Average Pittsburgh Sleep Quality Index Research Articles

The great recession, neurotic personality, and subjective sleep quality among patients with mood disorders

Previous studies exploring the effects of the business cycle on sleep have mostly focused on the general population, and their results have been inconclusive. This study aimed to explore the effects of the 2008 economic crisis and personality traits on the subjective sleep quality of outpatients with mood disorders. In this cross-sectional study, patients with mood disorders were recruited from two medical centers and a psychiatric hospital. Socio-demographics, the Eysenck Personality Questionnaire-Revised, and the Pittsburgh Sleep Quality Index (PSQI) were collected through in-person interviews. Candidate predictors significantly associated with PSQI scores in univariate analysis were included in a multiple linear regression model. There were 334 participants; 29% had unipolar depression, and 71% had bipolar affective disorder. The average PSQI score was 11.0 (±4.0). A higher degree of neuroticism [β(se) = 0.49 (0.07), p < 0.001] and recession period (vs. recovery period) [β(se) = 1.72 (0.47), p < 0.001] were associated with a higher PSQI score after adjusting for education, occupational class, and diagnosis. In conclusion, neuroticism and macroeconomy were independent predictors of subjective sleep quality in patients with mood disorders. This study suggests that large-scale economic crises have negative impacts on the sleep health of high-risk clinical populations.

Sleep quality of Chinese designers and the effects of digital screen time, stress, and job responsibility

The aim of this study was to describe the sleep status of Chinese designers and to identify the factors that affect their sleep quality. A total of 393 Chinese designers participated in the survey, which collected data on demographic information, digital screen time, stress, and the pittsburgh sleep quality index (PSQI). The average PSQI score of Chinese designers was 6.77, with 29% scoring equal to or higher than 9, indicating poor sleep quality. The most common sleep problem was difficulty falling asleep. Designers with management responsibilities had poorer sleep quality: the PSQI scores for those in design project management (M=8.74, SD=3.829) and design and management (M=9.05, SD=3.475) were significantly higher than for those in dedicated design (M=5.34, SD=2.908). There was a positive correlation between digital screen time for entertainment, work stress, other stress, and PSQI. The model equation was PSQI=1.160+0.276 * entertainment+0.675 * work stress+0.569 * other stress, with an r square of 0.232. Chinese designers should improve their sleep quality by reducing electronic entertainment and relieving stress. Managers in the design industry should pay special attention to their own sleep quality.

Poor sleep quality and overweight/obesity in healthcare professionals: a cross-sectional study.

This study aimed to analyze the relationship between the sleep quality of healthcare professionals and the incidence of overweight and obesity, exploring the potential impact of sleep quality on the onset of overweight and obesity in order to provide a scientific basis for formulating effective health intervention measures. A convenience sampling method was used to conduct a survey on the sleep characteristics and obesity status among healthcare professionals at Peking Union Medical College Hospital and Tianjin Dongli District Traditional Chinese Medicine Hospital. The survey was conducted via online questionnaires, which included demographic data, the Pittsburgh Sleep Quality Index (PSQI), height, weight, and related sleep, exercise, and dietary habits. Univariate and multivariate logistic regression analyses were applied to study the relationship between sleep quality and overweight/obesity among healthcare professionals. A total of 402 questionnaires were distributed, with a 100% retrieval rate, yielding 402 valid questionnaires. The average body mass index of the 402 participants was 23.22 ± 3.87 kg/m^2. Among them, 144 cases were overweight or obese, accounting for 35.8% (144/402) of the total. The prevalence of poor sleep quality among healthcare professionals was 27.4% (110/402), with an average PSQI score of 8.37 ± 3.624. The rate of poor sleep quality was significantly higher in the overweight and obese group compared to the normal weight group (36.1% vs. 22.5%, p = 0.003). The multivariate analysis indicated that gender, marital status, lower education level, sleep duration (odds ratio [OR] =1.411, 95% confidence interval [CI] 1.043-1.910, p = 0.026), and sleep disturbances (OR = 1.574, 95%CI 1.123-2.206, p = 0.008) were significant risk factors for overweight and obesity among healthcare professionals. Overweight or obese healthcare professionals had poorer sleep quality compared to those with a normal weight. Sleep duration and sleep disorders were identified as independent risk factors for overweight or obesity in healthcare professionals. Increasing sleep duration and improving sleep disorders may play a positive role in controlling overweight and obesity among healthcare professionals.

