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PubMed1995

Behaviour in mucopolysaccharide disorders.

This paper reports a study of the nature and prevalence of behaviour problems in 258 children with mucopolysaccharide disorders. Questionnaire data obtained through the post was supplemented by home visits to 42 families in the sample and by regular discussions with families at meetings of the Society for Mucopolysaccharide Diseases. High rates of behaviour problems were found, particularly in children with Sanfilippo's and Hunter's disease aged 5 to 9 years. These included destructiveness, restlessness, and aggressiveness. Sleep problems were common across subtypes with an overall prevalence of 66%. Parents reported that they received little or no support in the management of these difficult behaviours. It is concluded that behaviour problems are a primary feature of the mucopolysaccharide disorders and place a major strain on families. Services to help families cope with these problems are urgently needed.

Aggression↗
PubMed2005

Physical and mental health shortly after a disaster: first results from the Enschede firework disaster study.

OBJECTIVES: Two to three weeks after the explosion of a fireworks storage facility in a residential area (May 2000, Enschede, The Netherlands) we assessed the self-reported physical and mental health among those affected by the disaster. METHODS: A questionnaire survey was conducted among 3792 residents, passers-by, and rescue workers, who were involved in and/or affected by the disaster and were > or =18 years of age. RESULTS: At least 30% of those affected by the disaster reported serious physical and mental health problems 2-3 weeks after the explosion. Compared with reference values in the general Dutch population, high scores were found for somatic symptoms, sleeping problems, and restrictions in daily functioning due to physical and mental problems, such as anxiety, depression, and feelings of insufficiency. The strength of these differences varied between groups, based on the level of involvement and the level of being affected. CONCLUSIONS: Results indicate that the fireworks disaster had a substantial impact on the health of those affected by the disaster. The health impact was most pronounced for residents and passers-by and also for rescue workers living in the affected area, but to a lesser degree. Physical and mental health problems were strongly associated with the shocking experiences during and shortly after the disaster.

Adolescent↗
PubMed2000

Snoring in Portuguese primary school children.

OBJECTIVE: To determine the prevalence of snoring and its potential associations with sleep problems, such as daytime symptoms, medical conditions, school performance, and behavioral disturbances in Portuguese children attending primary school. METHODS: A previously validated questionnaire was sent to the parents of 1381 children attending primary schools in a parish of Coimbra, Portugal. To assess behavioral disturbances, the Portuguese version of Rutter's Children's Behavior Questionnaire for completion by teachers was used. RESULTS: Of the 988 questionnaires returned (71.5%), complete information concerning snoring was obtained for 976 children (496 girls and 480 boys; mean age: 8.1 +/- 1.5 years). Loud snoring during sleep was reported as frequent or constantly present (LSn) in 84 children (8.6%), as occasionally present in 299 children (30.6%), and as never present (NSn) by 593 children (60.8%). The LSn and NSn groups did not differ with respect to age, gender, sleep duration, time to fall asleep, frequency of night wakings, bedwetting, daytime tiredness, and school achievement. However, LSn was significantly associated with increased bedtime problems (fears and struggles), increased need for comforting activities to fall asleep, behaviors suggestive of parasomnias (sleep talking, teeth grinding, and night terrors), increased daytime sleepiness and irritability, and behavioral disturbances. Children in the LSn group were also more likely to report recurrent medical problems particularly those involving infections of the respiratory tract. CONCLUSIONS: Snoring is a common symptom in Portuguese children that is associated with behavioral daytime and sleep time disturbances. Children with loud snoring may benefit from early evaluation and intervention.

Achievement↗
PubMed2002

Comparative study on sleep health and lifestyle of the elderly in the urban areas and suburbs of Okinawa.

The sleep health and lifestyles of the elderly living in the urban and suburban areas of Okinawa prefecture, which is well known for the longevity of its inhabitants, were compared. The study revealed that sleep health and activities of daily living (ADL) were significantly better among the elderly living in suburban areas. There were more complaints of sleep problems from the elderly living in urban areas and their bedtimes were significantly later, indicating that a nocturnal lifestyle was related to sleep deterioration. In the suburbs, a significantly greater number of elderly people regularly took short naps and exercised in the evening. The study also suggested that daily habits such as short naps and taking appropriate exercise in the evenings contributed to good sleep, and that sleep health was related to the ADL of the elderly.

Aged↗
PubMed2006

Sleep in overweight adolescents: shorter sleep, poorer sleep quality, sleepiness, and sleep-disordered breathing.

