Groningen Sleep Quality Scale Research Articles

Modafinil Subjectively Does Not Impair Sleep in Aviators After a Period of Extended Wakefulness.

INTRODUCTION: Modafinil is used as a countermeasure to limit the effects of fatigue in military aviation. However, literature is conflicting about its negative effects on subsequent sleep.METHODS: This randomized placebo-controlled trial conducted by the Center of Man in Aviation of the Royal Netherlands Airforce is part of a larger study. It included 32 subjects (mean age 35 yr old, 84% male) who followed a normal daily routine and stayed awake the subsequent night. At midnight, all subjects received either 300 mg caffeine, 200 mg modafinil, or placebo. At the end of the test night, subjects were awake for a median period of 26 h. Afterwards, sleep questionnaires containing qualitative (Groningen Sleep Quality Scale) and quantitative parameters of sleep for the subsequent day (recovery sleep) and consecutive night (post-test sleep) were completed and statistically analyzed using Friedman and Wilcoxon signed rank tests.RESULTS: A statistically significant difference in the reported recovery sleep was observed. The modafinil group slept 30% shorter than placebo, but sleep efficiency was not statistically different. Quantitatively post-test sleep did not vary statistically significantly between the three groups. However, Groningen Sleep Quality Scale scores were lower post-test than pre-test in the modafinil group, while this was not the case in the caffeine and placebo group.DISCUSSION:This study found that modafinil subjectively does not negatively impact recovery sleep or subsequent nighttime sleep after an extended period of wakefulness and suggests it may decrease the need for recovery sleep compared to placebo or caffeine.Wingelaar-Jagt YQ, Wingelaar TT, Riedel WJ, Ramaekers JG. Modafinil subjectively does not impair sleep in aviators after a period of extended wakefulness. Aerosp Med Hum Perform. 2024; 95(6):290-296.

A Study to Assess the Effectiveness of Slow Back Massage on Quality of Sleep among Patients in Selected Government Hospitals, Daman

Sleep is the natural state of rest and that observed throughout the animal kingdom including mammals and birds and, in many reptiles, also amphibians and fish.in humans, other mammals and many other animals that have been studies -such as fish, birds, ants, and fruit-flies- regular sleep in necessary for survival. the capability for arousal from sleep is a protective mechanism and also necessary for health and survival.1 Sleep can also defined that normal state of altered consciousness during time of body rests; it is characterized by decreased responsiveness to the environments, and a person can be aroused from it by external stimuli.1Slow -stroke back massage, uses this slow stroke. Slow Back was introduced within a hospital context by Elizabeth in 1996 as slow, gentle, and rhythmic hand movements on the patients back as the steady speed (about 60 movements per minute), with mild and gentle pressure, for 10 minutes.3Back massage care provided those who are admitted in the Hospitals by using various techniques of back massage like Effleurage, petrissage, friction, tapotement by using these techniques to improvement in the blood flow and also to relieve the deeper muscle tension and clear out toxins.5 THE OBJECTIVES OF THE STUDY WERE TO- 1. assess the pre-test and post-test level on quality of sleep of slow back massage among patients admitted in selected government Hospitals, Daman 2. determine the effectiveness of slow back massage on quality of sleep among patients admitted in selected government Hospitals, Daman. 3. find out the association between the pre-test level on quality of sleep among patients with selected demographic variables in patients in selected Government Hospitals, Daman. METHODOLOGY: A Quantitative Research approach with pre-experimental, one-group pre-test post- test Research design was adopted for the study. A total 40 sample were selected in Government hospitals, Daman based on selection criteria.in this research study consecutive sampling technique was used. Data was collected by using demographic variables and the Groningen sleep quality scale for assessment of quality sleep before and after the intervention of slow back massage. RESULT: The present study assesses the effectiveness of slow back massage in terms of improvement of quality sleep among patients. The post-test mean sleep score 2.65(SD=2.007) was less than pre-test mean sleep score 11.95 (SD=1.934) and ‘t’ value was 15.353(t0.05, 39=2.02) which was the significant effect of the slow back massage (p<0.05) and there is significant mean difference between the pre-test and post-test.the mean difference between the pre-test and post-test was 9.300.the chi-square calculated value shows there was no significant association with demographic variable. INTERPRETATION: Statistical significance was calculated by using paired t -test and chi-square. After slow back massage the quality of sleep has improved among patients. The findings of the study indicated the need of hospital to use the slow back massage to improvement the quality of sleep. This conclude that the non-pharmacological therapy such a slow back massage has significant impact in improvement the quality of sleep. KEY WORDS: slow back, Massage, quality sleep, patients.

