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1.
Arch. argent. pediatr ; 122(1): e202303029, feb. 2024. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1524483

ABSTRACT

Introducción. Se describen los resultados preliminares del Programa de Acompañamiento al Sueño en la Infancia desde Terapia Ocupacional (PASITO) en niños y niñas con trastornos del neurodesarrollo (NN-TND), de 3 a 10 años, y con insomnio; realizado entre junio de 2020 y septiembre de 2021. Población y métodos. Estudio cuasiexperimental de preintervención y posintervención con un grupo de intervención y otro grupo de control, medido por el Cuestionario de Hábitos de Sueño (CHS) y el Diario de Sueño (DS). Resultados. Participaron 22 NN-TND, 8 en el grupo control. El puntaje total del CHS del grupo de intervención mejoró (p <0,001) de 54,9 (DE 5,5) a 48,4 (DE 4,5) y se acercó al rango de referencia 42,6 (DE 4,9). El DS evidenció aumento en duración, adelanto de fase de sueño y reducción en cantidad de despertares. Conclusión. Estos resultados provisorios y favorables muestran que PASITO podría ser una intervención posible para dificultades del sueño en NN-TND


Introduction. Here we describe the interim results of the Program to Support Child Sleep from the Occupational Therapy Perspective (Programa de Acompañamiento al Sueño en la Infancia desde Terapia Ocupacional, PASITO) for children with neurodevelopmental disorders (NDDs) aged 3­10 years with insomnia, conducted between June 2020 and September 2021. Population and methods. Pre- and post-intervention quasi-experiment in an intervention group and a control group using the Sleep Habits Questionnaire (SHQ) and the Consensus Sleep Diary (CSD). Results. A total of 22 children with NDDs participated, 8 in the control group. The overall SHQ score for the intervention group improved (p < 0.001) from 54.9 (SD: 5.5) to 48.4 (SD: 4.5) and moved closer to the reference range of 42.6 (SD: 4.9). The CSD showed an increased sleep duration, earlier sleep onset, and fewer night wakings. Conclusion. These interim favorable results demonstrate that the PASITO may be a possible intervention to manage sleep problems in children with NDDs.


Subject(s)
Humans , Child, Preschool , Child , Occupational Therapy , COVID-19 , Sleep Initiation and Maintenance Disorders/etiology , Sleep Initiation and Maintenance Disorders/therapy , Sleep , Pandemics
2.
Acta neurol. colomb ; 39(4)dic. 2023.
Article in Spanish | LILACS | ID: biblio-1533508

ABSTRACT

Introducción: La epilepsia es un desorden caracterizado por la predisposición a generar crisis epilépticas, mientras que el síndrome de apnea del sueño (SAOS) ha sido reconocido como un desorden crónico de colapso intermitente de la vía aérea que genera hipoxia recurrente. En este trabajo se aplicó la escala de trastornos del sueño (Sleep Apnea Scale of the Sleep Disorders Questionnaire SA-SDQ), previamente validada en inglés para pacientes con epilepsia, a fin de determinar su capacidad para detectar apnea de sueño en nuestra población. Materiales y métodos: En una primera etapa se realizó la adaptación transcultural de la escala SA-SDQ en castellano, provista por los autores, al español colombiano. Luego se recopiló la información de los pacientes en quienes se realizó polisomnografía entre mayo y agosto del 2022 y se determinó el valor de corte para diagnosticar SAOS con la escala SA-SDQ. Resultados: Cuarenta pacientes pudieron realizarse la polisomnografía, de los cuales 30 (75 %) tuvieron índices de apnea-hipopnea superiores a 5, lo que indica SAOS. El área bajo la curva fue 0,790 y la puntuación SA-SDQ de 21 proporcionó una sensibilidad del 73,3 % (IC 53,83-87,02 %) y una especificidad del 80 % (IC 44,2-96,5 %). La consistencia interna fue aceptable (α = 0,713). Conclusiones: La escala SA-SDQ es un instrumento útil para tamizar SAOS en la población colombiana que padece epilepsia. Nuestros resultados indican que los puntos de corte sugeridos anteriormente (2936 para hombres y 26-32 para mujeres) pueden ser demasiado altos para nuestra población. Sugerimos un punto de corte de 21 para ambos.


Introduction: Epilepsy is a disorder characterized by a predisposition to have epileptic seizures, while sleep apnea syndrome (OSAS) has been recognized as a chronic disorder of intermittent collapse of the airway that generates recurrent hypoxia. In this work, the sleep disorders scale (SA-SDQ) previously validated in English for patients with epilepsy was applied to determine its ability to detect sleep apnea in our population. Materials and methods: In the first stage, the cross-cultural adaptation of the SA-SDQ scale in Spanish provided by the authors was carried out into Colombian Spanish. then the information of the patients in whom polysomnography was performed between May and August 2022 was collected and the cut-off value was determined to diagnose OSAS with the SA-SDQ scale. Results: 40 patients were able to undergo polysomnography, of which 30 (75 %) had apnea-hypopnea indices greater than five, indicating OSAS. The area under the curve was 0.790 and the SA-SDQ score of 21 provided a sensitivity of 73.3 % (CI 53.83-87.02 %) and a specificity of 80 % (CI 44.2-96, 5 %). The internal consistency was acceptable (α = 0.713). Conclusions: The SA-SDQ scale is a useful instrument for screening OSAS in the Colombian population suffering from epilepsy. Our results indicate that the previously suggested cut-off points (29-36 for men and 26-32 for women) may be too high in our population. We suggest a cutoff of 21 for both.


