High Prevalence Of Sleep Disturbance Research Articles

Sleep disturbances in children and adolescents after kidney transplantation.

Disturbances of sleep are prevalent among children with chronic kidney disease. However, the aetiology of sleep disorders in children particularly after kidney transplantation is not clear. We sought to ascertain the prevalence and type of sleep disturbances in paediatric kidney transplant recipients and to identify predictors of sleep disturbances in this population. Caregivers of kidney transplant recipients completed online questionnaires about their child's sleep. The questionnaires utilised were the Sleep Disturbance Scale for Children (SDSC), the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), questions about sleep hygiene, and questions about restless leg syndrome. Demographic and clinical details were collected from medical records. Thirty-five children were included in the study, with a median (IQR) age of 14.1years (9.5-16.1) and median years (IQR) since transplant of 3.7 (0.7-8.7) years, and 72.0% were identified to have at least one category of sleep disturbance according to scores on the SDSC. The most common sleep disturbances reported were disorders of initiating and maintaining sleep (DIMS) (40.0%) and disorders of excessive somnolence (DOES) (31.4%). Statistically significant predictors of sleep disturbances include low estimated glomerular filtration rate and increased age. Among children who screened positive for DIMS and DOES, the majority indicated use of electronic devices in 1h before bed. A high prevalence of sleep disturbances has been identified in children after kidney transplants, and some risk factors may be modifiable. Further studies are required to understand whether there are other readily modifiable predictors of sleep disturbances.

Neighborhood problems and sleep difficulties predict subjective cognitive decline in Black American men living in urban areas

AbstractBackgroundThe impact of the residential neighborhood on health and aging is being increasingly recognized in medical and health sciences. Specifically, research suggests that the neighborhood where people live can be a risk or protective factor for various health outcomes, including brain health. Similar to the impact of neighborhood on health and aging, sleep has been linked to subjective cognitive decline (SCD) in older adults, which may signal a cognitive trajectory to Alzheimer’s disease and related dementia (ADRD). This study aims to evaluate whether neighborhood problems and sleep difficulties predict subjective cognitive decline in Black men living in urban areas and, thus, may be related to elevated risks for ADRD.MethodBlack American men (N = 117), age 40 – 70 years, were recruited through a targeted advert on Amazon Mechanical Turk (MTURK) over a 3‐week period. The participants responded to a survey assessing neighborhood problems, bodily symptoms, length of residence, sleep difficulties, self‐rated health, sociodemographic characteristics, and subjective cognitive decline.ResultWe performed hierarchical regression. In Model 1, only education was a significant predictor of SCD (F (3,113) = 8.52, p<.001), accounting for 18% of the variation in SCD. In Model 2, socioeconomic status, education, and bodily symptoms were significant predictors of SCD (F (5,111) = 13.99, p<.001) and explained 39% of the variation in SCD. In Model 3, neighborhood problems, length of residence added, socioeconomic status, education, and bodily symptoms were significant predictors and contributed 44% of the total variance in SCD (F (7,109) = 12.10, p<.001). In Model 4, sleep difficulties, length of residence, bodily symptoms, socioeconomic status, and education were significant predictors of SCD (F (9,107) = 13.59, p<.001), and accounted for 50% of the variation in SCD.ConclusionGiven that Black Americans have been found to have a higher prevalence of sleep disturbances compared to white Americans, our findings could add to inform future health interventions and policy recommendations that can address modifiable sources of poorer brain health in Black men.

Sleep and Its Disturbance in Parents of Children and Adolescents with Epilepsy: A Systematic Review and Meta-Analysis.

Sleep disturbances are commonly reported by parents of children and adolescents with epilepsy. However, evidence synthesis including quality and quantity of sleep in parents of children and adolescents with epilepsy is lacking. This systematic review and meta-analysis was conducted to quantify pooled mean estimates of parental sleep variables and to determine the prevalence of sleep disturbances in parents of children and adolescents with epilepsy. Five electronic databases, PubMed, Medline, Embase, PsychINFO, and CINAHL, were systematically searched from inception to September 2021. Eleven observational studies examining parents of pediatric patients aged <18 years with epilepsy using a quantitative measure of sleep duration, sleep quality, or sleep disturbance were reviewed. Our results showed that the pooled nocturnal sleep duration was 5.93 hours (95% CI: 4.64 to 7.21 hours). Overall sleep quality as estimated by the bias-adjusted pooled Pittsburgh Sleep Quality Index total score was 6.65 (95% CI: 5.98 to 7.33). Parents of children with epilepsy had significantly higher Pittsburgh Sleep Quality Index total scores compared to parents of healthy children (differences in means 1.84, 95% CI: 1.29 to 2.39). The pooled estimated prevalence of parental sleep disturbances was 58.1% (95% CI: 45.7% to 69.6%). Our findings demonstrate a high prevalence of sleep disturbances with poor sleep quality and substantial reductions in sleep time in parents of children and adolescents with epilepsy. Healthcare professionals in pediatric neurology clinics should proactively initiate screening for sleep disturbances in parents of children and adolescents with epilepsy and refer parents to a sleep specialist when necessary.

