Global Sleep Quality Research Articles

Psychological factors related to professional examinations and their association with sleep quality among Medical students

Background: In our country, medical education is considered a challenging, tough, and stressful process, which is significantly associated with depression, anxiety, and stress, particularly during exam seasons, adversely affecting the sleep quality of medical students. The objective of our study is to evaluate the depression, anxiety and stress levels, and determine their impact on sleep quality of medical students during exams. Materials and Methods: It was a descriptive cross-sectional study involving 391 students of Rawalpindi Medical University. Data was collected through a questionnaire. The questionnaire consisted of (1) socio-demographic details, (2) Depression, Anxiety and Stress Scale-21(DASS-21), (3) The Pittsburgh Sleep Quality Index (PSQI). Chi-square and t-tests were applied taking P<0.05 as significant. Spearman rho test was applied to measure the strength of association. Data analysis was done via (SPSS) v.23.0.Results: Out of 391 students, 197 (50.4%) were female while 194 (49.6%) were male. The mean age was 21.63 years (SD=1.59). Fourth-year students (n=117, 29.9%) formed the majority of the participants followed by final-year 108(27.6%), second-year 94 (24%), and third-year 72 (18.4%). 167(42.71%) students suffered from depression, 50.4% from anxiety and 351(89.8%) from stress. Quality of sleep was poorest (PSQI>5) in second-year students with a mean value of 9.72 for global sleep quality. Quality of sleep was significantly associated with anxiety and depression.Conclusion: Depression, anxiety, and stress are common among second as well as third-year students. Second-year students have the poorest quality of sleep. The sleep quality is significantly associated with anxiety and depression.

Internalized Weight Stigma, Psychological Well-Being, and Sleep in Women.

Many women internalize negative attitudes regarding body shape and size because of the societal standards for women's ideal body shapes and sizes. Internalized weight stigma is related to poorer physical and psychological health. A growing body of research has documented the links between other forms of internalized stigma (e.g., HIV-stigma) and poor sleep quality; however, little research examines the links between internalized weight stigma and sleep or the mechanisms that explain this relationship. Internalized weight stigma may be associated with poor sleep through increases in psychological distress. This study hypothesized that the links between internalized weight stigma and sleep would be mediated by higher levels of depression and anxiety. About 257 women were recruited via social media, word of mouth, and an undergraduate participant pool. Participants completed an online survey assessing various aspects of weight stigma and health through self-report questionnaires. Most women were non-Hispanic White (86.8%) and had a mean age of 31.40. The indirect effects of internalized weight stigma on poorer global sleep quality and daily disturbances through depression and anxiety were significant. In contrast, depressive symptoms but not anxiety explained the links between internalized weight stigma and perceived sleep quality and neither depressive symptoms nor anxiety explained the link between internalized weight stigma and sleep efficiency. Internalized weight stigma is linked to poorer sleep quality, and these links may be explained by psychological well-being. Understanding the mechanisms by which internalized weight stigma is associated with sleep quality can inform the psychological interventions employed.

Sleep-wake characteristics, daytime sleepiness, and glycemia in young adults with type 1 diabetes.

The purpose of this study was to describe objective sleep-wake characteristics and glycemia over 7-14 days in young adults with type 1 diabetes. In addition, person-level associations among objective sleep-wake characteristics (total sleep time, sleep variability, and sleep fragmentation index), daytime sleepiness, and glycemia (glycemic control and glucose variability) were examined. In this cross-sectional study, objective sleep-wake characteristics were measured via actigraphy and glucose variability via continuous glucose monitoring over 6-14 days. At baseline, participants completed the Psychomotor Vigilance Test, the Trail Making Test, and questionnaires on daytime sleepiness, sleep quality, and sleep disturbance including sleep diaries. Forty-six participants (mean age, 22.3 ± 3.2 years) wore a wrist actigraph and underwent continuous glucose monitoring concurrently for 6-14 days. Greater sleep variability was directly associated with greater glucose variability (mean of daily differences; r = .33, P = .036). Higher daytime sleepiness was directly associated with greater glucose variability (mean of daily differences; r = .50, P = .001). The association between sleep variability and glucose variability (mean of daily differences) was no longer significant when accounting for daytime sleepiness and controlling for type 1 diabetes duration (P > .05). A higher sleep fragmentation index was associated with greater glucose variability (B = 1.27, P = .010, pr2 = 0.40) after controlling for type 1 diabetes duration and accounting for higher daytime sleepiness. Sleep-wake variability, sleep fragmentation, daytime sleepiness, and the associations with glycemia are new dimensions to consider in young adults with type 1 diabetes. Sleep habits in this population may explain higher glucose variability, and optimizing sleep may improve overall diabetes management. Griggs S, Hickman RL Jr, Strohl KP, Redeker NS, Crawford SL, Grey M. Sleep-wake characteristics, daytime sleepiness, and glycemia in young adults with type 1 diabetes. J Clin Sleep Med. 2021;17(9):1865-1874.

