<strong>Background: </strong>Nursing staff exposed to 2019 novel coronavirus disease which might be at the increased risk of development mental health problems such as stress, anxiety and insomnia. <str...<strong>Background: </strong>Nursing staff exposed to 2019 novel coronavirus disease which might be at the increased risk of development mental health problems such as stress, anxiety and insomnia. <strong>Objectives:</strong> To estimate the spread of stress, anxiety and insomnia among the nursing staff who are working at Asir central hospital, Kingdom of Saudi Arabia. <strong>Methods:</strong> This study was a descriptive cross-sectional study, that involved with a 53 (44 Female and 9 Male) nurses who are working at Asir central hospital, Kingdom of Saudi Arabia. A convenient sampling technique was used to select the participants during the period from October to the mid of November 2020. A structured closed-ended questionnaire was used related with three standard tools (The Perceived Stress Scale, Generalized Anxiety Disorder and the Insomnia severity index).<strong> Results:</strong> The results revealed that 90.6% of participants had moderate stress and 7.5% showed low stress. Regarding anxiety, 37% of nurses had mild anxiety, 28.3% and 34% had moderate and severe anxiety, respectively. Moreover, sub-threshold insomnia was observed in 60.4% and clinical insomnia in 15% of study candidates. Additionally, a statistically significant association was found between levels of stress, anxiety and insomnia and the age of the studied nurses (P = 0.00). <strong>Conclusion: </strong>The results of this study showed that the spread of stress, anxiety and insomnia, was higher than some studies which have been reported in the previous researches. Significant difference was observed between mental distress and age of nurses, while there was no significant difference between the studied mental health problems and gender.展开更多
Excessive distress and insomnia are much too common in the modern world and often lead to a myriad of detrimental effects including loss of cognitive ability and even physical ailments such as cancer. Current pharmace...Excessive distress and insomnia are much too common in the modern world and often lead to a myriad of detrimental effects including loss of cognitive ability and even physical ailments such as cancer. Current pharmaceutical treatments can be addictive, detrimental to health, and in the case of insomnia don’t produce naturalistic sleep. We present a viewpoint on a potential adjunctive treatment of distress and insomnia that harnesses specific mental imagery as a component of mind/body relaxation technique. Via our perspective on the modern nature of stress and insomnia, our theoretical perspective on how specific guided mental imagery can be used to treat these ailments, and our review on the current literature on treatment with mental imagery, we hope to stimulate further research into mental health treatment with mental imagery which has traditionally been neglected. This perspective on the pathology of insomnia and distress is founded in prevailing “dysevolution” and hyper-arousal theories. Hyper-arousal is characterized in part by a vicious cycle of chronic physiological and emotional stimulation/distress. We argue for spatially based mental imagery in the form of nighttime-sky imagery to attenuate such pathology by breaking one away from a vicious cycle of stimulation and distress and discuss neuropsychological bases for its potential treatment mechanisms which include the autonomic nervous system and a phenomenal foundation of conscious cognition.展开更多
Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(...Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(OSA),also occurs frequently in PTSD,and emerging research indicates OSA fuels chronic insomnia.Scant research has investigated the impact of OSA treatment on insomnia outcomes(Insomnia Severity Index,ISI)in trauma survivors.Methods:OSA patients with moderately severe posttraumatic stress symptoms were studied in a retrospective chart review.Ninety-six patients who failed CPAP therapy due to expiratory pressure intolerance or complex sleep apnea or both underwent manual titration with advanced PAP modes[autobilevel(ABPAP);adaptive servo-ventilation(ASV)],which were subsequently prescribed.PAP use measured by