Histoire naturelle de l'insomnie et identification de facteurs de risque

Tableau d'honneur de la Faculté des études supérieures et postdoctorales, 2006-200

Cognitive behavioral therapy for insomnia in older adults

Insomnia is associated with significant morbidity and is often a persistent problem, particularly in older adults. It is important to attend to this complaint and not assume that it will remit spontaneously. In many cases, unfortunately, insomnia remains unrecognized and untreated, often because it is presumed that insomnia is an inevitable consequence of aging. Although the sleep structure naturally changes with advancing age, these changes are not necessarily associated with complaints of poor sleep, distress, or daytime consequences, while chronic insomnia clearly is. There is increasing evidence that cognitive behavioral therapy (CBT) is effective for the management of chronic insomnia in the elderly and that it is of significant benefit for insomnia comorbid with medical and psychological conditions, also more prevalent in older age. The aim of this article is to familiarize clinicians working with older adults with the different components of CBT for insomnia and how to adapt the treatment to this population. A clinical case and session-by-session implementation of CBT for insomnia are described to illustrate information and guidelines provided in this article

Insomnia in shift work

Background: Shift work disorder involves insomnia and/or excessive sleepiness associated with the work schedule. The present study examined the impact of insomnia on the perceived physical and psychological health of adults working on night and rotating shift schedules compared to day workers. Methods: A total of 418 adults (51% women, mean age 41.4 years), including 51 night workers, 158 rotating shift workers, and 209 day workers were selected from an epidemiological study. An algorithm was used to classify each participant of the two groups (working night or rotating shifts) according to the presence or absence of insomnia symptoms. Each of these individuals was paired with a day worker according to gender, age, and income. Participants completed several questionnaires measuring sleep, health, and psychological variables. Results: Night and rotating shift workers with insomnia presented a sleep profile similar to that of day workers with insomnia. Sleep time was more strongly related to insomnia than to shift work per se. Participants with insomnia in the three groups complained of anxiety, depression, and fatigue, and reported consuming equal amounts of sleep-aid medication. Insomnia also contributed to chronic pain and otorhinolaryngology problems, especially among rotating shift workers.Work productivity and absenteeism were more strongly related to insomnia. Conclusion: The present study highlights insomnia as an important component of the sleep difficulties experienced by shift workers. Insomnia may exacerbate certain physical and mental health problems of shift workers, and impair their quality of life

Tabusintac Bay (New Brunswick, Canada): an important spring migratory stopover for Atlantic Brant (Branta bernicla hrota)

Atlantic Brant (Branta bernicla hrota) is an Arctic-breeding migratory waterfowl that relies heavily on Common Eelgrass (Zostera marina) for food during migration and overwintering. Although the abundance of Atlantic Brant along the coasts of the Maritime provinces has declined drastically over the past decades, some flocks continue to migrate through the area in spring. Here, we present field observations of Atlantic Brant spring staging in the Tabusintac Bay, New Brunswick, Canada. We surveyed the Tabusintac Bay seven times between 26 May and 6 June 2018. We observed a maximum daily count of 1259 individuals, which is comparable to high counts from the 1970s. These spring surveys indicate the continuing importance of Tabusintac Bay to Atlantic Brant for spring staging. There is a pressing need to increase monitoring and research in the region and to preserve or enhance the quality of the area for spring staging brant

Modelagem teórica da experiência mimética e “Curso de ação” : análise de situações de formação na educação, na saúde e no desporto

