Impact of Promoting a Healthy Lifestyle on Anthropometric Characteristics, Climacteric Symptoms, Sleep Quality and Quality of Life in Women During Menopausal Transition

Background: Climacteric syndrome, occurring during menopausal transition, plays a key role in the alteration of women's quality of life. Aims: This study investigated the relationship between perimenopausal symptoms, sleep quality, quality of life, and food behavior in women on menopausal transition in western Algeria. Subjects and Methods: The study included 131 perimenopausal women (Mean age = 48 ± 3 years). The climacteric syndrome and quality of life were assessed by the menopause rating scale (MRS) questionnaire. The quality of sleep was evaluated by the Pittsburgh sleep quality index (PSQI) and food consumption by the 24h recall method. Results: The mean score of psychological (9.63 ± 2.93) and somatic (10.74 ± 3.43) symptoms were significantly higher (p= 0.000) and the total score of MRS was 24 ± 6, which means that women have an impaired quality of life. A high significance (p= 0.000) was also noted in subscales scores of sleep components; sleep disturbances (1.69± 0.62), subjective sleep quality (1.55± 0.93), and sleep latency (1.40 ± 1.23), compared to other sleep components. Poor sleep quality was explained by a high score of PSQI (8 ± 4). The MRS subscale scores showed a significant correlation with total PSQI score (r =0.600, p=0.01). A positive energy balance was also recorded with a high protein (13% of TEI) and polyunsaturated fatty acids intake (33%) and low lipids (23% of TEI), monounsaturated fatty acids (41%), and animal protein intake (26%). Conclusions: Perimenopause is a difficult period in a woman's life, disrupting her quality of life and sleep quality leading to disturbances in eating behavior and body weight gain. Keywords: Climacteric symptoms, menopausal transition, quality of life, sleep quality, food behavior.

This study aims to investigate the effects of 7 factors (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction), as measured by the Pittsburgh Sleep Quality Index, on the quality of life (QOL) in middle-aged individuals. A total of 194 middle-aged individuals aged 45 to 59 years participated in this study. The Chinese version of the medical outcomes study 36-item short-form health survey and the Pittsburgh Sleep Quality Index were used to assess the QOL and sleep quality, respectively. The relationship between sleep patterns and QOL was analyzed using fuzzy-set qualitative comparative analysis. Improvement in sleep disturbances and reduction in the use of sleeping medications are necessary conditions for enhancing QOL. Two configurations of sleep patterns positively influence QOL: the "sufficiency type" with high level of sleep duration, non-sleep disturbances, and non-daytime dysfunction as core conditions; and the "efficiency type" with high habitual sleep efficiency and non-daytime dysfunction as core conditions. Three configurations of sleep patterns negatively influence QOL: the "low-quality type" with non-high-level subjective sleep quality, sleep duration, and habitual sleep efficiency as core conditions; the "barrier type" with high level of sleep disturbances, non-high-level sleep latency, and non-high-level subjective sleep quality/sleep duration as core conditions; and the "drug-based type" with high level of use of sleeping medications and subjective sleep quality as core conditions. Using the fuzzy-set qualitative comparative analysis method, this study initially reveals that the influence of sleep patterns on QOL in middle-aged individuals is a holistic effect combining multiple elements. This deepens and enriches the understanding of the relationship between sleep patterns and QOL and expands new perspectives for more in-depth research on how to improve the QOL of middle-aged individuals through sleep interventions.

