Higher Sleep Quality Research Articles

MO888QUALITY OF LIFE AND QUALITY OF SLEEP IN MAINTENANCE HEMODIALYSIS PATIENTS: REPORTS FROM TWO HEMODIALYSIS CENTERS IN IRAN

Abstract Background and Aims Patients with End Stage Kidney Disease (ESKD) usually tend to have lower Quality of Life (QoL) compared to the general population. The purpose of this study was to determine the QoL and quality of sleep in patients on maintenance hemodialysis (MHD) and its relation with medical factors. Method This descriptive-analytical study was performed on 145 patients on MHD in two hospitals affiliated to Abadan University of Medical Sciences. Patients' QoL was assessed via KDQOL-SF questionnaire. For sleep quality, Pittsburgh Sleep Quality Questionnaire (PSQI) was used. Demographic information of patients, type of vascular access, history of dialysis, and frequency and duration of each dialysis session were collected. The average results of related laboratory tests in the last six months, were also recorded for each patient. Results Of 145 MHD patients, 81 (55%) were men and 64 were women. Most patients (53%) were between 30 and 60 years old. Illiteracy was present in 48 (33%) patients. Unemployed patients accounted for 70% of patients (99) and most of the participants (83.44%) lived in the city. Of 145 patients, 102 (70.34%) were married, 20 (13.79%) were single, and the rest were widows. The mean dialysis adequacy of patients was 1.14, and 53% had dialysis adequacy less than 1.2. The average quality of life score was 66.00 ±13, suggesting a high QoL in this group of patients. literacy was significantly associated with QoL score (P<0.001). Likewise, there was significant association between QoL score and income level (p <.001), the effect of Kidney disease on life (p <.001), working status (p <.009), social functioning (p <.046), and marital status (p <.001). The quality of social interactions was significantly associated with residence location (p <.001). On the other hand, the presence of Kidney disease burden, sexual dysfunction, unemployment, role emotional and role physical, was associated with low QoL scores. We found a significant relationship between hemoglobin level and cognitive function (p <.001, r= .075). In addition, significant relationships between phosphorus levels and physical function (p=.021) and role emotional (P:0.04) were observed. Seemingly, phosphorus levels were inversely related with sexual function in our patients (p <0.001, r= - .013). Our data also suggested that serum calcium levels may have an impact on the patients’ social function (p=.038). The mean score of sleep quality was 7.00±4.00. Most of the patients (61%) had a PSQI>5, indicating a poor sleep quality. High sleep quality (PSQI<5) is significantly associated with low age and high-income level. There was also a significant relationship between the average sleep quality and general health (p <0.001, r= -0.206), social function (p= 0.018, r=-0.208), and energy fatigue (p <0.001, r= -0.309). Conclusion Our study showed that a wide range of determinants, including demographic, socioeconomic and disease-related factors can significantly influence the QoL and sleep quality in ESKD patients undergoing hemodialysis. Among them, modifiable factors including laboratory test results, socioeconomic determinants and psychosocial status should be addressed and accordingly treated and solved. Hence, an improvement in both the QoL and sleep quality of maintenance hemodialysis patients will be expected. Keywords Hemodialysis, Quality of life, Sleep quality, Sociodemographic characteristics.

Pre-stroke habitual prolonged sleep as a predictor for post-stroke sleep quality, stroke-related quality of life, and lifestyle values

BackgroundProlonged sleep is a higher stroke risk, but post-stroke prolonged sleep facilitates stroke recovery. No study has explored the relationship between pre- and post-stroke prolonged sleep and their involvement in stroke-related quality of life (QOL).This study aimed to clarify the role of pre- and post-stroke prolonged sleep in QOL and sleep quality during hospitalization. MethodsFifty-one subacute stroke inpatients were enrolled. QOL was assessed by the Stroke and Aphasia QOL Scale-39-J. Sleep quality and lifestyle values were assessed by original questionnaires. ResultsPatients in pre-stroke prolonged sleep > 8 h had a higher incidence of post-stroke poor sleep quality than those belonging to the normal or shorter hours (OR 5.33, 95% CI 1.30–21.84, p = 0.047). In addition, pre-stroke prolonged sleep was associated with lower scores of psychosocial QOL and lifestyle values of “accepting disability; caring about what other people think of what you do”. In contrast, post-stroke prolonged sleep was associated with the lower risk of post-stroke poor sleep quality (OR 0.27, 95% CI 0.08–0.86, p = 0.045). Post-stroke high sleep quality had higher (better) scores of physical and energy QOL, and lifestyle values of “caring about what other people think of what you do; having some places to go out after discharge” compared with post-stroke poor sleep quality. Post-stroke prolonged sleep was derived from pre-stroke not prolonged sleep rather than pre-stroke prolonged sleep (p = 0.039, Chi-square test). ConclusionsPre-stroke prolonged sleep is associated with a higher incidence of post-stroke poor sleep quality and lower scores of QOL and lifestyle values after stroke.

