Sick and Tired: Understanding and Managing Sleep Difficulties in ...

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was also responsible for preparing the study documentation and facilitating participant recruitment. On success of the grant application we appointed a part-time research assistant to provide support with the administration of the project. I would like to acknowledge the valuable contribution of Joanna Rodriquez, an MSc student, from the University of Surrey, UK. Joanna‟s role involved providing administrative support, such as sending out the materials to eligible participants, ensuring follow up data was received and entering the data into the SPSS database. On completion of the data collection, I completed the data entry checks and data analysis. A letter confirming my contribution to the studies incorporated within this thesis from Dr Mark Cropley is contained in the appendices (see Appendix R). ix
Acknowledgments This thesis would not have been possible without the volunteers who kindly gave up their time to take part in this research and who were willing to share their experiences. I would like to express my sincere gratitude to the study participants and the Fibromyalgia Association, UK. I am also extremely grateful to have worked with such a supportive team of supervisors, who not only helped to guide me through this thesis, but have facilitated my development as a health professional. They have always been there to talk ideas through, to provide an encouraging word and offer timely feedback. Above all, I offer them my sincere thanks for their belief in me, which has helped me to believe in myself. I would also like to extend a genuine word of thanks to my friends and family for their inspiration, endless patience, and for reminding me that sometimes it really does help to just take that step back. Finally, a special thank you extends to my partner Paul. I have felt his support and encouragement behind every word of this thesis! His direct help in formatting some of the figures and text within this dissertation has also been greatly appreciated. I never would have completed this thesis without you all. Thank you. Funding My position at AUT is kindly sponsored byABI Rehabilitation Management. I would like to sincerely thank ABI Rehabilitation Management for their continued support and encouragement with the completion of this thesis and their generosity in supporting research to improve health outcomes for patients. I would also like to acknowledge the University of Surrey, UK for their financial support for the study exploring the effectiveness of mindfulness on sleep quality in Fibromyalgia Syndrome (described in Chapter Seven). This was funded by a contestable grant from the University of Surrey UK. The grant provided funding for part-time administrative support for the project and the cost of the equipment. x
Page 1 and 2: Sick and Tired: Understanding and M
Page 3 and 4: Chapter Four. The Nature and Effect
Page 5 and 6: References ........................
Page 7 and 8: List of Tables Table 1. Participant
Page 9: Co-authored Works Although the stud
Page 13 and 14: Intellectual Property Rights There
Page 15 and 16: Confidential Material No participan
Page 17 and 18: The role of sleep in FMS appears to
Page 19 and 20: little information was available as
Page 21 and 22: Psychophysiologic insomnia which is
Page 23 and 24: and are less able to inhibit the pa
Page 25 and 26: widely applied in clinical practice
Page 27 and 28: of fewer tender points; usually bet
Page 29 and 30: Current Management Strategies The t
Page 31 and 32: also likely to depend on a number o
Page 33 and 34: deep sleep (stages three and four)
Page 35 and 36: Although sleep moves through the sl
Page 37 and 38: Figure 3. The Integrative Model of
Page 39 and 40: However, conducting a blood test is
Page 41 and 42: As sleep is a complex process invol
Page 43 and 44: Sleep Diaries Sleep diaries are a k
Page 45 and 46: pain). Lentz et al (1999) revealed
Page 47 and 48: These results have also been suppor
Page 49 and 50: (McCracken & Iverson, 2002) which s
Page 51 and 52: Figure 4. Conceptual model of the d
Page 53 and 54: Clinical Implications Despite the p
Page 55 and 56: Chapter Three. Sleep in FMS As high
Page 57 and 58: & Penzien, 2003), although alpha wa
Page 59 and 60: pauses in breathing indicative of s
Page 61 and 62:
Relationships between Sleep and Pai
Page 63 and 64:
Managing Sleep Disturbance in FMS D
Page 65 and 66:
may be possible to help patients im
Page 67 and 68:
person to initiate an action (such
Page 69 and 70:
and Nicassio et al (1995) only expl
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1) Poor sleep quality, defined by t
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elow 0.7 are acceptable. Therefore
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heart disease (Epstein et al., 1999
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In order to explore the links betwe
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questionnaire 78 (77.2%) of the par
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efficiency, suggesting that partici
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Older age and longer length of illn
Page 85 and 86:
Table 2. Correlations between demog
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Logistic Regression As 97% of the s
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in bed, participants may have devel
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Relationship between Negative Affec
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participants, who may be less likel
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emotional problems, increased pain
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eactions are most likely to be detr
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It has been suggested that the auto
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For both groups, participants were
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with and without chronic medical co