We aimed to assess the sleep quality and the relationship between sleep and fatigue and quality of life in female lipedema patients. A total of 52 patients with lipedema (Group 1) and 40 healthy control subjects (Group 2) were enrolled. The type and stage of lipedema were recorded for Group 1. The quality of sleep was assessed by using the Pittsburgh Sleep Quality Index (PSQI). The Fatigue Severity Scale (FSS) was used for assessing fatigue. Quality of life was assessed with the World Health Organization Quality of Life. The mean age of the patient group was 45.26 ± 9.81, whereas it was 42.10 ± 6.36 years in the control group (p > 0.05). The mean body mass index was 30.23 ± 4.70 in Group 1 and 28.55 ± 4.14 in Group 2 (p > 0.05). The total PSQI score was 10 (range: 7-12.75) in Group 1 and 8 (range: 5-10) in Group 2 (p < 0.05). There was no difference between the groups in terms of FSS. In the assessment of quality of life, only the physical function domain was significantly poorer in Group 1 than in Group 2 (p < 0.05). Physical function was correlated with subjective sleep quality, sleep disorder, and daytime dysfunction; fatigue was correlated with sleep disorder, daytime dysfunction, and use of sleep medications (p < 0.05). There was a correlation between the total PSQI score and physical functioning and fatigue (p < 0.05). Female patients with lipedema have poor sleep quality and decreased quality of life. Sleep disturbance is associated with both physical function and fatigue. Quality of sleep should be questioned in every assessment of patients with lipedema.

Correlation between disease-specific and generic measures of quality of life (QOL) support improvement in nocturnal rhinitis-related QOL in allergic rhinitis (AR) patients treated with triamcinolone acetonide aqueous (TAA AQ) nasal spray

Despite the abundance of literature highlighting poor sleep quality among medical students and its detrimental impact on their mental well-being and academic performance, no study has been conducted to investigate the sleep quality of undergraduate medical students in Rwanda to date. Therefore, this study sought to determine the magnitude of sleep quality of undergraduate medical students in Rwanda and to compare the scores of seven components of sleep quality across classes. This cross-sectional study was conducted among 290 undergraduate medical students aged 18–35 years (mean = 24, SD = 2.9) randomly recruited countrywide from 1st November 2021 to 1st March 2022. The questionnaire was self-administered with 2 sections: characteristics of medical students, and Pittsburgh Sleep Quality Index (PSQI). The Pearson Chi-square test was used to test whether the categories of seven components of sleep quality differ between classes, then ANOVA followed by the post hoc test was used to test if the seven components and global score of Pittsburgh Sleep Quality Index differ between classes. The results revealed that the global PSQI mean score was 7.73 (SD = 2.83), with fifth-year medical students reporting the highest PSQI mean score (M = 8.44, SD = 2.77), followed by first-year (M = 8.15, SD = 3.31). One-way ANOVA showed that the global PSQI score (F = 2.76, p = 0.028), subjective sleep quality (F = 3.35, p = 0.011), habitual sleep efficiency (F = 10.20, p < 0.001), and daytime dysfunction (F = 3.60, p = 0.007) were significantly different across classes. Notably, the post hoc test revealed significant scores differences in the global PSQI score between class II and V (p = 0.026), in subjective sleep quality between class I and II (p = 0.043), and between class I and IV (p = 0.016); habitual sleep efficiency between class V and all other classes (p < 0.001); and daytime dysfunction between class III and IV (p = 0.023). This paper concludes by arguing that poor sleep quality is highly prevalent among medical students in Rwanda, with final and first-year students reporting the poorest sleep quality. There were significant differences across classes in the global PSQI, subjective sleep quality, habitual sleep efficiency, and daytime dysfunction. Intervention approaches such as sleep education, behavioral changes, and relaxing techniques are recommended to address contributing factors and ultimately maximize the academic goals of Rwandan medical students.