Comparing the Effects of Acupressure and Clonazepam Tablets on Sleep Quality of Hemodialysis Patients: A Randomized Controlled Trial.

Objective: The current study aimed to compare the impact of acupressure and clonazepam tablets on the quality of sleep in hemodialysis patients in light of the rising prevalence of chronic kidney disease (CKD), the high prevalence of sleep disturbance in these patients, and the side effects of hypnotic drugs. Method : A total of 60 patients were selected for this randomized, controlled clinical trial and randomly assigned to two groups. For two weeks during the researcher's evening shift, one group received acupressure (six spots bilaterally for three minutes each day). The opposing group was administered clonazepam tablets (0.5 mg) for two weeks. The Pittsburgh Sleep Quality Index (PSQI), which measures sleep quality, was used to compare sleep in the two groups before and after the intervention. Results: There was no statistically significant difference between the two groups prior to the intervention (P = 0.75) in terms of the mean pre-intervention PSQI scores for the acupressure and clonazepam groups, which were 15.83 ± 1.51 and 16.17 ± 0.91, respectively. However, the average PSQI scores after the intervention in the clonazepam and acupressure groups were 13.25 ± 2.88 and 8.97 ± 4.29, respectively, indicating a statistically significant difference (P < 0.0001). Both the acupressure and the clonazepam groups showed improvements in their post-intervention sleep quality among the patients. However, when the percentage changed in the mean scores of the total score and all of the PSQI components were calculated for each group, it became clear that acupressure was more effective at enhancing sleep than clonazepam tablets. Conclusion: The findings of the present investigation demonstrate that acupressure has a greater impact on patients' sleep quality compared to clonazepam tablets. Depending on the circumstances, acupressure can be used as a simple, safe, and non-drug way to enhance hemodialysis patients' quality of sleep.

E12 Sleep disturbance among Juvenile idiopathic arthritis patients

Abstract Background Juvenile idiopathic arthritis (JIA) is a common pediatric condition that is often associated with chronic pain and physical disability. Moreover, it is also comorbid with sleep problems which considerably affects the patient’s daily functioning [1]. Objectives The aim of this study was to assess sleep disturbances among JIA patients. Methods We conducted a cross-sectional study including patients with JIA according to the International League of Associations for Rheumatology (ILAR). Sociodemographic data as well as disease characteristics were collected. Sleep disturbance was assessed by two questionnaires: the BEARS Sleep Screening algorithm and PROMIS sleep disturbance short form according to the age of the patients (&amp;lt;18 years old, &amp;gt;18 years old respectively). The BEARS is an instrument divided into major sleep domains: bedtime problems, excessive daytime sleepiness, awakenings during the night, regularity and duration of sleep and snoring. PROMIS is an 8-item questionnaire that assess sleep quality. A higher T score corresponds to a poorer the sleep quality. Results The study included 31 patients. The mean age of the participants was 28.67 years [9–45 years]. There was a female predominance: 35.5% males vs 64.5% females. The mean age at onset was 6.6 years [2–13] and the mean disease duration was 256.5 months [36–444]. The distribution of the different subtypes was as follows: Enthesitis-related arthritis (n = 4), RF-positive polyarthritis (n = 10), RF-negative polyarthritis (n = 6), oligoarthritis (n = 7) and systemic arthritis (n = 4). Nineteen patients were receiving corticosteroids. Disease-modifying anti-rheumatic drugs were used by 18 patients: methotrexate (n = 11), sulfasalazine (n = 3), leflunomide (n = 4), biologics (n = 13). Twelve patients developed complications: coxitis (n = 11), growth retardation (n = 9), uveitis (n = 4). The majority of the respondents (90.3%) reported using screens daily before going to sleep. Among patients aged &amp;lt;18 years, 2 had an individual bedroom while 8 shared theirs with their siblings. Among the ten patients who answered the BEARS Sleep Screening algorithm, 40% had an excessive daytime sleepiness, 20% had night awakenings and 30% suffered from a snoring problem. Regularity and duration of sleep was respected in 6 out of the 10 patients. The most common bedtime problem mentioned were refusal to go to bed (73%) as well as bedtime stalling (23%). As for the PROMIS form, the mean score was 55.52 [27–66]. None to slight, mild, moderate and severe sleep disturbance were found in 16.1%, 19.3% and 6.4% of cases respectively. There was a significant association between poor sleep quality and higher disease activity (DAS28 ESR) (P &amp;lt; 0.043). However, we did not find a significant association between the sleeping disturbances and age at onset (P = 0.08), disease duration (P = 0.073), the CHAQ score (P = 0.059), corticosteroid use (P = 0.063) and the screen use (P = 0.092). Conclusion This study highlights the high prevalence of sleep disturbance among JIA patients which may affect their physical, emotional and cognitive well-being. It is important to screen for sleep problems for a better management of the disease. [1] Owens J. Classification and epidemiology of childhood sleep disorders. Prim Care 2008; 35(3):533–46

