Global Pittsburgh Sleep Quality Index Research Articles

#235 Quality of sleep and the quality of life in chronic kidney disease patients undergoing hemodialysis in a tertiary hospital in the Philippines

Abstract Background and Aims Sleep quality and quality of life are critical aspects of health and well-being, particularly for individuals undergoing hemodialysis. Hemodialysis is a life-sustaining treatment for individuals with end-stage kidney disease (ESKD), but it can significantly impact various dimensions of their health, including sleep quality and overall quality of life. Understanding the relationship between sleep and quality of life in hemodialysis patients is essential for developing effective interventions to improve their overall well-being. Studies have shown that hemodialysis patients often experience poor sleep quality, characterized by difficulty falling asleep, frequent awakenings during the night, and early morning awakening. Moreover, sleep disturbances experienced by hemodialysis patients can also affect their ability to perform daily activities which can have a negative impact on their overall quality of life. Factors that have been shown to be associated with quality of sleep and quality of life in hemodialysis patients include age, sex, comorbidity, mode and schedule of hemodialysis, hemoglobin, phosphorus and albumin. Physicians can provide patient-centered care more effectively when they have a better grasp of the quality of life. However, the quality of life is not thoroughly studied in individuals with chronic kidney disease, particularly those undergoing hemodialysis. To address these issues, it is essential to prioritize sleep quality and quality of life in hemodialysis patients. The aims of this study were to determine the prevalence of ‘poor sleepers’ in patients undergoing hemodialysis using a validated sleep quality questionnaire and to examine the relationship between patients’ sleep quality with the quality of life using a validated kidney-disease specific quality of life questionnaire. Method This was a descriptive cross-sectional study conducted at The Medical City Ortigas from May to July 2023. The subjects recruited were adult hemodialysis patients enrolled in The Medical City Ortigas. To get a 95% confidence level, a minimum population of 80 patients should be included based on 71% prevalence from the study of Iliescu in 2003. This study evaluated a total of 85 patients through random selection. Patients excluded were those <18 years of age, had been on dialysis for less than 3 months, were not competent to give informed consent, and those with diagnosed sleeping disorder prior to having chronic kidney disease. Quality of sleep and quality of life were measured using validated self-administered questionnaires; the Pittsburgh Sleep Quality Index (PSQI) and the Kidney Disease Quality of Life-Short Form v1.3 (KDQOL) respectively. Results Among the respondents 67 (78.82%) were found to be poor sleepers (PSQI >5) with a mean global PSQI of 9.25. Age appeared to be a significant factor as the percentage of bad sleepers belong to the 46-65 and >65 age groups. In contrast, sex, marital status, 150 employment, hemodialysis shift, BMI, kt/V, hemodialysis type, albumin, phosphorus, and hemoglobin levels did not have significant association with quality of sleep. There is significantly a greater number of bad sleepers that have a lower functioning due to symptoms experienced (50.65 bad sleepers vs 62.85 good sleepers). Bad sleepers also have worse quality of life in domains of cognitive function (66.67 vs 55.22), sleep (56.67 vs 46.9), patient satisfaction (57.41 vs 45.27) overall health (54.44 vs 43.28) and general health (40.83 vs 32.16). Correlations between the global PSQI score and the domains of KDQOL computed via Pearson r coefficient showing an inverse correlation between PSQI and the mental (-.392) and physical (-0.320) component summaries. Conclusion Poor sleep is common in hemodialysis patients and is associated with poorer quality of life.

The positive impact of smoking on poor sleep quality is moderated by IGF1 levels in cerebrospinal fluid: a case-control study among Chinese adults.

