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Sleep Initiation and Maintenance Disorders: HELP
Articles from University of Southern California
Based on 14 articles published since 2008

These are the 14 published articles about Sleep Initiation and Maintenance Disorders that originated from University of Southern California during 2008-2019.
+ Citations + Abstracts
1 Review Sleep deprivation: a mind-body approach. 2016

Aguirre, Claudia C. ·Department of Biological Sciences, University of Southern California, Los Angeles, California, USA. ·Curr Opin Pulm Med · Pubmed #27583670.

ABSTRACT: PURPOSE OF REVIEW: The purpose of this review is to summarize recent advances in our understanding of the impact sleep disturbances have on our health, with particular focus on the brain. The present review considers the influence of sleep disturbance on the neurovascular unit; the role of sleep disturbance in neurodegenerative diseases; and relevant strategies of neuro-immuno-endocrine interactions that likely contribute to the restorative power of sleep. Given the latest discoveries about the brain's waste clearance system and its relationship to neurodegenerative diseases like Alzheimer's disease, this review gives a brief overview on the molecular mechanisms behind sleep loss-related impairments. RECENT FINDINGS: Recent evidence indicates that sleep plays a vital role in neuro-immuno-endocrine homeostasis. Sleep loss has been linked to elevated risks for cognitive and mood disorders, underscored by impaired synaptic transmission. The glymphatic system has been shown to be modulated by sleep and implicated in neurodegenerative disorders. SUMMARY: Interactions between sleep quality, the immune system, and neurodegenerative disease are complex and a challenge to distil. These interactions are frequently bidirectional, because of sleep's characterization as an early symptom and as a potential factor contributing to the development and progression of mood and cognitive disorders. VIDEO ABSTRACT.

2 Review Management and challenges of corticosteroid therapy in men with metastatic castrate-resistant prostate cancer. 2013

Dorff, T B / Crawford, E D. ·Division of Cancer and Blood Diseases, Department of Medicine, USC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA. dorff_t@med.usc.edu ·Ann Oncol · Pubmed #22831986.

ABSTRACT: Extensive clinical development in metastatic castrate-resistant prostate cancer (mCRPC) has led to the introduction of three new agents in little more than a year, with more on the horizon. With the exception of autologous cellular immunotherapy, all of the agents approved by the US Food and Drug Administration for the treatment of mCRPC are approved for use in combination with corticosteroids. Corticosteroids play a crucial role in the management of men with mCRPC, but the availability of multiple lines of therapy that include corticosteroids raises potential toxicity considerations. In addition, the immunosuppressive effects of corticosteroids may alter the efficacy of immunotherapies. The recent increase in treatment options with different mechanisms of action raises the importance of understanding how corticosteroids are used and the implications of such use on treatment selection and sequencing. A number of corticosteroids with varied potencies are used in general medical practice at varying doses. The differences in potency, dose, and disease settings in which corticosteroids are used complicate the ability to fully understand the impact that any one corticosteroid can have, such as prednisone in prostate cancer. This article reviews the published literature on corticosteroid use in advanced cancer, focusing on their role in mCRPC.

3 Article Family-Driven Goals to Improve Care for Children With Autism Spectrum Disorder. 2018

Bellesheim, Katherine R / Cole, Lynn / Coury, Daniel L / Yin, Larry / Levy, Susan E / Guinnee, Meghan A / Klatka, Kirsten / Malow, Beth A / Katz, Terry / Taylor, Jane / Sohl, Kristin. ·Thompson Center for Autism and Neurodevelopmental Disorders, and. · Departments of Psychological Sciences and. · University of Rochester Medical Center, University of Rochester, Rochester, New York. · Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio. · Children's Hospital Los Angeles, Los Angeles, California. · Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. · Catalyst Research, Depew, New York. · National Institute for Children's Health Quality, Boston, Massachusetts. · Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee; and. · Department of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado. · Thompson Center for Autism and Neurodevelopmental Disorders, and sohlk@health.missouri.edu. · Child Health, University of Missouri, Columbia, Missouri. ·Pediatrics · Pubmed #30108141.

