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The International Journal of Pharmacy... Apr 2023Sleep is an essential part of mental and physical well-being. Sleep disorders may lead to psychiatric and physical conditions that contribute to morbidity and mortality....
BACKGROUND
Sleep is an essential part of mental and physical well-being. Sleep disorders may lead to psychiatric and physical conditions that contribute to morbidity and mortality. They lead to severe health and economic consequences across high-, intermediate- and low-income countries. Little is known about how pharmacists manage sleep disorders for patients in high, intermediate and low-income countries.
METHOD
Four databases were systematically searched, and titles, abstracts, and full texts were screened to detect relevant studies. Data were extracted from literature and thematically synthesised to identify descriptive and analytical themes.
RESULTS
Thirty-four studies met the inclusion criteria. Most studies were from high-income countries (n = 33) and based in community pharmacy settings (n = 17). Four descriptive themes were identified: (1) how pharmacists manage sleep disorders, (2) the impact of pharmacists' interventions on sleep, (3) barriers to managing sleep by pharmacists and (4) inappropriate sleep disorders management by pharmacists. Three analytical themes were synthesised from extracted data that identified the pharmacists have roles as (1) de-prescribers, (2) collaborators and (3) educators in sleep management services.
CONCLUSION
Pharmacists have three clear roles in sleep disorder management; deprescribing, collaboration with other healthcare professionals and educators. However, most of the literature is from high-income countries; therefore, further work is needed to explore these roles in low and middle-income countries.
Topics: Humans; Pharmacists; Sleep; Professional Role; Community Pharmacy Services
PubMed: 36840950
DOI: 10.1093/ijpp/riac102 -
International Journal of Public Health 2022This scoping review is to investigate the existing literature on the mental health of Healthcare workers, including stress or distress, anxiety, depression, burnout,...
This scoping review is to investigate the existing literature on the mental health of Healthcare workers, including stress or distress, anxiety, depression, burnout, insomnia, and fear or phobia within the different countries in the Eastern Mediterranean region (EMR) during the COVID-19 pandemic. We systematically searched to consolidate studies across EMR countries regarding the mental health morbidity studied, the scales, and the methodology used. The review focused on peer-reviewed academic literature published from March 2020 to November 2021. One hundred sixty-seven articles were included in the review. Most publications came from lower-middle-income countries such as Iran, Pakistan, and Egypt. Most of the literature was specific to Stress/Distress ( = 94), followed by anxiety ( = 93), depression ( = 66), burnout ( = 27), insomnia ( = 20), and fear/phobia ( = 12). Fear, phobia, and insomnia have all been examined extensively worldwide, yet they were among the Eastern Mediterranean region's least explored outcomes. In addition, most underdeveloped countries have a low rate of publication.
Topics: Humans; Anxiety; Burnout, Professional; COVID-19; Depression; Health Personnel; Mental Health; Pandemics; Sleep Initiation and Maintenance Disorders
PubMed: 36686382
DOI: 10.3389/ijph.2022.1604814 -
BMJ Open Jul 2022This review assesses interventions and their effectiveness in mitigating psychological consequences from pandemic.
OBJECTIVE
This review assesses interventions and their effectiveness in mitigating psychological consequences from pandemic.
METHOD
Published English literatures were searched from four databases (Medline, PubMed, Embase and PsycINFO) from January 2020 and September 2021. A total of 27 papers with 29 studies (one paper reported three studies) met inclusion criteria. Cochrane risk-of-bias tool is applied to assess the quality of all randomised controlled trials (RCT).
RESULTS
All studies were recently conducted in 2020. Publications were from high-income (13, 44.8%), upper middle-income (12, 41.4%) and lower middle-income countries (3, 10.3%) and global (1, 3.5%). Half of the studies conducted for general population (51.7%). One-third of studies (8, 27.6%) provided interventions to patients with COVID-19 and 20.7% to healthcare workers. Of the 29 studies, 14 (48.3%) were RCT. All RCTs were assessed for risk of biases; five studies (15, 35.7%) had low risk as measured against all six dimensions reflecting high-quality study.Of these 29 studies, 26 diagnostic or screening measures were applied; 8 (30.9%) for anxiety, 7 (26.9%) for depression, 5 (19.2%) for stress, 5 (19.2%) for insomnia and 1 (3.8%) for suicide. Measures used to assess the baseline and outcomes of interventions were standardised and widely applied by other studies with high level of reliability and validity. Of 11 RCT studies, 10 (90.9%) showed that anxiety interventions significantly lowered anxiety in intervention groups. Five of the six RCT studies (83.3%) had significantly reduced the level of depression. Most interventions for anxiety and stress were mindfulness and meditation based.