The effects of the menstrual cycle on the physiological responses to exercise in eumenorrheic women at high-altitude

Introduction
 The acute mountain sickness (AMS) prevalence increases with altitude; i.e.,10-25% at 2,500 m and 50-85% at ~5,000 m (Bärtsch & Swenson, 2013). Women are more likely affected by AMS than men (Richalet et al., 2012). AMS can affect exercise performance. However, the effects of the menstrual cycle (MC) on physiological responses to exercise and on tolerance to high-altitude (HA) remain underexplored. It has been reported that ovarian hormones stimulate ventilation in normoxic conditions (Saaresranta & Polo, 2002). Early findings suggest that running economy is lower in the mid-luteal (ML) compared to the early-follicular (EF) phase in normoxia (Goldsmith & Glaister, 2020). However, cycling efficiency at HA has not been explored yet. Thus, we investigated the effects of acute HA exposure on ventilatory responses at rest and during exercise in healthy females during two different phases of their MC.
 Methods
 Sixteen eumenorrheic women (age: 33 ± 7 yr; MC length: 27 ± 2 days; not taking any hormonal contraceptive) took part in this study. First, over a 6-month period, the participants’ MC were monitored using a calendar method. Then, they reached the Torino Hut (3,375 m) by cable car and spent one night at HA on two different MC phases; i.e., during the early-follicular (EF; MC day 4 ± 1) and the mid-luteal (ML; day 20 ± 2) phases. Each time, they underwent a submaximal (1.2 W/kg) test on a cycle ergometer ~17 h after arrival at HA. In addition to this, participants filled in two questionnaires, the Lake Louise AMS Score and the Groningen Sleep Quality Scale, ~16 h after arrival at HA.
 Results
 Resting ventilation was significantly higher during EF compared to ML (15.2 ± 1.9 vs. 13.2 ± 2.5 L/min, p = 0.039), while no differences were found for ventilation during exercise (53.9 ± 13.2 vs. 53.5 ± 13.4 L/min, p = 0.695), cycling efficiency (21.7 ± 0.0% vs. 19.8 ± 0.0%, p = 0.244), saturation at rest (92.4 ± 1.3 vs. 91.3 ± 3.2%, p = 0.142) and during exercise (87.2 ± 5.7 vs. 89.0 ± 4.0%, p = 0.528). Moreover, no differences in the Lake Louise AMS (2.2 ± 1.5 vs. 1.7 ± 1.5, p = 0.266) or Groningen (8.0 ± 3.3 vs. 7.5 ± 3.4, p = 0.668) scores were noted between the two MC phases.
 Discussion/Conclusion
 Despite a slightly higher resting ventilation during EF, when both oestrogens and progesterone are at their lowest levels, there were no differences in ventilatory responses to exercise and in AMS between the different phases of the MC. Consequently, there is currently very little evidence to aptly recommend a specific MC phase for mountaineering or any other HA activities (Burtscher et al., 2023). Further investigations are requested to assess whether other physiological responses to HA may be influenced by hormonal variations.
 References
 Bärtsch, P., & Swenson, E. R. (2013). Acute high-altitude illnesses. New England Journal of Medicine, 368, 2294–2302. https://doi.org/10.1056/NEJMcp1214870
 Burtscher, J., Raberin, A., Brocherie, F., Malatesta, D., Manferdelli, G., Citherlet, T., Krumm, B., Bourdillon, N., Antero, J., Rasica, L., Burtscher, M. & Millet, G. P. (2023). Recommendations for women in mountain sports and hypoxia training/conditioning. Sports Medicine. Advance online publication. https://doi.org/10.1007/s40279-023-01970-6
 Goldsmith, E., & Glaister, M. (2020). The effect of the menstrual cycle on running economy. The Journal of Sports Medicine and Physical Fitness, 60(4), 610–617. https://doi.org/10.23736/s0022-4707.20.10229-9
 Richalet, J.-P., Larmignat, P., Poitrine, E., Letournel, M., & Canouï-Poitrine, F. (2012). Physiological risk factors for severe high-altitude illness: A prospective cohort study. American Journal of Respiratory and Critical Care Medecine, 185(2), 192–198. https://doi.org/10.1164/rccm.201108-1396OC
 Saaresranta, T., & Polo, O. (2002). Hormones and breathing. American College of Chest Physicians, 122(6), 2165–2182. https://doi.org/10.1378/chest.122.6.2165

Effectiveness of Warm Water Foot Submerged Technique on the Level of Fatigue, Quality of Sleep, and Quality of Life among Patients with Cancer in Selected Hospital at Mangaluru

