Average Hours Of Sleep Research Articles

Sleep patterns and quality during summer and academic year among female university students.

To measure sleep patterns and quality during summer vacation and weeks 1-4 of the academic year among female university students. This retrospective prospective cohort study included female students at a university in Riyadh, Saudi Arabia. Participants were recruited with convenience sampling and completed questionnaires online. The questionnaire asked about 5 occasions using the Sleep Quality Scale (SQS) and about their sleep schedule during summer vacation and weeks 1-4 of the academic year. There were 385 participants. The number of students who slept before midnight increased over time from n=127 (32.9%) students during vacation to n=172 (44.6%) students in week 4 (p<0.001). The average sleep hours decreased from 8.97 (standard deviation (SD)=2.6) hours during summer to 7.01 (p<0.001, SD=2.7) hours in week 4. Students reported poorer sleep quality during the academic year, particularly in week 1 (p=0.023), than summer. Students reported higher satisfaction with sleep during summer vacation (n=97; 25.2%) than week 1 (n=38; 9.9%) and week 4 (n=36; 9.4%) (p<0.001). Students experienced daytime fatigue and tiredness (n=79; 20.5%; p=0.002) and low concentration in week 4 (n=79; 20.5%; p<0.001) compared to summer. In the studied population, multiple sclerosis was the most prevalent cause of ON. Women were more likely to have ON. The prognosis for eyesight was substantially connected with the length of ON.

Effects of Screen-Based Leisure Time on 24 Subsequent Health and Wellbeing Outcomes: A Longitudinal Outcome-Wide Analysis.

Previous research has shown that screen-based leisure time is related to physical and mental health, relationships, and prosocial behaviors. However, it remains unclear whether screen-based leisure time causally affects wellbeing, as previous studies have relied on cross-sectional data, focused on one type of media use (e.g., social media, video games, or internet), or assessed a narrow set of outcomes. We used three waves (2016, 2017, 2019) of national longitudinal data from the New Zealand Attitudes and Values Study to investigate the effects of screen-based leisure time on 24 parameters of wellbeing (n = 11,085). We operationalized screen-based leisure as the sum of time spent browsing the internet, using social media, watching/reading the news, watching videos, and playing video games. We followed the outcome-wide analytic design for observational data by performing a series of multivariable regression models estimating the effect of screen-based leisure time on 24 wellbeing outcomes and assessed potential unmeasured confounding using sensitivity analyses. In our primary analysis with the total sample, total screen-based leisure time was associated with a very modest decrease in body satisfaction and a very modest increase in body mass index. Possible evidence of associations was found with increases in number of hours spent exercising and volunteering each week, as well as decreases in number of average daily hours of sleep, self-control, and subjective health. Screen-based leisure time has the potential to affect health and wellbeing. Results are discussed in light of the high prevalence of screen-based leisure time.

The Interplay of Sleep Quality, Mental Health, and Sociodemographic and Clinical Factors among Italian College Freshmen.

Background/Objectives: Sleep and mental health are closely linked, with sleep deprivation increasing the risk of mental health problems in college students. This study aimed to analyze the role of sleep in the mental health status of a sample of Italian freshmen, considering various mental health outcomes and potential interactions between sleep and other relevant factors, such as sociodemographic characteristics, academic experiences, and mental health history. Methods: All freshmen from a medium-sized Italian university were invited to participate in a multidimensional online survey (n = 3756). Sleep quality was assessed through questions on average hours of sleep per night and on satisfaction of perceived sleep quality. Mental health outcomes included psychophysical well-being, psychological distress, substance use, and problematic internet use. Statistical analysis involved multivariate analysis of variance, followed by pairwise comparisons. Results: The sample (n = 721) exhibited low levels of well-being and a high prevalence of psychological distress (52.1%). Approximately one-third of students (n = 258) were dissatisfied with their sleep quality, and one-fourth (n = 186) reported inadequate sleep (less than 7 h per night). More specifically, 24.4% of students slept on average six hours per night, and 1.4% slept five hours or less. Satisfaction with perceived sleep quality significantly influenced well-being, psychological distress, and cannabis use (ηp2 = 0.02). Interaction effects were observed between satisfaction with sleep quality and drop-out intentions (ηp2 = 0.01), as well as between satisfaction with sleep quality and history of mental health diagnosis (ηp2 = 0.02), both of which were significant for psychological distress and cannabis use. Conclusions: This study highlights the influence of perceived sleep quality on academic distress among college freshmen, particularly those with higher intentions of leaving university and with a history of mental health diagnosis.

