Biomedical subjects

Markku Partinen

Publications and source records attributed to Markku Partinen.

13 recordsLinked to original sources

PubMed2006

Efficacy and safety of pramipexole in idiopathic restless legs syndrome: a polysomnographic dose-finding study--the PRELUDE study.

BACKGROUND AND PURPOSE: To evaluate the effects of pramipexole (0.125-0.75 mg/d) on polysomnographic (PSG) measures and patient and clinician ratings of restless legs syndrome (RLS). PATIENTS AND METHODS: Patients (n=109) with moderate to severe RLS were randomized to placebo or fixed doses of pramipexole during a 3-week, double-blind, placebo-controlled, dose-finding study. RESULTS: In each pramipexole dose group, the periodic limb movements during time in bed index (PLMI) decreased significantly, compared with placebo (adjusted mean difference in log-transformed data: 0.125 mg, -1.54; 0.25 mg, -1.93; 0.50 mg, -1.89; and 0.75 mg, -1.52; P<0.0001). At all doses, International RLS Study Group Rating Scale (IRLS) scores were also significantly reduced, with the greatest adjusted mean reduction in the 0.50mg group (-17.01). At all but the lowest pramipexole dose, the percentage of responders (> or =50% reduction of IRLS score) was substantially higher than for placebo (61.9-77.3, vs 33.3%). In the pramipexole groups, 50.0-77.3% of patients rated their condition as 'much better' or 'very much better', compared with 38.1% of patients in the placebo group (P=0.0139 for the 0.50 mg dose). Clinical global impressions (CGI) scale ratings of 'much improved' or 'very much improved' were given to 61.9-86.4% of patients in the pramipexole groups, compared with 42.9% in the placebo group (P<0.05 for the 0.25, 0.50, and 0.75 mg groups). Pramipexole was well tolerated and did not produce somnolence at any dose. CONCLUSION: Pramipexole is effective and safe in the treatment of both objective and subjective facets of RLS.

Adult↗

PubMed2006

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Letter↗

PubMed2005

Sleep duration and breast cancer: a prospective cohort study.

Breast cancer incidence has increased during recent decades for reasons that are only partly understood. Prevalence of sleeping difficulties and sleepiness has increased, whereas sleeping duration per night has decreased. We hypothesized that there is an inverse association between sleep duration and breast cancer risk, possibly due to greater overall melatonin production in longer sleepers. This population-based study includes information from women born in Finland before 1958. Sleep duration, other sleep variables, and breast cancer risk factors were assessed by self-administered questionnaires given in 1975 and in 1981. Breast cancer incidence data for 1976 to 1996 was obtained from the Finnish Cancer Registry. Hazard ratios (HR) and 95% confidence intervals (CI) were obtained from Cox proportional hazards models adjusting for potential confounders. Altogether, 242 cases of breast cancer occurred over the study period among the 12,222 women with sleep duration data in 1975. For these women, the HRs for breast cancer in the short (< or =6 hours), average (7-8 hours), and long sleep (> or =9 hours) duration groups were 0.85 (CI, 0.54-1.34), 1.0 (referent), and 0.69 (CI, 0.45-1.06), respectively. Analysis restricted to the 7,396 women (146 cases) whose sleep duration in 1975 and 1981 were in the same duration group (stable sleepers) yielded HRs of 1.10 (CI, 0.59-2.05), 1.0, and 0.28 (CI, 0.09-0.88), with a decreasing trend (P = 0.03). This study provides some support for a decreased risk of breast cancer in long sleepers.

Adult↗

PubMed2005

Reported bruxism and restless legs syndrome in media personnel with or without irregular shift work.

A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (n = 750) and to an equal number of randomly selected controls in the same company with regular 8-h daytime work. The questionnaire covered demographic items, employment details, general health experience, physical status, psychosocial status, stress, work satisfaction and performance, tobacco use, bruxism, and restless legs symptoms (RLS). The aim was to investigate among a multiprofessional media personnel the associations between reported bruxism and RLS, while simultaneously controlling the effects of gender, age, tobacco use, shift work, and dissatisfaction with current workshift schedule. The overall response rate was 58.3% (53.7% men). The response rate in the irregular shift work group was 82.3% (56.6% men) and in the regular daytime work group 34.3% (46.7% men). In the bivariate analyses, RLS was more prevalent in workers at either end of the studied age range (p < 0.05). Self-reported frequent bruxism was significantly associated with younger age (p < 0.05). Females reported RLS (11.4%) slightly more often than males (7.7%) (NS). In logistic regression, frequent bruxism (p < 0.05) and older age (p < 0.05) were significantly positively associated with RLS. Dissatisfaction with one's current workshift schedule (p < 0.05) and RLS (p < 0.05) were significantly positively associated with frequent bruxism, while age (p < 0.05) was significantly negatively associated. In conclusion, perceived bruxism may be a sign of a stressful situation or dissatisfaction, while RLS as a more stable trait may in itself negatively affect sleep quality and further enhance the problem.

