Nature Of Sleep Disturbance Research Articles

Retracted: Assessment and mitigation of sleep disturbances in Egyptian acute care settings

BackgroundSleep disturbances in acute care settings pose challenges to patient recovery and well-being. Acute care facilities provide a unique context to explore these issues due to their diverse patient populations. Understanding the prevalence and nature of sleep disturbances is crucial for developing effective interventions tailored to the acute care setting. AimAssess and mitigate of sleep disturbances in Egyptian Acute Care Settings among patients. MethodsA cross-sectional design was utilized, involving 158 adult patients aged 18 and above with various medical conditions. Sleep assessments utilized the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Berlin Questionnaire, and Insomnia Severity Index (ISI). Statistical analyses, including t-tests and ANOVA, were conducted using SPSS 26. ResultsThe study, encompassed 158 patients, revealed several key findings: heightened sleep latency (p = 0.042) and a substantial increase in the Global PSQI Score (p = 0.018), indicated compromised overall sleep quality. Daytime sleepiness escalated across activities (p < 0.01), hinted at potential sleep-related issues. Additionally, occurrences of snoring, witnessed apnoea's, and daytime sleepiness significantly rose (p < 0.05), suggested the possibility of sleep-disordered breathing. Results from the Insomnia Severity Index (ISI) underscored challenges across various sleep aspects (p < 0.01), highlighted the overall severity of insomnia symptoms (p = 0.001). These findings emphasized the necessity for targeted interventions to address these sleep disturbances ConclusionThe study underscored the significant impact of sleep disturbances on patients within Egyptian Acute Care Settings. With heightened sleep latency, compromised overall sleep quality, and increased daytime sleepiness observed among the patient cohort, there is a pressing need for tailored interventions to mitigate these issues. RecommendationsDevelop interventions tailored to address sleep disturbances, enhance healthcare provider awareness, and incorporate regular sleep assessments into patient care routines. Additionally, future research should evaluate the efficacy of these interventions within acute care environments.

Sleep disturbance, mental health, wellbeing and educational impact in UK university students: a mixed methods study

ABSTRACT Sleep disturbance has harmful psychological and physical effects and due to a range of biopsychosocial and environmental factors, university students are at an increased risk. Despite the importance of this topic, it is under-researched, especially in the UK. The objectives of this study were (1) to investigate the occurrence and nature of sleep disturbance in a sample of UK undergraduate university students, (2) to compare the incidence of sleep disturbance in first- and third-year students, (3) to explore associations between sleep disturbance, daytime sleepiness, mental health and wellbeing and (4) to obtain details on how participants felt their sleep habits affected both their health and wellbeing and their education and learning. A mixed methods approach was used to collect and analyse both quantitative and qualitative data using an online survey of widely used scales (quantitative) and free text open-ended questions (qualitative). Responses were obtained from 153 undergraduate students. Quantitative findings revealed relatively high levels of disturbed sleep, daytime sleepiness, depression, anxiety and reduced wellbeing in the sample studied. Significant associations were found between all these dimensions. Qualitative findings provided insight into how students felt sleep disruption affected their health and wellbeing and their education and learning, and the serious impact this had in many cases. Insights were also obtained on strategies they used to improve sleep quality. Effective treatments for sleep problems could have beneficial effects on associated mental health and wellbeing problems and educational attainment. Student mental health services and interventions should be aware of this possibility.

Effects of sleep disturbance on dyspnoea and impaired lung function following hospital admission due to COVID-19 in the UK: a prospective multicentre cohort study

