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Theorell-Haglöw, JennyORCID iD iconorcid.org/0000-0003-2819-2799
Publications (10 of 27) Show all publications
Phan, H. T., Tran, H. T., Tran, H. T., Dinh, A. P., Ngo, H. T., Theorell-Haglöw, J. & Gordon, C. J. (2018). An educational intervention to improve hand hygiene compliance in Vietnam. BMC Infectious Diseases, 18, Article ID 116.
Open this publication in new window or tab >>An educational intervention to improve hand hygiene compliance in Vietnam
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2018 (English)In: BMC Infectious Diseases, ISSN 1471-2334, E-ISSN 1471-2334, Vol. 18, article id 116Article in journal (Refereed) Published
Abstract [en]

Background: Hand hygiene compliance is the basis of infection control programs. In developing countries models to improve hand hygiene compliance to reduce healthcare acquired infections are required. The aim of this study was to determine hand hygiene compliance following an educational program in an obstetric and gynecological hospital in Vietnam.

Methods: Health care workers from neonatal intensive care, delivery suite and a surgical ward from Hung Vuong Hospital, Ho Chi Minh City, Vietnam undertook a 4-h educational program targeting hand hygiene. Compliance was monitored monthly for six months following the intervention. Hand hygiene knowledge was assessed at baseline and after six months of the study.

Results: There were 7124 opportunities over 370 hand hygiene recording sessions with 1531 opportunities at baseline and 1620 at 6 months following the intervention. Hand hygiene compliance increased significantly from baseline across all sites (43.6% [95% Confidence interval CI:41.1-46.1] to 63% [95% CI:60.6-65.3]; p < 0.0001). Health care worker hand hygiene compliance increased significantly after intervention (p < 0.0001). There were significant improvements in knowledge scores from baseline to 2 months post educational intervention with mean difference standard deviations (SD):1.5 (2.5); p < 0.001).

Conclusions: A simple educational model was implemented in a Vietnamese hospital that revealed good hand hygiene compliance for an extended period of time. Hand hygiene knowledge increased during the intervention. This hand hygiene model could be used in developing countries were resources are limited.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2018
Keywords
Compliance, Developing country, Education, Hand hygiene, Infection
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-350285 (URN)10.1186/s12879-018-3029-5 (DOI)000426760000002 ()29514595 (PubMedID)
Available from: 2018-05-14 Created: 2018-05-14 Last updated: 2018-05-14Bibliographically approved
Cai, G.-H., Janson, C., Theorell-Haglöw, J., Benedict, C., Elmståhl, S., Lind, L. & Lindberg, E. (2018). Both Weight at Age 20 and Weight Gain Have an Impact on Sleep Disturbances Later in Life: Results of the EpiHealth Study. Sleep, 41(1), Article ID zsx176.
Open this publication in new window or tab >>Both Weight at Age 20 and Weight Gain Have an Impact on Sleep Disturbances Later in Life: Results of the EpiHealth Study
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2018 (English)In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 41, no 1, article id zsx176Article in journal (Refereed) Published
Abstract [en]

Study Objectives: Obesity is often associated with impaired sleep, whereas the impact of body mass index (BMI) at younger age and previous weight gain on sleep problems remains unknown.

Methods: The present study utilized data from the Swedish EpiHealth cohort study. A total of 15 845 participants (45-75 years) filled out an internet-based questionnaire. BMI was calculated from both measured data at study time and self-reported data at age 20 from the questionnaire.

Results: Sleep-related symptoms were most common among obese individuals (BMI >30 kg/m(2)). An association between weight gain and sleep problems was found and those with a low BMI at age 20 were most vulnerable to weight gain when it came to risk of sleep problems. Among those who were underweight (BMI <18.5 kg/m(2)) at age 20, weight gain (kg/year) was associated with difficulties initiating sleep with an adjusted OR of 2.64 (95% CI: 1.51-4.62) after adjusting for age, sex, smoking, alcohol consumption, physical activity, education, and civil status. The corresponding adjusted OR's among those who had been normal weight (BMI 18.5-24.99) and overweight (BMI 25-29.99 kg/m(2)) at age 20 were 1.89 (1.47-2.45) and 1.02 (0.48-2.13), respectively. Also difficulties maintaining sleep and snoring were most strongly related to weight gain among those who were underweight at age 20 with decreasing odds with increasing BMI at that age.

