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Lentz unm school presentation slides

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Page 1: Lentz unm school presentation slides
Page 2: Lentz unm school presentation slides

A Research Career: There A Research Career: There Was Always Another Was Always Another Research QuestionResearch Question

Martha J Lentz, PhD, RNScholarship Day May 2013

College of NursingUniversity of New Mexico

Page 3: Lentz unm school presentation slides

Polar PlotPolar Plot

Page 4: Lentz unm school presentation slides

Temperature & Sleep Temperature & Sleep CycleCycle

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Hester McLaws Fund UW SONAmerican Nurses Foundation

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Mostly I learned, without Mostly I learned, without help even a small study is help even a small study is not possible.not possible.

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Perimenstrual SymptomsPerimenstrual Symptoms

NU1054

National Center for Nursing Research National Institutes of

Health

Nancy Woods PhD, RN, FAAN

Page 8: Lentz unm school presentation slides

Test-Retest Reliability & Stability Estimates

Test retest reliability r =r12r23/r13

Stability estimates s12=r13/r23

s23=r13/r12

s13=r132/r12r23

Page 9: Lentz unm school presentation slides

Fluid Retention

Reliability coefficient r = .74

Stability coefficient s13 = .55

Page 10: Lentz unm school presentation slides

Fluid

Standard cycle days

252321191715131197531

Me

an

sco

re12

10

8

6

4

2

0

Group

Low sx

PMS

PMM

Page 11: Lentz unm school presentation slides

Home Sleep

NR-01118, P30 NR 004001National Institute of Nursing Research

National Institutes of HealthJoan Shaver, PhD, RN, FAAN

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In Home Sleep In Home Sleep RecordingRecording

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Home Study-Insomnia Home Study-Insomnia TypesTypesSelf-reported Insomnia N=101Of ThesePP-type (3 noc <85% Slp Efficiency) N=33SO-type (3 noc >88% & 0 noc <85%) N=18Unclassified (fewer 3 noc <85%) N=50

Self-reported good sleep N=30Of TheseControl (3 noc >88% & 0 noc <85%) N=14

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What is sleep?What is sleep?

Self-report the experience of sleepPSG- brain wave activityActigraphy movement

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What does saying I have What does saying I have good sleep or poor sleep good sleep or poor sleep mean?mean?

Good sleep is what I am used to experiencing

Poor sleep, if different from past experience

Does PSG poor sleep arise from same mechanism in self-reported good and poor sleepers?

Are subtle PSG differences making the mis-match of self-report and PSG sleep quality?

Page 16: Lentz unm school presentation slides

Delta Deprivation

UW School of Nursing Intramural Fund

P30 NR 004001

Page 17: Lentz unm school presentation slides

Delta

Alpha

Alpha/Delta

Delta

Page 18: Lentz unm school presentation slides

Jim Rothermel, Res Scientist & Stacy Riffle, RN Res. Nurse

Page 19: Lentz unm school presentation slides

Median Percent of Delta Activity vs Baseline Night

0

10

20

30

40

50

60

70

80

Night 1 Night 2 Night 3n= 12

Page 20: Lentz unm school presentation slides

Bodily Feelings Scale Musculoskeletal

13.5

14

14.5

15

15.5

16

16.5

17

17.5

Baseline Morning 1 Morning 2 Morning 3

p<.01

p<.01

n= 12

Page 21: Lentz unm school presentation slides

Median Pressure in KG to Report of Pain

0

1

2

3

4

5

6

Baseline Morning1

Morning2

Morning3

p<.02

n= 7

Page 22: Lentz unm school presentation slides

Sleep In Women With and Without Fibromyalgia

NR-04001, P30 NR 004001National Institute of Nursing

Research National Institutes of Health

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Macro Macro SleepSleep Measures Measures

Fibromyalgia n = 33

Controln = 30

Sleep Period Time (min) 454.453.4 454.830.0

Total Sleep Time (min) 392.855.3 429.228.9

REM (min) 89.832.6 105.320.0

SWS 10.4% 8.5 12.2% 5.8

Wake (min) 58.940.5 25.311.2

Page 24: Lentz unm school presentation slides

Sleep Spindles in NREM Stage 2 in Fibromyalgia and Control Women

Sleep Spindle Variables Fibromyalgian = 33

Controln = 30

Number/minute in Stage 2, ( SD)* 3.85 ± 2.1 5.4 ± 2.9

Duration, mean seconds, ( SD)** 1.2 ± 0.2 1.1 ± 0.2

Spindle Time/epoch Stage 2, ( SD) *** 1.7 ± 1.2 2.7 ± 1.8

•Data are from C3; t-test, * P ≤ 0.02; ** P ≤ 0.03; *** P ≤ 0.02.

