SEARCH · PubMed Health

Results for “sleep problems”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 739 records · Page 41Linked to original sources

PubMed2006

Practice parameters for behavioral treatment of bedtime problems and night wakings in infants and young children.

Bedtime problems and frequent night wakings are highly prevalent in infants, toddlers, and preschoolers. Evidence suggests that sleep disruption and/or insufficient sleep have potential deleterious effects on children's cognitive development, regulation of affect, attention, health outcomes, and overall quality of life, as well as secondary effects on parental and family functioning. Furthermore, longitudinal studies have demonstrated that sleep problems first presenting in infancy may become chronic, persisting into the preschool and school-aged years. A solid body of literature now exists supporting the use of empirically-based behavioral management strategies to treat bedtime problems and night wakings in infants, toddlers, and preschoolers. The following practice parameters present recommendations for the use of behavioral (i.e., non-pharmacological) treatments of bedtime problems and night wakings in young children (aged 0 - 4. years 11 months). A companion review paper on which the recommendations are based was prepared by a taskforce appointed by the Standards of Practice Committee (SPC) of the American Academy of Sleep Medicine (AASM), and summarizes the peer-reviewed scientific literature on this topic. The authors of the review paper evaluated the evidence presented by the reviewed studies according to modified Sackett criteria. Using this information and a grading system described by Eddy (i.e., standard, guideline or option), the Standards of Practice Committee and Board of Directors of the American Academy of Sleep Medicine determined levels of treatment recommendation presented in the practice parameters below. These practice parameters provide 3 types of recommendations. First, recommendations are provided indicating that behavioral interventions are effective in the treatment of bedtime problems and night wakings in young children, producing reliable and significant clinical improvement in sleep parameters. Second, recommendations are made regarding specific behavioral therapies, including: (1) unmodified extinction, extinction with parental presence, and preventive parent education are all rated as individually effective therapies in the treatment of bedtime problems and night wakings (Standards), and (2) graduated extinction, bedtime fading/positive routines and scheduled awakenings are rated as individually effective therapies in the treatment of bedtime problems and night wakings but with less certainty (Guidelines). There was insufficient evidence to recommend standardized bedtime routines and positive reinforcement as single therapies. In addition, although behavioral therapies for bedtime problems and night wakings are often combined, there was insufficient evidence available to recommend one individual therapy over another or to recommend an individual therapy over a combination of therapies. Finally, recommendations are provided regarding the beneficial effects of behavioral treatments on secondary outcomes, including daytime functioning (child) and parental well-being.

Behavior Therapy↗

PubMed2000

A systematic review of treatments for settling problems and night waking in young children.

OBJECTIVES: To assess the efficacy of treatments for settling problems and night waking in young children. DESIGN: A systematic review of randomised controlled trials of interventions for settling problems and night waking in young children. SETTING: Electronic bibliographic databases and references on identified papers, hand searches, and personal contact with specialists. SUBJECTS: Children aged 5 years or less who had established settling problems or night waking. INTERVENTIONS: Interventions had to be described and a placebo, waiting list, or another intervention needed to have been used as a comparison. Interventions comprised drug trials or non-drug trials. MAIN OUTCOME MEASURES: Number of wakes at night, time to settle, or number of nights in which these problems occurred. RESULTS: Drugs seemed to be effective in treating night waking in the short term, but long term efficacy was questionable. In contrast, specific behavioural interventions showed both short term efficacy and possible longer term effects for dealing with settling problems and night waking. CONCLUSIONS: Given the prevalence and persistence of childhood sleep problems and the effects they can have on children and families, treatments that offer long lasting benefits are appealing and these are likely to be behavioural interventions.

Behavior Therapy↗

PubMed1984

Sleep-associated airway problems in children.

Several of the most common and most important sleep-associated airway problems are discussed, including obstructive sleep apnea syndrome, gastroesophageal reflux and nocturnal aspiration, spasmodic croup, nocturnal asthma, and sleep hypoxemia in chronic lung disease, and guidelines are offered for the often difficult diagnosis and for treatment.

