Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, Jan 29, 2016
To determine effects of yoga and aerobic exercise compared with usual activity on objective asses... more To determine effects of yoga and aerobic exercise compared with usual activity on objective assessments of sleep in midlife women. Secondary analyses of a randomized controlled trial in the Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) network conducted among 186 late transition and postmenopausal women aged 40-62 y with hot flashes. Women were randomized to 12 w of yoga, supervised aerobic exercise, or usual activity. The mean and coefficient of variation (CV) of change in actigraph sleep measures from each intervention group were compared to the usual activity group using linear regression models. Baseline values of the primary sleep measures for the entire sample were mean total sleep time (TST) = 407.5 ± 56.7 min; mean wake after sleep onset (WASO) = 54.6 ± 21.8 min; mean CV for WASO = 37.7 ± 18.7 and mean CV for number of long awakenings > 5 min = 81.5 ± 46.9. Changes in the actigraphic sleep outcomes from baseline to weeks 11-12 were small,...
This work was supported by National Institute of Nursing Research, Grants NROII18,NR04353, and NR... more This work was supported by National Institute of Nursing Research, Grants NROII18,NR04353, and NR04001.
The demystification of women’s bodies was the cornerstone of the popular women’s health movement ... more The demystification of women’s bodies was the cornerstone of the popular women’s health movement of the 1960s in the United States. Yet, despite early efforts to respond to this call for action, such as the Boston Women’s Health Book Collective’s publication of Our Bodies Ourselves (1973), the scientific community was slow to respond to women’s need for information about their unique physiology. The National Institutes of Health’s (NIH) Office of Research on Women’s Health (ORWH), for example, was not established until 1990. Nursing science was an exception to the scientific community’s early lack of attention to women’s health: By the time the OWHR published its first NIH Women’s Health Research Agenda (ORWH, 1991), women’s health research within nursing science was well established, reflecting an integrative view of women’s bodies coupled with a feminist critique of the sociopolitical milieu in which women experience health. Nursing’s contribution to women’s health science has continued to develop over the past 40 years, leading the way to a redefinition of women’s health that transcends merely reproductive health. A reconceptualization of women’s health services has evolved, often in collaboration with women, prompting the development of women’s health curricula for advanced practice nurses and significant contributions in nursing research to women’s health science across the life span (Taylor and Woods, 2001). Although often constrained by both the small amount of funding available and the limited interest of funders in topics related to women’s health, scholars in nursing have pushed knowledge of women’s health forward. In 1989, the National Institute of Nursing Research promoted women’s health research through funding the Center for Women’s Health Research. This center launched a number of interdisciplinary collaborations in areas important to symptom management and self-care (Heitkemper et al., 2008). Nursing scientists’ early acknowledgment of gender disparities in health has gone relatively unnoticed by policymakers in the United States. By contrast, the Canadian government has responded to such concerns with a robust policy on gender and health research that is supportive of a socially relevant study of embodied health (Morrow, Hankivsky, & Varcoe, 2007). Because of a lack of similar support, nurse researchers’ contribution to women’s health science might appear anemic in the United States, in contrast to its potential. There are, however, good reasons to remain positive about nursing scientists’ contributions. Our progress can, in fact, be seen in the pages of this very journal. In April 2004, we published a special issue of BRN entitled ‘‘Sex: Does It Matter to Biological Nursing Research?’’ We received 10 12 submissions in response to our call for papers for that issue and published 8 of them. For this current special issue, ‘‘Women’s Health Across the Life Span,’’ the call for papers attracted nearly 40 submissions, resulting in publication of 16 articles over two issues of the journal (12:1 and 12:2). The content of this double special issue provides evidence that biological nursing research makes unique contributions to the science of women’s health on topics spanning the life span, from birth to old age. A number of authors for this special issue present data and analysis that help support our understanding of how sociopolitical factors shape women’s experiences with disease and pregnancy as well as their infants’ survival chances. Melkus et al. report that diabetes self-management training improved metabolic control, quality of life, and perceptions of provider care among African American women with type 2 diabetes, whereas the addition of coping skills training may have assisted in sustaining long-term improvements in health outcomes (12:1). Kuo et al. report data that show a relationship between both stress and human chorionic gonadotropin (hCG) and nausea and vomiting in pregnancy (12:1). Two of the articles address preterm birth, a socially significant problem in the United States, costly whether the calculus is in human life or dollars. Maloni challenges long-held assumptions about the value of
