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

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Chapter Six. Exploring the Sleep Experience for Patients with FMS .......................... 107 Methodology .................................................................................................................... 107 Methods ........................................................................................................................... 110 Participant Recruitment ................................................................................................... 110 Data Collection ................................................................................................................ 110 Data Analysis ................................................................................................................... 112 Rigour .............................................................................................................................. 114 Results ............................................................................................................................. 114 Discussion ........................................................................................................................ 124 Strength and Limitations.................................................................................................. 127 Implications ..................................................................................................................... 129 Summary .......................................................................................................................... 129 Chapter Seven. Investigating the Effects of Mindfulness on Sleep Quality in FMS .. 130 The Mindfulness Approach ............................................................................................. 131 The Mindfulness Body Scan ............................................................................................ 133 Method ............................................................................................................................. 134 Participant Recruitment ................................................................................................... 134 Outcome Measures: ......................................................................................................... 135 Procedure ......................................................................................................................... 136 The Interventions ............................................................................................................. 137 Statistical Analysis: ......................................................................................................... 138 Results ............................................................................................................................. 138 Repeated Measures ANOVA analysis ............................................................................. 141 Discussion ........................................................................................................................ 145 Strengths and Limitations ................................................................................................ 146 Implications ..................................................................................................................... 149 Summary .......................................................................................................................... 150 Chapter Eight. Integrated Discussion ............................................................................ 151 Objective One. The Nature and Extent of Sleep Difficulties in FMS ............................. 151 Objective Two. The Psychological Factors Affecting Sleep Quality in FMS ................. 153 Objective Three. The Effect of Sleep Quality on Symptoms and Daily Life for People with FMS ......................................................................................................................... 153 Objective Four. An Intervention to Improve Sleep Quality ............................................ 154 Added Value of the Thesis to the Research Literature .................................................... 155 Thesis Limitations and Recommendations for Future Research ..................................... 158 Implications for Practice .................................................................................................. 162 Conclusion ........................................................................................................................... 163 iii
References ........................................................................................................................... 164 Glossary ............................................................................................................................... 185 Appendices .......................................................................................................................... 186 Appendix A: Search Strategy for Literature Review ....................................................... 186 Appendix B: Information Sheet and Consent Form for Study One (Chapter Four). ....... 187 Appendix C: Letter of Ethical Approval for Study One (Chapter Four) ......................... 189 Appendix D: Participant questionnaire for Study One (Chapter Four) ........................... 191 Appendix E: Published paper of Study One (Chapter Four) ........................................... 200 Appendix F: Information Sheet and Consent Form for Study Two................................. 207 Appendix G: Letter of Ethical Approval for Study Two (Chapter Five) ......................... 209 Appendix H: Participant Questionnaire for Study Two (Chapter Five) .......................... 210 Appendix I. Published Paper for Study Two (Chapter Five) ........................................... 216 Appendix J. Poster Advertising Study Three (Chapter Six) ............................................ 223 Appendix K. Information Sheet and Consent Form for Study Three (Chapter Six) ...... 224 Appendix L: Letter of Ethical Approval for Study Three (Chapter Six) ......................... 228 Appendix M. Letter to GPs for Study Three (Chapter Six) ............................................. 230 Appendix N. Participant Information Sheet and Consent Form for Study Four (Chapter Seven) .............................................................................................................................. 231 Appendix O: Poster Advertising Study Four (Chapter Seven) ........................................ 234 Appendix P: Letter of Ethical Approval for Study Four (Chapter Seven)....................... 235 Appendix Q: Participant Questionnaire for Study Four (Chapter Seven) ....................... 236 Appendix R. Letter from Dr Mark Cropley Verifying Own Contribution to the Works Included in this Thesis ..................................................................................................... 242 Appendix S: Curriculum Vitae ........................................................................................ 243 iv
Page 1 and 2: Sick and Tired: Understanding and M
Page 3: Chapter Four. The Nature and Effect
Page 7 and 8: List of Tables Table 1. Participant
Page 9 and 10: Co-authored Works Although the stud
Page 11 and 12: Acknowledgments This thesis would n
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
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& Penzien, 2003), although alpha wa
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pauses in breathing indicative of s
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Relationships between Sleep and Pai
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Managing Sleep Disturbance in FMS D
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may be possible to help patients im
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person to initiate an action (such
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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
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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
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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 (
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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
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References Abad, V. C., Sarinas, P.
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Brand, S., Gerber, M., Beck, J., Ha
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Crofford, L. J., & Demitrack, M. A.
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Goldenberg, D. L., Kaplan, K. H., N
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Johns, M. W. (2002). Sleep propensi
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Leung, Y. Y., Ho, K. W., Zhu, T. Y.
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Mease, P. J. (2005). Fibromyalgia s
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symptoms in healthy subjects; Corre
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approach with illustration to the h
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Thomas, E. N., & Blotman, F. (2010)
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Yunus, M. B., Masi, A. T., & Aldag,
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Appendices Appendix A: Search Strat
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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
Page 237 and 238:
220
Page 239 and 240:
222
Page 241 and 242:
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
Page 249 and 250:
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
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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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