Subjective Sleep Questionnaires Research Articles

Study protocol of the Hungarian Longitudinal Study of Healthy Brain Aging (HuBA).

<p>Neuro&shy;cog&shy;nitive aging and the associated brain diseases impose a major social and economic burden. Therefore, substantial efforts have been put into revealing the lifestyle, the neurobiological and the genetic underpinnings of healthy neurocognitive aging. However, these studies take place almost exclusively in a limited number of highly-developed countries. Thus, it is an important open question to what extent their findings may generalize to neurocognitive aging in other, not yet investigated regions. The purpose of the Hungarian Longitudinal Study of Healthy Brain Aging (HuBA) is to collect multi-modal longitudinal data on healthy neurocognitive aging to address the data gap in this field in Central and Eastern Europe.</p>. <p>We adapted the Australian Ima&shy;ging, Biomarkers and Lifestyle (AIBL) study of aging study protocol to local circumstances and collected demographic, lifestyle, men&shy;tal&nbsp;and physical health, medication and medical history related information as well as re&shy;cor&shy;ded a series of magnetic resonance imaging (MRI) data. In addition, participants were al&shy;so offered to participate in the collection of blood samples to assess circulating in&shy;flam&shy;matory biomarkers as well as a sleep study aimed at evaluating the general sleep quality based on multi-day collection of subjective sleep questionnaires and whole-night elec&shy;troencephalographic (EEG) data.</p>. <p>Baseline data collection has al&shy;ready been accomplished for more than a hundred participants and data collection in the se&shy;cond<br>session is on the way. The collected data might reveal specific local trends or could also indicate the generalizability of previous findings. Moreover, as the HuBA protocol al&shy;so offers a sleep study designed for tho&shy;rough characterization of participants&rsquo; sleep quality and related factors, our extended multi-modal dataset might provide a base for incorporating these measures into healthy and clinical aging research.&nbsp;</p>. <p>Besides its straightforward na&shy;tional benefits in terms of health ex&shy;pen&shy;di&shy;ture, we hope that this Hungarian initiative could provide results valid for the whole Cent&shy;ral and Eastern European region and could also promote aging and Alzheimer&rsquo;s disease research in these countries.</p>.

Beyond Polysomnography: Clinical Assessment of Pediatric Sleep Health and Sleep Problems.

This chapter reviews the Peds B-SATED model of pediatric sleep health and common pediatric sleep problems. Aspects of pediatric sleep health and sleep problems are considered across development, from infants through adolescents. Finally, information about clinical screening in both primary and specialty care is discussed, and subjective sleep questionnaires are reviewed.

Objective Sleep Quality Measurement based on Fuzzy Logic and Wearable Device

Sleep is the natural state of relaxation for human being. Sleep quality is an essential yet frequently neglected aspect of sleep in general. Sleep quality is essential because it allows the body to restore itself and prepare for the next day. The standard method for evaluating sleep quality was subjective evaluation. Actigraphy devices, which can measure the sleep cycle, are now widely available. This study developed a method using Fuzzy Logic and an actigraphy device to measure and classify sleep quality. The fuzzy logic method was developed in several stages, which are determining the sleep quality measurement parameters, constructing the fuzzy set for each input variable, and developing the fuzzy rules. To evaluate the proposed fuzzy model, five individuals were invited to participate in the experiment and required to complete the PSQI subjective sleep questionnaire. The evaluation result shows that our proposed Fuzzy model achieves lower error compared to the existing method.

Sleep Quality Evaluation Based on Single-Lead Wearable Cardiac Cycle Acquisition Device.

