Global Pittsburgh Sleep Quality Index Score Research Articles

Prediction Models for Sleep Quality Among College Students During the COVID-19 Outbreak: Cross-sectional Study Based on the Internet New Media

COVID-19 has been reported to affect the sleep quality of Chinese residents; however, the epidemic's effects on the sleep quality of college students during closed-loop management remain unclear, and a screening tool is lacking. This study aimed to understand the sleep quality of college students in Fujian Province during the epidemic and determine sensitive variables, in order to develop an efficient prediction model for the early screening of sleep problems in college students. From April 5 to 16, 2022, a cross-sectional internet-based survey was conducted. The Pittsburgh Sleep Quality Index (PSQI) scale, a self-designed general data questionnaire, and the sleep quality influencing factor questionnaire were used to understand the sleep quality of respondents in the previous month. A chi-square test and a multivariate unconditioned logistic regression analysis were performed, and influencing factors obtained were applied to develop prediction models. The data were divided into a training-testing set (n=14,451, 70%) and an independent validation set (n=6194, 30%) by stratified sampling. Four models using logistic regression, an artificial neural network, random forest, and naïve Bayes were developed and validated. In total, 20,645 subjects were included in this survey, with a mean global PSQI score of 6.02 (SD 3.112). The sleep disturbance rate was 28.9% (n=5972, defined as a global PSQI score >7 points). A total of 11 variables related to sleep quality were taken as parameters of the prediction models, including age, gender, residence, specialty, respiratory history, coffee consumption, stay up, long hours on the internet, sudden changes, fears of infection, and impatient closed-loop management. Among the generated models, the artificial neural network model proved to be the best, with an area under curve, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 0.713, 73.52%, 25.51%, 92.58%, 57.71%, and 75.79%, respectively. It is noteworthy that the logistic regression, random forest, and naive Bayes models achieved high specificities of 94.41%, 94.77%, and 86.40%, respectively. The COVID-19 containment measures affected the sleep quality of college students on multiple levels, indicating that it is desiderate to provide targeted university management and social support. The artificial neural network model has presented excellent predictive efficiency and is favorable for implementing measures earlier in order to improve present conditions.

Association Between Sleep Quality and Quality of Life Among Medical Students in Chiang Mai University

Objective: To explore and compare the sleep quality between pre-clinical and clinical medical students. The present study also assessed the influence of sleep quality on the quality of life in four domains, physical, psychological, social relationships, and environment. Materials and Methods: A cross-sectional study was conducted among 261 second-year students and 241 fourth-year students from the Faculty of Medicine, Chiang Mai University as the representatives of preclinical and clinical medical students. Participants completed questionnaires consisting of the Pittsburgh Sleep Quality Index (PSQI) Thai version and WHOQOL-BREF-THAI to assess sleep quality and quality of life. The sleep quality was examined by chi-square test for the comparison between the two groups. Linear regression was used to evaluate the overall influence of sleep quality on each domain of the quality of life after adjusting for other covariates. Results: Two hundred sixty-one participants or 46.7% had poor sleep quality with a PSQI of 6.5 or more. The sleep quality compared between the academic years had significantly worse results (p<0.001) in the preclinical students. Sleep latency and sleep disturbance were the two components of sleep quality that were statistically poorer in the preclinical students (p<0.001). Poor sleep was significantly associated with a poor quality of life in all domains (p<0.001). Each score increased in the global PSQI score, 2.924 score of total WHOQOL-BREF-THAI would be diminished, resulting in an impaired quality of life (p<0.001). Conclusion: The prevalence of poor sleep quality was significantly higher in the preclinical year. As poorer sleep is statistically associated with the poorer quality of life, the curriculum and schedule should give consideration and provision for good sleep quality, especially in preclinical students for the improvement of medical student’s well-being. Keywords: Sleep quality; Quality of life; Medical students

The relationship between iron deficiency anemia with restless leg syndrome and sleep quality in workers working in a textile factory in Iran: a cross-sectional study

