scholarly journals The Relationship between Fatigue and Actigraphy-Derived Sleep and Rest–Activity Patterns in Cancer Survivors

2021 ◽  
Vol 28 (2) ◽  
pp. 1170-1182
Author(s):  
Tristan Martin ◽  
Rosie Twomey ◽  
Mary E. Medysky ◽  
John Temesi ◽  
S. Nicole Culos-Reed ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Sleep Onset ◽  
Severity Index ◽  
Objective Measures ◽  
Sleep Onset Latency ◽  
Insomnia Severity Index ◽  
Cancer Related Fatigue ◽  
Activity Cycles ◽  
Insomnia Severity ◽  
Rest Activity

Cancer-related fatigue can continue long after curative cancer treatment. The aim of this study was to investigate sleep and rest–activity cycles in fatigued and non-fatigued cancer survivors. We hypothesized that sleep and rest–activity cycles would be more disturbed in people experiencing clinically-relevant fatigue, and that objective measures of sleep would be associated with the severity of fatigue in cancer survivors. Cancer survivors (n = 87) completed a 14-day wrist actigraphy measurement to estimate their sleep and rest–activity cycles. Fatigue was measured using the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F). Participants were dichotomised into two groups using a previously validated score (fatigued n = 51 and non-fatigued n = 36). The participant’s perception of sleep was measured using the Insomnia Severity Index (ISI). FACIT-F score was correlated with wake after sleep onset (r = −0.28; p = 0.010), sleep efficiency (r = 0.26; p = 0.016), sleep onset latency (r = −0.31; p = 0.044) and Insomnia Severity Index (ISI) score (r = −0.56; p < 0.001). The relative amplitude of the rest–activity cycles was lower in the fatigued vs. the non-fatigued group (p = 0.017; d = 0.58). After treatment for cancer, the severity of cancer-related fatigue is correlated with specific objective measures of sleep, and there is evidence of rest–activity cycle disruption in people experiencing clinically-relevant fatigue.

scholarly journals The Relationship between Fatigue and Actigraphy-Derived Sleep and Rest-Activity Patterns in Cancer Survivors

2019 ◽  
Author(s):  
Tristan Martin ◽  
Rosemary Twomey ◽  
Mary E Medysky ◽  
John Temesi ◽  
S. Nicole Culos-Reed ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Activity Patterns ◽  
Sleep Onset ◽  
Activity Cycle ◽  
Objective Measures ◽  
Sleep Onset Latency ◽  
Cancer Related Fatigue ◽  
Wrist Actigraphy ◽  
Activity Cycles ◽  
Rest Activity

Background: Cancer-related fatigue can continue long after curative cancer treatment. The aim of this study was to investigate sleep and rest-activity cycles in fatigued and non-fatigued cancer survivors. We hypothesized that sleep and rest-activity cycles would be more disturbed in people experiencing clinically-relevant fatigue, and that objective measures of sleep would be associated with the severity of fatigue in cancer survivors.Methods: Cancer survivors (n=87) completed a 14-day wrist actigraphy measurement for the estimation of sleep and rest-activity cycles. Fatigue was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F). Participants were dichotomised into two groups using a previously validated score (fatigued n=51 and non-fatigued n=36). Perception of sleep was measured using the Insomnia Severity Index (ISI).Results: FACIT-F score was correlated with wake after sleep onset (r =-0.28; p = 0.010), sleep efficiency (r=0.26; p=0.016), sleep onset latency (r=-0.31; p=0.044) and ISI score (r=-0.56; p &lt;0.001). The relative amplitude of the rest-activity cycles was lower in the fatigued vs. non-fatigued group (p=0.017; d=0.58). Conclusions: After treatment for cancer, the severity of cancer-related fatigue is correlated with specific objective measures of sleep, and there is evidence of rest-activity cycle disruption in people experiencing clinically-relevant fatigue.

scholarly journals 0514 Efficacy of a Forehead-Cooling Device for Treating Insomnia in Veterans