Journal of Clinical Sleep Medicine (JCSM), Feb 15, 2009
Obstructive sleep apnea (OSA) is associated with cognitive impairments in working memory (WM). Ne... more Obstructive sleep apnea (OSA) is associated with cognitive impairments in working memory (WM). Neuronal activation during WM tasks can be indirectly assessed by blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI). The purpose of this study was to describe BOLD-fMRI responses during 2 separate working memory tasks and a finger tapping task in men with OSA. A secondary aim was to explore the possible relation between OSA severity (apnea/hypopnea index) and BOLD-fMRI signal patterns. Nine treatment-naïve men (mean age [+/- SD] of 45.7 [+/- 6.6] years) with OSA underwent BOLD fMRI testing on a research-dedicated university-based MRI scanner. During BOLD-fMRI subjects performed a Paced Auditory Serial Addition task (PASAT), an auditory N-Back task (2-BACK) task, and an alternating finger tapping. PASAT and 2-BACK tasks produced similar patterns of increased bilateral activation in posterior parietal, prefrontal and cerebellar regions. BOLD signal deactivations ...
Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2017
To examine the congruence between polysomnography obstructive apnea hypopnea index (OAHI) and par... more To examine the congruence between polysomnography obstructive apnea hypopnea index (OAHI) and parent-reported obstructive sleep apnea (OSA) symptoms in 6- to 11-year-old children with juvenile idiopathic arthritis (JIA) and controls; and to compare fatigue and quality of life in JIA and control children based on OAHI and OSA symptoms. Sixty-eight children with JIA and 75 controls and a parent participated. Children underwent one night of polysomnography in a sleep laboratory. Parents completed the sleep-related breathing disorders scale-pediatric sleep questionnaire (PSQ), and both children and parents completed the Pediatric Quality of Life Generic Core Scale and the Multidimensional Fatigue Scale. In JIA, 86% who met the OAHI clinical criteria for OSA (≥1.5) were above the PSQ OSA symptom cut-off score with a sensitivity of 0.86 and a specificity of 0.28. In the control group, 63% who met the OAHI clinical criteria for OSA were above the PSQ OSA symptom cut-off score, with a sensi...
Objective.To examine the extent of polysomnographic (PSG) sleep disturbances [obstructive apnea h... more Objective.To examine the extent of polysomnographic (PSG) sleep disturbances [obstructive apnea hypopnea index (OAHI), number of wake bouts, arousals, periodic limb movements] and the effect of OAHI on neurobehavioral performance in juvenile idiopathic arthritis (JIA) with obstructive sleep apnea (OSA), JIA without OSA, and controls without OSA, adjusting for intelligence quotient (IQ), pain, medications, daytime sleepiness, and wake bouts.Methods.Children 6–11 years, 68 with JIA and 67 controls, underwent 1 night of PSG and completed self-reported daytime sleepiness surveys, multiple sleep latency tests for physiological sleepiness, and neurobehavioral performance tests the next day.Results.Compared with JIA and controls without OSA, mean OAHI and arousals were significantly higher in JIA with OSA (p < 0.001, respectively). In comparison with JIA and controls without OSA, mean simple reaction time and sustained attention were significantly slower in JIA with OSA, adjusting for I...
Although compelling logic suggests that melatonin may be effective for a variety of disorders, th... more Although compelling logic suggests that melatonin may be effective for a variety of disorders, there are few empirical clinical studies. The optimal dose of melatonin is not clear; most studies have used doses that produce supraphysiological blood levels. The timing of melatonin administration is important. Melatonin has few immediate side-effects except drowsiness, but the effects of chronic administration are unclear. Melatonin may be effective in reducing jet lag. In elderly patients with poor sleep and documented low melatonin production, melatonin may be helpful. In several studies, melatonin has been shown to shorten sleep latency. Further studies are needed to clarify the efficacy and safety of melatonin.
