Median Pittsburgh Sleep Quality Index Score Research Articles

Sleep quality after autologous breast reconstruction

BackgroundSleep is a fundamental aspect of human health and well-being, but is often interrupted in a hospital setting. Especially after surgery, poor sleep quality can negatively affect postoperative recovery and quality of life. Therefore the aim of this study is to gain insight in the quality of sleep in patients after autologous breast reconstruction and evaluate factors associated with quality of sleep. Materials and methodsIn this single-center observational cohort study, participants completed a sleep diary, including the Pittsburgh Sleep Quality Index (PSQI) and the EQ-5D-5L quality of life questionnaire, before surgery, during hospital admission and two weeks and three months postoperative. Additional variables such as pain, and anesthesia time were collected. ResultsTwenty-nine patients were included. Before surgery, 58% of them experienced poor quality of sleep, with a median PSQI score of 5.0. During hospital admission, 83% of the patients had a poor quality of sleep, with a PSQI score of 6.0. The PSQI score two weeks postoperative increased to 7.0 and was decreased three months postoperative to 5.0. Patients with a pain score >4 (‘pain’ group), had a higher median PSQI score than patients with a pain score ≤4 (‘no pain’ group) at all postoperative time points previously mentioned. No correlation was observed between anesthesia time or quality of life. ConclusionPoor sleep quality is experienced by most women after autologous breast reconstruction, especially in those with higher postoperative pain scores. This knowledge offers an opportunity to improve the postoperative care for these patients.

Association between sleep status in the first trimester and preterm birth

Objective: To investigate the relationship between sleep status in the first trimester and preterm birth. Methods: Clinical data of pregnant women who received regular prenatal examination and delivered in Peking University Third Hospital from September 1, 2019 to June 10, 2020 were collected. The Pittsburgh sleep quality index (PSQI) was used to investigate their sleep status during 8-12 weeks of gestation, and the delivery outcomes were followed up. According to the gestational age at delivery and the cause of preterm birth, they were divided into full-term delivery group (204 cases), preterm birth group (13 cases) and spontaneous preterm birth group (9 cases). The correlation between the sleep status in the first trimester and preterm birth or spontaneous preterm birth was analyzed. Results: The median PSQI score of full-term delivery group was 4.0 points (3.0, 6.0 points), which was lower than those of preterm delivery group [6.0 points (4.0, 8.0 points)] and spontaneous preterm delivery group [7.0 points (4.0, 8.0 points)], and the differences were statistically significant (all P<0.05). The proportion of pregnant women with poor sleep quality (PSQI score>7 points) in full-term delivery group [14.2% (29/204)] was lower than those in preterm delivery group (5/13) and spontaneous preterm delivery group (4/9), and the differences were statistically significant (all P<0.05). Compared with the full-term delivery group [8.0 hours (7.0, 9.0 hours)], the preterm birth group [7.0 hours (7.0, 8.0 hours)] and spontaneous preterm birth group [7.0 hours (7.0, 8.0 hours)] had significantly shorter sleep duration at night (all P<0.05). Multivariate analysis showed that PSQI score in the first trimester was an independent risk factor for preterm birth (aOR=1.22, 95%CI: 1.02-1.45; P=0.026). Pregnancy with assisted reproductive technology (aOR=5.55, 95%CI: 1.22-25.31; P=0.027), gestational diabetes mellitus (aOR=9.27, 95%CI: 1.96-43.82; P=0.005), PSQI score in the first trimester (aOR=1.27, 95%CI: 1.01-1.58; P=0.039) were independent risk factors for spontaneous preterm birth. Conclusion: Attention should be paid to the decreased sleep quality in the first trimester, which might significantly increase the risk of preterm birth and spontaneous preterm birth.