BackgroundThe aim of this study is to investigate the relationship between iron deficiency anemia with restless leg syndrome (RLS) and sleep quality in workers working in a textile factory in Iran. This cross-sectional study was conducted on 216 workers working in a textile factory in Iran. In addition to demographic and occupational variables, Pittsburgh Sleep Quality Index (PSQI) and RLS questionnaires were used for the data collection. To investigate iron deficiency anemia, 2 CC of blood was taken from the brachial artery with the help of a 10-CC syringe with a blue or pink tip. Then, relevant data were entered into SPSS26 and analyzed.ResultsThe mean (S. D.) age of the workers was 32.23 (6.14) and 60.6% of them were women. The prevalence of iron deficiency anemia was 21.2 and 69.5% in men and women, respectively. Most of the workers were in moderate condition in terms of RLS severity, and 78.2% had sleep disorders. There was an inverse and significant correlation between age (β= −0.200), work experience (β= −0.160), hemoglobin (β= −0.149), and ferritin (β= −0.186) with global PSQI score (P value<0.05). Also, an inverse and significant correlation was observed between age (β= −0.164), hemoglobin (β= −0.548), and ferritin (β= −0.410) with RLS score (P value<0.05). However, there was a direct and significant correlation between TIBC level and RLS score (β= 0.227) and global PSQI score (β= 0.395) (P value<0.05).ConclusionsIntervention programs to reduce iron deficiency anemia and periodic screening programs to identify sleep disorders and RLS in textile factory workers seem necessary.

Poor sleep quality during COVID-19 pandemic restrictions associated with reduced psychological wellbeing in healthcare students

ABSTRACT Sleep is inexorably linked to both physiological and psychological wellbeing. Restrictions imposed to control the COVID-19 pandemic likely impacted upon daily and weekly routines, which can have a negative impact on a range of factors including sleep quality, and/or quantity and general wellbeing. The aim of this study was to investigate the effect of COVID-19 related restrictions on sleep patterns and psychological wellbeing of healthcare students. A survey was delivered to healthcare students across three faculties at a single institution. Participants completed questionnaires on the effect of COVID-19 restrictions on course delivery and clinical placements, its effect on sleep-wake times, sleep quality, sleep hygiene, psychological wellbeing, their current sleep knowledge and sleep education in their current course. Using the Pittsburgh Sleep Quality Index (PSQI), over 75% of participants were found to have poor sleep quality. Changes in sleep habits and sleep behaviours during COVID-19 restrictions were associated with poorer sleep quality, and this poor sleep quality was associated with poor psychological wellbeing, particularly, motivation, stress and fatigue. Increases in negative sleep hygiene behaviours were associated with a statistically significant increase in PSQI global score. Positive emotions were positively correlated with PSQI (r = 0.22–0.24, p < .001), negative emotions were negatively correlated with PSQI (r = −0.22 - −0.31, p < .001). Also, a self-perceived lack of sleep education was identified. This study illustrates the negative association between self-reported poor sleep behaviour and poor sleep quality during COVID-19 restrictions on university student mental health and wellbeing. Additionally, there is a self-perceived lack of sleep education with little to no time spent educating students in their current degree. Hence, appropriate sleep education may improve sleep behaviours and subsequent sleep quality, which may prove to be a protective factor against poor mental health in the face of unexpected changes to routines.

Sleep Quality in Medical Students of a Portuguese University: a cross-sectional Study

