Insomnia Severity Lab Report

Insomnia is the most common sleep disorder. It can have a devastating impact on one’s emotion, physical, occupation and social life. While it occasionally can be seen in the clinical setting as a primary diagnosis, it most often presents as a comorbidity to a medical or psychiatric issue;

According to National Center on Sleep Disorders Research (NCSDR) an estimated 70 million Americans suffer from sleep problems, in which 60 percent are chronic disorders. The NCSDR also estimates $15.9 billion to the national health care bill are correlated to sleep disorders, sleep deprivation, and generalized sleepiness. Consequently, this has increased the cost of lost work production, accidents connected to lack of sleep, and/or contribute to other health problems (National Center on Sleep Disorders Research, 2016).

Sleep disturbance among the older adult population is known to be a prevalent issue (Gooneratne, Pack, Staley, Schutte-Rodin, Dinges, & Pack, 2011). Much study has

Fibromyalgia is primarily characterized as a chronic widespread pain condition that mainly affects an older female population (Arnold 2010). Even though pain is described as the primary symptom of Fibromyalgia, patients diagnosed with this condition also frequently describe significant poor sleep quality (Giorgio et al., 2012). In one study, out of 2,196 Fibromyalgia patients were that were surveyed; 11.2 % reported no sleep impediment symptom, 25.7% reported one sleep impediment symptom, and 63.05% percent reported two or more sleep impediment symptoms. When compared to control group subjects without Fibromyalgia, the prevalence of a sleep difficulty symptom was considerably lower in within the population without the

Ebben, M. R., & Narizhnaya, M. (2012). Cognitive and Behavioral Treatment Options for Insomnia. Mount Sinai Journal Of Medicine, 79(4)

The epidemiological study included data from 1,074 college students. The data consisted of sleep diaries and questions assessing mental health topics, such as stress, depression and anxiety. The results demonstrated that those with insomnia also were more likely to experience worse cases of stress, depression, and anxiety. This epidemiological study demonstrates a unique factor – insomnia – in the role of poor mental health, which can be brought into discussion at the community meeting. Many people and students know insomnia is an issue, but they just view it as a normal part of the college

Universal to every human from birth to death, sleep is a necessary function to survival, productivity, and happiness. While most fall asleep at night with ease, it is estimated that 50-70 million Americans battle sleep or wakefulness disorders. Although sleep disorders do not immediately present with a threat comparable to other common disorders such as depression, bipolar, or schizophrenia, sleep disorders prove very disruptive to one’s quality of life. Insufficient sleep may result in difficulty concentrating, difficulty with memory, trouble with personal care such as hygiene, driving, or managing finances, and poor performance in the workplace. While there is a wide array of sleep related illnesses that may plague any given individual,

Chronic pain in older adults is defined as ‘‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage, for persons who are either aged (65 to 79 years old) or very aged (80 and over) and who have had pain for greater than 3 months’’ (Lynch, 2000, p.270). The consequences of chronic pain may also be related to impaired activities of daily living (ADLs), physical disability, accidents, gait abnormalities, polypharmacy, and cognitive decline in older adults (Mantyselka et al., 2001; Kaye et al., 2010; Shega et al., 2010). Therefore, chronic pain has negative affects on older adults, their families, and social relationships.

To determine internal homogeneity, the researchers found Cronbach’s alpha to be 0.83, which demonstrates a high degree of internal consistency. They analyzed both individual items and the seven component scores, each of which demonstrated strong correlations with one another. To determine test-retest reliability, the researchers used paired t-tests to analyze the global PSQI score and the seven individual component scores. The results demonstrated no differences between the t-test values. Each of the scores were significantly correlated, demonstrating stability in the questionnaire. Validation of the PSQI was determined by looking at the significance of the global PSQI scores via ANCOVA with respect to age and sex as covariates. Age was found to be a significant covariate in the daytime dysfunction component, while sex was found to be a significant covariate in the sleeping medications and habitual sleep efficiency component. The sensitivity of the questionnaire as found to be 89.6% and the specificity was found to be 86.5%. To further validate the PSQI, researchers compared it to variables of sleep obtained via PSG. The PSQI and PSG showed similar scores for sleep latency; however the PSQI overestimates the past month’s sleep duration and efficiency. Overall, the PSQI is a valid measurement tool that demonstrated: (1) subjects and patients can easily use it;

According to American Geriatric Society (2002), chronic pain often associates with older adult. In United States, most of the older adults are suffering from pain in the absence of disease which is clearly not a normal part of aging (Bell et al. 2004). The common chronic pain in older adult is fibromyalgia, gout, neuropathy such as diabetic neuropathy, osteoarthritis and many more (Hiemenz and White 2002). It is estimated that 30% to 50% of older adult has multiple disease and its interaction with body physiologic changes may results in decreased in ability to respond stressors. Chronic pain among older adult has been associated with negative perception that it will lead to impaired in psychological functioning (American Geriatric Society 2002).

Physical and psychological health implications of chronic insomnia in the older adult contribute to a decreased quality of life. There is substantial evidence that suggests insomnia is an independent risk factor for the onset and maintenance of major depression disorder (Pigeon & Perlis, 2007). Depression and

“Many older persons (≥60 years of age) develop chronic illnesses that may be associated with persistent pain [1-4]. The inadequate treatment of persistent pain in older persons is associated with numerous adverse outcomes such as functional impairment, accidental falls (with or without injury), slow rehabilitation, decreased socialization, greater health care costs, and greater resource utilization. From 2010–2050, the US population of persons aged ≥65 years is projected to double. In the US, it is estimated that ∼100 million people have chronic pain. In comparison, current estimates of Americans affected with other common diseases are 29.1 million and 14 million for diabetes mellitus and cancer, respectively. However, some treatments

2. Mean fatigue diminished from 4.9 ( SD =1.86) to 3.44 ( SD 2.11). 3.Additionaly sleep disturbance lowered from 5.05( SD=2.12) to 2.81 ( SD=2.07). Feasibility of the study was assessed based on the post –study evaluations, and indicated that 77% of all participants found the interventions helpful in pain managements. Both the variety of provided strategies and their length were sufficient to get the desired effect.

Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic view (Mitchell et. al. 2012)

In the United States, pain is the most common reason for patients to seek medical attention. According to an Institute of Medicine report in 2011, at least 116 million people in the United States suffer from acute and chronic pain every year, including up to 80% of the elderly population, affecting more American adults than heart disease, diabetes, and cancer combined.1 The national annual economic cost associated with chronic pain is estimated to be $560-635 billion (or $2000 for each American), spent on medical treatment ($260-300b) and in lost productivity ($297-336b). In 2008, 14% of all federal Medicare expenditures are spent on pain management. Chronic pain is often associated with other co-morbidities such as