Conclusions: Sleep problems are related to weight gain and obesity. The impact of weight is most pronounced among those who had a low BMI when young.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS INC, 2018
Keywords
epidemiology, insomnia, obesity, aging, weight gain, EpiHealth study, body mass index (BMI), Epworth Sleepiness Scale (ESS), sleep problems, snoring
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-342460 (URN)10.1093/sleep/zsx176 (DOI)000422879100012 ()
Funder
Swedish Research Council
Available from: 2018-02-26 Created: 2018-02-26 Last updated: 2018-02-26Bibliographically approved
Theorell-Haglöw, J., Hoyos, C. M., Phillips, C. L., Yee, B. J., Herrmann, M., Brennan-Speranza, T. C., . . . Liu, P. Y. (2018). Changes of vitamin D levels and bone turnover markers after CPAP therapy: a randomized sham-controlled trial. Journal of Sleep Research, 27(4), Article ID e12606.
Open this publication in new window or tab >>Changes of vitamin D levels and bone turnover markers after CPAP therapy: a randomized sham-controlled trial
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2018 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, no 4, article id e12606Article in journal (Refereed) Published
Abstract [en]

The aim was to investigate whether continuous positive airway pressure treatment could modulate serum vitamin D (25-hydroxyvitamin D) and bone turnover markers (collagen-type 1 cross-linked C-telopeptide, osteocalcin and N-terminal propeptide of type 1 collagen) in secondary analysis from a randomized controlled trial. Sixty-five continuous positive airway pressure-naive male patients with obstructive sleep apnea (age=49 +/- 12years, apnea-hypopnea index=39.9 +/- 17.7events h(-1), body mass index=31.3 +/- 5.2kgm(-2)) were randomized to receive either real (n=34) or sham (n=31) continuous positive airway pressure for 12weeks. At 12weeks, all participants received real continuous positive airway pressure for an additional 12weeks. After 12weeks of continuous positive airway pressure (real versus sham), there were nobetween-group differences for any of the main outcomes [25-hydroxyvitamin D: -0.80 +/- 5.28ngmL(-1) (mean +/- SE) versus 3.08 +/- 3.66ngmL(-1), P=0.42; collagen-type 1 cross-linked C-telopeptide: 0.011 +/- 0.014ngmL(-1) versus -0.004 +/- 0.009ngmL(-1), P=0.48; osteocalcin: 1.13 +/- 1.12ngmL(-1) versus 0.46 +/- 0.75ng mL(-1), P=0.80; N-terminal propeptide of type 1 collagen: 2.07 +/- 3.05gL(-1) versus -1.05 +/- 2.13gL(-1), P=0.48]. There were no further differences in subgroup analyses (continuous positive airway pressure-compliant patients, patients with severe obstructive sleep apnea or sleepy patients). However, after 24weeks irrespective of initial randomization, vitamin D increased in patients with severe obstructive sleep apnea (9.56 +/- 5.51ngmL(-1), P=0.045) and in sleepy patients (14.0 +/- 4.69ngmL(-1), P=0.007). Also, there was a significant increase in osteocalcin at 24weeks (3.27 +/- 1.06ngmL(-1), P=0.01) in compliant patients. We conclude that 12weeks of continuous positive airway pressure did not modulate vitamin D or modulate any of the bone turnover markers compared with sham. However, it is plausible that continuous positive airway pressure may have late beneficial effects on vitamin D levels and bone turnover markers in selected groups of patients with obstructive sleep apnea.