Climacteric symptoms and sleep quality

Ramadan is a tenet of Islam and requires four weeks of continuous fasting during daylight hours. Muslims are prohibited from eating, drinking, taking medication, and engaging in sexual activities during the fasting period [1]. Nowadays, the non-Muslim community also has a negligible effect from the arising trend of intermittent diet approach in the replacement of traditionally common dietary strategies but the evidence of to which extent this dietary approach might benefit them is remain questionable [2]. The comorbid stress and fear of being infected and the effect of long COVID will affect the quality of life [3]. This is a novel health condition associated with physical or mental deterioration, fatigue, and cold which refers to “post-COVID conditions (PCC)” following COVID-19 infection [4]. Moreover, the consumption of late meals after performing Taraweeh might increase the nocturnal body temperature which leads to delayed bedtime sleep5. Therefore, this study aims to determine the comparison of sleep quality and quality of life among the healthy adult population in the period before Ramadan and during Ramadan and also to find out the possible correlation between these two parameters.&#x0D; &#x0D; This cross-sectional study was conducted on 106 healthy adult populations in Kuala Nerus. The majority (91.5%) of the respondents were aged 19 to 25 years old and 88 (83.0%) of the respondents were female while the rest, 18 (17.0%) were male. Assessment of sleep quality and quality of life was done in two-time intervals before Ramadan (BR) and during Ramadan (DR). Sleep quality; subjective sleep quality, sleep latency, duration of sleep, habitual sleep efficiency, sleep disturbances, sleep medication consumption, and daytime dysfunction were assessed by using PSQI-M, meanwhile, the SF-36 Malay version was used to evaluate the quality of life; physical functioning, role of limitation due to physical health, role of limitation due to emotional problem, energy/fatigue, emotional well-being, social functioning, pain, and general health. All outcomes were measured twice; before Ramadan (one to two weeks prior to Ramadhan month) and during Ramadan (week 2 to 4 of Ramadhan month).&#x0D; &#x0D; There was a significant improvement in overall sleep quality from the global PSQI score during Ramadan as compared to before Ramadan (6.3±2.0 vs 7.5±2.2, p&lt;0.001) followed by sleep latency (min) (0.9±0.6 vs 1.3±0.6, p&lt;0.001), sleep efficiency (%) (0.4±0.6 vs 0.8±0.9, p&lt;0.001) and sleep disturbances (AU) (M=0.8±0.5 vs 1.0±0.5). The rest sleep quality components were not statistically significant. Quality of life in terms of role limitations due to emotional problems during Ramadan is significantly improved than before Ramadan (84.3±24.4 vs 73.9±38.5, p= 0.010). Meanwhile, the other domains were non-statistically significant (Table 1).&#x0D; This study provides evidence on the benefit of practicing Ramadan fasting among a healthy adult population where sleep quality is statistically significantly higher during Ramadan as well as a statistically significant increase in the role limitation due to emotional problems. The greatest correlation is observed between the global PSQI score and pain which indicate the lower the global PSQI score, the absent the feeling of pain and limitation due to pain in the past 4 weeks during Ramadan. A wider population is suggested for future studies to better understand the benefit of Ramadhan Fasting on overall health.

Network analysis of postpartum depression, sleep problems, psychological birth trauma, and quality of life in women with high-risk pregnancy.

Spouses' support during menopausal transition has an important role for improving the quality of life in postmenopausal women. Since the first step in providing support is having adequate knowledge, this study aimed to investigate the effects of an educational program on menopause health for spouses on women's quality of life during the menopausal transition. This clinical trial was conducted in Yazd, Iran. A hundred healthy women aged 45 to 60 years were recruited by random sampling. The spouses in the intervention group (n = 50) attended three training sessions about the management and health of menopausal transition. The spouses in the control group (n = 50) did not receive any intervention. Knowledge and performance about menopausal health were assessed in all spouses before and 3 months after intervention. All women were assessed by the Menopause Rating Scale, and the Menopause Quality of Life questionnaire before and 3 months after educational intervention. Analyses were carried out using SPSS 16 software. The level of significance was set at P less than 0.05. The knowledge and performance of spouses in the intervention group were significantly higher 3 months after intervention (P < 0.0001). The quality of life in women in the intervention group was higher 3 months after intervention (P < 0.0001). The mean scores of psychological and physical domains were significantly lower in the intervention group (P = 0.002 and P = 0.001, respectively). The training of menopausal health for spouses improves the quality of life in women during menopausal transition. We suggest integrating such educational programs in menopausal management programs.

