Lower Sleep Quality Research Articles

Sleep Quality and Associated Factors Among Older Adults in Tabriz, Iran: Tabriz Older People Health Survey (TOPS-2019)

Objectives: The study aimed to investigate the sleep quality of aged people in Tabriz and identify its associated factors. Design: Cross-sectional study. Setting(s): Tabriz, the capital of the East Azerbaijan province in northwest Iran. Participants: A total of 1362 participants were selected from a representative sample of community-dwelling older people aged≥60 years who were living in Tabriz, using the probability proportional to size (PPS) sampling method. Outcome measures: Blood pressure (BP), sleep quality, depression, anxiety, loneliness, physical activity, daily activities, living independently, and social support were assessed using a standard mercury sphygmomanometer, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), the 6-item De Jong Gierveld Loneliness Scale, Physical Activity Scale for the Elderly (PASE), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), respectively. Results: The mean score of total PSQI was 5.39±2.91. The multivariable logistic regression model showed that being female (Odds ratio [OR]=1.68, 95% confidence interval [CI]=1.29 to 2.18), hypertensive (OR=2.12, 95% CI=1.52 to 2.95), diabetes mellitus (DM) (OR=1.29, 95% CI=0.96 to 1.72), abnormal anxiety level (OR=2.38, 95% CI=1.67 to 3.38), and low PASE score (OR=0.99, 95% CI=0.99 to 1) were significantly associated with a higher risk of poor sleep quality. Conclusions: Low physical activity is a modifiable risk factor for low sleep quality in older adults. Hence, the development of physical activity programs can be effective in improving sleep quality. Furthermore, women are the priority in designing interventions.

Association between sleep quality and duration with serum lipid profiles in older adults: A population-based study

AimsSleep duration and quality are increasingly recognized as potential contributors to cardiovascular disease risk, with serum lipids playing a crucial role in this relationship. However, the results regarding this association have been inconsistent across different ethnic groups. This study aims to investigate this association in an Iranian elderly population. MethodsTotally 1392 people 60 to 69 years old were included in this study. Sleep duration and quality were assessed by the Pittsburgh sleep quality index (PSQI). Logistic and linear regression models were employed to determine the association of sleep duration and quality with serum lipid levels; moreover, the effects of other potential confounders were also controlled. FindingsMost of the participants had low sleep quality (70.47 %), which was more notable in males (80.08 %), compared to females (59.15 %), and most of the participants slept 6–7 h per day (42.2 %). No association was observed between sleep quality and serum lipid levels including HDL (OR = 1.12; P = 0.871), LDL (OR = 0.80; P = 0.451), total cholesterol (OR = 0.89; P = 0.702) and triglyceride (OR = 1.13; P: 0.477). As well as, no association between sleep duration and LDL; (β = 0.35; P = 0.094), total cholesterol (β = 0.02; P = 0.918), triglycerides (β = −0.02; P = 0.846), and HDL (β = −0.06; P = 0.534). ConclusionIn the elderly population, poor sleep quality is typical, particularly among males. Sleep quality and duration were not associated with serum lipid profiles, including TG, TC, LDL, and HDL.

Impact of train horn noise on sleep disturbance and mental health

Train horns are commonly used at Australian level crossings to raise people’s awareness of trains and improve road safety. However, the use of train horn could generate broader social effects than road safety. This study aims to investigate the relationships between train horn use and the sleep quality and mental health of people who live nearby an operational train environment. A questionnaire was developed to measure participants’ emotional states (i.e., depression, anxiety and anxiety), sleep quality and exposure to train horns. Participants were divided into three groups according to their residence’s distance to train horn use location, i.e., horn impact group, railway impact group and control group. The data collection is still ongoing, and 105 participants completed the questionnaire to the submission date. Results from primary data analysis showed that participants in horn impact group spent a longer time falling asleep and also reported lower sleep quality scores, as compared to the other two groups. No difference in the emotional states was found between groups. The study provided a lens to examine the negative impacts of train horn use in the Australasian environment and shed light on future train horn procedures and applications.