Abstract Introduction Cancer is the most leading cause of death globally. Fatigue and poor quality of sleep are the common side effects of cancer treatment that lead to poor quality of life. There is a need of complementary therapy, which can help to minimize the side effects of cancer treatment and boosting relaxation. Warm water foot submerged technique helps to relieve fatigue and improve the quality of sleep; hence, quality of life can be improved. This study was conducted to assess effectiveness of warm water foot submerged technique on the level of fatigue, quality of sleep, and quality of life among patients with cancer. Materials and Methods A quasi-experimental pretest and post-test control group research design was adopted to conduct the study in oncology ward of selected hospital. Sixty-eight participants were recruited using a nonprobability purposive sampling technique and allocated to intervention and control groups. Data was collected using multidimensional fatigue inventory, Groningen sleep quality scale, EORTC QLQ-C30. The control group received normal routine care and the intervention group received warm water foot submerged technique that was given for 15 minutes two times per day for 5 consecutive days. Results Warm water foot submerged technique showed a significant difference in level of fatigue (p < 0.05), quality of sleep (p < 0.001), and quality of life (p < 0.001) in the intervention group. There was no significant difference in control group. Conclusion This study showed that the warm water foot submerged technique is effective in reducing the fatigue and improving the quality of sleep and quality of life among patients with cancer. Thus, this study was found to be effective.

Treatment of Willis-Ekbom Disease (Restless Leg Syndrome); The Efficacy of Mulligan's Traction Straight Leg Raise among Paramedical Professionals.

Background: Restless Leg Syndrome (RLS) is a generalized neurological sensory-motor disorder characterized by intense restlessness and discomfort in the lower extremities, leading to an urge to move the legs at sleep time. Treatment protocols for RLS may include thermotherapy, stretching exercises, and Mulligan’s traction straight leg raise (SLR). Mulligan’s traction SLR is an effective method that influences peripheral and central neural pathways through mobilization, thereby alleviating RLS symptoms. Objective: The study aimed to compare the efficacy of stretching exercises and Mulligan traction straight leg raise in reducing RLS severity among paramedical staff. Methods: This randomized clinical trial included a sample size of 38 paramedical staff members diagnosed with RLS using standard criteria. Participants were allocated using the Convenient Sampling Technique and randomly assigned into Group 1 (Stretching Exercises) and Group 2 (Mulligan Traction SLR) through coin tossing. Each group consisted of 19 participants. The interventions were conducted three times per week for one month. Assessments were made using the RLS Severity Scale, Numeric Pain Rating Scale, Groningen Sleep Quality Scale, and Goniometer at baseline, and after the 2nd and 4th weeks of treatment. Results: The study indicated that both treatments were effective in treating RLS, showing a significant difference with p<0.05. However, Mulligan's TSLR exhibited remarkable results in improving sleep quality, increasing SLR range of both legs, reducing pain intensity, and improving RLS symptoms, with p-values of 0.001, 0.000, 0.012, and 0.001, respectively. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 26. Conclusion: The study concluded that both Stretching Exercises and Mulligan's TSLR are effective treatments for RLS. However, Mulligan's TSLR showed superior effectiveness in reducing pain levels, RLS symptoms, and in improving sleep quality and SLR range among paramedical staff members.

A Standardized Withania somnifera (Linn.) Root Extract with Piperine Alleviates the Symptoms of Anxiety and Depression by Increasing Serotonin Levels: A Double-Blind, Randomized, Placebo-Controlled Study.

Background: Withania somnifera (Linn) or Ashwagandha is used in Ayurveda and other traditional medicine systems as an adaptogen and a neuroprotective supplement. Objective: The effect of Ashwagandha root extract (ARE) standardized for 2.5% full-spectrum withanolides as per The United States Pharmacopeia (USP) protocol with piperine (500 mg with 5 mg of 95% piperine) once a day (12.5 mg withanolides/day) was evaluated in individuals with mild to moderate depression and anxiety. Methods: In a randomized, double-blind placebo-controlled study, for 90 days, 70 participants were randomized to ARE (n = 34) or placebo (n = 36) once daily at night. Mean change in the Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS), Groningen Sleep Quality Scale (GSQS), and quality of life (QOL) from screening to days 30, 60, and 90 were evaluated. Safety was evaluated by monitoring any incidence of adverse events and laboratory parameters. Two-way analysis of variance (ANOVA) and repeated-measure ANOVA were used to compare ARE and placebo, and the changes within the group at different time points. Results: Seventy individuals were randomized and all of them completed the study. The HARS, HDRS, GSQS, and QOL scores improved significantly (p < 0.001) in all the participants taking ARE compared to placebo on days 30, 60, and 90. Anxiety and depression improved from baseline to end of the study in both groups, but the quantum of improvement was significantly higher in ARE. Serum levels of serotonin increased in ARE, but showed a decrease in placebo, the difference being statically significant (p < 0.001). Biochemical and hematological parameters remained in the normal range in all participants and ARE was well tolerated during the study. Conclusion: The results of the study suggest that 500 mg of ARE standardized for 2.5% withanolides with 5 mg piperine is beneficial in improving depression, and anxiety, by increasing serum serotonin levels. The trial was registered prospectively with the Clinical Trial Registry of India (CTRI) with the registration number CTRI/2022/05/042640, on May 18, 2022.

