Mean Pittsburgh Sleep Quality Index Research Articles

Determinants of sleep disturbances in patients with pulmonary arterial hypertension

Abstract Introduction Pulmonary arterial hypertension (PAH) is a rare, chronic disease that leads to the development of a range of cardiopulmonary and cardiovascular symptoms. Studies indicate that sleep problems may contribute to the deterioration of function in patients with PAH. Identifying factors that are related to the occurrence of sleep disorders can help identify them, and will also allow you to take steps to minimize the risk of insomnia. Purpose The aim of this study was to determine the determinants affecting the incidence of sleep disorders among patients with pulmonary arterial hypertension. Material and methods The study included 89 patients with a diagnosis of pulmonary arterial hypertension (PAH) who are chronically treated and participate in the state program for Therapeutic Treatment of Pulmonary Arterial Hypertension by the National Health Service. The study used standardized tools: a self-administered survey questionnaire, as well as the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Results Patients had a mean PSQI score of M=8.7 (SD=4.64), indicating low sleep quality. Factors that had a significant impact on sleep disturbance were: old age (r=0.373), chest pain (r=0.307), weakness (r=0.296), fatigue (r=0.316), shortness of breath (r=0.242), MWT score 6 (r= -0.237), NT-proBNP (r=0, 517), social support (r=0.237), staying in a relationship (r= -0.21), arrhythmia (r=0.211), number of hospitalizations (r=0.33), male gender (r=0.257), WHO FC class (r=0.503). Conclusions In the study group of patients with PAH, sleep disorders are present in the majority. The progression of clinical symptoms and selected sociodemographic data significantly correlate with the occurrence of insomnia.

Evaluation of Prenatal Comfort, Sleep, and Quality of Life in Pregnant Women with Cholestasis: A Cross-Sectional Study

Background: Associated with adverse pregnancy outcomes, intrahepatic cholestasis of pregnancy is the most prevalent liver disease that women typically experience during pregnancy. This study aimed to evaluate prenatal comfort, sleep, and quality of life in pregnant women with cholestasis. Methods: This cross-sectional study was implemented between November 2022 and June 2023 at Mardin Training and Research Hospital with 150 pregnant women who received a diagnosis of pregnancy-induced intrahepatic cholestasis and agreed to participate. The following tools were utilized to collect data: A personal information form exploring socio-demographic and obstetric characteristics of participants, the Prenatal Comfort Scale (PCS), the Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life-Brief Form (WHOQOL-BREF). Results: The mean age of participants was 27.79 ± 6.33 years. The mean PCS and PSQI scores were 61.20 ± 5.84 and 9.52 ± 3.02, respectively. The mean scores of “physical health, psychological health, social relationships, and environmental health” sub-dimensions in WHOQOL-BREF were 10.63 ± 2.18, 10.48 ± 2.10, 11.31 ± 3.28, and 11.27 ± 2.10, respectively. A significant difference was found for PSQI regarding hospitalization status and change in sleep quality variables (p = 0.025 and p = 0.035, respectively). Conclusions: Cholestasis of pregnancy creates problems such as pruritus, body image changes, hospitalization, and poor sleep quality in women. This study showed that pregnant women with cholestasis had low levels of sleep quality and quality of life, implying that cholestasis affects their sleep quality, prenatal comfort levels, and quality of life in general. In addition, it is seen that women with this problem do not want to fall pregnant again.

Eating attitudes, physical activity, and sleep quality levels of adolescents during the pandemic process

PurposeThe present study was conducted to determine the eating attitude, physical activity, and sleep quality levels of adolescents during the pandemic process. MethodThis descriptive study was completed by 987 adolescents. Data were collected by using the Adolescent Descriptive Characteristics Form, the Dutch Eating Behavior Questionnaire (DEBQ), the International Physical Activity Evaluation Questionnaire (IPAQ-Short Form), and the Pittsburgh Sleep Quality Index (PSQI). ResultsIt was found that the mean age of the adolescents who participated in the study was 16.30 ± 1.30 and 23.1 % of them were male. During the pandemic process, adolescents consumed pastries, sugary foods and beverages, french fries, chips, etc. consumption was found to increase (41.7 %, 42.2 %, 45.2 %, respectively). It was also found that the mean DEBQ score of the adolescents was 75.13 ± 19.65 and the mean PSQI score was 10.99 ± 4.22. In the IPAQ, 29.9 % of the adolescents were found to be inactive, 44.7 % minimally active, and 25.4 % very active. It was determined that BMI, PSQI, gender, pastry, and sugary food consumption were important predictors of eating behavior. When the increase in consumption of pastries and sugary foods was added, it was seen that BMI, PSQI, and gender explained 7 % of the change in DEBQ and when the increase in pastry and sugary foods was added, it explained 11 % of the change in DEBQ. It was found that BMI, PSQI (p < 0.001), and gender (p = 0.001) had significant effects on students' eating behavior scores. ConclusionAdolescents' eating out, emotional eating, and restrictive eating scores were found to be high during the COVID-19 pandemic. Adolescents were also found to have inadequate physical activity levels and poor sleep quality. It is recommended that projects and intervention studies be performed to help adolescents with these matters.

