A meta-analysis of imagery rehearsal for post-trauma nightmares: Effects on nightmare frequency, sleep quality, and posttraumatic stress

This meta-analysis evaluates the efficacy of imagery rehearsal as a treatment for nightmares, general sleep disturbance, and symptoms of post-traumatic stress. Bibliographic databases and cited references were searched to identify clinical trials of imagery rehearsal in individuals with post-trauma nightmares. Thirteen studies met inclusion criteria and reported sleep and post-traumatic stress outcomes in sufficient detail to calculate effect sizes. Results indicate that imagery rehearsal had large effects on nightmare frequency, sleep quality, and PTSD symptoms from the initial to post-treatment assessments. These effects were sustained through 6 to 12months follow-up. Furthermore, interventions that included both imagery rehearsal and cognitive behavioral therapy for insomnia resulted in greater treatment-related improvement in sleep quality than imagery rehearsal alone. Combined treatment did not improve outcomes for PTSD or nightmares. Notably, effect sizes were small in the single study that included an active-treatment control condition. Future research should identify necessary and sufficient components of interventions for trauma-related sleep disturbance and post-traumatic stress (e.g., exposure, cognitive reappraisal, sleep and circadian regulation).     

A survey assessing sleep efficiency among Saudis during COVID-19 home confinement using the Pittsburgh sleep quality index: A call for health education

The COVID-19 pandemic has introduced uncertainties that have disrupted regular routines. Sleep may be adversely affected by stressful circumstances that jeopardize general health. Hence, the impact of home confinement on the sleep efficiency of the general population was assessed.An online survey was conducted by using the Pittsburgh sleep quality index (PSQI) to assess sleep duration, sleep efficiency, latency to fall asleep, and global PSQI score. Questions pertaining to demography, home confinement, and anxiety were included. Data was collected from the residents of the Southwestern region from April 15, 2020 to May 15, 2020. Data were analyzed through bivariate, multivariate logistic regression, and independent t tests.A total of 593 subjects responded to the survey. Males (OR 1.92 [1.3–2.7], p < 0.001), and subjects aged ≥51 years (OR 2.49 [1.3–4.4], p = 0.002) were more likely to be poor sleepers (<6 h). In hypertensive subjects, inadequate sleep was twice as high (OR 2.2 [1.1–4.4], p < 0.05) than other comorbidities. Males were less likely to have sleep latency (OR 0.58 [0.40–0.86], p = 0.005) but smoking increased the latency of falling asleep (OR 2.41 [1.47–4.0], p < 0.001). Sleep duration was significantly influenced by home confinement (p = 0.002), whereas sleep duration (p = 0.001), latency (p = 0.018), sleep efficiency (p = 0.005), and global PSQI scores (p = 0.005) were significantly affected by anxiety.In the southwestern region, we found sleep influenced by anxiety about COVID-19. Community pharmacists are the most accessible health care professionals and could play a pivotal role in educating the lay public on the importance of sleep hygiene through posters displayed in pharmacies and with the help of public education material.     

补肾益髓方对复发缓解型多发性硬化患者睡眠及生命质量的影响

目的:研究补肾益髓方对复发缓解型多发性硬化患者生命质量的影响。方法:选取2015年1月至2016年12月首都医科大学附属北京天坛医院收治的复发缓解型多发性硬化患者作为观察组（n＝30）,选取健康志愿者作为对照组（n＝10）,观察组口服补肾益髓方,治疗半年,治疗前后测疲劳量表(Fatigue Scale-14)、匹兹堡睡眠质量指数量表(PSQI)和多发性硬化生命质量问卷(MSQOL-54)。结果:与对照组比较,观察组Fatigue Scale-14得分显著升高(P<0.01),MSQOL-54显著降低(P<0.01),PSQI中的入睡时间得分、睡眠效率得分、睡眠障碍得分、日间障碍得分和总得分显著升高(P<0.05)。与本组治疗前比较,观察组治疗后Fatigue Scale-14降低(P<0.05),MSQOL-54升高(P<0.05),PSQI降低,但差异无统计学意义。结论:复发缓解型多发性硬化患者服用补肾益髓方后,生命质量提高。     

Poorer sleep quality among adult patients with pectus excavatum in Taiwan: A pilot study

Objectives

Patients with pectus excavatum have a poorer quality of life than the general population. Sleep quality is a critical component of quality of life. This pilot study compared the sleep quality of adult patients with pectus excavatum with that of the general population in Taiwan.

