Correlation of anxiety and depression with sleep quality and post-traumatic growth in brain tumor patients and associated determinants

Objective To explore the correlation between post-traumatic growth (PTG) and sleep quality among parents of children with epilepsy. Methods In this cross-sectional study, 191 parents of children with epilepsy were selected from Shangdong Province Third Hospital by convenience sampling method, the questionnaire included socio-demographic questionnaire, the Post-Traumatic Growth Inventory (PTGI) and Pittsburgh Sleep Quality Index (PSQI). Results The score of PTGI and PSQI of parents of children with epilepsy were (28.63±10.85) and (5.97±3.72), respectively. The score of PTGI and PSQI in parents' health status with health, general, worse was (29.44±10.66), (25.28±11.26), (19.00±7.81) and (5.57±3.51), (7.23±3.53), (15.00±1.73), the difference was significant (F=3.07, 12.69, P<0.05 or 0.01). The score of PSQI in parents with or without major negative events was (8.50±4.16), (5.67±3.57), the difference was significant (t=-3.12, P<0.01). There was a negative correlation between PTGI and PSQI among parents of children with epilepsy (r=-0.159, P<0.05). Hierarchical regression analysis showed that there was a significant positive correlation between the dimension of PTG appreciation life and the sleep quality of parents (B=0.455, P<0.01). Conclusions Parents with epilepsy have normal sleep quality, but at the same time have a certain level of PTG, and the level of PTG appreciated by parents is related to their sleep quality. Therefore, by promoting parents with epilepsy to actively appreciate life, it helps to alleviate their sleep problems. Key words: Children with epilepsy; Parents; Post-traumatic growth; Sleep quality; Related factors

Background: Approximately 40% of the population reports sleep problems such as poor quality sleep and insufficient sleep duration. Physical activity (PA) can help improve sleep, but data on whether PA intensity or duration is most strongly associated with sleep are lacking. In addition, given that sedentary behaviour (e.g., TV, computer use) is distinct from physical inactivity, the association between sedentary behaviour and sleep in young adults needs to be characterized. Objective: To describe the relationships between sleep quality and sleep duration and (1) frequency and duration of light, moderate, and vigorous PA, and (2) different types of sedentary behaviours (TV, computer, reading) in young adults. Methods: Self-report data for 658 participants were from the 22nd wave of the Nicotine Dependence in Teens (NDIT) cohort study (mean age=24.0 years, 46% male [300 of 658]). PA measures assessed frequency (number of days) and minutes of light, moderate and vigorous PA in the past week. Sedentary measures assessed number of hours spent reading, watching TV, and using the computer per day. Sleep measures included (1) the Pittsburgh Sleep Quality Index (PSQI) which assessed seven dimensions of sleep (daytime dysfunction, disturbances, duration, efficiency, latency, quality, use of sleeping medications), (2) general sleep quality, and (3) sleep duration in the past month. General sleep quality and sleep duration were two separate additional measures distinct from similar PSQI items (r=0.73 between general sleep quality and PSQI score; r=0.69 between sleep duration and PSQI score). Data were analyzed using multiple linear regression. Due to evidence of non-normality the PSQI score was log-transformed. Results: Controlling for age, sex, and maternal education, each additional day of light or vigorous PA was associated with 3 minutes less sleep per night (p&lt;0.05). Each additional 10 minutes of moderate PA was associated with greater general sleep quality (β=0.004, p=0.04). TV was associated with a poorer PSQI score (β=0.01, p&lt;0.05) and each additional hour of reading was associated with 2 minutes less sleep per night (p=0.04). Computer use was associated with a poorer PSQI score (β=0.02, p=0.005) and poorer sleep quality (β=-0.02, p=0.05). Results were similar when sedentary and PA measures were included in the same model. The inclusion of body mass index, self-rated mental and general health, and stress did not affect the results and were omitted from the final models. Conclusion: PA and sedentary behaviours are independently associated with sleep duration and quality. Sedentary behaviours are associated with poorer sleep duration and quality. In contrast, PA frequency may decrease sleep duration while PA duration may improve sleep quality. Clinicians who treat sleep problems in young adults may need to take PA and sedentary behavior into account in treatment plans.

