0466 Evolution of Nonrestorative Sleep and Its Interactions with Insomnia Symptoms in a Longitudinal Survey of the American Population

Abstract Introduction Nonrestorative sleep (NRS) is one of the sleep disturbances that is under-appreciated. Some studies have set its prevalence at around 10% of the general population but definitions are heterogenous. Despite its frequency, studies that paid attention to that symptom are disparate and have often taken many routes. Our aim is to examine its prevalence, its incidence and its predictive factors. Methods The initial study was carried with 15,929 individuals from 15 US States. The longitudinal study was carried on in eight of these states. A total of 12,218 subjects were interviewed by phone during the first wave (W1) and 10,930 at the second wave (W2) three years apart. The analyses were carried on the subjects who participated in both interviews (N=10,930). NRS was assessed using a series of five questions. The global score determined the presence/absence of NRS. Results A total of 14.7% (CI95%: 14%-15.4%) reported NRS at W1. At follow-up, 13.1% (CI95%: 12.5%-13.7%) reported NRS. The incidence per year was 2.3%. NRS was chronic in 28.9% of cases. NRS occurred alone (i.e. without any other insomnia symptoms) in 5% of the sample at W1 and 3.6% at W2. 22.2% of those with NRS alone at W1 reported other insomnia symptoms at W2. Sleep duration was at least 6h30 in 81.6% of NRS alone cases at W1 and 76.5% at W2. Daytime repercussions were reported by 66.2% of NRS alone at W1 and 52.8% at W2. NRS alone (RR: 2.4) or in combination with insomnia symptoms (RR: 3.4) was one of the strongest predictors for developing a Major Depressive Disorder at W2. Conclusion NRS is a sleep disturbance that has some unique features that distinguish it from insomnia symptoms. Nonetheless, it can have a profound impact on daily life and can lead to further difficulties in other areas if not addressed properly. Support Arrillaga Foundation

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Residual Sleep Disturbances in Patients Remitted From Major Depressive Disorder: A 4-Year Naturalistic Follow-up Study

SLEEP ◽

10.5665/sleep.2008 ◽

2012 ◽

Vol 35 (8) ◽

pp. 1153-1161 ◽

Cited By ~ 40

Author(s):

Shirley X. Li ◽

Siu P. Lam ◽

Joey W. Y. Chan ◽

Mandy W. M. Yu ◽

Yun-Kwok Wing

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Sleep Disturbances ◽

Major Depressive ◽

Follow Up Study

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1016 Multiple Sleep Disturbances and Hypertension Risk Among White, Black, and Hispanic/Latina Women

SLEEP ◽

10.1093/sleep/zsaa056.1012 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A386-A386

Author(s):

J Lunyera ◽

Y M Park ◽

J B Ward ◽

S A Gaston ◽

N A Bhavsar ◽

...

Keyword(s):

Sleep Disturbances ◽

Menopausal Status ◽

Ethnic Disparities ◽

The United States ◽

Poor Sleep ◽

Hypertension Risk ◽

Increased Risk ◽

Race Ethnicity ◽

Insomnia Symptoms

Abstract Introduction Poor sleep has been associated with a higher risk of hypertension, but few prospective studies have included multiple sleep dimensions and few have investigated age differences or racial/ethnic disparities in this relationship among pre- and post-menopausal women. Methods To investigate the association between sleep disturbances and hypertension risk, we used data from women in the United States enrolled in the Sister Study who were aged 35 to 74 years at baseline (2003 to 2009) and did not have hypertension at enrollment. Participants were followed through September 2017. Sleep duration, inconsistent weekly sleep patterns, sleep debt, frequent napping, and insomnia symptoms were reported at baseline. During follow-up, participants reported whether they were diagnosed by a healthcare provider with hypertension. Adjusting for sociodemographic characteristics, health behaviors, and health conditions including diabetes and depression, we used Cox Proportional Hazards regression to estimate hypertension risk among women with vs. without unfavorable sleep characteristics. We also investigated potential modification by race/ethnicity, age,and menopausal status. Results Of 33,175 women without hypertension at baseline (mean age ± standard deviation: 53.9 ±8.8 years; 88.8% White, 6.4% Black, and 4.9% Hispanic/Latina), 19.9% developed hypertension over a median follow-up of 9.2 years (interquartile range: 7.6 to 10.9). After adjustment, insomnia symptoms (hazard ratio[HR]=1.08 (95% Confidence Interval [CI]: 1.03-1.15)) and insomnia symptoms combined with short sleep (HR=1.14 (95% CI: 1.06-1.23)) were associated with incident hypertension. While similar across race/ethnicity, these associations were stronger in younger (age <54 vs. ≥54 years) and premenopausal vs. postmenopausal women (p-values for interaction <0.05). Conclusion Sleep disturbances related to insomnia were associated with an increased risk of hypertension, especially among younger and premenopausal women. Support This work was funded by the Intramural Program at the National Institutes of Health (NIH), National Institute of Environmental Health Sciences (NIEHS, Z1AES103325-01 [CLJ] and Z01 ES044005 [DPS]).

