Association Of Sleep Quality Research Articles

Gender differences in the modifying effect of living arrangements on the association of sleep quality with cognitive function among community-dwelling older adults: a cross-sectional study.

Sleep quality is considered to be associated with cognitive function for older adults, but little is known about whether living with others can buffer mild cognitive impairment in older adults with poor sleep quality. The objective of this study was to examine the role of living arrangements in sleep quality and cognitive function among older adults aged 65 and over. 2,859 older adults over 65 years old were selected by using multi-stage stratified sampling method. Cognitive function and sleep quality were measured using Mini-Mental State Examination (MMSE) and Pittsburgh Sleep Quality Index (PSQI). Binary logistic regression was performed to examine the relationship between sleep quality and mild cognitive impairment, and the interaction effects of sleep quality and living arrangements on mild cognitive impairment stratified by gender. Poor sleep quality was associated with mild cognitive impairment among men and women regardless of living arrangements. The significantly protective role of living with others in reducing the incidence of mild cognitive impairment was found in men with poor sleep quality, but not in women. Targeted support for older adults with poor sleep quality may be effective in preventing mild cognitive impairment, and gender differences should be taken into account when promoting cohabitations.

Associations of sleep quality with the skeletal muscle strength in patients with type 2 diabetes with poor glycemic control

Patients with type 2 diabetes mellitus are reported to be at a high risk for sarcopenia, and are known to have a poorer sleep quality. However, the association between sleep quality and skeletal muscle in patients with type 2 diabetes mellitus is not yet precisely understood. A total of 110 inpatients with type 2 diabetes mellitus aged 40-90 years were enrolled. The sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Skeletal muscle mass was measured using bioelectrical impedance analysis. Muscle strength was evaluated by measuring the grip strength. We also performed dietary surveys and measurements of the plasma amino acid levels. A high total score on the PSQI was significantly associated with reduced muscle strength, and the association persisted even after adjustments for confounders. On the other hand, adjusted analysis did not reveal any significant associations between the PSQI total score and the skeletal muscle mass. In regard to the associations with subscores of the PSQI, the scores for sleep latency, sleep efficiency, and daytime dysfunction were significantly negatively associated with the muscle strength. Although poor sleep quality was associated with a high confectionery intake and low plasma arginine, citrulline, and ornithine levels, neither confectionery intake levels nor the plasma levels of these amino acids was associated with the muscle strength. Our study revealed a significant association between the sleep quality and muscle strength in patients with type 2 diabetes mellitus. These results suggest that poor sleep quality is an important risk factor for sarcopenia in patients with type 2 diabetes mellitus.

Abstract P6-05-14: The association of sleep quality with anxiety, depression and social support in breast cancer patients with chemotherapy

Abstract Background:Chemotherapy has side effects on breast cancer patients, and sleep disturbance is one of the common psychological symptoms. Purpose: This study aimed to examine the incidence of sleep disorders and investigate the relationship between anxiety and depression, hope, social support and sleep disorders in breast cancer patients with chemotherapy in China.Results:Total 350 patients were administered questionnaires, and 329 patients completed the questionnaires. The recovery rate was 94%. The majority of participants reported clinically significant sleep disturbance prior to chemotherapy (67.8%), during chemotherapy (71.8%), and after chemotherapy (72.2%). Pearson correlation analysis showed that the higher the direct support, emotional support, social interaction support, informational support and total social support score, the lower the total PSQI score of breast cancer patients (r = -0.212, -0.292, -0.236, -0.271, and -0.195 p< 0.01, respectively). Multifactorial model analysis showed that direct support, anxiety and age were the three main factors that affected sleep quality in breast cancer patients. Conclusions:social support may provide a powerful tool to reduce anxiety and improve sleep quality in breast cancer patients with chemotherapy. Citation Format: Wenjuan Zhu, Wanling Li, Hui Yang, Linying Wang, Jun Guo, Jinnan Gao. The association of sleep quality with anxiety, depression and social support in breast cancer patients with chemotherapy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-14.

The Role of Emotion Dysregulation in the Relationship Between Sleep Disturbances and PTSD Symptom Severity.