Adherence to Mediterranean Diet and Sleep Quality in University Students

A healthy diet is an important supporter of quality of life. Food is a basic human right. Sleep, like food, is an indispensable part of life. A healthy diet and quality sleep can contribute to our health and well-being. This study was conducted to determine the adherence to the Mediterranean diet and the sleep quality of university students. The study was carried out on 480 people, 331 women and 149 men, who were studying at Higher Education Institutions in the Republic of Türkiye and voluntarily accepted to participate in the study. The demographic characteristics of the individuals, smoking, alcohol and caffeinated beverage use, and dietary habits were questioned with a questionnaire. The Mediterranean Diet Adherence Scale (MEDAS) was used to assess adherence to the Mediterranean diet, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Participants were made up of 69.0% (n=331) females and 31% (n=149) males. The average age; was 21.00±2.853, mean body mass index was 21.23±4.921 kg/m2 in women; in males, it was found to be 24±3.223 kg/m2. Adherence to the Mediterranean diet of the participants was 47.3% (n=227) below 7 points, which was insufficient adherence, 27.1% (n=130) were within the range of 7-8 points, which was acceptable adherence, and 25.6% (n=123) It was found above 9 points, which is strict adherence. Again, the average PSQI score of the participants is 6.29±3.06, the average PSQI score of women is 6.33±2.93 while the average PSQI score of men is 6.19±3.36. There was no significant difference between the PSQI scores of women and men (p&gt;0.05). Sleep and nutritional status have many effects on health. For this reason, training should be given to individuals to increase the sleep quality of the students and to improve their nutritional status.

Physical Activity and Quality of Sleep Among Patient with Chronic Kidney Disease on Hemodialysis: A Cross-Sectional Study.

Chronic kidney disease (CKD) patients on hemodialysis face issues like poor quality of sleep and reduced physical activity, which can impair their quality of life. This study aimed to assess the physical activity and quality of sleep among CKD patients on hemodialysis. This cross-sectional study was conducted at All India Institute of Medical Sciences (AIIMS), Jodhpur. Data from 66 participants selected consecutively using self-reported standardized tools, namely, Global Physical Activity Questionnaire (GPAQ) and Pittsburgh Sleep Quality Index (PSQI), were collected, along with sociodemographic variables. After receiving written informed consent, questionnaires were administered through face-to-face interviews. The majority of the individuals, 45 (68.2%), were found to be physically active with a mean score of 2280.8 metabolic equivalents (MET)-min/week. The average PSQI score was 9.24 ± 4, and 49 (74.2%) participants had a PSQI score as higher than 5, suggesting poor quality of sleep. Physical activity and quality of sleep were found to have a significant relationship (P = 0.03). Physical activity was found to have a significant relationship with age (P = 0.01), whereas quality of sleep was associated with smoking status (P = 0.04), alcohol consumption (P < 0.01), and body mass index (BMI; P = 0.03). Contrary to many studies where CKD patients on hemodialysis were found to be physically inactive, the present study showed a substantial portion of them to be physically active. Poor quality of sleep was common; hence, interventions to promote sleep quality recommended.

