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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedAnan YH, Kahn NF, Garrison MM
Associations between sleep duration and positive mental health screens during adolescent preventive visits in primary care.
The objective of this paper was to understand associations between low sleep duration and positive mental health screens among adolescents seen for preventive visits in primary care. Data were taken from two randomized controlled trials that tested the efficacy of an electronic health risk behavior screening and feedback tool for adolescent preventive visits. The results showed that low sleep duration was associated with greater odds of positive depression screen, but not with a positive anxiety or co-occurring positive depression and anxiety screens. The authors concluded that, as pediatric primary care guidelines for sleep continue to evolve, further research, training, and support for sleep screening are necessary to ensure effective early intervention for adolescent sleep and mental health problems.
AHRQ-funded; HS023383.
Citation: Anan YH, Kahn NF, Garrison MM .
Associations between sleep duration and positive mental health screens during adolescent preventive visits in primary care.
Acad Pediatr 2023 Aug; 23(6):1242-46. doi: 10.1016/j.acap.2023.02.013..
Keywords: Children/Adolescents, Sleep Problems, Primary Care, Behavioral Health, Screening
Watach AJ, McPhillips MV, Saconi B
Exploring nurse practitioner students' perceptions of a sleep e-learning program.
The objective of this qualitative descriptive study was to explore nurse practitioner students' perceptions of a sleep e-learning program. Twenty-four students participated in two focus groups. The students embraced sleep education; they spoke of content relevance to themselves and patients and of their intentions to adopt sleep assessment practices. Two overarching themes emerged: perceptions of course design, and content. The authors concluded that their study highlighted the feasibility of increasing curricular exposure to sleep education and ensuring nurse practitioners have the skills to recognize implications of poor and disordered sleep for patients.
AHRQ-funded; HS026372.
Citation: Watach AJ, McPhillips MV, Saconi B .
Exploring nurse practitioner students' perceptions of a sleep e-learning program.
Nurs Educ Perspect 2023 Jul-Aug; 44(4):229-36. doi: 10.1097/01.Nep.0000000000001132..
Keywords: Education: Curriculum, Education: Academic, Sleep Problems, Provider: Nurse
Morrow EL, Mayberry LS, Duff MC
The growing gap: a study of sleep, encoding, and consolidation of new words in chronic traumatic brain injury.
Evidence from neuroscience emphasizes sleep as a crucial support for longitudinal memory and word learning. In numerous lab-based word learning experiments, participants encode and then retrieve new words within the same session. Single session designs are not adequate for capturing the full word learning process. Single session studies also inhibit exploration of the role of behavioral and lifestyle factors such as sleep in supporting longitudinal word learning. Adults with a history of traumatic brain injury (TBI), who experience challenges in the memory systems that support word learning and report related sleep disturbance, provide a unique opportunity to explore linkages between memory, sleep, and word learning. The purpose of this study was to evaluate longitudinal word learning and the influence of sleep on short- and long-term word recall in 50 adults with chronic moderate-severe traumatic brain injury (TBI) and 50 demographically matched neurotypical peers. Participants took part in the study over a two week period in their homes in an attempt to capture the process of real-world word learning and to measure sleep within normal living conditions. The study found that participants with TBI demonstrated a deficit in word learning that started at encoding, continued across time, and increased over the course of the week. The gap in performance between groups was greater at the 1-week post-test than the immediate post-test. Participants with and without TBI recalled more words when they slept after learning.
AHRQ-funded; HS026122.
Citation: Morrow EL, Mayberry LS, Duff MC .
The growing gap: a study of sleep, encoding, and consolidation of new words in chronic traumatic brain injury.
Neuropsychologia 2023 Jun 6; 184:108518. doi: 10.1016/j.neuropsychologia.2023.108518..
Keywords: Brain Injury, Chronic Conditions, Sleep Problems, Trauma
Kim B, Troxel WM, Dubowitz T
Neighborhood built environment and sleep health: a longitudinal study in low-income and predominantly African-American neighborhoods.