Emotion dysregulation is implicated in the development, maintenance, and treatment of sleep disturbances and posttraumatic stress disorder (PTSD) separately. However, few studies have assessed interactions among these variables. To address this gap, this study examined whether the associations of sleep quality and sleep quantity with PTSD severity were stronger at higher levels of negative and positive emotion dysregulation in a community sample of 199 trauma-exposed individuals. This study found that both poorer sleep quality and lower sleep quantity were associated with greater PTSD severity at low to average (but not high) levels of negative emotion dysregulation. Positive emotion dysregulation did not moderate the relationships between sleep quality or quantity and PTSD severity. Exploratory additive multiple moderation analyses showed significant associations between poorer sleep quality and lower sleep quantity with greater PTSD severity at low to average levels of negative emotion dysregulation, coupled with any level of positive emotion dysregulation. Findings inform theoretical perspectives on the sleep-PTSD relationship and clinical applications of targeting emotion dysregulation in the treatment of sleep disturbances and PTSD symptoms for trauma-exposed individuals.

Psychology University Students’ Mental Health Status during COVID-19 Pandemic in Karachi, Pakistan

Purpose: The COVID-19 pandemic has brought challenges in various domains of life but for low and middle-income country university students very demanding situations have emerged. University students’ psychological well-being has always been an area of concern worldwide and higher rates of anxiety and depression have been extensively reported among this cohort. Objective: To determine the frequency of depressive symptoms, anxiety symptoms, and quality of sleep and the association of sleep quality and personality traits with anxiety and depressive symptoms among university students in Karachi, Pakistan in the context of the pandemic COVID-19. Method: This web-based cross-sectional study was conducted among the students of a renowned, private, and HEC-recognized university during March 2020 to April 2020. Google forms were used to disseminate the online questionnaire to screen for depression-Patient Health Questionnaire—PHQ-9, anxiety-Generalized Anxiety Disorder—GAD-7, sleep-quality-Pittsburgh Sleep Quality Index Scale— PSQI and personality traits-Short Term Big Five Inventory—BFI-S. Results: Among the total sample size of 227 students, a considerable proportion of student participants had symptoms of mild anxiety [34.8%], moderate anxiety [15.9%], severe anxiety [18%], mild depression [19.8%], moderate depression [21.5%], moderately severe depression [13.3%] and severe depression [12%]. The majority of them were poor sleepers [77.5%]. Poor sleep quality was also associated with the level of depression and anxiety with a p-value of tiousness, Extroversion & Neuroticism were comparatively more vulnerable to anxiety and depression than people with other traits. Conclusion: This study gives strong evidence that a large percentage of university students have been suffering from depressive and anxiety symptoms during the COVID-19 pandemic accompanied by poor sleep quality. Protecting students’ mental health is an inevitable target during health crises by developing preventive strategies and interventions to address the psychological well-being of university students. The findings also highlight the significance of personality traits as a relevant component of individual differences to respond to various health-related emergencies.

Moderating effects of PER3 gene DNA methylation on the association of sleep quality with mental health in Chinese young adults

