共查询到20条相似文献,搜索用时 31 毫秒
1.
Tina Tanha Per Wollmer Artur Fedorowski Ola Thorsson Magnus K. Karlsson Magnus Dencker 《Clinical autonomic research》2016,26(3):197-203
Aim
To evaluate correlations between physical activity, VO2PEAK and body fat versus autonomic function in children.Methods
Children (n = 98) between 10 and 12 years underwent a maximal exercise test (VO2PEAK) and dual-energy X-ray absorptiometry measured body fat. General physical activity, moderate to vigorous physical activity and vigorous physical activity were assessed by accelerometers. Deep breath test with E/I-ratio calculation and a head-up tilt test were performed. The sum of z-scores represented an index score for autonomic function profile and included E/I-ratio plus difference in blood pressure and heart rate between supine and tilted position. Correlation analyses were performed between physical activity parameters, body fat and VO2PEAK versus autonomic function profile.Results
No significant correlations were found between autonomic function profile and physical activity or body fat (p > 0.05). VO2PEAK was correlated with autonomic function profile in boys (r = 0.30, p < 0.05), but not in girls (r = 0.04, NS). One girl and eight boys terminated head-up tilt test prematurely due to intolerance. Minutes of vigorous physical activity per day was lower in these boys compared with those (n = 48) who completed the head-up tilt test (5.1 ± 3.3 vs. 10.4 ± 6.6, p < 0.05).Conclusion
Physical activity or body fat was not associated with autonomic function profile. VO2PEAK correlated to autonomic function profile in boys.2.
Çağdaş Kalkan Çiğdem Soydal Elgin Özkan Ata Maden Irfan Soykan 《Clinical autonomic research》2016,26(3):189-196
Purpose
Autonomic nervous system dysfunction exists in autoimmune diseases. Symptoms of autoimmune gastritis are not specific, and some patients may present symptoms suggestive of delayed gastric emptying. This study aims to investigate whether any autonomic dysfunction exists in autoimmune gastritis patients, and if so, to clarify the relationship between the autonomic nervous dysfunction, delayed gastric emptying, and gastrointestinal symptoms.Methods
75 patients (50 women, mean age 56.73 ± 11.77) diagnosed with autoimmune gastritis were investigated by means of autonomic nervous system and gastric emptying tests. All patients underwent a standardized scintigraphic gastric emptying study and five tests evaluating autonomic nervous system. Patients with autonomic nervous system dysfunction were then analyzed and compared by means of existence of delayed gastric emptying and gastrointestinal symptoms.Results
62 patients had autonomic nervous system dysfunction (14 mild, 40 moderate, and 8 severe autonomic dysfunction). The mean total score of autonomic tests was 3.85 ± 2.35. Total autonomic score of patients (n = 60) with delayed gastric emptying was significantly higher than patients (n = 15) with normal gastric emptying (4.68 ± 1.7 vs. 1.53 ± 0.58, p < 0.001). Mean gastroparesis cardinal symptom index was significantly higher in patients (n = 60) with delayed gastric emptying half-time compared to patients (n = 15) with normal gastric emptying half-time (1.89 ± 1.16 vs 0.4 ± 0.3, p < 0.001).Conclusions
Most of patients with autoimmune gastritis also have autonomic nerve dysfunction. There is a close relationship between autonomic nervous system dysfunction and delayed gastric emptying. Gastroparesis cardinal symptom index has a high sensitivity and specificity in predicting both autonomic nerve function and delay in gastric emptying.3.
