Pittsburgh Sleep Quality Index Component Scores Research Articles

Effects of traditional Chinese medicine on symptoms of patients with spleen and stomach deficiency-related tinnitus.

Tinnitus affects 10%-30% of the population. Recent evidence suggests that tinnitus is associated with spleen deficiency. However, compared with kidney deficiency-related tinnitus, less research has been conducted on the impact of spleen deficiency-related tinnitus. To investigate the clinical efficacy of using Guipi Wan and dietary and lifestyle modification based on traditional Chinese medicine for treatment of patients with spleen and stomach deficiency-related tinnitus. We enrolled 110 patients with spleen and stomach deficiency-related tinnitus who were distributed into treatment (58 cases) and control (52 cases) groups. Tinnitus severity, sleep quality and emotional state were assessed by questionnaires [Tinnitus Evaluation Questionnaire (TEQ); Pittsburgh Sleep Quality Index (PSQI); Depression-Anxiety-Stress Scale-21 (DASS-21)] that were used for analysis in the two groups during the initial and intervention and after. In the treatment group, patients were treated with oral administration of Guipi Wan and consulted for healthy dietary and lifestyle modification. In the control group, patients were only assessed and not treated. At the end of the 6-months, TEQ scores decreased significantly in the treatment group (P = 0.021) but not in the Control group. Significant effects in the treatment group were noted for PSQI total score (P = 0.043) and several PSQI component scores in the treatment group (P < 0.05). After treatment, the DASS-21 scores were significantly reduced in the treatment group (P < 0.05). Guipi Wan combined with dietary and lifestyle modification based on regulating the spleen and stomach can be considered core to the treatment of tinnitus related to spleen and stomach deficiency.

Sleep Quality in Team USA Olympic and Paralympic Athletes.

To establish sleep-quality reference ranges for Olympic and Paralympic cohorts using the Pittsburgh Sleep Quality Index (PSQI) and explore differences based on sex and sport types. Team USA athletes (men = 805, women = 798) completed the PSQI as part of a health-history questionnaire. Descriptive statistics were used to create reference ranges and linear models, and χ2 test of independence determined differences in PSQI global and component scores between sex, games, season, and participation. Six hundred thirty-two (39.43%) athletes reported poor sleep (PSQIGlobal ≥ 5). Men displayed later bedtimes (P = .006), better global PSQI scores, shorter sleep latency, less sleep disturbance, and less use of sleep medication than women (all P < .001). Winter Games participants had later bedtime (P = .036) and sleep offset time (P = .028) compared with Summer Games athletes. Team-sport athletes woke earlier than individual-sport athletes (P < .001). Individual-sport athletes were more likely to have low (P = .005) and mild (P = .045) risk for reduced sleep duration than team-sport athletes. These data provide PSQI-specific reference ranges to identify groups at greatest risk for poor sleep, who may benefit most from targeted sleep interventions.

Vietnamese Version of Pittsburgh Sleep Quality Index: Reliability, Cut-Off Point, and Association With Depression Among Health Science Students

Background and Objective Sleep disturbances among medical students, including insufficient sleep duration and poor sleep quality, are prevalent issues with potential repercussions on mental health.Methods The study evaluated the Vietnamese version of the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality and investigated the correlation between the results of the PSQI and Beck Depression Inventory-II (BDI-II) scales in health sciences students.Results We conducted this cross-sectional study at the School of Medicine, Vietnam National University Ho Chi Minh City, involving 906 medical, pharmaceutical, and dental students. Data were collected through a self-reporting questionnaire.Conclusions The Vietnamese version of the PSQI scale demonstrates acceptable reliability. Furthermore, positive correlations were observed between the total PSQI score and components of the BDI-II. A recommended cut-off point above 5 is proposed for identifying sleep disturbances among health sciences students using the Vietnamese PSQI. Conclusions The study affirms the reliability of the Vietnamese PSQI scale, suggesting its suitability for screening sleep disturbances among health sciences students in Vietnam. PSQI component scores significantly correlated with total BDI-II score.