Poor sleep quality, often resulting from poor sleep hygiene, is common among medical students. Educational interventions aimed at improving sleep knowledge are beneficial for sleep quality in healthy populations. However, sleep education is often given minimal attention in medical school curriculums. The aim of the study was to explore whether a short educational intervention could improve sleep knowledge, and consequently sleep quality, among medical students. We recruited preclinical- and clinical-stage medical students during the 2017-2018 academic year. Students completed a demographic survey, the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Assessment of Sleep Knowledge in Medical Education (ASKME) questionnaire. Students then attended a lecture on the physiology and importance of sleep. To assess the efficacy of the intervention, questionnaires were repeated 4 months thereafter. A total of 87 students (31 preclinical) with a mean age of 25.86 years (standard deviation [SD], 3.33), 51 of whom were women, participated in the study. At baseline, students had poor sleep quality with a PSQI mean score of 5.9 (SD, 2.37), without significant sleepiness, and a mean ESS score of 8.86 (SD, 4.32). The mean ASKME scores were consistent with poor sleep knowledge at 11.87 (SD, 4.32). After the intervention, the mean ASKME results improved to 14.15 (SD, 4.5; P < .001), whereas sleep quality did not. The effect was similar in preclinical and clinical medical students. Sleep knowledge was inadequate among medical students, who also experienced poor sleep quality. A short educational intervention improved sleep knowledge but was insufficient at improving sleep quality. Further studies are needed to determine which interventions may provide benefit in both sleep knowledge and sleep quality.

Introduction: The prevalence of obesity continues to rise since 1980. This obesity epidemic has been paralleled by a trend of reduced sleep duration and sleep quality throughout the years. However, there is limited research on the relation between sleep duration and quality and its association with weight loss maintenance. The purpose of this study was to examine the association between sleep duration and quality and weight status in post-bariatric surgery patients at 9-y post-surgery. We tested the hypothesis that participants’ post-surgical weight change would be related to sleep duration and quality at 9-y. Methods: Sleep data were collected on a subset of participants (mean body weight = 94.1 kg ± 18.9) enrolled in an ancillary study to the Longitudinal Assessment for Bariatric Surgery trial. Self-reported hours of sleep per night and overall sleep quality were assessed once, at the 9-y visit using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Results: Complete data were available on 14 participants (10 females and 4 males, age 52.1 ± 15.6 y), current weight 94 kg ± 18.9. Average total weight loss from pre-surgery was 28.5% ± 10.6, with an average weight gain of 0.3 ± 6.2 % over the last 2 y of follow-up. Participants reported average sleep duration of 6.8 ± 2.0 h/night at the 9-y evaluation visit and an average score of 7.9 ± 3.7 on the PSQI. There was no relation between sleep duration and current weight or percent weight change after maximum weight loss, which occurred around 2-y post-surgery. However, there were trends for an association between sleep quality and percent weight change after maximum weight loss (p=0.057) and percent weight change in the last 2-y of follow-up (p=0.066). In general, participants who lost more weight over the last 2 y of the study had lower scores on the PSQI, indicating better quality of sleep. Conclusion: Our results showed no association between sleep quality or duration and long-term changes in weight for patients who underwent bariatric surgery. However, those with better sleep quality tended to have more beneficial changes in weight over the latest 2-y. It is important to note that this study cannot address causality and whether improved weight influenced sleep quality or whether sleep quality influenced weight change. Further studies should examine the temporality of these association. Sleep quality may be an important sleep metric to consider for long-term weight loss maintenance.