Comparison between self-reported and actigraphy-derived sleep measures in patients receiving home parenteral nutrition: Secondary analysis of observational data.

Patients receiving home parenteral nutrition (HPN) frequently report disrupted sleep. However, there are often inconsistencies between objectively measured and questionnaire-derived sleep measures. We compared sleep measures estimated from wrist actigraphy and self-report in adults receiving HPN. In this secondary analysis, we pooled data from two sleep-related studies enrolling adults receiving habitual HPN. We compared measures from 7-day averages of wrist actigraphy against comparable responses to a sleep questionnaire. Sleep measures included bedtime, wake time, time in bed, total sleep time, and sleep onset latency (SOL). Spearman correlation coefficients, Bland-Altman plots, and linear regression models for each set of sleep measures provided estimates of agreement. Participants (N = 35) had a mean age of 52 years, body mass index of 21.6 kg/m2 , and 77% identified as female. Correlation coefficients ranged from 0.35 to 0.90, were highest for wake time (r = 0.90) and bedtime (r = 0.74), and lowest for total sleep time (r = 0.35). Actigraphy overestimated self-reported bedtime, wake time, and total sleep time and underestimated self-reported time in bed and SOL. Regression coefficients indicated the highest calibration for bedtime and wake time and lower calibration for time in bed, total sleep time, and SOL. We observed strong-to-moderate agreement between sleep measures derived from wrist actigraphy and self-report in adults receiving HPN. Weaker correlations for total sleep time and SOL may indicate low wrist actigraphy sensitivity. Low-quality sleep resulting from sleep disruptions may have also contributed to an underreporting of perceived sleep quantity and lower concordance.

Comparison of Sleep Quality between Families of Dementia Patients and General Population in Community: Analysis with the Korea Community Health Survey

This study aimed to examine the difference of sleep quality between family members of dementia patients and general population in community.Participants (n=215,676) aged 19 years and over in the 2018 Korea Community Health Survey were classified into three groups; family members living at home with a person with dementia (FHD; n=2,445), family members living separately from a person with dementia (FSD; n=9,132), and family members without a person with dementia in the family (FwoD; n=204,099). The Pittsburgh Sleep Quality Index greater than 6 points was regarded as poor sleep quality (PSQ). Multiple logistic regression analysis was used to explore the associations between living with dementia patients and PSQ.The prevalence of PSQ was 48.3% in FHD, 40.7% in FSD, and 38.8% in FwoD. After adjusting for potential confounders, compared to FwoD, the odds ratio for PSQ was 1.42 (95% confidence interval [CI], 1.31-1.54) in FHD and 1.22 (95% CI, 1.17-1.27) in FSD. Additionally, almost all age- and sex-stratified family of dementia patients, except for the youngest (<40 years) men of FHD and the youngest (<40 years) men of FSD, had a higher risk for PSQ than FwoD.Both FHD and FSD have lower sleep quality than FwoD. Public psychological interventions and supports are needed to family members of dementia patients in the community.

Chinese Medicine Constitution that Influences Sleep Quality and Fatigue among Chinese Nurses Working in Shifts in Japan and China

Nurses who work in shifts may face poor sleep quality and oppressive fatigue. The purpose of this study was to clarify Chinese medicine constitution that influences sleep quality and fatigue among Chinese nurses engaged in shift work. Considering that these conditions might differ according to living environments, studies were conducted both in Japan and China. Data were gathered using the attributes of nurses, the Pittsburgh Sleep Quality Index to evaluate sleep quality, the Jikaku-sho shirabe to evaluate fatigue, and the Constitution in Chinese Medicine Questionnaire, which evaluates Chinese medicine constitution according to nine criteria. The survey was conducted via internet, with data analyzed from 100 Chinese subjects in Japan and 100 Chinese subjects in China. Increase in age, living in China, Qi-deficiency constitution and Blood-stasis constitution were causal factors for lower sleep quality. Sleep quality was significantly lower among nurses in China than those in Japan. The following factors were observed to be causal factors for increased fatigue: longer histories of working in shifts, living in Japan, poorer quality sleep, Qi-deficiency constitution, Yang- and Yin-deficiency constitution, Qi-stagnation constitution and Inherited special constitution. Nurses in Japan showed significantly greater fatigue at the end of a night shift than did those in China. It is suggested that adjustments of Qi-deficiency constitution and Blood-stasis constitution can improve sleep quality in nurses who work in shifts. We believe that improving sleep quality and making adjustments to the five types of Chinese medicine constitution can work to reduce fatigue.