objective data downloads divided the sample into three groups:compliant regular users(C-RU):n=68;subthreshold users(SC-RU):n=12;and noncompliant users(NC-MU):n=16.The average follow-up was 11.89±12.22 months.Baseline and posttreatment ISI scores were analyzed to assess residual insomnia symptoms as well as cure rates.Results:The C-RU group showed significant improvements in insomnia with very large effects compared to those in the NC-MU reference group(P=0.019).Insomnia severity significantly decreased in all three groups with large effects(C-RU,P=0.001;SC-RU,P=0.027;NC-MU,P=0.007).Hours of weekly PAP use and insomnia severity were inversely correlated(P=0.001,r=–0.321).However,residual insomnia symptoms based on established ISI cut-offs were quite common,even among the C-RU group.Post hoc analysis showed that several categories of sedating medications reported at baseline(hypnotics,anti-epileptic,opiates)as well as actual use of any sedating medication(prescription or nonprescription)were associated with smaller insomnia improvements than those in patients not using any sedating agents.Conclusions:In a retrospective,nonrandomized analysis of a select sample of sleep clinic patients with OSA and PTSD symptoms,advanced PAP therapy was associated with significant improvement in insomnia severity for both compliant and partial users.However,residual insomnia symptoms persisted,indicating that PAP therapy provides only limited treatment.RCTs are warranted to assess the effect of ABPAP and ASV modes of therapy on adherence and sleep outcomes,and their potential impact on posttraumatic stress symptoms.Treatment arms that combine PAP with CBT-I would be expected to yield the greatest potency.展开更多
目的观察针刺联合耳穴贴压治疗中风后失眠的临床疗效及其对患者脑血管血流速度的影响。方法将80例中风后失眠患者随机分为对照组(40例)和治疗组(40例),对照组口服艾司唑仑治疗,治疗组用针刺联合耳穴贴压治疗。观察治疗前后两组卒中专用...目的观察针刺联合耳穴贴压治疗中风后失眠的临床疗效及其对患者脑血管血流速度的影响。方法将80例中风后失眠患者随机分为对照组(40例)和治疗组(40例),对照组口服艾司唑仑治疗,治疗组用针刺联合耳穴贴压治疗。观察治疗前后两组卒中专用生存质量量表(stroke specific quality of life scale,SS-QOL)、爱泼沃斯嗜睡量表(Epworth sleepiness score,ESS)和匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)的评分变化;比较两组治疗前后睡眠质量相关指标[觉醒时长(wake after sleep onset,WASO)、睡眠潜伏时长(sleep-onset latency,SOL)和睡眠总时长(total sleep time,TST)]、脑血流速度(大脑前动脉、大脑中动脉和大脑后动脉)以及血清氧化应激指标[谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、丙二醛(malondialdehyde,MDA)和同型半胱氨酸(homocysteine,Hcy)]的水平。比较两组临床疗效和安全性。结果治疗组总有效率为90.0%,高于对照组的72.5%(P<0.05)。与对照组治疗后比较,治疗组治疗后SS-QOL评分和血清GSH-Px水平均升高(P<0.05),ESS和PSQI评分以及血清MDA和Hcy水平均降低(P<0.05),WASO和SOL都缩短(P<0.05),TST延长(P<0.05),大脑前动脉、中动脉和后动脉血流速加快(P<0.05)。治疗组不良反应发生率为2.5%,低于对照组的30.0%(P<0.05)。结论针刺联合耳穴贴压治疗中风后失眠可提高睡眠质量,改善脑血流速度和血清中氧化应激指标。展开更多
文摘<strong>Background: </strong>Nursing staff exposed to 2019 novel coronavirus disease which might be at the increased risk of development mental health problems such as stress, anxiety and insomnia. <strong>Objectives:</strong> To estimate the spread of stress, anxiety and insomnia among the nursing staff who are working at Asir central hospital, Kingdom of Saudi Arabia. <strong>Methods:</strong> This study was a descriptive cross-sectional study, that involved with a 53 (44 Female and 9 Male) nurses who are working at Asir central hospital, Kingdom of Saudi Arabia. A convenient sampling technique was used to select the participants during the period from October to the mid of November 2020. A structured closed-ended questionnaire was used related with three standard tools (The Perceived Stress Scale, Generalized Anxiety Disorder and the Insomnia severity index).<strong> Results:</strong> The results revealed that 90.6% of participants had moderate stress and 7.5% showed low stress. Regarding anxiety, 37% of nurses had mild anxiety, 28.3% and 34% had moderate and severe anxiety, respectively. Moreover, sub-threshold insomnia was observed in 60.4% and clinical insomnia in 15% of study candidates. Additionally, a statistically significant association was found between levels of stress, anxiety and insomnia and the age of the studied nurses (P = 0.00). <strong>Conclusion: </strong>The results of this study showed that the spread of stress, anxiety and insomnia, was higher than some studies which have been reported in the previous researches. Significant difference was observed between mental distress and age of nurses, while there was no significant difference between the studied mental health problems and gender.