A study to determine the possible links between subjective (fatigue questionnaires) and objective (bio-mathematical fatigue prevention model) fatigue detection methods

Introduction: Application of objective fatigue detection tools in aviation bases is limited. This study was envisaged to conduct a systematic comparative analysis between a well-established objective method and short fatigue questionnaires which are used in fatigue research to employ them as a fatigue screening tool for aviation personnel. Material and Methods: Thirty-eight aviation personnel volunteered for this cross-sectional observational study. Work-rest/sleep data collected using actigraphy over 1 week were fed to a PC running Fatigue Avoidance Scheduling Tool. Objective fatigue parameters in the form of Fatigue Risk Time (FRT) and Fatigue Free Occupational Time (FFOT) were retrieved. Fatigue questionnaires Groningen Sleep Quality Scale (GSQS) for assessing sleep quality and Stanford Sleepiness Scale (SSS) to detect day-time sleepiness were used as subjective fatigue parameters. Comparative analysis was carried out using appropriate statistical tests. Results: A consistent Total Sleep Time (TST) ranging from 353 to 378 min in the week of the study with no statistically significant differences between the nights were recorded. The increasing trend of FRT and decreasing trend of FFOT over the week were observed. The GSQS, SSS (morning), and SSS (afternoon) also demonstrated a progressive increase in the scores, but only the increase from day 1 to day 2 was statistically significant. Conclusion: Gradual increase in FRT with a reciprocal decrease in FFOT, which was observed, in this study, could be attributed to a progressive increase in sleep debt over the week. A consistent TST of the duration, which is less than the optimal duration of 7–8 h for night sleep, can lead to a gradual increase in sleep debt. The regression equations computed for FFOT was: FFOT = 657 + (0.24 × TST in min) – {(27 × Morning GSQS) + (73 × Day factor)}. This regression equation could be used to extrapolate the fatigue free occupation time for aviation personnel. The study has confirmed the effectiveness of both GSQS and SSS as the fatigue prevention tool and their application in the field setup, especially in the absence of any objective fatigue detection tool.

Differences in Next-Day Adverse Effects and Impact on Mood of an Evening of Heavy Alcohol Consumption between Hangover-Sensitive Drinkers and Hangover-Resistant Drinkers.

The combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero, are collectively referred to as the alcohol hangover. Previous research revealed that 10 to 20% of drinkers claim not to experience next-day hangovers. Past studies were usually limited to single timepoint assessments. The aim of the current semi-naturalistic study was to compare the next-day effects of an evening of alcohol consumption of self-reported hangover-resistant drinkers (n = 14) with those of a group of self-reported hangover-sensitive drinkers (n = 15) at hourly timepoint throughout the day (09:30 until 15:30). Assessments of 23 hangover symptoms, mood (Profiles of Mood States-Short Form), and daytime sleepiness (Karolinska Sleepiness Scale) were made hourly after both an alcohol day and an alcohol-free control day. Additional morning assessments were made for mood (State-Trait Anxiety Inventory-Y, Beck's Depression Inventory-II), risk-taking behavior (RT-18), past night sleep (Groningen Sleep Quality Scale), alcohol consumption, and activities during the test days. No significant differences were found regarding the amount of alcohol consumed and the total sleep time of the two groups. The hangover-sensitive group reported having a hangover as well as the presence of a variety of hangover-related symptoms, which were most severe in the morning and then gradually decreased during the day. The most frequently reported and most severe symptoms were sleepiness and fatigue, concentration problems, and headache. In contrast, the hangover-resistant group reported the absence of a hangover and the presence and severity of next-day symptoms did not significantly differ from the control day, except for increased fatigue and reduced vigor. The next-day effects on sleepiness-related complaints and vigor were significantly more pronounced among hangover-sensitive drinkers compared to hangover-resistant drinkers. In conclusion, contrary to hangover-resistant drinkers, hangover-sensitive drinkers report a variety of hangover symptoms that gradually ease during the day, but are still present in the afternoon.

