Level Of Daytime Sleepiness Research Articles

MODERN CONCEPT OF POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING URGENT LAPAROSCOPIC CHOLECYSTECTOMY

According to randomized studies, after surgical interventions such as laparoscopic cholecystectomy, severe and very severe pain is observed in 30 % to 87 % of patients. Regional techniques such as subcostal transversus abdominal plane block (Subcostal TAP-block) significantly improve the quality of postoperative analgesia. The aim of our study was to compare the effectiveness of postoperative analgesia when using multimodal analgesia and when combining it with subcostal TAP-block in patients with acute cholecystitis who underwent laparoscopic surgery. Materials and methods. 60 patients with acute cholecystitis who underwent laparoscopic surgery were examined. We investigated the level of pain according to the visual analog scale (VAS), hemodynamic parameters, glycemia level, frequency of nausea/vomiting, time to intestinal peristalsis recovery, time to activization, need for additional anesthesia, subjective assessment of sleep quality, level of daytime sleepiness (Epworth sleepiness scale), level of anxiety (Beck anxiety scale). Results. Upon admission, patients with acute cholecystitis had moderate pain syndrome (5.7±0.7 – 6.2±0.7 points according to VAS), both at rest and during movement, which was accompanied by nausea or vomiting in 43.1 % – 48.3 % of patients. In the early postoperative period, the level of pain when using the TAP block was significantly lower than in the control group, with a maximum effect after 2-4 hours. This was accompanied by a decrease in tachycardia by 12.7 % – 13.1 % (p<0.05), a decrease in the frequency of postoperative nausea and vomiting by 15.8 % – 42.5 % (p<0.05). Restoration of gastrointestinal function in the TAP block group was observed 4.4 hours earlier (p=0.049), and activation of patients was observed 7.9 hours earlier (p=0.01). Sleep quality in the TAP block group was significantly higher in the first three days after surgery, which led to a decrease in daytime sleepiness. Conclusions. In patients with acute cholecystitis, operated laparoscopically, the expansion of multimodal analgesia with regional techniques (TAP block) allowed to reduce the pain level to 1.8±0.5 – 3.1±0.4 points on the VAS at rest and to 1.9±0.6 – 3.0 ±0.4 points during movement; avoid the use of narcotic analgesics, reduce the level of tachycardia, accelerate the activation of the patient and the motor function of the intestine, as well as improve the psycho-emotional state of patients by improving the quality of night sleep and reducing the level of daytime drowsiness.

Insomnia symptoms in children and adolescents: screening for sleep problems with the two-item Sleep Condition Indicator (SCI-02)

BackgroundSleep problems are common in young people. Yet brief screening measures to identify those most in need of an intervention are lacking. This study investigated the potential of the two-item Sleep Condition Indicator (SCI-02) for screening insomnia symptoms in children and adolescents. We sought to establish whether there are distinct subgroups with different sleep profiles and whether subgroup membership varied with gender and school year group.MethodsStudents (school years 5–13; typical age 9–18 years) in England completed the OxWell Student Survey in 2021. Sleep measures included: SCI-02, sleep onset latency (SOL), sleep duration, daytime sleepiness, and worry disrupting sleep. Latent profile analysis and multinomial logistic regression explored sleep profiles and predicted class membership.ResultsIn total, 29,304 participants answered sleep items. Of these, 95% provided binary gender (n = 27,802, 55% female) for analyses. Five sleep profiles emerged. The profiles, labelled “good”, “moderate”, or “poor” sleepers, vary by sleep quality – which includes time taken to fall asleep (SOL), amount of sleep (sleep duration), and the disruption of sleep due to worry. The profiles are then further differentiated by high levels of daytime sleepiness – labelled “sleepy”. “Good Sleepers” (18,355, 66%), “Moderate Sleepers” (4825, 17.4%), “Moderate Sleepy Sleepers” (1250, 4.5%), “Poor Sleepers” (1037, 3.7%) and “Poor Sleepy Sleepers” (2335, 8.4%). Probable insomnia rates (SCI-02 ≤ 2) were high in both poor sleeper profiles (70–80%) compared with other profiles (0%) and the sample overall (9%). Compared with “Good Sleepers”, all other profiles were mostly female. Daytime sleepiness – the defining characteristic of the sleepy sleeper profiles – was more common in secondary school participants than primary school.ConclusionsThe SCI-02 is an efficient, two-question measure to screen for potential sleep problems in young people. Sleep disruption was high: one in ten were experiencing poor sleep. Females and adolescents appeared more vulnerable to poor sleep and daytime sleepiness. The SCI-02 has the potential for use in school and community contexts to identify children and adolescents who may benefit from support managing their sleep.

