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Goals for the present study were to (a) describe the sleep of healthy new mothers over a 6-month postpartum period, (b) examine how sleep quality relates to daytime levels of fatigue and sleepiness, and (c) evaluate the relationship between mothers’ and infants’ sleep parameters. The sample consisted of 37 healthy, partnered, first-time mothers who had experienced full-term vaginal birth and had a healthy infant. We investigated infants’ sleep parameters and mothers’ sleep, mood, and daytime functioning 2 and 6 months postpartum. We found that at 2 months postpartum, mothers reported sleeping 6 hours at night and just under one hour during the day. Despite relatively frequent nocturnal awakenings, mothers experienced minimal insomnia, nonrefreshing sleep, anxiety, depression, daytime sleepiness, or fatigue at either 2 or 6 months. The most robust relationship between mothers’ and infants’ sleep was in the number of nocturnal sleep-wake episodes. Of note is that none of the infant sleep parameters was related to mothers’ anxiety, depression, fatigue, sleepiness, or nonrefreshing sleep at either time period. Our results indicate that (1) selected low risk new mothers are resilient in terms of sleep quality, daytime functioning, and mood and (2) these are independent of their infants’ sleep parameters. [ABSTRACT FROM AUTHOR]

The goal was to examine comparative efficacy of polysomnography, actigraphy, and self-report in evaluating the sleep/wake experience of individuals with chronic fatigue syndrome (CFS). Sleep parameters were evaluated by the three measurement modalities for the same night in 49 participants with CFS. Psychological and daytime functioning were measured by self-report. Results indicate that: (a) objectively measured nocturnal sleep time effectively approximated subjective experience although nocturnal wakefulness did not; (b) total sleep time and sleep efficiency differentiated individuals with and without insomnia complaints; (c) daytime sleepiness, fatigue, and non-refreshing sleep were not reflected by the objective sleep-related measures (polysomnography and actigraphy). [ABSTRACT FROM AUTHOR]

Objectives were to explore: (1) whether sleep apnea/hypopnea syndrome (SAHS) should be considered a chronic fatigue syndrome (CFS) comorbidity, rather than a diagnostic exclusion criterion; and (2) to compare sleep/wake/ psychopathology in individuals with CFS, controls and another illness. Participants (CFS, SAHS, controls) completed questionnaires and were evaluated for SAHS; 68 percent were subsequently diagnosed with SAHS. CFS participants with and without SAHS did not differ. Both clinical groups were less well adjusted than controls. We conclude that SAHS should not be an exclusion criterion for CFS and that psychological problems in CFS seem a consequence of coping with illness. [ABSTRACT FROM AUTHOR]

Objective: To explore how individuals with chronic fatigue syndrome (CFS) describe their fatigue experience and examine how this differs from descriptions of fatigue in healthy controls. Methods: Fifty-two individuals with CFS and 27 controls listed words that described their fatigue. These words were grouped into 18 categories. Results: Individuals with CFS used more categories to describe their fatigue and more descriptors within each category. The most popular category used by both groups was energy depletion/physical weakness. CFS participants also experienced their fatigue as limiting their ability to function, frustrating, permanent/persistent, out of their control, depressing, and pervading all aspects of their lives. Controls reported that when they experienced fatigue, it was temporary, and they felt unmotivated, sleepy, and comfortable. Conclusion: The multidimensional descriptive pattern characterizing the fatigue of individuals with CFS differs dramatically from the experienced fatigue of healthy individuals, suggesting their "language of fatigue" has a distinctive quality. [ABSTRACT FROM AUTHOR]