Objective and subjective sleep characteristics in hospitalized older adults and their associations to hospital outcomes

PurposeSleep in the hospital setting is understudied, with limited literature describing measurement of sleep quality. This study among older inpatients in an acute-care hospital describes sleep characteristics both objectively and subjectively, and explores the associations of sleep with hospital outcomes.Materials and methodsOlder patients (n = 112) at Sutter Tracy Community Hospital were enrolled from January 2016 to November 2017. Sleep prior to admission was measured subjectively [Pittsburgh Sleep Quality Index (PSQI)], while sleep during hospitalization was measured subjectively (sleep diaries) and objectively (actigraphy, averaged over all nights). Outcomes measured included change in cognition during the hospital stay (i.e., Montreal Cognitive Assessment), length of stay (LOS), discharge to a skilled nursing facility (SNF), and re-admittance to a hospital within 30 days of discharge.ResultsThe participants were on average 68.7 ± 6.5 years old, predominately white (77%) and 55% women. Average PSQI was high (9.1 ± 4.2) indicating poor sleep quality prior to admission. Actigraphy was well-tolerated, with most (89%) having complete data. Sleep during the hospital stay was disturbed, with low levels of total sleep time (5.6 ± 2.0 h) and high levels of fragmentation (sleep efficiency 68.4 ± 15.0%). Sleep interruption was reported on 71% of sleep diaries, with the most common reasons being due to medical care [measurement of vitals (23%), staff interruptions (22%), blood draws (21%)]. Those with lower sleep efficiency had more cognitive decline upon discharge. Although underpowered, there was a suggestion of an association with poor sleep and the likelihood of being discharged to a SNF. Those with worse self-reported sleep quality (PSQI) prior to admission had a slightly longer LOS. No associations were seen with sleep quality and likelihood of readmission.ConclusionsCollection of objective and subjective sleep measures was feasible among hospitalized older adults. Disrupted sleep was common, and was potentially related to poor hospital outcomes. Our next steps will be to leverage these results to design and implement an intervention to improve sleep in hospitalized adults.

Internet Addiction and Its Effect on Sleep Quality Among Medical Students

Aim: This study was carried out to determine the prevalence of internet addiction in medical school students, and to examine the relationship between internet addiction and sleep quality, sleepiness and psychological resilience. Method: The study was conducted with 213 participants studying at Bolu Abant Izzet Baysal University Faculty of Medicine. A sociodemographic questionnaire, Young Internet Addiction Test-Short Form, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Brief Psychological Resilience Scale were applied to all participants, and the results were statistically evaluated. Results: The average age of the participants was found as 21.25±2.00. 65.3% (n=139) of the participants were women and 27.2% (n=58) were first-year students. The average score of Young's internet addiction was 27.15±7.35; the average Pittsburgh Sleep Quality Index score was 5.49±2.47. 60% of them were evaluated as having poor sleep quality. Average Epworth Sleepiness Scale scores were 6.62±4.22; average scores of the Psychological Resilience Scale were 19.35±5.04. There was a positive and significant relationship between Young Internet Addiction and Pittsburgh Sleep Quality. As internet addiction increased, sleep quality decreased. A negative significant relationship was found between Young's Internet Addiction and the Brief Psychological Resilience Scale. As internet addiction increased, psychological resilience decreased. Conclusion: In our study, it was determined that as internet addiction increased, sleep quality and psychological resilience decreased, and daytime sleepiness increased. We can improve sleep quality by preventing internet addiction, and increase participation in daily activities and psychological resilience by reducing daytime sleepiness. Keywords: internet addiction disorder, sleeplessness, resiliency, psychological