ABSTRACT: OBJECTIVES: Constipation and insomnia are not consistently identified and treated in children with autism spectrum disorder (ASD) despite their high prevalence and deleterious impact in this population. To standardize care, a constipation practice pathway and an insomnia practice pathway were previously developed by Autism Treatment Network clinicians. Our objective was to implement and refine these practice pathways in clinical settings. METHODS: Eleven Autism Treatment Network sites participated in a Learning Collaborative (ie, multidisciplinary quality improvement team) and chose to implement either the constipation or insomnia practice pathway in the clinical setting. Families set intervention goals (eg, increase stool frequency, decrease nighttime awakenings) before treatment. Each site began implementation with 1 patient and then increased implementation by factors of 5. Before each increase, the Learning Collaborative evaluated progress and refined the practice pathways. Process improvement was measured primarily by duration until goal attainment and by percentage of families who meet their goals. RESULTS: Across sites, 82 children with ASD and constipation and 101 children with ASD and insomnia were managed. Difficulties with intervention adherence and communication between providers and families were reported and were subsequently improved with parallel refinements to both practice pathways. The most notable modification was incorporating a goal-setting session in which families generated their own intervention goals (ie, family-driven goals). In this quality improvement initiative, 75% of families met at least 1 constipation or insomnia goal, with the median time to improvement being 6 weeks. CONCLUSIONS: By integrating a family-centered approach into the standardization of care, constipation and insomnia practice pathways may improve engagement, adherence, and management of medical conditions in children with ASD.

4 Article Poor sleep quality and insufficient sleep of a collegiate student-athlete population. 2018

Mah, Cheri D / Kezirian, Eric J / Marcello, Brandon M / Dement, William C. ·Stanford Sleep Disorders Clinic and Research Laboratory, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA; School of Medicine, University of California, San Francisco, San Francisco, CA, USA. Electronic address: cherimah@stanfordalumni.org. · USC Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. · Department of Athletics, Stanford University, Stanford, CA, USA. · Stanford Sleep Disorders Clinic and Research Laboratory, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA. ·Sleep Health · Pubmed #29776619.

ABSTRACT: OBJECTIVE: Poor and inadequate sleep negatively impact cognitive and physical functioning and may also affect sports performance. The study aim is to examine sleep quality, sleep duration, and daytime sleepiness in collegiate student-athletes across a wide range of sports. DESIGN: Questionnaire. SETTING: University setting. PARTICIPANTS: 628 athletes across 29 varsity teams at Stanford University. MEASUREMENTS: Athletes completed a questionnaire inquiring about sleep quality via a modified Pittsburgh Sleep Quality Index (PSQI), sleep duration, and daytime sleepiness via Epworth Sleepiness Scale. Sleep quality on campus and while traveling for competition was rated on a 10-point scale. RESULTS: Collegiate athletes were classified as poor sleepers (PSQI 5.38 ± 2.45), and 42.4% of athletes experience poor sleep quality (reporting PSQI global scores >5). Athletes reported lower sleep quality on campus than when traveling for competition (7.1 vs 7.6, P< .001). Inadequate sleep was demonstrated by 39.1% of athletes that regularly obtain <7 hours of sleep on weekdays. Fifty-one percent of athletes reported high levels of daytime sleepiness with Epworth scores ≥10. Teen student-athletes in the first and second year of college reported the highest mean levels of daytime sleepiness. Greater total sleep time was associated with daytime functioning including lower frequency of difficulty waking up for practice or class (P< .001) and lower frequency of trouble staying awake during daily activities (P< .001). CONCLUSIONS: Collegiate athletes frequently experience poor sleep quality, regularly obtain insufficient sleep, and commonly exhibit daytime sleepiness.

