Sleep Disturbance Domains Research Articles

The Impact of Adenotonsillectomy on the Quality of Life of Children with Obstructive Sleep Apnea.

Introduction In children, obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is caused by adenotonsillar hypertrophy and is characterized by upper airway obstruction disturbing sleep. Objective We conducted this study to evaluate health-related quality of life (QoL) in children with OSA before and after adenotonsillectomy. Methods A descriptive, observational study was conducted among 43 children in the 4-to-12 years old age group who had symptoms of OSA due to adenotonsillar hypertrophy and who underwent adenotonsillectomy at a tertiary care center during the period from February 2020 to February 2021. The QoL was assessed using the OSA-18 questionnaire preoperatively and at 2 and 6 months postoperatively. Results Among the study population, males (72)%) were more affected with OSA, with a male-to-female ratio of 2.6:1. Based on the OSA-18 questionnaire assessment, the most severe and frequently observed symptoms were in the domains of sleep disturbance and physical symptoms, in which the mean score was 77 preoperatively. After adenotonsillectomy, the mean OSA-18 score decreased to 28.605 and 22.465 at 2 and 6 months, respectively. At 2 months postsurgery, more significant improvement was noticed in sleep disturbances, physical symptoms, and parent's concern while at 6 months postsurgery, all domains showed equal improvement. Therefore, following adenotonsillectomy, the QoL improved significantly. Conclusion Obstructive sleep apnea can adversely affect sleep quality as well as neurocognitive and cardiovascular functions. Adenotonsillectomy resulted in significant improvement in the QoL.

Identification of age differences in cancer-related symptoms in women undergoing chemotherapy for breast cancer in China

BackgroundBoth contextual and cancer-related factors could be identified as causes of the interindividual variability observed for symptoms experienced during breast cancer treatment with chemotherapy. Understanding age differences and the predictors of latent class memberships for symptom heterogeneity could contribute to personalized interventions. This study aimed to identify the role of age differences on cancer-related symptoms in women undergoing chemotherapy for breast cancer in China.MethodsA cross‑sectional survey was conducted among patients with breast cancer in three tertiary hospitals in central China between August 2020 to December 2021. The outcomes of this study included sociodemographic and clinical characteristics, Patient-Reported Outcomes Measurement Information System (PROMIS)-57 and PROMIS-cognitive function short form scores.ResultsA total of 761 patients were included, with a mean age of 48.5 (SD = 11.8). Similar scores were observed across age groups for all symptoms except for fatigue and sleep disturbance domains. The most central symptoms varied among each group, and were fatigue, depression, and pain interference for the young-aged, middle-aged, and elderly-aged groups, respectively. In the young-aged group, patients without health insurance (OR = 0.30, P = 0.048) and in the fourth round of chemotherapy or above (OR = 0.33, P = 0.005) were more likely to belong to low symptom classes. In the middle-aged group, patients in menopause (OR = 3.58, P = 0.001) were more likely to belong to high symptom classes. In the elderly-aged group, patients with complications (OR = 7.40, P = 0.003) tended to belong to the high anxiety, depression, and pain interference classes.ConclusionsFindings from this study indicated that there is age-specific heterogeneity of symptoms present for Chinese women being treated for breast cancer with chemotherapy. Tailored intervention should consider the impact of age to reduce patients’ symptom burdens.

A Retrospective, Multicenter, Quantitative Analysis of Patients' Baseline Pain Quality (PROMIS-29) Entering into Pain and Spine Practices in the United States (ALIGN).