BackgroundPoor sleepers have a higher prevalence of mental health problems, and vice versa. However, the mechanisms underlying this association remain unknown. We aimed to examine the bidirectional association between sleep quality and mental health, and further explore the moderating effects of PER3 gene DNA methylation on the association. MethodsThis prospective longitudinal study was conducted from April 2019 to May 2021, integrated questionnaire and blood sample data from 2 universities in Anhui and Jiangxi Provinces. The current study recruited 1179 young adults at baseline and conducted the follow-up survey among 1135 half a year later. The sleep quality and depressive symptoms, anxiety symptoms, and stress symptoms were assessed using a questionnaire at baseline and follow-up. Blood samples were collected at baseline, and MethyTarget™ was used to detect the PER3 gene DNA methylation level. A cross-lag model was used to examine the bidirectional association between sleep quality and mental health. The PROCESS plug-in of SPSS software was used to analyse the moderating effects of PER3 gene DNA methylation. ResultsCross-lagged analyses suggested a significant bidirectional relationship between poor sleep quality and depressive symptoms, anxiety symptoms, and stress symptoms. Sleep quality at baseline was a significant predictor of depressive symptoms (β = 0.344, P < 0.001), anxiety symptoms (β = 0.348, P < 0.001), and stress symptoms (β = 0.324, P < 0.001) half a year later. Depressive symptoms (β = 0.049, P < 0.001), anxiety symptoms (β = 0.055, P < 0.001), and stress symptoms (β = 0.063, P < 0.001) at baseline were also significant predictors of poor sleep quality half a year later. Furthermore, PER3 gene DNA methylation has negative moderating effects between sleep quality at baseline and depressive symptoms (β = −11.706, P = 0.012), anxiety symptoms (β = −10.289, P = 0.019), and stress symptoms (β = −10.799, P = 0.024) half a year later and a sex difference. Among boys, PER3 gene DNA methylation has positive moderating effects between anxiety symptoms at baseline and sleep quality (β = 3.337, P = 0.018) half a year later. However, there was no association between mental health at baseline and sleep quality half a year later among girls. ConclusionBidirectional relationships were identified between sleep quality and mental health among Chinese young adults during the study period. DNA methylation evidence supports a negative moderating effect of PER3 gene DNA methylation on the relationship between sleep quality at baseline and mental health half a year later and had sex differences. Among boys, PER3 gene DNA methylation had positive moderating effects between anxiety symptoms at baseline and sleep quality half a year later. These findings point to the importance of circadian clock gene DNA methylation in the relationship between sleep quality and mental health.

Association of sleep quality and diffusion MRI derived interstitial fluid content – insights in cerebral waste clearance

AbstractBackgroundDisruptions in sleep are associated with Alzheimer’s disease (AD) progression. As cerebral waste clearance is most active during sleep, these reductions in sleep quality could induce impaired clearance function. Waste products are washed through the parenchyma in the interstitial fluid (ISF), its volume being regulated by the sleep‐wake cycle. A smaller ISF‐volume is found in awake states and after sleep deprivation. IntraVoxel Incoherent Motion (IVIM) MRI can detect the diffusion of cerebral ISF (Dint) and its volume fraction (fint).Using IVIM, the current exploratory study investigates whether alterations in a proxy of ISF‐volume (fint) are related to hours of sleep or self‐reported sleep quality.MethodTwenty neurotypical elderly subjects (Table 1) underwent ultra‐high field MRI (7T research system, Siemens Healthcare GmbH, Erlangen, Germany) (Table 2).The intermediate diffusion components (Dint) in the range 1.5*10‐3&lt;Diffusivity&lt;4.0*10‐3 mm2/s were calculated using spectral analysis (Figure 1). The relative signal contribution of Dint was quantified by the ISF‐fraction (fint). Median fint values were extracted from the white matter (WM) and gray matter (GM).Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). In addition to the clinically used total PSQI (sum of all 7 components), the PSQI1 (Subjective sleep quality) and PSQI3 (Sleep duration) components were considered.Pearson correlations were computed between the PSQI scores and fint for WM and GM. To check for potential confounding influences, partial correlations were performed adjusting for age and time of MRI‐acquisition.ResultThe sample characteristics and descriptive statistics are summarized in Table 1. Worse reported sleep quality (PSQI1) significantly relates to lower WM fint (Table 3 and Figure 2). After adjusting for potential confounding influences, a trend towards significance remained (R=‐0.437, p=0.061).ConclusionThe current explorative study identified a lower diffusion MRI‐derived proxy of ISF‐volume in the WM of subjects who reported a subjective feeling of long‐term sleep deprivation. A reduction in ISF‐volume may leave less space for waste products, such as soluble Amyloid‐beta, to be cleared from in‐between the cells. Thereby, this study puts forward a potential method for future studies to investigate impaired clearance function in relation to sleep in patients with AD pathology.

