Sleep Medicine Commons^™

The Effects Of Antidepressant Medications On Sleep Quality In Dominican University Of California Students, Natalie L. Davis, Kenna Wohlford, Stephanie Lee

Physician Assistant Studies | Graduate Research Papers

We spend approximately one third of our life time sleeping or attempting to sleep. The quality of our sleep is equally, if not more important than the amount of sleep we get. This study assesses the effects that medications, specifically antidepressants, can have on sleep quality in Dominican University of California students. 118 participants completed a Qualtrics survey including questions regarding stress, sleep quality, medication lists, and demographics. This study utilized the Pittsburgh Sleep Quality Index (PSQI) to quantify participants’ sleep quality as the outcome. Participant stress levels were assessed with a Likert scale question asking for stress levels on …

Efficacy Of Pharmacotherapy Vs Psychotherapy For Insomnia: A Clinical Review, Logan Lovell

The PA Department Journal of Medical Science

Introduction: Insomnia is a widespread sleep disorder with significant impacts on public health, economics, and vulnerable populations including the elderly and those with chronic health conditions. This review examines current literature comparing pharmacologic and non-pharmacologic treatments for insomnia.

Methods: A comprehensive literature search was conducted via PubMed using the keywords “insomnia,” “cognitive behavioral therapy,” and “pharmacotherapeutics” which was refined using MeSH terms, Boolean operators, and specific parameters (English, free full-text, published between 2019 and 2024). Six articles were selected for an in-depth review of pharmacotherapeutic and psychotherapeutic treatments for insomnia.

Results: The selected articles from the PubMed search were …

Reassessing Hourly Neurological Assessments: A Quality Improvement Initiative, Haley Lynne Johnson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Reassessing Hourly Neurological Assessments: A Quality Improvement Initiative

Haley Lynne Johnson, BSN, RN

Background: Stroke and brain injuries remain among the leading causes of mortality in the United States, accounting for 162,890 deaths in 2021 (Centers for Disease Control and Prevention [CDC], 2021). Although frequent neurological assessments are essential for monitoring patient status, limited evidence supports the prolonged use of hourly neuro-checks (LaBuzetta et al., 2022). Excessive neuro-check frequency has been linked to sleep deprivation, an increased risk of delirium, and inefficient resource utilization (Kishore et al., 2021).

Purpose: This project aimed to assess the impact of …

Improving Primary Care Providers Awareness, Knowledge, Attitude, And Intention To Change Practice About Uncontrolled Obstructive Sleep Apnea And Its Effect On Metabolic Dysfunction-Associated Steatotic Liver Disease, Formerly Non-Alcoholic Fatty Liver Disease Prognosis, Olivia Amoakowaa-Senya

Doctoral Scholarly Projects & Capstones

Non-alcoholic fatty liver disease (NAFLD), now known as metabolic dysfunction-associated steatotic liver disease (MASLD), is the leading cause of chronic liver disease in the world. The mechanisms involved in its development and progression continue to be a mystery that scientists are trying to unravel. However, many research studies found a correlation between uncontrolled obstructive sleep apnea (OSA) and worsening of NAFLD. Chronic intermittent hypoxia and sleep fragmentation in OSA increase sympathetic activity and promote oxidative stress, pro-inflammatory cytokine production, and metabolic dysregulation, which increases the risk of various diseases, including NAFLD/MASLD progression. Early assessment and screening for OSA in patients …

Obstructive Sleep Apnea And Obesity: How Weight Loss Improves Sleep Apnea Severity And Quality Of Life - An Integrative Review, Hannah Wilson, Neda Akbarshahi

Master's Projects

Introduction: With the growing prevalence of OSA due to the obesity epidemic, there is an urgent need to update treatment regimens. While CPAP continues to be the gold standard of OSA care, challenges with adherence and limited access to effective weight management strategies often impede care. The complex bidirectional relationship between obesity and OSA highlights the importance of addressing weight management in this patient population to help mitigate cardiometabolic risks. Personalized weight loss therapies should be integrated into standard OSA treatment regimens to reduce OSA severity, reduce comorbid conditions, and improve quality of life.