Adult↗

PubMed2005

Perceived orofacial pain and its associations with reported bruxism and insomnia symptoms in media personnel with or without irregular shift work.

A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (n = 750) and to an equal number of randomly selected controls in the same company with regular 8-hour daytime work. The aims were to investigate the prevalence and severity of perceived orofacial pain (Research Diagnostic Criteria for Temporomandibular Disorders Axis II) and to analyze whether current orofacial pain was associated with reported bruxism and insomnia symptoms (Diagnostic and Statistical Manual of Mental Disorders-IV and the International Classification of Sleep Disorders Revised). The response rate in the irregular shift-work group was 82.3% (56.6% men) and in the regular daytime-work group 34.3% (46.7% men). Current orofacial pain was found overall in 19.6%, of which 88.3% had experienced the pain over 6 months. All claimed that their pain fluctuated. No subjects with chronic orofacial pain reported disabling pain, and grades III and IV were not found. Insomnia symptoms and frequent bruxism were significantly more prevalent in chronic pain grade II than in lower grades. According to logistic regression, current orofacial pain was significantly positively associated with frequent bruxism (p < 0.001), female gender (p < 0.001), and disrupted sleep (p < 0.01), and significantly negatively associated with age over 45 years (p < 0.01). Our results revealed a clear-cut association between perceived orofacial pain and reported bruxism. The association held with both chronic orofacial pain intensity and current pain. Based on the multivariate analyses, it can be concluded that disrupted sleep and bruxism may be concomitantly involved in the development of orofacial pain.

Adult↗

PubMed2005

Circadian activity rhythm in demented and non-demented nursing-home residents measured by telemetric actigraphy.

There is a need to develop unobtrusive methods for long-term monitoring of sleep/wake and circadian activity patterns in the elderly both in nursing homes and at home settings as sleep is important for health and well-being. The IST Vivago WristCare is an active social alarm system, which provides continuous telemetric monitoring of the user's activity. We examined how the activity signal measured by IST Vivago differed between demented and non-demented subjects living in a nursing home, and how it correlated with the subjective assessment of sleep quality and daytime alertness. The activity signal data together with subjective assessments of sleep quality and daytime vigilance were collected from 42 volunteers (aged 56-97 years; 23 demented and 19 non-demented) for at least 10 days. The demented subjects had lower daytime activity and higher nocturnal activity than the non-demented subjects. Correlations between the activity parameters and self-assessments were weak but statistically significant. We also found correlation between functional ability and diurnal activity. The results are in line with previous studies with demented and non-demented elderly subjects and suggest that the IST Vivago system provides a valid instrument for unobtrusive continuous long-term monitoring of the circadian rhythm and sleep/wake patterns in the elderly.

Aged↗

PubMed2004

A cognitive-behavioral weight reduction program in the treatment of obstructive sleep apnea syndrome with or without initial nasal CPAP: a randomized study.

BACKGROUND AND PURPOSE: To evaluate (a) whether an active weight reduction strategy based on the cognitive-behavioral approach and an initial very-low-calorie diet might lead to short- and long-term weight loss and alleviation of OSAS; and (b) whether the results of this intervention could be enhanced by combining it with nasal continuous positive airway pressure (CPAP) treatment during the first 6 months. PATIENTS AND METHODS: Thirty-one obese male symptomatic sleep apnea patients underwent a 2-year weight reduction program with total follow-up of 36 months from baseline. The mean age (+/-SD) was 49.1+/-7.9 years, body mass index 43.8+/-5.4, and oxygen desaturation index (ODI4) 51.3+/-31.1. The patients were randomized to CPAP (17 patients) and non-CPAP groups (14 patients). RESULTS: The mean weight loss was 19.1+/-10.2 kg (14% of the original weight) for the whole group at 6 months, 18.3+/-13.2 (13%) at 12 months and 12.6+/-14.7 kg (9%) at 24 months. Excellent or good treatment results, as defined in terms of an ODI4 (average number of oxygen desaturation events p/h>4% from baseline) reduction of at least 50% from the baseline, were seen in 61% of patients at 6 months and were still observable in 42% of patients at 24 months. The correlations between changes in weight and in ODI4 were 0.59 (P<0.01) at 6 months, 0.68 (P<0.01) and 0.75 (P<0.01) at 24 months. Adding CPAP treatment to the weight reduction therapy for the first 6 months did not result in greater weight loss or diminution of desaturation indices (without CPAP) at any time point. One year after the termination of the program the mean weight loss was 6.6+/-12.9 kg, and 42% of patients still showed at least 5% weight loss as compared with their original weight. CONCLUSION: Satisfactory weight loss associated with improvement of OSAS could be achieved by means of a cognitive-behavioral weight loss program. Adding CPAP in the initial phase of the weight reduction program did not result in significantly greater weight loss.