Background:Chronic kidney disease (CKD)-associated pruritus (CKD-aP) contributes to poor quality of life, including reduced sleep quality and poor sleep quality is a source of patient stress and is linked to lower health-related quality of life. This study aimed to investigate the effectiveness of zolpidem 10 mg and acupressure therapy on foot acupoints to improve the sleep quality and overall quality of life among hemodialysis patients suffering from CKD-aP.Method:A multicenter, prospective, randomized, parallel-design, open label interventional study to estimate the effectiveness of zolpidem (10 mg) oral tablets versus acupressure on sleep quality and quality of life in patients with CKD-aP on hemodialysis. A total of 58 hemodialysis patients having sleep disturbance due to CKD-aP completed the entire 8-week follow-up. The patients were divided into a control (acupressure) group of 28 patients and an intervention (zolpidem) group of 30 patients.Results:A total of 58 patients having CKD-aP and sleep disturbance were recruited. In the control group there was a reduction in the PSQI score with a mean ± SD from 12.28 ± 3.59 to 9.25 ± 3.99, while in the intervention group the reduction in PSQI score with a mean ± SD was from 14.73 ± 4.14 to 10.03 ± 4.04 from baseline to endpoint. However, the EQ5D index score and EQ-visual analogue scale (VAS) at baseline for the control group with a mean ± SD was 0.49 ± 0.30 and 50.17 ± 8.65, respectively, while for the intervention group the values were 0.62 ± 0.26 and 47.17 ± 5.82, respectively. The mean EQ5D index score in the control group improved from 0.49 ± 0.30 to 0.53 ± 0.30, but in the intervention group there was no statistical improvement in mean EQ5D index score from 0.62 ± 0.26 to 0.62 ± 0.27 from baseline to week 8. The EQ 5D improved in both groups and the EQ-VAS score was 2.67 points higher at week 8 as compared to baseline in the control group, while in the intervention group the score was 3.33 points higher at week 8 as compared to baseline. Comparing with baseline, the PSQI scores were significantly reduced after week 4 and week 8 (P = < .001). Furthermore, at the end of the study, the PSQI scores were significantly higher in the control as compared to the intervention group (P = .012).Conclusion:An improvement in sleep quality and quality of life among CKD-aP patients on hemodialysis has been observed in both the control and intervention groups. Zolpidem and acupressure safety profiling showed no severe adverse effect other that drowsiness, nausea and daytime sleeping already reported in literature of zolpidem.

This study used contemporaneous networks and cross-lagged panel network (CLPN) to examine how the Simplified Sitting Badunjin (SSBDJ) intervention interacted with the fatigue, sleep disturbances, and quality of life (QoL) at different follow-up stages in advanced cancer patients. This was a secondary analysis of a randomized controlled trial. Data were collected at baseline (T0), 4weeks (T1), 8weeks (T2), 12weeks (T3) of the intervention, and 4weeks (T4) after the intervention. A total of 3 constructs with 16 dimensions (fatigue severity, fatigue interference, sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, physical discomfort, food related concerns, healthcare concerns, support, negative emotions, existential distress, sense of alienation, value of life) were included in the symptom network, which consists of contemporaneous and cross-lagged panel networks. A total of 175 participants were included in the network analysis. Within the contemporaneous network, "Fatigue interference" emerged as the central symptom in both the intervention and control groups (intervention group: EI value = 1.249 (T1), 2.610 (T2); control group: EI value = 1.462 (T1), 1.950 (T2)). In the longitudinal network analysis, SSBDJ was strongly negatively associated with fatigue severity and interference at T0 → T1 (β = -0.497, -0.504) and T1 → T2 (β = -0.210, -0.256). Additionally, fatigueconsistently served as a central node within the networks, demonstrating the highest out-expected influence across 12-week intervention period. The impact of fatigue (out-EI: r = 2.641) on sleep disturbances and quality of life tended to exert independent influencein the mid stage of intervention (T2 → T3). Furthermore, fatigue (out-predictability: r = 1.993) remained a dominant predictor of sleep disturbances and quality of life even after the intervention (T3 → T4). This study enhances the understanding of the longitudinal relationships between the SSBDJ intervention, fatigue, sleep disturbances, and QoL among patients with advanced cancer. It could provide an important insight for designing precise symptom management strategies in mind-body exercise interventions among this population.