Examination of Coaches’ Daytime Sleepiness Levels in Terms of Gender, Physical Activity Level and Waist Circumference

Introduction and Aim: The aim of this study is to examine coaches’ daytime sleepiness levels in terms of gender, physical activity level and some anthropometric variables. Materials and Methods: Participants in the study were 330 coaches, 173 of whom were women, working in the branches of basketball, boxing, fitness, football, karate, kickboxing, taekwondo and volleyball in the Bağcılar district of Istanbul. The participants’ daytime sleepiness levels were determined with the Epworth Sleepiness Scale, whose Turkish validity and reliability study was conducted by İzci et al. (2008), while their physical activity levels were determined with the International Physical Activity Questionnaire (IPAQ) short form, whose Turkish validity and reliability study was performed by Öztürk (2005). The participants’ anthropometric characteristics (body weight, height and waist circumference) were assessed on a self-report basis. Findings: Female coaches’ scores on the Epworth Sleepiness Scale were higher than those of male coaches (p < 0.05). In terms of physical activity level, male coaches’ IPAQ scores were higher than those of female coaches (p = 0.00). Waist circumferences and body mass indices (BMI) of male coaches were higher than those of female coaches (p = 0.00). No correlation was found between daytime sleepiness level and BMI (r = .066) or waist circumference (r = -.050) (p > 0.05). A significant negative correlation was found between physical activity level and daytime sleepiness level (r = -113, p < 0.05). Conclusion: The detection of a significant negative correlation between physical activity level and daytime sleepiness level indicates that physical activity is important for sleep health, which is similar to the literature. However, the fact that the study participants were young makes it difficult to explain the relationships between physical activity, gender, daytime sleepiness level and body composition. Repeating the study with middle-aged adults and older adults may produce different results

Fatigue in patients with hypothalamic syndrome – A cross-sectional analysis of the German childhood-onset craniopharyngioma cohort

ObjectivePatients with suprasellar tumors are at risk for hypothalamic syndrome (HS), including fatigue and excessive daytime sleepiness. The aim of this cross-sectional study was to determine the severity of fatigue in patients with and without HS. MethodsPatients diagnosed with CP or pilocytic astrocytoma were recruited from the KRANIOPHARYNGEOM studies. Eligibility criteria were availability of one completed Multidimensional Fatigue Inventory-20 (MFI-20) questionnaire and complete medical records on criteria for HS. The associations between HS and levels of fatigue symptoms (MFI-20 sum score) were assessed. MFI-20 scores were compared to sex- and age-matched reference values from a German normative population. ResultsData on 41 patients, with a median age of 22 years, were available for analyses of which 25 (61 %) patients presented with HS. After adjustment for age and sex, patients with HS reported higher scores in the physical (β= 3.39 [95 %-CI:1.18–5.60]) and sum MFI-20 (β=11.42 [95 %-CI:2.06–20.79]) domain than patients without HS. Compared to reference values, all patients reported higher mean scores in each fatigue domain. Abnormal self-reported daytime sleepiness was reported in 6 of 25 (24 %) patients with HS. Regardless of the level of daytime sleepiness in patients with HS, the reported fatigue scores were high. Daytime sleepiness did not correlate with fatigue. ConclusionsFatigue symptoms are present in patients with CP. However, patients with HS are more affected with physical and overall fatigue. It is crucial in clinical practice, to distinguish between daytime sleepiness and fatigue and to target patients with HS.

