Sleep Medicine Commons^™

Restoring Effective Sleep Time In Post Cardiac Surgery Patients: A Quality Improvement Project, Brooke Watts Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: Restoring Effective Sleep Time in Post Cardiac Surgery Patients: A Quality Improvement Project

Brooke Watts, BSN, RN, DNP Student, Murray State University

Dr. Kristin Reid, DNP, APRN, ACNS-BC, DNP Program Director/Assistant Professor Murray State University

Aims: This quality improvement project was developed using DNP project guidelines provided through Murray State University and was designed to improve sleep in hospitalized cardiac surgery patients.

Processes: IRB approval was obtained from the healthcare institution and academic institution. This two-phase quality improvement project was designed to analyze the effects of a change in normalized hospital routines on self-reported sleep in post-cardiac surgery patients. …

Study Protocol: Identifying Transcriptional Regulatory Alterations Of Chronic Effects Of Blast And Disturbed Sleep In United States Veterans, Molly J. Sullan, Kelly A. Stearns-Yoder, Zhaoyu Wang, Andrew J. Hoisington, Adam D. Brenoweth, Walter Carr, Yongchao Ge, Hanga Galfalvy, Fatemah Haghighi, Lisa A. Brenner

Faculty Publications

Injury related to blast exposure dramatically rose during post-911 era military conflicts in Iraq and Afghanistan. Mild traumatic brain injury (mTBI) is among the most common injuries following blast, an exposure that may not result in a definitive physiologic marker (e.g., loss of consciousness). Recent research suggests that exposure to low level blasts and, more specifically repetitive blast exposure (RBE), which may be subconcussive in nature, may also impact long term physiologic and psychological outcomes, though findings have been mixed. For military personnel, blast-related injuries often occur in chaotic settings (e.g., combat), which create challenges in the immediate assessment of …

Impact Of Sleep Deprivation On Stress And Performance In Students: Best Interventions, Brianna Crowley

Capstone Showcase

Sleep is an essential part of physical and mental well-being, yet, many individuals underestimate its importance.^1,2,4 Sleep deprivation can lead to a variety of detriments including memory loss, disorganized thinking, and mood changes.^3,6,7 Because of this, academic performance can be directly impaired as well, which further perpetuates a vicious cycle of sleep deprivation and increasing stress.⁸ Interventions to help improve sleep include adequate sleep hygiene, appropriate physical exercise, lifestyle changes, practicing mindfulness, and using pharmaceutical aids. Providers must continue to address this common issue among patients as it truly impacts various aspects of life and follow good …

Utilizing The Stop-Bang Questionnaire To Assess Risk Of Obstructive Sleep Apnea In Hospitalized Patients With Heart Failure To Facilitate Sleep Medicine Referrals Upon Discharge, Chelsea Mitchell

DNP Projects

Background: Obstructive sleep apnea (OSA) is the most common sleep-breathing disorder. Undiagnosed OSA is highly prevalent in the population, especially in those with heart failure. OSA and heart failure combined create a negative feedback loop that can lead to poor clinical outcomes. Unfortunately, many cardiac patients are never screened for OSA.

Purpose: The purpose of this project is to improve screening rates for OSA via the STOP-Bang questionnaire and establish an efficient and effective process for referrals to sleep medicine for heart failure patients screening high-risk.

Methods: The design was a quality improvement project with pre- and post-testing and a …

Relationship Between Arm Path, Ball Velocity, And Elbow Varus Torque In Professional Baseball Pitchers, Brittany Dowling, Alexander Hodakowski, Bjorn Olmanson, Matthew Cohn, Patrick Pauley, Nikhil Verma, Gregory Nicholson, Grant Garrigues

Rothman Institute Faculty Papers

BACKGROUND: Currently, most pitching instructors suggest a shorter arm path-the total distance the arm travels during pitching. Theoretically, this combination allows for better body segment sequencing, a more efficient energy transfer through the kinetic chain, and increased ball velocity, while limiting elbow varus torque.

HYPOTHESIS: Shorter arm paths would be associated with increased ball velocity and decreased elbow varus torque.

STUDY DESIGN: Descriptive laboratory study.