IntroductionMultidisciplinary patient-reported outcomes are a critical part of assessing patients to better understand their well-being during treatment. The use of multidisciplinary patient-reported outcomes is recommended in many areas of medicine. The Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) has been utilized as a common measurement language across universally relevant domains, including pain, mood, sleep, social participation, and function.MethodsRetrospective analysis of prospectively collected data was performed. Subjects were identified and consecutively enrolled upon entry into chronic pain centers across 24 sites in the United States. The PROMIS-29 v2.1 and the numerical rating scale (NRS) were recorded. The pain impact score and the Health Utilities Index Mark 3 (HUI-3) were calculated. Statistical differences were assessed between genders and among age groups comprising subjects less than 40, 41–60, 61–80, and over 80 years of age.ResultsA total of 19,546 patients were assessed over the enrollment period from 2018 to 2020. The PROMIS-29 v2.1 was evaluated across the seven domains, along with the numerical rating sale (NRS). The mean scores of the population for PROMIS SF v1.0 Pain Interference 4a, PROMIS SF v1.0 Sleep Disturbance 4a, PROMIS SF v1.0 Fatigue 4a, PROMIS SF v1.0 Anxiety 4a, PROMIS SF V1.0 Depression 4a, PROMIS SF v2.0 Ability to Participate in Social Roles and Activities 4a, and PROMIS SF v1.0 Physical Function 4a, measuring pain interference, sleep disturbance, fatigue, anxiety, depression, social participation, and physical function, were 64.61, 57.19, 58.50, 53.94, 54.45, 40.06, and 36.23, respectively. Pain intensity was 6.38 on an 11-point NRS scale. The pain impact score (PIS) and health utilities index mark 3 (HUI-3) scores, calculated across the designated age groups, were 33.19 and 0.67, respectively. Statistical differences were observed for the domains of sleep disturbance and physical function for age groups less than 40 and greater than 80 years of age.ConclusionThis data set is the first published normative data set describing the PROMIS-29 assessment in the chronic pain population. The patient population is more homogeneous than expected, and females were found to have higher levels of dysfunction.

Improvements in Health-Related Quality of Life for Patients Treated with LentiGlobin for Sickle Cell Disease (bb1111) Gene Therapy

Improvements in Health-Related Quality of Life for Patients Treated with LentiGlobin for Sickle Cell Disease (bb1111) Gene Therapy

Effects of endometriosis on sleep quality of women: does life style factor make a difference?

BackgroundThis study aimed to compare the lifestyle factors and SQ between women with and without endometriosis. Also in this essay, the influence of food intake, socio-demographic and clinical characteristics on sleep quality of women with endometriosis was determined.MethodsOf the 156 infertile women approached for the study, 78 women had endometriosis and 78 were included in the control group. At first, each participant completed a checklist including questions about demographics, physical activity, reproductive and menstrual status. SQ was assessed by the Pittsburgh Sleep Quality Index (PSQI). Dietary data were collected using a validated 147-item semi-quantitative FFQ.ResultsIrregular menstrual status, menorrhagia, dysmenorrhea, pelvic pain, history of abortion, family history of endometriosis were associated with endometriosis risk (P < 0.05). In women with physical activity more than 3 h per week, high consumption of the dairy product, and fruit endometriosis is less common (P < 0.05). The total PSQI score, and the scores for subjective sleep quality, sleep latency, sleep disturbance domains were significantly different between the two groups (P < 0.05). In women with endometriosis, poor SQ was associated with dysmenorrhea, pelvic pain, dyspareunia, physical activity, and low consumption of the dairy product, fruit, and nut (p < 0.05).ConclusionIn endometriosis women, SQ was lower than healthy individuals. Lifestyle factors can effect on SQ of these patients.

Rheumatoid arthritis is associated with negatively variable impacts on domains of sleep disturbances: evidence from a systematic review and meta-analysis

ABSTRACT The aim of this study was to identify the impact of rheumatoid arthritis (RA) on specific sleep quality domains and to determine its prevalence. A systematic literature search was performed on PubMed, Web of Science, Cochrane Library, and Embase until January 2018 to obtain eligible studies. Score of the Pittsburgh Sleep Quality Index (PSQI) was used as the outcome measurement, and weight mean differences (WMD) with 95% confidence intervals (CI) were calculated. In total, eight studies were eligible for inclusion criteria, comprising 658 RA patients and 485 healthy controls. In this meta-analysis, each domain of the PSQI score: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disorders, use of sleep medication, daytime dysfunction and the total score were higher in RA patients than healthy controls. In addition, the relative risk of sleep disturbances among people with RA was 2.37 (95% CI: 1.80, 3.11) compared with people without RA.In conclusion, RA patients scored higher in each dimension of PSQI, and sleep disturbances was more prevalent in RA patients than in controls. Further research is needed to identify effective strategies for preventing and treating sleep disturbances among RA patients.

