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Fernandes M, Calvello C, Placidi F, Izzi F, Castelli A, Pagano A, Mercuri NB, Liguori C. Sex effect on time to diagnosis and clinical features of narcolepsy type 1 and 2. Sleep Med 2025; 130:43-47. [PMID: 40157243 DOI: 10.1016/j.sleep.2025.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Revised: 01/28/2025] [Accepted: 03/22/2025] [Indexed: 04/01/2025]
Abstract
STUDY OBJECTIVES Sex influences sleep through physiological differences and impacts the clinical presentation and quality of life in patients with sleep disorders. However, there is a paucity of evidence regarding differences between men and women affected by narcolepsy. This study aimed to explore the sex-based dissimilarities in time to diagnosis and clinical features in narcolepsy. METHODS This retrospective observational study included adult patients with narcolepsy type 1 (NT1) and type 2 (NT2). Clinical, polysomnographic, and biofluid parameters were compared between men and women. RESULTS The study analyzed 42 patients: 27 with NT1 (64.3 %) and 15 with NT2 (35.7 %). Among these, 18 were male (42.9 %; mean age 34.72 ± 12.89 years) and 24 were female (57.1 %; mean age 37.96 ± 13.2 years). No significant sex differences were observed in the age at onset of symptoms. Notably, females had significantly longer diagnostic delay compared to males (p = 0.04) and a higher rate of misdiagnosis before receiving the diagnosis of narcolepsy (p < 0.001). Male patients exhibited significantly longer stage 2 of Non-REM sleep percentage compared to females patients (p = 0.024). There were no significant differences in psychiatric comorbidities (p = 0.30). CONCLUSIONS Women with narcolepsy experience longer time to obtain the correct diagnosis and are more frequently misdiagnosed with other disorders compared to men. The present findings highlight a potential sex-based disparity in diagnostic practices that may negatively impact the well-being of women with narcolepsy, as their symptoms are more commonly misdiagnosed.
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Affiliation(s)
- Mariana Fernandes
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carmen Calvello
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
| | - Francesca Izzi
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
| | - Alessandro Castelli
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
| | - Andrea Pagano
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy.
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Xie MR, Li G, Shi YT, Kang L, Dou NN, Liu B, Cao JL, Fu SQ, Hao SG. Study on the correlation between insomnia degree and quality of life in psychiatric outpatients in Chifeng city. World J Psychiatry 2025; 15:103669. [DOI: 10.5498/wjp.v15.i5.103669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2024] [Revised: 01/27/2025] [Accepted: 03/06/2025] [Indexed: 04/30/2025] Open
Abstract
BACKGROUND Insomnia is a common sleep disorder that negatively impacts quality of life and is frequently comorbid with depression and anxiety. Chronic insomnia affects approximately 15% of the global population, with higher prevalence among females and the elderly. While existing research suggests a bidirectional relationship between insomnia and emotional disorders, the specific impact of insomnia severity on depression, anxiety, and quality of life remains unclear. This study investigates the correlation between insomnia severity and these factors in psychiatric outpatients, hypothesizing that greater insomnia severity is associated with higher levels of depression and anxiety, as well as poorer quality of life.
AIM To explore the correlation between insomnia severity and depression, anxiety, and quality of life in primary chronic insomnia patients.
METHODS From June to December 2023, 345 patients with primary insomnia in Chifeng city were recruited and divided into three groups based on Pittsburgh sleep quality index (PSQI) scores: Mild (n = 137), moderate (n = 162), and severe (n = 46). Demographic data were collected via questionnaires. Self-rating depression scale (SDS), self-rating anxiety scale (SAS), PSQI, and short form 36 (SF-36) scores were compared, and Pearson and partial correlation analyses were performed.
RESULTS The greater the degree of insomnia, the greater the symptoms of depression and anxiety (P < 0.001). The more severe the insomnia, the lower the SF-36 score (excluding body pain), and the difference between the three groups was statistically significant (P < 0.001). Pearson correlation analysis and partial correlation analysis depicted the SDS score and SAS score were apparently positively correlated with the severity of insomnia (P < 0.001). Pearson correlation analysis and partial correlation analysis depicted the SF-36 scores were apparently positively correlated with the severity of insomnia (P < 0.05).
