St Mary's Hospital Sleep Research Articles

Effect of Guided Imagery Along With Breathing Relaxation on Sleep Quality of the Elderly Patients Under Abdominal Surgery: A Randomized Clinical Trial.

Elderly patients undergoing surgery often suffer from sleep disorder. Holistic therapies might help them sleep better. The aim of this research was to determine the effect of guided imagery along with breathing relaxation on sleep quality in elderly patients undergoing abdominal surgery. A double-blind randomized clinical trial was conducted on 90 elderly patients undergoing abdominal surgery in 2 educational hospitals in 2018, Mashhad, Iran. The elderly patients with different abdominal surgical procedures were distributed to the wardrooms and then the rooms were randomly assigned into 2 groups. In the intervention group, the patients learned breathing relaxation the day before surgery and then an audiotape was provided to perform the guided imagery from the day before surgery for 5 days (twice) along with breathing relaxation. St Mary's Hospital Sleep Inventory was completed the night before, 48 hours and 96 hours after the surgery. Data analysis was done using SPSS 21 through analytical tests. Results of the test indicated that the score of sleep quality was significantly higher in the intervention group the night before surgery (P = .001). The total scores of sleep quality in the intervention group 48 and 96 hours after the surgery were significantly higher (P < .001). Based on results of generalized estimating equation model, the score of sleep quality for patients was 8.76 units higher in the intervention group than in the control group by controlling for the effects of time. Guided imagery along with breathing relaxation improved the sleep quality of the elderly patients undergoing abdominal surgery.Trial registration: IRCT20180731040652N1.

Pediatric psycho-oncology in Russia: Caregiver mental health and sleep outcomes on the oncology wards.

Caregivers are at risk of poor sleep and elevated distress during their child's cancer treatment. Russia is currently underrepresented in the international psycho-oncology field, with no identified psychosocial standards of care, and limited or inconsistent psychological service provision, particularly for caregivers. This study aimed to determine the prevalence of Russian caregivers' psychological distress and identify factors associated with caregiver sleep duration when staying on the pediatric oncology ward. We recruited 74 caregivers of children with cancer and 74 comparison caregivers in Rostov-on-Don, Russia. Participants completed a survey assessing clinical outcomes, sleep (St Mary's Hospital Sleep Questionnaire), and psychological distress (Depression Anxiety Stress Scales-21 [DASS-21]). Caregivers of children with cancer reported significantly higher scores for all DASS-21 subscales and higher depression (48.6% vs. 24.6%), anxiety (47.3% vs. 12.3%), and stress (45.9% vs. 0%) scores from "moderate" to "extremely severe." Caregivers of children with cancer reported significantly shorter sleep duration (5.82 vs. 7.49 h, t[143] = -6.22, p = 0.002), more night-time awakenings (3.20 vs. 1.25, t[135] = 6.94, p < 0.001) and worse sleep quality (46.5% vs. 9.6%; x2 [1] = 24.4, p < 0.001) than comparison caregivers. Caregivers with a higher total DASS-21 score (B = -1.32, p = 0.032) and those who were closer to diagnosis (B = -1.53, p = 0.012) reported shorter sleep duration. Russian caregivers of children with cancer experience high rates of psychological distress and poor sleep on the oncology ward. These findings provide an important target for future research and culturally relevant clinical interventions to improve caregivers' mental health and capacity for care.

The Effects of Deep-Breathing Exercises on Postoperative Sleep Duration and Quality in Patients Undergoing Coronary Artery Bypass Graft (CABG): a Randomized Clinical Trial.

Introduction: Disordered sleep occurs frequently in patients who have undergone coronary bypass graft surgery, and it contributes to increased morbidity, mortality, and resource utilization. The present study aimed to determine the effects of deep-breathing exercises on postoperative sleep duration and quality in patients undergoing coronary artery bypass graft.Methods: This study was a clinical trial. The study sample included 64 patients who were coronary artery bypass graft hospitalized from January 2015 to April 2015 in Qazvin Booali-Sina hospital. The patients were selected by convenient sampling and then the participants were randomly allocated to the intervention and control groups. The baseline and postoperative (day 7) sleep duration and quality metrics were measured. The St Mary's Hospital Sleep Questionnaire was used to evaluate sleep quality in two groups.Results: Baseline night sleep duration was 5.72 (1.63) hours in the control group and 5.58 (1.07) hours in the intervention group. The initial findings showed that the mean of sleep quality score of patients in the intervention and control groups were 19.72 (2.68) and 18.22 (3.81) respectively. These measurements did not decline postoperatively in the intervention group while night sleep duration and quality declined in the control group. Deep breathing exercise program had a significant effect on sleep quality score in the intervention group compared to the control group.Conclusion: The results indicated that deep breathing exercises prevent decline in sleep quality postoperatively. It seems to be a safe method with no side effects for these patients. Furthermore, it is a simple method to implement and does not impose a high cost.