The purpose of this study was to explore the relationships between physical characteristics of neighborhoods and sleep health outcomes and evaluated the mediating role of physical activity in these relationships. The researchers conducted the longitudinal Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health (PHRESH) Zzz Study in 2 low-income, primarily African-American neighborhoods in Pittsburgh, Pennsylvania (n = 1,051). The study included repeated measures of neighborhood characteristics and sleep health outcomes from 2013 to 2018, and systematic field observations captured built environment measures of walkability, urban design, and neighborhood disorder. Sleep health outcomes included insufficient sleep, sleep duration, wakefulness after sleep onset, and sleep efficiency. Urban design features were correlated with lower levels of wakefulness after sleep onset. Neighborhood disorder and crime rate were negatively related with sleep efficiency. Neighborhood walkability was not associated with sleep outcomes.
AHRQ-funded; HS026120.
Citation: Kim B, Troxel WM, Dubowitz T .
Neighborhood built environment and sleep health: a longitudinal study in low-income and predominantly African-American neighborhoods.
Am J Epidemiol 2023 May 5; 192(5):736-47. doi: 10.1093/aje/kwad016..
Keywords: Sleep Problems, Racial and Ethnic Minorities, Low-Income
Lucchini M, Rayport Y, Valeri L
Racial/ethnic disparities in sleep-disordered breathing during pregnancy in the nuMoM2b study.
This study’s aim was to assess the prevalence and severity of sleep-disordered breathing (SDB) across racial/ethnic groups in 3702 pregnant people at 6 to 15 and 22 to 31 weeks gestational age; examine whether BMI modifies the association between race/ethnicity and SDB; and investigate whether interventions to reduce weight might reduce racial/ethnic disparities in SDB. The study cohort consisted of comprised 61.2% non-Hispanic White (nHW), 11.9% non-Hispanic Black (nHB), 18.5% Hispanic, and 3.7% Asian persons. SDB prevalence was higher for nHB compared with nHW pregnant people at 6 to 15 weeks, whereas at 21 to 32 weeks, Asian pregnant people had a higher SDB prevalence than nHW. The severity of SDB differed across racial/ethnic groups in early pregnancy, with nHB pregnant people having a higher apnea-hypopnea index (AHI) compared with nHW. Having overweight/obesity was associated with a higher AHI.
AHRQ-funded; HS024274.
Citation: Lucchini M, Rayport Y, Valeri L .
Racial/ethnic disparities in sleep-disordered breathing during pregnancy in the nuMoM2b study.
Obesity 2023 Apr;31(4):923-33. doi: 10.1002/oby.23697.
Keywords: Racial and Ethnic Minorities, Sleep Problems, Women, Maternal Care
Donovan LM, Parsons EC, McCall CA
Impact of mail-based continuous positive airway pressure initiation on treatment usage and effectiveness.
Traditional care for patients starting continuous positive airway pressure (CPAP) therapy has involved face-to-face visits with a trained professional for hands-on guidance and mask fitting assessment. However, in an effort to increase accessibility, numerous healthcare systems are transitioning to remote CPAP initiation by mailing equipment to patients. Although this method offers potential advantages, the impact on patient outcomes remains uncertain. Specifically, concerns have been raised about the potential decrease in CPAP adherence due to the absence of in-person training. The purpose of this study was to evaluate treatment usage following either in-person or mailed CPAP initiation. In response to the COVID-19 pandemic, the researcher’s medical center transitioned from in-person to mailed CPAP distribution in March 2020. A cohort of newly diagnosed obstructive sleep apnea (OSA) patients who began CPAP therapy in the months preceding (n = 433) and following (n = 186) this shift was form. The researchers then compared 90-day adherence between the two groups. The study found the average nightly PAP usage was moderate in both cohorts. No significant differences were observed in unadjusted or adjusted analyses.
AHRQ-funded; HS026369
Citation: Donovan LM, Parsons EC, McCall CA .
Impact of mail-based continuous positive airway pressure initiation on treatment usage and effectiveness.
Sleep Breath 2023 Mar;27(1):303-08. doi: 10.1007/s11325-022-02608-z.
Keywords: Respiratory Conditions, Sleep Problems, Patient Adherence/Compliance
Mills J, Harding MC
AHRQ Author: Mills J
Screening for obstructive sleep apnea in adults.
