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Sleep Initiation and Maintenance Disorders: HELP
Articles by Terri L. Blackwell
Based on 5 articles published since 2008
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Between 2008 and 2019, T. Blackwell wrote the following 5 articles about Sleep Initiation and Maintenance Disorders.
 
+ Citations + Abstracts
1 Article Restless Legs Syndrome and Depression: Effect Mediation by Disturbed Sleep and Periodic Limb Movements. 2016

Koo, Brian B / Blackwell, Terri / Lee, Hochang B / Stone, Katie L / Louis, Elan D / Redline, Susan / Anonymous8210878. ·Department of Neurology, Yale University School of Medicine, New Haven, CT; Department of Neurology, Connecticut Veterans Affairs Health System, West Haven, CT; Yale Center for Neuroepidemiology & Clinical Neurological Research, New Haven, CT. Electronic address: koobri@gmail.com. · California Pacific Medical Center, Research Institute, San Francisco, CA. · Department Psychiatry, Yale University School of Medicine, New Haven, CT; Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. · Department of Neurology, Yale University School of Medicine, New Haven, CT; Yale Center for Neuroepidemiology & Clinical Neurological Research, New Haven, CT. ·Am J Geriatr Psychiatry · Pubmed #27526989.

ABSTRACT: OBJECTIVE: To investigate an association between restless legs syndrome (RLS) and depression and to what extent sleep disturbance, periodic limb movements during sleep (PLMS), and antidepressant medication mediate this relationship. METHODS: A cross-sectional analysis was conducted of the Osteoporotic Fractures in Older Men Study data in 982 men assessed for RLS (International RLS Study Group scale [IRLSS]) and depression (Geriatric Depression Scale [GDS]), who underwent actigraphy (for sleep latency/efficiency) and polysomnography (for PLMS). Men were split into three groups: no RLS (N = 815), mild RLS (IRLSS ≤ 12, N = 85), moderate-to-severe RLS (IRLSS > 12, N = 82). Depression was defined as GDS score ≥ 6. Logistic and linear regression assessed associations of RLS and depression or number depressive symptoms, respectively. Models were adjusted for age, site, race, education, body mass index, personal habits, benzodiazepine/dopaminergic medication, physical activity, cardiovascular risk factors, and apnea-hypopnea index. RESULTS: Of 982 men, 167 (17.0%) had RLS. Depression was significantly associated with moderate-to-severe RLS after adjustment (versus no RLS: OR [95% CI] 2.85 [1.23, 6.64]). Further adjustment for potential mediators attenuated effect size modestly, most for sleep efficiency (OR: 2.85-2.55). Compared with no RLS, moderate-to-severe RLS was associated with the number of depressive symptoms after adjustment (adjusted means [95% CI]; no RLS: 1.14 [1.05, 1.24] versus IRLSS > 12: 1.69 [1.32, 2.11]). Further adjustment for potential mediators did not alter effect size. For men with PLMS index at least median, number of depressive symptoms significantly increased as RLS category became more severe. CONCLUSION: Depression is more common as RLS severity worsens. The RLS-depression relationship is modestly explained by sleep disturbance and PLMS.

2 Article Measures of Sleep-Wake Patterns and Risk of Mild Cognitive Impairment or Dementia in Older Women. 2016

Diem, Susan J / Blackwell, Terri L / Stone, Katie L / Yaffe, Kristine / Tranah, Greg / Cauley, Jane A / Ancoli-Israel, Sonia / Redline, Susan / Spira, Adam P / Hillier, Teresa A / Ensrud, Kristine E. ·Department of Medicine and Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN. Electronic address: sdiem@umn.edu. · California Pacific Medical Center Research Institute, San Francisco, CA. · Departments of Psychiatry, Neurology, and Epidemiology, University of California, San Francisco and the San Francisco VA Medical Center, San Francisco, CA. · Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. · Departments of Medicine and Psychiatry, University of California, San Diego, CA. · Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. · Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. · Kaiser Permanente Center for Health Research, Portland, OR. · Department of Medicine and Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN; Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN. ·Am J Geriatr Psychiatry · Pubmed #26964485.