Aim: The objective of this integrative …

What Are The Most Effective Non-Pharmacologic Practices For The Management Of Primary Insomnia In Adults?, Alexis Myhre

Theses and Graduate Projects

Objective: Primary insomnia is a mental health condition in which individuals struggle with falling asleep, staying asleep or early morning awakenings. As there are many treatments available that claim to help those with primary insomnia, this review looks specifically at therapy, exercise and acupuncture as management strategies.

Methods: This is a review of 15 peer-reviewed, randomized controlled trials completed in 2018 or later with one additional study completed in 2010. Also, there are four non primary insomnia based studies used to support the efficacy of alternative therapies to cognitive behavioral therapy (CBT). All the studies used in this review come …

Sleep Disturbances In Adults With Tsc: Influences Of Treatment And Clinical Features, Kirstin Risgaard

Dissertations and Theses (Open Access)

Tuberous sclerosis complex (TSC) is a rare genetic condition caused by pathogenic variants in the TSC1 or TSC2 genes. TSC is characterized by a multisystem, neurocutaneous phenotype including skin lesions, hamartomas, and epilepsy. Additionally, TSC can present with an array of behavioral, psychiatric, academic, psychosocial, intellectual, or neuropsychological difficulties comprehensively known as TAND, or TSC-associated neuropsychiatric disorders. Sleep disorders are a common feature of TAND; however, they are not well characterized in the adult TSC population. Likewise, little is known about how clinical features of the condition and commonly prescribed medications impact sleep. Therefore, this study aimed to determine the …

Co-Occurrence Of Autism Spectrum Disorder And Attention-Deficit/Hyperactivity Disorder With Idiopathic Hypersomnia: Data From The Hypersomnia Foundation Registry, Sophie Sevan Mikkelsen

Honors Undergraduate Theses

In recent years, hypersomnia patients and researchers alike have increasingly discussed the possibility of heightened comorbidities, or co-occurrences, of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) with the central disorders of hypersomnolence: idiopathic hypersomnia (IH) and narcolepsy (N). While a few scarce studies have investigated a link between ADHD and N, there has been no research on the co-occurrence of these conditions with IH. This study, using data from the Hypersomnia Foundation’s CoRDS Patient Registry, is the first to identify self-reported rates of ASD and ADHD diagnoses by people with idiopathic hypersomnia. Four chi-square tests were conducted to determine …

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 …

Dog Tired: Examining The Relation Between Dog And/Or Cat Ownership And Owners’ Sleep, Courtney J. Bolstad

Theses and Dissertations

Sleep is an essential part of life, and obtaining quality sleep is important for various areas of functioning. Behaviors to promote sleep include physical activity, managing stress, reducing anxiety symptoms, maintaining a consistent sleep schedule, and obtaining bright light exposure. Many of these behaviors overlap with benefits observed from pet ownership (PO). The present study aimed to examine the relation between PO and sleep as well as moderators and mediators of this relation. Four research questions were examined: 1) Is PO significantly related to sleep? 2) Does gender moderate the relation between PO and sleep? 3) Do sleep-promoting behaviors (i.e., …

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, …

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. …

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.

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 …

Prospective Investigation Of Insomnia Symptoms And Sleep Duration As Risk Factors For Stroke Incidence And All-Cause Mortality In U.S Adult, Wendemi Sawadogo

Theses and Dissertations

Background and Objectives: Stroke is the second leading cause of death in the world. In the United States, on average, someone has a stroke every 40 seconds and someone dies as a result of stroke every 3.5 minutes. Identifying modifiable risk factors of stroke is therefore a public health priority. The purpose of this study was to investigate the extent to which insomnia symptoms and sleep duration contribute to stroke incidence, all-cause mortality, and explore potential causal pathways.

Methods: The Health and Retirement Study (HRS) and the REasons for Geographic And Racial Differences in Stroke (REGARDS) study were …

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 …

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 …

Effects Of Expiratory Muscle Strength Training On Oropharyngeal Swallow Physiology In Persons With Obstructive Sleep Apnea (Osa): A Pilot Study, Ankita Murlidhar Bhutada

Graduate Theses and Dissertations (2019 - present)

Obstructive sleep apnea (OSA) is characterized by frequent narrowing of the upper airway during sleep. The estimated prevalence of swallowing impairments (dysphagia) in OSA patients ranges up to 80% and comprises approximately 50% of the caseload of practicing speech-language pathologists in the United States. Despite the high prevalence of dysphagia, there is a paucity of evidence supporting behavioral intervention(s) for ameliorating swallowing impairments in OSA. This pilot study assessed oropharyngeal swallowing physiology in persons with OSA and the feasibility and acceptability of a behavioral dysphagia intervention that specifically targets upper airway musculature – Expiratory Muscle Strength Training (EMST). A total …

