scholarly journals Chronic Insomnia in the Elderly: Current Approaches to Diagnosis and Treatment

2018 ◽  
Vol 7 (2) ◽  
pp. 135-161
Author(s):  
A.I. Melehin
Keyword(s):  
Sleep Disorders ◽  
Geriatric Patients ◽  
Behavioral Therapy ◽  
The Elderly ◽  
Cognitive Behavioral ◽  
Chronic Insomnia ◽  
Structural Components ◽  
Quality Of Sleep ◽  
First Line

The article shows that in the treatment of chronic insomnia in geriatric patients, it is recommended to use a step-by-step treatment and start with steps aimed at the elimination of somatic, environmental and psychological barriers which affect the quality of sleep. An algorithm for the evaluation of sleep disorders at a later age firstly desctibed. The specifics of the clinical and psychological evaluation of the quality of sleep in geriatric patients presented. Evidence on the effectiveness of pharmacological and non-pharmacological approaches for the treatment of chronic insomnia at a later age presented on the basis of a number of foreign studies. It is recommended to use multicomponent cognitive-behavioral psychotherapy as a first-line treatment of chronic insomnia at a later age Types, forms and structural components of cognitive-behavioral therapy of chronic insomnia in the elderly are detailed. Practical difficulties and reccomentations for the use of medical approach in the treatment of sleep disorders in the elderly are also presented.

The effectiveness of short-term cognitive behavioral therapy in the complex treatment of idiopathic restless legs syndrome with chronic insomnia

2021 ◽  
Vol LIII (2) ◽  
pp. 46-56
Author(s):  
Aleksey I. Melekhin
Keyword(s):  
Restless Legs Syndrome ◽  
Behavioral Therapy ◽  
Well Being ◽  
Sleep Hygiene ◽  
Cognitive Behavioral ◽  
Chronic Insomnia ◽  
Short Term ◽  
Restless Legs ◽  
Mental Well Being

Aim. To investigate the effectiveness of the short-term protocol of cognitive behavioral therapy RELEGS M. Hornyak et al. in complex treatment to improve the quality of sleep, reduce the symptoms of depression, anxiety, suicidal thoughts in patients with primary SBN comorbid with chronic insomnia. Methods. Study participants: 68 patients with primary restless legs syndrome with comorbid chronic insomnia. Women 56 (average age 52.110.3 years), men 12 (average age 50.39.4 years). The severity of restless legs syndrome is moderate to severe. The average age of the onset of the disease is 1848 years, the duration of the course of the disease is on average 1415 years. Taking various medications for the management of SBN for an average of 45 years. Study design: a randomized controlled trial, after screening 26 patients were assigned to the main group, underwent combined treatment, took a prolonged form of Pramipexole (Mirapex-PD, 1.5 mg.) and underwent the RELEGS CBT protocol (Restless Legs Skills program, Hornyak, Grossmann, 2018), which integrates the cognitive behavioral insomnia protocol (Morin, 2007) and Mindfulness-Based Stress therapy (Mindfulness-Based Stress Reduction, Bablas, 2016). The control group consisted of 24 people who received only general recommendations on sleep hygiene once. Both groups were treated with dopaminergic agonists under the supervision of a neurologist. Research methods: IRLS, ISI, DBAS-16, sleep diary analysis, actigraphy, BDI, SBQ-R, BAI. Results. The use of the CBT protocol in combination therapy with prolonged-acting dopaminergic agonists in patients with primary restless leg syndrome (mild and moderate severity) with comorbid chronic insomnia, in contrast to simple one-time general recommendations on sleep hygiene, is more effective for reducing dysfunctional behaviors, the spectrum of reinsurance and avoidance behavior both in relation to sleep and symptoms of restless legs. In patients with primary restless legs syndrome who underwent CBT, greater mental well-being was observed, which was expressed in a decrease in the severity of symptoms of insomnia, anxiety, and suicidal behavior after completion and persisted after 3 months of follow-up. Conclusion. As part of a personalized comprehensive approach, along with a drug-based approach and general recommendations for sleep hygiene, the use of short-term CBT (4 sessions, 60 minutes each) can significantly improve mental well-being, improve the quality of sleep of patients with restless legs syndrome with comorbid chronic insomnia.

