EFFECT OF STRUCTURED PHYSICAL ACTIVITY ON SLEEP-WAKE BEHAVIORS IN SEDENTARY ELDERS WITH MOBILITY LIMITATIONS

PubMed Central

Vaz Fragoso, Carlos A.; Miller, Michael E.; King, Abby C.; Kritchevsky, Stephen B.; Liu, Christine K.; Myers, Valerie H.; Nadkarni, Neelesh K.; Pahor, Marco; Spring, Bonnie J.; Gill, Thomas M.

2016-01-01

OBJECTIVE To evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elders with mobility limitations. DESIGN Multicenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors pre-specified as a tertiary outcome over a planned intervention period ranging between 24 and 30 months. SETTING Lifestyle Interventions and Independence in Elder (LIFE) Study. PARTICIPANTS 1635 community-dwelling persons, aged 70–89 years, who were initially sedentary with a Short Physical Performance Battery score <10. MEASUREMENTS Sleep-wake behaviors were evaluated by the Insomnia Severity Index (ISI) (≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (≥10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (> 5 defined poor sleep quality) — administered at baseline and subsequently at 6, 18, and 30 months. RESULTS The randomized groups were similar on baseline demographic variables, including mean age (79 years) and sex (67% female). Relative to health education, structured physical activity significantly reduced the likelihood of having poor sleep quality (adjusted odds ratios [adjOR] for PSQI >5 of 0.80 [0.68, 0.94]), including a reduction in new cases (adjOR for PSQI >5 of 0.70 [0.54, 0.89]) but not in resolution of prevalent cases (adjOR for PSQI ≤5 of 1.13 [0.90, 1.43]). No significant intervention effects were observed for ISI or ESS. CONCLUSION Structured physical activity reduced the likelihood of developing poor sleep quality (PSQI >5) over the intervention period, when compared with health education, but had no effect on prevalent cases of poor sleep quality, or on sleep-wake behaviors evaluated by the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated by the PSQI. PMID:26115386

Effect of Structured Physical Activity on Sleep-Wake Behaviors in Sedentary Elderly Adults with Mobility Limitations.

PubMed

Vaz Fragoso, Carlos A; Miller, Michael E; King, Abby C; Kritchevsky, Stephen B; Liu, Christine K; Myers, Valerie H; Nadkarni, Neelesh K; Pahor, Marco; Spring, Bonnie J; Gill, Thomas M

2015-07-01

To evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elderly adults with mobility limitations. Multicenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors prespecified as a tertiary outcome over a planned intervention period ranging from 24 to 30 months. Lifestyle Interventions and Independence for Elders Study. Community-dwelling persons aged 70 to 89 who were initially sedentary and had a Short Physical Performance Battery score less than 10 (N = 1,635). Sleep-wake behaviors were evaluated using the Insomnia Severity Index (ISI) (≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (≥10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (>5 defined poor sleep quality) administered at baseline and 6, 18, and 30 months. The randomized groups were similar in terms of baseline demographic variables, including mean age (79) and sex (67% female). Structured physical activity resulted in a significantly lower likelihood of having poor sleep quality (adjusted odds ratios (aOR) for PSQI >5 = 0.80, 95% confidence interval (CI) = 0.68-0.94), including fewer new cases (aOR for PSQI >5 = 0.70, 95% CI = 0.54-0.89), than health education but not in resolution of prevalent cases (aOR for PSQI ≤5 = 1.13, 95% CI = 0.90-1.43). No significant intervention effects were observed for the ISI or ESS. Structured physical activity resulted in a lower likelihood of developing poor sleep quality (PSQI >5) over the intervention period than health education but had no effect on prevalent cases of poor sleep quality or on sleep-wake behaviors evaluated using the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated using the PSQI. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Mister Sandman, bring me good marks! On the relationship between sleep quality and academic achievement.

PubMed

Baert, Stijn; Omey, Eddy; Verhaest, Dieter; Vermeir, Aurélie

2015-04-01

There is growing evidence that health factors affect tertiary education success in a causal way. This study assesses the effect of sleep quality on academic achievement at university. To this end, we surveyed 804 students about their sleep quality by means of the Pittsburgh Sleep Quality Index (PSQI) before the start of their first exam period in December 2013 at Ghent University. PSQI scores were merged with course marks in this exam period. Instrumenting PSQI scores by sleep quality during secondary education, we find that increasing total sleep quality with one standard deviation leads to 4.85 percentage point higher course marks. Based on this finding, we suggest that higher education providers might be incentivised to invest part of their resources for social facilities in professional support for students with sleep and other health problems. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impact of Sleep Disorders, Quality of Life and Gastric Emptying in Distinct Subtypes of Functional Dyspepsia in Japan

PubMed Central

Yamawaki, Hiroshi; Shimpuku, Mayumi; Sato, Hitomi; Wakabayashi, Taiga; Maruki, Yuuta; Kodaka, Yasuhiro; Nagoya, Hiroyuki; Shindo, Tomotaka; Kawagoe, Tetsuro; Sakamoto, Choitsu

2014-01-01

Background/Aims The association between clinical symptoms, gastric emptying, quality of life and sleep disorders in distinct functional dyspepsia (FD) patients has not been studied yet in detail. Methods We enrolled 79 FD patients (postprandial distress syndrome [PDS], n = 65; epigastric pain syndrome [EPS], n = 47; EPS-PDS overlap, n = 33) and 44 healthy volunteers. Gastric motility was evaluated. We used Rome III criteria to evaluate clinical symptoms and State-Trait Anxiety Inventory (STAI) scores to determine anxiety status. Sleep disorder was evaluated using the Pittsburgh Sleep Quality Index scores. Results There were no significant differences in age, sex and Helicobacter pylori positivity between FD subtypes and healthy volunteers. The scores of Glasgow dyspepsia severity scores (GDSS), SF-8 and Pittsburgh Sleep Quality Index (PSQI) in distinct subtypes of FD patients were significantly different from those in healthy volunteers. However, there were not significant differences in these scores, Tmax and T1/2 among 3 subtypes of FD patients. PSQI score was significantly (P = 0.027, P = 0.002 and P = 0.039, respectively) associated with GDSS among EPS, PDS and EPS-PDS overlap patients. In addition, 8-item short form health survey (SF-8; Physical Component Score and Mental Component Score) was significantly associated with global PSQI score in PDS and EPS-PDS overlap patients. In contrast, SF-8 (Mental Component Score) only was significantly linked to global PSQI score in EPS patients. Conclusions Prevalences for sleep disorders, gastric motility and quality of life in 3 subtypes of FD patients were similar levels. In PDS and EPS-PDS overlap patients, SF-8 was significantly associated with global PSQI score. PMID:24466451

Relationship Between Sleep Quality and Spiritual Well-Being/Religious Activities in Muslim Women with Breast Cancer.

PubMed

Khoramirad, Ashraf; Mousavi, Maryam; Dadkhahtehrani, Tahmineh; Pourmarzi, Davoud

2015-12-01

For determining relationship between quality of sleep and spiritual well-being/religious activities in Muslim women with breast cancer (WBC), we conducted a cross-sectional study on 80 WBC who presented at all chemotherapy clinics in Qom, Iran, in 2012. We used Pittsburgh Sleep Quality Index (PSQI), spiritual well-being scale (SWBS), and religious activities (RA) questionnaire. Global PSQI score and its seven components score were not significantly correlated with total score of SWBS and its two subscales. Global PSQI score was not significantly correlated with total score of RA questionnaire (P = 0.278), but its "sleep latency" (r = 0.235, P = 0.044) and "use of sleep medications" (r = 0.237, P = 0.040) components were significantly correlated with total score of RA. Global PSQI was significantly correlated with "I don't get much personal strength and support from my God," "I believe there is some real purpose for my life" questions in SWBS, and "Attendance in mosque or religious places" subscale of RA.

Association between work role stressors and sleep quality.

PubMed

Iwasaki, S; Deguchi, Y; Inoue, K

2018-05-17

Work-related stressors are associated with low sleep quality. However, few studies have reported an association between role stressors and sleep quality. To elucidate the association between role stressors (including role conflict and ambiguity) and sleep quality. Cross-sectional study of daytime workers whose sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Work-related stressors, including role stressors, were assessed using the Generic Job Stress Questionnaire (GJSQ). The association between sleep quality and work-related stressors was investigated by logistic regression analysis. A total of 243 participants completed questionnaires were received (response rate 71%); 86 participants reported poor sleep quality, based on a global PSQI score ≥6. Multivariable logistic regression analysis revealed that higher role ambiguity was associated with global PSQI scores ≥6, and that role conflict was significantly associated with sleep problems, including sleep disturbance and daytime dysfunction. These results suggest that high role stress is associated with low sleep quality, and that this association should be considered an important determinant of the health of workers.

Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia.

PubMed

Reid, Kathryn J; Baron, Kelly Glazer; Lu, Brandon; Naylor, Erik; Wolfe, Lisa; Zee, Phyllis C

2010-10-01

To assess the efficacy of moderate aerobic physical activity with sleep hygiene education to improve sleep, mood and quality of life in older adults with chronic insomnia. Seventeen sedentary adults aged >or=55 years with insomnia (mean age 61.6 [SD±4.3] years; 16 female) participated in a randomized controlled trial comparing 16 weeks of aerobic physical activity plus sleep hygiene to non-physical activity plus sleep hygiene. Eligibility included primary insomnia for at least 3 months, habitual sleep duration <6.5h and a Pittsburgh Sleep Quality Index (PSQI) score >5. Outcomes included sleep quality, mood and quality of life questionnaires (PSQI, Epworth Sleepiness Scale [ESS], Short-form 36 [SF-36], Center for Epidemiological Studies Depression Scale [CES-D]). The physical activity group improved in sleep quality on the global PSQI (p<.0001), sleep latency (p=.049), sleep duration (p=.04), daytime dysfunction (p=.027), and sleep efficiency (p=.036) PSQI sub-scores compared to the control group. The physical activity group also had reductions in depressive symptoms (p=.044), daytime sleepiness (p=.02) and improvements in vitality (p=.017) compared to baseline scores. Aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life in older adults with chronic insomnia.

Association between elder abuse and poor sleep: A cross-sectional study among rural older Malaysians.

PubMed

Yunus, Raudah Mohd; Wazid, Syeda Wasfeea; Hairi, Noran N; Choo, Wan Yuen; Hairi, Farizah M; Sooryanarayana, Rajini; Ahmad, Sharifah N; Razak, Inayah A; Peramalah, Devi; Aziz, Suriyati A; Mohamad, Zaiton L; Mohamad, Rosmala; Ali, Zainudin M; Bulgiba, Awang

2017-01-01

To examine the association between elder abuse and poor sleep using a Malay validated version of Pittsburgh Sleep Quality Index (PSQI). This study was divided into two phases. Phase I tested the construct validity and reliability of the Malay version of PSQI. Phase II was a population-based, cross-sectional study with a multi-stage cluster sampling method. Home-based interviews were conducted by trained personnel using a structured questionnaire, to determine exposure and outcome. Kuala Pilah, a district in Negeri Sembilan which is one of the fourteen states in Malaysia. 1648 community-dwelling older Malaysians. The Malay version of PSQI had significant test re-test reliability with intra-class correlation coefficients of 0.62. Confirmatory factor analyses revealed that one factor PSQI scale with three components (subjective sleep quality, sleep latency, and sleep disturbances) was most suitable. Cronbach's Alpha was 0.60 and composite reliability was 0.63. PSQI scores were highest among neglect (4.11), followed by physical (4.10), psychological (3.96) and financial abuse (3.60). There was a dose-response relationship between clustering of abuse and PSQI scores; 3.41, 3.50 and 3.84 for "no abuse", "1 type of abuse" and "2 types or more". Generalized linear models revealed six variables as significant determinants of sleep quality-abuse, co-morbidities, self-rated health, income, social support and gait speed. Among abuse subtypes, only neglect was significantly associated with poor sleep. The Malay PSQI was valid and reliable. Abuse was significantly associated with poor sleep. As sleep is essential for health and is a good predictor for mortality among older adults, management of abuse victims should entail sleep assessment. Interventions or treatment modalities which focus on improving sleep quality among abuse victims should be designed.

Impact of shift work on sleep and daytime performance among health care professionals.

PubMed

Alshahrani, Sultan M; Baqays, Abdulsalam A; Alenazi, Abdelelah A; AlAngari, Abdulaziz M; AlHadi, Ahmad N

2017-08-01

To evaluate sleep quality and daytime sleepiness in health care professionals who are performing shift work. Methods: This cross-sectional study was conducted on 510 health care professionals at Prince Sultan Military Medical City and King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia between December 2015 and April 2016. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Participants were divided into 2 groups: shift workers and non-shift workers. Results: We compared both groups regarding the effect of shift work on the total score of PSQI and ESS. We found that the PSQI global score (p less than 0.001) and the total ESS score (p=0.003) were significantly higher in shift work health care professionals.  Conclusion: Shift work among health care professionals is associated with poor sleep quality but not excessive daytime sleepiness. Health care professionals performing shift work have PSQI and ESS scores slightly higher than non-shift work health professionals.

Caffeine Consumption and Sleep Quality in Australian Adults

PubMed Central

Watson, Emily J.; Coates, Alison M.; Kohler, Mark; Banks, Siobhan

2016-01-01

Caffeine is commonly consumed to help offset fatigue, however, it can have several negative effects on sleep quality and quantity. The aim of this study was to determine the relationship between caffeine consumption and sleep quality in adults using a newly validated caffeine food frequency questionnaire (C-FFQ). In this cross sectional study, 80 adults (M ± SD: 38.9 ± 19.3 years) attended the University of South Australia to complete a C-FFQ and the Pittsburgh Sleep Quality Index (PSQI). Caffeine consumption remained stable across age groups while the source of caffeine varied. Higher total caffeine consumption was associated with decreased time in bed, as an estimate of sleep time (r = −0.229, p = 0.041), but other PSQI variables were not. Participants who reported poor sleep (PSQI global score ≥ 5) consumed 192.1 ± 122.5 mg (M ± SD) of caffeine which was significantly more than those who reported good sleep quality (PSQI global score < 5; 125.2 ± 62.6 mg; p = 0.008). The C-FFQ was found to be a quick but detailed way to collect population based caffeine consumption data. The data suggests that shorter sleep is associated with greater caffeine consumption, and that consumption is greater in adults with reduced sleep quality. PMID:27527212

Self-Reported Perceptions of Sleep Quality and Resilience Among Dance Students.

PubMed

Arbinaga, F

2018-04-01

This study examined relationships between self-perceived sleep quality and resilience among 116 dance students (Mean age = 21.6 years; SD = 4.348). who self-reported sleep quality with the Pittsburgh Sleep Quality Index (PSQI) and personal resilience with the Resilience Scale (RS). Most participants (59.5%) reported poor sleep quality on the PSQI, with 62.9% of the women and 42.1% of the men ( p = .092) scoring higher than five points on this instrument. On the RS, a large majority of the participants (75%) obtained scores less than 147, indicating low resilience, with no significant gender differences observed. Those reporting poor sleep quality (PSQI scores > 5) obtained lower resilience scores (RS < 147) than those reporting good sleep quality (PSQI scores ≤ 5; p = .025), and participants with poorer sleep quality were at higher risk of low resilience (Odds Ratio = 3.273) relative to those with good sleep quality ( p = .006). Those with shorter duration sleep (claiming they slept <7 hours/night) were also at higher risk for low resilience (Odds Ratio = 3.266), relative to those with longer duration sleep (>7 hours/night). These findings can help students and dance professionals improve their performance and face pressures inherent in dance practice. Follow-up research should verify these findings in varied populations with objective sleep measures and observational data from multiple respondents.

Associations between subjective sleep quality and brain volume in Gulf War veterans.

PubMed

Chao, Linda L; Mohlenhoff, Brian S; Weiner, Michael W; Neylan, Thomas C

2014-03-01

To investigate whether subjective sleep quality is associated with brain volume independent of comorbid psychiatric conditions. Cross-sectional. Department of Veterans Affairs (VA) Medical Center. One hundred forty-four Gulf War Veterans (mean age 45 years; range: 31-70 years; 14% female). None. Total cortical, lobar gray matter, and hippocampal volumes were quantified from 1.5 Tesla magnetic resonance images using Freesurfer version 4.5. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Multiple linear regressions were used to determine the association of sleep quality with total and regional brain volumes. The global PSQI score was positively correlated with lifetime and current posttraumatic stress disorder (PTSD) and current depressive symptoms (P < 0.001) and was higher in veterans with Gulf War Illness, trauma exposure, and those using psychotropic medication (P ≤ 0.03). After adjusting for these comorbid variables, age, intracranial volume, and multiple comparisons, global PSQI was inversely associated with total cortical and frontal gray matter volume (adjusted P ≤ 0.03). Within the frontal lobe, total PSQI was inversely associated with the superior and middle frontal, orbitofrontal, anterior cingulate, and frontal pole volumes (adjusted P ≤ 0.02). Examination of the 3-factor structure of the PSQI revealed that the associations were driven by perceived sleep quality. Poorer subjective sleep quality was associated with reduced total cortical and regional frontal lobe volumes independent of comorbid psychiatric conditions. Future work will be needed to examine if effective treatment of disturbed sleep leads to improved structural and functional integrity of the frontal lobes.

Sleep Disturbance in Psoriatic Disease: Prevalence and Associated Factors.

PubMed

Wong, Ian T Y; Chandran, Vinod; Li, Suzanne; Gladman, Dafna D

2017-09-01

We aimed to determine the prevalence and quality of sleep in patients with psoriatic arthritis (PsA) and those with psoriasis without PsA (PsC) followed in the same center, to identify factors associated with sleep disturbance, and to compare findings to those of healthy controls (HC). The study included 113 PsA [ClASsification for Psoriatic ARthritis (CASPAR) criteria] and 62 PsC (PsA excluded by a rheumatologist) patients and 52 HC. Clinical variables were collected using a standard protocol. The sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Other patient-reported outcomes collected included the Health Assessment Questionnaire (HAQ), Dermatology Life Quality Index, EQ-5D, Medical Outcomes Study Short Form-36 survey, patient's global assessment, and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) scale. Statistical analyses included descriptive statistics, Wilcoxon rank-sum test, and linear regression. The prevalence of poor sleep quality was 84%, 69%, and 50% in PsA, PsC, and HC, respectively. Total PSQI score was higher in both patients with PsA and patients with PsC compared with HC (p < 0.01) and higher in patients with PsA compared to patients with PsC (p < 0.0001). EQ-5D anxiety component, EQ-5D final, and FACIT-fatigue were independently associated with worse PSQI in patients with PsC and those with PsA (p < 0.05). Actively inflamed (tender or swollen) joints are independently associated with worse PSQI in patients with PsA (p < 0.01). Patients with psoriatic disease have poor sleep quality. Poor sleep is associated with fatigue, anxiety, and lower EQ-5D. In patients with PsA, poor sleep is associated with active joint inflammation.

The relationship of sleep problems to life quality and depression

PubMed Central

Sarıarslan, Hacı A.; Gulhan, Yıldırım B.; Unalan, Demet; Basturk, Mustafa; Delibas, Senol

2015-01-01

Objective: To identify the level of depression, the level of life quality, and the relationship between these, in patients applying to sleep centers for various sleep problems. Methods: This cross-sectional study included 229 patients who applied for polysomnography at sleeping centers under supervision of the Neurology and Chest Diseases Clinics of Kayseri Education and Research Hospital, Kayseri, Turkey between June and August 2013. The data collection tools were a socio-demographical data form, Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life Scale (WHOQOL-BREF). For statistical analyses, the Student t-test, Kruskal-Wallis-variant analysis, and chi-square tests were used. Significance level was considered as p<0.05. Results: In our study, patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom were observed to have significantly poorer sleep quality. While patients with any chronic disease had significantly higher scores for total PSQI and depression, their physical, mental, and social WHOQOL-BREF scores were significantly lower. The PSQI total scores, and depression scores of the smoking patients were significantly higher for physical, mental, and social WHOQOL-BREF fields. There was a positive correlation between PSQI scores and BDI scores while there was a negative correlation among BDI, PSQI, and WHOQOL-BREF life quality sub-scale scores. Conclusions: Sleep quality was significantly poorer in patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom. There was a significantly negative correlation among depression, sleep quality, and life quality, while there was a significantly positive correlation between life quality and depression. PMID:26166591

Sleep quality and correlates of poor sleep in patients with rheumatoid arthritis.

PubMed

Løppenthin, K; Esbensen, B A; Jennum, P; Østergaard, M; Tolver, A; Thomsen, T; Midtgaard, J

2015-12-01

The objective of this study is to examine sleep quality and correlates of poor sleep in patients with rheumatoid arthritis (RA). Five hundred patients with RA were recruited from a rheumatology outpatient clinic and included in this cross-sectional study. Sleep quality and disturbances were assessed using the Pittsburgh Sleep Quality Index (PSQI). Other instruments included the Multidimensional Fatigue Inventory, the Epworth Sleepiness Scale, and the Health Assessment Questionnaire. Disease activity was assessed according to disease activity score DAS28-CRP-based. Complete scores on PSQI were obtained from 384 patients (77 %). In those, the prevalence of poor sleep (PSQI >5) was 61 %, and the mean global PSQI score was 7.54 (SD 4.17). A linear association was found between poor sleep and mental fatigue, reduced activity related to fatigue, physical fatigue, and general fatigue. Mental fatigue and general fatigue were independently associated with sleep quality, sleep latency, sleep duration, sleep efficiency, and daytime dysfunction. However, in the linear multivariate analysis, only general fatigue 1.06 (95 % CI 1.03-1.09) and mental fatigue 1.03 (95 % CI 1.01-1.05) were found to be significant correlates for reporting poor sleep. This study shows that a majority of patients with RA experience poor sleep and that general fatigue and mental fatigue are associated with poor sleep.

Genetic and Environmental Influences on Sleep Quality in Middle-Aged Men: A Twin Study

PubMed Central

Genderson, Margo R.; Rana, Brinda K.; Panizzon, Matthew S.; Grant, Michael D.; Toomey, Rosemary; Jacobson, Kristen C.; Xian, Hong; Cronin-Golomb, Alice; Franz, Carol E.; Kremen, William S.; Lyons, Michael J.

2013-01-01

SUMMARY Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (VETSA)(mean age=55.4 years; range 51–60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 (SD=3.6; range 0–20). Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep—a dichotomous measure based on the cut-off of global PSQI>5--was 31% with no contribution of the common environment. Heritability of six of the seven PSQI component scores (Subjective Sleep Quality, Sleep Latency, Sleep Duration, Habitual Sleep Efficiency, Sleep Disturbances, and Daytime Dysfunction) ranged from .15 to .31, where as no genetic influences contributed to Use of Sleeping Medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step toward examination of the genetic relationship between sleep and other facets of aging. PMID:23509903

Menopause is associated with self-reported poor sleep quality in women without vasomotor symptoms.

PubMed

Hung, Hao-Chang; Lu, Feng-Hwa; Ou, Horng-Yih; Wu, Jin-Shang; Yang, Yi-Ching; Chang, Chih-Jen

2014-08-01

The aim of this study was to investigate the relationship between menopause and self-reported sleep quality in Chinese women without vasomotor symptoms. Cross-sectional data were collected from a decoded database of the National Cheng Kung University Hospital. Menopause was defined as absence of menses for at least 12 months or a history of hysterectomy and oophorectomy. Self-reported sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A higher global PSQI score indicates poorer self-reported sleep quality, and a global PSQI score greater than 5 differentiates poor sleepers from good sleepers. Of the 1,088 women recruited, 353 (32.4%) were in postmenopause status. Postmenopausal women had higher mean (SD) global PSQI scores (8.0 [3.3] vs. 6.1 [2.2], P < 0.001) and a greater prevalence of poor sleepers (73.1% vs. 60.8%, P < 0.001) compared with premenopausal women. Multivariate linear regression analysis showed that menopause (β = 1.532; 95% CI, 1.135 to 1.949; P < 0.001) and snoring (β = 0.764; 95% CI, 0.299 to 1.228; P = 0.001) were positively associated with global PSQI scores, whereas long sleep duration (β = -0.791; 95% CI, -1.113 to -0.468; P < 0.001) was negatively associated with global PSQI scores. Multivariate logistic regression analyses showed that menopause (odds ratio, 1.453; 95% CI, 1.030 to 2.051; P < 0.05), long sleep duration (odds ratio, 0.545; 95% CI, 0.418 to 0.710; P < 0.001), and snoring (odds ratio, 2.022; 95% CI, 1.312 to 3.116; P = 0.001) were independent predictors of poor sleepers. Postmenopausal women without vasomotor symptoms have significantly higher global PSQI scores and a higher risk of being poor sleepers than premenopausal women. In addition, menopause and snoring are associated with an increased risk of poor self-reported sleep quality independently of cardiometabolic factors and lifestyle, whereas long sleep duration is associated with a decreased risk of poor self-reported sleep quality.

Sleep disorders in patients with multiple sclerosis.

PubMed

Čarnická, Zuzana; Kollár, Branislav; Šiarnik, Pavel; Krížová, Lucia; Klobučníková, Katarína; Turčáni, Peter

2015-04-15

Poor sleep is a frequent symptom in patients with multiple sclerosis (MS). The objective of the study was to assess the relationship between nocturnal polysomnographic (PSG) findings and quality of sleep, fatigue, and increased daytime sleepiness among patients with MS. Clinical characteristics were collected. Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), and International Restless Legs Syndrome Rating Scale were used to assess quality of sleep, fatigue, excessive daytime sleepiness, and the presence of restless legs syndrome (RLS). All patients underwent nocturnal diagnostic PSG examination. Fifty patients with MS were enrolled into the study. Age was the only independent variable significantly determining apnea-hypopnea index and desaturation index (DI) (beta = 0.369, p = 0.010, beta 0.301, p = 0.040). PSQI and ESS score were significantly higher in a population with RLS (p = 0.004, p = 0.011). FSS significantly correlated with DI (r = 0.400, p = 0.048). Presence of RLS was the only independent variable significantly determining PSQI and ESS (p = 0.005, p = 0.025). DI and presence of RLS were independent variables determining FSS (p = 0.015, p = 0.024). Presence of RLS seems to be the main factor determining poor sleep, fatigue, and daytime somnolence. Sleep disordered breathing and its severity influences only fatigue in patients with MS. © 2015 American Academy of Sleep Medicine.

[Sleep quality in an adult population exposed to the noise of El Dorado Airport, Bogotá, 2012].

PubMed

Callejas, Lina María; Sarmiento, Rodrigo; Medina, Katalina; Sepúlveda, Henry; Deluque, Dayana; Escobar-Córdoba, Franklin E

2015-08-01

The airport of Bogotá lies within the city and its expansion could produce an increase in adverse effects on the health of the inhabitants of Fontibón and Engativá districts due to the noise it generates. To determine the prevalence of sleep disturbances and associated factors among residents of Fontibón exposed to this noise. A cross-sectional study design was used, involving a sample of 205 people aged 18 to 65, selected by means of stratified random sampling. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Descriptive statistics were carried out, as well as correlation tests between the different scales. A total of 60% of the residents reported poor quality sleep (PSQI>5), with a mean PSQI of 7.19 (SD=3.931), and the following pathological interruptions were found: subjective sleep quality, 27%; sleep latency, 39%; sleep duration, 33%; habitual sleep efficiency, 37%; sleep alterations, 30%; diurnal dysfunction, 40%, and use of sleeping medication, 5%. According to the Epworth Sleepiness Scale (ESS>10), 28% of residents reported daytime somnolence. Regarding the prevalence of poor quality sleep according to the Pittsburgh Sleep Quality Index, 17% of those who reported not being able to sleep because of noise associated this with air traffic. A correlation was observed between the index and the scale ( r =0.329, CI 95%: 0.20-0.44). Inhabitants of the district reported poor sleep quality due to exposure to noise, airport operations being one of the main generating sources. Noise mitigation strategies in the district need to be reviewed and the public health implications of the El Dorado Airport expansion should be considered.

Assessment of sleep quality in benign paroxysmal positional vertigo recurrence.

PubMed

Wang, Yun; Fei Xia, Fei; Wang, Wei; Hu, Wenli

2018-06-08

Despite the availability of highly effective treatments, there is a significant recurrence rate of benign paroxysmal positional vertigo (BPPV). This study is aimed to quantitatively measure sleep quality in BPPV patients and correlate it with the recurrence of BPPV. In this longitudinal cohort study, the clinical records of 67 elderly or middle-aged adult patients who were diagnosed with BPPV at Neurology Clinic, Beijing Chaoyang Hospital affiliated to Capital Medical University between 2013 and 2014. The "Recurrent" and "Non-recurrent" BPPV were respectively defined. Primary data collection included the medical history, blood test and Pittsburgh sleep quality index measurement. Among the total 67 patients after successful treatment, recurrent BPPV is observed in 37.31% patients (n = 25) within 2 years. Among all 11 variables analyzed between recurrent and non-recurrent groups, only the Pittsburgh Sleep Quality Index (PSQI) scores showed significant difference (P < 0.001). In details, these differences were also measured in five individual sleep items, including the subjective assessment of sleep quality, sleep latency, sleep duration, the use of sleep-aid medication and daytime dysfunctions (all P < 0.05). Regression analysis showed patients with higher PSQI score (lower sleep quality) had higher risk of BPPV recurrence (OR = 1.17, 95% CI: 1.04-1.32, P= 0.0082). The sleep quality in patients with BPPV recurrence is significantly poorer compared to non-recurrent patients. Our result suggested sleep quality as measured by PSQI is an independent risk factor of BPPV recurrence.

Sleep Quality in University Students with Premenstrual Dysphoric Disorder

PubMed Central

KHAZAIE, Habibolah; GHADAMI, Mohammad Rasoul; KHALEDI-PAVEH, Behnam; CHEHRI, Azita; NASOURI, Marzieh

2016-01-01

Background Up to 8% of women in their reproductive years are affected by Premenstral Dysphoric Disorder (PMDD). Sleep disturbances such as insomnia or hypersomnia are one of the DSM-IV-TR’s defining criteria for the diagnosis of PMDD and are found in about 70% of women with the disorder. However, studies are lacking that specifically address the effects of PMDD on quality of sleep. Aim This study was designed to evaluate the prevalence of Premenstrual DysphoricDisorder (PMDD) and its impact on sleep quality in female university students. Methods We developed an 18-item PMDD scale based on The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to diagnose PMDD in female university studentswho ranged in age from 18 to 30 years and had regular menstrual cycles.Participants were categorized into a PMDD group or a No/PMDD group and sleep quality was compared between the two groups. The evaluation tool used to measure sleep quality was the Pittsburgh Sleep Quality Index (PSQI). Results The prevalence of PMDD in female universitystudents was 25.5%. Analysis of the PSQI demonstrated that 80.5% of those in PMDD group had a PSQI that scored >5; however, only 56.4% in the No/PMDD grouphad a PSQI that scored >5 (χ2=12.459, p<0.001). The mean PSQI score was 8.2(3.4) in the PMDD group and was 6.5(3.1) in the No/PMDD group (t=3.648, p<0.001). Conclusions Female university students who experience PMDD are deeply affected by sleep problems. Lower sleep quality, daytime dysfunction, and sleep disturbance are common sleep problems among female university students with PMDD. PMID:28638182

Quality of sleep and health-related quality of life in renal transplant recipients.

PubMed

Liu, Hong-Xia; Lin, Jun; Lin, Xiao-Hong; Wallace, Linda; Teng, Sha; Zhang, Shu-Ping; Hao, Yu-Fang

2015-01-01

The purpose of this study was to examine the sleep quality and health-related quality of life (HRQOL) in patients after renal transplantation and to explore the relationship between the quality of sleep and the HRQOL. Sleep disorders are still an important clinical problem after renal transplantation. Previous studies mainly focused on patients' sleep quality before kidney transplant. More studies are needed to document sleep quality after renal transplantation. A cross-sectional design was used in this study. A convenience sample of renal transplant recipients was recruited at an outpatient transplant clinic of a general hospital in Beijing, China. The Pittsburgh Sleep Quality Index (PSQI) was used to measure quality of sleep. The Medical Outcomes Study 36-item Short Form (MOS SF-36) was used to measure health-related quality of life. The average PSQI score of the 204 renal transplant recipients was 5.81±3.52, significantly lower than the norm. Fifty (24.5%) recipients were classified as having poor sleep quality (global PSQI > 7). The mean scores of renal transplant recipients for SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) were 47.57±6.71 and 48.26±9.66 respectively. Compared with residents in Sichuan province, recipients' scores for SF-36 dimensions were statistically lower except the dimension of mental health. SF-36 scores of poor sleepers (PSQI > 7) were significantly lower than the good sleepers (PSQI ≤ 7) in both the MCS and PCS. Significant differences exist between the groups in physical function, bodily pain, vitality, and mental health dimensions. Sleep quality and HRQOL of patients after renal transplantation were lower than the norm. Poor sleep is associated with lower HRQOL. Health professionals need to pay attention to sleep quality and HRQOL in renal transplant recipients and take appropriate measures to improve patients' sleep quality and HRQOL.

Evaluation of sleep disorder and its effect on sexual dysfunction in patients with Fibromyalgia syndrome.

PubMed

Koca, Tuba Tülay; Karaca Acet, Günseli; Tanrıkut, Emrullah; Talu, Burcu

2016-12-01

Sexual problems are commonly seen in women with fibromyalgia syndrome (FMS). The objective of this study was to reveal the relationship between the severity of symptoms, sleep disorder, and sexual dysfunction in women with FMS. A total of 140 sexually active women with FMS aged 17-67 years who presented to our physical medicine and rehabilitation outpatient clinic between January 2016 and June 2016 were enrolled in the study. The patients' age, height, body weight, body mass index (BMI), and general pain score [visual analogue scale, (VAS)] for the last 1 week were recorded. The patients were given three different sets of questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Fibromyalgia Impact Questionnaire (FIQ), and Female Sexual Function Index (FSFI). The mean age of the patients was 40.3±8.5 years; the mean BMI was 27.1±4.4 kg/m 2 , VAS (last 1 week) was 6.9±2 cm, the mean PSQI was 24.8±10.8 (one patient with PSQI ≤5), FIQ was 65.9±19.2, and FSFI was 19.0±6.9. No significant relationship was observed between the mean PSQI and BMI values (p=0.401), whereas a significant relationship was found between the mean values of VAS, FIQ, and FSFI (p=0.03; p=0.034; p<0.001, respectively). In Pearson's correlation analysis, a positive correlation was noted between PSQI and VAS (r=0.324; p<0.001) and FIQ values (r=0.271; p=0.001). A significant relationship was found between the FIQ and VAS values (p<0.001). P less than 0.005 was considered statistically significant. Sleep disorder is regarded as the underlying cause for many signs and symptoms in FMS. Sexual dysfunction may develop in women with FMS, based on the severity of the disease and poor sleep quality. We found that sleep dysfunction was significantly related with the severity of disease, pain, and sexual disfunction. We also found a positive correlation between VAS and PSQI.

Personal Monitoring for Ambulatory Post-Traumatic Stress Disorder Assessment

DTIC Science & Technology

2009-10-01

M) ? Profile of mood states (mini-POMS) ? Impact of event scale - revised (IES-R) ? Beck anxiety inventory (BAI) ? Perceived stress scale (PSS...Pittsburgh sleep quality index (PSQI) ? Hospital anxiety and depression scale (HADS) ? Sheehan Disability Scale (SDS) 6...psychological and social measures are available for investigator selection, such as the PTSD Checklist – Military, Pittsburgh Sleep Quality Index, Beck Anxiety

Prevalence and factors associated with poor sleep quality among secondary school teachers in a developing country.

PubMed

Musa, Nor Asma; Moy, Foong Ming; Wong, Li Ping

2018-05-31

This study aimed to determine the prevalence and factors associated with poor sleep quality among secondary school teachers in the state of Selangor, Malaysia. This was a cross sectional study, conducted in two phases. Phase I tested the reliability of the Pittsburgh Sleep Quality Index in the Malay language (M-PSQI), whereas Phase II determined the prevalence and factors associated with poor sleep quality where a total of 1871 secondary school teachers were studied. Participants were recruited using multistage sampling. Self-administered questionnaire was used to collect data on socio-demographic and teaching characteristics, comorbidities and characteristics of sleep. The M-PSQI was used to measure sleep quality. The Depression Anxiety Stress Scale-21 was used to measure mental health status. Results showed that the M-PSQI had a good internal consistency and moderate reliability. The prevalence of poor sleep quality was 61 (95% CI: 54-67) %. Total teaching hours/day, depression and stress were significantly associated with poor sleep quality in the univariate analysis, while only stress (OR 1.04; 95% CI 1.02-1.05%) remained significant in the multivariate analyses. In conclusion, stress level of the secondary school teachers should be reduced to improve sleep quality.

Noninvasive ventilation in amyotrophic lateral sclerosis: effects on sleep quality and quality of life.

PubMed

Vandoorne, Eva; Vrijsen, Bart; Belge, Catharina; Testelmans, Dries; Buyse, Bertien

2016-12-01

Little is known about the effects of noninvasive ventilation (NIV) on sleep quality in amyotrophic lateral sclerosis (ALS). We aim to evaluate the long-term effects of NIV on sleep quality and quality of life in patients with ALS. In this prospective observational study, 13 ALS patients were followed for one year after initiating NIV. We evaluated sleep quality, quality of life and functional status with several questionnaires: Epworth sleepiness Scale (ESS), Pittsburg sleep quality index (PSQI), Short Form 36 Health Questionnaire (SF-36), McGill Quality of Life questionnaire (McGillQoL) and revised Amyotrophic Lateral Sclerosis Functional Rating Scale scores (ALSFRS-R). Median and interquartile range (IQR) at the start of NIV was 59 (53-65) years. The ALSFRS-R at start was 30 (24-37) (median, IQR), with three patients having severe bulbar impairment (ALSFRS-R-bulbar ≤ 9). The P a CO 2 at start of NIV treatment was 48 (43-52) mmHg (median, IQR). During the one-year follow-up period, a significant decrease in the ALSFRS-R was observed. The impact of NIV in a short term (1 month) revealed a statistically significant decrease in ESS, decrease in total PSQI and of four PSQI subscales and improvement of almost all subscales of the McGill questionnaire. Long-term analyses (9 months to 1 year) revealed that amelioration in ESS and total PSQI was sustained. We conclude that accurately titrated NIV in ALS patients can stabilize sleep quality and quality of life for at least one year, despite significant disease progression.

A history of binge drinking during adolescence is associated with poorer sleep quality in young adult Mexican Americans and American Indians.

PubMed

Ehlers, Cindy L; Wills, Derek; Gilder, David A

2018-06-01

Binge drinking during adolescence is common, and adolescents and young adults with alcohol problems may also have sleep difficulties. However, few studies have documented the effects of a history of adolescent binge drinking on sleep in young adulthood in high-risk minority populations. To quantify sleep disturbance, as indexed by the Pittsburgh Sleep Quality Index (PSQI), in a sample of young adult Mexican American and American Indian men and women (18-30 years, n = 800) with and without a history of alcohol binge drinking during adolescence, controlling for age, gender, and race. Gender was found to affect PSQI responses with females reporting waking up at night, having more bad dreams, and later habitual bedtimes than males, and males reporting more problems with breathing and snoring. Increasing age was associated with snoring or coughing, less hours spent in bed, and later evening bedtimes. Race also influenced the PSQI with American Indians reporting longer sleep latencies and sleep durations, more hours spent in bed, and more trouble with coughing and snoring than Mexican Americans, and Mexican Americans reporting later bedtimes. A history of adolescent regular binge drinking was associated with longer sleep latencies, more problems with breathing, bad dreams, and an overall higher PSQI total score, when controlling for age, race, and gender. This report suggests, like what has been found in young adults in general population samples, that binge drinking during adolescence is associated with deleterious consequences on sleep quality in young adulthood in these high-risk and understudied ethnic groups.

Sleep quality and associated factors among patients with chronic heart failure in Iran.

PubMed

Moradi, Mina; Mehrdad, Neda; Nikpour, Soghra; Haghani, Hamid; Aalaa, Maryam; Sanjari, Mahnaz; Sharifi, Farshad

2014-01-01

Sleep disorders are common among patients with chronic heart failure (HF), and it can have a significant effect on patients' daily activities as well as their health. The purpose of this study was to assess sleep quality and its predictors in Iranian patients with chronic HF. This cross-sectional study was conducted on a sample of 200 patients with HF in two hospitals of Tehran University of Medical Sciences from June to November 2009. These patients completed a demographic questionnaire, and their sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). One-way analysis of variance (ANOVA), Kruskal-Wallis test, t-test and Linear regression were used for data analysis. Seventy-nine percent of patients (n = 158) reported poor sleep quality (PSQI > 5). The range of global PSQI scores was 3-20. Also, a significant relationship was found between PSQI scores and patients' age (p<0.004), gender (p< 0.042), educational level (p< 0.001), occupational status (p< 0.038), number of hospitalizations (p< 0.005), type of referral (p< 0.001), non-cardiac diseases (p< 0.001), diuretic use (p< 0.021) and left ventricular ejection fraction (p< 0.015). Three predictors were identified using regression analyses with stepwise methods, and included age, type of referral and educational level. The high prevalence of poor sleep quality highlighted the importance of sleep disorders in HF patients. There are many factors associated with sleep quality and sleep disorders that health providers should recognize for improved and effective management.

Evaluation of latent links between irritable bowel syndrome and sleep quality

PubMed Central

Bellini, Massimo; Gemignani, Angelo; Gambaccini, Dario; Toti, Simona; Menicucci, Danilo; Stasi, Cristina; Costa, Francesco; Mumolo, Maria Gloria; Ricchiuti, Angelo; Bedini, Remo; de Bortoli, Nicola; Marchi, Santino

2011-01-01

AIM: To examine the links between quality of sleep and the severity of intestinal symptoms in irritable bowel syndrome (IBS). METHODS: One hundred and forty-two outpatients (110 female, 32 male) who met the Rome III criteria for IBS with no psychiatric comorbidity were consecutively enrolled in this study. Data on age, body mass index (BMI), and a set of life-habit variables were recorded, and IBS symptoms and sleep quality were evaluated using the questionnaires IBS Symptom Severity Score (IBS-SSS) and Pittsburgh Sleep Quality Index (PSQI). The association between severity of IBS and sleep disturbances was evaluated by comparing the global IBS-SSS and PSQI score (Pearson’s correlation and Fisher’s exact test) and then analyzing the individual items of the IBS-SSS and PSQI questionnaires by a unitary bowel-sleep model based on item response theory (IRT). RESULTS: IBS-SSS ranged from mild to severe (120-470). The global PSQI score ranged from 1 to 17 (median 5), and 60 patients were found to be poor sleepers (PSQI > 5). The correlation between the global IBS-SSS and PSQI score indicated a weak association (r = 0.2 and 95% CI: -0.03 to 0.35, P < 0.05), which becomes stronger using our unitary model. Indeed, the IBS and sleep disturbances severities, estimated as latent variables, resulted significantly high intra-subject correlation (posterior mean of r = 0.45 and 95% CI: 0.17 to 0.70, P < 0.05). Moreover, the correlations between patient features (age, sex, BMI, daily coffee and alcohol intake) and IBS and sleep disturbances were also analyzed through our unitary model. Age was a significant regressor, with patients ≤ 50 years old showing more severe bowel disturbances (posterior mean = -0.38, P < 0.05) and less severe sleep disturbances (posterior mean = 0.49, P < 0.05) than older patients. Higher daily coffee intake was correlated with a lower severity of bowel disturbances (posterior mean = -0.31, P < 0.05). Sex (female) and daily alcohol intake (modest) were correlated with less severe sleep disturbances. CONCLUSION: The unitary bowel-sleep model based on IRT revealed a strong positive correlation between the severity of IBS symptoms and sleep disturbances. PMID:22171143

Internet-based survey of factors associated with subjective feeling of insomnia, depression, and low health-related quality of life among Japanese adults with sleep difficulty.

PubMed

Aritake, Sayaka; Asaoka, Shoichi; Kagimura, Tatsuo; Shimura, Akiyoshi; Futenma, Kunihiro; Komada, Yoko; Inoue, Yuichi

2015-04-01

This study was conducted to determine what symptom components or conditions of insomnia are related to subjective feelings of insomnia, low health-related quality of life (HRQOL), or depression. Data from 7,027 Japanese adults obtained using an Internet-based questionnaire survey was analyzed to examine associations between demographic variables and each sleep difficulty symptom item on the Pittsburgh Sleep Quality Index (PSQI) with the presence/absence of subjective insomnia and scores on the Short Form-8 (SF-8) and Center for Epidemiologic Studies Depression Scale (CES-D). Prevalence of subjective insomnia was 12.2% (n = 860). Discriminant function analysis revealed that item scores for sleep quality, sleep latency, and sleep medication use on the PSQI and CES-D showed relatively high discriminant function coefficients for identifying positivity for the subjective feeling of insomnia. Among respondents with subjective insomnia, a low SF-8 physical component summary score was associated with higher age, depressive state, and PSQI items for sleep difficulty and daytime dysfunction, whereas a low SF-8 mental component summary score was associated with depressive state, PSQI sleep latency, sleeping medication use, and daytime dysfunction. Depressive state was significantly associated with sleep latency, sleeping medication use, and daytime dysfunction. Among insomnia symptom components, disturbed sleep quality and sleep onset insomnia may be specifically associated with subjective feelings of the disorder. The existence of a depressive state could be significantly associated with not only subjective insomnia but also mental and physical QOL. Our results also suggest that different components of sleep difficulty, as measured by the PSQI, might be associated with mental and physical QOL and depressive status.

Investigation on dysfunctional beliefs and attitudes about sleep in Chinese college students.

PubMed

Jin, Lairun; Zhou, Jun; Peng, Hui; Ding, Shushu; Yuan, Hui

2018-01-01

The aims of this study were to evaluate a subset of sleep-related cognitions and to examine whether dysfunctional beliefs and attitudes about sleep were associated with sleep quality in college students. A total of 1,333 college students were enrolled in this study by randomized cluster sampling. A brief version of Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16) was administered to college students at several colleges. Sleep quality was also assessed using the Pittsburgh Sleep Quality Index (PSQI). The DBAS-16 scores were analyzed across different demographic variables, corresponding subscales of 7-item PSQI, and relevant sleep behavior variables. A total of 343 participants were poor sleepers, while 990 were good sleepers, as defined by PSQI. The DBAS-16 scores were lower in poor sleepers than in good sleepers (46.32 ± 7.851 vs 49.87 ± 8.349, p < 0.001), and DBAS-16 scores were lower in females and nonmedical students when compared with those in males and medical students, respectively (48.20 ± 8.711 vs 49.73 ± 7.923, p = 0.001; 48.56 ± 8.406 vs 49.88 ± 8.208, p = 0.009, respectively). The total score for sleep quality, as measured by PSQI, was negatively correlated with the DBAS-16 total score ( r = -0.197, p < 0.01). There were significant differences in PSQI scores between individuals with attitudes and those without attitudes about sleep with respect to good sleep habits ( p < 0.001), self-relaxation ( p = 0.001), physical exercise ( p < 0.001), taking sleeping pills ( p = 0.004), and taking no action ( p < 0.001). Dysfunctional beliefs about sleep are associated with sleep quality and should be discouraged, especially for females and nonmedical college students.

The effect of cataract surgery on sleep quality: a systematic review and Meta-analysis

PubMed Central

Zheng, Ling; Wu, Xiao-Hang; Lin, Hao-Tian

2017-01-01

AIM To evaluate the effect of cataract surgery on sleep quality and to compare the difference between ultraviolet-blocking clear intraocular lens (UVB-IOL) and blue-filtering intraocular lens (BF-IOL) implantation. METHODS Electronic search was performed of PubMed, MEDLINE, Embase and the Cochrane Library up to January 2016. Studies were eligible when they evaluated the sleep quality before and after cataract surgery by Pittsburgh sleep quality index (PSQI). A random/fixed-effects Meta-analysis was used for the pooled estimate. Heterogeneity was assessed with the I2 test. RESULTS Six studies were selected from 5623 references. Cataract surgery significantly reduced the PSQI scores at postoperative 0-3mo [mean difference (MD) =-0.62, 95%CI: -1.14 to -0.11, P=0.02, I2=66%] and 3-12mo (MD=-0.32, 95%CI: -0.62 to -0.02, P=0.04, I2=0), respectively. Considering different intraocular lens (IOL) implantations, relative post-operative PSQI reduction was found for both UVB-IOL and BF-IOL, but a significant reduction was detected only for UVB-IOL. No significant difference was found with the effect of BF-IOL vs UVB-IOL on sleep quality. CONCLUSION This study found that cataract surgery significantly improved the PSQI score-derived subjective sleep quality irrespective of the IOL type implanted. These findings highlight a substantial benefit of cataract surgery on systemic health with photoreceptive restoration in addition to visual acuity improvements. PMID:29181319

Association between elder abuse and poor sleep: A cross-sectional study among rural older Malaysians

PubMed Central

Hairi, Noran N.; Choo, Wan Yuen; Hairi, Farizah M.; Sooryanarayana, Rajini; Ahmad, Sharifah N.; Razak, Inayah A.; Peramalah, Devi; Aziz, Suriyati A.; Mohamad, Zaiton L.; Mohamad, Rosmala; Ali, Zainudin M.; Awang Mahmud, Awang B.

2017-01-01

Objectives To examine the association between elder abuse and poor sleep using a Malay validated version of Pittsburgh Sleep Quality Index (PSQI). Design This study was divided into two phases. Phase I tested the construct validity and reliability of the Malay version of PSQI. Phase II was a population-based, cross-sectional study with a multi-stage cluster sampling method. Home-based interviews were conducted by trained personnel using a structured questionnaire, to determine exposure and outcome. Setting Kuala Pilah, a district in Negeri Sembilan which is one of the fourteen states in Malaysia. Participants 1648 community-dwelling older Malaysians. Results The Malay version of PSQI had significant test re-test reliability with intra-class correlation coefficients of 0.62. Confirmatory factor analyses revealed that one factor PSQI scale with three components (subjective sleep quality, sleep latency, and sleep disturbances) was most suitable. Cronbach’s Alpha was 0.60 and composite reliability was 0.63. PSQI scores were highest among neglect (4.11), followed by physical (4.10), psychological (3.96) and financial abuse (3.60). There was a dose-response relationship between clustering of abuse and PSQI scores; 3.41, 3.50 and 3.84 for “no abuse”, “1 type of abuse” and “2 types or more”. Generalized linear models revealed six variables as significant determinants of sleep quality–abuse, co-morbidities, self-rated health, income, social support and gait speed. Among abuse subtypes, only neglect was significantly associated with poor sleep. Conclusion The Malay PSQI was valid and reliable. Abuse was significantly associated with poor sleep. As sleep is essential for health and is a good predictor for mortality among older adults, management of abuse victims should entail sleep assessment. Interventions or treatment modalities which focus on improving sleep quality among abuse victims should be designed. PMID:28686603

The prevalence of poor sleep quality and its association with depression and anxiety scores in patients admitted for cardiovascular disease: A cross-sectional designed study.

PubMed

Matsuda, Risa; Kohno, Takashi; Kohsaka, Shun; Fukuoka, Ryoma; Maekawa, Yuichiro; Sano, Motoaki; Takatsuki, Seiji; Fukuda, Keiichi

2017-02-01

Poor sleep quality contributes to the development of various cardiovascular conditions. However, its real-world prevalence among cardiovascular inpatients and association with psychological disturbance is unknown. This study aimed to assess the prevalence of poor sleep quality and its association with depression and anxiety in cardiovascular patients, and explored whether sex and cardiovascular comorbidities modified these associations. A total of 1071 patients hospitalized for a broad spectrum of cardiovascular diseases at a single university hospital were assessed (790 men, mean age 64±14years). We assessed sleep quality during their index hospitalization period using the Pittsburgh Sleep Quality Index (PSQI); poor sleep quality was defined as PSQI>5. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS). The median PSQI score was 5.0 [3.0-7.0], and 461 inpatients (43%) had poor sleep quality. Multivariate regression analysis adjusting for patient background, medical risk factors, and laboratory data revealed that poor sleep quality was associated with higher HADS subscores for depression (HADS-depression; odds ratio [OR]: 1.09, 95% confidence interval [CI]: 1.03-1.15) and anxiety (HADS-anxiety; OR: 1.17, 95% CI: 1.11-1.24). Poor sleep quality was associated with markedly higher HADS-depression among women than men (p value for interaction: 0.008). The association between poor sleep quality and HADS-anxiety was more significant among patients without coronary artery diseases (p value for interaction: 0.017). Poor sleep quality was highly prevalent and associated with depression and anxiety in cardiovascular patients. These associations may be modified by sex and the presence of coronary artery diseases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Association of sleep quality in Behcet disease with disease activity, depression, and quality of life in Korean population

PubMed Central

Lee, Jimin; Kim, Sung-Soo; Jeong, Hye-Jin; Son, Chang-Nam; Kim, Ji-Min; Cho, Yong-Won; Kim, Sang-Hyon

2017-01-01

Background/Aims Sleep disturbance is prime concern in patients with Behcet disease. The purpose of this study was to find out the effects of sleep quality, in Korean patients suffering from Behcet disease. We further investigated the relationship between depression, quality of life and the clinical findings of Behcet disease. Methods The study was performed by the cross-sectional design. Sleep quality was assessed by the Korean version of Pittsburgh sleep quality index (PSQI). Disease activity of Behcet disease was evaluated by Behcet disease current activity form (BDCAF). Depression was assessed by the Korean version of Beck depression inventory second edition (BDI-2). Quality of life was assessed by the Korean version of the Leeds Behcet disease quality of life measure (BDQoL). Results Among the 100 patients studied, 42% reported poor sleep quality (PSQI ≥ 9). These patients have a higher BDI-2, total BDCAF and pain visual analogue scale (VAS) score (p < 0.001, p = 0.022, and p = 0.005). Considering BDCAF, the frequency of genital ulcer was significantly higher (p = 0.01). Behcet was higher in females. The BDQoL was lower in poor sleeper group (p = 0.004 and p < 0.001). Among 7 PSQI components, daytime dysfunction was higher in patients with high disease activity (p = 0.03). Total PSQI score were strongly correlated with BDCAF, BDI-2, BDQoL, and pain VAS score (p = 0.02, p < 0.001, p < 0.001, and p < 0.001, respectively). Conclusions Low sleep quality is directly associated with disease activity, depression, and quality of life in Korean patients with Behcet disease. PMID:28192886

Effects of low sleep quality on sexual function, in women with fibromyalgia.

PubMed

Amasyali, A S; Taştaban, E; Amasyali, S Y; Turan, Y; Kazan, E; Sari, E; Erol, B; Cengiz, M; Erol, H

2016-01-01

Sexual dysfunction is a common experience in women with fibromyalgia. However, the physiopathology of this association is unclear. We aimed to evaluate whether sleep disturbance has an influence on sexual function in women with fibromyalgia. Fifty-four sexually active premenopausal women with fibromyalgia were enrolled in the study. The following questionnaires were used: the Female Sexual Function Index (FSFI), the Pittsburgh Sleep Quality Index (PSQI), the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Depression Inventory (BDI). Appropriate statistical analyses were used by using SPSS 18. The mean FSFI score was 25.344 ± 6.52 and showed no correlation with age, body mass index, BDI or duration of fibromyalgia. However, a positive correlation between sexual dysfunction and low sleep quality was found (r=0.43; P=0.001). In addition, the median FSFI score was 29.2 (27.2-32.4) in patients with higher sleep quality (PSQI⩽5), whereas it was 21.4 (18.9-25.3) in patients with lower sleep quality (PSQI>5) (P<0.001). There was a positive correlation between sexual dysfunction and symptoms of fibromyalgia as indicated by a higher FIQ score (r=0.37; P=0.006). Sexual dysfunction in female patients with fibromyalgia may be due to low sleep quality. Treatment of the sleep disorder may improve female sexual function.

Restless Legs Syndrome and Poor Sleep Quality in Obese Children and Adolescents

PubMed

Baran, Rıza Taner; Atar, Müge; Pirgon, Özgür; Filiz, Serkan; Filiz, Meral

2018-06-01

Adult epidemiological studies suggest that the rate of Restless Legs syndrome (RLS) in the general population may range from 5% to 15%. The aim of this study was to investigate the frequency of RLS in a community sample of obese adolescents aged 10-16 years and to assess the association with sleep quality and health-related glucose metabolism markers. The study group comprised 144 obese and overweight children aged 10-16 yearsand the control group consisted of 66 age-matched healthy children. The RLS Questionnaire devised by the International RLS Study and the Pittsburgh Sleep Quality Index (PSQI), where a score >5 indicates poor sleep quality, was used to assess sleep quality. Mean body mass index (BMI) of the overweight/obese and control groups were 30.5±0.5 and 18.7±0.2, respectively. The frequency of RLS was higher in the obese group (21.7%) than the overweight (3.4%) and control (1.5%) (p<0.001) groups. The frequency of a poor PSQI score was significantly higher (p<0.001) in the obese group (37.3%) than the control group (24.2%). The obese with RLS group also had poorer sleep quality scores than the non-RLS obese group. Many symptoms of sleep disruption were more common in obese patients with RLS and RLS was independently correlated with a high PSQI score [odds ratio (OR): 2.25, confidence interval (Cl): 0.96-5.28, p<0.001)] and an increased BMI z-score (OR: 8.87, Cl: 2.04-38.61, p<0.001). RLS is common in obese children and may be associated with altered sleep quality. Obese children with RLS need to be assessed since they may need support to improve their sleep quality.

Restless Legs Syndrome and Poor Sleep Quality in Obese Children and Adolescents

PubMed Central

Baran, Rıza Taner; Atar, Müge; Pirgon, Özgür; Filiz, Serkan; Filiz, Meral

2018-01-01

Objective: Adult epidemiological studies suggest that the rate of Restless Legs syndrome (RLS) in the general population may range from 5% to 15%. The aim of this study was to investigate the frequency of RLS in a community sample of obese adolescents aged 10-16 years and to assess the association with sleep quality and health-related glucose metabolism markers. Methods: The study group comprised 144 obese and overweight children aged 10-16 yearsand the control group consisted of 66 age-matched healthy children. The RLS Questionnaire devised by the International RLS Study and the Pittsburgh Sleep Quality Index (PSQI), where a score >5 indicates poor sleep quality, was used to assess sleep quality. Results: Mean body mass index (BMI) of the overweight/obese and control groups were 30.5±0.5 and 18.7±0.2, respectively. The frequency of RLS was higher in the obese group (21.7%) than the overweight (3.4%) and control (1.5%) (p<0.001) groups. The frequency of a poor PSQI score was significantly higher (p<0.001) in the obese group (37.3%) than the control group (24.2%). The obese with RLS group also had poorer sleep quality scores than the non-RLS obese group. Many symptoms of sleep disruption were more common in obese patients with RLS and RLS was independently correlated with a high PSQI score [odds ratio (OR): 2.25, confidence interval (Cl): 0.96-5.28, p<0.001)] and an increased BMI z-score (OR: 8.87, Cl: 2.04-38.61, p<0.001). Conclusion: RLS is common in obese children and may be associated with altered sleep quality. Obese children with RLS need to be assessed since they may need support to improve their sleep quality. PMID:29175807

Genetic and environmental influences on sleep quality in middle-aged men: a twin study.

PubMed

Genderson, Margo R; Rana, Brinda K; Panizzon, Matthew S; Grant, Michael D; Toomey, Rosemary; Jacobson, Kristen C; Xian, Hong; Cronin-Golomb, Alice; Franz, Carol E; Kremen, William S; Lyons, Michael J

2013-10-01

Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (mean age = 55.4 years; range 51-60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 [SD = 3.6; range 0-20]. Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep-a dichotomous measure based on the cut-off of global PSQI>5-was 31%, with no contribution of the common environment. Heritability of six of the seven PSQI component scores (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, and daytime dysfunction) ranged from 0.15 to 0.31, whereas no genetic influences contributed to the use of sleeping medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step towards examination of the genetic relationship between sleep and other facets of aging. © 2013 European Sleep Research Society.

Sleep Quality and Fatigue Among Prehospital Providers

PubMed Central

Patterson, P. Daniel; Suffoletto, Brian P.; Kupas, Douglas F.; Weaver, Matthew D.; Hostler, David

2010-01-01

Background Fatigue is common among medical professionals and has been linked to poor performance and medical error. Objective To characterize sleep quality and its association with severe fatigue in emergency medical services (EMS) providers. Methods We studied a convenience sample of EMS providers who completed three surveys: the Pittsburgh Sleep Quality Index (PSQI), the Chalder Fatigue Questionnaire (CFQ), and a demographic survey. We used established measures to examine survey psychometrics and performed t-tests, analysis of variance (ANOVA), and chi- square tests to identify differences in PSQI and CFQ scores. Results One hundred nineteen surveys were completed. The eight-hour shift was most commonly reported (35.4%). A majority of subjects were overweight (41.9%) or obese (42.7%), and 59.6% had been diagnosed with one or more health conditions (e.g., diabetes). Results from psychometric tests were positive. The mean (± standard deviation) PSQI score was 9.2 (± 3.7). A CFQ score >4, indicating severe mental and physical fatigue, was present in 44.5% of the subjects. The mean PSQI score was higher among those reporting severe fatigue (11.3 ± 3.2) than among those not reporting fatigue (7.5 ± 3.0, p < 0.0001). Conclusions The results from this study suggest that the sleep quality and fatigue status of EMS workers are at unhealthy levels. The health and safety of the EMS worker and patient population should be considered in light of these results. PMID:20199233

Effects of estradiol and venlafaxine on insomnia symptoms and sleep quality in women with hot flashes.

PubMed

Ensrud, Kristine E; Guthrie, Katherine A; Hohensee, Chancellor; Caan, Bette; Carpenter, Janet S; Freeman, Ellen W; LaCroix, Andrea Z; Landis, Carol A; Manson, JoAnn; Newton, Katherine M; Otte, Julie; Reed, Susan D; Shifren, Jan L; Sternfeld, Barbara; Woods, Nancy F; Joffe, Hadine

2015-01-01

Determine effects of low-dose estradiol and low-dose venlafaxine on self-reported sleep measures in menopausal women with hot flashes. 3-arm double-blind randomized trial. Participants assigned in a 2:2:3 ratio to 17β estradiol 0.5 mg/day (n = 97), venlafaxine XR 75 mg/day (n = 96), or placebo (n = 146) for 8 weeks. Academic research centers. 339 community-dwelling perimenopausal and postmenopausal women with ≥2 bothersome hot flashes per day. Insomnia symptoms (Insomnia Severity Index [ISI]) and sleep quality (Pittsburgh Sleep Quality Index [PSQI]) at baseline, week 4 and 8; 325 women (96%) provided ISI data and 312 women (92%) provided PSQI data at baseline and follow-up. At baseline, mean (SD) hot flash frequency was 8.1/day (5.3), mean ISI was 11.1 (6.0), and mean PSQI was 7.5 (3.4). Mean (95% CI) change from baseline in ISI at week 8 was -4.1 points (-5.3 to -3.0) with estradiol, -5.0 points (-6.1 to -3.9) with venlafaxine, and -3.0 points (-3.8 to -2.3) with placebo (P overall treatment effect vs. placebo 0.09 for estradiol and 0.007 for venlafaxine). Mean (95% CI) change from baseline in PSQI at week 8 was -2.2 points (-2.8 to -1.6) with estradiol, -2.3 points (-2.9 to -1.6) with venlafaxine, and -1.2 points (-1.7 to -0.8) with placebo (P overall treatment effect vs. placebo 0.04 for estradiol and 0.06 for venlafaxine). Among perimenopausal and postmenopausal women with hot flashes, both low dose oral estradiol and low-dose venlafaxine compared with placebo modestly reduced insomnia symptoms and improved subjective sleep quality. NCT01418209 at www.clinicaltrials.gov. © 2014 Associated Professional Sleep Societies, LLC.

Effect of Melatonin Administration on Sleep Quality in Sulfur Mustard Exposed Patients with Sleep Disorders

PubMed Central

Mousavi, Seyyedeh Soghra; Shohrati, Majid; Vahedi, Ensieh; Abdollahpour-Alitappeh, Meghdad; Panahi, Yunes

2018-01-01

Sulfur mustard (SM) is a toxic agent that targets several tissues. It is the leading cause of persistent lung disease, progressive deterioration in lung function, and mortality among injured patients. Disturbed sleep and poor quality of sleep are common in SM-exposed patients with chronic respiratory problems. Melatonin is an alternative medication that has been widely used to treat poor sleep quality caused by several specific conditions. This study aimed to evaluate the efficacy of melatonin administration in improvement of sleep quality in SM-injured patients. In this randomized, double-blind and placebo-controlled trial study a total of 30 SM-exposed male patients were recruited. Patients received 3 mg melatonin (N = 15) or placebo (N = 15), orally in a single dose, 1 h before bedtime for 56 consecutive days. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI); daytime sleepiness was measured by Epworth Sleepiness Scale (ESS), and the risk of obstructive sleep apnea was determined by STOP-Bang questionnaire. Compared with placebo, melatonin administration significantly improved global PSQI score, particularly sleep latency (P = 0.03) and subjective sleep quality (P = 0.004). Mean of global PSQI score was declined significantly (P = 0.01) from 10.13 ± 3.44 to 6.66 ± 3.08 in melatonin group. No differences in ESS and STOP-Bang scores were observed between two groups. Melatonin was effective in improving global PSQI score and sleep latency, but not daytime sleepiness and obstructive sleep apnea in SM-exposed patients. Further long-term studies involving larger number of patients are needed before melatonin can be safely recommended for the management of sleep disturbances in these patients.

Association between stress-related sleep reactivity and cognitive processes in insomnia disorder and insomnia subgroups: preliminary results.

PubMed

Palagini, Laura; Faraguna, Ugo; Mauri, Mauro; Gronchi, Alessia; Morin, Charles M; Riemann, Dieter

2016-03-01

Stress-related sleep reactivity, sleep-related cognitions, and psychological factors play an important role in insomnia. The aim was to investigate their possible association in Insomnia Disorder, insomnia subgroups, and healthy subjects. The cross-sectional study consisted of 93 subjects who met diagnostic criteria for Insomnia Disorder according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and of 30 healthy subjects. Survey instruments included the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Ford Insomnia Response to Stress Test (FIRST), Dysfunctional Beliefs about Sleep scale (DBAS), Beck Depression Inventory (BDI), and Zung Self-Rating Anxiety Scale (SAS). Descriptive statistics, Pearson correlations, χ(2)-test, and multiple linear regression were performed. FIRST and SAS best determined the insomnia subjects vs good sleepers (FIRST χ(2) = 109.6, p <0.001, SAS χ(2) = 120.3, p <0.001). FIRST was best predicted by DBAS (p <0.001), PSQI (p <0.001), and SAS by PSQI (p <0.001), ISI (p <0.05), BDI (p <0.001). In the sleep onset subgroup FIRST was related to ISI, PSQI, and DBAS and in the combined subgroup with DBAS. In both subgroups SAS was related to PSQI, ISI, and BDI. Findings suggest potential implications: (1) among the factors that may contribute to insomnia, stress-related sleep reactivity, and psychological factors, such as anxiety symptoms, may distinguish insomnia subjects from good sleepers; (2) sleep reactivity and sleep-related cognitions seem interrelated, unhelpful beliefs may affect the stress reactivity; (3) psychological factors may influence sleep quality and the severity of insomnia; (4) these important sleep-related variables may have similar associations in insomnia subgroups; they may constitute the core factors for insomnia development and maintenance. Copyright © 2015 Elsevier B.V. All rights reserved.

Sleep Quality and Vigilance Differ Among Inpatient Nurses Based on the Unit Setting and Shift Worked.

PubMed

Surani, Salim; Hesselbacher, Sean; Guntupalli, Bharat; Surani, Sara; Subramanian, Shyam

2015-12-01

Sleepiness in nurses has been shown to impact patient care and safety. The objectives of this study are to measure sleep quality, sleepiness, fatigue, and vigilance in inpatient nurses and to assess how setting (intensive care unit versus the general floor) and shift worked (day versus night) affect these measures. Nurses from both the ICU and floor were included in the study. Participants completed questionnaires assessing self-reported sleep quality (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Stanford Sleepiness Scale and Epworth Sleepiness Scale, ESS), and fatigue (Fatigue Severity Scale, FSS). Vigilance was measured by means of the psychomotor vigilance test (PVT), before and after a 12-hour duty shift. The ESS was abnormal in 22% of all nurses, the FSS was abnormal in 33%, and the global PSQI was abnormal in 63%. More ICU nurses than floor nurses reported abnormal sleep quality (component 5) on the PSQI. Sleep medication use (PSQI component 6) was higher in night shift nurses. The FSS was greater in night shift nurses. On preshift PVT testing, day-shift nurses overall provided faster mean reaction time (RT) than night-shift nurses. ICU nurses working the day shift made more than twice as many total errors and false starts than day shift floor nurses. Floor nurses demonstrated a significant decrease from preshift to postshift in the mean of the fastest 10% RT. Our data indicate that a significant number of inpatient nurses have impaired sleep quality, excessive sleepiness, and abnormal fatigue, which may place them at a greater risk of making medical errors and harming patients; these problems are especially pronounced in night shift workers. PVT results were inconsistent, but floor and day shift nurses performed better on some tasks than ICU and night shift nurses.

Napping in college students and its relationship with nighttime sleep.

PubMed

Ye, Lichuan; Hutton Johnson, Stacy; Keane, Kathleen; Manasia, Michael; Gregas, Matt

2015-01-01

Abstract. To examine the habit of napping and its relationship with nighttime sleep in college students. Four hundred and forty undergraduate students who responded to an anonymous online survey in April 2010. Three questions were asked to determine the frequency, length, and timing of napping during the past month. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). The PSQI score significantly differed among self-reported nap-frequency (p=.047) and nap-length (p=.017) groups, with those who napped more than 3 times per week and those who napped more than 2 hours having the poorest sleep quality. Students who napped between 6 and 9 pm had shorter sleep on school nights compared with students in other nap-timing groups (p=.002). College students who are self-reported frequent, long, and late nappers may have a higher risk of poor nighttime sleep quality and more severe sleep deprivation.

Poor sleep quality is associated with increased arterial stiffness in Japanese patients with type 2 diabetes mellitus.

PubMed

Osonoi, Yusuke; Mita, Tomoya; Osonoi, Takeshi; Saito, Miyoko; Tamasawa, Atsuko; Nakayama, Shiho; Someya, Yuki; Ishida, Hidenori; Kanazawa, Akio; Gosho, Masahiko; Fujitani, Yoshio; Watada, Hirotaka

2015-06-18

While poor sleep quality can worsen cardiovascular risk factors such as glucose and lipid profiles in patients with type 2 diabetes mellitus (T2DM), the relationship between sleep quality and atherosclerosis remains largely unknown. The aim of this study was to examine this relationship. The study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. The relationships between sleep quality (assessed by the Pittsburgh Sleep Quality Index (PSQI)) and various clinical and laboratory parameters were investigated. The mean PSQI was 5.1 ± 3.0 (±SD). Patients were divided into three groups based on the total PSQI score; subjects with good sleep quality (n = 462), average sleep quality (n = 185), and poor sleep quality (n = 77). In the age/gender-adjusted model, patients with poor sleep quality tended to be obese, evening type and depressed. However, other lifestyles showed no significant trends. Alanine aminotransferase, fasting blood glucose, HbA1c, systolic blood pressure, urinary albumin excretion, and brachial-ankle pulse wave velocity (baPWV) tended to be higher in patients with poor sleep quality. High baPWV was the only parameter that correlated with poor sleep in a model adjusted for several other lifestyle factors. Our study indicates that poor sleep quality in T2DM patients correlates with increased arterial wall stiffness, a marker of atherosclerosis and a risk factor for cardiovascular diseases.

Relationship between cold pressor pain-sensitivity and sleep quality in opioid-dependent males on methadone treatment

PubMed Central

Lee, Chee Siong; Tan, Soo Choon; Mohamad, Nasir; Lee, Yeong Yeh; Ismail, Rusli

2015-01-01

Aim. Poor sleep quality due to pain has been reported among opioid-dependent male patients on methadone maintenance therapy (MMT) but objective pain data are lacking. This study aimed to investigate the rate of pain-sensitivity using cold pressor test (CPT) and the relationship between pain-sensitivity and sleep quality in this population. Methods. A total of 168 male participants were included into the study. Objective pain-tolerance was evaluated at 0 h and at 24 h after the first CPT. Malay version of the Pittsburgh Sleep Quality Index (PSQI) and the subjective opiate withdrawal scale (SOWS) questionnaires were administered to evaluate the quality of sleep and withdrawal symptoms, respectively. Results. The mean age of study participants was 37.22 (SD 6.20) years old. Mean daily methadone dose was 76.64 (SD 37.63) mg/day, mean global PSQI score was 5.47 (SD 2.74) and mean averaged SOWS score was 5.43 (SD 6.91). The averaged pain-tolerance time ranged from 7 to 300 s with a mean time of 32.16 (SE 2.72) s, slightly below the cut-off score of 37.53 s. More specifically, 78.6% (n = 132) of participants were identified as pain-sensitive (averaged pain-tolerance time ≤37.53 s), and 36 (21.4%) participants were pain-tolerant (averaged pain-tolerance time >37.53 s). The pain-sensitive group reported poorer sleep quality with mean (SD) PSQI of 5.78 (2.80) compared with the pain-tolerant group with mean (SD) PSQI of 4.31 (2.18) (p = 0.005). With analysis of covariance, pain-sensitive group was found to have higher global PSQI scores (adjusted mean 5.76, 95% CI 5.29; 6.22) than pain-tolerant participants (adjusted mean 4.42, 95% CI 3.52; 5.32) (p = 0.010). Conclusions. Majority of opioid-dependent male patients on methadone treatment are pain-sensitive with CPT. Poor sleep quality is associated with cold pressor pain-sensitivity. Pain and sleep complaints in this male population should not be overlooked. PMID:25870765

Gender and Regional Differences in Sleep Quality and Insomnia: A General Population-based Study in Hunan Province of China

PubMed Central

Tang, Jinsong; Liao, Yanhui; Kelly, Brian C.; Xie, Liqin; Xiang, Yu-Tao; Qi, Chang; Pan, Chen; Hao, Wei; Liu, Tieqiao; Zhang, Fengyu; Chen, Xiaogang

2017-01-01

Insomnia and the inability to sleep affect people’s health and well-being. However, its systematic estimates of prevalence and distribution in the general population in China are still lacking. A population-based cluster sampling survey was conducted in the rural and urban areas of Hunan, China. Subjects (n = 26,851) were sampled from the general population, with a follow-up using the Pittsburgh Sleep Quality Index (PSQI) for interview to assess quality of sleep and Insomnia (PSQI score >5). While the overall prevalence of insomnia was 26.6%, and little difference was found between males (26.3%) and females (27.0%); the mean PSQI score was 4.26 (±2.67), and significant higher in females (4.32 ± 2.70) than males (4.21 ± 2.64, p = 0.003). Individuals in the rural areas tended to report a higher PSQI score (4.45 ± 2.81) than urban residents did (4.18 ± 2.60) (p < 0.001) and the estimates of prevalence of insomnia was 29.4% in the rural areas, significant higher than 25.5% in the urban areas (p < 0.001). Multiple logistic regression analysis showed that female gender, older age, higher level of education, being unmarried, living in the rural area, cigarette smoking and alcohol drinking were associated with insomnia. Our study may provide important information for general and mental health research. PMID:28262807

Diabetic nephropathy: a strong predictor of sleep quality in hemodialysis patients.

PubMed

Edalat-Nejad, Mahnaz; Jafarian, Nahid; Yousefichaijan, Parsa

2014-07-01

Sleep complaints are common in hemodialysis (HD) patients. Sleep quality (SQ) is a predictor of quality of life and mortality risk in HD. The aim of this study was to examine factors that may have a role in SQ. In this cross-sectional analytic study, 138 end-stage renal disease patients receiving maintenance HD for >3 months were included. The Pittsburgh Sleep Quality Index (PSQI) was used to measure individual's SQ. Patients with a global PSQI score >5 were assumed as poor sleepers. Eighty-eight patients (64%) were classified as poor sleepers. Poor sleepers were older and more likely had diabetes. They had significantly higher serum ferritin and calcium levels and lower serum parathyroid hormone level (all P-values <0.05). The global PSQI score was positively correlated with age, serum calcium level and presence of diabetes as the underlying cause of renal failure. In the multi-variable binary regression model, presence of diabetes (Odds Ratio (OR) = 3.67, P = 0.008) and body pain (OR = 1.182, P = 0.014) were the significant independent predictors for poor SQ. Poor SQ was common among our HD patients, especially among diabetic cases and, therefore, there is a need to pay more attention to the care of this subgroup with regard to the diagnosis and management of sleep complaints.

Restless legs syndrome, sleep impairment, and fatigue in chronic obstructive pulmonary disease.

PubMed

Cavalcante, Antonio George Matos; de Bruin, Pedro Felipe Carvalhedo; de Bruin, Veralice Meireles Sales; Pereira, Eanes Delgado Barros; Cavalcante, Marina Medeiros; Nunes, Deuzilane Muniz; Viana, Cynthia Sampaio

2012-08-01

To investigate the frequency of factors associated with restless legs syndrome (RLS) in patients with chronic obstructive pulmonary disease (COPD). RLS diagnosis was investigated (International RLS Study Group, IRLSSG) and severity was assessed (IRLS rating scale) in 104 consecutive COPD patients (age 69.1±8). Other measures were dyspnea severity (Modified Medical Research Council, MMRC), sleep quality (Pittsburgh Sleep Quality Index, PSQI), daytime somnolence (Epworth Sleepiness Scale, ESS), depressive symptoms (Beck Depression Inventory, BDI-II), and fatigue (Fatigue Severity Scale, FSS). Laboratory values included hemoglobin, ferritin, creatinine, and fibrinogen. Thirty-two patients (30.8%) were diagnosed with RLS (65.6% women), which was moderate/severe (IRLS >11) in 26 (81.3%). RLS symptoms started after age 40 in most patients (93.3%). RLS patients had poorer sleep quality (PSQI >5=59.6%; p=0.002), worse fatigue (FSS >27=51%; p=0.005), and more depressive symptoms (BDI-II >10=14.4%; p=0.005). Patients with RLS also presented more severe dyspnea (p=0.009) and lower creatinine levels (p=0.005). Overall, fatigue severity was correlated with older age (p=0.001); level of dyspnea was positively correlated with PSQI and FSS (p<0.005) and negatively correlated with ferritin (p=0.03) and creatinine (p=0.005), and PSQI scores correlated positively with FSS (p<0.005) and negatively with ferritin (p=0.005) and creatinine (p=0.02). Quality of sleep was independently predicted by dyspnea severity and creatinine and fatigue by age and depression. RLS is common in COPD. Patients with RLS have low creatinine, poorer quality of sleep, and more fatigue and depressive symptoms. RLS symptom severity is correlated to lower ferritin and severity of dyspnea. Copyright © 2012 Elsevier B.V. All rights reserved.

Quality of sleep and psychosocial factors for patients undergoing peritoneal dialysis.

PubMed

Yang, Ju-Yeh; Huang, Jenq-Wen; Peng, Yu-Sen; Chiang, Shou-Shang; Yang, Chwei-Shiun; Yang, Chin-Ching; Chen, Huey-Wen; Wu, Ming-Shiou; Wu, Kwan-Dun; Tsai, Tun-Jun; Chen, Wan-Yu

2007-01-01

Sleep disorders are common in end-stage renal disease patients. This study examined the relationship between self-reported quality of sleep (QoS) and certain psychosocial domains for patients on peritoneal dialysis (PD). The study subjects included 190 PD patients from 7 urban dialysis clinics in Northern Taiwan, from whom we obtained biochemical parameters and demographic data. QoS, quality of life (QoL), religious/spiritual activity, and depression were assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire, Medical Outcomes Study Short Form (SF-36) for QoL, the Royal Free Questionnaire, and the Beck Depression Inventory, respectively. The average PSQI score was 9.1 +/- 4.1 and, in total, 85.8% of all patients were poor sleepers (global PSQI > or =5). There was no difference in age, gender, and mode or duration of PD between good and poor sleepers. Biochemical data did not differ between the two groups. Widowed patients experienced significantly poorer QoS than patients with other marital status (PSQI scores: 12.3 +/- 4.9 vs 8.88 +/- 4.0, p = 0.006). The percentage of patients that held a bachelor's degree or above was significantly higher in good sleepers (55.6% vs 29.4%, p = 0.008). The PSQI value correlated negatively with the QoL scale in both physical (r = -0.295, p < 0.001) and mental domains (r = -0.410, p < 0.001), and correlated positively with the depression scale (r = 0.351, p < 0.001). There appeared to be no association between QoS and spiritual/religious activity (r = -0.097, p = 0.223). Psychosocial factors including depression, patients' perceptions regarding QoL, marital status, and educational background correlated significantly to the subjective QoS for PD patients. When dealing with sleep disorders in PD patients, physicians should pay considerable attention to their psychosocial backgrounds.

Prospective evaluation of the impact of covert hepatic encephalopathy on quality of life and sleep in cirrhotic patients.

PubMed

Labenz, C; Baron, J S; Toenges, G; Schattenberg, J M; Nagel, M; Sprinzl, M F; Nguyen-Tat, M; Zimmermann, T; Huber, Y; Marquardt, J U; Galle, P R; Wörns, M-A

2018-06-04

Minimal hepatic encephalopathy (HE) and HE grade 1 (HE1) according to the West Haven criteria have recently been grouped as one entity named-covert HE- (CHE). Data regarding the impact of CHE on health-related quality of life (HRQoL) and sleep quality are controversial. First, to determine whether CHE affects HRQoL and sleep quality of cirrhotic patients and second, whether minimal HE (MHE) and HE1 affect HRQoL and sleep quality to a comparable extent. A total of 145 consecutive cirrhotic patients were enrolled. HE1 was diagnosed clinically according to the West Haven criteria. Critical flicker frequency and the Psychometric Hepatic Encephalopathy Score were used to detect MHE. Chronic Liver Disease Questionnaire (CLDQ) was used to assess HRQoL and Pittsburgh Sleep Quality Index (PSQI) was applied to assess sleep quality. Covert HE was detected in 59 (40.7%) patients (MHE: n = 40; HE1: n = 19). Multivariate analysis identified CHE (P < 0.001) and female gender (P = 0.006) as independent predictors of reduced HRQoL (CLDQ total score). CHE (P = 0.021), low haemoglobin (P = 0.024) and female gender (P = 0.003) were identified as independent predictors of poor sleep quality (PSQI total score). Results of CLDQ and PSQI were comparable in patients with HE1 and MHE (CLDQ: 4.6 ± 0.9 vs 4.5 ± 1.2, P = 0.907; PSQI: 11.3 ± 3.8 vs 9.9 ± 5.0, P = 0.3). Covert HE was associated with impaired HRQoL and sleep quality. MHE and HE1 affected both outcomes to a comparable extent supporting the use of CHE as a clinically useful term for patients with both entities of HE in clinical practice. © 2018 John Wiley & Sons Ltd.

Magnesium (Mg) Supplementation Improves Magnesium Status And Decreases Elevated C-reactive Protein in Adults Older Than 51 Years With Poor Quality Sleep.

USDA-ARS?s Scientific Manuscript database

NHANES data indicate that two-thirds of U.S. adults consume less than the RDA for Mg. A low Mg intake or status has been associated with poor quality sleep and inflammatory stress. Thus, 100 adults (22 males and 78 females) older than 51 yr with a Pittsburgh Sleep Quality Index (PSQI) higher than 5 ...

Effect of Tai Ji Quan training on self-reported sleep quality in elderly Chinese women with knee osteoarthritis: a randomized controlled trail.

PubMed

Lü, Jiaojiao; Huang, Lingyan; Wu, Xie; Fu, Weijie; Liu, Yu

2017-05-01

The purpose of this study was to explore the effects of a 24-week Tai Ji Quan training program on sleep quality, quality of life, and physical performance among elderly Chinese women with knee osteoarthritis (OA). A 24-week randomized, controlled trial of 46 elderly women with knee OA. Participants were randomly assigned to either a Tai Ji Quan group (n = 23) or a control group (n = 23). Participants in the Tai Ji Quan group completed training sessions three times per week, while those in the control group had bi-weekly educational classes. The primary outcome was total score of the Pittsburgh Sleep Quality of Index (PSQI). Secondary outcomes were: seven subscales of the PSQI; sleep latency; total sleep time; sleep efficiency; physical component summary (PCS) and mental component summary (MCS) of the 36-item Short Form Health Survey (SF-36); Berg Balance Scale (BBS); and Timed Up and Go (TUG). Compared with the control group, participants in the Tai Ji Quan group had significantly improved primary outcome (global PSQI score, p = 0.006) and secondary outcomes, including three PSQI sub-scores (sleep latency, p = 0.031; sleep duration, p = 0.043; daytime dysfunction, p = 0.007), total sleep time (p = 0.033), and SF-36 PCS (p = 0.006). The Tai Ji Quan group also had significant improvements compared with baseline in three PSQI sub-scores (sleep latency, p = 0.031; habitual sleep efficiency, p = 0.049; sleep disturbance, p = 0.016), sleep latency (p = 0.003), BBS (p = 0.001), and TUG (p = 0.006). Tai Ji Quan training is an effective treatment approach to improve sleep quality and quality of life in elderly Chinese women with knee OA. Chinese Clinical Trial Registry (June 16, 2013): ChiCTR-TRC-13003264. Copyright © 2017 Elsevier B.V. All rights reserved.

Poor sleep quality and insufficient sleep of a collegiate student-athlete population.

PubMed

Mah, Cheri D; Kezirian, Eric J; Marcello, Brandon M; Dement, William C

2018-06-01

Poor and inadequate sleep negatively impact cognitive and physical functioning and may also affect sports performance. The study aim is to examine sleep quality, sleep duration, and daytime sleepiness in collegiate student-athletes across a wide range of sports. Questionnaire. University setting. 628 athletes across 29 varsity teams at Stanford University. Athletes completed a questionnaire inquiring about sleep quality via a modified Pittsburgh Sleep Quality Index (PSQI), sleep duration, and daytime sleepiness via Epworth Sleepiness Scale. Sleep quality on campus and while traveling for competition was rated on a 10-point scale. Collegiate athletes were classified as poor sleepers (PSQI 5.38 ± 2.45), and 42.4% of athletes experience poor sleep quality (reporting PSQI global scores >5). Athletes reported lower sleep quality on campus than when traveling for competition (7.1 vs 7.6, P< .001). Inadequate sleep was demonstrated by 39.1% of athletes that regularly obtain <7 hours of sleep on weekdays. Fifty-one percent of athletes reported high levels of daytime sleepiness with Epworth scores ≥10. Teen student-athletes in the first and second year of college reported the highest mean levels of daytime sleepiness. Greater total sleep time was associated with daytime functioning including lower frequency of difficulty waking up for practice or class (P< .001) and lower frequency of trouble staying awake during daily activities (P< .001). Collegiate athletes frequently experience poor sleep quality, regularly obtain insufficient sleep, and commonly exhibit daytime sleepiness. Copyright © 2018 National Sleep Foundation. All rights reserved.

Associations of Self-Reported Sleep Quality with Circulating Interferon Gamma-Inducible Protein 10, Interleukin 6, and High-Sensitivity C-Reactive Protein in Healthy Menopausal Women

PubMed Central

Chang, Chia-Chu; Kor, Chew-Teng; Chen, Ting-Yu; Wu, Hung-Ming

2017-01-01

Introduction Sleep disturbance is very common in menopausal women and poor sleep quality has been linked to systemic inflammation. However, the impact of poor sleep quality on health outcomes of menopausal women remains unclear. This study evaluated the relationships between sleep quality and inflammation in menopausal women. Participants and design This cross-sectional study enrolled 281 healthy women aged 45 to 60 years. The Pittsburgh Sleep Quality Index (PSQI) was used to measure quality of sleep. Multiplex assays were used to measure the levels of 9 cytokines in morning fasting plasma samples. Other variables measured in this study included clinical characteristics and high-sensitivity C-reactive protein (hs-CRP). Setting The study was performed at a medical center. Results The 281 participants comprised 79 (28%) perimenopausal women and 202 (72%) postmenopausal women. Global PSQI scores were positively correlated with plasma hs-CRP levels (P = 0.012) and were marginally associated with interferon gamma-inducible protein-10 (IP10), interleukin 6 (IL6), and macrophage inflammatory protein-1beta (MIP-1β) levels. After adjusting for age, body mass index, menopause duration, and follicle stimulating hormone, multiple linear regression analysis revealed that high PSQI scores and sleep efficiency < 65% were associated with elevated plasma levels of hs-CRP, IP10, and IL6. In addition, sleep duration < 5 hours was associated with high hs-CRP levels. Conclusion Our data show that poor sleep quality and low sleep efficiency are associated with elevated levels of circulating inflammatory factors IP10, IL6 and hs-CRP and that short sleep duration is associated with high levels of hs-CRP in menopausal women. These findings provide novel evidence that poor sleep quality is linked to low-grade systemic inflammation in menopausal women. PMID:28060925

Sleep quality and fatigue after a stress management intervention for women with early-stage breast cancer in southern Florida.

PubMed

Vargas, Sara; Antoni, Michael H; Carver, Charles S; Lechner, Suzanne C; Wohlgemuth, William; Llabre, Maria; Blomberg, Bonnie B; Glück, Stefan; DerHagopian, Robert P

2014-12-01

Sleep disruption and fatigue are ubiquitous among cancer patients and are sources of stress that may compromise treatment outcomes. Previously, we showed that a cognitive behavioral stress management (CBSM) intervention reduced anxiety and other stress-related processes in women undergoing primary treatment for breast cancer. This study examined secondary outcomes from a CBSM intervention trial for women with early-stage breast cancer to test if CBSM would improve sleep quality and fatigue among these patients at a single site in southern Florida. CBSM-related effects have already been demonstrated for indicators of psychosocial adaptation (e.g., general and cancer-related anxiety). Patients were randomized to CBSM (n= 120) or a 1-day psychoeducation control group (n= 120). The Pittsburgh Sleep Quality Index (PSQI) and Fatigue Symptom Inventory were completed prior to randomization and 6 and 12 months after the baseline assignment. In latent growth analyses, women in CBSM reported greater improvements in PSQI sleep quality scores than controls, although there were no significant differences between conditions on PSQI total scores. Women in CBSM also reported greater reductions in fatigue-related daytime interference than controls, though there were no significant differences in changes in fatigue intensity. Changes in sleep quality were associated with changes in fatigue. Future work may consider integrating sleep and fatigue content into stress management interventions for women with early-stage breast cancer.

The relationship between lifestyle regularity and subjective sleep quality

NASA Technical Reports Server (NTRS)

Monk, Timothy H.; Reynolds, Charles F 3rd; Buysse, Daniel J.; DeGrazia, Jean M.; Kupfer, David J.

2003-01-01

In previous work we have developed a diary instrument-the Social Rhythm Metric (SRM), which allows the assessment of lifestyle regularity-and a questionnaire instrument--the Pittsburgh Sleep Quality Index (PSQI), which allows the assessment of subjective sleep quality. The aim of the present study was to explore the relationship between lifestyle regularity and subjective sleep quality. Lifestyle regularity was assessed by both standard (SRM-17) and shortened (SRM-5) metrics; subjective sleep quality was assessed by the PSQI. We hypothesized that high lifestyle regularity would be conducive to better sleep. Both instruments were given to a sample of 100 healthy subjects who were studied as part of a variety of different experiments spanning a 9-yr time frame. Ages ranged from 19 to 49 yr (mean age: 31.2 yr, s.d.: 7.8 yr); there were 48 women and 52 men. SRM scores were derived from a two-week diary. The hypothesis was confirmed. There was a significant (rho = -0.4, p < 0.001) correlation between SRM (both metrics) and PSQI, indicating that subjects with higher levels of lifestyle regularity reported fewer sleep problems. This relationship was also supported by a categorical analysis, where the proportion of "poor sleepers" was doubled in the "irregular types" group as compared with the "non-irregular types" group. Thus, there appears to be an association between lifestyle regularity and good sleep, though the direction of causality remains to be tested.

Data envelopment analysis in service quality evaluation: an empirical study

NASA Astrophysics Data System (ADS)

Najafi, Seyedvahid; Saati, Saber; Tavana, Madjid

2015-09-01

Service quality is often conceptualized as the comparison between service expectations and the actual performance perceptions. It enhances customer satisfaction, decreases customer defection, and promotes customer loyalty. Substantial literature has examined the concept of service quality, its dimensions, and measurement methods. We introduce the perceived service quality index (PSQI) as a single measure for evaluating the multiple-item service quality construct based on the SERVQUAL model. A slack-based measure (SBM) of efficiency with constant inputs is used to calculate the PSQI. In addition, a non-linear programming model based on the SBM is proposed to delineate an improvement guideline and improve service quality. An empirical study is conducted to assess the applicability of the method proposed in this study. A large number of studies have used DEA as a benchmarking tool to measure service quality. These models do not propose a coherent performance evaluation construct and consequently fail to deliver improvement guidelines for improving service quality. The DEA models proposed in this study are designed to evaluate and improve service quality within a comprehensive framework and without any dependency on external data.

Influence of WeChat on sleep quality among undergraduates in Chongqing, China: a cross-sectional study.

PubMed

Xu, Xianglong; Lin, Qianyi; Zhang, Yan; Zhu, Runzhi; Sharma, Manoj; Zhao, Yong

2016-01-01

Previous studies showed that social media is associated with sleep quality. WeChat (a native social media in China) is very popular in China, especially among the youth. In the second quarter of 2016, Tencent's WeChat had 806 million monthly active users. The study sought to identify the influence of WeChat on the sleep quality among undergraduate students. A cross-sectional survey adopted a multi-stage stratified sampling survey to investigate undergraduates in Chongqing, China. Data were collected on 1979 eligible adults, aged 20.27 (SD: 1.26) years old, using Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality. Respondents aged 20.27 ± 1.26 years included 535 (27.0%) males, and 1311 (66.3%) reported as having poor sleep quality. Of the 1979 participants, 1320 (66.70%) were WeChat users. In multivariable analyses, gender, grade, nationality, living costs, the student leader, the only child, type of university, WeChat usage was associated with domains of PSQI among undergraduates ( p  < 0.05 for all). Compared with non-users, WeChat users had a lower score of subjective quality of sleep, sleep latency, use of sleeping medication, daytime dysfunction, and global PSQI score ( p  < 0.05 for all). WeChat users may have better sleep quality than non-WeChat users among undergraduates. To determine causal relationships, further longitudinal studies will be required to test for the association between WeChat users and sleep quality. This study may also provide some implications for health promotion on sleep quality of undergraduate students.

Sleep disturbance in psoriasis - a case-controlled study.

PubMed

Jensen, P; Zachariae, C; Skov, L; Zachariae, R

2018-04-28

Sleep is essential for daytime functioning and health. Given the physical symptoms of psoriasis, a higher prevalence of sleep disorders could be expected. So far, the studies examining sleep disturbance in psoriasis have been of less-than-optimal methodological quality and with mixed results. We aimed to: 1) examine the prevalence of sleep disturbance in patients with plaque psoriasis compared to controls, 2) evaluate associations with health-related quality of life (HRQoL), and 3) examine possible disease-related predictors of disturbed sleep. We used a cross-sectional, case-controlled design. Participants included 179 consecutively recruited patients with plaque psoriasis and 105 controls. Measures included psoriasis severity (Psoriasis Area and Severity index [PASI]); HRQoL (Dermatology Life Quality Index [DLQI]); insomnia severity (Insomnia Severity Index [ISI]); sleep quality (Pittsburgh Sleep Quality Index [PSQI]); stress (Perceived Stress Scale [PSS]); Itch (Itch Severity Scale [ISS]); and depressive symptoms (Beck Depression Inventory [BDI]). Analyses included group comparisons and regression analyses to identify predictors of sleep disturbance. Twenty-five per cent of patients with psoriasis reported clinical insomnia (ISI > 15), compared with 10.5% of controls. In all, 53.9% of patients with psoriasis were poor sleepers (PSQI > 5), compared with 21.9% of controls. Itch was statistically significantly associated with all sleep-related outcomes. A higher proportion of patients with psoriasis suffer from poor sleep than controls from the general population. Itch was the main predictor of impaired sleep. Improved control of psoriasis with decreased itch may improve sleep disturbance in psoriasis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Randomized Controlled Clinical Trials of Eye-acupuncture Therapy for Patients with Post-stroke Insomnia].

PubMed

Liu, Lu-Yang; Wang, Peng-Qin

2017-02-25

To observe the therapeutic effect of eye-acupuncture therapy for post-stroke insomnia. Sixty patients (45-70 years in age) with post-stroke insomnia were randomized into eye-acupuncture group and routine acupuncture (body acupuncture) group (30 cases in each). Patients of the eye-acupuncture group were treated by acupuncture stimulation of bilateral Shangjiao (Upper-energizer) and Xin (Heart) regions and those of the routine acupuncture group treated by acupuncture stimulation of Baihui (GV 20), Sishencong (EX-HN 1), Anmian (EX-HN 16), etc. After Deqi , the filiform needles were retained for 20 min, and the treatment in both groups was conducted once a day, with 15 days being one therapeutic course and 2 courses altogether. The Pittsburgh Sleep Quality Index (PSQI) including the subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and total PSQI score was used to evaluate the overall sleep quality. The clinical efficacy was assessed according to the "Guiding Principles of Clinical Trials for New Drugs of Traditional Chinese Medicine" formulated by Chinese Ministry of Health. Following the treatment, of the two 30 cases in the eye-and routine acupuncture groups, 21 and 9 experienced a marked improvement in their symptoms, 8 and 17 were effective, and 1 and 4 invalid, with the effective rate being 96.7% and 86.7%, respectively. The PSQI scores of the subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and the total PSQI score were all significantly decreased in comparison with pre-treatment in each group ( P <0.01). The therapeutic effect of the eye-acupuncture was markedly superior to those of routine acupuncture in reducing sleep latency, sleep disturbances and daytime dysfunction ( P <0.05), but without significant differences between the two groups in the effective rate, sleep quality, sleep duration, sleep efficiency and total PSQI score ( P >0.05). Both eye-acupuncture and routine acupunture are effective in the treatment of post-stroke insomnia, and the eye-acupuncture is better than routine acupuncture in reducing sleep latency, improving sleep disturbances and daytime dysfunction.

The Effects of Poor Sleep Quality on Cognitive Function of Patients with Cirrhosis

PubMed Central

Stewart, Charmaine A.; Auger, Robert; Enders, Felicity T. B.; Felmlee-Devine, Donna; Smith, Glenn E.

2014-01-01

Objectives: This study was conducted to assess the ill-defined relationship between sleep quality and multiple, specific domains of cognitive function in patients with cirrhosis. Methods: A comprehensive battery of neuropsychological tests (divided into six neurocognitive domains) and a standardized, validated measure of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) were administered to patients with cirrhosis and without evidence of overt hepatic encephalopathy, recruited from liver transplant and advanced liver disease clinics (n = 34). An inflammatory bowel disease (IBD) control group (n = 23) was similarly recruited and evaluated to control for the secondary effect of a chronic illness on cognition. PSQI global and component scores were used to predict cognitive function in each neurocognitive domain, using linear regression Results: Global PSQI scores were significantly higher (indicating poorer sleep quality) in the cirrhosis group (median [range] = 10 [1-19]) than in IBD controls = 5 (1-14); p = 0.002). After controlling for age and education, short duration of sleep was associated with impaired memory for patients with cirrhosis; the use of soporific agents was associated with poor visual-perceptual function in patients with IBD. Conclusions: Poor sleep was associated with worsening of the already impaired cognitive function of patients with cirrhosis. Citation: Stewart CA; Auger R; Enders FTB; Felmlee-Devine D; Smith GE. The effects of poor sleep quality on cognitive function of patients with cirrhosis. J Clin Sleep Med 2014;10(1):21-26. PMID:24426816

Relationships of Sleep Duration With Weight-Related Behaviors of U.S. College Students.

PubMed

Quick, Virginia; Byrd-Bredbenner, Carol; Shoff, Suzanne; White, Adrienne A; Lohse, Barbara; Horacek, Tanya; Colby, Sarah; Brown, Onikia; Kidd, Tandalayo; Greene, Geoffrey

2016-01-01

This study describes sleep behaviors of U.S. college students (N = 1,252; 18-24 years old; 59% female) and examines associations of sleep duration with weight-related behaviors. More than one quarter of participants slept < 7 hr/night and had mean Pittsburgh Sleep Quality Index (PSQI) scores indicating poor sleep quality. There were significant differences for all PSQI scales among sleep duration categories, < 7 hr (n = 344), 7-8 hr (n = 449), ≥ 8 hr (n = 459) sleep/night. Compared to those who slept ≥ 8 hr, those who slept < 8 hr had significantly more negative eating attitudes (2% higher), poorer internal regulation of food (4% lower), and greater binge eating (4% higher) scores. Findings advocate for health care professionals to evaluate sleep behaviors of college students during office visits and promote good sleep behaviors.

The effect of depression on sleep quality and the circadian rhythm of ambulatory blood pressure in older patients with hypertension.

PubMed

Ma, Lina; Li, Yun

2017-05-01

To explore the effect of depression on the sleep quality, and the circadian rhythm of ambulatory blood pressure in patients with essential hypertension. A total of 73 older patients with hypertension were screened for depression and divided into two groups. The Pittsburgh Sleep Quality Index (PSQI) and the circadian rhythm of ambulatory blood pressure were compared between the non-depressed (control) and depressed (case) group. In the case group, 24h ambulatory SBP and DBP, and nocturnal SBP and DBP were higher than in the control group, and the circadian rhythm of non-dipper was higher (67.22% vs 40.13%，P<0.01). There was a positive correlation between PSQI and depression (r=0.432, P<0.01). There was a significant correlation between sleep quality and depression in older patients with hypertension. Depression increases the circadian rhythm of non-dipper in older patients with hypertension. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sleep Hygiene and Sleep Quality of Third-Trimester Pregnant Women.

