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PubMed2005

Music improves sleep quality in older adults.

AIM: The aim of this paper is to report an investigation of the effects of soft music on sleep quality in older community-dwelling men and women in Taiwan. BACKGROUND: Sleep is a complex rhythmic state that may be affected by the ageing process. Few studies have focused on the effects of music, a non-pharmacological method of improving the quality of sleep in older adults. METHOD: A randomized controlled trial was used with a two-group repeated measures design. Sixty people aged 60-83 years with difficulty in sleeping were recruited through community leaders and screened using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale. Those reporting depression, cognitive impairment, medical or environmental problems that might interfere with sleep; and those who used sleeping medications, meditation, or caffeine at bedtime were excluded. Participants listened to their choice among six 45-minute sedative music tapes at bedtime for 3 weeks. There were five types of Western and one of Chinese music. Sleep quality was measured with the PSQI before the study and at three weekly post-tests. Groups were comparable on demographic variables, anxiety, depressive symptoms, physical activity, bedtime routine, herbal tea use, napping, pain, and pretest overall sleep quality. RESULTS: Music resulted in significantly better sleep quality in the experimental group, as well as significantly better components of sleep quality: better perceived sleep quality, longer sleep duration, greater sleep efficiency, shorter sleep latency, less sleep disturbance and less daytime dysfunction (P = 0.04-0.001). Sleep improved weekly, indicating a cumulative dose effect. CONCLUSION: The findings provide evidence for the use of soothing music as an empirically-based intervention for sleep in older people.

Aged↗

PubMed2005

Sleep quality in complicated grief.

The aim of the present study was to evaluate severity of sleep disturbances in a group of 105 individuals presenting with complicated grief (CG) accompanied or not by comorbid depression and/or posttraumatic stress disorder (PTSD). A sample of 105 adults meeting criteria for CG was included in this study. All completed the Pittsburgh Sleep Quality Index (PSQI). The total sample presented a mean global PSQI score of 9.44, indicating overall poor sleep quality. Comorbid depression, but not PTSD, further worsened sleep quality. Further studies are required to investigate the potential role of poor sleep quality as a modifiable risk factor of complicated grief response.

Adult↗

PubMed1991

Sleep-quality among girls with different involvement in competitive sports during fall in the Arctic Circle.

Eight high-school girls participating in competitive sports and six non-participating girls living north of the polar circle recorded their sleep once a week during the Fall, including the period when the sun does not rise above the horizon. Sleep-quality scores were computed as the sum of answers identical to a present "right" answer indicating good sleep-quality. Significant differences on sleep-quality between the two groups were found, but a significant influence of amount of daylight or exercise could not be confirmed. When sleep-quality was ranked during three periods through the Fall, the girls participating in competitive sports showed a trend of increasing sleep-quality and the nonparticipants a decreasing one. An explanation based on influence of exercise thresholds upon sleep-quality is presented.

Adaptation, Psychological↗

PubMed2005

Influence of aging on the improvement of subjective sleep quality by atypical antipsychotic drugs in patients with schizophrenia: comparison of middle-aged and older adults.

OBJECTIVE: The authors investigated the influence of aging on the improvement of subjective sleep quality by atypical antipsychotic drugs in patients with schizophrenia. METHODS: Subjects were 86 inpatients (mean age: 61.4 years) who had been receiving treatment with conventional antipsychotic drugs and who met DSM-IV criteria for schizophrenia. Their antipsychotic medication was changed from conventional antipsychotics to one of four atypical antipsychotic drugs (olanzapine, perospirone, quetiapine, or risperidone). Patients were grouped by age (older or younger than 65 years). Subjective sleep quality and psychopathology were assessed twice: 1) at baseline, and 2) 8 weeks after switching to the atypical antipsychotic drugs. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and the Positive and Negative Syndrome Scale (PANSS) was used to measure psychopathology. RESULTS: The proportion of the patients who experienced improved subjective sleep quality was significantly higher in the elderly than in the middle-aged group. Logistic-regression analysis revealed that the improvement in subjective sleep quality through administration of atypical antipsychotic drugs was predicted by increased age, daytime dysfunction, and longer sleep latency at baseline. CONCLUSION: These results demonstrate that atypical antipsychotic drugs are beneficial to the quality of sleep in elderly patients with schizophrenia.