Evaluating Non-Pharmaceutical Sleep Hygiene Interventions For The Prevention Of Delirium And Improvement In Sleep Quality In Critical Care, Sonja L. Colby

Honors Undergraduate Theses

Patients admitted to an adult intensive care unit (ICU) are at risk of developing an acute condition known as ICU delirium, which can impact patients’ length of hospital stay and increase short term and 6-month mortality. The cause of ICU delirium is multifactorial, and lack of quality sleep is a known risk factor. Patients’ sleep in the ICU is frequently interrupted by clinicians involved in their care and equipment alarms. Sleep hygiene interventions to minimize these interruptions for the patient are one strategy to reduce the risk of ICU delirium. Examples of sleep hygiene interventions include eye masks, earplugs, and …

The Intertwined Relationship Of Stress And Sleep Quality Of Undergraduate Students During The Covid-19 Pandemic, Jordan Nguyen

Honors Undergraduate Theses

This study aims to examine the relationship between stress and sleep of undergraduate students during the course of the COVID-19 pandemic. The possibly correlational relationship between these two parameters was determined with respect to how this population was faring during recent times, two years into the pandemic. The study also served to examine how this relationship changed over time based on three time frames: before the pandemic, during the advent of the lockdown (March 2020-May 2020), and during recent times. A survey was developed to collect data from the undergraduate participants for correlation and regression analysis to determine the relationship …

Obstructive Sleep Apnea Education To The Rural Community, Brandi Harris

Doctor of Nursing Practice Projects

This project was executed to provide obstructive sleep apnea education to the men and women of the rural community. Many residents of rural communities remain undereducated and unaware of diseases and disorders in which they are subjected to or have increased risks for. Obstructive sleep apnea affects approximately twenty-two billion Americans. Of those affected, nearly eighty percent remain undiagnosed and untreated (Nagappa et al., 2015). Victims of the sleep disorder fail to acknowledge signs and symptoms of obstructive sleep apnea, many oblivious to the etiology, risk factors, symptoms, and pathophysiology of the disorder. Presenting education to residents of the rural …

Substance Use And Psychological Distress Correlates Of Sleep Quality Among College Students, Juanybeth Morales Ortega

Graduate Theses and Dissertations

Poor sleep quality in college students is a major problem associated with adverse health outcomes, cognitive performance, substance use, and psychological distress. Our study explored how substance use and psychological distress are associated with the sleep quality of college students. We analyzed secondary data collected in 2019 using a cross-sectional survey design. Measures included participants’ demographic characteristics, sleep quality using the Pittsburg Sleep Quality Index (PSQI), drug use, depression using the Patient Health Questionnaire-9 (PHQ-9), and suicidality. After excluding participants with missing information for sleep quality, a total of 555 students remained for the analysis. Our bivariate analysis found that …

Sleeping With The Enemy: Examining The Relationship Between Sleep And Pain In Post-9/11 Veterans, John L. Schwartz Jr.

Psychology Theses & Dissertations

United States veterans are a diverse group of individuals, yet as a result of their service, they share a unique set of customs, traditions, and values. Post-9/11 veterans are more likely to experience elevated levels of pain and poor sleep quality compared to their civilian counterparts; however, little is known about how beliefs related to veterans’ pain impact their sleep and how levels of pain acceptance influence the sleep-pain association. This study examined relationships between sleep and pain in a sample of 102 post-9/11 veterans. Results support associations between pain and sleep identified in other populations. Positive correlations were found …

Disability Injustice: A Latino’S Creative Autoethnographic Testimonio On The Organizational Culture Of Higher Education, Leonel A. Diaz Jr.

