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PubMed2002

Comparison of the effects of modafinil and sleep deprivation on sleep and cortical EEG spectra in mice.

Modafinil is a wakefulness-promoting substance whose profile differs from that of the classical psychostimulants. It is still unknown whether waking induced by modafinil and wakefulness induced by sleep deprivation differ in terms of their effect on subsequent sleep. To investigate this problem sleep was recorded in two groups of OF1 mice. One group received modafinil (200 mg/kg, i.p.) at light onset which induced a period of wakefulness of approx. 5 h, while animals of the subsequent control group were injected with vehicle and kept awake for an equivalent duration. The effect of the two treatments on sleep was similar. REM sleep was initially reduced and slow-wave activity (SWA; EEG power in the 0.75-4.0 Hz range) in nonREM sleep was enhanced for several hours. The SWA increase was more prominent over the frontal cortex than over the occipital cortex after both treatments. A minor difference was seen at the occipital site where the initial rise of power in the low-frequency range was larger after vehicle combined with enforced waking than after modafinil. The study shows that the homeostatic sleep response following the modafinil-induced wakefulness corresponds largely to the response following a non-pharmacologically induced extended waking episode.

Analysis of Variance↗
PubMed1995

Sleep disturbance in mid-life women.

A correlational field survey was used to describe sleep disturbance and explore the relationship of that sleep disturbance to the psychological and menopausal status of 23 mid-life women. Subjects were 40-55 years of age and had self-reported sleep problems. Instruments included the sleep disturbance questionnaire (SDQ), Centre for Epidemiologic Studies depression scale (CES-D), Speilberger state-trait anxiety scale (STAI), a demographic form, 4 cc blood sample for follicle stimulating hormone analysis, and a 7-night sleep diary ('self report of sleep', or SRS). Ten of the 23 subjects reported periodic limb movement on the SDQ. Sleep diaries (SRS) revealed a characteristic sleep disturbance among 13 of the 23 subjects, which paralleled in some respects the changes in sleep efficiency observed with advancing age, but was more pronounced and was present at an earlier age. There was no statistically significant relationship between sleep disturbance and menopausal status or symptoms, or anxiety and depression among subjects, as shown by correlational coefficient and chi-square statistical tests. Results suggest that a characteristic sleep disorder accompanied by periodic limb movement may be responsible for sleep disturbance in mid-life women. What remains unclear is whether this sleep disturbance is related to aspects of the perimenopause not addressed in this study or to other aspects of ageing.

Adult↗
PubMed2003

The problems of sleep for older women: changes in health outcomes.

OBJECTIVE: to identify the continuance of sleeping difficulty and medication use in a cohort of older Australian women from baseline to 3-year follow-up and to explore the relationship between these factors and health-related quality of life scores, falls and other health care use. METHOD: a 3-year longitudinal survey of 10,430 Australian women aged 70-75 years at baseline. These women were participants in the Australian Longitudinal Study on Women's Health randomly selected from the Australian Medicare database. RESULTS: a majority of women (63%) endorsed one or more items related to sleeping difficulty at 3-year follow-up: 33% reported one item only, 16% reported two or three items, and 14% reported more than three items; 4,194 (42.4%) reporting "waking in the early hours", 2,592 (26.0%) "taking a long time to get to sleep", 2,078 (21.0%) "sleeping badly at night", 1,072 (10.8%) "lying awake most of the night" and 1,087 (11.0%) "worry keeping you awake". Total scores on the Nottingham Health Profile sleep sub-scale ranged from 0-100 and were skewed to the right. The median score was 12.57. There was a strong statistical association between reporting sleeping difficulty at baseline and at follow-up. A total of 1,532 (15%) women reported use of sleeping medication at follow-up and women were 6.5 times more likely to report use if they also reported any item of sleep difficulty. There was a moderate level of agreement (88%, kappa=0.56) between taking sleeping medication within 4 weeks before the baseline survey and within 4 weeks before follow-up. On multivariate analysis, sleeping difficulty at baseline was negatively associated with general health perceptions, emotional role limitations and general mental health sub-scales of the Short-Form-36 Health Survey at follow-up; the use of sleep medication at baseline was negatively associated with physical functioning, bodily pain, vitality, social functioning and general mental health Short-Form-36 sub-scale scores. The use of sleep medication was also significantly associated with falls, accidents, and health care utilisation. CONCLUSION: sleeping difficulty is a common and persistent complaint among older women and is strongly associated with use of sleeping medications. Both behaviours are negatively associated with health status.

