scholarly journals An investigation of the relationship between sleep and fatigue in those with and without insomnia

2021 ◽  
Author(s):  
Andrea L. Harris

There is currently mixed evidence for the relationship between poor sleep and daytime fatigue. It is well documented that retrospective measures of insomnia and fatigue are highly correlated with one another. However, other studies fail to demonstrate a link between objectively less sleep and fatigue; that is, individuals with shorter sleep times do not necessarily report increased fatigue. As such, the relationship between these two constructs remains unclear. The current investigation will help to elucidate the complex relationship between sleep and fatigue among those with and without insomnia by advancing the existing literature in two important ways. First, this study proposed to examine the temporal relationship between sleep and fatigue across two weeks, thereby investigating whether sleep and fatigue occur in accordance with one anotherover time. Second, this study utilized a multi-method approach by collecting subjective (i.e.,sleep diary) and objective (i.e., actigraphy) measures of sleep, as well as retrospective (i.e.,visual analogue scales: VAS) and prospective (i.e., momentary ratings) measures of fatigue. Two separate hierarchical linear models were used to test whether sleep (measured by sleep quality and total sleep time) predicted daytime fatigue on the VAS and actigraph, respectively. The secondary objective asked whether cognitive-behavioural variables (i.e., maladaptive sleep beliefs, fear and avoidance of fatigue, and fatigue-based rumination) may help account for the relationship between sleep and fatigue using mediation. The results of the primary analyses suggested that sleep quality significantly predicted VAS fatigue ratings, whereas total sleep time was a significant predictor of fatigue within- but not between-persons. No significant relationships were found between objective measures of sleep and momentary fatigue ratings. Finally, each of the cognitive-behavioural variables, with the exception of avoidance of fatigue, were significant mediators of the relationship between sleep and fatigue. The results demonstrated that compared to sleep quantity, our perception of sleep may play a more important role in predicting reports of daytime fatigue. These findings could help decrease the burden that individuals with insomnia place on their total sleep times, and instead, treatment could focus on challenging maladaptive sleep-related cognitions, which ultimately could lessen the overall sleep-related anxiety.

2021 ◽  
Author(s):  
Andrea L. Harris

There is currently mixed evidence for the relationship between poor sleep and daytime fatigue. It is well documented that retrospective measures of insomnia and fatigue are highly correlated with one another. However, other studies fail to demonstrate a link between objectively less sleep and fatigue; that is, individuals with shorter sleep times do not necessarily report increased fatigue. As such, the relationship between these two constructs remains unclear. The current investigation will help to elucidate the complex relationship between sleep and fatigue among those with and without insomnia by advancing the existing literature in two important ways. First, this study proposed to examine the temporal relationship between sleep and fatigue across two weeks, thereby investigating whether sleep and fatigue occur in accordance with one anotherover time. Second, this study utilized a multi-method approach by collecting subjective (i.e.,sleep diary) and objective (i.e., actigraphy) measures of sleep, as well as retrospective (i.e.,visual analogue scales: VAS) and prospective (i.e., momentary ratings) measures of fatigue. Two separate hierarchical linear models were used to test whether sleep (measured by sleep quality and total sleep time) predicted daytime fatigue on the VAS and actigraph, respectively. The secondary objective asked whether cognitive-behavioural variables (i.e., maladaptive sleep beliefs, fear and avoidance of fatigue, and fatigue-based rumination) may help account for the relationship between sleep and fatigue using mediation. The results of the primary analyses suggested that sleep quality significantly predicted VAS fatigue ratings, whereas total sleep time was a significant predictor of fatigue within- but not between-persons. No significant relationships were found between objective measures of sleep and momentary fatigue ratings. Finally, each of the cognitive-behavioural variables, with the exception of avoidance of fatigue, were significant mediators of the relationship between sleep and fatigue. The results demonstrated that compared to sleep quantity, our perception of sleep may play a more important role in predicting reports of daytime fatigue. These findings could help decrease the burden that individuals with insomnia place on their total sleep times, and instead, treatment could focus on challenging maladaptive sleep-related cognitions, which ultimately could lessen the overall sleep-related anxiety.


