Mean Pittsburgh Sleep Quality Index Research Articles

Sleep Quality and Nocturnal Pain in Patients of Rotator Cuff Syndrome

Background: Shoulder pain during sleep leads to poor quality sleep. It is a common problem in patients with Rotator cuff syndrome. Rotator cuff syndrome is a condition where your rotator cuff tendons are intermittently trapped and pinched during shoulder movements Objective: To evaluate the relationship between sleep quality and nocturnal pain in patients of rotator cuff syndrome. Methods: Current study was conducted in orthopedic and physiotherapy department of Jinnah Hospital Lahore. Cross-sectional survey was used in this study. Subjects with age group 18-75 years, both genders, diagnosed with rotator cuff syndrome with positive shoulder impingement test and empty can test were included. Patients were requested to fill the comprehensive questionnaire about current medical history, shoulder pain, impact on daily life activities and quality of sleep. Patients with coexisting neck pain and radiculopathies (spleen, kidney, gallbladder) and also with other disabilities e.g., osteoarthritis, rheumatoid arthritis, back pain were excluded from current study. Thirty-six patients were enrolled and examined by using Pittsburgh Sleep Quality Index (PSQI). Data was analyzed using SPSS 20.0. Results: The results showed that sleep quality was disturbed in patients of rotator cuff syndrome with a mean Pittsburgh Sleep Quality Index score of 11.3333. The results showed that among 36 patients, 18 (50%) had moderate disturbance of sleep as calculated by PSQI scale and 11 (30.6%) had severe disturbance of sleep while 7 (19.4%) had mild disturbance of sleep due to rotator cuff syndrome. Conclusion: The current study concluded that subjective sleep disturbance connected to shoulder pain was obvious in patients with rotator cuff syndrome. Patients experienced low quality of sleep associated with rotator cuff syndrome and affected their activities of daily living causing severe pain and physical disability. Keywords: Shoulder pain, rotator cuff syndrome, Sleep quality.

Impact of pain severity on functioning domains, sleep, and cognition in painful diabetic peripheral polyneuropathy patients

BackgroundSeveral studies have observed that painful diabetic peripheral polyneuropathy (PDPN) had an impact on the level of functioning domains and quality of sleep as well as cognitive functions. This study is aimed to explore the relationship between severity of pain and level of functioning, sleep quality, and cognitive functions among these patients. We recruited 100 diabetics with a mean HbA1C% of 7.3±0.9, diagnosed with PDPN, and included in the study with a mean age of 51±12.8 years and disease duration of 10.2±7.4 years. The following assessment was done for each patient; clinical and neurophysiology assessment, routine laboratory assessment, measuring pain severity, and average pain severity interference scores using pain visual analog scale (VAS) and brief pain inventory (BPI) short form, respectively, sleep quality assessment using Pittsburgh Sleep Quality Index (PSQI) and Montreal cognitive function assessment (MOCA) scales.ResultsModerate to severe pain was recorded in 71% of patients according to the VAS pain score. The severe pain group recorded the significant highest average pain severity and interference scores in BPI and domains compared to other less pain groups with average pain intensity scores of 7.5±0.6 vs 5.3±0.8 in the moderate and 3.3±0.4 in mild pain groups. Poor sleep quality and pattern were observed in these patients with a mean PSQI score of 6.8±3.1, and the severe pain group had a significant highest score of 9.4±2.3 compared to other less group scores of 7±2.3 and 3.7±1.8. Their mean MOCA score was low 24.2±2.2. Out of them 48/100 patients had mild cognitive impairment and recorded high frequency in the severe pain group (28/32) followed by the moderate pain (15/39) group. There is a significant correlation between the score of VAS and PSQI as well as MOCA.ConclusionsPainful DPN patients had a poor level of functioning and sleep quality as well as cognitive impairment based on pain intensity.Trial registrationThis study was registered on a clinical trial with registration number NCT03275233 on 7 September 2017.

University Students' Sleep and Mental Health Correlates in South Korea.

