Class of 2013 Abstract / Specific Aims: To evaluate three complementary and alternative medicines (CAM), tai-chi, acupuncture, and melatonin, for treating insomnia using meta-analysis assessment of randomized controlled trials. Methods: The electronic database MEDLINE (PubMed) was searched from May of 2012 to November of 2012 by using the terms “sleep initiation and maintenance disorders” AND “tai-chi” OR “melatonin” OR “acupuncture”. All of the searches ended at November of 2012. Data extraction was conducted independently by 2 investigators and any disagreements were resolved by consensus. If the 2 investigators could not agree, the study was reviewed by all 4 investigators. Main Results: Out of 500 studies that were initially retrieved, 12 studies were included; 3 for tai-chi; 4 for acupuncture; 5 for melatonin. We found that the effect of each type of intervention was significantly different than zero, p<0.01 thus all were effective in treating insomnia. From our analysis, acupuncture was the most effective (standard mean difference, SMD=-0.66; p<0.01) followed by tai-chi (SMD=-0.43; p<0.01) whereas melatonin was the least effective (SMD=-0.26; p=0.04) but difference between acupuncture and melatonin was not significant (p=0.15).       Conclusion: All three interventions were found to be effective in treating insomnia. However, due to mixed and inconsistent data of the studies, poorly designed trials, and small sample size, further large, well-controlled trials are warranted.

Orientadores: Monica Sanches Yassuda, Anita Liberalesso Neri / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação / Made available in DSpace on 2018-08-07T23:56:37Z (GMT). No. of bitstreams: 1 Oliveira_BeatrizHelenaDomingos_M.pdf: 1071762 bytes, checksum: bbf416d9287be4204a0e443208e01ce2 (MD5) Previous issue date: 2006 / Resumo: Com o processo de envelhecimento humano observam-se alterações em características do sono e no desempenho cognitivo. O objetivo do presente trabalho foi investigar a associação e o efeito de alterações e transtornos do sono sobre funções cognitivas como memória, linguagem, praxia visuo-construtiva e funções executivas, bem como a relação de todas estas variáveis com características sócio-econômicas. A amostra foi composta por 158 idosos (idade entre 60 e 99 anos; M= 70,2; DP=8,2) residentes na comunidade da cidade de Juiz de Fora ¿ MG, integrantes do Estudo dos Processos de Envelhecimento Saudável (PENSA). Foram utilizados subtestes da bateria do Consortium Estabilish a Registry for Alzheimer¿ Disease - CERAD (Morris et al., 1987) e o questionário Mini-Sleep (Zomer et al., 1985). Pelas análises multivariadas observou-se que maior freqüência de sintomas de insônia esteve associada a pior desempenho em fluência verbal, e ainda, por uma análise regressão múltipla observou-se que maior escolaridade, menor idade e menor freqüência de sintomas de insônia são preditores de melhor desempenho cognitivo, com maior efeito da variável escolaridade. Os resultados do presente estudo corroboram os dados de pesquisas nacionais e internacionais, apontando assim para a necessidade de uma maior atenção ao impacto de transtornos do sono e variáveis sócio-demográficos sobre funções cognitivas na velhice / Abstract: Along with the aging process changes in sleep patterns and in cognitive performance are observed. The objective of the present study was to investigate the association and the effect of sleep changes and sleep disturbances on cognitive functions such as memory, language, constructional praxis and executive functions, as well as the relation of the cognitive and sleep variables to the socio-economic variables. The studied sample was formed by 158 community dwelling older adults from Juiz de Fora ¿ MG (age range from 60 to 99; M = 70,2; SD = 8,2), participants in the Estudo dos Processos do Envelhecimento Saudável (PENSA). Sub-tests from the CERAD battery Consortium to Estabilish a Registry for Alzheimer¿ Disease - CERAD (Morris et al., 1987) and the Mini-Sleep Questionary (Zomer et al., 1985) were selected for these analyses. Multivariate analyses indicated that higher frequency of insomnia symptoms was associated with worse verbal fluency performance, and multiple regression analyses suggested that higher education, lower age and lower frequency of insomnia symptoms are predictors of better cognitive performance, with stronger impact of years of education. Results from the present study confirm previous national and international research, indicating the need for more attention to the impact of sleep disturbances and socioeconomic variables on cognitive aging / Mestrado / Gerontologia / Mestre em Gerontologia