Subject(s)
Sleep Apnea, Obstructive , Sleep Disorders, Circadian Rhythm , Sleep Initiation and Maintenance Disorders , Epilepsy , Drug Resistant Epilepsy
3.
Rev. APS (Online) ; 25(3): 614-628, 06/02/2023.
Article in Portuguese | LILACS, BDENF | ID: biblio-1562483

ABSTRACT

Introdução: A insônia é capaz de modificar o padrão do sono e afetar a saúde e a funcionalidade das atividades desempenhadas pelo indivíduo. Os profissionais da área da saúde se apresentam como uma população em risco para a insônia, devido às características de seu trabalho. Objetivos: Este estudo analisou a prevalência de insônia e a presença de comorbidades entre esses profissionais. Métodos: Foi realizado um estudo observacional, transversal, em agentes comunitários de saúde (ACS), enfermeiros (ENF), médicos (MED) etécnicos de enfermagem (TEC) que atuam nas Unidades Básicas de Saúde (UBS) de um município do sul de Santa Catarina (SC), no período de maio até outubro de 2021. Os dados foram coletados por meio da aplicação de um questionário on-line auto administrado, via Google Docs. Os questionários foram aplicados em 168 profissionais de saúde, os quais foram alocados em dois grupos: ACS (93) e TEC (22), totalizando 115 participantes; ENF (24) e MED (29), com 53 participantes. As variáveis analisadas foram: perfil sociodemográfico e estilo de vida dos profissionais; presença de ansiedade, depressão, dor crônica e utilização de benzodiazepínico (BZD); presença de insônia; gravidade da insônia e bem-estar mental atual. Resultados: 53% dos ACS/TEC apresentam insônia (59%insônia leve, 32,8% insônia moderada, 8,2% insônia grave), 54,8% ansiedade, 33% depressão, 31,3% dor crônica e 23,5% utilizam benzodiazepínicos (BZD). Entre os ENF e MED, a prevalência de insônia foi de 34% (61,1% insônia leve e 38,9% insônia moderada), 35,8% ansiedade, 13,2% depressão, 5,7% crônica e 5,7% utilizam BZD. Conclusão: Foi possível constatar maior prevalência de insônia, ansiedade, depressão, dor crônica e utilização de benzodiazepínicos entre os profissionais de saúde quando comparados com a população geral, especialmente entre os ACS e TEC.


Introduction: Insomnia is able to modify the sleep pattern and affect the health and functionality of the activities performed by the individual. Health professionals are a population at risk for insomnia, due to the characteristics of their work. Objectives: This study analyzed the prevalence of insomnia and the presence of comorbidities among these professionals. Methods: An observational, cross-sectional study was carried out with community health agents (ACS), nurses (ENF), physicians (MED) and nursing technicians (TEC) who work in Basic Health Units (UBS) in a municipality in the south of Brazil. of Santa Catarina (SC), from May to October 2021. Data were collected through the application of a self-administered online questionnaire, via Google Docs. The questionnaires were applied to 168 health professionals, who were divided into two groups: ACS (93) and TEC (22), totaling 115 participants; ENF (24) and MED (29), with 53 participants. The variables analyzed were: sociodemographic profile and lifestyle of professionals; presence of anxiety, depression, chronic pain and use of benzodiazepines (BZD); presence of insomnia; severity of insomnia and current mental well-being. Results: 53% of the ACS/TEC have insomnia (59% mild insomnia, 32.8% moderate insomnia, 8.2% severe insomnia), 54.8% anxiety, 33% depression, 31.3% chronic pain and 23, 5% use benzodiazepines (BZD). Among ENF and MED, the prevalence of insomnia was 34% (61.1% mild insomnia and 38.9% moderate insomnia), 35.8% anxiety, 13.2% depression, 5.7% chronic and 5. 7% use BZD. Conclusion: It was possible to observe a higher prevalence of insomnia, anxiety, depression, chronic pain and use of benzodiazepines among health professionals when compared to the general population, especially among CHA and TEC.


Subject(s)
Sleep Initiation and Maintenance Disorders , Health Personnel
4.
Biomedical and Environmental Sciences ; (12): 715-724, 2023.
Article in English | WPRIM | ID: wpr-1007844

ABSTRACT

OBJECTIVE@#This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers (ICs) of hospitalized patients with lung cancer.@*METHODS@#A cross-sectional study on ICs of hospitalized patients with lung cancer was conducted from December 31, 2020 to December 31, 2021. ICs' burden was assessed using the Caregiver Reaction Assessment (CRA), Hospital Anxiety and Depression Scale (HADS), and Insomnia Severity Index (ISI). Linear and logistic regression models were used to identify the influencing factors.@*RESULTS@#Among 289 ICs of hospitalized patients with lung cancer, 83 (28.72%), 53 (18.34%), and 14 (4.84%) ICs experienced mild, moderate, and severe insomnia, respectively. The scores concerning self-esteem, lack of family support, financial problems, disturbed schedule, and health problems were 4.32 ± 0.53, 2.24 ± 0.79, 2.84 ± 1.14, 3.63 ± 0.77, and 2.44 ± 0.95, respectively. ICs with higher Activities of Daily Living Scale (ADLS) scores were associated with a lower risk of insomnia, with an odd ratio ( OR) and 95% confidence interval ( CI) of 0.940 (0.898-0.983). Among the ICs, female gender ( OR = 2.597), alcohol consumption ( OR = 3.745), underlying medical conditions ( OR = 11.765), long-term caregiving experience ( OR = 37.037), and higher monthly expenses ( OR = 5.714) were associated with a high risk of insomnia.@*CONCLUSION@#Of the hospitalized patients with lung cancer, 51.9% experienced insomnia. Patients' ADL, ICs gender, alcohol consumption, underlying medical conditions, caregiving duration, and monthly expenses were influencing factors. Therefore, prompt screening and early intervention for ICs of patients with lung cancer is necessary.