5 Article Risk of pneumonia in patients with insomnia: A nationwide population-based retrospective cohort study. 2018

Lin, Chia-Ling / Liu, Ta-Chun / Chung, Chi-Hsiang / Chien, Wu-Chien. ·Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan. · Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA. · Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan. · Department of Medical Research, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan. Electronic address: chienwu@ndmctsgh.edu.tw. ·J Infect Public Health · Pubmed #28916233.

ABSTRACT: Evidence is lacking regarding whether insomnia increases the risk of infectious disease. Accordingly, the present study examined the risk of pneumonia in patients with insomnia. This study was a population-based retrospective cohort study on a cohort of 8061 patients with insomnia and a control cohort of 16,112 patients (matched by age, sex, and year of diagnosis) from the Taiwan National Health Insurance Research Database for the 2000-2010 period. Overall incidence of pneumonia was 50.6 per 1000 person-years in the insomnia cohort, which was significantly higher than that in the control cohort (30.9 per 1000 person-years). Overall, the insomnia cohort exhibited a higher risk of pneumonia (HR=2.43; CI, 2.24-2.62). By age group, the risk of pneumonia was significantly higher in the insomnia cohort for those aged ≤40 years (HR=3.23, CI: 1.38-7.57), 41-65 years (HR=2.62, CI: 2.07-3.32), and >65years (CI: 2.21-2.61). Compared with the controls, the insomnia cohort exhibited a higher risk of pneumonia, particularly in young adults.

6 Article Sleep and mood in older adults: coinciding changes in insomnia and depression symptoms. 2018

Li, Michael J / Kechter, Afton / Olmstead, Richard E / Irwin, Michael R / Black, David S. ·Department of Preventive Medicine,Keck School of Medicine,University of Southern California,Los Angeles,California,USA. · Cousins Center for Psychoneuroimmunology,Semel Institute for Neuroscience,University of California,Los Angeles,California,USA. ·Int Psychogeriatr · Pubmed #28766467.

ABSTRACT: The aim of this analysis was to test if changes in insomnia symptoms and global sleep quality are associated with coinciding changes in depressed mood among older adults. We report on results yielded from secondary analysis of longitudinal data from a clinical trial of older adults (N = 49) aged 55 to 80 years who reported at least moderate levels of sleep problems. All measures were collected at baseline and after the trial ten weeks later. We computed change scores for two separate measures of disturbed sleep, the Athens Insomnia Scale (AIS) and the Pittsburgh Sleep Quality Index (PSQI), and tested their association with change in depressed mood (Beck Depression Inventory-II; BDI-II) in two separate linear regression models adjusted for biological covariates related to sleep (sex, age, body mass index, and NF-κB as a biological marker previously correlated with insomnia and depression). Change in AIS scores was associated with change in BDI-II scores (β = 0.38, p < 0.01). Change in PSQI scores was not significantly associated with change in BDI-II scores (β = 0.17, p = 0.26). Our findings suggest that improvements over ten weeks in insomnia symptoms rather than global sleep quality coincide with improvement in depressed mood among older adults.

7 Article A model linking video gaming, sleep quality, sweet drinks consumption and obesity among children and youth. 2017

Turel, O / Romashkin, A / Morrison, K M. ·Department of Information Systems and Decision Sciences, California State University, Fullerton, Fullerton, CA, USA. · Brain and Creativity Institute, Department of Psychology, University of Southern California, Los Angeles, CA, USA. · Department of Pediatrics, McMaster Children Hospital and Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. · School of Medicine, University of Queensland, Brisbane, Queensland, Australia. ·Clin Obes · Pubmed #28320073.

