ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009
S. K. Dørheim
Objective:, Women sleep less in the postnatal period and it has been suggested that mothers diagnosed with depression alternatively could be suffering from the effects of chronic sleep deprivation. Method:, From a population-based study, we recruited 42 women, of whom 21 scored ,10 on the Edinburgh Postnatal Depression Scale. Sleep was registered by the Pittsburgh Sleep Quality Index (PSQI), sleep diaries and actigraphy 2 months after delivery. Results:, There were significant differences in subjective sleep measured retrospectively by the PSQI between depressed and non-depressed women. In contrast, there were no significant differences in sleep measured prospectively by sleep diaries and actigraphy. Both depressed and non-depressed women had impaired sleep efficiency (82%) and were awake for about 1.5 h during the night. Primipara had worse sleep, measured by actigraphy, compared with multipara. Conclusion:, Measured objectively and prospectively, women with depression did not have worse sleep than non-depressed women. [source]

Vagus Nerve Stimulation Therapy Induces Changes in Heart Rate of Children during Sleep

EPILEPSIA, Issue 5 2007
Boubker Zaaimi
Summary:,Purpose: This study analyzed changes in the heart rates of children receiving vagus nerve stimulation (VNS) therapy for pharmacoresistant epilepsy. Methods: Changes in the heart rates of ten children receiving VNS therapy for pharmacoresistant epilepsy were evaluated with polysomnographic recordings, including electrocardiogram (ECG), EEG, thoraco-abdominal distension, nasal airflow, and VNS artifacts. Measurements during stimulation were compared with those at baseline for each patient. Result: While the VNS therapy pulse generator was delivering stimulation, the heart rates of four children increased significantly (p < 0.01), decreased for one child, and increased at the end of the stimulation for one child. The heart rates of four children did not change. Changes in heart rate varied during VNS, within stimulation cycles for individual children and from one child to another. Changes in heart rate differed between rapid eye movement (REM) and non-REM (NREM) sleep states. Respiratory changes (increases in frequency and decreases in amplitude) were concomitant with the changes in heart rate. Conclusion: In this case series of children with pharmacoresistant epilepsy, cardiorespiratory variations occurred while the VNS therapy pulse generator was delivering stimulation. Understanding these variations may allow further optimization of VNS parameters. [source]

Paroxysmal Motor Disorders of Sleep: The Clinical Spectrum and Differentiation from Epilepsy

EPILEPSIA, Issue 11 2006
Christopher P. Derry
Summary:, The diagnosis of paroxysmal events in sleep represents a significant challenge for the clinician, with the distinction of nocturnal epilepsy from nonepileptic sleep disorders often the primary concern. Diagnostic error or uncertainty is not uncommon in this situation, particularly with respect to nocturnal frontal lobe epilepsy (NFLE), which has a variable and often unusual presentation. Such errors can be minimized if the range of nonepileptic disorders with motor activity in sleep is fully appreciated. Here we review these disorders, before discussing the important clinical and electrographic features that allow their accurate differentiation from seizures. Particular emphasis is placed on the differentiation of nocturnal frontal lobe epilepsy from non,rapid eye movement (NREM) arousal disorders and other parasomnias. The value of recording episodes with video EEG polysomnography is discussed. [source]

Gabapentin Increases Slow-wave Sleep in Normal Adults

EPILEPSIA, Issue 12 2002
Nancy Foldvary-Schaefer
Summary: ,Purpose: The older antiepileptic drugs (AEDs) have a variety of effects on sleep, including marked reduction in rapid-eye-movement (REM) sleep, slow-wave sleep (SWS), and sleep latency, and an increase in light sleep. The effects of the newer AEDs on sleep are unknown. Our purpose was to study the effect of gabapentin (GBP) on sleep. Methods: Ten healthy adults and nine controls were the subjects of this study. All underwent baseline and follow-up polysomnography (PSG) and completed sleep questionnaires. After baseline, the treated group received GBP titrated to 1,800 mg daily. Polygraphic variables and Epworth Sleepiness Scale (ESS) scores, a subjective measure of sleep propensity, were compared by using the Wilcoxon signed rank test. Results: Nine of the treated subjects achieved the target dose; one was studied with 1,500 mg daily because of dizziness experienced at the higher dose. GBP-treated subjects had an increase in SWS compared with baseline. No difference in the ESS or other polygraphic variables was observed. However, a minor reduction in arousals, awakenings, and stage shifts was observed in treated subjects. Conclusions: GBP appears to be less disruptive to sleep than are some of the older AEDs. These findings may underlie the drug's therapeutic effect in the treatment of disorders associated with sleep disruption. [source]