Food Insecurity Among Pregnant and Recently Pregnant Emerging and Young Adults: An Online Cross-Sectional Survey Study

ABSTRACT This online, cross-sectional study examined food insecurity and sleep quality among pregnant/recently pregnant women (N = 486). The prevalence of food insecurity was highest among emerging adults (69%), followed by young adults (57%) and middle-aged adults (31%). In adjusted models, emerging and young adults had 2.42 (1.19, 4.97) and 2.62 (1.60, 4.37) times the odds of food insecurity compared to middle-aged adults. Individuals reporting low food security (−0.29 [−0.44, −0.13]) and very low food security (−0.61 [−0.80, −0.41]) had lower sleep quality compared to individuals reporting food security. Emerging adult mothers are at risk of food insecurity and associated low sleep quality.

Impact of Sleep Disturbance on Fatigue, Nausea, and Pain: Mediating Role of Depressive Symptoms Among Youth With Disorders of Gut-Brain Interaction.

A high degree of sleep disturbance is reported among youth with disorders of gut-brain interaction (DGBIs). Given that sleep quality impacts a range of pediatric health outcomes including somatic sensations (eg, pain) and depressive mood occurs relatively frequently among youth with DGBIs, there is a dire need to disentangle the unique contributions of sleep and depressive mood on the somatic sensations experienced by youth with DGBIs. We aimed to examine whether depressive mood mediates the relations among sleep disturbance and pain intensity, nausea, and fatigue among youth with DGBIs. One hundred eighteen patients aged 8-17 years ( Mage = 14.05, SD = 2.88; 70.34% female), 83.05% White/non-Hispanic recruited at a pediatric neurogastroenterology clinic completed measures of sleep disturbance, nausea, fatigue, pain intensity, and depressive mood. Three mediation models examined the effect of sleep disturbance on nausea, fatigue, and pain, with depressive mood as a mediator. Participants reported moderate sleep disturbance. Depressive mood partially mediated the significant, respective relations between greater sleep disturbance and more severe nausea and fatigue. Sleep disturbance was significantly associated with higher pain intensity; however, depressive mood was not a significant mediator of this relation. Sleep quality is a major concern among youth with DGBIs. Low sleep quality may worsen nausea and fatigue via co-occurring increases in depressive mood symptoms. In contrast, sleep disturbance may directly increase pain, regardless of youths' depressive mood symptoms. Future research should explore these relations through prospective studies leveraging a combination of subjective and objective assessment approaches.

Evaluation of quality of life, sleep, and sleepiness in dental students during active learning and remote emergency learning

Objective: This study aimed to evaluate the quality of life (QoL), quality of sleep, and sleepiness index in undergraduate dentistry students between their active learning (AL) and emergency remote learning (ERL) due to social distancing imposed during the COVID-19 pandemic. Methods: Information was collected using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36-BR), Epworth Sleepiness Scale (ESS-BR), and Pittsburgh Sleep Quality Index (PSQI-BR) questionnaires administered before and during the COVID-19 pandemic. A comparison regarding the type of education, demographic factors, academic performance, PSQI-BR, ESS-BR, and SF-36-BR between the groups was performed, considering a significance level of 0.05. Results: A total of 55 students were from AL, while 45 students were from ERL. The sample consisted of 74 women and 26 men aged 21–30 years. The academic coefficient of these students ranged from 7 to 8 points (AL= 38.2% and ERL= 57.8%). In addition, a large proportion of the students reported having no failures (AL=60% and ERL= 66.7%). Regarding QoL, the students presented a greater impairment in functional capacity (p = 0.01), followed by limitations in social aspects, general health perception, body pain, and vitality. According to the ESS-BR scores (p = 0.04), the students presented a lower quality of sleep. Conclusion: Dentistry students had the worst QoL panoramas and poor relative sleep quality before and during the COVID-19 pandemic. Furthermore, QoL instruments were reliable for quantifying health-related QoL in AL and ERL.