scholarly journals Advanced Cognitive Behavioral Therapy for Insomnia (CBT-I) Based on Acceptance and Commitment Therapy Compared With CBT-I: A Pilot Study

2021 ◽  
Vol 18 (2) ◽  
pp. 78-87
Author(s):  
Seonyeop Kim ◽  
Yoon Jung Shin ◽  
Bomi Park ◽  
Sunyoung Park ◽  
Jung-Won Shin
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Self Report ◽  
Cognitive Behavioral ◽  
Dysfunctional Beliefs ◽  
Quality Of Sleep ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Objectives: Cognitive behavioral therapy for insomnia (CBT-I) is the first line treatment for insomnia. However, many patients remain with sleep disturbances even after undergoing CBT-I, and those with short sleep durations have shown fewer gains. Acceptance and commitment therapy (ACT) is one of the third wave of behavioral therapies, and it is useful in helping patients get flexibility of mind. Therefore, we incorporated its components into CBT-I, came up with an advanced CBT-I program that involves cognitive behavior therapy based on ACT, and examined its efficacy in comparison to that of CBT-I. Methods: Patients with chronic primary insomnia were recruited at the memory center of CHA University Hospital from June to August 2020. To examine the efficacy of advanced CBT-I compared to that of CBT-I, the patients (n=16) were assigned to two groups (CBT-I: n=6; advanced CBT-I: n=10). The patients in each group were treated for 4 weeks (8 sessions). The quality of sleep, severity of insomnia, sleepiness, depression, anxiety, acceptance, efforts to sleep, and dysfunctional beliefs concerning sleep were assessed with self-report questionnaires. Results: The severity of insomnia, quality of sleep, depression, anxiety, acceptance, efforts to sleep, and dysfunctional beliefs concerning sleep improved after both CBT-I and advanced CBT-I treatment. Conclusions: This study examined the efficacy of advanced CBT-I in improving the severity of insomnia, sleep quality, and other symptoms related to sleep. The results suggest that components of ACT were useful for insomnia.

scholarly journals HUBUNGAN LATIHAN RELAKSASI OTOT PROGRESIF DENGAN KUALITAS TIDUR PADA LANSIA

2020 ◽  
Vol 15 (2) ◽  
pp. 289-295
Author(s):  
Kiki Anggini
Keyword(s):  
Sleep Quality ◽  
Sleep Disorders ◽  
Muscle Relaxation ◽  
The Elderly ◽  
Progressive Muscle Relaxation ◽  
P Value ◽  
Quality Of Sleep ◽  
Experiment Method ◽  
Relaxation Exercises

ABSTRACT  Insomnia sleep disorders that distrupt a person’s concentrartion causing insomnia or insufficient sleep, resulting in inefficient sleep. Cause stress if it continues to have an impact on anxiety, headaches, sexual decline in men, worsening vision, lack of concentration, fatigue, and anemia (Suci, 2014). The aim is to find out whether there is a relationship between progressive muscle relaxation exercises and sleep quality in the elderly at the Guna Budi Bakti Medan Foundation in 2020. This research uses quasy experiment method and uses one grub pretest posttest design, which uses two sample groups be interviewed before (pretest) and after (posttest) by filling out the questionnaire. Based on the results of the Wilcoxon signedrank test, that the value of Z = -4,256ᵇ with a p value of 0,000 <0.05, the Ha is accepted and the Ho is rejected. It was concluded that there was an improvement in the quality of sleep in the elderly by doing progressive muscle relaxation exercises. Hopefully this research can improve the quality of nurses working in institutions capable of applying progressive muscle relaxation exercises in the elderly. ABSTRAK   Insomnia adalah gangguan tidur yang mengganggu konsentrasi seseorang menyebabkan sulit tidur atau tidak cukup tidur , sehingga waktu tidur tidak efesien. Menyebabkan stres apabila berkelanjutan berdampak pada kecemasan, sakit kepala, penurunan seksual pada pria, penglihatan memburuk, tidak konsentrasi, mudah lelah, dan anemia (Suci, 2014). Tujuan untuk mengetahui adakah hubungan latihan relaksasi otot progresif dengan kualitas tidur pada lansia di Yayasan Guna Budi  Bakti Medan tahun 2020”. Penelitian ini menggunakan metode Quasy Eksperiment dan memakai rancangan One Group Pretest Posttest, yaitu menggunakan 2 kelompok sampel diwawancara sebelum (pretest) dan sesudah (possttest) dengan mengisi kuisioner (Soekijo Notoatmojo,2017).Berdasarkan hasil perhitungan wilcoxon signedrank test, bahwa nilai Z=-4.256ᵇ dengan nilai p value 0,000 <0,05 maka Ha diterima dan Ho ditolak. Disimpulkan bahwa terdapat peningkatan kualitas tidur pada lanjut usia dengan melakukan latihan relaksasi otot progresif. Semoga penelitian ini dapat meningkatkan kualitas perawat yang bekerja di panti mampu mengaplikasikan latihan relaksasi otot progresif pada lansia.