Adult↗

PubMed1985

Diagnosis and management of obstructive sleep apnea. A multidisciplinary approach.

Snoring has been shown to be the primary sign of a potentially serious medical condition, ie, obstructive sleep apnea (OSA). Traditionally, the otolaryngologist has been the primary medical resource for patients with snoring problems. However, until recently, little was known about the now-acknowledged serious complications of this phenomenon. Of the primary treatments for this condition, those most commonly utilized to date involve surgical procedures routinely performed by the otolaryngologist, ie, tracheostomy and uvulopalatopharyngoplasty. Thus, the practicing otolaryngologist has been thrust into the forefront in the diagnosis and management of OSA. Hence, it behooves the modern practitioner to be cognizant of the multidisciplinary approach to this problem. Herein, we review snoring as a medical problem, sleep laboratory studies of patients with OSA, and the interaction of multidisciplinary team members in the optimal management of this ubiquitous problem.

Airway Obstruction↗

PubMed2003

Limitations of current Parkinson's disease therapy.

Levodopa and other dopaminergic medications drastically improve the motor symptoms and quality of life of patients with Parkinson's disease in the early stages of the disease. However, once the "honeymoon" period has waned, usually after a few years of dopaminergic therapy, patients become progressively more disabled despite an ever more complex combination of available antiparkinsonian treatments. Sooner or later, they suffer from "dopa-resistant" motor symptoms (speech impairment, abnormal posture, gait and balance problems), "dopa-resistant" nonmotor signs (autonomic dysfunction, mood and cognitive impairment, sleep problems, pain) and/or drug-related side effects (especially psychosis, motor fluctuations, and dyskinesias). Therefore, the current antiparkinsonian therapy cannot be considered as ideal with regard to both efficacy and safety.

Antiparkinson Agents↗

PubMed1980

A sleep clinic within a general hospital psychiatry service.

A sleep clinic was founded within a general hospital psychiatry service. A practical approach toward sleep problems included: flexible diagnostic investigations; descriptive, imprecise diagnostic categories; and symptomatic treatment measures. A summary of 100 consecutive patients with chronic insomnia is presented to illustrate this approach. Of 36 treatment failures, most were due to incomplete treatment rather than irremediable problems. The general psychiatry service may provide a favorable base for a sleep clinic.

Adult↗

PubMed2005

Occurrence, severity, and longitudinal course of twelve common symptoms in 1129 consecutive patients during radiotherapy for cancer.

Little is known about the frequency, severity, and course of symptoms experienced by patients receiving radiotherapy (RT). For this descriptive study, 1129 patients with a variety of cancer diagnoses completed a 12-item Symptom Inventory (SI) at the start of RT; 419 of these patients also completed the SI weekly for an additional 4 weeks (five data points). Eighty-four percent of the 1129 patients were already experiencing symptoms when treatment began. All symptoms significantly increased in frequency over a typical 5 week RT course (all Ps<0.001). Skin problems showed the largest increase. The most common symptoms (fatigue, drowsiness, and sleep problems) were also the most severe. Female patients and patients younger than the median age (59 years) reported significantly more symptoms than males and those 59 years or older. Symptom frequency and severity varied significantly by cancer diagnosis. Improved understanding about the time course and dose response of radiation-induced toxicity will permit more accurate presentation of side effect risk at the time patient consent is obtained.

Adolescent↗

PubMed2002

Use of a lying hip abduction system in children with bilateral cerebral palsy: a pilot study.