This study compared heart-rate variability (HRV) indices of autonomic nervous system function dur... more This study compared heart-rate variability (HRV) indices of autonomic nervous system function during two nights of sleep between women with irritable bowel syndrome (IBS, n = 35) and healthy controls (n = 38), and among subgroups within the IBS sample based on predominant stool patterns. HRV measures were estimated in conjunction with polysomnographic sleep scoring to define sleep stage-specific autonomic indices. Overall, there were no differences in indicators of HRV between women with IBS and controls. However, within the IBS group, women with diarrhea-predominant IBS demonstrated significantly increased parasympathetic modulation and lower sympathetic/parasympathetic nervous system balance across sequential NREM periods and REM cycles compared to both constipation-predominant and alternating IBS subjects. These results suggest that differences in mean level of HRV between predominant bowel groups in IBS patients are large, and that this effect is consistent in the different sleep stages and at different times of night.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, Oct 4, 2016
The purpose of this study was to evaluate the feasibility, acceptability, and initial results of ... more The purpose of this study was to evaluate the feasibility, acceptability, and initial results of a structured assessment of sleep disorders in breast cancer survivors (BCS). Our goal was to determine whether the assessment could be easily used and whether it would capture problems suggestive of one or more underlying sleep disorders that require referral to a specialist for diagnostic validation through polysomnography and appropriate specialty treatment. A cross-sectional, feasibility study using convenience sampling. A total of 38 BCS completed the study. Recruitment procedures were adequate in finding eligible BCS, however, procedures used to establish possible patterns of sleep disorders (e.g., interview) were not feasible for screening for sleep disorders in the clinical setting due to the time it took to complete each interview. A total of seven sleep disorder categories were identified in the data with the majority of women having at least one possible sleep disorder. Study f...
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, Jan 29, 2016
To determine effects of yoga and aerobic exercise compared with usual activity on objective asses... more To determine effects of yoga and aerobic exercise compared with usual activity on objective assessments of sleep in midlife women. Secondary analyses of a randomized controlled trial in the Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) network conducted among 186 late transition and postmenopausal women aged 40-62 y with hot flashes. Women were randomized to 12 w of yoga, supervised aerobic exercise, or usual activity. The mean and coefficient of variation (CV) of change in actigraph sleep measures from each intervention group were compared to the usual activity group using linear regression models. Baseline values of the primary sleep measures for the entire sample were mean total sleep time (TST) = 407.5 ± 56.7 min; mean wake after sleep onset (WASO) = 54.6 ± 21.8 min; mean CV for WASO = 37.7 ± 18.7 and mean CV for number of long awakenings > 5 min = 81.5 ± 46.9. Changes in the actigraphic sleep outcomes from baseline to weeks 11-12 were small,...
This work was supported by National Institute of Nursing Research, Grants NROII18,NR04353, and NR... more This work was supported by National Institute of Nursing Research, Grants NROII18,NR04353, and NR04001.
