Sleep impairment and insomnia in sickle cell disease: A retrospective chart review of clinical and psychological indicators

Mann-Jiles, Valerie; Thompson, Kathrynn; Lester, Joanne

doi:10.1002/2327-6924.12212

Cited by 14 publications

(12 citation statements)

References 22 publications

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“…Based on a manual chart review of approximately 50 random insomnia patients, details such as the frequency of symptoms per week or the duration of symptoms, which would be necessary for a DSM-V diagnosis, were not documented for the vast majority of patients. These observations from our data are consistent with a previous report 56 . As a result, criteria such as DSM-V would be impractical to classify the insomnia status of patients in the EMR.…”

Section: Methodssupporting

confidence: 94%

Development of an Algorithm to Identify Patients with Physician-Documented Insomnia

Kartoun

Aggarwal

Beam

et al. 2018

Sci Rep

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We developed an insomnia classification algorithm by interrogating an electronic medical records (EMR) database of 314,292 patients. The patients received care at Massachusetts General Hospital (MGH), Brigham and Women’s Hospital (BWH), or both, between 1992 and 2010. Our algorithm combined structured variables (such as International Classification of Diseases 9th Revision [ICD-9] codes, prescriptions, laboratory observations) and unstructured variables (such as text mentions of sleep and psychiatric disorders in clinical narrative notes). The highest classification performance of our algorithm was achieved when it included a combination of structured variables (billing codes for insomnia, common psychiatric conditions, and joint disorders) and unstructured variables (sleep disorders and psychiatric disorders). Our algorithm had superior performance in identifying insomnia patients compared to billing codes alone (area under the receiver operating characteristic curve [AUROC] = 0.83 vs. 0.55 with 95% confidence intervals [CI] of 0.76–0.90 and 0.51–0.58, respectively). When applied to the 314,292-patient population, our algorithm classified 36,810 of the patients with insomnia, of which less than 17% had a billing code for insomnia. In conclusion, an insomnia classification algorithm that incorporates clinical notes is superior to one based solely on billing codes. Compared to traditional methods, our study demonstrates that a classification algorithm that incorporates physician notes can more accurately, comprehensively, and quickly identify large cohorts of insomnia patients.

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Section: Methodssupporting

confidence: 94%

Development of an Algorithm to Identify Patients with Physician-Documented Insomnia

Kartoun

Aggarwal

Beam

et al. 2018

Sci Rep

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“…In children, specific sleep disturbances associated with the sleep disorder insomnia, namely difficulty falling asleep and staying asleep, have been identified using daily sleep diaries (Valrie, Gil, Redding-Lallinger, & Daeschner, 2007a). In addition, using retrospective chart review, one recent study found insomnia symptoms were documented for 47% of the adults with SCD in that study (Mann-Jiles, Thompson, & Lester, 2015). Qualitative literature on sleep disturbances suggests that sleep disturbances have been reported as a distressing symptom (Panepinto, Torres, & Varni, 2012; Weisberg, Balf-Soran, Becker, Brown, & Sledge, 2013) and a quality of life priority for individuals with SCD (Treadwell, Hassell, Levine, & Keller, 2014).…”

Section: Introductionmentioning

confidence: 99%

Acute Pain and Depressive Symptoms: Independent Predictors of Insomnia Symptoms among Adults with Sickle Cell Disease

Moscou-Jackson

Allen

Kozachik

et al. 2016

Pain Management Nursing

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Background No studies to-date have systematically investigated insomnia symptoms among adults with sickle cell disease (SCD). The purpose of this study was to 1) describe the prevalence of insomnia symptoms and 2) identify bio-psychosocial predictors in community-dwelling adults with Sickle Cell Disease. Methods Cross-sectional analysis of baseline data from 263 African-American adults with SCD (aged 18 years or older). Measures included the Insomnia Severity Index (ISI), Center for Epidemiologic Studies in Depression scale, Urban Life Stress Scale, Brief Pain Inventory, and a chronic pain item. SCD genotype was extracted from the medical record. Results A slight majority (55%) of the sample reported clinically significant insomnia symptomatology (ISI ≥10), which suggests that insomnia symptoms are prevalent among community-dwelling African-American adults with SCD. While insomnia symptoms were associated with a number of bio-psychosocial characteristics, depressive symptoms and acute pain were the only independent predictors. Conclusion Given the high number of participants reporting clinically significant insomnia symptoms, nurses should screen for insomnia symptoms and to explore interventions to promote better sleep among adults with SCD with an emphasis on recommending treatment for pain and depression. In addition, current pain and depression interventions in this population could add insomnia measures and assess the effect of the intervention on insomnia symptomatology as a secondary outcome.

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“…[42] However, various factors can contribute to sleep disturbances, including stress from home and school. [43] Research has shown that sleep problems are associated with increased physical, mental, and environmental health issues. [43] In the case of individuals with SCA, episodes of acute pain known as VOC and sleep-disordered breathing have been identified as significant contributors to poor sleep.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial challenges of persons with sickle cell anemia: A narrative review

Essien,

Winter-Eteng,

Onukogu

et al. 2023

Medicine

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Sickle cell anemia (SCA) is a severe form of sickle cell disease that primarily affects black populations and individuals in tropical countries. This condition causes significant morbidity and mortality and leads to a range of psychosocial challenges. A preliminary search was conducted on Ovid Medline and public databases with a combination of Medical Subject Headings keywords, resulting in 368 articles. The articles were screened based on the selection criteria in a nonsystematic method by 3 researchers, and a narrative synthesis was done to analyze extracted data from selected peer-reviewed article. Mental disorders, sleep disturbances, interpersonal relationship challenges, stigmatization, and workplace discrimination were identified as significant contributors to the psychosocial distress experienced by individuals with SCA and their families. Depression and anxiety were prevalent among individuals with SCA, leading to poor treatment adherence, increased pain, and disruptions in various aspects of life. Sleep disturbances, including sleep-disordered breathing and sleepwalking, were also identified as significant contributors to poor sleep quality in SCA patients. Families of individuals with SCA also face challenges, including psychological stress, financial strain, and social disruption. Stigmatization is common, leading to misconceptions and discrimination. Workplace discrimination is prevalent, with a high unemployment rate among adult SCA patients. Comprehensive care is crucial to address these psychosocial issues. Early identification and intervention, comprehensive support programs, patient and family education, enhanced pain management strategies, and integration of mental health into clinical care are recommended. School-based support, research and advocacy, and community support groups are also important. By addressing these challenges through comprehensive care and support, healthcare professionals, policymakers, and society can reduce psychosocial distress and improve the lives of individuals with SCA.

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Sleep impairment and insomnia in sickle cell disease: A retrospective chart review of clinical and psychological indicators

Cited by 14 publications

References 22 publications

Development of an Algorithm to Identify Patients with Physician-Documented Insomnia

Development of an Algorithm to Identify Patients with Physician-Documented Insomnia

Acute Pain and Depressive Symptoms: Independent Predictors of Insomnia Symptoms among Adults with Sickle Cell Disease

Psychosocial challenges of persons with sickle cell anemia: A narrative review

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