Electrical Status Epilepticus of Sleep in Association with Topiramate

EPILEPSIA, Issue 11 2002
Maria Augusta Montenegro
First page of article [source]

Effects of Vigabatrin on Sleep,Wakefulness Cycle in Amygdala-Kindled Rats

EPILEPSIA, Issue 2 2000
Y. H. Raol
Summary: Purpose: Our aim was to study the effect of prolonged administration of vigabatrin (VGB) on sleep-wakefulness cycle in kindled seizure-induced rats. Methods: Adult male Wistar rats were implanted stereotaxically with electrodes for kindling and polysomnography. The rats were divided into two groups, kindled and VGB-treated kindled rats. VGB was administered intraperitonially every day for 21 days, and polysomnographic recordings were taken after doses 1, 7, 14, and 21. The drug effects were evaluated by comparing the records of kindled and drug-treated kindled rats. Results: The VGB-administered kindled rats showed an increase in total sleep time (TST) due to an increase in total non-rapid eye movement (NREM) and light slow-wave sleep stage I (SI) with a decrease in wakefulness. The number of episodes and REM onset latencies were found to be decreased after drug treatment. Conclusions: It can therefore be concluded that VGB has a somnolence-inducing effect and that it might mediate its anti-convulsant effect by altering sleep architecture through sleep-regulating areas. [source]

Sleep and Psychosomatic Medicine

EUROPEAN JOURNAL OF NEUROLOGY, Issue 11 2007
K. A. Jellinger
No abstract is available for this article. [source]

Sleep and the metabolic syndrome

EXPERIMENTAL PHYSIOLOGY, Issue 1 2007
Robert Wolk
The metabolic syndrome represents a clustering of several interrelated risk factors of metabolic origin that are thought to increase cardiovascular risk. It is still uncertain whether this clustering results from multiple underlying risk factors or whether it has a single cause. One metabolic abnormality that may underlie several clinical characteristics of the metabolic syndrome is insulin resistance. This review discusses the evidence that sleep disturbances (obstructive sleep apnoea, sleep deprivation and shift work) may independently lead to the development of both insulin resistance and individual clinical components of the metabolic syndrome. The converse may also be true, in that metabolic abnormalities associated with the metabolic syndrome and insulin resistance may potentially exacerbate sleep disorders. The notion that sleep disturbances exert detrimental metabolic effects may help explain the increasing prevalence of the metabolic syndrome and insulin resistance in the general population and may have important implications for population-based approaches to combat the increasing epidemic of metabolic and cardiovascular disease. [source]

Sleep and Headache: The Clinical Relationship

HEADACHE, Issue 7 2010
Dimos D. Mitsikostas MD
First page of article [source]

