SAMMANFATTNING   Bakgrund: Sömn är grundläggande för att människor ska uppleva hälsa och välbefinnande. Syftet: Att undersöka sömnrutiners och omgivande faktorers betydelse för god sömn hos patienter på rehabiliteringsklinik.                                                                                       Metod: En kvantitativ deskriptiv tvärsnittsstudie genomfördes med hjälp av en enkätundersökning på två rehabiliteringskliniker i Stockholm. Patienterna (n=33) togs ut enligt konsekutiv ordning utifrån att de bedömdes kunna fylla i enkäten (adekvata, orienterade till tid och rum, förstod svenska språket). Enkäten, ett validerat och reliabelt redan befintligt frågeformulär, Karolinska Sleep Questionaire (KSQ) användes efter omarbetning.      Resultat: Den sammanlagda bedömningen av sömnen utifrån de fyra indexen, sömnkvalitetsindex, uppvaknandebesvärsindex, snarkbesvärsindex och sömnighets/trötthetsindex visade att det var 76 % som ansåg sig ha dålig sömn. Sömnrutinernas betydelse bedömdes med hjälp av VAS- skalan. 63 % av patienterna skattade sömnrutinernas betydelse från medel till mycket viktig. I denna studie uppgav 42 % att de blev störda i sin sömn på grund av omgivande faktorer. Ljud var det som upplevdes som mest störande faktorn.                                                                                                                           Slutsats: En sömnanamnes tydliggör patientens sömnrutin och underlättar en god sömnkvalitet för patienten.   Nyckelord: sömnrutiner, sömnkvalitet, patienter, rehabilitering / ABSRACT Background: Sleep is essential to enable people to experience the health and welfare. Aim: To examine sleep routines and surrounding factors relevant for a good sleep in patients in rehabilitation clinic.                                                                                                       Method: A quantitative descriptive cross-sectional survey was carried out by means of a questionnaire survey in two rehabilitation clinics in Stockholm. The patients (n=33) were taken out in consecutive order, on the basis that they were able to complete the questionnaire (adequate, oriented in space and time, understood the Swedish language). The questionnaire was designed based on a validated and reliable questionnaire, Karolinska Sleep Questionaire (KSQ).                                                                                                                                 Result:The overall assessment of sleep based on the four indexes, sleep quality index, awakeningindex, snoringindex and sleepiness/fatigue index showed that it was 76% who believed they had poor sleep. Sleep routine significance was assessed based on the VAS scale. 63% of patients estimated sleep routine the importance of medium to very important. In this study 42 % stated that they were disturbed in their sleep because of the surrounding factors. The sound was seen as the most disruptive factor.                                                            Conclusion: A sleep history clarifies the patient's sleep routine, and facilitate a good sleep quality for the patient.     Keywords: sleep routines, sleep quality, patients, rehabilitation

Syftet med denna systematiska litteraturstudie var att beskriva hur restless legs inverkar på individens sömn och livskvalitet. Syftet var även att granska vilka olika former av behandlingar som finns att tillgå vid restless legs. För att finna information om detta ämne har endast vetenskapliga artiklar använts. Datainsamlingen har skett via databaser, internet samt Högskolans bibliotek, och artiklar från år 1995 och framåt har valts ut. Inklusionskriterier för denna studie var att de valda artiklarna skulle vara internationella vetenskapliga artiklar i fulltext. De funna artiklarna granskades med avseende på vetenskaplig kvalitet och poängsattes utifrån för ändamålet avsedda granskningsmallar. Denna bedömning resulterade i 21 artiklar. Resultatet visade att restless legs patienter upplever sömnbristen som det största problemet. För flertalet individer som drabbas av restless legs försämrades livskvaliteten och patienterna drabbades vanligtvis av psykologiska och fysiologiska besvär. Det vanligaste sättet att behandla restless legs var att använda dopaminerga läkemedel samt bensodiazepiner, antiepileptika och opioider. Andra former av behandlingar var järn, homeopatiska läkemedel, hypnos samt fysisk aktivitet. Det förekom även att restless legs patienter på eget initiativ använde hasch eftersom det ansågs lindra symtomen.

