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Sleep Apnea Among Gulf War Veterans: An Examination of VA Utilization Rates, Treatment Initiation, and Health Outcomes 海湾战争退伍军人中的睡眠呼吸暂停:对退伍军人利用率、开始治疗和健康结果的研究
IF 3.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-12-29 DOI: 10.1080/15402002.2023.2299675
Scott G. Ravyts, Yasmine M. Eshera, Sarah C. Griffin, Tate Halverson, Jeremy L. Grove, Jean C. Beckham, Mary J. Pugh, Nathan A. Kimbrel, Patrick S. Calhoun
Obstructive sleep apnea (OSA) among veterans is frequently underdiagnosed and undertreated. The present study sought to: 1) characterize the prevalence and rate of treatment of OSA among VA users a...
退伍军人中的阻塞性睡眠呼吸暂停(OSA)往往诊断不足、治疗不足。本研究旨在1)描述退伍军人中OSA的患病率和治疗率,以及OSA在退伍军人中的分布情况。
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引用次数: 0
Maternal Prenatal Depressive Symptoms and Infant Sleep Problems: The Role of Infant Temperament and Sex. 母亲的产前抑郁症状和婴儿睡眠问题:婴儿气质和性别的作用。
IF 3.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-11-02 Epub Date: 2022-12-19 DOI: 10.1080/15402002.2022.2155162
Cláudia Castro Dias, Tiago Miguel Pinto, Bárbara Figueiredo

Objectives: We aimed to analyze whether (1) infant temperament mediates the impact of maternal prenatal depressive symptoms on infant sleep problems and (2) the mediation role of infant temperament was moderated by the infant's sex.

Methods: The sample was comprised of 172 mother-infant dyads. Mothers completed self-reported measures of prenatal and postnatal depressive symptoms, infant temperament (negative affectivity, surgency/extraversion, and orienting regulation), and sleep problems.

Results: While controlling for maternal postnatal depressive symptoms, our results revealed that (1) infant negative affectivity at two weeks partially mediated the impact of maternal prenatal depressive symptoms on sleep anxiety at six months, and (2) this mediation is independent of the infant's sex.

Conclusions: Our findings provided evidence that negative affectivity can be an early specific marker of sleep anxiety and can partially explain the negative impact of maternal prenatal depressive symptoms on further sleep problems in the infant.

目的:我们旨在分析(1)婴儿气质是否介导母亲产前抑郁症状对婴儿睡眠问题的影响;(2)婴儿气质的介导作用是否受婴儿性别的调节。方法:样本由172对母婴组成。母亲们完成了产前和产后抑郁症状、婴儿气质(消极情感、暴躁/外向和定向调节)和睡眠问题的自我报告测量。结果:在控制母亲产后抑郁症状的同时,我们的研究结果表明:(1)两周时婴儿的负情感在一定程度上介导了母亲产前抑郁症状对六个月时睡眠焦虑的影响,(2)这种介导与婴儿的性别无关。结论:我们的研究结果提供了证据,证明消极情绪可能是睡眠焦虑的早期特定标志,并可以部分解释母亲产前抑郁症状对婴儿进一步睡眠问题的负面影响。
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引用次数: 0
Change in Insomnia and Depressive Symptoms During COVID-19: A Prospective Longitudinal Study of Iranian Women with Multiple Sclerosis. 新冠肺炎期间失眠和抑郁症状的变化:伊朗多发性硬化症妇女的前瞻性纵向研究。
IF 3.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-11-02 Epub Date: 2023-01-24 DOI: 10.1080/15402002.2022.2157417
Dena Sadeghi-Bahmani, Youkhabeh Mohammadian, Laleh Sadeghi Bahmani, Habibollah Khazaie, Nahid Piri, James J Gross, Robert W Motl

Background: There is some evidence that sleep patterns and psychological health have worsened in the general population as a result of the COVID-19-pandemic. Persons with multiple sclerosis (MS) represent a particularly vulnerable population for COVID-19 infections and effects of restrictions. The present study investigated whether insomnia and depressive symptoms, as well as other MS-related symptoms (i.e. fatigue and paresthesia), changed from before to during the COVID-19-pandemic among persons with diagnosed MS.