Previous research indicates associations between cigarette smoking, insulin-like growth factor-1 (IGF1), and sleep disturbances. This study aimed to examine the association between smoking and sleep quality and investigate the moderating role of IGF1. This case-control study involved 146 Chinese adult males (53 active smokers and 93 non-smokers) from September 2014 to January 2016. Sleep quality and disturbances were evaluated using the Pittsburgh Sleep Quality Index (PSQI), which includes seven scales. Pearson correlation analysis and logistic regression analysis were utilized to examine the link between IGF1 levels in cerebrospinal fluid (CSF) and PSQI scores. The effect of IGF1 was assessed using the moderation effect and simple slope analysis, with adjustments made for potential confounders. Active smokers exhibited significantly higher global PSQI scores and lower IGF1 levels in CSF compared to non-smokers. A significant negative correlation was observed between IGF1 and PSQI scores (â = -0.28, P < 0.001), with a stronger association in non-smokers (Pearson r = -0.30) compared to smokers (Pearson r = -0.01). Smoking was associated with higher global PSQI scores (â = 0.282, P < 0.001), and this association was moderated by IGF1 levels in CSF (â = 0.145, P < 0.05), with a stronger effect at high IGF1 levels (Bsimple = 0.402, p < 0.001) compared to low IGF1 levels (Bsimple = 0.112, p = 0.268). Four subgroup analysis revealed similar results for sleep disturbances (Bsimple = 0.628, P < 0.001), with a marginal moderation effect observed on subjective sleep quality (Bsimple = 0.150, P = 0.070). However, independent associations rather than moderating effects were observed between IGF1 and sleep efficiency and daytime disturbance. We provided evidence to demonstrate the moderation effect of IGF1 on the relationship between smoking and sleep in CSF among Chinese adult males.

Association of sleep quality with physical and psychological health indicators in overweight and obese rural Indians

ObjectiveTo measure the association of sleep quality with physical (i.e., grip strength, functional mobility, balance) and psychological (depression, anxiety) health indicators in an overweight/obese population. MethodsBaseline data of 2337 participants (1382 overweight/obese and 955 normal weight) from an aging cohort in rural southern India (CBR-SANSCOG) was analyzed retrospectively. Assessment tools included the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, dynamometry for Hand Grip Strength (HGS), Timed Up-and-Go (TUG) for functional mobility, Chair Stand Test (CST) for lower limb strength, Geriatric Depression scale (GDS-30) for depressive symptoms and Generalized Anxiety Disorder scale (GAD-7) for anxiety symptoms. Linear regression models, adjusted for known confounders, were used to examine the association of sleep quality with the health parameters in overweight/obese and normal-weight groups. ResultsIn the fully adjusted model, higher global PSQI score was associated with higher TUG time (β = 0.06, 95 % CI: 0.004,0.12), higher scores on GDS (β = 1.08, 95 % CI: 0.96,1.20) and GAD (β = 0.71, 95 % CI: 0.62,0.79), and lower scores on CST (β = -0.12, 95 % CI: -0.19,-0.06) in overweight/obese individuals. The sleep disturbance sub-component of PSQI was associated with most of the physical (TUG, CST) and psychological (GDS and GAD) health indicators. Sleep duration and use of sleep medication showed no significant association with any of the health indicators. ConclusionThe concurrent presence of poor sleep quality and overweight/obesity could worsen physical and psychological health in middle-aged and older adults. We highlight the importance of early detection and timely management of sleep problems in this population to reduce physical and psychological morbidities.

Assessment of Sleep Disorders in Patients with CVID.

Inborn errors of immunity have been associated with reduced health-related quality of life and increased fatigue. Sleep disorders, which have been shown to contribute to fatigue and other health concerns, are prevalent in the general population, but there are limited studies evaluating these conditions in patients with common variable immunodeficiency (CVID). Our aim was to evaluate the prevalence of fatigue, sleep disturbances, and sleep-disordered breathing in adults with CVID. Patients completed 4 validated, self-administered questionnaires and a 1-night disposable home sleep apnea test. Our results demonstrated increased median Patient-Reported Outcomes Measurement Information System fatigue scores of 58.7 in patients with CVID in addition to clinically significant fatigue as measured by Fatigue Severity Scale score (median, 5.2) and overall poor sleep quality based on global Pittsburgh Sleep Quality Index score (median, 9.0). For CVID patients who completed the home sleep apnea test, 76.9% met criteria for sleep-disordered breathing with an Apnea-Hypopnea Index score of 5 or greater. The results of our study indicate that patients with CVID may have increased rates of undiagnosed sleep disorders that may contribute to increased fatigue and reduced health-related quality of life.

