Inledning: Sömnlöshet (insomni) är ett stort och växande folkhälsoproblem för den vuxna befolkningen. I dagsläget rekommenderas läkemedel och kognitiv beteendeterapi som behandling för diagnosen, men inga särskilda vetenskapliga rekommendationer finns i syfte att förebygga insomni. Forskning visar att individers levnadsvanor verkar som bestämningsfaktorer för deras sömnkvalitet, men ännu bedöms området vara relativt outforskat. Syfte: Denna studie syftade till att undersöka om fysisk aktivitet kan förebygga kronisk sömnlöshet och sömnlöshetssymtom hos den vuxna befolkningen. Metod: Systematiskt litteraturstudie i PubMed. Resultat: Fysisk aktivitet visade sig vara associerat med kronisk insomni och sömnlöshetssymtom, och föreningen påverkades emellertid av individens body mass indiex. Skillnader beträffande intensitetsnivåer och form av fysisk aktivitet observerades både mellan könen och i olika åldersgrupper. Diskussion: Förskrivning av fysisk aktivitet på recept i förebyggande syfte för individer i riskgrupp för sömnlöshet, eller i behandlingssyfte för lidande patienter, utgör en potentiell framtida folkhälsosatsning av sömnlöshet, men kostnadseffektivitet måste utvärderas. / Introduction: Insomnia is a major and growing public health problem for the adult population. Currently recommend medication and cognitive behavior therapy as treatment for the diagnosis, but no special recommendations are available for the purpose of preventing chronic insomnia och insomnia symptoms. Research shows that peoples living habits appear to be determining factors for their sleep quality, but it is still estimated that the area is relatively unexplored. Aim: This study investigate whether physical activity can prevent chronic insomnia and symptoms of insomnia in adults. Method: Systematic literature study in PubMed. Result: Physical activity was found to be associated with chronic insomnia and insomnia symptoms, and the association was affected by the body mass index (BMI) of the individual. Differences in intensity levels and physical activity were observed between the sexes and in different age groups. Discussion: The prescription of physical activity to individuals at risk for insomnia, or for treatment of those suffering from insomnia, represents a potential future public health strategy for the management and prevention of insomnia, however, cost-effectiveness of these strategies must be evaluated.

Made available in DSpace on 2015-07-22T20:50:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-10-27 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Associação Fundo de Incentivo à Psicofarmacologia (AFIP) / O objetivo do presente estudo foi avaliar os efeitos do exercício aeróbio moderado no padrão do sono, na qualidade de vida e no perfil de humor de pacientes com insônia crônica primária, bem como verificar se esses efeitos são dependentes do horário da prática do exercício. Dezenove pacientes com insônia crônica primária (45 anos [EP  1,9]) foram distribuídos aleatoriamente entre os grupos MANHÃ (10:00  1 h) e TARDE (18:00  1 h). Todos os voluntários participaram de um protocolo de exercícios aeróbios, realizados em intensidade moderada (caminhada), durante 50 minutos, 3 vezes/semana, durante 6 meses. Para avaliar o sono foram utilizados a polissonografia e o diário do sono, a qualidade de vida foi medida pelo questionário Medical Outcome Study Short Form - 36 (MOS SF-36) e o humor pelo questionário Profile of Mood States (POMS). Na polissonografia, os resultados demonstraram, nos dois grupos (MANHÃ e TARDE), reduções na latência do sono, no tempo acordado após o início do sono, além de aumento na eficiência do sono, após a intervenção. No diário do sono, significantes melhoras foram observadas na latência do sono, na qualidade do sono e na sensação de descanso ao acordar, nos dois grupos. Além disto, a qualidade de vida (atividades sociais e limitação por aspectos emocionais) e o perfil de humor (tensão-ansiedade, depressão e distúrbio total de humor) melhoraram após a intervenção. Estes efeitos não diferiram quanto ao horário do dia. Podemos