An Objective and Robust Bayes Factor for the Hypothesis Test One Sample and Two Population Means.

It has been over 100 years since the discovery of one of the most fundamental statistical tests: the Student's t test. However, reliable conventional and objective Bayesian procedures are still essential for routine practice. In this work, we proposed an objective and robust Bayesian approach for hypothesis testing for one-sample and two-sample mean comparisons when the assumption of equal variances holds. The newly proposed Bayes factors are based on the intrinsic and Berger robust prior. Additionally, we introduced a corrected version of the Bayesian Information Criterion (BIC), denoted BIC-TESS, which is based on the effective sample size (TESS), for comparing two population means. We studied our developed Bayes factors in several simulation experiments for hypothesis testing. Our methodologies consistently provided strong evidence in favor of the null hypothesis in the case of equal means and variances. Finally, we applied the methodology to the original Gosset sleep data, concluding strong evidence favoring the hypothesis that the average sleep hours differed between the two treatments. These methodologies exhibit finite sample consistency and demonstrate consistent qualitative behavior, proving reasonably close to each other in practice, particularly for moderate to large sample sizes.

Correlation between sleep duration and prevalence of hypertension: the China Health and Nutrition Survey.

It is increasingly thought that sleep is a lifestyle factor that contributes to hypertension. However, the correlation between sleep duration and hypertension in the Chinese population remains largely unexplored. This study utilized data from the 2009 China Health and Nutrition Survey to investigate the correlation between sleep duration and hypertension. Average hours of sleep per day were grouped into following categories: ≤6, 7-9, and ≥10 h. The frequency of hypertension and odds ratio (OR) were computed across different sleep duration categories. Individuals sleeping 7-9 h per day were designated as the control group. Logistic regression was utilized for multivariate analysis. Among the 9435 participants, the mean sleep duration was 7.9±1.2 h. The prevalence of hypertension was 34.1, 21.7, and 29.3% for individuals sleeping ≤6, 7-9, and ≥10 h per day, respectively. Following adjustments for age, gender, body mass index, and diabetes, a significant association was observed between prolonged (≥10 h) sleep duration and hypertension. Compared to those sleeping 7-9 h per day, the OR for hypertension was 1.21 (95%CI: 1.02-1.43, P=0.03) for individuals sleeping ≥10 h per day. This study suggested that sleeping ≥10 h per day is associated with a higher risk of hypertension in adults.

Peripheral Nerve Stimulation With High-Frequency Electromagnetic Coupling at the Sural and Posterior Tibial Nerves for the Treatment of Complex Regional Pain Syndrome in Lower Extremities: Case Report

BACKGROUND: Complex regional pain syndrome (CRPS) type 1 is a debilitating condition that is notoriously difficult to treat due to its various manifestations. Peripheral nerve stimulation (PNS) is generally recommended when a patient’s symptoms are refractory to conservative measures, as CRPS often is. We present one case of CRPS with intractable lower extremity pain managed effectively with PNS. CASE REPORT: A 32-year-old man developed CRPS after a work-related accident that resulted in multiple injuries, including a crushed pelvis, injured left lower extremity, and a fractured face and skull. After pelvic and hip reconstruction, the patient was left with numbness, tingling, and pain in the left foot affecting functional activities and sleep. Previous therapies, including nerve blocks, physical therapy, narcotics, opioids, anticonvulsants, antidepressants, and nonsteroidal anti-inflammatory drugs, did not alleviate symptoms. The placement of a PNS device, however, led to significant improvement. RESULTS: Pain scores at baseline compared to 12-month follow-up decreased from 6/10 to 2/10 at rest and from 8/10 to 4/10 with activity. Average hours of sleep per night increased from 4 to 8 hours (an improvement of 100%). Antidepressants have been discontinued and opioids reduced to an as-needed basis (once every few days). The patient reports decreased sensitivity to cold, reduced swelling, and improved color changes in the foot. In addition, the patient has been able to increase activity, such as walking, standing, and wearing closed-toed shoes, from 20 minutes to now 4 hours at a time with pain levels maintained at a 4/10. CONCLUSIONS: Subthreshold PNS utilizing high-frequency electromagnetic coupling at the posterior tibial and sural nerves successfully relieved the patient’s chronic, debilitating pain in the lower extremity as a result of CRPS. KEY WORDS: Peripheral nerve stimulation, chronic pain, posterior tibial, sural, CRPS, lower extremity, foot

Assessment of Sleeping Disorders, Characteristics, and Sleeping Medication Use Among Pharmacy Students in Saudi Arabia: A Cross-Sectional Quantitative Study.

