Historically, patients presenting with acute symptoms related to PEH have required open repair, which is associated with significant morbidity and mortality. The acute group was older and sicker than our elective LPEHR patients and had more adverse events resulting in a longer LOS, even when compared with comorbidity-matched elective patients. However, the LOS remained shorter than that reported for open repair and there was no mortality. The recurrence rates in all groups were low and comparable to elective repairs.

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Sleep problems are pervasive among the United States population with insomnia being the most common sleep complaint among adults and older adults. Between 20 and 40 percent of older adults have symptoms of insomnia, which impacts quality of life, inflates healthcare costs, and is associated with a greater risk of chronic disease, comorbid mood disorders, and premature mortality. While pharmacotherapy offers immediate relief from insomnia, it is associated with adverse side effects and risks.Behavioral interventions, such as cognitive-behavioral therapy for insomnia (CBT-I), have longer-term benefits and fewer side effects. However, the full CBT-I protocol is resource intensive and can be difficult to access. The present study examined the ability of a brief Internet-based sleep intervention, stimulus control therapy (SCT; N = 26), to effectively reduce symptoms of insomnia and improve mood in a sample of 46 adults aged 60 years and older compared to a sleep hygiene psychoeducation-only group (N = 20). Participants were recruited from community sources and completed telephone screens. Eligible participants watched a 20-minute video (SCT or sleep hygiene) online and completed three surveys across a one-month period (baseline, 1-week, and 1-month) about mood and sleep. Results revealed no significant group differences but rather decreases in both groups on sleepiness, fatigue, anxiety, depression, and sleep locus of control over time, as well as a group-time interaction for anxiety and stress. Findings imply that both sleep hygiene and SCT have equivalent efficacy and that minimal insomnia treatments may effectively treat comorbid insomnia and anxiety and depression.