The objective of this study was to determine the effects race, sex and sleep disturbance have on the severity of Parkinson’s disease as assessed by the Hoehn Yahr (HY) score in both the medicated (ON) and non-medicated (OFF) states. The potentially confounding variables of age, time in years from the onset of symptoms to database entry, and education were taken into account. Secondary analysis was also conducted to determine how the non-motor symptoms of dementia, hallucinations and autonomic dysfunction impacted Hoehn Yahr ON and OFF scores. This study used the statistical techniques of the Student’s t-test, ANOVA, Tukey-Kramer test, univariate linear regression, and multivariate regression. The t-tests and ANOVA test revealed that there was no significant differences in mean HY ON and OFF scores between the sexes, patients with and without sleep disturbance, and between the different races analyzed in this study. Patients with and without sleep disturbance did show significantly higher HY ON scores as compared to HY OFF scores, which is peculiar as this finding suggests that these patients are not responding to their medication. The univariate linear regression models did show, however, that time in years from the onset of symptoms to database entry did significantly impact both HY ON and OFF scores, whereas age is only shown to have a significant impact on HY OFF scores. Additionally, the univariate linear regression model analyzing the association between education and HY OFF scores showed that having some high school education, but not receiving a degree, was associated with an increase in HY OFF scores. Several multivariate linear regression models where built to assess the impact different predictor variables had on HY ON and HY OFF scores. The first two multivariate models used the predictor variables of age, race, and time in years from the onset of symptoms until database entry. These models showed that only time in years from the onset of symptoms until database entry impacted HY ON scores, whereas all three of these predictor variables impacted HY OFF scores. Two additional multivariate linear regression models were built to assess how age, race, time in years from the onset of symptoms until database entry, dementia, autonomic dysfunction and hallucinations all impacted HY ON and OFF scores. These models revealed that all of these predictors, when taken together, significantly impacted HY OFF scores, but not HY ON scores. Finally a scatter plot was made comparing HY ON and HY OFF scores. A LOWESS scatter plot smooth line was also superimposed on top of this plot to show the overall trend these scores had on one another. This scatter plot was interesting because it suggested that there were two spate groups of patients contained in this database, those that responded well to medication and those that did not. Overall, this study showed that age, time in years from the onset of symptoms until database entry, education and race impacted HY OFF scores. Furthermore, the analysis indicated that patients who were asked about sleep disturbance did not appear to be responding to medication. There are several limitations to this study, however, with the most important being missing data and the cross-sectional design. Missing data prevented sleep disturbance from being thoroughly analyzed and the cross-sectional design does not allow for any causal relationships to be determined.

Research has shown that sleep disturbance (e.g., sleep latency, wakefulness after sleep onset [WASO]) negatively affects physical, emotional, and mental health. For many adults, the postpartum period is one that is particularly highlighted by sleep disturbance and fatigue. Postpartum mothers are also more vulnerable to psychiatric disorders such as depression. We sought to investigate whether the number of children and presence of an infant predicted clinically significant sleep disturbance, and subsequently, depressive symptoms, for both mothers and fathers. We found that having an infant was significantly associated with increased wife WASO, which in turn was associated with increased depressive symptoms for wives. Further, husband WASO was associated with decreased wife WASO which was similarly associated with decreased depressive symptoms for wives. Thus, by helping with nighttime care so that mothers can get more sleep fathers can greatly contribute to the physical and emotional health of mothers.

Parkinson’s disease (PD) is a neurodegenerative movement disorder and a leading cause of neurological disability in the older adult population. Historically, the research and treatment of PD has focused on the associated motor symptoms. Now the non-motor symptoms such as sleep disturbance are becoming an increased focus for researchers. Deep brain stimulation (DBS) is a surgical intervention that has proven to be beneficial for PD motor symptom management. There are claims from the literature that DBS may assist with the phenomenon of sleep disturbance. A case study analysis was done to explore this concept in the DBS-PD patient population using the framework of the Symptom Management Theory. From the analysis of the subjective and objective data gathered it is clear that the phenomenon of sleep disturbance in this population is multifaceted and that DBS may play a role in managing the phenomenon of sleep disturbance for this population.

Parkinson’s disease (PD) is a neurodegenerative movement disorder and a leading cause of neurological disability in the older adult population. Historically, the research and treatment of PD has focused on the associated motor symptoms. Now the non-motor symptoms such as sleep disturbance are becoming an increased focus for researchers. Deep brain stimulation (DBS) is a surgical intervention that has proven to be beneficial for PD motor symptom management. There are claims from the literature that DBS may assist with the phenomenon of sleep disturbance. A case study analysis was done to explore this concept in the DBS-PD patient population using the framework of the Symptom Management Theory. From the analysis of the subjective and objective data gathered it is clear that the phenomenon of sleep disturbance in this population is multifaceted and that DBS may play a role in managing the phenomenon of sleep disturbance for this population.

