Upper-lower limb and breathing exercise program for improving sleep quality and psychological status in multiple sclerosis: a pilot randomized controlled trial

2021 ◽  
pp. 1-17
Author(s):  
Tanja Grubić Kezele ◽  
Zrinka Trope ◽  
Valentina Ahel ◽  
Natali Ružić ◽  
Hrvoje Omrčen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Psychological Distress ◽  
Sleep Quality ◽  
Lower Limb ◽  
Exercise Program ◽  
Significant Group ◽  
Sleep Dysfunction ◽  
Daytime Sleep ◽  
Time Interaction ◽  
Insomnia Severity

Abstract Purpose: To examine the feasibility and possible effect of an 8-week exercise program on sleep quality, insomnia and psychological distress in individuals with multiple sclerosis (MS). Methods: Twenty-four individuals with MS were recruited into a controlled pre-post feasibility study and divided into 2 groups: exercise (n = 13; Expanded Disability Status Scale (EDSS): 1.0–7.5) and a related control group with no exercise (n = 11; EDSS: 1.0–7.0). The exercise group performed combined upper limb, lower limb and breathing exercises in a controlled group (2d/week, 60 min/session) for 8 weeks. Participants were administered measures to evaluate sleep quality (Pittsburgh Sleep Quality Index, PSQI), insomnia severity (Insomnia Severity Index, ISI), psychological distress (Clinical Outcomes in Routine Evaluation–Outcome Measure, CORE-OM) and additionally impact of fatigue (Modified Fatigue Impact Scale, MFIS) after 8-weeks. Results: Insomnia severity measured with ISI (F(1;22)=5.95, p = 0.023, η p 2 = 0.213, 90% CI = 0.02–0.42) and psychological distress measured with the CORE-OM (F(1;22)=4.82, p = 0.039, η p 2 = 0.179, 90% CI = 0.01–0.40) showed statistically significant group-by-time interaction. Sleep quality measured with the PSQI showed statistically significant group-by-time interaction only in an aspect of daytime sleep dysfunction (F(1;22)=5.33, p = 0.031, η p 2 = 0.195, 90% CI = 0.01–0.40). The fatigue impact measured with the MFIS showed statistically significant group-by-time interaction in physical (F(1;22)=6.80, p = 0.016, η p 2 = 0.236, 90% CI = 0.02–0.44) and cognitive aspects (F(1;22)=9.12, p = 0.006, η p 2 = 0.293, 90% CI = 0.05–0.49), and total score (F(1;22)=11.29, p = 0.003, η p 2 = 0.339, 90% CI = 0.08–0.52). Conclusions: Our 8-week program reduced insomnia severity, psychological distress and some aspects of fatigue (physical; cognitive; total), and improved sleep quality in an aspect of daytime sleep dysfunction in a small group of individuals with MS. Good feasibility and significant positive changes from baseline warrant further exploratory work.

scholarly journals Constructs of poor sleep quality in adolescents: associated factors

2021 ◽  
Vol 37 (8) ◽  
Author(s):  
Lailah Maria Luiza Gonzaga Cavalcanti ◽  
Rodrigo Antunes Lima ◽  
Caroline ramos de Moura Silva ◽  
Mauro Virgilio Gomes de Barros ◽  
Fernanda Cunha Soares
Keyword(s):  
Social Anxiety ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Sleep Latency ◽  
Clinical Depression ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Factors Associated ◽  
Sleep Dysfunction ◽  
Daytime Sleep