Association of sleep quality and diffusion MRI derived interstitial fluid content – insights in cerebral waste clearance

AbstractBackgroundDisruptions in sleep are associated with Alzheimer’s disease (AD) progression. As cerebral waste clearance is most active during sleep, these reductions in sleep quality could induce impaired clearance function. Waste products are washed through the parenchyma in the interstitial fluid (ISF), its volume being regulated by the sleep‐wake cycle. A smaller ISF‐volume is found in awake states and after sleep deprivation. IntraVoxel Incoherent Motion (IVIM) MRI can detect the diffusion of cerebral ISF (Dint) and its volume fraction (fint).Using IVIM, the current exploratory study investigates whether alterations in a proxy of ISF‐volume (fint) are related to hours of sleep or self‐reported sleep quality.MethodTwenty neurotypical elderly subjects (Table 1) underwent ultra‐high field MRI (7T research system, Siemens Healthcare GmbH, Erlangen, Germany) (Table 2).The intermediate diffusion components (Dint) in the range 1.5*10‐3&lt;Diffusivity&lt;4.0*10‐3 mm2/s were calculated using spectral analysis (Figure 1). The relative signal contribution of Dint was quantified by the ISF‐fraction (fint). Median fint values were extracted from the white matter (WM) and gray matter (GM).Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). In addition to the clinically used total PSQI (sum of all 7 components), the PSQI1 (Subjective sleep quality) and PSQI3 (Sleep duration) components were considered.Pearson correlations were computed between the PSQI scores and fint for WM and GM. To check for potential confounding influences, partial correlations were performed adjusting for age and time of MRI‐acquisition.ResultThe sample characteristics and descriptive statistics are summarized in Table 1. Worse reported sleep quality (PSQI1) significantly relates to lower WM fint (Table 3 and Figure 2). After adjusting for potential confounding influences, a trend towards significance remained (R=‐0.437, p=0.061).ConclusionThe current explorative study identified a lower diffusion MRI‐derived proxy of ISF‐volume in the WM of subjects who reported a subjective feeling of long‐term sleep deprivation. A reduction in ISF‐volume may leave less space for waste products, such as soluble Amyloid‐beta, to be cleared from in‐between the cells. Thereby, this study puts forward a potential method for future studies to investigate impaired clearance function in relation to sleep in patients with AD pathology.

Quality of Sleep Among Shift Work Nurses at the Baguio General Hospital: A Pilot Cross - Sectional Study

&#x0D; &#x0D; &#x0D; &#x0D; ABSTRACTObjective: The primary objective of this study was to determine the quality of sleep among 12- hour shift-work nurses at the Baguio General Hospital using the Pittsburg Sleep Quality Index (PSQI).&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Methods: This was a preliminary cross-sectional study with a primary endpoint of assessing the sleep quality of the participants using the PSQI. The association of sleep quality with individual and work factors was also determined.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Design:Cross - Sectional Study&#x0D; Setting:Tertiary Government Training Hospital &#x0D; Patient:154 12-hour shiftwork nurses&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Results: The majority (88.96%) of the participants self-reported having poor sleep quality. Among the components of the PSQI, current shift was significantly associated with habitual sleep efficiency (Fisher exact test p &lt; .049). No significant associations were found between demographic characteristics and PSQI Global score, with most respondents having poor sleep quality regardless of participant characteristics.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Conclusion: Majority of nurses working in 12-hour shifts had poor sleep quality. Night shift nurses had higher habitual sleep efficiency scores compared to day shift nurses indicating that those working in the night shift had poorer habitual sleep efficiency.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Association of sleep quality with lower urinary tract symptoms/benign prostatic hyperplasia among men in China: A cross-sectional study.