649 Coping strategies moderate the effect of perceived stress on sleep and health in older adults during the COVID-19 pandemic

IntroductionThe COVID-19 pandemic is an enormous stressor that can impact various dimensions of health, including sleep health. Older adults may be particularly vulnerable. Coping strategies to manage stress can also impact health outcomes by modifying the relationships between perceived stress and health outcomes. This study examined concurrent and longitudinal associations between perceived stress and sleep health, mental health, physical health, and overall perceived health outcomes among older adults. We also examined whether coping strategies moderate these associations.MethodsOlder adults (n = 115; Mage = 68.62, 58.3% female) reported perceived stress (PSS), coping strategies (Brief COPE), global sleep quality (PSQI global sleep quality score and dichotomous good/poor sleep quality), depressive symptoms (CES-D), and perceived mental, physical, and overall health (RAND-12) before and during the COVID-19 pandemic.ResultsThe number of individuals with poor sleep quality was greater during the COVID-19 pandemic than before (50% vs. 36.5%). Participants also reported poorer physical health during the COVID-19 pandemic than before. Hierarchical linear regression and hierarchical logistic regression revealed that higher perceived stress was cross-sectionally associated with poorer sleep (e.g., higher total PSQI score and dichotomous sleep quality category). Higher perceived stress was associated with worse depressive symptoms and global mental health concurrently and longitudinally. Coping strategies moderated the relationships between perceived stress and physical health and overall perceived health. For example, higher perceived stress was associated with poorer overall perceived health for those who have lower problem-focused coping—but not for those with higher problem-focused coping—both concurrently and longitudinally.ConclusionPerceived stress influences cross-sectional and longitudinal measures of sleep health and general health among older adults during the COVID-19 pandemic. Coping strategies can moderate the effects of perceived stress on health outcomes. Older adults may benefit from prevention and intervention strategies targeting stress management and problem-focused coping strategies.Support (if any)This research was supported by the National Institute of Aging (R01AG047139), the National Heart, Lung, and Blood Institute (T32HL007560; T32HL082610), and the National Institute of Mental Health (T32MH019986)

691 Associations of Sleep Quality and Burnout in Clinicians during the COVID-19 Pandemic

IntroductionClinicians have faced unprecedented challenges in care delivery during the COVID-19 pandemic due to increases in patient volume/acuity, alongside fears of COVID-19 exposure. Increased burnout rates are associated with chronic health condition risk and adverse organizational outcomes. It remains unclear whether sleep is associated to burnout in clinicians treating COVID-19 patients.MethodsA cross-sectional electronic survey was distributed via email across 3 hospital listserves from September to November, 2020. Clinicians delivering direct care to COVID-19 patients were eligible. Clinician burnout was measured using a single item from AHRQ’s Mini-Z survey. We assessed sleep using the Pittsburgh Sleep Quality Index (PSQI). Binary logistic regressions were used to determine the relationship between PSQI global score (global sleep quality) and burnout, controlling for age, race/ethnicity, gender, length of time employed, whether clinical role changed during COVID-19, and anxiety. In a separate model, we investigated the association between burnout and independent PSQI subcomponents: 1) sleep duration (“Hours of sleep per night”), and 2) subjective sleep quality (“How would you rate your sleep quality overall”) entered together, with the above covariates.ResultsThe final sample included 315 clinicians, predominantly nurses (57% White, 15% Hispanic/Latino, 89% female). Burnout symptoms were reported by 61.6%, and poor global sleep quality (PSQI global score >5) in 84.4% of participants. Poor global sleep quality (PSQI global score >5 vs. ≤5) was significantly associated with the presence of burnout symptoms (OR: 2.52, 95% CI: 1.20–5.28, p=0.015). In the secondary model, self-reported sleep quality (rating of fairly or very bad vs. rating of fairly or very good) was significantly associated with burnout (OR: 4.13, 95% CI: 2.33–7.32, p<0.05), whereas short sleep duration (<6 h vs. ≥6 h) was not (OR: 0.726, 95% CI: 0.41–1.30, p=0.28).ConclusionPoor sleep quality is common and associated with increased burnout in clinicians delivering care to COVID-19 patients. Interestingly, sleep quality appears to be more strongly related to burnout than sleep duration. Increased evidence about the negative implications of poor sleep and burnout are emerging. Interdisciplinary efforts aimed at promoting effective sleep quality in clinicians during this pandemic may lead to improvements in long-term clinician physical and psychological health.Support (if any):

