744 Correlates to improvement in sleep in acute mania

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A290-A290
Author(s):  
Raphael Golebiowski ◽  
Meghna Mansukhani ◽  
Bhanu Prakash Kolla
Keyword(s):  
Sleep Duration ◽  
Average Length ◽  
Manic Episode ◽  
Sleep Time ◽  
Substantial Improvement ◽  
Demographic Characteristics ◽  
Mood Stabilizers ◽  
Symptom Improvement ◽  
Hypnotic Medication ◽  
Length Of Hospitalization

Abstract Introduction Sleep disruption and reduced sleep duration are potential triggers and also core symptoms of a manic episode. Our understanding of how sleep duration changes during the course of a manic episode and its potential association with symptom improvement is limited. We examined the natural course of sleep duration and its association with time to discharge and other clinical and demographic factors in patients with mania. Methods This was a retrospective study conducted in patients admitted to an acute care psychiatric unit with a manic episode. Sleep duration was determined based on observer report as logged by nursing staff. Sleep duration at admission and discharge were determined by averaging the total sleep time on day 2/3 of hospitalization and day 3/2 preceding discharge date. We obtained data on possible confounders including antipsychotic (chlorpromazine equivalents), benzodiazepine (diazepam equivalents) and other hypnotic medication doses administered at admission and discharge. We examined the associations between the change in sleep duration from admission to discharge with length of hospitalization and other clinical and demographic characteristics. Results The sample consisted of 35 patients (54.3% male) aged 32 ± 9.96 years with an average length of hospitalization of 20.63 ± 18.62 days. The mean sleep duration on admission was 6.23 ± 1.77 hours and was 7.45 ± 1.49 hours on discharge, with a mean change of 1.23 ± 1.93 hours. The change in sleep duration was positively correlated with length of hospitalization (r=0.42; p=0.01). Other clinical factors including benzodiazepine or antipsychotic dose on admission, age, sex, and use of mood stabilizers were not correlated with the change in sleep duration. Conclusion There was a substantial improvement in the total sleep duration in patients with mania over the course of hospitalization. Overall, the change in sleep duration was only correlated to the length of stay and did not appear to be impacted by other clinical and demographic characteristics. Support (if any):

scholarly journals Analisis Efektivitas Biaya Terapi Kombinasi Mood Stabilizer dan Antipsikotik pada Pasien Gangguan Afektif Bipolar di Rawat Inap RSJ Grhasia Yogyakarta

2021 ◽  
Vol 6 (2) ◽  
pp. 210-216
Author(s):  
Novi Milasari ◽  
Dyah Aryani Perwitasari ◽  
Sawitri Sawitri
Keyword(s):  
Bipolar Disorder ◽  
Direct Medical Cost ◽  
Affective Disorder ◽  
Medical Cost ◽  
Average Length ◽  
Bipolar Affective Disorder ◽  
Mood Stabilizer ◽  
Manic Episode ◽  
Mood Stabilizers ◽  
Antipsychotic Therapy

Bipolar affective disorder is an episodic mental disorder characterized by manic, hypomanic, depressive, and mixed episodes, usually recurring and can last a lifetime. Patients with bipolar disorder have annual medical costs that were four times those of patients without bipolar disorder. The aim of this study is to analyze the cost-effectiveness of combination therapy between mood stabilizers and antipsychotics in patients with the bipolar affective disorder at Grhasia Mental Hospital Yogyakarta. This study is a retrospective with cohort study design using medical records and direct medical cost data during Januari-December 2018 period. Subjects are patients who were diagnosed with bipolar affective disorder manic episode (F31.2) and received a combination of mood stabilizer and antipsychotic therapy. The results were obtained in 46 patients with the affective disorder who met the inclusion criteria. The average direct medical cost of the sodium divalproate group was IDR 6.319.933 per day and in the lithium group was IDR 5.705.953 per day. The average length of stay in the sodium divalproate group was 25,79 days and in the lithium group was 25,75 days (P = 0,991). The Average Cost Effectivity Ratio (ACER) sodium divalproat group is lower than the lithium group (IDR 221.246 per day and IDR 245.434 per day, respectively). The conclusion of this study is that the combination of sodium divalproate-antipsychotic therapy is more cost-effective than lithium-antipsychotic therapy in a patient with bipolar affective disorder manic episode

scholarly journals Sleep maturation influences cognitive development of preterm toddlers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Akiko Ando ◽  
Hidenobu Ohta ◽  
Yuko Yoshimura ◽  
Machiko Nakagawa ◽  
Yoko Asaka ◽  
...  
Keyword(s):  
Cognitive Development ◽  
Sleep Duration ◽  
Sleep Time ◽  
Brain Maturation ◽  
Sleep Diary ◽  
Sleep Regulation ◽  
Wake Time ◽  
Daytime Nap ◽  
Nighttime Sleep ◽  
The Relationship