Fentanyl is a potent synthetic opioid that has been shown to produce sleep disturbances, and the deterioration of sleep quality is associated with drug abuse and relapse in humans. The hypocretin/orexin neuropeptide system is a plausible pharmacological target, and dual-hypocretin antagonists such as lemborexant may mitigate sleep disturbances associated with fentanyl dependence. The current study characterizes sleep macroarchitecture (time spent asleep or awake) and microarchitecture (the number of bouts, and NREM sleep spindle characterization) prior to fentanyl vapor exposure (baseline), following one week of drug abstinence, and four weeks of drug abstinence in female and male rats. Females and males showed a reduction in the amount of time spent in rapid eye movement (REM) sleep following one week of abstinence. The pre-treatment of lemborexant the following day increased the amount of time spent in REM, compared to vehicle at both one and four weeks of abstinence. While there was no effect of fentanyl abstinence on the amount of time spent in non-rapid eye movement (NREM) sleep and wakefulness, lemborexant increased the amount time spent in NREM and decreased the amount of time spent awake. Examination of microarchitecture demonstrated a decrease in the number of NREM bouts at one week of abstinence, which lemborexant subsequently brought back to baseline levels at weeks one and four. Abstinence from fentanyl did not impact the number of NREM sleep spindles, but indicated a trend showing a decrease in intra-spindle frequency at one week of abstinence. Lemborexant, however, increased the number of spindles at weeks one and four of abstinence. Presently, findings indicate that fentanyl abstinence produces changes in sleep macroarchitecture, particularly REM sleep disruptions, which may be alleviated by lemborexant. This highlights the need for further examination of the relationship between sleep disturbances and drug abstinence, and the use of dual-hypocretin antagonists as therapeutic intervention.

Studies have found a relationship between psychopathology and sleep disturbances, as well as between psychopathology and personality traits. What has not received attention to date, however, is the interplay amongst all three factors: psychopathology, sleep disturbances, and personality characteristics. This study explores the interaction amongst the three areas, as well as examines specific relationships between psychopathology and sleep disturbances and personality and sleep disturbances. Forty clients were recruited from a community mental health center. Participants were receiving outpatient psychological services, were over 18, and did not have a diagnosis of active psychosis or mental retardation. Participants completed 9 questionnaires covering items about demographic information, psychological concerns, sleep, personality style, and social desirability. They received a $10 gift card upon completion of the study. Participants had a mean age of 47.6 (70% female, 77% Caucasian). Results indicated that individuals with more severe psychopathology had poorer sleep quality and greater insomnia severity; however, participants with longer histories of psychopathology did not have more dysfunctional beliefs and attitudes about sleep. Participants with more extraverted personality styles did not sleep less than individuals who were less extraverted, and those who were more neurotic did not exhibit poorer sleep quality or greater insomnia severity. Lastly, when examining the relationship amongst all three factors, it was found that psychopathology may be a better predictor of sleep disturbances than personality is (depending on how sleep was assessed), and personality and sleep disturbances are both significant predictors of psychopathology. The results reinforce the interplay amongst psychopathology, personality, and sleep disturbances. Mental health professionals may want to place greater importance on the role of sleep in the treatment of psychological and personality disorders. Future research could replicate the study with a larger sample, utilize a different personality measure, or follow participants longitudinally from the start of their mental health treatment.

No description available.