Method: A sample of 90 Iranian females with MS (mean age; 37.62 years; median EDSS score: 2.5) completed a series of self-rating scales at two time points: Nine months before the COVID-19 outbreak in May 2019 (baseline) and then again during the COVID-19 pandemic in May 2020 (study end). Self-rating questionnaires covered sociodemographic and disease-related information, insomnia, depressive symptoms, fatigue, and paresthesia.

Results: Depressive symptoms increased over time with a significant p-value and medium effect size. Symptoms of insomnia increased over time (significant p-value, but small effect size), while no significant changes were observed in fatigue and paresthesia (very small effect sizes). The only predictor for insomnia during the COVID-19 pandemic was insomnia before the COVID-19 pandemic; the only predictor for depressive symptoms during the COVID-19 pandemic was insomnia before the COVID-19 pandemic.

Conclusions: Overall, the COVID-19 pandemic and its related social restrictions had significant effects on symptoms of depression and insomnia in this sample of Iranian women with MS, but had no effect on fatigue and paresthesia.

背景:有证据表明,由于新冠肺炎疫情,普通人群的睡眠模式和心理健康状况恶化。多发性硬化症(MS)患者是新冠肺炎感染和限制影响的特别脆弱人群。本研究调查了是否存在失眠和抑郁症状以及其他MS相关症状(即疲劳和感觉异常),在确诊为MS的人中,从新冠肺炎疫情前到疫情期间发生了变化。方法:90名患有MS的伊朗女性样本(平均年龄:37.62岁;EDSS得分中位数:2.5)在两个时间点完成了一系列自评量表:2019年5月新冠肺炎疫情爆发前9个月(基线),然后在2020年5月新冠肺炎疫情期间再次完成(研究结束)。自评问卷涵盖社会人口统计和疾病相关信息、失眠、抑郁症状、疲劳和感觉异常。结果:抑郁症状随着时间的推移而增加,具有显著的p值和中等效应大小。失眠的症状随着时间的推移而增加(显著的p值,但影响范围较小),而疲劳和感觉异常没有观察到显著变化(影响范围很小)。新冠肺炎大流行期间失眠的唯一预测因素是新冠肺炎大流行前的失眠;新冠肺炎大流行期间抑郁症状的唯一预测因素是新冠肺炎大流行前的失眠。结论:总体而言,新冠肺炎大流行及其相关的社会限制对该伊朗MS女性样本的抑郁和失眠症状有显著影响,但对疲劳和感觉异常没有影响。
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引用次数: 0
Children's Sleep and Externalizing Problems: A Day-to-day Multilevel Modeling Approach. 儿童睡眠与外部化问题:一种日常的多层次建模方法。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-11-02 Epub Date: 2022-12-13 DOI: 10.1080/15402002.2022.2156510
Maureen E McQuillan, John E Bates, Caroline P Hoyniak, Angela D Staples, Sarah M Honaker

Background: Sleep problems and externalizing problems tend to be positively associated, but the direction of this association is unclear.

Method: Day-to-day associations between sleep and behavior were examined in children (N = 22) ages 3-8 with clinical levels of externalizing problems. These children were enrolled in Parent Management Training and behavioral sleep intervention. During assessments before and after treatment, children wore actigraphs for seven days and parents concurrently completed sleep diaries and daily tallies of noncompliance, aggression, and tantrums. Multilevel modeling was used to account for the nested structure of the data, at the day-to-day level (level 1), within assessment points (level 2), and within children (level 3).

Results: Late sleep timing and fragmentation were predictive of next-day noncompliance and tantrums, respectively. There were fewer associations for a given day's behavior predicting that night's sleep, although children who showed more aggression and noncompliance at baseline tended to have later bedtimes and sleep onset times compared to other children.

