Global Pittsburg Sleep Quality Index Research Articles

Effect of Yoga Nidra Practice on the Sleep Quality of University Students

Introduction: Sleep is one of the basic needs for survival and quality of life however there is poor awareness about sleep quality in general. The prevalence of sleep issues is concerning worldwide among all age groups, especially in the adolescent and young population. Apart from the currently used interventions like Sleep hygiene, the practice of Yoga Nidra is found to reap benefits in improving sleep quality in the clinical population. Its effectiveness can be explored on university students with sleep issues. Methodology: The study was conducted at Sri Sri University, Cuttack, Odisha. The participants were university students (Age 18 to 28 years), 26 participants (20 males, 6 females) were selected for the study using a screening tool- Sleep Disorder Questionnaire out of 80. The participants were given a 10 day intervention of Yoga Nidra using a twenty minutes recorded version by H.H. Sri Sri Ravishankar Ji. The data was collected using a standardized sleep quality instrument- Pittsburg Sleep Quality Index (PSQI) to measure the quality and patterns of sleep in adults. Results: The analysis shows that there is a significant difference between Pre (M=7.42, SD=3.06) and Post (M=4.69, SD=2.81) scores of Global PSQI t (25) =4.984, p<0.05. There was a positive effect of the practice of Yoga Nidra with post scores being significantly lower than the pre scores on five components namely Subjective sleep quality, Sleep latency, Sleep duration, Habitual Sleep efficiency and Daytime dysfunction. There was a non-significant difference found in Sleep disturbance and a negative trend in the Use of sleep medication although it was non-significant. The results suggest that Yoga Nidra may be an effective technique for university students to reduce sleep issues and improve sleep quality.

0152 Natural disaster experiences and their varying impact on sleep impairment

Abstract Introduction As rates and severity of natural disasters increase due to climate change, it is crucial to consider their effects on mental health. Among Hurricane Katrina survivors, stressors experienced following the Hurricane, including financial losses, were more robustly predictive of rates of PTSD than traumatic experiences occurring during the Hurricane (Galea et al., 2008). Because sleep disturbance is intimately associated with trauma exposure and has been implicated in the etiology of PTSD, we examined relationships between experiences during and after Hurricane Harvey (a historic storm that hit Texas in 2017) and sleep disturbance in sample of college students impacted by the storm. Methods Undergraduate students (N = 191, age: M = 21.25, SD = 3.14) at the University of Houston completed online surveys 6-8 months after Hurricane Harvey. Sleep quality was measured using the Pittsburg Sleep Quality Index (PSQI) and post-traumatic stress (PTS) symptoms were measured using the PTSD Checklist for DSM-5, excluding sleep items. Participants also reported on experiences/events during, immediately after, and in the weeks/months following the Hurricane. Total traumatic experiences during the Hurricane (e.g., thinking oneself or others would get hurt or die) and stressful experiences after the storm (e.g., losing power, damage to car or property) were calculated. Financial stress was examined as a unique predictor. Analyses controlled for total traumatic life events measured with the Life Events Checklist for DSM-5. Results In a multiple linear regression model, we tested whether traumatic experiences during, stressors after, and financial stressors due to the Hurricane predicted global PSQI score, controlling for other traumatic life experiences and total PTS symptoms. The overall model was significant (R2 = 0.22, F (5,185) = 10.48, p < .000). Traumatic experiences during the Hurricane (B = 0.37, p = 0.04), but not stressors (B = 0.02, p = 0.87) or financial stress (B = -0.29, p = 0.67) following the Hurricane significantly predicted poor sleep quality at present. Conclusion Our findings suggest that among a sample of young adult college students impacted by Hurricane Harvey, traumatic experiences during the storm were the most robust predictor of sleep disturbance several months later even after accounting for PTS symptoms. Support (if any)

