Global Sleep Quality Research Articles

Life and Sleep Quality amongst Peritoneal Dialysis Patients: A Comparative Study

Introduction: Sleep disorders affect up to 70% of peritoneal dialysis (PD) patients and appear to have significant negative effects on their quality of life (QoL). We compared life and sleep quality between patients on automated PD (APD) and continuous ambulatory PD (CAPD). Material and Methods: Cross-sectional study in chronic PD patients followed in our Dialysis Unit in February 2022. We evaluated sleep quality with the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) and QoL with EUROHIS-QOL-8. Results: Fifty-two patients, mostly men (65.4%, n=32), with a mean age of 52.7±14.2 years and PD vintage of 24.3±17.1 months. Our sample had similar distribution between APD and CAPD; we found no difference between groups regarding demographic data, PD-related quality parameters or prevalence of previous sleep disturbances. Mean QoL index was 69.9%±9.3% and similar between APD and CAPD patients; EUROHIS-QOL-8 negatively correlated with the scores on ESS (p=0.004) and PSQI (p=0.011). Regarding sleep quality, the mean ESS was 8.8±4.2 and PSQI was 7.6±3.6. APD patients had similar scores on ESS, but higher prevalence of severe daytime sleepiness (ESS≥18) (p=0.04) and higher scores on PSQI (p=0.002). Within the PSQI, sleep’ latency (p=0.003), duration (p=0.002) and efficiency (p=0.013) were the most affected parameters. Higher PSQI scores also correlated with worse blood pressure control; a cut-off value for PSQI of 6 was found to increase the risk of uncontrolled hypertension. Conclusion: In our series, APD patients had worse global sleep quality (PSQI) when compared to ACPD patients. This difference was mainly due to worse sleep latency, duration and efficiency. The assessment of the quality of life showed no difference between groups, however there was a clear link between quality of life and sleep quality.

Exercise Predicts a Good Night's Sleep: Preliminary Findings from a UCLA Study of First-Episode Schizophrenia.

Physical exercise can improve sleep quality in the general population. Understanding the negative impact of poor sleep quality on multiple domains of functioning among persons with schizophrenia is a new frontier of exploration. It is also imperative to investigate non-pharmacologic methods to improve sleep quality as these approaches may not carry the side effect burdens associated with medication. We examined the relationship between regular physical exercise and sleep quality among participants in an intervention consisting of both cognitive training and exercise. Participants (N = 48) were schizophrenia patients who had a first psychotic episode within two years of study entry. Participants received 4 h/week of internet-based cognitive training and an aerobic exercise program over a 6-month period. Sleep was assessed with the Pittsburgh Sleep Quality Index at baseline and six months later. During the 3 months prior to the 6-month follow-up sleep assessment, participants completed an average of 12.6 group exercise sessions and an average of 12.9 individual at-home exercise sessions. A significant relationship between the number of exercise sessions and global sleep quality was seen at month six, r = -0.44, df = 39, p < 0.01. Group exercise frequency was also associated with improvement in global sleep quality over the six-month intervention, t(34) = -2.84, p = 0.008. We demonstrated that a group of young adults with schizophrenia can be engaged in a regular exercise program, even during the tumultuous early course of the disorder. The number of exercise sessions in which they participated was associated with better sleep quality at six months and pre-postintervention improvement in sleep quality. Improved sleep quality appears to be a benefit of regular exercise among individuals with serious mental illness.

Non-alcoholic fatty liver disease and sleep quality: a single center cross-sectional survey study

