S Ancoli-Israel

..This randomized controlled study tested the hypothesis that increased morning bright light, compared to dim light, would result in less fatigue in women with breast cancer undergoing chemotherapy...

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..Several studies have suggested that variations in habitual bedtime are 40-50% heritable...

..Using data from the multicenter Study of Osteoporotic Fractures (SOF), we tested the relationship between HT and sleep-wake estimated from actigraphy...

..Clinicians should ask elderly patients about satisfaction with sleep. Any sleep complaints warrant careful evaluation of contributing factors and appropriate treatment...

..This review summarizes the state of the literature on fatigue, sleep and circadian rhythms...

..However, most of the previous research examined women either during or after chemotherapy. This study examined sleep, fatigue, and circadian rhythms in women with breast cancer before the start of chemotherapy...

..Case reports such as this support the utility of larger, more systematic studies. It is unclear whether this degree of familiarity is representative of that in the general population...

..Although we think we have discovered many new features about sleep disorders, much of what we know today was suggested thousands of years ago and documented in the Bible and the Talmud...

..To examine the effects of galantamine and donepezil on patient and caregiver sleep...

..The contributors to this article discuss insomnia as it is experienced by each of these populations and present representative case examples and proposed treatment plans for each...

..Careful health assessment is necessary to screen out sleep complaints and disorders in older populations...

..This paper reports the results of a 1-year open-label extension phases of two randomized, double-blind trials of zaleplon...

..The contributors to this article discuss insomnia as it is experienced by each of these populations and present representative case examples and proposed treatment plans for each...

..To examine the association of sleep apnea with heart disease...

..Longer-term pharmacologic studies for insomnia in older individuals are sparse...

..Those issues have now been addressed and actigraphy may now be reaching the maturity needed for application in the clinical arena...

..The authors expand on an earlier pilot study by evaluating the effect of bright light therapy on agitated behavior in a large sample of patients with severe dementia...

..Members of the primary care groups ranged from policy makers to those with a special interest in sleep medicine, all of whom contributed to an understanding of the unique circumstances and concerns encountered in primary care...

..This study examined whether nondipping in older African Americans and older white subjects is related to the presence of sleep-disordered breathing (SDB) and hypertension...

..It would behoove nursing homes to consider increasing ambient light in multipurpose rooms where patients often spend much of their days...

..Cognitive-behavioral therapy alone and in combination with medication have been effective in improving sleep in older adults. Sleep disturbance is not a natural consequence of aging, but rather a treatable condition...

..To determine whether fragmented sleep in nursing home patients would improve with increased exposure to bright light...

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..One endpoint often used is the duration of the initial sleep period, which when evaluated in combination with the number of voiding episodes per night, might be an indication of the severity of sleep disruption in patients with nocturia...

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..This article reviews the specific associations between chronic insomnia and a wide range of chronic physical and psychiatric disorders...

..To examine whether treatment of obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) in patients with Alzheimer's disease (AD) results in better cognitive function...

..When hypnotics are indicated, the most appropriate short-acting agent should be considered...

..Nonpharmacological treatment techniques are discussed; pharmacological treatments are discussed in a companion article...

..We also examined if the PVT/fatigue relationship could be influenced by depressive symptoms...

..Obstructive sleep apnea (OSA) patients have a high frequency of arousals. We hypothesized that arousals significantly influence tonic sympathetic nervous system function...

..Although statistically significant, the strengths of the associations between interview variables and myoclonus indices were all small. No combination of demographic variables and symptoms allowed highly reliable prediction of PLMS...

..While caffeine partially explains the increased adrenergic tone in patients with OSA and the relationship between BP and NE, it does not appear to contribute significantly to the relationship between OSA and elevated BP...

..To test the hypothesis that a nocturnal decrease of secretion of inflammation markers and catecholamines would be associated with mood and stress variables even after controlling for objective sleep variables...

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..To determine the effects of both apnea and hypoxia on beta-adrenergic receptor sensitivity...

..These results confirm that circadian rhythms in nursing-home patients are disturbed with more disturbance in the severely demented. Much of the disturbance may be related not just to age but to mental status...

..Given that the disease is often associated with low endogenous levels of melatonin, exogenous melatonin administration may lead to improvements in sleep and agitation...

..Obstructive sleep apnea (OSA) is associated with poor sleep quality and a high incidence of nondipping. The aim of this study was to determine the association of sleep quality and nocturnal blood pressure (BP) dipping in an OSA population...

