Sleep
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Although insomnia is a prevalent complaint with significant morbidity, it often remains unrecognized and untreated. Brief and valid instruments are needed both for screening and outcome assessment. This study examined psychometric indices of the Insomnia Severity Index (ISI) to detect cases of insomnia in a population-based sample and to evaluate treatment response in a clinical sample. ⋯ These findings provide further evidence that the ISI is a reliable and valid instrument to detect cases of insomnia in the population and is sensitive to treatment response in clinical patients.
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Disturbances of the internal biological clock manifest as fatigue, poor concentration, and sleep disturbances-symptoms reminiscent of chronic fatigue syndrome (CFS) and suggestive of a role for circadian rhythm disturbance in CFS. We examined circadian patterns of activity, sleep, and cortisol secretion in patients with CFS. ⋯ We found no evidence of circadian rhythm disturbance in CFS. However, the role of autonomic activity in the experience of unrefreshing sleep warrants further assessment. The activity symptom-relationship modelled here is of clinical significance in the approach to activity and symptom management in the treatment of CFS.
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We sought to evaluate the contribution of genetic and non-genetic factors on habitual sleep/wake patterns in a community-dwelling agrarian population using a physical activity monitoring device, the Actical. ⋯ Objectively measured wake time, self-reported morningness-eveningness preference, and daytime sleepiness appear heritable and wake time may be associated with physical activity level.
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To assess the longitudinal course of cognitive functions in a cohort of patients with idiopathic REM sleep behavior disorder (iRBD). ⋯ Although no patients developed dementia, the decline observed in some tests involving the memory and visuo-constructional domains in idiopathic RBD suggests the presence of an underlying evolving degenerative process.
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Excessive daytime sleepiness (EDS) is associated with increased mortality in older adults, yet sleep disordered breathing (SDB), a common cause of sleepiness, has not been shown to increase mortality in older adults. This study examined the relationship between daytime sleepiness, SDB, self-report sleep parameters, and mortality in older adults. ⋯ The presence of SDB is an important risk factor for mortality from excessive daytime sleepiness in older adults. In the presence of SDB at an AHI ≥20 events/h, EDS was associated with an increased all-cause mortality risk in older adults, even when adjusting for other significant risk factors, such as prolonged sleep duration. In older patients who had SDB without EDS, or EDS without SDB, there was no increased all-cause mortality rate.