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Markström, Agneta
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Publications (10 of 23) Show all publications
Jönson Ring, I., Nevéus, T., Markström, A., Magnuson, A. & Bazargani, F. (2020). Rapid maxillary expansion in children with nocturnal enuresis: A randomized placebo-controlled trial. Angle orthodontist, 90(1), 31-38
Open this publication in new window or tab >>Rapid maxillary expansion in children with nocturnal enuresis: A randomized placebo-controlled trial
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2020 (English)In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 90, no 1, p. 31-38Article in journal (Refereed) Published
Abstract [en]

Objective:

To investigate whether rapid maxillary expansion (RME) is a useful treatment method for nocturnal enuresis (NE) and whether the treatment effect is due to placebo. The study also aimed to identify prognostic variables in patients responding to treatment.

Materials and Methods:

Thirty-eight children with therapy-resistant NE were recruited and randomized into two groups: the intervention group or placebo group. Both groups were treated with RME, but the placebo group received treatment with a sham appliance for 2 weeks before having the actual treatment. A medical history focused on micturition habits, previous treatment, heredity, and sleep disorders was taken. Daytime voided volumes and nocturnal urine production during wet nights were recorded before the intervention.

Results:

Of the 38 patients recruited, two dropped out as one patient was unable to take dental impressions and one refused to have the appliance fitted. There was a statistically significant reduction of wet nights after the RME treatment (P<.001). No significant reduction was found after the placebo treatment (P<.40). Eleven patients (35%) had their enuresis frequency reduced by >50%. Large voiding volume and a wide maxilla at baseline had a strong association with positive treatment outcome.

Conclusions:

RME has a modest effect on children with therapy-resistant NE. The treatment outcome does not seem to be due to a placebo effect of the appliance. A wide maxillary width and large voiding volume at baseline seem to be positive predictors regarding response to treatment.

Keywords
Rapid maxillary expansion, Nocturnal enuresis
National Category
Dentistry
Identifiers
urn:nbn:se:uu:diva-402622 (URN)10.2319/031819-219.1 (DOI)000505049700004 ()31306076 (PubMedID)
Available from: 2020-01-17 Created: 2020-01-17 Last updated: 2020-01-17Bibliographically approved
Jönson Ring, I., Nevéus, T., Markström, A., Magnuson, A. & Bazargani, F. (2019). Rapid maxillary expansion in children with nocturnal enuresis:: A randomized placebo-controlled trial. Angle orthodontist, 90(1), 31-38
Open this publication in new window or tab >>Rapid maxillary expansion in children with nocturnal enuresis:: A randomized placebo-controlled trial
Show others...
2019 (English)In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 90, no 1, p. 31-38Article in journal (Other academic) Published
Abstract [en]

OBJECTIVE:

To investigate whether rapid maxillary expansion (RME) is a useful treatment method for nocturnal enuresis (NE) and whether the treatment effect is due to placebo. The study also aimed to identify prognostic variables in patients responding to treatment.

MATERIALS AND METHODS:

Thirty-eight children with therapy-resistant NE were recruited and randomized into two groups: the intervention group or placebo group. Both groups were treated with RME, but the placebo group received treatment with a sham appliance for 2 weeks before having the actual treatment. A medical history focused on micturition habits, previous treatment, heredity, and sleep disorders was taken. Daytime voided volumes and nocturnal urine production during wet nights were recorded before the intervention.

RESULTS:

Of the 38 patients recruited, two dropped out as one patient was unable to take dental impressions and one refused to have the appliance fitted. There was a statistically significant reduction of wet nights after the RME treatment (P < .001). No significant reduction was found after the placebo treatment (P < .40). Eleven patients (35%) had their enuresis frequency reduced by >50%. Large voiding volume and a wide maxilla at baseline had a strong association with positive treatment outcome.

CONCLUSIONS:

RME has a modest effect on children with therapy-resistant NE. The treatment outcome does not seem to be due to a placebo effect of the appliance. A wide maxillary width and large voiding volume at baseline seem to be positive predictors regarding response to treatment.

