ELDERLY INSOMNIA--PASSIVE BODY HEATING

老年人失眠——被动发热

• 批准号: 3430281
• 负责人: CYNTHIA M DORSEY
• 金额: $ 6.11万
• 依托单位: MCLEAN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-01 至 1995-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3430281
• 关键词: biosensor device; body movement; body physical activity; body temperature; circadian rhythms; electrocardiography; electroencephalography; electromyography; electrooculography; electrophysiology; female; human old age (65+); human subject; human therapy evaluation; hyperthermia therapy; patient monitoring device; polygraphy; psychophysiology; respiratory airflow measurement; sleep; sleep disorders; thermometry

Sedative/hypnotic abuse among the elderly is a growing concern. Chronic insomnia occurs in 25-30% of 65-79 year olds and survey reports of sleep disturbances in the elderly correspond to a disproportionate use of sleep medication. Sleep medications can lose their efficacy after long-term use and can result in rebound insomnia upon withdrawal, sleepiness during the day, and complications when combined with other medications. Polysomnographic (PSG) changes in the elderly corresponding to subjective sleep complaints include: increases in nocturnal wake-time and substantial decreases in the amount and amplitude of slow-wave sleep (SWS). Slow-wave sleep, which has been considered to have physiological restorative properties, also is significantly suppressed by benzodiazepine hypnotic medications. There is a need for alternative methods for improving sleep overall and increasing slow-wave sleep in particular, in the elderly. Fourteen elderly female volunteers who complain of difficulty initiating and/or maintaining sleep will participate in a 9-nigh sleep study. Baseline actigraphic and sleep diary data will be collected for two weeks prior to the studies to evaluate objective and subjective sleep parameters and to confirm insomnia. Passive Body Heating (PBH) will be compared to a no-heat bath to study its effects on sleep parameters. The PBH intervention will involve having the subjects sit in a tub filled with 40 degrees C water for 20-30 minutes until their body temperature rises 1.0 degree C. Water temperature will be luke warm (37.5 degrees C) in the control, no-heat condition. PSG monitoring will be done on two separate series. the first lasting five consecutive days and the second lasting four consecutive days. A three-day rest period will be allowed between the two series. The first series will consist of a screening night, two baseline and two treatment nights of one of the two conditions (heat or no-heat). The second series will consist of two baseline and two treatment nights of the other condition. The order of treatment will be counterbalanced. Objective measures of sleep will be quantified using standard sleep scoring criteria. Changes in sleep continuity and slow-wave sleep will be inferred from changes in sleep efficiency while amplitude and density of slow wave sleep will be quantified using power spectral analysis. Subjective measures of sleep will be taken using a post-sleep questionnaire and a visual analog scale. Core body temperature and motor activity will be recorded continuously using ambulatory monitoring systems. The present study is designed to determine if PBH increases SWS and improves the continuity and quality of sleep in elderly insomniacs. Results may generalize to a geriatric population previous findings in young adults of elevations in core body temperature leading to altered objective and subjective sleep parameters. The proposed PBH technique should achieve the same effect without the added risks associated with having elderly individuals participate in strenuous exercise in order to elevate core body temperature. If the PBH procedure improves sleep measures, then it may be a useful non-pharmacologic adjunct method for treating insomnia in the elderly.

老年人滥用镇静剂/催眠药是一个日益令人关切的问题。慢性 65-79奥尔兹中有25-30%患有失眠症， 老年人的睡眠障碍与睡眠的不成比例有关 药睡眠药物在长期使用后可能会失去疗效 并可导致戒断后的反弹性失眠， 日，以及与其他药物联合使用时的并发症。 多导睡眠图（PSG）的变化，在老年人相应的主观 睡眠问题包括：夜间觉醒时间增加， 慢波睡眠（SWS）的数量和幅度减少。慢波 睡眠被认为具有生理恢复作用， 苯二氮卓类催眠药也显著抑制 药物治疗有必要寻找改善睡眠的替代方法 尤其是老年人的慢波睡眠。 14名老年女性志愿者抱怨难以启动 和/或保持睡眠的人将参加9晚睡眠研究。 将收集两周的基线活动记录和睡眠日记数据 在研究之前评估客观和主观睡眠参数 并确认失眠被动式身体加热（PBH）将与 无热浴，以研究其对睡眠参数的影响。PBH 干预将涉及让受试者坐在装满40 20-30分钟，直到体温上升1.0 摄氏度水温将是微温（37.5摄氏度）， 控制，无加热条件。PSG监测将在两个单独的 系列.第一个持续五天，第二个持续 连续四天。两个月内将有三天的休息时间， 两个系列第一个系列将包括一个放映之夜，两个 基线和两个治疗夜的两种条件之一（热或 不加热）。第二个系列将包括两个基线和两个治疗 另一个条件的夜晚。治疗的顺序将是 平衡。睡眠的客观测量将使用 标准睡眠评分标准。睡眠连续性和慢波的变化 睡眠将从睡眠效率的变化推断，而振幅 和密度的慢波睡眠将量化使用功率谱 分析.睡眠的主观测量将使用睡眠后 问卷调查和视觉模拟量表。核心体温和电机 将使用动态监测持续记录活动 系统.本研究旨在确定PBH是否增加SWS 提高老年失眠患者睡眠的连续性和质量。 结果可以推广到老年人口以前的研究结果， 年轻的成年人的核心体温升高，导致改变 客观和主观睡眠参数。提出的PBH技术 应该达到相同的效果，而不会增加与 让老年人参加剧烈运动， 提高核心体温。如果PBH手术能改善睡眠 措施，那么它可能是一个有用的非药物辅助方法， 治疗老年人失眠。