Pittsburgh Sleep Quality Index Component Research Articles

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.

ASSESSING SLEEP QUALITY AMONG MEDICAL AND DENTAL STUDENTS IN KHYBER PAKHTUNKHWA PROVINCE OF PAKISTAN: A CROSS-SECTIONAL SURVEY

Objectives: To determine the prevalence of poor sleep and factors associated with it among medical and dental students in Khyber Pakhtunkhwa province of Pakistan.Materials and Methods: A population-based analytical cross-sectional study was carried out from May to September 2022, consisting of 385 undergraduate students from 21 medical and dental colleges. A non-probability convenience sampling technique was employed to assess sleep quality with the help of Pittsburgh Sleep Quality Index (PSQI). Factors associated with poor sleep were determined using binary logistic regression.Results: Among the total, 263 (68.3%) students had poor sleep quality on the PSQI scale. Poor sleep was more likely (OR [95%CI]) among females (2.3 [1.3-3.9]), age≥21years (2.5 [1.1-5.8]), pre-clinical phase (3.1 [1.4-6.5]), BDS students (2.0 [1.1-3.5]), disrupted circadian rhythm (4.2 [2.0-8.6]), and hostelites (1.7 [1.0-2.9]) at signifi cance of P&lt;0.05. Participants’ per day sleep was 5.9hrs (SD=1.2hrs). Regarding PSQI components, the worst performance was noticed in sleep duration (M=1.60, SD=0.95). Of the total, 47 (12.2%) were taking sleep medications, 377 (97.9%) had bedtime phone usage and 242 (62.8%) had no familiarity with “Sleep hygiene”.Conclusion: Findings revealed that poor sleep was prevalent in more than half of the participants. Average sleep duration was suggestive of sleep deprivation indicating for immediate interventions to prevent its potential consequences.

Association between sleep quality and quality of life in Singapore.

Several studies have examined the relationship between sleep quality and health-related quality of life (HRQOL). However, there are a lack of generalizable data on this association in Singapore. Our study aimed to (1) investigate the association between sleep quality and HRQOL and (2) examine whether age moderated these associations. Data were obtained from nationwide Singapore Mental Health Study 2016 (n = 6126, response rate = 69.5%). Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI) where higher scores indicate poorer sleep quality. HRQOL [Physical component summary (PCS) and Mental component summary (MCS)] were measured using 12-item Short-Form Survey. Associations were investigated using multivariable linear regression models, adjusted for sociodemographic, physical, and mental comorbidities. Interactions between age and sleep quality were examined by including interaction terms individually. Poorer PSQI score was significantly associated with lower PCS (β = -0.44) and lower MCS (β = -0.73). Among PSQI components, lower PCS was significantly associated with subjective sleep quality (β = -1.06), sleep duration (β = -0.30), sleep disturbance (β = -0.33), and daytime dysfunction (β = -0.75). Lower MCS was significantly associated with subjective sleep quality (β = -1.36), sleep latency (β = -0.24), sleep disturbance (β = -0.16), using of sleeping medication (β = -1.12), and daytime dysfunction (β = -2.08). Age moderated the association between PSQI score with PCS and MCS. Stronger association between PSQI score and MCS was observed in younger individuals (β = -0.90) than older adults (β = -0.45). Our study found that poor sleep quality was associated with HRQOL of certain age groups more than others. Future studies may identify potential mediators to help people with chronic sleep problems.

Association of Oxidative Stress and Proinflammation with Insomnia in Perimenopause.

Background: The levels of oxidative stress and proinflammatory factors in perimenopausal females increased, and they were also deeply troubled by insomnia. The occurrence of insomnia is related to the changes of oxidative stress and inflammation levels in the body. Perimenopausal insomnia may be related to mild systemic inflammation, and oxidative stress can promote chronic inflammation. However, the underlying mechanism behind the phenomenon is still unclear. Objective: The aim was to investigate whether the occurrence of perimenopausal insomnia disorder is related to higher levels of oxidative stress and inflammation in the body, and to explore the role of inducible nitric oxide synthase (iNOS) in perimenopausal insomnia. Methods: A total of 127 perimenopausal participants were recruited in this study. Participants with global scores of the Pittsburgh sleep quality index (PSQI) >7 were diagnosed with insomnia (n = 54). The patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7) were evaluated, and sociodemographic data were obtained. The serum concentrations of iNOS, interleukin 6 (IL6), and tumor necrosis factor α (TNFα) were measured using commercial assays. Results: In the insomnia group, IL6 levels were positively correlated with scores of component 5 and component 7 of PSQI, respectively. PHQ-9 and GAD-7 were positively correlated with the global score of PSQI component 7 and PSQI, respectively; PHQ-9 was positively correlated with the global score of PSQI component 1. Finally, PHQ-9, iNOS, and IL6 were found to be independent predictors of perimenopausal insomnia using logistic regression. Conclusions: Moderate oxidative stress caused by a certain concentration of iNOS plays a protective role in perimenopausal insomnia, while proinflammation and depression are potential risk factors.

