Level Of Daytime Sleepiness Research Articles

Metabolic Syndrome and Vitamin D Levels in Patients with Obstructive Sleep Apnea Syndrome.

Numerous studies have indicated that obstructive sleep apnea syndrome (OSAS), may contribute to the development of metabolic syndrome (MetS) and diabetes. Moreover, OSAS has been associated with lowered vitamin D (Vit D) levels, but reports are inconclusive. Aim of the study was to compare Vit D levels according to the presence of MetS and its components in OSAS patients. The presence of MetS was evaluated and serum 25-hydroxy vitamin D [25(OH)D] levels were measured in consecutive newly diagnosed, by polysomnography, subjects with OSAS. A total of 107 subjects (88 men) with OSAS were included in the study. Patients were divided into group A (OSAS with MetS group: 55 subjects) and group B (OSAS without MetS: 52 subjects). There were no differences between the two groups in terms of age, body mass index, and sleep parameters. Patients in group A exhibited higher levels of daytime sleepiness, as expressed by Epworth Sleepiness Scale score (12 ± 5.5 vs. 9.3 ± 4.8 for groups A vs. B, p = 0.008). Serum 25(OH)D levels were significantly decreased in group A, as compared with group B (18 ± 8.6 ng/mL vs. 23.9 ± 14.1 ng/mL, respectively, p = 0.012). Group A was then subdivided in two smaller groups, according to patients' metabolic index: OSAS patients with metabolic score = 3 and OSAS patients with metabolic score >3. Serum 25(OH)D levels were higher in OSAS patients with metabolic score = 3 compared with OSAS patients with metabolic score >3 (19.8 ± 8.9 ng/mL vs. 15.1 ± 7.3 ng/mL respectively, p = 0.038). OSAS patients with concurrent MetS exhibit lower serum Vit D levels, as compared with those without MetS.

Poor sleep quality and insufficient sleep of a collegiate student-athlete population

ObjectivePoor and inadequate sleep negatively impact cognitive and physical functioning and may also affect sports performance. The study aim is to examine sleep quality, sleep duration, and daytime sleepiness in collegiate student-athletes across a wide range of sports. DesignQuestionnaire. SettingUniversity setting. Participants628 athletes across 29 varsity teams at Stanford University. MeasurementsAthletes completed a questionnaire inquiring about sleep quality via a modified Pittsburgh Sleep Quality Index (PSQI), sleep duration, and daytime sleepiness via Epworth Sleepiness Scale. Sleep quality on campus and while traveling for competition was rated on a 10-point scale. ResultsCollegiate athletes were classified as poor sleepers (PSQI 5.38 ± 2.45), and 42.4% of athletes experience poor sleep quality (reporting PSQI global scores >5). Athletes reported lower sleep quality on campus than when traveling for competition (7.1 vs 7.6, P< .001). Inadequate sleep was demonstrated by 39.1% of athletes that regularly obtain <7 hours of sleep on weekdays. Fifty-one percent of athletes reported high levels of daytime sleepiness with Epworth scores ≥10. Teen student-athletes in the first and second year of college reported the highest mean levels of daytime sleepiness. Greater total sleep time was associated with daytime functioning including lower frequency of difficulty waking up for practice or class (P< .001) and lower frequency of trouble staying awake during daily activities (P< .001). ConclusionsCollegiate athletes frequently experience poor sleep quality, regularly obtain insufficient sleep, and commonly exhibit daytime sleepiness.

Agreement between electronic and paper Epworth Sleepiness Scale responses in obstructive sleep apnoea: secondary analysis of a randomised controlled trial undertaken in a specialised tertiary care clinic

ObjectivesOriginally developed as a paper questionnaire, the electronic Epworth Sleepiness Scale (ESS) is widely used in sleep clinics and sleep population research. Despite potential differences between computer-based and conventional questionnaire...