CONCLUSIONS
Results from RCT studies (11%, 78.6%) were effective in mitigating psychological consequences from COVID-19 pandemic when applied to healthcare workers, patients with COVID-19 and general population. These effective interventions can be applied and scaled up in other country settings through adaptation of modes of delivery suitable to country resources, pandemic and health system context.
Topics: Anxiety; Anxiety Disorders; COVID-19; Health Personnel; Humans; Pandemics
PubMed: 35882462
DOI: 10.1136/bmjopen-2022-060804 -
Journal of Affective Disorders Oct 2022The COVID-19 pandemic impacted mental health, but the global evolution of mental health problems during the pandemic is unknown. We conducted a systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The COVID-19 pandemic impacted mental health, but the global evolution of mental health problems during the pandemic is unknown. We conducted a systematic review and meta-analysis of longitudinal studies to evaluate the global evolution of mental health problems during the pandemic.
METHODS
To conduct this systematic review, we searched for published articles from APA PsycInfo (Ovid), CINAHL (EBSCOhost), Embase (Ovid), MEDLINE (Ovid), and Web of Science. Longitudinal (at least 2 waves during the COVID-19 pandemic) and peer-reviewed articles on mental health problems conducted as from 2020 and after were included in the current study. Of 394 eligible full texts, 64 articles were included in the analysis. We computed random effects, standardized mean differences, and log odds ratio (LOR) with 95 % CIs. The meta-analysis protocol was registered with PROSPERO (CRD42021273624).
RESULTS
Results showed that anxiety (LOR = -0.33; 95 % CI, -0.54, -0.12) and depression symptoms (LOR = -0.12; 95 % CI, -0.21, -0.04) decreased from baseline to follow up. However, other mental health problems showed no change. Higher prevalence rates (40.9 %; 95 % CI, 16.1 %-65.8 %) of psychological distress were found in months after July 2020, respectively, while there were no significant month differences for the prevalence of other mental health problems. Higher means of anxiety (d = 3.63, 95 % CI, 1.66, 5.61), depression (d = 3.93; 95 % CI, 1.68, 6.17), and loneliness (d = 5.96; 95 % CI, 3.22, 8.70) were observed in May 2020. Higher prevalence of anxiety, depression, and PTSD and higher means of anxiety, depression and loneliness were observed in North America. The prevalence of psychological distress and insomnia was higher in Latin America and Europe, respectively.
LIMITATIONS
There is a lack of longitudinal studies in some parts of the world, such as Africa, the Caribbean, India, the Middle East, in Latin America, and Asia.
CONCLUSIONS
Results indicated that anxiety and depression symptoms decreased during the COVID-19 pandemic while other mental health problems showed no statistical change. The findings reveal that mental health problems peaked in April and May 2020. Prevalence of mental health problems remains high during the pandemic and mental health prevention, promotion and intervention programs should be implemented to mitigate the consequences of the COVID-19 pandemic on the global population.
Topics: Anxiety; Anxiety Disorders; COVID-19; Depression; Humans; Mental Health; Pandemics; Prevalence
PubMed: 35842064
DOI: 10.1016/j.jad.2022.07.011 -
International Journal of Chronic... 2022Physical activity (PA), sedentary behaviour (SB) and sleep are important lifestyle behaviours associated with chronic respiratory disease (CRD) morbidity and mortality.... (Review)
Review
ABSTRACT
Physical activity (PA), sedentary behaviour (SB) and sleep are important lifestyle behaviours associated with chronic respiratory disease (CRD) morbidity and mortality. These behaviours need to be understood in low- and middle-income countries (LMIC) to develop appropriate interventions.
