scholarly journals 707 Association of Self-Reported Anxiety, Informational Support, and Sleep in Sleep Medicine Patients during the COVID-19 Pandemic

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A276-A276
Author(s):  
Emily Arentson-Lantz ◽  
Ahmad Debian ◽  
Manasa Kokanda ◽  
Fidaa Shaib ◽  
Sara Nowakowski
Keyword(s):  
Sleep Disturbance ◽  
Sleep Medicine ◽  
Sunlight Exposure ◽  
Stressful Events ◽  
Accurate Information ◽  
Health Administration ◽  
Informational Support ◽  
Caffeine Consumption ◽  
Medicine Clinic ◽  
Insomnia Severity

Abstract Introduction Stressful events, such as the COVID-19 pandemic, can have a detrimental effect on sleep. It is important for practitioners to understand how their patients are affected by events to optimize their care. In this study we evaluated associations of anxiety and daily habits with self-reported sleep disturbance among sleep medicine clinic patients. Methods Between June-November 2020, 81 sleep medicine clinic patients (54.8±15.9 y, 44% male, 69% Caucasian) completed an online survey that included PROMIS measures (Sleep Disturbance, Sleep-Related Impairments, Informational Support, Emotional Distress-Anxiety) and Insomnia Severity Index (ISI). Patients were asked about changes in their daily habits (sunlight exposure, caffeine consumption). During the 5-month survey completion time window, the weekly average of positive COVID-19 cases in the Houston area was 2,914. Stepwise linear regression was performed using SAS to determine if self-reported anxiety and informational support predicted PROMIS Sleep Disturbance, PROMIS Sleep-Related Impairments and ISI. Results Anxiety had a significant effect on Sleep Disturbance (0.43 ± 0.11, p=0.0001), Sleep-Related Impairments (0.53 ± 0.12, p=0.0001) and ISI (0.28 ± 0.08, p=0.0004). Informational support had a significant inverse effect on Sleep Disturbance (-0.29 ± 0.10, p=0.0063), Sleep-Related Impairments (-0.26 ± 0.11, p=0.01) and ISI (-0.31 ± 0.08, p<0.0001) measures. Decreased sunlight exposure during the pandemic contributed to a significant increase in Sleep Disturbance scores (0.06 ± 0.03, p=0.045). Increased caffeine consumption during the pandemic had significant increase in ISI scores (16.3 ± 7.59, p=0.035). Conclusion Higher levels of anxiety and lower levels of informational support predicted greater insomnia severity, sleep disturbance, and sleep-related impairments in sleep medicine clinic patients during the COVID-19 pandemic. Decreased sunlight exposure and increased caffeine consumption also predicted greater sleep disturbance and insomnia severity, respectively. Addressing anxiety symptoms and access to accurate information during the pandemic is advised when treating sleep medicine clinic patients. Support (if any) This work is supported by National Institutes of Health (NIH) Grant # R01NR018342 (PI: Nowakowski) and by the Department of Veteran Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety (CIN 13–413).

scholarly journals 711 Changes in Healthcare Visits and Sleep Medication Use in Sleep Medicine Patients during the COVID-19 Pandemic

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A277-A278
Author(s):  
Ahmad Debian ◽  
Emily Arentson-Lantz ◽  
Manasa Kokanda ◽  
Fidaa Shaib ◽  
Sara Nowakowski
Keyword(s):  
Health Care ◽  
Sleep Disturbance ◽  
Online Survey ◽  
Medication Use ◽  
Severity Index ◽  
Sleep Medicine ◽  
Veterans Health ◽  
Health Administration ◽  
Sleep Medication ◽  
Insomnia Severity

Abstract Introduction Patients may be experiencing increased stress and sleep disturbance due to healthcare changes during the COVID-19 pandemic. Healthcare changes may include telemedicine visits, delayed or canceled appointments and sleep studies. The purpose of this study was to assess the association between changes in healthcare and sleep medication use on sleep disturbance and insomnia severity. Methods Between June-November 2020, 81 sleep medicine clinic patients (54.8 ± 15.9 y, 44% male, 69% Caucasian) completed an online survey that included questions about COVID-19 (tested for coronavirus, test results, willingness to be vaccinated for COVID-19, changes in health care visits and sleep medications during the pandemic), PROMIS measures (Sleep Disturbance, Sleep-Related Impairments), and Insomnia Severity Index (ISI). Stepwise linear regression was performed using SAS to determine if changes in healthcare and sleep medications predicted poorer sleep. Results Among participants, 32% were tested for coronavirus, out of those 8% tested positive for COVID-19. 74% were willing to get vaccinated and 65% were willing to get their children vaccinated. 35% changed their healthcare office appointments to telephone visits, 54% changed to video visits; whereas 26% cancelled and 32% rescheduled their healthcare appointments. Changes in health care visits during the pandemic had a significant increase on ISI score (3.98 ± 1.66, p=0.019). Changes in sleep medication during the pandemic had significant effect on Sleep Disturbance (7.15 ± 2.51, p=0.005), Sleep-Related Impairments (8.69 ± 2.68, p=0.001) and ISI (6.04 ± 1.66, p=0.001) measures. Conclusion Sleep medicine patients who reported changes in sleep medication reported higher insomnia severity, sleep disturbance, and sleep-related impairments. Patients who reported changes in healthcare visits during the pandemic reported higher insomnia severity. Assessing sleep medication changes and preference for healthcare visit format is advised when treating sleep medicine patients during the pandemic. Support (if any) This work is supported by National Institutes of Health (NIH) Grant # R01NR018342 (PI: Nowakowski) and by the Department of Veteran Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety (CIN 13–413).

