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Sleep Initiation and Maintenance Disorders: HELP
Articles by Kathryn A. Lee
Based on 8 articles published since 2008
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Between 2008 and 2019, Kathryn Lee wrote the following 8 articles about Sleep Initiation and Maintenance Disorders.
 
+ Citations + Abstracts
1 Article Sleep among bereaved caregivers of patients admitted to hospice: a 1-year longitudinal pilot study. 2016

Lerdal, Anners / Slåtten, Kari / Saghaug, Elisabeth / Grov, Ellen Karine / Normann, Are Peder / Lee, Kathryn A / Bjorvatn, Bjørn / Gay, Caryl L. ·Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway Lovisenberg Diakonale Hospital, Oslo, Norway. · Lovisenberg Diakonale University College, Oslo, Norway. · Lovisenberg Diakonale Hospital, Oslo, Norway. · Oslo and Akershus University College of Applied Sciences, Institute of Nursing, Oslo, Norway Department of Health, Sogn and Fjordane University College, Førde, Norway. · Department of Family and Health Care Nursing, University of California, San Francisco, San Francisco, California, USA. · Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Haukeland University Hospital, Norwegian Competence Center for Sleep Disorders, Bergen, Norway. · Lovisenberg Diakonale Hospital, Oslo, Norway Department of Family and Health Care Nursing, University of California, San Francisco, San Francisco, California, USA. ·BMJ Open · Pubmed #26729383.

ABSTRACT: OBJECTIVES: This pilot study aimed to describe the sleep of partners and other family caregivers prior to and in the first year after a hospice patient's death. The study also evaluated the feasibility of the study protocol and determined the effect sizes in preparation for a full-scale study. DESIGN: The pilot study used a longitudinal, descriptive and comparative design. SETTING AND PARTICIPANTS: Participants included primary family caregivers of patients admitted to a hospice in Oslo, Norway. PRIMARY OUTCOME: Caregiver sleep was measured subjectively with the Pittsburgh Sleep Quality Index (PSQI) and objectively using wrist actigraphy for 4 nights and 3 days at three different times: during the hospice stay, and at 6 and 12 months after the patient's death. RESULTS: 16 family caregivers (10 partners and 6 other family members) completed the 1-year study protocol. Overall, sleep quality and quantity were stable over time and at each assessment, approximately half of the sample had poor sleep quality, both by self-report and objective measures. However, the sleep trajectories differed significantly over time, with older caregivers (≥ 65 years) having significantly longer sleep durations than younger caregivers (<65 years). Furthermore, sleep quality also differed over time depending on the caregiver's relationship to the patient, with partner caregivers having significantly worse sleep quality than other family caregivers. CONCLUSIONS: Caring for a dying family member is known to interfere with sleep, yet little is known about bereaved caregivers. The results of this pilot study demonstrate the feasibility of the longitudinal study protocol and indicate that sleep problems are common for caregivers and continue into the bereavement period, particularly for partner caregivers. The caregiver's relationship to the patient may be an important factor to consider in future studies.

2 Article Sleep, Fatigue, and Problems With Cognitive Function in Adults Living With HIV. 2016

Byun, Eeeseung / Gay, Caryl L / Lee, Kathryn A. · ·J Assoc Nurses AIDS Care · Pubmed #26547298.

ABSTRACT: Up to 50% of people living with HIV have some neurocognitive impairment. We examined associations of sleep and fatigue with self-reported cognitive problems in 268 adults living with HIV. Multivariate regression was used to examine associations between cognitive problems, self-reported sleep quality, actigraphy-measured total sleep time and wake after sleep onset, and fatigue severity. Poorer self-reported sleep quality (p < .001), short or long total sleep time (<7 or >8 vs. 7-8 hours, p = .015), and greater fatigue (p < .001) were associated with lower self-reported cognitive function scores after controlling for demographic and clinical characteristics. However, objective measure of wake after sleep onset was unrelated to self-reported cognitive function scores. Findings suggest that assessing and treating poor sleep and complaints about fatigue would be areas for intervention that could have a greater impact on improving cognition function than interventions that target only cognitive problems.

3 Article Preoperative Sleep Disruption and Postoperative Delirium. 2015

Leung, Jacqueline M / Sands, Laura P / Newman, Stacey / Meckler, Gabriela / Xie, Yimeng / Gay, Caryl / Lee, Kathryn. ·Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA. · Center for Gerontology, Virginia Tech University, Blacksburg, VA. · School of Nursing, University of California, San Francisco, CA. ·J Clin Sleep Med · Pubmed #25979094.