concluir que o exercício aeróbio crônico, realizado em intensidade moderada, produz significantes melhoras no padrão do sono, na qualidade de vida e no perfil de humor de pacientes com insônia crônica primária. De forma geral, estes efeitos parecem não diferir quando o exercício físico é realizado pela manhã ou ao final da tarde. / To evaluate the effect of chronic moderate aerobic exercise on sleep, quality of life and mood of individuals with chronic primary insomnia, and to examine whether these effects differed for morning vs. late-afternoon exercise. Nineteen sedentary individuals with chronic primary insomnia (mean age 45.0 [SE  1.9] years) completed 6-month moderate aerobic exercise training (3 days/week), randomized to the morning (10:00  1 h) or late-afternoon (18:00  1 h). Across both time points, polysomnographic data demonstrated significant reductions in sleep onset latency and wake time after sleep onset, and a significant increase in sleep efficiency following exercise. Sleep diary data revealed significant improvements in sleep onset latency, sleep quality and feeling rested in the morning. There was generally no significant difference in response to morning vs. late-afternoon exercise. Following exercise, significant increases in some quality of life measures, and significant reductions in Profile of Mood State measures of tension-anxiety, depression and total mood disturbance were found. These effects did not vary by time of day. In conclusion, chronic moderate aerobic exercise elicited significant improvements in sleep, quality of life and mood in individuals with chronic primary insomnia; these effects generally did not differ for morning vs. late-afternoon exercise. / FAPESP: 2008/02862 - 1 / FAPESP: 98/14303 - 3 / TEDE / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2015-07-22T20:50:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-06-29 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Associação Fundo de Incentivo à Psicofarmacologia (AFIP) / No período do climatério, cerca de 80% das mulheres são acometidas pelas consequências do hipoestrogenismo: alterações fisiológicas, psicológicas, ondas de calor, nictúria, alterações de humor. Essas modificações contribuem para o aumento da prevalência de insônia nessa fase, que atinge cerca de 28% a 63% das mulheres pós-menopausadas. A presença de tais sintomas associados a condições sócio-culturais, como a aposentadoria, a valorização da juventude, o envelhecimento, refletem diretamente na qualidade de vida dessa população. Como a terapia hormonal tem sua indicação individualizada e não indicada em alguns casos, a procura por terapias coadjuvantes ou substitutivas é crescente, incluindo a massagem terapêutica, que pode aliviar os sintomas da insônia no período climatérico. O presente estudo é apresentado em dois trabalhos. O primeiro, um estudo piloto com sete voluntárias, que avaliou o efeito da massagem terapêutica em mulheres pós-menopausadas com insônia e apresentou melhora objetiva e subjetiva no sono. Os resultados deste estudo nos levaram à elaboração do segundo trabalho, randomizado e controlado. O trabalho 2 avaliou quarenta e quatro mulheres distribuídas em 3 grupos, controle, movimento passivo e massagem terapêutica. Os resultados dos questionários mostraram melhora no sono, nos sintomas climatéricos e na qualidade de vida. / In the climacteric period, approximately 80% of women are affected by consequences of hypoestrogenism: physiological and psychological alterations, hot flashes, nycturia, mood alterations. These changes contribute to the increase of insomnia prevalence in this phase, which affects approximately 28% to 63% of postmenopausal women. The presence of such symptoms associated with socio-cultural conditions, such as retirement, appreciation of youth, aging, reflect directly on quality of life of this population. As hormone therapy is indicated in certain cases and is not indicated for some patients, there has been an increase in the demand for complementary or alternative therapies, including therapeutic massage, which may relieve insomnia