THE ROLE OF OUTDOOR LIGHT EXPOSURE ON SLEEP QUALITY IN OLDER INDIVIDUALS WITH FRAILTY OF DIFFERENT LIVING TYPES

Abstract The study investigates the relationship between outdoor light exposure and sleep quality in older individuals with frailty in institutions and the community, where sleep disorders are common, and outdoor light exposure is inadequate.The study includes older individuals with frailty in community and institutions in Taiwan. Participants must be aged 65 or above and have a Clinical Frailty Scale score between 4 to 8. We collect sleep quality and outdoor light exposure data using questionnaires and actigraphy.The study includes 77 older individuals: 29 from day-care centers, 22 from conventional long-term care institutions, and 26 from unit care institutions. The average outdoor light exposure is 15 minutes per day, with an average Pittsburgh Sleep Quality Index (PSQI) score of 8, 74% sleep efficiency, and 125.8 minutes of wake after sleep onset. After controlling for multiple variables. Outdoor light exposure shows no relationship with PSQI, sleep efficiency, and wake after sleep onset.The average PSQI score is &amp;gt; 5, indicating poor subjective sleep quality. Additionally, Wake After Sleep Onset &amp;gt; 60 minutes, and sleep efficiency &amp;lt; 75%, suggesting poor objective sleep quality. The average outdoor light exposure time &amp;lt; 20 minutes, indicating a lack of outdoor light exposure. However, our study does not observe the effects of light exposure, possibly because the average daily light exposure is below the 30-minutes threshold. Older individuals with frailty experience poor sleep quality. It is possible that a longer duration of outdoor light exposure may be needed to observe its impact on sleep quality.

Sleep alterations following elective shoulder surgery: A systematic review

Background Poor sleep quality due to nocturnal pain is increasingly reported as a major symptom in several shoulder pathologies. Sleep disturbance has been reported in up to 89% after rotator cuff tears and is frequently reported as the primary reason for referring patients to surgery. As a result, it is important to understand the impact of shoulder surgery on a patient's sleep quality. Methods A systematic literature review in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines was performed to identify primary research articles reporting the relationship between sleep and shoulder surgery. The initial query yielded 276 articles. After applying inclusion and exclusion criteria, 12 articles were included discussing the relationship between sleep and shoulder surgery. Results A total of 1097 patients were included in the 12 studies evaluating the impact of shoulder surgery on sleep quality, with the Pittsburgh Sleep Quality Index (PSQI) as the most used survey. Average preoperative PSQI across studies was 9.9 (poor sleep), and postoperative PSQI scores of 5.4 at 6 months (improved sleep). Conclusion Patients with shoulder pathologies have a poor sleep quality that improves after shoulder surgery. However, this improvement might not return sleep quality within the normal range, suggesting other factors might impact postoperative sleep quality. Level of evidence III

Comparison of sleep quality between clear aligner and fixed appliance orthodontic therapies

Although available evidence suggests that orthodontic appliances can impact quality of life, there is limited information on the impact of orthodontic appliances on sleep quality. This study aimed to compare sleep quality between patients undergoing orthodontic treatments using conventional fixed appliances and clear aligners. Adult patients attending clinics in Saudi Arabia participated in this cross-sectional study. Sleep quality was assessed using the validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Statistical significance was determined using inferential analysis, with a P < 0.05 considered statistically significant. There were 69 patients included in the study. The average age of a patient (33.12 ± 8.1) who received the clear aligner was significantly higher than those who received the fixed appliance (27.7 ± 5.9) (P < 0.05). The variation in the average score of ESS because of the education level was found to be statistically significant (P < 0.05). No significant difference was observed between the mean average ESS and PSQI global scores across the two orthodontic treatment groups. The average sleep latency scores were significantly higher in females than males when analyzing the PSQI component score across sex (P < 0.05). In education, ESS, PSQI global, habitual sleep efficiency, the use of sleep medication, and daytime dysfunction had a positive, weak, but significant correlation. Overall, this study concluded that regardless of the orthodontic appliances used, there was no statistically significant difference in sleep quality during the treatment.

Comparing the Effects of Acupressure and Clonazepam Tablets on Sleep Quality of Hemodialysis Patients: A Randomized Controlled Trial.