ABSTRACT: STUDY OBJECTIVES: To describe preoperative and postoperative sleep disruption and its relationship to postoperative delirium. DESIGN: Prospective cohort study with 6 time points (3 nights pre-hospitalization and 3 nights post-surgery). SETTING: University medical center. PATIENTS: The sample consisted of 50 English-speaking patients ≥ 40 years of age scheduled for major non-cardiac surgery, with an anticipated hospital stay ≥ 3 days. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Sleep was measured before and after surgery for a total of 6 days using a wrist actigraph to quantify movement in a continuous fashion. Postoperative delirium was measured by a structured interview using the Confusion Assessment Method. Sleep variables for patients with (n = 7) and without (n = 43) postoperative delirium were compared using the unpaired Student t-tests or χ(2) tests. Repeated measures analysis of variance for the 6 days was used to examine within-subject changes over time and between group differences. The mean age of the patients was 66 ± 11 years (range 43-91 years), and it was not associated with sleep variables or postoperative delirium. The incidence of postoperative delirium observed during any of the 3 postoperative days was 14%. For the 7 patients who subsequently developed postoperative delirium, wake after sleep onset (WASO) as a percentage of total sleep time was significantly higher (44% ± 22%) during the night before surgery compared to the patients who did not subsequently developed delirium (21% ± 20%, p = 0.012). This sleep disruption continued postoperatively, and to a greater extent, for the first 2 nights after surgery. Patients with WASO < 10% did not experience postoperative delirium. Self-reported sleep disturbance did not differ between patients with vs. without postoperative delirium. CONCLUSIONS: In this pilot study of adults over 40 years of age, sleep disruption was more severe before surgery in the patients who experienced postoperative delirium. A future larger study is necessary to confirm our results and determine if poor sleep is associated with delirium in larger samples and what specific sleep problems best predict postoperative delirium in older surgical patients.

4 Article Cytokine polymorphisms and plasma levels are associated with sleep onset insomnia in adults living with HIV/AIDS. 2015

Gay, Caryl L / Zak, Rochelle S / Lerdal, Anners / Pullinger, Clive R / Aouizerat, Bradley E / Lee, Kathryn A. ·Department of Family Health Care Nursing, University of California, San Francisco, CA, USA; Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway; Lovisenberg Diakonale University College, Oslo, Norway. · Sleep Disorders Center, University of California, San Francisco, CA, USA. · Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway; Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway. · Department of Physiological Nursing, University of California, San Francisco, CA, USA; Cardiovascular Research Institute, University of California, San Francisco, CA, USA. · Department of Physiological Nursing, University of California, San Francisco, CA, USA; Institute for Human Genetics, University of California, San Francisco, CA, USA. · Department of Family Health Care Nursing, University of California, San Francisco, CA, USA. Electronic address: Kathryn.lee@nursing.ucsf.edu. ·Brain Behav Immun · Pubmed #25535857.

ABSTRACT: Sleep disturbance has been associated with inflammation and cytokine activity, and we previously described genetic associations between cytokine polymorphisms and sleep maintenance and duration among adults with HIV/AIDS. Although sleep onset insomnia (SOI) is also a commonly reported sleep problem, associations between cytokine biomarkers and SOI have not been adequately studied. The purpose of this study was to describe SOI in relation to cytokine plasma concentrations and gene polymorphisms in a convenience sample of 307 adults (212 men, 72 women, and 23 transgender) living with HIV/AIDS. Based on the Pittsburgh Sleep Quality Index item that asks the time it usually took to fall asleep in the past month, participants were categorized as either >30min to fall asleep (n=70, 23%) or 30min or less to fall asleep (n=237). Plasma cytokines were analyzed, and genotyping was conducted for 15 candidate genes involved in cytokine signaling: interferon-gamma (IFNG), IFNG receptor 1 (IFNGR1), interleukins (IL1R2, IL2, IL4, IL6, IL8, IL10, IL13, IL17A), nuclear factor of kappa light polypeptide gene enhancer in B cells (NFKB1 and NFKB2), and tumor necrosis factor alpha (TNFA). Demographic and clinical variables were evaluated as potential covariates. After adjusting for genomic estimates of ancestry, self-reported race/ethnicity and viral load, SOI was associated with higher IL-13 plasma levels and with six single nucleotide polymorphisms (SNPs): IL1B rs1143642 and rs1143623, IL6 rs4719714, IL13 rs1295686, NFKB1 rs4648110, and TNFA rs2857602. In addition, the IL1B rs1143642 polymorphism was associated with plasma levels of IL-1β in adjusted analyses. This study strengthens the evidence for an association between inflammation and sleep disturbance, particularly self-report of habitual SOI. In this chronic illness population, the cytokine polymorphisms associated with SOI provide direction for future personalized medicine intervention research.

