Global Pittsburgh Sleep Quality Index Score Research Articles

The association between nicotine dependence and sleep quality in patients referred to a smoking cessation outpatient clinic: A cross-sectional study.

Nicotine addiction is one of the most common forms of dependence. It is shown to be associated with many chronic diseases that develop mostly through smoking. The association between sleep quality and smoking or nicotine addiction has not been clarified yet. This study aimed to investigate the association between nicotine addiction and sleep quality. In this cross-sectional study, the Epworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), Fagerström test for nicotine dependence (FTND), and Hospital anxiety-depression scale (HADS) were administered to patients who applied to the smoking cessation outpatient clinic of a reference hospital between April and June 2023. FTND measured nicotine dependence, and its association with sleep quality estimated by PSQI was assessed by binary logistic regression with the potential confounders. In the study group of 280 participants, 67.1% were male, and 57.8% had poor sleep quality. The median (IQR) FNTD score was 7.0 (3.0), and the median global PSQI score was 6.0 (5.0). Poor sleep quality increased by 1.12 times (AOR=1.12; 95% CI: 1.02-1.22, p=0.016) for each unit increase in hospital anxiety score and by 1.22 times (AOR=1.22; 95% CI: 1.05-1.42, p=0.011) for each unit increase in FTND score. Increased nicotine dependence and anxiety are independently associated with poor sleep quality. The findings support smoking cessation efforts. It is recommended to study the effect of combating anxiety and tobacco addiction to improve sleep quality.

Sleep quality and the integrity of ascending reticular activating system – A multimodal MRI study

Sleep is crucial for maintaining brain homeostasis and individuals with insufficient sleep are prone to more pronounced brain atrophy as compared to sufficiently sleeping peers. Moreover, sleep quality deteriorates with ageing and ageing is also associated with cerebral structural and functional changes, pointing to their mutual bidirectional interrelationship. This study aimed at determining whether sleep quality and age, separately, affect brain integrity and subsequently, whether sleep significantly modulates the effect of age on brain structural and functional integrity. 113 healthy volunteers underwent a multi-modal MRI imaging to extract information about the microstructure and function of major nodes of the ascending reticular activating system. Sleep quality was assessed by self-administered Pittsburgh's sleep quality index (PSQI) questionnaire. Subject were divided into good (global PSQI score <5) and poor (global PSQI score ≥5) sleep quality group. Whereas only borderline correlations were found between sleep quality and MRI metrics, age exhibited widespread correlations with both functional and microstructural MRI metrics. The latter effect was significantly modulated by sleep quality in ascending reticular activating system, hypothalamus, thalamus and also hippocampus in MRI metrics associated with iron load, cellularity and connectivity, mainly in the subgroup with poor sleep quality. Ergo, our results indicate sleep quality as a substantial contributor to both microstructural and functional brain changes in ageing and call for further research in this emerging topic.

Disruptions in Sleep Health and Independent Associations with Psychological Distress in Close Family Members of Cardiac Arrest Survivors: A Prospective Study.

While recent guidelines have noted the deleterious effects of poor sleep on cardiovascular health, the upstream impact of cardiac arrest-induced psychological distress on sleep health metrics among families of cardiac arrest survivors remains unknown. Sleep health of close family members of consecutive cardiac arrest patients admitted to an academic center (8/16/2021 - 6/28/2023) was self-reported using the Pittsburgh Sleep Quality Index (PSQI). The baseline PSQI, focused on sleep in the month before cardiac arrest, was administered during hospitalization and repeated one month after cardiac arrest, alongside the Patient Health Questionnaire-8 (PHQ-8) to assess depression severity. Multivariable linear regressions analyzed associations between total PHQ-8 scores and changes in global PSQI scores between baseline and one month with higher scores indicating deterioration. A prioritization exercise explored potential interventions categorized into the family's information and well-being needs to reduce psychological distress. In our sample of 102 close family members (mean age 52±15 years, 70% female, 21% Black, 33% Hispanic), mean global PSQI scores showed a significant decline between baseline and one month after cardiac arrest (6.2±3.8 vs. 7.4±4.1; p<0.01). This deterioration was notable for sleep quality, duration, and daytime dysfunction. Higher PHQ-8 scores were significantly associated with higher change in PSQI scores, after adjusting for family members' age, sex, race/ethnicity, prior psychiatric history, and patient's discharge disposition [B=0.4 (95% C.I 0.24, 0.48); p<0.01, β=0.5]. Most families expressed a higher priority for information-based interventions over well-being needs to help alleviate psychological distress during the first month following cardiac arrest (76% vs. 34%, p<0.01). A significant sleep health decline was observed among close family members of cardiac arrest survivors during the acute period, with psychological distress associated with this disruption. Understanding these temporal associations will help guide the development of targeted interventions to support families during this uncertain time.