Stress during Home Confinement Is Associated with Eating Misalignment among Adults during COVID-19 Lockdown.

The COVID-19 pandemic forced Saudi Arabia to implement several measures including mandatory home confinement, banning entry to many cities, and suspending religious activities. Studies have reported inconsistent findings of the effect of home confinement on lifestyle factors. This study aims to assess the psychological impact of COVID-19 during home confinement and explore its association with dietary habits and weight change. A cross-sectional study was conducted among Saudi adults using an online survey between May and June 2020. Data on dietary habits, sleep quality, and stress were collected. A total of n = 503 participants responded. Of 254 analyzed, 87% were females, 49% were overweight/obese (body mass index (BMI) ≥ 25 kg/m2), and 79% were under lockdown for >40 days. In multiple linear regression, higher stress scores during confinement were associated with higher stress scores before confinement and poorer sleep quality. In multiple logistic regression, those who did not eat at the same time had higher stress scores compared to those who always ate at the same time, whereas consuming ≥three meals was associated with lower stress scores than consuming one-two meals. The odds of gaining weight during confinement were higher among married adults, those with lower sleep quality, and consuming ≥three meals. Stress during home confinement was associated with eating misalignment and the number of meals consumed. Although this study was limited by its cross-sectional design and reliance on self-reported data, it provides valuable insights into the dietary habits and weight-gain associated factors that need to be further explored and addressed in any future restrictions for improved well-being.

Evaluation of sleep quality and depressive symptoms among medical students during COVID-19 pandemic

BackgroundDepression and sleep disorders are interrelated and have high prevalence. Based on previous findings, medical students experience high rates of depression and low sleep quality, due to the challenges during medical training programs. During the COVID-19 pandemic, medical students faced extra physical and psychological pressure. This study aimed to evaluate sleep quality and depressive symptoms and their possible association among medical students during COVID-19 pandemic.ResultsOne hundred twenty-one medical students completed the survey. Twenty-six percent of participants had a good sleep quality. Mean sleep duration of participants was approximately 6 h per day. Moreover, they had a mean sleep latency of 28 min and a mean PSQI score of 7.76. We found the prevalence of moderate, moderately severe, and severe depression among participants to be 22%, 6%, and 7%, respectively. The participants’ mean PHQ-9 score was found to be 8.4.ConclusionsWe found a relatively high depression rate, poor sleep quality, and a significant inverse relationship between sleep quality and depression severity score among medical students who were doing their clinical rotations during the COVID-19 pandemic. Additionally, quarter of moderate to severely depressed participants were taking antidepressants. Our findings highlight the need for future interventional studies that address these issues among medical students.

Frailty and Diminished Human Relationships Are Associated with Poor Sleep Quality in Japanese Older Adults: A Cross-Sectional Study.

The purpose of this study was to examine the association between sleep quality, frailty, and human relationships in Japanese older adults (aged 65 years and above, excluding those certified as requiring long-term care). This cross-sectional study used a questionnaire survey to gather demographic information, data on frequency of conversation and conversation partners, and employed the following validated instruments: Kihon Checklist (KCL), a Japanese instrument used to determine the care needs and frailty of older adults; the Dysphagia Risk Assessment for Community-Dwelling Elderly (DRACE) scale; Japanese versions of Pittsburgh Sleep Quality Index (PSQI-J); the Geriatric Depression Scale-15 (GDS-15-J); and the University of California Los Angeles Scale (UCLA-J), an instrument to assess loneliness in older adults. The 500 respondents were divided into two groups based on sleep quality (PSQI-J): low sleep quality group (n = 167, 33.4%) and high sleep quality group (n = 333, 66.6%). Our analyses showed that the low sleep quality group had a KCL score of 5.55 ± 2.47, which indicated frailty. Binomial logistic regression analysis identified age, number of diseases under treatment, DRACE, GDS-15-J, and conversation frequency and discussion partner for important matters as factors (p < 0.05) associated with poor sleep quality. These factors could help enhance the detection of frailty and predictability of caregiving needs.