CONCLUSION Depression and anxiety are independent factors influencing insomnia severity in primary chronic insomnia patients. Higher depression/anxiety levels correlate with worse insomnia, impacting quality of life.
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Affiliation(s)
- Meng-Ran Xie
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Gang Li
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Yu-Ting Shi
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Li Kang
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Na-Na Dou
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Bing Liu
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Jia-Li Cao
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Shi-Qi Fu
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Shi-Guang Hao
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
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Lee SY, Huang SM, Hung CT, Fang SC. The Relationship Between Psychological Distress and Sleep Quality Among Middle-Aged and Older Adults: The Moderating Effect of Gender. J Nurs Res 2025; 33:e372. [PMID: 39787132 DOI: 10.1097/jnr.0000000000000655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2025] Open
Abstract
BACKGROUND Symptoms of psychological distress such as depression and anxiety as well as gender are known to be associated with sleep quality in middle-aged and older adults. However, little is known about the effect on sleep quality of interactions among these factors. PURPOSE This study was developed to investigate the moderating effect of gender on the relationship between psychological distress and sleep quality in middle-aged and older adults. METHODS A cross-sectional design, secondary data analysis of data on 5,590 individuals aged ≥ 45 years from the Taiwan Biobank database (2009-2018) was used. In this database, psychological distress was assessed using the Patient Health Questionnaire-4, and sleep quality was assessed using a self-report, one-question scale. Demographic data and health-related variables were evaluated as potential confounding factors. A hierarchical regression was conducted to examine the moderating effect of gender on the relationship between psychological distress and sleep quality after adjusting for potential confounders. RESULTS The participants with severe psychological distress were found to have a lower mean quality of sleep than those without ( p < .01), and males returned a better mean quality of sleep score than females ( p < .01). Moreover, a significant interaction effect between psychological distress and gender on sleep quality score was found ( b = 0.123, SE = 0.022, p = .03). In terms of participants with severe psychological distress, males reported significantly poorer sleep quality than females. CONCLUSIONS The findings provide evidence that gender moderates the relationship between sleep quality and psychological distress. Also, in terms of individuals with severe psychological distress, males reported worse sleep quality than women, indicating psychological distress impacts sleep quality in men more than women. Nurses should be aware of these findings when working with clinical professionals to tailor gender-specific education interventions to improve sleep quality and psychological health.
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Affiliation(s)
- Szu-Ying Lee
- Department of Nursing, MacKay Medical College, New Taipei City, Taiwan
| | - Sheng-Miauh Huang
- Department of Nursing, MacKay Medical College, New Taipei City, Taiwan
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Lawson Y, Wilding GE, El-Solh AA. Insomnia and risk of mortality in older adults. J Sleep Res 2024; 33:e14229. [PMID: 38685752 DOI: 10.1111/jsr.14229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
Existing evidence linking insomnia to all-cause mortality in older individuals remains inconclusive. We conducted a retrospective study of a large cohort of veterans aged 65-80 years old identified from the Corporate Data Warehouse, a large data repository derived from the Veterans Health Administration integrated medical records. Veterans' enrollees with and without International Classification of Diseases, Ninth and Tenth Revision, codes corresponding to insomnia diagnosis between 1 January 2010 and 30 March 2019 were assessed for eligibility. The primary outcome was all-cause mortality. A total of 36,269 veterans, 9584 with insomnia and 26,685 without insomnia, were included in the analysis. Baseline mean (SD) age was 72.6 (4.2) years. During a mean follow-up of 6.0 (2.9) years of the propensity score matched sample, the mortality rate was 34.8 [95% confidence interval: 33.2-36.6] deaths per 1000 person-years among patients with insomnia compared with 27.8 [95% confidence interval: 26.6-29.1] among patients without insomnia. In a Cox proportional hazards model, insomnia was significantly associated with higher mortality (hazard ratio: 1.39; [95% confidence interval: 1.27-1.52]). Patients with insomnia also had a higher risk of non-fatal cardiovascular events (hazard ratio: 1.21; [95% confidence interval: 1.06-1.37]). Secondary stratified analyses by sex, race, ethnicity and hypertension showed no evidence of effect modification. A higher risk of mortality (hazard ratio: 1.51; [95% confidence interval: 1.33-1.71]) was observed when depression was present compared with absent (hazard ratio: 1.26; [95% confidence interval: 1.12-1.44]; p = 0.02). In this cohort study, insomnia was associated with increased risk-adjusted mortality and non-fatal cardiovascular events in older individuals.