In clinical conditions, polysomnography (PSG) is regarded as the "golden standard" for detecting sleep disease and offering a reference of objective sleep quality. For healthy adults, scores from sleep questionnaires are more reliable than other methods in obtaining knowledge of subjective sleep quality. In practice, the need to simplify PSG to obtain subjective sleep quality by recording a few channels of physiological signals such as single-lead electrocardiogram (ECG) or photoplethysmography (PPG) signal is still very urgent. This study provided a two-step method to differentiate sleep quality into "good sleep" and "poor sleep" based on the single-lead wearable cardiac cycle data, with the comparison of the subjective sleep questionnaire score. First, heart rate variability (HRV) features and ECG-derived respiration features were extracted to construct a sleep staging model (wakefulness (W), rapid eye movement (REM), light sleep (N1&N2) and deep sleep (N3)) using the multi-classifier fusion method. Then, features extracted from the sleep staging results were used to construct a sleep quality evaluation model, i.e., classifying the sleep quality as good and poor. The accuracy of the sleep staging model, tested on the international public database, was 0.661 and 0.659 in Cardiology Challenge 2018 training database and Sleep Heart Health Study Visit 1 database, respectively. The accuracy of the sleep quality evaluation model was 0.786 for our recording subjects, with an average F1-score of 0.771. The proposed sleep staging model and sleep quality evaluation model only requires one channel of wearable cardiac cycle signal. It is very easy to transplant to portable devices, which facilitates daily sleep health monitoring.

The Subjective and Objective Improvement of Non-Invasive Treatment of Schumann Resonance in Insomnia-A Randomized and Double-Blinded Study.

PurposeAccumulated studies revealed that electromagnetic field can affect human brain and sleep, and the extremely low-frequency electromagnetic field, Schumann resonance, may have the potential to reduce insomnia symptoms. The purpose of this study was to investigate the responses of patients with insomnia to a non-invasive treatment, Schumann resonance (SR), and to evaluate its effectiveness by subjective and objective sleep assessments.Patients and MethodsWe adopted a double-blinded and randomized design and 40 participants (70% female; 50.00 ± 13.38 year) with insomnia completed the entire study. These participants were divided into the SR-sleep-device group and the placebo-device group and were followed up for four weeks. The study used polysomnography (PSG) to measure objective sleep and used sleep diaries, Pittsburgh Sleep Quality Inventory (PSQI), Epworth Sleepiness Scale (ESS), and visual analogy of sleep satisfaction to measure subjective sleep. The 36-Item Short-Form Health Survey (SF-36) was used to evaluate quality of life. Chi-square test, Mann–Whitney U-test, and Wilcoxon test were used to analyze the data.ResultsAbout 70% of the subjects were women, with an average age of 50±13.38 years and an average history of insomnia of 9.68±8.86 years. We found that in the SR-sleep-device group, objective sleep measurements (sleep-onset-latency, SOL, and total-sleep-time, TST) and subjective sleep questionnaires (SOL, TST, sleep-efficiency, sleep-quality, daytime-sleepiness, and sleep-satisfaction) were significantly improved after using the SR-sleep-device; in the placebo-device group, only such subjective sleep improvements as PSQI and sleep-satisfaction were observed.ConclusionThis study demonstrates that the SR-sleep-device can reduce the insomnia symptoms through both objective and subjective tests, with minimal adverse effects. Future studies can explore the possible mechanism of SR and health effects and, with a longer tracking time, verify the effectiveness and side effects.

0271 Actigraphy Based Measures of Sleep Disruption and Circadian Rhythms in the WashU Biomarkers of Alzheimer’s Disease in Sleep and EEG (BASE) Cohort

Abstract Introduction Prospective studies of Alzheimer’s disease (AD) demonstrate sleep-wake disturbances may precede and accelerate with cognitive decline. Use of wrist-actigraphy in conjunction with overnight polysomnography (PSG) enables researchers to evaluate diverse characteristics of sleep and circadian rhythms. Though outcome measures from these devices have been implicated in the progression of AD, because of great individual differences, it is valuable to internally replicate within cohort. Here we demonstrate application of actigraphy in the context of healthy aging to identify patterns of activity that predict cognitive decline. Methods Participants were prospectively recruited at Washington University as part of the BASE study and wore an Actiwatch2 (Philips-Respironics) and cross-validated for sleep and wake using polysomnography. The watch was worn continuously for at least 5 consecutive nights to be included in the analysis (n = 68, age = 71.1 ± 4.5 years). Rest-activity rhythms were computed using compiled code from National Sleep Research Resource (actiCircadian) pipeline implemented in MATLAB R2021a (Mathworks). Clinical Dementia Rating (CDR) scales and cognitive tests were conducted on the first day of actigraphy recording. Results Individuals with cognitive impairment (CDR Global Score &amp;gt; 0) had increased wake after sleep onset (WASO) and reduced sleep efficiency compared with individuals with no impairment (CDR = 0). (unpaired ttest: p = 0.02 and p = 0.02). Participants with cognitive impairment had a trend toward reduced relative amplitude (RA) (p = 0.06). Reduced (worse) RA was correlated with worse performance on the Trail Making Task A (Pearson r: -0.37, p = 0.002). Higher (better) interdaily Stability (IS) was associated with better responses on subjective questionnaires including Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index (Pearson r: -0.24 p = 0.051; r: 0.242, p = 0.047, respectively). Conclusion Actigraphically-derived rest-activity metrics are correlated with cognitive status, cognitive test performance, and subjective sleep questionnaires. Support (If Any) NIH R01 AG059507, ARCS Foundation Scholar