Objective: The current study aimed to compare the impact of acupressure and clonazepam tablets on the quality of sleep in hemodialysis patients in light of the rising prevalence of chronic kidney disease (CKD), the high prevalence of sleep disturbance in these patients, and the side effects of hypnotic drugs. Method : A total of 60 patients were selected for this randomized, controlled clinical trial and randomly assigned to two groups. For two weeks during the researcher's evening shift, one group received acupressure (six spots bilaterally for three minutes each day). The opposing group was administered clonazepam tablets (0.5 mg) for two weeks. The Pittsburgh Sleep Quality Index (PSQI), which measures sleep quality, was used to compare sleep in the two groups before and after the intervention. Results: There was no statistically significant difference between the two groups prior to the intervention (P = 0.75) in terms of the mean pre-intervention PSQI scores for the acupressure and clonazepam groups, which were 15.83 ± 1.51 and 16.17 ± 0.91, respectively. However, the average PSQI scores after the intervention in the clonazepam and acupressure groups were 13.25 ± 2.88 and 8.97 ± 4.29, respectively, indicating a statistically significant difference (P < 0.0001). Both the acupressure and the clonazepam groups showed improvements in their post-intervention sleep quality among the patients. However, when the percentage changed in the mean scores of the total score and all of the PSQI components were calculated for each group, it became clear that acupressure was more effective at enhancing sleep than clonazepam tablets. Conclusion: The findings of the present investigation demonstrate that acupressure has a greater impact on patients' sleep quality compared to clonazepam tablets. Depending on the circumstances, acupressure can be used as a simple, safe, and non-drug way to enhance hemodialysis patients' quality of sleep.

How do infant feeding method, sleeping location, and postpartum depression interact with maternal sleep quality?

New mothers generally experience poor and/or disrupted sleep. A range of infant care and mental health factors may impact new mothers' sleep quality. A cross-sectional online survey was completed by a sample of 101 Australian new mothers with children under 12 months (M = 5.52 months, SD = 3.29 months) to examine the relationship between infant feeding method, infant sleeping location, and postpartum depression with maternal sleep quality. Subjective maternal sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and postpartum depression was measured using the Edinburgh Postpartum Depression Scale (EPDS). Overall, new mothers experienced poor subjective sleep quality, with high average PSQI scores, above the cut-off of 5 (M = 9.63, SD = 4.07). The majority of new mothers did not experience postpartum depression, with an average EPDS score below the cut-off of 11 (8.66, SD = 5.20). Mothers who breastfed their infants experienced significantly better subjective sleep quality than mothers who bottle-fed, with a medium effect size (ηp2 = 0.458). Subjective maternal sleep quality did not differ based on infant sleeping location. Poor subjective maternal sleep quality was a significant predictor of postpartum depression. While poor sleep was common in this sample of Australian new mothers, this study demonstrated that new mothers who breastfeed may experience slightly better subjective sleep quality than other feeding methods. Further research into, and better services for the education and advocation of, new mothers’ sleep quality will be beneficial to both new mothers and clinicians.

COVID-Somnia: A Multicentric Study on Sleep Disturbances During the COVID-19 Pandemic With Spatial Mapping of Hotspots.

Objective The purpose of this study was to document sleep quality and assess its sociodemographic, behavioral (i.e., tobacco use, alcohol use, and screen time), and mental-health-related indicators (i.e., anxiety and depression) in adults aged 30-59 years across three states of India, and to geo-locate state and district-level findings of sleep quality during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Methods From October 2020 to April 2021, residents (aged 30-59 years) of Kerala, Madhya Pradesh, and Delhi completed a web-based survey that included sociodemographic and behavioral factors, clinical history of COVID-19, and mental health screening instruments for anxiety and depression, namely the Generalized Anxiety Disorder 2-item (GAD-2) and Patient Health Questionnaire-2 (PHQ-2). The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the quality of sleep. Average PSQI scores were geo-mapped. Results Of the 694 participants who responded, 647 completed the PSQI. The mean (SD) global PSQI score was 5.99 (3.2), with approximately 54% of participants reporting poor sleep quality (PSQI Score>5). Eight hotspot districts with severe sleep disturbances (mean score PSQI>6.5) were identified. Multivariable logistic regression analysis showed that compared to Madhya Pradesh, participants from Kerala and Delhi had 62% and 33% lower chances of having poor sleep quality, respectively. Those who screened positive for anxiety had higher odds of having poor sleep quality (adjusted odds ratio {aOR}=2.4, P=0.006*). Conclusion Overall, sleep quality was poor during the early stages of the COVID-19 pandemic (October 2020-April 2021), especially among those who reported high levels of anxiety. Among the three included states, there were differences in sleep quality.

