<p dir="ltr">Background. Although depression is a risk factor for cardiovascular disease (CVD), few clinical trials in people without CVD have examined the effect of depression treatment on CVD-related outcomes. It’s unknown if successful depression treatment improves indicators of CVD risk, such as CVD-relevant health behaviors, traditional CVD risk factors, and CVD events. </p><p dir="ltr">Methods. We examined data from eIMPACT trial, a phase II randomized controlled trial conducted from 2015-2020. Depressive symptoms, CVD-relevant health behaviors (self-reported CVD prevention medication adherence, sedentary behavior, and sleep quality) and traditional CVD risk factors (blood pressure and lipid fractions) were assessed. Incident CVD events over four years were identified using a statewide health information exchange. </p><p dir="ltr">Results. The intervention group exhibited greater improvement in depressive symptoms (p < 0.01) and sleep quality (p < 0.01) than the usual care group, but there was no intervention effect on systolic blood pressure (p = 0.36), low-density lipoprotein cholesterol (p = 0.38), high-density lipoprotein cholesterol (p = 0.79), triglycerides (p = 0.76), CVD prevention medication adherence (p = 0.64), or sedentary behavior (p = 0.57). There was an intervention effect on diastolic blood pressure that favored the usual care group (p = 0.02). CVD-relevant health behaviors did not mediate any intervention effects on traditional CVD risk factors. Twenty-two participants (10%) experienced an incident CVD event. The likelihood of an CVD event did not differ between the intervention group (12.1%) and the usual care group (8.3%; HR = 1.45, 95% CI: 0.62-3.40, p = 0.39). </p><p dir="ltr">Conclusions. Successful depression treatment alone improves self-reported sleep quality but is not sufficient to lower CVD risk of people with depression. Alternative approaches may be needed reduce CVD risk in depression. </p><p dir="ltr">Trial Registration: ClinicalTrials.gov Identifier: NCT02458690 </p><p dir="ltr">Keywords: depression, cardiovascular disease, blood pressure, lipids, medication adherence, sedentary behavior, sleep quality, collaborative care, internet interventions, clinical trial</p>

Problématique : L’édentement et les troubles du sommeil sont des affections chroniques fréquentes chez les personnes âgées et qui peuvent avoir des conséquences défavorables sur le bien-être de ces personnes, ainsi que sur leur qualité de vie. L’édentement pourrait perturber le sommeil par la modification de la structure crânio-faciale et des tissus mous environnants. Cependant, cette relation n'est pas suffisamment documenté. Objectifs : Le but de cette étude pilote était de préparer la mise en œuvre d’une étude clinique randomisée contrôlée concernant l’effet du port nocturne des prothèses complètes sur la qualité du sommeil. Méthodologie : Treize aînés édentés ont participé à cette étude clinique randomisée contrôlée de type croisé. L’intervention consistait à dormir avec ou sans les prothèses durant la nuit. Les participants à l'étude ont été assignés à porter et ne pas porter leurs prothèses dans des ordres alternatifs pour des périodes de 30 jours. La qualité du sommeil a été évaluée par la polysomnographie portable et le questionnaire Pittburgh Sleep Quality Index (PSQI). Les données supplémentaires incluent la somnolence diurne, évaluée par le questionnaire Epworth Sleepiness Scale (ESS), et la qualité de vie liée à la santé buccodentaire, évaluée par le questionnaire Oral Health Impact Profile 20 (OHIP-20). De plus, à travers les examens cliniques et radiologiques, les données des caractéristiques sociodémographiques, de la morphologie oropharyngée, des caractéristiques buccodentaires et des prothèses ont été recueillies. Les modèles de régression linéaire pour les mesures répétées ont été utilisés pour analyser les résultats. Résultats : L’étude de faisabilité a atteint un taux de recrutement à l’étude de 59,1% et un taux de suivi de 100%. Le port nocturne des prothèses dentaires augmentait l’index d'apnée-hypopnée (IAH) et le score PSQI par rapport au non port nocturne des prothèses : (IAH : Médiane = 20,9 (1,3 - 84,7) versus 11,2 (1,9 - 69,6), p = 0,237; le score PSQI : Médiane = 6,0 (3,0 - 11,0) versus 5,0 (1,0 - 11,0), p = 0,248). Cependant, ces différences n'étaient pas statistiquement significatives, sauf que pour le temps moyen d’apnée (plus long avec des prothèses) (p < 0,005) et le temps de ronflement relatif (moins élevé avec des prothèses) (p < 0,05). La somnolence diurne excessive et la qualité de vie liée à la santé buccodentaire étaient semblables pour les deux interventions (le score ESS : Médiane = 4,0 (3,0-10,0) versus 5,0 (2,0-10,0), p = 0,746; le score OHIP-20: Médiane = 31,0 (20,0-64,0) versus 27,0 (20,0-49,0), p = 0,670). L’impact néfaste du port nocturne des prothèses complètes sur le sommeil a été statistiquement significatif chez les personnes souffrant de l’apnée-hypopnée moyenne à sévère (p < 0,005). Conclusion : L’essai clinique pilote a montré que le port nocturne des prothèses complètes a un impact négatif sur la qualité du sommeil des gens âgés édentés, surtout chez les personnes avec l’apnée obstructive du sommeil modérée à sévère. Les résultats doivent être confirmés par l’étude clinique randomisée contrôlée de phase II. / Problem: Edentulism and sleep disturbance are common chronic conditions in older people and may have adverse consequences on well-being of these persons, as well as their quality of life. Indeed, edentulism can modify the craniofacial structure and surrounding soft tissue, and lead to sleep disturbance in edentate individuals. However, this relationship is not sufficiently documented. Objectives: The aim of this study was to prepare a pilot randomized controlled trial on the effect of nocturnal complete denture wear on sleep quality. Methods: Thirteen edentate