Sleep quality in patients of chronic obstructive pulmonary disease

Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory ailment with persistent airflow limitation associated with an enhanced chronic inflammatory response in airways and lungs to noxious particles or gases. This study aims to observe the sleep quality in these cases as it is known that most of them suffer from disturbed sleep. Aims and Objectives: The aims of this study were to assess the sleep quality in stable patients of COPD and compare with healthy controls. Material and Methods: This cross-sectional observational study was approved by ICMR and IEC and conducted in the department of Physiology and the Department of TB and Chest Medicine, Lady Hardinge Medical College, New Delhi. In this study, 33 clinically stable COPD patients and 33 normal subjects as controls were included in the study. Then, a detailed history including the demographic characteristics was recorded. Then, Pittsburg Sleep Quality Index (PSQI) Questionnaire (Hindi version was obtained from MAPI organization) was recorded by direct interview before lung functions were assessed by Spirometry. Results: In his study, COPD was found predominantly in male subjects compared to females. Poor sleep was found in majority of COPD cases. The median global PSQI scores were much higher in COPD cases compared to controls and the difference between them was statistically highly significant (P < 0.001). Conclusion: This study shows that the prevalence of poor sleep quality among COPD patients of urban Delhi is very high. Limitations are small sample size and hospital-based subjects and lack of polysomnography.

Lifestyle factors associated with poor sleep quality among undergraduate dental students at a Malaysian private university.

The purpose of this study was to look into the associations between lifestyle factors, gender, clinical level, and sleep quality among undergraduate dental students at a private university in Malaysia. A self-administered Pittsburg sleep quality index (PSQI) scale and the lifestyle and habits questionnaire-brief (LHQ-B) were used in this cross-sectional study. A global PSQI score of greater than 5 indicates poor sleep quality. All university dental students were invited to take part. Descriptive statistics and logistic regression analyses were used to analyze the data. A total of 338 students took part in the study, with a response rate of 90.4%. The proportion of females was higher (68.3 %) and more than half of the respondents (56.7 %) were in their clinical years. The prevalence of poor sleep quality was 36.7%. At multivariable level, poor sleep quality was associated with being male (OR=1.72 [95% confidence interval (1.05, 2.83)] and engaging in an unhealthy lifestyle for psychological health (OR=2.64 [95% confidence interval (1.34, 5.21)] and nutrition (OR=2.48 [95% confidence interval (1.028, 4.82)]. The prevalence of poor sleep quality among undergraduate dental students in our study was comparable to that found in other studies. Male students were more likely to have poor sleep quality than female students. Our findings indicate that poor sleep quality (PSQI score >5) may be linked to unhealthy lifestyle habits related to psychological health and nutrition. Health education that emphasizes these domains is essential for improving their lifestyle habits and sleep quality.

Association between night sleep latency and hypertension: A cross-sectional study.

Sleep disorders have been shown to increase the risk of hypertension, while the relationship between night sleep latency and hypertension is less well-known. We aimed to investigate the association between night sleep latency and hypertension, as well as related sleep factors by gender in the Chinese population. We conducted a cross-sectional study of the relationship between night sleep latency and hypertension. The sample size included 619 consecutive hospitalized patients (M/F: 302/317, 64.01 ± 12.27 years). T test, Chi-square test, and ANOVA were performed to analyze baseline data and intergroup comparisons. Spearman correlation analysis was performed to find the interrelationships. Multivariate logistic regression analysis was performed to adjust for covariables. The findings showed hypertension patients had longer night sleep latency (P < .001). After adjusting for confounding factors, night sleep latency was positively correlated with hypertension in both men and women (odds ratio: 1.065, 95% confidence interval: 1.044–1.087). Spearman correlation analysis suggested that night sleep latency was positively correlated with systolic blood pressure (r = 0.186, P < .001), diastolic blood pressure (r = 0.136, P < .001), sleep initiation time (r = 0.091, P = .023), and global Pittsburg Sleep Quality Index score (r = 0.371, P < .001), was negatively correlated with sleep duration (r = −0.186, P < .001), sleep time on weekdays (r = −0.183, P < .001), and sleep time on weekends (r = −0.179, P < .001). Longer night sleep latency was associated with an increased risk of hypertension in men and women, which might involve the pathological progression of hypertension along with other sleep factors.

JS09.5.A Is Radiation Dose to Sleep-relevant Brain Structures Associated with Lower Sleep Quality in Adults with Primary Brain Tumors?