Sleep disorders among women with post-menopausal osteoporosis

IntroductionOsteoporosis (OP) is characterized by low bone mass and microarchitectural deterioration of bone tissue. Recent studies have suggested that sleep may significantly influence the pathophysiology of OP.Objectives In the present study, we aimed to determine sleep disorders among women with post-menopausal OP.MethodsA cross-sectional study was conducted between January and June 2023. Patients with post-menopausal OP who visited the rheumatology department in a university hospital in Tunisia were interviewed. The Pittsburgh Sleep Quality Index (PSQI). It is a seven-component scale, including: sleep quality (C1), sleep latency (C2), sleep duration (C3), sleep efficiency (C4), sleep disturbances (C5), sleep medication use (C6), and daytime dysfunction (C7).PSQI ≤ 7 indicated normal sleep quality, and PSQI &gt; 7 indicated poor sleep quality.Results Ninety-three women diagnosed with post-menopausal OP were interviewed. the number of complete questionnaires was 72. The valid rate was 77.4%. All were women. The mean age was 72.5 (±1.08). The median duration of menopause was 23 years (IIQ= [10.5-28.5]). Forty-five women were diagnosed with bone fractures (62%). Thirty-three patients (45.8%) were obese (IMC&gt;30). The median PSQI score was 16 (IIQ = [6-18]). Forty-seven participants (65.3%) had poor sleep quality (PSQI &gt; 7). According to the items of PSQI: the median score of sleep duration, sleep Efficiency and sleep disturbances was 1 (IIQ= [1 -2]) for each item. The median score of sleep latency was 3 (IIQ=[2-3]). For daytime dysfunction, the median score was 2 (IIQ=[0-3]). Study analytics revealed a significant association between daytime dysfunction and the presence of bone fractures (p=10-3), the same was with sleep disturbances and bone fractures (p=10-3). Body mass index (BMI) was significantly and inversely associated with sleep quality (r= -0.313; p= 0.007). Sleep latency was significantly associated with physical activity (p&lt;10-3).ConclusionsIn conclusion, our results suggest that sleep quality is associated with physical activity and BMI. This is consistent with the most recent evidence in the literature. These findings support expanding the scope of wellness programs to promote healthy sleep among osteoporotic women.Disclosure of InterestNone Declared

A Comparative Study of Architecture and Quality of Sleep among Juvenile Myoclonic Epilepsy Patients and Healthy Individuals Attending Tertiary Care Hospital in Central India

&#x0D; &#x0D; &#x0D; &#x0D; Background and Objective: Primary sleep disorders are common in patients with epilepsy. Seizures, epileptiform discharges, and antiepileptic drugs alter the sleep architecture of patients with juvenile myoclonic epilepsy (JME). We evaluated sleep architecture and its quality in these patients.&#x0D; Materials and Methods: Thirty patients with JME (11 men and 19 women with mean age of 21.10 ± 4.55 years) and 30 healthy controls underwent overnight polysomnography (PSG). Sleep quality and daytime sleepiness were assessed using Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), respectively.&#x0D; Results: Myoclonus and generalized tonic-clonic seizures (GTCS) were present in all patients with JME, while absence seizures were in 13.3%. Sleep deprivation was the most frequent precipitating factor for seizures (56.6%) followed by fatigue, sound, and photic stimulation. Patients with JME reported a statistically significant drop in sleep efficiency (P&lt;0.001) with prolonged sleep onset latency (P&lt;0.001). There was prolongation in the N1 stage of non-rapid eye movement (NREM) sleep (P=0.002), and reduction in the N2 stage of NREM (P&lt;0.001) and rapid eye movement (REM) sleep (P&lt;0.001). The median PSQI score was higher in patients with JME, suggesting poor sleep quality (P&lt;0.001), and the daytime sleepiness was not different as indicated by the similar median ESS score (P=0.033).&#x0D; Conclusion: Our results suggest a significant alteration in the sleep architecture of patients with JME with reduced sleep efficiency and poor sleep quality. The possible role of the disease itself is suggested for these alterations as a simi- lar trend was also observed in drug naïve patients.&#x0D; &#x0D; &#x0D; &#x0D;

Sleep quality, perceived stress, and attention levels: A study on medical students

Background: Sleep is the most important yet least understood function of the brain. It is seen that students usually get lesser duration of sleep, due to academic and social demands. In our study, we are trying to use relatively short-duration tasks, which are software-based and can be easily used in a clinical setting for screening purpose, for the assessment of attention in individuals with poor sleep quality. Aims and Objectives: The aim of this study was to compare the perceived stress levels in students based on the quality of sleep and to compare the attention in students based on the quality of sleep. Materials and Methods: Eighty-four participants were divided into good and bad sleep quality based on the Pittsburgh sleep quality index (PSQI) scores and their perceived stress scores were obtained. All of them were subjected to smartphonebased cognitive function testing using color word and word color Stroop test. Results: Eighty-four subjects were recruited for the study from the Bidar Institute of Medical Sciences, Bidar, of which 34 (40%) were in the good sleep group and 50 (60%) in the bad sleep group. The median PSQI score in the group with bad sleep quality was found to be significantly higher than the median PSQI scores of the group with good sleep. The median word color Stroop score in the good sleep quality was found to be significantly higher than the score of the bad sleep group. Similarly, the median color word Stroop scores were significantly higher in the good sleep group than that of the bad sleep quality group. Conclusion: Sleep quality seems to increase the levels of perceived stress in students. Sleep affects the attention of the subjects in a negative way.