背景:睡眠问题和外化问题往往呈正相关,但这种关联的方向尚不清楚。方法:在3-8岁临床存在外化问题的儿童(N=22)中,研究睡眠和行为之间的日常关联。这些孩子参加了家长管理培训和行为睡眠干预。在治疗前后的评估中,孩子们连续七天佩戴活动记录仪,父母同时完成睡眠日记和不顺从、攻击和发脾气的每日记录。在日常水平(1级)、评估点内(2级)和儿童内(3级),使用多层次建模来解释数据的嵌套结构。结果:晚睡时间和碎片分别可以预测第二天的不顺从和发脾气。尽管与其他儿童相比,在基线时表现出更具攻击性和不顺从性的儿童往往睡得更晚,睡眠开始时间也更晚,但特定一天的行为预测当晚睡眠的关联更少。
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引用次数: 0
Sleep mHealth Applications and Behavior Change Techniques Evaluation. 睡眠mHealth应用和行为改变技术评估。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-11-02 Epub Date: 2023-01-10 DOI: 10.1080/15402002.2022.2161548
Brittany D Lancaster, Rachel Sweenie, Amy E Noser, Caroline M Roberts, Rachelle R Ramsey

Objectives: Mobile health apps may be an effective way to increase sleep management skills. Although little has been documented about the content and quality of available sleep management apps, providers often make app recommendations to help with sleep self-management. The objective of this study was to systematically evaluate the content and quality of commercially available sleep apps.

Methods: Following a systematic search of the Apple App and Google Play stores, 56 sleep management apps were evaluated. App content was evaluated using the taxonomy of behavior change techniques (BCTs), and app quality was assessed using the Mobile App Rating Scale.

Results: Sleep management apps included 0-15 BCTs (M = 6.89) and 0-9 sleep BCTs (M = 4.87). App quality ranged from 2.51 to 4.80 (M = 3.78) out of 5.00. Sleepiest Sleep Sounds Stories, ShutEye: Sleep Tracker, and Mintal Tracker: Sleep Recorder included the highest number of sleep BCTs and highest quality scores.

Conclusions: While the content and quality of sleep management apps is variable, the findings are promising as many apps included a high number of BCTs and high quality. Although evidence of efficacy through randomized controlled trials is necessary to establish efficacy, this review can aid in app selection in the interim.

目标:移动健康应用程序可能是提高睡眠管理技能的有效方法。尽管关于可用睡眠管理应用程序的内容和质量的文献很少,但提供商通常会提出应用程序建议,以帮助睡眠自我管理。这项研究的目的是系统地评估商用睡眠应用程序的内容和质量。方法:通过对苹果应用程序和谷歌Play商店的系统搜索,对56款睡眠管理应用程序进行了评估。应用程序内容使用行为改变技术分类法(BCT)进行评估,应用程序质量使用移动应用程序评分量表进行评估。结果:睡眠管理应用程序包括0-15个BCT(M=6.89)和0-9个睡眠BCT(M=4.87)。应用程序质量从2.51到4.80(M=3.78)不等(满分5.00)。Sleepiest Sleep Sounds Stories、ShutEye:睡眠跟踪器和Mintal Tracker:睡眠记录器包含最高数量的睡眠BCT和最高质量分数。结论:虽然睡眠管理应用程序的内容和质量各不相同,但研究结果很有希望,因为许多应用程序都包含大量BCT和高质量。尽管通过随机对照试验证明疗效对于确定疗效是必要的,但这篇综述可以帮助在此期间进行应用内选择。
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引用次数: 0
Short Sleep Duration in School-Age Children: Differential Factors on Weekdays and Weekends. 学龄儿童睡眠时间短:工作日和工作日的不同因素。
IF 3.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-11-02 Epub Date: 2023-01-03 DOI: 10.1080/15402002.2022.2164001
Tiffany B Koa, Jia Xu Seah, Juanita Q W Ong, June C Lo

Objectives: To quantify school-age children's sleep and parent-associated factors on weekdays and weekends in Singapore, and investigate school-related and parent-related factors associated with short sleep.