Sleep staging can be used to assess whether sleep structure is abnormal. According to the R&K rule, human sleep can be divided into four different stages: Awake, Light Sleep, Deep Sleep and Rapid-Eye-Movement (REM) Sleep. Conventionally, sleep staging are scored mainly by EEG signals and complementally by EOG and EMG signals. The goal of this study is to detect slow wave sleep (SWS) automatically by using different combinations of EEG, EOG, and EMG signals. In particular, a total of 16 combinations of channels have been studied. Based on high amplitude slow wave characteristics of SWS, this study develops many of feature variables to characterize SWS. A subset of these features are employed to design neural network classifier to detect SWS. This study has noted interpersonal-differences in physiological signals between people and proposes solutions to this problem to improve the performance of SWS detection. The number of tested subjects from two different sleep centers is 1318 and 947 subjects, respectively. These subjects were divided into five groups for training and testing data in order to test performance of our proposed approach. By applying the proposed approach to 1318 subjects, the experimental results show that the proposed method achieves kappa of 0.63 by using a single EEG channel, kappa of 0.6 by using two channels EOG and kappa of 0.66 by using the best combination of multi-channel singals. The size of dataset used in this work is significantly large than those of previous studies and thus provide more reliable experimental results. The experimental results show that the proposed approach can provide satisfactory performance in dealing with dataset with more than 1000 subjects.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2002. / Vita. Includes bibliographical references (leaves 128-135).

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 60-72).

Thesis (M. Phil.)--University of Hong Kong, 2002. / Includes bibliographical references (leaves 92-103).

published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Clinical professionals in South Africa are generally unaware of the impact of obstructive sleep apnoea (OS A). The cost to the state of untreated apnoea may be extremely high. In primary health care encounters OSA often goes undiagnosed. The cascade of symptoms linked to OSA is profound, placing patients at risk for debilitating problems impacting on self and others. The aim of this study was to validate a questionnaire, which could be used at a primary health care level to identify patients with OSA thus cutting costs and improving efficient, effective and ethical service to patients. The Berlin Questionnaire (BQ) (Netzer et al. 1999) was administered to a clinical sample of consenting patients at a private sleep laboratory in Durban, South Africa (N = 119)(completed n = 110). Home-based sleep studies (n = 116) on a portable cardio-respiratory screening device were also obtained for objective comparison. From the results obtained in this South African sample, the BQ showed low validity and reliability (Cronbach a = 0.62 - 0.84) to individual items of the BQ. The total BQ score and high-risk symptom category analysis showed mildly significant correlations with internationally approved protocols. The BQ identified 60% of the high-risk group (AHI >5). Furthermore, risk categories were useful in predicting AHI ratings in 64% of moderate OSA cases and 25% of severe OSA cases. The BQ therefore has useful psychometric properties as an adjunct assessment tool to screen for high-risk OSA cases where resources are scant. Clinical health psychologists are in an ideal position to recognise the risk factors and symptoms of OSA. The clinical assessment and the value of the correct diagnosis will alleviate the treatment of psychological symptoms at a superficial level in primary health care facilities. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.

Although a broad range of neuropsychological deficits have been reported to occur in patients with Obstructive Sleep Apnea Syndrome (OSAS), few studies have examined the executive functions in this patient group. The executive functions provide conscious control of the more basic cognitive functions and play an important role in daily living. They include capacities such as concept formation, planning, cognitive flexibility and resistance to interference. This study compared the performance of groups of moderate and severe OSAS patients with a group of unaffected individuals (N=24), on five tests of executive functioning. Two indices of sleep disordered breathing, sleep fragmentation and . hypoxemia, obtained from overnight polysomnography, were respectively used to categorise participants. ID patients with severe OSAS, executive function deficits were evident, while in those with moderate OSAS these abilities appeared largely intact. Further analyses revealed that the observed findings could not be attributed to differences in vigilance. These results suggest a discontinuity in the manifestation of executive function deficits between moderate and severe OSAS patients. There may be a threshold of OSAS severity, which if exceeded, impairments tend to occur. The magnitude of the impairment in patients with severe OSAS may be sufficient to interfere with daily cognitive functioning. Further research is needed both to replicate these findings and to establish the underlying pathogenesis of these deficits. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.

Nonrestorative sleep refers to the experience of sleep as insufficiently refreshing, often despite the appearance of normal sleep according to objective parameters. As a result, a valid and reliable measure of the subjective experience of NRS is required in order to allow for standardization and comparability in its assessment. This thesis reports the results of a study involving the development and validation of a scale to assess NRS, the Nonrestorative Sleep Scale (NRSS). The psychometric properties of the NRSS were assessed in a group of 256 participants recruited from a sleep clinic population. Principal component analysis revealed four domains. The scale demonstrated good internal and test-retest reliability and reasonable validity compared to other measures. Overnight polysomnographic variables were also compared to scores on the scale and a few were found to be weakly correlated with scale scores. These included alpha EEG, sleep efficiency, and REM latency.