PubMed

Tsai, Shao-Yu; Lee, Chien-Nan; Wu, Wei-Wen; Landis, Carol A

2016-02-01

The purpose of this descriptive study was to examine the associations of sleep hygiene and actigraphy measures of sleep with self-reported sleep quality in 197 pregnant women in northern Taiwan. Third-trimester pregnant women completed the Sleep Hygiene Practice Scale (SHPS) and the Pittsburgh Sleep Quality Index (PSQI) as well as the Center for Epidemiologic Studies-Depression Scale (CES-D), and wore an actigraph for 7 consecutive days. Student's t-test was used to compare the SHPS scores and means as well as variability of actigraphy sleep variables between poor sleepers (i.e., PSQI global score >5) and good sleepers (i.e., PSQI global score ≤5). Compared to good sleepers, poor sleepers reported significantly worse sleep hygiene, with higher SHPS scores and higher sleep schedule, arousal-related behavior, and sleep environment subscale scores. Poor sleepers had significantly greater intra-individual variability of sleep onset latency, total nighttime sleep, and wake after sleep onset than good sleepers. In stepwise linear regression, older maternal age (p = .01), fewer employment hours per week (p = .01), higher CES-D total score (p < .01), and higher SHPS arousal-related behavior subscale scores (p < .01) predicted self-reported global sleep quality. Findings support avoiding physically, physiologically, emotionally, or cognitively arousing activities before bedtime as a target for sleep-hygiene intervention in women during pregnancy. © 2015 Wiley Periodicals, Inc.

Randomized controlled trial on the effects of a combined sleep hygiene education and behavioral approach program on sleep quality in workers with insomnia.

PubMed

Kaku, Akiko; Nishinoue, Nao; Takano, Tomoki; Eto, Risa; Kato, Noritada; Ono, Yutaka; Tanaka, Katsutoshi

2012-01-01

To evaluate the effects of a combined sleep hygiene education and behavioral approach program on sleep quality in workers with insomnia, we conducted a randomized controlled trial at a design engineering unit in Japan. Employees evaluated for insomnia by the Athens Insomnia Scale (≥6 points) were divided into an intervention and control group. The intervention group received a short-term intervention (30 min) program that included sleep hygiene education and behavioral approaches (relaxation training, stimulus control, and sleep restriction) performed by occupational health professionals. We calculated differences in change in Pittsburgh Sleep Quality Index (PSQI) scores between the two groups from baseline to three months after the start of intervention after adjusting for gender, age, job title, job category, average number of hours of overtime during the study period, marital status, smoking habit, average number of days of alcohol consumption per week, exercise habits, K6 score, and baseline PSQI score. Results showed that the average PSQI score decreased by 1.0 in the intervention group but increased by 0.9 in the control group. Additionally, the difference in variation between the two groups was 1.9 (95% confidence interval: 0.6 to 3.4), which was significant. Taken together, these results indicate that the intervention program significantly improved the sleep quality of workers with insomnia.

Heterogeneity of sleep quality in relation to circadian preferences and depressive symptomatology among major depressive patients.

PubMed

Selvi, Yavuz; Boysan, Murat; Kandeger, Ali; Uygur, Omer F; Sayin, Ayca A; Akbaba, Nursel; Koc, Basak

2018-08-01

The current study aimed at investigating the latent dimensional structure of sleep quality as indexed by the seven components of the Pittsburgh Sleep Quality Index (PSQI), as well as latent covariance structure between sleep quality, circadian preferences and depressive symptoms. Two hundred twenty-five patients with major depressive disorder (MDD), with an average age of 29.92 ± 10.49 years (aged between 17 and 63), participated in the study. The PSQI, Morningness-Eveningness Questionnaire (MEQ) and Beck Depression Inventory (BDI) were administered to participants. Four sets of latent class analyses were subsequently run to obtain optimal number of latent classes best fit to the data. Mixture models revealed that sleep quality is multifaceted in MDD. The data best fit to four-latent-class model: Poor Habitual Sleep Quality (PHSQ), Poor Subjective Sleep Quality (PSSQ), Intermediate Sleep Quality (ISQ), and Good Sleep Quality (GSQ). MDD patients classified into GSQ latent class (23.6%) reported the lowest depressive symptoms and were more prone to morningness diurnal preferences compared to other three homogenous sub-groups. Finally, the significant association between eveningness diurnal preferences and depressive symptomatology was significantly mediated by poor sleep quality. The cross-sectional nature of the study and the lack of an objective measurement of sleep such as polysomnography recordings was the most striking limitation of the study. We concluded sleep quality in relation to circadian preferences and depressive symptoms has a heterogeneous nature in MDD. Copyright © 2018. Published by Elsevier B.V.

Insular cortex metabolite changes in obstructive sleep apnea.

PubMed

Yadav, Santosh K; Kumar, Rajesh; Macey, Paul M; Woo, Mary A; Yan-Go, Frisca L; Harper, Ronald M

2014-05-01

Adults with obstructive sleep apnea (OSA) show significant autonomic and neuropsychologic deficits, which may derive from damage to insular regions that serve those functions. The aim was to assess glial and neuronal status from anterior insular metabolites in OSA versus controls, using proton magnetic resonance spectroscopy (PMRS), and thus to provide insights for neuroprotection against tissue changes, and to reduce injury consequences. Cross-sectional study. University-based medical center. Thirty-six patients with OSA, 53 controls. None. We performed PMRS in bilateral anterior insulae using a 3.0-Tesla magnetic resonance imaging scanner, calculated N-acetylaspartate/creatine (NAA/Cr), choline/creatine (Cho/Cr), myo-inositol/creatine (MI/Cr), and MI/NAA metabolite ratios, and examined daytime sleepiness (Epworth Sleepiness Scale, ESS), sleep quality (Pittsburgh Sleep Quality Index, PSQI), and neuropsychologic status (Beck Depression Inventory II [BDI-II] and Beck Anxiety Inventory [BAI]). Body mass index, BAI, BDI-II, PSQI, and ESS significantly differed between groups. NAA/ Cr ratios were significantly reduced bilaterally, and left-sided MI/Cr and MI/NAA ratios were increased in OSA over controls. Significant positive correlations emerged between left insular MI/Cr ratios and apnea-hypopnea index values, right insular Cho/Cr ratios and BDI-II and BAI scores, and negative correlations appeared between left insular NAA/Cr ratios and PSQI scores and between right-side MI/Cr ratios and baseline and nadir change in O2 saturation. Adults with obstructive sleep apnea showed bilaterally reduced N-acetylaspartate and left-side increased myo-inositol anterior insular metabolites, indicating neuronal damage and increased glial activation, respectively, which may contribute to abnormal autonomic and neuropsychologic functions in the condition. The activated glial status likely indicates increased inflammatory action that may induce more neuronal injury, and suggests separate approaches for glial and neuronal protection.

Prevalence of Insomnia and Its Psychosocial Correlates among College Students in Hong Kong

ERIC Educational Resources Information Center

Sing, C. Y.; Wong, W. S.

2010-01-01

Objective: This study examined the prevalence of insomnia and its psychosocial correlates among college students in Hong Kong. Participants: A total of 529 Hong Kong college students participated in the study. Methods: Participants completed a self-reported questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), the Revised Life…

Prevalence of poor sleep quality, sleepiness and obstructive sleep apnoea risk factors in athletes.

PubMed

Swinbourne, Richard; Gill, Nicholas; Vaile, Joanna; Smart, Daniel

2016-10-01

Despite the perceived importance of sleep for athletes, little is known regarding athlete sleep quality, their prevalence of daytime sleepiness or risk factors for obstructive sleep apnoea (OSA) such as snoring and witnessed apnoeic episodes. The purpose of the present study was to characterise normative sleep quality among highly trained team sport athletes. 175 elite or highly trained rugby sevens, rugby union and cricket athletes completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Score (ESS) and Quality of Life questionnaires and an OSA risk factor screen. On average, athletes reported 7.9 ± 1.3 h of sleep per night. The average PSQI score was 5.9 ± 2.6, and 50% of athletes were found to be poor sleepers (PSQI > 5). Daytime sleepiness was prevalent throughout the population (average global score of 8.5) and clinically significant (ESS score of ≥10) in 28% of athletes. OSA may be an important clinical consideration within athletic populations, as a considerable number of athletes (38%) defined themselves as snorers and 8% reported having a witnessed apnoeic episode. The relationship between self-rated sleep quality and actual PSQI score was strong (Pearson correlation of 0.4 ± 0.1, 90% confidence limits). These findings suggest that this cohort of team sport athletes suffer a preponderance of poor sleep quality, with associated high levels of daytime sleepiness. Athletes should receive education about how to improve sleep wake schedules, extend total sleep time and improve sleep quality.

Monitoring changes in quality of life in patients with lung cancer under treatment with chemotherapy and co administration of zoledronic acid by using specialized questionnaires.

PubMed

Tremmas, Ioannis; Petsatodis, George; Potoupnis, Michael; Laskou, Stella; Giannakidis, Dimitrios; Mantalovas, Stylianos; Koulouris, Charilaos; Katsaounis, Athanasios; Pavlidis, Efstathios; Amaniti, Aikaterini; Huang, Haidong; Bai, Chong; Shi, Dongchen; Dardas, Athanasios; Zarogoulidis, Paul; Sardeli, Chrisanthi; Konstantinou, Fotis; Katsikogiannis, Nikolaos; Zarogoulidis, Konstantinos; Karapantzos, Ilias; Karapantzou, Chrysanthi; Shen, Xiaping; Kesisoglou, Isaak; Sapalidis, Konstantinos

2018-01-01

Background: Due to the severity of the primary disease in patients with lung cancer, quality of life (QoL) is often overlooked. Factors that form QoL should be taken in consideration when planning the appropriate treatment and determining therapy targets, because of the increasing frequency of bone metastasis leading to high levels of pain. Purpose of this study is to assess quality of life in patients with lung cancer, before and after treatment combined with zoledronic acid. Methods and materials: QoL was assessed in 80 patients (49 males-31 females), of which 45 developed bone metastasis. Prior and post treatment (with co administration of zoledronic acid) seven reliable scales: Pittsburgh Sleep Quality index (PSQI), Epworth Sleeping Scale (ess), Dyspnea Scale (ds), Fatigue Severity Scale (FSS), Brief Pain Inventory (BPI), Fact-G scale for sleep quality and EQ-5D for general health condition. Results: Statistically positive correlations were verified between PSQI-DS, PSQI-FSS, BPI-ESS, DS-FSS, DS-BPI and BPI-FSS (p<0,005) prior and post treatment. Patients sleep quality was improved, pain levels decreased and betterment in quality of life was marked (p<0,001). Although significant decrease in fatigue levels was observed (p<0,001) there has been an increase in dyspnea symptoms (p<0,001). Conclusions: Significant improvement was apparent when zoledronic acid was co administered in any treatment in patients with lung cancer. Sleep quality, fatigue and pain parameters also improved, with no positive impact on the symptoms of dyspnea.

Association of sleep quality components and wake time with metabolic syndrome: The Qazvin Metabolic Diseases Study (QMDS), Iran.

PubMed

Zohal, Mohammadali; Ghorbani, Azam; Esmailzadehha, Neda; Ziaee, Amir; Mohammadi, Zahrasadat

2017-11-01

The aim of this study was to determine the association of sleep quality and sleep quantity with metabolic syndrome in Qazvin, Iran. this cross sectional study was conducted in 1079 residents of Qazvin selected by multistage cluster random sampling method in 2011. Metabolic syndrome was defined according to the criteria proposed by the national cholesterol education program third Adult treatment panel. Sleep was assessed using the Pittsburgh sleep quality index (PSQI). A logistic regression analysis was used to examine the association of sleep status and metabolic syndrome. Mean age was 40.08±10.33years. Of 1079, 578 (52.2%) were female, and 30.6% had metabolic syndrome. The total global PSQI score in the subjects with metabolic syndrome was significantly higher than subjects without metabolic syndrome (6.30±3.20 vs. 5.83±2.76, P=0.013). In logistic regression analysis, sleep disturbances was associated with 1.388 fold increased risk of metabolic syndrome after adjustment for age, gender, and body mass index. Sleep disturbances component was a predictor of metabolic syndrome in the present study. More longitudinal studies are necessary to understand the association of sleep quality and its components with metabolic syndrome. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

The SIESTA Trial: A Randomized Study Investigating the Efficacy, Safety, and Tolerability of Acupressure versus Sham Therapy for Improving Sleep Quality in Patients with End-Stage Kidney Disease on Hemodialysis

PubMed Central

Cho, Yeoungjee; Pascoe, Elaine M.; Hawley, Carmel M.; Oliver, Veronica; Frazier, Jeremy; Jarvis, Elizabeth; Tan, Ken-Soon; Liu, Xusheng; Gobe, Glenda

2017-01-01

Objectives. To compare the effectiveness of real acupressure versus sham acupressure therapy in improving sleep quality in patients receiving hemodialysis (HD) or hemodiafiltration (HDF). Methods. A multicenter, single-blind, randomized controlled trial was conducted in two Australian dialysis units located in Princess Alexandra Hospital and Logan Hospital, respectively. Forty-two subjects with self-reported poor sleep quality were randomly assigned to real (n = 21) or sham (n = 21) acupressure therapy delivered thrice weekly for four consecutive weeks during routine dialysis sessions. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) score measured at week four adjusted for baseline PSQI measurements. Secondary outcomes were quality of life (QOL) (SF-8), adverse events, and patient acceptability (treatment acceptability questionnaire, TAQ). Results. The two groups were comparable on global PSQI scores (difference 0.19, 95% confidence interval [CI] −1.32 to 1.70) and on the subscale scores. Similar results were observed for QOL both in the mental (difference −3.88, 95% CI −8.63 to 0.87) and the physical scores (difference 2.45, 95% CI −1.69 to 6.58). There were no treatment-related adverse events and acupressure was perceived favorably by participants. Conclusion. Acupressure is a safe, well-tolerated, and highly acceptable therapy in adult hemodialysis patients in a Western healthcare setting with uncertain implications for therapeutic efficacy. PMID:28316636

Sleep Quality and Fatigue After A Stress Management Intervention For Women With Early-Stage Breast Cancer in Southern Florida

PubMed Central

Vargas, Sara; Antoni, Michael H.; Carver, Charles S.; Lechner, Suzanne C.; Wohlgemuth, William; Llabre, Maria; Blomberg, Bonnie B.; Glück, Stefan; DerHagopian, Robert P.

2015-01-01

Background Sleep disruption and fatigue are ubiquitous among cancer patients and is a source of stress that may compromise treatment outcomes. Previously we showed that a cognitive behavioral stress management (CBSM) intervention reduced anxiety and other stress-related processes in women undergoing primary treatment for breast cancer. Purpose This study examined secondary outcomes from a CBSM intervention trial for women with early-stage breast cancer to test if CBSM would improve sleep quality and fatigue among these patients at a single site in Southern Florida. CBSM-related effects have already been demonstrated for indicators of psychosocial adaptation (e.g., general and cancer-related anxiety). Methods Patients were randomized to CBSM (n = 120) or a one-day psychoeducation control group (n = 120). The Pittsburgh Sleep Quality Index (PSQI) and Fatigue Symptom Inventory were completed prior to randomization and 6 and 12 months after the baseline assignment. Results In latent growth analyses, women in CBSM reported greater improvements in PSQI sleep quality scores than controls, although there were no significant differences between conditions on PSQI total scores. Women in CBSM also reported greater reductions in fatigue-related daytime interference than controls, though there were no significant differences in changes in fatigue intensity. Changes in sleep quality were associated with changes in fatigue. Conclusions Future work may consider integrating sleep and fatigue content into stress management interventions for women with early-stage breast cancer. PMID:24318654

Impact of windows and daylight exposure on overall health and sleep quality of office workers: a case-control pilot study.

PubMed

Boubekri, Mohamed; Cheung, Ivy N; Reid, Kathryn J; Wang, Chia-Hui; Zee, Phyllis C

2014-06-15

This research examined the impact of daylight exposure on the health of office workers from the perspective of subjective well-being and sleep quality as well as actigraphy measures of light exposure, activity, and sleep-wake patterns. Participants (N = 49) included 27 workers working in windowless environments and 22 comparable workers in workplaces with significantly more daylight. Windowless environment is defined as one without any windows or one where workstations were far away from windows and without any exposure to daylight. Well-being of the office workers was measured by Short Form-36 (SF-36), while sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI). In addition, a subset of participants (N = 21; 10 workers in windowless environments and 11 workers in workplaces with windows) had actigraphy recordings to measure light exposure, activity, and sleep-wake patterns. Workers in windowless environments reported poorer scores than their counterparts on two SF-36 dimensions--role limitation due to physical problems and vitality--as well as poorer overall sleep quality from the global PSQI score and the sleep disturbances component of the PSQI. Compared to the group without windows, workers with windows at the workplace had more light exposure during the workweek, a trend toward more physical activity, and longer sleep duration as measured by actigraphy. We suggest that architectural design of office environments should place more emphasis on sufficient daylight exposure of the workers in order to promote office workers' health and well-being.

The relationships between migraine, depression, anxiety, stress, and sleep disturbances.

PubMed

Yalinay Dikmen, Pinar; Yavuz, Burcu Goksan; Aydinlar, Elif Ilgaz

2015-06-01

To assess the relationships between migraine, depression, anxiety, stress, and sleep problems. Psychiatric conditions and sleep disturbances are common in migraineurs. Depression, anxiety, stress, migraine, and sleep problems frequently coexist as comorbidities. Eighty-seven episodic migraineurs (62 females, 25 males; 32.8 ± 6.9) and 41 control subjects (25 females, 16 males; 31.5 ± 5.6) were prospectively enrolled for the study. The participants completed a sociodemographic data form and a migraine disability assessment scale (MIDAS), depression, anxiety, stress scale (DASS), and Pittsburg Sleep Quality Index (PSQI). In migraineurs, a significant positive correlation was found between PSQI total scores and MIDAS scores (migraine related disability for at least three consecutive months) (r = 0. 234, p = 0.04). Only 24.1 % of migraineus (n = 21) had minimal or no disability, 75.9 % of the patients (n = 66) had more than a little disability according to MIDAS scores. PSQI total scores were also correlated with pain intensity over a three month period (MIDAS B) (r = 0.221, p = 0.04). While PSQI scores were found significantly different between migraineurs and control subjects (5.5 ± 2.9 vs 4.5 ± 2.5; p = 0.04), the correlation of all the DASS subscale scores between the groups was not statistically significant. Our findings showed that episodic migraine was a risk factor on its own for sleep disturbances without comorbid depression, anxiety, and stress. Moreover, migraine-related disability and pain intensity in migraine attacks were related to poor sleep quality.

Agreement between self-reported sleep patterns and actigraphy in fibromyalgia and healthy women.

PubMed

Segura-Jiménez, Víctor; Camiletti-Moirón, Daniel; Munguía-Izquierdo, Diego; Álvarez-Gallardo, Inmaculada C; Ruiz, Jonatan R; Ortega, Francisco B; Delgado-Fernández, Manuel

2015-01-01

To examine the agreement between objective (accelerometer) and subjective measures of sleep in fibromyalgia women (FW) and healthy women (HW). To identify explanatory variables of the discrepancies between the objective and subjective measures in FW and in HW. 127 diagnosed FW and 53 HW filled the Fibromyalgia Impact Questionnaire (FIQ) and wore the SenseWear Pro Armband (SWA) for 7 days in order to assess sleep over the last week. Participants completed the Pittsburgh Sleep Quality Index (PSQI) when the SWA was returned. The SWA showed greater total duration (74 vs. 88 min/day) and average duration (7 vs. 9 min) of wake after sleep onset in FW compared with HW. The PSQI showed poorer sleep quality in all the variables studied in FW than in HW (all, p<0.001), except time in bed. There was a lack of inter-method agreement for total sleep time, sleep time without naps and sleep latency in FW. Age and educational status explained the inter-method mean difference in sleep time in FW. High discrepancy in sleep time between the SWA and the PSQI was related to higher FIQ scores (p<0.05). The objective measure only showed higher frequency and average duration of wake after sleep onset in FW compared with HW. The agreement between the SWA and the PSQI measures of sleep were poor in the FW group. Age, educational level and the impact of fibromyalgia might be explanatory variables of the inter-method discrepancies in FW.

Association of suicidal ideation with poor sleep quality among Ethiopian adults.

PubMed

Gelaye, Bizu; Okeiga, Joseph; Ayantoye, Idris; Berhane, Hanna Y; Berhane, Yemane; Williams, Michelle A

2016-12-01

The objective of this study was to examine the extent to which poor sleep quality is associated with suicidal ideation among Ethiopian adults. A cross-sectional study was conducted among 1054 adults attending outpatient clinical facilities in Ethiopia. Standardized questionnaires were utilized to collect data on demographics, sleep quality, lifestyle, and depression status. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9), while the Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess sleep quality. Multivariate logistic regression models were fit to estimate adjusted odds ratio (AOR) and 95 % confidence intervals (95 % CI). The prevalence of suicidal ideation was 24.3 % while poor sleep quality (PSQI global score of >5 vs. ≤5) was endorsed by 60.2 % of participants. After adjustment for confounders including depression, poor sleep quality was associated with more than 3-fold increased odds of suicidal ideation (AOR = 3.59; 95 % CI 2.34-5.51). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 20 % increased odds for suicidal ideation, even after adjusting for depression (AOR = 1.20; 95 % CI 1.14-1.27). Participants with both poor sleep quality and depression had much higher odds (AOR = 23.22, 95 % CI 14.10-38.28) of suicidal ideation as compared with those who had good sleep quality and no depression although inferences from this analysis are limited due to the wide 95 % CI. Suicidal ideation and poor sleep quality are highly prevalent. Individuals with poor sleep quality have higher odds of suicidal ideation. If confirmed, mental health services need to address sleep disturbances seriously to prevent suicidal episodes.

Association of Suicidal Ideation with Poor Sleep Quality among Ethiopian Adults

PubMed Central

Gelaye, Bizu; Okeiga, Joseph; Ayantoye, Idris; Berhane, Hanna Y.; Berhane, Yemane; Williams, Michelle A.

2016-01-01

Objective To examine the extent to which poor sleep quality is associated with suicidal ideation among Ethiopian adults. Methods A cross-sectional study was conducted among 1,054 adults attending outpatient clinical facilities in Ethiopia. Standardized questionnaires were utilized to collect data on demographics, sleep quality, lifestyle, and depression status. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9), while the Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess sleep quality. Multivariate logistic regression models were fit to estimate adjusted odds ratio (AOR) and 95% confidence intervals (95%CI). Results The prevalence of suicidal ideation was 24.3% while poor sleep quality (PSQI global score of > 5vs. ≤5) was endorsed by 60.2% of participants. After adjustment for confounders including depression, poor sleep quality was associated with more than 3-fold increased odds of suicidal ideation (AOR=3.46; 95%CI 2.27–5.26). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 20% increased odds for suicidal ideation, even after adjusting for depression (AOR=1.20; 95%CI 1.14–1.27). Participants with both poor sleep quality and depression had much higher odds (AOR=24.9, 95% CI 15.2–40.8) of suicidal ideation as compared with those who had good sleep quality and no depression although inferences from this analysis are limited due to the wide 95%CI. Conclusion Suicidal ideation and poor sleep quality are highly prevalent. Individuals with poor sleep quality have higher odds of suicidal ideation. If confirmed, mental health services need to address sleep disturbances seriously to prevent suicidal episodes. PMID:27771845

Long-term Correction in Sleep Disturbance Is Sustained After Arthroscopic Rotator Cuff Repair.

PubMed

Horneff, John G; Tjoumakaris, Fotios; Wowkanech, Charles; Pepe, Matthew; Tucker, Bradford; Austin, Luke

2017-06-01

Sleep disturbance is a major complaint of patients with rotator cuff disease that often leads them to seek treatment. The authors previously reported a prospective analysis of patients who underwent rotator cuff repair and found that sleep disturbance significantly improved at 3 months after surgery. That improvement in sleep was maintained at 6 months. In the current study, the authors sought to gain medium-term data on this same population at greater than 2 years. The hypotheses were that improvement in sleep disturbance after arthroscopic rotator cuff repair is maintained at 2-year follow-up and that the continued use of narcotic pain medication has a negative effect on sleep quality at 2-year follow-up. Case series; Level of evidence, 4. The original cohort of patients was contacted at a minimum of 24 months after their surgery. Thirty-seven of the 56 patients (66%) involved in the original study were available. Patient outcomes were scored using the Pittsburgh Sleep Quality Index (PSQI), Simple Shoulder Test (SST), visual analog scale (VAS) for pain, and Single Assessment Numeric Evaluation (SANE). The newly obtained scores were compared with prior scores, which ranged from preoperatively to 6 months postoperatively. The statistically significant improvement of the PSQI score demonstrated in our prior analysis at 6 months postoperatively was maintained, with a mean PSQI score of 5.5 for the 37 patients followed beyond 24 months. Of those patients, 41% still had a PSQI score >5, indicative of sleep disturbance. However, even those patients in our study with a PSQI score >5, indicative of sleep disturbance, had an improved mean score of 9.3 at greater than 24 months compared with those patients with a PSQI score >5 at 6 months, who had a mean PSQI score of 11.5 ( P = .13). Both the SST and VAS scores displayed continued improvement at greater than 24 months, with both displaying moderate strength correlation to the PSQI score (VAS: Spearman rho = 0.479, P < .001; SST: Spearman rho = -0.505, P < .001). Regression models again demonstrated the continued use of narcotic pain medication correlating with poor sleep as the difference in the mean PSQI score between users and nonusers increased as postoperative time increased. At greater than 24 months after surgery, patients using narcotics had a mean PSQI score that was 7.4 points higher than narcotic nonusers (standard error [SE] = 1.93; P = .00017). At greater than 24 months, 41% of patients still demonstrated sleep disturbance, with both SST and VAS scores showing improvement. The prolonged use of narcotic medication negatively affects sleep, with a greater effect seen over time.

Pregabalin beneficial effects on sleep quality or health-related quality of life are poorly correlated with reduction on pain intensity after an 8-week treatment course.

PubMed

Perez-Lloret, Santiago; Rojas, Gloria Meza; Menoni, Maria Celia; Ruiz, Gabriela; Velásquez, Carolina; Rodriguez, Hernán; Rey, María Verónica; Cardinali, And Daniel P

2012-01-01

Pregabalin (PGB) has been shown to improve sleep quality and health-related quality of life (HRQoL) as well as pain intensity in patients with neuropathic pain. The objective of the study was to explore the magnitude of the correlations between changes in pain intensity, sleep quality, and HRQoL after PGB treatment. One hundred thirty-eight patients with neuropathic pain of any origin and without an adequate response to analgesics received an 8-week treatment course of PGB in an open-label fashion. Pain intensity, sleep quality, and HRQoL outcomes were evaluated at baseline and at week 8 by means of an 11-point (0-10) numerical rating scale (NRS), the Pittsburgh Sleep Quality Index (PSQI), and the EuroQol health-state visuoanalogic scale (EQ-5D VAS) score, respectively. At week 8, mean PGB dose was 166.7 ± 7.8 mg/d. Pain intensity NRS score, PSQI total score, and EQ-5D VAS score were improved by 66.5% ± 1.9%, 40.0% ± 3.6%, and 26.4% ± 4.7% (all P < 0.01), respectively. Correlations between percent change from baseline in pain NRS score and PSQI total score or EQ-5D VAS scores were r = 0.36 (P < 0.01, R = 0.11) and r = -0.20 (P < 0.02, R = 0.05), respectively. A multivariate logistic regression analysis disclosed that PSQI score change below the median (ie, a better outcome) was related to higher EQ-5D VAS score change (odds ratio, 2.15; 95% confidence interval, 1.09-4.25), whereas pain intensity NRS score change below the median was not (odds ratio, 1.58; 95% confidence interval,0.78-3.23). In our study, PGB-related improvements in sleep quality and HRQoL were marginally related to reductions in pain intensity in patients with neuropathic pain. Improvement in sleep quality was a significant predictor of better HRQoL, whereas pain intensity reduction was not.

Insomnia symptoms, perceived stress and coping strategies in patients with systemic lupus erythematosus.

PubMed

Palagini, L; Mauri, M; Faraguna, U; Carli, L; Tani, C; Dell'Osso, L; Mosca, M; Riemann, D

2016-08-01

The aim of this study is to evaluate perceived stress and coping strategies in individuals with systemic lupus erythematosus (SLE) according to the presence of insomnia symptoms, using a set of variables that include anxiety and depressive symptoms evaluation. Ninety SLE women were evaluated in a cross-sectional study using the Perceived Stress Scale (PSS), Brief COPE, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Beck Depression Inventory (BDI) and Self-rating Anxiety Scale (SAS). Individuals with insomnia symptoms (n = 57, 66%) presented higher PSS (p < 0.001), PSQI (p < 0.0001), BDI, (p < 0.0001) scores and showed less-effective coping strategies such as the use of behavioral disengagement (p = 0.04), self-blame (p = 0.02) and emotional-focused coping (p = 0.001). In a multi-regression model ISI was the independent determinant of high PSS and of behavioral disengagement; PSQI was the only determinant of self-blame (p = 0.02) and emotional-focused coping. SLE individuals with insomnia symptoms show high levels of perceived stress and more frequent use of disengaging and emotional-focused coping strategies. This body of evidence suggests that individuals with SLE and comorbid insomnia symptoms may therefore require additional interventions for insomnia. © The Author(s) 2016.

Tired telomeres: Poor global sleep quality, perceived stress, and telomere length in immune cell subsets in obese men and women.

PubMed

Prather, Aric A; Gurfein, Blake; Moran, Patricia; Daubenmier, Jennifer; Acree, Michael; Bacchetti, Peter; Sinclair, Elizabeth; Lin, Jue; Blackburn, Elizabeth; Hecht, Frederick M; Epel, Elissa S

2015-07-01

Poor sleep quality and short sleep duration are associated with increased incidence and progression of a number of chronic health conditions observed at greater frequency among the obese and those experiencing high levels of stress. Accelerated cellular aging, as indexed by telomere attrition in immune cells, is a plausible pathway linking sleep and disease risk. Prior studies linking sleep and telomere length are mixed. One factor may be reliance on leukocytes, which are composed of varied immune cell types, as the sole measure of telomere length. To better clarify these associations, we investigated the relationships of global sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI), and diary-reported sleep duration with telomere length in different immune cell subsets, including granulocytes, peripheral blood mononuclear cells (PBMCs), CD8+ and CD4+ T lymphocytes, and B lymphocytes in a sample of 87 obese men and women (BMI mean=35.4, SD=3.6; 81.6% women; 62.8% Caucasian). Multiple linear regression analyses were performed adjusting for age, gender, race, education, BMI, sleep apnea risk, and perceived stress. Poorer PSQI global sleep quality was associated with statistically significantly shorter telomere length in lymphocytes but not granulocytes and in particular CD8+ T cells (b=-56.8 base pairs per one point increase in PSQI, SE=20.4, p=0.007) and CD4+ T cells (b=-37.2, SE=15.9, p=0.022). Among separate aspects of global sleep quality, low perceived sleep quality and decrements in daytime function were most related to shorter telomeres. In addition, perceived stress moderated the sleep-CD8+ telomere association. Poorer global sleep quality predicted shorter telomere length in CD8+ T cells among those with high perceived stress but not in low stress participants. These findings provide preliminary evidence that poorer global sleep quality is related to telomere length in several immune cell types, which may serve as a pathway linking sleep and disease risk in obese individuals. Copyright © 2014 Elsevier Inc. All rights reserved.

A cross-sectional study of shift work, sleep quality and cardiometabolic risk in female hospital employees.

PubMed

Lajoie, P; Aronson, K J; Day, A; Tranmer, J

2015-03-10

Investigating the potential pathways linking shift work and cardiovascular diseases (CVD), this study aimed to identify whether sleep disturbances mediate the relationship between shift work and the metabolic syndrome, a cluster of CVD risk factors. Cross-sectional study. A tertiary-level, acute care teaching hospital in Southeastern Ontario, Canada. Female hospital employees working a shift schedule of two 12 h days, two 12 h nights, followed by 5 days off (n=121) were compared with female day-only workers (n=150). Each of the seven components of the Pittsburgh Sleep Quality Index (PSQI) was measured. Of these, PSQI global score, sleep latency and sleep efficiency were examined as potential mediators in the relationship between shift work and the metabolic syndrome. Shift work status was associated with poor (>5) PSQI global score (OR=2.10, 95% CI 1.20 to 3.65), poor (≥2) sleep latency (OR=2.18, 95% CI 1.23 to 3.87) and poor (≥2) sleep efficiency (OR=2.11, 95% CI 1.16 to 3.84). Although shift work was associated with the metabolic syndrome (OR=2.29, 95% CI 1.12 to 4.70), the measured components of sleep quality did not mediate the relationship between shift work and the metabolic syndrome. Women working in a rapid forward rotating shift pattern have poorer sleep quality according to self-reported indicators of the validated PSQI and they have a higher prevalence of the metabolic syndrome compared with women who work during the day only. However, sleep quality did not mediate the relationship between shift work and the metabolic syndrome, suggesting that there are other psychophysiological pathways linking shift work to increased risk for CVD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A cross-sectional study of shift work, sleep quality and cardiometabolic risk in female hospital employees

PubMed Central

Aronson, K J; Day, A; Tranmer, J

2015-01-01

Objectives Investigating the potential pathways linking shift work and cardiovascular diseases (CVD), this study aimed to identify whether sleep disturbances mediate the relationship between shift work and the metabolic syndrome, a cluster of CVD risk factors. Design Cross-sectional study. Setting A tertiary-level, acute care teaching hospital in Southeastern Ontario, Canada. Participants Female hospital employees working a shift schedule of two 12 h days, two 12 h nights, followed by 5 days off (n=121) were compared with female day-only workers (n=150). Primary and secondary outcome measures Each of the seven components of the Pittsburgh Sleep Quality Index (PSQI) was measured. Of these, PSQI global score, sleep latency and sleep efficiency were examined as potential mediators in the relationship between shift work and the metabolic syndrome. Results Shift work status was associated with poor (>5) PSQI global score (OR=2.10, 95% CI 1.20 to 3.65), poor (≥2) sleep latency (OR=2.18, 95% CI 1.23 to 3.87) and poor (≥2) sleep efficiency (OR=2.11, 95% CI 1.16 to 3.84). Although shift work was associated with the metabolic syndrome (OR=2.29, 95% CI 1.12 to 4.70), the measured components of sleep quality did not mediate the relationship between shift work and the metabolic syndrome. Conclusions Women working in a rapid forward rotating shift pattern have poorer sleep quality according to self-reported indicators of the validated PSQI and they have a higher prevalence of the metabolic syndrome compared with women who work during the day only. However, sleep quality did not mediate the relationship between shift work and the metabolic syndrome, suggesting that there are other psychophysiological pathways linking shift work to increased risk for CVD. PMID:25757950

Sleep quality in fibromyalgia and rheumatoid arthritis: associations with pain, fatigue, depression, and disease activity.

PubMed

Ulus, Y; Akyol, Y; Tander, B; Durmus, D; Bilgici, A; Kuru, O

2011-01-01

The aim of this study was to compare the sleep quality in patients with rheumatoid arthritis (RA) and fibromyalgia syndrome (FMS); and to evaluate the relationship between sleep quality and pain, fatigue, depression, and disease activity in patients with RA and FMS. Forty RA, 40 FMS and 40 healthy controls were enrolled in the study. Disease activity and disease duration were reported in patients. Pain by visual analogue scale (VAS), fatigue by Multidimensional Assesment of Fatigue (MAF), depression by Beck Depression Index (BDI), and sleep quality by Pittsburgh Sleep Quality Index (PSQI) were gathered in all participants. All participants were aged between 20 and 65 years, with a mean age of 42.97±10.75 years. There was no significant difference with respect to demographic characteristics among the three study groups. Patients reported more depression than controls, but BDI scores were similar in FMS and RA patients. VAS pain scores and MAF scores were significantly different in the three groups (p<0.001). FMS and RA patients had poor sleep quality (p<0.001). FMS patients had daytime dysfunction due to sleep disorder and had worse habitual sleep efficiency than RA patients (p<0.05). In patients, positive correlations were found between PSQI and clinic assessment variables except disease duration. FMS and RA may have poor sleep quality when compared to subjects without rheumatologic disorders. The quality of sleep can be impaired by pain, fatigue, depression, and disease activity in such patients.

Sleep quality in patients with xerostomia: a prospective and randomized case-control study.

PubMed

Lopez-Jornet, Pia; Lucero Berdugo, Maira; Fernandez-Pujante, Alba; C, Castillo Felipe; Lavella C, Zamora; A, Pons-Fuster; J, Silvestre Rangil; Silvestre, Francisco Javier

2016-01-01

Objectives To investigate sleep quality, anxiety/depression and quality-of-life in patients with xerostomia. Materials and methods This prospective, observational, cross-sectional study was conducted among a group of xerostomia patients (n = 30) compared with 30 matched control subjects. The following evaluation scales were used to assess the psychological profile of each patient: the Hospital Anxiety and Depression Scale, the Oral Health Impact Profile-14 (OHIP-14), the Xerostomia Inventory, the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Results The PSQI obtained 5.3 3 ± 1.78 for patients with xerostomia compared with 4.26 ± 1.01 for control subjects (p = 0.006); ESS obtained 5.7 ± 2.1 for test patients vs 4.4 0 ± 1 for control subjects (p = 0.010). Statistical regression analysis showed that xerostomia was significantly associated with depression (p = 0.027). Conclusions Patients with xerostomia exhibited significant decreases in sleep quality compared with control subjects.

Sleep quality in long haul truck drivers: A study on Iranian national data.

PubMed

Sadeghniiat-Haghighi, Khosro; Yazdi, Zohreh; Kazemifar, Amir-Mohammad

2016-08-01

Iran has a high rate of road traffic accidents. Poor quality of sleep brings about loss of attention, which is an important cause of road traffic accidents particularly in monotonous roads. The causes of poor quality of sleep in occupational drivers are multifactorial. The objective of the present study was to assess the prevalence of poor sleep quality among occupational drivers with rotating work schedules and analyze its different risk factors. 2200 professional long-haul truck drivers who had been referred to the Occupational Health Clinic for routine education course were invited. We obtained data from eight provinces from various parts of Iran during 2012-2013. Data were collected using a questionnaire including questions about demographic and job characteristics. Pittsburg Sleep Quality Index (PSQI) was used to assess drivers' sleep quality. Mean working (driving) time was (9.3±2.5) hours daily and (55.5 ± 18.29) hours weekly. About 23.5% of the drivers reported history of smoking, 14.5% had low job satisfaction and 60% had irregular work schedule. 16.4% of drivers had an accidents leading to injury during the past five years. The mean PSQI score was 4.2 ± 2.7; 54% had a PSQI>5 (poor quality of sleep). Multivariate logistic regression showed that smoking, job satisfaction, history of accidents, shift work and work hours per day were the most important risk factors for poor sleep quality. Results obtained from the current study showed a high prevalence of poor quality of sleep among professional drivers. It warrants more attention to this significant problem using some measures to improve working conditions in professional drivers, as well as health promotion interventions.

The effect of nocturia on sleep quality and daytime function in patients with lower urinary tract symptoms: a cross-sectional study.

PubMed

Shao, I-Hung; Wu, Chia-Chen; Hsu, Hueih-Shing; Chang, Shyh-Chyi; Wang, Hsu-Hsiang; Chuang, Heng-Chang; Tam, Yuan-Yun

2016-01-01

Nocturia has been proven to have a negative impact on the quality of life and sleep quality in general elderly population. However, there are limited studies on the quantitative effect of nocturia on sleep quality and daytime dysfunction, specifically in patients with lower urinary tract symptoms. During March 1, 2015 to December 31, 2015, a total of 728 patients who visited our urology department due to voiding dysfunction and experienced nocturia at least once per night were enrolled. Three questionnaires were administered to them after obtaining their written consents. Pittsburgh Sleep Quality Index (PSQI) questionnaire, Epworth Sleepiness Scale (ESS) questionnaire, and International Prostate Symptom Score (IPSS) questionnaire were applied to evaluate their sleep quality, daytime dysfunction, and voiding problems, respectively. Statistical analysis of the impact of nocturia on sleep quality and daytime dysfunction was performed. The mean age of patients was 61 years, with a male-to-female ratio of 2.7. The mean nocturia number was 3.03. The IPSS, PSQI, and ESS scores were 17.56, 8.35, and 8.22, respectively. The nocturia number increased with age and was significantly correlated to ESS score (daytime dysfunction) and PSQI total score (sleep quality) in overall group. Among subgroups divided by age and sex, there was a significant correlation between nocturia number and daytime dysfunction in male patients or patients younger than 65 years. In patients with lower urinary tract symptoms, nocturia number increased with age and was significantly correlated with poor sleep quality. Nocturia plays an important role in patients younger than 65 years in daytime dysfunction.

Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders.

PubMed

Lim, Soo-Kyung; Yoo, Seung Jin; Koo, Dae Lim; Park, Chae A; Ryu, Han Jun; Jung, Yong Jin; Jeong, Ji Bong; Kim, Byeong Gwan; Lee, Kook Lae; Koh, Seong-Joon

2017-05-14

To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts. In this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call shifts. Among the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48 (28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores (PSQI) (8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm (83.3% vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work (81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD (OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality (PSQI ≥ 6) was a predictor of IBS (OR = 4.17, 95%CI: 1.92-19.02, P = 0.016). Physicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs.

Effect of Sleep Hygiene Education on Sleep Quality in Hemodialysis Patients

PubMed Central

Soleimani, Farzaneh; Hasanpour-Dehkordi, Ali

2016-01-01

Introduction Sleep is referred a regular, recurring and easily revocable state of organism which is characterized by relative immobility and significant increase in response threshold to environmental stimuli. Sleep disorders are common among haemodialysis patients. Aim The aim of this study was to investigate the effect of sleep hygiene education on sleep quality in haemodialysis patients. Materials and Methods This study is a randomized controlled clinical trial. The participants of this study were 60 haemodialysis patients admitted to the Dialysis Center of Shahid Ayatollah Madani Hospital of Khoy, affiliated with the Urmia University of Medical Sciences. Sampling was done randomly and the partcipants were randomly divided into intervention group (30 patients) and control group (30 patients). Sleep quality of participants was measured before and after the intervention by Pittsburgh Sleep Quality Index (PSQI). Training process for sleep hygiene behaviours was presented to the participants face-to-face. The data were analysed using SPSS 16. Results A significant difference in the mean (standard deviation) score for PSQI (p<0.001) was observed before and after intervention in the intervention group, while in the control group, the difference was not significant (p=0.704), In addition, a significant difference was observed in the mean (standard deviation) score for PSQI between the two, intervention and control groups after the educational intervention (p=0.034). Conclusion Sleep hygiene education, alongside other appro-aches, is a low-cost, accessible and practical method which can be implemented within a short period of time. PMID:28208884

Poor Sleep Quality and Associated Inflammation Predict Preterm Birth: Heightened Risk among African Americans.

PubMed

Blair, Lisa M; Porter, Kyle; Leblebicioglu, Binnaz; Christian, Lisa M

2015-08-01

Poor sleep promotes inflammation. In turn, inflammation is a causal mechanism in term as well as preterm parturition. In the United States, a persistent racial disparity in preterm birth exists, with African Americans showing ∼1.5 times greater risk. This study examined associations among sleep quality, serum proinflammatory cytokines, and length of gestation in a racially diverse sample of 138 pregnant women. Observational. Women completed the Pittsburgh Sleep Quality Index (PSQI) and other psychosocial and behavioral measures during midpregnancy. Serum levels of interleukin (IL)-6, IL-8, IL-1β, and tumor necrosis factor (TNF)-α were determined by high-sensitivity assays. Birth outcomes were determined via medical record review. Among African American women (n = 79), shorter gestation was predicted by poorer overall sleep (rs = -0.35, P = 0.002) as well the following PSQI subscales: subjective sleep quality (rs = -0.34, P = 0.002), sleep latency (rs = -0.27, P = 0.02), and sleep efficiency (rs = -0.27, P = 0.02). African American women with poor sleep quality (PSQI > 5) had 10.2 times the odds of preterm birth compared to those with good sleep quality. In contrast, among European American women (n = 53), gestational length was not significantly predicted by sleep quality (Ps > 0.12). Bootstrapping analyses showed that, among African Americans, IL-8 significantly mediated the association between sleep quality and length of gestation (indirect effect estimate -0.029; 95% confidence interval -0.06, -0.002). The data provide novel evidence that African American women exhibit greater inflammation in response to sleep disturbance than European American women and these effects correspond with length of gestation. Racial differences in susceptibility to sleep induced immune dysregulation may contribute to marked racial disparities in preterm birth. © 2015 Associated Professional Sleep Societies, LLC.

Poor Sleep Quality, Antepartum Depression and Suicidal Ideation among Pregnant Women

PubMed Central

Gelaye, Bizu; Addae, Gifty; Neway, Beemnet; Larrabure-Torrealva, Gloria T.; Qiu, Chunfang; Stoner, Lee; Fernandez, Miguel Angel Luque; Sanchez, Sixto E.; Williams, Michelle A.

2016-01-01

Objective To evaluate the independent and combined associations of maternal self-reported poor sleep quality and antepartum depression with suicidal ideation during the third trimester Methods A cross-sectional study was conducted among 1,298 pregnant women (between 24 and 28 gestational weeks) attending prenatal clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Multivariate logistical regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) after adjusting for putative confounders. Results Approximately, 17% of women were classified as having poor sleep quality (defined using the recommended criteria of PSQI global score of >5 vs. ≤5). Further, the prevalence of antepartum depression and suicidal ideation were 10.3% and 8.5%, respectively in this cohort. After adjusting for confounders including depression, poor sleep quality was associated with a 2.81-fold increased odds of suicidal ideation (OR=2.81; 95% CI 1.78–4.45). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 28% increase in odds for suicidal ideation, even after adjusting for depression (OR=1.28; 95% CI 1.15–1.41). The odds of suicidal ideation was particularly high among depressed women with poor sleep quality (OR=13.56 95% CI 7.53–24.41) as compared with women without either risk factor. Limitations This cross-sectional study utilized self-reported data. Causality cannot be inferred, and results may not be fully generalizable. Conclusion Poor sleep quality, even after adjusting for depression, is associated with antepartum suicidal ideation. Our findings support the need to explore sleep-focused interventions for pregnant women. PMID:27930912

Poor sleep quality, antepartum depression and suicidal ideation among pregnant women.

PubMed

Gelaye, Bizu; Addae, Gifty; Neway, Beemnet; Larrabure-Torrealva, Gloria T; Qiu, Chunfang; Stoner, Lee; Luque Fernandez, Miguel Angel; Sanchez, Sixto E; Williams, Michelle A

2017-02-01

To evaluate the independent and combined associations of maternal self-reported poor sleep quality and antepartum depression with suicidal ideation during the third trimester METHODS: A cross-sectional study was conducted among 1298 pregnant women (between 24 and 28 gestational weeks) attending prenatal clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Multivariate logistical regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) after adjusting for putative confounders. Approximately, 17% of women were classified as having poor sleep quality (defined using the recommended criteria of PSQI global score of >5 vs. ≤5). Further, the prevalence of antepartum depression and suicidal ideation were 10.3% and 8.5%, respectively in this cohort. After adjusting for confounders including depression, poor sleep quality was associated with a 2.81-fold increased odds of suicidal ideation (OR=2.81; 95% CI 1.78-4.45). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 28% increase in odds for suicidal ideation, even after adjusting for depression (OR=1.28; 95% CI 1.15-1.41). The odds of suicidal ideation was particularly high among depressed women with poor sleep quality (OR=13.56 95% CI 7.53-24.41) as compared with women without either risk factor. This cross-sectional study utilized self-reported data. Causality cannot be inferred, and results may not be fully generalizable. Poor sleep quality, even after adjusting for depression, is associated with antepartum suicidal ideation. Our findings support the need to explore sleep-focused interventions for pregnant women. Copyright © 2016 Elsevier B.V. All rights reserved.

Eat, sleep, work, play: associations of weight status and health-related behaviors among young adult college students.

PubMed

Quick, Virginia; Byrd-Bredbenner, Carol; White, Adrienne A; Brown, Onikia; Colby, Sarah; Shoff, Suzanne; Lohse, Barbara; Horacek, Tanya; Kidd, Tanda; Greene, Geoffrey

2014-01-01

To examine relationships of sleep, eating, and exercise behaviors; work time pressures; and sociodemographic characteristics by weight status (healthy weight [body mass index or BMI < 25] vs. overweight [BMI ≥ 25]) of young adults. Cross-sectional. Nine U.S. universities. Enrolled college students (N = 1252; 18-24 years; 80% white; 59% female). Survey included the Pittsburgh Sleep Quality Index (PSQI), Three-Factor Eating Questionnaire (TFEQ), Satter Eating Competence Inventory (ecSI), National Cancer Institute Fruit/Vegetable Screener, International Physical Activity Questionnaire, Work Time Pressure items, and sociodemographic characteristics. Chi-square and t-tests determined significant bivariate associations of sociodemographics, sleep behaviors, eating behaviors, physical activity behavior, and work time pressures with weight status (i.e., healthy vs. overweight/obese). Statistically significant bivariate associations with weight status were then entered into a multivariate logistic regression model that estimated associations with being overweight/obese. Sex (female), race (nonwhite), older age, higher Global PSQI score, lower ecSI total score, and higher TFEQ Emotional Eating Scale score were significantly (p < .05) associated with overweight/obesity in bivariate analyses. Multivariate logistic regression analysis showed that sex (female; odds ratio [OR] = 2.05, confidence interval [CI] = 1.54-2.74), older age (OR = 1.35, CI = 1.21-1.50), higher Global PSQI score (OR = 1.07, CI = 1.01-1.13), and lower ecSI score (OR = .96, CI = .94-.98), were significantly (p < .05) associated with overweight/obesity. Findings suggest that obesity prevention interventions for college students should include an education component to emphasize the importance of overall sleep quality and improving eating competence.

[Effect of acupuncture combined with massage of sole on sleeping quality of the patient with insomnia].

PubMed

Zhong, Zhi-Guo; Cai, Heng; Li, Xiao-Long; Lü, Dong

2008-06-01

To assess effect of acupuncture combined with massage of sole on sleeping quality of the patient with insomnia. Fifty-eight cases of insomnia were randomly divided into an observation group (n = 32) and a control group (n = 26). The observation group were treated with oral administration of Alprazolam, massage of sole, and acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), etc. on the abdomen as main points; the control group were treated with Alprazolam. Clinical therapeutic effects, and scores for Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were assessed before and after treatment in the two groups. The effective rate was 93.75 in the observation group and 88.46% in the control group with no significant difference between the two groups; after treatment, there were significant or very significant differences in scores for various factors in the PSQI, SAS and SDS (P < 0.01, P < 0.05). Abdominal acupuncture as main combined with massage of sole can obviously improve sleeping quality of the patient with insomnia.

Recognizing Academic Performance, Sleep Quality, Stress Level, and Mental Health using Personality Traits, Wearable Sensors and Mobile Phones

PubMed Central

Sano, Akane; Phillips, Andrew J.; Yu, Amy Z.; McHill, Andrew W.; Taylor, Sara; Jaques, Natasha; Czeisler, Charles A.; Klerman, Elizabeth B.; Picard, Rosalind W.

2017-01-01

What can wearable sensors and usage of smart phones tell us about academic performance, self-reported sleep quality, stress and mental health condition? To answer this question, we collected extensive subjective and objective data using mobile phones, surveys, and wearable sensors worn day and night from 66 participants, for 30 days each, totaling 1,980 days of data. We analyzed daily and monthly behavioral and physiological patterns and identified factors that affect academic performance (GPA), Pittsburg Sleep Quality Index (PSQI) score, perceived stress scale (PSS), and mental health composite score (MCS) from SF-12, using these month-long data. We also examined how accurately the collected data classified the participants into groups of high/low GPA, good/poor sleep quality, high/low self-reported stress, high/low MCS using feature selection and machine learning techniques. We found associations among PSQI, PSS, MCS, and GPA and personality types. Classification accuracies using the objective data from wearable sensors and mobile phones ranged from 67–92%. PMID:28516162

Polysomnographic Study of Sleep in Survivors of Breast Cancer

PubMed Central

Reinsel, Ruth A.; Starr, Tatiana D.; O'Sullivan, Barbara; Passik, Steven D.; Kavey, Neil B.

2015-01-01

Study Objective: Insomnia is a frequent complaint in breast cancer patients during and after treatment. Breast cancer survivors, 1–10 years posttreatment, underwent in-lab polysomnography (PSG) to objectively define the insomnia in those patients with such a complaint. Methods: Twenty-six breast cancer survivors (aged 39–80, mean 54.0 months posttreatment) spent 2 nights in the sleep laboratory. Sleep on Night 2 was scored for sleep stages, sleep onset latency, REM sleep onset latency, wake time, apneas and hypopneas, periodic limb movements and arousals. Subjects were allocated into 2 groups by their scores on the Pittsburgh Sleep Quality Index (PSQI): no/ mild sleep disturbance (PSQI score ≤ 9, n = 15) or moderate/ severe sleep disturbance (PSQI ≥ 10, n = 11). Results: Standard PSG/EEG parameters failed to differentiate insomniacs from non-insomniacs. The single variable that distinguished the insomnia group was periodic limb movements in sleep (PLMS). PLMS were significantly correlated (r ≅ 0.7, p < 0.02) with subjective report of insomnia on PSQI and insomnia severity index. Log[Number of PLMS] was higher in the moderate/severe insomnia group (p = 0.008). Five of 11 patients in the moderate/severe insomnia group had a PLMS index ≥ 15, compared to only one of 15 patients in the none/mild insomnia group (p = 0.02). Menopausal symptoms and use of caffeine, hypnotics, and antidepressants were unrelated to insomnia severity or PLMS. Conclusions: PLMS was the sole PSG variable that separated breast cancer survivors with moderate/severe insomnia from those with no/mild sleep disturbance. Further study of the incidence and significance of PLMS in breast cancer survivors with the complaint of insomnia is merited. Citation: Reinsel RA, Starr TD, O'Sullivan B, Passik SD, Kavey NB. Polysomnographic study of sleep in survivors of breast cancer. J Clin Sleep Med 2015;11(12):1361–1370. PMID:26194735

Self-reported data on sleep quality and psychologic characteristics in patients with myofascial pain and disc displacement versus asymptomatic controls.

PubMed

Sener, Sevgi; Guler, Ozkan

2012-01-01

The aim of this research was to compare the differences between patients with myofascial pain and disc displacement and asymptomatic individuals based on aspects of psychologic status and sleep quality. One hundred thirty patients (81 women, 49 men; mean ages: 30.0 and 31.0 years, respectively) with temporomandibular disorder were selected, and 64 control subjects (32 women, 32 men; mean ages: 27.2 and 27.5 years, respectively) were included in the investigation over a period of 1 year. Clinical diagnosis of 65 patients with myofascial pain and 65 patients with disc displacement with or without limitation and joint pain was determined according to the Research Diagnostic Criteria for Temporomandibular Disorders. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Psychologic status was assessed using Symptom Checklist-90-Revised (SCL-90-R). Chi-square, Kolmogorov-Smirnov, one-way analysis of variance, and Tukey Honestly Significant Difference post hoc multiple comparison or Tamhane T2 tests were used for statistical analysis. There was a significant difference between patients with myofascial pain and disc displacement regarding somatization and paranoid ideation. No statistically significant difference was found between patients with disc displacements and controls in all dimensions of the SCL-90-R. Total score for the PSQI was statistically significantly different between patients with myofascial pain and controls; no significant differences were found between patients with disc displacement and those with myofascial pain or controls regarding the PSQI. To manage patients with myofascial pain, psychologic assessments including sleep quality should be considered.

Depressive symptoms are associated with daytime sleepiness and subjective sleep quality in dementia with Lewy bodies.

PubMed

Elder, Greg J; Colloby, Sean J; Lett, Debra J; O'Brien, John T; Anderson, Kirstie N; Burn, David J; McKeith, Ian G; Taylor, John-Paul

2016-07-01

Sleep problems and depression are common symptoms in dementia with Lewy bodies (DLB), where patients typically experience subjectively poor sleep quality, fatigue and excessive daytime sleepiness. However, whilst sleep disturbances have been linked to depression, this relationship has not received much attention in DLB. The present cross-sectional study addresses this by examining whether depressive symptoms are specifically associated with subjective sleep quality and daytime sleepiness in DLB, and by examining other contributory factors. DLB patients (n = 32) completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and the 15-item Geriatric Depression Scale (GDS-15). Motor and cognitive functioning was also assessed. Pearson correlations were used to assess the relationship between GDS-15, ESS and PSQI scores. GDS-15 scores were positively associated with both ESS (r = 0.51, p < 0.01) and PSQI (r = 0.59, p < 0.001) scores. Subjective poor sleep and daytime sleepiness were associated with depressive symptoms in DLB. Given the cross-sectional nature of the present study, the directionality of this relationship cannot be determined, although this association did not appear to be mediated by sleep quality or daytime sleepiness. Nevertheless, these findings have clinical relevance; daytime sleepiness or poor sleep quality might indicate depression in DLB, and subsequent work should examine whether the treatment of depression can reduce excessive daytime sleepiness and improve sleep quality in DLB patients. Alternatively, more rigorous screening for sleep problems in DLB might assist the treatment of depression. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.

Sleep patterns and predictors of disturbed sleep in a large population of college students.

PubMed

Lund, Hannah G; Reider, Brian D; Whiting, Annie B; Prichard, J Roxanne

2010-02-01

To characterize sleep patterns and predictors of poor sleep quality in a large population of college students. This study extends the 2006 National Sleep Foundation examination of sleep in early adolescence by examining sleep in older adolescents. One thousand one hundred twenty-five students aged 17 to 24 years from an urban Midwestern university completed a cross-sectional online survey about sleep habits that included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, the Horne-Ostberg Morningness-Eveningness Scale, the Profile of Mood States, the Subjective Units of Distress Scale, and questions about academic performance, physical health, and psychoactive drug use. Students reported disturbed sleep; over 60% were categorized as poor-quality sleepers by the PSQI, bedtimes and risetimes were delayed during weekends, and students reported frequently taking prescription, over the counter, and recreational psychoactive drugs to alter sleep/wakefulness. Students classified as poor-quality sleepers reported significantly more problems with physical and psychological health than did good-quality sleepers. Students overwhelmingly stated that emotional and academic stress negatively impacted sleep. Multiple regression analyses revealed that tension and stress accounted for 24% of the variance in the PSQI score, whereas exercise, alcohol and caffeine consumption, and consistency of sleep schedule were not significant predictors of sleep quality. These results demonstrate that insufficient sleep and irregular sleep-wake patterns, which have been extensively documented in younger adolescents, are also present at alarming levels in the college student population. Given the close relationships between sleep quality and physical and mental health, intervention programs for sleep disturbance in this population should be considered. Copyright 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.

Burnout and Sleep Quality: A Cross-Sectional Questionnaire-Based Study of Medical and Non-Medical Students in India

PubMed Central

Thawani, Rajat; Goel, Ashish

2015-01-01

Introduction It is well documented that on entering college, students experience a multitude of changes in sleep habits. Very few studies have been conducted that explore sleep quality in Indian undergraduate students; fewer still study the effects of burnout in the same population. Medical students, in particular, are believed to be more stressed, sleep deprived, and burnt out than their non-medical peers. Methods A cross-sectional study was conducted to study sleep disturbances and burnout in a sample of 214 Indian undergraduate students (112 medical, 102 non-medical). The instruments used to measure the sleep quality and burnout were the PSQI (Pittsburgh Sleep Quality Index) and OLBI (Oldenburg Burnout Inventory), respectively. Differences between continuous variables were analysed using Wilcox Mann Whitney U-tests. Bivariate Spearman’s rho correlations were done to identify correlations between the individual burnout components and the PSQI sleep quality components. Results Of the students surveyed, 62.6% were found to be poor sleepers with an average score of 6.45 ± 2.85. It was seen that 20% of the students (n = 43) slept less than five hours a day. Medical students, in particular, were found to have more poor sleep (72.9%) than their non-medical peers (51.9%; p < 0.001). Of the sampled women, 65.8% were poor sleepers, as compared to 62.1% of the sampled men, but the difference was not statistically significant. The average scores of the burnout dimensions were 2.43 ± 0.57 for exhaustion and 2.32 ± 0.53 for disengagement. Both exhaustion and disengagement correlated with PSQI sleep scores (Rho 0.21, p 0.001) and (Rho = 0.18, p = 0.008), respectively. The exhaustion dimension of burnout was higher in medical students (2.46 ± 0.55) than in non-medical students (2.38 ± 0.59), but was seen to correlate more with the PSQI sleep score in the non-medical group (Rho = 0.62, p < 0.001). The PSQI scores showed a weak but significant correlation with academic year (rho = -0.19, p = 0.004). Unlike the sleep scores, the burnout dimensions did not correlate well with the academic year. Conclusions Burnout and sleep quality are both uncommonly studied topics in India. Fostering a healthier and more proactive approach to tackling burnout and poor sleep quality may help unearth culture specific causes for some of the results we have demonstrated. PMID:26623216

Burnout and Sleep Quality: A Cross-Sectional Questionnaire-Based Study of Medical and Non-Medical Students in India.

PubMed

Shad, Rohan; Thawani, Rajat; Goel, Ashish

2015-10-21

Introduction It is well documented that on entering college, students experience a multitude of changes in sleep habits. Very few studies have been conducted that explore sleep quality in Indian undergraduate students; fewer still study the effects of burnout in the same population. Medical students, in particular, are believed to be more stressed, sleep deprived, and burnt out than their non-medical peers. Methods A cross-sectional study was conducted to study sleep disturbances and burnout in a sample of 214 Indian undergraduate students (112 medical, 102 non-medical). The instruments used to measure the sleep quality and burnout were the PSQI (Pittsburgh Sleep Quality Index) and OLBI (Oldenburg Burnout Inventory), respectively. Differences between continuous variables were analysed using Wilcox Mann Whitney U-tests. Bivariate Spearman's rho correlations were done to identify correlations between the individual burnout components and the PSQI sleep quality components. Results Of the students surveyed, 62.6% were found to be poor sleepers with an average score of 6.45 ± 2.85. It was seen that 20% of the students (n = 43) slept less than five hours a day. Medical students, in particular, were found to have more poor sleep (72.9%) than their non-medical peers (51.9%; p < 0.001). Of the sampled women, 65.8% were poor sleepers, as compared to 62.1% of the sampled men, but the difference was not statistically significant. The average scores of the burnout dimensions were 2.43 ± 0.57 for exhaustion and 2.32 ± 0.53 for disengagement. Both exhaustion and disengagement correlated with PSQI sleep scores (Rho 0.21, p 0.001) and (Rho = 0.18, p = 0.008), respectively. The exhaustion dimension of burnout was higher in medical students (2.46 ± 0.55) than in non-medical students (2.38 ± 0.59), but was seen to correlate more with the PSQI sleep score in the non-medical group (Rho = 0.62, p < 0.001). The PSQI scores showed a weak but significant correlation with academic year (rho = -0.19, p = 0.004). Unlike the sleep scores, the burnout dimensions did not correlate well with the academic year. Conclusions Burnout and sleep quality are both uncommonly studied topics in India. Fostering a healthier and more proactive approach to tackling burnout and poor sleep quality may help unearth culture specific causes for some of the results we have demonstrated.

[Quality of sleep and academic performance in high school students].

PubMed

Bugueño, Maithe; Curihual, Carolina; Olivares, Paulina; Wallace, Josefa; López-AlegrÍa, Fanny; Rivera-López, Gonzalo; Oyanedel, Juan Carlos

2017-09-01

Sleeping and studying are the day-to-day activities of a teenager attending school. To determine the quality of sleep and its relationship to the academic performance among students attending morning and afternoon shifts in a public high school. Students of the first and second year of high school answered an interview about socio-demographic background, academic performance, student activities and subjective sleep quality; they were evaluated using the Pittsburgh Sleep Quality Index (PSQI). The interview was answered by 322 first year students aged 15 ± 5 years attending the morning shift and 364 second year students, aged 16 ± 0.5 years, attending the afternoon shift. The components: sleep latency, habitual sleep efficiency, sleep disturbance, drug use and daytime dysfunction were similar and classified as good in both school shifts. The components subjective sleep quality and duration of sleep had higher scores among students of the morning shift. The mean grades during the first semester of the students attending morning and afternoon shifts were 5.9 and 5.8, respectively (of a scale from 1 to 7). Among students of both shifts, the PSQI scale was associated inversely and significantly with academic performance. A bad sleep quality influences academic performance in these students.

A study on the sleep quality of incoming university students.

PubMed

Cheng, Shu Hui; Shih, Chi-Chen; Lee, I Hui; Hou, Yi-Wen; Chen, Kao Chin; Chen, Kow-Tong; Yang, Yen Kuang; Yang, Yi Ching

2012-05-30

This study was designed to examine the prevalence and the risk factors of poor sleep quality in 4318 incoming university students in Taiwan. The test battery comprised a self-administered structured questionnaire, including items related to personal medical history and lifestyle habits, the Measurement of Support Functions (MSF), Pittsburgh Sleep Quality Index (PSQI), Chinese Internet Addiction Scale-Revision (CIAS-R), neuroticism subscale of the Maudsley Personality Inventory (MPI), and the 12-item Chinese Health Questionnaire (CHQ-12). Of the total study population, 2360 students (54.7%) were classified into the poor sleep quality group, as defined by a PSQI score ≥6. Based on the results of multivariate logistic regression analysis, poor sleep quality was significantly associated with undergraduate students, female gender, skipping breakfast, tea drinking, a higher tendency toward internet addition, poor social support, higher neuroticism, and higher CHQ scores. Poor sleep quality is prevalent among incoming university students in Taiwan, and more work is needed on the identification of the factors influencing poor sleep, and in providing systematic education in the importance of sleep and time management skills to university students. Copyright © 2012 Elsevier Ltd. All rights reserved.

Subjective sleep disturbance in Chinese adults with epilepsy: Associations with affective symptoms.

PubMed

Shen, Yeru; Zhang, Mengmeng; Wang, Yu; Wang, Lanlan; Xu, Xiangjun; Xiao, Gairong; Chen, Jing; Zhang, Ting; Zhou, Nong

2017-09-01

As well as being a very common neurological disease worldwide, epilepsy significantly impairs patients' emotional, behavioral, and cognitive functioning. Sleep disturbances are the most frequent complaint in patients with epilepsy. The present study assesses the impact of a range of affective symptoms on subjective sleep quality and sleep disturbances in Chinese adults with epilepsy. Adults with epilepsy who visited our epilepsy clinic from July 2015 to March 2016 were enrolled in our study. Both patients and healthy controls completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Mini-mental State Examination (MMSE). Subjective sleep quality and sleep disturbances were examined with regard to self-reported symptoms of depression and anxiety, seizure-related factors, and demographic factors. The PSQI scores and ISI scores of patients were significantly higher (indicating lower quality sleep and more serious insomnia) than those of the control group. Symptoms associated with depression and anxiety were independently related to impaired subjective sleep quality and insomnia. Affective symptoms explained more of the variance in PSQI scores and ISI scores than did seizure-related or demographic variables. In addition, these variables also seemed to be less powerful contributing factors to subjective sleep quality and insomnia than affective symptoms, several seizure-related factors, such as seizure control, partial seizures and duration of epilepsy, which are also significantly associated with subjective sleep quality and insomnia. In addition, use of lamotrigine (LTG) was also associated with insomnia and use of clonazepam (CZP) and phenobarbital (PB) with daytime sleepiness in patients with epilepsy. Chinese adults with epilepsy have poorer self-reported subjective sleep quality and a higher prevalence of insomnia than the control group. Depressive- and anxiety-related symptoms independently exert an adverse effect on the subjective sleep quality and insomnia of patients. In addition, seizure control, partial seizures, and the duration of epilepsy affect the quality of sleep and insomnia in patients, but seem less powerful predictors of sleep quality and insomnia than affective symptoms. Early identification and treatment of affective symptoms is of great importance in improving the sleep quality and insomnia of patients with epilepsy. Copyright © 2017 Elsevier B.V. All rights reserved.

Sleep disorders in cirrhotics; how can we detect ?

PubMed

Gencdal, Genco; Gunsar, Fulya; Meral, Cenk E; Salman, Esin; Gürsel, Berna; Oruç, Nevin; Karasu, Zeki; Ersöz, Galip; Akarca, Ulus Salih

2014-09-01

Sleep disorders (SDs) are common in cirrhotics and are often associated with hepatic encephalopathy. SDs negatively affect patients' daily activities and work efficiency. For this reason, early diagnosis is important. The methods used for diagnosis of SDs are not practical and need longer periods of application and evaluation. In this study, we aimed to investigate sleep disorders and related clinical parameters in cirrhosis and also wanted to investigate the using of Sleep Timing and Sleep Quality Screening questionnaire (STSQS), a simple form with a short application time, for diagnosis of SDs and its correlation with Pittsburg Sleep Quality Index (PSQI) form. Cirrhotic patients and age-matched healthy volunteers were enrolled. Patients were excluded from this study if they had neuropsychiatric disease or used excessive alcohol or drugs known to affect sleep. Both groups completed validated Turkish form of PSQI and STSQS. SD was defined as PSQI score (0-21) of >5 or STSQS ≥5. One hundred and thirty-one cirrhotic patients and 18 healthy volunteers were enrolled. SDs in cirrhotics and control group were detected 56.5% and 27.8% by PSQI, 49.6% and 16.7% by STSQS respectively. SDs are the most frequent in the Child C patients, and the least frequent in the Child A patients (P > 0.05). No correlation was found between the MELD score and SDs. SDs were more common in cirrhotic patients with hypoalbuminaemia and low haemoglobin levels. In addition, the patients with decompensated cirrhosis had more frequently SDs than the patients with compensated cirrhosis. In the patient group, sleep latency and total sleep time, sleep parameters were correlated with SDs. STSQS had statistical significant correlation with PSQI for diagnosis of SDs. SDs are common in cirrhotics and STSQS could be an appropriate and practical method for diagnosis of SDS in these patients. We can use it in cirrhotic patients at outpatient clinics. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Poor sleep quality predicts decreased cognitive function independently of chronic mountain sickness score in young soldiers with polycythemia stationed in Tibet.

PubMed

Kong, Fan-Yi; Li, Qiang; Liu, Shi-Xiang

2011-01-01

Little is known about the association between poor sleep and cognitive function in people with polycythemia at high altitude. The aim of this study was to survey the sleep quality of individuals with polycythemia at high altitude and determine its association with cognitive abilities. We surveyed 230 soldiers stationed in Tibet (all men; mean age 21-52±4.30 yr) at altitudes ranging from 3658 to 3996 m. All participants were given a blood tests for hemoglobin level and a questionnaire survey of cognitive function. Polycythemia was defined as excessive erythrocytosis (Hb≥21 g/dL in men or ≥19 g/dL in women). Poor sleepers were defined as having a global Pittsburgh Sleep Quality Index score (PSQI)>5. Cognitive abilities were determined by the Chinese revision of the Wechsler Adult Intelligence Scale and the Benton Visual Retention Test. Multiple linear regression analysis was used to determine the association between the PSQI and cognitive function. Logistic regression analysis was performed to determine the independent effect of sleep quality on cognitive function. The global PSQI score of enrolled participants was 8.14±3.79. Seventy-five (32.6%) soldiers were diagnosed with polycythemia. The proportion of poor sleepers was 1.45 times greater in those with polycythemia compared with those without polycythemia [95% (confidence interval) CI 1.82-2.56], and they had a statistically significant lower score for cognitive function. Multiple linear regression analysis showed that the global PSQI score was negatively associated with IQ (β=0.11, 95% CI -0.16 to -0.05) and digit symbol scores (β=0.66, 95% CI -0.86 to -0.44). Poor sleep quality was determined to be an independent predictor of impaired IQ [odds ratio (OR) 1.59, 95% CI 1.30-1.95] and digit symbol score (OR 1.18, 95% CI 1.07-1.31) in logistic regression analysis. The present study showed that for young soldiers with polycythemia at high altitude impaired subjective sleep quality was an independent predictor of decreased cognitive function, especially IQ and verbal short-term memory.

Prevalence and correlates of poor sleep quality and daytime sleepiness in Belgian truck drivers.

PubMed

Braeckman, Lutgart; Verpraet, Rini; Van Risseghem, Marleen; Pevernagie, Dirk; De Bacquer, Dirk

2011-03-01

Sleepiness and sleep complaints are common among professional drivers. Sleepiness is a considerable problem not only because it affects the drivers' well-being, but also because of the consequences for performance and safety. Assessment of the (self-reported) prevalence and research into the risk factors are thus an important health issue and are also indispensable to prevent productivity loss and work-related accidents and injuries. Therefore, the aim of this study was to describe sleeping, driving, and health characteristics of Belgian truck drivers and to determine occupational and individual factors associated with poor sleep quality and daytime sleepiness. Cross-sectional data were collected using a self-administered questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Berlin Questionnaire (BQ). The mean (SD) age of the 476 studied truck drivers was 42.7 (10.2) yrs and the mean (SD) body mass index was 27.3 (5.1) kg/m(2). Approximately 47% declared that they drove >50 h/wk and found their work schedule unrealistic. The mean (SD) PSQI score was 4.45 (2.7); poor quality of sleep (PSQI >5) was found in 27.2%. The mean (SD) ESS score was 6.79 (4.17); 18% had a score >10. The BQ indicated that 21.5% had a higher risk on obstructive sleep apnea. In multiple logistic regression analysis, low educational level (odds ratio [OR] 1.86), current smoking (OR 1.75), unrealistic work schedule (OR 1.75), and risk for obstructive sleep apnea (OR 2.97) were found to be independent correlates of daytime sleepiness. Poor sleep quality was significantly associated with poor self-perceived health (OR 1.95), unrealistic work schedule (OR 2.85), low job satisfaction (OR 1.91), and less driving experience (OR 1.73). These results show that poor sleep quality and daytime sleepiness were prevalent in Belgian truck drivers. Taking into account that several significant correlates with respect to these sleep problems were identified both at the individual and the occupational level, comprehensive countermeasures to improve working conditions and organization are needed, as well as health promotion interventions, to ensure the safety and well-being of truck drivers.

A community-based cross-sectional study of sleep quality in middle-aged and older adults.

PubMed

Zhang, Hui-Shan; Li, Yuan; Mo, Hai-Yun; Qiu, De-Xing; Zhao, Jing; Luo, Jia-Li; Lin, Wei-Quan; Wang, Jia-Ji; Wang, Pei-Xi

2017-04-01

Sleep quality has been widely studied among western countries. However, there is limited population-based evidence on insomnia in Chinese adult populations, especially in middle-aged and older adults. The aims of present study are to (1) examine the prevalence of poor sleep among Chinese middle-age and older adults, (2) compare the Pittsburgh Sleep Quality Index (PSQI) seven domain scores across different physical health statuses, (3) explore factors associated with insomnia. A cross-sectional survey was conducted using a multi-instrument questionnaire. In total, 1563 residents aged 45 or older in the community were interviewed. The Chinese version of the PSQI was used to assess sleep quality while poor sleep was defined as a total PSQI score >5. Socio-demographic, lifestyle and physical health data were also collected. The prevalence of poor sleep among adults aged over 45 years was 20.67 %. Clusters logistic regression analysis identified that migrant workers, single marital status, lower education level, no physical exercise, illness within 2 weeks, and a higher total number of chronic diseases contribute to increased risk of poor sleep (P < 0.05). Among three clusters, physical health has the biggest independent contribution on sleep quality. Our results indicated that poor sleep was common in middle-aged and older adults. It was associated with identity of migrant worker, education level, exercise, illness within 2 weeks and number of chronic disease. Being ill within 2 weeks and having more chronic diseases were the major physical health-related factors contributing to poor sleep in the middle-aged and older people. Physical health may be a major determinant in sleep quality.

Effect of Inhaled Lavender and Sleep Hygiene on Self-Reported Sleep Issues: A Randomized Controlled Trial

PubMed Central

Lillehei, Angela Smith; Savik, Kay; Reis, Reilly

2015-01-01

Abstract Objectives: To compare the effectiveness of lavender (Lavandula angustifolia) and sleep hygiene versus sleep hygiene alone on sleep quantity and sleep quality and to determine sustained effect at two-week follow-up. Design: A randomized controlled trial with investigator blinding and steps taken to blind the participants. Setting: Participants' usual sleep setting. Subjects: Seventy-nine college students with self-reported sleep issues. Interventions: The intervention took place over five nights with baseline, postintervention, and two-week follow-up assessments. Both groups practiced good sleep hygiene and wore an inhalation patch on their chest at night. One group wore a patch with 55 μl of lavender essential oil and the other group wore a blank patch. Outcome measures: Sleep quantity was measured using a Fitbit® tracker and a sleep diary, and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) sleep disturbance short form. Results: The lavender and sleep hygiene group demonstrated better sleep quality at postintervention and two-week follow-up (PSQI p=0 .01, <0.001 and PROMIS p=0.04, 0.007, respectively). The sleep-hygiene-only group also demonstrated better sleep quality but to a lesser extent (PSQI p=0.02, 0.06 and PROMIS p=0.03, 0.03, respectively). Additionally, a clinical effect was found for the lavender group at postintervention, along with a significant finding for waking feeling refreshed (p=0.01). Sleep quantity did not differ between groups. Conclusions: Lavender and sleep hygiene together, and sleep hygiene alone to a lesser degree, improved sleep quality for college students with self-reported sleep issues, with an effect remaining at follow-up. PMID:26133206

Impact of Windows and Daylight Exposure on Overall Health and Sleep Quality of Office Workers: A Case-Control Pilot Study

PubMed Central

Boubekri, Mohamed; Cheung, Ivy N.; Reid, Kathryn J.; Wang, Chia-Hui; Zee, Phyllis C.

2014-01-01

Study Objective: This research examined the impact of daylight exposure on the health of office workers from the perspective of subjective well-being and sleep quality as well as actigraphy measures of light exposure, activity, and sleep-wake patterns. Methods: Participants (N = 49) included 27 workers working in windowless environments and 22 comparable workers in workplaces with significantly more daylight. Windowless environment is defined as one without any windows or one where workstations were far away from windows and without any exposure to daylight. Well-being of the office workers was measured by Short Form-36 (SF-36), while sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI). In addition, a subset of participants (N = 21; 10 workers in windowless environments and 11 workers in workplaces with windows) had actigraphy recordings to measure light exposure, activity, and sleep-wake patterns. Results: Workers in windowless environments reported poorer scores than their counterparts on two SF-36 dimensions—role limitation due to physical problems and vitality—as well as poorer overall sleep quality from the global PSQI score and the sleep disturbances component of the PSQI. Compared to the group without windows, workers with windows at the workplace had more light exposure during the workweek, a trend toward more physical activity, and longer sleep duration as measured by actigraphy. Conclusions: We suggest that architectural design of office environments should place more emphasis on sufficient daylight exposure of the workers in order to promote office workers' health and well-being. Citation: Boubekri M, Cheung IN, Reid KJ, Wang CH, Zee PC. Impact of windows and daylight exposure on overall health and sleep quality of office workers: a case-control pilot study. J Clin Sleep Med 2014;10(6):603-611. PMID:24932139

Perceived stress as a mediator between social constraints and sleep quality among Chinese American breast cancer survivors.

PubMed

Yeung, Nelson C Y; Ramirez, Jeffrey; Lu, Qian

2017-07-01

Previous studies primarily fo c used on how disease- and treatment-related variables affect cancer survivors' sleep quality. Little is known about the impact of the psychosocial factors on their sleep quality. Social constraints are perceived negative social interactions inhibiting one's disclosure. This study examined the association between social constraints and Chinese American breast cancer survivors' (BCS) sleep quality and tested perceived stress as a mediator explaining the association. Chinese American BCS (n = 94) were recruited from Southern California. Participants' social constraints, perceived stress, and sleep quality were measured in a questionnaire package. Social constraints were associated with higher perceived stress (r = 0.32, p = .002) and poorer sleep quality (r = 0.33, p < .001). Perceived stress was associated with poorer sleep quality (r = 0.47, p < .001). Results from structural equation modeling supported the proposed mediation model, with satisfactory model fit indices (χ 2 (23) = 33.28, p = .08, comparative fit index = 0.98, Tucker-Lewis index = 0.97, root-mean-square error of approximation = 0.07). The indirect effect from social constraints to poor sleep quality (indicated by the Pittsburgh Sleep Quality Index; PSQI) via perceived stress was significant (β = 0.20; 95% confidence intervals (CI) = 0.06, 0.40). The path coefficient for direct effect from social constraints to PSQI significantly dropped from β = 0.32 (95% CI = 0.11, 0.51) to β = 0.13 (95% CI = -0.12, 0.35) after considering perceived stress as a mediator, suggesting a mediation effect. This study implied that social constraints may worsen sleep quality among Chinese American BCS through increasing perceived stress. Interventions to reduce social constraints and perceived stress may improve sleep quality.

Insular Cortex Metabolite Changes in Obstructive Sleep Apnea

PubMed Central

Yadav, Santosh K.; Kumar, Rajesh; Macey, Paul M.; Woo, Mary A.; Yan-Go, Frisca L.; Harper, Ronald M.

2014-01-01

Study Objective: Adults with obstructive sleep apnea (OSA) show significant autonomic and neuropsychologic deficits, which may derive from damage to insular regions that serve those functions. The aim was to assess glial and neuronal status from anterior insular metabolites in OSA versus controls, using proton magnetic resonance spectroscopy (PMRS), and thus to provide insights for neuroprotection against tissue changes, and to reduce injury consequences. Design: Cross-sectional study. Setting: University-based medical center. Participants: Thirty-six patients with OSA, 53 controls. Interventions: None. Measurements and Results: We performed PMRS in bilateral anterior insulae using a 3.0-Tesla magnetic resonance imaging scanner, calculated N-acetylaspartate/creatine (NAA/Cr), choline/creatine (Cho/Cr), myo-inositol/creatine (MI/Cr), and MI/NAA metabolite ratios, and examined daytime sleepiness (Epworth Sleepiness Scale, ESS), sleep quality (Pittsburgh Sleep Quality Index, PSQI), and neuropsychologic status (Beck Depression Inventory II [BDI-II] and Beck Anxiety Inventory [BAI]). Body mass index, BAI, BDI-II, PSQI, and ESS significantly differed between groups. NAA/ Cr ratios were significantly reduced bilaterally, and left-sided MI/Cr and MI/NAA ratios were increased in OSA over controls. Significant positive correlations emerged between left insular MI/Cr ratios and apnea-hypopnea index values, right insular Cho/Cr ratios and BDI-II and BAI scores, and negative correlations appeared between left insular NAA/Cr ratios and PSQI scores and between right-side MI/Cr ratios and baseline and nadir change in O2 saturation. Conclusions: Adults with obstructive sleep apnea showed bilaterally reduced N-acetylaspartate and left-side increased myo-inositol anterior insular metabolites, indicating neuronal damage and increased glial activation, respectively, which may contribute to abnormal autonomic and neuropsychologic functions in the condition. The activated glial status likely indicates increased inflammatory action that may induce more neuronal injury, and suggests separate approaches for glial and neuronal protection. Citation: Yadav SK, Kumar R, Macey PM, Woo MA, Yan-Go FL, Harper RM. Insular cortex metabolite changes in obstructive sleep apnea. SLEEP 2014;37(5):951-958. PMID:24790274

Depressive Symptoms are the Main Predictor for Subjective Sleep Quality in Patients with Mild Cognitive Impairment—A Controlled Study

PubMed Central

Seidel, Stefan; Dal-Bianco, Peter; Pablik, Eleonore; Müller, Nina; Schadenhofer, Claudia; Lamm, Claus; Klösch, Gerhard; Moser, Doris; Klug, Stefanie; Pusswald, Gisela; Auff, Eduard; Lehrner, Johann

2015-01-01

Objective Controlled data on predictors of subjective sleep quality in patients with memory complaints are sparse. To improve the amount of comprehensive data on this topic, we assessed factors associated with subjective sleep quality in patients from our memory clinic and healthy individuals. Methods Between February 2012 and August 2014 patients with mild cognitive impairment (MCI) and subjective cognitive decline (SCD) from our memory clinic and healthy controls were recruited. Apart from a detailed neuropsychological assessment, the subjective sleep quality, daytime sleepiness and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS) and the Beck Depression Inventory (BDI-II). Results One hundred fifty eight consecutive patients (132 (84%) MCI patients and 26 (16%) SCD patients) and 75 healthy controls were included in the study. Pairwise comparison of PSQI scores showed that non-amnestic MCI (naMCI) patients (5.4±3.5) had significantly higher PSQI scores than controls (4.3±2.8, p = .003) Pairwise comparison of PSQI subscores showed that naMCI patients (1.1±0.4) had significantly more “sleep disturbances” than controls (0.9±0.5, p=.003). Amnestic MCI (aMCI) (0.8±1.2, p = .006) and naMCI patients (0.7±1.2, p = .002) used “sleep medication” significantly more often than controls (0.1±0.6) Both, aMCI (11.5±8.6, p<.001) and naMCI (11.5±8.6, p<.001) patients showed significantly higher BDI-II scores than healthy controls (6.1±5.3). Linear regression analysis showed that the subjective sleep quality was predicted by depressive symptoms in aMCI (p<.0001) and naMCI (p<.0001) patients as well as controls (p<.0001). This means, that more depressive symptoms worsened subjective sleep quality. In aMCI patients we also found a significant interaction between depressive symptoms and global cognitive function (p = .002) Discussion Depressive symptoms were the main predictor of subjective sleep quality in MCI patients and controls, but not in SCD patients. Better global cognitive function ameliorated the negative effect of depressive symptoms on the subjective sleep quality in aMCI patients. PMID:26090659

Comprehensive Health-Related Quality of Life is Influenced by Nocturia and Sleep Disturbance: Investigation Based on the SF-8.

PubMed

Suekane, Shigetaka; Ueda, Kousuke; Suyama, Shunsuke; Hayashi, Tokumasa; Toyozawa, Noriyuki; Yoshitake, Maki; Nishihara, Kiyoaki; Sakashita, Nao; Uchimura, Naohisa; Matsuoka, Kei

2016-01-01

We investigated the influence of nocturia and sleep disturbance on health-related quality of life(HRQOL) using the Medical Outcomes Study 8-item Short Form Health Survey (SF-8) in patients with nocturia. We also assessed the effect of therapeutic intervention by means of an anticholinergic agent on the results of the SF-8. One hundred and eighty-four patients who voided at least once per night were surveyed using the SF-8, Overactive Bladder Symptom Score (OABSS), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). These parameters were also evaluated before and after 12 weeks of imidafenacin treatment in 51 patients with OAB accompanied by nocturia. The SF-8 physical component summary score (PCS) showed a significant decrease as nighttime voiding frequency increased. The mental health component summary score was 47.1 and 47.6 (which were lower than the standard value of 50) in the group with a nighttime frequency of once and ≥3/night, respectively. The SF-8 PCS and 6 subscales were negatively associated with nighttime voiding frequency, while the PSQI global score was positively associated with it. Imidafenacin significantly improved the OABSS, PSQI, and ESS, as well as the SF-8 score. This is the first study using the SF-8 to show that nocturia and sleep disturbance have a major influence on comprehensive HRQOL and that the SF-8 can be used to monitor HRQOL in OAB patients receiving treatment for nocturia.

Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders

PubMed Central

Lim, Soo-Kyung; Yoo, Seung Jin; Koo, Dae Lim; Park, Chae A; Ryu, Han Jun; Jung, Yong Jin; Jeong, Ji Bong; Kim, Byeong Gwan; Lee, Kook Lae; Koh, Seong-Joon

2017-01-01

AIM To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts. METHODS In this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call shifts. RESULTS Among the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48 (28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores (PSQI) (8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm (83.3% vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work (81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD (OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality (PSQI ≥ 6) was a predictor of IBS (OR = 4.17, 95%CI: 1.92-19.02, P = 0.016). CONCLUSION Physicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs. PMID:28566894

Prevalence, symptomatic features, and factors associated with sleep disturbance/insomnia in Japanese patients with type-2 diabetes.

PubMed

Narisawa, Hajime; Komada, Yoko; Miwa, Takashi; Shikuma, Junpei; Sakurai, Mamoru; Odawara, Masato; Inoue, Yuichi

2017-01-01

To clarify the prevalence and symptomatic characteristics of sleep disturbance/insomnia among type-2 diabetes mellitus (DM) Japanese patients. A cross-sectional survey of Japanese patients with the disorder was conducted. Participants consisted of 622 type-2 DM patients (mean 56.1±9.56 years) and 622 sex- and age-matched controls. Participants' scores in the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J), the Japanese version of the 12-item Center for Epidemiologic Studies Depression Scale (CES-D), the Medical Outcomes Study 8-item Short Form Health Survey (SF-8), and the glycated hemoglobin A1c (HbA1c) of type-2 DM patients were analyzed. There were 253 poor sleepers (43.9%) in the type-2 DM group as a result of dichotomization with the PSQI-J cutoff total score of 5.5. The type-2 DM group recorded a higher mean PSQI-J total score ( P <0.01) and manifested poorer sleep maintenance. Poor sleepers in both groups had lower mental component summary from SF-8 (MCS), physical component summary from SF-8 (PCS), and CES-D than good sleepers, and good sleepers in both groups had higher MCS, PCS, and CES-D than poor sleepers. Higher body mass index, presence of smoking habit, and living alone were significantly associated with sleep disturbance/insomnia symptoms, but HbA1c was not associated with sleep disturbance/insomnia in the type-2 DM group. Individuals affected with type-2 DM are likely to experience sleep problems, characterized by disturbance in sleep maintenance. Sleep disturbance/insomnia symptoms in DM patients might considerably reduce health-related quality of life.

Sleep disturbance and correlates in menopausal women in Shanghai.

PubMed

Sun, Dongmei; Shao, Hongfang; Li, Changbin; Tao, Minfang

2014-03-01

The aim of this study was to investigate the sleep disturbance and its correlates in Chinese middle-aged women. A total of 2046 Chinese women 40-60 years of age were recruited in this cross-sectional descriptive study. The subjects were surveyed using the Pittsburgh Sleep Quality Index (PSQI), the modified Kupperman Index (KI), and a general questionnaire to obtain sociodemographic data. Data were analyzed using SPSS 20.0 software. In this study, the mean (standard deviation) age of the participants was 51.69 (6.54) years and the mean PSQI score was 6.88 (3.20). The prevalence of sleep disturbance was 33.2% (a PSQI global score ≥8). The prevalence of sleep disturbance was higher in women with a menopausal status (from 34.8% in premenopausal women to 40.9% in postmenopausal women, P < .001) and in women with an increased age (from 21.7% in women 40-44 years of age to 41.8% in women 55-60 years of age, P < .001). Vasomotor symptoms (classical menopausal symptoms, VMS) were associated with sleep disturbance. An increase in the severity of menopausal symptoms (higher total KI scores) was observed in women who experienced sleep disturbance. A logistic regression analysis revealed that menopausal status, vasomotor symptoms, modified KI scores, a history of disease, and older age (≥ 50 years) were significant risk factors for sleep disturbance. Sleep disturbance was highly prevalent in this large sample of middle-aged Chinese women. Therefore, clinicians should pay more attention to sleep problems in middle-aged Chinese women and measures should be taken to improve the quality of sleep in these women. Copyright © 2013 Elsevier Inc. All rights reserved.

The effects of reflexology on pain and sleep deprivation in patients with rheumatoid arthritis: A randomized controlled trial.

PubMed

Bakir, Ercan; Baglama, Sevgin Samancioglu; Gursoy, Savas

2018-05-01

This study was intended to examine the effect of foot reflexology on RA patients' pain and sleep quality. This is a randomized controlled trial and was held at the "Rheumatology Follow-up Polyclinic" in Turkey between January-July 2015. A total of 60 patients were included in the research. A sociodemographic data form, the Pittsburgh Sleep Quality Index (PSQI) and the Visual Analogue Scale (VAS) were used. Foot Reflexology was administered to the experimental group. The research found that the pain scores of the experimental group were statistically more significant than those of the control group (p < .01). The experimental group's average pain was reduced by the six weeks of foot reflexology. The total PSQI score of the experimental group was lowered. Foot reflexology is a non-pharmacological nursing intervention that may reduce the pain and sleep deprivation symptoms of RA patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effects of an irregular bedtime schedule on sleep quality, daytime sleepiness, and fatigue among university students in Taiwan.

PubMed

Kang, Jiunn-Horng; Chen, Shih-Ching

2009-07-19

An irregular bedtime schedule is a prevalent problem in young adults, and could be a factor detrimentally affecting sleep quality. The goal of the present study was to explore the association between an irregular bedtime schedule and sleep quality, daytime sleepiness, and fatigue among undergraduate students in Taiwan. A total of 160 students underwent a semi-structured interview and completed a survey comprising 4 parts: Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), and a rating of irregular bedtime frequency. Participants were grouped into 3 groups in terms of irregular bedtime frequency: low, intermediate, or high according to their 2-week sleep log. To screen for psychological disorders or distress that may have affected responses on the sleep assessment measures, the Chinese health questionnaire-12 (CHQ-12) was also administered. We found an increase in bedtime schedule irregularity to be significantly associated with a decrease in average sleep time per day (Spearman r = -0.22, p = 0.05). Multivariate regression analysis revealed that irregular bedtime frequency and average sleep time per day were correlated with PSQI scores, but not with ESS or FSS scores. A significant positive correlation between irregular bedtime frequency and PSQI scores was evident in the intermediate (partial r = 0.18, p = 0.02) and high (partial r = 0.15, p = 0.05) frequency groups as compared to low frequency group. The results of our study suggest a high prevalence of both an irregular bedtime schedule and insufficient sleep among university students in Taiwan. Students with an irregular bedtime schedule may experience poor sleep quality. We suggest further research that explores the mechanisms involved in an irregular bedtime schedule and the effectiveness of interventions for improving this condition.

Sleeping problems in mothers and fathers of patients suffering from congenital central hypoventilation syndrome.

PubMed

Paddeu, Erika Maria; Giganti, Fiorenza; Piumelli, Raffaele; De Masi, Salvatore; Filippi, Luca; Viggiano, Maria Pia; Donzelli, Gianpaolo

2015-09-01

Advanced medical technology has resulted in an increased survival rate of children suffering from congenital central hypoventilation syndrome. After hospitalization, these technology-dependent patients require special home care for assuring ventilator support and the monitoring of vital parameters mainly during sleep. The daily challenges associated with caring for these children can place primary caregivers under significant stress, especially at night. Our study aimed at investigating how this condition affects mothers and fathers by producing poor sleep quality, high-level diurnal sleepiness, anxiety, and depression. The study included parents of 23 subjects with congenital central hypoventilation syndrome and 23 healthy subjects. All parents filled out the Pittsburgh Sleep Quality Index (PSQI) questionnaire, Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory (BAI). A comparison between the two groups showed that parents of patients had poorer sleep quality, greater sleepiness, and higher BDI-II scores compared to that of parents of healthy subjects (respectively, PSQI score 6.5 vs 3.8, ESS score 6.2 vs 4.3, BDI-II score 8.4 vs 5.7). Specifically, mothers of patients showed poorer sleep quality and higher BDI-II scores compared to that of mothers of controls (respectively, PSQI score 7.5 vs 3.8, BDI-II score 9.3 vs 5.9), whereas fathers of patients showed greater levels of sleepiness with respect to fathers of healthy children (respectively, ESS score 6.8 vs 4.0). These differences emerged in parents of younger children. Congenital central hypoventilation syndrome impacts the family with different consequences for mothers and fathers. Indeed, while the patients' sleep is safeguarded, sleeping problems may occur in primary caregivers often associated with other psychological disorders. Specifically, this disease affects sleep quality and mood in the mothers and sleepiness levels in the fathers.

Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study.

PubMed

Lucassen, Eliane A; de Mutsert, Renée; le Cessie, Saskia; Appelman-Dijkstra, Natasha M; Rosendaal, Frits R; van Heemst, Diana; den Heijer, Martin; Biermasz, Nienke R

2017-01-01

Sleep deprivation has detrimental metabolic consequences. Osteopenia and sarcopenia usually occur together and increase risk of fractures and disease. Results from studies linking sleep parameters to osteopenia or sarcopenia are scarce and inconsistent. To examine the associations of sleep parameters with osteopenia and sarcopenia, considering the influence of sex and menopause. Cross-sectional analysis of 915 participants (45-65 years, 56% women, BMI 26 (range: 18-56) kg/m2) in the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study. Sleep duration, quality, and timing were assessed with the Pittsburgh Sleep Quality Index (PSQI); bone mineral density and relative appendicular muscle mass were measured by DXA scans. Linear and logistic regressions were performed to associate sleep parameters to bone mineral density, relative appendicular muscle mass, osteopenia (t-score between -1 and -2.5) and sarcopenia (1 SD below average muscle mass). After adjustment for confounding factors, one unit increase in PSQI score (OR and 95% CI, 1.09, 1.03-1.14), declined self-rated sleep quality (1.76, 1.03-3.01), sleep latency (1.18, 1.06-1.31), and a one hour later sleep timing (1.51, 1.08-2.11), but not sleep duration (1.05, 0.90-1.23), were associated with osteopenia. PSQI score (1.10, 1.02-1.19) was also associated with sarcopenia; OR's of sleep latency and later mid-sleep time with sarcopenia were 1.14 (0.99-1.31) and 1.54 (0.91-2.61), respectively. Associations were somewhat stronger in women and varied per menopausal status. These results suggest that decreased sleep quality and a later sleep timing are risk factors for osteopenia and sarcopenia in middle aged individuals.

The relationship between serum asymmetric dimethylarginine levels and subjective sleep quality in normotensive patients with type 2 diabetes mellitus.

PubMed

Aribas, Alpay; Kayrak, Mehmet; Tekinalp, Mehmet; Akilli, Hakan; Alibasic, Hayrudin; Yildirim, Serkan; Gunduz, Mehmet; Taner, Alpaslan; Unlu, Ali

2015-05-01

Poor sleep quality (SQ) is associated with increased cardiovascular mortality and morbidity. Additionally, asymmetric dimethylarginine (ADMA) is an independent predictor of cardiovascular mortality and morbidity. However, no sufficient data regarding the relationship between ADMA levels and SQ have been reported. The goal of the current study was to evaluate the association between SQ and ADMA levels in normotensive patients with type 2 diabetes mellitus. The study participants consisted of 78 normotensive type 2 diabetics. The SQ of all participants was assessed using the Pittsburgh Sleep Quality Index (PSQI). Patients with a global PSQI score > 5 were defined as "poor sleepers." Factors associated with poor SQ were analyzed using a multiple regression model. Serum ADMA levels were measured using high performance liquid chromatography. The median ADMA levels of the poor sleepers were increased compared with patients defined as good sleepers (5.5 [4.2 to 6.6] vs. 4.4 [2.9 to 5.4], p < 0.01, respectively). However, the L-arginine/ADMA ratio was decreased in poor sleepers (p < 0.01). Global PSQI scores were positively correlated with ADMA levels (p < 0.01) and negatively correlated with the L-arginine/ADMA ratio (p = 0.02). ADMA levels were correlated with sleep latency (p < 0.01) and sleep efficiency (p = 0.01). Logistic regression analysis showed that ADMA levels (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.16 to 2.44; p = 0.01) and body mass index (OR, 1.15; 95% CI, 1.01 to 1.31; p = 0.04) were associated with poor SQ independently of glomerular filtration rate, sex, age, duration of diabetes, hemoglobin A1c, total cholesterol, and systolic blood pressure. Self-reported SQ was independently associated with ADMA levels in normotensive patients with diabetes mellitus.

Subjective Assessment of Sleep in Huntington Disease: Reliability of Sleep Questionnaires Compared to Polysomnography.

PubMed

Piano, Carla; Della Marca, Giacomo; Losurdo, Anna; Imperatori, Claudio; Solito, Marcella; Calandra-Buonaura, Giovanna; Provini, Federica; Cortelli, Pietro; Bentivoglio, Anna Rita

2017-01-01

The aim of the study was to evaluate the clinical reliability of subjective sleep evaluation, based on sleep and psychometric questionnaires, by comparing the results with those obtained with laboratory-based video-polysomnography (V-PSG). Thirty consecutive Huntington disease (HD) patients were enrolled. Subjective evaluation of sleep included the Pittsburgh Sleep Quality Index (PSQI), the sleep questionnaire for HD (HDQ), the Epworth Sleepiness Scale, the Bologna questionnaire for sleepiness (BQ), the Berlin questionnaire, and the RBD questionnaire; the International Restless Legs Syndrome Study Group scale was administered to patients with positive screening. The psychometric evaluation included the Zung Anxiety Scale, the short form of the Beck Depression Inventory, and the Maudsley Obsessive-Compulsive Inventory. All patients underwent V-PSG. In sleepiness evaluation, the Epworth score was above the cutoff in 6 subjects, and the BQ detected a "high risk" of sleepiness in 7 cases. The results were concordant in 24 and discordant in 5 cases. In the evaluation of sleep quality, the PSQI score was above the cutoff in 18 subjects. According to the HDQ, 10 subjects were poor sleepers. The results were concordant with the PSQI in 20 subjects. All comparisons between scale scores and PSG results showed poor or totally absent concordance between subjective and objective measures. The subjective evaluation of sleep in HD patients shows a poor correlation with PSG results. © 2017 S. Karger AG, Basel.

Efficacy of rehabilitation with Tai Ji Quan in an Italian cohort of patients with Fibromyalgia Syndrome.

PubMed

Maddali Bongi, Susanna; Paoletti, Gianluca; Calà, Michael; Del Rosso, Angela; El Aoufy, Khadija; Mikhaylova, Svetlana

2016-08-01

Fibromyalgia Syndrome (FMS) is characterized by musculoskeletal pain, muscle tenderness leading to disability, impaired quality of life (QoL), fatigue and it is accompanied by sleep disorders and psychological distress. Mind body therapies (MBT), such as Tai Ji Quan (TJQ), use different techniques to facilitate the ability of the mind to influence disease characteristics and symptoms. Some studies showed that TJQ, in patients with rheumatic diseases, particularly FMS, improved QoL, disability and psychological distress. To evaluate the efficacy of TJQ on disability, QoL, fatigue, sleep and psychological distress in an Italian cohort of FMS patients. We enrolled 44 FMS patients: 22 patients (Experimental Group) participated to a course of Tai Ji Quan style of (2/week for 16 weeks); 22 patients (Control Group) participated to an educational course about FMS (2/week for 16 weeks). At baseline (T0) and at the end of treatment (T1), patients were assessed for disability [Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ)], Quality of Life [Short-Form 36 (SF36)], fatigue [Functional Assessment of Chronic Illness-Fatigue (FACIT-F)], pain [Widespread Pain Index (WPI)], tenderness [Tender Points (TP)], Sleep Quality [Pittsburgh Sleep Quality Index (PSQI)] and mood disorders [Hospital Anxiety and Depression Scale (HADS)]. At T1 versus T0, patients of the Experimental Group showed a significant improvement in FIQ, FACIT, SF36 (Summary Physical Index, Physical activity, physical role, bodily pain, general health, vitality, emotional role limitations), in WPI, TP, PSQI (total, sleep duration, and sleep disturbance) and HADS (total score and anxiety subscale), while Patients in the Control Group did not improve in any parameter. In FMS patients TJQ, if performed by an expert physiotherapist, should be regarded as an effective rehabilitation method. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Influence of Sleep Disorders on Voice Quality.