Subject(s)
Humans , Female , Caregivers , Activities of Daily Living , Cross-Sectional Studies , Sleep Initiation and Maintenance Disorders/epidemiology , Lung Neoplasms/epidemiology
5.
Chinese Acupuncture & Moxibustion ; (12): 1311-1314, 2023.
Article in English | WPRIM | ID: wpr-1007475

ABSTRACT

Starting from the perspective of meridian theory, this article briefly analyzes the meridian pathophysiology of snoring and the relationship between snoring and meridian theory. It proposes that acupuncture treatment for snoring should focus on regulating qi from the shaoyang meridians, harmonizing the spirit by the governor vessel, resolving phlegm through the three yang meridians, and harmonizing qi and blood from the yangming meridians. Additionally, attention is placed on both the root cause and the symptoms, the theory of "four seas". The ultimate goal is to promote the flow of meridian and qi-blood, improve symptoms such as nighttime snoring, poor sleep quality, and daytime sleepiness, and achieve the desired outcome of stopping snoring and ensuring restful sleep.


Subject(s)
Humans , Meridians , Snoring/therapy , Acupuncture Therapy , Sleep Initiation and Maintenance Disorders , Mucus , Acupuncture Points
6.
Chinese Acupuncture & Moxibustion ; (12): 1014-1017, 2023.
Article in Chinese | WPRIM | ID: wpr-1007435

ABSTRACT

OBJECTIVE@#To compare the effect of acupuncture based on syndrome differentiation and estazolam in the treatment of chronic insomnia and its influence on cognitive function.@*METHODS@#A total of 90 patients with chronic insomnia were randomly divided into an acupuncture group and a medication group, 45 cases in each group. The acupuncture group was treated with acupuncture at Sishencong (EX-HN 1) and bilateral Shenmen (HT 7), Sanyinjiao (SP 6) combined with compatibility of acupoints based on syndrome differentiation, once a day for 6 d and then rest for 1 d, for a total of 4 weeks. The medication group was treated with oral estazolam tablets before bedtime, 1 tablet each time, for a total of 4 weeks. Before and after treatment, the scores of Pittsburgh sleep quality index (PSQI), mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and auditory verbal memory test (AVMT) of the two groups were compared, and the effects were evaluated.@*RESULTS@#After treatment, the PSQI sub-item scores and total scores of the two groups were lower than those before treatment ( P<0.05 ), and above scores in the acupuncture group were lower than those in the medication group ( P<0.05 ); the scores of MMSE, MoCA and AVMT in the two groups were higher than those before treatment ( P<0.05 ), and the scores in the acupuncture group were higher than those in the medication group ( P<0.05 ). The total effective rate of the acupuncture group was 80.0% (36/45), which was higher than 53.3% (24/45) in the medication group (P<0.05).@*CONCLUSION@#Syndrome differentiation acupuncture can improve the sleep quality and cognitive function of patients with chronic insomnia, and the curative effect is better than that of estazolam.


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/therapy , Estazolam , Acupuncture Therapy , Cognition , Acupuncture Points , Syndrome
7.
Chinese Acupuncture & Moxibustion ; (12): 1008-1013, 2023.
Article in Chinese | WPRIM | ID: wpr-1007434

ABSTRACT

OBJECTIVE@#To observe the effects of Tiaoshen (regulating the spirit) acupuncture on cognitive function and sleep quality in patients with primary insomnia (PI).@*METHODS@#Sixty patients with PI were randomly divided into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 2 cases dropped off, 1 case was excluded). The patients in the observation group were treated with acupuncture at Baihui (GV 20), Shenting (GV 24), Sishencong (EX-HN 1), and bilateral Benshen (GB 13), Shenmen (HT 7), Neiguan (PC 6), Sanyinjiao (SP 6). The patients in the control group were treated with shallow needling at non-effective points. Each treatment was provided for 30 min, once every other day, 3 treatments per week for 4 weeks. The Montreal cognitive assessment (MoCA), digit span test (DST), trail making test (TMT)-A, Pittsburgh sleep quality index (PSQI), and fatigue scale-14 (FS-14) were used to assess cognitive function and sleep quality before and after treatment, as well as in follow-up of 4-week after treatment completion. Correlation analysis was conducted between the differences in PSQI scores and differences in MoCA scores before and after treatment in the observation group.@*RESULTS@#Compared with before treatment, the total score, visuospatial and executive function score and delayed memory score of MoCA as well as DST backward score were increased (P<0.01), while TMT-A time, PSQI and FS-14 scores were significantly reduced (P<0.01) after treatment and in follow-up in the observation group. Compared with before treatment, the PSQI score in the control group was reduced (P<0.01, P<0.05). After treatment and in follow-up, the observation group had significantly higher total score, visuospatial and executive function score, delayed memory score of MoCA, and DST backward score compared to the control group (P<0.05, P<0.01). In the observation group, the TMT-A time was significantly shorter than that in the control group (P<0.05, P<0.01), and the PSQI and FS-14 scores were significantly lower than those in the control group (P<0.01). In the observation group, there was a negative correlation between the difference in PSQI scores (post-treatment minus pre-treatment) and the difference in MoCA scores (post-treatment minus pre-treatment) (r=-0.481, P<0.01). A similar negative correlation was found between the difference in PSQI scores (follow-up minus pre-treatment) and the difference in MoCA scores (follow-up minus pre-treatment) (r=-0.282, P<0.05).@*CONCLUSION@#Tiaoshen acupuncture could improve cognitive function, enhance sleep quality, and alleviate daytime fatigue in patients with PI. The improvement in cognitive function in patients with PI is correlated with the improvement in sleep quality.