Sleep closely relates to emotional instability. Recent studies report an increase in young adults’ poor sleep and associated mental health problems, including attention deficit hyperactivity disorder (ADHD), anxiety, depression, and so on. However, the information on related modifiable factors of these variables is still lacking. This cross-sectional study examined the association of sleep patterns and sleep quality with ADHD and depression in university students. A total of 290 participants aged 18–27 (Mean = 22.0, SD = 2.1) completed a structured questionnaire consisting of the Pittsburgh Sleep Quality Index (PSQI), the Adult ADHD, and the Center for Epidemiologic Studies Depression scales (CES-D). Of the participants, more than half (52.7%) slept 6 to 8 h per night, and 37% slept less than 6 h. Only 10% reported they went to bed before midnight; 40% went to sleep after 2 am. The mean PSQI score was 5.9 (SD = 2.9) for total participants and significantly correlated with ADHD scores and with depression scores. After adjusting for covariates, PSQI significantly aligned with increased risk for ADHD (β = 0.29, p = 0.036) and depression (β = 0.67; p < 0.001). Late bedtime was a significant factor for depression only. Sleep quality rather than sleep pattern significantly related to ADHD scores, whereas both sleep quality and bedtime aligned with depression scores. Additional studies are needed to develop strategic interventions for university students with ADHD and depression as well as underlying mechanisms.

Examining factors associated with sleep quality in parents of children 4–10 years with autism spectrum disorder

Purpose Parents of children with autism spectrum disorder often report poorer sleep compared to parents of typically developing children. When parents do not obtain enough quality sleep, functioning may be compromised placing the onus of care on already stressed parents. However, improving sleep duration may not improve sleep quality and is not always feasible. This study aimed to measure sleep quality in parents of children with autism spectrum disorder, determine if stress and children’s sleep are associated with sleep quality and whether resources, appraisals, and coping moderate these relationships. Materials and Methods Multivariable regression was used to determine the effects of stress and children’s sleep problems on sleep quality and test modifying effects. Results Mean (SD) Pittsburgh Sleep Quality Index scores was 8.81 (3.76), with 77.6% of parents scoring above the clinical cut-off. Mean (SD) Children’s Sleep Habits Questionnaire scores was 54.03 (8.32), with 96.3% of parents rating their child’s sleep above the clinical cut-off. Children’s sleep was the only significant predictor and none of the expected effect modifiers were significant. Conclusion Children’s sleep may be an important target to improve parent sleep quality but requires systematic assessment with interventional research. Implications for rehabilitation Both parents and their 4–10-year-old children with ASD experience high levels of sleep disturbances. Clinicians can start the conversation early with parents about their children’s sleep by providing them with information to increase awareness and recognize healthy sleep habits in their children. Clinicians are important in the assessment, management, and evaluation of pediatric sleep problems, which may have significant spillover effects on parents of children with ASD. There is a need for more resources and training to be available to clinicians to assess children and their parents for sleep problems, which could extend beyond the assessment of sleep and consider parent’s daytime functioning and mental health.

How to Improve Patients' Perceived Quality of Sleep During Hospitalization Through a Multicomponent "Good Sleep Bundle": A Prospective Before and After Controlled Study.

Despite sound evidence on the importance of sleep for human beings and its role in healing, hospitalized patients still experience sleep disruption with deleterious effects. Many factors affecting patients' sleep can be removed or minimized. We evaluated the efficacy of a multicomponent Good Sleep Bundle (GSB) developed to improve patients' perceived quality of sleep, through which we modified environmental factors, timing of nighttime clinical interventions, and actively involved patients in order to positively influence their experience during hospitalization. In a prospective, before and after controlled study, two different groups of 65 patients each were admitted to a cardiothoracic unit in two different periods, receiving the usual care (control group) and the GSB (GSB group), respectively. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) at the admission, discharge, and 30 days after discharge in all patients enrolled. Comparisons between the two groups evaluated changes in PSQI score from admission to discharge (primary endpoint), and from admission to 30 days after discharge (secondary endpoint). The mean PSQI score difference between admission and discharge was 4.54 (SD 4.11) in the control group, and 2.05 (SD 4.25) in the GSB group. The mean difference in PSQI score change between the two groups, which was the primary endpoint, was 2.49 (SD 4.19). This difference was highly significant (p = 0.0009). The GSB was associated with a highly significant reduction of the negative effects that hospitalization produces on patients' perceived quality of sleep compared with the usual care group.

