Background: Insomnia occurs frequently in older adults. The underlying factors for the disorder are physiological changes of the sleep-wake cycle, comorbid diseases and drug treatment. Cognitive behavioural therapy (C...Background: Insomnia occurs frequently in older adults. The underlying factors for the disorder are physiological changes of the sleep-wake cycle, comorbid diseases and drug treatment. Cognitive behavioural therapy (CBT I) combined with light therapy and physical activity can be effective in the treatment of comorbid insomnia in older adults. Methods: Sixty-three (63) insomnia patients (47 female, 16 male) with an average age of 66.6 years participated in the program. Before and after the treatment, the participants completed questionnaires to assess their sleep quality (PSQI), day-time sleepiness (ESS), mood (BDI) and well-being (WHO-5-Index). In addition, they kept sleep diaries for six weeks. Results: Pre-post comparisons revealed a significant improvement in sleep latency and sleep quality, as well as a significant reduction of day-time sleepiness. In patients with both insomnia and depression, all depression scores improved slightly but significantly. Conclusions: Non-pharmacological combination treatment using CBT I, light therapy and physical activity seemed to be effective in older adults with comorbid insomnia and improve additionaly depressive symptoms.展开更多
As aging comes, an increased prevalence of medical maladies and chronic pain independently or interactively disrupt sleep, which in turn can exacerbate either one. Furthermore, anxiety about pain can further negativel...As aging comes, an increased prevalence of medical maladies and chronic pain independently or interactively disrupt sleep, which in turn can exacerbate either one. Furthermore, anxiety about pain can further negatively impact sleep. Fortunately, good quality sleep can improve pain management. Because benzodiazepine receptor agonists (including the “Z” drugs) can reduce anxiety and improve sleep, they seem a convenient choice. However, their use in this population, particularly for more than short-term (guidelines range from 2 to 6 weeks max), is not recommended because of increased likelihood of falls, further disruption of sleep, dependence, and problems with discontinuation (withdrawal). Besides, this population is often likely to take concomitant medication for pain or other central nervous system depressants leading to potentially serious and even life-threatening interactions involving synergistic amplification of respiratory depression (opioids being a particularly dangerous interaction). Therefore, insomnia in older adults should ideally be treated with a non-benzodiazepine receptor agonist;if indicated, they may be used, but should be closely monitored and tapered to avoid long-term adverse problems (direct or from withdrawal). Older adult patients with insomnia may be more optimally treated with sleep aids that do not interact with the GABAA receptor.展开更多
目的系统综述正念干预对失眠老年人的健康效益。方法采用主题词检索法,在Web of Science、PubMed、Embase、EBSCO、中国知网、维普和万方数据库中,检索正念干预影响失眠老年人睡眠质量的相关文献,发表时间为建库至2023年8月。采用物理...目的系统综述正念干预对失眠老年人的健康效益。方法采用主题词检索法,在Web of Science、PubMed、Embase、EBSCO、中国知网、维普和万方数据库中,检索正念干预影响失眠老年人睡眠质量的相关文献,发表时间为建库至2023年8月。采用物理治疗证据数据库(PEDro)量表对纳入研究进行方法学质量评价。运用《国际疾病分类第11次修订本》、《国际功能、残疾和健康分类》和《国际健康干预分类》对失眠、睡眠功能以及正念干预进行编码,基于PRISMA指南开展系统综述。结果共纳入9项研究,来自4个国家,涉及800例被试。研究设计均为随机对照试验。PEDro量表平均得分为7.1分。老年人的睡眠与健康相关问题涉及失眠和失眠并发轻度认知障碍。采用的正念干预方法主要有正念失眠疗法、正念减压疗法、正念认知疗法和正念冥想。干预场所涉及研究机构或健康中心、养老机构、社区卫生服务中心。干预周期6~8周。正念干预的健康效益包括改善睡眠质量以及改善心理和行为健康。结论正念干预可以改善失眠老年人睡眠质量,减轻老年人抑郁、焦虑、压力感知等负性情绪,提高生活质量。展开更多