531 Efficacy of a physical activity intervention for managing restless legs syndrome in multiple sclerosis: A pilot RCT

Abstract Introduction Restless legs syndrome (RLS) occurs in approximately 26% of persons with multiple sclerosis (MS) and can worsen other symptoms of MS, including sleep quality. Physical activity represents a promising approach for managing RLS and its secondary effects in MS. This pilot randomized controlled trial examined the feasibility and efficacy of a physical activity intervention for improving RLS severity and secondary sleep outcomes among a sample of adults with MS. Methods Participants with MS (N=15) were randomly assigned into intervention (n=8) or waitlist control (n=7) conditions. The physical activity behavioral intervention was delivered over a 16-week period and outcomes were assessed at baseline and immediately following the 16-week period in both conditions. Results There was a significant, positive effect of the intervention on overall RLS severity (p=.01;ηρ2=.43), RLS severity during the night (p=.03,ηρ2=.35), RLS severity during the day while resting (p=.01,ηρ2=.44), and RLS severity during the day while active (p&amp;lt;.01,ηρ2=.61), and non-significant improvements in RLS severity while falling asleep (p=.33,ηρ2=.09). There were significant positive effects on sleep satisfaction (p&amp;lt;.01,ηρ2=.49) and non-significant improvements in self-reported global sleep quality (p=.35,ηρ2=.08). There was a significant intervention effect on self-reported time in bed (p=.03,ηρ2=.37) and total sleep time (p=.03,ηρ2=.36), and non-significant improvements in self-reported sleep latency (p=.08,ηρ2=.25), sleep efficiency (p=.27,ηρ2=.11), and daytime sleepiness (p=.52,ηρ2=.04; p=.35,ηρ2=.08; p=.51,ηρ2=.04). There was no significant effect of the intervention on device-measured sleep quality. Conclusion This study provides initial evidence for the feasibility and efficacy of a physical activity intervention for reducing RLS severity and possibly self-reported sleep quality outcomes in persons with MS. These preliminary results should inform a future, fully-powered randomized controlled trial that further establishes the efficacy of physical activity for reducing symptoms of RLS and secondary outcomes in a larger sample of adults with MS and RLS. Support (if any) This work was supported, in part, by the Eunice Kennedy Shriver National Institute Of Child Health &amp; Human Development of the National Institutes of Health [F31HD097903]. ClinicalTrials.gov Identification Number: NCT0406168.

742 Linkages between sleep quality and mental health among couples coping with type 1 diabetes across survey and daily diary methods