Daytime sleepiness and sleep quality in Charcot–Marie–Tooth disease

BackgroundSleep abnormalities have been reported in Charcot–Marie–Tooth disease (CMT), but data are scanty. We investigated their presence and correlation in a large CMT patients’ series.MethodsEpworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were administered to CMT patients of the Italian registry and controls. ESS score > 10 indicated abnormal daytime somnolence, PSQI score > 5 bad sleep quality. We analyzed correlation with disease severity and characteristics, Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS), Body Mass Index, drug use.ResultsESS and PSQI questionnaires were filled by 257 and 253 CMT patients, respectively, and 58 controls. Median PSQI score was higher in CMT patients than controls (6 vs 4, p = 0.006), with no difference for ESS score. Abnormal somnolence and poor sleep quality occurred in 23% and 56% of patients; such patients had more frequently anxiety/depression, abnormal fatigue, and positive sensory symptoms than those with normal ESS/PSQI. Moreover, patients with PSQI score > 5 had more severe disease (median CMT Examination Score, CMTES, 8 vs 6, p = 0.006) and more frequent use of anxiolytic/antidepressant drugs (29% vs 7%, p < 0.001).ConclusionsBad sleep quality and daytime sleepiness are frequent in CMT and correlated with anxiety, depression and fatigue, confirming that different components affect sleep. Sleep disorders, such as sleep apnea and restless leg syndrome, not specifically investigated here, are other factors known to impact on sleep quality and somnolence. CMT patients’ management must include sleep behavior assessment and evaluation of its correlated factors, including general distress and fatigue.

0779 Impact of 8-h Time Limited Eating on Sleep in Adolescents with Obesity

Abstract Introduction Time-based interventions, such as time-limited eating (TLE), have become a promising dietary strategy in adults with obesity. TLE involves shortening the daily eating window to a pre-specified number of hours and fasting for the remaining hours of the day without altering diet quality. No study to date has examined the impact of TLE on sleep quality in adolescents with obesity. Methods We conducted a secondary analysis of a 12-week pilot study that compared TLE (8-h eating window/16-h fasting window) to a prolonged window (12-h eating window/12-h fasting window) in adolescents with obesity (ages 14 to19, 72% female, 74% Hispanic). All youth completed the Pittsburgh Sleep Quality Index (PSQI) at baseline (n = 42), weeks 4 (n = 43), and 12 (n = 42). The seven component PSQI score, develops a global score that ranges from 0 to 21, where higher scores indicates worse sleep. Glycemic profiles were captured via continuous glucose monitors (CGM) worn for the duration of the study. Mixed effects generalized linear model in log scale and ordinal logistic regression models were utilized to (a) examine the change in PSQI total score and (b) assess the association between glycemic variability and PSQI total score overtime by intervention arm. Results Across all youth included in this analysis (n = 43), there was improvement in PSQI total score at week 12 compared to baseline that was marginally significant after adjusting for multiple testing (% change = -19.60, 95%CI = -31.83 to -5.18, p = 0.057). The median PSQI score for the TLE group (n = 29) was 6 at week 0 (5 to10) and 5 at week 12 (2.5 to 7), suggesting sleep quality improved. The changes in PSQI total score, sleep ratio, and sleep onset score over the course of study were not statistically different between groups (p &amp;gt; 0.05). There was no significant association between glycemic variability and PSQI score between the groups. Conclusion Findings from this secondary analysis indicate that TLE does not negatively alter sleep quality or duration in adolescents with obesity. The potential effects of TLE on sleep should be further investigated in larger randomized trials. Support (if any)

Effect of Vitamin E Supplementation on Chronic Insomnia Disorder in Postmenopausal Women: A Prospective, Double-Blinded Randomized Controlled Trial.