目的总结有关成人失眠预测因素的文献证据,并确定其与北美护理诊断学会国际组织(NorthAmerica Nursing Diagnosis Association International,NANDA-I)护理诊断——失眠的诊断指标的一致性。方法检索Pubmed,虚拟健康图书馆和CINAHI数据...目的总结有关成人失眠预测因素的文献证据,并确定其与北美护理诊断学会国际组织(NorthAmerica Nursing Diagnosis Association International,NANDA-I)护理诊断——失眠的诊断指标的一致性。方法检索Pubmed,虚拟健康图书馆和CINAHI数据库,纳入2011—2018年以英语、葡萄牙语或西班牙语发表的48篇文章。分析失眠的预测因素、NANDA-I相关因素之间的一致性。结果本研究发现的预测因素与NANDA-I相关因素具有一致性,但悲伤和白天频繁打盹除外。吸烟、咖啡因摄入,睡眠信念功能失调、肥胖和照顾者角色障碍可能是新的相关因素;慢性病可能也是新的相关因素,婚姻状况变化,经济困难、女性、年龄增长和夜班工作者可能是新的高危人群。结论与NANDA-I诊断要素相一致的失眠预测因素可为护理诊断提供证据基础。本研究发现的与失眠护理诊断相关因素没有对应关系的预测因素可考虑纳入NANDA-I分类,从而为护士和学生的临床应用提供支持。展开更多
文摘Background: Insomnia occurs frequently in older adults. The underlying factors for the disorder are physiological changes of the sleep-wake cycle, comorbid diseases and drug treatment. Cognitive behavioural therapy (CBT I) combined with light therapy and physical activity can be effective in the treatment of comorbid insomnia in older adults. Methods: Sixty-three (63) insomnia patients (47 female, 16 male) with an average age of 66.6 years participated in the program. Before and after the treatment, the participants completed questionnaires to assess their sleep quality (PSQI), day-time sleepiness (ESS), mood (BDI) and well-being (WHO-5-Index). In addition, they kept sleep diaries for six weeks. Results: Pre-post comparisons revealed a significant improvement in sleep latency and sleep quality, as well as a significant reduction of day-time sleepiness. In patients with both insomnia and depression, all depression scores improved slightly but significantly. Conclusions: Non-pharmacological combination treatment using CBT I, light therapy and physical activity seemed to be effective in older adults with comorbid insomnia and improve additionaly depressive symptoms.
文摘As aging comes, an increased prevalence of medical maladies and chronic pain independently or interactively disrupt sleep, which in turn can exacerbate either one. Furthermore, anxiety about pain can further negatively impact sleep. Fortunately, good quality sleep can improve pain management. Because benzodiazepine receptor agonists (including the “Z” drugs) can reduce anxiety and improve sleep, they seem a convenient choice. However, their use in this population, particularly for more than short-term (guidelines range from 2 to 6 weeks max), is not recommended because of increased likelihood of falls, further disruption of sleep, dependence, and problems with discontinuation (withdrawal). Besides, this population is often likely to take concomitant medication for pain or other central nervous system depressants leading to potentially serious and even life-threatening interactions involving synergistic amplification of respiratory depression (opioids being a particularly dangerous interaction). Therefore, insomnia in older adults should ideally be treated with a non-benzodiazepine receptor agonist;if indicated, they may be used, but should be closely monitored and tapered to avoid long-term adverse problems (direct or from withdrawal). Older adult patients with insomnia may be more optimally treated with sleep aids that do not interact with the GABAA receptor.
文摘目的系统综述正念干预对失眠老年人的健康效益。方法采用主题词检索法,在Web of Science、PubMed、Embase、EBSCO、中国知网、维普和万方数据库中,检索正念干预影响失眠老年人睡眠质量的相关文献,发表时间为建库至2023年8月。采用物理治疗证据数据库(PEDro)量表对纳入研究进行方法学质量评价。运用《国际疾病分类第11次修订本》、《国际功能、残疾和健康分类》和《国际健康干预分类》对失眠、睡眠功能以及正念干预进行编码,基于PRISMA指南开展系统综述。结果共纳入9项研究,来自4个国家,涉及800例被试。研究设计均为随机对照试验。PEDro量表平均得分为7.1分。老年人的睡眠与健康相关问题涉及失眠和失眠并发轻度认知障碍。采用的正念干预方法主要有正念失眠疗法、正念减压疗法、正念认知疗法和正念冥想。干预场所涉及研究机构或健康中心、养老机构、社区卫生服务中心。干预周期6~8周。正念干预的健康效益包括改善睡眠质量以及改善心理和行为健康。结论正念干预可以改善失眠老年人睡眠质量,减轻老年人抑郁、焦虑、压力感知等负性情绪,提高生活质量。
文摘目的总结有关成人失眠预测因素的文献证据,并确定其与北美护理诊断学会国际组织(NorthAmerica Nursing Diagnosis Association International,NANDA-I)护理诊断——失眠的诊断指标的一致性。方法检索Pubmed,虚拟健康图书馆和CINAHI数据库,纳入2011—2018年以英语、葡萄牙语或西班牙语发表的48篇文章。分析失眠的预测因素、NANDA-I相关因素之间的一致性。结果本研究发现的预测因素与NANDA-I相关因素具有一致性,但悲伤和白天频繁打盹除外。吸烟、咖啡因摄入,睡眠信念功能失调、肥胖和照顾者角色障碍可能是新的相关因素;慢性病可能也是新的相关因素,婚姻状况变化,经济困难、女性、年龄增长和夜班工作者可能是新的高危人群。结论与NANDA-I诊断要素相一致的失眠预测因素可为护理诊断提供证据基础。本研究发现的与失眠护理诊断相关因素没有对应关系的预测因素可考虑纳入NANDA-I分类,从而为护士和学生的临床应用提供支持。