BACKGROUND Insomnia is a growing problem, especially among university students, and is associated with sleep disorders, poor academic performance, and quality of sleep. The purpose of this study was to assess the prevalence of insomnia sleeping characteristics, managing techniques, and attitudes toward sleeping pill usage among pharmacy students. MATERIAL AND METHODS A cross-sectional web-based study was conducted among pharmacy students of King Saud University, College of Pharmacy, Riyadh, Saudi Arabia between February and March 2023. SPSS version 26 was used for data analysis. A P value of <0.05 and was considered statistically significant. RESULTS In this study, 61.7% (n=108) of the students' slept an average of 6-10 h and 35.4% (n=62) slept an average of 6 h. Regarding sleeping patterns, nearly two-thirds (n=112, 64%) of the students had day and night sleeping patterns while more than one-third (n=63, 36%) had only night sleeping patterns. In this study, 2.9% (n=5) of the students had severe clinical insomnia, while 21.7% (n=38) reported moderately severe clinical insomnia, 44% (n=77) of them had subthreshold insomnia, and 31.4% (n= 55) had no clinically significant insomnia. The mean scores of the insomnia severity index were significantly related to the usage of stimulants (P=0.048), average hours of sleep (P=0.0001), and average minutes needed to fall asleep (P=0.0001). CONCLUSIONS The current findings demonstrated varying levels of insomnia among students, yet few students used sleeping pills.

Physical Inactivity in the COVID-19 Period: Determinants and Possible Relationship with Adverse Psychological Effects

Objectives: The primary aim of this study was to look into the possible factors associated with physical inactivity during the COVID-19 pandemic period. Secondly, it seeks to investigate the effect of physical activity (PA) levels on self-reported psychological outcomes following the curfews. Materials and Methods: A cross-sectional study was conducted in Physiotherapy and Rehabilitation Outpatient Clinic. A total of 105 healthy participants, aged between 18-65 years, were recruited. For the purposes of characterisation, clinical and demographic data were collected. The participants were divided into three groups based on their total International Physical Activity Questionnaire (IPAQ) scores in pre- and post-pandemic periods: Group 1: high PA (≥3000 MET min/week), Group 2: moderate PA (600≤MET&amp;lt;3000 min/week), and Group 3: low PA (&amp;lt;600 MET min/week). To evaluate the depression, anxiety, and stress levels of the participants, the Depression, Anxiety, and Stress Scale (DASS-21) was used. While clinical and demographic data were used as variables to determine possible factors associated with PA during the COVID-19 period, the change of IPAQ and DASS-21 scores over time was taken as a criterion in the relationship between PA levels and psychological problems. Results: ANCOVA revealed a significant group*period interaction effect regarding depression, anxiety, and stress, respectively. The depression, anxiety, and stress levels of the participants showed significant differences between the two periods [(p&amp;lt;.001; η2p=.175); (p=.033; η2p=.064); (p=&amp;lt;.001; η2p=.132), respectively]. The results demonstrated a clear association between low PA and deterioration of emotional status in terms of both periods. In bivariate analysis, female sex, higher average hours of sleep (≥9.2 hours), being smoker, higher levels of depression (≥7.3), anxiety (≥4.9), and stress (≥9.2) were associated with a low PA during the pandemic (p=&amp;lt;.001-.049). Conclusion: A clear association between reduced PA and impaired emotional state was found in this study. It seems necessary to address these factors and increase awareness of individuals.