A large body of evidence has accumulated over the last five decades regarding the consequences of insufficient sleep duration and/or inadequate sleep quality (including sleep breathing disorders such as obstructive and central sleep apnea). It has been shown that insufficient sleep duration, sleep apnea, and insomnia are associated with a variety of adverse health outcomes.1 The negative effects of sleep disturbances may affect many aspects of human health by inducing metabolic, cardiovascular, immunological, and mental alterations. Furthermore, sleep duration has been found to be an independent risk factor for total mortality. A pioneering population-based study including 1 064 004 individuals, published more than 50 years ago, suggested that an increased mortality risk in men was associated with either short (6 hours or less) or long (9 hours or more) sleep duration.2 In particular, individuals who slept less than five hours per night had very high death rates, and this was also the case for who slept ten or more hours per night. A recent meta-analysis of 60 studies representing over 3 million participants showed a possible increase in cardiovascular mortality associated with either longer or shorter duration of sleep than 7 or 8 hours, thus providing an updated evidence in favor of a J-shaped relationship between sleep duration and mortality.3 It is also worth of mention that subjective poor sleep quality, assessed in 17 out of 60 studies, was independently associated with coronary heart disease but not with cardiovascular mortality and non-fatal stroke. A scientific statement released in 2016 by the American Heart Association, based on a comprehensive review of individual studies and their meta-analyses, highlighted the fact that sleep duration, mostly short sleep, and sleep disorders (insomnia symptoms, sleep-disordered breathing, periodic limb movement disorder, restless leg syndrome) are related to adverse cardiometabolic risk factors, such as obesity, metabolic syndrome, hypertension, type 2 diabetes mellitus, as well as to cardiovascular disease.4 The mechanisms underlying the association between sleep disturbances and unfavorable health consequences remain a topic of debate. Poor sleep quality has been shown to increase circulating levels of leptin and ghrelin, which in turn may promote insulin resistance and development of obesity. Increased plasma adrenaline, norepinephrine, and cortisol concentrations as well as low-grade inflammation and endothelial dysfunction have been associated with abnormal sleep patterns. A putative link between sleep disorders with heightened sympathetic nervous activity and/or reduced parasympathetic activity leading to sympathovagal imbalance and, ultimately, to cardiac autonomic dysfunction has been reported in different clinical settings.5, 6 Several epidemiological studies have shown significant associations between chronic insomnia, short sleep duration, poor sleep quality, and the risk of hypertension resulting from chronic sympathetic overactivity and/or arterial baroreflex dysfunction.7 A meta-analysis from 13 studies (6 cross-sectional studies and 7 prospective cohort studies) including a total of 347,759 participants (115,007 with hypertension) showed a U-shaped relationship between sleep duration and hypertension.8 In particular, the excess of hypertension risk associated with a short sleep period (ie, ≤5 hours) was 81% greater compared to the reference sleep time (ie, 7 hours) in cross-sectional studies and 31% greater in prospective cohort studies. Notably, the association between short sleep duration and hypertension was stronger in women than men. A more recent meta-analysis (comprising 54 studies and 1 074 207 subjects) targeted the relationship between six sleep parameters (ie, obstructive sleep apnea, oxygen desaturation index, sleep quality, short or long sleep duration, and snoring) and revealed that poor sleep quality but not sleep duration was a key risk factor for hypertension (OR = 1.38, 95% CI :1.082–1.760).9 In this issue of the Journal Oliveira-Silva and coworkers10 report the results of a cross-sectional study aimed at investigating the association between sleep quality with cardiac autonomic dysfunction, as assessed by the spectral analysis of heart rate (HR) and blood pressure (BP) variability, in a group of forty-seven treated essential hypertensive men. The study sample did not include patients with overt cardiovascular disease, subclinical target organ damage, grade II and III obesity, elderly, patients on treatment with insulin, beta-blockers, and non-dihydropyridine calcium channel antagonists. Sleep quality was investigated by the Pittsburgh Sleep Quality Index (PSQI). PSQI is a questionnaire examining seven sleep items: subjective sleep quality (a subjective feeling of satisfaction in daily sleep), sleep latency (time for transition from full wakefulness to sleep), habitual sleep efficiency (ratio of hours slept to total hours in bed), daytime dysfunction (trouble staying awake during social activities), sleep duration and use of sleep medication, and sleep disturbance (interruption of sleep). The global PSQI score ranges from 0 to 21, higher numbers reflecting worse sleep quality. A total of 24 out of 47 patients included in the study were identified as "poor sleepers" (PQSI score> 5); their demographic and clinical characteristics were not different from those of patients with preserved or good sleep quality.10 Furthermore, no differences were found in the number antihypertensive drugs (2/3 of patients in both groups were on monotherapy) as well as in the various classes of BP-lowering drugs, in particular diuretics. Cardiovascular parameters were assessed with the patients in sitting position by ten minutes recording of HR and beat-to-beat BP using photo-plethysmography. Autonomic modulation was then evaluated by the spectral analysis of HR and BP variability. Patients with poor sleep quality exhibited an impaired cardiac parasympathetic modulation (ie, lower HR high-frequency band) and reduced cardiac baroreflex sensitivity. In addition, correlation analyses showed that PSQI score was directly related to average HR and inversely related to HR high-frequency band, HR total variance, and cardiac baroreflex sensitivity. Some previous studies evaluating the effect of global sleep status on cardiac autonomic function, as assessed by HR variability and catecholamine levels, have been carried out in patients with cardiovascular disease (ie, acute myocardial infarction). In this critical setting, higher levels of adrenaline and norepinephrine, a significant increase in low-frequency power as well as low-frequency/high-frequency power ratio and reduced high-frequency power were found in 147 patients (61% men) with poor sleep quality as compared to their counterparts with good sleep quality (n = 156, 67% men).11 In clinical terms, sympathetic hyperactivity, associated with short-lasting poor sleep quality, resulted in increased prevalence of ventricular tachycardia in the following week after acute myocardial infarction. The findings provided by Oliveira-Silva et al. extend to the uncomplicated hypertension setting the view that poor sleep quality may adversely affect the sympathovagal balance and worsen the risk of cardiovascular complications in poor sleeper hypertensive patients. Some aspects and limits of this interesting study deserve to be commented on. Subjective and objective estimates of sleep (ie, actigraphy) are often discordant among subjects with sleep disorders who generally tend to under-report sleep time and over-report wake time at night. The PSQI is widely used by clinicians and researchers in order to assess several aspects of sleep as it has been validated in general population-based samples as well as in many different clinical settings. It cannot be ignored, however, that several studies have reported rather limited correlations between subjective evaluation of quality and duration of sleep and more-objective measures. For instance, an analysis of 669 participants in the CARDIA (Coronary Artery Risk Development in Young Adults) Sleep Study documented a moderate correlation (r = 0.45) between self-reported and objectively measured sleep duration based on wrist actigraphy, providing evidence of systematic errors and bias of subjective evaluations.12 Similar conclusions were reported in a large study aimed at comparing self-report sleep quality and actigraphy results in a cohort of 2,086 Hispanic Americans.13 Overall, the PSQI can be regarded as a good screening tool, but not a substitute for sleep disorder diagnoses based on a comprehensive clinical interview performed by skilled clinicians with the support of objective measurements; therefore, data obtained by this questionnaire should be considered with caution.14 The high prevalence of patients with poor sleep quality (ie, 51%) in the Oliveira-Sousa study was similar to that reported by Wang et al. in acute myocardial infarction 11 and raises the question of whether this sample reflects the real burden of sleep disturbances in the community. Data from the 2007 to 2008 National Health Nutrition Examination Survey (NHANES) targeting the prevalence of sleep symptoms have shown that long sleep latency, self-reported difficulty in falling asleep, sleep maintenance difficulties, and early morning awakenings were reported by more than 50% of the participants.15 This supports the concept that sleep disturbances involve a very large fraction of the general population and, consequently, conditions such as hypertension, obesity, diabetes could be even more exposed to the risk of poor quality sleep. Finally, differences in sleep between men and women have been reported in the literature in the last decades; unfortunately, the present study did not address the intriguing aspect of gender-based differences in the association between sleep disorders and cardiac autonomic dysfunction. In community-based studies, women have been shown to report shorter sleep duration, more frequently sleep symptoms, and higher rates of insomnia.16 Furthermore, the strength of association between short sleep duration/poor quality sleep and hypertension has been reported to be stronger in women than in men. In conclusion, the study by Oliveira-Souza and coworkers has the merit of raising the question about the relationship between sleep quality and cardiac autonomic function in the hypertension setting, suggesting that poor sleep quality is accompanied by substantial alterations of the sympathovagal modulation. Assessment of sleep quality, a point so far neglected, should be included in clinical practice and research, as it may contribute to a more comprehensive cardiovascular risk stratification of hypertensive patients as well as to the analysis of factors responsible for cardiac damage. It is evident that further larger studies, based on more accurate evaluation of sleep, are needed in order to more deeply explore the role of alterations of sleep quality on cardiovascular outcomes, as in the recent past it has been performed for the sleep apnea syndrome.17, 18 The authors report no conflicts of interest.

