Association Of Sleep Disturbance Research Articles

Sleep quality and cardiovascular risk in the watch setting in the Far North

Background. The study shows gender differences in sleep quality and also association of sleep disturbances (SD) with cardiovascular diseases (CVD). The watch work contributes to the biorhythms of the body disorders, including SD. Autonomous nervous system is the key regulator of circadian rhythms.Aim: To study sleep quality (SQ) in the gender aspect and cardiovascular risk in the workers of the Far North watch.Material and methods. In Yamburg, the settlement in the Far North (68° 21’ 40” north latitude), 99 males (M) and 81 females (F) with SD and normal sleep, comparable in age, northern experience, level of office blood pressure (BP) were examined. SQ analysis was conducted according to the questionnaire (Pittsburg Sleep Quality Index – PSQI). 24-hour BP monitoring, biochemical blood analysis, ultrasound examination of the carotid arteries, echocardiography, and assessment of autonomic changes was performed.Results. M significantly more often than F assessed their sleep subjectively better (p = 0.046); M and F with SD had elevated variability of systolic BP at night (p = 0.036; p = 0.039), BP 24-hour profile disorder did not depend on SQ (p = 0.2607), SD in both genders was accompanied by the increase of volumes and indices of left atrium (p = 0.0285; p = 0.0445), enhanced probability of left ventricle diastolic dysfunction for 1.9 times. SD in F enhanced the level of insulin (p = 0.0267), С-peptide (p = 0.0424), NTpro-BNP (p = 0.042) and was accompanied by autonomic dysfunction.Conclusion. In the conditions of the Arctic watch, SD is often revealed in F, is accompanied by the signs of autonomic dysfunction, more evident in F. 24-hour BP profile disorder typical for the watch work is not connected with SQ and more evident in M. SD in both genders is associated with atrial remodeling, the formation of diastolic dysfunction, but an increase in the frequency of atherosclerotic lesions of the carotid arteries, an increase in vascular inflammation factors, metabolic disorders, and neurohumoral activation, more pronounced in F, which may determine an increased risk of CVD in F in Arctic watch work conditions.

Association of Sleep Disturbances With Brain Amyloid and Tau Burden, Cortical Atrophy, and Cognitive Dysfunction Across the AD Continuum.

Patients with Alzheimer disease (AD) frequently suffer from various sleep disturbances. However, how sleep disturbance is associated with AD and its progression remains poorly investigated. We investigated the association of total sleep time with brain amyloid and tau burden, cortical atrophy, cognitive dysfunction, and their longitudinal changes in the AD spectrum. In this retrospective cohort study, we enrolled participants on the AD spectrum who were positive on 18F-florbetaben (FBB) PET. All participants underwent the Pittsburgh Sleep Quality Index, brain MRI, FBB PET, 18F-flortaucipir (FTP) PET, and detailed neuropsychological testing. In addition, a subset of participants completed follow-up assessments. We analyzed the association of total sleep time with the baseline and longitudinal FBB-standardized uptake value ratio (SUVR), FTP-SUVR, cortical thickness, and cognitive domain composite scores. We examined 138 participants on the AD spectrum (15 with preclinical AD, 62 with prodromal AD, and 61 with AD dementia; mean age 73.4 ± 8.0 years; female 58.7%). Total sleep time was longer in the AD dementia group (7.4 ± 1.6 hours) compared with the preclinical (6.5 ± 1.4 hours; p = 0.026) and prodromal groups (6.6 ± 1.4 hours; p = 0.001), whereas other sleep parameters did not differ between groups. Longer total sleep time was not associated with amyloid accumulation but rather with tau accumulation, especially in the amygdala, hippocampus, basal forebrain, insular, cingulate, occipital, inferior temporal cortices, and precuneus. Longer total sleep time predicted faster tau accumulation in Braak regions V-VI (β = 0.016, p = 0.007) and disease progression to mild cognitive impairment or dementia (hazard ratio = 1.554, p = 0.024). Longer total sleep time was also associated with memory deficit (β = -0.19, p = 0.008). Prolonged total sleep time was associated with tau accumulation in sleep-related cortical and subcortical areas as well as memory dysfunction. It also predicted faster disease progression with tau accumulation. Our study highlights the clinical importance of assessing total sleep time as a marker for disease severity and prognosis in the AD spectrum.