Place, publisher, year, edition, pages
WILEY, 2018
Keywords
bone turnover markers, continuous positive airway pressure therapy, obstructive sleep apnea, randomized controlled trial, vitamin D
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-361040 (URN)10.1111/jsr.12606 (DOI)000438350700005 ()28944524 (PubMedID)
Funder
Swedish Heart Lung FoundationSwedish Society for Medical Research (SSMF)
Available from: 2018-09-21 Created: 2018-09-21 Last updated: 2018-09-21Bibliographically approved
Palm, A., Midgren, B., Theorell-Haglöw, J., Ekström, M., Ljunggren, M., Janson, C. & Lindberg, E. (2018). Factors influencing adherence to continuous positive airway pressure treatment in obstructive sleep apnea and mortality associated with treatment failure -: a national registry-based cohort study.. Sleep Medicine, 51, 85-91, Article ID S1389-9457(18)30401-5.
Open this publication in new window or tab >>Factors influencing adherence to continuous positive airway pressure treatment in obstructive sleep apnea and mortality associated with treatment failure -: a national registry-based cohort study.
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2018 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 51, p. 85-91, article id S1389-9457(18)30401-5Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: Adherence to continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) is crucial. Our aim was to identify protective and risk factors against the discontinuation of CPAP treatment in patients with OSA and to estimate the mortality risk in those who were non-adherent to CPAP therapy.

METHODS: This was a registry-based cohort study from 37 centers across Sweden with OSA patients on CPAP in the Swedevox Swedish national registry between July 2010 and March 2017.

RESULTS: In 16,425 patients (70.8% men) with complete follow-up data after 1.2 ± 0.8 years the adjusted relative risk ratio (aRRR) for the discontinuation of CPAP was 0.57 (95% confidence interval (CI) 0.50-0.65) for use of humidifier, 0.87 (95% CI 0.82-0.92) for increasing age per 10 years, 0.80 (95% CI 0.77-0.83) for increasing apnea hypopnea index (AHI) per 5 units/hour, and 0.96 (95% CI 0.95-0.97) per increased unit on the Epworth Sleepiness Scale (ESS). Increasing BMI was associated with increased adherence up to BMI 35. Women and patients with hypertension ran an increased risk of discontinuing CPAP treatment, aRRR 1.28 (95% CI 1.12-1.46) and 1.24 (95% CI 1.12-1.42) respectively. The adjusted hazard ratio (HR) for mortality was 1.74 (95% CI 1.32-2.28) among those who did not adhere to CPAP (median follow-up period 2.4 years after the one year adherence evaluation).

CONCLUSION: Use of humidifier is associated with greater adherence to CPAP treatment. Other factors predicting adherence are increasing age, more severe OSA and overweight up to BMI 35, whereas female gender and coexisting hypertension are risk factors for discontinuation of CPAP. Failure to adhere to CPAP is associated with increased mortality.

Keywords
Adherence, BMI, Continuous positive airway pressure (CPAP), Gender, Humidifier, Obstructive sleep apnea (OSA)
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-361337 (URN)10.1016/j.sleep.2018.07.007 (DOI)30103074 (PubMedID)
Available from: 2018-09-23 Created: 2018-09-23 Last updated: 2018-11-23Bibliographically approved
Theorell-Haglöw, J., Miller, C. B., Bartlett, D. J., Yee, B. J., Openshaw, H. D. & Grunstein, R. R. (2018). Gender differences in obstructive sleep apnoea, insomnia and restless legs syndrome in adults - What do we know?: A clinical update. Sleep Medicine Reviews, 38, 28-38
Open this publication in new window or tab >>Gender differences in obstructive sleep apnoea, insomnia and restless legs syndrome in adults - What do we know?: A clinical update
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2018 (English)In: Sleep Medicine Reviews, ISSN 1087-0792, E-ISSN 1532-2955, Vol. 38, p. 28-38Article, review/survey (Refereed) Published
Abstract [en]

Research in sleep medicine over the last decades has involved a broad variety of sleep disorders in both men and women. Gender differences have been identified in sleep physiology as well as in the three most common sleep disorders: obstructive sleep apnoea (OSA), insomnia and restless legs syndrome (RLS). However, research on gender differences in sleep medicine appears limited. This clinical review aims to give an updated overview of gender differences, in relation to prevalence, clinical presentation, treatment and quality of life in OSA, insomnia and RLS. Future research directions in the adult population will also be discussed. (C) 2017 Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Saunders Elsevier, 2018
Keywords
Gender, Sleep apnoea, Insomnia, Restless legs, Review, Clinical
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-350682 (URN)10.1016/j.smrv.2017.03.003 (DOI)000425282500004 ()28495359 (PubMedID)
Available from: 2018-05-21 Created: 2018-05-21 Last updated: 2018-05-21Bibliographically approved
Cai, G.-H., Theorell-Haglöw, J., Janson, C., Svartengren, M., Elmstahl, S., Lind, L. & Lindberg, E. (2018). Insomnia symptoms and sleep duration and their combined effects in relation to associations with obesity and central obesity. Sleep Medicine, 46, 81-87
Open this publication in new window or tab >>Insomnia symptoms and sleep duration and their combined effects in relation to associations with obesity and central obesity
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2018 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 46, p. 81-87Article in journal (Refereed) Published
Abstract [en]

