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      Non-pharmacological interventions for sleep and quality of life: a randomized pilot study*

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          ABSTRACT

          Objective:

          to estimate the effects of non-pharmacological interventions to improve the quality of sleep and quality of life of patients with heart failure.

          Method:

          pilot study of a randomized controlled trial with 32 individuals assigned to four groups. Sleep was assessed using the Pittsburgh Sleep Quality Inventory, while health-related quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire, at the baseline and at the 12 th and 24 th weeks. The means of the outcomes according to intervention groups were compared using analysis of covariance; effect sizes were calculated per group.

          Results:

          all groups experienced improved quality of sleep and health-related quality of life at the end of the intervention (week 12) and at follow-up (week 24), though differences were not statistically significant (p between 0.22 and 0.40). The effects of the interventions at the 12 th week ranged between -2.1 and -3.8 for the quality of sleep and between -0.8 and -1.7 for quality of life, with similar values at the 24 th week.

          Conclusion:

          the effects found in this study provide information for sample size calculations and statistical power for confirmatory studies. Brazilian Clinical Trials Registry - RBR 7jd2mm

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          Most cited references61

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          Multiple Comparisons Using Rank Sums

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            Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia.

            To assess the efficacy of moderate aerobic physical activity with sleep hygiene education to improve sleep, mood and quality of life in older adults with chronic insomnia. Seventeen sedentary adults aged >or=55 years with insomnia (mean age 61.6 [SD±4.3] years; 16 female) participated in a randomized controlled trial comparing 16 weeks of aerobic physical activity plus sleep hygiene to non-physical activity plus sleep hygiene. Eligibility included primary insomnia for at least 3 months, habitual sleep duration 5. Outcomes included sleep quality, mood and quality of life questionnaires (PSQI, Epworth Sleepiness Scale [ESS], Short-form 36 [SF-36], Center for Epidemiological Studies Depression Scale [CES-D]). The physical activity group improved in sleep quality on the global PSQI (p<.0001), sleep latency (p=.049), sleep duration (p=.04), daytime dysfunction (p=.027), and sleep efficiency (p=.036) PSQI sub-scores compared to the control group. The physical activity group also had reductions in depressive symptoms (p=.044), daytime sleepiness (p=.02) and improvements in vitality (p=.017) compared to baseline scores. Aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life in older adults with chronic insomnia.
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              Evidence-based recommendations for the assessment and management of sleep disorders in older persons.

              Sleep-related disorders are most prevalent in the older adult population. A high prevalence of medical and psychosocial comorbidities and the frequent use of multiple medications, rather than aging per se, are major reasons for this. A major concern, often underappreciated and underaddressed by clinicians, is the strong bidirectional relationship between sleep disorders and serious medical problems in older adults. Hypertension, depression, cardiovascular disease, and cerebrovascular disease are examples of diseases that are more likely to develop in individuals with sleep disorders. Conversely, individuals with any of these diseases are at a higher risk of developing sleep disorders. The goals of this article are to help guide clinicians in their general understanding of sleep problems in older persons, examine specific sleep disorders that occur in older persons, and suggest evidence- and expert-based recommendations for the assessment and treatment of sleep disorders in older persons. No such recommendations are available to help clinicians in their daily patient care practices. The four sections in the beginning of the article are titled, Background and Significance, General Review of Sleep, Recommendations Development, and General Approach to Detecting Sleep Disorders in an Ambulatory Setting. These are followed by overviews of specific sleep disorders: Insomnia, Sleep Apnea, Restless Legs Syndrome, Circadian Rhythm Sleep Disorders, Parasomnias, Hypersomnias, and Sleep Disorders in Long-Term Care Settings. Evidence- and expert- based recommendations, developed by a group of sleep and clinical experts, are presented after each sleep disorder.
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                Author and article information

                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                14 November 2018
                2018
                : 26
                : e3079
                Affiliations
                [1 ]Universidade Federal de Mato Grosso do Sul, Três Lagoas, MS, Brazil.
                [2 ]Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
                [3 ]Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brazil.
                [4 ]University of Washington, Department of Rehabilitation Medicine, Seattle, WA, United States of America.
                [5 ]University of Washington, Department of Behavioral Nursing and Health Informatics, Seattle, WA, United States of America.
                Author notes
                [Corresponding Author: ] Mariana Alvina dos Santos E-mail: marifamema@ 123456yahoo.com.br
                Author information
                http://orcid.org/0000-0002-7940-6673
                Article
                00379
                10.1590/1518-8345.2598.3079
                6248705
                30462790
                992d8dc2-a6ff-4a50-bde9-ed9259bab537
                © 2018 Revista Latino-Americana de Enfermagem

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 26 February 2018
                : 01 September 2018
                Page count
                Figures: 6, Tables: 9, Equations: 0, References: 58, Pages: 1
                Categories
                Original Articles

                sleep,sleep hygiene,phototherapy,quality of life,heart failure,nursing

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