Sleep behaviors predicted sleep disturbances among Chinese health science students: a cross-sectional study.

Healthy sleep is essential for individuals' physiological and psychological health. Health science students experience a high prevalence of sleep disturbances which may be due to maladaptive behaviors. This study aimed to examine the associations of sleep behaviors including sleep hygiene and bedtime procrastination with the associations of sleep disturbances (e.g., poor sleep quality, insomnia, and short sleep). This cross-sectional study included health science students from a medical university in Shanghai, China. Sleep disturbances included poor sleep quality, insomnia, and short sleep. They were measured by the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and one question "How many hours of sleep did you usually get during the past week?", respectively. Sleep behaviors included sleep hygiene and bedtime procrastination measured by the Sleep Hygiene Index (SHI) and Bedtime Procrastination Scale (BPS), respectively. Logistic regression was performed while controlling for potential confounders. A total of 464 health science students participated.Poorer overall sleep hygiene and more bedtime procrastination were independently associated with higher odds of poor sleep quality (OR=1.065, 95% CI 1.028-1.103; OR=1.040, 95% CI 1.006-1.075, respectively) and insomnia (OR=1.059, 95% CI 1.018-1.101; OR=1.093, 95% CI 1.049-1.139, respectively). More bedtime procrastination was associated with higher odds of short sleep (OR=1.148, 95% CI 1.093-1.206). Commonly reported specific sleep behaviors, such as "Going to bed later than intended", "Doing other things than sleep at bedtime", and "Easily stopping what I am doing at bedtime", were also related to higher odds of sleep disturbances. Sleep hygiene and bedtime procrastination were strong predictors of sleep disturbances. Tailored interventions targeting specific sleep behaviors are warranted to clarify their effect on sleep disturbances.

Associations of sleep disturbances with cognitive function and plasma Alzheimer’s biomarkers in Chinese rural‐dwelling older adults: A population‐based study

AbstractBackgroundSleep disturbances have been associated with cognitive impairment, but their associations with plasma Alzheimer’s disease (AD) biomarkers have been rarely explored. We sought to investigate the relationships of self‐reported and cardiopulmonary coupling (CPC)‐assessed sleep disturbances, cognitive function, and plasma AD biomarkers among rural‐dwelling older adults in China.MethodThis population‐based cross‐sectional study included 1987 dementia‐free individuals (age ≥60 years, 55.0% women) who participated in the CPC‐substudy as part of the baseline assessments of the MIND‐China Study; of these, 830 had data on plasma Aβ42, Aβ40, total‐tau, and neurofilament light chain (NfL) that were measured using the single molecule array (SIMOA) technology. We collected data via face‐to‐face interviews, clinical examinations, and neuropsychological test. Sleep disturbances were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the self‐administered Berlin Questionnaire, and the ECG‐based CPC analysis. We used the neuropsychological test battery to assess memory, language, attention, and executive function. Data were analyzed using logistic and general linear regression models.ResultOf the 1987 participants, CPC‐measured total sleep time (TST) >8 hours/night (vs. 5‐8 hours) was significantly associated with a lower composite z‐score of memory (β = ‐0.080; 95% CI = ‐0.160 ‐ ‐0.001), language (‐0.114; ‐0.186 ‐ ‐0.042), attention (‐0.104; ‐0.175 ‐ ‐0.033), and executive function (‐0.117; ‐0.193 ‐ ‐0.041). Self‐reported poor sleep quality was associated with a lower composite z‐score of attention function (β = ‐0.077; 95% CI = ‐0.143 ‐ ‐0.011). Self‐reported excessive daytime sleepiness (EDS) was associated with a lower composite z‐score of memory (β = ‐0.217; 95% CI = ‐0.350 ‐ ‐0.084), language (‐0.182; ‐0.303 ‐ ‐0.061), and attention function (‐0.162; ‐0.282 ‐ ‐0.041). In the plasma biomarker subsample, CPC‐measured TST >8 hours/night was significantly associated with lower plasma Aβ42/Aβ40 ratio (β = ‐0.522; 95% CI = ‐0.764‐ ‐0.281) and higher plasma concentrations of Aβ40 (13.419; 6.515‐20.323), total‐tau (0.216; 0.071‐0.360), and NfL (0.071; 0.002‐0.140). There was no significant association between CPC‐measured apnea hypopnea index (AHI) and plasma AD biomarkers (P>0.05).ConclusionLong sleep duration and self‐reported EDS were associated with poor memory, language, and attention function among older adults, in which AD pathology and neurodegeneration may be the common pathways linking sleep disturbances with cognitive impairment.