scholarly journals The effects of cognitive-behavioral training and muscle relaxation on the degree of tinnitus and the quality of sleep

2019 ◽  
Author(s):  
Mojtaba Tavakoli ◽  
Seyed Ali Marashi ◽  
Najme Hamid ◽  
Kioumars Beshlideh
Keyword(s):  
Relaxation Training ◽  
Behavioral Therapy ◽  
Muscle Relaxation ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Quality Of Sleep ◽  
Behavioral Training ◽  
Experimental Group

Background and Aim: Tinnitus is an annoying distressing phantom phenomenon that can cause major problems, such as insomnia and sleep deprivation. Therefore, the present study was conducted to determine the effects of cognitive-behavioral training (CBT) and muscle relaxation on the level of tinnitus and the quality of sleep in patients with tinnitus in Ahvaz City in 2018−2019. Methods: This study is a semi-experimental, pretest, post-test, and follow-up with control group. There are two experimental groups and one control group in this plan. Participants in the first experimental group received eight sessions of CBT and participants in the second experimental group received eight sessions of relaxation training. Control group were not sub­ject to any intervention. Results: The results of this study showed that cognitive-behavioral approach and muscle rela­xation have reduced the amount of tinnitus and increased sleep quality using multivariate cova­riance analysis. The most important results of this study are the effectiveness and usefulness of cognitive-behavioral approach and muscle relaxation on reducing tinnitus and increasing the quality of sleep. Conclusion: Cognitive-behavioral therapy and muscle relaxation approaches were effective in improving tinnitus and quality of sleep. More attention and emphasize in these approaches will be a good alternative to some invasive (electric stimulation) or with some side-effects (drug therapy) approaches

An Evaluation of Cognitive Behavioral Therapy for Insomnia: A Systematic Review and Application of Tolin’s Criteria for Empirically Supported Treatments

2019 ◽  
Author(s):  
Cassandra L. Boness ◽  
Rachel Hershenberg ◽  
Joanna Kaye ◽  
Margaret-Anne Mackintosh ◽  
Damion Grasso ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Empirically Supported Treatments ◽  
Inclusion Criteria ◽  
American Psychological ◽  
Strong Recommendation ◽  
Empirically Supported ◽  
High Quality Evidence

The American Psychological Association’s Society of Clinical Psychology recently adopted the “Tolin Criteria” to evaluate empirically supported treatments. These criteria better account for strength and quality of rapidly accumulating evidence bases for various treatments. Here we apply this framework to Cognitive Behavioral Therapy for Insomnia (CBT-I). Following procedures outlined by Tolin and colleagues (2015), Step 1 included an examination of quantitative systematic reviews; nine met inclusion criteria. Step 2 evaluated review quality and effect size data. We found high-quality evidence that CBT-I produces clinically and statistically significant effects on insomnia and other sleep-related outcomes. Based on the Tolin Criteria, the literature merits a “strong” recommendation for CBT-I. This report is a working model for subsequent applications of the Tolin Criteria.