Sleep quality and self-efficacy for managing chronic disease: A cross-sectional study in the elderly Population in Edirne Province

Objective: To examine the relationship between sleep quality and self-efficacy for managing chronic diseases in elderly individuals living at home in Edirne province. Methods: In this cross-sectional study, the data was collected through simple random sampling and home visits from 244 individuals aged 60 years and older between March and December 2018. The Pittsburgh Sleep Quality Index, the Self-Efficacy for Managing Chronic Disease 6-Item Scale, and the Interview Form were used in the study. The data was collected using descriptive analysis, t-test, one-way ANOVA, Pearson correlation, and linear regression analysis. Results: Most of the individuals (86.1%) had poor sleep quality and the mean Pittsburgh Sleep Quality Index total score was 7.16±3.04. The mean of Self-Efficacy for Managing Chronic Disease 6-Item Scale total score was 4.82±1.79. Sleep quality was worse in individuals who were women, single, retired, perceiving their health as bad, and with comorbidities (p˂0.05). There was a negative and significant relationship between the scales in correlation and regression analyses (p˂0.05). Conclusions: Self-efficacy in chronic disease management was an important factor in improving sleep quality. Healthcare professionals must be knowledgeable and experienced in practices that increase self-efficacy in primary care.

Telehealth cognitive behaviour therapy for the management of sleep disturbance in women with early breast cancer receiving chemotherapy: a feasibility study

PurposeSleep quality commonly deteriorates in people receiving chemotherapy for breast cancer (BC). We aimed to determine feasibility and acceptability of telehealth-delivered cognitive behaviour therapy for insomnia (CBT-I) in people with early BC receiving (neo)adjuvant chemotherapy.MethodsMulti-centre, single arm, phase 2 feasibility trial. People with stage I-III BC received 4 sessions of telehealth CBT-I over 8 weeks, during chemotherapy. Participants completed Pittsburgh Sleep Quality Index (PSQI) and other Patient Reported Outcome Measures (PROMs) at baseline, post-program (week 9) and post-chemotherapy (week 24); and an Acceptability Questionnaire at week 9. Primary endpoint was proportion completing 4 sessions of telehealth CBT-I.ResultsIn total, 41 participants were recruited: mean age 51 years (range 31–73). All 4 CBT-I sessions were completed by 35 (85%) participants. Acceptability of the program was high and 71% reported ‘the program was useful’. There was no significant difference in the number of poor sleepers (PSQI score ≥ 5) at baseline 29/40 (73%) and week 24 17/25 (68%); or in the mean PSQI score at baseline (7.43, SD 4.06) and week 24 (7.48, SD 4.41). From baseline to week 24, 7/25 (28%) participants had a ≥ 3 point improvement in sleep quality on PSQI, and 5/25 (20%) had a ≥ 3 point deterioration. There was no significant difference in mean PROM scores.ConclusionIt is feasible to deliver telehealth CBT-I to people with early BC receiving chemotherapy. Contrary to literature predictions, sleep quality did not deteriorate. Telehealth CBT-I has a potential role in preventing and managing sleep disturbance during chemotherapy.Australian New Zealand Clinical Trials Registry (ANZCTR) registration number: ACTRN12620001379909 and date 22/12/2020.