Sleep-wake disorders are probably a part of Nonalcoholic Fatty Liver Disease (NAFLD) etiology. This study aimed to evaluate the relationship between NAFLD and the Pittsburgh Sleep Quality Index (PSQI) components. Sleep quality was assessed by the PSQI, which comprised seven components. Participants diagnosed with hepatic steatosis using ultrasonographic imaging and healthy volunteers were given the questionnaire. The percentage of subjects with poor sleep quality was noticeably higher in the NAFLD patients than in the non-NAFLD control group (OR: 4.58, 95% CI: 2.67-7.85) (p&lt;0.001). Compared to the control group, the NAFLD group reported shorter sleep duration (p=0.044), a longer sleep onset delay (p&lt;0.001), worse subjective sleep quality (p&lt;0.001), a higher percentage of subjects with sleep disturbances (p&lt;0.001), a higher percentage of subjects using hypnotic drugs (p=0.009), and a higher percentage of subjects with daytime dysfunction (p&lt;0.001). When the subjects were split into two groups based on gender, global PSQI sleep quality and subjective sleep quality were significantly worse in both genders with NAFLD than in the non-NAFLD group (p&lt;0.001). The sleep onset delay of the NAFLD group was substantially longer in males (p=0.002) and females (p&lt;0.001) compared to controls. Sleep disturbances were significantly higher in both sexes with NAFLD compared to controls (p&lt;0.001). The rate of those with daytime dysfunction in the NAFLD group was considerably higher in both genders compared to the non-NAFLD group (p=0.001). Only among the male patients in the NAFLD group the prevalence of hypnotic drug use was substantially greater (p=0.033) than in the non-NAFLD group. Poor sleep was associated with NAFLD in both genders.

An experimental study on effect of deep breathing exercise in promoting quality of sleep among geriatrics those are staying in a selected old age home, Bhubaneswar, Odisha

Sleep disturbances is a common problem in the society at large with disastrous health implications the most notable change in elderly sleep architecture is decrease quality of sleep, increase sleep disturbance, difficulty falling and maintaining sleep. There is an increasing in non-pharmacological interventions, among which deep breathing exercise is powerful method help to increase sleep quality in geriatrics. In the present study, a pre-experimental, one group pre-test, post-test design was adopted to assess the effect of deep breathing exercise on quality of sleep among geriatrics in selected old age home, Bhubaneswar by taking 60 participants. They were geriatrics between 60 to 80 years of age. Sampling technique was simple raandom sampling method. The tool used for the study included interview schedule for socio demographic variables, standardized self-rating sleep quality index to assess effect of deep breathing exercise on quality of sleep. A simple four-step breathing exercise was created, each of which was performed three times daily for fifteen days. During the pre-test, the majority of samples (87%) had modest sleep quality, while 13% had moderate sleep quality. At the time of the post-test, the majority of study samples (52%) had moderate sleep quality, while the remainder (48%) had mild sleep quality. This study concluded this study found that deep breathing exercises with an appropriate tool increase sleep quality in 60-80-year-olds. Deep breathing exercises improved PSQI global sleep quality in this study. The intervention improved geriatric sleep quality. Deep breathing exercises improve elderly sleep quality. Deep breathing exercises improve geriatrics&#39; sleep, according to the study.

Extreme racism-related events and poor sleep in African-American women

RationaleMuch of the research linking racism-related stressors to poor health has focused on fairly non-violent forms of racism that directly impact individuals under study. Exposure to particularly extreme and/or violent racist events are increasingly visible via smartphone recordings and social media, with consistent anecdotal reports of the effects of seeing and hearing about these events on sleep among minorities who racially identify with the victims. ObjectiveThis study examines whether exposure to direct and vicarious racism-related events (RREs), including more extreme events, are associated with sleep quality. Additionally, we examine effects of less and more violent direct RREs and vicarious RREs witnessed in person and via social media. MethodsAmong 422 African-American women, we assessed exposure to RREs using a modified version of the Race-Related Events Scale and assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Linear regression analyses were used to model continuous global sleep. ResultsDirect (β = 0.24 [95% CI: 0.13, 0.35]) RREs were associated with worse continuous global sleep quality scores in analyses adjusted for sociodemographics and risk factors for poor sleep. More violent direct RREs (β = 0.59 [95% CI: 0.30, 0.89]) had stronger associations with poor sleep quality than less violent direct RREs (β = 0.25 [95% CI: 0.11, 0.40]). Vicarious RREs overall (β = 0.04 [95% CI: 0.14, 0.21]) and those witnessed via social media (β = −0.07 [95% CI: 0.29, 0.14]) were not associated with global sleep quality; conversely, vicarious RREs witnessed in person were (β = 0.52 [95% CI: 0.21, 0.83]). ConclusionExtreme, direct experiences of racism, particularly those that are violent in nature, are associated with poor sleep quality. However, extreme vicarious experiences are not-- unless witnessed in person.