As the population aged, voiding dysfunction has been steadily rising among males during the past decade. Increasing evidence showed that sleep disorders are associated with an increasing risk of various diseases, but the association between sleep disorders and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) among Chinese males have not been well characterized. We conducted a cross-sectional analysis of data from West China Natural Population Cohort Study (WCNPCS) 2019-2021. Sleep quality was assessed by Pittsburgh sleep quality index (PSQI) in Chinese version. LUTS/BPH as a dependent variable of a binary variable, assessed by a self-reported questionnaire. Multivariate logistic regression analysis were performed to evaluate the correlation between sleep disorders and the risk of LUTS/BPH after adjusting for confounding factors. 11,824 eligible Chinese men participated in this cross-sectional survey. In multivariate logistic regression analysis, after adjusting for confounding variables, global PSQI score (OR: 1.257, 1.119-1.411, p < 0.001) and its six compounds (Subjective sleep quality: OR: 1.376, 1.004-1.886, p = 0.048; Sleep latency: OR: 0.656, 0.557-0.773, p < 0.001; Sleep duration: OR: 1.441, 1.189-1.745, p < 0.001; Habitual sleep efficiency: OR: 1.369, 1.193-1.570, p < 0.001; Daytime dysfunction: OR: 1.702, 1.278-2.267, p < 0.001) except the use of sleep drug subgroup were significantly positively correlated with LUTS/BPH prevalence. Significant interaction effects were observed in age subgroups (age-young group: age < 51; age-middle group: 51 ≤ age ≤ 61; age-older group: age > 61) (P < 0.05). Among older participants, sleep disorders were more significantly associated with the risk of LUTS/BPH. There was a significant association between poor sleep quality and increased prevalence of LUTS/BPH, especially among the elderly male population, suggesting an important role of healthy sleep in reducing prostate disease burden.

Association of Sleep Quality and Duration with Gestational Diabetes Mellitus

Introduction: Association of a good sleep quality and adequate nocturnal sleep duration with metabolic health has been reported in several epidemiological studies. This study aimed to evaluate the impact of sleep quality and duration on gestational diabetes mellitus (GDM) occurrence. Methods: In this longitudinal study, 821 pregnant women with the gestational age of ≤14 weeks were included from 2018 to 2020 by convenience sampling. The participants were evaluated in terms of sleep quality using the Pittsburgh Sleep Quality Index and nocturnal sleep duration. They were also examined for GDM at gestational weeks 24–28. Two GDM and non-GDM groups were compared regarding sleep quality and duration. The multivariate logistic regression analysis was performed to assess the independent association of sleep-related variables with GDM occurrence. Results: The final analysis was performed on 658 participants. The means of age and gestational week of the participants were 29.8 ± 4.9 years and 8.8 ± 4.4 weeks, respectively, on inclusion in the study. During follow-up, GDM occurred in 104 (15.8%) participants. Poor sleep quality, sleep quality components, and nocturnal sleep duration showed no significant difference between groups. The frequency of night sleep duration &lt;7 h was higher in the GDM group compared to the non-GDM group (14.4% vs. 7.8%, P = 0.028). However, in the multivariate analysis, there was no independent association between nocturnal sleep &lt;7 h and GDM occurrence. Conclusion: Sleep quality, nocturnal sleep duration, and short nocturnal sleep duration had no independent association with GDM occurrence.

Association of sleep quality with temperament among one-month-old infants in The Japan Environment and Children’s Study

This study aimed to examine the association between infant sleep quality and temperament in one-month-old infants using a large cohort study data. We used data from the Japan Environment and Children’s Study, a cohort study which follows around 100,000 women from pregnancy until their children’s development. The mothers were asked about their infants’ sleep and temperament using a structured questionnaire. Frequent crying (adjusted odds ratio [AOR]: 1.05, 95% confidence interval [CI]: 1.00–1.10) and intense crying (AOR: 1.19, 95% CI: 1.13–1.25) were positively associated with longer sleep periods during the day than at night. Female infants with longer daytime sleep periods than that at nighttime were more likely to cry frequently (AOR: 1.11, 95% CI: 1.04–1.20). Parous women with infants who had frequent night awakening believed their infants cried more intensely (AOR: 1.17, 95% CI: 1.03–1.31). The study demonstrated a specific association between sleep quality and temperament in one-month-old infants. Based on the results of this study, further sleep intervention studies are required to improve infant temperament.

Association of sleep quality and nap duration with cognitive frailty among older adults living in nursing homes.

