Integrative Sleep Medicine

2021 ◽  
Keyword(s):  
Circadian Rhythm ◽  
Sleep Disorders ◽  
Health Care Providers ◽  
Sleep Disturbances ◽  
Well Being ◽  
Sleep Medicine ◽  
Whole Body ◽  
Care Providers ◽  
Obstructive Sleep ◽  
The Many

Sleep is one of the key underpinnings of human health, yet sleep disturbances and impaired sleep are rampant in modern life. Healthy sleep is a whole-body process impacted by circadian rhythm, daily activities, and emotional well-being, among others. When properly aligned, these work in concert to produce restorative and refreshing sleep. When not in balance, however, sleep disorders result. Yet too often, the approach to treatment of sleep disorders is compartmentalized, failing to recognize all of the complex interactions that are involved. This text offers a comprehensive approach to sleep and sleep disorders by delineating the many factors that interplay into healthy sleep. Health care providers can learn how to better manage their patients with sleep disorders by integrating complementary and conventional approaches. Using an evidence-based approach throughout, this book describes the basics of normal sleep then delves into the foundations of integrative sleep medicine, including the circadian rhythm, mind/body-sleep connection, light, dreaming, the gastrointestinal system, and botanicals/supplements. Specific sleep issues and disorders are then addressed from an integrative perspective, including insomnia, obstructive sleep apnea, sleep related movement disorders, and parasomnias.

scholarly journals 0907 Implementation Of Pathway For Severe Obstructive Sleep Apnea Management In Children

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A345-A345
Author(s):  
S Gehring ◽  
L Auricchio ◽  
S Kidwell ◽  
K Oppy ◽  
S Smallwood ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Health Care Providers ◽  
Therapeutic Option ◽  
Sleep Medicine ◽  
Close Monitoring ◽  
Severe Obstructive Sleep Apnea ◽  
Care Providers ◽  
Oxygen Supplementation ◽  
Obstructive Sleep

Abstract Introduction Obstructive Sleep Apnea (OSA) is associated with neuro-cognitive, cardiovascular and metabolic morbidity in children. Adeno-tonsillectomy is the first line of treatment for OSA with PAP therapy and Oxygen supplementation being alternative therapeutic options in select cases. Severe Obstructive Sleep Apnea is a known risk factor for postoperative respiratory complications after adenotonsillectomy. Therefore, inpatient adenotonsillectomy with close monitoring is recommended for this group of children. Challenges to safe and timely care for this high risk group of children can be overcome with effective coordination of care between different locations and health care providers. Methods All children seeking treatment at Dayton Children’s Division of Sleep Medicine were managed through a pathway developed by a multi-disciplinary team involving sleep medicine, otolaryngology and clinical logistics. Severe OSA was defined as AHI ≥15 events/hr (children <2 year old), AHI ≥15 events/hr with three or more Oxygen desaturations <80% (children ≥2 to <6 years old), AHI ≥ 30 events/hr with three or more Oxygen desaturations <80% (Children ≥6 to 18 years old). Results A total of 78 children were diagnosed with severe OSA in 2019. All children were successfully triaged to appropriate therapeutic option (Adenonotonsillectomy, PAP, O2) within 24 hours of diagnosis. Urgent adenotonsillectomy was performed on the same day in 4 children and within 2 weeks on 12 children. There was no postoperative respiratory complication after urgent adenotonsillectomy. Thirteen children had adenotonsillectomy after 2 weeks. PAP therapy was started in 28 children (34%). Therapy was initiated on the same day in 10 children and the next day on one child. Oxygen supplementation was started in 21 children (27%). Conclusion A multidisciplinary collaborative approach can result in delivery of timely and safe care for severe OSA in children. Support NA

Effect of Sleep Disturbances on Blood Pressure

Hypertension ◽  
2021 ◽  
Author(s):  
Nour Makarem ◽  
Carmela Alcántara ◽  
Natasha Williams ◽  
Natalie A. Bello ◽  
Marwah Abdalla
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Shift Work ◽  
Health Care Providers ◽  
Sleep Disturbances ◽  
Care Providers ◽  
Short Sleep ◽  
Hypertension Risk ◽  
Obstructive Sleep