Objective To investigate the factors influencing sleep disturbance and comorbid anxiety and depression after cerebral infarction.Methods A total of 216 patients with first onset of cerebral infarction were enrolled and divided into a post-stroke comorbid anxiety and depression (PSCAD) group, a pure anxiety group, a pure depression group and a non-anxiety and no-depression group. Smoking, alcohol intake, educational background, life or work pressure and exercise frequency were compared among the four groups along with ultrasound images of the carotid artery and brain blood vessels. The subjects' sleep quality was evaluated with the Pittsburgh sleep quality index (PSQI).Results The conditions studied showed no significant difference among the four groups. There were significant differences among the four groups in HAMA and HAMD scores. HAMD overall scores were higher in the PSCAD group than in the other three groups. HAMA overall scores were higher in the PSCAD group than in the pure depression group or the non-anxiety and no-depression groups. The PSCAD group showed significantly higher scores on all the dimensions and in their overall scores than those in the non-anxiety and no-depression group. Subjective sleep quality, sleep latency, sleep duration, sleep efficiency, day-time dysfunction and the overall PSQI score were all significantly higher in the PSCAD group than in the pure anxiety group. Sleep latency, sleep duration, day-time dysfunction and the overall PSQI scores were significantly higher in the PSCAD group than in the pure depression group. Age, life or work pressure, smoking, alcohol intake were the main factors influencing sleep quality in the PSCAD group.Conclusions The sleep quality of anxious and depressed patients after cerebral infarction is worse than that of those suffering only anxiety or depression alone, especially in terms of subjective sleep quality, sleep latency, sleep duration, sleep efficiency and day-time dysfunction. Age, life or work pressure, smoking and alcohol intake are the main factors influencing sleep quality in such comorbid individuals after cerebral infarction. Key words: Cerebral infarction; Anxiety; Depression; Sleep quality; Comorbidity