Evaluation of the correlation between frailty and sleep quality among elderly patients with osteoporosis: a cross-sectional study

BackgroundThe incidence of osteoporosis increases with age. Frailty is a distinct characteristic seen in older osteoporosis patients. Poor sleep quality is common in elderly individuals. However, there are few studies on the correlation between frailty and sleep quality in elderly patients with osteoporosis in China.MethodsThis cross-sectional study was conducted from December 8, 2020, to April 30, 2021. A total of 247 patients who met the inclusion and exclusion criteria were recruited in outpatient departments at West China Hospital. A self-designed demographic data questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Frailty Phenotype scale were used to evaluate the sleep quality and frailty of the participants. Multivariate logistic regression was performed to evaluate the factors affecting frailty and sleep quality in osteoporosis patients.ResultsA total of 231 valid questionnaires were statistically analysed. The mean frailty score was 3.2 ± 1.6 and a total of 152 (65.8%) were frailty. The mean PSQI score was 11.9 ± 4.5 and a total of 183 (79.2%) patients had poor sleep quality (PSQI > 7). Multiple logistic regression showed that female, pain, polypharmacy, activities of daily living status (ADLs), and sleep quality were independent influencing factors for frailty, while comorbidity, ADLs and frailty status were independent influencing factors for sleep quality.ConclusionWe found that frailty and sleep quality were prevalent and that frailty was positively correlated with the PSQI score in elderly patients with osteoporosis in China. The higher the frailty score is, the worse the sleep quality. It means the frailer old patients were, the worse their sleep quality, and poor sleep quality may increase the risk of frailty in elderly patients with osteoporosis. To manage elderly patients with osteoporosis effectively, medical staff should pay attention to frailty, sleep quality and its influencing factors.

Sleep Quality Impairment Is Associated With Pandemic Attitudes During the Coronavirus Disease 2019 (COVID-19) Circuit Breaker Lockdown in England: A Cross-Sectional Study.

ObjectivesThe COVID-19 pandemic has been associated with sleep quality impairment and psychological distress, and the general public has responded to the pandemic and quarantine requirements in a variety of ways. We aimed to investigate whether sleep quality is low during a short-term (circuit break) quarantine restriction, and whether sleep quality is associated with respondents' overall attitudes to the pandemic using a validated scale.Design and SettingOnline cross-sectional study in England in November 2020.ParticipantsThe study included 502 respondents over the age of 18.MeasurementsSleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and pandemic attitudes were assessed using the Oxford Pandemic Attitudes Scale–COVID-19 (OPAS-C), a validated 20-item, 7-domain scale that assesses pandemic-related stress, fear, loneliness, sense of community, sense of exaggerated concern, non-pharmaceutical interventions, and vaccine hesitancy. Unadjusted and multivariable logistic regression odds ratios of association were assessed between the dependent variable of poor sleep quality (PSQI>5) and risk factors, including OPAS-C score, age, sex, educational status, and income.ResultsThe mean (SD) PSQI score was 7.62 (3.49). Overall, 68.9% of respondents met criteria for poor sleep quality using the PSQI cutoff of >5. The mean (SD) OPAS-C score was 60.3 (9.1). There was a significantly increased odds of poor sleep quality in the highest vs. lowest OPAS-C quartiles (OR 4.94, 95% CI [2.67, 9.13], p < 0.0001). Age, sex, income, political leaning, employment status, and education attainment were not associated with poor sleep quality.ConclusionsMore than two-thirds of respondents met criteria for poor sleep quality. The odds of poor sleep quality increased in a dose-response relationship with pandemic attitudes (such as higher levels of pandemic-related stress, fear, or loneliness). The association between poor sleep quality and pandemic attitudes suggests opportunities for public health and sleep medicine interventions, and highlights the need for further research.