Adolescent↗
PubMed2004

Childhood reactions to terrorism-induced trauma: a review of the past 10 years.

OBJECTIVE: To summarize the literature about the clinical presentation and treatment interventions of childhood reactions to terrorism-induced trauma. METHOD: The literature on children's responses to terrorist activities was reviewed. RESULTS: Over the past 10 years, more research has emerged on the subject of terrorism in children. Many of the effects of terrorism-induced trauma are similar to the effects of natural and man-made trauma. Children's responses include acute stress disorder, posttraumatic stress disorder, anxiety, depression, regressive behaviors, separation problems, sleep difficulties, and behavioral problems. However, several aspects of terrorist attacks result in unique stressors and reactions and pose specific challenges for treatment. The unpredictable, indefinite threat of terrorist events, the profound effect on adults and communities, and the effect of extensive terrorist-related media coverage exacerbates underlying anxieties and contributes to a continuous state of stress and anxiety. Intervention strategies include early community-based interventions, screening of children at risk, triage and referral, and trauma-loss-focused treatment programs. CONCLUSIONS: Advances have been made in the research of childhood reactions to terrorism-induced trauma. Further research is needed to identify children at risk and to determine the long-term impact on children's development. Although the preliminary results of interventions developed to help children are promising, outcome data have not been examined, and further research is needed to evaluate their effectiveness.

Child↗
PubMed2005

One month after diagnosis: quality of life, coping and previous functioning in siblings of children with cancer.

BACKGROUND: The aim of the present study is to describe the quality of life (QoL) of siblings of children with cancer and to predict it according to their health before the diagnosis of cancer in the ill child and their ways of coping with the illness. METHODS: Participants were 83 siblings from 56 families-46 girls and 37 boys, aged 7-18. The assessment took place 1 month to 8 weeks after the diagnosis of cancer in the ill child. The siblings' QoL was assessed with the TNO-AZL children's quality of life questionnaire (TACQOL). Coping strategies were assessed with the Cognitive Coping Strategies Scale for siblings (CCSS-s). Physical problems and eating and sleeping problems that existed before the ill child was diagnosed were determined in a structured interview with the parents. RESULTS: A substantial number of siblings reported impaired cognitive and emotional QoL compared to the reference group. School-aged siblings (7-11 years) reported more trouble with motor functioning than peers. The coping strategy 'predictive control' (maintaining positive expectations regarding the illness) positively predicted siblings' QoL. The presence of health problems before diagnosis was negatively associated with siblings' QoL. Older siblings reported more negative emotions, while girls reported lower social QoL and reliance on 'interpretative control' (trying to understand the illness) was associated with fewer positive emotions. CONCLUSIONS: During the first 2 months after the diagnosis of cancer in a brother or sister, siblings have relatively lower QoL than peers. Health problems that existed before diagnosis may be a predictor of later adjustment problems. Positive expectations about the course of the illness appear to protect siblings from distress. Information about the illness is a delicate issue that requires parental guidance.

Adaptation, Psychological↗
PubMed1994

An investigation into primary nursing and its effect upon the nursing attitudes about and administration of prn night sedation.