Effect on Sleep of Posterior Hypothalamus Stimulation in Cluster Headache

HEADACHE, Issue 7 2007
Roberto Vetrugno MD
Objective.,To evaluate the structure and quality of sleep and the circadian rhythm of body core temperature (BcT°) in patients with drug-resistant chronic cluster headache (CH) before and during deep brain stimulation (DBS) of the posterior hypothalamus. Background.,Chronic CH is a severe primary headache and frequently associated with disturbances in sleep. Posterior hypothalamus DBS is performed as an effective treatment of drug-resistant chronic CH. The effects of posterior hypothalamus DBS on sleep and the circadian rhythm of BcT° are unknown. Methods.,Three male patients with chronic drug-resistant CH underwent 48-hour consecutive polysomnography (PSG) by means of the VITAPORT® system with determination of BcT° by means of a rectal probe. Recordings were done before electrode implantation in the posterior hypothalamus and after optimized DBS of posterior hypothalamus. Results.,Before electrode implantation PSG showed nocturnal CH attacks, reduced sleep efficiency, fragmented sleep and increased periodic limb movements in sleep (PLMS). During DBS nocturnal CH attacks were abolished and sleep efficiency and PLMS improved. BcT° circadian rhythm was normal both before and during DBS. Conclusions.,Our data show that DBS of posterior hypothalamus in drug-resistant chronic CH is effective in curtailing nocturnal CH attacks, and is associated with improved sleep structure and quality. Chronic CH displays a normal circadian rhythm of BcT°, unchanged during hypothalamic DBS. [source]

Sleep and Headache Disorders: Clinical Recommendations for Headache Management

HEADACHE, Issue 2006
Jeanetta C. Rains PhD
Clinical practice points were drawn from a review of sleep and headache disorders published in the regular issue of Headache (released in tandem with this supplement). The recommendations include: (1) Sleep as well as psychiatric disorders tend to become prevalent in more complex and severe headache patterns and regulation of sleep and mood may favorably impact headache threshold; (2) Specific headache patterns, irrespective of headache diagnosis, are suggestive of a potential sleep disorder (eg, "awakening" or morning headache, chronic daily headache); (3) Sleep disorders most implicated with headache include obstructive sleep apnea, primary insomnia, and circadian phase abnormalities, and treatment of such sleep disorders may improve or resolve headache; (4) Inexpensive screening tools (eg, sleep history interview, headache/sleep diary, validated questionnaires, prediction equations) aid identification of patients warranting polysomnography; and (5) Pharmacologic and behavioral therapies are effective in the regulation of sleep and are compatible with usual headache care. [source]

Hypnic Headache Associated With Stage 3 Slow Wave Sleep

HEADACHE, Issue 9 2000
José Antonio Molina Arjona MD
We describe the polysomnographic data of a 79-year-old woman with an 11-year history of nocturnal headaches that were clinically consistent with hypnic headache. A polysomnographic study showed arousal at stage 3 slow wave sleep because of a headache episode. Although this finding could be nonspecific, it suggests the possible relationship between stage 3 slow wave sleep and hypnic headache. [source]

Circadian rhythm disturbances in depression,

HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2008
Anne Germain
Abstract Objective The aim of this article is to review progress in understanding the mechanisms that underlie circadian and sleep rhythms, and their role in the pathogenesis and treatment of depression. Methods Literature was selected principally by Medline searches, and additional reports were identified based on ongoing research activities in the authors' laboratory. Results Many physiological processes show circadian rhythms of activity. Sleep and waking are the most obvious circadian rhythms in mammals. There is considerable evidence that circadian and sleep disturbances are important in the pathophysiology of mood disorders. Depressed patients often show altered circadian rhythms, sleep disturbances, and diurnal mood variation. Chronotherapies, including bright light exposure, sleep deprivation, and social rhythm therapies, may be useful adjuncts in non-seasonal and seasonal depression. Antidepressant drugs have marked effects on circadian processes and sleep. Conclusions Recent progress in understanding chronobiological and sleep regulation mechanisms may provide novel insights and avenues into the development of new pharmacological and behavioral treatment strategies for mood disorders. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Serotonin and Sleep: Molecular, Functional and Clinical Aspects.

HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 6 2008
B. L. Jacobs, D. J. Nutt., Edited by J. M. Monti, S. R. Pandi-Perumal
No abstract is available for this article. [source]

Maternal Psychosocial Adversity and the Longitudinal Development of Infant Sleep

INFANCY, Issue 5 2008
Alison Cronin
Research has identified associations between indicators of social disadvantage and the presence of child sleep problems. We examined the longitudinal development of infant sleep in families experiencing high (n = 58) or low (n = 64) levels of psychosocial adversity, and the contributions of neonatal self-regulatory capacities and maternal settling strategies to this development. Assessments of infant sleep at 4-, 7-, and 12-weeks postpartum indicated no differences in sleeping difficulties between high- and low-adversity groups. However, more infant sleep difficulties were reported in the high- versus low-adversity groups at 12- and 18-month follow-ups. Neonatal self-regulatory capacities were not related to the presence or absence of adversity, or to subsequent infant sleep quality. However, there were group differences in maternal settling strategies that did predict subsequent infant sleep difficulties. The pattern of sleep disturbance observed in association with maternal psychosocial adversity at 18-months was consistent with risk for broader impairments in child functioning. [source]