Digital cognitive behavior therapy for insomnia improving sleep quality: a real-world study

BackgroundDigital cognitive behavior therapy for insomnia (dCBT-I) is an effective treatment in alleviating insomnia. This study examined the effect of dCBT-I for improving sleep quality in patients with insomnia complaints from a clinical population in a real-world setting.MethodsThe study included 6,002 patients aged 18 years and above with primary complaints of dissatisfying sleep from a sleep clinic in a psychiatric hospital from November 2016 to April 2021. Patients were diagnosed with insomnia, anxiety disorders, or anxiety comorbid with insomnia or depression according to ICD-10. A mobile app was developed for self-reported assessment and delivering dCBT-I interventions and treatment prescriptions to participants. The primary outcome was change in global sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI). At 8- and 12-week follow-up, 509 patients were reassessed. Data were analyzed with non-parametric tests for repeated measures.ResultsPatients treated with dCBT-I monotherapy were younger, with a more frequent family history of insomnia compared to those with medication monotherapy and those with combined dCBT-I and medication therapy. Improvements of sleep quality from baseline to 8-week follow-up were significant in each treatment type. Compared to 8-week follow-up, PSQI scores at 12-week were significantly decreased in the depression group receiving combined therapy and in the anxiety group treated with dCBT-I monotherapy and with combined therapy. A time-by-treatment interaction was detected in anxiety patients indicating differential reduction in PSQI scores over time between different treatment options.ConclusionThe current findings suggest dCBT-I is a practical and effective approach for lessening insomnia symptoms, especially for patients with anxiety symptoms suggesting with a more extended intervention period (i.e., 12 weeks).Trial registrationChinese Clinical Trial Registry (ChiCTR1900022699).

Sex differences in Actigraph‐estimated versus Self‐reported sleep quality and Alzheimer’s disease neuropathology among cognitively‐unimpaired older adults

AbstractBackgroundDespite implications of sleep disturbances in Alzheimer’s disease (AD) pathophysiology (e.g. cerebral amyloid accumulation, atrophy in AD‐pathology sensitive brain regions); contradictory findings on sleep/neuropathology relationships at preclinical‐AD stage exist, possibly due to sex‐differences and/or methodological disparities and inconsistencies in sleep evaluation. We sought to address this conundrum using self‐reported versus actigraphy‐based data, to explore sex differences associated with amyloid load and MRI whole brain/sub‐regional volumetric indices, among asymptomatic older adults.MethodSex‐stratified analysis of CHARIOT:PRO SubStudy baseline data (519 cognitively‐unimpaired participants: 60–85 years) was performed, using a‐priori confounder‐adjusted multivariable regression models, aimed at assessing the effect‐modifying role of sex on associations of sleep quality measures (objective: 7‐day actigraphy, subjective: Pittsburg‐Sleep‐Quality‐Index questionnaire) with (i) Brain amyloid pathology status (positive/negative), (ii) volumetric‐MRI whole brain, (iii) hippocampal and (iv) frontal regions. Bivariate correlation analysis compared self‐reported and actigraphy sleep measures.Result49.1% of the participants were amyloid‐positive and more likely to report poor sleep. Only 5% of the cohort accurately estimated their overall sleep quality and were more likely to be younger (mean±SD: 69.1 ± 6.4), compared to inaccurate‐reporters (underestimated‐sleepQ: 72.7±5.5; overestimated‐sleepQ: mean 71.3±5.30; F (2, 336) = 5.18, P &lt; 0.01). Women were more likely to underestimate their sleep quality compared to men (χ2 (2, 336) = 9.32, P &lt; 0.01). Indeed, actigraphy revealed higher odds of insufficient sleep duration (OR, 1.75, 95% CI [1.13‐2.70]) and sleep efficiency impairments (OR, 4.36, 95% CI [1.47‐12.90] in men compared to women. Effect modification on associations of neurodegeneration indices and global sleep quality by sex revealed better self‐reported sleep quality specifically for women with larger hippocampal volumes (β:1.07e‐03;CI:2.48e‐04,1.89e‐03) and larger whole brain volumes (β:1.02e‐05;CI:3.06e‐06,1.74e‐05). Similarly, associations with amyloid pathology status showed worse actigraphy‐ascertained sleep efficiency for amyloid‐positive men (β:−1.44;CI:−2.79,−0.08).ConclusionActigraphy‐derived sleep quality metrices proved useful (compared to self‐reports) in differentiating sex dichotomies related to amyloid status and brain volumetric measures, emphasizing the importance of accounting for sex/gender divergence in subjective reporting, when exploring relationships between sleep quality and AD neuropathology. Further studies are warranted, extending upon these observations to explore potential predictive value for cognitive and functional trajectories from pre‐symptomatic stages.