Time estimation was examined in 148 older good and poor sleepers in analogue and naturalistic sleep settings. On analogue tasks, both "empty" time and time listening to an audio-book were overestimated by both good and poor sleepers. There were no differences between groups. "Empty" time was experienced as "dragging." In the sleep setting, most poor sleepers underestimated nocturnal sleep and overestimated awake times related to their own sleep problem: sleep onset vs. sleep maintenance insomnia. Good sleepers did the opposite. Severity of sleep problem and size of time estimation errors were unrelated. Greater night-to-night wake time variability was experienced by poor than by good sleepers. Psychological adjustment was unrelated to time estimations and to magnification or minimization of sleep problems. The results suggest that for poor sleepers who magnify their sleep problem, self-monitoring can be of benefit by demonstrating that the sleep problem is not as severe as believed. [ABSTRACT FROM AUTHOR]

Effectiveness of two modified stimulus control insomnia interventions plus daily sleep self-monitoring for managing insomnia was investigated in a community sample of older adults. Significant post intervention improvement was observed in both interventions as well as in a self-monitoring only control condition. This unexpected finding led us to question the role of self-monitoring as a potential mediator of therapeutic change. Therefore, we compared long-term follow-up data from treated participants to data from similarly poor sleepers who only completed the questionnaire battery at Pre-test and long term follow-up, with no intervening treatment or self-monitoring. Both groups of poor sleepers reduced their reported amount of nocturnal wakefulness. However, only treated participants improved on their perceived frequency of insomnia episodes and insomnia-related distress. Our findings have implications both for the definition and the treatment of insomnia. [ABSTRACT FROM AUTHOR]

Explores and compares psychological adjustment and lifestyle in older adults with and without insomnia. Psychophysiological factors associated with aging; Relationships among sleep characteristics; Aspects of insomnia complaint; Popular myths about insomnia in older adults.

To determine whether older good and poor sleepers with and without insomnia complaints differ in the nature of activities they engage in during periods of nocturnal wakefulness, the authors developed and evaluated the Sleep Behaviors Scale: 60+. Good sleepers (n = 163), low-distress poor sleepers (n = 49), and high-distress poor sleepers (n = 28) were compared on this measure as well as on sleep parameters, personality, lifestyle, and cognitive-affective variables. Findings indicate good psychometric properties for the new measure, offer a rationale for examining the frequency of the nocturnal behaviors reflected by the measure's 4 subscales (Active Behaviors, Relaxation, Cognitive Arousal, and Medication), and suggest a possible role for these behaviors in the etiology and treatment of insomnia. [ABSTRACT FROM AUTHOR]

Parasomnias are a group of sleep disorders characterized by abnormal and unpleasant motor, verbal, or behavioral events that occur during sleep or during transitions between wake and sleep states. They disrupt sleep and can have a detrimental impact on the individual experiencing them. Our goal was to identify types of parasomnias and their prevalence in the current and recent post-secondary student population and to explore their coping strategies for parasomnias they found distressing. Seventy-seven post-secondary students completed the 21-item Munich Parasomnia Screening (MUPS) frequency scale. They also rated, on a 10-point scale, how disturbing each parasomnia experienced was. Not only did 92% percent of students report at least one parasomnia, but our results also indicate that the vast majority of students experienced several parasomnias. This led us to investigate the likelihood of the co-occurrence of different parasomnias. With respect to the level of subjectively experienced distress, the most prevalent parasomnias were not always the more disturbing. Coded open-ended responses about what students do about the disturbing parasomnias indicate that grounding strategies (i.e., coping strategies that help manage distressing feelings) and physical manipulation of one's body were the most common, although most participants indicated that in spite of distress, they do nothing to cope. In conclusion, our study found a strikingly high prevalence of parasomnias in this sample of young adults and a lack of knowledge about effective means of dealing with these. Therefore, we provide some accepted ways of dealing with these. [ABSTRACT FROM AUTHOR]

