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1
Klug, Björn. « Predicting forthcoming sleep disturbances - the role of emotional regulation ». Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-21305.
Texte intégralRésumé :
The role of emotional regulation as a predictor for forthcoming sleep disturbances was investigated within the Prospective Investigations on Psychological Processes for Insomnia (PIPPI) study. Participants were classified to one of four sleep groups in accordance with a classification algorithm based on self report-data on nighttime symptoms, daytime symptoms, and sleep disorders other than insomnia. Measures of baseline emotional regulation were then examined as a predictor for follow-up sleep group affiliation. The results indicate that emotional regulation is a non-significant predictor of forthcoming sleep disturbances, also when individual sleep group-movements are controlled for. It is suggested that models on how sleep disturbances evolve are revised, that measures of emotional regulation are refined, and that a person oriented approach is adopted.Betydelsen av emotionell reglering som prediktor för kommande sömnstörningar undersöktes inom projektet "Prospektiva undersökningar på psykologiska processer rörande insomni". Baserat på självrapporteringsdata för nattidssymptom, dagtidssymptom och andra sömnstörningar än insomni, klassificerades deltagarna till en av fyra sömngrupper i enlighet med en klassificeringsalgoritm. Baslinjedata för emotionell reglering undersöktes sedan som prediktor för sömngruppstillhörighet vid uppföljningsmätningen. Resultatet indikerar att emotionell reglering inte är en signifikant prediktor för kommande sömnstörningar, detta även när individuella förflyttningar mellan sömngrupper tas i beaktande. Det föreslås att modeller för hur sömnstörningar utvecklas revideras, att mått för emotionell reglering förfinas samt att en personorienterad ansats antas.
2
Liukkonen, T. (Timo). « Low-grade inflammation in depression, anxiety and sleep disturbances ». Doctoral thesis, Oulun yliopisto, 2011. http://urn.fi/urn:isbn:9789514296475.
Texte intégralRésumé :
Abstract Depression, anxiety and sleep disorders have been reported to be associated with low level of inflammation, i.e., low-grade inflammation, but mainly in males. The evidence has mainly been based on laboratory or clinical studies with small sample sizes or epidemiological studies with elderly subpopulations. In this study the association of low-grade inflammation with depression, anxiety, and sleep disturbances was investigated using the Northern Finland 1966 Birth Cohort (NFBC 1966). In women, the effect of hormonal factors, menopause and the use of oral contraceptives/hormone replacement therapy on the association between low-grade inflammation and depression was also studied by using the Pieksämäki Study data. In 31-year follow-up of NFBC 1966 (N=6007), the depressive and anxiety symptoms were assessed by Hopkins Symptom Checklist-25 (HSCL-25) and sleep disorders by 15-D questionnaires, while the marker of low-grade inflammation, plasma concentration of high sensitivity C-reactive protein (hs-CRP), was measured. In the Pieksämäki study a representative sample of inhabitants in the town of Pieksämäki were invited to clinical examination. Depressive symptoms were obtained by Beck’s Depression Inventory-21, and hs-CRP was measured (512 women). The results of this study revealed that at epidemiological level, elevated hs CRP levels of ≥1.0 mg/L increased the probability of current depressive symptoms of single depressive episode in the two highest subgroups (i.e., HSCL-25 mean scores ≥1.75 and ≥2.01) 1.4- and 1.7- fold in males, respectively. In addition, anxiety symptoms (HSCL-25 anxiety scale mean score ≥1.75) increased independently the probability of elevated hs-CRP levels (>3.0 mg/L) in males over 2-fold. Risk ratio of 1.3 was found for males with moderate to severe sleep disturbances and elevated hs-CRP levels (≥1.0 mg/L). Regarding females, a positive correlation between elevated hs-CRP levels and depressive symptoms was found only among peri- and postmenopausal women not using exogenous hormones. The results suggest that low-grade inflammation is associated not only with depression but also with anxiety and sleep disturbances in young adult men. In women, hormonal factors may have an effect on the association between low-grade inflammation and depression. Further investigations are called for to confirm these findings and furthermore, to determine the possible role of low-grade inflammation in the pathophysiology of these disordersTiivistelmä Depressio, ahdistuneisuushäiriöt ja unihäiriöt on yhdistetty elimistön matala-asteiseen tulehdustilaan, joskin pääasiallisesti vain miehillä. Tulosten yleistettävyyttä ovat rajoittaneet tutkimusten pienet otoskoot tai painottuminen iäkkäisiin väestöaineistoihin. Tässä tutkimuksessa selvitettiin matala-asteisen tulehduksen yhteyttä depressioon, ahdistuneisuuteen ja unihäiriöihin Pohjois-Suomen syntymäkohortti 1966 -aineistossa. Lisäksi Pieksämäki-tutkimuksen aineistossa selvitettiin naisilla menopaussin ja ehkäisyvalmisteiden/vaihdevuosihormonikorvaushoidon vaikutusta depression ja matala-asteisen tulehduksen väliseen yhteyteen. Pohjois-Suomen syntymäkohortti 1966 -tutkimuksen 31-vuotisseurannassa kartoitettiin 6007 henkilöltä masennus- ja ahdistuneisuusoireita Hopkins Symptom Checklist-25 -arviointiasteikolla (HSCL-25) ja unihäiriöitä 15-D-kyselyllä. Lisäksi mitattiin matala-asteisen tulehduksen mittarina käytetyn herkän C-reaktiivisen proteiinin (CRP) pitoisuus. Pieksämäki-tutkimuksessa edustava otos Pieksämäen asukkaista kutsuttiin kliiniseen tutkimukseen ja depressiivisiä oireita kartoitettiin Beckin 21-osioisella arviointiasteikolla ja mitattiin herkkä CRP (512 naista). Nuorilla aikuisilla miehillä, joiden herkkä CRP oli kohonnut (≥1.0 mg/l), todettiin 1.7-kertainen masennusoireiden riski, kun katkaisupisteenä käytettiin HSCL-25-kyselyn masennuskeskiarvopistettä ≥2.01. Ahdistuneisuusoireet (HSCL-25-kyselyn ahdistuneisuuskeskiarvopisteet ≥1.75) lisäsivät kohonneen herkän CRP:n riskiä (>3.0 mg/l) yli kaksinkertaiseksi miehillä. Keskivaikeasta tai vaikeasta unihäiriöstä kärsivillä todettiin 1.3-kertainen kohonneen herkän CRP:n (≥1.0 mg/l) riski. Naisilla positiivinen yhteys masennuksen ja kohonneen herkän CRP:n välillä todettiin vain peri- ja postmenopausaalisilla naisilla, jotka eivät käyttäneet hormonikorvaushoitoa tai suun kautta otettavia ehkäisyvalmisteita. Tutkimustulokset viittaavat matala-asteisen tulehduksen liittyvän depressioon, ahdistukseen ja unihäiriöön nuorilla aikuisilla miehillä. Naisilla hormonaaliset seikat mahdollisesti vaikuttavat depression ja matala-asteisen tulehduksen väliseen yhteyteen. Tulevaisuuden tutkimushaasteena on selvittää matala-asteisen inflammaation mahdollinen merkitys depression, ahdistuneisuuden ja unihäiriöiden patofysiologiassa
3
Altier, Heather R. « Thwarted Interpersonal Needs, Depression, and Sleep Disturbances in Primary Care : Does Gratitude Help You Sleep ? » Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etd/3797.
Texte intégralRésumé :
Sleep disturbances are prevalent in primary care patients and can be exacerbated by interpersonal dysfunction and depression. As well, thwarted interpersonal needs (TIN), including thwarted belongingness and perceived burdensomeness, contribute to depression. However, the presence of gratitude, a cognitive-emotional protective factor, may improve symptoms. We longitudinally examined the mediating role of depressive symptoms on the relation between TIN and sleep disturbances, and the moderating role of gratitude on the TIN-sleep disturbances and depression-sleep disturbances linkages. Our primary care patient sample (N = 223) completed self-report surveys at baseline (T1) and at a one-year follow-up (T2; n = 97). Patients with greater TIN reported more depressive symptoms (T1) and, in turn, increased sleep disturbances (T2). Gratitude did not moderate the belongingness model but, in the burdensomeness model, buffered the linkage between burdensomeness and sleep disturbances and strengthened the relation between depressive symptoms and sleep disturbances. Clinical implications and future research directions are discussed.
4
Bernert, Rebecca A. « Objectively-assessed sleep disturbances as a unique suicide risk factor ». Tallahassee, Florida : Florida State University, 2009. http://etd.lib.fsu.edu/theses/available/etd-10302009-203942/.
Texte intégralRésumé :
Thesis (Ph. D.)--Florida State University, 2009.Advisor: Thomas Joiner, Florida State University, College of Arts and Sciences, Dept. of Psychology. Title and description from dissertation home page (viewed on May 25, 2010). Document formatted into pages; contains vii, 34 pages. Includes bibliographical references.
5
Lind, Mackenzie J. « Sleep disturbances and depression : the role of genes and trauma ». VCU Scholars Compass, 2017. http://scholarscompass.vcu.edu/etd/4858.
Texte intégralRésumé :
Sleep disturbances and insomnia are prevalent, with around 33% of adults indicating that they experience at least one main symptom of insomnia, and bidirectional relationships exist with common psychopathology, particularly major depressive disorder (MDD). However, genetic and environmental (e.g., traumatic event exposure) contributions to the etiology of these phenotypes are not yet well understood. A genetically informative sample of approximately 12,000 Han Chinese women aged 30-60 (50% with recurrent MDD) was used to address several gaps within the sleep literature. Sleep disturbances were assessed in all individuals using a general item addressing sleeplessness (GS). A sleep within depression sum score (SDS) was also created in MDD cases, combining information from the GS and two insomnia items within MDD. A total of 11 traumatic events were assessed and additional information on childhood sexual abuse (CSA) was also obtained. First, factor analyses were conducted to determine trauma factor structure. The best-fit solution included 3 factors: interpersonal, child interpersonal, and non-assaultive, and composite variables were constructed accordingly. A series of hierarchical regressions were run to examine differential effects of trauma type and timing on sleeplessness. All traumatic events predicted sleeplessness at similar magnitudes, although population models indicated that childhood interpersonal trauma may be particularly potent. An association between CSA and sleeplessness was also replicated. A series of genetic analyses demonstrated that the single nucleotide polymorphism-based heritability of sleep phenotypes did not differ significantly from zero. Further, association analyses did not identify any genome-wide significant loci. However, using a liberal false discovery rate threshold of 0.5, two genes of interest, KCNK9 and ALDH1A2, emerged for the SDS. Polygenic risk score (PRS) analyses demonstrated genetic overlap between the SDS in MDD cases and GS in MDD controls, with PRSs explaining 0.2-0.3% of the variance. A final combined model of both genetic and environmental risk indicated that both PRS and traumatic events were significant predictors of sleeplessness. While genetic results should be interpreted with caution given the lack of heritability, additional research into the genetic and environmental contributions to insomnia, utilizing more standardized phenotypes and properly ascertained samples, is clearly warranted.
6
Elam, Julie Lynn. « Predictors of sleep-wake disturbances in breast cancer survivors compared to women without breast cancer ». Thesis, Connect to resource online, 2008. http://hdl.handle.net/1805/1666.
Texte intégralRésumé :
Thesis (Ph.D.)--Indiana University, 2008.Title from screen (viewed on June 1, 2009). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). ADVISOR(S): Janet S. Carpenter. Includes vita. Includes bibliographical references (leaves 227-243).
7
Wintner, Birgit. « "Night, night, sleep tight" : Effects of exercise and light on sleep physiology ». Thesis, Högskolan i Skövde, Institutionen för biovetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-15510.