Adult↗

PubMed2003

Sleep quality among patients treated with implantable atrial defibrillation therapy: effect of nocturnal shock delivery and psychological distress.

INTRODUCTION: The Medtronic ICD-AT has atrial/ventricular therapies, which can be programmed to deliver atrial defibrillation during sleep, intended to potentially decrease shock anxiety/pain and lifestyle disruption. However, these shocks may diminish sleep quality. This study examined atrial shock characteristics (i.e., mode, frequency), AF symptoms, and psychological factors as determinants of sleep quality. METHODS AND RESULTS: The 96 ICD-AT patients were mostly men (72%; M age 65 +/- 12 years) and implanted for 1.6 years (SD = 0.8 years). Patients were divided into shock groups based on the proportion of mode (> or =90%) of total atrial shocks received. Patients were grouped into either automatic-nocturnal shock group (8 P.M.-8 A.M.; n = 35) or manual-awake shock group (n = 42). Psychological measures included Pittsburgh Sleep Quality Index (PSQI), Center for Epidemiology Studies-Depression Scale, State-Trait Anxiety Inventory, and Illness Intrusiveness Rating Scale. Atrial fibrillation disease burden was assessed via atrial symptom score and atrial shock use. PSQI global scores were similar between manual (7.67 +/- 2.53) and automatic shock (8.20 +/- 2.93) groups. A multiple hierarchical regression analysis indicated that no atrial shock variables were predictive of sleep quality; yet, both AF symptom (B = 0.226, P = 0.040) and depression (B = 0.392, P = 0.034) scores predicted diminished sleep quality, accounting for 42% of the variance in global sleep quality (P < 0.001). CONCLUSION: These results suggest that atrial defibrillation therapy does not have a deleterious impact on sleep. However, the significance of AF symptoms and depression indicate that comprehensive care of both physical and psychological symptomatology may improve sleep quality in ICD-AT patients.

Aged↗

PubMed2005

Self-assessed sleep quality in chronic kidney disease.

BACKGROUND: Although sleep complaints are commonly reported in persons with end stage renal disease (ESRD), little is known about the prevalence of sleep complaints in chronic kidney disease (CKD), and the relation of sleep quality to the severity of kidney disease. METHODS: We administered the Kidney Disease Quality of Life (KDQOL) sleep scale to 156 subjects, 78 with ESRD and 78 with CKD. Glomerular filtration rate (GFR) was estimated using the six variable Modification of Diet in Renal Disease (MDRD) equation and used to stratify subjects with CKD as mild-moderate (GFR >25 ml/min/1.73 m(2)) and advanced (GFR <25 ml/min/1.73 m(2)). We used multivariable linear regression to determine independent predictors of KDQOL sleep scale scores. Higher scores indicate higher self-reported quality of sleep. RESULTS: Median scores on the KDQOL sleep scale were 59 (interquartile range 40-80) in subjects with ESRD and 69 (interquartile range 53-80) in subjects with CKD (P=0.04). Thirty-four percent of subjects with ESRD, 27% of subjects with advanced CKD, and 14% of subjects with mild to moderate CKD had sleep maintenance disturbances (P=0.05). Thirteen percent of subjects with ESRD, 11% of subjects with advanced CKD, and no subjects with mild-moderate CKD had complaints of daytime somnolence (P=0.03). There was no significant difference in the prevalence of sleep adequacy complaints in persons with ESRD versus CKD. In multivariable analyses, only age and ESRD status (vs. CKD) were significant predictors of lower KDQOL sleep scores. Among subjects with CKD, there was a significant direct association between estimated GFR and scores on the KDQOL sleep scale in non-African American subjects (P=0.01). CONCLUSIONS: Sleep complaints are common in persons with CKD and ESRD and may be associated with the severity of kidney disease.

