| 1. |
- Hagell, Peter, et al.
(författare)
-
Measurement properties and hierarchical item structure of the Epworth Sleepiness Scale in Parkinson's disease
- 2007
-
Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 16:1, s. 102-109
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this work was to evaluate the measurement properties and hierarchical item structure of the Epworth Sleepiness Scale (ESS) in patients with Parkinson's disease (PD). Data were taken from a cross-sectional study regarding fatigue and sleep-related aspects of PD. One hundred and eighteen consecutive patients with neurologist-diagnosed PD without significant co-morbidities (54% men; mean age, 64 years; mean PD duration, 8.4 years) from four Swedish neurological outpatient clinics participated. The ESS displayed good data quality with few missing items (0–2.5%): good reliability (Cronbach's alpha, 0.84), marginal floor and no ceiling effects (1.7% and 0% respectively), and differentiated between those reporting problems staying awake during the past month and those who did not. Item–total correlations, factor and Rasch analyses indicated that items tap a single underlying construct. Rasch analysis supported basic rating scale assumptions and demonstrated an item hierarchy similar to that previously found in patients with other sleep disorders. Gaps in the levels of sleep propensity covered by ESS items and their response options were identified at the higher and lower ends of the underlying sleepiness continuum. This study provides an evidence base for using the ESS in PD by demonstrating good psychometric properties and a stable hierarchical item structure. However, addition of new items and use of Rasch scoring has potential to further enhance the clinical usefulness of the ESS.
|
|
| 2. |
- Jensen, Elmo, et al.
(författare)
-
Insomnia in an 80-year-old population: relationship to medical, psychological and social factors
- 1998
-
Ingår i: Journal of Sleep Research. - : Wiley. - 1365-2869 .- 0962-1105. ; 7:3, s. 183-189
-
Tidskriftsartikel (refereegranskat)abstract
- In this study, insomnia in 80-year-olds was related to medical, psychological and social factors. The data were based on examinations every year in people aged between 80 and 89 years. Of 333 people living in the city of Lund and born in 1908, 67% participated. Increased severity of insomnia was significantly associated with use of diuretics, other cardiovascular drugs, hypnotics and laxatives, and with nervousness, difficulty relaxing, anorexia, nausea, constipation, backache, feeling cold, sweating, loss of weight, dizziness, depression, general fatigue, exhaustion, angina pectoris, cardiac insufficiency, worsened objective and subjective health, presence of negative T-waves on ECG, anxiety, total life satisfaction, neuroticism, disbelief in a just world, feeling lonely and lower survival rates. Thus insomnia has widespread associations with different aspects of life in 80-year-olds.
|
|
| 3. |
- Åkerstedt, Torbjörn, et al.
(författare)
-
Reaction of sleepiness indicators to partial sleep deprivation, time of day and time on task in a driving simulator - the DROWSI project
- 2010
-
Ingår i: Journal of Sleep Research. - : Wiley. - 1365-2869 .- 0962-1105. ; 19:2, s. 298-309
-
Tidskriftsartikel (refereegranskat)abstract
- Studies of driving and sleepiness indicators have mainly focused on prior sleep reduction. The present study sought to identify sleepiness indicators responsive to several potential regulators of sleepiness: sleep loss, time of day (TOD) and time on task (TOT) during simulator driving. Thirteen subjects drove a high-fidelity moving base simulator in six 1-h sessions across a 24-h period, after normal sleep duration (8 h) and after partial sleep deprivation (PSD; 4 h). The results showed clear main effects of TOD (night) and TOT but not for PSD, although the latter strongly interacted with TOD. The most sensitive variable was subjective sleepiness, the standard deviation of lateral position (SDLAT) and measures of eye closure [duration, speed (slow), amplitude (low)]. Measures of electroencephalography and line crossings (LCs) showed only modest responses. For most variables individual differences vastly exceeded those of the fixed effects, except for subjective sleepiness and SDLAT. In a multiple regression analysis, SDLAT, amplitude/peak eye-lid closing velocity and blink duration predicted subjective sleepiness bouts with a sensitivity and specificity of about 70%, but were mutually redundant. The prediction of LCs gave considerably weaker, but similar results. In summary, SDLAT and eye closure variables could be candidates for use in sleepiness-monitoring devices. However, individual differences are considerable and there is need for research on how to identify and predict individual differences in susceptibility to sleepiness.
|
|
| 4. |
- Pevernagie, Dirk, et al.