Sleep quality, anxiety, depression, and quality of life in rheumatoid arthritis patients and impact of disease activity

BackgroundRheumatoid arthritis (RA) is an autoimmune lifelong disease. Systemic manifestations represent a significant aspect of the disease burden. This study aimed to assess sleep quality and psychosocial aspects among RA patients and the impact of disease duration and activity.ResultsThe mean age for included RA patients was 50.00 ± 9.37 years. The median disease duration was 9.50 (Interquartile range (IQR)=5–15) years and 90% of patients were females. Disease activity score 28 was 4.65 ± 1.66. Anxiety and depression were significantly higher among RA participants. Regarding sleep quality assessment, RA group had significantly higher levels of insomnia than the control group (Insomnia Severity Index median (IQR) was 4.5 (0–15) versus 1 (0–3); p value = 0.013) and daytime sleepiness (Epworth Sleepiness Scale median (IQR) was 4 (1–11.25) versus 1 (0–3); p value = 0.002). RA patients showed significantly higher values of Pittsburgh Sleep Quality Index components as well as the global score indicating poor sleep quality. The 36-item short-form health survey domains, representing physical and mental health, were significantly lower among RA cases versus control subjects. Higher disease activity was positively correlated with anxiety, depression, insomnia, sleep quality, sleep efficiency, and daytime dysfunction, while negatively correlated with all domains of the 36-item short-form health survey.ConclusionsRA patients have increased anxiety and depression levels in addition to poor sleep quality. High disease activity is linked to increased anxiety and depression levels, impaired quality of life, and poor sleep quality.

Bifidobacterium longum 1714 improves sleep quality and aspects of well-being in healthy adults: a randomized, double-blind, placebo-controlled clinical trial

Stress and sleep are linked with overall well-being. Bifidobacterium longum 1714 has been shown to influence stress responses and modulate neural responses during social stress, and influence sleep quality during examination stress in healthy adults. Here, we explored the ability of this strain to alter sleep quality in adults using subjective and objective measures. Eighty-nine adults (18–45y) with impaired sleep quality assessed with the Pittsburgh Sleep Quality Index (PSQI) and with a global score ≥ 5 were randomized to receive B. longum 1714 or placebo daily for eight weeks. Assessing the effect of the strain on PSQI global score was the primary objective. Secondary objectives assessed sleep quality and well-being subjectively and sleep parameters using actigraphy objectively. While PSQI global score improved in both groups, B. longum 1714 significantly improved the PSQI component of sleep quality (p < 0.05) and daytime dysfunction due to sleepiness (p < 0.05) after 4 weeks and social functioning (p < 0.05) and energy/vitality (p < 0.05) after 8 weeks, compared to placebo. No significant effect on actigraphy measures were observed. The 1714 strain had a mild effect on sleep, demonstrated by a faster improvement in sleep quality at week 4 compared to placebo, although overall improvements after 8 weeks were similar in both groups. B. longum 1714 improved social functioning and increased energy/vitality in line with previous work that showed the strain modulated neural activity which correlated with enhanced vitality/reduced mental fatigue (ClinicalTrials.gov: NCT04167475).

The Interplay of Anxiety, Depression, Sleep Quality, and Socioeconomic Factors in Somali Hemodialysis Patients.