The ontogeny of diurnal rhythmicity in bed-sharing and solitary-sleeping infants: a preliminary report,

INFANT AND CHILD DEVELOPMENT, Issue 4 2007
Melissa M. Burnham
Abstract The purpose of the current study was to investigate the development of sleep,wake and melatonin diurnal rhythms over the first 3 months of life, and the potential effect of bed-sharing on their development. It was hypothesized that increased maternal contact through bed-sharing would affect the development of rhythms in human infants. Ten solitary-sleeping and 8 bed-sharing infants' sleep,wake patterns and melatonin secretion were examined for 72 h at 1 and 3 months of age in their homes. Infants wore actigraphs on their ankles to study sleep,wake patterns. 6-Sulphatoxymelatonin was obtained through urine extracted from each diaper used over the 72-h study period. No significant differences were apparent in the timing of appearance or magnitude of sleep,wake or melatonin rhythms between bed-sharing and solitary-sleeping infants. Sleep,wake results were in the expected direction, with bed-sharing infants displaying more robust rhythms. A large degree of individual variability was evident in both rhythms, especially at 1 month. Three infants' parents regularly used a bright light source at night for feedings and diaper changes; the rhythms of these infants were less robust than the rest of the sample. Trends were mostly in the hypothesized direction and deserve attempts at replication with a larger sample. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Prevalence of snoring and sleep-disordered breathing in a group of commercial bus drivers in Hong Kong

INTERNAL MEDICINE JOURNAL, Issue 4 2002
D. S. C. Hui
Abstract Objectives:,To assess the prevalence of sleep-disordered breathing (SDB) and its associated symptoms in a group of commercial bus drivers in Hong Kong. Methods:,Two hundred and sixteen of 410 bus drivers from three different shifts were interviewed with the Sleep & Health Questionnaire (SHQ) and the Epworth sleepiness scale (ESS) at a Hong Kong bus depot. Seventeen subjects from each shift were then randomly selected for at-home sleep study using the Mesam IV device (Madaus Medizin,Elektronik, Freiburg, Germany). Results:,There were 207 men and nine women (mean age 42.4 ± 7.5 years; body mass index (BMI) 25.4 ± 4.5 kg/m2; ESS 5.3 ± 4.2). From the SHQ it was discovered that: (i) daytime sleepiness was reported by 87 subjects (40%), (ii) snoring , 3 times per week was reported by 80 subjects (37%), (iii) witnessed apnoea was reported by 17 subjects (7.9%) and (iv) 29 subjects (13.4%) reported having fallen asleep during driving. Among the 51 subjects who underwent the at-home sleep study: (i) 31 subjects (61%) had respiratory disturbance index (RDI) , 5 per hour of sleep, (ii) 21 subjects (41%) had RDI , 10 per hour of sleep, (iii) 12 subjects (24%) had RDI , 15 per hour of sleep and (iv) 35 subjects (68.6%) snored objectively , 10% of the night. Ten subjects (20%) had RDI , 5 and sleepiness at work, while five subjects (9.8%) had RDI , 5 and ESS > 10. No significant differences were noted in the SHQ responses, ESS, objective snoring or RDI among the three groups. Multiple regression analysis showed that BMI and witnessed apnoea were the only positive independent predictors of RDI. Conclusions:,This study showed a high prevalence of objective snoring and SDB in a group of commercial bus drivers. Neither self-reported sleepiness nor the ESS could identify subjects with SDB. (Intern Med J 2002; 32: 149,157) [source]

Sleep and the smoker

INTERNAL MEDICINE JOURNAL, Issue 5 2000
R. J. PIERCE
No abstract is available for this article. [source]