0745 Sleep Characteristics and Cardiovascular Disease Risk Among Midlife Thai Women

Abstract Introduction Sleep disturbances (i.e. poor sleep quality, low sleep efficiency, and Obstructive Sleep Apnea (OSA)) are common during menopausal transition and menopause. These disturbances are associated with increased risk of cardiovascular disease (CVD), obesity, hypertension, and diabetes. However, the association of sleep disturbances and CVD risk among midlife Thai women, living in the US, have not been fully explored. Thus, this study examined the association between sleep characteristics and CVD risk in those women. Methods In this cross-sectional study, 120 midlife Thai women completed the Pittsburgh Sleep Quality Index (PSQI), Berlin questionnaire, and Menopause Rating Scale. The main outcome, 10-year risk of CVD, was determined using the BMI-based Framingham Risk Score (FRS). Descriptive, bivariate, robust regression, and Structural Equation Model (SEM) analysis for mediation model were performed using STATA 15.1. Results Among participants, their mean age was 51.53 years (SD=7.73), length of stay in the USA was 21.77 years (SD=12.96) and CVD risk score was 6.56 % (SD=5.74). Twenty participants (17%) were at high risk of CVD. The mean subjective sleep quality measured by PSQI was 4.18 (SD=3.03). The majority of participants were good sleepers (n=97, 80.83%). The mean sleep efficiency was 95.36% (SD=5.96). A small portion of the participants had a high risk of OSA as assessed by Berlin questionnaire (n=17, 14.17%). Among sleep characteristics, only the increased risk of OSA was significantly associated with higher CVD risk (B=4.601, p< 0.001). Conclusion The findings of this study indicated that an increased risk of OSA is associated with the risk of CVD among midlife women. Sleep duration, sleep quality, or sleep efficiency neither mediated nor moderated CVD risk. Future studies should use objective measures of sleep, such as actigraphy, to better elucidate the effects of sleep parameters on cardiovascular risk. Support (if any)

Association of Sleep Disturbance With Catastrophizing and Knee Pain: Data From the Osteoarthritis Initiative.

To investigate the relationship between sleep disturbance, catastrophizing, and knee pain in middle-aged and older individuals. Data from the Osteoarthritis Initiative cohort from months 48 to 96 were used, where month 48 was treated as baseline. Knee pain (Western Ontario and McMaster Universities Osteoarthritis Index pain scale score ≥5 [range 0-20]), catastrophizing (extracted from Coping Strategies Questionnaire score ≥3 [range 0-6]), and sleep quality (extracted from Center for Epidemiologic Studies Depression Scale [range 1-4]) were assessed annually. We described the association of sleep disturbance with the presence and risk of knee pain and catastrophizing. The mediation effect of knee pain and catastrophizing on the sleep-catastrophizing and sleep-pain association was evaluated, respectively. Catastrophizing and knee pain were reported in 346 (10%) and 917 (24%) of the 3,813 participants (mean 64.9 years, 58% female) at baseline. Participants with worse sleep disturbance were more likely to have knee pain (prevalence ratio [PR] 1.4-2.0, P for trend <0.001) and catastrophizing (PR 1.4-3.1, P for trend <0.001). Sleep disturbance at baseline predicted the risk of knee pain (risk ratio [RR] 1.1, P for trend <0.001) and catastrophizing (RR 1.2-1.7, P for trend <0.001) during follow-up. No statistically significant interactions between sleep disturbance and knee pain or catastrophizing were observed. Knee pain and catastrophizing mediated the sleep-catastrophizing and sleep-pain association, respectively, at baseline, and knee pain negatively mediated the sleep-catastrophizing association longitudinally. Sleep disturbance was associated with the presence and risk of catastrophizing and knee pain. Sleep interventions may have a universal and independent effect in preventing incident knee pain.

Sleep Disturbances in At-Risk Mental States and First Episode of Psychosis: A Narrative Review on Interventions.

