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991.
992.
Purpose of the researchTo attempt to replicate the associations found in our previous study of patients and family caregivers between interleukin 6 (IL6) and nuclear factor kappa beta 2 (NFKB2) and sleep disturbance and to identify additional genetic associations in a larger sample of patients with breast cancer.Methods and samplePatients with breast cancer (n = 398) were recruited prior to surgery and followed for six months. Patients completed a self-report measure of sleep disturbance and provided a blood sample for genomic analyses. Growth mixture modeling was used to identify distinct latent classes of patients with higher and lower levels of sleep disturbance.Key resultsPatients who were younger and who had higher comorbidity and lower functional status were more likely to be in the high sustained sleep disturbance class. Variations in three cytokine genes (i.e., IL1 receptor 2 (IL1R2), IL13, NFKB2) predicted latent class membership.ConclusionsPolymorphisms in cytokine genes may partially explain inter-individual variability in sleep disturbance. Determination of high risk phenotypes and associated molecular markers may allow for earlier identification of patients at higher risk for developing sleep disturbance and lead to the development of more targeted clinical interventions.  相似文献   
993.
失眠是临床最常见的疾病和症状之一。失眠的临床诊治过程中,如何能够在较短的时间内,通过问诊较为准确地把握失眠的发生发展过程,找到失眠的发病机制及其规律?通过笔者的临床经验总结失眠的心理问诊内容对于提高临床疗效和诊疗的效率有十分重要的意义。  相似文献   
994.
Objective: To assess the effects of tinnitus treatments on sleep disorders in patients with tinnitus. Design: Subjects completed the Pittsburg Sleep Quality Index (PSQI), Tinnitus Handicap Inventory (THI), Self-rating Depression Scale (SDS), and State Trait Anxiety Inventory (STAI). The questionnaire results and the patients’ sex, age, time since the onset of tinnitus, and mean hearing level were examined, and differences between a sleep disorder group and a normal sleep group were examined. Patients completed the questionnaires again after initiating tinnitus treatments (counselling and use of sound generators), and the change in questionnaire scores at follow-up was evaluated. Study sample: Patients (N?=?100) with tinnitus who visited Keio University Hospital and started treatment without medication between 2005 and 2008. Results: Sixty-six percent of the patients had sleep disorders. Compared with patients without sleep disorders, patients with sleep disorders had significantly higher SDS and STAI scores at the first visit. The mean PSQI scores showed significant improvement at follow-up. Conclusions: Sleep disorders in patients with tinnitus improved after tinnitus treatments. Complex interactions between depressive symptoms and anxiety may occur in these patients. The improvement in sleep disorders at follow-up was correlated with improvements in tinnitus severity and state anxiety.  相似文献   
995.
《Sleep medicine》2013,14(9):814-823
ObjectiveWe aimed to evaluate frequency and co-occurrence of insomnia and sleep-disordered breathing (SDB) symptoms and potential co-morbidity (complex insomnia).MethodsA prospective self-assessment was conducted for adult patients with no prior sleep issues who presented to community-based primary care clinics for nonsleep-related complaints between November 2009 and June 2012.ResultsA brief sleep health survey (SHS) assessed insomnia and SDB symptoms. Of 801 patients, 660 (82.4%) reported at least one insomnia symptom, and 289 (36.1%) reported an insomnia disorder (Insomnia Severity Index [ISI] >7 and self-reported daytime impairment due to insomnia). At least one SDB symptom was reported by 478 (59.7%) patients, and 177 (22.1%) reported two or more symptoms. Co-occurrence of insomnia and SDB symptoms (minimum of one symptom each of insomnia and SDB) occurred in 50.8% of the sample. Using liberal criteria to assess potential co-morbid disorders (complex insomnia), 187 (23.4%) patients reported an insomnia disorder and at least one SDB symptom. With more stringent criteria, including only those patients with moderate or severe insomnia disorders plus two SDB symptoms, 48 patients (6.0% of the sample or 16.6% of all patients with insomnia disorders) indicated potential complex insomnia.ConclusionsCo-occurrence of insomnia and SDB symptoms as well as the rate of potential complex insomnia was common among a moderately large sample of primary care patients without prior evaluations or diagnoses of sleep disorders. Clinical and research implications are discussed.  相似文献   
996.
《Sleep medicine》2013,14(9):877-882
ObjectiveWe aimed to investigate the relationship between alcohol consumption and sleep problems among Hong Kong adolescents.MethodsIn the 2006 and 2007 Hong Kong Student Obesity Surveillance project, 33,692 secondary students completed an anonymous questionnaire on lifestyles and health. Alcohol consumption was categorized as nondrinkers (reference group), those who drank less than 1 day per week (less than weekly drinkers), and those who drank 1 to 7 days per week (weekly drinkers, including some daily drinkers). Students reported if they had any sleep problems in the past 30 days, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), snoring, and difficulty breathing during sleep (DBS). Insomnia was defined as any reports of DIS, DMS, or EMA. Logistic regression was used to assess the association between alcohol and each sleep problem. Multiple imputations were used to impute missing data.ResultsCompared with nondrinkers, less than weekly and weekly drinkers were more likely to report snoring with adjusted odds ratios (AOR) of 1.64 (95% confidence interval [CI], 1.40–1.92) and 1.82 (95% CI, 1.55–2.14), respectively (P < .001). The corresponding figures were 1.24 (95% CI, 1.02–1.50) and 1.50 (95% CI, 1.24–1.82) for DBS (P < .001) and 1.12 (95% CI, 1.02–1.22) and 1.15 (95% CI, 1.04–1.27) for insomnia (P = .002). Weekly drinking was positively associated with DMS but negatively associated with DIS and EMA. Less than weekly drinking was positively associated with DIS, DMS, and EMA.ConclusionsBoth less than weekly drinking and weekly drinking were associated with snoring, DBS, and insomnia. The association of individual symptoms of insomnia with drinking varied with the frequency of consumption.  相似文献   
997.