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8
Afolalu, Esther F. « Sleep disturbances and the experience of pain : a multi-methodological approach ». Thesis, University of Warwick, 2017. http://wrap.warwick.ac.uk/103282/.
Texte intégralRésumé :
Poor sleep and pain conditions present a major public health challenge due to their pervasive impact on well-being. Using a mix of experimental and observational methodologies, this thesis assesses sleep disruptions and its potential associations with the experience of pain. Chapter 4 comprises two experimental studies in healthy young adults (n = 57; n = 118) revealing that impairment in central pain inhibitory processes (conditioned pain modulation response) may be associated with self- reported sleep disruptions. The studies also support the validity of the conditioned pain modulation response as a physiological marker of pain inhibition. Chapter 5 presented a quasi-experimental study comparing chronic pain groups (Fibromyalgia n = 9; Chronic Back Pain n = 8) with healthy controls (n = 9) across range of self-reported and objective sleep and pain-related parameters. Findings revealed differences in patterns of self-reported sleep but not objective sleep between the two chronic pain conditions compared with healthy controls. The study also provided some extension of the findings from Chapter 4 by exploring the associations of objective sleep disturbance with less efficient pain inhibitory processes. To expand on these findings, the thesis adopted an epidemiological approach to explore the long-term interrelationship between sleep and pain-related outcomes in the general population. A systematic literature review (Chapter 6) of 16 longitudinal studies involving 61,000 participants consolidated evidence that changes in sleep are associated with several dimensions of the pain experience (risk of developing a pain condition, elevations in levels of inflammatory markers, and a decline in self-reported physical health status). Finally, Chapter 7 presents an analysis of a sample of the UK population and revealed the association between four-year changes in different insomnia symptom (sleep onset latency, awakenings, and daytime sleepiness) and perceived physical and psychological well-being in the general population (n = 30,594) and a subgroup with arthritis (n = 4,300). Overall, the findings from this thesis provide support for the associations of sleep disturbances with the processes underlying and shaping the experience of pain. The thesis highlights future research and beneficial interventions aimed at improving sleep and addressing associated pain-related health outcomes.
9
Min, Alice A., David A. Sbarra et Samuel M. Keim. « Sleep disturbances predict prospective declines in resident physicians’ psychological well-being ». Co-Action, 2015. http://hdl.handle.net/10150/621337.
Texte intégralRésumé :
UA Open Access Publishing FundBackground: Medical residency can be a time of increased psychological stress and sleep disturbance. We examine the prospective associations between self-reported sleep quality and resident wellness across a single training year. Methods: Sixty-nine (N69) resident physicians completed the Brief Resident Wellness Profile (M17.66, standard deviation [SD] 3.45, range: 017) and the Pittsburgh Sleep Quality Index (M6.22, SD 2.86, range: 1225) at multiple occasions in a single training year. We examined the 1-month lagged effect of sleep disturbances on residents’ self-reported wellness. Results: Accounting for residents’ overall level of sleep disturbance across the entire study period, both the concurrent (within-person) within-occasion effect of sleep disturbance (B 0.20, standard error [SE]0.06, p0.003, 95% confidence interval [CI]: 0.33, 0.07) and the lagged within-person effect of resident sleep disturbance (B 0.15, SE0.07, p0.037, 95% CI: 0.29, 0.009) were significant predictors of decreased resident wellness. Increases in sleep disturbances are a leading indicatorof resident wellness, predicting decreased well-being 1 month later. Conclusions: Sleep quality exerts a significant effect on self-reported resident wellness. Periodic evaluation of sleep quality may alert program leadership and the residents themselves to impending decreases in psychological well-being.
10
Pradhan, Asik. « Supplemental light exposure for sleep disturbances associated with type 2 diabetes ». Thesis, Queensland University of Technology, 2021. https://eprints.qut.edu.au/208390/1/Asik_Pradhan_Thesis.pdf.
Texte intégralRésumé :
This experimental case series provides a proof of concept for the beneficial effect of supplemental light to improve sleep behaviour in people with type 2 diabetes with no clinical retinopathy. Photoreceptor dysfunctions identified using novel pupillometry protocols in this population point towards sub-optimal entrainment of the master clock leading to sleep and circadian disruption. These preliminary data will guide future clinical trials in early-stage diabetes to develop light therapy for managing sleep disturbances.
11
Tomy, Amitha Therese. « Sleep disturbances among immigrants in Sweden : A cross-sectional online survey study ». Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-104570.
Texte intégralRésumé :
Introduction: adequate sleep is essential to maintain a healthy life. Inadequate sleep causes various health impacts. The Centers for disease control and prevention (CDCP) from the USA announced in 2015 that sleep disorders and insufficient sleep are global health epidemics. Globally, immigration has risen especially in Sweden compared to past decades. Immigration is one of the factors of social determinants of health. Since immigration show an increasing trend, it is necessary to give much attention to the sleep health of immigrants in a health science context. Aim: The main purpose of this study is to explore the prevalence and factors associated with sleep disturbances among immigrants in Sweden. Method: Cross-sectional survey study conducted by distributing self-administered questionnaires online. Results: the prevalence of sleep disturbance among immigrants in Sweden was 69.16% (n=83). The most common self-identified factors associated with sleep disturbance were stress (62.4%, n=73) as psychological factors and high room temperature (48.3%, n=58) as environmental factors Conclusion: These findings show the necessity of taking immediate action to prevent further sleep consequences and climate change effects because of the increasing immigration trend. Future research studies can focus more on interventions that could control the impact of climate change-related sleep disturbances.
12
Vivek, Venugopal. « THE EFFICACY OF MINDFULNESS-BASED MEDITATION IN ATTENUATING SLEEP DISTURBANCES AMONG HIGH TRAIT RUMINATORS ». Kent State University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=kent1373384909.
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13
Heming, Meike. « Workplace violence and its association with sleep disturbances in the Swedish working population ». Thesis, Stockholms universitet, Institutionen för folkhälsovetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-182514.
Texte intégralRésumé :
Aim: The purpose of this study was to investigate associations between workplace violence and sleep disturbances in the Swedish working population, and to estimate potential dose-response relationships. Methods: Data were derived from two waves (2014 and 2016) of the Swedish Longitudinal Occupational Survey of Health (n=9364). Sleep disturbances were measured with four items of the Karolinska Sleep Questionnaire and one question asked whether the participants were exposed to violence or threats of at the workplace in the past six months. Multiple logistic regression analyses were performed. Results: Exposure to workplace violence was associated with higher odds of concurrent sleep disturbances (cross-sectional approach). Workplace violence was also associated with higher odds of subsequent sleep disturbances, but only when covariates were not adjusted for (prospective approach). Sleep disturbances were associated with higher odds of subsequent workplace violence (reverse approach). A dose-response relationship was found in the cross-sectional approach but not in the prospective and reverse approach. Conclusion: The findings suggested that there was a cross-sectional association between workplace violence and sleep disturbances, and that sleep disturbances were prospectively associated with exposure to workplace violence, but the results did not support a statistically significant prospective association between workplace violence and sleep disturbances.
14
Clark, Mary. « Straight A's and Perfect 10's : The Effects of Perfectionism and Anxiety on Sleep Disturbances and Burnout in Gymnasts ». Scholarship @ Claremont, 2017. http://scholarship.claremont.edu/scripps_theses/945.
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A common reason why athletes retire from their sport is burnout. Athletic burnout often occurs when athletes are over-trained and do not get enough rest. The present study examines the question: why is it that some athletes are able to perform at a high level for many years while others fizzle out? The purpose of the proposed study is to investigate the effects of perfectionism and anxiety on sleep disturbances and athletic burnout in high school students. The proposed method will be a correlational within-participants design and participants will be high school-age female gymnasts. The gymnasts will complete measures of perfectionism surrounding academics and athletics, anxiety, and burnout. Additionally, the gymnasts’ parents will complete measures of perfectionism and their perceptions of their child’s burnout. Athletes will then be given a sleep tracker to wear each night for a week to measure the athlete’s sleep per night. It is predicted that academic perfectionism and amount of sleep will interact to result in higher burnout levels. Additionally, it is predicted that there will be an interaction between anxiety levels and amount of sleep resulting in higher levels of burnout. The proposed study could give more insight into the mental and physiological processes behind athletic burnout. The relationship between perfectionism, anxiety, sleep, and burnout is one that requires further research but may be useful information for coaches, parents, and athletes to prevent athletic burnout.
15
Vivek, Venugopal. « The efficacy of mindfulness-based meditation in attenuating sleep disturbances among high trait ruminators ». Thesis, Kent State University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3618844.
Texte intégralRésumé :
Negative affect is widely recognized as a common precipitant of both subjective and objective sleep disturbances (Vandekerckhove & Cluydts, 2010). Since repetitive thought forms such as rumination can sustain negative affect states, they may play a critical role in the etiology of sleep impairment. However, extant research suffers from a number of methodological shortcomings, including a lack of objective sleep assessment and 'first-night' effects. Further, this literature has yet to adequately address the treatment implications of the association between rumination and sleep. Mindfulness-based meditation has emerged as a favorable candidate for such an intervention in recent years (Carney & Segal, 2005). Therefore, the present studies aimed to investigate the association between rumination and sleep outcomes using a multi-method approach to sleep assessment. The efficacy of mindfulness-based meditation in extinguishing rumination and improving sleep was also explored.
A sample of 42 university students who scored high on a trait-level measure of rumination participated in two, week-long studies. Participants provided informed consent, received an actiwatch, and were randomly assigned to either a mindfulness or distraction group before the studies began. During Study 1, participants in both groups completed brief, electronic questionnaires assessing daily levels of rumination just prior to bedtime. Immediately after waking, participants reported the duration and quality of sleep they experienced the previous night. Analyses revealed that daily rumination (z = 2.44; p < .05) was significantly associated with actigraphy-based sleep-onset latency (SOL), but not with total sleep time (TST) or sleep efficiency (SE). Daily rumination was also significantly associated with self-reported SOL (z = 3.18; p < .01) and SQ (z = 2.39; p < .01), but not with TST.
During Study 2, participants in the mindfulness and distraction groups partook respectively in a mindfulness- or distraction-induction task immediately after the nightly questionnaires. A significant effect emerged between group membership and actigraphy-based SOL (z = - 2.13; p < .05), diary-based TST (z = 2.38; p < .05), and diary-based SQ (z = - 2.88; p < .05), with the mindfulness group reporting better sleep outcomes. With respect to within-person effects over the course of the two studies, the mindfulness group exhibited shorter actigraphy-based SOL (z = - 2.30; p < .05), higher actigraphy-based SE (z = 6.54; p < .01), and higher diary-based SQ (z = - 2.22, p < .05) during Study 2 than during Study 1. There were no significant differences in any sleep outcome between Studies 1 and 2 for the distraction group.
These data suggest that rumination is associated with both subjective and objective sleep impairment, and that mindfulness-based meditation can help attenuate this effect. Implications for current behavioral treatments for insomnia are discussed.
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Bradley, Joanne. « Sleep disturbances following traumatic brain injury : lived experiences and the use of psychological interventions ». Thesis, Lancaster University, 2015. http://eprints.lancs.ac.uk/75015/.