symptoms in the climacteric period. The present study is presented in two studies. The first one, a pilot study with seven individuals, evaluated the effects of therapeutic massage on post-menopausal insomniac women and demonstrated subjective and objective sleep improvement. The results of this study led us to conduct a second one, now a randomized and controlled trial, including 44 women, distributed into 3 groups (control, passive movement and therapeutic massage). The results of the questionnaires demonstrated improvement in sleep, climacteric symptoms and quality of life. / FAPESP: 98/143030-3 / TEDE / BV UNIFESP: Teses e dissertações

One of the most common complaints of mothers at the paediatrician's is complaint about the night sleep disorder, especially in older infants and toddlers. Long-term insomnia of a child negatively affects well-being of parents and disrupts peaceful atmosphere of home. We often encounter sleep disorders in babies; mostly they are frequent nocturnal awakenings and difficulty falling asleep. Parents should be therefore informed about sleep issues already at neonatal units, as they are informed about breastfeeding. The target group of this research was mothers of infants and nurses working at neonatal units and in primary paediatric care. The aim of the study was to determine the level of awareness of paediatric nurses and parents about infant sleep and create educational material for nurses. The survey was carried out using a snow ball technique, in-depth interviews with mothers and a questionnaire with open questions for nurses. Collected data were then transcribed, coded, and processed using frame analysis by. Then, using the snow ball method, we gradually extended the sample to 7 mothers of unsleepy infants and 7 mothers of sleepy infants, i.e. to cases that were supposed to strongly manifest the problem. Also, paediatric nurses were selected intentionally according to their place of work at neonatal departments and in primary paediatric care. Parents receive information about infant sleep most often on the Internet, from specialized books and from their own mothers and friends; and they usually do not ask nurses for information on infant sleep. Parent only find out at home that there is a problem with their child's sleep. They tend to try various interventions to lull their baby to sleep. Research has shown that the most common source of knowledge for nurses is their personal experience with their own children. Nurses also use their rich experience gained during long years of practice. Furthermore, they educate themselves in this issue using specialized books, visiting seminars, and they also use the internet. Nurses' advice to mothers regarding infant insomnia is shown in two perspectives in our research. The first is the perspective of mothers and the second one is the perspective of nurses. Surprisingly, there are discrepancies, especially regarding the nurses in primary care. Interventions that were reported by nurses coincide with working techniques of lulling a baby to sleep. In contrast, some interventions which were described by mothers as advice from a nurse rather indicate ignorance or indifference of some nurses. The research showed that the quality of infant sleep may be to some extent influenced by the information given to parents already at neonatal unit by medical staff, because they are in the best position to provide such information. However, mothers often choose different sources. The research has shown that mothers usually instinctively select proper techniques to lull restless infants to sleep without consulting a paediatric nurse. These results have prompted the development of an educational leaflet for nurses which informs about proper practices and appropriate techniques to lull restless unsleepy infants to sleep.