ABSTRACT: There is a growing need to curb paediatric obesity. The aim of this study is to untangle associations between video-game-use attributes and obesity as a first step towards identifying and examining possible interventions. Cross-sectional time-lagged cohort study was employed using parent-child surveys (t1) and objective physical activity and physiological measures (t2) from 125 children/adolescents (mean age = 13.06, 9-17-year-olds) who play video games, recruited from two clinics at a Canadian academic children's hospital. Structural equation modelling and analysis of covariance were employed for inference. The results of the study are as follows: (i) self-reported video-game play duration in the 4-h window before bedtime is related to greater abdominal adiposity (waist-to-height ratio) and this association may be mediated through reduced sleep quality (measured with the Pittsburgh Sleep Quality Index); and (ii) self-reported average video-game session duration is associated with greater abdominal adiposity and this association may be mediated through higher self-reported sweet drinks consumption while playing video games and reduced sleep quality. Video-game play duration in the 4-h window before bedtime, typical video-game session duration, sweet drinks consumption while playing video games and poor sleep quality have aversive associations with abdominal adiposity. Paediatricians and researchers should further explore how these factors can be altered through behavioural or pharmacological interventions as a means to reduce paediatric obesity.

8 Article Longitudinal changes in menopausal symptoms comparing women randomized to low-dose oral conjugated estrogens or transdermal estradiol plus micronized progesterone versus placebo: the Kronos Early Estrogen Prevention Study. 2017

Santoro, Nanette / Allshouse, Amanda / Neal-Perry, Genevieve / Pal, Lubna / Lobo, Rogerio A / Naftolin, Frederick / Black, Dennis M / Brinton, Eliot A / Budoff, Matthew J / Cedars, Marcelle I / Dowling, N Maritza / Dunn, Mary / Gleason, Carey E / Hodis, Howard N / Isaac, Barbara / Magnani, Maureen / Manson, JoAnn E / Miller, Virginia M / Taylor, Hugh S / Wharton, Whitney / Wolff, Erin / Zepeda, Viola / Harman, S Mitchell. ·1Department of Obstetrics & Gynecology 2Department of Biostatistics, University of Colorado School of Medicine, Aurora, CO 3Department of Obstetrics, Gynecology & Women's Health and Neurosciences, Albert Einstein College of Medicine, Bronx, NY 4Department of Obstetrics & Gynecology, Yale University School of Medicine, New Haven, CT 5Department of Obstetrics & Gynecology, Columbia University College of Physicians and Surgeons, New York, NY 6Department of Obstetrics & Gynecology, New York University School of Medicine, New York, NY 7Department of Epidemiology & Biostatistics, University of California at San Francisco, San Francisco, CA 8Utah Foundation for Biomedical Research, Salt Lake City, UT 9Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor UCLA, Torrance, CA 10Department of Obstetrics & Gynecology, University of California at San Francisco, San Francisco, CA 11Departments of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI 12Kronos Longevity Research Institute, Phoenix, AZ 13Department of Medicine and Public Health, University of Wisconsin, Madison, WI 14Atherosclerosis Research Unit, University of Southern California, Los Angeles, CA 15Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 16Departments of Surgery and Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN 17Department of Neurology, Emory University, Atlanta, GA 18Department of Reproductive Biology and Medicine, National Institutes of Health, Bethesda, MD 19Department of Medicine, Endocrine Division, Phoenix VA Health Care System, Phoenix, AZ. ·Menopause · Pubmed #27779568.