This study aimed to assess anxiety, depression, and sleep quality in kidney failure patients receiving hemodialysis (HD) in Somalia and examine the relationship between anxiety, depression, and sleep quality. We conducted a study with 200 kidney failure patients on HD treatment for over 3 months. Participants completed sociodemographic questionnaires, the Patient Health Questionnaire-9 (PHQ-9), the Hospital Anxiety and Depression Scale (HADS), the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). Among the 200 participants (mean age = 52.3; SD = 14.13), 58.5% were men, 64% had CKD for 1-5 years, and 52.6% received HD for 1-5 years. Depressive symptoms were found in 61.5% (PHQ-9) and 37.5% (HADS depression subscale) of HD patients. Poor sleep quality (PSQI) was observed in 31.5% and significantly correlated with PHQ-9 (rs = 0.633), HADS anxiety (rs = 0.491), and HADS depression (rs = 0.529). The ISI score correlated significantly with PHQ-9 (rs = 0.611), HADS anxiety (rs = 0.494), and HADS depression (rs = 0.586). All PSQI components correlated with depression and anxiety, except sleep medication use. Hierarchical regression analysis revealed that HADS anxiety (β = 0.342) and HADS depression (β = 0.372) predicted ISI scores. HADS anxiety (β = 0.307) and HADS depression (β = 0.419) predicted PSQI scores. Higher anxiety and depression levels negatively correlated with various dimensions of sleep quality in kidney failure patients. Early identification and appropriate management of these psychological disturbances are crucial for enhancing patients' overall quality of life.

Structural validity of the Pittsburgh Sleep Quality Index among medical students in Iran

The Pittsburgh Sleep Quality Index (PSQI) is a self-reported questionnaire evaluating sleep quality based on seven domains of sleep disorders. However, the factor structure of PSQI needs to be well-established among medical students. This study was conducted to establish the factor structure of PSQI among medical students. Four-hundred and four medical students completed the PSQI. Considering each PSQI component as an "observed variable," exploratory factor analysis was conducted. Six models explaining the factor structure of PSQI were compared by confirmatory factor analysis to achieve the best model. All PSQI components were loaded on three factors. The first factor included sleep duration and habitual sleep efficiency, the second was subjective sleep quality and sleep latency, and the third was sleep disturbances, sleeping medications, and daytime dysfunction (root mean square error of approximation = < 0.01, goodness of fit index = 0.99). The differences in Bayesian information criteria and root mean square error of approximation between our best-fit model and each of the other resulted in rejection of all other Models. Besides confirming the structural validity among medical students, our findings indicated the adequacy of the 3-factor structure of PSQI, including sleep efficiency, perceived sleep quality, and daily disturbances in this population.

Relationship Between Sleep Duration and Academic Performance Among Saudi Medical Students at &amp;apos;&amp;apos;KSAU-HS&amp;apos;&amp;apos; and KSU Riyadh, Saudi Arabia

Objective: This study aimed to identify the sleep patterns and frequency of nighttime sleep among male and female medical students in KSAU-HS and KSU and to assess the association between sleep duration and academic performance (final GPA). Methods: A cross-sectional study was conducted using a self-administered questionnaire targeting medical students from KSAU-HS and KSU, Riyadh. The Pittsburgh sleep quality index (PSQI) survey was used to assess sleep deprivation. Results: A total of 243 participants were included in the study. Most participants 187 (77%) were males, 171 (70.4%) were from KSAU-HS, 95 (39.1%) were 6th year students. The most frequently reported grade was B (27.6%) participants. Almost 87 (35.8%) had a GPA of 4-4.5. In regards to the components of PSQI; the mean global PSQI score was found to be 9.30±3.64. The vast majority (95.1%) had poor sleep quality. Sleep efficiency was found to be less than 65% for the vast majority (98.4%) of the participants. Academic performance was found to be significantly associated with sleep duration. University and academic year were found to be significantly associated with sleep quality (p-value= 0.02 and 0.003 respectively). Participants from KSAU-HS University and 6th year students had better sleep quality. Conclusion: Poor PSQI scores and sleep quality among study participants were found. The sleep duration score was low as compared to that in parallel studies. Poor academic performance was significantly associated with poor sleep quality according to PSQI scores.

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.

Association of sleep quality and mitochondrial DNA copy number in healthy middle-aged adults

ObjectivesMitochondria contribute to various compromised health, yet the association between sleep and mitochondria remains unclear. This study investigated the association between sleep quality and mitochondrial function in healthy middle-aged adults in the Republic of Korea. MethodThis cross-sectional study recruited 238 middle-aged adults using convenience sampling. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Mitochondrial function, represented by mitochondrial DNA copy number (mtDNAcn), was measured using real-time quantitative polymerase chain reaction on peripheral blood leukocytes. Multivariate linear regression analyses were performed to determine the association between sleep quality and mtDNAcn. ResultsSleep quality was negatively associated with mtDNAcn (r = −.15, p = .025); the poor sleep quality group had a notably lower mtDNAcn compared to the good sleep quality group (t = 2.40, p = .017). Among the PSQI components, sleep latency was significantly associated with reduced mtDNAcn (r = −.18, p = .005). Univariate regression analysis revealed that mtDNAcn was significantly associated with education level (β = 0.15, p = .017), shift work (β = -0.17, p = .010), global PSQI score (β = -0.15, p = .025), and sleep latency (β = −0.18, p = .005). After adjusting for educational level and shift work in the final model, longer sleep latency was independently associated with reduced mtDNAcn (β = −.16, p = .011). ConclusionsPoor sleep quality is associated with reduced mtDNAcn, suggesting a potential biological mechanism whereby poor sleep quality, specifically long sleep latency, accelerates cellular aging and impairs health through mitochondrial dysfunction. These findings enhance our understanding of the health effects of sleep quality and highlight the importance of screening and intervention strategies for mitochondrial dysfunction.

