Sleep Initiation Disorders Research Articles

Characteristics of the sleep quality, stress and anxiety during the COVID-19 pandemic in nurses of therapeutic departments and nurses working in departments provided help to patients with coronavirus disease COVID-19

Summary. The coronavirus disease (COVID-19) pandemic has become a serious experience not only for Ukrainian society, but for the whole humanity, negatively affecting the healthcare systems of many countries and increasing the risk of psychological disorders among medical staff. The aim of the study – to examine the frequency and severity of sleep disorders, stress and anxiety during the COVID-19 pandemic in nurses working in therapeutic units and in units where patients with COVID-19 coronavirus disease are treated. Materials and Methods. A total of 56 therapeutic nur­ses took part in the study, of whom 30 worked in therapeutic departments and 26 in specialized departments where care for patients with coronavirus COVID-19 is provided. We used a subjective sleep assessment questionnaire to clinically assess the severity of insomnia. To assess stress and anxiety during the COVID-19 pandemic, nurses used the SAVE-9 questionnaire for medical staff. Statistical data processing was performed using standard “Statistica” information processing software. Results. Sleep disturbances among the nurses of therapeutic profile who work in the departments where care is provided to patients with COVID-19 were found in 42.3 % (n=11) of respondents. According to the structure of sleep disorders were distributed as follows: presomnia (sleep initiation disorders) were observed in 50.0 % (n=13); intrasomnic (sleep support disorders) – in 30.8 % (n=4); postsomnic (awakening disorders) – in 19.2 % (n=4); daytime sleepiness – in 30.8 % (n=8) of respondents. An analysis of the SAVE-9 mean score in therapeutic nurses working in COVID-19 care units found that the mean stress and anxiety level in the study group was (14.5±0.62) points. This result is statistically significantly higher (by 42.2 %) than in the group of nurses of therapeutic departments (p 0.05). Conclusions. Significantly higher levels of sleep, stress, and anxiety disorders were found in therapeutic nurses working in COVID-19 care units than in therapeutic nurses, which indicate the need to develop and implement a number of preventive measures for nurses involved in providing care to patients with acute coronavirus disease to ensure their quality and effective professional activities

The problem of insomnia in infant/young children: issues of diagnosis and treatment

OBJECTIVE To obtain further evidence of the efficacy of dormikind in infant/young children. MATERIAL AND METHODS The study was performed in the group of 114 patients, aged 6 months to 2.5 years, with sleep and sleep initiation disorders. Sixty-four patients received treatment with dormikind (group 1) and 50 patients received behavioral therapy (group 2) for 28 days. RESULTS AND CONCLUSION In group 1, sleep initiation decreased by 1.7 times and reached 26.2±4.8 minutes, the number of children sleeping on hands dropped by 8.7 times and sleeping in the parent's bed by 2 times. In group 2, the same characteristics changed by 1.1, 1.3 and 1.5 times, respectively, and sleep initiation reached 33.4±2.9 minutes. The number of patients of group 1 falling asleep in their own beds increased by 3.2 times vs 1.2 times in group 2. Duration of night sleep increased and frequency of awakening reduced as well. The significant positive dynamics was noted in the emotional-behavior state of children after therapy: the total score significantly improved by 2.9 times to the end of treatment compared to group 2 (by 1.3 times). IMOS score showed significant difference between the groups on «total recovery» and «significant improvement». Therefore, the high efficacy and safety of dormikind in children have been confirmed.

Cognitive behavioural therapy for primary insomnia: a systematic review

This paper reports a systematic review of seven studies evaluating the efficacy of cognitive behavioural therapy (CBT) for persistent primary insomnia. Insomnia is one of the most common health complaints reported in the primary care setting. Although non-pharmacological treatments such as the CBT have been suggested to be useful in combating the persistent insomnia, the efficacy and clinical utility of CBT for primary insomnia have yet to be determined. A systematic search of Ovid, MEDLINE, psychINFO, PsycARTICLES, CINAHL, and EMBASE databases of papers published between 1993 and 2004 was conducted, using the following medical subject headings or key words: insomnia, primary insomnia, psychophysiological insomnia, sleep maintenance disorders, sleep initiation disorders, non-pharmacological treatment, and cognitive behavioural therapy. A total of seven papers was included in the review. Stimulus control, sleep restriction, sleep hygiene education and cognitive restructuring were the main treatment components. Interventions were provided by psychiatrists except for one study, in which the CBT was delivered by nurses. Among beneficial outcomes, improvement of sleep efficacy, sleep onset latency and wake after sleep onset were the most frequently reported. In addition, participants significantly reduced sleep medication use. Some studies gave follow-up data which indicated that the CBT produced durable clinical changes in total sleep time and night-time wakefulness. These randomized controlled trial studies demonstrated that CBT was superior to any single-component treatment such as stimulus control, relaxation training, educational programmes, or other control conditions. However, heterogeneity in patient assessment, CBT protocols, and outcome indicators made determination of the relative efficacy and clinical utility of the therapy difficult. Therefore, the standard components of CBT need to be clearly defined. In addition, a comprehensive assessment of patients is essential for future studies.

Epidemiologia da insônia

A vast literature review on the insomnia epidemiology, the most common sleep disorder, using MEDLINE and LILACS last 30 years of data, was performed from January 2002 to November 2003. The key-words were: sleep initiation disorders, sleep maintenance disorders, early awakening disorder, insomnia, sleep disorders, insomnia prevalence, insomnia consequences. Several insomnia definition criteria and epidemiology researches methods, with data comparison difficulties, were noticed. In the future it will be necessary similar insomnia definition and epidemiology studies criteria.