Sleep disturbances are a common yet often overlooked symptom of psychosis that can drastically affect the quality of life and well-being of those living with the condition. Sleep disorders are common in people diagnosed with schizophrenia and have significant negative effects on the clinical course of the illness and the functional outcomes and quality of life of patients. There is a limited number of studies addressing this question in first-episode psychosis (FEP). In this narrative review, we aimed to provide an overview of sleep disorders in populations with FEP and at-risk mental states (ARMS). The review was focused on the various treatments currently used for sleep disorders, including both non-pharmacological and pharmacological treatments. A total of 48 studies were included. We found that sleep disturbances are associated with attenuated psychotic symptoms and other psychopathological symptoms in ARMSs. The association of sleep disturbances with the transition to psychosis has been poorly investigated. Sleep disturbances have an impact on the quality of life and the psychopathological symptoms of people suffering from FEP. The non-pharmacological treatments include cognitive behavioral therapy for insomnia, bright light therapy, cognitive restructuring techniques, sleep restriction therapy, basic sleep hygiene education, and the provision of portable sleep trackers. Other treatments include antipsychotics in acute phases and melatonin. The early intervention in sleep disturbances may improve overall prognosis in emerging psychosis populations.

Association of Sleep Disturbance With Neurocognition, Symptom Severity, and Recovery in Pediatric Concussion: A 10-Year Retrospective Analysis of a Tertiary Referral Concussion Clinic.

To investigate the relationship between sleep disturbance, neurocognition, symptom severity, and recovery in children and adolescents with concussion. Sex-related comparisons were also examined. Pediatric tertiary referral concussion clinic. Children and adolescents (aged 6-18 years; n = 554) diagnosed with concussion. Cross-sectional retrospective study. Assessment data were obtained from Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) Applications. Sleep disturbance was quantified using the sleep-related domains of the Post-Concussion Symptom Scale (PCSS) and self-report sleep duration. Sleep duration was categorized as short (<7 hours), intermediate (7-9 hours), and long (≥9 hours). Outcome measures included neurocognition, measured via composite scores of ImPACT cognitive domains (verbal memory, visual memory, visual motor speed, reaction time); symptom severity, using the PCSS; and concussion recovery time (days). Short sleep resulted in significantly poorer verbal memory ( P = .03), visual memory ( P = .02), and reaction time ( P = .01). Sleep disturbance was strongly associated with total symptom burden (ρ = 0.90, P < .001). Recovery time, median (interquartile range), was significantly prolonged with short sleep, 61 (30-136) days, compared with intermediate, 38 (21-72) days, and long, 34 (19-71) days, sleep ( P < .001). Overall, female participants demonstrated significantly longer recovery times than male participants (mean 91 ± 95 vs 58 ± 85 days, P < .001). Females exhibited similar concussion recovery times irrespective of reported sleep duration ( P = .95), whereas mean recovery time in males was significantly longer with short sleep (84 ± 82 days) than with intermediate (61 ± 106 days) and long (49 ± 62 days) sleep ( P < .001). Sleep disturbance following concussion poses as a promising modifiable risk factor to alleviate postinjury impairments, including cognitive deficits and symptom burden. Female children were found to experience more severe concussion symptoms and protracted recovery times than their male counterparts. Investigations into the factors that may contribute to sex-related differences following concussion are warranted.

Association of sleep disturbance with shift work, occupational stress, and musculoskeletal pain in Chinese public hospital emergency workers: A multicentre cross-sectional study

ABSTRACT Poor sleep, which is reportedly prevalent among healthcare professionals, could lead to various detrimental consequences. This study aimed to investigate the sleep quality of individuals working in emergency departments of public hospitals in China and explore the potential factors influencing sleep disturbance. A self-administered questionnaire was completed by 7688 emergency workers from 147 public hospitals in Shandong, China. Log-binomial regression analysis was performed to explore the relationship of sleep disturbance with possible influencing factors, including individual and work characteristics, occupational stress, shift work, and musculoskeletal pain. The participants’ mean Pittsburgh Sleep Quality Index score was 9.6 ± 4.8, with 5341 (69.5%, 68.2–70.7%) of them experiencing sleep disturbance. The sleep quality was poorer in doctors (10.2 ± 5.1, 71.0%, 69.0–73.0%) than in nurses (9.2 ± 4.5, 68.6%, 67.0–70.1%), and poorer in those working in secondary (9.9 ± 4.5, 70.2%, 68.0–72.3%) and tertiary (12.2 ± 4.9, 77.5%, 75.3–79.7%) hospitals than in primary hospitals (8.0 ± 4.1, 64.6%, 62.6–66.6%). High prevalence of sleep disturbance was significantly associated with shift work, occupational stress, musculoskeletal pain, fewer breaks in a work shift, and less exercise during leisure time, after adjusting for confounding variables. Sleep disturbance occurred in emergency workers in the following order: two-shift rotation > three-shift rotation > permanent night shift > permanent day shift. Emergency workers in public hospitals in China had poor sleep quality and commonly experienced musculoskeletal pain. Urgent and comprehensive measures are needed to combat these issues.