elders participated in this randomized cross-over clinical trial. The intervention consisted of sleeping with or without dentures at night. The study participants were assigned to wear and not wear their denture in alternate orders for periods of 30 days. Sleep quality was assessed by portable polysomnography and the Pittsburgh Sleep Quality Index (PSQI). Additional data included: daytime sleepiness assessed by the Epworth Sleepiness Scale (ESS) and oral-health-related quality of life assessed by the Oral Health Impact Profile 20 (OHIP-20). Furthermore, through the clinical and radiographic examinations, data on sociodemographic, oropharyngeal morphology, and oral and prosthesis characteristics were gathered. Linear regression models for repeated measures were used to analyze the data. Results: The recruitment rate for this study was 59.1% and the follow-up rate was 100%. Sleeping with dentures resulted in higher apnea-hypopnea index (AHI) and higher PSQI score when compared with sleeping without dentures (AHI: Median = 20.9 (1.3-84.7) vs. 11.2 (1.9-69.6), p = 0.237; PSQI score: Median = 6.0 (3.0-11.0) vs. 5.0 (1.0-11.0), p = 0.248). However, these differences were not statistically significant, except for the mean apnea time (more with dentures) (p < 0.005) and the relative snoring time (less with dentures) (p < 0.05). Excessive daytime sleepiness and the oral-health-related quality of life were similar for two interventions (ESS score: Median = 4.0 (3.0-10.0) vs. 5.0 (2.0-10.0), p = 0.746; OHIP-20 score: Median = 31.0 (20.0-64.0) vs. 27.0 (20.0-49.0), p = 0.670). The negative impact of sleeping with complete dentures wear was statistically significant in individuals suffering from moderate and severe apnea-hypopnea index (p < 0.005). Conclusion: The pilot clinical trial showed that wearing complete dentures at night has negative effects on the sleep quality of edentate elders, especially in individuals with moderate and severe obstructive apnea sleep. The results need to be confirmed with phase-II randomized clinical trial.

Sammanfattning Syfte och frågeställningar Syftet med studien var att få en inblick i hur omfattande smartphoneanvändning var bland människor och hur denna användning samvarierade med den mentala hälsan. En annan del av syftet var att se om ett beteendemönster kunde ändras hos smartphoneanvändarna och på så vis ändra den mentala hälsan. För att uppnå syftet ställdes två frågeställningar: (1) Finns det något samband mellan grad av smartphoneberoende och upplevd psykisk hälsa? (2) Kan en kortare tids intervention där man begränsar användandet av smartphone hos deltagarna påverka deras subjektiva psykiska välmående? Metod För att få en inblick i hur utbrett smartphoneberoendet är i dagsläget och om det påverkar den subjektiva psykiska hälsan valdes enkät som metod eftersom det var tidseffektivt och gav ett brett urval. För att kunna skapa en beteendeförändring så behövdes en aktiv interaktion med respondenterna, därför kom beslutet att utföra en intervention. Interventionen gick ut på att deltagarna under sex dagar skulle reducera sitt mobilanvändande i största mån möjligt för att se om deras mentala hälsa kunde påverkas. Urvalet bestod av 76 kvinnor och 56 män med en medelålder på 25 år. Resultat Enligt korrelationsanalysen fanns ett svagt samband r = - 0,218 mellan mental hälsa och smartphoneberoende som var statistiskt signifikant (p = 0.013). Analys av enkätdata visade en stor grupp som klassades som smartphoneberoende = 48.2% och 51.8% som ej smartphoneberoende. Detta visade att fler personer är mobilberoende i detta urval än vad andra studier hittat. Interventionen bortgick på grund av ett stort bortfall. Slutsats Resultatet visade på ett svagt negativt samband mellan mental hälsa och smartphoneberoende. Kausalitetssamband klargjordes inte och vidare forskning krävs på ämnet för att i framtiden kunna urskilja om en mental ohälsa leder till mer smartphoneanvändande eller om mycket smartphoneanvändning leder till mental ohälsa i sig. / Abstract Purpose and objective The purpose of this study was to survey the use of mobile phones amongst people and how it coincides with mental health. We also wanted to investigate whether or not we could create a behavioral change amongst the mobile phone users and thereby see if it affected their mental health. To achieve this objective we emanated from two questions: (1) Is there a relationship between Smartphone addiction and subjective mental health? (2) Can a short intervention, where you decrease the time spent on smartphones amongst users improve their subjective well-being? Method To get an insight in how widespread the use of mobile phones is and if it affects subjective well-being we chose to collect data through surveys because it was time effective and gave a wide group of people. To be able to create a behavioral change we concluded we had to actively interact with the respondents, so we chose to perform an intervention. During the intervention the participants would reduce their mobile phone usage to the greatest extent possible to see if their mental health could be improved. Result According to the correlation analysis, there is a weak relationship r = - 0,218 between mental health and smartphone addiction which is statistically significant (p=0.013). Analysis of survey data showed a large group classified as smartphone addicted = 48.2% and 51.8% as non-smartphone addicted. This shows that more people are smartphone addicted in this study than other studies have found. The intervention failed due to many dropouts. Conclusions The result showed a weak negative correlation between mental health and smartphone addiction. Causal correlation was not clarified and further research is required on the subject in order to determine whether mental health issues leads to more smartphone usage or if a lot of smartphone usage leads to mental health issues by itself.