PENGARUH BACK MASSAGE DENGAN LAVENDER ESSENTIAL OIL PADA KUALITAS TIDUR IBU HAMIL TRIMESTER III

Based on data from the Jepara District Health Office in 2021, the Tahunan area has the highest number of pregnancies, reaching 1204 pregnancies compared to other sub-districts in Jepara Regency, with 43.1% of them experiencing sleep disturbances. This study aims to determine the effect of back massage with lavender essential oil on the sleep quality of third-trimester pregnant women in the working area of the Annual Public Health Center, Jepara Regency. This type of research is a quasi-experimental one-group pretest-posttest design. The population taken in this study were 50 pregnant women in their third trimester in July – August 2022 in the working area of the Annual Health Center in Jepara Regency. The sampling technique was purposive, and a sample of 44 people was obtained. The data collection tool in this study used the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Data analysis was performed using the Wilcoxon test. The results showed an effect of back massage with lavender essential oil on the sleep quality of third-trimester pregnant women in the working area of the Annual Public Health Center, Jepara Regency (p-value &lt;0.05). The average PSQI score before a back massage with lavender essential oil was 8.95 and then decreased to 3.70 after giving a back massage with lavender essential oil. A decrease in PSQI scores indicates an improvement in sleep quality. Based on the Z value obtained, it was 5.811, which means that every one time back massage intervention with lavender essential oil given two times a week in the third trimester of pregnant women has the potential to improve sleep quality 5.811 times. Keywords: Back massage, Lavender essential oil, Sleep quality

A cross-sectional study on the effect of bedtime smartphone usage on sleep quality, sleep duration and daytime sleepiness in medical students

Background: Sleep is a physiological phenomenon. It is a condition of unawareness that the body regulates homeostatic. Sleep is essential because it plays a leading role in mental and physical function, removing toxins, preventing diseases, etc. Reduced sleep among young adults is becoming a significant health problem worldwide. Several factors have been shown to lead to poor sleep quality, but the reason smartphone use creates sleep disorders in young adults has attracted great curiosity for a few years. The study aimed to assess sleep quality, duration, and daytime sleep dysfunction among medical students who use their smartphones at bedtime. Materials and methods: This cross-sectional study included 109 medical students. The data was collected using a pre-validated questionnaire about bedtime mobile phone usage and Pittsburgh sleep quality index (PSQI). The means were calculated, and the association was determined using statistical analysis. Results: In the study, 60% of participants indicated poor sleep quality was due to prolonged bedtime smartphone usage. The average global PSQI score was 5.4±2.5. Conclusion: This study concluded that participants had poor sleep quality measured by PSQI. In addition, prolonged smartphone usage during bedtime was strongly co-related to poor sleep latency.

Evaluation of sleep quality and duration using wearable sensors in shift laborers of construction industry: A public health perspective.

Approximately 21% of the workers in developing and developed countries are shift laborers. The laborer's work shifts can affect personal life and sleep standards, adversely impacting laborers and their manage. This study assesses the impact of various shift plans (seven evenings/7 days, fixed-night or fixed-day, and backup shifts) on shift laborers, considering four shift schedules. Most laborers were on rotational shifts, whereas others were on a permanent day, permanent night, and standby shifts. In a cross-sectional study, 45 development laborers from the National Construction firm were enlisted. Bio-wearable sensors were provided to monitor sleep. Participants were approached and asked to complete a survey bundle comprising the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS). Differences in sleep models were estimated using a Fitbit watch at various shift schedules. The average age of laborers who participated in the study was 37.5 years, and their average experience in the construction company was 6.5 years. The average total sleep time was 346 ± 46 min. The rotational shift laborers yielded the minimum total sleep time compared to the average PSQI and ESS scores of 7.66 ± 1.3 and 6.94 ± 3.4, respectively. Fifteen shift laborers (33.33%) were affected by a sleeping disorder in the present experimental investigation, and 30 participants had inadequate standards of sleep based on the PSQI scores. Poor sleep quality and duration among construction shift laborers decrease productivity at work. Additional studies are expected to assess sleep-related issues affecting construction shift laborers.