NO DIFFERENCE IN SUBJECTIVE SLEEP MEASUREMENTS BETWEEN MIDDLE-AGED AND OLDER ADULTS

Abstract With age, sleep quality tends to decline. Poor sleep quality is associated with adverse physical and mental health outcomes, especially in the aging population. The purpose was to compare subjective sleep quality measurements between middle age (45-64 years) and older adults (over 65 years). Participants (N=200) completed the Pittsburgh Sleep Quality Index (PSQI) and were classified by age as either middle age (MID: n=105, 71.4% female, M±SD: age: 55.5±5.8 years; mass: 85.3±17.4 kg, height: 168.4±9.2 cm, education: 18.2±3.6 years) or older adults (OLD: n=95, 76.8% female, M±SD: age: 69.0±2.9 years; mass: 80.6±14.9 kg, height: 166.2±8.9 cm, education: 17.9±3.5 years). The PSQI Component and Global Scores were calculated. Data were analyzed using descriptive statistics, crosstabulations, and independent samples t-tests (p ≤ .05). The results showed there was no difference (p &amp;lt; .05) between the two age groups on subjective sleep measures, including sleep quality, latency, duration, and disruptions. The average Global score for the MID and OLD adults was 6.3±3.2 and 6.0±3.6, respectively. Only 17% of MID adults and 25% of OLD adults were classified as good quality sleepers (PSQI Global score ≤ 4) and 21.9% and 30.5% rated their sleep quality as very good, respectively. While previous research has shown deterioration in subjective sleep quality measures occurs with age, there was not a difference in subjective measures between middle age and older adults in the present investigation. Further analysis is warranted to examine additional factors impacting sleep quality such as physical activity levels, co-morbidities, and living situation.

An examination of the impact of age and sleep quality on neurocognition within a multi‐ethnic sample

AbstractBackgroundOlder adults and ethnoracially diverse groups (e.g., non‐Latinx Black (NLB), Latinx) are at higher risk of poor sleep quality. Poor sleep is linked to neurocognitive (NC) decline in middle/older adults, but much of the sleep literature has relied on global NC screening measures. This study examined the effects of age and sleep quality on NC functioning within a multi‐ethnic sample of middle/older adults utilizing a multi‐domain NC battery.MethodThis cross‐sectional study included 119 middle/older adults (M age = 65.3, SD age = 6.9; 46% NLB, 31% Latinx, and 23% non‐Latinx White (NLW); 63% female) who completed demographic questionnaires, the Pittsburgh Sleep Quality Index (PSQI), and a comprehensive NC battery. PSQI global and component scores (e.g., Daytime Dysfunction; PSQI‐DD) measured subjective reporting of sleep quality. Demographically‐adjusted NC T‐scores were used to compute 8 NC‐domain and global average T‐scores. Pearson’s correlations, ANOVA, and multiple regressions were used to test hypotheses.ResultGlobal NC was not related to any PSQI components, and the PSQI components did not differ across ethnoracial groups (all p’s&lt;.05). However, within‐group correlations revealed that the relationship between PSQI components and NC domains significantly differed across ethnoracial groups. For example, frequency of sleep medication usage was significantly negatively correlated with executive functioning in the NLB group (r = ‐.39, p = .02), but not NLW or Latinx groups. Multiple regressions, including age and the interactions between race/ethnicity and PSQI component scores, significantly predicted 21‐39% of the variance in all NC domains (p’s&lt;.05), except attention/working memory (p = .60). The interaction between PSQI‐DD and ethnoracial status significantly predicted memory (p’s&lt;.05); this relationship was positive in the NLW group (B = 20.20), yet negative in the NLB (B = ‐1.16) and Latinx (B = ‐0.56) groups (ps&lt;.05).ConclusionDisordered sleep may have a greater impact on NC functioning, namely memory, among middle/older adults from diverse ethnoracial groups, who are already at heightened risk for NC decline. Importantly, global cognitive screening may be insufficient in examining the effects of sleep quality on NC in middle/older adults. Given the ethnoracial differences in sleep quality, future research should consider culturally‐tailored sleep interventions. Using objective sleep quality measures (e.g., actigraphy) may better quantify sleep components.