Methods: In an online survey, 251 parents with a child aged 7-12 y in Singapore reported their child's sleep duration and school start time. Parent-related factors including sleep hygiene (e.g., parent-set bedtime), sleep priority (the amount of sleep respondents allowed their children to trade for other activities), and both parents' sleep durations, were also reported.

Results: The prevalence of short sleep among the children was 64.5% on weekdays and 19.5% on weekends. Children's sleep duration increased from 8.42 h on weekdays to 9.45 h on weekends (p < .001). Relative to weekdays, on weekends, parents showed similar increases in sleep durations (p < .001), imposed poorer sleep hygiene on their children (reduced likelihood of setting bedtimes and increased pre-bedtime electronic device use; p < .001), and allowed their children to trade more sleep for interacting with family and friends, social media, gaming, and TV / videos (p < .001). Shorter sleep duration in children was significantly associated with earlier school start time (B = 0.80, p = .02) and poorer sleep hygiene on weekdays (B = 0.16, p < .001), but lower sleep priority (B = 0.05, p = .002) and shorter parental sleep duration on weekends (maternal: B = 0.18, p < .001, paternal: B = 0.17, p = .002).

Conclusions: Delaying school start times may be effective in increasing school-age children's sleep duration on weekdays, while family-based interventions designed to enhance sleep hygiene, priority of sleep over other activities, and parents' sleep durations can benefit children's sleep duration on both weekdays and weekends.

目的:量化新加坡学龄儿童在工作日和周末的睡眠和父母相关因素,并调查与睡眠不足相关的学校和父母相关的因素。方法:在一项在线调查中,新加坡251名有7-12岁孩子的父母报告了他们孩子的睡眠时间和开学时间。还报告了与父母相关的因素,包括睡眠卫生(例如,父母设定的就寝时间)、睡眠优先级(受访者允许孩子进行其他活动的睡眠量)以及父母双方的睡眠时间。结果:儿童睡眠不足的发生率在工作日为64.5%,在周末为19.5%。儿童的睡眠时间从工作日的8.42小时增加到周末的9.45小时(p p p p B=0.80,p=.02),工作日的睡眠卫生较差(B=0.16,p B=0.05,p=.002),父母周末的睡眠时间较短(母亲:B=0.18,p B=0.17,p=.002)工作日,而旨在提高睡眠卫生、睡眠优先于其他活动以及父母的睡眠时间的基于家庭的干预措施可以有利于儿童在工作日和周末的睡眠时间。
{"title":"Short Sleep Duration in School-Age Children: Differential Factors on Weekdays and Weekends.","authors":"Tiffany B Koa,&nbsp;Jia Xu Seah,&nbsp;Juanita Q W Ong,&nbsp;June C Lo","doi":"10.1080/15402002.2022.2164001","DOIUrl":"10.1080/15402002.2022.2164001","url":null,"abstract":"<p><strong>Objectives: </strong>To quantify school-age children's sleep and parent-associated factors on weekdays and weekends in Singapore, and investigate school-related and parent-related factors associated with short sleep.</p><p><strong>Methods: </strong>In an online survey, 251 parents with a child aged 7-12 y in Singapore reported their child's sleep duration and school start time. Parent-related factors including sleep hygiene (e.g., parent-set bedtime), sleep priority (the amount of sleep respondents allowed their children to trade for other activities), and both parents' sleep durations, were also reported.</p><p><strong>Results: </strong>The prevalence of short sleep among the children was 64.5% on weekdays and 19.5% on weekends. Children's sleep duration increased from 8.42 h on weekdays to 9.45 h on weekends (<i>p</i> < .001). Relative to weekdays, on weekends, parents showed similar increases in sleep durations (<i>p</i> < .001), imposed poorer sleep hygiene on their children (reduced likelihood of setting bedtimes and increased pre-bedtime electronic device use; <i>p</i> < .001), and allowed their children to trade more sleep for interacting with family and friends, social media, gaming, and TV / videos (<i>p</i> < .001). Shorter sleep duration in children was significantly associated with earlier school start time (<i>B</i> = 0.80, <i>p</i> = .02) and poorer sleep hygiene on weekdays (<i>B</i> = 0.16, <i>p</i> < .001), but lower sleep priority (<i>B</i> = 0.05, <i>p</i> = .002) and shorter parental sleep duration on weekends (maternal: <i>B</i> = 0.18, <i>p</i> < .001, paternal: <i>B</i> = 0.17, <i>p</i> = .002).</p><p><strong>Conclusions: </strong>Delaying school start times may be effective in increasing school-age children's sleep duration on weekdays, while family-based interventions designed to enhance sleep hygiene, priority of sleep over other activities, and parents' sleep durations can benefit children's sleep duration on both weekdays and weekends.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"774-786"},"PeriodicalIF":3.1,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10468670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of a Novel Behavioral Sleep Medicine Education Workshop Designed to Increase Trainee Psychologists' Knowledge and Skills in Insomnia Management. 开发一个新的行为睡眠医学教育讲习班,旨在提高实习心理学家在失眠管理方面的知识和技能。
IF 3.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-11-02 Epub Date: 2023-01-05 DOI: 10.1080/15402002.2022.2164766
Hailey Meaklim, Imogen C Rehm, Moira F Junge, Melissa Monfries, Gerard A Kennedy, Romola S Bucks, Lisa J Meltzer, Melinda L Jackson

