Thesis (M.Med.Sc.)--University of Hong Kong, 2004. / Also available in print.

Thesis (Ph.D.)--Victoria University (Melbourne, Vic.), 2009.

Thesis (B.A. (Hons.)) - University of Queensland, 2004. / Includes bibliography.

Thesis (Ph. D.)--University of Texas at Austin, 2007. / Vita. Includes bibliographical references.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2006. / Title from title screen (site viewed June 11, 2007). PDF text: viii, 133 p. : ill. UMI publication number: AAT 3239364. Includes bibliographical references. Also available in microfilm and microfiche formats.

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The available evidence suggests insomnia is common in individuals who experience psychosis. Poor sleep within this population has been associated with numerous detriments to mental health and well-being. Nevertheless, the majority of work to date has focused on chronic presentations, with few studies investigating the role of insomnia in recently onset psychosis. Understanding and treating psychosis following the first presentation is important to promote recovery and prevent the development of long-term illness. This work therefore aimed to utilise mixed methods to comprehensively investigate insomnia in early psychosis. It is presented in a series of five research papers, supplemented by additional chapters to provide an introduction, additional methodological details and general discussion. Paper one presents a systematic review, which aimed to synthesise the relevant literature with regards to the nature and correlates of insomnia in early psychosis. Paper two utilised qualitative methods aiming to understand the experience of insomnia, its impacts and experiences of help-seeking in early psychosis. Paper three aimed to investigate the nature of insomnia symptoms in first episode psychosis, compared to a healthy control group, using actigraphy and sleep diary measurement over a 14-day period. Paper four aimed to investigate how poor sleep was associated with next-day mental health and functioning, presenting data from an electronic diary study conducted alongside the sleep profiling presented in paper three. Paper five aimed to assess the acceptability of a Brief Behavioural Treatment for Insomnia (BBTI) delivered to a first episode psychosis group. Findings across studies indicated insomnia to have a wide range of detrimental outcomes, indicating the treatment of insomnia may be an important target for relevant mental health services.

Objectives: To investigate slow wave sleep (SWS) spectral power proportions in distinct clinical conditions sharing non-restorative sleep and fatigue complaints without excessive daytime sleepiness (EDS), namely the Chronic Fatigue Syndrome (CFS) and Primary Insomnia (PI). Impaired sleep homeostasis has been suspected in both CFS and PI. Methods: We compared perceived sleep quality, fatigue and sleepiness symptom-intensities, polysomnography (PSG) and SWS spectral power distributions of drug-free CFS and PI patients without comorbid sleep or mental disorders, with a good sleeper control group.Results: Higher fatigue without EDS and impaired perceived sleep quality were confirmed in both patient groups. PSG mainly differed in sleep fragmentation and SWS durations. Spectral analysis revealed a similar decrease in central ultra slow power (0.3-0.79Hz) proportion during SWS for both CFS and PI and an increase in frontal power proportions of faster frequencies during SWS in PI only. The latter was correlated to affective symptoms whereas lower central ultra slow power proportions were related to fatigue severity and sleep quality impairment. Conclusions: In combination with normal (PI) or even increased SWS durations (CFS), we found consistent evidence for lower proportions of slow oscillations during SWS in PI and CFS. Significance:Observing normal or increased SWS durations but lower proportions of ultra slow power, our findings suggest a possible quantitative compensation of altered homeostatic regulation. / Doctorat en Sciences de la motricité / info:eu-repo/semantics/nonPublished

Due to a globally aging population, there is a growing demand for smart home technology which can serve to monitor the health and safety of adults. Therefore, sleep monitoring has emerged as a crucial tool to improve the health and autonomy of adults. While polysomnography (PSG) is an effective and accurate tool for sleep monitoring, it is obtrusive as the user must wear the instruments during the experiment. Therefore, there has been a growing interest in deploying unobtrusive sleep monitoring devices, specifically for long-term patient monitoring. This thesis proposes multiple algorithms applicable to unobtrusive pressure sensitive sensor arrays in order to assess sleep quality. These algorithms can be listed as adaptive movement detection, sensor data fusion and bed occupancy detection. This thesis also investigates long-term sleep pattern changes from previously recorded data. The methods developed in the thesis can be of interest for future clinical remote patient monitoring systems.

