Pittsburgh Sleep Quality Index Questionnaire Research Articles

24-hour urinary potassium excretion is negatively associated with self-reported sleep quality in the general population, independently of sleep-disordered breathing.

To investigate the association of 24-hour urinary potassium excretion with self-reported sleep quality in the general population. In this cross-sectional study, a population of patients aged 18 years or older was randomly selected from Xinjiang, China in 2019, 24-hour urine samples collected, and Pittsburgh Sleep Quality Index (PSQI) questionnaires assessed. Participants were divided into 2 groups (upper and lower median of 24-hour urinary potassium excretion). Poor sleep quality was defined as PSQI global score ≥ 6. Associations between 24-hour urinary potassium excretion and [24.8 mmol/L] sleep quality were assessed by multiple logistic regression analysis in total participants and those stratified by sex. In total, 24-hour urine samples were collected from 1,147 participants, of whom data for those with complete urine samples and PSQI data were analyzed (n = 727; mean age = 48.7 years; percentage of women = 62%). Compared with the upper median group for 24-hour urinary potassium excretion, the lower median group showed a significantly higher PSQI global score (6 vs 5, P = .011), and prevalence of poor sleep quality (51.7% vs 42.2%, P = .011). In a fully-adjusted model of multivariate logistic regression, the lower median group showed 1.50-fold increased odds for presence of poor sleep quality (95% confidence interval: 1.01-2.24, P = .045). Sex-specific analyses translated these results to women, but not to men. These results suggest that low potassium intake, indicated by lower potassium excretion, is associated with poor sleep quality in the general population, especially among women. Therefore, additional research is necessary to clarify the effect of increasing potassium intake to improve sleep quality. Li M, Heizhati M, Wang L, etal. 24-hour urinary potassium excretion is negatively associated with self-reported sleep quality in the general population, independently of sleep-disordered breathing. J Clin Sleep Med. 2022;18(11):2589-2596.

Physical activity and sleep behaviour in women carrying BRCA1/2 mutations

The aim of the present study is to explore the potential association between sleep quality and physical activity (PA) in women carriers of BRCA1/2 mutations. 63 women completed the Pittsburgh Sleep Quality Index (PSQI) and Godin Shepard Leisure-Time Physical Activity Questionnaire (GSL-TPAQ) and were included in the present cross-sectional analysis. Globally, women showed a PSQI score of 7.0 ± 3.6 and a GSL-TPAQ score of 22.8 ± 18.3. Good sleepers (PSQI score ≤ 5) showed significantly higher PA levels compared to bad sleepers (PSQI score > 5). Women in the higher tertile of GSL-TPAQ total score (≥ 27 METs/week) have a prevalence ratio (PR) of being a good sleeper of 2.85 (1.25–6.52, 95% confidence intervals) compared to women in the lower tertile (≤ 11 METs/week). These results were consistent in BRCA1 and BRCA2 women. Considering each single question of PA intensity, the PR of being a good sleeper by unit of increase of MET/week was higher and significant in women engaged in strenuous and moderate intensity PA. These results suggests a direct association between PA and sleep quality in women carriers of BRCA mutations.

A study on the effect of mobile phone use on sleep.

Several studies have been conducted globally to assess the impact of usage of mobile phones on quality and duration of sleep as also on day time sleepiness. The objective of the present study was to assess the effect of mobile phone usage on the quality and composition of sleep in a sample from Indian population. The study was conducted at two tertiary care hospitals in north India from July 2014 to September 2019. A total of 566 participants were recruited in this study from both the centres. Sleep quality was assessed with the help of the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Subsequently, actigraphy was done in 96 participants and polysomnography in 95 participants. Of the 566 participants, 128 (22.61%) had PSQI ≥5, reflecting poor sleep quality. A higher use of mobile phone was significantly associated with a poor sleep quality as a component of PSQI questionnaire (P=0.01) and higher overall PSQI score (P=0.01). The latency from sleep onset to N2 and N3 sleep stages was significantly shorter in participants having a higher mobile phone usage as compared to those with a lower usage [Median (range): 13.5 min (1.5-109) vs. 6.5 min (0-89); P=0.02] and [Median (range): 49 min (8.5-220.5) vs. 28.75 min (0-141); P=0.03], respectively. This study focused on the maladaptive changes brought on by mobile phone usage on sleep. More studies with larger sample sizes need to be done that may serve to confirm the hypothesis generating findings of our study.

Reduced serum vitamin D levels are associated with poor sleep quality in early stroke patients.