Subject(s)
Humans , Pilot Projects , Sleep Initiation and Maintenance Disorders/therapy , Acupuncture Therapy , Cognition , Fatigue
8.
Chinese Acupuncture & Moxibustion ; (12): 955-958, 2023.
Article in Chinese | WPRIM | ID: wpr-1007425

ABSTRACT

Insomnia induced by mental retardation is related to the synergistic dysfunction of "shaoyang, sanjiao and haishi (the period of the day from 9 pm to 11 pm) " in pathogenesis. Based on "trinity theory of shaoyang, sanjiao and haishi ", the acupoints of hand and food shaoyang meridians on the head and face (Fengchi [GB 20], Sizhukong [TE 23] and Jiaosun [TE 20]) and those on the four limbs (Sanyangluo [TE 8], Zhongzhu [TE 3], Qiuxu [GB 40] and Xiaxi [GB 43]) are selected to regulate the pivot function of shaoyang. Front-mu and back-shu points (Sanjiaoshu [BL 22], Danzhong [CV 17] and Tianshu [ST 5]), as well as auricular points (Gan [CO12], Dan [CO11] and Sanjiao [CO17]) are chosen to promote qi circulation of shaoyang and sanjiao meridians. In association with the relevant knowledge of time acupuncture at haishi, the circadian rhythm of sleep is set up and the appropriate sleep pattern is developed.


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/therapy , Intellectual Disability , Acupuncture Therapy , Meridians , Acupuncture Points
9.
The Philippine Journal of Psychiatry ; : 54-2023.
Article in English | WPRIM | ID: wpr-1006499

ABSTRACT

Objective@#The aim of this study was to determine the comorbid sleep disorders on Polysomnography (PSG) of patients complaining of insomnia symptoms.@*Methodology@#This is a retrospective study among patients who underwent diagnostic and split-night polysomnography from April 2014 to February 2019. Those who had at least one of the following insomnia symptoms of difficulty initiating sleep, difficulty maintaining sleep and early morning awakening with or without a history of sleep aide use were identified as patients with insomnia. Polysomnography sleep parameters and outcome were tabulated and statistical analysis was done using SPSS v 20.0.@*Results@#Out of the 302 patients who were included in the study, 34.4% of subjects had a family history of sleep disorder and 70.4% had a history of sleep aide use. Among the medical comorbidities, 47.7% of the subjects were diagnosed with hypertension while 10.65% were diagnosed with psychiatric disorder. Most of the patients complained of both difficulty initiating sleep and early morning awakening. PSG sleep parameters showed that patients did not experience excessive daytime sleepiness or delayed sleep latency. On the other hand, poor sleep efficiency could be due to increased arousal index. Half of the patients turned out to have severe obstructive sleep apnea (52%) while 2.3% of the patients had periodic limb movement disorder. Among those diagnosed with severe OSA, 53.3% had a history of sleep aide use.@*Conclusion@#The study showed the importance of screening patients with insomnia for underlying comorbid sleep disorders. The American Academy of Sleep Medicine (AASM) treatment guidelines for chronic insomnia emphasized the need to have a high index of suspicion for this population in order to recommend diagnostic procedures such as polysomnography. Diagnosing a patient with insomnia to have an underlying sleep apnea and/or periodic limb movement disorder would change the course of management among patients with chronic insomnia and eventually avoid prescribing medications that could actually worsen the patient’s condition.


Subject(s)
Sleep Initiation and Maintenance Disorders , Sleep Wake Disorders , Polysomnography , Comorbidity
10.
Chinese Acupuncture & Moxibustion ; (12): 294-298, 2023.
Article in Chinese | WPRIM | ID: wpr-969987