Four Weeks of a Neuro-Meditation Program Improves Sleep Quality and Reduces Hypertension in Nursing Staff During the COVID-19 Pandemic: A Parallel Randomized Controlled Trial.

The purpose of this study was to examine the effectiveness of a neuro-meditation program to support nurses during the COVID-19 pandemic. Forty-five (10 men and 35 women) nurses were classified into three groups based on their systolic blood pressure: normotensive (G-nor; n = 16, 43.8 ± 11.0 year), hypertensive (G-hyp; n = 13, 45.2 ± 10.7 year) and control (G-con; n = 16, 44.9 ± 10.6 year). Using a parallel, randomly controlled design across a 4-week period, 10 × 30-min sessions using the Rebalance© Impulse were completed. Sleep was assessed by wrist actigraphy and subjective sleep questionnaires; perceived sleep quality, Ford Insomnia Response to Stress Test questionnaire and the Spiegel Sleep Quality questionnaire (SSQ). Blood pressure, resting heart rate, mean heart rate (HRmean), heart rate variability index (RMSSD), cortisol, and alpha-amylase were also measured. Statistical analysis was completed using factorial ANOVA. Sleep improved in the G-hyp group; SSQ (p < 0.01); perceived sleep quality (p < 0.01); sleep efficiency and fragmentation index (p < 0.05). In the G-nor group, sleep was improved to a lesser extent; perceived sleep quality (p < 0.01). A significant time–group interaction was reported in resting heart rate (p < 0.01), systolic blood pressure (p < 0.01), and diastolic blood pressure (p < 0.05) with these measures being significantly reduced in the G-hyp group. RMSSD increased in the G-nor group (p < 0.01). This initial evidence suggests that neuro-meditation reduces excessive sympathetic activity, promoting enhanced sleep quality and autonomic control during periods of increased work-related stress.Clinical Trial RegistrationThe study was conducted at Bioesterel, Sophia-Antipolis, France as a clinical trial: Neuro-meditation improves sleep quality, https://www.drks.de/ui_data_web/DrksUI.html?locale=en, DRKS00025731.

Subjective Measures of Workload and Sleep in Australian Army Recruits; Potential Utility as Monitoring Tools.

Subjective measures may offer practitioners a relatively simple method to monitor recruit responses to basic military training (BMT). Yet, a lack of agreement between subjective and objective measures may presents a problem to practitioners wishing to implement subjective monitoring strategies. This study therefore aims to examine associations between subjective and objective measures of workload and sleep in Australian Army recruits. Thirty recruits provided daily rating of perceived exertion (RPE) and differential RPE (d-RPE) for breathlessness and leg muscle exertion each evening. Daily internal workloads determined via heart rate monitors were expressed as Edwards training impulse (TRIMP) and average heart rate. External workloads were determined via global positioning system (PlayerLoadTM) and activity monitors (step count). Subjective sleep quality and duration was monitored in 29 different recruits via a customized questionnaire. Activity monitors assessed objective sleep measures. Linear mixed-models assessed associations between objective and subjective measures. Akaike Information Criterion assessed if the inclusion of d-RPE measures resulted in a more parsimonious model. Mean bias, typical error of the estimate (TEE) and within-subject repeated measures correlations examined agreement between subjective and objective sleep duration. Conditional R2 for associations between objective and subjective workloads ranged from 0.18 to 0.78, P < 0.01, with strong associations between subjective measures of workload and TRIMP (0.65-0.78), average heart rate (0.57-0.73), and PlayerLoadTM (0.54-0.68). Including d-RPE lowered Akaike Information Criterion. The slope estimate between objective and subjective measures of sleep quality was not significant. A trivial relationship (r = 0.12; CI -0.03, 0.27) was observed between objective and subjective sleep duration with subjective measures overestimating (mean bias 25 min) sleep duration (TEE 41 min). Daily RPE offers a proxy measure of internal workload in Australian Army recruits; however, the current subjective sleep questionnaire should not be considered a proxy measure of objective sleep measures.