5 Article Cytokine polymorphisms are associated with poor sleep maintenance in adults living with human immunodeficiency virus/acquired immunodeficiency syndrome. 2014

Lee, Kathryn A / Gay, Caryl / Pullinger, Clive R / Hennessy, Mary Dawn / Zak, Rochelle S / Aouizerat, Bradley E. ·Department of Family Health Care Nursing, University of California at San Francisco, San Francisco, CA. · Department of Family Health Care Nursing, University of California at San Francisco, San Francisco, CA ; Lovisenberg Diakonale Hospital, Oslo, Norway ; Lovisenberg Diakonale University College, Oslo, Norway. · Department of Physiological Nursing, University of California at San Francisco, San Francisco, CA ; Cardiovascular Research Institute, University of California at San Francisco, San Francisco, CA. · Department of Women, Children, and Family Health Sciences, University of Illinois at Chicago, Chicago, IL. · Sleep Disorders Center, University of California at San Francisco, San Francisco, CA. · Department of Physiological Nursing, University of California at San Francisco, San Francisco, CA ; Institute for Human Genetics, University of California at San Francisco, San Francisco, CA. ·Sleep · Pubmed #24587567.

ABSTRACT: STUDY OBJECTIVES: Cytokine activity and polymorphisms have been associated with sleep outcomes in prior animal and human research. The purpose of this study was to determine whether circulating plasma cytokines and cytokine polymorphisms are associated with the poor sleep maintenance commonly experienced by adults living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). DESIGN: Cross-sectional descriptive study. SETTING: HIV clinics and community sites in the San Francisco Bay area. PARTICIPANTS: A convenience sample of 289 adults (193 men, 73 women, and 23 transgender) living with HIV/AIDS. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: A wrist actigraph was worn for 72 h to estimate the percentage of wake after sleep onset (WASO%) and total sleep time (TST), plasma cytokines were analyzed, and genotyping was conducted for 15 candidate genes involved in cytokine signaling: interferon-gamma (IFNG), IFNG receptor 1 (IFNGR1), interleukins (IL1B, IL1R2, IL1R2, IL2, IL4, IL6, IL8, IL10, IL13, IL17A), nuclear factor of kappa light polypeptide gene enhancer in B cells (NFKB1 and NFKB2), and tumor necrosis factor-alpha (TNFA). Controlling for demographic variables such as race and sex, and clinical variables such as CD4+ count and medications, higher WASO% was associated with single nucleotide polymorphisms (SNPs) of IL1R2 rs11674595 and TNFA rs1041981 and less WASO% was associated with IL2 rs2069776. IL1R2 rs11674595 and TNFA rs1041981 were also associated with short sleep duration. CONCLUSIONS: This study strengthens the evidence for an association between inflammation and sleep maintenance problems. In this chronic illness population, cytokine polymorphisms associated with wake after sleep onset provide direction for intervention research aimed at comparing anti-inflammatory mechanisms with hypnotic agents for improving sleep maintenance and total sleep time.

6 Article Prevalence and correlates of sleep disturbance in postmenopausal women: the Australian Healthy Aging of Women (HOW) Study. 2014

Seib, Charrlotte / Anderson, Debra / Lee, Kathryn. ·1 Institute of Health and Biomedical Innovation, Queensland University of Technology , Queensland, Australia . ·J Womens Health (Larchmt) · Pubmed #24261649.