CP-01. FATIGUE IN PATIENTS WITH HYPOTHALAMIC SYNDROME – A CROSS-SECTIONAL ANALYSIS IN THE GERMAN CHILDHOOD-ONSET CRANIOPHARYNGIOMA COHORT

Abstract BACKGROUND Patients with tumors of the sellar region are at risk of developing hypothalamic syndrome. Survivors experience fatigue and excessive daytime sleepiness even years after tumor treatment. The aim of this cross-sectional study was to determine the severity of fatigue in patients with and without hypothalamic syndrome. METHODS Patients diagnosed with CP or pilocytic astrocytoma were recruited from the KRANIOPHARYNGEOM 2000/2007/Registry 2019 studies and included in this analysis. Eligibility criteria were regular participation in outpatient after-care, one completed Multidimensional Fatigue Inventory-20 (MFI-20) questionnaire and complete medical records on criteria for hypothalamic syndrome. With univariable and multivariable linear regression, the relation of hypothalamic syndrome and levels of fatigue symptoms (MFI-20 sum score) were assessed. MFI-20 scores were compared to sex- and age-matched reference values from a German normative population using paired t-test. RESULTS Data on 46 patients, with a median age of 20 years, was available for this analysis of which 28 (61%) patients presented with hypothalamic syndrome. After adjustment for age and sex, patients with hypothalamic syndrome reported higher scores in the physical (= 3.61 [95% CI: 1.38–5.85]), mental (= 2.80 [95% CI: 0.28–5.32]) and sum MFI-20 (= 12.02 [95% CI: 2.93–21.10]) domain than patients without hypothalamic syndrome. Compared to reference values from a general German population, all patients reported higher mean scores in each fatigue domain. Regardless of the level of daytime sleepiness in patients with hypothalamic syndrome, the reported fatigue scores were high. Daytime sleepiness did not correlate with fatigue. CONCLUSIONS Fatigue symptoms are present in patients with CP. However, patients with hypothalamic syndrome are more affected in mental, physical and overall fatigue. It is crucial in clinical practice, to distinguish between sleep disorders and fatigue and to target patients with hypothalamic syndrome.

Revealing inconsistencies between Epworth scores and apnea-hypopnea index when evaluating obstructive sleep apnea severity: a clinical retrospective chart review.

A common practice in clinical settings is the use of the Epworth Sleepiness Scale (ESS) and apnea-hypopnea index (AHI) to demonstrate the severity of obstructive sleep apnea (OSA). However, several instances were noted where there were discrepancies in the reported severity between Epworth scores and AHI in our patient sample, prompting an investigation into whether OSA severity as demonstrated by AHI or predicted by ESS quantification of sleepiness is primarily responsible for inconsistencies. Discrepancies were examined between Epworth scores and AHI by categorizing patients into two categories of inconsistency: individuals with either ESS < 10 and AHI ≥ 15 events/h or ESS ≥ 10 and AHI < 15 events/h. The potential influence of sex on these categories was addressed by assessing whether a significant difference was present between mean Epworth scores and AHI values for men and women in the sample. We investigated BMI both by itself as its own respective variable and with respect to the sex of the individuals, along with a consideration into the role of anxiety. Furthermore, we tested anxiety with respect to sex. In the first category of inconsistency the average ESS of 5.27 ± 0.33 suggests a normal level of daytime sleepiness. However, this contrasts with the average AHI of 32.26 ± 1.82 events/h which is indicative of severe OSA. In the second category the average ESS of 14.29 ± 0.47 suggests severe daytime sleepiness, contradicting the average AHI of 9.16 ± 0.44 events/h which only indicates mild OSA. Sex, BMI (both as a variable by itself and with respect to sex), and anxiety (both as a variable by itself and with respect to sex) contributed to observed inconsistencies. The findings of our study substantiate our hypothesis that Epworth scores should be de-emphasized in the assessment of OSA and a greater importance should be placed on measures like AHI. While Epworth scores offer insights into patients' daytime sleepiness levels and the perceived severity of their OSA, the inconsistencies highlighted in our results when compared to AHI-based OSA severity underscore their potential inaccuracy. Caution is advised when utilizing Epworth scores for evaluating OSA severity in clinical settings.