Abstract Background Sleep plays a central role in optimal brain health and daily functioning, and poor sleep is associated with impaired cognitive functioning and reduced quality of life. Despite improved precision of modern radiotherapy (RT) for brain tumors, radiation to healthy tissue, including brain structures relevant for sleep/wake regulation, is often inevitable. In the present study, we investigate whether radiation dose to sleep/wake-relevant brain structures is associated with poorer patient-reported sleep quality in primary brain tumor patients. Material and Methods Patients who had received RT for non-glioblastoma primary brain tumors between 2006 and 2016 were included. They completed the Pittsburg Sleep Quality Index (PSQI) and mean radiation doses to sleep/wake-relevant structures (i.e., brainstem, thalamus, hypothalamus, and the pituitary and pineal glands) were calculated based on planning CTs and contrast-enhanced MR-images. Mean radiation dose (Dmean) to brain structures were compared between patients with and without impaired sleep outcomes using bootstrapped independent t-tests. Differences with effect sizes (ES, Cohen’s d) exceeding ± 0.3 are reported. Results A total of 78 patients (glioma, grade 1-3 = 28; meningioma = 22, pituitary = 16, other = 12) were included. Median time since RT was 4.6 years (range = 8.4 years). Mean global PSQI score was 5.13 (SD = 3.1). No differences were observed between tumor types, F (3,74) = 0.37, η 2= .02. Clinical sleep disturbance (PSQI &amp;gt; 5) was reported by 37.2% (n=29). Compared with patients without sleep disturbance, those with sleep disturbance had received a higher radiation dose to the pituitary gland, Dmean = 26.11 Gy, SE = 2.59, versus 34.57 Gy, SE = 3.43, ES(d) = - 0.46, 95% CI [-0.93, 0.003]. Furthermore, compared with patients reporting normal sleep latency (SL), those with poor SL had received a higher radiation dose to the pituitary gland, Dmean = 24.55 Gy, SE = 3.71, versus 32.60 Gy, SE = 2.48, ES(d) = - 0.44, 95% CI [-0.90, 0.03], and the brain stem, Dmean = 15.32 Gy, SE = 2.71, versus 20.20 Gy, SE = 2.01, ES(d) = -3.44, 95% CI [-0.80, 0.12]. Finally, compared with patients with a high sleep efficiency (&amp;gt;85%), those with a low sleep efficiency had received a higher radiation dose to the thalamus, Dmean = 18.11 Gy, SE = 2.36, versus 24.55 Gy, SE = 4.43, ES(d) = -0.35, 95% CI [-0.83, 0.15], and the pineal gland, Dmean = 16.20 Gy, SE = 2.48, versus 23.10 Gy, SE = 4.25, ES(d) = -0.36, 95% CI [-0.85, 0.13]. Conclusion The prevalence of clinical sleep disturbances in patients with primary brain tumors was high (37%). Our results indicated that higher radiation doses to the pituitary gland, brain stem, thalamus, and pineal gland may be risk factors for poor sleep quality in patients with a primary brain tumor.

Sleep impairment: Is it an overlooked burden in painful diabetic peripheral neuropathy? A single-centre, cross-sectional study from south India

Background and aimsPainful diabetic peripheral neuropathy (PDPN) is a common complication of type 2 diabetes. The unrelenting pain associated with PDPN adversely affects a patient's quality of life. Recognizing the crucial role that sleep plays in the metabolic control of diabetes, this study aims to estimate the prevalence of sleep impairment in painful diabetic peripheral neuropathy (PDPN) and identify the factors associated with it. MethodsWe conducted a cross-sectional study among 156 patients in a tertiary care hospital in south India. We recruited consenting adults with PDPN. Sleep quality was analyzed using the Pittsburg sleep quality index (PSQI), a self-rating scale. Hba1c served as a measure of glycemic control. Anxiety and depression were assessed using the hospital anxiety and depression (HAD) scale. Data were analyzed in SPSS 26.0. ResultsA total of 156 patients were included in the study with a mean age of 58.39 ± 9.12 years. In 151 (96.79%) patients demonstrated sleep impairment with a global PSQI score of 10.92 ± 2.87. Female sex, ischemic heart disease (IHD), high anxiety levels and use of insulin, pregabapentin, and duloxetine; were significantly associated with poor sleep quality (p < 0.05). The median Hba1c was high (9% [7.46–11.1]). However, there was no statistical correlation between the degree of sleep impairment and glycemic control. ConclusionWe found a high prevalence of sleep impairment in patients with PDPN. Female sex, IHD, high anxiety levels and use of neuropathic drugs were predictors of poor sleep quality.