(författare)
-
European guidelines for the certification of professionals in sleep medicine: report of the task force of the European Sleep Research Society
- 2009
-
Ingår i: Journal of Sleep Research. - : Wiley. - 1365-2869 .- 0962-1105. ; 18:1, s. 136-141
-
Tidskriftsartikel (refereegranskat)abstract
- In recent years, sleep medicine has evolved into a full-grown discipline, featuring a multidisciplinary approach to diagnosis and treatment of patients with sleep disorders. Sleep medicine cuts across the boundaries of different conventional disciplines and is therefore open to medical and non-medical professionals with different specialty backgrounds. The aim of the current paper is to introduce a qualification for those professionals whose main occupation is to practice sleep medicine in the setting of a sleep medicine centre. The drafting of guidelines dealing with requirements for such qualification was entrusted to a task force by the European Sleep Research Society. The guidelines are the result of a progressive consensus procedure in which standards were defined for education, training, and evaluation. The final step along this pathway is a theoretical and practical examination, providing proof of proficiency in the field of sleep medicine. This paper describes the object of specific competences, the scope of sleep medicine, and the qualification procedures that pertain to three professional categories: medical specialists, non-medical professionals with a university master degree (such as psychologists and biologists), and nurses and technologists. Indices of preceding practical experience and theoretical knowledge are presented in Appendices 1 and 2. These guidelines are a European standard. They may be adapted in the future according to new scientific insights. National certification programs that comply with these guidelines may be subject to homologation by the ESRS.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
- Akerstedt, Torbjorn, et al.
(författare)
-
Predicting long-term sickness absence from sleep and fatigue.
- 2007
-
Ingår i: J Sleep Res. - : Wiley. - 0962-1105 .- 1365-2869. ; 16:4, s. 341-5
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Predicting long-term sickness absence from sleep and fatigue.Akerstedt T, Kecklund G, Alfredsson L, Selen J.Institute for Psychosocial Medicine, Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. torbjorn.akerstedt@ipm.ki.seDisturbed or shortened sleep is prospectively related to disease. One might also expect that sickness absence would be another consequence but very little data seem to exist. The present study used 8300 individuals in a national sample to obtain information on reports of disturbed sleep and fatigue 1 year and merged this with data on long-term sickness absence 2 years later. A logistic regression analysis was applied to the data with adjustments for demographic and work environment variables. The results showed that individuals without registered sickness absence at the start had a higher probability of entering a period of long-term (>/=90 days, odds ratio [OR] = 1.24 with 95% confidence interval [CI] = 1.02-1.51) sickness absence 2 years later if they reported disturbed sleep at the start. The figure for fatigue was OR = 1.35 (CI = 1.14-1.60). When fatigue or disturbed sleep was separately excluded the OR increased to OR = 1.44 and OR = 1.47, respectively. Intermediate sickness absence (14-89 days) showed similar but slightly weaker results. The results indicate that disturbed sleep and fatigue are predictors of long-term absence and it is suggested that impaired sleep may be part of a chain of causation, considering its effects on fatigue.PMID: 18036078 [PubMed - in process]
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
- Anund, Anna, et al.
(författare)
-
Driver sleepiness and individual differences in preferences for countermeasures.
- 2008
-
Ingår i: J Sleep Res. - : Wiley. - 1365-2869 .- 0962-1105. ; 17:1, s. 16-22
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- 1: J Sleep Res. 2008 Mar;17(1):16-22. LinksDriver sleepiness and individual differences in preferences for countermeasures.Anund A, Kecklund G, Peters B, Akerstedt T.Swedish National Road and Transport Research Institute (VTI), Linköping, Sweden. anna.anund@vti.seThe aim of the present national questionnaire study was to relate the use of sleepiness countermeasures among drivers to possible explanatory factors such as age, sex, education, professional driving, being a shift worker, having experience of sleepy driving, sleep-related crashes, problems with sleep and sleepiness in general and sleep length during working days. Also the attitude to countermeasures related to information or driver support system was studied. A random sample of 3041 persons was drawn from the national register of vehicle owners. The response rate was 62%. The most common countermeasures were to stop to take a walk (54%), turn on the radio/stereo (52%), open a window (47%), drink coffee (45%) and to ask passengers to engage in conversation (35%). Logistic regression analysis showed that counteracting sleepiness with a nap (a presumably efficient method) was practiced by those with experience of sleep-related crashes or of driving during severe sleepiness, as well as by professional drivers, males and drivers aged 46-64 years. The most endorsed means of information to the driver about sleepiness was in-car monitoring of driving performance providing drivers with information on bad or unsafe driving. This preference was related to experience of sleepy driving, not being a professional driver and male gender. Four clusters of behaviours were identified: alertness-enhancing activity while driving (A), stopping the car (S), taking a nap (N) and ingesting coffee or other sources of caffeine (C) (energy drinks, caffeine tablets). The participants were grouped according to their use of any of the four categories of countermeasures. The most common cluster was those who used activity, as well as stopping and drinking caffeine.PMID: 18275551 [PubMed - in process]
|
|
| 13. |
|
|
| 14. |
- Arnardottir, Erna S I F, et al.