Comparison of painful temporomandibular disorders, psychological characteristics, sleep quality, and oral health-related quality of life of patients seeking care before and during the Covid-19 pandemic

BackgroundLiterature concerning Temporomandibular disorders (TMDs) and the Covid-19 pandemic is limited and disparate findings related to TMD frequencies, psychological distress, and quality of life were presented. This study investigated the prevalence of painful Temporomandibular disorders (TMDs) and compared the psychological, sleep, and oral health-related quality of life profiles of patients seeking TMD care before and during the Covid-19 pandemic.MethodsData were accrued from consecutive adult patients 12 months before (BC; control) and during (DC; case group) the Covid-19 pandemic. The Diagnostic Criteria for TMDs (DC/TMD), Depression, Anxiety, Stress Scales (DASS)-21, Pittsburgh Sleep Quality Index (PSQI), and Oral Health Impact Profile (OHIP)-TMDs were utilized and statistical analysis was performed using Chi-square/non-parametric tests (α = 0.05).ResultsThe prevalence of painful TMDs was 50.8% before and 46.3% during the pandemic. Significant differences in PSQI and OHIP component scores were discerned between the BC and DC groups contingent on TMD pain. Total-DASS was moderately correlated to total-PSQI/OHIP (rs = 0.41–0.63).ConclusionThe covid-19 pandemic did not appear to exacerbate psychological distress but affected sleep and increased unease over TMD dysfunction.

Age-Based Differences in Sleep Quality, Pre-Sleep Arousal, and Psychosocial Factors during the Second Wave Lockdown of the COVID-19 Pandemic in Georgia—A Higher Vulnerability of Younger People

The COVID-19 pandemic has deeply disrupted sleep and mental health of people around the world. We aimed to investigate age-based differences in the prevalence of and relationship between sleep quality, pre-sleep arousal, and psychosocial factors during the second wave lockdown of the COVID-19 pandemic in Georgia. Data were collected through an online survey (n = 1117). Participants were categorized into four age groups: 18-29, 30-41, 42-53, and 54-70 years. The youngest participants reported the most prevalent disruption of sleep behavior. Overall, 58.3% of respondents were poor sleepers. The Pittsburgh Sleep Quality Index (PSQI) global score was highest in the youngest age group but the difference was not significant. There was a significant difference in the PSQI component scores for subjective sleep quality, sleep latency, and daytime dysfunction, all being worse in young respondents. We also observed a significantly higher prevalence rate of worse sleep quality in the youngest age group, relative to the pre-pandemic period. On the other hand, the oldest respondents showed significantly greater use of sleeping medications. Significantly higher levels of somatic and cognitive pre-sleep arousal, perceived stress, feeling depressed, anxious, and socially isolated were reported by the youngest age group. Study findings indicate a higher vulnerability of younger people to the impact of the COVID-19 pandemic. Assessment of pre-sleep arousal and implementation of specific, age-based interventions may prove beneficial to improve possible consequences of the pandemic on sleep and mental health.

The association of 1-year weight loss from bariatric surgery and self-reported sleep: a prospective cohort.

This study examined the association of weight loss following bariatric surgery with self-reported sleep quality after accounting for other sleep-related factors. Participants were from the Bariatric Experience Long Term (BELONG) study. Participants completed a survey up to 6 months before surgery and approximately 1 year after surgery. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. One-year percentage total weight loss (%TWL) was determined from electronic medical records. Covariates included demographics, Charlson Comorbidity Index, geocoded variables to assess neighborhood quality, and physical activity. The authors assessed the association between %TWL at 1 year and PSQI component scores with separate cumulative logit models. There were 997 participants in the analytic cohort. Participants were 86.2% women, 37.0% Hispanic, and 13.7% Black adults. Mean one-year %TWL was 26.3 (SD 8.7). Each 1% increase in %TWL was associated with a 3% better daytime dysfunction score (odds ratio=1.03; 95% CI: 1.02-1.05) and a 2% better sleep quality score (odds ratio=1.02; 95% CI: 1.00-1.03). No significant differences were found for the other PSQI components. Weight loss from bariatric surgery was associated with better self-reported sleep at 1 year. For people undergoing bariatric surgery, there may be an added benefit of better sleep.