Objectives: Despite the clear influence of poor sleep on mental health, sleep education has been neglected in psychology training programs. Here, we develop a novel behavioral sleep medicine (BSM) education workshop, the Sleep Psychology Workshop, designed for integration within graduate psychology programs. We also examined the potential efficacy and acceptability of the workshop to upskill trainee psychologists in sleep and insomnia management.

Methods: The Sleep Psychology Workshop was developed using a modified Delphi Method. Eleven trainee psychologists completing their Master of Psychology degrees (90% female, 24.4 ± 1.6 years old) attended the workshop, delivered as three, two-hour lectures (total of six hours). Sleep knowledge, attitudes, and practice assessments were completed pre-and post-intervention using the GradPsyKAPS Questionnaire. A focus group and 6-month follow-up survey captured feedback and qualitative data.

Results: Trainees' sleep knowledge quiz scores (% correct) increased from 60% to 79% pre- to post-workshop (p = .002). Trainees' self-efficacy to use common sleep-related assessment instruments and empirically supported interventions to manage sleep disturbances increased, along with their confidence to manage insomnia (all p < .02). Participant feedback was positive, with 91% of trainees rating the workshop as "excellent" and qualitative data highlighting trainees developing practical skills in BSM. Six months post-intervention, 100% of trainees endorsed routinely asking their clients about sleep, with 82% reporting improvements in their own sleep.

Conclusions: The Sleep Psychology Workshop is a potentially effective and acceptable introductory BSM education program for trainee psychologists, ready for integration within the graduate psychology curriculum.