The Relationship Between Post-Earthquake Anxiety Status with Sleep Problems, Low Back and Neck Pain in Victims of the Kahramanmaraş-Centred Earthquakes

Background: This study aims to examine the relationship between the post-earthquake anxiety status of victims of the Kahramanmaraş-centered earthquake and sleep problems, low back and neck pain. Materials and Methods: Individuals with a mean age of 27.9±9.1 years who experienced the Kahramanmaraş-centered earthquake were included in the study. The individuals included in the study was evaluated with the Beck Anxiety Inventory (BAI), the Oswestry Disability Index (ODI), the Neck Disability Index (NDI), and the Pittsburgh Sleep Quality Index (PSQI). Results: Of the participants, 67% were determined to have mild, moderate, and severe anxiety, and all of them had poor sleep quality (6.9±3.8). While the mean PSQI score of 57% of the participants sheltered in their own homes was 5 and above, this rate was 75% for those sheltered outside their homes. Of the individuals sheltered in their own homes, 27% and 37% of those sheltered outside their own homes had the ODI score percentages above 20%. A statistically moderate correlation was determined between the BAI score and the ODI score, the NDI score, and the PSQI score (r=0.511, r=0.604, r=0.539, respectively). Conclusions: Post-earthquake anxiety was revealed to be associated with sleep problems and low back and neck pain. Considering the relationship between the presence of anxiety, sleep problems, low back and neck pain in the support approaches to be adopted toward earthquake victims, approaches involving these parameters should be planned.

Sleep quality and sedentary behavior among cancer survivors: is there a possible link?

Purpose: Disrupted sleep patterns can be frequent in cancer survivors not only during treatment but also during survival. This study aimed to analyze the possible link between sleep quality and sedentary behavior among cancer patients.&#x0D; Methods: Demographic and clinical information was obtained through an assessment form. Sleep quality and physical inactivity level were assessed by the Pittsburgh Sleep Quality Index (PSQI) and Sedentary Behavior Questionnaire (SBQ), respectively. This cross-sectional study was conducted between April and June 2023 in the Medical Oncology unit of Izmir Bakırçay University Faculty of Medicine.&#x0D; Results: This study was completed with a total of 80 patients with most of the types of cancer being breast (n=55). The mean PSQI score was 7.68±4.02. SBQ scores were 8.16±3.90, and 6.85±3.86 hours on weekdays and weekends, respectively. No significant association was observed between PSQI and SBQ total scores (p&gt;.05). Age was correlated with sleep disturbances (r=-.24, p=0.03), daytime dysfunction (r=-.34, p=0.002), and first item of SBQ (watching TV) both on weekdays (r=.35, p=0.001) and weekends (r=.38, p=0.001), respectively.&#x0D; Conclusion: This study showed that there was no significant relationship between sedentary behavior and sleep quality among cancer patients, however, the remarkable rate of poor sleep quality was evident in this sample. However, it might be reasonable to suggest that the increased screen time especially for older cancer patients due to significant associations between screen time and age, should be well managed while sleep hygiene and daytime dysfunction should be considered further among younger cancer survivors.

Working from home is associated with changes in sleep hygiene practice.

Sleep hygiene habits and self-reported sleep quality of those who work from home have yet to be fully understood. As working from home was widely implemented during the COVID-19 pandemic, the period might be a convenient model for studying the measures, as mentioned earlier. This study aimed to assess sleep hygiene habits and self-reported sleep quality in people working from home in March 2020, when the COVID-19 pandemic began. This study was designed as a cross-sectional web-based survey. An anonymous questionnaire consisted of sociodemographic variables and questions about personal habits, e.g., exercise activities and caffeine consumption. The outcome measures to assess sleep hygiene and sleep quality were the Sleep Hygiene Index (SHI) before and after the home office (HO) and the Pittsburgh Sleep Quality Index (PSQI). A total of 204 responses were received. The prevalence of significant sleep disturbance (PSQI > 5) was 51 %. The mean PSQI and SHI scores were 6.15±3.385 and 17.67±7.836, respectively. PSQI and SHI showed a significant mutual positive correlation at the level of significance p < 0.001. The total score for SHI was similar before and after working from home (p = 0.982). However, differences were observed in its components. The total score on SHI did not change when compared before and during HO. However, working from home was associated with sleep hygiene malpractice in some individual components of SHI. On the other hand, some aspects of sleep hygiene behavior improved during HO.