The Effect of Sleep Quality and Mental Health on Academic Performance Among the Medical Students of King Abdulaziz University.

Sleep quality has an important role in brain functioning and development. Affected sleep quality and mental health can negatively affect the academic performance of college students. To assess the effect of sleep quality and mental health on the academic performance of medical students at King Abdulaziz University, Jeddah, Saudi Arabia. We conducted a cross-sectional study among medical students at King Abdulaziz University. The dependent variable was the current grade point average (GPA). For the independent variables, two validated tools were used in the study: the Pittsburgh Sleep Quality Index (PSQI) for sleep assessment; and theDepression, Anxiety and Stress Scale (DASS-21) for mental health assessment. A total of 382 responses were analyzed. The majority of students (86.6%) had GPAs greater than 3.75/5, while only 1% of the sample had a GPA lower than 2.75/5. The PSQI showed a median and interquartile range of (9, 6-11). Normal DASS-21 represented the majority as follows: depression at 67%, anxiety at 63.1%, and stress at 82.2%. In the statistical analyses, sleep quality, depression, anxiety, and stress were not statistically significant with the student's GPA. Low levels of sleep quality were found among medical students in our study. While sleep quality and mental health status did not show an effect on the GPA of the medical students, lower sleep quality was significantly correlated with increased scores of depression, anxiety, and stress. Our findings mandate interventions directed at improving sleep quality among medical students.

Prevalence of Sleep Disorders Among Patients With Type 2 Diabetes Mellitus at Primary Healthcare Centers in the South Region of Abha City.

Background Type 2 diabetes is a chronic condition that affects the way the body processes blood sugar (glucose). This issue is of considerable importance in the field of public health, as it has a global impact on a substantial number of individuals. The primary emphasis in the management of type 2 diabetes is centered around achieving glycemic control, implementing lifestyle adjustments, and employing pharmaceutical therapies as preventive measures or for the purpose of managing problems that may arise as a result of the disease. Aim This research aimed to investigate the prevalence of sleep-belated issues among individuals diagnosed with type 2 diabetes. Methodology A total of 230 participants with type 2 diabetes patients of primary healthcare in Abha city whose age is ≥18 years were included in the study. The data collection process involved the distribution of a self-administered questionnaire that assessed various aspects of sleep disturbances, including difficulties in falling asleep, waking up during the night, excessive daytime sleepiness, and restless legs or leg muscle cramps. The questionnaire also collected demographic information and data on potential risk factors such as alcohol consumption, caffeine consumption, and smoking/tobacco product use. Data analysis was conducted using chi-square tests and significance levels were set at p < 0.05. Results The findings revealed a prevalence of sleep disturbances among individuals with type 2 diabetes. Difficulties in falling asleep and waking up during the night were reported by a substantial proportion of participants, and a notable number experienced excessive daytime sleepiness. Restless legs or leg muscle cramps that interrupted sleep were experienced occasionally by 16.5% and frequently by 8.7% of the participants. The study also found a significant association between the presence of sleep problems and lower sleep quality ratings. However, no significant associations were found between sleep disturbances and the duration of type 2 diabetes or the examined risk factors. Conclusion The findings from this study emphasize the detrimental effects of sleep disturbances on sleep quality and suggest that improving sleep quality can positively influence the overall health and well-being of individuals with type 2 diabetes.

Sleep characteristics and parameters of bone turnover and strength in the adult population: results from the Study of Health in Pomerania-TREND.