scholarly journals 710 Association of Social Isolation, Perceived Stress, and CPAP Use in Sleep Medicine Patients during the COVID-19 Pandemic

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A277-A277
Author(s):  
Sara Nowakowski ◽  
Emily Arentson-Lantz ◽  
Ahmad Debian ◽  
Manasa Kokanda ◽  
Fidaa Shaib
Keyword(s):  
Social Isolation ◽  
Perceived Stress ◽  
Online Survey ◽  
Clinical Care ◽  
Sleep Medicine ◽  
Stepwise Logistic Regression ◽  
Veterans Health ◽  
Health Administration ◽  
Medicine Clinic ◽  
Department Of Veteran Affairs

Abstract Introduction Due to the COVID-19 pandemic, many individuals are likely experiencing increased stress and social isolation. This study aimed to examine the effect of perceived stress and social isolation on self-reported continuous positive airway pressure (CPAP) use and treatment adherence among sleep medicine clinic patients during the pandemic. Methods Between June-November 2020, 81 sleep medicine clinic patients (54.8±15.9y, 44% male, 69% Caucasian) completed an online survey that included self-reported changes in CPAP use and using CPAP as advised; and PROMIS Social Isolation and Perceived Stress Scale (PSS). CPAP measures were categorized based on reported changes during the pandemic. Stepwise logistic regression was performed using SAS to determine if Social Isolation and PSS predicted change in CPAP measures. Results Among participants, 53% reported using CPAP. Out of those, 61% reported change, 16% reported no change, and 23% reported they do not know if there is a change in using CPAP as advised during the pandemic. Social Isolation predicted an increase in odds of CPAP use by a factor of 1.15 (p=0.024). PSS predicted a decrease in odds of using CPAP therapy as advised by a factor of 0.86 (p=0.049). Conclusion Increases in perceived stress predicted lower odds of utilizing CPAP as advised. Increases in self-reported social isolation predicted greater odds of CPAP use in sleep medicine clinic patients during the COVID-19 pandemic. Addressing stressors/coping and social isolation/support as part of routine clinical care in sleep medicine clinic patients is advised. Support (if any) This work is supported by National Institutes of Health Grant # R01NR018342 (PI: Nowakowski) and by the Department of Veteran Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety (CIN 13–413).

Using the STOPBANG questionnaire and other pre-test probability tools to predict OSA in younger, thinner patients referred to a sleep medicine clinic

2017 ◽  
Vol 21 (4) ◽  
pp. 869-876 ◽  
Author(s):  
Michael J. McMahon ◽  
Karen L. Sheikh ◽  
Teotimo F. Andrada ◽  
Aaron B. Holley
Keyword(s):  
Sleep Medicine ◽  
Medicine Clinic ◽  
Test Probability

581 Impact of Weight on Insomnia Severity, Sleep Quality, and Insomnia Improvement in a Clinically Referred Pediatric Sample

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A229-A229
Author(s):  
Kara Duraccio ◽  
Danielle Graef ◽  
Dean Beebe ◽  
Kelly Byars
Keyword(s):  
Sleep Quality ◽  
Weight Status ◽  
Sleep Hygiene ◽  
Sleep Medicine ◽  
Initial Evaluation ◽  
Clinically Referred ◽  
Adolescent Sleep ◽  
The Impact ◽  
Insomnia Severity ◽  
Over Time