Philipp Moog O. Eren S. Kossegg K. Valda A. Straube M. Grünke H. Schulze-Koops M. Witt 《Clinical autonomic research》2017,27(6):385-392
Objective
To assess autonomic function by infrared dynamic pupillometry in patients with ANCA-vasculitis (AAV) in correlation to autonomic symptoms, disease specific clinical parameters and cardiovascular reflex tests.Methods
Patients with AAV and healthy controls underwent pupillometry at rest and after sympathetic stimulation (cold pressor test). Three parasympathetic parameters (amplitude, relative amplitude, maximum constriction velocity) and one sympathetic parameter (late dilatation velocity) were assessed. Results were correlated with clinical parameters, symptoms of autonomic dysfunction (COMPASS31 questionnaire), heart rate variability during deep breathing test and blood pressure response to pain.Results
23 patients and 18 age-matched controls were enrolled. Patients had a smaller amplitude (1.44 vs. 1.70 mm; p = 0.009) and a slower constriction velocity (4.15 vs. 4.71 mm/s; p = 0.028) at baseline and after sympathetic stimulation (1.47 vs. 1.81 mm, p = 0.001; 4.38 vs. 5.19 mm/s, p = 0.006, respectively). Relative amplitude was significantly smaller in patients after sympathetic stimulation (28.6 vs. 32.5%; p = 0.043), but not at baseline. There was no difference in sympathetic pupillary response between the groups. In patients, parasympathetic pupil response was correlated negatively with age and positively with parasympathetic cardiac response. After adjusting for age, no significant correlation was observed with clinical parameters. However, there was a trend towards a negative correlation with disease duration, vasculitis damage index and CRP.Conclusion
Patients with AAV exhibit parasympathetic pupillary autonomic dysfunction. Although correlations were weak and not significant, pupillary autonomic dysfunction is rather linked to chronic damage than to active inflammation or symptoms of autonomic dysfunction.4.
P. Moog O. Eren M. Witt V. Rauschel S. Kossegg A. Straube M. Grünke H. Schulze-Koops 《Clinical autonomic research》2016,26(4):279-285
Objective
To assess symptoms and objective parameters of autonomic dysfunction (AD) in patients with ANCA-associated vasculitides.Methods
Symptoms and objective parameters of AD were assessed in patients with ANCA-associated vasculitis and in age-matched healthy controls. Autonomic symptoms were explored by COMPASS31, a validated questionnaire addressing symptoms of six autonomic domains (orthostatic, vasomotor, secretomotor, gastrointestinal, pupillomotor, and bladder dysfunction). Objective autonomic parameters consisted of expiratory/inspiratory (E/I) ratio during the deep breathing test (DBT), blood pressure response to cold pressor test (CPT), and skin conductance changes during mental arithmetic.Results
27 patients and 27 healthy controls have been enrolled. 27 patients and 27 controls completed COMPASS31. 21 patients and 18 controls underwent objective autonomic testing. Vasculitis patients had significantly higher COMPASS31 total scores than controls (median 10.4 vs 3.0; p = 0.005). In the sub-domain analysis, significant differences were seen in the vasomotor and the bladder domain (p = 0.004; p < 0.001, respectively). No correlation was found between COMPASS31 score and disease duration, number of affected organs, or Birmingham vasculitis activity score (BVAS). There was no significant difference in any of the objective autonomic parameters between patients and controls. In a subgroup analysis, no difference in objective autonomic parameters was found between patients with active disease (n = 12) and patients in remission (n = 7).Conclusion
Patients with ANCA-associated vasculitides commonly have symptoms of autonomic dysfunction that are independent of disease duration and disease severity. However, at least in this single-centre observation, there was no evidence of impaired autonomic regulation in three autonomic function tests in vasculitis patients.5.
Caterina Compostella Leonida Compostella Ruggiero D’Elia 《Clinical autonomic research》2008,18(1):6-12
Background
Human immunodeficiency virus (HIV) infection is associated with autonomic neuropathy. The resultant autonomic dysfunction impairs quality of life and can have fatal consequences. Our aim was to clearly define the symptoms of autonomic dysfunction in African HIV-positive patients and determine whether these symptoms were related with (a) autonomic reflex responses (b) the degree of immunosupression.Methods
Thirty-one HIV-positive treatment-naïve African patients (mean CD4 cell count 269.5 ± 253.4/mm3) and 12 healthy controls completed a detailed questionnaire (Autonomic System Profile, Mayo Clinic, Rochester, MN) relating to specific symptoms of autonomic dysfunction. After completion of the questionnaire, subjects underwent a standard battery of autonomic reflex tests.Results
The autonomic symptom score was higher in the male HIV-positive patients (26.7 ± 14.7 points) and female patients with CD4 <200/mm3 (24.7 ± 18.0) than sex-matched controls (male controls, 9.9 ± 6.8, P < 0.05; female controls, 8.8 ± 10.1; P < 0.05). Six patients had scores indicative of severe autonomic dysfunction (>43.8 points). The most common autonomic symptoms were: orthostatic intolerance, secretomotor and gastrointestinal dysfunction. There was no relationship between CD4 cell counts and autonomic symptom scores. The blood pressure response to sustained handgrip was blunted, but all other cardiovascular reflex tests were within the normal range or borderline.Conclusion
African HIV-positive patients report symptoms of autonomic dysfunction, despite normal or borderline autonomic reflex responses.6.
