadian rhythms, sleep and SCRD in severe mental illnesses. A deeper understanding of these links will provide not only a greater understanding of disease mechanisms, but also holds the promise of novel avenues for therapeutic intervention. Copyright © 2013. Published by Elsevier Ltd.

Sleep-Related Orgasms in a 57-Year-Old Woman: A Case Report.

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Irfan, Muna; Schenck, Carlos H

2018-01-15

We report a case of problematic spontaneous orgasms during sleep in a 57-year-old woman who also complained of hypnic jerks and symptoms of exploding head syndrome. To our knowledge, this is the first case report in the English language literature of problematic spontaneous orgasms during sleep. She had a complex medical and psychiatric history, and was taking oxycontin, venlafaxine, amitriptyline, and lurasidone. Prolonged video electroencephalogram monitoring did not record any ictal or interictal electroencephalogram discharges, and nocturnal video polysomnography monitoring did not record any behavioral or orgasmic event. Periodic limb movement index was zero events/h. Severe central sleep apnea was detected with apnea-hypopnea index = 130 events/h, but she could not tolerate positive airway pressure titration. Sleep architecture was disturbed, with 96.4% of sleep spent in stage N2 sleep. Bedtime clonazepam therapy (1.5 mg) was effective in suppressing the sleep-related orgasms and hypnic jerks. © 2018 American Academy of Sleep Medicine

Remember the Drive Home? An Assessment of Emergency Providers' Sleep Deficit.

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Ferguson, Brian A; Shoff, Hugh W; McGowan, Jennifer E; Huecker, Martin R

2018-01-01

Sleep deprivation decreases work performance and predisposes workers to deleterious health outcomes. We sought to evaluate sleep hygiene and fatigue among emergency physicians. In March-June 2016, physicians and residents at an academic emergency medicine program were invited to complete a survey evaluating sleep and alertness. Six attending physicians and 26 residents completed the survey. Among six personal priorities, sleep ranked fourth behind family, work, and leisure. 75% stated poor sleep impedes effectiveness as a physician while 53% noted difficulty falling asleep before a night shift. In the last three months, 39% of subjects forgot driving home from a shift, and 34% had fallen asleep while driving. 34% used medications to assist with sleep (including melatonin (36%), alcohol (27%), and prescription drugs (9%)). Most providers attested to phone (88%) and television exposure (69%) immediately prior to goal sleep onset. Despite sleep being identified as a priority among EM physicians, deleterious habits remain. Poor sleep affects perceived effectiveness and personal safety, as evidenced by a significant portion of providers falling asleep on the commute home. Night shift is the chief obstacle to optimal sleep hygiene.

Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management.

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Budhiraja, Rohit; Siddiqi, Tauseef A; Quan, Stuart F

2015-03-15

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be complicated by sleep disorders. Insomnia and obstructive sleep apnea are commonly encountered in patients with COPD. Nocturnal hypoxemia is also prevalent in COPD may occur despite adequate awake oxygenation and can be especially severe in rapid eye movement sleep. Additionally, several factors--some of them unique to COPD--can contribute to sleep-related hypoventilation. Recognition of hypoventilation can be vital as supplemental oxygen therapy itself can acutely worsen hypoventilation and lead to disastrous consequences. Finally, accruing data establish an association between restless leg syndrome and COPD--an association that may be driven by hypoxemia and/or hypercapnia. Comorbid sleep disorders portend worse sleep quality, diminished quality of life, and multifarious other adverse consequences. The awareness and knowledge regarding sleep comorbidities in COPD has continued to evolve over past many years. There are still several lacunae, however, in our understanding of the etiologies, impact, and therapies of sleep disorders, specifically in patients with COPD. This review summarizes the latest concepts in prevalence, pathogenesis, diagnosis, and management of diverse sleep disorders in COPD. © 2015 American Academy of Sleep Medicine.

Remember the Drive Home? An Assessment of Emergency Providers’ Sleep Deficit

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Brian A. Ferguson

2018-01-01

Full Text Available Objective. Sleep deprivation decreases work performance and predisposes workers to deleterious health outcomes. We sought to evaluate sleep hygiene and fatigue among emergency physicians. Methods. In March–June 2016, physicians and residents at an academic emergency medicine program were invited to complete a survey evaluating sleep and alertness. Results. Six attending physicians and 26 residents completed the survey. Among six personal priorities, sleep ranked fourth behind family, work, and leisure. 75% stated poor sleep impedes effectiveness as a physician while 53% noted difficulty falling asleep before a night shift. In the last three months, 39% of subjects forgot driving home from a shift, and 34% had fallen asleep while driving. 34% used medications to assist with sleep (including melatonin (36%, alcohol (27%, and prescription drugs (9%. Most providers attested to phone (88% and television exposure (69% immediately prior to goal sleep onset. Conclusion. Despite sleep being identified as a priority among EM physicians, deleterious habits remain. Poor sleep affects perceived effectiveness and personal safety, as evidenced by a significant portion of providers falling asleep on the commute home. Night shift is the chief obstacle to optimal sleep hygiene.

The opium poppy as a symbol of sleep in Bertel Thorvaldsen's relief of 1815.