Off-training physical activity and training responses as determinants of sleep quality in young soccer players

This study aimed to quantify and assess the relationship of young soccer players' off-training physical activity (PA) and training responses on sleep quality. Eleven adolescent soccer players (13 ± 0.5 years old) were monitored during weekdays for four consecutive weeks, throughout soccer practice days. Off-training PA and sleep quality were assessed using 100 Hz tri-axial accelerometers and training responses analyzed using 20 Hz global positioning measurement units. A cluster analysis classified all cases into three different dimensions, (1) off-training PA, (2) training responses and (3) sleep quality. For each dimension, the most important variables for classifying the cases into clusters were sedentary PA and moderate-to-vigorous PA; total distance covered and impacts; and sleep onset latency and sleep fragmentation index, respectively. Afterwards, a correspondence analysis was used to identify whether off-training PA and training responses affected sleep quality. Results exposed that high to medium off-training PA combined with medium to high training responses may have decreased sleep quality. Conversely, no correspondence was observed between off-training PA and training responses, with higher sleep quality. This study emphasizes the importance of sports organizations adopting a holistic approach to youth soccer players’ development, that appropriately considers the inter-relationship between lifestyle, performance and health-related information.

308 Sleep Quality Predicts Discrepancy between Objective and Self-Ratings of Performance in Cadets during U.S Army ROTC Advanced Camp

Abstract Introduction U.S. Army Reserve Officer Training Corps (ROTC) Advanced Camp (AC) is a month-long capstone course that evaluates Cadet leadership. Although the relationship between sleep and objective performance is well established, less is known about how sleep may impact self-perception of performance, especially in the military context. This study examined the impact of habitual sleep on self-expected and objective AC performance. Methods 577 Cadets (age 22.22 ± 2.74; 74.36% male) completed the Pittsburgh Sleep Quality Index (PSQI) at baseline to measure subjective sleep quality (Global; higher scores indicate poorer sleep quality) and total sleep time (TST) in the month before training. Self-expected AC performance was captured by asking Cadets to estimate what their final performance score would be and objective performance was determined from summary scores from Instructors. Performance discrepancy was calculated as the difference between Cadet’s expected and objective scores. Regression models assessed the predictive utility of habitual TST and Global on performance. Results Ordinal regressions showed that as Global increased, expected AC score also decreased with an OR of .684 (95% CI, -.694 to -.064), Wald χ2(1) = 5.56, p = .018. Further, Global independently predicted performance discrepancies, where the odds of a difference existing between a Cadet’s self-expected and their objective performance was .895 less likely for those with increasing Global (p = .028). Together TST and Global predicted discrepancy magnitude between Cadet self-expected and objective performance, F(2, 349) = 2.99, p = .05, with Global as a independent predictor p < .05. Independent findings related to TST were varied and warrant further testing. Conclusion Cadets with poorer sleep quality prior to AC self-expected to perform worse and had discrepancies between their self-expected and objective performance when compared to those with higher sleep quality. TST enhanced the predictive power of Global when predicting magnitude of performance discrepancy. Therefore future research examining Global, while accounting for TST, is warranted to better understand how sleep may influence self-expectations of military performance. Support (if any) Support for this study came from the Military Operational Medicine Research Program of the United States Army Medical search and Development Command.