Keywords
Rapid maxillary expansion, nocturnal enuresis
National Category
Dentistry
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-383403 (URN)10.2319/031819-219.1 (DOI)
Available from: 2019-05-14 Created: 2019-05-14 Last updated: 2020-02-20Bibliographically approved
Israelsson-Skogsberg, Å., Markström, A., Laakso, K., Hedén, L. & Lindahl, B. (2019). Siblings' Lived Experiences of Having a Brother or Sister With Home Mechanical Ventilation: A Phenomenological Hermeneutical Study. Journal of Family Nursing, 25(3), 469-492
Open this publication in new window or tab >>Siblings' Lived Experiences of Having a Brother or Sister With Home Mechanical Ventilation: A Phenomenological Hermeneutical Study
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2019 (English)In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 25, no 3, p. 469-492Article in journal (Refereed) Published
Abstract [en]

Over the past few decades, there has been an increase in the number of children receiving home mechanical ventilation (HMV), and in many ways, families have taken responsibility for the required advanced homecare, which has placed considerable time demands on the family unit. Little is known about the life situation of the siblings of HMV-assisted children; their own voices and an insider perspective are missing. The aim of this study was to illuminate the everyday life experiences of siblings of HMV-assisted children. Data were obtained via interviews with 10 siblings with a median age of 9 years. Data were analyzed using a phenomenological hermeneutical method inspired by the French philosopher Ricoeur. Four themes emerged, all of which suggest that a complex and profound intertwined sibling bond develops that links the past, present, and future. The findings of this study provide valuable information from an insider's perspective about the meaning of having an HMV-assisted sibling. Family-focused care with particular attention and support for siblings of HMV-assisted children can encourage the development of internal strengths, self-confidence, and resilience.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS INC, 2019
Keywords
child, family, home mechanical ventilation, sibling relationships, family nursing
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-396124 (URN)10.1177/1074840719863916 (DOI)000479436000001 ()31354023 (PubMedID)
Available from: 2019-10-30 Created: 2019-10-30 Last updated: 2019-10-30Bibliographically approved
Danielsson, K., Jansson-Fröjmark, M., Jan-Erik, B. & Markström, A. (2018). Light therapy with scheduled rise times in young adults with delayed sleep phase disorder: Therapeutic outcomes and possible predictors. Behavioural Sleep Medicine, 16(4), 325-336
Open this publication in new window or tab >>Light therapy with scheduled rise times in young adults with delayed sleep phase disorder: Therapeutic outcomes and possible predictors
2018 (English)In: Behavioural Sleep Medicine, ISSN 1540-2002, E-ISSN 1540-2010, Vol. 16, no 4, p. 325-336Article in journal (Refereed) Published
Abstract [en]

Clinical trials with light therapy (LT) for delayed sleep phase disorder (DSPD) are sparse and little is known about factors that are favorable for improvements. In this study, LT with scheduled rise times was conducted at home for 14 days by 44 participants with DSPD aged 16–26 years. Primary outcomes were sleep onset and sleep offset. Potential predictors were demographic characteristics, chronotype, dim light melatonin onset, the number of days the LT lamp was used, the daily duration of LT, daytime sleepiness, anxiety, depression, worry, and rumination. Significant advances were observed in sleep onset and sleep offset from baseline to the end of treatment. The number of days of LT predicted earlier sleep onset and sleep offset.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2018
National Category
Neurosciences Neurology
Identifiers
urn:nbn:se:uu:diva-298760 (URN)10.1080/15402002.2016.1210150 (DOI)000431524200002 ()27712107 (PubMedID)
Available from: 2016-07-07 Created: 2016-07-07 Last updated: 2018-07-04Bibliographically approved
Bergdahl, L., Broman, J.-E., Berman, A. H., Haglund, K., von Knorring, L. & Markström, A. (2017). Auricular acupuncture versus cognitive behavioural therapy in the discontinuation of hypnotic drug usage and treatment effects of anxiety-, depression and insomnia symptoms. European Journal of Integrative Medicine, 16, 15-21
Open this publication in new window or tab >>Auricular acupuncture versus cognitive behavioural therapy in the discontinuation of hypnotic drug usage and treatment effects of anxiety-, depression and insomnia symptoms
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2017 (English)In: European Journal of Integrative Medicine, ISSN 1876-3820, E-ISSN 1876-3839, Vol. 16, p. 15-21Article in journal (Refereed) Published
Abstract [en]

Introduction: The interest in non-pharmacological interventions for insomnia disorder has increased. The aim was to assess the immediate treatment effects of auricular acupuncture (AA) and cognitive behavioural therapy for insomnia (CBT-i) regarding discontinuation of hypnotic usage and symptoms of anxiety, depression and insomnia.

Method: Prospective randomised controlled study. Fifty-seven participants (mean age 61 years (SD 8.6)) with insomnia disorder and long-term use of non-benzodiazepine hypnotics received group-treatment with AA or CBT-i. Pre- and post-treatment measures included symptoms of anxiety, depression and insomnia via self-report questionnaires: Hospital Anxiety and Depression scale (HAD-A, HAD-D) and Insomnia Severity Index (ISI). Other sleep parameters and hypnotic consumption were measured with a sleep diary. Linear mixed models were performed to examine treatment effect over time within and between the groups.