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As previously described on page 61,
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Figure 7. Scree plot for the explor
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Figure 8. Scree plot for the explor
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Table 6. Participant characteristic
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Table 7. Measures of central tenden
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CON = DBAS-10 Dysfunctional beliefs
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The Exp (B) values revealed that hi
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has explored the use of napping on
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It became clear, through the analys
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interventions. With this in mind, t
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The philosophy of phenomenology was
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Methods Participants were given a w
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Table 11. Interview schedule for th
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Rigour The interview transcripts we
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“The main symptom is this overwhe
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Theme Two. Inter-relationship betwe
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where I live, so I don‟t know, I
Page 139 and 140:
Participants also described how the
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“XXXX (name of person) planned a
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A strong theme that emerged in this
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conducted at several time points, w
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Chapter Seven. Investigating the Ef
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activities because they no longer f
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Therefore as this was a feasibility
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Self-reported sleep quality was ass
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The progressive muscle relaxation (
Page 157 and 158:
Exploring the baseline data, there
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Consequently, univariate analysis w
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There was no significant correlatio
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people with FMS (Perlis, Giles, Men
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The aim of this study was to explor
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observed in perceived overall sleep
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elaborated on in Chapter Six, which
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Four) revealed that global sleep qu
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Modifications to the Call-Schmidt a
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MBSR programme in people with FMS (
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diagnostic criteria for these sleep
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comprehensive measures to look at t
Page 181 and 182:
References Abad, V. C., Sarinas, P.
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Brand, S., Gerber, M., Beck, J., Ha
Page 185 and 186:
Crofford, L. J., & Demitrack, M. A.
Page 187 and 188:
Goldenberg, D. L., Kaplan, K. H., N
Page 189 and 190:
Johns, M. W. (2002). Sleep propensi
Page 191 and 192:
Leung, Y. Y., Ho, K. W., Zhu, T. Y.
Page 193 and 194:
Mease, P. J. (2005). Fibromyalgia s
Page 195 and 196:
symptoms in healthy subjects; Corre
Page 197 and 198:
approach with illustration to the h
Page 199 and 200:
Thomas, E. N., & Blotman, F. (2010)
Page 201 and 202:
Yunus, M. B., Masi, A. T., & Aldag,
Page 203 and 204:
Appendices Appendix A: Search Strat
Page 205 and 206:
Sleep and Fibromyalgia Syndrome Con
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190
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The following questions relate to y
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There are lots of ways to try to de
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42. I try hard to prevent other thi
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During the past month have you had
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Appendix E: Published paper of Stud
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202
Page 221 and 222:
204
Page 223 and 224:
206
Page 225 and 226:
Sleep and Fibromyalgia Syndrome Con
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Appendix H: Participant Questionnai
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Below are 10 statements reflecting
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The questions in this scale ask you
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Appendix I. Published Paper for Stu
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218
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220
Page 239 and 240:
222
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Appendix K. Information Sheet and C
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Sleep in Fibromyalgia Syndrome Cons
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Appendix L: Letter of Ethical Appro
Page 247 and 248:
Appendix M. Letter to GPs for Study
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What are the side effects of any tr
Page 251 and 252:
Appendix O: Poster Advertising Stud
Page 253 and 254:
Appendix Q: Participant Questionnai
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HAD Scale Read each item and place
Page 257 and 258:
During the past month have you had
Page 259 and 260:
Appendix R. Letter from Dr Mark Cro
Page 261 and 262:
PUBLICATIONS Peer Reviewed Journal
Page 263:
and panic-like episodes, Faculty of
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