Socioeconomic status and insomnia

This investigation compared the likelihood of insomnia and insomnia-related health consequences among individuals of different socioeconomic status. A random-digit dialing procedure was used to recruit at least 50 men and 50 women in each age decade from 20 to 80+ years old. Participants completed 2 weeks of sleep diaries as well as questionnaires related to fatigue, sleepiness, and psychological distress. Socioeconomic status was measured by education status assessed at 3 different levels: individual, household, and community. Results indicated that individuals of lower individual and household education were significantly more likely to experience insomnia even after researchers accounted for ethnicity, gender, and age. Additionally, individuals with fewer years of education, particularly those who had dropped out of high school, experienced greater subjective impairment because of their insomnia.     

Sleep Hygiene Practices of Good and Poor Sleepers in the United States: An Internet-Based Study

This Internet-based investigation assessed the frequency of multiple sleep hygiene practices in 128 good sleepers and 92 poor sleepers (mean age = 41.6, SD = 12.8, 61.8% women). The Pittsburgh Sleep Quality Index was used to measure sleep quality (< 5 = good sleep, > 7 = poor sleep). Although sleep hygiene practices were generally good, poor sleepers showed increased cognitive activity in the bed, even after controlling for global indices of depression and anxiety. Poor sleepers also reported statistically significant increases in excessive noise in the bedroom, uncomfortable nighttime temperature, and activities that were exciting, emotional, or demanded high concentration near bedtime. Future studies should further investigate the prevalence of these variables and their potential impact on sleep quality.     

Independence of blood pressure and locomotor hyperactivity in normotensive and genetically hypertensive rat

The spontaneously hypertensive rat (SHR) exhibits locomotor hyperactivity in comparison to its normotensive progenitor Wistar-Kyoto (WKY) strain. We asked whether the hyperactive behavior was a direct consequence of elevated blood pressure in the hypertensive rat. Three experimental protocols were used to chronically alter blood pressure. In the first protocol, a group of adult SHRs was given hydralazine (20 mg/kg/day) in their drinking water to lower blood pressure. These animals exhibited a significant decrease in blood pressure, but no change in locomotor activity. In the second protocol, young SHRs (4 weeks of age) were treated with the same dosage of hydralazine until 16 weeks of age. Blood pressure was significantly decreased in these animals with no change in locomotor activity. In the third protocol, normotensive WKY and Sprague-Dawley (SD) rats were made hypertensive with unilateral renal clips. The resulting increase in blood pressure in these animals did not alter locomotor activity. These results suggest that locomotor hyperactivity is an inherent property of the SHR and is independent of blood pressure.     

Depression Screening in Medically Ill Homecare Elderly

PURPOSE: This article provides data on a depression screening model (HOME) in acute home health care designed to detect clinical depression among medically ill homebound older patients. The model was developed to address the lack of mental health services in home health care settings and to specifically improve geriatric depression screening as part of routine care. Authors report on the concordance of homecare and research interview ratings of depression in older homecare patients. DESIGN AND METHODS: Using a prospective cohort design, data were collected from 289 elderly patients, aged 65 and older, from a large home health care agency to examine depression, cognitive functioning, medical comorbidity, functional status, and social isolation. Research interviews used the depression module of the structured clinical interview for DSM (SCID). RESULTS: The overall prevalence of major depression was 5.7 percent according to both homecare and research raters. The prevalence of subthreshold depressive disorder was 16.4 percent as reported by research raters. Observed agreement was 73 percent and kappa agreement was 0.42, indicating a fair to moderate agreement. We identified patient characteristics that may influence the accuracy of homecare worker estimates of depressive symptoms. IMPLICATIONS: Findings suggest that depression continues to be underdetected in medically ill homebound elderly patients. Ongoing training in depression screening methods, patient follow-up interviews, and appropriate referral would improve care of depressed elderly homecare patients.     

Cognitive Behavioral Treatment for Insomnia in Veterans with Long-Standing Posttraumatic Stress Disorder: A Pilot Study

This uncontrolled pilot study assessed the effects of cognitive behavioral therapy for insomnia in veterans with long-standing posttraumatic stress disorder. Male veterans with current chronic insomnia and PTSD (n?=?8; M age = 58.6, SD?=?3.0; 87.5% African American, 12.5% European American; 87.5% Vietnam Veterans, 12.5% 1st Gulf War Veterans) reported a trauma related to their military service. Participants appeared for five weekly individual sessions of cognitive behavioral therapy for insomnia and completed one-week assessments of objective sleep (actigraphy) and subjective sleep (sleep diaries), the Insomnia Severity Index, and measures of functioning, posttraumatic stress disorder, and psychological distress both before and after treatment. Paired t tests revealed significant posttreatment improvements for various subjective assessments of sleep patterns but actigraphy-defined sleep was unchanged. Measures of functioning, nightmares, and posttraumatic stress disorder severity were also unchanged at posttreatment. Preliminary results were encouraging in improving subjective perceptions of sleep in individuals with posttraumatic stress disorder, warranting further study with more rigorous methodology.