Factors Affecting the Sleep Quality of the Elderly in Thailand

One of challenging global phenomena is the growth of elderly population which underlines human longevity across the globe.  Thailand has emerged and become a society of older persons.  Sleep problems are neither uncommon nor inherent of physiological change of ageing process. The elderly health vulnerability and complex evidently derive from one of sleep problems.  This research explored and presented sleep problems of the elderly at the national perspective scales.  Research objectives were established to examine sleep quality throughout the country and explore correlation between individual factors and sleep quality in the elderly.  The established research question asks “How do individual factors affect sleep quality in the elderly in Thailand?”  This correlative study was purposely designed  to explore the relationship of essential elements of individual factors and sleep quality of the elderly population in Thailand.  The stratified sampling method [1]was employed in identifying 400 samplings in 15 provinces of 4 regions across Thailand.  The field survey approach engaged the in-depth interview by using a modified PSQI questionnaire [2] whose content validity and reliability was approved by the established Expert Committee.   The study results succinctly identified three core elements. The first one is related to individual and personal factors.   The majority of samplings occupied age ranges of 65-70 years who are mostly male and married and have adequate income and their own lodgings.Though having some personal medical conditions, the majority of them drink neither alcohols nor caffeine and do not smoke and do not practice physical exercise either.  The most disturbing environment factors affecting sleep is noise. The majority of samplings experienced depression and did not perform prayers or meditation before sleep.  The second element is related to sleep quality under the PSQI guidelines. It was found that the majority of 315 persons (78.8%)  did not have a good sleep quality with the total PSQI scores of greater than 5 points.   The minority of them or 85 persons (21.2 %) has a good sleep quality with the total PSQI scores of less than 5 points.  The third element captures and present the result of hypothesis testing which found that age, marital status, medical conditions, consumption of alcohol and caffeine, physical exercise, disturbing environment, depression with known and unknown causes and practice of prayers and meditation before sleep are correlated with sleep quality of the elderly.   Gender has no correlation with sleep quality of the elderly as the good and bad sleep quality of either gender is of proportional results.    

Nitric oxide regulates human eosinophil adhesion mechanisms in vitro by changing integrin expression and activity on the eosinophil cell surface

1. The nitric oxide synthase (NOS) inhibitor, N(ω)-nitro-L-arginine methyl ester (L-NAME), inhibits both rat and human eosinophil chemotaxis in vitro. Here, the role of nitric oxide (NO) in human eosinophil cell surface integrin expression and function was investigated. 2. Human peripheral blood eosinophils were treated with L-NAME (0.01 – 1.0 mM) and their adhesion to human fibronectin and serum observed. Adhesion of cells to fibronectin and serum increased by 24.0±4.6 and 43.8±4.7%, respectively, when eosinophils were treated with 1.0 mM L-NAME. Increased adhesion by L-NAME could be abolished when cells were co-incubated with VLA-4- and Mac-1-specific monoclonal antibodies (mAbs). 3. The NO donor, sodium nitroprusside (2.5 mM), significantly inhibited eosinophil adhesion to fibronectin and serum by 34.3±4.5 and 45.2±5.6%, respectively. This inhibition was accompanied by a 4 fold increase in the levels of intracellular cyclic GMP. 4. Flow cytometrical analysis demonstrated that L-NAME induced an increased expression of CD11b (Mac-1) on the eosinophil cell surface of 36.3±7.4%. L-NAME had no effect upon CD49d (VLA-4) expression. 5. Treatment of human eosinophils, in vitro, with H-[1,2,4] oxadiazolo quinoxalin-1-one (ODQ) (0.1 mM), an inhibitor of soluble guanylate cyclase, also significantly increased eosinophil adhesion to fibronectin and serum by 73.5±17.9 and 91.7±12.9%, respectively. This increase in adhesion could also be inhibited by co-incubation with the Mac-1 and VLA-4-specific mAbs. 6. In conclusion, results indicate that NO, via a cyclic GMP-dependent mechanism, inhibits the adhesion of human eosinophils to the extracellular matrix (ECM). This inhibition is accompanied by a decrease in the expression and function of the eosinophil's adhesion molecules, in particular, the expression of the Mac-1 integrin and the function of the VLA-4 integrin