scholarly journals Refreshing Sleep and Sleep Continuity Determine Perceived Sleep Quality

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Eva Libman ◽  
Catherine Fichten ◽  
Laura Creti ◽  
Kerry Conrod ◽  
Dieu-Ly Tran ◽  
...  

Sleep quality is a construct often measured, employed as an outcome criterion for therapeutic success, but never defined. In two studies we examined appraised good and poor sleep quality in three groups: a control group, individuals with obstructive sleep apnea, and those with insomnia disorder. In Study 1 we used qualitative methodology to examine good and poor sleep quality in 121 individuals. In Study 2 we examined sleep quality in 171 individuals who had not participated in Study 1 and evaluated correlates and predictors of sleep quality. Across all six samples and both qualitative and quantitative methodologies, the daytime experience of feeling refreshed (nonrefreshed) in the morning and the nighttime experience of good (impaired) sleep continuity characterized perceived good and poor sleep. Our results clarify sleep quality as a construct and identify refreshing sleep and sleep continuity as potential clinical and research outcome measures.

Lupus ◽  
2014 ◽  
Vol 23 (13) ◽  
pp. 1350-1357 ◽  
Author(s):  
L Palagini ◽  
C Tani ◽  
R M Bruno ◽  
A Gemignani ◽  
M Mauri ◽  
...  

Objectives Sleep disturbances are frequently observed in rheumatic diseases including systemic lupus erythematosus (SLE). This study aimed at evaluating the prevalence of insomnia, poor sleep quality and their determinants in a cohort of SLE patients. Methods Eighty-one consecutive SLE female patients were evaluated in a cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Beck Depression Inventory (BDI) and the Self-rating Anxiety Scale (SAS) were administered. Patients with previous diagnosis of obstructive sleep apnea or restless legs syndrome were excluded. Fifty-three women with hypertension (without SLE) were enrolled as control group (H). Results In the SLE cohort poor sleep quality (65.4% vs 39.6%, p < 0.01) and difficulty in maintaining sleep and/or early morning awakening (65.4% vs 22.6%, p < 0.001), but not insomnia (33.3% vs 22.6%, p = ns), were more prevalent than in H. Depressive symptoms were present in 34.6% of SLE vs 13.2% H patients ( p < 0.001) while state anxiety was more common in H patients (H 35.8% vs SLE 17.3%, p < 0.005). SLE was associated with a 2.5-times higher probability of presenting poor sleep quality in comparison to H (OR 2.5 [CI 1.21–5.16]). After adjusting for confounders, both depressive symptoms (OR 4.4, [1.4–14.3]) and use of immunosuppressive drugs (OR 4.3 [CI 1.3–14.8]) were significantly associated with poor sleep quality in SLE patients. Furthermore, poor sleep quality was not associated either with disease duration or activity. Conclusions In a cohort of SLE women, insomnia and poor sleep quality, especially difficulties in maintaining sleep, were common. Depressive symptoms might be responsible for the higher prevalence of poor sleep quality in SLE.


2019 ◽  
Vol 81 (3-4) ◽  
pp. 190-196
Author(s):  
Byung Joon Kim ◽  
Kang Min Park

Background: Both obstructive sleep apnea (OSA) and obesity are associated with poor sleep quality. However, there have been no studies investigating sleep quality in OSA patients with obesity. The aims of this study were to (1) evaluate the sleep quality in OSA patients with obesity and (2) identify the parameters most related to sleep quality in OSA patients with obesity. Methods: Of the patients with polysomnography (PSG), OSA patients with obesity (body mass index [BMI] ≥25) were enrolled and then divided into 2 groups based on the Pittsburg Sleep Questionnaire Index (PSQI): patients with good sleep quality (PSQI ≤5, good sleepers) and those with poor sleep quality (PSQI >5, poor sleepers). In addition, we enrolled OSA patients without obesity as a disease control group. Results: Eighty-two OSA patients with obesity met the inclusion criteria (28 were good sleepers, whereas 54 were poor sleepers). We found that the BMI of the poor sleepers was significantly higher than that of the good sleepers, whereas the N-stage sleep ratio of good sleepers was higher than that of poor sleepers. Logistic ­regression analysis also showed that a high BMI and low ­N-stage sleep ratio were independently associated with poor sleep quality. In addition, BMI and N-stage sleep ratio were significantly correlated with PSQI. However, in 56 OSA patients (n = 56) without obesity, there were no differences of demographic/clinical characteristics and PSG parameters between the good (n = 18) and poor sleepers (n = 38). Discussions: About two-thirds of OSA patients with obesity show poor sleep quality. The sleep quality of these patients was more affected by the severity of obesity, but not the severity of OSA. Thus, we recommend weight loss in OSA patients with obesity to improve sleep quality as well as the severity of OSA.