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A197-A197
Author(s):  
E Nofzinger
Keyword(s):  
Prospective Study ◽  
Large Scale ◽  
Prospective Trial ◽  
Sleep Onset ◽  
Severity Index ◽  
Post Treatment ◽  
Cooling Device ◽  
Insomnia Severity Index ◽  
Before And After ◽  
Insomnia Severity

Abstract Introduction In 2 independent studies, we explored whether a forehead-cooling device was effective in improving insomnia in veterans. Methods Both studies were uncontrolled and exploratory in nature. The first study involved 20 veterans who expressed interest in using the forehead-cooling device and received 4 weeks treatment. The second study involved 19 veterans who were recruited via media to participate in a 4-week study and were compensated for their participation. All participants completed questionnaires before and after treatment. Results In the retrospective analysis, veterans had improvements over baseline in insomnia severity index (M ± SD =17.6 ± 4.7 pre- vs 6.9 ± 3.5 post-treatment, t(19) = -9.4, p&lt;0.00001), in sleep latency (M ± SD = 61.7 ± 49.1 minutes pre- vs 25.0 ± 20.8 minutes post-treatment, t(19) = -4.6, p&lt;0.001) and in minutes awake after sleep onset (M ± SD =78.7 ± 57.8 minutes pre- vs 29.9 ± 18.3 minutes post-treatment, t(19) = -4.0, p&lt;0.001). In the prospective study, veterans had improvements in insomnia severity index over baseline (M ± SD = 20.7 +3.8 pre- vs 9.5 ± 7.5 post-treatment, t(18) = 5.8, p&lt;0.00001), depression severity on the PHQ-9 (M ± SD = 21.5 ±6.1 pre- vs 14.2 ± 5.1 post-treatment, t(18) =4.1, p&lt;0.001) and anxiety severity on the GAD 7 (M ± SD = 9.8 ±7.1 pre- vs. 6.2 ± 5.4 post-treatment, t(18) = -3.1, p&lt;0.01). Conclusion Use of a forehead-cooling device improved insomnia in veterans. These findings were replicated in an independent prospective trial. Reductions in depressive and anxiety symptoms from baseline were also noted in the prospective study. These promising preliminary data suggest the need for further large scale randomized controlled trials to establish the efficacy of forehead-cooling on insomnia in veterans. Support Ebb Pharmaceuticals, Pittsburgh, PA 15222

Psychometric properties of the Insomnia Severity Index in cancer survivors

2019 ◽  
Vol 28 (3) ◽  
pp. 540-546
Author(s):  
Miryam Yusufov ◽  
Eric S. Zhou ◽  
Christopher J. Recklitis
Keyword(s):  
Cancer Survivors ◽  
Psychometric Properties ◽  
Severity Index ◽  
Insomnia Severity Index ◽  
Insomnia Severity

scholarly journals Swedish Translation and Validation of the Pediatric Insomnia Severity Index

2019 ◽  
Author(s):  
Charlotte Angelhoff ◽  
Peter Johansson ◽  
Erland Svensson ◽  
Anna Lena Sundell
Keyword(s):  
Quality Of Life ◽  
Structural Equation ◽  
Sleep Onset ◽  
Well Being ◽  
Severity Index ◽  
Swedish Version ◽  
Insomnia Severity Index ◽  
Pediatric Insomnia ◽  
Insomnia Severity

