Dear Editor,
The Marilyn Harris Commentary on Celebrating Nightingale's 200th Birthday in the May/June issue served to remind me of nursing's strong roots. I am fortunate to have had the opportunity to view the Florence Nightingale stained glass window in the National Cathedral in Washington, DC-images of caring as the "Lady of the Lamp" and as a scientist, as she preserved her assessments and conclusions in her Notes on Nursing.
As a retired nurse with 36 years in home care, many of which were collaborating with Marilyn Harris, I reflect on the opportunities that we have as trusted professionals. The importance of leading by example is as true today as it was in Nightingale's time. Teaching patients, students, and new clinicians life-saving procedures of infection control is one aspect of this. Consider incorporating lessons learned from our roots into inservices on infection control for a creative way to influence and mentor clinicians. Florence Nightingale reading from Notes on Nursing could augment the delivery of information.
When safe, I encourage everyone to share in the joy and pride of nursing by visiting the National Cathedral in Washington, DC, and viewing the Florence Nightingale stained glass window.
Joan Yuan, MSN, RN
Retired Director of Education/QAI
Abington Memorial Hospital Home Care & Hospice
Willow Grove, Pennsylvania
Poor Sleep Linked With Higher Blood Sugar Levels in African Americans
NIH: African American men and women are up to 2 times more likely to develop diabetes over their lifetimes than white Americans. Previous studies in white and Asian populations have linked disturbances in sleep to increased blood glucose levels. These disturbances may be caused by sleep apnea, a condition where breathing stops or gets very shallow for periods during the sleep cycle. Sleep apnea reduces the amount of oxygen that reaches the organs of the body, potentially leading to many health problems.
To see if links between disrupted sleep and high blood glucose levels also exist in African Americans, researchers led by Dr. Yuichiro Yano from Duke University looked at data collected between 2012 and 2016 by the Jackson Heart Study. The analysis included about 800 participants who underwent home sleep apnea testing. They also wore a wrist actigraph (a device that measures wakefulness and sleep) for a week, and kept a sleep diary. This information was used to calculate how long people slept, how often they woke up during the night, and variability in these sleep patterns. Measurements of blood glucose were taken in the clinic.
The participants were mostly women, and about 25% had diabetes. Around a third were found to have sleep apnea, most of whom were not receiving treatment for the condition. The study was funded in part by NIH and results were published in the Journal of the American Heart Association.
Both sleep apnea and fragmented sleep patterns recorded during the study were associated with higher blood glucose levels. People with the most severe sleep apnea had 14% higher fasting blood glucose levels than those without sleep apnea. In people who already had diabetes, greater disturbances in sleep were associated with lower sensitivity to insulin, the hormone that signals cells to take up sugar from the blood. Treatments for sleep apnea include lifestyle changes and use of a continuous positive air pressure (CPAP) machine. More research is needed to determine if treating sleep apnea and encouraging better sleep patterns can improve blood glucose levels and prevent diabetes in African Americans.