Sleep Quality among Medical Students of a Portuguese University

Introduction: Sleep is a complex physiological process shared by most living beings. Sleep disorders have been increasing exponentially. University students, particularly medical students, are especially vulnerable to this problem. However, the existing literature on the subject is scarce, especially in Portugal. The aim of this study is to assess the quality of sleep among medical students attending the University of Beira Interior, Covilhã, Portugal and to analyse the differences and existing relationships according to age, gender, cohabitation status and academic year. Method: This is a cross-sectional study in which the students completed the Pittsburgh Sleep Quality Index (PSQI) that was previously validated for the Portuguese population. The values obtained for each component of the PSQI were initially analysed for the total sample, and then coupled with sociodemographic variables, in order to obtain statistically significant relationships. Results: Two hundred and ninety-six students completed the questionnaire. A percentage of 62.2% of them stated that their sleep was good; 42.4% scored 2 in the component 2; 50% admitted that they usually sleep between 6 and 7 hours; 73.9% of the participants showed adequate sleep efficiency; 85.5% reported little or no sleep disturbance; 83.8% reported never having used sleep medications; and 60.8% mentioned little or no daytime disturbance. As for global PSQI score, 72.6% of the students’ scores were greater than 5, which indicates poor sleep quality. 74.7% of the female participants and 67.7% of the male respondents showed poor sleep quality. 91.3% of the students who were living alone at the time also revealed poor sleep quality. Of the 1st year students, 82.4% reported poor sleep quality, as did 77.5% of the 2nd year students, 72.1% of the 3rd year students, 77.8% of the 4th year students, 65.8% of the 5th year students, and 71.4% of those attending the 6th year. Conclusion: Generally speaking, the students who took part in this study showed a poor sleep quality, with a PSQI score superior to 5. However, the ratings in each of the components are not so negative. Most of the participants rated their sleep as good or very good, almost half of the participants reported sleeping more than 7 hours and the majority had a sleep efficiency of more than 85%. Similarly, 83.8% had never used sleep medication. Since this is not a robust result, it is imperative to carry out more studies that unequivocally prove it. Moreover, such studies will also be essential to identify situations in which therapeutic intervention will improve such parameters.

Sleep Quality in Team USA Olympic and Paralympic Athletes.

To establish sleep-quality reference ranges for Olympic and Paralympic cohorts using the Pittsburgh Sleep Quality Index (PSQI) and explore differences based on sex and sport types. Team USA athletes (men = 805, women = 798) completed the PSQI as part of a health-history questionnaire. Descriptive statistics were used to create reference ranges and linear models, and χ2 test of independence determined differences in PSQI global and component scores between sex, games, season, and participation. Six hundred thirty-two (39.43%) athletes reported poor sleep (PSQIGlobal ≥ 5). Men displayed later bedtimes (P = .006), better global PSQI scores, shorter sleep latency, less sleep disturbance, and less use of sleep medication than women (all P < .001). Winter Games participants had later bedtime (P = .036) and sleep offset time (P = .028) compared with Summer Games athletes. Team-sport athletes woke earlier than individual-sport athletes (P < .001). Individual-sport athletes were more likely to have low (P = .005) and mild (P = .045) risk for reduced sleep duration than team-sport athletes. These data provide PSQI-specific reference ranges to identify groups at greatest risk for poor sleep, who may benefit most from targeted sleep interventions.

Predictors and disturbances of sleep quality between men and women: results from a cross-sectional study in Jordan

BackgroundSleep disturbances, a public health concern that may lead to critical physiological conditions, are associated with personal characteristics such as gender. Limited evidence is available from the Middle East population on the gender disparities in sleep quality. Therefore, the current study examined gender-specific differences in sleep quality and disturbances among Jordanian citizens.MethodA cross-sectional design was used to recruit a convenient sample of 1,092 adults from different Jordanian cities. Data was collected using a self-reported questionnaire comprising the Pittsburgh Sleep Quality Index (PSQI), which was distributed online via social media networks. The participants were categorized according to their global PSQI scores into poor (PSQI ≥ 5) and good sleepers (PSQI < 5). The analysis focused on finding differences between women and men in terms of sleep quality and the effects of demographic, lifestyle, and socioeconomic factors on reported sleep problems.ResultsWomen were revealed to have a higher prevalence of all types of sleep disturbances than men. Women who were over 55 (compared to younger than 20 years), did not smoke, had multiple jobs or part-time employment (compared to unemployed women), and had a monthly income of more than 500 JD (compared to those with an income of < 500 JD) were less likely to experience poor sleep than other women. In contrast, men who neither smoked nor drank coffee, ate no sweets or only one to two pieces daily (compared to participants who ate more than two pieces daily), and worked fixed night shifts (compared to alternating shifts workers) were less likely to experience poor sleep than other men.ConclusionThis study builds a more nuanced understanding of how different demographic, lifestyle, and socioeconomic factors - such as a participant’s age, time of working duty, income, daily sweet consumption, daily caffeine consumption, and smoking - affect the sleep quality of men and women. Thus, promoting a healthier lifestyle for both genders by modifying risk factors - such as smoking cessation, as well as reducing their intake of caffeine and sweets - is the first step toward improving their sleep quality. Further studies are needed to examine how the social role of Arabic women affects their sleep.

