scholarly journals Sleep Phenotypes of Caregivers for Persons Living With Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 379-380
Author(s):  
Glenna Brewster ◽  
Christina Pierpaoli ◽  
Fayron Epps ◽  
Kalisha Bonds Johnson ◽  
Kate Yeager
Keyword(s):  
Randomized Controlled Trial ◽  
Sleep Disturbance ◽  
Thematic Analysis ◽  
Qualitative Data ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Poor Sleep ◽  
Sleep Patterns ◽  
Structured Interviews ◽  
Randomized Controlled

Abstract Sleep disturbance is prevalent among caregivers of people living with dementia. Gaps exist regarding when caregivers begin to experience sleep disturbance along their caregiving trajectory. This study aimed to identify and describe phenotypes of current caregivers’ sleep patterns before and during caregiving and describe caregivers’ perception of their current sleep quality relative to their pre-caregiving sleep. We conducted semi-structured interviews with 19 caregivers participating in a larger, randomized controlled trial. Interviews were about caregivers’ sleep patterns and were conducted after caregivers completed the first 6 months of the study. Interviews were audio-recorded using a videoconferencing platform and ranged from 20 to 45 minutes. We conducted thematic analysis of the interview transcripts. Four distinct caregiver-sleep phenotypes emerged from the qualitative data: Changed and Dissatisfied, Changed and Satisfied, Unchanged and Dissatisfied, and Unchanged and Satisfied. Caregivers whose sleep was categorized as Changed experienced a difference in their pre-caregiving sleep, usually from good to poor sleep. Caregivers whose sleep was Unchanged had poor sleep pre-caregiving and continued to have poor sleep during caregiving. Caregivers also reported being Satisfied or Dissatisfied with their current sleep pattern, defined in terms of daily distress and impairment. These 4 subtypes highlight the heterogeneity of caregivers’ sleep experiences and debut a useful clinical framework with which to identify, categorize, and target caregivers at risk for sleep disturbance. Identifying caregivers’ sleep phenotypes will enable healthcare providers to determine caregivers’ needs and readiness for interventions.

scholarly journals Testing a mindfulness meditation mobile app for the treatment of sleep-related symptoms in adults with sleep disturbance: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244717
Author(s):  
Jennifer L. Huberty ◽  
Jeni Green ◽  
Megan E. Puzia ◽  
Linda Larkey ◽  
Breanne Laird ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Sleep Disturbance ◽  
Daytime Sleepiness ◽  
Controlled Trial ◽  
Intervention Group ◽  
Mobile App ◽  
Wait List ◽  
Wait List Control ◽  
Randomized Controlled ◽  
Sleep Arousal

The objective of this randomized controlled trial was to test whether a commercially available, mindfulness meditation mobile app, (i.e., Calm app), was effective in reducing fatigue (primary outcome), pre-sleep arousal, and daytime sleepiness (secondary outcomes) in adults with sleep disturbance (Insomnia Severity Index Score >10) as compared to a wait-list control group. Associations between the use of the Calm app (i.e., adherence to the intervention) and changes in sleep quality was also explored in the intervention group only. Adults with sleep disturbance were recruited (N = 640). Eligible and consenting participants (N = 263) were randomly assigned to the intervention (n = 124) or a wait-list control (n = 139) group. Intervention participants were asked to meditate using the Calm app ≥10 minutes/day for eight weeks. Fatigue, daytime sleepiness, and pre-sleep arousal were assessed at baseline, mid- (4-weeks) and post-intervention (8-weeks) in both groups, whereas sleep quality was evaluated only in the intervention group. Findings from intent-to-treat analyses suggest the use of the Calm app for eight weeks significantly decreased daytime fatigue (p = .018) as well as daytime sleepiness (p = .003) and cognitive (p = .005) and somatic (p < .001) pre-sleep arousal as compared to the wait-list control group. Within the intervention group, use of the Calm app was associated with improvements in sleep quality (p < .001). This randomized controlled trial demonstrates that the Calm app can be used to treat fatigue, daytime sleepiness, and pre-sleep arousal in adults with sleep disturbance. Given that the Calm app is affordable and widely accessible, these data have implications for community level dissemination of a mobile app to improve sleep-related symptoms associated with sleep disturbance. Trial registration: ClinicalTrials.gov NCT04045275.

scholarly journals Polysomnographic Predictors of Treatment Response to Cognitive Behavioral Therapy for Insomnia in Participants With Co-morbid Insomnia and Sleep Apnea: Secondary Analysis of a Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Alexander Sweetman ◽  
Bastien Lechat ◽  
Peter G. Catcheside ◽  
Simon Smith ◽  
Nick A. Antic ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Sleep Apnea ◽  
Cognitive Behavioral Therapy ◽  
Sleep Disturbance ◽  
Treatment Response ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Randomized Controlled ◽  
Pre Treatment