BackgroundSleep status, including sleep quality and nap duration, may be associated with frailty and cognitive impairment in older adults. Older adults living in nursing homes may be more prone to physical and cognitive frailties. This study aimed to investigate the association between sleep quality and nap duration, and cognitive frailty among older adults living in nursing homes.MethodsThis study included 1,206 older adults aged ≥ 60 years from nursing homes in Hunan province, China. A simple frailty questionnaire (FRAIL scale) was used and Mini-Mental State Examination was conducted to assess physical frailty and cognitive impairment, respectively, to confirm cognitive frailty. The Pittsburgh Sleep Quality Index was used to assess the sleep quality. Nap duration was classified as follows: no, short (≤30 min), and long (>30 min) napping. Multinomial logistic regression was conducted to estimate the odds ratio (OR) and 95% confidence interval (CI).ResultsThe prevalence of cognitive frailty among the older adults in nursing homes was 17.5%. Approximately 60.9% of the older adults had a poor sleep quality. Among the 1,206 participants, 43.9% did not take naps, 29.1% had short naps, and 26.9% had long naps. After adjusting for all covariates, poor sleep quality (OR 2.53; 95% CI 1.78–3.59; P < 0.001) and long nap duration (OR 1.77; 95% CI 1.19–2.64; P = 0.003) were associated with higher odds of cognitive frailty, but short nap duration (OR 0.60; 95% CI 0.40–0.89; P = 0.012) was associated with low prevalence of cognitive frailty.ConclusionPoor sleep quality and long nap duration are significantly associated with high risk of cognitive frailty among the older adults in nursing homes. Short nap duration was associated with low prevalence of cognitive frailty. However, these associations require further validation in older adults.Clinical trial registrationhttps://osf.io/57hv8.

Association of sleep quality and chronification of musculoskeletal pain in an older adult: A case report

BackgroundSleep disorders and chronic musculoskeletal pain are highly prevalent conditions that are often comorbid clinically. The role of sleep disorder on the chronification of musculoskeletal pain is well documented, although the mechanisms have not yet been fully established. ObjectivesHere we present a case study demonstrating the clinical comorbidity of sleep disorder with chronification of musculoskeletal pain in an older adult with clinical history of hypothyroidism. The aim of this case is to highlight important risk factors of age, gender and hypothyroidism, which the clinician should be aware of for their potential contributory role in the development of sleep disorder and chronification of musculoskeletal pain. Clinical featuresPatient presented with a flare-up of pain in right shoulder and neck that had been intermittently present for several years but of which the intensity had become increasingly worse over time. The patient was diagnosed with chronic right rotator cuff tendonitis and a grade III supraspinatus tear. Clinical history revealed that significant sleep disorder and hypothyroidism were also present in this case. Intervention and outcomesTreatment focused on relieving pain and restoring function to the right shoulder. Interventions including passive mobilization, manual ischemic trigger point therapy, and passive traction were applied. Patient also provided with diaphragmatic breathing exercises to help alleviate her sleep disorder. After 12 weeks patient reported decreased pain levels and improved ROM of the right shoulder. Patient also reported improved sleep, both in quality and quantity. ConclusionThis case demonstrates the importance of considering the association between sleep disorder and the chronification of musculoskeletal pain in older adults. This study highlights common potential risk factors of age, gender and hypothyroidism which may contribute to the development of these conditions in older patients.

Association between sleep quality and depressive symptoms

BackgroundDepression is a common mental health disorder. Despite sleep disturbance being associated with depression, limited data regarding the association of sleep quality with depression exists. We aimed to investigate the association between sleep quality and depressive symptoms in the South Korean population. MethodsThis cross-sectional study used data from the 2018 Korean Community Health Survey, a nationwide representative survey conducted annually at national public health centers since 2008. The study population comprised 176,794 individuals (78,356 male and 98,438 female) aged 19 years and over. Sleep quality was measured using the Korean version of Pittsburgh Sleep Quality Index and depressive symptoms with the Patient Health Questionnaire-9. Data were analyzed using multiple logistic regression. ResultsThe average PSQI score was 5.03 for men and 5.98 for women. Individuals of both sexes with poor sleep quality were more likely to be depressed (men: odds ratio (OR) = 7.02 [95% confidence interval (CI) = 6.17–7.99]). In subgroup analysis stratified by independent variables, participants with the following characteristics had greater association between poor sleep quality and depressive symptoms: unmarried, college or higher education, white-collar occupation, current smoker, frequent drinker, walking physical activity, and no-stress. LimitationsLimitations included the cross-sectional nature of the study, use of only secondary data and a self-rated questionnaire for evaluating depressive symptoms, and inherent limitations in the PSQI. ConclusionsPoor sleep quality may contribute to depressive symptoms among Korean adults. Screening for poor sleep quality and implementing measures to improve sleep behaviors may prevent the onset of depression.