Poor Sleep Quality in Jamaican Adults With Sickle Cell Disease: Prevalence, Risk Factors, and Association With Quality of Life

Poor sleep and chronic illnesses have a bidirectional relationship where presence of one can worsen the other. Sickle cell disease (SCD) is associated with significant morbidity and early mortality. In this study, we examine sleep quality, its predictors, and its association with quality of life in Jamaican adults with SCD. This cross-sectional study evaluated 177 well adult SCD patients for sleep quality using The Pittsburgh Sleep Quality Index (PSQI) and quality of life using the Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me). Multiple linear regression models examined the predictors of poor sleep quality. The mean global PSQI score was 6.9 (SD 4.2) with 56.5% having poor sleep quality. Women had significantly worse scores for sleep efficiency (p 0.005), sleep latency (p 0.03) and higher use of sleeping medications (p 0.02). Those overweight/obese had significantly worse subjective sleep quality (p 0.001) and sleep efficiency (p 0.05). In multivariate regression analysis, overweight individuals had poorer sleep quality (OR: 2.9; 95% C.I.: 1.07, 7.88) than those with normal weight whereas those unemployed and looking for a job had lower prevalence of poor sleep quality (OR 0.2; 95% C.I.: 0.05, 0.77) compared to employed individuals. Participants with good sleep quality had significantly better functioning in all 5 domains of the ASCQ-Me. In conclusion, persons with SCD who are overweight or obese are at increased risk of poor sleep which can negatively affect quality of life. Patient populations and healthcare providers will need to manage the emerging burden of overweight/obesity.

Early morning sport scheduling is associated with poorer subjective sleep characteristics in British student-athletes.

This study presents the sleep characteristics of British student-athletes and examines the relationships between sport scheduling and time demands on sleep outcomes. Student-athletes (n = 157, 51% male) completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Sleep Hygiene Index (SHI). Self-reported sleep characteristics on weekdays and weekends, weekly frequencies of early morning and late evening sport sessions, and academic-related and sport-related time demands were also collected. Questionnaires revealed a high prevalence of undesired sleep characteristics including poor sleep quality (global PSQI >5 in 49.0%) and low sleep durations on weekdays (25% reporting <7 h). Paired t-tests revealed significant differences in bedtime, waketime, sleep duration, and sleep onset latency between weekdays and weekends (all p < 0.01). Hierarchical regression analyses indicated that early morning sport frequency was a significant predictor of PSQI (β = 0.30) and SHI (β = 0.24) global scores, weekday waketimes (β = -0.17), and weekday sleep durations (β = -0.25; all p < 0.05) in models adjusted for participant characteristics. Late evening sport frequency, and academic-related and sport-related time demands, were not significant predictors of any sleep outcome. Adjusting sport scheduling to avoid early start times could provide a means to improve sleep outcomes and may improve sporting performance and academic attainment.