Restless legs syndrome affects sleep in de novo Parkinson's disease patients.

Restless legs syndrome (RLS) is common in Parkinson's disease (PD) patients and can affect the motor symptoms and non-motor symptoms (NMSs) of PD patients. The aim of this study was to identify the clinical factors affected by RLS in patients with PD. We included 369 de novo PD patients. RLS was assessed via face-to-face interviews and the motor symptoms and NMSs of the patients were assessed using relevant scales. RLS frequency in the patients was 12.2% (45/369). PD patients with RLS (PD-RLS) exhibited a greater global Pittsburgh Sleep Quality Index (PSQI) score than those without RLS (PD-No RLS). PD-RLS exhibited significantly greater scores in the daytime dysfunction and sleep disturbances components of the PSQI than PD-No RLS. PD-RLS exhibited a significantly greater score in the cardiovascular, sleep/fatigue, and attention/memory subdomain of the Non-Motor Symptoms Scale than PD-No RLS. The International RLS Study Group rating scale score was significantly related to PSQI components scores in the sleep disturbances, sleep latency, habitual sleep efficiency, and subjective sleep quality. RLS frequency in de novo PD patients is higher than that in the general population, and the main NMS affected by RLS in these patients is sleep disturbances. Therefore, it is necessary to manage RLS in PD patients with sleep disturbances.

71 Sleep Quality and Measures of Attention and Learning in Middle-Aged Adults

Objective:Sleep has been shown to directly impact cognitive function throughout the lifespan; good quality sleep benefits and improves cognitive function, including processing speed and attention, while poor quality sleep can contribute to negative cognitive outcomes1. In particular, attention, learning, and memory have been demonstrated to be sensitive to sleeping changes, including fragmentation and restriction2. Subjective sleeping scales are utilized in both research and clinical practice, allowing sleep to be measured via self-report on various domains, including duration and factors that can contribute to sleep disruption and disturbances3. This study aims to examine the possible relation between subjective sleep quality and cognitive function among middle-aged adults to inform future research for early interventions of modifiable behaviors that can contribute to abnormal cognitive decline.Participants and Methods:Data for this analysis is part of the preliminary results of an ongoing pilot study. 29 middle-aged (40-65 years, inclusive), cognitively unimpaired individuals were recruited from the community. Subjective sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Attention and memory were measured using the California Verbal Learning Test, Third Edition (CVLT-III).Results:Multiple hierarchical regression analyses were conducted to evaluate if aspects of sleep quality were significantly correlated to complex attention and learning performance in this sample. First, correlation amylases showed significant relationships between PSQI Component 6 (Use of Sleeping Medication) and Trials 1 to 2 Learning Slope (R2 = -0.56, p =0.002) and CVLT-III Trials 1 through 5 Recall Discriminability (R2 = -0.42, p = 0.02), each with significant regression analyses outcomes (b =0.42, p = 0.04 and b = -0.46, p = 0.04, respectively). There were other variables that were found to be significantly correlated; however, after adjusting for relevant demographic variables (age, education, sex), the hierarchical regression analyses revealed no association between the aforementioned variables.Conclusions:While multiple aspects of sleep quality were expected to influence measures of attention and learning, only PSQI Component 6 was found to be statistically significantly associated with only two learning variables. Limitations of this study included a small sample size which was limited to cognitive and relatively physically healthy middle-aged adults. Further, sleep quality was measured with one subjective measure and no objective data was collected to support the hypotheses. Future analysis is needed to continue to explore the relation between subjective sleep quality and cognitive outcomes. As this is an ongoing study, we look forward to exploring this research question in more detail as the study progresses.