The impact of foot reflexology on fatigue and sleep quality in school-aged children undergoing hemodialysis

ABSTRACT Objective: This study aimed to evaluate the effects of foot reflexology on fatigue and sleep quality in school-aged children receiving hemodialysis. Methods: A quasi-experimental pretest–posttest design was utilized. Thirty children of ages 6–12 undergoing in-center hemodialysis were recruited. The Pittsburgh Sleep Quality Index (PSQI) and Inventory of Fatigue Symptom (IFS) scales were administered at baseline. Participants then received 30 min of foot reflexology massage before hemodialysis sessions 3 days per week for 12 weeks. Posttest administration of the sleep and fatigue scales occurred after the intervention period. Results: Reflexology massage led to significant improvements in sleep quality components, including duration (0%–30% normal sleepers), efficiency (0%–50% &gt;85%), latency (50%–0% &gt;60 min), disturbances, and daytime dysfunction. The mean PSQI score decreased from 18.2 to 9.7 (P &lt; 0.05). Fatigue severity substantially decreased, with the mean IFS score improving from 105.7 to 64.1 (P &lt; 0.05). Conclusion: Foot reflexology is an effective nursing intervention for reducing fatigue and improving sleep quality in children on hemodialysis, warranting integration into routine care.

A cross-sectional study of sleep disturbance among middle-aged cancer patients at Vietnam National Cancer Hospital.

Sleep disorders are common in cancer patients and have negative consequences for patient well-being and treatment outcomes. This study aimed to investigate sleep quality and related factors in Vietnamese middle-aged cancer patients. A cross-sectional study was conducted on 246 middle-aged in-patient cancer patients at Vietnam National Cancer Hospital (VNCH) from 1/2021 to 7/2021. Sleep was measured by the Pittsburgh Sleep Quality Index (PSQI), with a cutoff of 5. The results showed a male/female ratio of 0.85 with an average age of 52. The five most prevalent cancer types were breast, colorectal, lung, and esophagus-stomach cancer, primarily in the late stage and treated with chemotherapy. The prevalence of sleep disturbances was 58.5%. The mean PSQI score was 7.5, with sleep duration and latency of 5.4 h and 1 h, respectively. Approximately 44% of participants reported poor sleep quality, nearly 9% had daytime dysfunction, and 10.6% used sleep medication. The multivariate logistic regression results indicate that people with depression were 8.89 times more likely to have poor sleep than those without depression (95% CI:2.63-28.27, p < .001). Sleep problems are common among middle-aged people with cancer in Vietnam, especially individuals with depression. It is necessary to have more effective approaches to sleep management for cancer patients with limited resources.

IJCM_57A: Assessment of quality of Sleep among working women of an urban area in Ernakulam district-A cross-sectional study

Background: Women from diverse backgrounds in India are now employed, facing challenges that impact their sleep and well-being. The demands of their jobs, extended working hours, family responsibilities, lifestyle changes, and various socio-demographic factors make unwinding and falling asleep difficult. Objective: The study was conducted to assess the quality of sleep and the sociodemographic factors affecting it among the working women of an urban area in Ernakulam District, Kerala. Methodology: A community based cross sectional study was conducted among 141working women aged 18 years and above residing at Perumbavoor municipality of Ernakulam district. Women who were paid wages for their work were considered as working women. From the 27 wards in the Perumbavoor municipality 14 wards were selected randomly. From each selected ward 10 households were sampled by systematic random sampling. If more than one working woman was found in a house only one woman was interviewed. Data was collected using semi structured questionnaire and Pittsburgh Sleep Quality Index (PSQI) was used to assess the quality of sleep. Results: 69.5% of the working women belonged to the age-group of 30-39 years, 80.1% belonged to APL category by colour of ration card, 90.1% were married, 22% worked for more than 8 hours and 11% worked in night shifts. Poor sleep quality was seen in 70.9 % of working women with mean PSQI Score 6.17(SD + 2.68).76.37% married women had poor sleep quality compared to 21.4%of unmarried/widowed women (?2=18.46, d f=1, p&lt;.0001). Conclusion: The study suggests poor quality of sleep among working women. Counselling sessions could help them set up a daily routine that will help them improve their sleep patterns.