PURPOSE
Where and how have free-living PA, SB and sleep data been collected for adults living with CRD in LMIC? What are the free-living PA, SB and sleep levels of adults living with CRD?
PATIENTS AND METHODS
The literature on free-living PA, SB and sleep of people living with CRD in LMIC was systematically reviewed in five relevant scientific databases. The review included empirical studies conducted in LMIC, reported in any language. Reviewers screened the articles and extracted data on prevalence, levels and measurement approach of PA, SB and sleep using a standardised form. Quality of reporting was assessed using bespoke criteria.
RESULTS
Of 89 articles, most were conducted in Brazil (n=43). PA was the commonest behaviour measured (n=66). Questionnaires (n=52) were more commonly used to measure physical behaviours than device-based (n=37) methods. International Physical Activity Questionnaire was the commonest for measuring PA/SB (n=11). For sleep, most studies used Pittsburgh Sleep Quality Index (n=18). The most common ways of reporting were steps per day (n=21), energy expenditure (n=21), sedentary time (n=16), standing time (n=13), sitting time (n=11), lying time (n=10) and overall sleep quality (n=32). Studies revealed low PA levels [steps per day (range 2669-7490steps/day)], sedentary lifestyles [sitting time (range 283-418min/day); standing time (range 139-270min/day); lying time (range 76-119min/day)] and poor sleep quality (range 33-100%) among adults with CRD in LMIC.
CONCLUSION
Data support low PA levels, sedentary lifestyles and poor sleep among people in LMIC living with CRDs. More studies are needed in more diverse populations and would benefit from a harmonised approach to data collection for international comparisons.
Topics: Adult; Developing Countries; Exercise; Humans; Pulmonary Disease, Chronic Obstructive; Sedentary Behavior; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 35469273
DOI: 10.2147/COPD.S345034 -
Sleep Jul 2022Sleep disturbances are a common and unmet health problem in Latinx. While Latinx report similar sleep disturbances as non-Hispanic Whites [NHW], Latinx suffer from these... (Review)
Review
Sleep disturbances are a common and unmet health problem in Latinx. While Latinx report similar sleep disturbances as non-Hispanic Whites [NHW], Latinx suffer from these disturbances to a greater degree than their NHW counterparts. Sleep disturbances are associated with increased risk of chronic health conditions, which Latinx experience at high rates. Research also points to significant sleep differences within Latinx. Given that Latinx are a rapidly growing population in the United States, sleep disparities between Latinx and NHWs and sleep differences within Latinx warrant further investigation. While research on Latinx sleep is growing, the last narrative review on US Latinx sleep health was published by Loredo and colleagues in 2010. Our narrative review expands on Loredo et al.'s work, adding the literature on Latinx sleep published since 2010 (N = 70). A total of 78 peer-reviewed articles related to young to middle-aged (i.e., 18-65 years) healthy Latinx adult sleep were identified in three databases-PsycInfo, PubMed/Medline, and Web of Science. With the socioecological model as framework, this review (1) summarizes current evidence pertaining to sleep health in healthy, community dwelling, urban Latinx adults; (2) discusses measurement challenges related to investigating Latinx sleep disparities and differences; and (3) discusses potential contributors to Latinx sleep. The prevalence of short sleep duration, long sleep duration, and poor sleep quality is high among Latinx; there are differences by Latinx subgroup. Our review identifies several multi-level influences associated with poor sleep: SES, sexual minority status, racial discrimination, access to care, neighborhood environment, and shift work. N = 250/250.
Topics: Adult; Chronic Disease; Ethnicity; Humans; Middle Aged; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; United States; White People
PubMed: 35460556
DOI: 10.1093/sleep/zsac092 -
Frontiers in Psychiatry 2021This meta-review aimed to provide a comprehensive overview of overall mental health of healthcare professionals during the COVID-19 pandemic.
OBJECTIVE
This meta-review aimed to provide a comprehensive overview of overall mental health of healthcare professionals during the COVID-19 pandemic.
METHOD
We conducted a comprehensive literature search on Academic Search Premier, CINAHL, Cochrane Library, and MEDLINE. A predefined eligibility criterion was used to screen the articles. The methodology quality of eligible studies was assessed using Joanna Briggs Institute checklist for systematic reviews. The data were narratively synthesised in line with the meta-review aim.