Sleep behaviors predicted sleep disturbances among Chinese health science students: a cross-sectional study.

Healthy sleep is essential for individuals' physiological and psychological health. Health science students experience a high prevalence of sleep disturbances which may be due to maladaptive behaviors. This study aimed to examine the associations of sleep behaviors including sleep hygiene and bedtime procrastination with the associations of sleep disturbances (e.g., poor sleep quality, insomnia, and short sleep). This cross-sectional study included health science students from a medical university in Shanghai, China. Sleep disturbances included poor sleep quality, insomnia, and short sleep. They were measured by the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and one question "How many hours of sleep did you usually get during the past week?", respectively. Sleep behaviors included sleep hygiene and bedtime procrastination measured by the Sleep Hygiene Index (SHI) and Bedtime Procrastination Scale (BPS), respectively. Logistic regression was performed while controlling for potential confounders. A total of 464 health science students participated.Poorer overall sleep hygiene and more bedtime procrastination were independently associated with higher odds of poor sleep quality (OR=1.065, 95% CI 1.028-1.103; OR=1.040, 95% CI 1.006-1.075, respectively) and insomnia (OR=1.059, 95% CI 1.018-1.101; OR=1.093, 95% CI 1.049-1.139, respectively). More bedtime procrastination was associated with higher odds of short sleep (OR=1.148, 95% CI 1.093-1.206). Commonly reported specific sleep behaviors, such as "Going to bed later than intended", "Doing other things than sleep at bedtime", and "Easily stopping what I am doing at bedtime", were also related to higher odds of sleep disturbances. Sleep hygiene and bedtime procrastination were strong predictors of sleep disturbances. Tailored interventions targeting specific sleep behaviors are warranted to clarify their effect on sleep disturbances.

Correlations between Sleep Features and Iron Status in Children with Neurodevelopmental Disorders: A Cross-Sectional Study.

A high prevalence of sleep disturbances has been reported in children with neurodevelopmental disorders (NDDs), such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and intellectual disability (ID). The etiology of sleep disorders in these children is heterogeneous and, recently, iron deficiency has received increasing attention. This study aims to investigate sleep features in children with NDDs and to explore a possible correlation between serum iron status biomarkers and qualitative features of sleep. We included 4- to 12-year-old children with a diagnosis of ASD, ADHD, or ID and assessed their sleep features through the children's sleep habits questionnaire (CSHQ). Venous blood samples were collected to investigate ferritin, transferrin, and iron levels. The mean CSHQ total score exceeds the cut-off in all groups of children. In the ASD group, the Parasomnias subscale negatively correlated with serum ferritin levels (Rho = 0.354; p = 0.029). Our findings may suggest the existence of an association between iron status, sleep quality, and neurodevelopmental processes. In clinical practice, sleep assessment should be included in the routine assessment for patients with NDDs. Furthermore, a routine assessment of iron status biomarkers should be recommended for children with NDDs who have sleep disturbances.

