Difficulty In Falling Asleep Research Articles

Difficulty of falling asleep and non-high-density lipoprotein cholesterol level among Canadian older adults: a cross-sectional analysis of the Canadian Longitudinal Study for Aging baseline data.

OBJECTIVETo examine whether difficulty of falling asleep (DoFA) is associated with non-high-density lipoprotein cholesterol (non-HDL-C) level among Canadian older adults.METHODS26,954 individuals aged 45–85 years from the baseline data of the Canadian Longitudinal Study for Aging were included in this study. DoFA was categorized into five groups by answer to the question “Over the last month, how often did it take you more than 30 min to fall asleep?” Response options are “Never, < 1 time/week, 1−2 times/week, 3−5 times/week, or 6−7 times/week”. Non-HDL-C, the difference of total cholesterol and HDL-C, were categorized into five categories based on these cut-offs (< 2.6 mmol/L, 2.6−3.7 mmol/L, 3.7−4.8 mmol/L, 4.8−5.7 mmol/L, and ≥ 5.7 mmol/L). Ordinal logistic regression (logit link) continuation ratio models were used to estimate the odds of higher non-HDL-C levels for DoFA status. Adjusted means of non-HDL-C by DoFA status were estimated by general linear models. All analyses were sex separately using analytic weights to ensure generalizability.RESULTSThe proportions of DoFA in five categories were 41.6%, 25.7%, 13.6%, 9.4%, 9.7% for females and 52.9%, 24.9%, 10.5%, 6.1%, 5.6% for males, respectively. After adjustment of demographical and other covariates (such as depression, comorbidity, sleeping hour, etc.) compared to those who reported never having DoFA, the ORs (95% CIs) of higher levels of non-HDL-C for those whose DoFA status in < 1 time/week, 1−2 times/week, 3−5 times/week, and 6−7 times/week were 1.12 (1.05−1.21), 1.09 (0.99−1.18), 1.20 (1.09−1.33), 1.29 (1.17−1.43) in females and 1.05 (0.98−1.13), 0.95 (0.87−1.05), 1.21 (1.08−1.37), 0.97 (0.85−1.09) in males, respectively. The adjusted means of non-HDL-C among the five DoFA status were 3.68 mmol/L, 3.73 mmol/L, 3.74 mmol/L, 3.82 mmol/L, 3.84 mmol/L for females and 3.54 mmol/L, 3.58 mmol/L, 3.51 mmol/L, 3.69 mmol/L, 3.54 mmol/L for males, respectively.CONCLUSIONSThe results of this study have identified a risk association pattern between DoFA status and non-HDL-C levels in females but not in males. Further research is needed to confirm these findings.

Effect of evidence-based nursing on the postoperative complications and negative effects of type 2 diabetic patients with coronary disease

Objective To explore the effect of evidence-based nursing on the postoperative complications and negative effects of type 2 diabetic patients with coronary disease. Methods A total of 78 patients with coronary heart disease and type 2 diabetes mellitus who had adopted interventional therapy in our hospital were randomly divided into observation group and control group.The observation group was given the evidence-based nursing, while the control group adopted the routine care.The postoperative complications and negative effects of the two groups were observed. Results The arrhythmia, hypoglycemia and vascular injury of the observation group were significantly lower than that of the control group (P<0.05). The difficulty in falling asleep, body aches, constipation, vagal reflex, difficulty urinating, bleeding or hematoma, hypotension of the observation group was significantly lower than that of the control group, and the differences were statistically significant (P<0.05). Conclusions The evidence-based care applied in the interventional treatment for patients with coronary artery disease and diabetes type 2 can reduce the incidence of postoperative complications and negative effects. Key words: Coronary artery disease and type 2 diabetes; Interventional therapy; Evidence-based care; Postoperative complications; Negative effects

The analysis of sleep structure and its influence factors in epilepsy

Objective To investigate sleep structure characteristics in different types of epilepsy, and to analyze the factors affecting sleep quality in epilepsy. Methods Forty six epilepsies and 13 controls were assessed with polysomnography. Results N2[(71.33±11.91)% vs (55.54±6.94)%, P<0.05]in generalized epilepsy was significantly higher than controls. N3[(9.75±10.70)% vs (18.31±4.64)%, P<0.05]and rapid eye movement stage(REM)[(8.58±6.32)% vs (17.77±4.66)%, P<0.05]in generalized epilepsy were significantly lower than controls. The sleep latency of REM in unclassification of attack was significantly lower than other groups(P<0.05). Age older than 35 years old in epilepsy was easy to have decreased sleep efficiency(P=0.014), and the onset age after 35 years old in epilepsy regularly had difficulty in falling asleep (P=0.038). Conclusions Generalized epilepsy has obviously sleep structural abnormalities; Age older than 35 years old in epilepsy is easy to have decreased sleep efficiency, and the onset age after 35 years old in epilepsy regularly has difficulty in falling asleep. Key words: Epilepsy/PP; Sleep; Polysomnography