目的:尽管睡眠不足对心理健康有明显影响,但在心理学培训项目中,睡眠教育一直被忽视。在这里,我们开发了一个新的行为睡眠医学(BSM)教育研讨会,即睡眠心理学研讨会,旨在整合研究生心理学课程。我们还研究了研讨会在睡眠和失眠管理方面提高实习心理学家技能的潜在疗效和可接受性。方法:采用改进的德尔菲法建立睡眠心理学工作坊。11名完成心理学硕士学位的实习心理学家(90%为女性,24.4±1.6岁)参加了研讨会,授课时间为三、两小时(共六小时)。使用GradPsyKAPS问卷在干预前后完成睡眠知识、态度和实践评估。一个焦点小组和6个月的后续调查收集了反馈和定性数据。结果:学员的睡眠知识测验得分(%正确率)在研讨会前后从60%提高到79%(p=0.002)。学员使用常见睡眠相关评估工具和经验支持的干预措施来管理睡眠障碍的自我效能感提高,以及他们管理失眠的信心(所有p结论:睡眠心理学研讨会是一个潜在有效且可接受的实习心理学家BSM入门教育计划,准备纳入研究生心理学课程。
{"title":"Development of a Novel Behavioral Sleep Medicine Education Workshop Designed to Increase Trainee Psychologists' Knowledge and Skills in Insomnia Management.","authors":"Hailey Meaklim,&nbsp;Imogen C Rehm,&nbsp;Moira F Junge,&nbsp;Melissa Monfries,&nbsp;Gerard A Kennedy,&nbsp;Romola S Bucks,&nbsp;Lisa J Meltzer,&nbsp;Melinda L Jackson","doi":"10.1080/15402002.2022.2164766","DOIUrl":"10.1080/15402002.2022.2164766","url":null,"abstract":"<p><strong>Objectives: </strong>Despite the clear influence of poor sleep on mental health, sleep education has been neglected in psychology training programs. Here, we develop a novel behavioral sleep medicine (BSM) education workshop, the Sleep Psychology Workshop, designed for integration within graduate psychology programs. We also examined the potential efficacy and acceptability of the workshop to upskill trainee psychologists in sleep and insomnia management.</p><p><strong>Methods: </strong>The Sleep Psychology Workshop was developed using a modified Delphi Method. Eleven trainee psychologists completing their Master of Psychology degrees (90% female, 24.4 ± 1.6 years old) attended the workshop, delivered as three, two-hour lectures (total of six hours). Sleep knowledge, attitudes, and practice assessments were completed pre-and post-intervention using the GradPsyKAPS Questionnaire. A focus group and 6-month follow-up survey captured feedback and qualitative data.</p><p><strong>Results: </strong>Trainees' sleep knowledge quiz scores (% correct) increased from 60% to 79% pre- to post-workshop (<i>p</i> = .002). Trainees' self-efficacy to use common sleep-related assessment instruments and empirically supported interventions to manage sleep disturbances increased, along with their confidence to manage insomnia (all <i>p</i> < .02). Participant feedback was positive, with 91% of trainees rating the workshop as \"excellent\" and qualitative data highlighting trainees developing practical skills in BSM. Six months post-intervention, 100% of trainees endorsed routinely asking their clients about sleep, with 82% reporting improvements in their own sleep.</p><p><strong>Conclusions: </strong>The Sleep Psychology Workshop is a potentially effective and acceptable introductory BSM education program for trainee psychologists, ready for integration within the graduate psychology curriculum.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"787-801"},"PeriodicalIF":3.1,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10490264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Post-Stroke Insomnia Increased the Risk of Cognitive Impairments: A Hospital-Based Retrospective Cohort Study. 卒中后失眠增加认知障碍的风险:一项基于医院的回顾性队列研究。
IF 3.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-11-02 Epub Date: 2023-01-05 DOI: 10.1080/15402002.2023.2165491
Faizul Hasan, Muhammad Solihuddin Muhtar, Dean Wu, Hsin-Chien Lee, Yen-Chun Fan, Ting-Jhen Chen, Hsiao-Yean Chiu

Objectives/background: Insomnia is a common sleep complaint among patients who had a stroke and has been recognized as an independent risk factor for cognitive impairment. However, the relationship between poststroke insomnia and cognitive impairment over time is under-researched. Therefore, we examined the association between poststroke insomnia and the risk of cognitive impairment.

Participants: Stroke participants who had a stroke and were 20 years and older.

Methods: This multicenter hospital-based retrospective cohort study with a 13-year follow-up period (2004-2017). The diagnosis of stroke, insomnia, and cognitive impairment was based on the International Classification of Diseases. The study participants who experienced a stroke were divided into two cohorts: those who also had insomnia and those who did not have insomnia. A Cox proportional-hazards regression model was used.