The Relationship Between Leg Muscle Cramps and Sleep Quality in Pregnant Women Visited the Health Centers in Tabriz

Abstract Background: Leg muscle cramps (LMCs) and sleep disorders are a common problem during pregnancy, and may be correlated. Objectives: The aims of this study were to determine the features of LMCs and sleep quality as well as their association in the third trimester of pregnancy. Methods: This cross-sectional study was conducted on 439 pregnant women referred to health centers/posts of Tabriz, Iran, in 2014. The participants were selected through double stage cluster sampling method. Data were collected by using a socio-demographic questionnaire, Pittsburgh sleep quality index and leg muscle cramp characteristics questionnaire. Chi-square, Independent t, Pearson and Spearman correlation and Mann-Whitney U tests were used for data analysis. Results: The mean ± SD total sleep quality score was 8.8 ± 3.9, within a possible score range of 0 to 21. About 84% of the women had sleep quality disturbances. LMCs were observed in more than half of the participants and there was a statistically significant correlation between the occurrence of LMCs and total sleep quality score (P = 0.001) and sub domains of sleep disturbances and daytime dysfunction (P < 0.001). There was also a significant relationship between occurrence of sleep quality disturbances and occurrence of LMCs (P = 0.006). Conclusions: The present study showed that leg muscle cramps and sleep disorder are common during pregnancy and sleep quality disturbances are correlated with occurrence of leg muscle cramps. Prevention and treatment actions should be considered in the prenatal care.

DOZ047.107: Increased quality of life burden related to obstructive sleep apnea in children with aerodigestive disease

Abstract Objective The aim of this study was to determine the impact of sleep-disordered breathing on quality of life (QOL) in children with aerodigestive disease compared to children without aerodigestive disease. Methods Retrospective, IRB-approved, single-institution review of OSA-18 survey results administered to an unselected population of pediatric otolaryngology patients, some of whom had also been seen in the multidisciplinary aerodigestive clinic, was carried out. Results 476 non-aerodigestive patients and 43 aerodigestive patients were compared using total OSA-18 score and the summed scores from the 5 domains that comprise the OSA-18: (1) sleep disturbance, (2) physical suffering, (3) emotional distress, (4) daytime problems, and (5) caregiver concern. Sleep-related QOL was significantly worse for children with aerodigestive disease compared to those without aerodigestive disease across domains of sleep disturbance (P = 0.011), physical suffering (P = 0.028), and caregiver concern (P = 0.016). Total OSA-18 scores were in the mild impact range, and they did not differ significantly between the two populations. Conclusion While the focus of many aerodigestive programs is on the pathophysiological relationship between the upper digestive tract, the laryngotracheal airway, and the lungs, the present study elucidates a significant impact of upper airway obstruction during sleep on the QOL of children with aerodigestive disease. In recognition of this impact, certain airway centers have added a multidisciplinary approach to upper airway obstruction to their aerodigestive treatment armamentarium. At the minimum, airway treatment centers should consider systematic screening of all children with aerodigestive disease for QOL burden related to OSA.

Cardiorespiratory Fitness Modifies Influence of Sleep Problems on Cerebrospinal Fluid Biomarkers in an At-Risk Cohort.

Previous studies indicate that cardiorespiratory fitness (CRF) and sleep are each favorably associated with Alzheimer's disease (AD) pathophysiology, including reduced amyloid-β (Aβ) and tau pathology. However, few studies have examined CRF and sleep in the same analysis. To examine the relationship between sleep and core AD cerebrospinal fluid (CSF) biomarkers among at-risk healthy late-middle-aged adults and determine whether CRF modifies this association. Seventy-four adults (age = 64.38±5.48, 68.9% female) from the Wisconsin Registry for Alzheimer's Prevention participated. Sleep was evaluated using the Medical Outcomes Study Sleep Scale, specifically the Sleep Problems Index I (SPI), which incorporates domains of sleep disturbance, somnolence, sleep adequacy, and shortness of breath. Higher scores indicate greater sleep problems. To assess CRF, participants underwent a graded exercise test. CSF was collected via lumbar puncture, from which Aβ42, total-tau (t-tau), and phosphorylated-tau (p-tau) were immunoassayed. Regression analyses examined the association between SPI and CSF biomarkers, and the interaction between SPI and CRF on these same biomarkers, adjusting for relevant covariates. Higher SPI scores were associated with greater p-tau (p = 0.027) and higher t-tau/Aβ42 (p = 0.021) and p-tau/Aβ42 (p = 0.009) ratios. Analyses revealed significant SPI*CRF interactions for t-tau (p = 0.016), p-tau (p = 0.008), and p-tau/Aβ42 (p = 0.041); with a trend for t-tau/Aβ42 (p = 0.061). Specifically, the relationship between poorer sleep and these biomarkers was significant among less fit individuals, but not among those who were more fit. In a late-middle-aged at-risk cohort, CRF attenuated the association between poor sleep and levels of select CSF biomarkers. This suggests fitness may play an important role in preventing AD by protecting against pathology, even in impaired sleep.