Organization, Information and Learning Sciences ETDs

Using creative autoethnographic testimonio (CAT), a story is told about the injustices within the learning environment and work environment of higher education toward a person with disabilities: sleep apnea, learning disabilities, negative mental health. The author explores the health difficulties of addressing sleep deprivation while attending graduate school and working full-time as a professional. With sleep apnea impacting his health, his mental health declines. As his health declines, there is an increase in discrimination, hostility, oppression, bullying, and toxic masculinity. Initially, the medical system dismisses his declining health and refuses to look further into it. Once he receives medical care …

Aromatherapy As A Non-Pharmacological Complementary And Integrative Sleep Intervention For Veterans, Amy D. Stewart

Doctor of Nursing Practice Projects

Twenty-seven percent to 54% of military personnel and veterans experience insomnia, with apnea and insomnia being the most common disorders in this same population. Due to high incidences of sleep disorders in the veteran population, this project sought to identify and validate a non-pharmacological intervention, aromatherapy, as a viable option for veterans with sleep problems. Aromatherapy, essential oils, have proven to be a natural, safe, low-cost, and non-pharmacological option for improving patient health outcomes and patient satisfaction.

Sleep-Related Problems, Sleep-Related Distress, And Sleep-Related Functional Status Among Adult Inpatients Receiving Palliative Care, Lisa C. Sievers

Theses and Dissertations

Palliative care patients may be at a higher risk for sleep-related problems and their negative effects compared to the general population, yet limited sleep research has been done with this population. The purpose of this dissertation was to determine prevalence rates for excessive sleepiness, insomnia, restless legs syndrome (RLS), and high risk for sleep apnea (HRSA); examine relationships between the aforementioned sleep-related problems, sleep-related distress (SD), and sleep-related functional status (SFS); and to determine which sleep-related problem measures along with age and gender predicted SD and SFS among a sample of adult palliative care inpatients. Secondary aims were to understand …

Determining The Severity Of Obstructive Sleep Apnea (Osa) By Using Numerical Analysis, Ming Lok Ang

Student Works (2020-2029)

Computational technologies and biomechanical theories have been applied to study upper airway mechanics in obstructive sleep apnea (OSA). In this study, the patient is selected from ENT Department, UMMC, diagnosed with mild to severe OSA. In addition, the patient underwent maxillomandibular advancement (MMA) surgical treatment. Therefore, 3-dimensional modeling software will be used to model the upper airway, based on patient specific geometrical characteristics obtained from medical imaging and computed tomography (CT). Hence, providing an accurate assessment of airflow characteristics. Computational fluid dynamics (CFD) analysis will be combined with upper airway geometries obtained before and after surgical to determine the effects …

A Positive Framed Message To Improve Cpap Compliance For Patients With Osa, Frances Clark

Evidence-Based Practice Project Reports

Obstructive sleep apnea (OSA) affects 24% of the US population (DiNapoli, 2014). Untreated OSA causes many diseases, affects one’s quality of life, and increases mortality (Pengo et al., 2018). Continuous positive airway pressure (CPAP) is the lifelong treatment for OSA; yet 30%-80% of OSA patients are CPAP noncompliant within one year. The purpose of this EBP project was to determine if implementing a positive frame message intervention would improve CPAP compliance for newly diagnosed OSA patients. Based on the evidence, implementation of behavioral interventions, such as a positive framed message, was effective in improving CPAP compliance (Pengo et al., 2018). …

Examining The Relationship Of Exercise And Sleep In Students Across Multiple Academic Disciplines, Taylor Zewe

Honors Projects

Students in college learn the importance of balancing their academic studies with their sleep and exercise habits. The amount of sleep and exercise a student recieves has been examined in previous research studies. In these studies it was found that exercise had a postive affect on the amount of sleep received. However, there is little research on the affect academic discipline has on sleep habits and/or exercise habits of students in college. The purpose of this study is to examine the sleep and exercise habits among students in multiple academic majors at Bowling Green State University.

Comprehensive Sleep Apnea Screening In Veterans With Posttraumatic Stress Disorder, Richard W. Schulz

Doctor of Nursing Practice Final Manuscripts

Objectives: Recent studies have shown a higher prevalence of sleep apnea in veterans with Posttraumatic Stress Disorder (PTSD). It is estimated that 69 to 83% of veterans have Obstructive Sleep Apnea (OSA) while 80 to 90% are undiagnosed or untreated. Untreated OSA can lead to severe chronic medical conditions as well as impairment of neurocognitive and fear extinction processing potentially decreasing responsiveness to trauma focused therapy. Despite the widespread dissemination of knowledge regarding the negative effects of OSA, many veterans are not screened. The goal of this project is to increase the rate of identifying veterans who are high-risk for …