Abstract Introduction Sleep serves an important role in maintaining and promoting metabolic and mental health. The interdependent nature of couple relationships makes examining sleep quality from a dyadic perspective critical. This study examined the effect of sleep quality on mental health among couples coping with type 1 diabetes across survey and daily diary methods and investigated whether relationship satisfaction moderated these relations. Methods 199 persons with type 1 diabetes (Mage = 46.82) and their spouses (Mage = 46.41) completed one survey questionnaire reporting their own sleep quality (PSQI), depressive symptoms (CESD), and relationship satisfaction (CSI). They also completed 14-day diaries reporting on their own sleep quality and negative affect. The actor-partner interdependence model and multi-level model were used to examine the effect of sleep quality on mental health across the cross-sectional and daily diary surveys. Multi-level modeling examined effects of within-person and between-person effects of sleep quality on next-day daily negative affect (controlling for prior day affect). Results Cross-sectional survey data revealed an association between poorer global sleep quality and higher depressive symptoms for both partners (actor effects). Spouses’ poorer sleep quality was associated with higher depressive symptoms for persons with T1D (partner effects). Daily diary data demonstrated an association between within-person and between-person effects of own poor sleep quality and higher negative affect for both partners. Poorer daily sleep quality for persons with T1D was associated with higher negative affect for spouses (partner effects). When examining the moderating role of relationship satisfaction, spouses’ poorer overall sleep quality was associated with greater depressive symptoms and overall negative affect respectively for those with lower relationship satisfaction but not for those with higher relationship satisfaction across both methods. Conclusion Findings support the conceptualized link between sleep quality and mental health as both an intraindividual and dyadic process among couples coping with T1D across survey and daily diary methods. Additionally, better relationship satisfaction may buffer the effect of overall poor sleep quality on mental health for spouses. Support (if any) This work was supported by NIH NIDDK program project grant (DP3DK103999). Individual support was provided by T32 MH019986 (ELT).

Aerobic and resistance exercise improve patient-reported sleep quality and is associated with cardiometabolic biomarkers in Hispanic and non-Hispanic breast cancer survivors who are overweight or obese: results from a secondary analysis.

Poor sleep quality affects nearly one-third of breast cancer survivors and is associated with insulin resistance. The purpose of this secondary analysis was to examine the effects of a 16-week exercise intervention on patient-reported sleep quality among breast cancer survivors and assess whether changes in patient-reported sleep quality were associated with cardiometabolic biomarkers. We explored Hispanic ethnicity as a moderator of the effects of exercise on patient-reported sleep quality. Breast cancer survivors who were overweight or obese were randomized to exercise (n = 50) or usual care (n = 50). The 16-week intervention included aerobic and resistance exercise. Patient-reported sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and biomarkers of cardiometabolic health were assessed at baseline and post-intervention. Within- and between-group differences were assessed using general linear models repeated-measures analyses of variance and mixed-model repeated-measure analysis, respectively. Associations between changes in PSQI and cardiometabolic biomarkers were computed using Pearson correlations. Linear mixed-models were used to evaluate effect modification by ethnicity. Participants were 52 ± 10.4 years old, and over half were of Hispanic ethnicity. As compared to usual care, PSQI global scores improved significantly in the exercise group (mean between-group difference -2.2; 95% CI -3.2 to -0.6). Change in PSQI was inversely associated with changes in all cardiometabolic biomarkers (p < 0.01) among the exercise group. Ethnicity was found to moderate the effects of exercise training on global sleep quality (p < 0.001). An aerobic and resistance exercise intervention effectively improved patient-reported sleep quality in breast cancer survivors. Hispanic ethnicity as a moderator showed greater improvement in patient-reported sleep indicating Hispanic versus non-Hispanic breast cancer survivors may derive larger sleep benefits. NCT01140282.

Self-reported sleep relates to microstructural hippocampal decline in ß-amyloid positive Adults beyond genetic risk.

Study ObjectivesA critical role linking sleep with memory decay and β-amyloid (Aβ) accumulation, two markers of Alzheimer’s disease (AD) pathology, may be played by hippocampal integrity. We tested the hypotheses that worse self-reported sleep relates to decline in memory and intra-hippocampal microstructure, including in the presence of Aβ.MethodsTwo-hundred and forty-three cognitively healthy participants, aged 19–81 years, completed the Pittsburgh Sleep Quality Index once, and two diffusion tensor imaging sessions, on average 3 years apart, allowing measures of decline in intra-hippocampal microstructure as indexed by increased mean diffusivity. We measured memory decay at each imaging session using verbal delayed recall. One session of positron emission tomography, in 108 participants above 44 years of age, yielded 23 Aβ positive. Genotyping enabled control for APOE ε4 status, and polygenic scores for sleep and AD, respectively.ResultsWorse global sleep quality and sleep efficiency related to more rapid reduction of hippocampal microstructure over time. Focusing on efficiency (the percentage of time in bed at night spent asleep), the relation was stronger in presence of Aβ accumulation, and hippocampal integrity decline mediated the relation with memory decay. The results were not explained by genetic risk for sleep efficiency or AD.ConclusionsWorse sleep efficiency related to decline in hippocampal microstructure, especially in the presence of Aβ accumulation, and Aβ might link poor sleep and memory decay. As genetic risk did not account for the associations, poor sleep efficiency might constitute a risk marker for AD, although the driving causal mechanisms remain unknown.