PubMed

Rocha, Bruna Rainho; Behlau, Mara

2017-09-19

To verify the influence of sleep quality on the voice. Descriptive and analytical cross-sectional study. Data were collected by an online or printed survey divided in three parts: (1) demographic data and vocal health aspects; (2) self-assessment of sleep and vocal quality, and the influence that sleep has on voice; and (3) sleep and voice self-assessment inventories-the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and the Voice Handicap Index reduced version (VHI-10). A total of 862 people were included (493 women, 369 men), with a mean age of 32 years old (maximum age of 79 and minimum age of 18 years old). The perception of the influence that sleep has on voice showed a difference (P < 0.050) between measures of sleep quality and vocal self-assessment. There were higher scores on the ESS, PSQI, and VHI-10 protocols if sleep and vocal self-assessment were poor. The results indicate that the greater the effect that sleep has on voice, the greater the perceived voice handicap. The aspects that influence a voice handicap are vocal self-assessment, ESS total score, and self-assessment of the influence that sleep has on voice. The absence of daytime sleepiness is a protective factor (odds ratio [OR] > 1) against perceived voice handicap; the presence of daytime sleepiness is a damaging factor (OR < 1). Sleep quality influences voice. Perceived poor sleep quality is related to perceived poor vocal quality. Individuals with a voice handicap observe a greater influence of sleep on voice than those without. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus.

PubMed

Cai, Shirong; Tan, Sara; Gluckman, Peter D; Godfrey, Keith M; Saw, Seang-Mei; Teoh, Oon Hoe; Chong, Yap-Seng; Meaney, Michael J; Kramer, Michael S; Gooley, Joshua J

2017-02-01

To examine the influence of maternal sleep quality and nocturnal sleep duration on risk of gestational diabetes mellitus (GDM) in a multiethnic Asian population. A cohort of 686 women (376 Chinese, 186 Malay, and 124 Indian) with a singleton pregnancy attended a clinic visit at 26-28 weeks of gestation as part of the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort study. Self-reported sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). GDM was diagnosed based on a 75-g oral glucose tolerance test administered after an overnight fast (1999 WHO criteria). Multiple logistic regression was used to model separately the associations of poor sleep quality (PSQI score > 5) and short nocturnal sleep duration (<6 h) with GDM, adjusting for age, ethnicity, maternal education, body mass index, previous history of GDM, and anxiety (State-Trait Anxiety Inventory score). In the cohort 296 women (43.1%) had poor sleep quality and 77 women (11.2%) were categorized as short sleepers; 131 women (19.1%) were diagnosed with GDM. Poor sleep quality and short nocturnal sleep duration were independently associated with increased risk of GDM (poor sleep, adjusted odds ratio [OR] = 1.75, 95% confidence interval [CI] 1.11 to 2.76; short sleep, adjusted OR = 1.96, 95% CI 1.05 to 3.66). During pregnancy, Asian women with poor sleep quality or short nocturnal sleep duration exhibited abnormal glucose regulation. Treating sleep problems and improving sleep behavior in pregnancy could potentially reduce the risk and burden of GDM. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Effects of music listening on stress, anxiety, and sleep quality for sleep-disturbed pregnant women.

PubMed

Liu, Yu-Hsiang; Lee, ChihChen Sophia; Yu, Chen-Hsiang; Chen, Chung-Hey

2016-01-01

Prenatal sleep disturbance has been associated with undesirable birthing outcomes. To determine the effectiveness of listening to music at home in improving sleep quality, 121 Taiwanese pregnant women with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score > 5) were systematically assigned, with a random start to music listening (n = 61) or control (n = 60) group. Participants in the music listening group self-regulated listening to music in addition to receiving general prenatal care similar to that in the control group for 2 weeks. The PSQI and State-Anxiety Inventory were used to assess outcomes. ANCOVA analyses were used with the pretest scores as covariates and showed significant improvement in sleep quality, stress, and anxiety in the music listening group compared with the control group. The most frequently used music genre by participants in the experimental group was lullabies, followed by classical music and crystal baby music. This study supported the theory that 2-week music listening interventions may reduce stress, anxiety, and yield better sleep quality for sleep-disturbed pregnant women. The analysis of participants' journals also implied that the expectant mothers' choices of musical genres may correlate more with perceived prenatal benefits or the desire to interact with their unborn child.

Sleep quality, sleeping postures, and sleeping equipment in patients with ankylosing spondylitis

PubMed

Yolbaş, Servet; Yıldırım, Ahmet; Düzenci, Deccane; Gündoğdu, Barış; Özgen, Metin; Koca, Süleyman Serdar

2017-08-23

Background/aim: Inflammatory back pain, spinal stiffness, and limited spinal mobility are characteristic features of ankylosing spondylitis (AS). Sleeping postures can affect and/or reflect sleeping disturbances. The aim of the study was to evaluate sleeping postures and sleep disturbances in patients with AS. Materials and methods: Seventy-seven patients with AS and 49 healthy controls were enrolled. The Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) were applied to both groups. The most common sleeping postures were noted. Results: There was no significant difference between the groups in terms of sleeping postures. Total PSQI and ISI scores were higher in the AS group than in the controls (P = 0.004 and P = 0.038, respectively). The selection of sleeping postures of active and inactive patients were similar. The number of pillows used was not the same in the AS and control groups (P = 0.016). The frequency of customized bed use was higher in the AS group compared to the control group (P = 0.004). Conclusion: Sleep disturbances are more of a problem in patients with AS compared to healthy patients and in active AS patients compared to inactive ones. However, sleeping postures do not seem to affect either sleep disturbances or disease activity in patients with AS.

Determinants of sleep quality among pregnant women in China: a cross-sectional survey.

PubMed

Yang, Ying; Mao, Jing; Ye, Zhiying; Zeng, Xiaoli; Zhao, Huimin; Liu, Yueting; Li, Jie

2017-08-03

Sleep disturbances are common during pregnancy, yet few studies are currently available regarding the determinants of sleep quality among pregnant women in China. This study aimed to: (a) calculate the prevalence of sleep disorder during pregnancy, (b) examine the difference in sleep quality among three trimesters, and (c) identify determinants of sleep quality in pregnant women. This study was designed as a cross-sectional survey. Five hundred pregnant women were recruited at the outpatient department of obstetrics and gynecology of two teaching hospitals in central China. Five selfreport questionnaires were used for gathering data, including information of sample characteristics, sleep quality (Pittsburgh Sleep Quality Index (PSQI)), prenatal depression (the Edinburgh Postnatal Depression Scale (EPDS)), perceived stress (Perceived Stress Scale (PSS)), and perceived social support (Multidimensional Scale of Perceived Social Support (MSPSS)). A total of 454 pregnant women participated in the study between September 2016 and April 2017. Eighty-seven percent pregnant women experienced sleep disorder (PSQI score >5). Poorer global sleep quality, subjective sleep quality, lower sleep efficiency and sleep disturbances were most prevalent during third trimester. The significant contributors to sleep quality for pregnant women were prenatal depression, maternal age, and gestational age. Sleep disorder is very common in pregnant women from China. Depressive symptoms, increased maternal age, and gestational age are determinants of sleep quality. These determinants can assist healthcare professionals in preventative intervention.

Association between Personality Traits and Sleep Quality in Young Korean Women

PubMed Central

Kim, Han-Na; Cho, Juhee; Chang, Yoosoo; Ryu, Seungho

2015-01-01

Personality is a trait that affects behavior and lifestyle, and sleep quality is an important component of a healthy life. We analyzed the association between personality traits and sleep quality in a cross-section of 1,406 young women (from 18 to 40 years of age) who were not reporting clinically meaningful depression symptoms. Surveys were carried out from December 2011 to February 2012, using the Revised NEO Personality Inventory and the Pittsburgh Sleep Quality Index (PSQI). All analyses were adjusted for demographic and behavioral variables. We considered beta weights, structure coefficients, unique effects, and common effects when evaluating the importance of sleep quality predictors in multiple linear regression models. Neuroticism was the most important contributor to PSQI global scores in the multiple regression models. By contrast, despite being strongly correlated with sleep quality, conscientiousness had a near-zero beta weight in linear regression models, because most variance was shared with other personality traits. However, conscientiousness was the most noteworthy predictor of poor sleep quality status (PSQI≥6) in logistic regression models and individuals high in conscientiousness were least likely to have poor sleep quality, which is consistent with an OR of 0.813, with conscientiousness being protective against poor sleep quality. Personality may be a factor in poor sleep quality and should be considered in sleep interventions targeting young women. PMID:26030141

A Subjective Assessment of the Prevalence and Factors Associated with Poor Sleep Quality Amongst Elite Japanese Athletes.

PubMed

Hoshikawa, Masako; Uchida, Sunao; Hirano, Yuichi

2018-02-26

The amount, quality, and timing of sleep are considered important for athletes' ability to train, maximize training responses, and recover. However, some research has shown that elite athletes do not obtain sufficient sleep. Based on this background, researchers recently started to assess and manage sleep in elite athletes. The purpose of this study was to clarify the prevalence of poor sleep quality and its associated factors amongst elite Japanese athletes. Eight hundred and ninety-one candidates for the 17th Asian Games Incheon 2014, who were over 20 years old, participated in this study. They completed a questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, two-question case-finding instruments, and a checklist for sleep hygiene. Data from 817 of the 891 athletes (91.7%) with no missing values were analyzed. The mean time in bed was 7 h and 29 min. Two hundred and twenty-nine (28.0%) athletes showed a PSQI global score above the clinical criteria. A multiple logistic analysis revealed that sleep quality was significantly associated with five factors: "time in bed," "eating breakfast every morning," "avoiding the use of electronic devices (PC, smartphone, etc.) just before bedtime," "depressive mood", and "not thinking about troubles while in bed." Forty percent of athletes reported they had been informed by someone about "snoring loudly" and/or "leg twitching or jerking during sleep." The results of this study demonstrate that 28% of the athletes showed the PSQI score above the cutoff for poor sleep quality (> 5.5), which suggests that there may be a high prevalence of poor sleep quality in this population of athletes. To improve athletes' sleep, the five factors associated with sleep quality should be emphasized in athletes' sleep education. Furthermore, in medical evaluations of athletes, it may be desirable to include screening for sleep disorders.

Association of Poor Subjective Sleep Quality with Suicidal Ideation among Pregnant Peruvian Women

PubMed Central

Gelaye, Bizu; Barrios, Yasmin V.; Zhong, Qiu-Yue; Rondon, Marta B.; Borba, Christina P.C.; Sánchez, Sixto E.; Henderson, David C.; Williams, Michelle A.

2015-01-01

Objective To examine the independent and joint relationships of poor subjective sleep quality, and antepartum depression with suicidal ideation among pregnant women. Methods A cross-sectional study was conducted among 641 pregnant women attending prenatal care clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale. Antepartum subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression procedures were performed to estimate odds ratios (aOR) and 95% confidence intervals (95% CI) adjusted for confounders. Results Overall, the prevalence of suicidal ideation in this cohort was 16.8% and poor subjective sleep quality was more common among women endorsing suicidal ideation as compared to their counterparts who did not (47.2%vs.24.8%, p<0.001). After adjustment for confounders including maternal depression, poor subjective sleep quality (defined using the recommended criteria of PSQI global score of >5vs. ≤5) was associated with a 1.7-fold increased odds of suicidal ideation (aOR=1.67; 95%CI 1.02–2.71). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in an 18% increase in odds for suicidal ideation, even after adjusting for depression (aOR=1.18; 95%CI 1.08–1.28). Women with both poor subjective sleep quality and depression had a 3.5-fold increased odds of suicidal ideation (aOR=3.48; 95%CI 1.96–6.18) as compared with those who had neither risk factor. Conclusion Poor subjective sleep quality was associated with increased odds of suicidal ideation. Replication of these findings may promote investments in studies designed to examine the efficacy of sleep-focused interventions to treat pregnant women with sleep disorders and suicidal ideation. PMID:25983188

Psychometric Evaluation of the PSQI in U.S. College Students

PubMed Central

Dietch, Jessica R.; Taylor, Daniel J.; Sethi, Kevin; Kelly, Kimberly; Bramoweth, Adam D.; Roane, Brandy M.

2016-01-01

Study Objectives: Examine the psychometric properties of the PSQI in two U.S. college samples. Methods: Study I assessed convergent and divergent validity in 866 undergraduates who completed a sleep diary, PSQI, and other sleep and psychosocial measures. Study II assessed PSQI insomnia diagnostic accuracy in a separate sample of 147 healthy undergraduates with and without insomnia. Results: The PSQI global score had only moderate convergent validity with sleep diary sleep efficiency (prospective global measure of sleep continuity; r = 0.53), the Insomnia Severity Index (r = 0.63), and fatigue (r = 0.44). The PSQI global score demonstrated good divergent validity with measures of excessive daytime sleepiness (r = 0.18), circadian preference (r = −0.08), alcohol (r = 0.08) and marijuana (r = 0.05) abuse scales, and poor divergent validity with depression (r = 0.48), anxiety (r = 0.40), and perceived stress (r = 0.33). Examination of other analogous PSQI and sleep diary components showed low to moderate convergent validity: sleep latency (r = 0.70), wake after sleep onset (r = 0.37), sleep duration (r = 0.51), and sleep efficiency (r = −0.32). Diagnostic accuracy of the PSQI to detect insomnia was very high (area under the curve = 0.999). Sensitivity and specificity were maximized at a cutoff of 6. Conclusions: The PSQI demonstrated moderate convergent validity compared to measures of insomnia and fatigue and good divergent validity with measures of daytime sleepiness, circadian phase preference, and alcohol and marijuana use. The PSQI demonstrated considerable overlap with depression, anxiety, and perceived stress. Therefore, caution should be used with interpretation. Citation: Dietch JR, Taylor DJ, Sethi K, Kelly K, Bramoweth AD, Roane BM. Psychometric evaluation of the PSQI in U.S. college students. J Clin Sleep Med 2016;12(8):1121–1129. PMID:27166299

Characteristics of Sleep Disturbances in Patients with Gastroesophageal Reflux Disease.

PubMed

Iwakura, Narika; Fujiwara, Yasuhiro; Shiba, Masatsugu; Ochi, Masahiro; Fukuda, Takashi; Tanigawa, Tetsuya; Yamagami, Hirokazu; Tominaga, Kazunari; Watanabe, Toshio; Arakawa, Tetsuo

2016-01-01

Objective Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances; however, the detailed differences in the characteristics of sleep disturbances between GERD and non-GERD patients are unknown. The aim of the present study was to analyze the clinical characteristics as well as health-related quality of life in GERD and non-GERD patients with sleep disturbances. Methods Three hundred and fifty patients, including 124 patients with GERD and 226 patients without GERD, completed a self-administered questionnaire that evaluated clinical information. The Pittsburg Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and 8-item Short-Form Health Survey (SF-8) were also used. Sleep disturbance was considered to be present if the PSQI was >5.5. Results The prevalence of sleep disturbances was significantly higher in the GERD patients (66/124, 53.9%) than in the non-GERD patients (89/226, 39.3%). Depression and anxiety were significantly more common in the subjects with sleep disturbances than in those without sleep disturbances, although there were no differences between the GERD and non-GERD patients. Among the subjects with sleep disturbances, daytime sleepiness was more common in the GERD patients than in the non-GERD patients. The subjects with sleep disturbances had a poorer health-related quality of life. The physical components of quality of life were impaired, particularly in the GERD patients with sleep disturbances. Conclusion GERD patients with sleep disturbances commonly experience daytime sleepiness and an impaired health-related quality of life, especially in terms of physical components.

Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity and frequency of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) symptoms in women.

PubMed

Milrad, Sara F; Hall, Daniel L; Jutagir, Devika R; Lattie, Emily G; Ironson, Gail H; Wohlgemuth, William; Nunez, Maria Vera; Garcia, Lina; Czaja, Sara J; Perdomo, Dolores M; Fletcher, Mary Ann; Klimas, Nancy; Antoni, Michael H

2017-02-15

Poor sleep quality has been linked to inflammatory processes and worse disease outcomes in the context of many chronic illnesses, but less is known in conditions such as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). This study examines the relationships between sleep quality, pro-inflammatory cytokines, and CFS/ME symptoms. Sixty women diagnosed with CFS/ME were assessed using the Pittsburgh Sleep Quality Index (PSQI), Fatigue Symptom Inventory (FSI) and Center for Disease Control and Prevention (CDC)-based CFS/ME symptom questionnaires. Circulating plasma pro-inflammatory cytokine levels were measured by ELISA. Multiple regression analyses examined associations between sleep, cytokines and symptoms, controlling for age, education, and body mass index. Poor sleep quality (PSQI global score) was associated with greater pro-inflammatory cytokine levels: interleukin-1β (IL-1β) (β=0.258, p=0.043), IL-6 (β=0.281, p=0.033), and tumor necrosis factor-alpha (TNF-α) (β=0.263, p=0.044). Worse sleep quality related to greater fatigue severity (β=0.395, p=0.003) and fatigue-related interference with daily activities (β=0.464, p<0.001), and more severe and frequent CDC-defined core CFS/ME symptoms (β=0.499, p<0.001, and β=0.556, p<0.001, respectively). Results underscore the importance of managing sleep-related difficulties in this patient population. Further research is needed to identify the etiology of sleep disruptions in CFS/ME and mechanistic factors linking sleep quality to symptom severity and inflammatory processes. Copyright © 2016 Elsevier B.V. All rights reserved.

[Acupuncture therapy for the improvement of sleep quality of outpatients receiving methadone maintenance treatment: a randomized controlled trial].

PubMed

Li, Yi; Liu, Xue-bing; Zhang, Yao

2012-08-01

To study the efficacy and safety of acupuncture therapy for the improvement of sleep quality of outpatients receiving methadone maintenance treatment (MMT). Using randomized double-blinded controlled design, seventy-five MMT outpatients with low sleep quality [score of Pittsburgh sleep quality index (PSQI) > or = 8], were randomly assigned to the acupuncture group (38 cases) and the sham-acupuncture group (37 cases). All patients maintained previous MMT. Acupuncture was applied to Baihui (GV20), Shenmen (bilateral, TF4), Shenting (GV24), Sanyinjiao (bilateral, SP6), and Sishencong (EX-HN1) in the acupuncture group. The same procedures were performed in the sham-acupuncture group, but not to the acupoints (5 mm lateral to the acupoints selected in the acupuncture group) with shallow needling technique. The treatment was performed 5 times each week for 8 successive weeks. The PSQI was assessed before treatment, at the end of the 2nd, 4th, 6th, and 8th week of the treatment. The detection ratio of low sleep quality and the incidence of adverse acupuncture reactions were compared between the two groups at the end of the 8th week. The overall PSQI score was obviously higher in the acupuncture group than in the sham-acupuncture group with statistical difference (P < 0.01). The detection ratio of low sleep quality at the end of the 8th week was lower in the acupuncture group (60.53%, 23/38 cases) than in the sham-acupuncture group (83.78%, 31/37 cases) with statistical difference (P < 0.05). The rate of adverse acupuncture reaction was 5.26% (2/38 cases) in the acupuncture group and 2.70% (1/37 cases) in the sham-acupuncture group respectively, showing no statistical difference (P > 0.05). Acupuncture therapy could effectively and safely improve the sleep quality of outpatients receiving MMT.

Restless Leg Syndrome and Sleep Quality in Lumbar Radiculopathy Patients

PubMed Central

Terzi, Murat; Akpinar, Kursad; Paksoy, Kemal; Cebeci, Ibrahim; Iyigun, Omer

2014-01-01

Background. To investigate the frequency of restless leg syndrome (RLS), sleep quality impairment, depression, fatigue, and sleep behavior disorder and to determine the effects of surgery on these parameters in radiculopathy patients resistant to conservative treatment. Methods. The present study included 66 lumbar radiculopathy patients, who were resistant to conservative treatment and had indication of surgery. Five different questionnaires were performed to assess depression (the Beck Depression Inventory (BDI)), sleep quality (the Pittsburgh Sleep Quality Index (PSQI)), fatigue (the Fatigue Severity Scale (FSS)), and presence of RLS and rapid eye movement sleep behavior disorder (RBD). The same questionnaires were also performed on a control group (n = 61). Results. Of the radiculopathy patients, 68.1% had RLS and 92.4% had fatigue. Of the controls, 16.4% had RLS and 59% had fatigue. RBD was present in 8 (12.1%) patients and 3 (4.9%) controls. The PSQI revealed that sleep quality was impaired in 46 (69.7%) patients and 35 (57.4%) controls (P > 0.05). The number of individuals having substantial depression according to the BDI was significantly higher in the patients than in the controls. Conclusions. There was a significant increase in the frequency of RLS, which was significantly decreased in the postoperative period in the radiculopathy patients. PMID:25110396

Sleep quality, but not quantity, is associated with self-perceived minor error rates among emergency department nurses.

PubMed

Weaver, Amy L; Stutzman, Sonja E; Supnet, Charlene; Olson, DaiWai M

2016-03-01

The emergency department (ED) is demanding and high risk. The impact of sleep quantity has been hypothesized to impact patient care. This study investigated the hypothesis that fatigue and impaired mentation, due to sleep disturbance and shortened overall sleeping hours, would lead to increased nursing errors. This is a prospective observational study of 30 ED nurses using self-administered survey and sleep architecture measured by wrist actigraphy as predictors of self-reported error rates. An actigraphy device was worn prior to working a 12-hour shift and nurses completed the Pittsburgh Sleep Quality Index (PSQI). Error rates were reported on a visual analog scale at the end of a 12-hour shift. The PSQI responses indicated that 73.3% of subjects had poor sleep quality. Lower sleep quality measured by actigraphy (hours asleep/hours in bed) was associated with higher self-perceived minor errors. Sleep quantity (total hours slept) was not associated with minor, moderate, nor severe errors. Our study found that ED nurses' sleep quality, immediately prior to a working 12-hour shift, is more predictive of error than sleep quantity. These results present evidence that a "good night's sleep" prior to working a nursing shift in the ED is beneficial for reducing minor errors. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Independent Associations of Physical Activity and Sleep with Cognitive Function in Older Adults.

PubMed

Falck, Ryan S; Best, John R; Davis, Jennifer C; Liu-Ambrose, Teresa

2018-01-01

Current evidence suggests physical activity (PA) and sleep are important for cognitive health; however, few studies examining the role of PA and sleep for cognitive health have measured these behaviors objectively. We cross-sectionally examined whether 1) higher PA is associated with better cognitive performance independently of sleep quality; 2) higher sleep quality is associated with better cognitive performance independently of PA; and 3) whether higher PA is associated with better sleep quality. We measured PA, subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and objective sleep quality (i.e., fragmentation, efficiency, duration, and latency) using the MotionWatch8© in community-dwelling adults (N = 137; aged 55+). Cognitive function was indexed using the Alzheimer's Disease Assessment Scale-Plus. Correlation analyses were performed to determine relationships between PA, sleep quality, and cognitive function. We then used latent variable modelling to examine the relationships of PA with cognitive function independently of sleep quality, sleep quality with cognitive function independently of PA, and PA with sleep quality. We found greater PA was associated with better cognitive performance independently of 1) PSQI (β= -0.03; p < 0.01); 2) sleep fragmentation (β= -0.02; p < 0.01); 3) sleep duration (β= -0.02; p < 0.01); and 4) sleep latency (β= -0.02; p < 0.01). In addition, better sleep efficiency was associated with better cognitive performance independently of PA (β= -0.01; p = 0.04). We did not find any associations between PA and sleep quality. PA is associated with better cognitive performance independently of sleep quality, and sleep efficiency is associated with better cognitive performance independently of PA. However, PA is not associated with sleep quality and thus PA and sleep quality may be related to cognitive performance through independent mechanisms.

Sleep Quality and Body Composition Variations in Obese Male Adults after 14 Weeks of Yoga Intervention: A Randomized Controlled Trial

PubMed Central

Rshikesan, PB; Subramanya, Pailoor; Singh, Deepeshwar

2017-01-01

Background: Obesity is a big challenge all over the world. It is associated with many noncommunicable diseases. Yoga known to be add-on treatment may be effective for obesity control. Aim: To assess the effect of integrated approach of yoga therapy (IAYT) for body composition and quality of sleep in adult obese male. Subjects and Methods: A randomized controlled trial was conducted for 14 weeks on obese male of urban setting. Eighty individuals were randomly divided into two groups, i.e., yoga group (n = 40; age; 40.03 ± 8.74 years, body mass index [BMI] 28.7 ± 2.35 kg/m2) and control group (age; 42.20 ± 12.06 years, BMI 27.70 ± 2.05 kg/m2). The IAYT was imparted to yoga group for 1½ hour for 5 days in a week for 14 weeks. The control group continued their regular activities. The body composition by InBody R20 and sleep quality by Pittsburgh Sleep Quality Index (PSQI) were assessed. Statistical analysis was done for within and between groups using SPSS version 21. The correlation analysis was done on the difference in pre-post values. Results: The results showed that weight (P = 0.004), BMI (P = 0.008), bone mass (P = 0.017), obesity degree (P = 0.005), and mineral mass (P = 0.046) were improved in yoga group and no change in control group (P > 0.05). The global score of PSQI improved (P = 0.017) in yoga group alone. Conclusion: The results indicate the beneficial effects of IAYT on body composition and sleep quality in obese males. The yoga practice may reduce obesity with the improvement in quality of life. PMID:29422743

[Associations between dormitory environment/other factors and sleep quality of medical students].

PubMed

Zheng, Bang; Wang, Kailu; Pan, Ziqi; Li, Man; Pan, Yuting; Liu, Ting; Xu, Dan; Lyu, Jun

2016-03-01

To investigate the sleep quality and related factors among medical students in China, understand the association between dormitory environment and sleep quality, and provide evidence and recommendations for sleep hygiene intervention. A total of 555 undergraduate students were selected from a medical school of an university in Beijing through stratified-cluster random-sampling to conduct a questionnaire survey by using Chinese version of Pittsburgh Sleep Quality Index (PSQI) and self-designed questionnaire. Analyses were performed by using multiple logistic regression model as well as multilevel linear regression model. The prevalence of sleep disorder was 29.1%(149/512), and 39.1%(200/512) of the students reported that the sleep quality was influenced by dormitory environment. PSQI score was negatively correlated with self-reported rating of dormitory environment (γs=-0.310, P<0.001). Logistic regression analysis showed the related factors of sleep disorder included grade, sleep regularity, self-rated health status, pressures of school work and employment, as well as dormitory environment. RESULTS of multilevel regression analysis also indicated that perception on dormitory environment (individual level) was associated with sleep quality with the dormitory level random effects under control (b=-0.619, P<0.001). The prevalence of sleep disorder was high in medical students, which was associated with multiple factors. Dormitory environment should be taken into consideration when the interventions are taken to improve the sleep quality of students.

Dream anxiety is an emotional trigger for acute myocardial infarction.

PubMed

Selvi, Yavuz; Aydin, Adem; Gumrukcuoglu, Hasan Ali; Gulec, Mustafa; Besiroglu, Lutfullah; Ozdemir, Pinar G; Kilic, Sultan

2011-01-01

The aim of the present study was to investigate the relationship between nightmares and acute myocardial infarction (AMI) occurring during sleep, and also to evaluate the influence of several related factors. The sample comprised AMI patients who had been admitted to the coronary care unit. The patients were grouped into two categories; the asleep-AMI group consisted of 36 patients who had the onset of symptoms of AMI during sleep, and the awake-AMI group included 183 patients who had AMI while they were awake. The sleep quality and dream anxiety for the 1-month interval before AMI were assessed with Pittsburgh Sleep Quality Index (PSQI) and Van Dream Anxiety Scale (VDAS), respectively. Asleep-AMI patients reported significantly poorer subjective sleep quality, significantly higher global PSQI scores, and displayed significantly higher nightmare frequency, difficulty in falling asleep after a nightmare, higher autonomic hyperactivity, dream recall frequency, daytime anxiety, psychological problems, and higher global dream anxiety scores than awake-AMI patients. The present study suggests that sleep anxiety and related emotions are associated with AMI during sleep. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

The Relationship Between Apolipoprotein ε4 Carrier Status and Sleep Characteristics in Cognitively Normal Older Adults.

PubMed

Kahya, Melike; Vidoni, Eric; Burns, Jeffrey M; Thompson, Ashley N; Meyer, Kayla; Siengsukon, Catherine F

2017-09-01

The apolipoprotein (APOE) ε4 allele, a well-described genetic risk factor for late-onset Alzheimer disease (AD), is associated with sleep disturbances even in cognitively normal older adults, although it is not clear whether this association is independent of sleep apnea. We sought to extend previous studies by examining whether cognitively normal older adults without self-reported sleep apnea who carry the APOE ε4 allele have altered sleep characteristics compared to noncarriers. Data from N = 36 (APOE ε4 carriers [n = 9], noncarriers [n = 27]) cognitively normal older adults (Clinical Dementia Rating [CDR] scale = 0) without self-reported sleep apnea were used for these analyses. Participants wore an actigraph for 7 days to determine sleep characteristics. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to assess sleep quality and daytime sleepiness, respectively. The APOE ε4 carriers had a higher number of awakenings compared to the noncarriers ( P = .02). There was no significant difference in the PSQI global score and the ESS; however, the PSQI subcomponent of daily disturbances was significantly higher in APOE ε4 carriers ( P = .03), indicating increased daytime dysfunction is related to disrupted sleep. This study provides evidence that individuals who are cognitively normal and genetically at risk of AD may have disrupted sleep. These findings are consistent with prior studies and suggest that sleep disruption may be present in the presymptomatic stages of AD.

Sleep and mood disorders in dry eye disease and allied irritating ocular diseases.

PubMed

Ayaki, Masahiko; Kawashima, Motoko; Negishi, Kazuno; Kishimoto, Taishiro; Mimura, Masaru; Tsubota, Kazuo

2016-03-01

The aim of the present study was to evaluate sleep and mood disorders in patients with irritating ocular diseases. The study design was a cross-sectional/case-control study conducted in six eye clinics. Out of 715 outpatients diagnosed with irritating ocular surface diseases and initially enrolled, 301 patients with dry eye disease (DED) and 202 age-matched control participants with other ocular surface diseases were analyzed. The mean Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) scores were 6.4 ± 3.2 and 11.1 ± 5.7 for severe DED (n = 146), 5.5 ± 3.3 and 9.8 ± 4.0 for mild DED (n = 155), 5.5 ± 3.1 and 9.5 ± 6.6 for chronic conjunctivitis (n = 124), and 5.0 ± 3.3 and 8.9 ± 5.3 for allergic conjunctivitis (n = 78). There were significant differences among these diagnostic groups for PSQI (P < 0.05). Regression analysis of patients with DED revealed the PSQI and HADS scores were significantly correlated with the severity of DED (P < 0.05). Our results demonstrate that sleep quality in patients with DED is significantly worse than in patients with other irritating ocular surface diseases and it is correlated with the severity of DED.

SLEEP AND GAMBLING SEVERITY IN A COMMUNITY SAMPLE OF GAMBLERS

PubMed Central

Parhami, Iman; Siani, Aaron; Rosenthal, Richard J.; Lin, Stephanie; Collard, Michael; Fong, Timothy W.

2012-01-01

Although sleep has been extensively studied in substance related disorders, it has yet to be examined as thoroughly in gambling-related disorders. The purpose of this study is to examine the relationship between gambling severity and sleep disturbances in a sample of non-treatment seeking gamblers (N = 96) using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Mean ESS scores for recreational, problem, and pathological gamblers were 4.13, 5.81, and 8.69, respectively, with a significant difference between pathological gamblers and both problem (P = .007) and recreational gamblers (P < .001). Mean PSQI scores for recreational, problem, and pathological gamblers were 3.35, 5.30, and 5.44, respectively, with a significant difference in sleep quality between recreational and problem gamblers (P = .018), as well as recreational and pathological gamblers (P = .008). As the first study to use objective sleep measures, these findings will not only increase awareness of this relationship, but also provide a foundation on which others can investigate the benefits of screening and adjunct treatment for sleep disorders in the gambling population. PMID:22356670

The interaction between sleep quality and academic performance.

PubMed

Ahrberg, K; Dresler, M; Niedermaier, S; Steiger, A; Genzel, L

2012-12-01

Sleep quality has significant effects on cognitive performance and is influenced by multiple factors such as stress. Contrary to the ideal, medical students and residents suffer from sleep deprivation and stress at times when they should achieve the greatest amount of learning. In order to examine the relationship between sleep quality and academic performance, 144 medical students undertaking the pre-clinical board exam answered a survey regarding their subjective sleep quality (Pittsburgh sleep quality index, PSQI), grades and subjective stress for three different time points: semester, pre- and post-exam. Academic performance correlated with stress and sleep quality pre-exam (r = 0.276, p < 0.001 and r = 0.158, p < 0.03, note that low performance meant low sleep quality and high stress), however not with the stress or sleep quality during the semester and post-exam. 59% of all participants exhibited clinically relevant sleep disturbances (PSQI > 5) during exam preparation compared to 29% during the semester and 8% post-exam. This study shows that in medical students it is not the generally poor sleepers, who perform worse in the medical board exams. Instead students who will perform worse on their exams seem to be more stressed and suffer from poor sleep quality. However, poor sleep quality may negatively impact test performance as well, creating a vicious circle. Furthermore, the rate of sleep disturbances in medical students should be cause for intervention. Copyright © 2012 Elsevier Ltd. All rights reserved.

The association of sleep duration and sleep quality with non-alcoholic fatty liver disease in a Taiwanese population.

PubMed

Chou, Yu-Tsung; Cheng, Hsiang-Ju; Wu, Jin-Shang; Yang, Yi-Ching; Chou, Chieh-Ying; Chang, Chih-Jen; Lu, Feng-Hwa

2018-06-18

The association of sleep duration/quality with nonalcoholic fatty liver disease (NAFLD) is inconclusive. Several important covariates were not adjusted concomitantly in some studies, and the severity of NAFLD was not considered. Furthermore, the gender impact of sleep duration or sleep quality on NAFLD remains unclear. We thus aimed to examine the association of sleep duration and quality with NAFLD by gender in a Taiwanese population. A total of 6663 subjects aged 18 years or more were enrolled. The severity of NAFLD was divided into mild, moderate, and severe degrees based on ultrasound findings. The sleep duration was classified into three groups: short (<6h), normal (6-8h), and long (>8h). Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and poor sleep quality was defined as a global PSQI score greater than 5. After adjustment for potential confounders, multinomial logistic regression showed that poor sleep quality was negatively associated with both mild and moderate-to-severe NAFLD in males, but sleep duration was not independently related to NAFLD. In females, sleep condition was not related to NAFLD. Poor sleep quality but not sleep duration was associated with a lower risk of not only moderate to severe but also mild NAFLD in males. In females, the association of sleep quality and duration with the risk of NAFLD was insignificant. Copyright © 2018 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Cross-sectional Internet-based survey of Japanese permanent daytime workers' sleep and daily rest periods.

PubMed

Ikeda, Hiroki; Kubo, Tomohide; Sasaki, Takeshi; Liu, Xinxin; Matsuo, Tomoaki; So, Rina; Matsumoto, Shun; Yamauchi, Takashi; Takahashi, Masaya

2018-05-25

This study aimed to describe the sleep quantity, sleep quality, and daily rest periods (DRPs) of Japanese permanent daytime workers. Information about the usual DRP, sleep quantity, and sleep quality (Japanese version of the Pittsburgh Sleep Quality Index: PSQI-J) of 3,867 permanent daytime workers in Japan was gathered through an Internet-based survey. This information was analyzed and divided into the following eight DRP groups: <10, 10, 11, 12, 13, 14, 15, and ≥16 h. The sleep durations for workers in the <10, 10, 11, 12, 13, 14, 15, and ≥16 h DRP groups were found to be 5.3, 5.9, 6.1, 6.3, 6.5, 6.7, 6.7, and 6.9 h, respectively. The trend analysis revealed a significant linear trend as the shorter the DRP, the shorter was the sleep duration. The PSQI-J scores for the <10, 10, 11, 12, 13, 14, 15, and ≥16 h DRP groups were 7.1, 6.7, 6.7, 6.3, 6.0 (5.999), 5.6, 5.2, and 5.2, respectively. The trend analysis revealed a significant linear trend as the shorter the DRP, the lower was the sleep quality. This study described sleep quantity, sleep quality, and DRP in Japanese daytime workers. It was found that a shorter DRP was associated with poorer sleep quantity as well as quality.

Reliability and validity of the Daily Cognitive-Communication and Sleep Profile: a new instrument for monitoring sleep, wakefulness and daytime function.

PubMed

Fung, Christina Hoi Ling; Nguyen, Michelle; Moineddin, Rahim; Colantonio, Angela; Wiseman-Hakes, Catherine

2014-06-01

The Daily Cognitive Communicative and Sleep Profile (DCCASP) is a seven-item instrument that captures daily subjective sleep quality, perceived mood, cognitive, and communication functions. The objective of this study was to evaluate the reliability and validity of the DCCASP. The DCCASP was self-administered daily to a convenience sample of young adults (n = 54) for two two-week blocks, interspersed with a two-week rest period. Afterwards, participants completed the Pittsburgh Sleep Quality Index (PSQI). Internal consistency and criterion validity were calculated by Cronbach's α coefficient, Concordance Correlation Coefficient (CCC), and Spearman rank (rs) correlation coefficient, respectively. Results indicated high internal consistency (Cronbach-s α = 0.864-0.938) among mean ratings of sleep quality on the DCCASP. There were significant correlations between mean ratings of sleep quality and all domains (rs=0.38-0.55, p<0.0001). Criterion validity was established between mean sleep quality ratings on the DCCASP and PSQI (rs=0.40, p<0.001). The DCCASP is a reliable and valid self-report instrument to monitor daily sleep quality and perceived mood, cognitive, and communication functions over time, amongst a normative sample of young adults. Further studies on its psychometric properties are necessary to clarify its utility in a clinical population. Copyright © 2014 John Wiley & Sons, Ltd.

Quality of Sleep and its Relationship to Quality of Life in Hemodialysis Patients

PubMed Central

Parvan, Kobra; lakdizaji, Sima; Roshangar, Fariborz; Mostofi, Mahtab

2013-01-01

Introduction: Despite many advances in the treatment of chronic renal failure, the quality of sleep in patients who suffer from this disease is at the risk. The high prevalence of sleep disorders in hemodialysis patients, which is concomitant with physical, behavioral, and psychological problems, has always affected these patients' quality of life (QOL). This study aimed to determine the relationship between quality of sleep and quality of life in hemodialysis patients. Methods: By using a descriptive and correlational design, this study was conducted on 245 hemodialysis patients in 2012. Patients were selected by convenience sampling from the hemodialysis ward of four training hospitals of Tabriz and Maragheh. Quality of sleep was measured by the Pittsburgh Sleep Quality Index (PSQI), and the quality of life for patients was measured by the Kidney Disease Quality Of Life questionnaire (KDQOL-SF). Results: 83.3% of hemodialysis patients had poor quality of sleep. Poor quality of life was significantly associated with poor quality of sleep. There was a significant negative correlation between global PSQI and important aspects of quality of life including physical health, symptoms and problems, the impact of kidney disease on daily life, burden of kidney disease, mental health, social support, and sexual function. Conclusion: The low quality of sleep in hemodialysis patients has an effect on the deterioration of their quality of life. Therefore, training, counseling, and advocacy programs should be developed to improve the patients' quality of sleep and quality of life, especially those with lower education level and income, and older people. PMID:25276738

Global Assessment of the Impact of Type 2 Diabetes on Sleep through Specific Questionnaires. A Case-Control Study.

PubMed

Lecube, Albert; Sánchez, Enric; Gómez-Peralta, Fernando; Abreu, Cristina; Valls, Joan; Mestre, Olga; Romero, Odile; Martínez, María Dolores; Sampol, Gabriel; Ciudin, Andreea; Hernández, Cristina; Simó, Rafael

2016-01-01

Type 2 diabetes (T2D) is an independent risk factor for sleep breathing disorders. However, it is unknown whether T2D affects daily somnolence and quality of sleep independently of the impairment of polysomnographic parameters. A case-control study including 413 patients with T2D and 413 non-diabetic subjects, matched by age, gender, BMI, and waist and neck circumferences. A polysomnography was performed and daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). In addition, 135 subjects with T2D and 45 controls matched by the same previous parameters were also evaluated through the Pittsburgh Sleep Quality Index (PSQI) to calculate sleep quality. Daytime sleepiness was higher in T2D than in control subjects (p = 0.003), with 23.9% of subjects presenting an excessive daytime sleepiness (ESS>10). Patients with fasting plasma glucose (FPG ≥13.1 mmol/l) were identified as the group with a higher risk associated with an ESS>10 (OR 3.9, 95% CI 1.8-7.9, p = 0.0003). A stepwise regression analyses showed that the presence of T2D, baseline glucose levels and gender but not polysomnographic parameters (i.e apnea-hyoapnea index or sleeping time spent with oxigen saturation lower than 90%) independently predicted the ESS score. In addition, subjects with T2D showed higher sleep disturbances [PSQI: 7.0 (1.0-18.0) vs. 4 (0.0-12.0), p<0.001]. The presence of T2D and high levels of FPG are independent risk factors for daytime sleepiness and adversely affect sleep quality. Prospective studies addressed to demonstrate whether glycemia optimization could improve the sleep quality in T2D patients seem warranted.

Glucose fluctuations reduce quality of sleep and of life in patients with liver cirrhosis.

PubMed

Haraguchi, Masafumi; Miyaaki, Hisamitsu; Ichikawa, Tatsuki; Shibata, Hidetaka; Honda, Takuya; Ozawa, Eisuke; Miuma, Satoshi; Taura, Naota; Takeshima, Fuminao; Nakao, Kazuhiko

2017-01-01

Sleep disturbance and decreased health-related quality of life (HRQOL) are significant complaints in patients with liver cirrhosis. Although the etiology of these complications is unclear, we propose that glucose intolerance may be a predisposing factor. Therefore, our aim was to investigate the relationship between glucose intolerance and these complications. We assessed continuous glucose monitoring in 43 patients with chronic liver disease. Among these patients, 36 completed the Pittsburgh Sleep Quality Index (PSQI), the 36-Item Short-form Health Survey (SF-36), and the Neuropsychological Test (NPT). We also assessed the change in glucose fluctuations between preoperative periods and 1 year after liver transplantation in 13 patients. Standard deviation (SD) of blood glucose was 24.15 ± 13.52. SD values correlated to glucose metabolism measures, including HbA1c and glycoalbumin. SD values also correlated to markers of liver fibrosis, including type IV collagen. Twenty-one patients (58.3 %) were classified as "poor" sleepers, with a global PSQI score ≥6. Glucose fluctuations correlated with the global PSQI score (r = 0.456, p = 0.008) and the SF-36 score (r = 0.434, p = 0.013). Multivariate regression analysis identified SD values as an independent risk factor for sleep disturbance (r = 0.12, p = 0.039) and decreased HRQOL (r = -0.32, p = 0.024). SD values did not correlate with the NPT. SD values were also improved in 11 (84.6 %) patients 1 year after liver transplantation. Abnormal glucose fluctuations are a risk factor for sleep disturbance and decrease of HRQOL in patients with cirrhosis.

Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study

PubMed Central

de Mutsert, Renée; le Cessie, Saskia; Appelman-Dijkstra, Natasha M.; Rosendaal, Frits R.; van Heemst, Diana; den Heijer, Martin; Biermasz, Nienke R.

2017-01-01

Context Sleep deprivation has detrimental metabolic consequences. Osteopenia and sarcopenia usually occur together and increase risk of fractures and disease. Results from studies linking sleep parameters to osteopenia or sarcopenia are scarce and inconsistent. Objective To examine the associations of sleep parameters with osteopenia and sarcopenia, considering the influence of sex and menopause. Design, setting and participants Cross-sectional analysis of 915 participants (45–65 years, 56% women, BMI 26 (range: 18–56) kg/m2) in the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study. Sleep duration, quality, and timing were assessed with the Pittsburgh Sleep Quality Index (PSQI); bone mineral density and relative appendicular muscle mass were measured by DXA scans. Linear and logistic regressions were performed to associate sleep parameters to bone mineral density, relative appendicular muscle mass, osteopenia (t-score between -1 and -2.5) and sarcopenia (1 SD below average muscle mass). Results After adjustment for confounding factors, one unit increase in PSQI score (OR and 95% CI, 1.09, 1.03–1.14), declined self-rated sleep quality (1.76, 1.03–3.01), sleep latency (1.18, 1.06–1.31), and a one hour later sleep timing (1.51, 1.08–2.11), but not sleep duration (1.05, 0.90–1.23), were associated with osteopenia. PSQI score (1.10, 1.02–1.19) was also associated with sarcopenia; OR’s of sleep latency and later mid-sleep time with sarcopenia were 1.14 (0.99–1.31) and 1.54 (0.91–2.61), respectively. Associations were somewhat stronger in women and varied per menopausal status. Conclusions These results suggest that decreased sleep quality and a later sleep timing are risk factors for osteopenia and sarcopenia in middle aged individuals. PMID:28459884

Effects of electroacupuncture on stress-related symptoms in medical students: a randomised placebo-controlled study.

PubMed

Dias, Marcio; Vellarde, Guillermo Coca; Olej, Beni; Teófilo Salgado, Ana Emília; de Barros Rezende, Ighor

2014-02-01

To assess the effects of electroacupuncture (EA) on relieving stress-related symptoms-sleep disorders, anxiety, depression and burnout-in medical students. Eighty-two students were randomised into an EA treatment group (n=30), a sham TENS group (n=18) and an untreated control group (n=34). EA was applied at a continuous frequency of 2 Hz to the limbs, face, ears and scalp for 20 min once a week, over 6-8 weeks. Sham transcutaneous electrical nerve stimulation (TENS) was performed on similar sites for the same number of times in each session and for the same length of time. Outcome measurements included a comparison of the indices obtained by different self-applied questionnaires before and after treatment. The surveys used were the Mini-Sleep Questionnaire (MSQ), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), the Beck Depression and Anxiety Inventories (BDI and BAI) and the Maslach Burnout Inventory-Student Survey (MBI-SS), in addition to the Quality of Life Questionnaire-abbreviated version (WHOQOL-bref). EA significantly improved scores on the MSQ, PSQI, BDI and the cynicism and academic efficacy (AE) dimensions of the MBI-SS in relation to the control. Sleep quality (MSQ) improved from 36.9 (SD 7.6) to 25.0 (5.7) with EA, 37.6 (6.0) to 32.1 (6.9) with sham TENS, and 36.5 (5.9) to 33.6 (6.7) in the controls (p=0.0000). Compared with the sham TENS group, EA significantly reduced scores on the PSQI. Score improvements in the sham TENS group in relation to control group were significant in the MSQ, BDI and AE. In the EA group, the number of students with better scores after intervention was significantly higher for the MSQ, PSQI, ESS and BAI. This only occurred for the MSQ in the sham TENS group and for the MSQ and ESS in the control group. EA significantly reduced stress-related mental symptoms. The improvement obtained by sham TENS compared with the control group confirmed the presence of a placebo effect resulting from the treatment ritual.

So Tired: Predictive Utility of Baseline Sleep Screening in a Longitudinal Observational Survey Cohort of First-Year Residents.

PubMed

Zebrowski, Jonathan P; Pulliam, Samantha J; Denninger, John W; Berkowitz, Lori R

2018-06-01

Sleep impairment is highly prevalent among resident physicians and is associated with both adverse patient outcomes and poor resident mental and physical health. Risk factors for sleep problems during residency are less clear, and no screening model exists to identify residents at risk for sleep impairment. The objective of this study was to assess change in resident sleep during training and to evaluate utility of baseline sleep screening in predicting future sleep impairment. This is a prospective observational repeated-measures survey study. The participants comprised PGY-1 residents across multiple specialties at Partners HealthCare hospitals. Main measures used for this study were demographic queries and two validated scales: the Pittsburgh Sleep Quality Index (PSQI), measuring sleep quality, and the Epworth Sleepiness Scale (ESS), measuring excessive daytime sleepiness. Two hundred eighty-one PGY-1 residents completed surveys at residency orientation, and 153 (54%) completed matched surveys 9 months later. Mean nightly sleep time decreased from 7.6 to 6.5 hours (p < 0.001). Mean PSQI score increased from 3.6 to 5.2 (p < 0.001), and mean ESS score increased from 7.2 to 10.4 (p < 0.001). The proportion of residents exceeding the scales' clinical cutoffs increased over time from 15 to 40% on the PSQI (p < 0.001) and from 26 to 59% on the ESS (p < 0.001). Baseline normal sleep was not protective: 68% of residents with normal scores on both scales at baseline exceeded the clinical cutoff on at least one scale at follow-up. Greater age and fewer children increased follow-up PSQI score (p < 0.001) but not ESS score. During PGY-1 training, residents experience worsening sleep duration, quality of sleep, and daytime sleepiness. Residents with baseline impaired sleep tend to remain impaired. Moreover, many residents with baseline normal sleep experience sleep deterioration over time. Sleep screening at residency orientation may identify some, but not all, residents who will experience sleep impairment during training.

Sleep disturbances as predictors of prolonged exposure therapy effectiveness among veterans with PTSD.

PubMed

Sexton, Minden B; Avallone, Kimberly M; Smith, Erin R; Porter, Katherine E; Ashrafioun, Lisham; Todd Arnedt, J; Rauch, Sheila A M

2017-10-01

Sleep disturbances (SD) are pronounced in Veterans with posttraumatic stress disorder (PTSD). In clinical trials, SD have been shown to limit the effectiveness of evidence-based treatments for non-PTSD disorders. The purpose of this study was to investigate the relationships between pretreatment SD and the effectiveness of Prolonged Exposure (PE) therapy for Veterans with PTSD. Twenty-one Veterans completed the Pittsburgh Sleep Quality Index (PSQI) and the Clinician Administered PTSD Scale upon presenting to a PTSD specialty clinic. Veterans completed the PTSD Symptom Checklist-Civilian (PCL-C) at the initiation of PE and biweekly thereafter for the duration of treatment (96 total assessments). Correlations and hierarchical linear modeling were utilized to examine the potential impact of baseline sleep variables on the slope and magnitude of treatment outcomes. Higher PSQI total scores, and higher sleep latency and sleep medication use subscale scores were associated with higher PCL-C scores at baseline. Veterans evidenced significant reductions in PTSD symptoms during the course of the treatment study. Total PSQI scores and composites were not associated with reduced effectiveness of PE treatment or the slope of PTSD symptom changes. Sleep disturbances do not preclude Veterans from benefits derived from engagement in this gold standard PTSD intervention. Published by Elsevier B.V.

Randomised controlled trial of the effectiveness of using foot reflexology to improve quality of sleep amongst Taiwanese postpartum women.

PubMed

Li, Chia-Yen; Chen, Su-Chiu; Li, Chung-Yi; Gau, Meei-Ling; Huang, Chiu-Mieh

2011-04-01

to examine the effectiveness of using foot reflexology to improve sleep quality in postpartum women. randomised controlled trial, conducted at two postpartum centres in northern Taiwan. 65 postpartum women reporting poor quality of sleep were recruited from July 2007 to December 2007. participants were assigned randomly to either an intervention or a control group. Participants in both groups received the same care except for reflexology therapy. The intervention group received a single 30-minute foot reflexology session at the same time each evening for five consecutive days. Sessions were administered by a certified nurse reflexologist. MEASURES AND FINDINGS: the outcome measure was the Pittsburgh sleep quality index (PSQI), and this was performed at baseline and post test. Mean PQSI scores for both groups declined over time between baseline and post test. Using a generalised estimation equation to control several confounding variables, the changes in mean PSQI were found to be significantly lower in the intervention group (β=-2.24, standard error=0.38, p<0.001) than in the control group. an intervention involving foot reflexology in the postnatal period significantly improved the quality of sleep. midwives should evaluate maternal sleep quality and design early intervention programmes to improve quality of sleep in order to increase maternal biopsychosocial well-being. Midwives interested in complementary therapies should be encouraged to obtain training in reflexology and to apply it in clinical settings if it is allowed. Copyright © 2009 Elsevier Ltd. All rights reserved.

Home exercise improves the quality of sleep and daytime sleepiness of elderlies: a randomized controlled trial.

PubMed

Brandão, Glauber Sá; Gomes, Glaucia Sá Brandão Freitas; Brandão, Glaudson Sá; Callou Sampaio, Antônia A; Donner, Claudio F; Oliveira, Luis V F; Camelier, Aquiles Assunção

2018-01-01

Aging causes physiological changes which affect the quality of sleep. Supervised physical exercise is an important therapeutic resource to improve the sleep of the elderlies, however there is a low adherence to those type of programs, so it is necessary to implement an exercise program which is feasible and effective. The study aimed to test the hypothesis that a semi-supervised home exercise program, improves sleep quality and daytime sleepiness of elderlies of the community who present poor sleep quality. This was a randomized controlled trial study, conducted from May to September 2017, in Northeastern Brazil, with elderlies of the community aging 60 years old or older, sedentary, with lower scores or equal to 5 at the Pittsburgh Sleep Quality Index (PSQI) and without cognitive decline. From one hundred ninety-one potential participants twenty-eight refused to participate, therefore, one hundred thirty-one (mean age 68 ± 7 years), and 88% female, were randomly assigned to an intervention group - IG (home exercise and sleep hygiene, n  = 65) and a control group - CG (sleep hygiene only, n  = 66). Sleep assessment tools were used: PSQI, Epworth sleepiness scale (ESS) and clinical questionnaire of Berlin. The level of physical activity has been assessed by means of International Physical Activity Questionnaire adapted for the elderly (IPAQ) and Mini-Mental State Examination for cognitive decline. All participants were assessed before and after the 12-week intervention period and, also, the assessors were blind. The IG showed significant improvement in quality of sleep with a mean reduction of 4.9 ± 2.7 points in the overall PSQI ( p  < 0.01) and in all its 7 components of evaluation ( p  < 0.05), and improvement of secondary endpoint, daytime sleepiness, a decline of 2.8 ± 2.2 points in the ESS (p < 0.01). Our results suggest that semi-supervised home exercise is effective in improving the quality of sleep and self-referred daytime sleepiness of sedentary elderlies of the community who presented sleep disorders. Ensaiosclinicos.gov.br process number: RBR-3cqzfy.

Effects of insomnia and sleep medication on health-related quality of life.

PubMed

Sasai, Taeko; Inoue, Yuichi; Komada, Yoko; Nomura, Takashi; Matsuura, Masato; Matsushima, Eisuke

2010-05-01

This study, using Short-Form 8 (SF-8), was undertaken to assess the effects of insomnia and sleep medication use on quality of life (QOL) in 2822 people (ages 20-97years) in a rural population. Factors associated with deterioration of the mental component summary (MCS) score and physical component summary (PCS) score were investigated. Questionnaires asked participants' basic information and included assessments using SF-8, the Pittsburgh Sleep Quality Index (PSQI), and a 12-item version of the Center for Epidemiological Studies Depression scale. Results of PSQI supported the classification of subjects as good sleepers, good sleepers using sleep medication, insomniacs, and insomniacs using sleep medication. Insomnia was associated with low scores of MCS and PCS. Nevertheless, sleep medication use was associated with low PCS scores only. Good sleepers using sleep medication had significantly higher MCS scores than either insomniacs or insomniacs using sleep medication, but lower scores than good sleepers. Similarly to insomniacs using sleep medication, good sleepers using sleep medication had significantly lower PCS scores than either good sleepers or insomniacs. Sleep medication was useful to improve mental QOL. That usage, however, might degrade the physical QOL, possibly because of the medication's adverse effects. Copyright 2010 Elsevier B.V. All rights reserved.

Low serum uric acid levels in chronic insomnia patients: A case-control study.

PubMed

Zhao, Kai; Luan, Xiaoqian; Liu, Zhihua; Zhu, Zhuoying; Chen, Huijun; Shen, Huiping; Cai, Yan; Qiu, Huihua; Wang, Qiongzhang; Gu, Yingying; Zhu, Lin; He, Jincai

2017-09-14

Recent studies have demonstrated the presence of oxidative stress in insomnia patients. Uric acid (UA) is regarded as one of the most important antioxidants that may attenuate oxidative stress. The aim of our study was to investigate whether there is an alteration of serum UA levels in chronic insomnia patients. The association between sleep quality and serum UA in chronic insomnia patients was also investigated. We recruited 300 chronic insomnia patients and 300 age- and gender-matched normal controls. The uricase-PAP method was used to measure the concentration of UA both in patient and normal control subjects. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality of chronic insomniac participants. As a result, significantly lower serum UA levels were observed in patients with chronic insomnia when compared with normal control subjects (279.56±65.80 vs. 299.10±61.17μmol/L, t=-3.991, p<0.001). Low serum UA levels were correlated with high PSQI scores in multiple linear regression models (β=-0.322, p<0.001). Our results suggested that low serum UA levels were associated with the presence and severity of chronic insomnia. Copyright © 2017 Elsevier B.V. All rights reserved.

Morning administration of oral methamphetamine dose-dependently disrupts nighttime sleep in recreational stimulant users.

PubMed

Herrmann, Evan S; Johnson, Patrick S; Bruner, Natalie R; Vandrey, Ryan; Johnson, Matthew W

2017-09-01

Use of amphetamine-type stimulants (e.g., methamphetamine) is associated with acute sleep disruptions. No prior reports have characterized the acute effects of methamphetamine on sleep using polysomnography, the gold standard for objective sleep monitoring. Recreational stimulant users (n=19) completed a baseline assessment, which included questionnaires assessing demographic and substance use characteristics, and the Pittsburgh Sleep Quality Index (PSQI), which assesses sleep quality over the past month. Participants were administered 0mg (placebo), 20mg, or 40mg oral methamphetamine at 08:15h on study days, using a double-blind, randomized, within-subjects design. Sleep was monitored using polysomnography from 22:20 that evening until 06:15 the following morning. PSQI scores indicated more than half of participants reported poor sleep quality at baseline. Methamphetamine dose-dependently increased sleep latency, and decreased total sleep time, sleep efficiency, time in NREM 2 sleep, number of REM periods, and total time in REM sleep. Sleep under placebo conditions was consistent with what would be expected from healthy adults. Morning oral administration of methamphetamine produces robust disruptions in nighttime sleep. Future research should examine relations between stimulant use and sleep disruption in naturalistic settings, with regard to both stimulant abuse and licit prescription use. Copyright © 2017. Published by Elsevier B.V.

Clinical Trial Research on Mongolian Medical Warm Acupuncture in Treating Insomnia.

PubMed

Bo, Agula; Si, Lengge; Wang, Yuehong; Xiu, Lan; Wu, Rihan; Li, Yutang; Mu, Rigenjiya; Ga, Latai; Miao, Mei; Shuang, Fu; Wu, Yunhua; Jin, Qiu; Tong, Suocai; Wuyun, Gerile; Guan, Wurihan; Mo, Rigen; Hu, Sileng; Zhang, Lixia; Peng, Rui; Bao, Lidao

2016-01-01

Objective. Insomnia is one of the most common sleep disorders. Hypnotics have poor long-term efficacy. Mongolian medical warm acupuncture has significant efficacy in treating insomnia. The paper evaluates the role of Mongolian medical warm acupuncture in treating insomnia by investigating the Mongolian medicine syndromes and conditions, Pittsburgh sleep quality index, and polysomnography indexes. Method. The patients were diagnosed in accordance with International Classification of Sleep Disorders (ICSD-2). The insomnia patients were divided into the acupuncture group (40 cases) and the estazolam group (40 cases). The patients underwent intervention of Mongolian medical warm acupuncture and estazolam. The indicators of the Mongolian medicine syndromes and conditions, Pittsburgh sleep quality index (PSQI), and polysomnography indexes (PSG) have been detected. Result. Based on the comparison of the Mongolian medicine syndrome scores between the warm acupuncture group and the drug treatment group, the result indicated P < 0.01. The clinical efficacy result showed that the effective rate (85%) in the warm acupuncture group was higher than that (70%) in the drug group. The total scores of PSQI of both groups were approximated. The sleep quality indexes of both groups decreased significantly ( P < 0.05). The sleep quality index in the Mongolian medical warm acupuncture group decreased significantly ( P < 0.01) and was better than that in the estazolam group. The sleep efficiency and daytime functions of the patients in the Mongolian medical warm acupuncture group improved significantly ( P < 0.01). The sleep time was significantly extended ( P < 0.01) in the Mongolian medical warm acupuncture group following PSG intervention. The sleep time during NREM in the Mongolian warm acupuncture group increased significantly ( P < 0.01). The sleep time exhibited a decreasing trend during REM and it decreased significantly in the Mongolian warm acupuncture group ( P < 0.01). The percentage of sleep time in the total sleep time during NREM3+4 in the Mongolian medical warm acupuncture group increased significantly. Conclusion. Mongolian medical warm acupuncture is efficient and safe in treating insomnia. It is able to better improve the patients' sleep time and daytime functions. It is better than that in the estazolam group following drug withdrawal in terms of improving the sleep time. It is more effective in helping the insomnia patients than hypnotics.

A Four-Session Sleep Intervention Program Improves Sleep for Older Adult Day Health Care Participants: Results of a Randomized Controlled Trial

PubMed Central

Song, Yeonsu; Hughes, Jaime; Jouldjian, Stella; Dzierzewski, Joseph M.; Fung, Constance H; Rodriguez Tapia, Juan Carlos; Mitchell, Michael N.; Alessi, Cathy A

2017-01-01

Abstract Study Objective To test the effectiveness of a 4-week behavioral Sleep Intervention Program (SIP: sleep compression, modified stimulus control, and sleep hygiene) compared to a 4-week information-only control (IC) among older adults attending a VA Adult Day Health Care (ADHC) program in a double-blind, randomized, clinical trial. Methods Forty-two individuals (mean age: 77 years, 93% male) enrolled in a VA ADHC program were randomized to receive SIP or IC. All completed in-person sleep and health assessments at baseline, post-treatment and 4-months follow-up that included 3 days/nights of wrist actigraphy, the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). Mixed repeated measures analysis was used to compare sleep outcomes at post-treatment and 4-months follow-up, with baseline values as covariates. Results SIP participants (n = 21) showed significant improvement on actigraphy sleep efficiency (p = .007), number of nighttime awakenings (p = .016), and minutes awake at night (p = .001) at post-treatment, compared to IC participants (n = 21). Benefits were slightly attenuated but remained significant at 4-month follow-up (all p’s < .05). There were no differences in total sleep time between groups. There was significant improvement on PSQI factor 3 (daily disturbances) at 4-month follow-up (p = .016), but no differences were observed between SIP and IC on other PSQI components or ISI scores at post-treatment or 4-month follow-up. Conclusions A short behavioral sleep intervention may have important benefits in improving objectively measured sleep in older adults participating in ADHC. Future studies are needed to study implementation of this intervention into routine clinical care within ADHC. PMID:28482053

[Excessive Daytime Sleepiness, Poor Quality Sleep, and Low Academic Performance in Medical Students].

PubMed

Machado-Duque, Manuel Enrique; Echeverri Chabur, Jorge Enrique; Machado-Alba, Jorge Enrique

2015-01-01

Quality of sleep and excessive daytime sleepiness (EDS) affect cognitive ability and performance of medical students. This study attempts to determine the prevalence of EDS, sleep quality, and assess their association with poor academic performance in this population. A descriptive, observational study was conducted on a random sample of 217 medical students from the Universidad Tecnológica de Pereira, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth sleepiness scale. Sociodemographic, clinic and academic variables were also measured. Multivariate analyses for poor academic performance were performed. The included students had a mean age of 21.7±3.3 years, of whom 59.4% were men. Almost half (49.8%) had EDS criteria, and 79.3% were poor sleepers (PSQI ≥ 5), while 43.3% had poor academic performance during the last semester. The bivariate analysis showed that having used tobacco or alcohol until intoxicated, fairly bad subjective sleep quality, sleep efficiency < 65%, and being a poor sleeper were associated with increased risk of low performance. Sleep efficiency < 65% was statistically associated with poor academic performance (P=.024; OR = 4.23; 95% CI, 1.12-15.42) in the multivariate analysis. A poor sleep quality determined by low efficiency was related to poor academic achievement at the end of semester in medical students. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Watching television for more than two hours increases the likelihood of reporting poor sleep quality among Brazilian schoolteachers.

PubMed

de Souza, Sara Carolina Scremin; Campanini, Marcela Zambrim; de Andrade, Selma Maffei; González, Alberto Durán; de Melo, Juliana Moura; Mesas, Arthur Eumann

2017-10-01

Although time spent watching television and sleep problems have increased in the last few decades, it is unclear whether these conditions are associated in working adults after controlling for lifestyle, job characteristics and other individual aspects. The present study analyzed the association between time spent watching television and sleep quality among teachers from public schools in Londrina, Brazil. In this cross-sectional study, information from the Pittsburgh Sleep Quality Index (PSQI) and about time spent watching television was obtained during personal interviews. Logistic regression models adjusted by the main confounders (sociodemographic, occupational and lifestyle variables) were used in the analyses. Among the 959 studied teachers (68.2% women, median age: 42years), teachers who watched >120min/day had a higher likelihood of reporting poor sleep quality (PSQI>5) (odds ratio=1.41; 95% confidence interval=1.01; 1.98) compared with those who watched television for up to 60min/day, regardless of gender, age, work hours, leisure time physical activity and other lifestyle variables. This association did not remain significant after the adjustment for health conditions, i.e., obesity, anxiety, depression and chronic pain, which may act as confounding variables in the relationship between watching television and poor sleep quality. Watching television for >120min/day was independently associated with poorer sleep quality, which should be considered in the prevention and treatment of sleep disturbances among working population. Copyright © 2017 Elsevier Inc. All rights reserved.

Mobile usage and sleep patterns among medical students.

PubMed

Yogesh, Saxena; Abha, Shrivastava; Priyanka, Singh

2014-01-01

Exposure of humans to radio frequency electromagnetic field (EMF) both during receiving and transmitting the signals has amplified public and scientific debate about possible adverse effects on human health. The study was designed with the objective of assessing the extent of mobile phone use amongst medical students and finding correlation if any between the hours of usage of mobile to sleep pattern and quality. hundred medical students grouped as cases (n = 57) (> 2 hours/day of mobile usage) and control (n = 43) (≤ 2 hours/day of mobile usage) were examined for their sleep quality & pattern by Pittsburg sleep Quality Index (PSQI). Differences between groups were examined with the Mann Whitney "U" test for proportions (Quantitative values) and with Student't' test for continuous variables. The association of variables was analyzed by Spearman Rank's correlation. Probability was set at < 0.05 as significant. Sleep disturbance, latency and day dysfunction was more in cases especially females. A significant association of hours of usage and sleep indices were observed in both genders (males r = 0.25; p = 0.04, females r = 0.31; p = 0.009). Evening usage of mobile phone in cases showed a statistically significant negative association (-0.606; p = 0.042) with Sleep quality (higher PSQI means sleep deprivation). Students using mobile for > 2 hours/day may cause sleep deprivation and day sleepiness affecting cognitive and learning abilities of medical students.

Mindfulness-based stress reduction for chronic insomnia in adults older than 75 years: a randomized, controlled, single-blind clinical trial.

PubMed

Zhang, Jia-Xu; Liu, Xiao-Hui; Xie, Xin-Hui; Zhao, Dan; Shan, Mo-Shui; Zhang, Xi-Liang; Kong, Xiao-Ming; Cui, Hong

2015-01-01

To assess the effectiveness of mindfulness-based stress reduction (MBSR) for chronic insomnia and combined depressive or anxiety symptoms of older adults aged 75 years and over. A randomized, controlled, single-blind clinical trial. Participants included 60 adults aged 75 years and over with chronic insomnia. Participants were randomly assigned to the eight-week MBSR group or the wait-list control group. Assessments using the Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Sale (SAS), and Geriatric Depression Scale (GDS) were taken at baseline and post-treatment. For each outcome measure, a repeated measures analysis of variance was used to detect changes across assessments. There was a significant time × group interaction for the PSQI global score (P = .006); the MBSR group had a decrease in the PSQI global score (Cohen׳s d = 1.12), while the control group did not (Cohen׳s d = -0.06). Among the PSQI components, there was a significant time × group interaction for daytime dysfunction (P = .048); Cohen׳s d of the MBSR group was 0.76, while Cohen׳s d of control group was -0.04. There was no significant time × group interaction for the SAS score (P = .116), while for the GDS there was a significant time × group interaction (P = .039); the Cohen׳s d value for the MBSR group was 1.20, and it was 0.12 for the control group. This study demonstrated that the MBSR program could be a beneficial treatment for chronic insomnia in adults aged 75 years and older. Copyright © 2015 Elsevier Inc. All rights reserved.

Sleep disturbance associated with rotator cuff tear: correction with arthroscopic rotator cuff repair.

PubMed

Austin, Luke; Pepe, Matthew; Tucker, Bradford; Ong, Alvin; Nugent, Robert; Eck, Brandon; Tjoumakaris, Fotios

2015-06-01

Sleep disturbance is a common complaint of patients with a rotator cuff tear. Inadequate and restless sleep, along with pain, is often a driving symptom for patients to proceed with rotator cuff repair. To date, no studies have examined sleep disturbance in patients undergoing rotator cuff repair, and there is no evidence that surgery improves sleep disturbance. Sleep disturbance is prevalent in patients with a symptomatic rotator cuff tear, and sleep disturbance improves after arthroscopic rotator cuff repair. Case series; Level of evidence, 4. A total of 56 patients undergoing arthroscopic rotator cuff repair for full-thickness tears were enrolled in a prospective study. Patients were surveyed preoperatively and postoperatively at intervals of 2, 6, 12, 18, and 24 weeks. Patient outcomes were scored using the Pittsburgh Sleep Quality Index (PSQI), Simple Shoulder Test (SST), visual analog scale for pain (VAS), and single assessment numeric evaluation (SANE). Demographic and surgical factors were also collected for analysis. Preoperative PSQI scores indicative of sleep disturbance were reported in 89% of patients. After surgery, a statistically significant improvement in PSQI was achieved at 3 months (P = .0012; 91% follow-up) and continued through 6 months (P = .0179; 93% follow-up). Six months after surgery, only 38% of patients continued to have sleep disturbance. Multivariable linear regression of all surgical and demographic factors versus PSQI was performed and demonstrated that preoperative and prolonged postoperative narcotic use negatively affected sleep. Sleep disturbance is common in patients undergoing rotator cuff repair. After surgery, sleep disturbance improves to levels comparable with those of the general public. Preoperative and prolonged postoperative use of narcotic pain medication negatively affects sleep. © 2015 The Author(s).

Cognitive Behavior Therapy to Treat Sleep Disturbance and Fatigue After Traumatic Brain Injury: A Pilot Randomized Controlled Trial.

PubMed

Nguyen, Sylvia; McKay, Adam; Wong, Dana; Rajaratnam, Shantha M; Spitz, Gershon; Williams, Gavin; Mansfield, Darren; Ponsford, Jennie L

2017-08-01

To evaluate the efficacy of adapted cognitive behavioral therapy (CBT) for sleep disturbance and fatigue in individuals with traumatic brain injury (TBI). Parallel 2-group randomized controlled trial. Outpatient therapy. Adults (N=24) with history of TBI and clinically significant sleep and/or fatigue complaints were randomly allocated to an 8-session adapted CBT intervention or a treatment as usual (TAU) condition. Cognitive behavior therapy. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) posttreatment and at 2-month follow-up. Secondary measures included the Insomnia Severity Index, Fatigue Severity Scale, Brief Fatigue Inventory (BFI), Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale. At follow-up, CBT recipients reported better sleep quality than those receiving TAU (PSQI mean difference, 4.85; 95% confidence interval [CI], 2.56-7.14). Daily fatigue levels were significantly reduced in the CBT group (BFI difference, 1.54; 95% CI, 0.66-2.42). Secondary improvements were significant for depression. Large within-group effect sizes were evident across measures (Hedges g=1.14-1.93), with maintenance of gains 2 months after therapy cessation. Adapted CBT produced greater and sustained improvements in sleep, daily fatigue levels, and depression compared with TAU. These pilot findings suggest that CBT is a promising treatment for sleep disturbance and fatigue after TBI. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The Use of Media as a Sleep Aid in Adults.

PubMed

Exelmans, Liese; Van den Bulck, Jan

2016-01-01

A sample of 844 adults, aged 18-94 years old, was queried about media habits and sleep behavior in face-to-face interviews with standardized questionnaires. A substantial proportion of this sample reported using books (39.8%), television (31.2%), music (26.0%), Internet (23.2%), and videogames (10.3%) as a sleep aid. The use of media as sleep aids was associated with increased fatigue and higher scores on the Pittsburgh Sleep Quality Index (PSQI), indicating poorer sleep quality. There was no relationship with sleep duration. Finally, results suggest that media use coincides with later bedtimes, but also later rise times, a process called time shifting.

Global sleep quality as a moderator of alcohol consumption and consequences in college students.

PubMed

Kenney, Shannon R; LaBrie, Joseph W; Hummer, Justin F; Pham, Andy T

2012-04-01

The authors examined the relationship between global sleep quality and alcohol risk, including the extent to which global sleep quality moderated the relationship between alcohol use and drinking-related consequences. Global sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and alcohol-related consequences were assessed using the Rutgers Alcohol Problem Index (RAPI). The sample consisted of 261 college students (61.3% female, 58.2% Caucasian) who completed online surveys. Using a four-step hierarchical multiple regression model, global sleep quality was found to predict alcohol consequences, over and above assessed covariates (demographics and weekly drinking). Further, global sleep quality emerged as a strong moderator in the drinking-consequences relationship such that among heavier drinkers, those with poorer global sleep quality experienced significantly greater alcohol-related harm. Campus health education and alcohol interventions may be adapted to address the importance of maintaining a healthy lifestyle, both in terms of healthful sleeping and drinking behaviors, which appear to play a strong synergistic role in alcohol-related risk. Copyright © 2012 Elsevier Ltd. All rights reserved.

Correlation between sleep and psychological mood states in female wheelchair basketball players on a Japanese national team

PubMed Central

Tsunoda, Kenji; Mutsuzaki, Hirotaka; Hotta, Kazushi; Shimizu, Yukiyo; Kitano, Naruki; Wadano, Yasuyoshi

2017-01-01

[Purpose] Although some studies suggest the importance of getting adequate sleep for enhancing mood, there is not yet sufficient evidence on the relationship between sleep and mood states in athletes, especially for athletes with physical disability. The purpose of this study is to reveal relationships between sleep and psychological mood states in female wheelchair basketball players. [Subjects and Methods] Seventeen female wheelchair basketball players (30.9 ± 9.4 years old) on a Japanese national team participated. Sleep states were assessed with the Pittsburgh Sleep Quality Index (PSQI), and mood states with the Japanese version of the Profile of Mood States short form (POMS-SF). Spearman’s rank correlations were computed. [Results] The mean PSQI score was 5.4 ± 2.6 points, and 9 athletes (52.9%) exceeded the cutoff point (5.5) for insomnia. Higher sleep efficiency (rS=0.58), fewer sleep disturbances (rS=−0.58), and lower total PSQI score (rS=−0.51) were significantly correlated with higher vigor. Lower likelihood of daytime dysfunction was also significantly correlated with lower tension (rS=0.50). [Conclusion] Vigor was the mood state most frequently correlated with sleep variables. Because vigor is a known key psychological factor in optimal performance, the findings are valuable for wheelchair basketball players. PMID:28931975

Efficacy, safety and risk of augmentation of rotigotine for treating restless legs syndrome.

PubMed

Inoue, Yuichi; Hirata, Koichi; Hayashida, Kenichi; Hattori, Nobutaka; Tomida, Takayuki; Garcia-Borreguero, Diego

2013-01-10

The present study aimed to examine the long-term efficacy and safety of rotigotine treatment for restless legs syndrome (RLS), as well as the rate of clinically significant augmentation, in a 1-year open-label study of Japanese subjects. Japanese patients with RLS who had been treated with rotigotine or placebo in a double-blind trial were enrolled in a 1-year, open-label, uncontrolled extension study and treated with rotigotine at a dose of up to 3 mg/24 h after an 8-week titration phase. Outcomes included International Restless Legs Syndrome Study Group rating scale (IRLS scale), Pittsburgh Sleep Quality Index (PSQI), safety, and investigator-/expert panel-assessed augmentation (including Augmentation Severity Rating Scale). Overall, 185 patients entered the open-label study and 133 completed the study. IRLS and PSQI total scores improved throughout the 52-week treatment period (IRLS, from 23.2±5.1 to 7.8±7.6 and PSQI, from 8.0±3.1 to 5.0±2.9). Treatment-emergent adverse events were mild to moderate in severity, and included application site reactions (52.4%) and nausea (28.6%). Clinically significant augmentation occurred in five patients (2.7%). These results indicate a good long-term efficacy of rotigotine for treating RLS, with a relatively low risk of clinically significant augmentation. Copyright © 2012 Elsevier Inc. All rights reserved.

To Assess Sleep Quality among Pakistani Junior Physicians (House Officers): A Cross-sectional Study.

PubMed

Surani, A A; Surani, A; Zahid, S; Ali, S; Farhan, R; Surani, S

2015-01-01

Sleep deprivation among junior physicians (house officers) is of growing concern. In developed countries, duty hours are now mandated, but in developing countries, junior physicians are highly susceptible to develop sleep impairment due to long working hours, on-call duties and shift work schedule. We undertook the study to assess sleep quality among Pakistani junior physicians. A cross-sectional study was conducted at private and public hospitals in Karachi, Pakistan, from June 2012 to January 2013. The study population comprised of junior doctors (house physicians and house surgeons). A consecutive sample of 350 physicians was drawn from the above-mentioned study setting. The subject underwent two validated self-administered questionnaires, that is, Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). A total of 334 physicians completely filled out the questionnaire with a response rate of 95.4% (334/350). Of 334 physicians, 36.8% (123/334) were classified as "poor sleepers" (global PSQI score > 5). Poor sleep quality was associated with female gender (P = 0.01), excessive daytime sleepiness (P < 0.01), lower total sleep time (P < 0.001), increased sleep onset latency (P < 0.001), and increased frequency of sleep disturbances (P < 0.001). Abnormal ESS scores (ESS > 10) were more prevalent among poor sleepers (P < 0.01) signifying increased level of daytime hypersomnolence. Sleep quality among Pakistani junior physicians is significantly poor. Efforts must be directed towards proper sleep hygiene education. Regulations regarding duty hour limitations need to be considered.

Sleep quality, posttraumatic stress, depression, and human errors in train drivers: a population-based nationwide study in South Korea.

PubMed

Jeon, Hong Jin; Kim, Ji-Hae; Kim, Bin-Na; Park, Seung Jin; Fava, Maurizio; Mischoulon, David; Kang, Eun-Ho; Roh, Sungwon; Lee, Dongsoo

2014-12-01

Human error is defined as an unintended error that is attributable to humans rather than machines, and that is important to avoid to prevent accidents. We aimed to investigate the association between sleep quality and human errors among train drivers. Cross-sectional. Population-based. A sample of 5,480 subjects who were actively working as train drivers were recruited in South Korea. The participants were 4,634 drivers who completed all questionnaires (response rate 84.6%). None. The Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), the Impact of Event Scale-Revised (IES-R), the State-Trait Anxiety Inventory (STAI), and the Korean Occupational Stress Scale (KOSS). Of 4,634 train drivers, 349 (7.5%) showed more than one human error per 5 y. Human errors were associated with poor sleep quality, higher PSQI total scores, short sleep duration at night, and longer sleep latency. Among train drivers with poor sleep quality, those who experienced severe posttraumatic stress showed a significantly higher number of human errors than those without. Multiple logistic regression analysis showed that human errors were significantly associated with poor sleep quality and posttraumatic stress, whereas there were no significant associations with depression, trait and state anxiety, and work stress after adjusting for age, sex, education years, marital status, and career duration. Poor sleep quality was found to be associated with more human errors in train drivers, especially in those who experienced severe posttraumatic stress. © 2014 Associated Professional Sleep Societies, LLC.

Effect of mandibular advancement device on sleep bruxism score and sleep quality.

PubMed

Solanki, Nehal; Singh, Balendra Pratap; Chand, Pooran; Siddharth, Ramashankar; Arya, Deeksha; Kumar, Lakshya; Tripathi, Suryakant; Jivanani, Hemant; Dubey, Abhishek

2017-01-01

The use of mandibular advancement devices (MADs) in the treatment of sleep bruxism is gaining widespread importance. However, the effects of MADs on sleep bruxism scores, sleep quality, and occlusal force are not clear. The purpose of this clinical study was to analyze the effect of MADs on sleep bruxism scores, sleep quality, and occlusal force. This uncontrolled before and after study enrolled 30 participants with sleep bruxism. Outcomes assessed were sleep quality, sleep bruxism scores (sleep bruxism bursts and sleep bruxism episodes/hour), and occlusal force before and after 15 and 30 days of using a MAD. Sleep bruxism scores were assessed by ambulatory polysomnography and sleep quality by using the Pittsburgh sleep quality index (PSQI). Occlusal force was recorded by using a digital gnathodynamometer in the first molar region on both sides. Statistical analysis was done by 1-factor repeated measures ANOVA (α=.05). Statistically significant reductions in sleep bruxism bursts/h, sleep bruxism episodes/h, and PSQI scores were found after 15 and 30 days of using a MAD (P<.001). Statistically significant reduction in occlusal force on both sides was found only after 15 days (P<.001) but not after 30 days of using a MAD (P=.292 on left side, and P=.575 on the right side). The study showed a short-term improvement in sleep bruxism scores, sleep quality, and reduction in occlusal force in sleep bruxism participants after using MADs. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Plasma Vitamin D Deficiency Is Associated with Poor Sleep Quality and Night-Time Eating at Mid-Pregnancy in Singapore

PubMed Central

Cheng, Tuck Seng; Loy, See Ling; Cheung, Yin Bun; Cai, Shirong; Colega, Marjorelee T.; Godfrey, Keith M.; Chong, Yap-Seng; Tan, Kok Hian; Shek, Lynette Pei-Chi; Lee, Yung Seng; Lek, Ngee; Chan, Jerry Kok Yen; Chong, Mary Foong-Fong; Yap, Fabian

2017-01-01

Plasma 25-hydroxyvitamin D (25OHD) deficiency, poor sleep quality, and night-time eating, have been independently associated with adverse pregnancy outcomes, but their inter-relationships are yet to be evaluated. We aimed to investigate the associations between maternal plasma 25OHD status and sleep quality and circadian eating patterns during pregnancy. Data on pregnant women (n = 890) from a prospective cohort (Growing Up in Singapore Towards healthy Outcomes) were analyzed. Plasma 25OHD concentration was measured, while the Pittsburgh sleep quality index (PSQI) and 24-h dietary recall were administered to women at 26–28 weeks’ gestation. Plasma 25OHD status was defined as sufficient (>75 nmol/L), insufficient (50–75 nmol/L), or deficient (<50 nmol/L). Poor sleep quality was defined by a total global PSQI score >5. Predominantly day-time (pDT) and predominantly night-time (pNT) were defined according to consumption of greater proportion of calories (i.e., >50%) from 07:00–18:59 and from 19:00–06:59, respectively. After adjustment for confounders, women with plasma 25OHD deficiency had higher odds of poor sleep quality (odds ratio (OR) 3.49; 95% confidence interval (CI) 1.84–6.63) and pNT eating (OR: 1.85; 95% CI 1.00–3.41) than those who were 25OHD sufficient. Our findings show the association of maternal plasma 25OHD deficiency with poor sleep quality and pNT eating at mid-pregnancy. PMID:28353643

Impact of weak social ties and networks on poor sleep quality: A case study of Iranian employees.

PubMed

Masoudnia, Ebrahim

2015-12-01

The poor sleep quality is one of the major risk factors of somatic, psychiatric and social disorders and conditions as well as the major predictors of quality of employees' performance. The previous studies in Iran had neglected the impacts of social factors including social networks and ties on adults sleep quality. Thus, the aim of the current research was to determine the relationship between social networks and adult employees' sleep quality. This study was conducted with a correlational and descriptive design. Data were collected from 360 participants (183 males and 177 females) who were employed in Yazd public organizations in June and July of 2014. These samples were selected based on random sampling method. In addition, the measuring tools were the Pittsburgh Sleep Quality Index (PSQI) and Social Relations Inventory (SRI). Based on the results, the prevalence rate of sleep disorder among Iranian adult employees was 63.1% (total PSQI>5). And, after controlling for socio-demographic variables, there was significant difference between individuals with strong and poor social network and ties in terms of overall sleep quality (p<.01), subjective sleep quality (p<.01), habitual sleep efficiency (p<.05), and daytime dysfunction (p<.01). The results also revealed that the employees with strong social network and ties had better overall sleep quality, had the most habitual sleep efficiency, and less daytime dysfunction than employees with poor social network and ties. It can be implied that the weak social network and ties serve as a risk factor for sleep disorders or poor sleep quality for adult employees. Therefore, the social and behavioral interventions seem essential to improve the adult's quality sleep. Copyright © 2015 Elsevier B.V. All rights reserved.

Cellular aging and restorative processes: subjective sleep quality and duration moderate the association between age and telomere length in a sample of middle-aged and older adults.

PubMed

Cribbet, Matthew R; Carlisle, McKenzie; Cawthon, Richard M; Uchino, Bert N; Williams, Paula G; Smith, Timothy W; Gunn, Heather E; Light, Kathleen C

2014-01-01

To examine whether subjective sleep quality and sleep duration moderate the association between age and telomere length (TL). Participants completed a demographic and sleep quality questionnaire, followed by a blood draw. Social Neuroscience Laboratory. One hundred fifty-four middle-aged to older adults (age 45-77 y) participated. Participants were excluded if they were on immunosuppressive treatment and/or had a disease with a clear immunologic (e.g., cancer) component. N/A. Subjective sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI) and TL was determined using peripheral blood mononuclear cells (PBMCs). There was a significant first-order negative association between age and TL. Age was also negatively associated with the self-reported sleep quality item and sleep duration component of the PSQI. A significant age × self-reported sleep quality interaction revealed that age was more strongly related to TL among poor sleepers, and that good sleep quality attenuated the association between age and TL. Moreover, adequate subjective sleep duration among older adults (i.e. greater than 7 h per night) was associated with TL comparable to that in middle-aged adults, whereas sleep duration was unrelated to TL for the middle-aged adults in our study. The current study provides evidence for an association between sleep quality, sleep duration, and cellular aging. Among older adults, better subjective sleep quality was associated with the extent of cellular aging, suggesting that sleep duration and sleep quality may be added to a growing list of modifiable behaviors associated with the adverse effects of aging.

Nicotine dependence and sleep quality in young adults.

PubMed

Dugas, E N; Sylvestre, M P; O'Loughlin, E K; Brunet, J; Kakinami, L; Constantin, E; O'Loughlin, J

2017-02-01

More cigarette smokers report poor sleep quality than non-smokers, but the association between nicotine dependence (ND) and sleep quality has not been well-characterized. The objective of this study was to describe the associations among frequency and intensity of cigarette smoking, ND symptoms, and sleep quality in young adults. Data on past-year smoking frequency, number of cigarettes smoked in the past month, five ND indicators (i.e., withdrawal, craving, self-medication symptoms, mFTQ, ICD-10 criteria for tobacco dependence), and sleep quality (measured with the Pittsburgh Sleep Quality Index (PSQI)) were collected in 2011-12 in self-report questionnaires completed by 405 young adult smokers (mean age 24 (0.6) years; 45% male; 45% daily smokers) participating in a longitudinal investigation of the natural course of ND. Associations between indicators of cigarette smoking, ND symptoms, and sleep quality were examined in multivariable logistic regression analyses controlling for age, sex, mother's education, and alcohol use. Thirty-six percent of participants reported poor sleep quality (PSQI>5). Higher cigarette consumption (OR(95% CI), 1.03(1.001-1.05)) but not frequency of past-year smoking, more frequent withdrawal symptoms (1.05(1.004-1.10)), more frequent cravings (1.05(1.004-1.10)), higher mFTQ scores (1.14(1.02-1.27)), and endorsing more ICD-10 criteria for tobacco dependence (1.19(1.04-1.36)) were also associated with poor sleep quality. Cigarette smoking and ND symptoms are associated with poor sleep quality in young adult smokers. Advice from practitioners to cut back on number of cigarettes smoked per day and treatment of ND symptoms may improve sleep quality in young adult smokers. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Effectiveness of short educational intervention in patients with insomnia in primary care].

PubMed

Gancedo-García, Ana; Gutiérrez-Antezana, Angélica Faviola; González-García, Pablo; Salinas-Herrero, Sally; Prieto-Merino, David; Suárez-Gil, Patricio

2014-12-01

To evaluate the effectiveness of providing an educational intervention in primary care (PC) alongside a pharmacological treatment for insomnia. Single blinded non randomised clinical trial. Two urban primary health centers in Gijón (Asturias, Spain). Patients who consulted for insomnia between July 2012-January 2013 and met the inclusion criteria (n=50) were assigned systematically to the control group (CG) or intervention group (IG). All patients initiated treatment with lorazepam 1mg in the evenings and had four weekly 15 min visits plus a follow-up visit after another month. The IG received training for control of stimuli, sleep hygiene and respiration and relaxation techniques in the four visits. The CG had only non invasive measures taken. Considering as cured those who reached a Pittsburgh Sleep Quality Index PSQI <6 or a 50% reduction from baseline level. It was also analyzed the change in the PSQI from baseline to final visit and to follow-up visit, and voluntary interruption of lorazepam. Analysis by Bayesian inference. Twelve out of recoveries after intervention against one out of 24 among control group. Mean change in PSQI to final visit and follow-up visit was: -4.7 (95%CrI:-5.9 to -3.5) and -6,3 (95%ICred: -7.5 to -5.1) in IG; -1.8 (95%ICred: -3 to -0.5) and -1.7 (95%ICred: -2.9 to -0.4) in CG. Interruption of lorazepan: in 4 controls (16,7%) and 9 (34,6%) in IG. Twenty nine patients in GI and 17 in GC completed the trial. Per protocol analysis showed similar results. The educational intervention in PC improves sleep quality and reduces the need of treatment with benzodiacepines. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

The SENSE Study: Treatment Mechanisms of a Cognitive Behavioral and Mindfulness-Based Group Sleep Improvement Intervention for At-Risk Adolescents.

PubMed

Blake, Matthew; Schwartz, Orli; Waloszek, Joanna M; Raniti, Monika; Simmons, Julian G; Murray, Greg; Blake, Laura; Dahl, Ronald E; Bootzin, Richard; McMakin, Dana L; Dudgeon, Paul; Trinder, John; Allen, Nicholas B

2017-06-01

The aim of this study was to test whether a cognitive behavioral and mindfulness-based group sleep intervention would improve sleep and anxiety on school nights in a sample of at-risk adolescents. We also examined whether benefits to sleep and anxiety would be mediated by improvements in sleep hygiene awareness and presleep hyperarousal. Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 60%; mean age = 14.48) who had high levels of sleep problems and anxiety symptoms. Participants were randomized into a sleep improvement intervention (n = 63) or active control "study skills" intervention (n = 60). Preintervention and postintervention, participants completed the Pittsburgh Sleep Quality Index (PSQI), Spence Children's Anxiety Scale (SCAS), Sleep Beliefs Scale (SBS), and Presleep Hyperarousal Scale (PSAS) and wore an actiwatch and completed a sleep diary for five school nights. The sleep intervention condition was associated with significantly greater improvements in actigraphy-measured sleep onset latency (SOLobj), sleep diary measured sleep efficiency (SEsubj), PSQI, SCAS, SBS, and PSAS, with medium to large effect sizes. Improvements in the PSQI and SCAS were specifically mediated by the measured improvements in the PSAS that resulted from the intervention. Improvements in SOLobj and SEsubj were not specifically related to improvements in any of the putative treatment mechanisms. This study provides evidence that presleep arousal but not sleep hygiene awareness is important for adolescents' perceived sleep quality and could be a target for new treatments of adolescent sleep problems. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Pilot study of a mindfulness-based, multi-component, in-school group sleep intervention in adolescent girls.

PubMed

Bei, Bei; Byrne, Michelle L; Ivens, Clare; Waloszek, Joanna; Woods, Michael J; Dudgeon, Paul; Murray, Greg; Nicholas, Christian L; Trinder, John; Allen, Nicholas B

2013-05-01

Existing literature links poor sleep and anxiety symptoms in adolescents. This pilot study aimed to develop a practical method through which a program to improve sleep could reach adolescents in need and to examine the feasibility of a mindfulness-based, multi-component group sleep intervention using sleep and anxiety as outcome measures. Sixty-two grade 9 students (aged 13-15) at a girls' school were screened with the Pittsburgh Sleep Quality Index (PSQI) and Spence Children's Anxiety Scale (SCAS). Ten participants with self-reported poor sleep were enrolled into a six-session program based on Bootzin & Stevens, with added stress/anxiety-specific components. Sessions covered key aspects of basic mindfulness concepts and practice, sleep hygiene, sleep scheduling, evening/daytime habits, stimulus control, skills for bedtime worries and healthy attitudes to sleep. Treatment changes were measured by pre-post scores on the PSQI, SCAS and 7-day actigraphy-measured sleep. The program demonstrated high acceptability, with a completion rate of 90%. Based on effect-size analysis, participants showed significant improvement on objective sleep onset latency (SOL), sleep efficiency and total sleep time; actigraphy data also showed significantly earlier bedtime, rise time and smaller day-to-day bedtime variation. Post-intervention global PSQI scores were significantly lower than that of pre-intervention, with significant improvement in subjective SOL, sleep quality and sleep-related daytime dysfunction. There were small improvements on some subscales of the SCAS, but change on its total score was minimal. A mindfulness-based, multi-component, in-school group sleep intervention following brief screening is feasible, and has the potential to improve sleep. Its impact on anxiety needs further investigation. © 2012 Wiley Publishing Asia Pty Ltd.

α(1)-adrenoceptor blocker naftopidil improves sleep disturbance with reduction in nocturnal urine volume.

PubMed

Yokoyama, Osamu; Aoki, Yoshitaka; Tsujimura, Akira; Takao, Tetsuya; Namiki, Mikio; Okuyama, Akihiko

2011-04-01

To examine the mechanism underlying improvements in nocturia by α(1)-blockers, we investigated whether the α(1)-blocker naftopidil acts on nocturia with sleep disturbance using a frequency/volume chart (FVC). A total of 56 male patients with lower urinary tract symptoms were enrolled. The inclusion criteria were as follows: eight or more points on the I-PSS; three or more points on the I-PSS score for nocturia; and prostate volume larger than 20 ml. Patients received 50 mg of naftopidil once daily for 4 weeks, and non-responders received 75 mg for another 4 weeks. All patients were examined, and their data entered into FVC for 2 days before and after administration of naftopidil. Quality of sleep was also evaluated using modified Pittsburgh sleep quality index (PSQI). Patients with sleep quality scores of three or four were assigned to sleep disturbance group (n = 33), while those with scores of less than three were assigned to non-disturbance group (n = 23). After administration of naftopidil, total I-PSS decreased and nocturia score decreased from 3.5 to 2.6 (P < 0.01). Total mean score of modified PSQI in sleep disturbance group became significantly lower after administration of naftopidil (from 16.9 to 14.0; P < 0.01). Naftopidil significantly decreased nocturnal urine volume, resulting in a decrease in the nocturnal polyuria index in both sleep disturbance and non-disturbance groups. These results suggest that α(1)-blockers have the ability to normalize sleep disorders. Naftopidil improved nocturnal polyuria regardless of the presence of sleep disturbance, meaning that it might directly reduce nocturnal urine production.

Effect of aromatherapy via inhalation on the sleep quality and fatigue level in people undergoing hemodialysis.

PubMed

Muz, Gamze; Taşcı, Sultan

2017-10-01

The most common problems in hemodialysis patients are sleep disorders and fatigue. This randomized-controlled experimental study was conducted to determine the effect of aromatherapy applied by inhalation on sleep quality and fatigue level in hemodialysis patients. The study was completed in five hemodialysis centers settled in two provinces with 27 intervention group patients and 35 controls, being totally 62 patients, recruited with simple randomization. Ethical approval, informed consent from the individuals and institutional permission were obtained. Data were collected with a questionnaire form and Visual Analogue Scale (VAS) for fatigue, Piper fatigue scale, Pittsburgh Sleep Quality Index (PSQI), and follow-up forms for the patient and the researcher. Aromatherapy inhalation (sweet orange and lavender oil) was performed before going to bed every day for one month to the intervention group patients. No other application has been made to the control group patients except for standard hemodialysis treatment. All of the forms were performed at baseline and at follow-up at the end of the four weeks (baseline and last follow-up), VAS and Piper fatigue scale were performed during follow-ups at the end of every week (the first, second and third follow-ups). Data were statistically analyzed with Independent Samples t-test, one way analysis of variance, Pearson correlation analysis, chi-square test, Friedman and Mann Whitney U tests and Bonferroni test. p<0.05 was set as statistically significant in comparisons. Mean total and sub-dimension scores of VAS, Piper fatigue scale and PSQI (except for daytime sleepiness dysfunction sub-dimension) of the intervention and control groups at baseline were not significantly different (p>0.05). It was found that mean total and sub-dimension scores of VAS, Piper fatigue scale and PSQI of the intervention group significantly decreased in other follow-ups compared to the control group (p<0.05). Consequently, it was determined that aromatherapy applied by inhalation improved sleep quality, decreased fatigue level and severity in hemodialysis patients. Accordingly, aromatherapy prepared with sweet orange and lavender oil may be recommended to increase sleep quality and to decrease fatigue level of the hemodialysis patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Sleep quality and disturbances in patients with different-sized rotator cuff tear.

PubMed

Gumina, S; Candela, V; Passaretti, D; Venditto, T; Mariani, L; Giannicola, G

2016-12-01

The literature is unanimous in saying that shoulder pain, due to rotator cuff tear (RCT), may be mostly at night; to our knowledge, this statement is not supported by scientific evidence. Our aim was to investigate sleep quality and disturbances in patient with RCT and in a control group. A case-control design study was used. We enrolled 324 consecutive patients (Group A) (156M-168F, mean age ± SD: 64.94 ± 6.97; range 47-74) who underwent arthroscopic rotator cuff repair. Tear size was determined intraoperatively. The control group (Group B) included 184 subjects (80M-104F, mean age ± SD = 63.34 ± 6.26; range 44-75) with no RCT. All participants were submitted to two standardized self-reported questionnaires evaluating sleep quality and disturbances: the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Data were submitted to statistics. We found no significant differences between the two groups according to both PSQI (Group A: 5.22 ± 2.59; Group B: 5.21 ± 2.39) and ESS (Group A: 2.59 ± 2.54; Group B: 5.76 ± 2.63), p > 0.05. Patients with small tears had average PSQI and ESS higher than patients with large and massive lesions (p < 0.005). Pearson's test showed that tear severity was negatively correlated with both sleep latency (r 2  = -0.35, β = 0.069, p < 0.005) and sleep disturbances (r 2  = -0.65, β = 0.053, p < 0.001). RCT is only one of the responsible causes for sleep disturbance in middle-aged and elderly subjects. Patients with small tears have a poorer sleep quality with respect to those with a more severe tear; particularly, they not only take more time to fall asleep, but also have a more disturbed sleep compared to patients with large and massive tears. III.

Depression-Specific Outcomes After Treatment of Chronic Rhinosinusitis

PubMed Central

Schlosser, Rodney J.; Hyer, J. Madison; Smith, Timothy L.; Mace, Jess C.; Cortese, Bernadette M.; Uhde, Thomas W.; Rudmik, Luke; Soler, Zachary M.

2016-01-01

IMPORTANCE Depression is frequently undiagnosed in patients with chronic rhinosinusitis (CRS) and affects quality of life, productivity, and health care use. OBJECTIVE To examine depression-specific outcomes after medical or surgical treatment of CRS. DESIGN, SETTING, AND PARTICIPANTS A multi-institutional, prospective study of patients with refractory CRS treated at tertiary academic rhinology centers was performed from March 1, 2011, to November 1, 2015. Data analysis was performed from October 1, 2015, to November 1, 2015. INTERVENTIONS Patients self-selected to undergo continued medical management or endoscopic sinus surgery for refractory CRS. MAIN OUTCOMES AND MEASURES Patients completed the 22-item Sinonasal Outcome Test (SNOT22), Rhinosinusitis Disability Index (RSDI), Pittsburgh Sleep Quality Index (PSQI), and missed productivity and medication use questionnaires before and at least 6 months after treatment. Computed tomography and endoscopy scoring were performed with reviewers masked to patient-reported data. Depression-specific outcomes were recorded using the 2-item Patient Health Questionnaire (PHQ2). RESULTS Baseline data were available on 685 patients, with 167 (24.4%) having depression according to the PHQ2 scores. The mean (SD) age of the patients was 50.5 (15.0) years, and 332 (48.4%) were male. Revision surgery status was the only baseline factor associated with depression (53.9%vs 38.0%, P < .001). Patients with depression had worse baseline SNOT22 (mean, 64.5 vs 47.6), PSQI (mean, 12.8 vs 8.4), productivity (mean, 22.8 vs 5.2 days missed), and medication use scores for oral antibiotics (mean, 23.8 vs 14.8) and oral corticosteroids (mean, 17.8 vs 9.9) (P < .001 for all). Medical and surgical treatments had similar outcomes for patients with depression with mean improvement in the PHQ2 scores from 3.96 to 1.91 (P < .001), and 110 of 167 patients (65.9%) categorized as having depression at baseline were categorized as not having depression after treatment. Improvements in the PHQ2 scores were associated with improvements in the SNOT22, PSQI, oral antibiotic use, and productivity scores (P ≤ .001 for all). CONCLUSIONS AND RELEVANCE Depression is a common comorbidity in patients with CRS and affects numerous quality-of-life and health care outcomes. There are few objective baseline factors to aid physicians in identifying depression in patients with CRS. Medical and surgical treatments for CRS improve depression and related clinical outcomes. PMID:26967171

Sleep Characteristics and Carotid Atherosclerosis Among Midlife Women.