(författare)
-
Sleep-related sweating in obstructive sleep apnoea: association with sleep stages and blood pressure
- 2010
-
Ingår i: JOURNAL OF SLEEP RESEARCH. - : Wiley. - 0962-1105 .- 1365-2869. ; 19:1, s. 122-130
-
Tidskriftsartikel (refereegranskat)abstract
- Pandgt;The aim of this study was to investigate sleep-related sweating as a symptom of obstructive sleep apnoea (OSA). Fifteen otherwise healthy male non-smoking patients with untreated moderate-to-severe OSA underwent polysomnography, including measurements of skin and core body temperature and electrodermal activity (EDA) as an objective indicator of sweating. Evening and morning blood pressure was measured as well as catecholamines in nocturnal urine. All measurements were repeated after 3 months on successful continuous positive airway pressure (CPAP) treatment. The untreated OSA subjects had a mean (+/- SD) apnoea-hypopnoea index of 45.3 +/- 3.9 and a mean EDA index during sleep of 131.9 +/- 22.4 events per hour. Patients with higher EDA indices had higher systolic blood pressure in the evening and morning (P = 0.001 and 0.006) and lower rapid eye movement (REM) sleep percentage (P = 0.003). The EDA index decreased significantly to 78.5 +/- 17.7 in the patients on CPAP treatment (P = 0.04). The decrease correlated with lower evening systolic and diastolic blood pressure (P = 0.05 and 0.006) and an increase in REM% (P = 0.02). No relationship was observed between EDA and skin or core body temperature, or to catecholamine levels in urine. OSA patients who experience sleep-related sweating may have increased blood pressure and decreased REM sleep compared with other OSA patients. CPAP treatment appears to lower blood pressure and increase REM sleep to a higher extent in these patients compared with other OSA patients.
|
|
| 15. |
|
|
| 16. |
- Björnsdóttir, Erla, et al.
(författare)
-
Insomnia in untreated sleep apnea patients compared to controls
- 2012
-
Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 21:2, s. 131-138
-
Tidskriftsartikel (refereegranskat)abstract
- Insomnia and obstructive sleep apnea (OSA) often coexist, but the nature of their relationship is unclear. The aims of this study were to compare the prevalence of initial and middle insomnia between OSA patients and controls from the general population as well as to study the influence of insomnia on sleepiness and quality of life in OSA patients. Two groups were compared, untreated OSA patients (n = 824) and controls ≥ 40 years from the general population in Iceland (n = 762). All subjects answered the same questionnaires on health and sleep and OSA patients underwent a sleep study. Altogether, 53% of controls were males compared to 81% of OSA patients. Difficulties maintaining sleep (DMS) were more common among men and women with OSA compared to the general population (52 versus 31% and 62 versus 31%, respectively, P < 0.0001). Difficulties initiating sleep (DIS) and DIS + DMS were more common among women with OSA compared to women without OSA. OSA patients with DMS were sleepier than patients without DMS (Epworth Sleepiness Scale: 12.2 versus 10.9, P < 0.001), while both DMS and DIS were related to lower quality of life in OSA patients as measured by the Short Form 12 (physical score 39 versus 42 and mental score 36 versus 41, P < 0.001). DIS and DMS were not related to OSA severity. Insomnia is common among OSA patients and has a negative influence on quality of life and sleepiness in this patient group. It is relevant to screen for insomnia among OSA patients and treat both conditions when they co-occur.
|
|
| 17. |
- Broström, Anders, et al.