ASSOCIATION BETWEEN SLEEP QUALITY AND ACADEMIC PERFORMANCE AMONG PRIVATE UNIVERSITY STUDENTS DURING COVID-19 ENDEMIC IN CYBERJAYA, MALAYSIA

Introduction: Malaysia was struck by the Covid-19 pandemicin 2020 which left a significant impact on the population. Since then, the aftereffects especially poor sleep quality are still affecting us. Thus, this study aims to assess the sleep quality of students at the University of Cyberjaya (UOC) post-COVID-19 pandemic and its relation to students' academic performance. This study aimed to assess any association between students' sociodemographic factors and sleep quality. This is a cross-sectional study where a convenience sampling technique was used. Methods:The study population consisted of 350 students comprised of those aged 18 years and above, and currently a student at the University of Cyberjaya while those that were diagnosed with health issues were excluded. A validated self-rated questionnaire, the Pittsburgh Sleep Quality Index (PSQI) was used to assess students' sleep quality. A global PSQI score holds a diagnostic sensitivity of 89.6% and a specificity of 86.5% to differentiate good and poor sleepers. Sociodemographic background questions of students' and respective semester cumulative grade point average (CGPA) were self-reported. Results:Our results revealed that 83.4% (292) of the students had poor sleep quality while 16.6% (58) had good sleep quality. However, there is no meaningful association between sociodemographic factors, sleep quality, and academic performance. Although, those with good academic performance had better sleep quality than those who achieved excellent grades. Conclusion:most UOC students reported poor sleep quality, but interestingly this does not affect their academic performance.

Factors related to sleep quality in hospitalized antepartum women: A cross-sectional study.

This study investigated the sleep quality and its psychological correlates among hospitalized antepartum women. A cross-sectional correlation study design and convenience sampling were conducted in the gynecological ward of a medical center in northern Taiwan. A total of 101 hospitalized antepartum women were recruited. A self-administered structured questionnaire including demographic profiles, State-Trait Anxiety Inventory (STAI), Antepartum Hospital Stressors Inventory (AHSI), and Pittsburgh Sleep Quality Index (PSQI) was used for the study. Bivariate and multiple linear regressions were used to analyze the data. A majority of the participants had poor sleep quality (82.8%), based on the global PSQI score. Sleep quality correlated with age, marital and employment status, parity, method of conception, multiple gestation, history of pregnant complications, anxiety symptom and hospital stressors which explained 21% of the variance in sleep quality. This study found a high prevalence of poor sleep quality in hospitalized antepartum women. Anxiety symptom was a significant predictor of sleep quality. Healthcare providers should be encouraged to assess sleep and emotional status in antepartum women during hospitalization and provide them appropriate interventions to improve sleep and reduce anxiety symptoms and hospital stressors.

Home-based Aerobic Interval Training Combined with Resistance Training Improved Daytime Dysfunction in Adults with Obesity and Sleep-Disordered Breathing

Abstract Introduction There have been many barriers to exercising at a gym due to the coronavirus disease 2019 (COVID-19) pandemic worldwide. Home-based aerobic interval training (AIT) combined with resistance training (RT) may be helpful for obese adults with sleep-disordered breathing (SDB) to overcome those barriers and improve their subjective sleep disorders. Thus, the present study aimed to examine the effects of home-based AIT combined with RT on subjective sleep disorders in obese adults with SDB. Material and Methods This study has a one-group pretest-posttest design. Twenty-one adults with obesity and SDB were assigned to perform 8 weeks of AIT combined with RT. Subjective sleep disorder variables including the Pittsburgh Sleep Quality Index (PSQI), Berlin Questionnaire, and Epworth Sleepiness Scale were defined as primary outcomes. Anthropometric variables, physical fitness components, and blood biomarkers were assigned as secondary outcomes. All outcome measurements were examined at baseline and after 8 weeks of training. Results Daytime dysfunction of PSQI was significantly improved after 8 weeks of the exercise program (p &lt; 0.05). Upper and lower chest expansion and estimated maximum oxygen consumption were significantly increased after 8 weeks of the exercise program (all p &lt; 0.05). None of the blood biomarkers changed after 8 weeks of training. Conclusion This study suggests that home-based AIT combined with RT effectively alleviates daytime dysfunction and seems to be more helpful in improving global PSQI in adults with obesity. Future studies with a larger sample size, under a controlled trial are recommended to prove the benefits of the exercise program.

Association between physical activity and sleep quality among healthcare students.