Fatigue was a common symptom of non-alcoholic fatty liver disease (NAFLD), which seriously affected patients' quality of life. The aim of this study was to detect fatigue rate and to evaluate factors associated with fatigue in NAFLD patients. A cross-sectional study was carried out from the Huadong Sanatorium between April 2022 and May 2023, and 133 NAFLD patients were included in this study. They completed Fatigue Severity Scale to assess fatigue, the Hospital Anxiety and Depression Scale to estimate psychological status, and the Pittsburgh Sleep Quality Index for sleep quality. Data were analyzed by independent samples t-tests, χ2 tests and logistic regression models. We found that 51.1% of NAFLD patients had fatigue. Exercise, anxiety, depression, subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disorders, daytime dysfunction and overall sleep quality were related to fatigue among NAFLD patients. Moreover, logistic regression models indicated anxiety, habitual sleep efficiency and sleep disorders as important predictors of fatigue. This was the first time to explore demographic, clinical, psychological and sleeping correlated factors for fatigue in Chinese NAFLD patients. Our study showed that more than half of NAFLD patients had fatigue, and anxiety, habitual sleep efficiency and sleep disorders were significantly associated with fatigue in NAFLD. The findings indicated that it was very necessary to pay more attention to fatigue of NAFLD patients, especially those with negative emotions and poor sleep quality by favorable intervention to relieve fatigue symptoms, so as to improve quality of life.

BackgroundBoth sleep time and quality can be associated with overweight or obesity. In obese people, visceral fat tissue develops, which results in an increment in the production of cytokines. The increased production of inflammatory cytokines can disturb the sleep/wake cycle. Therefore, weight loss by reducing fat tissue can improve sleep disorders. Intermittent fasting diets are popular and effective diets that can decrease body weight and improve anthropometric data and body composition. The present study aimed to evaluate the effect of Alternate-day Modified Fasting (ADMF) on sleep quality, body weight, and daytime sleepiness.MethodsClassification of 56 obese or overweight women, based on age and body mass index (BMI), was done using stratified randomization. Then individuals were assigned to the ADMF group (intervention) or Daily Calorie Restriction (CR) group (control) using the random numbers table for 8 weeks. We measured the Pittsburgh sleep quality Index (PSQI), weight, BMI, and the Epworth sleepiness scale (ESS) as primary outcomes and assessed subjective sleep quality (SSQ), sleep latency, sleep disturbances, habitual sleep efficiency, daytime dysfunction, and sleep duration as secondary outcomes at baseline and after the study.ResultsFollowing an ADMF diet resulted in a greater decrease in weight (kg) [−5.23 (1.73) vs. −3.15 (0.88); P < 0.001] and BMI (kg/m2) [−2.05 (0.66) vs. −1.17 (0.34); P < 0.001] compared to CR. No significant differences were found in the changes of PSQI [−0.39 (1.43) vs. −0.45 (1.88); P = 0.73] and ESS [−0.22 (1.24) vs. −0.54 (1.67); P = 0.43] between two groups. Also, following the ADMF diet led to significant changes in SSQ [−0.69 (0.47) vs. −0.08 (0.40); P = <0.001], and daytime dysfunction [−0.65 (0.57) vs. 0.04 (0.75); P: 0.001] in compare with CR diet.ConclusionThese results suggested that an ADMF could be a beneficial diet for controlling body weight and BMI. The ADMF diet didn’t affect PSQI and ESS in women with overweight or obesity but significantly improved SSQ and daytime dysfunction.Clinical Trial RegistrationThe Iranian Registry of Clinical Trials (IRCT20220522054958N3), https://www.irct.ir/trial/64510.

