Sleep disturbances are common in older people. This study was conducted to examine the effects of a hot pack, which was used to warm the lower limbs, on the sleep of elderly people living in a nursing home. This is a prospective cohort involving seven elderly women. Subjects aged 74-93 years old were treated by warming the lower limbs for 40 minutes using hot packs every night over 8 weeks. A hot pack made of a dense polymer and warmed in a microwave oven was used as a warming device. In the first and last week, the subjects were required to wear an activity monitor to determine their sleep-awake status. During the second to ninth week, they received limb-warming treatment by a hot pack heated to 42°C for 40 min every night. Surface skin temperature data were collected by thermographic measurement. As a result, lower-limb warming by a hot pack significantly improved the quality of sleep in the subjects. During warming, the surface temperature of the hands and face rose by approximately 0.5-1.5°C. This study showed that lower-limb warming with a hot pack reduced sleep latency and wake episodes after sleep onset; thus, improving the quality of sleep in elderly people living in a nursing home.
Although complete decongestive therapy (CDT) is considered to reduce the volume of lymphedema, there is no concrete evidence to sustain its efficacy. The purpose of the present study was to find new evidence of CDT based on visualizing the changes of lymph fluid accumulating in an edematous limb using indocyanine green (ICG) fluorescent lymphography in real time.Twelve lymphedema rats were divided randomly into two groups. On the first day, ICG was injected into an edematous limb of rats, and no-intervention and CDT was applied to groups 1 and 2, respectively, for two weeks. ICG lymphography and circumferential measurements were done every two days in each two-week observation. The results indicates that a fluorescent flow to the ipsilateral axillary fossa was identified in all rats. In addition, network-like and dermal backflow patterns were observed in the lower legs and thighs. While manual lymph drainage was applied in the CDT group, the flow moved more rapidly through this pathway than that in the no-intervention group. An area of high-intensity fluorescent signals concentrated around the injection sites diminished in the CDT group more than that in the no-intervention-group after two weeks. Circumferential lengths of the edematous limbs were longer than the non-edematous limbs in both groups 1 and 2 on the day of ICG injection. The no-intervention group 1 showed no significance differences during 14 days, whereas the CDT group 2 exhibited very significant differences. These results suggest that CDT has beneficial effects in lymphedema treatment.
Background: Sleep patterns of patients who admitted the intensive care unit (ICU) after surgery have shown fragment and disturbed sleep during early postoperative days. However, there is less information about sleep status in patients after transferred to a surgical ward from the ICU. The aim of this study was to evaluate the sleep patterns in elderly patients after cardiac surgery including stay in both the ICU and surgical ward. Methods: Twelve patients aged ≥ 65 years were examined for 3 days before and 6 days after surgery. We used to examine sleep quality an actigraph and the Oguri-Shirakawa-Azumi sleep inventory (version for patients of middle age and older) for sleep. Results: Total sleep time was significantly decreased postoperative day 3 (median, 368.5 min) and 4 (median, 433.5 min) than before surgery (median 526.0 min) (p<0.05). Nocturnal sleep time showed significant decreases from preoperative values until postoperative day 1-4 (p<0.05). Duration of longest sleep was significantly decreased postoperative day 1-3 than before surgery (p<0.05). Sleep scale (sleep length and maintenance of sleep) scores indicated a decline in sleep quality on POD3 compared with preoperative values (p<0.05). The sleep disturbances did not reach preoperative levels until at least POD4. Conclusions: The sleep disturbances persisted not only throughout patients' ICU stay but also after they had been discharged from the ICU. Therefore, close collaboration between surgical ward and ICU nurses are the key to provide more appropriate and early interventions.
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