SLEEP ◽  
2020 ◽  
Author(s):  
Andrea L Harris ◽  
Nicole E Carmona ◽  
Taryn G Moss ◽  
Colleen E Carney

Abstract Study Objectives There is mixed evidence for the relationship between poor sleep and daytime fatigue, and some have suggested that fatigue is simply caused by lack of sleep. Although retrospective measures of insomnia and fatigue tend to correlate, other studies fail to demonstrate a link between objectively disturbed sleep and fatigue. The current study prospectively explored the relationship between sleep and fatigue among those with and without insomnia disorder. Methods Participants meeting Research Diagnostic Criteria for insomnia disorder (n = 33) or normal sleepers (n = 32) completed the Consensus Sleep Diary (CSD) and daily fatigue ratings for 2 weeks. Baseline questionnaires evaluated cognitive factors including unhelpful beliefs about sleep and rumination about fatigue. Hierarchical linear modeling tested the within- and between-participant relationships between sleep quality, total sleep time, and daily fatigue ratings. Mediation analyses tested if cognitive factors mediated the relationship between insomnia and fatigue. Results Self-reported nightly sleep quality significantly predicted subsequent daily fatigue ratings. Total sleep time was a significant predictor of fatigue within, but not between, participants. Unhelpful sleep beliefs and rumination about fatigue mediated the relationship between insomnia and fatigue reporting. Conclusions The results suggest that perception of sleep plays an important role in predicting reports of daytime fatigue. These findings could be used in treatment to help shift the focus away from total sleep times, and instead, focus on challenging maladaptive sleep-related cognitions to change fatigue perception.


Partner Abuse ◽  
2017 ◽  
Vol 8 (4) ◽  
pp. 347-360
Author(s):  
Sharon Rose ◽  
Linda Berg-Cross ◽  
Nancy A. Crowell

This study explored the relationship between psychological abuse and sleep deprivation among nonclinical cohabiting couples. Thirty-one couples participated in completing a variety of sleep measures, a psychological abuse scale, and a relationship satisfaction survey. Results indicated a persistent relationship between everyday sleep deficits (sleep quality, daytime sleepiness, and self-reported total sleep time) and the perceived perpetration and felt victimization of psychological abuse. Overall, results were as hypothesized, but there were gender differences. Male psychological abuse victimization and perpetration were significantly related to sleep quality and daytime sleepiness, but for women, only sleep duration was predictive of felt victimization. The sleep variables were significantly related to women’s—but not men’s—reported relationship satisfaction. Overall, minimal sleep deprivation appears to be related to increased psychological abuse perpetration and victimization even among a normative population scoring outside the clinical range on these measures. Implications for prevention and treatment are discussed.


2021 ◽  
pp. 097275312110390
Author(s):  
Jayaram Thimmapuram ◽  
Robert Pargament ◽  
Sonya Del Tredici ◽  
Theodore Bell ◽  
Deborah Yommer ◽  
...  