Sleep disturbances among nursing home residents

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2002
Arne Fetveit MD
Abstract Study objectives This study assesses the prevalence and characteristics of sleep disturbances among an entire nursing home population, consisting of 29, mainly demented, long-term patients. Design and setting Sleep was evaluated for 14 consecutive days using actigraphic measurements and nursing staff observations. No alterations were made in every-day routines or medications during the observation period. Measurements and results Actigraphy showed a mean sleep onset latency of one hour and a mean wake after sleep onset of more than two hours, while there was no findings of early morning awakening. Mean sleep efficiency was 75%, and more than 13 hours were spent in bed. 72% of the subjects had sleep efficiency below 85%. Nursing staff reported sleep onset latency of more than 30 minutes in 158 of the 203 analysed days, while early morning awakening was reported in only 12 of 203 days. Actigraphical measurements and nursing staff observations gave similar results. The validity of actigraphy in this population is discussed. Conclusion Sleep disturbances were common among the residents in this nursing home. Sleep onset latency was prolonged, and the patients experienced frequent wake bouts after sleep onset. The diminished ability of sustained sleep may have been influenced by the prolonged time in bed. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Daily Variations in Objective Nighttime Sleep and Subjective Morning Pain in Older Adults with Insomnia: Evidence of Covariation over Time

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2010
Joseph M. Dzierzewski MS
OBJECTIVES: To examine the relationship between objectively measured nocturnal sleep and subjective report of morning pain in older adults with insomnia; to examine not only the difference between persons in the association between sleep and pain (mean level over 14 days), but also the within-person, day-to-day association. DESIGN: Cross-sectional. SETTING: North-central Florida. PARTICIPANTS: Fifty community-dwelling older adults (mean age±standard deviation 69.1±7.0, range 60,90) with insomnia. MEASUREMENTS: Daily home-based assessment using nightly actigraphic measurement of sleep and daily self-report of pain over 14 consecutive days. RESULTS: Between persons, average sleep over 14 days was not associated with average levels of rated pain, but after a night in which an older adult with insomnia experienced above-average total sleep time he or she subsequently reported below-average pain ratings. The model explained approximately 24% of the within-person and 8% of the between-person variance in pain ratings. CONCLUSIONS: Sleep and pain show day-to-day associations (i.e., covary over time) in older adults with insomnia. Such associations may suggest that common physiological systems underlie the experience of insomnia and pain. Future research should examine the crossover effects of sleep treatment on pain and of pain treatment on sleep. [source]

Evidence-Based Recommendations for the Assessment and Management of Sleep Disorders in Older Persons

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2009
AGSF, Harrison G. Bloom MD
Sleep-related disorders are most prevalent in the older adult population. A high prevalence of medical and psychosocial comorbidities and the frequent use of multiple medications, rather than aging per se, are major reasons for this. A major concern, often underappreciated and underaddressed by clinicians, is the strong bidirectional relationship between sleep disorders and serious medical problems in older adults. Hypertension, depression, cardiovascular disease, and cerebrovascular disease are examples of diseases that are more likely to develop in individuals with sleep disorders. Conversely, individuals with any of these diseases are at a higher risk of developing sleep disorders. The goals of this article are to help guide clinicians in their general understanding of sleep problems in older persons, examine specific sleep disorders that occur in older persons, and suggest evidence- and expert-based recommendations for the assessment and treatment of sleep disorders in older persons. No such recommendations are available to help clinicians in their daily patient care practices. The four sections in the beginning of the article are titled, Background and Significance, General Review of Sleep, Recommendations Development, and General Approach to Detecting Sleep Disorders in an Ambulatory Setting. These are followed by overviews of specific sleep disorders: Insomnia, Sleep Apnea, Restless Legs Syndrome, Circadian Rhythm Sleep Disorders, Parasomnias, Hypersomnias, and Sleep Disorders in Long-Term Care Settings. Evidence- and expert-based recommendations, developed by a group of sleep and clinical experts, are presented after each sleep disorder. [source]

