Why cardiac nurses need good sleep health literacy

2021 ◽  
pp. 1-7
Author(s):  
Michael Le Grande ◽  
Debra Kerr ◽  
Alison Beauchamp ◽  
Alun Jackson
Keyword(s):  
Sleep Disorders ◽  
Psychological Health ◽  
Sleep Apnoea ◽  
Poor Sleep ◽  
Health It ◽  
Sleep Health ◽  
Holistic View ◽  
Obstructive Sleep ◽  
Patient Health ◽  
Good Sleep

A holistic view of patient health recognises sleep as an important pillar of wellbeing. There is increasing evidence that sleep disorders are associated with both the cause and consequences of a patient's cardiac conditions. It follows, therefore, that recognition and treatment of these disorders may be of particular importance in the secondary prevention of coronary heart disease. The purpose of this commentary is to outline how two major sleep disorders (obstructive sleep apnoea and insomnia) are associated with poor sleep quality, psychological health and cardiac health. It is hoped that health professionals, including cardiac nurses, can obtain a basic understanding of these associations so that they may better explain the importance of screening and treatment for sleep disorders to their patients.

Insomnia and Clinical Sleep Disturbance in Later Life

2019 ◽  
Author(s):  
Simon Smith
Keyword(s):  
Psychological Health ◽  
Sleep Disturbances ◽  
Behavioral Therapy ◽  
Later Life ◽  
Poor Sleep ◽  
Sleep Health ◽  
Reasonable Expectation ◽  
Key Factor ◽  
Good Sleep

Sleep health is understood as a key factor in lifelong health and for social participation, function, and satisfaction. In later life, insomnia and other sleep disturbances are common. Insomnia is experienced as poor, disrupted, or insufficient sleep associated with significant daytime impairments including increased fatigue or reduced energy, impaired cognitive function, and increased mood disturbance. Poor sleep is associated with negative outcomes across a range of dimensions that impair quality of life, increases risk for other diseases, and may interact negatively with the progression and treatment of other disorders. Evidence for effective psychological interventions to improve sleep in later life, specifically cognitive behavioral therapy for insomnia, is robust and well described. Good sleep should be understood as a substrate for psychological health and a reasonable expectation in later life.

scholarly journals Sleep disorders in psychiatry

2018 ◽  
Vol 24 (4) ◽  
pp. 273-283 ◽  
Author(s):  
Hugh Selsick ◽  
David O'Regan
Keyword(s):  
Mental Health ◽  
Sleep Disorders ◽  
Sleep Medicine ◽  
Sleep Apnoea ◽  
Learning Objectives ◽  
List Type ◽  
Obstructive Sleep ◽  
Psychiatric Conditions ◽  
Respiratory Conditions ◽  
Broad Understanding

SUMMARYSleep medicine is a truly multidisciplinary field that covers psychiatric, neurological and respiratory conditions. As the field has developed it has become increasingly clear that there is a great deal of overlap between sleep and psychiatric disorders and it is therefore essential for psychiatrists to have some knowledge of sleep medicine. Even those disorders, such as obstructive sleep apnoea, that may seem to be outside the remit of psychiatry can have complex and important interactions with psychiatric conditions. In this article we give a brief overview of the range of sleep disorders a psychiatrist might encounter, how they are recognised, investigated and treated, and how they relate to psychiatric conditions.LEARNING OBJECTIVES•Be aware of the range of sleep disorders that might be encountered in psychiatric practice•Understand how these sleep disorders affect mental health•Have a broad understanding of how these disorders are investigated and treatedDECLARATION OF INTERESTH.S. has accepted speaker fees from Janssen Pharmaceuticals.

Abstract P544: Sleep Apnea Severity is More Strongly Associated With Cardiovascular Health Than a Composite Measure of Sleep Health in Adults With Sleep Apnea and Diabetes

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Christopher C Imes ◽  
Zhadyra Bizhanova ◽  
Christopher E Kline ◽  
Susan M Sereika ◽  
Eileen Chasens
Keyword(s):  
Physical Activity ◽  
Sleep Apnea ◽  
Sleep Diary ◽  
Time Range ◽  
Apnea Hypopnea Index ◽  
Sleep Health ◽  
Health Measures ◽  
Lipid Panel ◽  
Obstructive Sleep ◽  
Good Sleep