ABSTRACT: OBJECTIVE: Sleep disturbances are common in older adults. Little is known about the sleep of cognitively intact older adults and its relationship to subsequent cognitive impairment. The objective of this study was to examine the association between objective sleep-wake measures and risk of incident cognitive impairment. METHODS: In this prospective cohort study encompassing four U.S. sites, 1,245 women (mean age: 82.6 years) without dementia participated in the Study of Osteoporotic Fractures and completed actigraphy at the baseline visit and comprehensive cognitive assessment at follow-up. The association between sleep-wake patterns measured by actigraphy and risk of incident mild cognitive impairment (MCI) and dementia was examined. RESULTS: A total of 473 women (38%) developed cognitive impairment during an average (SD) follow-up of 4.9 (0.6) years; 290 (23.3%) developed MCI and 183 (14.7%) developed dementia. After controlling for multiple potential confounders, women in the lowest quartile of average sleep efficiency (<74%) had a 1.5-fold higher odds of developing MCI or dementia compared with women in the highest quartile of sleep efficiency (>86%) (odds ratio: Q1 versus Q4 1.53; 95% CI: 1.07, 2.19; Wald χ(2) [1, N = 1,223] = 5.34 for p for trend = 0.03). Longer average sleep latency, but not total sleep time, was also associated with higher odds of developing cognitive impairment. Greater variability in both sleep efficiency and total sleep time was associated with an increased odds of developing MCI or dementia. CONCLUSION: Lower average sleep efficiency, longer average sleep latency, and greater variability in sleep efficiency and total sleep time are associated with increased odds of developing cognitive impairment. Further research is needed to explore the mechanisms underlying these associations.

3 Article Sleep disturbances and frailty status in older community-dwelling men. 2009

Ensrud, Kristine E / Blackwell, Terri L / Redline, Susan / Ancoli-Israel, Sonia / Paudel, Misti L / Cawthon, Peggy M / Dam, Thuy-Tien L / Barrett-Connor, Elizabeth / Leung, Ping C / Stone, Katie L / Anonymous9360639. ·Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA. ensru001@umn.edu ·J Am Geriatr Soc · Pubmed #19793160.

ABSTRACT: OBJECTIVES: To test the hypothesis that sleep disturbances are independently associated with frailty status in older men. DESIGN: Cross-sectional analysis of prospective cohort study. SETTING: Six U.S. centers. PARTICIPANTS: Three thousand one hundred thirty-three men aged 67 and older. MEASUREMENTS: Self-reported sleep parameters (questionnaire); objective parameters of sleep-wake patterns (actigraphy data collected for an average of 5.2 nights); and objective parameters of sleep-disordered breathing, nocturnal hypoxemia, and periodic leg movements with arousals (PLMAs) (in-home overnight polysomnography). Frailty status was classified as robust, intermediate stage, or frail using criteria similar to those used in the Cardiovascular Health Study frailty index. RESULTS: The prevalence of sleep disturbances, including poor sleep quality, excessive daytime sleepiness, short sleep duration, lower sleep efficiency, prolonged sleep latency, sleep fragmentation (greater nighttime wakefulness and frequent, long wake episodes), sleep-disordered breathing, nocturnal hypoxemia, and frequent PLMAs, was lowest in robust men, intermediate in men in the intermediate-stage group, and highest in frail men (P-for-trend < or =.002 for all sleep parameters). After adjusting for multiple potential confounders, self-reported poor sleep quality (Pittsburgh Sleep Quality Index > 5, multivariable odds ratio (MOR)=1.28, 95% confidence interval (CI)=1.09-1.50), sleep efficiency less than 70% (MOR=1.37, 95% CI=1.12-1.67), sleep latency of 60 minutes or longer (MOR=1.42, 95% CI=1.10-1.82), and sleep-disordered breathing (respiratory disturbance index > or =15, MOR=1.38, 95% CI=1.15-1.65) were each independently associated with higher odds of greater frailty status. CONCLUSION: Sleep disturbances, including poor self-reported sleep quality, lower sleep efficiency, prolonged sleep latency, and sleep-disordered breathing, are independently associated with greater evidence of frailty.