Association between sleep duration and dental caries in a nationally representative U.S. population

BackgroundDental caries is considered one of the most prevalent chronic diseases worldwide despite all dental public health efforts. Short sleep duration has been established as a risk factor for several medical conditions. In this study, we aimed to examine the relationship between sleep duration and dental caries.MethodsData were collected from the 2017–2018 cycle of the National Health and Nutrition Examination Survey, a nationally representative health survey conducted in the United States. Participants who completed sleep questionnaires were examined by dentists using standardized clinical criteria. Analysis was limited to Individuals aged ≥ 16 years with complete clinical oral examination data and who completed the sleep questionnaire (N = 5,205). The data were weighted to provide a national estimate, and multiple potential covariates were included in the analysis to account for the complex sample design. The main outcomes of the study were untreated dental caries and dental caries experience. The main predictor variables were average sleep hours/night and a binary variable with 7 h/night as a cut off. Multiple weighted Poisson and logistic regression analyses were conducted to test the hypothesis that people with short sleep duration are more likely to exhibit dental caries.ResultsThis study showed a statistically significant negative relationship between sleep duration and dental caries amongst all weighted adjusted analyses conducted. For a one hour increase in average sleep hours, the Adjusted Odds Ratio (AOR) of having a dental caries experience might decrease by 0.86 (AOR = 0.86, 95% CI = 0.75–0.98, P < 0.05). Individuals who reported an average sleep of ≥ 7 h were less likely to have a dental caries experience compared to individuals who reported an average sleep of < 7 h (AOR = 0.52, 95% CI = 0.33–0.82, P < 0.05). For a one hour increase in average sleep hours, the Adjusted Mean Ratio (AMR) of having a dental caries experience might decrease by 0.97 (AMR = 0.97, 95% CI = 0.96–0.99, P < 0.05), and was lower for those who reported sleeping ≥ 7 h/night than individuals who reported sleeping < 7 h/night (AMR = 0.92, 95% CI = 0.87–0.99, P < 0.05).ConclusionFindings of this cross-sectional representative study of the U.S. population revealed a statistically significant negative association between sleep duration and dental caries. In this study, individuals who slept < 7 h/night were more likely to exhibit dental caries.

0930 What explains high self-reports of poor sleep quality in Native Hawaiian/Pacific Islanders?

Abstract Introduction High rates of poor sleep quality have been reported among patients of Native Hawaiian/Pacific Islander (NHPI) race. Unrestful sleep might be attributable to short sleep times or to elevated rates of obstructive sleep apnea among NHPIs. We aimed to evaluate factors associated with self-reported poor sleep quality among NHPIs in a nationwide, representative community sample. Methods Using the 2014 National Health Interview Survey (NHIS), we used logistic regression to model the odds of individuals reporting that they did not awake feeling rested at least two out of the prior seven days. NHPIs from the NHPI-NHIS and non-NHPIs from the general sample were compared. Age, sex, BMI, smoking status, report of heavy drinking, employment status, marital status, and reported average hours of sleep time were evaluated in terms of their effects on self-reported sleep quality. Results Data from 36,697 non-NHPI and 2,590 NHPI individuals was available for analysis. There were significant differences in age, BMI, marital and current employment status between NHPIs vs. non-NHPIs. NHPI patients reported less sleep (mean 6.86±1.41 hours) in contrast to non-NHPIs (mean 7.12±1.42 hours) (P&amp;lt; 0.001). NHPIs were more likely to report two or more days awakening not feeling rested (Odds Ratio (OR) 1.22, 95% confidence interval (95CI) 1.12–1.32) as compared to non-NHPIs. After adjusting for demographics, BMI, alcohol, smoking, and marital and employment status, the relationship persisted (OR 1.17, 95CI 1.07-1.28). When additionally controlling for sleep time, which was strongly associated with the likelihood of awakening unrested (OR 3.1 95CI 2.9-3.2 for six or fewer average hours of sleep), there was no significant relationship between race and likelihood of awakening unrested (OR 1.02, 95CI 0.93-1.13). Findings were similar when evaluating different thresholds of unrestful nights per week. Conclusion NHPIs are more likely to awake feeling unrested than non-NHPIs. The higher rate of unrestful sleep is associated with higher reports of short (6 hours or less) sleep time. Therefore, future research to improve sleep quality in NHPIs should also investigate the cultural and social factors leading to short sleep time. Support (if any) BWL: NIH Ruth L. Kirschstein National Research Service Award 5T32HL105321 and the ATS ASPIRE Fellowship

0675 Levels of Depression Differentially Affect Sleep in People Who Have Had Cancer: Findings from the National Health Interview Survey