Introduction: Sleep health is multi-dimensional. The RSATED Sleep Health composite score, hereafter referred to as RSATED, includes regularity, satisfaction, alertness, timing, efficiency, and duration. RSATED has been associated with cardiovascular (CV) health in a nationally representative sample. However, the association between RSATED and CV health in adults with obstructive sleep apnea (OSA) and type 2 diabetes mellitus (T2DM) have not been examined. Purpose: This secondary analysis examined the associations between RSATED and CV health measures including body mass index (BMI), lipid levels, and physical activity. Methods: We used baseline data from the Diabetes Sleep Treatment Trial, a randomized controlled trial that examined if adults with co-existing OSA and T2DM treated with continuous positive airway pressure had better glycemic control compared to participants that received a non-therapeutic treatment. Data collected included questionnaires, anthropometric measurements, a lipid panel, objective physical activity (PA) data (BodyMedia), apnea-hypopnea index (AHI; ApneaLink Pro), and a modified Consensus Sleep Diary. RSATED was calculated using up to 7 days of sleep data and Epworth Sleepiness Scale (ESS). Individual components were given a score of 0 or 1 with 1 representing “good” sleep. “Good” sleep was defined as: >80% of awakenings occurring during the same time range (regularity); mean sleep quality of “good” or “very good” (satisfaction); ESS total score ≤10 (alertness); >80% of sleep midpoint occurring between 2-4 am (timing); sleep efficiency ≥85% (efficiency); and mean sleep duration of 7-9 hrs/night (duration). The total score could range from 0-6; higher scores represented better sleep. The associations between RSATED and CV health measures were examined using linear regression models. All models were adjusted for AHI, marital status, race, age, and education. Results: A total of 350 individuals underwent screening. Of the 253 participants with complete data, the majority were female (52.2%) and white (54.2%) with a mean (± SD) age of 56.6 ± 10.5 yrs, BMI of 34.2 ± 7.1, and AHI of 14.1 ± 15.1. Mean RSATED was 2.8 ± 1.2 (range 0-5). The RSATED score was not associated with any of the CV health measures. However, there was a trend for significance for better sleep health to be associated with greater vigorous PA (b = 0.46, p = .08). Whereas, greater AHI was associated with higher BMI, higher total cholesterol, greater sedentary time, and less moderate- and vigorous-intensity PA (p-values from .05 to <.0001). Conclusions: Among adults with co-existing OSA and T2DM, AHI was more strongly associated with measures of CV health than RSATED. While sleep health is essential, the underlying impact of OSA on CV health and its treatment should remain a priority. Future studies should continue to examine the associations between sleep health and other measures of health and wellness.

Sleep Epidemiology

2019 ◽  
pp. 11-46
Author(s):  
Susan Redline ◽  
Brian Redline ◽  
Peter James
Keyword(s):  
Sleep Quality ◽  
Quality Index ◽  
Self Report ◽  
Poor Sleep ◽  
Sleep Health ◽  
Sugar Sweetened Beverage ◽  
Social Jetlag ◽  
Obstructive Sleep ◽  
Quality Sleep ◽  
Different Dimensions

This chapter is a primer on sleep epidemiology—the methods of assessment on how sleep is measured (e.g., self-report [such as the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale] vs. with use of objective tools such as actigraphy); validity of sleep measurements; the different dimensions of sleep health and disorders that are of interest (e.g., sleep duration, sleep quality, sleep fragmentation, insomnia, obstructive sleep apnea, social jetlag, snoring, narcolepsy, etc.); general sleep biology and physiology; and why sleep matters (i.e., the epidemiologic consequences of poor sleep health, e.g., connection to other health behaviors and health outcomes such as drug use; sexual risk behaviors; depression; dietary behaviors such as sugar-sweetened beverage consumption; cardiometabolic diseases like obesity, diabetes, and hypertension; and cancer outcomes such as breast cancer).

scholarly journals Three Decades of Progress in Sleep Disorders and Sleep Health for Women

2020 ◽  
Vol 4 ◽  
pp. 247028972094187
Author(s):  
Jennifer L. Marsella ◽  
Katherine M. Sharkey
Keyword(s):  
Sleep Disorders ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Future Research ◽  
Sex And Gender ◽  
Sleep Health ◽  
Sleep Behavior ◽  
Obstructive Sleep ◽  
And Gender ◽  
The Impact

Over the past 3 decades, significant strides have been made in the field of sleep medicine for women. The impact of sex and gender on sleep health and sleep disorders received little attention in the early 1990s, but driven by policies ensuring inclusion of women in medical research, more recent studies have identified sex differences in sleep and investigated gender differences in sleep disorders. Nevertheless, disparities remain: diagnosis of sleep disorders, such as obstructive sleep apnea, narcolepsy, and rapid eye movement (REM) sleep behavior disorder are often delayed and underdiagnosed in women. Future research should continue to examine how biological sex and identity across the gender spectrum influence sleep health and sleep disorders, allowing for more personalized health care for all patients.