AbstractOur recent study on full-term toddlers demonstrated that daytime nap properties affect the distribution ratio between nap and nighttime sleep duration in total sleep time but does not affect the overall total amount of daily sleep time. However, there is still no clear scientific consensus as to whether the ratio between naps and nighttime sleep or just daily total sleep duration itself is more important for healthy child development. In the current study, to gain an answer to this question, we examined the relationship between the sleep properties and the cognitive development of toddlers born prematurely using actigraphy and the Kyoto scale of psychological development (KSPD) test. 101 premature toddlers of approximately 1.5 years of age were recruited for the study. Actigraphy units were attached to their waist with an adjustable elastic belt for 7 consecutive days and a child sleep diary was completed by their parents. In the study, we found no significant correlation between either nap or nighttime sleep duration and cognitive development of the preterm toddlers. In contrast, we found that stable daily wake time was significantly associated with better cognitive development, suggesting that sleep regulation may contribute to the brain maturation of preterm toddlers.

Pain relief with elastic therapeutic taping

2021 ◽  
pp. bmjspcare-2021-003381
Author(s):  
Ekta Gupta ◽  
Courtland Lee ◽  
Amy Ng ◽  
Eduardo Bruera
Keyword(s):  
Rating Scale ◽  
Symptom Burden ◽  
Substantial Improvement ◽  
Functional Mobility ◽  
Background Information ◽  
Symptom Improvement ◽  
Plantar Surface ◽  
Pain Rating Scale ◽  
Pain Improvement

Background and purposeChemotherapy-induced peripheral neuropathy (CIPN) occurs in 19%–85% of patients undergoing cancer treatment. Due to the high symptom burden, specifically pain in the soles of feet, we explore the role of elastic therapeutic (ET) taping for treatment of CIPN.Case descriptionWe report two cases of patients with CIPN-induced foot pain while admitted to the hospital. Their background information, including chemotherapy history, treatments trialed and effects of ET on their pain, is discussed. Each patient underwent ET using the epidermis, dermis, fascia technique for CIPN. An occupational therapist applied ET to the plantar surface of both feet to the ankle with 0% stretch on the tape for 24–96 hours. We also showed the effect of symptom improvement in their individualized rehabilitation session following application of ET.OutcomesPain score, verbally documented by 10 point numerical pain rating scale, decreased by >50% in both patients within 24 hours of application. This reflects a substantial improvement in pain with the intervention of ET. This allowed for improved tolerance in engaging in functional mobility, with improvement in distances ambulated.DiscussionET taping of the distal leg and foot showed pain improvement for these two patients. Our findings suggest that a clinical trial aimed at better characterising the role of ET in these patients is justified.

scholarly journals Delayed Lactogenesis II is Associated With Lower Sleep Efficiency and Greater Variation in Nightly Sleep Duration in the Third Trimester

2019 ◽  
Vol 35 (4) ◽  
pp. 713-724
Author(s):  
Theresa Casey ◽  
Hui Sun ◽  
Helen J. Burgess ◽  
Jennifer Crodian ◽  
Shelley Dowden ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Blood Glucose ◽  
Sleep Duration ◽  
Body Mass ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Delayed Onset ◽  
Wrist Actigraphy

Background: Metabolic and hormonal disturbances are associated with sleep disturbances and delayed onset of lactogenesis II. Research aims: The aim of this study was to measure sleep using wrist actigraphy during gestation weeks 22 and 32 to determine if sleep characteristics were associated with blood glucose, body mass index, gestational related disease, delayed onset of lactogenesis II, or work schedule. Methods: Demographic data were collected at study intake from primiparous women who wore a wrist actigraph during gestation weeks 22 ( n = 50) and 32 ( n = 44). Start and end sleep time, total nighttime sleep, sleep efficiency, wake after sleep onset, and sleep fragmentation were measured. Night to night variability was assessed with the root mean square of successive difference. Blood glucose levels, body mass index, and gestational disease data were abstracted from medical charts. Timing of lactogenesis II was determined by survey. Results: Between gestation week 22 and 32, sleep efficiency decreased and fragmentation increased ( p < .05). During gestation week 32, blood glucose was negatively correlated with sleep duration, and positively related to fragmentation ( p < .05). Women who experienced delayed lactogenesis II had lower sleep efficiency and greater fragmentation ( p < .05), and greater night-to-night variability in sleep start and end time, efficiency, and duration during gestation week 32 ( p < .05). Conclusion: Women with better sleep efficiency and more stable nightly sleep time are less likely to experience delayed onset of lactogenesis II. Interventions to improve sleep may improve maternal health and breastfeeding adequacy.