Results: A total of 1,775 patients with a mean age of 67.6 years were included. Of these patients, 146 and 75 patients were diagnosed with insomnia and cognitive impairment during the follow-up period, respectively. The cumulative incidence of cognitive impairment in the stroke with insomnia cohort was significantly lower than that in the stroke without insomnia cohort (log-rank test, P < .001). The adjusted hazard ratio and 95% confidence interval (CI) of the stroke with insomnia cohort indicated a higher risk of cognitive impairment compared with the stroke without insomnia cohort (adjusted hazard ratio: 2.38; 95% CI: 1.41-4.03).

Conclusions: Patients who had a stroke and were diagnosed with insomnia exhibited a substantial increased risk of cognitive impairment over time.

目的/背景:失眠是中风患者常见的睡眠问题,已被公认为认知障碍的独立风险因素。然而,随着时间的推移,脑卒中后失眠与认知障碍之间的关系仍在研究中。因此,我们研究了脑卒中后失眠与认知障碍风险之间的关系。参与者:20岁及以上的中风参与者。方法:这项基于医院的多中心回顾性队列研究,随访期为13年(2004-2017)。中风、失眠和认知障碍的诊断基于国际疾病分类。经历过中风的研究参与者被分为两组:同样失眠的人和没有失眠的人。采用Cox比例风险回归模型。结果:共纳入1775名患者,平均年龄67.6岁。在这些患者中,146名和75名患者在随访期间分别被诊断为失眠和认知障碍。脑卒中伴失眠队列中认知障碍的累计发生率显著低于脑卒中不伴失眠队列(log秩检验,P<.001)。脑卒中伴失眠症队列的校正危险比和95%置信区间(CI)表明,与脑卒中不伴有失眠队列相比,认知障碍的风险更高(调整后的危险比:2.38;95%可信区间:1.41-4.03)。结论:随着时间的推移,中风并被诊断为失眠的患者出现认知障碍的风险显著增加。
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引用次数: 1
The Effect of Cognitive Behavioral Therapy for Insomnia (CBT-I) on Cardiometabolic Health Biomarkers: A Systematic Review of Randomized Controlled Trials. 失眠认知行为疗法(CBT-I)对心脏代谢健康生物标志物的影响:随机对照试验的系统评价。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-11-02 Epub Date: 2022-12-07 DOI: 10.1080/15402002.2022.2154213
Kimberly L Savin, Taylor L Clark, Perla Perez-Ramirez, Tara S Allen, Maíra Tristão Parra, Linda C Gallo

Objectives: To assess the effectiveness of Cognitive Behavioral Therapy for Insomnia (CBT-I) on cardiometabolic health biomarkers.

Method: Cochrane CENTRAL, Embase, Medline, and PsycINFO were searched, and records were screened by two independent reviewers. Inclusion criteria were adult population, delivery of CBT-I, randomized controlled trial design, ≥1 cardiometabolic health outcome, and peer-review. Hedge's g effect sizes were calculated, and the quality of the evidence was appraised using the Cochrane Risk of Bias 2 tool.

Results: After screening 1649 records, 15 studies were included (total N = 2067). Inflammatory markers (CRP, IL-6, TNF-α), blood pressure (SBP, DBP), and glycemic regulation (HbA1c) were most frequently reported (in ≥3 studies each). HbA1c and CRP were reduced in the CBT-I group compared to the control group (in 3 studies each). Effects varied or were null for IL-6, TNF-α, SBP, and DBP. Six studies were judged as low, four as moderate, and five as high risk of bias.

Conclusion: CBT-I was most consistently associated with improved HbA1c and CRP, which are relatively temporally stable, suggesting influences on enduring habits rather than short-term behavior changes. High risk of bias limits the interpretation of findings. Methodologically adequate studies are needed to better understand cardiometabolic effects of CBT-I.