Abstract Introduction Children with overweight/obesity are more likely to have shortened sleep, though little is known about the role of weight status in insomnia severity, sleep quality, and sleep hygiene in clinically referred youth. Methods A total of 1133 children (43.7% female) presented to a Pediatric Behavioral Sleep Medicine Clinic for insomnia. At the initial evaluation, caregivers of children ages 2–10.9 years (N = 744) completed the Pediatric Insomnia Severity Scale (PISI) and the Children’s Sleep Habits Questionnaire (CSHQ); adolescents ages 11–18 years (N = 389) completed the PISI, the Adolescent Sleep Hygiene Scale (ASHS), and the Adolescent Sleep Wake Scale (ASWS). The PISI was completed during at least one Pediatric Behavioral Sleep Medicine visit subsequent to evaluation and initiation of treatment. Patient height and weight, objectively measured within 3 months of the initial evaluation, was used to determine sex-adjusted body mass index z-scores (BMIz). Hierarchal linear regression models were used to determine the impact of BMIz on baseline PISI insomnia severity scores, and CSHQ, ASHS, and ASWS total scores, after covarying for income. Repeated-measures general linear modeling was used to determine whether weight status moderated improvement in insomnia severity over time, covarying for income. Results For children (ages 2–10.9), weight was not associated with baseline insomnia severity (p=.62) or predictive of insomnia improvement following behavioral sleep medicine intervention (p=.71), though higher weight predicted poorer parent-reported sleep quality (p=.006). For adolescents (ages 11–18), higher weight was predictive of higher baseline insomnia severity (p=.026), though did not predict insomnia improvement over time (p = .86); higher weight was also predictive of poorer sleep hygiene (p<.001) and worse sleep quality (p=.03). Conclusion Initial insomnia severity and subjective sleep quality may be worse for youth of higher weight, particularly for adolescents; these findings increase our understanding of how and when overweight/obesity negatively impacts sleep. Fortunately, youth with higher weight respond equally well to pediatric behavioral sleep medicine interventions as their lower-weight peers, suggesting that these interventions need not be modified based on patient weight. Support (if any) Cincinnati Children’s Hospital Medical Center Division of Behavioral Medicine and Clinical Psychology’s Research Funds

scholarly journals A Pragmatic Pilot Study Of Cognitive Behavioural Therapy For Insomnia Among People Living With HIV

2021 ◽  
Author(s):  
Tyler Gordon Tulloch
Keyword(s):  
Pilot Study ◽  
Sleep Disturbance ◽  
Cognitive Behavioural Therapy ◽  
Thematic Analysis ◽  
Behavioural Therapy ◽  
Future Research ◽  
People Living With Hiv ◽  
Cognitive Behavioural ◽  
Living With Hiv ◽  
Insomnia Severity

The prevalence of insomnia among people living with HIV (PWH) is considerably higher than in the general population. Cognitive, behavioural, and biopsychosocial explanations for this elevated prevalence have been proposed, but there is a lack of consensus in the literature. Sleep disturbance is associated with disrupted immune functioning at the cellular level and increased risk of contracting infectious diseases; therefore, insomnia may be particularly problematic for PWH. Cognitive behavioural therapy for insomnia (CBT-I) is the first-line treatment for insomnia, and is effective at treating insomnia among individuals with comorbid medical disorders. Surprisingly, no study has examined its efficacy among PWH. This pragmatic pilot study examined features of insomnia among 48 PWH and was the first study to examine sleep disturbance among PWH using American Academy of Sleep Medicine guidelines for evaluating chronic insomnia. On average, insomnia chronicity was 8.2 years and was of moderate severity. Psychiatric comorbidity was common, as were comorbid sleep disorders. Insomnia severity was associated with psychosocial variables including sleep effort, self-efficacy for sleep, depression, anxiety, stress, and social functioning-related quality of life. This study was also the first to examine safety, feasibility, acceptability, and intervention effects of CBT-I. These were examined among a subsample of 10 PWH using single-case interrupted time-series design. Thematic analysis was used to explore participant perceptions of CBT-I. Large effect sizes were observed for improvement in insomnia severity, sleep efficiency, and total wake time. Reliable and clinically significant reduction in insomnia severity was observed for all but one participant, and half met criteria for insomnia remission. Overall, CBT-I was an efficacious treatment for insomnia, and participant feedback was consistent with quantitative results. Participants viewed CBT-I as a safe and acceptable treatment for insomnia. Participant feedback identified preexisting needs, positive impacts and challenges of CBT-I, perceived mechanisms of change, and suggested modifications to tailor CBT-I for PWH. Given this preliminary support for the efficacy of CBT-I among PWH, future research should seek to demonstrate generalizability of these effects. Partnering with HIV community organizations may be important next step in conducting future research and increasing accessibility of CBT-I to PWH. Keywords: HIV, insomnia, cognitive behavioural therapy, pilot study, pragmatic trial, thematic analysis

Sleep Medicine and Psychiatry

2020 ◽  
pp. 3-11
Author(s):  
Piyush Das ◽  
Anoop Narahari ◽  
Amit Chopra
Keyword(s):  
Psychiatric Disorder ◽  
Sleep Disturbance ◽  
Scientific Evidence ◽  
Sleep Medicine ◽  
Psychiatric Practice ◽  
Psychiatric Disturbances ◽  
Bidirectional Relationship ◽  
Growing Body

Psychiatry and sleep medicine are two peas in a pod perhaps due to shared underlying brain mechanisms. Traditionally, in psychiatric practice, sleep disturbance has been considered to be symptom of the psychiatric disorder. However, growing body of scientific evidence indicates that there is a bidirectional relationship between sleep and psychiatric disturbances. This chapter, as a prelude to the book, highlights landmark developments in the field of sleep medicine and its integration with psychiatry in the last century and opens the window to understanding the crucial relationship between these two specialties.

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