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PubMedDate not supplied

Feasibilty of a sleep intervention during adjuvant breast cancer chemotherapy.

PURPOSE/OBJECTIVES: To evaluate the feasibility of an intervention designed to promote sleep and modify fatigue during four cycles of adjuvant breast cancer chemotherapy. DESIGN: Prospective, repeated measures, quasi-experimental feasibility study. SETTING: Midwestern urban oncology clinics. SAMPLE: 25 women between the ages of 40-65 (mean = 54.3) with stage I-II breast cancer receiving doxorubicin-based chemotherapy. METHODS: Each woman developed, reinforced, and revised an individualized sleep promotion plan (ISPP) with four components: sleep hygiene, relaxation therapy, stimulus control, and sleep restriction techniques. A daily diary, the Pittsburgh Sleep Quality Index, a wrist actigraph, and the Piper Fatigue Scale were used to collect data two days before and seven days after each treatment. MAIN RESEARCH VARIABLES: Adherence, sleep and wake outcomes, and fatigue. FINDINGS: Adherence rates with the components of the ISPP varied during treatments one through four: sleep hygiene (68%-78%), relaxation therapy (57%-67%), stimulus control (46%-67%), and sleep restriction (76%-80%). Mean sleep and wake outcomes at baseline, peak, and rebound times were that (a) sleep latency remained brief (less than 30 minutes per night), (b) time awake after sleep onset exceeded the desired less than 30 minutes per night, (c) sleep efficiency scores remained stable at 85%-90%, (d) total rest time remained stable at 8-10 hours per night, (e) subjective ratings of feelings on arising were stable, and (f) nighttime awakenings were 8-10 per night. Fatigue outcomes were that fatigue was stable two days after each treatment and mean daily fatigue intensity was lower at treatment three than at treatment one but rebounded at treatment four. CONCLUSIONS: The intervention was feasible, adherence rates improved over time, and most sleep and wake patterns were consistent with normal values. Revisions will focus on decreasing nighttime awakenings. IMPLICATIONS FOR NURSING: Adopting behaviors to promote sleep may assist in maintaining sleep and managing fatigue during chemotherapy.

Adult↗
PubMed2001

Follow-up and outcomes of nasal CPAP therapy in patients with sleep apnea syndrome.

The large and growing numbers of patients with obstructive sleep apnea syndrome (OSAS) attending sleep disorders clinics create major logistical difficulties for the follow-up of these patients, particularly those on nasal continuous positive airway pressure therapy (CPAP). Follow-up of patients on CPAP should focus on treatment efficacy, side effects, and compliance with therapy. The adequacy and comfort of mask fit and the appropriate selection of pressure level at the time of initial titration have a major influence on treatment efficacy. Outcome measures of treatment efficacy include improvements in daytime performance and quality of life measures in addition to impact on cardiovascular morbidity, particularly hypertension. Side effects and compliance with CPAP are also influenced greatly by the adequacy of mask fit and pressure selection, which underlines the great importance of adequate technical expertise and patient education at the time of initiation of therapy. The recent development of automatically adjusting CPAP devices should greatly simplify the initiation of CPAP therapy and also the subsequent follow-up of OSAS patients on CPAP therapy. However, the much higher cost of auto-CPAP devices compared to standard CPAP does not justify the routine use of these more expensive devices at this time.

Humans↗
PubMed2003

[Perioperative continuous positive airway pressure therapy for severe obstructive sleep apnea hypopnea syndrome patients].