Texte intégralRésumé :
Sleep disturbances are common following traumatic brain injury (TBI). Biological, psychological and social aetiological factors have been identified, with consequences of sleep disturbances including mood disturbances and exacerbation of cognitive difficulties, with potential impacts on rehabilitation outcomes. Therefore, gaining a better understanding of sleep disturbances post-TBI is necessary to inform appropriate interventions and evaluate their efficacy. There is limited research into the efficacy of interventions for sleep disturbances post-TBI. However, the use of medications can be problematic due to their impacts on cognitive functioning, thus alternatives should be considered. The first section of this work presents a narrative review which outlines the biological, psychological and social factors which influence the development and maintenance of sleep disturbance post-TBI and justifying the use of cognitive behavioural therapy for insomnia (CBT-I) in the management of sleep disturbances post-TBI. Limited but promising research exploring the efficacy of CBT-I post-TBI is reviewed, with therapy adaptations outlined and limitations of CBT-I post-TBI discussed. Given the potential consequences of disrupted sleep for the individual, there is a lack of research on individual experiences of sleep post-TBI. Consequently, individuals’ experiences of sleep disturbance post-TBI were explored. Interpretative phenomenological analysis was used to analyse data gathered from semi-structured interviews with nine participants. Three themes resulted: (1) "Why is that happening?": Making sense of sleep changes; (2) "Don't worry because it makes it worse": Finding a way to manage; (3) "Everyone's different": A unique and personal experience. Potential clinical implications of the findings are highlighted, with discussion of limitations and areas for future research. The critical appraisal explores several considerations for conducting qualitative research with individuals post-TBI and provides further reflections on the research process.
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Marcolongo, Ellen. « The Relationships Between Sleep Disturbances, Depression, Inflammatory Markers, and Sexual Trauma in Female Veterans ». Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5266.
Texte intégralRésumé :
The purpose of this secondary data analysis was to assess for the relationships among sleep disturbances, depressive symptoms, inflammatory markers, and sexual trauma in female veterans. This may contribute to an understanding of the physical and mental health effects of sexual trauma in female veterans. Correlational analyses were conducted to evaluate the strength of these relationships. A reported history of sexual trauma was significantly correlated with longer sleep latencies, poorer sleep efficiency, shorter sleep durations, more daytime dysfunction, and poorer overall sleep quality in female veterans. A reported history of sexual trauma was also significantly correlated with depressive symptoms including anhedonia and a negative affect in female veterans. No significant correlations were noted between inflammatory markers and a reported history of sexual trauma in female veterans. Female veterans with a reported history of sexual trauma had more trouble falling and staying asleep, had more trouble functioning during daytime hours, and had total poorer sleep quality. These veterans also appeared depressed and they found normally pleasurable activities unenjoyable. Disturbed sleep and depressive symptoms may be risk factors in the development of chronic health diseases. By assessing and treating the sleep disturbances and depressive symptoms experienced by sexually traumatized female veterans, nurses may help to prevent the development of costly and deadly chronic diseases
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Koffel, Erin Anne. « Structure of sleep disturbances and its relation to symptoms of psychopathology : evidence for specificity ». Diss., University of Iowa, 2012. https://ir.uiowa.edu/etd/3485.
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A large body of research has demonstrated general relations of sleep complaints with psychological disorders, including anxiety, depression, and dissociation/schizotypy. In contrast, very few studies have focused on the specificity of sleep complaints to daytime symptoms. Identifying sleep disturbances that show evidence of specificity is important for differential diagnosis and assessment. This study used the structure of self-reported sleep complaints as a framework for examining specificity. Comprehensive questionnaire and interview measures of sleep disturbance were submitted to factor analyses in students and psychiatric patients. These analyses revealed the presence of three well defined higher order factors: Lassitude, Insomnia, and Unusual Sleep Experiences. These factors were then correlated with interview and questionnaire measures of daytime symptoms. Lassitude was specific to dysphoria, whereas Insomnia had weaker, nonspecific relations with daytime symptoms. Fatigue, a component of Lassitude, showed the strongest evidence of specificity. Unusual Sleep Experiences was specific to symptoms of posttraumatic stress disorder (PTSD) and dissociation. In particular, the Nightmares component of Unusual Sleep Experiences was strongly related to PTSD and the Sleep Hallucinations component of Unusual Sleep Experiences was strongly related to dissociation.
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Rocha, Celia Regina da Silva. « Depressão, compulsão alimentar e disturbios do sono em estudantes do terceiro ano do ensino medio e de cursos pre-vestibulares ». [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311893.
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Orientador: Rubens Nelson Amaral de Assis ReimãoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: A adolescência é tida como um período de transição, marcado por significativas transformações nos aspectos bioquímicos, fisiológico e psicossocial, acarretando ansiedade e muita angústia, configurando-se como fatores de risco para o surgimento de algum tipo de distúrbio. Neste estudo, verificamos a ocorrência de sintomas de depressão, compulsão alimentar e distúrbios do sono em estudantes do terceiro ano do ensino médio e de curso pré-vestibular. Foi realizado um estudo transversal, descritivo. A amostra de 529 estudantes (M=241; F=288) de sete escolas públicas e privadas e dois cursos pré-vestibulares, de um bairro de classe média, da cidade de São Paulo, na faixa etária entre 16 e 19 anos. Os instrumentos utilizados foram: Inventário Beck de Depressão (BDI), Questionário sobre Padrões Alimentares e Peso - Revisado (QEWP-R) e o Índice de Qualidade do Sono de Pittsburgh (IQSP). A análise dos dados indica maior percentual de sintomatologia depressiva no grupo feminino e entre estudantes dos cursinhos. Verificou-se a presença de indícios de compulsão alimentar com maior percentual nos estudantes das escolas particulares. Em relação aos distúrbios do sono mostram diferenças significativas no período de estudo, problemas para ficar acordado, qualidade subjetiva do sono, latência, duração do sono, uso de medicação, eficiência habitual do sono, sonolência diurna e distúrbios do sono e número de pessoas na casa. Houve Associação entre distúrbios do sono e indícios de compulsão alimentar, distúrbios do sono e sintomatologia depressiva. Concluímos que na população estudada existe a ocorrência de sintomatologia depressiva, indícios de episódios de compulsão alimentar e distúrbios do sono
Abstract: Adolescence is a period of transition marked by significant transformations in biochemical, physiological and psychosocial aspects, leading to anxiety and anguish, which consist in risk factors for the appearance of some type of disturbance. In this study, we verified the occurrence of symptoms of depression, eating compulsion and sleep disturbances in third-year intermediate students and students enrolled in courses for university entrance examination. This was a transversal and descriptive study comprising 529 students (241 males; 288 females) from seven public and private schools and two courses for university entrance examination located in a middle-class district in the city of São Paulo, in the age group of 16-19 years. The instruments used were: Beck Depression Inventory (BDI), Questionnaire on Eating and Weight Patterns - Revised (QEWP-R) and the Pittsburgh Sleep Quality Index (PSQI). The data analysis indicated a major percentage of depressive symptomatology in the group of females and among students of the courses. It was verified a major percentage of eating compulsion signs in students of private schools. Concerning sleep disturbances, they showed significant differences regarding the period of study, difficulty staying awake, subjective quality of sleep, latency, sleep duration, medication use, habitual sleep efficiency, daytime sleepiness, and number of people at home. There was an association between sleep disturbances and eating compulsion signs, as well as sleep disturbances and depressive symptomatology. We could conclude that there was an occurrence of depressive symptomatology, signs of eating compulsion and sleep disturbances
Doutorado
Saude da Criança e do Adolescente
Doutor em Saude da Criança e do Adolescente
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Arenas, Velásquez Angela Maria [UNESP]. « Avaliação do potencial tripanocida de diaminas, diaminas de ferroceno e derivados de 1,4-naftoquinonas em cepas de Trypanosoma brucei ». Universidade Estadual Paulista (UNESP), 2013. http://hdl.handle.net/11449/95824.
Texte intégralRésumé :
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arenasvelasquez_am_me_araiq.pdf: 997352 bytes, checksum: 9599053b27f7ec5bce201d3d5079009a (MD5)Trypanosoma brucei é o agente etiológico da tripanossomíase africana ou doença do sono, transmitida por dípteros do gênero Glossina, conhecidos como moscas tsé-tsé. O diagnóstico e tratamento da doença não são satisfatórios, uma vez que para o tratamento está disponível um número de drogas altamente tóxicas e com um efeito limitado, pois dependem da fase da doença, das condições fisiológicas do hospedeiro, da suscetibilidade e variabilidade genética da cepa. Além do alto custo, o tratamento é potencialmente perigoso e está limitado ao surgimento de resistência generalizada aos fármacos utilizados. O diagnóstico é limitado à associação dos sintomas com a doença, muitas vezes é confundido com outras doenças pelo que o paciente não recebe o tratamento adequado. Por isso, tem-se a necessidade de buscar novos fármacos com melhor atividade tripanocida. Neste trabalho, avaliou-se a atividade tripanocida de 38 compostos diferentes e inéditos, como N1,N2-dibenziletano-1,2-diamina (cloridratos de benzil diaminas), N1-benzil,N2-metilferroceniletano-1,2-diamina (cloridratos de diaminas de ferroceno), 2-metoxi/hidroxi-3-(1-alquenil)-1,4-naftoquinonas e seus derivados 2-amina-1,4-naftoquinonas contra as cepas 427 e 29-13 de T. brucei. A eficácia dos compostos foi avaliada pelo método colorimétrico do MTT [brometo de 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazoliom]. Os resultados encontrados foram similares aos das atividades metabólicas das células (parasitas e/ou células HepG2 - linhagem de células de hepatoma, usada como modelo para simular funções hepáticas humanas in vitro), sendo o IC50 (metade da concentração inibitória máxima) calculado por regressão linear para cada composto. Da série anterior, o composto cloridrato de...
Trypanosoma brucei is the etiologic agent of sleeping sickness (Human African Trypanosomiasis [HAT]), transmitted by flies of Glossina genus, known as tsetse flies. The diagnostic and treatment of this disease are not satisfactory, since the treatment uses many toxicity drugs with limited effects, because depend on the stage of the disease, morphological diversity, heterogeneous biological behaviour, different clinical courses and the virulence appears to be an intrinsic property of each strain and high genetic variability. Besides the high cost, the treatment is potentially dangerous and limited the emergence of widespread drug resistance. The diagnosis is limited to the association of symptoms with the disease, is often confused with other diseases so the patient does not receive adequate treatment. Thus, the development of new research is necessary in order to generate new drugs with trypanocidal activity. In this work, we evaluated the trypanocidal activity of 38 inedited compounds of N1,N2-dibenzylethane-1,2-diamine hydrochlorides, N1-benzyl,N2-methyferrocenylethane-1,2-diamine hydrochlorides, 2-metoxy/hydroxy-3-(1-alquenyl)-1,4-naphtoquinones and amine derivatives of this compounds (2-amine-1,4-naphtoquinones) against 427 and 29-13 T. brucei parasite strains. The efficacy of these compounds was also measured using the reduction of MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide]. The results were similar to the metabolic activity of cells (parasites and/or HepG2 - hepatoma cell line used as a model to simulate human hepatic functions in vitro), being the IC50 (half of the maximum inhibitory concentration) calculated by linear regression for each sample. The compounds N-(ferrocenylmetyl)-N’-(4-metoxybenzyl)ethane-1,2-diamine) hydrochlorides and 2-metoxy-3-(2-phenylethenyl)-1,4-naphtoquinone... (Complete abstract click electronic access below)
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Bertoli, Elizangela. « A COMPARISON BETWEEN MASTICATORY MUSCLE AND TEMPOROMANDIBULAR JOINT PAIN PATIENTS WITH REGARD TO THE PREVALENCE AND IMPACT OF POST-TRAUMATIC STRESS DISORDER SYMPTOMS ». UKnowledge, 2005. http://uknowledge.uky.edu/gradschool_theses/239.
