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Variability of Sleep Duration Is Related to Subjective Sleep Quality and Subjective Well-Being: An Actigraphy Study  [PDF]
Sakari Lemola, Thomas Ledermann, Elliot M. Friedman
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0071292
Abstract: While there is a large body of evidence that poor subjective sleep quality is related to lower subjective well-being, studies on the relation of objective sleep measures and subjective well-being are fewer in number and less consistent in their findings. Using data of the Survey of Mid-Life in the United States (MIDUS), we investigated whether duration and quality of sleep, assessed by actigraphy, were related to subjective well-being and whether this relationship was mediated by subjective sleep quality. Three hundred and thirteen mainly white American individuals from the general population and 128 urban-dwelling African American individuals between 35 and 85 years of age were studied cross-sectionally. Sleep duration, variability of sleep duration, sleep onset latency, and time awake after sleep onset were assessed by actigraphy over a period of 7 days. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index, positive psychological well-being and symptoms of psychological distress were assessed with the Satisfaction with Life Scale and the Mood and Anxiety Symptom Questionnaire. In both white and African Americans high day-to-day variability in sleep duration was related to lower levels of subjective well-being controlling age, gender, educational and marital status, and BMI. By contrast, sleep duration, sleep onset latency, and time awake after sleep onset were not related to subjective well-being controlling covariates and other sleep variables. Moreover, the relationship between variability in sleep duration and well-being was partially mediated by subjective sleep quality. The findings show that great day-to-day variability in sleep duration – more than average sleep duration – is related to poor subjective sleep quality and poor subjective well-being.
Subjective assessment of mastication as parameter for successful prosthetic therapy  [PDF]
Mileki? Bojana,Pu?kar Tatjana,Markovi? Dubravka
Stomatolo?ki Glasnik Srbije , 2009, DOI: 10.2298/sgs0904187m
Abstract: Introduction. Success in functional rehabilitation of the craniomandibular system in patients without teeth, which have total prosthesis, can be assessed using different clinical and functional methods. Subjective assessment, motivation, comfort level and functional efficacy are important elements for adaptation to dental prosthesis as well as base for success in prosthetic therapy. The aim of this study was to evaluate the importance of subjective assessment of the mastication in people with new dental prosthesis as well as to assess the value of that parameter in determining the successful prosthetic therapy. Material and Methods. Study was conducted at the Dental Clinic in Novi Sad. Thirty patients (16 males and 14 females) with average age of 62.5 years who received total prosthesis were included. Analysis was done according to the data from the medical records and conducted survey in the form of questionnaire which was adjusted to our clinical examinations. Results. Results showed that 96.6% of the patients were satisfied with new prosthesis. Subjective assessment of the quality of their mastication before therapy showed that 63.4% consider their mastication as unsatisfied, 26.6% satisfied while 10% of toothless patients thought their mastication was good. Statistic analysis showed there was significant difference in subjective assessment before and after the therapy (p<0.01). In fact, there was significant connection between subjective assessment of the mastication and satisfaction with new prosthesis and therapy at all (p<0.01). Conclusion. Patients satisfaction with total prosthesis and subjective assessment of mastication are in direct correlation with successful prosthetic treatment. Results of subjective assessment of the mastication are important and can be used as a parameter for success along with precise survey.
Sleep Problem in the Elderly  [cached]
Pelin Yazgan
Türkiye Fiziksel Tip ve Rehabilitasyon Dergisi , 2009,
Abstract: Sleep is an active, complicated and organized condition. Various changes occur in sleep with aging: a) latent period is prolonged; b) sleep duration becomes shorter; c) sleep time is variable; d) tendency to sleep is increased but wakening becomes quicker. Insomnia is the most common sleep problem in advanced age. Objective and subjective tests are used to evaluate sleep disorders in the elderly. Treatment includes: changing the behaviours before the sleeping period, medical treatment options and additionally alternative medicine methods. Turk J Phys Med Rehab 2009; 55 Suppl 2: 67-8.