L’observance du traitement par pression positive continue : étude prospective de 103 patients suivis au service de pneumologie de Nabeul-Tunisie

Continuous positive airways pressure (CPAP) is the standard treatment for obstructive sleep apnea syndrome (OSAS). It produces substantial benefits if used for the appropriate indication and if patients adhere to treatment. We conducted a prospective study of 103 patients treated with CPAP over four years follow-up. Our population had a mean age of 52 years with a sex ratio of 0.63. Face to face, individual education was provided in all cases. CPAP titration was performed by an unattended domiciliary autoadjusted CPAP device in 83.5% of patients for 15 days to one month. Twenty patients refused CPAP treatment after the period of titration. Eighty two patients (98.8%) were treated by constant CPAP. Seventy five percent of the patients complained of at least one side effect. The more common were nasal (56.6%)and mask related problems (40%). Seventy six percent of patients used CPAP for more than 4hours per day. Eleven patients stopped CPAP therapy because of intolerance (10 cases) and reluctance to instrumental therapy (one case). Adherence to CPAP therapy was associated with the severity of OSAS, the level of daytime sleepiness, higher pressures, repeated education during the course of follow up, clinical efficacy and the presence of fewer side-effects. We obtained satisfactory rates of adherence and tolerance of CPAP assisted by regular medical and technical follow-up of patients.

Qualidade do sono em pacientes com apneia obstrutiva após cinco anos de uso de CPAP

Introdução: A Síndrome da Apneia/Hipopneia Obstrutiva do Sono (SAHOS) é caracterizada pela obstrução recorrente das vias aéreas superiores durante o sono. O tratamento de escolha é a aplicação de pressão positiva continua nasvias aéreas (CPAP) por máscara nasal. Apesar de extremamente efetivo, a adesão ao CPAP é variável, pois o fluxo contínuo de ar nas vias aéreas pode ocasionar desconforto, e muitas vezes resultar na interrupção do tratamento.Objetivos: Comparar se há melhora do estado de sonolência diurna, da qualidade do sono, da composição corporal e do risco para apneia após cinco anos da utilização de CPAP.Materiais e Métodos: Estudo longitudinal, com acompanhamento de 11 pacientes (9 homens, idade média de 63,73±9,1), com observações prévias ao uso do CPAP e após utilizarem durante cinco anos. Foram avaliadas a sonolência diurna (escala de Epworth), a qualidade do sono (escala visual), além de variáveis antopométricas, e da escala de Berlin (verificar maior risco de apneia). Dados foram analisados pelos testes t pareado e Wilcoxon.Resultados: A análise da escala de Epworth mostrou uma diminuição do nível de sonolência diurna, assim como houve melhora no relato da qualidade do sono, no entanto variáveis antropométricas e o risco de apneia foram semelhantes após cinco anos de tratamento.Conclusões: O uso do CPAP por um período contínuo é uma intervenção que melhora a qualidade de sono e níveis de sonolência diurna e, apesar de não interferir na massa corporal, pode ser uma estratégia importante na vida de pacientes com apneia do sono.

“Silent” Sleep Apnea in Dentofacial Deformities and Prevalence of Daytime Sleepiness After Orthognathic and Intranasal Surgery

The purposes of this study were to determine the occurrence of undiagnosed "silent" obstructive sleep apnea (OSA) in dentofacial deformity (DFD) patients at initial surgical presentation and to report on the level of daytime sleepiness in DFD patients with OSA and chronic obstructive nasal breathing (CONB) after undergoing bimaxillary, chin, and intranasal surgery. A retrospective cohort study of patients with a bimaxillary DFD and CONB was implemented. Patients were divided into those with no OSA (group I) and those with OSA (group II). Group II was further subdivided into patients referred with polysomnogram (PSG)-confirmed OSA (group IIa) and those with a diagnosis of OSA only after surgical consultation, airway evaluation, and a positive PSG (group IIb). Group II patients were analyzed at a minimum of 1year after surgery (range, 1 to 10years) for daytime sleepiness with the Epworth Sleepiness Scale.Patients with postoperative excessive daytime sleepiness were assessed for risk factors and continued need for OSA treatment. Patients in group II were studied to determine which DFD patterns were most associated with OSA. We compared the prevalence of OSA between our study population and the general population. Two hundred sixty-two patients met the inclusion criteria. Of these, 23% (60 of 262) had PSG-confirmed OSA (group II). This rate was much higher than that found in the general population. Of the patients, 7% (19 of 262) were known to have OSA at initial surgical consultation (group IIa). An additional 16% (41 of 262) were later confirmed by PSG to have OSA (group IIb). Patients with primary mandibular deficiency and short face DFDs were most likely to have OSA (P<.001 and P=.001, respectively).In group II, 91% (55 of 60) rated their daytime sleepiness as "not sleepy" at a minimum of 1year after surgery. A significant association was found between group II patients with postoperative excessive daytime sleepiness ("sleepy" or "very sleepy") and a preoperative body mass index category of overweight (P=.026). Our study found silent OSA to be frequent in the DFD population. The prevalence of OSA in DFD patients exceeded that estimated in the general population, with retrusive jaw patterns most affected. In DFD patients also presenting with OSA and CONB, we confirmed low levels of daytime sleepiness long-term after simultaneous bimaxillary orthognathic, chin, and intranasal surgery.