Association Between Sleep and Physical Function in Older Men: The Osteoporotic Fractures in Men Sleep Study

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2008
Thuy-Tien L. Dam MD
OBJECTIVES: To determine whether sleep quality is associated with physical function in older men. DESIGN: Cross-sectional. SETTING: Six U.S. centers. PARTICIPANTS: Two thousand eight hundred sixty-two community-dwelling men. MEASUREMENTS: Total hours of nighttime sleep (TST), wake after sleep onset (WASO), sleep latency (SL), and sleep efficiency (SE) measured using actigraphy; sleep stage distribution, respiratory disturbance index (RDI), and hypoxia measured using polysomnography; measures of physical function: grip strength, walking speed, chair stand, and narrow walk. RESULTS: In age-adjusted models, <6 or >8 hours TST, SE less than 80%, WASO of 90 minutes or longer, RDI of 30 or greater, and hypoxia were associated with poorer physical function. (Mean grip strength was 2.9% lower and mean walking speed was 4.3% lower in men with WASO ,90 minutes than men with WASO <90 minutes.) After adjusting for potential covariates, differences in grip strength and walking speed remained significantly associated with WASO of 90 minutes or longer, SE less than 80%, and hypoxia but not with TST or RDI of 30 or greater. CONCLUSION: Greater sleep fragmentation and hypoxia are associated with poorer physical function in older men. [source]

Self-Reported Napping and Duration and Quality of Sleep in the Lifestyle Interventions and Independence for Elders Pilot Study

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2008
Jennifer L. Picarsic MD
OBJECTIVES: To determine the prevalence of self-reported napping and its association with subjective nighttime sleep duration and quality, as measured according to sleep-onset latency and sleep efficiency. DESIGN: Cross-sectional study. SETTING: Lifestyle Interventions and Independence for Elders Pilot Study. PARTICIPANTS: Community-dwelling older adults (N=414) aged 70 to 89. MEASUREMENTS: Self-report questionnaire on napping and sleep derived from the Pittsburgh Sleep Quality Index (PSQI) scale. RESULTS: Fifty-four percent of participants reported napping, with mean nap duration of 55.0±41.2 minutes. Nappers were more likely to be male (37.3% vs 23.8%, P=.003) and African American (20.4% vs 14.4%, P=.06) and to have diabetes mellitus (28% vs 14.3%, P=.007) than non-nappers. Nappers and non-nappers had similar nighttime sleep duration and quality, but nappers spent approximately 10% of their 24-hour sleep occupied in napping. In a multivariate model, the odds of napping were higher for subjects with diabetes mellitus (odds ratio (OR)=1.9, 95% confidence interval (CI)=1.2,3.0) and men (OR=1.9, 95% CI=1.2,3.0). In nappers, diabetes mellitus (,=12.3 minutes, P=.005), male sex (,=9.0 minutes, P=.04), higher body mass index (,=0.8 minutes, P=.02), and lower Mini-Mental State Examination score (,=2.2 minutes, P=.03) were independently associated with longer nap duration. CONCLUSION: Napping was a common practice in community-dwelling older adults and did not detract from nighttime sleep duration or quality. Given its high prevalence and association with diabetes mellitus, napping behavior should be assessed as part of sleep behavior in future research and in clinical practice. [source]

Self-Reported Sleep and Nap Habits and Risk of Falls and Fractures in Older Women: The Study of Osteoporotic Fractures