IntroductionSleep is a complex physiological process present in all living beings, performing essential functions for various biological functions. The prevalence of sleep disorders has increased exponentially, as well as studies relating to sleep patterns of the general population.University students are especially vulnerable to a decrease in sleep quality, particularly medical students. Even so, the literature on sleep quality in medical students is scarce, especially when referring to Portugal, where studies are almost non-existent.ObjectivesTo evaluate sleep quality in medical students and to analyze the differences in sleep quality according to age, sex, cohabitation and physical activity. It is also intended to compare the sleep quality of medical students throughout the various phases of the medical course.MethodsThis is a cross-sectional study involving medical students at the University of Beira Interior, Covilhã, Portugal. All medical students were invited to complete the Pittsburgh Sleep Quality Index (PSQI), which has been validated for the portuguese population. First, the scores obtained in each of the components of the PSQI and the global PSQI score were analyzed for the global population. Lastly, the global PSQI score was correlated with each of the sociodemographic variables to verify the existence of a statistically significant relationship.Results296 students completed the instrument. Of these, 62.2% classify their sleep quality as good; 42.4% scored 2 in the sleep latency component; 50% reported sleeping 6 to 7 hours; 73.9% stated an adequate sleep efficiency; 85.5% mentioned few or no sleep disturbances; 83,8% said they never used sleep medication; and 60.8% had low or no sleepiness or daytime dysfunction.As for the overall PSQI score, 72.6% of the students had a score greater than 5, indicating a poor quality of sleep. 74.7% of female respondents have a low quality of sleep, as well as 67.7% of male respondents. Likewise, 91.3% of students who live alone have poor sleep quality, as well as 76.8% of those living with family members and 69.8% of those living with colleagues.Regarding the course year, 82.4% of the first-year students report a poor quality of sleep, as well as 77.5% of the second-year students, 72.1% of the third-year students, 77.8% of the fourth-year, 65.8% of the fifth-year students and 71.4% of the sixth-year students.ConclusionsMedical students seem to be more likely to have poor sleep quality, especially when compared to other university students. Thus, further studies are needed to prove this susceptibility as well as therapeutic interventions aimed at improving sleep parameters.Disclosure of InterestNone Declared

The effect of music to improve sleep quality in depression related insomnia

IntroductionInsomnia in depression is common and difficult to resolve. Music is commonly used as a sleep aid, and clinical trials pointing to positive effects of music as a sleep aid are increasing adding to the evidence base. There is little knowledge on the effectiveness of music for depression related insomnia.ObjectivesA recent RCT study conducted in psychiatry at Aalborg University Hospital examined effects of a music intervention for insomnia in depression. The intervention group listened to music at bedtime for four weeks, controls were offered music intervention post-test. Primary outcome measure was Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included Actigraphy, The Hamilton depression Rating Scale (HAMD-17) and World Health Organisation well-being questionnaires (WHO-5, WHOQOL-BREF).MethodsA two-armed randomized controlled trial (n=112) and a qualitative interview study (n=4)ResultsThe RCT study showed signficant improvements for the music intervention group in sleep quality and quality of life at four weeks according to global PSQI scores (effect size= -2.1, 95%CI -3.3; -0.9) and WHO-5 scores (effect size 8.4, 95%CI 2.7; 14.0). Actigraphy measures showed no changes and changes in depression symptoms (HAMD-17) were not detected.The interview study unfolded examples of the influences of music on sleep and relaxation. Music distracted, affected mood and arousal positively and supported formation of sleep habits.Results from the trial are discussed and merged with findings from the interview study. The results from the trial suggested moderate effects of music listening for the population while findings from the interview study showed examples of individual and highly varying outcomes.ConclusionsMusic is suggested as a low-cost, side-effect free and safe intervention in supplement to existing treatments improving sleep in depression.Disclosure of InterestNone Declared

The Effect of Shiatsu Therapy on Sleep Quality in Patients With Low Back Pain: A Secondary Analysis.

The aim of this study is to investigate the efficacy of shiatsu therapy for chronic low back pain and sleep disturbance. We conducted a secondary analysis of the randomized trial at a large academic hospital in Tokyo. Patients with chronic low back pain were included. Patients were randomly assigned to either shiatsu therapy in addition to standard care or standard care only by computer randomization. Our primary outcome was improvement of the global Pittsburgh Sleep Quality Index (PSQI) score, and the secondary outcomes were improvement in each component of the PSQI at weeks 4 and 8. We included a total of 59 patients. The mean age was 67.8 (SD: 13.5) years, and 21 patients (35.6%) were male. The global PSQI scores improved in the intervention group at week 4 (adjusted β coefficient: 1.16, 95% confidence interval: 0.10-2.21) and week 8 (adjusted β coefficient: 1.82, 95% confidence interval: 0.74-2.90). In terms of each component of the PSQI, sleep efficiency (component 4) and sleep disturbance (component 5) were improved, but use of sleep medication (component 5) worsened in the intervention group compared with the control group in several models. Shiatsu therapy in addition to standard therapy for chronic low back pain may improve sleep quality after intervention.