Assessment of sleep quality, fatigue and its association with occupational injuries among shift workers in an electronic industrial environment

Objectives. This study explores the association between sleep quality, cumulative fatigue and occupational injuries among shift workers in Pakistan’s manufacturing industries. Methods. The study surveyed 200 shift workers using a self-administered questionnaire. Sleep quality was assessed with the Pittsburgh sleep quality index (PSQI), and fatigue with the standard shiftwork index (SSI). Statistical analyses included t tests, χ 2 tests and logistic regression. Results. Night shift employees had higher odds of occupational injuries (odds ratio [OR] 3.591, 95% confidence interval [CI] [1.079, 11.944], p = 0.037) compared to day shift workers. Cumulative fatigue (OR 3.044, 95% CI [1.145, 8.089], p = 0.026) and PSQI global score (OR 1.249, 95% CI [1.002, 1.556], p = 0.048) also indicated an increased injury risk. Conclusion. Night shift workers experienced poorer sleep quality, higher fatigue and increased injuries than day shift workers. Employers should implement artificial intelligence to detect and manage fatigue, set strategic shift schedules for maximum sleep opportunities and train workers to improve sleep quality.

Sleep quality in middle-aged and elderly hemodialysis patients: Impact of a structured nursing intervention program.

Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being. This study aimed to evaluate the effectiveness of a structured nursing intervention program in improving sleep quality in middle-aged and elderly hemodialysis patients. To evaluate the impact of nursing intervention on sleep quality in hemodialysis patients. This cross-sectional study was conducted in a tertiary hospital, the First Affiliated Hospital of Nanchang University, in 2023. This study included 105 middle-aged and elderly hemodialysis patients aged ≥ 45 years who underwent maintenance hemodialysis for at least 3 mo, utilizing the Pittsburgh Sleep Quality Index (PSQI) to identify poor sleepers. Those identified underwent a 12-wk nursing intervention program focusing on education, relaxation techniques, and counseling. Post-intervention, sleep quality was reassessed using the PSQI. The study found that 68.6% of hemodialysis patients were poor sleepers. Following the 12-wk nursing intervention program, there was a significant decrease in the mean global PSQI score from 8.9 ± 3.2 to 5.1 ± 2.7 (P < 0.001), indicating improved sleep quality. This demonstrated the effectiveness of the structured nursing intervention in enhancing sleep quality for middle-aged and elderly hemodialysis patients. The structured nursing intervention program focusing on sleep hygiene education, relaxation techniques, and counseling effectively improved sleep quality among middle-aged and elderly hemodialysis patients. The significant decrease in the mean global PSQI score post-intervention indicates the positive impact of tailored nursing interventions in addressing poor sleep quality in this patient population. These findings emphasize the importance of implementing targeted nursing interventions to enhance the quality of life for hemodialysis patients by addressing the prevalent issue of poor sleep quality.

Associations between sleep disorders and clinical outcomes of patients with primary biliary cholangitis

PurposePrimary biliary cholangitis (PBC) is a chronic autoimmune liver disease characterized by a range of symptoms, including sleep disturbances. The present study aimed to investigate the prevalence of sleep disorders and the associations between sleep disorders and clinical outcomes in PBC. Patients and methodsWe enrolled 177 patients with PBC and 165 healthy controls (age- and sex-matched). Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Demographic and clinical data were collected from comprehensive clinical records to investigate whether sleep disorder was correlated with disease severity, therapeutic response and liver cirrhosis. ResultsThe prevalence of sleep disorders in patients with PBC (50.8 ​%) was significantly higher than healthy controls (18.2 ​%). Patients with sleep disorders presented with higher levels of laboratory parameters including globulin (GLO), aspartate aminotransferase (AST), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), total bilirubin (TBIL), direct bilirubin (DBIL) and immunoglobulin M (IgM), as well as higher ratio of poor therapeutic response and liver cirrhosis (p ​< ​0.05). There was a positive correlation between global PSQI score and AST, ALP, GGT, TBIL, DBIL and IgM in patients with PBC. Patients with poor therapeutic response and liver cirrhosis in PBC had a higher proportion of sleep disorders and more chaotic sleep patterns, whereas a stronger correlation between sleep quality and laboratory parameters was found in patients with liver cirrhosis. ConclusionsSleep disorders were prevalent and manifested as adverse effects in PBC. Assessment of sleep quality and intervention were essential to the overall clinical management of patients with PBC.