Effects of Transcutaneous Occipital Nerve Stimulation and Instrument-Assisted Soft Tissue Mobilization in Chronic Migraine

ObjectiveThe purpose of this study was to examine the effects of transcutaneous occipital nerve stimulation (TONS) and instrument-assisted soft tissue mobilization (IASTM) on pain, sleep, and quality of life in patients with chronic migraine. MethodsForty-five female patients with chronic migraine were randomly assigned to control (n = 15), IASTM (n = 15), and TONS (n = 15) groups. Neck exercises were given to all groups once per day for 5 weeks. IASTM, using a smooth metal scraping massage tool, was applied to the patients in the IASTM group twice per week for 5 weeks. Patients in the TONS group were treated with transcutaneous electrical nerve stimulation 3 times per week for 5 weeks. The outcome measures were a Numeric Pain Scale, the Headache Impact Test-6, the Pittsburgh Sleep Quality Index, and the Short Form-36. ResultsThe IASTM and TONS groups had significantly lower mean Headache Impact Test-6 scores than the control group in the last measurement (F = 3.908, P = .028). The IASTM and TONS groups had lower mean Numeric Pain Scale scores than the control group (F = 13.861, P = .001). The IASTM group had a lower mean Pittsburgh Sleep Quality Index score in the last measurements than the other 2 groups (F = 6.792, P = .003). There was no difference between the groups in the general health perception scores obtained in the last measurements (F = 1.585, P = .217). In the last measurement, the IASTM and TONS groups had higher mean general health scores than the control group. ConclusionIASTM and TONS applications reduced head and neck pain and improved sleep and quality of life in patients with chronic migraine. Neither had superiority over the other.

Sleep As Preamble Of Optimal Health Among Elderly Hypertensive Adults

Introduction: Healthy Aging is for everyone, not just those who are currently disease-free. Many factors influence the health of the elderly, including underlying physiological and psychological changes, health-related behaviour, disease status and also environments in which people are living strongly influence their health. Methodology: The 240 elderlies between the age group of 60-75 years from Primary Health Centre, Muthukur, Nellore, Andhra Pradesh, India was selected as study participants by simple random sampling technique and excluded those who were mentally and physically sick at the time of data collection. The Pittsburgh Sleep Quality Index (PSQI) scale was used to collect and Sleep promoting measures were taught and followed to experimental group for the period of six months. Results: In this study, the posttest mean PSQI sleep score among experimental group was 6.16 and control group was 7.95, with the mean difference was 1.79, as it was large and it was statistically significant difference at the value of t=3.34 at p≤ 0.001 level which indicate sleep promoting measures was effective to enhance sleep quality and to maintain normal blood pressure. Conclusion: Compared to the control group, the experimental group's elderly had better sleep quality; hence healthy sleep promoting measures are effective to manage and to maintain normal blood pressure.

Long-term follow-up of motor cortex stimulation on central poststroke pain in thalamic and extrathalamic stroke.

To investigate the long-term effects of motor cortex stimulation (MCS) on central poststroke pain (CPSP) in patients with thalamic and extrathalamic stroke. We retrospectively analyzed 21 cases of CPSP patients who were treated with MCS. Pain intensity was evaluated using the visual analog scale (VAS) and Neuropathic Pain Symptom Inventory (NPSI) before the operation and at follow-up assessments. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The average follow-up time was 65.43 ± 26.12 months. In the thalamus stroke group (n=11), the mean preoperative VAS score was 8.18 ± 0.75 and the final mean follow-up VAS score was 4.0 ± 2.14. The mean total NPSI score at the last follow-up (20.45 ± 12.7) was significantly reduced relative to the pre-MCS score (30.27 ± 8.97, p < 0.001). Similarly, the mean PSQI value at the last follow-up (12.63 ± 1.91) was significantly reduced compared with the pre-MCS value (16.55 ± 1.97, p < 0.001). In the extrathalamic stroke group (n=11), the mean preoperative VAS score was 8.2 ± 0.79 and the final mean follow-up VAS score was 6.6 ± 2.12. The mean total NPSI score before MCS was not statistically different from that at the last follow-up. There were no statistical differences in sleep quality before versus after surgery. Motor cortex stimulation has higher long-term efficacy in CPSP patients with stroke confined to the thalamus than in CPSP patients with stroke involving extrathalamic structures.