Global psychological assessment with the evaluation of life and sleep quality and sexual and cognitive function in a large number of patients with acromegaly: a cross-sectional study.

Acromegaly is associated with somatic disfigurements which impair self-perception of well-being and quality of life. Nowadays, limited data are available on the interplay between hormonal excess and psychological discomfort. The study aimed at investigating the psychological profile, sleep quality, sexual function, cognitive functions, and quality of life in patients with acromegaly. In 223 acromegaly patients from 5 referral centres, global psychological profile, sleep quality, sexual function, cognitive function, and quality of life were investigated. Depression was found in ~30% of patients, and anxiety in two-thirds, together with severe discomfort in body image mainly in women. Obstructive sleep apnoea syndrome risk and sleep disorders were found in >50% of patients and daily sleepiness in ~20%. Sexual dysfunction was reported in most of the patients, with the most severe impairment in women. Cognitive functions were compromised in ~10% of cases. Disease duration and patient's age and gender were the main determinants of these psychopathological conditions. Depression (P = 0.047), somatic-affective mood lowering (P = 0.021), state (P < 0.001) and trait (P = 0.013) anxiety, and body image distortion in body uneasiness test A (P < 0.001) and B (P = 0.006) were significantly worsened in patients <45 years and slightly worsened in those with disease duration less than 2 years. Male (P < 0.001) and female (P < 0.001) sexual function scores were significantly worsened in patients aged >64 years and slightly worsened in those with disease duration for more than 10 years, particularly in presence of cardiometabolic and respiratory complications. Cognitive symptoms were slightly worsened in older patients and in those with long disease duration. Acromegaly is associated with a relevant impairment of psychological profile persisting despite remission and long-term medical treatment.

Perceived sleep quality mediates the relationship between posttraumatic stress and somatic symptoms.

Posttraumatic stress symptoms (PTSS) have been associated with increased somatic symptom expression. Sleep concerns have been associated with PTSS and somatic symptoms. Previous research suggests that sleep affects multiple domains of functioning including comorbid psychological and physical health concerns. The current study examines whether perceived sleep quality or sleep efficiency/duration may be mediating the relationship between PTSS and somatic symptoms in a trauma-exposed sample. The sample consisted of 864 students, recruited from a large Midwestern university and compensated with research participation credit. Data were collected online over approximately 39 months (October 2015 through January 2019), and the pertinent scales examined in this study included Pittsburgh Sleep Quality Index, Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, and Screening for Somatoform Symptoms-7. Of the 864 students, 668 participants identified as female (77.3%) and 540 identified as non-Hispanic White (62.5%), with an overall average age of 23.14 years (SD = 6.64). Mediation analyses indicated that the overall model examining global sleep quality complaints as a mechanism of the relationship between PTSS and somatic symptoms was significant, F(3, 860) = 193.97, R² = .40, p < .001, and that perceived sleep quality was found to be the only significant specific mediator (indirect effect = .21). Although females reported greater somatic severity, PTSS, and sleep concerns, models were significant, even after examining the influence of gender. Global sleep complaints are associated with both PTSS and somatic symptoms. Perceived sleep quality specifically mediated the relationship between PTSS and somatic symptoms, highlighting a potential intervention for improving physical health consequences in trauma-exposed individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sleep Quality Among Patients with Myocardial Infarction