Aged↗

PubMed2001

Sleep quality, estradiol levels, and behavioral factors in late reproductive age women.

OBJECTIVE: To estimate the prevalence of perceived poor sleep in women aged 35-49 years and to correlate sleep quality with levels of gonadal steroids and predictors of poor sleep. METHODS: A cohort of 218 black and 218 white women aged 35-47 years at enrollment (aged 37-49 at final follow-up) with regular menstrual cycles was identified through random digit dialing for a longitudinal study of ovarian aging correlates. Data obtained at four assessment periods, including enrollment, over a 2-year interval were collected between days 1 and 6 (mean = 3.9) of the menstrual cycle. The primary outcome measure was subjects' rating of sleep quality at each assessment period. Associations of sleep quality with hormone levels (estradiol, follicle-stimulating hormone, luteinizing hormone, testosterone, and dehydroepiandrosterone sulfate) and other clinical, behavioral, and demographic variables were examined in bivariable and multivariable analyses. RESULTS: Approximately 17% of subjects reported poor sleep at each assessment period. Significant independent associations with poor sleep included greater incidence of hot flashes (odds ratio [OR] 1.52; 95% confidence interval [CI] 1.08, 2.12, P =.02), higher anxiety levels (OR 1.03; 95% CI 1.00, 1.06, P =.04), higher depression levels (OR 1.05; 95% CI 1.02, 1.07, P <.001), greater caffeine consumption (OR 1.25; 95% CI 1.04, 1.49, P =.02), and lower estradiol levels in women aged 45-49 (OR 0.53; 95% CI 0.34, 0.84, P =.006), after adjustment for current use of sleep medications. CONCLUSION: Both hormonal and behavioral factors were associated with sleep quality. Estradiol levels are an important factor in poor sleep reported by women in the 45-49 age group. Further evaluation of estrogen treatment for poor sleep of women 45 years and older is warranted.

Adult↗

PubMed2005

An examination of the association between eating problems, negative mood, weight and sleeping quality in young women and men.

The aim of this study was to determine if low mood influenced the association between eating problem symptoms and self report sleeping quality in a large group of young women and men. A group of 381 female and male undergraduate students completed a set of self-report inventories in order to test a model developed for this study observing the association between eating problems, low mood, restricted dieting, weight and self-reported sleeping quality using a path analysis model. The model that best fit the data indicated that eating problem symptoms were associated with low mood and low mood was related to sleeping quality. There was also a direct association between eating problems and sleeping quality but this was reduced by the presence of low mood in the equation. There were no other direct relationships with sleeping quality but there was an association between low mood and low weight. There were also differences reported between men and women on sleeping quality suggesting that women in this sample reported more sleeping difficulties than men. In all this research demonstrates with a large non-clinical sample the links between eating problems, mood and sleeping difficulties.

Adolescent↗

PubMed2005

Sleep quality in hospitalized patients.

AIMS AND OBJECTIVES: The objective of this study was to evaluate and compare sleep quality of the hospitalized patients and matched healthy controls. BACKGROUND: Although the functions of sleep are not clearly understood, it is generally accepted that it is necessary for the maintenance of good health. Hospitalized patients' sleep may not be refreshing or restorative. The reasons for this can be categorized into three groups: environmental, physiological and psychological. DESIGN AND METHODS: This research was conducted at the Cumhuriyet University Hospital in Turkey. One hundred and fifty hospitalized patients (psychiatry = 50; orthopaedic + general surgery + cardiovascular surgery + urology = 50; internal medicine + chest diseases + infectious diseases + physical therapy and rehabilitation = 50) and 50 healthy controls constituted the sample. The researchers administered to the patient and control groups Sociodemographic Information Form and the Pittsburgh Sleep Quality Index. We compared sociodemographic and illness variables with sleep characteristics. The following statistical analyses were used in order to evaluate the data: variance analysis, Tukey HSD test, Student's t-test, Kruskall-Wallis test. RESULTS: We found that patients in psychiatric ward experienced worse sleep quality than the other patients, worse in female patients than male patients, and worse sleep characteristics in patients than controls. CONCLUSIONS: Health professionals must be educated about sleep and must provide intervention when needed. Relevance to clinical practice. The enhancing of sleep quality accelerates to the recovery from illness.