BackgroundThe association between sleep disorders and other non-motor symptoms (NMS) in Parkinson's disease (PD) has been scarcely investigated.ObjectiveTo describe the prevalence of insomnia and hypersomnia in PD and analyze their relationship with other NMS.MethodsCross-sectional, multicenter study including 388 PD patients evaluated with Hoehn and Yahr, Clinical Impression of Severity Index for PD, Scales for Outcomes in Parkinson's Disease (SCOPA)-Sleep(S), SCOPA-Cognition, SCOPA-Psychiatric Complications, SCOPA-Autonomic, Hospital Anxiety and Depression Scale, and fatigue and pain visual analogue scales. Spearman correlation coefficients, Mann–Whitney test and multiple linear regression analysis were applied.ResultsMean age (54% male) was 65.9 ± 11.2 years old, with disease duration of 8.1 ± 6.0 years and median HY = 2 (range: 1–5). Mean SCOPA-S nocturnal sleep (NS) was 5.4 ± 4.0 (range: 0–15), daytime sleepiness (DS) was 3.76 ± 3.04 (range: 0–15). Most of the sample declared nocturnal or daytime sleep problems (87.4%). Weak-to-moderate correlations were found between sleep disturbances and other NMS (range: 0.14–0.37). SCOPA-S subscales showed higher scores with the presence of most other NMS such as psychiatric complications and autonomic dysfunctions (p < 0.05). Regression models showed that fatigue, depression, urinary, cardiovascular, and thermoregulatory dysfunctions were significant determinants of SCOPA-NS score (variance: 23%); cognitive impairment, urinary, cardiovascular, and pupillomotor disorders influenced SCOPA-DS score (variance: 14%).ConclusionsInsomnia and daytime sleepiness are extremely prevalent in PD. Depression, fatigue, cognitive impairment, cardiovascular, urinary and thermoregulatory dysfunctions may contribute to insomnia/hypersomnia. This is the first clinical study to relate cardiovascular and thermoregulatory dysfunctions with sleep in PD.  相似文献   
998.
IntroductionSleep is considered as a major protective factor for good health and quality of life. The epidemiology of chronic insomnia and other sleep disorders has recently been developed in France. The aim of this study was to evaluate total sleep time and the prevalence of chronic insomnia in the general population aged 15 to 85 years. It was also to investigate factors associated with sleep disorders.MethodsWithin the framework of the Health Barometer 2010, a French general population survey, 27,653 15 to 85-year-old individuals were questioned about their health behaviors and attitudes, in particular about their sleeping time and habits.ResultsThe average sleeping time of the 15 to 85-year-old was 7 hours 13 minutes. It was higher for women than for men (7 hours 18 minutes vs 7 hours 07 minutes; P < 0.001), whereas 15.8 % of the population presented criteria for chronic insomnia, 19.3 % of women and 11.9 % of men (P < 0.001). The prevalence of chronic insomnia was stable with age among women, around 19 %, whereas it increased for men from 3 % in the 15–19-year age range to 18 % in the 45–54-year age range, before decreasing to 8 % beyond 65 years. Chronic insomnia was also found to be related to precarious situations and to several difficult events of life such as violence or chronic alcohol abuse, whereas the relationship observed with tobacco smoking was no longer found after logistic regression adjustment for socio-demographic characteristics. Since the beginning of 1990s, a single-question inquiry on “sleeping problems present during the last 8 days” has been asked in the Health Barometer. The rate of subjects concerned increased from 1995, with a prevalence stabilized at a high level since 2000.ConclusionsBased on these data, we think that the surveillance of sleep disorders is an important public health issue and that prevention and health educational initiatives should be launched in the general population to promote a better quality of sleep.  相似文献   
999.
目的比较佐匹克隆与艾司唑仑治疗老年失眠症的疗效与不良反应比较。方法对96例老年失眠症患者,随机分为佐匹克隆组(48例)与艾司唑仑组(48例),疗程2周。采用睡眠状况问卷自评量表(SRSS)于治疗前后评定临床疗效,用治疗中出现的症状量表(TESS)评定不良反应。结果两组均有显著疗效,无显著性差异(P>0.05)。SRSS评分较治疗前显著降低(P<0.01)。两组TESS评分的比较有显著性差异(P<0.01)。结论佐匹克隆在治疗失眠症方面与艾司唑仑疗效相当,但副作用小、安全性好,是一种有效、耐受性好的治疗失眠症的药物。  相似文献   
1000.
Sleep disturbance and excessive daytime sleepiness have been reported in patients with hepatic cirrhosis. The objective of this study was to evaluate daytime somnolence and sleep complaints in a group of 178 patients with cirrhosis compared to a control group. Sleep features and excessive daytime sleepiness were evaluated by the Basic Nordic Sleep Questionnaire (BNSQ) and the Epworth Sleepiness Scale (ESS). We collected clinical and laboratory data, neurological assessment and EEG recordings in cirrhotic patients. Patients with cirrhosis complained of more daytime sleepiness (p<0.005), sleeping badly at least three times a week (p<0.005), difficulties falling asleep (p<0.01) and frequent nocturnal awakening (p<0.005) than controls. We found a poor correlation between sleep disorders and clinical or laboratory parameters. Our results confirm previous literature reports suggesting a high prevalence of sleep disturbance in patients with cirrhosis. Insomnia and daytime sleepiness are the main complaints. Sleep disorders are probably a multifactorial phenomenon.  相似文献   
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