Effects of Sleep Quality on Academic Performance and Psychological Distress Among Medical Students in Saudi Arabia

Background: Sleep hygiene habits are essential to maintaining a healthy lifestyle. Sleep deprivation is a prevalent problem worldwide. Multiple studies have shown a high prevalence of sleep insufficiency among medical students due to high academic load, caffeine intake, and high-stress levels. Objectives: This study explores the relationship between sleep quality, academic performance, and psychological distress among medical students at Alfaisal University, Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted on medical students of all academic years at Alfaisal University, Riyadh. Two popular surveys – the Pittsburgh sleep quality index (PSQI) and K10 - were used to assess sleep quality and psychological distress, respectively. In addition, the survey contained questions on socio-demographics and academic performance. Sociodemographic characteristics were assessed across groups having poor and good sleep quality. In multivariate analysis, we employed conscious variable selection to develop models. All statistical tests were two-sided at P &lt; 0.05 as statistically significant. Results: A total of 241 respondents participated in the study. Most respondents reported poor sleep quality (75.93%). The highest psychological distress was reported among respondents with poor sleep quality (48.63%). The relationship between Kessler's Psychological Distress score and sleep quality score was significantly positive and linear (P &lt; 0.0001). The mean PSQI score was higher in students with lower GPAs (1.50 - 2.99) than in those with higher GPAs (3.00 - 4.00). This shows that those students who sleep well perform academically better. Conclusions: The quality of sleep among medical students is poor, which is associated with psychological distress and poor academic performance. It is highly suggested that the awareness of sleep hygiene with healthy sleep habits be campaigned among medical students. Also, academic mentors, program directors, and coordinators play a crucial role in ensuring that medical students are not academically overwhelmed.

Association between quality of sleep and screen time during the COVID-19 outbreak among adolescents in the United Arab Emirates.

SummaryThe COVID‐19 pandemic had a major impact on people of all ages. Adolescents' exposure to online learning is linked to excessive screen time on digital devices, which leads to poor sleep quality. This study aimed to investigate the association between screen time on different electronic devices and sleep quality among adolescents in the United Arab Emirates. This study was based on a self‐reported questionnaire, which was administered online to school‐aged adolescents (aged 12–19 years). The multicomponent questionnaire collected information on sociodemographic characteristics, sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and screen time (minutes) on TV, TV‐connected devices, laptops, smartphones, and tablets on weekdays, weeknight, and weekends using the Screen Time Questionnaire (STQ). Univariate and multivariate analyses were used to identify factors correlated with poor sleep quality. A total of 1720 adolescents were recruited from private and public schools (mean age 14.6 ± 1.97 years). The mean PSQI score was 8.09 ± 3.37, and 74.3% of participants reported poor sleep (cutoff score >5). Mean scores were highest for the sleep latency (1.85 ± 0.97) and sleep disturbance (1.56 ± 0.62) domains. The highest STQ score was observed for smartphones, with a median screen time of 420 min on weekdays and 300 min on weekends. Screen time related to smartphones on weekends (p = 0.003) and increased screen time in bed (p < 0.001) were significantly associated with poor sleep. Our results confirmed the correlation between sleep and screen time in adolescents. The results may inform educational polices that target screen time and sleep among adolescents during and after the COVID‐19 pandemic.

The relationship between sleep problems and gaming addiction in adults

IntroductionProlonged exposure to Video games may have several negative cognitive and emotional consequences.However, a few investigations have explored the effects of video games addiction on sleep.ObjectivesTo study the effects of gaming addiction on sleep patterns in young adultsMethods We conducted a cross-sectional, descriptive and analytical study.Data were collected using a self-administered questionnaire on social networks targeting young adults between 18–40 years. We used the gaming addiction scale (GAS) in its validated Arabic short version. We also used the validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI) to assess the sleep quality of our participants.ResultsOne hundred and nine participants were included. The mean age was 29.6 ± 10.3. Males accounted for 60.6% of the study population. The mean Gas score was 13.11± 6.08.According to the GAS,25.7% were addicted gamers. The mean PSQI score was 7.25± 3.15. A poor sleep quality pattern (score &gt; 6) was found in 59.6% of the participants. We found that the GAS score was significantly correlated to the total score of PSQI( P=0.003). We also found that the group with poor sleep quality had higher GAS scores (p= 0.014). We found a correlation between the GAS score and the following components of the PSQI: subjective sleep quality ( p= 0.01), sleep disturbances (p=0.024) and the use of sleep-promoting medication ( p=0.046)ConclusionsOur study showed that video gaming behavior had a significant effect on sleep quality. This can have negative consequences on life quality, together with an impaired performance at awakening.DisclosureNo significant relationships.