Association between Sleep Disturbances and Emotional/Behavioral Problems in Chinese and Japanese Preschoolers

ABSTRACTObjectives: Sleep disturbances are often associated with emotional/behavioral problems in young children, but whether the association differs among Asian countries remains unknown. This study aimed to investigate the association between sleep disturbances and emotional/behavioral problems in Chinese and Japanese preschoolers and to explore potential differences.Methods: Participants were 1,020 Chinese preschoolers from 10 cities and 438 Japanese preschoolers from 1 city aged 4 to 5 years. Parents filled out the Children’s Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ).Results: Chinese children with sleep disturbances (defined as total CSHQ score >41) demonstrated more peer problems than children without, while there was no such difference in Japanese preschoolers. Domains of sleep disturbances associated with emotional/behavioral problems in Chinese children were sleep disordered breathing and daytime sleepiness, yet in Japanese children were sleep anxiety and night wakings. Children with a higher score of sleep anxiety showed more emotional problems in Japan, but fewer conduct problems in China.Conclusions: Sleep disturbances were associated with emotional/behavioral problems in preschoolers with differences between China and Japan, indicating subcultural differences in preschoolers’ sleep within Asian countries.Abbreviations: CSHQ: Children’s Sleep Habits Questionnaire; SDQ: Strengths and Difficulties Questionnaire; ANCOVA: analysis of covariance; SD: standard deviation; CI: confidence interval.

Systemic lupus erythematosus is associated with negatively variable impacts on domains of sleep disturbances: a systematic review and meta-analysis

Sleep disturbances are common in systemic lupus erythematosus (SLE), but the features of sleep disturbances are not well understood. The aim of this study was to identify the impact of SLE on specific sleep quality domains and to determine its prevalence and associations. We performed a systematic review and meta-analysis to compare the sleep outcomes of individuals with SLE and healthy controls. PubMed, MEDLINE, EMBASE, Cochrane Library, Web of Science CNKI, VIP, CNKI and Wanfang database were searched to find the published literatures (from these databases established to May 2017). Studies were screened according to inclusion and exclusion criteria and the qualities of included studies were evaluated. The data was analyzed using Revman5.3 software. Score of the Pittsburgh Sleep Quality Index (PSQI) scoring system was used as the outcome measurement, and mean differences (MD) with 95% confidence intervals (CI) were calculated. Five studies were included, including 350 SLE and 1396 healthy controls. A total of 5 studies including 827 patients were eligible for inclusion in the systematic review and meta-analysis. In this meta-analysis, each domain of the PSQI score: subjective sleep quality (MD, .58; 95% CI, .26, .89), sleep latency(MD, .47; 95% CI, .21, .73), sleep duration (MD, .36; 95% CI, .13, .58), habitual sleep efficiency (MD, .58; 95% CI, .32, .84),sleep disorders (MD, .56; 95% CI, .34, .77), use of sleep medication (MD, .56; 95% CI, .33, .80), daytime dysfunction (MD, .57; 95% CI, .11, 1.04) and the global score (MD, 3.59; 95% CI, 1.37, 5.80) were higher in SLE women than healthy controls. Furthermore, subjective sleep quality and habitual sleep efficiency were most severely affected especially. It demonstrated that targeted interventions should be done to improve their sleep quality. Early recognition and appropriate intervention are essential to reduce the negative impact of sleep disturbances on the patient’s sleep quality and outcome of their disease.