Effect of Multimodal Integrative Interventions on Pain-Related Outcomes among Critically Ill Patients

Context: Pain, a persistent problem in critically ill patients, adversely affects outcomes. Despite recommendations, no evidence-based non-pharmacological approaches for pain treatment in critically ill patients have been found.&#x0D; Aim: To evaluate the effect of multimodal integrative interventions on pain-related outcomes among critically ill patients.&#x0D; Methods: A quasi-experimental design (pre / post-test) was utilized to fulfill the aim of this study. A convenience sample of sixty adult critically ill patients was recruited from the intensive care unit at Benha University Hospital, affiliated to Benha University at Qualyubia Governorate, Egypt. Three tools were used to conduct this study as follows: Critically ill patients' assessment record; The Critical-Care Pain Observation Tool (CCPOT); The Groningen Sleep Quality Scale.&#x0D; Results: The results show decreased frequency of pain occurs in the post-intervention periods (75%) immediately post to 50% after 48 hours of intervention compared with pre-intervention (100%). The results show highly statistically significant differences at p ≤0.001 between pre and post of intervention periods regarding the intensity of the pain mean score among studied patients. It also shows statistically significant differences with p-value ≤0.05 regarding all items of sleep quality immediately after and after 48 hours of intervention compared to pre-intervention, except those related to having a deep sleep last night and feeling like a slept poorly last night with a p-value ≥0.05. There was a highly positive statistically significant correlation at p-value ≤ 0.001 between pain intensity and other secondary outcomes, including quality of sleep, blood pressure, heart rate, and respiratory rate.&#x0D; Conclusion: Multimodal integrative interventions effectively decrease pain and improve pain-related outcomes among critically ill patients. Appropriate pain assessment must be partnered with an adequate, multimodal, evidence-based management strategy that incorporates pharmacologic and non-pharmacologic pain control modalities.

A cross-sectional field study of bedroom ventilation and sleep quality in Denmark during the heating season

Parameters describing the bedroom environment and sleep quality were measured overnight for one week in 84 randomly selected actual bedrooms in Denmark from September to December 2020. The median age of participants was 26 years (interquartile range (IQR) [24-32] years); 41 were males. Carbon dioxide (CO2), temperature, and relative humidity were measured continuously. Sleep quality was assessed by the Groningen Sleep Quality Scale (GSQS) on two mornings and was assessed using wrist-worn sleep trackers. Skin temperature was monitored continuously. Bedroom indoor air quality (IAQ) was rated by participants on two occasions just before sleep in the evening and upon waking up in the morning. Measurements from 75 bedrooms were complete. The median [IQR] of mean CO2, air temperature and relative humidity measured during sleep were 1,120 [741–4,804] ppm, 23.4 [22.3–24.4]°C, and 48.6 [44.7–55.4]%. The median [IQR] of GSQS was 4.0 [1.0–6.0] suggesting medium to poor subjectively rated sleep quality; the objectively measured sleep efficiency, and percentage of light, deep and REM sleep were in normal ranges: 88.1 [86.1–89.5]%, 59.4 [54.9–64.5]%, 18.3 [15.0–21.7]%, and 23.0 [18.4–26.4]%. The subjectively-assessed sleep quality decreased when perceived IAQ was reduced. Opening the bedroom door or window, which is a proxy for enhanced ventilation, also improved subjectively-assessed sleep quality and IAQ. The cross-sectional nature of the study prompts the validation of the present results with protocols that include measurements of other pollutants besides CO2 as well as the examination of underlying mechanisms. Nevertheless, they strongly suggest that keeping high bedroom IAQ is essential.

Pilot study on applying various research methodologies to investigate the effectiveness of e-learning materials

The COVID-19 pandemic had a major impact on higher education. Students were required to adopt a more independent way of learning, and instructors had to redesign courses to fit the digital space. Increasingly frequent e-learning research provides substantial support for the expansion of online education. The aim of this article is to investigate the effectiveness of e-learning materials among university students using a variety of research methodologies (Groningen Sleep Quality Scale, psychomotor vigilance task, verbal fluency and digit span tests, NASA Task Load indeX and eye tracking). In a pilot study conducted in a laboratory environment, 15 participants were divided into three groups and assigned to study from prepared course pages using content-equivalent e-learning materials. The results demonstrated that the applied research methodologies were appropriate for investigating the issue, allowing the pilot study to reveal a set of criteria encompassing the preferences of students for course structures and e-learning materials.