..This survey indicates that sleep-disordered breathing is more common, especially among minorities, than had been previously believed, but less co-morbidity may be associated...

..The purpose of this study is to determine factors that affect arousal scoring reliability and night-to-night arousal variability...

..Despite statistical significance, all of the associations between interview variables and apnea indices were small. No combination of demographic variables and symptoms allowed highly reliable prediction of AI or RDI...

..We hypothesized that disrupted sleep as verified by polysomnography is associated with increased levels of prothrombotic hemostasis factors previously shown to predict CAD risk...

..We studied the effect of continuous positive airway pressure (CPAP) treatment on sympathetic nervous activity in 38 patients with obstructive sleep apnea...

..These results suggest that older patients suffering from mild to moderate SDB may benefit from the treatment of SDB, even if they are not markedly hypoxemic...

..People who use more passive and less active coping report more depressive symptoms. We examined relationships between coping and depressive symptoms in OSA...

..This paper reviews the diagnoses and characteristics of sleep disorders generally found in the older adult. While aimed at the practicing geriatrician, this paper is also of importance for any gerontologist interested in sleep...

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..To determine whether 1-week continuous positive airway pressure (CPAP) treatment, compared with placebo CPAP, improves cognitive functioning in patients with obstructive sleep apnea (OSA)...

..It may be that factors that are secondary to or associated with sleep-disordered breathing (SDB), such as cardiovascular or pulmonary disease, predispose these elderly to death...

..The predictive value was 50%. Sleep disordered breathing measured at a single point in time is rather weakly predictive of the severity of breathing disorder 4-8 years later...

..This study examines the relationship between mastery and sympathetic arousal in elderly caregivers, as measured by norepinephrine (NE) reactivity to an acute psychological stressor...

..However, no large polysomnographic study has closely examined the relationship of PLMS to sleep architecture and arousals from sleep. We investigated the prevalence and correlates of PLMS in a community-based sample of older women...

..Patients with Alzheimer's disease (AD) and obstructive sleep apnea (OSA) experience disrupted sleep. This study examined the effect of continuous positive airway pressure (CPAP) on sleep parameters in AD patients with OSA...

..002) and caregiver health (p=0.008), whereby mastery attenuated the effect of stress on these outcomes. We conclude that personal mastery appears to reduce the effects of stress on depression and health outcomes over time...

..This implies that correcting the intermittent nocturnal hypoxemia alone may prevent the cardiovascular morbidity associated with obstructive sleep apnea...

..The downregulation of cardiac beta-adrenergic receptor activity may explain the inability of people with sleep apnea to respond with appropriate cardiac contractility to a mild perturbation...

..CONCLUSION: Implementing some environmental and culture changes could result in significant improvement in the sleep of nursing home residents...

..However, the efficacy of CPAP therapy has not been evaluated against a suitable control. We investigated the effectiveness of CPAP therapy in improving sleep quality in patients with OSA. We hypothesized that CPAP improves sleep quality...

..However, changes in local time reference were not significantly and consistently associated with actigraphic sleep or activity measures...

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..Our findings suggest that polysomnographic indicators of sleep quality and sleep continuity may be an important influence determining many aspects of HRQoL in OSA patients...

..observations resulted in a sensitivity of 87% and specificity of 90%. We conclude that the Actillume is the most feasible technique for studying sleep and wake activity in demented nursing-home patients...

..Increasing evidence documents the fact that individuals whose blood pressure drops or 'dips' relatively little at night have a higher risk of numerous cardiovascular illnesses...

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..The primary objective was to investigate whether persistent depressive symptoms would relate to elevated platelet activation in response to acute psychological stress over a three-year period...

..e. sleep disturbances, fatigue and depression) into one symptom cluster, to explore the associations between pre-treatment cluster categories and longitudinal profiles of these same symptoms during chemotherapy...

..Longitudinal studies are needed to empirically demonstrate the direction of relationships between each of the variables tested...

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..To present expert consensus recommendations for a standard set of research assessments in insomnia, reporting standards for these assessments, and recommendations for future research...

..Continuous positive airway pressure (CPAP) has recently been shown to have beneficial effects on cognition in AD. Little attention has focused on the long-term benefits of CPAP in these patients...