目的:评估失眠认知行为疗法(CBT-I)对心脏代谢健康生物标志物的有效性。方法:检索Cochrane CENTRAL、Embase、Medline和PsycINFO,并由两名独立评审员筛选记录。纳入标准为成年人群、CBT-I的交付、随机对照试验设计、≥1的心脏代谢健康结果和同行评审。计算Hedge的g效应大小,并使用Cochrane偏倚风险2工具评估证据的质量。结果:筛选1649份记录后,纳入15项研究(总N=2067)。炎症标志物(CRP、IL-6、TNF-α)、血压(SBP、DBP)和血糖调节(HbA1c)的报告频率最高(各研究≥3项)。与对照组相比,CBT-I组的HbA1c和CRP降低(各3项研究)。IL-6、TNF-α、SBP和DBP的作用各不相同或无效。六项研究被判定为低风险,四项被判定为中等风险,五项被判断为高风险。结论:CBT-I与HbA1c和CRP的改善最为一致,这两个指标在时间上相对稳定,表明其影响了持久的习惯,而不是短期的行为变化。偏见的高风险限制了对研究结果的解释。需要进行充分的方法学研究,以更好地了解CBT-I的心脏代谢作用。
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引用次数: 0
Parental Discontent with Infant Sleep During the First Two Years of Life. 父母对婴儿出生前两年睡眠的不满。
IF 3.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-11-02 Epub Date: 2023-01-10 DOI: 10.1080/15402002.2022.2156867
Margreet W Harskamp-van Ginkel, Nicola L E Imkamp, Lieke van Houtum, Tanja G M Vrijkotte, Yassmina Ben Haddi-Toutouh, Mai J M Chinapaw

Background: Problematic sleep in infants can have a high impact on families. We examined parental discontent with infant sleep in the first six months of life and parent-perceived problematic sleep during the second year of life.

Methods: We used Sarphati Cohort data of 1471 children. During periodic youth health care visits in the first six months of life, professionals registered parental discontent with infant sleep. In the second year of life, parents filled out the Brief Infant Sleep Questionnaire (BISQ), from which we defined parent-perceived problematic sleep and BISQ-defined problematic sleep. We examined the association of parental discontent with infant sleep during the first six months with both BISQ-derived outcomes up to age two, using multivariable logistic regression analysis.

Results: 26% of parents were discontented with infant sleep during the first six months of life. During the second year of life, 27% of the parents perceived their child's sleep as problematic, and 9% of the infants had BISQ-defined problematic sleep. Early parental discontent with infant sleep was associated with parent-perceived problematic sleep [adjusted OR 2.50 (95% CI 1.91-3.28)], and BISQ-defined problematic sleep [adjusted OR 1.88 (1.11-3.17)].

Conclusions: Early registered parental discontent with infant sleep was a predictor of parent-perceived problematic sleep in early toddlerhood. Registering parental discontent during infancy might enable professionals to identify a group of infants at risk for later problematic sleep. We recommend screening and parental support for sleep difficulties in an early stage.

背景:婴儿睡眠问题会对家庭产生很大影响。我们调查了父母在婴儿出生前六个月对婴儿睡眠的不满,以及父母在婴儿第二年对睡眠问题的看法。方法:我们使用1471名儿童的Sarphati队列数据。在生命的前六个月,专业人员定期对青少年进行医疗保健访问,记录父母对婴儿睡眠的不满。在婴儿出生的第二年,父母填写了婴儿睡眠简要问卷(BISQ),根据该问卷,我们定义了父母感知的问题睡眠,BISQ定义了问题睡眠。我们使用多变量逻辑回归分析,研究了父母对婴儿前六个月睡眠的不满与两岁之前BISQ得出的结果之间的关系。结果:26%的父母对婴儿出生前6个月的睡眠不满意。在出生的第二年,27%的父母认为孩子的睡眠有问题,9%的婴儿有BISQ定义的问题睡眠。早期父母对婴儿睡眠的不满与父母感知的问题睡眠有关[调整OR 2.50(95%CI 1.91-3.28)],BISQ定义的问题睡眠[调整OR 1.88(1.11-3.17)]。在婴儿期登记父母的不满可能使专业人员能够识别出一组有可能在以后出现睡眠问题的婴儿。我们建议在早期阶段对睡眠困难进行筛查和家长支持。
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引用次数: 1
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Behavioral Sleep Medicine
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