Search PubMed⌕ Search

Biomedical subjects

M T Hyyppä

Publications and source records attributed to M T Hyyppä.

At least 19 recordsLinked to original sources

Individual-level relationships between social capital and self-rated health in a bilingual community.

BACKGROUND: Previous register studies have shown that mortality rates and disability pension statistics favor Swedish-speakers when compared to their Finnish-speaking neighbors in the same bilingual region in Finland. The purpose of the present questionnaire survey was to determine whether the Swedish-speaking community has more social capital and if the social capital is associated with health at the individual level. METHODS: The study population consisted of randomly selected samples of Finnish-speakers (N 1,000, response rate 66%) and Swedish-speakers (N 1,000, response rate 63%) representing all adults living in bilingual Ostrobothnian municipalities (75,000 Finnish-speakers and 78,000 Swedish-speakers). To inquire into social capital and health indicators, a bilingual questionnaire was composed to cover variables and indicators of sociodemography, health status, health behavior, and social capital (interpersonal trust and civic engagement). Data were analyzed with multiple logistic regression for two binary outcome variables: language group (Finnish vs Swedish) and self-rated health (good vs almost good/fair/poor/bad). RESULTS: When health-related variables (urban residence, migration, age, BMI, household income, smoking, singing in a choir, membership in any voluntary association, participation in community events, and long-term diseases) were controlled for, the Finnish-speakers were more often migrated (P = 0.0001) and mistrusting (P = 0.0001) and less active in community events (P = 0.0016) and in singing in a choir (P = 0.02) than the Swedish-speakers. After controlling for language and the above-mentioned health-related variables, the number of auxiliary (willing to help) friends (P = 0.001), mistrust (P = 0.037), and membership in any religious association (P = 0.0096) were significantly and independently associated with good self-rated health in the whole sample. CONCLUSIONS: The Swedish-speaking community seems to hold a fair quantity of social capital, which is associated with good health. Since the ecological and socioeconomic circumstances are equal for both language communities, a great deal of health inequality can be explained by differences in social capital.

Adult↗

Why do Swedish-speaking Finns have longer active life? An area for social capital research.

We performed ecological and individual register studies to compare disability-free life expectancies and disability pensions among Swedish-speaking and Finnish-speaking Finns residing on the western coast of Finland. The study was conducted to establish our assumption that the Swedish-speaking ethnic minority has a longer active life than the Finnish-speaking majority and to show that this disparity can be seen in a limited geographical area with similar socio-economic and health service structures. We suggest that the observed disparities in active life and in mortality depend on differences in the extent of social capital. A detailed characterization of the social capital and its impact on the health of the Swedish-speaking individuals is in progress.

Adult↗

Subjective quality of sleep and use of hypnotics in an elderly urban population.

To investigate the characteristics and subjective quality of sleep, the use of hypnotics and their correlates in an urban elderly population, a structured interview was administered to a stratified random sample of 600 elderly subjects in five age groups. Interrupted sleep and napping were common; nonetheless, 88% of the subjects considered their sleep at least satisfactory. According to specific criteria, 17% were good, 72% moderate and 11% poor sleepers. Habitual insomnia was reported by 12% of the subjects. Quality of sleep did not differ between age groups or genders. Hypnotics were habitually used by 8% of the men and 25% of the women. Consumption increased with age in both sexes, and 77% of the hypnotics were benzodiazepines. In multivariate regression analyses, insomnia and habitual use of hypnotics were associated with poor health, but only the latter with age and gender. As a conclusion, most of the subjects considered their sleep satisfactory, and aging itself did not seem to have an effect on the quality of sleep. The use of hypnotics was common, more prevalent in women and increased with age. Aging and poor health were independently associated with the use of hypnotics, but not with poor quality of sleep or insomnia.

Age Factors↗

Quality of sleep during economic recession in Finland: a longitudinal cohort study.