Texte intégralRésumé :
The purpose of this study was to evaluate masticatory muscle (MM) and temporomandibular joint (TMJ) pain patients regarding the prevalence of Posttraumatic Stress Disorder (PTSD) symptoms, and evaluate the level of psychological dysfunction and its relationship to PTSD symptoms in these patients. This study included 445 adult patients (male = 42, female = 403). Psychological questionnaires included the Symptom Check List-90-Revised (SCL-90-R), the Multidimensional Pain Inventory, the Pittsburgh Sleep Quality Index and the PTSD Check List Civilian. The total sample of patients was divided into two major groups: The MM group (n=242) and TMJ group (n=203). Each group was divided into three subgroups according to the presence of a stressor and severity of PTSD symptoms. Thirty six patients (14.9%) in the MM group and 20 patients (9.9%) in the TMJ group presented symptomatology of PTSD. MM and TMJ pain patients in the positive PTSD subgroups scored higher on all scales of the SCL-90-R (p = .000) than the other two subgroups and reached levels of distress that were indicative of psychological dysfunction. MM and TMJ pain patients in the positive PTSD subgroups were more often classified as dysfunctional than as adaptive copers and presented with more sleep disturbances than patients in the no stressor and negative PTSD subgroups. A somewhat elevated prevalence rate for PTSD symptomatology was found in the MM than in the TMJ group. Significant levels of psychological dysfunction appear limited to temporomandibular disorder patients with symptoms of PTSD.
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Arenas, Velásquez Angela Maria. « Avaliação do potencial tripanocida de diaminas, diaminas de ferroceno e derivados de 1,4-naftoquinonas em cepas de Trypanosoma brucei / ». Araraquara, 2013. http://hdl.handle.net/11449/95824.
Texte intégralRésumé :
Orientador: Regina Maria Barretto CicarelliBanca: Marcia Graminha
Banca: Alberto José Cavalheiro
Resumo: Trypanosoma brucei é o agente etiológico da tripanossomíase africana ou doença do sono, transmitida por dípteros do gênero Glossina, conhecidos como moscas tsé-tsé. O diagnóstico e tratamento da doença não são satisfatórios, uma vez que para o tratamento está disponível um número de drogas altamente tóxicas e com um efeito limitado, pois dependem da fase da doença, das condições fisiológicas do hospedeiro, da suscetibilidade e variabilidade genética da cepa. Além do alto custo, o tratamento é potencialmente perigoso e está limitado ao surgimento de resistência generalizada aos fármacos utilizados. O diagnóstico é limitado à associação dos sintomas com a doença, muitas vezes é confundido com outras doenças pelo que o paciente não recebe o tratamento adequado. Por isso, tem-se a necessidade de buscar novos fármacos com melhor atividade tripanocida. Neste trabalho, avaliou-se a atividade tripanocida de 38 compostos diferentes e inéditos, como N1,N2-dibenziletano-1,2-diamina (cloridratos de benzil diaminas), N1-benzil,N2-metilferroceniletano-1,2-diamina (cloridratos de diaminas de ferroceno), 2-metoxi/hidroxi-3-(1-alquenil)-1,4-naftoquinonas e seus derivados 2-amina-1,4-naftoquinonas contra as cepas 427 e 29-13 de T. brucei. A eficácia dos compostos foi avaliada pelo método colorimétrico do MTT [brometo de 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazoliom]. Os resultados encontrados foram similares aos das atividades metabólicas das células (parasitas e/ou células HepG2 - linhagem de células de hepatoma, usada como modelo para simular funções hepáticas humanas in vitro), sendo o IC50 (metade da concentração inibitória máxima) calculado por regressão linear para cada composto. Da série anterior, o composto cloridrato de... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Trypanosoma brucei is the etiologic agent of sleeping sickness (Human African Trypanosomiasis [HAT]), transmitted by flies of Glossina genus, known as tsetse flies. The diagnostic and treatment of this disease are not satisfactory, since the treatment uses many toxicity drugs with limited effects, because depend on the stage of the disease, morphological diversity, heterogeneous biological behaviour, different clinical courses and the virulence appears to be an intrinsic property of each strain and high genetic variability. Besides the high cost, the treatment is potentially dangerous and limited the emergence of widespread drug resistance. The diagnosis is limited to the association of symptoms with the disease, is often confused with other diseases so the patient does not receive adequate treatment. Thus, the development of new research is necessary in order to generate new drugs with trypanocidal activity. In this work, we evaluated the trypanocidal activity of 38 inedited compounds of N1,N2-dibenzylethane-1,2-diamine hydrochlorides, N1-benzyl,N2-methyferrocenylethane-1,2-diamine hydrochlorides, 2-metoxy/hydroxy-3-(1-alquenyl)-1,4-naphtoquinones and amine derivatives of this compounds (2-amine-1,4-naphtoquinones) against 427 and 29-13 T. brucei parasite strains. The efficacy of these compounds was also measured using the reduction of MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide]. The results were similar to the metabolic activity of cells (parasites and/or HepG2 - hepatoma cell line used as a model to simulate human hepatic functions in vitro), being the IC50 (half of the maximum inhibitory concentration) calculated by linear regression for each sample. The compounds N-(ferrocenylmetyl)-N'-(4-metoxybenzyl)ethane-1,2-diamine) hydrochlorides and 2-metoxy-3-(2-phenylethenyl)-1,4-naphtoquinone... (Complete abstract click electronic access below)
Mestre
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Miner, Stacy. « EVALUATION OF THE RELATIONSHIP OF SLEEP DISTURBANCES TO SEVERITY AND COMMON BEHAVIORS IN AUTISM SPECTRUM DISORDER ». Case Western Reserve University School of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case160769321512457.
Texte intégral
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Huss, Debra B. « Comorbidity of pediatric migraine and sleep disturbances the role of a dysfunctional autonomic nervous system / ». Lexington, Ky. : [University of Kentucky Libraries], 2007. http://hdl.handle.net/10225/766.
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Thesis (Ph. D.)--University of Kentucky, 2007.Title from document title page (viewed on March 18, 2008). Document formatted into pages; contains: vii, 48 p. : ill. Includes abstract and vita. Includes bibliographical references (p. 37-45).
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Huss, Debra B. « COMORBIDITY OF PEDIATRIC MIGRAINE AND SLEEP DISTURBANCES : THE ROLE OF A DYSFUNCTIONAL AUTONOMIC NERVOUS SYSTEM ». UKnowledge, 2008. http://uknowledge.uky.edu/gradschool_diss/582.
Texte intégralRésumé :
This study compared psychological and physiological differences between children diagnosed with migraine and their healthy peers. Physiological measures were obtained at baseline, after discussing an emotionally relevant stressor, and after recovery in 21 children with pediatric migraine and 32 healthy peers. Comparisons were also made on psychological measures investigating sleep problems, anxiety, and family stress. It was hypothesized that children with migraine compared to their peers 1) would report more sleep disturbances, anxiety, and family stress 2) would exhibit greater sympathetic activation at rest, in response to an emotional stressor, and after a recovery period and 3) that autonomic functioning would mediate the relation between the presence of pediatric migraine and sleep disturbances. Results indicated that the migraine group reported significantly greater anxiety compared to peers but there were no significant differences in sleep disturbances or family stress. Within the migraine group, migraine severity was significantly associated with total sleep disturbance and greater incidence of parasomnias, while migraine duration was significantly associated with greater night time awakenings. Migraine children also exhibited a significantly higher pulse rate compared to their peers at rest and a significantly higher diastolic blood pressure and marginally significant higher LF/HF ratio at recovery from an emotional stressor. These findings suggest that sleep disturbance and pediatric migraine are significantly related but the relation is unclear and warrants additional research. Results also indicate that children with migraine may experience more anxiety than peers. Of most interest, results suggest that children with migraine may experience a disinhibition of the autonomic nervous system characterized by a dominance of the sympathetic nervous system resulting in a longer recovery period following an emotional stressor.
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Bergstrand, Vera [Verfasser]. « Translation of the PROMIS item bank for sleep disturbances for application in Latvia / Vera Bergstrand ». Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2020. http://d-nb.info/1223928233/34.
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Balke, Britta, et Malin Plate. « Sömnmönster, sömnproblem och psykisk ohälsa i de yngre tonåren ». Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-44017.
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Bates, Allison Lynn. « An Investigation into the Interaction of Psychopathology, Personality, and Sleep Disturbances in Clients from a Community Mental Health Center ». NSUWorks, 2010. http://nsuworks.nova.edu/cps_stuetd/5.
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Studies have found a relationship between psychopathology and sleep disturbances, as well as between psychopathology and personality traits. What has not received attention to date, however, is the interplay amongst all three factors: psychopathology, sleep disturbances, and personality characteristics. This study explores the interaction amongst the three areas, as well as examines specific relationships between psychopathology and sleep disturbances and personality and sleep disturbances.
Forty clients were recruited from a community mental health center. Participants were receiving outpatient psychological services, were over 18, and did not have a diagnosis of active psychosis or mental retardation. Participants completed 9 questionnaires covering items about demographic information, psychological concerns, sleep, personality style, and social desirability. They received a $10 gift card upon completion of the study.
Participants had a mean age of 47.6 (70% female, 77% Caucasian). Results indicated that individuals with more severe psychopathology had poorer sleep quality and greater insomnia severity; however, participants with longer histories of psychopathology did not have more dysfunctional beliefs and attitudes about sleep. Participants with more extraverted personality styles did not sleep less than individuals who were less extraverted, and those who were more neurotic did not exhibit poorer sleep quality or greater insomnia severity. Lastly, when examining the relationship amongst all three factors, it was found that psychopathology may be a better predictor of sleep disturbances than personality is (depending on how sleep was assessed), and personality and sleep disturbances are both significant predictors of psychopathology.
The results reinforce the interplay amongst psychopathology, personality, and sleep disturbances. Mental health professionals may want to place greater importance on the role of sleep in the treatment of psychological and personality disorders. Future research could replicate the study with a larger sample, utilize a different personality measure, or follow participants longitudinally from the start of their mental health treatment.
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Gilles, Allyson A. « Treatment of Sleep Disturbances in Children with Autistic Disorder : Utilization of Behavioral Intervention, Social Story, and Picture Activity Schedule ». Fogler Library, University of Maine, 2008. http://www.library.umaine.edu/theses/pdf/GillesAA2008.pdf.
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Bartlett, Danielle Megan. « The utility of multidisciplinary rehabilitation as a treatment strategy for circadian rhythm and sleep disturbances in premanifest Huntington’s Disease ». Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2018. https://ro.ecu.edu.au/theses/2143.
Texte intégralRésumé :
Background: Huntington’s disease (HD) is a rare, neurodegenerative disease caused by an expanded cytosine-adenine-guanine (CAG) sequence in the Huntingtin gene, resulting in the production of an aberrant protein, mutant huntingtin (mHTT). The mHTT protein exhibits a toxic loss and gain in function, leading to degeneration of neurons in the brain. Consequently, the classic triad of motor, cognitive and mood features of the disease develop. Among the earliest features of HD are circadian rhythm and sleep disturbances. These anomalies present many years prior to formal clinical diagnosis of HD and, while it has been postulated that these disturbances arise as a result of hypothalamic pathology, the neurobiological mechanisms underpinning these sleep disturbances have not yet been robustly investigated. The hypothalamus of the brain contains several key nuclei that are essential in maintaining circadian rhythm and sleep/wake cycles. Hypothalamic pathology and dysregulation of neuroendocrine factors that mediate the sleep/wake cycle have been reported in HD, as early as the premanifest stage. It is not known however if hypothalamic pathology precedes neuroendocrine dysregulation. Identification of mechanisms underpinning sleep and circadian rhythm disturbances will enable the development of therapeutic strategies aimed at mitigating sleep and circadian rhythm anomalies. To date, no therapies exist to combat pathological changes in sleep architecture and circadian rhythm.