Sleep characteristics in patients with substance use disorder after detoxification treatment: self-report and actigraphy data

IntroductionSleep problems are common in patients with substance use disorders (SUD) and have been related to poor treatment outcomes. Little is known about the sleep characteristics in patients with opioid and alcohol use disorders after detoxification program.ObjectivesTo compare sleep quantitative and qualitative characteristics between patients with opioid and alcohol use disorders.MethodsThis is a secondary data analysis of the longitudinal data from the observational study in St. Petersburg, Russia. The sample included 75 patients (22.7% female) who received detoxification treatment for alcohol (n=49) or opioid (n=26) withdrawal. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and underwent daily wrist actigrahy.Results Good internal consistency was demonstrated for self-report and actigraphy data (r =-0,405, p&lt;0,01). Sleep duration and sleep onset latency were not different between alcohol and opioid groups (5.7 vs. 6.1 hours; 74 vs. 65 minutes, respectively) based on self-report data. The majority of the patients (57-100%) had sleep complaints and low quality of sleep after detoxification completion (at baseline). In both groups, the mean PSQI score had a tendency to decrease, representing better sleep quality, over the 1-week following detoxification program completion (from 12 at baseline to 10 at 1-week in alcohol group; from 13 to 12 in opioid group, p&lt;0,001).ConclusionsThe findings show that sleep characteristics are similar in patients with different SUD and insomnia symptoms are prevalent after detoxification, suggesting the rationale for sleep assessment before hospital discharge. Despite the positive changes in sleep quality over 1-week abstinence, patients might benefit from the therapeutic sleep interventions.DisclosureThis work was financially supported by a research grant from Russian Foundation for Basic Research, 18-013-00481.

0235 A Systematic Review of Sleep Health and Outpatient Opioid Use Disorder Treatment in Adults

Abstract Introduction Opioid Use Disorder (OUD) affects 2 million people in the United States and poor sleep health (satisfaction, alertness, timing, efficiency, and duration) is a primary driver of medication-assisted treatment (MAT) failure and relapse. It is known that people in therapy for OUD have a high prevalence of sleep problems (&amp;gt;75%) and poorer sleep health compared to people without OUD (e.g., lower sleep efficiency, shorter duration, and more awakenings). However, sleep health is not routinely assessed. Thus, in this systematic review, we examined original studies on sleep health within the context of adults receiving outpatient MAT for OUD. Methods We conducted a systematic review of original research on sleep health in adults receiving outpatient treatment for OUD. Multiple electronic databases (PubMed, PsycINFO, and CINAHL) were searched for relevant studies published in English from the establishment of each database to September 14, 2021. Quality was assessed with the Mixed Methods Appraisal Tool (v. 2001). Results Sixty two studies were selected including 17,913 adults with OUD and 604 comparison participants without OUD (mean age = 37.4 ± 6.6 years; 54.1% male). Sixty-one studies were quantitative (50 cross sectional, 6 longitunal, 5 interventional) and 1 was mixed methods. Participants with OUD had poorer satisfaction (Pittsburgh Sleep Quality Index mean 7.4 ± 2.2 v. 4.7 ± 2.3), shorter polysomnography (PSG) measured total sleep time (336.6 ± 41.4 mins (5.6 h) v. 411.8 ± 33.3 mins (6.8 h), spent less time in PSG measured slow wave N3 sleep (7.2 ± 5.8% v. 13.4 ± 6.4%), and had a lower percentage of PSG measured rapid eye movement sleep (14.6 ± 4.6% v. 21.7 ± 4.0%) than comparison participants without OUD. Conclusion Studies were predominantly observational ranging from a period of 1-2 nights to 2 years with participants at various points in treatment. More work is needed to understand the multidimensional depth of sleep health in adults with OUD. Optimizing sleep health in adults with OUD may improve their addiction trajectory and should be a priority in practice and research. Support (If Any) American Academy of Sleep Medicine (220-BS-19).