Jinhua Zheng Xinglong Yang Yalan Chen Quanzhen Zhao Sijia Tian Hongyan Huang Yanming Xu 《Clinical autonomic research》2017,27(2):103-106
Purpose
To compare the order of presentation of bladder and motor symptoms between multiple system atrophy phenotypes.Methods
Medical records were retrospectively reviewed in 144 patients.Results
Bladder symptoms occurred either before or within 12 months after onset of motor symptoms in significantly more patients with the cerebellar phenotype than the parkinsonian phenotype (80 vs. 53%, p = 0.003); similar results were observed for urinary incontinence (79 vs. 45%, p = 0.001).Conclusions
Urinary dysfunction is more likely to appear either before or shortly after motor symptoms in the cerebellar phenotype than in the parkinsonian phenotype.7.
Sandro Marini Andrea Morotti Umme K. Lena Joshua N. Goldstein Steven M. Greenberg Jonathan Rosand Christopher D. Anderson 《Neurocritical care》2018,28(1):77-82
Background
Infectious complications worsen outcome after intracerebral hemorrhage (ICH). We investigated the impact of sex on post-ICH infections and mortality.Methods
Consecutive ICH patients (admitted to a single hospital between 1994 and 2015) were retrospectively assessed via chart review to ascertain the following in-hospital infections: urinary tract infection (UTI), pneumonia, and sepsis. Adjusted logistic regression was performed to identify associations between sex, infection, and mortality at 90 days.Results
Two thousand and four patients were investigated, 1071 (53.7%) males. Men were more likely to develop pneumonia (21.9 vs 15.5% p < 0.001) and sepsis (3.4 vs 1.6%, p = 0.009), whereas women had higher risk of UTI (19.9 vs 11.7% p < 0.001). Multivariate analyses confirmed association between male sex and pneumonia (Odds Ratio (OR) 1.37, 95% confidence interval (CI) 1.08–1.74, p = 0.011). Male sex (OR 1.40; CI 1.07–1.85; p = 0.015) and infection (OR 1.56; CI 1.11–1.85; p = 0.011) were independently associated with higher 90-day mortality.Conclusions
Types and rates of infection following ICH differ by sex. Male sex independently increases pneumonia risk, which subsequently increases 90-day mortality. Sex-specific preventive strategies to reduce the risk of these complications may be one strategy to improve ICH outcomes.8.
Kazumasa Shindo Michiaki Miwa Fumikazu Kobayashi Takamura Nagasaka Yoshihisa Takiyama 《Clinical autonomic research》2016,26(1):1-5
Purpose
To determine whether frontotemporal lobar degeneration (FTLD) is associated with similar cardiovascular autonomic dysfunction to that seen in amyotrophic lateral sclerosis (ALS), we compared cardiovascular parameters between ALS patients and patients with FTLD.Methods
In ten patients with FTLD (mean age ± SD: 71.6 ± 4.6 years) and 12 patients with ALS (mean age ± SD: 71.4 ± 4.6 years), MSNA (using microneurography), heart rate (HR), and blood pressure (BP) were recorded simultaneously.Results
MSNA was significantly higher in both groups of patients compared with the controls (p < 0.01), while there were no significant differences in MSNA between the patients with FTLD and those with ALS. During head-up tilt, changes in HR, BP, and the frequency of MSNA bursts were smaller in the patients than in controls (p < 0.05 or p < 0.01).Conclusions
Patients with FTLD and ALS showed similar dysfunction of HR, BP, and sympathetic outflow to muscles.9.