Results: Seventy-one percent of the AA participants and 84% of the CBT-i participants managed to discontinue their hypnotic drug consumption post-treatment. Symptoms of anxiety and depression decreased within the AA group (HAD-A (p < 0.05), HAD-D (p < 0.05)) and insomnia symptoms decreased within the CBT-i group (ISI (p < 0.001)). The only between-group difference occurred in ISI (p < 0.001), in favour of CBT-i. According to the within-group sleep diary results, the CBT-i group went to bed later (p < 0.001), fell asleep quicker (p < 0.05), increased their sleep efficiency (p < 0.001) and self-rated sleep quality (p < 0.05) post-treatment.

Conclusions: Both groups ended/maintained low hypnotic drug consumption post-treatment. Short-term reductions occurred in the AA group in anxiety and depression symptoms and in the CBT-i group regarding insomnia symptoms.

Keywords
Auricular acupuncture, Cognitive behavioural therapy, Hypnotic consumption, Anxiety Insomnia Depression
National Category
Medical and Health Sciences Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-319923 (URN)10.1016/j.eujim.2017.10.002 (DOI)000417392500003 ()
Available from: 2017-04-12 Created: 2017-04-12 Last updated: 2020-03-04Bibliographically approved
Ring, I. J., Nevéus, T., Markström, A., Arnrup, K. & Bazargani, F. (2017). Nocturnal enuresis impaired children's quality of life and friendships. Acta Paediatrica, 106(5), 806-811
Open this publication in new window or tab >>Nocturnal enuresis impaired children's quality of life and friendships
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2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 5, p. 806-811Article in journal (Refereed) Published
Abstract [en]

AimThere have not been any continence-specific measurement tools in Swedish that have allowed clinicians to investigate the quality of life (QoL) in children with bladder dysfunction. This study evaluated the QoL in Swedish children with nocturnal enuresis and tested the reliability of a Swedish translation of the Paediatric Incontinence Questionnaire (PinQ). MethodsThis prospective study comprised 46 children aged six to 18 years with nocturnal enuresis, who completed the PinQ after it was translated into Swedish. It was completed twice by 33 patients, and these responses were included in the test-retest evaluation. ResultsThe self-reported mean sum score for the whole group was 26.3 13.37 (range: 5-58), and the most affected domains were social relations with peers and self-esteem. The highest individual scores were four, three or two for 71.7%, 17.4% and 10.9% of the study population, respectively. Cronbach's alpha was 0.87 for the whole questionnaire, indicating good internal consistency. The test-retest stability was excellent, with an intra-class correlation coefficient of 0.76. ConclusionChildren with nocturnal enuresis had impaired self-esteem, and their impaired QoL affected their relationships with friends. The Swedish version of the PinQ proved to be a reliable tool that will be used in further studies.

Place, publisher, year, edition, pages
WILEY, 2017
Keywords
Nocturnal enuresis, Quality of life, Questionnaire, Self-esteem, Urinary incontinence
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-321783 (URN)10.1111/apa.13787 (DOI)000398859300021 ()28199734 (PubMedID)
Available from: 2017-05-11 Created: 2017-05-11 Last updated: 2019-05-14Bibliographically approved
Ring, I. J., Markström, A., Bazargani, F. & Nevéus, T. (2017). Sleep disordered breathing in enuretic children and controls. Journal of Pediatric Urology, 13(6), 620.e1-620.e6
Open this publication in new window or tab >>Sleep disordered breathing in enuretic children and controls
2017 (English)In: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 13, no 6, p. 620.e1-620.e6Article in journal (Refereed) Published
Abstract [en]

Introduction: Nocturnal enuresis and sleep disordered breathing are common childhood problems that are reported to be associated with each other. Sleep disordered breathing is often found in children with upper airway obstruction and, according to some studies, its presence is associated with an increased risk of nocturnal enuresis. Respiration during sleep in children with therapy-resistant enuresis, but no history of snoring or sleep apneas, has previously been investigated, and subclinical signs of disordered respiration were found in this group. However, sleep disordered breathing in enuretic children without a history of snoring or sleep apneas has not been thoroughly studied before.

Aim: To evaluate sleep disordered breathing in enuretic children and compare them with healthy control children.

Subjects and methods: Children aged 8-13 years with nocturnal enuresis were included. Exclusion criteria were: daytime incontinence, on-going anti-enuretic treatment, and concomitant urological, endocrinological, nephrological or psychiatric disorders. Twenty children (19 boys and 1 girl) suffering from therapy-resistant nocturnal enuresis, and 21 healthy controls (18 boys and 3 girls) underwent one night of polygraphic sleep registration focused on respiratory variables. The registration included electroencephalography as well as assessment of respiratory movements, nasal airflow and oxygen saturation; it was performed with a portable sleep device at the subjects' homes. In addition to this, OSA 18, a health-related quality of life instrument, was used to evaluate subjective issues related to sleep and breathing.