OBJECTIVE: (1) To investigate the severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients' perioperative variations of their polysomnographic indices, to discuss the necessity for their perioperative treatment; (2) To investigate the effects of continuous positive airway pressure (CPAP) on severe OSAHS patients during their perioperative period. METHODS: (1) 21 cases severe OSAHS patients were selected for at least 7 days preoperative CPAP therapy, and this group of patients were also given 3 continuous nights autotitrated CPAP (AutoSet) therapy postoperatively, i.e., the first 3 nights after operation. The 21 cases were remonitored with PSG during the second night after operation with their AutoSet ON. And all the 21 cases had revised uvulopalatopharygoplasty, in which the uvula is reserved completely. All patients apnea hypopnea index(AHI), lowest SaO2 (LSaO2), and sleep structure indices were calculated. (2) Another 24 cases of severe OSAHS patients without preoperative CPAP therapy or tracheotomy were selected as the control group, all patients received polysomnography (PSG) on the second night postoperatively. RESULTS: (1) 6 cases' condition of the control group got worse during the second night after operation, their LSaO2 are lower and their AHI got higher than pre-operation. For the another 18 cases, their condition got better than before operation. (2) 21 cases' AHI and LSaO2 are 61.1 +/- 9.9, 65.0% +/- 9.6% respectively before CPAP treatment, and the AHI and LSaO2 are 2.2 +/- 1.4, 94.5% +/- 2.9% during CPAP therapy. P < 0.001 (TTEST). All the 21 cases main symptoms disappeared after 1 week CPAP therapy. All 21 cases could tolerate AutoSet treatment well for the first 3 nights after operation. During the 2nd night with AutoSet therapy, the AHI and LSaO2 are 3.6 +/- 1.8 and 93.7% +/- 3.4% respectively. (3) For the 2nd night after operation, the CPAP and AutoSet treating group's AHI is lower than that of the control group, also the LSaO2 is higher, the deep and REM sleep stages are longer, and the S1, S2 sleep stages are shorter than that of the latter. CONCLUSION: For severe OSAHS patients, the postoperative condition has the possibility of getting worse. Perioperative CPAP therapy can have OSAHS patients severe condition alleviated, so the perioperative risks could be lowered; During the first 3 postoperative nights, AutoSet can be well tolerated by severe OSAHS patients.

Adult↗
PubMed1996

Oral appliance therapy for the treatment of obstructive sleep apnea.

A variety of oral appliances (OA) are now available for the treatment of obstructive sleep apnea (OSA), OA therapy is effective in some patients with mild to moderate OSA and is associated with greater patient satisfaction than nasal CPAP. Adjustable OA are associated with improved treatment success and fewer compliance failures compared to non-adjustable OA. Large randomized clinical trials are necessary to further determine the precise indications, benefits, and risks of each OA in the treatment of OSA.

Humans↗
PubMed2005

[To evaluate the effectiveness of a standardized protocol of auricular therapy using magnetic pearls on sleep promotion in the elderly].

OBJECTIVE: To examine the effectiveness of adopting a standardized protocol of auricular therapy using magnetic pearls on sleep promotion in the elderly. METHODS: Sixty eligible participants were invited to receive a 3-week auricular therapy using magnetic pearls (@66 Gauss). Seven auricular points (Shenmen, Heart, Kidney, Liver, Spleen, Subcortex, Occiput) which are thought to have an effect on promoting sleep in the elderly were selected. RESULTS: Significant improvement in the sleep efficiency (SE) collected by wrist actigraphy was observed before, during and after treatment course (P<0.01). The overall effective rate in insomnia with different TCM syndrome types ranged from 66.7% to 90.9% (average 81.7%). No significant difference in the effect of the therapy in terms of SE could be observe between clients with excessive or deficiency syndrome even when the treatment protocol was standardized (P>0.05). CONCLUSION: A standardized protocol of auricular therapy using magnetic pearls for sleep improvement might be appropriate for the ageing population who are homogeneous in terms of age and general health status.

Acupuncture Points↗
PubMed1998

Changes in work performances in obstructive sleep apnea patients after dental appliance therapy.

The effects of dental appliances on work performances of obstructive sleep apnea syndrome (OSAS) is not well examined. This study evaluated the polysomnographic and psychological findings before and after therapy. Nine patients were diagnosed OSAS by nocturnal polysomnography. The psychological batter, was performed from 13:00 to 14:00, which consisted of Uchida-Kraepelin psychodiagnostic test (U-K's test) and Bourdon's cancellation test (Bourdon's test). Approximately 3 months after the treatment, the examinations were performed. Apnea and desaturation index decreased significantly after the therapy. In addition, sleep architecture improved after the therapy compared with that before the therapy. Dysfunction of task performances, such as mean level of work amounts in U-K's test, mean error, mean performance time and mean deviation in Bourdon's test improved after therapy. We conclude that dental appliances therapy is effective not only to apnea but also to work performance in OSAS.

Adult↗
PubMed1985

Antidepressant effects of sleep deprivation in bright and dim light.

In order to test whether exposure to bright artificial light at night is a necessary condition for the antidepressant response to sleep deprivation therapy, five patients were totally sleep-deprived on two separate nights, once in very bright light and once in nearly total darkness. During the day after the sleep-deprivation night patients were found to have responded equally well to sleep deprivation in both conditions. During the sleep-deprivation night, however, antidepressant responses may have been greater in the bright light condition. Thus, light at night is not necessary for the antidepressant response to sleep deprivation, but we cannot rule out the possibility that the effects of light exposure and sleep deprivation are additive or that exposure to light at some time after sleep deprivation begins (including during the following day) is necessary for the response.