Ketogenic dietary lifestyle intervention effects on sleep, cognition, and behavior in mild cognitive impairment: Study design.

IntroductionSleep and diet are modifiable risk factors for Alzheimer's disease (AD) that may be salient areas for the development of preventive intervention strategies against dementia in people with mild cognitive impairment (MCI). Sleep disturbances account for up to 15% of the population attributable risk for AD. Diet influences sleep quality, such that diets high in sugars, fat, and processed food affect sleep quality and cognition in older adults. The combination of poor sleep and diet health may increase risk for dementia in people with MCI, yet it is unknown how intervening on diet may influence sleep health.MethodsThe MCI Sleep Study assesses longitudinal changes in objective and subjective measures of sleep between two investigational diet groups in the Brain Energy for Amyloid Transformation in Alzheimer's Disease study: the modified Mediterranean ketogenic diet (MMKD) and the American Heart Association diet. Objective sleep assessments include an in‐home sleep study using the WatchPAT Central Plus (Itamar Medical, Ltd) at baseline and the end of the 4‐month diet intervention. Subjective sleep questionnaires include the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. The MCI Sleep Study outcome measures include longitudinal change in cognitive performance, mood, behavior, and quality of life.ResultsStudy recruitment is currently ongoing. We hypothesize the low‐carb MMKD diet to have a beneficial impact on sleep health in individuals with MCI. Pre‐ and post‐diet changes in sleep metrics across diet groups will be examined using mixed effects analysis of variance models.DiscussionEarly assessment of chronic sleep and diet behaviors may be vital in understanding when interventions are necessary and the lifestyle modifications that should accompany future AD prevention and therapy recommendations.

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.

Supplemental light exposure improves sleep architecture in people with type 2 diabetes.

People with type 2 diabetes (T2D) suffer from sleep disorders, with the mechanism not clearly understood. In T2D, the light transducing retinal photoreceptors that regulate sleep behaviours are dysfunctional; hence, we determine here whether supplemental light exposure ameliorates sleep quality and daytime sleepiness in T2D. Supplemental light (10,000Lux, polychromatic) was self-administered for 30min every morning for 14days by ten participants with T2D with no diabetic retinopathy (DR). The effectiveness of supplemental light was assessed by comparing subjective sleep questionnaire (PSQI and ESS) scores and salivary dim light melatonin onset (DLMO) before and after the light exposure as well as with a self-maintained sleep diary during the light exposure. Compared to the baseline, supplemental light significantly improved the excessive daytime sleepiness score (p = 0.004) and phase-advanced the DLMO on average by ~ 23min. Sleep diary analyses showed that afternoon nap duration significantly shortened over the first week of supplemental light exposure (p = 0.019). Afternoon naps and midnight awakening were significantly longer in diabetic participants with thinner perifoveal retina. In this case series, we provide initial evidence that supplemental bright light improves daytime sleepiness in T2D with no DR, with the critical period of light exposure showing a beneficial effect after one week. We infer that supplemental light augments photoreceptor signalling in T2D and therefore optimises circadian photoentrainment leading to improved sleep. Our findings inform the development of tailored light therapy protocols in future clinical trials for improving sleep architecture in diabetes.