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Affiliation(s)
- Yolanda Lawson
- The Veterans Affairs Western New York Healthcare System, Buffalo, New York, USA
| | - Gregory E Wilding
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Ali A El-Solh
- The Veterans Affairs Western New York Healthcare System, Buffalo, New York, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Jacobs School of Medicine, Buffalo, New York, USA
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
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Jiang L, Yang L, Hong Z, Yao X. Association between frailty status and falling in older adults with hip fracture: a cross-sectional study. Postgrad Med 2024; 136:651-658. [PMID: 39046320 DOI: 10.1080/00325481.2024.2384827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/17/2024] [Accepted: 07/23/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVES There is limited research on the relationship between frailty status and falls in hip fractures in older participants. This study aimed to investigate the relationship between frailty and falls in older adults who had experienced a hip fracture. METHODS From June 2023 to January 2024, the study population comprised 253 hip fracture patients aged 60 years and over. They were admitted to the orthopedic department of a tertiary care hospital. We excluded participants with incomplete information. The 5-item FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight) was used to assess frailty status and the patient's self-reported falls. We analyzed the relationship between frailty and falls in older hip fracture patients using logistic regression models, subgroup analyses, and stratified analyses. RESULTS Finally, 174 older participants with hip fractures were identified in this study, where 155 (89.1%) had falls. Among 155 falls, 39 (78.0%) were in the robust group, 65 (91.5%) were in the pre-frail group, and 51 (96.2%) were in the frail group. An analysis revealed that among more than 60 years old hip fracture patients, each additional point in frailty score was significantly linked to a higher likelihood of experiencing a fall (OR: 1.97, 95% CI: 1.10-3.52, p < 0.05). While frailty appeared as a categorical variable, this association was stronger with an OR of 2.68 (95% CI: 0.71-10.21) in the pre-frailty group and 7.95 (95% CI: 1.11-57.08), compared to the robust group (p for trend < 0.005). In subgroup analyses, an interaction was observed between frailty and falling according to sex. In stratified analyses, the relationship between frailty status and fall significantly differed between the male and female groups (male OR: 1.49, 95% CI: 0.71 -3.13; female OR: 7.54, 95% CI: 1.13 - 50.32, p for interaction = 0.035). CONCLUSIONS The study revealed a notable correlation between frailty and falls, with gender and frailty showing an interaction impact on the increased occurrence of falls. Therefore, further research across diverse disease populations is needed to explore the link between frailty status and falls. Large-scale prospective studies are necessary to clarify the causality of this relationship. CLINICAL TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR2300073031).