The impact of epilepsy and antiseizure medications on sleep: Findings from a large European survey in adults with epilepsy and matched controls

ObjectiveTo assess the impact of epilepsy and antiseizure medications (ASMs) on sleep quality in people with epilepsy (PWE). MethodsAn online survey was conducted in France, Germany, Italy, Spain and the UK among PWE taking >1 ASM and matched controls. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Associations between sleep quality (global PSQI) and overall quality of life (QoL; assessed using the 12-Item Short Form Survey [SF-12]) and sleep quality and depressive symptoms (assessed using the Neurological Disorders Depression Inventory for Epilepsy [NDDI-E]) were also evaluated. ResultsOverall, 500 PWE and 500 matched controls were included. PWE had significantly greater mean global PSQI scores than controls (9.32 vs 7.56; p < 0.0001), with 80% reporting a score >5 versus 66% of controls (p < 0.001). PWE experienced significantly more problems with most PSQI components than controls. Mean global PSQI scores in PWE receiving 2 versus ≥3 ASMs were 9.03 and 10.18, respectively (p < 0.004); global PSQI scores >5 were reported in 76% versus 90%, respectively (p = 0.001). Regimens containing lamotrigine or phenobarbital were associated with poorer sleep quality than those without these ASMs. In PWE, negative correlations were identified between global PSQI scores and both the SF-12 physical and mental components (Pearson’s correlation coefficient [PCC], −0.61 and −0.40, respectively); NDDI-E and global PSQI scores were positively correlated (PCC, 0.6). ConclusionsPWE experience significantly worse sleep quality than people without epilepsy, with some ASMs contributing to poorer sleep. QoL and physical and mental health were all affected by sleep quality in PWE.

Comparison of sleep quality between clear aligner and fixed appliance orthodontic therapies

Although available evidence suggests that orthodontic appliances can impact quality of life, there is limited information on the impact of orthodontic appliances on sleep quality. This study aimed to compare sleep quality between patients undergoing orthodontic treatments using conventional fixed appliances and clear aligners. Adult patients attending clinics in Saudi Arabia participated in this cross-sectional study. Sleep quality was assessed using the validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Statistical significance was determined using inferential analysis, with a P < 0.05 considered statistically significant. There were 69 patients included in the study. The average age of a patient (33.12 ± 8.1) who received the clear aligner was significantly higher than those who received the fixed appliance (27.7 ± 5.9) (P < 0.05). The variation in the average score of ESS because of the education level was found to be statistically significant (P < 0.05). No significant difference was observed between the mean average ESS and PSQI global scores across the two orthodontic treatment groups. The average sleep latency scores were significantly higher in females than males when analyzing the PSQI component score across sex (P < 0.05). In education, ESS, PSQI global, habitual sleep efficiency, the use of sleep medication, and daytime dysfunction had a positive, weak, but significant correlation. Overall, this study concluded that regardless of the orthodontic appliances used, there was no statistically significant difference in sleep quality during the treatment.

Comparing the Effects of Acupressure and Clonazepam Tablets on Sleep Quality of Hemodialysis Patients: A Randomized Controlled Trial.

Objective: The current study aimed to compare the impact of acupressure and clonazepam tablets on the quality of sleep in hemodialysis patients in light of the rising prevalence of chronic kidney disease (CKD), the high prevalence of sleep disturbance in these patients, and the side effects of hypnotic drugs. Method : A total of 60 patients were selected for this randomized, controlled clinical trial and randomly assigned to two groups. For two weeks during the researcher's evening shift, one group received acupressure (six spots bilaterally for three minutes each day). The opposing group was administered clonazepam tablets (0.5 mg) for two weeks. The Pittsburgh Sleep Quality Index (PSQI), which measures sleep quality, was used to compare sleep in the two groups before and after the intervention. Results: There was no statistically significant difference between the two groups prior to the intervention (P = 0.75) in terms of the mean pre-intervention PSQI scores for the acupressure and clonazepam groups, which were 15.83 ± 1.51 and 16.17 ± 0.91, respectively. However, the average PSQI scores after the intervention in the clonazepam and acupressure groups were 13.25 ± 2.88 and 8.97 ± 4.29, respectively, indicating a statistically significant difference (P < 0.0001). Both the acupressure and the clonazepam groups showed improvements in their post-intervention sleep quality among the patients. However, when the percentage changed in the mean scores of the total score and all of the PSQI components were calculated for each group, it became clear that acupressure was more effective at enhancing sleep than clonazepam tablets. Conclusion: The findings of the present investigation demonstrate that acupressure has a greater impact on patients' sleep quality compared to clonazepam tablets. Depending on the circumstances, acupressure can be used as a simple, safe, and non-drug way to enhance hemodialysis patients' quality of sleep.