Chronic insomnia disorder is one of the most common problems in postmenopausal women, exacerbated by underdiagnosis and improper treatment. This double-blinded, randomized, placebo-controlled trial was conducted to evaluate the potential of vitamin E to treat chronic insomnia as an alternative to sedative drugs and hormonal therapy. The study enrolled 160 postmenopausal women with chronic insomnia disorder, divided randomly into two groups. The vitamin E group received 400 units of mixed tocopherol daily, while the placebo group received an identical oral capsule. The primary outcome of this study was sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI), a self-evaluated and standardized questionnaire. The secondary outcome was the percentage of participants using sedative drugs. There were no significant differences in baseline characteristics between the study groups. However, the median PSQI score at baseline was slightly higher in the vitamin E group compared with the placebo (13 (6, 20) vs. 11 (6, 20); p-value 0.019). After one month of intervention, the PSQI score was significantly lower (indicating better sleep quality) in the vitamin E group compared with the placebo (6 (1, 18) vs. 9 (1, 19); p-value 0.012). Moreover, the improvement score was significantly higher in the vitamin E group compared with the placebo (5 (-6, 14) vs. 1 (-5,13); p-value < 0.001). In addition, there was a significant reduction in the percentage of patients using sedative drugs in the vitamin E group (15%; p-value 0.009), while this reduction was not statistically significant in the placebo group (7.5%; p-value 0.077). This study demonstrates vitamin E's potential as an excellent alternative treatment for chronic insomnia disorder that improves sleep quality and reduces sedative drug use.

Association between negative psychology and sleep quality in dialysis patients during the COVID-19 pandemic.

The aim of this study was to assess the sleep quality in dialysis patients during the COVID-19 epidemic and explore the association between negative psychology (including depression, anxiety, and stress) and sleep quality in this population. A cross-sectional study including three centres. This cross-sectional study included 378 dialysis patients from April to May 2022 in three dialysis centres in Shanghai. Depression, anxiety, stress, and sleep quality were measured by the Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale-14 (PSS-14), and Pittsburgh sleep quality index (PSQI), respectively. With a threshold of 5 to classify participants into good and poor sleep quality, with HADS/PSS-14 scores as independent variables (per standard deviation (SD) increment), respectively and binary Logistic regression model was constructed to explore the association between the three negative psychological aspects of depression, anxiety, and stress and sleep quality. The median PSQI score was 11.0 (mean ± SD: 11.8 ± 4.8). Among them, poor sleep quality (i.e., PSQI >5) was reported by 90.2% of participants. After adjusting for sociodemographic and disease-related information, HADS-depression was associated with a significant 49% (odds ratio (OR): 1.49; 95% CI 1.02-2.18) increase in the risk of poor sleep quality for each additional SD (2.4). Correspondingly, for each SD (7.1) increase in PSS-14, the risk of poor sleep quality was significantly increased by 95% (OR: 1.95; 95% CI 1.35-2.82). During the COVID-19 pandemic, there was a significant negative association between negative psychology, such as depression and stress, and sleep quality in dialysis patients, and this relationship was independent of the dialysis modality. In the context of the rampant COVID-19, the vast majority of dialysis-dependent chronic kidney disease presents with severe sleep quality problems, and negative psychology is a potential influencing factor.

Improving Sleep Quality to Prevent Perinatal Depression: The Obstetric Nurse Intervention

Throughout their life, women should pay attention to their mental health. Evidence indicates that poor sleep quality is related to depressive symptoms in pregnancy, justifying the intervention of health professionals in improving sleep quality to promote the mental health of pregnant women. The objective of our study is to analyze the relationship between sleep quality and perinatal depression, and to identify the obstetric nurse’s intervention in improving sleep quality in the perinatal period. A total of 53 pregnant women between the 28th week of pregnancy and the 7th day after delivery completed the Edinburgh Postnatal Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI). Women were also asked about the strategies used by the obstetric nurse to improve their quality of sleep. Data analysis was performed using IBM SPSS Statistics software, version 25.0. The Mann–Whitney-U and Kruskal-Wallis tests were carried out. A p-value &lt; 0.05 was considered statistically significant. The median PSQI score was 10 (±3.63), and 9.2% (n = 9) had good quality sleep. The median EPDS score was 12 (±4.43), and 27 participants (50.9%) had probable depression. The women with likely depression had worse sleep quality (p = 0.016). Most participants reported that the obstetric nurse showed no interest in their sleep quality during pregnancy. Women of other nationalities have a higher risk of depression (p = 0.013). Based on our results, it is crucial to assess sleep quality in the perinatal period to promote women’s health during the prenatal and postnatal periods, and more action is needed since we are facing one of the most significant challenges of this century, preventing depression.

