Symptoms of narcolepsy tend to arise during adolescence or young adulthood, a formative time in human development during which people are usually completing their education and launching a career. Little is known about the impact of narcolepsy on the social aspects of health-related quality of life in young adults. The purpose of this study was to examine relationships between health-related stigma, mood (anxiety and depression) and daytime functioning in young adults with narcolepsy compared to those without narcolepsy. Young adults (age 18–35) with narcolepsy (N = 122) and without narcolepsy (N = 93) were mailed a packet that included questionnaires and a self-addressed postage paid envelope. The questionnaire included demographic information and a composite of instruments including the SF 36, Functional Outcomes of Sleep Questionnaire (FOSQ), Fife Stigma Scale (FSS), Epworth Sleepiness Scale (ESS) and Hospital Anxiety and Depression Scale (HADS). Variable associations were assessed using descriptive statistics, ANOVA, Mann-Whitney U Test, correlations, stepwise multiple regression and path analysis. Young adults with narcolepsy perceived significantly more stigma and lower mood and health-related quality of life than young adults without narcolepsy (p<0.01). Health-related stigma was directly and indirectly associated with lower functioning through depressed mood. Fifty-two percent of the variance in functioning was explained by the final model in the young adults with narcolepsy. Health-related stigma in young adults with narcolepsy is at a level consistent with other chronic medical illnesses. Health-related stigma may be an important determinant of functioning in young adults with narcolepsy. Future work is indicated toward further characterizing stigma and developing interventions that address various domains of stigma in people with narcolepsy.

Introduction: Physical activity monitors, motivational text messages, personal calls, and group meetings, have proven to be efficacious physical activity interventions. However, individual participant response to these interventions varies drastically. A SMART design (sequential multiple assignment randomized trial) provides an effective way to test interventions that start with an initial treatment and then transition to an augmented treatment for non-responders. We describe a SMART to determine the most effective adaptive intervention to increase physical activity (steps, moderate-to-vigorous physical activity) and improve cardiovascular health among employed women who are not regularly physically active. The SMART uses combinations of four treatments: 1) enhanced physical activity monitor (Fitbit wearable activity monitor and mobile app with goal setting and physical activity prescription), 2) text messages, 3) personal calls, and 4) group meetings.Methods: Participants (N = 312) include women ages 18-70 employed at a large academic medical center. Women will be randomized to an initial intervention, either an enhanced physical activity monitor or enhanced physical activity monitor + text messaging. Non-responders to the initial intervention at 2 months will be randomized to either personal calls or groups meetings for the next 6 months. At 8 months, all participants will return to only an enhanced physical activity monitor until their final 12-month assessment.Discussion: Results of this study will add to the literature on improving physical activity in employed women. This study will identify effective interventions for women who respond to less intensive treatments, while maximizing benefits for those who need a more intensive approach.

Background Actigraphy is commonly used to measure sleep outcomes so sleep can be measured conveniently at home over multiple nights. Validity of actigraphy has been demonstrated in people with sleep disturbances; however, validity of scoring settings in people with chronic medical illnesses such as chronic obstructive pulmonary disease remains unclear. The purpose of this secondary analysis was to compare actigraphy customized scoring settings with polysomnography for measurement of sleep outcomes in people with chronic obstructive pulmonary disease who have insomnia. Methods Participants underwent overnight sleep assessment simultaneously by polysomnography and actigraphy at the University of Illinois of Chicago Sleep Science Center. Fifty participants (35 men, 15 women) with mild to severe chronic obstructive pulmonary disease and insomnia were included in the analysis. Sleep onset latency, total sleep time, wake after sleep onset, and sleep efficiency were calculated independently from data derived from polysomnography and from actigraphy. Actigraphy sleep outcome scores obtained at the default setting and several customized actigraphy settings were compared to the scored polysomnography results. Results Although no single setting was optimal for all sleep outcomes, the combination of 10 consecutive immobile minutes for sleep onset or end and activity threshold of 10 worked well. Actigraphy overestimated TST and SE and underestimated WASO but there was no difference in variance between PSG and actigraphy in TST and SE when the 10*10 combination was used. As the average TST and SE increased, the agreement between PSG and actigraphy appeared to increase and as the average WASO decreased, the agreement between PSG and actigraphy appeared to increase. Conclusion Results support the conclusion that the default actigraphy settings may not be optimal for people with chronic obstructive pulmonary disease and insomnia.

The purpose of this study was to investigate the effect of abdominal exercises on abdominal fat. Twenty-four healthy, sedentary participants (14 men and 10 women), between 18 and 40 years, were randomly assigned to 1 of the following 2 groups: control group (CG) or abdominal exercise group (AG). Anthropometrics, body composition, and abdominal muscular endurance were tested before and after training. The AG performed 7 abdominal exercises, for 2 sets of 10 repetitions, on 5 d·wk(-1) for 6 weeks. The CG received no intervention, and all participants maintained an isocaloric diet throughout the study. Significance was set at p = 0.05 for all tests. There was no significant effect of abdominal exercises on body weight, body fat percentage, android fat percentage, android fat, abdominal circumference, abdominal skinfold and suprailiac skinfold measurements. The AG performed significantly greater amount of curl-up repetitions (47 ± 13) compared to the CG (32 ± 9) on the posttest. Six weeks of abdominal exercise training alone was not sufficient to reduce abdominal subcutaneous fat and other measures of body composition. Nevertheless, abdominal exercise training significantly improved muscular endurance to a greater extent than the CG.