ABSTRACT

OBJECTIVE@#To observe the clinical efficacy and safety of Jianpi Peiyuan acupoint thread embedding therapy on perimenopausal obesity (PMO).@*METHODS@#Ninety-six patients of PMO were randomly divided into an observation group (48 cases) and a control group (48 cases). The control group received health education and lifestyle intervention. On the basis of the treatment in the control group, the observation group was treated with acupoint thread embedding at the main acupoints of Shangwan (CV 13), Zhongwan (CV 12), Xiawan (CV 10), Yinlingquan (SP 9) and Fenglong (ST 40), etc. as well as the supplementary acupoints in accordance with the syndrome differentiation, once every 2 weeks for 8 weeks (4 times in total). The indexes of obesity (body mass index [BMI], waist circumference, hip circumference and body mass), modified Kupperman score, insomnia severity index (ISI) score, self-rating anxiety scale (SAS) score, and self-rating depression scale (SDS) score of the two groups were observed before and after treatment, and the safety was evaluated.@*RESULTS@#After treatment, BMI, waist circumference, hip circumference and body mass in the two groups were lower than before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). After treatment, Kupperman, ISI and SAS scores in the observation group were lower than before treatment (P<0.05), and ISI score in the control group was lower than before treatment (P<0.05). Kupperman, ISI and SAS scores in the observation group were lower than those in the control group (P<0.05). There was no significant difference in SDS between the two groups or within groups (P>0.05). No serious adverse reactions occurred during the experiment.@*CONCLUSION@#Jianpi Peiyuan acupoint thread embedding therapy can reduce the degree of obesity in PMO patients, and improve patients' the perimenopausal symptoms, insomnia and anxiety, with good safety.


Subject(s)
Humans , Acupuncture Points , Perimenopause , Sleep Initiation and Maintenance Disorders , Anxiety , Obesity
11.
Chinese Acupuncture & Moxibustion ; (12): 255-260, 2023.
Article in Chinese | WPRIM | ID: wpr-969980

ABSTRACT

OBJECTIVE@#To observe the effect of Shugan Tiaoshen acupuncture (acupuncture for soothing the liver and regulating the mentality) combined with western medication on depression and sleep quality in the patients with depression-insomnia comorbidity due to COVID-19 quarantine, and investigate the potential mechanism from the perspective of cortical excitability.@*METHODS@#Sixty patients with depression-insomnia comorbidity due to COVID-19 quarantine were randomly divided into an acupuncture group and a sham-acupuncture group, 30 cases in each one. The patients of both groups were treated with oral administration of sertraline hydrochloride tablets. In the acupuncture group, Shugan Tiaoshen acupuncture was supplemented. Body acupuncture was applied to Yintang (GV 24+), Baihui (GV 20), Hegu (LI 4), Zhaohai (KI 6), Qihai (CV 6), etc. The intradermal needling was used at Xin (CO15), Gan (CO12) and Shen (CO10). In the sham-acupuncture group, the sham-acupuncture was given at the same points as the acupuncture group. The compensatory treatment was provided at the end of follow-up for the patients in the sham-acupuncture group. In both groups, the treatment was given once every two days, 3 times a week, for consecutive 8 weeks. The self-rating depression scale (SDS) and insomnia severity index (ISI) scores were compared between the two groups before and after treatment and 1 month after the end of treatment (follow-up) separately. The cortical excitability indexes (resting motor threshold [rMT], motor evoked potential amplitude [MEP-A], cortical resting period [CSP]) and the level of serum 5-hydroxytryptamine (5-HT) were measured before and after treatment in the two groups.@*RESULTS@#After treatment and in follow-up, SDS and ISI scores were decreased in both groups compared with those before treatment (P<0.05), and the scores in the acupuncture group were lower than those in the sham-acupuncture group (P<0.05), and the decrease range in the acupuncture group after treatment was larger than that in the sham-acupuncture group (P<0.05). After treatment, rMT was reduced (P<0.05), while MEP-A and CSP were increased (P<0.05) in the acupuncture group compared with that before treatment. The levels of serum 5-HT in both groups were increased compared with those before treatment (P<0.05). The rMT in the acupuncture group was lower than that in the sham-acupuncture group, while MEP-A and CSP, as well as the level of serum 5-HT were higher in the acupuncture group in comparison with the sham-acupuncture group (P<0.05).@*CONCLUSION@#Shugan Tiaoshen acupuncture combined with western medication can relieve depression and improve sleep quality in the patients with depression-insomnia comorbidity due to COVID-19 quarantine, which is probably related to rectifying the imbalanced excitatory and inhibitory neuronal functions.


Subject(s)
Humans , Depression , Quarantine , Serotonin , Sleep Initiation and Maintenance Disorders , COVID-19 , Acupuncture Therapy , Comorbidity
12.
Asian Journal of Andrology ; (6): 421-425, 2023.
Article in English | WPRIM | ID: wpr-981940

ABSTRACT

Sleep has attracted extensive attention due to its significance in health. However, its association with erectile dysfunction (ED) is insufficiently investigated. To investigate the potential causal links between sleep traits (insomnia, sleep duration, and chronotype) and ED, this study was performed. The single-nucleotide polymorphisms (SNPs) associated with insomnia, sleep duration, and chronotype were retrieved from previous genome-wide association studies (GWAS). A conventional two-sample Mendelian randomization (MR) was used to estimate the causal links between sleep traits and ED. The summary statistics of ED were from individuals of European ancestry (6175 cases vs 217 630 controls). As shown by the random effect inverse-variance-weighting (IVW) estimator, genetically predicted insomnia was causally associated with a 1.15-fold risk of ED (95% confidence interval: 1.07-1.23, P < 0.001). Sleep duration and morningness were not causally associated with ED, as indicated by the IVW (all P > 0.05). These findings were consistent with the results of sensitivity analyses. Based on genetic data, this study provides causal evidence that genetically predicted insomnia increases the risk of ED, whereas sleep duration and chronotype do not.