Associations of Sleep Quality with Gait Speed and Falls in Older Adults: The Mediating Effect of Muscle Strength and the Gender Difference

Introduction: Although previous studies have reported the significant associations of sleep quality with gait speed and falls, the mechanisms underlying these associations are unclear. We aimed to examine the gender-specific associations of sleep quality with gait speed and falls among older adults and to explore the possible mediating effect of muscle strength on these relationships. Methods: Data were taken from wave 6 (2012–2013) of the English Longitudinal Study of Aging (ELSA), including 7,664 participants aged 60 years and older. Sleep quality and falls were assessed by self-report. Gait speed was measured by the “timed walking test” and then adjusted by height. As an indicator of overall muscle strength, grip strength was measured by using the Smedley dynamometer. Baron and Kenny’s causal steps and the Karlson/Holm/Breen method were used to examine the mediating effect. Results: Higher sleep quality was associated with the higher level of gait speed (β = 0.008, p = 0.031 in men; β = 0.008, p = 0.017 in women) and with lower prevalence of falls (OR = 0.878, 95% CI: 0.773, 0.998 in men; OR = 0.874, 95% CI: 0.792, 0.965 in women). Grip strength mediated these associations in men but not in women, and the mediating effects of grip strength can explain 23.74 and 11.01% of the total effect of sleep quality on gait speed and falls, respectively. Conclusion: Our findings help explain the mechanism underlying the associations of sleep quality with gait speed and falls. Effort to maintain the mobility of the older men should focus on improving both sleep quality and muscle strength.

Self-reported daily sleep quality modulates the impact of the framing effect on outcome evaluation in decision-making under uncertainty: An ERP study

A growing body of research has largely confirmed and supported the idea that experimental sleep loss, such as sleep deprivation or sleep restriction, could affect individuals' risk-taking behavior and brain activity. However, whether self-reported sleep quality resulting from daily life modulates how feedback is evaluated during decision-making is still unclear. In this study, we used event-related potentials (ERPs) with a Balloon Analogue Risk Task (BART) to investigate how self-reported daily sleep quality modulates the brain's response to feedback from decision-making in the gain and loss frames. Behavioral data showed an increased aversion to uncertainty in the gain frame relative to the loss frame for individuals with higher sleep quality. However, this was not true for individuals with lower voluntary sleep quality. Similarly, the ERP data demonstrated that individuals with lower self-reported daily sleep quality displayed no changes in feedback-related negativity (FRN) in response to outcomes from decision-making in the gain and loss frames; however, individuals with higher self-reported daily sleep quality showed a greater FRN in response to decision-making in the gain frame than that in the loss frame. A Pearson correlation analysis showed that self-reported daily sleep quality was positively related to the variance of the FRN amplitude in response to the gain and loss frames. These findings suggest that framing effects on decision-making under uncertainty may depend on self-reported daily sleep quality and that the effects disappear when the sleep quality declines.

The value of Bayesian predictive projection for variable selection: an example of selecting lifestyle predictors of young adult well-being

BackgroundVariable selection is an important issue in many fields such as public health and psychology. Researchers often gather data on many variables of interest and then are faced with two challenging goals: building an accurate model with few predictors, and making probabilistic statements (inference) about this model. Unfortunately, it is currently difficult to attain these goals with the two most popular methods for variable selection methods: stepwise selection and LASSO. The aim of the present study was to demonstrate the use predictive projection feature selection – a novel Bayesian variable selection method that delivers both predictive power and inference. We apply predictive projection to a sample of New Zealand young adults, use it to build a compact model for predicting well-being, and compare it to other variable selection methods.MethodsThe sample consisted of 791 young adults (ages 18 to 25, 71.7% female) living in Dunedin, New Zealand who had taken part in the Daily Life Study in 2013–2014. Participants completed a 13-day online daily diary assessment of their well-being and a range of lifestyle variables (e.g., sleep, physical activity, diet variables). The participants’ diary data was averaged across days and analyzed cross-sectionally to identify predictors of average flourishing. Predictive projection was used to select as few predictors as necessary to approximate the predictive accuracy of a reference model with all 28 predictors. Predictive projection was also compared to other variable selection methods, including stepwise selection and LASSO.ResultsThree predictors were sufficient to approximate the predictions of the reference model: higher sleep quality, less trouble concentrating, and more servings of fruit. The performance of the projected submodel generalized well. Compared to other variable selection methods, predictive projection produced models with either matching or slightly worse performance; however, this performance was achieved with much fewer predictors.ConclusionPredictive projection was used to efficiently arrive at a compact model with good predictive accuracy. The predictors selected into the submodel – felt refreshed after waking up, had less trouble concentrating, and ate more servings of fruit – were all theoretically meaningful. Our findings showcase the utility of predictive projection in a practical variable selection problem.

