Browsing by Subject "Sleep"

Now showing 1 - 10 of 41
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    A One-year Longitudinal Study of the Stress, Sleep, and Parenting of Mothers of Toddlers
    (Elsevier, 2022) McQuillan, Maureen E.; Bates, John E.; Staples, Angela D.; Deater-Deckard, Kirby; Pediatrics, School of Medicine
    Objectives: The present study, building on cross-sectional research showing links between mothers' sleep, stress, and parenting, used a longitudinal design to consider (1) the temporal direction of links between mothers' sleep and stress, (2) whether mother sleep deficits predict change in parenting across time, and (3) whether mother sleep deficits mediate the inverse association between stress and positive parenting. Design: The study used repeated measures of stress, mother sleep, and positive parenting at toddler ages 30, 36, and 42 months. Setting: Data were collected at 2 sites, one in the Midwest and one in the East. Participants: Four hundred thirteen mother-toddler pairs were followed. Mothers were mostly married, college educated, and middle class, but there was also considerable variability between families. Measurements: Stress was measured via parenting hassles, CHAOS, and role overload scales. Mother sleep was measured via actigraphy. Positive parenting was observed during the bedtime routine and rated using the HOME scale and other items. Results: Mother stress and sleep were inextricably linked across toddlerhood, and worse sleep was predictive of less observed positive parenting, even when controlling for prior levels of stress and parenting. Conclusions: Improving mothers' sleep may be important in efforts to improve their parenting.
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    Acceptance and commitment therapy for symptom interference in metastatic breast cancer patients: a pilot randomized trial
    (Springer Nature, 2018-06) Mosher, Catherine E.; Secinti, Ekin; Li, Ruohong; Hirsh, Adam T.; Bricker, Jonathan; Miller, Kathy D.; Schneider, Bryan; Storniolo, Anna Maria; Mina, Lida; Newton, Erin V.; Champion, Victoria L.; Johns, Shelley A.; Psychology, School of Science
    PURPOSE: Breast cancer is the leading cause of cancer mortality in women worldwide. With medical advances, metastatic breast cancer (MBC) patients often live for years with many symptoms that interfere with activities. However, there is a paucity of efficacious interventions to address symptom-related suffering and functional interference. Thus, this study examined the feasibility and preliminary efficacy of telephone-based acceptance and commitment therapy (ACT) for symptom interference with functioning in MBC patients. METHODS: Symptomatic MBC patients (N = 47) were randomly assigned to six telephone sessions of ACT or six telephone sessions of education/support. Patients completed measures of symptom interference and measures assessing the severity of pain, fatigue, sleep disturbance, depressive symptoms, and anxiety. RESULTS: The eligibility screening rate (64%) and high retention (83% at 8 weeks post-baseline) demonstrated feasibility. When examining within-group change, ACT participants showed decreases in symptom interference (i.e., fatigue interference and sleep-related impairment; Cohen's d range = - 0.23 to - 0.31) at 8 and 12 weeks post-baseline, whereas education/support participants showed minimal change in these outcomes (d range = - 0.03 to 0.07). Additionally, at 12 weeks post-baseline, ACT participants showed moderate decreases in fatigue and sleep disturbance (both ds = - 0.43), whereas education/support participants showed small decreases in these outcomes (ds = - 0.24 and - 0.18 for fatigue and sleep disturbance, respectively). Both the ACT and education/support groups showed reductions in depressive symptoms (ds = - 0.27 and - 0.28) at 12 weeks post-baseline. Group differences in all outcomes were not statistically significant. CONCLUSIONS: ACT shows feasibility and promise in improving fatigue and sleep-related outcomes in MBC patients and warrants further investigation.
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    Acute Changes in Sleep Duration on Eating Behaviors and Appetite-Regulating Hormones in Overweight/Obese Adults
    (Taylor & Francis, 2015) Hart, Chantelle N.; Carskadon, Mary A.; Demos, Kathryn E.; Van Reen, Eliza; Sharkey, Katherine M.; Raynor, Hollie A.; Considine, Robert V.; Jones, Richard N.; Wing, Rena R.; Department of Medicine, IU School of Medicine
    There is considerable interest in the role of sleep in weight regulation, yet few studies have examined this relationship in overweight/obese (OW/OB) adults. Using a within-subject, counterbalanced design, 12 OW/OB women were studied in lab with two nights of short (5 hr time in bed [TIB]) and two nights of long (9 hr TIB) sleep. Hunger, consumption at a buffet, and fasting hormone levels were obtained. Significant polysomnographic differences occurred between conditions in total sleep time and sleep architecture (ps < .001). Percent energy from protein at the buffet increased following short sleep. No differences were observed for total energy intake or measured hormones. Further research is needed to determine how lengthening sleep impacts weight regulation in OW/OB adults.