Fatigue and sleep patterns among Canadian wildland firefighters during a 17-day fire line deployment

The purpose of this investigation was to enhance our understanding of the effects the current British Columbia Wildfire Service (BCWS) firefighting schedule have on the development of fatigue and sleep deprivation. This was a cohort study that objectively and subjectively measured sleep quantity, sleep quality, and fatigue throughout a 17-day British Columbia wildland firefighting deployment. Wildland firefighters (n = 30) conducted daily testing of sleep and fatigue measures during 14 days of activity on the fire line and three days immediately post deployment during their three-day rest period, for a total of 17 days of data collection. Sleep was assessed using wrist-worn actigraphy (ActiGraph LLC, Pensacola, FL) and subjective sleep questionnaires. Fatigue was assessed using subjective fatigue questionnaires and cognitive performance through the psychomotor vigilance test. Total sleep time was less on fire days (M = 6.6 h ± 49.2 min) compared to non-fire days (M = 6.8 h ± 92.2 min). Participants performed poorer on cognitive performance tests, (p = 0.288), and reported being significantly sleepier, (p = 0.038), toward the end of their 17-day deployment compared to day 1. Participants continued to report high levels of sleepiness, fatigue, and poor quality of sleep on their rest days compared to their fire line days. Working 14 consecutive days was associated with increased levels of objective fatigue and suboptimal sleep in wildland firefighters. Wildland firefighters reported significantly higher levels of fatigue and decreased alertness with increasing days on deployment and these levels did not improve following a three-day rest period.

Relationships between Post-Concussion Sleep and Symptom Recovery: A Preliminary Study.

Post-concussion sleep disturbances can be debilitating and may influence days to symptom recovery; however, evidence is minimal. The purpose of this study was to explore relationships between days to symptom recovery and aspects of sleep, as measured by actigraphy and subjective sleep questionnaires in a concussed sample. Thirty-one college students were physician-diagnosed with a concussion and asked to complete a daily sleep symptom checklist. Participants (n = 14) were excluded based on lack of compliance/early termination (22.6%), recorded <5 nights of data (12.9%), and protracted recoveries (3.2%). Final concussed sample included 17 college-aged students (varsity student-athletes, n = 5; university students, n = 12). A wrist-worn ActiGraph GT9X Link was provided during initial evaluation (within 72 h post-injury) and worn continuously until symptom recovery (follow-up evaluation; 14.3 ± 5.9 days post-injury). The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) also were completed at follow-up. Pearson's correlations were conducted to determine relationships between days to symptom recovery and actigraphy sleep outcomes (sleep onset latency, wake after sleep onset (WASOnorm), total sleep time, sleep efficiency (SE), and number of awakenings) across recovery stages (2-3 days post-injury, mid-point, and end). Spearman's rho correlations were used to determine relationships between subjective sleep (PSQI global), sleepiness (ESS total), and sleep cluster symptom severity and days to symptom recovery. At recovery mid-point, individuals who were awake longer throughout the night (24.1 ± 9.0%) and/or were less efficient at sleeping (73.7 ± 9.7%) took longer to recover (WASOnorm: r = 0.58, p = 0.015; SE: r = -0.51, p = 0.035). Poorer post-concussion sleep quality (based on PSQI) was correlated with longer recovery (rs = 0.70, p = 0.001). Post-concussion sleep-wake disturbances at recovery mid-point and overall poorer sleep quality may be associated with longer symptom recovery. Our findings provide preliminary guidance on identifying those who may be at risk for longer recoveries based on poorer sleep post-injury.

Significance of sleep stability using cardiopulmonary coupling in sleep disordered breathing

The aim of this study was to assess the sleep quality and sleep stability according to the severity of obstructive sleep apnea (OSA) by using questionnaires and cardiopulmonary coupling (CPC) analysis. Two hundred and twenty-one adults were evaluated using subjective sleep questionnaires, CPC parameters, and respiratory parameters measured during full-night polysomnography. We measured the differences in the CPC parameters of each OSA group and the correlation between the apnea-hypopnea index (AHI) and CPC parameters. AHI and CPC parameters were not associated with sleep questionnaires. AHI is negatively correlated with high frequency coupling (HFC, r = -0.725, P < 0.001) and very low frequency coupling (VLFC, r = -0.475, P < 0.001), but it is positively correlated with low frequency coupling (LFC, r = 0.786, P < 0.001) and narrow- and broadband-elevated low frequency coupling (e-LFCNB and e-LFCBB ; r = 0.522, P < 0.001 and r = 0.668, P < 0.001, respectively). We also found similar results regarding the correlation between the arousal index and CPC parameters. In addition, there were significant differences in HFC, LFC, VLFC, e-LFCNB , and e-LFCBB (all P < 0.001) between the severe OSA group and all other groups. We found that CPC parameters significantly correlated with AHI. In addition, sleep stability-related parameters differ significantly based on OSA severity, and apneic parameters in the severe OSA group are significantly different from those in the other groups. 4 Laryngoscope, 130: 2069-2075, 2020.