This review summarizes recent literature addressing the association of short sleep duration, shift work, and obstructive sleep apnea with hypertension risk, blood pressure (BP) levels, and 24-hour ambulatory BP. Observational studies demonstrate that subjectively assessed short sleep increases hypertension risk, though conflicting results are observed in studies of objectively assessed short sleep. Intervention studies demonstrate that mild and severe sleep restriction are associated with higher BP. Rotating and night shift work are associated with hypertension as shift work may exacerbate the detrimental impact of short sleep on BP. Further, studies demonstrate that shift work may increase nighttime BP and reduce BP control in patients with hypertension. Finally, moderate to severe obstructive sleep apnea is associated with hypertension, particularly resistant hypertension. Obstructive sleep apnea is also associated with abnormal 24-hour ambulatory BP profiles, including higher daytime and nighttime BP, nondipping BP, and a higher morning surge. Continuous positive airway pressure treatment may lower BP and improve BP dipping. In conclusion, efforts should be made to educate patients and health care providers about the importance of identifying and treating sleep disturbances for hypertension prevention and management. Empirically supported sleep health interventions represent a critical next step to advance this research area and establish causality.

scholarly journals Risk Perception and Worries among Health Care Workers in the COVID-19 Pandemic: Findings from an Italian Survey

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 535
Author(s):  
Mariangela Valentina Puci ◽  
Guido Nosari ◽  
Federica Loi ◽  
Giulia Virginia Puci ◽  
Cristina Montomoli ◽  
...  
Keyword(s):  
Health Care ◽  
Risk Perception ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
Sleep Disturbances ◽  
Well Being ◽  
Care Providers ◽  
Cross Sectional ◽  
Care Workers

The ongoing pandemic scenario, due to the coronavirus disease 2019 (COVID-19), has had a considerable impact on public health all over the world. Italy was one of the most affected countries, as the first European full-blown outbreak occurred there. The exposure of the Italian health care workers to COVID-19 may be an important risk factor for psychological distress. The aim of this cross-sectional study was to describe worries and risk perception of being infected among Italian Health Care Workers (HCWs) during the first wave of the pandemic. In total, 2078 HCWs participated in a web survey (78.8% were females). The highest percentage of respondents were physicians (40.75%) and nurses (32.15%), followed by medical (18.00%), health care support (4.50%) and administrative (4.60%) staff. In a score range between 0 (not worried) and 4 (very worried), our results showed that participants declared that they were worried about the Coronavirus infection with a median score of 3 (IQR 2-3) and for 59.19% the risk perception of being infected was very high. In addition, HCWs reported they suffered from sleep disturbances (63.43%). From the analysis of the psychological aspect, a possible divergence emerged between the perceived need for psychological support (83.85%) and the relative lack of this service among health care providers emerged (9.38%). Our findings highlight the importance of psychological and psychiatric support services not only during the COVID-19 pandemic, but also in other emerging infectious diseases (EIDs) scenarios. These services may be useful for health authorities and policymakers to ensure the psychological well-being of health care professionals and to promote precautionary behaviors among them.

scholarly journals Orvosok kiégettségének összefüggése az egészséggel, életérzéssel, alváskörülményekkel

2016 ◽  
Vol 157 (16) ◽  
pp. 623-630
Author(s):  
Anikó Németh
Keyword(s):  
Health Care ◽  
Life Satisfaction ◽  
Health Care Providers ◽  
Sleep Disturbances ◽  
Protective Factor ◽  
Well Being ◽  
Care Providers ◽  
Chi Square ◽  
Cross Sectional ◽  
Psychosomatic Symptoms

Introduction: Burnout is common among health care providers and doctors. Aim: The correlations between burnout and health, psychosomatic symptoms, life satisfaction and sleep were investigated. Method: An online quantitative cross-sectional questionnaire was administered to 186 doctors. Burnout was assessed by the means of the 21-item questionnaire of Pines and Aronson (1981). Data were analysed with chi-square probe, Mann-Whitney test, correlational analysis and linear regression. Results: Level of burnout correlated negatively with age (p = 0.040; r = –0.151), years spent in the health care system (p = 0.027; r = –0.162) and positive well-being (p<0.001, r = –0.670), while there was a negative correlation with negative well-being (p<0.001; r = 0.585) and life satisfaction (p<0.001; r = –0.532). Doctors with burnout reported worse health (p<0.001), more frequent psychosomatic symptoms (p<0.001), tumours (p = 0.007), allergies (p = 0.030), psychiatric disorders (p = 0.025) and sleep disturbances. Conclusions: One-third of the doctors were affected by burnout in the present study. Higher age and having more children served as a protective factor. Orv. Hetil., 2016, 157(16), 623–630.

scholarly journals Sleep Disorders During Pregnancy and Postpartum: A Systematic Review