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Affiliation(s)
- Lan Jiang
- Department of Trauma and Orthopedic Surgery, The Huangshan City People's Hospital, Huangshan, China
| | - Lili Yang
- Department of Trauma and Orthopedic Surgery, The Huangshan City People's Hospital, Huangshan, China
| | - Ziyuan Hong
- Department of Trauma and Orthopedic Surgery, The Huangshan City People's Hospital, Huangshan, China
| | - Xuewei Yao
- Department of Trauma and Orthopedic Surgery, The Huangshan City People's Hospital, Huangshan, China
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Canever JB, Zurman G, Vogel F, Sutil DV, Diz JBM, Danielewicz AL, Moreira BDS, Cimarosti HI, de Avelar NCP. Worldwide prevalence of sleep problems in community-dwelling older adults: A systematic review and meta-analysis. Sleep Med 2024; 119:118-134. [PMID: 38669835 DOI: 10.1016/j.sleep.2024.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/09/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024]
Abstract
The understanding of the prevalence of sleep problems in older adults can provide a broad and reliable perspective into the occurrence of such issues among older adults. This systematic review and meta-analysis aimed to estimate the worldwide prevalence of sleep problems in community-dwelling older adults. Studies that provide information on the prevalence of sleep problems in community-dwelling older adults (≥60 years) were screened between December 2022 and March 2023. A total of 20,379 studies were identified in database searches, from which 252 were included in this review. These studies covered the last 35 years (from 1988 to 2023) and pooled a sample of 995,544 participants from 36 countries. The most frequent sleep problem worldwide was obstructive sleep apnea (46.0%), followed by poor sleep quality (40.0%), other sleep problems (37.0%), insomnia (29.0%), and excessive daytime sleepiness (19.0%). No significant difference in the prevalence estimates of all sleep problems was observed between the sexes. This systematic review and meta-analysis showed a high prevalence of some sleep problems, mainly obstructive sleep apnea, poor sleep quality, and other sleep problems. Our estimates can be useful for managers and policymakers in planning healthcare strategies for sleep problems aimed at the older population.
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Affiliation(s)
- Jaquelini Betta Canever
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil; Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Gabriela Zurman
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Felipe Vogel
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Daiana Vieira Sutil
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Ana Lúcia Danielewicz
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health and Aging, Federal University of Minas Gerais and Oswaldo Cruz Foundation - Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Helena Iturvides Cimarosti
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil
| | - Núbia Carelli Pereira de Avelar
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Wijnhoven HAH, Kok AAL, Schaap LA, Hoekstra T, van Stralen MM, Twisk JWR, Visser M. The associations between sleep quality, mood, pain and appetite in community dwelling older adults: a daily experience study. J Nutr Health Aging 2024; 28:100028. [PMID: 38388106 DOI: 10.1016/j.jnha.2023.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/29/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVES To investigate the daily life experiences of sleep, mood, and pain in relation to appetite in community-dwelling older adults aged 75 years and older, stratified by sex. DESIGN Existing data from a daily experience study embedded in the Longitudinal Aging Study Amsterdam (LASA) among the oldest-old (≥75 years). SETTING LASA is an ongoing cohort study of a nationally representative sample of older adults aged ≥55 years from three culturally distinct regions in the Netherlands. PARTICIPANTS 434 community-dwelling older adults aged ≥75 years. MEASUREMENTS Participants filled-out a one-week diary on daily experience of pain, mood, last night sleep (10-point Likert scale), and appetite (5-point Likert scale) on five measurement occasions between 2016 and 2021. (Hybrid) linear mixed models were used to investigate overall, within-subject and between-subject association between mood, sleep, and pain (independent variables) and appetite (dependent variable), while correcting between-subject associations for season, age, educational level, partner status, body mass index, alcohol consumption, physical activity level, smoking status, chronic diseases and use of nervous system medication, stratified by sex. RESULTS Averaged over all days, males reported a poor appetite on 12% of the days and females on 19% of the days. Statistically significant between-subject associations with a poorer appetite were found for lower mood (unstandardized b = 0.084 [95% CI 0.043-0.126] (males), (b = 0.126 [95% CI 0.082-0.170] (females)), poorer sleep (b = 0.045 [95% CI 0.007-0.083] (males), (b = 0.51 [95% CI 0.017-0.085] (females)) and more severe pain in males only (b = 0.026 [95% CI 0.002-0.051]). Except for pain, within-subject associations were somewhat weaker: mood: b = 0.038 [95% CI 0.016-0.060] (males), (b = 0.082 [95% CI 0.061-0.104] (females)); sleep: b = 0.029 [95% CI 0.008-0.050] (males), (b = 0.15 [95% CI 0.005-0.025] (females)); and pain (b = 0.032 [95% CI 0.004-0.059] (males)). CONCLUSIONS This study found that poor sleep, low mood (more strongly in females) and more severe pain (males only) are associated with poor appetite in older adults on a daily level both within and between persons. Sex differences in factors related to poor appetite should be considered in future research.