Abstract Background: To increase health and well-being in young children, it is important to acknowledge and promote the child’s sleep behaviour. However, there is a lack of brief, validated sleep screening instruments for children. The aim of this study was to present a Swedish version of the Pediatric Insomnia Severity Index (PISI), analyse the structure, test the validity and reliability of the instrument. Methods: The English version of the PISI was translated into Swedish, translated back into English, and agreed upon before use. Parents of healthy 3- to 10-year-old children filled out the Swedish version of the PISI and the generic health-related quality of life instrument KIDSCREEN-27 two times. Exploratory and confirmatory factor analyses for baseline and test-retest, structural equation modelling, and correlations between the PISI and KIDSCREEN-27 were performed Results: In total, 160 parents filled out baseline questionnaires (test), whereof 100 parents (63%) filled out the follow-up questionnaires (retest). Confirmative factor analysis of the PISI found two correlated factors: sleep onset problems (SOP) and sleep maintenance problems (SMP). The PISI had substantial construct and test-retest reliability. The PISI factors influenced all KIDSCREEN-27 dimensions. Conclusions: The Swedish version of the PISI is applicable for screening sleep problems and is a useful aid in dialogues with families about sleep. It is also relevant in research and for evaluation of treatment. Keywords: Child; Child, Preschool; Health Promotion; Sleep; Translations; Pediatrics; Validation Studies; Quality of Life

scholarly journals 1192 The Accuracy of a Novel Sleep Ring Device for Estimating Sleep Onset with Good and Poor Sleepers

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A456-A456
Author(s):  
H Scott ◽  
A Whitelaw ◽  
A Canty ◽  
N Lovato ◽  
L Lack
Keyword(s):  
Home Environment ◽  
Sleep Onset ◽  
Severity Index ◽  
Sleep Laboratory ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Additional Funding ◽  
Multiple Sleep Latency ◽  
Insomnia Severity ◽  
Intense Vibration

Abstract Introduction THIM is a new ring-like sleep device that, if found to accurately measure sleep onset, could be used for a variety of clinical purposes. These include administering a brief but effective treatment for insomnia called Intensive Sleep Retraining, facilitating the optimal 10-minute power nap, and administering Multiple Sleep Latency Tests (MSLTs) outside of the sleep laboratory. This study assessed the accuracy of THIM for measuring sleep onset latency compared to polysomnography (PSG). Methods Twenty healthy individuals aged 23.6 years (SD = 4.89) underwent overnight PSG recording whilst using THIM on two nights in the sleep laboratory, one week apart. On each night, participants completed sleep onset trials for four hours whilst monitored via PSG. In these trials, participants attempted to fall asleep whilst responding to vibrations emitted from THIM. Once they failed to respond to two consecutive stimuli, THIM woke them with an intense vibration. Participants had a short break before attempting the next trial. Results On average, THIM overestimated sleep onset on the first night by 0.24 minutes (SD = 0.90). On the second night, THIM overestimated sleep onset by 0.82 minutes (SD = 1.31) and this discrepancy was not significantly different to that obtained on the first night, p = .08. The accuracy of THIM did not differ between good sleepers (Insomnia Severity Index (ISI) score &lt; 7) or poor sleepers (ISI score 8-15), p = .98. Conclusion The findings suggest that THIM is accurate at estimating sleep onset latency for both good and poor sleepers. The next step is to test THIM outside of the laboratory environment. The goal is to develop an accurate yet practical device that can translate laboratory-based procedures to the home environment, to the benefit of patients and clinicians wanting to improve sleep. Support The project was funded in-part by the manufacturers of THIM, Re-Time Pty. Ltd., with additional funding provided by Flinders University.

scholarly journals Mindfulness-based therapy for insomnia for older adults with sleep difficulties: a randomized clinical trial

2021 ◽  
pp. 1-11
Author(s):  
Francesca Perini ◽  
Kian Foong Wong ◽  
Jia Lin ◽  
Zuriel Hassirim ◽  
Ju Lynn Ong ◽  
...  
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Exercise Program ◽  
Severity Index ◽  
Poor Sleep ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Insomnia Severity

