Autism Spectrum Disorder is a neurodevelopmental disorder characterized by language and communication deficits, and difficulties with social interaction (Twisk, 2001). Research has shown that 80% of youth with ASD experience sleep challenges which can lead to sleep-related health issues, exacerbate problematic behaviors, and increase vulnerability to anxiety and depression (Wachob & Lorenzi, 2015; Williams et al., 2004; Richdale & Schreck, 2009). Sleep plays a central role in adaptive functioning, and insufficient sleep can hinder learning, memory, and neuroplasticity for children with ASD (Cohen et al., 2014). As these unhealthy behavior patterns can lead to more adverse long-term health consequences, it is critical to develop interventions that may improve health-related behaviors in youth with ASD. Martial arts, especially judo, is unique because it integrates both physical activity and mind-body components (Bell et al., 2016). Judo may be particularly appealing to youth with ASD due to the structured format and repetitive exercises typically observed during judo sessions (Bell et al., 2016). Recent studies have found that judo interventions in youth with ASD may increase participation in physical activity, improve self-confidence, decrease levels of anxiety, and reduce the frequency of negative behaviors in this population (Morales et al., 2021; Garcia et al., 2020; Renziehausen et al., 2022). Research has shown that participation in physical activity may be associated with sleep quality in both NT youth and youth with ASD (Masters et al., 2019). Therefore, the purpose of this study was to examine the effects of a 16-week judo intervention on sleep quality in youth with ASD. It was hypothesized that this program would improve components of sleep quality in youth with ASD. METHODS: A USA Judo certified coach with prior experience teaching judo to youth with ASD led the 45-minute weekly sessions. Each participant was given an Actigraph GT9X accelerometer and a link to the Qualtrics parent surveys including a child sleep diary. Participants were instructed to wear the accelerometers for seven days and nights over two data collection points: baseline and post-intervention. A validated sleep algorithm was applied to the data to calculate total sleep time, sleep efficiency, sleep latency, and wake after sleep onset. Non-parametric t-tests were used to compare sleep quality outcome variables at pre- and post-intervention. RESULTS: The sleep data of 18 participants was analyzed, consisting of an approximately 80% male sample, a mean age of 13.17 ± 3.76, and approximately 55% of the sample being white. There was a positive statistical correlation between participation in the Judo program and increased sleep efficiency (p=0.05), decreased wake after sleep onset (p=0.02), and decreased sleep latency (p=0.001). CONCLUSION: Judo, a mindfulness form of martial arts, has the potential to serve as a therapeutic intervention to improve sleep outcomes in children with ASD.

Patients admitted to an adult intensive care unit (ICU) are at risk of developing an acute condition known as ICU delirium, which can impact patients’ length of hospital stay and increase short term and 6-month mortality. The cause of ICU delirium is multifactorial, and lack of quality sleep is a known risk factor. Patients’ sleep in the ICU is frequently interrupted by clinicians involved in their care and equipment alarms. Sleep hygiene interventions to minimize these interruptions for the patient are one strategy to reduce the risk of ICU delirium. Examples of sleep hygiene interventions include eye masks, earplugs, and grouping patient care to minimize nighttime interruptions. The primary purpose of this thesis was to review the available evidence on non-pharmacological sleeping interventions and how they can prevent the development of ICU delirium in adults hospitalized with a critical illness. A secondary aim of this thesis was to study the impact of non-pharmacological interventions on sleep quality. Seven studies conducted in critical care units were included in this scoping review, which examined how non-pharmacological sleep hygiene interventions impacted both the prevention of ICU delirium, and sleep quality. Study results were analyzed to determine their effectiveness in relation to the two outcome measures. Although this review identified many benefits of non-pharmacological sleep interventions, the results on which are most effective in preventing delirium and improving sleep quality are inconclusive. Future research needs to be done to evaluate which sleep-promoting intervention(s) will benefit critical care patients most in preventing or lowering their risk of delirium. The feasibility of both health care staff consistently and effectively executing the intervention(s) outside of research conditions, and patient compliance to the interventions needs to be further studied. Additionally, there is a need for future studies measuring sleep quality as a result of sleep promoting interventions to be measured by PSG rather than subjective written/oral reports in order to obtain objective, reliable results.

Sleep is an essential part of life, and obtaining quality sleep is important for various areas of functioning. Behaviors to promote sleep include physical activity, managing stress, reducing anxiety symptoms, maintaining a consistent sleep schedule, and obtaining bright light exposure. Many of these behaviors overlap with benefits observed from pet ownership (PO). The present study aimed to examine the relation between PO and sleep as well as moderators and mediators of this relation. Four research questions were examined: 1) Is PO significantly related to sleep? 2) Does gender moderate the relation between PO and sleep? 3) Do sleep-promoting behaviors (i.e., physical activity, perceived stress, anxiety symptoms, bright light exposure, sleep-wake variability) mediate the relation between PO and sleep? 4) Do the mediating effects of the sleep-promoting behaviors on the relation between PO and sleep depend on the regularity of walking? Participants (N = 1,250; 80.8% White; 50.5% men) residing in the United States reported on their sleep, physical activity, perceived stress, anxiety symptoms, and light exposure. Participants were 25.5% non-pet owners (NPO), 24.1% cat-only owners (CO), 25.7% dog-only owners (DO), and 24.7% owned dogs and cats (DCO). Data analyses included ANCOVA, Moderation, Parallel Mediation, and Conditional Process Modeling. Key findings included that PO was significantly related to sleep, with NPO sleeping worse than PO (CO/DO/DCO combined) and DCO reporting the best sleep of all four PO groups. The relation between PO and sleep did not significantly differ for men and women. The relation was significantly mediated by anxiety symptoms, perceived stress, light exposure, and sleep-wake variability depending on the groups compared and scoring methods used. Anxiety symptoms and perceived stress were the most robust mediators of the relation between PO and sleep. Walking regularity did not change the mediating effects between PO and sleep. This study is one of the first to examine daytime mechanisms of the relation between PO and sleep. The findings provide a foundation for future research examining how the integration of PO and sleep-promoting behaviors can improve adherence to sleep health recommendations, thus improving owners’ sleep.

