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Biomedical subjects

T H Monk

Publications and source records attributed to T H Monk.

At least 91 records · Page 5Linked to original sources
PubMed1989

The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research.

Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.

Adult↗
PubMed1989

The timing of bedtime and waketime decisions in free-running subjects.

Twelve "free-running" temporal isolation studies were performed using healthy human subjects aged 20-81 years (4 males, 8 females). Circadian rhythms were measured in subjective alertness (using a visual analogue scale technique) and rectal temperature. In all 12 subjects best fitting rhythm period were found to be shorter for rectal temperature (mean = 24.3 hours) than for subjective alertness (mean = 24.8 hours). Both rhythms were predictive of bedtime and waketime decisions. Bedtime decisions tended to cluster on the falling arm of the temperature and alertness cycles (modal times = 120 degrees (temperature) and 140 degrees (alertness) after acrophase); waketime decisions on the rising arm (modal times = 240 degrees (temperature) and 300 degrees (alertness) after acrophase). When this pattern was violated, sleep episodes were significantly more variable in length and disturbed by intruding wakefulness.

Adult↗
PubMed1989

Circadian determinants of subjective alertness.

Four healthy male subjects each experienced a temporal isolation experiment lasting several months. During part of each experiment (2-5 weeks), the subject's entire imposed daily routine (including light-dark, rest-activity, and meal routines) was either stretched (two subjects: T = 25.8 hr, 26.0 hr) or reduced (two subjects: T = 22.8 hr, 23.1 hr) to beyond the range of entrainment of the endogenous circadian pacemaker (ECP), which then ran at a different period (tau). Subjective alertness was measured approximately three times per hour (during wakefulness), using a computerized visual analogue scale technique. Circadian rhythms in subjective alertness were then plotted both at tau, the period length of the ECP, and at T, the period length of the imposed sleep-wake cycle (SWC) and light-dark cycle. At tau, the alertness rhythm was closely in phase with the temperature rhythm. At T, the alertness rhythm showed an "inverted-U" function with a peak toward the middle of the subjective day, upon which was superimposed a "postlunch dip" for one subject. Thus, subjective alertness would appear to be under the control fo both ECP and SWC mechanisms, which combine to produce the composite time-of-day function normally observed in a diurnal setting.

Arousal↗
PubMed1989

Sleep disorders in the elderly. Circadian rhythm.

Circadian rhythms are observable in almost every neuroendocrine, behavioral, and psychophysiologic function, in addition to the classic vital signs. This article discusses how the circadian system might change with advanced age, how these changes interact with behavior changes, and how the resultant effects might influence sleep and daytime functioning.

Aged↗
PubMed1988

Removal of temporal constraints in the middle-aged and elderly: effects on sleep and sleepiness.

Ten healthy middle-aged and elderly subjects (44-81 years old; 4 men and 6 women) were studied in time isolation experiments involving: (a) entrainment to the subject's habitual routine (EN condition) and (b) removal of all temporal constraints or "free-running" (FR condition) with the subjects able to choose their own bed and meal times. Subjective day lengths and circadian temperature cycle periods were longer under FR than under EN, but not by an equal amount. Perhaps as a consequence, although time-in-bed (TIB) fractions were greater under FR than under EN, actual sleep fractions were not, reflecting a decline in sleep efficiency. Neither was there an increase in slow-wave sleep (SWS) under FR compared with EN. Daytime subjective alertness did, however, increase upon release into FR, also showing a slightly earlier peak than that observed under the EN condition. The results point to the need to regard sleep and sleepiness as rhythmic, as well as homeostatic, processes.

Aged↗
PubMed1988

Inducing jet lag in the laboratory: patterns of adjustment to an acute shift in routine.

Eight middle-aged males were studied in a temporal isolation experimental lasting 15 d. After 5 d and nights of entrainment to his own habitual routine, each subject experienced an acute, unheralded 6-h phase advance in routine, accomplished by truncating his sixth sleep episode. For the remaining 10 d of the study, subjects were held to a routine 6-h phase advanced to the original. Significant symptoms of jet lag appeared in mood, performance efficiency, sleep, and circadian temperature rhythms. When plotted as a function to "days post-shift," some variables (temperature phase, percent rapid eye movement sleep) showed a fairly monotonic recovery to baseline levels. However, other variables (actual sleep duration, percent slow wave sleep, motivation loss, subjective sleepiness) showed a zig-zag recovery pattern, suggesting the interaction of two competing processes, and reinforcing the need for greater sophistication in the development of jet lag coping strategies.

Adult↗
PubMed1987

Subjective ratings of sleepiness--the underlying circadian mechanisms.

Previous field and laboratory studies have revealed that there is a diurnal variation in subjective sleepiness that is different in form to that of objective sleepiness and many measures of performance efficiency. The worst subjective sleepiness occurs at the trough in the circadian temperature rhythm, the least subjective sleepiness about 7 h before the peak in temperature. A series of forced desynchronization experiments, in which the endogenous circadian oscillator controlling the temperature rhythm ran at a different period to the sleep/wake cycle, revealed that these findings can be explained by postulating subjective sleepiness to be under the control of both factors, with minimum sleepiness occurring at the peak in temperature in terms of the temperature cycle and about 6 h after waking in terms of the sleep/wake cycle.

Adult↗
PubMed1986

Interactions between inter-individual and inter-task differences in the diurnal variation of human performance.

Thirty-six undergraduate subjects were divided into 'larks' and 'owls' by median split using the morningness test devised by Horne and Ostberg. Each was given a battery of two performance tests at six times of day, in a design that counter-balanced for practice effects. Oral temperatures were also recorded. Slight (1 hr) phase differences (in the predicted direction) were observed between 'larks' and 'owls' in temperature rhythm, and in the performance test that paralleled temperature (a serial search task). Much more striking differences, though, were observed in the cognitive (logical reasoning) performance test which (as predicted) peaked earlier in the day, on average, than the serial search task. Not only did 'larks' peak much earlier in the day than 'owls', but there were also quite dramatic differences between the two groups in amplitude and shape. Possible mechanisms regarding oscillatory control and performance strategy are discussed.

Adult↗
PubMed1985

Diurnal variation in mood and performance in a time-isolated environment.

In order to document circadian rhythmicity in various psychological functions under the chronobiologically 'pure' condition of temporal isolation, a battery of mood and performance tests were administered about 6 times per day to a heterogeneous group of 18 subjects (ages 19-81, 5 female). Each subject spent about 5 days in temporal isolation, entrained to a routine equivalent to his/her own habitual sleep/wake cycle. Average time of day functions were obtained for the mood and performance variables, and compared to rectal temperature data subjected to exactly the same statistical analysis. Significant time of day effects were found in the mood variables of alertness, sleepiness, weariness, effort required, happiness and well-being. Times of 'best' mood were different from the time of peak temperature. Moreover, the minima of sleepiness, weariness and effort occurred earlier in the day than the maximum of alertness. Significant time of day effects were also found in the speed with which search and dexterity tasks were completed. Only the dexterity tasks showed a complete parallelism with the temperature rhythm.

Adult↗