Evidence from mouse models of HD shows that the circadian rhythm and sleep-wake cycle are amenable to environmental interventions, including exercise, bright light therapy and temporally scheduled feeding. Furthermore, previous studies in HD of multidisciplinary rehabilitation- a construct of exercise and cognitive training, along with social interaction have been shown to increase grey matter volume in the caudate tail and dorsolateral prefrontal cortex in manifest HD, with accompanying improvements in verbal learning and memory. It is postulated that this intervention paradigm could also improve sleep outcomes in HD. Studies in Parkinson’s disease have shown that multidisciplinary rehabilitation improves sleep quality, however, the effects of multidisciplinary rehabilitation on circadian rhythm and sleep outcomes have not yet been investigated in HD and particularly not in premanifest HD when the effects of intervention would be most beneficial.
Aims: The initial aim of this thesis was to determine, through a review of the literature, the potential neurobiological mechanisms associated with circadian rhythm and sleep disturbances in individuals with premanifest HD. This was used to inform the next study, which was to determine whether hypothalamic pathology was associated with circadian rhythm and habitual sleep disturbances in individuals with premanifest HD. The next aim was to then determine if nine-months of multidisciplinary rehabilitation could impact on circadian rhythm and habitual sleep outcomes and associated hypothalamic volume in individuals with premanifest HD. The aim of the final study was to explore the effects of a nine-month multidisciplinary rehabilitation program on sleep architecture in individuals with premanifest HD.
Methods: For the study presented in Chapter 3 (aim 2), 32 individuals with premanifest HD and 29 healthy age- and gender-matched controls underwent magnetic resonance imaging scans to evaluate hypothalamic volume. Circadian rhythm and habitual sleep were assessed via measurement of morning and evening cortisol and melatonin levels, wrist-worn actigraphy, the Consensus Sleep Diary and sleep questionnaires. Information on mood, physical activity levels and body composition were also collected.
In the study presented in Chapter 4 (aim 3) 18 individuals with HD (ten premanifest and eight prodromal) undertook a nine-month multidisciplinary rehabilitation intervention (intervention group) and were compared to a community sample of 11 individuals with premanifest HD receiving standard care (control group). Hypothalamic volume, blood-based BDNF, salivary cortisol and melatonin concentrations, subjective sleep quality, daytime somnolence, habitual sleep-wake patterns and stress, anxiety and depression symptomatology were all evaluated prior to and following the intervention. Sixteen of these individuals also underwent polysomnography and sleep-dependent memory consolidation prior to and following the ninemonth intervention to assess sleep architecture and sleep-dependent memory consolidation (Chapters 4 and 5).
Results: Here in Chapter 2, a review of the literature revealed the hypothalamus as a potential modulator of circadian rhythm and sleep disturbances in HD. Chapter 3 shows that hypothalamic grey matter volume in premanifest HD individuals is reduced compared to ageand gender-matched healthy controls. We also observed reduced sleep quality and an increased number of awakenings in premanifest HD individuals compared to healthy controls. Contrary to expectation, there were no strong associations between sleep outcomes and hypothalamic volume. There were, however, differences in the associations between hypothalamic volume and neuroendocrine factors in premanifest HD individuals compared to healthy controls.
Following nine months of multidisciplinary rehabilitation, a reduced rate of loss of grey matter volume in the hypothalamus was observed in the premanifest HD intervention group compared to the premanifest HD standard care group (Chapter 4). This was accompanied by a maintenance of brain-derived neurotrophic factor (BDNF) levels in the intervention compared to the control group. No robust changes were observed in the release of circadian-regulated hormones or in habitual sleep outcomes; however, exploratory data revealed changes in sleep architecture, particularly in REM percentage and latency, following the nine-month intervention (Chapter 5).
Conclusion: Data presented in this thesis suggests that, although hypothalamic volume is reduced in individuals with premanifest HD, circadian rhythm is maintained, perhaps via neural compensation. Moreover, we provide, for the first time, preliminary data suggesting that multidisciplinary rehabilitation is useful in reducing the loss of volume of the hypothalamus and, while no robust effects on circadian rhythm were observed, improvements in sleep architecture were observed in individuals with premanifest HD. Further randomised controlled studies in a larger cohort of individuals with premanifest and manifest HD are required to confirm and extend on these preliminary findings
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Virtanen, M. « Long working hours and health in office workers : a cohort study of coronary heart disease, diabetes, depression and sleep disturbances ». Thesis, University College London (University of London), 2012. http://discovery.ucl.ac.uk/1344097/.
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This thesis examined the association between long working hours and health outcomes with high public health relevance; coronary heart disease (CHD), type 2 diabetes, depression and sleep disturbances, in a cohort of middle-aged white-collar British civil servants. Earlier research has shown mixed results on the topic but the evidence relies largely on cross-sectional and case-control studies. I used data from the longitudinal Whitehall II study where self-reported working hours were assessed at phase 3 (1991-1993) when the employed participants were 39 to 61 years of age. The second assessment of working hours was at phase 5 (1997-1999). CHD was assessed at phases 3, 5, and 7 (2003-04); type 2 diabetes at phases 3 and 7; depression at phases 3 and 5, and sleep disturbances at phases 3, 5, and 7. Analyses of each outcome disorder were based on a cohort free from the specific disorder at baseline. Follow-up time ranged between 6 to 11 years depending on the outcome, and the number of participants in each part of the study ranged between 913 and 6014 depending on the baseline and follow-up data available. Incidence of CHD was indicated by CHD death, non-fatal myocardial infarction and angina defined on the basis of clinical examinaton, clinical records, and nitrate medication use. Type 2 diabetes was ascertained from high fasting or postload plasma glucose levels, self-reported information on doctor-diagnosed diabetes and use of medication assessed during clinical examinations. Onset of depression was assessed by University of Michigan version of Composite International Diagnostic Interview (UM-CIDI) and onset of sleep disturbances were requested by survey questions on sleep length and four types of sleep disturbances (the Jenkins Scale). Several known confounding and mediating covariates were assessed and included in the analyses. Working 11-12 hours per day (or >55 hours per week) at baseline, compared with working 7-8 hours per day (or 35-40 per week) was associated with an increased risk of CHD, depression and most types of sleep disturbances at follow-up. Working long hours was not associated with an increased incidence of type 2 diabetes except among prediabetic participants. These findings were robust to adjustments for relevant confounding factors at baseline. The results of this thesis indicate that long working hours could be recognized as a potential risk marker for the development of CHD, depression, and sleep disturbances. However, the results are generalisable to British white-collar workers only, and as this study is based on observational data it is not known whether the associations are causal.
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Riedel, Frank. « Prävalenz schlafbezogener Atmungsstörungen bei Herzschrittmacherpatienten ». Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 1998. http://dx.doi.org/10.18452/14398.
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Ziel der Untersuchung war die Ermittlung der Prävalenz schlafbezogener Atmungsstörungen (SBAS) in einer Gruppe von Herzschrittmacherpatienten. Durch Gegenüberstellung mit der in der Literatur angegebenen Prävalenz SBAS in vergleichbaren Patientengruppen ohne Herzschrittmacher sollte eine Aussage über einen möglichen Zusammenhang zwischen SBAS und schrittmacherbedürftigen Herzrhythmusstörungen getroffen werden. Dieser Zusammenhang könnte indirekt über die bekannte Koinzidenz zwischen SBAS und arterieller Hypertonie bzw. KHK bestehen. Es wurden 192 Patienten (100 Männer, 92 Frauen) der Rhythmussprechstunde des Universitätsklinikums Charité in Berlin mit einem Durchschnittsalter von 62,2 +/- 12,2 Jahren ambulant für eine Nacht untersucht. Zum Einsatz kam das tragbare Schlafapnoe-Monitoring-Gerät MESAM IV. Schlafbezogene Atmungsstörungen lagen dann vor, wenn der respiratorische Gesamtindex (RDI = respiratory disturbance index) als Summe der Apnoen und Hypopnoen pro Stunde Schlaf größer oder gleich 10 war. Anhand des RDI erfolgte eine Einteilung der Patienten in Diagnosegruppen: Gruppe A (RDI < 5, kein Vorliegen SBAS), Gruppe B (RDI >= 5 und < 10, Grenzbefund) und Gruppe C (RDI >= 10, Vorliegen SBAS). Ergebnisse (Gesamtkollektiv / Männer / Frauen): Gruppe A: 100 / 44 / 56 Patienten (52,1 / 44,0 / 60,9 %) Gruppe B: 30 / 16 / 14 Patienten (15,6 / 16,0 / 15,2 %) Gruppe C: 62 / 40 / 22 Patienten (32,3 / 40,0 / 23,9 %). Signifikant häufiger wurden SBAS (Gruppe C) bei Männern als bei Frauen nachgewiesen. Ebenso liegen das Durchschnittsalter (Gruppe A: 58,5 +/- 14,5 Jahre, Gruppe C 67,3 +/- 6,8 Jahre) sowie der durchschnittliche Body-Mass-Index (Gruppe A: 24,8 +/- 3,4 kg/m2, Gruppe C 27,1 +/- 3,3 kg/m2) bei Patienten mit SBAS signifikant höher als bei Patienten ohne SBAS. Patienten mit unterschiedlichen, der Schrittmacherimplantation zugrundeliegenden, Herzerkrankungen (z. B. Sick-Sinus-Syndrom, AV-Block, Bradyarrhythmia absoluta) wiesen keine signifikanten Differenzen in der Häufigkeit SBAS auf. Gleichermaßen konnte das Vorliegen zusätzlicher kardiovaskulärer Erkrankungen und Risikofaktoren (z. B. KHK, arterielle Hypertonie, Rauchen) nicht als Einflußfaktor für das gehäufte Auftreten SBAS nachgewiesen werden. Angaben zur Prävalenz SBAS in der Literatur schwanken für die entsprechende Altersgruppe von Patienten ohne Herzschrittmacher zwischen 24 % und 73 %. Die für die Herzschrittmacherpatienten ermittelte Prävalenz der SBAS mit 32,3 % liegt innerhalb dieser großen Spannbreite. Die Untersuchungsergebnisse ergaben daher keinen Zusammenhang zwischen SBAS und schrittmacherbedürftigen Herzrhythmusstörungen. Auch konnte kein Unterschied im Auftreten SBAS in Abhängigkeit von der Art der Herzrhythmusstörung nachgewiesen werden. Weiterführende Untersuchungen (z. B. in Form einer Fall-Kontroll-Studie) erscheinen notwendig.The study was aimed to determine prevalence of sleep-related respiratory disturbances (SRRD) in a group of pacemaker patients. It was investigated if SRRD are more prevalent in pacemaker patients compared to corresponding patients without pacemaker. This question was raised in background of the wellknown coincidence of SRRD and arterial hypertension respectively coronary heart disease. References about the prevalence of SRRD in corresponding elderly people served as standard of comparison. 192 hospital outpatients (100 men and 92 women) from rhythmological ambulance of university hospital "Charité" in Berlin were randomly selected and examined for one night by means of MESAM IV device, a Non-laboratory-monitoring-system". The mean age of these patients was 62,2 +/- 12,2 years. A respiratory disturbance index (RDI; the sum of apneas and hypopneas per hour of sleep) equal or greater than 10 was laid down for the existence of SRRD. The RDI built the basis for dividing the patients into three groups: Group A (RDI < 5, no SRRD), Group B (RDI >= 5 and < 10, borderline SRRD) an Group C (RDI >= 10, SRRD). Results (all patients / men / women): Group A: 100 / 44 / 56 patients (52,1 / 44,0 / 60,9 %) Group B: 30 / 16 / 14 patients (15,6 / 16,0 / 15,2 %) Group C: 62 / 40 / 22 patients (32,3 / 40,0 / 23,9 %). Significant differences occured in the frequency of SRRD (Group C) between men and women. Apart from that the mean age (Group A: 58,5 +/- 14,5 years, Group C: 67,3 +/- 6,8 years) as well as the Body-Mass-Index (Group A: 24,8 +/- 3,4 kg/m2, Group C: 27,1 +/. 3,3 kg/m2) were significantly higher in patients with SRRD than in patients without SRRD. No significant differences in the frequency of SRRD could be demonstrated in dependence on underlying rhythm disturbances (e. g. Sick-Sinus-Syndrom, atrioventricular block, Bradyarrhythmia absoluta). In the same manner no evidences regarding significant influences of additionally existing cardiovascular diseases or risk factors (e. g. coronary heart disease, arterial hypertension, smoking) on the appearance of SRRD were shown. References about the prevalence of SRRD in corresponding elderly people without pacemaker vary from 24 % to 73 %. The prevalence of SRRD in pacemaker patients (32,3 %) fits right in the frame of this great variety. A more frequent appearance of SRRD in patients with pacemaker than in patients without could not be proved. Equally, the underlying rhythm disturbance has apparently no correlation to SRRD. Extended studies are necessary.