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Prospective study of insomnia and incident asthma in adults: the HUNT study

European Respiratory Journal ◽

10.1183/13993003.01327-2016 ◽

2017 ◽

Vol 49 (2) ◽

pp. 1601327 ◽

Cited By ~ 6

Author(s):

Ben Brumpton ◽

Xiao-Mei Mai ◽

Arnulf Langhammer ◽

Lars Erik Laugsand ◽

Imre Janszky ◽

...

Keyword(s):

Population Based ◽

Chronic Insomnia ◽

Odds Ratios ◽

Sleep Maintenance ◽

Nonrestorative Sleep ◽

Increased Risk ◽

Hunt Study ◽

Incident Asthma ◽

Insomnia Symptoms

Insomnia is highly prevalent among asthmatics; however, few studies have investigated insomnia symptoms and asthma development. We aimed to investigate the association between insomnia and the risk of incident asthma in a population-based cohort.Among 17 927 participants free from asthma at baseline we calculated odds ratios and 95% confidence intervals for the risk of incident asthma among those with insomnia compared to those without. Participants reported sleep initiation problems, sleep maintenance problems and nonrestorative sleep. Chronic insomnia was defined as those reporting one or more insomnia symptom at baseline and 10 years earlier. Incident asthma was defined by questions on asthma at baseline and follow-up (average 11 years).The prevalence of sleep initiation problems, sleep maintenance problems and nonrestorative sleep were 1%, 1% and 5%, respectively. The multi-adjusted odds ratios were 1.18 (95% CI 0.97–1.44), 1.30 (95% CI 1.03–1.64) and 1.70 (95% CI 1.37–2.11) for people with one, two and three insomnia symptoms, respectively, compared with people without symptoms (p<0.01 for trend). The risk of developing asthma in those with chronic insomnia was three times higher (adjusted OR 3.16, 95% CI 1.37–6.40) than those without.Insomnia symptoms were associated with increased risk of incident asthma in this study.

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SARS-CoV-2 transmissions in students and teachers: seroprevalence follow-up study in a German secondary school in November and December 2020

BMJ Paediatrics Open ◽

10.1136/bmjpo-2021-001036 ◽

2021 ◽

Vol 5 (1) ◽

pp. e001036

Author(s):

Jakob Peter Armann ◽

Carolin Kirsten ◽

Lukas Galow ◽

Elisabeth Kahre ◽

Luise Haag ◽

...

Keyword(s):

Secondary School ◽

Initial Study ◽

Educational Settings ◽

Igg Antibody ◽

Registration Number ◽

Study Population ◽

Serial Blood Sampling ◽

Low Prevalence ◽

Second Wave

ObjectiveTo quantify the number of undetected SARS-CoV-2 infections in educational settings.DesignSerial SARS-CoV-2 seroprevalence study before and during the second wave of the COVID-19 pandemic.SettingSecondary school in Dresden, Germany.ParticipantsGrade 8–12 students and their teachers were invited to participate in serial blood sampling and SARS-CoV-2 IgG antibody assessment.Main outcome measureSeroprevalence of SARS-CoV-2 antibodies in study population.Results247 students and 55 teachers participated in the initial study visit and 197 students and 40 teachers completed follow-up. Seroprevalence increased from 1.7% (0.3–3.3) to 6.8% (3.8–10.1) during the study period mirroring the increase of officially reported SARS-CoV-2 infections during this time. The ratio of undetected to detected SARS-CoV-2 infections ranged from 0.25 to 0.33.ConclusionsWe could not find evidence of relevant silent, asymptomatic spread of SARS-CoV-2 in schools neither in a low prevalence setting nor during the second wave of the pandemic, making it unlikely that educational settings play a crucial role in driving the SARS-CoV-2 pandemic.Trial registration numberDRKS00022455.