The Military Service Sleep Assessment: an instrument to assess factors precipitating sleep disturbances in U.S. military personnel.

Military personnel frequently experience sleep difficulties, but little is known regarding which military or life events most impact their sleep. The Military Service Sleep Assessment (MSSA) was developed to assess the impact of initial military training, first duty assignment, permanent change of station, deployments, redeployments, and stressful life events on sleep. This study presents an initial psychometric evaluation of the MSSA and descriptive data in a cohort of service members. The MSSA was administered to 194 service members in a military sleep disorders clinic as part of a larger study. Average sleep quality on the MSSA was 2.14 (on a Likert scale, with 1 indicating low and 5 indicating high sleep quality), and 72.7% (n = 140) of participants rated their sleep quality as low to low average. The events most reported to negatively impact sleep were stressful life events (41.8%), followed by deployments (40.6%). Military leadership position (24.7%) and birth/adoption of a child (9.7%) were the most frequently reported stressful life events to negatively impact sleep. There were no significant differences in current sleep quality among service members with a history of deployment compared with service members who had not deployed. The MSSA is the first military-specific sleep questionnaire. This instrument provides insights into the events during a service member's career, beyond deployments, which precipitate and perpetuate sleep disturbances and likely chronic sleep disorders. Further evaluation of the MSSA in nontreatment-seeking military populations and veterans is required.

Association between Depression, Lifestyles, Sleep Quality and Sense of Coherence in a Population with Cardiovascular Risk.

People with cardiovascular risk have more depression than the general population. Depression and cardiovascular risk have been commonly linked to lower sense of coherence (SOC) values, unhealthy lifestyles, and poor sleep quality. The aim of this study was to analyze the association between depression, health-related lifestyles, sleep quality, and SOC in a population with cardiovascular risk. A cross-sectional study was conducted in 310 participants (aged 35–75 years) with cardiovascular risk. Sociodemographic and anthropometric characteristics, cardiovascular risk, SOC score, depression levels, sleep quality, and lifestyles (physical activity, diet quality (measured as the adherence to the Mediterranean diet), and tobacco and alcohol consumption) were determined. The regression analysis showed significant associations between depression levels and sex (odds ratio (OR): 2.29; 95% CI: 1.29, 4.07), diet (OR: 0.85; 95% CI: 0.73, 0.99), body mass index (BMI) (OR: 1.06; 95% CI: 1.01, 1.12), cardiovascular disease (CVD) (OR: 2.55; 95% CI: 1.18, 5.48), sleep quality (OR: 0.26; 95% CI: 0.15, 0.46), and SOC (OR: 0.96; 95% CI: 0.94, 0.98). Protective effects of male sex, a lower BMI, no CVD, a higher adherence to the Mediterranean diet, a high sleep quality, and a higher SOC were found. In conclusion, among lifestyles determined, only diet was associated with depression levels. SOC and sleep quality were also found as significant predictors for depression levels.

The Moderating Role of Sleep Quality on the Association between Neuroticism and Frontal Executive Function in Older Adults

ABSTRACT Objective/Background Personality traits are regarded as risk factors for cognitive impairment in older adults, while sleep disturbance and physical inactivity are also considered as modifiable risk factors. Therefore, it could be beneficial to investigate the effects of those modifiable risk factors on the relationship between personality traits and cognitive functions, to prepare appropriate strategies for mitigating cognitive impairment. Participants A total of 155 cognitively unimpaired older adults were included. Methods All participants underwent cognitive function tests using the Seoul Neuropsychological Screening Battery and examinations for personality traits using the Big Five Inventory. Individual physical activity and sleep quality were assessed using the International Physical Activity Questionnaire and Pittsburgh Sleep Quality Index, respectively. A hierarchical linear multiple regression analysis was performed to demonstrate the direct association between personality traits and cognitive functions, and the multiple moderator analysis was used to analyze the moderating effects of lifestyle factors on this association. Results Among the five personality traits, only neuroticism was negatively associated with the frontal executive and visuospatial functions after controlling age, sex, and years of education. Interestingly, the negative relationship between neuroticism and frontal executive function was alleviated in older adults with higher sleep quality. Conclusions Our findings demonstrated that higher sleep quality has significant moderating effects on the negative association between neuroticism and frontal executive functions in older adults, which suggests intervention for improving sleep quality such as cognitive behavioral therapy can be considered in older adults who have personality traits associated with a high risk of cognitive impairment.

