Transient Effects of Sleep on Next-Day Pain and Fatigue in Older Adults With Symptomatic Osteoarthritis

Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.Peer reviewedPublisher PD

Sleep disturbance as a moderator of the association between physical activity and later pain onset among American adults aged 50 and over : evidence from the Health and Retirement Study

Funding DW is supported by a Foundation Fellowship Versus Arthritis (Award Number: 21742). Contributors DW, HG, LMS, TJB, AK and GLD were involved in study conception and design, and advised on the statistical analysis plan and interpretation of the data. HG compiled the dataset and DW performed the statistical analysis. DW drafted the manuscript. HG, LMS, TJB, AK and GLD reviewed the manuscript, provided amendments and approved the final version. DW, HG and GLD had full access to study data and take responsibility for its accuracy and the integrity of the analysis. Data availability statement Data are available in a public, open access repository. The dataset used for this study was generated from data products publicly released by the Health and Retirement Study (HRS): https://hrs.isr.umich.edu. The HRS is sponsored by the National Institute on Ageing (grant number NIA U01AG009740).Peer reviewedPublisher PD

Restless legs syndrome and health‐related quality of life in adults with multiple sclerosis

Restless legs syndrome (RLS) is a sleep disorder that may exacerbate many of the symptoms and consequences of multiple sclerosis (MS), and may have further implications for health‐related quality of life (HRQOL). The present study examined the relationships among RLS, symptoms and HRQOL in people with MS. Participants with MS (n = 275) completed the Cambridge‐Hopkins Restless Legs Syndrome Questionnaire, the International Restless Legs Syndrome Study Group Scale, the Multiple Sclerosis Impact Scale, the Pittsburgh Sleep Quality Index, the Fatigue Severity Scale, the Hospital Anxiety and Depression Scale and the Patient Determined Disease Steps. There were 74 (26.9%) persons with MS who had RLS (MS + RLS). The MS + RLS group reported worse physical and psychological HRQOL (p = 0.020 and p = 0.017, respectively) and greater perceived fatigue (p = 0.006) and anxiety symptoms (p = 0.042) than the MS‐only group. Within the MS + RLS group, RLS severity was associated with physical (r = 0.43) and psychological (r = 0.46) HRQOL, sleep quality (r = 0.38), perceived fatigue (r = 0.28), depression (r = 0.38) and anxiety (r = 0.28). The relationships between RLS severity and the domains of HRQOL were attenuated when accounting for fatigue, depression and/or anxiety. Worse RLS severity was associated with reduced HRQOL, which was accounted for by fatigue, depression and anxiety.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155491/1/jsr12880.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155491/2/jsr12880_am.pd

Recognition and Diagnosis of Obstructive Sleep Apnea in Older Americans

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145334/1/jgs15372.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145334/2/jgs15372_am.pd

Cannabinoid use among Americans with MS : Current trends and gaps in knowledge

Acknowledgements: The National Multiple Sclerosis Society (NMSS) provided participant recruitment support. The Michigan Institute for Clinical & Health Research (MICHR:NIH award number UL1TR002240) provided participant recruitment support through UMHealthResearch.org. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or NMSS. The investigators thank Shubha Kulkarni for her assistance with data collection.Peer reviewedPublisher PD

Interpersonal Experiential Learning and Cancer Research Training Designed to Enhance the Motivation of Participating Interns Utilizing Self-Determination Theory: A Longitudinal Study with Photovoice Methodology

Historically, the underrepresentation of individuals from disadvantaged backgrounds, disabled, and diverse racial/ethnic groups in STEM fields is prevalent. Equity in stem fields allows for different perspectives and knowledge backgrounds allows for the cognitive diversity needed to tackle complex research topics. The Knight Scholars Program (KSP) aims to support underrepresented and disadvantaged high school and undergraduate students pursuing a research career by teaching them the tools they need to succeed. Spanning over three summers, KSP utilized the Self-Determination Theory (SDT) of motivation to create an inclusive learning environment and to strengthen the high schoolers\u27 motivation to pursue research careers focusing on the three physiological needs: autonomy, relatedness, and competency. Photovoices created by a cohort about their overall experiences during the two ten-week-long program segments underwent qualitative analysis to gauge the influences on scholars\u27 motivations present during their participation via qualitative analysis. These findings, discussed in the context of trainee recruitment and retention of individuals supporting diversity, equity, inclusion, and accessibility goals of programs, highlight the need for systematic support of trainees’ inherent needs for autonomy, relatedness, and competency

Sleep disturbances and progression of mobility disability: Longitudinal findings from the Nurses’ Health Study