舒眠胶囊治疗失眠症疗效观察及对PSQI的影响

目的:观察舒眠胶囊治疗失眠症的临床疗效。方法:将86例失眠症患者随机分为对照组和观察组,每组43例;对照组给予艾司唑仑治疗,观察组给予舒眠胶囊治疗,2组均连续治疗4周,观察比较2组临床疗效及不良反应情况,并采用匹兹堡睡眠质量指数(PSQI)评分评价其睡眠质量。结果:总有效率观察组为97.67%,对照组为83.73%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组PSQI评分均较治疗前明显下降(P<0.05),且观察组PSQI评分明显低于对照组(P<0.05)。不良反应率治疗组为4.65%,对照组为13.95%,2组比较,差异有统计学意义(P<0.05)。结论:舒眠胶囊治疗失眠症疗效确切,可显著改善患者睡眠质量,且用药安全性良好,值得临床推广应用。     

Social timing influences sleep quality in patients with sleep disorders

ObjectivesWe aimed to compare three variants of the Pittsburgh Sleep Quality Index (PSQI usual, work- and work-free days: PSQI_u, PSQI_w, PSQI_f) and to assess whether chronotype (MSF_sc)/social jetlag (SJL) are associated with sleep quality in patients with sleep disorders (SD).MethodsIn sum, 431 SD patients and 338 subjects from the general population (GP) were included. Participants filled in three variants of the PSQI and the Munich ChronoType Questionnaire (MCTQ). We used Generalized Estimating Equations (GEE) to investigate effects of group (GP, SD), PSQI (usual, work or free) and their interaction (group1PSQI) on scores. To investigate associations between MSF_sc/SJL and the difference between PSQI_w and PSQI_f (PSQI_diff) in patients with SD we used linear regressions (N = 352). We used Sobel to test whether there was a mediation effect of SJL on the association between MSF_sc and PSQI_diff.ResultsPSQI scores differed between groups (p < 0.001). Post-hoc analysis revealed a significant difference between PSQI_u vs. PSQI_f and PSQI_w vs. PSQI_f with PSQI_f presenting lower scores, while PSQI_u vs. PSQI_w did not differ in any group. In line with previous findings, SJL was associated to PSQI_diff in SD patients.ConclusionsPSQI_u mainly represents sleep quality on workdays also in SD patients. Being a late chronotype seems to be associated with higher differences in sleep quality on work-vs. free days mostly when it coincides with societal time constraints. Since sleep quality is poorer on workdays even in SD patients, we suggest that treatment strategies should address social aspects affecting sleep, including ways of minimizing SJL.     

针药结合治疗老年性失眠:随机对照研究

目的:比较西药、针刺和西药结合针刺3种方法治疗老年性失眠的疗效差异.方法:将98例老年性失眠患者随机分为西药组30例、针刺组33例、针药组35例.西药纽予舒乐安定1 mg,每晚睡前30 min服用,口服谷维素20 mg,每日3次,共治疗4周;针刺组采用单纯针刺治疗,取穴神门、安阴交、安眠、百会、四神聪,并配合辨证取穴,每日1次,每周治疗5天,共治疗4周;针药组采用西药结合针刺治疗,西药给药量与服用方法同西药组,针刺取穴及治疗方法同针刺组,3组均治疗4周.观察3组于治疗前、治疗4周后及停止治疗4周后匹兹堡睡眠质量指数(PSQI)和临床疗效.结果:治疗4周后西药组、针刺组和针药组的临床治愈率分别为3.3％(1/30)、21.2％(7/33)和25.7％(9/35),3组的总有效率分别为70.0％(21/30)、93.9％(31/33)和97.1％(34/35),针药组和针刺组的临床治愈率和总有效率均高于西药组(均P＜0.01);治疗4周后3组PSQI评分与治疗前比较均有改善(均P＜0.05),针药组和针刺组PSQI评分均低于西药组,差异具有统计学意义(均P＜0.05);停止治疗4周后,针刺、针药组均疗效平稳,PSQI评分与治疗第4周时比较无变化,而西药组出现反复,PSQI评分接近治疗前水平(P＞0.05).治疗过程中西药组少数患者出现口干,其他两组未见不良反应.结论:针药结合治疗老年性失眠症,起效快,能迅速改善症状,临床治愈率和总有效率较高,且远期疗效较西药好,是3种治疗方法中之首选.     