Abstract Introduction Cancer survivors experience an increased stress burden. Twenty-five percent (25%) of cancer survivors experience persistent depressive and anxiety symptoms and 40% are afflicted with chronic sleep problems. Analysis of this relationship between survivors’ mental health and sleep may elucidate components of stress burden in a particularly vulnerable population. This study examined the relationship between anxious and depressive symptoms and frequency predicting sleep patterns, comparing individuals with a cancer history versus those without. Methods Data emanated from the 2020 National Health Interview Survey dataset (n=31,568). Six percent (n=1936) of respondents reported a cancer history. The primary outcome was sleep duration, based on the average hours of sleep per night an individual reported over the past month, which was coded into “healthy” (7-8 hrs.) vs “unhealthy” (&amp;lt; 7 hrs. or &amp;gt; 9 hrs.) sleep. Level of anxiety and depression as well as frequency of reported symptoms were included in the models as predictors. Binary logistic regression models were performed to determine the discrete impact of depression and anxiety on sleep duration among individuals with and without a cancer history. Adjusted models included the demographic covariates of age, sex, education, household income, and race. Results In adjusted models, frequency of anxious feelings (OR = 1.19, p&amp;lt;.01,), frequency of depressive feelings (OR =1.29, p&amp;lt;.01,), level of anxious feelings (OR = 1.38, p&amp;lt;.01,), and level of depressive feelings (OR=1.15, p&amp;lt;.01) significantly predicted unhealthy sleep in the full sample. However, among individuals with a cancer history, frequency of anxious feelings (OR =1.16, p&amp;lt;.01,), level of anxious feelings (OR = 1.28, p&amp;lt;.01,) and frequency of depressive feelings (OR = 1.23, p&amp;lt;.01,) significantly predicted unhealthy sleep duration, but level of depressive feelings did not (OR = 1.08, p=.13,). Conclusion Mental health and sleep are closely and bidirectionally connected in the general population, but among individuals with a history of cancer the link between level of depression and healthy sleep were not significant. Further research is needed to understand the complex relationship between mental health and sleep among people with a cancer history. Support (if any) K01HL135452, K07AG052685, R01AG072644, R01HL152453, R01MD007716, R01HL142066, R01AG067523, R01AG056031, and R01AG075007.

Abstract MP42: Associations Between Psychological Resilience and Lifestyle Behaviors Among Adults in Puerto Rico Affected by Repeated Adverse Events

Residents of Puerto Rico have repeatedly experienced adverse events over the past five years including Hurricanes Irma and Maria in 2017, earthquakes in 2019-2020, Hurricane Fiona in 2022, sociopolitical unrest, a deep economic crisis, and the COVID-19 pandemic (including strict lockdown protocols). Higher psychological resilience, or the ability to “bounce back” after adversity, has been associated with better cardiovascular health in other contexts. One potential mechanism for this relationship is that higher resilience may contribute to engaging in healthier behaviors, such as higher diet quality, more physical activity, and healthier sleep duration and quality, as well as less smoking and drinking. However, such relationships have not yet been explored in this population. We cross-sectionally surveyed 1,240 adults in Puerto Rico in 2019-2022, with recruitment both before and during the COVID-19 pandemic, as part of the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT). Participants responded to the Brief Resilience Scale (BRS) and Brief Resilient Coping Scale (BCS). Diet was assessed with a food frequency questionnaire and diet quality was defined by the Alternate Healthy Eating Index (AHEI). Physical activity was measured via the Harvard Alumni Activity Survey. We also collected data on average hours of sleep, quality of sleep, alcohol intake, and tobacco use. Logistic regression models estimated the odds ratios (OR, 95% CI) for following each healthy behavior by established categories of resilience (high and medium vs. low), adjusted for sociodemographic factors and co-morbidities. Of the sample, 39% (452 out of 1175) and 73% (851 out of 1170) were classified with high resilience and coping using the BRS and BCS, respectively. Adults with high resilience (vs. low) on the BRS had twice the odds [OR: 2.01, 95% CI: 1.22, 3.29] of reporting healthy sleep hours (7-8 hours/night compared to either 6 or fewer/night or 9 or more/night). High resilience was also associated with higher odds of being in the upper AHEI tertile (better diet quality) [OR: 1.61 (0.97, 2.68)], and having moderate or heavy physical activity [OR: 1.54 (1.04, 2.29) compared to sedentary or light activity]. These associations persisted when further adjusting for mental health disorders, perceived stress, and social support. Moreover, the relationships were stronger among participants interviewed during the COVID-19 pandemic, suggesting that psychological resilience may be particularly relevant during an ongoing stressor. No significant associations were noted between resilience and tobacco or alcohol use. Given Puerto Rico’s susceptibility to adverse events, seeking to improve population resilience in this and similarly vulnerable populations may lead to better health over the life course.