• Driving profiles at baseline did not predict adherence to treatment. • Sleepiness and AHI are associated with official driving record violations. • Fatigue is associated with self-reported driving violations. • Fatigue and sleepiness should be assessed and analyzed separately in studies of driving risk. The present investigation examines the role of daytime sleepiness and fatigue and how these relate to driving behaviors and risk assessment in people newly diagnosed with obstructive sleep apnea (OSA). We recruited 47 individuals, (24 female, 23 male), between the ages of 25 and 71 (mean age = 51, SD = 11.28). Of those, 24 individuals were newly diagnosed with OSA and 23 individuals were in a comparison sample with similar proportions of biological sex and ages, who tested negative for OSA. All participants completed questionnaire measures related to sleep, psychological adjustment, driving behavior, sleepiness and fatigue, immediately after their follow-up appointment. We collected data on driving violations from registered driving records for the 5 years preceding their enrolment in the study, as well as sleep-related data for all participants. Results show that individuals with OSA (M = 1.08, SD = 1.38) do not commit more driving violations than control participants (M = 0.64, SD = 1.26). Although drivers with OSA indicate significantly worse scores for fatigue (M = 7.73, SD = 3.71) compared with controls (M = 4.26, SD = 3.66), there was no significant difference for sleepiness between drivers with OSA (M = 10, SD = 3.57) and Controls (M = 8, SD = 3.69). An association between driving violations and sleepiness was found for drivers with OSA – r (24) = −0.45, p <.05 – but not for Controls – r (23) = −0.22, p >.05. Fatigue, and sleepiness should be assessed as distinct constructs, and each should be taken into account separately in studies of driving risk. [ABSTRACT FROM AUTHOR]

We explored the impacts of the remote and return-to-in-person work periods on sleep and well-being as reported by faculty (n = 22) and non-teaching staff (n = 21) with and without disabilities. Participants were recruited through college platforms and personal contacts. Our results show that contrary to expectations, the COVID-19 remote teaching/working period resulted in better sleep, as well as greater well-being, than the return-to-in-person work period. With respect to sleep, faculty members had slightly more negative outcomes than staff, most evident in heightened anxiety and work aspects. Faculty with disabilities had somewhat worse sleep and well-being during the remote period than faculty without disabilities. During the return to in-person work, both faculty and non-teaching staff reported more negative than positive sleep and well-being outcomes. In particular, during the in-person period, faculty members experienced slightly more negative sleep outcomes related to anxiety and work, while staff members experienced slightly more negative sleep outcomes related to the need to commute and lifestyle. Our findings show that there were benefits and disadvantages to both remote and in-person work periods, suggesting a hybrid work schedule should be considered in more detail, particularly as an optional reasonable accommodation for faculty and staff with disabilities. Our study highlights that training to keep faculty abreast of the latest technological innovations, ways to promote work–life balance, and steps to remedy classroom size and building ventilation to prevent the spread of disease all need urgent attention. [ABSTRACT FROM AUTHOR]

In our previous studies, we offered older family medicine patients testing for obstructive sleep apnea (OSA) and discovered that 80% of patients who accepted, were later diagnosed with unsuspected OSA. In the present study, we followed such patients for 3 years of usual treatment. The goals were to (1) observe whether wider testing for OSA would increase case recognition and treatment uptake; (2) identify symptom and health characteristics associated with diagnosis and treatment efficacy. 101 women and 75 men (>45 years) recruited from family medicine clinics completed questionnaires, polysomnography and consented to chart review (Time 1). Participants with OSA were offered treatment and follow-up with a sleep medicine specialist. All were re-evaluated after 3 years (Time 2). At Time 1, 93% of participants received a diagnosis of OSA. Of these, 53 initiated treatment (46 PAP therapy); at Time 2, 24 PAP users met criteria for adherence. PAP-adherent participants had worse OSA and worse reported symptoms at Time 1 than non-adherent participants. At Time 2, PAP-adherent participants improved on insomnia and daytime symptoms compared to non-adherent participants who showed no change. Adherent and non-adherent participants showed no difference in health indices at Time 1 and no change at three-year follow-up. Benefits of treatment included improvements in co-morbid insomnia and daytime functioning; however, offering wider testing for OSA to older, family medicine patients yielded a high rate of diagnosis but low treatment adoption and adherence. Therefore, a cost-effective strategy would identify and support those likely to adopt and adhere to treatment. [ABSTRACT FROM AUTHOR]