Effects of sleep pattern, duration, and quality on premenstrual syndrome and primary dysmenorrhea in korean high school girls

BackgroundSleep deprivation is known to be a risk factor for premenstrual syndrome and primary dysmenorrhea in adults. However, it has rarely been investigated in adolescents. The aim of this study was to investigate whether sleep pattern, duration, and quality independently affect premenstrual syndrome and primary dysmenorrhea in adolescent girls. An additional purpose was to investigate the sleep status in Korean adolescent girls during the COVID-19 pandemic.MethodsA cross-sectional survey study was conducted in 519 high school girls aged 15 to 18 years in Gyeonggido, South Korea, in 2021 during the COVID-19 lockdown. Menstrual pain intensity and menstrual symptoms were assessed using the visual analogue scale (VAS) and Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed by the premenstrual symptoms screening tool (PSST). Sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). The known risk factors of dysmenorrhea, including menstrual and lifestyle characteristics and stress, were assessed as covariates.ResultsDuring the pandemic, approximately 68% of girls slept 7 h or less, while about 60% reported poor sleep quality. Additionally, 64% of participants had a bedtime later after 1AM, and 34% woke up later after 8AM. Late bedtime significantly affected VAS (P = 0.05), CMSS severity and frequency (both P < 0.01), and PSST symptom (P < 0.01). Waking up late affected CMSS severity (P < 0.05), PSST symptom (P = 0.05), and PSST function (P < 0.05). However, the significance of these effects disappeared after controlling for covariates. Sleeping less than 5 h affected CMSS frequency (P < 0.05) and PSST symptoms (P < 0.001). After controlling for covariates, the significance of the effect on PSST symptom remained (P < 0.05). General sleep quality and PSQI components, including subjective sleep quality, sleep latency, sleep disturbance, use of sleeping medication, and daytime dysfunction, significantly affected CMSS frequency and severity and PSST symptom after controlling for covariates (P < 0.05, P < 0.01, or P < 0.001). The multiple regression analysis revealed that among sleep characteristics, sleep quality was the most important risk factor of premenstrual syndrome and dysmenorrhea.ConclusionOur study result heightens the importance of healthy sleep hygiene, especially sleep quality in the management of premenstrual syndrome and dysmenorrhea in adolescent girls.

Washed microbiota transplantation targeting both gastrointestinal and extraintestinal symptoms in patients with irritable bowel syndrome

ObjectiveFecal microbiota transplantation (FMT) has been reported with the treatment potential for irritable bowel syndrome (IBS). However, the knowledge of its effect on extraintestinal symptoms of IBS is limited. This study aimed to evaluate the efficacy of the improved methodology of FMT, washed microbiota transplantation (WMT), on sleep disturbances, and psychological and gastrointestinal symptoms among patients with IBS. MethodsThis was a prospective observational study involving patients with IBS who underwent WMT. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The Gastrointestinal Symptom Rating Scale (GSRS) and IBS Severity Scoring System (IBS-SSS) were used to evaluate gastrointestinal symptoms and IBS severity, respectively. The Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) were used to evaluate depression and anxiety, respectively. All the symptoms were evaluated at baseline and one month after WMT. A multiple logistic regression model was used to determine the predictive factors of sleep improvement one month after WMT. ResultsSeventy-three patients with IBS were included in the study. Sleep quality (Z = −4.211, P < 0.001), anxiety (Z = −4.775, P < 0.001), depression (Z = −4.610, P < 0.001), gastrointestinal symptoms (Z = −5.364, P < 0.001), and IBS severity (Z = −6.468, P < 0.001) significantly improved one month after WMT in all patients. The scores of the five components of PSQI including subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, and sleep disturbances decreased in 52 patients with poor sleep quality (all P < 0.05). Baseline sleep duration scores were identified as an independent predictive factor of sleep improvement one month after WMT in patients with poor sleep quality (OR 2.180 [95% CI = 1.017–4.673]; P = 0.045). Patients that experienced sleep improvement demonstrated greater alleviation in depression (Z = −1.990, P = 0.047) and IBS severity (Z = −2.486, P = 0.013) compared with patients without sleep improvement. ConclusionThis study suggested that WMT might be a promising therapy for patients with IBS, especially those with comorbid sleep and psychological disorders.