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    Correspondence between actigraphy and PSG measures of sleep onset latency in young children
    (Associated Professional Sleep Societies, LLC, 2012-06-12) Craven, Hannah J.; Seifer, Ronald; LeBourgeois, Monique K.
    INTRODUCTION: Actigraphy is a non-invasive tool providing objective measurement of sleep onset, offset, and efficiency for extended periods of time based upon wrist-activity levels. Whether actigraphy may also provide an adequately-valid estimate of sleep-onset latency (SOL) in young children is not well-established. This study examined concordance between the gold standard of SOL, polysomnography (PSG), and actigraphy in a cohort of 2-5 year-olds studied at five different levels of prior wakefulness. METHODS: Participants were 8 healthy children (3 males) studied at three longitudinal time points (2.5-3.0y, 3.5-4.0y, 5.5-6.0y). Children followed a strict sleep schedule for at least 5 days before each of five home-based, PSG recordings in which they also wore an actigraph (AW64). Sleep assessments occurred after 4h, 7h, 10h, 13h, and 16h of prior wakefulness, reflecting different levels of sleep pressure. Visual stage scoring used 30-sec epochs from C3/A2. Lights-out time was simultaneously marked on PSG and actigraphy with event markers. Sleep-onset was the first epoch of stage 2 sleep (PSG) and the first of three consecutive epochs of scored sleep after lights-out (actigraphy). RESULTS: Analysis included 9-14 sleep assessments per child of SOL (concurrent PSG and ACT). Averaged SOL varied across sleep assessments and age (PSG range: 4.9+3.1 to 26.9+13.7; ACT range 4.2+3.1 to 19.3+15.9). We performed a nested correlation between PSG- and actigraphy-derived measures of SOL, covarying sleep pressure and age of assessment, nested within subject. The median partial correlation was r=.874 (p<.001), with a range of r=.243 to r=.969. Two children had very-low, non-significant correlations resulting from an outlier in which actigraphy underestimated SOL. CONCLUSION: Overall, these findings suggest actigraphy has adequate validity for estimating SOL in young children when using tightly-controlled data collection and analysis procedures. Future analyses should address methods for establishing the minimum number of nights for a reliable estimate of SOL.
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    Coxsackie B2 Virus Infection Causing Multiorgan Failure and Cardiogenic Shock in a 42-Year-Old Man
    (Texas Heart Institute Journal, 2019-02-01) Hopkins, Kali A.; Abdou, Mahmoud H.; Hadi, M. Azam; Department of Internal Medicine, IU School of Medicine
    Infections from coxsackie B2 viruses often cause viral myocarditis and, only rarely, multisystem organ impairment. We present the unusual case of a 42-year-old man in whom coxsackie B2 virus infection caused multiorgan infection, necessitating distal pancreatectomy, splenectomy, renal dialysis, and venoarterial extracorporeal membrane oxygenation with mechanical ventilation. In addition, the patient had a rapid-eye-movement sleep-related conduction abnormality that caused frequent sinus pauses of longer than 10 s, presumably due to myocarditis from the coxsackievirus infection. He recovered after permanent pacemaker placement and was discharged from the hospital. We discuss our aggressive supportive care and the few other reports of multiorgan impairment from coxsackieviruses.