Abstract Objective Poor sleep is a modifiable risk factor for multiple disorders. Frontline treatments (e.g. cognitive-behavioral therapy for insomnia) have limitations, prompting a search for alternative approaches. Here, we compare manualized Mindfulness-Based Therapy for Insomnia (MBTI) with a Sleep Hygiene, Education, and Exercise Program (SHEEP) in improving subjective and objective sleep outcomes in older adults. Methods We conducted a single-site, parallel-arm trial, with blinded assessments collected at baseline, post-intervention and 6-months follow-up. We randomized 127 participants aged 50–80, with a Pittsburgh Sleep Quality Index (PSQI) score ⩾5, to either MBTI (n = 65) or SHEEP (n = 62), both 2 hr weekly group sessions lasting 8 weeks. Primary outcomes included PSQI and Insomnia Severity Index, and actigraphy- and polysomnography-measured sleep onset latency (SOL) and wake after sleep onset (WASO). Results Intention-to-treat analysis showed reductions in insomnia severity in both groups [MBTI: Cohen's effect size d = −1.27, 95% confidence interval (CI) −1.61 to −0.89; SHEEP: d = −0.69, 95% CI −0.96 to −0.43], with significantly greater improvement in MBTI. Sleep quality improved equivalently in both groups (MBTI: d = −1.19; SHEEP: d = −1.02). No significant interaction effects were observed in objective sleep measures. However, only MBTI had reduced WASOactigraphy (MBTI: d = −0.30; SHEEP: d = 0.02), SOLactigraphy (MBTI: d = −0.25; SHEEP: d = −0.09), and WASOPSG (MBTI: d = −0.26; SHEEP (d = −0.18). There was no change in SOLPSG. No participants withdrew because of adverse effects. Conclusions MBTI is effective at improving subjective and objective sleep quality in older adults, and could be a valid alternative for persons who have failed or do not have access to standard frontline therapies.

319 Validation of the Insomnia Severity Index Short-Form for Identifying Insomnia Disorder in Young Adult Cancer Survivors

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A128-A128
Author(s):  
Lydia Chevalier ◽  
Alexis Michaud ◽  
Eric Zhou ◽  
Grace Chang ◽  
Christopher Recklitis
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Sensitivity And Specificity ◽  
Short Form ◽  
A Priori ◽  
Severity Index ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
Insomnia Severity

Abstract Introduction Insomnia is a common and impairing late effect experienced by many young adult cancer survivors (YACS). Although routine evaluation of sleep disorders in cancer survivors is recommended, lack of consensus on appropriate screening measures contributes to under-identification and under-treatment of these disorders in YACS. As screening measures are ideally as brief as possible while maintaining validity, we sought to validate the recently published three-item Insomnia Severity Index Short-Form (ISI-SF) in YACS. Methods 250 YACS completed the ISI and the Structured Clinical Interview for the DSM-5 (SCID-5). The ISI-SF was created by summing three ISI items: distress (item #6), interference (item #7), and satisfaction (item #4). In receiver operating characteristic (ROC) analyses, area under the curve (AUC) was calculated to compare discrimination on the ISI-SF to two criteria: the full-scale ISI using a cutoff of ≥8 recently validated in this sample, and the SCID-5 insomnia module. Consistent with previous research, we specified a priori that a cut-off score on the ISI-SF with sensitivity ≥.85 and specificity ≥.75 would be acceptable. Results The ISI-SF had excellent discrimination when compared to the full-scale ISI (AUC = .97) and a cut-off score of ≥4 met criteria with a sensitivity of 97% and specificity of 86%. The ISI-SF had good discrimination when compared to the SCID-5 (AUC = .88), but none of the cut-off scores met a priori criteria for sensitivity and specificity. A cut-off score of ≥4 came closest with a sensitivity of 94% and specificity of 70%. Conclusion Although the ISI-SF did not meet sensitivity and specificity criteria for a stand-alone screening measure when compared to a diagnostic interview, it demonstrated utility as the first step in a two-step screening procedure. Specifically, the high sensitivity of the ≥4 ISI-F cut-off score is well-suited to accurately screening out YACS who do not need insomnia services; as a second screen, the SCID-5 insomnia module could be administered only to those elevated on the ISI-SF in order to identify false positives cases before making referrals for insomnia specialists. Support (if any) National Cancer Institute (1R21CA223832), Swim Across America

scholarly journals Sleep Disturbances in Individuals Quarantined Due to SARS-CoV-2 Pandemic in Poland: A Mixed Methods Design Study