An Overview of the Patient‐Reported Outcomes Measurement Information System (PROMIS) for Assessing Chronic Low Back Pain Patients

This study aimed to demonstrate the relevance of the Patient‐Reported Outcomes Measurement Information System (PROMIS) measures to the assessment of chronic low back pain. A literature search was conducted to find all relevant articles regarding the PROMIS domains of pain impact, behavior, interference, quality, and intensity, as well as the other PROMIS domains of sleep disturbance, fatigue, satisfaction with social roles, anxiety, depression, and physical function. Findings were compiled. Although few measures assessed low back pain specifically, all were found reliable and valid, and useful for a wide variety of other populations. The PROMIS has several advantages over other “legacy” measures, including generalizability, comparability, ease of access and use, having a wide range of methodologies to utilize in assessment, and free availability to the public. Having the PROMIS available at no additional cost will help further research by making it more accessible.

Relationship between sleep disturbance and functional outcomes in daily life habits of children with Down syndrome.

The goal of this study was to describe sleep patterns and accomplishment of daily life habits in children with Down syndrome (DS) and to investigate the relationship between subjective indicators of sleep disturbance with functional outcomes in daily life. Cross-sectional study with an Internet sample. Online survey filled out at home. 110 parents of children with DS and 29 parents of children with typical development (TD), age 5 to 18 years. N/A. Children's Sleep Habits Questionnaire was employed to collect information about sleep disturbances in 8 domains (subscales) and a total score. The Life Habits (Life-H) questionnaire sampled information about daily life habits in 11 domains. Multivariable regression modeling was used to assess the associations between sleep disturbances and the accomplishment of daily life habits. Sleep disordered breathing (SDB) was a significant explanatory factor in 10 of 11 daily life habits and the total Life-H score. Sleep anxiety and parasomnias significantly influenced the accomplishment of life habits in children with DS as compared to children with typical development. When evaluated in multivariable models in conjunction with the other 7 domains of sleep disturbances, SDB was the most dominant explanatory factor for accomplishment of life habits. Sleep disturbances are negatively related to accomplishment of daily life functions. Prevention and treatment of sleep problems, particularly sleep disordered breathing, in children with DS may lead to enhanced accomplishment of daily life habits and activities.

The Effectiveness of Epinastine Hydrochloride for Pediatric Sleep- Disordered Breathing Related Symptoms Caused By Hyperesthetic Non- Infectious Rhinitis

Objectives: The aims of this study were to prospectively evaluate the effectiveness of oral epinastine hydrochloride in pediatric outpatients with Sleep-Disordered Breathing- (SDB) related symptoms caused by hyperesthetic non-infectious rhinitis, and to assess their Quality of Life (QOL) prior to and following treatment. Study design: Prospective Methods: Pediatric outpatients (9 boys and 10 girls; average age, 5.6 years [SD=1.4]), with SDB related symptoms influenced by hyperesthetic non-infectious rhinitis were recruited. The children were all treated with oral epinastine hydrochloride dry syrup for 4 weeks. Before and after the 4-week treatment period, the following data were collected from each participant: otolaryngological findings, obstructive sleep apnea-18 (OSA-18) scores, and evaluation of QOL. Results: Epinastine hydrochloride significantly improved the swelling of the inferior nasal turbinate mucosa and decreased the quantity of nasal discharge. The initial total mean OSA-18 score was 58.5, whereas the total score reduced to 22.8 after oral epinastine hydrochloride treatment. Significant (p < 0.01) differences were found between pre- and post-treatment total OSA-18 scores as well as pre- and post-treatment measurements of domains of sleep disturbance, physical symptoms, and caregiver concerns. Conclusions: Epinastine hydrochloride therapy may improve nasal findings and QOL in pediatric outpatients with SDB related symptoms caused by hyperesthetic non-infectious rhinitis.