Sleep disturbance is common following hospital admission both for COVID-19 and other causes. The clinical associations of this for recovery after hospital admission are poorly understood despite sleep disturbance contributing to morbidity in other scenarios. We aimed to investigate the prevalence and nature of sleep disturbance after discharge following hospital admission for COVID-19 and to assess whether this was associated with dyspnoea. CircCOVID was a prospective multicentre cohort substudy designed to investigate the effects of circadian disruption and sleep disturbance on recovery after COVID-19 in a cohort of participants aged 18 years or older, admitted to hospital for COVID-19 in the UK, and discharged between March, 2020, and October, 2021. Participants were recruited from the Post-hospitalisation COVID-19 study (PHOSP-COVID). Follow-up data were collected at two timepoints: an early time point 2-7 months after hospital discharge and a later time point 10-14 months after hospital discharge. Sleep quality was assessed subjectively using the Pittsburgh Sleep Quality Index questionnaire and a numerical rating scale. Sleep quality was also assessed with an accelerometer worn on the wrist (actigraphy) for 14 days. Participants were also clinically phenotyped, including assessment of symptoms (ie, anxiety [Generalised Anxiety Disorder 7-item scale questionnaire], muscle function [SARC-F questionnaire], dyspnoea [Dyspnoea-12 questionnaire] and measurement of lung function), at the early timepoint after discharge. Actigraphy results were also compared to a matched UK Biobank cohort (non-hospitalised individuals and recently hospitalised individuals). Multivariable linear regression was used to define associations of sleep disturbance with the primary outcome of breathlessness and the other clinical symptoms. PHOSP-COVID is registered on the ISRCTN Registry (ISRCTN10980107). 2320 of 2468 participants in the PHOSP-COVID study attended an early timepoint research visit a median of 5 months (IQR 4-6) following discharge from 83 hospitals in the UK. Data for sleep quality were assessed by subjective measures (the Pittsburgh Sleep Quality Index questionnaire and the numerical rating scale) for 638 participants at the early time point. Sleep quality was also assessed using device-based measures (actigraphy) a median of 7 months (IQR 5-8 months) after discharge from hospital for 729 participants. After discharge from hospital, the majority (396 [62%] of 638) of participants who had been admitted to hospital for COVID-19 reported poor sleep quality in response to the Pittsburgh Sleep Quality Index questionnaire. A comparable proportion (338 [53%] of 638) of participants felt their sleep quality had deteriorated following discharge after COVID-19 admission, as assessed by the numerical rating scale. Device-based measurements were compared to an age-matched, sex-matched, BMI-matched, and time from discharge-matched UK Biobank cohort who had recently been admitted to hospital. Compared to the recently hospitalised matched UK Biobank cohort, participants in our study slept on average 65 min (95% CI 59 to 71) longer, had a lower sleep regularity index (-19%; 95% CI -20 to -16), and a lower sleep efficiency (3·83 percentage points; 95% CI 3·40 to 4·26). Similar results were obtained when comparisons were made with the non-hospitalised UK Biobank cohort. Overall sleep quality (unadjusted effect estimate 3·94; 95% CI 2·78 to 5·10), deterioration in sleep quality following hospital admission (3·00; 1·82 to 4·28), and sleep regularity (4·38; 2·10 to 6·65) were associated with higher dyspnoea scores. Poor sleep quality, deterioration in sleep quality, and sleep regularity were also associated with impaired lung function, as assessed by forced vital capacity. Depending on the sleep metric, anxiety mediated 18-39% of the effect of sleep disturbance on dyspnoea, while muscle weakness mediated 27-41% of this effect. Sleep disturbance following hospital admission for COVID-19 is associated with dyspnoea, anxiety, and muscle weakness. Due to the association with multiple symptoms, targeting sleep disturbance might be beneficial in treating the post-COVID-19 condition. UK Research and Innovation, National Institute for Health Research, and Engineering and Physical Sciences Research Council.

Insomnia and treatment-resistant depression.

Depression and sleep disturbance are related closely with bidirectional relationship. The heterogenic diagnostic criteria of major depressive disorder composed by the myriad combination of symptoms including sleep disturbance. Insomnia is an identifiable risk factor for depression and the treatment of insomnia might be able to prevent subsequent major depressive episodes which draws psychiatrists' attention to the interface of psychiatry and sleep medicine field. It is important to identify occult sleep disturbance in patients with treatment-resistant depression to improve treatment outcome. New tools to objectively measure sleep at home environment represent a great march in clinical care and research modalities but need further validation before they can be applying widespread at sleep and depression intersection. Careful evaluation and measurement of the phenotype and nature of sleep disturbance will continue to advance understanding of the biological bases of psychiatric disorders and the connections with sleep.

Sleep quality and its correlation with clinical severity in carpal tunnel syndrome

Nocturnal pain and paresthesias are hallmark of carpal tunnel syndrome (CTS) and they commonly disturb sleep. However, there is limited literature on the nature of sleep disturbances in CTS, even though this is the commonest neuropathy. We aimed to systematically analyze sleep quality in CTS and correlate with the clinical severity.