2021 ◽  
Vol 10 ◽  
pp. 216495612110207
Author(s):  
Sabina Krupa ◽  
Witt Paweł ◽  
Wioletta Mędrzycka-Dąbrowska ◽  
Agnieszka Lintowska ◽  
Dorota Ozga
Keyword(s):  
Mixed Methods ◽  
Sleep Disturbances ◽  
Acute Stress ◽  
Sleep Problems ◽  
Severity Index ◽  
Structured Interview ◽  
Mixed Methods Design ◽  
Design Study ◽  
Insomnia Severity Index ◽  
Insomnia Severity

Objectives The study aimed to assess sleep disturbances in patients subjected to home quarantine due to suspected SARS-CoV-2 infection. The study used a mixed methods design study as a research methodology. Methods A semi-structured interview and the scale for Insomnia Severity Index (ISI) were used to achieve the aim of the study. The survey was conducted from 16 to 20 April 2020 and 1 to 2 September 2020 in Poland, at the during of SARS-CoV-2 epidemic in this country. The data were coded and cross-processed. The (COREQ) checklist was followed. Results Interviews with patients and a thorough analysis of recordings revealed commonly used phrases in the following categories: “anxiety”, “ Am I going crazy?”, “Sleep problems”. 10 out of 11 respondents reported sleep disorders of varying severity according to the Insomnia Severity Index scale. Patients presented a fear related to the return to society and normal functioning after quarantine. Additionally, some study participants voiced concerns related to their mental health; some cases of hallucinations were reported. Conclusions Further global population studies should be conducted to analyse this phenomenon. Acute Stress Disorder should be understood as a threat to life and health of an isolated society in quarantine. Further research in this area should be promoted and the need for global guidelines for the entire population should be developed.

scholarly journals The effect of sleep-wake intraindividial variability in digital cognitive behaviour therapy for insomnia: A mediation analysis of a large-scale RCT

SLEEP ◽  
2021 ◽  
Author(s):  
Cecilie L Vestergaard ◽  
Øystein Vedaa ◽  
Melanie R Simpson ◽  
Patrick Faaland ◽  
Daniel Vethe ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Large Scale ◽  
Controlled Trial ◽  
Sleep Onset ◽  
Depression Scale ◽  
Mediating Effect ◽  
Sleep Onset Latency ◽  
Composite Measures ◽  
Cognitive Behaviour ◽  
Insomnia Severity

Abstract Study Objectives Digital Cognitive Behavioural Therapy for Insomnia (dCBT-I) is an effective treatment for insomnia. However, less is known about mediators of its benefits. The aim of the present study was to test if intraindividual variability in sleep (IIV) was reduced with dCBT-I, and whether any identified reduction was a mediator of dCBT-I on insomnia severity and psychological distress. Methods In a two-arm randomized controlled trial (RCT), 1720 adults with insomnia (dCBT-I = 867; patient education about sleep = 853) completed the Insomnia Severity Index (ISI), the Hospital Anxiety and Depression Scale (HADS) and sleep diaries, at baseline and 9-week follow-up. Changes in IIV were analysed using linear mixed modelling followed by mediation analyses of ISI, HADS, and IIV in singular sleep metrics and composite measures (Behavioural Indices (BI-Z) and Sleep-disturbance Indices (SI-Z)). Results dCBT-I was associated with reduced IIV across all singular sleep metrics, with the largest between-group effect sizes observed for sleep onset latency (SOL). Reduced IIV for SOL and wake after sleep onset had the overall greatest singular mediating effect. For composite measures, SI-Z mediated change in ISI (b = -0.74; 95% Confidence Interval (CI) -1.04 to -0.52; 13.3%) and HADS (b = -0.40; 95% CI -0.73 to -0.18; 29.2%), whilst BI-Z mediated minor changes. Conclusion Reductions in IIV in key sleep metrics mediate significant changes in insomnia severity and especially psychological distress when using dCBT-I. These findings offer important evidence regarding the therapeutic action of dCBT-I and may guide the future development of this intervention.

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