PubMed

Thurston, Rebecca C; Chang, Yuefang; von Känel, Roland; Barinas-Mitchell, Emma; Jennings, J Richard; Hall, Martica H; Santoro, Nanette; Buysse, Daniel J; Matthews, Karen A

2017-02-01

Midlife, which encompasses the menopause transition in women, can be a time of disrupted sleep and accelerated atherosclerosis accumulation. Short or poor sleep quality has been associated with cardiovascular disease (CVD) risk; few studies have investigated relations among midlife women. We tested whether shorter actigraphy sleep time or poorer subjective sleep quality was associated with carotid atherosclerosis among midlife women. Two hundred fifty-six peri- and postmenopausal women aged 40-60 years completed 3 days of wrist actigraphy, hot flash monitoring, questionnaires (Pittsburgh Sleep Quality Index [PSQI], Berlin), a blood draw, and carotid ultrasound [intima media thickness (IMT), plaque]. Associations of objective (actigraphy) and subjective (PSQI) sleep with IMT/plaque were tested in regression models (covariates: age, race, education, body mass index, blood pressure, lipids, insulin resistance, medications, snoring, depressive symptoms, sleep hot flashes, and estradiol). Shorter objective sleep time was associated with higher odds of carotid plaque (for each hour shorter sleep, plaque score ≥ 2, odds ratio (OR) [95% confidence interval, CI] = 1.58 [1.11-2.27], p = .01; plaque score = 1, OR [95% CI] = 0.95 [0.68-1.32], p = .75, vs. no plaque, multivariable). Poorer subjective sleep quality was associated with higher mean IMT [β, b (standard error, SE) = 0.004 (0.002), p = .03], maximal IMT [b (SE) = 0.009 (0.003), p = .005], and plaque [plaque score ≥ 2, OR (95% CI) = 1.23 (1.09-1.40), p = .001; score = 1, OR (95% CI) = 1.06 (0.93-1.21), p = .37, vs. no plaque] in multivariable models. Findings persisted additionally adjusting for sleep hot flashes and estradiol. Shorter actigraphy-assessed sleep time and poorer subjective sleep quality were associated with increased carotid atherosclerosis among midlife women. Associations persisted adjusting for CVD risk factors, hot flashes, and estradiol. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Global Assessment of the Impact of Type 2 Diabetes on Sleep through Specific Questionnaires. A Case-Control Study

PubMed Central

Lecube, Albert; Sánchez, Enric; Gómez-Peralta, Fernando; Abreu, Cristina; Valls, Joan; Mestre, Olga; Romero, Odile; Martínez, María Dolores; Sampol, Gabriel; Ciudin, Andreea; Hernández, Cristina; Simó, Rafael

2016-01-01

Abstract Type 2 diabetes (T2D) is an independent risk factor for sleep breathing disorders. However, it is unknown whether T2D affects daily somnolence and quality of sleep independently of the impairment of polysomnographic parameters. Material and Methods A case-control study including 413 patients with T2D and 413 non-diabetic subjects, matched by age, gender, BMI, and waist and neck circumferences. A polysomnography was performed and daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). In addition, 135 subjects with T2D and 45 controls matched by the same previous parameters were also evaluated through the Pittsburgh Sleep Quality Index (PSQI) to calculate sleep quality. Results Daytime sleepiness was higher in T2D than in control subjects (p = 0.003), with 23.9% of subjects presenting an excessive daytime sleepiness (ESS>10). Patients with fasting plasma glucose (FPG ≥13.1 mmol/l) were identified as the group with a higher risk associated with an ESS>10 (OR 3.9, 95% CI 1.8–7.9, p = 0.0003). A stepwise regression analyses showed that the presence of T2D, baseline glucose levels and gender but not polysomnographic parameters (i.e apnea-hyoapnea index or sleeping time spent with oxigen saturation lower than 90%) independently predicted the ESS score. In addition, subjects with T2D showed higher sleep disturbances [PSQI: 7.0 (1.0–18.0) vs. 4 (0.0–12.0), p<0.001]. Conclusion The presence of T2D and high levels of FPG are independent risk factors for daytime sleepiness and adversely affect sleep quality. Prospective studies addressed to demonstrate whether glycemia optimization could improve the sleep quality in T2D patients seem warranted. PMID:27315083

Sleep Disturbances among Pregnant Women with History of Migraines: a Cross-sectional Study

PubMed Central

Qiu, Chunfang; Frederick, Ihunnaya O.; Sorensen, Tanya; Aurora, Sheena K.; Gelaye, Bizu; Enquobahrie, Daniel A.; Williams, Michelle A.

2015-01-01

Background Migraine is associated with sleep disturbances in men and non-pregnant women. However, relatively little is known about sleep disturbances among pregnant migraineurs. We investigated sleep disturbances among pregnant women with and without history of migraine. Methods This cross-sectional study was conducted among 1,324 women who were recruited during early pregnancy. Migraine diagnoses were based on the International Classification of Headache Disorders-II criteria. Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to evaluate sleep-related characteristics including sleep duration, sleep quality, excessive daytime sleepiness, and other sleep traits. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results Migraineurs were more likely than non-migraineurs to report short sleep duration (≤6 hours) (AOR=1.47, 95% CI 1.07–2.02), poor sleep quality (PSQI>5) (AOR=1.73, 95% CI 1.35–2.23), and daytime dysfunction due to sleepiness (AOR=1.51, 95% CI 1.12–2.02). Migraineurs were also more likely than non-migraineurs to report taking sleep medication during pregnancy (AOR=1.71, 95% CI 1.20–2.42). Associations were generally similar for migraine with or without aura. The odds of sleep disturbances were particularly elevated among pre-pregnancy overweight migraineurs. Conclusion Migraine headache and sleep disturbances are common co-morbid conditions among pregnant women. PMID:25633375

Sleep disturbances among pregnant women with history of migraines: A cross-sectional study.

PubMed

Qiu, Chunfang; Frederick, Ihunnaya O; Sorensen, Tanya; Aurora, Sheena K; Gelaye, Bizu; Enquobahrie, Daniel A; Williams, Michelle A

2015-10-01

Migraine is associated with sleep disturbances in men and non-pregnant women. However, relatively little is known about sleep disturbances among pregnant migraineurs. We investigated sleep disturbances among pregnant women with and without history of migraine. This cross-sectional study was conducted among 1324 women who were recruited during early pregnancy. Migraine diagnoses were based on the International Classification of Headache Disorders-II criteria. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to evaluate sleep-related characteristics including sleep duration, sleep quality, excessive daytime sleepiness, and other sleep traits. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Migraineurs were more likely than non-migraineurs to report short sleep duration (<6.5 hours) (AOR = 1.47, 95% CI 1.07-2.02), poor sleep quality (PSQI>5) (AOR = 1.73, 95% CI 1.35-2.23), and daytime dysfunction due to sleepiness (AOR = 1.51, 95% CI 1.12-2.02). Migraineurs were also more likely than non-migraineurs to report taking sleep medication during pregnancy (AOR = 1.71, 95% CI 1.20-2.42). Associations were generally similar for migraine with or without aura. The odds of sleep disturbances were particularly elevated among pre-pregnancy overweight migraineurs. Migraine headache and sleep disturbances are common comorbid conditions among pregnant women. © International Headache Society 2015.

Sleep patterns and disorders among university students in Lebanon.

PubMed

Assaad, Shafika; Costanian, Christy; Haddad, Georges; Tannous, Fida

2014-01-01

Insufficient sleep is a significant public health issue with adverse medical consequences. Sleep disturbances are common among university students and have an effect on this group's overall health and functioning. The aim of this study was to investigate sleep habits and disorders in a population of university students across Lebanon. This was a cross-sectional study carried out in 2012 among 735 students aged 18-25 yrs. old, enrolled at six universities across Lebanon. The Pittsburg Sleep Quality Index (PSQI) was used to assess sleep quality and habits. Less than half of the total study population (47.3%) were good sleepers (PSQI<5). Upon bivariate analysis, males experienced more sleep difficulties than females (57.8% vs. 40.8%). The majority (60%) of males vs. 40% of females had trouble performing daily activities more than once per week (P=0.02). Results of the multivariate analysis revealed that reporting poor sleep quality was strongly associated with daytime dysfunction and sleep- enhancing medication use especially more than once per week. This is the first study to describe the nature of sleep problems among university students in Lebanon. This study suggests that sleep problems among Lebanese college students were common and such problems may interfere with daily performance. Findings from this study have important implications for programs intended to improve academic performance by targeting sleep habits of students.

Adverse Effects of Induced Hot Flashes on Objectively Recorded and Subjectively Reported Sleep: Results of a Gonadotropin-Releasing Hormone Agonist Experimental Protocol

PubMed Central

Joffe, Hadine; White, David P.; Crawford, Sybil L.; McCurnin, Kristin E.; Economou, Nicole; Connors, Stephanie; Hall, Janet E.

2013-01-01

Objectives The impact of hot flashes on sleep is of great clinical interest, but results are inconsistent, especially when both hot flashes and sleep are measured objectively. Using objective and subjective measurements, we examined the impact of hot flashes on sleep by inducing hot flashes with a gonadotropin-releasing hormone agonist (GnRHa). Methods The GnRHa leuprolide was administered to 20 healthy premenopausal volunteers without hot flashes or sleep disturbances. Induced hot flashes were assessed objectively (skin-conductance monitor) and subjectively (daily diary) during one-month follow-up. Changes from baseline in objective (actigraphy) and subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI]) were compared between women who did and did not develop objective hot flashes, and, in parallel analyses, subjective hot flashes. Results New-onset hot flashes were recorded in 14 (70%) and reported by 14 (70%) women (80% concordance). Estradiol was universally suppressed. Objective sleep efficiency worsened in women with objective hot flashes and improved in women without objective hot flashes (median decrease 2.6%, increase 4.2%, p=0.005). Subjective sleep quality worsened more in those with than without subjective hot flashes (median increase PSQI 2.5 vs. 1.0, p=0.03). Objective hot flashes were not associated with subjective sleep quality, nor were subjective symptoms linked to objective sleep measures. Conclusions This experimental model of induced hot flashes demonstrates a causal relationship between hot flashes and poor sleep quality. Objective hot flashes result in worse objective sleep efficiency, while subjective hot flashes worsen perceived sleep quality. PMID:23481119

Impact of working hours on sleep and mental health.

PubMed

Afonso, P; Fonseca, M; Pires, J F

2017-07-01

The number of hours people are required to work has a pervasive influence on both physical and mental health. Excessive working hours can also negatively affect sleep quality. The impact at work of mental health problems can have serious consequences for individuals' as well as for organizations' productivity. To evaluate differences in sleep quality and anxiety and depression symptoms between longer working hours group (LWHG) and regular working hours group (RWHG). To examine factors influencing weekly working hours, sleep quality and anxiety and depressive symptoms. Participants were divided into two groups, RWHG and LWHG, based on working hours, with a cut-off of 48 h per week. We used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression symptoms and the Pittsburgh Sleep Quality Index (PSQI) to measure the quality and patterns of sleep. The response rate was 23%. Among the 429 study participants, those in the LWHG group (n = 256, 53%) had significantly more depressive and anxiety symptoms and worse sleep quality than those in RWHG (n = 223, 47%). Working time was significantly positively correlated with higher corporate position and HADS scores. Moreover, HADS scores were positively correlated with PSQI scores and negatively correlated with age. This study suggests that longer working hours are associated with poorer mental health status and increasing levels of anxiety and depression symptoms. There was a positive correlation between these symptoms and sleep disturbances. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Poor precompetitive sleep habits, nutrients' deficiencies, inappropriate body composition and athletic performance in elite gymnasts.

PubMed

Silva, M-R G; Paiva, T

2016-09-01

This study aimed to evaluate body composition, sleep, precompetitive anxiety and dietary intake on the elite female gymnasts' performance prior to an international competition. Sixty-seven rhythmic gymnasts of high performance level were evaluated in relation to sport and training practice, body composition, sleep duration, daytime sleepiness by the Epworth Sleepiness Scale (ESS), sleep quality by the Pittsburgh Sleep Quality Index (PSQI), precompetitive anxiety by the Sport Competition Anxiety Test form A (SCAT-A) and detailed dietary intake just before an international competition. Most gymnasts (67.2%) suffered from mild daytime sleepiness, 77.6% presented poor sleep quality and 19.4% presented high levels of precompetitive anxiety. The majority of gymnasts reported low energy availability (EA) and low intakes of important vitamins including folate, vitamins D, E and K; and minerals, including calcium, iron, boron and magnesium (p < .05). Gymnasts' performance was positively correlated with age (p = .001), sport practice (p = .024), number of daily training hours (p = .000), number of hours of training/week (p = .000), waist circumference (WC) (p = .008) and sleep duration (p = .005). However, it was negatively correlated with WC/hip circumference (p = .000), ESS (p = .000), PSQI (p = .042), SCAT-A (p = .002), protein g/kg (p = .028), EA (p = .002) and exercise energy expenditure (p = .000). High performance gymnasts presented poor sleep habits with consequences upon daytime sleepiness, sleep quality and low energy availability.

The Relationship Between Sexual Function and Quality of Sleep in Caregiving Mothers of Sons with Duchenne Muscular Dystrophy

PubMed Central

Nozoe, Karen T; Hachul, Helena; Hirotsu, Camila; Polesel, Daniel N; Moreira, Gustavo A; Tufik, Sergio; Andersen, Monica L

2014-01-01

Introduction The task of the caregiver, especially a caregiving mother of a son with a chronic and fatal disease, may interfere with their quality of sleep, sexuality, and some hormone levels. Aim The aim of this study was to evaluate the sexual function and the quality of sleep of caregiving mothers of sons with Duchenne muscular dystrophy (DMD). Methods We evaluated 20 caregiving mothers of sons with DMD and 20 caregiving mothers of sons without any neuromuscular or chronic disease. All of them voluntarily responded to the evaluating questionnaires about their sexuality and their quality of sleep, and gave blood samples to evaluate their hormonal levels. Main Outcome Measures All mothers were evaluated using the questionnaire of Female Sexual Function Index (FSFI) and the Pittsburgh questionnaire (PSQI). The blood samples were tested to determine serum levels of testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, progesterone, adrenocorticotropic hormone, and cortisol. Results Caregiving mothers of sons with DMD had significantly lower scores in the FSFI questionnaire, suggesting a higher risk for sexual dysfunction. The PSQI demonstrated that these caregiving mothers present increased sleep latency, reduced sleep efficiency, daytime dysfunction, and poor sleep quality. Blood tests showed a rise in cortisol levels, which correlated with the compromised sexuality and quality of sleep. Conclusions This study indicates that caregiving mothers of sons with DMD show major risk for sexual dysfunction and a reduction in their quality of sleep mediated in part by the hormonal changes related to stress. Nozoe KT, Hachul H, Hirotsu C, Polesel DN, Moreira GA, Tufik S, and Andersen ML. The relationship between sexual function and quality of sleep in caregiving mothers of sons with Duchenne muscular dystrophy. Sex Med 2014;2:133–140. PMID:25356310

Antisomnogenic cytokines, quality of life, and chronic rhinosinusitis: a pilot study.

PubMed

Alt, Jeremiah A; Sautter, Nathan B; Mace, Jess C; Detwiller, Kara Y; Smith, Timothy L

2014-04-01

Sleep disturbance, reduced quality of life (QOL), and other components of "sickness behavior" in patients with chronic rhinosinusitis (CRS) are poorly understood. These complex changes in central behavior are due to the effects of immune mediators acting in the brain. We hypothesized that immune mediators that have been associated with CRS are also associated with sickness behavior, somnifacient complaints, and CRS disease-specific QOL. Pilot study. Twenty patients with CRS were prospectively enrolled and completed the Pittsburgh Sleep Quality Index (PSQI), disease-specific QOL, and olfactory instruments. Ethmoid mucosa was obtained and reverse transcription-polymerase chain reaction was performed for the cytokines interleukin (IL)-4, -13, and transforming growth factor-β (TGF-β). Average change in crossover threshold was calculated, and differences in gene expression were correlated with sleep quality, CRS-specific QOL, and disease severity. Patients with CRS reported overall poor sleep quality and poor CRS-specific QOL with significant correlations between them. Increased expression of TGF-β (r = -0.443; P = .050) and IL-4 (r = -0.548; P = .012) correlated with sleep dysfunction, whereas IL-13 expression was linearly associated with worse sleep quality (PSQI scores r = -0.417; P = .075). IL-4 and TGF-β expression was not associated with CRS disease severity or QOL, whereas significantly higher levels of IL-13 expression correlated with worse CRS disease severity and QOL. Patients with CRS exhibited behavioral changes commonly referred to as sickness behavior, which include poor sleep quality and reduced QOL. The upregulation of IL-4 and TGF-β may contribute to inflammatory brain-mediated effects on sleep quality, whereas IL-13 may be a pleiotropic signaling molecule influencing sleep, QOL, and CRS disease severity. 2b. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Impact of a Mindfulness-Based Weight-Loss Intervention on Sleep Quality Among Adults with Obesity: Data from the SHINE Randomized Controlled Trial.

PubMed

Adler, Elizabeth; Dhruva, Anand; Moran, Patricia J; Daubenmier, Jennifer; Acree, Michael; Epel, Elissa S; Bacchetti, Peter; Prather, Aric A; Mason, Ashley; Hecht, Frederick M

2017-03-01

Sleep disturbance is a common problem among adults with obesity. Mindfulness interventions have been shown to improve sleep quality in various populations but have not been investigated in adults with obesity. The aim of this study was to compare the effects of a mindfulness-based weight-loss intervention with an active control on self-reported sleep quality among adults with obesity. This study was a secondary analysis of a randomized controlled trial and included 194 adults with a body mass index in the range 30-45 kg/m 2 . The treatment intervention included mindfulness-based eating and stress-management practices, and the active control intervention included training in progressive muscle relaxation (PMR). Both groups received identical diet and exercise guidelines in 17 group sessions conducted over 5.5 months that were matched for time, attention, and social support. The primary outcome of this analysis was between-group change in self-reported sleep quality, which was assessed using the Pittsburgh Sleep Quality Index (PSQI) global score at baseline and at 6, 12, and 18 months. Between-group differences in mean PSQI change scores in the mindfulness group (n = 100) compared to the control group (n = 94) were -0.27 (-0.68, 1.22; p = 0.58) at 6 months, -0.57 (-0.35, 1.50; p = 0.22) at 12 months, and -0.50 (-0.53, 1.53; p = 0.34) at 18 months, all in the direction of more sleep improvement in the mindfulness group but none reaching statistical significance. In the mindfulness group, average weekly minutes of meditation practice time was associated with improved sleep quality from baseline to 6 months. No statistically significant evidence was found that a weight-loss program that incorporates mindfulness improves self-reported sleep quality compared to a control diet/exercise intervention that included PMR. Within the mindfulness group, average weekly minutes of mindfulness practice was associated with improved sleep quality.

Cognitive Behavioral Therapy Using a Mobile Application Synchronizable With Wearable Devices for Insomnia Treatment: A Pilot Study.

PubMed

Kang, Seung-Gul; Kang, Jae Myeong; Cho, Seong-Jin; Ko, Kwang-Pil; Lee, Yu Jin; Lee, Heon-Jeong; Kim, Leen; Winkelman, John W

2017-04-15

The use of telemedicine with a mobile application (MA) and a wearable device (WD) for the management of sleep disorders has recently received considerable attention. We designed an MA synchronizable with a WD for insomnia treatment. Our pilot study determined the efficacy of simplified group cognitive behavioral therapy for insomnia (CBT-I) delivered using our MA and assessed participant adherence to and satisfaction with the device. The efficacy of the CBT-I using MA (CBT-I-MA) was assessed by comparing sleep variables (sleep efficiency [SE], Insomnia Severity Index [ISI], and Pittsburgh Sleep Quality Inventory [PSQI] scores) before and after a 4-week treatment protocol in 19 patients with insomnia disorder patients. SE was assessed using a sleep diary, actigraphy, and the PSQI. The intervention significantly improved all three measures of SE ( P < .05), and the response rate to treatment was high (94.7%). Total ISI and PSQI scores and sleep latency, as measured by the sleep diary, improved significantly. Participants showed relatively good adherence to our MA, and sleep diary entries were made on 24.3 ± 3.8 of 28 days. Moreover, 94.7% of the participants reported that our MA was effective for treating insomnia. Our pilot study suggested the clinical usefulness of a CBT-I-MA. We expect that our findings will lead to further development and replication studies of CBT-I-MA. © 2017 American Academy of Sleep Medicine

Sleep Patterns in Adults with a Diagnosis of High-Functioning Autism Spectrum Disorder

PubMed Central

Baker, Emma K.; Richdale, Amanda L.

2015-01-01

Study Objectives: To examine sleep patterns and sleep problems and their relationship with daytime functioning in adults with a diagnosis of an autism spectrum disorder and no comorbid intellectual disability (high-functioning autism spectrum disorder [HFASD]) compared to neurotypical (NT) adults. Design: Cross-sectional. Setting: Home-based study. Participants: 36 adults with HFASD and 36 age-, intelligence quotient- and sex-matched NT adults. Measurements: Participants completed an online questionnaire battery including the Pittsburgh Sleep Quality Index (PSQI), a 14-d sleep wake diary and 14-d actigraphy data collection. Results: Adults with HFASD had significantly more general sleep disturbances and higher scores on the PSQI, longer sleep onset latencies (actigraphy), and poorer sleep efficiency (diary) and these results remained significant after accounting for the False Discovery Rate. Those adults with HFASD who did not have a comorbid diagnosis of anxiety/depression had significantly shorter total sleep time (diary and actigraphy) compared to NT adults. Compared to NT adults, the HFASD group self-reported significantly poorer refreshment scores upon waking in the morning and higher scores on the daytime dysfunction due to sleepiness subscale of the PSQI. Conclusions: These findings support the notion that problems related to sleep, in particular insomnia, continue into adulthood in individuals with high-functioning autism spectrum disorder. Citation: Baker EK, Richdale AL. Sleep patterns in adults with a diagnosis of high-functioning autism spectrum disorder. SLEEP 2015;38(11):1765–1774. PMID:26237770

Sleep Quality in an Adult American Indian Community Sample.

PubMed

Ehlers, Cindy L; Wills, Derek N; Lau, Philip; Gilder, David A

2017-03-15

Epidemiological studies have found that insufficient sleep (< 7 h/night) is more common among American Indians/Alaska Natives (AI/AN). In this study we sought to identify specific demographic, clinical, and cultural factors that may be associated with reduced sleep quality in an American Indian community sample. Information on demography along with personal medical, psychiatric, and drinking history was obtained using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). The adult participants (n = 386, 54% women) had a mean ± standard deviation age of 31.35 ± 14.4 y. Higher degrees of AI ancestry, but not cultural identification, being older than 30 y, and having a high school diploma all were factors predictive of having a short sleep duration (< 6 h). The global score on the PSQI was significantly higher in those participants with a lifetime diagnosis of substance use disorders, anxiety disorders, and affective disorders. Alcohol use disorders and affective disorders were significant predictors of sleep latency whereas anxiety and affective disorders were correlated with waking more often in the night/early morning. Nicotine dependence was associated with having trouble breathing, and alcohol use disorders and anxiety disorders with bad dreams. Alcohol use disorders are associated with poorer quality of sleep in this population and substance use disorders were associated with different aspects of sleep than anxiety and depressive disorders. These findings add to the understanding of the interactions between sleep and substance use, anxiety, and affective disorders in an understudied and underserved population. © 2017 American Academy of Sleep Medicine

Dispositional optimism and sleep quality: a test of mediating pathways

PubMed Central

Cribbet, Matthew; Kent de Grey, Robert G.; Cronan, Sierra; Trettevik, Ryan; Smith, Timothy W.

2016-01-01

Dispositional optimism has been related to beneficial influences on physical health outcomes. However, its links to global sleep quality and the psychological mediators responsible for such associations are less studied. This study thus examined if trait optimism predicted global sleep quality, and if measures of subjective well-being were statistical mediators of such links. A community sample of 175 participants (93 men, 82 women) completed measures of trait optimism, depression, and life satisfaction. Global sleep quality was assessed using the Pittsburgh Sleep Quality Index. Results indicated that trait optimism was a strong predictor of better PSQI global sleep quality. Moreover, this association was mediated by depression and life satisfaction in both single and multiple mediator models. These results highlight the importance of optimism for the restorative process of sleep, as well as the utility of multiple mediator models in testing distinct psychological pathways. PMID:27592128

Dispositional optimism and sleep quality: a test of mediating pathways.

PubMed

Uchino, Bert N; Cribbet, Matthew; de Grey, Robert G Kent; Cronan, Sierra; Trettevik, Ryan; Smith, Timothy W

2017-04-01

Dispositional optimism has been related to beneficial influences on physical health outcomes. However, its links to global sleep quality and the psychological mediators responsible for such associations are less studied. This study thus examined if trait optimism predicted global sleep quality, and if measures of subjective well-being were statistical mediators of such links. A community sample of 175 participants (93 men, 82 women) completed measures of trait optimism, depression, and life satisfaction. Global sleep quality was assessed using the Pittsburgh Sleep Quality Index. Results indicated that trait optimism was a strong predictor of better PSQI global sleep quality. Moreover, this association was mediated by depression and life satisfaction in both single and multiple mediator models. These results highlight the importance of optimism for the restorative process of sleep, as well as the utility of multiple mediator models in testing distinct psychological pathways.

Patient Safety and Quality Improvement in Otolaryngology Education: A Systematic Review.

PubMed

Gettelfinger, John D; Paulk, P Barrett; Schmalbach, Cecelia E

2017-06-01

Objective The breadth and depth of patient safety/quality improvement (PS/QI) research dedicated to otolaryngology-head and neck surgery (OHNS) education remains unknown. This systematic review aims to define this scope and to identify knowledge gaps as well as potential areas of future study to improved PS/QI education and training in OHNS. Data Sources A computerized Ovid/Medline database search was conducted (January 1, 1965, to May 15, 2015). Similar computerized searches were conducted using Cochrane Database, PubMed, and Google Scholar. Review Methods The study protocol was developed a priori using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were classified by year, subspecialty, Institute of Medicine (IOM) Crossing the Chasm categories, and World Health Organization (WHO) subclass. Results Computerized searches yielded 8743 eligible articles, 267 (3.4%) of which met otolaryngology PS/QI inclusion criteria; 51 (19%) were dedicated to resident/fellow education and training. Simulation studies (39%) and performance/competency evaluation (23.5%) were the most common focus. Most projects involved general otolaryngology (47%), rhinology (18%), and otology (16%). Classification by the IOM included effective care (45%), safety/effective care (41%), and effective and efficient care (7.8%). Most research fell into the WHO category of "identifying solutions" (61%). Conclusion Nineteen percent of OHNS PS/QI articles are dedicated to education, the majority of which are simulation and focus on effective care. Knowledges gaps for future research include facial plastics PS/QI and the WHO category of "studies translating evidence into safer care."

Sleep disturbances and risk of falls in an old Chinese population-Rugao Longevity and Ageing Study.

PubMed

Ma, Teng; Shi, Guoping; Zhu, Yinsheng; Wang, Yong; Chu, Xuefeng; Jiang, Xiaoyan; Liu, Zuyun; Cai, Jian; Wang, Hongfei; Jin, Li; Wang, Zhendong; Wang, Xiaofeng

2017-11-01

To explore the relationship between sleep disturbances and falls in an elderly Chinese population. Data from 1726 individuals aged 70-87 years from the Rugao Longevity and Ageing Study were used. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep variables. Outcomes were falls ≥1 time per year and falls ≥2 times per year. A total of 22.7% of the participants experienced ≥1 fall, and 9.8% experienced ≥2 falls per year. Poor sleep quality was associated with ≥1 fall (OR 1.08, 95% CI 1.05-1.12; OR 1.27, 95% CI 1.14-1.41) and ≥2 falls (OR 1.08, 95% CI 1.03-1.14; OR 1.28, 95% CI 1.10-1.48), with an increase per PSQI score and SD PSQI score, respectively. In addition, sleep quality, sleep latency, sleep efficiency, and sleep disturbance subcomponents were associated with an increased risk of ≥1 fall with ORs of 1.44 (95% CI, 1.21-1.72), 1.23 (95%CI,1.09-1.40), 1.12 (95%CI, 1.01-1.23) and 1.70 (95% CI,1.35-2.14), respectively, and were associated with an increased risk of ≥2 falls with ORs 1.54 (95%CI, 1.22-1.96), 1.21(95%CI, 1.02-1.44), 1.17 (95% CI 1.02-1.33), and 1.78 (95%CI, 1.31-2.44), respectively. Further, participants slept ≤5h per night had an increased risk of ≥1 fall (OR 2.34; 95%CI, 1.59-3.46) and ≥2 falls (OR 2.19; 95%CI, 1.30-3.69). Poor sleep quality and several subcomponent sleep symptoms were consistently associated with increased risk of falls ≥1 time and ≥2 times in Chinese elderly. The identification of sleep disturbances may help identify high-risk Chinese elders who may benefit from fall prevention education. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of Ayurvedic Oil-Dripping Treatment with Sesame Oil vs. with Warm Water on Sleep: A Randomized Single-Blinded Crossover Pilot Study.

PubMed

Tokinobu, Akiko; Yorifuji, Takashi; Tsuda, Toshihide; Doi, Hiroyuki

2016-01-01

Ayurvedic oil-dripping treatment (Shirodhara) is often used for treating sleep problems. However, few properly designed studies have been conducted, and the quantitative effect of Shirodhara is unclear. This study sought to quantitatively evaluate the effect of sesame oil Shirodhara (SOS) against warm water Shirodhara (WWS) on improving sleep quality and quality of life (QOL) among persons reporting sleep problems. This randomized, single-blinded, crossover study recruited 20 participants. Each participant received seven 30-minute sessions within 2 weeks with either liquid. The washout period was at least 2 months. The Shirodhara procedure was conducted by a robotic oil-drip system. The outcomes were assessed by the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, Epworth Sleepiness Scale (ESS) for daytime sleepiness, World Health Organization Quality of Life 26 (WHO-QOL26) for QOL, and a sleep monitor instrument for objective sleep measures. Changes between baseline and follow-up periods were compared between the two types of Shirodhara. Analysis was performed with generalized estimating equations. Of 20 participants, 15 completed the study. SOS improved sleep quality, as measured by PSQI. The SOS score was 1.83 points lower (95% confidence interval [CI], -3.37 to -0.30) at 2-week follow-up and 1.73 points lower (95% CI, -3.84 to 0.38) than WWS at 6-week follow-up. Although marginally significant, SOS also improved QOL by 0.22 points at 2-week follow-up and 0.19 points at 6-week follow-up compared with WWS. After SOS, no beneficial effects were observed on daytime sleepiness or objective sleep measures. This pilot study demonstrated that SOS may be a safe potential treatment to improve sleep quality and QOL in persons with sleep problems.

Evaluation of restless legs syndrome in fibromyalgia syndrome: an analysis of quality of sleep and life.

PubMed

Civelek, Gul Mete; Ciftkaya, Pinar Oztop; Karatas, Metin

2014-01-01

The aim of this study is to find prevalence and severity of restless legs syndrome (RLS) in patients with fibromyalgia syndrome (FMS) and detect effect of FMS and RLS coexistance on quality of sleep and life. In this study, presence and severity of RLS were detected in patients with FMS and Pitsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Fibromyalgia Impact Questionnaire (FIQ) scores of all patients were measured. One hundred and fifteen female patients with median age 49 (39.0-57.0)[median (25-75{\\%} interquartile range)] were included in the study. In 42.6% of patients RLS coexisting with FMS was found. RLS was classified as moderate in 42.9% of patients and as severe in 49.0% of patients. In patients with FMS ans RLS sleep quality, daytime sleepiness and quality of life were more severely impaired (PSQI scores were 9.0 ± 4.4 vs 7.8 ± 4.3, p=0.003; ESS scores were 5.0(3.0-7.5) vs 3.0(1.0-4.3), p=0.036 and FIQ scores were 68.1 ± 9.8 vs 59.4 ± 16.9, p=0.027) compared to patients with only FMS. Prevalence of RLS was found higher in FMS than normal population and quality of sleep and quality of life were worse in patients with RLS. Presence of RLS should be investigated in every patient with FMS and treatment plans should also cover RLS in case of coexistance with FMS. Prospective cohort studies are needed for better explanation of FMS and RLS coexistance.

Sex-Specific Difference in the Association Between Poor Sleep Quality and Abdominal Obesity in Rural Chinese: A Large Population-Based Study.

PubMed

Liu, Ru-Qing; Qian, Zhengmin; Wang, Si-Quan; Vaughn, Michael G; Geiger, Sarah Dee; Xian, Hong; Lin, Shao; Paul, Gunther; Zeng, Xiao-Wen; Yang, Bo-Yi; Hu, Li-Wen; Xu, Shu-Li; Yang, Mo; Dong, Guang-Hui

2017-04-15

Existing studies on sleep quality and associated obesity are inconsistent, and few studies have prospectively evaluated the association between sleep quality and abdominal obesity among Chinese individuals. To fill this void, the current study aimed to assess the association between sleep quality and abdominal obesity in a rural Chinese population. A representative sample of 9,404 adults aged 20-93 years in northeastern China was selected between 2012 and 2013 by a multistage cluster and random sampling method. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), where a score of 6 or higher indicated sleep disorder. Abdominal obesity was measured by waist circumference (WC), with abdominal obesity defined as WC > 90 cm for men and WC > 80 cm for women. Male participants with abdominal obesity had higher global PSQI scores in addition to higher subscores in almost all of the elements compared to normal values. The odds ratios of abdominal obesity among participants with sleep disorders were 1.64 (95% confidence interval [CI]: 1.39-1.95) and 1.14 (95% CI: 0.98-1.32) for males and females compared to the reference group. The risk in all sleep elements was significantly increased, with odds ratios ranging from 1.28 (95% CI: 1.08-1.51) to 5.81 (95% CI: 3.54-9.53) for males. The risk only in four elements was significantly increased, from 1.28 (95% CI: 1.12-1.47) to 2.27 (95% CI: 1.36-3.80) for females. Poor sleep quality was associated with abdominal obesity in Chinese. Furthermore, effects in males were larger than those in females. © 2017 American Academy of Sleep Medicine

Sleep-Wake Disturbances in Sedentary Community-Dwelling Elders With Functional Limitations

PubMed Central

Vaz Fragoso, Carlos A.; Miller, Michael E.; Fielding, Roger A.; King, Abby C.; Kritchevsky, Stephen B.; McDermott, Mary M.; Myers, Valerie; Newman, Anne B.; Pahor, Marco; Gill, Thomas M.

2014-01-01

OBJECTIVES To evaluate sleep-wake disturbances in sedentary community-dwelling elders with functional limitations. DESIGN Cross-sectional. SETTING Lifestyle Interventions and Independence in Elder (LIFE) Study. PARTICIPANTS 1635 community-dwelling persons, mean age 78.9, who spent <20 minutes/week in the past month of regular physical activity and <125 minutes/week of moderate physical activity, and had a Short Physical Performance Battery (SPPB) score <10. MEASUREMENTS Mobility was evaluated by the 400-meter walk time (slow gait speed defined as <0.8 m/s) and SPPB score (≤7 defined moderate-to-severe mobility impairment). Physical inactivity was defined by sedentary time, as percent of accelerometry wear time with activity <100 counts/min); top quartile established high sedentary time. Sleep-wake disturbances were evaluated by the Insomnia Severity Index (ISI) (range 0–28; ≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (range 0–24; ≥10 defined daytime drowsiness), Pittsburgh Sleep Quality Index (PSQI) (range 0–21; >5 defined poor sleep quality), and Berlin Questionnaire (high risk of sleep apnea). RESULTS Prevalence rates were 43.5% for slow gait speed and 44.7% for moderate-to-severe mobility impairment, with 77.0% of accelerometry wear time spent as sedentary time. Prevalence rates were 33.0% for insomnia, 18.1% for daytime drowsiness, 47.8% for poor sleep quality, and 32.9% for high risk of sleep apnea. Participants with insomnia, daytime drowsiness, and poor sleep quality had mean values of 12.1 for ISI, 12.5 for ESS, and 9.2 for PSQI, respectively. In adjusted models, measures of mobility and physical inactivity were generally not associated with sleep-wake disturbances, using continuous or categorical variables. CONCLUSION In a large sample of sedentary community-dwelling elders with functional limitations, sleep-wake disturbances were prevalent but only mildly severe, and were generally not associated with mobility impairment or physical inactivity. PMID:24889836

Non suicidal self-injury, emotional eating and insomnia after child sexual abuse: Are those symptoms related to emotion regulation?

PubMed

Demirci, Esra

2018-01-01

The aim of this article was to assess the effects of child sexual abuse (CSA) on emotion regulation (ER) in adolescents and to evaluate the relationships between non suicidal self-injury (NSSI), emotional eating, insomnia and emotion disregulation (ED). Fifty two adolescents, aged 10-18 years, without who weren't diagnosed a psychiatric disease before abuse and completed 6-months of follow-up after abuse included the study. Control group consisted of 33 healthy voluntary participants without any known psychiatric disorders. Patients and volunteers who participated in the study were assessed with the Inventory of Statements About Self-injury (ISAS), Dutch Eating Behavior Questionnaire (DEBQ), Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), and the Difficulties in Emotion Regulation Scale (DERS). In our study, PSQI scores, DERS total scores and DEBQ emotional eating subscores were significantly higher in the CSA victims (In orderly; p = 0,034, p < 0.001, p = 0,023). 55.7% of the CSA victims reported self-injurious behavior, while 15.5% of healthy voluntary participants reporting self-injurious behavior. The CSA victims reporting NSSI had higher DERS scores than CSA victims without NSSI. (p = 0.024). The CSA victims with post-traumatic stress disorder (PTSD) and CSA victims without PTSD had a positive correlation between DEBQ emotional eating subscores and DERS total scores (In orderly: r = 0.762, p = 0.031; r = 0.872, p < 0.001). There was a positive correlation between the PSQI scores and DERS scores in the CSA victims with PTSD (r = 0.827, p = 0.023). Further studies are needed to assess the relationship between self-injury, emotional eating, insomnia and ED, and to determine how sexual abuse effect the ER in a clinical sample of CSA. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

A Four-Session Sleep Intervention Program Improves Sleep for Older Adult Day Health Care Participants: Results of a Randomized Controlled Trial.

PubMed

Martin, Jennifer L; Song, Yeonsu; Hughes, Jaime; Jouldjian, Stella; Dzierzewski, Joseph M; Fung, Constance H; Rodriguez Tapia, Juan Carlos; Mitchell, Michael N; Alessi, Cathy A

2017-08-01

To test the effectiveness of a 4-week behavioral Sleep Intervention Program (SIP: sleep compression, modified stimulus control, and sleep hygiene) compared to a 4-week information-only control (IC) among older adults attending a VA Adult Day Health Care (ADHC) program in a double-blind, randomized, clinical trial. Forty-two individuals (mean age: 77 years, 93% male) enrolled in a VA ADHC program were randomized to receive SIP or IC. All completed in-person sleep and health assessments at baseline, post-treatment and 4-months follow-up that included 3 days/nights of wrist actigraphy, the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). Mixed repeated measures analysis was used to compare sleep outcomes at post-treatment and 4-months follow-up, with baseline values as covariates. SIP participants (n = 21) showed significant improvement on actigraphy sleep efficiency (p = .007), number of nighttime awakenings (p = .016), and minutes awake at night (p = .001) at post-treatment, compared to IC participants (n = 21). Benefits were slightly attenuated but remained significant at 4-month follow-up (all p's < .05). There were no differences in total sleep time between groups. There was significant improvement on PSQI factor 3 (daily disturbances) at 4-month follow-up (p = .016), but no differences were observed between SIP and IC on other PSQI components or ISI scores at post-treatment or 4-month follow-up. A short behavioral sleep intervention may have important benefits in improving objectively measured sleep in older adults participating in ADHC. Future studies are needed to study implementation of this intervention into routine clinical care within ADHC. Published by Oxford University Press on behalf of Sleep Research Society (SRS) 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Preoperative and post-operative sleep quality evaluation in rotator cuff tear patients.

PubMed

Serbest, Sancar; Tiftikçi, Uğur; Askın, Aydogan; Yaman, Ferda; Alpua, Murat

2017-07-01

The aim of this study was to examine the potential relationship between subjective sleep quality and degree of pain in patients with rotator cuff repair. Thirty-one patients who underwent rotator cuff repair prospectively completed the Pittsburgh Sleep Quality Index, the Western Ontario Rotator Cuff Index, and the Constant and Murley shoulder scores before surgery and at 6 months after surgery. Preoperative demographic, clinical, and radiologic parameters were also evaluated. The study analysed 31 patients with a median age of 61 years. There was a significant difference preoperatively versus post-operatively in terms of all PSQI global scores and subdivisions (p < 0.001). A statistically significant improvement was determined by the Western Ontario Rotator Cuff Scale and the Constant and Murley shoulder scores (p ˂ 0.001). Sleep disorders are commonly seen in patients with rotator cuff tear, and after repair, there is an increase in the quality of sleep with a parallel improvement in shoulder functions. However, no statistically significant correlation was determined between arthroscopic procedures and the size of the tear and sleep quality. It is suggested that rotator cuff tear repair improves the quality of sleep and the quality of life. IV.

Relation of plasma tryptophan concentrations during pregnancy to maternal sleep and mental well-being: The GUSTO cohort.

PubMed

van Lee, Linde; Cai, Shirong; Loy, See Ling; Tham, Elaine K H; Yap, Fabian K P; Godfrey, Keith M; Gluckman, Peter D; Shek, Lynette P C; Teoh, Oon Hoe; Goh, Daniel Y T; Tan, Kok Hian; Chong, Yap Seng; Meaney, Michael J; Chen, Helen; Broekman, Birit F P; Chong, Mary F F

2018-01-01

Evidence suggests a relation between plasma tryptophan concentrations and sleep and mental well-being. As no studies have been performed in pregnant women, we studied the relation of plasma tryptophan concentrations during pregnancy with sleep quality, and mood during and after pregnancy. Pregnant women (n = 572) from the Growing Up in Singapore Towards healthy Outcomes study completed the Pittsburgh Sleep Quality Index (PSQI), the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI) at 26-28 weeks gestation and three months post-delivery. Plasma tryptophan concentrations were measured at 26-28 weeks gestation. Poisson regressions estimated prevalence ratios (PR) for the association between tryptophan and poor sleep quality (PSQI global score > 5), probable antenatal depression (EPDS ≥ 15) and probable anxiety (STAI-state ≥ 41) were calculated adjusting for covariates. Mean plasma tryptophan concentrations was 48.0µmol/L (SD: 8.09). Higher plasma tryptophan concentrations were associated with a lower prevalence of antenatal poor sleep quality adjusting for covariates [PR: 0.88 (95% CI 0.80, 0.97) per 10µmol/L], especially in those participants who also suffered from anxiety symptoms [PR: 0.80 (95% CI 0.67, 0.95)]. No associations were observed between tryptophan concentrations during pregnancy and postnatal sleep quality or mental well-being. Subjective measures were used to assess sleep and mental well-being. We observed that higher plasma tryptophan concentrations were associated with a 12% lower prevalence of poor sleep quality during pregnancy, in particular among those with anxiety symptoms. These findings suggest the importance of having adequate tryptophan concentrations during pregnancy. Copyright © 2017 Elsevier B.V. All rights reserved.

Parental sleep quality and continuous glucose monitoring system use in children with type 1 diabetes.

PubMed

Landau, Z; Rachmiel, M; Pinhas-Hamiel, O; Boaz, M; Bar-Dayan, Y; Wainstein, J; Tauman, R

2014-01-01

To compare sleep quality and sleep-wake patterns in parents of children with type 1 diabetes before routine use of the continuous glucose monitoring system (CGMS) and while using it. Thirteen parents completed the Pittsburg Sleep Quality Index (PSQI), a 7-day sleep diary, and wore an actigraph (a wristwatch-size motion detector) during the night for 1 week before pediatric use of CGMS and 4-8 weeks after initiating routine use of the CGMS. Mean age of parents (ten mothers, three fathers) was 39 (range 32-47) years; mean age of children was 9.3 years (range 5.5-16.5 years); mean disease duration was 3.4 (range 0.6-11.2) years. PSQI total score demonstrated similar quality of sleep with and without use of the CGMS (4.6 and 4.9, respectively, p = 0.45). Six of the 13 parents reported severe sleep problems (PSQI ≥ 5) with and without the CGMS. The sleep diary indicated a greater number of awakening episodes during CGMS use than without the CGMS (1.6 and 1, respectively, p = 0.03), and actigraphy documented an increase in the number of wake bouts (22.9 and 19.7, p = 0.03) as well as in total wake time (48.3 and 42.2 min, p = 0.03) during CGMS use as compared with the period prior to CGMS use. Although self-perception of sleep quality remained unchanged, CGMS use appeared to affect actual parental sleep continuity somewhat negatively. This should be made clear to parents who may hold expectations of improvement in sleep quality following initiation of CGMS use.

Association between poor sleep, fatigue, and safety outcomes in Emergency Medical Services providers

PubMed Central

Patterson, P. Daniel; Weaver, Matthew D.; Frank, Rachel C.; Warner, Charles W.; Martin-Gill, Christian; Guyette, Francis X.; Fairbanks, Rollin J.; Hubble, Michael W.; Songer, Thomas J.; Callaway, Clifton W.; Kelsey, Sheryl F.; Hostler, David

2011-01-01

Objective To determine the association between poor sleep quality, fatigue, and self-reported safety outcomes among Emergency Medical Services (EMS) workers. Methods We used convenience sampling of EMS agencies and a cross-sectional survey design. We administered the 19-item Pittsburgh Sleep Quality Index (PSQI), 11-item Chalder Fatigue Questionnaire (CFQ), and 44-item EMS Safety Inventory (EMS-SI) to measure sleep quality, fatigue, and safety outcomes, respectively. We used a consensus process to develop the EMS-SI, which was designed to capture three composite measurements of EMS worker injury, medical errors and adverse events (AE), and safety compromising behaviors. We used hierarchical logistic regression to test the association between poor sleep quality, fatigue, and three composite measures of EMS worker safety outcomes. Results We received 547 surveys from 30 EMS agencies (a 35.6% mean agency response rate). The mean PSQI score exceeded the benchmark for poor sleep (6.9, 95%CI 6.6, 7.2). Greater than half of respondents were classified as fatigued (55%, 95%CI 50.7, 59.3). Eighteen percent of respondents reported an injury (17.8%, 95%CI 13.5, 22.1), forty-one percent a medical error or AE (41.1%, 95%CI 36.8, 45.4), and 89% (95%CI 87, 92) safety compromising behaviors. After controlling for confounding, we identified 1.9 greater odds of injury (95%CI 1.1, 3.3), 2.2 greater odds of medical error or AE (95%CI 1.4, 3.3), and 3.6 greater odds of safety compromising behavior (95%CI 1.5, 8.3) among fatigued respondents versus non-fatigued respondents. Conclusions In this sample of EMS workers, poor sleep quality and fatigue is common. We provide preliminary evidence of an association between sleep quality, fatigue, and safety outcomes. PMID:22023164

Sleep bruxism, awake bruxism and sleep quality among Brazilian dental students: a cross-sectional study.

PubMed

Serra-Negra, Júnia Maria; Scarpelli, Ana Carolina; Tirsa-Costa, Débora; Guimarães, Flávia Helena; Pordeus, Isabela Almeida; Paiva, Saul Martins

2014-01-01

The aim of the study was to evaluate the association of sleep bruxism, awake bruxism and sleep quality among dental students of the Federal University of Minas Gerais, Belo Horizonte, Brazil. A cross-sectional study was performed including 183 Brazilian dental students aged from 17 to 46 years old. The complete course curriculum consists of 9 semesters. Students enrolled in the first semester, the middle semester and the final semester of the course participated in the survey. The PSQI-BR (the Brazilian version of the Pittsburgh Sleep Questionnaire Index) was used for data collection. The PSQI-BR was distributed during lecture classes. Sleep bruxism and awake bruxism diagnosis was based on self-reported data. Descriptive analysis, Kruskal-Wallis, Mann-Whitney and Poisson regression with robust estimator were the statistical tests used. Sleep bruxism prevalence was 21.5% and awake bruxism prevalence was 36.5%. Sleep duration components were associated with sleep bruxism (PR=1.540; 95% CI: 1.00-2.37) and awake bruxism (PR=1.344; 95% CI: 1,008-1,790). There was an association between awake bruxism and habitual sleep efficiency component (PR=1.323; 95% CI: 1.03-1.70). Sleep disturbance component and awake bruxism were associated (PR=1.533; 95% CI: 1.03-2.27). Poor sleep quality was an important factor among dental students, who reported sleep bruxism as well as among those who presented awake bruxism.

Association between Serum Vitamin D Levels and Sleep Disturbance in Hemodialysis Patients.

PubMed

Han, Bin; Zhu, Fu-Xiang; Shi, Chao; Wu, Heng-Lan; Gu, Xiao-Hong

2017-02-14

Sleep disturbance is a frequent and serious complication of hemodialysis (HD). Low serum vitamin D levels have been associated with sleep quality in non-HD subjects. Our aim was to examine the possible association between serum vitamin D levels and the presence of sleep disturbance in HD patients. We recruited 141 HD patients at the HD center of the First Affiliated Hospital of Jiaxing University during 2014-2015. Serum levels of 25-hydroxyvitamin D (25(OH)D) were determined by the competitive protein-binding assay. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Demographic, clinical and laboratory data were recorded. Meanwhile, 117 healthy control subjects were also recruited and underwent measurement of 25(OH)D. Eighty-eight patients (62.4%) had sleep disturbance (PSQI scores ≥ 5). Patients with sleep disturbance showed lower levels of 25(OH)D as compared to those without sleep disturbance (85.6 ± 37.4 vs. 39.1 ± 29.1 nmol/L, p < 0.001). In multivariate analyses, serum levels of 25(OH)D (≤48.0 nmol/L) were independently associated with sleep disturbance in HD patients (OR 9.897, 95% CI 3.356-29.187, p < 0.001) after adjustment for possible variables. Our study demonstrates that low serum levels of vitamin D are independently associated with sleep disturbance in HD patients, but the finding needs to be confirmed in future experimental and clinical studies.

Simplified sleep restriction for insomnia in general practice: a randomised controlled trial.

PubMed

Falloon, Karen; Elley, C Raina; Fernando, Antonio; Lee, Arier C; Arroll, Bruce

2015-08-01

Insomnia is common in primary care. Cognitive behavioural therapy for insomnia (CBT-I) is effective but requires more time than is available in the general practice consultation. Sleep restriction is one behavioural component of CBT-I. To assess whether simplified sleep restriction (SSR) can be effective in improving sleep in primary insomnia. Randomised controlled trial of patients in urban general practice settings in Auckland, New Zealand. Adults with persistent primary insomnia and no mental health or significant comorbidity were eligible. Intervention patients received SSR instructions and sleep hygiene advice. Control patients received sleep hygiene advice alone. Primary outcomes included change in sleep quality at 6 months measured by the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and sleep efficiency (SE%). The proportion of participants reaching a predefined 'insomnia remission' treatment response was calculated. Ninety-seven patients were randomised and 94 (97%) completed the study. At 6-month follow-up, SSR participants had improved PSQI scores (6.2 versus 8.4, P<0.001), ISI scores (8.6 versus 11.1, P = 0.001), actigraphy-assessed SE% (difference 2.2%, P = 0.006), and reduced fatigue (difference -2.3 units, P = 0.04), compared with controls. SSR produced higher rates of treatment response (67% [28 out of 42] versus 41% [20 out of 49]); number needed to treat = 4 (95% CI = 2.0 to 19.0). Controlling for age, sex, and severity of insomnia, the adjusted odds ratio for insomnia remission was 2.7 (95% CI = 1.1 to 6.5). There were no significant differences in other outcomes or adverse effects. SSR is an effective brief intervention in adults with primary insomnia and no comorbidities, suitable for use in general practice. © British Journal of General Practice 2015.

Interaction of sleep quality and sleep duration on glycemic control in patients with type 2 diabetes mellitus.

PubMed

Tang, Yunzhao; Meng, Lingling; Li, Daiqing; Yang, Min; Zhu, Yanjuan; Li, Chenguang; Jiang, Zhenhuan; Yu, Ping; Li, Zhu; Song, Hongna; Ni, Changlin

2014-01-01

Copious evidence from epidemiological and laboratory studies has revealed that sleep status is associated with glucose intolerance, insulin resistance, thus increasing the risk of developing type 2 diabetes. The aim of this study was to reveal the interaction of sleep quality and sleep quantity on glycemic control in patients with type 2 diabetes mellitus. From May 2013 to May 2014, a total of 551 type 2 diabetes patients in Tianjin Metabolic Diseases Hospital were enrolled. Blood samples were taken to measure glycosylated hemoglobin (HbA1c), and all the patients completed the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire to evaluate their sleep status. "Good sleep quality" was defined as PQSI <5, "average sleep quality" was defined as PQSI 6-8, and "poor sleep quality" was defined as PQSI >8. Poor glycemic control was defined as HbA1c ≥7%. Sleep quantity was categorized as <6, 6-8, and >8 hours/night. Short sleep time was defined as sleep duration <6 hours/night. In the poor glycemic control group, the rate of patients who had insufficient sleep was much higher than that in the other group (χ(2) = 11.16, P = 0.037). The rate of poor sleep quality in poor glycemic control group was much greater than that in the average control group (χ(2) = 9.79, P = 0.007). After adjusted by gender, age, body mass index, and disease duration, the adjusted PSQI score's OR was 1.048 (95% CI 1.007-1.092, P = 0.023) for HbA1c level. The sleep duration's OR was 0.464 (95% CI 0.236-0.912, P = 0.026) for HbA1c level. One-way analysis of variance showed that the poor sleep quality group had the highest homeostasis model assessment-insulin resistance (P < 0.01). Inadequate sleep, in both quality and quantity, should be regarded as a plausible risk factor for glycemic control in type 2 diabetes. Poor sleep might bring much more serious insulin resistance and could be the reason for bad glycemic control. A good night's sleep should be seen as a critical health component tool in the prevention and treatment of type 2 diabetes. It is important for clinicians to target the root causes of short sleep duration and/or poor sleep quality.

Sleep disorder status of nurses in general hospitals and its influencing factors.

PubMed

Han, Yanjie; Yuan, Yingzi; Zhang, Li; Fu, Yanru

2016-06-01

This study aimed to evaluate the current sleep disorder status of nurses in general hospitals and analyze its influencing factors. A total of 2,033 nurses who have worked for 6 months in 3 general hospitals, namely, The First Affiliated Hospital of Harbin Medical University, The Second Affiliated Hospital of Harbin Medical University, and The Third Affiliated Hospital of Harbin Medical University, were selected by random sampling from April 2015 to November 2015 and investigated. The Effort-Reward Imbalance Questionnaire (ERI) and Job Content Questionnaire (JCQ) were applied to evaluate occupational stress. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep disorder status of the research subjects. Logistic regression analysis was adopted to determine the influencing factors of nurses' sleep disorders. The average PSQI score of 2,003 research subjects is 7.26±3.56, including 860 subjects with PSQI ≥8, accounting for 42.9%. The female research subjects in the department of gynecology and obstetrics, emergency department, and ICU show high risks of sleep disorders (i.e., many years of working; job title: registered nurse; many times of night shift per month; no frequent exercise; many efforts and few rewards; high decision-making autonomy). Educational background and marital status did not exhibit statistical relevance with sleep disorders. The sleep disorder status of nurses in general hospitals is closely related to occupational stress. As such, nurse managers should focus more attention to the influencing factors of nurses' sleep disorders and relieve their occupational stress to reduce the occurrence rate of sleep disorders.

Nocturnal serum melatonin levels in sulfur mustard exposed patients with sleep disorders.

PubMed

Mousavi, Seyyedeh Soghra; Vahedi, E; Shohrati, M; Panahi, Y; Parvin, S

2017-12-01

Sulfur mustard (SM) exposure causes respiratory disorders, progressive deterioration in lung function and mortality in injured victims and poor sleep quality is one of the most common problems among SM-exposed patients. Since melatonin has a critical role in regulation of sleep and awareness, this study aimed to evaluate the serum melatonin levels in SM-injured subjects. A total of 30 SM-exposed male patients and 10 controls was evaluated. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI); daytime sleepiness was measured by the Epworth Sleepiness Scale (ESS), and the risk of obstructive sleep apnoea was determined by the STOP-Bang questionnaire. Polysomnography (PSG) and pulmonary function tests (PFTs) were also available. Nocturnal serum melatonin levels were measured using an ELISA kit. The mean of PSQI, ESS and STOP-Bang scores in patients (11.76±3.56, 12.6±3.03 and 5.03±1.09, respectively) were significantly (p<0.01) higher than those in the controls (2.78±0.83, 4.69±1.15 and 1.18±0.82, respectively). PFTs also showed declined respiratory quality in SM-patients. There was a significant difference regarding the PSG results between patients and controls (p<0.01). The mean of nocturnal serum melatonin levels in patients (29.78±19.31 pg/mL) was significantly (p=0.005) lower than that in the controls (78.53±34.41 pg/mL). Reduced nocturnal serum melatonin and respiratory disorders can be the reasons for poor sleep quality among these patients. IRCT2015092924267N1, Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effects of industrial wind turbine noise on sleep and health.

PubMed

Nissenbaum, Michael A; Aramini, Jeffery J; Hanning, Christopher D

2012-01-01

Industrial wind turbines (IWTs) are a new source of noise in previously quiet rural environments. Environmental noise is a public health concern, of which sleep disruption is a major factor. To compare sleep and general health outcomes between participants living close to IWTs and those living further away from them, participants living between 375 and 1400 m (n = 38) and 3.3 and 6.6 km (n = 41) from IWTs were enrolled in a stratified cross-sectional study involving two rural sites. Validated questionnaires were used to collect information on sleep quality (Pittsburgh Sleep Quality Index - PSQI), daytime sleepiness (Epworth Sleepiness Score - ESS), and general health (SF36v2), together with psychiatric disorders, attitude, and demographics. Descriptive and multivariate analyses were performed to investigate the effect of the main exposure variable of interest (distance to the nearest IWT) on various health outcome measures. Participants living within 1.4 km of an IWT had worse sleep, were sleepier during the day, and had worse SF36 Mental Component Scores compared to those living further than 1.4 km away. Significant dose-response relationships between PSQI, ESS, SF36 Mental Component Score, and log-distance to the nearest IWT were identified after controlling for gender, age, and household clustering. The adverse event reports of sleep disturbance and ill health by those living close to IWTs are supported.

Achievement of take-home dose privileges is associated with better-perceived sleep and with cognitive status among methadone maintenance treatment patients.

PubMed

Peles, Einat; Schreiber, Shaul; Domany, Yoav; Sason, Anat; Tene, Oren; Adelson, Miriam

2014-12-01

Methadone maintenance treatment (MMT) patients may achieve up to a 2-week privilege of methadone take-home doses (THD), which is associated with considerable responsibility. MMT patients are characterized as having poor sleep quality and low cognitive states. We studied sleep indices and cognitive status with respect to THD privileges. A sample of 123 MMT patients stratified by THD groups was studied. Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the cognitive Clock Drawing Test (CDT) were performed. Thirty-one of 123 patients never had any THD and 92 did (25 had the maximum of 2 weeks). The never THD had history of longer duration of opiate usage and a shorter period in MMT. They had the highest rates of poor sleep (80.6%, PSQI > 5), daily sleepiness ("fall asleep while talking") (41.9%), and impaired cognitive status (58.1%, CDT < 3), while those who had 2-week privileges had the lowest (56, 8, and 28%, respectively). Logistic regression characterized THD patients as no-benzodiazepine and no-cocaine, short opiate usage duration, low ADHD scores, and no cognitive impairment (CDT = 3) and its interaction with treatment duration. Privileges that reflect patients' abstinence and rehabilitation were also expanded to be associated with better cognitive states. These finding confirm the THD dispensing performance. Including CDT as part of the decision for dispensing THD may be considered.

The Effect of Cognitive Behavior Therapy in Insomnia due to Methadone Maintenance Therapy: A Randomized Clinical Trial

PubMed Central

Soleimani, Robabeh; Modabbernia, Mohammad Jafar; Habibi, Sharareh; Roudsary, Maryam Habibi; Elahi, Masoumeh

2015-01-01

Background: Sleep disturbance is a common complaint of patients undergoing methadone maintenance therapy (MMT). There are limited studies about the effect of different treatments on insomnia due to MMT. In this study, we evaluated the effect of cognitive-behavioral treatment for insomnia (CBTI) on sleep disorders in patients undergoing MMT. Methods: Twenty-two patients with insomnia due to MMT (aged 18-60 years) participated in this randomized double-blind clinical trial. The intervention group received CBTI from a clinical psychologist for 8 weeks, whereas the control group received behavioral placebo therapy (BPT). The duration of individual sessions was 45 minutes, which was conducted once a week. The primary outcome was sleep disturbance assessed with Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using SPSS software version 19. Results: Eleven patients were assigned to each group. Two groups were matched according to demographic characteristics (age, marital status, education, and daily methadone doses). Although PSQI score was significantly reduced during weeks 5 and 8 after both interventions, there was a significant difference in intervention versus time interaction (P<0.02). The effects of CBTI versus placebo were significantly different (P<0.001). The time course was also significant (P<0.001). Conclusion: This study showed that CBTI is more effective than BPT in overall sleep quality. We recommend further studies, with a larger sample, on CBTI in patients undergoing MMT. PMID:26379345

Sleep disordered breathing in a cohort of patients with sporadic inclusion body myositis.

PubMed

Della Marca, Giacomo; Sancricca, Cristina; Losurdo, Anna; Di Blasi, Chiara; De Fino, Chiara; Morosetti, Roberta; Broccolini, Aldobrando; Testani, Elisa; Scarano, Emanuele; Servidei, Serenella; Mirabella, Massimiliano

2013-08-01

The aims of the study were: (1) to evaluate subjective sleep quality and daytime sleepiness in patients affected by sporadic inclusion-body myositis (IBM); (2) to define the sleep and sleep-related respiratory pattern in IBM patients. Thirteen consecutive adult patients affected by definite IBM were enrolled, six women and seven men, mean age 66.2 ± 11.1 years (range: 50-80). Diagnosis was based on clinical and muscle biopsy studies. All patients underwent subjective sleep evaluation (Pittsburgh Sleep Quality Index, PSQI and Epworth Sleepiness Scale, ESS), oro-pharingo-esophageal scintigraphy, pulmonary function tests, psychometric measures, anatomic evaluation of upper airways, and laboratory-based polysomnography. Findings in IBM patients were compared to those obtained from a control group of 25 healthy subjects (13 men and 12 women, mean age 61.9 ± 8.6 years). Disease duration was >10 years in all. Mean IBM severity score was 28.8 ± 5.4 (range 18-36). Dysphagia was present in 10 patients. Nine patients had PSQI scores ≥ 5; patients had higher mean PSQI score (IBM: 7.2 ± 4.7, CONTROLS: 2.76 ± 1.45, p=0.005); one patient (and no controls) had EES>9. Polysomnography showed that IBM patients, compared to controls, had lower sleep efficiency (IBM: 78.8 ± 12.0%, 94.0 ± 4.5%, p<0.001), more awakenings (IBM: 11.9 ± 11.0, CONTROLS: 5.2 ± 7.5, p=0.009) and increased nocturnal time awake (IBM: 121.2 ± 82.0 min., 46.12 ± 28.8 min., p=0.001). Seven Patients (and no controls) had polysomnographic findings consistent with sleep disordered breathing (SDB). Data suggest that sleep disruption, and in particular SDB, might be highly prevalent in IBM. Data indicate that IBM patients have poor sleep and high prevalence of SDB. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Silexan, an orally administered Lavandula oil preparation, is effective in the treatment of 'subsyndromal' anxiety disorder: a randomized, double-blind, placebo controlled trial.

PubMed

Kasper, Siegfried; Gastpar, Markus; Müller, Walter E; Volz, Hans-Peter; Möller, Hans-Jürgen; Dienel, Angelika; Schläfke, Sandra

2010-09-01

This study was performed to investigate the anxiolytic efficacy of silexan, a new oral lavender oil capsule preparation, in comparison to placebo in primary care. In 27 general and psychiatric practices 221 adults suffering from anxiety disorder not otherwise specified (Diagnostic and Statistical Manual of Mental disorders-IV 300.00 or International Statistical Classification of Diseases and Related Health Problems, Tenth revision F41.9) were randomized to 80 mg/day of a defined, orally administered preparation from Lavandula species or placebo for 10 weeks with visits every 2 weeks. A Hamilton Anxiety Scale (HAMA) total score >or=18 and a total score >5 for the Pittsburgh Sleep Quality Index (PSQI) were required. The primary outcome measures were HAMA and PSQI total score decrease between baseline and week 10. Secondary efficacy measures included the Clinical Global Impressions scale, the Zung Self-rating Anxiety Scale, and the SF-36 Health Survey Questionnaire. Patients treated with silexan showed a total score decrease by 16.0+/-8.3 points (mean+/-SD, 59.3%) for the HAMA and by 5.5+/-4.4 points (44.7%) for the PSQI compared to 9.5+/-9.1 (35.4%) and 3.8+/-4.1 points (30.9%) in the placebo group (P<0.01 one-sided, intention to treat). Silexan was superior to placebo regarding the percentage of responders (76.9 vs. 49.1%, P<0.001) and remitters (60.6 vs. 42.6%, P=0.009). Lavandula oil preparation had a significant beneficial influence on quality and duration of sleep and improved general mental and physical health without causing any unwanted sedative or other drug specific effects. Lavandula oil preparation silexan is both efficacious and safe for the relief of anxiety disorder not otherwise specified. It has a clinically meaningful anxiolytic effect and alleviates anxiety related disturbed sleep.

[Application of spatial working memory task fMRI in evaluation of primary insomnia patient's cognitive dysfunction].

PubMed

Dou, Shewei; Wang, Enfeng; Zhang, Hongju; Tong, Li; Zhang, Xiaoqi; Shi, Dapeng; Cheng, Jingliang; Li, Yongli

2015-06-02

To explore abnormal brain activation of spatial working memory in primary insomnia and its potential neuromechanism. we recruited 30 cases primary insomnia (PI) patients and 30 cases age, gender matched healthy control (HC) subjects from July 2013 to December 2013, the diagnosis of primary insomnia matched the diagnosis criterion of DSM-IV and Classification and diagnostic criteria of mental disorders in China third edition (CCMD-3). All the subjects attended the tests of PSQI, HAMA, HAMD and index of spatial working memory. And then, we collected the data of routine MRI and spatial working memory task fMRI on 3.0 T MRI scanner. After that, we used SPM8 and REST1.8 to analyze the fMRI data, compared difference of PSQI, HAMA, HAMD, index of spatial working memory and brain activation of spatial working memory between PI group and HC group. There were significant difference between PI group and HC group in PSQI, HAMA, HAMD and index of spatial working memory (P < 0.05). In the spatial working memory related activate brain region, compared with HC group, left temporal lobe, occipital lobe and right frontal lobe activation increased and bilateral parahippocampalis, temporal cortex, frontal cortex and superior parietal lobule activation reduced in PI group. Spatial working memory task fMRI revealed the pathological mechanisms of cognitive dysfunction of clinical spatial working memory and emotional disorder in primary insomnia patients.

Association between quality of sleep and health-related quality of life in persons with diabetes mellitus type 2.

PubMed

Bani-Issa, Wegdan; Al-Shujairi, Arwa M; Patrick, Linda

2018-04-01

To estimate the relationship of sleep quality with health-related quality of life (HRQOL) in persons with diabetes mellitus type 2 (DMT2) living in the United Arab Emirates (UAE). DMT2 is an epidemic health condition in the UAE that has enormous impacts on heath, and consequent effects on HRQOL. However, because of an absence of screening for quality of sleep, people with DMT2 who experience poor sleep are likely to go untreated, which may compound the distressing impacts of DMT2 on their HRQOL. This is a cross-sectional quantitative research design. A sample of 268 participants with DMT2 were recruited from community healthcare settings in the UAE using cluster sampling. Participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI) and the World Health Organization HRQOL. Data analysis used descriptive and correlational statistics. Of the 268 participants, 34% identified as "poor sleepers" and 55% had poor HRQOL. Poor sleepers showed significantly lower scores for HRQOL than good sleepers. The global PSQI scores were found to be independently predictive of global HRQOL. Subjective perceptions of sleep quality, the use of sleep medications and impaired daytime functioning were the variables found to have the highest correlations with global HRQOL and its four domains. This study found that people with DMT2 who indicate experiencing poor quality sleep are more likely to show a negative correlation with HRQOL. Additional research is needed to investigate how poor sleep may impact the health of people with DMT2. Findings suggest that assessment of sleep quality should be an essential component of diabetes care. Understanding sleep practices may aid public health practitioners and other healthcare providers in the design of culturally appropriate interventions to improve sleep quality in persons with DMT2. © 2017 John Wiley & Sons Ltd.

Sleep Architecture in Partially Acclimatized Lowlanders and Native Tibetans at 3800 Meter Altitude: What Are the Differences?

PubMed

Kong, Fanyi; Liu, Shixiang; Li, Qiong; Wang, Lin

2015-09-01

It is not well known whether high altitude acclimatization could help lowlanders improve their sleep architecture as well as Native Tibetans. In order to address this, we investigated the structural differences in sleep between Native Tibetans and partially acclimatized lowlanders and examined the association between sleep architecture and subjective sleep quality. Partially acclimatized soldiers from lowlands and Native Tibetan soldiers stationed at Shangri-La (3800 m) were surveyed using the Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Rating Scale (HAMD). The sleep architecture of those without anxiety (as determined by HAMA>14) and/or depression (HAMD>20) was analyzed using polysomnography and the results were compared between the two groups. One hundred sixty-five male soldiers, including 55 Native Tibetans, were included in the study. After partial acclimatization, lowlanders still exhibited differences in sleep architecture as compared to Native Tibetans, as indicated by a higher PSQI score (8.14±2.37 vs. 3.90±2.85, p<0.001), shorter non-rapid eye movement (non-REM) sleep (458.68±112.63 vs. 501±37.82 min, P=0.03), lower nocturnal arterial oxygen saturation (Spo2; mean 91.39±1.24 vs. 92.71±2.12%, p=0.03), and increased times of Spo2 reduction from 89% to 85% (median 48 vs.17, p=0.04) than Native Tibetans. Sleep onset latency (β=0.08, 95%CI: 0.01 to 0.15), non-REM latency (β=0.011, 95%CI 0.001 to 0.02), mean Spo2 (β=-0.79, 95%CI: -1.35 to -0.23) and time in stage 3+4 sleep (β=-0.014, 95%CI: -0.001 to -0.028) were slightly associated with the PSQI score. Partially acclimatized lowlanders experienced less time in non-REM sleep and had lower arterial oxygen saturation than Native Tibetans at an altitude of 3800 m. The main independent contributors to poor sleep quality are hypoxemia, difficulty in sleep induction, and time in deep sleep.

Dietary patterns, metabolic markers and subjective sleep measures in resident physicians.

PubMed

Mota, Maria Carliana; De-Souza, Daurea Abadia; Rossato, Luana Thomazetto; Silva, Catarina Mendes; Araújo, Maria Bernadete Jeha; Tufik, Sérgio; de Mello, Marco Túlio; Crispim, Cibele Aparecida

2013-10-01

Shiftwork is common in medical training and is necessary for 24-h hospital coverage. Shiftwork poses difficulties not only because of the loss of actual sleep hours but also because it can affect other factors related to lifestyle, such as food intake, physical activity level, and, therefore, metabolic patterns. However, few studies have investigated the nutritional and metabolic profiles of medical personnel receiving training who are participating in shiftwork. The aim of the present study was to identify the possible negative effects of food intake, anthropometric variables, and metabolic and sleep patterns of resident physicians and establish the differences between genders. The study included 72 resident physicians (52 women and 20 men) who underwent the following assessments: nutritional assessment (3-day dietary recall evaluated by the Adapted Healthy Eating Index), anthropometric variables (height, weight, body mass index, and waist circumference), fasting metabolism (lipids, cortisol, high-sensitivity C-reactive protein [hs-CRP], glucose, and insulin), physical activity level (Baecke questionnaire), sleep quality (Pittsburgh Sleep Quality Index; PSQI), and sleepiness (Epworth Sleepiness Scale; ESS). We observed a high frequency of residents who were overweight or obese (65% for men and 21% for women; p = 0.004). Men displayed significantly greater body mass index (BMI) values (p = 0.002) and self-reported weight gain after the beginning of residency (p = 0.008) than women. Poor diet was observed for both genders, including the low intake of vegetables and fruits and the high intake of sweets, saturated fat, cholesterol, and caffeine. The PSQI global scores indicated significant differences between genders (5.9 vs. 7.5 for women and men, respectively; p = 0.01). Women had significantly higher mean high-density lipoprotein cholesterol (HDL-C; p < 0.005), hs-CRP (p = 0.04), and cortisol (p = 0.009) values than men. The elevated prevalence of hypertriglyceridemia and abnormal values of low-density lipoprotein cholesterol (LDL-C; >100 mg/dL) were observed in most individuals. Higher than recommended hs-CRP levels were observed in 66% of the examined resident physicians. Based on current recommendations, a high prevalence of low sleep quality and excessive daytime sleepiness was identified. These observations indicate the need to monitor health status and develop actions to reassess the workload of medical residency and the need for permission to perform extra night shifts for medical residents to avoid worsening health problems in these individuals.

Evaluating the Effectiveness of Fatigue Management Training to Improve Police Sleep Health and Wellness: A Pilot Study.

PubMed

James, Lois; Samuels, Charles H; Vincent, Fiona

2018-01-01

To evaluate the effectiveness of an intervention for improving sleep health in a sample of employees from the Royal Canadian Mounted Police (RCMP). Using a pre- and post-design we exposed 61 RCMP members to a fatigue-management training program. Pre- and post-intervention surveys included the Pittsburg Sleep Quality Index (PSQI), the World Health Organization Quality of Life (WHOQOL) instrument, and the six item index of psychological distress (Symptom Checklist-90). We found the training improved member satisfaction with sleep (Wald = 2.58; df = 1; P = 0.03) and reduced symptoms of insomnia (Wald = 5.5; df = 1; P = 0.02). Furthermore, the training reduced the incidence of headaches (Wald = 6.5; df = 1; P = 0.01). Our findings suggest that a fatigue management training program resulted in positive sleep health benefits for police. We stress the importance of continued evaluation to inform the large-scale implementation of fatigue-management programs.

Shift-work disorder and sleep-related environmental factors in the manufacturing industry.

PubMed

Taniyama, Yukari; Nakamura, Arisa; Yamauchi, Takenori; Takeuchi, Shouhei; Kuroda, Yoshiki

2015-03-01

The aim of this study was to examine the relationship between shift-work disorder (SWD) and environmental and somatic factors related to falling asleep among rapidly rotating shift workers in a manufacturing industry.A total of 556 male workers were recruited to complete a self-administered questionnaire regarding age, shift work experience, lifestyle, and family structure; the Epworth sleepiness scale (ESS); the Pittsburgh sleep quality index (PSQI); and the Horne and Ostberg questionnaire, a questionnaire for environmental and somatic factors related to falling asleep. We classified workers according to having SWD or not, and compared workers with SWD with those without this disorder in terms of all items covered in the aforementioned questionnaires. A total of 208 workers (62.8%) working rapidly rotating shifts were diagnosed with SWD. The ESS and PSQI scores and scores for environmental and somatic factors were significantly higher in workers with SWD than in those without this disorder. The ESS scores and scores for environmental and somatic factors were also associated with SWD in the logistic regression analyses. We suggest that susceptibility to SWD in the manufacturing industry may be associated with environmental and somatic factors related to falling asleep.

Correlation of occupational stress with depression, anxiety, and sleep in Korean dentists: cross-sectional study.

PubMed

Song, Kyung-Won; Choi, Won-Seok; Jee, Hee-Jung; Yuh, Chi-Sung; Kim, Yong-Ku; Kim, Leen; Lee, Heon-Jeong; Cho, Chul-Hyun

2017-12-12

This study aimed to investigate the degree of occupational stress and the clinical mental state of dentists. In addition, we investigated the correlation of occupational stress with depression, anxiety, and sleep among dentists in Korea. A cross-sectional survey on 231 dentists was conducted using the Doctor Job Stress Scale, Center for Epidemiologic Studies Depression Scale (CES-D), State-Trait Anxiety Index (STAI), and Pittsburgh Sleep Quality Index (PSQI). Correlation of occupational stress with mental health was investigated by adjusted multiple regression analysis. The scores of CES-D, STAI, and PSQI revealed a significant correlation with the Doctor Job Stress Scale (t = 3.93, P < 0.0001; t = 4.05, P < 0.0001; t = 4.18, P < 0.0001, respectively). In particular, patient factors and clinical responsibility/judgment factors were significantly associated with depression (t = 2.80, P = 0.0056; t = 4.93, P < 0.0001, respectively), anxiety (t = 2.35, P = 0.0195; t = 5.11, P < 0.0001, respectively), and sleep (t = 3.78, P = 0.0002; t = 4.30, P < 0.0001, respectively), whereas work factors were not associated with any mental health state. This study confirms that dentists as professions experience more severe mental states. For successful mental health care among dentists, stress management focusing on interpersonal relationship with patients and responsibility as an expert rather than the intensity of work should be considered.

Comparing the Effects of Reflexology and Footbath on Sleep Quality in the Elderly: A Controlled Clinical Trial

PubMed Central

Valizadeh, Leila; Seyyedrasooli, Alehe; Zamanazadeh, Vahid; Nasiri, Khadijeh

2015-01-01

Background: Sleep disorders are common mental disorders reported among the elderly in all countries, and with nonpharmacological interventions, they could be helped to improve their sleep quality. Objectives: The aim of this study was to compare the effects of two interventions, foot reflexology and foot bath, on sleep quality in elderly people. Patients and Methods: This three-group randomized clinical trial (two experimental groups and a control group) was conducted on 69 elderly men. The two experimental groups had reflexology (n = 23) and foot bath (n = 23) interventions for 6 weeks. The reflexology intervention was done in the mornings, once a week for ten minutes on each foot. The participants in the foot bath group were asked to soak their feet in 41°C to 42°C water one hour before sleeping. The pittsburgh sleep quality index (PSQI) was completed before and after the intervention through an interview process. Results: The results showed that the PSQI scores after intervention compared to before it in the reflexology and foot bath groups were statistically significant (P = 0.01 , P = 0.001); however, in the control group did not show a statistically significant difference (P = 0.14). In addition, the total score changes among the three groups were statistically significant (P = 0.01). Comparing the score changes of quality of sleep between the reflexology and foot bath groups showed that there was no significant difference in none of the components and the total score (P = 0.09). The two interventions had the same impact on the quality of sleep. Conclusions: It is suggested that the training of nonpharmacological methods to improve sleep quality such as reflexology and foot bath be included in the elderly health programs. In addition, it is recommended that the impact of these interventions on subjective sleep quality using polysomnographic recordings be explored in future research. PMID:26734475

Comparing the Effects of Reflexology and Footbath on Sleep Quality in the Elderly: A Controlled Clinical Trial.

PubMed

Valizadeh, Leila; Seyyedrasooli, Alehe; Zamanazadeh, Vahid; Nasiri, Khadijeh

2015-11-01

Sleep disorders are common mental disorders reported among the elderly in all countries, and with nonpharmacological interventions, they could be helped to improve their sleep quality. The aim of this study was to compare the effects of two interventions, foot reflexology and foot bath, on sleep quality in elderly people. This three-group randomized clinical trial (two experimental groups and a control group) was conducted on 69 elderly men. The two experimental groups had reflexology (n = 23) and foot bath (n = 23) interventions for 6 weeks. The reflexology intervention was done in the mornings, once a week for ten minutes on each foot. The participants in the foot bath group were asked to soak their feet in 41°C to 42°C water one hour before sleeping. The pittsburgh sleep quality index (PSQI) was completed before and after the intervention through an interview process. The results showed that the PSQI scores after intervention compared to before it in the reflexology and foot bath groups were statistically significant (P = 0.01 , P = 0.001); however, in the control group did not show a statistically significant difference (P = 0.14). In addition, the total score changes among the three groups were statistically significant (P = 0.01). Comparing the score changes of quality of sleep between the reflexology and foot bath groups showed that there was no significant difference in none of the components and the total score (P = 0.09). The two interventions had the same impact on the quality of sleep. It is suggested that the training of nonpharmacological methods to improve sleep quality such as reflexology and foot bath be included in the elderly health programs. In addition, it is recommended that the impact of these interventions on subjective sleep quality using polysomnographic recordings be explored in future research.

Efficacy and safety of adjunctive modafinil treatment on residual excessive daytime sleepiness among nasal continuous positive airway pressure-treated japanese patients with obstructive sleep apnea syndrome: a double-blind placebo-controlled study.

PubMed

Inoue, Yuichi; Takasaki, Yuji; Yamashiro, Yoshihiro

2013-08-15

This double-blind study evaluated the efficacy and safety of modafinil for treating excessive daytime sleepiness in Japanese patients with obstructive sleep apnea syndrome (OSAS). Patients with residual excessive sleepiness (Epworth Sleepiness Scale [ESS] ≥ 11) on optimal nasal continuous positive airway pressure (nCPAP) therapy (apnea-hypopnea index ≤ 10) were randomized to either 200 mg modafinil (n = 52) or placebo (n = 62) once daily for 4 weeks. Outcomes included baseline-week 4 changes in ESS total score, sleep latency on maintenance of wakefulness test (SL-MWT), nocturnal polysomnography, Pittsburgh Sleep Quality Index (PSQI), and safety. All 114 randomized patients completed the study. Mean change in ESS total score (-6.6 vs -2.4, p < 0.001) and SL-MWT (+2.8 vs -0.4 minutes, p = 0.009) were significantly greater with modafinil than with placebo. ESS total score decreased from > 11 to < 11 at the final assessment in 69.2% of modafinil-treated patients and 30.6% of placebo-treated patients (p < 0.001). Corresponding rates at week 1 were 57.7% and 33.9% (p = 0.014). Changes in nocturnal polysomnography, PSQI, and apnea-hypopnea index from baseline to the final assessment were similar in both groups. Adverse drug reactions occurred in 36.5% and 22.6% of patients in the modafinil and placebo groups, respectively (p = 0.146). Once-daily modafinil was effective and well tolerated for managing residual daytime sleepiness in Japanese OSAS patients with residual excessive daytime sleepiness on optimal nCPAP therapy.

Low intake of vegetables, high intake of confectionary, and unhealthy eating habits are associated with poor sleep quality among middle-aged female Japanese workers.

PubMed

Katagiri, Ryoko; Asakura, Keiko; Kobayashi, Satomi; Suga, Hitomi; Sasaki, Satoshi

2014-01-01

Although workers with poor sleep quality are reported to have problems with work performance, few studies have assessed the association between dietary factors and sleep quality using validated indexes. Here, we examined this association using information acquired from validated questionnaires. A total of 3,129 female workers aged 34 to 65 years were analyzed. Dietary intake was assessed using a self-administered diet history questionnaire (DHQ), and subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The relationship between the intake of several food groups and nutrients and sleep quality was examined using multivariable logistic regression models. The effect of eating habits on sleep quality was also examined. Poor sleep quality was associated with low intake of vegetables (p for trend 0.002) and fish (p for trend 0.04) and high intake of confectionary (p for trend 0.004) and noodles (p for trend 0.03) after adjustment for potential confounding factors (age, body mass index, physical activity, depression score, employment status, alcohol intake and smoking status). Poor sleep quality was also significantly and positively associated with consumption of energy drinks and sugar-sweetened beverages, skipping breakfast, and eating irregularly. In addition, poor sleep quality was significantly associated with high carbohydrate intake (p for trend 0.03). A low intake of vegetables and fish, high intake of confectionary and noodles and unhealthy eating habits were independently associated with poor sleep quality. Poor sleep quality was also associated with high carbohydrate intake in free-living Japanese middle-aged female workers.

Association between long working hours and sleep problems in white-collar workers.

PubMed

Nakashima, Motoko; Morikawa, Yuko; Sakurai, Masaru; Nakamura, Koshi; Miura, Katsuyuki; Ishizaki, Masao; Kido, Teruhiko; Naruse, Yuchi; Suwazono, Yasushi; Nakagawa, Hideaki

2011-03-01

The purpose of this study is to examine the association between long work hours and sleep disturbance among white-collar workers. We evaluated 1510 male white-collar full-time employees, between the ages of 18 and 59 years, using a comprehensive sleep quality questionnaire, the Pittsburgh Sleep Quality Index (PSQI). All subjects worked in a light metal products factory in Japan. The mean number of monthly overtime work hours was determined using data from the previous 6 months from timecard records. Subjects were divided into five groups based on quintiles of the mean number of monthly overtime work hours: <26 h month(-1); ≥26 but <40; ≥40 but <50; ≥50 but <63; and >63. Leisure time physical activity, drinking habits just before sleep, presence of family/partner and health status were used as confounding factors in the multiple regression model. The prevalence of short sleep hours, impairment of sleep efficiency and daytime dysfunction among seven components of PSQI increased, in a dose-response relationship, with overtime work hours. The prevalence of high global score (>5.5 points) was highest in workers with overtime hours ≥50 h week(-1). The odds ratios after adjustment for confounding factors for high global score using less than 26 h as a reference group were 1.67 for workers with ≥50 h and <63 h, and 1.87 for workers with 63 h and more. To conclude, the present results suggest that long work hours correlate with reduced sleep quality in a dose-response manner. © 2010 European Sleep Research Society.

Color of intra-ocular lens and cataract type are prognostic determinants of health indices after visual and photoreceptive restoration by surgery.

PubMed

Ayaki, Masahiko; Negishi, Kazuno; Suzukamo, Yoshimi; Tsubota, Kazuo

2015-04-01

This study compared post-operative quality of life and sleep according to the type of cataract opacity and color of the implanted intra-ocular lens (IOL). This is a cohort study and participants were 206 patients (average age 74.1 years) undergoing cataract surgery with the implantation of a clear ultra-violet (UV)-blocking IOL (C) or a yellow blue-light-blocking IOL (Y). Participants were evaluated using the National Eye Institute Visual Function Questionnaire (VFQ-25) and Pittsburgh Sleep Quality Index (PSQI) before surgery and 2 and 7 months after surgery. Changes in sub-scale scores of VFQ-25 and PSQI were compared. Sub-scale analyses for improvement after surgery revealed significant differences in ocular pain scores on the VFQ-25 (Y>C; the higher the score, the better the outcome). Furthermore, there were significant differences between the two IOLs in terms of the sleep latency score (C>Y) and sleep disturbances score (C>Y). A posterior sub-capsular cataract was significantly correlated with improvements in ocular pain and sleep latency scores. These effects were successfully represented by the change in scores rather than absolute post-operative scores because individual standard of response may often change after intervention, recognized as a response shift phenomenon in patient-reported outcome study. Regarding seasonal differences, patients who had surgery in summer exhibited relatively better sleep quality than those who had surgery in winter. Analysis of sub-scales of health indices demonstrated characteristic prognoses for each IOL and cataract type. Cataract surgery may potentially contribute to systemic health in older adults.

Sleep and fatigue in multiple sclerosis: A questionnaire-based, cross-sectional, cohort study.

PubMed

Nociti, Viviana; Losavio, Francesco Antonio; Gnoni, Valentina; Losurdo, Anna; Testani, Elisa; Vollono, Catello; Frisullo, Giovanni; Brunetti, Valerio; Mirabella, Massimiliano; Della Marca, Giacomo

2017-01-15

Fatigue and sleep disorders are frequently reported in patients affected by Multiple Sclerosis (MS) but the causes and the relationship are not yet fully understood. This study aimed at evaluating their prevalence, at determining the relationships between clinical findings of MS and the occurrence of sleep disorders and at investigating the relations between sleep disorders and fatigue. One hundred and two MS patients were enrolled in the study. They were analyzed on both their clinical features (type of MS, disease duration, clinical severity, type of treatment, presence of spinal demyelinating lesions) and specific scales scores (Expanded Disability Status Scale, Modified Fatigue Impact Scale - MFIS, Self-Administered Anxiety Scale - SAS, Beck's Depression Inventory - BDI, Pittsburgh Sleep Quality Index - PSQI, Epworth Sleepiness Scale - ESS, and the Berlin's questionnaire for Obstruction Sleep Apnea Syndrome - OSAS). Patients with poor sleep quality are more frequently fatigued (p=0.001), have higher MFIS global scores (p<0.001), higher prevalence of RLS symptoms (p=0.049), and show higher scores at BDI (p=0.017) and SAS (p≤0.001). Conversely patients with fatigue show older age (p=0.005), higher prevalence of sleepiness (p=0.021), higher prevalence of RLS symptoms (p=0.030), higher prevalence of poor sleep quality (p<0.001) with higher PSQI scores (p<0.001), higher scores on the BDI (p<0.001) and SAS (p≤0.001). This study shows that MS is associated with a high prevalence of sleep complaints, including subjectively poor sleep quality, excessive daytime sleepiness, RLS and symptoms of OSAS. Further, it demonstrated a strict relation between fatigue and sleep disorders. Finally, it underlines their relationship with anxiety and depression in MS patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of 16-weeks of Pilates on health perception and sleep quality among elderly women.

PubMed

Curi, V S; Vilaça, J; Haas, A N; Fernandes, H M

2018-01-01

The objective of this study was to determine the effect of 16 weeks of mat-based Pilates training on health perception and sleep quality among elderly women. A randomized and controlled trial was conducted in Caxias do Sul, Brazil, in 2015, in which 61 healthy older women were divided into two groups: experimental group (EG; n=31, average of 64.25 years old, SD 0.14) and control group (CG; n=30, average of 63.75 years old, SD 0.08). The EG participants performed mat-based Pilates exercises twice a week in 60-min sessions, whereas the CG did not train. All participants completed Brazilian-adapted and validated versions of the Pittsburgh Sleep Quality Index (PSQI-BR) and General Health Questionnaire (GHQ-12) at baseline and after 16 weeks. Significant time x group interaction effects were found for the GHQ-12 total score (p<0.001, η 2 =0.19), and the depression (p=0.002, η 2 =0.15) and social dysfunction subscales (p=0.001, η 2 =0.18), as well as the PSQI-BR total score (p=0.017, η 2 =0.09), and the sleep latency (p=0.023, η 2 =0.09) and use of sleeping medication subscales (p=0.019, η 2 =0.09), indicating better improvements (reductions) in these outcome variables for the Pilates EG when compared to the CG. All significant effects were classified as moderate to high. These results indicate that 16 weeks of mat-based Pilates training significantly improves the perceived health status and some sleep quality indices among elderly women. However, more studies are needed to assess the effectiveness of equipment-based Pilates exercises among this population. Copyright © 2017 Elsevier B.V. All rights reserved.

[Relations between problems on sleeping and suicidal behaviors in middle school students].

PubMed

Chen, Jing; Wan, Yuhui; Sun, Ying; Tao, Fangbiao

2014-02-01

To understand the epidemiological characteristics and possible associations between sleeping problems and suicidal behaviors among middle school students. A total of 13 817 middle school students were selected in Shenyang,Xinxiang, Chongqing and Guangzhou cities and cluster sampling method was used. Questionnaires would include information on demographics, quality of sleep, psychopathological status and suicidal behaviors. Pittsburgh Sleep Quality index (PSQI) and Adolescent Multidimensional Sub-health Questionnaire (MSQA) were used to assess the quality of sleep and psychosomatic symptoms, respectively. Rates on sleeping problems and suicidal behaviors were compared in students with specific characteristics. Effects related to sleeping problems and suicidal behaviors were analyzed, using the multivariate logistic regression model. The overall prevalence of problems related to sleeping among middle school students was 26.5%. 28.2% of the girls and 35.2% of senior students reported as having more sleeping problems. Rates on suicide related ideation, planning and attempts were 16.6%, 9.6% and 4.7% , respectively. Girls reported more suicide ideation than boys. However, no gender differences were found in suicide planning or attempted suicide. It also suggested that the incidence of the suicidal behavior among students with sleeping problems was significantly higher than students without sleeping problems. Data from Multivariable logistic regression analysis showed that sleeping problems appeared as independent risk factors on suicidal behavior. Higher PSQI scores seemed coincide with the increased risk of suicidal behaviors. Students having sleeping time less than 5 hours per day showed higher risk of suicidal behaviors. Problems on sleeping seemed a strong risk factor for suicidal behaviors among middle school students. Improvement on the quality of sleep and reasonable arrangement of sleeping time could help prevent related suicidal behaviors among middle school students.

Impact of Eating Attitude and Impairment of Physical Quality of Life Between Tertiary Clinic and Primary Clinic Functional Dyspepsia Outpatients in Japan

PubMed Central

Shimpuku, Mayumi; Futagami, Seiji; Tajima, Natsuki; Yamawaki, Hiroshi; Maruki, Yuuta; Kodaka, Yasuhiro; Nagoya, Hiroyuki; Gudis, Katya; Kawagoe, Tetsuro; Sakamoto, Choitsu

2014-01-01

Background/Aims There is no available data on factors associated with healthcare-seeking behavior for functional dyspepsia (FD) symptoms at either tertiary or primary clinics in Japan. Therefore, we aimed to compare clinical symptoms and life styles such as sleep disorders and eating attitude in FD patients visiting general practitioners at primary clinics with those consulting gastroenterologists at tertiary clinics to clarify healthcare-seeking patterns in Japanese patients. Methods Fifty-one FD outpatients in a tertiary clinic (college hospital), 50 FD outpatients visiting primary clinics and 50 healthy volunteers were enrolled. Clinical symptoms, quality of life, sleep disorders, eating attitude and anxiety were estimated using the Gastrointestinal Symptom Rating Scale (GSRS), Social Functioning-8 (SF-8) test, Pittsburg Sleep Quality Index (PSQI) test and State-Trait Anxiety Inventory (STAI) for FD outpatients and healthy volunteers. Results FD outpatients exhibited higher mean scores of GSRS than healthy volunteers. The SF-8 physical component summary scores in the tertiary clinic group were significantly lower than those in the primary clinic group. GSRS scores were significantly (P < 0.001, P = 0.002) associated with global PSQI scores in FD outpatients as well as with STAI-trait scores (P = 0.006, P = 0.001) compared to healthy volunteers. The frequency of eating between meals in the primary clinic group was significantly (P < 0.05) higher than that in the tertiary clinic group. Conclusions It may be important for clarification of healthcare-seeking behavior to determine the difference in both impairment of physical quality of life and eating attitudes between tertiary clinic and primary clinic FD outpatients in Japan. PMID:25273121

Relationships among acculturative stress, sleep, and nondipping blood pressure in Korean American women.

PubMed

Suh, Minhee; Barksdale, Debra J; Logan, Jeongok

2013-02-01

Generally blood pressure (BP) should drop or dip by 10-20% during sleep. The phenomenon of nondipping BP during sleep has gained interest because of its association with various damaging effects to end-organs. This exploratory study examined nighttime nondipping BP, acculturative stress and quality of sleep in 30 Korean American women. Acculturative stress and sleep quality were measured using the Revised Social, Attitudinal, Familial, and Environmental Acculturative Stress Scale (R-SAFE) and the Pittsburg Sleep Quality Index (PSQI), respectively. Participants' BP was monitored over a 24-hour period. Participants were categorized as dippers and nondippers based on the drop in nocturnal systolic BP. Of the 30 women, 8 (26.7%) were nondippers. A shorter sleep duration and more disturbed sleep were associated with nondipping and, interestingly, less acculturative stress was also associated with nondipping BP. Our finding supports that sleep evaluation is needed in caring for individuals with nondipping BP.

Effects of Ayurvedic Oil-Dripping Treatment with Sesame Oil vs. with Warm Water on Sleep: A Randomized Single-Blinded Crossover Pilot Study

PubMed Central

Yorifuji, Takashi; Tsuda, Toshihide; Doi, Hiroyuki

2016-01-01

Abstract Objectives: Ayurvedic oil-dripping treatment (Shirodhara) is often used for treating sleep problems. However, few properly designed studies have been conducted, and the quantitative effect of Shirodhara is unclear. This study sought to quantitatively evaluate the effect of sesame oil Shirodhara (SOS) against warm water Shirodhara (WWS) on improving sleep quality and quality of life (QOL) among persons reporting sleep problems. Methods: This randomized, single-blinded, crossover study recruited 20 participants. Each participant received seven 30-minute sessions within 2 weeks with either liquid. The washout period was at least 2 months. The Shirodhara procedure was conducted by a robotic oil-drip system. The outcomes were assessed by the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, Epworth Sleepiness Scale (ESS) for daytime sleepiness, World Health Organization Quality of Life 26 (WHO-QOL26) for QOL, and a sleep monitor instrument for objective sleep measures. Changes between baseline and follow-up periods were compared between the two types of Shirodhara. Analysis was performed with generalized estimating equations. Results: Of 20 participants, 15 completed the study. SOS improved sleep quality, as measured by PSQI. The SOS score was 1.83 points lower (95% confidence interval [CI], −3.37 to −0.30) at 2-week follow-up and 1.73 points lower (95% CI, −3.84 to 0.38) than WWS at 6-week follow-up. Although marginally significant, SOS also improved QOL by 0.22 points at 2-week follow-up and 0.19 points at 6-week follow-up compared with WWS. After SOS, no beneficial effects were observed on daytime sleepiness or objective sleep measures. Conclusions: This pilot study demonstrated that SOS may be a safe potential treatment to improve sleep quality and QOL in persons with sleep problems. PMID:26669255

Associations Between Sleep Quality and Migraine Frequency

PubMed Central

Lin, Yu-Kai; Lin, Guan-Yu; Lee, Jiunn-Tay; Lee, Meei-Shyuan; Tsai, Chia-Kuang; Hsu, Yu-Wei; Lin, Yu-Zhen; Tsai, Yi-Chien; Yang, Fu-Chi

2016-01-01

Abstract Migraine has been associated with sleep disturbances. Relationship between sleep quality and migraine frequency is yet to be determined. The present study aimed to investigate sleep disturbances among low-frequency, moderate-frequency, high-frequency, and chronic migraineurs, with and without auras, with well-controlled confounding variables. This cross-sectional controlled study included 357 subjects from an outpatient headache clinic in Taiwan. Standardized questionnaires were utilized to collect demographic, migraine, sleep, depression, anxiety, and restless leg syndrome characteristics in all participants. According to frequency of migraine attacks, patients were divided into 4 groups: with 1 to 4 migraine days per month, 5 to 8 migraine days in a month, 9 to 14 migraine days in a month, and >14 migraine days per month. The Pittsburgh Sleep Quality Index (PSQI) and subgroup items were used to evaluate sleep quality. The association between migraine frequency and sleep quality was investigated using multivariable linear regression and logistic regression. The PSQI total score was highest in patients with high frequent migraine (10.0 ± 3.4) and lowest in controls (7.0 ± 3.4) with a significant trend analysis (P for trend = 0.006). Migraine frequency had an independent effect on the items “Cannot get to sleep within 30 minutes” (P < 0.001), “Wake up in the middle of the night or early morning” (P < 0.001), “Bad dreams” (P = 0.001), “Pain” (P = 0.004), and “Quality of sleep” (P < 0.001). The result showed the effect of migraine frequency in both the aura-present (P for trend = 0.008) and the aura-absent subgroups (P for trend = 0.011). High migraine frequency correlates with poor sleep quality and a higher prevalence of poor sleepers. These associations occur in migraine with aura and without aura. PMID:27124064

Patterns and Predictors of Sleep Quality Before, During, and After Hospitalization in Older Adults

PubMed Central

Dzierzewski, Joseph M.; Mitchell, Michael; Rodriguez, Juan Carlos; Fung, Constance H.; Jouldjian, Stella; Alessi, Cathy A.; Martin, Jennifer L.

2015-01-01

Study Objectives: The impact of hospitalization on sleep in late-life is underexplored. The current study examined patterns of sleep quality before, during, and following hospitalization, investigated predictors of sleep quality patterns, and examined predictors of classification discordance between two suggested clinical cutoffs used to demarcate poor/good sleep. Methods: This study included older adults (n = 163; mean age 79.7 ± 6.9 years, 31% female) undergoing inpatient post-acute rehabilitation. Upon admission to inpatient post-acute rehabilitation, patients completed the Pittsburgh Sleep Quality Index (PSQI) retrospectively regarding their sleep prior to hospitalization. They subsequently completed the PSQI at discharge, and 3 months, 6 months, 9 months, and 1 year post discharge. Patient demographic and clinical characteristics (pain, depression, cognition, comorbidity) were collected upon admission. Results: Using latent class analysis methods, older adults could be classified into (1) Consistently Good Sleepers and (2) Chronically Poor Sleepers based on patterns of self-reported sleep quality pre-illness, during, and up to 1 year following inpatient rehabilitation. This pattern was maintained regardless of the clinical cutoff employed (> 5 or > 8). Logistic regression analyses indicated that higher pain and depressive symptoms were consistently associated with an increased likelihood of being classified as a chronic poor sleeper. While there was substantial classification discordance based on clinical cutoff employed, no significant predictors of this discordance emerged. Conclusions: Clinicians should exercise caution in assessing sleep quality in inpatient settings. Alterations in the cutoffs employed may result in discordant clinical classifications of older adults. Pain and depression warrant detailed considerations when working with older adults on inpatient units when poor sleep is a concern. Citation: Dzierzewski JM, Mitchell M, Rodriguez JC, Fung CH, Jouldjian S, Alessi CA, Martin JL. Patterns and predictors of sleep quality before, during, and after hospitalization in older adults. J Clin Sleep Med 2015;11(1):45–51. PMID:25325580

Night sleep influences white matter microstructure in bipolar depression.