Background: Good sleep is vital for a healthy heart. Studies showed that short sleep duration contributes to the development of myocardial infarction (MI). ST-segment elevated myocardial infarction (STEMI) in comparison to non-ST-segment elevated myocardial infarction (NSTEMI) is considered a dangerous health condition. Sleep qualities among patients with NSTEMI and those with STEMI are less clear in the available literature. So, the author undertook this study. Objective: To assess and compare the sleep quality among patients with STEMI and those with NSTEMI in cardiology units of a tertiary care hospital, Chandigarh. Methodology: The research design was descriptive and the approach used was the quantitative approach. A total of 100 patients were chosen by using the consecutive sampling technique. The interview technique was used to collect data with the help of the interview schedule comprised of socio-demographic profile sheets, clinical profile sheets and the Pittsburgh Sleep Quality Index (to assess the sleep quality). Results: The data revealed that more than 76% of patients were diagnosed with STEMI, whereas less than 24% of patients were diagnosed with NSTEMI. A significantly higher percentage of patients suffering from NSTEMI (40%) reported very good subjective sleep quality than those suffering from STEMI (12%) ( p &lt; 0.05). However, no statistically significant difference was seen in the sleep quality and sleep duration between patients with NSTEMI and those with STEMI as assessed by the Global Sleep Quality Index ( p &gt; 0.05). Conclusion: Each patient, irrespective of their type of MI, reported sleep difficulty. Patients with NSTEMI showed comparatively better sleep quality and sleep duration than those with STEMI. More efforts are required to improve the sleep qualities of patients with both NSTEMI and STEMI for the prevention of secondary cardiovascular events.

Sleep and Social Wellness: Does Current Subjective and Objective Sleep Inform Future Social Well-Being?

Objectives: The present study aimed to investigate the link between sleep and broader social well-being. Specifically, the current study evaluated whether subjective and objective sleep indices were associated with subsequent social well-being. Methods: The archival data from the Midlife in the United States Study (MIDUS II and III, Project 1 and 4) were utilized for the current investigation. The participants completed cross-sectional surveys as part of their involvement in both study waves, 10 years apart. They were 213 adults, 59.6% female-identifying, with an average age of 56 years, who completed 8 days of sleep measurement via wrist actigraphy, sleep diary, as well as the PSQI. The participants also completed the measures of depressive symptoms and social well-being. Results: The actigraphic total sleep time, the diary-reported sleep quality, and the global sleep quality measured by the PSQI emerged as the significant predictors of social well-being over a 10-year period. Conclusions: The present study is an initial step in providing evidence for the importance of sleep for social functioning. Future research should attend to the association between past sleep behaviors and social functioning, specifically the mechanisms by which sleep is associated with social well-being as well as the temporal associations in an adult sample.

The Relationship Between Physical Activity and Sleep Quality in the Elderly in the Malang City Community

The elderly have been more susceptible to being exposed to COVID-19. Decreased sleep quality in the elderly is caused by psychological, environmental and physiological factors so that the function of neurotransmitters decreases and substances to stimulate sleep (e.g., norepinephrine) also decrease. Physical activity is beneficial for sleep quality and has a positive impact on onset and total sleep time. This study aimed to determine the relationship between physical activity and sleep quality in the elderly in the Malang community. This was a cross-sectional study with a total sample of 65 people recruited through purposive sampling. Physical activity was measured using the Global Physical Activity Questionnaire and sleep quality was measured using the Pittsburgh Sleep Quality Index questionnaire. The results showed that there was a significant correlation between physical activity and sleep quality.&#x0D; Keywords: physical activity, sleep quality, elderly

Abstract P098: Association Between Postpartum Sleep Characteristics And Twenty-four Hour Blood Pressure Patterns In Women With And Without A History Of Preeclampsia