Sleep Quality Relates to Metabolic Health in Second Trimester of Pregnancy

ObjectivesExamine the relationships between self-reported sleep quality parameters and markers of metabolic health during pregnancy.MethodsBaseline data collected at 12–20 weeks gestation from pregnant women enrolled in a high-fiber RCT (SPROUT; NCT04868110) were analyzed. Exclusion criteria included any known metabolic disturbance (e.g., history of diabetes, preeclampsia, hypertension). At the visit, a fasted blood draw, height, and weight were performed. Self-reported pre-pregnancy weight was collected. Sleep quality was assessed using the global Pittsburg Sleep Quality Index score (PSQI; >5 indicates poorer overall sleep quality) and sleep efficiency from the PSQI (100-point scale, higher indicates better efficiency). Total cholesterol (TC), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), triglycerides (TG), serum glucose, serum insulin, and hemoglobin A1c were analyzed using standardized protocols. Pearson's correlations, means, and standard deviations were performed.ResultsThirty-three participants were included in the analyses. Participants had a pre-pregnancy BMI of 25.4 ± 4.3 kg/m2, PSQI of 4.61 ± 2.4, and sleep efficiency of 89.8 ± 10.7. Sleep efficiency was related to TC (r = −0.41, p = 0.018) and LDL-C (r = −0.418, p = 0.016); and PSQI was related to LDL-C (r = 0.372, p = 0.033). No relationships were found between sleep parameters and other lipid or glycemic markers.ConclusionsIn a group of low-risk pregnant women, lower sleep efficiency and overall sleep quality were related to higher levels of blood lipids.Funding SourcesInternal funding received from School of Health Professions at presenting author's academic institution.

Sleep among Obstetrics and Gynecology Trainees: Results from a Yoga-Based Wellness Initiative.

This study aimed to determine the feasibility of using a wrist-based fitness tracking device to assess sleep among Obstetrics and Gynecology (OBGYN) trainees who engaged in a yoga-based wellness program. We also sought to evaluate the effects of yoga on sleep. A quality improvement initiative consisting of an 8-week wellness program of weekly yoga classes, nutrition, and physical challenges was implemented for OBGYN residents and Maternal-Fetal Medicine fellows. The Polar A370 fitness tracker device was provided and synced to the Polar Flow for Coach program for inclusion. Data obtained included total and restful sleep from each night the device were worn. Pre- and post-assessment of the Pittsburg Sleep Quality Index (PSQI) were compared. Linear mixed models were used to estimate and test the effect of yoga on sleep while controlling for on-call shifts. Of the 15 participants who synced their device, 13 (87%) were included for analysis. Sleep data from 572 nights were analyzed. The mean (SD) total sleep was 434.28 (110.03) minutes over the 8 weeks. A minimum of 7 hours (420 minutes) of total sleep occurred 59.3% of the time. After controlling for Friday or Saturday night on-call, those who attended yoga class had a significantly greater total sleep (yoga: 425.14 minutes [41.89], no yoga: 357.33 [43.04] minutes; p = 0.04). There was no significant change in the mean global PSQI score after the program (pre: 5.0 [1.6], post: 5.1 [2.5], p = 0.35). Wearable fitness monitors provide insight into sleep patterns displayed during training and can serve as a tool to identify those who are sleep deprived and assist in the evaluation of trainee wellness. Training programs are encouraged to provide access to yoga and mindfulness interventions to improve sleep and possibly clinical performance. · Yoga improves trainee sleep by approximately 60 minutes.. · Total and restful sleep are reduced during night float rotation.. · Trainees obtained 7 hours of sleep approximately 60% of the time..

Effects of sleep duration and sleep quality in early pregnancy and their interaction on gestational diabetes mellitus.

To examine the association of sleep duration and quality in early pregnancy with gestational diabetes mellitus (GDM), and explore their interaction effect on GDM. Participants from 2 hospitals were enrolled in this case-control study between April 2018 and November 2020. Sleep duration and quality were measured using the Pittsburg Sleep Quality Index (PSQI). A total of 1300 participants (396 GDM and 904 controls) were included. After adjusting for potential confounders, higher global PSQI scores or poor sleep quality were associated with GDM with odds ratios of 1.13 (95% CI 1.07, 1.19, p < 0.001) and 1.75 (95% CI 1.29, 2.38, p < 0.001), respectively; sleep duration < 7h, 9-9.9h and ≥ 10h were all associated with increased GDM with odds ratios of 4.28 (95% CI 2.51, 7.31, p < 0.001), 1.69 (95% CI 1.20, 2.39, p = 0.003), and 4.42 (95% CI 3.01, 6.50, p < 0.001), respectively. In the stratified analysis based on sleep duration, the effect of poor sleep quality on GDM in the < 7h group (OR 5.47, 95% CI 2.57, 11.64, p < 0.001) was much stronger than that in the 7-8.9h group (OR 1.24, 95% CI 0.81, 1.91, p = 0.327), and the p value of the interaction was 0.011. Poor sleep quality and short or long sleep duration in early pregnancy were all associated with GDM, and an interaction effect between short sleep duration and poor sleep quality on GDM was noted.