The association of sleep quality and burnout among Chinese medical residents under standardized residency training in a tertiary hospital.

PurposeTo investigate the impact of sleep quality and chronotype on job burnout among medical residents under standardized residency training (SRT) in a tertiary hospital in Beijing, China.MethodsMedical residents in the Department of Internal Medicine of Peking Union Medical College Hospital were assessed by Morning and Evening Questionaire-5 (MEQ-5), Pittsburgh sleep quality index (PSQI), and Maslach Burnout Inventory-General Survey (MBI-GS). Factors associated with burnout were analyzed.ResultsA total of 142 respondents returned completed questionnaires. Burnout was present in 85 (60%) residents. Prevalence of high emotional exhaustion, high depersonalization, and low personal accomplishment were 51%, 28%, and 18%, respectively. The global PSQI score of residents was 5.9 ± 2.4, and the self-reported sleep duration was 6.2 ± 0.8 h/day. The MEQ-5 distribution skewed towards morningness, with a median score of 14.5 [13.0, 16.3]. Poor daytime function significantly predicted emotional exhaustion and depersonalization. Chronotypes were not associated with any of the burnout components.ConclusionSleep-related daytime dysfunction was strongly related to burnout. Strategies protecting the sleep of residents should be incorporated into the SRT programs for both efficiency and sustainability considerations.

The Association of Self-Reported ADHD Symptoms and Sleep in Daily Life of a General Population Sample of School Children: An Inter- and Intraindividual Perspective.

Sleep and Attention-Deficit/Hyperactivity Disorder (ADHD) have repeatedly been found to be associated with each other. However, the ecological validity of daily life studies to examine the effect of sleep on ADHD symptoms is rarely made use of. In an ambulatory assessment study with measurement burst design, consisting of three bursts (each 6 months apart) of 18 days each, 70 German schoolchildren aged 10–12 years reported on their sleep quality each morning and on their subjective ADHD symptom levels as well as their sleepiness three times a day. It was hypothesized that nightly sleep quality is negatively associated with ADHD symptoms on the inter- as well as the intraindividual level. Thus, we expected children who sleep better to report higher attention and self-regulation. Additionally, sleepiness during the day was hypothesized to be positively associated with ADHD symptoms on both levels, meaning that when children are sleepier, they experience more ADHD symptoms. No association of sleep quality and ADHD symptoms between or within participants was found in multilevel analyses; also, no connection was found between ADHD symptoms and daytime sleepiness on the interindividual level. Unexpectedly, a negative association was found on the intraindividual level for ADHD symptoms and daytime sleepiness, indicating that in moments when children are sleepier during the day, they experience less ADHD symptoms. Explorative analyses showed differential links of nightly sleep quality and daytime sleepiness, with the core symptoms of inattention and hyperactivity/impulsivity, respectively. Therefore, future analyses should take the factor structure of ADHD symptoms into account.

Association of Sleep Quality and Duration With Preterm Birth: The Qazvin Maternal and Neonatal Metabolic Study (QMNMS)

Background: Preterm birth (PB) is a worldwide gestational problem. Poor sleep quality and short duration have been reported as possible predisposing factors of PB in some studies. Objective: This study was conducted to investigate the roles of sleep quality/duration in the occurrence of PB. Methods: This longitudinal study was performed on pregnant women with gestational age ≤14 weeks. The sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI) at the first visit and women were followed until delivery. A total of 76 women with preterm and 441 women with term delivery were compared regarding the sleep quality components, sleep duration, and long or short sleep duration. The multivariate logistic regression was performed to examine the independent association of sleep quality/duration with PB. Findings: Data from 517 participants were analyzed. PB occurred in 14.7% of participants. No significant difference of 7 items of sleep quality was observed between preterm and non-preterm groups (P&gt;0.05 for each comparison). The total PSQI score in the preterm group was significantly higher (poorer quality) compared to the non-preterm group (5.6±2.1 vs 5.3±2.4, P=0.076). In multivariate logistic regression, each unit of worsening PSQI was independently associated with a 20% higher risk of PB occurrence. Sleep duration was not associated with PB either in unadjusted or adjusted models. Conclusion: No relationship was observed between poor sleep quality (defined as PSQI&gt;5) and PB; however, based on our results, poorer sleep quality (as a continuous variable) can be an independent risk factor for PB.

