Mary Grace Umlauf

Objectives: To describe the preconception health status of Iraqi women in 2001 following the trade embargo imposed on Iraq beginning in 1991 and only partially removed in 1996.Design: A descriptive cross‐sectional prevalence study.Sample: 500 Iraqi women at a premarital clinic in Baghdad in 2001.Measurements: Women were surveyed for age, area of residence, menstrual history, household crowding, consanguinity, and a family history of congenital problems. Clinical findings regarding height, weight, and hemoglobin level were included in the data.Results: Almost one third of the women were below the age of 20 and the majority were between 20 and 25 years of age. More than half of the women in this study had an intermediate‐level education or less and lived in very crowded housing. Most of the women were anemic and reported a delay in menarche, suggesting malnutrition. Most of the women were planning consanguineous unions even though many reported congenital conditions in their family of origin.Conclusions: Young Iraqi women who endured embargo needed, and continue to need, aggressive preventive health services to recoup health gains lost during the 1990s and to address prevention of common congenital disorders.

Although much of the emphasis in treating Bipolar Disorder patients is on pharmacotherapy, sleep loss is an important trigger for mania and plays an important role in the condition. The purpose of this paper is to fully explore the chronobiological, environmental, social, and genetic factors that contribute to the sleep disruption that is characteristic of mania and bipolar disorder. This review is important because sleep, chronobiology, and genetics are under-emphasized content areas in nursing education. As a result, many practicing nurses are unaware of the importance of sleep for mental health or what to teach patients to improve both the quality of their sleep and the management of their condition.

The purpose of this study was to examine the relationship between nocturia and obstructive sleep apnea (OSA) in community dwelling older men and women A repeated measures design was employed over a 24-hour period. The study was conducted in a clinical research center. Thirty community-dwelling elders (mean age=65.5, SD=8.4 years) with symptoms of nocturia and sleep disordered breathing, volunteered to participate. Both men (n=13) and women (n=17) and minority subjects (African-Americans, n=19; Caucasian, n=11) were included in the study. NA Blood specimens were collected every 4 hours, except for an 8-hour collection period overnight. Urine specimens were collected ad libitum and at the end of each data collection interval. Urine and blood specimens were analyzed for ANP and AVP content. Polysomnography was conducted using a full 18-channel montage. Apnea was defined as a decrease in airflow of ≥ 90% for a minimum of 10 seconds. Hypopnea was defined as ≥ 30% decrease in airflow and desaturations required a ≥ 3% decrease in oxygen saturation for a minimum of 10 seconds. The apnea hypopnea index (AHI) was calculated as the sum of apneas and hypopneas divided by hours of sleep. Twenty of the thirty subjects were found to have clinically diag-nosable OSA (AHI ≥5). AVP excretion was not correlated with changes in AHI levels. Conversely, total urine output, plasma ANP and urine ANP excretion were significantly higher among subjects with higher AHI levels (>15). In subjects with elevated AHI (>15), nighttime urine production and ANP excretion are elevated.

ISSUES AND PURPOSE. Nocturnal enuresis (bedwetting) can linger long into childhood. Sleep research has documented that nocturia and bedwetting are symptoms of obstructive sleep apnea (OSA) in adults and that bedwetting is predictive of OSA in children. CONCLUSIONS. Nocturnal polyuria is a cardiovascular response to negative pressure breathing (inspiration against a closed glottis), which is characteristic of OSA. PRACTICE IMPLICATIONS. Evidence of nocturnal polyuria and sleep‐disordered breathing are important signs of OSA, a serious but treatable condition.