Sammanfattning Bakgrund:De senaste åren har förekomsten av sömnstörning ökat. I Sverige anses det numera vara ett av våra stora folkhälsoproblem. Sömnstörning har visat sig vara mer förekommande hos individer med samtidig sjukdom än hos den allmänna populationen. Brist på sömn medför ofta dagtidssymtom vilka påverkar individens tillvaro. Sjuksköterskan är ofta, främst på sjukhus, den första som möter patienters problem gällande sömn. Det är således viktigt att sjuksköterskan besitter adekvat kunskap om hur dessa problem kan yttra sig och vilka konsekvenser de kan medföra individen. Syfte:Syftet med denna studie är att beskriva patienters upplevelser av sömnstörning vid samtidig sjukdom. Metod: Vald metod för denna studie är en litteraturöversikt. Studien inkluderar åtta vetenskapliga artiklar av både kvalitativ och kvantitativ ansats. Resultat: I analysen framkommer fyra kategorier; Upplevelsen om vad som bidrar till sömnstörning, Trötthet och sömnighet, Förändringar i den sociala tillvaron och Förändringar i sinnesstämning. Olika somatiska, psykologiska, aktivitetsrelaterade och miljömässiga faktorer upplevs bidra till sömnstörning. I majoriteten av artiklarna beskriver patienter trötthet och sömnighet som symtom vilka medför konsekvenser i livet. Mellanmänskliga relationer påverkas och patienterna känner hjälplöshet och hopplöshet i sin situation. De tappar lättare humöret vilket upplevs försämra deras förmåga att hantera svårigheter som uppkommer i det dagliga livet. Diskussion: Diskussionen bearbetas utifrån teorin om livsvärldsperspektivet. De förändringar som patienterna genomgår vid sömnstörning och samtidig sjukdom påverkar deras livsvärld och hela deras existens. Då livsvärlden är högst personlig och unik för varje människa, bör sjuksköterskan vara lyhörd inför patientens egen beskrivning av sin livsvärld och sina upplevelser. Detta för att skapa förståelse kring hur patienten hanterar sin sömnstörning och hur den påverkar dennes liv. / Abstract Background: In recent years the prevalence of sleep disturbance has increased. It is currently regarded as one of the major public health problems in Sweden. Sleep disturbance has also been shown to be more common among individuals with concurrent disease than among the general population. Lack of sleep is often associated with daytime symptoms which severely affect the individuals’ situation. In the case of hospitalization, the nurse is often the first to encounter patients sleep problems. This means that it is important for the nurse to have adequate knowledge of how such problems express themselves and what consequences they may bring. Aim: The aim of this study is to describe the patients’ experience of sleep disturbance during concurrent disease. Method: The chosen method for this study is a literary survey. The study includes eight scientific articles of both qualitative and quantitative design. Result: Four categories emerged from the analysis; The experience about what contributes to sleep disturbance, Tiredness and sleepiness, Changes in social life and Changes in mood. Patients experience that somatic, psychological, activity-related and environmental factors contribute to sleep disturbance. In the majority of articles, patients describe tiredness and sleepiness as symptoms which have consequences in life. Patients experience that sleep disturbance results in a change in interpersonal relationships. They also experience feelings of helplessness and hopelessness due to their situation. They easily lose their temper and they feel that this impairs their ability to handle problems that occur in their daily lives. Discussion: The discussion is processed through the theory of the life-world perspective. The changes that patients undergo during sleep disturbance and concurrent disease will affect their life-world and their very existence. Though the life-world is highly personal and unique to each person, the nurse should be sensitive to the patient’s own description of his/hers life-world and his/hers experiences. This is to create an understanding of how patients manage their sleep disturbance and how it affects his/her life.

It is widely accepted that sleep disturbances occur in patients recovering from coronary artery bypass graft (CABG) surgery. This sleep disturbance, at least in theory, might retard or limit the return of functionality and exacerbate psychological states known to increase use of health care services and adversely affect prognosis. This study explored possible relations between sleep, self-rated aerobic physical capacity and physical activity in a sample of patients who underwent CABG surgery. Secondary analysis investigated the possible concurrent influences of post-CABG health complaints and depression on sleep function. Measures included the Pittsburgh Sleep Quality Questionnaire; the Veterans Specific Activity Questionnaire; the Paffenbarger Physical Activity Questionnaire; the Health Complaint Scale and the Beck Depression Inventory, Version II. The physical measure of body composition was also used. Fifty-five subjects completed baseline questionnaires for all measures just prior to surgery, excluding the Paffenbarger Physical Activity Questionnaire. Follow-up evaluations were repeated at 3 mo post-CABG for the same measures and the patients were also asked to report their patterns of post-surgical physical activity involvement. Correlation coefficients were calculated to determine whether a correlation existed between the measures. Significant correlations were found between pre-surgical and post-surgical sleep score, sleep subscales, functional capacity, depression and health complaints (p < 0.05). Post-CABG sleep and physical activity did not exhibit a significant correlation. A number of secondary analyses were performed in an effort to isolate possible influences of confounding factors, such as depression, body mass index > 27, and a ventricular ejection fraction (EF) < 30. In the low EF subgroup, overall sleep score and self-rated functional capacity were strongly correlated before surgery was performed (r = -0.85; p < 0.01). Stepwise regression equations were constructed to predict sleep outcome before and after surgery. Somatic health complaints, depression, and skinfold measures were found to be predictors for pre-surgical sleep (R2 = 0.52), as well as post-surgical sleep (R2 = 0.78). Fitness measures of functional capacity and physical activity were not a significant predictor of sleep. The findings of this study suggest that a modest correlation exists between functional capacity and sleep in CABG patients; however, predictors including health complaints, depression and skinfold measures serve as better indicators for sleep outcome before and after CABG surgery. / Master of Science

No description available.