重复经颅磁刺激治疗广泛性焦虑障碍对照研究

目的：探讨重复经颅磁刺激治疗广泛性焦虑障碍患者的疗效和安全性。方法将60例广泛性焦虑障碍患者随机分为两组,研究组予以重复经颅磁刺激,同时口服复合维生素片治疗,对照组口服丁螺环酮治疗,同时予以经颅磁假刺激,观察4周。于治疗前后采用汉密顿焦虑量表、焦虑自评量表、匹兹堡睡眠质量指数量表评定临床疗效,随时记录治疗过程中出现的不良反应。结果治疗各时点两组各量表评分均较治疗前显著下降（P＜0.01）,同期两组间评分比较差异均无显著性（ P＞0.05）;治疗过程中两组均未出现严重不良反应。结论重复经颅磁刺激治疗广泛性焦虑障碍疗效显著,与丁螺环酮相当,治疗安全性高,依从性好。     

某部2013年新兵睡眠质量及相关因素分析

目的了解某部2013年新兵的睡眠质量状况。方法采用自制的新兵心理卫生调查问卷及匹兹堡睡眠质量指数量表（PSQI）对某部200名2013年新兵进行调查测试。结果2013年新兵的睡眠质量异常检出率为17．01％,高于正常男性群体和2010年新兵（P=0．001）;2013年新兵的主观睡眠质量（SSQ）、入睡潜伏时间（sL）、睡眠干扰因素（Sdi）、应用催眠药物（USM）、白天功能障碍（DD）分值及PSQI总分均高于正常男性群体（P〈0．05,P〈0．01）;睡眠效率（HSE）低于正常男性群体（P〈0．05）,2013年新兵的SL、HSE、Sdi．及PSQI总分高于2010年新兵（P〈0．01）,睡眠时间（Sdu）分值低于2010年新兵（P〈0．05）。Logistic回归分析显示：非自愿入伍（P〈0．001,OR=8．782。95％CI=3．860～19．979）、认为不适应部队生活（P〈0．001,OR=6．731,95％CI=2．943—15．392）为2013年新兵睡眠质量异常的显著危险因子。结论2013年新兵的睡眠质量状况不容乐观,应当给予持续关注;乐观向上的心态有助于良好的睡眠质量。     

某部新兵睡眠质量及影响因素调查

目的了解某部新兵的睡眠质量状况。方法整群抽取某部495名新兵采用自制的新兵心理卫生调查问卷及匹兹堡睡眠质量指数(PSQI)量表进行测试。结果新兵的睡眠质量异常检出率为13.54%,高于正常男性群体(χ2=7.96,P=0.005);新兵的主观睡眠质量(SSQ)、入睡潜伏时间(SL)、睡眠干扰因素(Sdi)、应用催眠药物(USM)、白天功能障碍(DD)分值及PSQI总分均高于正常男性群体(U=2.76~39.01,P0.01);Logistic回归分析显示:非自愿入伍(P0.001,OR=9.987,95%CI=4.609-22.866)、认为不适应部队生活(P0.001,OR=7.001,95%CI=3.018-16.981)及认为部队管理方式严格(P0.001,OR=3.096,95%CI=1.887-9.087)为新兵睡眠质量异常的显著危险因子。结论新兵的睡眠质量状况不容乐观,应当给予持续关注;乐观向上的心态有助于新兵睡眠质量的提升。