Paul N. Pfeiffer Marcia Valenstein Dara Ganoczy Jennifer Henry Steven K. Dobscha John D. Piette 《Social psychiatry and psychiatric epidemiology》2017,52(2):183-191
Background
Following discharge, patients hospitalized for depression are at high risk for poor retention in outpatient care and adverse outcomes.Aims
Pilot tests a post-hospital monitoring and enhanced support program for depression.Method
48 patients at a Veterans Affairs Medical Center discharged following a depression-related inpatient stay received weekly visits or phone calls for 6 months from their choice of either a family member/friend (n = 19) or a certified peer support specialist (n = 29). Participants also completed weekly automated telephone monitoring calls assessing depressive symptoms and antidepressant medication adherence.Results
Over 90% of participants were more satisfied with their care due to the service. The mean change from baseline to 6 months in depression symptoms was ?7.9 (p < 0.05) according to the Patient Health Questionnaire and ?11.2 (p < 0.05) according to the Beck Depression Inventory-II for those supported by a family member/friend, whereas those supported by a peer specialist had mean changes of ?3.5 (p < 0.05) and ?1.7 (p > 0.10), respectively.Conclusions
Increased contact with a chosen support person coupled with automated telephone monitoring after psychiatric hospitalization is an acceptable service for patients with depression. Those who received the service, and particularly those supported by a family member/friend, experienced reductions in symptoms of depression.10.
Ari J. Elliot Nicholas A. Turiano Benjamin P. Chapman 《Annals of behavioral medicine》2017,51(2):240-250
Background
Socioeconomic health disparities research may benefit from further consideration of dispositional factors potentially modifying risk associated with low socioeconomic status, including that indexed by systemic inflammation.Purpose
This study was conducted to investigate interactions of SES and the Five-Factor Model (FFM) personality traits in predicting circulating concentrations of the inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP).Method
Using a sample of middle-aged and older adults from the Midlife in the United States Survey (MIDUS) biomarker project (N = 978), linear regression models tested interactions of each FFM trait with a composite measure of SES in predicting IL-6 and CRP, as well as the explanatory role of medical morbidity, measures of adiposity, and health behaviors.Results
SES interacted with conscientiousness to predict levels of IL-6 (interaction b = .03, p = .002) and CRP (interaction b = .04, p = .014) and with neuroticism to predict IL-6 (interaction b = ?.03, p = .004). Socioeconomic gradients in both markers were smaller at higher levels of conscientiousness. Conversely, the socioeconomic gradient in IL-6 was larger at higher levels of neuroticism. Viewed from the perspective of SES as the moderator, neuroticism was positively related to IL-6 at low levels of SES but negatively related at high SES. Interactions of SES with both conscientiousness and neuroticism were attenuated upon adjustment for measures of adiposity.Conclusions
Conscientiousness may buffer, and neuroticism amplify, excess inflammatory risk associated with low SES, in part through relationships with adiposity. Neuroticism may be associated with lower levels of inflammation at high levels of SES.11.
Alessandra Fanciulli Georg Göbel Jean Pierre Ndayisaba Roberta Granata Susanne Duerr Stefano Strano Carlo Colosimo Werner Poewe Francesco E. Pontieri Gregor K. Wenning 《Clinical autonomic research》2016,26(2):97-105
Objective
Supine hypertension (SH) is a feature of cardiovascular autonomic failure that often accompanies orthostatic hypotension and may represent a negative prognostic factor in parkinsonian syndromes. Here we investigated the frequency rate as well as the clinical and tilt test correlates of SH in Parkinson’s disease (PD) and multiple system atrophy (MSA).Methods
197 PD (33 demented) and 78 MSA (24 MSA-Cerebellar, 54 MSA-Parkinsonian) patients who had undergone a tilt test examination were retrospectively included. Clinical-demographic characteristics were collected from clinical records at the time of the tilt test examination.Results
SH (>140 mmHg systolic, >90 mmHg diastolic) occurred in 34 % of PD patients (n = 66, mild in 71 % of patients, moderate in 27 %, severe in 2 %) and 37 % of MSA ones (n = 29, mild in 55 % of patients, moderate in 17 %, severe in 28 %). No difference was observed in SH frequency between demented versus gender-, age- and disease duration-matched non-demented PD patients, or between patients with the parkinsonian (MSA-P) versus the cerebellar (MSA-C) variant of MSA. In PD, SH was associated with presence of cardiovascular comorbidities (p = 0.002) and greater systolic (p = 0.007) and diastolic (p = 0.002) orthostatic blood pressure fall. Orthostatic hypotension (p = 0.002), and to a lesser degree, lower daily dopaminergic intake (p = 0.01) and use of anti-hypertensive medications (p = 0.04) were associated with SH in MSA.Interpretation
One-third of PD and MSA patients suffer from mild to severe SH, independently of age, disease duration or stage. In PD, cardiovascular comorbidities significantly contribute to the development of SH, while in MSA, SH appears to reflect cardiovascular autonomic failure.12.