OBJECTIVE: To document the sleep of overweight adolescents and to explore the degree to which weight-related sleep pathology might account for diminished psychosocial outcome. METHODS: Sixty children aged 10-16.9 from a weight-management clinic were compared to 22 healthy controls using comprehensive actigraphic, polysomnographic, and parent- and self-report questionnaire assessments. RESULTS: Overweight participants averaged more symptoms of sleep-disordered breathing, later sleep onset, shorter sleep time, and more disrupted sleep than controls. Although the groups did not differ in self-reported sleep habits, multiple concerns were reported by parents of overweight participants, including daytime sleepiness, parasomnias, and inadequate sleep. Group differences in academic grades and depressive symptoms were at least partially accounted for by short sleep and daytime sleepiness. CONCLUSIONS: Excessive weight is associated with an increased risk of sleep problems. There is a need for further research in this area and for clinicians who work with overweight children to evaluate their sleep.

Adolescent↗
PubMed1999

Anxiety, depression and sleep in male patients undergoing coronary artery bypass surgery.

The aim of this study was to examine the prevalence of depression and anxiety following coronary artery bypass surgery (CABG) and to see how those patients with depression and anxiety differ in sleeping pattern. The individual reaction to sleep loss was tested as a predictor of certain emotional symptoms in the follow-up period. Thirty-eight males, between 45 and 68 years, were interviewed prior to, and 1 month after, surgery, and received a questionnaire at the 6-month follow-up. Eighty per cent scored moderate anxiety prior to surgery and six patients were depressed. An anxiety-prone individual reactivity persisted in the same patients in 38.9% (n = 14) following CABG, with significantly more sleep disturbances, firedness, energy deficits, immobility, and lower degree of quality of life (QoL). Sad/depressed mood or cognitive/behavioural fatigue symptoms as reactions to sleep loss were predictors of sleep problems and daytime sequelae, whereas a higher postoperative NYHA class was predicted by cognitive/behavioural fatigue and dysphoria reactions. Being less refreshed by sleep on final awakening prior to surgery related to 44.5% of the variance in QoL outcome 6 months following surgery. In conclusion, an anxiety-prone individual reactivity is significantly associated with sleep disturbances. Reactions to sleep loss prior to surgery are associated with emotional distress after surgery.

Aged↗
PubMed2006

Sleep disturbance in patients with rheumatoid arthritis: evaluation by medical outcomes study and visual analog sleep scales.

OBJECTIVE: Except for some polysomnography studies, there have been no large quantitative studies of sleep disturbance (SD) in rheumatoid arthritis (RA). SD has taken on new importance with the observation that etanercept and infliximab reduce daytime sleepiness, and patient groups indicate that sleep is an important issue. METHODS: We evaluated 8676 patients with RA and a comparison group of 1364 subjects with non-fibromyalgia, noninflammatory disorders (NID) using the Medical Outcome Study (MOS) sleep questionnaire, including 2 MOS sleep problem indexes (SPI-I, SPI-II) and the MOS SD scale. In addition, patients completed a visual analog scale (VAS) sleep disturbance scale (SDS). RESULTS: The scales had similar mean values: SPI-I 35.4 (19.4), SPI-II 36.0 (19.1), SDS 35.0 (24.7), and VAS sleep 36.1 (29.7), and the values for the MOS scales exceeded population norms by 25% (VAS by 42%). In multivariable analyses SD was primarily determined by pain and mood. Patients receiving anti-tumor necrosis factor (TNF) did not have less abnormal sleep scores. SD was comparable in RA and NID. The VAS scale was more strongly associated with RA clinical variables than the MOS scales; however, the distributional characteristics of the scales differed, with the VAS scales capturing more extreme values. The standard error of the measurement (SEM), which is related to minimal (important) change, was SPI-I 9.0, SPI-II 7.3, SDS 9.6, and VAS sleep 10.4. CONCLUSION: SD is increased in RA, and 25% to 42% of SD can be attributed to RA. SD is linked to pain, mood, and disease activity. SD is slightly greater in women and is less with increasing age. All scales appear to be valid in RA, with minimal differences in SEM.

Age Factors↗
PubMed1990

Zopiclone versus triazolam in insomniac geriatric patients: a specific increase in delta sleep with zopiclone.

This double-blind study was performed on 10 aged insomniac patients who received, during 15 days, either triazolam (0.25 mg) or zopiclone (7.5 mg) at bed time. This in-patient period was bounded by two ambulatory periods of 5 days each, and two in-patient periods of 3 days each, during which the patients received a placebo tablet at bed time. Thirteen sleep recordings per patient were performed before (3 nights), upon initiation of active treatment (3 nights), at the end of the active treatment period (3 nights) and during the following 3 "withdrawal" nights. A clear improvement of sleep patterns was observed with both drugs, although opposite effects on delta sleep were observed, namely a decrease with triazolam and an increase with zopiclone. A carry-over effect of the enhancement of delta sleep by zopiclone took place during the first 3 withdrawal nights. As is well known, sleep problems become increasingly common with age. Epidemiological studies show that although they only represent 11% of the population. Americans over 60 years old are prescribed about 40% of sleeping pills (Mendelson, 1980). Disturbed sleep in this population is often associated with medical disorders or induced by drugs like beta-adrenergic blockers. It must be admitted, however, that, possibly due to the association with medical or situational problems there have been only few attempts to assess the efficiency of hypnotic drugs in elderly insomniac patients. These are the reasons why in this study the effectiveness of zopiclone was compared to that of triazolam in insomniac patients aged over 60 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2005

Sleep disorders in the elderly.