Psychometric properties and moderated mediation analysis of the ICIQ-NQOL in Chinese primary care patients with nocturia

BackgroundMany individuals consider nocturia a significant nuisance, leading to a reduced health-related quality of life (HRQOL). However, there has been a lack of psychometrically sound patient-reported outcome measures to assess the impact of nocturia on patients in Chinese contexts. This study aimed to translate, culturally adapt, and validate the International Consultation on Incontinence Questionnaire Nocturia Quality of Life Module (ICIQ-NQOL) for use among primary care patients in Hong Kong, China. Additionally, it sought to investigate the mechanisms that link nocturia and sleep quality with HRQOL by employing moderated mediation analysis.MethodsThe traditional Chinese version of the ICIQ-NQOL was developed through iterative translations, cognitive debriefing interviews, and panel reviews. The psychometric evaluation included assessments of factor structure, convergent validity, concurrent validity, known-group validity, internal consistency, test-retest reliability and responsiveness. Study instruments included the ICIQ-NQOL, International Prostate Symptom Score (IPSS), Pittsburgh Sleep Quality Index (PSQI), and a modified Incontinence Impact Questionnaire-Short Form (IIQ-7).ResultsA total of 419 primary care patients were recruited from general outpatient clinics, among whom 228 experiencing an average of two or more nocturia episodes per night over the past four weeks. Confirmatory factor analysis supported the two-factor structure of the ICIQ-NQOL. Concurrent validity was confirmed by moderate correlations between the IIQ-7 total score and the total score as well as two domain scores of the ICIQ-NQOL (r ranging from 0.43 to 0.49, all p < 0.001). The ICIQ-NQOL also had moderate correlations with the IPSS total symptom score (r ranging from 0.40 to 0.48, all p < 0.001). Convergent validity was supported by moderate correlations between the global PSQI score and the total score as well as two domain scores of the ICIQ-NQOL (r ranging from 0.42 to 0.52, all p < 0.001). Known-group comparisons showed that the ICIQ-NQOL could differentiate between patients with and without nocturia in terms of sleep/energy domain score (p < 0.001), bother/concern domain score (p < 0.001), and total score (p < 0.001), each demonstrating a moderate Cohen’s d effect size. Item-total correlations corrected for overlap exceeded 0.4, and Cronbach’s alpha coefficients were greater than 0.7. Test-retest reliability was confirmed with intraclass correlation coefficients exceeding 0.7 among patients reporting no change in their nocturia symptoms at a 2-week follow-up. Regarding responsiveness, the Cohen’s d effect sizes for differences in domain and total scores between the baseline and 2-week follow-up assessments were greater than 0.3 among patients showing improvement in nocturia. Our moderated mediation analysis indicated that sleep quality significantly moderated the impact of nocturia on HRQOL, with a notably stronger indirect effect among females compared to males.ConclusionsThe ICIQ-NQOL is a reliable and valid instrument for assessing the HRQOL in primary care patients suffering from nocturia. The findings advocate for gender-specific approaches in the management and treatment of nocturia to optimize HRQOL.

Influence of shift work on sleep quality and circadian patterns of heart rate variability among nurses.