Objective: To examine longitudinal associations between self-reported sleep disturbances and mobility disability progression among women, including subgroups with multiple sclerosis (MS), diabetes, and osteoarthritis (OA). Methods: Prospective cohort study using data from Nurses’ Health Study long-form questionnaires (2008, 2012, 2014, 2016). Logistic regression was used to quantify associations between sleep-related variables at baseline and subsequent increase in mobility disability. Results: Of 70,303 women (mean age 73), 392 had MS, 7,302 had diabetes, and 24,099 had OA. Between 2008–2016, mobility disability increased by 16.9 % overall, 27.8 % in the MS subgroup, 27.0 % in the diabetes subgroup, and 23.7 % in the OA subgroup. Known/suspected obstructive sleep apnea was significantly associated with an increase in mobility disability between 2008 and 2016, overall (OR:1.4, 95 %CI:1.2,1.5), and in the diabetes (OR:1.5, 95 %CI:1.2,1.9) and OA subgroups (OR:1.2, 95 %CI:1.0,1.4), but not in the MS subgroup (OR:2.3, 95 %CI:0.6,8.9); however, across 2012–2016, this association was significant for MS (OR:4.0, 95 %CI:1.0,16.1). Suboptimal sleep duration was significantly associated with increased odds of mobility disability progression overall, but not in disease subgroups. Perception of adequate sleep was associated with lower odds of mobility disability progression overall (OR:0.82, 95 %CI:0.78,0.87) and for the OA subgroup (OR:0.83, 95 %CI:0.76,0.91). Excessive daytime sleepiness was associated with mobility disability progression overall (OR:1.2, 95 %CI:1.1,1.4) and for the OA subgroup (OR:1.2, 95 %CI:1.0,1.4). Conclusions: Prevalent sleep disturbances could increase disability progression among women. Chronic disease populations may be uniquely vulnerable. Informed by these data, future research could offer new insight into sleep-based strategies to ameliorate mobility decline

Development of a person-centered conceptual model of perceived fatigability

Purpose: Perceived fatigability, reflective of changes in fatigue intensity in the context of activity, has emerged as a potentially important clinical outcome and quality of life indicator. Unfortunately, the nature of perceived fatigability is not well characterized. The aim of this study is to define the characteristics of fatigability through the development of a conceptual model informed by input from key stakeholders who experience fatigability, including the general population, individuals with multiple sclerosis (MS), and individuals with fibromyalgia (FM). Methods: Thirteen focus groups were conducted with 101 participants; five groups with n = 44 individuals representing the general population, four groups with n = 26 individuals with MS, and four groups with n = 31 individuals with FM. Focus group data were qualitatively analyzed to identify major themes in the participants’ characterizations of perceived fatigability. Results: Seven major themes were identified: general fatigability, physical fatigability, mental fatigability, emotional fatigability, moderators of fatigability, proactive and reactive behaviors, and temporal aspects of fatigability. Relative to those in the general sample, FM or MS groups more often described experiencing fatigue as a result of cognitive activity, use of proactive behaviors to manage fatigability, and sensory stimulation as exacerbating fatigability. Conclusions: Fatigability is the complex and dynamic process of the development of physical, mental, and/or emotional fatigue. Trait- and state-like biological, psychological, social, and environmental moderators contribute to tremendous variability in fatigability (both between and within-person variability). Future research to further characterize fatigability across populations, test treatments for fatigability, and develop new measures of this construct are greatly needed

Multiple sclerosis relapse risk in the postoperative period: Effects of invasive surgery and anesthesia.

BACKGROUND: Postoperative multiple sclerosis (MS) relapses are a concern among patients and providers. OBJECTIVE: To determine whether MS relapse risk is higher postoperatively. METHODS: Data were extracted from medical records of MS patients undergoing surgery at a tertiary center (2000–2016). Conditional logistic regression estimated within-patient unadjusted and age-adjusted odds of postoperative versus preoperative relapse. RESULTS: Among 281 patients and 609 surgeries, 12 postoperative relapses were identified. The odds of postoperative versus preoperative relapse in unadjusted (OR=0.56, 95%CI:0.18–1.79; P=0.33) or age-adjusted models (OR=0.66, 95%CI:0.20–2.16; P=0.49) were not increased. CONCLUSIONS: Surgery/anesthesia exposure did not increase postoperative relapse risk. These findings require confirmation in larger studies

Well-being at midlife: Correlates of mental health in ambulatory menopausal women with multiple sclerosis.

BACKGROUND: A majority of women with multiple sclerosis (MS) are diagnosed prior to menopause, yet their experiences during this transition are not well characterized. OBJECTIVES: To explore associations between mental health, sleep, and other quality of life metrics, and vasomotor symptoms (VMSs) in ambulatory, menopausal women with MS. METHODS: A secondary analysis was performed of baseline data from two trials enrolling ambulatory peri/postmenopausal women with MS: NCT02710214 (N = 24, bothersome VMS) and NCT04002934 (ongoing, N = 35, myelin repair). Measures analyzed were 36-Item Short-Form Survey (SF-36) (primary scale: general mental health), subjective sleep quality (Pittsburg Sleep Quality Index), VMS (daily diary, interference), mood (Center for Epidemiologist Studies-Depression Scale (CES-D)), walking impairment (timed 25-foot walk (T25FW)), and global disability (Expanded Disability Status Scale (EDSS)). RESULTS: Participants characteristics (N = 59) were: mean age 51.8 years (SD = 3.4), mean disease duration 11.3 years (SD = 7.6), median EDSS 3.0 (IQR = 2.0-4.0). Mental health was associated with better sleep quality (rho = -0.41, p = 0.019) and better mood (rho = -0.75, p < 0.001), but not with EDSS or T25FW (rho < 0.20, p > 0.10). Worse sleep quality also correlated with more frequent VMS (rho = 0.41, p = 0.02) and VMS interference (rho = 0.59, p < 0.001). CONCLUSIONS: Findings suggest that optimizing sleep quality, mood, and hot flash quantity/interference could substantially improve mental health in menopausal women with MS-and highlight an important care gap in this population