Restless Legs Syndrome (RLS) in Patients (pts) with Polycythemia Vera (PV): Is Iron Deficiency (ID) the Only Culprit?

Background: RLS is a sensorimotor disorder that causes discomfort in the legs and the urge to move them. In its etiology, there are many conditions including ID. PV is a myeloproliferative neoplasia (MPN), and in pts with PV, ID may develop during the course of the disease. In one study, 29.6% of PV pts had RLS, which was thought to be associated with phlebotomy and ID (Med Oncol. 2010;27(1):105-7). Essential thrombocythemia (ET) is another MPN, in which ID is not typically observed. In our study, we sought to evaluate the frequency of RLS in PV and to search for possible factors other than ID that might have a role in the etiology of RLS among MPN pts. Methods: Previously diagnosed pts with PV and ET, who admitted to our clinic between August and December 2021 were included. All PV pts were evaluated for the study regardless of their iron status. ET pts with ID were not included, since ET cases formed the non-ID MPN control group. Pts with a transferrin saturation below 20% and ferritin level below 20 µg/L were considered as cases with ID. Pts with comorbidities that may lead to RLS generation were excluded. Fasting plasma glucose, HbA1c values, urea, creatinine, thyroid function tests, vitamin B12, and magnesium values were measured. According to these parameters, pts with biochemical disorders that may affect the development of RLS were also excluded (Figure 1). In accordance with the PV and ET groups, pts with ID and healthy subjects (HS) were included as the positive and negative controls, respectively. Demographic characteristics, treatments, complete blood count (CBC) parameters, iron studies, and biochemical tests of the subjects were recorded. Neurological examination was performed in all cases, electromyography (EMG) was taken and evaluated for polyneuropathy. All subjects were questioned according to the RLS diagnostic criteria, and all subjects underwent Pittsburgh Sleep Quality Index (PSQI) tests. Results: In the final analysis, 27 PV, 23 ET, and 22 ID pts and 23 HS were included (Figure 1). Pts in the ID group were significantly younger than other groups (p=0.025) (Table 1). The median follow-up duration of the ET pts was significantly higher than those of others (p=0.011). Other demographic features were comparable between groups (Table 1). No significant pathology was detected in the neurological examination in all subjects. RLS was detected in 25.9%, 34.8%, and 45.5% of PV, ET, and ID pts, respectively. While there was no difference between these groups in terms of the presence of RLS, RLS was not detected in HS. In pts with PV 66% had ID, and there were no significant differences in terms of CBC parameters, iron studies, biochemical parameters, and the JAK2V617F mutational status in PV and ET pts with and without RLS. In addition, polyneuropathy was detected in one ET patient by EMG and RLS was not detected in this patient. There was no significant difference between these groups regarding median PSQI scores, but the median PSQI score was found to be significantly higher in pts with RLS (p=0.001) (Table 1). When we investigated the relationship between cytoreductive treatments and RLS in PV and ET pts, we found that the frequency of RLS was higher in pts receiving interferon-alfa (IFN-a) and anagrelide (Table 2). In pts with PV and ET, IFN-a and anagrelide usage, and magnesium (Mg) levels were found to have an impact on RLS in univariate analysis, but only Mg levels was associated with RLS in multivariate analysis (Table 3). Conclusion: In our study, the high prevalence of RLS in pts with ID and the absence of RLS among HS both indicate that our RLS questionnaire results are reliable. Although not all PV pts had ID, the prevalence of RLS was higher when compared to HS as was described previously (Med Oncol. 2010;27(1):105-7). In addition, although not significantly different, the frequency of RLS was higher in ET pts than that observed in PV cases. These results suggest that, RLS may occur during the course of the disease in MPN pts, due to factors independent of ID and other known RLS triggering conditions. In light of all these, further studies are needed to elucidate the etiology of RLS developing in pts with PV and ET. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Subjective Assessment of Sleep Quality and Excessive Daytime Sleepiness in Conventional Hemodialysis Population: A Single-Center Experience.