Sleep, Sensory Processing, &amp; Emotional States Among Older Adults

Abstract Date Presented 04/22/2023 The high prevalence of sleep disturbances in older adults warrants further research exploring their negative impacts on occupational engagement. Sensory loss and sensory impairment are common occurrences during normal aging and may result in difficulties in engaging in occupations such as sleep (Correia et al., 2016). This study examined the relationship between emotional states, including depression, anxiety, and stress, and sleep in older adults. Primary Author and Speaker: Megan C. Chang Additional Authors and Speakers: Madeline Bennet, Bailey Coe, Angela Santana, Katherine Schultz, Erin Serrano

Nighttime sleep and daytime sleepiness patterns among left ventricular assist device patients.

Despite the high prevalence of sleep disturbance in the heart failure population, information about its consequence on daytime function in patients with left-ventricular assist devices (LVADs) is limited. This study examined the nighttime and daytime sleep patterns and changes from pre-implant to 6months post-implant. This study included 32 LVAD patients. Demographics, nighttime and daytime sleep variables were collected pre-implant and at 1, 3, and 6months post-implant. Wrist actigraphy and self-report questionnaires measured objective and subjective sleep, respectively. Objective nighttime sleep data were sleep efficiency (SE), sleep latency (SL), total sleep time (TST), wake after sleep onset (WASO), and sleep fragmentation (SF). Objective daytime sleep data were nap times. Self-reported Subjective Sleep Quality Scale (SSQS) and Stanford Sleepiness Scale (SSS) were subjective measures. Increased SF and WASO scores and decreased TST and SE scores were found pre-LVAD implant, indicative of poor sleep quality. TST, SE, naptime and SSQS scores were higher at 3 and 6months post-implant compared to baseline. Decreases in TST and SF scores were observed at 3 and 6months post-implant along with increases in SSS scores. Increasing SSS scores and decreasing overall scores from pre- and up to 6months post-implant suggest improvement in daytime function. This study provides information on sleep-daytime function in the LVAD patient population. Improvements in daytime sleepiness do not imply "good" sleep quality, consistent with the extant knowledge in LVAD literature. Future investigations should elucidate the mechanism by which sleep-daytime function influences quality of life.

0782 Sleep and Its Disturbance in Parents of Children and Adolescents with Epilepsy: A Systematic Review and Meta-Analysis

Abstract Introduction Sleep disturbances are commonly reported by parents of children and adolescents with epilepsy. However, evidence synthesis including quality and quantity of sleep in parents of children and adolescents with epilepsy is lacking. A greater understanding of the characteristics of sleep patterns and sleep problems in parents of children with epilepsy is needed because when the sleep of the parents is compromised, the parents’ ability to provide quality care for the child may be hampered. The purpose of this systematic review and meta-analysis was to synthesize published studies examining sleep and its disturbance in parents of children and adolescents with epilepsy. Methods Five electronic databases, PubMed, Medline, Embase, PsychINFO, and CINAHL, were systematically searched from inception to September 2021. Studies examining parents or caregivers of pediatric patients aged &amp;lt; 18 years with epilepsy using a quantitative measure of sleep duration, sleep quality, or sleep disturbance were included. Available data were pooled using random-effects or fixed-effects models on the basis of heterogeneity between studies. Results Eleven observational studies with a total of 934 parents of children and adolescents with epilepsy were reviewed. The pooled nocturnal sleep duration was only 5.93 hours (95% CI: 4.64 to 7.21 hours). Overall sleep quality as estimated by the bias-adjusted pooled Pittsburgh Sleep Quality Index total score was 6.65 (95% CI: 5.98 to 7.33). Parents of children with epilepsy had significantly higher Pittsburgh Sleep Quality Index total scores in comparison to parents of healthy children (differences in means: 1.84, 95% CI: 1.29 to 2.39). The pooled estimated prevalence of parental sleep disturbances was 58.1% (95% CI: 45.7% to 69.6%). Conclusion Our findings demonstrate a high prevalence of sleep disturbances with poor sleep quality and substantial reductions in sleep time in parents of children and adolescents with epilepsy. Healthcare professionals in pediatric neurology clinics should initiate screening of sleep disturbances in parents and refer parents to a sleep specialist when necessary. Support (if any) This work was supported by Ministry of Science and Technology, Taiwan, MOST 110-2628-B-002-039.

Prevalence, risk factors, and clinical correlates of anxiety, depression, and sleep disorders in chaperones for children in the emergency department in China during COVID-19.