Problems with sleep, including acute and chronic conditions, increase with age. Expertise in dealing with sleep problems using pragmatic management strategies is an essential component of comprehensive geriatric patient care. This article provides a succinct review of the physiology, diagnosis, and treatment of sleep disorders in the elderly.

Aged↗
PubMed2003

Shift work and disturbed sleep/wakefulness.

Of the many health-related effects of shift work, disturbed sleep is the most common. This review describes the main observed effects of the three principal shifts (night, morning and afternoon) on patterns of sleep and wakefulness. The mechanism of sleep disruption in relation to circadian rhythms and the specific impact of aspects of shift organization (speed and direction of rotation) are discussed. The most troublesome acute symptoms are difficulty getting to sleep, shortened sleep and somnolence during working hours that continues into successive days off. These are only partially amenable to amelioration by manipulating shift patterns. However, there is no clear indication that chronic sleep problems result from long-term shift work.

Circadian Rhythm↗
PubMed1995

The contributions of disease activity, sleep patterns, and depression to fatigue in systemic lupus erythematosus. A proposed model.

OBJECTIVE: This study describes lupus fatigue multidimensionally and introduces a multivariate model: Sleep problems and depression, through reciprocal effects on each other, act as mediators through which lupus disease activity increases fatigue. METHODS: Self-reported sleep patterns, depression, and fatigue were assessed in 48 women with systemic lupus erythematosus (SLE) and 27 women from the general population. Rheumatologists rated current lupus disease activity. RESULTS: The SLE group reported greater overall fatigue than did the controls. Temporal and affective dimensions of fatigue were more differentiating than sensory or severity dimensions. The SLE group also reported longer sleep latency and total sleep time, but not higher depression. Using 2-stage regression, a form of structural equation modeling, the proposed lupus fatigue model was supported. CONCLUSION: These preliminary results describe fatigue as a multidimensional phenomenon arising out of several contributing factors. They suggest that fatigue treatment strategies should address mediating processes such as sleep and depression, in addition to disease activity.

Adult↗
PubMed2006

Self-reported sleep duration in Finnish general population.

Self-reported short or long sleep duration has been repeatedly found to be associated with increased mortality and health risks. However, there is still an insufficient amount of detailed knowledge available to characterize the short and long sleep duration groups in general population. Consequently, the underlying mechanisms potentially explaining the health risks associated with short and long sleep duration are unclear. In the present study, the self-reported sleep duration in a sample of Finnish general population was studied, and its possible associations with such factors as self-perceived health, sociodemographic characteristics, lifestyle, sleep difficulties and daytime concomitants were analyzed. In particular, an effort was made to define mutually statistically-independent determinants of sleep duration. In the Finnish Health 2000 Survey, a representative sample of 8,028 subjects of 30 years of age or older and a sample of 1,894 subjects of 18-29 years of age were invited to take part in the health interview and health examination. The participation rate of the study was over 80%. The most important and statistically-independent determinants of short and long sleep duration were gender, physical tiredness, sleep problems, marital status, main occupation and physical activity. However, in the multivariable model they only accounted for approximately 16% of the variance in sleep duration in short and long sleepers, suggesting multiple sources of variance. The present study also suggests a dose-response like relationship between the sleep duration and many of its determinants within both short and long sleepers. A more detailed analysis of the clinical status of the short and long sleep duration groups is needed to evaluate the possible importance of these findings for health risks associated with sleep duration.

Adolescent↗
PubMed2004

Effect of antipsychotic withdrawal on behavior and sleep/wake activity in nursing home residents with dementia: a randomized, placebo-controlled, double-blinded study. The Bergen District Nursing Home Study.