A Sleep Laboratory Evaluation of the Long-Term Efficacy of Zopiclone

1988 ◽  
Vol 33 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Jonathan A.E. Fleming ◽  
Jean Bourgouin ◽  
Peter Hamilton
Keyword(s):  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Laboratory Evaluation ◽  
Sleep Study ◽  
Sleep Studies ◽  
Metallic Taste ◽  
Hypnotic Medication ◽  
Drug Free

Six patients between the ages of 25 and 59, with chronic, primary insomnia received the new, non-benzodiazepine, hypnotic zopiclone continuously for 17 weeks after a drug free interval of 12 nights. To qualify for the study, sleep efficiency, determined by a sleep study on two, consecutive, placebo-controlled nights, had to be less than 75%. Patients evaluated their sleep by questionnaire and had sleep studies completed throughout active treatment. Zopiclone (7.5 mg) increased sleep efficiency by decreasing sleep latency, wakefulness after sleep onset and increasing total sleep time. Sleep architecture was minimally affected by zopiclone treatment; no significant changes in delta or REM sleep were observed. The commonest side effect was a bitter or metallic taste. No significant changes in biological functioning were noted throughout the study period. These findings indicate that zopiclone is a safe and effective hypnotic medication which maintains its effectiveness with protracted use.

scholarly journals Personality Traits and Insomnia Symptoms in Shift Workers

2021 ◽  
Vol 12 ◽  
Author(s):  
Brigitte Holzinger ◽  
Lucille Mayer ◽  
Gerhard Klösch
Keyword(s):  
Sleep Quality ◽  
Personality Traits ◽  
Sleep Duration ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Work Schedule ◽  
Shift Workers ◽  
Time In Bed ◽  
Shift Schedules ◽  
Insomnia Symptoms

The discrepancy between natural sleep-wake rhythm and actual sleep times in shift workers can cause sleep loss and negative daytime consequences. Irregular shift schedules do not follow a fixed structure and change frequently, which makes them particularly harmful and makes affected individuals more susceptible to insomnia. The present study compares insomnia symptoms of non-shift workers, regular shift workers, and irregular shift workers and takes into account the moderating role of the Big Five personality traits and levels of perfectionism. Employees of an Austrian railway company completed an online survey assessing shift schedules, sleep quality and duration, daytime sleepiness, and personality traits. A total of 305 participants, of whom 111 were non-shift workers, 60 regular shift workers, and 134 irregular shift workers, made up the final sample. Irregular shift workers achieved significantly worse scores than one or both of the other groups in time in bed, total sleep time, sleep efficiency, sleep duration, sleep quality, sleep latency, and the number of awakenings. However, the values of the irregular shifts workers are still in the average range and do not indicate clinical insomnia. Participants working regular shifts reported the best sleep quality and longest sleep duration and showed the least nocturnal awakenings, possibly due to higher conscientiousness- and lower neuroticism scores in this group. Agreeableness increased the effect of work schedule on total sleep time while decreasing its effect on the amount of sleep medication taken. Perfectionism increased the effect of work schedule on time in bed and total sleep time. Generalization of results is limited due to the high percentage of males in the sample and using self-report measures only.

scholarly journals O010 The role of dysfunctional beliefs and attitudes about sleep in the association between daily sleep and affect in adolescents and emerging adults

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A5-A5
Author(s):  
E Chachos ◽  
L Shen ◽  
S Maskevich ◽  
Y Yap ◽  
J Stone ◽  
...  
Keyword(s):  
Positive Affect ◽  
Emerging Adults ◽  
Sleep Duration ◽  
Cognitive Vulnerability ◽  
Sleep Time ◽  
Dysfunctional Beliefs ◽  
Low Dimensions ◽  
Modifiable Factor ◽  
Beliefs And Attitudes

