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- Asthma (1)
- Brain Injury (2)
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- Children/Adolescents (5)
- Critical Care (1)
- Education: Continuing Medical Education (1)
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- (-) Sleep Problems (18)
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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 18 of 18 Research Studies DisplayedFeltnerl. C, Wallace IF, Aymes S
Screening for obstructive sleep apnea in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to examine the evidence on screening for obstructive sleep apnea (OSA) in asymptomatic adults or those with unrecognized OSA symptoms to inform the U.S. Preventive Services Task Force. The researchers utilized data from PubMed/MEDLINE, Cochrane Library, Embase, and trial registries through August 23, 2021 and surveillance data through September 23, 2022. The main outcomes were accuracy, excessive daytime sleepiness, sleep-related and general health-related quality of life (QOL), and harms. Eighty-six studies were included (N = 11,051), researchers finding that no study directly compared screening with no screening. Five studies evaluating the accuracy of other screening tools provided inconsistent results. When compared with inactive control, positive airway pressure was associated with a significant improvement in ESS score from baseline, sleep-related QOL, and general health-related QOL measured by the 36-Item Short Form Health Survey (SF-36) mental health component summary score change, and SF-36 physical health component summary score change. When compared with controls, utilization of mandibular advancement devices was also related with a significantly larger ESS score change. Reporting of other health outcomes was scarce; no trial included in the study found significant benefit related with treatment on mortality, cardiovascular events, or motor vehicle crashes. In 3 systematic reviews, positive airway pressure was significantly associated with reduced blood pressure; but the difference was relatively small. The researchers concluded that the accuracy and clinical usefulness of OSA screening tools was unclear.
Citation: Feltnerl. C, Wallace IF, Aymes S .
Screening for obstructive sleep apnea in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Nov 15;328(19):1951-71. doi: 10.1001/jama.2022.18357..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sleep Problems, Screening, Evidence-Based Practice, Prevention
Manjunath J, Silverberg JI
Association of sleep disturbances with geriatric age in atopic dermatitis patients.
The purpose of this cross-sectional study was to investigate the association of geriatric age with atopic dermatitis (AD) severity and sleep disturbances (SD). Patients over the age of 18 seen at an eczema clinic were recruited and completed a self-administered questionnaire for encounters between 2014 and 2019. AD severity was assessed using the patient-oriented eczema measure (POEM), eczema area and severity index, Scoring AD (SCORAD), SCORAD-itch, investigator global assessment, and patient global assessment. The frequency of SD due to eczema was assessed using POEM. The impact of itching on the activity of falling asleep was assessed using 5 dimensions (5D) of itch. Fatigue was assessed using the patient-reported outcome measurement information system (PROMIS)-global health. Difficulty sleeping, falling asleep, and staying asleep was assessed using PROMIS-SD. The study found that geriatric AD patients had more profound SD, particularly staying asleep and fatigue, despite having AD severity similar to younger adult AD patients. The researchers concluded that future research is needed to understand why there is a difference between geriatric and non-geriatric patients as related to increased itching from atopic dermatitis and sleep disorders.
AHRQ-funded; HS023011.
Citation: Manjunath J, Silverberg JI .
Association of sleep disturbances with geriatric age in atopic dermatitis patients.
J Am Acad Dermatol 2022 Jul;87(1):206-08. doi: 10.1016/j.jaad.2021.07.039..
Keywords: Elderly, Sleep Problems, Skin Conditions
Wickwire EM, Bailey MD, Somers VK
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
The purpose of this study was to examine the impact of adherence to continuous positive airway pressure (CPAP) therapy on health care utilization among a nationally representative and sample of older adults with multiple morbidities and pre-existing cardiovascular disease and subsequently diagnosed with obstructive sleep apnea in the United States. The investigators concluded that in this nationally representative sample of older Medicare beneficiaries with multiple morbidities and relative to low adherers, high adherers demonstrated reduced inpatient utilization.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Bailey MD, Somers VK .
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
J Clin Sleep Med 2022 Jan;18(1):39-45. doi: 10.5664/jcsm.9478..
Keywords: Elderly, Medicare, Sleep Problems, Cardiovascular Conditions, Patient Adherence/Compliance, Hospitalization, Healthcare Utilization, Respiratory Conditions
Zhou NY, Nili A, Blackwell CK
Parent report of sleep health and attention regulation in a cross-sectional study of infants and preschool-aged children with atopic dermatitis.
