Global Pittsburg Sleep Quality Index Research Articles

Factors Affecting Sleep Quality in Women with Cancer Undergoing Radiotherapy

Purpose: The purpose of this study was to investigate the severity of subjective sleep quality and factors related to sleep disturbances in breast and gynecologic cancer patients undergoing radiotherapy. Methods: Ninety four women (68 breast cancer and 26 gynecologic cancer) undergoing radiotherapy were recruited and asked to complete the Pittsburg Sleep Quality Index (PSQI), Piper Fatigue Scale, and Hospital Anxiety Depression Scale. The data were analyzed using χ2-test, t-test, ANOVA and logistic regression. Results: The average global PSQI score was 8.34± 4.41 and 70.2% of the patients reported poor sleep quality (PSQI> 5). There were significant differences between the poor sleepers and the good sleepers in concurrent chemo-radiotherapy (p= .022), number of radiation treatments (p=.013), total amount of radiation dosage (p=.048), sleeping pills (p=.030), fatigue (p< .001), anxiety (p<.001), and depression (p=.024). Logistic regression showed that significant predictors for poor sleep quality were fatigue and concurrent chemo-radiotherapy. Conclusion: These findings suggest that sleep disturbance was a significant health problem in patients with breast and gynecologic cancer who were receiving radiotherapy. Also that fatigue and concurrent chemo-radiotherapy were highly associated with sleep disturbance. However, limited evidence was found for the role of radiotherapy in the sleep disturbance of these patients.

Poor sleep quality is associated with a negative cognitive bias and decreased sustained attention.

Poor sleep quality has been demonstrated to diminish cognitive performance, impair psychosocial functioning and alter the perception of stress. At present, however, there is little understanding of how sleep quality affects emotion processing. The aim of the present study was to determine the extent to which sleep quality, measured through the Pittsburg Sleep Quality Index, influences affective symptoms as well as the interaction between stress and performance on an emotional memory test and sustained attention task. To that end, 154 undergraduate students (mean age: 21.27years, standard deviation=4.03) completed a series of measures, including the Pittsburg Sleep Quality Index, the Sustained Attention to Response Task, an emotion picture recognition task and affective symptom questionnaires following either a control or physical stress manipulation, the cold pressor test. As sleep quality and psychosocial functioning differ among chronotypes, we also included chronotype and time of day as variables of interest to ensure that the effects of sleep quality on the emotional and non-emotional tasks were not attributed to these related factors. We found that poor sleep quality is related to greater depressive symptoms, anxiety and mood disturbances. While an overall relationship between global Pittsburg Sleep Quality Index score and emotion and attention measures was not supported, poor sleep quality, as an independent component, was associated with better memory for negative stimuli and a deficit in sustained attention to non-emotional stimuli. Importantly, these effects were not sensitive to stress, chronotype or time of day. Combined, these results suggest that individuals with poor sleep quality show an increase in affective symptomatology as well as a negative cognitive bias with a concomitant decrease in sustained attention to non-emotional stimuli.

Impact of eating attitude and impairment of physical quality of life between tertiary clinic and primary clinic functional dyspepsia outpatients in Japan.

Background/AimsThere is no available data on factors associated with healthcare-seeking behavior for functional dyspepsia (FD) symptoms at either tertiary or primary clinics in Japan. Therefore, we aimed to compare clinical symptoms and life styles such as sleep disorders and eating attitude in FD patients visiting general practitioners at primary clinics with those consulting gastroenterologists at tertiary clinics to clarify healthcare-seeking patterns in Japanese patients.MethodsFifty-one FD outpatients in a tertiary clinic (college hospital), 50 FD outpatients visiting primary clinics and 50 healthy volunteers were enrolled. Clinical symptoms, quality of life, sleep disorders, eating attitude and anxiety were estimated using the Gastrointestinal Symptom Rating Scale (GSRS), Social Functioning-8 (SF-8) test, Pittsburg Sleep Quality Index (PSQI) test and State-Trait Anxiety Inventory (STAI) for FD outpatients and healthy volunteers.ResultsFD outpatients exhibited higher mean scores of GSRS than healthy volunteers. The SF-8 physical component summary scores in the tertiary clinic group were significantly lower than those in the primary clinic group. GSRS scores were significantly (P < 0.001, P = 0.002) associated with global PSQI scores in FD outpatients as well as with STAI-trait scores (P = 0.006, P = 0.001) compared to healthy volunteers. The frequency of eating between meals in the primary clinic group was significantly (P < 0.05) higher than that in the tertiary clinic group.ConclusionsIt may be important for clarification of healthcare-seeking behavior to determine the difference in both impairment of physical quality of life and eating attitudes between tertiary clinic and primary clinic FD outpatients in Japan.