Poor sleep quality or sleep deprivation may be related to decreased bone mineral density. We aimed to assess whether associations of sleep characteristics and bone turnover or strength are present in adults from the general population and whether these are independent of common risk factors such as sex, age, and obesity. A total of 1037 participants from the Study of Health in Pomerania-TREND underwent laboratory-based polysomnography and quantitative ultrasound measurements at the heel. Of these participants, 804 completed standardised questionnaires to assess daytime sleepiness, insomnia, and sleep quality. Serum concentrations of two bone turnover markers, intact amino-terminal propeptide of type 1 procollagen (P1NP) and carboxy-terminal telopeptide of type 1 collagen (CTX) were measured. Cross-sectional associations of polysomnography variables (total sleep time, sleep efficiency, time spent wake after sleep onset, oxygen desaturation index, apnea-hypopnea index, and obstructive sleep apnea [OSA]), as well as sleep questionnaire scores with the bone turnover markers and the ultrasound-based stiffness index were assessed in linear regression models. In adjusted models, higher insomnia scores and lower sleep quality scores were related to a higher bone turnover in women but not in men. However, associations between polysomnography variables or questionnaire scores and the stiffness index were absent. Our study provides limited evidence for relationships between sleep characteristics and bone turnover and strength independent of common risk factors for OSA and osteoporosis. Nevertheless, women reporting poor sleep or insomnia in combination with risk factors for osteoporosis might benefit from an evaluation of bone health.

Chronic fatigue and recovery among nurses working two-shift and three-shift rotations

BackgroundShift patterns influence nurses’ work and rest conditions. Limited information is available about the nurses' recovery, fatigue, and their associated factors considering shift patterns. AimThis study explored the association between fatigue and recovery and factors associated with recovery and chronic fatigue among nurses working a three-shift (8 hour shifts) or two-shift (more than 12 hour shifts) rotations in Japan. MethodsThis cross-sectional secondary analysis included 807 nurses from a previous questionnaire survey. Fatigue (acute and chronic) and intershift recovery were measured using the Occupational Fatigue Exhaustion Recovery Scale. FindingsIntershift recovery was significantly lower among nurses working a three-shift rotations compared to nurses working a two-shift rotations. Nurses aged ≥40 years tended to experience severe chronic fatigue working in the two-shift rotations. In both shift patterns, overtime hours and low sleep quality were associated with lower intershift recovery and higher chronic fatigue. In the three-shift rotations, having children and being activity-oriented in leisure time were associated with higher intershift recovery and lower chronic fatigue. In the two-shift rotations, activity orientation was significantly associated with lower chronic fatigue. DiscussionsThe three-shift rotations influenced nurses’ intershift recovery more than the two-shift rotations. Regardless of shift patterns, managers must restrict overtime and encourage nurses to maintain sleep quality, family roles, and leisure activities. Moreover, considering nurses’ age while selecting and organising shift patterns may prevent chronic fatigue. ConclusionFatigue management based on the characteristics and associated factors of fatigue and recovery for each shift pattern revealed in this study prevents chronic fatigue, which may contribute to the retention of nurses.

Sleep disturbance and dysregulation of circadian clock machinery in sudden sensorineural hearing loss

Background The cochlea contains a robust biological clock associated with auditory function, exhibiting diurnal sensitivity to noise or ototoxicity Objectives We examined the relationship between disrupted circadian rhythm and altered expression of circadian clock genes in patients with sudden sensorineural hearing loss (SSNHL) and explored whether the circadian clock genes serve as prognostic biomarkers. Material and Methods Twelve patients with SSNHL were enrolled study group. Twelve people with normal hearing were enrolled voluntarily for comparison. Audiological evaluation was performed to evaluate hearing thresholds. Korean version of the Pittsburgh Sleep Quality Index Questionnaire was performed to evaluate sleep quality and patterns. Circadian clock genes including for PERI, PER2, PER3, CRYI, CRY2, CLOCK, ARNTL, CSNKIE, and TIMELESS expression in blood were evaluated using real-time quantitative PCR method. Results Compared with healthy controls without hearing loss, most of the circadian clock genes were markedly downregulated, coupled with low sleep quality and disturbing patterns, in patients with SSNHL. Intriguingly, a weak correlation between hearing improvement following steroid treatment and altered levels of circadian clock genes was observed. Conclusions and Significance This study provides an additional basis for the relevance of disrupted circadian rhythm to SSNHL and suggests a possible prognostic biomarker for SSNHL treatment.