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2006
Katie L. Stone PhD
OBJECTIVES: To test the association between self-reported sleep and nap habits and risk of falls and fractures in a large cohort of older women. DESIGN: Study of Osteoporotic Fractures prospective cohort study. SETTING: Clinical centers in Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the Monongahela Valley, near Pittsburgh, Pennsylvania. PARTICIPANTS: Eight thousand one hundred one community-dwelling Caucasian women aged 69 and older (mean 77.0). MEASUREMENTS: Sleep and nap habits were assessed using a questionnaire at the fourth clinic visit (1993/94). Fall frequency during the subsequent year was ascertained using tri-annual questionnaire. Incident hip and nonspinal fractures during 6 years of follow-up were confirmed using radiographic reports. RESULTS: Five hundred fifty-three women suffered hip fractures, and 1,938 suffered nonspinal fractures. In multivariate models, women who reported napping daily had significantly higher odds of suffering two or more falls during the subsequent year (odds ratio=1.32, 95% confidence interval (CI)=1.03,1.69) and were more likely to suffer a hip fracture (hazard ratio (HR)=1.33, 95% CI=0.99,1.78) than women who did not nap daily. Those sleeping at least 10 hours per 24 hours had a higher risk of nonspinal fracture than (HR=1.26, 95% CI=1.00,1.58) and a similar but nonsignificant increased risk of hip fracture to (HR=1.43, 95% CI=0.95,2.15) those who reported sleeping between 8 and 9 hours. CONCLUSION: Self-reported long sleep and daily napping are associated with greater risk of falls and fractures in older women. Interventions to improve sleep may reduce their risk of falls and fractures. Future research is needed to determine whether specific sleep disorders contribute to these relationships. [source]

Evening Light Exposure: Implications for Sleep and Depression

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2002
Geralyn M. Wallace-Guy MA
OBJECTIVES: To examine whether dim illumination in the evening is a factor in sleep disturbances of aging, depression, and circadian phase advance. DESIGN: One-week continuous recordings were made to record illumination exposure and to infer 24-hour sleep patterns from wrist activity. SETTING: Recordings took place during normal home and community activities. PARTICIPANTS: Complete data of 154 postmenopausal women, mean age 66.7, were selected from a larger study of participants in the Women's Health Initiative. MEASUREMENTS: Illumination in lux was averaged for 4 hours before bedtime and over 24 hours. Mood was measured using a brief eight-item screen. RESULTS: Illumination in the 4 hours before bedtime was quite dim: median 24 lux. Nevertheless, evening light exposure was not significantly related to sleep amount (in bed or out of bed) sleep efficiency, sleep latency, wake within sleep, or mood. In contrast, the overall amount of light throughout the 24 hours was negatively correlated with sleep latency, wake within sleep, and depressed mood. CONCLUSIONS: Low evening lighting does not appear to be a crucial factor in sleep and mood disturbances of aging, but overall lighting may contribute to these disturbances. [source]

Effect of Light Treatment on Sleep and Circadian Rhythms in Demented Nursing Home Patients

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2002
Sonia Ancoli-Israel PhD
First page of article [source]

Independent Autonomic Modulation of Sinus Node and Ventricular Myocardium in Healthy Young Men During Sleep

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 10 2000
PETER KOWALLIK M.D.
Autonomic Modulation of Sinus Node and Ventricle. Introduction. The aim of this study was to investigate whether autonomic modulation of ventricular repolarization may spontaneousiy differ from that of the sinoatrial node. Methods and Results. Onset of P waves. QRS complexes, and the apex and end of T waves were detected heat to heat in high-resolution ECGs from nine healthy young men during the night. There were time-dependent fluctuations in the QT/RR slopes of consecutive 5-minute segments that could not he explained by the mean RR cycle length of the respective segment. Because the variahility found in QT intervals could not be explained hy either possible effects of rate dependence or hysteresis, autonomic effects were obvious. Power speetral analysis was performed for consecutive 5-minute segments of PP and QT techograms. In a given subject. trends in the time course of low-frequency (LF) and high-frequency (HF) power in PP and QT often were similar, but they were quite different at other times. The mean LF/HF ratio for QTend (0.75 ± 0.1) was different from that of PP (1.8 ± 0.2; P = 0.002), indicating differences in sympathovagal balance at the different anatomic sites. Furthermore, at a given mean heart rate, averaged QT intervals were different on a time scale of several minutes to hours. The QT/RR slope of 5-minute segments correlated significantly with the HF power of QT variability but not with that of PP variability, indicating effects of the autonomic nervous system on ventricular action potential restitution. Conclusion. These differences demonstrate that changes in sinus node automaticity are not necessarily indicative of the autonomic control of ventricular myocardium. (J Cardiavasc Electrophysiol, Vol. II, pp. 1063-1070. October 2000) [source]