The Effect of Warm Footbath on the Quality of Sleep on Patients with Acute Coronary Syndrome in Cardiac Care Unit.

Introduction: This study aimed to determine the effect of warm footbath before bedtime on the quality of sleep on patients with acute Coronary Syndrome in Cardiac Care Unit.Methods: This study was conducted on 120 patients admitted to CCU at Mazandaran Heart Center and randomly divided into two groups of intervention and control. In the intervention group, warm footbath was performed after the second night in hospital before bed time by 41 C water for 20 minutes for three consecutive nights; in contrast, the control group did not receive anything of this sort. The next day, St Mary's Hospital Sleep Questionnaire was completed to evaluate sleep quality. Then, the obtained data were analyzed using SPSS software and Friedman, Wilcoxon exact statistical tests.Results: The quality of sleep in the first night of hospitalization was different from the third night after the intervention in both groups and the improvement process of sleep quality was observed in both groups. Most patients had moderate impairments (23-36), which had not changed during the intervention. In intervention groups, 8 patients had severe sleep disorders (greater than 37), which declined to 1 after three nights of intervention. While, in the control group this number fell from 10 patients with severe sleep disorders to 5. Warm footbath had a great positive impact on patients suffering from severe sleep disorders (P<0.05).Conclusion: Although warm footbath did not improve the quality of sleep in all patients, it reduced the number of patients who had severe sleep disturbances.

Comparison between St Mary's Hospital Sleep and Richards-Campbell Sleep Questionnaires on Sleep Quality in Patients with Acute Coronary Syndrome

زمینه و هدف: محققان از پرسشنامه‌های مختلفی برای بررسی خواب بیماران بستری در بخش‌های مراقبت ویژه استفاده می‌کنند. این مطالعه با هدف مقایسه دو پرسشنامه خواب ریچارد کمپل و خواب بیمارستان سنت ماری جهت برر

Richards-Campbell sleep questionnaire: psychometric properties of Chinese critically ill patients.

Sleep abnormalities occur frequently in critically ill patients. Nurses are strategically placed, specifically in intensive care units, to promote sleep in such patients. Currently, an effective sleep assessment tool in Chinese is not available for intensive care settings. This study aimed to assess the reliability and validity of the Chinese version of the Richards-Campbell Sleep Questionnaire (RCSQ-C). It also aimed to evaluate patient-nurse reliability and agreement of the RCSQ-C in the intensive care unit (ICU). We translated the original RCSQ into Chinese and then back-translated it into English to ensure its accuracy of translation. Internal consistency, discrimination validity and construct validity of the RCSQ-C were examined in 150 critically ill patients. The convergent validity of the RCSQ-C was evaluated in 44 of 150 critically ill patients, and data from the RCSQ-C were compared with those of the Chinese version of St Mary's Hospital Sleep Questionnaire (SMHSQ). Comparisons were also made between RCSQ-C scores obtained from patients and their nurses. Cronbach's α of the RCSQ-C was 0.923; thus, it showed high reliability. The corrected item-total correlation coefficient was in the range of 0·680∼0·805, which showed that the items were homogeneous for evaluating sleep. The content validity was 0·84. One factor was extracted with a cumulative contribution rate of 76·597%. Confirmatory factor analysis showed that the original single-factor structure proposed by Richards adequately fit the data. The RCSQ-C could discriminate poor and good sleepers, which supported discriminant validity. There was a close correlation between the scores obtained from the RCSQ patient's version and those from the SMHSQ. The intraclass correlation coefficients of the patient and nurse ranged from 0·315 to 0·609. The psychometric properties of the RCSQ-C suggest its utility in critically ill patients. Patient-nurse reliability on the RCSQ-C was "fair" to "substantial", with nurses tending to overestimate patients' perceived sleep quality. If the validity of this questionnaire is supported in other ICU samples, RCSQ-C could be used as a routine evaluation instrument to distinguish good and poor sleepers and then direct nurses to form corresponding treatment plans to promote sleep.