Older children with atopic dermatitis (AD) suffer from poor sleep and attention problems. However, until recently, the dearth of developmentally sensitive assessment tools impeded characterization in younger children. In this study the investigators aimed to characterize sleep and attention problems in young children with AD and identify modifiable factors. The investigators concluded that more severe AD correlates with poor sleep health and attention dysregulation.
AHRQ-funded; HS023011.
Citation: Zhou NY, Nili A, Blackwell CK .
Parent report of sleep health and attention regulation in a cross-sectional study of infants and preschool-aged children with atopic dermatitis.
Pediatr Dermatol 2022 Jan;39(1):61-68. doi: 10.1111/pde.14889..
Keywords: Children/Adolescents, Newborns/Infants, Sleep Problems, Skin Conditions
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
Shear TC, Balachandran JS, Mokhlesi B
Risk of sleep apnea in hospitalized older patients.
This study assessed the prevalence of undiagnosed obstructive sleep apnea (OSA) among general medical inpatients and to investigate whether OSA risk is associated with in-hospital sleep quantity and quality. It found that two of every 5 inpatients older than 50 years screened at high risk for OSA. Those screening at high risk have worse in-hospital sleep quantity and quality.
AHRQ-funded; HS016967.
Citation: Shear TC, Balachandran JS, Mokhlesi B .
Risk of sleep apnea in hospitalized older patients.
J Clin Sleep Med 2014 Oct 15;10(10):1061-6. doi: 10.5664/jcsm.4098..
Keywords: Elderly, Sleep Problems, Risk, Respiratory Conditions
Petrov ME, Kim Y, Lauderdale DS
Objective sleep, a novel risk factor for alterations in kidney function: the CARDIA study.
The investigators determined the association between objectively measured sleep and 10-year changes in estimated glomerular filtration rate. They found that, in this community-based sample, shorter sleep and poorer sleep quality were related to higher kidney filtration rates over 10 years.
AHRQ-funded; HS013852.
Citation: Petrov ME, Kim Y, Lauderdale DS .
Objective sleep, a novel risk factor for alterations in kidney function: the CARDIA study.
Sleep Med 2014 Sep;15(9):1140-6. doi: 10.1016/j.sleep.2014.05.021.
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Keywords: Risk, Sleep Problems, Kidney Disease and Health
Petrov ME, Howard VJ, Kleindorfer D
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
The authors investigated the relation between sleep medication use and incident stroke. At the sleep assessment, 9.6% of the participants used prescription sleep medication and 11.1% used over-the-counter sleep aids. Over an average follow-up of 3.3 ± 1.0 years, 297 stroke events occurred. The authors found that over-the-counter sleep medication use was associated with increased risk of incident stroke; however, there was no significant association with prescription sleep medications. They concluded that over-the-counter sleep medication use may independently increase the risk of stroke beyond other risk factors in middle-aged to older individuals with no history of stroke.
AHRQ-funded; HS013852.
Citation: Petrov ME, Howard VJ, Kleindorfer D .
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
J Stroke Cerebrovasc Dis 2014 Sep;23(8):2110-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.03.025.
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Keywords: Medication: Safety, Medication, Risk, Sleep Problems, Stroke, Cardiovascular Conditions, Racial and Ethnic Minorities
Le XH, Luque AE, Wang D
Assessing the usage of a guideline-driven interactive case simulation tool for insomnia screening and treatment in an HIV clinical education program.
The researchers report the preliminary results from a study to assess the usage of a guideline-driven insomnia screening and treatment case simulation tool. Using system usage diagrams as an instrument, they quantified visit frequency and length of stay for different types of system resources. Preliminary results have shown that both recommendations and interactive decision diagrams were frequently used, with the former having a longer length of stay but fewer visits.
AHRQ-funded; HS022057.
Citation: Le XH, Luque AE, Wang D .
Assessing the usage of a guideline-driven interactive case simulation tool for insomnia screening and treatment in an HIV clinical education program.
Stud Health Technol Inform 2013;192:323-7..
Keywords: Education: Continuing Medical Education, Guidelines, Human Immunodeficiency Virus (HIV), Screening, Simulation, Sleep Problems