Quality of sleep and depression in family caregivers of patients receiving palliative care

Introduction: This study aimed to evaluate the depression symptoms and quality of sleep of palliative care patients’ family caregivers. Methods: A total of 120 patients were hospitalized at the palliative care center and primary caregivers were included. Depression symptoms of caregivers was assessed by the Beck Depression Inventory (BDI) and quality of sleep with Pittsburgh Sleep Quality Index (PSQI). Results: The mean age of 120 caregivers included in the study was 47.2±12.8 years. The mean BDI score was 10.4±7.2, and the mean PSQI score was 4.6±2.9. Significantly higher rates of depression symptoms were observed in singles than in married people (p=0.037). The healthy sleep rate of the patients whose caregiving period was 6-10 years was significantly lower (p=0.018). While 78.5% of those who received support from their families had a healthy sleep, this rate was 52.4% in those who did not receive support from their families (p=0.034). A significant difference was found between PSQI and BDI categories (p=0.004). People with moderate depressive symptoms were more likely to have poor sleep quality and long-term sleep disorders. Conclusions: Family caregivers of patients receiving palliative care are at risk for poor sleep quality and depression symptoms. We think that the evaluation of these people in terms of the presence of depression symptoms and poor sleep quality may provide early intervention to alleviate the symptoms.

Abstract MP41: Associations Between Reallocations of Daytime Movement Behaviors and Self-Reported Sleep Quality and Insomnia Severity in Desk Workers

Introduction: While moderate- to vigorous-intensity physical activity (MVPA) is commonly associated with better sleep, few studies have considered the influence of sedentary behavior (SB) or light-intensity PA (LPA) on sleep or how reallocation of these daytime movement behaviors are associated with sleep. Purpose: To examine the association of reallocating time spent in daytime movement behaviors (SB, LPA, MVPA) with self-reported sleep quality and insomnia severity. Methods: Using baseline data from a clinical trial, 170 adults with desk jobs were included in analyses (84.1% white; 51.2% female; body mass index [BMI]=31.1±6.6 kg/m 2 ; age=44.7±10.8 y). Daily SB and MVPA were measured with activPAL and ActiGraph GT3x accelerometers, respectively, over ~7 days; SB was categorized into short- and long-bout SB (time spent in &lt;30 or ≥30 min bouts, respectively). Daily LPA was calculated as activPAL-assessed wear time minus SB and MVPA. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) assessed sleep quality and insomnia severity, respectively. Isotemporal substitution analyses utilized linear regression to demonstrate the effects of replacing one movement behavior (short-bout SB, long-bout SB, LPA, MVPA) with an equivalent amount of another movement behavior on sleep. All analyses adjusted for age, sex, BMI, and device wear time. Results: On average, participants spent 4.7±1.3 h/day in short-bout SB, 6.3±2.2 h/day in long-bout SB, 4.3±1.6 h/day in LPA, and 37.3±21.8 min/day in MVPA. Mean PSQI and ISI scores were 5.5±3.0 and 7.2±4.8, respectively; 42.4% had poor sleep quality (PSQI&gt;5) and 40.6% had at least mild-severity insomnia (ISI≥8). Reallocating time from short-bout SB to MVPA was significantly associated with better sleep quality (-0.73±0.37 unit change in PSQI score per 30-min reallocation [P=.05]); reallocations from long-bout SB or LPA to MVPA trended toward significantly better sleep quality (P=.08 and P=.09, respectively). Reallocating time from SB or LPA to MVPA was not significantly associated with lower insomnia severity (each P&gt;.16). Conclusions: Increasing moderate-vigorous physical activity at the expense of sedentary behavior or light-intensity physical activity was associated with better sleep quality, though the strengths of these associations were mild at best. Support: NIH R01 HL134809, R01 HL147610.

Relationship between Physical Activity Level and Sleep Quality in Mothers of Individuals with Special Needs

Purpose: The study aimed to investigate the relationship between physical activity level and sleep quality in mothers of individuals with special needs.&#x0D; Material and Methods: Three hundred twenty-one mothers (average age: 41.92±9.53 years) with a disabled child participated in the study from Osmangazi county of Bursa province in Türkiye. Demographic characteristics of the mothers were collected through a personal information form prepared by the researchers. The mothers’ physical activity level was determined using the International Physical Activity Questionnaire-short form (IPAQ-SF). The mothers’ sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI). The physical activity level of the disabled individuals was determined based on their mothers’ statements. &#x0D; Results: The mean IPAQ-SF score of the mothers was found to be 1080.58±986.88 MET-min/week, and their mean PSQI score was determined to be 7.46±3.62. The disabled individuals’ physical activity level was evaluated as a)15.9% (n=51) of the disabled individuals regularly participated in a sporting activity, b) 32.4% (n=104) did not participate in sports but made efforts to stay active, and c) 51.7% (n=166) were considered inactive. Pearson correlation analysis revealed that a) there was no relationship between IPAQ-SF and PSQI scores (r: -0.056, p=0.313), b) the physical activity level of individuals with special needs did not correlate with PSQI scores of the mothers (r: -0.95, p=0.089), and c) no relationship was determined between the age of individuals with special needs and mothers' sleep quality and physical activity level.&#x0D; Conclusion: It can be concluded that increasing the physical activity level of mothers cannot be an effective intervention to improve sleep quality in mothers of individuals with special needs. Further research is needed to explore the relationship between physical activity level and sleep quality in mothers of individuals with special needs.