IMPLICATION OF SLEEPING DURATION ON THE OVERALL HEALTH STATE OF FAMILY CAREGIVERS

Abstract Family caregiving is integral to long-term care for older adults. The National Alliance for Caregiving and AARP Public Policy Institute in 2020 estimated there are 53 million Americans providing care for loved ones. Caregiving intensity often impacts the health and well-being of caregivers, including influencing their sleep duration. The Centers for Disease Control and Prevention (CDC) recommended an average of 7 or more sleeping hours for adults. Unfortunately, most caregivers' average hours of sleep per night do not meet this recommendation. Using secondary data from the Long-Term Caregiving study conducted by the AP-NORC Center for Public Affairs Research, the present study establishes the effect of sleep duration on the overall health of family caregivers while adjusting for socio-demographic factors. A binary logistic analysis was conducted to infer the effects of sleep duration, age, gender education, race, employment status, and household income relative to reporting high or low overall health wellbeing. The binary logistic model was statistically significant, χ2(16) = 77.5, p &amp;lt; .0001, Nagelkerke R2=0.111. Family caregivers with a sleeping duration of 7 hours or more were twice as likely to report a high overall health status than those who slept less than 7 hours (OR=2.08, 95%CI [1.52 – 2.84]). Increasing household income and being employed were positively associated with high overall health status. We do not find a statistically significant effect of gender, education level, age group, and race on overall health status. We recommend that policies that support family caregivers at a micro and macro level be implemented.

Home call during nephrology fellowship: Burden or benefit?

Home call is one of the factors that can influence physician wellness. Nephrology fellows at the University of Wisconsin tracked home call activities in an attempt to quantify the impact of sleep to identify areas for improvement. Each of the 6 nephrology fellows filled out a daily survey between November 9, 2020, and January 31, 2021, to address total hours, quality of sleep, and if the fellows reported to the hospital. The average amount of sleep per night was 5.3 hours. When necessary to report to the hospital (50%), the average hours of sleep dropped to 4.3 hours. However, if not called in, sleep increased to 5.8 hours per night. Sleep quality during night call was described as restful for 55% of nights. Obtaining an understanding of how a call can impact a learner is essential to making decisions about programmatic structural changes. Programs might use this data to compare their programs when making decisions about call structure. Hospital culture or overnight management changes can be made to impact the number of phone calls or needs to report to the hospital.

Biopsychosocial Approach in Identifying Risk Factors of Kinesiophobia in Persons with Subacromial Pain Syndrome and Developing a Clinical Prediction Tool.

Although the negative effects of kinesiophobia on functional status in subacromial pain syndrome (SAPS) patients are clearly demonstrated, no study examines the risk factors of kinesiophobia in individuals with SAPS from a biopsychosocial perspective. The present study aims to determine the risk factors of kinesiophobia in individuals with SAPS using a biopsychosocial approach. This study also aims to explore the compounding effects of multiple associative risk factors by developing a clinical prediction tool to identify SAPS patients at higher risk for kinesiophobia. This cross-sectional study included 549 patients who were diagnosed with SAPS. The Tampa-Scale of Kinesiophobia (TSK) was used to assess kinesiophobia. Visual analog scale (VAS), The Shoulder Pain and Disability Index (SPADI), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, the presence of metabolic syndrome, using any non-steroidal anti-inflammatory drugs, Pain Catastrophizing Scale (PCS), Illness Perception Questionnaire-revised (IPQ-R), Hospital Anxiety and Depression Scale (HADS), behavioral pattern of the patient, sociodemographic characteristics, and treatment expectancy were outcome measures. Thirteen significant risk factors of having kinesiophobia were: VASat rest (≥ 5.2), VASduring activity (≥ 7.1), DASH (≥ 72.1), presence of metabolic syndrome, PCShelplessness (≥ 16.1), IPQ-Rpersonal control (≤ 17.1), IPQ-Rtreatment control (≤ 16.3), HADSdepression (≥ 7.9), avoidance behavior type, being female, educational level (≤ high school), average hours of sleep (≤ 6.8), and treatment expectancy (≤ 6.6). The presence of seven or more risk factors increased the probability of having high level of kinesiophobia from 34.3 to 51%. It seems necessary to address these factors, increase awareness of health practitioners and individuals. Level IV.

The Effect of Night Float Rotation on Resident Sleep, Activity, and Well-Being.