Characterization of Patients Who Present With Insomnia: Is There Room for a Symptom Cluster-Based Approach?

This study examined empirically derived symptom cluster profiles among patients who present with insomnia using clinical data and polysomnography. Latent profile analysis was used to identify symptom cluster profiles of 175 individuals (63% female) with insomnia disorder based on total scores on validated self-report instruments of daytime and nighttime symptoms (Insomnia Severity Index, Glasgow Sleep Effort Scale, Fatigue Severity Scale, Beliefs and Attitudes about Sleep, Epworth Sleepiness Scale, Pre-Sleep Arousal Scale), mean values from a 7-day sleep diary (sleep onset latency, wake after sleep onset, and sleep efficiency), and total sleep time derived from an in-laboratory PSG. The best-fitting model had three symptom cluster profiles: "High Subjective Wakefulness" (HSW), "Mild Insomnia" (MI) and "Insomnia-Related Distress" (IRD). The HSW symptom cluster profile (26.3% of the sample) reported high wake after sleep onset, high sleep onset latency, and low sleep efficiency. Despite relatively comparable PSG-derived total sleep time, they reported greater levels of daytime sleepiness. The MI symptom cluster profile (45.1%) reported the least disturbance in the sleep diary and questionnaires and had the highest sleep efficiency. The IRD symptom cluster profile (28.6%) reported the highest mean scores on the insomnia-related distress measures (eg, sleep effort and arousal) and waking correlates (fatigue). Covariates associated with symptom cluster membership were older age for the HSW profile, greater obstructive sleep apnea severity for the MI profile, and, when adjusting for obstructive sleep apnea severity, being overweight/obese for the IRD profile. The heterogeneous nature of insomnia disorder is captured by this data-driven approach to identify symptom cluster profiles. The adaptation of a symptom cluster-based approach could guide tailored patient-centered management of patients presenting with insomnia, and enhance patient care.

Sleep Quality, Perceived Stress, and Caffeinated Drinks Intake in Psychiatry Residents: A Cross-Sectional Study.

Background: Medical residencies are highly demanding and stressful and have been associated with mental and emotional problems. Studies that evaluated this relationship in Italian psychiatry residents are scarce. In this study, we examined sleep quality and its association with perceived stress and caffeinated beverages consumption in Italian psychiatry residents.Methods: Seventy-two PGY1–5 psychiatry residents at two University Hospitals in Italy were asked to complete an anonymous questionnaire. The Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were used to determine the sleep quality and the level of daytime sleepiness (EDS). In addition, we investigated perceived stress and caffeinated drinks consumption (coffee, tea, soda, energy drinks).Results: Seventy psychiatry residents responded to the survey (97.2% response rate) (M = 34.3%, F = 65.7%; mean age = 30.5 ± 4.2 SD years). 44.3% had poor sleep quality and 15.7% had abnormal EDS. 64.3% reported significant perceived stress. Perceived stress score and coffee consumption were associated with greater likelihood of poor sleep quality.Conclusions: Psychiatry residents have high prevalence of poor sleep quality. Future longitudinal studies are needed to investigate causality and identify appropriate coping strategies and lifestyle changes aimed to improve mental health in psychiatry trainees.