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Many U.S. adolescents suffer from sleep disorders. Although poor sleep habits may contribute to health issues, less is known about how parental perspectives influence sleep health in adolescents. The purpose of this descriptive phenomenological study was to address a knowledge gap in understanding parental views to promote better sleep habits in adolescents. The blended theoretical framework included the theories of caring science, social learning, advocacy paradigm, and repair and restoration of sleep. Twenty parents in the Southeastern United States participated in open-ended interviews. Research questions were designed to elicit parental perspectives about recognizing unhealthy sleep habits, improving daily sleep health routines, and identifying conditions that led to consultation with health professionals. Colaizzi's data analysis strategy demonstrated thematic parental reports of declines in attitudes, behaviors, and performances as factors for recognizing unhealthy sleep habits; consistent and routine schedules as options for promoting improved sleep habits; and irregular sleep or health problems as reasons for consultation with health professionals. Recommendations for future research include exploring other geographical locations and investigating school bus schedules interfering with early morning sleep loss. To affect positive social change, dissemination of this study's findings to health practitioners may influence enhanced provider-patient communications and ultimately contribute to improved sleep habits among adolescents. Additionally, this study's findings may inform health care administrators with strategies to develop effective parent and provider education programs while reducing unnecessary health services' utilization and resulting costs for adolescent health.

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Purpose: Restoring Effective Sleep Time in Post Cardiac Surgery Patients: A Quality Improvement Project Brooke Watts, BSN, RN, DNP Student, Murray State University Dr. Kristin Reid, DNP, APRN, ACNS-BC, DNP Program Director/Assistant Professor Murray State University Aims: This quality improvement project was developed using DNP project guidelines provided through Murray State University and was designed to improve sleep in hospitalized cardiac surgery patients. Processes: IRB approval was obtained from the healthcare institution and academic institution. This two-phase quality improvement project was designed to analyze the effects of a change in normalized hospital routines on self-reported sleep in post-cardiac surgery patients. Phase one involved no change in unit nursing routines to draw baseline data. Phase two involved the quality improvement intervention where routine patient assessments and vital signs were executed at 11:00 p.m., and at 04:00 a.m. Any non-timed lab work or routine radiological studies were postponed until after 04:00am. Patient participation for both phase one (n=4) and phase two (n=3) were determined by exclusion criteria. The Richards Campbell Sleep Questionnaire (RCSQ) was utilized for data collection and patients were asked to complete the questionnaire daily. Results: Comparison of mean patient-reported sleep scores between the pre-intervention and intervention groups showed a positive association between the quality improvement intervention and patient reported sleep. Limitations: Limitations for this project included a small sample size in both phases. IRB stipulations required a low-risk profile which limited eligible participants. There was a limited timeframe for project execution due to time required for IRB approval and to meet course-related timelines. The project was further limited by lack of on-site dedicated project staff overseeing qualifying patient enrollment. Conclusions: Key findings were in alignment with sleep-related findings in comparable studies and projects where unit routines were adjusted. Execution of similar projects should occur to provide more substantial evidence supporting this quality change. With evidence of this project in mind, providers and nurses can practice mindfully and incorporate creative approaches to safely care for patients and improve sleep.

Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical. Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity and mortality is on the horizon unless aggressive measures are taken at mitigating risk. Similarly, as the obesity epidemic expands, obesity-related comorbid conditions including obstructive sleep apnea (OSA) are likely to grow. The purpose of this research was to explore the relationship between ambulatory orthopedic patient-reported activities (quality of life metrics) and diagnostic factors (physical and perioperative care data) in the immediate postoperative period that are predictive of arterial oxygen desaturation. Data was obtained using a novel patient journal exploring sleep, pain, nausea, tobacco use, alcohol use, and appetite in conjunction with a valid and reliable portable, wrist-worn pulse oximeter. Additional assessment data was taken from the preanesthetic assessment. All participants were scored according to the STOP-Bang questionnaire, an accepted survey of OSA risk. Patients were recruited from a busy metropolitan ambulatory surgery center in Richmond, Virginia that sees approximately 500 cases monthly, and a 309-bed tertiary care hospital in West Burlington, Iowa. The target sample included 52 individual patients with data collected over the first two post-operative nights following discharge. Two patients were excluded. Negative binomial regression, log10 transformation, and least-squares regression examined the relationships the STOP-Bang questionnaire, quality of life data, and physical perioperative data had on postoperative desaturation events. Results suggested the STOP-Bang score predicted desaturation events and that age and BMI were significant individual predictors. Opiate pain medication treatment, a happy mood, and home CPAP use were associated with decreased events. This study provided a unique perspective in patient safety research, relating human behaviors and experiences with postoperative oxygen desaturation. Future research projects aligned with postoperative monitoring, pulse oximetry, patient safety, and obstructive sleep apnea are potential following the findings of this study.

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No description available.