Effect of Epilepsy on Sleep Quality During Pregnancy and Postpartum.

This study seeks to understand how sleep is affected in pregnant women with epilepsy (WWE) relative to healthy pregnant women during pregnancy and postpartum and to nonpregnant WWE during comparative periods. Sleep affects maternal health and mood during pregnancy. Maternal sleep disturbances are related to poor fetal growth and increased fetal deaths. Epilepsy is the most common neurologic condition in pregnancy. Sleep disruption can worsen epileptic seizures. The interplay between epilepsy, pregnancy, and sleep is poorly understood. The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is an NIH-funded, prospective, observational, multicenter study, enrolling women from December 2012 through January 2016. Sleep quality was assessed using the average Pittsburgh Sleep Quality Index collected during pregnancy, postpartum, or analogous periods. Sleep scores range from 0 to 21 with higher scores indicating worse sleep quality; scores >5 are associated with poor sleep quality. Of 351 pregnant WWE, 105 healthy pregnant women, and 109 nonpregnant WWE enrolled in the MONEAD study, data from 241 pregnant WWE, 74 healthy pregnant women, and 84 nonpregnant WWE were analyzed. Pregnant WWE had worse sleep (a higher mean sleep score) during pregnancy compared with healthy pregnant women in unadjusted analysis (p = 0.006), but no longer significant in adjusted analysis (p = 0.062); pregnant WWE (least square mean sleep score [95% CI] = 5.8 [5.5-6.1]) vs healthy pregnant women (5.1 [4.6-5.7]). During postpartum period, WWE (5.6 [5.4-5.9]) had similarly impaired sleep compared with healthy women (5.7 [5.2-6.2]; adjusted p = 0.838). Sleep was significantly worse in pregnant WWE vs nonpregnant WWE (for comparable period) in pregnancy and postpartum in unadjusted and adjusted analyses; adjusted scores for pregnant WWE in pregnancy (5.7 [5.4-6.0]) and those in postpartum (5.7 [5.4-6.0]) compared with those for nonpregnant WWE (4.7 [4.2-5.3]; p = 0.002) and (4.1 [3.6-4.7]; p < 0.001), respectively. Sleep quality between pregnancy and postpartum varied only in healthy pregnant women (change in mean score = 0.8 [0.2-1.3]; p = 0.01), whose sleep was worse in postpartum. Pregnant WWE had worse sleep during pregnancy and postpartum period than nonpregnant WWE during comparable periods in the adjusted analysis. The study is registered at ClinicalTrials.gov as NCT01730170.

Prevalence and risk factors of poor sleep quality in continuous ambulatory peritoneal dialysis patients in Nanchang, Southeast China

This study aimed to explore the prevalence and risk factors of poor sleep quality in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) at the peritoneal dialysis center of the First Affiliated Hospital of Nanchang University. This cross-sectional study was conducted from March 2019 to December 2019. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of patients undergoing CAPD. A PSQI score of ≥5 was defined as poor sleep quality, whereas a PSQI of <5 was defined as good sleep quality. Logistic regression analysis was used to analyze risk factors for poor sleep quality. In total, 456 patients undergoing CAPD were investigated. The average PSQI score was 5.0 ± 2.9. Among the participants, 46.3% had poor sleep quality, and 45.6% were female patients. The average age was 49.4 ± 13.3 years. Compared with good sleepers, poor sleepers included a higher proportion of females and calcium–phosphorus (Ca × P) product, longer dialysis durations, lower total endogenous creatinine clearance rates, less residual renal function, and lower albumin levels. Multivariate logistic regression analysis showed that a long dialysis duration, low albumin level, and high Ca × P product were independent risk factors for poor sleep quality in patients undergoing CAPD. Odds ratios (95% confidence interval) for these risk factors were 1.01 (1.00–1.02), 0.95 (0.91–1.00), and 1.02 (1.00–1.03), respectively. Interventions aimed at improving albumin and Ca × P product levels may improve quality of life for CAPD patients.