Shift work implementation is essential for providing continuous patient care in hospitals. However, working in shifts on a routine basis may disrupt the circadian pattern and alter the sleep-wakefulness cycle in nurses. Stress due to shift work can influence the adaptability of the cardiovascular system, produce psychophysiological strain and deteriorate work performance in female nurses. This study investigated the effect of morning and night shift work on sleep quality and circadian patterns governing heart rate variability (HRV) in female nurses working in a tertiary care hospital. Thirty-eight healthy female nurses were recruited. Frequency and time domain parameters of HRV were recorded as markers of cardiac autonomic function. A student t-test was used to investigate differences in HRV between morning and night shift workers. Mann-Whitney non-parametric test was applied for the difference between Pittsburgh Sleep Quality Index (PSQI) scores in the two groups. Standard deviation of the normal-to-normal interval (SDNN) (msec), total power (ms2) and high-frequency (HF) band power (ms2) were significantly reduced in night shift nurses than in morning shift nurses. The low-frequency (LF)/HF ratio was significantly increased in night shift nurses. The differences in standard deviation of the averages of NN intervals (SDaNN) (msec), root mean square of successive differences between adjacent NN intervals (RMSSD), mean NN, very low-frequency (VLF) band power (ms2) and LF band power (ms2) were not statistically significant. The global PSQI score was significantly higher among night shift workers than in morning shifts. Inadequate sleep can disrupt the body's ability to regulate heart rhythm and increase the risk of cardiovascular diseases and mortality. The research suggests a propensity for autonomic imbalance in night shift workers when compared to their counterparts on morning shifts.

Longer-term Effect of Physical Activity Intervention on Sleep Quality: A Secondary Analysis of Cluster Randomized Controlled Trial.

To examine the longer-term effect of physical activity (PA) intervention on sleep quality and whether the effect was heterogeneous between daytime nappers and non-nappers. This study was a secondary analysis of a cluster randomized controlled trial in China. Eight villages were randomized 1:1 to intervention or control group. The intervention group received an 8-week PA intervention, while the control group did not. The primary outcome of this study was the change in the Pittsburgh Sleep Quality Index (PSQI) global score at 24 months. The 511 participants had a mean age of 70.94 years (SD 5.73) and 55.6% were female. The intervention showed improvements in the PSQI global score at 8 weeks (adjusted mean difference -1.05; P=0.002), and the effect diminished at 24 months (-0.64; P=0.06). There were statistically significant improvements in the PSQI global score for daytime nappers, but not for non-nappers at 8 weeks (adjusted mean difference -0.98; P=0.01 vs -1.27; P=0.05), 12 months (-0.86; P=0.03 vs -0.84; P=0.21), and 24 months (-0.80; P=0.04 vs -0.14; P=0.84), although these improvements were below the minimum detectible level of the PSQI which is 1 point. The 8-week PA intervention was effective in improving sleep quality, while the effect was diminished and below the minimum detectible level of the PSQI which is 1 point after 24 months. The effect of PA intervention on sleep quality was more pronounced in daytime nappers. Additional interventions (e.g., focusing on multiple behavioral interventions such as PA and healthy diet) are needed to maintain the beneficial effect of PA on sleep quality in the general older populations. Further research is required to confirm the mechanisms of the effect of napping and develop tailored interventions.

Effect of music therapy combined with aerobic exercise on sleep quality among breast cancer patients undergoing chemotherapy after a radical mastectomy: a randomized controlled trial

PurposeWe aimed to study the effect of music therapy combined with aerobic exercise on the sleep quality of patients undergoing chemotherapy after a radical mastectomy.MethodsA randomized controlled trial was conducted at the Breast Disease Diagnosis and Treatment Center, Shaanxi Province Tumor Hospital, from July 2017 to June 2019. 110 female breast cancer patients who underwent a radical mastectomy were recruited and randomly allocated into an intervention group or a control group. The intervention group completed music therapy combined with aerobic exercise from the first to the sixth admission to the hospital for chemotherapy, while the control group received only routine nursing care. The sleep quality of these patients was measured using the Pittsburgh Sleep Quality Index (PSQI). A linear mixed model was used to adjust the PSQI of patients after controlling for other confounding factors.ResultsThe mean sleep quality score of the breast cancer patients who received chemotherapy after a radical mastectomy (baseline) was 8.86 ± 2.34. The intervention group had a significantly lower mean global PSQI score than the control group from the first test to the third test, with an adjusted mean difference of -1.05 (95%CI: -1.86, -0.24; P = 0.01), -2.89 (95%CI: -3.70, -2.08; P < 0.001) and − 4.84 (95%CI: -5.65, -4.03; P < 0.001), respectively. A change in the global PSQI score from baseline for the intervention group was from 0.55 (95%CI: -0.24, 1.34; P = 0.171) at the first test to 2.75 (95%CI: 1.96, 3.53; P < 0.001) at the last test, and for the control group was from − 0.51 (95%CI: -1.31, 0.29; P = 0.213 at the first test to -2.10 (95%CI: -2.91, -1.30; P < 0.001) at the last test.ConclusionsAn intervention of music therapy combined with aerobic exercise can significantly improve the sleep quality of female breast cancer patients undergoing chemotherapy after a radical mastectomy, and this intervention continuously improves many aspects of sleep reactivity.Clinical trial registrationThis study was registered in the Chinese Clinical Trial Registry (ChiCTR2100042975, 02/02/2021).