The association of smartphone addiction, sleep quality and perceived stress amongst Jordanian dental students.

Smartphone addiction has been associated with sleeping problems and psychological anxiety. However, little is known about the association of smartphone addiction, sleep quality and perceived stress amongst university students particularly in dentistry. This study investigated the association of these variables amongst dental students in a Jordanian dental faculty. A sample of 420 undergraduate dental students enrolled for academic year 2017/2018 at the Jordan University of Science and Technology participated in this study. They were given a set of self-administered questionnaires which consisted of questions regarding demographic information, characteristics of smartphone use, assessment of smartphone addiction, sleep quality as well as perceived stress. The mean Smartphone Addiction Scale (SAS) score amongst Jordanian dental students was high (109.9±23.8). The correlation between SAS and Global Pittsburg Sleep Quality Index (PSQI) score was significant (r=0.137, P=0.005) indicating that the higher the smartphone addiction level, the poorer the quality of sleep. Similarly, a significant correlation was found between Perceived Stress Scale-10 (PSS-10) score and Global PSQI score (r=0.348, P<0.001) which implied that students who have higher perceived stress experienced poorer sleep quality. Year 3 students (clinical year), smartphone addiction and perceived stress were determinants of sleep quality. Dental students who have high levels of smartphone addiction or high perceived stress levels experienced poor sleep quality. Identifying smartphone addicts amongst students as well as stressors are imperative measures to allow timely assistance and support in the form of educational campaigns, counselling, psychotherapy and stress management.

Association of sleep disturbance with diabetic retinopathy.

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

Fighting the Freshman Fifteen: Sleep, Exercise, and BMI in College Students.

To examine how sleep and physical activity predict body mass index (BMI) in college students. Cross-sectional. Medium-sized public university in the Southeastern United States. 386 undergraduate students (245 females; 18-25 years). Surveys included the Pittsburg Sleep Quality Index (PSQI) and Concise Physical Activity Questionnaire (CPAQ). PSQI provided 5 sleep scores: PSQI Global Score, Sleep Quality Factor Score, Sleep Efficiency Factor Score, Sleep Duration, and Habitual Sleep Efficiency. Height and weight measurements were taken to calculate Body Mass Index (BMI). Correlational analyses were completed first. Linear and moderation regression models using CPAQ as the moderator were used to predict BMI. The Johnson-Neyman technique determined regions of significance where sleep significantly predicted BMI dependent on CPAQ score. Sleep Duration significantly predicted BMI (β= -.385, p = .043) while significant interaction terms predicting BMI were found for Global PSQI Score × CPAQ (β= -.103, p = .015) and Sleep Quality Factor Score × CPAQ (β = -.233, p = .013). Johnson-Neyman analyses demonstrated that better sleep quality (measured by Global PSQI and Sleep Quality Factor Scores) predict lower BMI when exercise levels are low and higher BMI when exercise levels are high. At low levels of exercise, better sleep quality significantly predicts lower BMI, suggesting that interventions designed to increase sleep quality could promote healthy weight maintenance in college students.

0401 Sleep Characteristic Differences During Early Postpartum in White and African American Women

Abstract Introduction In the general population, poor sleep quality and shorter sleep duration is associated with several adverse health outcomes. African American adults are more likely to report poorer sleep quality and shorter total sleep duration compared to White adults. However, there is limited information comparing sleep characteristics in White and African American women during postpartum, when many women experience reduced sleep quality. The purpose of this study was to compare sleep quality at 6-8 weeks postpartum in White and African American women. Methods White (n=84) and African American (n=37) women, who gave birth to a singleton at ≥ 37 weeks of gestation, completed the Pittsburg Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) at 6-8 weeks postpartum. The PSQI was used to assess global sleep quality, time in bed, and 7 components regarding sleep. The components included: Subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The ESS total score was used to assess daytime sleepiness. Results The global PSQI score was higher for African American women (8.8 ± 3.3, mean ± SD), indicating poorer sleep quality than White women (7.1 ± 3.0, p=.006). African American women had higher sleep latency and shorter sleep duration compared to White women (p=.0179 and p&amp;lt;.0001, respectively). Time in bed was not statistically different for African American women compared to White women (485.6 ± 143.7 and 530.8 ± 85 minutes/night, p=.08). No other components of the PSQI were significantly different between the two racial groups. African American women scored higher on the ESS than White women (8.9 ± 3.1, 6.6 ± 3.2, p=.0002) indicating greater daytime sleepiness. Conclusion These results suggest that African American women experience lower sleep quality and greater daytime sleepiness in early postpartum compared to White women. Support National Institute On Minority Health And Health Disparities of the National Institutes of Health under Award Number R21MD012740.

