Evaluation of sleep quality, insomnia severity and OSAS risk in primary care population: A descriptive study

Background: Alternate day fasting combined with a low carbohydrate diet (ADF-LC) is an effective weight loss regimen. Whether the weight loss induced by ADF-LC can improve sleep, remains unknown. Objective: This study examined the effect an ADF-LC diet on sleep quality, duration, insomnia severity and the risk of obstructive sleep apnea. Methods: Adults with obesity (n = 31) participated in ADF (600 kcal “fast day”; ad libitum intake “feast day”) with a low-carbohydrate diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period. Results: Reductions in body weight (−5 ± 1 kg, p < 0.001) and fat mass (−4 ± 1 kg, p < 0.01) were noted during the weight loss period, and these reductions were sustained during the weight maintenance period. Lean mass and visceral fat remained unchanged. The Pittsburgh Sleep Quality Index (PSQI) score indicated poor sleep quality at baseline (6.4 ± 0.7) with no change by month 3 or 6, versus baseline. ISI score indicated subthreshold insomnia at baseline (8.5 ± 1.0), with no change by month 3 or 6, versus baseline. The percent of subjects with high risk of obstructive sleep apnea at baseline was 45%, with no change by month 3 or 6. Wake time, bedtime, and sleep duration remained unchanged. Conclusion: The ADF-LC diet does not impact sleep quality, duration, insomnia severity or the risk of obstructive sleep apnea in adults with obesity.

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Sleep symptomatology is associated with greater subjective cognitive concerns: Findings from the community-based Healthy Brain Project

SLEEP ◽

10.1093/sleep/zsab097 ◽

2021 ◽

Author(s):

Jessica Nicolazzo ◽

Katharine Xu ◽

Alexandra Lavale ◽

Rachel Buckley ◽

Nawaf Yassi ◽

...

Keyword(s):

Cognitive Function ◽

Sleep Quality ◽

Cognitive Performance ◽

Sex Education ◽

Severity Index ◽

Analysis Of Covariance ◽

Psychomotor Function ◽

Community Based ◽

The Relationship ◽

Insomnia Severity

Abstract Study objectives To examine if sleep symptomatology was associated with subjective cognitive concerns or objective cognitive performance in a dementia-free community-based sample. Methods A total of 1421 middle-aged participants (mean±standard deviation = 57±7; 77% female) from the Healthy Brain Project completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) to measure sleep quality, insomnia symptom severity, and daytime sleepiness, respectively. Participants were classified as having no sleep symptomatology (normal scores on each sleep measure), moderate sleep symptomatology (abnormal scores on one sleep measure), or high sleep symptomatology (abnormal scores on at least two sleep measures), using established cut-off values. Analysis of covariance was used to compare objective cognitive function (Cogstate Brief Battery) and subjective cognitive concerns (Modified Cognitive Function Instrument) across groups. Results Following adjustments for age, sex, education, mood, and vascular risk factors, persons classified as having high sleep symptomatology, versus none, displayed more subjective cognitive concerns (d=0.24) but no differences in objective cognitive performance (d=0.00-0.18). Subjective cognitive concerns modified the association between sleep symptomatology and psychomotor function. The strength of the relationship between high sleep symptomatology (versus none) and psychomotor function was significantly greater in persons with high as compared with low cognitive concerns (β±SE =-0.37±0.16; p=0.02). Conclusions More severe sleep symptomatology was associated with greater subjective cognitive concerns. Persons reporting high levels of sleep symptomatology may be more likely to display poorer objective cognitive function in the presence of subjective cognitive concerns.

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Behavioral and biologic evidence of persistent high-risk behavior in an HIV primary care population

AIDS ◽

10.1097/00002030-200002180-00012 ◽

2000 ◽

Vol 14 (3) ◽

pp. 297-301 ◽

Cited By ~ 49

Author(s):

Emily J. Erbelding ◽

David Stanton ◽

Thomas C. Quinn ◽

Anne Rompalo

Keyword(s):

Primary Care ◽

High Risk ◽

Risk Behavior ◽

High Risk Behavior ◽

Primary Care Population ◽

Hiv Primary Care

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Cross-Cultural Comparisons of Subjective Cognitive Complaints in a Diverse Primary Care Population

Journal of Alzheimer s Disease ◽

10.3233/jad-201399 ◽

2021 ◽

pp. 1-11

Author(s):

Danelly Rodríguez ◽

Emmeline Ayers ◽

Erica F. Weiss ◽

Joe Verghese

Keyword(s):