The predictive power of sleep quality by morning-evening chronotypes, job satisfaction, and shift schedule in nurses: A cross-sectional study

Background:Among nurses, sleep quality is an important factor which can be associated with many other factors, including job satisfaction, Morning-Evening (ME) chronotypes, and shift schedule. Besides, poor sleep quality can cause some problems for nurses and negatively affect the quality of nursing care. Therefore, the present study aimed to determine the predictive power of sleep quality by ME chronotypes, job satisfaction, and shift schedule in nurses working in Urmia teaching hospitals in 2019.Materials and Methods:A total of 327 nurses working in teaching hospitals affiliated to Urmia University of Medical Sciences were recruited using stratified sampling. Data were collected using the demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Minnesota Satisfaction Questionnaire (MSQ), and the Composite Scale of Morningness (CSM). Data were analyzed using linear regression analysis and Pearson correlation coefficient.Results:The results of the Pearson correlation coefficient and linear regression analysis showed that the ME chronotypes (R2 = 0.51, p = 0.006), job satisfaction (R2 = 0.51, p = 0.001), and shift schedule (R2 = 0.51, p = 0.005) are significantly correlated with the sleep quality among nurses.Conclusions:We concluded that the sleep quality was correlated with ME chronotypes, job satisfaction, and shift schedule, so that increased job satisfaction was associated with improved sleep quality, and the shift to the morning chronotype was associated with decreased sleep quality. Rotating shifts were also associated with higher sleep quality.

The Impact of COVID-19 on Informal Caregivers’ Health Behaviors

The population of older adults aged 65+ in the US is projected to increase from 15% to 21% in the next 30 years. Aging in place provides cost-savings and familiarity to the older adult, but often requires informal caregivers. Informal caregivers, individuals who provide unpaid care of assistance to family members and friends may have been uniquely impacted by the COVID-19 pandemic and shelter-at-home orders. Research is needed to examine how the pandemic impacted caregivers’ caregiving responsibilities and health behaviors (e.g., physical activity, sedentary time, fruit and vegetable intake, snacking, etc.) as this information will be invaluable to determine if health promotion interventions are needed for informal caregivers. Self-reported data were gathered from informal caregivers providing care to someone aged 50+ (n=835) through Amazon’s Mechanical Turk. Respondents reported their current and pre-pandemic health behaviors and demographics. Chi-square tests were used to examine bivariate associations between pandemic time (pre vs. post) and each examined behavior. The analysis identified some positive health behavior changes due to the pandemic: caregivers felt since the pandemic they ate more fruits and vegetables (p < .001), walked more, exercised more (p < .001), increased amounts of sleep (p < .001), and higher sleep quality (p < .001). However, respondents also had more screen time (p < .001) and sedentary time (p < .001). Future planned analyses will focus on examining whether these changes were consistent across all sociodemographic subgroups of caregivers and whether they persist after the pandemic recedes.

Better Night’s Sleep and Subjective Cognition: The Role of Day and Night Work Shifts