Background: Medical residents are vulnerable to poor sleep quality due to intense work shifts and academic load. Studies objectively quantified with sleep quantity and quality among resident physicians are limited. Meditation techniques have been shown to improve sleep but are rarely studied in this population. The aim of the present study is to evaluate sleep patterns of internal medicine residents and the effect of a structured Heartfulness meditation program to improve sleep quality. Methods: A total of 36 residents participated in a pre–post cohort study from January 2019 through April 2019. Sleep was monitored during a one-week outpatient rotation with two validated assessment tools, namely consensus sleep diary and actigraphy. After four intervening weeks, when the residents returned to the same rotation, Heartfulness meditation was practiced and the same parameters were measured. At the end of the study period, an anonymous qualitative feedback survey was collected to assess the feasibility of the intervention. Results: All 36 residents participated in the study (mean age 31.09 years, SD 4.87); 34 residents (94.4%) had complete pre–post data. Consensus sleep diary data showed decreased sleep onset time from 21.03 to 14.84 min ( P = .01); sleep quality and restfulness scores increased from 3.32 to 3.89 and 3.08 to 3.54, respectively ( P < .001 for both). Actigraphy showed a change in sleep onset time from 20.9 min to 14.5 min ( P = .003). Sleep efficiency improved from 83.5% to 85.6% ( P = .019). Wakefulness after initial sleep onset changed from 38.8 to 39.9 min ( P = .682). Sleep fragmentation index and the number of awakenings decreased from 6.16 to 5.46 ( P = .004) and 41.71 to 36.37 ( P = .013), respectively. Conclusions: Residents obtained nearly 7 h of sleep during outpatient rotation. Findings suggest a structured Heartfulness meditation practice to be a feasible program to improve subjective sleep onset time and several objective measures among resident physicians.


Author(s):  
Arturo Laflor ◽  
Mabel Vazquez-Briseno ◽  
Fernanda Murillo-Munoz

<p class="Abstract">Computational sciences have gradually allowed scientists to develop novel technological projects to promote a healthy way of life. Most efforts have focus in promoting healthy diets and physical activity. Sleeping is also a crucial activity for humans. Poor sleep quality has adverse effects on health and might lead to physical and mental deterioration. Many computer systems have been used to measure sleep quantity and quality; however, there are few efforts to guide users about aspects that can influence sleeping. Sleep hygiene is a concept that allows controlling sleep-related habits and promoting good sleep quality; unfortunately, modern lifestyles can cause people to adopt wrong habits without being aware of their impact on sleep quality. This work describes a framework developed to guide user’s during the day in order to achieve good sleep quality during sleep time. A set of sleep hygiene factors (SHFs) intended to control hours before going to sleep was defined. The framework identifies personal SHFs using machine learning algorithms; furthermore, a new algorithm was designed to improve results. The framework also includes a mobile persuasive system to encourage users to control personal SHFs.</p>


2013 ◽  
Vol 18 (3) ◽  
pp. 763-768 ◽  
Author(s):  
Milva Maria Figueiredo De Martino ◽  
Ana Cristina Basto Abreu ◽  
Manuel Fernando dos Santos Barbosa ◽  
João Eduardo Marques Teixeira

The scope of this study was to evaluate the sleep/wake cycle in shift work nurses, as well as their sleep quality and chronotype. The sleep/wake cycle was evaluated by keeping a sleep diary for a total of 60 nurses with a mean age of 31.76 years. The Horne & Östberg Questionnaire (1976) for the chronotype and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality were applied. The results revealed a predominance of indifferent chronotypes (65.0%), followed by moderately evening persons (18.3%), decidedly evening persons (8.3%), moderately morning persons (6.6%) and decidedly morning persons (1.8%). The sleep quality perception was analyzed by the visual analogical scale, showing a mean score of 5.85 points for nighttime sleep and 4.70 points for daytime sleep, which represented a statistically significant difference. The sleep/wake schedule was also statistically different when considering weekdays and weekends. The PSQI showed a mean of 7.0 points, characterizing poor sleep quality. The results showed poor sleep quality in shift work nurses, possibly due to the lack of sport and shift work habits.