Introduction: Women with a history of preeclampsia (hxPE), a hypertensive pregnancy disorder, are at a four-fold elevated risk of chronic hypertension postpartum compared with healthy pregnancy. The postpartum period is particularly vulnerable to adverse sleep characteristics such as poor sleep quality and frequent sleep disturbances, which are associated with hypertension risk. However, the relation between postpartum sleep characteristics, nighttime blood pressure (BP) and diurnal BP variation assessed by twenty-four hour ambulatory BP monitoring is not well-studied. Methods: Women with a hxPE (N=13, age 37 ± 5 years) and healthy pregnancy controls (N=12, 36 ± 3 years) without history of sleep disorders were enrolled between 1-5 years postpartum (2.9 ± 1.3 years). Subjective sleep characteristics were reported using the Pittsburgh Sleep Quality Index (PSQI). Ambulatory BP monitoring was conducted to measure 24-hour, day and night BP as well as nocturnal BP dipping and morning BP surge quantified by sleep-trough surge. Results: Women with a hxPE tended to report poorer global sleep quality (7 ± 3 vs 5 ± 3 PSQI score, P=0.09) related to more frequent sleep disturbance (8 ± 4 vs 5 ± 3 score, P=0.053) without differences in habitual sleep duration (7 ± 1 vs 7 ± 1 hours, P=0.37) or sleep latency (18 ± 11 vs 17 ± 9 min, P=0.89). In the entire group, frequency of sleep disturbance was associated with greater 24-hour BP (systolic: r = 0.42, P=0.046; diastolic: r = 0.43, P=0.04) but not night BP (systolic: r = 0.19, P=0.40; diastolic: r = 0.19, P=0.40). Only sleep latency was related to blunted nocturnal BP dipping % (r = -0.38, P=0.08), and no sleep characteristics were associated with augmented morning BP surge. Conclusions: Women with a hxPE reported poorer overall sleep quality compared with healthy pregnancy controls 1-5 years postpartum, particularly frequent sleep disturbances. Frequency of sleep disturbance was associated with elevated 24-hour BP, but not higher nighttime BP or attenuated nocturnal BP dipping, indicating that the impact of postpartum sleep characteristics on BP is not attributable to diurnal BP variation.

Extreme racism-related events and poor sleep in African-American women

RationaleMuch of the research linking racism-related stressors to poor health has focused on fairly non-violent forms of racism that directly impact individuals under study. Exposure to particularly extreme and/or violent racist events are increasingly visible via smartphone recordings and social media, with consistent anecdotal reports of the effects of seeing and hearing about these events on sleep among minorities who racially identify with the victims. ObjectiveThis study examines whether exposure to direct and vicarious racism-related events (RREs), including more extreme events, are associated with sleep quality. Additionally, we examine effects of less and more violent direct RREs and vicarious RREs witnessed in person and via social media. MethodsAmong 422 African-American women, we assessed exposure to RREs using a modified version of the Race-Related Events Scale and assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Linear regression analyses were used to model continuous global sleep. ResultsDirect (β = 0.24 [95% CI: 0.13, 0.35]) RREs were associated with worse continuous global sleep quality scores in analyses adjusted for sociodemographics and risk factors for poor sleep. More violent direct RREs (β = 0.59 [95% CI: 0.30, 0.89]) had stronger associations with poor sleep quality than less violent direct RREs (β = 0.25 [95% CI: 0.11, 0.40]). Vicarious RREs overall (β = 0.04 [95% CI: 0.14, 0.21]) and those witnessed via social media (β = −0.07 [95% CI: 0.29, 0.14]) were not associated with global sleep quality; conversely, vicarious RREs witnessed in person were (β = 0.52 [95% CI: 0.21, 0.83]). ConclusionExtreme, direct experiences of racism, particularly those that are violent in nature, are associated with poor sleep quality. However, extreme vicarious experiences are not-- unless witnessed in person.

Does physical activity timing differentially correlate with symptoms of restless legs syndrome in adults with multiple sclerosis?

Objective/backgroundThe present study examined the associations among physical activity during different times of the day(i.e., morning, midday,evening) and days of the week(i.e., weekdays, weekend days) with restless legs syndrome(RLS) severity and sleep quality in adults with multiple sclerosis(MS). Patients/methodsParticipants(N = 39) completed the International Restless Legs Syndrome Study Group Scale and the Pittsburgh Sleep Quality Index as measures of RLS severity and global sleep quality, respectively, and wore an ActiGraph GT3X + on the non-dominant hip for seven days for measuring physical activity(i.e., light physical activity[LPA], moderate-to-vigorous physical activity[MVPA], and steps). ResultsThere was a significant effect of time of day wherein participants had more midday activity compared with morning or evening for LPA, MVPA, and steps; there was no effect of day of the week. Spearman's rho correlations across the week indicated higher evening LPA, evening steps, and overall daily steps (ρ = −0.42,ρ = −0.51,ρ = −0.40,respectively) were associated with lower RLS severity. Similar associations were demonstrated for weekdays(ρ = −0.39,ρ = −0.50,ρ = −0.41,respectively) and weekend days(ρ = −0.44,ρ = −0.51,ρ = −0.39,respectively). Higher evening MVPA on weekend days(ρ = −0.42) was associated with lower RLS severity. Higher morning and overall daily LPA(ρ = 0.34,ρ = 0.33,respecitvely) were associated with worse sleep quality. Similar associations were demonstrated on weekdays(ρ = 0.33,ρ = 0.37,respectively) and more evening MVPA(ρ = 0.32) was associated with worse sleep quality. On weekend days, more morning MVPA(ρ = 0.42) was associated with worse sleep quality. ConclusionsOur results suggest that undertaking physical activity, particularly LPA and steps, in evenings may be important for managing symptoms of RLS without worsening sleep quality.