To assess the relationship between physical activity (PA) and sleep quality (SQ) in Mohammed Bin Rashid University (MBRU) students in Dubai, United Arab Emirates. Taking into account this being one of the first studies exploring this aspect among healthcare students in the Gulf Cooperation Council (GCC) countries. This is an analytical cross-sectional study that involved disseminating online surveys via email to students of all 5 colleges in MBRU between March-June 2023. The survey encompassed queries on demographics, the Saltin-Grimby Physical Activity Level Scale (SGPALS), the International Physical Activity Questionnaire-Short Form (IPAQ-SF), and the Pittsburgh Sleep Quality Index (PSQI). The survey was completed by 105 students. Most students were from the medical college (98/105; 93.3%) and were females (84/105; 80.0%). Females engaged the most in low PA (44.0%) while males engaged the most in high PA (42.9%) according to the IPAQ-SF. There was a significant association between SGPALS and gender (p = 0.007, X2 = 12.0). The global PSQI score showed that 70.5% of the students had bad-quality sleep. Sleep efficiency and leisurely PA are significantly negatively correlated (p = 0.026, ρ = -0.217) while sitting minutes and sleep duration are significantly positively correlated (p = 0.030, r = 0.212). Significant negative correlations between sleep efficiency and leisurely PA demonstrate that while exercise has been implicated in the improvement of SQ, excessive exercise can behave as an additional stressor and induce negative changes in the SQ of healthcare students. Meanwhile, significant positive correlations between sleep duration and sitting indicate that adequate rest should not be undervalued in its effects on sleep. Furthermore, the findings of this study highlight public health implications that warrant attention by educators and policymakers in academic health systems.

Factors Associated With Sleep Quality Among Undergraduate Nursing Students During Clinical Practicums.

Limited evidence exists on factors influencing nursing students' sleep quality during clinical practicums. This study examined the sleep quality of nursing students and factors that affect sleep quality during clinical practicums. Undergraduate nursing students (n = 135) enrolled in clinical practicums in 3 universities completed questionnaires including sociodemographics and the Pittsburgh Sleep Quality Index (PSQI). Stepwise linear regression evaluated factors predicating sleep quality. Seventy percent of nursing students reported poor sleep quality. Weekly work hours and clinical hours were significant factors in predicting global PSQI scores, subjective sleep quality, sleep duration, sleep efficiency, and daytime dysfunctions. The race was related to sleep latency and sleeping medication. Clinical hours and living on campus were associated with sleep disturbances. Knowing the factors that influence nursing students' sleep during clinical practicums, nurse educators can help students improve sleep health and clinical experience.

Predictors of Sleep Quality Among Type 2 Diabetes Mellitus Patients

One of the health problems experienced by patients with type 2 diabetes mellitus is poor sleep quality. Poor sleep quality is an important factor in poor blood sugar regulation. This study aims to determine the predictors of sleep quality in patients with type 2 diabetes mellitus at a private hospital in Yogyakarta. This research was conducted using a cross sectional approach on 150 type 2 diabetes mellitus patients who were recruited at the Endocrine Clinic at a private hospital in Yogyakarta. The questionnaires used in this research were demographic data questionnaires, Perceived Stress Scale (PSS-10), Pittsburgh Sleep Quality Index (PSQI). Data analysis was carried out using Multiple hierarchical linear regression. The research results show that the average stress score of respondents in this study was 16.13 (SD = 4.59), which is in the medium category. Global PSQI showed that respondents experienced poor sleep quality (mean = 5.33, SD = 1.79). The Perceived Stress Scale score contributed 23.6% to the sleep quality score. The higher the respondent's stress level, the lower the respondent's sleep quality. Nurses can develop interventions to improve the sleep quality of type 2 diabetes mellitus patients.

Sleep quality among family medicine physicians before and during COVID-19 in Jeddah, Saudi Arabia