Sleep quality and insomnia during the COVID-19 lockdown among the Saudi public: A cross-sectional study.

Objectives:To measure the Saudi population’s sleep quality during the lockdown of COVID-19.Methods:An internet-based questionnaire that was performed during the lockdown of the COVID-19 pandemic among the Saudi population over 2 weeks from April 1 to April 15, 2020. We used the instant messaging application WhatsApp and Twitter to reach the targeted population. Saudi citizens and non-Saudi residents who can read and understand the questionnaire were recruited. Data were analyzed using Stata and SPSS.Results:A total of 790 responses were included. The majority of participants were the Saudi population 735 (92.9%). The prevalence of insomnia and poor sleep quality were 54.4% and 55.5%, respectively. Saudi citizenship was associated with longer sleep duration (p=0.031). Female gender and being married were associated with worse global PSQI, sleep quality, sleep distribution, sleep latency, and daytime dysfunction.Conclusion:Our findings showed that during the COVID-19 pandemic, the Saudi population had a high prevalence of insomnia and poor sleep quality. Routine monitoring of the psychological impact of life-threatening outbreaks and the adoption of effective early mental health actions should be considered.

Delayed Sleep Timing in Obsessive-Compulsive Disorder Is Associated With Diminished Response to Exposure and Ritual Prevention

Exposure and ritual prevention (ERP) and pharmacotherapy are typically associated with significant symptom reductions for individuals with obsessive-compulsive disorder (OCD). However, many patients are left with residual symptoms and other patients do not respond. There is increasing evidence that delays in sleep timing/circadian rhythms are associated with OCD but the potential effects of delays in sleep timing on ERP warrant attention. This paper presents data from 31 outpatients with OCD who participated in ERP. Results showed that delayed sleep timing was common and that individuals with delayed bedtimes benefited significantly less from treatment and were significantly more likely to be nonresponders compared to individuals with earlier bedtimes. Further, the effects of sleep timing remained statistically significant even after controlling for global sleep quality, negative affect, and several other variables. These findings add to a growing literature suggesting the utility of better understanding the role of disruptions in the timing of sleep in OCD.

Feasibility and efficacy of a physical activity intervention for managing restless legs syndrome in multiple sclerosis: Results of a pilot randomized controlled trial

BackgroundThis pilot randomized controlled trial examined the feasibility and efficacy of a physical activity behavior change intervention for improving restless legs syndrome (RLS) severity and secondary sleep outcomes among a sample of adults with multiple sclerosis (MS). MethodsParticipants with MS(N=15) were randomly assigned into intervention(n=8) or waitlist control(n=7) conditions. The physical activity intervention was delivered over a 16-week period and outcomes were assessed at baseline and immediately following the 16-week period in both conditions. ResultsThere was a significant, positive effect of the intervention on overall RLS severity (p=.01;ηρ2=.43), severity during the night(p=.03,ηρ2=.35), severity during the day while resting(p=.01,ηρ2=.44), and severity during the day while active(p<.01,ηρ2=.61), and non-significant improvements in RLS severity while falling asleep (p=.33,ηρ2=.09). There were significant positive effects on sleep satisfaction(p<.01,ηρ2=.49) and non-significant improvements in self-reported global sleep quality(p=.35,ηρ2=.08). There was a significant intervention effect on self-reported time in bed(p=.03,ηρ2=.37) and total sleep time(p=.03,ηρ2=.36), and non-significant improvements in self-reported sleep latency (p=.08,ηρ2=.25), sleep efficiency(p=.27,ηρ2=.11), and daytime sleepiness (p=.52,ηρ2=.04;p=.35,ηρ2=.08;p=.51,ηρ2=.04). There was no significant effect of the intervention on device-measured sleep quality. ConclusionsWe provide preliminary evidence for the feasibility and efficacy of a physical activity intervention for reducing RLS severity and potentially improving self-reported sleep outcomes in adults with MS. ClinicalTrials.gov Identification NumberNCT04061681

Do Benzodiazepines Impair Motor and Nonmotor Symptoms in a Sample of Parkinson’s Disease Patients?