Subjective and objective evaluation of alertness and sleep quality in depressed patients
Milos Matousek, Katerina Cervena, Lucie Zavesicka, Martin Brunovsky
BMC Psychiatry , 2004, DOI: 10.1186/1471-244x-4-14
Abstract: Among patients with depression, altogether 28 patients with insomnia were examined. Their answers to typical questions, as they are used during a psychiatric interview, were scored. In parallel, night sleep quality and alertness level in the daytime were objectively estimated by means of polygraphic recording.The subjective statements on the type of insomnia, the estimated time of falling asleep, frequent awakenings and occurrence of disturbing dreams seem to be unreliable. Similarly, the results were disappointing when the patients were asked about alertness disturbances in the daytime. An unexpected finding was the lack of any significant correlation to the scores obtained by means of Epworth's scale. Among the factors possibly influencing the patients' reports, age, sex, coffee intake and also chronic administration of sedatives or hypnotics showed a low correlation with the sleep and alertness indicators.The statistical evaluation indicated rather poor agreement between the subjective and objective items. The statistical evaluation suggested that anxiety and depression significantly influence reports on sleep quality and alertness disturbances in the daytime.The symptoms which are associated with alertness level and sleep belong to the usual complaints in depression [1]. Besides insomnia, many patients suffer from fatigue and sleepiness in the daytime, others report "nervousness" and inability to relax. The common denominator of these symptoms is the fact that they reflect subjective feelings which are only vaguely defined. It is possible to show that even healthy individuals use expressions like "fatigue" and "tiredness" in various senses [2] and the content varies still more in psychiatric patients [3]. In contrast, alertness and sleep level can be objectively measured by means of neurophysiological methods. Sleep polygraphy belongs today to the routine medical examinations (a review can be found e.g. in Broughton 1999 [4]) and the conventional sleep indicator
Subjective and Objective Appraisal of Activity in Adults with Obstructive Sleep Apnea
Eileen R. Chasens,Susan M. Sereika,Martin P. Houze,Patrick J. Strollo
Journal of Aging Research , 2011, DOI: 10.4061/2011/751819
Abstract: Objective. This study examined the association between obstructive sleep apnea (OSA), daytime sleepiness, functional activity, and objective physical activity. Setting. Subjects (=37) being evaluated for OSA were recruited from a sleep clinic. Participants. The sample was balanced by gender (53% male), middle-aged, primarily White, and overweight or obese with a mean BMI of 33.98 (SD=7.35; medianBMI=32.30). Over 40% reported subjective sleepiness (Epworth Sleepiness Scale (ESS) ≥10) and had OSA (78% with apnea
Midazolam daytime residual effect evaluated by the multiple sleep latency test
Reim?o, Rubens;
Arquivos de Neuro-Psiquiatria , 1993, DOI: 10.1590/S0004-282X1993000200002
Abstract: daytime sleepiness after ingestion of midazolam as a hypnotic was quantitatively studied employing the multiple sleep latency test (mslt). we evaluated 20 healthy volunteers, 10 of which received a single oral dose of midazolam (15 mg, one tablet) and 10 of which received placebo, in a double-blind design. tablets were administered at 2200 h, bedtime. on the following day, all subjects were submitted to a clinical evaluation, a subjective checklist and the mslt. the mean age was 34.7 + 8.9 years in the midazolam and 38.0+10.6 years in the placebo groups (n.s.). sex and weight distributions were similar in both groups (n.s.). clinical evaluation and subjective symptom checklist did not make evident significant differences between midazolam and placebo groups (n.s.). the mstl was performed at 0900, 1100, 1300, 1500 and 1700 h. mean sleep latencies were 12.0, 12.7, 8.0, 13.5, 17.0 min in the midazolam group; mean sleep latencies were 13.8, 9.0, 6.9, 9.5, 13.6 min in the placebo group (n.s.). in the single dose, double-blind design here evaluated, midazolam did not show differences in relation to placebo on the following day, detectable by the mslt.
Depression in the Spousally Bereaved Elderly: Correlations with Subjective Sleep Measures  [PDF]
Timothy H. Monk,Marissa K. Pfoff,Joette R. Zarotney
Depression Research and Treatment , 2013, DOI: 10.1155/2013/409538
Abstract: Complaints of poor sleep and symptoms of depression are likely to coexist in the spousally bereaved elderly. This study was concerned with the correlation between depressive symptoms and various measures of subjectively reported sleep using questionnaire and diary instruments in 38 bereaved seniors (60y+). Correlations between the sleep measures and days since loss and grief intensity were also calculated. All sleep disruption measures correlated significantly with depression score, but only sleep duration correlated with grief intensity, and no sleep measure correlated with days since loss. Therapies which address both sleep and depression are likely to be of benefit to bereaved seniors. 1. Introduction The elderly are especially vulnerable to depression, partly due to endogenous factors linked to the aging process [1]. Superimposed upon this, though, is the fact that at some time in the older person's life the individual's spouse may die, leaving them spousally bereaved. Spousal bereavement is a very devastating, life-altering event that becomes more likely with advancing age [2, 3]. Widowhood affects millions of men, and a greater number of women, around the world every year. Immediately after the loss of a close loved one, people experience a period of acute grief that generally includes intrusive thoughts, intense emotional distress, and withdrawal from normal daily activities [4]. This period, along with the chronic grief experience that follows, may vary in length and intensity from individual to individual and often resembles clinical depression [5]. Major depression afflicts about 28% of the spousally