Previous research indicates poor sleep and cognitive functioning are associated. Studies have yet to consider the role of work shift on this relationship. The current study examined the sleep and subjective cognition relationship in nurses, and if this relationship differed for day- and night- shift nurses. Sixty-one nurses (M=35.39, SD=11.73; 39 day-, 22 night-shift) reported their nightly sleep characteristics and next-day subjective cognition (i.e., processing speed, memory, and mental focus) using ecological momentary assessments for 2 weeks. Multilevel models controlled for sociodemographic characteristics and decomposed the variance attributed by between- and within-person levels. At the within-person level, better sleep the previous night was associated with better subjective cognition the following day. This relationship was more apparent in night-shift nurses than in day-shift nurses, such that (a) longer sleep duration predicted better mental focus (B=1.62, p<.05) and (b) higher sleep quality predicted better memory (B=8.67, p<.001). At the between-person level, better sleep overall was associated with better subjective cognition across days. This association was more apparent in day-shift nurses than in night-shift nurses, such that (a) better sleep quality and sufficiency predicted faster processing speed (B=34.33; B=26.28; p<.001) and (b) better sleep quality and greater sleep sufficiency predicted better memory (B=30.94; B=23.09; p<.001). Findings suggest that sleep characteristics are associated with subjective cognition in nurses day-to-day and on average. Specific sleep characteristics associated with subjective cognition differ between day- and night-shift nurses, presumably due to differences in their sleep issues and perceived cognitive abilities.

Self‐reported quality of sleep is related to frontoparietal network connectivity in mild cognitive impairment

AbstractBackgroundSleep has been identified as a modifiable factor involved in both the development and progression of Alzheimer’s disease (AD). Previous findings have suggested that poor sleep may be associated with increased risk of AD. Conversely, higher quality of sleep may slow progression of pathophysiological mechanisms in mild cognitive impairment (MCI) through functional connectivity reorganization of neural networks underlying higher cognitive functions.MethodIn clinic, 38 MCI patients and 38 age‐matched controls completed structural magnetic resonance imaging (MRI), resting‐state functional MRI (rs‐fMRI), and a cognitive test battery, covering memory, executive functions, and language. The Sleep Continuity in Alzheimer’s Disease Scale (SCADS) was used to assess sleep quality. Patients were stratified into “good” (n=20) and “poor” (n=18) sleepers, using the median SCADS score as a cut‐point. Default mode (DMN) and left and right frontoparietal (FPN) networks were reconstructed through an independent component analysis approach. Differences in network connectivity across MCI groups were investigated with non‐parametric inference using FSL randomize (n=5000 permutations), corrected at a threshold‐free‐cluster enhancement level of pFWE &lt; 0.025. Grey matter and sex were inserted as covariates in the analysis. The same model was implemented to investigate associations between connectivity and cognition in MCI. Finally, between‐network connectivity was assessed through partial correlation with sex as covariate.ResultMCI good sleepers showed increased FPN connectivity compared to MCI poor sleepers. Increased FPN connectivity was positively associated with language performance in the former group. Finally, we found a positive coupling connectivity between DMN and FPN and between left and right FPN in MCI good sleepers, while this pattern was disrupted in MCI patients with lower quality of sleep.ConclusionThese findings suggest a relationship between sleep quality and FPN connectivity in MCI, highlighting possible sleep‐induced compensatory mechanisms. Future studies in larger samples using longitudinal methods and objective measures of sleep will be necessary to confirm this finding. However, these results further support the concept that better sleep may be protective on the pathway to AD.

Sleep health is associated with next-day mindful attention in healthcare workers

ObjectivesPrevious studies have focused on the role of mindfulness in improving sleep health. Sleep health may also increase daily mindfulness; however, this potential directionality is understudied, with a lack of research on healthcare workers who need high-quality sleep and mindful attention for patient care. This study examined whether sleep health predicts next-day mindful attention, and vice versa, in nurses. DesignSmartphone-based ecological momentary assessment. SettingU.S. hospitals. ParticipantsSixty-one full-time nurses. MeasurementsFor 2 consecutive weeks, participants provided actigraphy-measured and self-reported daily sleep characteristics. We examined 8 sleep variables across 5 key dimensions: satisfaction (self-report of sleep sufficiency, quality, and insomnia symptoms), alertness (self-report of daytime sleepiness), timing (actigraphy bed- and wake- times), efficiency (actigraphy percentage of time spent asleep during time in bed), and duration (actigraphy sleep duration). Participants reported state mindfulness specific to attention and awareness. Covariates included previous night's sleep, sociodemographics, work shift, workday (vs. nonworkday), and weekend (vs. weekday). ResultsMultilevel modeling revealed that, at the within-person level, after nights with greater sleep sufficiency, better sleep quality, lower efficiency, and longer sleep duration, daily mindful attention was greater than usual. Daily mindful attention was inversely associated with sleepiness, but not predictive of other sleep characteristics. At the between-person level, participants with greater sleep sufficiency, higher sleep quality, and fewer insomnia symptoms reported greater mindful attention overall. ConclusionFindings show that optimal sleep health is an antecedent of daily mindful attention in nurses. Improving sleep may provide important benefits to their well-being and to the quality of patient care.