RESULT
Forty systematic reviews (represented as = 40), which reported data from 1,828 primary studies () and 3,245,768 participants, met the inclusion criteria. The findings from a pooled prevalence indicate that anxiety (16-41%, = 30, = 701), depression (14-37%, = 28, = 584), and stress/post-traumatic stress disorder (18.6-56.5%, = 24, = 327) were the most prevailing COVID-19 pandemic-related mental health conditions affecting healthcare workers. Other reported concerns included insomnia, burnout, fear, obsessive-compulsive disorder, somatization symptoms, phobia, substance abuse, and suicidal thoughts. Considering regions/countries, the highest anxiety was reported in the United-Kingdom [22.3, 95% Confidence Interval (CI):7-38, = 4] compared to other countries, while the highest depression was in the Middle-East, (41, 95% CI:16-60, = 5) and stress in the Eastern Mediterranean region (61.6, 95% CI:56.4-66.8, = 2) compared to other regions. The most significant risk factors include female gender, younger age, being a nurse, and frontline professional. The most-reported coping strategies include individual/group psychological support, family/relative support, training/orientation, and the adequacy of personal protective equipment.
CONCLUSION
It was concluded that healthcare professionals (nurses, doctors, allied health) have experienced various mental health issues during COVID-19 pandemic. The meta-review, therefore, recommends targeted interventions and health policies that address specific mental health issues to support health professionals worldwide during the duration of the COVID-19 pandemic and similar future health crises.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD4202126200, identifier: CRD42021262001.
PubMed: 35111089
DOI: 10.3389/fpsyt.2021.804525 -
Sleep Medicine Reviews Apr 2022Insomnia is a highly prevalent disorder and a state of 24 h hyperarousal is considered as a key factor of this condition. Various physiological markers of hyperarousal... (Meta-Analysis)
Meta-Analysis Review
Insomnia is a highly prevalent disorder and a state of 24 h hyperarousal is considered as a key factor of this condition. Various physiological markers of hyperarousal have been investigated, including the activity of the HPA axis. However, these studies yielded heterogenous results. The aim of this study was to qualitatively and quantitatively evaluate whether there are differences in cortisol levels, the hormonal end product of the HPA axis, between patients with insomnia and good sleeper controls (GSC). The databases PubMed, Cinahl, PsycInfo, PsycArticles and Web of Science were searched for case-control studies comparing cortisol levels in patients with insomnia and GSC. Twenty studies (449 patients with insomnia, limited to ages 18-70 not taking any medications; 357 GSC) met the inclusion criteria. For each study, standardized mean differences (SMD) were calculated as a measure of effect size. Results suggest that patients with insomnia show moderately increased cortisol levels (SMD = 0.50, 95% CI: [0.21-0.80]). Higher effect sizes were found by including only studies using blood samples in the analysis (SMD = 0.67, 95% CI: [0.15-1.18]). Furthermore, a positive, but insignificant association was found between the extent of objective sleep loss in insomnia patients and group differences in cortisol levels.
Topics: Adolescent; Adult; Aged; Case-Control Studies; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Middle Aged; Pituitary-Adrenal System; Sleep Initiation and Maintenance Disorders; Young Adult
PubMed: 35091194
DOI: 10.1016/j.smrv.2022.101588 -
Journal of Affective Disorders Feb 2022Acute effects of COVID-19 can be life-threatening. Alterations in mental health during the active infection have been documented, but the long-term consequences are less...
BACKGROUND
Acute effects of COVID-19 can be life-threatening. Alterations in mental health during the active infection have been documented, but the long-term consequences are less clear.
METHOD
A systematic review was undertaken to investigate the effect of COVID-19 infection on long-term mental health outcomes. Three databases [PubMed, Medline (Ovid) and Cochrane library] were searched between 1st October 2019 and 29th August 2021 with additional hand searching to identify all published studies reporting symptoms of generalised anxiety, depression, post-traumatic stress disorder (PTSD), or sleep disturbance in participants at least one month after COVID-19 infection. The prevalence and mean symptom score of each were assessed.