Association of Sleep Disturbances with Body Mass Index and Age in Adult Participants

The aim of this study was to examine the association between sleep disturbances, as an indicator of sleep quality, Body Mass Index, and age in adult participants. The study involved 73 participants (62 women and 11 men) with an average age of 35.74 years. Through an online questionnaire, we collected the data on participants’ height, body mass, gender, and sleep disturbances. Based on their height and mass, we calculated the Body Mass Index as an indicator of body fat for each participant. We used items from a shorter version of the Pittsburgh Sleep Quality Index to assess sleep disturbances. Participants were asked to answer how often they experienced different disturbances while falling asleep or sleeping in the last month. The results of the study indicated an association between sleep disturbances and Body Mass Index. Compared to participants who rarely experienced sleep disturbances, participants with frequent disturbances were more likely to have a high Body Mass Index (indicating excess mass or obesity). Although older participants in most cases had a high Body Mass Index compared to younger participants, no significant association was found between sleep disturbances and age. The results of the study also suggest that the association between sleep disturbances and Body Mass Index did not depend on the age of the participants. The research findings indicate that in addressing the issues of obesity and excess mass, public health attention should also be given to sleep quality issues.

The Association of Sleep Disturbance and Suicide Risk Among Firefighters: Exploring Emotion Regulation Dimensions

Aim This study explored the extent to which emotion regulation dimensions statistically mediate the association between sleep disturbance and suicide risk among firefighters. Method Participants were 865 firefighters working for a fire department in an urban area in the southern U.S. Bootstrapping was used to test the indirect effects of sleep disturbance on suicide risk through emotion regulation dimensions, after controlling for depression and trauma exposure Results The effect of sleep disturbance on suicide risk was significantly statistically mediated by emotion regulation difficulties (β= .09, SE = .02, 95% CI: .05, .14). Moreover, each of the five dimensions of emotion regulation difficulties significantly statistically mediated this association, with difficulties in engaging in goal-direct behavior (β = .09, SE = .02, 95% CI: .05, .14) and lack of strategies to reduce distress demonstrating the strongest indirect effects (β = .07, SE = .02, 95% CI: .04, .11), after accounting for depression and trauma exposure. Conclusion Results suggest that suicide interventions for firefighters who suffer from sleep disturbance should focus on the development of emotion regulation strategies.

Association of sleep disturbances with geriatric age in atopic dermatitis patients

Association of sleep disturbances with geriatric age in atopic dermatitis patients

R4. Association of Sleep Disturbance and Pain in Chronic Low Back Pain: Subjective and Objective Sleep Indicators

Sleep disturbance in chronic low back pain (CLBP) is a common problem, which may intensify pain. Few studies have examined subjective (self-assessment) and objective (wrist actigraphy) measures of sleep simultaneously. This study aimed to evaluate the association between pain experience in CLBP and sleep disturbance, using subjective and objective sleep indicators. CLBP (N=69; mean age 56±12 yrs;57% female) patients were enrolled and self-report measures of sleep indicators (quality, disturbance) Pittsburgh Sleep Quality Index (PSQI), sleep diary (SD) and pain experiences (severity and interference with activities) using Brief Pain Inventory (BPI) obtained. All participants completed PSQI and SD for average of six nights. A subset of the sample (N=13; mean age 55±9 yrs.; 92% female) tracked their sleep for six nights using a wrist actigraphy (WA). Eighty five percent of the total sample had mean PSQI scores at or above the cut-score indicating poor sleep. Individuals who reported greater PSQI sleep disturbance also recorded greater sleep awakening (r=.4, p=.002) and feeling less rested upon awakening (r=-.35, p=.013) in their sleep diaries. Greater pain severity was associated with greater sleep disturbance (r=.59, p=.000) and with poorer sleep quality (r=-.26, p= 0.06) and feeling less rested (r=-.29, p= 0.03). Likewise, greater pain interference was associated with greater sleep disturbance (r=.45, p=.000) and with poor sleep quality (r=-.32, p= 0.019) and feeling less rested (r=-.32, p= 0.019). Sub-group analysis of wrist actigraphy data were consistent with poor sleep quality which revealed increased sleep latency (28.12+13.1 min), lower sleep efficiency (80.86+6.8%), and increased awakenings after sleep onset (49.11±23.9), relative to normative values. Findings demonstrate that CLBP patients who reported greater sleep disturbance experienced greater pain severity and greater pain interference with activities. Actigraphy data adds insight to understand sleep disturbances. Including assessment and management of sleep disturbance will provide for more comprehensive management in CLBP.