(författare)
-
Association of Type D personality to perceived side effects and adherence in CPAP-treated patients with OSAS
- 2007
-
Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 16:4, s. 439-447
-
Tidskriftsartikel (refereegranskat)abstract
- Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side effects are common and long-term adherence low. The Type D (distressed) personality is defined as a combination of negative affectivity and social inhibition. The association of Type D personality with adherence has not been studied in CPAP-treated patients with OSAS. This study aimed to describe the prevalence of Type D personality in OSAS patients with CPAP treatment longer than 6 months and the association with self-reported side effects and adherence. A cross-sectional descriptive design was used. A total of 247 OSAS patients with a mean use of CPAP treatment for 55 months (6-182 months) were included. Data collection was achieved by two questionnaires; the Type D scale 14 (DS14) (Type D personality), SECI (side effects of CPAP), as well as from medical records (clinical variables and objective adherence to CPAP treatment). Type D personality occurred in 30% of the patients with OSAS and significantly (P < 0.05-0.001) increased the perceived frequency and severity of a broad range of side effects. The objective adherence was significantly lower (P < 0.001) for OSAS patients with Type D compared to OSAS patients without Type D, both with regard to a mean use of 4 h per night and 85% of the self-rated sleep time per night. The additional effect of a Type D personality on perceived side effects and adherence to CPAP treatment found in this study could be used by healthcare personnel when evaluating patients waiting for treatment.
|
|
| 18. |
|
|
| 19. |
|
|
| 20. |
- RODENSTEIN, DANIEL, et al.
(författare)
-
Driving in Europe: the need of a common policy for drivers with obstructive sleep apnoea syndrome
- 2008
-
Ingår i: Journal of sleep research. - : Wiley. - 1365-2869 .- 0962-1105. ; 17:3, s. 281-284
-
Tidskriftsartikel (refereegranskat)abstract
- Obstructive sleep apnoea syndrome (OSA) increases the risk of motor vehicle crashes, and of all medical disorders, has greatest risk in this respect. There is no consistency in the way OSA is considered by the national 'Physical Fitness to Drive' legislations within the 27 member countries of the European Union (EU), and most ignore OSA. This is further reflected by the absence of any reference to OSA in Annex III of the Directive 91/439/EEC, harmonizing Driving License regulations in the EU. A recent meeting brought together experts from several European and other countries, together with a representative of the European Commission. They discussed the best way to design and implement a uniform policy within Europe, for OSA and driving. It was agreed that: (i) other forms of pathological sleepiness be included, (ii) it covers both private and professional drivers, (iii) police accident report forms should explicitly consider sleepiness as a potential cause, (iv) sleep-wake education should be incorporated into the mandatory program of continuous education for professional drivers, ideally from 2010, (v) driver screening methods should contain questions on sleepiness at the wheel, habitual snoring and witnessed apneas during sleep, as well as the Epworth Sleepiness Score and Body Mass Index and (vi) following effective and efficient treatment, patients should be permitted to drive. In the light of medical, scientific and technical progress, EU procedures exist to enable the rapid modification of existing legislation. If such a procedure could be enacted for these aspects of driver sleepiness, then roads would be safer for 400 million people.
|
|
| 21. |
|
|
| 22. |
- Schwarz, Johanna F. A., et al.
(författare)
-
In-car countermeasures open window and music revisited on the real road : popular but hardly effective against driver sleepiness
- 2012
-
Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 21:5, s. 595-599
-
Tidskriftsartikel (refereegranskat)abstract
- This study investigated the effects of two very commonly used countermeasures against driver sleepiness, opening the window and listening to music, on subjective and physiological sleepiness measures during real road driving. In total, 24 individuals participated in the study. Sixteen participants received intermittent 10-min intervals of: (i) open window (2 cm opened); and (ii) listening to music, during both day and night driving on an open motorway. Both subjective sleepiness and physiological sleepiness (blink duration) was estimated to be significantly reduced when subjects listened to music, but the effect was only minor compared with the pronounced effects of night driving and driving duration. Open window had no attenuating effect on either sleepiness measure. No significant long-term effects beyond the actual countermeasure application intervals occurred, as shown by comparison to the control group (n = 8). Thus, despite their popularity, opening the window and listening to music cannot be recommended as sole countermeasures against driver sleepiness.
|
|
| 23. |
- Svensson, Malin, et al.