A Strategy to Inform Athlete Sleep Support From Questionnaire Data and Its Application in an Elite Athlete Cohort.

Information from the Pittsburgh Sleep Quality Index (PSQI) and Athlete Sleep Behavior Questionnaire (ASBQ) provide the ability to identify the sleep disturbances experienced by athletes and their associated athlete-specific challenges that cause these disturbances. However, determining the appropriate support strategy to optimize the sleep habits and characteristics of large groups of athletes can be time-consuming and resource-intensive. The purpose of this study was to characterize the sleep profiles of elite athletes to optimize sleep-support strategies and present a novel R package, AthSlpBehaviouR, to aid practitioners with athlete sleep monitoring and support efforts. PSQI and ASBQ data were collected from a cohort of 412 elite athletes across 27 sports through an electronic survey. A k-means cluster analysis was employed to characterize the unique sleep-characteristic typologies based on PSQI and ASBQ component scores. Three unique clusters were identified and qualitatively labeled based on the z scores of the PSQI components and ASBQ components: cluster 1, "high-priority; poor overall sleep characteristics + behavioral-focused support"; cluster 2, "medium-priority, sleep disturbances + routine/environment-focused support"; and cluster 3, "low-priority; acceptable sleep characteristics + general support." The findings of this study highlight the practical utility of an unsupervised learning approach to perform clustering on questionnaire data to inform athlete sleep-support recommendations. Practitioners can consider using the AthSlpBehaviouR package to adopt a similar approach in athlete sleep screening and support provision.

Associations between sleep and Alzheimer’s disease biomarkers within the EPAD cohort

AbstractBackgroundChanges in sleep quality are common in Alzheimer’s Disease (AD) and may even play a role in the onset and accumulation of disease. However, in preclinical stages, it is unclear whether sleep quality or sleep disturbance relate to disease pathology after controlling for known covariates and AD risk factors. This study aimed to determine if self‐reported sleep quality is associated with AD biomarkers after accounting for such factors.MethodData were obtained from the European Prevention of Alzheimer’s Disease (EPAD) Longitudinal Cohort Study (LCS) data set (v1500.0). Cerebrospinal fluid (CSF) samples were collected for measurement of b‐amyloid (Ab42) and phosphorylated tau (p‐tau). Self‐reported sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Participants with Clinical Dementia Rating (CDR) scale scores greater than 0.5, indicative of dementia, were excluded. Linear regression models were used to determine whether the p‐tau/Ab42 ratio was associated with PSQI component scores when controlling for multiple potential confounders such as demographics, ApoE4 status, depressive symptoms, body mass index, vascular risks, smoking status, use of psychotropics, white matter lesions, and hippocampal volume. PSQI component scores of 2 or 3 were combined due to small numbers of participants with component scores of 3.ResultFrom the 1500 participants in the EPAD‐LCS v1500.0 data, a total of 1239 participants were included in the regression analysis (mean age=65.30 years, SD=7.11; mean PSQI total score=5.31, SD=3.38). After adjustment for all covariates, higher p‐tau/Ab42 ratio was found to be associated with longer self‐reported sleep latency (component score of 1: b=0.16, p=0.007; component score of 2/3: b=0.12, p=0.134; R2=0.22) and better self‐reported sleep efficiency (component score of 1: b=‐0.22, p=0.04; component score of 2/3: b=‐0.31, p=0.009; R2=0.22)ConclusionWithin the EPAD cohort, longer sleep latency and greater efficiency are associated with greater AD pathology after controlling for covariates. These findings contribute to growing evidence suggesting sleep is an important early marker of underlying neurodegeneration. Longitudinal assessment of EPAD‐LCS participants will allow for the evaluation of self‐reported sleep as a predictive marker of neurodegeneration.