The relationship between sleep, pain,and musculoskeletal injuries in US Army Soldiers

IntroductionThe purpose of this study was to investigate the relationship between sleep and pain in military personnel and to determine if metrics of sleep and pain intensity differ between the...

The role of sleep and heart rate variability in metabolic syndrome: evidence from the Midlife in the United States study.

Poor sleep and autonomic dysregulation can both disrupt metabolic processes. This study examined the individual and combined effects of poor sleep and reduced heart rate variability (HRV) on metabolic syndrome among 966 participants in the Midlife in the United States II (MIDUS II) study. Self-reported sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). HRV was acquired from 11-minute resting heart rate recordings. Spearman correlations, general linear regression, and logistic regression models were used to examine the study hypotheses. Poor sleep quality was associated with metabolic syndrome when global PSQI scores were evaluated as a continuous (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.03 to 1.11) or categorical measure (cutoff > 5, OR: 1.58, 95% CI: 1.19 to 2.10), after adjustment for confounding. There also was an association between reduced HRV and metabolic syndrome (ln [HF-HRV] OR: 0.89, 95% CI: 0.80 to 0.99; ln [LF-HRV] OR: 0.82, 95% CI: 0.72 to 0.92; ln [SDRR] OR: 0.59, 95% CI: 0.43 to 0.79; ln [RMSSD] OR: 0.75, 95% CI: 0.60 to 0.94). When the combined effects of poor sleep and low HRV were examined, the association with metabolic syndrome was further strengthened relative to those with normal sleep and HRV. To the best of the author's knowledge, this is the first study to suggest a combined effect of poor sleep and low HRV on the odds of metabolic syndrome.

P165 Vitamin D deficiency is associated with poor sleep quality in patients with Crohn’s disease

Abstract Background Sleep disturbances affect 40-50% of patients with Crohn’s Disease and are associated with disease flares. Symptoms, treatment side effects and pro-inflammatory status have been shown to have an effect on sleep quality and duration. Vitamin D deficiency affects between 18% and 70% of inflammatory bowel disease (IBD) patients and is independently associated with lower Health Related Quality of Life and greater disease activity. Our primary aim was to assess for a correlation between sleep quality and Vitamin D deficiency in people with IBD. Our secondary aim was to assess the impact of these factors on quality of life. Methods 54 patients with Crohn’s Disease were invited to attend for Vitamin D testing and complete a survey. Vitamin D deficiency was defined as a serum Vitamin D less than 30 nmol/L. The survey included general demographic information, inflammatory bowel disease information, Pittsburgh Sleep Quality Index (PSQI), disease activity score (Harvey Bradshaw Index), and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). One-way ANOVA tests and unpaired t-tests were used to calculate the statistical significance. Results · Median age 42.5 years. 50% female (n=27) and 50% male (n=27). · Mean duration of IBD was 17 years · 46% of patients were in clinical remission per HBI, 13% had mild activity, 37% moderate activity and 4% severe disease. · The mean global PSQI score was 7.7, with 61% (n=33) of participants having a global PSQI score &amp;gt;5, indicating poor sleep quality. · 24% of patients (n=15) had Vitamin D deficiency · Mean PSQI of patients with Vitamin D deficiency was 10.5 compared to 6.7 in those without (P= 0.008). Conclusion Vitamin D deficiency is associated with poorer sleep quality in IBD, which in turn impacts quality of life in patients with IBD. IBD patients presenting with fatigue and sleep difficulties should be assessed for Vitamin D levels and treated where deficient.