The Effect of Sleep Enhancement Educational Program on Maternal Sleep Quality for Nulliparous Pregnant Women: A Randomized-Controlled Trial.

Pregnancy is a critical period during which women usually do not prefer taking medication. Therefore, non-pharmacological and safe methods are needed to improve sleep quality during pregnancy. This study aims to identify whether an educational program on sleep enhancement for pregnant women has any effect on maternal sleep quality. This was a randomized-controlled trial. Pregnant women (N = 181) were divided into two groups, an intervention group (n = 90) and a control group (n = 91). A two-session educational program for the enhancement of sleep quality was provided to the intervention group, whereas solely the routine practices of the hospital were put in place for the control group. The intervention group had a significantly lower mean Pittsburgh Sleep Quality Index score, and accordingly, better sleep quality than the control group. Participation in the education program was significantly related to sleep quality and accounted for 6% of the total variance in sleep quality (R2 = 0.055) (p < 0.001). It was concluded that the educational program on sleep enhancement implemented to improve the sleep quality of pregnant women enhanced maternal sleep quality. URL: clinicaltrials.gov . NCT04262349.

The quality of sleep: evaluation among university students.

This study explored the quality of sleep among university students in the South of Italy during the Covid-19 pandemic. A cross-sectional study was conducted between March 2022 and January 2023 and involved students over the age of 18, who were invited to complete a self-administered questionnaire using an online application. Overall, 88% of men and 94.5% of women had Pittsburgh Sleep Quality Index (PSQI) scores of ≥5 and a mean PSQI score of 9.2 ± 3. Students with severe or extremely depression score, with sever or extremely stress score, male and who did not had Covid-19 infection were more likely to have a PSQI global score. Moreover, 62.6% of the students declared a reduction in social relations and 72.3% an increase in the use of social media during the pandemic period. The majority of respondents reported an extremely severe level of depression (68.1%), anxiety (84.4%) and stress (71.9%). This finding indicate that a relevant percentage of students are poor sleepers with a higher overall PSQI score with depression and stress and underline the role the implementation of public health interventions to promote healthy life styles and in particular focus on the duration of long night sleep.

Is There a Correlation Between Internet Use and Sleep and Cognitive Function Among Medical Students?

Background: Currently, the Internet is widely used by students for academic purposes; however, excessive Internet use might have negative consequences on students’ academic performance, sleep quality, and cognitive abilities. Objectives: This study aimed to investigate the relationship between Internet usage, sleep quality, and cognitive function among medical students. Methods: This analytical cross-sectional study was conducted on 525 pre-internship medical students, including 304 first- and second-year students, 113 third-year students, and 108 externs, within 2019 and 2021 at Mashhad University of Medical Sciences, Mashhad, Iran. The participants were selected using a stratified sampling method. All participants completed the Cognitive Ability Questionnaire (CAQ), Internet Addiction Questionnaire (IAQ), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using SPSS software (version 22). Results: According to the IAQ, 430 participants (81.9%) were categorized as average Internet users, 94 participants (17.9%) had occasional or frequent problems, and 1 participant had significant problems with Internet use. Mean PSQI and CAQ scores were significantly higher among participants with occasional or frequent problems/significant problems than the average Internet users (P &lt; 0.001 each). The total IAQ score showed a positive correlation with total CAQ (r = 0.439, P &lt; 0.001) and total PSQI (r = 0.264, P &lt; 0.001) scores. Among the PSQI subscales, sleep latency (P = 0.032), daytime dysfunction due to sleepiness (P &lt; 0.001), sleep efficiency (P = 0.001), and overall sleep quality (P &lt; 0.001) were worse in participants with occasional or frequent problems/significant problems than in average Internet users. Conclusions: Excessive Internet use negatively affects the sleep quality and cognitive performance of medical students.