The Development of a Rapid Classification Scale for Sleep Quality in Community-Dwelling Older Adults - The Yilan Study, Taiwan.

ObjectivePoor sleep quality is prevailing, deleterious, but heterogeneous in older adults. This study aimed to develop a simplified instrument to screen and classify poor sleep quality in community-dwelling older adults, by which stepped care with needs-based interventions could be implemented.MethodsCohorts of adults aged 65 years and older were used to develop the Rapid Classification Scale for Sleep Quality (RCSSQ). Poor sleep quality was defined with the Pittsburgh Sleep Quality Index (PSQI). Established subgroups of poor sleep quality in the development dataset (n = 2622) were used as the criterion standard. Two independent validation datasets (n = 964 and 193, respectively) were used to examine the external validity. Questions in the PSQI were examined by the stepwise multinomial logistic regressions to determine the optimal numbers of items in the RCSSQ. On the premise of item parsimony and instrument validity, the optimal combination of reduced items was determined.ResultsIn the development dataset, the 4-item RCSSQ (RCSSQ-4) was the optimal predictive model. In terms of internal validity, the accuracy rates to identify PSQI-defined poor sleep quality and its subgroups in the developmental dataset by the RCSSQ-4 were 89.0% and 79.9%, respectively. Meanwhile, the RCSSQ-4 also had good external validity in the validation datasets to detect PSQI-defined poor sleep quality (accuracy rates: 89.1–90.7%). Furthermore, the profiles of PSQI component scores and comorbid conditions for the predicted subgroups in the validation dataset were comparable with the criterion standard.ConclusionThe RCSSQ-4 is a valid instrument for screening and subgrouping poor sleep quality in community-dwelling older adults. The RCSSQ-4 may help guide tailored interventions under the context of stepped care in the community.

The Pittsburgh Sleep Quality Index: Reliability, Factor Structure, and Related Clinical Factors among Children, Adolescents, and Young Adults with Chronic Pain.

This study is aimed at assessing the psychometric properties and the factorial structure of the Pittsburgh Sleep Quality Index (PSQI) in a clinical sample of children, adolescents, and young adults with chronic pain. Data of 482 participants (aged 8-21 years) from two crosssectional studies and a chronic pain services outpatient clinic were analyzed. Exploratory and confirmatory factor analysis and reliability analysis of PSQI component scores were performed. Relationships between the PSQI global score and various clinical measures were investigated to assess external validity. The findings exhibit the reliability and validity of a single-factor model of the PSQI in a clinical sample of youth with chronic pain and support the relationship in this specific population between poor sleep quality and important clinical measures of well-being. These results support an informed decision regarding its use with this specific population and underscore the clinical relevance of assessing sleep quality.

Sleep and occupational well-being in active duty special operations soldiers: A replication and expansion

ObjectiveTo assess the relationship between sleep quality and occupational well-being in active duty military Service Members. DesignLongitudinal prospective analysis. SettingAn annual military training event. ParticipantsUS Army special operations Soldiers (n = 60; 100% male; age 25.41 ± 3.74). InterventionNone. MeasurementsThe Pittsburgh Sleep Quality Index (PSQI) was administered prior to the training event, and the Emotional Exhaustion Scale, the Role Overload Scale, the Walter Reed Army Institute of Research Soldier-Specific Functional Impairment Scale, and the Perceived Stress Scale were administered after the event. Linear regression models were used to assess the relationship between sleep and occupational wellness measures, and the outcome measures of “good” and “poor” sleepers (per the PSQI scoring criteria) were compared with Student's t tests. ResultsHigher (poorer) PSQI Global Scores predicted poorer occupational wellness of all measures (emotional exhaustion: B = 1.60, P < .001, R2 = 0.25; functional impairment: B = 0.29, P = .03, R2 = 0.14; role overload: B = 0.28, P = .008, R2 = 0.12; and perceived stress: B = 0.34, P = .004, R2 = 0.20). There were additional relationships between specific PSQI component scores and occupational wellness measures, which is a replication of This team's previous work. Furthermore, emotional exhaustion (t(58) = −4.18, P < .001), functional impairment (t(59)= −3.68, P = .001), role overload (t(58) = −3.20, P = .002), and perceived stress (t(58) = −2.43, P = .02) were all higher in poor sleepers. ConclusionsThe findings of this study suggest that US Army special operations Soldiers who have poorer sleep quality may be at increased risk for having poorer occupational well-being.