Subject(s)
Male , Humans , Sleep Initiation and Maintenance Disorders/genetics , Genome-Wide Association Study , Erectile Dysfunction/genetics , Sleep/genetics , Phenotype , Polymorphism, Single Nucleotide
13.
China Journal of Chinese Materia Medica ; (24): 2620-2624, 2023.
Article in Chinese | WPRIM | ID: wpr-981365

ABSTRACT

Chaihu Jia Longgu Muli Decoction was firstly recorded in Treatise on Cold Damage(ZHANG Zhong-jing, Eastern Han dynasty). According to this medical classic, it is originally used in the treatment of the Shaoyang and Yangming syndrome. Based on the modern pathophysiological mechanism, this study interpreted the classic provisions of Chaihu Jia Longgu Muli Decoction. Original records of "chest fullness" "annoyance" "shock" "difficult urination" "delirium" "heavy body and failing to turn over" all have profound pathophysiological basis, involving disorders in cardiovascular, respiratory, nervous, and mental systems. This formula is widely used, which can be applied to treat epilepsy, cerebral arteriosclerosis, cerebral infarction, and other cerebrovascular diseases, hypertension, arrhythmia, and other cardiovascular diseases, insomnia, constipation, anxiety, depression, cardiac neurosis and other acute and chronic diseases as well as diseases in psychosomatic medicine. The clinical indications include Bupleuri Radix-targeted syndrome such as fullness and discomfort in chest and hypochondrium, bitter taste mouth, dry throat, and dizziness, the insomnia, anxiety, depression, susceptibility to fright, upset, dreamfulness and other psychiatric symptoms, red tongue, thick and yellow tongue coating, and wiry hard and powerful pulse. This formula was found to be used in combination with other formulas, such as Gualou Xiebai Decoction, Wendan Decoction, Zhizhu Pills, Juzhijiang Decoction, Suanzaoren Decoction, and Banxia Baizhu Tianma Decoction.


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/drug therapy , Drugs, Chinese Herbal/therapeutic use , Hypertension/drug therapy , Syndrome , Arrhythmias, Cardiac/drug therapy , Medicine, Chinese Traditional
14.
Chinese Acupuncture & Moxibustion ; (12): 809-812, 2023.
Article in Chinese | WPRIM | ID: wpr-980799

ABSTRACT

The paper summarizes professor ZHANG Wei-hua's clinical experience in treatment of insomnia with Zhenjing Anshen (calming-down the spirit) method. It is believed that insomnia results from the unstable spirit in pathogenesis of TCM. The basic therapeutic principle is regulating the spirit, in which, stabilizing the primary spirit and tranquilizing the heart spirit are emphasized. Main acupoints are Baihui (GV 20), Sishencong (EX-HN 1) and Yintang (GV 24+) to stabilize the primary spirit, located on the head; and Shenmen (HT 7) located on the wrist to calm-down the heart spirit, as well as Sanyinjiao (SP 6) and Yongquan (KI 1) in the lower extremities to benefit yin and balance yang, and then to house the spirit eventually. The needles are inserted in different depths and to various directions. The external application of herbal plaster is combined at Yongquan (KI 1) and the supplementary acupoints are selected in terms of syndrome differentiation. This therapy is simple in acupoint selection and very effective in treatment of insomnia.


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/therapy , Acupuncture Points , Emotions , Heart , Lower Extremity
15.
Chinese Acupuncture & Moxibustion ; (12): 634-638, 2023.
Article in Chinese | WPRIM | ID: wpr-980772

ABSTRACT

OBJECTIVE@#To observe the clinical efficacy of Bushen Anshen acupuncture (acupuncture for tonifying kidney and calming spirit ) in treating perimenopausal insomnia (PMI) of kidney-yin deficiency.@*METHODS@#A total of 72 patients with PMI of kidney-yin deficiency were randomized into an observation group (36 cases, 1 case dropped off) and a control group (36 cases, 1 case dropped off). Acupuncture was applied at Baihui (GV 20) and bilateral Shenshu (BL 23), Taixi (KI 3), Anmian (Extra) in the observation group, while sham acupuncture of shallow needling at non-acupoints was applied in the control group. The treatment was required once every other day, 3 times a week for 10 times in the two groups. Before and after treatment, Pittsburgh sleep quality index (PSQI) was used to evaluate the subjective sleep quality, and polysomnography (PSG) was used to monitor the objective sleep quality in the two groups.@*RESULTS@#After treatment, the scores of sleep quality, sleep latency, sleep duration, sleep efficiency, hypnotic, daytime dysfunction and total score of PSQI were decreased compared with those before treatment in the observation group (P<0.01), the scores of sleep duration, sleep efficiency and total score of PSQI were decreased compared with those before treatment in the control group (P<0.05); the scores of sleep quality, sleep latency, sleep efficiency, hypnotic and total score of PSQI in the observation group were lower than those in the control group (P<0.05). After treatment, the sleep time was prolonged, the sleep efficiency was improved, the sleep latency and the awake time after falling asleep were shortened, the arousal awake index was reduced (P<0.01) when PSG indexes were monitored, and the percentage of non-rapid eye movement sleep period 1 (N1%) was decreased while the percentage of non-rapid eye movement sleep period 3 (N3%) was increased (P<0.05) compared with those before treatment in the observation group; there was no statistical difference in the PSG indexes compared with those before treatment in the control group (P>0.05). After treatment, compared with the control group, the sleep time was prolonged, the sleep efficiency was improved, the sleep latency and the awake time after falling asleep were shortened, the arousal awake index and N1% were decreased in the observation group (P<0.01).@*CONCLUSION@#Bushen Anshen acupuncture can effectively improve the subjective and objective sleep quality in PMI patients of kidney-yin deficiency.