Letter: Prevalence and Correlates of Disordered Sleep in Southeast Asian Indians with Type 2 Diabetes (Diabetes Metab J 2012;36:70-6)

Rajendran et al. [1] recently reported the positive association between of and global Pittsburg Sleep Quality Index (PSQI) score for 120 patients after adjustment for several related factors. By overviewing the characteristics of the patients presented in their Table 1, the diabetic management seems not satisfactory. They speculated that increase in the prevalence of neuropathy and nocturia by long of would accelerate worsening of global PSQI score. But before accepting their results, there are three queries on their approach for making final conclusion. First, they adopted a logistic regression analysis after presenting simple correlation coefficient. Namely, there was a positive relationship between global PSQI score and of in years with 18.1% of explanation rate (P<0.05), which was presented in their Fig. 1. Thereafter, they presented main results in their Table 3. Unfortunately, a regression coefficient of duration of diabetes was -0.196, and the odds ratio (95% confidence interval) was 0.822 (0.728 to 0.928). This value presents a negative relationship between of and global PSQI score, and the explanation rate was 13.2%. Odds ratios of other variables such as age, sex, medication, body mass index, and HbA1c presented reasonable direction in change compared with past academic information, although they did not reach the level of statistical significance. The explanation rate was not satisfactory to accept their results, and multivariate analysis presented a negative association between of and global PSQI score. Second, I recommend conducting multiple regression analysis instead of logistic regression analysis to avoid information loss for global PSQI score. Hung et al. [2] recently reported that decreased sleep quality judged by PSQI was related to pre-diabetes and newly diagnosed except impaired fasting glucose. They adopted multivariate linear regression analysis and logistic regression analysis by adjusting several cardiometabolic risk factors. The dependent values are derived from PSQI in both analyses, and information loss is larger in logistic regression analysis from the statistical viewpoint. Finally, I suppose that duration of diabetes itself has a difficulty for making adequate judgment on the onset of diabetes. In addition, the pathophysiological severity of is different from person to person, and the medication as a variable should be handled with caution. Furthermore, there is no information on physical activity or fitness, which is an important factor to affect [3] and sleep status [4]. Sleep is important for the occurrence of [5-7], and itself has an important factor to make disturbance for sleep [6]. I suppose that Rajendran et al. intended to show the latter relationship, although causality could not be clarified by cross-sectional study. I appreciate their effort to conduct such a clinical study, but large-scale and long-term prospective cohort studies are required to make a conclusion on the relationship between of and sleep quality.

Response: Prevalence and Correlates of Disordered Sleep in Southeast Asian Indians with Type 2 Diabetes (Diabetes Metab J 2012;36:70-6)

We are grateful for the careful reading and comments of the authors of the letter regarding our article, Prevalence and correlates of disordered sleep in southeast Asian Indians with type 2 diabetes. The author's comments are quite valid and do brings out the inherent and methodological limitations of our study. Further we present multiple regression analysis of our data as desired by the author in Table 1. The multiple regression analysis strengthens our conclusion that duration of diabetes strongly correlates (positively) with the global Pittsburg Sleep Quality Index (PSQI) score and in turn sleep dysfunction. A larger prospective study that further examines the influence of duration of diabetes on sleep will clarify some questions raised by our small study. Table 1 Results of multiple regression analysis We once again thank you for taking interest in our study and also for your comments.

Case–control study of restless legs syndrome and quality of sleep in Parkinson's disease

In a case–control study involving 400 study subjects, we found a higher prevalence of restless legs syndrome (RLS) in our Parkinson's disease (PD) patients compared to controls (3.0% vs 0.5%) (odds ratio 6.2) ( p = 0.07). Polysomnographic studies confirmed that study subjects with RLS had grossly elevated PLMS index, PLMS arousal index and reduced sleep efficiency. None of these PD patients reported a family history of PD or RLS. The average age of onset of RLS was 61.7 ± 10.8 years old. The mean global Pittsburg Sleep Quality Index (PSQI) score of PD patients was significantly higher than the controls (9.1 ± 4.5 vs 4.3 ± 2.8, p < 0.0001). All the seven components of PSQI in PD patients were significantly different from controls ( p < 0.0001). Multivariate analysis revealed that only Hoehn and Yahr staging correlated with the global PSQI score ( p < 0.0001). Similar results were obtained when we compared the PSQI score between PD patients without RLS with controls. Our case–control study demonstrated a weak association between RLS and PD. PD patients have significant poor quality of sleep, and this correlated with the severity of PD. RLS did not play an important role in sleep dysfunction in our PD cohort. A high index of suspicion for sleep problems in advanced PD patients is important as early management could improve their quality of life.