The outbreak of novel coronavirus pneumonia in Wuhan, Hubei Province, in 2019 and its rapid spread across the country caused severe public panic in China. The purpose of this study was to investigate the mental health problems of children's chaperones at the emergency clinic during the coronavirus disease 2019 (COVID-19) outbreak and to analyze the related influencing factors. A total of 260 chaperones for children in the emergency department participated in this cross-sectional study through the questionnaire constellation platform. The survey period was from February to June 2021. Information collected included demographic data and mental health scales. The Self-Assessment Scale for Anxiety, the Self-Rating Scale for Depression, and the Pittsburgh Sleep Quality Index assessed anxiety, depression, and sleep quality, respectively. Logistic regression was used to analyze influential factors associated with mental health problems. The prevalence of depression, anxiety, and sleep disorders among family members accompanying children attending the emergency room was 41.54%, 20.00%, and 93.08%, respectively, with 21.54% of family members suffering from moderate sleep disorders. Univariate analysis showed that being in Wuhan or not during the city closure (X2 = 8.61, P < .01) was strongly associated with the occurrence of depression; female (X2 = 4.87, P = .03), working or not (X2 = 6.39, P = .01) and fear of going to the hospital (X2 = 7.80, P = .01) were key factors for the occurrence of anxiety symptoms; Knowledge of transmission routes and prevention of COVID-19 (X2 = 12.56, P = .03) was a key factor for sleep disorders; logistic stepwise regression analysis showed that fear of going to the hospital was a risk factor for anxiety symptoms (odds ratio = 2.51, P < .01, 95% confidence interval = 1.30-4.85). Our findings suggest that mental health problems were prevalent among family members accompanying children attending the emergency department during the COVID-19 outbreak, with a high prevalence of sleep disturbances in particular. Relevant factors included presence or absence in Wuhan during the outbreak closure, gender, work or absence, and fear of hospital visits. There is a need to focus on the mental health distress of the chaperones for children in the emergency department, and to provide timely intervention and diversion.

Sleep Disturbances in Adolescents With Idiopathic Intracranial Hypertension

BackgroundWe aimed to assess the presence of sleep disturbances in adolescents with idiopathic intracranial hypertension (IIH) and to determine whether demographic, anthropometric, and clinical factors are associated with disrupted sleep. MethodsSleep disturbances and patterns were evaluated in a cohort of adolescents (aged 12 to 18 years) with ongoing IIH and compared with a healthy age- and sex-matched control group. All participants responded to three self-rating questionnaires: the School Sleep Habits Survey (SSHS), the Pediatric Sleep Questionnaire (PSQ), and the Depression, Anxiety, and Stress Scale. The study group's demographic, clinical, laboratory, and radiological data were documented, and their association with sleep patterns was examined. ResultsThirty-three adolescents with ongoing IIH and 71 healthy controls were included. There was a significantly higher prevalence of sleep disturbances in the IIH group compared with the controls (SSHS, P < 0.001 and PSQ, P < 0.001), as well as of their independent subscales: sleep-related breathing disorders (P = 0.006), daytime sleepiness (P = 0.04), sleep/wake disruptions (P < 0.001), and sleep-related depressive tendencies (P < 0.001). According to subgroup analyses, these differences were also present between the normal-weight adolescents but not between the overweight IIH and control adolescents. No differences were found in the demographic, anthropometric, and IIH disease-related clinical measures between individuals with IIH with disrupted and normal sleep patterns. ConclusionsSleep disturbances are common among adolescents with ongoing IIH, irrespective of their weight and disease-related characteristics. Screening adolescents with IIH for sleep disturbances is recommended as part of their multidisciplinary management.

A STUDY OF SLEEP QUALITY IN ADOLESCENTS: THE IMPACT OF OVER USE OF MOBILE CELL PHONE IN URBAN SETTING: A CROSS SECTIONAL STUDY

Background: The increase in the number of mobile phone users has increased worldwide . Excessive use of the mobile phone among adolescents often led to later poor sleep quality , which is important for the development for the psychophysiological capabilities. The study assessed the relationship between mobile phone addiction and sleep quality among adolescents Aim: To study the prevalence of mobile phone addiction and sleep quality. To know the role of socio-demographic factors on mobile phone Objective of the study: over use and sleep quality among adolescents. A cross sectional study using convenient sampling method, wit Methodology: Study design: h a study sample consisting of 110 adolescents recruited from under graduate students and people who residing in area of Andhra medical college .Bivariable and multivariable logistic regression analyses were used for the study (1) Semi structured Performa Study tools: for sociodemographic data,(2) Pittsburgh Sleep Quality Index (PSQI), (3) Mobile Phone Addiction Scale (MAPS) – 37 items. High M Results: obile Phone Addiction Scale (MAPS)were associated with a high prevalence of sleep disturbance in both boys and girls . These ndings persisted after controlling for other factors in the multiple regression model. Adolescents with mobile phone addiction were more prone Conclusion: to suffer from poor sleep quality. It is recommended that aware the adolescents on adverse effects of excessive use including poor sleep quality. These ndings are implications for adolescents, parents, authorities and researchers

Application of Grey Relational Analysis to Predict Dementia Tendency by Cognitive Function, Sleep Disturbances, and Health Conditions of Diabetic Patients.