To assess the association between the economic recession of the 1990s in Finland and sleep behaviour, a longitudinal study was conducted in an adult Finnish population cohort. Baseline data were obtained by means of reports on sleep behaviour, health-related behaviour, health status, and objective laboratory tests in 1983-1987. The second screening conducted in 1992-1995, i.e. during economic recession, repeated data collection by postal questionnaires. The prevalences of various sleep symptoms including insomnia, daytime tiredness, fatigue, parasomnias and the use of hypnotics remained similar in the same age cohorts during economic recession. Alcohol consumption and snoring increased among the middle-aged (30-49 years), though snoring shows the greatest individual stability among various sleep symptoms. Despite some baseline differences in the sleep/health behaviour frequencies, the changes were independent of gender and socioeconomic class. The prevalences over eight years of insomnia and snoring show fair chronicity, whereas daytime tiredness and fatigue seem to be less chronic. Middle-aged participants who were stably employed at the initial screening but became unemployed during economic recession were studied separately. Prospectively unemployed persons suffered more from insomnia and used more hypnotics than the continuously employed. We conclude that the sleep quality of the general Finnish population has not drastically deteriorated during severe economic recession except among unemployed blue-collar workers.

Adult↗

Sleep in monozygotic twin pairs discordant for obesity.

Nocturnal motor breathing and cardiac activity were recorded by using the static charge-sensitive bed, and sleep habits were studied by questionnaire in 24 pairs of monozygotic twins discordant for their body mass index; the mean intrapair difference between co-twins was 6.7 kg/m2. Intrapair differences in sleep characteristics between co-twins were related to intrapair differences in physiological and anthropometric characteristics. Two questions were tested. First, do monozygotic twins discordant for body mass index differ in sleep behavior? Second, if they do, are differences in sleep associated with nongenetic differences in the body weight and metabolism or with other environmental factors? Obese twins had higher nocturnal motor activity levels, less quiet sleep, and more habitual snoring than did their nonobese co-twins. Differences in sleep were associated with obesity-related factors. However, habitual snoring did not explain other intrapair differences in sleep. It was concluded that relatively moderate obesity is associated with disruption of physiological structure of sleep as measured by the static charge-sensitive bed method and that this disruption seems not to be associated with snoring or breathing disturbances.

Adipose Tissue↗

Nocturnal motor activity in fibromyalgia patients with poor sleep quality.

Nocturnal motor activity was examined in long-term rehabilitation patients complaining of poor sleep and having fibromyalgia syndrome (N = 24) or other musculoskeletal disorders (N = 60) and compared with that in 91 healthy controls drawn from a random community sample. Self-reports on sleep complaints and habits were collected. The frequency of nocturnal body movements, the "apnoea" index and ratio of "quiet sleep" to total time in bed were measured using the Static Charge Sensitive Bed (SCSB) (BioMatt). As a group, patients with fibromyalgia syndrome did not differ from patients with other musculoskeletal disorders or from healthy controls in their nocturnal motor activity. The "apnoea" index was a little higher in the fibromyalgia group than in the healthy control group but did not differ from that of the group of other musculoskeletal patients. Further multivariate analyses adjusted for age, BMI, medication and "apnoea" index did not support the assumption that an increased nocturnal motor activity characterizes patients with fibromyalgia syndrome.

Adult↗

Nocturnal breathing abnormalities in acromegaly after adenomectomy.