Sleep quality is a construct often measured, employed as an outcome criterion for therapeutic success, but never defined. In two studies we examined appraised good and poor sleep quality in three groups: a control group, individuals with obstructive sleep apnea, and those with insomnia disorder. In Study 1 we used qualitative methodology to examine good and poor sleep quality in 121 individuals. In Study 2 we examined sleep quality in 171 individuals who had not participated in Study 1 and evaluated correlates and predictors of sleep quality. Across all six samples and both qualitative and quantitative methodologies, the daytime experience of feeling refreshed (nonrefreshed) in the morning and the nighttime experience of good (impaired) sleep continuity characterized perceived good and poor sleep. Our results clarify sleep quality as a construct and identify refreshing sleep and sleep continuity as potential clinical and research outcome measures. [ABSTRACT FROM AUTHOR]

Compares long sleepers and short sleepers in older adults. Investigation of psychological adjustment, lifestyle, and sleep parameters in older adults; Study of responses on variables investigating sleep parameters and sleep-related affect and beliefs; Evaluation of psychological adjustment including cognitive and somatic arousal, nocturnal tension, anxious, negative, unpleasant and worrying self-talk; Indication of short sleepers getting up earlier, spending less time in bed, and having lower sleep efficiencies than long sleepers.

The frequency of difficulty initiating and maintaining sleep increases with age. Yet, not all poor sleepers complain of insomnia. Our cognitive model of insomnia predicts that sleep complaints in poor sleepers are a function of negative thinking during nocturnal wakefulness as well as of poor sleep quality. To test descriptive aspects of the model, we examined the content and valence of thoughts listed or endorsed by two large samples of older adults. We compared positive and negative thoughts reported by good sleepers and by 2 types of poor sleepers: those experiencing either high or low distress about their insomnia. Thought listing and inventory results both support the model: negative thought frequencies were closely related to poor sleep, distress about insomnia, and poor daytime psychological adjustment. The findings provide an empirical basis for the modification of maladaptive cognitions as potentially important in therapeutic intervention for insomnia. [ABSTRACT FROM AUTHOR]

In a previous investigation we showed that thoughts experienced during periods of nocturnal wakefulness contribute to understanding the insomnia complaint. We also demonstrated the problems with open-ended thought listings, such as low thought frequencies, large standard deviations, loss of subjects due to missing data, and difficulties with states-of-mind (SOM) ratios. Because of these difficulties and the expertise and expense involved in coding thoughts, in the current study we developed and evaluated the Self-Statement Test:60+ (SST:60+) -- a 34-item inventory measure of thoughts reported by older individuals while trying to fall asleep. Results on 445 individuals showed good reliability and validity for the measure. The findings also demonstrated that negative thoughts and the SOM ratio provide good indices of dysfunctional thinking during periods of nocturnal arousal. Positive thinking, which appears to be a strategy to combat negative thoughts, may serve to buffer the impact of negatives. [ABSTRACT FROM AUTHOR]