Made available in DSpace on 2014-12-17T15:36:54Z (GMT). No. of bitstreams: 1 PatriciaCR.pdf: 428870 bytes, checksum: 48df95894e05ff05b5a20f8974a6b856 (MD5) Previous issue date: 2008-12-12 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Brain injury can be associated with changes in the sleep-wake cycle. However, studies about sleep disturbances and their relationship with quality of sleep are scarce. Besides, it remains to be known how stroke affects the mechanisms of sleep. The aim of this study was to investigate quality of sleep, complaints of sleep disturbances and associated factors in stroke patients from the Physical Therapy services in Natal -RN. This was a cross-sectional descriptive study involving 70 individuals (aged 45-65 years), 40 patients (57 ? 7 years), 11 ? 9 months after injury, and 30 healthy individua ls (52 ? 6 years), evaluated with the Pittsburgh Sleep Quality Index (PSQI) and Sleep Habits Questionnaire. The data were analyzed by Chi-square test, t Student test and logistic regression. Poor quality sleep was found in 57,5% of the patients (6,3 ? 3,5) and was significantly higher than in the control population (3,9 ? 2,2) (t Student test, p=0,002). The patients showed significantly higher value of PSQI than controls: sleep latency (p=0,019), length of sleep (p=0,039) and dysfunction during the day (p=0,001). Regarding complaints of sleep disturbances (dyssomnias and parasomnias) analyzed by Chi-square test, the complaint of insomnia was the most prevalent (patients: 37,5%; healthy subjects: 6,7%; p=0,007). Regression analysis showed that sl eep latency (p=0,036) and complaint of insomnia (p=0,036) were associated with quality sleep. In addition, female gender (p=0,036) and complaint of broken sleep (p=0,003) were considered risk factors for the presence of insomnia. Our results show that stroke affects the homeostatic process of sleep. Shorter sleep latency and the absence of insomnia are considered protective factors for good sleep quality and this should be taken into consideration in the diagnostic and therapeutic strategies / A les?o cerebral pode estar associada a altera??es do ciclo sono-vig?lia. No entanto, estudos sobre dist?rbios do sono e suas rela??es com a qualidade de sono s?o raros. Al?m disso, ainda precisa ser conhecido como o Acidente Vascular Cerebral (AVC) afeta os mecanismos do sono. O objetivo deste estudo foi investigar a qualidade de sono, as queixas de dist?rbios do sono e os fatores associados nos pacientes com AVC de servi?os de Fisioterapia em Natal-RN. Este foi um estudo transversal e volvendo 70 indiv?duos (idade 45-65 anos) , 40 pacientes (57 ? 7 anos), 11 ? 9 meses ap?s a les?o, e 30 saud?veis (52 ? 6 anos), avaliados com o ?ndice de Qualidade de sono de Pittsburgh (IQSP) e o Question?rio de H?bitos do Sono. Os dados foram analisados atrav?s dos testes Qui-quadrado, t Student e da Regress?o Log?stica. Qualidade de sono ruim foi encontrada em 57,5% dos pacientes (6,3 ? 3,5) e foi significativamente maior do que na popula??o controle (3,9 ? 2,2) (teste t Student, p=0,002). Os pacientes apresentaram valor significativamente maior de IQSP do que os controles: lat?ncia para o sono ( p=0,019), dura??o do sono (p=0,039) e disfun??o durante o dia (p=0,001). Com rela??o ?s queixas de dist?rbios de sono (dissonias e parassonias) analisadas pelo Qui-quadrado, a queixa de ins?nia foi a mais prevalente (pacientes: 37,5%; saud?veis: 6,7%; p=0,007). A an?lise de regress?o mostrou que a lat?ncia para o sono (p=0,036) e a queixa de ins?nia (p=0,036) estiveram associadas com qualidade de sono. Al?m disso, o sexo feminino (p=0,036) e a queixa de sono fragmentado (p=0,003) foram considerados fatores de risco para a presen?a de ins?nia. Nossos resultados mostram que o AVC afeta o processo homeost?tico do sono. A menor lat?ncia para o sono e a aus?ncia de ins?nia s?o consideradas fatores de prote??o para a boa qualidade de sono e isso deve ser levado em considera??o nas estrat?gias diagn?stica e terap?utica.