Evaluating the prevalence and nature of sleep disturbances in prostate cancer patients receiving androgen deprivation therapy using a combination of actigraphy and sleep questionnaires.

e17046 Background: Sleep disturbances and cancer related fatigue are commonly associated. Prostate cancer patients may suffer from disturbed sleep as a result of their diagnosis and following treatment, especially with androgen deprivation therapy (ADT). Wrist actigraphy is a non-invasive objective method of sleep data collection. This feasibility study compares sleep data obtained by actigraphy with subjective data from sleep questionnaires in order to determine the nature and severity of sleep disturbances in patients with and without ADT use. Methods: A prospective cross-sectional pilot study was conducted on 74 patients with prostate cancer attending a regional oncology clinic. Two validated subjective sleep questionnaires namely the Pittsburgh Sleep Quality Index [PSQI] and the Epworth Sleepiness Scale [ESS] were used. Patients wore actigraphy watches for a minimum of five consecutive days. The parameters of interest included: actual sleep time, sleep efficiency, fragmentation index, daytime napping frequency and duration. The questionnaire and actigraphy data were compared between 20 patients receiving ADT and 41 who were treatment-naive. Results: The compliance rate for completed actigraphy was 85%. Complete data sets with actigraphy and questionnaires were available from 61 patients. Those already receiving ADT were on LHRH analogues for a median duration of 2.35 years. Poor sleep quality as self-identified by patients from the PSQI (cut-off &gt; 5) was 49% in the treatment-naive group which increased to 70% for those on ADT. For daytime sleepiness as assessed by ESS (cut-off &gt; 10) this was 16% and 20% respectively. Actigraphy showed that patients on ADT reported longer sleep duration (7.4 vs 6.5 hours, p = 0.02), higher levels of nocturnal wakings (51.1% vs 36.7%, p = 0.002), with greater daytime napping duration (80.7mins vs 53.0mins, p = 0.04), and frequency (8.6 vs 5.6, p = 0.02) compared to treatment-naive patients. Conclusions: Self-reported poor sleep quality is common in prostate cancer patients, which appears worse for those receiving ADT. In patients receiving ADT, data derived from actigraphy suggests that although they were sleeping for longer at night, the quality of sleep was poor which, in turn, may be responsible for an increase in the frequency and duration of daytime napping. Based on the current findings, we recommend the use of actigraphy to characterise patients’ sleep patterns and to assess if sleep treatment is needed. Actigraphic data may allow for direct comparisons of different hormonal agents on sleep whilst identifying those with specific sleep disorders amenable to therapeutic intervention.

Sleep disturbances in children with functional gastrointestinal disorders: demographic and clinical characteristics.

Research indicates a deleterious effect of sleep disturbances on pain and illness-related functioning across pediatric populations. Sleep problems in youth with functional gastrointestinal disorders (FGIDs) are understudied, despite studies in adult FGIDs indicating sleep disruptions increase pain and symptom severity. This study sought to better characterize sleep problems in school-age children with FGIDs and to assess relationships with demographic characteristics and gastrointestinal symptoms. Sixty-seven children with FGIDs (pediatric Rome IV criteria) and 59 parents completed questionnaires assessing sleep problems, and children completed a 2-week pain/stooling diary. Sleep problems in this sample were compared with published normative samples, and children above and below the clinical cutoff were compared on demographics and FGID symptoms. Of the sample, 61% were above the clinical cutoff for sleep disturbances, with significantly greater bedtime resistance, sleep onset delay, sleep duration, and daytime sleepiness than the comparison group. Children above the clinical cutoff reported greater mean abdominal pain severity and pain interference. Relative to White participants, Black/African-American participants were more likely to be above the clinical cutoff and indicated more frequent night wakening and symptoms of sleep-disordered breathing, but lower maximum and overall mean abdominal pain severity. Sleep problems in children with FGIDs are common and related to greater day-to-day abdominal pain severity and pain interference. Results suggest sleep-pain relationships may differ across racial/ethnic groups. Assessing sleep in children with FGIDs is important, and further research is needed to assess underlying mechanisms and evaluate sleep as a potential treatment target in this population.