Пошук асоціацій між використанням мобільного телефону та якістю сну у хворих на цукровий діабет другого типу

Objective: to investigate and analyze the relationship between mobile phone use and sleep quality in patients with type 2 diabetes. Materials and methods. For the purpose of retrospective analysis of medical records, 71 patients with type 2 diabetes were included, and the BMI of these patients was calculated. The next stage of our research was a telephone survey to assess the quality of mobile phone use behavior. The level of daytime sleepiness was assessed according to the Epworth questionnaire. Statistical processing of the results was carried out using the computer program STATISTICA 7.0. Research results and their discussion. When comparing the studied indicators of patients with T2DM of different ages depending on the duration of mobile phone use, it was established that the systolic blood pressure, age and BMI were probably higher in mature patients with a duration of mobile phone use of more than 8 years compared to the data of patients who have been using the phone for 5-8 years. At the same time, the age of patients and SAT among the elderly group was probably higher in patients with a term of use of more than 8 years compared to those who have been using a mobile phone for 5-8 years. Patients with T2DM have moderate (14.08%) and severe (77.47%) daytime sleepiness. Conclusions. A significantly higher percentage of mature and elderly T2DM patients who used a phone for more than 8 years was established, compared to the indicators in the group with a duration of 5-8 years of phone use, which in the case of mature age was associated with a significantly higher level of systolic blood pressure and BMI.

Evaluating Sleep Challenges in Hospitalized Youth.

To characterize sleep quality and sleep disruptions among youth hospitalized outside of the intensive care unit (ICU). Participants were eligible for the survey-based study if they were 8-17 years old, English-speaking, hospitalized for ≥3 days outside of the ICU, and developmentally able to understand surveys. Survey administration included a sleep diary, the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), and a study-specific Inpatient Sleep Disruptors Questionnaire. The chart review provided additional clinical information. Descriptive and comparative statistics were performed to assess the association between overnight clinical monitoring and daytime sleepiness. Forty-five participants (mean age 13.4 years, 60% female), recruited between May and December 2022, were included in the study. Mean total sleep time (8.2 ± 1.7 hours) and ESS-CHAD score (8.6 ± 4.3) were normal with 79% reporting fair to good sleep the previous night.Participants rated alarms on equipment, vital signs, and noise as most disruptive to sleep. Participants with vital signs every four hours showed higher levels of daytime sleepiness compared with participants with vitals measured every shift (9.3 vs. 6.3; p=0.04). Most participants reported normal sleep, although there was wide variability with a portion with impaired sleep quality and elevated daytime sleepiness. Alarms on equipment, vital signs, and noise were most disruptive, and increased vital sign frequency was also associated with increased daytime sleepiness. In clinically stable pediatric patients, a reduction in vital sign monitoring overnight may be an important change to improve patient sleep.

Daytime Sleepiness from Preschool Children's and Parents' Perspectives: Is There a Difference?

This cross-sectional study investigated the level of daytime sleepiness and sleep-related behaviors in preschool children and compared their self-evaluations with the evaluations of their parents. It was conducted in Split-Dalmatian County, Croatia, among 196 preschool children aged 6-7 years seen at regular medical examinations, accompanied by their parents, using the Epworth sleepiness scale for children and parents/caregivers. Compared to their child's reports, parents tended to underestimate their child's sleepiness while sitting in a classroom at school (p = 0.001) and overestimate their child's sleepiness when lying down to rest or nap in the afternoon (p < 0.001). Boys were sleepier while sitting in a classroom at school during the morning than girls (p = 0.032). As much as 48.2% of preschool children had their own cellphones/tablets. Boys used video games (p < 0.001) and cellphones/tablets more than girls did (p = 0.064). Parental estimation of children playing video games at bedtime was lower than the child's report (p < 0.001). Children who had a TV in their bedroom reported more daytime sleepiness (p = 0.049), and those who played video games at bedtime went to sleep later during the weekend (p = 0.024). Also, children owning cellphone/tablets had longer sleep latency during the weekend compared to children not owning a cellphone (p = 0.015). This study confirmed that parents tend to underestimate children's habits of playing video games at bedtime and children's sleepiness during morning classes. Preschool children who use electronic devices at bedtime more frequently have prolonged sleep latency. These findings provide further evidence of the effects of electronic media devices on preschoolers' sleep patterns and daytime sleepiness.

Rehabilitation in obstructive sleep apnea: an ignored treatment adjunct.