Adolescent↗

PubMedDate not supplied

Sleep quality and pain threshold in patients with fibromyalgia.

The purpose of the study was to examine the association between the subjective sleep quality and pain threshold in fibromyalgia. Sixteen patients with fibromyalgia were included in the study. The pain threshold was determined using a manual algometer. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The pain threshold was negatively correlated with the scores for subjective sleep quality, habitual sleep efficiency, and sleep disturbance and the PSQI global score. We conclude that there is a negative correlation between pain and sleep disturbance: increased pain sensitivity is associated with greater sleep disturbance.

Adult↗

PubMed1988

Stability of EEG sleep and sleep quality in healthy seniors.

When the electroencephalogram-recorded (EEG) sleep of 19 healthy seniors (9 men, 10 women) aged 60-82 years was restudied after an average interval of 2.2 years, most measures of EEG sleep and sleep quality were stable over time. Both elderly men and women showed more awakenings during the second recording series, but no change in visual or computer-scored delta activity. Furthermore, gender-dependent sleep changes were noted only in phasic rapid eye movement (REM) measures (increasing in men, decreasing in women). Reports of sleep quality were also stable over time despite the increase in awakenings, with women reporting a lower sleep quality than men.

Aged↗

PubMed2000

Effect of melatonin on sleep quality of COPD intensive care patients: a pilot study.

Sleep deprivation is extremely common in the intensive care unit (ICU), and this lack of sleep is associated with low melatonin secretion. The objective of the current study was to explore the effect of exogenous melatonin administration on sleep quality in patients hospitalized in the pulmonary intensive care unit (ICU). We performed a double-blind, placebo-controlled study in the pulmonary ICU of a tertiary care hospital. Eight adult patients hospitalized in the pulmonary ICU with respiratory failure caused by exacerbation of chronic obstructive pulmonary disease (COPD) or with pneumonia were studied. Patients received either 3 mg of controlled-release melatonin or a placebo at 22:00, and sleep quality was evaluated by wrist actigraphy. Treatment with controlled-release melatonin dramatically improved both the duration and quality of sleep in this group of patients. Our results suggest that melatonin administration to patients in intensive care units may be indicated as a treatment for sleep induction and resynchronization of the "biologic clock." This treatment may also help in the prevention of the "ICU syndrome" and accelerate the healing process.

Adult↗

PubMed2006

Treating complicated grief: effects on sleep quality.

Complicated grief (CG) is characterized by recurrent distressing emotions and intrusive thoughts related to the loss of a loved one and avoidance of reminders of the deceased. Poor sleep quality characterizes CG. Cognitive-behavioral therapy and interpersonal psychotherapy reduce CG symptom severity. The effect of these treatments on sleep quality is not known, however. We investigated whether complicated grief treatments (CGTs) improve sleep quality, as assessed by the Pittsburgh Sleep Quality Index. Data collected from 95 adults who participated in a randomized controlled trial were reviewed. Poor sleep quality persisted despite clinically significant improvements in CG severity posttreatment. Given that sleep disturbance is a risk factor for poor health outcomes, adjunctive sleep interventions may be necessary to enhance CGT outcomes.

Adjustment Disorders↗

PubMed1997

Objective components of individual differences in subjective sleep quality.