Silva-Batista, C, de Brito, LC, Corcos, DM, Roschel, H, de Mello, MT, Piemonte, MEP, Tricoli, V, and Ugrinowitsch, C. Resistance training improves sleep quality in subjects with moderate Parkinson's disease. J Strength Cond Res 31(8): 2270-2277, 2017-The objectives of this study were to test if 12 weeks of progressive resistance training (RT) improves sleep quality and muscle strength in subjects with moderate Parkinson's disease (PD) and if sleep quality values of subjects with moderate PD are closer to those of age-matched healthy controls (HC) at posttraining. This was a randomized controlled trial conducted between March 2013 and September 2014. Twenty-two subjects with moderate PD were randomly assigned to a nonexercising control group (n = 11) or an RT group (n = 11). Thirty-one HC were not randomized to any group. The RT group performed a RT program twice a week for 12 weeks, whereas the control group made no change to their weekly routine. For subjects with PD, sleep quality (i.e., Pittsburgh Sleep Quality Index [PSQI]) and knee-extensor peak torque were assessed before and after 12 weeks of intervention; for HC, these outcomes were assessed at pretest only. There were differences between RT and control groups in PSQI scores, PSQI subscores(i.e., subjective sleep quality and daytime dysfunction), and knee-extensor peak torque at posttraining (p ≤ 0.05). After RT, the average subjects with PD showed lower (i.e., improved) PSQI scores than the average HC (p ≤ 0.05). A negative association was observed between changes in PSQI scores and changes in knee-extensor peak torque at posttraining (r = -0.58, p = 0.028). No adverse events were reported. The RT is recommended as an adjunct therapeutic method for improving sleep quality of subjects with moderate PD and moving these levels to those observed in HC.

Sleep is a vital requirement during pregnancy for the betterment of the fetus and the mother. Sleep quality could vary due to pregnancy-specific psychological and physiological changes. To introduce a tailored programme to enhance the sleep quality of mothers, it is paramount to assess the sleep quality and determinants of sleep. Therefore, this study aimed to assess the determinants of sleep quality among pregnant women in a selected institution in the Southern province of Sri Lanka. Hospital-based cross-sectional study was carried out with 245 antenatal women, selected using a systematic random sampling method. A pretested self-administered questionnaire was used to collect data which contains four parts. Below variables were involved and both continuous and categorical data were collected as required. 'Maternal sleep quality, socio-demographic data and gestational age, maternal depression and anxiety.' Data were analyzed using IBM SPSS version 25.0 for Windows by using descriptive statistics, Pearson's Chi-square test, and independent sample T-test (p < 0.05). Logistic regression analysis was used to find the relationship with sleep quality and other variables. P-value of less than 0.05 was considered statistically significant, at 95% CI. The majority of women (60.8%) had good sleep quality and they didn't have either depressive symptoms (63.4%) or anxiety (64.2%). Aged between 34-41 years and third-trimester women had higher rates of poor sleep quality. Varying quality of sleep was identified among three-trimesters with subjective sleep quality, sleep latency, habitual sleep efficiency, and sleep disturbances. In comparison with the first and second trimester, pregnant women in the third trimester had higher score of global PSQI (5.22 ± 2.35), subjective sleep quality (1.23 ± 0.70), sleep latency (1.25 ± 0.86), habitual sleep efficiency (0.14 ± 0.43), and sleep disturbances (1.39 ± 0.58). There was a significant association between gestational age (P = .006), maternal age (P = .009), antenatal depression (P = .034), and anxiety (P = .013) with sleep quality. However, multinomial logistic regression revealed that only gestational age affected on quality of sleep. The first trimester was a protective factor for good quality sleep (Adjusted OR = 3.156) compared to the other two trimesters. This study revealed that the majority of women had good sleep quality but quality of sleep was deprived with gestational age. It is expected that the findings of this research will be helpful for health and social care policymakers when formulating guidelines and interventions regarding improving the quality of sleep among pregnant women in Sri Lanka.