Author(s):  
Ieva Kalere ◽  
Ilze Konrāde ◽  
Anna Proskurina ◽  
Sabīne Upmale ◽  
Tatjana Zaķe ◽  
...  

Abstract There is a close relationship between melatonin as a circadian regulator and insulin, glucagon and somatostatin production. This study aimed to describe subgroups of type 2 diabetes mellitus (T2DM) patients that may benefit from melatonin clock-targeting properties. The study involved 38 participants: 26 T2DM patients, and 12 participants without diabetes in the control group. Subjects were asked to complete the questionnaire of Pittsburgh Sleep Quality Index (PSQI). Standard biochemical venous sample testing was performed, and a sample of saliva was collected for melatonin testing. Melatonin concentration in participants without obesity (body mass index (BMI) < 30 kg/m2) was significantly higher than in obese participants: 13.2 (6.4; 23.50) pg/ml vs 5.9 (0.78; 13.1) pg/ml, p = 0.035. Subjects with BMI 30 kg/m2 had a significantly higher PSQI score than non-obese subjects: 7 (4.5; 10) vs 5.5 (3; 7), p = 0.043. T2DM patients showed significantly lower levels of melatonin than the control group: 6.1 (0.78; 12.2) pg/ml vs 17.8 (8.2; 25.5) pg/ml, p = 0.003. T2DM patients using short-acting insulin analogues showed a significantly higher PSQI score than patients not using insulin: 9 (6; 10) vs 6 (3; 8), respectively (p = 0.025). Poor sleep quality was more prevalent in patients with diabetic retinopathy than in those without this complication (p = 0.031). Lower melatonin levels were detected in T2DM and obese patients. Furthermore, poor sleep quality was observed in T2DM patients using short-acting insulin analogues and those with diabetic retinopathy, and obese individuals.


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 1025-1025
Author(s):  
Vence L. Bonham ◽  
Kayla Cooper ◽  
Caterina P. Minniti ◽  
Khadijah Abdallah ◽  
Ashley Buscetta

Background: Approximately 57% of individuals with Sickle Cell Disease (SCD) suffer from sleep disorders and poor sleep quality. Poor sleep quality may cause excessive daytime sleepiness and is often associated with psychosocial and clinical factors contributing to disease burden and stress levels. One of these psychosocial factors is John Henryism (JH). Defined as a high-effort, active coping style, JH is used by persons with a strong determination to succeed in the face of chronic stressors. Both sleep and JH have mostly been shown to be negatively associated with cardiovascular health. Living with SCD is a unique stressor and how persons cope with their disease may impact their quality of life and health outcomes. The objective of this study is to 1) evaluate the impact of sleep quality and 2) quantify the effect of sleep quality on high-effort coping among persons with SCD. Methods: The sample comprised 191 adults aged 19-71 with SCD. Most participants were women (57%) and had a mean age of 39 years (SD+12.2) (see Table 1). All participants were enrolled in the Insights into Microbiome and Environmental Contributions to SCD and Leg Ulcers (INSIGHTS) study (NCT02156102). All participants were administered a variety of psychosocial measures, a comprehensive medical history and physical exam, and provided blood and saliva samples for clinical and research analysis. Our binary outcome assessed participants' high or low utilization of JH coping style by using the John Henryism Active Coping Scale (JHAC12). JHAC12 scores were measured from participant responses to a 12-item Likert scale. Scores range from 12 to 60 with higher scores indicting higher utilization of JH active coping. Based on the median JH score of our participants, scores between 12-50.9 were categorized as low utilization of JH and scores between 51-60 were categorized as high utilization of JH. Predictors included demographic data and psychosocial measures. Sleep quality was assessed via clinical and survey measures. Clinically, obstructive sleep apnea was self-reported during a comprehensive medical exam. The ASCQ-ME sleep survey is a 5-item measure, and was used to ascertain participant sleep patterns within the past seven days. Scores range from 40 to 60. Scores less than 50 are considered abnormal. Multivariable logistic regression was performed to evaluate differences within the cohort. Results: Mean ASCQ-ME sleep score of the entire cohort was 46, indicating worse sleep quality for participants compared to the ASCQ-ME national SCD reference cohort. Obstructive sleep-apnea was self-reported by 23 participants (12%). The mean JH score was 52, indicating high utilization of active coping. Poorer sleep quality was associated with higher JH coping (OR:1.14, 95% CI: [1.06-1.22]) (see Table 2). There were no significant associations between utilization of JH active coping with the demographic data including sex, age, education and marital status. Worse sleep quality within the SCD cohort was associated with increased usage of hydroxyurea (r= .16, p<.05), history of cardiovascular disease (r= .13, p<.05), higher pain score at study visit (r=.15, p<.05) and increased systolic blood pressure (r=.18, p<.01). Conclusion: Preliminary findings support a relationship between JH and sleep quality in a SCD cohort. In a disease population with high sleep apnea prevalence, these findings have potential clinical implications. Future work should focus on how these psychosocial factors impact sleep and clinical presentation. Disclosures Minniti: Doris Duke Foundation: Research Funding.