Adult↗

PubMed2004

Associations of perceived pain and painless TMD-related symptoms with alexithymia and depressive mood in media personnel with or without irregular shift work.

The aim of the present study was to analyze whether previously emerged pain symptoms and painless temporomandibular disorder (TMD) symptoms are associated with alexithymia and self-rated depression among media personnel in or not in irregular shift work. A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company in irregular shift work (n = 750) and to an equal number of randomly selected controls in regular 8-h daytime work. The questionnaire covered demographic items, employment details, general health experience, physical status, psychosomatic symptoms, psychosocial status, stress, work satisfaction and performance, and health-care use. Studied age groups, marital status, gender or perceived health were not significantly associated with alexithymia in the bivariate analyses. Most studied painless TMD symptoms associated significantly with alexithymia. Alexithymia was also significantly more prevalent among those who reported having more often than average neck pain (P < 0.05), head pain (P < 0.05), and tender teeth (P < 0.01). According to logistic regression, the probability of alexithymia was significantly positively associated with pain symptoms (P < 0.05) and painless TMD-related symptoms (P < 0.01), and significantly negatively associated with female gender (P < 0.01). Additionally, depressive mood was significantly positively associated with dissatisfaction of one's work-shift schedule (P < 0.05), and poorer health experience (P < 0.01). Neither alexithymia nor depression was associated with irregular shift work in itself. In conclusion, depressive mood may be a sign of dissatisfaction and impaired well-being. In the case of perhaps less disabling but common physical symptoms alexithymia as a possible underlying factor may be relevant in the diagnosis and management of such disorders.

Adult↗

PubMed2003

Automatic sleep-wake and nap analysis with a new wrist worn online activity monitoring device vivago WristCare.

STUDY OBJECTIVE: Vivago WristCare is a new activity monitoring device, which allows long-term online monitoring of the activity of the user. This study evaluates the ability of the device to discriminate sleep/wake patterns during nighttime and during napping. DESIGN: Participants spent one night in the sleep laboratory where signals from polysomnography, actigraphy and WristCare were acquired. In addition, actigraphy and WristCare were used for 3-6 days for nap-analysis. SETTING: NA. PATIENTS OR PARTICIPANTS: Participants were 32 adults aged 26-89 years. The participants were studied in three study groups: all subjects, senior subjects (age > 65 years) and middle-aged subjects (age < 65 years). INTERVENTIONS: NA. RESULTS: Sleep/wake patterns were extracted from polysomnography, actigraphy and WristCare for the night slept in sleep laboratory. The agreement percents between the scorings of polysomnography and actigraphy, and between polysomnography and WristCare were about 80 % for all study groups. As total sleep time was estimated and the algorithm was optimized for this measure, the performance of the WristCare and actigraphy were similar. Both actigraphy and WristCare overestimated appreciably total sleep time (TST). Also in nap-analysis, actigraphy and WristCare performed similarly as the number of naps and the length of the naps were compared. CONCLUSIONS: The performance of the WristCare can be assumed to be well comparable to actigraphy in sleep/wake studies. The study suggests that the device may be used in long-term monitoring of sleep/wake patterns with similar performance to actigraphy.

Adult↗

PubMed2003

Effect of controlled-release melatonin on sleep quality, mood, and quality of life in subjects with seasonal or weather-associated changes in mood and behaviour.

This study aimed to explore the effects of melatonin on sleep, waking up and well being in subjects with varying degrees of seasonal or weather-associated changes in mood and behaviour. Fifty-eight healthy adults exhibiting subsyndromal seasonal affective disorder (s-SAD) and/or the negative or positive type of weather-associated syndrome (WAS) were randomised to either 2 mg of sustained-release melatonin or placebo tablets 1-2 h before a desired bedtime for 3 weeks. Outcome measures were changes from baseline in sleep quality, sleepiness after waking, atypical depressive symptoms and health-related quality of life by week three. Early morning salivary melatonin concentrations were measured at baseline and treatment cessation in all subjects. Melatonin administration significantly improved the quality of sleep (P=0.03) and vitality (P=0.02) in the subjects with s-SAD, but attenuated the improvement of atypical symptoms and physical parameters of quality of life compared to placebo in the subjects with WAS, positive type.