BackgroundPoor sleep quality and vitamin D deficiency are common in stroke patients. Our aim was to evaluate the possible association between vitamin D and sleep quality in acute ischemic stroke (AIS) patients.MethodsA total of 301 AIS patients were screened and completed 1-month follow-up. Serum 25-hydroxyvitamin D [25(OH)D] was used to assess the vitamin D status by a competitive protein-binding assay at baseline. All patients were divided into equal quartile according to the distribution of 25(OH)D. One month after stroke, sleep quality was evaluated by using Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaire; depression status was confirmed by 17-item Hamilton Depression Scale (HAMD).ResultsThere were 89 (29.6%) AIS patients with poor sleep quality 1-month post-event. Within 24 h after admission, serum 25(OH)D levels were significantly lower in patients with poor sleep quality after stroke (P < 0.001). In the results of multivariate-adjusted logistic regression analysis, the odds ratio (OR) of poor sleep quality was 6.199 (95% CI, 2.066–18.600) for the lowest quartile of 25(OH)D compared with the highest quartile. In patients without depression, reduced 25(OH)D were still significantly associated with poor sleep quality (OR = 8.174, 95% CI = 2.432–27.473). Furthermore, 25(OH)D and HAMD score were combined to enhance the diagnostic accuracy of poor sleep quality, with the area under the receiver operating characteristic curve of 0.775.ConclusionReduced serum levels of vitamin D at admission were independently and significantly associated with poor sleep quality at 1 month after stroke. Our findings suggested the combination of vitamin D and depression status could provide important predictive information for post-stroke sleep quality.

Is sleep quality a potential predictor of neurocognitive disorders? A 6-year follow-up study in Chinese older adults.

To investigate the longitudinal association of sleep quality with incidence of neurocognitive disorders in 6years. This was a 6-year follow-up study of community-living older adults who scored a Clinical Dementia Rating (CDR) of 0 at baseline. Sleep quality was assessed by the self-rated Pittsburgh Sleep Quality Index (PSQI) questionnaire, where higher scores indicated poorer sleep quality, and a cutoff score of 5 or above was suggestive of sleep disorder. The study outcome was incident neurocognitive disorders in 6years, as identified by a CDR of 0.5 or above. Poisson regression analysis was conducted to test if baseline sleep quality was independently associated with risk of incident neurocognitive disorders in 6years. Of the 290 participants in this study, 166 (57.2%) developed neurocognitive disorders in 6years. They had poorer sleep quality (mean [SD] total PSQI score: 6.2 [3.8] vs. 4.9 [3.2], p=0.001) and higher prevalence of sleep disorder (100 [60.2%] vs. 56 [45.2%], p=0.01) at baseline than those who remained free of neurocognitive disorder. After controlling for age, gender, education, and physical and psychiatric morbidities, the risk ratios (RRs) for incident neurocognitive disorders were 1.05 (95% confidence interval (CI)=1.00-1.11, p<0.05) for PSQI total score and 1.50 (95% CI=1.05-2.14, p=0.03) for sleep disorder at baseline. Sleep quality might predict the development of neurocognitive disorders. From a clinical perspective, enquiry of sleep quality and screening for sleep disorder should be promoted as part of the neurocognitive disorder risk assessment in older adults.

Burnout and sleep quality among community health workers during the pandemic in selected city of Andhra Pradesh

BackgroundThis pandemic has resulted in physical and emotional exhaustion among everyone, especially among community healthcare workers (CHWs), resulting in increased burnout and poor sleep quality. This pandemic has increased responsibilities for Accredited Social Health Activist (ASHA) workers and Auxiliary Nurse Midwife (ANM) at the grassroots. Previous studies have shown that infectious diseases like SARS and MERS directly affect sleep. With the COVID-19 pandemic, burnout and poor sleep among healthcare workers are expected to increase. AimTo determine the prevalence of burnout and sleep quality among community health workers Settingsand Design: This Cross-sectional study was conducted from February to April 2020 in Urban Primary Health care centres of Guntur city, Andhra Pradesh. Methods and materialCopenhagen Burnout Inventory scale (CBI) with a 5-point Likert scale and Pittsburgh Sleep Quality Index (PSQI) Questionnaire were used among four hundred and ten study participants. Descriptive statistics and the Chi-square test were used; a p-value of ≤0.05 is considered significant. ResultsThe prevalence of personal burnout was 16.8%, while work-related and pandemic-related burnouts were 10.5% and 25.4%, respectively. The prevalence of poor sleep quality was 35.09%. Fear of contracting the virus was present among 38.3%. Fear of infecting the family members because of their exposure was reported by 36.6% of the respondents; 71.7% and 79.3% reported receiving support from the organisation and colleagues, respectively. ConclusionsThe provision of necessary equipment, regular check-ups and timely interventions will minimise the risk of stress and burnout.