Background: The number of elderly diabetic patients has been increasing recently, and these patients have a higher morbidity of dementia than those without diabetes. Diabetes is associated with an increased risk for the development of dementia in elderly individuals, which is a serious health problem. Objectives: The primary aim was to examine whether diabetes is a risk factor for dementia among elderly individuals. The secondary aim was to apply grey theory to integrate the results and how they relate to cognitive impairments in elderly diabetic patients and to predict which participants are at high risk of developing dementia. Methods: Two hundred and twenty patients aged 50 years or older who were diagnosed with diabetes mellitus were recruited. Information on demographics, disease characteristics, activities of daily living, Mini Mental State Examination, sleep quality, depressive symptoms, and health-related quality of life was collected via questionnaires. The grey relational analysis approach was applied to evaluate the relationship between the results and health outcomes. Results: A total of 13.6% of participants had cognitive disturbances, of whom 1.4% had severe cognitive dysfunction. However, with regard to sleep disorders, 56.4% had sleep disturbances of varying degrees from light to severe. Further investigation is needed to address this problem. A higher prevalence of sleep disturbances among diabetic patients translates to a higher degree of depressive symptoms and a worse physical and mental health-related quality of life. Furthermore, based on the grey relational analysis, the grey relation coefficient varies from 0.6217~0.7540. Among the subjects, Participant 101 had the highest value, suggesting a need for immediate medical care. In this study, we observed that 20% of the total participants, for whom the grey relation coefficient was 0.6730, needed further and immediate medical care.

The circadian variation of sleep and alertness of postmenopausal women.

Several factors may contribute to the high prevalence of sleep disturbances occurring in postmenopausal women. However, the contribution of the circadian timing system to their sleep disturbances remains unclear. In the present study, we aim to understand the impact of circadian factors on changes of sleep and alertness occurring after menopause. Eight healthy postmenopausal women and 12 healthy young women in their mid-follicular phase participated in an ultradian sleep-wake cycle procedure (USW). This protocol consisted of alternating 60-min wake periods and nap opportunities for ≥ 48 h in controlled laboratory conditions. Core body temperature (CBT), salivary melatonin, self-reported alertness, and polysomnographically recorded sleep were measured across this procedure. In both groups, all measures displayed a circadian variation throughout the USW procedure. Compared to young women, postmenopausal women presented lower CBT values, more stage N1 and N2 sleep, and number of arousals. They also showed a reduced amplitude of the circadian variation of melatonin, total sleep time (TST), sleep onset latency (SOL), stage N3 sleep, and alertness levels. Postmenopausal women fell asleep faster and slept more during the biological day and presented higher alertness levels during the biological night than young women. These results support the hypothesis of a weakened circadian signal promoting sleep and wakefulness in older women. Aging processes including hormonal changes may be main contributors to the increased sleep-wake disturbances after menopause.

Sleep disturbances, sleep quality, and cardiovascular risk factors in women with polycystic ovary syndrome: Systematic review and meta-analysis.

Objectives(1) To establish the prevalence of sleep disorders in women with PCOS. (2) To establish the association between sleep disturbance and cardiovascular risk factors in women with PCOS.MethodsThe electronic databases PubMed and EMBASE were searched for observational studies of individuals with PCOS published in English from inception to 21 October 2021. The dichotomous outcome measure was presented as odds ratio (OR) and 95% confidence interval (CI). The mean difference (MD) in continuous variables was expressed for each study.ResultsA total of 18 articles were included in this meta-analysis, with a total of 16,152 participants from nine different countries. Women with PCOS had a high prevalence of sleep disturbance (OR = 6.22; 95% CI: 2.77, 13.97; p < 0.001), higher PSQI scores (MD = 2.10; 95% CI: 0.29, 3.90; p = 0.02), and shorter duration of sleep (MD = −15.65 min; 95% CI: −27.18, −4.13; p = 0.008). We found that body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-c), fasting glucose, 2-h glucose, and waist circumference (WC) levels were significantly higher and high-density lipoprotein cholesterol (HDL-c) was significantly lower in PCOS with sleep disturbance than in PCOS without sleep disturbance.ConclusionsThe current study shows a high prevalence of sleep disturbance in women with PCOS and provides evidence of an association between cardiovascular risk factors and sleep disturbance among this population. Increased attention should be paid to sleep management in clinical guidelines for PCOS. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022298040.