PubMed

Benedetti, Francesco; Melloni, Elisa M T; Dallaspezia, Sara; Bollettini, Irene; Locatelli, Clara; Poletti, Sara; Colombo, Cristina

2017-08-15

Alteration of circadian rhythms and sleep disruption are prominent trait-like features of bipolar disorder (BD). Diffusion tensor imaging (DTI) measures suggest a widespread alteration of white matter (WM) microstructure in patients with BD. Sleep promotes myelination and oligodendrocyte precursor cells proliferation. We hypothesized a possible association between DTI measures of WM microstructure and sleep quantity measures in BD. We studied 69 inpatients affected by a depressive episode in course of type I BD. We used whole brain tract-based spatial statistics on DTI measures of WM microstructure: axial, radial, and mean diffusivity (AD, RD, MD), and fractional anisotropy (FA). Self-assessed measures of time asleep (TA) and total sleep time (TST) were extracted from the Pittsburgh Sleep Quality Index (PSQI). Actigraphic recordings were performed on a subsample of 23 patients. We observed a positive correlation of DTI measures of FA with actigraphic measures of TA and TST, and with PSQI measure of TA. DTI measures of RD inversely associated with actigraphic measure of TA, and with PSQI measures of TA and TST. Several WM tracts were involved, including corpus callosum, cyngulate gyrus, uncinate fasciculus, left superior and inferior longitudinal and fronto-occipital fasciculi, thalamic radiation, corona radiata, retrolenticular part of internal capsule and corticospinal tract. The study is correlational in nature, and no conclusion about a causal connection can be drawn. Reduced FA with increased RD and MD indicate higher water diffusivity associated with less organized myelin and/or axonal structures. Our findings suggest an association between sleep disruption and these measures of brain microstructure in specific tracts contributing to the functional connectivity in BD. Copyright © 2017 Elsevier B.V. All rights reserved.

Cognitive Behavioral Therapy Using a Mobile Application Synchronizable With Wearable Devices for Insomnia Treatment: A Pilot Study

PubMed Central

Kang, Seung-Gul; Kang, Jae Myeong; Cho, Seong-Jin; Ko, Kwang-Pil; Lee, Yu Jin; Lee, Heon-Jeong; Kim, Leen; Winkelman, John W.

2017-01-01

Study Objectives: The use of telemedicine with a mobile application (MA) and a wearable device (WD) for the management of sleep disorders has recently received considerable attention. We designed an MA synchronizable with a WD for insomnia treatment. Our pilot study determined the efficacy of simplified group cognitive behavioral therapy for insomnia (CBT-I) delivered using our MA and assessed participant adherence to and satisfaction with the device. Methods: The efficacy of the CBT-I using MA (CBT-I-MA) was assessed by comparing sleep variables (sleep efficiency [SE], Insomnia Severity Index [ISI], and Pittsburgh Sleep Quality Inventory [PSQI] scores) before and after a 4-week treatment protocol in 19 patients with insomnia disorder patients. SE was assessed using a sleep diary, actigraphy, and the PSQI. Results: The intervention significantly improved all three measures of SE (P < .05), and the response rate to treatment was high (94.7%). Total ISI and PSQI scores and sleep latency, as measured by the sleep diary, improved significantly. Participants showed relatively good adherence to our MA, and sleep diary entries were made on 24.3 ± 3.8 of 28 days. Moreover, 94.7% of the participants reported that our MA was effective for treating insomnia. Conclusions: Our pilot study suggested the clinical usefulness of a CBT-I-MA. We expect that our findings will lead to further development and replication studies of CBT-I-MA. Citation: Kang SG, Kang JM, Cho SJ, Ko KP, Lee YJ, Lee HJ, Kim L, Winkelman JW. Cognitive behavioral therapy using a mobile application synchronizable with wearable devices for insomnia treatment: a pilot study. J Clin Sleep Med. 2017;13(4):633–640. PMID:28162145

Oral lichen planus: salival biomarkers cortisol, immunoglobulin A, adiponectin.

PubMed

Lopez-Jornet, Pia; Cayuela, Cristina Aznar; Tvarijonaviciute, Asta; Parra-Perez, Francisco; Escribano, Damian; Ceron, Jose

2016-03-01

Oral lichen planus (OLP) is a chronic mucocutaneous disease, inflammatory and autoimmune in character, in which the pathogenesis is not fully understood. Psychological stress has also been implicated in triggering or exacerbating the disease. The aim of this study was to evaluate the psychological profile, sleep, and salivary biological markers-cortisol, immunoglobin A (IgA), and adiponectin - in patients with oral lichen planus (OLP). The sample consisted of 65 patients (33 with OLP and 32 control patients). Patients completed hospital anxiety and depression scales (HADD, HADA). Questionnaires were used to assess sleepiness: the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale (ESS). A visual analog scale (VAS) was used for rating pain. Unstimulated whole saliva was evaluated, together with total proteins: cortisol, IgA, and adiponectin. Patients with OLP obtained significantly higher HADA and PSQI scores than control subjects (P = 0.001, P = 0.012, respectively). Total salivary protein (flow at rest) analysis found that total proteins were higher in the OLP group (P = 0.001). In the OLP group, IgA was 80.3 ± 51.3 vs. the control group 48.9 ± 32.8 (P = 0.005). Mean cortisol was 0.5 ± 0.3 μg/dl in the OLP group vs. 0.4 ± 0.2 μg/dl in the control group (P = 0.010). The OLP group showed a correlation between the HADA variable and pain (r = 0.358; P = 0.041), HADD (r = 0.568; P = 0.001), and PSQI (r = 0.537; P = 0.001). OLP patients presented worse psychological profiles and sleep disturbances, as well as higher values for IgA, cortisol, and total proteins than control subjects. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Working Memory, Sleep, and Hearing Problems in Patients with Tinnitus and Hearing Loss Fitted with Hearing Aids.

PubMed

Zarenoe, Reza; Hällgren, Mathias; Andersson, Gerhard; Ledin, Torbjörn

2017-02-01

Tinnitus is a common condition and there is a need to evaluate effects of tinnitus management in relation to moderating factors such as degree of hearing loss. As it is possible that tinnitus influences concentration, and thus is likely to disturb cognitive processing, the role of cognitive functioning also needs to be investigated. To compare a group of patients with sensorineural hearing loss and tinnitus to a control group with only sensorineural hearing loss (and no tinnitus). To investigate working memory, sleep, and hearing problems measured before and after hearing rehabilitation. A prospective study. The sample consisted of 100 patients, 50 with hearing loss and tinnitus, and 50 controls with hearing loss but no tinnitus. All patients were between 40 and 82 yr old and had a pure-tone average (PTA; average of 0.5, 1, 2, and 4 kHz) <70 dB HL. Patients were tested before and after rehabilitation with hearing aids with regard to their working memory capacity, sleep quality, hearing problems, speech recognition, and tinnitus annoyance. Eight patients dropped out of the study. Thus, a total of 92 patients were included for analysis, with 46 in each group. As a consequence of unplanned age and PTA differences between the groups, an age-matched subsample (n = 30 + 30) was selected for further analysis. Tests including the Reading Span, Hearing-in-Noise Test (HINT), Tinnitus Handicap Inventory (THI), Hearing Handicap Inventory for the Elderly (HHIE), and Pittsburgh Sleep Quality Index (PSQI) were administered before and after hearing aid rehabilitation. There were no between-group differences at baseline in the full sample (n = 92), with the exception of the THI (p < 0.001) and the PSQI (p < 0.002), on which the hearing loss and tinnitus group had significantly higher scores. Pre/post changes were significant for both groups on the Reading Span, and HHIE. However, these improvements were significantly larger for the patients in the hearing loss and tinnitus group on the Reading Span test (p < 0.001) and the PSQI (p < 0.001). Patients with tinnitus and hearing loss also exhibited significantly improved THI scores at follow-up, compared to baseline (p < 0.001). We conducted the same analyses for the age-matched subsample (n = 30 + 30). For the baseline data, only the THI (p < 0.001) and the PSQI (p < 0.015) difference remained significant. With regard to the pre/post changes, we found the same differences in improvement in Reading Span (p < 0.001) and the PSQI (p < 0.015) as in the full sample. Patients with tinnitus benefited from hearing aid rehabilitation. The observed differences in cognitive function were unexpected, and there were larger score improvements on the Reading Span test in the hearing loss and tinnitus group than in the hearing loss group. Patients with tinnitus and hearing loss may receive extra benefit in terms of cognitive function following hearing aid rehabilitation. American Academy of Audiology

The impact on sleep of a multidisciplinary cognitive behavioural pain management programme: a pilot study.

PubMed

Cunningham, Jennifer M; Blake, Catherine; Power, Camillus K; O'Keeffe, Declan; Kelly, Valerie; Horan, Sheila; Spencer, Orla; Fullen, Brona M

2011-01-10

Reduced sleep quality is a common complaint among patients with chronic pain, with 50-80% of patients reporting sleep disturbance. Improvements in pain and quality of life measures have been achieved using a multidisciplinary cognitive behavioural therapy pain management programme (CBT-PMP) that aims to recondition attitudes to pain, and improve patients' self-management of their condition. Despite its high prevalence in patients with chronic pain, there is very limited objective evidence for the effect of this intervention on sleep quality. The primary research objective is to investigate the short-term effect of a multidisciplinary CBT-PMP on subjective (measured by Pittsburg Sleep Quality Index) and objective sleep quality (measured by Actigraphy) in patients with chronic pain by comparison with a control group. The secondary objectives will investigate changes in function and mood, and then explore the relationship between objective and subjective sleep quality and physical and psychological outcome measures. Patients who fulfil the inclusion criteria for attendance on the multidisciplinary CBT-PMP in the Adelaide and Meath Hospital, Tallaght, Dublin and are currently listed on the PMP waiting list will be invited to participate in this pilot study. Potential patients will be screened for sleep disturbance [determined by the Pittsburgh Sleep Quality Index (PSQI)]. Those patients with a sleep disturbance (PSQI >5) will be assigned to either the intervention group (immediate treatment), or control group (deferred treatment, i.e. the PMP they are listed for is more than six months away) based on where they appear on the waiting list. Baseline measures of sleep, function, and mood will be obtained using a combination of self-report questionnaires (the Hospital Anxiety and Depression Scale, the Short Form 36 health survey, the Pittsburgh Sleep Quality Index, the Tampa Scale for Kinesiophobia), and functional outcome measures. Sleep will be measured for seven days using actigraphy (Actiwatch 7). These measures will be repeated after the four week multidisciplinary cognitive behavioural therapy pain management programme, and at a two month follow-up. The waiting list control group will be assessed at baseline, and two months later. Analysis for the primary outcome will include between group differences of subjective and objective sleep parameters from baseline to follow-up using Independent T-tests or Mann-Whitney U tests. The secondary outcomes establishing relationships between the sleep variables and physical and psychological outcome measures will be established using multiple linear regression models. This pilot study will evaluate the impact of a multidisciplinary CBT-PMP on both subjective and objective measures of sleep in patients with chronic pain and provide guidance for a larger clinical trial. Current controlled trial ISRCTN: ISRCTN74913595.

Sleep Quality Improves During Treatment With Bryophyllum pinnatum: An Observational Study on Cancer Patients.

PubMed

Simões-Wüst, Ana Paula; Hassani, Taziri Al; Müller-Hübenthal, Boris; Pittl, Sandra; Kuck, Angela; Meden, Harald; Eberhard, Jutta; Decker, Michael; Fürer, Karin; von Mandach, Ursula

2015-09-01

Cancer patients frequently suffer from poor sleep quality. Bryophyllum pinnatum is a herbal medication used in anthroposophic medicine, which has been shown to be associated with improvements in sleep quality during pregnancy with only few and minor or moderate side-effects reported. In this study, the sleep quality of cancer patients during treatment with B pinnatum was investigated. In this prospective, observational study, cancer patients suffering from sleep problems were treated with B pinnatum (350 mg tablets, corresponding to 50% of leaf pressed juice [Weleda AG, Arlesheim, Switzerland], dosage at physician's consideration, but most frequently 2 tablets with evening meal and 2 before going to bed). Sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daily sleepiness (Epworth Sleeping Scale [ESS]), and fatigue (Fatigue Severity Scale [FSS]) were assessed at the beginning of the treatment and after 3 weeks. Possible adverse drug reactions perceived by the patients during the treatment were recorded. From the 28 recruited patients, 20 completed both questionnaires and were considered in the present analysis. Data are expressed as mean ± standard deviation. Patients were 61 ± 10.4 years old and the majority were female (17 out of 20). During treatment with B pinnatum, the PSQI decreased from 12.2 ± 3.62 to 9.1 ± 3.61 (P < .01), and ESS changed from 8.4 ± 3.18 to 7.1 ± 3.98 (P < .05). There was no change in FSS. The treatment was well tolerated by the majority of patients, with only 6 patients reporting discomfort that might have been caused by B pinnatum (fatigue n = 3, dry throat n = 1, agitation n = 1, difficult digestion n = 1). No serious adverse drug reactions were detected. B pinnatum may be a suitable treatment for sleep problems of cancer patients. Controlled, randomized clinical trials of the use of B pinnatum in sleep disorders are urgently needed. © The Author(s) 2015.

Comparative effect of beclomethasone dipropionate and cetirizine on acoustic rhinometry parameters in children with perennial allergic rhinitis: a randomized controlled trial.

PubMed

Malizia, V; Fasola, S; Ferrante, G; Cilluffo, G; Gagliardo, R; Landi, M; Montalbano, L; Marchese, D; La Grutta, S

2018-04-24

The effect of intranasal corticosteroids and oral antihistamines on acoustic rhinometry parameters was not directly compared in previous studies. Objectives: The primary aim was to compare the effect of 21-day treatment with nasal beclomethasone dipropionate (nBDP) versus cetirizine (CTZ) on nasal patency measured by acoustic rhinometry in children with PAR. Comparing their effect on nasal cytology, symptom severity, sleep quality and quality of life was the secondary aim. In this 21-day, open-label, randomized controlled study, 34 PAR children (6-14 years) with Total 5 Symptom Score (T5SS) ≥5 received nBDP 100 µg per nostril twice daily or CTZ 10 mg tablets once daily. Effect measures were the least square mean changes (LSmc) in nasal volume and Minimal Cross-sectional Area (MCA), nasal cytology, T5SS, Pittsburgh Sleep Quality Index (PSQI) and Paediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ). After 21 days, nBDP improved nasal volume and MCA more than CTZ (LSmc 2.21 cm3 vs 0.20 cm3, p=0.013 and LSmc 0.63 cm2 vs 0.13 cm2, p=0.002, respectively). In the nBDP group, with respect to the CTZ group, larger improvement was found in: eosinophil (LSmc -1.10 vs -0.40, p=0.031) and neutrophil (LSmc -0.97 vs -0.17, p=0.010) classes, T5SS (LSmc -5.63 vs -3.54, p=0.008), PSQI (LSmc -1.30 vs -0.19, p=0.025) and PRQLQ total scores (LSmc -1.15 vs -0.69, p=0.031). In children with PAR, nBDP is more effective than CTZ in improving nasal patency measured by acoustic rhinometry, with associated beneficial effects on nasal cytology, symptoms, sleep quality and quality of life.

Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances

PubMed Central

Black, David S.; O’Reilly, Gillian A.; Olmstead, Richard; Breen, Elizabeth C.; Irwin, Michael R.

2015-01-01

IMPORTANCE Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep. OBJECTIVE To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5). INTERVENTIONS A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework. MAIN OUTCOMES AND MEASURES The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)–κB. RESULTS Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. The between-group mean difference was 1.8 (95%CI, 0.6–2.9), with an effect size of 0.89. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity (P < .05 for all). Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups (P < .05). CONCLUSIONS AND RELEVANCE The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01534338 PMID:25686304

Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial.

PubMed

Black, David S; O'Reilly, Gillian A; Olmstead, Richard; Breen, Elizabeth C; Irwin, Michael R

2015-04-01

Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep. To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances. Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5). A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework. The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)-κB. Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. The between-group mean difference was 1.8 (95% CI, 0.6-2.9), with an effect size of 0.89. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity (P < .05 for all). Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups (P < .05). The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life. clinicaltrials.gov Identifier: NCT01534338.

Associations of quality of sleep with lifestyle factors and profile of studies among Lithuanian students.

PubMed

Preišegolavičiūtė, Evelina; Leskauskas, Darius; Adomaitienė, Virginija

2010-01-01

The objective of the study was to analyze associations among quality of sleep, profile of the studies, and lifestyle factors among the students of three different study profiles (medicine, economics, and law). A total of 405 randomly selected students from the first and fourth years of studies from 4 different universities in Lithuania answered the standardized questionnaires consisting of two parts: 1) the Pittsburgh Sleep Quality Index (PSQI) for subjective evaluation of sleep quality; 2) the questionnaire about sleep and lifestyle habits and impact of poor sleep on the quality of life developed by the researchers. More than half (59.4%) of the students scored higher than 5 on the PSQI, which allowed suspecting sleep disorders. A significant difference in the frequency of poor sleepers was found regarding the profile of studies (P<0.05) showing the highest frequency of sleep disturbances among medical students. There was a significant correlation between quality of sleep and subjective evaluation of quality of life (P<0.01). Medical students experienced the highest impact of poor sleep on the quality of life (P=0.008). Students studying before going to sleep, spending more time studying, and having less leisure time had worse quality of sleep (P<0.01). A significant difference was found among three profiles of studies regarding the anxiety about studies (P<0.0005) and subjective estimation of success in studies (χ²=27.9, P<0.0005), showing the highest anxiety and worst satisfaction among students of medicine. The incidence of sleep problems is high among students in Lithuania, reaching 59.4%. Medical students have worse quality of sleep and worse impact of poor sleep on the quality of life compared to students of law and economics. A significant difference was found between medical students and their peers in other profiles of studies regarding their attitudes and habits related to studies: medical students spent more time for studying, were more anxious about studies and less satisfied with the results, studied more often before going to sleep.

Mindfulness-Based Stress Reduction vs. Pharmacotherapy for Primary Chronic Insomnia: A Pilot Randomized Controlled Clinical Trial

PubMed Central

Gross, Cynthia R.; Kreitzer, Mary Jo; Reilly-Spong, Maryanne; Wall, Melanie; Winbush, Nicole Y.; Patterson, Robert; Mahowald, Mark; Cramer-Bornemann, Michel

2011-01-01

Objective To investigate the potential of Mindfulness-Based Stress Reduction (MBSR) as a treatment for chronic primary insomnia. Design Randomized controlled trial. Setting University health center. Patients 30 adults with primary chronic insomnia based on DSM-IV-TR criteria were randomized 2:1 to MBSR or pharmacotherapy (PCT). Interventions MBSR, a program of mindfulness meditation training consisting of 8 weekly 2.5 hour classes and a day-long retreat, with ongoing home meditation practice expectations during 3 month follow-up; PCT, consisting of 3 mg of eszopiclone (LUNESTA™) nightly for 8 weeks, followed by 3 months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions. Main Outcomes The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries and wrist actigraphy collected pre-treatment, post-treatment (8 weeks), and at 5 months (self-reports only). Results Between baseline and 8-weeks, sleep onset latency measured by actigraphy decreased 8.9 minutes in the MBSR arm (P<.05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, sleep onset latency and sleep efficiency (Ps<.01, all) from baseline to 5 month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. 27 out of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by: sleep diary, actigraphy, well-validated sleep scales and measures of remission and clinical recovery. PMID:21397868

Development of the athlete sleep behavior questionnaire: A tool for identifying maladaptive sleep practices in elite athletes

PubMed Central

Driller, Matthew W; Mah, Cheri D; Halson, Shona L

2018-01-01

Introduction Existing sleep questionnaires to assess sleep behaviors may not be sensitive in determining the unique sleep challenges faced by elite athletes. The purpose of the current study was to develop and validate the Athlete Sleep Behavior Questionnaire (ASBQ) to be used as a practical tool for support staff working with elite athletes. Methods 564 participants (242 athletes, 322 non-athletes) completed the 18-item ASBQ and three previously validated questionnaires; the Sleep Hygiene Index (SHI), the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). A cohort of the studied population performed the ASBQ twice in one week to assess test-retest reliability, and also performed sleep monitoring via wrist-actigraphy. Results Comparison of the ASBQ with existing sleep questionnaires resulted in moderate to large correlations (r=0.32 - 0.69). There was a significant difference between athletes and non-athletes for the ASBQ global score (44±6 vs. 41±6, respectively, p<0.01) and for the PSQI, but not for the SHI or the ESS. The reliability of the ASBQ was acceptable (ICC=0.87) when re-tested within 7 days. There was a moderate relationship between ASBQ and total sleep time (r=-0.42). Conclusion The ASBQ is a valid and reliable tool that can differentiate the sleep practices between athletes and non-athletes, and offers a practical instrument for practitioners and/or researchers wanting to evaluate the sleep behaviors of elite athletes. The ASBQ may provide information on areas where improvements to individual athletes’ sleep habits could be made. PMID:29796200

[Preliminary investigation of psychologic factors in 76 tinnitus patients].

PubMed

Mao, Kunhua; Jiang, Wen; Feng, Yong

2011-08-01

To study the psychological aspects of tinnitus patients, to analyze the distribution of psychologic obstacle in tinnitus patients, and then to provide information for diagnosing and treating tinnitus clinically. All patients were detected their frequency and loudness of tinnitus. Then they were evaluated by symptom checklist 90 (SCL-90), life satisfaction scale, Pittsburgh sleep quality index (PSQI) and tinnitus handicap inventory (THI). All data were analyzed with statistical software SPSS11.0. (1)There was no straight line correlation between frequency, loudness of tinnitus and the patient's scores from SCL-90, life satisfaction rating scale (LSR), life satisfaction index A (LSIA), LSIB, PSQI, THI. (2) To 76 tinnitus patients, some factors of SCL-90 were higher than internal nom. Compared with internal nom, tinnitus patients' score of LSR, LSIA and LSIB were all lower than it. Many of tinnitus patients had sleep disorder, the ratio was higher than internal nom. (3) Grouping these patients, based on the score of THI. To THI four grade group and THI five grade group, their satisfaction of lives were lower, some factors of SCL-90 were higher than internal nom. To THI five grade group, the ratio about sleep disorder was higher than internal nom. There is no straight line correlation between frequency, loudness of tinnitus and the patient's scores from SCL-90, LSR, LSIA, LSIB, PSQ1, THI. Grouping based on the score of THI, the groups of THI four grade and THI five grade are approved that they have psychologic obstacle obviously, they should be paid close attention.

Indicators and correlates of psychological disturbance in Chinese patients receiving maintenance hemodialysis: a cross-sectional study.

PubMed

Wang, Si-Yuan; Zang, Xiao-Ying; Liu, Jun-Duo; Cheng, Mei; Shi, Yue-Xian; Zhao, Yue

2015-04-01

Depression and anxiety have been considered as the most common comorbidities in maintenance hemodialysis (MHD) patients. This study aimed to assess mental disorder in hemodialysis patients and to study the indicators and correlates of psychological disturbance among patients receiving MHD in China. A cross-sectional study was conducted in 187 outpatients undergoing regular hemodialysis for at least 3 months. All the participants completed the Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue, Chinese mainland version), Pittsburgh Sleep Quality Index (PSQI), Family APGAR Index (PAGAR), Family Adaptability and Cohesion Evaluation Scale (FACES II, Chinese version) and the Social Functioning Questionnaire (SFQ). Based on the cutoff point of HADS-D/A ≥ 8, 51 (27.3%) and 29 (15.5%) patients reported depression and anxiety, respectively; 26 (13.9%) of all reported both depression and anxiety. Depressive patients had lower economic status, less subsidies, less than 3 years duration on hemodialysis and comorbidities when compared to patients without depression (all P < 0.05). HADS-D showed positive correlations with HADS-A, PSQI and SFQ and negative correlations with FACIT-Fatigue, PAGAR, family cohesion and adaptability (all P < 0.001). Patients with better family cohesion showed higher level of psychosocial well-being no matter their economic status. Binary logistic regression analysis demonstrated that anxiety (OR 1.80, P < 0.001) and bad social functioning (OR 1.31, P < 0.001) were independently associated with depression. More attention should be paid on assessment and management psychological disturbance, and development family/social/medical supporting system for Chinese patients receiving MHD.

Sleep disturbances in juvenile myoclonic epilepsy: a sleep questionnaire-based study.

PubMed

Krishnan, Pramod; Sinha, Sanjib; Taly, Arun B; Ramachandraiah, Chaitra T; Rao, Shivaji; Satishchandra, Parthasarathy

2012-03-01

Sleep and epilepsy share a complex pathophysiological association. Juvenile myoclonic epilepsy (JME) is a common sleep-sensitive epilepsy in which the effect of seizures could have therapeutic implications in terms of sleep disturbances and seizure control. This study aimed to analyze the effect of epilepsy on sleep in patients with JME. Fifty patients on valproic acid (VPA) monotherapy, and age- and gender-matched controls were recruited into this prospective, hospital-based, case-control study after informed consent and screening for inclusion criteria. They underwent a detailed clinical assessment, electroencephalogram (EEG) and neuroimaging, and were administered validated sleep questionnaires, which included the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and NIMHANS Sleep Disorders Questionnaire. The patient and control groups had identical numbers of males and females (M: F=22: 28), without any significant difference in the age and body mass index (BMI). The clinical profile of JME was similar to published literature while the prevalence of EEG abnormalities was less compared to similar studies. The mean ESS and PSQI scores and the number of subjects with abnormal scores on one or both questionnaires were significantly more in patients. Patients had a higher prevalence of sleep disturbances, insomnia and excessive daytime somnolence. No significant seizure- or treatment-related factors influencing sleep could be identified. This study, the first of its kind, revealed that patients with JME have significant sleep disturbances characterized by excessive daytime sleepiness and disturbed night sleep, despite adequate medications and good seizure control. The role of VPA in the genesis of these symptoms needs clarification. Copyright © 2012 Elsevier Inc. All rights reserved.

Effect of brief sleep hygiene education for workers of an information technology company.

PubMed

Kakinuma, Mitsuru; Takahashi, Masaya; Kato, Noritada; Aratake, Yutaka; Watanabe, Mayumi; Ishikawa, Yumi; Kojima, Reiko; Shibaoka, Michi; Tanaka, Katsutoshi

2010-01-01

To investigate the effects of sleep hygiene education for workers of an information technology (IT) company, we conducted a controlled clinical trial providing 581 workers one-hour sleep hygiene education. The contents of the sleep hygiene education program were a review of sleep habits, provide sleep hygiene education, and the establishment of sleep habit goals. A self-report questionnaire was used to measure outcomes including the Pittsburgh Sleep Quality Index (PSQI), Karolinska Sleepiness Scale (KSS), Checklist Individual Strength (CIS), Center for Epidemiologic Studies for Depression (CES-D), and mean sleep duration on weekdays before and 4 wk after the intervention. A total of 391 participants were included in the analysis, with 214 participants in the sleep hygiene education group and 177 in the waiting list group. KSS score at 2 P.M. decreased by 0.42 points in the sleep hygiene education group, but increased by 0.08 points in the waiting list group, showing a significant effect size of 0.50 (95%CI, -0.97 to -0.04, p<0.05). PSQI score also improved, but the inter-group difference was not statically significant. The present study provides preliminary evidence that brief sleep hygiene education may improve afternoon sleepiness at work, but not sleep at night for IT workers.

Abnormal Neural Network of Primary Insomnia: Evidence from Spatial Working Memory Task fMRI.

PubMed

Li, Yongli; Liu, Liya; Wang, Enfeng; Zhang, Hongju; Dou, Shewei; Tong, Li; Cheng, Jingliang; Chen, Chuanliang; Shi, Dapeng

2016-01-01

Contemporary functional MRI (fMRI) methods can provide a wealth of information about the neural mechanisms associated with primary insomnia (PI), which centrally involve neural network circuits related to spatial working memory. A total of 30 participants diagnosed with PI and without atypical brain anatomy were selected along with 30 age- and gender-matched healthy controls. Subjects were administered the Pittsburgh Sleep Quality Index (PSQI), Hamilton Rating Scale for Depression and clinical assessments of spatial working memory, followed by an MRI scan and fMRI in spatial memory task state. Statistically significant differences between PSQI and spatial working memory were observed between PI patients and controls (p < 0.01). Activation of neural networks related to spatial memory task state in the PI group was observed at the left temporal lobe, left occipital lobe and right frontal lobe. Lower levels of activation were observed in the left parahippocampal gyrus, right parahippocampal gyrus, bilateral temporal cortex, frontal cortex and superior parietal lobule. Participants with PI exhibited characteristic abnormalities in the neural network connectivity related to spatial working memory. These results may be indicative of an underlying pathological mechanism related to spatial working memory deterioration in PI, analogous to recently described mechanisms in other mental health disorders. © 2016 S. Karger AG, Basel.

Prevalence of psychological stress, depression and anxiety among medical students in Egypt.

PubMed

Fawzy, Mohamed; Hamed, Sherifa A

2017-09-01

Poor psychological health in medical students has been reported nationwide. This study estimated the prevalence of depression, anxiety and stress symptoms among medical students who were enrolled in a public university in Upper Egypt and determine the association of these morbidities with the students' basic socio-demographic variables. This cross-sectional study included 700 students. A self-administered, questionnaire for the socio-demographic characteristics, Depression Anxiety Stress Scale (DASS 21) and Pittsburgh Sleep Quality Index (PSQI) questionnaire were used for assessment. High frequencies of depression (65%), anxiety (73%) and stress (59.9%) were reported. Stress scores were significantly higher than depression and anxiety (P=0.001). 55.7% were poor sleepers. In univarate analysis, females, those living in the University campus/students' residence facility, in the preclinical years and with lower academic achievement had higher scores of DASS and PSQI compared to their comparative partners. Significant correlations were reported between stress with depression, anxiety and PQSI scores (P=0.0001). In multivariate analysis, stress scores were significantly associated with female sex, depression and anxiety scores. We conclude that depression, anxiety and stress symptoms are common in medical students of Assiut University relative to other schools and female gender was significantly correlated with these findings. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Association Between Blood Pressure Lowering and Quality of Life by Treatment of Azilsartan.

PubMed

Fujiwara, Nobuharu; Tanaka, Atsushi; Kawaguchi, Atsushi; Tago, Motoko; Oyama, Jun-Ichi; Uchida, Yasufumi; Matsunaga, Kazuo; Moroe, Kazuo; Toyoda, Shigeru; Inoue, Teruo; Ikeda, Hideo; Node, Koichi

2017-10-21

The authors assessed the effects of switching from a conventional angiotensin II receptor blocker (ARB) to azilsartan on blood pressure (BP) and health-related quality of life (HR-QOL) in patients with uncontrolled hypertension. Key eligibility criteria were uncontrolled hypertension treated for ≥ 1 month with an ARB, excluding azilsartan, that did not reach the target BP. We recruited 147 patients (64 males and 83 females; mean ± standard deviation age 73 ± 15 years). Azilsartan reduced both systolic and diastolic BP significantly, from 151 ± 16/82 ± 12 to 134 ± 17/73 ± 12 mm Hg, 3 months after switching. Although scores on the comprehensive QOL scale, the EuroQoL 5 dimensions (EQ5D), and the simplified menopausal index (SMI) did not change, the Geriatric Depression Scale (GDS) score improved significantly, and there was a significant association between the change in the GDS score and systolic BP lowering (r = 0.2554, P = 0.030). The Pittsburgh sleep quality index (PSQI) improved significantly only in the female subgroup. Besides sufficient BP lowering activity, anti-hypertensive treatment with azilsartan may have a favorable impact on depression in geriatric patients with uncontrolled hypertension.

Association between Chinese cooking oil fumes and sleep quality among a middle-aged Chinese population.

PubMed

Wei, Fu; Nie, Guanghui; Zhou, Bo; Wang, Liang; Ma, Yifei; Peng, Suwan; Ou, Songfeng; Qin, Jian; Zhang, Li'e; Li, Shu; Zou, Ruosi; Zeng, Xiaoyun; Zhang, Zhiyong; Zou, Yunfeng

2017-08-01

Poor sleep quality is an important symptom of many medical or psychiatric disorders. However, the impact of cooking oil fumes (COFs) on sleep quality has not been studied. This population-based cross-sectional study was conducted to examine the association between COFs of Chinese household cooking and sleep quality. Individual sleep quality assessment was completed in 2197 participants with an average age of 37.52 years, through Pittsburgh Sleep Quality Index (PSQI). Information about their cooking practice were also collected by self-reported questionnaire. As an internal biomarker of COFs, urinary 1-hydroxypyrene (1-HOP) (n = 562) was further measured using high-performance liquid chromatography. Binary logistic regression models were performed to evaluate the association between exposure to COFs and individual sleep quality. We found that, subjective poor kitchen ventilation, preheating oil to smoking, and cooking for over 30 minutes were positively associated with overall poor sleep quality (global PSQI score >5) [odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.43-2.16; 1.25, (1.03-1.52); 1.42, (1.15-1.76), respectively]. After adjusting for potential confounders, subjective poor kitchen ventilation still tend to increase the risk of long sleep latency, sleep disturbances, and daytime dysfunction [OR = 1.37, 95% CI = 1.09-1.73; 1.91, (1.39-2.61); 1.54, (1.23-1.93), respectively]. Similar results were observed in participants who preheated oil to smoking [OR = 1.36, 95% CI = 1.08-1.72; 1.55, (1.14-2.14); 1.25, (1.02-1.55), respectively] and cooked for over 30 minutes [OR = 1.34, 95% CI = 1.05-1.72; 1.46, (1.03-2.06); 1.36, (1.08-1.72), respectively]. Furthermore, high urinary 1-HOP level was also positively associated with overall poor sleep quality (OR = 2.30, 95% CI = 1.31-4.05). The results indicated that exposure to COFs from Chinese household cooking may be a risk factor for poor sleep quality among middle-aged Chinese population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of cognitive behavioral therapy in patients with depressive disorder and comorbid insomnia: A propensity score-matched outcome study.

PubMed

Hsu, Hui-Min; Chou, Kuei-Ru; Lin, Kuan-Chia; Chen, Kuan-Yu; Su, Shu-Fang; Chung, Min-Huey

2015-10-01

We evaluated the effects of cognitive behavioral therapy for insomnia (CBT-I) in inpatients with a diagnosis of depression and comorbid insomnia. This study used a prospective, parallel-group design. The experimental group received CBT-I for no more than 90 min once weekly for 6 weeks and the control group only have health education manuals for insomnia. The following questionnaires were administered at baseline: the Hamilton Rating Scale for Depression (HAM-D), Dysfunctional Beliefs and Attitudes about Sleep (DBAS), Presleep Arousal Scale (PSAS), Sleep Hygiene Practice (SHP), and Pittsburgh Sleep Quality Index. The questionnaires were readministered after the completion of the 6-wk CBT-I intervention and 1 month following the completion of CBT-I, to determine the effects of the CBT-I intervention over time. The analysis of Generalized Estimation Equations was identified the difference between the experimental group and the control group by controlling for the variables in BZD dose and propensity score of gender, age, and the scores for the DBAS-16, PSAS, SHPS, and HAM-D. Consequently, the significant difference in the PSQI scores was observed at the 1-month follow-up assessment however, no significant intergroup difference in the PSQI scores was found at the completion of the CBT-I intervention between two groups. As a conclusion, we found that overall sleep quality significantly improved in patients who received CBT-I after we controlled for the BZD dose and propensity score, which suggests that CBT-I may represent a useful clinical strategy for improving sleep quality in patients with depression and comorbid insomnia. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effects of electroacupuncture on stress-related symptoms in medical students: a randomised controlled pilot study.

PubMed

Dias, Marcio; Pagnin, Daniel; de Queiroz Pagnin, Valéria; Reis, Regina Lucia Ribeiro; Olej, Beni

2012-06-01

To assess the effects of electroacupuncture on stress-related symptoms-sleep disorders, anxiety, depression and burnout-in medical students, and provide data to inform a power analysis to determinate numbers for future trials. Twenty-five students were randomly assigned to an electroacupuncture (n=12) group or control group (n=13) that did not receive treatment. Electroacupuncture was applied at a continuous frequency 2 Hz for 20 min once a week for 8 weeks at sites on the extremities, face, ear and scalp. The outcomes of the students treated with electroacupuncture were compared with those of the control group at the endpoint, controlling the influence of baseline scores. The instruments used were self-administered questionnaires that comprised the validated Portuguese version of the mini-sleep questionnaire (MSQ), the Pittsburgh sleep quality index (PSQI), the Epworth sleepiness scale (ESS), the Beck depression inventory (BDI), the Beck anxiety inventory, the Maslach burnout inventory-student survey (MBI-SS), and World Health Organization quality of life assessment - abbreviated version (WHOQOL-bref). The medical students treated with electroacupuncture showed a significant decrease compared with the control group for MSQ scores (p=0.04) and PSQI (p=0.006). After treatment, 75% students in the electroacupuncture group presented a good sleep quality, compared with 23.1% of the students in the control group. No significant difference on daytime sleepiness was shown by the ESS. The electroacupuncture group showed significant improvement on depressive symptoms (BDI), the emotional exhaustion and cynicism dimensions of burnout (MBI-SS) and physical health (WHOQOL-bref). Electroacupuncture was associated with a significant reduction of stress-related symptoms, but because of the study design the authors cannot say what proportion of the reduction was due to needle stimulation.

Sleep disturbances and health-related quality of life in adults with steady-state bronchiectasis.

PubMed

Gao, Yonghua; Guan, Weijie; Xu, Gang; Lin, Zhiya; Tang, Yan; Lin, Zhimin; Li, Huimin; Gao, Yang; Luo, Qun; Zhong, Nanshan; Chen, Rongchang

2014-01-01

Sleep disturbances are common in patients with chronic lung diseases, but little is known about the prevalence in patients with bronchiectasis. A cross sectional study was conducted to investigate the prevalence and determinants associated with sleep disturbances, and the correlation between sleep disturbances and quality of life (QoL) in adults with steady-state bronchiectasis. One hundred and forty-four bronchiectasis patients and eighty healthy subjects were enrolled. Sleep disturbances, daytime sleepiness, and QoL were measured by utilizing the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and St. George Respiratory Questionnaire (SGRQ), respectively. Demographic, clinical indices, radiology, spirometry, bacteriology, anxiety and depression were also assessed. Adults with steady-state bronchiectasis had a higher prevalence of sleep disturbances (PSQI>5) (57% vs. 29%, P<0.001), but not daytime sleepiness (ESS≥10) (32% vs. 30%, P = 0.76), compared with healthy subjects. In the multivariate model, determinants associated with sleep disturbances in bronchiectasis patients included depression (OR, 10.09; 95% CI, 3.46-29.37; P<0.001), nocturnal cough (OR, 1.89; 95% CI, 1.13-3.18; P = 0.016), aging (OR, 1.04; 95% CI, 1.01-1.07; P = 0.009) and increased 24-hour sputum volume (OR, 2.01; 95% CI, 1.22-3.33; P = 0.006). Patients with sleep disturbances had more significantly impaired QoL affecting all domains than those without. Only 6.2% of patients reported using a sleep medication at least weekly. In adults with steady-state bronchiectasis, sleep disturbances are more common than in healthy subjects and are related to poorer QoL. Determinants associated with sleep disturbances include depression, aging, nighttime cough and increased sputum volume. Assessment and intervention of sleep disturbances are warranted and may improve QoL.

Sleep and Depression in Postpartum Women: A Population-Based Study

PubMed Central

Dørheim, Signe Karen; Bondevik, Gunnar Tschudi; Eberhard-Gran, Malin; Bjorvatn, Bjørn

2009-01-01

Study Objectives: (1) To describe the prevalence of and risk factors for postpartum maternal sleep problems and depressive symptoms simultaneously, (2) identify factors independently associated with either condition, and (3) explore associations between specific postpartum sleep components and depression. Design: Cross-sectional. Setting: Population-based. Participants: All women (n = 4191) who had delivered at Stavanger University Hospital from October 2005 to September 2006 were mailed a questionnaire seven weeks postpartum. The response rate was 68% (n = 2830). Interventions: None. Measurements and results: Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI), and depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS). The prevalence of sleep problems, defined as PSQI > 5, was 57.7%, and the prevalence of depression, defined as EPDS ≥ 10, was 16.5%. The mean self-reported nightly sleep duration was 6.5 hours and sleep efficiency 73%. Depression, previous sleep problems, being primiparous, not exclusively breastfeeding, or having a younger or male infant were factors associated with poor postpartum sleep quality. Poor sleep was also associated with depression when adjusted for other significant risk factors for depression, such as poor partner relationship, previous depression, depression during pregnancy and stressful life events. Sleep disturbances and subjective sleep quality were the aspects of sleep most strongly associated with depression. Conclusions: Poor sleep was associated with depression independently of other risk factors. Poor sleep may increase the risk of depression in some women, but as previously known risk factors were also associated, mothers diagnosed with postpartum depression are not merely reporting symptoms of chronic sleep deprivation. Citation: Dørheim SK; Bondevik GT; Eberhard-Gran M; Bjorvatn B. Sleep and depression in postpartum women: a population-based study. SLEEP 2009;32(7):847-855. PMID:19639747

Sleep problems in university students – an intervention

PubMed Central

Schlarb, Angelika Anita; Friedrich, Anja; Claßen, Merle

2017-01-01

Introduction Up to 60% of all college students suffer from a poor sleep quality, and 7.7% meet all criteria of an insomnia disorder. Sleep problems have a great impact on the students’ daily life, for example, the grade point average. Due to irregular daytime routines, chronotype changes, side jobs and exam periods, they need specialized treatments for improving sleep. “Studieren wie im Schlaf” (SWIS; (studying in your sleep)) is a multicomponent sleep training that combines Cognitive Behavioral Therapy for Insomnia and Hypnotherapy for Insomnia to improve students’ sleep, insomnia symptoms and nightmares. The aim of the present study is to evaluate the acceptance, feasibility and the first effects of SWIS. Methods Twenty-seven students (mean =24.24, standard deviation =3.57) participated in a study of pre–post design. The acceptance and feasibility were measured with questionnaires. In addition, the Pittsburgh Sleep Quality Index (PSQI), sleep logs and actigraphy were implemented. Further variables encompassed daytime sleepiness, sleep-related personality traits and cognitions about sleep. Results Seventy-four percent of the participants reported symptoms of an insomnia disorder, and 51.9% fulfilled all criteria of an insomnia disorder according to the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). Correspondingly, the students suffered from clinically relevant sleep problems according to the PSQI. The SWIS sleep training is a well-accepted and feasible program. Significant improvements were observed in the subjective sleep quality and sleep-related personality traits, as well as clinical improvements in objective sleep measures. Discussion Findings showed that SWIS is a feasible program for the treatment of sleep problems in college and university students due to its various effects on sleep and cognitive outcomes. Further evaluation of follow-up measurements and additional variables, that is, cognitive performance and mental health, is needed. PMID:28794633

Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.

PubMed

Fiz, Jimena; Durán, Marta; Capellà, Dolors; Carbonell, Jordi; Farré, Magí

2011-04-21

The aim of this study was to describe the patterns of cannabis use and the associated benefits reported by patients with fibromyalgia (FM) who were consumers of this drug. In addition, the quality of life of FM patients who consumed cannabis was compared with FM subjects who were not cannabis users. Information on medicinal cannabis use was recorded on a specific questionnaire as well as perceived benefits of cannabis on a range of symptoms using standard 100-mm visual analogue scales (VAS). Cannabis users and non-users completed the Fibromyalgia Impact Questionnaire (FIQ), the Pittsburgh Sleep Quality Index (PSQI) and the Short Form 36 Health Survey (SF-36). Twenty-eight FM patients who were cannabis users and 28 non-users were included in the study. Demographics and clinical variables were similar in both groups. Cannabis users referred different duration of drug consumption; the route of administration was smoking (54%), oral (46%) and combined (43%). The amount and frequency of cannabis use were also different among patients. After 2 hours of cannabis use, VAS scores showed a statistically significant (p<0.001) reduction of pain and stiffness, enhancement of relaxation, and an increase in somnolence and feeling of well being. The mental health component summary score of the SF-36 was significantly higher (p<0.05) in cannabis users than in non-users. No significant differences were found in the other SF-36 domains, in the FIQ and the PSQI. The use of cannabis was associated with beneficial effects on some FM symptoms. Further studies on the usefulness of cannabinoids in FM patients as well as cannabinoid system involvement in the pathophysiology of this condition are warranted.

The ipRGC-Driven Pupil Response with Light Exposure, Refractive Error, and Sleep.

PubMed

Abbott, Kaleb S; Queener, Hope M; Ostrin, Lisa A

2018-04-01

We investigated links between the intrinsically photosensitive retinal ganglion cells, light exposure, refractive error, and sleep. Results showed that morning melatonin was associated with light exposure, with modest differences in sleep quality between myopes and emmetropes. Findings suggest a complex relationship between light exposure and these physiological processes. Intrinsically photosensitive retinal ganglion cells (ipRGCs) signal environmental light, with pathways to the midbrain to control pupil size and circadian rhythm. Evidence suggests that light exposure plays a role in refractive error development. Our goal was to investigate links between light exposure, ipRGCs, refractive error, and sleep. Fifty subjects, aged 17-40, participated (19 emmetropes and 31 myopes). A subset of subjects (n = 24) wore an Actiwatch Spectrum for 1 week. The Pittsburgh Sleep Quality Index (PSQI) was administered, and saliva samples were collected for melatonin analysis. The post-illumination pupil response (PIPR) to 1 s and 5 s long- and short-wavelength stimuli was measured. Pupil metrics included the 6 s and 30 s PIPR and early and late area under the curve. Subjects spent 104.8 ± 46.6 min outdoors per day over the previous week. Morning melatonin concentration (6.9 ± 3.5 pg/ml) was significantly associated with time outdoors and objectively measured light exposure (P = .01 and .002, respectively). Pupil metrics were not significantly associated with light exposure or refractive error. PSQI scores indicated good sleep quality for emmetropes (score 4.2 ± 2.3) and poor sleep quality for myopes (5.6 ± 2.2, P = .04). We found that light exposure and time outdoors influenced morning melatonin concentration. No differences in melatonin or the ipRGC-driven pupil response were observed between refractive error groups, although myopes exhibited poor sleep quality compared to emmetropes. Findings suggest that a complex relationship between light exposure, ipRGCs, refractive error, and sleep exists.

Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS): reliability, initial validity and normative scores in higher education students.

PubMed

Allen Gomes, Ana; Ruivo Marques, Daniel; Meia-Via, Ana Maria; Meia-Via, Mariana; Tavares, José; Fernandes da Silva, Carlos; Pinto de Azevedo, Maria Helena

2015-04-01

Based on successive samples totaling more than 5000 higher education students, we scrutinized the reliability, structure, initial validity and normative scores of a brief self-report seven-item scale to screen for the continuum of nighttime insomnia complaints/perceived sleep quality, used by our team for more than a decade, henceforth labeled the Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS). In study/sample 1 (n = 1654), the items were developed based on part of a larger survey on higher education sleep-wake patterns. The test-retest study was conducted in an independent small group (n = 33) with a 2-8 week gap. In study/sample 2 (n = 360), focused mainly on validity, the BaSIQS was completed together with the Pittsburgh Sleep Quality Index (PSQI). In study 3, a large recent sample of students from universities all over the country (n = 2995) answered the BaSIQS items, based on which normative scores were determined, and an additional question on perceived sleep problems in order to further analyze the scale's validity. Regarding reliability, Cronbach alpha coefficients were systematically higher than 0.7, and the test-retest correlation coefficient was greater than 0.8. Structure analyses revealed consistently satisfactory two-factor and single-factor solutions. Concerning validity analyses, BaSIQS scores were significantly correlated with PSQI component scores and overall score (r = 0.652 corresponding to a large association); mean scores were significantly higher in those students classifying themselves as having sleep problems (p < 0.0001, d = 0.99 corresponding to a large effect size). In conclusion, the BaSIQS is very easy to administer, and appears to be a reliable and valid scale in higher education students. It might be a convenient short tool in research and applied settings to rapidly assess sleep quality or screen for insomnia complaints, and it may be easily used in other populations with minor adaptations.

Effect of non-alcoholic beer on Subjective Sleep Quality in a university stressed population.

PubMed

Franco, L; Bravo, R; Galán, C; Rodríguez, A B; Barriga, C; Cubero, Javier

2014-09-01

Sleep deprivation affects the homeostasis of the physiological functions in the human organism. Beer is the only beverage that contains hops, a plant which has a sedative effect. Our objective is to determine the improvement of subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI). The sample was conducted among a population of 30 university students. The study took place during a period of 3 weeks, the first 7 days were used for the Control, and during the following 14 days the students ingested beer (were asked to drink non-alcoholic beer) while having dinner. The results revealed that Subjective Sleep Quality improved in the case of those students who drank one beer during dinner compared to the Control, this is corroborated by the fact that Sleep Latency decreased (p < 0.05) compared to their Control. The overall rating Global Score of Quality of Sleep also improved significantly (p < 0.05). These results confirm that the consumption of non-alcoholic beer at dinner time helps to improve the quality of sleep at night.

How are age-related differences in sleep quality associated with health outcomes? An epidemiological investigation in a UK cohort of 2406 adults

PubMed Central

Gadie, Andrew; Shafto, Meredith; Leng, Yue

2017-01-01

Objectives To examine age-related differences in self-reported sleep quality and their associations with health outcomes across four domains: physical health, cognitive health, mental health and neural health. Setting Cambridge Centre for Ageing and Neuroscience (Cam-CAN) is a cohort study in East Anglia/England, which collected self-reported health and lifestyle questions as well as a range of objective measures from healthy adults. Participants 2406 healthy adults (age 18–98) answered questions about their sleep quality (Pittsburgh Sleep Quality Index (PSQI)) and measures of physical, cognitive, mental and neural health. A subset of 641 individuals provided measures of brain structure. Main outcome measures PSQI scores of sleep and scores across tests within the four domains of health. Latent class analysis (LCA) is used to identify sleep types across the lifespan. Bayesian regressions quantify the presence, and absence, of relationships between sleep quality and health measures. Results Better self-reported sleep is generally associated with better health outcomes, strongly so for mental health, moderately for cognitive and physical health, but not for sleep quality and neural health. LCA identified four sleep types: ‘good sleepers’ (68.1%, most frequent in middle age), ‘inefficient sleepers’ (14.01%, most frequent in old age), ‘delayed sleepers’ (9.28%, most frequent in young adults) and ‘poor sleepers’ (8.5%, most frequent in old age). There is little evidence for interactions between sleep quality and age on health outcomes. Finally, we observe U-shaped associations between sleep duration and mental health (depression and anxiety) as well as self-reported general health, such that both short and long sleep were associated with poorer outcomes. Conclusions Lifespan changes in sleep quality are multifaceted and not captured well by summary measures, but instead should be viewed as as partially independent symptoms that vary in prevalence across the lifespan. Better self-reported sleep is associated with better health outcomes, and the strength of these associations differs across health domains. Notably, we do not observe associations between self-reported sleep quality and white matter. PMID:28760786

Effect of acupuncture on patients with insomnia: study protocol for a randomized controlled trial.

PubMed

Han, Kyung-Hun; Kim, Sang-Young; Chung, Sun-Yong

2014-10-23

Hypnotic drugs tend to be the dominant form of treatment of insomnia, but these come with a number of reported side effects. Acupuncture has been studied as an alternative, resulting in a rising need for methodological research towards verifying its efficacy as insomnia treatment. We describe a proposal for a single-center, patient-assessor-blinded, randomized controlled trial with two parallel arms. A total of 38 patients complete screening tests at the first visit, are registered into the clinical trial, and then randomly assigned to the experimental or sham control groups (19 patients for each group). All subjects are clinical insomnia patients who score a 6 or above on the Pittsburgh Sleep Quality Index (PSQI) and meet all inclusion criteria. All subjects are treated with acupuncture and intradermal acupuncture (IDA) three times during the first week. Five sham acupoints are used in the control group. In the experimental group, five real acupoints (PC6, SP6, HT7, KI6, and BL62) are used unilaterally in turn. Sham acupoints are over 1 cm away from each real acupoint.The primary outcomes are the scores on the Insomnia Severity Index (ISI) and PSQI. Secondary outcomes are the sleep log, the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the World Health Organization Quality of Life Abbreviated Version (WHOQOL-BREF), the Korean-Auditory Verbal Learning Test (K-AVLT), the Digit Span Test (DS), Event Related Potentials (ERPs) and heart rate variability (HRV) to assess emotional states, sleep quality, cognitive functioning, and electro-physiological changes.Subjects are assessed at three time points: baseline, post-treatment and follow-up. The duration of the clinical trial is 18 days. To study the enhancement of the effectiveness of acupuncture for insomnia, we test the intradermal acupuncture method, which is performed continuously on the subject's skin and stimulated at home by the subject every night. In the trial, objective measurements including ERPs and HRV are used to evaluate states of cognition and autonomic nervous system functioning and subjective self-report questionnaires assess insomnia symptoms.'Sham' acupuncture points provided by STRICTA are used for the control group. ClinicalTrials.gov: NCT01956760, registered 5 September 2013.

More daytime sleeping predicts less functional recovery among older people undergoing inpatient post-acute rehabilitation.

PubMed

Alessi, Cathy A; Martin, Jennifer L; Webber, Adam P; Alam, Tarannum; Littner, Michael R; Harker, Judith O; Josephson, Karen R

2008-09-01

To study the association between sleep/wake patterns among older adults during inpatient post-acute rehabilitation and their immediate and long-term functional recovery Prospective, observational cohort study. Two inpatient post-acute rehabilitation sites (one community and one Veterans Administration). Older patients (aged > or = 65 years, N = 245) admitted for inpatient post-acute rehabilitation. None. Based on 7-day wrist actigraphy during the rehabilitation stay, mean nighttime percent sleep was only 52.2% and mean daytime percent sleep was 15.8% (16.3% based on structured behavioral observations). Using the Pittsburgh Sleep Quality Index (PSQI), participants reported their sleep was worse during rehabilitation compared to their premorbid sleep. Functional recovery between admission and discharge from rehabilitation (measured by the motor component of the Functional Independence Measure) was not significantly associated with reported sleep quality (PSQI scores) or actigraphically measured nighttime sleep. However, more daytime percent sleep (estimated by actigraphy and observations) during the rehabilitation stay was associated with less functional recovery from admission to discharge, even after adjusting for other significant predictors of functional recovery (mental status, hours of rehabilitation therapy received, rehospitalization, and reason for admission; adjusted R2= 0.267, P < 0.0001). More daytime sleeping during rehabilitation remained a significant predictor of less functional recovery in adjusted analyses at 3-month follow-up. Sleep disturbance is common among older people undergoing inpatient post-acute rehabilitation. These data suggest that more daytime sleeping during the rehabilitation stay is associated with less functional recovery for up to three months after admission for rehabilitation.

Do Magnetic Resonance Imaging Characteristics of Full-Thickness Rotator Cuff Tears Correlate With Sleep Disturbance?

PubMed

Reyes, Bryan A; Hull, Brandon R; Kurth, Alexander B; Kukowski, Nathan R; Mulligan, Edward P; Khazzam, Michael S

2017-11-01

Many patients with rotator cuff tears suffer from nocturnal shoulder pain, resulting in sleep disturbance. To determine whether rotator cuff tear size correlated with sleep disturbance in patients with full-thickness rotator cuff tears. Cross-sectional study; Level of evidence, 3. Patients with a diagnosis of unilateral full-thickness rotator cuff tears (diagnosed via magnetic resonance imaging [MRI]) completed the Pittsburgh Sleep Quality Index (PSQI), a visual analog scale (VAS) quantifying their shoulder pain, and the American Shoulder and Elbow Surgeons (ASES) questionnaire. Shoulder MRI scans were analyzed for anterior-posterior tear size (mm), tendon retraction (mm), Goutallier grade (0-4), number of tendons involved (1-4), muscle atrophy (none, mild, moderate, or severe), and humeral head rise (present or absent). Bivariate correlations were calculated between the MRI characteristics and baseline survey results. A total of 209 patients with unilateral full-thickness rotator cuff tears were included in this study: 112 (54%) female and 97 (46%) male (mean age, 64.1 years). On average, shoulder pain had been present for 24 months. The mean PSQI score was 9.8, and the mean VAS score was 5.0. No significant correlations were found between any of the rotator cuff tear characteristics and sleep quality. Only tendon retraction had a significant correlation with pain. Although rotator cuff tears are frequently associated with nocturnal pain and sleep disruption, this study demonstrated that morphological characteristics of full-thickness rotator cuff tears, such as size and tendon retraction, do not correlate with sleep disturbance and have little to no correlation with pain levels.

Sleep quality, morningness-eveningness preference, mood profile, and levels of serum melatonin in migraine patients: a case-control study.

PubMed

Kozak, Hasan Hüseyin; Boysan, Murat; Uca, Ali Ulvi; Aydın, Adem; Kılınç, İbrahim; Genç, Emine; Altaş, Mustafa; Güngör, Dilara Cari; Turgut, Keziban; Özer, Nejla

2017-03-01

The melatonin as the pineal gland's secretory product is implicated in the pathophysiology of migraine. Melatonin has critical functions in human physiology, and research underscores the importance of melatonin in circadian rhythm, sleep, and mood regulation. Clinical observations have indicated that migraine attacks have a seasonal, menstrual, and circadian timing, suggesting that chronobiological mechanisms and their alterations may causally involve in the etiology of the disease. However, the topic has received relatively little attention in the migraine literature. Associations between melatonin, circadian preference, sleep, and mood states were investigated in the current study. Fifty-five patients (47 females and 8 males) were compared to 57 gender and age-matched control subjects (40 females and 17 males). A socio-demographical questionnaire, the Beck Depression Inventory, Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), Profile of Mood States (POMS), and Morningness-Eveningness Questionnaire were administered to volunteers. Blood samples were taken from all participants at about 1:00 AM in an unlit room not to hamper melatonin secretion, and blood melatonin levels were measured using quantitative ELISA test. In comparison with controls, melatonin levels were significantly lower among migraine patients. Migraineurs reported significantly greater scores on the BAI, confusion-bewilderment subscale of the POMS, and total and sleep latency subscale of the PSQI. Migraine patients who had nausea during the migraine attacks and who reported bouts relevant to certain food consumption, such as cheese or chocolate, had significantly lower levels of melatonin. Contrarily, groups did not reveal statistically substantial difference in circadian preferences.

Rotigotine may improve sleep architecture in Parkinson's disease: a double-blind, randomized, placebo-controlled polysomnographic study.

PubMed

Pierantozzi, Mariangela; Placidi, Fabio; Liguori, Claudio; Albanese, Maria; Imbriani, Paola; Marciani, Maria Grazia; Mercuri, Nicola Biagio; Stanzione, Paolo; Stefani, Alessandro

2016-05-01

Growing evidence demonstrates that in Parkinson's Disease (PD) sleep disturbances are frequent and difficult to treat. Since the efficacy of rotigotine on sleep is corroborated by studies lacking polysomnography (PSG), this study explores the possible rotigotine-mediated impact on PSG parameters in PD patients. This is a randomized, double-blind, placebo-controlled, parallel-group study to determine the efficacy of rotigotine vs placebo on PSG parameters in moderately advanced PD patients. An unusual protocol was utilized, since patches were maintained from 18:00 h to awakening, minimizing the possible diurnal impact on motor symptoms. All participants underwent sleep PSG recordings, subjective sleep questionnaires (Parkinson Disease Sleep Scale [PDSS], Pittsburgh Sleep Quality Index [PSQI]), and the assessment of early-morning motor disability. We evaluated 42 PD patients (Hoehn & Yahr stages 2 and 3) with sleep impairment randomly assigned to active branch (N =21) or placebo (N = 21). Rotigotine significantly increased sleep efficiency and reduced both wakefulness after sleep onset and sleep latency compared to placebo. Moreover, the mean change in REM sleep quantity was significantly higher in the rotigotine than placebo group. The improvement of PSG parameters corresponded to the amelioration of PDSS and PSQI scores together with the improvement of patient morning motor symptoms. This study demonstrated the significant effect of rotigotine on sleep quality and continuity in PD patients by promoting sleep stability and increasing REM. The effectiveness of rotigotine on sleep may be ascribed to its pharmacokinetic/pharmacodynamic profile directly on both D1 and D2 receptors. Copyright © 2016 Elsevier B.V. All rights reserved.

Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors.

PubMed

Singh, Rupali; Teel, Cynthia; Sabus, Carla; McGinnis, Patricia; Kluding, Patricia

2016-01-01

Fatigue is a persistent symptom, impacting quality of life (QoL) and functional status in people with type 2 diabetes, yet the symptom of fatigue has not been fully explored. The purpose of this study was to explore the relationship between fatigue, QoL functional status and to investigate the predictors of fatigue. These possible predictors included body mass index (BMI), Hemoglobin A1C (HbA1C), sleep quality, pain, number of complications from diabetes, years since diagnosis and depression. Forty-eight individuals with type 2 diabetes (22 females, 26 males; 59.66±7.24 years of age; 10.45 ±7.38 years since diagnosis) participated in the study. Fatigue was assessed by using Multidimensional Fatigue Inventory (MFI-20). Other outcomes included: QoL (Audit of Diabetes Dependent QoL), and functional status (6 minute walk test), BMI, HbA1c, sleep (Pittsburg sleep quality index, PSQI), pain (Visual Analog Scale), number of complications, years since diagnosis, and depression (Beck's depression Inventory-2). The Pearson correlation analysis followed by multivariable linear regression model was used. Fatigue was negatively related to quality of life and functional status. Multivariable linear regression analysis revealed sleep, pain and BMI as the independent predictors of fatigue signaling the presence of physiological (sleep, pain, BMI) phenomenon that could undermine health outcomes.

Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors

PubMed Central

Teel, Cynthia; Sabus, Carla; McGinnis, Patricia; Kluding, Patricia

2016-01-01

Fatigue is a persistent symptom, impacting quality of life (QoL) and functional status in people with type 2 diabetes, yet the symptom of fatigue has not been fully explored. The purpose of this study was to explore the relationship between fatigue, QoL functional status and to investigate the predictors of fatigue. These possible predictors included body mass index (BMI), Hemoglobin A1C (HbA1C), sleep quality, pain, number of complications from diabetes, years since diagnosis and depression. Forty-eight individuals with type 2 diabetes (22 females, 26 males; 59.66±7.24 years of age; 10.45 ±7.38 years since diagnosis) participated in the study. Fatigue was assessed by using Multidimensional Fatigue Inventory (MFI-20). Other outcomes included: QoL (Audit of Diabetes Dependent QoL), and functional status (6 minute walk test), BMI, HbA1c, sleep (Pittsburg sleep quality index, PSQI), pain (Visual Analog Scale), number of complications, years since diagnosis, and depression (Beck’s depression Inventory-2). The Pearson correlation analysis followed by multivariable linear regression model was used. Fatigue was negatively related to quality of life and functional status. Multivariable linear regression analysis revealed sleep, pain and BMI as the independent predictors of fatigue signaling the presence of physiological (sleep, pain, BMI) phenomenon that could undermine health outcomes. PMID:27824886

The evaluation in terms of sarcopenia of patients with fibromyalgia syndrome.

PubMed

Koca, Irfan; Savas, Esen; Ozturk, Zeynel Abidin; Boyaci, Ahmet; Tutoglu, Ahmet; Alkan, Samet; Yildiz, Hamit; Kimyon, Gezmiş

2016-11-01

Fibromyalgia syndrome (FMS) is an extra-articular rheumatic illness, characterized by widespread body pain and decreased muscle function. Generalized loss of muscle mass and strength is named as sarcopenia. The objective of this study was to evaluate patients with FMS regarding sarcopenia. This was a cross sectional, case-controlled, single-blinded, and single-centered study. The FMS patients were assessed by Fibromyalgia Impact Questionnaire (FIQ), visual analog scale (VAS), Beck Depression Index (BDI), and Pittsburg Sleep Quality Scale (PSQI). All the participants were evaluated for sarcopenia by bioimpedance analysis (BIA), anthropometric measurements, handgrip strength, and the parameters of walking speed. In this study, 82 patients with FMS and 38 healthy control female subjects were included. VAS, BDI, and PSQI scores were statistically higher in the FMS group than the control group (p < 0.001). Handgrip strength (HS) and walking speed (WS) scores in the group with FMS were statistically lower than the control group (p = 0.023, p < 0.001 respectively). VAS score of FMS patients was significantly correlated with BIA, body mass index, waist circumference, HS, and WS scores (r = 0.284, p = 0.012; r = 0.228, p = 0.045; r = 0.249, p = 0.028; r = - 0.361, p = 0.001; and r = - 0.230, p = 0.043 respectively). Also FIQ in patients was significantly correlated with BIA, waist circumference, HS, WS, and body mass index (r = 0.267, p = 0.018; r = 0.291, p = 0.010; r = - 0.319, p = 0.004; r = - 0.360, p = 0.001; and r  = 0.304, p = 0.007 respectively). Evaluation of female patients with primary FMS by the sarcopenia parameters could contribute a more objective evaluation during the patients' follow-up.

Are there associations between sleep bruxism, chronic stress, and sleep quality?

PubMed

Ohlmann, Brigitte; Bömicke, Wolfgang; Habibi, Yasamin; Rammelsberg, Peter; Schmitter, Marc

2018-07-01

The purpose of this study was to identify associations between definite sleep bruxism, as defined by the American academy of sleep medicine, and chronic stress and sleep quality. Sleep bruxism was determined by use of questionnaires, assessment of clinical symptoms, and recording of electromyographic and electrocardiographic data (recorded by the Bruxoff ® device). The study included 67 participants. Of these, 38 were identified as bruxers and 29 as non-bruxers. The 38 bruxers were further classified as 17 moderate and 21 intense bruxers. Self-reported stress and self-reported sleep quality were determined by use of the validated questionnaires "Trier Inventory for the Assessment of Chronic Stress" (TICS) and the "Pittsburgh Sleep Quality Index" (PSQI). No statistically significant association was found between sleep bruxism and self-reported stress or sleep quality. However, a significant association between specific items of chronic stress and poor sleep quality was identified. The results of this study indicate an association between subjective sleep quality and subjective chronic stress, irrespective of the presence or absence of sleep bruxism. Chronic stress and sleep quality do not seem to be associated with sleep bruxism. (clinical trial no. NCT03039985). Copyright © 2018 Elsevier Ltd. All rights reserved.

Self-Monitoring vs. Implementation Intentions: a Comparison of Behaviour Change Techniques to Improve Sleep Hygiene and Sleep Outcomes in Students.

PubMed

Mairs, Lucinda; Mullan, Barbara

2015-10-01

This study seeks to investigate and compare the efficacy of self-monitoring and implementation intentions-two post-intentional behaviour change techniques-for improving sleep hygiene behaviours and sleep outcomes in university students. Seventy-two undergraduate students completed baseline measures of four sleep hygiene behaviours (making the sleep environment restful, avoiding going to bed hungry/thirsty, avoiding stress/anxiety-provoking activities near bed time and avoiding caffeine in the evening), as well as the Pittsburgh sleep quality index (PSQI) and the insomnia severity index (ISI). Participants were randomly assigned to an active-control diary-keeping, self-monitoring condition or completed implementation intentions for each behaviour. Post-intervention measurement was completed 2 weeks after baseline. Repeated measures analyses of variance found significant main effects of time for improvements in making the sleep environment restful and avoiding going to bed hungry or thirsty, as well as PSQI and ISI scores. Non-significant interactions suggested no group differences on any variable, except for increasing avoidance of stress and anxiety-provoking activities before bed time, for which only implementation intentions were found to be effective. Attrition was higher amongst self-monitoring participants. Both self-monitoring and implementation intentions appear to be promising behaviour change techniques for improving sleep hygiene and sleep. Future research should examine the acceptability of the two behaviour change techniques and the relationship with differential attrition, as well as effect size variations according to behaviour and technique. Researchers should investigate potential additive or interactive effects of the techniques, as they could be utilised in a complementary manner to target different processes in effecting behaviour change.

Mindfulness-based stress reduction versus pharmacotherapy for chronic primary insomnia: a randomized controlled clinical trial.

PubMed

Gross, Cynthia R; Kreitzer, Mary Jo; Reilly-Spong, Maryanne; Wall, Melanie; Winbush, Nicole Y; Patterson, Robert; Mahowald, Mark; Cramer-Bornemann, Michel

2011-01-01

The aim of this study was to investigate the potential of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia. A randomized controlled trial was conducted. The study was conducted at a university health center. Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th Edition were randomized 2:1 to MBSR or pharmacotherapy (PCT). Mindfulness-based stress reduction, a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat, was provided, with ongoing home meditation practice expectations during three-month follow-up; PCT, consisting of three milligrams of eszopiclone (LUNESTA) nightly for eight weeks, followed by three months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions. The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy were collected pretreatment, posttreatment (eight weeks), and at five months (self-reports only). Between baseline and eight weeks, sleep onset latency (SOL) measured by actigraphy decreased 8.9 minutes in the MBSR arm (P < .05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, SOL, and sleep efficiency (P < .01, all) from baseline to five-month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. Twenty-seven of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by sleep diary, actigraphy, well-validated sleep scales, and measures of remission and clinical recovery. Copyright © 2011 Elsevier Inc. All rights reserved.

Sleep Pattern, Duration and Quality in Relation with Glycemic Control in People with Type 2 Diabetes Mellitus.

PubMed

Gozashti, Mohammad Hossein; Eslami, Nazanin; Radfar, Mohammad Hadi; Pakmanesh, Hamid

2016-11-01

Sleep disturbances have been shown to be associated with diabetes control, but the relation between planned wakings or napping with glycemic indices has not been evaluated yet. This study evaluated the relation between sleep quality, duration, and pattern, including daytime napping of people with diabetes and their glycemic control. A cross-sectional correlation research design was used for this study. We enrolled 118 people with type 2 diabetes receiving oral agents without major complications at the Shahid Bahonar Center, Kerman. The age, weight, height, serum HbA1c, as well as other glycemic indices and lipid profile were measured. BMI was also calculated. All participants were requested to fill in the Pittsburgh Sleep Quality Index (PSQI) questionnaire to evaluate their sleep quality. In addition, they were inquired about their sleep schedule during day and night. Pearson correlation and multiple regression analyses were conducted to examine the correlation between HbA1c and sleep pattern variables. The variables were also compared between participants with or without napping using t-test. All analyses were performed with the SPSS version 19 (SPSS, Chicago, IL, USA). The mean age was 58±11 years and mean HbA1c (%) was 7.8±11 (62±13 mmol/mol). Sleep duration and the number of sleep segments significantly predicted HbA1c (F (2,114)=5.232, P=0.007, R2=0.084). A one-hour increment in sleep duration was associated with a 0.174% (1.4 mmol/mol) decrement in HbA1c. PSQI score did not contribute to the regression model. Moreover, participants who napped (66%) had a lower HbA1c (7.6±1) compared to others (8.1±1.3) (P=0.04). We concluded that napping and segmented sleep are associated with a better glycemic control in type 2 diabetes and there is a linear correlation between sleep duration and better glycemic control.

Habitual sleep quality and diurnal rhythms of salivary cortisol and dehydroepiandrosterone in postmenopausal women.

PubMed

Huang, Tianyi; Poole, Elizabeth M; Vetter, Celine; Rexrode, Kathryn M; Kubzansky, Laura D; Schernhammer, Eva; Rohleder, Nicolas; Hu, Frank B; Redline, Susan; Tworoger, Shelley S

2017-10-01

Dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis has been suggested as a potential mechanism linking sleep and cardiometabolic disorders. However, the associations of two primary outputs of the HPA axis, cortisol and its antagonist dehydroepiandrosterone (DHEA), with sleep are less well studied. In the Nurses' Health Study II, 233 postmenopausal women provided five timed saliva samples over one day (immediately upon waking, 45min, 4h, and 10h after waking, and prior to going to sleep) to measure cortisol and DHEA. Of these, 209 completed assessment of their habitual sleep patterns using the Pittsburgh Sleep Quality Index (PSQI). We used piecewise linear mixed models to compare cross-sectional associations of slopes reflecting diurnal cortisol and DHEA rhythms with overall sleep quality and with seven sub-components. Overall, we observed no differences in the diurnal patterns of cortisol or DHEA between good versus poor sleepers as assessed by the global PSQI score. However, longer sleep latency was associated with significantly reduced cortisol awakening rise (p=0.02). Poorer subjective sleep quality (p=0.02), shorter sleep duration (p=0.02), and lower sleep efficiency (p=0.03) were associated with slower rate of cortisol decline later in the day. Women reporting daytime dysfunction had a sharper cortisol decline early in the day (p=0.03) but a flattened decline later in the day (p=0.01). The differences in diurnal patterns of DHEA between good versus poor sleepers, though less pronounced, were similar in direction to those of cortisol. Self-reported sleep duration, efficiency, latency and daytime dysfunction were associated with altered diurnal rhythms of cortisol and, to a lesser extent, DHEA. These findings provide support for the interplay between sleep and the HPA axis that may contribute to cardiometabolic disease. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

PubMed Central

Lind, Mackenzie J.; Brown, Emily; Farrell-Carnahan, Leah; Brown, Ruth C.; Hawn, Sage; Berenz, Erin; McDonald, Scott; Pickett, Treven; Danielson, Carla Kmett; Thomas, Suzanne; Amstadter, Ananda B.

2017-01-01

Study Objectives: Sleep disturbances are well documented in relation to trauma exposure and posttraumatic stress disorder (PTSD), but correlates of such disturbances remain understudied in veteran populations. We conducted a preliminary study of sleep disturbances in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (n = 133; mean [standard deviation] age = 29.8 [4.7] y). Methods: Veterans were assigned to one of three groups based on responses to the Clinician Administered PTSD Scale: control (no trauma-exposure [TE] or PTSD), TE, and PTSD. Sleep disturbance was assessed using the Pittsburgh Sleep Quality Index (PSQI). Measures of resilience, trauma load, personality, coping, alcohol use, and mild traumatic brain injury were also assessed via self-report. Results: The PTSD group had significantly more disturbed sleep (PSQI global score mean = 8.94, standard deviation = 3.12) than control (mean = 5.27, standard deviation = 3.23) and TE (mean = 5.34, standard deviation = 3.17) groups, but there were no differences between TE and control. The same pattern emerged across most PSQI subscales. Results of linear regression analyses indicated that current smoking, Army (versus other military branches), neuroticism, and using substances to cope were all significant correlates of higher sleep disturbance, whereas post-deployment social support was associated with less sleep disturbance. However, when combined together into a model with PTSD status, only neuroticism and substance use coping remained significant as predictors of more disturbed sleep. Conclusions: These initial findings suggest that TE itself may not be an independent risk factor for disturbed sleep in veterans, and that neurotic personality and a tendency to cope by using substances may partially explain sleep disturbance, above and beyond a diagnosis of PTSD. Citation: Lind MJ, Brown E, Farrell-Carnahan L, Brown RC, Hawn S, Berenz E, McDonald S, Pickett T, Danielson CK, Thomas S, Amstadter AB. Sleep disturbances in OEF/OIF/OND veterans: associations with PTSD, personality and coping. J Clin Sleep Med 2017;13(2):291–299. PMID:27998375

Higher sleep reactivity and insomnia mutually aggravate depressive symptoms: a cross-sectional epidemiological study in Japan.

PubMed

Nakajima, Shun; Komada, Yoko; Sasai-Sakuma, Taeko; Okajima, Isa; Harada, Yutaka; Watanabe, Kazue; Inoue, Yuichi

2017-05-01

Sleep reactivity assessed using the Ford Insomnia Response to Stress Test (FIRST) is associated with depression. This study clarified stress reactivity and insomnia effects on depressive symptoms. A cross-sectional questionnaire survey was administered to 2645 participating government employees (35.4% female, mean age 42.8 years) during health checks conducted at Tottori prefecture, Japan, in June 2012. Questionnaire items included: demographic information; the FIRST; the Pittsburgh Sleep Quality Index (PSQI); and a 12-item version of the Center for Epidemiological Studies Depression scale (CES-D). The study defined CES-D scores of ≥12 points as positive for depression, PSQI scores of ≥5.5 points as positive for insomnia symptoms, and FIRST scores of ≥19 points as indicating higher sleep reactivity. Multivariate logistic regression analysis revealed insomnia (adjusted OR = 3.40), higher sleep reactivity (adjusted OR = 1.78), presence of disease currently being treated (adjusted OR = 1.84), and being female (adjusted OR = 1.53) as independently associated with depression. Participants with insomnia and a high FIRST score showed higher CES-D scores than those with insomnia alone and those with high FIRST without insomnia (all p < 0.01). Sleep reactivity might be associated with depression, independent of insomnia. Elevated sleep reactivity and insomnia symptoms are thought to aggravate depressive symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

Patient-reported outcomes and socioeconomic status as predictors of clinical outcomes following hematopoietic stem cell transplantation: A study from the BMT CTN 0902 trial

PubMed Central

Knight, Jennifer M; Syrjala, Karen L; Majhail, Navneet S; Martens, Michael; Le-Rademacher, Jennifer; Logan, Brent R; Lee, Stephanie J; Jacobsen, Paul B; Wood, William A; Jim, Heather SL; Wingard, John R; Horowitz, Mary M; Abidi, Muneer H; Fei, Mingwei; Rawls, Laura; Rizzo, J Douglas

2016-01-01

This secondary analysis of a large, multi-center Blood and Marrow Transplant Clinical Trials Network (BMT CTN) randomized trial assessed whether patient-reported outcomes (PROs) and socioeconomic status (SES) before hematopoietic stem cell transplantation (HCT) are associated with each other and predictive of clinical outcomes including time to hematopoietic recovery, acute graft-versus-host disease, hospitalization days, and overall survival (OS) among 646 allogeneic and autologous HCT recipients. Pre-transplant Cancer and Treatment Distress (CTXD), Pittsburgh Sleep Quality Index (PSQI), and mental and physical component scores (MCS and PCS) of the SF-36 were correlated with each other and with SES variables. PROs and SES variables were further evaluated as predictors of clinical outcomes, with the PSQI and CTXD evaluated as OS predictors (p<.01 considered significant given multiple testing). Lower attained education was associated with increased distress (p=.002); lower income was related to worse physical functioning (p=.005) and increased distress (p=.008); lack of employment pre-transplant was associated with worse physical functioning (p<.01); unmarried status was associated with worse sleep (p=.003). In this large heterogeneous cohort of HCT recipients, while PROs and SES variables were correlated at baseline, they were not associated with any clinical outcomes. Future research should focus on HCT recipients at greater psychosocial disadvantage. PMID:27565521

Association of Calf Muscle Pump Stimulation With Sleep Quality in Adults.

PubMed

Baniak, Lynn M; Pierce, Carolyn S; McLeod, Kenneth J; Chasens, Eileen R

2016-12-01

Prevention of lower extremity fluid pooling (LEFP) is associated with improved sleep quality. Physical activity and compression stockings are non-invasive methods used to manage LEFP, but both are associated with low adherence. Calf muscle pump (CMP) stimulation is an alternative and more convenient approach. Convenience sampling was used to recruit 11 participants between ages 45 and 65 with poor sleep quality. A within-person single-group pre-test-post-test design was used to evaluate changes in sleep quality, daytime sleepiness, and functional outcomes sensitive to impaired sleep as measured by the Pittsburgh Sleep Quality Index (PSQI), Functional Outcomes of Sleep Questionnaire, and Epworth Sleepiness Scale after 4 weeks of CMP stimulation. Statistical analysis included effect size (ES) calculations. After daily use of CMP stimulation, participants demonstrated improvement in overall sleep quality (ES = -.97) and a large reduction in daily disturbance from poor sleep (ES = -1.25). Moderate improvements were observed in daytime sleepiness (ES = -.53) and functional outcomes sensitive to sleepiness (ES = .49). Although causality could not be determined with this study design, these results support further research to determine whether CMP stimulation can improve sleep quality. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A comparison of passive and active estimates of sleep in a cohort with schizophrenia.

PubMed

Staples, Patrick; Torous, John; Barnett, Ian; Carlson, Kenzie; Sandoval, Luis; Keshavan, Matcheri; Onnela, Jukka-Pekka

2017-10-16

Sleep abnormalities are considered an important feature of schizophrenia, yet convenient and reliable sleep monitoring remains a challenge. Smartphones offer a novel solution to capture both self-reported and objective measures of sleep in schizophrenia. In this three-month observational study, 17 subjects with a diagnosis of schizophrenia currently in treatment downloaded Beiwe, a platform for digital phenotyping, on their personal Apple or Android smartphones. Subjects were given tri-weekly ecological momentary assessments (EMAs) on their own smartphones, and passive data including accelerometer, GPS, screen use, and anonymized call and text message logs was continuously collected. We compare the in-clinic assessment of sleep quality, assessed with the Pittsburgh Sleep Questionnaire Inventory (PSQI), to EMAs, as well as sleep estimates based on passively collected accelerometer data. EMAs and passive data classified 85% (11/13) of subjects as exhibiting high or low sleep quality compared to the in-clinic assessments among subjects who completed at least one in-person PSQI. Phone-based accelerometer data used to infer sleep duration was moderately correlated with subject self-assessment of sleep duration (r = 0.69, 95% CI 0.23-0.90). Active and passive phone data predicts concurrent PSQI scores for all subjects with mean average error of 0.75 and future PSQI scores with a mean average error of 1.9, with scores ranging from 0-14. These results suggest sleep monitoring via personal smartphones is feasible for subjects with schizophrenia in a scalable and affordable manner. SMARTPHONES CAN TRACK SCHIZOPHRENIA-RELATED SLEEP ABNORMALITIES: Smartphones may one-day offer accessible, clinically-useful insights into schizophrenia patients' sleep quality. Despite the clinical relevance of sleep to disease severity, monitoring technologies still evade convenience and reliability. In search of a preferential method, a group of Harvard University researchers led by Patrick Staples investigated the validity of data collected via patients' own mobile phones. The team, with a cohort of 17 schizophrenia patients, compared the quality of data produced by smartphone sensors and smartphone-delivered questionnaires to that of an in-clinic evaluation. The results significantly showed that smartphone monitoring could generate information that approached the accuracy of in-clinic assessments. The team noted some areas for improvement; however, this study provides convincing justifications for further research into this non-invasive, low-cost, scalable method to monitor the sleep quality of schizophrenic patients.

Sleep Quality Among Low-Income Young Women in Southeast Texas Predicts Changes in Perceived Stress Through Hurricane Ike.

PubMed

Wu, Zhao Helen; Stevens, Richard G; Tennen, Howard; North, Carol S; Grady, James J; Holzer, Charles

2015-07-01

To document the time course of perceived stress among women through the period of a natural disaster, to determine the effect of sleep quality on this time course, and to identify risk factors that predict higher levels of perceived stress. Longitudinal study from 2006-2012. Community-based family planning clinics in southeast Texas. There were 296 women aged 18-31 y who experienced Hurricane Ike, September 2008. Cohen Perceived Stress Scale (PSS) was administered every 2 mo from 6 mo before to 12 mo after Hurricane Ike. Sleep quality was assessed 1 mo after Hurricane Ike using the Pittsburg Sleep Quality Index (PSQI). Good sleep was defined as a PSQI summary score < 5, and poor sleep as a score ≥ 5. Hurricane Ike stressors (e.g., property damage, subjective stressors) and pre-Ike lifetime major life events and emotional health (e.g., emotional dysregulation, self-control) were also assessed. Over the entire period of 18 mo (6 mo before and 12 mo after the hurricane), perceived stress was significantly higher among poor sleepers compared to good sleepers, and only good sleepers showed a significant decrease in perceived stress after Hurricane Ike. In addition, a higher level of perceived stress was positively associated with greater Ike damage among poor sleepers, whereas this correlation was not observed among good sleepers. In the final multivariate longitudinal model, Ike-related subjective stressors as well as baseline major life events and emotional dysregulation among poor sleepers predicted higher levels of perceived stress over time; among good sleepers, additional factors such as lower levels of self-control and having a history of a psychiatric disorder also predicted higher levels of perceived stress. Sleep quality after Hurricane Ike, an intense natural disaster producing substantial damage, impacted changes in perceived stress over time. Our findings suggest the possibility that providing victims of disasters with effective interventions to improve sleep quality could help to reduce their perceived stress over time. © 2015 Associated Professional Sleep Societies, LLC.

Inverse U-shaped Association between Sleep Duration and Semen Quality: Longitudinal Observational Study (MARHCS) in Chongqing, China

PubMed Central

Chen, Qing; Yang, Huan; Zhou, Niya; Sun, Lei; Bao, Huaqiong; Tan, Lu; Chen, Hongqiang; Ling, Xi; Zhang, Guowei; Huang, Linping; Li, Lianbing; Ma, Mingfu; Yang, Hao; Wang, Xiaogang; Zou, Peng; Peng, Kaige; Liu, Taixiu; Cui, Zhihong; Ao, Lin; Roenneberg, Till; Zhou, Ziyuan; Cao, Jia

2016-01-01

Study Objectives: To investigate the association between sleep duration and semen parameters as well as reproductive hormone levels. Methods: We designed a cohort of male college students in Chongqing, China. A total of 796 subjects were recruited in 2013 and 656 (82.4%) were followed up in 2014. Each time, semen and peripheral blood samples were collected for semen quality and reproductive hormone measurement. Sleep duration was estimated by revised Munich Chronotype Questionnaire. In 2014, sleep quality was also measured by Pittsburgh Sleep Quality Index (PSQI). Results: There was a substantial inverse U-shaped association between sleep duration and two semen parameters (semen volume and total sperm number), with 7.0–7.5 h/day of sleep showing highest parameters. Either longer or shorter sleep was associated with decreased semen parameters in a dose-response manner (P = 0.002 and 0.001, respectively). Sleeping > 9.0 h was associated with a 21.5% (95% confidence interval 9.2, 32.2) reduction in semen volume and 39.4% (23.3, 52.1) reduction in total sperm number; sleeping ≤ 6.5 h was associated with 4.6% (−10.5, 22.3) and 25.7% (−1.2, 60.1) reduction. Increase of the two parameters was found in those who changed sleep duration toward 7.0–7.5 h/day from 2013 to 2014. The U-shaped association was independent from PSQI and was replicated in another dataset of 1,346 males. No association found between sleep duration and reproductive hormone. Conclusions: Either restricted or excessive sleep may impair semen quality. Further research is needed to validate this finding. Citation: Chen Q, Yang H, Zhou N, Sun L, Bao H, Tan L, Chen H, Ling X, Zhang G, Huang L, Li L, Ma M, Yang H, Wang X, Zou P, Peng K, Liu T, Cui Z, Ao L, Roenneberg T, Zhou Z, Cao J. Inverse u-shaped association between sleep duration and semen quality: longitudinal observational study (MARHCS) in Chongqing, China. SLEEP 2016;39(1):79–86. PMID:26350472

Gratitude influences sleep through the mechanism of pre-sleep cognitions.

PubMed

Wood, Alex M; Joseph, Stephen; Lloyd, Joanna; Atkins, Samuel

2009-01-01

To test whether individual differences in gratitude are related to sleep after controlling for neuroticism and other traits. To test whether pre-sleep cognitions are the mechanism underlying this relationship. A cross-sectional questionnaire study was conducted with a large (186 males, 215 females) community sample (ages=18-68 years, mean=24.89, S.D.=9.02), including 161 people (40%) scoring above 5 on the Pittsburgh Sleep Quality Index, indicating clinically impaired sleep. Measures included gratitude, the Pittsburgh Sleep Quality Index (PSQI), self-statement test of pre-sleep cognitions, the Mini-IPIP scales of Big Five personality traits, and the Social Desirability Scale. Gratitude predicted greater subjective sleep quality and sleep duration, and less sleep latency and daytime dysfunction. The relationship between gratitude and each of the sleep variables was mediated by more positive pre-sleep cognitions and less negative pre-sleep cognitions. All of the results were independent of the effect of the Big Five personality traits (including neuroticism) and social desirability. This is the first study to show that a positive trait is related to good sleep quality above the effect of other personality traits, and to test whether pre-sleep cognitions are the mechanism underlying the relationship between any personality trait and sleep. The study is also the first to show that trait gratitude is related to sleep and to explain why this occurs, suggesting future directions for research, and novel clinical implications.

Clinical characteristics of sleep disorders in patients with Parkinson's disease.

PubMed

Mao, Zhi-Juan; Liu, Chan-Chan; Ji, Su-Qiong; Yang, Qing-Mei; Ye, Hong-Xiang; Han, Hai-Yan; Xue, Zheng

2017-02-01

In order to investigate the sleep quality and influencing factors in patients with Parkinson's disease (PD), 201 PD patients were enrolled and underwent extensive clinical evaluations. Subjective sleep evaluation was assessed using the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). It was found that poor sleep quality (77.11%) and excessive daytime sleepiness (32.34%) were commonly seen in PD patients and positively correlated with disease severity. Then 70 out of the 201 PD patients and 70 age- and sex-matched controls underwent a polysomnographic recording. The parameters were compared between PD group and control group and the influencing factors of sleep in PD patients were analyzed. The results showed that sleep efficiency (SE) was significantly decreased (P<0.01), and sleep latency (SL) and the arousal index (AI) were increased (P<0.05) in the PD group as compared with those in the control group. SE and total sleep time (TST) were positively correlated with the Hoehn and Yahr (H&Y) stage. There was significant difference in the extent of hypopnea and hypoxemia between the PD group and the control group (P<0.05). Our results indicate that PD patients have an overall poor sleep quality and a high prevalence of sleep disorder, which may be correlated with the disease severity. Respiratory function and oxygen supply are also affected to a certain degree in PD patients.

Sustained attention assessment of narcoleptic patients: two case reports.

PubMed

Moraes, Mirleny; Wilson, Barbara A; Rossini, Sueli; Osternack-Pinto, Kátia; Reimão, Rubens

2008-01-01

Narcolepsy is a sleep disorder characterized by uncontrollable REM sleep attacks which alter the patients wake state and can lead to difficulties in attention aspects, such as maintaining attention when performing activities or tasks. This study aimed to evaluate sustained attention performance of two narcoleptic patients on the d2 Test, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Hamilton Rating Scale for Depression (HAM-D). Results showed that the maintenance of attention was associated with a slowing of the target symbols processing function in visual scanning with accuracy in task performance. A high degree of excessive sleepiness was observed, along with mild and moderate degrees of depressive signs and symptoms. One subject also presented with a nocturnal sleep disorder which could represent an important factor affecting attentional and affective capacity.

Age and gender effects on the prevalence of poor sleep quality in the adult population.

PubMed

Madrid-Valero, Juan J; Martínez-Selva, José M; Ribeiro do Couto, Bruno; Sánchez-Romera, Juan F; Ordoñana, Juan R

Sleep quality has a significant impact on health and quality of life and is affected, among other factors, by age and sex. However, the prevalence of problems in this area in the general population is not well known. Therefore, our objective was to study the prevalence and main characteristics of sleep quality in an adult population sample. 2,144 subjects aged between 43 and 71 years belonging to the Murcia (Spain) Twin Registry. Sleep quality was measured by self-report through the Pittsburgh Sleep Quality Index (PSQI). Logistic regression models were used to analyse the results. The prevalence of poor sleep quality stands at 38.2%. Univariate logistic regression analyses showed that women were almost twice as likely as men (OR: 1.88; 95% confidence interval [95%CI]: 1.54 to 2.28) to have poor quality of sleep. Age was directly and significantly associated with a low quality of sleep (OR: 1.05; 95%CI: 1.03 to 1.06). The prevalence of poor sleep quality is high among adults, especially women. There is a direct relationship between age and deterioration in the quality of sleep. This relationship also appears to be more consistent in women. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Adding Agnus Castus and Magnolia to Soy Isoflavones Relieves Sleep Disturbances Besides Postmenopausal Vasomotor Symptoms-Long Term Safety and Effectiveness

PubMed Central

De Franciscis, Pasquale; Grauso, Flavio; Luisi, Anna; Schettino, Maria Teresa; Torella, Marco; Colacurci, Nicola

2017-01-01

The effectiveness for vasomotor symptoms and sleep disorders plus the long-term safety of a nutraceutical combination of agnus-castus and magnolia extracts combined with soy isoflavones (SI) and lactobacilli were assessed in postmenopausal women. A controlled study was carried out in menopausal women comparing this nutraceutical combination (ESP group) with a formulation containing isoflavones alone (C group) at the dosage recommended. The Kuppermann index, The Pittsburgh Sleep Quality Index (PSQI), and Short Form 36 (SF-36) were determined at baseline, three, six and 12 months. Endometrial thickness, mammary density and liver function were evaluated at baseline and after 12 months. One hundred and eighty women were enrolled in the study (100 in the ESP group and 80 in the C group). At the end of the treatment, mammary density, endometrial thickness, and hepatic function did not show substantial differences between groups. The Kuppermann index and particularly the tendency for hot flashes progressively and significantly decreased in frequency and severity during ESP versus C treatment. At the same time, a significant increase in sleep quality and psychophysical wellness parameters was observed in the ESP versus C groups. No adverse events were observed. Agnus-castus and magnolia, combined with SI + lactobacilli, can effectively and safely be used in symptomatic postmenopausal women, mainly when quality of sleep is the most disturbing complaint. The endometrium, mammary glands and liver function were unaffected after 12 months of treatment. PMID:28208808

Adding Agnus Castus and Magnolia to Soy Isoflavones Relieves Sleep Disturbances Besides Postmenopausal Vasomotor Symptoms-Long Term Safety and Effectiveness.

PubMed

De Franciscis, Pasquale; Grauso, Flavio; Luisi, Anna; Schettino, Maria Teresa; Torella, Marco; Colacurci, Nicola

2017-02-13

The effectiveness for vasomotor symptoms and sleep disorders plus the long-term safety of a nutraceutical combination of agnus-castus and magnolia extracts combined with soy isoflavones (SI) and lactobacilli were assessed in postmenopausal women. A controlled study was carried out in menopausal women comparing this nutraceutical combination (ESP group) with a formulation containing isoflavones alone (C group) at the dosage recommended. The Kuppermann index, The Pittsburgh Sleep Quality Index (PSQI), and Short Form 36 (SF-36) were determined at baseline, three, six and 12 months. Endometrial thickness, mammary density and liver function were evaluated at baseline and after 12 months. One hundred and eighty women were enrolled in the study (100 in the ESP group and 80 in the C group). At the end of the treatment, mammary density, endometrial thickness, and hepatic function did not show substantial differences between groups. The Kuppermann index and particularly the tendency for hot flashes progressively and significantly decreased in frequency and severity during ESP versus C treatment. At the same time, a significant increase in sleep quality and psychophysical wellness parameters was observed in the ESP versus C groups. No adverse events were observed. Agnus-castus and magnolia, combined with SI + lactobacilli, can effectively and safely be used in symptomatic postmenopausal women, mainly when quality of sleep is the most disturbing complaint. The endometrium, mammary glands and liver function were unaffected after 12 months of treatment.

Association between sleep and residential environments in the summertime in Japan.

PubMed

Kayaba, Momoko; Ihara, Tomohiko; Kusaka, Hiroyuki; Iizuka, Satoru; Miyamoto, Kenji; Honda, Yasushi

2014-05-01

We aimed to identify the effect of environmental factors on sleep in the summertime in Japan. A self-reported questionnaire survey was conducted in Japan. Age of participants ranged from 20 to 70 years. The mean Pittsburgh Sleep Quality Index (PSQI) score was 4.9 (±2.7), and 123 (35.0%) participants had scores of >5. According to the results of multivariate logistic regression analysis, the adjusted odds ratio (aOR) for PSQI scores of >5 without installation of air conditioner was 1.8 (95% confidence interval [CI], 1.0-3.3; P<.05), use of a light bulb was 3.7 (95% CI, 1.1-12.6; P<.05), and noise was 2.1 (95% CI, 1.1-4.1; P<.05) after controlling for several confounding variables. Difficulty initiating sleep (DIS) was associated with installation of an air conditioner (1 [reference] to 3 [aOR, 2.5 {95% CI, 1.2-5.1}] and 4 [aOR, 2.8 {95% CI, 1.1-7.1}]) and noise (1 [reference] to 3 [aOR, 2.4 {95% CI, 1.0-5.9}] and 4 [aOR, 8.8 {95% CI, 3.1-25.0}]). Difficulty maintaining sleep (DMS) was associated with installation of a fan (1 [reference] to 2 [aOR, 0.4 {95% CI, 0.2-0.8}] and noise (1 [reference] to 3 [aOR, 2.3 {95% CI, 1.0-5.3}]) after controlling for several confounding variables. Our finding using analysis of the association between residential environments and subjective sleep statuses, which determined that the installation of an air conditioner and lighting equipment might affect sleep, may be useful to discuss sleep environments and improve sleep quality. Copyright © 2014 Elsevier B.V. All rights reserved.

Bedtime mobile phone use and sleep in adults.

PubMed

Exelmans, Liese; Van den Bulck, Jan

2016-01-01

The few studies that have investigated the relationship between mobile phone use and sleep have mainly been conducted among children and adolescents. In adults, very little is known about mobile phone usage in bed our after lights out. This cross-sectional study set out to examine the association between bedtime mobile phone use and sleep among adults. A sample of 844 Flemish adults (18-94 years old) participated in a survey about electronic media use and sleep habits. Self-reported sleep quality, daytime fatigue and insomnia were measured using the Pittsburgh Sleep Quality Index (PSQI), the Fatigue Assessment Scale (FAS) and the Bergen Insomnia Scale (BIS), respectively. Data were analyzed using hierarchical and multinomial regression analyses. Half of the respondents owned a smartphone, and six out of ten took their mobile phone with them to the bedroom. Sending/receiving text messages and/or phone calls after lights out significantly predicted respondents' scores on the PSQI, particularly longer sleep latency, worse sleep efficiency, more sleep disturbance and more daytime dysfunction. Bedtime mobile phone use predicted respondents' later self-reported rise time, higher insomnia score and increased fatigue. Age significantly moderated the relationship between bedtime mobile phone use and fatigue, rise time, and sleep duration. An increase in bedtime mobile phone use was associated with more fatigue and later rise times among younger respondents (≤ 41.5 years old and ≤ 40.8 years old respectively); but it was related to an earlier rise time and shorter sleep duration among older respondents (≥ 60.15 years old and ≥ 66.4 years old respectively). Findings suggest that bedtime mobile phone use is negatively related to sleep outcomes in adults, too. It warrants continued scholarly attention as the functionalities of mobile phones evolve rapidly and exponentially. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Treatment of insomnia with shujing massage therapy: a randomized controlled trial].

PubMed

Tang, Hongliang; Chen, Zhao; Pang, Jun; Mo, Qiaoming

2015-08-01

To compare the differences in the clinical efficacy on insomnia between shujing massage therapy and medication with estazolam. Eighty patients of insomnia were randomized into a shujing mass age therapy group (40 cases) and a medication group (40 cases). In the shujing massage therapy group, the spreading massage manipulation was applied along the running course of the gallbladder meridian of foot-shaoyang on the temporal area. The pressing and kneading manipulation was done at Yangbai (GB 14), Benshen (GB 13), Toulinqi (GB 15), Zhengying (GB 17), Chengling (GB 18), Shuaigu (GB 8), and Fengchi (GB 20), etc, 1 min at each acupoint. In the medication group, 1 mg estazolam was taken orally half an hour before sleep. The treatment was given once every day in the two groups. After the continuous treatment for 1 month, every dimensional score and the total score in the Pittsburgh sleep quality index scale (PSQI) and the clinical efficacy were evaluated between the two groups. After the intervention, the each item score of PSQI was improved as compared with that before treatment in the patients of the two groups (all P<0. 05). The differences in sleep time and the time for falling into sleep were not significant between the two groups (both P>0. 05). In the shujing massage therapy group, the scores of sleep quality, sleep efficiency, sleep disturbance and daytime dysfunction, as well as the total score were all lower than those in the medication group (all P<0. 05). The total effective rate was 92. 1% (35/38) in the shujing massage group and was 84. 2% (32/38) in the medication group, indicating the significant difference (P<0. 05). Shujing massage therapy achieves the superior efficacy on insomnia compared with the oral administration of estazolam.

Sleep restoration is associated with reduced plasma C-reactive protein and depression symptoms in military personnel with sleep disturbance after deployment.

PubMed

Heinzelmann, Morgan; Lee, Hyunhwa; Rak, Hannah; Livingston, Whitney; Barr, Taura; Baxter, Tristin; Scattergood-Keepper, Lindsay; Mysliwiec, Vincent; Gill, Jessica

2014-12-01

Deployed military personnel are vulnerable to chronic sleep disturbance, which is highly comorbid with post-traumatic stress disorder (PTSD) and depression, as well as declines in health-related quality of life (HRQOL). Inflammation is associated with HRQOL declines and sleep-related comorbidities; however, the impact of sleep changes on comorbid symptoms and inflammation in this population is unknown. In this observational study, we examined the relationship between reported sleep changes and concentrations of inflammatory biomarkers, interleukin 6 (IL-6), and C-reactive protein (CRP) in peripheral blood. The sample was dichotomized into two groups: (1) decrease in Pittsburgh Sleep Quality Index (PSQI; restorative sleep) and (2) no change or increase in PSQI (no change). Mixed between-within subjects analysis of variance tests were used to determine group differences on changes of inflammation and comorbid symptoms. In our sample of 66 recently deployed military personnel with insomnia, 34 participants reported restorative sleep whereas 32 reported no sleep changes. The two groups did not differ in demographic or clinical characteristics, with the exception of PTSD diagnosis at baseline. The restorative sleep group had significant reductions in CRP concentrations and depression symptoms, as well as reduced fatigue and improvements in emotional well-being, social functioning, and physical functioning at follow-up. Military personnel who report sleep restoration after deployment have reduced CRP concentrations, decreased severity of depression, and improved HRQOL. These findings suggest that treatment for sleep disturbances may be associated with improvements in mental and physical health, thereby supporting continued study in this line of research. Copyright © 2014 Elsevier B.V. All rights reserved.

Sleep disorders among Yusho patients highly intoxicated with dioxin-related compounds: A 140-case series.

PubMed

Kondo, Hideaki; Tanio, Keiko; Nagaura, Yuki; Nagayoshi, Mako; Mitoma, Chikage; Furue, Masutaka; Maeda, Takahiro

2018-06-13

Patients with Yusho, a condition caused by exposure to dioxins and dioxin-like compounds, have diverse mental and physical complaints. However, the relationship between dioxins and sleep disorders has not yet been examined. This cross-sectional study was designed to investigate problems associated with sleep among patients with Yusho. A total of 140 participants (52.9% men, average age: 67.1 ± 12.2 years) were examined using questionnaires and medical interviews by an expert on sleep medicine. Demographic and clinical characteristics, including blood concentrations of 2,3,4,7,8-pentachlorodibenzofuran (PeCDF), which is the major cause of Yusho, were obtained from the results of recent surveys conducted by the Yusho Study Group. Moderate to severe symptoms of insomnia were present in 51.8% of the patients. The median Pittsburgh Sleep Quality Index global score (PSQI GS) was 8 (interquartile range: 5-11). The prevalence of restless legs syndrome/Willis-Ekbom disease (RLS/WED) was 30.7%; 24.3% of patients had severe RLS/WED (distressing symptoms with a frequency ≥ 1day per week). A higher blood concentration of 2,3,4,7,8-PeCDF (≥72.27 pg/g lipid) and severe RLS/WED were associated with higher odds of a PSQI GS ≥8, after adjusting for covariates (odds ratio [95% confidence interval]: 4.84 [1.10-21.25] and 4.15 [1.53-11.28], respectively). Symptoms of insomnia were frequent, and the prevalence of RLS/WED was high in patients with Yusho. In addition to the presence of RLS/WED, a higher blood concentration of 2,3,4,7,8-PeCDF was associated with lower subjective sleep quality. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

Quality of Life in Patients With Chronic Rhinosinusitis and Sleep Dysfunction Undergoing Endoscopic Sinus Surgery: A Pilot Investigation of Comorbid Obstructive Sleep Apnea.