Effect of desflurane maintenance on postoperative sleep quality in patients undergoing elective breast surgery: A non-inferiority randomized controlled trial

BackgroundPostoperative sleep disturbance (PSD) is prevalent in perioperative patients，and has significant impact on postoperative recovery and prognosis. The aim of this study was to investigate the effect of desflurane maintenance on postoperative sleep quality, in order to optimize patients' perioperative sleep management. MethodA total of 118 patients undergoing elective breast surgery were randomized to receive either desflurane-based volatile anesthesia (desflurane group) or propofol-based total intravenous anesthesia (propofol group) for anesthesia maintenance. The primary outcome was the quality of sleep, which was assessed by the Pittsburgh Sleep Quality Index (PSQI) on 3 days after operation (POD3). Secondary outcomes were PSQI on postoperative day 7 (POD7) and 30 (POD30), and postoperative anxiety, depression, and pain score, as well as objective sleep parameters including total sleep time (TST), WASO (Wakefulness after sleep onset), REM (Rapid eye movement) and NREM (Non-rapid Eye Movement) measured by Fitbit Charge 2TM during the initial 3 postoperative days. ResultsThe global PSQI scores on POD3 in the desflurane group was non-inferior to that in the propofol group [mean (SD) 8.47 (3.46) vs. 7.65 (3.16); mean difference (95 % CI) 0.82 (−0.43, 2.07); p < 0.001 for non-inferiority]. There were no significant differences in PSQI scores on POD3 and POD7. In addition, the score of anxiety, depression, and pain on the 3rd, 7th, and 30th day after surgery have no significant differences between the propofol and the desflurane group, respectively. The postoperative NREM was higher in the desflurane group than that in the propofol group. ConclusionThe effects of desflurane-based volatile anesthesia maintenance on postoperative sleep quality is not inferior to that of propofol-based total intravenous anesthesia, and these two drugs may have different effects on the sleep structure. Trial registrationClinicalTrials.gov Identifier: NCT04805775.

Effectiveness of Japanese traditional medicine yokukansan for nocturia due to sleep disorders

AbstractAimTo evaluate the effectiveness of yokukansan, a traditional Japanese medicine, as treatment for nocturia due to sleep disorders.MethodsIn this study, we included patients diagnosed with nocturia due to sleep disorders, evaluated using the Pittsburgh Sleep Quality Index (PSQI). Participants received 2.5 g of yokukansan, three times daily, for 12 weeks. We evaluated the changes in the overactive bladder (OAB) symptom score (OABSS), hours of undisturbed sleep (HUS), and PSQI score. In addition, patients were categorized based on the severity of their sleep disorders, and we divided patients into two groups according to whether the severity of the disorder was downgraded after treatment: the improved and unchanged groups.ResultsAmong 35 patients with a mean ± standard deviation age of 73.2 ± 10.5 years, yokukansan administration was associated with significant improvements in nighttime urinary frequency (from 3.8 ± 2.1 to 2.1 ± 1.9), total OABSS score (from 4.9 ± 1.8 to 2.9 ± 1.9), OABSS urgency score (from 1.3 ± 1.0 to 0.7 ± 0.9), HUS (from 2.2 ± 0.6 to 3.5 ± 1.1 h), and global PSQI score (from 11.9 ± 3.1 to 10.0 ± 1.4; all p &lt; 0.001). In addition, significant improvements were noted in both the improved and unchanged groups in terms of the total OABSS, nocturia, and urgency scores. Furthermore, yokukansan treatment was related to improved global PSQI scores in both groups (improved group: from 10.8 ± 0.7 to 8.6 ± 0.5, p = 0.001; unchanged group: from 12.3 ± 3.4 to 10.4 ± 1.3, p = 0.004).ConclusionYokukansan may effectively ameliorate nocturia due to sleep disorders.