P865 Anxiety and Depression is Associated with Poor Sleep Quality in patients with Inflammatory Bowel Disease (IBD)

Abstract Background Sleep disturbances affect 40-50% of patients with IBD and are associated with disease flares. Symptoms, treatment side effects and pro-inflammatory status have been shown to have an effect on sleep quality and duration. Anxiety and Depression disorders are also common with both conditions affecting approximately 20% of IBD patients. These disorders may also be associated with sleep disturbance Aim Our primary aim was to assess for a correlation between sleep quality and mood disorders in people with IBD. Our secondary aim was to assess the impact of these factors on quality of life. Methods 87 patients with IBD were invited to complete an online survey. This survey included general demographic information, inflammatory bowel disease information, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), disease activity scores (Harvey Bradshaw Index and partial MAYO score), and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). One-way ANOVA tests, Fisher’s test and unpaired t-tests were used to calculate the statistical significance. Results Mean age 43years. 46% male (n=40) and 54% female (n=47). Ulcerative Colitis 35.6% (n=31), Crohn’s Disease 62.1% (n=54), and indeterminate 2.3% (n=2). The mean global PSQI score was 7.66, with 62% (n=54) of participants having a global PSQI score &amp;gt;5, indicating poor sleep quality. Poor sleep quality was not associated with age or disease duration. However unsurprisingly, it was associated with increased disease activity; Remission 5.89, mild activity 7.53, and moderate activity 10.61 (p&amp;lt;0.001). See FIGURE 1 Participants with poor quality of sleep had significantly higher rates of anxiety (HADSA &amp;gt;8) with a mean HADS anxiety score of 10.78 with 79% (n=39/49) reporting anxiety, compared to those with good reported sleep with mean scores of 4.97 and 21% (n=7/33).reporting anxiety p&amp;lt;0.001. They also had higher rates of depression, 42%(n=21/49) versus 6%(n=2/33), p&amp;lt;0.001. Conclusion Poor sleep quality increases levels of anxiety and depression, which in turn impacts quality of life in patients with IBD. Physicians should enquire about sleep &amp; mood when treating patients with IBD to improve sleep quality.

Association between Sleep Quality and Body Weight Status in Adults during the COVID-19 Pandemic

Introduction: The COVID-19 pandemic is a new emerging situation that has dramatically impacted sleep quality and body weight status. This study aimed to determine the association between sleep quality and body weight status in Malaysian adults during the COVID-19 pandemic. Methods: An online cross-sectional study involved 427 Malaysian adults aged 18 to 59. The convenience sampling method was used. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). Self-administered socio-demographic, height, and weight for BMI were obtained. Pearson correlation test was conducted to measure the association between sleep quality and body weight status using IBM SPSS Statistics for Windows version 22.0. Results: A total of 78.5% of them were females, and 84.8% of Malaysian adults reported poor sleep quality. The participants’ mean global PSQI score and body mass index were 8.1 (±2.7) and 24.6 (±6.1) kg/m2, respectively. 8.0% were underweight, followed by 55.5% of normal BMI, 17.5% overweight, and 19.0% obese. The study showed a significant and positive correlation between global PSQI score and body mass index (r=0.137, p=0.005). Conclusion: Sleep quality is significantly associated with body weight status. Adults with poorer sleep quality should be targeted when promoting healthy body weight. Future research on the interventions to improve adults’ sleep quality is essential, particularly during the pandemic.