Individuals with primary brain tumors and their caregivers experience substantial psychological distress, yet positive psychological outcomes, such as post-traumatic growth (PTG), remain understudied. This study aimed to assess the prevalence and profile of PTG among primary brain tumor patients and caregivers, examine associations with demographic, medical, and psychological variables, and inform future neuro-oncology interventions. In this prospective cross-sectional study, 141 participants (96 patients, 45 caregivers) completed validated surveys assessing PTG, depression, anxiety, and death anxiety. Participants were recruited via online neuro-oncology support and advocacy groups. PTG was measured using the Post-Traumatic Growth Inventory (PTGI). PTG profiles were examined using descriptives and associations between PTG and patient/caregiver characteristics, tumor-related medical variables, and psychological distress were examined using t-tests, ANOVAs, and Pearson correlations. 70% of patients and 48.8% of caregivers reported moderate-to-high PTG. Appreciation of Life was the most frequently endorsed subscale in both groups. Patients with high-grade tumors exhibited significantly higher PTG than those with low-grade tumors; caregivers of patients with left-hemisphere tumors trended toward higher PTG. PTG was positively associated with death anxiety in patients but unrelated to depression or generalized anxiety in either group. Despite significant distress, many patients and caregivers experience PTG following a brain tumor diagnosis, particularly in appreciating life. These findings highlight the potential for psychosocial and palliative interventions to harness PTG through meaning-making and existential engagement.