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Tekiner, Halil; Kosar, Muberra

2016-03-01

Danish sculptor Bertel Thorvaldsen (1770-1844) is one of the most remarkable representatives of Neoclassicist sculptural art in Europe, which was largely inspired by the classical art and culture of Greek and Roman antiquity. A pair of marble reliefs, Night and Day, exhibited in the Thorvaldsen Museum (Copenhagen), marks the culmination of Thorvaldsen's relief art and is of particular interest to the history of sleep medicine. In the first relief, Night, an angel with her neck bent and eyes closed has two babies in her embrace and seems to be floating down in grief, with an owl hovering behind her. Her hair is also twined with opium poppies, the symbol of sleep and death in antiquity. Our findings suggest that this relief not only indicates a mythological association between the opium poppy and sleep but also has a strong connotation with the poppy's medicinal use for inducing sleep throughout the centuries. Copyright © 2015 Elsevier B.V. All rights reserved.

Stilbene Glucoside, a Putative Sleep Promoting Constituent from Polygonum multiflorum Affects Sleep Homeostasis by Affecting the Activities of Lactate Dehydrogenase and Salivary Alpha Amylase.

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Wei, Qian; Ta, Guang; He, Wenjing; Wang, Wei; Wu, Qiucheng

2017-01-01

Chinese herbal medicine (CHM) has been used for treating insomnia for centuries. The most used CHM for insomnia was Polygonum multiflorum. However, the molecular mechanism for CHM preventing insomnia is unknown. Stilbene glucoside (THSG), an important active component of P. multiflorum, may play an important role for treating insomnia. To test the hypothesis, Kunming mice were treated with different dosages of THSG. To examine the sleep duration, a computer-controlled sleep-wake detection system was implemented. Electroencephalogram (EEG) and electromyogram (EMG) electrodes were implanted to determine sleep-wake state. RT-PCR and Western blot was used to measure the levels of lactate dehydrogenase (LDH) and saliva alpha amylase. Spearman's rank correlation coefficient was used to identify the strength of correlation between the variables. The results showed that THSG significantly prolonged the sleep time of the mice (palpha amylase (palpha amylase (pamylase were negatively associated with sleep duration (palpha amylase.

Sleep Patterns in Chinese Preschool Children: A Population-Based Study.

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Wu, Ran; Wang, Guang-Hai; Zhu, Hong; Jiang, Fan; Jiang, Chun-Lei

2018-04-15

This study aimed to (1) provide data on normal sleep patterns in Chinese preschool children, (2) identify cross-cultural differences of sleep patterns among children from China and other countries, (3) estimate the prevalence of sleep duration not meeting the optimal amount, and (4) characterize delayed weekend sleep pattern. A population-based sample of 1,610 children aged 3-6 years was recruited from 10 cities across China. Parents completed questions about their child's sleep patterns adapted from the Children's Sleep Habits Questionnaire (CSHQ). The mean bedtime was 9:31 PM, wake time was 7:27 AM, nighttime sleep duration was 9 hours 30 minutes, daytime sleep duration was 1 hour 31 minutes, and total sleep duration was 11 hours 2 minutes. The children had a shorter nighttime sleep duration but longer daytime naps, resulting in no differences in total sleep duration compared with counterparts predominantly in the west. Of the children, 85.3% met the recommended amount of sleep of 10 to 13 hours, and 10.8% slept fewer than 10 hours. The prevalence of sleep less than 10 hours was higher in older children and children from eastern China. Children went to bed and woke up more than 30 minutes later on weekends than weekdays, accounting for 40.1% and 50%, respectively. Children in western China showed longer delay than children in eastern China ( P < .05). Age- and region-specific variability of sleep patterns are reported as well as insufficient sleep and delayed weekend sleep pattern in Chinese preschool children. The cross-cultural difference of sleep patterns was in temporal placement rather than sleep duration. © 2018 American Academy of Sleep Medicine.

Dream Recall Frequencies and Dream Content in Wilson’s Disease with and without REM Sleep Behaviour Disorder: A Neurooneirologic Study

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Gotthard G. Tribl

2016-01-01

Full Text Available Objective. Violent dream content and its acting out during rapid eye movement sleep are considered distinctive for rapid eye movement sleep behaviour disorder (RBD. This study reports first quantitative data on dreaming in a cohort of patients with treated Wilson’s disease (WD and in patients with WD with RBD. Methods. Retrospective questionnaires on different dimensions of dreaming and a prospective two-week home dream diary with self-rating of emotions and blinded, categorical rating of content by an external judge. Results. WD patients showed a significantly lower dream word count and very few other differences in dream characteristics compared to age- and sex-matched healthy controls. Compared to WD patients without RBD, patients with WD and RBD reported significantly higher nightmare frequencies and more dreams with violent or aggressive content retrospectively; their prospectively collected dream reports contained significantly more negative emotions and aggression. Conclusions. The reduction in dream length might reflect specific cognitive deficits in WD. The lack of differences regarding dream content might be explained by the established successful WD treatment. RBD in WD had a strong impact on dreaming. In accordance with the current definition of RBD, violent, aggressive dream content seems to be a characteristic of RBD also in WD.

Insomnia in Iranian Traditional Medicine

Science.gov (United States)

Feyzabadi, Zohre; Jafari, Farhad; Feizabadi, Parvin Sadat; Ashayeri, Hassan; Esfahani, Mohammad Mahdi; Badiee Aval, Shapour