Orientador: Maria Filomena Ceolim / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T15:12:15Z (GMT). No. of bitstreams: 1 Pereira_AlexandreAlves_M.pdf: 1520399 bytes, checksum: 72e63b6e3cf94505105d6ffd2c213b81 (MD5) Previous issue date: 2011 / Resumo: Objetivo: Descrever a influência da atividade física, da velocidade da marcha, da capacidade funcional, dos sintomas de insônia, do cochilo diurno e dos sintomas depressivos sobre a ocorrência de quedas em idosos residentes na comunidade. Métodos: Estudo retrospectivo, de corte transversal. Dos 900 idosos recrutados em domicílio na cidade de Campinas, foram incluídos nesse estudo 689 idosos selecionados por desempenho superior à nota de corte no Mini-Exame do Estado Mental. Os instrumentos incluíram questionários para avaliação dos sintomas de insônia, cochilo diurno e ocorrência de quedas nos últimos 12 meses; medida observacional de velocidade da marcha; as versões brasileiras da Geriatric Depression Scale e do Minnesota Leisure Activity Questionnaire; 13 atividades avançadas de vida diária (AAVDs) e sete atividades instrumentais de vida diária (AIVDs). Resultados: A idade média foi 72,19 (dp = 5,33). Dos entrevistados, 68,8% eram do sexo feminino; 49,93% queixaram-se de um ou mais sintomas de insônia e 62,94% referiram o hábito de cochilar; 19,61% apresentaram sintomas depressivos; 56% eram sedentários, contudo a maioria mostrou-se independente funcionalmente (AAVDs, AIVDs e velocidade da marcha); a prevalência de quedas foi de 26,2%, sendo 11,87% a freqüência de quedas recorrentes. Dentre as variáveis investigadas, sexo feminino, idade igual ou acima de 80 anos, limitação funcional em AIVDs, uso de medicamentos para dormir, sintomas de insônia, cochilo diurno e sintomas depressivos apresentaram associação significativa com quedas recorrentes. No modelo multivariado de análise permaneceram associados a quedas recorrentes o sexo feminino, cochilos diurnos, sintomas depressivos e idade igual ou acima de 80 anos. Conclusões: os achados desse estudo mostraram que os sintomas de insônia e cochilo diurno estão associados ao risco aumentado de quedas em idosos da comunidade. As estratégias de prevenção de quedas em idosos da comunidade devem focar na intervenção dos fatores de risco modificáveis. Deste modo, os resultados dessa pesquisa indicam a necessidade de avaliação da qualidade do sono e suas conseqüências nessa população / Abstract: Objective: to describe the influence of physical activity, walking speed, functional performance, insomnia symptoms, daytime napping and depressive symptoms on the incident of fall in community-dwelling elderly people. Methods: Retrospective, cross-sectional study. Of the 900 elderly people recruited at home in Campinas, 689 were selected from those who scored above the cutoff point for the Mini-Mental State Examination. The instruments included questionnaires to assess insomnia symptoms, daytime napping and falls in the previous 12 months; walking speed; the Brazilian versions of the Geriatric Depression Scale and Minnesota Leisure Activity Questionnaire; 13 advanced activities of daily living (AAVDs) and seven instrumental activities of daily living. Results: Of the respondents, 68% were female; 49,93% complained one or more insomnia symptoms and the most of the sample reported napping; 19,61% had depressive symptoms; 56% were sedentary, although most proved to be functionally independent; the prevalence of falls was 26.2% and 11.87% frequency of recurrent falls. Among the variables investigated, female, age above 80 years, functional limitation in IADL, use of sleep medications, insomnia symptoms, daytime nap and depressive symptoms were significantly associated with recurrent falls. In multivariate analysis, female, age above 80 years, daytime napping and depressive symptoms remained associated with recurrent falls. Conclusion: the findings of this study showed that insomnia symptoms and daytime napping are associated with greater risk of falls in community elderly people. The strategies to prevent falls in community elderly people should aim to the intervention in the modifiable risk factors. Thus, the results of this survey indicate the need for assessment of sleep quality and its consequences in this population / Mestrado / Gerontologia / Mestre em Gerontologia