ABSTRACT: OBJECTIVE: The objective of the present study was to compare the efficacy of two forms of menopausal hormone therapy in alleviating vasomotor symptoms, insomnia, and irritability in early postmenopausal women during 4 years. METHODS: A total of 727 women, aged 42 to 58, within 3 years of their final menstrual period, were randomized to receive oral conjugated estrogens (o-CEE) 0.45 mg (n = 230) or transdermal estradiol (t-E2) 50 μg (n = 225; both with micronized progesterone 200 mg for 12 d each mo), or placebos (PBOs; n = 275). Menopausal symptoms were recorded at screening and at 6, 12, 24, 36, and 48 months postrandomization. Differences in proportions of women with symptoms at baseline and at each follow-up time point were compared by treatment arm using exact χ tests in an intent-to-treat analysis. Differences in treatment effect by race/ethnicity and body mass index were tested using generalized linear mixed effects modeling. RESULTS: Moderate to severe hot flashes (from 44% at baseline to 28.3% for PBO, 7.4% for t-E2, and 4.2% for o-CEE) and night sweats (from 35% at baseline to 19% for PBO, 5.3% for t-E2, and 4.7% for o-CEE) were reduced significantly by 6 months in women randomized to either active hormone compared with PBO (P < 0.001 for both symptoms), with no significant differences between the active treatment arms. Insomnia and irritability decreased from baseline to 6 months postrandomization in all groups. There was an intermittent reduction in insomnia in both active treatment arms versus PBO, with o-CEE being more effective than PBO at 36 and 48 months (P = 0.002 and 0.05) and t-E2 being more effective than PBO at 48 months (P = 0.004). Neither hormone treatment significantly affected irritability compared with PBO. Symptom relief for active treatment versus PBO was not significantly modified by body mass index or race/ethnicity. CONCLUSIONS: Recently postmenopausal women had similar and substantial reductions in hot flashes and night sweats with lower-than-conventional doses of oral or transdermal estrogen. These reductions were sustained during 4 years. Insomnia was intermittently reduced compared with PBO for both hormone regimens.

9 Article Caffeine consumption, insomnia, and sleep duration: Results from a nationally representative sample. 2016

Chaudhary, Ninad S / Grandner, Michael A / Jackson, Nicholas J / Chakravorty, Subhajit. ·Department of Emergency Medicine, UAB School of Medicine, Birmingham, AL; Department of Epidemiology, UAB School of Public Health, Birmingham, AL. Electronic address: Drninadsc@gmail.com. · University of Arizona College of Medicine, Tucson, AZ. · University of Southern California, Los Angeles, CA. · Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA; Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA. ·Nutrition · Pubmed #27377580.

ABSTRACT: OBJECTIVE: Insomnia symptoms have been individually associated with both caffeine consumption and sleep duration abnormalities in prior studies. The goal of this study was to determine whether caffeine consumption was associated with insomnia symptoms from a population perspective and whether this relationship depended on habitual sleep duration. METHODS: Data were extracted from the 2007-2008 National Health and Nutritional Examination Survey (N = 4730). Caffeine consumption was quantified as mg/d from 2 typical days of use, 7 to 10 d apart. Insomnia symptoms were evaluated using frequencies of difficulty falling asleep (DFA), difficulty staying asleep (DSA), non-restorative sleep (NRS), and daytime sleepiness (DS). Habitual sleep duration was assessed as the hours of sleep obtained on a typical night. Binomial logistic regression analysis evaluated the relationships of individual insomnia and sleepiness symptoms (DFA, DSA, NRS, and DS) with caffeine consumption and sleep duration variables, after adjusting for covariates. RESULTS: The mean ± SD caffeine consumption was 176.6 ± 201 mg/d. Mean habitual sleep duration was 6.8 ± 1.4 h. Insomnia symptoms were prevalent in 19.1% to 28.4% of the respondents. Although caffeine consumption was associated with all insomnia symptoms in the unadjusted models, the adjusted models demonstrated a trend toward significance with DSA. Sleep duration was inversely associated with the insomnia symptoms in unadjusted and adjusted analysis. Finally, NRS was associated with an interaction between increased caffeine consumption and sleep duration. CONCLUSION: The association between caffeine use and insomnia symptoms depends on habitual sleep duration at a population level.

10 Article Reversible Fluoxetine-Induced Hyperthyroidism: A Case Report. 2016

Lai, Jianbo / Xu, Dongrong / Peterson, Bradley S / Xu, Yi / Wei, Ning / Zhang, Minming / Hu, Shaohua. ·*Department of Mental Health, The First Affiliated Hospital, Zhejiang UniversitySchool of Medicine, Hangzhou, China; †MRI Unit, Epidemiology Division, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY; ‡Institute of the Developing Mind, Children's Hospital Los Angeles, Keck School of Medicine at the University of Southern California, Los Angeles, CA; §The Key Laboratory of Mental Disorder's Management in Zhejiang Province; and ∥Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. ·Clin Neuropharmacol · Pubmed #26626429.