2017 ◽  
pp. jramc-2016-000677
Author(s):  
Seyyedeh Soghra Mousavi ◽  
E Vahedi ◽  
M Shohrati ◽  
Y Panahi ◽  
S Parvin

BackgroundSulfur mustard (SM) exposure causes respiratory disorders, progressive deterioration in lung function and mortality in injured victims and poor sleep quality is one of the most common problems among SM-exposed patients. Since melatonin has a critical role in regulation of sleep and awareness, this study aimed to evaluate the serum melatonin levels in SM-injured subjects.MethodsA total of 30 SM-exposed male patients and 10 controls was evaluated. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI); daytime sleepiness was measured by the Epworth Sleepiness Scale (ESS), and the risk of obstructive sleep apnoea was determined by the STOP-Bang questionnaire. Polysomnography (PSG) and pulmonary function tests (PFTs) were also available. Nocturnal serum melatonin levels were measured using an ELISA kit.ResultsThe mean of PSQI, ESS and STOP-Bang scores in patients (11.76±3.56, 12.6±3.03 and 5.03±1.09, respectively) were significantly (p<0.01) higher than those in the controls (2.78±0.83, 4.69±1.15 and 1.18±0.82, respectively). PFTs also showed declined respiratory quality in SM-patients. There was a significant difference regarding the PSG results between patients and controls (p<0.01). The mean of nocturnal serum melatonin levels in patients (29.78±19.31 pg/mL) was significantly (p=0.005) lower than that in the controls (78.53±34.41 pg/mL).ConclusionsReduced nocturnal serum melatonin and respiratory disorders can be the reasons for poor sleep quality among these patients.Trial registration numberIRCT2015092924267N1, Pre-results.


2019 ◽  
Vol 8 (1) ◽  
pp. 117
Author(s):  
Marnila Yesni

The heart failure disease incident rate is high in the world and Indonesia. Heart failure patients suffer from poor sleep quality. This affects the disease recovery process and increases the mortality and morbidity rates. Patients need an intervention to overcome the issue and the role of a nurse is highly needed to overcome it. The purpose of this research was to identify the effects of nursing intervention of therapy of right lateral position on the sleep quality of heart failure patients. The method used was the Quasi Experiment with the pre and post test control group consisting of 15 respondents of intervention group and 14 respondents of control group treated at RSUP M Djamil Padang, determined according to the inclusion criteria. The results of research indicated that there was a significant difference in the sleep quality of right lateral position group and the control group with the value (p = value = 0,001). The statistics test used was the independent T test. Sleep is the necessity of human beings. By giving the intervention of therapy of right lateral position, the issue of poor sleep quality in heart failure patients may be resolved. Health care service, particularly nurses, is advised to apply this therapy as an independent nursing intervention to increase the sleep quality of heart failure patients treated at the hospital.