This study aims to evaluate factors associated with sleep quality (overall and by domains) in adolescents. A cross-sectional study. This study was conducted with 1,296 first-year high school students from public schools in the Northern Region of the State of Pernambuco, Brazil. Demographic, socioeconomic, and behavioral data were obtained with a questionnaire. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) Body mass index (BMI) was calculated based on the ratio of weight and height squared. Multilevel linear and logistic regressions evaluated factors associated with sleep quality. We observed 53% of adolescents reported poor sleep quality. Adolescents at higher risk of clinical depression were 3.45 times more likely to have poor sleep quality (95%CI: 2.04; 5.81), and each additional unit in the social anxiety score presented 1.03 (95%CI: 1.01; 1.05) higher odds of adolescents having poor sleep quality. Adolescents with depressive symptoms had higher sleep latency, greater sleep disturbance, and greater daytime sleep dysfunction. Social anxiety was associated with sleep latency, sleep disturbance, and daytime sleep dysfunction. Higher risk of clinical depression was associated with all domains related to sleep quality. Negative health perception was associated with sleep disturbance, and physical inactivity was associated with daytime sleep dysfunction. Social anxiety and especially higher risk of clinical depression were determinants of poor sleep quality. Changes in sleep latency, sleep disturbance and daytime sleep dysfunction seems to be relevant to poor sleep quality.

scholarly journals A Pilot Randomized Controlled Trial to Assess Feasibility and Treatment Effect of a Web-Based Delivered Cognitive Behavioral Therapy for Insomnia Program in Individuals with Multiple Sclerosis

2020 ◽  
Author(s):  
Catherine F. Siengsukon ◽  
Eber Silveira Beck ◽  
Michelle Drerup
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Behavioral Therapy ◽  
Sleep Quality ◽  
Treatment Effect ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Chronic Insomnia ◽  
Web Based ◽  
Phone Calls ◽  
Insomnia Severity

Abstract Background: At least 40% of individuals with multiple sclerosis (MS) experience chronic insomnia. Recent studies indicate that cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for insomnia symptoms in individuals with MS. CBT-I delivered using web-based applications has been shown to be effective and may increase access to CBT-I for individuals with MS who have mobility difficulties, fatigue, or live in rural areas. Therefore, the purpose of this study was to assess the feasibility and treatment effect of CBT-I delivered using a web-based application with or without biweekly phone calls to improve sleep quality and fatigue in individuals with MS and symptoms of insomnia. Methods: Forty-one individuals with MS and symptoms of insomnia were randomized into either a group that participated in a 6-week web-based CBT-I program (wCBT-I) or a group that participated in a web-based CBT-I program and received biweekly support phone calls (wCBT-I+PC). Participants completed surveys online to assess insomnia severity, sleep quality, fatigue, sleep self-efficacy, depression, anxiety, and motivation to change their sleep behavior. Results: The overall retention rate was 48.8%, and the adherence rate was 96.34%. Both groups had a significant improvement in insomnia severity, sleep quality, anxiety, and sleep self-efficacy. Only the wCBT-I group had a significant improvement in depression and fatigue. Conclusions: Web-delivered CBT-I is feasible and effective in improving sleep outcomes and concomitant symptoms in individuals with MS. Web-based CBT-I may increase the accessibility of CBT-I treatment and provide a stepped-care approach to treating chronic insomnia in individuals with MS.

311 Can a Brief Sleep Education Training Improve Sleep Quality Among Shipboard Sailors?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A124-A124
Author(s):  
Elizabeth Harrison ◽  
Emily Schmied ◽  
Vanessa Perez ◽  
Suzanne Hurtado ◽  
Gena Glickman
Keyword(s):  
Sleep Quality ◽  
Education Program ◽  
Military Service ◽  
Intervention Group ◽  
Future Research ◽  
Post Intervention ◽  
Significant Group ◽  
Sleep Education ◽  
Time Interaction ◽  
Study Results