FOOT REFLEXOLOGY ON FATIGUE, QUALITY OF SLEEP &amp; QUALITY OF LIFE AMONG PRIMI POST-CAESAREAN MOTHERS - A PILOT STUDY

Aim: The aim of the study was to evaluate the effectiveness of foot reexology on the levels of fatigue, quality of sleep, and quality of life among primi post-cesarean mothers. Experimental design (pre-test and post-test only) was used in the study. The samples wereDesign: Methods: selected by using a simple random sampling technique by adopting the lottery method (without replacement) at the Sapra Multispeciality Hospital, Haryana. The data was collected by using a self-structured questionnaire on the Fatigue Severity Scale (FSS), the Groningen Sleep Quality Scale (GSQS), and the World Health Organization Quality of Life Scale (WHO-QOL-100). The foot reexology was performed among primi post- cesarean mothers in the experimental group for 30 minutes (15 minutes on each foot) twice a day for 5 consecutive days in the morning at 10 am and in the evening at 3.30 pm, whereas the control group received routine postnatal care. The obtained paired 't' value of fatigue, quality ofResults: sleep, quality of life (11.56), (5.75), (5.01) in the experimental group, and (4.14), (2.44), (2.44) in the control group which indicates there were signicant changes in fatigue, quality of sleep, and quality of life in the experimental group, and there was no association between demographic variables like age, sex, qualication, experience, and source of knowledge (p&lt;0.05), along with the obtained post-test correlation, which shows a negative correlation between fatigue and sleep and a positive correlation between the quality of sleep and quality of life in the experimental group. Conclusion: The results showed that foot reexology reduced the level of fatigue and improved the quality of sleep and quality of life among primi post-cesarean mothers in the experimental group, which will help the nurses implement it in the hospitals.

Effect of Benson’s relaxation therapy on pain and sleep quality among post-cesarean mothers

Aim The aim of the current study was to evaluate the effect of Benson’s relaxation therapy (BRT) on pain and sleep quality among post-cesarean mothers. Design A quasi-experimental design with the pretest and posttest control group design was used. Setting This study was conducted at postpartum wards at Mansoura University Hospital, Egypt. Subjects The purposive sample consisted of 62 post-cesarean mothers on their first and second postoperative days, who were divided into intervention and control groups of 31 participants each. Tools Structured interview schedule, visual analog pain scale to assess pain intensity, and Groningen sleep quality scale to assess sleep quality were used for collecting data. Results There was no statistically significant difference between the studied groups concerning their general characteristics. Nevertheless, a statistically significant reduction was found in the mean of post-cesarean pain score for the intervention group compared with the control group by 5.09±0.94 versus 7.03±0.66 on the second day and 2.42±1.09 versus 5.32±0.75 on the third day, respectively. Moreover, the quality of sleep improved on the second and third day postoperatively with highly statistically significant difference, whereas the mean score on the second day was 5.03±3.58 versus 8.87±4.17 compared with 2.26±2.48 versus 6.03±4.13 on the third day, respectively. Furthermore, a positive correlation was found between pain intensity and quality of sleep. Conclusion It was evident that BRT is an effective and safe method and have a positive effect in reducing pain intensity and improving quality of sleep among post-cesarean mothers. Recommendations Integrating BRT in the protocol of nursing for the care of post-cesarean section mothers.

Spanish Adaptation of the Groningen Sleep Quality Scale (GSQS-8)

Professional drivers are a group susceptible to sleep problems or incorrect rest patterns resulting from work stress that causes alterations in biological stress markers, such as cortisol, or in cardiovascular parameters that show a state of physiological hyper-activation. The current research objective was to adapt and validate the Groningen Sleep Scale (Meijman et al., 1990) in a Spanish population. We analysed its internal structure, reliability and evidence of validity. The participants in this study were 372 drivers (93.4% men, 6.6% women), with a mean age of 40.9 (SD = 10.54), obtained through non-probabilistic sampling. The SPSS 23.0 and AMOS (5.0) programs were used. With the confirmatory factor analysis (CFA) of the AMOS program (5.0), the indicators NFI = 0.902; TLI = 0.844; CFI = 0.913; RMSEA = 0.129 were obtained and showed an acceptable adjustment of the unifactorial model with 8 items. Adequate reliability (0.90) and appropriate evidence of validity with TDS-38, MBI-GS, Irritation, MP-9, DII, and Trans-18. We can conclude that the Groningen Sleep Scale (GSQS-8) is a reliable and valid instrument, suitable in the Spanish language for evaluating the sleep quality of professional drivers.

