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"sleep medicine"
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A Four-Session Sleep Intervention Program Improves Sleep for Older Adult Day Health Care Participants: Results of a Randomized Controlled Trial
Abstract
Study Objective
To test the effectiveness of a 4-week behavioral Sleep Intervention Program (SIP: sleep compression, modified stimulus control, and sleep hygiene) compared to a 4-week information-only control (IC) among older adults attending a VA Adult Day Health Care (ADHC) program in a double-blind, randomized, clinical trial.
Methods
Forty-two individuals (mean age: 77 years, 93% male) enrolled in a VA ADHC program were randomized to receive SIP or IC. All completed in-person sleep and health assessments at baseline, post-treatment and 4-months follow-up that included 3 days/nights of wrist actigraphy, the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). Mixed repeated measures analysis was used to compare sleep outcomes at post-treatment and 4-months follow-up, with baseline values as covariates.
Results
SIP participants (n = 21) showed significant improvement on actigraphy sleep efficiency (p = .007), number of nighttime awakenings (p = .016), and minutes awake at night (p = .001) at post-treatment, compared to IC participants (n = 21). Benefits were slightly attenuated but remained significant at 4-month follow-up (all p’s < .05). There were no differences in total sleep time between groups. There was significant improvement on PSQI factor 3 (daily disturbances) at 4-month follow-up (p = .016), but no differences were observed between SIP and IC on other PSQI components or ISI scores at post-treatment or 4-month follow-up.
Conclusions
A short behavioral sleep intervention may have important benefits in improving objectively measured sleep in older adults participating in ADHC. Future studies are needed to study implementation of this intervention into routine clinical care within ADHC.
Journal Article
Mapping the darkness : the visionary scientists who unlocked the mysteries of sleep
Journalist Kenneth Miller weaves science with history to tell the story of four outsider academics who carried the study of sleep from fringe discipline to mainstream obsession. In the 1920s Nathaniel Kleitman founded the world's first dedicated sleep lab, with breakthrough experiments in 1938. Kleitman mentored Eugene Aserinsky who discovered REM sleep, and William Dement, who became known as the father of sleep medicine. Dement, in turn, mentored Mary Carskadon, who uncovered an epidemic of sleep deprivation among teenagers.-- Adapted from book jacket flap.
Book
Randomized, Prospective Study of the Impact of a Sleep Health Program on Firefighter Injury and Disability
Abstract
Study Objectives:
Firefighters’ schedules include extended shifts and long work weeks which cause sleep deficiency and circadian rhythm disruption. Many firefighters also suffer from undiagnosed sleep disorders, exacerbating fatigue. We tested the hypothesis that a workplace-based Sleep Health Program (SHP) incorporating sleep health education and sleep disorders screening would improve firefighter health and safety compared to standard practice.
Design:
Prospective station-level randomized, field-based intervention.
Setting:
US fire department.
Participants:
1189 firefighters.
Interventions:
Sleep health education, questionnaire-based sleep disorders screening, and sleep clinic referrals for respondents who screened positive for a sleep disorder.
Measurements and Results:
Firefighters were randomized by station. Using departmental records, in an intention-to-treat analysis, firefighters assigned to intervention stations which participated in education sessions and had the opportunity to complete sleep disorders screening reported 46% fewer disability days than those assigned to control stations (1.4 ± 5.9 vs. 2.6 ± 8.5 days/firefighter, respectively; p = .003). There were no significant differences in departmental injury or motor vehicle crash rates between the groups. In post hoc analysis accounting for intervention exposure, firefighters who attended education sessions were 24% less likely to file at least one injury report during the study than those who did not attend, regardless of randomization (OR [95% CI] 0.76 [0.60, 0.98]; χ2 = 4.56; p = .033). There were no significant changes pre- versus post-study in self-reported sleep or sleepiness in those who participated in the intervention.
Conclusions:
A firefighter workplace-based SHP providing sleep health education and sleep disorders screening opportunity can reduce injuries and work loss due to disability in firefighters.
Journal Article
Change your schedule, change your life : how to harness the power of clock genes to lose weight, optimize your workout, and finally get a good night's sleep
\"An eye-opening handbook from a leading Ayurvedic physician that blends cutting-edge science on \"clock genes\" with ancient eastern wisdom to help us understand how to harness the power of chronobiology to effortlessly lose weight, sleep better, exercise stronger, reduce stress, and boost our well being. \"It's not you, it's your schedule.\" Does it sound like magic? It's not. We've all heard of circadian rhythms--those biological processes that give us jet lag and make us night owls or early birds. But few of us know just how profoundly these diurnal patterns affect our overall health. Bad habits like skipping meals, squeezing in workouts when it's convenient, working late into the night to maximize productivity and then trying to \"catch up\" on sleep during the weekend disrupt our natural cycles. A growing body of research on chronobiology reveals just how sensitive the human body is to these rhythms all the way down to the genetic level. Our \"clock genes\" control more than we realize, and small changes can make the difference between battling our bodies, and effortlessly managing weight, sleep, stress, inflammation, and more. Marrying ancient Ayurvedic wisdom with the latest scientific research, Dr. Suhas Kshirsagar's holistic step-by-step 30-day plan gives you the tools--and the schedule--you need to transform your life. With diagnostic quizzes to determine your specific mind-body type, you will learn to adapt you schedule for effortless wellness for life\"-- Provided by publisher.
