Hassan S Dashti1,2,3,4, Meghna Godbole1, Angela Chen1, Kris M Mogensen5, Aaron Leong4,6,7,8, David L Burns9, Marion F Winkler10, Richa Saxena1,2,3,4, Charlene Compher11. 1. Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. 2. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. 3. Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA. 4. Broad Institute, Cambridge, Massachusetts, USA. 5. Department of Nutrition, Brigham and Women's Hospital, Boston, Massachusetts, USA. 6. Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. 7. Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA. 8. Diabetes Unit, Division of Endocrinology, Massachusetts General Hospital, Boston, Massachusetts, USA. 9. Department of Gastroenterology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA. 10. Department of Surgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, Rhode Island, USA. 11. Biobehavioral Health Sciences Department, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.
Abstract
BACKGROUND: Patients supported with home parenteral nutrition (HPN) often report poor sleep; however, limited research has been conducted to objectively measure sleep patterns of HPN-dependent patients. METHODS: We aimed to characterize the sleep patterns of patients receiving HPN through 7-day actigraphy in a home-based observational study. Sleep measures of clinical importance were derived from actigraphy, including sleep duration, sleep efficiency, sleep onset latency, and wake after sleep onset. Participants also completed validated sleep surveys. RESULTS: Twenty participants completed all study procedures (mean [SD]: age = 51.6 [13.9] years, body mass index = 21.4 [4.6], and 80% female). The population median (IQR) for sleep duration, sleep efficiency, sleep onset latency, and wake after sleep onset was 6.9 (1.1) h, 83.3% (7.8%), 11.8 (7.1) min, and 57.2 (39.9) min, respectively, and 55%, 60%, 35%, and 100% of participants did not meet the recommendations for these measures from the National Sleep Foundation. Sixty-five percent of participants reported napping at least once during the 7-day period. Based on the Insomnia Severity Index, 70% of participants were classified as having subthreshold or more severe insomnia. Based on the Pittsburgh Sleep Quality Index, 85% were classified as having significant sleep disturbance. CONCLUSION: Most HPN-dependent patients likely have disrupted sleep largely driven by difficulty maintaining sleep. The extent to which HPN contributed to poor sleep cannot be elucidated from this observational study. Addressing known factors that contribute to sleep disruption and considering sleep interventions may improve the overall quality of life of patients receiving HPN.
BACKGROUND: Patients supported with home parenteral nutrition (HPN) often report poor sleep; however, limited research has been conducted to objectively measure sleep patterns of HPN-dependent patients. METHODS: We aimed to characterize the sleep patterns of patients receiving HPN through 7-day actigraphy in a home-based observational study. Sleep measures of clinical importance were derived from actigraphy, including sleep duration, sleep efficiency, sleep onset latency, and wake after sleep onset. Participants also completed validated sleep surveys. RESULTS: Twenty participants completed all study procedures (mean [SD]: age = 51.6 [13.9] years, body mass index = 21.4 [4.6], and 80% female). The population median (IQR) for sleep duration, sleep efficiency, sleep onset latency, and wake after sleep onset was 6.9 (1.1) h, 83.3% (7.8%), 11.8 (7.1) min, and 57.2 (39.9) min, respectively, and 55%, 60%, 35%, and 100% of participants did not meet the recommendations for these measures from the National Sleep Foundation. Sixty-five percent of participants reported napping at least once during the 7-day period. Based on the Insomnia Severity Index, 70% of participants were classified as having subthreshold or more severe insomnia. Based on the Pittsburgh Sleep Quality Index, 85% were classified as having significant sleep disturbance. CONCLUSION: Most HPN-dependent patients likely have disrupted sleep largely driven by difficulty maintaining sleep. The extent to which HPN contributed to poor sleep cannot be elucidated from this observational study. Addressing known factors that contribute to sleep disruption and considering sleep interventions may improve the overall quality of life of patients receiving HPN.
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Authors: Sonia Ancoli-Israel; Roger Cole; Cathy Alessi; Mark Chambers; William Moorcroft; Charles P Pollak Journal: Sleep Date: 2003-05-01 Impact factor: 5.849
Authors: Michael T Smith; Christina S McCrae; Joseph Cheung; Jennifer L Martin; Christopher G Harrod; Jonathan L Heald; Kelly A Carden Journal: J Clin Sleep Med Date: 2018-07-15 Impact factor: 4.062