The nocturnal panic attacks: polysomnographic features and comorbidities

Background Panic disorder refers to the repeated or unexpected anxiety or panic attacks. It makes patients feel extreme pain. Although the episodes of most patients with panic disorder happen at daytime, the nocturnal panic attacks (NPA) are quite common. Paients pay more attention to NPA. Insomnia is more serious in patients with NPA than those patients with panic disorder attack at daytime. Many patients may occur anxiety and avoidance behavior after NPA. Patients are often afraid of sleeping, or even do not sleep. The aim of this study is to analyze polysomnographic (PSG) parameter changes and clinical concomitant symptoms of patietns with NPA, to explore the characteristics of sleep, in order to provide better diagnosis, differential diagnosis and treatment for these patients. Methods The features of sleep of 20 NPA patients and 23 healthy controls were monitored by video-PSG. Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) were used to assess the state of anxiety, depression, and dyssomnia of the patients. Results In comparison with normal control group, the NPA group showed shortened total sleep time (TST), decreased sleep efficiency (SE) and sleep maintenance rate, delayed arousal time, increased number of arousal and number of arousal episode longer than 5 minutes, increased percentage of non-rapid eye movement (NREM) sleep stage Ⅰ, decreased percentage of NREM sleep stageⅢ and percentage of rapid eye movement (REM) sleep ( P 0.05, for all). In NPA group, there were 13 cases (13/20) with anxiety, 17 (17/20) with depression, 13 cases/times (13/20) with difficulty of falling asleep, 17 cases/times (17/20) with difficulties in maintaining sleep (frequent arousals and difficult to fall asleep again) and 7 cases/times (7/20) with wake up early. Conclusion NPA patients present decreased deep sleep, increased shallow sleep and poor sleep quality, and are mostly accompanied with mild or moderate depression and (or) anxiety, and dyssomnia. Application of polysomnography can rule out those diseases (for example, obstructive sleep apnea syndrome, nightmare, etc) which may easily confuse with NPA, and avoid misdiagnosis.

Relations between aggressive behavior and family factors among preschool children in Shanghai

To describe the prevalence of aggressive behavior among preschool children and its related family factors. 1234 preschool children in ten kindergartens were rated on their aggressive behavior by their parents, using Child Behavior Checklist (CBCI), Parent Behavior Inventory (PBI) and a general questionnaire. The overall prevalence of aggressive behavior among preschool children was 12.9% (95%CI: 11.0 - 15.0) according to the CBCL assessment, with the rate being slight higher (13.7%, 93/680) in boys than in girls (11.9%, 66/554). Data from logistic regression analysis showed that parents' hostile/coercive parenting style (OR = 2.396, 95%CI: 1.636 - 3.510) and inconsistent parenting attitude between parents and grandparents (OR = 1.867, 95%CI: 1.287 - 2.710) would lead to more aggressive behaviors in preschool children. Compared with children without difficulty in falling asleep, those who often (OR = 3.415, 95%CI: 1.901 - 6.135) or sometimes (OR = 2.147, 95%CI: 1.256 - 3.671) had problem falling asleep at night had more aggressive behaviors. On the other hand, factors as: watching TV less than 1 hour each day (OR = 0.252, 95%CI: 0.136 - 0.467), father in older age (OR = 0.703, 95%CI: 0.503 - 0.983) and participating in regular outdoor activities (OR = 0.617, 95%CI: 0.399 - 0.955) were protective factors to the aggressive behaviors of the children. The prevalence of aggressive behavior in preschool children was high which called for more attention. Intervention programs targeting the family should consider the influencing factors as ways of parenting, consistent attitude on parenting in the family etc. to reduce the occurrence of aggressive behavior among preschool children.

Sleep in thyrotoxicosis

Objective:Pattern of sleep in hyperthyroid state / thyrotoxicosis has not been systematically studied. It is being characterized as poor without further elaboration. We analyzed the pattern of sleep in a large sample of individuals with thyrotoxicosis who came to our endocrine center in southern India.Materials and Methods:We identified individuals with the diagnosis of ‘thyrotoxicosis’ from our electronic medical record database, and evaluated clinical parameters and pattern of their sleep: difficulty in falling asleep (DFA), difficulty in maintaining sleep (DMS), excess daytime sleepiness). In the first phase, univariate analysis with logistic regression was performed. Multivariate logistic regression was performed in the next phase on variables with a P-value < 0.1: these were considered as potential categories/ variables.Results:In model response variable with DFA, multivariate logistic regression predicted that subjects with abnormal appetite (more 1.7 or less 2.2), change in bowel motion (loose 1.5 or constipation 2.8), in mood (easy loss of temper 3.4), change of voice -- hoarse 7.4 or moderately hoarse 3.1), tended to have higher chances of difficulty in falling asleep (DFA). Patients with tremor (yes = 5.4) had greater likelihood of difficulty in maintaining sleep (DMS).Conclusions:Individuals with hyperthyroidism/thyrotoxicosis principally had difficulty in falling asleep DFA, which was related to hyperkinetic features.