BackgroundAnxiety and sleep disturbances are prevalent in Parkinson’s disease (PD). Benzodiazepines (BZDs) are commonly used to treat these symptoms; however, they are associated with unfavorable side effects such as falls and cognitive slowing in the general non-PD population. Examining the effects of BZDs in PD is imperative as these medications could pose an increased risk to PD patients who are already vulnerable to falls and cognitive deficits.MethodsEighty-four patients diagnosed with idiopathic PD, of which 60% were Hispanic, underwent clinical evaluations including the Unified Parkinson’s Disease Rating Scale (UPDRS) and comprehensive neuropsychological testing examining global cognition, language, visuospatial skills, memory, executive function, mood, and sleep quality. Thirty-six patients taking BZDs (BZD+) were compared to forty-eight patients not using any BZDs (BZD-) employing appropriate statistical tests depending on the measures’ characteristics.ResultsBZD+ PD patients performed below the BZD- group on short-term memory but not on delayed recall, and performed better on a measure of visuospatial judgment. The BZD+ group endorsed more symptoms of anxiety and depression as well as poorer sleep quality. No significant differences were noted on other measures of cognition or motor function.ConclusionPD patients taking BZDs may experience select changes in cognition and mood. These changes are isolated and mild, and suggest that for some patients, BZDs may be a viable pharmacologic intervention that does not alter cognitive and motor function compared to those not taking these medications.

An Investigation of the Rate and Predictors of Initiating and Attending Group Cognitive Behavioral Therapy for Insomnia After Referral

Although group Cognitive Behavioral Therapy for Insomnia (CBT-I) is an efficacious and well-studied treatment, relatively less is known about its clinical effectiveness in community outpatient settings. Prior research has suggested that dropout from CBT-I may be high in treatment settings vs. clinical trials. The current study therefore investigated the rates and predictors of initiating and attending CBT-I group within an outpatient psychiatry clinic. Participants were 75 consecutive outpatients presenting for treatment at a specialty sleep and anxiety clinic who completed an evaluation and were referred to CBT-I group. Participants completed self-report measures at initial evaluation, and their attendance throughout treatment was tracked. The majority of patients attended ≥1 session, with a mean of 3/5 sessions completed for initiators. Those with poorer global sleep quality and longer sleep onset latency were less likely to attend group and attended fewer sessions. Those with more severe anxiety and depression were less likely to initiate attendance and attended fewer sessions. The majority of patients referred to CBT-I initiated group and attended at least half of the sessions. Further, demographics do not seem to impact these rates. Unfortunately, those with the most severe symptoms, and thus in most need for treatment, are least likely to initiate and attend. This may be due to comorbid anxiety or depression symptoms. Future research should replicate these findings, as well as explore how to encourage those most in need of treatment to initiate and attend CBT-I.

Sleep quality and cortical amyloid-β deposition in postmenopausal women of the Kronos early estrogen prevention study.

Hormone therapy improves sleep in menopausal women and recent data suggest that transdermal 17β-estradiol may reduce the accumulation of cortical amyloid-β. However, how menopausal hormone therapies modify the associations of amyloid-β accumulation with sleep quality is not known. In this study, associations of sleep quality with cortical amyloid-β deposition and cognitive function were assessed in a subset of women who had participated in the Kronos early estrogen prevention study. It was a randomized, placebo-controlled trial in which recently menopausal women (age, 42-58; 5-36 months past menopause) were randomized to (1) oral conjugated equine estrogen (n = 19); (2) transdermal 17β-estradiol (tE2, n = 21); (3) placebo pills and patch (n = 32) for 4 years. Global sleep quality score was calculated using Pittsburgh sleep quality index, cortical amyloid-β deposition was measured with Pittsburgh compound-B positron emission tomography standard uptake value ratio and cognitive function was assessed in four cognitive domains 3 years after completion of trial treatments. Lower global sleep quality score (i.e., better sleep quality) correlated with lower cortical Pittsburgh compound-B standard uptake value ratio only in the tE2 group (r = 0.45, P = 0.047). Better global sleep quality also correlated with higher visual attention and executive function scores in the tE2 group (r = -0.54, P = 0.02) and in the oral conjugated equine estrogen group (r = -0.65, P = 0.005). Menopausal hormone therapies may influence the effects of sleep on cognitive function, specifically, visual attention and executive function. There also appears to be a complex relationship between sleep, menopausal hormone therapies, cortical amyloid-β accumulation and cognitive function, and tE2 formulation may modify the relationship between sleep and amyloid-β accumulation.