OBJECTIVE: The incidence of sleep apnoea is increased in acromegaly. The aim of the study was to determine the occurrence of nocturnal breathing abnormalities and upper airway morphology in acromegalic patients some years after adenomectomy. DESIGN: A case-control study. PATIENTS: Eleven patients with treated acromegaly and two control groups: (1) sleep studies: 197 subjects randomly selected from the population, (2) cephalometry: 27 healthy subjects and 17 patients with obstructive sleep apnoea. MEASUREMENTS: Nocturnal breathing was monitored with a static charge-sensitive bed. The upper airway soft tissues and bone morphology were assessed by cephalometric X-ray photography. The upper airway collapsibility was investigated with dynamic nasopharyngoscopy. Endocrinological investigations were also performed. RESULTS: Nocturnal breathing abnormalities were present in all but one acromegalic patient (91%), which was far more frequent than in the general population (29.4%, P < 0.0001). Treated acromegaly was the most powerful predictor of breathing abnormalities, independent of the other significant predictors, age and body mass index. The predominant breathing abnormality was periodic breathing with symmetrically waxing and waning respiratory effort without a major body movement component. Episodes of complete obstruction with repetitive arousals were rare. Except for the longer soft palate, the cephalometric findings were similar to normal. In comparison to obstructive sleep apnoea, the treated acromegalic patients had rather prognathic than retrognathic mandibles. Fibreoptic endoscopy in the acromegalic patients revealed collapsible upper airways at the level of the soft palate, whereas at the base of the tongue little, if any, dynamic narrowing was observed. CONCLUSION: Our study confirms that nocturnal breathing abnormalities are common in treated acromegaly, and may persist years after the removal of the GH secreting tumour. The breathing abnormalities and the upper airway morphology in acromegalic patients after adenomectomy are different from those observed in primary obstructive sleep apnoea, suggesting a different pathophysiology of the airway obstruction.

Acromegaly↗

What does the multiple sleep latency test measure in a community sample?

Multiple sleep latency test (MSLT)-defined daytime sleepiness and its relationships with nocturnal and daytime psychophysiological activation were investigated in a random community sample of 77 subjects aged 35-55 years. The correlation structure between all study variables was explained by a simple model of daytime sleepiness. The model suggested that indicators of psychophysiological arousal (psychological distress, nocturnal motor activity and serum thyrotropin level) and daytime reported tiredness, body mass index (BMI) and age were related significantly and independently to MSLT-defined daytime sleepiness. The arousal theory of insomnia and poor sleep in relation to MSLT behavior is discussed and the need of a multivariate approach is emphasized in MSLT studies.

Adult↗

Chronic illness and subjective quality of sleep in the elderly.

The effect of chronic illness on the subjective quality of sleep, and the use of hypnotics was studied in a stratified random sample of elderly people. Six hundred subjects aged 65 years or over were included in the study. A structured interview on the quality of sleep and medical history was carried out. In addition, the majority of diagnoses were confirmed from the national health insurance documents of the subjects. Logistic regression analysis disclosed that only perceived poor health and peptic ulcer or esophagitis were associated with perceived poor sleep. Age did not contribute to the quality of sleep. Age over 80 years and the presence of peptic ulcer or esophagitis, heart failure, cholelithiasis, and, in particular, depression were associated with the habitual use of hypnotics. The results stress the importance of perceived poor general health status, and acid-related gastrointestinal diseases as the determinants of subjective poor sleep, rather than age or many specific somatic diseases as such. On the other hand, depression is a major determinant for the habitual use of hypnotics.

Aged↗

Upper airway obstruction in hypothyroidism.

OBJECTIVES: To determine the occurrence and frequency of nocturnal upper airway obstruction in hypothyroidism. DESIGN: A case-control study of patients with newly diagnosed hypothyreosis and euthyroid subjects who had been selected from the population register. The subjects underwent sleep recordings with a static-charge-sensitive bed (SCSB). SETTING: Turku University Hospital and Research and Development Unit, Social Insurance Institution, Turku, Finland. SUBJECTS: Twenty six consecutive patients underwent sleep recordings with SCSB and a pulse oximeter. One hundred and eighty-eight euthyroid subjects who were previously studied with the SCSB were used as controls. MAIN OUTCOME MEASURES: In a multivariate analysis, hypothyroidism, gender, age, and body mass index (BMI) were considered as predictors for the occurrence of nocturnal breathing abnormalities. RESULTS: Nocturnal breathing abnormalities were frequent in both groups. Fifty per cent of the hypothyroid patients and 29.3% of the control subjects had at least some episodes of partial or complete upper airway obstruction (P = 0.04). Severe obstruction with episodes of repetitive apnoea was present in 7.7% of the patients and in 1.5% of the controls. The multivariate analysis revealed that the presence of hypothyroidism did not significantly (P = 0.06), and independently of age, BMI or gender, predict nocturnal breathing abnormalities, whereas obesity (P < 0.0001) and male gender (P = 0.0001) were independent and significant predictors. CONCLUSIONS: The incidence of nocturnal upper airway obstruction is increased in hypothyroidism, but is related to obesity and male gender rather than to hypothyroidism per se.