Barbara H. Brumbach Wendy C. Birmingham Watcharaporn Boonyasiriwat Scott Walters Anita Y. Kinney 《Annals of behavioral medicine》2017,51(5):694-706
Background
Understanding the pathways by which interventions achieve behavioral change is important for optimizing intervention strategies.Purpose
We examined mediators of behavior change in a tailored-risk communication intervention that increased guideline-based colorectal cancer screening among individuals at increased familial risk.Methods
Participants at increased familial risk for colorectal cancer (N = 481) were randomized to one of two arms: (1) a remote, tailored-risk communication intervention (Tele-Cancer Risk Assessment and Evaluation (TeleCARE)) or (2) a mailed educational brochure intervention.Results
Structural equation modeling showed that participants in TeleCARE were more likely to get a colonoscopy. The effect was partially mediated through perceived threat (β = 0.12, p < 0.05), efficacy beliefs (β = 0.12, p < 0.05), emotions (β = 0.22, p < 0.001), and behavioral intentions (β = 0.24, p < 0.001). Model fit was very good: comparative fit index = 0.95, root-mean-square error of approximation = 0.05, and standardized root-mean-square residual = 0.08.Conclusion
Evaluating mediating variables between an intervention (TeleCARE) and a primary outcome (colonoscopy) contributes to our understanding of underlying mechanisms that lead to health behavior change, thus leading to better informed and designed future interventions.Trial Registration Number
ClinicalTrials.gov, NCT01274143.13.
Mario Habek Luka Crnošija Mila Lovrić Anamari Junaković Magdalena Krbot Skorić Ivan Adamec 《Clinical autonomic research》2016,26(6):385-393
Objective
The aim of this study was to determine the prevalence of autonomic dysfunction using the composite autonomic scoring scale (CASS) and heart rate variability (HRV) in patients with clinically isolated syndrome (CIS) and to correlate autonomic dysfunction with other measures of MS disease activity.Methods
CASS, HRV and plasma catecholamines during supine and tilted phase were performed in 104 CIS patients. MRI findings were analyzed for total number of lesions and the presence of brainstem and cervical spinal cord lesions.Results
Autonomic dysfunction (CASS >1) was present in 59.8 % of patients, parasympathetic dysfunction in 5 %, sympathetic in 42.6 % and sudomotor in 32.7 % of patients. Patients with autonomic dysfunction on CASS had lower level of norepinephrine in the supine position compared to patients without autonomic dysfunction (1.06 ± 0.53 vs. 1.37 ± 0.86, p = 0.048). The CASS score showed positive correlation with s-HF (r = 0.226, p = 0.031), s-SDNN (r = 0.221, p = 0.035), t-HF (r = 0.225, p = 0.032), and t-HFnu (r = 0.216, p = 0.04), and a negative correlation with t-LF/HF (r = ?0.218, p = 0.038). More patients with MRI brainstem lesions had a positive adrenergic index (p = 0.038). Patients with MRI brainstem lesions also had a lower t-SDNN (26.2 ± 14.2 vs. 32 ± 13.3, p = 0.036) and a lower t-LF (median 415.0 vs. 575.5, p = 0.018) compared to patients without these lesions. Patients with adrenergic index ≥1 had a significantly higher standing heart rate compared to patients with an adrenergic index of 0 (96 ± 13.5 vs. 90 ± 12, p = 0.032).Conclusion
Autonomic (primarily sympathetic) dysfunction is present in a large proportion of early MS patients and it seems to be related to brainstem involvement.14.