Fourteen children aged 4 to 14 years with hip subluxation due to cerebral palsy (CP) were considered for a trial in a lying hip abduction system (Jenx Dreama, Jenx Limited, Sheffield, UK). Baseline data were recorded for 6 months, then assessments of the system were made for one year at 6 and 12 months. Assessments consisted of hip radiographs in the standard position, a parental questionnaire, and a sleep chart, which was completed by parents every Friday night during the trial. Three children could not enter the trial because of general sleep problems, and three could not complete it because they were unable to sleep with the system. One further child withdrew from the study just before the end because of unacceptable deterioration for which surgery was needed. The remaining seven children completed the trial and there was an overall improvement in rate of hip migration percentage on the right from 7% per annum in the baseline period to 4% with the system (p<0.05). On the left, changes were -3% and 0% respectively (ns). Average sleep at night changed from 9 to 9.4 hours (ns) and wakenings/night from 1 to 1.3 (ns). On the parental questionnaire, there were significant improvements noted with the system in position for seating and sleeping, ease of hip abduction for washing, and with pain reduction. This pilot study supports the use of this type of lying system but further studies are needed to establish the acceptability and efficacy of these systems, particularly in children aged 2 to 5 years when irreversible bony deformities of the hip tend to occur.

Adolescent↗

PubMed1996

Effects of critical care unit noise on the subjective quality of sleep.

Nurse researchers have provided evidence that hospital critical care unit (CCU) noise may put patients at risk for sleep problems. Technological advances in this setting have been described as contributing to this problem. Although data on the negative effects of CCU noise on physiological sleep are available, less attention has been given to self-reports of the subjective quality of sleep following exposure to this stressor. This study hypothesized that subjects exposed to CCU sound levels would report poorer subjective sleep than subjects in a quieter environment. Sixty female subjects, attempting to sleep overnight in a laboratory, were randomly assigned to an experimental group, where they heard an audiotape recording of CCU sounds throughout the night, or to a quiet group where the audiotape recording of CCU sounds was withheld. A self-rating questionnaire was used to assess subjective sleep. The noise condition subjects reported taking longer to fall asleep, less time sleeping, more awakenings, poorer quality of sleep compared to home, as well as fewer positive and more negative adjectives descriptive of sleep. Self-reports of the time spent sleeping and the number of negative adjectives descriptive of sleep yielded the greatest number of significant correlations with scores for the other measures of sleep, indicating that these measures may be more accurate. Data on the quality of dreams yielded no difference between groups. The results provide support for the hypothesis that CCU sound levels impact negatively on subjective sleep. It was recommended, now that CCU sound levels were isolated in the laboratory as a potential stressor, that future research should attempt to replicate this study in a hospital CCU.

Adult↗

PubMed2002

Sleepiness in children and adolescents: clinical implications.

Over the past decade, excessive sleepiness among children and adolescents has been identified as a major societal concern. Professionals working with pediatric groups must increasingly factor sleepiness into assessments of waking function. We define and discuss excessive sleepiness in children and adolescents and review available evidence regarding effects on behavior, mood, and performance. Findings for daytime sleepiness and subsequent impairment in these domains are classified as robust to unknown. Empirical evidence clearly indicates that children and adolescents experience significant daytime sleepiness as a result of inadequate or disturbed sleep. The specific effect of sleepiness on functional domains in pediatric groups are less well-studied, but existing data suggests that children are likely to experience impairment in behavioral, mood, and performance domains. However, such variables as developmental differences in the type and degree of impairment, the degree of sleep disturbance required to produce impairments, and potential risk and protective factors for the effects of sleepiness in children have yet to be described. Further research is clearly warranted, and we discuss important questions and methodological concerns to encourage inquiry in both clinical and experimental settings. Advice is offered with regard to screening for sleep problems and associated sleepiness with children and adolescents.

Achievement↗

PubMed2001

Relationships between quality of sleep and its related factors among elderly Chinese immigrants in the Seattle area.

The risk factors related to quality of sleep in elderly adults, such as life-style events, physical illness, psychological factors, and gender have been well identified by several studies. However, information regarding the relationship between quality of sleep and its related factors among elderly Chinese immigrants is not available in recent sleep literature. The purposes of this study were to explore the quality of sleep and discover the relationships between sleep quality and its related factors among elderly Chinese immigrants people in the Seattle area. Pearson's correlation and descriptive statistics were used to analyze data. Eighty community-dwelling Chinese elderly people, aged from 66 to 93, were recruited from the Chinese Senior Day Care Center, local Chinese churches, elderly Chinese individuals' private homes, and Chinese retirement apartments within the Seattle area. Three questionnaires were utilized to collect data, and personal interviews were used to facilitate the subjects in completing the questionnaires. The findings of this study showed that (1) 55% (n = 44) of the participants were identified as poor sleepers and 45% (n = 36) as good sleepers. (2) depression and the number of current diseases experienced by the subjects were in statistically significant correlation with quality of sleep, with r = .477, p = .00 and r = .221, p = .049 respectively. (3) daytime napping did not affect nighttime sleep in this study' population. The findings of this study can provide information regarding sleep problems among elderly Chinese immigrants to improve the elderly's quality of sleep.