Abstract Introduction Sleep and affect are closely related. Late adolescence and emerging adulthood are associated with unique sleep patterns and risk for mood disturbances. This daily study examined whether dysfunctional beliefs and attitudes about sleep (DBAS), a modifiable cognitive vulnerability factor, moderated daily sleep-affect associations. Methods 421 community adolescents (n=205, 54.1% females, M±SDage=16.9±0.87) and emerging adults (n=216, 73.1% females, M±SDage=21.31±1.73) self-reported sleep and affect (adapted 12-item PANAS) and wore an actigraphy device for 7–28 days, providing &gt;5000 daily observations. Linear mixed models tested whether DBAS moderated daily associations between self-reported and actigraphic sleep duration (total sleep time), sleep efficiency, and next-day affect on between and within-person levels. Both valence (positive/negative) and arousal (high/low) dimensions of affect were examined. Covariates included age, gender, ethnicity, day of week, and previous-day affect. Results DBAS significantly moderated associations between average sleep and next-day positive, but not negative, affect. Individuals with higher DBAS had significantly lower high arousal positive affect as average sleep duration (actigraphic: p=.002; self-reported: p=.014) and efficiency (actigraphic: p=.014) decreased. Similar moderation was found for average self-reported sleep duration and low arousal positive affect (p=.032). No significant results emerged on the within-person level. Previous-day affect significantly predicted next-day affect across models and outcomes (all p&lt;.001). Discussion Adolescents and emerging adults with more negative views about sleep may experience dampened positive affect in shorter, or poorer, sleep periods. DBAS may constitute a modifiable factor increasing affective vulnerability on a global but not day-to-day level, and a therapeutic target for sleep-related affect disturbances in youths.

scholarly journals Penerapan Clinical Pathways sebagai Instrumen Pengendalian Biaya Pelayanan : Studi Penelitian Tindakan Penderita BPJS yang Menjalani Operasi Caesar dengan Sistem Pembayaran INA-CBG

2021 ◽  
Vol 4 (2) ◽  
pp. 593-599
Author(s):  
Annisa Fitria ◽  
Andri Sofa Armani ◽  
Thinni Nurul Rochmah ◽  
Bangun Trapsila Purwaka ◽  
Widodo Jatim Pudjirahardjo
Keyword(s):  
Action Research ◽  
Caesarean Section ◽  
Length Of Stay ◽  
Cesarean Section ◽  
Clinical Pathway ◽  
Average Length ◽  
Clinical Pathways ◽  
Hospital Costs ◽  
Average Length Of Stay ◽  
Length Of Hospitalization

This study aims to determine the effect of using clinical pathways to control total actual hospital costs for BPJS patients who undergo a cesarean section. The method used in this research is action research. The results showed that the average actual hospital costs were significantly higher after the application of CP with p = 0.019. The average length of stay, service costs, and hospital costs were significantly lower in the entire CP form group with p = 0.012, p = 0.013, and p = 0.012. In conclusion, this study shows that the application of clinical pathways can reduce the length of hospitalization and actual hospital costs for cesarean section patients and indicates that clinical pathways can make services more efficient.   Keywords: Hospital Costs, Clinical Pathway, Caesarean Section

Abstract 15080: Chronic Mild Sleep Curtailment Increases Markers of Adiposity While Maintained Healthy Sleep Reduces These Measures in Women

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Faris M Zuraikat ◽  
Samantha E Scaccia ◽  
Arindam RoyChoudhury ◽  
Marie-Pierre St-Onge
Keyword(s):  
Skeletal Muscle ◽  
Body Weight ◽  
Sleep Duration ◽  
Cardiovascular Health ◽  
Sleep Time ◽  
Whole Body ◽  
Body Volume ◽  
Insufficient Sleep ◽  
Wrist Actigraphy ◽  
Sleep Condition

Introduction: Over one-third of US adults do not achieve adequate sleep duration of 7 or more h per night. Short sleep is linked to higher odds of cardiometabolic diseases, including obesity. However, whether prolonged insufficient sleep causes increased body weight or adiposity remains unclear. Objective: To compare, in women, changes in body weight and composition in response to prolonged mild sleep restriction (SR) vs maintenance of healthy, habitual sleep (HS). Methods: Women (n=55; age: 35±13 y; BMI: 25.5±3.5 kg/m 2 ) with average adequate sleep duration (total sleep time [TST]=455±23 min) took part in a randomized crossover study with two 6-wk phases: HS and SR. In HS, usual bed and wake times (determined from 2 wk wrist actigraphy and sleep logs) were maintained. In SR, TST was reduced by 1.5 h/night. Sleep was measured continuously and verified weekly for compliance. Body weight and composition were measured at 0 and 6 wk using magnetic resonance imaging (MRI). Linear-mixed models tested interactions of sleep condition with week on outcome measures. Results: Average TST was reduced in SR and unchanged in HS (-87±19 vs -7±26 min, P<0.01). Significant study condition by week interactions were observed for whole-body volume (WBV), waist circumference (WC), and skeletal muscle. In HS, WBV and WC decreased while these measures increased in SR (WBV: -0.47±0.22 vs 0.27±0.05 L, P=0.02; WC: -1.04 ± 0.78 vs 1.16 ± 0.54 cm, P=0.04). Results were similar for skeletal muscle (-0.19 ± 0.07 vs 0.17 ± 0.01 L, P<0.01). A trend for a reduction in weight was observed in HS relative to SR (-0.39±0.31 vs 0.34±0.09 kg, P=0.09). Conclusions: This is the first evidence that prolonged insufficient sleep leads to increased body size in women. Conversely, maintaining adequate sleep may improve body composition. Our data suggest that healthy sleep duration should be a key component of strategies to improve cardiovascular health in women.