Night float call systems are becoming increasingly common at training programs with the goal of reducing fatigue related to sleep deprivation and sleep disturbance. Previous studies have shown that trainees obtain less sleep during the night float rotation and have decreased sleep efficiency for several days after the rotation. The impact on physical and emotional well-being has not been documented. Twenty-seven anesthesia residents were enrolled in a study using wearable sleep and activity trackers and National Institutes of Health Patient-Reported Outcome Measurement Information System (NIH PROMIS) surveys for sleep disturbance, fatigue, and positive affect to record data the week before ("baseline"), during ("night float"), and 1 week after ("recovery") their night float rotation. Each subject's data during the night float week and recovery week were compared to his or her own baseline week data using a paired, nonparametric analysis. The primary outcome variable was the change in average daily sleep hours during the night float week compared to the baseline week. Average daily rapid eye movement (REM) sleep, daily steps, and NIH PROMIS scores comparing night float and recovery weeks to baseline week were prespecified secondary outcomes. NIH PROMIS scores range from 0 to 100 with 50 as the national mean and more of the construct having a higher score. There was no difference in average daily sleep hours between the night float and the baseline weeks (6.7 [5.9-7.8] vs 6.7 [5.5-7.7] hours, median [interquartile range]; P = .20). Residents had less REM sleep during the night float compared to the baseline weeks (1.1 [0.7-1.5] vs 1.4 [1.1-1.9] hours, P = .002). NIH PROMIS fatigue scores were higher during the night float than the baseline week (58.8 [54.6-65.1] vs 48.6 [46.0-55.1], P = .0004) and did not return to baseline during the recovery week (51.0 [48.6-58.8], P = .029 compared to baseline). Sleep disturbance was not different among the weeks. Positive affect was reduced after night float compared to baseline (39.6 [35.0-43.5] vs 44.8 [40.1-49.6], P = .0009), but returned to baseline during the recovery week (43.6 [39.6-48.2], P = .38). The residents slept the same number of total hours during their night float week but had less REM sleep, were more fatigued, and had less positive affect. All of these resolved to baseline except fatigue, that was still greater than the baseline week. This methodology appears to robustly capture psychophysiological data that might be useful for quality initiatives.

Self-reported Sleep Quality and Associated Factors among Undergraduate Students in a Nigerian Tertiary Institution

Background: The quality and quantity of sleep is strongly related to physiological and physical health and other measures of wellbeing. Undergraduates are particularly susceptible to increasing academic and social demands that can cause sleep quality.&#x0D; Aim: This study aims to determine the prevalence and distribution of self-reported sleep quality among undergraduates and the association between certain academic and non-academic related factors and quality of sleep.&#x0D; Material and Method: A cross-sectional study among three hundred and twenty-seven undergraduates of the College of Health Sciences, faculty of law and faculty of art of Obafemi Awolowo University Ile-Ife who registered for the 2018/2019 academic session. A self-administered questionnaire was used to obtain sociodemographic and academic information (including the number of courses per semester, Cumulative grade point average (CGPA) and carried over course(s)). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality.&#x0D; Results: The mean age of participants was 22 years. The prevalence of self- reported sleep quality among the participants was 35.8%. Female students (66.3%) had better sleep quality when compared with their male counterparts (61.7%). Bivariate analysis shows a statistically significant association between the course of study and the quality of sleep (p=0.003). Total average sleep hour per day (p=0.002) and known environmental factors affecting bedtime or sleep pattern (p=0.01) also showed statistically significant association with sleep quality.&#x0D; Conclusion: There was a high prevalence of self-reported impaired sleep quality among the undergraduate population in which this study was conducted. The course being studied, total average sleep hours in a day and environmental factors were associated with the quality of sleep.

The Association of Sugar-Sweetened Beverages to Children's Weights Status Is Moderated by Frequency of Adding Sugars and Sleep Hours.