Patients with obstructive sleep apnea (OSA) remain physically inactive during the day, are deconditioned, and have an impaired health-related quality of life (HRQoL). The role of rehabilitation is not yet defined in OSA, despite proven effective modalities for chronic illnesses like chronic obstructive pulmonary disease. In this prospective study, over a period of one year, 30 individuals with sleep-disordered breathing were included. Before recruitment, every patient was receiving continuous positive airway pressure treatment for at least 4 weeks. A statistically significant negative correlation was seen between the apnea hypopnea index and reductions in 6-minute walk distance, energy, and general health, which signified that patients with greater levels of daytime sleepiness have poor quality of life and are more deconditioned. Enrolled patients in the study underwent a 20-session rehabilitation program (with a minimum of 2 sessions per week). The patient received resistance and endurance exercises, dietary guidance, and counseling at each session. Before and after rehabilitation, target parameters such as 6MWD, HRQoL domains, Epworth sleepiness scale (ESS), and body mass index (BMI) were recorded. All 8 HRQoL domains showed improvement post-rehabilitation. Along with improvements in ESS and BMI, the 6MWD was also improved. No adverse event such as cardio-respiratory distress occurred in individuals undergoing rehabilitation. To conclude, rehabilitation is a safe and efficacious modality as an adjunct to positive airway pressure therapy in OSA patients.

Predictors of adherence to a brief sleep extension protocol in emerging adults.

This study examined how mental health symptoms (i.e., depression, anxiety, stress) and baseline sleep characteristics (i.e., sleep quality and levels of daytime sleepiness) predicted adherence to and initial success of a brief sleep extension research protocol in emerging adults. 184 emerging adults (ages 18-25; M = 20.96, SD = 2.04) were asked to extend their nightly sleep opportunity to 8hr for 1 week and to anchor bedtime and waketime. Sleep outcomes (adherence and initial protocol success) were tracked using actigraphy. Baseline sleep quality, daytime sleepiness, depression, anxiety, and stress were assessed using self-report questionnaires. Poorer baseline sleep quality predicted better adherence to the protocol (p = .002). Other baseline sleep characteristics and mental health were not predictive of adherence (ps>.50). Lower levels of baseline daytime sleepiness approached significance in predicting greater initial protocol success following the protocol (p = .05). Baseline sleep quality and mental health did not predict initial protocol success (ps > 0.34). Mental health symptoms did not significantly predict adherence to or the success of a sleep extension protocol. Surprisingly, individuals with poor baseline sleep quality were more likely to adhere to the extension protocol, perhaps suggesting heightened motivation for change or increased risk for sleep problems. This research provides valuable insight into factors that predict adherence to sleep extension protocols in emerging adults.

An expedited model for identifying potential patients with periodic leg movements.

Periodic leg movements during sleep (PLMS) may have crucial consequences in adults. This study aimed to identify baseline characteristics, symptoms, or questionnaires that could help to identify sleep-disordered breathing patients with significant PLMS. Patients aged 20-80 years who underwent polysomnography for assessing sleep disturbance were included. Various factors such as sex, age, body measurements, symptoms, apnea-hypopnea index (AHI), and sleep quality scales were analysed to determine the presence of PLMS. The study included 1480 patients with a mean age of 46.4 ± 13.4 years, among whom 110 (7.4%) had significant PLMS with a PLM index of 15 or higher. There were no significant differences observed in terms of sex or BMI between patients with and without significant PLMS. However, the odds ratios (OR) for PLMS were 4.33, 4.41, and 4.23 in patients who were aged over 50 years, had insomnia, or had an ESS score of less than 10, respectively. Notably, the OR increased up to 67.89 times in patients who presented with all three risk factors. Our analysis identified significant risk factors for PLMS: age over 50, self-reported insomnia, and lower daytime sleepiness levels. These findings aid in identifying potential PLMS patients, facilitating confirmatory examinations and managing associated comorbidities.

Evaluating the effect of daytime sleepiness and sleep quality on balance, fatigue and life quality of shift workers.

Changes in the sleep-wake cycle in shift workers can cause many health problems. The aim of this study was to investigate the relationship between daytime sleepiness and sleep quality on balance, physical activity level, fatigue and quality of life in shift and non-shift workers. A total of 58 employees, 29 shifts and 29 non-shifts, were included in the study. Data were collected using the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the Tandem Posture Test, the One-Foot Stand Test, the Ten-Step Tandem Walking Test, the International Physical Activity Questionnaire-Short Form, the Fatigue Severity Scale, and the Nottingham Health Profile. Individuals working in shifts had higher fatigue severity and daytime sleepiness levels (p < 0.05), while physical activity levels and sleep quality were lower than those working without shifts (p < 0.05). It was determined that as the daytime sleepiness of individuals working in shifts and non-shifts increased, their quality of life decreased (p < 0.05). According to the data obtained from the study, individuals working in shifts compared to individuals working without shifts experienced higher levels of daytime sleepiness and fatigue severity level while sleep quality and physical activity level were lower.