METHODS: A total of 182 professional pitchers threw 8 to 12 fastball pitches while evaluated by 3-dimensional motion capture (480 Hz). The arm path was calculated as the total distance the hand marker traveled during …

Proceedings Of The 2023 Iaom Convention, International Association Of Orofacial Myology

International Journal of Orofacial Myology and Myofunctional Therapy

The International Association of Orofacial Myology (IAOM) held its 2023 Convention in Chandler, Arizona from October 13 - 15. The Proceedings of the Convention contain abstracts and summaries of podium and poster presentations.

A Quality Improvement Project: Implementing A Sleep Disturbance Screening Questionnaire In A Primary Care Clinic, David Elder Hamby

Doctoral Projects

At present time, it is estimated that 50-70 million Americans suffer from some form of sleep disturbance (disrupted sleep) and subsequently, sleep disorders (formal diagnosis) (Hanson & Huecker, 2022), which has a direct correlation between sleep disorders and many existing common comorbid conditions. Patients commonly report experiencing excessive daytime sleepiness, inability to focus or concentrate, generalized fatigue, decreased libido, and lability of emotions. As a person ages, there is an increasing trend in the reduction of quality and quantity of sleep. Due to Americans living longer, the number of Americans living with sleep disturbance has significantly ballooned in recent decades. …

Forensic Evaluation Of A Single Episode Of A Disorder Of Arousal In A Sleepwalking Defense: Cognitive Function Versus Prior Clinical History, Mark R. Pressman

Department of Medicine Faculty Papers

Introduction

The clinical diagnosis of disorders of arousal (DOA) is based primarily on a clinical history including amnesia for episodes. The presence of amnesia means the patient cannot provide direct evidence. In a forensic setting, when the defendant has been charged criminally with violent actions or sexual related assaults allegedly during sleep, a sleepwalking defense may be presented. As opposed to clinical history, the prosecution generally focuses on the single episode of alleged DOA that resulted in the criminal charges against the defendant. The prosecution will argue that this episode of complex behavior was not consistent with a DOA. A …

Sleep And Behavioral Problems Among Preschool Children: Correlations From Pakistan Urban, Seema Zainulabdin Lasi, Somal Kayani, Noreen Afzal

Human Development Programme

The study was undertaken to explore patterns, habits, and problems for sleep in preschool children of urban Karachi, Pakistan. Two schools participated with a sample size of 297 preschool children. A cross-sectional study design was implemented. The mean age of children was 4.6 ± 0.71 years, and the male/female ratio was 49:51. The average daily sleep duration (nocturnal + daytime nap) was 9.51 ± 1.21 hours. At least one sleep problem was reported in 73% of children, the most frequently found sleep problems were, bedtime and wakeup resistance (25.6%), sleepy or tired during the day (46%), complains of growing pains …

On The Respiratory Syncytial Virus Vaccine, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Use Of Electronic Ecological Momentary Assessment Methodologies In Physical Activity, Sedentary Behavior, And Sleep Research In Young Adults: Systematic Review, Kimberly R. Hartson, Luz Huntington-Moskos, Clara G. Sears, Gina Genova, Cara Mathis, Wessly Ford, Ryan E. Rhodes

Faculty Scholarship

Background: Recent technological advances allow for the repeated sampling of real-time data in natural settings using electronic ecological momentary assessment (eEMA). These advances are particularly meaningful for investigating physical activity, sedentary behavior, and sleep in young adults who are in a critical life stage for the development of healthy lifestyle behaviors.

Objective: This study aims to describe the use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults.

Methods: The PubMed, CINAHL, PsycINFO, Embase, and Web of Science electronic databases were searched through August 2022. Inclusion criteria were use of eEMA; sample of young adults …

Better Sleep, Brighter Mornings: A Sleep Hygiene Protocol For Older Adults As A Quality-Of-Life Enhancement, Melissa Baltazar

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to emphasize the importance of and educate patients on primary prevention techniques for sleep hygiene to use as a tool to enhance quality of life by increasing patient’s self-reported sleep quality.