Study on the Evaluation of Average Daytime Sleepiness among Female College Students using ESS Questionnaire

The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. Two hundred adults answered the ESS, They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. The highest mean was found for the question number 7 i.e. the highest chance of dozing was sitting quietly after a lunch without alcohol, followed by question one i.e. sitting and reading. Results show that category of daytime sleepiness was significantly correlated with Body Mass Index (BMI) and anxiety score.

Circadian rhythm : Influence on Epworth Sleepiness Scale score

The Epworth Sleepiness Scale (ESS) is frequently used to determine daytime sleepiness in patients with sleep-disordered breathing. It is still unclear whether different levels of alertness induced by the circadian rhythm influence ESS score. The aim of this study is to investigate the influence of circadian rhythm-dependent alertness on ESS performance. In amonocentric prospective noninterventional observation study, 97patients with suspected sleep-disordered breathing were investigated with respect to daytime sleepiness in temporal relationship to polysomnographic examination and treatment. The Karolinska Sleepiness Scale (KSS) and the Stanford Sleepiness Scale (SSS) served as references for the detection of present sleepiness at three different measurement times (morning, noon, evening), prior to and following adiagnostic polysomnography night as well as after acontinuous positive airway pressure (CPAP) titration night (9measurements in total). The KSS, SSS, and ESS were performed at these times in arandomized order. The KSS and SSS scores revealed acircadian rhythm-dependent curve with increased sleepiness at noon and in the evening. Following adiagnostic polysomnography night, the scores were increased compared to the measurements prior to the night. After the CPAP titration night, sleepiness in the morning was reduced. KSS and SSS reflect the changes in alertness induced by the circadian rhythm. The ESS score war neither altered by the intra-daily nor by the inter-daily changes in the level of alertness. According to the present data, the ESS serves as areliable instrument to detect the level of daytime sleepiness independently of the circadian rhythm-dependent level of alertness.

Sleep–Wake Cycle, Daytime Sleepiness, and Attention Components in Children Attending Preschool in the Morning and Afternoon Shifts

ABSTRACTChildren tend to sleep and wake up early and to exhibit daytime sleep episodes. To evaluate the impact of school start times on sleepiness and attention in preschool children, this study compared the temporal patterns of sleep, daytime sleepiness, and the components of attention between children aged 4–6 years that study in the morning (n = 66) and the afternoon (n = 144) shifts. The former get up 1 hr and 30 min earlier on weekdays and show lower efficiency on the sustained attention task than those who study in the afternoon. Thus, the morning shift was associated with a reduction in nighttime sleep, which might have a negative effect on children's performance in the morning, causing higher levels of daytime sleepiness and a decline in sustained attention. Because only one parameter of one component of attention was negatively affected, further studies are needed to confirm this effect on cognition.

Sleep Problems and Daytime Sleepiness in Children with Nocturnal Enuresis

Purpose Nocturnal enuresis (NE) is one of the most common problems in childhood. NE has a multifactorial etiology and is influenced by sleep and arousal mechanisms. The aim of the present study was to prospectively evaluate sleep problems and patterns in children with NE compared with normal healthy controls. Methods Twenty-eight children with NE and 16 healthy controls were included in the study. To evaluate sleep habits and disturbances, parents and children filled out a questionnaire that included items about sleep patterns and sleep-related behaviors prior to treatment for NE. Demographic factors and other data were compared for the two groups based on the responses to the sleep questionnaire. Results Night awakening, sleepwalking, and periodic limb movements were more prevalent in children with NE, but symptoms of sleep-disordered breathing were not increased in this group. There were statistically significant differences in periodic limb movements and daytime sleepiness between the two groups. Conclusion Children with NE seemed to have more sleep problems such as night awakening, sleepwalking, and periodic limb movements. In addition, a higher level of daytime sleepiness and hyperactivity in patients with NE suggested a relationship between NE and sleep disorders. Key words: Nocturnal enuresis; Children; Sleep disorder; Periodic limb movement

Conjoint influence of mind-wandering and sleepiness on task performance.