Adult↗

Self-perceived fatigue and cortisol secretion in a community sample.

The possible relation of cortisol secretion to self-perceived fatigue was examined in an adult community sample. Serum cortisol levels measured after the dexamethasone suppression test (DST) did not predict fatigue whereas depression assessed by the Beck Depression Inventory (BDI) and current medical treatment were significant and independent predictors. Confounding variables such as age, gender, body mass and social status were not predictive of fatigue. Of putative hypothalamic-pituitary-adrenal abnormalities hypersecretion of cortisol does not typify subjects with self-perceived fatigue.

Adolescent↗

Nocturnal motor activity in a community sample.

The relationships between nocturnal motor activity and daytime psychophysiological activation were investigated in a random community sample of 199 subjects aged 35-55 years. Nocturnal motor activity was recorded with the static charge sensitive bed (SCSB, Bio-Matt). The association of nocturnal motor activity with demographic features, health status, laboratory blood values, afternoon electrodermal activity (EDA) and psychological distress was studied. A model for nocturnal motor activity was constructed and statistically analyzed. The analysis revealed that psychological distress, breathing disturbance, plasma glucose level and sympathetic activity were related significantly and independently to nocturnal motor activity. Their relations and the associations of sex, age, body mass index (BMI), sleep latency and health status with nocturnal motor activity were discussed in the context of the arousal theory of poor sleep.

Adult↗

Couple therapy improves mental well-being in chronic low back pain patients. A controlled, five year follow-up study.

Fifty-six chronic low back pain (CLBP) patients participated in a controlled, prospective 5-yr follow-up study evaluating the long-term effects of five-session couple therapy. Twenty-eight patients were included both in the treatment group and in the control group. Outcome measures were self-reported psychological distress, marital satisfaction, health locus of control, pain and disability as well as clinical examinations. The reliability of the outcome measures was statistically analysed and found acceptable. At the 5-yr follow-up assessments, psychological distress was found to be decreased in the treatment group and increased in controls. The difference between the groups was significant. No difference was found in the other self-reported or clinical outcome measures. We conclude that couple therapy has a prolonged beneficial effect on the mental well-being of CLBP patients.

Adaptation, Psychological↗

Mental well-being of good sleepers in a random population sample.

It is generally assumed that a good night's sleep has a beneficial effect on mood. The present survey aimed to evaluate what a good night's sleep means for mental well-being and psychic functional capacity. A random community sample of 670 adult subjects was divided into three groups: good, intermediate and poor sleepers according to a sleep habit questionnaire based on self-reports. Their cognitive, emotional and personality features were assessed with various psychometric and personality tests, and differences between the groups were evaluated statistically. In the age- and gender-adjusted population the average good sleeper turned out to be a person who falls asleep in 10 minutes, after which his/her 7.5 hours' sleep is serene and without parasomnias. Immediately on awakening in the morning and later during the day he/she is mentally alert without distress or emotional problems. Definite mood and personality differences between good and other sleepers in the adult population surveyed revealed that good sleepers are psychologically capable of maintaining a self-esteem which is in functional balance with their life-goals and mental well-being.

Adaptation, Psychological↗

Chronic low back pain patient and spouse.

Marital adjustment, psychological distress, health attitudes and prevalence of musculoskeletal pain symptoms were studied and compared between 63 chronic low back pain (CLBP) patients and their spouses. The CLBP patients experienced somatization significantly more than their spouses, while other psychological distress scores did not reveal statistically significant differences between the couples. The CLBP patients experienced significantly more feelings of guilt at having pain than their spouses. The patients experienced significantly more internal control, while their spouses experienced more external locus control of health. The female spouses had had significantly more musculoskeletal pain symptoms in neck and shoulders during the past week than the male spouses. The prevalence of musculoskeletal pain symptoms in the CLBP patients did not differ significantly between sexes. The results of this study are compared to population studies where the same methods have been used.

Adaptation, Psychological↗