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Affiliation(s)
- Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Almar A L Kok
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Methodology Programme, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, Amsterdam Public Health Research Institute, Aging & Later Life Programme, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Methodology Programme, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Uygur H, Ahmed O, Uygur OF, Miller CB, Hursitoglu O, Bahar A, Demiroz D, Drake CL. Validity and Reliability of the Turkish Version of the Sleep Condition Indicator: A Clinical Screening Instrument Based on the DSM-5 Criteria for Insomnia. Nat Sci Sleep 2024; 16:63-74. [PMID: 38318264 PMCID: PMC10840414 DOI: 10.2147/nss.s433656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
Purpose We aimed to adapt the Turkish Sleep Condition Indicator (SCI) version and examine its psychometric properties among the general population. Methods This study was a cross-sectional study. The item-total correlation, standard error of measurement, Cronbach's α, and McDonald's ω were used for internal consistency. We ran confirmatory factor analysis (CFA) and network analysis to confirm the factor structure. Multigroup CFA was run to assess the measurement invariance across gender, whether clinical insomnia or not, and poor sleep quality. We correlated SCI scores with Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) scores to evaluate construct validity. A receiver operating characteristic (ROC) curve analysis was conducted to calculate the cut-off score of the SCI. The temporal stability was examined with the intraclass correlation coefficient. Results Eight hundred thirty-four participants attended. Over half of the participants were women (63.2% n = 527); the mean age was 36.15 ± 9.64. Confirmatory factor and network analysis results show that the two-factor correlated model had a good model fit for the SCI. The SCI had scalar level invariance across gender, having clinical insomnia and poor sleep quality in the Multigroup CFA. ROC curve analysis shows that the SCI has good sensitivity (90.3%) and specificity (91.8%) for cut-off ≤ 15. The intraclass correlation coefficient computed between the first and second SCI total scores was significant (r=0.80 with a 95% confidence interval from 0.78 to 0.87; p < 0.001). Conclusion The Turkish SCI is a practical self-reported insomnia scale with good psychometric properties that can be used to screen for insomnia disorder.
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Affiliation(s)
- Hilal Uygur
- Department of Psychiatry, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh
| | - Omer Faruk Uygur
- Department of Psychiatry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Christopher B Miller
- Big Health Ltd, London, UK
- Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
| | - Onur Hursitoglu
- Department of Psychiatry, Sular Academy Hospital, Kahramanmaras, Turkey
| | - Aynur Bahar
- Department of Psychiatric Nursing, Gaziantep University Faculty of Health Sciences, Gaziantep, Turkey
| | - Dudu Demiroz
- Department of Psychiatry, Karamanoglu Mehmetbey University, Karaman, Turkey
| | - Christopher L Drake
- Henry Ford Hospital Sleep Disorders and Research Center, Detroit, MI, USA
- Department of Psychiatry and Behavioral Neurosciences, Wayne State College of Medicine, Detroit, MI, USA
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9
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Impact of Gender on Insomnia. Brain Sci 2023; 13:brainsci13030480. [PMID: 36979290 PMCID: PMC10046211 DOI: 10.3390/brainsci13030480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
There is a distinct preponderance of female insomniacs when compared to male insomniacs. The aim of this study was to examine possible gender differences in the causes for insomnia, and the phenotypes of insomnia, and to investigate whether gender-specific insomnia diagnosis and treatment could be relevant in clinical practice. Data were collected from 121 insomniac patients by a medical specialist in the framework of normal clinical practice in Germany. The data consist of the patient’s medical history and various sleep-related patient questionnaires. Data from both genders were tested for independence using chi-square tests and Mann–Whitney U tests. We found a correlation between the gender of the patient and insomnia phenotypes in several aspects: concomitant lipometabolic disorders, diabetes mellitus, and high BMIs are more common in male insomniacs (p < 0.05). Frequency of insomnia occurrence in certain age groups, insomnia severity, distribution of SOI (sleep onset insomnia), SMI (sleep maintenance insomnia) and combined SOI + SMI, sleep duration, the time needed to seek medical consultation, trying out sleep-inducing drugs/techniques and the trigger, etiology and familial predisposition of the insomniac disorder were independent of the patient’s gender. We would like to re-evaluate the results with a larger number of patients in a further study.