Subtypes of acute and chronic temporomandibular disorders: Their relation to psychological and sleep impairments.

To determine the differences in psychological states and sleep quality in patients with various temporomandibular disorder (TMD) subtypes, and to ascertain the relationships between TMD duration with psychological and sleep impairments. A total of 830 TMD patients were recruited categorized into pain-related (PT), intra-articular (IT), and combined (CT) TMD groups. Each group was further divided into acute and chronic subtypes. The Depression, Anxiety, and Stress Scales-21 (DASS-21), and Pittsburgh Sleep Quality Index (PSQI) were used to assess emotional states and sleep problems. Although chronic TMDs generally had higher levels of anxiety, depression, stress, and sleep impairments than acute TMDs, significant differences were only observed for the PT group. Ranking of the mean depression, anxiety, and stress scores was as follows: acute TMDs: CT>PT>IT; chronic TMDs: PT>CT>IT. For both acute and chronic TMDs, the ranking of mean PSQI global and component scores was PT≥CT≥IT. Logistic regression analyses indicated that stress (ORs=4.40) and depression (ORs=2.82) increased the risks of chronic pain-related TMDs (p<.05). Chronic pain-related TMDs are associated with high levels of psychological distress and poorer sleep, while chronic intra-articular TMDs are not. Stress and depression increased the probability of chronic pain-related TMDs.

0313 Is Healthy Sleep Possible for Professional Firefighters? A Comparison of “On-Duty” and “Off-Duty” Sleep Quantity and Quality

Abstract Introduction Healthy sleep is vital for firefighter safety, health, wellness, and for public well-being. However, professional firefighters experience disturbed sleep at disproportionately high rates. The current study investigated whether firefighters can obtain healthy sleep by identifying (1) differences in sleep while “on-duty” and “off-duty” and (2) risk factors for poor sleep. Methods Professional firefighters in Richmond, Virginia’s Department of Fire and Emergency Services (N=268), reported their sleep using the Pittsburgh Sleep Quality Index (PSQI) both on- and off-duty. Good and poor sleepers were identified using the PSQI global score cutoff of 5. Demographic and STOP-BANG questionnaires were also completed. Results Using a repeated measures MANOVA, on-duty sleep was significantly worse compared to off-duty sleep across PSQI component and global scores F(7, 253)=45.24 p&amp;lt;.001, η²=.56. On-duty, 76.1% of firefighters were classified as poor sleepers compared to 42.9% off-duty. 34.7% were reclassified as good sleepers or stayed good sleepers (22.4%) when off-duty. A sizeable minority experienced consistently poor sleep while on- and off-duty (41.4%), and a small number reported worse sleep when off-duty (1.5%). More night calls and poorer self-rated mental health predicted worse on-duty sleep (p&amp;lt;.001) and poorer self-rated mental health predicted worse off-duty sleep (p&amp;lt;.001). Conclusion Healthy sleep is possible for professional firefighters. Almost a quarter of the sample was classified as “good sleepers” on-duty and over half were classified as “good sleepers” off-duty. Nonetheless, sleep on-duty was significantly worse overall, with over a third of the sample experiencing consistently poor sleep. When working a 24-hour variable shift schedule, it appears that poor sleep may “carryover” from on-duty to off-duty. Poorer self-rated mental health and more night calls were identified as risk factors. Further research is needed to probe risk and protective factors within this population. Support N/A

Effects of a multidisciplinary quality of life intervention on sleep quality in patients with advanced cancer receiving radiation therapy

