Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD.
OBJECTIVE: To determine the feasibility and efficacy of a six-month, cell phone-based exercise persistence intervention for patients with chronic obstructive pulmonary disease (COPD) following pulmonary rehabilitation. METHODS: Participants who completed a two-week run-in were randomly assigned to either MOBILE-Coached (n = 9) or MOBILE-Self-Monitored (n = 8). All participants met with a nurse to develop an individualized exercise plan, were issued a pedometer and exercise booklet, and instructed to continue to log their daily exercise and symptoms. MOBILE-Coached also received weekly reinforcement text messages on their cell phones; reports of worsening symptoms were automatically flagged for follow-up. Usability and satisfaction were assessed. Participants completed incremental cycle and six minute walk (6MW) tests, wore an activity monitor for 14 days, and reported their health-related quality of life (HRQL) at baseline, three, and six months. RESULTS: The sample had a mean age of 68 +/-11 and forced expiratory volume in one second 18% predicted. Participants reported that logging their exercise and symptoms (FEV(1)) of 40 +/- was easy and that keeping track of their exercise helped them remain active. There were no differences between groups over time in maximal workload, 6MW distance, or HRQL (p > 0.05); however, MOBILE-Self-Monitored increased total steps/day whereas MOBILE-Coached logged fewer steps over six months (p =0.04). CONCLUSIONS: We showed that it is feasible to deliver a cell phone-based exercise persistence intervention to patients with COPD post-rehabilitation and that the addition of coaching appeared to be no better than self-monitoring. The latter finding needs to be interpreted with caution since this was a purely exploratory study. TRIAL REGISTRATION: ClinicalTrials.gov (NCT00373932). (+info)
Characterizing recovery of sleep after four successive night shifts.
The purpose of this study was to characterize the recovery pattern of sleep following simulated, four successive night shifts in ten healthy men (22.9 + or - 3.2 yr). Poor sleep was defined as sleep efficiency of 80% or lower as determined actigraphically. The results showed that four (rapid, slow, pseudo, and incomplete) patterns of sleep recovery were observed over three recovery sleep periods. The rapid and slow recovery pattern represented immediate and slow return to baseline level prior to the nightshifts, respectively. The pseudo recovery pattern demonstrated poor sleep at the 3rd recovery sleep period, despite transient recovery at the 2nd sleep period. The incomplete recovery pattern was characterized by consistently poorer sleep during the entire recovery period. The correlation analysis indicated that sleep habits (bed time and variation of wake time) prior to the experiment were significantly related to the recovery patterns, rather than performance and alertness during the night shifts. (+info)
Sex differences in subjective and actigraphic sleep measures: a population-based study of elderly persons.
STUDY OBJECTIVES: To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons. DESIGN: Cross-sectional study. SETTING: The study was embedded in the Rotterdam Study, a population-based study. PARTICIPANTS: Nine hundred fifty-six participants aged 59 to 97 years. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Participants wore an actigraph and kept a sleep diary for an average of 6 consecutive nights. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. Unadjusted sex differences in sleep parameters were assessed with t tests. Women reported shorter total sleep time, a less favorable sleep-onset latency, lower sleep efficiency, and worse global sleep quality, as compared with men. When assessed with actigraphy, however, women were found to have longer and less-fragmented sleep than men. Sex differences in diary-reported sleep duration and other subjective sleep parameters were attenuated by adjustment for marital status, the use of sleep medication, and other covariates, but all sex differences remained significant in a multivariate-adjusted model. Sex differences in actigraphic sleep parameters were barely attenuated by multivariate adjustment, although the shorter actigraphically measured sleep duration in men was partly explained by their higher alcohol consumption. Some covariates (eg, sleep medication) had a different relationship with diary-reported or actigraphic total sleep time in men and women. CONCLUSIONS: If assessed by diary or interview, elderly women consistently reported shorter and poorer sleep than elderly men. In contrast, actigraphic sleep measures showed poorer sleep in men. These discrepancies are partly explained by determinants of sleep duration, such as sleep medication use and alcohol consumption. (+info)