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.

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 Safety and Efficacy of Armodafinil in the Treatment of Excessive Sleepiness

2011 ◽  
Vol 3 ◽  
pp. CMT.S5124
Author(s):  
Jamie N. Brown ◽  
Dustin T. Wilson
Keyword(s):  
Adverse Effects ◽  
Health Care Providers ◽  
English Language ◽  
Rating Scales ◽  
Data Extraction ◽  
Current Evidence ◽  
Care Providers ◽  
Sleep Study ◽  
Excessive Sleepiness ◽  
Obstructive Sleep

Objective To review the efficacy and safety of armodafinil for the treatment in patients with excessive sleepiness. Data sources Literature was accessed via MEDLINE (1966–February 2011) and EMBASE (1980–February 2011) using the medical subject heading terms armodafinil and sleep. Study selection and data extraction All English-language, peer-reviewed publications were analyzed for relevance. Studies appropriate to the objective were evaluated if they prospectively assessed the effectiveness of armodafinil in patients with excessive sleepiness in a multiple-dose, comparator trial. The literature search identified published reports of 7 randomized, placebo-controlled studies. Data synthesis Armodafinil is a wakefulness-promoting agent used in the treatment of patients with excessive sleepiness and is the R-enantiomer of modafinil. Studies have demonstrated that armodafinil may be effective and safe when used in patients with obstructive sleep apnea, circadian rhythm disorders, and narcolepsy. Although the studies identified had limited sample sizes, they consistently demonstrated improvement on various efficacy rating scales for sleep. Study durations ranged from 3 days to 12 weeks, with doses ranging from 50 mg to 250 mg daily. The most common adverse effects associated with armodafinil therapy were headache, nausea, diarrhea, dizziness, and anxiety, although increases in systolic blood pressure and pulse rate were also reported. Conclusion Current evidence suggests that armodafinil significantly improves wakefulness in patients with excessive sleepiness in studies up to 12 weeks. Long-term effectiveness and safety cannot be adequately determined at this time. Although armodafinil should be considered safe for use, health-care providers should monitor for adverse effects, particularly cardiovascular complications.

scholarly journals Community Integration After Traumatic Brain Injury and Related Factors: A Study in the Nepalese Context

2020 ◽  
Vol 6 ◽  
pp. 237796082098178
Author(s):  
Sumana Lama ◽  
Jintana Damkliang ◽  
Luppana Kitrungrote
Keyword(s):  
Social Support ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Care Providers ◽  
Physical Environment ◽  
Community Integration ◽  
Sampling Technique ◽  
Care Providers ◽  
Related Factors ◽  
High Level

Introduction Community integration is an essential component for rehabilitation among traumatic brain injury (TBI) survivors, which yields positive outcomes in terms of social activities, community participation, and productive work. A factor that usually facilitates community integration among TBI survivors is social support, whereas physical environment and fatigue are most often found as barriers. Objectives This study aimed to (1) describe the level of community integration, fatigue, physical environment, and social support of persons after TBI, and (2) examine the relationship between community integration and these three factors. Methods This is a descriptive correlational study. One hundred and twenty TBI survivors living in the communities of Province Number Three, Nepal were enrolled using the stratified sampling technique. The data were collected using the Community Integration Questionnaire, Modified Fatigue Impact Scale, Craig Hospital Inventory of Environmental Factors, and the Multidimensional Scale of Perceived Social Support. Descriptive statistics and Pearson’s correlation were used to analyze the data. Results Community integration, fatigue, and physical environment showed a moderate level, while social support revealed a high level. Fatigue was significantly correlated with overall community integration, whereas physical environment was found to correlate with two subscales of community integration, home integration and productive activities. Conclusion To enhance the level of community integration among TBI survivors, health care providers, in particular rehabilitation nurses and community nurses, should plan and implement strategies such as follow-up appointments or continued rehabilitation at home.

scholarly journals Health anxiety and related factors among pregnant women during the COVID-19 pandemic: a cross-sectional study from Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Najmieh Saadati ◽  
Poorandokht Afshari ◽  
Hatam Boostani ◽  
Maryam Beheshtinasab ◽  
Parvin Abedi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Health Care Providers ◽  
Health Anxiety ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Sectional Study ◽  
Third Trimester ◽  
Related Factors ◽  
Cross Sectional ◽  
The Third

Abstract Background The COVID-19 pandemic has affected many countries around the world and Iran was no exception. The aim of this study was to evaluate health anxiety of Iranian pregnant women during the COVID-19 pandemic. Methods In this cross-sectional study, 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety Questionnaire were used to collect data. Scores of < 27, 27–34 and more than 35 were defined as low, moderate and high health anxiety, respectively. Due to nationwide restrictions, data were collected through social media groups. Chi-square tests, ANOVA and multiple linear regression were used to analyze the data. Results Mean (SD) total anxiety scores were 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimesters of pregnancy, respectively. 9, 13 and 21% of women had severe anxiety in the first, second and third trimesters of pregnancy, respectively. Women in the third trimester had significantly higher health anxiety scores than those in the first trimester (p = 0.045). Conclusion At the time of the COVID-19 pandemic, women in the second and third trimesters of pregnancy were more worried about consequences of disease, but total health anxiety scores were significantly higher among women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as the COVID-19 pandemic.