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    Development and Temporal Validation of an Electronic Medical Record-Based Insomnia Prediction Model Using Data from a Statewide Health Information Exchange
    (MDPI, 2023-05-05) Holler, Emma; Chekani, Farid; Ai, Jizhou; Meng, Weilin; Khandker, Rezaul Karim; Ben Miled, Zina; Owora, Arthur; Dexter, Paul; Campbell, Noll; Solid, Craig; Boustani, Malaz; Electrical and Computer Engineering, School of Engineering and Technology
    This study aimed to develop and temporally validate an electronic medical record (EMR)-based insomnia prediction model. In this nested case-control study, we analyzed EMR data from 2011–2018 obtained from a statewide health information exchange. The study sample included 19,843 insomnia cases and 19,843 controls matched by age, sex, and race. Models using different ML techniques were trained to predict insomnia using demographics, diagnosis, and medication order data from two surveillance periods: −1 to −365 days and −180 to −365 days before the first documentation of insomnia. Separate models were also trained with patient data from three time periods (2011–2013, 2011–2015, and 2011–2017). After selecting the best model, predictive performance was evaluated on holdout patients as well as patients from subsequent years to assess the temporal validity of the models. An extreme gradient boosting (XGBoost) model outperformed all other classifiers. XGboost models trained on 2011–2017 data from −1 to −365 and −180 to −365 days before index had AUCs of 0.80 (SD 0.005) and 0.70 (SD 0.006), respectively, on the holdout set. On patients with data from subsequent years, a drop of at most 4% in AUC is observed for all models, even when there is a five-year difference between the collection period of the training and the temporal validation data. The proposed EMR-based prediction models can be used to identify insomnia up to six months before clinical detection. These models may provide an inexpensive, scalable, and longitudinally viable method to screen for individuals at high risk of insomnia.
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    Ecological momentary assessment versus traditional retrospective self-reports as predictors of health-relevant outcomes
    (2013-09-05) Zielke, Desiree Joy; Stewart, Jesse C.; Rand, Kevin L.; Williams, Jane R.; Cyders, Melissa A.; Hazer, John
    Ecological momentary assessment (EMA) has been asserted by proponents of the technique as being superior to standard paper-and-pencil measurements in terms of the reliability and validity of the information obtained; however, this claim has not yet been fully evaluated in the literature. Accordingly, the purpose of this study was to evaluate one aspect of this assertion by comparing the utility of EMA and retrospective measures of depressive symptoms in predicting health-relevant biological and behavioral outcomes. It was hypothesized that (1) the EMA measure will have better predictive utility when examining objective sleep quality (a biological outcome), and that (2) the retrospective measure will have better predictive utility when examining blood donation intention (a behavioral outcome). Ninety-six undergraduate females participated in this 2-week study. Depressive symptoms were measured momentarily and retrospectively using the Center for Epidemiological Studies-Depression Scale (CES-D). The biological outcome was assessed by actigraphy, whereas the behavioral outcome was measured via a self-report questionnaire. Unfortunately, it was not possible to fully test these hypotheses due to the failure to observe relationships between the predictor variables and the outcomes. The reported results, although limited, did not provide support for the hypotheses. Supplemental analyses revealed a moderate to high amount of shared variance between the EMA and retrospective measures, a similar extent of random error in both measures, and potentially a greater degree of systematic error in the retrospective measure. Due to the paucity of literature examining the claim of superior reliability and validity of EMA versus retrospective measures, as well as the failure of the current study to evaluate this assertion sufficiently, it appears that this claim remains unfounded. Therefore, suggestions for future research are provided.
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    Feasibility and Usability of EnergyPoints: A Mobile Health App to Guide Acupressure Use for Cancer Symptom Management
    (Sage, 2024) Beck, Susan L.; Smith, Ryan; Mindes, Janet; Beck, Karl; Kim, JungYoon Leah; Weitzman, Matthew; Stone, Jennifer A. M.; Veleber, Susan; Dudley, William N.; Medicine, School of Medicine
    Objective: To examine the feasibility and usability of EnergyPoints™, an innovative mobile health app that teaches and guides people with cancer to implement daily acupressure to self-manage their fatigue and sleep disturbances. Methods and intervention: The study used an integrated agile, human-centered approach. Adults (age 18 years and over) with cancer experiencing at least moderate fatigue, and living in the Greater New York City community, were recruited from social media, patient advocacy groups, and referrals. Twenty participants (in 3 sprints of 3, 5, and 12) were video-recorded thinking aloud while using the app for the first time. They then used the app at home to self-administer acupressure (twice daily for 1 week) while continuously wearing a fitness tracker. Each participant completed an exit interview and modified Computer System Usability Questionnaire post-participation. Results: Participants were ages 40 to 76 years and 65% female; 65% were non-Hispanic white. Mean pass rates per ritual exceeded 80%. Users completed (totally or partially) greater than 90% of stimulating acupressure and 70% of relaxing acupressure rituals. Sprint 3 SPs totally completed at least 1 ritual 87% of the time. The majority agreed or strongly agreed the app was easy to use (90%), easy to learn (85%), easy to understand (75%), and effective in helping perform self-acupressure (85%). In an analysis of ease of completing 5 key tasks, all successfully completed the tasks; 3 users required some assistance. Of 654 usability statements, those coded as personal experience/context (197), content related to acupressure learning (105), and content related to the onboarding/profile (71) were most frequent. The design team integrated recommendations into the app before the next sprint. Conclusions: Findings supported feasibility and usability, as well as acceptability, and led to significant alterations and improvements. EnergyPoints™ offers an opportunity to mainstream acupressure and help cancer survivors self-manage their symptoms.