Association between Sleep Quality and Gastroesophageal Reflux in Medical Students.

BACKGROUND Due to stressful occupational conditions, irregular dietary and sleep schedules, medical students are at increased risk of developing gastrointestinal disorders, gastroesophageal reflux (GERD) in particular, as well as sleep disturbances. Therefore, for the first time, we aimed to assess the correlation between GERD and sleep disturbances among medical students. METHODS The current cross-sectional study was done on 290 medical students at different study periods in Iran during 2018-2019. Age, sex, stage of studying, residence, and body mass index were gathered. The frequency scale for the symptoms of gastroesophageal reflux (FSSG) was utilized to assess gastrointestinal symptoms among them and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Eventually, the association of sleep disturbances with demographic factors and gastrointestinal symptoms was evaluated. RESULTS Living in the dormitory (p = 0.048; OR: 1.73; 95%CI: 1.01-2.99) and being overweight (p < 0.001; OR: 3.09; 95%CI: 1.58-6.06) were independently correlated with impaired sleep quality. GERD presented either by heartburn (p < 0.001) or regurgitation (p < 0.001) was associated with a lower quality of life. CONCLUSION GERD was correlated with poor sleep quality among medical students. In addition, residence in dormitory and being overweight were correlated with poor sleep quality.

Assessment of Depression, Anxiety, and Sleep Disturbance in COVID-19 Patients at Tertiary Care Center of North India.

Background and Objective The novel Coronavirus pandemic surfaced in Wuhan, China in December 2019 and spread rapidly across the globe. In recent available literature, most of the studies were done to estimate the burden of psychiatric problems among general population due to this pandemic, Therefore, this study was planned to assess depression, anxiety, and sleep disturbance among Coronavirus disease-2019 (COVID-19) patients. Materials and Methods A hospital-based, cross-sectional study was done from June 2020 to August 2020 among 100 COVID-19 patients who were admitted and fulfilled the inclusion criteria. Assessment of depression, anxiety, and sleep disturbance were done by patient health questionnaire-9 (PHQ-9) scale, generalized anxiety disorder-7 (GAD-7) scale and Pittsburg sleep quality index (PSQI), respectively. Results In this study, 73% were males and 27% were females. The mean age of the patients in present study was 42.90 ± 16.33 years. This study reveals that depression was in 27%, anxiety in 67%, and sleep disturbance in 62% of patients. Depression and anxiety were found significantly associated with presence of comorbidity and severity of illness ( p < 0 0.05). The association of sleep disturbance with severity of illness was also found statistically significant ( p < 0.05). Conclusion The risk of psychological stress is high in COVID-19 patients. The psychological problems among COVID-19 patients are commonly related to the consequences of disease, and severity and contagiousness of the disease. Therefore, in this present pandemic situation, it is more important to identify these psychological problems among COVID-19 patients, so that better care and timely interventions can be done with respect to psychological issues.

Association of sleep disturbances and craniofacial characteristics in children with class ii malocclusion: An evaluative study.