scholarly journals Modafinil in the treatment of selected sleep disorders

2021 ◽  
Vol 21 (3) ◽  
pp. 213-218
Author(s):  
Wacław Dyrda ◽  
Daria Smułek ◽  
Adam Wichniak ◽  
Keyword(s):  
Quality Of Life ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Shift Work ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Shift Work Sleep Disorder ◽  
Obstructive Sleep ◽  
Idiopathic Hypersomnia

Until 2010, modafinil, which is a wakefulness promoting agent, was approved in Europe for a wider spectrum of indications, such as narcolepsy, idiopathic hypersomnia, obstructive sleep apnoea and shift work sleep disorder. Currently, it is registered by the European Medicines Agency only for the treatment of narcolepsy, and is used as an off-label therapy in other sleep disorders. This paper presents the efficacy of modafinil in selected sleep disorders. Modafinil remains first-choice treatment for narcolepsy. It reduces the frequency of bouts of inadvertent sleep and nap episodes, the duration and intensity of daytime hypersomnolence, and also significantly improves the quality of life of patients. However, it is associated with only a slight improvement in cataplexy and other symptoms. In idiopathic hypersomnia, modafinil reduces the frequency of naps and unintentional sleep episodes, as well as subjective sleepiness measured with the Epworth Sleepiness Scale. Furthermore, the drug is used to treat hypersomnia from obstructive sleep apnoea in the case of lack of improvement despite optimal positive airway pressure therapy. Modafinil is also approved by the U.S. Food and Drug Administration for the treatment of shift work sleep disorder. The drug has been shown to reduce the level of somnolence, but it has not been found to reduce unintentional sleep episodes, reported mistakes or accidents at work. Given the strong negative impact of hypersomnolence on performance at work and school, the risk of accidents and the quality of life, the risk-benefit assessment of modafinil often justifies its use in the treatment of hypersomnolence also outside the approved indications.

P1487EFFECT OF PREDIALYSIS FLUID OVERLOAD ON SLEEP QUALITY IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Haitham Ismail ◽  
Hussein Abdallah ◽  
Ahmed Emara ◽  
Mohamed Arafa Ahmed
Keyword(s):  
Sleep Quality ◽  
Sleep Disorders ◽  
Fluid Overload ◽  
Whole Body ◽  
Hydration Status ◽  
Poor Sleep ◽  
Dialysis Session ◽  
Poor Sleep Quality ◽  
Obstructive Sleep ◽  
Group 2

Abstract Background and Aims Sleep disorders are common among end stage renal disease (ESRD)patients undergoing hemodialysis (HD). The etiology of sleep disorders in these patients is known to be multifactorial. However, the role of hydration status in sleep disorders in HD patients is not well studied. Therefore, our aim was to study the effect of predialysis fluid overload on sleep quality in HD patients. Methods This cross-sectional study included 100 prevalent HD patients from HD unit of El Sahel teaching hospital. fluid status and fluid compartments [total body water (TBW)], extracellular water (ECW)] and overhydration index (OH) were analyzed by a portable whole-body bio-impedance spectroscopy (Body Composition Monitor ‘BCM’) before mid-week dialysis session. Overhydration was defined as OH/ECW ≥15%. HD patients were then classified into 2 groups: Group 1 (non- overhydrated) and Group 2 (Overhydrated) according to OH/ECW. Sleep quality were assessed in all patients by Pittsburgh Sleep Quality Index (PSQI) questionnaire. Patients with Concurrent diagnosis of either obstructive sleep Apnea or psychiatric disorder and patients on any medications which affect the sleep pattern were excluded. Results our study included 100 HD patients (49 male, 51 female - mean age 49.3 ±11). 42 patients (42%) had overhydration (i.e. Group 2). Poor sleep quality (defined as PSQI score ≥5) was reported in 57% (n=57) of HD patients included in our study. Poor sleep quality was significantly higher in the HD patients with overhydrated (Group 2). Total PSQI scores were significantly higher in overhydrated patients (Group2) compared to non-overhydrated patients (Group1) (7.92±3.32 vs 4.83±2.27, P= &lt;0.001). The component scores 1, 2, 3, 4, 6 and 7 of the PSQI showed significant differences between the overhydration and non-overhydration groups with higher values (i.e poor sleep quality) in overhydrated patients (Group2). Moreover, there was significant positive correlation between total PSQI score and overhydration index (OH/ECW %) in all HD patients included in the study (r=0.283, P= 0.004). Conclusion We may conclude from our study that sleep disorders are prevalent in HD patients. Predialysis fluid overload in HD patients may be associated significantly with poor sleep quality.