Page 25: Lentz unm school presentation slides

Growth Hormone Across Growth Hormone Across Noc By GroupNoc By Group

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Delta Increase

UW School of Nursing Intramural Fund

P30 NR 004001National Institute of Nursing

Research National Institutes of Health

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Ways to Increase SWS

Sleep DelayWhole Body Warming

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Delta After Whole Body Delta After Whole Body WarmingWarming

Non-REM Cycle4.003.002.001.00

Su

m600.00

400.00

200.00

0.00

WarmingBaseline

Page 29: Lentz unm school presentation slides

Armitage CFS Twin Sleep Delay Delta

Page 30: Lentz unm school presentation slides

Nocturnal Asthma in Children

UW School of Nursing Intramural FundNR-08238, P30 NR 004001, T32

NR007106 National Institute of Nursing Research

National Institutes of HealthGail Kieckhfer, PhD, ARNP

Page 31: Lentz unm school presentation slides

Study Procedures

At Home for 1 WeekDaily Peak FlowDaily Symptom DiaryWrist Actigraphy

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Laboratory Procedures

PSG

Page 33: Lentz unm school presentation slides

Laboratory Procedures

Pulmonary FunctionFEV 1FEV 25-75eNo

Page 34: Lentz unm school presentation slides

FEV 25-75FEV 25-75

session

UB+8 hours after sleep onset

UB+4 hrs after sleep onset

usual bedtime

(UB)

Mea

n

110

100

90

80

70

60

50

UB+8 hours after sleep onset

UB+4 hrs after sleep onset

usual bedtime

(UB)

Does the child have a diagnosis of asthma?

yesno

Error bars: 95% CI

fef25_75 sleep delay night

fef25_75 baseline night

Page 35: Lentz unm school presentation slides

eNO eNO

session

UB+8 hours after sleep onset

UB+4 hrs after sleep onset

usual bedtime

(UB)

Mea

n

35.00

30.00

25.00

20.00

15.00

10.00

5.00

UB+8 hours after sleep onset

UB+4 hrs after sleep onset

usual bedtime (UB)

Does the child have a diagnosis of asthma?"

yesno

Error bars: 95% CI

MNO sleep delay nightMNO baseline night

Page 36: Lentz unm school presentation slides

Contingent ProbabilityNight Cough

Child Report

Parent Report

Not at all

A little bit

Somewhat

A lot

Not at all 95%

100%

A little bit

A little bit

A lotNR

100%

Without Asthma

75%

100%

With Asthma

Page 37: Lentz unm school presentation slides

Contingent ProbabilityNight Cough

Child Report

Parent Report

Not at all

A little bit

Somewhat

A lot

Not at all 95%

15% 4% 2% 100%

A little bit

A little bit

A lotNR

100%

Without Asthma

75%

100%

With Asthma

Page 38: Lentz unm school presentation slides

NapsNaps

Non-Nappers

N=37

NappersN=17

Asthma

N (%) N (%)

Yes 15 (40.5)

12 (70.6)

p<0.05

No 22 (59.5)

5 (29.4)

Page 39: Lentz unm school presentation slides

Mean SD Mean SD

P

valu

e

sleep onset 22.35 (0.83) 23.09 (1.33) 0.04 * sleep offset 7.36 (0.85) 7.52 (0.87) 0.52

total sleep,

min 465.47 (41.22) 437.60 (54.42) 0.04 * sleep onset

var. 0.64 (0.36) 1.08 (0.53)

<0.0

1 * sleep offset

var. 0.71 (0.44) 0.76 (0.52) 0.67

Actigraphy VariablesNon-

Nappers

N=37

Nappers

N=17

Page 40: Lentz unm school presentation slides

Mean SD Mean SD

P

valu

e

sleep onset 22.35 (0.83) 23.09 (1.33) 0.04 *

total sleep,

min 465.47 (41.22) 437.60 (54.42) 0.04 *

sleep onset

var. 0.64 (0.36) 1.08 (0.53)

<0.0

1 *

Actigraphy VariablesNon-

Nappers

N=37

Nappers

N=17

Page 41: Lentz unm school presentation slides

Mean SD Mean SD

P

valu

e

sleep onset 22.35 (0.83) 23.09 (1.33) 0.04 *

sleep onset

var. 0.64 (0.36) 1.08 (0.53)

<0.0

1 *

Actigraphy VariablesNon-

Nappers

N=37

Nappers

N=17

Page 42: Lentz unm school presentation slides

Motivational Interviewing

Page 43: Lentz unm school presentation slides

Talk Research

Clarify & Sharpen ConceptsDeepen and Extend Conceptual

RelationshipsIdentify Implicit AssumptionsGet to Core of What We Know