Behaviour problems, poor academic performance and failure to thrive are some of the potential sequelae of sleep problems in children. Hence, there is a need to evaluate the prevalence of sleep problems and significant associations in children with skeletal class II malocclusion with mandibular retrognathism. This study aimed to determine associations if any between sleep practices and problems and craniofacial characteristics in children with skeletal class II malocclusion with mandibular deficiency. A cross-sectional study was conducted among a group of children with skeletal class II malocclusion with mandibular retrognathism. Fifty children aged 8-14 years with skeletal class II with mandibular retrognathism and who required myofunctional therapy were selected. A validated sleep questionnaire assessed the sleep practices and problems. A detailed clinical examination including tonsils and evaluation for mouth breathing was performed. A lateral cephalogram recorded specific linear, angular variables as well as upper and lower pharyngeal airway space. Descriptive statistics, frequency, and percentages were calculated, and the Chi-square test was used. All children reported at least one sleep problem, with snoring reported by 76% of the children. Forty-two percent of the children showed a decreased upper airway, whereas 80% showed a decreased lower airway. Significant associations were seen between SN-MP and noisy breathing, upper airway, and snoring with a P value of 0.017. We also found significant associations between upper and lower airway and sleep positions with a P value of 0.021 and 0.005, respectively. All the children exhibited at least one sleep problem. There was a strong association of certain sleep practices and sleep problems with cephalometric variables.

Impact of Sleep Disturbances on the Quality of Life Among Schizophrenic Out-patients of Jimma University Medical Center, Southwest Ethiopia: Hospital Based Cross-sectional Study

Aim: Current study was aimed to assess the impacts of sleep disturbances on patient’s quality of life. Background: Schizophrenia is a syndrome, which affects sleep. Up to 80% of schizophrenic patients complain of sleep disturbances which affect the quality of life Objectives: To assess the association of sleep disturbances and quality of life and other contributing factors among schizophrenic patients on follow-up treatment at Jimma University Southwest Ethiopia. Methods: A cross-sectional study with a consecutive sampling of 411 out-patients at Jimma University medical center was employed from April 21-June 20, 2019. Sleep disturbances and the quality of life were assessed by Pittsburgh sleep quality index and WHOQOL-BREF, respectively. Epi data version 3.1 and SPSS version 23.0 software was used. Chi-square and independent samples t-test were used for association and P-value &lt; 0.05 was considered for statistical significance. Results: Most participants had sleep disturbances and the mean score of positive scale on PANSS was higher for patients with sleep disturbances. About one-fourth of the patients had very good subjective sleep quality and &gt; 85% of sleep efficiency was reported by 139 participants. More than half (51.1%) of the subjects had used sleep medication and the majority (64.7%) of them were reported daytime dysfunctions in the past month. The social domain (M±SD=3.92±2.51, t=8.46, p= &lt;0.001, eta2=0.15) and overall WHOQOL (M±SD=57.60±16.87, t=9.24, p= &lt; 0.001, eta2= 0.17) score had a large difference of means and about 15% and 17% of the variance in sleep disturbance have been explained. Conclusion: Generally, the finding of the current study was in agreement with most of the previous studies and sleep disturbances respectively moderate to significant effects on the patient’s quality of life.

Association of sleep disturbance and freezing of gait in Parkinson disease: prevention/delay implications.

Freezing of gait (FOG) severely impairs life quality of Parkinson disease (PD) patients. The relationship between sleep disturbance and FOG in PD remains unclear, so in this study, we aimed to investigate that relationship. First, we assessed clinical characteristics of freezers and nonfreezers among PD patients. Next, we assessed clinical characteristics of PD patients with different PDSS1 scores (score on first item of Parkinson's Disease Sleep Scale). Finally, we prospectively followed a cohort of nonfreezers from a baseline clinical visit and to a maximum of 18 months and performed a Cox regression analysis to further investigate the relationship between PDSS1 score and FOG in PD. A total of 163 participants with PD were included in the baseline analysis. The freezers had significantly worse sleep compared with the nonfreezers. The proportion of freezers in the patients with low PDSS1 score (PDSS1 < 6) was significantly higher than that in the patients with high PDSS1 score (PDSS1 ≥ 6). A total of 52 nonfreezers were prospectively followed. During a maximum 18-month follow-up, FOG incidence (73%) in the PDSS1 < 6 group was significantly higher than that (24%) in the PDSS1 ≥ 6 group (P = .008). Low PDSS1 score (hazard ratio = 4.23, 95% CI 1.64-10.92, P = .003) and high levodopa equivalent daily dose (hazard ratio = 4.18, 95% CI 1.62-10.75, P = .003) were significantly associated with an increased hazard of FOG. Our study indicated that low PDSS1 score may be a risk indicator for the development of FOG and provided important insights into potential targets for the prevention/delay of FOG in PD.