Adding extra sugars in milk and the moderating effect of sleep has yet to be investigated, setting the aim of this study. A total of 1361 school-aged children were included, aged 10–12 years old, by randomly sampling schools. Data were interview-obtained by trained personnel using a validated 17-item food frequency questionnaire, with specifics on type of milk and extra sugar additions. Analyses were stratified by average recommended hours of sleep. Predictive probability margins were obtained following necessary adjustments. Mean BMI was significantly lower, the level of SSB intake was higher, and the prevalence of adding sugars to milk four or more times per week was higher in children that slept ≥10 h. Most children (64%) consumed full fat milk, 21% had low fat, and 19.7% chocolate milk, with a significantly larger proportion of overweight or obese children consuming full fat or chocolate milk, also adding extra sugars four or more times per week (4.1% compared to 9.6%, and 12.2% compared to 39.5%, respectively). The predictive probability of being overweight or obese exponentially increased for children consuming >0.5 SSB/day while also adding sugars to their milk frequently, although this effect remained significant only for children sleeping <10 h/day. In conclusion, to accurately address the effect of SSBs on children’s body weight, frequency of any type of sugar addition in milk should be accounted for, as well as average sleep hours that may further moderate the effect.

STRESS AND BURNOUT SYNDROME AMONG MOROCCAN MEDICAL STUDENTS: A CROSS-SECTIONAL STUDY

Background:Christina Maslach and colleagues define burnout as a psychological syndrome in response to chronic interpersonal stressors on the job which is further characterized by its three dimensions of exhaustion, depersonalization, and a decreased sense of accomplishment. Burnout and stress are symptomatically similar, with burnout attributed specifically to occupational or academic stressors. Both can cause seriousconsequences on studenthealth, professionalism, and patient care. There are few studies evaluating the level of stress and burnoutsyndrome among medical students in Morocco.The aim of this study was to assess the prevalence and levels of burnout syndrome to identify associated factors as well as the level of stress among a group of medical students in Morocco. Method: Our study was descriptive andcross-sectional. It focused on 5th grade level medical students and was carried out during the month of November 2014. Data was collected through a self-administered questionnaire based on volunteering. Results:The study was conducted in a total of 178 fifth-year medical students. The response rate was 97.2% (n = 173). The mean age was 22.2 years (SD = 0.87 years) with a female predominance (74%). The average daily working hours were 8.33 hours (SD= 2.74) and the average daily hours of sleep was 7 hours (SD= 1.1). The majority of students (96.5%) were single.The prevalence of burnout, based on Maslach Burnout Inventory, was 49% (n = 87) of students.The prevalence of high emotional exhaustion was 44%, high depersonalization was 33.3% and high burnout score for personal accomplishment accounted for 64 %.We found a positive correlation between the number of working hours and the burnout score (r = 0.341, p &lt;0.001) as well as the stress score (r=0.3, p=0.009). We also found a negative correlation between the number of hours of sleep and the Burnout score (r = -0.215, p = 0.019).Clearly, this study provides an idea for necessity to plan specific interventions to reduce student stress and avoid burnout.

Associations between sleep duration and Mediterranean diet score in Costa Rican adults

Both insufficient and excessive sleep duration have been associated with lower-quality diets in adult populations. However, investigations in Latin America, where different sleep norms may exist (e.g., daily napping), are scarce. Therefore, we examined whether weekday sleep duration and inconsistencies between weekday and weekend sleep duration were related to adherence to the Mediterranean diet among Costa Rican adults. The study population included 2169 controls (74% men) from a population-based case-control study. Usual sleep duration (weekday versus weekend) was self-reported and defined as short, recommended, and long (<7 h, 7–9 h, >9 h, respectively). Inconsistent weekday-weekend sleep duration was defined as >1-h difference. Diet was assessed with a food frequency questionnaire, and adherence to the Mediterranean diet was calculated with the Alternative Mediterranean Diet Score (AMED). Sex-stratified linear regression models were conducted with AMED score as a continuous outcome and sleep variables as categorical or dichotomous exposures (in separate models). Models were adjusted for age, area of residence, education, napping, caffeine intake, smoking status, type 2 diabetes mellitus, hypertension, and physical activity. Average (SD) hours of sleep per night reported were 7.0 (1.4) on weekdays and 7.3 (1.6) on weekends for men, and 7.0 (1.5) on weekdays and 7.2 (1.6) on weekends for women. Among women, sleep duration <7-h per night was associated with a lower AMED score compared to those with recommended sleep duration (β: −0.35, CI: −0.63 to −0.07). Unstratified models showed a suggestive association between inconsistent weekday-weekend sleep and lower AMED scores that did not vary by sex (β: −0.08, CI: −0.16, 0.006; P, interaction with sex = 0.93). Lastly, the napping frequency was not associated with AMED scores in any model. In conclusion, short and inconsistent sleep duration may affect the dietary patterns of Costa Ricans.