INTRODUÇÃO: A insônia, distúrbio do início e/ou manutenção do sono, é a queixa mais freqüente na clínica pediátrica entre os distúrbios de sono dos bebês, embora só se revele como tal após ter provocado repercussões e dificuldades nos pais relativas à privação de sono. Sendo o ritmo de sono a primeira função fisiológica a ser submetida a uma organização a partir do nascimento, a insônia pode ser considerada o primeiro distúrbio funcional. Pode estar associada a problemas na constituição subjetiva do bebê, que se desenvolve tendo como base a relação mãe-filho. OBJETIVOS: Investigar a eficácia adaptativa de mães de bebês com insônia, sua qualidade de sono, sinais e sintomas depressivos; analisar hábitos relacionados ao sono e comparar estes dados aos obtidos das mães de bebês sem insônia. MÉTODO: Estudou-se 30 mães de crianças entre três e 24 meses com queixa de insônia de seus filhos, comparadas com 30 mães do grupocontrole, cujos bebês, com características semelhantes aos do grupoestudo, não apresentavam insônia. Os instrumentos utilizados foram: Escala Diagnóstica Adaptativa Operacionalizada, questionário do Índice de Qualidade de Sono de Pittsburgh, Inventário de Depressão de Beck, diário de sono da criança, Teste de Denver II e Classificação Econômica Brasil. RESULTADOS: A média diária de horas de sono dos bebês insones foi de 11h28min. Houve diferença estatisticamente significante entre a eficácia adaptativa das mães do grupo-estudo e do grupo-controle, com eficácia adaptativa pior no grupo-estudo; as mães deste grupo apresentaram pior qualidade de sono e pior eficiência do sono em relação ao grupo-controle, assim como maiores níveis de sinais e sintomas depressivos. Dentre os hábitos relacionados ao sono, ressaltou-se que as mães dos bebês insones ofereciam alimentação durante a noite, e que esses bebês dormiam com alguma fonte de luz acesa; suas mães mais freqüentemente amamentavam ao seio e por mais tempo. CONCLUSÕES: A eficácia adaptativa das mães dos bebês insones foi pior que a das mães dos bebês sem insônia, principalmente no campo das relações afetivas. A qualidade e a eficiência do sono, sonolência diurna e depressão revelaram-se piores nas mães dos bebês insones. Entre os hábitos relacionados ao sono, nos bebês portadores de insônia houve maior incidência de alimentação noturna / INTRODUCTION: Insomnia, a disorder of initiating and / or maintaining sleep, is the most frequent complaint in Pediatrics concerning babys sleep, although it only becomes known after parents are suffering from symptoms of sleep deprivation. Since sleep rhythm is the first physiological function to undergo organization after birth, insomnia may rightly be considered the first functional disorder. It can be associated with problems in the babys subjective constitution, which develops on the mother-child relationship basis. OBJECTIVES: To investigate the adaptive efficacy of insomniac babies mothers, their sleep quality, depressive signs and symptoms; to analyze sleep-related habits, and compare this data with that coming from mothers whose babies do not report insomnia. METHODS: 30 mothers reporting insomnia of their babies (aged 3 to 24 months) were compared with other 30 mothers whose babies from the same characteristics did not report sleep complaints. The instruments used were: Operationalised Adaptive Diagnosis Scale, Pittsburgh Sleep Quality Index, Beck Depression Inventory, the babies sleep diary, Denver II Test, Brazil Economic Classification. RESULTS: The daily average hours sleep of insomniac babies was 11h28m. A statistically significant difference between adaptive efficacy in mothers from study group and control group was pointed out, with study-group mothers showing worse adaptive efficacy; mothers in this group had worse sleep quality and worse sleep efficiency than control-group mothers, along with higher levels of depressive signs and symptoms. Among sleep-related habits, it is worth mentioning that mothers of insomniac babies usually feed them at night, that babies slept near a source of light, and that mothers usually fed babies from the breast and for a longer time. CONCLUSIONS: The adaptive efficacy of insomniac babies mothers was worse than that of mothers whose babies were not insomniac, chiefly concerning affective relationships. Sleep quality and efficiency, daytime sleepiness and depression were worse in insomniac babies mothers. Among sleep-related habits, feeding insomniac babies at night stands out