A Quasi Experimental Study to Assess the Effectiveness of Hot Water Foot Bath Therapy on Quality of Sleep among the Elderly in Selected Old Age Home, Agartala, Tripura West

A quasi experimental study to assess the effectiveness of hot water foot bath therapy on quality of sleep among the elderly in a selected old age home, Agartala, Tripura West. The objectives of the study is to assess the quality of sleep among the elderly and to determine the effectiveness of hot water foot bath therapy on quality of sleep among the elderly. The conceptual framework was used based on Wiedenbach’s modified Prescription theory. In this study elderly persons of old age home were selected as a sample. 40(fourty) samples were selected for the study, 20 (twenty) for both experimental group and control group by convenient sampling technique .Sleep quality of the elderly in both experimental group and control group assessed using modified Groningen sleep quality scale by interview technique which is modified by 7 (seven) experts of various nursing and medical department as well as by the statistician. Reliablity of the tool was 0.85 (r), that was checked using Kerl pearsons correlation coefficient method. Statistical analysis was done by chi square test and t test both paired t test, unpaired t test to determine the effectiveness of hot water foot bath therapy in quality of sleep among the elderly in both experimental and control group. There was significantly increased in mean post test score in experimental group with the mean deviation of 3.4 at 0.05 level of significance. The finding of the study revealed that paired ‘t’ test between pretest and post test score in experimental group showed significant increase in quality of sleep (tcal = 15.86, pcal = 0.53, pcal = 5.09, p2 = 5.714, p< 0.05) and there was no significant association between the pre-test quality of sleep scores with remaining demographic variables. The study concludes that hot water foot bath therapy is effective in improve the quality of sleep among the elderly.

Effects of window opening on the bedroom environment and resulting sleep quality

The effects of two window states (closed or open) on the bedroom environment and on sleep quality were investigated. Twenty-seven subjects (14 males and 13 females, 20–33 years old) without sleep disorders and chronic diseases participated. The subjects slept for two consecutive nights with windows open and two consecutive nights with windows closed in four dormitory rooms adapted for the purpose of this study, one person at a time. The order of exposure was balanced among participants. Bed temperature, room temperature, relative humidity (RH), carbon dioxide (CO2), particles (PM2.5), and noise were monitored during sleep. Sleep quality was measured using subjective ratings, a wrist-worn sleep tracker, and (for one group of 14 subjects only) polysomnography (PSG) for home use; snoring in this sub-group and awakenings were also registered. Higher PM2.5 and noise levels were found with windows open, while higher room temperature, RH, and CO2 levels were measured with windows closed. There were no differences between conditions in terms of objectively measured sleep stages but the subjects with the PSG attached snored significantly less and woke up significantly less often when sleeping with windows open. Start sleep time, end sleep time, total sleep time (TST) and time in bed (TIB) measured with the sleep tracker were confirmed by the measurements made using PSG, light sleep (N1 + N2) and sleep latency were in moderate agreement but there was no significant agreement for REM and deep sleep (N3). When sleeping with windows open, the subjects rated the air as fresher but reported higher noise levels, feeling less rested, a worse mental state and well-being, and their replies on the Groningen sleep quality scale indicated poorer sleep quality. There was no clear association between the performance test score and sleep quality. These results suggest that sleeping with windows open can provide some benefits by increasing ventilation with outdoor air, reducing CO2 concentrations, improving air quality as indicated by the subjectively rated air freshness and some of the parameters defining sleep quality, but it may also result in some discomfort if there are episodic loud noise events outdoors. Further studies are required to clarify the role of open windows in achieving good sleep quality.

Comparing the Effects of Melatonin and Zolpidem on Sleep Quality, Depression, and Anxiety in PatientsWithColorectalCancerUndergoingChemotherapy.

Introduction:Patients with cancer may have many complications involving their psychosomatic systems, such as sleep disturbance, depression, and anxiety. Thus, many research studies were conducted to reduce these complications. Zolpidem, as a short-term non-benzodiazepine treatment of insomnia, and melatonin as a chronobiological functionregulatory hormone, are commonly used for improving sleep quality. This randomized clinical trial aims to compare the effects of zolpidem and melatonin on sleep quality, depression, and anxiety in patients with colorectal cancer.Methods:In this single-blinded trial, 90 patients with colorectal cancer undergoing chemotherapy who had obtained a score of 5 or higher on the Pittsburgh Sleep Quality Index (PSQI) were randomly divided into two groups (n=45). One group was treated with 10 mg zolpidem at bedtime, and the other group received 6 mg melatonin at bedtime for 30 days. PSQI on weeks 0, 4, 8, Groningen sleep quality scale, Hamilton rating scale for depression, and Hamilton anxiety rating scale questionnaires were performed to assess patients on weeks 0, 4, and 8. The outcome was then analyzed, and P≤0.05 was considered statistically significant.Results:Both zolpidem and melatonin had significant impacts on sleep quality in week 4 (P<0.05). After stopping the treatments, the conditions were noticeably reversed on week 8 (P<0.05). Zolpidem and melatonin were relatively similar in affecting sleep duration, latency, efficiency, and disturbance. None of the two study medications had any considerable influence on anxiety and depression.Conclusion:Melatonin and zolpidem are promising agents for treating sleep complications and, to some extent, depression, and anxiety in cancer patients, according to the present study. However, further clinical trials are recommended to confirm the results of this study.