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/therapy , Perimenopause , Yin Deficiency , Acupuncture Therapy , Kidney , Hypnotics and Sedatives
16.
Chinese Acupuncture & Moxibustion ; (12): 629-633, 2023.
Article in Chinese | WPRIM | ID: wpr-980771

ABSTRACT

OBJECTIVE@#To observe the effects of acupuncture at "umbilical four-acupoints" on chronic insomnia and its comorbid symptoms.@*METHODS@#A total of 120 patients with chronic insomnia were randomly divided into an observation group (60 cases, 8 cases dropped off) and a control group (60 cases, 5 cases dropped off). The patients in the observation group were treated with acupuncture at regular acupoints (Baihui [GV 20] and bilateral Shenmen [HT 7], Neiguan [PC 6], Anmian [Extra]) and "umbilical four-acupoints", while the patients in the control group were treated with acupuncture at regular acupoints. Acupuncture was given once a day, 6 times a week, for a total of 3 weeks in the two groups. The Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI) scores were observed before treatment, after treatment and in follow-up of one month after treatment completion; the Beck anxiety inventory (BAI), Beck depression inventory (BDI), fatigue severity scale (FSS), and Epworth sleepiness scale (ESS) scores were observed before and after treatment; the sleep parameters of polysomnography (PSG), including sleep latency (SL), awake-up time (AT), sleep efficiency (SE) and total sleep time (TST), were observed before and after treatment using polysomnography monitor in the two groups.@*RESULTS@#Compared with those before treatment, the PSQI and ISI scores in both groups were reduced after treatment and in follow-up (P<0.05), and the PSQI and ISI scores in the observation group were lower than those in the control group after treatment and in follow-up (P<0.05). Compared with those before treatment, the BAI, BDI, FSS and ESS scores in both groups were reduced after treatment (P<0.05), and the BAI, BDI, FSS and ESS scores in the observation group were lower than those in the control group after treatment (P<0.05). Compared with those before treatment, the SL and AT in both groups were reduced after treatment (P<0.05), while SE and TST were increased after treatment (P<0.05); after treatment, the SL and AT in the observation group were lower than those in the control group (P<0.05), while SE and TST in the observation group were higher than those in the control group (P<0.05).@*CONCLUSION@#On the basis of regular acupoint selection, acupuncture at "umbilical four-acupoints" could improve sleep quality, alleviate the severity of insomnia, and improve the comorbid symptoms i.e. anxiety, depression, fatigue and lethargy in patients with chronic insomnia.


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/therapy , Acupuncture Points , Acupuncture Therapy , Sleep , Fatigue
17.
Chinese Acupuncture & Moxibustion ; (12): 374-378, 2023.
Article in Chinese | WPRIM | ID: wpr-980731

ABSTRACT

OBJECTIVE@#To observe the impacts of acupuncture on depressive mood and sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia, and explore its effect mechanism.@*METHODS@#A total of 60 patients with comorbid mild-to-moderate depressive disorder and insomnia were randomly divided into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 2 cases dropped off). In the observation group, acupuncture and low frequency repeated transcranial magnetic stimulation (rTMS) were combined for the intervention. Acupuncture was applied to Baihui (GV 20), Yintang (GV 24+), Neiguan (PC 6) and Yanglingquan (GB 34), etc., the needles were retained for 30 min; and the intradermal needles were embedded at Xinshu (BL 15) and Danshu (BL 19) for 2 days. After acupuncture, the rTMS was delivered at the right dorsolateral prefrontal cortex (R-DLPFC), with 1 Hz and 80% of movement threshold, lasting 30 min in each treatment. In the control group, the sham-acupuncture was adopted, combined with low frequency rTMS. The acupoint selection and manipulation were the same as the observation group. In the two groups, acupuncture was given once every two days, 3 times weekly; while, rTMS was operated once daily, for consecutive 5 days a week. The duration of treatment consisted of 4 weeks. Hamilton depression scale-17 (HAMD-17) and Pittsburgh sleep quality index (PSQI) scores were observed before and after treatment, as well as 1 month after the treatment completion (follow-up period) separately. Besides, the levels of nerve growth factor (BDNF) and γ-aminobutyric acid (GABA) in the serum were detected before and after treatment in the two groups.@*RESULTS@#After treatment and in follow-up, the HAMD-17 scores were lower than those before treatment in the two groups (P<0.05), and the scores in the observation group were lower than the control group (P<0.05). After treatment, the total scores and the scores of each factor of PSQI were reduced in the two groups in comparison with those before treatment except for the score of sleep efficiency in the control group (P<0.05); the total PSQI score and the scores for sleep quality, sleep latency, sleep efficiency and daytime dysfunction in the observation group were all lower than those in the control group (P<0.05). In the follow-up, except for the scores of sleep duration and sleep efficiency in the control group, the total PSQI score and the scores of all the other factors were reduced compared with those before treatment in the two groups (P<0.05); the total PSQI score and the scores of sleep quality, sleep latency, sleep duration, sleep efficiency and daytime dysfunction in the observation group were lower than the control group (P<0.05). After treatment, the levels of serum BDNF and GABA were increased in comparison with those before treatment in the observation group (P<0.05), and the level of serum BDNF was higher than that in the control group (P<0.05).@*CONCLUSION@#Acupuncture relieves depressive mood and improves sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia. The effect mechanism may be related to the regulation of BDNF and GABA levels and the promotion of brain neurological function recovery.


