The Pittsburgh Sleep Diary

SUMMARY  Increasingly, there is a need in both research and clinical practice to document and quantify sleep and waking behaviors in a comprehensive manner. The Pittsburgh Sleep Diary (PghSD) is an instrument with separate components to be completed at bedtime and waketime. Bedtime components relate to the events of the day preceding the sleep, waketime components to the sleep period just completed. Two-week PghSD data is presented from 234 different subjects, comprising 96 healthy young middle-aged controls, 37 older men, 44 older women, 29 young adult controls and 28 sleep disorders patients in order to demonstrate the usefulness, validity and reliability of various measures from the instrument. Comparisons are made with polysomnographic and actigraphic sleep measures, as well as personality and circadian type questionnaires. The instrument was shown to have sensitivity in detecting differences due to weekends, age, gender, personality and circadian type, and validity in agreeing with actigraphic estimates of sleep timing and quality. Over a 12–31 month delay, PghSD measures of both sleep timing and sleep quality showed correlations between 0.56 and 0.81 ( n = 39, P < 0.001).     

Time spent moving is related to systolic blood pressure among older women

Isolated systolic hypertension is present in the majority of older women. Exercise is an attractive antihypertensive lifestyle therapy for older women with isolated systolic hypertension, but the amount of exercise needed to reduce blood pressure (BP) is not clear. Evidence is accumulating that lower levels of physical exertion are associated with decreased BP. The authors sought to determine if BP was related to daily time spent moving. Participants were 109 women (mean +/- SD, 75.2+/-7.2 yr). A majority (63.3%) had hypertension, and 48.6% had isolated systolic hypertension. Systolic BP was lower among women moving > or =5 h/d (142.2+/-18.7 mm Hg) than those moving <5 h/d (149.8+/-19.0 mm Hg) (p=0.038). Multiple regression analysis indicated that the potentially strong confounding effects of antihypertensive medication use, adiposity, and age did not eliminate these favorable associations between daily time spent moving and systolic BP. Older women should be encouraged to regularly engage in physical activities typical of everyday life such as walking because of its BP benefits.     

REM sleep in primary depression: a computerized analysis.

REM sleep in 35 inpatients with primary depression was automatically analyzed for 7 consecutive nights during placebo administration. For the total night of sleep, as well as each individual REM period, the number of REMs, their total voltage integral over time, the sum of their durations and the average REM size were automatically calculated. Validity of these automated REM measures was established by significant correlations with manually scored REM measures. Changes in REM sleep across the night were also investigated. Similar to findings in normal subjects, REM time did not change from REM period to REM period. Average REM size increased significantly from REM period 2-3 and 3-4. Contrary to what is seen in normal subjects, REM frequency was high during the first REM period, significantly decreased from the first to second REM period and then remained constant. Finally, a significant inverse correlation between REM frequency for the first REM period and REM latency was noted. This pattern of REM sleep is interpreted as indicating a high pressure for phasic REM at the beginning of the night which is dissipated by the first REM period.     

Electroencephalographic sleep findings in depressed outpatients

We compared the electroencephalographic (EEG) sleep characteristics of 20 outpatients with those of 20 age-matched inpatients with major primary depressive disorders. Both groups showed similar patterns of sleep disturbance: reduced rapid eye movement (REM) sleep latencies, sleep efficiencies, and slow wave sleep. While the inpatients had greater REM activity in the first REM period than did the outpatients, both groups showed evidence of greater REM sleep time and REM activity during the first half of the night than do normals. The outpatients demonstrated a level of adaptation in that more REM sleep time and activity were present on night 2 than on night 1.