This Putting Prevention into Practice case study was created to increase understanding of the USPSTF final recommendation on screening for obstructive sleep apnea (OSA) in adults. A case study was presented using a 41-year-old man with a history of class 1 obesity but was otherwise feeling well. The patient has an uncle who was recently diagnosed with OSA, and the patient has some questions. Three multiple-choice questions are presented regarding USPSTF recommendations whether to screen for OSA for that patient.
AHRQ-authored.
Citation: Mills J, Harding MC .
Screening for obstructive sleep apnea in adults.
Am Fam Physician 2023 Mar;107(3):297-98.
Keywords: U.S. Preventive Services Task Force (USPSTF), Sleep Problems, Guidelines, Prevention, Evidence-Based Practice, Case Study
Gong F, Loeb S, Siu K
Sleep disturbances are underappreciated in prostate cancer survivorship.
Limited research exists on the prevalence of sleep issues in prostate cancer (PCa) survivors and the degree of urologist involvement in addressing sleep-related concerns. The researchers conducted a survey with PCa survivors (n = 167) and urologists (n = 145) to examine sleep problems and survivorship care practices. The study found a significant number of PCa survivors experienced sleep difficulties, with 50.9% reporting suboptimal sleep quality, 18.0% suffering from moderate/severe insomnia, and 36.5% at an elevated risk for sleep apnea. However, only a small number of urologists consistently screened for sleep disruptions, as advised in national cancer survivorship guidelines.
AHRQ-funded; HS026120
Citation: Gong F, Loeb S, Siu K .
Sleep disturbances are underappreciated in prostate cancer survivorship.
Prostate Cancer Prostatic Dis 2023 Mar;26(1):210-12. doi: 10.1038/s41391-022-00630-6.
Keywords: Cancer, Cancer: Prostate Cancer, Sleep Problems
Fishbein AB, Lor J, Penedo FJ
Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: cross-sectional study of the patient reported outcomes measurement information system pediatric sleep measures and actigraphy.
The purposes of this cross-sectional study were to test the Patient-Reported Outcomes Measurement Information System (PROMIS) sleep measures in pediatric atopic dermatitis (AD) and to develop an algorithm to screen, evaluate, and intervene to reduce sleep disturbances. Participants were children with AD aged 5 to 17 and one parent who completed sleep, itch, and AD-specific questionnaires. Clinicians assessed disease severity. PROMIS sleep disturbance parent proxy reliability was high and was differentiated among Patient-Oriented Eczema Measure (POEM)-determined disease severity groups. The authors concluded that sleep disturbance in pediatric AD should be screened using the POEM sleep question, and further assessment using the PROMIS sleep disturbance measure or objective sleep monitoring if it is needed.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Lor J, Penedo FJ .
Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: cross-sectional study of the patient reported outcomes measurement information system pediatric sleep measures and actigraphy.
J Am Acad Dermatol 2023 Feb; 88(2):348-56. doi: 10.1016/j.jaad.2020.05.138..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice
Lei DK, Yousaf M, Janmohamed SR
Validation of patient-reported outcomes information system sleep disturbance and sleep-related impairment in adults with atopic dermatitis.
This study examined the measurement properties of the Patient-Reported Outcomes Measurement System (PROMIS) Sleep Disturbance (SD) and Sleep-Related Impairment (SRI) questionnaires to assess sleep disturbances in adults with atopic dermatitis (AD). The authors performed a prospective dermatology-practice-based study using questionnaires and evaluation by a dermatologist (n=420). Both questionnaires showed good construct validity, internal consistency, and feasibility to assess sleep in patients with AD.
AHRQ-funded; HS023011.
Citation: Lei DK, Yousaf M, Janmohamed SR .
Validation of patient-reported outcomes information system sleep disturbance and sleep-related impairment in adults with atopic dermatitis.
Br J Dermatol 2020 Nov;183(5):875-82. doi: 10.1111/bjd.18920..
Keywords: Sleep Problems, Skin Conditions
Luther M, Poppert Cordts KM, Williams CN
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
This is a systematic review to quantify sleep wake disturbances (SWD) after pediatric traumatic brain injury (TBI). These SWD can place children at risk for worse outcomes since sleep is needed for brain development and healing after injury. They also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. Literature was searched from 1999-2019 evaluating sleep or fatigue in children hospitalized for TBI. Two independent reviewers assessed quality of the studies using the Newcastle-Ottowa Score for observational studies. Out of 966 identified articles, 126 full text articles were reviewed and 24 studies were included. Studies showed at least 20% of children with TBI had some degree of SWD including trouble falling or staying asleep, fatigue, daytime fatigue, and nightmares. SWD was negatively correlated with cognitive, behavioral, and quality of life outcomes. There was moderate-high risk of bias for all studies due to small sample size and lack of validated or objective SWD measures.