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/therapy , Transcranial Magnetic Stimulation , Brain-Derived Neurotrophic Factor , Treatment Outcome , Acupuncture Therapy , Acupuncture Points , gamma-Aminobutyric Acid , Depressive Disorder
18.
Journal of Central South University(Medical Sciences) ; (12): 114-122, 2023.
Article in English | WPRIM | ID: wpr-971376

ABSTRACT

OBJECTIVES@#The use of anticholinergic drugs in the elderly may lead to negative events such as falls, delirium, urinary retention and cognitive decline, and the higher the number of anticholinergic drugs use, the more such negative events occur. This study aims to analyze the risk factors associated with the prescription of total anticholinergic drugs in elderly outpatients and evaluate the rationality of anticholinergic drugs, and to provide a reference for reducing the adverse effects of anticholinergic drugs.@*METHODS@#A list of drugs with anticholinergic activity based on the Beers criteria was established. The basic information (such as age and gender), clinical diagnosis, and medications of elderly outpatient were extracted from hospital electronic medical records, and the Anticholinergic Cognitive Burden (ACB) Scale was used to calculate the anticholinergic burden for each patient. Logistic regression analysis was used to identify the potential risk factors for the occurrence of problems such as multiple medication and insomnia.@*RESULTS@#A total of 1 840 prescriptions for elderly patients were reviewed. Of these patients, ACB score was more than or equal to 1 in 648 (35.22%) patients. Number of prescription medication (95% CI: 1.221 to 1.336) and insomnia (95% CI: 3.538 to 6.089) were independent factors affecting ACB scores (both P<0.01). Medications for patients of ACB scores were most commonly treated with the central nervous system drugs (such as alprazolam and eszopiclone) and for the cardiovascular system drugs (such as metoprolol and nifedipine).@*CONCLUSIONS@#There is a high rate of ACB drugs use in geriatric patients, and the clinical focus should be on multiple medication prescriptions, especially on the central nervous system drugs (such as alprazolam and eszopiclone) and cardiovascular system drugs (such as metoprolol and nifedipine). The prescription review should be emphasized to reduce adverse reactions to anticholinergic drugs in elderly patients.


Subject(s)
Humans , Aged , Cholinergic Antagonists/adverse effects , Outpatients , Metoprolol , Alprazolam , Eszopiclone , Nifedipine , Sleep Initiation and Maintenance Disorders , Risk Factors
19.
Journal of Central South University(Medical Sciences) ; (12): 92-105, 2023.
Article in English | WPRIM | ID: wpr-971374

ABSTRACT

OBJECTIVES@#Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model.@*METHODS@#The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention.@*RESULTS@#The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful.@*CONCLUSIONS@#Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.


Subject(s)
Humans , COVID-19 , Sleep Initiation and Maintenance Disorders , Crisis Intervention , Psychosocial Intervention , SARS-CoV-2 , Mental Health , Depression/epidemiology , Health Personnel/psychology , Anxiety/etiology
20.
Chinese Journal of Preventive Medicine ; (12): 522-527, 2023.
Article in Chinese | WPRIM | ID: wpr-984767

ABSTRACT

Objective: To analyze the association between sleep duration and cognitive function of the elderly in six provinces of China. Methods: Based on the cross-sectional survey data of the elderly from the Healthy Ageing Assessment Cohort Study in 2019, 4 644 participants' sociodemographic and economic indicators, lifestyle, prevalence of major chronic diseases, and sleep status, including night-time sleep duration, daytime sleep duration and insomnia, were collected by questionnaires. Cognitive function was evaluated by the Mini-Mental State Examination. Multivariate logistic regression was used to analyze the association between night-time sleep duration, daytime sleep duration and cognitive function. Results: The mean age of 4 644 respondents was (72.3±5.7) years, and 2 111 of them were males (45.5%). The mean total daily sleep time of the elderly was (7.9±1.9) hours, and the proportion of those who slept less than 7.0, 7.0-8.9 and≥9.0 hours was 24.1% (1 119), 42.1% (1 954) and 33.8% (1 571), respectively. The mean sleep time at night was (6.9±1.7) hours. About 23.7% (1 102) of the elderly did not sleep during the day, and the mean duration of the elderly who slept during the day was (78±51) minutes. Among the elderly with insomnia, 47.9% were still satisfied with their sleep quality. The mean value of MMSE score of 4 644 respondents was (24.5±5.3), and the cognitive impairment rate was 28.3% (1 316). The results of multivariate logistic regression model analysis showed that the OR (95%CI) value of the risk of cognitive impairment in older people who did not sleep, slept for 31 to 60 minutes and slept more than one hour was 1.473 (1.139 to 1.904), 1.277 (1.001 to 1.629) and 1.496 (1.160 to 1.928), respectively, compared with those who slept for 1 to 30 minutes during the daytime. Compared with those who slept for 7.0‒8.9 hours at night, the OR (95%CI) value of the risk of cognitive impairment in older people who slept more than 9.0 hours was 1.239 (1.011 to 1.519). Conclusion: The cognitive function is related to sleep duration in the Chinese elderly.


Subject(s)
Male , Humans , Aged , Female , Sleep Initiation and Maintenance Disorders/complications , Cross-Sectional Studies , Cohort Studies , Sleep , Sleep Wake Disorders , Cognition , China/epidemiology
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