Primary Care ◽

Depressive Symptoms ◽

Cognitive Function ◽

African Americans ◽

Primary Care Clinic ◽

Depression Scale ◽

Cognitive Complaints ◽

Care Clinic ◽

Primary Care Population ◽

Subjective Cognitive Complaints

Background: Very few studies have explored the utility of subjective cognitive complaints (SCCs) in primary care settings. Objective: We aim to investigate associations between SCCs (item-level), objective cognitive function (across domains and global), and mood in a diverse primary care population, including subjects with mild cognitive impairment. Methods: We studied 199 (75.9%females; 57.8%Hispanics; 42.2%African Americans) older adults (mean age 72.5 years) with memory concerns at a primary care clinic. A five-item SCC questionnaire, and objective cognitive assessments, including the Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale, were administered. Results: Logistic regression analyses showed associations between SCC score and depressive symptoms. A memory-specific (“memory worsening”) SCC predicted scores on the MoCA (p = 0.005) in Hispanics. Conclusion: SCCs are strongly linked to depressive symptoms in African Americans and Hispanics in a primary care setting; a specific type of SCC is related to global cognitive function in Hispanics.

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The effect of 4-h versus 6-h time restricted feeding on sleep quality, duration, insomnia severity and obstructive sleep apnea in adults with obesity

Nutrition and Health ◽

10.1177/02601060211002347 ◽

2021 ◽

pp. 026010602110023

Author(s):

Sofia Cienfuegos ◽

Kelsey Gabel ◽

Faiza Kalam ◽

Mark Ezpeleta ◽

Vicky Pavlou ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Quality ◽

Sleep Onset ◽

Control Group ◽

Sleep Onset Latency ◽

Restricted Feeding ◽

Wake Time ◽

Obstructive Sleep ◽

Insomnia Severity

Background: Time restricted feeding (TRF) involves deliberately restricting the times during which energy is ingested. Preliminary findings suggest that 8–10-h TRF improves sleep. However, the effects of shorter TRF windows (4–6 h) on sleep, remain unknown. Aims: This study compared the effects of 4-h versus 6-h TRF on sleep quality, duration, insomnia severity and the risk of obstructive sleep apnea. Methods: Adults with obesity ( n = 49) were randomized into one of three groups: 4-h TRF (eating only between 3 and 7 p.m.), 6-h TRF (eating only between 1 and 7 p.m.), or a control group (no meal timing restrictions) for 8 weeks. Results: After 8 weeks, body weight decreased ( p < 0.001) similarly by 4-h TRF (–3.9 ± 0.4 kg) and 6-h TRF (–3.4 ± 0.4 kg), versus controls. Sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI), did not change by 4-h TRF (baseline: 5.9 ± 0.7; week 8: 4.8 ± 0.6) or 6-h TRF (baseline: 6.4 ± 0.8; week 8: 5.3 ± 0.9), versus controls. Wake time, bedtime, sleep duration and sleep onset latency also remained unchanged. Insomnia severity did not change by 4-h TRF (baseline: 4.4 ± 1.0; week 8: 4.7 ± 0.9) or 6-h TRF (baseline: 8.3 ± 1.2; week 8: 5.5 ± 1.1), versus controls. Percent of participants reporting obstructive sleep apnea symptoms did not change by 4-h TRF (baseline: 44%; week 8: 25%) or 6-h TRF (baseline: 47%; week 8: 20%), versus controls. Conclusion: These findings suggest that 4- and 6-h TRF have no effect on sleep quality, duration, insomnia severity, or the risk of obstructive sleep apnea.

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Triptan use after starting prophylactic migraine treatment: A retrospective cohort study in a primary care population

Cephalalgia ◽

10.1177/0333102414521511 ◽

2014 ◽

Vol 34 (11) ◽

pp. 927-932 ◽

Cited By ~ 2

Author(s):

Antonia FH Smelt ◽

Willem JJ Assendelft ◽

Christel E van Dijk ◽

Jeanet W Blom

Keyword(s):

Primary Care ◽

Clinical Trials ◽

Cohort Study ◽

Retrospective Cohort ◽

Daily Practice ◽

Rank Test ◽

Migraine Treatment ◽

Prophylactic Effect ◽

Primary Care Population ◽

Wilcoxon Rank Test

Background Clinical trials on the prophylactic effect of propranolol and metoprolol for migraine show that starting this medication leads to a decrease in the use of attack medication of 0.9–8.9 doses per month. However, studies in daily practice are lacking. Methods We compared the number of triptans prescribed in the six months before and the six months after the start of propranolol/metoprolol in a Dutch national representative primary care cohort. Results Of the 168 triptan-using patients who started with propranolol or metoprolol, the number of triptans prescribed before starting was 4.6 doses per month. The number of triptans prescribed six months before compared with six months after starting propranolol/metoprolol decreased with 1.0 dose per month (Wilcoxon rank test; p = 0.000). Conclusion In this primary care population, although the number of triptans prescribed decreased after starting propranolol or metoprolol, the decrease is relatively small compared to data from clinical trials.

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