Low Sleep Satisfaction Is Related to High Disease Burden in Tinnitus.

Previous studies have shown a high prevalence of sleep disturbances in tinnitus patients. However, no study has yet evaluated subjective sleep satisfaction. The present study aimed to investigate associations of self-reported sleep satisfaction with sociodemographic factors, tinnitus-related distress, depression, and self-reported quality of life. This is a retrospective analysis of 2344 outpatients with tinnitus presenting at a tertiary German tinnitus clinic from 2010 to 2020. Patients who filled in five questionnaires (Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Major Depression Inventory (MDI), Tinnitus Sample Case History Questionnaire (TSCHQ), and the World Health Organization Quality of Life Brief Version (WHOQOL-Bref)) were included. Based on the question about sleep satisfaction in the WHOQOL-Bref, group classification into (I) sleep-satisfied, (II) neither satisfied or dissatisfied, and (III) sleep-dissatisfied patients was performed. Associations between sleep satisfaction and quality of life, depression, tinnitus distress, and tinnitus characteristics were analyzed by group differences and a multinomial regression model with elastic net penalization. A total of 42.38% of patients were satisfied or very satisfied with sleep, whereas 40.91% of patients were dissatisfied or very dissatisfied with sleep. The remaining patients reported being neither satisfied nor dissatisfied with sleep. Sleep-dissatisfied patients were significantly more burdened in questionnaires on depressive symptoms (MDI), tinnitus distress (TQ, THI), and quality of life (WHOQOL-Bref). In addition, they suffered significantly more often from comorbidities such as headache, neck pain, or temporomandibular joint disorder (TMJ). The elastic net regression based on sum scores of THI, TQ, MDI, the four domains of WHOQOL-Bref, as well as all individual questions from the TSCHQ was able to classify patients satisfied with their sleep with an accuracy of 79%, 87.8% sensitivity, and 70.4% specificity. The model could not identify patients indifferent with the quality of their sleep (neither satisfied nor dissatisfied) (sensitivity: 0%; specificity: 100%). The accuracy of the model to predict patients dissatisfied with their sleep was 80.7%, with 83% sensitivity and 78.4% specificity. Poor physical and mental health (Domain I/II WHOQOL-Bref) as well as tinnitus distress were the strongest predictors of sleep dissatisfaction. Conversely, for sleep satisfaction, good physical and mental health as well as low tinnitus distress were the strongest predictors. The division into sleep-satisfied and sleep-dissatisfied tinnitus patients allows a very good discrimination regarding disease burden as indicated by depression, tinnitus distress, quality of life, and pain-related comorbidities. Physical and mental health as well as tinnitus distress seem to be strongly related to sleep satisfaction underscoring the concept of “tinnitus” versus “tinnitus disorder”, but also the importance of sleep satisfaction as a global health indicator. Moreover, these data indicate the relevance of addressing sleep disorders in the therapeutic management of chronic tinnitus patients.

The effects of hormonal contraceptive use on sleep patterns in women of reproductive age

PurposeHormonal contraceptives alter hormone levels in women and have been linked to alterations in sleep patterns; however, previous studies yielded inconsistent results and lacked generalizability. This study examines hormonal contraceptive use and its impact on sleep outcomes, including sleep duration and sleep disturbances. MethodsWomen self-reported their sleep patterns and use of contraceptives in the 2017 population-based Behavioral Risk Factor Surveillance System Survey (n=1,970). Participants were categorized by use of hormonal or non-hormonal contraceptives for the purpose of pregnancy prevention. Sleep duration was defined as having met the recommended sleep levels of 7-9 hours per 24 hours. Sleep disturbances were defined as trouble falling asleep, staying asleep, or sleeping too much ≥ 6 days within a 14-day period. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated to examine the association between contraceptive use and each sleep outcome. SAS-callable SUDAAN was used for analyses to account for the complex sampling design. ResultsWomen who used hormonal contraceptives had 6% higher prevalence of sleep disturbances (PR: 1.06, 95% CI: 0.99, 1.14) and 17% lower prevalence of not meeting sleep duration recommendations (PR: 0.83, 95% CI: 0.71, 0.98) compared to those who used non-hormonal contraceptives after adjustment for age. ConclusionThese findings suggest the use of hormonal contraceptives may have negative impacts on sleep disturbances, and positive effects on sleep duration among women using contraceptives for preventing pregnancy. Future studies should be conducted in diverse populations utilizing objective measurements of sleep patterns.