No description available.

Insomnia is a risk factor for suicidal behavior including attempts and suicide. We investigated whether insomnia symptom severity predicted suicidality and suicide in an at-risk sample. The sample included deceased psychiatric patients seen at Weber Human Services since 2008 (N=180) who completed the Outpatient Questionnaire-45.2 (OQ) prior to death. Insomnia symptom severity was assessed using item 41 from the OQ. Manner of death was determined by death records and autopsy reports. History of suicidal ideation and prior suicide attempts were determined through review of electronic medical records. Cases were grouped into 4 categories: no history of suicidality (n = 30), history of suicidal ideation (n = 36), suicide attempt history (n = 95), and death by suicide (n = 19). Insomnia symptom severity was compared across groups using linear regression. Logistic regression was used to determine whether OQ reported insomnia symptom severity predicted suicide, adjusting for psychiatric disorders. Compared to the non-suicidal group, the suicide attempt and the suicide groups reported significantly higher insomnia symptom severity, OR=3.52, p=0.001 and OR=6.53, p<0.001, respectively. Greater insomnia symptom severity reported on the OQ was a significant predictor of suicide attempt and suicide, OR=2.67, p=0.011 and OR=5.53, p=0.002, respectively, even after adjusting psychiatric diagnoses. Results suggest that insomnia symptoms are more strongly associated with suicidal behavior than suicidal ideation. The presence of insomnia symptoms in psychiatric patients may indicate risk for suicidal behavior and is a target for suicide prevention.

No description available.

No description available.

Since 2002, the number of veterans enrolled in universities has nearly doubled, although 30-40% of veterans fail to complete their degree. While research efforts to understand the challenges veterans face transitioning from military life to college has increased in recent years, few studies have looked beyond the effects of post-traumatic stress disorder (PTSD). Insomnia is the most frequently reported symptom of combat veterans and can have serious implications for college students. The purpose of this study was to examine the role of insomnia and student veteran adaptation to college relative to civilian students. College students (N = 588) were administered a Background Information Questionnaire, the Insomnia Severity Index, the Deployment Risk and Resilience Inventory, and the Student Adaptation to College Questionnaire. Results revealed that students with insomnia reported significantly lower adaptation to college than students without insomnia. Student veterans reported better academic and personal-emotional adaptation to college than civilian students, while civilians reported better social adjustment than veterans. Although combat veterans without insomnia scored consistently higher academic adjustment than non-combat veterans and civilian students, when present insomnia seemed to have a greater negative effect on combat veterans’ academic adjustment relative to civilian students. Furthermore, insomnia mediated the relationship between combat exposure and veteran’s personal-emotional adjustment to college. Implications and future directions for research are discussed.

Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

研究目的：失眠為國人常見的健康問題，造成患者夜間睡眠的痛苦，對白天生活品質也有明顯的影響，站在預防失眠慢性化的角度切入，找出情境性失眠高危險群的心理病理特性，應可為防治失眠疾患提供更積極的建議。本研究目的一即是想透過與好眠組的比較，討論壓力因應風格、持續失眠相關病因(對睡眠不適當認知、睡眠相關安全行為、身心激發程度)在失眠高危險族群及慢性失眠者的特性為何。第二個目的則想驗證失眠持續因素對失眠的影響路徑，並探討壓力因應風格在失眠持續模式中的影響性為何。 研究方法：本研究以橫斷式問卷調查法收集資料，蒐集有效問卷情境性失眠高風險群組74份、好眠組75份、與慢性失眠組62份，總共211份有效問卷。統計方法則根據不同研究目的分別採用單因子變異數分析及結構方程模型的路徑分析進行資料處理。 研究結果：慢性失眠者比好眠者與慢性失眠者有更高的睡眠不適當認知、更多睡眠相關安全行為更高的睡前激發程度。慢性失眠者與情境性失眠高危險族群在面對壓力時，也比好眠者使用較多的「社會支持、情緒調節與發洩的調解」、「逃避」、「問題解決、重釋與接受」等因應策略。此外，情境性失眠高危險族群也比好眠者用更多的睡眠相關安全行為來因應疲憊或睡不好的狀況。另外，本研究路徑分析結果發現睡眠不適當認知會透過安全行為及激發程度而影響失眠，且在考驗各個壓力因應風格對失眠持續模式之影響時，發現較一致的結果是逃避因應可能會增加個體使用更多睡眠相關安全行為而惡化失眠 研究討論：研究結果支持過去理論認為睡眠不適當認知、睡眠相關安全行為及睡前激發程度為失眠的持續因子。為預防情境性失眠高危險族群其失眠症狀慢性化，建議重點應放在睡眠的衛生教育，並且不只是教導適當因應失眠的行為，重要的是需包括增強對失眠處理的控制感、建立適當合理的藥物使用概念、矯正對失眠後果的災難化想法。最後，過去少有其他研究討論逃避因應風格與失眠的關係，建議對此有興趣的研究者可對逃避因應風格與失眠的關係做進一步的重覆驗證與探討。 / OBJECTIVE: The goals of the study are to examine (1) the differences of coping, dysfunctional beliefs and attitudes about sleep, sleep related safety behaviors and pre-sleep arousals among chronic insomniacs, normal sleepers vulnerable to stress-related sleep disturbance and good sleepers (2) the interactions of coping with other etiological factors in the model of persistent insomnia. METHOD: The sample was composed of 211 participants. Participants were asked to complete a set of questionnaires, including the Ford Insomnia Response to Stress Test (FIRST), the Insomnia Severity Index, the Pre-Sleep Arousal Scale, the Sleep-Related Behaviour Questionnaire, the Dysfunctional beliefs and attitudes about sleep questionnaire, COPE, the Center for Epidemiologic Studies Depression Scale, the Beck Anxiety Inventory and the Pittsburgh Sleep Quality Inventory. The participants were categorized into three subgroups, 75 good sleepers, 74 normal sleepers vulnerable to stress-related sleep disturbance, and 62 chronic insomniacs, according to clinical interview and/or their scores on the FIRST. RESULT: The results showed that chronic insomniacs reported more dysfunctional beliefs and attitudes about sleep, sleep related safety behaviors and pre-sleep arousals than the other groups. In addition, chronic insomniacs and normal sleepers vulnerable to stress-related sleep disturbance used more coping styles of “problem solving, positive reinterpretation and acceptance”, “social support, focus on and venting of emotions”, and “avoidance” than good sleepers. Also, normal sleepers vulnerable to stress-related sleep disturbance reported more safety behaviors to cope insomnia than good sleepers. Furthermore, the path analysis showed that the safety behaviors and arousal play an important mediating role between dysfunctional beliefs and attitudes about sleep and insomnia in chronic insomniacs. Finally, data showed that avoidance coping could predict the frequency of sleep related safety behaviors. CONCLUSION: The results imply that in order to prevent normal sleepers vulnerable to stress-related sleep disturbance from becoming chronic insomniacs, sleep hygiene education program should incorporate methods that are designed to reduce maladaptive sleep beliefs and sleep related safety behaviors. The relationship found between avoidance coping and insomnia is also of interest and require replication in future researches.