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10
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Kuo W, Ersig AL, Kunkul F, Brown RL, Oakley LD. Linking chronic stress to insomnia symptoms in older adults: The role of stress co-occurrence during the pandemic. Res Nurs Health 2023; 46:68-79. [PMID: 36445114 PMCID: PMC9839487 DOI: 10.1002/nur.22278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/30/2022] [Accepted: 11/06/2022] [Indexed: 12/02/2022]
Abstract
Studies examining the associations of chronic stressors with sleep health in older adults have shown conflicting results. While the COVID-19 pandemic increased perceived stress at the population level, less is known about chronic stressors experienced by older adults in the context of the COVID-19 pandemic and its impact on sleep health in an aging population. This study aims to examine the association of older adults' chronic stress with insomnia symptoms during the first year of the COVID-19 pandemic. A cross-sectional analysis was performed using early-release COVID-19 data from the Health and Retirement Study. Data on chronic stressors and insomnia symptoms in older adults (N = 2021; mean age = 68.8) were examined. Co-occurrence network analysis, latent class analysis, Rao-Scott χ2 tests, and multivariable logistic regression were used to characterize the co-occurrence of chronic stressors and associations with insomnia symptoms. The most common co-occurring chronic stressors during the first year of the COVID-19 pandemic were self-health issues, family-health issues, and financial stress. Older adults experiencing frequent stress co-occurrence had 91% higher odds of difficulty initiating sleep (p < 0.001), 40% higher odds of frequent nocturnal awakening (p = 0.028), and 83% higher odds of nonrestorative sleep (p < 0.001). However, adjustment for health risk factors and COVID-19 concerns attenuated the effects, leaving strongest association for difficulty initiating sleep (odds ratio = 1.51, p = 0.010). Frequent stress co-occurrence plays an important role linking chronic stress to insomnia symptoms in an aging population. Ongoing research is needed to examine the lingering effects of frequent stress co-occurrence on older adults' sleep health in the post COVID-19 era.
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Affiliation(s)
- Wan‐Chin Kuo
- School of Nursing University of Wisconsin–Madison Madison Wisconsin USA
| | - Anne L. Ersig
- School of Nursing University of Wisconsin–Madison Madison Wisconsin USA
| | - Fatih Kunkul
- School of Nursing University of Wisconsin–Madison Madison Wisconsin USA
| | - Roger L. Brown
- School of Nursing University of Wisconsin–Madison Madison Wisconsin USA
| | - Linda D. Oakley
- School of Nursing University of Wisconsin–Madison Madison Wisconsin USA
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Jesudoss D, Rathinasamy Lazarus E, Wahid R. Insomnia and Sleep Quality Among Older People Residing in Old Age Homes at Andhra Pradesh, India. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Amarti K, Schulte MHJ, Kleiboer A, Van Genugten CR, Oudega M, Sonnenberg C, Gonçalves GC, Rocha A, Riper H. Feasibility of Digital Cognitive Behavioral Therapy for Depressed Older Adults With the Moodbuster Platform: Protocol for 2 Pilot Feasibility Studies. JMIR Res Protoc 2022; 11:e41445. [PMID: 36282565 PMCID: PMC9644251 DOI: 10.2196/41445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 11/25/2022] Open
Abstract
Background Internet-based interventions can be effective in the treatment of depression. However, internet-based interventions for older adults with depression are scarce, and little is known about their feasibility and effectiveness. Objective To present the design of 2 studies aiming to assess the feasibility of internet-based cognitive behavioral treatment for older adults with depression. We will assess the feasibility of an online, guided version of the Moodbuster platform among depressed older adults from the general population as well as the feasibility of a blended format (combining integrated face-to-face sessions and internet-based modules) in a specialized mental health care outpatient clinic. Methods A single-group, pretest-posttest design will be applied in both settings. The primary outcome of the studies will be feasibility in terms of (1) acceptance and satisfaction (measured with the Client Satisfaction Questionnaire-8), (2) usability (measured with the System Usability Scale), and (3) engagement (measured with