A case-control study to investigate the prevalence of obstructive sleep apnea and the utility of the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire in children and young people with epilepsy.

Epilepsy and obstructive sleep apnea syndrome (OSAS) are each relatively common in children. OSAS may affect cognition, such that recognition of OSAS is important for children and young people with epilepsy (CYPWE). Published pilot data reported 55% of CYPWE had symptoms suggestive of OSAS, compared with 7% of typically developing controls. The primary aim of this study was to ascertain OSAS prevalence by polysomnography in CYPWE, with secondary aims being to evaluate the utility of sleep questionnaires in CYPWE. CYPWE and age- and sex-matched typically developing controls were studied. A single night of level I attended polysomnography was undertaken, along with questionnaires (Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire, Pittsburgh Sleep Quality Index, and the childhood and adolescent Epworth Sleepiness Scale). OSAS was defined as obstructive apnea-hypopnea index of ≥ 1 event/h. Polysomnography was performed in 72 children including 48 CYPWE (60% male) and 24 controls (54% male). Mean age (11 years) was similar for CYPWE and controls (P = .42), with slightly higher body mass index z scores (0.7 vs 0.1, P = .03) noted in CYPWE. Mean obstructive apnea-hypopnea index was 0.61 in CYPWE vs 0.42 in controls (P = .62). Despite higher Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire scores in CYPWE (0.38 vs 0.12, P < .001), no difference in OSAS prevalence (10% vs 4%, P = .78) was found. CYPWE had higher childhood and adolescent Epworth Sleepiness Scale (6 vs 3.5, P = .01) and Pittsburgh Sleep Quality Index (5 vs 3.3, P = .02) scores, indicating greater levels of daytime sleepiness and poorer sleep quality. The study found no evidence for increased OSAS prevalence in CYPWE, and the utility of the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire in predicting OSAS appears limited for CYPWE. CYPWE are, however, demonstrably sleepier and have poorer sleep quality. The cause for these findings remains unclear. Registry: ClinicalTrials.gov; Name: Investigation of Sleep Quality and Prevalence of Sleep-disordered Breathing in Children and Young People With Epilepsy; URL: https://www.clinicaltrials.gov/study/NCT03103841; Identifier: NCT03103841. Urquhart DS, McLellan AE, Hill LE, etal. A case-control study to investigate the prevalence of obstructive sleep apnea and the utility of the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire in children and young people with epilepsy. J Clin Sleep Med. 2024;20(7):1039-1047.

Sleep Disturbances as a Consequence of Long COVID-19: Insights from Actigraphy and Clinimetric Examinations—An Uncontrolled Prospective Observational Pilot Study

The COVID-19 pandemic represents a global health and social challenge. However, the impact of a SARS-CoV-2 infection itself on mental health and sleep quality remains poorly understood. The purpose of the present uncontrolled prospective observational pilot study was to evaluate the impact of past COVID-19 disease on the incidence of quantitative and qualitative sleep disturbances. A group of 61 subjects (37 female, 24 male) reported sleep disturbances that had lasted for at least one month and had started after recovery from COVID-19. The study used self-reported instruments: the Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI), as well as an objective method—actigraphy—for quantitative analysis of sleep architecture. It was shown that sleep disturbances most commonly started after recovery (68.3%, n = 41) and lasted for more than one month (83.6%, n = 51). ESS scores of 7.8 ± 5.0 points indicate moderate daytime sleepiness, and ISI scores of 16.3 ± 5.8 points denote moderate insomnia. ESS scores were negatively correlated with total time in bed (r = −0.3780, p = 0.003), total sleep time (r = −0.2969, p = 0.020), and wakefulness after sleep onset (r = −0.2654, p = 0.039). In addition, ESS scores were correlated negatively with the respondents’ age (B = −0.17, p = 0.000) and time from COVID-19 onset. A positive correlation was found between wakefulness after sleep onset and ESS scores (B = −0.05, p = 0.039). ISI scores were positively correlated with time in bed (r = 0.3275, p = 0.010). Female gender was found to be a significant predictor of insomnia’s severity (B = 2.159, t = 3.04, p = 0.004). In conclusion, patients with a history of COVID-19 report long-lasting sleep disturbances that do not subside spontaneously. In the patient group studied, moderate levels of daytime sleepiness and insomnia were found. The most frequently reported problems included irregular sleep, frequent awakenings, and difficulty maintaining sleep, while normal sleep duration was preserved. These findings underscore the need for continued attention to the long-term consequences of COVID-19 on sleep health and emphasize the importance of targeted interventions to address these enduring sleep disturbances in affected individuals.