Sleep disturbances are prevalent in cancer patients, especially those with advanced disease. There are few published intervention studies that address sleep issues in advanced cancer patients during the course of treatment. This study assesses the impact of a multidisciplinary quality of life (QOL) intervention on subjective sleep difficulties in patients with advanced cancer. This randomized trial investigated the comparative effects of a multidisciplinary QOL intervention (n = 54) vs. standard care (n = 63) on sleep quality in patients with advanced cancer receiving radiation therapy as a secondary endpoint. The intervention group attended six intervention sessions, while the standard care group received informational material only. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), administered at baseline and weeks 4 (post-intervention), 27, and 52. The intervention group had a statistically significant improvement in the PSQI total score and two components of sleep quality and daytime dysfunction than the control group at week 4. At week 27, although both groups showed improvements in sleep measures from baseline, there were no statistically significant differences between groups in any of the PSQI total and component scores, or ESS. At week 52, the intervention group used less sleep medication than control patients compared to baseline (p = 0.04) and had a lower ESS score (7.6 vs. 9.3, p = 0.03). A multidisciplinary intervention to improve QOL can also improve sleep quality of advanced cancer patients undergoing radiation therapy. Those patients who completed the intervention also reported the use of less sleep medication.

Physical activity, chronotype and sleep in a sample of Italian elderly population

This study aims to evaluate the role of physical habits and chronotype on sleep patterns in a sample of Italian elderly population. One-hundred Italian elderly individuals (50 males; mean age ± SD 70.9 ± 6.3 years) were enrolled and completed the Morningness–Eveningness Questionnaire, the International Physical Activity Questionnaire-Short Form and the Pittsburgh Sleep Quality Index (PSQI). Moreover, we evaluated the lipid profile (total cholesterol, triglycerides, HDL, LDL values, total cholesterol/HDL and LDL/HDL ratios). Active subjects (AS) collected better PSQI value compared to inactive subjects (IS) (mean ± SD 5.3 ± 3.1 vs 6.2 ± 3.4). The AS made less use of sleep medications (p < 0.003) and reported less sleep disturbances (p < 0.003) and daytime dysfunctions (p < 0.006) compared to IS. PSQI final and component scores for neither types (N-types) were lower compared to those of morning types (M-types). Referring to the females, active N-type collected lower PSQI value compared to active M-types (mean ± SD 3.9 ± 3 vs 6.2 ± 3.5, respectively; p < 0.05). Active M-types made less use of sleep medications (f < 0.05; p < 0.02) and had less sleep dysfunction (f < 0.03; p < 0.03) compared to inactive M-types, while active N-types reported less daytime dysfunctions (f < 0.03; p < 0.03) compared to inactive N-types. Focusing on males, active M-types reported less disturbances compared to inactive N-types (f < 0.05; p < 0.05). IS showed lower HDL level compared to AS (p < 0.005). M-types had worst sleeping habits compared to N-types. IS had worse global sleep quality, more sleep disturbances and made greater use of sleep medications than AS did. An active lifestyle could be considered as useful tool to improve sleep and reduces sleep problems during aging.

Effect of Traditional East Asian Medicinal herbal tea (HT002) on insomnia: a randomized controlled pilot study