Aged↗

PubMed2006

Sleep disturbance in patients with lichen simplex chronicus and its relationship to nocturnal scratching: A case control study.

BACKGROUND: Lichen simplex chronicus (LSC) is a common pruritic disorder resulting from repeated rubbing and scratching. Nighttime pruritus is a common feature in LSC and may disrupt the sleep pattern. The aim of this study is to determine whether there are sleep abnormalities in patients with LSC. PATIENTS AND METHODS: Fifteen patients with LSC and 15 age-, sex- and body mass index-matched control subjects were enrolled in the study. No participant had any other medical or psychiatric illness. All subjects were evaluated by overnight polysomnography, scratch electrodes, Epworth sleepiness scale and a general questionnaire for demographic data and sleep problems. RESULTS: There were no significant differences in the groups for total sleep time, sleep efficiency, sleep latency, rapid eye movement (REM) latency, percentage of stage 1 non-REM sleep and REM sleep. The percentage of stage 2 non-REM sleep was higher (P < 0.05) and the percentage of slow wave sleep (stages 3 and 4) was lower in the study group (P < 0.05) than in the controls. The patient group had a mean of 15.9 +/- 7.5 arousal index and 22.8 +/- 14.1 awakenings compared with 9.5 +/- 3.1 and 10.4 +/- 3.9, respectively, in the controls (P < 0.05, P < 0.01, respectively). Arousals of patients were mainly observed in non-REM sleep. The number of scratching bouts ranged from 6 to 20 per night. Scratching episodes were observed frequently during stage 2 non-REM sleep. CONCLUSION: Polysomnographic findings of patients with LSC demonstrated that sleep structure is disturbed by arousals and awakenings related to scratching bouts during sleep.

Adult↗

PubMed2000

A systematic review of treatment of settling problems and night waking in young children

OBJECTIVE: To assess the efficacy of treatment of settling problems and night waking in young children. DESIGN: A systematic review of randomized controlled trials of interventions. SETTING: Electronic bibliographic databases and references on identified papers, hand searches, and personal contact with specialists. SUBJECTS: Children aged 5 years or younger who had established settling problems or night waking. INTERVENTIONS: Interventions had to be described and a placebo, waiting list, or another intervention needed to have been used as a comparison. Interventions comprised drug trials or nondrug trials. Main outcome measures Number of wakes at night, time to settle, or number of nights in which these problems occurred. RESULTS: Drugs seemed to be effective in treating night waking in the short term, but long-term efficacy was questionable. In contrast, specific behavioral interventions showed both short-term efficacy and possible longer term effects for dealing with settling problems and night walking. CONCLUSIONS: Given the prevalence and persistence of childhood sleep problems and the effects they can have no children and families, treatments that offer long-lasting benefits are more appealing, and these are likely to be behavioral interventions.

Journal Article↗

PubMed1988

Effects upon circadian rhythmicity of an alteration to the sleep-wake cycle: problems of assessment resulting from measurement in the presence of sleep and analysis in terms of a single shifted component.