2021 ◽  
Vol 26 (2) ◽  
pp. 20-25
Author(s):  
Andrea Díaz Pacheco ◽  
Jesús Moo Estrella

In Parkinson's disease (PD), poor sleep quality and sleep disorders are central part of the non-motor symptoms. The aim was to compare sleep quality (SQ), REM sleep behavior disorder (RBD) and excessive daytime sleepiness (EDS) among adults with and without Parkinson's disease (PD). A second objective was to know the relationship of SQ and RBD with EDS in patients with PD. Method. sixty adults (38 % women,  mean age 66.7 ± 8.11 years), 50 % with PD diagnosis and 50 % healthy controls, Instruments: Epworth Sleepiness Scale, Sleep Quality Pittsburgh Index and REM Behavioral Disorder Sleep Questionnaire, which was designed for this study. Results. Differences were found in SQ (PD = 9.90 ±4.47 vs Control group = 7.23 ±4.71, t = 2.25, p = .028), and the percentage of cases with symptoms of RBD (PD = 30%, control group = 6.7%, ji2 = 5.455, p = .020). No differences were found in EDS (PD = 7.43 ± 5.46 vs Control group = 6.50 ± 5.28, t = .673, p = .504). According to the linear regression analysis, the increase in EDS was not associated with SQ, EDS was only associated with RBD. Conclusion, the PD group presents a poor sleep quality and a higher prevalence of RBD symptoms. EDS did not differ between adults with and without PD. However, RBD was associated with an increase in EDS in the PD group.


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4786-4786
Author(s):  
Marlise Luskin ◽  
Eric Zhou ◽  
Zilu Zhang ◽  
Daniel J. DeAngelo ◽  
Richard Stone ◽  
...  

BACKGROUND: Most patients with myelodysplastic syndromes (MDS) describe difficulty sleeping (Luskin et al Br J Haem 2017) and sleep disturbance is a likely contributor to the fatigue experienced by patients with MDS and acute leukemia. Data are sparse regarding the sleep of this patient population as formally assessed with sleep-focused survey instruments. METHODS: We surveyed consecutive adult patients with MDS, AML or ALL at the Dana-Farber Leukemia clinic. With permission from the treating oncologist, patients with a physician-assessed life expectancy ≥ 12 weeks were mailed a questionnaire packet assessing insomnia symptom severity (Insomnia Severity Index; ISI), sleep quality (Pittsburgh Sleep Quality Index; PSQI), obstructive sleep apnea risk (STOP-Bang), and depressive symptoms (Patient Health Questionnaire-9; PHQ-9). Respondents underwent concomitant medical record review. RESULTS: Of 332 eligible patients contacted, 158 (47.6%) responded. Responders were 56% male with a median age of 67 years. Overall, 42% of patients reported insomnia symptoms (ISI ≥10) with the prevalence of such symptoms similar among patients with MDS and acute leukemia (48% vs 38%, p=0.23). OSA risk was high (58%), particularly in patients with MDS (67% vs 52% p=0.10). Those with high OSA risk were more likely to have clinical insomnia as defined by ISI ≥10 (OR 2.6, p=0.01). Depression was uncommon: only 7% had PHQ-measured moderately severe or severe depression. Median sleep duration for the entire cohort was 6.9 hours (range 3-12) indicating that over half of respondents slept less than the 7 hours per night recommended by the National Sleep Foundation for healthy adults. Poor sleep quality (PSQI "Bad Sleep") was seen in 79% of the overall cohort. CONCLUSION: When measured with validated tools, disturbed sleep is common among patients with MDS and acute leukemia. OSA risk is also prevalent but does not likely explain all of the poor sleep quality seen. These data suggest that strategies are needed to improve both quantity and quality of sleep in this population. Table Disclosures DeAngelo: Abbvie: Research Funding; GlycoMimetics: Research Funding; Blueprint: Consultancy, Research Funding; Amgen: Consultancy; Celgene: Consultancy; Shire: Consultancy; Incyte: Consultancy; Novartis: Consultancy, Research Funding; Takeda Pharmaceuticals: Consultancy; Jazz Pharmaceuticals Inc: Consultancy; Pfizer: Consultancy. Garcia:Abbvie: Research Funding; Genentech: Research Funding. Winer:Jazz Pharmaceuticals, Pfizer: Consultancy. Steensma:Aprea: Research Funding; Arrowhead: Equity Ownership; Pfizer: Consultancy; H3 Biosciences: Other: Research funding to institution, not investigator.; Astex: Consultancy; Onconova: Consultancy; Stemline: Consultancy; Summer Road: Consultancy.


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