Abstract Introduction Sleep disturbance is pervasive among active duty military service members (ADSM) and has serious adverse effects on performance and health. Interventions designed to improve sleep in operational settings are critical to maintain the health and readiness of this at-risk population. The objective of this study is to evaluate a novel sleep education program developed for ADSM. Methods Participants were U.S. Sailors (N=150; 82.7% male, 35.3% <25 years old) assigned to either an intervention (44.7%) or control (55.3%) condition. Intervention participants attended the Circadian, Light, and Sleep Skills program for military personnel (“CLASS-M”). The 30-minute education program was designed to teach ADSM how to maximize sleep quality in operational environments. All participants completed a questionnaire at both baseline and 2 months post-intervention assessing demographics, sleep quality (Pittsburgh Sleep Quality Index; PSQI), sleep-related behaviors, knowledge and motivation. During the follow-up period, participants went underway for 2–8 weeks. Results At baseline, scores were comparable for the PSQI (Control: 8.58±0.35 vs. Intervention: 8.58±0.38), sleep behaviors (12.26±0.35 vs. 11.32±0.38; Range: 0–17), sleep-related knowledge (0.48±0.21 vs. 0.50±0.24; Range: 0–1), and sleep motivation (4.12±0.35 vs. 4.07±0.34; Range: 0–5). A significant group x time interaction indicating benefits for the intervention group were observed on PSQI (F (1,139) = 7.99, p=0.005), knowledge (F (1,139) = 36.54, p<0.001), and behaviors (F (1,139) = 4.75, p=0.03), but not motivation (p>.05). Main effects of group were observed (p<0.05) on PSQI and sleep knowledge only. Conclusion Study results indicate that participation in a brief, educational program prior to deploying may improve ADSM’s sleep quality. Future research is needed to explore mechanisms of intervention effect, and to determine best practices for disseminating such programs force-wide. Support (if any) This work was supported by Defense Health Program 6.7 under work unit no. N1634. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.

scholarly journals Impact of psychosocial intervention on prognosis of cardiac surgery patients

2020 ◽  
Vol 8 (3) ◽  
Author(s):  
Marlyn Thomas Savio ◽  
Meena Hariharan
Keyword(s):  
Psychological Distress ◽  
Psychosocial Intervention ◽  
Artery Bypass ◽  
Psychosocial Interventions ◽  
Significant Group ◽  
Time Interaction ◽  
Standard Medical Treatment ◽  
Positive Direct ◽  
Discharge From Hospital ◽  
The Impact

The study examined the impact of two types of psychosocial intervention on prognosis and psychological distress of patients subjected to Coronary Artery Bypass Grafting (CABG), and investigated whether such impact was direct or mediated. A sample of 300 participants (243 men and 57 women; mean age: 56.1 years) was recruited into three groups. One group received a unique psycho-educational intervention called Programme for Affective and Cognitive Education (PACE), the second group was given a Relaxation intervention (Guided Imagery), and the third group had only standard medical treatment (Control). The PACE and Relaxation interventions were administered to patients alongside standard treatment a day before CABG as well as a day before discharge from hospital. Prognosis was assessed six weeks after discharge. Psychological distress was measured at baseline, week after discharge, and six weeks after discharge. Analyses of variance revealed a significant effect of groups on prognosis and a significant group × time interaction for psychological distress. The highest prognosis after CABG and the lowest psychological distress were found in the PACE group. Path analyses indicated that the PACE and Relaxation interventions negatively impacted psychological distress which in turn predicted higher prognosis. Only the PACE intervention additionally had a positive direct impact on prognosis. Both psychosocial interventions helped enhance the prognosis of patients after CABG primarily by reducing psychological distress. PACE emerged as a more effective intervention than Relaxation.

scholarly journals Short-Term Effect of Aerobic Exercise on Symptoms in Multiple Sclerosis and Chronic Fatigue Syndrome

2014 ◽  
Vol 16 (2) ◽  
pp. 76-82 ◽  
Author(s):  
Yvonne C. Learmonth ◽  
Lorna Paul ◽  
Angus K. McFadyen ◽  
Rebecca Marshall-McKenna ◽  
Paul Mattison ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Aerobic Exercise ◽  
Chronic Fatigue ◽  
Moderate Intensity ◽  
Karnofsky Score ◽  
Significant Group ◽  
Cycling Exercise ◽  
Fatigue Syndrome ◽  
Time Interaction ◽  
Group Time