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Williamsson, Frida. « Physical and psychosocial effects related to sleep inchildren with neurodevelopmental disorders : A study of the relationship between motor proficiency, sleep efficiency and possible influencing factors ». Thesis, Linnéuniversitetet, Institutionen för psykologi (PSY), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-60387.
Texte intégralRésumé :
The purpose of the study was to examine the relationship between sleep patterns, motor proficiency and commonly co-occurring neurodevelopmental disorders in children, attitude to physical activity, mental health, and age. The study also looked at differences in sleep efficiency, as well as, perceived adequacy in physical activity between typically developing children and children with low motor proficiency. The sample consisted of 127 participants, 6-12 years old living in Perth, Western Australia. 51% participants were considered typically developing and 49% to have low motor proficiency. Motor proficiency, indications of Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder and anxiety/depression, adequacy in, or predilection for physical activity did not show a relationship to sleep efficiency. Significant differences between groups in sleep efficiency or adequacy in physical activity were not found. No interaction effect of neurodevelopmental disorders were identified. Sleep in children with movement impairments caused by neurodevelopmental disorders is an area where continued studies are of great importance. Although no relationship was identified in the current study, previous research has suggested sleep may play an important role for development and optimal everyday functioning. A better understanding of physical and psychological consequences and possible contributing factors of low motor proficiency in childhood is important as the risk of long-term dysfunction in emotional, cognitive and physical areas may be reduced in an optimal environment.
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Flesch, Laura L. « Improving Sleep Efficiency and Quality in Caregivers of Bone Marrow Transplant Patients ». Xavier University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1525353229277475.
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Johansson, Peter. « Health‐related quality of life, depression, sleep and breathing disorders in the elderly : With focus on those with impaired systolic function/heart failure ». Doctoral thesis, Linköpings universitet, Kardiologi, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-15784.
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The overall aim of this thesis was to describe the prevalence of depressive symptoms, sleep disordered breathing (SDB) and sleep complaints, as well as to investigate the prognostic value of health-related quality of life (Hr-QoL) and depressive symptoms on mortality in an elderly community living population with a focus on those with impaired systolic function/heart failure (HF). Descriptive, prognostic and explorative study designs were used to examine if a single question about global perceived health (GPH) is associated with the domains of Hr-QoL as assessed by the SF-36 (I), as well as to evaluate whether GPH provided prognostic information concerning cardiovascular mortality (II). The aim was also to evaluate if depressive symptoms are associated with mortality (III), and to describe the prevalence of SDB and its relationship to impaired systolic function, different insomnia symptoms, as well as excessive daytime sleepiness (IV). In primary care elderly patients with HF, GPH correlated to the physical and mental aspects of Hr-QoL. Patients who rated poor GPH also scored worse physical and mental Hr-QoL compared to patients with good GPH, but the mental aspect of Hr-QoL was however not significant (p<0.07) (I). Moreover, GPH also had an independent association with cardiovascular mortality during a ten-year follow-up. Compared to patients with good GPH, those who scored poor GPH had a four times increased risk for cardiovascular mortality (II). A total of 24% of the patients with HF suffered from depressive symptoms, not significantly different compared to 19% among those without HF. Depressive symptoms were a poor prognostic sign during the six-year follow-up and HF patients with depressive symptoms had the highest risk for cardiovascular mortality compared to HF patients without depressive symptoms (III). SDB is common among elderly people living in the community, almost one quarter (23%) had moderate or severe SDB. However, people with moderate impaired systolic function had a median apnea hypopnea index that was more than twice as high compared to those with normal systolic function (10.9 vs. 5.0, p<0.001). No obvious associations between SDB and excessive daytime sleepiness or the insomnia symptoms; difficulties maintaining sleep; non-restorative sleep; or early morning awakenings were detected. Difficulties initiating sleep were however more common in those with moderate or severe SDB (IV). GPH can be used as a simple tool in clinical routine practice as an aid in identifying patients in need of additional management. SDB is a common phenomenon among elderly people and associated with impaired systolic function, but with a limited impact on subjective sleep complaints. Depressive symptoms were shown to be a poor prognostic sign and may amplify the patient’s experience of suffering. Screening for depressive symptoms could therefore be an important action in the management of patients with HF.
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Barichello, Elizabeth. « Distúrbios no padrão do sono em pacientes submetidos à cirurgia oncológica ». Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-06102008-142923/.
Texte intégralRésumé :
Distúrbios no padrão do sono são sintomas comuns em pacientes com câncer e a literatura pertinente é escassa. Sabe-se que suas conseqüências são fortemente relacionadas à qualidade de vida dos sobreviventes do câncer. Objetivo: avaliar o padrão do sono em pacientes cirúrgicos oncológicos após a alta hospitalar e relacioná-lo com as dimensões da qualidade de vida. Método: estudo de pesquisa exploratória com delineamento observacional-transversal, realizado em 46 pacientes com diagnóstico de câncer, submetidos a procedimento cirúrgico nas especialidades de cabeça e pescoço e de urologia, no período de um até o sexto mês de pósoperatório. As entrevistas foram realizadas no ambulatório da Associação de Combate ao Câncer do Brasil Central, localizada na cidade de Uberaba MG, após assinatura do termo de consentimento. Para obtenção dos dados foram utilizados três questionários: instrumento A, para obter características sociais e clínicas dos pacientes; Índice de Qualidade do Sono de Pittsburg PSQI, utilizado na mensuração da qualidade subjetiva do sono e para a ocorrência de seus distúrbios; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 itens (EORTC-QLQ-C30), para abordar os aspectos relacionados com a qualidade de vida no câncer. A consistência interna das escalas do PSQI e do EORTC foi verificada por meio do Coeficiente Alfa de Cronbach. Para este estudo, adotou-se p value inferior a 0,05 como estatisticamente significante. Resultados e Discussão: os procedimentos cirúrgicos na área de Cabeça e Pescoço corresponderam a 30,4% (14) dos pacientes e os da Urologia, a 69,6% (32). A confiabilidade alfa de Cronbach da escala do PSQI e do EORTC foi 0,794 e 0,8139, respectivamente. A correlação de Pearson entre o Estado Geral de Saúde (EGS) do EORTC e o escore global do PSQI foi r=-0,339 e entre o escore global do PSQI e o domínio de insônia do EORTC, de r= 0,710. Em relação às respostas fornecidas pelos entrevistados, observou-se: 73,9% possuem comprometimento da qualidade subjetiva do sono; os itens estatisticamente significantes para os dados sociodemográficos e clínicos, em relação ao escore global do PSQI, foram a renda, a escolaridade e o local do câncer; para os domínios do EORTC, em relação ao escore global do PSQI, foram o EGS, desempenho de papel, função social, dispnéia, fadiga, insônia e dificuldade financeira. Considerações: distúrbios no padrão do sono são freqüentes em sobreviventes do câncer e aceita-se que geralmente levam a problemas crônicos, que interferem diretamente na qualidade de vida. Espera-se que este estudo sensibilize a equipe de enfermagem, quanto à necessidade de investigar possíveis causas para distúrbios no padrão do sono em sobreviventes e conseguir implementar cuidados necessários para garantir melhor qualidade de vida.sleep pattern disturbances are common in patients with cancer and pertinent references are scarce. It is known that their consequences are closely related to quality of life of cancer survivors. Objective: to evaluate the sleep pattern of surgical oncology patients after hospital discharge and to relate it with quality of life dimensions. Method: exploratory research with transversal-observational design, in 46 postoperative head & neck and urology cancer patients, one to six months after the operation. Outpatient interviews were made in the Associação de Combate ao Câncer do Brasil Central, located in the city of Uberaba MG, after obtention of signed consent form. Data were collected by use of three questionnaires: instrument A, to obtain social characteristics and patients\' clinical information; Pittsburgh Sleep Quality Index PSQI, for evaluation of subjective quality of sleep and for occurrence of sleep disturbances; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 itens (EORTC-QLQ-C30), to register aspects related to cancer quality of life. The internal consistency of the scales of PSQI and of EORTC was verified by means of Cronbach\'s Alpha Coefficient. For this study, p values lower than 0.05 were considered statistically significant. Results and Discussion: surgical procedures of Head and Neck corresponded to 30.4% (14) of the patients, compared to 69.6% (32) for Urology. Cronbach\'s alpha reliability of the scales of PSQI and EORTC were 0.794 and 0.8139, respectively. Pearson\'s Correlation between General Health Condition (EGS) of EORTC and global PSQI score was r=-0.339, and between global PSQI score and the insomnia domain of EORTC was r= 0.710. Regarding the answers supplied by the interviewees, it was observed: 73,9% have impairment of the subjective quality of sleep; the statistically significant items for social and clinical data, relative to global PSQI score, were the income, the level of schooling and the location of the cancer; for the domains of EORTC, relative to global PSQI score, were EGS, daily activity performance, social function, dyspnea, fatigue, insomnia and financial difficulty. Considerations: sleep pattern disturbances are frequent in cancer survivors and it is accepted that they usually lead to chronic problems, which interfere directly with quality of life. It is expected that this study sensitizes the nursing team, regarding the need to investigate possible causes for sleep pattern disturbances in survivors and to get implemented necessary cares to guarantee better quality of life.
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Gama, RÃmulo Lopes. « SÃndromes parkinsonianas : diagnÃstico diferencial por ressonÃncia magnÃtica e avaliaÃÃo das alteraÃÃes do sono ». Universidade Federal do CearÃ, 2010. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=4785.