4 Article The association between sleep duration and obesity in older adults. 2008

Patel, S R / Blackwell, T / Redline, S / Ancoli-Israel, S / Cauley, J A / Hillier, T A / Lewis, C E / Orwoll, E S / Stefanick, M L / Taylor, B C / Yaffe, K / Stone, K L / Anonymous2410613 / Anonymous2420613. ·Division of Pulmonary, Critical Care, and Sleep Medicine and Center for Clinical Investigation, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, OH 44106, USA. srp20@case.edu ·Int J Obes (Lond) · Pubmed #18936766.

ABSTRACT: BACKGROUND: Reduced sleep has been reported to predict obesity in children and young adults. However, studies based on self-report have been unable to identify an association in older populations. In this study, the cross-sectional associations between sleep duration measured objectively and measures of weight and body composition were assessed in two cohorts of older adults. METHODS: Wrist actigraphy was performed for a mean (s.d.) of 5.2 (0.9) nights in 3055 men (age: 67-96 years) participating in the Osteoporotic Fractures in Men Study (MrOS) and 4.1 (0.8) nights in 3052 women (age: 70-99 years) participating in the Study of Osteoporotic Fractures (SOF). A subgroup of 2862 men and 455 women also underwent polysomnography to measure sleep apnea severity. RESULTS: Compared to those sleeping an average of 7-8 h per night, and after adjusting for multiple risk factors and medical conditions, a sleep duration of less than 5 h was associated with a body mass index (BMI) that was on average 2.5 kg/m(2) (95% confidence interval (CI): 2.0-2.9) greater in men and 1.8 kg/m(2) (95% CI: 1.1-2.4) greater in women. The odds of obesity (BMI >or= 30 kg/m(2)) was 3.7-fold greater (95% CI: 2.7-5.0) in men and 2.3-fold greater in women (95% CI: 1.6-3.1) who slept less than 5 h. Short sleep was also associated with central body fat distribution and increased percent body fat. These associations persisted after adjusting for sleep apnea, insomnia and daytime sleepiness. CONCLUSIONS: In older men and women, actigraphy-ascertained reduced sleep durations are strongly associated with greater adiposity.

5 Article Actigraphy-measured sleep characteristics and risk of falls in older women. 2008

Stone, Katie L / Ancoli-Israel, Sonia / Blackwell, Terri / Ensrud, Kristine E / Cauley, Jane A / Redline, Susan / Hillier, Teresa A / Schneider, Jennifer / Claman, David / Cummings, Steven R. ·Research Institute, California Pacific Medical Center, 185 Berry St, Lobby 4, Fifth Floor, Ste 5700, San Francisco, CA 94107-1762, USA. kstone@sfcc-cpmc.net ·Arch Intern Med · Pubmed #18779464.

ABSTRACT: BACKGROUND: Prior studies have suggested that insomnia and self-reported poor sleep are associated with increased risk of falls. However, no previous study, to our knowledge, has tested the independent associations of objectively estimated characteristics of sleep and risk of falls, accounting for the use of commonly prescribed treatments for insomnia. METHODS: Study subjects were participants in the Study of Osteoporotic Fractures. In 2978 primarily community-dwelling women 70 years and older (mean age, 84 years), sleep and daytime inactivity were estimated using wrist actigraphy data collected for a minimum of 3 consecutive 24-hour periods (mean duration, 86.3 hours). Fall frequency during the subsequent year was ascertained by a triannual questionnaire. Use of medications was obtained by examiner interview. RESULTS: In multivariate-adjusted models, relative to those with "normal" nighttime sleep duration (>7 to 8 hours per night), the odds of having 2 or more falls in the subsequent year was elevated for women who slept 5 hours or less per night (odds ratio, 1.52; 95% confidence interval, 1.03-2.24). This association was not explained by the use of benzodiazepines. Indexes of sleep fragmentation were also associated with an increased risk of falls. For example, women with poor sleep efficiency (<70% of time in bed spent sleeping) had 1.36-fold increased odds of falling compared with others (odds ratio, 1.36; 95% confidence interval, 1.07-1.74). CONCLUSION: Short nighttime sleep duration and increased sleep fragmentation are associated with increased risk of falls in older women, independent of benzodiazepine use and other risk factors for falls.