Comparison of sleep characteristics between Parkinson's disease with and without freezing of gait: A systematic review

Parkinson's disease (PD) is a neurodegenerative disorder characterized by a range of motor and non-motor symptoms. Among the motor complaints, freezing of gait (FOG) is a common and disabling phenomenon that episodically hinders patients' ability to produce efficient steps. Concurrently, sleep disorders are prevalent in PD and significantly impact the quality of life of affected individuals. Numerous studies have suggested a bidirectional relationship between FOG and sleep disorders. Therefore, our objective was to systematically review the literature and compare sleep outcomes in PD patients with FOG (PD + FOG) and those without FOG (PD-FOG). By conducting a comprehensive search of the PubMed and Web of Science databases, we identified 20 eligible studies for inclusion in our analysis. Our review revealed that compared to PD-FOG, PD + FOG patients exhibited more severe symptoms of rapid eye movement sleep behavior disorder in nine studies, increased daytime sleepiness in eight studies, decreased sleep quality in four studies, and more frequent and severe sleep disturbances in four studies. These findings indicate that PD + FOG patients generally experience worse sleep quality, higher levels of daytime sleepiness, and more disruptive sleep disturbances compared to those without FOG (PD-FOG). The association between sleep disturbances and FOG highlights the importance of evaluating and monitoring these symptoms in PD patients and open the possibility for future studies to assess the impact of managing sleep disturbances on the severity and occurrence of FOG, and vice versa.

The Sleepiness-Depression Link in Obstructive Sleep Apnea: Preliminary Results on the Mediation of Impulsivity.

Emotional impulsivity has been found to be relevant in explaining the association between sleep problems and depressive symptoms, suggesting the potential role of impulsivity as a key underlying mechanism of this link. The objective of this study was to take a preliminary step in understanding the mediating role of impulsivity in the relation between excessive daytime sleepiness (EDS) and depression in patients with obstructive sleep apnea syndrome (OSAS) and to compare psychological and demographic characteristics between different levels of daytime sleepiness. A total of 138 patients with OSAS underwent polygraphic cardiorespiratory monitoring and completed a series of questionnaires investigating perceived sleepiness, depression, impulsivity, and other psychological characteristics. A mediational model was tested in order to assess whether impulsivity mediated the relation between sleepiness and depressive symptoms while controlling for the effects of age, sex, BMI, and oxygen saturation parameters. the mediation model showed that there was a significant indirect effect of impulsivity in the sleepiness-depression link (αβ = 0.084 [0.0243-0.1617]). The here-presented results showed that the sleepiness-depression link is not direct as previous studies asserted, but instead it may be better explained by impulsivity. Research and practical implications are discussed.

Sleep Architecture and Daytime Sleepiness in Patients with Erectile Dysfunction.

Obstructive sleep apnea is considered a risk factor for erectile dysfunction. The aim of this study was to determine sleep architecture and assess daytime sleepiness in patients with erectile dysfunction. The study group included 280 patients. The 107 enrolled patients had reported erectile dysfunction. The control group consisted of 173 patients who had no history of erectile dysfunction. The Epworth sleepiness scale (ESS) was used to measure the subjects' level of daytime sleepiness. All patients underwent a standardized overnight, single-night polysomnography in sleep laboratory. In the erectile dysfunction group, we observed increased ESS total score and N1 sleep phase duration. Mean and minimal oxygen saturation and mean oxygen desaturation were decreased in comparison to the control group. In summary, subjects with erectile dysfunction have altered sleep architecture, oxygen saturation parameters and increased daytime sleepiness.