ObjectiveCo-morbid insomnia and sleep apnea (COMISA) is a common and debilitating condition that is more difficult to treat compared to insomnia or sleep apnea-alone. Emerging evidence suggests that cognitive behavioral therapy for insomnia (CBTi) is effective in patients with COMISA, however, those with more severe sleep apnea and evidence of greater objective sleep disturbance may be less responsive to CBTi. Polysomnographic sleep study data has been used to predict treatment response to CBTi in patients with insomnia-alone, but not in patients with COMISA. We used randomized controlled trial data to investigate polysomnographic predictors of insomnia improvement following CBTi, versus control in participants with COMISA.MethodsOne hundred and forty five participants with insomnia (ICSD-3) and sleep apnea [apnea-hypopnea index (AHI) ≥ 15] were randomized to CBTi (n = 72) or no-treatment control (n = 73). Mixed models were used to investigate the effect of pre-treatment AHI, sleep duration, and other traditional (AASM sleep macrostructure), and novel [quantitative electroencephalography (qEEG)] polysomnographic predictors of between-group changes in Insomnia Severity Index (ISI) scores from pre-treatment to post-treatment.ResultsCompared to control, CBTi was associated with greater ISI improvement among participants with; higher AHI (interaction p = 0.011), less wake after sleep onset (interaction p = 0.045), and less N3 sleep (interaction p = 0.005). No quantitative electroencephalographic, or other traditional polysomnographic variables predicted between-group ISI change (all p &gt; 0.09).DiscussionAmong participants with COMISA, higher OSA severity predicted a greater treatment-response to CBTi, versus control. People with COMISA should be treated with CBTi, which is effective even in the presence of severe OSA and objective sleep disturbance.

scholarly journals 1032 Auricular Point Acupressure for Sleep Disturbance in Women With Breast Cancer: A Pilot Randomized Controlled Trial

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A392-A392
Author(s):  
Y Wang ◽  
J Wu ◽  
J Li ◽  
J Zhou
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Sleep Disturbance ◽  
Controlled Trial ◽  
Control Group ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Auricular Point ◽  
Pilot Randomized Controlled Trial

Abstract Introduction Sleep disturbance is reported in up to 60% of cancer patient. In traditional Chinese medicine, evidence suggests that auricular point acupressure (APA) improves sleep. However, little is known about APA’s effect on sleep disturbance in patients with breast cancer (BC). We tested the preliminary efficacy of APA on sleep in BC women undergoing chemotherapy. Methods A pilot randomized controlled trial was conducted in 41 BC patients (mean age=50±14) with self-reported poor sleep [Pittsburgh Sleep Quality Index (PSQI)≥7]. Participants were randomly assigned to an APA group (n=22) and a control group (n=19). All patients received sleep hygiene education. Additionally, for the APA group, magnetic pellets were attached to selected auricular points once a week for 3 weeks at the clinic, and the participants were instructed to self-press the pellets 4 times a day. Sleep were objectively measured by Actiwatch Spectrum and subjectively using PSQI at baseline and post-intervention. Paired t-tests and analyses of covariance using the variable baseline values were used to examine changes in sleep parameters. Results Twenty-one participants from the APA and sixteen from the control groups completed the study. Within the APA group, PSQI [mean difference (MD)=3.85, 95% Confidence Interval (C)=3.12~4.60] and sleep onset latency (MD=18.02, 95%CI=5.96~30.09) were significantly decreased, and the sleep duration (MD=-0.53, 95%CI=-0.99~-2.35) and sleep efficacy (MD=-5.00, 95%CI=-8.72~-1.28) were significant increased at post-intervention. Compared to the control group, participants in the APA group had significantly lower PSQI (F=30.77, p&lt;0.001) and greater sleep efficacy (F=5.25, p=0.028) at post-intervention. Conclusion APA may be an inexpensive and effective approach to improve sleep in patients with BC. More rigorous research with larger samples is needed to further test the efficacy of APA on promoting sleep in BC patients. Support None

Randomized controlled trial of a simplified adductor canal block performed for analgesia following total knee arthroplasty

2019 ◽  
Vol 44 (3) ◽  
pp. 348-353 ◽  
Author(s):  
Jeffrey D Swenson ◽  
Jacob E Pollard ◽  
Christopher L Peters ◽  
Mike B Anderson ◽  
Nathan L Pace
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Adductor Canal Block ◽  
Adductor Canal ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Wide Range ◽  
Registration Number ◽  
Total Knee

Background and objectivesThe objective of the study was to determine if injection of local anesthetic into the vastus medialis and sartorius muscles adjacent to the adductor canal produces sensory changes comparable with adductor canal block (ACB). This could result in a technically easier and potentially safer alternative to ACB.MethodsIn this randomized controlled trial, patients received either ACB (n=20) or a simplified adductor canal (SAC) block performed using a new fenestrated nerve block needle (n=20). The time to perform each block as well as the number of attempts to position the needle were evaluated. A non-inferiority test was used to compare pain scores and opioid requirements for the ACB and the SAC block.ResultsThe SAC block was performed more rapidly, with fewer needle passes, and had a higher success rate than the ACB. Three block failures and two vessel punctures were observed in the ACB group, while none of these events occurred in SAC block patients. Analgesia and opioid consumption for patients treated with the SAC block were not inferior to ACB.ConclusionThe SAC block is technically easier to perform and potentially safer than ACB. This procedure can be performed using easily visible ultrasound landmarks and has the potential for use among a wide range of healthcare providers.Trial registration numberNCT02786888.

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