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    A Feasibility Study: Testing Whether a Sleep Application Providing Objective Sleep Data to Physicians Improves Patient-Physician Communication Regarding Sleep Experiences, Habits, and Behaviors
    (Springer, 2022) Durrani, Sana; Cao, Sha; Bo, Na; Pai, Jennifer K.; Baker, Jarod; Rawlings, Lori; Qureshi, Zaina P.; Sigua, Ninotchka L.; Manchanda, Shalini; Khan, Babar; Medicine, School of Medicine
    Introduction: Sleep tracker data have not been utilized routinely in sleep-related disorders and their management. Sleep-related disorders are common in primary care practice and incorporating sleep tracker data may help in improving patient care. We conducted a pilot study to assess the feasibility of a sleep program using the Fitbit Charge 2™ device and SleepLife® application. The main aim of the study was to examine whether a program using a commercially available wearable sleep tracker device providing objective sleep data would improve communication in primary care settings between patients and their providers. Secondary aims included whether patient satisfaction with care would improve as result of the program. Methods: A prospective, randomized, parallel group, observational pilot study was conducted in 20 primary care clinics in Indianapolis, IN from June 2018 to February 2019. Inclusion criteria included patients over the age of 18, have a diagnosis of insomnia identified by electronic medical record and/or a validated questionnaire, and were on a prescription sleep aid. The study was not specific to any sleep aid prescription, branded or generic, and was not designed to evaluate a drug or drug class. Each primary care clinic was randomized to either the SleepLife® intervention or the control arm. All patients were provided with a Fitbit Charge 2™ device. Only patients in the intervention arm were educated on how to use the SleepLife® application. Physicians in the intervention arm were set up with the SleepLife® portal on their computers. Results: Forty-nine physicians and 75 patients were enrolled in the study. Patients had a mean age of 57 (SD 12.8) years and 61% were female. Mean age of physicians was 47 (SD 10.6) years. Patients showed high rates of involvement in the program with 83% completing all survey questions. Physician survey completion rate was 55%. Only one physician logged into the SleepLife portal to check their patients' sleep status. At the end of the 6-week intervention, patients' composite general satisfaction scores with sleep health management decreased significantly in the intervention arm when compared to controls (p = 0.03). Patients' satisfaction with communication also decreased significantly in the intervention group (p = 0.01). The sleep outcomes, which were calculated on the basis of study questionnaire answers, improved significantly in the intervention group as compared to the control group (p = 0.04). Physician communication satisfaction scores remained unchanged (p = 0.12). Conclusions: SleepLife® and its related physician portal can facilitate physician-patient communication, and it captures patient sleep outcomes including behaviors and habits. Patients were highly engaged with the program, while physicians did not demonstrate engagement. The study design and questionnaires do not specifically address the reasons behind the decreased patient satisfaction with care and communication, but it was perceived to be a result of physician non-responsiveness. Sleep quality scores on the other hand showed an improvement among SleepLife® users, suggesting that patients may have implemented good sleep practices on their own. Given that it was a feasibility study, and the sample size was small, we were not able to make major inferences regarding the difference between sleep disorder types. Additionally, we excluded patients with a history of alcohol use, substance abuse, or depression because of concerns that they may affect sleep independently. To promote the growth of technology in primary care, further research incorporating results from this study and physician engagement techniques should be included.