Causative Factors for Complications in Transpalatal Advancement.

Transpalatal advancement (TPA) is a procedure that is used when modern variants of uvulopharyn-gopalatoplasty are unable to provide enough anterior traction. Although successful in reduction of obstructive sleep apnea (OSA) parameters, it also comes with procedure-specific risks. Formation of an oro-nasal fistula (ONF) is a complication that results in significant morbidity and a protracted treatment course. After approval from the University of Wollongong Health Research Ethics Committee, a retrospective chart review of all cases undergoing TPA performed by a single surgeon over a 10-year period from 2008 to 2018 was performed. Patients underwent pre- and postoperative level 1 or 2 polysomnography. Factors potentially contributing to palatal complications, as well as pre- and postoperative polysomnographic parameters, subjective sleep questionnaires, and body mass index (BMI) were statistically analyzed where a P value <.05 was considered a significant result. A total of 59 patients were included. Overall palatal complication rate was 25.4% (15/59), with the most common being transient velo-palatal insufficiency (VPI) (8/59, 13.6%). ONF developed in 4/59 (6.8%) of patients. None of the analyzed contributing factors for palatal complications were statistically significant, except the presence of a high-arched palate and development of ONF. All analyzed sleep parameters, as well as BMI, were significantly different when comparing pre- to postoperative results. This study suggests that TPA has a role in current sleep surgery paradigms and can significantly improve both objective and subjective outcome measures of OSA. Surgeons contemplating TPA on patients with high-arched hard palates should do so with caution.

Individualized sleep education improves subjective and objective sleep indices in elite cricket athletes: A pilot study

ABSTRACT The aim of the current study was to evaluate the effect of personalized sleep hygiene education on sleep indices in elite athletes. Nine elite male cricket players performed 3 weeks of baseline sleep monitoring (PRE), followed by group and individualized sleep hygiene education and a further 3 weeks of sleep monitoring (POST). Subjective sleep questionnaires included the Athlete Sleep Behaviour Questionnaire (ASBQ), the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). Objective sleep indices were monitored via wrist actigraphy. There were significant improvements (p < 0.05) in two of the sleep questionnaires (ESS and PSQI) and in sleep efficiency (+5%), sleep latency (−29 min) and sleep onset variance (−28 min) following the intervention, all associated with large or very large effect sizes (d= 1.38, −0.85 and −0.88, respectively). The current study reports that personalized sleep hygiene education using the ASBQ to target maladaptive sleep behaviours may be effective in acutely improving sleep indices in elite male athletes.

Rotigotine may improve sleep architecture in Parkinson's disease: a double-blind, randomized, placebo-controlled polysomnographic study

Background/ObjectivesGrowing evidence demonstrates that in Parkinson's Disease (PD) sleep disturbances are frequent and difficult to treat. Since the efficacy of rotigotine on sleep is corroborated by studies lacking polysomnography (PSG), this study explores the possible rotigotine-mediated impact on PSG parameters in PD patients. MethodsThis is a randomized, double-blind, placebo-controlled, parallel-group study to determine the efficacy of rotigotine vs placebo on PSG parameters in moderately advanced PD patients. An unusual protocol was utilized, since patches were maintained from 18:00 h to awakening, minimizing the possible diurnal impact on motor symptoms. All participants underwent sleep PSG recordings, subjective sleep questionnaires (Parkinson Disease Sleep Scale [PDSS], Pittsburgh Sleep Quality Index [PSQI]), and the assessment of early-morning motor disability. ResultsWe evaluated 42 PD patients (Hoehn & Yahr stages 2 and 3) with sleep impairment randomly assigned to active branch (N =21) or placebo (N = 21). Rotigotine significantly increased sleep efficiency and reduced both wakefulness after sleep onset and sleep latency compared to placebo. Moreover, the mean change in REM sleep quantity was significantly higher in the rotigotine than placebo group. The improvement of PSG parameters corresponded to the amelioration of PDSS and PSQI scores together with the improvement of patient morning motor symptoms. ConclusionsThis study demonstrated the significant effect of rotigotine on sleep quality and continuity in PD patients by promoting sleep stability and increasing REM. The effectiveness of rotigotine on sleep may be ascribed to its pharmacokinetic/pharmacodynamic profile directly on both D1 and D2 receptors.