IntroductionSleep disturbances are common in patients with end-stage kidney disease on hemodialysis (hemodialysis population: HDP). Higher rates of primary sleep disorders, demographic characteristics, metabolic abnormalities, and the efficacy of treatment place HDP at higher risk. The pattern observed is delayed onset of sleep, frequent awakening episodes, insomnia, sleep apnoea, excessive daytime sleepiness, restless leg syndrome, abnormal limb movements, pain in limbs, confusion, and nightmares. Two commonly used subjective assessment scores are the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality and the Epworth Sleepiness Scale (ESS) to assess excessive daytime sleepiness.ObjectiveSubjective assessment of sleep using PSQI and ESS scores in HDP and correlation with clinical and demographic characteristics.Patients and MethodsA cross-sectional descriptive study of 148 patients with ESKD undergoing in-center hemodialysis. From June 2021 to October 2021 in Madurai medical college, Madurai, India. Subjective assessment with PSQI and ESS scores was done to identify sleep quality and daytime sleepiness, respectively.ResultsThe median PSQI score was 6 (IQ:4–10), and as much as 68.24% scored >5 on the PSQI (poor sleepers). The median ESS score of the study participants was 4 (Iq range 3–7), and 19.59% had a total ESS score of more than 10 (excessive daytime sleepiness). The mean age of the participants was 44±14.5. Age more than 60, lower body mass index, unemployment, higher dialysis vintage of more than 2 years, lower hemoglobin, high calcium-phosphorus product are statistically significant for both PSQI and ESS scores.ConclusionThe prevalence of poor sleep quality and excessive daytime sleepiness is high in HDP. Subjective assessment scores (PSQI and ESS) on the bedside are valuable tools in identifying sleep quality and EDS where objective assessment methods are not feasible and will help in the short time identification and management of sleep disturbances.

Sleep quality in the Brazilian general population: A cross-sectional study

ObjectiveThis study aimed to assess sleep quality and the independent predictors of poor sleep quality in the Brazilian population. MethodsAn online survey was conducted in adults from all five Brazilian regions. Participants answered a structured questionnaire including variables such as sex, age, geographic region, state, socioeconomic class, education level, the existence of a partner/roommate, self-reported insomnia, and smart phone/interactive media use. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. A logistic regression model was built to assess potential independent predictors of poor sleep quality (PSQI >5). ResultsA total of 2,635 adult individuals were included in the study (median age: 35 years, 54.1% females). Median PSQI score was 7.0 (IQR: 4.0; 65.5% of poor sleepers). Multivariate model showed that females (OR: 1.079; 95% CI: 1.041-1.119); age <55 years (OR: 1.107; 95% CI: 1.031–1.189); having a partner/roommate sleeping in another bed (OR: 1.086; 95% CI: 1.005–1.172) and in another room (OR: 1.137; 95% CI: 1.046–1.235); self-reported insomnia (OR: 1.410; 95% CI: 1.357–1.465); living in Midwest (OR: 1.125; 95% CI: 1.005-1.259), South (OR: 1.121; 95% CI: 1.015-1.239) and Southeast (OR: 1.125; 95% CI: 1.025-1.236) regions, compared to North; and smart phone/interactive media use (OR: 1.129; 95% CI: 1.088-1.171) were predictors of poor sleep quality. ConclusionPoor sleep quality is prevalent among the Brazilian population. Being younger, female, having a partner sleeping in another bed or room, self-reported insomnia, and smart phone/interactive media use were predictors of poor sleep quality.

Abstracts from the ISSAID 2021 Periodic Congress

Abstracts from the ISSAID 2021 Periodic Congress

Pittsburgh Sleep Quality Index score predicts all-cause mortality in Chinese dialysis patients.

The relationship between Pittsburgh Sleep Quality Index (PSQI) score and survival of dialysis patients has not been well studied. The aim of this study was to explore the association between PSQI score and all-cause mortality in dialysis patients. Fifty-one hemodialysis and 58 peritoneal dialysis patients were enrolled in this study. PSQI score > 5 and ≤ 5 indicated "poor sleepers" and "good sleepers", respectively. The primary outcome was all-cause mortality. Kaplan-Meier survival curve and Cox proportional hazards regression analysis were performed. The median PSQI score was 7.0 (4.0-10.0). Sixty-seven (61.5%) patients had poor sleep quality (SQ). Compared with good sleepers, poor sleepers had significantly lower levels of hemoglobin [74.0 (61.0, 85.0) vs. 78.0 (68.0, 97.0), P = 0.03] and serum bicarbonate (18.0 ± 4.5 vs. 20.0 ± 3.7, P = 0.022). The follow-up time was 69.1 ± 29.9months. By multivariate Cox proportional hazards analysis, PSQI total score was the independent risk factor of all-cause mortality [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.05-1.36, P = 0.007]. Restricted cubic spline (RCS) analysis showed that 7 was the cutoff value at which the effect of PSQI score on mortality changed. Patients with a PSQI score > 7 had a 2.96-fold increased risk of all-cause mortality (HR 2.96, 95% CI 1.15-7.61, P = 0.025). PSQI score can be used as a predictor of all-cause mortality in dialysis patients, and those with PSQI > 7 were associated with increased odds of mortality.