Sleep quality among medical students during third wave of COVID-19 pandemic: A cross-sectional study in Government Medical College Jammu

Background: COVID-19 has caused lot of suffering for everyone. Hundreds of thousands of people were affected in all aspects. Increased stress due to the pandemic may affect medical students' sleep quality. The authors aimed to evaluate the sleep quality of medical students during pandemic and relationship, if any, between sleep quality and and socio-demographic variables. Methods: An online survey of medical students was conducted in January 2022, when India was in third wave of pandemic. This cross-sectional study was conducted using the Pittsburgh Sleep Quality Index (PSQI) questionnaire at a tertiary teaching hospital in Jammu, UT, J&amp;K, India. Results: Among 307 participants, mean global PSQI score was 9.91± 3.62 which indicated a poor quality of sleep. Among the component scores, habitual sleep efficiency had the highest score of 2.99± 0.16. Majority (91.53%) of the respondents had a poor sleep quality with global PSQI score &gt;5. Among the socio-demographic variables, alcohol intake and any conflict in the family were found to be statistically significant (p&lt;0.05). Conclusion: Nine out of ten medical students have insufficient sleep, which is a real cause for concern. The authors recommend that stress management (anxiety), lifestyle changes, and sleep training be included in the medical record and updated regularly.

Faktor-faktor yang Berhubungan dengan Kualitas Tidur Pasien dengan Lupus Eritematosus Sistemik

Introduction. Sleep disturbances are often found among Systemic Lupus Erythematosus (SLE) patients. Poor sleep may cause low quality of life. Study about sleep quality among SLE patients and related factors in Indonesia is scarce. This study aimed to know factors related to poor sleep quality among SLE patients. Methods. This cross-sectional study was conducted among SLE patients at Cipto Mangunkusumo Hospital Jakarta Indonesia. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), with global PSQI score &gt;5 indicates poor sleep quality. Factors evaluated were symptoms of depression and anxiety by Hospital Anxiety Depression Scale (HADS), pain by Visual Analogue Scale (VAS), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), autonomic dysfunction by Low Frequency/High Frequency (LF/HF) ratio from Heart Rate Variability (HRV), and high sensitivity C-Reactive Protein (hs-CRP) level. Bivariate analysis was done by Chi Square or Fisher’s test. Multivariate analysis was done by logistic regression, p value &lt;0.05 was considered statistically significant. Results. Total of 166 SLE patients were included. Mean age was 32.7 years old with the majority in age group of 21-30 years old and female. Poor sleep quality in SLE patients was found in 82.5% of subjects. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage. Musculoskeletal component of the SLEDAI-2K was associated with month- and week-long sleep quality, sleep latency, and daytime dysfunction. Hematologic involvement was associated with daytime dysfunction, whereas mucocutaneous involvement was associated with sleep disturbances. Conclusions. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage.

Mental Health, Sleep Quality, and Psychological Well-Being during the Holy Month of Ramadan.

Ramadan, a significant month for Muslims, presents unique challenges, particularly in the context of the USA. This study aimed to explore the relationship between mental health factors (depression, anxiety, and stress), sleep quality, and psychological well-being (subjective happiness and life satisfaction) during the month of Ramadan among participants and by gender. This study enlisted 163 participants (74% female, 25.7% male), with an average age of 36.8 years (SD = 13.1), mostly of Middle Eastern descent. Recruitment was conducted via flyers at local community mosques, social media, and outreach through local religious leaders. Data collection took place in the last three weeks of Ramadan, utilizing a Qualtrics survey that included the Depression Anxiety and Stress Scale (DASS-21), the Subjective Happiness Scale (SHS), Satisfaction with Life Scale (SWLS), and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by means of descriptive statistics and multiple linear regression models using SPSS version 28. The study indicates that while mental health and psychological well-being remained within normal levels during Ramadan, sleep scores indicated significant sleep disturbance among participants. Multiple linear regression models revealed that subjective happiness, sleep duration, and the global PSQI score were significant predictors of stress for the total sample (F = 9.816, p = 0.001). Life satisfaction was the only significant predictor of anxiety (F = 7.258, p = 0.001), and it, alongside subjective happiness, significantly predicted depression (F = 12.317, p = 0.001). For men, subjective happiness alone predicted stress, while life satisfaction was a predictor for both anxiety and depression (F = 4.637, p = 0.001). In women, sleep duration and medication usage were linked to stress but not anxiety. Life satisfaction and subjective happiness were, however, predictors of depression (F = 6.380, p = 0.001). Fostering positive affective states can serve as a protective mechanism against the potential psychological distress associated with altered sleep patterns and lifestyle changes that accompany Ramadan. This study highlights that Ramadan is a tool for bolstering happiness and life satisfaction, thereby lowering levels of stress, anxiety, and depression. In non-Muslim majority contexts like the USA, there is a need for accommodations to safeguard against potential psychological distress.