Sympathetic neural responses to sleep disorders and insufficiencies

2022 ◽  
Author(s):  
Ian M. Greenlund ◽  
Jason R. Carter
Keyword(s):  
Sleep Deprivation ◽  
Sleep Disorders ◽  
Sleep Duration ◽  
Muscle Sympathetic Nerve Activity ◽  
Experimental Models ◽  
Plasma Norepinephrine ◽  
Poor Sleep ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Obstructive Sleep

Short sleep duration and poor sleep quality are associated with cardiovascular risk, and sympathetic nervous system (SNS) dysfunction appears to be a key contributor. The present review will characterize sympathetic function across several sleep disorders and insufficiencies in humans, including sleep deprivation, insomnia, narcolepsy, and obstructive sleep apnea (OSA). We will focus on direct assessments of sympathetic activation (e.g., plasma norepinephrine and muscle sympathetic nerve activity), but include heart rate variability (HRV) when direct assessments are lacking. The review also emphasizes sex as a key biological variable. Experimental models of total sleep deprivation and sleep restriction are converging to support epidemiological studies reporting an association between short sleep duration and hypertension, especially in women. A systemic increase of SNS activity via plasma norepinephrine is present with insomnia, and has also been confirmed with direct, regionally-specific evidence from microneurographic studies. Narcolepsy is characterized by autonomic dysfunction via both HRV and microneurographic studies, but with opposing conclusions regarding SNS activation. Robust sympathoexcitation is well documented in OSA, and is related to baroreflex and chemoreflex dysfunction. Treatment of OSA with continuous positive airway pressure results in sympathoinhibition. In summary, sleep disorders and insufficiencies are often characterized by sympathoexcitation and/or sympathetic/baroreflex dysfunction, with several studies suggesting women may be at heightened risk.

Abstract MP21: Better Sleep Health is Associated With Greater Weight Loss During a 12-month Behavioral Weight Loss Intervention

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Christopher E Kline ◽  
Zhadyra H Bizhanova ◽  
Susan M Sereika ◽  
Daniel Buysse ◽  
Christopher C Imes ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Change ◽  
Apnea Hypopnea Index ◽  
Poor Sleep ◽  
Weight Loss Intervention ◽  
Behavioral Weight Loss ◽  
Sleep Health ◽  
Obstructive Sleep ◽  
Behavioral Weight Loss Intervention ◽  
The Relationship

Introduction: Sleep is consistently associated with obesity risk, but minimal research has examined its relationship with attempted weight loss. Most of the available evidence has focused on sleep duration, which fails to recognize the multidimensional nature of sleep. Purpose: To examine the relationship between a composite measure of sleep health and weight change in a sample of adults who participated in a 12-month behavioral weight loss intervention. Methods: 125 adults with overweight or obesity enrolled in the EMPOWER study (50.3±10.6 years, 91% female, 81% white) were included in analyses. All individuals participated in a 12-month behavioral weight loss intervention, with assessments at baseline, 6 months, and 12 months. Six dimensions of sleep were included in our operationalization of sleep health: regularity, satisfaction, alertness, timing, efficiency, and duration. Sleep dimensions were assessed using validated questionnaires and actigraphy, with values dichotomized into ‘good’ and ‘poor’ sleep. A composite sleep health score was calculated based upon the sum of the ‘good’ individual dimensions (range: 0-6), with higher scores indicating better sleep health. Obstructive sleep apnea (OSA) was assessed in a subset of participants (n=117) with a portable home sleep testing device, using the apnea-hypopnea index (AHI) as a marker of OSA severity. Linear mixed modeling was used to examine the relationship between sleep health and weight change during the subsequent 6-month interval with adjustment for age, gender, bed partner, and race. An additional model adjusted for AHI along with the previously noted covariates. Results: Mean sleep health was 4.5±1.1 at baseline and 4.5±1.2 at 6 months, and mean % weight change from 0 to 6 months and 6 to 12 months was -9.3±6.1% and 0.4±4.8%, respectively. In the adjusted model, greater sleep health was associated with greater weight loss (b=-0.77, SE=0.32; P=.02). Following additional adjustment for AHI, the relation between sleep health and weight loss was no longer significant (b=-0.53, SE=0.34; P=.12). Among individual sleep dimensions, only regularity and satisfaction showed trends to be associated with weight change (b=-1.28, SE=0.72 [P=.08] and b=-1.67, SE=0.86 [P=.06], respectively); however, these marginal associations were not retained after AHI adjustment (each P=.15). Conclusions: Better sleep health was associated with greater weight loss, but this association did not persist after accounting for OSA severity. Because OSA negatively impacts sleep health, future research should address whether improving sleep health, OSA, and/or the combination leads to better weight loss.

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