Results: The mean apnea hypopnea index values were 0.96 +/- 0.8 for the patient group and 0.46 +/- 0.4 for the control group. The oxygen desaturation index was slightly higher for the children with nocturnal enuresis compared with the healthy controls (P = 0.05). No other differences were found in the respiratory variables. Both groups of children showed low levels of arousals (Summary Table). The enuretic children reported significantly more subjective sleep disturbances and a lower quality of life than their healthy peers.

Discussion: This was the first controlled study of sleep disordered breathing in children with nocturnal enuresis. One limitation of the study was that some variables were known to be underestimated when scoring polygraphic data. The apnea hypopnea index was such a variable and was indeed lower than in a previous study.

Conclusion: No major differences in respiration during sleep were found between enuretic children and controls.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2017
Keywords
Nocturnal enuresis, Sleep disordered breathing, Respiratory polygraphy, Children
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-340287 (URN)10.1016/j.jpurol.2017.05.012 (DOI)000418045800024 ()
Available from: 2018-01-29 Created: 2018-01-29 Last updated: 2019-05-14Bibliographically approved
Bergdahl, L., Broman, J.-E., Berman, A. H., Haglund, K., von Knorring, L. & Markström, A. (2017). Sleep patterns in a randomized controlled trial of auricular acupuncture and cognitive behavioral therapy for insomnia. Complementary Therapies in Clinical Practice, 28, 220-226
Open this publication in new window or tab >>Sleep patterns in a randomized controlled trial of auricular acupuncture and cognitive behavioral therapy for insomnia
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2017 (English)In: Complementary Therapies in Clinical Practice, ISSN 1744-3881, E-ISSN 1873-6947, Vol. 28, p. 220-226Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to objectively examine how sleep patterns were affected in a short- and long-term perspective after auricular acupuncture (AA) and cognitive behavioral therapy for insomnia (CBT-i). Sixty participants with insomnia disorders (men/women 9/51; mean age of 60.5 years, (SD 9.4)), were randomized to group treatment with AA or CBT-i. Actigraphy recordings were made at baseline, post-treatment and 6-month follow-up. The CBT-i group reduced their time in bed, their actual sleeping time, their sleep latency and their actual time awake. The AA group slept longer, increased their time in bed and decreased their sleep latency post-treatment. The between-groups results differed in wake-up time, rising, time in bed, actual sleep time and actual wake time. The differences were not maintained six months later. In accordance with previous findings the results support the notion that the objective sleep time does not necessarily affect the subjective perception of insomnia.

Keywords
Actigraphy, Auricular acupuncture, Cognitive-behavioral therapy, Insomnia disorder, Non-pharmacological, Treatment
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-320044 (URN)10.1016/j.ctcp.2017.06.006 (DOI)000407722900030 ()28779933 (PubMedID)
Funder
Ekhaga Foundation, 2011 59
Available from: 2017-04-12 Created: 2017-04-12 Last updated: 2020-03-04Bibliographically approved
Bergdahl, L., Broman, J.-E., Berman, A. H., Haglund, K., von Knorring, L. & Markström, A. (2016). A randomised controlled trial of auricular acupuncture and cognitive behavioural therapy for insomnia: a short-term self-assessment. Paper presented at 23rd Congress of the European-Sleep-Research-Society, SEP 13-16, 2016, Bologna, ITALY. Journal of Sleep Research, 25, 213-213
Open this publication in new window or tab >>A randomised controlled trial of auricular acupuncture and cognitive behavioural therapy for insomnia: a short-term self-assessment
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2016 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, p. 213-213Article in journal, Meeting abstract (Other academic) Published
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-309494 (URN)000383445201008 ()
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: 2017-04-18Bibliographically approved
Broman, J.-E., Danielsson, K. & Markström, A. (2016). A Swedish version of the Flinders Fatigue Scale: measurement properties in patients with insomnia disorder. Paper presented at 23rd Congress of the European-Sleep-Research-Society, SEP 13-16, 2016, Bologna, ITALY. Journal of Sleep Research, 25, 346-346
Open this publication in new window or tab >>A Swedish version of the Flinders Fatigue Scale: measurement properties in patients with insomnia disorder
2016 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, p. 346-346Article in journal, Meeting abstract (Other academic) Published
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-309506 (URN)000383445201429 ()
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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