Recent research suggests that sleepiness and mind-wandering-the experience of thoughts that are both stimulus-independent and task-unrelated-frequently co-occur and are both associated with poorer cognitive functioning. Whether these two phenomena have distinguishable effects on task performance remains unknown, however. To investigate this question, we used the online experience sampling of mind-wandering episodes and subjective sleepiness during a laboratory task (the Sustained Attention to Response Task; SART), and also assessed mind-wandering frequency and sleep-related disturbances in daily life using self-report questionnaires. The results revealed that the tendency to experience mind-wandering episodes during the SART and daily life was associated with higher levels of daytime sleepiness and sleep-related disturbances. More important, however, mind-wandering and sleepiness were independent predictors of SART performance at both the within- and between-individuals levels. These findings demonstrate that, although mind-wandering and sleepiness frequently co-occur, these two phenomena have distinguishable and additive effects on task performance. (PsycINFO Database Record

Determination of restless legs syndrome prevalence in children aged 13–16 years in the provincial center of Kayseri

ObjectiveThis study was conducted to determine the prevalence rate of restless legs syndrome (RLS) and associated factors in adolescents aged 13–16years in the provincial center of Kayseri. Materials and methodsThe study sample included 5720 adolescents who were selected from among 74,421 grade 7–10 students aged 13–16years in the provincial center of Kayseri. Overall, datas from 4792 subjects were included into analysis. Data were collected by using a self reported questionnaire and the Epworth Sleepiness Scale (ESS). The prevalence rate of RLS was determined by questionnaire datas and phone interviews. The effects of age, gender, economical status and body weight on RLS prevalence rate were analyzed. Mean ESS score was calculated. The effect of RLS on academic success, as measured by grade point average, was also assessed. The subjects were stratified as underweight, normal, overweight and obese according to the body mass index and the RLS prevalence rate was compared among groups. ResultsThe RLS prevalence rate was determined to be 2.9% among adolescents aged 13–16years in the study group. It was found that gender and economical status had no significant effect on RLS prevalence. Mean age at symptom onset was 11.4years of age. There was a positive family history in 11.3% of subjects. Mean body mass index (BMI) was found to be significantly higher in subjects with RLS (21.5±3.8 vs. 20.5±3.2). Academic success (72.0±11.2 vs. 77.0±12.0) was found to be poorer and daytime sleepiness level, as measured by ESS (11.4±3.9 vs. 6.3±4.0), was found to be higher in subjects with RLS. ConclusionThe RLS prevalence rate was 2.9% in the study sample while gender and economical status had no significant effect on prevalence rate. The RLS, which results in decreased sleep quality and academic success, is an important disorder with a considerable prevalence in the population.

Sleep quality, level of daytime sleepiness and fatigue among working nursing students

Introduction: The aim of this study was to assess sleep quality, level of daytime sleepiness and fatigue among working nursing students and to determine possible relations among them. Methods: It was a descriptive, analytical cross-sectional study conducted in two Colleges of Health Studies in Serbia and Montenegro on a sample of 76 students. Instruments used in this research included: The Pittsburgh Sleep Quality Index (PSQI) for the assessment of sleep quality, The Epworth Sleepiness Scale (ESS) for the assessment of level of daytime sleepiness, The Chalder Fatigue Questionnaire (CFQ) for the assessment of fatigue rates, the socio-demographic questionnaire and the questionnaire on behavior and lifestyle factors. Results: Sleep quality was poor in 65.8% of students and symptoms of daytime sleepiness and fatigue were confirmed in 50.0% and 55.3% of students. The average values of the total score in the PSQI, ESS and CFQ were significantly different with respect to gender, shift work and satisfaction with the current work schedule. The strong positive correlation was calculated between sleep quality, excessive daytime sleepiness and fatigue severity. The findings of the present study suggest the need for establishing effective educational strategies that promote healthy sleep among nursing students and nurses, as well as the implementation of sleep hygiene programmess in higher education of nursing studies.

The Effect of Patient Neighborhood Income Level on the Purchase of Continuous Positive Airway Pressure Treatment among Patients with Sleep Apnea.