Sleep Quality and New Onset Postpartum Hypertension

Background: Chronic sleep deficiency is a stressful situation which has an association with high blood pressure. After delivery, mothers have disrupted sleep due to frequent awakenings by their infants. What is not known is how significant this relationship is inwomen during the postpartum period as well as other factors that may affect their Sleep quality. Sleep quality is a measure of duration and disruption.Aim and Objectives: Study is aimed at determining the relationship between Sleep quality and new onset postpartum hypertension. The specific objectives are; to determine the Sleep quality of mothers in the postpartum period using the Pittsburgh Sleep quality index (PSQI), identify factors that affect Sleep quality of mothers in the post-partum period and determine blood pressure patterns of mothers in the postpartum period.Materials and Methods: This was a longitudinal study. Using systematic random sampling, a sample size of 126 women were recruited between June and August 2016 in the Postnatal clinic of the 37 Military Hospital. Written consent was obtained from participants. Sitting blood pressure was checked and recorded and a modified form of the Pittsburgh Sleep quality index (PSQI) was used to assign a global score for Sleep quality. A global score of more than 5 indicated poor Sleep quality in that mother. Clients were first recruited at the 1st postnatal visit with follow-up at the 2nd routine postnatal visit (6weeks). Only mothers whose blood pressures were normal during pregnancy and upon discharge from hospital were included. For categorical data, Pearson’s chisquare test was used for comparisons and logistic regression as used to determine significant factors that contribute to new onset hypertension in postpartum women. A P-value less than 0.05 was considered significant.Results: Majority of mothers (92.1% and 90.5% at first and second visits respectively) had poor Sleep quality. Mothers who slept away from their babies at the sixth week visit had better sleep. Mean global Sleep quality scores had no significant association with new onset hypertension but mean scores of some Age , p=0.001, OR =1.20 (C.I: 1.09-1.32) and some sleep components sleep disturbance, p=0.041, OR =1.86(C.I: 1.02-3.37), and use of sleep medicine, p=0.031, OR =1.54 (C.I:1.04- 2.29) were significantly associated with new onset postpartum hypertension.Conclusion: Global poor Sleep quality is not associated with increased odds of new onset hypertension but the Sleep quality components, sleep disturbance and increased use of sleep medicine, were significantly associated with new onset hypertension in mothers.

Adverse childhood experiences and sleep links in a predominantly Black sample of overweight adults.

Adverse childhood experiences (ACEs) have been associated with worse sleep, but existing literature is limited by use of predominantly White samples, lack of objective sleep measurement, and use of non-standardized questionnaires. We investigated associations between retrospectively reported ACEs and sleep in adulthood in a sample of 43 adults 20-53years of age, free from chronic conditions, with a Body mass index (BMI) ≥ 25 (Mean age=33.14 [SD=10.05], 74% female, 54% Black). Sleep efficiency (SE), total sleep time (TST), wake after sleep onset (WASO), and sleep onset latency (SOL), were measured by actigraphy and daily diary. Global sleep quality and insomnia severity were measured by questionnaires. Sleepiness, fatigue, and sleep quality were also measured by daily diary. Adjusting for demographic characteristics and BMI, ACEs were significantly associated with poorer global sleep quality and diary measures of greater daytime sleepiness, fatigue, and poorer sleep quality. There were no significant associations between ACEs and SE, TST, WASO, or SOL measured by diary or actigraphy. Findings suggest that ACEs are associated with worse sleep perception and daytime functioning in adulthood. Larger prospective studies are needed to replicate these findings, examine racial/ethnic differences, and determine temporal associations between ACEs, sleep, and health (e.g., BMI).