Using Actigraphy to Measure Sleep Patterns in Rheumatoid Arthritis: A Pilot Study in Patients Taking Night‐Time Prednisone

ObjectivePoor sleep quality is a commonly reported but under-investigated consequence of rheumatoid arthritis (RA). Actigraphy is a non-invasive way of measuring sleep, estimated from the frequency and intensity of physical movement at the wrist. We used actigraphy to measure sleep parameters compared with sleep questionnaire data, and assessed the practicality of actigraph use in patients with RA.MethodsIn a pilot study of actigraphy conducted within an investigation of night-time prednisone treatment and circadian interleukin-6 concentrations in ten patients with active RA, we compared actigraphy with the St Mary’s Hospital Sleep Questionnaire and assessed whether night-time administration of prednisone resulted in increased sleep disturbance.ResultsThe actigraph watch was well tolerated by our patients, producing adequate data for analysis for 128 out of 133 test days (96.2%). The results indicated reasonable concordance between actigraph and sleep questionnaire data in the present sample. Patient satisfaction with sleep (question 11) strongly correlated with sleep efficiency measured by the actigraph (r = 0.71, p = 0.22) and showed a trend for inverse correlation with the fragmentation index (r = −0.60, p = 0.067). Quality of sleep (question 9) correlated non-significantly with the fragmentation index (r = −0.59, p = 0.072). We were unable to identify any significant correlations between clinical measures of disease and sleep parameters in this sample. There were no apparent detrimental consequences of the night-time dose of prednisone on the measures of sleep quality and quantity.ConclusionIn spite of the physical disability imposed by RA, the actigraph was well tolerated and gave a useful measure of sleep in patients with active disease. It has the potential for use in larger controlled trials.

A double-blinded randomized evaluation of alfentanil and morphine vs fentanyl: analgesia and sleep trial (DREAMFAST)

Patients using fentanyl patient-controlled analgesia (PCA), the standard first-line choice in our hospitals, commonly complain of postoperative sleep disruption due to pain. The aim of this study was to determine whether the PCA combination of alfentanil and morphine, which provides longer analgesia without compromising onset speed, would improve postoperative pain-related sleep interference. Two hundred and twelve adults undergoing major surgery where PCA was the planned principal postoperative analgesic modality were randomized to either the combination of alfentanil and morphine (Group AM) or fentanyl (Group F). The primary outcome was pain-related awakenings during the second postoperative night as measured by the study questionnaire, based on the St Mary's Hospital Sleep Questionnaire. Analgesic efficacy, other sleep measures, and opioid-related side-effects were also assessed. There was no difference in pain-related sleep disturbance between the groups, with 41% of Group AM and 53% of Group F waking due to pain (P=0.10). Group AM had better rest and dynamic analgesia in the first 24 h with fewer requiring rescue ketamine infusion during the 2 day study period (2 vs 14%, P=0.001). Those in Group AM experienced less nausea and vomiting in the second 24 h (18 vs 35%, P=0.028) but more pruritus (40 vs 23%, P=0.013). Despite better early postoperative analgesia, pain-related sleep interference was not improved by the PCA combination of alfentanil and morphine. AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY: Ref: ACTRN12608000118303.

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.

Effect of crocetin from Gardenia Jasminoides Ellis on sleep: A pilot study

Crocetin is a pharmacologically active carotenoid compound of Gardenia jasminoides Ellis used as a traditional herbal medicine and natural colorant. The present pilot study investigated the effect of crocetin on sleep. The clinical trial comprised a double-blind, placebo-controlled, crossover trial of 21 healthy adult men with a mild sleep complaint. It included two intervention periods of 2 weeks each, separated by a 2-week washout period. We measured objective sleep quality using an actigraph, and assessed the subjective symptoms using St Mary's Hospital Sleep Questionnaire. Actigraph data showed that after administration of crocetin, the number of wakening episodes was reduced compared to that of the placebo (p=0.025). Subjective data from St Mary's Hospital Sleep Questionnaire showed that crocetin tended to improve the quality of sleep compared to sleep before its intake. Additionally, no side effects from crocetin intake were observed. The results suggest that crocetin may contribute to improving the quality of sleep.

The nature, time course and severity of methamphetamine withdrawal

To characterize the natural history of methamphetamine withdrawal during the first 3 weeks of abstinence. Cross-sectional study with comparison group. Setting A substance use treatment facility in Chiang Mai Province, Thailand. The sample comprised 21 in-patients undergoing treatment for methamphetamine dependence. Nine age- and sex-matched non-dependent individuals provided comparison data. Instruments including: the Amphetamine Withdrawal Questionnaire, a modified version of the Cocaine Selective Severity Assessment, Clinical Global Impression scale and the St Mary's Hospital Sleep Questionnaire were completed daily for the first 3 weeks of abstinence. Methamphetamine withdrawal severity declined from a high initial peak within 24 hours of the last use of amphetamines reducing to near control levels by the end of the first week of abstinence (the acute phase). The acute phase of amphetamine withdrawal was characterized by increased sleeping and eating, a cluster of depression-related symptoms and less severely, anxiety and craving-related symptoms. Following the acute withdrawal phase most withdrawal symptoms remained stable and at low levels for the remaining 2 weeks of abstinence. This study has provided evidence of a methamphetamine withdrawal syndrome that can be categorized into two phases, the acute phase lasting 7-10 days during which overall symptom severity declined in a linear pattern from a high initial peak, and a subacute phase lasting at least a further 2 weeks.