Assessment of Sleep Quality among Nursing Students on Clinical Posting in a Tertiary Health Facility in North-Western Nigeria

Context: The sleep quality of nursing students needs to be assessed in the context of their living conditions in order to know the best way to improve any abnormality noted. Aim: To assess the quality of sleep of nursing students and determine its relationship with their conditions of living among other factors. Methods and Material: A cross-sectional descriptive study involving nursing students on postings in a tertiary health facility. The socio-demographic data were collected with the aid of a structured questionnaire. The sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires. Statistical Analysis Used: Data were analyzed using the Statistical Product for Service Solution (SPSS) for Windows version 22. Chi-square (χ2) or Fisher’s exact tests were used to determine the association between sleep quality and various parameters. Results: The total participants were 255 with a mean age of 21.5 ± 3.4 yrs and a male to female ratio of 0.4:1. The mean sleep latency period and mean sleep duration were 21.5 ± 14.0 minutes and 6.4 ± 1.4 hours respectively. The mean ESS was 9.8 ± 3.5 indicating an increased tendency for daytime sleepiness. The mean PSQI was 6.2 ± 3.0. Seventy-three percent of the participants were poor sleepers (had scores of ≥5); 7.1% of them had a level of severity needing medical help. The quality of sleep and daytime sleepiness were significantly associated with the number of roommates and source of funding respectively. Conclusion: Most of the participants have poor sleep quality which is significantly associated with the number of roommates and source of funding.

Investigating a clinically informed sleep disturbance threshold for physical and mental health among Gulf War Illness veterans.

This study (1) assessed sleep quality and health in Gulf War veterans (GWV) meeting the Gulf War Illness (GWI) criteria and (2) compared health associations for both those meeting a "clinically disturbed sleep" threshold, and those below, as determined by the Pittsburgh Sleep Quality Index (PSQI) cutoff for military populations (≥10) on measures of physical, mental, and cognitive health. Participant data consisted of questionnaires and assessments completed prior to group assignment in a clinical trial. The sample consisted of 147 GWV, where 81.0% were males, and the median age was 53.4 years. The mean (SD) PSQI global score was 12.34 (4.00) with 61% of the sample qualifying as clinically disturbed sleepers according to the cutoff (global PSQI ≥ 10). GWI veterans with PSQI scores ≥10 did not differ from others in age (p = 0.20), sex (p = 0.19), or years of education (p = 0.87), but showed worse GW-related symptomology on the Gulf War Kansas questionnaire (p < 0.01), and poorer mental health on the Veterans Rand-36 (p < 0.01). Disturbed sleep was associated with measures of pain, fatigue, and cognitive health. Our results suggest that a previously determined clinical threshold for clinically disturbed sleep is useful when examining the health status of the study population. Given that GWI is associated with elevated PSQI scores and a high frequency of disturbed sleep, cutoffs determining sleep health should be sensitive to population exposures and health history to improve interpretability.

Wake-Up Call to Address Sleep Health in Non-Muscle Invasive Bladder Cancer: Underappreciated Contributor to Poor Quality of Life.

Few studies have specifically examined sleep health in patients with non-muscle invasive bladder cancer (NMIBC). Further study is warranted to inform future strategies in patients with NMIBC. We aim to describe sleep health in a cohort of patients with NMIBC, and its relationship with quality of life (QOL). We conducted an observational cross-sectional study in patients undergoing surveillance for NMIBC. The validated Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep health (scores from 0-21) in the overall study population as well as stratified. We assessed QOL among participants with and without poor sleep quality using the SF-12 and QLQ-NMIBC-24. In a cohort of 94 NMIBC patients, median age was 67 years (IQR: 58, 72) and median time since initial diagnosis was 27 months (IQR: 9, 41). The mean PSQI score was 6.3 (SD: 3.8) and 64% percent of participants met or exceeded the PSQI cut-off score of 5, with a score of 5 or more indicating overall poor sleep quality. In those with poor sleep quality, there were statistically significant detriments in multiple QOL domains. In patients undergoing surveillance for NMIBC, there is a substantial burden of sleep disturbances and resulting decrements in QOL. These data support the need for future interventions to support sleep quality and highlight the importance of addressing sleep health as part of NMIBC survivorship care to improve QOL in patients with NMIBC.