Correlation of Thrombocytopenia and Length of Hospitalization in Dengue Child Patient

2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Riyadi Adrizain ◽  
Ananda Hanifah Husna ◽  
Andri Rezano
Keyword(s):  
Average Length ◽  
Rank Correlation ◽  
Secondary Data ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Severe Thrombocytopenia ◽  
Weak Correlation ◽  
Spearman’S Rank Correlation ◽  
Child Patients ◽  
Length Of Hospitalization

Dengue virus infection (DVI) is one of the major health problems that cause 500 thousand patients hospitalized annually. Thrombocytopenia is one of the abnormal hematologic findings that is always found in DVI patients. This study aimed to determine the correlation of thrombocytopenia and length of hospitalization in dengue child patients. This retrospective analysis study used secondary data from seven major hospitals in Bandung with a total sampling method. The inclusion criteria were patients aged 0–18 years old diagnosed with dengue fever (DF), or dengue hemorrhagic fever (DHF), or dengue shock syndrome (DSS) who was admitted from January to December 2015 and excluded when there was comorbid as well as incomplete data. The correlation was analyzed by Spearman’s rank correlation test. There were 2,025 samples from a total of 5,712 DVI cases during 2015. Among those who admitted, most of the patients experienced severe thrombocytopenia (40%) with the average length of hospitalization was 4.84 days. This result was not much different from the patients with moderate (38.1%) and mild (21.9%) thrombocytopenia who were treated for an average of 4.13 days and 4.08 days, respectively. The analysis of correlation obtained a significant relationship between thrombocytopenia and length of hospitalization despite showing a weak correlation (r=0.231; p=0.001). In conclusion, there is a weak correlation between thrombocytopenia and length of hospitalization among dengue child patients. KORELASI TROMBOSITOPENIA DENGAN LAMA RAWAT INAP PADA PASIEN ANAK TERINFEKSI VIRUS DENGUEInfeksi virus dengue (IVD) merupakan salah satu masalah kesehatan utama yang menyebabkan 500 ribu pasien dirawat di rumah sakit setiap tahun. Trombositopenia adalah salah satu temuan abnormal hematologi yang selalu ditemukan pada pasien IVD. Penelitian ini bertujuan mengetahui korelasi trombositopenia dengan lama rawat inap pada pasien anak terinfeksi virus dengue. Penelitian analitik retrospektif ini menggunakan data sekunder tujuh rumah sakit besar di Kota Bandung dengan metode total sampling. Kriteria inklusi adalah pasien anak usia 0–18 tahun yang didiagnosis demam dengue (DD), atau demam berdarah dengue (DBD), atau sindrom syok dengue (SSD) yang dirawat dari bulan Januari hingga Desember 2015. Kriteria eksklusi meliputi komorbiditas dan data rekam medis yang tidak lengkap. Analisis dilakukan dengan uji korelasi rank Spearman. Terdapat 2.025 sampel dari total 5.712 kasus DVI selama tahun 2015. Di antara yang dirawat, sebagian besar pasien mengalami trombositopenia berat (40%) dengan lama rawat inap rerata 4,84 hari. Hasil ini tidak jauh berbeda dengan pasien dengan trombositopenia sedang (38,1%) dan ringan (21,9%) yang dirawat selama rerata 4,13 hari dan 4,08 hari masing-masing. Analisis korelasi diperoleh hubungan yang bermakna antara trombositopenia dan lama rawat inap meskipun dengan nilai korelasi lemah (r=0,231; p=0,001). Simpulan, terdapat korelasi lemah antara trombositopenia dan lama rawat inap pada pasien anak terinfeksi virus dengue.

Sign in / Sign up

Export Citation Format

Share Document