Clarifying sleep characteristics and analyzing risk factors of sleep disorders to promote a predictive, preventive, and personalized medicine in patients with burn scars

This study assessed sleep quality in patients with burn scars and investigated risk factors of sleep disorders to guide clinical therapy. From the strategy of predictive, preventive, and personalized medicine (PPPM/3PM), we proposed that risk assessment based on clinical indicators could prompt primary prediction, targeted prevention, and personalized interventions to improve the management of sleep disorders present in patients with burn scars. This retrospective study recruited patients with burn scars and healthy volunteers from the Shanghai Burn Treatment Center between 2017 and 2022. Relevant information and data, including demographic characteristics, scar evaluation, and sleep quality, were obtained through the hospital information system, classical scar scale, and self-report questionnaires. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and monitored using a cardiopulmonary-coupled electrocardiograph. Pain and pruritus were assessed using the visual analog scale (VAS). Scar appearance was assessed using the modified Vancouver scar scale (mVSS). The sample was comprised of 128 hypertrophic scar (HS) patients, with 61.7% males, a mean age of 41.1 ± 11.6years, and burn area of 46.2 ± 27.9% total body surface area (TBSA). Patients with PSQI ≥ 7 accounted for 76.6%, and the global PSQI score was 9.4 ± 4.1. Objective sleep data showed that initial enter deep sleep time, light sleep time, awakening time, light sleep efficiency, and sleep apnea index were higher but deep sleep time, sleep efficiency, and deep sleep efficiency were lower in HS patients than that in healthy controls. Preliminary univariate analysis showed that age, hyperplasia time of scar, narrow airway, microstomia, VAS for pain and pruritus, and mVSS total (comprised of pigmentation, vascularity, height and pliability) were associated with the PSQI score (p < 0.1). Multivariable linear regression showed narrow airway, VAS for pain and pruritus, and mVSS specifically height, were the risk factors for PSQI score (p < 0.1). This study model identified that narrow airway, pain, pruritus and scar appearance specifically height may provide excellent predictors for sleep disorders in HS patients. Our results provided a basis for the predictive diagnostics, targeted prevention, and individualized therapy of somnipathy predisposition and progression of HS patients in the setting of PPPM/3PM health care system, which contributed to a paradigm shift from reactive cure to advanced therapy.

Sleep quality among undergraduate medical students in Rwanda: a comparative study

Despite the abundance of literature highlighting poor sleep quality among medical students and its detrimental impact on their mental well-being and academic performance, no study has been conducted to investigate the sleep quality of undergraduate medical students in Rwanda to date. Therefore, this study sought to determine the magnitude of sleep quality of undergraduate medical students in Rwanda and to compare the scores of seven components of sleep quality across classes. This cross-sectional study was conducted among 290 undergraduate medical students aged 18–35 years (mean = 24, SD = 2.9) randomly recruited countrywide from 1st November 2021 to 1st March 2022. The questionnaire was self-administered with 2 sections: characteristics of medical students, and Pittsburgh Sleep Quality Index (PSQI). The Pearson Chi-square test was used to test whether the categories of seven components of sleep quality differ between classes, then ANOVA followed by the post hoc test was used to test if the seven components and global score of Pittsburgh Sleep Quality Index differ between classes. The results revealed that the global PSQI mean score was 7.73 (SD = 2.83), with fifth-year medical students reporting the highest PSQI mean score (M = 8.44, SD = 2.77), followed by first-year (M = 8.15, SD = 3.31). One-way ANOVA showed that the global PSQI score (F = 2.76, p = 0.028), subjective sleep quality (F = 3.35, p = 0.011), habitual sleep efficiency (F = 10.20, p < 0.001), and daytime dysfunction (F = 3.60, p = 0.007) were significantly different across classes. Notably, the post hoc test revealed significant scores differences in the global PSQI score between class II and V (p = 0.026), in subjective sleep quality between class I and II (p = 0.043), and between class I and IV (p = 0.016); habitual sleep efficiency between class V and all other classes (p < 0.001); and daytime dysfunction between class III and IV (p = 0.023). This paper concludes by arguing that poor sleep quality is highly prevalent among medical students in Rwanda, with final and first-year students reporting the poorest sleep quality. There were significant differences across classes in the global PSQI, subjective sleep quality, habitual sleep efficiency, and daytime dysfunction. Intervention approaches such as sleep education, behavioral changes, and relaxing techniques are recommended to address contributing factors and ultimately maximize the academic goals of Rwandan medical students.