Long-term exposure to ambient black carbon is associated with sleep disturbance in college students

BackgroundEvidence suggests an association of air pollution with sleep quality. However, there is limited knowledge regarding the effect of black carbon, a key component of ambient particulate matter, on sleep. ObjectivesTo investigate the association of long-term exposure to black carbon and sleep quality in a group of college students. MethodsA retrospective cohort study was conducted in five universities in different regions of China. The concentrations of black carbon and other environment factors were defined as the averages during the 6 years prior to the recruitment. Averagely daily dose of black carbon exposure was estimated according to the respiratory rate. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) with a cutoff >5 indicating sleep disturbance. Linear regression and logistic regression models were used to estimate the association. The sensitivity analyses were conducted to estimate the effects of 1-month, 6-month and 1-year mean levels of exposure to black carbon on sleep quality. ResultsA total of 20,053 incoming college students were included. 29.3% reported impaired sleep quality, with a mean PSQI score of 4.3 ± 2.2. The logistic regression showed that the risk of impaired sleep quality was positively associated with black carbon exposure, especially in the highest quantile (OR: 1.26, 95% CI: 1.11–1.43) compared with the lowest quartile after adjusting for potential confounders. Subgroup analysis showed that the effect of black carbon on sleep quality was stronger in participants with higher BMI, lower household income, and lower parental educational level. The results of sensitivity analyses were similar with main analyses. ConclusionLong-term exposure to black carbon is associated with sleep disturbance in college students. Improvement of air quality may help improve sleep quality.

The impact of sleep disorders on the daily activity and quality of life in rheumatoid arthritis patients - a systematic review and meta-analysis.

We aimed at determining the relationship between sleep disorders and daily activity and quality of life (QoL) of patients with rheumatoid arthritis (RA). A systematic search of databases was carried out. We used the Cochrane guidelines to perform the meta-analysis following the PRISMA statement. Fifteen full-text papers were ultimately included in the subsequent statistical analyses. The study was registered in the PROSPERO database (No. CRD42021245664). In group 1, the mean sleep quality score measured with the Pittsburgh Sleep Quality Index (PSQI) was 6.93. The mean QoL score for the physical domain and the mental domain of the Short Form (36) Health Survey (SF-36) was 38.15 and 41.83, respectively. In group 2, the mean PSQI score was 7.21. The mean daily activity score measured with the Health Assessment Questionnaire (HAQ) was 0.80. A strong negative correlation was observed between the PSQI scores, and the SF-36 total score each unit increase in the SF-36 total score was associated with an average decrease of 0.35 points in the PSQI score. A one-point increase in the PSQI score was associated with an average decrease of 2.4 points in the QoL score measured with SF-36. RA patients have a low quality of sleep. Sleep disorders correlate negatively with the QoL scores in the physical and mental domains.

Sleep quality and the associated factors among in-hospital nursing assistants in general hospital: A cross-sectional study

BackgroundSleep quality and the associated factors in professional nurses have been extensively investigated. However, as an important part of the workforce in hospitals, sleep quality and influencing factors among in-hospital nursing assistants is rarely investigated. AimThis study aimed to assess the sleep quality and the associated factors of in-hospital nursing assistants in general hospital. MethodsA cross-sectional survey study was conducted in a tertiary general hospital. Data were collected from 187 in-hospital nursing assistants using convenience sampling from June to July 2018. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate participants’ sleep quality. A multiple linear regression was performed to identify associated factors with sleep quality. ResultsThis study revealed a mean PSQI score of 5.96 ± 3.64 among all participants, of which 62.3% (114/187) participants suffered from impaired sleep quality. In-hospital nursing assistants with significant medical condition, low monthly income, irregular diet and high family burden reported more worse sleep quality. ConclusionThe study showed that poor sleep quality is a highly prevalent issue among Chinese in-hospital nursing assistants in general hospital. Measures to enhance nursing assistants’ wellbeing status (health and burden) and improve their salary (monthly income) are recommended.