Objective: Previous studies have shown that both sleep duration and insomnia have an impact on obesity and central obesity. However, studies of the joint effects of these sleep disorders are still sparse. Methods: The present study utilized data from the Swedish EpiHealth cohort study. Participants (45 - 78 y) were asked to fill out an internet-based questionnaire. Body mass index (BMI) and central obesity (calculated from waist circumference) were based on measured data. Results: A total of 18,823 participants (mean age = 60 ys) were included in this study. The reported prevalence of short (<6 h/night) and long (>9 h/night) sleep duration was 8% and 4% respectively, and insomnia symptoms was 19%. Of the study population, 16% were obese (BMI >= 30 kg/m(2)) and 40% had central obesity. There was a U-shaped association between sleep duration and obesity and central obesity, and significant associations between insomnia symptoms and obesity. When stratifying sleep duration by concurrent insomnia symptoms, there were associations (odds ratios, (95% confidence intervals)) between the combination of both short (1.48, (1.22-1.80)) and long sleep duration (1.77 (1.00 - 3.16)) with insomnia symptoms and obesity and central obesity (1.36 (1.16-1.61) and 2.44 (1.41-3.24) respectively). However, there was no significant association between insomnia symptoms and obesity or central obesity in participants with normal sleep duration. For central obesity there was an association with long sleep duration regardless of insomnia symptoms, while the association with short sleep duration was significant only if insomnia symptoms were present. Conclusions: Both short and long sleep duration, as well as insomnia symptoms, are associated with obesity and central obesity. There is an important joint effect of sleep duration and insomnia symptoms and there is no association between insomnia symptoms and obesity, as long as a normal sleeping time can be attained. This indicates that sleep duration rather than insomnia symptoms per se is of importance for the relationship between sleep and obesity.

Keywords
Insomnia symptoms, Sleep duration, Obesity, Waist circumference, Body mass index (BMI), EpiHealth study
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-357266 (URN)10.1016/j.sleep.2018.03.009 (DOI)000432571600012 ()29773216 (PubMedID)
Funder
Swedish Research Council
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2018-08-20Bibliographically approved
Ljunggren, M., Lindberg, E., Franklin, K. A., Öhagen, P., Larsson, M., Theorell-Haglöw, J. & Naessén, T. (2018). Obstructive sleep apnea during rapid eye movement sleep is associated with early signs of atherosclerosis in women.. Sleep, 41(7)
Open this publication in new window or tab >>Obstructive sleep apnea during rapid eye movement sleep is associated with early signs of atherosclerosis in women.
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2018 (English)In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 41, no 7Article in journal (Refereed) Published
Abstract [en]

Study Objectives: Although obstructive sleep apnea (OSA) is associated with overall cardiovascular disease and mortality, the association with atherosclerotic cardiovascular disease is less clear, especially in women. Recently, it has been suggested that OSA during rapid eye movement (REM) sleep, associated with long apneas and deep desaturations, could have severe cardiometabolic consequences. The aim of this study was to investigate whether OSA during REM sleep is associated with early signs of atherosclerosis in a population-based sample of women.

Methods: In the community-based "Sleep and Health in Women" (SHE) cohort study, 400 women underwent polysomnography, anthropometric measurements, blood sampling, blood pressure measurement, and answered questionnaires. Ten years later, 201 of the original participants, free of known atherosclerotic disease at baseline and without continuous positive airway pressure treatment for OSA, underwent a high-frequency ultrasound of the common carotid artery to assess the individual thickness of the layers of the artery wall.