The effect of daily walking exercise on sleep quality in healthy young adults

PurposeWalking has beneficial effects on sleep quality in elderly population and patients in clinical settings. However, less is known whether walking improves sleep quality among healthy young adults. This study examined the effectiveness of a 12-week walking intervention on sleep quality among sedentary young adults.MethodsFifty-four healthy adults aged 19 to 36-years old participated a pedometer based aerobic walking intervention, a cross-over randomized control trial. Participants were assigned into two groups (group A and group B) randomly. The 12-week intervention was divided into three sessions equally. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI) before and after session 1 and session 3. Omron HJ-112 pedometer and daily walking diary facilitated the intervention process. Within group and between group comparisons were made for statistical analysis.ResultsWithin group comparison by repeated measures showed that sleep duration (p < 0.01, F-test 22.79), sleep medication (p < 0.05, F-test 5.22), subjective sleep (p < 0.05, F-test 5.51) and global sleep quality (p < 0.01, F-test 12.19) were significantly improved. The comparison between intervention group and control group showed that sleep disturbance was significantly improved (p < 0.05).ConclusionDaily walking exercise has a significant effect on facilitating sleep quality and sleep components among young adults. Further studies are suggested to examine the impact of walking intensity on sleep quality.

The effectiveness of diaphragmatic breathing relaxation training for improving sleep quality among nursing staff during the COVID-19 outbreak: a before and after study

ObjectivesRecent studies have demonstrated that first-line nurses involved in the coronavirus disease-2019 (COVID-19) crisis may experience sleep disturbances. As breathing relaxation techniques can improve sleep quality, anxiety, and depression, the current study aimed to evaluate the effectiveness of diaphragmatic breathing relaxation training (DBRT) for improving sleep quality among nurses in Wuhan, China during the COVID-19 outbreak. MethodsThis study used a quasi-experimental (before and after) intervention strategy, with 151 first-line nurses from four wards in Leishenshan hospital. The Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) to evaluate the effectiveness of DBRT before and after the intervention. Data were examined using the Shapiro–Wilk test, Levene's test, and paired t-test. ResultsA total of 140 nurses completed the DBRT sessions. First-line nurses achieved significant reductions in global sleep quality (p < 0.01), subjective sleep quality (p < 0.001), sleep latency (p < 0.01), sleep duration (p < 0.001), sleep disturbances (p < 0.001), habitual sleep efficiency (p = 0.015), daytime dysfunction (p = 0.001), and anxiety (p = 0.001). There were no significant reductions in the use of sleeping medication (p = 0.134) and depression (p = 0.359). ConclusionDBRT is a useful non-pharmacological treatment for improving sleep quality and reducing anxiety among first-line nurses involved in the COVID-19 outbreak.The study protocol was clinically registered by the Chinese Clinical Trial Registry. Clinical Trial Registration number: ChiCTR2000032743.