The cost of continuous positive airway pressure (CPAP) treatment for patients with low socioeconomic status may be an important barrier to successful treatment of obstructive sleep apnea under a copayment health care system. We evaluated an association between patient neighborhood income level and the purchase of a CPAP device under a cost-sharing health care insurance system. All adults who underwent a first diagnostic sleep study at St. Michael's Hospital (Toronto, ON, Canada) between 2004 and 2010 were included. Severity of obstructive sleep apnea was determined by the apnea-hypopnea index (AHI) and level of daytime sleepiness (by the Epworth Sleepiness Scale). Patient data were linked to provincial health administrative data from 1991 to 2013 to determine the purchase of CPAP equipment, comorbidities, neighborhood income, and rural status at baseline. Neighborhood income was categorized into quintiles, ranked from poorest (Q1) to wealthiest (Q5). Assuming that the majority of participants with severe obstructive sleep apnea (AHI > 30 events/h) and excessive daytime sleepiness (Epworth Sleepiness Scale ≥ 10) would have been strongly recommended CPAP, we evaluated the association between patient neighborhood income and purchase of a CPAP device in this group via multivariable Cox regressions. Of the 695 participants with severe obstructive sleep apnea and excessive daytime sleepiness, 400 (58%) purchased a CPAP device. Patients who accepted CPAP were more likely to live in a higher-income neighborhood. Cumulative incidence of CPAP acceptance at 6 months was 43% for individuals in a low-income neighborhood (Q1) and 52% in combined higher-income neighborhoods (Q2-5) (P = 0.05). Controlling for sex and age, living in higher-income neighborhoods was associated with a 27% increased chance of accepting CPAP compared with the lowest-income neighborhood (hazard ratio Q2-5 vs. Q1, 1.27; 95% confidence interval, 0.98-1.64; P = 0.07). Living in an unfavorable neighborhood is not an obstacle to CPAP treatment among symptomatic patients with severe obstructive sleep apnea under a copayment health care system. However, a potential 27% improvement in CPAP acceptance associated with higher neighborhood income is not inconsequential. Also, the overall CPAP acceptance rate was relatively low, suggesting that obstacles other than finances are primarily responsible.

Daytime sleepiness in patients with type 2 Diabetes Mellitus – a prospective cohort study

Introduction: Daytime sleepiness is an independent factor for increased health care utilization and all cause mortality. Diabetic patients are more likely to be sleepy during the daytime than non-diabetics.Objectives to examine factors influencing the evolution of daytime sleepiness in patients with type 2 diabetes (T2D) in a two-year follow-up study.Methods: Patients (N=145) aged from 40 to 60 (55.0±3.3) of both genders were consecutively recruited and evaluated for comorbidity severity (Charlson Comorbidity Index), depressive symptoms (Beck Depression Inventory, BDI II), sleep quality (Pittsburgh Sleep Quality Index) and physical activity levels (International Physical Activity Questionnaire, IPAQ). Daytime sleepiness was assessed by the Epworth Sleepiness Scale (ESS)Results: Excessive daytime sleepiness (ESS>10) was found in 51 (35.2%) patients. Initially, men had more excessive daytime sleepiness; however, women evolved with more sleepiness after two years. Levels of physical activity were independently associated with more excessive daytime sleepiness and patients with a sedentary lifestyle developed worse levels of daytime sleepiness after two years. Active lifestyle was more beneficial for reducing daytime sleepiness in women. In this study, among all, levels of physical activity (IPAQ) improved after two years.Conclusion: Excessive daytime sleepiness affects approximately 1/3 of T2D patients and women evolve with more sleepiness. Better levels of physical activity are independently associated with less daytime sleepiness reinforcing the concept that a sedentary lifestyle has a negative influence in sleep-wake alterations. The implementation of physical exercise is a possible break of chain involving sleep-wake alterations and comorbidities in T2D.

