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Actigraphy analysis methods and terms. Vertical lines represent the activity count in a 15-second epoch. Red markers at base of actigraphy bars represent epochs scored as awake by the software/algorithm. Light channel (yellow) removed from panels B and C in order to demonstrate activity patterns. (A) Hospitalized adult with long sleep bouts. Rest intervals (light blue background) are determined by the scorer, using decreased activity levels and light level changes, as periods where the subject is likely to be sleeping/trying to sleep. Sleep bouts within the rest interval are determined by the software's algorithm, which scores sleep or wake based on activity count thresholds in a particular epoch and multiple surrounding epochs; the sum total of these sleep bouts give the total duration of sleep within a particular interval. Please note the clear changes in activity level between daytime and nighttime, as well as the minimal amount of wrist activity during sleep for this individual. (B) Hospitalized adult with short sleep bouts. Here, sleep within the rest interval is characterized by multiple short sleep bouts (examples shown with arrows in this panel), suggesting substantial sleep fragmentation. (C) Acutely ill, hospitalized adult with Confusion Assessment Method–positive delirium. This individual was noted to become delirious overnight. Note the increased and prolonged activity during the night, as well as the lack of sleep. Daytime rest periods ≥30 minutes were designated as naptime rest intervals; naps were summed together with the nighttime sleep to determine the total sleep time for a 24-hour period. Gray area in this panel is time prior to the start of the device's recording.

Melatonin and Sleep in Preventing Hospitalized Delirium: A Randomized Clinical Trial

Studies suggest that melatonin may prevent delirium, a condition of acute brain dysfunction occurring in 20%-30% of hospitalized older adults that is associated with increased morbidity and mortality. We examined the effect of melatonin on delirium prevention in hospitalized older adults while measuring sleep parameters as a possible underlying mechanism. Methods This was a randomized […]

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Sleep-Disordered Breathing in Obese Hospitalized Patients (video)

Sleep-disordered breathing is a common sleep disorder. Recent studies have shown that hospitalized obese patients have a high likelihood of unrecognized sleep-disordered breathing. However, no systematic large study has so far evaluated the outcomes of a screening program. This study provides demographic, clinical, and outcome data from a screening program at a tertiary care academic […]

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Short Sleep Duration & Impaired Glycemic Control (video)

Is insomnia linked to poor glycemic control? In this study, people who habitually slept less than seven hours per night had elevated glucose levels, as measured by morning oral glucose tolerance test. In this video, American Journal of Medicine Editor-in-Chief Dr. Joseph Alpert explains the clinical implications of the findings. Read the Research: Habitual and Recent […]

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Sleep Duration & Risk for Impaired Glycemic Control (video)

We examined how habitual sleep duration interacts with recent sleep (2 nights) to predict morning oral glucose tolerance test results. We hypothesized that short habitual and recent sleep durations would be additive for poor glucose control. Methods A biracial population of adults (n = 1559) without known diabetes and recruited from the workforce of 2 urban […]

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Kaplan-Meier curves across the longitudinal categories of insomnia. Insomnia was defined by International Classification of Sleep Disorders criteria and participants categorized into 3 groups: never insomnia (green), intermittent insomnia (blue), or persistent insomnia (red).

Researchers Find Link between Persistent Insomnia and Increased Mortality Risk

A connection between persistent insomnia and increased inflammation and mortality has been identified by a group of researchers from the University of Arizona. Their study, published in The American Journal of Medicine, found that people who suffer from persistent insomnia are at greater risk than those who experience intermittent insomnia. Although about 20% of U.S. […]

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Image Credit: David Hogg, Wiki Creative Commons

Restless Legs

Is Restless Legs Syndrome Associated with Cardiovascular Disease? Restless legs syndrome is a common condition characterized by a strong urge to move the limbs that is usually worse during the evening and nighttime hours, that is worsened by rest, and that improves with activity. However, the prevalence has varied in different studies, primarily depending on […]

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