| 61. |
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| 62. |
- Nordin, Maria, et al.
(författare)
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Sleep and sleepiness in environmental intolerances : a population-based study
- 2016
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 24, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Background: About one fourth of the general population report environmental intolerance (El) to odorous/pungent chemicals, certain buildings, electromagnetic fields (EMFs), and/or sounds. EI sufferers show various clinical features, of which sleep disturbance is one. Sleep disturbance is common also in the general population, but it is not known whether the disturbance is more prominent in EI sufferers than in individuals who do not experience EI. Therefore, El was compared on various sleep aspects with referents without El. Methods: A population-based sample of 3406 individuals, aged 18-79 years, was recruited from Northern Sweden. Sleep quality, non-restorative sleep, daytime sleepiness, obstructive breathing, and nocturnal insomnia were assessed with the Karolinska Sleep Questionnaire. Single questions assessed time slept, amount of hours of needed sleep, and extent of enough time slept. Results: All four EI groups, compared to the referents, reported significantly poorer sleep quality, more non-restorative sleep, more daytime sleepiness, more obstructive breathing and higher prevalence of nocturnal insomnia than the referents. Nocturnal insomnia was an important factor for El groups attributing their most prevalent symptoms to chemicals and sounds, irrespective of distress and certain syndromes. None of the EI groups differed significantly from the referents on time slept, but reported needing more sleep time (the EMF-intolerance group showing only a tendency), and all four groups reported to perceive enough sleep to a significantly lesser extent. Conclusion: Sleep disturbance and daytime sleepiness are more common in individuals reporting El compared to normal referents. Moreover, nocturnal insomnia is an important symptom in its own right in various types of EI. This evokes the question of whether or not sleep therapy may attenuate the severity of the El.
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| 63. |
- Norell-Clarke, A., 1979-, et al.
(författare)
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Cognitive behavioural therapy for comorbid insomnia and depression : A randomised, controlled study
- 2013
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Ingår i: Sleep Medicine. - Amsterdam : Elsevier. - 1389-9457 .- 1878-5506. ; 14:Suppl. 1, s. e99-e99
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Insomnia and depression is a common comorbidity and several pilot studies have demonstrated promising results on both conditions by targeting insomnia only. The aim was to investigate the effects of CBT for insomnia (CBT-I) on both sleep and depressive symptoms in a sample with insomnia comorbid with major depression, minor depression or depressive symptoms, using a randomized controlled study.Materials and methods: 64 participants were recruited through advertisements and randomised to receive either CBT-I or an active control (relaxation training: RT) in groups during four sessions over seven weeks. Insomnia and depressive severity was measured before, during and after treatment, using Insomnia Severity Index (ISI) and Beck Depression Inventory (BDI- II).Results: We used independent t-tests to investigate if groups were different on symptom severity prior to treatment. There was no difference between CBT-I and RT regarding insomnia severity (t (55) = 1.30, p = 0.20) or depression severity (t (53) = −0.77, p = 0.44). Looking at development over time, mixed between-within subjects ANOVAs demonstrated a significant interaction between treatment type and time for both insomnia and depression (ISI: F (2, 54) = 4.96, p = 0.01; BDI: F (2, 58) = 2.80, p = 0.07) meaning that CBT-I meant a larger decrease of both insomnia and depressive severity compared to control treatment. There was also a significant main effect for time with decreasing scores for both groups over time on ISI (F (2, 52) = 28.86, p = 0.0005) and BDI-II (F (2, 58) = 7.11, p = 0.002) and a main effect for group on ISI (F (1, 53) = 9.25, p = 0.01) but not on BDI-II (F (1, 59) = 0.27, p = 0.60). A six months follow-up assessment is currently conducted and those results will also be presented during the conference.Conclusion: CBT-I was associated with a greater reduction in insomnia and depression severity compared to control treatment. These results show that it is possible to have an effect on both insomnia and depression during a relatively short and cost effective group treatment, targeting insomnia only.
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| 64. |
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| 65. |
- Ohayon, M. M., et al.