Disturbed sleep is common in asthma and impairs quality of life in these patients. Melatonin has sleep-inducing activity and reportedly affects smooth muscle tone and inflammation. The aim of this study was to evaluate the effect of melatonin on sleep in female patients with stable mild and moderate asthma. Twenty consecutive patients were recruited into the study. After a two-week run-in period, they were randomized to receive melatonin 3 mg (n= 10) or placebo for four weeks. Sleep quality and daytime somnolence were assessed by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, respectively. Pulmonary function was assessed by spirometry. Use of relief medication, asthma symptoms and morning and evening peak expiratory flow rate (PEFR) were recorded daily. Melatonin treatment, but not placebo, significantly improved subjective quality of sleep (p = 0,034), sleep latency (p = 0.031), sleep duration (p = 0,034), sleep disturbances (p = 0,034), daytime dysfunction (p = 0,025) and subjective daytime somnolence (p = 0,028). No significant difference in asthma symptoms, use of relief medication and daily PEFR was found between the two groups. We conclude that melatonin can improve sleep in patients with asthma without significantly affecting pulmonary function or asthma symptoms. Further studies looking into long-term effects of melatonin on airway inflammation and bronchial hyperresponsiveness are needed before melatonin can be safely recommended in asthmatic patients. / AlteraÃÃes do sono sÃo comuns na asma, dificultando o manuseio desta condiÃÃo e reduzindo a qualidade de vida dos seus portadores. A melatonina (MLT) possui aÃÃo indutora do sono e apresenta baixa incidÃncia de efeitos adversos. Existem relatos de que a MLT tambÃm possui aÃÃo sobre o tÃnus da musculatura lisa e exerce atividade imunomoduladora, potencialmente Ãteis no tratamento da asma. O objetivo principal deste estudo foi avaliar os efeitos da administraÃÃo noturna da MLT sobre o sono e a funÃÃo pulmonar de pacientes com asma persistente leve e moderada. O estudo foi um ensaio clÃnico randomizado, duplo-cego, controlado por placebo e duraÃÃo total de seis semanas. Vinte pacientes do sexo feminino foram submetidas a um perÃodo de prÃ-tratamento de duas semanas com beclometasona na dose de 1000 mcg/dia e salbutamol quando necessÃrio, ambos por via inalatÃria. ApÃs esse perÃodo, foram randomizadas para receber MLT na dose de 3 mg (n= 10) ou placebo (n= 10) duas horas antes do horÃrio habitual de sono, por quatro semanas. A qualidade do sono e a sonolÃncia diurna foram avaliadas pelo Ãndice de Qualidade de Sono de Pittsburgh (IQSP) e pela Escala de SonolÃncia de Epworth (ESE) respectivamente, enquanto a funÃÃo pulmonar foi avaliada por espirometria. Foram realizadas medidas domiciliares diurnas e noturnas do pico de fluxo expiratÃrio. Um registro diÃrio de sintomas de asma e de uso de broncodilatador inalatÃrio foi mantido durante todo o perÃodo. ApÃs a fase de tratamento, a qualidade do sono, a sonolÃncia diurna e a funÃÃo pulmonar foram reavaliadas. Os resultados demonstram que o grupo que utilizou a MLT, ao contrÃrio do grupo placebo, apresentou melhora da qualidade subjetiva do sono (p= 0,034), da latÃncia do sono (p= 0,031), da duraÃÃo do sono (p= 0,034), dos distÃrbios do sono (p= 0,034), das disfunÃÃes diurnas (p= 0,025) e do grau de sonolÃncia diurna subjetiva (p= 0,028). Nenhuma diferenÃa estatisticamente significante foi observada nos sintomas de asma, no uso de broncodilatador para alÃvio de sintomas e nas medidas diÃrias de PFE entre os grupos MLT e placebo. Em conclusÃo, a MLT melhora a qualidade do sono e reduz a sonolÃncia diurna em pacientes com asma persistente leve e moderada, sem produzir efeitos detectÃveis sobre sintomas ou sobre a funÃÃo pulmonar. Estudos adicionais sobre os efeitos a longo prazo da MLT na inflamaÃÃo das vias aÃreas e na hiper-responsividade brÃnquica, sÃo necessÃrios antes que esta substÃncia possa ser recomendada com seguranÃa em pacientes asmÃticos.