The Pittsburg Sleep Quality Index (PSQI) and Associated Factors in Middle-school Students: A Cross-sectional Study.

PurposeThe purpose of this study was to evaluate the current level of sleep quality among Korean middle-school students using the Pittsburg Sleep Quality Index (PSQI), and to analyze the factors influencing sleep quality.MethodsThe study used a descriptive cross-sectional design and a self-report questionnaire. The participants were 744 middle-school students. The questionnaire included the PSQI and health-related questions, such as the types of diseases they had been diagnosed with and the frequency of hospital admissions. The data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and linear multiple regression.ResultsThe global PSQI score was 4.21, which indicated good sleep quality. The major factors that were associated with the sleep quality of middle-school students were the number of diseases they had been diagnosed with (β=.54, p=.001) and atopic dermatitis (β=.32, p=.001). In addition, asthma and the frequency of hospital admissions were significant factors influencing each component of the PSQI.ConclusionThe findings from this study suggest that sleep quality was associated with several health-related factors. Thus, nurses, school nurses, and nursing researchers may need to assess the health-related factors associated with adolescents’ sleep quality as part of efforts to improve their sleep quality.

Sleep duration is a significant predictor of cardiac autonomic neuropathy in type 2 diabetes mellitus

AimTo investigate the association between sleep quality outcomes and measures of cardiac autonomic function and to assess the predictive ability of sleep quality outcomes for cardiac autonomic neuropathy (CAN) in type 2 diabetes mellitus (T2DM). MethodsFifty patients with T2DM (age, 51.3±7.01years; glycemic control, 8.4±1.65%) completed the study. Patients were diagnosed for CAN using the standard clinical autonomic test battery and were also assessed for heart rate variability (HRV) under resting conditions. Sleep quality was examined using the Pittsburg Sleep Quality Index (PSQI). ResultsSleep duration, sleep onset latency, sleep efficiency, daytime dysfunction and global PSQI score showed significant correlations with measures of cardiac autonomic control (p<0.05). At an optimal cut-off of≤5.83h (area under the curve: 0.76, p=0.0003; sensitivity: 50%; specificity: 94.4%), sleep duration predicted occurrence of CAN (odds ratio, confidence interval: 0.18, 0.04–0.70; p=0.01) in T2DM after adjusting for various clinical confounders. ConclusionFindings of the present study suggest that subjective sleep outcomes such as sleep duration, sleep onset latency, sleep efficiency, daytime dysfunction and overall sleep quality are associated with the indices of cardiac autonomic function in T2DM. Moreover, short sleep duration may be considered a predictor in the occurrence of CAN in these patients. Considering the role of sleep in the pathophysiology of CAN, sleep should be routinely examined in patients with T2DM and appropriate therapeutic interventions should be implemented particularly in case of reduced sleep duration.

Evaluating the impact of adenotonsillectomy for pediatric sleep-disordered breathing on parental sleep.