Examining subjective sleep quality in adults with hoarding disorder

Hoarding disorder (HD), characterized by difficulty parting with possessions and functionally impairing clutter, affects 2–6% of the population. Originally considered part of Obsessive-Compulsive Disorder (OCD), HD became a distinct diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. While sleep impacts OCD, little is known about sleep in HD. As HD patients often report poor sleep in clinical settings, understanding global subjective sleep quality and disturbances may lead to novel therapeutic targets. To address this gap, the authors used a sample of convenience: an existing data set designed to screen research study eligibility and explore the psychopathology and phenomenology of OCD and HD. The data set included information collected from individuals with HD (n = 38), OCD (n = 26), and healthy participants (n = 22) about insomnia, sleep quality, and mood using interviews and structured instruments including the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Depression Anxiety Stress Scales (DASS). In this data set, HD and OCD groups reported significantly greater insomnia symptoms and poorer sleep quality compared with healthy controls while controlling for depression, age, and gender. A sizable minority of HD and OCD individuals met criteria for comorbid sleep disorders. OCD and HD groups differed in delayed sleep phase prevalence. To our knowledge, this is the first study examining subjective sleep quality and insomnia in HD as compared to healthy individuals and those with OCD, while controlling for relevant clinical characteristics. Given that there are evidence-based treatments for insomnia and other sleep disorders, our study raises the possibility that treatment interventions targeting sleep may improve HD outcomes.

Fighting the Freshman Fifteen: Sleep, Exercise, and BMI in College Students.

To examine how sleep and physical activity predict body mass index (BMI) in college students. Cross-sectional. Medium-sized public university in the Southeastern United States. 386 undergraduate students (245 females; 18-25 years). Surveys included the Pittsburg Sleep Quality Index (PSQI) and Concise Physical Activity Questionnaire (CPAQ). PSQI provided 5 sleep scores: PSQI Global Score, Sleep Quality Factor Score, Sleep Efficiency Factor Score, Sleep Duration, and Habitual Sleep Efficiency. Height and weight measurements were taken to calculate Body Mass Index (BMI). Correlational analyses were completed first. Linear and moderation regression models using CPAQ as the moderator were used to predict BMI. The Johnson-Neyman technique determined regions of significance where sleep significantly predicted BMI dependent on CPAQ score. Sleep Duration significantly predicted BMI (β= -.385, p = .043) while significant interaction terms predicting BMI were found for Global PSQI Score × CPAQ (β= -.103, p = .015) and Sleep Quality Factor Score × CPAQ (β = -.233, p = .013). Johnson-Neyman analyses demonstrated that better sleep quality (measured by Global PSQI and Sleep Quality Factor Scores) predict lower BMI when exercise levels are low and higher BMI when exercise levels are high. At low levels of exercise, better sleep quality significantly predicts lower BMI, suggesting that interventions designed to increase sleep quality could promote healthy weight maintenance in college students.

A Cross Sectional Study To Assess Sleep Hygiene Among School going adolescents

INTRODUCTION: Sleep is a physiological process which is required for good physical, mental and social well being (Beebe, 2011). A good sleep is essential to maintain body’s circadian rhythm. Sleep deprivation can disrupts body’s homeostasis leading to various ill effects like heart disease, diabetes, depression, accidents, impaired cognition, and a poor life quality. In recent days, lifestyle modifications have increased the prevalence of sleep disturbances especially among adolescents. As adolescence is the vital transitional phase where an individual have to determine their future both personal and professionally, any disturbance in sleep would affect their health and also would affect their academic performance. So the current study focused to assess sleep hygiene among school going adolescents. AIM &amp; OBJECTIVE: To assess the sleep hygiene and pattern among going adolescents. To analyse the risk factors of compromised sleep hygiene and pattern among going adolescents METHODOLOGY: This cross sectional study analysed the sleep pattern among school going adolescents (n=278) using Pittsburgh Sleep Quality Index (PSQI) which differentiates poor (Global PSQI Score &gt;5) from good (Global PSQI Score &lt;5) sleep by measuring seven domains. Then the Sleep Hygiene among these adolescents was analysed using 13 item Sleep Hygiene Index Inventory tool. RESULTS: The current study shows that the prevalence of sleep deprivation among the study participants were 52.17% and the average sum of global PSQI score was above 5 indicating poor sleep index. There was a positive correlation (R2 = 0.2535) between poor sleep hygiene and Global Sleep quality index. Also we found that participants with higher caffeine intake, stress, Inconsistent bed timing, uncomfortable sleeping ambience and longer exposure to screen time (Television &amp; electronic gadgets) had greater PSQI scores. CONCLUSION The current study explicitly states that sleep deprivation is one of the global burden among adolescents and better understanding of sleep hygiene and sleep pattern will help to reduce the incidence of sleep related lifestyle disorders.