PubMed

Alt, Jeremiah A; DeConde, Adam S; Mace, Jess C; Steele, Toby O; Orlandi, Richard R; Smith, Timothy L

2015-10-01

Patients with chronic rhinosinusitis (CRS) have reduced sleep quality linked to their overall well-being and disease-specific quality of life (QOL). Other primary sleep disorders also affect QOL. To determine the impact of comorbid obstructive sleep apnea (OSA) on CRS disease-specific QOL and sleep dysfunction in patients with CRS following functional endoscopic sinus surgery. Prospective multisite cohort study conducted between October 2011 and November 2014 at academic, tertiary referral centers with a population-based sample of 405 adults. Functional endoscopic sinus surgery for medically refractory symptoms of CRS. Primary outcome measures consisted of preoperative and postoperative scores operationalized by the Rhinosinusitis Disability Index (RSDI) survey, the 22-item Sinonasal Outcome Test (SNOT-22), and the Pittsburgh Sleep Quality Index (PSQI). Obstructive sleep apnea was the primary, independent risk factor. Of 405 participants, 60 (15%) had comorbid OSA. A total of 285 (70%) participants provided preoperative and postoperative survey responses, with a mean (SD) of 13.7 (5.3) months of follow-up. Significant postoperative improvement (P < .05) was reported across all mean disease-specific QOL measures for both participants with and without comorbid OSA. Participants without OSA reported significant greater improvement in unadjusted mean (SD) RSDI global scores (−25.0 [23.3] vs. −16.5 [22.1]; P = .03), RSDI physical (−10.7 [9.2] vs. −7.3 [9.1]; P = .03) and functional (−8.4 [8.7] vs. −5.1 [7.5]; P = .03) subdomain scores, and SNOT-22 rhinologic symptom domain scores (−9.1 [7.7] vs. −5.7 [6.9]; P = .008). Participants without OSA also reported greater improvements on mean (SD) PSQI global (−1.9 [4.0] vs. −0.5 [3.7]; P = .03), sleep quality (−0.4 [0.8] vs. −0.03 [0.7]; P = .02), and sleep disturbance (−0.4 [0.7] vs. −0.1 [0.7]; P = .03) scores. The majority of these associations were found to be durable after adjustment for alternate independent cofactors using stepwise linear regression modeling. Patients with CRS and comorbid OSA have poor QOL with substantial disease-specific QOL improvements following surgery. Patients who present with CRS should be assessed for primary sleep disorders and, if identified, should be treated concurrently for both CRS and OSA to improve sleep dysfunction to optimize surgical outcomes. clinicaltrials.gov Identifier: NCT01332136.

Relationship between prenatal maternal stress and sleep quality in Chinese pregnant women: the mediation effect of resilience.

PubMed

Li, Guopeng; Kong, Linghua; Zhou, Haiyan; Kang, Xiaofei; Fang, Yueyan; Li, Ping

2016-09-01

To examine the relationship between prenatal maternal stress, resilience, and sleep quality, and to determine whether resilience plays a mediating role in the relationship between prenatal maternal stress and sleep quality among pregnant women. Two hundred and thirty-one pregnant women in their second trimester participated in the study. They completed questionnaires, including: the Pittsburgh Sleep Quality Index (PSQI), the Pregnancy Stress Rating Scale (PSRS), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). A structural equation model was used to analyze the relationships among prenatal maternal stress, resilience, and sleep quality, with resilience as a mediator. Prenatal maternal stress was negatively associated with sleep quality in pregnant women (p < 0.01), whereas resilience was positively associated with sleep quality (p < 0.01). Furthermore, resilience mediated the relationship between prenatal maternal stress and sleep quality, and the mediation effect ratio was 22.0% (p < 0.01). The risk factor for disturbed sleep was pregnancy-specific stress; however, the protective factor for sleep quality was resilience. This finding could provide scientific evidence for the development of intervention strategies with which to improve sleep quality in pregnant women. Copyright © 2016 Elsevier B.V. All rights reserved.

Add-on prolonged-release melatonin for cognitive function and sleep in mild to moderate Alzheimer's disease: a 6-month, randomized, placebo-controlled, multicenter trial.

PubMed

Wade, Alan G; Farmer, Mildred; Harari, Gil; Fund, Naama; Laudon, Moshe; Nir, Tali; Frydman-Marom, Anat; Zisapel, Nava

2014-01-01

A link between poor sleep quality and Alzheimer's disease (AD) has recently been suggested. Since endogenous melatonin levels are already reduced at preclinical AD stages, it is important to ask whether replenishing the missing hormone would be beneficial in AD and whether any such effects would be related to the presence of sleep disorder in patients. The effects of add-on prolonged-release melatonin (PRM) (2 mg) to standard therapy on cognitive functioning and sleep were investigated in 80 patients (men [50.7%], women [49.3%], average age 75.3 years [range, 52-85 years]) diagnosed with mild to moderate AD, with and without insomnia comorbidity, and receiving standard therapy (acetylcholinesterase inhibitors with or without memantine). In this randomized, double-blind, parallel-group study, patients were treated for 2 weeks with placebo and then randomized (1:1) to receive 2 mg of PRM or placebo nightly for 24 weeks, followed by 2 weeks placebo. The AD Assessment Scale-Cognition (ADAS-Cog), Instrumental Activities of Daily Living (IADL), Mini-Mental State Examination (MMSE), sleep, as assessed by the Pittsburgh Sleep Quality Index (PSQI) and a daily sleep diary, and safety parameters were measured. Patients treated with PRM (24 weeks) had significantly better cognitive performance than those treated with placebo, as measured by the IADL (P=0.004) and MMSE (P=0.044). Mean ADAS-Cog did not differ between the groups. Sleep efficiency, as measured by the PSQI, component 4, was also better with PRM (P=0.017). In the comorbid insomnia (PSQI ≥6) subgroup, PRM treatment resulted in significant and clinically meaningful effects versus the placebo, in mean IADL (P=0.032), MMSE score (+1.5 versus -3 points) (P=0.0177), and sleep efficiency (P=0.04). Median ADAS-Cog values (-3.5 versus +3 points) (P=0.045) were significantly better with PRM. Differences were more significant at longer treatment duration. PRM was well tolerated, with an adverse event profile similar to that of placebo. Add-on PRM has positive effects on cognitive functioning and sleep maintenance in AD patients compared with placebo, particularly in those with insomnia comorbidity. The results suggest a possible causal link between poor sleep and cognitive decline.

Restless Legs Syndrome in Adults in Peking Union Medical College Hospital.

PubMed

Chen, Jian-Hua; Huang, Rong; Luo, Jin-Mei; Xiao, Yi; Zhong, Xu; Liu, Xiu-Qin

2016-10-10

Objective To investigate the clinical characteristics of restless legs syndrome (RLS) in adults in Peking Union Medical College Hospital and explore the sleep quality,fatigue degree,daytime sleepiness,disease severity,depression and anxiety of RLS patients.Methods Totally 4739 consecutive patients who visited the outpatient departments with any sleep complaint or leg discomforts were recruited in the study. Patients under 18 years were excluded. All participants answered RLS questionnaire. The subjects fulfilled all four criteria would be followed up and given advanced examinations to rule out secondary RLS and RLS mimics. Primary RLS patients were evaluated with International Restless Legs Scale (IRLS),Pittsburgh Sleep Quality Index (PSQI),Fatigue Severity Scale (FSS),Epworth Sleepiness Scale (ESS),and Hospital Anxiety and Depression Scale for depression and anxiety (HADD and HADA). Another two groups of age-and gender-matched healthy subjects and non-RLS insomnia patients were served as normal and non-RLS insomnia controls.Results There were 162 (3.42%,162/4739) subjects fulfilling all four criteria for RLS; 42 (0.89%,42/4739) subjects were diagnosed as primary RLS and 33 (0.70%,33/4739) as RLS mimics. In primary RLS patients,41(97.6%) were found to be with poor sleep,13 (31.0%) with anxiety,and 4(9.5%) with depression. The scores of PSQI(q=11.69,P=0.000),HADA(q=8.02,P=0.000),and HADD(q=6.60,P=0.000)in primary RLS patients were significantly higher than those in normal controls. The scores of FSS(q=3.74,P=0.001),ESS(q=2.97,P=0.012),and HADD(q=4.15,P=0.000) in primary RLS patients were significantly lower than those in non-RLS insomnia controls. The scores of HADA and HADD were significantly correlated with those of PSQI(r=0.340,P=0.028;r=0.383,P=0.012),FSS(r=0.445,P=0.003;r=0.511,P=0.001),and IRLS(r=0.477,P=0.001;r=0.578,P=0.000). Conclusions RLS should be considered in the patients with any sleep-related complaint or leg discomforts. Primary RLS patients suffer from bad sleep and are more susceptible to anxiety and depression. Secondary RLS and RLS mimics should be excluded before the diagnosis of primary RLS.

[Expressions of neurotransmitters in patients of insomnia differentiated as liver stagnation transforming into fire treated with acupuncture].

PubMed

Ji, Xiangdong; Wang, Qunsong; Zhu, Wenxian

2015-06-01

To compare the difference in the efficacy between acupuncture and oral administration of trazodone and the expressions of neurotransmitters in patients of insomnia differentiated as liver stagnation transforming into fire. Seventy patients of insomnia differentiated as liver stagnation transforming into fire were randomized into an observation group and a control group, 35 cases in each one. In the observation group, acupuncture therapy was adopted at Shenmen (HT 7), Baihui (GV 20), Yintang (GV 29), Hegu (LI 4), Taichong (LR 3), etc. The needles were retained for 20 min each time. The treatment was given once a day, the treatment of 2 weeks made one session. In the control group, trazodone, 100 mg, oral administration, once a day, the treatment of 2 weeks made one session. Two sessions were required in the two groups. The scores in Pittsburgh sleep quality index (PSQI) and Asberg rating scale for side effects (SERS), the levels of neurotransmitters such as 5-hydroxy tryptamine (5-HT) and norepinephrine (NE) and the expressions of protein kinase C (PKC) and brain-derived neurotrophic factor (BDNF) in peripheral blood were observed before and after treatment in the two groups. PSQI score and SERS score after treatment were all decreased compared with those in both groups before treatment (both P<0. 05). After treatment, PSQI score and SERS score in the observation group were lower apparently than those in the control group (both P<0. 05). After treatment NE content and PKC level were decreased; 5-HT content and BDNF mRNA were increased compared with those in both groups before treatment (all P<0. 05). NE content and PKC level in the observation group were lower apparently than those in the control group (both P<0. 05). The serum 5-HT content and BDNF mRNA expression in the observation group were higher than those in the control group separately (both P<0. 05). Acupuncture therapy improves the sleeping quality of patients of insomnia differentiated as liver stagnation transforming into fire, and reduces serum NE level and increases 5-HT content and BDNF expression, which achieves the better efficacy as compared with the oral administration of trazodone. It is one of the effective approaches to the treatment of insomnia differentiated as liver stagnation transforming into fire.

How are age-related differences in sleep quality associated with health outcomes? An epidemiological investigation in a UK cohort of 2406 adults.

PubMed

Gadie, Andrew; Shafto, Meredith; Leng, Yue; Kievit, Rogier A

2017-07-31

To examine age-related differences in self-reported sleep quality and their associations with health outcomes across four domains: physical health, cognitive health, mental health and neural health. Cambridge Centre for Ageing and Neuroscience (Cam-CAN) is a cohort study in East Anglia/England, which collected self-reported health and lifestyle questions as well as a range of objective measures from healthy adults. 2406 healthy adults (age 18-98) answered questions about their sleep quality (Pittsburgh Sleep Quality Index (PSQI)) and measures of physical, cognitive, mental and neural health. A subset of 641 individuals provided measures of brain structure. PSQI scores of sleep and scores across tests within the four domains of health. Latent class analysis (LCA) is used to identify sleep types across the lifespan. Bayesian regressions quantify the presence, and absence, of relationships between sleep quality and health measures. Better self-reported sleep is generally associated with better health outcomes, strongly so for mental health, moderately for cognitive and physical health, but not for sleep quality and neural health. LCA identified four sleep types: 'good sleepers' (68.1%, most frequent in middle age), 'inefficient sleepers' (14.01%, most frequent in old age), 'delayed sleepers' (9.28%, most frequent in young adults) and 'poor sleepers' (8.5%, most frequent in old age). There is little evidence for interactions between sleep quality and age on health outcomes. Finally, we observe U-shaped associations between sleep duration and mental health (depression and anxiety) as well as self-reported general health, such that both short and long sleep were associated with poorer outcomes. Lifespan changes in sleep quality are multifaceted and not captured well by summary measures, but instead should be viewed as as partially independent symptoms that vary in prevalence across the lifespan. Better self-reported sleep is associated with better health outcomes, and the strength of these associations differs across health domains. Notably, we do not observe associations between self-reported sleep quality and white matter. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Red light and the sleep quality and endurance performance of Chinese female basketball players.

PubMed

Zhao, Jiexiu; Tian, Ye; Nie, Jinlei; Xu, Jincheng; Liu, Dongsen

2012-01-01

Good sleep is an important recovery method for prevention and treatment of overtraining in sport practice. Whether sleep is regulated by melatonin after red-light irradiation in athletes is unknown. To determine the effect of red light on sleep quality and endurance performance of Chinese female basketball players. Cohort study. Athletic training facility of the Chinese People's Liberation Army and research laboratory of the China Institute of Sport Science. Patients or Other Participants: Twenty athletes of the Chinese People's Liberation Army team (age = 18.60 6 3.60 years) took part in the study. Participants were divided into red-light treatment (n = 10) and placebo (n = 10) groups. The red-light treatment participants received 30 minutes of irradiation from a red-light therapy instrument every night for 14 days. The placebo group did not receive light illumination. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was completed, serum melatonin was assessed, and 12-minute run was performed at preintervention (baseline) and postintervention (14 days). The 14-day whole-body irradiation with red-light treatment improved the sleep, serum melatonin level, and endurance performance of the elite female basketball players (P < .05). We found a correlation between changes in global Pittsburgh Sleep Quality Index and serum melatonin levels (r = -0.695, P = .006). Our study confirmed the effectiveness of body irradiation with red light in improving the quality of sleep of elite female basketball players and offered a nonpharmacologic and noninvasive therapy to prevent sleep disorders after training.

Dream anxiety in renal transplant recipients.

PubMed

Yazla, Ece; Ozkurt, Sultan; Musmul, Ahmet

2015-06-01

Although low quality of sleep has been reported in kidney transplant patients with functioning allografts, there are no previous studies investigating the dreams of these patients. We aimed to investigate the differences in dream anxiety level between renal transplant patients and healthy control subjects. We also planned to compare depression and anxiety symptoms, sleep quality and sleepiness level between these two groups. Twenty-two living-donor renal transplant recipients followed at an outpatient nephrology clinic and 22 healthy controls were enrolled in this observational cross-sectional study. Sociodemographic Data Collection Form, and the Van Dream Anxiety Scale (VDAS), the Pittsburg Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), Beck Depression and Anxiety Inventories were used for the assessment of the necessary features. Hemoglobin (Hb), blood urea nitrogen (BUN), creatinine (Cr) and glucose levels were measured. There were no significant differences between the groups in terms of dream anxiety (p = 0.45), depression (p = 0.76), sleep quality (p = 0.8), insomnia severity (p = 0.08) and Hb (p = 0.11) and glucose levels (p = 0.14). Although, BUN (p = 0.00) and creatinine (p = 0.00) levels differed significantly between the two groups, both parameters were found to be within their normal range. In our study, chronic renal failure patients with a successful kidney transplant were found to be able to completely return to normal in terms of metabolic parameters, sleep quality and mood. Similar levels of dream anxiety are also consistent with these findings.

Blood Pressure, Sleep Quality and Fatigue in Shift Working Police Officers: Effects of a Twelve Hour Roster System on Cardiovascular and Sleep Health.

PubMed

Elliott, Jaymen L; Lal, Sara

2016-01-29

Police officers have been reported to exhibit a high incidence of pathologies, which present prematurely in an otherwise healthy population. Shift work has also been associated with an increased risk of cardiovascular and sleep disorders, attributable to its propensity for circadian rhythm dysfunction. However, contention exists as to whether shift work has a direct effect upon blood pressure (BP) regulation. This cross-sectional study sought to determine changes in BP and associations with the overall sleep quality and fatigue in 206 general duties police officers (n = 140 males) of the New South Wales Police Force in Australia. The subjects' BP was assessed before and after their twelve hour shift, during which time they also completed the Lifestyle Appraisal Questionnaire, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale and Fatigue Severity Scale (FSS). Poor sleep quality (PSQI) and fatigue severity (FSS) were found to predominate in the sample (69% and 51% respectively). Although there was no change in BP for male participants, female officers' systolic blood pressure (SBP) was found to increase significantly across the shift (p < 0.001), but with no change found in females' diastolic blood pressure (DBP). Finally, higher pre and post-shift SBP (r = -0.26, p = 0.001; r = -0.25, p = 0.001, respectively) and DBP (r = -0.26, p = 0.001; r = -0.26, p = 0.001, respectively) were significantly correlated with lower FSS scores after accounting for age, waist-hip ratio and lifestyle risk factors. Based on these preliminary findings, there was a significant increase in SBP of female police officers after shift work, while BP and fatigue levels in all police officers were strongly related. Moreover, the predominating poor sleep quality and impact of fatigue in this sample remain a concern. Further research is required to ensure the physiological welfare of police officers, while strategies must be implemented to manage the detrimental effects shift work may be having upon their cardiovascular and sleep health.

Associations of Objectively and Subjectively Measured Sleep Quality with Subsequent Cognitive Decline in Older Community-Dwelling Men: The MrOS Sleep Study

PubMed Central

Blackwell, Terri; Yaffe, Kristine; Laffan, Alison; Ancoli-Israel, Sonia; Redline, Susan; Ensrud, Kristine E.; Song, Yeonsu; Stone, Katie L.

2014-01-01

Study Objectives: To examine associations of objectively and subjectively measured sleep with subsequent cognitive decline. Design: A population-based longitudinal study. Setting: Six centers in the United States. Participants: Participants were 2,822 cognitively intact community-dwelling older men (mean age 76.0 ± 5.3 y) followed over 3.4 ± 0.5 y. Interventions: None. Measurements and Results: Objectively measured sleep predictors from wrist actigraphy: total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of long wake episodes (LWEP). Self-reported sleep predictors: sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), TST. Clinically significant cognitive decline: five-point decline on the Modified Mini-Mental State examination (3MS), change score for the Trails B test time in the worse decile. Associations of sleep predictors and cognitive decline were examined with logistic regression and linear mixed models. After multivariable adjustment, higher levels of WASO and LWEP and lower SE were associated with an 1.4 to 1.5-fold increase in odds of clinically significant decline (odds ratio 95% confidence interval) Trails B test: SE < 70% versus SE ≥ 70%: 1.53 (1.07, 2.18); WASO ≥ 90 min versus WASO < 90 min: 1.47 (1.09, 1.98); eight or more LWEP versus fewer than eight: 1.38 (1.02, 1.86). 3MS: eight or more LWEP versus fewer than eight: 1.36 (1.09, 1.71), with modest relationships to linear change in cognition over time. PSQI was related to decline in Trails B performance (3 sec/y per standard deviation increase). Conclusions: Among older community-dwelling men, reduced sleep efficiency, greater nighttime wakefulness, greater number of long wake episodes, and poor self-reported sleep quality were associated with subsequent cognitive decline. Citation: Blackwell T; Yaffe K; Laffan A; Ancoli-Israel S; Redline S; Ensrud KE; Song Y; Stone KL. Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study. SLEEP 2014;37(4):655-663. PMID:24899757

Relationship between circadian rhythm amplitude and stability with sleep quality and sleepiness among shift nurses and health care workers.

PubMed

Jafari Roodbandi, Akram; Choobineh, Alireza; Daneshvar, Somayeh

2015-01-01

Sleep is affected by the circadian cycle and its features. Amplitude and stability of circadian rhythm are important parameters of the circadian cycle. This study aims to examine the relationship between amplitude and stability of circadian rhythm with sleep quality and sleepiness. In this cross-sectional research, 315 shift nurses and health care workers from educational hospitals of Kerman University of Medical Sciences (KUMS), Iran, were selected using a random sampling method. The Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Circadian Type Inventory (CTI) were used to collect the required data. In this study, 83.2% suffered from poor sleep and one-half had moderate and excessive sleepiness. The results showed that flexibility in circadian rhythm stability, job stress and sleepiness are among the factors affecting quality sleep in shift workers. Those whose circadian rhythm amplitude was languid suffered more from sleepiness and those whose circadian stability was flexible had a better sleep. Variables including circadian rhythm stability (flexible/rigid) and amplitude (languid/vigorous) can act as predictive indices in order to employ people in a shift work system so that sleepiness and a drop in quality of sleep are prevented.

Association of Psychological Characteristics and Functional Dyspepsia Treatment Outcome: A Case-Control Study.

PubMed

Chen, Yiping; Wang, Caihua; Wang, Jinyu; Zheng, Leilei; Liu, Weibo; Li, Huichun; Yu, Shaohua; Pan, Bin; Yu, Hualiang; Yu, Risheng

2016-01-01

This study was to investigate the association of psychological characteristics and functional dyspepsia treatment outcome. 109 patients who met the criteria for FD were enrolled. Eysenck Personality Questionnaire (EPQ), Symptom Checklist 90 (SCL90), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure personality, psychological symptoms, and sleep quality in our patients. Leeds Dyspepsia Questionnaire (LDQ) was used to assess dyspeptic symptoms at baseline and after eight weeks of treatment. The LDQ scores change after therapy, and the degraded rate of LDQ was used to assess the prognosis of patients. Logistic regression model was used to assess the effect of the personality, psychological symptoms, and sleep quality on the prognosis of patients. Our result revealed that poor sleep quality (OR = 7.68, 95% CI 1.83-32.25) and bad marriage status (OR = 1.22, 95% CI 1.10-1.36) had the negative effect on the prognosis of FD, while extroversion in personality traits (OR = 0.86, 95% CI 0.76-0.96) had positive effect on the prognosis of FD. We should pay attention to the sleep quality, the personality, and the marriage status of FD patients; psychological intervention may have benefit in refractory FD.

Sleep quality of German soldiers before, during and after deployment in Afghanistan-a prospective study.

PubMed

Danker-Hopfe, Heidi; Sauter, Cornelia; Kowalski, Jens T; Kropp, Stefan; Ströhle, Andreas; Wesemann, Ulrich; Zimmermann, Peter L

2017-06-01

In this prospective study, subjective sleep quality and excessive daytime sleepiness prior to, during and after deployment of German soldiers in Afghanistan were examined. Sleep quality (Pittsburgh Sleep Quality Index; PSQI) and daytime sleepiness (Epworth Sleepiness Scale; ESS) were assessed in 118 soldiers of the German army, who were deployed in Afghanistan for 6 months (deployment group: DG) and in 146 soldiers of a non-deployed control group (CG) at baseline. Results of the longitudinal analysis are reported, based on assessments conducted prior to, during the deployment and afterwards in the DG, and in the CG in parallel. Sleep quality and daytime sleepiness in the DG were already impaired during the predeployment training phase and remained at that level during the deployment phase, which clearly indicates the need for more attention on sleep in young soldiers, already at this early stage. The percentage of impaired sleepers decreased significantly after deployment. Programmes to teach techniques to improve sleep and reduce stress should be implemented prior to deployment to reduce sleep difficulties and excessive daytime sleepiness and subsequent psychiatric disorders. © 2017 European Sleep Research Society.

Effective Relief of Pain and Associated Symptoms With Closed-Loop Spinal Cord Stimulation System: Preliminary Results of the Avalon Study.

PubMed

Russo, Marc; Cousins, Michael J; Brooker, Charles; Taylor, Nathan; Boesel, Tillman; Sullivan, Richard; Poree, Lawrence; Shariati, Nastaran Hesam; Hanson, Erin; Parker, John

2018-01-01

Conventional spinal cord stimulation (SCS) delivers a fixed-input of energy into the dorsal column. Physiologic effects such as heartbeat, respiration, spinal cord movement, and history of stimulation can cause both the perceived intensity and recruitment of stimulation to increase or decrease, with clinical consequences. A new SCS system controls stimulation dose by measuring the recruitment of fibers in the dorsal column and by using the amplitude of the evoked compound action potentials (ECAPs) to maintain stimulation within an individualized therapeutic range. Safety and efficacy of this closed-loop system was evaluated through six-month postimplantation. Chronic pain subjects with back and/or leg pain who were successfully trialed received a permanent system (Evoke; Saluda Medical, Sydney, Australia). Ratings of pain (100-mm visual analogue scale [VAS] and Brief Pain Instrument [BPI]), quality of life (EuroQol instrument [EQ-5D-5L]), function (Oswestry Disability Index [ODI]), and sleep (Pittsburgh Sleep Quality Index [PSQI]) were collected at baseline and repeated three and six months after implantation. Fifty-one subjects underwent a trial procedure; permanent implants were placed in 36 subjects. The proportion of subjects with ≥50% relief was 92.6% (back) and 91.3% (leg) at three months, and 85.7% (back) and 82.6% (leg) at six months. The proportion with ≥80% pain relief was 70.4% (back) and 56.5% (leg) at three months, and 64.3% (back) and 60.9% (leg) at six months. Statistically significant improvements in mean BPI, EQ-5D-5L, ODI, and PSQI were also observed at both time points. The majority of subjects experienced profound pain relief at three and six months, providing preliminary evidence for the effectiveness of the closed-loop SCS system. The exact mechanism of action for these outcomes is still being explored, although one likely hypothesis holds that ECAP feedback control may minimize recruitment of Aβ nociceptors and Aδ fibers during daily use of SCS. © 2017 International Neuromodulation Society.

Can sleep quality and wellbeing be improved by changing the indoor lighting in the homes of healthy, elderly citizens?

PubMed Central

Sander, Birgit; Markvart, Jakob; Kessel, Line; Argyraki, Aikaterini; Johnsen, Kjeld

2015-01-01

The study investigated the effect of bright blue-enriched versus blue-suppressed indoor light on sleep and wellbeing of healthy participants over 65 years. Twenty-nine participants in 20 private houses in a uniform settlement in Copenhagen were exposed to two light epochs of 3 weeks with blue-enriched (280 lux) and 3 weeks blue-suppressed (240 lux) indoor light or vice versa from 8 to 13 pm in a randomized cross-over design. The first light epoch was in October, the second in November and the two light epochs were separated by one week. Participants were examined at baseline and at the end of each light epoch. The experimental indoor light was well tolerated by the majority of the participants. Sleep duration was 7.44 (95% CI 7.14–7.74) hours during blue-enriched conditions and 7.31 (95% CI 7.01–7.62) hours during blue-suppressed conditions (p = 0.289). Neither rest hours, chromatic pupillometry, nor saliva melatonin profile showed significant changes between blue-enriched and blue-suppressed epochs. Baseline Pittsburgh Sleep Quality Index (PSQI) was significantly worse in females; 7.62 (95% CI 5.13–10.0) versus 4.06 (95% CI 2.64–5.49) in males, p = 0.009. For females, PSQI improved significantly during blue-enriched light exposure (p = 0.007); no significant changes were found for males. The subjective grading of indoor light quality doubled from participants habitual indoor light to the bright experimental light, while it was stable between light epochs, although there were clear differences between blue-enriched and blue-suppressed electrical light conditions imposed. Even though the study was carried out in the late autumn at northern latitude, the only significant difference in Actiwatch-measured total blue light exposure was from 8 to 9 am, because contributions from blue-enriched, bright indoor light were superseded by contributions from daylight. PMID:26181467

Sleep quality and risk factors of atherosclerosis in predialysis chronic kidney disease.

PubMed

Guney, Ibrahim; Akgul, Yavuz S S; Gencer, Vedat; Aydemir, Harun; Aslan, Uysaler; Ecirli, Samil

2017-01-13

Chronic kidney disease (CKD) patients have more frequent sleep disorders and cardiovascular disease than normals. Since arterial stiffness as a risk factor of atherosclerosis can be evaluated with pulse wave velocity (PWV), we aimed to investigate the prevalance of sleep quality (SQ) and the relationship between SQ and risk factors of atherosclerosis and whether there is a relationship between SQ and PWV (the indicator of arterial stiffness) in predialysis CKD patients. This cross-sectional study was carried out in CKD patients followed at the Nephrology Department in Konya, Turkey, between November 2014 and March 2015. A total of 484 CKD patients were screened. Of the 484 patients, 285 patients were excluded. The remaining 199 CKD patients without cardiovascular disease at stage 3, 4, and 5 (predialysis) were included in the final study. The SQ of the patients was evaluated by the Pittsburgh Sleep Quality Index (PSQI). PWV was measured by using a single-cuff arteriography device (Mobil-O-Graph PWA, a model pulse wave analysis device; IEM). A total of 199 predialysis CKD patients were included in the study, 73 of whom (36.7 %) were 'poor sleepers' (global PSQI >5). Patients with poor SQ were older than those with good SQ (p = 0.077). SQ was worse in female patients compered to male patients (p = 0.001). SQ was worse in obese patients. As laboratory parameters, serum phosphorus, LDL cholesterol, and triglycerides levels correlated positively with SQ (respectively; r = 0.245, p&0.001; r = 0.142, p = 0.049; r = 0.142, p = 0.048). The indicator of arterial stiffness, PWV, was higher in patients with poor SQ (p = 0.033). Hyperphosphatemia and female gender are determined as risk factors for poor SQ in multivariate analysis (p = 0.049, ExpB = 1.477; p = 0.009, ExpB = 0,429, respectively). Our study showed for the first time that there is a relationship between SQ and risk factors of atherosclerosis in predialysis CKD patients.

Sleep Disturbances and Health-Related Quality of Life in Adults with Steady-State Bronchiectasis

PubMed Central

Lin, Zhiya; Tang, Yan; Lin, Zhimin; Li, Huimin; Gao, Yang; Luo, Qun; Zhong, Nanshan; Chen, Rongchang

2014-01-01

Background Sleep disturbances are common in patients with chronic lung diseases, but little is known about the prevalence in patients with bronchiectasis. A cross sectional study was conducted to investigate the prevalence and determinants associated with sleep disturbances, and the correlation between sleep disturbances and quality of life (QoL) in adults with steady-state bronchiectasis. Methods One hundred and forty-four bronchiectasis patients and eighty healthy subjects were enrolled. Sleep disturbances, daytime sleepiness, and QoL were measured by utilizing the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and St. George Respiratory Questionnaire (SGRQ), respectively. Demographic, clinical indices, radiology, spirometry, bacteriology, anxiety and depression were also assessed. Results Adults with steady-state bronchiectasis had a higher prevalence of sleep disturbances (PSQI>5) (57% vs. 29%, P<0.001), but not daytime sleepiness (ESS≥10) (32% vs. 30%, P = 0.76), compared with healthy subjects. In the multivariate model, determinants associated with sleep disturbances in bronchiectasis patients included depression (OR, 10.09; 95% CI, 3.46–29.37; P<0.001), nocturnal cough (OR, 1.89; 95% CI, 1.13–3.18; P = 0.016), aging (OR, 1.04; 95% CI, 1.01–1.07; P = 0.009) and increased 24-hour sputum volume (OR, 2.01; 95% CI, 1.22–3.33; P = 0.006). Patients with sleep disturbances had more significantly impaired QoL affecting all domains than those without. Only 6.2% of patients reported using a sleep medication at least weekly. Conclusions In adults with steady-state bronchiectasis, sleep disturbances are more common than in healthy subjects and are related to poorer QoL. Determinants associated with sleep disturbances include depression, aging, nighttime cough and increased sputum volume. Assessment and intervention of sleep disturbances are warranted and may improve QoL. PMID:25036723

Sleep disorders in high school and pre-university students.

PubMed

Rocha, Célia R S; Rossini, Sueli; Reimão, Rubens

2010-12-01

Adolescence is a period in which youngsters have to make choices such as applying for university. The selection process is competitive, and it brings distress and anxiety, risk factors for the appearance of sleep disorders. To verify the occurrence of sleep disorders in third-year high school and pre-university students. This cross-sectional descriptive study comprised a sample of 529 students (M=241, F=288) from three public schools, four private schools and two pre-university courses - a middle-class neighborhood in the city of São Paulo - aged between 16 and 19 years old. We used the Pittsburgh Sleep Quality Index (PSQI) - a standardized questionnaire. The participants (52.9%) took about 30 minutes to fall asleep, with an average of 306.4 minutes asleep, moderate daytime sleepiness (n=243, 45.9%) and indisposition (n=402, 75.9%) to develop the activities. The scores (M and F) were similar regarding problems that affect sleep. The investigated population showed sleep disorders and poor sleep quality.

Social relationships play a role in sleep status in Chinese undergraduate students.

PubMed

Jin, Yulian; Ding, Zheyuan; Fei, Ying; Jin, Wen; Liu, Hui; Chen, Zexin; Zheng, Shuangshuang; Wang, Lijuan; Wang, Zhaopin; Zhang, Shanchun; Yu, Yunxian

2014-12-15

The purpose of this study was to examine whether social relationships were associated with sleep status in Chinese undergraduate students. A cross-sectional questionnaire survey was conducted in November 2012 at Huzhou Teachers College, China. The questionnaire involved demographic characteristics, personal lifestyle habits, social relationships and Pittsburgh Sleep Quality Index (PSQI). The associations between social relationships and sleep status were analyzed by using regression models after adjustment for potential factors. Poor sleep quality was prevalent among Chinese undergraduate students. Men tended to have better sleep than women. Lower social stress, better management of stress and good social support were correlated with better sleep status, and stress or support from friends, family and classmates were all related with sleep variables. While only weak associations between number of friends and sleep were detected. The results were consistent in men and women. Educators and instructors should be aware of the importance of social relationships as well as healthy sleep in undergraduates. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Subjective Sleep Quality as a Possible Mediator in the Relationship between Personality Traits and Depressive Symptoms in Middle-Aged Adults

PubMed Central

Peck, Katlyn; Mallya, Sasha; Lupien, Sonia J.

2016-01-01

This study explored the mediating role of sleep in the relationship between personality traits and depressive symptoms in a group of community-dwelling men and women (Mage = 57.92, SD = 4.00). Participants completed the short form NEO Five Factor Inventory (NEO-FFI), Pittsburgh Sleep Quality Index (PSQI), and the Center for Epidemiologic Studies Depression Scale (CES-D). High neuroticism and low conscientiousness was associated with poor sleep, as well as greater depressive symptom severity. Partial indirect mediation effects were found between personality traits (i.e., neuroticism and conscientiousness) and depressive symptoms through self-report sleep measures. An alternative model was also explored, entering depression as the mediator; however a smaller portion of the variance was explained by this model, compared with the hypothesized model. The current study provides preliminary information regarding the mechanisms that influence the relationship between personality traits, sleep, and depression among a group of community-dwelling middle-aged adults. Implications and future directions are discussed. PMID:27285159

Relationship Between Mood Disturbance and Sleep Quality in Oncology Outpatients at the Initiation of Radiation Therapy

PubMed Central

Van Onselen, Christina; Dunn, Laura B.; Lee, Kathryn; Dodd, Marylin; Koetters, Theresa; West, Claudia; Paul, Steven M.; Aouizerat, Bradley E.; Wara, William; Swift, Patrick; Miaskowski, Christine

2010-01-01

Purpose of the research The purpose of this study was to describe the occurrence of significant mood disturbance and evaluate for differences in sleep quality among four mood groups (i.e., neither anxiety nor depression, only anxiety, only depression, anxiety and depression) prior to the initiation of radiation therapy (RT). Methods and sample Patients (n=179) with breast, prostate, lung, and brain cancer were evaluated prior to the initiation of RT using the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiological Studies Depression Scale, and the Spielberger State Anxiety Inventory. Differences in sleep disturbance among the four mood groups were evaluated using analyses of variance. Key results While 38% of the patients reported some type of mood disturbance, 57% of the patients reported sleep disturbance. Patients with clinically significant levels of anxiety and depression reported the highest levels of sleep disturbance. Conclusions Overall, oncology patients with mood disturbances reported more sleep disturbance than those without mood disturbance. Findings suggest that oncology patients need to be assessed for mood and sleep disturbances. PMID:20080444

The relationship between serum vitamin D levels and sleep quality in fixed day indoor field workers in the electronics manufacturing industry in Korea.

PubMed

Jung, Young Saeng; Chae, Chang Ho; Kim, Young Ouk; Son, Jun Seok; Kim, Chan Woo; Park, Hyoung Ouk; Lee, Jun Ho; Shin, Young Hoo; Kwak, Ho Sung

2017-01-01

Although recent studies have investigated the influence of vitamin D on sleep patterns, there is a lack of research on the relationship between vitamin D and sleep patterns in Korean workers. This study focused on the relationship between serum vitamin D levels and sleep in fixed day indoor field workers in the electronics manufacturing industry in Korea. The 1472 subjects who were included in this study were selected from fixed day workers in the electronics manufacturing industry who had received a worker's special health examination at a hospital in Changwon, South Gyeongsang Province between January 2015 and December 2015. Nighttime workers and those who showed symptoms of depression were excluded from this study. The sociodemographic and lifestyle variables of the participants were investigated, including age, sex, marital status, level of education, body mass index, smoking habits, alcohol consumption habits, and regular exercise. Work-related factors were evaluated, such as employee tenure and occupational stress. Serum 25-hydroxyvitamin D was measured as an indicator of vitamin D levels, and quality of sleep was evaluated using the Pittsburgh Sleep Quality Index (PSQI) translated into Korean. The subjects had a mean serum vitamin D level of 13.70 ± 5.93 ng/mL. Vitamin D deficiency, defined as a serum vitamin D level of <10 ng/mL, was found in 24.8% of males and significantly more frequently in females (47.6%). Poor sleep quality was reported by 19.8% of participants with serum vitamin D levels ≥10 ng/mL and by 21.7% of those with serum vitamin D levels <10 ng/mL, which was a significant difference ( P  = .007). Multiple logistic regression analysis adjusting for significant variables found that poor sleep quality was more likely in those with vitamin D deficiency than those with higher serum vitamin D levels (odds ratio = 1.36; 95% CI, 1.01-1.82). A comparison of serum vitamin D levels and PSQI components showed that the mean scores for subjective sleep quality, sleep latency, and sleep duration were significantly higher in the vitamin D-deficient participants, indicating that the vitamin D-deficient participants had poorer sleep quality. This study investigated serum vitamin D levels in fixed day indoor field workers in the manufacturing industry in Korea and analyzed the relationship of vitamin D deficiency with sleep quality. A significant correlation was found between serum vitamin D deficiency and poor sleep quality. Based on the results of this study, sleep disorder management for workers can be improved by providing regular examinations checking their serum vitamin D levels and supplying vitamin D to workers with serum vitamin D deficiency to enhance their quality of sleep.

Patient-Reported Outcomes and Socioeconomic Status as Predictors of Clinical Outcomes after Hematopoietic Stem Cell Transplantation: A Study from the Blood and Marrow Transplant Clinical Trials Network 0902 Trial.

PubMed

Knight, Jennifer M; Syrjala, Karen L; Majhail, Navneet S; Martens, Michael; Le-Rademacher, Jennifer; Logan, Brent R; Lee, Stephanie J; Jacobsen, Paul B; Wood, William A; Jim, Heather S L; Wingard, John R; Horowitz, Mary M; Abidi, Muneer H; Fei, Mingwei; Rawls, Laura; Rizzo, J Douglas

2016-12-01

This secondary analysis of a large, multicenter Blood and Marrow Transplant Clinical Trials Network randomized trial assessed whether patient-reported outcomes (PROs) and socioeconomic status (SES) before hematopoietic stem cell transplantation (HCT) are associated with each other and predictive of clinical outcomes, including time to hematopoietic recovery, acute graft-versus-host disease, hospitalization days, and overall survival (OS) among 646 allogeneic and autologous HCT recipients. Pretransplantation Cancer and Treatment Distress (CTXD), Pittsburgh Sleep Quality Index (PSQI), and mental and physical component scores of the Short-Form 36 were correlated with each other and with SES variables. PROs and SES variables were further evaluated as predictors of clinical outcomes, with the PSQI and CTXD evaluated as OS predictors (P < .01 considered significant given multiple testing). Lower attained education was associated with increased distress (P = .002), lower income was related to worse physical functioning (P = .005) and increased distress (P = .008), lack of employment before transplantation was associated with worse physical functioning (P < .01), and unmarried status was associated with worse sleep (P = .003). In this large heterogeneous cohort of HCT recipients, although PROs and SES variables were correlated at baseline, they were not associated with any clinical outcomes. Future research should focus on HCT recipients at greater psychosocial disadvantage. Copyright © 2016 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial.

PubMed

Moustafa, Ibrahim M; Diab, Aliaa A

2015-07-01

The aim of this study was to investigate the immediate and long-term effects of a one-year multimodal program, with the addition of upper cervical manipulative therapy, on fibromyalgia management outcomes in addition to three-dimensional (3D) postural measures. This randomized clinical trial with one-year follow-up was completed at the research laboratory of our university. A total of 120 (52 female) patients with fibromyalgia syndrome (FMS) and definite C1-2 joint dysfunction were randomly assigned to the control or an experimental group. Both groups received a multimodal program; additionally, the experimental group received upper cervical manipulative therapy. Primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), whereas secondary outcomes included Pain Catastrophizing Scale (PCS), algometric score, Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and 3D postural measures. Measures were assessed at three time intervals: baseline, 12 weeks, and 1 year after the 12-week follow-up. The general linear model with repeated measures indicated a significant group × time effect in favor of the experimental group on the measures of 3D postural parameters (P < .0005), FIQ (P < .0005), PCS (P < .0005), algometric score (F = P < .0005), PSQI (P < .0005), BAI (P < .0005), and BDI (P < .0005). The addition of the upper cervical manipulative therapy to a multimodal program is beneficial in treating patients with FMS.

Correlation of sleep disturbances, anxiety and depression in Croatian war veterans with posttraumatic stress disorder.

PubMed

Jevtović, Sasa; Gregurek, Rudolf; Kalenić, Barbara; Brajković, Lovorka; Bras, Marijana; Loncar, Mladen; Germain, Anne

2011-01-01

The aim of the study was to examine the relationships between global sleep quality and its specific components and Posttraumatic Stress Disorder (PTSD) symptom severity questionnaire. We also researched whether sleep quality and sleep disturbances differed among groups of PTSD based on symptom severity categories. This study was conducted on the sample of 120 Croatian war veterans with PTSD. The following self-report instruments were used: Pittsburgh Sleep Quality Index, the Pittsburgh Sleep Quality Index Addendum for PTSD, the Mississippi Scale for Combat-Related PTSD, the Spielberger State and Trait Anxiety Inventory and the Beck Depression Inventory. There were statistically significant differences between the three PTSD severity groups on general nervousness (PSQI-A variable), where patients with extremely severe PTSD have more symptoms of general nervousness than groups with severe or moderate PTSD. Differences were found between PTSD severity groups in episodes of terror and acting-out dreams, where patients with extremely severe PTSD have more symptoms of episodes of terror and acting-out dreams than groups with severe or moderate PTSD. Sleep quality was significantly correlated with state anxiety, trait anxiety, and depression, indicating that with decrease of anxiety and depression, sleep quality improves. Sleep latency was positively correlated with both state and trait anxiety. There wasn't any significant correlation between sleep latency and depression. Study suggests that sleep disturbances are equally severe across groups of veterans based on PTSD severity and that the severity of sleep disturbances is significantly related to severity of anxiety and depression symptoms.

Relationship of sleep quality with coping and life styles in female Moroccan immigrants in Germany.

PubMed

Voss, Ursula; Tuin, Inka

2008-01-01

Epidemiologic studies conducted in Western societies show poorer sleep quality in women compared with men. Socioeconomic and stress-related psychological variables have been shown to influence sleep, but not much is known about sociological and psychological influences on the sleep of women in general and non-Western women in particular. The present study reports on sociodemographic and coping variables in relation to sleep quality in female Moroccan immigrants living in Germany. Participants took part in a structured personal interview on Pittsburg Sleep Quality Inventory (PSQI) sleep quality, coping style preferences, and information related to the degree of identification with Western life style. Sleep quality was poor (PSQI > 6) in 39% of women. Surprisingly, women who had identified with a more Western lifestyle had poorer sleep quality than women who had retained their traditional Moroccan life style. An unusually large proportion of women preferred monitoring (i.e., information-seeking coping style) and adaptive coping (48% and 19%, respectively), regardless of sleep quality. Monitoring was more frequent in women who were less integrated into German culture. Results on sleep quality suggest that for Moroccan immigrant women in Germany, adopting a Western life style may be more stressful than retaining their native life style. The high preference for an information seeking approach in coping may reflect the desire for information rather than actual coping behavior.

Efficacy and Safety of Adjunctive Modafinil Treatment on Residual Excessive Daytime Sleepiness among Nasal Continuous Positive Airway Pressure-Treated Japanese Patients with Obstructive Sleep Apnea Syndrome: A Double-Blind Placebo-Controlled Study

PubMed Central

Inoue, Yuichi; Takasaki, Yuji; Yamashiro, Yoshihiro

2013-01-01

Study Objectives: This double-blind study evaluated the efficacy and safety of modafinil for treating excessive daytime sleepiness in Japanese patients with obstructive sleep apnea syndrome (OSAS). Methods: Patients with residual excessive sleepiness (Epworth Sleepiness Scale [ESS] ≥ 11) on optimal nasal continuous positive airway pressure (nCPAP) therapy (apnea-hypopnea index ≤ 10) were randomized to either 200 mg modafinil (n = 52) or placebo (n = 62) once daily for 4 weeks. Outcomes included baseline-week 4 changes in ESS total score, sleep latency on maintenance of wakefulness test (SL-MWT), nocturnal polysomnography, Pittsburgh Sleep Quality Index (PSQI), and safety. Results: All 114 randomized patients completed the study. Mean change in ESS total score (-6.6 vs -2.4, p < 0.001) and SL-MWT (+2.8 vs -0.4 minutes, p = 0.009) were significantly greater with modafinil than with placebo. ESS total score decreased from > 11 to < 11 at the final assessment in 69.2% of modafinil-treated patients and 30.6% of placebo-treated patients (p < 0.001). Corresponding rates at week 1 were 57.7% and 33.9% (p = 0.014). Changes in nocturnal polysomnography, PSQI, and apnea-hypopnea index from baseline to the final assessment were similar in both groups. Adverse drug reactions occurred in 36.5% and 22.6% of patients in the modafinil and placebo groups, respectively (p = 0.146). Conclusions: Once-daily modafinil was effective and well tolerated for managing residual daytime sleepiness in Japanese OSAS patients with residual excessive daytime sleepiness on optimal nCPAP therapy. Clinical Trial Registration: JapicCTI-No.090777 Citation: Inoue Y; Takasaki Y; Yamashiro Y. Efficacy and safety of adjunctive modafinil treatment on residual excessive daytime sleepiness among nasal continuous positive airway pressure-treated Japanese patients with obstructive sleep apnea syndrome: a double-blind placebo-controlled study. J Clin Sleep Med 2013;9(8):751-757. PMID:23946704

Sleep disturbances in patients of liver cirrhosis with minimal hepatic encephalopathy before and after lactulose therapy.

PubMed

Singh, Jatinderpal; Sharma, Barjesh Chander; Puri, Vinod; Sachdeva, Sanjeev; Srivastava, Siddharth

2017-04-01

Sleep disturbances are common in patients of cirrhosis with minimal hepatic encephalopathy (MHE) and affect health related quality of life (HRQOL). No study has evaluated effect of lactulose on sleep disturbances and correlation with HRQOL in patients with MHE. We assessed sleep disturbances in cirrhosis with MHE and effect of lactulose on sleep disturbances and HRQOL. One hundred patients of cirrhosis [MHE; (n = 50, age 45.3 ± 11.2 years, 45 males) no-MHE (n = 50, age 46.3 ± 10.4 years, 44 males)] were included. MHE was diagnosed with psychometric hepatic encephalopathy score (PHES) ≤ -5. All patients underwent laboratory parameters including arterial ammonia and critical flicker frequency (CFF) Sleep disturbances were measured with Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and polysomnography. HRQOL was measured with SF-36(v2) questionnaire. Patients with MHE were given lactulose therapy for 3 months and all the parameters were repeated. Poor quality of sleep and excessive day time sleepiness were more common in patients with MHE, compared to without MHE. With lactulose therapy there was improvement in MHE in 21 patients and arterial ammonia levels (93.74 ± 14.8 vs. 71.44 ± 18.8 μmol/L: p < 0.001), CFF (34.83 ± 3.54 vs. 39.44 ± 4.95 Hz: p < 0.001), PHES (-7.64 ± 2.1 vs. -5.58 ± 2.09: p < 0.001), PSQI (8.6 ± 3.3 vs. 5.2 ± 1.5: p < 0.001), ESS (12.52 ± 3.01 vs. 9.24 ± 2.27: p < 0.001) and HRQOL (p = 0.01). Excessive day time sleepiness and impaired sleep quality are common in patients with MHE and correlate with neuropsychiatric impairment. Improvement in MHE with lactulose also leads to improvement in sleep disturbances and HRQOL.

Sex-specific sleep patterns among university students in Lebanon: impact on depression and academic performance

PubMed Central

Kabrita, Colette S; Hajjar-Muça, Theresa A

2016-01-01

Good sleep quality and quantity are fundamental to the maintenance of normal physiological processes. Changes in sleep patterns are commonly observed among young adults and are shown to impact neurocognitive, academic, and psychological well-being. Given the scarcity of sleep information about Lebanon and acknowledging the sex differences in various sleep dimensions, we conducted a study that aimed at assessing sex differences in sleep habits among university students in Lebanon in relation to psychoacademic status. A total of 540 students (50.6% females) completed a questionnaire that inquired about sociodemographics and evaluated sleep quality and depression using the Pittsburg Sleep Quality Index (PSQI) and Center for Epidemiological Studies Depression Scale (CES-D), respectively. The mean PSQI global score (6.57±3.49) indicated poor sleep, with no significant differences between men and women. The sleep/wake rhythm was delayed on weekends for both sexes. Females exhibited earlier bedtimes and rise times and longer sleep durations on both weekdays and weekends. However, unlike males females showed a greater phase delay in wake times than bedtimes on weekends (149 minutes vs 74 minutes, respectively). In all, 70.9% of females suffered from depressive symptoms, which was a significantly higher proportion compared with 58.5% of males (P<0.01). Based on the mean cumulative self-reported grade point average (GPA), the academic performance of females was significantly better than that of males (2.8±0.61 vs 2.65±0.61, P<0.05, respectively). Depression, as scored by CES-D, in females was significantly negatively correlated with the cumulative GPA (r=−0.278, P<0.01), earlier wake time (r=−0.168, P<0.05), and average sleep duration (r=−0.221, P<0.01) on weekdays. GPA of males was significantly correlated with bedtime on weekends (r=−0.159, P<0.05). We conclude that sex differences in sleep timing, such as bedtime/rise time and nocturnal sleep duration, rather than sleep quality exist among Lebanese university students. Sex-specific sleep patterns have differential impact on psychological and academic well-being. PMID:27382345

Dry eye, sleep quality, and mood status in glaucoma patients receiving prostaglandin monotherapy were comparable with those in non-glaucoma subjects.

PubMed

Ra, Shugyoku; Ayaki, Masahiko; Yuki, Kenya; Tsubota, Kazuo; Negishi, Kazuno

2017-01-01

Prior studies suggested that glaucoma patients suffer worse dry eye and mood and sleep disorders than non-glaucoma subjects. Prostaglandin analogues are first-line therapy for glaucoma, inducing few instillation problems and sufficient pressure-reduction effects. This study compared dry eye, sleep quality, and mood status between glaucoma patients receiving prostaglandin monotherapy and non-glaucoma subjects. This cross-sectional study evaluated 1520 patients (579 males and 941 females) for glaucoma status and dry eye-related symptoms (dryness, eye fatigue, photophobia, pain, blurring) and signs (Schirmer test, tear break-up time, corneal staining scores). Of the total cohort, 93 patients were also evaluated by Pittsburgh sleep quality index (PSQI) and hospital anxiety and depression score (HADS). Inclusion criteria were consecutive patients ≥ 51 years of age and best-corrected visual acuity ≥ 20/25. Glaucoma patients included those treated with prostaglandin or a fixed combination including prostaglandin. Exclusion criteria were history of ocular surgery within one month. Data were analyzed using the chi-square or Mann-Whitney U tests, at 5% significance. There were no significant differences in dry eye-related signs and symptoms between the control (n = 1431, mean age of 66.9 years) and glaucoma groups (n = 89, 67.9 years). The psychiatric sub-analysis of the control (n = 61, 66.2 years) and glaucoma groups (n = 32, 67.3 years) revealed mean scores of 5.02 ± 3.10 and 5.16 ± 3.46 for PSQI (normal range ≤ 5), 9.47 ± 5.61 and 9.42 ± 7.36 for HADS (normal range ≤ 10), 4.84 ± 3.22 and 4.71 ± 3.45 for anxiety (normal range ≤ 5), and 4.63 ± 3.05 and 4.71 ± 4.40 for depression (normal range ≤ 5), respectively, without statistical significance. Our results were comparable between glaucoma patients on prostaglandin monotherapy and non-glaucoma subjects for dry eye-related clinical manifestations, sleep quality, and mood status.

A randomized controlled trial of problem-solving therapy compared to cognitive therapy for the treatment of insomnia in adults.

PubMed

Pech, Melissa; O'Kearney, Richard

2013-05-01

To compare the efficacy of problem-solving therapy (PST) combined with behavioral sleep strategies to standard cognitive therapy (CT) combined with behavioral sleep strategies in the treatment of insomnia. A six-week randomized controlled trial with one month follow-up. The Australian National University Psychology Clinic, Canberra, Australia. Forty-seven adults aged 18-60 years recruited from the community meeting the Research Diagnostic Criteria for insomnia. Participants received 6 weeks of treatment including one group session (sleep education and hygiene, stimulus control instructions and progressive muscle relaxation) followed by 5 weeks of individual treatment of PST or CT. Primary outcomes included sleep efficiency (SE) from sleep diaries, the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). Secondary measures assessed dysfunctional sleep beliefs, problem-solving skills and orientations, and worry. Both treatments produced significant post therapy improvements in sleep which were maintained at 1 month follow-up (on SE Cohen d = 1.42, 95% CI 1.02-1.87 for PST; d = 1.26, 95% CI 0.81-1.65 for CT; on ISI d = 1.46, 95% CI 1.03-1.88 for PST; d = 1.95, 95% CI 0.52-2.38 for CT; for PSQI d = 0.97, 95% CI 0.55-1.40 for PST and d = 1.34, 95% CI 0.90-1.79 for the CT). There were no differences in PST and CT in the size or rate of improvement in sleep although CT produced a significant faster rate of decline in negative beliefs about sleep than PST and there was a trend (P = 0.08) for PST to produce a faster rate of improvement in negative problem orientation than CT. The results provide preliminary support for problem solving treatment as an equally efficacious alternative component to cognitive therapy in psychological interventions for insomnia.

Differences in sensory reweighting due to loss of visual and proprioceptive cues in postural stability support among sleep-deprived cadet pilots.

PubMed

Cheng, Shan; Ma, Jin; Sun, Jicheng; Wang, Jian; Xiao, Xiao; Wang, Yihan; Hu, Wendong

2018-04-26

Sleep deprivation is known to diminish postural control. We investigated whether sleep deprivation affects sensory reweighting for postural control due to loss of visual and proprioceptive cues. Two cohorts of cadet pilots were deprived of sleep for 40 h. Variabilty in force-platform center of pressure was analyzed based on the whole path length (WPL); circumference area (CA); mean of displacement along x and y axes and corresponding standard deviations (SDx, SDy); and frequency of body-sway intensity, all of which were recorded while the cadets stood with eyes open (NEO), eyes closed (NEC), and eyes closed on a foam platform base (FEC) A sleepiness index (SUBI) based on principal component analysis of selected Cohort 1 data (n = 37) was used to compare Cohort 2 data (n = 29) with scores for the Stanford Sleepiness Scale (SSS) and Pittsburg Sleep Quality Index (PSQI). Balance began to deteriorate at 16 h for NEO and at 28 h for NEC and FEC (p < 0.05). At 40 h, WPL, CA, and SDy of COP for NEO indicated balance deteriorated further while WPL and SDy for NEC and WPL, CA, SDx, and SDy for FEC indicated balance incrementally improved. Frequency bias of body-sway differed between NEO, NEC, and FEC. In Cohort 2, the SUBI correlated significantly with SSS (p < 0.05), but not with PSQI. Effects of sleep deprivation were mitigated over time, suggesting that compensatory mechanisms influenced sensory reweighting for NEC and FEC between 28 and 40 h of sleep deprivation, but not for NEO. Frequency bias of body-sway suggested that sensory reweighting in the absence of visual cues differed from that in the absence of both visual and proprioceptive cues. Copyright © 2018 Elsevier B.V. All rights reserved.

Sleep-disordered breathing in patients with newly diagnosed lung cancer.

PubMed

Dreher, Michael; Krüger, Stefan; Schulze-Olden, Susanne; Keszei, András; Storre, Jan Hendrik; Woehrle, Holger; Arzt, Michael; Müller, Tobias

2018-05-16

There are currently no data on the prevalence of sleep-disordered breathing (SDB) in patients with newly-diagnosed lung cancer. This might be of interest given that SDB is associated with increased cancer incidence and mortality. Furthermore, intermittent hypoxia has been linked with tumor growth and progression. The aim of the current study was to investigate the prevalence of SDB in patients with newly-diagnosed lung cancer. Patients with newly-diagnosed lung cancer from three centers in Germany were screened for SDB using a two-channel screening system (ApneaLink™). SDB was defined as an apnea-hypopnea index of > 5/h, and was classified as mild if the AHI was 5-15/h whereas an AHI ≥15/h was classified as severe SDB. The presence of SDB-related symptoms was assessed using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). A total of 100 patients were included. The overall prevalence of SDB was 49%; 32 patients (32%) had mild SDB with a median AHI of 7.7/h (quartile [Q1 5.4/h, Q3 10.4/h]) and a median oxygen desaturation index of 8.5 [Q1 4.2/h; Q3 13.4/h] and seventeen patients (17%) had moderate to severe SDB with a median AHI of 25.2 [Q1 18/h, Q3 45.5/h] and a median oxygen desaturation index of 20.6/h [Q1 9.6/h, Q3 36.6/h]. Patients with moderate to severe SDB had mild daytime sleepiness (ESS score 8.24 ± 3.96 vs. 5.74 ± 3.53 in those without SDB vs. 6.22 ± 2.72 in those with mild SDB; p = 0.0343). The PSQI did not differ significantly between the three groups (p = 0.1137). This study showed a high prevalence of SDB in patients with newly-diagnosed lung cancer. In these patients SDB was associated with intermittent hypoxia and increased daytime sleepiness. Additional research is needed to determine whether SDB influences prognosis and morbidity in patients with lung cancer. NCT02270853 (ClinicalTrials.gov), date of registration: 14th October 2014.

Sleep quality during exam stress: the role of alcohol, caffeine and nicotine.

PubMed

Zunhammer, Matthias; Eichhammer, Peter; Busch, Volker

2014-01-01

Academic exam stress is known to compromise sleep quality and alter drug consumption in university students. Here we evaluated if sleeping problems and changes in legal drug consumption during exam stress are interrelated. We used the Pittsburgh Sleep Quality Index (PSQI) to survey sleep quality before, during, and after an academic exam period in 150 university students in a longitudinal questionnaire study. Self-reports of alcohol, caffeine, and nicotine consumption were obtained. The Perceived Stress Questionnaire (PSQ-20) was used as a measure of stress. Sleep quality and alcohol consumption significantly decreased, while perceived stress and caffeine consumption significantly increased during the exam period. No significant change in nicotine consumption was observed. In particular, students shortened their time in bed and showed symptoms of insomnia. Mixed model analysis indicated that sex, age, health status, as well as the amounts of alcohol and caffeine consumed had no significant influence on global sleep quality. The amount of nicotine consumed and perceived stress were identified as significant predictors of diminished sleep quality. Nicotine consumption had a small-to-very-small effect on sleep quality; perceived stress had a small-to-moderate effect. In conclusion, diminished sleep quality during exam periods was mainly predicted by perceived stress, while legal drug consumption played a minor role. Exam periods may pose an interesting model for the study of stress-induced sleeping problems and their mechanisms.

Sleep Quality during Exam Stress: The Role of Alcohol, Caffeine and Nicotine

PubMed Central

Zunhammer, Matthias; Eichhammer, Peter; Busch, Volker

2014-01-01

Academic exam stress is known to compromise sleep quality and alter drug consumption in university students. Here we evaluated if sleeping problems and changes in legal drug consumption during exam stress are interrelated. We used the Pittsburgh Sleep Quality Index (PSQI) to survey sleep quality before, during, and after an academic exam period in 150 university students in a longitudinal questionnaire study. Self-reports of alcohol, caffeine, and nicotine consumption were obtained. The Perceived Stress Questionnaire (PSQ-20) was used as a measure of stress. Sleep quality and alcohol consumption significantly decreased, while perceived stress and caffeine consumption significantly increased during the exam period. No significant change in nicotine consumption was observed. In particular, students shortened their time in bed and showed symptoms of insomnia. Mixed model analysis indicated that sex, age, health status, as well as the amounts of alcohol and caffeine consumed had no significant influence on global sleep quality. The amount of nicotine consumed and perceived stress were identified as significant predictors of diminished sleep quality. Nicotine consumption had a small-to-very-small effect on sleep quality; perceived stress had a small-to-moderate effect. In conclusion, diminished sleep quality during exam periods was mainly predicted by perceived stress, while legal drug consumption played a minor role. Exam periods may pose an interesting model for the study of stress-induced sleeping problems and their mechanisms. PMID:25279939

Prevalence of mood and sleep problems in chronic skin diseases: a pilot study.

PubMed

Mostaghimi, Ladan

2008-05-01

The relationship between chronic skin problems and mood and sleep disorders merits more attention. Mood and sleep problems add to comorbidity of chronic skin diseases and affect patient compliance with dermatologic treatment. A pilot study was conducted to determine the prevalence of mood and sleep problems in participants with chronic skin diseases in outpatient dermatology clinics at the University of Wisconsin, Madison, using 4 self-assessment questionnaires. Study participants included willing adults with any skin problem of at least 6 months' duration. The participants were asked to complete the questionnaires, which included Current Life Functioning, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory. In summary, 15 of 16 participants had poor sleep quality. Six participants had poor sleep quality without any mood problems (depression or anxiety). Mood problems worsened the quality of sleep and functioning. Nine of 16 participants (56.25%) reported mood problems (depression or anxiety). The results show a high prevalence of depression and anxiety and a very high prevalence of poor sleep quality. Considering the negative effect of comorbid psychiatric and sleep problems on treatment and prognosis of chronic skin diseases, this study demonstrates the need for further evaluation and eventual screening of all patients with chronic skin diseases for mood and sleep problems.

Relationship between Physical Function and Sleep Quality in African Americans

PubMed Central

Thorpe, Roland J.; Gamaldo, Alyssa A.; Salas, Rachel E.; Gamaldo, Charlene E.; Whitfield, Keith E.

2016-01-01

Study Objectives: There is a growing body of research examining the relationship between sleep and functional outcomes. However, little is known about sleep and physical functioning in older African Americans. Methods: Data for this project included 450 community-dwelling older African Americans (71.4 ± 9.2 years of age) who participated in the Baltimore Study of Black Aging. Overall sleep pattern and quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Physical functioning was measured by the number of activities of daily living that each participant reported difficulty (ADL; e.g. eating, dressing, and bathing). Negative binomial regression models were conducted to estimate the association between sleep quality and physical functioning. Results: Seventy-two percent of the participants reported poor sleep quality. African Americans who reported poor sleep quality had a greater likelihood of an increase in the number of difficulties in ADLs that they reported even after accounting for demographic characteristics and health conditions. The relationship between sleep quality and physical functioning did not vary by gender. Conclusions: Sleep may be an important factor to consider when seeking to improve physical functioning among community-dwelling older African Americans. Citation: Thorpe Jr RJ, Gamaldo AA, Salas RE, Gamaldo CE, Whitfield KE. Relationship between physical function and sleep quality in African Americans. J Clin Sleep Med 2016;12(10):1323–1329. PMID:27448426

[Integrated Chinese and Western medical treatment on postoperative fatigue syndrome in patients with gastric cancer].

PubMed

Dong, Qian-Tong; Zhang, Xiao-Dong; Yu, Zhen

2010-10-01

To evaluate the effect of the combined use of Shenmai Injection (SMI) and enteral nutrition on postoperative fatigue syndrome (POFS) in patients with gastric cancer (GC). Fifty-eight GC patients were randomized into the parenteral nutrition group (PNG, 19 cases), enteral nutrition group (ENG, 19 cases) and combined treatment group (CTG, 20 cases). The post-operative recovery in patients was observed; patients' conditions of fatigue, mood and sleep were evaluated respectively by visual analogue scale of fatigue, profile of mood states (POMS) and Pittsburgh sleep quality index (PSQI). Meanwhile, nutritional variables, such as serum contents of total protein, albumin, pre-albumin, were measured at different time points: before operation (d0) and the 1st, 5th, and 9th day (d1, d5 and d9) after operation. Immune variables such as subsets of lymphocytes (CD3, CD4, CD8), serum immunoglobulins (IgG, IgM, IgA) were also determined. Conditions of recovery, POMS and PSQI were better and the postoperative fatigue reduced more significantly in CTG than those in the other two groups (P < 0.05). On d9, levels of pre-albumin, CD3, CD4, CD4/CD8 in CTG were significantly higher than those in the PNG and ENG (P < 0.05), meantime, levels of albumin and IgA were higher in CTG than those in PNG (P < 0.05). Combined treatment of SMI and enteral nutrition can regulate mood and sleep to some extents, and reduce the postoperative fatigue through improving nutritional status and immune function, thus speeding up the recovery of patients.

Safety behaviors and sleep effort predict sleep disturbance and fatigue in an outpatient sample with anxiety and depressive disorders.

PubMed

Fairholme, Christopher P; Manber, Rachel

2014-03-01

Theoretical and empirical support for the role of dysfunctional beliefs, safety behaviors, and increased sleep effort in the maintenance of insomnia has begun to accumulate. It is not yet known how these factors predict sleep disturbance and fatigue occurring in the context of anxiety and mood disorders. It was hypothesized that these three insomnia-specific cognitive-behavioral factors would be uniquely associated with insomnia and fatigue among patients with emotional disorders after adjusting for current symptoms of anxiety and depression and trait levels of neuroticism and extraversion. Outpatients with a current anxiety or mood disorder (N = 63) completed self-report measures including the Dysfunctional Beliefs About Sleep Scale (DBAS), Sleep-Related Safety Behaviors Questionnaire (SRBQ), Glasgow Sleep Effort Scale (GSES), Pittsburgh Sleep Quality Index (PSQI), NEO Five-Factor Inventory (FFI), and the 21-item Depression Anxiety and Stress Scale (DASS). Multivariate path analysis was used to evaluate study hypotheses. SRBQ (B = .60, p < .001, 95% CI [.34, .86]) and GSES (B = .31, p < .01, 95% CI [.07, .55]) were both significantly associated with PSQI. There was a significant interaction between SRBQ and DBAS (B = .25, p < .05, 95% CI [.04, .47]) such that the relationship between safety behaviors and fatigue was strongest among individuals with greater levels of dysfunctional beliefs. Findings are consistent with cognitive behavioral models of insomnia and suggest that sleep-specific factors might be important treatment targets among patients with anxiety and depressive disorders with disturbed sleep. Copyright © 2013 Elsevier Inc. All rights reserved.

Validation of a Chinese Version of the Geriatric Anxiety Scale Among Community-Dwelling Older Adults in Mainland China.

PubMed

Lin, Xiao-Ling; Lu, Da-Li; Gottschling, Juliana; Segal, Daniel L; Tang, Si-Yuan

2017-03-01

The Geriatric Anxiety Scale (GAS) was developed as an international screening instrument for anxiety in older adults. The aims of the present study were to translate the GAS into Chinese and to subsequently evaluate the preliminary psychometric properties of the Chinese version of the GAS (GAS-C) among community-dwelling Chinese older adults. The translation of the GAS into Chinese was developed through a translation and back translation process. A sample of 206 community-dwelling older adults (51.9 % men, Mean age = 70.70 years, SD = 8.15 years) completed the GAS-C, the Beck Anxiety Inventory (BAI), the Geriatric Depression Scale (GDS) and the Pittsburgh Sleep Quality Index (PSQI). A confirmatory factor analysis was conducted to examine the factor structure of the GAS-C. Internal consistency and convergent validity were used to evaluate the psychometric properties of the translated measure. The factor analyses were in support of a unidimensional factor model of the GAS-C in this Chinese sample, and the item-total correlations for all 25 items ranged from 0.40 to 0.83. The internal consistency for the GAS-C total score was excellent (α = 0.92). The GAS-C total score were significantly and strongly correlated with the BAI (r = 0.86), the GDS (r = 0.78) and the PSQI (r = 0.63), which indicated good convergent validity of the GAS-C. The GAS-C appears to be a reliable and valid screening instrument to assess anxiety symptoms among community-dwelling older adults in mainland China.

Can standardized sleep questionnaires be used to identify excessive daytime sleeping in older post-acute rehabilitation patients?

PubMed

Skibitsky, Megan; Edelen, Maria Orlando; Martin, Jennifer L; Harker, Judith; Alessi, Cathy; Saliba, Debra

2012-02-01

Excessive daytime sleeping is associated with poorer functional outcomes in rehabilitation populations and may be improved with targeted interventions. The purpose of this study was to test simple methods of screening for excessive daytime sleeping among older adults admitted for postacute rehabilitation. Secondary analysis of data from 2 clinical samples. Two postacute rehabilitation (PAR) units in southern California. Two hundred twenty-six patients older than 65 years with Mini-Mental State Examination (MMSE) score higher than 11 undergoing rehabilitation. The primary outcome was excessive daytime sleeping, defined as greater than 15% (1.8 hours) of daytime hours (8 am to 8 pm) sleeping as measured by actigraphy. Participants spent, on average, 16.2% (SD 12.5%) of daytime hours sleeping as measured by actigraphy. Thirty-nine percent of participants had excessive daytime sleeping. The Pittsburgh Sleep Quality Index (PSQI) was significantly associated with actigraphically measured daytime sleeping (P = .0038), but the Epworth Sleepiness Scale (ESS) was not (P = .49). Neither the ESS nor the PSQI achieved sufficient sensitivity and specificity to be used as a screening tool for excessive daytime sleeping. Two additional models using items from these questionnaires were not significantly associated with the outcome. In an older PAR population, self-report items from existing sleep questionnaires do not identify excessive daytime sleeping. Therefore we recommend objective measures for the evaluation of excessive daytime sleeping as well as further research to identify new self-report items that may be more applicable in PAR populations. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Sleep quality and spiritual well-being in hemodialysis patients.

PubMed

Eslami, Ahmad Ali; Rabiei, Leili; Khayri, Freidoon; Rashidi Nooshabadi, Mohammad Reza; Masoudi, Reza

2014-07-01

Sleep disorders are considered as one of the most important problems in hemodialysis patients, making their everyday life a serious hazard. Sleep quality of hemodialysis patients and consequences of sleep disorders on other aspects of health such as spiritual well-being are important issues. This study examined the relationship between spiritual well-being and quality of sleep in hemodialysis patients in Isfahan, Iran. This study was a correlation research, carried out on 190 hemodialysis patients. Data collection Questionnaires included demographic forms, Pittsburgh sleep quality index (PSQI), and Ellison and Paloutzian spiritual well-being scale. Data were analyzed using descriptive and inferential statistics (Pearson correlation and linear regression analysis) at P < 0.05 significance level, by SPSS software version 18. Of 190 study participants, 163 (85.78%) with scores more than five index had sleep disturbances and 27 (14.12%) had no sleep disturbance; 3 (1.52%) had mild, 163 (85.78%) moderate, and 24 (12.30%) good spiritual health conditions. Pearson correlation test showed significant relationship between the sleep quality items of Pittsburg and spiritual well-being (P < 0.04, r = 0.149). Through the regression analyses of spiritual health, family, education, financial status, marital status, occupation, and use of sleep medication, the predictive power of these variables was found 0.417% and prediction of spiritual well-being was more than others (ß = 0.209). Considering bed as one of the most vital physical, mental, and emotional needs, it is very important in mental and spiritual well-being of hemodialysis patients as an influencing factor in mental relaxation and reducing disease tensions. Paying attention to sleep quality and spiritual well-being components of hemodialysis patients in formulating and promoting healthcare programs is recommended.

Relationships of eating competence, sleep behaviors and quality, and overweight status among college students.

PubMed

Quick, Virginia; Shoff, Suzanne; Lohse, Barbara; White, Adrienne; Horacek, Tanya; Greene, Geoffrey

2015-12-01

Little is known about the relationships between eating competence (intra-individual approach to eating and food-related attitudes and behaviors that entrain positive bio-psychosocial outcomes) and sleep behaviors and quality in college students, a high-risk group for poor eating habits, weight gain, and inadequate sleep. Thus, data from full-time college students (N=1035; 82% White; 61% female) aged 18-24 years from 5 U.S. universities were obtained from online questionnaires (eating competence (ecSI), Pittsburg Sleep Quality Index (PSQI), physical activity, demographics) and physical assessments (measured height, weight), to explore sleep behavior and quality between eating-competent (EC; ecSI score≥32) and non-EC groups (ecSI<32). Generalized linear models controlling for gender, body mass index, and physical activity were utilized. A higher proportion of those in the EC group reported adequate sleep quality (67% vs. 57% in non-EC, p=0.001), sleep duration of ≥7 h nightly (58% vs. 50% in non-EC, p=0.007), and infrequent daytime dysfunction (72% vs. 65% in non-EC, p=0.02). When ecSI scores were grouped as tertiles, those in the highest tertile reported a higher prevalence of no sleep disturbances (7% vs. 2% in the lowest ecSI tertile, p=0.006) and lower prevalence of sleep medication use (10% vs. 15% in the lowest ecSI tertile, p=0.04). Results suggest that competent eaters are more likely to have better overall sleep quality and fewer sleep-related issuescompared to less competent eaters. These findings may inform future longitudinal studies, and health promotion and weight management interventions for young adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

A randomized comparative trial of a combined oral contraceptive and azelaic acid to assess their effect on sleep quality in adult female acne patients.

PubMed

Albuquerque, Rachel Gimenes; da Rocha, Marco Alexandre Dias; Hirotsu, Camila; Hachul, Helena; Bagatin, Edileia; Tufik, Sergio; Andersen, Monica Levy

2015-12-01

Several studies have reported an increase in the prevalence of adult female acne. This subtype of acne presents particular characteristics, and can be triggered by several factors such as smoking, stress, the use of oily cosmetics and even by poor sleep. Sleep quality is related to well-being and the maintenance of body homeostasis. In addition, several skin diseases present a bidirectional relationship with sleep, demonstrating an important connection between skin and the central nervous system. With this in mind, we aimed to compare the effect of two types of treatment for adult female acne (azelaic acid or a combined oral contraceptive) on sleep quality and on concentrations of stress hormones. Also, we proposed to assess the correlation of sleep and hormonal parameters with acne severity. In order to do this, 32 women underwent a clinical evaluation, completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and had their blood collected for hormone assays. These procedures were performed at baseline and after 6 months of treatment. At baseline there were no differences between the groups in terms of body mass index, age, acne severity and hormone concentrations. Results showed that both treatments demonstrated effectiveness but that women treated with azelaic acid presented a better sleep quality after the treatment compared to baseline and to the group treated with the combined oral contraceptive. The combined oral contraceptive group presented an increase in cortisol and a decrease in free testosterone concentration in relation to baseline. These data suggest that both azelaic acid and combined oral contraceptive are effective in the treatment of adult female acne but, azelaic acid seems to be a more suitable option for those women who may benefit from a better subjective sleep quality.

Relationships of eating competence, sleep behaviors and quality, and overweight status among college students

PubMed Central

Quick, Virginia; Shoff, Suzanne; Lohse, Barbara; White, Adrienne; Horacek, Tanya; Greene, Geoffrey

2015-01-01

Little is known about the relationships between eating competence (intra-individual approach to eating and food-related attitudes and behaviors that entrains positive bio-psychosocial outcomes), and sleep behaviors and quality in college students, a high risk group for poor eating habits, weight gain and inadequate sleep. Thus, data from full-time college students (N=1035; 82% White; 61% female) aged 18-24 years from 5 U.S. universities were obtained from online questionnaires (eating competence (ecSI), Pittsburg Sleep Quality Index (PSQI), physical activity, demographics) and physical assessments (measured height, weight), to explore sleep behavior and quality between eating competent (EC; ecSI score ≥ 32) and non-EC groups (ecSI < 32). Generalized linear models controlling for gender, body mass index, and physical activity were utilized. A higher proportion of those in the EC group reported adequate sleep quality (67% vs. 57% in non-EC, p=0.001), sleep duration of ≥ 7 hours nightly (58% vs. 50% in non-EC, p=0.007), and infrequent daytime dysfunction (72% vs. 65% in non-EC, p=0.02). When ecSI scores were grouped as tertiles, those in the highest tertile reported a higher prevalence of no sleep disturbances (7% vs. 2% in the lowest ecSI tertile, p=0.006) and lower prevalence of sleep medication use (10% vs. 15% in the lowest ecSI tertile, p=0.04). Results suggest that competent eaters are more likely to have better overall sleep quality and fewer sleep-related issues, compared to less competent eaters. These findings may inform future longitudinal studies, and health promotion and weight management interventions for young adults. PMID:26164670

[Association between sleep quality and life function among elderly community residents].

PubMed

Tanaka, Mika; Kusaga, Mari; Tagaya, Hirokuni; Miyoko, I; Oshima, Asami; Watanabe, Chiho

2012-01-01

To investigate the association between sleep quality and life function in an elderly Japanese population. A total of 563 residents of a village in Kumamoto Prefecture aged ≥65 years were asked to fill out a self-administered questionnaire survey from June to July 2010. Sleep quality and life function were respectively evaluated using the Pittsburgh Sleep Quality Index (PSQI) and Basics Check List, which is used to screen elderly individuals at high risk of needing long-term care in the future. As adjustment factors, age, sex, economic situation, residency status, medical history, depression status, and cognitive function were assessed. We examined the relationship between sleep quality and life function using multiple logistic regression analysis, with life function as a dependent variable. Subjects already receiving care or with psychiatric disorders or severe cognitive disturbance were excluded from analysis. Among the subjects (n=395), a significant relationship was found between poor sleep quality and impaired life function in all models. The odds ratio was 1.82 (95% confidence interval: 1.03-3.23) in the final model controlling for all adjustment factors. Our findings here suggest a significant relationship between poor sleep quality and impaired life function among elderly community residents. Given these findings, intervention to improve sleep may help delay or prevent the need for long-term care among elderly individuals.

"Effect of pranayama and meditation as an add-on therapy in rehabilitation of patients with Guillain-Barré syndrome--a randomized control pilot study".

PubMed

Sendhilkumar, Ragupathy; Gupta, Anupam; Nagarathna, Raghuram; Taly, Arun B

2013-01-01

To study the add-on effects of pranayama and meditation in rehabilitation of patients with Guillain-Barré syndrome (GBS). This randomized control pilot study was conducted in neurological rehabilitation unit of university tertiary research hospital. Twenty-two GBS patients, who consented for the study and satisfied selection criteria, were randomly assigned to yoga and control groups. Ten patients in each group completed the study. The yoga group received 15 sessions in total over a period of 3 weeks (1 h/session), one session per day on 5 days per week that consisted of relaxation, Pranayama (breathing practices) and Guided meditation in addition to conventional rehabilitation therapeutics. The control group received usual rehabilitation care. All the patients were assessed using Pittsburgh Sleep Quality Index, Numeric pain rating scale, Hospital anxiety and Depression scale and Barthel index score. Mann-Whitney U test and Wilcoxon's signed rank test were used for statistical analysis. Quality of sleep improved significantly with reduction of PSQI score in the yoga group (p = 0.04). There was reduction of pain scores, anxiety and depression in both the groups without statistical significance between groups (pain p > 0.05, anxiety p > 0.05 and depression p > 0.05). Overall functional status improved in both groups without significant difference (p > 0.05). Significant improvement was observed in quality of sleep with yogic relaxation, pranayama, and meditation in GBS patients.

Prevalence of Sleep Disorders and Their Impacts on Occupational Performance: A Comparison between Shift Workers and Nonshift Workers

PubMed Central

Yazdi, Zohreh; Sadeghniiat-Haghighi, Khosro; Loukzadeh, Ziba; Elmizadeh, Khadijeh; Abbasi, Mahnaz

2014-01-01

The consequences of sleep deprivation and sleepiness have been noted as the most important health problem in our modern society among shift workers. The objective of this study was to investigate the prevalence of sleep disorders and their possible effects on work performance in two groups of Iranian shift workers and nonshift workers. This study was designed as a cross-sectional study. The data were collected by PSQI, Berlin questionnaire, Epworth Sleepiness Scale, Insomnia Severity Index, and RLS Questionnaire. Occupational impact of different sleep disorders was detected by Occupational Impact of Sleep Disorder questionnaire. These questionnaires were filled in by 210 shift workers and 204 nonshift workers. There was no significant difference in the age, BMI, marital status, and years of employment in the two groups. Shift workers scored significantly higher in the OISD. The prevalence of insomnia, poor sleep quality, and daytime sleepiness was significantly higher in shift workers. Correlations between OISD scores and insomnia, sleep quality, and daytime sleepiness were significant. We concluded that sleep disorders should receive more attention as a robust indicator of work limitation. PMID:24977041

Perceived inadequate care and excessive overprotection during childhood are associated with greater risk of sleep disturbance in adulthood: the Hisayama Study.

PubMed

Shibata, Mao; Ninomiya, Toshiharu; Anno, Kozo; Kawata, Hiroshi; Iwaki, Rie; Sawamoto, Ryoko; Kubo, Chiharu; Kiyohara, Yutaka; Sudo, Nobuyuki; Hosoi, Masako

2016-07-07

Sleep disturbance and poor sleep quality are major health problems worldwide. One potential risk factor for the development and maintenance of sleep disturbance is the parenting style experienced during childhood. However, its role in sleep disturbance in adulthood has not yet been estimated. This Japanese population study was done to clarify the relation between the parenting styles "care" and "overprotection" during childhood and sleep disturbance in adulthood. A total of 702 community-dwelling Japanese residents aged ≥ 40 years were assessed in 2011 for their perceptions of the parenting style of their parents by use of the Parental Bonding Instrument (PBI) and for sleep disturbance by use of the Pittsburgh Sleep Quality Index (PSQI). The odds ratio (OR) for sleep disturbance (a global PSQI score > 5) was calculated using a logistic regression model. The prevalence of sleep disturbance was 29 %. After adjusting for sociodemographic, lifestyle, and physical factors in a comparison with the optimal parenting styles (high care and low overprotection), the ORs for sleep disturbance by men were significantly higher for low paternal care, by 2.49 times (95 % confidence interval [CI]: 1.21-5.09), and for high overprotection, by 2.40 times (95 % CI: 1.19-4.85), while the ORs were not significant for low maternal care and high overprotection. For women the only significant factor was high maternal overprotection, by 1.62 times (95 % CI: 1.05-2.52), while the ORs were not significant for low maternal care, low paternal care and high paternal overprotection. The association remained significant for high paternal overprotection for men after additionally controlling for depression. This study suggests that parenting style, especially inadequate care and excessive overprotection during childhood, is related to sleep disturbance in adulthood and that the association is much more significant for parents of the same sex as the child.

Disparities in sleep characteristics by race/ethnicity in a population-based sample: Chicago Area Sleep Study.

PubMed

Carnethon, Mercedes R; De Chavez, Peter John; Zee, Phyllis C; Kim, Kwang-Youn A; Liu, Kiang; Goldberger, Jeffrey J; Ng, Jason; Knutson, Kristen L

2016-02-01

Prior studies report less favorable sleep characteristics among non-Whites as compared with non-Hispanic Whites. However, few population-based studies have used objective measures of sleep duration, especially in more than two racial/ethnic groups. We tested whether objectively estimated sleep duration and self-reported sleep quality varied by race and whether differences were at least partially explained by the variability in clinical, psychological, and behavioral covariates. Adults aged 35-64 years who self-identified as White, Black, Asian, or Hispanic were randomly sampled from Chicago, IL, and the surrounding suburbs. Our analytic sample included adults who had an apnea-hypopnea index <15 after one night of screening and who completed seven nights of wrist actigraphy for determination of sleep duration, sleep percentage, minutes of wake after sleep onset, and sleep fragmentation (n = 495). Daytime sleepiness was estimated using the Epworth Sleepiness Scale (ESS), and sleep quality was estimated from the Pittsburgh Sleep Quality Index (PSQI). Following statistical adjustment for age, gender, education, work schedule (ie, day vs. night shift), smoking status, depressive symptoms, body mass index (BMI), hypertension, and diabetes, sleep duration (minutes) was significantly (all p < 0.01) shorter in Black (mean = 399.5), Hispanic (mean = 411.7), and Asian (mean = 409.6) participants than in White participants (mean = 447.4). All remaining sleep characteristics were significantly less favorable among Black participants as compared with White participants. Asian participants also reported significantly more daytime sleepiness than did White participants. Differences in sleep characteristics by race/ethnicity are apparent in a sample of adults with a low probability of sleep apnea and following adjustment for known confounders. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of maternal migraine on children's quality of sleep.

PubMed

Güngen, Belma; Yildirim, Ahmet; Aras, Yeşim Guzey; Acar, Bilgehan Atılgan; Tekeşin, Aysel; Ayaz, Ayse Burcu

2017-11-30

Sleep disorders are common problems associated with migraine. These sleep disorders are known to have a debilitating impact on daily lives of migraine patients. The purpose of this study is to assess the effects of sleep disorders experienced by individuals suffering from migraine on their children as well as the presence of sleep disorders in their children. This study included 96 mothers diagnosed with migraine and their 96 healthy children, and a control group formed of 74 healthy mothers and their children. Exclusion criteria were chronic systemic disease or central nervous system disease or a history of smoking/alcohol use for mothers, and chronic disease or regularly occurring headaches or recurrent abdominal pain for children. For maternal evaluation, the Visual Analogue Scale (VAS), Migraine Disability Assessment Scale (MIDAS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Index (BDI) and Beck Anxiety Index (BAI) were used and for the assessment of the children's quality of sleep, the Children's Sleep Habits Questionnaire (CSHQ) was used. The SPSS 21.0 program was employed for statistical analysis, with statistical significance set at p<0.05. The mean age of the group with migraine was 36.6±7.1 years, while that of the control group was 38.01±4.7. Mood and sleep disorders were more frequently observed in the participants with migraine (p<0.05). Sleep disorders were significantly low in children with migraineur mothers (p=0.02); and child sleep anxiety is significantly high in control group (p=0.048). Maternal BAI scores had a significant influence on their children's quality of sleep. In our study, the presence of migraine-type headache in mothers was observed to have a positive effect on reducing sleep disorders in the children. Recurrent headaches of the migraineur mothers with or without sleep disorders and psychiatric comorbidities did not influence the quality of sleep in their children directly, but the sleep anxiety of the children may have had an impact on it.

A Comparison of Sleep Difficulties among Iraq/Afghanistan Theater Veterans with and without Mental Health Diagnoses

PubMed Central

Ulmer, Christi S.; Van Voorhees, Elizabeth; Germain, Anne E.; Voils, Corrine I.; Beckham, Jean C.

2015-01-01

Study Objectives: Sleep disturbance is among the most common complaints of veterans and military personnel who deployed to the conflicts in Iraq and Afghanistan. A growing body of research has examined cross-sectional and longitudinal relationships between sleep disturbance and mental health symptoms and specific diagnoses in this population. However, prior research has not examined these relationships in terms of the presence or absence of any mental health diagnosis. The objective of the current study is to characterize the sleep complaints (sleep characteristics, sleep quality, insomnia symptoms, and distressing dreams and nightmares) of previously deployed military personnel in terms of the presence or absence of a mental health disorder, diagnosed using structured clinical diagnostic interviews. Methods: Participants (n = 1,238) were veterans and active duty military personnel serving in the military since September 11, 2001, and deployed at least once. Scale scores and item-level data from the Pittsburgh Sleep Quality Index (PSQI), the PSQI-Addendum, the Davidson Trauma Scale, and the Symptom Checklist-90 were used to compare sleep across mental health status (with/without mental health disorder). Results: As expected, self-reported sleep impairments were worse among those meeting criteria for a mental health disorder. However, findings also revealed very poor sleep among those without a mental health diagnosis as well. Mean values for both groups were suggestive of short sleep duration, low sleep efficiency, long sleep onset latencies, poor sleep quality, frequent insomnia symptoms, and nightmare frequencies that are well above norms for the general population. Conclusions: Given the evidence for adverse mental and physical health sequelae of untreated sleep disturbance, increased attention to sleep in this population may serve as a primary prevention strategy. Citation: Ulmer CS, Van Voorhees E, Germain AE, Voils CI, Beckham JC; VA Mid-Atlantic Mental Illness Research Education and Clinical Center Registry Workgroup. A comparison of sleep difficulties among Iraq/Afghanistan theater veterans with and without mental health diagnoses. J Clin Sleep Med 2015;11(9):995–1005. PMID:26094928

The Longitudinal Relationship between Fatigue and Sleep in Breast Cancer Patients Undergoing Chemotherapy

PubMed Central

Liu, Lianqi; Rissling, Michelle; Natarajan, Loki; Fiorentino, Lavinia; Mills, Paul J.; Dimsdale, Joel E.; Sadler, Georgia Robins; Parker, Barbara A.; Ancoli-Israel, Sonia

2012-01-01

Study Objective: Fatigue and sleep disturbances are two of the most common and distressing symptoms of cancer patients. A relationship between the two symptoms was reported in symptom cluster studies; however, only subjective measurements of sleep were examined and most studies were cross-sectional. In this study of women with breast cancer undergoing chemotherapy, we explored the longitudinal relationship between fatigue and sleep measured both subjectively and objectively. Design: Prospective study. Data were collected at 7 time points: before (baseline) and during the 3 weeks of cycle 1 and cycle 4 chemotherapy. Participants: Ninety-seven women with newly diagnosed stage I-III breast cancer who were scheduled to receive at least four 3-week cycles of chemotherapy. Measurement and Results: Objective sleep parameters were measured with an Actillume actigraph (Ambulatory Monitoring Inc.). Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Fatigue was assessed with the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Fatigue became worse during both cycles of chemotherapy (P-values < 0.01). Subjective sleep quality was poor at baseline and remained unchanged throughout treatment. Objective nighttime and daytime total sleep time increased compared to baseline during the treatment administration week of both cycles; daytime total wake time decreased during the treatment week of both cycles and during the last 2 week of cycle 4. Mixed model results revealed that fatigue was positively associated with total PSQI scores and with objective measures of total nap time, and negatively associated with total wake time during the day (all P-values < 0.01). Conclusion: Fatigue was significantly associated with subjective reports of poor sleep and objective measures of daytime sleepiness, but not with nocturnal sleep as measured with actigraphy. This relationship between fatigue and sleep warrants further studies to explore their possible common underlying etiology. Citation: Liu L; Rissling M; Natarajan L; Fiorentino L; Mills PJ; Dimsdale JE; Sadler GR; Parker BA; Ancoli-Israel S. The longitudinal relationship between fatigue and sleep in breast cancer patients undergoing chemotherapy. SLEEP 2012;35(2):237-245. PMID:22294814

Effect of Diabetes Sleep Education for T2DM Who Sleep After Midnight: A Pilot Study from China.

PubMed

Li, Mingzhen; Li, Daiqing; Tang, Yunzhao; Meng, Lingling; Mao, Cuixiu; Sun, Lirong; Chang, Baocheng; Chen, Liming

2018-02-01

Our prior study showed that patients with sleep disorders had poor blood pressure (BP), glycemic control, and more severe complications. Therefore, sleep is very important for diabetic control. Our work was to investigate whether individualized diabetes sleep education significantly improve sleep quality and glycemic control in type 2 diabetic patients who sleep after midnight and potential mechanism by a randomized parallel interventional study. T2D patients were randomly recruited to an intervention or control group. Patients received structured special diabetes sleep education program with 3-month follow-up. Pittsburg Sleep Quality Index (PSQI) was scored for each participant. Demographic data, HbA1c, biochemical, and some hormones were also examined. SPSS 13.0 was used for statistical analysis. One hundred patients were approached, and 45 were enrolled into our trial. Eventually, 31 patients completed the study. Patients in the intervention group greatly improved their sleep hygiene. After intervention, PSQI scores were lowered significantly (-1.48 ± 0.88 vs. -0.51 ± 0.71, P < 0.001), as well as significant reduction of HbA1c (-1.5 ± 0.55 vs. -1.11 ± 0.47, P < 0.05). Fasting plasma glucose was also lowered significantly. Homeostasis model assessment of insulin resistance was reduced significantly (-1.29 ± 0.97 vs. 1.04 ± 0.91, P < 0.01). Serum concentrations for interleukin (IL)-6, cortisol, and ghrelin were decreased significantly. Ghrelin (coefficients -0.65, P < 0.001), cortisol (coefficients -0.38, P < 0.05), and IL-6 (coefficients 0.452, P < 0.05) were correlated with HbA1c improvement. The change of ghrelin was negatively associated with the improvement of HbA1c. Diabetes sleep education could improve sleep quality, better blood glucose and BP, and decrease insulin resistance through healthier sleep hygiene. Lower serum concentration of ghrelin might be partly involved in the reduction of HbA1c.

Fatigue in Patients With Advanced Terminal Cancer Correlates With Inflammation, Poor Quality of Life and Sleep, and Anxiety/Depression.

PubMed

Rodrigues, Alex Rua; Trufelli, Damila Cristina; Fonseca, Fernando; de Paula, Larissa Carvalho; Giglio, Auro Del

2016-12-01

To assess which laboratory and clinical factors are associated with fatigue in patients with terminal cancer. We evaluated 51 patients with advanced incurable solid tumors using the Chalder Fatigue Questionnaire (CFQ) and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale for fatigue; the Pittsburgh Sleep Quality Index (PSQI-BR) for sleep quality; the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression; the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire, Version 3.0 (QLQ C-30); and Functional Assessment of Cancer Therapy (FACT) for quality of life. We also analyzed several inflammatory markers and the modified Glasgow prognostic score (mGPS). We observed severe fatigue in 19 (38%) patients (FACIT-F score >36). There was a significant correlation between fatigue as evaluated by the CFQ and quality of sleep and between the CFQ mental fatigue subscale scores and TNF-α level. When fatigue was evaluated using the FACIT-F scale, we observed a significant association between fatigue and anxiety/depression, quality of sleep, mGPS, and hemoglobin levels. Fatigue measured both with the CFQ and FACIT-F scale correlated with poor quality of life according to the EORTC QLQ C-30. In patients with advanced cancer, fatigue is a common symptom associated with the presence of inflammation, poor quality of sleep, depression/anxiety, and poor quality of life. © The Author(s) 2015.

Childhood trauma, depression, and sleep quality and their association with psychotic symptoms and suicidality in schizophrenia.

PubMed

Kilicaslan, Esin Evren; Esen, Asli Tugba; Kasal, Meltem Izci; Ozelci, Erdal; Boysan, Murat; Gulec, Mustafa

2017-12-01

This study involved the examination of the relationship between childhood trauma and both psychotic symptoms and suicidality in patients with schizophrenia after controlling for the possible confounding factors, such as clinical features, depression, and sleep quality. The Childhood Trauma Questionnaire-Short Form, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Pittsburgh Sleep Quality Index (PSQI), and the suicidality subscale of Mini-International Neuropsychiatric Interview (MINI) were administered to 199 patients with schizophrenia. We used sequential multiple stepwise regression analyses in which positive symptoms, negative symptoms, overall psychopathology, total symptoms of schizophrenia, and suicidality were dependent variables. Depressive symptomatology and childhood physical abuse significantly contributed to positive, negative, general psychopathology, and global schizophrenia symptomatology. Interestingly, general psychopathology scores were negatively associated with childhood physical neglect. Also, subjective sleep quality significantly contributed to positive schizophrenia symptoms. Although prior suicide attempts and depression were significant antecedents of suicidal ideation, no association between suicidality and both childhood trauma and sleep was found. Childhood physical abuse could have an impact on psychopathology in schizophrenia. In addition to childhood trauma, depression, sleep disturbances, and clinical features should be considered and inquired about in the course of clinical care of schizophrenia patients. Copyright © 2017 Elsevier B.V. All rights reserved.

The Impact of Sleep Timing, Sleep Duration, and Sleep Quality on Depressive Symptoms and Suicidal Ideation amongst Japanese Freshmen: The EQUSITE Study

PubMed Central

Supartini, Atin; Honda, Takanori; Basri, Nadzirah A.; Haeuchi, Yuka; Chen, Sanmei; Ichimiya, Atsushi; Kumagai, Shuzo

2016-01-01

Aim. The aim of this study was to identify the impact of bedtime, wake time, sleep duration, sleep-onset latency, and sleep quality on depressive symptoms and suicidal ideation amongst Japanese freshmen. Methods. This cross-sectional data was derived from the baseline survey of the Enhancement of Q-University Students Intelligence (EQUSITE) study conducted from May to June, 2010. A total of 2,631 participants were recruited and completed the following self-reported questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), and the original Health Support Questionnaires developed by the EQUSITE study research team. Results. Of 1,992 participants eligible for analysis, 25.5% (n = 507) reported depressive symptoms (CES-D total score ≥ 16), and 5.8% (n = 115) reported suicidal ideation. The present study showed that late bedtime (later than 01:30), sleep-onset latency (≥30 minutes), and poor sleep quality showed a marginally significant association with depressive symptoms. Poor sleep quality was seen to predict suicidal ideation even after adjusting for depressive symptoms. Conclusion. The current study has important implications for the role of bedtime in the prevention of depressive symptoms. Improving sleep quality may prevent the development of depressive symptoms and reduce the likelihood of suicidal ideation. PMID:27042358

The Association Between Trait Gratitude and Self-Reported Sleep Quality Is Mediated by Depressive Mood State.

PubMed

Alkozei, Anna; Smith, Ryan; Kotzin, Megan D; Waugaman, Debby L; Killgore, William D S

2017-01-27

It has been shown that higher levels of trait gratitude are associated with better self-reported sleep quality, possibly due to differences in presleep cognitions. However previous studies have not taken into account the role of depressive symptoms in this relationship. In this study, 88 nonclinical 18-29-year-olds completed the Gratitude Resentment and Appreciation Test (GRAT) as a measure of trait gratitude. The Glasgow Content of Thought Inventory (GCTI) was used to measure the intrusiveness of cognitions prior to sleep onset, the Motivation and Energy Inventory (MEI) assessed daytime fatigue, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess self-reported sleep quality. The BDI-II assessed self-reported depressive symptoms. Consistent with previous work, GRAT scores were positively associated with higher daytime energy and greater number of hours of sleep per night. Importantly, however, we further observed that depressive symptoms mediated the relationships between gratitude scores and sleep metrics. Depressive mood state appears to mediate the association between gratitude and self-reported sleep quality metrics. We suggest, as one plausible model of these phenomena, that highly grateful individuals have lower symptoms of depression, which in turn leads to fewer presleep worries, resulting in better perceived sleep quality. Future work should aim to disentangle the causal nature of these relationships in order to better understand how these important variables interact.

Obstructive sleep apnea syndrome and sleep quality in hypertensive patients.

PubMed

Bacci, Marcelo Rodrigues; Emboz, Jonathan Naim Mora; Alves, Beatriz da Costa Aguiar; Veiga, Glaucia Luciano da; Murad, Neif; Meneghini, Adriano; Chagas, Antonio Carlos P; Fonseca, Fernando Luiz Affonso

2017-12-01

Obstructive sleep apnea and hypopnea syndrome (OSAHS) is one of the developmental factors of high blood pressure (HBP), a relevant global public health problem. OSAHS is characterized by the reduction or complete cessation of respiratory airflow due to intermittent airway collapse. Additionally, significant changes in sleep rhythm and pattern are observed in these patients. To evaluate the association between OSAHS and sleep quality in essential and resistant hypertensives. A cross-sectional, observational study evaluated 43 hypertensive patients treated at the outpatient clinics of the Faculdade de Medicina do ABC (FMABC) who were medicated with two or more antihypertensive drugs and divided into nonresistant or resistant to treatment. Group I (using up to two antihypertensive agents - 60.47% of the sample) presented mean systolic blood pressure (SBP) of 127.5±6.4 mmHg, mean diastolic blood pressure (DBP) of 79.6±5.2 mmHg, mean body mass index (BMI) of 27.2±5.3 kg/m2 and mean age of 51.2±15.1 years. Group II (using more than two antihypertensive drugs - 37.2% of the sample) presented mean SBP of 132.1±9.3 mmHg, mean DBP of 84.5±5.8 mmHg, mean BMI of 27.2±7.2 kg/m2 and mean age of 55.5±13.4 years. The patients presented low quality of sleep/sleep disorder evaluated by the Pittsburgh Sleep Quality Index (PSQI), which represents a preponderant factor for OSAHS. Patients at high risk for OSAHS had poor sleep quality and high levels of DBP, suggesting a causal relation between these parameters. However, they did not present a higher prevalence of resistant high blood pressure (RHBP).

Self-reported napping and duration and quality of sleep in the lifestyle interventions and independence for elders pilot study.