Background: Sleep patterns change as we age, however, aging itself is not necessarily a cause of sleep problems. Sleep is one of the most important activities for a person’s health and overall well-being. A growing body of literature shows that not enough sleep and poor sleep quality is associated with hypertension, heart disease, stroke, diabetes, …

Interpretive Phenomenological Analysis [Ipa]: Examining The Impact Of Sleep Disturbances On Lived Experiences Of Persons With Parkinson’S Disease (Pwpd), Adriana Ornelas, Angela Blackwell, Karen Aranha

Spring 2023 Virtual OTD Capstone Symposium

Introduction: This investigation aimed to examine the lived experiences of PwPD who suffer from insomnia. Sleep disturbance affects up to 96% of individuals with PD. The non-motor symptom (NMS) significantly reduces HR-QOL, positively correlates with disease severity and duration, and increases the disease burden of care. Due to the nature of the disease, typical sleep hygiene protocols may not be the most effective intervention for this population. Understanding their challenges is vital to developing a sleep hygiene protocol tailored to their needs.

Methodology: A pilot qualitative study using an interpretive phenomenological analysis (IPA) with PwPD (N=12). The study received IRB …

Identification Of Molecular Markers Associated With Copd In Non-Smokers And Smokers: A Bioinformatics Analysis, Agede O. Ayodele, Isa M. Wasagu, Ademola E. Fawibe, Alakija K. Salami

The University of Louisville Journal of Respiratory Infections

Background

Even though the proportional burden of COPD among never-smokers is significant in both developing and developed nations, accounting for around 30% of all COPD in the community, there is little awareness of the prevalence of COPD in this population. Understanding the molecular processes that underlie COPD in nonsmokers is essential.

Methods

Dataset (GSE146560) was acquired from the Gene Expression Omnibus (GEO). The limma and clusterProfiler software tools were used to identify differentially expressed genes (DEGs) and conduct a functional enrichment analysis respectively.

Results

In all, 10,583 DEGs were found, of which 1,065 were up-regulated and 9,518 were down-regulated. The …

Review Of Nighttime Temperature Effects On Long-Term Health Condition Through Sleep Studies, Sydnie Matkins

Modeling, Simulation and Visualization Student Capstone Conference

Over the past 40 years, there has been increasing interest in human sleep quality and duration. This nonsystematic review looked at over 80 peer-reviewed papers on the association among sleep, temperature, and long-term health conditions. Generally, warmer temperatures lend to poorer sleep quality, and poor sleep quality lend to mental illness and a higher risk of coronary heart disease and mortality. Future research should be to conduct a study that relies more on health records rather than questionnaires to accurately map current and future health quality.

Gender Disparities In The Diagnosis Of Sleep Disordered Breathing, Kenna Haile, Nesrine Ibrahim, Safwan Badr, Apala Vaishnav

Medical Student Research Symposium

Introduction: Current diagnostic guidelines for sleep disordered breathing (SDB) require that apneas and hypopneas be accompanied by a 4% desaturation for it to constitute a respiratory event (AHI-Accepted). However, the American Academy of Sleep Medicine recommends expanding the diagnostic criteria to include apneas and hypopneas accompanied by a 3% desaturation or a cortical arousal for diagnosis (AHI-Recommended). We hypothesized that a clinical sample of both men and women would demonstrate that women are more likely to be misdiagnosed using the accepted criteria compared to the recommended criteria.

Methods: The clinical sample consisted of all patients receiving a PSG at the …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

What? Now A Respiratory Syncytial Virus Epidemic, Aya Allam, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Recurrent Cyanotic Spells In An Octogenarian, Chin Tong Kwok, Chun Kit Wong

Journal of the Hong Kong College of Cardiology

We report rare case of an octogenarian who, after years of diagnostic delay, was found to have a patent foramen ovale, and due to an ascending aortic aneurysm that anatomically facilitated right-to-left shunt, presenting with life-threatening cyanotic attacks. The characteristic orthodeoxia-platypnea syndrome and high alveolar arterial gradient hint to the diagnosis. She was eventually treated successfully with urgent percutaneous PFO closure. Routine ordering of a transthoracic echocardiogram, without agitated saline injection under provocation maneuvers, may not be sufficient to rule out shunts.

What Are We Missing In Adult Obstructive Sleep Apnea Clinical Evaluation? Review Of Official Guidelines, Eduardo J. Correa, Carlos O´Connor-Reina, Laura Rodriguez-Alcalá, Diego M. Conti, Alberto Rabino, Peter M. Baptista, Maria-Teresa Garcia-Iriarte, Guillermo Plaza

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: This article presents a narrative review of current recommendations for the clinical evaluation and management of adult patients with obstructive sleep apnea (OSA) to identify points missing from a myofunctional perspective.