Background: This study aimed to assess the sleep quality of family medicine physicians before and during the COVID-19 pandemic in Jeddah, Saudi Arabia, and to explore the associations between sleep quality and various demographic and health-related factors. Methods: A total of 109 family medicine physicians participated in this cross-sectional study. The Pittsburgh sleep quality index (PSQI) was utilized to evaluate sleep quality, encompassing seven components: subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction. Data were collected asking questions regarding both before and during the pandemic period. Descriptive statistics, paired-sample t-tests, and Chi-square tests were used for data analysis. Results: The study revealed significant changes in sleep quality components before and during the pandemic. While sleep latency and sleep duration improved, sleep disturbance, use of sleep medication, and daytime dysfunction worsened during the pandemic. The overall global PSQI score indicated a decline in sleep quality during the pandemic. Females reported poorer sleep quality than males. Participants with general anxiety disorder, diabetes mellitus, and hypertension experienced worse sleep quality. Other demographic and health-related factors exhibited mixed associations with sleep quality. Conclusions: The study highlights the nuanced impact of the COVID-19 pandemic on the sleep quality of family medicine physicians. The observed changes in sleep quality components and their associations with various factors underscore the need for tailored interventions to address sleep disturbances among healthcare professionals. These findings contribute to a comprehensive understanding of sleep quality dynamics in the context of a global crisis and emphasize the significance of promoting well-being among healthcare providers for enhanced patient care.

Physical activity attenuates the association of long-term exposure to nitrogen dioxide with sleep quality and its dimensions in Chinese rural older adults

BackgroundJoint impacts of air pollution and physical activity (PA) on sleep quality remain unaddressed. We aimed to investigate whether PA attenuates the association of long-term exposure to nitrogen dioxide (NO2) with sleep quality and its dimensions in older adults. MethodsThis study included 3408 Chinese rural older adults. Annual NO2 was estimated using the Space-Time Extra-Trees model. PA was assessed by International Physical Activity Questionnaire. Sleep quality was evaluated using Pittsburgh Sleep Quality Index (PSQI) scale. Linear regression models were used to assess the associations of long-term NO2 exposure and PA with sleep quality and its dimensions, and interaction plots were used to depict the attenuating effect of PA on associations of NO2 with sleep quality and its dimensions. ResultsThree-year (3-y) average NO2 (per 0.64-μg/m3 increment) was positively associated with global PSQI (β = 0.41, 95 % CI: 0.23, 0.59), sleep duration (β = 0.16, 95 % CI: 0.11, 0.21), and habitual sleep efficiency (β = 0.22, 95 % CI: 0.17, 0.27), while PA was negatively associated with global PSQI (β = −0.33, 95 % CI: −0.46, −0.20) and five domains of PSQI other than sleep duration and sleep disturbances. The associations of NO2 with global PSQI, sleep duration, and habitual sleep efficiency were attenuated with increased PA (Pinteraction were 0.037, 0.020, and 0.079, respectively). ConclusionsPA attenuates the adverse impacts of long-term NO2 exposure on sleep quality, especially on sleep duration, and habitual sleep efficiency, in Chinese rural elderly people. Participating in PA should be encouraged in this population, and continued efforts are still needed to reduce air pollution.

Investigating a clinically informed sleep disturbance threshold for physical and mental health among Gulf War Illness veterans.

This study (1) assessed sleep quality and health in Gulf War veterans (GWV) meeting the Gulf War Illness (GWI) criteria and (2) compared health associations for both those meeting a "clinically disturbed sleep" threshold, and those below, as determined by the Pittsburgh Sleep Quality Index (PSQI) cutoff for military populations (≥10) on measures of physical, mental, and cognitive health. Participant data consisted of questionnaires and assessments completed prior to group assignment in a clinical trial. The sample consisted of 147 GWV, where 81.0% were males, and the median age was 53.4 years. The mean (SD) PSQI global score was 12.34 (4.00) with 61% of the sample qualifying as clinically disturbed sleepers according to the cutoff (global PSQI ≥ 10). GWI veterans with PSQI scores ≥10 did not differ from others in age (p = 0.20), sex (p = 0.19), or years of education (p = 0.87), but showed worse GW-related symptomology on the Gulf War Kansas questionnaire (p < 0.01), and poorer mental health on the Veterans Rand-36 (p < 0.01). Disturbed sleep was associated with measures of pain, fatigue, and cognitive health. Our results suggest that a previously determined clinical threshold for clinically disturbed sleep is useful when examining the health status of the study population. Given that GWI is associated with elevated PSQI scores and a high frequency of disturbed sleep, cutoffs determining sleep health should be sensitive to population exposures and health history to improve interpretability.