To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on insomnia and other sleep disturbances in health care professionals. A survey was distributed using social media and organizational emails to Brazilian active health care professionals during the COVID-19 outbreak. We explored potential associated factors including age, sex, occupation, workplace, work hours, income, previous infection with COVID-19, recent/current contact with COVID-19 patients, regional number of incident deaths, anxiety, and burnout. We evaluated new-onset/previous insomnia worsening episodes (primary outcome), new pharmacological treatments, sleep quality, duration, nightmares, and snoring (secondary outcomes). A total of 4,384 health professionals from all regions of the country were included in the analysis (44 ± 12 years, 76% females, 53.8% physicians). Overall, 55.7% were assisting patients with COVID-19, and 9.2% had a previous COVID-19 infection. The primary outcome occurred in 32.9% of respondents in parallel to 13% new pharmacological treatments for insomnia. The sleep quality worsened for 61.4%, while 43.5% and 22.8% reported ≥ 1-hour sleep duration reduction and worsening or new-onset nightmares, respectively. Multivariate analyses showed that age (odds ratio [OR]: 1.008; 95% confidence interval [CI] 1.001-1.015), females (OR: 1.590; 95% CI 1.335-1.900), weight change (decrease: OR: 1.772; 95% CI 1.453-2.161; increase: OR: 1.468; 95% CI 1.249-1.728), prevalent anxiety (OR: 3.414; 95% CI 2.954-3.948), new-onset burnout (OR: 1.761; 95% CI 1.489-2.083), family income reduction > 30% (OR: 1.288; 95% CI 1.069-1.553), and assisting patients with COVID-19 (OR: 1.275; 95% CI 1.081-1.506) were independently associated with new-onset or worsening of previous insomnia episodes. We observed a huge burden of insomnia episodes and other sleep disturbances in health care professionals during the COVID-19 pandemic. Drager LF, Pachito DV, Moreno CRC, etal. Insomnia episodes, new-onset pharmacological treatments, and other sleep disturbances during the COVID-19 pandemic: a nationwide cross-sectional study in Brazilian health care professionals. J Clin Sleep Med. 2022;18(2):373-382.

ObjectiveTo investigate the clinical implications of sleep quality, anxiety and depression in patients with advanced lung cancer (LC) and their family caregivers (FCs).MethodsA total of 98 patients with advanced LC...

