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Browsing by Subject "Sleep Initiation and Maintenance Disorders"
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Item Confirmatory factor analysis of the Pittsburgh Sleep Quality Index in women with hot flashes(Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2015-11) Otte, Julie L.; Rand, Kevin L.; Landis, Carol A.; Paudel, Misti L.; Newton, Katherine M.; Woods, Nancy; Carpenter, Janet S.; IU School of NursingOBJECTIVE: Women, especially those with hot flashes, report poor sleep quality during various stages of the menopausal transition and postmenopause. Sleep measurements vary widely because of the copious instruments available. The Pittsburgh Sleep Quality Index (PSQI) is a frequently used questionnaire that produces a single score for sleep quality. This one-factor structure has not received consistent support in the literature. The goal of this analysis was to determine the best factor structure of the PSQI in women with hot flashes. METHODS: A confirmatory factor analysis was conducted on PSQI baseline data from three randomized controlled clinical trials enrolling perimenopausal and postmenopausal women with hot flashes (N = 849) from the Menopause Strategies: Finding Lasting Answers for Symptoms and Health network. Several a priori factor models were compared. RESULTS: One-factor and two-factor models did not fit the data. A three-factor model comprising sleep efficiency, perceived sleep quality, and daily disturbance showed good fit; however, the sleep medication item was dropped because of poor fit and low rates of sleep medication use. The three-factor model was examined in African-American and white subsamples and was found to be similar in both groups; however, two items showed small group differences in strength as indicators. CONCLUSIONS: Sleep quality in midlife women with hot flashes, as measured by the PSQI, seems to comprise three correlated factors. Minor measurement differences detected between groups are of research interest but do not necessitate different scoring practices. Additional research is needed to further define sleep quality and its associations with health-related outcomes.Item Efficacy of yoga for vasomotor symptoms: a randomized controlled trial(Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2014-04) Newton, Katherine M.; Reed, Susan D.; Guthrie, Katherine A.; Sherman, Karen J.; Booth-LaForce, Cathryn; Caan, Bette; Sternfeld, Barbara; Carpenter, Janet S.; Learman, Lee A.; Freeman, Ellen W.; Cohen, Lee S.; Joffe, Hadine; Anderson, Garnet L.; Larson, Joseph C.; Hunt, Julie R.; Ensrud, Kristine E.; LaCroix, Andrea Z.; IU School of NursingOBJECTIVE: This study aims to determine the efficacy of yoga in alleviating vasomotor symptoms (VMS) frequency and bother. METHODS: This study was a three-by-two factorial, randomized controlled trial. Eligible women were randomized to yoga (n = 107), exercise (n = 106), or usual activity (n = 142), and were simultaneously randomized to a double-blind comparison of ω-3 fatty acid (n = 177) or placebo (n = 178) capsules. Yoga intervention consisted of 12 weekly 90-minute yoga classes with daily home practice. Primary outcomes were VMS frequency and bother assessed by daily diaries at baseline, 6 weeks, and 12 weeks. Secondary outcomes included insomnia symptoms (Insomnia Severity Index) at baseline and 12 weeks. RESULTS: Among 249 randomized women, 237 (95%) completed 12-week assessments. The mean baseline VMS frequency was 7.4 per day (95% CI, 6.6 to 8.1) in the yoga group and 8.0 per day (95% CI, 7.3 to 8.7) in the usual activity group. Intent-to-treat analyses included all participants with response data (n = 237). There was no difference between intervention groups in the change in VMS frequency from baseline to 6 and 12 weeks (mean difference [yoga--usual activity] from baseline at 6 wk, -0.3 [95% CI, -1.1 to 0.5]; mean difference [yoga--usual activity] from baseline at 12 wk, -0.3 [95% CI, -1.2 to 0.6]; P = 0.119 across both time points). Results were similar for VMS bother. At week 12, yoga was associated with an improvement in insomnia symptoms (mean difference [yoga - usual activity] in the change in Insomnia Severity Index, 1.3 [95% CI, -2.5 to -0.1]; P = 0.007). CONCLUSIONS: Among healthy women, 12 weeks of yoga class plus home practice, compared with usual activity, do not improve VMS frequency or bother but reduce insomnia symptoms.Item A Practical Application Primer on Cognitive Behavioral Therapy for Insomnia for Medical Residents(Association of American Medical Colleges, 2019-12-13) Chernyak, Yelena; Psychiatry, School of MedicineIntroduction: Cognitive behavioral therapy for insomnia (CBT-I) is a well-established nonpharmacological intervention that is the gold standard treatment for insomnia. CBT-I has been utilized and empirically validated in many modalities, including group treatment, telemedicine, and primary care. Despite the wealth of evidence on its effectiveness, many medical providers, including those in primary care, where most insomnia complaints are raised, have limited exposure, knowledge, and resources to direct or implement this intervention. Methods: Medical educators from an academic medical center developed a module focused on teaching medical residents the techniques of CBT-I. The educational activity was an interactive 90-minute seminar that included a lecture followed by a case presentation illustrating the application of medical knowledge. A postseminar survey was used to evaluate the topic and content of the seminar. Results: In a survey of 32 primary care and psychiatry residents and sleep medicine fellows, 97% of respondents indicated that the topic of CBT-I should be included in the seminar series, and 84% indicated that the topic was of interest to them. Qualitative feedback underscored the relevance of this topic to trainees' clinical practice, as well as its underratedness. Discussion: The seminar on CBT-I was well received and viewed as a valuable tool in practicing medicine. The slides and vignettes provided enable replication of this workshop in other settings with medical learners who have a cursory knowledge of sleep medicine. The workshop is applicable to other health professionals, including medical students, nurses, social workers, and psychology trainees.