Sonia Ancoli-Israel

..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...

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

..We examined the relationship between chronic caregiving stress and endothelial function...

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

..This study examined the effects of caregiver gender and severity of the spouse's dementia on sleep, coagulation, and inflammation in the caregiver...

..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...

..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...

..05). These relationships suggest that cancer-related fatigue and sleep disturbances may share common underlying biochemical mechanisms...

..The results demonstrate that laboratory acute stress tests continued to produce robust platelet reactivity on three activation markers among older adults over 3 years...

..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...

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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 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...

..Further support for these findings may impact psychological treatments for distressed caregivers...

..These findings provide more evidence of the link between chronic caregiving stress and cardiovascular disease and indicate that enduring the experience of caregiving over a period of years might be associated with atherosclerotic burden...

..However, increased mastery is associated with increased receptor sensitivity, and may therefore serve as a resource factor for improved health in this population...

..This study examined the effects of anthracycline-based chemotherapy on plasma sICAM-1 and VEGF, as well as soluble P-selectin, von Willebrand factor, and interleukin-6 levels...

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

..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...

..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...

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

..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...

..This study examined the longitudinal associations between stress, depressive symptoms, leisure satisfaction, and endothelial function as measured by FMD...

..In this study of women with breast cancer undergoing chemotherapy, we explored the longitudinal relationship between fatigue and sleep measured both subjectively and objectively...

..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...

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

..The purpose of this study was to test a mediational model of the associations between patient problem behaviors, escape-avoidance coping, and depressive symptoms in Alzheimer caregivers...

..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...

..Providing care for a spouse with Alzheimer's disease has been associated with an increased risk of coronary heart disease, potentially due to the impact of caregiving stress on the atherosclerotic disease process...

..Effect size estimates suggest that such D-dimer increases may have clinical implications, particularly among late-stage caregivers...

..The objective of this study was to examine whether personal mastery moderates the relationship between caregiving status (caregiver/non-caregiver) and multiple dimensions of fatigue...

..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...

..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...

..e., negative life events and caregiving distress) and Plasminogen Activator Inhibitor (PAI)-1 antigen, an inhibitor of fibrinolysis implicated in the development of cardiovascular disease...

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

..Selective deprivation of SWS may contribute to adverse blood pressure in older men...

..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)...

..Cross-sectional studies have linked sleep-disordered breathing to poor cognition; however, it remains unclear whether sleep-disordered breathing precedes cognitive impairment in older adults...

..68 to 6.47 (P=.01) after 3 weeks of therapeutic CPAP. CONCLUSION: These data provide evidence of the effectiveness of CPAP in reducing subjective daytime sleepiness in patients with AD with SDB...

..Fatigue is also a hallmark depressive symptom. The authors wondered if depressive symptoms in patients with obstructive sleep apnea would account for some of the fatigue beyond that explained by obstructive sleep apnea severity...

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

..Inflammation in response to chemotherapy is most significantly related to inflammation that existed prior to chemotherapy but also potentially to treatment regimen and to certain disease characteristics...

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

..We examined how vigilance and sustained attention, as assessed by the Psychomotor Vigilance Task (PVT), were related to quality of life after controlling for apnea severity and depression in subjects with OSA...

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

..We conclude that CPAP therapy reduces both daytime and nighttime blood pressure in patients with OSA, perhaps through mechanisms other than improvement of nocturnal oxyhemoglobin saturation...

..The goal of the present study was to better understand fatigue in OSA by examining self-reported sleep quality, depressive symptoms, excessive daytime sleepiness, and OSA severity in a group of newly diagnosed OSA patients...

..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...

..Treating these patients' SDB may increase their amount of REM sleep, which may result in improved daytime functioning. Controlled trials of SDB treatment in AD are needed to answer this question...

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

..The purpose of this study was to investigate the potential protective role of coping self-efficacy on the relationship between caregiving stress and circulating concentrations of IL-6...

..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...

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

..The present study examined whether three weeks of CPAP treatment had specific therapeutic effects on mood symptoms in patients with OSA compared with placebo...

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

..OSA severity explained 4.2% of variance in fatigue while depressive symptoms explained an additional 42.3%. Here, we report a replication of these findings in a new, independent sample...

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

..Both therapeutic CPAP and O(2) supplementation resulted in decreased psychological symptoms. Results suggest hypoxemia may play a stronger role than sleep disruption vis-à-vis OSA related psychological distress...

..Given this, future neuroimaging studies may want to be aware of this potential confound...

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

..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...

..32, p=0.03) during the trial. CONCLUSION: Patients with AD with obstructive sleep apnea can tolerate CPAP. Adherence and long-term use may be more difficult among those patients with more depressive symptoms...

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

..Double-blind, placebo-controlled studies are needed to better understand causality and the effect of each AChEI on sleep architecture in patients with AD...

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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...

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

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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...

..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...

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

..We illustrate the sigmoidally transformed cosine curves, and compare them to harmonic regression modelling, in a sample of eight activity recordings made on patients in a nursing home...

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

..05). In two separate studies, Blacks had longer TST, more minutes of REM, and lower percentage deep sleep. These findings suggest possible ethnic differences in sleep architecture...

..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...

..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...

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

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..The purpose of this study was to investigate whether stress-related experience of depressive symptoms and reductions in personal mastery were related to alterations in ss2-adrenergic receptor sensitivity...

..05). These observations suggest that the effects of stress related to one's ethnic group membership carry over into sleep...

..Caring for a spouse with Alzheimer's disease has been associated with increased mortality and reduced time to developing cardiovascular disease (CVD), possibly due to impaired fibrinolysis resulting from chronic stress...

..No significant time x treatment effect was observed for either group. We could not show a specific beneficial impact of CPAP treatment on mood in OSA patients...

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..Future research will need to further clarify the relationship between sleep and ADHD and the effects of stimulants on sleep of children with ADHD...

..Cancer patients experience their fatigue as "moderate to extreme" 33% of the time...

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

..Many individual risk factors for insomnia have been identified for women with a history of breast cancer. We assessed the relative importance of a wide range of risk factors for insomnia in this population...

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

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

..In this study, we explored whether community-based cancer education sites and educators serving the African American community could be used to recruit minority participants to research...

..The goal of this study was to test whether participants with major depressive disorder have a greater disruption of daily sleep and motor activity following disrupting life events when compared to normal controls...

..Key issues pertaining to sleep during menstrual cycles, pregnancy and postpartum, perimenopausal transition, and aging are presented. Clinical implications and areas for further research are identified...

..This study examined the association between disturbed sleep and poorer daytime function in older women...

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..Because of limited or absent evidence for reliability and/or validity, a standardized RAND/UCLA consensus process was employed for recommendation of specific rules for the scoring of sleep-associated movements...