bereaved [6]. This risk of depression appears to peak during the first six months of bereavement [2, 7], although depressive symptoms can be present for up to 2 years [8]. Even bereaved persons with subclinical levels of depressive symptomatology may suffer extensively, for they too have a greater likelihood of functional impairment, poorer health, more physician visits and mental health counseling, and increased use of antidepressants than do nonbereaved individuals [3, 9, 10]. In a parallel manner, elderly persons are (again, probably for endogenous reasons) particularly vulnerable to sleep disruption [11, 12]. Also, bereavement per se has been shown to interfere with sleep [10, 13]. Thus, depressive symptoms and complaints of poor sleep are likely to coexist in the spousally bereaved elderly. This study was concerned with the correlation between depressive symptoms (as measured by the Hamilton Rating Scale for Depression (HRSD) [14]), and
An Investigation into the Strength of the Association and Agreement Levels between Subjective and Objective Sleep Duration in Adolescents  [PDF]
Teresa Arora, Emma Broglia, Dunstan Pushpakumar, Taha Lodhi, Shahrad Taheri
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0072406
Abstract: Study Objectives The majority of adolescent sleep research has utilized self-reported sleep duration and some have based information on a solitary question. Whilst some have claimed to have validated sleep survey data with objective actigraphy measures in adolescents, the statistical approach applied only demonstrates the strength of the association between subjective and objective sleep duration data and does not reflect if these different methods actually agree. Methods Data were collected as part of the Midlands Adolescents Schools Sleep Education Study (MASSES). Adolescents (n=225) aged 11-13 years provided estimates for weekday, weekend and combined sleep duration based on self-reported survey data, a 7-day sleep diary, and wrist-worn actigraphy. Results We assessed the strength of the relationship as well as agreement levels between subjective and objectively determined sleep duration (weekday, weekend and combined). Subjective diary sleep duration was significantly correlated with actigraphy estimates for weekday and weekend sleep duration r=0.30, p≤0.001 and r=0.31, p≤0.001 respectively. Pitman’s test demonstrated no significant difference in the variance between weekend sleep duration (r=0.09, p=0.16) and combined sleep duration (r=0.12, p=0.08) indicating acceptable agreement between actigraphy and sleep diary sleep duration only. Self-reported sleep duration estimates (weekday, weekend and combined) did not agree with actigraphy determined sleep duration. Conclusions Sleep diaries are a cost-effective alternative to survey/questionnaire data. Self-reported measures of sleep duration in adolescents do not agree with actigraphy measures and should be avoided where possible. Previous adolescent sleep studies that have utilized self-reported survey data may not provide a complete representation of sleep on the outcome measure of interest.
Correlations between subjective and objective features of nocturnal sleep and excessive diurnal sleepiness in patients with narcolepsy
Jiménez-Correa, Ulises;Haro, Reyes;Obdulia González, Rosa;Velázquez-Moctezuma, Javier;
Arquivos de Neuro-Psiquiatria , 2009, DOI: 10.1590/S0004-282X2009000600006
Abstract: objective: to determine the correlations between excessive daytime sleepiness (eds), assessed by the epworth sleepiness scale (ess), and the multiple sleep latency test (mslt) and nocturnal sleep architecture features, clinical symptoms of narcolepsy (csn) and subjective sleep quality (ssq) in patients with narcolepsy. method: twenty three untreated patients were studied and compared with a matched control group. diagnosis of narcolepsy was carried out employing a clinical interview, a polysomnographic (psg) record, and an mslt. results: subjective number of awakenings was the ssq indicator that best correlated with eds (ess and mslt). regarding clinical features, diurnal tiredness and sleep paralysis correlated with ess values. increase in ess was related with decrease in total sleep time, sws, and sleep onset latency. on the other hand, increase in mslt was related with decrease in sws. conclusion: these data suggest that eds in patients with narcolepsy could be impaired by disturbed nocturnal sleep.
Changes before and after improvement of subjective sleep state of a man diagnosed with pre-diabetes and sleep disorder  [PDF]
Miki Sato, Yuko Yasuhara, Tetsuya Tanioka, Yukie Iwasa, Toshiyuki Yasui, Masafumi Miyake, Haruo Kobayashi, Waraporn Kongsuwan, Rozzano C. Locsin
Health (Health) , 2013, DOI: 10.4236/health.2013.53A069
Abstract: The purpose of this case study was to examine the changes before and after improvements of the subjective sleep status of Mr A, a 40-year-old man diagnosed with pre-diabetes and a sleep disorder. Data were collected using a Holter monitor for 24 hours a day for 3 days to assess autonomic nervous activity by recording bed-time and waking time activity (activity counts: ACs). Mr. A kept a diary of activities and completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The study revealed that subjective sleeping hours correlated almost precisely with those measured by the actigraph and as described in the diary. Both the parasympathetic and sympathetic nervous system activities were imbalanced. However, no correlation was observed between the ACs and autonomic nervous activity. Subjective sleep state according to the PSQI score improved remarkably by dietary and exercise therapy from 13 to 3 points, after six months, with corresponding high level sleep satisfaction level. Significant correlations were observed between ACs and high-frequency spectral power of R-R intervals, and between ACs and the low-frequency/high frequency ratio of spectral power of R-R intervals. Although Mr. A’s sleep satisfaction level has improved, the autonomic nervous system activity remained different from that of healthy people.
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