No description available.

The purpose of this dissertation was to examine the associations between sleep problems, sleep hygiene and ADHD symptoms in young adults. The first chapter of this dissertation provides an overview of ADHD in adulthood, and a review of the literature that has associated ADHD and sleep problems. This chapter also highlights the need to develop a valid and reliable instrument to assess sleep hygiene. The second chapter presents a manuscript which outlines the development of a new self-report measure of sleep hygiene in young adults. Exploratory and confirmatory factor analyses were used to develop two sleep hygiene scales (substance abuse and poor sleep scheduling) and overall results indicated that the new instrument has sound psychometric properties, as well as good construct and convergent validity. The third chapter presents a manuscript which outlines two empirical studies that examined the associations between sleep problems, sleep hygiene and ADHD symptoms in young adults. Results indicated that young adults with elevated ADHD symptoms reported more sleep problems (specifically insomnia and sleepiness) and poorer sleep hygiene (specifically substance abuse and poor sleep scheduling) than young adults without elevated ADHD symptoms. Young adults with ADHD also reported more sleep problems even after accounting for substance abuse and poor sleep scheduling, suggesting that poor sleep hygiene is not responsible for the sleep problems of young adults with ADHD. The fourth chapter presents a summary of the research findings, as well as a discussion of the methodological limitations and directions for future research. / Thesis (Ph.D, Psychology) -- Queen's University, 2010-01-20 15:27:40.187

Numerous studies have shown the relationship between sleep and overall health. A common measure of sleep is sleep quality which has been shown to be influenced by a variety of factors such as physical activity, diet, stress, social engagement, cognitive stimulating, and sleep hygiene behaviors. Data was analyzed from a previous study to determine whether trying to change one’s sleep would improve sleep quality and if this was more effective than physical exercise. A group of 104 individuals, randomized to the treatment group, were asked to log their daily activities, via smartphone app, within these six behavioral domains for six months. Behavioral change scores were computed as the difference between six-month behavioral level and baseline behavioral level, for each of the six domains. Factor analysis that revealed that two latent factors explained the majority of the variance in behavioral change, with a "Physical Body Related behavior change” factor ("Physical") and a "Mental/Emotional" behavior change factor ("Mental"). In linear regression models, Physical significantly predicted sleep quality improvement over the six months (p=.029), but Mental did not (p=.606). In the middle aged adults in this study, the behavioral change pattern of increasing diet quality and physical activity, significantly predicted improvements in sleep quality. While efforts to improve one's cognitive and emotional well-being were not found to predict to sleep improvement, they still may be important for cognitive health overall. This information can prove useful as different interventions and programs are implemented to improve sleep in the population.

No description available.

As alterações do sono estão entre as respostas frequentes que interferem no bem estar das pessoas com insuficiência cardíaca (IC). Dispor de evidências sobre os efeitos e aplicabilidade de intervenções não farmacológicas para melhorar a qualidade do sono é essencial para as boas práticas em saúde. Objetivo: Investigar a exequibilidade de um ECR de intervenções não farmacológicas no sono e qualidade de vida de pacientes com IC e, adicionalmente testar o efeito da terapia de higiene do sono, da fototerapia e da terapia combinada (higiene do sono + fototerapia) no sono em comparação com orientações sobre o manejo da doença. Método: Trata-se de um piloto de um ensaio clínico randomizado cego em que 32 indivíduos (sexo feminino: 59,4%; idade média: 55,4 (DP=10,4) anos, classe funcional II-III: 90,7%) foram randomizados para três grupos intervenção (Fototerapia, Medidas de Higiene do Sono e Terapia Combinada) e um grupo controle (orientações sobre o manejo da doença e medicações em uso) para testar a efetividade na melhora do sono (Pittsburg Sleep Quality Index) e qualidade de vida relacionada à saúde (Minessota Living with Heart Failure Questionaire). Os indivíduos foram avaliados na linha de base e na 4ª, 8ª, 12ª e 24ª semanas de seguimento. As variáveis de desfecho foram analisadas longitudinalmente pela ANOVA para medidas repetidas. Foi realizada análise por intenção de tratamento. Resultados: Todos os grupos apresentaram melhora estatisticamente significante no padrão do sono na evolução até a 12ª semana (F: 63,09; p<0,001) e até a 24ª semana (F: 64,06; p<0,001); e na qualidade de vida relacionada à saúde até a 12ª semana (F: 13,81; p<0,001) e até a 24ª semana (F: 15,02; p<0,001). Não houve diferença estatisticamente significante entre os grupos na melhora do sono e qualidade de vida. Conclusão: Medidas de higiene do sono e fototerapia isoladas ou combinadas entre si e orientações sobre o manejo dos sintomas da doença têm efeito positivo similar no sono e qualidade de vida de pacientes com IC. Estudos com amostras maiores são necessários. / Sleep disturbances are common responses that affect well-being of people with heart failure (HF). Available evidence on effects, meaning and feasibility of non-pharmacological interventions to improve sleep are essential for best health care practices. Aim: Investigate the feasibility of an RCT of non-pharmacological interventions on sleep and quality of life of patients with HF and additionally test the effect of sleep hygiene therapy, phototherapy and combination therapy (phototherapy sleep hygiene +) sleep compared with guidance on disease management. Method: This is a pilot of a blinded randomized clinical trial in which 32 subjects (women: 59.4%; mean age: 55.4 (SD=10.4) years, NYHA II-III: 90.7%) were randomized to three intervention groups (phototherapy, measures of sleep hygiene and combined therapy) and a control group (guidance on management of the disease and medications) to test the effectiveness of sleep interventions in sleep (Pittsburg Sleep Quality Index) and health-related quality of life (Minnesota Living with Heart Failure Questionnaire) improvement. Participants were assessed at baseline, 4th, 8th, 12th and 24th weeks of follow up. Outcomes were analyzed longitudinally by repeated measures-ANOVA. An intention-to-treat analysis was conducted. Results: Statistically significant improvement were found in both intervention and control groups in sleep pattern by the 12th week (F: 63.09, p<0,001) and 24th week (F:64.06, p<0,001), and in related-health quality of life by the 12th week (F: 13.81, p<0,001) and 24th week (F:15.02, p<0,001). No statistically significant difference was found in sleep and health-related quality of life improvement between groups. Conclusion: Measures of sleep hygiene and phototherapy, isolated or combined with each other, and education about the management of the symptoms of the disease have a similar positive effect on sleep and quality of life of patients with HF. Studies with larger samples are needed.