PubMed

Picarsic, Jennifer L; Glynn, Nancy W; Taylor, Christopher A; Katula, Jeffrey A; Goldman, Suzanne E; Studenski, Stephanie A; Newman, Anne B

2008-09-01

To determine the prevalence of self-reported napping and its association with subjective nighttime sleep duration and quality, as measured according to sleep-onset latency and sleep efficiency. Cross-sectional study. Lifestyle Interventions and Independence for Elders Pilot Study. Community-dwelling older adults (N=414) aged 70 to 89. Self-report questionnaire on napping and sleep derived from the Pittsburgh Sleep Quality Index (PSQI) scale. Fifty-four percent of participants reported napping, with mean nap duration of 55.0+/-41.2 minutes. Nappers were more likely to be male (37.3% vs 23.8%, P=.003) and African American (20.4% vs 14.4%, P=.06) and to have diabetes mellitus (28% vs 14.3%, P=.007) than non-nappers. Nappers and non-nappers had similar nighttime sleep duration and quality, but nappers spent approximately 10% of their 24-hour sleep occupied in napping. In a multivariate model, the odds of napping were higher for subjects with diabetes mellitus (odds ratio (OR)=1.9, 95% confidence interval (CI)=1.2-3.0) and men (OR=1.9, 95% CI=1.2-3.0). In nappers, diabetes mellitus (beta=12.3 minutes, P=.005), male sex (beta=9.0 minutes, P=.04), higher body mass index (beta=0.8 minutes, P=.02), and lower Mini-Mental State Examination score (beta=2.2 minutes, P=.03) were independently associated with longer nap duration. Napping was a common practice in community-dwelling older adults and did not detract from nighttime sleep duration or quality. Given its high prevalence and association with diabetes mellitus, napping behavior should be assessed as part of sleep behavior in future research and in clinical practice.

Sleep patterns and sleep disturbances across pregnancy.

PubMed

Mindell, Jodi A; Cook, Rae Ann; Nikolovski, Janeta

2015-04-01

This study sought to characterize sleep patterns and sleep problems in a large sample of women across all months of pregnancy. A total of 2427 women completed an Internet-based survey that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, vitality scale of the Short Form 36 Health Survey (SF-36), Insomnia Severity Index (ISI), Berlin questionnaire, International Restless Legs Syndrome (IRLS) question set, and a short version of the Pregnancy Symptoms Inventory (PSI). Across all months of pregnancy, women experienced poor sleep quality (76%), insufficient nighttime sleep (38%), and significant daytime sleepiness (49%). All women reported frequent nighttime awakenings (100%), and most women took daytime naps (78%). Symptoms of insomnia (57%), sleep-disordered breathing (19%), and restless legs syndrome (24%) were commonly endorsed, with no difference across the month of pregnancy for insomnia, sleep-disorder breathing, daytime sleepiness, or fatigue. In addition, high rates of pregnancy-related symptoms were found to disturb sleep, especially frequent urination (83%) and difficulty finding a comfortable sleep position (79%). Women experience significant sleep disruption, inadequate sleep, and high rates of symptoms of sleep disorder throughout pregnancy. These results suggest that all women should be screened and treated for sleep disturbances throughout pregnancy, especially given the impact of inadequate sleep and sleep disorders on fetal, pregnancy, and postpartum outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.

Sleep Complaints in Older Blacks: Do Demographic and Health Indices Explain Poor Sleep Quality and Duration?

PubMed Central

Gamaldo, Alyssa A.; Gamaldo, Charlene E.; Allaire, Jason C.; Aiken-Morgan, Adrienne T.; Salas, Rachel E.; Szanton, Sarah; Whitfield, Keith E.

2014-01-01

Objective: To examine the relationship between measures of sleep quality and the presence of commonly encountered comorbid and sociodemographic conditions in elderly Black subjects. Method: Analyses included participants from the Baltimore Study of Black Aging (BSBA; n = 450; mean age 71.43 years; SD 9.21). Pittsburgh Sleep Quality Index (PSQI) measured overall sleep pattern and quality. Self-reported and objective measures of physical and mental health data and demographic information were collected for all participants. Results: Sociodemographic and comorbid health factors were significantly associated with sleep quality. Results from regression analyses revealed that older age, current financial strain, interpersonal problems, and stress were unique predictors of worse sleep quality. Sleep duration was significantly correlated with age, depressive affect, interpersonal problems, and stress; only age was a unique significant predictor. While participants 62 years or younger had worse sleep quality with increasing levels of stress, there was no significant relationship between sleep quality and stress for participants 81 years and older. Conclusions: Several potential mechanisms may explain poor sleep in urban, community dwelling Blacks. Perceived stressors, including current financial hardship or hardship experienced for an extended time period throughout the lifespan, may influence sleep later in life. Citation: Gamaldo AA, Gamaldo CE, Allaire JC, Aiken-Morgan AT, Salas RE, Szanton S, Whitfield KE. Sleep complaints in older blacks: do demographic and health indices explain poor sleep quality and duration? J Clin Sleep Med 2014;10(7):725-731. PMID:25024649

Associations between chronotype, sleep quality, suicidality, and depressive symptoms in patients with major depression and healthy controls.

PubMed

Selvi, Yavuz; Aydin, Adem; Boysan, Murat; Atli, Abdullah; Agargun, Mehmed Yucel; Besiroglu, Lutfullah

2010-10-01

Research interest concerning associations between sleep characteristics and suicidality in psychopathology has been growing. However, possible linkages of suicidality to sleep characteristics in terms of sleep quality and chronotypes among depressive patients have not been well documented. In the current study, the authors investigated the possible effects of sleep quality and chronotype on the severity of depressive symptoms and suicide risk in patients with depressive disorder and healthy controls. The study was conducted on 80 patients clinically diagnosed with major depression and 80 healthy subjects who were demographically matched with the patient group. All participants completed a questionnaire package containing self-report measures, including the Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), and Suicide Ideation Scale (SIS), and subjects were interviewed with the suicidality section of the Mini-International Neuropsychiatric Interview (MINI). Results are as follows: (a) logistic regression analyses revealed that poor sleep quality and depression symptom severity significantly predicted onset of major depression; (b) morningness-type circadian rhythm may play as a significant relief factor after onset of major depression; (c) sleep variables of chronotype and sleep quality did not significantly predict suicide ideation after controlling for depressive symptoms in the major depression group; and (d) suicide ideation and poor sleep quality were antecedents of depression symptom severity in patients with major depression, and in healthy controls. Findings are discussed under the theoretical assumptions concerning possible relations between chronotype, sleep quality, depression, and suicidality.

The relationship between depressive symptoms among female workers and job stress and sleep quality.

PubMed

Cho, Ho-Sung; Kim, Young-Wook; Park, Hyoung-Wook; Lee, Kang-Ho; Jeong, Baek-Geun; Kang, Yune-Sik; Park, Ki-Soo

2013-07-22

Recently, workers' mental health has become important focus in the field of occupational health management. Depression is a psychiatric illness with a high prevalence. The association between job stress and depressive symptoms has been demonstrated in many studies. Recently, studies about the association between sleep quality and depressive symptoms have been reported, but there has been no large-scaled study in Korean female workers. Therefore, this study was designed to investigate the relationship between job stress and sleep quality, and depressive symptoms in female workers. From Mar 2011 to Aug 2011, 4,833 female workers in the manufacturing, finance, and service fields at 16 workplaces in Yeungnam province participated in this study, conducted in combination with a worksite-based health checkup initiated by the National Health Insurance Service (NHIS). In this study, a questionnaire survey was carried out using the Korean Occupational Stress Scale-Short Form(KOSS-SF), Pittsburgh Sleep Quality Index(PSQI) and Center for Epidemiological Studies-Depression Scale(CES-D). The collected data was entered in the system and analyzed using the PASW (version 18.0) program. A correlation analysis, cross analysis, multivariate logistic regression analysis, and hierarchical multiple regression analysis were conducted. Among the 4,883 subjects, 978 subjects (20.0%) were in the depression group. Job stress(OR=3.58, 95% CI=3.06-4.21) and sleep quality(OR=3.81, 95% CI=3.18-4.56) were strongly associated with depressive symptoms. Hierarchical multiple regression analysis revealed that job stress displayed explanatory powers of 15.6% on depression while sleep quality displayed explanatory powers of 16.2%, showing that job stress and sleep quality had a closer relationship with depressive symptoms, compared to the other factors. The multivariate logistic regression analysis yielded odds ratios between the 7 subscales of job stress and depressive symptoms in the range of 1.30-2.72 and the odds ratio for the lack of reward was the highest(OR=2.72, 95% CI=2.32-3.19). In the partial correlation analysis between each of the 7 subscales of sleep quality (PSQI) and depressive symptoms, the correlation coefficient of subjective sleep quality and daytime dysfunction were 0.352 and 0.362, respectively. This study showed that the depressive symptoms of female workers are closely related to their job stress and sleep quality. In particular, the lack of reward and subjective sleep factors are the greatest contributors to depression. In the future, a large-scale study should be performed to augment the current study and to reflect all age groups in a balanced manner. The findings on job stress, sleep, and depression can be utilized as source data to establish standards for mental health management of the ever increasing numbers of female members of the workplace.

The self-morningness/eveningness (Self-ME): An extremely concise and totally subjective assessment of diurnal preference.

PubMed

Turco, M; Corrias, M; Chiaromanni, F; Bano, M; Salamanca, M; Caccin, L; Merkel, C; Amodio, P; Romualdi, C; De Pittà, C; Costa, R; Montagnese, S

2015-01-01

The assessment of diurnal preference, or the preferred timing of sleep and activity, is generally based on comprehensive questionnaires such as the Horne-Östberg (HÖ). The aim of the present study was to assess the reliability of a subject's self-classification as extremely morning (Self-MM), more morning than evening (Self-M), more evening than morning (Self-E) or extremely evening (Self-EE) type, based on the last question of the HÖ (Self-ME). A convenience sample of 461 subjects [23.8 ± 4.7 years; 322 females] completed a full sleep-wake assessment, including diurnal preference (HÖ), night sleep quality (Pittsburgh Sleep Quality Index, PSQI), daytime sleepiness (Karolinska Sleepiness Scale, KSS), and habitual sleep-wake timing (12 d sleep diaries; n = 296). Significant differences in HÖ total score were observed between Self-ME classes, with each class being significantly different from neighboring classes (p < 0.0001). Significant differences in sleep-wake timing (bed time, try to sleep and sleep onset, wake up, and get up time) were observed between Self-ME classes. Such differences were maintained when sleep-wake habits were analysed separately on work and free days, and also in a smaller group of 67 subjects who completed the Self-ME as a stand-alone rather than as part of the original questionnaire. Significant differences were observed in the time-course of subjective sleepiness by Self-ME class in both the large and the small group, with Self-MM and Self-M subjects being significantly more alert in the morning and sleepier in the evening hours compared with their Self-E and Self-EE counterparts. Finally, significant differences were observed in night sleep quality between Self-ME classes, with Self-EE/Self-E subjects sleeping worse than their Self-MM/Self-M counterparts, and averaging just over the abnormality PSQI threshold of 5. In conclusion, young, healthy adults can define their diurnal preference based on a single question (Self-ME) in a way that reflects their sleep-wake timing, their sleepiness levels over the daytime hours, and their night sleep quality. Validation of the Self-ME across the decades and in diseased populations seems worthy.

Exploring the Effect of Lactium™ and Zizyphus Complex on Sleep Quality: A Double-Blind, Randomized Placebo-Controlled Trial

PubMed Central

Scholey, Andrew; Benson, Sarah; Gibbs, Amy; Perry, Naomi; Sarris, Jerome; Murray, Greg

2017-01-01

Acute, non-clinical insomnia is not uncommon. Sufferers commonly turn to short-term use of herbal supplements to alleviate the symptoms. This placebo-controlled, double-blind study investigated the efficacy of LZComplex3 (lactium™, Zizyphus, Humulus lupulus, magnesium and vitamin B6), in otherwise healthy adults with mild insomnia. After a 7-day single-blind placebo run-in, eligible volunteers (n = 171) were randomized (1:1) to receive daily treatment for 2 weeks with LZComplex3 or placebo. Results revealed that sleep quality measured by change in Pittsburgh Sleep Quality Index (PSQI) score improved in both the LZComplex3 and placebo groups. There were no significant between group differences between baseline and endpoint on the primary outcome. The majority of secondary outcomes, which included daytime functioning and physical fatigue, mood and anxiety, cognitive performance, and stress reactivity, showed similar improvements in the LZComplex3 and placebo groups. A similar proportion of participants reported adverse events (AEs) in both groups, with two of four treatment-related AEs in the LZComplex3 group resulting in permanent discontinuation. It currently cannot be concluded that administration of LZComplex3 for 2 weeks improves sleep quality, however, a marked placebo response (despite placebo run-in) and/or short duration of treatment may have masked a potential beneficial effect on sleep quality. PMID:28218661

Sleep-wake cycle phenotypes in young people with familial and non-familial mood disorders.

PubMed

Scott, Jan; Naismith, Sharon; Grierson, Ashlee; Carpenter, Joanne; Hermens, Daniel; Scott, Elizabeth; Hickie, Ian

2016-12-01

Converging evidence identifies that the offspring of parents with bipolar disorder (BD), individuals at clinical high risk of BD, and young people with recent onset BD may differ from other clinical cases or healthy controls in terms of sleep-wake profiles. However, it is possible that these differences may reflect current mental state, subtype of mood disorder, or familial traits. This study aimed to determine objective and subjective sleep-wake profiles in individuals aged 15-25 years with a current major depressive episode, in relation to familial traits. Frequency matching was employed to ensure that each individual with a confirmed family history of BD (FH+) could be compared to four controls who did not have a familial mood disorder (FH-). Pre-selected objective actigraphy and subjective Pittsburgh Sleep Quality Index (PSQI) ratings were compared using one-way analysis of variance (ANOVA) and applying the Benjamini-Hochberg (BH) correction for false discoveries. The sample comprised 60 individuals with a mean age of 19 years. The FH+ (n=12) and FH- groups (n=48) differed on three key sleep parameters: mean sleep duration on week nights (P=.049), variability in waking after sleep onset (P=.038), and daily disturbances (PSQI dimension of sleep disturbance and daytime dysfunction; P=.01). The sleep profiles we identified in this study, especially the daily disturbances phenotype, provide support for research into endophenotypes for BD. Also, the findings may offer the opportunity for more tailored, personalized interventions that target specific components of the sleep-wake cycle in individuals with a family history of BD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Association of CHRNA4 gene rs1044396 and rs1044397 polymorphisms with Parkinson's disease symptoms and smoking.

PubMed

Zhang, L M; Zhang, X P; Chen, Y Q; Ye, W

2015-05-12

We assessed the CHRNA4 exon 5 rs1044396 and rs1044397 polymorphisms and investigated their relationship with Parkinson's disease (PD) severity and several non-motor symptoms. Ninety-seven patients with primary PD and 108 controls were recruited, and their smoking history identified. Patients with PD were assessed using the unified PD rating scale (UPDRS), Hoehn & Yahr (H&Y) grade, Hamilton depression rating scale (HAMD), visual analogue 10-points scale (VAS), and the Pittsburgh sleep quality index (PSQI). Polymerase chain reaction amplification and direct sequencing was performed on genomic DNA to identify polymorphic variants. Statistical analysis demonstrated that there were no gender differences in rs1044396(C→T) and rs1044397(G→A) frequencies. More smokers were identified among carriers of rs1044396 CT/TT genotypes. We also found no differences between PD and control groups in frequencies of either polymorphism. However, in women, PD onset was latest in rs1044397 GA/AA (P = 0.015). rs1044396 CT/TT genotype carriers and rs1044397 GG genotype patients with PD had higher VAS scores. No differences were found on the course of PD, H&Y grade, or UPDRS-II or -III scores between various genotypes, nor were differences found on scores of HAMD, nocturia, or PSQI in PD patients. Our results suggested that the CHRNA4 rs1044396 CT/TT genotype is related to cigarette smoking, that the rs1044397 polymorphism may associate with PD age of onset in women, and that rs1044396 and rs1044397 may relate to pain in PD patients, but not to the course or severity of disease, or to depression or nocturnal or sleeping disorders.

Biological dysrhythm in remitted bipolar I disorder.

PubMed

Iyer, Aishwarya; Palaniappan, Pradeep

2017-12-01

Recent treatment guidelines support treatment of biological rhythm abnormalities as a part of treatment of bipolar disorder, but still, literature examining various domains (Sleep, Activity, Social, and Eating) of biological rhythm and its clinical predictors are less. The main aim of our study is to compare various domains of biological rhythm among remitted bipolar I subjects and healthy controls. We also explored for any association between clinical variables and biological rhythm among bipolar subjects. 40 subjects with Bipolar I disorder and 40 healthy controls who met inclusion and exclusion criteria were recruited for the study. Diagnoses were ascertained by a qualified psychiatrist using MINI 5.0. Sociodemographic details, biological rhythm (BRIAN-Biological Rhythm Interview of assessment in Neuropsychiatry) and Sleep functioning (PSQI- Pittsburgh Sleep Quality Index) were assessed in all subjects. Mean age of the Bipolar subjects and controls were 41.25±11.84years and 38.25±11.25 years respectively. Bipolar subjects experienced more biological rhythm disturbance when compared to healthy controls (total BRIAN score being 34.25±9.36 vs 28.2±6.53) (p=0.002). Subsyndromal depressive symptoms (HDRS) had significant positive correlation with BRIAN global scores(r=0.368, p=0.02). Linear regression analysis showed that number of episodes which required hospitalization (β=0.601, t=3.106, P=0.004), PSQI (β=0.394, t=2.609, p=0.014), HDRS (β=0.376, t=2.34, t=0.036) explained 31% of variance in BRIAN scores in remitted bipolar subjects. Biological rhythm disturbances seem to persist even after clinical remission of bipolar illness. More studies to look into the impact of subsyndromal depressive symptoms on biological rhythm are needed. Copyright © 2017 Elsevier B.V. All rights reserved.

High impact of sleeping problems on quality of life in transgender individuals: A cross-sectional multicenter study

PubMed Central

Auer, Matthias K.; Liedl, Anita; Fuss, Johannes; Nieder, Timo; Briken, Peer; Stalla, Günter K.; Hildebrandt, Thomas

2017-01-01

Introduction Studies in the general population suggest that determinants of QoL are often sex-dependent. Sex-dependent analyses of QoL in transgender populations have not been performed so far. Aim To identify sex-specific and potentially modifiable determinants of QoL in transgender patients Methods In this cross-sectional multicentre study including 82 transwomen (TW) and 72 transmen (TM) at different treatment stages, we investigated potential determinants for QoL focusing on the impact of mood (BDI, STAI-X), sleep quality (PSQI), chronic pain (GPQ), body image (FBeK) and social support (SSS). Main outcome measure Health-related quality of life measured with the Short Form (36) Health Survey (SF-36). Results The age-adjusted SF-36 total score and its subscales did not significantly differ between TM and TW. Using a multivariate regression analysis approach, we identified common but also sex-dependent determinants for QoL (Adjusted R2 = 0.228; 0.650 respectively). Accounting for general characteristics such as age, BMI and treatment status, sleep quality according to the PSQI was an independent and strong determinant of QoL in both sexes (β = -0.451, p = 0.003 TM; β = -0.320; p = 0.0029 TW). Chronic pain was a significant independent predictor of QoL in TM (β = -0.298; p = 0.042) but not in TW. In contrast, anxiety (β = -0.451; p< 0.001) being unemployed (β = -0.206; p = 0.020) and insecurity about the own appearance (FBeK) (β = -0.261; p = 0.01) were independent predictors of QoL in TW. The rate of those reporting high sleep disturbances (PSQI ≥5) was high with 79.2% in TW and 81.2% in TM. Accordingly, age-adjusted QoL was also significantly lower in those reporting poor sleep in both sexes. Conclusions Sleep strongly affected QoL in both genders, while other factors, like pain and body image, seem to be gender specific in transgender individuals. PMID:28199359

Atypical work schedules are associated with poor sleep quality and mental health in Taiwan female nurses.

PubMed

Lin, Pei-Chen; Chen, Chung-Hey; Pan, Shung-Mei; Pan, Chih-Hong; Chen, Chiou-Jong; Chen, Yao-Mei; Hung, Hsin-Chia; Wu, Ming-Tsang

2012-11-01

To investigate the effects of shift work schedules on sleep quality and mental health in female nurses in south Taiwan. This study recruited 1,360 female registered nurses in the Kaohsiung area for the first survey, and among them, 769 nurses had a rotation shift schedule. Among the 769 rotation shift work nurses, 407 completed another second survey 6-10 months later. Data collection included demographic variables, work status, shift work schedule, sleep quality (Pittsburgh Sleep Quality Index), and mental health (Chinese Health Questionnaire-12). Nurses on rotation shift had the poor sleep quality and mental health compared to nurses on day shift. The nurses on rotation shift had a relatively higher OR of reporting poor sleep quality and poor mental health (OR, 2.26; 95% CI, 1.57-3.28; and OR, 1.91; 95% CI, 1.39-2.63, respectively). Additionally, rotation shift nurses who had ≥2 days off after their most recent night shifts showed significantly improved sleep quality and mental health (PSQI decreased of 1.23 and CHQ-12 decreased of 0.86, respectively). Comparison of sleep quality between the first and second surveys showed aggravated sleep quality only in nurses who had an increased frequency of night shifts. Female nurses who have a rotation shift work schedule tend to experience poor sleep quality and mental health, but their sleep quality and mental health improve if they have ≥2 days off after their most recent night shifts. This empirical information is useful for optimizing work schedules for nurses.

A Randomized Controlled Trial of Problem-Solving Therapy Compared to Cognitive Therapy for the Treatment of Insomnia in Adults

PubMed Central

Pech, Melissa; O'Kearney, Richard

2013-01-01

Study Objectives: To compare the efficacy of problem-solving therapy (PST) combined with behavioral sleep strategies to standard cognitive therapy (CT) combined with behavioral sleep strategies in the treatment of insomnia. Design: A six-week randomized controlled trial with one month follow-up. Setting: The Australian National University Psychology Clinic, Canberra, Australia. Participants: Forty-seven adults aged 18-60 years recruited from the community meeting the Research Diagnostic Criteria for insomnia. Interventions: Participants received 6 weeks of treatment including one group session (sleep education and hygiene, stimulus control instructions and progressive muscle relaxation) followed by 5 weeks of individual treatment of PST or CT. Measurements and Results: Primary outcomes included sleep efficiency (SE) from sleep diaries, the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). Secondary measures assessed dysfunctional sleep beliefs, problem-solving skills and orientations, and worry. Both treatments produced significant post therapy improvements in sleep which were maintained at 1 month follow-up (on SE Cohen d = 1.42, 95% CI 1.02-1.87 for PST; d = 1.26, 95% CI 0.81-1.65 for CT; on ISI d = 1.46, 95% CI 1.03-1.88 for PST; d = 1.95, 95% CI 0.52-2.38 for CT; for PSQI d = 0.97, 95% CI 0.55-1.40 for PST and d = 1.34, 95% CI 0.90-1.79 for the CT). There were no differences in PST and CT in the size or rate of improvement in sleep although CT produced a significant faster rate of decline in negative beliefs about sleep than PST and there was a trend (P = 0.08) for PST to produce a faster rate of improvement in negative problem orientation than CT. Conclusions: The results provide preliminary support for problem solving treatment as an equally efficacious alternative component to cognitive therapy in psychological interventions for insomnia. Citation: Pech M; O'Kearney R. A randomized controlled trial of problem-solving therapy compared to cognitive therapy for the treatment of insomnia in adults. SLEEP 2013;36(5):739-749. PMID:23633757

[Sleep disorders associated with essential tremor and Parkinson's disease].

PubMed

Chen, Juping; Yao, Jianxin; Chen, Li; Miao, Hong; Mao, Chengjie; Liu, Chunfeng

2015-01-20

To evaluate the sleep quality and explore the manifestations of sleep disorders for 62 essential tremor (ET) patients, 60 normal controls and 62 Parkinson's disease (PD) patients. A total of 62 ET patients, 60 normal controls and 62 PD patients from June 2009 to December 2013 were recruited. All of them were outpatients at Second Affiliated Hospital, Soochow University and Hospital of Changshu Hospital of Traditional Chinese Medicine. Sleep was assessed with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). The global PSQI score was 4.7 ± 2.5 in controls, 6.0 ± 4.0 in ET cases and 7.4 ± 3. 7 in PD cases. PD cases had the highest PSQI score, followed by ET (intermediate) and lowest scores in controls (F = 9.022, P = 0.000). A poor quality of sleep was observed in normal controls (23/62, 38.3%) compared to ET cases (34/62, 54.8%) and PD cases (40/62, 64.5%) (χ² = 8.555, P = 0.014 when comparing all three groups and χ² = 1.206, P = 0.272 when ET vs PD). The ESS score increased from normal controls (4.4 ± 2.5) to ET cases (6.3 ± 4.8) and PD cases (8.2 ± 4.2). An ESS score ≥ 10 (an indicator of greater than normal levels of daytime sleepiness) was observed in 6 (10.0%) normal controls, compared to ET cases (16, 25.8%) and PD cases (20, 32.3%) (χ² = 9.047, P = 0.011 when comparing all three groups and χ² = 0.626, P = 0.429 when ET vs PD). For normal controls, ET and PD patients, the factor scores of subjective sleep were 0.6 ± 0.7, 0.8 ± 0.8 and 1.1 ± 0.7; the factor scores of quality sleep latency 0.6 ± 0.7, 0.9 ± 0.9 and 1.1 ± 1.0; the factor scores of sleep duration 0.6 ± 0.8, 0.7 ± 1.0 and 1.0 ± 0.9; the factor scores of sleep efficiency 0.6 ± 0.8, 0.9 ± 0.9 and 1.0 ± 1.0; the factor scores of sleep disturbances 1.2 ± 0.6, 1.2 ± 0.5 and 1.7 ± 0.7; the factor scores of daytime dysfunction 1.2 ± 1.0, 1.3 ± 1.0 and 2.0 ± 1.1 respectively. There were inter-group statistical differences in subjective sleep (F = 7.709, P = 0.001), quality sleep latency (F = 4.414, P = 0.013), sleep duration (F = 4.464, P = 0.013), sleep efficiency (F = 3.201, P = 0.043), sleep disturbances (F = 12.594, P = 0.000) and daytime dysfunction (F = 9.022, P = 0.000) . However, no inter-group statistical differences existed in use of sleeping medication (F = 1.200, P = 0.304). There were statistical differences in subjective sleep (P < 0.05), sleep efficiency (P < 0.05) and daytime dysfunction (P < 0.05) between ET and PD patients. Some sleep scores in ET are intermediate between those of PD cases and normal controls. And it suggests that a mild form of sleep dysregulation may be present in ET.

Higher-protein diets improve indexes of sleep in energy-restricted overweight and obese adults: results from 2 randomized controlled trials.

PubMed

Zhou, Jing; Kim, Jung Eun; Armstrong, Cheryl Lh; Chen, Ningning; Campbell, Wayne W

2016-03-01

Limited and inconsistent research findings exist about the effect of dietary protein intake on indexes of sleep. We assessed the effect of protein intake during dietary energy restriction on indexes of sleep in overweight and obese adults in 2 randomized, controlled feeding studies. For study 1, 14 participants [3 men and 11 women; mean ± SE age: 56 ± 3 y; body mass index (BMI; in kg/m(2)): 30.9 ± 0.6] consumed energy-restricted diets (a 750-kcal/d deficit) with either beef and pork (BP; n = 5) or soy and legume (SL; n = 9) as the main protein sources for 3 consecutive 4-wk periods with 10% (control), 20%, or 30% of total energy from protein (random order). At baseline and the end of each period, the global sleep score (GSS) was assessed with the use of the Pittsburgh Sleep Quality Index (PSQI) questionnaire. For study 2, 44 participants (12 men and 32 women; age: 52 ± 1 y; BMI: 31.4 ± 0.5) consumed a 3-wk baseline energy-balance diet with 0.8 g protein · kg baseline body mass(-1) · d(-1). Then, study 2 subjects consumed either a normal-protein [NP (control); n = 23] or a high-protein (HP; n = 21) (0.8 compared with 1.5 g · kg(-1) · d(-1), respectively) energy-restricted diet (a 750-kcal/d deficit) for 16 wk. The PSQI was administered during baseline week 3 and intervention weeks 4, 8, 12, and 16. GSSs ranged from 0 to 21 arbitrary units (au), with a higher value representing a worse GSS during the preceding month. In study 1, we showed that a higher protein quantity improved GSSs independent of the protein source. The GSS was higher (P < 0.05) when 10% (6.0 ± 0.4 au) compared with 20% (5.0 ± 0.4 au) protein was consumed, with 30% protein (5.4 ± 0.6 au) intermediate. In study 2, at baseline, the GSS was not different between NP (5.2 ± 0.5 au) and HP (5.4 ± 0.5 au) groups. Over time, the GSS was unchanged for the NP group and improved for the HP group (P-group-by-time interaction < 0.05). After intervention (week 16), GSSs for NP and HP groups were 5.9 ± 0.5 and 4.0 ± 0.6 au, respectively (P < 0.01). The consumption of a greater proportion of energy from protein while dieting may improve sleep in overweight and obese adults. This trial was registered at clinicaltrials.gov as NCT01005563 (study 1) and NCT01692860 (study 2). © 2016 American Society for Nutrition.

Association between sleep behavior and sleep-related factors among university students in Hong Kong.

PubMed

Suen, Lorna K P; Hon, K L Ellis; Tam, Wilson W S

2008-09-01

Sleep problems among university students are common; however, the association between many sleep-related factors and sleep behaviors is still unclear. The purpose of this study is to examine different sleep behaviors and sleep-related factors influencing such behaviors in university students. A descriptive survey was conducted on 400 university students in Hong Kong. The instruments for data collection consisted of the Pittsburgh Sleep Quality Index (PSQI), a sleep hygiene practice questionnaire, demographic data, and other sleep-related factors. The results reveal that 57.5% of the 400 university students are poor sleepers. Sex, year of study, sleep hygiene practice, and perceived adequate sleep in the past month all demonstrate significant associations with poor sleepers. A high prevalence of sleep-related problems among college students is confirmed and associated factors are identified. Students should be encouraged to follow sleep hygiene practice, adequate time management for academic and social activities, and suitable stress-relieving measures.

Effect of early trauma on the sleep quality of euthymic bipolar patients.

PubMed

Aubert, E; Jaussent, I; Olié, E; Ducasse, D; Azorin, J M; Bellivier, F; Belzeaux, R; Bougerol, T; Etain, B; Gard, S; Henry, C; Kahn, J P; Leboyer, M; Loftus, J; Passerieux, C; Lopez-Castroman, J; Courtet, Ph

2016-12-01

Poor quality of sleep is frequent in euthymic bipolar patients and conveys worse clinical outcomes. We investigated the features of euthymic bipolar patients associated with poor sleep quality, with a focus on the effect of childhood trauma. 493 euthymic patients with DSM-IV-defined bipolar disorders were recruited in FondaMental Advanced Centers of Expertize for Bipolar Disorders (FACE-BD) between 2009 and 2014. Clinical variables were recorded. Subjective sleep quality and history of childhood trauma were respectively measured by the Pittsburgh Sleep Quality Index (PSQI) and the Childhood Trauma Questionnaire (CTQ). Poor sleepers were older, less professionally active, had significantly higher anxiety levels, took more anxiolytic drugs and did endorse more suicide attempts and suicidal ideas than good sleepers after adjusting for anxiety levels and age. Emotional abuse was associated with poor sleep quality after adjustment for BMI, age, professional activity, and bipolar disorders (BD) type (OR=1.83; 95% CI [1.30; 3.10]; p=0.02). However, this association was lost after adjustment for anxiety levels, anxiolytic treatment and suicide ideation/attempts. The main limitation was the type of sleep assessment, which only measured the subjective part of sleep complaints. A history of emotional abuse might underlie sleep problems in many bipolar patients but anxiety seems to act as a confounding factor in this relationship. New studies are needed to elucidate the role of childhood maltreatment on poor sleep among bipolar patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Poor Self-Reported Sleep Quality Predicts Mortality within One Year of Inpatient Post-Acute Rehabilitation among Older Adults

PubMed Central

Martin, Jennifer L.; Fiorentino, Lavinia; Jouldjian, Stella; Mitchell, Michael; Josephson, Karen R.; Alessi, Cathy A.

2011-01-01

Study Objective: To evaluate the association between self-reported sleep quality among older adults during inpatient post-acute rehabilitation and one-year survival. Design: Prospective, observational cohort study. Setting: Two inpatient post-acute rehabilitation sites (one community and one Veterans Administration). Participants: Older patients (aged ≥ 65 years, n = 245) admitted for inpatient post-acute rehabilitation. Interventions: None. Measurements and Results: Within one year of post-acute rehabilitation, 57 participants (23%) were deceased. Cox proportional hazards models showed that worse Pittsburgh Sleep Quality Index (PSQI) total scores during the post-acute care stay were associated with increased mortality risk when controlling for amount of rehabilitation therapy received, comorbidities, and cognitive functioning (Hazard ratio [95% CI] = 1.11 [1.02-1.20]). Actigraphically estimated sleep was unrelated to mortality risk. Conclusions: Poorer self-reported sleep quality, but not objectively estimated sleep parameters, during post-acute rehabilitation was associated with shorter survival among older adults. This suggests self-reported poor sleep may be an important and potentially modifiable risk factor for negative outcomes in these vulnerable older adults. Studies of interventions to improve sleep quality during inpatient rehabilitation should therefore be undertaken, and the long-term health benefits of improved sleep should be explored. Citation: Martin JL; Fiorentino L; Jouldjian S; Mitchell M; Josephson KR; Alessi CA. Poor self-reported sleep quality predicts mortality within one year of inpatient post-acute rehabilitation among older adults. SLEEP 2011;34(12):1715-1721. PMID:22131610

Comparison of the clinical outcomes between unattended home APAP and polysomnography manual titration in obstructive sleep apnea patients.

PubMed

Wongsritrang, Krongthong; Fueangkamloon, Sumet

2013-09-01

To compare the clinical outcomes and determine the difference in therapeutic pressure between Automatic positive airway pressure (APAP) and polysomnography manual titration. Fifty patients of obstructive sleep apnea (OSA), moderate to severe cases, were randomized into two groups of intervention: 95-percentile pressure derived from APAP titration and an optimal pressure derived from manual titration. Clinical outcomes were assessed before and after four weeks. The average 95-percentile pressure derived from APAP titration was 11.7 +/- 0.3 cmH2O with median mask leak 1.3 L/min. The average optimal pressure derived from manual titration was 8.2 +/- 0.3 cmH2O. Pearson correlation analysis showed weak positive correlation (r = 0.336, p = 0.017). The Epworth Sleepiness Score (ESS), Quality of life tests: PSQI (Pittsburg Sleep Quality Index), and SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey) were improved significantly in both groups, but there were no statistical significant differences between groups. An APAP titration is an effective method of pressure determination for conventional CPAP therapy and shows no difference in clinical outcomes comparing the standard titration.

Circadian type and bed-timing regularity in 654 retired seniors: correlations with subjective sleep measures.

PubMed

Monk, Timothy H; Buysse, Daniel J; Billy, Bart D; Fletcher, Mary E; Kennedy, Kathy S; Schlarb, Janet E; Beach, Scott R

2011-02-01

Using telephone interview data from retired seniors to explore how inter-individual differences in circadian type (morningness) and bed-timing regularity might be related to subjective sleep quality and quantity. MANCOVA with binary measures of morningness, stability of bedtimes, and stability of rise-times as independent variables; sleep measures as dependent variables; age, former shift work, and gender as covariates. Telephone interviews using a pseudo-random age-targeted sampling process. 654 retired seniors (65 y+, 363M, 291F). none. (1) circadian type (from Composite Scale of Morningness [CSM]), and stability of (2) bedtime and (3) rise-time from the Sleep Timing Questionnaire (STQ). Pittsburgh Sleep Quality Index (PSQI) score, time in bed, time spent asleep, and sleep efficiency, from Sleep Timing Questionnaire (STQ). Morning-type orientation, stability in bedtimes, and stability in rise-times were all associated with better sleep quality (P < 0.001, for all; effect sizes: 0.43, 0.33, and 0.27). Morningness was associated with shorter time in bed (P < 0.0001, effect size 0.45) and time spent asleep (P < 0.005, effect size 0.26). For bedtime and rise-time stability the direction of effect was similar but mostly weaker. In retired seniors, a morning-type orientation and regularity in bedtimes and rise-times appear to be correlated with improved subjective sleep quality and with less time spent in bed.

Sleep and quality of life in urban poverty: the effect of a slum housing upgrading program.

PubMed

Simonelli, Guido; Leanza, Yvan; Boilard, Alexandra; Hyland, Martín; Augustinavicius, Jura L; Cardinali, Daniel P; Vallières, Annie; Pérez-Chada, Daniel; Vigo, Daniel E

2013-11-01

To evaluate the effect of a housing transition on sleep quality and quality of life in slum dwellers, participating in a slum housing upgrading program. Observational before-and-after study with a convergent-parallel mixed method design. Five slums located in the metropolitan area of Buenos Aires, Argentina. A total of 150 slum dwellers benefited by a housing program of the nonprofit organization TECHO (spanish word for "roof"). Participants moved from their very low-quality house to a basic prefabricated 18 m(2) modular house provided by TECHO. The Pittsburgh Sleep Quality Index (PSQI) and World Health Organization Quality of Life brief scale (WHOQOL-BREF) were administered before and after housing upgrading. Data about housing conditions, income, education, sleeping conditions, and cardiovascular risk were also collected. Semistructured interviews were used to expand and nuance quantitative data obtained from a poorly educated sample. Results showed that sleep quality significantly increased after the housing program (z = -6.57, P < 0.001). Overall quality of life (z = -6.85, P < 0.001), physical health domain (z = -4.35, P < 0.001), psychological well-being domain (z = -3.72, P < 0.001) and environmental domain (z = -7.10, P < 0.001) of WHOQOL-BREF were also improved. Interviews demonstrated the importance of serenity for improving quality of life. A minimal improvement in the quality of basic housing can significantly increase sleep quality and quality of life among slum dwellers. Understanding sleep and daily life conditions in informal urban settlements could help to define what kind of low-cost intervention may improve sleep quality, quality of life, and reduce existent sleep disparity.

The Effects of the Sleep Quality of 112 Emergency Health Workers in Kayseri, Turkey on Their Professional Life.

PubMed

Senol, Vesile; Soyuer, Ferhan; Guleser, Gulsum Nihal; Argun, Mahmut; Avsarogullari, Levent

2014-12-01

Sleep adequacy is one of the major determinants of a successful professional life. The aim of this study is to determine the sleep quality of emergency health workers and analyze its effects on their professional and social lives. The study was carried out on 121 voluntary emergency health workers in 112 Emergency Aid Stations in Kayseri, Turkey, in 2011. The data was collected through the Socio-Demographics Form and the Pittsburgh Sleep Quality Index (PSQI) and analyzed via SPSS 18.00. The statistical analysis involved percentage and frequency distributions, mean±standard deviations, a chi-square test, correlations, and logistic regression analysis. The mean score of the participants according to the Pittsburgh Sleep Quality Index was 4.14±3.09, and 28.9% of participants had poor sleep quality. Being single and being a woman accounted for 11% (p=0.009, 95% CI: 0.111-0.726) and 7% (p=0.003, 95% CI: 0.065-0.564) of poor sleep quality respectively. There was a positive correlation between sleep quality scores and negative effects on professional and social life activities. Negative effects on professional activities included increased loss of attention and concentration (40.0%, p=0,016), increased failure to take emergency actions (57.9%, p=0.001), reduced motivation (46.2%, p=0.004), reduced performance (41.4%, p=0.024), and low work efficiency (48.1%, p=0.008). Poor sleep quality generally negatively affected the daily life of the workers (51.6%, p=0.004), restricted their social life activities (45.7%, p=0.034), and caused them to experience communication difficulties (34.7%, p=0.229). One third of the emergency health workers had poor sleep quality and experienced high levels of sleep deficiency. Being a woman and being single were the most important factors in low sleep quality. Poor sleep quality continuously affected daily life and professional life negatively by leading to a serious level of fatigue, loss of attention-concentration, and low levels of motivation, performance and efficiency.

A Collaborative Paradigm for Improving Management of Sleep Disorders in Primary Care: A Randomized Clinical Trial.

PubMed

Edinger, Jack D; Grubber, Janet; Ulmer, Christi; Zervakis, Jennifer; Olsen, Maren

2016-01-01

To test a collaborative care model for interfacing sleep specialists with primary care providers to enhance patients' sleep disorders management. This study used a randomized, parallel group, clinical intervention trial design. A total of 137 adult (29 women) VA outpatients with sleep complaints were enrolled and randomly assigned to (1) an intervention (INT) consisting of a one-time consultation with a sleep specialist who provided diagnostic feedback and treatment recommendations to the patient and the patient's primary care provider; or (2) a control condition consisting of their usual primary care (UPC). Provider-focused outcomes included rates of adherence to recommended diagnostic procedures and sleep-focused interventions. Patient-focused outcomes included measures taken from sleep diaries and actigraphy; Pittsburgh Sleep Quality Index (PSQI) scores; and self-report measures of sleepiness, fatigue, mood, quality of life, and satisfaction with health care. The proportions of provider-initiated sleep-focused interventions were significantly higher in the INT group than in the UPC group for polysomnography referrals (49% versus 6%; P < 0.001) and mental health clinic referrals (19% versus 6%; P = 0.02). At the 10-mo follow up, INT recipients showed greater estimated mean reductions in diary total wake time (-17.0 min; 95% confidence interval [CI]: -30.9, -3.1; P = 0.02) and greater increases in sleep efficiency (+3.7%; 95% CI: 0.8, 6.5; P = 0.01) than did UPC participants. A greater proportion of the INT group showed ≥ 1 standard deviation decline on the PSQI from baseline to the 10-mo follow-up (41% versus 21%; P = 0.02). Moreover, 69% of the INT group had normal (≤ 10) Epworth Sleepiness Scale scores at the 10-mo follow-up, whereas only 50% of the UPC group fell below this clinical cutoff (P = 0.03). A one-time sleep consultation significantly increased healthcare providers' attention to sleep problems and resulted in benefits to patients' sleep/wake symptoms. This study is registered with clinicaltrials.gov with identifier # NCT00390572. © 2016 Associated Professional Sleep Societies, LLC.

A randomized, double-blind study of the efficacy and tolerability of extended-release quetiapine fumarate (quetiapine XR) monotherapy in patients with major depressive disorder

PubMed Central

Wang, Gang; McIntyre, Alexander; Earley, Willie R; Raines, Shane R; Eriksson, Hans

2014-01-01

Objectives To evaluate the efficacy and tolerability of once-daily extended release quetiapine fumarate (quetiapine XR) monotherapy in patients with major depressive disorder (MDD). Patients and methods This was a 10-week (8-week active treatment/2-week post-treatment) randomized, double-blind, placebo- and active-controlled study (D1448C00004). Patients received quetiapine XR 150 mg/day, escitalopram 10 mg/day, or placebo; patients with an inadequate response (<20% improvement in Montgomery–Åsberg Depression Rating Scale [MADRS] total score) at week two received double-dose treatment. The primary end point was week eight change from randomization in MADRS total score. Secondary end points included MADRS response (≥50% improvement) and remission (score ≤8); Hamilton Rating Scale for Depression total and item 1; Hamilton Rating Scale for Anxiety total, psychic, and somatic; Clinical Global Impressions – Severity of Illness total; Pittsburgh Sleep Quality Index (PSQI) global; and Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form percentage maximum total scores. Tolerability was assessed throughout. Results A total of 471 patients was randomized. No significant improvements in MADRS total score were observed at week eight (last observation carried forward) with either active treatment (quetiapine XR, −17.21 [P=0.174]; escitalopram, −16.73 [P=0.346]) versus placebo (−15.61). There were no significant differences in secondary end points versus placebo, with the exception of week-eight change in PSQI global score (quetiapine XR, −4.96 [P<0.01] versus placebo, −3.37). Mixed-model repeated-measures analysis of observed-case data suggested that the primary analysis may not be robust. Most commonly reported adverse events included dry mouth, somnolence, and dizziness for quetiapine XR, and headache and nausea for escitalopram. Conclusion In this study, neither quetiapine XR (150/300 mg/day) nor escitalopram (10/20 mg/day) showed significant separation from placebo. Both compounds have been shown previously to be effective in the treatment of MDD; possible reasons for this failed study are discussed. Quetiapine XR was generally well tolerated, with a profile similar to that reported previously. PMID:24511235

The effect of acupuncture treatment for insomnia in chronic hemodialysis patients

NASA Astrophysics Data System (ADS)

Widjaja, J. A.; Simadibrata, C.; Srilestari, A.; Marbun, M. B. H.

2017-08-01

Insomnia is a problem often experienced by patients on chronic dialysiswhich reduces their quality of life. Current management of insomnia with this specific group of patients has yet to produce optimum results. In this study, we explored the roleof acupuncture as a treatment for symptoms of insomnia in patients on chronic dialysis. Twenty-eight hemodialysis patients suffering from insomnia were divided randomly into two groups, an acupuncture group (n = 15) who received acupuncture treatment at the points HT7 Shenmen, PC6 Neiguan, GV20 Baihui, and EX-HN1 Sishenchong, anda control group (n = 13) who underwenta sham procedure in which a needle was inserted into an elastic bandage at the same points. The acupuncture treatment was done during hemodialysis twice a week for five weeks. PSQI scores and the WHOQOL-BREF were assessed before treatment, after the fifth treatment, and at the end of the treatment. Significant differences were found in the PSQI score ((4.20±2.27 vs. 11.23±3.37) p = 0.000) and in the WHOQOL-BREF ((94.53±10.08 vs. 82.69±11.90) p = 0.008) between the acupuncture group and the control group by the end of the period of treatment. Acupuncture treatment effectively improved the quality of sleep and the quality of life for these chronic hemodialysis patients.

Validity and reliability of the Traditional Chinese version of the Multidimensional Fatigue Inventory in general population.

PubMed

Chuang, Li-Ling; Chuang, Yu-Fen; Hsu, Miao-Ju; Huang, Ying-Zu; Wong, Alice M K; Chang, Ya-Ju

2018-01-01

Fatigue is a common symptom in the general population and has a substantial effect on individuals' quality of life. The Multidimensional Fatigue Inventory (MFI) has been widely used to quantify the impact of fatigue, but no Traditional Chinese translation has yet been validated. The goal of this study was to translate the MFI from English into Traditional Chinese ('the MFI-TC') and subsequently to examine its validity and reliability. The study recruited a convenience sample of 123 people from various age groups in Taiwan. The MFI was examined using a two-step process: (1) translation and back-translation of the instrument; and (2) examination of construct validity, convergent validity, internal consistency, test-retest reliability, and measurement error. The validity and reliability of the MFI-TC were assessed by factor analysis, Spearman rho correlation coefficient, Cronbach's alpha coefficient, intraclass correlation coefficient (ICC), minimal detectable change (MDC), and Bland-Altman analysis. All participants completed the Short-Form-36 Health Survey Taiwan Form (SF-36-T) and the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) concurrently to test the convergent validity of the MFI-TC. Test-retest reliability was assessed by readministration of the MFI-TC after a 1-week interval. Factor analysis confirmed the four dimensions of fatigue: general/physical fatigue, reduced activity, reduced motivation, and mental fatigue. A four-factor model was extracted, combining general fatigue and physical fatigue as one factor. The results demonstrated moderate convergent validity when correlating fatigue (MFI-TC) with quality of life (SF-36-T) and sleep disturbances (PSQI) (Spearman's rho = 0.68 and 0.47, respectively). Cronbach's alpha for the MFI-TC total scale and subscales ranged from 0.73 (mental fatigue subscale) to 0.92 (MFI-TC total scale). ICCs ranged from 0.85 (reduced motivation) to 0.94 (MFI-TC total scale), and the MDC ranged from 2.33 points (mental fatigue) to 9.5 points (MFI-TC total scale). The Bland-Altman analyses showed no significant systematic bias between the repeated assessments. The results support the use of the Traditional Chinese version of the MFI as a comprehensive instrument for measuring specific aspects of fatigue. Clinicians and researchers should consider interpreting general fatigue and physical fatigue as one subscale when measuring fatigue in Traditional Chinese-speaking populations.

Validity and reliability of the Traditional Chinese version of the Multidimensional Fatigue Inventory in general population

PubMed Central

Chuang, Li-Ling; Chuang, Yu-Fen; Hsu, Miao-Ju; Huang, Ying-Zu; Wong, Alice M. K.

2018-01-01

Background Fatigue is a common symptom in the general population and has a substantial effect on individuals’ quality of life. The Multidimensional Fatigue Inventory (MFI) has been widely used to quantify the impact of fatigue, but no Traditional Chinese translation has yet been validated. The goal of this study was to translate the MFI from English into Traditional Chinese (‘the MFI-TC’) and subsequently to examine its validity and reliability. Methods The study recruited a convenience sample of 123 people from various age groups in Taiwan. The MFI was examined using a two-step process: (1) translation and back-translation of the instrument; and (2) examination of construct validity, convergent validity, internal consistency, test-retest reliability, and measurement error. The validity and reliability of the MFI-TC were assessed by factor analysis, Spearman rho correlation coefficient, Cronbach’s alpha coefficient, intraclass correlation coefficient (ICC), minimal detectable change (MDC), and Bland-Altman analysis. All participants completed the Short-Form-36 Health Survey Taiwan Form (SF-36-T) and the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) concurrently to test the convergent validity of the MFI-TC. Test-retest reliability was assessed by readministration of the MFI-TC after a 1-week interval. Results Factor analysis confirmed the four dimensions of fatigue: general/physical fatigue, reduced activity, reduced motivation, and mental fatigue. A four-factor model was extracted, combining general fatigue and physical fatigue as one factor. The results demonstrated moderate convergent validity when correlating fatigue (MFI-TC) with quality of life (SF-36-T) and sleep disturbances (PSQI) (Spearman's rho = 0.68 and 0.47, respectively). Cronbach’s alpha for the MFI-TC total scale and subscales ranged from 0.73 (mental fatigue subscale) to 0.92 (MFI-TC total scale). ICCs ranged from 0.85 (reduced motivation) to 0.94 (MFI-TC total scale), and the MDC ranged from 2.33 points (mental fatigue) to 9.5 points (MFI-TC total scale). The Bland-Altman analyses showed no significant systematic bias between the repeated assessments. Conclusions The results support the use of the Traditional Chinese version of the MFI as a comprehensive instrument for measuring specific aspects of fatigue. Clinicians and researchers should consider interpreting general fatigue and physical fatigue as one subscale when measuring fatigue in Traditional Chinese-speaking populations. PMID:29746466

The relationship between depressive symptoms among female workers and job stress and sleep quality

PubMed Central

2013-01-01

Objective Recently, workers' mental health has become important focus in the field of occupational health management. Depression is a psychiatric illness with a high prevalence. The association between job stress and depressive symptoms has been demonstrated in many studies. Recently, studies about the association between sleep quality and depressive symptoms have been reported, but there has been no large-scaled study in Korean female workers. Therefore, this study was designed to investigate the relationship between job stress and sleep quality, and depressive symptoms in female workers. Methods From Mar 2011 to Aug 2011, 4,833 female workers in the manufacturing, finance, and service fields at 16 workplaces in Yeungnam province participated in this study, conducted in combination with a worksite-based health checkup initiated by the National Health Insurance Service (NHIS). In this study, a questionnaire survey was carried out using the Korean Occupational Stress Scale-Short Form(KOSS-SF), Pittsburgh Sleep Quality Index(PSQI) and Center for Epidemiological Studies-Depression Scale(CES-D). The collected data was entered in the system and analyzed using the PASW (version 18.0) program. A correlation analysis, cross analysis, multivariate logistic regression analysis, and hierarchical multiple regression analysis were conducted. Results Among the 4,883 subjects, 978 subjects (20.0%) were in the depression group. Job stress(OR=3.58, 95% CI=3.06-4.21) and sleep quality(OR=3.81, 95% CI=3.18-4.56) were strongly associated with depressive symptoms. Hierarchical multiple regression analysis revealed that job stress displayed explanatory powers of 15.6% on depression while sleep quality displayed explanatory powers of 16.2%, showing that job stress and sleep quality had a closer relationship with depressive symptoms, compared to the other factors. The multivariate logistic regression analysis yielded odds ratios between the 7 subscales of job stress and depressive symptoms in the range of 1.30-2.72 and the odds ratio for the lack of reward was the highest(OR=2.72, 95% CI=2.32-3.19). In the partial correlation analysis between each of the 7 subscales of sleep quality (PSQI) and depressive symptoms, the correlation coefficient of subjective sleep quality and daytime dysfunction were 0.352 and 0.362, respectively. Conclusion This study showed that the depressive symptoms of female workers are closely related to their job stress and sleep quality. In particular, the lack of reward and subjective sleep factors are the greatest contributors to depression. In the future, a large-scale study should be performed to augment the current study and to reflect all age groups in a balanced manner. The findings on job stress, sleep, and depression can be utilized as source data to establish standards for mental health management of the ever increasing numbers of female members of the workplace. PMID:24472381

SLEEP QUALITY AND ITS ASSOCIATION WITH PSYCHOLOGICAL SYMPTOMS IN ADOLESCENT ATHLETES

PubMed Central

Gomes, Gabriel Cordeiro; dos Passos, Muana Hiandra Pereira; Silva, Hítalo Andrade; de Oliveira, Valéria Mayaly Alves; Novaes, Wbinayara Alves; Pitangui, Ana Carolina Rodarti; de Araújo, Rodrigo Cappato

2017-01-01

ABSTRACT Objective: To verify the prevalence of poor sleep quality and its association with personal characteristics and symptoms of depression, anxiety and stress in amateur adolescent athletes. Methods: 309 adolescent athletes aged between 10 and 19 years were enrolled. Data collection included: a structured questionnaire, with personal information; the Pittsburgh Sleep Quality Index (PSQI); and the Depression, Anxiety and Stress Scale (DASS-21). Results are described in mean and standard deviation (numeric variables) and absolute and relative frequencies (categorical variables). For the inferential analysis, Student’s t-test and chi-square test were performed, in addition to Poisson regression. Prevalence ratios (PR) were calculated in a 95% confidence interval (95%CI). Results: The mean age of participants was 14.1±2.1, being 13.8±2.0 and 15.0±2.1, respectively, for those with good and poor sleep quality. Poor sleep quality was recorded in 28.2% (n=87), depression in 26.9% (n=83) and anxiety/stress in 40.1% (n=124). Poor sleep quality was associated with ages between 15 and 19 years (PR 1.24; 95%CI 1.14-1.37), overweight (PR 1.12; 95%CI 1.01-1.24) and psychological symptoms of depression (PR 1.23; 95%CI 1.08-1.40) and anxiety/stress (PR 1.16; 95%CI 1.04-1.28). Conclusions: The presence of overweight and psychological symptoms and the age over 15 years were risk factors for increasing the likelihood of poor sleep quality in adolescent athletes. PMID:28977294

Anxiety and depression in adult outpatients with bronchiectasis: Associations with disease severity and health-related quality of life.

PubMed

Gao, Yong-Hua; Guan, Wei-Jie; Zhu, Ya-Nan; Chen, Rong-Chang; Zhang, Guo-Jun

2018-04-01

Anxiety and depression might frequently affect bronchiectasis patients, but data in Chinese patients, including their association with disease severity assessed with Bronchiectasis Severity Index (BSI) and FACED score, are limited. To investigate the rate, risk factors, association with disease severity and impact of anxiety and depression on health-related quality of life (HRQoL) in adult outpatients with steady-state bronchiectasis. This cross-sectional study included 163 outpatients (102 females; mean age, 45.8 years) and 80 healthy subjects (47 females; mean age, 47.1 years). Demographic, clinical indices, radiology, spirometry, aetiology, sputum bacteriology, Hospital Anxiety and Depression Scales (HADS), Pittsburgh Sleep Quality Index (PSQI) and St. George's Respiratory Questionnaire (SGRQ) were assessed. Patients with steady-state bronchiectasis had a higher rate of depression (HADS-depression >7) (30.1% vs 10.0%, P = .001) and anxiety (HADS-anxiety >7; 39.9% vs 6.3%, P < .001) compared with healthy subjects. Notably, no significant differences in the rate of anxiety and depression were found across different disease severity, assessed with BSI and FACED score (all P > .05). In multivariate model, factors associated with anxiety included younger age (OR = 1.05), education below college graduate (OR = 4.55) and sleep disturbance (PSQI ≥ 6; OR = 2.95); whereas sleep disturbance was the sole factor associated with depression (OR = 5.98). Patients with either depression or anxiety had more markedly impaired HRQoL affecting most domains than those without. Anxiety and depression are common in bronchiectasis and can negatively affect HRQoL, but not related to disease severity. Prompt assessment and treatment of these mental disorders, regardless of bronchiectasis severity, are advocated and might improve HRQoL. © 2017 John Wiley & Sons Ltd.

Sleep quality and duration are associated with performance in maximal incremental test.

PubMed

Antunes, B M; Campos, E Z; Parmezzani, S S; Santos, R V; Franchini, E; Lira, F S

2017-08-01

Inadequate sleep patterns may be considered a trigger to development of several metabolic diseases. Additionally, sleep deprivation and poor sleep quality can negatively impact performance in exercise training. However, the impact of sleep duration and sleep quality on performance during incremental maximal test performed by healthy men is unclear. Therefore, the purpose of the study was to analyze the association between sleep pattern (duration and quality) and performance during maximal incremental test in healthy male individuals. A total of 28 healthy males volunteered to take part in the study. Sleep quality, sleep duration and physical activity were subjectively assessed by questionnaires. Sleep pattern was classified by sleep duration (>7h or <7h of sleep per night) and sleep quality according to the sum of measured points and/or scores by the Pittsburgh Sleep Quality Index (PSQI). Incremental exercise test was performed at 35 watts for untrained subjects, 70 watts for physically active subjects and 105 watts for well-trained subjects. HR max was correlated with sleep quality (r=0.411, p=0.030) and sleep duration (r=-0.430, p=0.022). Participants reporting good sleep quality presented higher values of W max , VO 2max and lower values of HR max when compared to participants with altered sleep. Regarding sleep duration, only W max was influenced by the amount of sleeping hours per night and this association remained significant even after adjustment by VO 2max . Sleep duration and quality are associated, at least in part, with performance during maximal incremental test among healthy men, with losses in W max and HR max . In addition, our results suggest that the relationship between sleep patterns and performance, mainly in W max , is independent of fitness condition. Copyright © 2017 Elsevier Inc. All rights reserved.

Association between overuse of mobile phones on quality of sleep and general health among occupational health and safety students.

PubMed

Eyvazlou, Meysam; Zarei, Esmaeil; Rahimi, Azin; Abazari, Malek

2016-01-01

Concerns about health problems due to the increasing use of mobile phones are growing. Excessive use of mobile phones can affect the quality of sleep as one of the important issues in the health literature and general health of people. Therefore, this study investigated the relationship between the excessive use of mobile phones and general health and quality of sleep on 450 Occupational Health and Safety (OH&S) students in five universities of medical sciences in the North East of Iran in 2014. To achieve this objective, special questionnaires that included Cell Phone Overuse Scale, Pittsburgh's Sleep Quality Index (PSQI) and General Health Questionnaire (GHQ) were used, respectively. In addition to descriptive statistical methods, independent t-test, Pearson correlation, analysis of variance (ANOVA) and multiple regression tests were performed. The results revealed that half of the students had a poor level of sleep quality and most of them were considered unhealthy. The Pearson correlation co-efficient indicated a significant association between the excessive use of mobile phones and the total score of general health and the quality of sleep. In addition, the results of the multiple regression showed that the excessive use of mobile phones has a significant relationship between each of the four subscales of general health and the quality of sleep. Furthermore, the results of the multivariate regression indicated that the quality of sleep has a simultaneous effect on each of the four scales of the general health. Overall, a simultaneous study of the effects of the mobile phones on the quality of sleep and the general health could be considered as a trigger to employ some intervention programs to improve their general health status, quality of sleep and consequently educational performance.

Sleep Quality and Sleep Patterns in Relation to Consumption of Energy Drinks, Caffeinated Beverages and Other Stimulants among Thai College Students

PubMed Central

Lohsoonthorn, Vitool; Khidir, Hazar; Casillas, Gardenia; Lertmaharit, Somrat; Tadesse, Mahlet G.; Pensuksan, Wipawan C.; Rattananupong, Thanapoom; Gelaye, Bizu; Williams, Michelle A.

2012-01-01

Purpose Poor sleep and heavy use of caffeinated beverages have been implicated as risk factors for a number of adverse health outcomes. Caffeine consumption and use of other stimulants are common among college students globally. However, to our knowledge, no studies have examined the influence of caffeinated beverages on sleep quality of college students in Southeast Asian populations. We conducted this study to evaluate the patterns of sleep quality; and to examine the extent to which poor sleep quality is associated with consumption of energy drinks, caffeinated beverages and other stimulants among 2,854 Thai college students. Methods A questionnaire was administered to ascertain demographic and behavioral characteristics. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep habits and quality. Chi-square tests and multivariate logistic regression models were used to identify statistically significant associations. Results Overall, the prevalence of poor sleep quality was found to be 48.1%. A significant percent of students used stimulant beverages (58.0%). Stimulant use (OR 1.50; 95%CI 1.28-1.77) was found to be statistically significant and positively associated with poor sleep quality. Alcohol consumption (OR 3.10; 95% CI 1.72-5.59) and cigarette smoking (OR 1.43; 95% CI 1.02-1.98) also had statistically significant association with increased daytime dysfunction. In conclusion, stimulant use is common among Thai college students and is associated with several indices of poor sleep quality. Conclusion Our findings underscore the need to educate students on the importance of sleep and the influences of dietary and lifestyle choices on their sleep quality and overall health. PMID:23239460

Bullying as a risk for poor sleep quality among high school students in China.

PubMed

Zhou, Ying; Guo, Lan; Lu, Ci-yong; Deng, Jian-xiong; He, Yuan; Huang, Jing-hui; Huang, Guo-liang; Deng, Xue-qing; Gao, Xue

2015-01-01

To determine whether involvement in bullying as a bully, victim, or bully-victim was associated with a higher risk of poor sleep quality among high school students in China. A cross-sectional study was conducted. A total of 23,877 high school students were surveyed in six cities in Guangdong Province. All students were asked to complete the adolescent health status questionnaire, which included the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and bullying involvement. Descriptive statistics were used to evaluate sleep quality and the prevalence of school bullying. Multi-level logistic regression analyses were conducted to examine the association between being victimized and bullying others with sleep quality. Among the 23,877 students, 6,127 (25.66%) reported having poor sleep quality, and 10.89% reported being involved in bullying behaviors. Of the respondents, 1,410 (5.91%) were pure victims of bullying, 401 (1.68%) were bullies and 784 (3.28%) were bully-victims. Frequently being involved in bullying behaviors (being bullied or bullying others) was related to increased risks of poor sleep quality compared with adolescents who were not involved in bullying behaviors. After adjusting for age, sex, and other confounding factors, the students who were being bullied (OR=2.05, 95%CI=1.81-2.32), bullied others (OR=2.30, 95%CI=1.85-2.86) or both (OR=2.58, 95%CI=2.20-3.03) were at a higher risk for poor sleep quality. Poor sleep quality among high school students is highly prevalent, and school bullying is prevalent among adolescents in China. The present results suggested that being involved in school bullying might be a risk factor for poor sleep quality among adolescents.

Bullying as a Risk for Poor Sleep Quality among High School Students in China

PubMed Central

Lu, Ci-yong; Deng, Jian-xiong; Huang, Jing-hui; Huang, Guo-liang; Deng, Xue-qing; Gao, Xue

2015-01-01

Objective To determine whether involvement in bullying as a bully, victim, or bully-victim was associated with a higher risk of poor sleep quality among high school students in China. Methods A cross-sectional study was conducted. A total of 23,877 high school students were surveyed in six cities in Guangdong Province. All students were asked to complete the adolescent health status questionnaire, which included the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and bullying involvement. Descriptive statistics were used to evaluate sleep quality and the prevalence of school bullying. Multi-level logistic regression analyses were conducted to examine the association between being victimized and bullying others with sleep quality. Results Among the 23,877 students, 6,127 (25.66%) reported having poor sleep quality, and 10.89% reported being involved in bullying behaviors. Of the respondents, 1,410 (5.91%) were pure victims of bullying, 401 (1.68%) were bullies and 784 (3.28%) were bully-victims. Frequently being involved in bullying behaviors (being bullied or bullying others) was related to increased risks of poor sleep quality compared with adolescents who were not involved in bullying behaviors. After adjusting for age, sex, and other confounding factors, the students who were being bullied (OR=2.05, 95%CI=1.81-2.32), bullied others (OR=2.30, 95%CI=1.85-2.86) or both (OR=2.58, 95%CI=2.20-3.03) were at a higher risk for poor sleep quality. Conclusions Poor sleep quality among high school students is highly prevalent, and school bullying is prevalent among adolescents in China. The present results suggested that being involved in school bullying might be a risk factor for poor sleep quality among adolescents. PMID:25811479

Restless leg syndrome, sleep quality and fatigue in multiple sclerosis patients.

PubMed

Moreira, N C V; Damasceno, R S; Medeiros, C A M; Bruin, P F C de; Teixeira, C A C; Horta, W G; Bruin, V M S de

2008-10-01

We have tested the hypothesis that restless leg syndrome (RLS) is related to quality of sleep, fatigue and clinical disability in multiple sclerosis (MS). The diagnosis of RLS used the four minimum criteria defined by the International Restless Legs Syndrome Study Group. Fatigue was assessed by the Fatigue Severity Scale (FSS >27), quality of sleep by the Pittsburgh Sleep Quality Index (PSQI >6), excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS >10) and clinical disability by the Expanded Disability Status Scale (EDSS). Forty-four patients (32 women) aged 14 to 64 years (43 +/- 14) with disease from 0.4 to 23 years (6.7 +/- 5.9) were evaluated. Thirty-five were classified as relapsing-remitting, 5 as primary progressive and 4 as secondary progressive. EDSS varied from 0 to 8.0 (3.6 +/- 2.0). RLS was detected in 12 cases (27%). Patients with RLS presented greater disability (P = 0.01), poorer sleep (P = 0.02) and greater levels of fatigue (P = 0.03). Impaired sleep was present in 23 (52%) and excessive daytime sleepiness in 3 cases (6.8%). Fatigue was present in 32 subjects (73%) and was associated with clinical disability (P = 0.000) and sleep quality (P = 0.002). Age, gender, disease duration, MS pattern, excessive daytime sleepiness and the presence of upper motor neuron signs were not associated with the presence of RLS. Fatigue was best explained by clinical disability and poor sleep quality. Awareness of RLS among health care professionals may contribute to improvement in MS management.

Prevalence and Associated Factors of Sleep Quality among Adults in Jimma Town, Southwest Ethiopia: A Community-Based Cross-Sectional Study

PubMed Central

Geleta, Daniel

2018-01-01

Background An estimated 150 million people worldwide and nearly 17% of the populations in the developing nations are currently suffering from sleep problems. The aim of the present study was to determine the prevalence and associated factors of sleep quality among adults in Ethiopia. Method A cross-sectional study was conducted on 422 randomly selected adults using validated and pretested Pittsburgh Sleep Quality Index. Data were entered into EpiData and analyzed using SPSS version 20 considering bivariable (P value < 0.25) and multivariable (P < 0.05) logistic regression procedures at 95% confidence interval. Result The overall prevalence of poor sleep quality (PSQI score > 5) was 65.4% with higher proportion among males (79 (63.0%)) and age group of 40–49 years (174 (28.6%)). A multivariable logistic regression analysis indicated that age category of 40–49 years (AOR = 2 [95% CI (1.1, 3.6)]) (P = 0.03), monthly income ≤ 1000 ETB (AOR = 2.2 [95% CI (14, 3.5)]) (P = 0.01), current khat chewing (AOR = 1.8 [95% CI (1.1, 3.1)]) (P = 0.03), daily khat chewing (AOR = 3.4 [95% CI (1.2, 11.1)]) (P = 0.04), and obesity (AOR = 1.2 [95% CI (1.3, 2.5)]) (P = 0.03) were identified as risk factors of poor sleep quality. Conclusion The current study is informative for government to work on poverty reduction, create awareness for weight reduction, and develop legislation for khat control to prevent poor sleep quality. PMID:29850261

[The prevalence of temporomandibular disorder symptoms in 898 university students and its relationship with psychological distress and sleep quality].

PubMed

Xia, W D; Fu, K Y; Lu, W X; Zhao, C M; Yang, H Y; Ye, Z X

2016-09-01

To investigate the prevalence of temporomandibular disorders(TMD) symptoms, psychological distress and sleep quality in a population of Chinese university students, and discuss the relationship between psychological distress, sleep quality and TMD symptoms. A total of 898 stomatological university students from 5 Chinese universities(342 males and 556 females with a mean age of 20.5 years) were included in the study. Self-reported TMD symptoms using diagnostic criteria for temporomandibular disorders symptom questionnaire were collected. Depression, anxiety and stress scales-21(DASS-21) and Pittsburgh sleep quality index(PSQI) were used to measure psychological distress and sleep quality. 61.9% (556/898) of the students had TMD symptoms. The most common symptoms were pain and clicking of joint, with a prevalence of 42.3% (380/898) and 34.2% (307/898), respectively. The prevalence of depression, anxiety, stress and sleep quality among the students who had TMD symptoms was 33.5%(186/556), 63.1%(351/556), 29.5%(164/556) and 30.2%(243/556), respectively, which was significantly higher than those who had no TMD symptoms(24.3% [83/342], 48.5% [166/342], 21.6%[74/342] and 21.9%[75/342])(P<0.05). Stepwise logistic regression analysis demonstrated that anxiety (OR 1.57, 95%CI 1.14-2.15) and female(OR 1.57, 95%CI 1.19-2.08) were possible risk indicators for TMD symptoms(P<0.05). Chinese university students reported a high prevalence of TMD symptoms, which may have a correlation with psychological distress symptoms such as anxiety.

[Sleep disorder of schizophrenia treated with shallow needling: a randomized controlled trial].

PubMed

Huang, Yanxi; Zheng, Ying

2015-09-01

To compare the clinical effective differences between shallow needling and medication for the sleep disorder of schizophrenia. Ninety-six patients with the sleep disorder of schizophrenia were randomly divided into a shallow needling group and a medication group, 48 cases in each one (one case dropping in the shallow needling group and two cases dropping in the medication group). The same dose paliperidone tablets were adopted in the two groups. In the shallow needling group, the main acupoints were Baihui (GV 20), Shangenxue (Extra) and Ezhongxian (MS 1), and the acupoints based on syndrome differentiation were selected. The shallow needling manipulation was used once a day, 5 times a week. In the medication group, 3 mg eszopiclone tablets were prescribed orally before sleep once every night. The patients were treated for 6 weeks in the two groups. Sleep condition was evaluated by Pittsburgh sleep quality index (PSQI) before and after treatment, and the clinical efficacy and the adverse reaction were assessed by positive and negative symptoms scale (PANSS) and treatment emergent symptom scale (TESS) before and after 2-week, 4-week and 6-week treatment. The clinical effects between the two groups were compared. After treatment in the two groups, both the total scores and the each factor score of the PSQI and the PANSS were apparently decreased (P<0. 05, P<0. 01). As for the PSQI scale, after treatment the daytime dysfunctional score of the shallow needling group was reduced more obviously than that of the medication group (P<0. 05), and the falling asleep time in the medication group was declined more markedly compared with that in the shallow needling group (P<0. 05). Regarding the PANSS, the improvement of the pathological factor in the shallow needling group was better than that in the medication group after treatment (P<0. 05), and the improvement of the positive factor in the medication group was superior to that in the shallow needling group after treatment (P<0. 05). The total scores and each factor score of the PSQI and the PANSS were not statistically different between the two groups after treatment (P>0. 05). At the end of the 6th week, the curative and effective rate was 63. 9% (30/47) and the total effective rate was 95. 8% (45/47) in the shallow needling group;the curative and effective rate was 58. 7% (27/46) and the total effective rate was 91. 3% (42/46) in the medication group. The difference of the effect was not statistically significant between the two groups (P>0. 05). The scores of TESS in the shallow needling group were lower than those in the medication group (P<0. 01, P<0. 05). The effect of shallow needling for assisting the sleeping disorder of schizophrenia is reliable and it is similar with the efficacy of eszopiclone. Also, the shallow needling can improve the daytime dysfunction and the pathological factor apparently without adverse reaction and pain. Its safety is obviously better than that of eszopiclone.

Sex Differences in the Relationship between Sleep Behavior, Fish Consumption, and Depressive Symptoms in the General Population of South Korea.

PubMed

Supartini, Atin; Oishi, Taro; Yagi, Nobuyuki

2017-07-14

Sleep, fish consumption, and depression have a close relationship; however, the role of sex differences in sleep, fish consumption, and depression research is not yet well-established. This study aimed to examine whether the impact of bedtime, sleep-onset latency, sleep duration, sleep quality, and fish consumption on depressive symptoms differed in women and men. An online survey was conducted in South Korea with a stratified random sample of 600 participants between the ages of 20 and 69, whose gender and age were proportional to estimates of Korea's general population. The 20-item Center for Epidemiologic Studies Depression Scale was used to measure depressive symptoms with a cut-off score of 16. The Pittsburgh Sleep Quality Index (PSQI) was applied to evaluate sleep timing, sleep-onset latency, sleep duration, and sleep quality. Our results indicated that late bedtime and short sleep duration were independently associated with depressive symptoms in women. Sleep-onset latency and poor sleep quality were independently associated with increased prevalence of depressive symptoms in both men and women. Higher fish consumption was significantly associated with decreased prevalence of depressive symptoms in men only. Our findings suggested the importance of a different approach for men and women in terms of promoting healthy sleep habits. In addition, higher fish consumption may be beneficial in the primary prevention of depression in Korean men. Further research is needed to confirm the findings from this cross-sectional study.

Sleep Quality, Sleep Patterns and Consumption of Energy Drinks and Other Caffeinated Beverages among Peruvian College Students

PubMed Central

Sanchez, Sixto E.; Martinez, Claudia; Oriol, Raphaelle A.; Yanez, David; Castañeda, Benjamín; Sanchez, Elena; Gelaye, Bizu; Williams, Michelle A.

2014-01-01

Objectives To evaluate sleep quality in relation to lifestyle characteristics including consumption of energy drinks and other caffeinated beverages among Peruvian college students. Methods A total of 2,458 college students were invited to complete a self-administered questionnaire that collected information about a variety of behaviors including consumption of energy drinks, caffeinated and alcoholic beverages. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Logistic regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for poor sleep quality in relation to lifestyle characteristics. Results A total of 965 males and 1,493 female students were enrolled in the study. 52.0% of males and 58.4% of females experienced poor sleep quality (p=0.002). Females (OR=1.28; 95% CI 1.08–1.51) and those who reported consuming ≥ 3 stimulant beverages per week (OR=1.88; 95% CI 1.42–2.50) had higher odds of poor sleep quality. Students who consumed 1–19 alcoholic beverages monthly (OR=1.90; 95% CI 1.46–2.49) had a higher odds of long sleep latency. Consumption of ≥ 3 stimulant beverages per week was associated with daytime dysfunction due to sleep loss (OR=1.45; 95% CI 1.10–1.90), short sleep duration (OR= 1.49; 95% CI 1.14–1.94), and use of sleep medication (OR= 2.10; 95% CI 1.35–3.28). Conclusions Consumption of energy drinks, other caffeinated beverages and alcoholic beverages are risk factors of poor sleep quality. Increased awareness of these associations should promote interventions to improve students’ lifestyle habits, including consumption of alcoholic and caffeinated beverages, and overall health. PMID:25243056

Familiality and clinical outcomes of sleep disturbances in major depressive and bipolar disorders.

PubMed

Lai, Yin-Chieh; Huang, Ming-Chyi; Chen, Hsi-Chung; Lu, Ming-Kun; Chiu, Yi-Hang; Shen, Winston W; Lu, Ru-Band; Kuo, Po-Hsiu

2014-01-01

Sleep disturbances are frequently observed in major depressive (MDD) and bipolar disorder (BD). This study reported sleep profiles of patients and their relatives versus controls, and examined the familiality of sleep features in mood disorder families. We also evaluated the influences of sleep disturbance on patients' quality of life (QOL), functional impairment, and suicidality. We recruited 363 BD and 157 MDD patients, 521 first-degree relatives, and 235 healthy controls, which completed a diagnostic interview, Pittsburgh Sleep Quality Index (PSQI), and QOL questionnaire. The magnitude of heritability of sleep features was calculated and familiality was evaluated by mixed regression models and intraclass correlation coefficient (ICC). The associations between sleep problems and clinical outcomes were examined using multiple regression models. More than three-quarters of mildly-ill patients were classified as "poor sleepers". MDD patients had significantly worse sleep quality as compared to BD patients. Moderate but significant familial aggregation was observed in subjective sleep quality, sleep latency, disturbance, daytime dysfunction, and global score (ICC=0.10-0.21, P<.05). Significant heritability was found in sleep quality (0.45, P<.001) and sleep disturbance (0.23, P<.001). Patients with good sleep quality had better QOL and less functional impairment (P<.05) than poor sleepers. Poor sleep quality and nightmares further increased the risk for suicidal ideation (ORadj=2.8) and suicide attempts (ORadj=1.9-2.8). Subjectively measured sleep features demonstrated significant familiality. Poor sleep quality further impaired patients' daily function and QOL, in addition to increasing the risk of suicidality, and thus requires special attention in related clinical settings. Copyright © 2013 Elsevier Inc. All rights reserved.

The impact of psychological factors on self-reported sleep disturbance among people living in the vicinity of wind turbines.

PubMed

Jalali, Leila; Nezhad-Ahmadi, Mohammad-Reza; Gohari, Mahmood; Bigelow, Philip; McColl, Stephen

2016-07-01

Canada's wind energy capacity has grown from approximately 137MW (MW) in 2000 to over 9700MW in 2014, and this progressive development has made Canada the fifth-largest market in the world for the installation of new wind turbines (WTs). Although wind energy is now one of the fastest growing sources of power in Canada and many other countries, the growth in both number and size of WTs has raised questions regarding potential health impacts on individuals who live close to such turbines. This study is the first published research using a prospective cohort design, with noise and sleep measurements obtained before and after installation of WTs to investigate effect of such turbines on self-reported sleep disturbances of nearby residents. Subjective assessment of sleep disturbance was conducted in Ontario, Canada through standard sleep and sleepiness scales, including the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth daytime Sleepiness Scale (ESS). Both audible and infra-sound noises were also measured inside the bedroom. Descriptive and comparison analyses were performed to investigate the effect of WT exposure on sleep data. Results of the analysis show that participants reported poorer sleep quality if they had a negative attitude to WTs, if they had concerns related to property devaluation, and if they could see turbines from their properties. This study provides evidence for the role of individual differences and psychological factors in reports of sleep disturbance by people living in the vicinity of WTs. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Validation of the German version of the short form of the dysfunctional beliefs and attitudes about sleep scale (DBAS-16).

PubMed

Lang, Christin; Brand, Serge; Holsboer-Trachsler, Edith; Pühse, Uwe; Colledge, Flora; Gerber, Markus

2017-06-01

Research shows that dysfunctional sleep-related cognitions play an important role in the development, maintenance and exacerbation of insomnia. This study examines the factorial validity, psychometric properties and both concurrent and predictive validity of the German version of the 16-item DBAS (dysfunctional beliefs and attitudes about sleep) scale. Data was collected in 864 vocational students from the German-speaking part of Switzerland (43% females, M age  = 17.9 years). Data collection took place twice within a 10-month interval. The students completed a German translation of the DBAS-16, the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), and provided information about their psychological functioning. Descriptive statistics, factorial validity, internal consistency, gender differences, concurrent, and predictive validity were examined. Confirmatory factor analysis supported the 4-factor structure of the DBAS-16. All factors (consequences, worry/helplessness, expectations, medication) were positively correlated and had acceptable psychometric properties. Females reported higher scores across all DBAS measures. Weak-to-moderate correlations were found between dysfunctional sleep-related beliefs, insomnia and poor sleep quality. Dysfunctional sleep-related beliefs were also associated with decreased psychological functioning, and consistently predicted insomnia and poor psychological functioning at follow-up, even after controlling for socio-demographic background and baseline levels. The present study provides support for the validity and psychometric properties of the German version of the DBAS-16. Most importantly, it corroborates the relevance of cognitive-emotional factors in the onset and maintenance of insomnia and psychological symptoms among young people.

Association between the amount of sleep and obesity in Chilean schoolchildren.

PubMed

Durán Agüero, Samuel; Haro Rivera, Pablo

2016-04-01

Studies mainly performed in adults have shown an association between the amount of sleep and obesity. To determine if there is an association between nocturnal sleep deprivation during the week and the weekend, eating habits, physical activity and nutritional status among Chilean schoolchildren. Crosssectional study. An anthropometric assessment was done among 6-11 year-old students; the Pittsburgh Sleep Quality Index (PSQI) was used among parents to measure their children's quality of sleep; they were asked about eating habits and physical activity. One thousand eight hundred and ten schoolchildren of both sexes, attending public schools in Santiago, were assessed. Out of these schoolchildren, 49.9% slept fewer hours per night than recommended. An association in the crude model (crude OR 1.82; CI 95%: 1.29-2.56), in model 2 adjusted for cola drinks (OR 1.83; CI 95%: 1.30-2.59) and in model 3 adjusted for dinner, cola drink and caffeine beverage consumption and nocturia (OR 1.85; CI 95%: 1.30-2.62) was observed. It was also noticed that exercising was a protective factor against overweight and obesity; however, periodic limb movement during sleep was a risk factor. This study showed an association between fewer hours of sleep and an increase in the risk of overweight/obesity. Sociedad Argentina de Pediatría.

A maintenance three-day-per-week schedule with the single tablet regimen efavirenz/emtricitabine/tenofovir disoproxil fumarate is effective and decreases sub-clinical toxicity: the A-TRI-WEEK pilot trial.

PubMed

Rojas, Jhon; Blanco, Jose L; Sanchez-Palomino, Sonsoles; Marcos, Maria A; Guardo, Alberto C; Gonzalez-Cordon, Ana; Lonca, Montserrat; Tricas, Amparo; Rodriguez, Ana; Romero, Anabel; Miro, Jose M; Mallolas, Josep; Gatell, Jose M; Plana, Montserrat; Martinez, Esteban

2018-05-09

Antiretroviral drugs contained in single tablet Atripla® have pharmacokinetic properties that could allow for longer than once-daily (OD) dosing. We hypothesized that simplifying Atripla® OD to 3-day per week would be feasible, able to maintain viral suppression and less toxic. Virologically suppressed (≥2 years) HIV+ adults on Atripla® OD, CD4 >350/mm at inclusion, and no prior documented virological failure or evidence of resistance mutations to efavirenz, tenofovir, or emtricitabine were randomized to maintain their OD regimen or to reduce it to 3 days (Mondays, Wednesdays, and Fridays) a week (3W). Primary end-point was the proportion of patients free of treatment failure (non-completer = failure) at 24 weeks. CD4 and CD8 cells, ultrasensitive HIV-1 RNA, Pittsburg Sleep Quality Index (PSQI), bone mineral density, plasma efavirenz levels, and fasting blood and urine chemistries were measured at baseline and 24 weeks. The study is registered at ClinicalTrials.gov, NCT01778413. Sixty-one patients were randomized. All patients in both arms remained free of treatment failure (estimated difference 0%; 95% confidence interval -14.1 to 14.1). Ultrasensitive plasma HIV-1 RNA below detection threshold showed no difference between arms (70% in the 3W arm vs. 71% in the OD arm, P = 0.933) at 24 weeks. Total cholesterol and femur T-score significantly increased, while PSQI, plasma efavirenz, albumin/creatinine and beta-2-microglobulin in urine significantly decreased in the 3W arm relative to OD arm. The A-TRI-WEEK study represents a proof of concept for the feasibility of three-day per week Atripla® maintenance that should be further confirmed in a larger, well-powered clinical trial.

The effects of mindfulness-based stress reduction on objective and subjective sleep parameters in women with breast cancer: a randomized controlled trial.

PubMed

Lengacher, Cecile A; Reich, Richard R; Paterson, Carly L; Jim, Heather S; Ramesar, Sophia; Alinat, Carissa B; Budhrani, Pinky H; Farias, Jerrica R; Shelton, Melissa M; Moscoso, Manolete S; Park, Jong Y; Kip, Kevin E

2015-04-01

The purpose of this study was to investigate the effects of mindfulness-based stress reduction for breast cancer survivors (MBSR(BC)) on multiple measures of objective and subjective sleep parameters among breast cancer survivors (BCS). Data were collected using a two-armed randomized controlled design among BCS enrolled in either a 6-week MBSR(BC) program or a usual care (UC) group with a 12-week follow-up. The present analysis is a subset of the larger parent trial (ClinicalTrials.gov Identifier: NCT01177124). Seventy-nine BCS participants (mean age 57 years), stages 0-III, were randomly assigned to either the formal (in-class) 6-week MBSR(BC) program or UC. Subjective sleep parameters (SSP) (i.e., sleep diaries and the Pittsburgh Sleep Quality Index (PSQI)) and objective sleep parameters (OSP) (i.e., actigraphy) were measured at baseline, 6 weeks, and 12 weeks after completing the MBSR(BC) or UC program. Results showed indications of a positive effect of MBSR(BC) on OSP at 12 weeks on sleep efficiency (78.2% MBSR(BC) group versus 74.6% UC group, p = 0.04), percent of sleep time (81.0% MBSR(BC) group versus 77.4% UC group, p = 0.02), and less number waking bouts (93.5 in MBSR(BC) group versus 118.6 in the UC group, p < 0.01). Small nonsignificant improvements were found in SSP in the MBSR(BC) group from baseline to 6 weeks (PSQI total score, p = 0.09). No significant relationship was observed between minutes of MBSR(BC) practice and SSP or OSP. These data suggest that MBSR(BC) may be an efficacious treatment to improve objective and subjective sleep parameters in BCS. Copyright © 2014 John Wiley & Sons, Ltd.

Comprehensive assessment of the impact of life habits on sleep disturbance, chronotype, and daytime sleepiness among high-school students.

PubMed

Shimura, Akiyoshi; Hideo, Sakai; Takaesu, Yoshikazu; Nomura, Ryota; Komada, Yoko; Inoue, Takeshi

2018-04-01

Sleep affects adolescents in various ways. However, the effects of multiple factors on sleep hygiene remain unclear. A comprehensive assessment of the effects of life habits on sleep in high-school students was conducted. A cross-sectional survey of 344 high school students (age range 15-17; 171 boys, 173 girls) in Tokyo, Japan was conducted in 2015. Complete responses were provided by 294 students. Demographic variables, Pittsburgh Sleep Quality Index (PSQI), diurnal type scale, Pediatric Daytime Sleepiness Scale (PDSS), and life habits such as dinnertime, viewing electronic displays, caffeine intake, sunlight in the morning, and the brightness of the room in the night were asked. The mean scores were PSQI: 5.9 (±2.3), PDSS: 19.0 (±5.8), and the diurnal type scale: 16.7 (±3.4). Using an electronic display in bed (OR = 3.01; (95%CI) 1.24-7.30), caffeine intake at night always (OR = 2.22; 1.01-4.90), and waking up before dawn (OR = 3.25; 1.34-7.88) were significantly associated with sleep disturbance. Irregular timing of the evening meal (OR = 2.06; 1.10-3.84) and display viewing within 2 h before bedtime (OR = 2.50; 1.01-6.18) or in bed (OR = 3.60; 1.41-9.21) were significantly associated with excessive daytime sleepiness. Using an electronic display within 2 h before bedtime (OR = 2.64; 1.10-6.38) or in bed (OR = 3.50; 1.40-8.76) and a living room which is bright at night (OR = 1.89; 1.06-3.36) were significantly associated with eveningness. Each type of sleep-related problem had its own associated life habit factors. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Sleep-related attentional bias in poor versus good sleepers is independent of affective valence.

PubMed

Barclay, Nicola L; Ellis, Jason G

2013-08-01

Contradictory evidence exists relating to the presence of an attention bias to sleep-related stimuli in poor sleepers/insomnia using the emotional Stroop task (EST). These inconsistencies may be due to methodological issues related to the affective valence of the sleep-related stimuli. Thus, individuals may attend differentially to sleep-related stimuli not because of their 'sleep' properties, but their negativity. The current study addresses this by controlling the affective valence of sleep-related words. A total of 107 participants [mean age = 33.22 years, standard deviation (SD) = 12.31 years; 61.7% female] were recruited during an evening event at the Newcastle Science Festival. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and a computerized EST containing 20 non-affective sleep-related, 20 neutral and 20 negatively valenced threat words. Good and poor sleepers were categorized using the PSQI. There were no significant differences between groups on response latency to sleep-related words (t(105) = -0.30, P = 0.76). However, the interaction between good versus poor sleepers and word-type on response latency was significant (F(2,210) = 3.06, P < 0.05). Poor sleepers took longer to respond to sleep-related words (mean = 723.35, SD = 172.55) compared to threat words (mean = 694.63, SD = 162.17) than good sleepers (mean = 713.20, SD = 166.32; and mean = 716.65, SD = 181.14). The results demonstrate the presence of an attention bias towards sleep-related stimuli compared to threat stimuli in poor sleepers. Accordingly, poor sleepers may be consumed by stimuli relevant to their specific difficulties, as well as being more highly attuned to negative cues that signal anxious states. Thus, the present research suggests that there are two opposing forces at play: one which facilitates performance (non-specific threats) and one which hinders performance (personally relevant threats). © 2013 European Sleep Research Society.

Comparing effects of citalopram with fluoxetine on sleep quality in patients with major depressive disorder.

PubMed

Shahsavand-Ananloo, E; Berenji, F; Sadeghniiat, K; Alimadadi, A; Zahiroddin, A R; Tabatabaee, M; Abbasi-Asl, M; Ghaeli, P

2013-05-01

Sleep disturbance is a common complaint in major depressive disorder (MDD) including impairment of both subjective and objective parameters. All antidepressants affect sleep architecture and quality. This trial was designed to compare the effects of short-term use of citalopram with fluoxetine on sleep quality (SQ) of patients with MDD based on Diagnostic and Statistical Manual for Mental Disorders - Text Revision 4th edition (DSM-IV-TR) criteria. Patients who met the study criteria entered this open-label study. Sleep quality and depression severity were evaluated by using Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory-II (BDI-II), respectively. Patients could not have received any antidepressant for at least one month prior entering the study. Subjects were assigned to receive either fluoxetine or citalopram for 8 weeks. The relationships between SQ and severity of depression were also studied at weeks 4 and 8. Data was analyzed by using SPSS 11.5 version. Nineteen patients received fluoxetine 20-40 mg/day and 21 received citalopram 20-40 mg/day. After 4 and 8 weeks treatment with both fluoxetine and citalopram, significant improvements in SQ were noted in both groups. However, no significant difference between the two groups was observed. Additionally, a significant and positive correlation between improvements in SQ and depression was noted after 8 weeks treatment with citalopram but not with fluoxetine. This study noted that both citalopram and fluoxetine improved SQ in outpatients with MDD after 8 weeks without any significant difference between the 2 groups.

The effect of vitamin D supplement on the score and quality of sleep in 20-50 year-old people with sleep disorders compared with control group.

PubMed

Majid, Mohammad Shahi; Ahmad, Hosseini Seyed; Bizhan, Helli; Mohammad Hosein, Haghighi Zade; Mohammad, Abolfathi

2017-05-05

Sleep quality may be directly related with vitamin D serum level. Some studies found that people with lower vitamin D serum level experienced a lower sleep quality. Consequently, this study aimed at determining the effect of vitamin D supplements on sleep score and quality in 20-50 year-old people with sleep disorders. This double blind, clinical trial was performed in November 2015-February 2016 on 89 people with sleep disorders based on Petersburg's Sleep Index. Patient samples were divided randomly into two groups: intervention and placebo. At the end of the study, the data on 89 subjects (44 in intervention group and 45 people in placebo group) were examined. Intervention group received a 50 000-unit vitamin D supplement, one in a fortnight for 8 weeks. Meanwhile, placebo group received placebo. Before and after intervention, Petersburg's Sleep Quality Questionnaire, International Physical Activity Questionnaire, general information questionnaire, sun exposure, vitamin D serum level and 3-day food record questionnaire were assessed and recorded for all participants. To analyze data, t-test, chi square, ANCOVA, U-Mann-Whitney and Wilcoxon statistical tests were used. Based on the results of the present study, at the end of the study sleep score (PSQI) reduced significantly in vitamin recipients as compared with placebo recipients (P < 0.05). This difference was significant even after modifying confounding variables (P < 0.05). This study shows that the use of vitamin D supplement improves sleep quality, reduces sleep latency, raises sleep duration and improves subjective sleep quality in people of 20-50 year-old with sleep disorder.

Good sleep quality is associated with better academic performance among Sudanese medical students.

PubMed

Mirghani, Hyder Osman; Mohammed, Osama Salih; Almurtadha, Yahia Mohamed; Ahmed, Moneir Siddig

2015-11-23

There is increasing awareness about the association of sleep quality and academic achievement among university students. However, the relationship between sleep quality and academic performance has not been examined in Sudan; this study assessed the relationship between sleep quality and academic performance among Sudanese medical students. A case-control study was conducted among 165 male and female medical students at two Sudanese universities. Excellent (A) and pass (C) academic groups were invited to respond to a self-administered questionnaire, using the Pittsburgh Sleep Quality Index (PSQI). Students also completed a diary detailing their sleep habits for 2 weeks prior to filling out the questionnaire. Various parameters of sleep quality were then compared between the two groups. A significant difference (p < 0.001) between the excellent and average groups was found for overall sleep quality, subjective sleep rating, bedtime later than midnight, sleep latency, and daytime dysfunction (during driving, preparing a meal, etc.). No differences were found between groups for the use of sleep medications. The mean sleeping hours was (7 ± 1.9) and (6.3 ± 1.9) for the excellent and pass groups respectively (p < 0.05). A significant difference (p < 0.001) between the excellent and average groups was found for weekday and weekend bedtime, weekend wake-up time, and weekend wake-up delay. No differences were found between groups for the weekday's wake- up time, and bedtime delay during weekends. Besides, snoring was present in 9.2 % of the excellent group versus 28 % in pass group (p < 0.005).

SOCIAL RELATIONSHIPS AND SLEEP QUALITY

PubMed Central

Kent, Robert G.; Uchino, Bert N.; Cribbet, Matthew R.; Bowen, Kimberly; Smith, Timothy W.

2015-01-01

Background The quality of social relationships and social support appears to be associated with physical health outcomes and sleep quality. Almost all previous research in this area focuses on positive aspects of relationships. Purpose The present study thus intended to examine the links between supportive, aversive, ambivalent, and indifferent network ties and sleep quality. Methods Relationship data, PSQI-assessed sleep quality, and depression were examined in 175 middle-aged and older adults. Results Consistent with hypotheses, supportive ties were positively related to sleep quality, while aversive ties predicted worse sleep quality; associations that were primarily seen for close relationships. Ambivalent and indifferent ties were not significant predictors of sleep quality. Importantly, depression was found to mediate the link between relationship quality and sleep quality. Conclusions These data suggest the more specific types of social relationships that may be linked to poor sleep quality, and that depression appears to underlie these associations. PMID:25976874

Sleep and Quality of Life in Urban Poverty: The Effect of a Slum Housing Upgrading Program

PubMed Central

Simonelli, Guido; Leanza, Yvan; Boilard, Alexandra; Hyland, Martín; Augustinavicius, Jura L.; Cardinali, Daniel P.; Vallières, Annie; Pérez-Chada, Daniel; Vigo, Daniel E.

2013-01-01

Study Objectives: To evaluate the effect of a housing transition on sleep quality and quality of life in slum dwellers, participating in a slum housing upgrading program. Design: Observational before-and-after study with a convergent-parallel mixed method design. Setting: Five slums located in the metropolitan area of Buenos Aires, Argentina. Participants: A total of 150 slum dwellers benefited by a housing program of the nonprofit organization TECHO (spanish word for “roof”). Interventions: Participants moved from their very low-quality house to a basic prefabricated 18 m2 modular house provided by TECHO. Measurements and Results: The Pittsburgh Sleep Quality Index (PSQI) and World Health Organization Quality of Life brief scale (WHOQOL-BREF) were administered before and after housing upgrading. Data about housing conditions, income, education, sleeping conditions, and cardiovascular risk were also collected. Semistructured interviews were used to expand and nuance quantitative data obtained from a poorly educated sample. Results showed that sleep quality significantly increased after the housing program (z = -6.57, P < 0.001). Overall quality of life (z = -6.85, P < 0.001), physical health domain (z = -4.35, P < 0.001), psychological well-being domain (z = -3.72, P < 0.001) and environmental domain (z = -7.10, P < 0.001) of WHOQOL-BREF were also improved. Interviews demonstrated the importance of serenity for improving quality of life. Conclusions: A minimal improvement in the quality of basic housing can significantly increase sleep quality and quality of life among slum dwellers. Understanding sleep and daily life conditions in informal urban settlements could help to define what kind of low-cost intervention may improve sleep quality, quality of life, and reduce existent sleep disparity. Citation: Simonelli G; Leanza Y; Boilard A; Hyland M; Augustinavicius JL; Cardinali DP; Vallières A; Pérez-Chada D; Vigo DE. Sleep and quality of life in urban poverty: the effect of a slum housing upgrading program. SLEEP 2013;36(11):1669-1676. PMID:24179300

Sleep and Circadian Rhythms in Spousally Bereaved Seniors

PubMed Central

Monk, Timothy H.; Begley, Amy E.; Billy, Bart D.; Fletcher, Mary E.; Germain, Anne; Mazumdar, Sati; Moul, Douglas E.; Shear, M. Katherine; Thompson, Wesley K.; Zarotney, Joette R.

2009-01-01

A laboratory study of sleep and circadian rhythms was undertaken in 28 spousally bereaved seniors (≥60 yrs) at least four months after the loss event. Measures taken included two nights of polysomnography (second night used), ∼36 h of continuous core body temperature monitoring, and four assessments of mood and alertness throughout a day. Preceding the laboratory study, two-week diaries were completed, allowing the assessment of lifestyle regularity using the 17-item Social Rhythm Metric (SRM) and the timing of sleep using the Pittsburgh Sleep Diary (PghSD). Also completed were questionnaires assessing level of grief (Texas Revised Inventory of Grief [TRIG] and Index of Complicated Grief [ICG]), subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI]), morningness-eveningness (Composite Scale of Morningness [CSM]), and clinical interview yielding a Hamilton Depression Rating Scale (HDRS) score. Grief was still present, as indicated by an average TRIG score of about 60. On average, the bereaved seniors habitually slept between ∼23:00 and ∼06:40 h, achieving ∼6 h of sleep with a sleep efficiency of ∼80%. They took about 30 min to fall asleep, and had their first REM episode after 75 min. About 20% of their sleep was in Stage REM, and about 3% in Stages 3 or 4 (slow wave sleep). Their mean PSQI score was 6.4. Their circadian temperature rhythms showed the usual classic shape with a trough at ∼01:00 h, a fairly steep rise through the morning hours, and a more gradual rise to mid-evening, with an amplitude of ∼0.8°C. In terms of lifestyle regularity, the mean regularity (SRM) score was 3.65 (slightly lower than that usually seen in seniors). Mood and alertness showed time-of-day variation with peak alertness in the late morning and peak mood in the afternoon. Correlations between outcome sleep/circadian variables and level of grief (TRIG score) were calculated; there was a slight trend for higher grief to be associated with less time spent asleep (p = 0.07) and reduced alertness at 20:00 h (p = 0.05). Depression score was not correlated with TRIG score (p > 0.20). When subjects were divided into groups by the nature of their late spouse's death (expected/after a long-term chronic illness [n = 18] versus unexpected [n = 10]), no differences emerged in any of the variables. In conclusion, when studied at least four months after the loss event, there appears to be some sleep disruption in spousally bereaved seniors. However, this disruption does not appear to be due to bereavement-related disruptions in the circadian system. PMID:18293151

Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period.

PubMed

Tomfohr, Lianne M; Buliga, Elena; Letourneau, Nicole L; Campbell, Tavis S; Giesbrecht, Gerald F

2015-08-01

The aim of this study was to investigate trajectories of sleep quality and associations with mood in the perinatal period. Although it is commonly accepted that subjective sleep quality declines during pregnancy and the transition to parenthood, some women may follow qualitatively distinct trajectories. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were collected from 293 women at four time points: during early pregnancy, at Time 1 (T1; < 22 w gestational age [GA]; late pregnancy, at Time 2 (T2; 32 w GA); during the postnatal period at Time 3 (T3; 3 mo postpartum); and Time 4 (T4; 6 mo postpartum). A group-based semiparametric mixture model was used to estimate patterns of sleep quality throughout the perinatal period. Four trajectory groups were identified, including patterns defined by high sleep quality throughout (21.5%), mild decrease in sleep quality (59.5%), significant decrease in sleep quality (12.3%) and a group with poor sleep quality throughout (6.7%). Women who had the worst sleep quality at Time 1 and those who experienced significant increases in sleep problems throughout pregnancy were also the groups who reported the highest levels of anxiety and depressive symptoms in early pregnancy and the lowest levels of social support. After controlling for covariates, the groups with worst subjective sleep quality during pregnancy were also the most likely to experience high symptoms of depression in the postpartum period. Most of the women in our sample reported mild sleep disturbances through the perinatal period. A subgroup of women reported a significant decline in sleep quality from early to late pregnancy and another reported poor subjective sleep quality throughout pregnancy; these groups had the greatest risk of experiencing high symptoms of depression in the postpartum period. © 2015 Associated Professional Sleep Societies, LLC.

The Effect of Aerobic Exercise on Quantity and Quality of Sleep Among Elderly People Referring to Health Centers of Lar City, Southern of Iran; A Randomized Controlled Clinical Trial.