Sleep problems among Chinese preschool children: prevalence and associated factors

Introduction Sleep is a critical issue in child development and may be affected by a range of socio-demographic variables, parenting style and emotional/ behavior, etc. This study aimed to (1) characterize sleep patterns and sleep disturbances among Chinese preschool children, (2) determine the prevalence of sleep disturbances according to published norms, and (3) examine socio-demographic factors, parenting factors and emotional/behavioral problems that might be associated with sleep disturbances. Materials and methods A sample of 561 preschool children (53.2% male) aged 2–6 years was recruited from 10 kindergartens in Shijiazhuang city, China. Their parents completed the Children’s Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ) and self-made questionnaire including demographic characteristics, using of electronics as well as parenting styles. Results The mean bedtime was 21:23 (SD = 33 min), mean wake-up time was 7:02 am (SD = 21 min), mean sleep duration was 9 h 20 min (SD = 42 min). Overall, 49.4% of the children suffered from global sleep disturbances (CSHQ total score above 41). The prevalence of specific sleep disturbances ranged from 4.3% (falling asleep while watching TV) to 32.4% (needing parents in room to sleep). Correlations between most domains of sleep disturbances and emotional/behavioral problems were statistically significant, with Pearson’s correlation coefficients varying from 0.1 to 0.3 (p ∣ Â = −0.13, p ∣ Â = 0.17, p ∣ Â = 0.15, p ∣ Â = 0.18, p ∣ Â = 0.14, p ∣ Â = 0.14, p Conclusion Short sleep duration and sleep disturbances are prevalent among Chinese preschool children. Sleep disturbances are associated with age, co-sleeping, parenting attitude, emotional symptoms and hyperactivity.

Prevalence of restless legs syndrome and sleep quality in carriers of the fragile X premutation.

This study examined the relationship between the fragile X premutation and restless legs syndrome (RLS). Demographic, medical history and survey responses related to sleep were collected from 213 participants (127 carriers and 86 age matched controls). Subjects were asked about the presence of the four formal diagnostic criteria for RLS. Individuals with the premutation were 1.9 times as likely to meet criteria for RLS (95% CI 1.1–3.2, p=0.025) as controls. Premutation carriers with RLS also experienced significantly worse symptoms than matched controls with adjusted mean scores of 15.1±8.8 vs 7.9±4.4, respectively on the International Restless Legs Scale (IRLS). As markers for domains of sleep disturbance, all subjects completed the Epworth Sleepiness Scale (ESS), the Insomnia Severity Index (ISA) and the Pittsburgh Sleep Quality Index (PSQI). Premutation carriers demonstrated significantly more pathology on these tests except for the ESS where there was a trend towards increased daytime sleepiness in carriers. RLS joins a host of other conditions that should be carefully screened for in those carrying the fragile X premutation and sleep should be a focus for clinicians providing care to them.

1370 – Adolescents’ mental health evaluation in ukraine using adapted seyle protocol

Modern situation n Ukraine is charachterized by rapid growth of socio-economic inequality. To evaluate mental health, psychosocial problems and suicidality in adolescents aged 14-17 years with regards to socio-economic factors of the families. To evaluate role of socio-economic enaquality as a factor impairing adolescents’ mental health. Components of SEYLE protocol were adapted to local regulations and were used to measure wide range of psycho- social factors characterizing adolescents’ mental health. 250 children aged 14-17 representing different types of schools (from elite gymnasiums to municipal boarding-schools) were questioned. It was found that main psychosocial problems of adolescents were in the domains of sleep disturbances, internet addiction, unhealthy life styles including smoking, alcohol and risky behaviours. Both negative and positive characteristics have a tendency to clastering. Suicidal thoughts are admitted by 30% of children with a slight prevalence in girls. One of the strong predictors of negative life styles and mental health problems is the answer to the question if a child have ever seen a parent being drunk. There was a marked association between mental health problems and socio-economic status of the family. Poorer economic status of the family was associated with higher level of depression, feeling of stress, loneliness, psychosomatic symptoms and suicidal thoughts in adolescents. Socio-economic status of the families, parents life styles, internet abuse and fatigue play an important role in adolescents suicidality. Children are very susceptible to the stress in parents caused by socio-economic circumstances.