Sleep patterns among bipolar disorder patients

Background Bipolar disorder (BD) is a lifelong, potentially treatable psychiatric disorder with substantial morbidity and mortality. Sleep is a very important factor for the quality of life, risk for relapse, affective functioning, cognitive functioning, impulsivity, and general health. It is important to note that a bidirectional relationship likely exists between sleep disturbance and mood disorders, as symptoms of mood disorders may disrupt sleep, and disrupted sleep can increase symptoms of mood disorders. Moreover, the sources of inflammation and immune activation, which play a role in depression, may contribute to the inflammatory burden in patients with mania. Aim The aim of this study was to study the nature of sleep disturbance in bipolar patients and to detect the correlation between the severity of BD and sleep disturbance. Patients and methods In this case–control study, fifty BD patients (28 male patients and 22 female patients) and 20 age-matched controls were recruited for this study. Structured Clinical Interview for DSM-IV Axis I Disorders for diagnosis of BD; Beck Depression Inventory-II and Young Mania Rating Scale (YMRS) were used to assess the severity of BD. Assessment of sleep pattern was carried out by Pittsburgh Sleep Quality Index (PSQI), and C-reactive protein (CRP) was measured. Results In the current study, with regard to Beck scores before medication, there were inverse relations with YMRS and PSQI. These relations become direct after medication. As regards YMRS scores before medication, there was an inverse relation with Beck, direct relations with PSQI, which did not show any change after medication, except for sleep disturbance, which become an inverse relation. As regards PSQI’s total scores before medication, it showed an inverse relation with Beck, direct relations with YMRS and the relation with Beck scores became direct after medication. As regards CRP levels, there was a significant difference between cases before and after medication and significant difference between the case and control groups. Conclusion PSQI is a cheap valid test that can be used in Egypt to report sleep profile and abnormalities, to follow-up the patients and prevent relapse. Hence, bipolar patients with depressive symptoms improved and responded better on treatment, with better improvement in sleep profile than patients with manic symptoms. Moreover, a definite correlation between sleep disturbance and CRP levels could not be concluded.

Sleep complications following traumatic brain injury

Recent research has provided extensive characterization as to the frequency and nature of sleep disturbances following traumatic brain injury (TBI). This review summarizes the current state of knowledge and proposes future directions for research. Complaints of sleep disturbance are common following TBI, and objective assessments of sleep largely corroborate these complaints. Sleep is often disturbed in the acute phase postinjury and can persist for decades, with the prevalence of sleep disorders higher in patients with TBI as compared with the general population. The factors causing sleep disturbance appear to involve numerous interrelated primary and secondary factors, including direct damage to vital sleep-regulating regions of the brain, alterations in the circadian system, lowered mood as well as increased anxiety and pain. The complex web of contributing factors implies that combination therapies targeting a number of putative causal mechanisms may yield the greatest success in terms of improving sleep postinjury. Sleep disturbance is a common consequence of TBI. Research is needed to ascertain the primary drivers of sleep disturbance postinjury to guide the development of targeted interventions. In the absence of a single mechanism, combination therapies may prove most fruitful.

Measurement, Classification and Evaluation of Sleep Disturbance in Psoriasis: A Systematic Review.

BackgroundPsoriasis is a long-term immune-mediated inflammatory disorder mainly, but not only, affecting skin, and is associated with significant medical and psychological morbidity. Evidence suggests that sleep is disrupted in psoriasis, however high quality empirical evidence is lacking. Given the importance of sleep for health, characterisation of sleep disruption in psoriasis is an important goal. We therefore conducted a systematic review of the sleep-psoriasis literature.MethodsSearches were conducted in Pubmed, SCOPUS and Web of Science from inception to May 2016. Studies were compared against inclusion/exclusion criteria and underwent a quality evaluation. Given the heterogeneity of studies, we conducted a narrative synthesis of the findings.ResultsSearches revealed 32 studies which met our predetermined inclusion/exclusion criteria. Whilst 93.7% of studies reported sleep disruption in this population, ranging from 0.05% to 85.4%, many had important methodological shortcomings. Over half of all quantitative studies (54.8%; 17/31) relied on non-validated measures, contributing to heterogeneity in study findings. In those that employed valid measures, assessing sleep was often not the primary objective. We frequently found the absence of adequate sample size calculations and poor statistical reporting.ConclusionThis review showed that in psoriasis, reported sleep rates of sleep disturbance varied substantially. Most studies lacked a hypothesis driven research question and/or failed to use validated measures of sleep. We were unable to draw firm conclusions about the precise prevalence and nature of sleep disturbance within the psoriasis population. We offer suggestions to help advance understanding of sleep disturbance in psoriasis.

Multifactorial Influences, Including Comorbidities, Contributing to Sleep Disturbance in Children with a Neurodevelopmental Disorder.