睡眠失功能信念在慢性失眠的病理上扮演重要的角色，可能讓個體產生不良睡眠行為與過度睡前激發狀態，進而造成失眠。而癌症相關失眠患者由於其病理的獨特性也可能出現其獨特的睡眠失功能信念，本研究探討在癌症相關失眠的病理機轉中加入癌症相關睡眠失功能信念，是否可較單純一般慢性失眠之睡眠失功能信念對癌症相關失眠有更全面的了解。而癌症相關失眠具有許多不同於一般慢性失眠的要素，其中除了與疾病相關的特殊睡眠失功能信念外，尚有可能與睡眠困擾相關的癌因性疲憊干擾存在。因此，本研究的目的在探討：1）加入癌症相關的睡眠信念之整合睡眠失功能信念與失眠症狀的關聯性是否與單純一般的睡眠失功能信念有所不同；2）其影響路徑是否透過不良睡眠行為與睡前激發狀態影響失眠嚴重度；3）疲憊嚴重度是否使整合睡眠失功能信念對不良睡眠行為的預測力增加。本研究使用問卷調查對混合癌症患者進行各因素的測量後 (N=148)，運用結構方程模型進行路徑與因果分析，研究結果顯示，在疲憊嚴重度較高時，加入癌症相關睡眠失功能信念的整合睡眠失功能信念，其中「對失眠之負向影響預期與擔憂」向度會透過睡前生理激發狀態對「失眠對白天功能影響」程度有正向預測力、而「安眠藥物對疾病影響」向度對「失眠對白天功能影響」程度有負向預測力、不良睡眠行為對「失眠對白天功能影響」程度有正向預測力、一般睡眠失功能信念之預測路徑則多透過認知激發狀態影響；在疲憊嚴重度較低時，「對失眠之負向影響預期與擔憂」向度對「失眠對白天功能影響」程度有正向預測力、「睡眠與健康及病後修復關聯性的信念」向度對「失眠對白天功能影響」程度有負向預測力、「安眠藥物對疾病影響」向度對「睡眠困難」與「主觀痛苦」程度有正向預測力、一般睡眠失功能信念可預測之細項有所減少。研究結果顯示一般睡眠失功能信念會透過睡前認知激發影響失眠嚴重度，而加入癌症睡眠失功能信念後的整合睡眠失功能信念會透過睡前生理激發影響失眠嚴重度，疲憊嚴重度在其中扮演調節變項的角色，疲憊程度高低會使癌症睡眠失功能信念透過不同路徑影響失眠嚴重度。 / Dysfunctional beliefs about sleep play an important role in the pathological mechanism of chronic insomnia. Sleep-related behaviors and presleep arousal may mediate the relationship between the dysfunctional beliefs and severity of insomnia. Since cancer-related insomnia is associated with specific physiological and psychological conditions, there are specific dysfunctional beliefs that might have different influence to patients' sleep. Also, cancer-related fatigue could be closely related to sleep disturbance in cancer patients and demands to be explored. Therefore, the primary purpose of the current study is to explore: 1) whether adding cancer-related dysfunctional sleep beliefs to general dysfunctional sleep beliefs would show different pattern of association with severity of insomnia, comparing to the pattern of general dysfunctional sleep beliefs alone; 2) whether the sleep behavior and presleep arousal mediate the relationship between the dysfunctional beliefs to severity of insomnia in this path of model or not; 3) whether the severity of fatigue is a moderator of the predictibility of combided dysfunctional sleep beliefs to sleep-related behavior. The study recruited 148 mixed cancer diagnosis patients. They were instructed to fill out a package of questionnaires to assess their dysfunctional sleep beliefs, insomnia severity, cancer-related fatigue, etc. Structural equation modeling (SEM) was conducted for path analysis and causality test. Accroding to the result of SEM, presleep arousal was found to be a mediator of the positive association between the beliefs about “expectation and worries of negative consequence of insomnia” and daytime difficulties among subjects with high level of fatigue. Also the beliefs about “harmfulness of hypnotic” have negative predictibility to “daytime difficulty” in these subjects. Sleep behavior, on the other hand, have positive prediction to the “daytime difficulty”. General sleep dysfunctional beliefs showed pathway through presleep cognitive arousal level. For subjects with lower level of fatigue, the beliefs about “expectation and worries of negative consequence of insomnia” have positive association with the “daytime difficulty”. The beliefs about “beliefs about association between sleep and health and recovery from illnesss” were shown to have negative prediction to the “daytime difficulty”. The belief about “hypnotic related to disease” showed positive association with the “sleep difficulty” and associated “distress”. General sleep dysfunctional beliefs had less predictive factors. Based on the results of this study, adding cancer-related dysfunctional sleep beliefs was shown to have different relationship with severity of insomnia compared to general sleep dysfunctional beliefs. General dysfunctional sleep beliefs showed a pathway to insomnia severity through the mediation presleep cognitive arousal level. On the other hand, combided sleep dysfunctional beliefs showed a pathway to insomnia severity through the mediation of presleep somatic arousal level. Furthermore, severity of fatigue is a moderator. Subjets differed in the level of fatigue showed different path from combided dysfunctional sleep beliefs to severity of insomnia.

