Persistent Sleep Disturbance Research Articles

4462992 Nitroimidazole radiosensitizers for hypoxic tumor cells and compositions thereof : Krishna C Agrawal, Masakazu Sakaguchi assigned to Research Corporation

This study aimed to synthesize the available knowledge of symptom trajectories in patients with breast cancer and identify predictors associated with these trajectories.Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in four databases (PubMed, Embase, Web of Science, and CINAHL). The retrieved articles’ publication time was limited to 2010 to 2020, and only peer-reviewed English articles were included.Twenty-seven articles were included. The findings of the relevant studies were analyzed using thematic analysis. They were grouped into two themes: symptom trajectories of patients with breast cancer (symptom trajectories in patients with breast cancer, in patients who underwent surgery, and in patients who received cancer-related treatment) and associated factors (socioeconomic factors, health characteristics, cancer-related treatment characteristics). Newly diagnosed patients tended to report high trajectories of depression and persistent sleep disturbance. Most patients who underwent surgery reported significant sleep disturbance and anxiety shortly after surgery. For patients who received cancer-related treatment, only a small proportion had a high level of physical activity after cancer-related therapy over time. A high body mass index, a low relationship quality, parental responsibilities, insufficient social support, a low educational background, and an unhealthy lifestyle may increase the risk of negative symptom trajectories in patients with breast cancer. Additionally, old patients were more likely to report cognitive impairment after chemotherapy, while young patients tended to report trajectories of persistent sexual dysfunction. Concurring symptoms and poor health status also contributed to adverse symptom trajectories.The findings of this review add to the body of knowledge of the interindividual variability of symptom trajectories in patients with breast cancer. Despite the overall similarity in appraisal at baseline, the patients reported varied symptom trajectories over time. It is recommended that nurses consider sociodemographic, clinical and cancer-related treatment characteristics and perform targeted early preventive interventions for patients with breast cancer.

Human sleep during chronic morphine intoxication

The sleep of 6 opiate addicts was studied for 11 nights during 3 phases of a chronic morphine cycle. The control phase consisted of 5 consecutive nights before morphine administration. The induction phase consisted of 1 night at 21-36 days after the onset of morphine administration, when the daily dose was 140-220 mg. The stable dose phase consisted of 5 consecutive nights after the subjects had received 240 mg of morphine daily for 8-19 weeks. No sleep could be studied during the withdrawal phase. Sleep was continuously monitored with EEG, EMG and EOG. Chronic morphine produces signs of a small but persistent sleep disturbance: delta sleep (early night) becomes less stable and shifts toward later in the night, waking state increases during the middle of the night, RME sleep (expecially its activated EEG without eye movements) decreases, the RMES cycle increases, and burst of delta activity (with mean duration of 5-6 sec) increase. Although this disturbance persists throughout the night, it is much less than that seen after single doses of morphine in a previous study. With chronic morphine, therefore, partial tolerance develops to the sleep disturbance produced by morphine. The small but persistent nocturnal arousal during chronic morphine contrasts with the sedation seen during chronic methadone. Both opioids produce an increase in delta bursts during chronic administration, which might be an EEG phenomenon specific to chronic opioid intake.