Adult↗
PubMed2004

Treatment of postpartum depression, part 2: a critical review of nonbiological interventions.

BACKGROUND: While postpartum depression is a common mental condition with significant burden, it often remains undiagnosed and untreated. The objective of this article is to critically review the literature to determine the current state of scientific knowledge related to the treatment of postpartum depression from a nonbiological perspective. DATA SOURCES: Databases searched for this review included MEDLINE, PubMed, CINAHL, PsycINFO, EMBASE, ProQuest, the Cochrane Library, and the WHO Reproductive Health Library from 1966 to 2003. The search terms used were postpartum/postnatal depression and randomized controlled/clinical trials. Published peer-reviewed articles in English from 1990 to 2003 were included in the review, although select earlier studies were also included based on good methodological quality and/or the absence of more recent work. METHOD: The criteria used to evaluate the interventions were based on the standardized methodology developed by the U.S. Preventive Services Task Force and the Canadian Task Force on Preventive Health Care. RESULTS: Twenty-one studies that met inclusion criteria were examined. These studies included interpersonal psychotherapy, cognitive-behavioral therapy, peer and partner support, nondirective counseling, relaxation/massage therapy, infant sleep interventions, infant-mother relationship therapy, and maternal exercise. Although some of these interventions have been better studied for depression unrelated to childbirth, methodological limitations render their efficacy equivocal for postpartum depression. CONCLUSIONS: Definite conclusions cannot be reached about the relative effectiveness of most of the nonbiological treatment approaches due to the lack of well-designed investigations. Randomized controlled trials are needed to compare different treatment modalities, examine the effectiveness of individual treatment components, and determine which treatments are most useful for women with different risk factors or clinical presentations of postpartum depression.

Cognitive Behavioral Therapy↗
PubMed1994

[The treatments of manic-depressive psychosis].

There are a number of types of treatment for manic-depressive psychosis, including pharmacotherapy, psychotherapy, electroconvulsive therapy and continuous sleep treatment. The most generally used therapy for mania is pharmacotherapy, including the use of lithium and major tranquilizers. With regard to depression, the choice of treatment from among pharmacotherapy, psychotherapy and physiotherapy must be made on a case by case basis. In some cases, we have chosen electroconvulsive therapy, continuous sleep treatment or other forms of therapy. On admission, it is difficult to obtain the patient's consent for treatment, when he lacks insight about his condition. In this paper, we describe the choice of treatments, requirements for admission, and management of the structure of treatment.

Antidepressive Agents↗
PubMed1995

Prediction of outcome in behaviorally based insomnia treatments.

Factors related to successful behavioral intervention for individuals with insomnia are not well understood. In this study we employed the Neuroticism, Extraversion and Openness (NEO) Personality Inventory, to predict successful treatment outcome. Two behavioral treatments for insomnia, sleep restriction therapy (SRT) and relaxation training (RT) were employed in 32 elderly insomniacs. Following two baseline weeks, subjects underwent four weeks of individual treatment. Daily telephone call-ins generated data on sleep times and sleep latency. Follow-up occurred three months after the end of treatment. Results indicated that subjects showing the greatest improvement in total sleep time with both treatments were more traditional, conventional and rigid. Improvement in sleep onset latency was unrelated to NEO Scores. SRT appeared to be more effective for increasing total sleep time in these older subjects.

Aged↗
PubMed1980

A study of the diagnostic value of waking and sleep EEGs after sleep deprivation in epileptic patients on anticonvulsive therapy.

One hundred and twenty-seven waking and sleep EEGs were recorded from 102 epileptic patients on anticonvulsant therapy, after sleep deprivation. Epileptiform activity was found in 63% of the patients, or 57% of the records. Since in previously recorded waking EEGs epileptic discharges had been registered in 19%, or 17% respectively, the rate of increase was considerable. The rate of activation was 51% in patients without epileptic activity in their waking EEGS. Two-thirds of the epileptiform activity were already recorded in the waking EEGS, after sleep deprivation, One-third was recorded only during sleep. Epileptic discharges in the different sleep stages ranged from 25% (E) to 48% (C). On the other hand, approximately the same frequency was recorded in the separate sleep stages in patients whose waking EEGS after sleep deprivation showed epileptiform activity. The EEG changes were correlated with the different clinical parameters (type of seizure, frequency and duration of seizures, age at the first seizure and the time of examination, neurological findings, and personality changes).

Adolescent↗