the Twente Engagement with eHealth Technologies Scale). Secondary outcomes include (1) the severity of depressive symptoms (measured with the 8-item Patient Health Questionnaire depression scale), (2) participant and therapist experience with the digital technology (measured with qualitative interviews), (3) the working alliance between patients and practitioners (from both perspectives; measured with the Working Alliance Inventory–Short Revised questionnaire), (4) the technical alliance between patients and the platform (measured with the Working Alliance Inventory for Online Interventions–Short Form questionnaire), and (5) uptake, in terms of attempted and completed modules. A total of 30 older adults with mild to moderate depressive symptoms (Geriatric Depression Scale 15 score between 5 and 11) will be recruited from the general population. A total of 15 older adults with moderate to severe depressive symptoms (Geriatric Depression Scale 15 score between 8 and 15) will be recruited from a specialized mental health care outpatient clinic. A mixed methods approach combining quantitative and qualitative analyses will be adopted. Both the primary and secondary outcomes will be further explored with individual semistructured interviews and synthesized descriptively. Descriptive statistics (reported as means and SDs) will be used to examine the primary and secondary outcome measures. Within-group depression severity will be analyzed using a 2-tailed, paired-sample t test to investigate differences between time points. The interviews will be recorded and analyzed using thematic analysis. Results The studies were funded in October 2019. Recruitment started in September 2022. Conclusions The results of these pilot studies will show whether this platform is feasible for use by the older adult population in a blended, guided format in the 2 settings and will represent the first exploration of the size of the effect of Moodbuster in terms of decreased depressive symptoms. International Registered Report Identifier (IRRID) PRR1-10.2196/41445
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Affiliation(s)
- Khadicha Amarti
- Clinical Psychology Section, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Mieke H J Schulte
- Clinical Psychology Section, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Annet Kleiboer
- Clinical Psychology Section, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Claire Rosalie Van Genugten
- Clinical Psychology Section, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Mardien Oudega
- Amsterdam Universitair Medisch Centrum, Vrije Universiteit, Public Health Research Institute and Neuroscience Amsterdam, Amsterdam, Netherlands
- Department of Old Age Psychiatry, Geestelijk Gezondheidszorg inGeest Specialized Mental Health Care, Amsterdam, Netherlands
| | - Caroline Sonnenberg
- Amsterdam Universitair Medisch Centrum, Vrije Universiteit, Public Health Research Institute and Neuroscience Amsterdam, Amsterdam, Netherlands
- Department of Old Age Psychiatry, Geestelijk Gezondheidszorg inGeest Specialized Mental Health Care, Amsterdam, Netherlands
| | - Gonçalo C Gonçalves
- Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal
| | - Artur Rocha
- Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal
| | - Heleen Riper
- Clinical Psychology Section, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
- Department of Old Age Psychiatry, Geestelijk Gezondheidszorg inGeest Specialized Mental Health Care, Amsterdam, Netherlands
- Institute of Telepsychiatry, University of Southern Denmark, Odense, Denmark
- Faculty of Medicine, University of Turku, Turku, Finland
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Kara O, Elibol T, Koc Okudur S, Smith L, Soysal P. Associations between anemia and insomnia or excessive daytime sleepiness in older adults. Acta Clin Belg 2022; 78:223-228. [PMID: 36036443 DOI: 10.1080/17843286.2022.2116895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Sleep disorders including excessive daytime sleepiness (EDS), insomnia and anemia are both common. The aim of this study is to investigate associations between anemia and insomnia/EDS in the elderly. METHODS A total of 744 older outpatients were included in this cross-sectional study. Anemia was defined as a hemoglobin concentration below 12 g/dL in females and <13 g/dl in males. Patients were divided into two groups as anemic and non-anemic. The Epworth Sleepiness Scale score of ≥11 points indicates EDS. Insomnia Severity Index with