THU0321 A Randomized Controlled Study of Pregabalin in Patients with Fibromyalgia and Comorbid Depression Taking Concurrent Antidepressant Medication

BackgroundDepression is often comorbid with fibromyalgia (FM) and many FM patients (pts) take antidepressants for their depression. Managing FM pain in these pts is important.ObjectivesTo determine the efficacy and safety...

Sleep Disorders and Multiple Sclerosis: A Clinical and Polysomnography Study

Background: Patients with multiple sclerosis (MS) report sleep disturbances (SD) and excessive daytime sleepiness (EDS) more frequently than the general population. Our objectives were to evaluate SD and EDS in MS patients and to test the reliability of subjective sleep questionnaires. Methods: Demographic and clinical characteristics of unselected consecutive patients with MS were collected. Different questionnaires were used to assess quality of sleep, daytime sleepiness, fatigue, anxiety, depression and quality of life (QoL). Nocturnal polysomnography and Multiple Sleep Latency Test (MSLT) were performed in 25 selected MS patients with fatigue and with or without EDS. Results: 205 MS patients were enrolled. More than half of the MS patients were classified as ‘poor sleepers’. In multivariate analysis, SD were correlated with disability, fatigue, depression, QoL, and pain, but not with EDS. Subjective sleepiness evaluated with the Epworth Sleepiness Scale and SD with the Pittsburgh Sleep Quality Index were not correlated with the results of the objective assessments of vigilance (MSLT) and sleep. Conclusions: SD and EDS are frequent among MS patients. Objective assessment of vigilance and sleep can be challenging but MS patients who are poor sleepers should receive immediate assessment and treatment in order to improve QoL.

Increased Corticomuscular Coherence in Idiopathic REM Sleep Behavior Disorder

The authors hypothesized that if locomotor drive increases along with rapid eye movement (REM) sleep without atonia in idiopathic REM sleep behavior disorder (RBD), then RBD patients would have greater corticomuscular coherence (CMC) values during REM sleep than at other sleep stages and than in healthy control subjects during REM sleep. To explore this hypothesis, we analyzed beta frequency range CMC between sensorimotor cortex electroencephalography (EEG) and chin/limb muscle EMG in idiopathic RBD patients. Eleven drug naive idiopathic RBD patients and 11 age-matched healthy control subjects were included in the present study. All participants completed subjective sleep questionnaires and underwent polysomnography for one night. The CMC value between EEGs recorded at central electrodes and EMGs acquired at leg and chin muscles were computed and compared by repeated measures analysis of variance (ANOVA). Sleep stages and muscle (i.e., chin vs. leg) served as within-subject factors, and group served as the between-subject factor. Repeated measures ANOVA revealed no significant main effect of group (F1,20 = 0.571, p = 0.458) or muscle (F1,20 = 1.283, p = 0.271). However, sleep stage was found to have a significant main effect (F2.067,41.332 = 20.912, p < 0.001). The interaction between group and sleep stage was significant (F2.067,41.332 = 3.438, p = 0.040). RBD patients had a significantly higher CMC value than controls during REM sleep (0.047 ± 0.00 vs. 0.052 ± 0.00, respectively, p = 0.007). This study reveals increased CMC during REM sleep in patients with RBD, which indicates increased cortical locomotor drive. Furthermore, this study supports the hypothesis that sufficient locomotor drive plays a role in the pathophysiology of RBD in addition to REM sleep without atonia.