P273 Factors related to insomnia in patients with psoriatic arthritis: a cross-sectional study

Abstract Background/Aims Several studies have demonstrated an increased prevalence of sleep disorders in patients with psoriatic arthritis (PsA). However, there are few data on the relationship between sleep disturbance and disease activity in PsA. We conducted a cross-sectional study to investigate the prevalence of insomnia symptoms and poor sleep quality in PsA and examine correlation with demographic, clinical and patient-reported outcome measures. Methods Patients were recruited from rheumatology clinics at a single centre. Patients had a diagnosis of PsA, met the CASPAR (ClASsification criteria for Psoriatic ARthritis) criteria and were aged ≥ 18 and ≤ 80 years. They had no other confirmed sleep disorder diagnoses. Disease activity was calculated using the cDAPSA (Clinical Disease Activity in PSoriatic Arthritis) score. Disease impact was measured using a pain visual analogue scale (VAS) and the Psoriatic Arthritis Impact of Disease (PsAID)-12 questionnaire and functional impairment was assessed using the health assessment questionnaire (HAQ). We used the Sleep Condition Indicator (SCI) to assess symptoms of Diagnostic and Statistical Manual of Mental Disorders (DSM)-V insomnia disorder (ID). The SCI is a score from 0-30 with lower scores indicating worse subjective sleep. We used the Pittsburgh Sleep Quality Index (PSQI) to assess subjective sleep quality. Relationships between clinical characteristics and sleep disturbance were examined using Pearson’s correlation coefficients and multivariable logistic regression. Results Thirty participants were enrolled in the study, of which 13 were female. Mean (SD) age of participants was 49 (13.5) years. Overall, the prevalence of probable DSM-V ID (SCI score ≤ 16) was 43.33% (13/30) with a mean (SD) SCI score of 6.80 (4.79). Mean (SD) PSQI score was 6.77 (3.22) with 60% (18/30) classified as subjective poor sleepers. Mean (SD) pain VAS, PsAID-12 and HAQ were 33.89 (28.67), 2.97 (2.05) and 46.12 (38.83), respectively. Mean (SD) cDAPSA score was 12.3 (15). A significant correlation was observed between the SCI score and cDAPSA (r=-0.3809, p = 0.038), and SCI and PsAID-12 scores (r=-0.3809, p = 0.033). No correlation was found between SCI score and HAQ, age, pain VAS, or disease duration. Multivariable logistic regression controlling for age found an association between cDAPSA and probable ID (OR:1.098 95%CI:1.014-1.253). This association did not persist once pain level, gender, PsAID-12 and HAQ scores were controlled for. Conclusion This cross-sectional analysis of patients with PsA demonstrates that sleep disturbance is highly prevalent. Symptoms of insomnia in this small cohort were related to higher baseline disease activity and self-reported disease impact. This study is the first to demonstrate these findings and warrants further exploration in a larger sample size with longitudinal data. It would be of interest to understand the relationship between insomnia and disease activity and whether insomnia is responsive to treating PsA to low disease activity levels. Disclosure D. McGagh: None. N.M. McGowan: None. S. Elahi: None. J. MacDonald: None. K.E.A. Saunders: None. L.C. Coates: None.

Psychosocial issues and sleep quality among seafarers: a mixed methods study

BackgroundSeafarers, especially those working for a prolonged period of time, are exposed to a high number of social, psychological and physical stressors including irregular working hours.AimThis study aims to identify important aspects of Asian seafarers’ psychosocial wellbeing and quality of sleep that could affect safety and health of the seafarers in long voyage tankers.MethodsIn this mixed method study, psychological health issues were investigated through semi-structured interviews with 17 Asian male seafarers. Participants were selected through purposive sampling. In the quantitative phase, 179 seafarers completed the Pittsburgh Sleep Quality Index (PSQI) on sleep quality.ResultsFrom the interviews, three categories consisting of six themes emerged, including sleep abnormalities, inevitable stressors, and lack of social communication. The majority of the seafarers believed that their quality of sleep was affected by their physical work environment and by issues raised by their families. As reasons for stress at sea, they mentioned the nature of the occupation and the psychosocial work environment. Most participants pointed out that lack of social communications had adverse effects on both their work lives on board and their private lives at home. In the quantitative phase, the response rate was 81.4%. Mean PSQI index was 5.9 (SD 2.6 and range from 2 to 14). Sleep impairment was higher in academic than non-academic individuals (p < 0.001).ConclusionSleep abnormalities and lack of social communication should be considered as modifiable risk factors for seafarers’ psychosocial well-being at sea.