Adult↗

PubMed2003

The impact of somatic health problems on insomnia in middle age.

OBJECTIVE: The objective of this study is to assess the impact on insomnia symptoms of somatic diseases, psychological factors, living habits and life events during the previous year. BACKGROUND: Although health problems are a significant cause of insomnia, psychosocial factors are considered to be even more important. The relative impact of these and other factors on insomnia calls for further evaluation. METHODS: A questionnaire study in a randomly selected middle-aged population in Finland (N=626, 264 men and 362 women). RESULTS: In our study, 9.8% of men and 17.0% of women reported the occurrence of insomnia at least once a week during the previous 3 months. Insomniacs perceived their health as 'poor' or 'rather poor' more often than others and depression, allergic rhinitis, asthma, hypertension and heart symptoms such as arrhythmias were more common among them. Insomnia was not a side-effect of the treatment of these diseases; lack of medical treatment was associated with a higher incidence of insomnia. Work-related factors such as 'moving to a poorer job or to poorer working conditions' during the past year increased the possibility of insomnia, while moving house seemed to have a positive effect. When comparing these associations in logistic regression models, nervousness and tension were, however, the factors most significantly associated with insomnia. CONCLUSIONS: Psychosocial factors appeared to be more significantly associated with prolonged insomnia than somatic health problems.

Adult↗

PubMed2003

Reported bruxism and stress experience in media personnel with or without irregular shift work.

A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (n = 750) and to an equal number of randomly selected controls with regular 8-hour daytime work. The aim was to analyze whether irregular shift work, workload in terms of weekly working hours, dissatisfaction with current workshift schedule, health-care use, age and gender were associated with self-reported bruxism and experienced stress. The response rates were 58.3% (n = 874, 53.7% men) overall, 82.3% (n = 617, 56.6% men) for irregular shift workers and 34.3% (n = 257, 46.7% men) for the regular daytime work group. Those with irregular shifts were more often dissatisfied with their current workshift schedule than those in daytime work (25.1% versus 5.1%, P < 0.01). Irregular shift work was significantly associated with more frequent stress (P < 0.001), but not with self-reported bruxism. Workers dissatisfied with their current schedule reported both bruxism (P < 0.01) and stress (P < 0.001) more often than those who felt satisfied. In multivariate analyses, frequent bruxism was significantly associated with dissatisfaction with current workshift schedule (P < 0.05), number of dental visits (P < 0.05), and visits to a physician (P < 0.01), and negatively associated with age (P < 0.05), while severe stress was significantly positively associated with number of visits to a physician (P < 0.001). It was concluded that dissatisfaction with one's workshift schedule and not merely irregular shift work may aggravate stress and bruxism.

Adult↗

PubMed2002

Insomnia and global sleep dissatisfaction in Finland.

The purpose of this study is to assess the prevalence of insomnia symptoms and diagnoses in the general population of Finland. A total of 982 participants, aged 18 years or older and representative of the general population of Finland, were interviewed by telephone using the Sleep-EVAL system. The participation rate was 78%. The questionnaire included the assessment of sleep habits, insomnia symptomatology according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) and International Classification of Sleep Disorders (ICSD), associated and sleep/mental disorders and daytime consequences. The overall prevalence of insomnia symptoms occurring at least three nights per week was 37.6%. Difficulty initiating sleep were mentioned by 11.9% of the sample, difficulty maintaining sleep by 31.6%, early morning awakenings by 11.0% and non-restorative sleep by 7.9% of the sample. Global dissatisfaction with sleep was found in 11.9% of the sample. Daytime consequences (fatigue, mood changes, cognitive difficulties or daytime sleepiness) were reported by 39.9% of participants with insomnia symptoms and 87.6% of those with sleep dissatisfaction. A deterioration of sleep in summer or winter was associated with more complaints of sleep dissatisfaction. Prevalence of any DSM-IV insomnia diagnosis was 11.7%. More specifically, DSM-IV diagnosis of primary insomnia had a prevalence of 1.6% and DSM-IV diagnosis of insomnia related to another mental disorder was at 2.1%. Insomnia was a symptom of another sleep disorder in about 16% of cases and of a mental disorder in about 17% of cases. As reported in other Nordic studies, sleep quality was worse in summer. Insomnia symptomatology was common and was reported by more than a third of Finnish participants. Compared with other European countries studied with the same methodology (France, the UK, Germany, and Italy), the prevalence of DSM-IV insomnia diagnosis was 1.5 to two times higher in Finland.

Adolescent↗