The term neurodevelopmental disorder (NDD) implies an impairment of the growth and development of the CNS caused by genetic, metabolic, toxic, or traumatic factors. Childhood neuropsychiatric disorder is a subset of NDD. Sleep disturbance is reported in many children with NDD although the details of this association, including extent and types of sleep disturbance, etiology, and assessment and treatment issues, need to be clarified by further research. This review considers the nature of sleep disturbance in NDD. Emphasis is placed on sleep disorders (i.e., the specific conditions that cause sleep problems) of which many are now recognized in the International Classification of Sleep Disorders (ICSD-3), and also intrinsic pathophysiological factors, physical and psychiatric comorbidities, and pharmacological and parental influences, which might contribute to the sleep disorders in children with NDD. The implications of this complexity for assessment and treatment in such children are then discussed. Appropriate treatment based on precise diagnosis of the causes of sleep disturbance is required to mitigate the harmful developmental effects of disordered sleep on children with NDD and their families.

Burden of Sleep and Fatigue in US Adults With Atopic Dermatitis.

Intense itch associated with atopic dermatitis (AD) can negatively impact sleep. However, the nature of sleep disturbance and fatigue in AD has not been fully elucidated. The aim of this study was to determine the burden of sleep disturbance and fatigue in US adults with AD. This study used a cross-sectional, questionnaire-based survey using a nationally representative sample of 5563 adults from the 2005 to 2006 National Health and Nutrition Examination Survey. Respondents were asked about history of AD, sleep disturbance, and fatigue-related instrumental activity of daily living (IADL) impairment. There was no significant association between having AD and having a diagnosed sleep disorder (10.44% vs 7.27%; odds ratio [OR] [95% confidence interval (CI)], 1.49 [0.84-2.64]; P = 0.23); however, respondents were more likely to report sleep disturbances to clinicians (33.38% vs 23.67%; OR [95% CI], 1.62 [1.10-2.38]; P = 0.04). In multivariate regression models controlling for sociodemographic and lifestyle factors, adults with AD had higher odds of sleep disturbances, including shorter sleep duration (adjusted OR [95% CI], 1.61 [1.16-2.25]), trouble falling asleep (adjusted OR [95% CI], 1.57 [1.10-2.24]), and early morning awakenings (adjusted OR [95% CI], 1.86 [1.24-22.78]). Those with AD also had significantly higher odds of feeling unrested and feeling too tired to perform IADLs. United States adults with AD have significantly impaired sleep and fatigue affecting IADLs, and sleep disturbances may be underdiagnosed in this population.

Prevalence and profile of sleep disturbances in Guillain-Barre Syndrome: a prospective questionnaire-based study during 10 days of hospitalization

Sleep disturbances in Guillain-Barre Syndrome (GBS), though common, have not received focused attention. To study frequency and nature of sleep disturbances in patients with GBS, using validated questionnaires, and analyze the contributing factors. This prospective study included 60 patients fulfilling National Institute of Neurological and Communicative Diseases and Stroke (NINCDS) criteria for GBS (mean age: 32.7 ± 12.9 years; median: 30 years; M:F = 46:14), evaluated from 2008 to 2010. Data regarding sleep were collected on 10 consecutive days following admission using Richard Campbell Sleep score, St Mary's Hospital Sleep Questionnaire, and Pittsburgh Sleep Quality Index (PSQI) and correlated with various possible contributing factors like pain, paresthesia, anxiety, depression, autonomic dysfunctions, severity of disease, and therapeutic interventions among others. Qualitative and quantitative sleep disturbances were rather frequent and involved over 50% patients: abnormal PSQI - 13.3%, abnormal score on Richard scale - 51.6%, abnormal sleep onset latency - 35%, sleep fragmentation - 40%, and reduced sleep duration - 46.6%. The symptoms were severe during the first week of hospitalization and reduced thereafter. Sleep disturbances as scored on Richard scale significantly correlated with anxiety, pain, paresthesia, and severity of immobility (P < 0.05) but not with depression and use of analgesics or antineuritic drugs. This study first of its kind suggests that sleep disturbance in GBS is frequent, multi-factorial, often disturbing, and varies during the course of illness. Routine enquiry into the sleep disturbances and timely intervention may reduce morbidity and improve their quality of life.