Människors allmänna välbefinnande och livskvalitet påverkas av deras sömn.    Sömnproblemen ökar och resulterar i ökade kostnader för den enskilde, arbetsgivarna och samhället. Syftet med litteraturstudien var att beskriva effekter av sömnhygieniska åtgärder riktade till individer inom hälsovården med primär insomni. Resultatet visade att en kombination av åtgärder utifrån personliga behov gav bäst resultat men också att det rådde begreppsförvirring runt sömnhygieniska åtgärder och deras effektivitet. Fördjupad kunskap behövs vad det gäller de enskilda sömnhygieniska rådens effektivitet. Vidare forskning föreslås för att komma fram till gemensamma internationella sömnhygieniska råd för att effektivt kunna vidareutveckla de sömnhygieniska råden och hur dessa ska användas. / People's general well-being and quality of life is affected by their sleep. Costs referring to sleeping disorders increase for individuals, employers as well as society as a whole. The aim of this literature review was to describe the effects of sleep hygiene measures regarding individuals in the healthcare system with primary insomnia. The results from this study showed that a combination of interventions based on personal needs gave the best results furthermore that there was a confusion regarding concepts of sleep hygiene interventions and their effectiveness. Deeper knowledge is needed to evaluate the efficiency of each of the sleep hygiene advice. Future research is suggested in order to achieve common and unified international sleep hygiene advice to effectively enable further development to the sleep hygiene advice and guidelines.

Sleep problems affect a considerable number (49-86%) of patients undergoing peritoneal dialysis (PD) treatment. Insomnia i.e. difficulties to initiate and/or maintain sleep or too early wakening, combined with daytime symptoms, seems to be the dominating problem. Despite these facts there is a lack of research in PD-patients, especially studies with objective data on the sleep-wake cycle and evaluation of sleep promoting non-pharmacological  interventions. The overall aim of this thesis was to describe sleep problems from different perspectives, and how these problems affect daily life and health in patients treated with PD at home. The aim was also to evaluate an individualised non-pharmacological intervention for improvement of sleep quality outcomes. Four studies were conducted during eight years, starting in 2002. Patients from six hospitals in the south-east of Sweden were invited to participate. In addition, data from a reference group with Coronary Artery Disease and a population group were used for comparisons with PD-patients in one of the studies. Data was collected by self-reported questionnaires, actigraphy registrations and interviews. Sleep was evaluated in a 17-week single-case study with an intervention focusing on sleep hygiene advice. Data from a total of 700 sleep-wake cycles was collected in the patients’ homes. The main findings clearly demonstrated that PD-patients have seriously fragmented sleep compared to the CAD- and population group, and that the PD-patients have a high prevalence of insomnia. The sleep was mainly disturbed by pruritus and Restless Legs Syndrome (RLS). Daytime impairments and a frequent napping behaviour were detected. The prevalence of fatigue was also reported to be extremely high. The patients described that an ever-present tiredness and poor sleep had consequences in their everyday life both physically, mentally, socially and existentially. The nurse-led intervention demonstrated that individual, non-pharmacological sleep interventions can improve sleep and daytime activities in PD-patients. This thesis elucidates that deteriorated sleep with serious fragmentation leads to a variety of daytime impairments and fatigue. By adopting “renal supportive care” in clinical work a more elaborate assessment and individualised non-pharmacological treatment of sleep problems may improve sleep quality and activity in frail patients undergoing peritoneal dialysis at home.

No description available.