OBJECTIVES: To explore the effect on sleep/wake activity and on behavioral and psychological symptoms of the withdrawal of antipsychotic medications from nursing home (NH) patients with dementia. DESIGN: Randomized, placebo-controlled, double-blind trial. SETTING: NHs in Bergen, Norway. PARTICIPANTS: Thirty patients (mean age 83.5) taking haloperidol, risperidone, or olanzapine for nonpsychotic symptoms. INTERVENTION: Study participants were randomly assigned to withdrawal (intervention group) or continued treatment with antipsychotic medications (reference group) for 4 consecutive weeks. MEASUREMENTS: Behavioral rating using the Neuropsychiatric Inventory Questionnaire (NPI-Q) and actigraphy. RESULTS: After antipsychotic withdrawal, behavioral scores remained stable or improved in 11 of 15 patients, whereas four had worsening scores. Actigraphy revealed decreased sleep efficiency after drug discontinuation and increased 24-hour and night activity in both groups. Actigraphy records of nighttime and daytime activity indicated sleep problems and restlessness, in terms of the NPI-Q. One patient was restarted on antipsychotics. CONCLUSION: Antipsychotic drug withdrawal affected activity and sleep efficiency over the short term. Increases in total activity and impaired sleep quality after drug discontinuation should be monitored, because the long-term effect of these changes is not known. The NPI-Q and actigraphy are feasible tools that disclose relevant changes occurring during antipsychotic withdrawal in NH patients with dementia. Their use in clinical practice should be substantiated by larger studies.

Aged↗
PubMed2005

[Analysis of risk factors for deficits in the quality of life in allergic rhinitis patients].

To assess the possible negative aspects in the quality of life (QOL) of patients with allergic rhinitis based on the factors such as the symptoms and examination of the nasal cavity, we examined QOL deficits using the Japanese Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ No1). Thirteen hundred seventy eight allergic rhinitis patients who visited clinics or hospitals between April and July 2003 were assessed for clinical symptoms, had the examination of their nasal cavity graded and answered QOL questionnaires. Gender, period of the disease, antigen, clinical symptoms and the results of the nasal cavity examination were evaluated and analyzed to reveal risk factors associated with negative QOL factors. These negative QOL factors tended to be more severe in women than in men, and more severe in pollen allergy than in house dust mite allergy. There was no association of the period of the disease with negative QOL factors. It was revealed that nasal discharge was the strongest risk factor for problems in usual daily activities, outdoor activities and social functioning in six QOL domains, and nasal congestion was the major factor associated with sleep problems, general physical problems and emotional function. Nasal congestion was also the strongest risk factor in the total score of the QOL questionnaire and the overall face scale of the patients. In the nasal cavity examination, the amount of aqueous secretion was the strongest risk factor for all items associated with negative QOL factors. According to the risk factors we identified, we can treat allergic rhinitis patients taking their QOL into consideration.

Adult↗
PubMed1999

[Sleep and vigilance in students].

A cross-sectional survey was carried out among students with the higher education system in Paris in November, 1992, during a medical exam carried out during their first year of study. The objective was to better determine the characteristics of sleep, vigilance and prevalence of sleep problems. This survey concerned 3152 students, 52% of them girls. The average age was 20 years +/- 2.38% of students felt they don't sleep sufficiently. Twenty one percent of students maintained that they experience sleep difficulties. Ten percent of students said they are sleepy during the day. Four percent of students take medications for sleeping. 3% of students snore regularly. The practice of a sport, living environment, the duration of daily transportation, remunerated work, and the consumption of stimulants all impact on sleep and/or daytime vigilance.

Adult↗
PubMed1998

[Epidemiology of sleep disorders].

The survey of insomnia, sleep breathing disorders and circadian rhythm sleep disorders in the world included Japan were reviewed in this article. We introduced the 1995 annual report of the national research project team supported by the grant of the Ministry of Health and Welfare that 18.7% of men and 20.3% of women in the outpatients of 11 general hospitals of Japan had severe sleep problems, and 11.7% of the patients had the persistent insomnia. Okada et al. estimated a prevalence of 3.28% of men for the obstructive sleep apnea syndrome in Japan. The survey by the telephone and self-reported questionnaire in the general population was reported that the prevalence of possible patients of circadian rhythm sleep disorders was estimated at 0.44% of Japanese.

Adult↗
PubMed1987

Chronic stress, catecholamines, and sleep disturbance at Three Mile Island.

The present study was concerned with the relationship between chronic stress and sleep disturbance. Previous research has provided evidence of chronic stress responding among people living near the Three Mile Island nuclear generating facility. Compared to control subjects, the TMI group has exhibited greater symptom reporting, poorer performance on behavioral measures of concentration, and elevated levels of urinary norepinephrine and epinephrine. Other research has suggested a relationship between arousal and insomnia. The extent to which stress and sleep disturbances were experienced by residents at TMI was examined and compared to levels of stress and sleep disturbance among a group of control subjects. The relationship between stress and sleep disturbances was also examined. Results indicated that TMI area residents exhibited more stress than the controls and reported greater disturbance of sleep. Modest relationships among stress and sleep measures suggested that the symptoms of stress measured in this study were not primary determinants of sleep problems.

Accidents↗