Este artigo apresenta uma reflexão teórica para estudar os processos de aprendizagem-desenvolvimento no trabalho em ambientes de formação que confrontam intencionalmente o formando com o mundo dos outros. Estes ambientes, concebidos a partir de filmes de trabalho real ou de observação em situação de simulação e/ou práticas acompanhadas, exigem a articulação de processos miméticos, reflexivos, projetivos e lúdicos. Durante o período 2011-2020, foram realizados três estudos relativos a situações de formação em vídeo e/ou simulação em diferentes áreas profissionais (formação de professores, parteiras, chefes de equipa) no quadro de um programa de pesquisa empírica conhecido como o “Curso de ação” ou de “antropologia cultural ativa”. Um modelo teórico foi desenvolvido para dar conta desses processos silenciosos e complexos de mimese social que ligam experiências vividas pelos atores (imersão, imitação, emulação, ser semelhante, representação, antecipação). Essa redução teórica baseada na hexatomia da unidade de ação abre pistas metodológicas que permitem compreender melhor as dimensões implícitas da atividade corporal e sensível, muito presentes nessa relação com o mundo dos outros, e, ao mesmo tempo, compreender melhor as condições de performatividade da ação (mimese como recuperação criativa vs mimetização como cópia da realidade).Este artículo presenta una reflexión teórica para estudiar los procesos de aprendizaje-desarrollo que se ponen en marcha en contextos de formación que deliberadamente hacen que los participantes de ésta se enfrenten al mundo del otro. Esos contextos, concebidos a partir de filmaciones de trabajo real o de la observación en una situación de simulación y/o de prácticas acompañadas, requieren de la articulación de procesos miméticos, reflexivos, proyectivos y lúdicos. Durante el período 2011-2020, en el marco del programa de investigación empírica llamado “Curso de acción” o de “antropología cultural enactiva”, se llevaron a cabo tres estudios relativos a situaciones de video-formación y/o de simulación en ámbitos profesionales diferentes (formación de docentes, de matronas y de conductores de carruajes). Para dar cuenta de esos procesos de mímesis social silenciosos y complejos que ponen en relación experiencias vividas por los actores (inmersión, imitación, emulación, hacer lo mismo, representación, anticipación), se desarrolló una modelización teórica. Esta reducción teórica basada en la hexatomia de la unidad de acción abre pistas metodológicas que permiten al mismo tiempo, captar mejor las dimensiones implícitas de la actividad corporal y sensible muy presentes en esa relación con el mundo del otro y, a la vez, comprender mejor las condiciones de performatividad de la acción (mímesis como repetición creativa vs mimetismo como copia de lo real).Cet article présente une réflexion théorique pour étudier les processus d’apprentissage-développement à l’œuvre dans des environnements de formation qui confrontent intentionnellement les formés au monde d’autrui. Ces environnements conçus à partir de films du travail réel ou à partir d’observation en situation de simulation et/ou de pratiques accompagnées, sollicitent l’articulation de processus mimétiques, réflexifs, projectifs et ludiques. Au cours de la période 2011-2020, trois études relatives à des situations de vidéoformation et/ou de simulation dans des domaines professionnels différents (formation d’enseignants, de sages-femmes, de meneurs d’attelage de chevaux) ont été conduites dans le cadre du programme de recherche empirique dit du “ Cours d’action » ou d’” anthropologie culturelle enactive ». Une modélisation théorique a été développée pour rendre compte de ces processus de mimésis sociale silencieux et complexes de mises en relation d’expériences vécues par les acteurs (immersion, imitation, émulation, faire le semblable de, représentation, anticipation). Cette réduction théorique basée sur l’hexatomie de l’unité d’action ouvre des pistes méthodologiques à la fois pour mieux saisir les dimensions implicites de l’activité corporelle et sensible très présentes dans ce rapport au monde d’autrui et, en même temps, permet de mieux comprendre les conditions de performativité de l’action (mimésis comme reprise créative vs mimétisme comme copie du réel).This paper presents a theoretical reflection to study the processes of work learning and development proceeding in the training environments which intentionally bring together the trainees to other people’s world. These environments are built up from movies of real work or from observations in simulating and/or supported practices situations. These environments seek articulation between mimetic, reflexive, projective and ludic processes. Over the 2011-2020 period, three studies regarding video-training and/or simulation situations in various professional fields (teachers, midwifes and carriage drivers training) have been led within the framework of the empirical research program known as the “Course of action” or “enactive cultural anthropology”. A theoretical modelling has been developed to account for these silent and complex social mimesis processes of linking agents experiences (immersion, imitation, emulation, “acting similarly to”, representation, anticipation). This theoretical reduction based on the hexatomy of the course of action unit opens up some methodological paths to both better comprehend the implicit dimensions of body and sensitive activity, very active in this relation to other’s world, and to better understand the performativity conditions of action (mimesis as a creative remake vs mimesis as a copy of reality)

The use of natural products for sleep: A common practice?