Effect of Internet Addiction on Sleep Quality and Academic Performance in Undergraduate Dental Students

Abstract Aim This study aimed to evaluate the prevalence of Internet addiction and its effect on sleep patterns and university academic performance among dental undergraduates. Methodology A total of 400 dental undergraduates were targeted in a cross-sectional setting. The students were invited to fill out a pretested questionnaire consisting of the Pittsburgh Sleep Quality Index (PSQI) and the Internet Addiction Test. Data was analyzed using the Statistical Package for Social Science (SPSS) software (version 20.0). Frequencies and percentages along with mean and standard deviation were calculated. Results A total of 274 study subjects participated in the study out of which the majority of respondents were females (N = 230; 83.9%). Seventy-six percent of the population was using the Internet for 0 to 6 hours. Excellent academic performance scores have not been reported in any of the years except the second year. The mean global PSQI score and Internet addiction score both are seen to be reducing as the year of study increases. Internet addiction is positively associated with poor PSQI scores. Conclusion The authors concluded that adequate sleep is undoubtedly the most important factor. Internet usage is a dynamic issue; the students need to manage it in a strict schedule to manage a decent total sleeping time.

Disruptions in Sleep Health and Independent Associations with Psychological Distress in Close Family Members of Cardiac Arrest Survivors: A Prospective Study.

While recent guidelines have noted the deleterious effects of poor sleep on cardiovascular health, the upstream impact of cardiac arrest-induced psychological distress on sleep health metrics among families of cardiac arrest survivors remains unknown. Sleep health of close family members of consecutive cardiac arrest patients admitted at an academic center (8/16/2021 - 6/28/2023) was self-reported on the Pittsburgh Sleep Quality Index (PSQI) scale. The baseline PSQI administered during hospitalization was cued to sleep in the month before cardiac arrest. It was then repeated one month after cardiac arrest, along with the Patient Health Questionnaire-8 (PHQ-8) to assess depression severity. Multivariable linear regressions estimated the associations of one-month total PHQ-8 scores with changes in global PSQI scores between baseline and one month with higher scores indicating deteriorations. A prioritization exercise of potential interventions categorized into family's information and well-being needs to alleviate psychological distress was conducted at one month. In our sample of 102 close family members (mean age 52±15 years, 70% female, 21% Black, 33% Hispanic), mean global PSQI scores showed a significant decline between baseline and one month after cardiac arrest (6.2±3.8 vs. 7.4±4.1; p<0.01). This deterioration was notable for sleep quality, duration, and daytime dysfunction components. Higher PHQ-8 scores were significantly associated with higher change in PSQI scores, after adjusting for family members' age, sex, race/ethnicity, and patient's discharge disposition [β=0.4 (95% C.I 0.24, 0.48); p<0.01]. Most (n=72, 76%) prioritized interventions supporting information over well-being needs to reduce psychological distress after cardiac arrest. There was a significant decline in sleep health among close family members of cardiac arrest survivors in the acute phase following the event. Psychological distress was associated with this sleep disruption. Further investigation into their temporal associations is needed to develop targeted interventions to support families during this period of uncertainty. Sleep health has been identified as a key element in maintaining cardiovascular health.Close family members of critically ill patients experience suboptimal sleep health and psychological distress may contribute to it. It is breaking new ground in understanding the sleep health dynamics of close family members of cardiac arrest survivors, a critical but often overlooked group of caregivers.The study highlights significant associations between psychological distress and poor sleep that further deteriorates within the first month after a loved one's cardiac arrest.Families of cardiac arrest survivors expressed a high priority for information-based interventions to help alleviate psychological distress during the initial month following the cardiac event emphasizing the need for targeted, accessible, resources to address their psychological and potentially sleep-related challenges.