ABSTRACT: BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are typically used as antidepressants. Clinically significant SSRI-induced thyroid dysfunction is rare. CASE: We report a case of hyperthyroidism induced by fluoxetine in a female patient with major depressive disorder. Her thyroid profiles indicated hyperthyroidism after a 10-week treatment with fluoxetine and were restored after discontinuation of fluoxetine and administration with venlafaxine. In the first year of follow-up, her thyroid functions as well as her depressive symptoms remained perfectly normal. CONCLUSIONS: This case highlights the necessity of monitoring thyroid profiles during SSRI treatment.

11 Article Sleep duration, cognitive decline, and dementia risk in older women. 2016

Chen, Jiu-Chiuan / Espeland, Mark A / Brunner, Robert L / Lovato, Laura C / Wallace, Robert B / Leng, Xiaoyan / Phillips, Lawrence S / Robinson, Jennifer G / Kotchen, Jane M / Johnson, Karen C / Manson, JoAnn E / Stefanick, Marcia L / Sarto, Gloria E / Mysiw, W Jerry. ·Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA. Electronic address: jcchen@usc.edu. · Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA. · Department of Family and Community Medicine, University of Nevada School of Medicine, Reno, NV, USA. · Departments of Epidemiology & Medicine, University of Iowa, Iowa City, IA, USA. · Atlanta VA Medical Center and Division of Endocrinology, Emory University School of Medicine, Atlanta, GA, USA. · Department of Population Health, Medical College of Wisconsin, Milwaukee, WI, USA. · Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA. · Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · Department of Medicine, Stanford University, Stanford, CA, USA. · University of Wisconsin Center for Women's Health Research, Madison, WI, USA. · Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH, USA. ·Alzheimers Dement · Pubmed #26086180.

ABSTRACT: INTRODUCTION: Consistent evidence linking habitual sleep duration with risks of mild cognitive impairment (MCI) and dementia is lacking. METHODS: We conducted a prospective study on 7444 community-dwelling women (aged 65-80 y) with self-reported sleep duration, within the Women's Health Initiative Memory Study in 1995-2008. Incident MCI/dementia cases were ascertained by validated protocols. Cox models were used to adjust for multiple sociodemographic and lifestyle factors, depression, cardiovascular disease (CVD), and other clinical characteristics. RESULTS: We found a statistically significant (P = .03) V-shaped association with a higher MCI/dementia risk in women with either short (≤6 hours/night) or long (≥8 hours/night) sleep duration (vs. 7 hours/night). The multicovariate-adjusted hazard for MCI/dementia was increased by 36% in short sleepers irrespective of CVD, and by 35% in long sleepers without CVD. A similar V-shaped association was found with cognitive decline. DISCUSSION: In older women, habitual sleep duration predicts the future risk for cognitive impairments including dementia, independent of vascular risk factors.

12 Article Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. 2015

Black, David S / O'Reilly, Gillian A / Olmstead, Richard / Breen, Elizabeth C / Irwin, Michael R. ·Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles. · Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles. ·JAMA Intern Med · Pubmed #25686304.

ABSTRACT: IMPORTANCE: Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep. OBJECTIVE: To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances. DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5). INTERVENTIONS: A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework. MAIN OUTCOMES AND MEASURES: The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)-κB. RESULTS: Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. The between-group mean difference was 1.8 (95% CI, 0.6-2.9), with an effect size of 0.89. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity (P < .05 for all). Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups (P < .05). CONCLUSIONS AND RELEVANCE: The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01534338.

13 Article Smoking-related correlates of depressive symptom dimensions in treatment-seeking smokers. 2011

Leventhal, Adam M / Zvolensky, Michael J / Schmidt, Norman B. ·University of Southern California Keck School of Medicine, 2250 Alcazar Street, Los Angeles, CA 90033, USA. adam.leventhal@usc.edu ·Nicotine Tob Res · Pubmed #21471305.