2021 ◽  
Vol 12 (2) ◽  
pp. 81-93
Author(s):  
Zahra Behboodi Moghadam ◽  
Elham Rezaei ◽  
Azam Rahmani
Keyword(s):  
Sleep Disorders ◽  
Sleep Disorder ◽  
Health Care Providers ◽  
English Language ◽  
Care Providers ◽  
Related Factors ◽  
Sleep Related Breathing Disorders ◽  
Obstructive Sleep ◽  
Pregnancy And Postpartum ◽  
Health Related

This study aimed to asses previous research results about bio-physiological alterations during pregnancy and postpartum, and make clear outlook about prevalence and related factors of sleep disorders during pregnancy and postpartum. In this review, the articles that published from 2000 to 2019 were reviewed. Related articles were searched from databases in English language. After evaluation of inclusion and exclusion criteria, articles were chosen and reviewed based on the University of York strategies. Sleep disorders in present study were classified according to the International Classification of Sleep Disorders-3. The search revealed 4449 articles, after evaluating and assessing qualified articles, finally 56 article selected to review. According to the results of this review, The prevalence of sleep disorders was almost 76%–97% in whole pregnancy. The most common sleep disorders included central disorders of hyper somnolence (waking up in the middle of the night, daytime sleepiness, sleeplessness) or insomnia, sleep-related movement disorders (restless legs syndrome), sleep related breathing disorders (obstructive sleep apnea), and parasomnia. In addition, sleep disorder may continue 3–12 months postpartum (33.2%). Sleep disorders induced by physiological processes (fetal movement, excessive weight gain, male sex of the fetus, and multiparty), health-related risks (metabolism disorders, cardiovascular diseases, and mood disorders), and physical or sexual abuse in childhood. In addition, these disorders could have maternal outcomes that can be greatest trigger to postpartum psychiatric disorders and fetal outcomes that have harmful sequences during childhood (sexual, fertility, emotional, and cognitive problems). Health care providers should evaluate the mothers’ sleep quality because sleep disorder leads to harmful consequences in fetuses and children.

Contemporary Concepts in the Diagnosis and Management of Obstructive Sleep Apnea

2021 ◽  
pp. 1-17
Author(s):  
Rajasekar Arumugam
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Wide Spectrum ◽  
Well Being ◽  
Comprehensive Overview ◽  
Sleep Related Breathing Disorders ◽  
Surgical Interventions ◽  
Obstructive Sleep

Optimal sleep is an inseparable component of both physical and psychological well-being. With the widespread increase in the prevalence of sleep disorders, there has been an immense interest among the global researchers in exploring the molecular biology of sleep and innovative modalities for diagnosing and treating sleep disorders. Notably, sleep disorders encompass a wide spectrum of sleep disturbances with potential multisystem complications. Polysomnography is an overnight sleep study that is widely considered as the gold standard objective diagnostic method for diagnosing obstructive sleep apnea (OSA) and provision of continuous positive airway pressure (CPAP), which maintains airway patency during sleep remains the cornerstone therapy for OSA. Although CPAP remains the mainstay of therapy for OSA, various oral appliances and surgical interventions have widely been considered for OSA. This chapter provides a comprehensive overview of contemporary diagnostic and therapeutic approaches available in clinical practice for sleep-related breathing disorders with particular emphasis on OSA.

scholarly journals Sleep disorders and main determinants among hospital staffs in a referral hospital in Iran

2021 ◽  
Vol 6 (1) ◽  
pp. e01-e01
Author(s):  
Zahra Fotokian ◽  
Reza Ebrahimi Rad ◽  
Masume Asghari Valujai
Keyword(s):  
Sleep Quality ◽  
Sleep Disorders ◽  
Health Care Providers ◽  
Work Experience ◽  
Sleep Disturbances ◽  
Hospital Staff ◽  
Care Providers ◽  
Work Shifts ◽  
Main Determinants ◽  
Night Shifts