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..A hypercoagulable state thought to underly atherosclerosis has been described in both OSA and systemic hypertension. We wondered about the respective contribution of apnea and hypertension to a hypercoagulable state...

..The findings indicate that sleep apnea is associated with a diminished beta 2-adrenergic receptor function but no change in postreceptor components and suggest a mechanism for the high comorbidity between sleep apnea and hypertension...

..Sleep disruption is prevalent in patients with cancer and survivors, but the prevalence of insomnia, a distressing sleep disorder, in these populations has yet to be determined in large-scale studies...

..The purpose of this review was to examine the literature on gender differences in OSA and to analyze whether or not these differences in pathogenic mechanisms affect diagnosis or treatment...

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..Few studies have examined the association between anxiety symptoms and objectively measured sleep quality in older adults. The authors determined this association in a large cohort of very old community-dwelling women...

..Both HRT and the chronic stress of caregiving have been associated with increased cardiovascular risk, potentially through a mechanism of platelet hyperactivity...

..Plasma norepinephrine levels were not significantly elevated in apneic patients but were elevated in hypertensive patients both during sleep and in the morning (p < 0.05)...

..Although many of the characteristics of the sleep complaints are easily detected, most patients with insomnia are not treated effectively...

..Controlling for response bias on the MOS and other self-report measures is important in both research and clinical situations with OSA and potentially other chronically ill patients...

..Whereas sleep restriction in the laboratory induces sleepiness and mood disturbances, it is not certain whether a short sleep duration impairs the quality of everyday life...

..The current study examined the relations between the level of depressive symptoms in spousal caregivers and the physiological response to a psychological stress task...

..In this study, we examined if sleep disturbance of elderly caregivers was associated with physiologic markers of cardiovascular risk, including plasma norepinephrine, epinephrine, and the hemostasis marker D-dimer...

..We hypothesized that the TNF receptor might play an important role in the inflammation as well as sleep architecture changes in patients with OSA...

..We examined the impact of Alzheimer caregiver transitions (i.e., placement and bereavement) on psychological outcomes and on plasma D-dimer levels, an end product of the coagulation cascade associated with increased cardiovascular risk...

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..001). The findings contribute to the literature by showing that both pre-chemotherapy and chemotherapy-induced changes in inflammation are related to changes in fatigue and quality of life in response to chemotherapy...

..The task for the geriatric psychiatrist is to identify the causes of these complaints and then initiate appropriate treatment...

..To investigate the relationship between sleep quality and nocturnal blood pressure dipping in normal subjects. We hypothesized that sleep quality correlates with dipping...

..To determine whether sleep quality is associated with physical function in older men...

..We hypothesized that arousal frequency and changes in sleep architecture contribute to the fatigue experienced by patients with OSA...

..The objective of this study is to examine the diurnal variability of C-reactive protein (CRP) in obstructive sleep apnea (OSA)...

..Healthy aging is associated with cognitive deficits similar to those found in obstructive sleep apnea (OSA). As in OSA, older adults show compensatory cerebral activation during cognitive demands in the face of neurocognitive decline...

..The authors examined the effects of being a spousal caregiver of a patient with Alzheimer disease (AD) on the lymphocyte beta(2)-adrenergic receptor...

..We investigated the short-term effectiveness of continuous positive airway pressure (CPAP) and oxygen in improving sleep quality in patients with obstructive sleep apnea (OSA)...

..Results will provide a scientific basis for future intervention studies, particularly studies with light therapy which can re-synchronize rhythms. ..

..After 3 weeks, the sham group will also be switched to CPAP. Measures of neuropsychological performance will be obtained at baseline and after 3 and 6 weeks of treatment. ..

..The long-term goal of this line of research is to find a new approach that might improve the quality of life, delay dementia, and reduce caregiver stress. ..

..The reported phenomena of chemobrain will be examined to see if it is related to the complaint of fatigue or sleep disruptions, both of which are known to contribute to decreases in cognitive functioning. ..

..The long-term goal of this line of research is to find a new approach that might improve the quality of life, delay dementia, and reduce caregiver stress. ..

..The results will both help us understand the causes of sleep fragmentation and suggest practical treatment options...

..The intervention trials will help determine whether agitation can be reduced by these approaches. The results will both help us understand the correlates of agitation and suggest treatment options. ..

..The long-term goal of this line of research is to find a new approach that might improve the quality of life, delay dementia, and reduce caregiver stress. ..