Association Between Sleep Disturbances and Frailty: Evidence From a Population-Based Study

ObjectiveTo explore the association between both self-reported quality and quantity sleep characteristics and frailty status in a large non–sex-specific population of older individuals in Greece. DesignCross-sectional study. Setting and ParticipantsIn total, 1984 older individuals (≥65 years old) were drawn from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). MeasuresFrailty was assessed using 3 different definitions, the Frailty Index (FI), the Tilburg Frailty Indicator (TFI), and the Groningen Frailty Indicator (GFI). Sleep quality was evaluated through the Sleep Index II, which includes 9 of the 12 self-reported items of the Medical Outcomes Study-Sleep Scale. To examine sleep duration, participants were asked to report on how many hours they slept each night during the past 4 weeks. Logistic regression models adjusted for multiple covariates were explored. Additional analyses, stratified by gender, adjusting for sleep-related medications and excluding participants diagnosed with dementia, were also performed. ResultsIn total, 389 (20%), 619 (31.9%), and 608 (31.3%) participants were categorized as frail according to the FI, the TFI, and the GFI respectively. Sleep quality was significantly associated with frailty in all models. Even after adjusting for subjective sleep duration, compared with participants who subjectively reported high sleep quality, those with low sleep quality had 3.7, 2.6, and 2.5 more times to be frail as measured with FI, TFI, and GFI respectively. Regarding the associations between frailty and self-reported sleep duration, sex-specific associations were observed: prolonged sleep duration was associated with frailty in the subsample of male participants. Conclusions and ImplicationsThe present study shows a strong correlation between subjective sleep quality and frailty status, contributing substantial information to the growing literature demonstrating that sleep is associated with older people's overall health. Sleep complaints should not be underestimated, and older individuals who self-report sleep disorders should be further assessed for frailty.

Which objective sleep elements predict children's perceptions of good sleep quality? A preliminary investigation based on polysomnography and actigraphy

ObjectivesObjective sleep elements that underlie child ratings of sleep quality are largely unknown. Child-based sleep recommendations, therefore, typically focus on duration. An expert panel recently provided specific recommendations regarding objective sleep parameters that correspond with higher quality sleep, but child-based studies from which to draw conclusions were notably limited. The present study used actigraphy and polysomnography to explore sleep continuity and architectural variables that correspond with higher ratings of sleep quality in a sample of school-aged children. MethodsFifty-two healthy, prepubertal children (aged 7–11 years) completed one night of unattended ambulatory polysomnography at home with concurrent actigraphy and provided sleep quality ratings the following morning. Associations between sleep variables and subjective ratings were examined using polynomial regression models to examine potential linear and nonlinear relationships. ResultsIn contrast to findings among adults, total sleep time, sleep onset latency, and sleep efficiency values were unrelated to child ratings of sleep quality. Wake after sleep onset (WASO) showed a curvilinear (reversed j-shaped) relationship such that perceptions of sleep quality were high when WASO values were less than approximately 30 minutes. For sleep architecture, N1% showed a significant quadratic association with sleep quality such that N1% between 2% and 6% corresponded with high sleep quality ratings. ConclusionsOur findings support expert recommendations regarding WASO values that predict high quality sleep in children, but also await replication. There is need for additional research aimed at understanding objective sleep elements and other influences of children's perceptions of sleep quality using linear and nonlinear models.