Despite a paucity of data on efficacy and safety of natural (herbal and dietary) products, their use appears to be widespread. This study aimed at examining the frequency of natural products’ use for sleep and their correlates in a population-based sample. Methods A randomly selected sample of adults (n = 997; 59.9% women) from the province of Quebec completed a postal survey on sleep, use of sleep-promoting products (natural products, prescribed medication, over-the-counter medication and alcohol), physical and mental health, lifestyle habits and demographics. Results A total of 18.5% of participants reported having used natural products as sleep aids in the past 12 months, with chamomile being the most popular product. Participants who exclusively used natural products as sleep aids (10.3% of the sample) were predominantly females, younger and had a higher educational level than those using prescribed medications. Natural products users reported engaging in more health-promoting behaviors than the nonusers of sleep aids and, despite the presence of subthreshold insomnia symptoms (mean Insomnia Severity Index score = 9.33), they tended to perceive themselves as healthier when compared with prescribed medication users and nonusers of sleep aids. Conclusions The use of natural products as sleep aids is a common practice. Often associated with a general health-promoting lifestyle, it may reflect the common perception that natural products are necessarily beneficial for sleep and without risk

Prevalence of insomnia and its treatment in Canada

Objectives : To estimate the prevalence of insomnia and examine its correlates (for example, demographics and physical and mental health) and treatments. Methods : A sample of 2000 Canadians aged 18 years and older responded to a telephone survey about sleep, health, and the use of sleep-promoting products. Respondents with insomnia were identified using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and the International Classification of Diseases, Tenth Edition, criteria. Results : Among the sample, 40.2% presented at least 1 symptom of insomnia (that is, trouble falling or staying asleep, or early morning awakening) for a minimum of 3 nights per week in the previous month, 19.8% were dissatisfied with their sleep, and 13.4% met all criteria for insomnia (that is, presence of 1 insomnia symptom 3 nights or more per week for at least 1 month, accompanied by distress or daytime impairment). Insomnia was associated with female sex, older age, and poorer self-rated physical and mental health. Thirteen per cent of respondents had consulted a health care provider for sleep difficulties once in their lifetime. Moreover, 10% had used prescribed medications for sleep in the previous year, 9.0% used natural products, 5.7% used over-the-counter products, and 4.6% used alcohol. There were differences between French- and English-speaking adults, with the former group presenting lower rates of insomnia (9.5%, compared with 14.3%) and consultation (8.7%, compared with 14.4%), but higher rates of prescribed medications (12.9%, compared with 9.3%) and the use of natural products (15.6%, compared with 7.4%). Conclusions : Insomnia is a prevalent condition, although few people seek professional consultation for this condition. Despite regional differences in the prevalence and treatments used to manage insomnia, prescribed medications remain the most widely used therapeutic option.Objectifs : Estimer la prévalence de l'insomnie et examiner ses corrélats (par exemple, les données démographiques et la santé physique et mentale) et les traitements. Méthodes : Un échantillon de 2000 Canadiens de 18 ans et plus ont répondu à une enquête téléphonique sur le sommeil, la santé et l'utilisation de produits qui favorisent le sommeil. Les répondants souffrant d'insomnie ont été identifiés à l'aide des critères du Manuel diagnostique et statistique des troubles mentaux, 4e édition révisée, et de la Classification internationale des maladies, 10e édition. Résultats : Dans l'échantillon, 40,2 % présentaient au moins 1 symptôme d'insomnie (c'est-à-dire, difficulté à s'endormir ou à rester endormi, ou réveil tôt le matin) pour un minimum de 3 nuits par semaine durant le mois précédent, 19,8 % étaient insatisfaits de leur sommeil, et 13,4 % satisfaisaient à tous les critères de l'insomnie (c'est-à-dire, la présence d'un symptôme d'insomnie 3 nuits ou plus par semaine pendant au moins 1 mois, accompagnée de détresse ou d'incapacité durant le jour). L'insomnie était associée avec le sexe féminin, l'âge avancé, et une mauvaise santé physique et mentale auto-déclarée. Treize pour cent des répondants avaient consulté un prestataire de soins de santé pour des difficultés de sommeil une fois dans leur vie. En outre, 10 % avaient utilisé des médicaments prescrits pour le sommeil dans l'année précédente, 9,0 % avaient utilisé des produits naturels, 5,7 % avaient utilisé des produits en vente libre, et 4,6 % avaient utilisé de l'alcool. Il y avait des différences entre les adultes francophones et anglophones, le premier groupe présentant des taux plus faibles d'insomnie (9,5 %, comparé à 14,3 %) et de consultations (8,7 %, comparé à 14,4 %), mais des taux plus élevés de médicaments prescrits (12,9 %, comparé à 9,3 %) et d'utilisation de produits naturels (15,6 %, comparé à 7,4 %). Conclusions : L'insomnie est une affection prévalente, bien que peu de gens aient recours à une consultation professionnelle pour ce problème. Malgré des différences régionales de prévalence et des traitements utilisés pour gérer l'insomnie, les médicaments prescrits demeurent l'option thérapeutique la plus utilisée