文摘Excessive distress and insomnia are much too common in the modern world and often lead to a myriad of detrimental effects including loss of cognitive ability and even physical ailments such as cancer. Current pharmaceutical treatments can be addictive, detrimental to health, and in the case of insomnia don’t produce naturalistic sleep. We present a viewpoint on a potential adjunctive treatment of distress and insomnia that harnesses specific mental imagery as a component of mind/body relaxation technique. Via our perspective on the modern nature of stress and insomnia, our theoretical perspective on how specific guided mental imagery can be used to treat these ailments, and our review on the current literature on treatment with mental imagery, we hope to stimulate further research into mental health treatment with mental imagery which has traditionally been neglected. This perspective on the pathology of insomnia and distress is founded in prevailing “dysevolution” and hyper-arousal theories. Hyper-arousal is characterized in part by a vicious cycle of chronic physiological and emotional stimulation/distress. We argue for spatially based mental imagery in the form of nighttime-sky imagery to attenuate such pathology by breaking one away from a vicious cycle of stimulation and distress and discuss neuropsychological bases for its potential treatment mechanisms which include the autonomic nervous system and a phenomenal foundation of conscious cognition.
基金small private donations to the Sleep&Human Health Institute.
文摘Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(OSA),also occurs frequently in PTSD,and emerging research indicates OSA fuels chronic insomnia.Scant research has investigated the impact of OSA treatment on insomnia outcomes(Insomnia Severity Index,ISI)in trauma survivors.Methods:OSA patients with moderately severe posttraumatic stress symptoms were studied in a retrospective chart review.Ninety-six patients who failed CPAP therapy due to expiratory pressure intolerance or complex sleep apnea or both underwent manual titration with advanced PAP modes[autobilevel(ABPAP);adaptive servo-ventilation(ASV)],which were subsequently prescribed.PAP use measured by objective data downloads divided the sample into three groups:compliant regular users(C-RU):n=68;subthreshold users(SC-RU):n=12;and noncompliant users(NC-MU):n=16.The average follow-up was 11.89±12.22 months.Baseline and posttreatment ISI scores were analyzed to assess residual insomnia symptoms as well as cure rates.Results:The C-RU group showed significant improvements in insomnia with very large effects compared to those in the NC-MU reference group(P=0.019).Insomnia severity significantly decreased in all three groups with large effects(C-RU,P=0.001;SC-RU,P=0.027;NC-MU,P=0.007).Hours of weekly PAP use and insomnia severity were inversely correlated(P=0.001,r=–0.321).However,residual insomnia symptoms based on established ISI cut-offs were quite common,even among the C-RU group.Post hoc analysis showed that several categories of sedating medications reported at baseline(hypnotics,anti-epileptic,opiates)as well as actual use of any sedating medication(prescription or nonprescription)were associated with smaller insomnia improvements than those in patients not using any sedating agents.Conclusions:In a retrospective,nonrandomized analysis of a select sample of sleep clinic patients with OSA and PTSD symptoms,advanced PAP therapy was associated with significant improvement in insomnia severity for both compliant and partial users.However,residual insomnia symptoms persisted,indicating that PAP therapy provides only limited treatment.RCTs are warranted to assess the effect of ABPAP and ASV modes of therapy on adherence and sleep outcomes,and their potential impact on posttraumatic stress symptoms.Treatment arms that combine PAP with CBT-I would be expected to yield the greatest potency.
文摘目的观察针刺联合耳穴贴压治疗中风后失眠的临床疗效及其对患者脑血管血流速度的影响。方法将80例中风后失眠患者随机分为对照组(40例)和治疗组(40例),对照组口服艾司唑仑治疗,治疗组用针刺联合耳穴贴压治疗。观察治疗前后两组卒中专用生存质量量表(stroke specific quality of life scale,SS-QOL)、爱泼沃斯嗜睡量表(Epworth sleepiness score,ESS)和匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)的评分变化;比较两组治疗前后睡眠质量相关指标[觉醒时长(wake after sleep onset,WASO)、睡眠潜伏时长(sleep-onset latency,SOL)和睡眠总时长(total sleep time,TST)]、脑血流速度(大脑前动脉、大脑中动脉和大脑后动脉)以及血清氧化应激指标[谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、丙二醛(malondialdehyde,MDA)和同型半胱氨酸(homocysteine,Hcy)]的水平。比较两组临床疗效和安全性。结果治疗组总有效率为90.0%,高于对照组的72.5%(P<0.05)。与对照组治疗后比较,治疗组治疗后SS-QOL评分和血清GSH-Px水平均升高(P<0.05),ESS和PSQI评分以及血清MDA和Hcy水平均降低(P<0.05),WASO和SOL都缩短(P<0.05),TST延长(P<0.05),大脑前动脉、中动脉和后动脉血流速加快(P<0.05)。治疗组不良反应发生率为2.5%,低于对照组的30.0%(P<0.05)。结论针刺联合耳穴贴压治疗中风后失眠可提高睡眠质量,改善脑血流速度和血清中氧化应激指标。