To evaluate the impact of adenotonsillectomy for pediatric sleep-disordered breathing (SDB) on parental sleep quality, daytime sleepiness, and child quality of life. Prospective cohort study. Pediatric patients aged 2 to 10 years with SDB and suspected obstructive sleep apnea (OSA) requiring adenotonsillectomy were identified at a single tertiary-care pediatric otolaryngology hospital. Parental daytime sleepiness and quality of sleep were evaluated pre- and postoperatively using the Epworth Sleepiness Scale (ESS) and Pittsburg Sleep Quality Index (PSQI), respectively. Child quality of life, in the context of suspected OSA, was evaluated by the Obstructive Sleep Apnea Quality of Life Survey (OSA-18), pre- and postoperatively. Paired-samples t tests were conducted to analyze data. Forty-seven patients with a mean (standard deviation [SD]) age of 4.9 (2.2) years, participated. Mean (SD) parental age was 35.5 (4.6) years. Statistically significant decreases of 2.1 points were observed between preoperative and postoperative parental mean global ESS (P = .007; 95% confidence interval [CI]: 0.6-3.6) and mean total PSQI (P = .001; 95% CI: 0.9-3.1) scores. A statistically significant improvement (41.6 points) was observed between preoperative and postoperative on mean OSA-18 scores (P < .0001; 95% CI: 35.7-47.6). Adenotonsillectomy performed in the pediatric population for SDB, with suspected OSA, can positively impact parental daytime sleepiness and sleep quality in addition to pediatric quality of life. 2 Laryngoscope, 130:232-237, 2020.

Sleep quality and psychosocial characteristics of patients with painful post-traumatic trigeminal neuropathies

The aim of this study was to explore how pain and psychological distress influence the sleep quality of patients with painful post-traumatic trigeminal neuropathy (PPTN). Thirty-two patients with a diagnosis of PPTN according to the International Classification for Headache Disorders of the International Headache Society were enrolled. All patients completed a number of questionnaires that examined sleep quality, psychological distress, and quality of life. The global Pittsburg Sleep Quality Index (PSQI) score was "5" or greater in 75% of the patients. Additionally, the Symptom Check List-90-Revised (SCL-90-R) global severity index (GSI) revealed that 71.9% of the study sample reported values of psychological distress over the level of clinical significance. Sleep quality was analyzed through a linear regression model of global PSQI (dependent variable) that included gender, age, pain intensity, and pain duration (independent variables). This model revealed a significant positive association between the PSQI global score and the SCL-90-R GSI that was independent of age, gender, pain intensity, and duration. Patients with PPTN present higher levels of sleep disturbance and psychological distress compared with the general population. Sleep quality disturbances and levels of psychological distress are strongly associated and seem to be independent of age, gender, medication use, pain intensity and duration.

A randomized controlled trial on an aerobic exercise programme for depression outpatients

There were limitations in the conventional treatments for depression. This study investigated if an aerobic exercise programme would be a beneficial adjunct for outpatients on treatment for depression in Hong Kong. We performed a single blind randomized controlled trial on 34 adult patients (between 18 and 65) suffering from major depressive disorder. Their Hamilton Depression Rating Scale (HAM-D) scores were at least 14. They were randomly assigned to receive a 12-week aerobic exercise programme in addition to usual psychiatric care (intervention), or to continue with usual psychiatric care alone (control). The outcomes included depression severity, sleep quality, somatic symptoms distress level, and anxiety level. Seventeen participants were randomly allocated to each group. There was statistically significant reduction in the mean HAM-D scores in both intervention (18.5–9.8) and control (19.5–14.5) groups. There were statistically significant main effects for time, for group, and for time*group interaction. On the sleep quality measures, there was statistically significant improvement in the global Pittsburg Sleep Quality Index in the intervention group only (from 12.0 to 9.0). This study provided suggestive evidence that aerobic exercise might be a beneficial adjunct treatment for depression.

Sleep Hygiene Practices and Their Relation to Sleep Quality in Medical Students of Qazvin University of Medical Sciences.

Introduction: Poor quality of sleep is a distressing and worrying condition that can disturb academic performance of medical students. Sleep hygiene practices are one of the important variables that affect sleep quality. The objective of this study was to assess association between sleep hygiene practices and sleep quality of medical students in Qazvin University of Medical Sciences. Methods:In this descriptive-correlational study, a total of 285 medical students completed a self-administered questionnaire. Demographic data, sleep-wake schedule in weekday and weekend, and sleep duration were collected. Students' sleep quality was assessed by Pittsburg Sleep Quality Index (PSQI). Data were analyzed by SPSS Ver 13. Results: Overall, 164 (57.5) of students had poor sleep quality. Mean global PSQI score and average score of four subscales were significantly higher in male than female. Regression analysis showed that male students (β=-0.85, P<0.05), students at senior level (β=-0.81, P<0.05), married students (β=-0.45, P<0.05), and those with improper sleep hygiene practices slept worse. Conclusion: The findings of this study showed that the prevalence of poor sleep quality in medical students is high. Improper sleep hygiene behaviors might be a reason for poor quality of sleep in medical students.