Human rights-based conceptions of deservingness: health and precarity

2020 ◽  
Vol 16 (3) ◽  
pp. 279-292
Author(s):  
Sarah Marshall
Keyword(s):  
Health Care ◽  
Human Rights ◽  
Health Care Providers ◽  
Health Care Access ◽  
Migrant Health ◽  
Dominant Negative ◽  
Care Providers ◽  
Content Type ◽  
Care Access ◽  
Health Related

Purpose Ideas of health-related deservingness in theory and practise have largely been attached to humanitarian notions of compassion and care for vulnerable persons, in contrast to rights-based approaches involving a moral-legal obligation to care based on universal citizenship principles. This paper aims to provide an alternative to these frames, seeking to explore ideas of a human rights-based deservingness framework to understand health care access and entitlement amongst precarious status persons in Canada. Design/methodology/approach Drawing from theoretical conceptualizations of deservingness, this paper aims to bring deservingness frameworks into the language of human rights discourses as these ideas relate to inequalities based on noncitizenship. Findings Deservingness frameworks have been used in public discourses to both perpetuate and diminish health-related inequalities around access and entitlement. Although, movements based on human rights have the potential to be co-opted and used to re-frame precarious status migrants as “undeserving”, movements driven by frames of human rights-based deservingness can subvert these dominant, negative discourses. Originality/value To date, deservingness theory has primarily been used to speak to issues relating to deservingness to welfare services. In relation to deservingness and precarious status migrants, much of the literature focuses on humanitarian notions of the “deserving” migrant. Health-related deservingness based on human rights has been under-theorized in the literature and the authors can learn from activist movements, precarious status migrants and health care providers that have taken on this approach to mobilize for rights based on being “human”.

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 &lt;2 year old), AHI ≥15 events/hr with three or more Oxygen desaturations &lt;80% (children ≥2 to &lt;6 years old), AHI ≥ 30 events/hr with three or more Oxygen desaturations &lt;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 VoIP for Telerehabilitation: A Pilot Usability Study for HIPAA Compliance

2012 ◽  
Vol 4 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Valerie R. Watzlaf ◽  
Briana Ondich
Keyword(s):  
Health Care Providers ◽  
Future Research ◽  
Software Systems ◽  
Usability Study ◽  
Care Providers ◽  
Privacy And Security ◽  
Related Services ◽  
Security Applications ◽  
Health Related ◽  
Hipaa Compliance

Consumer-based, free Voice and video over the Internet Protocol (VoIP) software systems such as Skype and others are used by health care providers to deliver telerehabilitation and other health-related services to clients. Privacy and security applications as well as HIPAA compliance within these protocols have been questioned by practitioners, health information managers, and other healthcare entities. This pilot usability study examined whether four respondents who used the top three, free consumer-based, VoIP software systems perceived these VoIP technologies to be private, secure, and HIPAA compliant;  most did not.  While the pilot study limitations include the number of respondents and systems assessed, the protocol can be applied to future research and replicated for instructional purposes.  Recommendations are provided for VoIP companies, providers, and users. 

scholarly journals Health-related needs and barriers for forcibly displaced women: a systematic review

2019 ◽  
Author(s):  
Jenny Jesuthasan ◽  
Zara Witte ◽  
Sabine Oertelt-Prigione
Keyword(s):  
Health Care Providers ◽  
Cochrane Library ◽  
Care Providers ◽  
Culturally Sensitive Care ◽  
Barriers To Access ◽  
Innovative Methodology ◽  
Health Related ◽  
Unequal Access ◽  
Available Information ◽  
Specific Health

Abstract Introduction Women represent a large proportion of the currently internationally displaced individuals. Due to gender roles, care duty, educational and economic imbalance their experiences and vulnerability during flight and relocation differ from that of men and children. The currently available information about their specific health-related needs and barriers to access is scarce and scattered. Methods We searched PubMed, Medline, EMBASE, Cochrane Library and Scopus to identify publications that explored the unique experiences of female refugees between 1 January 2008 and 30 June 2018. Publications needed to address the health needs of refugees, asylum seekers or displaced individuals, include at least 50% women in their study and employ a user-centered perspective, i.e. focus on the perspective of displaced individuals themselves and not health care providers. A framework of themes was identified and applied to all publications. Results We identified 1945 publications of which 13 could be included in the present review. Twelve of these publications employed qualitative and/or innovative methodology (e.g. ethnographies, index cards, photovoice). We identified five broad categories of health-related needs (immediate healthcare, communication, sultural/spiritual, social, economic), which are further detailed. Conclusions A concerted action providing information and culturally-sensitive care, while supporting language acquisition and economic empowerment is essential to improving the health status of female refugees. Transformative interventions need to address multiple axes of unequal access for female refugees to increase participation and overall health.

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