Assessment of the Therapeutic Effect of Physiotherapy on Minimizing Imbalances of Geriatric Patients

2020 ◽  
Vol 62 (2) ◽  
pp. 86-91
Author(s):  
Justyna Pawlak ◽  
Małgorzata Dudkiewicz ◽  
Łukasz Kikowski
Keyword(s):  
Quality Of Life ◽  
Therapeutic Effect ◽  
Body Mass ◽  
Geriatric Patients ◽  
The Elderly ◽  
Risk Of Falling ◽  
Increased Risk ◽  
Climbing Stairs ◽  
Tinetti Test

Introduction: The progressing aging process and comorbidities worsen the efficiency of the balance system in the elderly, which leads to a weakening of stability and, as a consequence, to falls and injuries. The first ones lead to: worsening of functioning, reduced mobility, an increased risk of disease and mortality, therefore systematic physical activity and shaping the balance using physiotherapy, which can prevent dangerous falls is very important. Aim: Assessment of the therapeutic effect of physiotherapy on minimizing imbalances in geriatric patients. M aterial and Methods: The study group consisted of 46 people, including 32 women (69.6%) and 14 men (30.4%); average age of respondents – 72.5 years. They were patients of the Department of Rehabilitation of Poddębice Health Center, Ltd. The researchers used a self-made questionnaire, body mass to height index (BMI) and the Tinetti Test. Results: Patients with an elevated BMI (89.1%), as well as those taking more than 4 medication (78.3%), have had more falls over the past year (respectively 91.4% and 81.4%). After the use of comprehensive therapy, none of the patients achieved a worse result than before the physiotherapy while 91.3% of the respondents had an increase in the number of points scored in the Tinetti Test. The percentage of patients at high risk of falling reduced from 67.4% to 37%. There was also a decrease in the fear of walking (in 58.7%), falling (in 57.7%) and climbing stairs (in 47.9%). According to 78.3% of respondents, physiotherapy positively affected their independence and quality of life. Conclusions: The use of comprehensive physiotherapy reduces the fear of walking, climbing stairs and falling, which can be a good predictor of prevention. Both polypragmasia and an elevated body mass index (BMI) increase the risk of falling. Comprehensive physiotherapy of geriatric patients helps to improve balance and gait stereotype. Physiotherapy for the elderly helps improve the quality of life, independence, minimize imbalances, and thus reduce the risk of falls. Balance exercises play an important role in preventing falls.

scholarly journals 696 Quality of sleep is the only predictor of suicide during Covid-19 lockdown in University students?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A272-A272
Author(s):  
Alessandra Castelnuovo ◽  
Samantha Mombelli ◽  
Daniela Bottoni ◽  
Antonella Somma ◽  
Andrea Fossati ◽  
...  
Keyword(s):  
Medical Students ◽  
Suicidal Ideation ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Social Stress ◽  
Depression Symptoms ◽  
Daily Routine ◽  
Quality Of Sleep ◽  
Suicidal Thoughts

Abstract Introduction COVID-19 epidemic led to great psychological and social stress, related to anxiety, depression, sleep disorders, suicidal risk and behavior, and changes in daily routine. The aim of this study was to assess the psychological impact of COVID-19 lockdown in Italian students. We focused on perceived sleep quality, anxiety and depression symptoms, and mostly on risk of suicide. Methods A total of 307 students (mean age 22.84±2.68) completed Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II). In our study, we focused on item 9 of BDI-II, that is related to suicide. We divided our sample on presence or absence of suicidal ideation based on this item. Results We found that 30.1% showed depressive, while 38.2% anxious symptoms. Concerning item 9 of BDI-II (suicidal thoughts or wishes), 84.7% answered that they do not have any thoughts of killing themselves, while 15.3% answered that they have some suicidal ideation. Concerning sleep variables, we found that 58% of our sample showed a PSQI total score higher than 5 (poor quality of sleep), and a global worsening in sleep quality and increase of insomnia both in student with and without suicidal ideation. Conclusion Our results on risk of suicide are in line with literature. Recent reviews focused on suicidal ideation in medical students found that depressive symptoms and suicidal ideation are common among medical students, finding a prevalence of suicidal ideation of 11%. Several studies suggest that sleep disorders are a risk factor for suicidal thoughts and behaviours. Our findings show that sleep cannot considered a predictive factor of risk of suicide during health emergency, because the risk is polyfactorial. Support (if any) None

Sign in / Sign up

Export Citation Format

Share Document