2020 ◽  
Vol 24 (4) ◽  
pp. 253-258
Author(s):  
Jasmin Faber ◽  
Indra Steinbrecher-Hocke ◽  
Peter Bommersbach ◽  
Angelika A. Schlarb

Abstract Objective Media use can affect sleep. However, research regarding various populations is sparse. The objective of this study was to examine the relationship between media use directly before bedtime and various sleep parameters in patients of a psychosomatic rehabilitation clinic. Methods Patients from a German psychosomatic rehabilitation clinic were tested regarding subjective sleep quality and insomnia symptoms based on questionnaires such as the Pittsburgh Sleep Quality Index (PSQI). Eligible patients also completed an additional sleep log over a period of 1 week. A total of 347 insomnia patients were enrolled, with a mean age of 49.77 years (range 22–64 years; median = 52 years). 57.5% of the patients were 50 years or older. Results Analysis showed that media use and various sleep diary parameters such as total sleep time (r = −0.386, p = 0.042; rTST2 = 0.149) and sleep efficiency (r = −0.507, p = 0.006; rSE2 = 0.257) were significantly associated. In detail, more media consumption was associated with less total sleep time and a lower sleep efficiency. The same result was found for media use and sleep efficiency on weekdays (r = −0.544, p = 0.002; rSE2 = 0.296), but not for other sleep parameters. However, media use time and subjective sleep quality were not significantly correlated, r = −0.055, p = 0.768. Conclusion This study, which is the first to examine the relation between media use and sleep in patients of a psychosomatic rehabilitation clinic, suggests a significant association between media use and sleep duration as well as sleep efficiency. However, more research is needed to investigate the relationship between media use and sleep in more detail, to increase patients’ quality of life and to incorporate these findings into the daily life of clinicians and therapists as well as into sleep hygiene education and sleep trainings.


2021 ◽  
Vol 15 ◽  
Author(s):  
Eva S. van den Ende ◽  
Kim D. I. van Veldhuizen ◽  
Belle Toussaint ◽  
Hanneke Merten ◽  
Peter M. van de Ven ◽  
...  

Objectives: Sleeping disorders are a common complaint in patients who suffer from an acute COVID-19 infection. Nonetheless, little is known about the severity of sleep disturbances in hospitalized COVID-19 patients, and whether these are caused by disease related symptoms, hospitalization, or the SARS-CoV-2 virus itself. Therefore, the aim of this study was to compare the quality and quantity of sleep in hospitalized patients with and without COVID-19, and to determine the main reasons for sleep disruption.Methods: This was an observational comparative study conducted between October 1, 2020 and February 1, 2021 at the pulmonary ward of an academic hospital in the Netherlands. This ward contained both COVID-19-positive and -negative tested patients. The sleep quality was assessed using the PROMIS-Sleep Disturbance Short Form and sleep quantity using the Consensus Sleep Diary. Patient-reported sleep disturbing factors were summarized.Results: A total of 79 COVID-19 patients (mean age 63.0, male 59.5%) and 50 non-COVID-19 patients (mean age 59.5, male 54.0%) participated in this study. A significantly larger proportion of patients with COVID-19 reported not to have slept at all (19% vs. 4% of non-COVID-19 patients, p = 0.011). The Sleep quality (PROMIS total score) and quantity (Total Sleep Time) did not significantly differ between both groups ((median PROMIS total score COVID-19; 26 [IQR 17-35], non-COVID-19; 23 [IQR 18-29], p = 0.104), (Mean Total Sleep Time COVID-19; 5 h 5 min, non-COVID-19 mean; 5 h 32 min, p = 0.405)). The most frequently reported disturbing factors by COVID-19 patients were; ‘dyspnea’, ‘concerns about the disease’, ‘anxiety’ and ‘noises of other patients, medical staff and medical devices’.Conclusion: This study showed that both patients with and without an acute COVID-19 infection experienced poor quality and quantity of sleep at the hospital. Although the mean scores did not significantly differ between groups, total sleep deprivation was reported five times more often by COVID-19 patients. With one in five COVID-19 patients reporting a complete absence of night sleep, poor sleep seems to be a serious problem. Sleep improving interventions should focus on physical and psychological comfort and noise reduction in the hospital environment.