Benson Relaxation Technique: Reducing Pain Intensity, Anxiety level and Improving Sleep Quality among Patients Undergoing Thoracic Surgery

Thoracic surgery threatens the integrity of body, such as physical, psychological, social and spiritual aspects and may cause discomfort such as pain response and sleep disturbance. Aim: The study aimed to determine the effect of Benson's relaxation technique on reducing pain intensity, anxiety level and improving sleep quality among patients undergoing thoracic surgery. Design: A quasi experimental research design was utilized. Setting: The study was conducted in thoracic surgery department at Mansoura chest hospital and Mansoura University Hospital- chest department. Subjects: A purposive sample of 160 post thoracic surgery were recruited in this study. Tools: Four tools were used; Tool I: Assessment interview questionnaire sheet includes personal and health relevant data, Tool II: Short Form McGill Pain Questionnaire (SFMPQ), Tool III: Groningen Sleep Quality Scale (GSQS) and Tool V: Hospital Anxiety and Depression Scale (HADS). Results: There was a statistically significant effect of Benson's Relaxation Technique on reducing pain intensity, anxiety level and improving sleep quality among patients undergoing thoracic surgery. Conclusion: The study concluded that, Benson relaxation technique has a positive improvement in level of pain, quality of sleep and anxiety & depression among the study group who applied Benson's relaxation technique. Also, the most common factors that can affect the sleep quality level for those patients is the pain. Recommendation: This study recommended that, the nurses should pay more attention to Benson's relaxation technique as a simple, cheap and effective technique while taking care of post operative patients.

Psychometric Evidence of the 7-Item Generalized Anxiety Disorder Questionnaire in Brazil

Generalized anxiety disorder (GAD) is one of the most prevalent and impairing psychological disorders. GAD is defined as a persistent and excessive worry associated with physical and psychological symptoms. Despite the potentially severe nature of GAD, it has been estimated that nearly half of patients live with the symptoms for about 2 years before being appropriately diagnosed and treated. To allow early identification of this disorder, valid and reliable measures for the screening of GAD are essential. Therefore, the present study aimed to gather psychometric evidence of the 7-Item Generalized Anxiety Disorder Questionnaire (GAD-7) in Brazil (N = 746). The findings suggested a stable one-factor structure (CFI = .99; TLI = .99; RMSEA = .05) that is likely to be replicated (H-Latent = .92; H-Observed = .86) and have excellent reliability (ω = .91; CR = .91). Furthermore, the GAD-7 correlated positively with the DASS-21 stress (r = .73), depression (r = .53), and anxiety (r = .60) factors, along with the Groningen Sleep Quality Scale (r = .45) and the personality trait of neuroticism (r = .49), supporting its convergent validity. Finally, the GAD-7 is able to differentiate between participants with mild, moderate, and severe level of anxiety. Taken together, the present findings indicate that the GAD-7 is a suitable psychometric measure to assess generalized anxiety disorder in Brazil.

The relationship between subjective sleep quality and cognitive performance in healthy young adults: Evidence from three empirical studies

The role of subjective sleep quality in cognitive performance has gained increasing attention in recent decades. In this paper, our aim was to test the relationship between subjective sleep quality and a wide range of cognitive functions in a healthy young adult sample combined across three studies. Sleep quality was assessed by the Pittsburgh Sleep Quality Index, the Athens Insomnia Scale, and a sleep diary to capture general subjective sleep quality, and the Groningen Sleep Quality Scale to capture prior night’s sleep quality. Within cognitive functions, we tested working memory, executive functions, and several sub-processes of procedural learning. To provide more reliable results, we included robust frequentist as well as Bayesian statistical analyses. Unequivocally across all analyses, we showed that there is no association between subjective sleep quality and cognitive performance in the domains of working memory, executive functions and procedural learning in healthy young adults. Our paper can contribute to a deeper understanding of subjective sleep quality and its measures, and we discuss various factors that may affect whether associations can be observed between subjective sleep quality and cognitive performance.