AHRQ-funded; HS022981.
Citation: Luther M, Poppert Cordts KM, Williams CN .
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
Sleep 2020 Oct;43(10):zsaa083. doi: 10.1093/sleep/zsaa083..
Keywords: Children/Adolescents, Sleep Problems, Brain Injury, Neurological Disorders, Trauma, Risk, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Evidence-Based Practice
Mouch CA, Baskin AS, Yearling R CA, Baskin AS, Yearling R
Sleep patterns and quality among inpatients recovering from elective surgery: a mixed-method study.
This study examined sleep quality and barriers to sleep among adult hospital inpatients recovering from elective surgery. A quantitative survey was used followed by a qualitative phone interview with a subsample of participants. Of 113 eligible patients, 102 (90%) completed the survey. Less than half reported sleeping well the night prior to surgery and 93% reported less sleep in the hospital compared to home. A median of 5 (4-7) interruptions were reported each night. Patients with more than three interruptions were likely to report poor sleep compared with those who had three or less. Barriers to sleep included staff interruptions and roommate noise but not pain. Patients interviewed suggested improved timing and knowledge of interruptions or use of noise-reduction aids that would facilitate sleep.
AHRQ-funded; HS026030.
Citation: Mouch CA, Baskin AS, Yearling R CA, Baskin AS, Yearling R .
Sleep patterns and quality among inpatients recovering from elective surgery: a mixed-method study.
J Surg Res 2020 Oct;254:268-74. doi: 10.1016/j.jss.2020.04.032..
Keywords: Sleep Problems, Surgery, Quality Improvement, Quality of Care, Inpatient Care, Hospitals, Patient Experience
Poppert Cordts KM, Hall TA, Hartman ME
Sleep measure validation in a pediatric neurocritical care acquired brain injury population.
Lingering morbidities including physical, cognitive, emotional, and psychosocial sequelae, termed the Post-Intensive Care Syndrome, persist years after pediatric neurocritical care (PNCC) hospitalization. Sleep disturbances impact other Post-Intensive Care Syndrome domains and are under-evaluated to date due to a lack of appropriate measurement tools. The present study evaluated the validity of the Sleep Disturbance Scale for Children (SDSC) to address the growing need for assessing sleep problems after PNCC.
AHRQ-funded; HS022981.
Citation: Poppert Cordts KM, Hall TA, Hartman ME .
Sleep measure validation in a pediatric neurocritical care acquired brain injury population.
Neurocrit Care 2020 Aug;33(1):196-206. doi: 10.1007/s12028-019-00883-5..
Keywords: Children/Adolescents, Sleep Problems, Neurological Disorders, Intensive Care Unit (ICU), Hospitalization, Quality of Life
Lei D, Yousaf M, Janmohamed SR
Validation of four single-item patient-reported assessments of sleep in adult atopic dermatitis patients.
The purpose of this study was to assess the measurement properties of sleep-related items from the Patient-Oriented Eczema Measure (POEM), SCORing AD (SCORAD), 5-dimensions of itch (5D), and Itch-Related Quality of Life (ItchyQOL) in adults with atopic dermatitis (AD). Results showed modest overlap and weak to moderate concordance of responses to the different assessments. The researchers conclude that sleep-related items from POEM, SCORAD, 5D, and ItchyQOL showed good validity and responsiveness to monitor sleep disturbances in adult AD patients.
AHRQ-funded; HS023011.
Citation: Lei D, Yousaf M, Janmohamed SR .
Validation of four single-item patient-reported assessments of sleep in adult atopic dermatitis patients.
Ann Allergy Asthma Immunol 2020 Mar;124(3):261-66. doi: 10.1016/j.anai.2019.12.002..
Keywords: Sleep Problems, Skin Conditions, Quality of Life, Patient-Centered Outcomes Research
McKenzie C, Paller AS, Fishbein A
Association between the longitudinal course of AD, sleep disturbance, and overall health in US children.
