Biomedical subjects

J Wisbey

Publications and source records attributed to J Wisbey.

4 recordsLinked to original sources

PubMed2000

Compliance with CPAP in elderly patients with OSA.

Background: Obstructive sleep apnea (OSA) is common in the general population and especially in the geriatric age group. Nasal continuous positive airway pressure (CPAP) is a highly effective treatment but can be difficult for some patients to use.Objective: We investigated the question if older patients were less compliant with CPAP therapy than younger patients and may not realize its benefits.Methods: We conducted a prospective, non-randomized study comparing use of CPAP in patients over age 65 with patients under age 65. One hundred and seven consecutive patients with a new diagnosis of obstructive sleep apnea were started on therapy with nasal CPAP. We obtained follow-up data on all 107 patients. Compliance with CPAP was assessed by patients subjective report of use and, in a subset of 21 patients, by objective measurement using a microchip installed in the CPAP unit that measures actual hours of use at therapeutic pressure.Results: The percentage of patients using CPAP regularly was not different in the two groups: 70% of patients in the over age 65 group used CPAP regularly vs. 72% of patients under age 65. The over 65 group used CPAP 6.5 nights per week, an average of 6.5 h of use per night. The under 65 group was not significantly different, using CPAP 6.8 nights per week, a mean of 6.7 h of use per night.Conclusion: Patients over age 65 are able to tolerate CPAP as well as patients under age 65.

Journal Article↗

PubMed1997

Assessing sleep in psychiatric inpatients: nurse and patient reports versus wrist actigraphy.

This study was designed to evaluate the conventional techniques of assessing sleep, nursing and patient report, of inpatients on a clinical psychiatric unit. Nurses assessed sleep/wake status at hourly checks and patients completed a sleep diary. For three nights patients wore a wrist actigraph, a portable instrument which provides objective data about sleep/wake activity. The nursing and patient data obtained were compared with actigraphy data. Nursing staff evaluated sleep with satisfactory agreement (76.5% night 1 and 81.6% night 3) that improved over the first three nights of hospitalization (p < 0.03). When the nurses' report did not agree with the actigraph, they tended to overestimate sleep. Patients tended to underestimate their total sleep time and total time awake after sleep onset. Time in bed and initial sleep latency were overestimated. There was great intersubject variability, making determination of agreement impossible. This data suggest that treatment teams on psychiatric units should in general consider nursing reports of sleep more accurate than patient self-report. However, since nursing staff and patients observe different aspects of sleep, both sources of data are important to inpatient treatment teams on clinical units.

Adult↗

PubMed1995

Seasonal variation in human illumination exposure at two different latitudes.

The authors measured ambient illumination exposure in healthy volunteers in San Diego, California (latitude 32 degrees 43' N, n = 30), and Rochester, Minnesota (latitude 44 degrees 1' N, n = 24), during each of the four quarters of the year, which were centered on the solstices and equinoxes. Subjects wore photosensors on their wrists and lapels (or foreheads while in bed) 24 h per day for an average of 5-6 days per quarter. The maximum of the two illumination readings was stored each minute. Annual average time spent per day in outdoor illumination (> or = 1000 lux) was significantly higher in San Diego than it was in Rochester (p < .04). Daily durations of illumination at or exceeding thresholds of 1, 10, 100, 1000, and 10,000 lux were highly seasonal in the sample as a whole (p < .01 at 1 lux, p < .0001 at other thresholds). Seasonal variation in outdoor illumination was far more pronounced in Rochester than it was in San Diego (interaction p < .001) but remained significant in San Diego (p < or = .03). Seasonal variation in indoor illumination was generally similar in the two cities. The median Rochester subject experienced illumination > or = 1000 lux for 2 h 23 min per day during summer and 23 min per day during winter. The corresponding times in San Diego were 2 h 10 min and 1 h 20 min. Neither age nor gender predicted illumination duration at any level. Both season and geographic location strongly influenced human illumination exposure, and behavior (choice of indoor vs. outdoor environment) was the most important mediating factor.

Adult↗

PubMed1992

Wrist actigraphy in insomnia.

To assess the use of actigraphy in evaluating insomnia, 36 patients with a serious complaint of insomnia slept 3 nights each in the laboratory, where the usual polysomnograms (PSGs) were obtained as well as actigraphic assessments of their sleep. Patients also wore actigraphs for 7 days at home, were extensively interviewed and filled out psychometric tests. Based on all this information, the patients were then diagnosed according to the International Classification of Sleep Disorders. Averaged over the 3 nights for each insomniac, the mean discrepancy between actigram and PSG was 49 minutes per night. In three-fourths of the cases, actigram and PSG agreed to within 1 hour on the total amount of sleep per night. Discrepancies, however, were not random: In patients with psychophysiologic insomnia and in insomnia associated with psychiatric disease, the actigram typically overestimated sleep when compared with the PSG. In patients with sleep-state misperception, the actigram was either quite accurate or it underestimated sleep when compared with the PSG. Comparing laboratory with home sleep, one-third of all insomniacs slept better in the laboratory and two-thirds slept better at home. In addition, night-by-night variability was higher at home than in the laboratory. Based on our study, we now recommend actigraphy as an additional tool in the clinical evaluation of insomnia, but we believe that in complex cases it should be combined with 1 PSG night in the sleep disorders center.

Adult↗