Texte intégralRésumé :
nÃo hÃEste trabalho consiste de dois estudos: o primeiro estudo avalia o papel da morfometria por ressonÃncia magnÃtica (RM) no diagnÃstico diferencial das sÃndromes parkinsonianas; o segundo avalia as alteraÃÃes do sono nessas sÃndromes e suas relaÃÃes com alteraÃÃes estruturais na RM. Nas fases iniciais da doenÃa o diagnÃstico diferencial entre as sÃndromes parkinsonianas pode ser de difÃcil realizaÃÃo. As medidas por RM podem contribuir para o diagnÃstico diferencial entre a doenÃa Parkinson (DP), paralisia supranuclear progressiva (PSP) e atrofia de mÃltiplos sistemas (AMS). O objetivo do primeiro estudo foi avaliar o valor diagnÃstico das alteraÃÃes anatÃmicas estruturais identificadas pela RM no diagnÃstico diferencial dessas sÃndromes. Foram estudados 21 casos com DP, 11 casos com atrofia de mÃltiplos sistemas forma cerebelar (AMS-c), 8 casos de atrofia de mÃltiplos sistemas forma parkinsoniana (AMS-p) e 20 com PSP. A Ãrea sagital mediana do mesencÃfalo (Ams), Ãrea sagital mediana da ponte (Apn), largura mÃdia do pedÃnculo cerebelar mÃdio (PCM) e pedÃnculo cerebelar superior (PCS) foram medidas pela RM. ComparaÃÃes mÃltiplas foram realizadas entre a PD, AMS-c, AMS-p e PSP. A morfometria da Apn, PCM e PCS apresentaram diferenÃas entre os casos com diferentes diagnÃsticos. A Ams e a morfometria do PCS foram as medidas mais preditivas para o diagnÃstico de PSP, de tal forma que uma Ãrea do mesencÃfalo < 105 mm2 e a medida do PCS < 3 mm mostraram uma grande probabilidade para este diagnÃstico (sensibilidade de 95,0 e 80,0%, respectivamente). Nos casos de AMS-c, a morfometria da Apn < 315mm2 apresentou boa especificidade e valor preditivo positivo para o diagnÃstico (93,8% e 72,7%, respectivamente). Em conclusÃo, demonstramos que dimensÃes e valores de cortes obtidos a partir de exames de RM podem diferenciar entre PD, PSP e AMS-c, com boa sensibilidade, especificidade e precisÃo. Na segunda etapa desse trabalho, foram avaliados e comparados os distÃrbios do sono em pacientes com DP, AMS e PSP e as possÃveis associaÃÃes com a morfometria por RM do encÃfalo em 16 casos de DP, 13 AMS, 14 PSP e 12 controles. Os distÃrbios do sono foram avaliados pela escala de SonolÃncia de Epworth, Ãndice de Qualidade do sono de Pittsburgh (IQSP), escala de pernas inquietas e questionÃrio de Berlim. A Apn e Ams e largura do PCS e do PCM foram medidas pela RM. A mà qualidade do sono, o risco da sÃndrome da apnÃia obstrutiva do sono (SAOS) e sÃndrome das pernas inquietas (SPI) foi detectado em todos os grupos. Pacientes com AMS apresentaram maior risco de SAOS e menor nÃmero de casos com SPI. Nos casos de AMS, uma correlaÃÃo entre os escores do IQSP e o estÃgio do Hoehn & Yahr foi observada (p<0,05). Na PSP, a SPI foi freqÃente (57%) e relacionou-se com a menor duraÃÃo e pior eficiÃncia do sono. Na DP, sonolÃncia diurna excessiva relacionou-se com a atrofia do PCM (p=0,01). Em conclusÃo, o alto risco de SAOS foi comum e proeminente nos casos de AMS. SPI foi mais freqÃente na DP e na PSP. Nos casos com PSP, a SPI associou-se com uma reduÃÃo da eficiÃncia e duraÃÃo do sono; e nos pacientes com DP e sonolÃncia excessiva diurna apresentaram maior atrofia do PCM (DP com sonolÃncia excessiva diurna PCM= 16,08Â0,93; DP sem sonolÃncia excessiva diurna PCM =17,82 0,80 p=0,01), sugerindo degeneraÃÃo de estruturas do tronco cerebral nesses pacientes.
We describe two studies, as follows: one concerns the role of cerebral morphometry as evaluated by magnetic resonance imaging (MRI) in the differential diagnosis of the parkinsonian syndromes; the other is about sleep alterations and the relationship with MRI changes in these syndromes. MRI measures can be useful for differential diagnosis between Parkinson disease (PD), progressive supranuclear palsy (PSP) and multiple system atrophy (MSA). The aim of this study was to evaluate the diagnostic value of structural anatomic changes identified by MRI in the differential diagnosis of these syndromes. We studied 21 cases with PD, 11 with MSA-c, 8 with MSA-p, 20 with PSP and 12 controls. Midbrain area (Ams), Pons area (Apn), middle cerebellar peduncle (MCP) and superior cerebellar peduncle (SCP) width were measured using MRI. Multiple comparisons were made between PD, MSA-p, MSA-c and PSP and we show that Apn, MCP and SCP width morphometry dimensions have clear cut differences in these syndromes. The Ams and SCP were the most predictive measures of PSP. A Midbrain area below 105 mm2 and SCP less than 3 mm showed a major probability for this diagnosis (sensitivity of 95.0 and 80.0%, respectively). For the group of MSA-c patients, an Apn area below 315mm2 showed good specificity and positive predictive value (93.8% and 72.7%, respectively). In conclusion, we demonstrate that dimensions and cut off values obtained from routine MRI can differentiate between PD, PSP and MSA-c with good sensitivity, specificity and accuracy. Despite common reports in PD, in other parkinsonian syndromes, sleep disturbances have been less frequently described. We compare sleep disturbances in patients with PD, MSA and PSP and analyze associations with brain MRI morphometry. This was a cross-sectional study of 16 PD cases, 13 MSA and 14 PSP. Sleep disturbances were evaluated by Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI), Restless Legs Scale and Berlin questionnaire. Apn, Ams, MCP width, and SCP width were measured using MRI. Poor quality sleep, risk of obstructive sleep apnea (OSA) and restless legs syndrome (RLS) were detected in all groups. Patients with MSA showed higher risk of OSA and less frequent RLS. In MSA, a correlation between PSQI scores and Hoehn and Yahr stage was observed (p<0.05). In PSP, RLS was frequent (57%) and related with reduced sleep duration and efficiency. In PD, excessive daytime sleepiness was related to atrophy of the MCP (p= 0.01). High risk of OSA was common and prominent in MSA cases. RLS was more frequent in PD and PSP, and in PSP, was associated with reduced sleep efficiency and sleep duration. In conclusion, the morphometric analysis of PD patients with excessive daytime sleepiness showed more atrophy of MCP (PD with excessive daytime sleepiness MCP= 16.08Â0.93; PD without excessive daytime sleepiness MCP=17.82Â0.80 p= 0.01) suggesting widespread degeneration of brainstem sleep structures on the basis of sleep abnormalities in these patients.
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Johar, Hamimatunnisa Binti [Verfasser], et Annette [Akademischer Betreuer] Peters. « Cortisol secretion patterns in the elderly : in the perspectives of frailty and cognitive function and sleep disturbances as risk factors of cognitive decline / Hamimatunnisa Binti Johar. Betreuer : Annette Peters ». München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2016. http://d-nb.info/1111505233/34.
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Davidson, Judith Rutherford. « Cancer and sleep disturbance ». Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/NQ59523.pdf.
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Eriksson, Annsofi, et Lisa Lövgren. « Internetbaserad kognitiv beteendeterapi för personer med bipolär sjukdom -en pilotstudie ». Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-29336.
Texte intégralRésumé :
En betydande andel individer med bipolär sjukdom upplever kvarvarande, subkliniska symtom mellan egentliga sjukdomsepisoder. Sådana restsymtom är förenade med sänkt livskvalitet och förhöjd risk för återfall i sjukdomsepisoder. Syftet med föreliggande studie var att undersöka huruvida en kort, internetadministrerad behandling är genomförbar och kan ge en minskning av depressiva restsymtom, genom interventioner riktade mot sömn och emotionsreglering. För detta syfte användes en single-subject design med upprepade mätningar (n=4). Studiens resultat visar att behandlingen är genomförbar och att den, för vissa individer, kan ge en minskning av depressiva restsymtom. Vidare forskning kring behandlingen är motiverad.A significant proportion of persons diagnosed with bipolar disorder experience subclinical, residual symptoms between major episodes. Residual symptoms are associated with poor quality of life and increased risk of relapse. The current study aims at investigating whether a time limited, internet-based treatment targeting disturbed sleep and emotion regulation is feasible and successful in reducing residual depressive symptoms. Pertaining to this purpose, a single-subject design with repeated measures was used (n=4). Results show that the treatment is feasible and, for some individuals, can lead to a decrease in depressive symptoms. Future studies regarding this treatment are warranted.
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Reyner, Louise Ann. « Sleep, sleep disturbance and daytime sleepiness in normal subjects ». Thesis, Loughborough University, 1995. https://dspace.lboro.ac.uk/2134/27108.
Texte intégralRésumé :
The concept of sleep disturbance is rather vague. Many people claim to suffer from sleep disturbance, but yet find it hard to describe exactly what they mean by the label in subjective terms. Sleep researchers have a similar problem, it is difficult to describe what is meant by sleep disturbance either in an objective or a subjective way, and harder still to relate sleep disturbance to sleepiness shown the following day.
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France, Karyn G. « Understanding and managing infant sleep disturbance ». Thesis, University of Canterbury. Psychology, 1989. http://hdl.handle.net/10092/6906.
Texte intégralRésumé :
This thesis reviewed the major aetiological and treatment literature on infant sleep disturbance and concluded that the conceptual and methodological limitations of this literature have prevented progress in understanding the phenomenon. A model integrating the major findings of the literature was developed. The ethics of intervening to modify infant sleep disturbance were explored, in preparation for the experimental section.
There were four separate studies. The first evaluated extinction as an intervention for infant sleep disturbance and found it effective in reducing all aspects of infant sleep disturbance. These reductions were still evident at three months and two years follow-up. This study contributes to the literature through its use of a systematic multiple baseline design, its inclusion of reliability assessment and by confining its consideration to the more uniform developmental stage of infancy, rather than including infants and pre-schoolers together.
The second study evaluated two administration regimes for trimeprazine, a sedative widely prescribed for sleep disturbed infants in New Zealand. Trimeprazine increased the number of nights the infants slept through, however its effect was highly variable and in most cases not clinically significant. There was no evidence that use of the medication at either dose led to a lasting decrease in sleep disturbance. Study Two had the same strengths as Study One, and also contributes to the literature by its examination of a lower dose rate than any previously published study.
Study Three compared extinction alone as a treatment, with extinction plus trimeprazine and extinction plus placebo. It aimed to establish whether the use of trimeprazine would lead to less infant distress, more infant security and less parental anxiety during treatment. There was some evidence that the use of the drug led to less infant distress, but an important finding was that infant security and maternal anxiety improved for all treated groups over time. This finding was important given some of the criticisms made against the use of extinction on ethical grounds.
Study Four directly measured a wide range of infant behaviours in a group treated with extinction and two control groups. There was no evidence that extinction had any negative side effects and some evidence in fact, that it had positive side effects.
This series of studies answered several important questions, particularly regarding the limitations of drug use and the efficacy and safety of extinction. The combination of these two treatments has provided another treatment alternative, particularly where parents are reluctant to use extinction. Several directions for future research were highlighted. These included not only the continued investigation of treatments for infant sleep disturbance, but also the factors determining whether a sleep disturbed infant presents for treatment and the effect of behavioural interventions on the development of infant sleep per se.
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Insana, Salvatore. « Postpartum sleep disturbance and psychomotor vigilance performance ». Morgantown, W. Va. : [West Virginia University Libraries], 2008. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=5578.
Texte intégralRésumé :
Thesis (M.S.)--West Virginia University, 2008.Title from document title page. Document formatted into pages; contains viii, 70 p. : ill. Includes abstract. Includes bibliographical references (p. 37-45).
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Griffin, Sarah C. « LONELINESS AND SLEEP DISTURBANCE IN OLDER AMERICANS ». VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5965.