Effect of Smartphone Usage during Night Time on Sleep Patterns of Young Adults: A Cross-sectional Observational Study

Introduction: Excessive smartphone usage among adolescents and young adults has been consistently linked to poor sleep. Moreover, smartphone overuse has been associated with daytime tiredness, longer sleeps latency, and reduced sleep duration. The significance of addressing poor sleep among adolescents and young adults is underscored by recent research linking it to adverse physical and psychological health outcomes, such as mood disturbances, impaired cognitive function, and increased risk incidence of hypertension and diabetes. Aim: To evaluate the effects of smartphone usage on sleep quality among individuals using Pittsburgh Sleep Quality Index (PSQI) and hypnogram data. Materials and Methods: In this cross-sectional observational study, sleep patterns were assessed using the PSQI questionnaire and Prime Nap sleep tracker app (version 1.1.4). The study was conducted by Deccan College of Medical Sciences, Hyderabad, Telangana, India. The data was collected in the form of a hypnogram and the study was conducted in the participants’ homes (under domicile conditions) in the city of Hyderabad, Telangana, India from March 2020 to April 2020. A total of 60 participants (both male and female) in the age group of 15-25 years were recruited and divided into two groups: one comprising 30 individuals with regular prolonged exposure to smartphone screens at night, and the other consisting of 30 individuals who experienced minimal or no smartphone exposure once they prepared to sleep. Descriptive statistics were applied to the collected data using Microsoft Excel and IBM Statistical Package for Social Sciences (SPSS) for Windows version 25.0. Results: Adding up the average scores of the seven factors gives a global PSQI score from 0 to 21, with 0-4 indicating good sleep and 5-21 indicating poor sleep. Among those who used smartphones regularly at night time, 20 participants (66.67%) had PSQI score &gt;5 and poor sleep quality, 24 participants (80%) had prolonged sleep latency, 18 participants (60%) had poor sleep duration, 27 participants (90%) had sleep disturbances, and 22 participants (73.33%) had increased daytime dysfunction. Hypnogram abnormalities were seen in &gt;15 participants (50%) of subjects. Conclusion: The prevalence of smartphone addiction is widely acknowledged in the medical literature, highlighting the need for its assessment, especially among adolescents and young adults. The study reveals that poor sleeping habits among participants were attributable either to a lack of awareness or neglect. By recognising the importance of adequate sleep, improvement in the quality of daily activities can be made by reducing daily screen time, consequently alleviating both physical and mental stress. Furthermore, the findings have implications for individuals whose work involves prolonged exposure to computer screens, especially during night time.

Assessment and mitigation of sleep disturbances in Egyptian acute care settings

BackgroundSleep disturbances in acute care settings pose challenges to patient recovery and well-being. Acute care facilities provide a unique context to explore these issues due to their diverse patient populations. Understanding the prevalence and nature of sleep disturbances is crucial for developing effective interventions tailored to the acute care setting. AimAssess and mitigate of sleep disturbances in Egyptian Acute Care Settings among patients. MethodsA cross-sectional design was utilized, involving 158 adult patients aged 18 and above with various medical conditions. Sleep assessments utilized the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Berlin Questionnaire, and Insomnia Severity Index (ISI). Statistical analyses, including t-tests and ANOVA, were conducted using SPSS 26. ResultsThe study, encompassed 158 patients, revealed several key findings: heightened sleep latency (p = 0.042) and a substantial increase in the Global PSQI Score (p = 0.018), indicated compromised overall sleep quality. Daytime sleepiness escalated across activities (p < 0.01), hinted at potential sleep-related issues. Additionally, occurrences of snoring, witnessed apnoea's, and daytime sleepiness significantly rose (p < 0.05), suggested the possibility of sleep-disordered breathing. Results from the Insomnia Severity Index (ISI) underscored challenges across various sleep aspects (p < 0.01), highlighted the overall severity of insomnia symptoms (p = 0.001). These findings emphasized the necessity for targeted interventions to address these sleep disturbances ConclusionThe study underscored the significant impact of sleep disturbances on patients within Egyptian Acute Care Settings. With heightened sleep latency, compromised overall sleep quality, and increased daytime sleepiness observed among the patient cohort, there is a pressing need for tailored interventions to mitigate these issues. RecommendationsDevelop interventions tailored to address sleep disturbances, enhance healthcare provider awareness, and incorporate regular sleep assessments into patient care routines. Additionally, future research should evaluate the efficacy of these interventions within acute care environments.