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

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

Age Group Differences in the Association Between Sleep Status and Frailty Among Community-Dwelling Older Adults: The SONIC Study.

Objective: We aimed to determine whether the association of sleep status with frailty differs between age groups of older adults. Method: This cross-sectional study was part of the observational Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. Subjects were community-dwelling older adults in their 70s and 80s. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria (J-CHS). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep status. Poor sleep quality was defined as a PSQI global score ≥6. Sleep duration was categorized as short (<6 hr), normal (6-8), and long (>8). We performed multivariable logistic regression to investigate the association between sleep status and frailty separately for each age group adjusted for multiple covariates. Results: In those in their 70s, long sleep duration and sleep medication use were independently associated with frailty. In those in their 80s, poor sleep quality was independently associated with frailty. Conclusions: The association between sleep status and frailty was different between age groups. The findings underscore the importance of incorporating the evaluation of sleep quantity and non-pharmacological therapies in those in their 70s and the evaluation of sleep quality in those in their 80s to help prevent the onset of frailty.

Efficacy and safety of "Jollab Monzej" as a traditional persian compound medicine for the treatment of multiple sclerosis-related fatigue: A randomized placebo-controlled trial.

The purpose of this study was to investigate the efficacy and safety of Jollab monzej (JMZ), a Traditional Persian compound medicine, on multiple sclerosis-related fatigue (MSRF). We did a double-blind randomized controlled phase3 clinical trial on the JMZ syrup in fifty-six relapsing-remitting MS (RRMS) patients aged 18-55 years with moderate to severe fatigue using the Expanded Disability Status Scale (EDSS) score ≤ 6. We randomly assigned (1;1) participants to the JMZ syrup or placebo syrup groups treated for one month. Participants, investigators, and assessors were unaware of the assignments. The primary outcome was changes in the fatigue score on the Fatigue Severity Scale (FSS), at baseline and one month after treatment using the intention-to-treat (ITT) analysis. The secondary outcomes were changes in the score of Visual Analogue Scale (VAS), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI). Outcomes were measured at baseline, one month after treatment, and 2-week follow-up. Safety was detected in all participants. We randomly assigned 56 participants to the JMZ group (n=28) and placebo group (n=28). Fatigue scores significantly changed in both groups; however, the JMZ group had a greater reduction in FSS score in the ITT analysis. The adjusted mean difference was 8.80 (Confidence interval (CI) 95%, 2.90-14.70, P = 0.00). The mean difference of VAS, BDI, and global PSQI scores were statistically significant (P=0.01, P₌0.00, P₌0.01; respectively). Regarding safety, mild adverse events (AEs) were reported. The results of our study revealed that the administration of JMZ syrup alleviated MSRF and also could improve depression and sleep disorders.

Evaluating the Relationship between Sleep Quality and Temperament in Older Adults: Data from TOPS (Tabriz Older People Survey)

The quality of sleep changes with age and a reduction in sleep duration is observed in the elderly. Mizaj (temperament) is a fundamental theory in traditional Persian medicine. It is defined as all sides of personality describing a person’s morphological, psychological, and physiological situations. Although the evidence showed that temperament and sleep quality are related, no research has evaluated this issue statistically so far. Hence, this study aimed to evaluate the correlation between sleep quality and temperament. This cross-sectional study included 1,359 elderly people (aged 60) in Tabriz, Iran in 2019. An interviewer accomplished the Tabriz Older People Survey (TOPS), Temperament and Sleep Quality Test, and Pittsburgh Sleep Quality Index (PSQI). A p value less than 0.05 was considered as significant. Our findings indicated that there was a significant relationship between global PSQI and wet temperament (p value = 0.036). In addition, hot-cold temperament was statistically related to demographical items like gender, marital status, and occupational status (p value ≤ 0.05). A similar statistically significant relationship was also seen for wet-dry temperament (p value ≤ 0.05). Moreover, the global PSQI score in female and illiterates subjects and those who lived in detached houses was high, meaning that the sleep quality was poor in these groups. According to our findings, Mizaj affects the quality of sleep in older adults. Also, living conditions of the elderly, such as gender, type of residence, level of education, and job, affect the Mizaj of the elderly people.