Insomnia and its relationship to health-care utilization, work absenteeism, productivity and accidents

Background and purpose To document and provide a micro analysis of the relationship between insomnia and health problems, health-care use, absenteeism, productivity and accidents. Participants and methods A population-based sample of 953 French-speaking adults from Québec, Canada. Participants were categorized as having insomnia syndrome (SYND) or insomnia symptoms (SYMPT) or as good sleepers (GS). They completed questionnaires on sleep, health, use of health-care services and products, accidents, work absences and reduced work productivity. Data were also obtained from the Québec-government-administered health insurance board on selected variables (e.g., consultations with health-care professionals, diagnoses). Results There were significantly more individuals in the SYND group relative to the GS group reporting at least one chronic health problem (83% vs. 53%; OR: 2.78) and who had consulted a health-care professional in the past year (81% vs. 60%; OR: 2.8). There were also higher proportions of individuals in the SYND group than in the GS group who had used prescription medications (57% vs. 30.7%; OR: 2.8), most notably to treat insomnia, mood and anxiety disorders, or who had used over-the-counter products (75.6% vs. 62.0%; OR: 1.8) and alcohol as a sleep aid (17.8% vs. 3.9%; OR: 4.6). In terms of daytime function, 25.0% of the SYND had been absent from work relative to 17.1% of GS (OR: 1.7), 40.6% reported having experienced reduced productivity compared to 12.3% of GS (OR: 4.8) and non-motor-vehicle accidents occurred at higher rates in the SYND group (12.5% vs. 6.4% for GS; OR: 2.4). No differences were found for hospitalisations or motor-vehicle accidents. Most of the associations remained significant even after controlling for psychiatric comorbidity. Rates for the SYMPT group were situated between SYND and GS on all major dependent variables. Furthermore, insomnia and fatigue were perceived as contributing significantly to accidents, absences and decreased work productivity, regardless of insomnia status. Conclusions This study indicates that insomnia is associated with significant morbidity in terms of health problems and health-care utilization, work absenteeism and reduced productivity, and risk of non-motor-vehicle accidents. Future studies should evaluate whether treating insomnia can reverse this morbidity

Monthly fluctuations of insomnia symptoms in a population-based sample

Study Objectives: To document the monthly changes in sleep/insomnia status over a 12-month period; to determine the optimal time intervals to reliably capture new incident cases and recurrent episodes of insomnia and the likelihood of its persistence over time. Design: Participants were 100 adults (mean age = 49.9 years; 66% women) randomly selected from a larger population-based sample enrolled in a longitudinal study of the natural history of insomnia. They completed 12 monthly telephone interviews assessing insomnia, use of sleep aids, stressful life events, and physical and mental health problems in the previous month. A total of 1,125 interviews of a potential 1,200 were completed. Based on data collected at each assessment, participants were classified into one of three subgroups: good sleepers, insomnia symptoms, and insomnia syndrome. Results: At baseline, 42 participants were classified as good sleepers, 34 met criteria for insomnia symptoms, and 24 for an insomnia syndrome. There were significant fluctuations of insomnia over time, with 66% of the participants changing sleep status at least once over the 12 monthly assessments (51.5% for good sleepers, 59.5% for insomnia syndrome, and 93.4% for insomnia symptoms). Changes of status were more frequent among individuals with insomnia symptoms at baseline (mean = 3.46, SD = 2.36) than among those initially classified as good sleepers (mean = 2.12, SD = 2.70). Among the subgroup with insomnia symptoms at baseline, 88.3% reported improved sleep (i.e., became good sleepers) at least once over the 12 monthly assessments compared to 27.7% whose sleep worsened (i.e., met criteria for an insomnia syndrome) during the same period. Among individuals classified as good sleepers at baseline, risks of developing insomnia symptoms and syndrome over the subsequent months were, respectively, 48.6% and 14.5%. Monthly assessment over an interval of 6 months was found most reliable to estimate incidence rates, while an interval of 3 months proved the most reliable for defining chronic insomnia. Conclusions: Monthly assessment of insomnia and sleep patterns revealed significant variability over the course of a 12-month period. These findings highlight the importance for future epidemiological studies of conducting repeated assessment at shorter than the typical yearly interval in order to reliably capture the natural course of insomnia over time