Improvement in Polysomnographic Objective Sleep Quality in Adults with Pectus Excavatum After the\xa0Nuss Procedure

BackgroundPatients with pectus excavatum have a poorer subjective sleep quality and quality of life than the general population. The Nuss procedure has been shown to improve these patients’ quality of life, but data regarding their postoperative sleep quality are lacking. We aimed to evaluate the objective sleep quality of adults with pectus excavatum before and after the Nuss procedure.MethodsTwenty-eight participants completed this study. Epworth Sleepiness Scale (ESS) scores for daytime sleepiness, Pittsburgh Sleep Quality Index (PSQI) scores for subjective sleep quality, and overnight polysomnography for objective sleep quality were evaluated before and 6 months after the Nuss procedure.ResultsSubjective sleep quality improved after the Nuss procedure. The median PSQI score decreased from 7 [interquartile range (IQR): 5; 9] to 5 (IQR: 4; 7, p = 0.029); the median percentage of poor PSQI sleep quality decreased from 64.3 to 35.7% (p = 0.048). The median percentage of rapid eye movement sleep significantly increased after surgery [15.6% (IQR: 12.2%; 19.8%) vs. 20.4% (IQR: 14.5%; 24.9%), p = 0.016]. Sleep interruptions also improved, with the median arousal index decreasing from 9.5 (IQR: 4.8; 18.2) to 8.2 (IQR: 4.3; 12.1; p = 0.045). However, there was no significant change in ESS scores after surgery (p = 0.955).ConclusionsPectus excavatum may be associated with poor subjective and objective sleep quality in adults, and the condition may improve after the Nuss procedure. For adults with pectus excavatum who report poor subjective sleep quality, polysomnography should be considered to assess their preoperative and postoperative sleep condition.

An assessment of sleep quality and daytime sleepiness in hemodialysis patients: a cross-sectional study from Palestine

BackgroundPatients on hemodialysis (HD) commonly suffer from poor sleep quality which in turn compromises their quality of life and well as their mortality risk according to many studies. In Palestine however, no single study had emphasized the association and prevalence of sleep quality and daytime sleepiness among hemodialysis patients (HDP). Therefore, we conducted this study to determine the relationship between regular HD and the situation regarding sleep quality and daytime sleepiness in HDP.MethodsIn this cross-sectional survey, we targeted HDP at one HD center in An-Najah National University Hospital. Sleep problems were assessed by both the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), which are considered as standardized tools for the assessment of sleep quality and daytime sleepiness, respectively.ResultsOf the 192 dialysis patients who were interviewed, 167 were included in the final analysis of this study, with a response rate of 87%. The mean age of the participants was 57.6 ± 12.9. Fifty-two percent were males, and an equal percentage of the participants were 60 years old or older. The median ESS of the participants was 7 [4–11] and 43.1% of the participants had 9 or more ESS score, indicating excessive daytime sleepiness. The median PSQI score was 8 [6–12] and 76.65% of the participants scored more than 5 points on the PSQI, indicating poor sleep quality. Neither the ESS score nor the PSQI score were significantly associated with any particular category of participants, based on their demographic or clinical characteristics.ConclusionsIn conclusion, we found that dialysis patients had poor sleep quality, evident by their high median PSQI score, though their excessive daytime sleepiness was less evident by their median ESS score in the high normal values. Additionally, we found a high prevalence of poor sleep quality among HDP, whereas excessive daytime sleepiness was less prevalent. Finally, no significant association was found between either of the two scores and the participants’ demographic or clinical characteristics surveyed in this study.