ObjectiveTo examine associations of sleep duration and quality with cognitive impairment in older adults and the moderating role of gender and age in these associations.MethodsThis community-based cross-sectional study included 4,837 participants aged 60 years and above. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE), and the participants were grouped based on the presence of cognitive impairment. The duration and quality of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression models were used to analyze associations of sleep duration and quality with cognitive impairment. The role of age and gender in these associations have also been explored.ResultsThe age (mean ± SD) of the participants was 71.13 ± 5.50 years. Of all older adults, 1,811 (37.44%) were detected as cognitive impairment, and 1755 (36.8%) had poor sleep quality. Among those with cognitive impairment, 51.09% were female. The proportion of the participants with cognitive impairment is significantly higher in those with symptoms of depression (49.73%, 273/549) (χ2 = 41.275, p < 0.001) than in those without depressive symptoms. After adjustment for multiple confounding factors and the crucial covariate (depressive symptoms), the odds ratios (OR) (95% confidence interval [CI]) of cognitive impairment (with 7–7.9 h regarded as the reference group) for individuals with a sleep duration of <6, 6–6.9, 8–8.9, and ≥ 9 h were 1.280 (1.053–1.557), 1.425 (1.175–1.728), 1.294 (1.068–1.566), and 1.360 (1.109–1.668), respectively. Subgroup analysis showed a V-shaped association between night sleep duration and cognitive impairment in males (p ≤ 0.05), and the association was stronger for individuals aged 60–80 years. With regard to sleep quality, the fully adjusted OR (95%CI) of cognitive impairment were 1.263 (1.108–1.440). According to scores of subscales in the PSQI, daytime dysfunction was associated with an increased risk of cognitive impairment (OR: 1.128, 95%CI: 1.055–1.207). Subgroup analysis also revealed a statistically significant correlation between poor sleep quality (including daytime dysfunction) and cognitive impairment in different gender and age groups, with the association being stronger in females (OR: 1.287, 95%CI: 1.080–1.534) and those aged 81–97 years (OR: 2.128, 95%CI: 1.152–3.934). For cognitive impairment, the group aged 81–97 years with daytime dysfunction was associated with a higher odds ratio than other age groups.ConclusionThe present study showed that inadequate or excessive sleep was associated with cognitive impairment, especially in males, who exhibited a V-shaped association. Cognitive impairment was also associated with poor sleep quality as well as daytime dysfunction, with females and individuals aged 81–97 years exhibiting the strongest association.

Background:Many patients in the intensive care unit (ICU) suffer from post-traumatic stress disorder (PTSD), which seriously affects the treatment, recovery, and prognosis of patients.Objective:To observe the effect of empowerment psychological intervention on the status of PTSD in ICU patients.Methods:A total of 86 patients with PTSD who were treated in ICU from July 2019 to December 2021 were divided into two groups according to the intervention method. The control group (n = 43) used routine psychological intervention, while the intervention group (n = 43) used empowerment psychological intervention led by specialist nurses. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality of the patients. The Resilience Questionnaire (CD-RISC) was used to evaluate the resilience of the patients, and the Post Traumatic Stress Disorder Self-Rating Scale (PTSD-SS) was used to assess the severity of the symptoms. The Hamilton Anxiety and Depression Inventory (HAMA and HAMD) was adapted to assess the degree of anxiety and depression, and the Post-Traumatic Growth Inventory (PTGI) was adapted to evaluate the post-traumatic growth of the patients.Results:After the intervention, the total CD-RISC score and its tenacity, self-improvement, and optimism scores in the two groups were all higher than before, and the total PSQI score and its sleep quality, time, efficiency and impairment, as well as hypnotic drugs, daytime dysfunction and time to sleep were lower than before, and the CD-RISC score in the intervention group was higher than that in the control group, PSQI score was lower than that in the control group (p < 0.05). After the intervention, PTSD-SS scores and anxiety-depression scores were lower, and PTGI scores were higher in both groups than before (p < 0.05).Conclusion:The empowerment psychological intervention led by specialist nurses applied to ICU patients with PTSD can improve their psychological resilience and sleep quality, reduce negative emotions, alleviate clinical symptoms, and promote post-traumatic growth.