This study aims to explore the administration of prn night sedation by qualified night nurses on primary nursing and team nursing wards using a quasi-experimental design. The purpose of the study was to examine the attitudes of qualified nurses (n = 20) about sleep problems in hospital and sleep medication and compare these attitudes with behaviour (the administration of prn night sedation) reporting any differences between wards using team and primary nursing philosophies of care. Ten nurses from team nursing wards and 10 nurses from primary nursing wards were interviewed about the amount of night sedation they had administered during one night shift. This was followed by a questionnaire aimed at examining their attitudes about sleep and night sedation using several visual analogue scales. Findings proved to be significant in that results confirmed that team nurses gave out almost three times as much prn night sedation as nurses on primary nursing wards and held attitudes that closely correlated with more of a 'medical model' approach such as an emphasis on the advantages of night sedation and the need for its continued use in the clinical area.

Adult↗
PubMed1995

Implementation of napping in industry and the problem of sleep inertia.

It seems reasonable to believe that in specific situations napping at the work place would be possible and used if authorized and encouraged. Very short naps could have very positive long-term effects on biological functions. Training someone to sleep for short periods appears feasible if there is a high motivation to do so. Sleep inertia can be considered as one of the main limiting factors in napping strategy. Sleep inertia depends on different factors such as sleep stage preceding the awakening, temporal placement of the nap, duration of nap and wakefulness preceding it, etc. The effects of sleep inertia might be different depending on the type of task, and a reactivation technique applied immediately after awakening may remove it. Despite the fact that its implementation in industry raises some practical issues, napping can be considered as a possible strategy to increase the vigilance level of night workers.

Journal Article↗
PubMed2004

Snoring and its association with asthma in Indigenous children living in the Torres Strait and Northern Peninsula Area.

OBJECTIVE: Respiratory health of Indigenous and minority ethnic groups in affluent countries is poorer than their non-minority counterparts and sleep disorders are no exception. In children, obstructive sleep apnoea has the potential to result in serious long-term consequences. In 1999, we studied 1650 children and adolescents living in the Torres Strait and the Northern Peninsula Area, Australia. Here we report prevalence of snoring in these communities and relate its association with asthma symptoms. METHODS: A population-based cross-sectional study was conducted in the Torres Strait region. Five indigenous communities were randomly selected and information was collected using a structured face-to-face interview based on a standardized questionnaire. There was a 98% response rate, and 1650 children, 0-17 years of age, were included in the study. RESULTS: Overall, the prevalence of snoring was 14.2% (95% CI 12.5-15.9); 3.6% (95% CI 2.7-4.6) reported snorting, and 6% (95% CI 4.9-7.2) reported restless sleep. The prevalence of snoring was significantly higher among males (17.1% for males and 10.8 for females, P = 0.005). Children were five times more likely to have experienced snoring and snorting if they reported wheezing in the last 12 months. CONCLUSION: We conclude that the prevalence of symptoms suggestive of obstructive sleep problems is relatively high in children of this region. This highlights the need for awareness among the community patients and physicians about the problem of obstructive sleep-disordered breathing, especially in children with asthma, and for the need for further studies to measure prevalence of sleep breathing disorders among Indigenous Australians.

Adolescent↗
PubMed2002

[Sleep and vigilance in hyperactive children].

Inattention, impulsiveness and hyperactivity are the main clinical features that characterise the attention deficit hyperactivity disorder (ADHD). Children with ADHD essentially present with diurnal manifestations but studies have recently shown a link between sleep and daytime symptoms. ADHD children could present sleep problems such as agitated sleep, sleep-onset difficulties, low arousal threshold during the night. Such sleep difficulties have been shown to occur more frequently in children with severe diurnal ADHD symptoms. Sleep studies using polysomnography have been performed in children with ADHD. Abnormalities during sleep such as increased motricity could be responsible for hypovigilance as measured using multiple sleep latency tests. Prevalence and physiopathology of sleep disorders including awakening mechanisms (micro-arousals, arousal threshold) from sleep yet need to be clarified in ADHD children. Understanding the mechanisms governing the sleep-wake balance seems essential for the comprehension of ADHD. Excessive nocturnal motricity could be the expression of a monoaminergic dysfunctioning previously reported in ADHD and could lead to new therapeutic gateways as well as hypovigilance.

Attention↗