The demystification of women’s bodies was the cornerstone of the popular women’s health movement ... more The demystification of women’s bodies was the cornerstone of the popular women’s health movement of the 1960s in the United States. Yet, despite early efforts to respond to this call for action, such as the Boston Women’s Health Book Collective’s publication of Our Bodies Ourselves (1973), the scientific community was slow to respond to women’s need for information about their unique physiology. The National Institutes of Health’s (NIH) Office of Research on Women’s Health (ORWH), for example, was not established until 1990. Nursing science was an exception to the scientific community’s early lack of attention to women’s health: By the time the OWHR published its first NIH Women’s Health Research Agenda (ORWH, 1991), women’s health research within nursing science was well established, reflecting an integrative view of women’s bodies coupled with a feminist critique of the sociopolitical milieu in which women experience health. Nursing’s contribution to women’s health science has continued to develop over the past 40 years, leading the way to a redefinition of women’s health that transcends merely reproductive health. A reconceptualization of women’s health services has evolved, often in collaboration with women, prompting the development of women’s health curricula for advanced practice nurses and significant contributions in nursing research to women’s health science across the life span (Taylor and Woods, 2001). Although often constrained by both the small amount of funding available and the limited interest of funders in topics related to women’s health, scholars in nursing have pushed knowledge of women’s health forward. In 1989, the National Institute of Nursing Research promoted women’s health research through funding the Center for Women’s Health Research. This center launched a number of interdisciplinary collaborations in areas important to symptom management and self-care (Heitkemper et al., 2008). Nursing scientists’ early acknowledgment of gender disparities in health has gone relatively unnoticed by policymakers in the United States. By contrast, the Canadian government has responded to such concerns with a robust policy on gender and health research that is supportive of a socially relevant study of embodied health (Morrow, Hankivsky, & Varcoe, 2007). Because of a lack of similar support, nurse researchers’ contribution to women’s health science might appear anemic in the United States, in contrast to its potential. There are, however, good reasons to remain positive about nursing scientists’ contributions. Our progress can, in fact, be seen in the pages of this very journal. In April 2004, we published a special issue of BRN entitled ‘‘Sex: Does It Matter to Biological Nursing Research?’’ We received 10 12 submissions in response to our call for papers for that issue and published 8 of them. For this current special issue, ‘‘Women’s Health Across the Life Span,’’ the call for papers attracted nearly 40 submissions, resulting in publication of 16 articles over two issues of the journal (12:1 and 12:2). The content of this double special issue provides evidence that biological nursing research makes unique contributions to the science of women’s health on topics spanning the life span, from birth to old age. A number of authors for this special issue present data and analysis that help support our understanding of how sociopolitical factors shape women’s experiences with disease and pregnancy as well as their infants’ survival chances. Melkus et al. report that diabetes self-management training improved metabolic control, quality of life, and perceptions of provider care among African American women with type 2 diabetes, whereas the addition of coping skills training may have assisted in sustaining long-term improvements in health outcomes (12:1). Kuo et al. report data that show a relationship between both stress and human chorionic gonadotropin (hCG) and nausea and vomiting in pregnancy (12:1). Two of the articles address preterm birth, a socially significant problem in the United States, costly whether the calculus is in human life or dollars. Maloni challenges long-held assumptions about the value of
Journal of Clinical Sleep Medicine (JCSM), Feb 15, 2009
Obstructive sleep apnea (OSA) is associated with cognitive impairments in working memory (WM). Ne... more Obstructive sleep apnea (OSA) is associated with cognitive impairments in working memory (WM). Neuronal activation during WM tasks can be indirectly assessed by blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI). The purpose of this study was to describe BOLD-fMRI responses during 2 separate working memory tasks and a finger tapping task in men with OSA. A secondary aim was to explore the possible relation between OSA severity (apnea/hypopnea index) and BOLD-fMRI signal patterns. Nine treatment-naïve men (mean age [+/- SD] of 45.7 [+/- 6.6] years) with OSA underwent BOLD fMRI testing on a research-dedicated university-based MRI scanner. During BOLD-fMRI subjects performed a Paced Auditory Serial Addition task (PASAT), an auditory N-Back task (2-BACK) task, and an alternating finger tapping. PASAT and 2-BACK tasks produced similar patterns of increased bilateral activation in posterior parietal, prefrontal and cerebellar regions. BOLD signal deactivations ...
Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2017
To examine the congruence between polysomnography obstructive apnea hypopnea index (OAHI) and par... more To examine the congruence between polysomnography obstructive apnea hypopnea index (OAHI) and parent-reported obstructive sleep apnea (OSA) symptoms in 6- to 11-year-old children with juvenile idiopathic arthritis (JIA) and controls; and to compare fatigue and quality of life in JIA and control children based on OAHI and OSA symptoms. Sixty-eight children with JIA and 75 controls and a parent participated. Children underwent one night of polysomnography in a sleep laboratory. Parents completed the sleep-related breathing disorders scale-pediatric sleep questionnaire (PSQ), and both children and parents completed the Pediatric Quality of Life Generic Core Scale and the Multidimensional Fatigue Scale. In JIA, 86% who met the OAHI clinical criteria for OSA (≥1.5) were above the PSQ OSA symptom cut-off score with a sensitivity of 0.86 and a specificity of 0.28. In the control group, 63% who met the OAHI clinical criteria for OSA were above the PSQ OSA symptom cut-off score, with a sensi...
Objective.To examine the extent of polysomnographic (PSG) sleep disturbances [obstructive apnea h... more Objective.To examine the extent of polysomnographic (PSG) sleep disturbances [obstructive apnea hypopnea index (OAHI), number of wake bouts, arousals, periodic limb movements] and the effect of OAHI on neurobehavioral performance in juvenile idiopathic arthritis (JIA) with obstructive sleep apnea (OSA), JIA without OSA, and controls without OSA, adjusting for intelligence quotient (IQ), pain, medications, daytime sleepiness, and wake bouts.Methods.Children 6–11 years, 68 with JIA and 67 controls, underwent 1 night of PSG and completed self-reported daytime sleepiness surveys, multiple sleep latency tests for physiological sleepiness, and neurobehavioral performance tests the next day.Results.Compared with JIA and controls without OSA, mean OAHI and arousals were significantly higher in JIA with OSA (p < 0.001, respectively). In comparison with JIA and controls without OSA, mean simple reaction time and sustained attention were significantly slower in JIA with OSA, adjusting for I...
Although compelling logic suggests that melatonin may be effective for a variety of disorders, th... more Although compelling logic suggests that melatonin may be effective for a variety of disorders, there are few empirical clinical studies. The optimal dose of melatonin is not clear; most studies have used doses that produce supraphysiological blood levels. The timing of melatonin administration is important. Melatonin has few immediate side-effects except drowsiness, but the effects of chronic administration are unclear. Melatonin may be effective in reducing jet lag. In elderly patients with poor sleep and documented low melatonin production, melatonin may be helpful. In several studies, melatonin has been shown to shorten sleep latency. Further studies are needed to clarify the efficacy and safety of melatonin.
This study compared heart-rate variability (HRV) indices of autonomic nervous system function dur... more This study compared heart-rate variability (HRV) indices of autonomic nervous system function during two nights of sleep between women with irritable bowel syndrome (IBS, n = 35) and healthy controls (n = 38), and among subgroups within the IBS sample based on predominant stool patterns. HRV measures were estimated in conjunction with polysomnographic sleep scoring to define sleep stage-specific autonomic indices. Overall, there were no differences in indicators of HRV between women with IBS and controls. However, within the IBS group, women with diarrhea-predominant IBS demonstrated significantly increased parasympathetic modulation and lower sympathetic/parasympathetic nervous system balance across sequential NREM periods and REM cycles compared to both constipation-predominant and alternating IBS subjects. These results suggest that differences in mean level of HRV between predominant bowel groups in IBS patients are large, and that this effect is consistent in the different sleep stages and at different times of night.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, Oct 4, 2016
The purpose of this study was to evaluate the feasibility, acceptability, and initial results of ... more The purpose of this study was to evaluate the feasibility, acceptability, and initial results of a structured assessment of sleep disorders in breast cancer survivors (BCS). Our goal was to determine whether the assessment could be easily used and whether it would capture problems suggestive of one or more underlying sleep disorders that require referral to a specialist for diagnostic validation through polysomnography and appropriate specialty treatment. A cross-sectional, feasibility study using convenience sampling. A total of 38 BCS completed the study. Recruitment procedures were adequate in finding eligible BCS, however, procedures used to establish possible patterns of sleep disorders (e.g., interview) were not feasible for screening for sleep disorders in the clinical setting due to the time it took to complete each interview. A total of seven sleep disorder categories were identified in the data with the majority of women having at least one possible sleep disorder. Study f...
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