SLEEP ◽  
2019 ◽  
Vol 43 (4) ◽  
Author(s):  
Jayne Trickett ◽  
Chris Oliver ◽  
Mary Heald ◽  
Hayley Denyer ◽  
Andrew Surtees ◽  
...  

Abstract Study Objectives The objectives of the study were (1) to compare both actigraphy and questionnaire-assessed sleep quality and timing in children with Smith–Magenis syndrome (SMS) to a chronologically age-matched typically developing (TD) group and (2) to explore associations between age, nocturnal and diurnal sleep quality, and daytime behavior. Methods Seven nights of actigraphy data were collected from 20 children with SMS (mean age 8.70; SD 2.70) and 20 TD children. Daily parent/teacher ratings of behavior and sleepiness were obtained. Mixed linear modeling was used to explore associations between total sleep time and daytime naps and behavior. Results Sleep in children with SMS was characterized by shorter total sleep time (TST), extended night waking, shorter sleep onset, more daytime naps, and earlier morning waking compared to the TD group. Considerable inter-daily and inter-individual variability in sleep quality was found in the SMS group, so caution in generalizing results is required. An expected inverse association between age and TST was found in the TD group, but no significant association was found for the SMS group. No between-group differences in sleep hygiene practices were identified. A bidirectional negative association between TST and nap duration was found for the SMS group. In the SMS group, increased afternoon sleepiness was associated with increased irritability (p = .007) and overactivity (p = .005). Conclusion These findings evidence poor sleep quality in SMS and the need to implement evidence-based interventions in this population.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A320-A320
Author(s):  
R H Roth ◽  
E Harrison ◽  
H Kang ◽  
J Lobo ◽  
J Logan ◽  
...  

Abstract Introduction Few studies have explored how patients sleep or what characteristics might be predictive of poor sleep during clinically-indicated polysomnography (PSG) in an in-laboratory setting. Methods We reviewed clinically indicated diagnostic PSG studies completed over a 10-year period in a single academic sleep center. Total sleep time (TST) and sleep efficiency (SE) were used as proxies for sleep quality. Patients were categorized as normal or poor sleepers based on TST &lt;4 hours or SE &lt;50%. Multivariate linear and logistic regression analyses were performed to determine factors associated with sleep quality while controlling for demographics, medications, comorbidities and measures of sleep. Results We included 4957 patients, who were mostly female (58.9%), middle-aged (52.9 y), Caucasian (69.3%), and overweight or obese (91.3%). 3682 patients (74.2%) were diagnosed with sleep apnea (Apnea Hypopnea Index(AHI)&gt;5/hr). Average TST was 5.75±1.43 hours (Interquartile range [IQR] = 4.94 - 6.73) and average SE was 75.1%±16.1% (IQR=66.9 - 87.2). TST and SE were lower for males compared to females (5.48 vs 5.93 hr, p&lt;0.001; 73% vs 77%, p&lt;0.001). In multivariable analysis, older age (TST: OR = 1.04, 95% CI:[1.03,1.05]; SE: OR = 1.04, 95% CI:[1.04,1.05]), male sex (TST: 1.38,[1.14,1.68]; SE: 1.34,[1.07,1.68]), normal body habitus (TST: 1.47,[1.02,2.08]; SE: 1.51,[1.01,2.27]) and a higher AHI (TST: 1.02,[1.02,1.03]; SE: 1.02,[1.003,1.03]) were significantly associated with being a poor sleeper for both TST and SE. Antidepressant use was associated with poor sleep for TST (0.77, [0.59,1]), but not for SE (0.98, [0.73,1.3]). Conclusion Sleep quality during the in-laboratory PSG differed by sex, age and presence of sleep apnea. Sleep quality during in-lab PSG is thought to be compromised by obtrusive monitoring and an unfamiliar environment, but average sleep quality may be higher than expected for patients in the laboratory. Future studies should consider examining in-lab sleep quality in different patient populations. Support N/A


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