Understanding sleep disturbances in African‐American breast cancer survivors: a pilot study

The goals of this study were (i) to report the prevalence and nature of sleep disturbances, as determined by clinically significant insomnia symptoms, in a sample of African-American breast cancer survivors; (ii) to assess the extent to which intrusive thoughts about breast cancer and fear of recurrence contributes to insomnia symptoms; and (iii) to assess the extent to which insomnia symptoms contribute to fatigue. African-American breast cancer survivors completed surveys pertaining to demographics, medical history, insomnia symptoms, and intrusive thoughts about breast cancer, fear of cancer recurrence, and fatigue. Hierarchical regression models were performed to investigate the degree to which intrusive thoughts and concerns of cancer recurrence accounted for the severity of insomnia symptoms and insomnia symptom severity's association with fatigue. Forty-three percent of the sample was classified as having clinically significant sleep disturbances. The most commonly identified sleep complaints among participants were sleep maintenance, dissatisfaction with sleep, difficulty falling asleep, and early morning awakenings. Intrusive thoughts about breast cancer were a significant predictor of insomnia symptoms accounting for 12% of the variance in insomnia symptom severity. After adjusting for covariates, it was found that insomnia symptom severity was independently associated with fatigue accounting for 8% of variance. A moderate proportion of African-American breast cancer survivors reported significant problems with sleep. Sleep disturbance was influenced by intrusive thoughts about breast cancer, and fatigue was associated with the severity of participants' insomnia symptoms. This study provides new information about sleep-related issues in African-American breast cancer survivors.

Sleep Profile in Patients With Chronic Opioid Abuse

Background Sleep disturbances occur in various stages of substance abuse, which might have a significant impact on the treatment success. Despite this fact, the number of researches studying sleep in substance abuse patients is relatively scarce. Objectives To study the profile of sleep in opioid abusers, after the period of detoxification, highlighting whether there is a remote effect of opioid abuse on sleep or not, exploring the nature of such sleep disturbances, if present. Methodology The case group comprised 33 opioid-dependent male patients who were admitted to the substance abuse treatment unit at the Institute of Psychiatry, Ain Shams University from June 1, 2006 to May 31, 2008, and who fulfilled the inclusion criteria and agreed to participate in the study. They were assessed 3 weeks after admission and after resolution of most of the withdrawal symptoms using Addiction Severity Index, Beck Depression Inventory, Comprehensive Sleep Disorder Questionnaire, and all-night polysomnography. Ten healthy matched volunteers were taken as controls to be assessed using Sleep Questionnaire and all-night polysomnography. Results Significant differences in sleep complaints included reports of insomnia, hypersomnolence, increased sleep latency, and reduced sleep time in the group of patients. Regarding polysomnography, patients differed significantly from controls, in having prolonged sleep latency, decreased sleep efficiency, increased arousal index, increased stages I and II, and decreased slow wave sleep (SWS). Patients with moderate and severe depressive states had significantly lower SWS than those with mild depressive state. Conclusions Patients with opioid dependence suffer from sleep disturbances that continue for a period of time, even after discontinuation of the abuse drug. The nature of sleep disturbance is related more to NREM sleep, especially SWS and sleep continuity, as well as efficiency parameters. No significant correlation was found between sleep profile and various abuse variables such as duration of abuse and type of opioids.

Characterization of sleep disturbance in Cornelia de Lange Syndrome

Objective Prior studies have suggested that sleep disturbance is common in Cornelia de Lange Syndrome (CdLS); however, the nature of this sleep disturbance has not been well characterized. In this study, we evaluate the prevalence of sleep disordered breathing (SDB) and sleepiness in children and young adults with CdLS. Methods Caregivers of 22 patients with CdLS completed 3 validated Pediatric Sleep Questionnaires: the Pediatric Sleep Questionnaire (PSQ), Pediatric Daytime Sleepiness Scale (PDSS), and OSA18. Results Both measures of SDB (OSA18 and PSQ) suggest that 35–36% of these patients may have moderate to severe SDB. This is much higher than the general population estimates of 1–4% for SDB with a relative risk of 5.2 (95% CI: 2.8–9.9). Correlation between the OSA18 and PSQ was significant ( R = 0.67; 95% CI: 0.33–0.85, p = 0.0007). Confirming these results among patients with a high probability of SDB (based upon OSA18 scores ≥60), there was a non-significant trend toward increased sleepiness with a relative risk of 2.0 (95% CI: 0.73–5.7, p = 0.31) on the PDSS and 2.9 (95% CI: 0.93–9.1, p = 0.08) on the PSQ sleepiness scale. In those patients with low probability of SDB (OSA18 < 60), sleepiness was still seen in 13–29% of patients. Overall 23–35% of participants were characterized as sleepy. Conclusions Sleep disordered breathing and sleepiness appear to be common in CdLS although small sample sizes limit further conclusions. Additional studies with larger sample size and confirmation with polysomnography are needed to further explore the nature and extent of sleep disturbance in this population.