Results: Severe OSA during REM sleep (REM apnea-hypopnea index [AHI] ≥ 30) was associated with a thicker intima. This association was still significant after adjustment for age, body mass index, alcohol, and smoking, as well as for further adjustment for systolic blood pressure, low-density lipoprotein, C-reactive protein, and diabetes (β-coefficient, 0.008; p-value, 0.022). The association between a REM AHI of ≥30 and intima thickness was also seen in women with no or mild OSA and normal non-REM AHI.

Conclusions: In this study of a community-based sample of women, severe OSA during REM sleep was independently associated with early signs of atherosclerosis.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-364687 (URN)10.1093/sleep/zsy099 (DOI)29762755 (PubMedID)
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2018-10-31
Schwarz, J. F. A., Akerstedt, T., Lindberg, E., Gruber, G., Fischer, H. & Theorell-Haglöw, J. (2017). Age affects sleep microstructure more than sleep macrostructure. Journal of Sleep Research, 26(3), 277-287
Open this publication in new window or tab >>Age affects sleep microstructure more than sleep macrostructure
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2017 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 26, no 3, p. 277-287Article in journal (Refereed) Published
Abstract [en]

It is well known that the quantity and quality of physiological sleep changes across age. However, so far the effect of age on sleep microstructure has been mostly addressed in small samples. The current study examines the effect of age on several measures of sleep macro- and microstructure in 211 women (22-71years old) of the Sleep and Health in Women' study for whom ambulatory polysomnography was registered. Older age was associated with significantly lower fast spindle (effect size f(2)=0.32) and K-complex density (f(2)=0.19) during N2 sleep, as well as slow-wave activity (log) in N3 sleep (f(2)=0.21). Moreover, total sleep time (f(2)=0.10), N3 sleep (min) (f(2)=0.10), rapid eye movement sleep (min) (f(2)=0.11) and sigma (log) (f(2)=0.05) and slow-wave activity (log) during non-rapid eye movement sleep (f(2)=0.09) were reduced, and N1 sleep (f(2)=0.03) was increased in older age. No significant effects of age were observed on slow spindle density, rapid eye movement density and beta power (log) during non-rapid eye movement sleep. In conclusion, effect sizes indicate that traditional sleep stage scoring may underestimate age-related changes in sleep.

Keywords
age, polysomnography, sleep, sleep spindles, spectral analysis, REM
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-323758 (URN)10.1111/jsr.12478 (DOI)000401525900004 ()28093830 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareSwedish Heart Lung Foundation
Available from: 2017-06-12 Created: 2017-06-12 Last updated: 2018-01-13Bibliographically approved
Theorell-Haglöw, J., Hoyos, C. M., Phillips, C. L., Yee, B. J., Melehan, K. L., Liu, P. Y., . . . Grunstein, R. R. (2016). Associations between obstructive sleep apnea and measures of arterial stiffness. Paper presented at 23rd Congress of the European-Sleep-Research-Society, SEP 13-16, 2016, Bologna, ITALY. Journal of Sleep Research, 25, 173-173
Open this publication in new window or tab >>Associations between obstructive sleep apnea and measures of arterial stiffness
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2016 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, p. 173-173Article in journal, Meeting abstract (Other academic) Published
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-309493 (URN)000383445200451 ()
Conference
23rd Congress of the European-Sleep-Research-Society, SEP 13-16, 2016, Bologna, ITALY
Available from: 2016-12-05 Created: 2016-12-05 Last updated: 2017-11-29Bibliographically approved
Theorell-Haglöw, J., Hoyos, C. M., Phillips, C. L., Yee, B. J., Grunstein, R. R. & Liu, P. Y. (2016). CPAP therapy, vitamin D and bone turnover markers - a randomized controlled trial. Paper presented at 23rd Congress of the European-Sleep-Research-Society, SEP 13-16, 2016, Bologna, ITALY. Journal of Sleep Research, 25, 40-40
Open this publication in new window or tab >>CPAP therapy, vitamin D and bone turnover markers - a randomized controlled trial
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2016 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, p. 40-40Article in journal, Meeting abstract (Other academic) Published
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-309489 (URN)000383445200077 ()
Conference
23rd Congress of the European-Sleep-Research-Society, SEP 13-16, 2016, Bologna, ITALY
Available from: 2016-12-05 Created: 2016-12-05 Last updated: 2017-11-29Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-2819-2799

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