The relation between subjective and objective (polysomnography) is of obvious interest in understanding sleep. The aim of the present study was to examine the item structure of the Karolinska Sleep Diary (KSD), and the covariation between KSD and sleep-stage variables, with cross-sectional (inter-individual) data obtained in natural conditions. Thirty-seven subjects had a polysomnography prior to a work day. After rising they completed the Karolinska Sleep Diary. A factor analysis of the diary yielded two factors: (1) a sleep-quality index (SQI) related to the initiation and maintenance of sleep, and (2) a second factor related to difficulties waking-up and to whether sleep was recuperative and sufficient. The strongest predictors (multiple regression) of the sleep quality index was slow-wave sleep (SWS) and sleep efficiency [and variables related to sleep continuity total sleep time (TST) and the amount of stage 0]. The obtained results were in agreement with previous laboratory findings. It was concluded that sleep quality seems to be a matter of depth of sleep and sleep continuity.

Adult↗

PubMed2002

Short naps and exercise improve sleep quality and mental health in the elderly.

The effects of short naps and exercise on the sleep quality and mental health of elderly people was investigated. 'Interventions' by short naps after lunch and exercise of moderate intensity in the evening were carried out for 4 weeks. After the 'intervention', awake time after sleep onset decreased significantly and sleep efficiency increased significantly, demonstrating that sleep quality had improved. Also, the frequency of nodding in the evening decreased significantly. These results demonstrate that proper awakening maintenance in the evening was effective in improving sleep quality. After the 'intervention', mental health and volition and physical health had also improved with improving sleep quality.

Aged↗

PubMed2003

The effect of caffeine reduction on sleep quality and well-being in persons with HIV.

OBJECTIVES: With reports of high rates of sleep disruption in Human Immunodeficiency Virus (HIV) + persons, this study tested whether there were differences in sleep quality and well-being between a group of HIV+ persons who reduced their caffeine intake from baseline by 90% or greater for 30 days (n=44) versus a group of HIV+ persons who continued their usual caffeine consumption (n=44). METHODS: Subjects were administered pre- and post-Pittsburgh Sleep Quality Index (PSQI), Perceived Well-being Scale-Revised (PWB-R) and MOS-HIV Health Survey instruments, with MOS-HIV summary scores used as a covariate. RESULTS: On ANCOVA analysis for sleep quality (F=14.032, P<.001), a 35% improvement in sleep among experimental subjects was identified. There was no significant difference between the two groups on ANCOVA analysis for well-being (F=0.111. P=.739). CONCLUSIONS: High levels of caffeine consumption may have an exacerbating effect on already prevalent HIV-related sleep pattern disturbances, and significant reductions of caffeine may improve sleep quality.

Adult↗

PubMed2002

Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students.

College students are known for their variable sleep schedules. Such schedules, along with other common student practices (e.g., alcohol and caffeine consumption), are associated with poor sleep hygiene. Researchers have demonstrated in clinical populations that improving sleep hygiene knowledge and practices is an effective treatment for insomnia. However, researchers who have examined relationships between sleep hygiene and practices in nonclinical samples and overall sleep quality have produced inconsistent findings, perhaps because of questionable measures. In this study, the authors used psychometrically sound instruments to examine these variables and to counter the shortcomings in previous investigations. Their findings suggest that knowledge of sleep hygiene is related to sleep practices, which, in turn, is related to overall sleep quality. The data from their regression modeling indicated that variable sleep schedules, going to bed thirsty, environmental noise, and worrying while falling asleep contribute to poor sleep quality.

Adult↗

PubMedDate not supplied

Sleep quality in children with juvenile rheumatoid arthritis.

Children with juvenile rheumatoid arthritis (JRA) report poor sleep quality, daytime sleepiness, fatigue, anxiety, and altered mood. Sleep disturbances in school-aged children are an issue of serious concern. Children are at an age when sleep is of primary importance to physical and intellectual growth, and sleep disturbances that begin in childhood may persist into adulthood. In this article we will review what is currently known about sleep in children with JRA, the influence of medications on sleep quality, the potential impact of poor sleep quality on daily life issues, and complementary/alternative modalities that may be effective in reducing sleep disturbances.

Arthritis, Juvenile↗