Book
Management of obstructive sleep apnoea in a primary care vs sleep unit setting: a randomised controlled trial
ObjectiveTo assess the effectiveness and cost-effectiveness of primary care (PC) and sleep unit (SU) models for the management of subjects with suspected obstructive sleep apnoea (OSA).MethodsMulticentre, open-label, two-arm, parallel-group, non-inferiority randomised controlled trial. A total of 302 subjects with suspected OSA and/or resistant hypertension were consecutively enrolled, 149 were treated at 11 PC units and 153 patients at a SU. The primary outcomes were a 6-month change in the Epworth Sleepiness Scale (ESS) score and Health Utilities Index (HUI). The non-inferiority margin for the ESS score was −2.0.ResultsA total of 80.2% and 70.6% of the PC and SU patients were diagnosed with OSA, respectively, and 59.3% and 60.4% of those were treated with CPAP in PC and SU units, respectively. The Apnoea–Hypopnoea Index was similar between the groups (PC vs SU (median (IQR); 23.1 (26.8) events/h vs 21.8 (35.2) events/h), and the baseline ESS score was higher in the PC than in the SU group (10.3 (6.6) vs 9 (7.2)). After 6 months, the ESS score of the PC group decreased from a mean of 10.1 to 7.6 (−2.49; 95% CI −3.3 to −1.69), and that of the SU group decreased from 8.85 to 5.73 (−3.11; 95% CI −3.94 to 2.28). The adjusted difference between groups for the mean change in the ESS score was −1.25 (one-sided 95% CI −1.88; p=0.025), supporting the non-inferiority of PC management. We did not observe differences in the HUI between groups. The cost analysis showed a median savings of €558.14/patient for the PC setting compared with the SU setting.ConclusionsAmong patients with suspected OSA, the PC model did not result in a worse ESS score or HUI than the specialist model and generated savings in terms of management cost. Therefore, the PC model was more cost-efficient than the SU model.Trial registrationResults; >>NCT02234765, Clinical Trials.gov.
Journal Article
Undergraduate dental sleep medicine teaching at German university dental schools - a questionnaire-based survey
Purpose
Diagnosing and treating obstructive sleep apnea (OSA) requires fundamental understanding of sleep medicine, including training and clinical experience. So far, dental sleep medicine (DSM) has not yet become a mandatory part of dental education in Germany. This questionnaire-based survey for both lecturers and students aimed to evaluate DSM education among undergraduate students.
Methods
A structured questionnaire was sent to the managing directors and student councils of all 30 German university dental schools. The questionnaire contained 13 questions on teaching quantity and content, lecturers’ knowledge, and future interest in DSM. For each university dental school, only one questionnaire should be completed by the student council and the managing director. A scoring system assessed lecturers’ knowledge based on clinical experience and qualifications. Descriptive data and correlation coefficients were calculated (
P
< 0.05).
Results
The responses of 24 lecturers (80%) and 28 students (93.3%) could be evaluated. DSM was reported to be included in the curriculum by 14 lecturers (58.3%) and 4 students (14.3%). Mean teaching hours per semester were 1.4 ± 1.4 h (lecturers) and 0.2 ± 0.6 h (students) accordingly. Greater knowledge of lecturers in DSM was positively correlated with the inclusion of DSM in the curriculum (
P
= 0.022) and with the number of teaching hours per semester (
P
= 0.001).
Conclusion
Postgraduate education and incorporating DSM knowledge into undergraduate education (“Teach the Teacher”) seems to play a key role in fundamentally training future dentists in this field.
Journal Article
SleepOMICS: How Big Data Can Revolutionize Sleep Science
Sleep disorders have reached epidemic proportions worldwide, affecting the youth as well as the elderly, crossing the entire lifespan in both developed and developing countries. “Real-life” behavioral (sensor-based), molecular, digital, and epidemiological big data represent a source of an impressive wealth of information that can be exploited in order to advance the field of sleep research. It can be anticipated that big data will have a profound impact, potentially enabling the dissection of differences and oscillations in sleep dynamics and architecture at the individual level (“sleepOMICS”), thus paving the way for a targeted, “one-size-does-not-fit-all” management of sleep disorders (“precision sleep medicine”).
Journal Article