• Driving records disclosed less driving violations than drivers themselves reported. • Drivers with OSA did not commit more driving violations than Controls. • The DVI and the driving simulator similarly discriminated drivers with OSA. • The DVI is a simple tool that can identify a driver with OSA who is likely to weave. Sleepiness is recognized as an important risk factor for risky driving and motor vehicle accidents. This study explores whether self-reported driving violations can be used as an accurate assessment of driving risk in individuals with obstructive sleep apnea (OSA). We recruited 29 participants with OSA and 29 age- and biological sex-matched controls, obtained governmental sourced driving records for all participants and administered a monotonous driving simulator task to measure driving performance. We administered the Driving Violations Inventory (DVI) to all participants—a self-report measure that asks participants to record which of the official list of violations were committed. Data from DVI were compared with official driving records and with driving simulator results. Drivers with OSA did not have more registered driving violations than the control group. The overall number of self-reported violations was highly correlated with the driving simulator lateral position variable only for drivers with OSA. There were no significant associations between the number of official driving violations and simulator deviation of the lateral position for either group. Our findings indicate that the DVI is an accessible measure that could mirror some of the risk associated with impaired driving behavior in general, perhaps particularly for individuals with OSA. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the sleep characteristics, metabolic syndrome disease and likelihood of obstructive sleep apnea in a sample of older, family medicine patients previously unsuspected for sleep apnea.Methods: A total of 295 participants, minimum age 45, 58.7% women, were recruited from two family medicine clinics. None previously had been referred for sleep apnea testing. All participants completed a sleep symptom questionnaire and were offered an overnight polysomnography study, regardless of questionnaire results. 171 followed through with the sleep laboratory component of the study. Health data regarding metabolic syndrome disease (hypertension, hyperlipidemia, diabetes and obesity) were gathered by chart review.Results: Overall, more women than men enrolled in the study and pursued laboratory testing. Of those who underwent polysomnography testing, 75% of the women and 85% of the men were diagnosed with sleep apnea based on an apnea/hypopnea index of 10 or greater. Women and men had similar polysomnography indices, the majority being in the moderate to severe ranges. In those with OSA diagnosis, gender differences in sleep symptom severity were not significant.Conclusions: We conclude that greater gender equality in sleep apnea rates can be achieved in family practice if sleep apnea assessments are widely offered to older patients. [ABSTRACT FROM AUTHOR]

The aims of this study were to examine the presence, type, and severity of insomnia complaints in obstructive sleep apnea (OSA) patients and to assess the utility of the Sleep Symptom Checklist (SSC) for case identification in primary care. Participants were 88 OSA patients, 57 cognitive-behavioral therapy for insomnia (CBT-I) patients, and 14 healthy controls (Ctrl). Each completed a sleep questionnaire as well as the SSC, which includes insomnia, daytime functioning, psychological, and sleep disorder subscales. Results showed that OSA patients could be grouped according to 3 insomnia patterns: no insomnia (OSA), n = 21; insomnia (OSA-I), n = 30, with a subjective complaint and disrupted sleep; and noncomplaining poor sleepers (OSA-I-NC), n = 37. Comparisons among the OSA, CBT-I, and Ctrl groups demonstrate distinct profiles on the SSC subscales, indicating its potential utility for both case identification and treatment planning. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The present investigation was designed to explore the role and implications of both daytime sleepiness and fatigue in obstructive sleep apnea syndrome with respect to sleep, perceived health quality, and psychological functioning. Methods: Our participants consisted of two groups: 124 older community volunteers who completed a polysomnographic sleep study and were diagnosed with sleep apnea, and 19 healthy controls. All participants completed self-report measures of sleepiness, fatigue, sleep quality, health quality, and psychological functioning. Results: The apnea sample was divided according to clinically relevant cut-offs on sleepiness and fatigue. When those with mid-range scores were ruled out, the following groups remained: low sleepiness/low fatigue (LL, n=23), high sleepiness/high fatigue (HH, n=28), high sleepiness/low fatigue (HS, n=10) and low sleepiness/high fatigue (HF, n=13). The respiratory disturbance index did not differ significantly among these groups and only the two highly fatigued groups (HH and HF) experienced significantly lower average oxygen saturation than the control group. Analyses revealed that the HH group was significantly worse than the LL and control groups on most sleep, health quality, and psychological measures. On these same measures, the groups for whom fatigue was low (LL and HS), regardless of sleepiness, were similar to controls. Conclusion: When patients with sleep apnea are classified into different sleepiness/fatigue categories, the results show that high fatigue is associated with more severe dysfunction than high sleepiness. The current debate on whether to treat apnea patients with low sleepiness needs to consider the impact of fatigue. [Copyright &y& Elsevier]