BAKGRUND: Sömn är ett regelbundet återkommande tillstånd som är livsnödvändigt för att kroppen skall återhämta sig på ett korrekt vis. Personer med insomni och sömnapné är två patientgrupper som lider utav långvariga sömnproblem. Orsakerna till den dåliga sömnen kan vara många, och därför är det viktigt för sjuksköterskan att vara lyhörd och kunna stötta patienterna med hjälp av sina kunskaper gällande de åtgärder och behandlingar som finns att använda sig av. SYFTE: Syftet med denna litteraturöversikt var att belysa vilka åtgärder sjuksköterskan kan tillämpa för att stödja patienter med långvariga sömnproblem. METOD: En litteraturöversikt där 13 vetenskapliga artiklar granskades och analyserades. Fribergs (2006) modell för litteraturöversikter användes vid datainsamling och analysförfarande. RESULTAT: Fyra kategorier framkom ur analysen av de vetenskapliga artiklarna: egenvård, akupunktur, kognitiv beteendeterapi, och stödprogram. Dessa kategorier gör det möjligt för sjuksköterskan att tillämpa stöd till patienterna. Hos patienter med långvariga sömnproblem har de stödjande åtgärderna visat sig ge ökad sömn- och livskvalitet. SLUTSATS: Forskningen kring de långvariga sömnproblemen har ökat under de senaste åren men trots det finns det bristande kunskap om hur sjuksköterskan kan ge de behandlingar och det stödet som patienterna med insomni och sömnapné behöver. / BACKGROUND: Sleep is a periodic state which is essential for the body to recover in a proper manner. Insomnia and people with sleep apnea are two groups of patients out of long-term sleep problems. There are many causes of poor sleep, and that’s why there are so important for the nurse to be sensitive and support patients through their knowledge concerning the actions and processes that exist to use. AIM: The purpose of this literature review was to illustrate which measures nurse can apply to support patients with long-term sleep problems. METHOD: A literature overview, including 13 reviewed and analyzed articles. Fribergs (2006) model for literature overview were used in data collection and analysis procedure. RESULT: Four categories emerged from the analysis of the articles: self-care, acupuncture, cognitive behavioral therapy, and support program. These categories make it enable for the nurse to apply support to patients who suffer out of prolonged sleeping problem. Patients perceive that both their sleep and quality of life improves with the help of different treatments. CONCLUSION: Research into long-term sleep problems has increased in recent years. Despite this, there is a lack of knowledge about how nurse can provide treatment and support for patients with insomnia and sleep apnea.

Kognitiv beteendeterapi för primär insomni är inte lika effektivt som KBT för annan problematik. Behandlingen har mest fokuserat på förändring av sömn och bortsett från andra faktorer som kan bidraga till problematiken. Denna studie syftade till att utvärdera effekten av att addera en intervention mot en ytterligare faktor, nämligen oro, till behandling. Studien hade en single subject-design med två betingelser, med och utan oroshantering, för- och eftermätning och sju deltagare. Resultaten tyder på att metoden konstruktiv oro tillförde bättre utfall på sömn, oro och daglig funktion. Slutsatsen är att fokus på fler faktorer än sömn, som oro och dagtidsfunktion, kan effektivisera KBT för primär insomni. / Cognitive behavioral therapy for primary insomnia is not as effective as CBT for other problems. The treatment has primary focused on change of sleep and neglected other factors which can contribute to the problem. The purpose of this study was to investigate the effect of adding an intervention aimed at an additional factor, namely worry, to treatment. The study had a single subject design with two conditions, with and without constructive worry, pre- and posttest and seven participants. The results indicated that the intervention constructive worry added better outcomes on sleep, worry and daytime function.  The conclusion that can be drawn is that a focus on more factors than sleep, such as worry and daytime function, can render CBT for primary insomnia more effective.

This study investigated the relationship among anxiety, depression, and sleep disturbances and the treatment of these three disorders through neurotherapy. Research suggests that these conditions commonly co-occur in the general population and that central nervous system (CNS) arousal may play a primary role in the development and maintenance of these disorders. Several recent studies suggested that neurotherapy, a biofeedback-based treatment for CNS dysregulation, might be an effective treatment for comorbid conditions, particularly the ones of interest here, depression, anxiety, and sleep disturbances. This investigation used a clinical case-series design to assess pre/post neurotherapy changes on objective measures of anxiety, depression, and sleep and to determine whether changes in anxiety and depression then predict improvements in sleep quality. Data for 23 participants (10 males) were obtained from files of adults (Mage = 40.22 years, SD = 16.20) who received at least 15 neurotherapy sessions (M = 47.83 sessions, SD = 22.23) the University of North Texas Neurotherapy Lab. Matched pair t-tests revealed that symptoms of sleep disturbance, depression, and anxiety showed significant improvements following neurotherapy. Neurotherapy treatment effect sizes generally ranged from moderate to large (d = .414 - .849). Multiple regression analysis found that changes in self-reported anxiety symptoms, but not depressive symptoms, predicted observed improvements in sleep quality (adjusted R2 = .26). Last, the implications and limitations were discussed in relation to neurotherapy practice and the associated research.