Introduction: The prevalence rate of sleep disorders among hospital staff is expected to high due to shift work and its related circadian cycle disturbance. Complexity, high prevalence, and health implications related to sleep disorders are of great importance. Objectives: The present study aimed to assess the prevalence and main determinants of sleep disorders among hospital staff. Patients and Methods: This cross-sectional study was performed on 200 head nurses, nurses, midwives, operating room technicians, health care providers, service staffs of all departments, and physicians at Shaheed Rajaei hospital in Tonekabon city, Iran in 2015. The questionnaire which assessed the sleep disturbances was sourced from four scaling systems of Global Sleep Assessment Questionnaire (GSAQ), insomnia severity index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS). Results: According to the assessment by the study adopted questionnaire, 78% (78.6% of males and 77.8% of females) suffered from work-related sleep disorders. Regarding association between work shifts and likelihood of sleep disorders, it was shown a significantly higher rate of sleep disturbances in the staffs with morning and evening shifts (100%), morning and night shifts (100%), or evening and night shifts (100%), simultaneously (P<0.001). Marital status, work experience, and gender could not affect sleep quality. Conclusion: Most of the hospital staff especially practical nurses and nurses suffered from sleep disturbances. Simultaneous and multi-sectional work shifts lead to higher likelihood of sleep problem among staffs.

scholarly journals 407 - The Baycrest Quick-Response Caregiver Tool: The Role for a New Tool for Caregivers of Persons with Dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 123-123
Author(s):  
Ken Schwartz ◽  
Robert Madan ◽  
Anna Berall ◽  
Marsha Natadira ◽  
Anna Santiago
Keyword(s):  
Family Caregivers ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Well Being ◽  
Moderate Degree ◽  
Quick Response ◽  
Care Providers ◽  
High Level ◽  
Person With Dementia ◽  
The Impact

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.

scholarly journals Depression and Suicidality in Gay Men: Implications for Health Care Providers

2017 ◽  
Vol 11 (4) ◽  
pp. 910-919 ◽  
Author(s):  
Carrie Lee ◽  
John L. Oliffe ◽  
Mary T. Kelly ◽  
Olivier Ferlatte
Keyword(s):  
Health Care ◽  
Gay Men ◽  
Health Care Providers ◽  
Help Seeking ◽  
Adult Population ◽  
Well Being ◽  
Sexual Practices ◽  
Care Providers ◽  
Physical And Mental Health ◽  
Prevalence Of Depression

Gay men are a subgroup vulnerable to depression and suicidality. The prevalence of depression among gay men is three times higher than the general adult population. Because depression is a known risk factor for suicide, gay men are also at high risk for suicidality. Despite the high prevalence of depression and suicidality, health researchers and health care providers have tended to focus on sexual health issues, most often human immunodeficiency virus in gay men. Related to this, gay men’s health has often been defined by sexual practices, and poorly understood are the intersections of gay men’s physical and mental health with social determinants of health including ethnicity, locale, education level, and socioeconomic status. In the current article summated is literature addressing risk factors for depression and suicidality among gay men including family acceptance of their sexual identities, social cohesion and belonging, internalized stigma, and victimization. Barriers to gay men’s help seeking are also discussed in detailing how health care providers might advance the well-being of this underserved subgroup by effectively addressing depression and suicidality.

Intimate Partner Violence Screening and Referral Practices in an Outpatient Care Setting

2017 ◽  
Vol 35 (23-24) ◽  
pp. 5877-5888 ◽  
Author(s):  
Cari Jo Clark ◽  
Lynette M. Renner ◽  
Mary E. Logeais
Keyword(s):  
Intimate Partner Violence ◽  
Health Care Providers ◽  
Partner Violence ◽  
Primary Care Clinic ◽  
Well Being ◽  
Intimate Partner ◽  
Care Providers ◽  
Care Clinic ◽  
Barriers And Opportunities ◽  
Academic Primary Care

Health care providers who screen for intimate partner violence (IPV) and counsel patients can reduce victimization and positively impact women’s health and well-being; yet only 2% to 50% of medical professionals report routinely screening female patients. The purpose of this study was to identify current practices, policies, barriers, and opportunities for a coordinated and routinized response to IPV in an outpatient academic primary care clinic. Data were collected through interviews and the Physician Readiness to Manage Intimate Partner Violence questionnaire. Data on IPV screening practices over a 5-month period were also available through the electronic health record. Study participants expressed that there was no uniform method of documenting screening results and great variability in the patient populations and circumstances that prompted screening. Over two thirds of the survey respondents reported either a lack of IPV protocol or a lack of knowledge about one if it existed. Providers and staff who participated believed it was within their scope of work to screen for IPV and recognized IPV as a serious health threat; however, they cited an absence of patient education resources, a lack of staff training and awareness, and no established IPV referral network as barriers to screening for IPV. The results of the pilot are in line with existing research highlighting a general lack of screening, variability in process, and the absence of systems-level policies and protocols and linkages to community resources. Pilot findings have been used to initiate a project which encompasses routinized screening, documentation, and care coordination between providers and community organizations to improve patient well-being.

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