Sleep and Perceived Stress: An Exploratory Mediation Analysis of the Role of Self-Control and Resilience among University Students.

High levels of stress are frequent in university education, and a lack of sleep has been reported to make students more vulnerable to stress. The mechanisms through which sleep harms students have not been sufficiently clarified; therefore, this study aimed to explore the mediating role of self-control and resilience in the relationship between sleep quality and duration and perceived stress. Of 32 first-year college students, 21 (78%) were women, with a mean age of 18.47 (±0.84). They responded to a self-administered survey that included questions on stress, resilience, and sleep quality and recorded their daily sleep duration using a wristband for six days. Perceived stress was significantly correlated with resilience (r = -0.63), self-control (r = -0.46), sleep duration (r = -0.35), and lower sleep quality (r = 0.57). Path analysis revealed that self-control and resilience were partially mediated by sleep quality (R2 = 0.62; p < 0.01) and completely mediated by sleep duration (R2 = 0.46; p < 0.01). In both models, self-control had a direct effect on resilience and had a good-fit index. Being resilient seems to play a mediating role in the relationship between sleep and perceived stress; this ability can be favored by self-control, which is directly influenced by sleep.

Longitudinal relations of sleep quality with depressive symptoms, diabetes distress and self-efficacy in young people with type 1 diabetes

PurposeTo examine the longitudinal, bidirectional associations of sleep quality with depressive symptoms, diabetes-specific distress and diabetes management self-efficacy among adolescents and young adults with type 1 diabetes. MethodsCross-lagged analyses used baseline, three-, six- and nine-month data from a randomized trial among 60 young people. Self-report measures included the Pittsburgh Sleep Quality Index, Center for Epidemiological Studies – Depressed Mood scale, Problem Areas in Diabetes Teen version, and Diabetes Management Self-efficacy Scale. ResultsLower sleep quality at baseline was associated with higher three-month depressive symptoms (b = 0.21, p = 0.005) and lower diabetes self-efficacy (b = −0.18, p = 0.014), but not diabetes distress (b = 0.06, p = 0.403). Similar patterns were found at six and nine months. Three-month psychological functioning was not associated with six-month sleep quality. ConclusionsAmong adolescents and young adults with type 1 diabetes, lower sleep quality predicted subsequent depressive symptoms and lower diabetes self-efficacy rather than vice versa. Sleep deserves a central place in diabetes care.

Sleep Quality and Related Factors Among Liver Transplant Recipients in Korea: A Cross-Sectional Study.

Poor sleep quality is common after liver transplantation, which lowers health-related quality of life. However, the detection and management of sleeping difficulties in liver transplant recipients have been limited. This study was designed to assess sleep quality in liver transplant recipients in Korea and associated factors, including symptom experience, depression, and family support, using the theory of unpleasant symptoms as a theoretical framework. This cross-sectional study of 149 liver transplant recipients in a Korean tertiary hospital was conducted in 2019. Data were obtained using several structured self-report questionnaires, including the Pittsburgh Sleep Quality Index, Modified Transplant Symptom Occurrence and Symptom Distress Scale, Center for Epidemiologic Studies Depression Scale-Revised, and Family Support Scale. Multiple linear regression was used to determine the factors associated with sleep quality. The prevalence of sleep disturbance was 55% in the sample. Low sleep quality was associated with being female and with having a higher symptom experience, higher depressive symptoms, and lower family support. In the multiple linear regression analysis, depression and symptom experience was shown to significantly affect sleep quality. The liver transplant recipients in this study reported poor sleep quality. The factors associated with the sleep quality included depression and symptom experience. To enhance sleep quality, interventions designed to reduce depression and symptoms related to liver transplantation should be provided. The results of this study may be used to develop nursing strategies to improve sleep quality in liver transplant recipients.