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Ongoing or re-emerging subjective insomnia symptoms after full/partial remission or recovery of major depressive disorder mainly with the selective serotonin reuptake inhibitors and risk of relapse or recurrence: A 52-week follow-up study

Journal of Affective Disorders ◽

10.1016/j.jad.2011.05.056 ◽

2011 ◽

Vol 134 (1-3) ◽

pp. 257-265 ◽

Cited By ~ 24

Author(s):

Mustafa Gulec ◽

Yavuz Selvi ◽

Murat Boysan ◽

Adem Aydin ◽

Lutfullah Besiroglu ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Serotonin Reuptake ◽

Partial Remission ◽

Selective Serotonin Reuptake Inhibitors ◽

Major Depressive ◽

Follow Up Study ◽

Insomnia Symptoms ◽

Risk Of Relapse

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Sleeping under the waves: a longitudinal study across the contagion peaks of COVID-19 pandemic in Italy

10.1101/2021.01.17.21249947 ◽

2021 ◽

Author(s):

Federico Salfi ◽

Aurora D’Atri ◽

Daniela Tempesta ◽

Michele Ferrara

Keyword(s):

Risk Factors ◽

High Risk ◽

Sleep Quality ◽

Sleep Disturbances ◽

Large Scale ◽

Well Being ◽

Poor Sleep ◽

Second Wave ◽

Insomnia Symptoms ◽

Risk Categories

AbstractAfter the March–April 2020 COVID-19 outbreak, a second contagion wave afflicted Europe in autumn. This study aimed to evaluate sleep health/patterns of Italians during this further challenging situation.A total of 2013 Italians longitudinally participated in a web-based survey during the two contagion peaks of the COVID-19 outbreak. We investigated the risk factors for sleep disturbances during the second wave, and we compared sleep quality and psychological well-being between the two assessments (March–April and November–December 2020). Female gender, low education, evening chronotype, being at high-risk for COVID-19 infection, reporting negative social or economic impact, and evening smartphone overuse predicted a higher risk of poor sleep and insomnia symptoms during the second wave. Advanced age, living with high-risk subjects for COVID-19 infection, and having a relative/friend infected with COVID-19 before the prior two weeks were risk categories for poor sleep quality. Living with children, having contracted COVID-19 before the prior two weeks, being pessimistic on the vaccine, and working in healthcare were risk factors for insomnia symptoms. The follow-up assessment highlighted reduced insomnia symptoms and anxiety. Nevertheless, we showed reduced sleep duration, higher daytime dysfunction and sleep medication use, and advanced sleep phase, confirming the alarming prevalence of poor sleepers (∼60%) and severe depression (∼20%) in a context of increased perceived stress.This study demonstrated a persistent impact of the COVID-19 pandemic on sleep and mental health. Large-scale interventions to counteract the chronicity and exacerbation of sleep and psychological disturbances are necessary, especially for the risk categories.

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Entrepreneurial Mindset

Conference Proceedings of the Academy for Design Innovation Management ◽

10.33114/adim.2019.03.312 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Nusa FAIN ◽

Michel ROD ◽

Erik BOHEMIA

Keyword(s):

Influencing Factors ◽

Future Study ◽

Engineering Students ◽

Initial Study ◽

Longitudinal Survey ◽

Teaching Approaches ◽

Approaches To Teaching ◽

Design Students ◽

Commerce Students ◽

Case Based

This paper explores the influence of teaching approaches on entrepreneurial mindset of commerce, design and engineering students across 3 universities. The research presented in this paper is an initial study within a larger project looking into building ‘entrepreneurial mindsets’ of students, and how this might be influenced by their disciplinary studies. The longitudinal survey will measure the entrepreneurial mindset of students at the start of a course and at the end. Three different approaches to teaching the courses were employed – lecture and case based, blended online and class based and fully project-based course. The entrepreneurial mindset growth was surprisingly strongest within the engineering cohort, but was closely followed by the commerce students, whereas the design students were slightly more conservative in their assessments. Future study will focus on establishing what other influencing factors beyond the teaching approaches may relate to the observed change.