A comparison of quality of sleep between patients with chronic kidney disease not on hemodialysis and end-stage renal disease on hemodialysis in a developing country

Few studies have compared quality of sleep between pre-dialysis chronic kidney disease (pre-dialysis CKD) patients and end-stage renal disease patients on dialysis (ESRD) and have found inconsistent results. Objective of this study is to compare quality of sleep between patients with pre-dialysis CKD and ESRD in a developing country. This study was conducted in an out-patient department and hemodialysis unit of a tertiary care facility. Patients included had either pre-dialysis CKD or ESRD. Assessment of quality of sleep was done using Pittsburgh sleep quality index (PSQI). A total of 152 patients were included in the study. Out of these patients, 79 (52%) had ESRD and 73 (48%) had pre-dialysis CKD. Median PSQI score was 6 (IQR 3–8.8). Poor sleep quality (PSQI ≥5) was present in 100 (65.8%) patients. Only hemoglobin (β = −0.39, p < .01), depression (β = 0.56, p < .01) and history of cardiovascular disease (β = 0.22, p < .01) were associated with PSQI global score in a multiple linear regression analysis. There was no significant association between ESRD vs. pre-dialysis CKD and PSQI global scores and no significant co-relation between eGFR and global PSQI score (r = −0.34, p value .80) in pre-dialysis CKD patients. Poor sleep quality is common in patients with CKD including hemodialysis patients in a developing country, which is independent of kidney function in non-dialysis patients. There is no difference in quality of sleep between pre-dialysis CKD and ESRD patients.

The prevalence of poor sleep quality and its association with depression and anxiety scores in patients admitted for cardiovascular disease: A cross-sectional designed study

BackgroundPoor sleep quality contributes to the development of various cardiovascular conditions. However, its real-world prevalence among cardiovascular inpatients and association with psychological disturbance is unknown. This study aimed to assess the prevalence of poor sleep quality and its association with depression and anxiety in cardiovascular patients, and explored whether sex and cardiovascular comorbidities modified these associations. MethodsA total of 1071 patients hospitalized for a broad spectrum of cardiovascular diseases at a single university hospital were assessed (790 men, mean age 64±14years). We assessed sleep quality during their index hospitalization period using the Pittsburgh Sleep Quality Index (PSQI); poor sleep quality was defined as PSQI>5. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS). ResultsThe median PSQI score was 5.0 [3.0–7.0], and 461 inpatients (43%) had poor sleep quality. Multivariate regression analysis adjusting for patient background, medical risk factors, and laboratory data revealed that poor sleep quality was associated with higher HADS subscores for depression (HADS-depression; odds ratio [OR]: 1.09, 95% confidence interval [CI]: 1.03–1.15) and anxiety (HADS-anxiety; OR: 1.17, 95% CI: 1.11–1.24). Poor sleep quality was associated with markedly higher HADS-depression among women than men (p value for interaction: 0.008). The association between poor sleep quality and HADS-anxiety was more significant among patients without coronary artery diseases (p value for interaction: 0.017). ConclusionsPoor sleep quality was highly prevalent and associated with depression and anxiety in cardiovascular patients. These associations may be modified by sex and the presence of coronary artery diseases.

The evaluation of sleep quality and response to anti-tumor necrosis factor α therapy in rheumatoid arthritis patients.

Poor sleep quality (SQ) is increasingly recognized as giving rise to decreased quality of life, and raising pain perception. Our aim is to evaluate the SQ in rheumatoid arthritis (RA) patients treated with anti-tumor necrosis factor alpha (anti-TNF-α) therapy. This was a prospective observational and open-label study of RA patients. A total of 35 patients with RA were enrolled in this study. Of the 35 patients, 22 had high disease activity (DA), and 13 were in remission. High DA group was initiated an anti TNF-α therapy. Clinical and objective parameters of SQ were assessed by using the Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG). The total PSQI score and the frequency of poor SQ were high in 60% of the RA patients. The median PSQI score was significantly higher in the high DA group than in the remission group (P=0.026). Following an anti-TNF-α therapy initiation, significant improvements were observed in the high DA group by PSQI test (P=0.012). However, no statistically significant difference was found by PSG (P>0.05). Although an improvement in DA with anti-TNF-alpha therapy did not provide an amelioration in laboratory parameters, we found a significant improvement in SQ by subjective PSQI test. These findings may support that sleep disorders in RA are likely to be associated with a complex pathophysiology.