(författare)
-
Relationship Between Sleep-Disordered Breathing and Markers of Systemic Inflammation in Women From the General Population
- 2012
-
Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 21:2, s. 147-154
-
Tidskriftsartikel (refereegranskat)abstract
- Sleep-disordered breathing (SDB) is a risk factor for cardiovascular disease (CVD). The underlying pathogenesis is not clear. In patients with obstructive sleep apnoea syndrome (OSAS) elevated levels of inflammatory markers, such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumour necrosis factor a (TNFa) have been found. These markers have also been shown as independent markers of CVD in other populations. The aim of the study was to investigate the association between SDB and systemic inflammation in a population-based cohort of women. From 6817 women who previously answered a questionnaire concerning snoring habits, 230 habitually snoring women and 170 women regardless of snoring status went through polysomnography, anthropometric measurements and blood sampling. Analyses were made for CRP, TNFa, IL-6, myeloperoxidase (MPO) and lysozyme. The levels of CRP, IL-6 and lysozyme were significantly higher in subjects with apnoeahypopnoea index (AHI) =15 compared with women with lower AHI. All inflammatory markers except MPO correlated to AHI and oxygen desaturation measures, and to waist circumference. In multiple linear regressions adjusting for age, waist circumference and smoking, independent correlations between oxygen desaturation indices (ODI) and inflammation were found for IL-6 (P = 0.03 for % sleep time with saturation <90%) and TNFa (P = 0.03 for ODI 3%). No significant correlations were found between AHI and inflammation. Also, for women from the general population there is an independent correlation between SDB and inflammation, even after adjusting for obesity. The results indicate that intermittent hypoxia, and not the AHI, is related to systemic inflammation seen in OSAS.
|
|
| 24. |
- Valli, Katja, et al.
(författare)
-
Can observers link dream content to behaviours in rapid eye movement sleep behaviour disorder? : A cross-sectional experimental pilot study
- 2012
-
Ingår i: Journal of Sleep Research. - : Wiley-Blackwell. - 0962-1105 .- 1365-2869. ; 21:1, s. 21-29
-
Tidskriftsartikel (refereegranskat)abstract
- Motor activity in rapid eye movement (REM) sleep behaviour disorder (RBD) has been linked to dream content. Systematic and controlled sleep laboratory studies directly assessing the relation between RBD behaviours and experienced dream content are, however, largely lacking. We aimed to investigate whether a link can be established between RBD behaviours and dream content when both are systematically sampled in a controlled setting. We investigated six patients with Parkinson syndrome and RBD who underwent 23 nights of videopolysomnographic recording during which they were awakened from REM sleep (10 min after the onset of the second and successive REM periods). Spontaneous free-worded dream reports and a structured dream questionnaire were obtained. Video recordings of motor manifestations were each combined with four dream reports, and seven judges had to match the video clip with the correctly reported dream content from a choice of four possibilities. Of the 35 REM sleep awakenings performed, a total of 17 (48.6%) motor-behavioural episodes with recalled dream content were obtained. The mean of correctly identified video-dream pairs was 39.5% (range 0100%). Our data showed that reported dream content can be linked to motor behaviours above chance level. Matching accuracy was affected mainly by the clarity of dream reports and the specific nature of movements manifest in video recordings.
|
|
| 25. |
- Gillberg, M., et al.
(författare)
-
Longitudinal changes in the sleep habits of Swedish adolescents
- 2006
-
Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 15:Suppl. 1, s. 83-
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Sleep habits change during adolescence both for biological and psychological/social reasons. Longitudinal studies on suchhabits are, however, scarce. The aim of the present study was toinvestigate the longitudinal changes of subjective sleep habits in Swedish adolescents.Method: The present study was part of a larger investigation mainlyon food habits that originally included all (about 2500) 14 year oldfrom three representative middle-sized Swedish towns. The adolescents filled in questionnaires at 14, 15 and 18 years of age. The 638 adolescents that answered all the questions on their sleephabits at each of the three occasions were included in the present study.Results and discussion: The adolescents developed later weekday bed- and rise times with increasing age (bedtimes from 22:35 h to23:20 h; risetimes from 06:50 h to 07:05 h). Consequently, time inbed on weekday nights decreased (from 8:15 h to 7:45 h). On weekends the adolescents went to bed later (around 2 h) and stayed in bed longer (around 1:20 h) than during the weekdays. Weekend time in bed decreased with increasing age. Differences between genders indicated that the changes observed were more obvious among boys. A dropout analysis implied that those adolescents that only participated at one occasion (at the age of 14) or at two occasions (at 14 and 15 years of age), respectively, went to bed later, woke up later and had shorter sleep compared to those who participated at all three occasions. Hence, the results might not be completely representative.Conclusions: A delay of bedtimes and of shortening of sleep duration as a function of age was observed. Weekend changes showed a delay of bedtimes and a (presumably) compensatory increase in sleep duration. Boys seemed 'worse off'.
|
|