Why Sleep is Key: Poor Sleep Quality is a Mechanism for the Bidirectional Relationship between Major Depressive Disorder and Generalized Anxiety Disorder Across 18 Years

BackgroundGeneralized anxiety disorder (GAD) and major depressive disorder (MDD) reliably precede and predict one another. However, there is insufficient data on mediators through which the longitudinal GAD-MDD association unfold. Based on insomnia theories, such as the hyperarousal model of sleep, we tested the degree to which poor global sleep quality functioned as a mediator of the prospective bidirectional anxiety-depression relationship. MethodParticipants were 3,294 community-dwelling adults who partook in three measurement waves nine years apart. The Composite International Diagnostic Interview-Short Form assessed GAD and MDD in-person at baseline (Time 1 [T1]), Time 2 (T2; nine years after T1), and 18 years later (T3). T2 global sleep quality was measured using the multiple-domain Pittsburgh Sleep Quality Index self-report at T2. We used longitudinal structural equation modeling mediation analyses. ResultsAnalyses showed that higher T1 MDD and GAD severity individually predicted lower T2 global sleep quality (Cohen’s d = −0.561 to −0.480) and less T2 global sleep quality, thereby forecasted both higher T3 MDD and GAD (d = −0.275 to −0.190). Poorer T2 global sleep quality significantly mediated the T1 GAD–T3 MDD relation, explaining 41% of the association. Worse global sleep quality at T2 also significantly mediated the T1 MDD–T3 GAD association, mediating 11% of the T1 MDD–T3 GAD pathway. The results remained similar after controlling for multiple sociodemographic and clinical variables. Conclusions: Findings offer evidence for transdiagnostic theories of sleep and insomnia. Theoretical and clinical implications, such as prioritizing sleep improvement in cognitive-behavioral therapies, are also discussed.

Undergraduate Student Stress, Sleep, and Health Before and during the COVID-19 Pandemic

Before the COVID-19 pandemic, undergraduate students experienced sleep problems and mental health issues that were negatively associated with academic achievement. Studies comparing undergraduate sleep and health pre- to mid-pandemic have yielded mixed results, necessitating additional research on other cohorts and examination of potential moderators. The present study was conducted to examine whether American undergraduate students tested mid-pandemic experienced poorer sleep, health, and academic achievement relative to students tested pre-pandemic, as well as to examine whether poor sleep during the pandemic was preferentially associated with poorer health in women. The current cross-sectional study included 217 participants tested pre-pandemic (February-December 2019) and a separate sample of 313 participants tested mid-pandemic (November-December 2020). Participants in both samples provided demographic information and completed questionnaires inquiring about participant sleep quality, insomnia, and cumulative grade point average (GPA); participants in the mid-pandemic sample also reported on measures of general, physical, and mental health. Participants tested mid-pandemic reported poorer global sleep quality, greater insomnia severity, greater stress, and higher cumulative GPAs relative to participants tested pre-pandemic. For the mid-pandemic sample only, poorer sleep quality was associated with reduced physical health; interactions indicated that women with poor sleep quality reported poorer mental health relative to both women with good sleep quality and men with poor quality sleep. Perceived stress mediated the association between sleep problems and GPA. These findings indicate that the pandemic negatively impacted the functioning of undergraduate students and highlights the need for future studies examining additional moderators of the reported effects.

Influence of SARS-CoV-2 pandemic on sleep habits in a pediatric population.

ObjectiveAssessment of changes in sleep habits at home in children during COVID-19 lockdown.MethodsRetrospective, transversal study in a pediatric ward of a level II hospital. Questionnaires concerning sleep quality, patterns and its modifications during lockdown were distributed from June to August 2020. Comparison with a control sample from previous study (2019). Statistical analysis on SPSS Statistics23.ResultsTwo groups were compared: during lockdown (n=36, mean age 9.3 years-old) and before lockdown (n=48, mean age 8.8 years-old). 55.6% stated changes in sleep patterns. There was an increase in sleep hours, specifically in school-aged children (p=0.05) and adolescents (p=0.03), with no impact in global subjective sleep quality. Significative increase in screen hours (p=0.02) and its use after dinner (p=0.04).DiscussionChanges in sleep patterns during lockdown were frequent, alongside a higher use of screens. However, these did not affect the subjective sleep quality nor increased the occurrence of sleep disturbances.