As alterações do sono estão entre as respostas frequentes que interferem no bem estar das pessoas com insuficiência cardíaca (IC). Dispor de evidências sobre os efeitos e aplicabilidade de intervenções não farmacológicas para melhorar a qualidade do sono é essencial para as boas práticas em saúde. Objetivo: Investigar a exequibilidade de um ECR de intervenções não farmacológicas no sono e qualidade de vida de pacientes com IC e, adicionalmente testar o efeito da terapia de higiene do sono, da fototerapia e da terapia combinada (higiene do sono + fototerapia) no sono em comparação com orientações sobre o manejo da doença. Método: Trata-se de um piloto de um ensaio clínico randomizado cego em que 32 indivíduos (sexo feminino: 59,4%; idade média: 55,4 (DP=10,4) anos, classe funcional II-III: 90,7%) foram randomizados para três grupos intervenção (Fototerapia, Medidas de Higiene do Sono e Terapia Combinada) e um grupo controle (orientações sobre o manejo da doença e medicações em uso) para testar a efetividade na melhora do sono (Pittsburg Sleep Quality Index) e qualidade de vida relacionada à saúde (Minessota Living with Heart Failure Questionaire). Os indivíduos foram avaliados na linha de base e na 4ª, 8ª, 12ª e 24ª semanas de seguimento. As variáveis de desfecho foram analisadas longitudinalmente pela ANOVA para medidas repetidas. Foi realizada análise por intenção de tratamento. Resultados: Todos os grupos apresentaram melhora estatisticamente significante no padrão do sono na evolução até a 12ª semana (F: 63,09; p<0,001) e até a 24ª semana (F: 64,06; p<0,001); e na qualidade de vida relacionada à saúde até a 12ª semana (F: 13,81; p<0,001) e até a 24ª semana (F: 15,02; p<0,001). Não houve diferença estatisticamente significante entre os grupos na melhora do sono e qualidade de vida. Conclusão: Medidas de higiene do sono e fototerapia isoladas ou combinadas entre si e orientações sobre o manejo dos sintomas da doença têm efeito positivo similar no sono e qualidade de vida de pacientes com IC. Estudos com amostras maiores são necessários. / Sleep disturbances are common responses that affect well-being of people with heart failure (HF). Available evidence on effects, meaning and feasibility of non-pharmacological interventions to improve sleep are essential for best health care practices. Aim: Investigate the feasibility of an RCT of non-pharmacological interventions on sleep and quality of life of patients with HF and additionally test the effect of sleep hygiene therapy, phototherapy and combination therapy (phototherapy sleep hygiene +) sleep compared with guidance on disease management. Method: This is a pilot of a blinded randomized clinical trial in which 32 subjects (women: 59.4%; mean age: 55.4 (SD=10.4) years, NYHA II-III: 90.7%) were randomized to three intervention groups (phototherapy, measures of sleep hygiene and combined therapy) and a control group (guidance on management of the disease and medications) to test the effectiveness of sleep interventions in sleep (Pittsburg Sleep Quality Index) and health-related quality of life (Minnesota Living with Heart Failure Questionnaire) improvement. Participants were assessed at baseline, 4th, 8th, 12th and 24th weeks of follow up. Outcomes were analyzed longitudinally by repeated measures-ANOVA. An intention-to-treat analysis was conducted. Results: Statistically significant improvement were found in both intervention and control groups in sleep pattern by the 12th week (F: 63.09, p<0,001) and 24th week (F:64.06, p<0,001), and in related-health quality of life by the 12th week (F: 13.81, p<0,001) and 24th week (F:15.02, p<0,001). No statistically significant difference was found in sleep and health-related quality of life improvement between groups. Conclusion: Measures of sleep hygiene and phototherapy, isolated or combined with each other, and education about the management of the symptoms of the disease have a similar positive effect on sleep and quality of life of patients with HF. Studies with larger samples are needed.

Lack of restorative sleep is implicated in threats to public health and safety as well as negative individual health outcomes, which are more pronounced among those living in rural poverty. This study addressed the need for an approach to these problems that is sensitive to culture and community. The purpose of this phenomenological study was to explore the lived experience of sleep among young adults living in rural poverty to inform development of strategies to improve sleep behavior in this population. Research questions explored the lived experience of sleep, constructs of the theory of planned behavior which was used as a framework for the study, and the larger cultural context of sleep. This study used semistructured interviews with a purposeful sample (n = 12) of young adults aged 18-24 years living in 5 counties in northernmost New York State. Thematic analysis was used to code data and identify themes. Key themes included the presence of a persistent struggle to balance sleep with preferred activities and a belief that the body controlled sleep behavior. Participants identified family and employers as influencing their sleep behavior and reported an overall lack of agency regarding sleep behavior. Participant comments included cautious intentions about sleep coupled with reluctance to exert themselves to engage in intended sleep behavior. Findings may contribute to positive social change by amplifying the voices of participants as consumers of services in a manner that informs the development of education and treatment strategies.