A Human Model That Suggests a Role for Sleep in the Cognitive Neuropsychology of PTSD and Recovery

A Human Model That Suggests a Role for Sleep in the Cognitive Neuropsychology of PTSD and Recovery

NAPSAQ-1: National Patient Sleep Assessment Questionnaire in depression

Objectives. Sleep disturbance is a common feature of depression. Symptoms often persist after treatment of the depressive episode, representing a risk factor for relapse. There is a lack of data regarding the nature of sleep disturbance in depression in the UK. Methods. We surveyed patients’ views about their depressive symptoms and associated sleep difficulties. We received 513 responses via postal questionnaire. Results. A total of 97% reported sleep difficulties during depression: symptoms of insomnia were more frequently reported than hypersomnia. Ninety-nine percent of those with sleep problems also reported daytime symptoms including lack of concentration, exhaustion and lethargy, no energy and feeling sleepy; 40% admitted napping during the day; 59% indicated that poor sleep greatly affected their quality of life (QOL); 34% considered it to be “very distressing”; 69% of respondents were taking antidepressant medication at the time (44% said it improved their sleep, 56% said it had no effect or worsened their sleep); 69% had sought extra treatment for their sleep problems. Conclusions. Sleep disturbance in depression is a common and distressing problem that seems relatively unresolved by treatment. There is a need for more successful management in order to improve QOL in these patients and reduce a factor in depressive relapse.

Sleep Disturbances in Burn Patients Following Hospital Discharge - Preliminary Findings from a Follow-up Survey

Frequent reports of sleep disturbances by burn patients have led to an increased awareness of the problem resulting in a much closer look at the underlying causes and how they may be prevented or treated. The purpose of this study is to investigate the prevalence of sleep disturbance over time among burn patients. A brief post-burn survey was mailed to consenting patients following discharge from a regional burn center. The self-report survey consisted of 10 questions and sought information regarding the nature of sleep disturbances and the reasons attributed for this problem. Data was obtained at 2 months post-discharge (n = 52), 6 months (n = 42) and >12 months post-injury (n = 59). The sample was predominantly male (72%). The mean age of patients across the three groups was 37 years and the mean total body surface area burned was 22%. Results showed that 65.5 % of burn...

Sleep disturbances in palliative cancer patients attending a pain and symptom control clinic

The nature of sleep disturbances in palliative cancer patients has not been delineated clearly or fully understood due to limited clinical information. The purpose of this study was to describe sleep disturbance patterns, treatments, and communication in an advanced cancer outpatient population attending a pain and symptom control clinic. One hundred oncology outpatients who came for consultation at a multidisciplinary pain and symptom control clinic were asked and agreed to complete a self-report questionnaire that elicited information about their sleeping habits, sleep concerns, sleep enhancement strategies, and related communication with health care providers. The majority of participants (72%) reported a wide variety of sleep disturbances, after cancer diagnosis, with the three most frequent elevated symptoms (> or = 5) being not feeling rested in the morning (72%), difficulty staying asleep (63%), and difficulty falling asleep (40%). Approximately one-fifth of participants (19%) reported having insomnia problems prior to their cancer diagnosis. In a correlational comparison with four other symptoms (i.e., fatigue, pain, anxiety, depression), the three highest correlations were between difficulty falling asleep and fatigue (r = 0.612), early awakening and fatigue (r = 0.596), and difficulty falling asleep and anxiety (r = 0.572). Fifty-three percent of participants reported using a variety of interventions for their sleep problems, the most frequent being sleep medication (37%). Of the 52 participants who reported an elevated level of concern about their sleeping difficulties (> or = 5), 48 (92%) discussed their concerns with a health care provider. However, of the 20 participants with elevated symptoms (> or = 5) and low levels of concern (<5), only 7 (35%) communicated their concerns to a health care provider. The results of this study underline the importance of routine clinical assessments to detect sleep problems and interventions designed specifically to improve the overall sleep quality of cancer patients.