Poor Sleep Quality Is Associated with Altered Taste Perception in Chinese Adults

BackgroundSmall clinical studies have suggested that individuals with insufficient sleep could experience taste dysfunction. However, this notion has not been examined in a large-scale, population-based study. ObjectiveThis study aimed to examine whether overall sleep quality, as assessed by insomnia, daytime sleepiness, snoring, and sleep duration, was associated with the odds of having altered taste perception in a large population-based study. DesignThis was a cross-sectional study that used data from a subcohort of the Kailuan study, an ongoing multicenter cohort study that began in 2006 in Tangshan City, China. Participants/settingThe participants were 11,030 adults aged 25 years or older (mean age 53.7 ± 10.7 years), who were free of neurodegenerative diseases. All the participants had undergone questionnaire assessments and medical examinations at Kailuan General Hospital from June 2012 to October 2013. Main outcome measuresAltered taste and olfactory perception were assessed via a questionnaire with two questions regarding whether participants had any problems with sense of taste or smell for ≥3 months. Statistical analyses performedThe association between sleep quality and altered taste/olfactory perception was examined using a logistic regression model, adjusting for age, sex, lifestyle factors (eg, obesity, smoking, alcohol intake, and physical activity) and health status (eg, lipid profiles, blood pressure, modification use, and presence of chronic diseases). ResultsPoor overall sleep quality was associated with a higher risk of having altered taste perception (adjusted odds ratio for low vs high sleep quality 2.03, 95% CI 1.42 to 2.91; P < 0.001). Specifically, insomnia, daytime sleepiness, and short sleep duration, but not prolonged sleep duration and snoring, were significantly associated with altered taste perception. A significant association between overall sleep quality and the risk of having altered olfactory perception was also observed (adjusted odds ratio for low vs high sleep quality 2.17, 95% CI 1.68 to 2.80; P < 0.001). ConclusionsIn this population-based study, poor sleep quality was associated with a high likelihood of altered taste perception.

Healthier dietary patterns are associated with better sleep quality among midlife Mexican women.

To evaluate whether dietary patterns are associated with sleep quality in Mexican midlife women. The study population included 4,467 Mexican women from a longitudinal study of teachers. In 2008, a semiquantitative food frequency questionnaire was administered. Principal components analysis identified 3 dietary patterns: Fruits and Vegetables, Western (meat and processed), and Modern Mexican (tortillas and soda, low in fiber and dairy). Starting in 2012, follow-up questionnaires included the Pittsburgh Sleep Quality Index, which yields a score ranging from 0 to 21 (higher scores = worse quality). Modified Poisson regression analyses examining the association between dietary patterns (categorized into quartiles) and poor sleep quality (score > 5) were conducted, adjusting for socio-demographic and lifestyle confounders and baseline comorbid conditions. Women were 41.0 ± 7.1 years at baseline, with an average follow-up of 5.5 ± 0.7 years. In fully adjusted models, women in the least-healthy quartile of the Fruits and Vegetables pattern compared with the most were 21% more likely to have poor quality sleep at follow-up (95% confidence interval 1.06, 1.42), while those in the highest quartiles of the Modern Mexican pattern were 23% more likely to have poor quality sleep compared with the lowest quartiles (95% confidence interval 1.06 to 1.43, respectively). A fruit and vegetable-based dietary pattern was associated with higher sleep quality, while an unhealthier diet pattern was associated with worse sleep quality in midlife women.

Sleep quality among orthopaedic patients in Denmark – A nationwide cross-sectional study

BackgroundHospitalised patients sleep less and have a lower quality of sleep compared to patients who recover in their own home. Low sleep quality is associated with complications such as increased pain sensation, delirium and reduced rehabilitation capacity. PurposeTo investigate patients’ self-reported sleep quality and factors related to sleep quality during admission to a department of Orthopaedic Surgery. MethodsThe Richard-Campbell Sleep Questionnaire was used to assess patients’ sleep quality, measured using a VAS 0–100 scale, (a higher score indicating good sleep quality). The moderated Pittsburgh Sleep Quality Index assessed the most severe and frequent barriers to high sleep quality. ResultsA total of 533 patients undergoing orthopaedic surgery participated. There was an overall mean sleep quality score of 54. The most common and severe factors impacting sleep quality were; waking during the night, difficulties falling asleep, waking early, waking for toileting or pain. The intensity of the pain was found to be proportional to the quality of sleep. ConclusionPatients reported their overall quality of sleep to be moderately good due to difficulties falling asleep, waking up during the night or early morning and having pain. The results call for better pain management and non-pharmacological nursing interventions to optimise sleep quality.