BackgroundComplementary and alternative medicine treatment for insomnia has been sought due to the possible adverse effects of conventional pharmacotherapies. We performed a preliminary evaluation of the feasibility of using, and of the effect of a herbal tea (HT002), based on Traditional East Asian Medicine, in mild-to-moderate insomnia. MethodsPatients (n=40) with mild-to-moderate insomnia were randomized to the HT002 (n=20) or waitlist (n=20) groups. The HT002 group consumed HT002 twice daily for 4 weeks. Outcomes were assessed using the Insomnia Severity Scale (ISI), Pittsburgh Sleep Quality Index (PSQI), and 12-item Short Form Health Survey (SF-12) at baseline and after 4 and 8 weeks. ResultsThe ISI score differences from baseline at weeks 4 and 8 were significantly greater in the HT002 than that in the waitlist group (week 4: −4.0±0.8 vs. −0.4±0.8, p<0.05; week 8: −4.8±0.7 vs. −0.9±0.7, p<0.05). Changes in PSQI and SF-12 physical component scores in the HT002 group were significantly greater at weeks 4 and 8 (p<0.05), while SF-12 mental component scores were only significantly larger at 4 weeks (p<0.05). HT002 was well-tolerated, with only one (5.0%) dropout, and no significant mean liver and renal function test changes post-treatment. ConclusionOur preliminary results suggest that a 4-week treatment with HT002 may reduce the severity of insomnia symptoms and improve the quality of life. Further studies devoid of the limitations of our protocol may provide stronger conclusions. Trial registrationClinical Research Information Service (CRIS), KCT0001900.

Factor structure and psychometric properties of the Pittsburgh Sleep Quality Index in community-based adolescents.

The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report questionnaire that assesses general sleep quality. This study aimed to validate the single-factor scoring structure and related psychometric properties in the English language version of the PSQI in community-based adolescents. Participants were 889 (352 males, 39.6%) students (age M = 15.71 ± 1.57; 12.08-18.92 years) recruited from 14 Australian secondary schools. Participants completed the PSQI, Center for Epidemiological Studies-Depression (CES-D) scale, and Spence Children's Anxiety Scale (SCAS). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of PSQI component scores were performed on two independent random half-samples (i.e. cross-validation approach). The internal consistency of PSQI components and convergent validity of the PSQI global score with CES-D and SCAS total scores were also assessed. EFA yielded a single-factor model. CFA of the single-factor model in a separate sample yielded acceptable model fit to the data after important relationships were modeled. Namely, modification indices suggested improved model fit by correlating residual scores of PSQI components of sleep duration and sleep efficiency, and sleep efficiency and sleep latency. Internal consistency was acceptable (Cronbach's α = 0.73). The PSQI global score had moderate-to-large positive correlations with CES-D (r = 0.58) and SCAS (r = 0.45) total scores, demonstrating good convergent validity with emotional problems as predicted. The findings validate the single-factor scoring structure of the PSQI in an adolescent sample and highlight important covariation between poor sleep duration, efficiency, and latency in this age group. Further validation studies are required to determine an appropriate PSQI clinical cut-off score for adolescents.

A survey of sleep quality of employed nurses in military hospitals

Objective: To investigate the sleep quality of the employed nurses in three grade A tertiary military hospitals in Beijing, China and its influential factors and to provide a reference for improving the sleep quality of employed nurses. Methods: From January 2014 to January 2017, a questionnaire survey was carried out to investigate the sleep quality of 253 employed nurses in three grade A tertiary military hospitals in Beijing, China using the Pittsburgh Sleep Quality Index (PSQI) and a general status questionnaire. The results were compared with the adult norms to analyze the influential factors for sleep quality of the employed nurses. Results: The global PSQI score of the 253 employed nurses was 7.76 ± 3.53. Their global PSQI score and PSQI component scores were significantly higher than the adults norms (P<0.05) . And 54.94% of the employed nurses had poor sleep quality; they had high scores of daytime dysfunction (1.39±0.83) , sleep latency (1.67±0.94) , sleep quality (1.33±0.88) , and sleep time (1.23±0.78) . The one-way analysis of variance showed that the sleep quality of the employed nurses was associated with nursing age, educational background, professional title, whether to have children, frequency of night shifts, and department (P<0.05) . The multivariate logistic regression analysis showed that the risk factors for sleep quality of the employed nurses were technical secondary school education (OR=4.292) and emergency department and intensive care unit (OR=2.582) ; the protective factors for sleep quality of the employed nurses were outpatient department and assistant department (OR=0.312) , no children (OR=0.318) , and no night shift (OR=0.332) . Conclusion: The employed nurses in military hospitals have poorer sleep quality than the normal adults. The influential factors for sleep quality of employed nurses are educational background, department, whether to have children, and frequency of night shifts.