ABSTRACTThis study investigated the latent classes of sleep quality based on the Pittsburgh Sleep Quality index (PSQI) in Chinese adults, and analyzed whether these latent classes differed between men and women. A total of 982 adults (age: 18–59 years) participated in the questionnaire survey, and the PSQI was used to assess sleep quality. Two latent classes of sleep quality were found in men, and the cut-off value of PSQI for predicting the poor sleep quality group was 6. Four latent classes were found in women, which were named ‘good sleep’, ‘daytime dysfunction’, ‘inadequate sleep’, and ‘poor sleep’, respectively. In women, the optimal cut-off values of the PSQI for predicting the poor and good sleep quality groups were 9 and 6, respectively. Women who were not included in the ‘poor sleep’ group but had a score not less than 2 in the ‘sleep duration’ or ‘daytime dysfunction’ dimensions of PSQI were classified into the ‘inadequate sleep’ group or the ‘daytime dysfunction’ group. The findings may benefit the identification of sleep problems and assist in more effective alleviation of these issues.

Sleep duration and quality in relation to non-alcoholic fatty liver disease in middle-aged workers and their spouses

Background: Major depressive disorder (MDD) is a common mental disorder characterized by a wide range of symptoms and a substantial contribution to global disease burden. Our study aimed to examine the relationships between childhood trauma, sleep quality, dissociative symptoms, posttraumatic growth, and suicidality in patients diagnosed with MDD. Methods: Our sample consisted of 115 patients with MDD and 84 healthy controls. Participants were administered the Hamilton Depression Rating Scale (HDRS), Beck Scale for Suicidal Ideation (BSSI), Pittsburgh Sleep Quality Index (PSQI), Childhood Trauma Questionnaire (CTQ-33), Dissociative Experiences Scale (DES), and Posttraumatic Growth Inventory (PTGI). Group differences were analyzed, and associations among variables within the MDD group were examined using correlation and mediation analyses. Results: Compared to healthy controls, patients with MDD had significantly higher scores on all scales except the PTGI (p < 0.001 for each). Within the MDD group, individuals with a history of suicide attempts had significantly higher CTQ total scores, physical and sexual abuse subscale scores, and DES scores than those without previous attempts. Additionally, dissociative experiences had a partial mediating role in the relationship between depression severity and suicidal ideation, as well as in the relationship between childhood traumas and sleep quality. Conclusions: The findings highlight the clinical relevance of dissociative experiences and sleep disturbances in the heterogeneous presentation of MDD and their association with illness severity and suicidality. In the follow-up and treatment process of patients with MDD, risk and protective factors should be evaluated together, and individualized treatment programs should be targeted.

The sleep patterns of humans are greatly influenced by age and sex and have various effects on overall health as they change continuously during the lifespan. We investigated age-dependent changes in sleep properties and their relation to sex in middle-aged individuals. We analyzed data from 2,640 participants (mean age of 49.8 ± 6.8 years at baseline, 50.6% women) in the Korean Genome and Epidemiology Study, which assessed sleep habits using the Pittsburgh Sleep Quality Index and other clinical characteristics. We analyzed the sleep habit changes that occurred between baseline and a follow-up point (mean interval: 12.00 ± 0.16 years). Associations of age and sex with 9 sleep characteristics were evaluated. Age was associated with most of the sleep characteristics cross-sectionally and longitudinally (P < .05), except for the time in bed at baseline (P = .455) and change in sleep duration (P = .561). Compared with men, women had higher Pittsburgh Sleep Quality Index scores, shorter time in bed, shorter sleep duration, and longer latency at baseline (P ≤ .001). Longitudinal deterioration in Pittsburgh Sleep Quality Index score, habitual sleep efficiency, duration, and latency was more prominent in women (P < .001). The sex differences in these longitudinal sleep changes were mainly noticeable before age 60 years (P < .05). Worsening of Pittsburgh Sleep Quality Index scores, habitual sleep efficiency, and latency was most evident in perimenopausal women. Men presented with greater advancement of chronotype (P = .006), with the peak sex-related difference occurring when they were in their late 40s (P = .048). Aging is associated with substantial deterioration in sleep quantity and quality as well as chronotype advancement, with the degree and timing of these changes differing by sex.