0358 Prevalence of Insomnia Symptoms and Insomnia Disorder within VA Subacute Rehabilitation

Abstract Introduction Approximately 40% of Veterans report insomnia symptoms and 12% of Veterans have a formal insomnia disorder diagnosis. While these numbers reflect outpatient prevalence rates, there is little data on the prevalence of insomnia symptoms and insomnia disorder among the 32,000 Veterans receiving care within VA Community Living Centers (CLC) (rehabilitation and long-term care facilities) each year. The present analysis provides an initial step in understanding the prevalence of insomnia disorder vs. insomnia symptoms within a local VA CLC subacute rehabilitation unit. This analysis is part of a clinical innovation project that evaluated Veterans’ sleep during admission for the purposes of informing clinical interventions. Methods 67 Veterans were admitted to a VA subacute rehabilitation unit following hospital discharge between March and August 2022. Veterans were asked to complete a brief evaluation within 7 days of admission, including the Insomnia Severity Index (ISI), Sleep Need Questionnaire (SNQ), and Epworth Sleepiness Scale (ESS). Sleep disorder diagnoses were obtained through chart reviews. Descriptive statistics were used to evaluate the prevalence of sleep disorders, insomnia severity, sleep need, and daytime sleepiness. Results 48 of 67 (71.6%) Veterans (Mage=72.8±12.0;97.9%male;79.2%white) completed evaluations within 7 days of admission. 52.1% of Veterans reported at least subthreshold insomnia (ISI≥8) with 22.9% reporting moderately severe clinical insomnia (ISI≥15). 50% reported not meeting their sleep need (SNQ≥13) and 33.3% reported at least mild levels of daytime sleepiness (ESS≥11). Chart reviews indicated only 25% of Veterans had a formal sleep disorder diagnosis in their chart and only 4.2% Veterans had a formal diagnosis of insomnia disorder. Conclusion The results of this preliminary analysis highlighted the discrepancy between national outpatient statistics and local inpatient statistics on the prevalence of insomnia symptoms and disorder. While the Veterans admitted to the CLC may be experiencing additional factors influencing their sleep (e.g., environmental disruptors), this does not wholly explain the discrepancy between the local and national ­samples. Future evaluations should include multiple VA sites to obtain a more representative sample of Veterans. Clinically, these findings suggest that insomnia disorder should be considered a standalone diagnosis and added to Veterans’ charts when clinically elevated symptomology is endorsed. Support (if any)

0123 Sleep Problems and Externalizing Behaviors for Youth in Juvenile Justice Facilities

Abstract Introduction Adolescents who experience insufficient, poor quality sleep, and sleep problems might experience difficulties with externalizing behaviors including aggression and impulse control (Bauducco et al., 2019; Brown et al., 2022). Surprisingly, sleep and behavior for youth residing in long and short-term juvenile justice facilities is understudied. The present preliminary analysis explores self-reported sleep problems and aggressive and impulse control symptoms for youth under the care of the Department of Juvenile Services (DJS). Methods Participants (N=62, 86% male, mean age = 16.8, SD=1.2) were recruited from 11 DJS detention and treatment facilities in Maryland. Racial Backgrounds: 55% Black, 18% White, 14% Multiracial, and 12% Other. They completed an online questionnaire focused on sleep behaviors (daytime sleepiness, sleep-wake behavior problems) and daytime functioning including aggressive and impulse control behaviors (e.g., modified Aggression Questionnaire, Buss &amp; Perry, 1992; Weinberger Adjustment Inventory, WAI, 1990). Using Pearson correlations, associations between sleep problems, daytime sleepiness and externalizing behaviors were examined. Results Self-reported daytime sleepiness and sleep-wake behavior problems were associated with increased aggressive and impulse control difficulties. Youth with more sleep-wake behavior problems reported higher levels of aggressive behaviors (r = .39, p &amp;lt; .01) and impulse control behaviors as measured by the WAI (r = .33, p &amp;lt; .05). Similarly, youth with high levels of daytime sleepiness also reported more impulse control behaviors (r = .40, p &amp;lt; .01). Conclusion Preliminary findings suggest that youth residing in juvenile justice facilities with sleep difficulties are more likely to report aggressive and impulse control challenges. Further analyses will provide a greater understanding of the modifying factors to better understand the youth’s sleep-living environment. Support (if any) This research is made possible by the American Academy of Sleep Medicine (AASM) Foundation Award #22-CS-19 and Maryland Department of Juvenile Services’ supportive collaboration.