ABSTRACT: INTRODUCTION: The symptomatic heterogeneity of depression poses a barrier to understanding the smoking-depression relationship. Different types of depressive symptoms have evidenced disparate relations to smoking. Yet, depression measures employed in past depression-smoking research yield symptom subdimensions, which may not be sufficiently comprehensive or distinct. The Inventory of Depression and Anxiety Symptoms (IDAS; Watson, D., O'Hara, M. W., Chmielewski, M., McDade-Montez, E. A., Koffel, E., Naragon, K., et al. (2008). Further validation of the IDAS: Evidence of convergent, discriminant, criterion, and incremental validity. Psychological Assessment, 20, 248-259. doi:10.1037/a0012570) produce 8 distinguishable depressive symptom dimensions: dysphoria (anhedonia, sadness, psychomotor disturbance, worthlessness, worry, and cognitive difficulty), lassitude (anergia and hypersomnia), suicidality (self-harm thoughts/behaviors), ill temper (anger), well-being (positive thinking), appetite loss, appetite gain, and insomnia. The present study examined common and unique relations of IDAS depression subdimensions to (a) smoking rate (cigarettes perday), (b) tobacco dependence, and (c) smoking motivation. METHODS: Secondary analysis of cross-sectional associations in baseline data collected from 338 daily smokers enrolled in a larger cessation study. RESULTS: In individual models examining each symptom dimension in isolation, each symptom dimension was significantly with associated smoking rate, tobacco dependence, and/or various aspects of smoking motivation (e.g., subjective addiction, habit, appetite control, affect modulation). In combined models including all 8 dimensions as simultaneous regressor variables, dysphoria was the only dimension to retain most of its significant associations to smoking characteristics. CONCLUSIONS: Relations of depressive symptoms to tobacco dependence, smoking rate, and motivation may be explained by (a) variance specific to dysphoria symptoms and (b) shared variance across depressive symptom subdimensions. Dysphoria symptoms, which contain core DSM-IV depression criteria, may be central to depression-smoking comorbidity, whereas other symptoms may play a less prominent role.

14 Article Prevalence and impact of sleep disorders and sleep habits in the United States. 2010

Ram, Saravanan / Seirawan, Hazem / Kumar, Satish K S / Clark, Glenn T. ·Division of Diagnostic Sciences, Orofacial Pain and Oral Medicine Center, USC School of Dentistry, Los Angeles, CA, 90089-0641, USA. saravanr@usc.edu ·Sleep Breath · Pubmed #19629554.

ABSTRACT: PURPOSE: Epidemiologic studies on sleep disorders in the USA have mostly focused on specific disorders in specific groups of individuals. Most studies on sleep habits and sleep-related difficulties have focused on children and adolescents. The authors describe the prevalence of the three common physician-diagnosed sleep disorders (insomnia, sleep apnea, and restless legs syndrome (RLS)) by age, gender, and race in the US population. In addition, the authors describe the sleep habits and sleep-related difficulties in carrying routine daily activities. The authors also investigate the impact of the sleep disorders on performing routine daily activities. METHODS: Data from the 2005-2006 National Health and Nutrition Examination Survey for 6,139 individuals over the age of 16 was analyzed for sleep-related parameters. RESULTS: The prevalence was highest for sleep apnea (4.2%), followed by insomnia (1.2%) and RLS (0.4%). Hispanics and Whites reported longer sleep duration than Blacks by 24 to 30 min. The predominant sleep habits were snoring while sleeping (48%), feeling unrested during the day (26.5%), and not getting enough sleep (26%). Difficulty concentrating (25%) or remembering (18%) were the main sleep-related difficulties in our sample. Insomnia, sleep apnea, and RLS had the highest impact on concentration and memory. CONCLUSIONS: Our findings suggest that the prevalence of sleep disorders in the USA is much lower than previously reported in the literature suggesting under diagnosis of sleep disorders by primary care physicians.