Methods: The authors reviewed current official guidelines for adult patients with OSA, searching clinical evaluation and treatment recommendations for myofunctional therapy.

Results: None of the current guidelines for evaluation of adult OSA recommend performing a myofunctional evaluation. Only two guidelines consider myofunctional therapy (MFT) as a treatment modality for adult patients with OSA.

Conclusion: Despite the role of the pharyngeal dilator muscles as an …

Evaluation Of Sleep Benefits Following A 16-Week Judo Program For Children With Autism Spectrum Disorder, Neha R. Chittaluru

Honors Undergraduate Theses

Autism Spectrum Disorder is a neurodevelopmental disorder characterized by language and communication deficits, and difficulties with social interaction (Twisk, 2001). Research has shown that 80% of youth with ASD experience sleep challenges which can lead to sleep-related health issues, exacerbate problematic behaviors, and increase vulnerability to anxiety and depression (Wachob & Lorenzi, 2015; Williams et al., 2004; Richdale & Schreck, 2009). Sleep plays a central role in adaptive functioning, and insufficient sleep can hinder learning, memory, and neuroplasticity for children with ASD (Cohen et al., 2014). As these unhealthy behavior patterns can lead to more adverse long-term health consequences, it …

Benefits Of A Family-Based Judo Program For Parents Of Children With Autism Spectrum Disorder, Jeslin George

Honors Undergraduate Theses

A diagnosis of Autism Spectrum Disorder (ASD) can impact the entire family. Parents of children with ASD reportedly have greater stress levels, family conflict, financial concerns, and poor health habits than parents of neurotypical (NT) children. While many parent-focused interventions have been developed, these interventions focus on parent training and child behavior outcomes rather than the health and well-being of the parents. Therefore, this study aimed to examine the effects of a 15-week family judo program on physical and psychosocial health in parents of children with ASD. A total of 18 parents of children with ASD participated in a weekly …

The Relationship Between Evening Screen Time Use And Objectively Measured Sleep Outcomes In U.S. College Students, Donya Sedaghat

Honors Undergraduate Theses

Research suggests that elevated levels of screen time in the evening can negatively impact sleep outcomes (sleep duration, quality, and latency). Yet, there is a lack of evidence exploring if this relationship exists in college students. The purpose of this study is to investigate the relationship between evening screen time use and objectively measured sleep outcomes in US college students. College students (N = 29) junior or senior standing in a Health Sciences major were recruited to participate in this cross-sectional study. Participants wore accelerometers on their wrist for 24hr/day for seven days to capture sleep duration, efficiency, awakenings, and …

The Mental And Dental Repercussions Of Obstructive Sleep Apnea And Its Treatments, Emily E. Mcgoohan

Honors Undergraduate Theses

The purpose of this study is to examine the relationship between dental and mental health. To dive deeper into seeing this connection, patients with sleep apnea will be asked to share their experiences with the treatments for sleep apnea and how it had affected their mental or dental health.

The Balance Between Sleep And Lifestyle: How Lifestyle Impacts Insufficient Sleep, Evan Hartman, John Monnig

Scholarship in Medicine - All Papers

Sleep insufficiency is a common but overlooked problem for many people. This is harmful because adequate sleep is important to cognitive, emotional, and physical health. This study analyzed how food environment index, smoking, physical activity, and median household income impact sleep insufficiency on an Ohio population. All data was utilized from the County Health Rankings (CHR) database. This analysis presented that the food environment index (r = -0.676, p < .001) and median household income (r = -0.743, p <.001) negatively correlated to insufficient sleep percentage. Furthermore, both adult smoking percentage (r = 0.735, p < .001) and physical inactivity (r = 0.761, p < .001) positively correlated to insufficient sleep percentage. It is also important to note that there was a significant difference between Ohio and Indiana counties (t = -12.347, p < .001), two neighboring states that both contain a mixture of urban and rural populations. Lastly, there was no significant difference between rural and urban Ohio counties (t=-1.521, p=.132). This data presents that more physical activity and less smoking may have positive benefits on sleep along with eating healthier, more nutrient dense food. Moreover, increased median household income may also positively impact sleep. Lifestyle factors such as smoking, physical activity, and increased nutritious food consumption are all avenues for patients to try to implement into their own lives to improve their sleep. Hopefully, such lifestyle modifications will improve sleep quality and thus result in an improvement in other aspects of their overall health.