Sleep Quality in Rheumatoid Arthritis: Relationship Between the Disease Severity, Depression, Functional Status and the Quality of Life

BackgroundThe aim of this study was to evaluate sleep quality and the related variables in patients with rheumatoid arthritis (RA).MethodsNinety-four patients diagnosed with RA and fifty two healthy controls were enrolled in the study. Disease activity was assessed through the Disease Activity Score (DAS) 28 scale. All patients were assessed using the Rheumatoid Arthritis Quality of Life and Health Assessment Questionnaire scales, together with the Beck Depression Inventory. Radiological damage was calculated with the modified Larsen method. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of the sleep disturbance.ResultsThe patients with RA had significantly higher scores in the subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance domains and the total PSQI score compared to the healthy control group. According to the results of Spearman’s analysis, there was a significantly correlation between the age, disease activity, CRP, pain, fatigue, depression, functional disability, quality of life, radiological damage, menopause status, duration of morning stiffness, ESR levels and the sleep disturbance. The logistic regression analysis indicated that depression and DAS 28 scores were predictors for poor sleep quality.ConclusionThe sleep quality is disturbed in patients with RA. The poor sleep quality is especially associated with the disease activity and depression.

Sleep patterns and sleep disturbances among Chinese school-aged children: Prevalence and associated factors

The study aimed to (1) characterize sleep patterns and sleep disturbances among Chinese school-aged children, (2) determine the prevalence of their short sleep duration and sleep disturbances based on clinical cutoffs, and (3) examine possible factors (socio-demographic factors and emotional/behavioral problems) that are associated with sleep disturbances. A large representative sample of 912 children aged 6-14years was recruited from Shenzhen, China. Their parents completed the Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ). The mean bedtime was 9:45pm (SD=1h 11min), mean wake-up time was 7:03am (SD=31min), mean sleep duration was 9h 14min (SD=46min), and 23.8% of the children had sleep duration <9h. Overall, 69.3% of the children suffered from global sleep disturbances (CSHQ total score >41). Bedtime resistance (22.9%), sleep anxiety (22.1%), sleep duration (21%) and daytime sleepiness (20%) were the most prevalent sleep disturbances; followed by sleep disordered breathing (12.1%), parasomnias (9.4%), sleep onset delay (6.9%), and night waking (5.2%). The prevalence of specific sleep disturbances ranged from 3.2% (falling asleep while watching television) to 81.9% (awakening by others in the morning). Correlations between most domains of sleep disturbances and emotional/behavioral problems were statistically significant (p<0.05 or p<0.01). Hierarchical multiple regression analysis revealed that gender (β=0.10, p<0.01), school grade (β=-0.09, p<0.05), co-sleeping (β=0.25, p<0.01), emotional symptoms (β=0.24, p<0.01), conduct problems (β=0.09, p<0.05), and hyperactivity (β=0.17, p<0.01) accounted for significant variance in CSHQ total score. Short sleep duration and sleep disturbances are prevalent among Chinese school-aged children. Sleep disturbances are associated with gender, school grade, co-sleeping, emotional symptoms, conduct problems, and hyperactivity.

Fibromyalgia Syndrome Module at OMERACT 9: Domain Construct

The objective of the module was to (1) establish a core domain set for fibromyalgia (FM) assessment in clinical trials and practice, (2) review outcome measure performance characteristics, (3) discuss development of a responder index for assessment of FM in clinical trials, (4) review objective markers, (5) review the domain of cognitive dysfunction, and (6) establish a research agenda for outcomes research. Presentations at the module included: (1) Results of univariate and multivariate analysis of 10 FM clinical trials of 4 drugs, mapping key domains identified in previous patient focus group: Delphi exercises and a clinician/researcher Delphi exercise, and breakout discussions to vote on possible essential domains and reliable measures; (2) Updates regarding outcome measure status; (3) Update on objective markers to measure FM disease state; and (4) Review of the issue of cognitive dysfunction (dyscognition) in FM. Consensus was reached as follows: (1) Greater than 70% of OMERACT participants agreed that pain, tenderness, fatigue, patient global, multidimensional function and sleep disturbance domains should be measured in all FM clinical trials; dyscognition and depression should be measured in some trials; and stiffness, anxiety, functional imaging, and cerebrospinal fluid biomarkers were identified as domains of research interest. (2) FM domain outcome measures have generally proven to be reliable, discriminative, and feasible. More sophisticated and comprehensive measures are in development, as is a responder index for FM. (3) Increasing numbers of objective markers are being developed for FM assessment. (4) Cognitive dysfunction assessment by self-assessed and applied outcome measures is being developed. In conclusion, a multidimensional symptom core set is proposed for evaluation of FM in clinical trials. Research on improved measures of single domains and composite measures is ongoing.