Background
Inpatient video-EEG monitoring (VEM) can contribute to the diagnosis and treatment in many of the monitored patients. Most admissions to VEM are elective and are scheduled ahead before the monitoring session.Purpose
To retrospectively evaluate the yield of non-elective VEM sessions.Methods
We retrospectively reviewed the VEM recordings and medical records of all the patients admitted to our one-bed VEM unit from June 2007 to June 2015. A VEM session was diagnostic when a seizure, an event or previously unreported interictal epileptiform discharges were recorded.Results
The study group included 304 adults aged 18–92 years (mean 40.4 ± 17.4 years), 181 (59%) women. The diagnostic yield of non-elective and elective VEM session was similar (66 and 69%, respectively). In non-elective VEM, fewer patients had known epilepsy (p = 0.0001), session duration was shorter (p = 0.0001), and seizures and interictal epileptiform discharges were recorded less frequently compared to elective VEM (p = 0.005 and p = 0.0001, respectively).Conclusion
Non-elective VEM can provide useful information in patients admitted to the neurology department with recent neurological or behavioral events. A timely and correct diagnosis in these patients can potentially reduce unnecessary use of antiepileptic drugs in patients with psychogenic nonepileptic seizures and the morbidity and mortality associated with undiagnosed seizures.15.
Stephanie M. Wolahan Mayumi L. Prins David L. McArthur Courtney R. Real David A. Hovda Neil A. Martin Paul M. Vespa Thomas C. Glenn 《Neurocritical care》2017,26(2):239-246
Background
The objective was to investigate the impact of targeting tight glycemic control (4.4–6.1 mM) on endogenous ketogenesis in severely head-injured adults.Methods
The data were prospectively collected during a randomized, within-patient crossover study comparing tight to loose glycemic control, defined as 6.7–8.3 mM. Blood was collected periodically during both tight and loose glycemic control epochs. Post hoc analysis of insulin dose and total nutritional provision was performed.Results
Fifteen patients completed the crossover study. Total ketones were increased 81 μM ([38 135], p < 0.001) when blood glucose was targeted to tight (4.4–6.1 mM) compared with loose glycemic control (6.7–8.3 mM), corresponding to a 60 % increase. There was a significant decrease in total nutritional provisions (p = 0.006) and a significant increase in insulin dose (p = 0.008).Conclusions
Permissive underfeeding was tolerated when targeting tight glycemic control, but total nutritional support is an important factor when treating hyperglycemia.16.
Objective
To assess the effects of PR-fampridine on cognitive functioning, fatigue and depression in patients with multiple sclerosis (PwMS).Methods
Thirty-two PwMS were included in this trial. Cognitive performance was assessed in an open-label and randomized double-blind, placebo-controlled study design using a comprehensive neuropsychological test battery as well as questionnaires examining depression and fatigue.Results
We found significant improvements in cognitive measures assessing alertness (tonic alertness, p = 0.0244 and phasic alertness, p = 0.0428), psychomotor speed (p = 0.0140) as well as verbal fluency (p = 0.0002) during open-label treatment with PR-fampridine. These effects of performance were paralleled by patients’ perception of reduced fatigue (physical, p = 0.0131; cognitive, p = 0.0225; total, p = 0.0126). Fampridine-induced improvements in phasic alertness (p = 0.0010) and measures of fatigue (physical, p = 0.0014; cognitive, p = 0.0003; total, p = 0.0005) were confirmed during randomized, double-blind, placebo-controlled assessment in the second year. In addition, we found positive effects of PR-fampridine on depressive symptoms (p = 0.0049). We demonstrated persisting beneficial effects of PR-fampridine on fatigue in PwMS over a period of more than 2 years. Drug responsiveness regarding cognitive performance and fatigue was not limited to walking responders.Conclusions
Our data demonstrate significant positive effects of treatment with PR-fampridine over 2 years on different cognitive domains as well as fatigue and depression in a cohort of PwMS. These findings imply that PR-fampridine should be considered as symptomatic treatment improving aspects of cognition, fatigue and depression in PwMS.17.