Exploring The Reduction Of Ipap Below Epap In The Therapy Of Obstructive Sleep Apnea, William Noah, Sue Lynn Myhre

TriStar Division Research Day 2023

No abstract provided.

Pilot Feasibility And Acceptability Study Evaluating Use Of Group Cbt-I In Improving Sleep And Fatigue In Older Adults, Aisling Smyth, Shehnas Alam, Sabine Pangerl

Research outputs 2022 to 2026

Objective: This paper describes a pilot study, in a small sample of older adults, designed to ascertain the feasibility, acceptability and potential effectiveness of group Cognitive Behavioural Therapy For Insomnia (CBT-I). Methods: Eleven older adults participated in a 3-week group CBT-I intervention with pre- and post-intervention outcome measures of sleep and fatigue. Acceptability was measured via post-intervention focus groups. Feasibility was measured via recruitment, retention and completion data. Subjective sleep outcomes were measured pre- and post-intervention using the Pittsburgh Sleep Quality Index. Fatigue was measured using the Fatigue Severity Index. Objective sleep outcome measures were obtained via pre- and post-intervention …

Advances And Updates On Open-Access Publishing By The Ijom, Nancy Pearl Solomon

International Journal of Orofacial Myology and Myofunctional Therapy

An online, open-access, no-fee model of the International Journal of Orofacial Myology and Myofunctional Therapy (IJOM) was established in December 2020 and includes all archived articles back to the journal’s origin in 1975. While aiming to increase content for the journal, the Editorial Review Board (ERB) has also been diligent about maintaining high standards for publication. This note From the Editor highlights recent publications, conference proceedings, and special issues. It also lists updates and challenges in terms of policies and practices. The IJOM remains both a traditional association-supported journal and is on the cutting edge of open-access publishing.

The Spectral Sensitivity Of Human Circadian Phase Resetting And Melatonin Suppression To Light Changes Dynamically With Light Duration, Melissa A. St Hilaire, María L. Ámundadóttir, Shadab A. Rahman, Shantha M. W. Rajaratnam, Melanie Rüger, George C. Brainard, Charles A. Czeisler, Marilyne Andersen, Joshua J. Gooley, Steven W. Lockley

Department of Neurology Faculty Papers

Human circadian, neuroendocrine, and neurobehavioral responses to light are mediated primarily by melanopsin-containing intrinsically-photosensitive retinal ganglion cells (ipRGCs) but they also receive input from visual photoreceptors. Relative photoreceptor contributions are irradiance- and duration-dependent but results for long-duration light exposures are limited. We constructed irradiance-response curves and action spectra for melatonin suppression and circadian resetting responses in participants exposed to 6.5-h monochromatic 420, 460, 480, 507, 555, or 620 nm light exposures initiated near the onset of nocturnal melatonin secretion. Melatonin suppression and phase resetting action spectra were best fit by a single-opsin template with lambda_max at 481 and 483 …

Tonsillectomy In Children With 22q11.2 Deletion Syndrome., Jill M. Arganbright, Paul Bryan Hankey, Meghan Tracy, Srivats Narayanan, Janelle R. Noel-Macdonnell Phd, David G. Ingram Md

Manuscripts, Articles, Book Chapters and Other Papers

Tonsillectomy is one of the most common procedures performed in children, however there are currently no published studies evaluating tonsillectomy in children with 22q11.2 deletion syndrome (22q11DS). With this study, our goal was to investigate the indications, efficacy, and complications of tonsillectomy in a pediatric cohort of patients with 22q11DS. This is a retrospective chart review of patients in our 22q Center's repository. Inclusion criteria were a diagnosis of 22q11DS and a history of tonsillectomy or adenotonsillectomy. Data collected included: indications for tonsillectomy, preoperative and postoperative polysomnography (PSG) results, and surgical complications. In total, 33 patients were included. Most common …