Background: This pilot study was conducted to determine whether a 15-minute bout of moderate-intensity aerobic cycling exercise would affect symptoms (pain and fatigue) and function (Timed 25-Foot Walk test [T25FW] and Timed Up and Go test [TUG]) in people with multiple sclerosis (MS) or chronic fatigue syndrome (CFS), and to compare these results with those of a healthy control group. Methods: Eight people with MS (Expanded Disability Status Scale score 5–6; Karnofsky score 50–80), eight people with CFS (Karnofsky score 50–80), and eight healthy volunteers participated in the study. Pain and fatigue levels and results of the T25FW and TUG were established at baseline as well as at 30 minutes, 2 hours, and 24 hours following a 15-minute stationary cycling aerobic exercise test. Repeated-measures analysis of variance (ANOVA) and covariance (ANCOVA) were used to analyze the findings over time. Results: At baseline there were statistically significant differences between groups in fatigue (P = .039), T25FW (P = .034), and TUG (P = .010). A significant group/time interaction emerged for fatigue levels (P= .005). We found no significant group/time interaction for pain levels or function. Conclusions: Undertaking 15 minutes of moderate-intensity aerobic cycling exercise had no significant adverse effects on pain or function in people with MS and CFS (with a Karnofsky score of 50–80) within a 24-hour time period. These initial results suggest that people with MS or CFS may undertake 15 minutes of cycling as moderate aerobic exercise with no expected negative impact on pain or function.

scholarly journals Mindfulness-based therapy for insomnia for older adults with sleep difficulties: a randomized clinical trial

2021 ◽  
pp. 1-11
Author(s):  
Francesca Perini ◽  
Kian Foong Wong ◽  
Jia Lin ◽  
Zuriel Hassirim ◽  
Ju Lynn Ong ◽  
...  
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Exercise Program ◽  
Severity Index ◽  
Poor Sleep ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Insomnia Severity

Abstract Objective Poor sleep is a modifiable risk factor for multiple disorders. Frontline treatments (e.g. cognitive-behavioral therapy for insomnia) have limitations, prompting a search for alternative approaches. Here, we compare manualized Mindfulness-Based Therapy for Insomnia (MBTI) with a Sleep Hygiene, Education, and Exercise Program (SHEEP) in improving subjective and objective sleep outcomes in older adults. Methods We conducted a single-site, parallel-arm trial, with blinded assessments collected at baseline, post-intervention and 6-months follow-up. We randomized 127 participants aged 50–80, with a Pittsburgh Sleep Quality Index (PSQI) score ⩾5, to either MBTI (n = 65) or SHEEP (n = 62), both 2 hr weekly group sessions lasting 8 weeks. Primary outcomes included PSQI and Insomnia Severity Index, and actigraphy- and polysomnography-measured sleep onset latency (SOL) and wake after sleep onset (WASO). Results Intention-to-treat analysis showed reductions in insomnia severity in both groups [MBTI: Cohen's effect size d = −1.27, 95% confidence interval (CI) −1.61 to −0.89; SHEEP: d = −0.69, 95% CI −0.96 to −0.43], with significantly greater improvement in MBTI. Sleep quality improved equivalently in both groups (MBTI: d = −1.19; SHEEP: d = −1.02). No significant interaction effects were observed in objective sleep measures. However, only MBTI had reduced WASOactigraphy (MBTI: d = −0.30; SHEEP: d = 0.02), SOLactigraphy (MBTI: d = −0.25; SHEEP: d = −0.09), and WASOPSG (MBTI: d = −0.26; SHEEP (d = −0.18). There was no change in SOLPSG. No participants withdrew because of adverse effects. Conclusions MBTI is effective at improving subjective and objective sleep quality in older adults, and could be a valid alternative for persons who have failed or do not have access to standard frontline therapies.

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