Jennifer Fillo Stephanie Brooks Holliday Amy DeSantis Anne Germain Daniel J. Buysse Karen A. Matthews Wendy M. Troxel 《Annals of behavioral medicine》2017,51(6):879-889
Background
Emerging research has begun to examine associations between relationship functioning and sleep. However, these studies have largely relied on self-reported evaluations of relationships and/or of sleep, which may be vulnerable to bias.Purpose
The purpose of the study was to examine associations between relationship functioning and sleep in military couples. This is the first research to examine associations between observed relationship behaviors and subjective and polysomnographically measured sleep in a sample at-risk for both sleep and relationship problems.Methods
The sample included 35 military veterans and their spouses/partners. Marital functioning was coded from a videotaped conflict interaction. Analyses focused on behavioral codes of hostility and relationship-enhancing attributions. Sleep was assessed via self-report and in-home polysomnography.Results
Greater hostility was associated with poorer sleep efficiency for oneself (b = ?0.195, p = .013). In contrast, greater relationship-enhancing attributions were associated with higher percentages of stage N3 sleep (b = 0.239, p = .028). Partners’ hostility was also positively associated with higher percentages of stage N3 sleep (b = 0.272, p = .010). Neither hostility nor relationship-enhancing attributions was associated with self-reported sleep quality, percentage of REM sleep, or total sleep time.Conclusions
Both partners’ positive and negative behaviors during conflict interactions were related to sleep quality. These findings highlight the role that effective communication and conflict resolution skills may play in shaping not only the marital health of veterans and their spouses but also the physical health of both partners as well. Understanding the links between relationship functioning and sleep may be important targets of intervention in the aftermath of war.18.
Purpose
Postural tachycardia syndrome (POTS) is a disorder featured by orthostatic intolerance. The purpose of this study was to investigate the severity of quality of life issues in POTS patients.Methods
Online surveys for health related quality of life, sleep quality, fatigue, pain, and suicidal ideation were completed by 624 POTS patients and 139 controls.Results
People with POTS have significantly more days of poor physical health (p < 0.001), fewer days with good energy (p < 0.001), and significantly more days with activity limitations (p < 0.001) than controls. Pain severity was significantly higher for those with POTS (p < 0.001) while feelings of control over life was lower than controls (p < 0.001). Sleep quality and daytime fatigue were also significantly worse for those with POTS than controls (p < 0.001). Finally, those with POTS have a significantly higher risk of suicide compared with controls (p < 0.001).Interpretation
The myriad of symptoms from which many POTS patients suffer is associated with a decreased quality of life. Nearly half of our sample with POTS was at high risk for suicide. More work needs to be done to determine the underlying issues surrounding suicide in POTS so that an appropriate treatment regimen can be developed.19.
Jonathan Rabner Alessandra Caruso David Zurakowski Lori Lazdowsky Alyssa LeBel 《Clinical autonomic research》2016,26(6):455-459
Purpose
To examine symptoms indicating central nervous system (CNS) autonomic dysfunction in pediatric patients with migraine and tension-type headache.Methods
A retrospective chart review assessed six symptoms (i.e. constipation, insomnia, dizziness, blurry vision, abnormal blood pressure, and cold and clammy palms and soles) indicating central nervous system (CNS) autonomic dysfunction in 231 patients, ages 5–18 years, diagnosed with migraine, tension-type headache (TTH), or Idiopathic Scoliosis (IS).Results
Higher frequencies of “insomnia,” “dizziness,” and “cold and clammy palms and soles” were found for both migraine and TTH patients compared to the IS control group (P < 0.001). Frequencies of all six symptoms were greater in TTH than migraine patients with “cold and clammy palms and soles” reaching significance (P < 0.001).Conclusions
The need for prospective research investigating autonomic dysfunction in pediatric headache patients is discussed.20.
Kirsten Hauber Albert Eduard Boon Robert Vermeiren 《Child and adolescent psychiatry and mental health》2017,11(1):58