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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
Polar PlotPolar Plot
Temperature & Sleep Temperature & Sleep CycleCycle
Hester McLaws Fund UW SONAmerican Nurses Foundation
Mostly I learned, without Mostly I learned, without help even a small study is help even a small study is not possible.not possible.
Perimenstrual SymptomsPerimenstrual Symptoms
NU1054
National Center for Nursing Research National Institutes of
Health
Nancy Woods PhD, RN, FAAN
Test-Retest Reliability & Stability Estimates
Test retest reliability r =r12r23/r13
Stability estimates s12=r13/r23
s23=r13/r12
s13=r132/r12r23
Fluid Retention
Reliability coefficient r = .74
Stability coefficient s13 = .55
Fluid
Standard cycle days
252321191715131197531
Me
an
sco
re12
10
8
6
4
2
0
Group
Low sx
PMS
PMM
Home Sleep
NR-01118, P30 NR 004001National Institute of Nursing Research
National Institutes of HealthJoan Shaver, PhD, RN, FAAN
In Home Sleep In Home Sleep RecordingRecording
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
What is sleep?What is sleep?
Self-report the experience of sleepPSG- brain wave activityActigraphy movement
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?
Delta Deprivation
UW School of Nursing Intramural Fund
P30 NR 004001
Delta
Alpha
Alpha/Delta
Delta
Jim Rothermel, Res Scientist & Stacy Riffle, RN Res. Nurse
Median Percent of Delta Activity vs Baseline Night
0
10
20
30
40
50
60
70
80
Night 1 Night 2 Night 3n= 12
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
Median Pressure in KG to Report of Pain
0
1
2
3
4
5
6
Baseline Morning1
Morning2
Morning3
p<.02
n= 7
Sleep In Women With and Without Fibromyalgia
NR-04001, P30 NR 004001National Institute of Nursing
Research National Institutes of Health
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
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.
Growth Hormone Across Growth Hormone Across Noc By GroupNoc By Group
Delta Increase
UW School of Nursing Intramural Fund
P30 NR 004001National Institute of Nursing
Research National Institutes of Health
Ways to Increase SWS
Sleep DelayWhole Body Warming
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
Armitage CFS Twin Sleep Delay Delta
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
Study Procedures
At Home for 1 WeekDaily Peak FlowDaily Symptom DiaryWrist Actigraphy
Laboratory Procedures
PSG
Laboratory Procedures
Pulmonary FunctionFEV 1FEV 25-75eNo
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
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
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
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
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)
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
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
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
Motivational Interviewing
Talk Research
Clarify & Sharpen ConceptsDeepen and Extend Conceptual
RelationshipsIdentify Implicit AssumptionsGet to Core of What We Know