Sleep disorders in patients with endometriosis; a cross-sectional study

BackgroundEndometriosis affects 10–15% of women of reproductive age and is considered a critical gynecological problem. Endometriosis causes pain and infertility, both of which can impair the patient’s quality of life. Sleep disorders account for the most bothersome presentation of impaired quality of life. This study investigated the frequency and severity of sleep disorders in women with endometriosis.MethodsIn this analytical cross-sectional study, 665 women referred to three hospitals in Tehran, Rasool-e-Akram, Pars, and Nikan, were included (463 patients with endometriosis and 202 women without endometriosis). All of them were informed about the study design and the aim of the research, and then they were asked to sign the consent form and complete the Pittsburgh Sleep Quality Index (PSQI). After data gathering and entering, they were analyzed by SPSS version 22 and were considered significant with P < 0.05.ResultsThe study population’s mean age was 35.4 ± 7.9 years. The mean global PSQI score in the case group (endometriosis patients) was higher than in the control group (non-endometriosis patients) (10.6 vs. 7.1; P < 0.001). Patients with dyspareunia, dysuria, pelvic pain, and dyschezia had a significantly higher PSQI score (P < 0.05).ConclusionAccording to the findings of the present study, the sleep quality in endometriosis patients is low, and there is a need to pay greater attention to these patients. This may result in some changes in the therapeutic strategies for this disease.

The subcortical basis of subjective sleep quality.

To assess the association between self-reported sleep quality and cortical and subcortical local morphometry. Sleep and neuroanatomical data from the full release of the young adult Human Connectome Project dataset were analyzed. Sleep quality was operationalized with the Pittsburgh Sleep Quality Index (PSQI). Local cortical and subcortical morphometry was measured with subject-specific segmentations resulting in voxelwise thickness measurements for cortex and relative (i.e., cross-sectional) local atrophy measurements for subcortical regions. Relative atrophy across several subcortical regions, including bilateral pallidum, striatum, and thalamus, was negatively associated with both global PSQI score and sub-components of the index related to sleep duration, efficiency, and quality. Conversely, we found no association between cortical morphometric measurements and self-reported sleep quality. This work shows that subcortical regions such as the bilateral pallidum, thalamus, and striatum, might be interventional targets to ameliorate self-reported sleep quality.

Influence of Meditative Technique on Musculoskeletal Pain, Sleep Quality, Stress and State Anxiety on Geriatric Participants: A Randomized Controlled Trial

ObjectiveMusculoskeletal pain, sleep disturbances and psychological stress are common issues faced by the elderly. There are limited studies eliciting the effects of specific meditation techniques among the elderly. The present study was undertaken to assess the effect of the Mind Sound Resonance Technique (MSRT) on pain, sleep quality, stress and state anxiety. MethodsSeventy elderly participants with self-reported pain symptoms were randomly assigned to meditation and control groups with an equal allocation ratio. The meditation group received practice of MSRT for 8 weeks. The control group was offered lifestyle suggestions. The primary outcome of this study is Musculoskeletal Health Questionnaire (MSHQ), secondary outcomes are Perceived Stress Scale (PSS), Geriatric Anxiety Scale (GAS) and Pittsburgh Sleep Quality Index (PSQI). They were assessed at baseline and 8 weeks. Independent and paired t-tests were performed to assess the between and within group changes. ResultsThe Between-group analysis has shown MSRT meditation to be better than control for MSHQ (p <0.01), PSQI global score (p <0.01), and GAS global score (p<0.01) along with its subscale (p <0.01). Within group analysis for primary variable MSHQ (p <0.05) secondary variable PSQI, PSS AND GAS has shown significant improvement (p <0.001) when compared to baseline. ConclusionMSRT is safe and useful for geriatric population to reduce musculoskeletal pain, improve sleep quality, while reducing stress and anxiety.