Associations of sleep quality, anxiety symptoms and social support with subjective well-being among Chinese perimenopausal women

BackgroundFew studies have explored the internal pathway of the association between sleep quality and subjective well-being among perimenopausal women. MethodsA survey was performed of 1063 perimenopausal women aged 40 to 60 years who participated in a regular health examination conducted at the First Hospital of Jilin University, China. Participants were asked to complete a study questionnaire. The Pittsburgh Sleep Quality Index, Zung Self-rating Anxiety Scale, Perceived Social Support Scale and Subjective Well-being Scale for Chinese Citizens were used to assess sleep quality, anxiety symptoms, social support and subjective well-being, respectively. The data were analyzed using t-tests, analysis of variance, Pearson correlation analysis, multiple linear regression analysis and the PROCESS macro. ResultsThe mean total subjective well-being score was 90.14 ± 12.80. The correlation analyzes showed that sleep quality (r = −0.341, P < 0.001) and anxiety symptoms (r = −0.490, P < 0.001) were negatively correlated with subjective well-being. Social support was positively correlated with subjective well-being (r = 0.480, P < 0.001). The effect of sleep quality on subjective well-being was partially mediated by anxiety symptoms (Effect = −0.462, 95% CI = [−0.577, −0.363]). In addition, social support moderated the association between anxiety symptoms and subjective well-being (Index = −0.006, 95% CI = [−0.012, −0.001]). LimitationsThis was a cross-sectional study. ConclusionsThe effect of sleep quality on subjective well-being was partially mediated by anxiety symptoms, and social support moderated the association between anxiety symptoms and subjective well-being among perimenopausal women.

Poor sleep quality is negatively associated with low cognitive performance in general population independent of self-reported sleep disordered breathing

BackgroundSleep disordered breathing (SDB) plays a significant role in both sleep quality and cognition and whether it has an impact on the relationship between above two factors remains to be clear. The study aimed to explore the association between sleep quality and cognitive performance in general population by considering influence of sleep disordered breathing (SDB).MethodsIn this cross-sectional study, we enrolled subjects aged ≥ 18 years using a multi-stage random sampling method. Cognitive status was assessed using Mini Mental State Examination (MMSE) questionnaire, sleep quality using Pittsburgh Sleep Quality Index (PSQI) and SDB was assessed using No-SAS scale, respectively. Multi-variable logistic regression was applied to examine the association of sleep quality and cognitive performance. Subgroup analyses were performed in different age groups, and in those with and without SDB.ResultsFinally, 30,872 participants aged 47.5 ± 13.8 years with 53.5% women were enrolled, of whom 32.4% had poor sleep quality and 18.6% had low cognitive performance. Compared with good sleepers, subjects with poor sleep quality exhibited significantly higher presence of low cognitive performance (23.7% vs 16.2%, P < 0.001). Poor sleepers revealed 1.26 (95%CI: 1.16,1.36), 1.26 (1.08,1.46) and 1.25 (1.14,1.37) fold odds for low cognitive performance in general population and in subjects with and without self-reported SDB respectively. Stratified by age and SDB, the association was observed in young and middle-aged group without SDB (OR = 1.44, 95%CI: 1.30,1.59) and in the elderly group with SDB (OR = 1.30, 95%CI: 1.07,1.58).ConclusionsSleep quality is in a negative association with cognitive performance in general population independent of SDB, implying improvement of sleep disturbances is a potential objective of intervention strategies for cognitive protection at population level.