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Effects and utility of an online forward triage tool during the SARS-CoV-2 pandemic: patient perspectives (Preprint)

10.2196/preprints.26553 ◽

2020 ◽

Author(s):

Janet Michel

Keyword(s):

Decision Making ◽

Health System ◽

Information Source ◽

Patient Perspectives ◽

User Friendliness ◽

Fear And Anxiety ◽

Mail Address ◽

Second Wave ◽

E Mail

BACKGROUND Background: Online forward triage tools (OFTT) or symptom checkers are being widely used during this COVID-19 pandemic. The effects and utility of such tools however, have not been widely assessed. OBJECTIVE Objective: To assess the effects (quantitatively) and the utility (qualitatively) of a COVID-19 OFTT in a pandemic context, exploring patient perspectives as well as eliciting recommendations for tool improvement. METHODS Methods: We employed a mixed-method sequential explanatory study design. Quantitative data of all users of the OFTT between March 2nd, 2020 and May 12th, 2020 were collected. A follow-up survey of people who consented to participation was conducted. Secondly, qualitative data was collected through key informant interviews (n=19) to explain the quantitative findings, as well as explore tool utility, user experience and elicit recommendations. RESULTS Results: An estimate of the effects, (quantitatively) and the utility (qualitatively) of a COVID-19 OFTT in a pandemic context, and recommendations for tool improvement. In the study period, 6,272 users consulted our OFTT; 560 participants consented to a follow-up survey and provided a valid e-mail address. 176 (31.4%) participants returned a complete follow-up questionnaire. 85.2% followed the recommendations given. 41.5% reported that their fear was allayed after using tool and 41.1% would have contacted the GP or visited a hospital had the tool not existed. Qualitatively, seven overarching themes emerged namely i) accessibility of tool, ii) user-friendliness of tool, iii) utility of tool as an information source, iv) utility of tool in allaying fear and anxiety, v) utility of tool in decision making (test or not to test), vi) utility of tool in reducing the potential for onward transmissions (preventing cross infection) and vii) utility of tool in reducing health system burden. CONCLUSIONS Conclusion: Our findings demonstrated that a COVID-19 OFTT does not only reduce the health system burden, but can also serve as an information source, reduce anxiety and fear, reduce cross infections and facilitate decision making (to test or not to test). Further studies are needed to assess the transferability of these COVID-19 OFTT findings to other contexts as the second wave sweeps across Europe.

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FACTORS ASSOCIATED WITH PARTIAL REMISSION IN DEPRESSION

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465899273031 ◽

1999 ◽

Vol 27 (3) ◽

pp. 215-222 ◽

Cited By ~ 1

Author(s):

Peter L. Cornwall ◽

Jan Scott

Keyword(s):

Partial Remission ◽

Self Esteem ◽

Significant Loss ◽

Clinical Implications ◽

Major Depressive ◽

Factors Associated ◽

Full Remission ◽

Loss Of Self ◽

Observer Ratings

We report a subgroup analysis of 24 out of 42 subjects who were hospitalized for non-psychotic major depressive disorder and who agreed to participate in interviews at admission and 2 years afterwards (as reported previously by Domken, Scott, & Kelly, 1994; Bothwell & Scott, 1997). At 2 year follow-up, these 24 subjects were categorized according to established criteria into clients meeting criteria for full remission (FR; n=9) and those meeting criteria for partial remission (PR; n=15). The most striking findings were that, over time, PR subjects showed significant loss of self-esteem and showed greater divergence in self-ratings compared to observer ratings of their depressive symptoms, whilst the same ratings in the FR group changed in the opposite direction. We suggest that the persistence of depression in PR subjects may provide evidence to support Teasdale’s (1988) hypothesis that some individuals “get depressed about being depressed”. The research and clinical implications of the results are noted.

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