scores of ≥8 indicates insomnia. RESULTS The mean age was 79.8±7.7 years. The prevalence of insomnia, EDS and anemia was 62.1%, 23.8%, and 47.2%, respectively. Insomnia (66.3% vs 58.5%) and EDS (29.6% vs 18.6%) were more common in patients with anemia compared to those without anemia (p<0.05). In univariate analysis, there were significant associations between anemia and insomnia [odds ratio (OR):1.4, 95% confidence interval (CI):1.0-1.9], and EDS (OR:1.8,95% CI:1.3-2.6). In multivariate analysis, the relationship between insomnia and nocturia, chronic obstructive pulmonary disease (COPD), and number of drugs used persisted, whereas being male, of an older age, coronary arterial disease, COPD, Parkinson's disease, dementia, and urinary incontinence were associated with EDS (p<0.05), but there was no significant relationships between anemia and insomnia/EDS (p>0.05). CONCLUSION The present data suggests that an elderly who has anemia is 1.4 times more likely to experience insomnia and 1.8 times more likely to experience EDS than those without anemia.
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Affiliation(s)
- Osman Kara
- Department of Hematology, Bahcesehir University Medical Park Goztepe Hospital, Istanbul, Turkey
| | - Tayfun Elibol
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Saadet Koc Okudur
- Department of Geriatric Medicine, Manisa State Hospital, Manisa, Turkey
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Liu Y, Bai X, Zhang H, Zhi X, Jiao J, Wang Q, Ji Y, Zheng X, Zhang X, Tong X, Liu J, Sun Y, Liu P. Efficacy and safety of tuina for senile insomnia: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28900. [PMID: 35212294 PMCID: PMC8878604 DOI: 10.1097/md.0000000000028900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Insomnia is a common diseases of the elderly, tuina is a widely used treatment. At present, there is a lack of supportive evidence on efficacy and safety of tuina for senile insomnia. The purpose of this systematic review is to assess the effectiveness and safety of tuina therapy in the treatment of senile insomnia. METHODS Literature on tuina for senile insomnia in the PubMed, EMBASE, Web of Science, Cochrane, China National Knowledge Infrastructure Database, Wanfang, Chinese Scientific and Journal Database, Japanese medical database, Korean Robotics Institute Summer Scholars, and Thai-Journal Citation Index Center will be conducted to search from the creation of these databases. We will search the databases from the beginning to January 2022. The primary outcome was the Pittsburgh Sleep Quality Index score, and the secondary outcomes included clinical efficacy and safety. RevMan 5.4.1 will be used for the meta-analysis. RESULTS This study aimed to will prove the effectiveness and safety of tuina therapy for the treatment of insomnia in the elderly. CONCLUSION This study provides up-to-date evidence of the effectiveness and safety of tuina for the treatment of senile insomnia. INPLASY REGISTRATION NUMBER INPLASY2021110063. ETHICS AND COMMUNICATION This systematic review will evaluate the effectiveness and safety of massage therapy for insomnia in the elderly population. As all the included data have been published, systematic reviews do not require ethical approval.
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Affiliation(s)
- Yangshengjie Liu
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Xuejiao Bai
- Acupuncture and Massage center, The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Hongshi Zhang
- Nursing College of Changchun University of Chinese Medicine, Changchun, China
| | - Xiaoyu Zhi
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Jundong Jiao
- Department of Acupuncture and Tuina, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Quanwu Wang
- Department of Acupuncture and Tuina, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Yuanyuan Ji
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Xu Zheng
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Xinlu Zhang
- Department of Acupuncture and Tuina, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Xue Tong
- Department of Tuina, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
| | - Jiayi Liu
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Yahui Sun
- Department of Acupuncture and Tuina, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Peng Liu
- Department of Acupuncture and Tuina, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
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