RESULTS
Eight hundred and eighty five studies were found, of which 33 were included in the review involving a total of 6743 participants. The studies' risk of bias were typically fair quality. The median study age of participants was 57.8 years (IQR 49.3-60.7), with 63.0% male (IQR 57.0%-73.0%). Participants typically experienced no or mild symptoms of long-term anxiety (GAD-7, STAI-S, HADS) and depression (PHQ-9, BDI, PHQ-2, HADS). Prevalence varied depending on the measurement tool. Sleep disturbances (primarily insomnia) were most commonly reported as mild. PTSD prevalence was similar to anxiety and depression.
CONCLUSION
The overall effect of the pandemic has been linked with worsening psychiatric symptoms. However, the long-term effect from direct COVID-19 infection has been associated with no or mild symptoms. Studies exhibited the long-term prevalence of anxiety, depression, PTSD, and sleep disturbances to be comparable to general population levels.
Topics: Anxiety; COVID-19; Depression; Female; Humans; Male; Mental Health; Middle Aged; Pandemics; SARS-CoV-2
PubMed: 34798148
DOI: 10.1016/j.jad.2021.11.031 -
Medicine Oct 2021Patients with long-term insomnia generally experience anxiety and depression. Traditional sleeping pills and anti-anxiety drugs have certain limitations. Xiao Yao San... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Patients with long-term insomnia generally experience anxiety and depression. Traditional sleeping pills and anti-anxiety drugs have certain limitations. Xiao Yao San (XYS), a complementary and alternative therapy, has been widely used to treat insomnia combined with anxiety. This study aims to evaluate the efficacy and safety of XYS in the treatment of insomnia combined with anxiety.
METHODS
Related literature was retrieved from 8 electronic databases from the establishment time to March 2021. The subjects were diagnosed with insomnia combined with anxiety. We assessed the methodological quality of randomized controlled trials (RCTs) according to the Cochrane Handbook. Data analysis was conducted using RevMan 5.3 software.
RESULTS
The analysis includes 9 RCTs involving 681 patients. Meta-analysis supported that as an auxiliary drug for Western medicine (WM), XYS could enhance the clinical efficacy of insomnia calculated according to the traditional Chinese medicine (TCM) syndrome score scale (risk ratio [RR]: 1.26; 95% confidence interval [CI]: 1.13-1.43; P = .0002) and reduced the scores of Hamilton Anxiety Scale (mean difference [MD]: -5.19; 95% CI: -7.78 to -2.60; P < .001), Pittsburgh Sleep Quality Index (MD: -3.35; 95% CI: -4.86 to -1.84; P < .001), Self-rating Anxiety Scale (MD: -9.38; 95% CI: -10.20 to -8.75; P < .001), TCM syndrome score scale for insomnia (MD: -4.45; 95% CI: -6.65 to -2.24; P < .001), and TCM syndrome score scale for anxiety (MD: -5.54; 95% CI: -9.48 to -1.6; P = .006). The summary analysis also shows that the separate use of XYS was advantageous in reducing the scores of the Hamilton Anxiety Scale (MD: -3.70; 95% CI: -6.31 to -1.09; P = .005), Pittsburgh Sleep Quality Index (MD: -1.82; 95% CI: -2.39 to -1.24; P < .001), and Self-rating Anxiety Scale (MD: -10.79; 95% CI: -14.09 to -7.49; P < .001). The incidence of adverse events with XYS as an ancillary drug or used separately was lower than that in the WM.
CONCLUSION
Our systematic evaluation and meta-analysis showed that XYS combined with WM or XYS alone was beneficial for improving sleep quality and relieving anxiety. Due to the low methodological quality, small sample size, and significant heterogeneity of RCTs, more rigorous and scientific clinical trials are required to further evaluate the efficacy and safety of XYS.
PROSPERO REGISTRATION NUMBER
CRD42020190613.
Topics: Adolescent; Adult; Aged; Anxiety; Drugs, Chinese Herbal; Female; Humans; Male; Middle Aged; Randomized Controlled Trials as Topic; Sleep Initiation and Maintenance Disorders; Young Adult
PubMed: 34713840
DOI: 10.1097/MD.0000000000027608