Effectiveness of Comfort Nursing Combined with Continuous Nursing on Patients with Colorectal Cancer Chemotherapy.

Purpose To analyze the application effect of continuous nursing combined with comfort nursing on patients with colorectal cancer chemotherapy and its influence on sleep quality and immune function. Methods The data of 96 patients with colorectal cancer in the Oncology Department of Peking Union Medical College Hospital from July 2018 to July 2020 were collected and randomized into the control group and study group according to the odd and even numbers, with 48 cases in each group. The control group received routine care during chemotherapy, and the study group implemented continuous care combined with comfort care. Results After intervention, the results were in favor of the study group than the control group with higher compliance, higher level of various immune indicators, higher quality of life scores, and higher nursing satisfaction rate. In addition, the Generalized Anxiety Disorder (GAD-7) scores and the average Pittsburgh Sleep Quality Index (PSQI) score of the study group after intervention was drastically lower than the control group (P < 0.001). Conclusion The implementation of continuous care combined with comfort care for patients with colorectal cancer undergoing chemotherapy can effectively improve sleep quality and quality of life, relieve anxiety, and yield high patient compliance, which is worthy of clinical promotion.

Prevention of perinatal mental disorders in women of advanced maternal age with pregnancy resulted from assisted reproduction

Women of advanced maternal age (AMA) with pregnancies resulting from assisted reproductive technology (ART) have a high risk of the onset and progression of anxious and depressive disorders, associated with adverse obstetric and perinatal outcomes.&#x0D; The aim. To improve the mental well-being of pregnant AMA women after ART using the developed algorithm of preventive psychological support.&#x0D; Materials and methods. The prospective study comprised 150 patients divided into three equal groups of 50 nulliparous women aged 35–45 years with a singleton pregnancy in the cephalic presentation: the main group consolidated of pregnant women after ART who have got routine psychological support; patients with a pregnancy after ART included to the comparison group and patients with a spontaneous pregnancy from the control group were not consulted routinely.&#x0D; To estimate the psychological condition of the patients the level of maternal anxiety using the Spielberg State-Trait Anxiety Inventory (STAI); sleep quality using Pittsburgh Sleep Quality Index (PSQI); the presence of depressive manifestations using Edinburgh Postnatal Depression Scale (EPDS) were assessed.&#x0D; Results. We did not observe a significant difference in trait (TA) and state anxiety (SA) levels between the main and comparison groups at terms of 22–24 weeks of gestation; however, these values were significantly lower in the control group. The numbers of patients with high TA and SA levels in the main and comparison groups were also significantly higher than in the control group (p&lt;0.05). We observed no significant increase in TA and SA levels in the main group at gestational terms of 35–37 weeks, in contrast to the comparison and control group. The number of patients with high TA and SA levels in the main group remained significantly lower than in the comparison group. A gradual decrease in TA and SA levels in all groups was observed in the postpartum period, but the differences between the groups remained consistent.&#x0D; We did not observe a significant difference in sleep quality score between the study groups at terms of 22–24 weeks of gestation. Patients of all study groups reported sleep disturbance with the pregnancy progression, but average PSQI values at terms of 35–37 weeks of gestation and 6-8 weeks after delivery were significantly lower in the main group compared to the comparison group.&#x0D; The incidence and severity of postnatal depressive symptoms, along with the number of patients at high risk of developing depression in the postpartum, were significantly lower in the main group than in the comparison group.&#x0D; Conclusions. AMA patients after ART formed a high-risk group for developing anxious and depressive disorders during the pregnancy and postpartum. High anxiety levels compromised sleep patterns have leaded to poorer quality of life of women. Preventive psychological support for patients during the pregnancy and postpartum enabled early detection and correction of depressive symptoms; validly reduced anxiety levels, improved sleep quality and consequently improved the quality of life of women and prevented adverse obstetric, perinatal, and psychiatric outcomes