PubMed

Sharif, Farkhondeh; Seddigh, Maryam; Jahanbin, Iran; Keshavarzi, Sareh

2015-01-01

Aging is associated with reduced quality and quantity of sleep. 50% of senior citizens living in the community and 70% of those living in nursing homes suffer from sleep disorders. Moreover, insomnia increases the risk of mortality and morbidity in older adults. We aimed to investigate the effect of aerobic exercise on quantity and quality of sleep among the elderly people referring to health centers of Lar city, southern Iran. We enrolled 60 elderly people whose age range was 60-75 years and (mean ±SD) age was (64.8±5.2). Participants were randomly assigned into two groups of 30 each (case group= 30 and control group=30). The patients in the case group participated in exercise trainings consisted of three one-hour sessions per week for 12 consecutive weeks. Sleep quantity and quantity in the participants was evaluated before and after intervention using Pittsburgh Sleep Quality Index (PSQI). Independent t-test showed that sleep quality score was improved by 44.46% in the case group (p<0.0001). Furthermore, sleep duration was improved by 98/16% (p=0.038) and sleep latency was improved by 76/6% in the case group; while, the difference between the two groups regarding the changes in the sleep latency was not statistically significant (p=0.089). Aerobic exercise program could improve the sleep quality and quantity in the elderly. It could also be used as a cost effective and long lasting method of therapy with no side effect which could be used for the treatment of insomnia in older people.

Childhood abuse is associated with stress-related sleep disturbance and poor sleep quality in pregnancy

PubMed Central

Gelaye, Bizu; Kajeepeta, Sandhya; Zhong, Qiu-Yue; Borba, Christina P.C.; Rondon, Marta B.; Sánchez, Sixto E.; Henderson, David C.; Williams, Michelle A.

2015-01-01

Objectives Childhood abuse is associated with increased risks of adult psychiatric disorders and physical health conditions. Accumulating evidence documents associations of childhood abuse with sleep disturbances in adulthood. However, to date, no study has evaluated associations of childhood abuse and sleep disturbances among pregnant women. Methods This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding socio-demographic characteristics, history of childhood abuse, and complaints of sleep disturbances. Spanish language version of the Ford Insomnia Response to Stress Test (FIRST-S) and the Pittsburgh Sleep Quality Index (PSQI-S) were used to assess stress-related sleep disturbance and sleep quality, respectively. Logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CIs). Results Women who experienced any childhood abuse had a 1.65-fold increased odds of stress-related sleep disturbance (aOR=1.65; 95% CI: 1.15–2.38) and 2.11-fold increased odds of poor sleep quality during early pregnancy (aOR=2.11; 95% CI: 1.35–3.30) as compared with women who reported no abuse. Compared with women who reported no childhood abuse, those who reported both physical and sexual abuse during childhood were more than twice as likely to suffer from stress-related sleep disturbance (aOR=2.26; 95% CI:1.44–3.53) and poor sleep quality (aOR=2.43; 95% CI:1.45–4.09). Conclusions A history of childhood abuse is associated with increased odds of stress-related sleep disturbance and poor sleep quality during pregnancy. These findings, if replicated, should be used to inform the development of trauma-informed care for such sleep disturbances induced by childhood trauma. PMID:26429757

Effect of Calorie Restriction on Mood, Quality of Life, Sleep, and Sexual Function in Healthy Nonobese Adults: The CALERIE 2 Randomized Clinical Trial.

PubMed

Martin, Corby K; Bhapkar, Manju; Pittas, Anastassios G; Pieper, Carl F; Das, Sai Krupa; Williamson, Donald A; Scott, Tammy; Redman, Leanne M; Stein, Richard; Gilhooly, Cheryl H; Stewart, Tiffany; Robinson, Lisa; Roberts, Susan B

2016-06-01

Calorie restriction (CR) increases longevity in many species and reduces risk factors for chronic diseases. In humans, CR may improve health span, yet concerns remain about potential negative effects of CR. To test the effect of CR on mood, quality of life (QOL), sleep, and sexual function in healthy nonobese adults. A multisite randomized clinical trial (Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy Phase 2 [CALERIE 2]) was conducted at 3 academic research institutions. Adult men and women (N = 220) with body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 22.0 to 28.0 were randomized to 2 years of 25% CR or an ad libitum (AL) control group in a 2:1 ratio favoring CR. Data were collected at baseline, 12 months, and 24 months and examined using intent-to-treat analysis. The study was conducted from January 22, 2007, to March 6, 2012. Data analysis was performed from July 18, 2012, to October 27, 2015. Two years of 25% CR or AL. Self-report questionnaires were administered to measure mood (Beck Depression Inventory-II [BDI-II], score range 0-63, higher scores indicating worse mood, and Profile of Mood States [POMS], with a total mood disturbance score range of -32 to 200 and higher scores indicating higher levels of the constructs measured), QOL (Rand 36-Item Short Form, score range 0-100, higher scores reflecting better QOL, and Perceived Stress Scale, score range 0-40, higher scores indicating higher levels of stress), sleep (Pittsburgh Sleep Quality Index [PSQI], total score range 0-21, higher scores reflecting worse sleep quality), and sexual function (Derogatis Interview for Sexual Function-Self-report, total score range 24-188, higher scores indicating better sexual functioning). In all, 218 participants (152 women [69.7%]; mean [SD] age, 37.9 (7.2) years; mean [SD] BMI, 25.1 [1.6]) were included in the analyses. The CR and AL groups lost a mean (SE) of 7.6 (0.3) kg and 0.4 (0.5) kg, respectively, at month 24 (P < .001). Compared with the AL group, the CR group had significantly improved mood (BDI-II: between-group difference [BGD], -0.76; 95% CI, -1.41 to -0.11; effect size [ES], -0.35), reduced tension (POMS: BGD, -0.79; 95% CI, -1.38 to -0.19; ES, -0.39), and improved general health (BGD, 6.45; 95% CI, 3.93 to 8.98; ES, 0.75) and sexual drive and relationship (BGD, 1.06; 95% CI, 0.11 to 2.01; ES, 0.35) at month 24 as well as improved sleep duration at month 12 (BGD, -0.26; 95% CI, -0.49 to -0.02; ES, -0.32) (all P < .05). Greater percent weight loss in the CR group at month 24 was associated with increased vigor (Spearman correlation coefficient, ρ = -0.30) and less mood disturbance (ρ = 0.27) measured with the POMS, improved general health (ρ = -0.27) measured with the SF-36, and better sleep quality per the PSQI total score (ρ = 0.28) (all P < .01). In nonobese adults, CR had some positive effects and no negative effects on health-related QOL. clinicaltrials.gov Identifier: NCT00427193.

Trial of Prazosin for Post-Traumatic Stress Disorder in Military Veterans.

PubMed

Raskind, Murray A; Peskind, Elaine R; Chow, Bruce; Harris, Crystal; Davis-Karim, Anne; Holmes, Hollie A; Hart, Kimberly L; McFall, Miles; Mellman, Thomas A; Reist, Christopher; Romesser, Jennifer; Rosenheck, Robert; Shih, Mei-Chiung; Stein, Murray B; Swift, Robert; Gleason, Theresa; Lu, Ying; Huang, Grant D

2018-02-08

In randomized trials, prazosin, an α 1 -adrenoreceptor antagonist, has been effective in alleviating nightmares associated with post-traumatic stress disorder (PTSD) in military veterans. We recruited veterans from 13 Department of Veterans Affairs medical centers who had chronic PTSD and reported frequent nightmares. Participants were randomly assigned to receive prazosin or placebo for 26 weeks; the drug or placebo was administered in escalating divided doses over the course of 5 weeks to a daily maximum of 20 mg in men and 12 mg in women. After week 10, participants continued to receive prazosin or placebo in a double-blind fashion for an additional 16 weeks. The three primary outcome measures were the change in score from baseline to 10 weeks on the Clinician-Administered PTSD Scale (CAPS) item B2 ("recurrent distressing dreams"; scores range from 0 to 8, with higher scores indicating more frequent and more distressing dreams); the change in score from baseline to 10 weeks on the Pittsburgh Sleep Quality Index (PSQI; scores range from 0 to 21, with higher scores indicating worse sleep quality); and the Clinical Global Impression of Change (CGIC) score at 10 weeks (scores range from 1 to 7, with lower scores indicating greater improvement and a score of 4 indicating no change). A total of 304 participants underwent randomization; 152 were assigned to prazosin, and 152 to placebo. At 10 weeks, there were no significant differences between the prazosin group and the placebo group in the mean change from baseline in the CAPS item B2 score (between-group difference, 0.2; 95% confidence interval [CI], -0.3 to 0.8; P=0.38), in the mean change in PSQI score (between-group difference, 0.1; 95% CI, -0.9 to 1.1; P=0.80), or in the CGIC score (between-group difference, 0; 95% CI, -0.3 to 0.3; P=0.96). There were no significant differences in these measures at 26 weeks (a secondary outcome) or in other secondary outcomes. At 10 weeks, the mean difference between the prazosin group and the placebo group in the change from baseline in supine systolic blood pressure was a decrease of 6.7 mm Hg. The adverse event of new or worsening suicidal ideation occurred in 8% of the participants assigned to prazosin versus 15% of those assigned to placebo. In this trial involving military veterans who had chronic PTSD, prazosin did not alleviate distressing dreams or improve sleep quality. (Funded by the Department of Veterans Affairs Cooperative Studies Program; PACT ClinicalTrials.gov number, NCT00532493 .).

Effect of CPAP therapy on job productivity and psychosocial occupational health in patients with moderate to severe sleep apnea.

PubMed

Jurádo-Gámez, Bernabé; Guglielmi, Ottavia; Gude-Sampedro, Francisco; Buela-Casal, Gualberto

2015-12-01

The aim of the present study was to assess the effect of continuous positive airflow pressure (CPAP) therapy on burnout symptoms and job productivity, stress, and satisfaction in patients with obstructive sleep apnea syndrome. The sample was composed of 55 patients (mean age 48.5 ± 8.9, BMI 31.1 ± 5.7, AIH 56.8 ± 22.1), diagnosed with obstructive sleep apnea syndrome (OSAS) using polysomnography (PSG) with a therapeutic indication of CPAP. Before and after 6 months of receiving CPAP therapy, participants completed the following questionnaires: the index of the impact of the disease on job productivity (IMPALA), the job content questionnaire(JCQ), the Maslach burnout inventory-general survey (MBI-GS), the Shirom-Melamed burnout questionnaire (SMBQ), the index of job satisfaction, the Epworth sleepiness scale (ESS), and the Pittsburgh sleep quality index (PSQI). We explored the efficacy of CPAP therapy at improving the indices of severity of OSAS using therapeutic PSG. CPAP therapy was associated with a beneficial effect on job productivity (IMPALA) (p = 0.000) and decreasing burnout symptoms such as physical fatigue (SMBQ) (p = 0.000), emotional exhaustion (SMBQ) (p = 0.014), cognitive weariness (SMBQ) (p = 0.004), exhaustion (MBI) (p = 0.000), and cynicism (MBI) (p = 0.002). However, CPAP did not decrease job stress or job dissatisfaction. In patients with severe OSAS, CPAP therapy has a beneficial effect on patients' occupational well-being and job productivity.

Randomized and controlled prospective trials of Ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment for lower back post-herpetic neuralgia.

PubMed

Pi, Z B; Lin, H; He, G D; Cai, Z; Xu, X Z

2015-01-01

To evaluate the efficacy of ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment for lower back post-herpetic neuralgia. 128 cases of lower back or anterior abdominal wall acute post-herpetic neuralgia patients were selected. They were randomly divided into two groups. Group A: oral treatment only with gabapentin + celecoxib + amitriptyline. Group B: while taking these drugs, patients were treated with radiofrequency (RF) pulses using a portable ultrasound device using the paravertebral puncture technique. In both groups, sudden outbreaks of pain were treated with immediate release 10mg morphine tablets. Visual analogue scale (VAS) was used for pain score, Pittsburgh Sleep Quality Index scale (PSQI) was used to evaluate sleep quality and morphine consumption were recorded at different time points, before and after treatment. Treatment efficiency was calculated while the occurrence of complications was documented. At each time point after treatment, VAS scores were lower, but scores in the RF group was significantly lower than those of the oral-only group. In terms of sleep quality scores and morphine consumption between the two groups, the RF group was significantly lower than the oral-only group. During the procedure no error occurred with needle penetrating the abdominal cavity, chest, offal or blood vessels. Ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment of lower back or anterior abdominal wall post-herpetic neuralgia proved effective by reducing morphine use in patients and led to fewer adverse reactions.

Impact of coexisting irritable bowel syndrome and non-erosive reflux disease on postprandial abdominal fullness and sleep disorders in functional dyspepsia.

PubMed

Futagami, Seiji; Yamawaki, Hiroshi; Shimpuku, Mayumi; Izumi, Nikki; Wakabayashi, Taiga; Kodaka, Yasuhiro; Nagoya, Hiroyuki; Shindo, Tomotaka; Kawagoe, Tetsuro; Sakamoto, Choitsu

2013-01-01

The association between clinical symptoms and sleep disorders in functional dyspepsia (FD)-overlap syndrome has not been studied in detail. The subjects were 139 patients with FD, 14 with irritable bowel syndrome (IBS), 12 with nonerosive reflux disease (NERD), and 41 healthy volunteers. Gastric motility was evaluated with the (13)C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Sleep disorders were evaluated with Pittsburgh Sleep Quality Index (PSQI) scores. There were no significant differences in age, body-mass index, alcohol intake, and smoking rate between patients with FD alone and those with FD-overlap syndrome. The postprandial abdominal fullness score in patients with FD-NERD-IBS was significantly greater than that in patients with FD-NERD overlap syndrome (p<0.001) or FD alone (p<0.001). The score for the feeling of hunger in patients with FD-NERD-IBS was significantly greater than that in patients with FD alone (p=0.0025), FD-NERD overlap syndrome (p=0.0088), or FD-IBS overlap syndrome (p=0.0057). The heartburn score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone (p=0.0035) or FD-IBS overlap syndrome (p=0.0026). The Tmax in patients with FD-overlap syndrome or FD alone was significantly higher than that in healthy volunteers. The Pittsburgh Sleep Quality Index score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone. Symptom scores, such as those for postprandial abdominal fullness, heartburn, and the feeling of hunger, in patients with FD-overlap syndromes are significantly greater than those in patients with FD alone. Further studies are necessary to clarify whether various symptoms are related to sleep disorders in patients with FD-NERD-IBS overlap syndrome.

Mindfulness meditation for insomnia: A meta-analysis of randomized controlled trials.

PubMed

Gong, Hong; Ni, Chen-Xu; Liu, Yun-Zi; Zhang, Yi; Su, Wen-Jun; Lian, Yong-Jie; Peng, Wei; Jiang, Chun-Lei

2016-10-01

Insomnia is a widespread and debilitating condition that affects sleep quality and daily productivity. Although mindfulness meditation (MM) has been suggested as a potentially effective supplement to medical treatment for insomnia, no comprehensively quantitative research has been conducted in this field. Therefore, we performed a meta-analysis on the findings of related randomized controlled trials (RCTs) to evaluate the effects of MM on insomnia. Related publications in PubMed, EMBASE, the Cochrane Library and PsycINFO were searched up to July 2015. To calculate the standardized mean differences (SMDs) and 95% confidence intervals (CIs), we used a fixed effect model when heterogeneity was negligible and a random effect model when heterogeneity was significant. A total of 330 participants in 6 RCTs that met the selection criteria were included in this meta-analysis. Analysis of overall effect revealed that MM significantly improved total wake time and sleep quality, but had no significant effects on sleep onset latency, total sleep time, wake after sleep onset, sleep efficiency, total wake time, ISI, PSQI and DBAS. Subgroup analyses showed that although there were no significant differences between MM and control groups in terms of total sleep time, significant effects were found in total wake time, sleep onset latency, sleep quality, sleep efficiency, and PSQI global score (absolute value of SMD range: 0.44-1.09, all p<0.05). The results suggest that MM may mildly improve some sleep parameters in patients with insomnia. MM can serve as an auxiliary treatment to medication for sleep complaints. Copyright © 2016 Elsevier Inc. All rights reserved.

Behavioral treatment of chronic insomnia in older adults: does nocturia matter?

PubMed

Tyagi, Shachi; Resnick, Neil M; Perera, Subashan; Monk, Timothy H; Hall, Martica H; Buysse, Daniel J

2014-04-01

To evaluate the impact of nocturia on the therapeutic response of chronic insomnia to behavioral treatment in older adults. Secondary analysis of a randomized clinical trial designed to assess the efficacy of brief behavioral treatment of insomnia (BBTI) vs. an information-only control (IC) in 79 community-dwelling older adults with chronic insomnia. For the current analysis, participants were stratified into 2 groups: those with self-reported nocturia at baseline i.e., ≥ 1 void/night (N = 30; 16 IC, 14 BBTI) and those without nocturia (N = 49; 24 IC, 25 BBTI). We then determined the impact of BBTI on sleep, sleep quality, and nocturia as assessed by self-report, actigraphy, and polysomnography. Individuals without baseline nocturia responded well to BBTI with significant decrease in sleep latency, wake after sleep onset, and total sleep time assessed by sleep diary and actigraphy; these changes were significantly greater than those in the IC group. In comparison, changes in the same sleep parameters among participants with nocturia were not significantly different from the IC control. Although BBTI showed significant improvement in sleep quality in groups with and without nocturia (as assessed by PSQI and sleep diary), the effect size of these improvements was larger in those without nocturia than in those with nocturia (PSQI d = 0.82 vs. 0.53, diary sleep quality d = 0.83 vs. 0.51). These secondary analyses suggest that brief behavioral treatment of insomnia may be more efficacious in improving insomnia in participants without nocturia. Addressing nocturia may improve the efficacy of behavioral insomnia treatment.

REM desensitization as a new therapeutic method for post-traumatic stress disorder: a randomized controlled trial.

PubMed

Ahmadi, Khodabakhsh; Hazrati, Majid; Ahmadizadeh, Mohammadjavad; Noohi, Sima

2015-04-01

to evaluate potential efficacy of a new therapeutic approach in posttraumatic stress disorder in comparison with eye movement desensitization and reprocessing (EMDR), a standard treatment approach and controls. the study was designed using a randomized controlled trial methodology. Participants were recruited from military servicemen aged between 25 to 50 years who were admitting hospitals of Bushehr, Iran, with the final diagnosis of PTSD. Finally 33 male patients were devided into three subgroups: G1: EMDR; G2: REM Desensitization; and group 3: controls who received no therapy. Mississippi Scale for Posttraumatic Stress Disorder, Pittsburgh Sleep Quality Index (PSQI) and a 37 item death anxiety questionnaire were used for measures. multiple comparisons showed that intrusive thoughts were significantly more likely to improve with REM Desensitization versus EMDR (P=0.03), while depression was more responsive to EMDR (p=0.03). Among the Pittsburgh scale for the quality of sleep items, sleep quality (p=0.02), sleep duration (p=0.001), and total sleep quality score (p=0.002) were significantly more likely to improve in the REM Desensitization group. Change in the absolute death anxiety scores was not different between subgroups excepting EMDR versus control group (p=0.05). REM, desensitization, the new therapeutic approach to PTSD is a highly effective strategy, even more than EMDR, the standard treatment, in most of the evaluated subjects, with special emphasis on sleep symptoms, and also in the management of intrusive thoughts. Depression is the only factor in which, REM Desensitization was significantly less likely to represent a superior therapeutic effect than EMDR.

High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women.

PubMed

Rice, Jayne R; Larrabure-Torrealva, Gloria T; Luque Fernandez, Miguel Angel; Grande, Mirtha; Motta, Vicky; Barrios, Yasmin V; Sanchez, Sixto; Gelaye, Bizu; Williams, Michelle A

2015-09-02

Obstructive sleep apnea (OSA), a common and serious disorder in which breathing repeatedly stops during sleep, is associated with excess weight and obesity. Little is known about the co-occurrence of OSA among pregnant women from low and middle-income countries. We examined the extent to which maternal pre-pregnancy overweight or obesity status are associated with high risk for OSA, poor sleep quality, and excessive daytime sleepiness in 1032 pregnant women in Lima, Peru. The Berlin questionnaire was used to identify women at high risk for OSA. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to examine sleep quality and excessive daytime sleepiness, respectively. Multinomial logistic regression procedures were employed to estimate odds ratios (aOR) and 95% confidence intervals (CI) adjusted for putative confounding factors. Compared with lean women (<25 kg/m(2)), overweight women (25-29.9 kg/m(2)) had 3.69-fold higher odds of high risk for OSA (95% CI 1.82-7.50). The corresponding aOR for obese women (≥30 kg/m(2)) was 13.23 (95% CI: 6.25-28.01). Obese women, as compared with their lean counterparts had a 1.61-fold higher odds of poor sleep quality (95% CI: 1.00-2.63). Overweight or obese pregnant women have increased odds of sleep disorders, particularly OSA. OSA screening and risk management may be indicated among pregnant women in low and middle income countries, particularly those undergoing rapid epidemiologic transitions characterized by increased prevalence of excessive adult weight gain.

Memory for Therapy in Bipolar Disorder and Comorbid Insomnia

PubMed Central

Lee, Jason Y.; Harvey, Allison G.

2014-01-01

Objective To examine the extent to which patients recall the contents of therapy from one session to the next and to determine whether recall is associated with treatment outcome. Method Thirty inter-episode individuals with bipolar disorder and comorbid insomnia (ages 21-62 years, 56.7% female, 56.7% Caucasian) participated in an RCT of psychotherapies. Patients received either Cognitive Behavioral Therapy for Insomnia (CBTI-BP; n = 17) or Psychoeducation (PE; n = 13). At the beginning of each weekly session, patients freely recalled as many therapy points (i.e., distinct ideas, principles, and experiences) as they could from their previous session. After each session, therapists recorded a list of all therapy points delivered. Treatment outcome was measured via the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Patient-Reported Outcome Measurement Info System—Sleep (PROMIS-Sleep), and Quality of Life—Sleep (QOL-Sleep), administered at pre and post treatment, and treatment evaluation questions administered at post treatment. Results Patients recalled 19.6% to 36.9% of therapy points listed by therapists. Raw numbers of therapy points recalled were positively correlated with reductions in ISI and gains in QOL-Sleep, and with most treatment evaluation questions. Percentages of therapy points recalled were positively correlated with gains in QOL-Sleep, but with no other sleep outcome measures or any of the treatment evaluation questions. Patients in CBTI-BP recalled more therapy points than those in PE, but did not differ in the percentages of points recalled. Conclusions Memory for therapy is poor. The amount of content recalled is positively associated with treatment outcome. Enhancing memory for therapy might play a key role in improving treatment outcome. PMID:25222800

Interaction of sleep quality and psychosocial stress on obesity in African Americans: the Cardiovascular Health Epidemiology Study (CHES).

PubMed

Bidulescu, Aurelian; Din-Dzietham, Rebecca; Coverson, Dorothy L; Chen, Zhimin; Meng, Yuan-Xiang; Buxbaum, Sarah G; Gibbons, Gary H; Welch, Verna L

2010-09-28

Compared with whites, sleep disturbance and sleep deprivation appear more prevalent in African Americans (AA). Long-term sleep deprivation may increase the risk of obesity through multiple metabolic and endocrine alterations. Previous studies have reported contradictory results on the association between habitual sleep duration and obesity. Accordingly, we aimed to assess whether sleep quality and duration are inversely associated with body mass index (BMI) and obesity and test whether these associations are modified by psychosocial stress, known to influence sleep quality. A sample of 1,515 AA residents of metropolitan Atlanta, aged 30-65 years, was recruited by a random-digit-dialing method in 2007-08. The outcome obesity was defined by BMI (kg/m²) continuously and categorically (BMI ≥ 30 versus BMI < 30). Global sleep quality (GSQ) score was computed as the sum of response values for the seven components of the Pittsburgh Sleep Quality Index (PSQI) scale. GSQ score was defined as a continuous variable (range 0-21) and as tertiles. The general perceived stress (GPS), derived from the validated Cohen scale, was categorized into tertiles to test the interaction. Chi-square tests, correlation coefficients and weighted multiple linear and logistic regression were used to assess the associations of GSQ, GPS and obesity. The mean (standard deviation) age was 47.5 (17.0) years, and 1,096 (72%) were women. GSQ score categorized into tertiles was associated with BMI. Among women, after multivariable adjustment that included age, gender, physical activity, smoking status, education, total family income, financial stress and history of hypertension, hypercholesterolemia, diabetes and myocardial infarction, obesity was associated with sleep quality as assessed by GSQ continuous score, [odds ratio, OR (95% C.I.): 1.08 (1.03 - 1.12)], and with a worse sleep disturbance subcomponent score [OR (95% C.I.): 1.48 (1.16 - 1.89)]. Among all participants, stress modified the association between obesity and sleep quality; there was an increased likelihood of obesity in the medium stress category, OR (95% C.I.): 1.09 (1.02 - 1.17). Sleep quality was associated with obesity in women. The association of sleep quality with obesity was modified by perceived stress. Our results indicate the need for simultaneous assessment of sleep and stress.

Fatigue and sleep quality in rheumatoid arthritis patients during hospital admission.

PubMed

Szady, Paulina; Bączyk, Grażyna; Kozłowska, Katarzyna

2017-01-01

Rheumatoid arthritis (RA) is a systemic disease of connective tissue characterised by chronic course with periods of exacerbation and remission. Even in the early stages of the disease patients report the occurrence of fatigue and sleep disorders. Reduced sleep quality and chronic fatigue are common among patients with rheumatoid arthritis. The aim of the research was to evaluate the severity of fatigue and sleep quality assessment among patients hospitalised with rheumatoid arthritis and to determine the relation between the level of symptoms of fatigue and sleep quality and variables such as: age, gender, disease duration, marital status, applied pharmacological treatment, and pain intensity. The study involved 38 patients (12 men and 26 women) hospitalised in the Rheumatologic Ward of the Orthopaedics and Rehabilitation Hospital of the University of Medical Sciences. The average age of the entire group was 56.26 years. Fatigue was evaluated with use of Polish version of Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), while in order to evaluate sleep quality within the examined group of patients the Pittsburgh Sleep Quality Index (PSQI) was used. Patients with rheumatoid arthritis in the analysed group have lower sleep quality, and within subjects with such a diagnosis the fatigue is present. The relation was found between fatigue and such variables as: age, illness duration, marital status, applied pharmacological treatment, and severity of pain. Sleep quality within patients with RA is correlated by such variables as: age, gender, applied pharmaceutical treatment, and severity of pain. It was identified that patients with lower sleep quality experience increased levels of fatigue. There is a need to clarify which factors determine the level of fatigue and sleep quality in patients suffering from RA in future population-based research and to indicate to doctors, nurses, psychologists, and physiotherapists the significance and importance of the problem, which requires specialised and holistic care.

Sleep among bereaved caregivers of patients admitted to hospice: a 1-year longitudinal pilot study

PubMed Central

Slåtten, Kari; Saghaug, Elisabeth; Grov, Ellen Karine; Normann, Are Peder; Lee, Kathryn A; Bjorvatn, Bjørn; Gay, Caryl L

2016-01-01

Objectives This pilot study aimed to describe the sleep of partners and other family caregivers prior to and in the first year after a hospice patient's death. The study also evaluated the feasibility of the study protocol and determined the effect sizes in preparation for a full-scale study. Design The pilot study used a longitudinal, descriptive and comparative design. Setting and participants Participants included primary family caregivers of patients admitted to a hospice in Oslo, Norway. Primary outcome Caregiver sleep was measured subjectively with the Pittsburgh Sleep Quality Index (PSQI) and objectively using wrist actigraphy for 4 nights and 3 days at three different times: during the hospice stay, and at 6 and 12 months after the patient's death. Results 16 family caregivers (10 partners and 6 other family members) completed the 1-year study protocol. Overall, sleep quality and quantity were stable over time and at each assessment, approximately half of the sample had poor sleep quality, both by self-report and objective measures. However, the sleep trajectories differed significantly over time, with older caregivers (≥65 years) having significantly longer sleep durations than younger caregivers (<65 years). Furthermore, sleep quality also differed over time depending on the caregiver's relationship to the patient, with partner caregivers having significantly worse sleep quality than other family caregivers. Conclusions Caring for a dying family member is known to interfere with sleep, yet little is known about bereaved caregivers. The results of this pilot study demonstrate the feasibility of the longitudinal study protocol and indicate that sleep problems are common for caregivers and continue into the bereavement period, particularly for partner caregivers. The caregiver's relationship to the patient may be an important factor to consider in future studies. PMID:26729383

Self-reported Napping, Sleep Duration and Quality in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) Study

PubMed Central

Picarsic, Jennifer L.; Glynn, Nancy W.; Taylor, Christopher A.; Katula, Jeffery; Goldman, Suzanne E.; Studenski, Stephanie; Newman, Anne B.

2010-01-01

OBJECTIVES To determine the prevalence of self-reported napping and its association with subjective nighttime sleep duration and quality, as measured by sleep-onset latency and sleep efficiency. DESIGN Cross-sectional study. SETTING Lifestyle Interventions and Independence for Elder’s Pilot Study. PARTICIPANTS Community-dwelling older adults (N=414), aged 70 to 89 years. MEASUREMENTS Self-report questionnaire on napping and sleep, derived from the Pittsburgh Sleep Quality Index (PSQI) scale. RESULTS A total of 54 percent of participants reported napping with mean nap duration of 55 minutes, (SD 41.2 minutes). Compared to non-nappers, nappers were more often men (37.3% vs. 23.8%, P = .003), African American (20.4% vs.14.4%, P = .06), or diabetic (28% vs. 14.3%, P = .007). Nappers and non-nappers had similar nighttime sleep duration and quality, but nappers spent about 10 percent of their 24-hour sleep occupied in napping. In a multivariate model, the odds of napping were higher for diabetics (OR: 1.9; 95% CI: 1.2–3.0) and men (OR: 1.9; 95% CI: 1.2–3.0)). In nappers, diabetes mellitus (β = 12.3 minutes, P =.005), male gender (β = 9.0 minutes, P = .04), higher BMI (β = 0.8 minutes, P = .02), and lower MMSE (β = 2.2, P = .03) were independently associated with longer nap duration. CONCLUSION Napping was a common practice in community-dwelling older adults and did not detract from nighttime sleep duration or quality. Given its high prevalence and association with diabetes, napping behavior should be assessed as part of sleep behavior, both in future research and in clinical practice. PMID:18662202

OnabotulinumtoxinA effectiveness on chronic migraine, negative emotional states and sleep quality: a single-center prospective cohort study.

PubMed

Aydinlar, Elif Ilgaz; Dikmen, Pinar Yalinay; Kosak, Seda; Kocaman, Ayse Sagduyu

2017-12-01

OnabotulinumtoxinA (OnabotA) is considered effective in in patients with chronic migraine (CM) who failed on traditional therapies. This study was designed to evaluate the effect of OnabotA injection series on migraine outcome, negative emotional states and sleep quality in patients with CM. A total of 190 patients with CM (mean (SD) age: 39.3 (10.2) years; 87.9% were female) were included. Data on Pittsburgh sleep quality index (PSQI), headache frequency and severity, number of analgesics used, Migraine Disability Assessment Scale. (MIDAS) scores and Depression, Anxiety and Stress Scale (DASS-21) were evaluated at baseline (visit 1) and 4 consecutive follow up visits, each conducted after OnabotA injection series; at week 12 (visit 2), week 24 (visit 3), week 36 (visit 4) and week 48 (visit 5) to evaluate change from baseline to follow up. From baseline to visit 5, significant decrease was noted in least square (LS) mean headache frequency (from 19.5 to 8.4, p = 0.002), headache severity (from 8.1 to 6.1, p = 0.017), number of analgesics (from 26.9 to 10.4, p = 0.023) and MIDAS scores (from 67.3 to 18.5, p < 0.001). No significant change from baseline was noted in global PSOI and DASS-21 scores throughout the study. Our findings revealed that OnabotA therapy was associated with significant improvement in migraine outcome leading to decrease in headache frequency and severity, number of analgesics used and MIDAS scores. While no significant change was noted in overall sleep quality and prevalence of negative emotional states, patients without negative emotional states at baseline showed improved sleep quality throughout the study.

Fatigue - but not mTBI history, PTSD, or sleep quality - directly contributes to reduced prospective memory performance in Iraq and Afghanistan era Veterans.

PubMed

Rau, Holly K; Hendrickson, Rebecca; Roggenkamp, Hannah C; Peterson, Sarah; Parmenter, Brett; Cook, David G; Peskind, Elaine; Pagulayan, Kathleen F

2017-10-13

Memory problems that affect daily functioning are a frequent complaint among Veterans reporting a history of repetitive mild traumatic brain injury (mTBI), especially in cohorts with comorbid PTSD. Here, we test the degree to which subjective sleep impairment and daytime fatigue account for the association of PTSD and self-reported mTBI history with prospective memory. 82 Veterans with and without personal history of repeated blast-related mTBI during deployment were administered the Clinician Administered PTSD Scale (CAPS), Memory for Intentions Test (MIST), Patient Health Questionnaire-9 (PHQ-9), Neurobehavioral Symptom Inventory (NSI), and the Pittsburgh Sleep Quality Index (PSQI). Relationships between self-reported mTBI, PTSD, self-reported poor sleep and daytime fatigue, and MIST performance were modeled using partial least squares structural equation modeling (PLS-SEM). Reported daytime fatigue was strongly associated with poorer prospective memory performance. Poor subjective sleep quality was strongly and positively associated with reported daytime fatigue, but had no significant direct effect on prospective memory performance. PTSD diagnosis and self-reported mTBI history were only associated with prospective memory via their impact on subjective sleep quality and daytime fatigue. Results suggest that daytime fatigue may be a mediating factor by which both mTBI and PTSD can interfere with prospective memory. Additional attention should be given to complaints of daytime fatigue, independent of subjective sleep quality, in the clinical care of those with a self-reported history of mTBI, and/or PTSD. Further research into whether interventions that decrease daytime fatigue lead to improvement in prospective memory and subjective cognitive functioning is warranted.

Behavioral Treatment of Chronic Insomnia in Older Adults: Does Nocturia Matter?

PubMed Central

Tyagi, Shachi; Resnick, Neil M.; Perera, Subashan; Monk, Timothy H.; Hall, Martica H.; Buysse, Daniel J.

2014-01-01

Objective: To evaluate the impact of nocturia on the therapeutic response of chronic insomnia to behavioral treatment in older adults. Methods: Secondary analysis of a randomized clinical trial designed to assess the efficacy of brief behavioral treatment of insomnia (BBTI) vs. an information-only control (IC) in 79 community-dwelling older adults with chronic insomnia. For the current analysis, participants were stratified into 2 groups: those with self-reported nocturia at baseline i.e., ≥ 1 void/night (N = 30; 16 IC, 14 BBTI) and those without nocturia (N = 49; 24 IC, 25 BBTI). We then determined the impact of BBTI on sleep, sleep quality, and nocturia as assessed by self-report, actigraphy, and polysomnography Results: Individuals without baseline nocturia responded well to BBTI with significant decrease in sleep latency, wake after sleep onset, and total sleep time assessed by sleep diary and actigraphy; these changes were significantly greater than those in the IC group. In comparison, changes in the same sleep parameters among participants with nocturia were not significantly different from the IC control. Although BBTI showed significant improvement in sleep quality in groups with and without nocturia (as assessed by PSQI and sleep diary), the effect size of these improvements was larger in those without nocturia than in those with nocturia (PSQI d = 0.82 vs. 0.53, diary sleep quality d = 0.83 vs. 0.51). Conclusions: These secondary analyses suggest that brief behavioral treatment of insomnia may be more efficacious in improving insomnia in participants without nocturia. Addressing nocturia may improve the efficacy of behavioral insomnia treatment. Citation: Tyagi S; Resnick NM; Perera S; Monk TH; Hall MH; Buysse DJ. Behavioral treatment of chronic insomnia in older adults: does nocturia matter? SLEEP 2014;37(4):681-687. PMID:24899759

Cytokine-induced depression during IFN-α treatment: the role of IL-6 and sleep quality

PubMed Central

Prather, Aric A.; Rabinovitz, Mordechai; Pollock, Bruce G.; Lotrich, Francis E.

2009-01-01

Depressive symptoms, poor sleep quality, and systemic markers of inflammation (e.g. interleukin (IL)-6) are frequently associated. Interferon-alpha (IFN-α) therapy results in major depressive disorder (MDD) in some people, offering the possibility to elucidate the relationship of MDD to sleep and inflammation during treatment. In particular, delineating the temporal relations among these factors could help inform their causal relationships. To this end, a cohort of 95 non-depressed hepatitis C patients was followed prospectively for four consecutive months during IFN-α therapy. We found that higher pre-treatment levels of circulating IL-6 predicted incidence of MDD (X2(1)=7.7; p<0.05). Time-lagged mixed-effect analyses supported uni-directional associations in which IL-6 predicted next month’s PSQI scores (F(47, 11.6) = 78.4; p<0.0005), and PSQI scores predicted next month’s depressive Beck Depression Inventory-II (BDI) scores (F(16,22.6) = 3.4; p<0.005). In addition, on any given month of treatment, IL-6 levels predicted BDI symptoms the following month (F(16,97.5) = 7.3; p<0.0005), and conversely BDI predicted next month’s IL-6 (F(14,7.4) = 5.2; p<0.05) – providing evidence for a positive feedback relationship between depressive symptoms and systemic inflammation. These data provide further evidence that high levels of inflammation and poor sleep quality may be risk factors for IFN-α induced depression. Furthermore, these findings highlight the complex temporal relationships that exist among sleep, depression, and inflammation, and support the need for further prospective investigations to elucidate the dynamics that underlie depression during IFN-α treatment. PMID:19615438

The Relationship between Sleep Quality and Social Intimacy, and Academic Burn-Out in Students of Medical Sciences.

PubMed

Arbabisarjou, Azizollah; Hashemi, Seyed Mehdi; Sharif, Mohammad Reza; Haji Alizadeh, Kobra; Yarmohammadzadeh, Peyman; Feyzollahi, Zahra

2015-11-05

Academic burnout leads to creation of a series of negative and scattered thoughts, loss of hope and emotional and physical exhaustion in carrying out activities. Two factors that affect academic burnout are sleep quality and social intimacy. This study was conducted in order to investigate the relationship between sleep quality and social intimacy, and academic burn-out in the students of Tabriz University of Medical Sciences. This study was descriptive and correlational. The population of this study consisted of the students in Tabriz University of Medical Sciences and 196 medical students were selected. They completed Berso et al. Academic Burnout Questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Miller Social Intimacy Scale (MSIS). The validity of the questionnaires confirmed by experts' views. Their reliability were obtained as 77%, 64% and 85% for academic burnout, sleep quality and social intimacy questionnaires respectively by calculating the internal consistency (Cronbach's alpha). For data analysis, descriptive statistics and Pearson correlation test, Regression, cluster analysis and t-test were used. The results showed that there was a positive and significant relationship between sleep quality and academic burnout at the level p<0.05 (r=0.38). There was a negative and significant relationship between social intimacy and academic burnout at the level p<0.05 (r= -0.40). Also, the regression results showed that sleep quality and social intimacy were able to predict 37% and 39% of academic burnout respectively. Moreover, the students were divided into two clusters of individuals with high social intimacy and individuals with low social intimacy. No significant difference was found between the two types in terms of the variable of academic burn-out. Based on the research results, it can be stated that the variables of sleep quality and social intimacy are the predictor factors of academic burn-out.

Differences in quality of life determinants according to the presence of fibromyalgia in middle-aged female patients with systemic lupus erythematosus: a multicenter, cross-sectional, single-ethnicity cohort.

PubMed

Moon, Su-Jin; Kang, Kwi Young; Kwok, Seung-Ki; Ju, Ji Hyeon; Hong, Yeon-Sik; Park, Sung-Hwan; Jeon, Chan Hong; Choi, Sang Tae; Song, Jung-Soo; Min, Jun-Ki

2018-06-01

The purpose of this study was to identify whether determinants of health-related quality of life (HRQoL) in middle-aged female patients with systemic lupus erythematosus (SLE) differed according to the presence or absence of fibromyalgia. One hundred and fifty-two patients with SLE and 139 healthy controls (HCs) completed the Medical Outcomes Study 36-Item Short Form (SF-36) and EuroQol EQ-5D questionnaires about HRQoL. Disease activity and cumulative disease damage were assessed with standard indices. Sleep quality was assessed using the Korean version of the Pittsburgh Sleep Quality Index (K-PSQI). The mean EQ-5D and physical and mental components of SF-36 were lower in SLE patients with fibromyalgia (n = 41) than in those without fibromyalgia (n = 111) and HCs. The scores in all eight domains of the SF-36 were lower in SLE patients with fibromyalgia than in patients without fibromyalgia and HCs. Poor sleep (defined as a K-PSQI > 5) was reported by 85% of SLE patients with fibromyalgia, by 51% of patients without fibromyalgia, and by 33% of HCs. Multivariate logistic regression analysis showed that lower educational level, cumulative organ damage severity and poor sleep quality were independent determinants of HRQoL in SLE patients with fibromyalgia, whereas disease activity, sleep quality and depressive mood were independent determinants of HRQoL in those without fibromyalgia. Poor sleep quality is the common independent risk factor for poor HRQoL in both middle-aged SLE patients with fibromyalgia and without fibromyalgia. Sleep quality improvement may improve HRQoL in female SLE patients, even in those without fibromyalgia. © 2018 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Functional limitation and associated factors in outpatients with ankylosing spondylitis in Southwest China.

PubMed

Song, Yuqing; Wang, Chen; Chen, Hong

2017-04-01

Functional limitation is often complained by patients with ankylosing spondylitis (AS). With a rising number of patients suffering from AS, there are a limited number of reports focusing on functional limitation of AS in Chinese patients. This study was conducted to investigate the level of functional limitation and explore its associations with demographic, disease-related factors. A total of 303 AS outpatients were recruited in this cross-sectional study from a tertiary general hospital in Southwest China. Functional limitation was measured by the Bath Ankylosing Spondylitis Functional Index (BASFI). Other data were collected by the following questionnaires: the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Patient Global Score (BAS-G), and the Pittsburgh Sleep Quality Index Questionnaire (PSQI). Finally, 295 outpatients with AS completed this survey. The median BASFI was 0.80. Worse function limitation was found in outpatients with extra-spinal manifestation, older age, lower household income, more back pain, higher disease activity and morning stiffness, poorer sleep, and worse patient's well-being (all P < 0.05). Multivariate regression analysis indicated that patient's well-being (P < 0.001), disease activity (P < 0.001), and disease duration (P < 0.05) were the positive predictors of functional limitation. AS outpatients in Southwest China had a mild level of functional limitation. The factors associated with functional limitation included disease duration, disease activity, and patients' well-being, which should be taken into consideration when assessing functional limitation of AS outpatients. Besides, more comprehensive and targeted interventions should be conducted for AS patients as early as possible, which will be effective to improve functional outcome.

Polyunsaturated Fatty Acid (PUFA) Status in Pregnant Women: Associations with Sleep Quality, Inflammation, and Length of Gestation

PubMed Central

Christian, Lisa M.; Blair, Lisa M.; Porter, Kyle; Lower, Mary; Cole, Rachel M.; Belury, Martha A.

2016-01-01

Mechanistic pathways linking maternal polyunsaturated fatty acid (PUFA) status with gestational length are poorly delineated. This study examined whether inflammation and sleep quality serve as mediators, focusing on the antiinflammatory ω-3 docosahexaenoic acid (DHA; 22:6n3) and proinflammatory ω-6 arachidonic acid (AA; 20:4n6). Pregnant women (n = 135) provided a blood sample and completed the Pittsburgh Sleep Quality Index (PSQI) at 20–27 weeks gestation. Red blood cell (RBC) fatty acid levels were determined by gas chromatography and serum inflammatory markers [interleukin (IL)-6, IL-8, tumor necrosis factor-α, IL-1β, and C-reactive protein] by electrochemiluminescence using high sensitivity kits. Both higher serum IL-8 (95% CI = 0.10,3.84) and poor sleep (95% CI = 0.03,0.28) served as significant mediators linking lower DHA:AA ratios with shorter gestation. Further, a serial mediation model moving from the DHA:AA ratio → sleep → IL-8 → length of gestation was statistically significant (95% CI = 0.02, 0.79). These relationships remained after adjusting for depressive symptoms, age, BMI, income, race, and smoking. No interactions with race were observed in relation to length of gestation as a continuous variable. However, a significant interaction between race and the DHA:AA ratio in predicting preterm birth was observed (p = 0.049); among African Americans only, odds of preterm birth decreased as DHA:AA increased (p = 0.048). These data support a role for both inflammatory pathways and sleep quality in linking less optimal RBC PUFA status with shorter gestation in African American and European American women and suggest that African-Americans have greater risk for preterm birth in the context of a low DHA:AA ratio. PMID:26859301

[Cardiodoron® bei Patienten mit Schlafstörungen - Ergebnisse einer prospektiven Beobachtungsstudie].

PubMed

Rother, Claudia; Schnelle, Martin

Hintergrund: Schlafstörungen gehören zu den häufigsten gesundheitlichen Problemen der heutigen Zeit. Stress und die dadurch bedingte innere Anspannung sowie eine unrhythmische Lebensführung z.B. durch Schichtarbeit sind bekannte auslösende Faktoren. Weniger bekannt ist, dass auch funktionelle Herz-Kreislauf-Beschwerden zu Störungen des Schlafs führen können und dass deren Behandlung zu einer Verbesserung der Schlafqualität beiträgt. Ganzheitlich betrachtet geht es daher um die Wiederherstellung einer gesunden Rhythmik, insbesondere des Herz-/Atem- sowie des Schlaf-Wach-Rhythmus, die Cardiodoron®, eine Heilpflanzenkomposition aus Primula veris, Hyoscyamus niger und Onopordum acanthium, unterstützt. Patienten und Methoden: Mittels einer prospektiven, multizentrischen Beobachtungsstudie sollte ermittelt werden, wie sich funktionelle Herz-Kreislauf-Beschwerden und/oder Schlafstörungen unter der Behandlung mit Cardiodoron® (Dilution) über 3-6 Monate entwickeln. Im Zeitraum von September 2009 bis März 2012 dokumentierten 92 Ärzte 501 Patienten, von denen 380 über Schlafstörungen klagten und deren Daten in dieser Publikation näher betrachtet werden. Nach einer Aufnahmeuntersuchung erfolgte nach 90 Tagen eine Abschlussuntersuchung und bei Fortführung der Therapie nach nochmals 90 Tagen eine Follow-up-Untersuchung. Neben 30 ärztlicherseits bewerteten Symptomen beurteilten die Patienten ihr Befinden mittels Pittsburgh Sleep Quality Index (PSQI) nach Buysse und der Beschwerden-Liste nach von Zerssen (B-L und B-L'). Ergebnisse: Unter der Cardiodoron®-Therapie gingen bei guter Verträglichkeit sowohl die Ausprägung der Schlafstörungen (um 65% von 2,0 auf 0,7 Punkte) als auch die erfassten 30 Symptome (um 59% von 24,3 auf 9,9 Punkte) deutlich zurück (p < 0,01). Weiterhin reduzierten sich der PSQI und der Gesamtwert der Beschwerden-Liste signifikant (p < 0,0001) um 60% bzw. 56% (von 12,2 auf 4,8 bzw. von 25,6 auf 11,4 Punkte). Schlussfolgerungen: Bei Patienten mit Schlafstörungen (mit oder ohne funktionelle Herz-Kreislauf-Beschwerden) kann die Ausprägung der Beschwerden mit Cardiodoron® deutlich gesenkt werden. Cardiodoron® ist gut verträglich. © 2016 S. Karger GmbH, Freiburg.

Rotigotine transdermal system as add-on to oral dopamine agonist in advanced Parkinson's disease: an open-label study.

PubMed

Kim, Jong-Min; Chung, Sun Ju; Kim, Jae Woo; Jeon, Beom Seok; Singh, Pritibha; Thierfelder, Stephan; Ikeda, Junji; Bauer, Lars

2015-02-28

Achieving optimal symptom control with minimal side effects is a major goal in clinical practice. Dual-agent dopamine receptor agonist (DA) therapy in Parkinson's disease (PD) may represent a promising approach to treatment, as the combination of different pharmacokinetic/pharmacological profiles may result in a lesser need for high dosages and, accordingly, may be well tolerated. The objective of the current study was to investigate safety and efficacy of rotigotine transdermal system as add-on to oral DA in patients with advanced PD inadequately controlled with levodopa and low-dose oral DA. PD0015 was an open-label, multinational study in patients with advanced-PD and sleep disturbance or early-morning motor impairment. Patients were titrated to optimal dose rotigotine (≤8 mg/24 h) over 1-4 weeks and maintained for 4-7 weeks (8-week treatment). Dosage of levodopa and oral DA (pramipexole ≤1.5 mg/day, ropinirole ≤6.0 mg/day) was stable. Primary variable was Clinical Global Impressions (CGI) item 4: side effects, assessing safety. Other variables included adverse events (AEs), Patient Global Impressions of Change (PGIC), Unified Parkinson's Disease Rating Scale (UPDRS) II and III, Parkinson's Disease Sleep Scale (PDSS-2), Pittsburgh Sleep Quality Index (PSQI), and "off" time. Of 90 patients who received rotigotine, 79 (88%) completed the study; 5 (6%) withdrew due to AEs. Most (83/89; 93%) had a CGI-4 score <3 indicating that rotigotine add-on therapy did not interfere with functioning; 6 (7%) experienced drug-related AEs that interfered with functioning (score ≥3). AEs occurring in ≥5% were application site pruritus (13%), dizziness (10%), orthostatic hypotension (10%), nausea (8%), dyskinesia (8%), and nasopharyngitis (6%). Numerical improvements in motor function (UPDRS III), activities of daily living (UPDRS II), sleep disturbances (PDSS-2, PSQI), and reduction in "off" time were observed. The majority (71/88; 81%) improved on PGIC. Addition of rotigotine transdermal system to low-dose oral DA in patients with advanced-PD was feasible and may be associated with clinical benefit. ClinicalTrials.gov identifier NCT01723904 . Trial registration date: November 6, 2012.

[Administration of Cardiodoron® in patients with functional cardiovascular disorders and/or sleep disorders--results of a prospective, non-interventional study].

PubMed

Rother, Claudia

2013-01-01

Functional cardiovascular disorders (FCD) can be attributed to around 25-40% of all heart patients, i.e. organic causes are not detectable. Characteristic symptoms are tachycardia, palpitations, cardiac arrhythmia, hyperventilation, vertigo, vasovagal syncopes and sleep disorders, with the latter being a problem of its own. Disturbed vegetative rhythms form the basis of these diseases. The medicinal product Cardiodoron counteracts the dysfunctional vegetative rhythmicity with 3 medicinal plants--Primula veris (common cowslip), Hyoscyamus niger (black henbane) and Onopordum acanthium (cotton thistle). By means of a prospective, multicentre, non-interventional study, the development of disease-specific disorders during treatment with Cardiodoron (drops) was supposed to be shown. Between September 2009 and March 2012, 92 physicians documented 501 patients suffering from functional cardiovascular and/or sleep disorders who have been treated with Cardiodoron for 3-6 months. After an initial examination, a final examination after 90 (± 10) days and, in case of continuation of therapy, a follow-up examination after 90 (± 10) days were carried out. Besides 30 symptoms assessed by the physicians, the patients rated their condition on the basis of the complaints list according to v. Zerssen (B-L and B-L') and the Pittsburgh Sleep Quality Index (PSQI) according to Buysse. The severity of functional cardiovascular disorders as well as sleep disorders was significantly reduced. The same applies for all of the documented 30 disease-specific symptoms. Furthermore, the total score of the complaints list was significantly reduced as well as the PSQI. The largest effect regarding all parameters was detectable after 3 months. Continuation of Cardiodoron therapy stabilised the symptomatology once more and resulted in further improvement. On average, patients reported initial improvement after 13 days of treatment. Tolerability was almost consistently assessed with 'very good / good'. Accordingly, the acceptance of the preparation by the patients was good, which resulted in a very good compliance of 70%. 52% of the patients used additional therapies. Cardiodoron shows positive effects in medical practice; it is a well-tolerated medicinal product for treatment of functional cardiovascular and/or sleep disorders with or without concomitant therapies. © 2013 S. Karger GmbH, Freiburg.

Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period

PubMed Central

Tomfohr, Lianne M.; Buliga, Elena; Letourneau, Nicole L.; Campbell, Tavis S.; Giesbrecht, Gerald F.

2015-01-01

Objective: The aim of this study was to investigate trajectories of sleep quality and associations with mood in the perinatal period. Although it is commonly accepted that subjective sleep quality declines during pregnancy and the transition to parenthood, some women may follow qualitatively distinct trajectories. Design, Setting, and Participants: Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were collected from 293 women at four time points: during early pregnancy, at Time 1 (T1; < 22 w gestational age [GA]; late pregnancy, at Time 2 (T2; 32 w GA); during the postnatal period at Time 3 (T3; 3 mo postpartum); and Time 4 (T4; 6 mo postpartum). A group-based semiparametric mixture model was used to estimate patterns of sleep quality throughout the perinatal period. Results: Four trajectory groups were identified, including patterns defined by high sleep quality throughout (21.5%), mild decrease in sleep quality (59.5%), significant decrease in sleep quality (12.3%) and a group with poor sleep quality throughout (6.7%). Women who had the worst sleep quality at Time 1 and those who experienced significant increases in sleep problems throughout pregnancy were also the groups who reported the highest levels of anxiety and depressive symptoms in early pregnancy and the lowest levels of social support. After controlling for covariates, the groups with worst subjective sleep quality during pregnancy were also the most likely to experience high symptoms of depression in the postpartum period. Conclusions: Most of the women in our sample reported mild sleep disturbances through the perinatal period. A subgroup of women reported a significant decline in sleep quality from early to late pregnancy and another reported poor subjective sleep quality throughout pregnancy; these groups had the greatest risk of experiencing high symptoms of depression in the postpartum period. Citation: Tomfohr LM, Buliga E, Letourneau NL, Campbell TS, Giesbrecht GF. Trajectories of sleep quality and associations with mood during the perinatal period. SLEEP 2015;38(8):1237–1245. PMID:25845691

The relationship between quality of sleep and night shift rotation interval.

PubMed

Kim, Jae Youn; Chae, Chang Ho; Kim, Young Ouk; Son, Jun Seok; Kim, Ja Hyun; Kim, Chan Woo; Park, Hyoung Ouk; Lee, Jun Ho; Kwon, Soon Il; Kwon, Sun Il

2015-01-01

Shift work is closely related with workers' health. In particular, sleep is thought to be affected by shift work. In addition, shift work has been reported to be associated with the type or direction of shift rotation, number of consecutive night shifts, and number of off-duty days. We aimed to analyze the association between the night shift rotation interval and the quality of sleep reported by Korean female shift workers. In total, 2,818 female shift workers from the manufacturing industry who received an employee physical examination at a single university hospital from January to August in 2014 were included. Subjects were classified into three groups (A, B, and C) by their night shift rotation interval. The quality of sleep was measured using the Korean version of the Pittsburgh Sleep Quality Index (PSQI). Descriptive analysis, univariate logistic regression, and multivariate logistic regression were performed. With group A as the reference, the odds ratio (OR) for having a seriously low quality of sleep was 1.456 (95% CI 1.171-1.811) and 2.348 (95% CI 1.852-2.977) for groups B and C, respectively. Thus, group C with the shortest night shift rotation interval was most likely to have a low quality of sleep. After adjustment for age, obesity, smoking status, alcohol consumption, exercise, being allowed to sleep during night shifts, work experience, and shift work experience, groups B and C had ORs of 1.419 (95% CI 1.134-1.777) and 2.238 (95% CI 1.737-2.882), respectively, compared to group A. Our data suggest that a shorter night shift rotation interval does not provide enough recovery time to adjust the circadian rhythm, resulting in a low quality of sleep. Because shift work is influenced by many different factors, future studies should aim to determine the most optimal shift work model and collect accurate, prospective data.

Intimate Partner Violence Is Associated with Stress-Related Sleep Disturbance and Poor Sleep Quality during Early Pregnancy

PubMed Central

Sanchez, Sixto E.; Islam, Suhayla; Zhong, Qiu-Yue; Gelaye, Bizu; Williams, Michelle A.

2016-01-01

Objectives To examine the associations of Intimate partner violence (IPV) with stress-related sleep disturbance (measured using the Ford Insomnia Response to Stress Test [FIRST]) and poor sleep quality (measured using the Pittsburgh Sleep Quality Index [PSQI]) during early pregnancy. Methods This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding IPV history, and sleep traits. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CIs) were calculated using logistic regression procedures. Results Lifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance (95% CI: 1.08–2.17) and a 1.93-fold increased odds of poor sleep quality (95% CI: 1.33–2.81). Compared with women experiencing no IPV during lifetime, the aOR (95% CI) for stress-related sleep disturbance associated with each type of IPV were: physical abuse only 1.24 (95% CI: 0.84–1.83), sexual abuse only 3.44 (95%CI: 1.07–11.05), and physical and sexual abuse 2.51 (95% CI: 1.27–4.96). The corresponding aORs (95% CI) for poor sleep quality were: 1.72 (95% CI: 1.13–2.61), 2.82 (95% CI: 0.99–8.03), and 2.50 (95% CI: 1.30–4.81), respectively. Women reporting any IPV in the year prior to pregnancy had increased odds of stress-related sleep disturbance (aOR = 2.07; 95% CI: 1.17–3.67) and poor sleep quality (aOR = 2.27; 95% CI: 1.30–3.97) during pregnancy. Conclusion Lifetime and prevalent IPV exposures are associated with stress-related sleep disturbance and poor sleep quality during pregnancy. Our findings suggest that sleep disturbances may be important mechanisms that underlie the lasting adverse effects of IPV on maternal and perinatal health. PMID:27023005

Effects of cognitive behavioral therapy on insomnia of maintenance hemodialysis patients.

PubMed

Hou, Yongmei; Hu, Peicheng; Liang, Yanping; Mo, Zhanyu

2014-07-01

The objective of the study was to evaluate the effects of cognitive behavioral therapy [sleep-related behavior modification and progressive muscle relaxation on insomnia of maintenance hemodialysis (MHD) patients] on improving insomnia of MHD patients. 103 MHD patients complicated with insomnia were randomly assigned to treatment (n = 52) and control (n = 51) groups. The control group was treated with conventional hemodialysis, and the treatment group was additionally treated with cognitive behavioral therapy for 3 months (sleep-related behavior modification and progressive muscle relaxation). All cases were assessed by Symptom Checklist 90 (SCL-90) and Pittsburgh Sleep Quality Index (PSQI) before and 2, 4, 6, 8, 10, and 12 weeks after treatment. Fifty-one patients in the treatment group and 47 patients in the control group completed the experiments. After treatment, the total mean scores were (1.94 ± 0.50/2.29 ± 0.31); scores of somatization, depression, anxiety, hostility, and additional items were (1.87 ± 0.58/2.56 ± 0.26), (2.25 ± 0.80/2.79 ± 0.50), (1.79 ± 0.26/2.37 ± 0.34), (1.71 ± 0.46/2.25 ± 0.43), and (1.91 ± 0.67/2.26 ± 0.59) in SCL-90, respectively. The total scores for PSQI were (12.63 ± 2.27/16.40 ± 2.16); scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, hypnotics, and daytime dysfunction which were (1.98 ± 0.76/2.57 ± 0.58), (1.75 ± 0.59/2.60 ± 0.50), (2.10 ± 0.50/2.62 ± 0.53), (2.06 ± 0.47/2.57 ± 0.54), (2.04 ± 0.69/2.45 ± 0.72), (1.02 ± 0.79/1.51 ± 0.98), and (1.69 ± 0.55/2.09 ± 0.58), respectively, were significantly lower in the treatment group compared with the control group. However, there were no significant differences in the scores of factors of obsessive-compulsive (2.26 ± 0.62/2.32 ± 0.38), interpersonal sensitivity (2.23 ± 0.64/2.43 ± 0.47), phobic anxiety (1.98 ± 0.62/2.01 ± 0.67), paranoid ideation (1.55 ± 0.43/1.69 ± 0.39), and psychoticism (1.57 ± 0.46/1.66 ± 0.49). The conclusion is that sleep-related behavior modification in combination with progressive muscle relaxation effectively improved the mental state and sleep quality of MHD patients with insomnia.

Night-shift work increases cold pain perception.

PubMed

Pieh, Christoph; Jank, Robert; Waiß, Christoph; Pfeifer, Christian; Probst, Thomas; Lahmann, Claas; Oberndorfer, Stefan

2018-05-01

Although night-shift work (NSW) is associated with a higher risk for several physical and mental disorders, the impact of NSW on pain perception is still unclear. This study investigates the impact of NSW on cold pain perception considering the impact of mood and sleepiness. Quantitative sensory testing (QST) was performed in healthy night-shift workers. Cold pain threshold as well as tonic cold pain was assessed after one habitual night (T1), after a 12-hour NSW (T2) and after one recovery night (T3). Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) before T1, sleepiness with the Stanford Sleepiness Scale (SSS) and mood with a German short-version of the Profile of Mood States (ASTS) at T1, T2 and T3. Depending on the distribution of the data, ANOVAs or Friedman tests as well as t- or Wilcoxon tests were performed. Nineteen healthy shift-workers (13 females; 29.7 ± 7.5 years old; 8.1 ± 6.6 years in shift work, PSQI: 4.7 ± 2.2) were included. Tonic cold pain showed a significant difference between T1 (48.2 ± 27.5 mm), T2 (61.7 ± 26.6 mm; effect size: Cohen's d=.49; percent change 28%), and T3 (52.1 ± 28.7 mm) on a 0-100 mm Visual Analog Scale (p = 0.007). Cold pain threshold changed from 11.0 ± 7.9 °C (T1) to 14.5 ± 8.8 °C (T2) (p = 0.04), however, an ANOVA comparing T1, T2, and T3 was not significant (p = 0.095). Sleepiness (SSS) and mood (ASTS) changed significantly between T1, T2 and T3 (p-values < 0.01). The change of mood but not of sleepiness correlated with the difference in tonic cold pain from T1 to T2 (R: 0.53; R 2 : 0.29; p = 0.022). NSW increases cold pain perception. The same tonic cold pain stimulus is rated 28% more painful after NSW and normalizes after a recovery night. Increases in cold pain perception due to NSW appear to be more strongly related to changes in mood as compared to changes in sleepiness. Copyright © 2018 Elsevier B.V. All rights reserved.

Improved Sleep Quality is Associated with Reductions in Depression and PTSD Arousal Symptoms and Increases in IGF-1 Concentrations

PubMed Central

Rusch, Heather L.; Guardado, Pedro; Baxter, Tristin; Mysliwiec, Vincent; Gill, Jessica M.

2015-01-01

Study Objectives: One-third of deployed military personnel will be diagnosed with insomnia, placing them at high risk for comorbid depression, posttraumatic stress disorder (PTSD), and medical conditions. The disruption of trophic factors has been implicated in these comorbid conditions, which can impede postdeployment recovery. This study determined if improved sleep quality is associated with (1) reductions in depression and posttraumatic symptoms, as well as enrichments in health-related quality of life (HRQOL), and (2) changes in plasma concentrations of brain derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1). Methods: Forty-four military personnel diagnosed with insomnia underwent clinical evaluations and blood draws at pretreatment and at posttreatment following cognitive behavioral therapy for insomnia and automatic positive airway pressure treatment. Participants were classified as sleep improved (n = 28) or sleep declined (n = 16) based on their change in pretreatment to posttreatment Pittsburgh Sleep Quality Index (PSQI) score. Both groups were compared on outcomes of depression, PTSD, HRQOL, BDNF, and IGF-1. Results: Paired t-tests of the sleep improved group revealed significant declines in depression (p = 0.005) and posttraumatic arousal (p = 0.006) symptoms, and a significant increase in concentrations of IGF-1 (p = 0.009). The sleep declined group had no relevant change in psychiatric symptoms or trophic factors, and had further declines on five of eight dimensions of HRQOL. Between-group change score differences were significant at p < 0.05. Conclusions: These findings suggest that interventions, which successfully improve sleep quality, are an effective means to reduce the depression and posttraumatic arousal symptoms common to military personnel, as well as increase protective trophic factors implicated in these conditions. Citation: Rusch HL, Guardado P, Baxter T, Mysliwiec V, Gill JM. Improved sleep quality is associated with reductions in depression and PTSD arousal symptoms and increases in IGF-1 concentrations. J Clin Sleep Med 2015;11(6):615–623. PMID:25766717

Interrelationship of sleep and juvenile myoclonic epilepsy (JME): a sleep questionnaire-, EEG-, and polysomnography (PSG)-based prospective case-control study.

PubMed

Ramachandraiah, C T; Sinha, S; Taly, A B; Rao, S; Satishchandra, P

2012-11-01

We studied the effects of 'epilepsy on sleep and its architecture' and 'sleep on the occurrence and distribution of interictal epileptiform discharges (ED)' using 'sleep questionnaires', 'EEG', and 'PSG' in patients with JME. Forty patients with JME [20 on valproate (Group I - 20.8±4.0 years; M: F=9:11) and 20 drug-naïve (Group II - 24.4±6.7 years; M: F=9:11)] and 20 controls (M: F=9:11; age: 23.5±4.7 years) underwent assessment with Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), overnight PSG, and scalp-EEG. Epileptiform discharges (EDs) were quantified in different sleep stages. The 'ED Index' was derived as number of EDs/min per stage. Statistical Package for the Social Sciences (SPSS) vs. 11 was used for statistical analysis. A 'p' <0.05 was considered as statistically significant. There was poor sleep quality in patients compared to controls (p=0.02), while there was no significant difference in ESS scores between the groups. The PSG parameters were comparable in both groups. Routine EEG revealed EDs in 22/40 (Group I: 7 and Group II: 15) patients. Thirty-five patients had EDs in various sleep stages during PSG (Group I: 17 and Group II: 18): N1 - Group I: 9 and Group II: 14, N2 - Group I: 14 and Group II: 14, N3 - Group I: 14 and Group II: 10, and REM - Group I: 9 and Group II: 11. The ED Index was higher during N2/N3 in Group I and N1/REM in Group II. The epileptiform discharges were frequently associated with arousals in N1/REM and K-complexes in N2. There was no other significant difference between Groups I and II. In conclusion, there was poor sleep quality in patients with JME compared to controls, especially those on valproate who had altered sleep architecture. Epileptiform activity was observed more often in sleep than wakefulness. Sleep stages had variable effect on epileptiform discharges with light sleep having a facilitatory effect in the drug-naïve group and slow wave sleep having a facilitatory effect in the valproate group. Copyright © 2012 Elsevier Inc. All rights reserved.

Psychological Distress Mediates the Association between Food Insecurity and Suboptimal Sleep Quality in Latinos with Type 2 Diabetes Mellitus.

PubMed

Bermúdez-Millán, Angela; Pérez-Escamilla, Rafael; Segura-Pérez, Sofia; Damio, Grace; Chhabra, Jyoti; Osborn, Chandra Y; Wagner, Julie

2016-10-01

Evidence increasingly indicates that poor sleep quality is a major public health concern. Household food insecurity (HFI) disproportionately affects Latinos and is a novel risk factor for poor sleep quality. Psychological distress may be a potential mechanism through which HFI affects sleep quality. Sleep, food insecurity, and distress are linked to type 2 diabetes mellitus. We examined the relations between HFI, psychological distress, and sleep quality and tested whether psychological distress mediates the relation between HFI and sleep in people with diabetes mellitus. Latinos with type 2 diabetes mellitus (n = 121) who completed baseline assessments for the CALMS-D (Community Health Workers Assisting Latinos Manage Stress and Diabetes) stress management intervention trial completed the US Household Food Security Survey, and measures of depressive symptoms [Personal Health Questionnaire Depression Scale (PHQ-8)], anxiety symptoms [Patient-Reported Outcomes Measurement Information System (PROMIS)-short], diabetes distress [Problem Areas in Diabetes Questionnaire (PAID-5)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)]. Psychological distress was operationalized with the PHQ-8, PROMIS-short, and PAID-5 scales. We used unadjusted and adjusted indirect effect tests with bias-corrected bootstrapped 95% CIs on 10,000 samples to test both relations between variables and potential mediation. Mean age was 61 y, 74% were women, and 67% were food insecure. Experiencing HFI was associated with both greater psychological distress and worse sleep quality (P < 0.05). Depressive symptoms (adjusted R 2 : 2.22, 95% CI: 1.27, 3.42), anxiety symptoms (adjusted R 2 : 1.70, 95% CI: 0.87, 2.85), and diabetes mellitus distress (adjusted R 2 : 0.60, 95% CI: 0.11, 1.32) each mediated the relation between HFI and worse sleep quality with and without adjustment for age, education, income, marital status, and employment status. Household food insecurity is a common and potent household stressor that is associated with suboptimal sleep quality through psychological distress. Efforts to improve food security and decrease psychological distress may yield improved sleep in this high-risk population. The CALMS-D stress management trial was registered at clinicaltrials.gov as NCT01578096. © 2016 American Society for Nutrition.

Identification of chronic rhinosinusitis phenotypes using cluster analysis.

PubMed

Soler, Zachary M; Hyer, J Madison; Ramakrishnan, Viswanathan; Smith, Timothy L; Mace, Jess; Rudmik, Luke; Schlosser, Rodney J

2015-05-01

Current clinical classifications of chronic rhinosinusitis (CRS) have been largely defined based upon preconceived notions of factors thought to be important, such as polyp or eosinophil status. Unfortunately, these classification systems have little correlation with symptom severity or treatment outcomes. Unsupervised clustering can be used to identify phenotypic subgroups of CRS patients, describe clinical differences in these clusters and define simple algorithms for classification. A multi-institutional, prospective study of 382 patients with CRS who had failed initial medical therapy completed the Sino-Nasal Outcome Test (SNOT-22), Rhinosinusitis Disability Index (RSDI), Medical Outcomes Study Short Form-12 (SF-12), Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire (PHQ-2). Objective measures of CRS severity included Brief Smell Identification Test (B-SIT), CT, and endoscopy scoring. All variables were reduced and unsupervised hierarchical clustering was performed. After clusters were defined, variations in medication usage were analyzed. Discriminant analysis was performed to develop a simplified, clinically useful algorithm for clustering. Clustering was largely determined by age, severity of patient reported outcome measures, depression, and fibromyalgia. CT and endoscopy varied somewhat among clusters. Traditional clinical measures, including polyp/atopic status, prior surgery, B-SIT and asthma, did not vary among clusters. A simplified algorithm based upon productivity loss, SNOT-22 score, and age predicted clustering with 89% accuracy. Medication usage among clusters did vary significantly. A simplified algorithm based upon hierarchical clustering is able to classify CRS patients and predict medication usage. Further studies are warranted to determine if such clustering predicts treatment outcomes. © 2015 ARS-AAOA, LLC.

Insomnia and Relationship with Anxiety in University Students: A Cross-Sectional Designed Study.

PubMed

Choueiry, Nour; Salamoun, Tracy; Jabbour, Hicham; El Osta, Nada; Hajj, Aline; Rabbaa Khabbaz, Lydia

2016-01-01

Sleep disorders (SDs) are now recognized as a public health concern with considerable psychiatric and societal consequences specifically on the academic life of students. The aims of this study were to assess SDs in a group of university students in Lebanon and to examine the relationship between SDs and anxiety. An observational cross-sectional study was conducted at Saint-Joseph University, Lebanon, during the academic year 2013-2014. Four questionnaires were face-to-face administered to 462 students after obtaining their written consent: Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Generalized Anxiety Disorder 7-item scale (GAD-7). The prevalence of clinically significant insomnia was 10.6% (95% CI: 7.8-13.4%), more frequent in first year students. ISI mean score was 10.06 (SD = 3.76). 37.1% of the participants were poor sleepers. Excessive daytime sleepiness (EDS) and poor sleep were significantly more frequent among participants with clinical insomnia (p = 0.031 and 0.001 respectively). Clinically significant anxiety was more frequent in students suffering from clinical insomnia (p = 0.006) and in poor sleepers (p = 0.003). 50.8% of the participants with clinically significant anxiety presented EDS versus 30.9% of those with no clinically significant anxiety (p<0.0001). The magnitude of SDs in this sample of Lebanese university students demonstrate the importance of examining sleep health in this population. Moreover, the link between SD and anxiety reminds us of the importance of treating anxiety as soon as detected and not simply targeting the reduction of sleep problems.

[Multi-central controlled study on three-part massage therapy for treatment of insomnia of deficiency of both the heart and spleen].

PubMed

Zhou, Yun-feng; Wei, Yu-long; Zhang, Pu-lin; Gao, Shan; Ning, Guo-li; Zhang, Zhen-qiang; Hu, Bin; Wang, Dan-yi; Yan, Mei-rong; Liu, Wen-jun

2006-06-01

To make multi-central clinical evaluation for three-part massage therapy for treatment of insomnia of deficiency of both the heart and spleen. One hundred and sixty-six cases were randomly divided into a test group (n = 84) and a control group (n = 82). Multi-central, randomized and controlled methods were adopted. The test group were treated by the three-part massage therapy, i. e. acupoints at the head, abdomen and back were massaged, once each day; and the control group by oral administration of Guipi Pills [symbol: see text], 8 pills each time, thrice daily. The treatment was given for 15 consecutive days and then the therapeutic effects were observed. Sixty-seven cases were cured, 11 markedly effective, 3 effective, and 3 ineffective in the test group, and the corresponding figures were 10, 21, 29 and 22 in the control group with a very significant difference between the two groups (P< 0.001). The test group was superior to the control group in improvement for Pittsburgh Sleep Quality Index (PSQI), Sleepless Anxiety Scale (SAS) and Sleepless Depression Scale (SDS) (P < 0.001). The three-part massage therapy has definite therapeutic effect on insomnia of deficiency of both the heart and spleen with safety.

Sleep timing is more important than sleep length or quality for medical school performance.

PubMed

Genzel, L; Ahrberg, K; Roselli, C; Niedermaier, S; Steiger, A; Dresler, M; Roenneberg, T

2013-07-01

Overwhelming evidence supports the importance of sleep for memory consolidation. Medical students are often deprived of sufficient sleep due to large amounts of clinical duties and university load, we therefore investigated how study and sleep habits influence university performance. We performed a questionnaire-based study with 31 medical students of the University of Munich (second and third clinical semesters; surgery and internal medicine). The students kept a diary (in 30-min bins) on their daily schedules (times when they studied by themselves, attended classes, slept, worked on their thesis, or worked to earn money). The project design involved three 2-wk periods (A: during the semester; B: directly before the exam period--pre-exam; C: during the subsequent semester break). Besides the diaries, students completed once questionnaires about their sleep quality (Pittsburgh Sleep Quality Index [PSQI]), their chronotype (Munich Chronotype Questionnaire [MCTQ]), and their academic history (previous grades, including the previously achieved preclinical board exam [PBE]). Analysis revealed significant correlations between the actual sleep behavior during the semester (MS(diary); mid-sleep point averaged from the sleep diaries) during the pre-exam period and the achieved grade (p = 0.002) as well as between the grades of the currently taken exam and the PBE (p = 0.002). A regression analysis with MS(diary) pre-exam and PBE as predictors in a model explained 42.7% of the variance of the exam grade (effect size 0.745). Interestingly, MS(diary)--especially during the pre-exam period-was the strongest predictor for the currently achieved grade, along with the preclinical board exam as a covariate, whereas the chronotype did not significantly influence the exam grade.

Prevalence of Restless Legs Syndrome in Patients with Inflammatory Bowel Disease.

PubMed

Takahara, Ikuko; Takeshima, Fuminao; Ichikawa, Tatsuki; Matsuzaki, Toshihisa; Shibata, Hidetaka; Miuma, Satoshi; Akazawa, Yuko; Miyaaki, Hisamitsu; Taura, Naota; Nakao, Kazuhiko

2017-03-01

There has been increased interest in sleep disorders in patients with inflammatory bowel disease (IBD). Studies in North America and Europe reported that the prevalence of restless legs syndrome (RLS) is much higher in patients with Crohn's disease (CD) than in the general population. The aim of this study was to reveal the prevalence and clinical features of RLS in Japanese patients with IBD and investigate the influence of RLS on sleep quality and quality of life (QOL). The study included 80 outpatients with IBD who visited Nagasaki University Hospital between December 2012 and July 2014. All patients completed the international RLS study group rating scale, a validated measure of the presence of RLS. Sleep quality was assessed using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI), and health-related QOL was assessed using the Japanese version of the 36-item short form healthy profile (SF-36) version 2. The prevalence of RLS in patients with IBD was 20%, including rates of 21.7% in patients with ulcerative colitis (UC) and 17.6% in patients with CD. Among patients with CD, the proportion of women and serum level of CRP were higher in the RLS group than in the non-RLS group. Among those with UC, there were no differences in clinical characteristics between the RLS and non-RLS groups. Patients in the RLS group slept significantly less well than those in the non-RLS group (PSQI > 5; 62.5 vs. 34.4%, P < 0.05). No significant relationships were observed between QOL indices and the presence of RLS (SF-36 physical score, 46.8 vs. 50.1; mental score, 43.8 vs. 45.7; role/social score, 48.1 vs. 49.2). RLS occurs frequently in Japanese patients with UC as well as CD. RLS affects sleep quality but not QOL, and it should be considered one of the causes of sleep disturbance in patients with IBD.

The use of Valeriana officinalis (Valerian) in improving sleep in patients who are undergoing treatment for cancer: a phase III randomized, placebo-controlled, double-blind study (NCCTG Trial, N01C5).

PubMed

Barton, Debra L; Atherton, Pamela J; Bauer, Brent A; Moore, Dennis F; Mattar, Bassam I; Lavasseur, Beth I; Rowland, Kendrith M; Zon, Robin T; Lelindqwister, Nguyet A; Nagargoje, Gauri G; Morgenthaler, Timothy I; Sloan, Jeff A; Loprinzi, Charles L

2011-01-01

Sleep disorders are a substantial problem for cancer survivors, with prevalence estimates ranging from 23% to 61%. Although numerous prescription hypnotics are available, few are approved for long-term use or have demonstrated benefit in this circumstance. Hypnotics may have unwanted side effects and are costly, and cancer survivors often wish to avoid prescription drugs. New options with limited side effects are needed. The purpose of this trial was to evaluate the efficacy of a Valerian officinalis supplement for sleep in people with cancer who were undergoing cancer treatment. Participants were randomized to receive 450 mg of valerian-or placebo orally 1 hour before bedtime for 8 weeks. The primary end point was area under the curve (AUC) of the overall Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included the Functional Outcomes of Sleep Questionnaire, the Brief Fatigue Inventory (BFI), and the Profile of Mood States (POMS). Toxicity was evaluated with both self-reported numeric analogue scale questions and the Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. Questionnaires were completed at baseline and at 4 and 8 weeks. A total of 227 patients were randomized into this study between March 19, 2004, and March 9, 2007, with 119 being evaluable for the primary end point. The AUC over the 8 weeks for valerian was 51.4 (SD = 16), while that for placebo was 49.7 (SD = 15), with a P value of 0.6957. A supplemental, exploratory analysis revealed that several fatigue end points, as measured by the BFI and POMS, were significantly better for those taking valerian over placebo. Participants also reported less trouble with sleep and less drowsiness on valerian than placebo. There were no significant differences in toxicities as measured by self-report or the CTCAE except for mild alkaline phosphatase increases, which were slightly more common in the placebo group. This study failed to provide data to support the hypothesis that valerian, 450 mg, at bedtime could improve sleep as measured by the PSQI. However, exploratory analyses revealed improvement in some secondary outcomes, such as fatigue. Further research with valerian exploring physiologic effects in oncology symptom management may be warranted.

Lack of exposure to natural light in the workspace is associated with physiological, sleep and depressive symptoms.

PubMed

Harb, Francine; Hidalgo, Maria Paz; Martau, Betina

2015-04-01

The diurnal light cycle has a crucial influence on all life on earth. Unfortunately, modern society has modified this life-governing cycle by stressing maximum production and by giving insufficient attention to the ecological balance and homeostasis of the human metabolism. The aim of this study is to evaluate the effects of exposure or lack of exposure to natural light in a rest/activity rhythm on cortisol and melatonin levels, as well as on psychological variables in humans under natural conditions. This is a cross-sectional study. The subjects were allocated split into two groups according to their workspace (10 employees in the "with window" group and 10 in the "without window" group). All participants were women and wore anactigraph (Actiwatch 2, Philips Respironics), which measures activity and ambient light exposure, for seven days. Concentrations of melatonin and cortisol were measured from the saliva samples. Participants were instructed to collect saliva during the last day of use of the actigraph at 08:00 am, 4:00 pm and 10:00 pm. The subjects answered the Self-Reporting Questionnaire-20 (SRQ-20) to measure the presence of minor psychiatric disorders; the Montgomery-Asberg (MA) scale was used to measure depression symptoms, and the Pittsburgh Sleep Quality Index questionnaire (PSQI) was used to evaluate the quality of sleep. The Rayleigh analysis indicates that the two groups, "with window" an d "without window", exhibited similar activities and light acrophases. In relation to light exposure, the mesor was significantly higher (t = -2.651, p = 0.023) in t he "with window" group (191.04 ± 133.36) than in the "without window" group (73.8 ± 42.05). Additionally, the "with window" group presented the highest amplitude of light exposure (298.07 ± 222.97). Cortisol levels were significantly different between the groups at 10:00 pm (t = 3.009, p = 0.008; "without window" (4.01 ± 0.91) "with window" (3.10 ± 0.30)). In terms of the melatonin levels, the groups differed at two different times of day: 08:00 am (t = 2.593, p = 0.018) and 10:00 pm (t = -2.939, p = 0.009). The "with window" group had a lower melatonin level at 08:00 am (3.54 ± 0.60) but a higher level at 10:00 pm (24.74 ± 4.22) than the "without window" group. Higher cortisol levels were positively correlated with minor psychiatric disorders and depressive symptoms (MA) at 10:00 pm. Lower melatonin levels at 10:00 pm were correlated with depressive symptoms and poor quality of sleep (PSQI). Our study demonstrated that not only may light pollution affect human physiology but also lack of exposure to natural light is related to high levels of cortisol and lower levels of melatonin at night, and these, in turn, are related to depressive symptoms and poor quality of sleep.

Sleep habits and road traffic accident risk for Iranian occupational drivers.

PubMed

Ebrahimi, Mohammad Hossein; Sadeghi, Masoumeh; Dehghani, Mohsen; Niiat, Khosro Sadegh

2015-01-01

The aim of this study is to assess the sleep quality and sleep disorders (prevalence of obstructive sleep apnea and sleepiness) among occupational drivers in Iran and to determine which demographic factors and occupational habits are linked to road traffic accidents. In this analytic cross-sectional study 556 occupational road drivers from Shahroud city (in the northeast of Iran) participated, upon a prior verbal informed consent, during 2013-2014. The Pittsburgh Sleep Quality Index (PSQI) standard questionnaire that scored on 7 point scale, the 8-item Epworth Sleepiness Scale (ESS) questionnaire and the 8-question STOP-Bang questionnaire along with demographic information and occupational data were used. To explore the independent factors associated with odds of poor sleep quality and road accident, multiple logistic regression models were used. Prevalence of previous road accidents, sleepiness while driving, and obstructive sleep apnea scored ≥ 3 in the study, and drivers accounted for 23.8%, 29%, and 24.8%, respectively. The global mean score of sleep quality and excessive sleepiness score were 5.2 and 4.8, respectively. The main factors related to the odds of poor sleep quality were snoring (odds ratio (OR) = 2.34; 95% confidence interval (CI): 1.15-4.77), smoking (OR = 2.12; 95% CI: 1.15-3.97), and driving times in a day (OR = 1.12; 95% CI: 1.03-1.21). The Epworth Sleepiness Scale (OR = 1.13; 95% CI: 1.07-1.23) and suffering from apnea (OR = 4.89; 95% CI: 1.07-23.83) were the best predictors for odds (increased risk) of road accidents. A considerable proportion of Iranian drivers had records of road accidents; poor sleep quality, sleepiness while driving, and sleep disorder breathing (obstructive sleep apnea - OSA). Snoring, smoking, driving time in a day, excessive sleepiness, and presumably apnea increase the odds of poor sleep quality and road traffic accident for Iranian occupational drivers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Novel Combined Training Approach Improves Sleep Quality but Does Not Change Body Composition in Healthy Elderly Women: A Preliminary Study

PubMed Central

Sousa, Thiago Matheus da Silva; Ruberti, Olivia de Moraes; Novais, Tânia Maria Gaspar; Oliveira, Paula de Lourdes Lauande; Almeida, Fabiano de Jesus Furtado; Pulcherio, Janaína Oliveira Bentivi

2017-01-01

The aim of this study was to investigate the effects of a novel combined training protocol on sleep quality and body composition of healthy elderly women. The study sample consisted of 8 sedentary elderly individuals with mean (±SD) of 67 (±8) years of age, 96.0 (±7.8) mg/dL fasting blood glucose, 94.4 (±36.1) mg/dL triglycerides, 179.1 (±22.4) mg/dL total cholesterol, 57.2 (±15.7) mg/dL high-density lipoprotein (HDL), 103.1 (±25.2) mg/dL low-density lipoprotein (LDL), 125.3 (±8.4) mmHg systolic blood pressure, and 72.6 (±10.1) mmHg diastolic blood pressure. The training protocol consisted of resistance training exercises (approximately 18-minute duration) combined with aerobic exercises (approximately 26-minute duration), performed interspersed in the same session, for 8 weeks (3 times a week), with a 24-hour interval rest between each session. Continuous variables were expressed as the mean (±standard deviation) and the paired sample t-test compares baseline with final measurement. The results showed a significant improvement (p = 0.01) in quality of sleep (4.9 ± 1.5 versus 3.8 ± 1.8 for total PSQI index) without body significant improvements in the fat-free mass (59.9 ± 4.0 versus 60.5 ± 4.4; p = 0.20) and fat mass (40.1 ± 4.0 versus 39.5 ± 4.4; p = 0.20) in healthy elderly women. In this sense, the novel combined training proposed may be an effective alternative or adjunct to present therapies aimed at improving the sleep quality in this population. PMID:29062575

Stress-related sleep vulnerability and maladaptive sleep beliefs predict insomnia at long-term follow-up.

PubMed

Yang, Chien-Ming; Hung, Chih-Ying; Lee, Hsin-Chien

2014-09-15

Vulnerability to stress-related sleep disturbances and maladaptive sleep beliefs has been proposed to be predisposing factors for insomnia. Yet previous studies addressing these factors have been cross-sectional in nature and could not be used to infer the time sequences of the association. The current study used a six-year follow-up to examine the predisposing roles of these two factors and their interactions with major life stressors in the development of insomnia. One hundred seventeen college students recruited for a survey in 2006 participated in this follow-up survey in 2012. In 2006, they completed a packet of questionnaires including the Dysfunctional Beliefs and Attitudes about Sleep Questionnaire, 10-item version (DBAS-10), the Ford Insomnia Response to Stress Test (FIRST), and the Pittsburgh Sleep Quality Index (PSQI); in 2012 they completed the Insomnia Severity Index (ISI) and the modified Life Experiences Survey (LES). Fourteen of the participants were found to suffer from insomnia as measured by the ISI. Logistic regression showed that scores on both DBAS-10 and FIRST could predict insomnia at follow-up. When the interaction of DBAS-10 and LES and that of FIRST and LES were added, both DBAS-10 and FIRST remained significant predictors, while the interaction of FIRST and LES showed a near-significant trend in predicting insomnia. The results showed that both vulnerability to stress-related sleep disturbances and maladaptive sleep beliefs are predisposing factors for insomnia. The hypothesized interaction effect between sleep vulnerability and major life stressors was found to be marginal. The maladaptive sleep beliefs, on the other hand, showed a predisposing effect independent from the influences of negative life events. © 2014 American Academy of Sleep Medicine.

Characteristics of napping in community-dwelling insomnia patients.

PubMed

Jang, Kwang Ho; Lee, Jung Hie; Kim, Seong Jae; Kwon, Hyo Jeong

2018-05-01

We aimed to determine napping characteristics of community-dwelling patients with insomnia disorder (ID) compared to characteristics of normal controls (NC), and to examine the effect of napping on nocturnal sleep. Adult volunteers who were more than 18 years old were recruited from three rural public health centers in Korea. Data from actigraphy recording and a sleep diary filled out for seven days were obtained. Finally, 115 ID patients and 80 NC subjects were included in this study. Parameters and timing of nocturnal sleep and nap were compared between the ID and NC groups. Two-way analysis of covariance (ANCOVA) was performed to determine the effect of ID diagnosis and napping on sleep parameters. Sleep efficiency (SE) in the ID group was significantly lower (p = 0.010), and wake time after sleep onset (WASO) was significantly greater (p = 0.023), compared to the NC group. There was no significant difference in nocturnal sleep or nap timing between the two groups. Nap frequency in the ID group was significantly higher than that in the NC group (p = 0.025). Although ID diagnosis and napping had no independent effect on fragmentation index, their interaction had a significant effect on fragmentation index (p = 0.021). Nap frequency was positively correlated with PSQI score (r = 0.166, p = 0.033). Insomnia patients showed no significant difference in nap timing or nap duration compared to NC subjects. However, insomnia patients showed higher nap frequency. Frequent napping was associated with poorer subjective sleep quality. Therefore, although napping might not have a negative impact on nocturnal sleep maintenance in NC subjects, it did have an effect on nocturnal sleep in insomnia patients. Copyright © 2018 Elsevier B.V. All rights reserved.

Chapter 8 Military Personnel With Traumatic Brain Injuries and Insomnia Have Reductions in PTSD and Improved Perceived Health Following Sleep Restoration: A Relationship Moderated by Inflammation.

PubMed

Barr, Taura; Livingston, Whitney; Guardado, Pedro; Baxter, Tristin; Mysliwiec, Vincent; Gill, Jessica

2015-01-01

Up to one-third of deployed military personnel sustain a traumatic brain injury (TBI). TBIs and the stress of deployment contribute to the vulnerability for chronic sleep disturbance, resulting in high rates of insomnia diagnoses as well as symptoms of posttraumatic stress disorder (PTSD), depression, and declines in health-related quality of life (HRQOL). Inflammation is associated with insomnia; however, the impact of sleep changes on comorbid symptoms and inflammation in this population is unknown. In this study, we examined the relationship between reported sleep changes and the provision of the standard of care, which could include one or more of the following: cognitive behavioral therapy (CBT), medications, and continuous positive airway pressure (CPAP). We compared the following: (a) the group with a decrease in the Pittsburgh Sleep Quality Index (PSQI; restorative sleep) and (b) the group with no change or increase in PSQI (no change). Independent t tests and chi-square tests were used to compare the groups on demographic and clinical characteristics, and mixed between-within subjects analysis of variance tests were used to determine the effect of group differences on changes in comorbid symptoms. Linear regression models were used to examine the role of inflammation in changes in symptoms and HRQOL. The sample included 70 recently deployed military personnel with TBI, seeking care for sleep disturbances. Thirty-seven participants reported restorative sleep and 33 reported no sleep changes or worse sleep. The two groups did not differ in demographic characteristics or clinical symptoms at baseline. The TBI+restored sleep group had significant reductions in PTSD and depression over the 3-month period, whereas the TBI+no change group had a slight increase in both PTSD and depression. The TBI+restored sleep group also had significant changes in HRQOL, including the following HRQOL subcomponents: physical functioning, role limitations in physical health, social functioning, emotional well-being, energy/fatigue, and general health perceptions. In a linear regression model using a forced entry method, the dependent variable of change in C-reactive protein (CRP) concentrations was significantly related to changes in PTSD symptoms and HRQOL in the TBI+restored sleep group, with R2=0.43, F33,3=8.31, p<.01. Military personnel with TBIs who have a reduction in insomnia symptoms following a standard-of-care treatment report less severe symptoms of depression and PTSD and improved HRQOL, which relate to decreased plasma concentrations of CRP. These findings suggest that treatment for sleep disturbances in this TBI+military population is associated with improvements in health and decreases in inflammation. The contributions of inflammation-induced changes in PTSD and depression in sleep disturbances in TBI + military personnel require further study.

Who benefits from adolescent sleep interventions? Moderators of treatment efficacy in a randomized controlled trial of a cognitive-behavioral and mindfulness-based group sleep intervention for at-risk adolescents.

PubMed

Blake, Matthew J; Blake, Laura M; Schwartz, Orli; Raniti, Monika; Waloszek, Joanna M; Murray, Greg; Simmons, Julian G; Landau, Elizabeth; Dahl, Ronald E; McMakin, Dana L; Dudgeon, Paul; Trinder, John; Allen, Nicholas B

2018-06-01

The aim of this study was to test moderators of therapeutic improvement in an adolescent cognitive-behavioral and mindfulness-based group sleep intervention. Specifically, we examined whether the effects of the program on postintervention sleep outcomes were dependent on participant gender and/or measures of sleep duration, anxiety, depression, and self-efficacy prior to the interventions. Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 59.34%; mean age = 14.48 years, range 12.04-16.31 years) who had elevated levels of sleep problems and anxiety symptoms. Participants were randomized into either a group sleep improvement intervention (n = 63) or group active control 'study skills' intervention (n = 60). The sleep intervention ('Sleep SENSE') was cognitive behavioral in approach, incorporating sleep education, sleep hygiene, stimulus control, and cognitive restructuring, but also had added anxiety-reducing, mindfulness, and motivational interviewing elements. Components of the active control intervention ('Study SENSE') included personal organization, persuasive writing, critical reading, referencing, memorization, and note taking. Participants completed the Pittsburgh Sleep Quality Index (PSQI), Spence Children's Anxiety Scale (SCAS), Center for Epidemiologic Studies Depression Scale (CES-D), and General Self-Efficacy Scale (GSE) and wore an actigraph and completed a sleep diary for five school nights prior to the interventions. Sleep assessments were repeated at postintervention. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612001177842; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12612001177842&isBasic=True). The results showed that compared with the active control intervention, the effect of the sleep intervention on self-reported sleep quality (PSQI global score) at postintervention was statistically significant among adolescents with relatively moderate to high SCAS, CES-D, and GSE prior to the intervention, but not among adolescents with relatively low SCAS, CES-D, and GSE prior to the intervention. The results were consistent across genders. However, the effects of the sleep intervention on actigraphy-measured sleep onset latency and sleep diary-measured sleep efficiency at postintervention were not dependent on actigraphy-measured total sleep time, SCAS, CES-D, or GSE prior to the intervention. This study provides evidence that some sleep benefits of adolescent cognitive-behavioral sleep interventions are greatest among those with higher levels of anxiety and depressive symptoms, suggesting that this may be an especially propitious group to whom intervention efforts could be targeted. Furthermore, adolescents with lower levels of self-efficacy may need further targeted support (e.g. additional motivational interviewing) to help them reach treatment goals. © 2017 Association for Child and Adolescent Mental Health.

Moderate exercise plus sleep education improves self-reported sleep quality, daytime mood, and vitality in adults with chronic sleep complaints: a waiting list-controlled trial.

PubMed

Gebhart, Carmen; Erlacher, Daniel; Schredl, Michael

2011-01-01

Research indicates that physical exercise can contribute to better sleep quality. This study investigates the six-week influence of a combined intervention on self-rated sleep quality, daytime mood, and quality of life. A nonclinical sample of 114 adults with chronic initiating and the maintaining of sleep complaints participated in the study. The intervention group of 70 adults underwent moderate physical exercise, conducted weekly, plus sleep education sessions. Improvements among participants assigned to the intervention group relative to the waiting-list control group (n = 44) were noted for subjective sleep quality, daytime mood, depressive symptoms and vitality. Derived from PSQI subscores, the intervention group reported increased sleep duration, shortened sleep latency, fewer awakenings after sleep onset, and overall better sleep efficiency compared to controls. The attained scores were well sustained and enhanced over a time that lasted through to the follow-up 18 weeks later. These findings have implications in treatment programs concerning healthy lifestyle approaches for adults with chronic sleep complaints.

Moderate Exercise Plus Sleep Education Improves Self-Reported Sleep Quality, Daytime Mood, and Vitality in Adults with Chronic Sleep Complaints: A Waiting List-Controlled Trial

PubMed Central

Gebhart, Carmen; Erlacher, Daniel; Schredl, Michael

2011-01-01

Research indicates that physical exercise can contribute to better sleep quality. This study investigates the six-week influence of a combined intervention on self-rated sleep quality, daytime mood, and quality of life. A nonclinical sample of 114 adults with chronic initiating and the maintaining of sleep complaints participated in the study. The intervention group of 70 adults underwent moderate physical exercise, conducted weekly, plus sleep education sessions. Improvements among participants assigned to the intervention group relative to the waiting-list control group (n = 44) were noted for subjective sleep quality, daytime mood, depressive symptoms and vitality. Derived from PSQI subscores, the intervention group reported increased sleep duration, shortened sleep latency, fewer awakenings after sleep onset, and overall better sleep efficiency compared to controls. The attained scores were well sustained and enhanced over a time that lasted through to the follow-up 18 weeks later. These findings have implications in treatment programs concerning healthy lifestyle approaches for adults with chronic sleep complaints. PMID:23471095

Validation of the Japanese version of the Ford Insomnia Response to Stress Test and the association of sleep reactivity with trait anxiety and insomnia.

PubMed

Nakajima, Shun; Okajima, Isa; Sasai, Taeko; Kobayashi, Mina; Furudate, Naomichi; Drake, Christopher L; Roth, Thomas; Inoue, Yuichi

2014-02-01

Our study was conducted to validate the Japanese version of the Ford Insomnia Response to Stress Test (FIRST-J) and to clarify the association of the measure with trait anxiety and insomnia in healthy subjects and insomnia patients. We studied 161 healthy subjects and 177 insomnia patients who completed the FIRST-J, Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), and State-Trait Anxiety Inventory-Trait (STAI). The healthy subjects and the insomnia patients were classified, respectively, into two groups with high FIRST-J and low FIRST-J scores (divided by the median value of healthy subjects). Cronbach α coefficients of the FIRST-J in the insomnia patients and healthy subjects were 0.89 and 0.87, respectively. Factor analysis revealed that the FIRST-J had a single-factor structure. The FIRST-J score significantly correlated with all other measures in the healthy subjects, though the score only correlated with the score of the STAI in the insomnia patients. The healthy subjects with high FIRST-J scores showed higher scores of the AIS and STAI than those with low FIRST-J scores. Furthermore, insomnia patients had a higher total score of the FIRST-J than the healthy subjects. The FIRST-J is an important tool for assessing vulnerability to insomnia. Copyright © 2013 Elsevier B.V. All rights reserved.

A School-Based Study of Irritable Bowel Syndrome in Medical Students in Beijing, China: Prevalence and Some Related Factors

PubMed Central

Liu, Yang; Liu, Liang; Yang, Yi; He, Yuxi; Zhang, Yanli; Wang, Miao; Chen, Shuo; Yao, Shukun

2014-01-01

Purpose. To investigate the prevalence and some related factors about irritable bowel syndrome (IBS) in medical students. Methods. A cross-sectional study was carried out from February 2014 to Jun 2014 in Beijing University of Chinese Medicine, Beijing, China. All participants were asked to completed self-administered questionnaires. Results. Seven hundred and sixty-seven medical students (23.26 ± 2.88 years, 25.6% males) completed the survey. The prevalence of IBS was 33.3%, with a high prevalence in women (36.1%). Among the IBS patients, 112 cases were IBS-M (43.9%) and 77.6% had moderately severe IBS. There were no statistical differences between control group and IBS patients in anxiety and depression scores (P > 0.05). The total score of Pittsburgh sleep quality index (PSQI) was significantly higher for medical students with IBS and 35.5% of IBS patients had severe sleep disorder; the scores of child trauma questionnaire (CTQ) and student-life stress inventory (SLSI) were also higher in IBS patients. Sex and sleep disorder were independently associated with IBS (OR, 1.914, 95%CI, 1.281–2.860; OR, 1.143, 95%CI, 1.074–1.216). Conclusion. Our study has many valuable findings and they may provide valuable suggestions for the necessary intervention and treatment measures towards medical students. PMID:25371668

The presence of a perseverative iterative style in poor vs. good sleepers.

PubMed

Barclay, N L; Gregory, A M

2010-03-01

Catastrophizing is present in worriers and poor sleepers. This study investigates whether poor sleepers possess a 'perseverative iterative style' which predisposes them to catastrophize any topic, regardless of content or affective valence, a style previously found to occur more commonly in worriers as compared to others. Poor (n=23) and good sleepers (n=37) were distinguished using the Pittsburgh Sleep Quality Index (PSQI), from a sample of adults in the general population. Participants were required to catastrophize 2 topics: worries about sleep, and a current personal worry; and to iterate the positive aspects of a hypothetical topic. Poor sleepers catastrophized/iterated more steps to a greater extent than good sleepers to these three interviews, (F(1, 58)=7.35, p<.05). However, after controlling for anxiety and worry, this effect was reduced to non-significance for the 'sleep' and 'worry' topics, suggesting that anxiety may mediate some of the association between catastrophizing and sleep. However there was still a tendency for poor sleepers to iterate more steps to the 'hypothetical' topic, after controlling for anxiety and worry, which also suggests that poor sleepers possess a cognitive style which may predispose them to continue iterating consecutive steps to open-ended tasks regardless of anxiety and worry. Future research should examine whether the presence of this cognitive style is significant in leading to or maintaining insomnia.

Abnormal amygdala connectivity in patients with primary insomnia: evidence from resting state fMRI.

PubMed

Huang, Zhaoyang; Liang, Peipeng; Jia, Xiuqin; Zhan, Shuqin; Li, Ning; Ding, Yan; Lu, Jie; Wang, Yuping; Li, Kuncheng

2012-06-01

Neurobiological mechanisms underlying insomnia are poorly understood. Previous findings indicated that dysfunction of the emotional circuit might contribute to the neurobiological mechanisms underlying insomnia. The present study will test this hypothesis by examining alterations in functional connectivity of the amygdala in patients with primary insomnia (PI). Resting-state functional connectivity analysis was used to examine the temporal correlation between the amygdala and whole-brain regions in 10 medication-naive PI patients and 10 age- and sex-matched healthy controls. Additionally, the relationship between the abnormal functional connectivity and insomnia severity was investigated. We found decreased functional connectivity mainly between the amygdala and insula, striatum and thalamus, and increased functional connectivity mainly between the amygdala and premotor cortex, sensorimotor cortex in PI patients as compared to healthy controls. The connectivity of the amygdala with the premotor cortex in PI patients showed significant positive correlation with the total score of the Pittsburgh Sleep Quality Index (PSQI). The decreased functional connectivity between the amygdala and insula, striatum, and thalamus suggests that dysfunction in the emotional circuit might contribute to the neurobiological mechanisms underlying PI. The increased functional connectivity of the amygdala with the premotor and sensorimotor cortex demonstrates a compensatory mechanism to overcome the negative effects of sleep deficits and maintain the psychomotor performances in PI patients. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.