Association of sleep disturbance with diabetic retinopathy.

Diabetes mellitus (DM) patients are more likely to experience sleep disturbances than normal. Sleep disturbances may contribute to the development of diabetic retinopathy (DR) by higher inflammatory markers in circulation. We investigated the association between sleep quality and DR. Institutional case control study with type 2 DM patients of <10 years duration and HbA1c ⩽8%; 70 cases with DR and 70 controls without DR (NODR) (power 0.8). Sleep quality was assessed by Pittsburg sleep quality index (PSQI) questionnaire and compared. Cronbach's alpha was 0.777 with high internal homogeneity. Global PSQI score in DR (7.44 ± 3.99; 95%CI 6.88, 9.42) was more than in NODR (4.30 ± 3.26; 95%CI 3.87, 6.45) (p < 0.001). All sleep disturbance scores were more in DR except sleep duration. Poor sleep (PSQI score>5) was more prevalent in DR (p = 0.000) and associated with increasing DR severity (p = 0.026). Normal sleep latency was recorded in 78.57% and 42.85% patients in NODR and DR respectively (p < 0.001). Severe difficulty in subjective sleep quality (p = 0.024), sleep latency (p = 0.002) and daytime dysfunction (p < 0.001) was seen more in DR. Elevated daytime dysfunction was observed with increasing DR severity (p = 0.008). The optimal cut-off for global PSQI score and sleep latency for DR was 5.5 (OR: 5.97; 95%CI 2.86, 12.47) and 25 min(OR: 4.89; 95%CI 2.32, 10.26) respectively. Sleep disturbance is positively associated with DR. Our study identifies cut off value for DR of a modifiable parameter like sleep latency. It emphasizes the need of sleep quality assessment for risk assessment of DR.

1097 Sleep Disturbances, Sleep Burden, And Depressive Symptoms In US Hispanics/Latinos: Results From The HCHS/SOL Sueño Study

Abstract Introduction While sleep disturbances and depression often co-occur, these associations are understudied among Hispanics/Latinos. We examined the associations of sleep disturbances and sleep burden with depressive symptoms among Hispanic/Latino adults in the United States. Methods We used cross-sectional data from the Hispanic Community Health Study/Study of Latinos Sueño Ancillary study (2010-2013). The study enrolled 2072 adults (ages 18-64; 51.5% females) who completed one-week wrist-actigraphy and sleep questionnaires. Sleep burden was operationalized as the total count of sleep disturbances across six domains (duration, efficiency, midpoint, variability, insomnia, sleepiness). Depressive symptoms were assessed using the Center for Epidemiological Studies Depression scale (CESD-10). We used weighted survey linear regressions to evaluate the association of sleep disturbances and sleep burden with elevated depressive symptoms (CESD≥10) in individual models adjusted for age, gender, site, heritage, nativity, education, income, and employment. Sensitivity analyses further adjusted for behavioral health risk factors and apnea-hypopnea index. Results An estimated 28.3% had elevated depressive symptoms, 8.0% had short sleep duration (&amp;lt;6 hours of sleep), 10.9% had long sleep duration (&amp;gt;9 hours), 45.2% exhibited a later sleep midpoint (≥4:00AM), 38.4% had high sleep timing variability (upper third tertile for between day sleep midpoint), 15.3% had insomnia (ISI≥10), 17.3% had excessive daytime sleepiness (ESS ≥10), 21.5% had poor sleep efficiency (&amp;lt;85%), and 77.4% had a total sleep burden count of ≥0. Insomnia (ß=0.49,95%CI:.43,.56), later sleep timing (ß=0.10,95%CI:.04,.16), excessive daytime sleepiness (ß=0.19,95%CI:.11,.27), poor sleep efficiency (ß=0.09,95%CI:.02,.17), high variability (ß=0.07, 95%CI:.01,.12), and sleep burden (ß=0.11,95%CI:.09,.13), were each positively associated with elevated depressive symptoms in individual adjusted models and sensitivity analyses. Extreme sleep durations were not associated with elevated depressive symptoms. Conclusion Multiple inter-related sleep disturbances, particularly those pertaining to sleep quality and timing, are associated with depression and may be targets for future interventions aimed at improving mood among Hispanics/Latinos. Support HL127307, HL098927, HL125748