Atopic dermatitis (AD) is a chronic inflammatory skin disease impacting 13% of children in the United States. It is associated with sleep disturbances. In this paper the investigators sought to examine the associations of AD onset, AD persistence, and comorbid atopic conditions with sleep disturbance and overall health in childhood. This study added to previous studies by demonstrating that comorbid atopy and AD course, particularly early-onset and more persistent AD, were associated with sleep disturbance.
AHRQ-funded; HS023011.
Citation: McKenzie C, Paller AS, Fishbein A .
Association between the longitudinal course of AD, sleep disturbance, and overall health in US children.
J Allergy Clin Immunol Pract 2020 Feb;8(2):812-14.e1. doi: 10.1016/j.jaip.2019.08.027..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions
Oka S, Goto T, Hirayama A
Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002.
Researchers investigated the association of obstructive sleep apnea (OSA) with acute asthma severity in a retrospective cohort study that used State Inpatient Databases from eight geographically diverse states. Outcomes examined were markers of acute severity such as mechanical ventilation use, hospital length of stay, and in-hospital mortality. The researchers found that, among patients hospitalized for acute asthma, OSA was associated with a higher risk of noninvasive positive pressure ventilation use and longer length of stay compared with those without OSA.
AHRQ-funded; HS023305.
Citation: Oka S, Goto T, Hirayama A .
Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002.
Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002..
Keywords: Healthcare Cost and Utilization Project (HCUP), Sleep Problems, Asthma, Respiratory Conditions, Hospitalization
Albrecht JS, Wickwire EM
Sleep disturbances among older adults following traumatic brain injury.
The objective of this study was to assess the risk of newly diagnosed sleep disorders following traumatic brain injury (TBI) among adults aged 65 and older. Subjects diagnosed with TBI and non-TBI controls were identified through a large commercial insurance database. Results showed that TBI was associated with an increased risk of insomnia and any sleep disorder. Recommendations included following TBI among older adults, screening, and education on sleep disorders.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Wickwire EM .
Sleep disturbances among older adults following traumatic brain injury.
Int Rev Psychiatry 2020 Feb;32(1):31-38. doi: 10.1080/09540261.2019.1656176..
Keywords: Elderly, Sleep Problems, Neurological Disorders
Williams CN, Hartman ME, McEvoy CT
Sleep-wake disturbances after acquired brain injury in children surviving critical care.
Sleep-wake disturbances are underevaluated among children with acquired brain injury surviving critical care. In this prospective cohort study, the investigators aimed to quantify severity, phenotypes, and risk factors for sleep-wake disturbances. The investigators concluded that over half of children surviving critical care with acquired brain injury have sleep-wake disturbances. They indicated that many sleep-wake disturbances phenotypes were identified, but most children had disturbance in initiation and maintenance of sleep.
AHRQ-funded; HS022981.
Citation: Williams CN, Hartman ME, McEvoy CT .
Sleep-wake disturbances after acquired brain injury in children surviving critical care.
Pediatr Neurol 2020 Feb;103:43-51. doi: 10.1016/j.pediatrneurol.2019.08.010..
Keywords: Children/Adolescents, Brain Injury, Critical Care, Sleep Problems, Trauma, Injuries and Wounds, Neurological Disorders
Wickwire EM, Vadlamani A, Tom SE
Economic aspects of insomnia medication treatment among Medicare beneficiaries.
The purpose of this study was to examine economic aspects of insomnia and insomnia medication treatment among a nationally representative sample of older adult Medicare beneficiaries. A total of 23,079 beneficiaries with insomnia were included. Of these, 5,154 (22%) received >1 fills for an FDA-approved insomnia medication following insomnia diagnosis. For both treated and untreated individuals, healthcare utilization and costs increased during the 12 months prior to diagnosis. Insomnia treatment was associated with significantly increased ED visits and prescription fills in the year following insomnia diagnosis.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Vadlamani A, Tom SE .
Economic aspects of insomnia medication treatment among Medicare beneficiaries.
Sleep 2020 Jan;43(1):pii: zsz192. doi: 10.1093/sleep/zsz192..
Keywords: Medication, Sleep Problems, Medicare, Healthcare Costs