Prevalence of poor sleep quality, sleepiness and obstructive sleep apnoea risk factors in athletes

Purpose: Despite the perceived importance of sleep for athletes, little is known regarding athlete sleep quality, their prevalence of daytime sleepiness or risk factors for obstructive sleep apnoea (OSA) such as snoring and witnessed apnoeic episodes. The purpose of the present study was to characterise normative sleep quality among highly trained team sport athletes.Methodology:175 elite or highly trained rugby sevens, rugby union and cricket athletes completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Score (ESS) and Quality of Life questionnaires and an OSA risk factor screen.Results: On average, athletes reported 7.9 ± 1.3 h of sleep per night. The average PSQI score was 5.9 ± 2.6, and 50% of athletes were found to be poor sleepers (PSQI > 5). Daytime sleepiness was prevalent throughout the population (average global score of 8.5) and clinically significant (ESS score of ≥10) in 28% of athletes. OSA may be an important clinical consideration within athletic populations, as a considerable number of athletes (38%) defined themselves as snorers and 8% reported having a witnessed apnoeic episode. The relationship between self-rated sleep quality and actual PSQI score was strong (Pearson correlation of 0.4 ± 0.1, 90% confidence limits).Conclusion: These findings suggest that this cohort of team sport athletes suffer a preponderance of poor sleep quality, with associated high levels of daytime sleepiness. Athletes should receive education about how to improve sleep wake schedules, extend total sleep time and improve sleep quality.

Sleep extension improves serving accuracy: A study with college varsity tennis players

ObjectiveThis study investigated the effects of sleep extension on tennis serving accuracy, as well as daytime sleepiness in college varsity tennis players. MethodsTwelve (seven females and five males) healthy students on a college varsity tennis team maintained their habitual sleep–wake schedule for a one-week baseline period followed by a one-week sleep extension period. Participants were requested to sleep at least nine hours, including naps, during the sleep extension period. Serving accuracy was assessed when participants were sleep deprived (prior to the sleep extension period) and after the sleep extension period. Levels of daytime sleepiness were monitored via the Epworth Sleepiness Scale and the Stanford Sleepiness Scale, and caffeine consumption was recorded throughout the study. ResultsParticipants slept significantly more in the second week — the sleep extension week — compared with the first week — the baseline week (8.85 vs. 7.14h; p<0.05). Following the sleep extension period, accuracy of the tennis serves improved significantly (35.7% vs. 41.8%; p<0.05), and the Epworth Sleepiness Scale and Stanford Sleepiness Scale scores declined significantly (12.15 vs. 5.67; p<0.05 and 3.56 vs. 2.67; p<0.05, respectively). ConclusionsThis study demonstrates that an increase in sleep of approximately 2h per night significantly increased athletic performance in college varsity tennis players.

Subjective sleep impairment in adults with type 1 or type 2 diabetes: Results from Diabetes MILES—The Netherlands

AimsDespite growing recognition of the impact of sleep on diabetes, a clear profile of people with diabetes regarding subjective sleep impairment has yet to be established. This study examines: (1) subjective sleep characteristics in adults with type 1 and type 2 diabetes; (2) the relationship of poor subjective sleep quality with glycaemic control, self-care and daytime functioning; (3) possible risk markers for poor sleep quality. MethodsIn a cross-sectional study, Dutch adults with type 1 (n=267) or type 2 diabetes (n=361) completed an online survey, including the Pittsburgh Sleep Quality Index (PSQI), socio-demographic, clinical, self-care and psychological measures. ResultsPoor sleep quality (PSQI-score >5) was reported by 31% of adults with type 1 and 42% of adults with type 2 diabetes. Participants with good and poor sleep quality did not differ in self-reported HbA1c or the frequency of meeting lifestyle recommendations. Poor sleep quality was related to a higher self-care burden and higher levels of daytime sleepiness, fatigue, depressive and anxiety symptoms, and diabetes-specific distress. In multivariable logistic regression analyses examining risk markers, poor sleep quality was associated with depressive symptoms in adults with type 1 (OR=1.39, 95% CI 1.25–1.54) and type 2 diabetes (OR=1.31, 1.16–1.47), and with being female in those with type 2 diabetes (OR=2.72, 1.42–5.20). ConclusionsPoor subjective sleep quality is prevalent both in adults with type 1 and type 2 diabetes, and is related to poor daytime functioning and higher self-care burden. The temporal relation with depression and merits of therapy should be explored.