Development and implementation of a noise reduction intervention programme: a pre- and postaudit of three hospital wards

JOURNAL OF CLINICAL NURSING, Issue 23 2009
Annette Richardson
Aims., By developing, implementing and delivering a noise reduction intervention programme, we aimed to attempt to reduce the high noise levels on inpatient wards. Background., Sleep is essential for human survival and sleep deprivation is detrimental to health and well being. Exposure to noise has been found to disrupt sleep in hospitalised patients which is to be expected as noise levels have been measured and reported as high. Design., A primarily nursing focused, multi-method approach, involving development of clinical guidelines, ward environment review and a staff noise awareness and education programme, was used to target mainly nursing staff plus other healthcare staff on three wards within one hospital. Methods., This practice development initiative was carried out in three key phases (1) Preaudit of ward noise levels, (2) The development, implementation and delivery of a noise reduction intervention programme, (3) Postaudit of ward noise levels. Results., Preintervention average peak decibel levels over 24 hours were found to be 96·48 dB(A) and postintervention average peak decibel levels were measured at 77·52 dB(A), representing an overall significant reduction in noise levels (p < 0·001). Conclusions., This study describes one way to reduce peak noise levels on inpatient hospital wards. Relevance to clinical practice., Sleep deprivation is detrimental to patients with acute illness, so any developments to improve patients' sleep are important. Nurses have a key role in leading, developing and implementing changes to reduce peak noise levels on inpatient wards in hospitals. This nurse-led practice development programme has demonstrated how improvements can be achieved by significantly reducing peak noise levels using simple multi-method change strategies. [source]

Sleep in adolescence: a review of issues for nursing practice

JOURNAL OF CLINICAL NURSING, Issue 13 2009
Tamara Vallido
Aims and objectives., The aim of this review was to explore the literature to determine what is known about adolescent sleep, the causes and consequences of disturbed sleep in adolescence and the implications this has for nursing practice. Background., Sleep disorders are relatively common in young people. Disturbed sleep can be both a cause and a result of ill health and if recognised can indicate psychosocial, psychological or physical difficulties. Design., Literature review. Methods., Searching of key electronic databases. Results., Disturbed sleep in adolescents has several potential consequences, including daytime sleepiness, reduced academic performance and substance use/abuse. However, despite its significance and frequency, sleep disturbance is an area of adolescent health that is almost entirely unaddressed within the nursing literature. Conclusion., Nursing has a role to play in assisting adolescents and their families to recognise the importance of sleep to the general health and well-being of young people. Relevance to clinical practice., There is a need for nursing to develop tools to assess sleep in adolescent clients and non-pharmaceutical interventions to assist adolescents achieve optimum sleep and rest. Nurses may also contribute to educating adolescents and their families regarding the importance of good sleep hygiene. [source]

Sleep in individuals with Cri du Chat syndrome: a comparative study

JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 8 2009
A. P. H. M. Maas
Abstract Background Sleep problems are common in individuals with intellectual disability. Little is known about sleep in children and adults with Cri du Chat syndrome (CDC). Method Sleep was investigated in 30 individuals with CDC using a sleep questionnaire. Sleep problems and sleep behaviours in individuals with CDC were compared with individuals with non-specific intellectual disabilities (NS) (n = 30) and Down's syndrome (DS) (n = 30). Results Nine individuals with CDC (i.e. 30%) had a sleep problem, compared with seven individuals with NS (i.e. 23%) and three individuals with DS (i.e. 10%). Though there were few differences between diagnostic groups, night waking problems were most common in CDC. Individuals with CDC frequently showed behaviours related to disordered breathing and poor-quality sleep. Several behaviours related to sleep had a higher occurrence in CDC than in DS (P < 0.05) but not in NS. Conclusions It is concluded that individuals with CDC do not have an increased probability of sleep problems as compared with other individuals who share similar demographic characteristics. Hypotheses about causes of night waking problems in CDC are generated and suggestions for future research of sleep in individuals with CDC are given. [source]