Texte intégralRésumé :
Loneliness is a risk factor for premature mortality but the mechanics of this relationship remain obscure. A potential mechanism is sleep disturbance. The present study aimed to examine the association between loneliness and sleep disturbance, evaluate loneliness as a risk factor for sleep disturbance and vice-versa, model effects between loneliness and sleep disturbance over time, and evaluate a mediation model of loneliness, sleep disturbance, and health. Data came from the 2006-2012 waves of the Health and Retirement Study, a nationally-representative study of older Americans; participants > 65 were included (n=11,400). Analyses included (i) linear regressions accounting for complex sampling and (ii) path analysis (cross-lagged panel and mediation models). Loneliness and sleep disturbance were correlated and were risk factors for one another. Cross-lagged panel models showed reciprocal effects between loneliness and sleep disturbance. Cross-lagged mediation models showed that loneliness predicted subsequent sleep disturbance, which in turn predicted poor self-reported health. Moreover, there was evidence of a direct and indirect effect of loneliness on sleep disturbance. All associations were weakened— but remained—when accounting for demographics, isolation, and depression. Collectively, these findings are consistent with the theory that sleep disturbance is a mechanism through which loneliness damages health. However, effects between loneliness and sleep are reciprocal, rather than unidirectional. Moreover, longitudinal effects were very small. Further research is necessary to speak to causality, assess daily associations between loneliness and sleep, assess a comprehensive model of the mechanics of loneliness and health, and examine loneliness and sleep in the context of other factors.
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Blom, Lovisa, et Emma Hilldén. « Att främja sömnen hos personer med demenssjukdom : En allmän litteraturöversikt ». Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-52741.
Texte intégralRésumé :
Bakgrund: Sömnstörningar är ett vanligt fenomen hos personer med demenssjukdom. Störningarna yttrar sig ofta genom upplevd trötthet under dagtid och osammanhängande sömn under natten. Sömnen är betydelsefull för återhämtningen och bidrar till en ökad livskvalitet. Problem: Personer med demenssjukdom lider ofta av flera symtom som kan förvärras vid sömnbrist. Omvårdnadsåtgärder som sjuksköterskan kan använda för att främja sömnen för personer med demenssjukdom är bristande och behöver tydliggöras samt lyftas fram. Syfte: Syftet är att skapa en översikt av omvårdnadsåtgärder för att främja sömnen hos personer med demenssjukdom. Metod: En litteraturöversikt med kvalitativa-, mixade- samt kvantitativa artiklar. Resultat: Resultatet visade flera olika omvårdnadsåtgärder som kan tillämpas vid sömnstörningar för att främja sömnen hos personer med demenssjukdom. De olika kategorierna som presenteras under resultatet är: Miljöns betydelse, kvalitetssäkra rutiner för sömn och vikten av beröring. Slutsats: Några generella slutsatser kunde inte dras då evidensen för omvårdnadsåtgärderna är låg och kräver mer forskning. Sömnen kunde dock främjas genom de omvårdnadsåtgärder som presenteras i resultatet.Background: Sleep disorders are a common phenomenon in people with dementia. The disorders are often manifested by perceived fatigue during the day and incoherent sleep during the night. Sleep is important for recovery and contributes to an increased quality of life. Problem: People with dementia can suffer from several symptoms that can be worsened by a lack of sleep. Nursing interventions that can be used to promote sleep in people with dementia are deficient therefore, they need to be clarified and highlighted. Aim: The aim is to create an overview of nursing measures to promote sleep in people with dementia. Method: A literature review with qualitative-, mixed-and quantitative articles. Results: The results showed several different nursing interventions that can be applied in sleep disorders to promote sleep in people with dementia. The importance of the environment, quality-assured routines for sleep and the importance of touch. Conclusion: No general conclusions could be drawn as the evidence for nursing measures is low and needs more research. However, sleep could be promoted through the nursing measures presented in the development.
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Henderson, Jacqueline Mary Therese. « The Development of Infant Sleep : Implications for the Prevention of Infant Sleep Disturbance ». Thesis, University of Canterbury. Educational Studies and Human Development, 2001. http://hdl.handle.net/10092/1897.
Texte intégralRésumé :
This thesis reviews the literature on the development of infant sleep to
establish whether relevant criteria for planning primary preventive intervention of
infant sleep disturbance (ISD), derived from Mrazek and Haggerty's (1994) criteria
for evaluating prevention interventions, have been met. It concludes that the
methodological and conceptual limitations of this literature have prevented the two
most critical criteria from being met. These are, when preventive intervention should
occur, and what specific infant and parent factors should be targeted.
In order to address these criteria a prospective longitudinal repeated measures
design was employed. Parents of 75 normally developing infants, 52 from the age of 1
month, and 23 from the age of 2 months completed sleep diaries for six consecutive
days, each month until the infant had reached 12 months of age. All night, infra-red,
time-lapse video recording (TLVR) was also obtained for the purpose of reliability.
There were two separate studies. The first challenged traditional definitions of
sleeping through and demonstrated an 8 hour criterion to be behaviourally meaningful
and developmentally realistic. It then investigated the norms for this developmental
task. The results indicated the optimal time for prevention to be within the first 2
months. By six months two discrete group of infants were identified, one group with
emerging sleep disturbance and the other demonstrating settled sleep. Stability in
infants' relative sleep scores was demonstrated across the first 12 months although
many parents intervened.
The second study tested the predictions from a developmental model (France
& Blampied, 1999) which suggested the proximal parent and infant risk factors that
precede and predict lSD. At 1 month a discriminant function analysis identified 3
variables that correctly classified 90.4% of the infants into either a group of infants
with emerging sleep disturbance or a group without sleep disturbance at 6 months of
age. Two of these 3 variables also predicted group membership at 12 months.
This research has filled some critical gaps in the research base by identifying
parent and infant factors to be targeted, and the optimal time for prevention. It
empirically supports and extends the developmental model, thereby providing a
framework for planning primary prevention of ISD. Several directions for future
research are presented.
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Wilson, Shannae Louise. « Effects on sleep-state organisation of a behavioural intervention for infant sleep disturbance ». Thesis, University of Canterbury. Psychology, 2013. http://hdl.handle.net/10092/8044.
Texte intégralRésumé :
Establishing healthy sleep-wake patterns early in infancy is vitally important as sleep problems can persist. Behavioural sleep interventions such as the parental presence procedure are well established and have been found to improve infant sleep as determined by parent report. The exact nature of this improvement is, however, unclear. Sleep consolidation, sleep-state organisation, and self-soothing are thought likely to change after intervention; however, no known research has comprehensively determined which of these variables change as infant sleep changes in response to intervention. Three participants aged between 7 to 11 months who met the criteria for Infant Sleep Disturbance (ISD) were referred by a Health Centre and the parental presence behavioural sleep intervention was implemented. Parental report and videosomonography (VSG) data were used to measure sleep before and after intervention. While parental report is limited in that parents can only report what they can hear and/or see, VSG offers a tool that can be used to measure sleep-state organisation, state changes, and periods when the infant is awake and quiet. The present research found that infants’ sleep became more consolidated resulting in fewer sleep-wake transitions and night wakings. Infants who had difficulties initiating sleep on their own also demonstrated decrease in Sleep Onset Delay (SOD). Furthermore, infants were found to sleep through a greater number of sleep-state transitions and sleep for a greater duration of time before waking. Collectively this research provides some evidence that changing parental behaviours to those that promote self-initiation through self-soothing and consistency, can change sleep-state organisation and improve self-soothing.
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Tininenko, Jennifer R. « Actigraphic evaluation of sleep disturbance in young children / ». Connect to title online (Scholars' Bank) Connect to title online (ProQuest), 2008. http://hdl.handle.net/1794/8336.
Texte intégralRésumé :
Thesis (Ph. D.)--University of Oregon, 2008.Typescript. Includes vita and abstract. Includes bibliographical references (leaves 99-111). Also available online in Scholars' Bank; and in ProQuest, free to University of Oregon users.
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Breslin, Jennifer H. « Sleep Disturbance, Cognition, and Behavior in Down Syndrome ». Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/201494.
Texte intégralRésumé :
Children and adolescents with Down Syndrome (DS) have a high incidence of sleep problems, including Obstructive Sleep Apnea Syndrome (OSAS). They are also likely to have deficits in neuropsychological tasks tapping prefrontal function and hippocampal function. There has recent revival of literature suggesting an active role for sleep in memory consolidation and problem-solving in both children and adults. Furthermore, given the cognitive and behavioral sequellae of OSAS in typically developing children it is logical to test if the hypoxemia and increased sleep fragmentation, the two major pathophysiological mechanisms of OSAS, seen in children with DS and OSAS may exacerbate learning or behavior disorders.Forty children with DS aged 7-18 were administered the Arizona Cognitive Test Battery (ACTB) for DS (Edgin et al., 2010), and in-home ambulatory polysomnography. Their parents were asked to complete several questionnaires assessing their child's sleep and behavior. Seventy-seven percent (n = 40) of our sample met criteria for pediatric sleep apnea (AHI>1.5), and the mean apnea hypoppnea index (AHI) was 8.4 events per hour. Our sample had a mean arousal index of 10.3, a respiratory arousal index of 3.2, and a SaO2 nadir of 86.9%. Over 70% of our sample had a SaO2 nadir below 90%. We examined the relationship between OSAS severity and cognitive and behavioral outcomes. We found that children with DS with a lower apnea hypopnea index (AHI) attained a greater number of stages on the CANTAB PAL task compared to chronologically age-matched children with higher AHI, and the variance in performance was partially explained by sleep fragmentation (i.e., the arousal index) and experimenter-rated "attention" but not hypoxemia. In addition, we also found that the low apnea group showed a trend toward outperforming the high apnea group on the KBIT-II Verbal IQ scale and DAS-2 Pattern Construction subtest.These findings have important clinical implications. First, these results suggest that early screening for OSAS in DS is important, as OSAS severity seems to explain some of the variance in cognitive functioning. Second, these findings suggest that an early intervention for OSAS might be warranted.
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Tininenko, Jennifer R. 1978. « Actigraphic evaluation of sleep disturbance in young children ». Thesis, University of Oregon, 2008. http://hdl.handle.net/1794/8336.
Texte intégralRésumé :
xiv, 111 p. A print copy of this title is available through the UO Libraries. Search the library catalog for the location and call number.Sleep studies have rarely explored individual differences in sleep disruption and associated outcomes at early ages. In two studies, this dissertation addresses both of these limitations using actigraphy, an activity-derived assessment of sleep, to increase understanding of negative impacts of sleep on early development. Study 1 investigated sleep disruption in foster children and sleep-related treatment outcomes of the Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) intervention program. Study 2 explored individual differences in the associations among sleep, children's behavior, and neurohormonal activity. Four groups of participants ages 3- to 7-years-old were included in both studies: (1) Regular foster care (RFC; n=15); (2) MTFC-P intervention (TFC; n= 17); (3) Low-income community (LIC; n= 18); and 4. Middle-income community (MIC; n=29). Results of Study 1 indicated greater sleep disruption in foster groups, as evidenced by longer sleep latencies and increased variability of sleep duration, in the TFC group than in community groups. There was also indication of a treatment effect as the TFC group slept longer than RFC and LIC groups and had earlier bedtimes, fell asleep earlier, and spent more time in bed than either community group. LIC children had marginally more active sleep than MIC children, indicating a possible role for socioeconomic status in sleep quality. In Study 2, correlational and causal modeling approaches were used to investigate associations among sleep disruption, problem behaviors, and diurnal cortisol. Influences of foster care placement, gender, and age were also examined as potential individual difference factors. Results of mixed linear autoregressive models indicated that children were more likely to display inattentive/hyperactive behaviors after shortened sleep durations. Furthermore, at lower sleep durations, differences among care groups and genders emerged as children in foster care and males were at heightened risk for inattentive/hyperactive behavior problems. No associations between sleep and disruptive problem behaviors were found and there were few associations with morning and evening cortisol values. Results of these studies are discussed in terms of the effectiveness of the MTFC-P program for addressing sleep problems in foster children. Additionally, clinical implications of the heightened likelihood of inattentive/hyperactive behavior problems after disrupted sleep in some children are discussed.
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