(författare)
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Prevalence, incidence, evolution and associated factors of sleep paralysis in a longitudinal study of the US general population
- 2022
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Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 98, s. 62-67
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Tidskriftsartikel (refereegranskat)abstract
- Background and objective: Sleep paralysis is a common phenomenon which causes and consequences are seldomly studied. The aim of this study was to investigate the incidence and prevalence of sleep paralysis (SP) in the American adult population and its evolution on a 3-year period.Methods: This longitudinal study was conducted between 2002 and 2015 and included a representative sample of the US general population. A total of 12,218 subjects were initially interviewed (W1) and 10,931 were re-interviewed three years later (W2). The subjects participated in telephone interviews using the Sleep-EVAL expert system. Each interview lasted for about 1 h. SP episodes were assessed according to their frequency and duration.Results: At W1, 9.7% (95%CI: 9.1%–10.3%) reported having ≥1 episode of SP in the previous year. At W2, 15.1% (95%CI: 14.4%–15.8%) reported SP. A total of 29.9% of subjects with SP at W1 still reported episodes at W2. The 1-year incidence was 2.7% (95%CI: 2.4–3.0%). After adjusting for age and sex, prevalent SP (i.e., present at W2) was predicted by age and race and the following factors present at W1: major depressive disorder, pain, hypersomnolence, cataplexy, hypnagogic and hypnopompic hallucinations, posttraumatic stress disorder, a reduction in sleep duration of ≥60 min, and the use of analgesic/antipyretic medication. Incident SP (i.e. new cases at W2) had similar predictive factors.Discussion: Episodes of SP are frequent in the general population. Its persistence is predicted by several factors associated with narcolepsy like hypersomnolence and cataplexy but also by other factors like posttraumatic stress disorder or pain.
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| 66. |
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| 67. |
- Palm, Andreas, 1971-, et al.
(författare)
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Factors influencing adherence to continuous positive airway pressure treatment in obstructive sleep apnea and mortality associated with treatment failure - a national registry-based cohort study
- 2018
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 51, s. 85-91
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Adherence to continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) is crucial. Our aim was to identify protective and risk factors against the discontinuation of CPAP treatment in patients with OSA and to estimate the mortality risk in those who were non-adherent to CPAP therapy.Methods: This was a registry-based cohort study from 37 centers across Sweden with OSA patients on CPAP in the Swedevox Swedish national registry between July 2010 and March 2017.Results: In 16,425 patients (70.8% men) with complete follow-up data after 1.2 ± 0.8 years the adjusted relative risk ratio (aRRR) for the discontinuation of CPAP was 0.57 (95% confidence interval (CI) 0.50–0.65) for use of humidifier, 0.87 (95% CI 0.82–0.92) for increasing age per 10 years, 0.80 (95% CI 0.77–0.83) for increasing apnea hypopnea index (AHI) per 5 units/hour, and 0.96 (95% CI 0.95–0.97) per increased unit on the Epworth Sleepiness Scale (ESS). Increasing BMI was associated with increased adherence up to BMI 35. Women and patients with hypertension ran an increased risk of discontinuing CPAP treatment, aRRR 1.28 (95% CI 1.12–1.46) and 1.24 (95% CI 1.12–1.42) respectively. The adjusted hazard ratio (HR) for mortality was 1.74 (95% CI 1.32–2.28) among those who did not adhere to CPAP (median follow-up period 2.4 years after the one year adherence evaluation).Conclusion: Use of humidifier is associated with greater adherence to CPAP treatment. Other factors predicting adherence are increasing age, more severe OSA and overweight up to BMI 35, whereas female gender and coexisting hypertension are risk factors for discontinuation of CPAP. Failure to adhere to CPAP is associated with increased mortality.
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| 68. |
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| 69. |
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| 70. |
- Palm, Andreas, et al.
(författare)
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The impact of obesity and weight gain on development of sleep problems in a population-based sample
- 2015
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 16:5, s. 593-597
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objective of this study was to investigate the role of obesity and weight gain in the development of sleep problems in a population-based cohort. Material and methods: A population-based sample of men (n = 1896, aged 40-79 years) and women (n = 5116, age = 20 years) responded to questionnaires at baseline and follow-up after 10-13 years. Sleep problems were assessed through questions about difficulties initiating sleep (DIS), difficulties maintaining sleep (DMS), excessive daytime sleepiness (EDS), and insomnia. Body mass index (BMI) was calculated from self-reported weight and height at both baseline and follow-up, while confounding factors (physical activity, tobacco and alcohol use, somatic disease, and snoring) were based on responses at baseline. Results: Although overweight and obese subjects reported more sleep problems at baseline, there was no independent association between BMI level at baseline and development of new sleep problems. Subjects in the quartile with the highest rise in BMI with a weight gain exceeding 2.06 kg/m(2) had a higher risk of developing DMS [adjusted odds ratio (OR) 1.58; 95% confidence interval (CI) 1.25-2.01), EDS (2.25; 1.65-3.06], and insomnia (2.78; 1.60-4.82). Weight gain was not associated with the development of DIS. Conclusions: Weight gain is an independent risk factor for developing several sleep problems and daytime sleepiness. The presence of overweight and weight gain should be considered when treating patients with sleep problems. (C) 2015 Elsevier B.V. All rights reserved.
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