0494 The Associations Between Insomnia Symptoms and Emotional Regulation Among Typically Developing Adolescents during the COVID-19 Pandemic

IntroductionA high prevalence of sleep disturbances was observed in adolescents during the coronavirus disease (COVID-19) pandemic. This has been interpreted as being related to disruptions in daily routines and social life caused by pandemic-related societal restrictions. Although the COVID-19 pandemic interrupted the routines of all adolescents, not all adolescents developed insomnia in response to pandemic-related changes. A reduced ability to regulate negative emotions is associated with a higher risk of developing insomnia, yet it is not known if it is associated with higher levels of insomnia in adolescents. Cognitive reappraisal, which consists of changing the way one thinks about potentially emotion-inducing events, is effective in downregulating negative emotion. Expressive suppression, which is changing the way one behaviorally responds to emotion-eliciting events, can decrease a positive emotional experience but does not alter the experience of negative emotion. The objective of this study was to examine the associations between insomnia symptoms in typically developing adolescents during the COVID-19 pandemic and the tendency to use cognitive reappraisal or expressive suppression to regulate emotions. It was hypothesized that high levels of insomnia symptoms among adolescents during the COVID-19 pandemic would be associated with more frequent use of expressive suppression and less frequent use of cognitive reappraisal when regulating emotions.Methods49 adolescents aged 11-16 (M= 13.43, SD= 1.67) participated in the study during the first wave of the COVID-19 pandemic in Canada (May 15 to June 30, 2020). The Insomnia Severity Index (ISI) was used to assess the severity of nighttime and daytime components of insomnia. The Emotion Regulation Questionnaire was used to assess respondents' tendencies to regulate their emotions using cognitive reappraisal or expressive suppression.ResultsHigher ISI total scores were significantly associated with lower reappraisal scores on the Emotion Regulation Questionnaire.ConclusionA higher level of insomnia symptoms among typically developing adolescents during the COVID-19 pandemic was associated with less frequent use of emotional regulation strategy that is effective in downregulating negative emotion. Limitations: Given the cross-sectional design of the study, it is not possible to determine causality.Support (If Any)CIHR 418638 to Reut GruberRGPIN-2015-04467 to Reut Gruber

Association of sleep disturbance with shift work, occupational stress, and musculoskeletal pain in Chinese public hospital emergency workers: A multicentre cross-sectional study

ABSTRACT Poor sleep, which is reportedly prevalent among healthcare professionals, could lead to various detrimental consequences. This study aimed to investigate the sleep quality of individuals working in emergency departments of public hospitals in China and explore the potential factors influencing sleep disturbance. A self-administered questionnaire was completed by 7688 emergency workers from 147 public hospitals in Shandong, China. Log-binomial regression analysis was performed to explore the relationship of sleep disturbance with possible influencing factors, including individual and work characteristics, occupational stress, shift work, and musculoskeletal pain. The participants’ mean Pittsburgh Sleep Quality Index score was 9.6 ± 4.8, with 5341 (69.5%, 68.2–70.7%) of them experiencing sleep disturbance. The sleep quality was poorer in doctors (10.2 ± 5.1, 71.0%, 69.0–73.0%) than in nurses (9.2 ± 4.5, 68.6%, 67.0–70.1%), and poorer in those working in secondary (9.9 ± 4.5, 70.2%, 68.0–72.3%) and tertiary (12.2 ± 4.9, 77.5%, 75.3–79.7%) hospitals than in primary hospitals (8.0 ± 4.1, 64.6%, 62.6–66.6%). High prevalence of sleep disturbance was significantly associated with shift work, occupational stress, musculoskeletal pain, fewer breaks in a work shift, and less exercise during leisure time, after adjusting for confounding variables. Sleep disturbance occurred in emergency workers in the following order: two-shift rotation > three-shift rotation > permanent night shift > permanent day shift. Emergency workers in public hospitals in China had poor sleep quality and commonly experienced musculoskeletal pain. Urgent and comprehensive measures are needed to combat these issues.