ASSOCIATIONS BETWEEN MEASURES OF SLEEP QUALITY, PHYSICAL ACTIVITY, ANXIETY, AND STRESS AMONG ADULTS

Abstract Good quality sleep is important for physical and mental well-being and plays a vital role in healthy aging. Additionally, sleep quality is influenced by multiple factors associated with aging, such as lifestyle, depression, and physical activity levels. Therefore, the purpose of this study was to explore the relationship between self-reported measures of physical activity levels, anxiety, stress, and sleep quality among adults aged 45-75 years. Adults (N = 204) completed the short form International Physical Activity Questionnaire (IPAQ), Generalized Anxiety Disorder 7-Item Scale (GAD-7), Perceived Stress Scale (PSS), and the Pittsburgh Sleep Quality Index (PSQI). Participants were classified as either good quality sleepers (GQS, n = 65, 67.7% female, M±SD: age: 61.7±8.9 yrs; mass: 82.8±16.7 kg, height: 169.6±10.2 cm, education: 17.3 yrs) or poor quality sleepers (PQS, n = 139, 77.7% female, M±SD: age: 61.9±8.0 yrs; mass: 83.1±16.2 kg, height: 166.4±8.5 cm, education: 18.0 yrs) using their PSQI global score. A score of ≥5 denoted PQS. Data were analyzed using descriptive statistics, Spearman correlation, and Chi-square (p ≤ .05). Sleep quality was negatively associated with the PSS (r = -.17, p = .02) and GAD-7 (r = -.19, p &amp;lt; .01). Adults reporting PQS presented with higher levels of perceived stress and generalized anxiety. The relation between sleep quality and IPAQ was significant (X2 = 8.47, p = .01). These results suggest there was a greater tendency for PQS to report lower levels of physical activity and higher levels of stress and generalized anxiety.

Assessing sleep health dimensions in frontline registered nurses during the COVID-19 pandemic: implications for psychological health and wellbeing.

The COVID-19 pandemic altered work environments of nurses, yielding high rates of stress and burnout. Potential protective factors, including effective sleep, may influence psychological health and wellbeing. Evidence about sleep in nurses may help develop interventions that mitigate burnout and poor psychological outcomes. A cross sectional survey was distributed across three hospitals to nurses in New York City (NYC). During the first wave of the pandemic (March-April 2020), NYC had the highest incidence of laboratory-confirmed COVID-19 cases (915/100 000) and half of all COVID-related deaths nationwide. Multivariable logistic regression was used to determine associations between Pittsburgh Sleep Quality Index (PSQI) global sleep score, PSQI sleep dimensions, and psychological health (burnout, depression, anxiety, and compassion fatigue), unadjusted and then controlling for individual and professional characteristics. More than half of the participants reported burnout (64%), depression, (67%), and anxiety (77%). Eighty percent of participants had PSQI global scores >5 (poor sleep) (mean 9.27, SD 4.14). Respondents reporting good sleep (PSQI ≤ 5) had over five times the odds of no burnout (OR: 5.65, 95% CI: 2.60, 12.27); increased odds of screening negative for depression (OR: 6.91, 95% CI: 3.24, 14.72), anxiety (OR: 10.75, 95% CI: 4.22, 27.42), and compassion fatigue (OR: 7.88, 95% CI: 1.97, 31.51). Poor subjective sleep quality PSQI subcomponent was associated with burnout (OR: 2.21, 95% CI: 1.41, 3.48) but sleep duration subcomponent was not (OR: 0.84, 95% CI: 0.59, 1.19). Daytime dysfunction was significantly associated with all psychological outcomes. Sleep disturbances and medications yielded higher anxiety odds. Overall, sleep quality appears more strongly related to burnout than sleep duration in nurses working during the COVID-19 pandemic. Sleep interventions should target individual sleep dimensions in nurses.