Experiments were performed upon groups of three or four human subjects in an isolation chamber (total n = 14). Subjects lived initially on a conventional lifestyle and then delayed their hours of sleep by 8 hr (so mimicking some aspects of nightwork) for 2 or 5 days. They also performed two constant routines--protocols designed to minimize any effects due to the environment, mealtimes, and activity. Regular samples of urine were taken when subjects were awake, and were analyzed for sodium, potassium, and chloride; rectal temperature was measured and logged at 6-min intervals throughout. Shifts in circadian rhythms produced by the change in sleep time were assessed by cosinor and cross-correlation techniques. The protocol enabled these assessments to be made on days when sleep was allowed and under constant-routine conditions, so that masking and behavioral effects could be investigated also. The results confirmed that adjustment to the change in sleep time was slow and only partial, and that assessments made on days when sleep was allowed overestimated this adjustment. Furthermore, it was concluded that, whereas cosinor and cross-correlation techniques using only one shifting component were equally useful in describing the observed changes, both were inferior to a cross-correlation technique that made use of two shifting components. Some practical and theoretical implications of these results are discussed.

Adolescent↗

PubMed1986

[Cognitive therapy of psychogenic sleep disorders: an explanatory and treatment approach].

First the paper presents an explanation for psychogenous sleep disturbances, basing on coincidence of psychophysiological and biorhythmical sleep patterns with special cognitive and emotional variables. Related thereto a concept for prevention and psychotherapy of these sleep disturbances is elaborated. Both concepts content five structuring elements, standing in a circular feed back relationship: 1. subjective misconceptions about the nature of sleep, 2. dysfunctional norms and goals for the own sleep, 3. cognitive misevaluations of the experienced sleep events, 4. development of a dysfunctional self concept, 5. development of dysfunctional patterns and goals of behavior for coping sleep problems. The elements display the structure for development and diagnosis of these sleep disturbances and for the preventive and psychotherapeutic work. Finally, related to this concept, therapeutic strategies were presented, basing on cognitive and behavior therapy.

Behavior Therapy↗

PubMed1996

[Sleep disturbances in elderly hypertensive patients].

OBJECTIVE: To investigate the subjective and objective perturbations in the elderly hypertensive patients. SAMPLE: 32 individuals were studied with ages > or = 65 years, 14 men and 18 women, with controlled idiopathic high blood pressure, diagnosed over a year ago, and able to lead autonomous lives. METHODS: These outpatients were asked to answer sleep questionnaires adapted from Stanford's questionnaire, and a nocturnal sleep polygraphic register was kept. RESULTS AND CONCLUSIONS: This group of elderly hypertensive outpatients slept badly but never consulted a doctor due to sleeping problems. The most frequent complaints were fatigue, body pains, frequent interruptions of sleep during the night and sleepiness during the day. In the polysonographic register, we highlight insomnia, snoring, obstructive apnea and the periodic movements during sleep. These findings could explain the patient's complaints. Research must be continued on sleep apnea in the elderly hypertensive patients particularly in those with snoring.

Aged↗

PubMed2005

Prevalence, associated risks, and treatment patterns of insomnia.

Insomnia, the most commonly reported sleep problem, affects about one third of the adult American population. Insomnia impairs the individual's functioning, diminishes his or her quality of life, and contributes to accidents, health care costs, and problems at work. Insomnia is frequently comorbid with physical and mental illness, as either a consequence or a contributing factor. In particular, considerable research supports a strong association between insomnia and depression. Because the majority of individuals who have trouble sleeping attempt to treat the problem independently using over-the-counter medications or alcohol, insomnia is undertreated by health care providers, despite its serious consequences.

Alcohol Drinking↗

PubMed2003

Frontal electroencephalogram alpha asymmetry during sleep: stability and its relation to affective style.

Electroencephalogram (EEG) alpha (8-12 Hz) asymmetries were collected from the mid-frontal and central regions during presleep wakefulness and Stage 1, Stage 2, and rapid eye movement (REM) sleep in 11 healthy right-handed participants who were free of psychiatric, neurological, and sleep problems. The authors found significant correlations between presleep wakefulness and different stages of sleep in the frontal, but not central, EEG alpha asymmetry measure. The strongest correlation was between presleep waking and REM sleep, replicating and extending relation earlier work to a normal population. The high degree of association between presleep waking and REM sleep may be a result of high cortical activation common to these states and may reflect a predisposition to different styles of emotional reactivity.

Adult↗