ABSTRACT: BACKGROUND: Sleep disturbance in midlife women has been studied extensively, although less is known about sleep after menopause. This study examined the relative impact of sociodemographics, modifiable lifestyle factors, and health status on sleep disturbance in postmenopausal women from Queensland, Australia. METHODS: The longitudinal Healthy Aging of Women (HOW) Study examines health-related quality of life (HRQOL measured by the 12-item Short Form [SF-12(®)] survey [Medical Outcomes Trust, Hanover, CA]); chronic illness; modifiable lifestyle factors, such as physical activity, alcohol consumption, smoking; and sleep disturbance (General Sleep Disturbance Scale [GSDS] (Lee, San Francisco, CA) ≥43 represents poor sleep) in midlife and older women from low- and high-socioeconomic rural and urban areas of South East Queensland, Australia. This article presents cross-sectional data from the 322 women, aged 60-70 years, participating in the HOW study in 2011. RESULTS: For women in this study, sleep disturbance was relatively common, with 23% (n=83) reporting poor sleeping (GSDS ≥43). Sleep-disturbance scores were strongly correlated with being unemployed or on a disability support pension (β=18.69, p<0.01), sedentary lifestyle (β=23.84, p<0.01), and lower mental (β=-0.60, p<0.01) and physical HRQOL scores (β=-0.32, p=0.01), and these variables explained almost one-third of variance in sleep-disturbance scores (ηρ(2)=29%). CONCLUSIONS: Multivariable analysis revealed that sleep disturbance was correlated with physical and mental HRQOL, disability, and sedentary lifestyle but not other lifestyle and sociodemographic characteristics. It may be, however, that modifiable lifestyle factors may indirectly impact sleep by influencing health status.

7 Article Types of sleep problems in adults living with HIV/AIDS. 2012

Lee, Kathryn A / Gay, Caryl / Portillo, Carmen J / Coggins, Traci / Davis, Harvey / Pullinger, Clive R / Aouizerat, Bradley E. ·Department of Family Health Care Nursing, University of California, San Francisco, CA 94143-0606, USA. Kathryn.lee@nursing.ucsf.edu ·J Clin Sleep Med · Pubmed #22334812.

ABSTRACT: OBJECTIVE: To characterize specific types of sleep problems experienced by adults with HIV. METHOD: The design was cross-sectional involving sleep questionnaires, diaries, and wrist actigraphy. The convenience sample included 290 adults living with HIV, 22-77 years of age. Measures included self-report for sleep onset latency, and wrist actigraphy estimates of total sleep time at night, wake after sleep onset, and daytime sleep. RESULTS: Nearly half (45%) of the sample slept < 6 h per night. Difficulty falling asleep was reported by 34%, and 56% had fragmented sleep according to actigraphy; 20% had both problems, and 30% were good sleepers. Participants reporting difficulty falling asleep had actigraphy and clinical measures similar to the good sleepers, but subjectively they experienced greater sleep disturbance and symptom burden (particularly anxiety and morning fatigue) and reported more use of sleep medication. Participants with fragmented sleep reported low levels of sleep disturbance and symptom burden similar to the good sleepers, despite actigraphy measures indicating they obtained less sleep both at night and during the day. Sleep fragmentation was also associated with sociodemographic factors and slightly lower CD4+ T-cell counts. Participants reporting both sleep problems had actigraphy and clinical profiles similar to those who had only fragmented sleep, but their symptom experience was similar to participants with only sleep initiation difficulties. CONCLUSIONS: Findings support the need for targeting efforts to improve sleep for the majority of adults living with HIV/AIDS and tailoring interventions to the specific type of sleep problem regardless of the person's clinical and demographic profile.

8 Article Sleep disturbances in women with HIV or AIDS: efficacy of a tailored sleep promotion intervention. 2008

Hudson, Angela L / Portillo, Carmen J / Lee, Kathryn A. ·Los Angeles School of Nursing, University of California, CA, USA. ·Nurs Res · Pubmed #18794720.

ABSTRACT: BACKGROUND: Poor sleep is a frequent complaint of persons with HIV infection. OBJECTIVES: To pilot test a tailored sleep promotion intervention protocol based on principles of sleep hygiene in a convenience sample of 30 HIV seropositive women. METHODS: At baseline and 1 week after implementing the intervention, sleep was assessed by self-report measures and wrist actigraphy. Objective sleep measures include total sleep time, number of awakenings, and sleep efficiency, as well as level of daytime activity, 24-hr activity rhythm, and amount of sleep during the day. RESULTS: Prior to the intervention, women averaged 6.4 hr (SD = 1.99) of sleep, and 67% (n = 20) of the sample napped more than 30 min per day. After allowing 1 week to implement sleep hygiene principles to promote healthy sleep behaviors, there was a significant improvement in their perception of sleep and a significant change in their 24-hr activity rhythm. This involved more activity and less napping during the day. DISCUSSION: Although there was minimal change in objective measures of nighttime sleep for the group as a whole, those with initiation insomnia and maintenance insomnia benefited most from the intervention. These findings support the utility of a tailored sleep promotion intervention for women who are HIV positive to address their unique form of sleep disturbance.