Relationship Between Sleep Quality and Falls Among Elderly People in Amirkola, Northern of Iran

Background: Aging is considered a biological, natural, and inevitable phenomenon that is associated with common problems of sleep quality and falls. The aim of this study was to evaluate the relationship between sleep quality and falls among the elders of Amirkola. Methods: In this case-control study, 250 elders, who were exposed to the falling, and 500 people without the previous falling were randomly selected during 2016-2017. The data were collected according to demographic and Pittsburgh Sleep Quality Index (PSQI) questionnaires. Results: There was a significant relationship between sleep quality and falling, while no significant relationship was found between demographic characteristics (e.g., gender, marital situation, age, educational level, occupation, and satisfaction of income) and falling. The mean of chronic diseases was 3.65±2.29 and 4.38±2.75 in control and case groups, respectively (P=0.0001). A significant difference was found between the two groups regarding the number of falls during the last 12 months (P=0.0001). There was a significant positive correlation between the score of poor sleep quality and the number of chronic diseases (P=0.001, r=0.352), the number of falls during the last 12 months (P=0.001, r=0.137), and the number of falling during the last 12 months with the number of chronic diseases (P=0.001, r=0.208). There was a significant negative correlation between poor quality sleep with the score of physical activity (P=0.001, r=-0.166) and the number of chronic diseases with the physical activity score (P=0.001, r=-0.259). After adjusting the other variables, the number of chronic diseases (P=0.002, OR=1.114) and history of smoking (P=0.018, OR=1.678) were the most effective factors of falling. Finally, a direct positive correlation was observed between the total scores of sleep quality and falling in terms of gender in the older woman of Amirkola (P=0.001, OR=2.080). Conclusion: Awareness of the factors of falls can help develop prevention strategies and appropriate health services.

HUBUNGAN KUALITAS TIDUR DENGAN MEMORI JANGKA PENDEK SANTRI MA YAJRI DI PONDOK PESANTREN SIROJUL MUKHLASIN 2 PAYAMAN

Background: The students was categorized as the group of teenagers who most often experienced sleep disturbances. Poor sleep period will cause disruption of brain functions such as memory disorders. Of the several types of memory that are most affected short-term memory, previous studies on short-term memory and sleep quality have yielded mixed and mixed results. Purpose: Knowing the relationship between sleep quality and short-term memory students. Method: This research is quantitative with an analytical observational design using a cros sectional study approach. Data collection uses a simple random sampling the sample is 67 respondent and technique sleep quality was measured by the PSQI (Pittsburgh Sleep Quality Index) questionnaire and working memory was measured by the Span Digit Test. Result: Respondents with good sleep quality were 21 people (31.3%) while 46 people (68.7%) had poor sleep quality. There are 33 people with low memory (49.3%) and 34 people with high memory (50.7%). Conclusion: There is a significant relationship between sleep quality and short-term memory students, with a significance value of chi square test p= 0.001 (p &lt;0.05).&#x0D; Keywords: Students, sleep quality, short-term memory.

Environmental exposure to per- and polyfluoroalkyl substances and sleep disturbance in pregnant women: A prospective cohort study

Previous studies on the association between exposure to per- and polyfluoroalkyl substances (PFAS) and sleep patterns in pregnant women are limited. This cohort study aims to assess the associations between PFAS and sleep quality in pregnant women. Of the 4127 women who participated in the Shanghai Birth Cohort, 3174, 3070, and 2887 women in their first, second, and third trimesters of gestation, respectively, were included in our analysis. Sleep measures were taken using the Pittsburgh Sleep Quality Index questionnaire. Ten PFAS were measured in blood samples collected in early pregnancy. We first evaluate the associations between individual PFAS and sleep quality in the three trimesters. Weighted quantile sum (WQS) regression models were performed to test the overall effect of the PFAS mixture on sleep quality during the three trimesters. Longitudinal analyses throughout pregnancy were performed with generalized estimating equation models. Furthermore, the effect of the PFAS mixture on longitudinal sleep patterns was examined using longitudinal latent class analyses combined with WQS models. The single pollutant analysis suggested that most PFAS were associated with increased sleep disturbance risk, lower sleep efficiency, and shorter sleep duration in the three trimesters. Similarly, the WQS models revealed a significant association between the PFAS mixtures and elevated sleep disturbance risk in pregnant women, with perfluorobutane sulfonate acting as the predominant risk factor. Additionally, the longitudinal analysis confirmed the effects of PFAS exposure on increased sleep disturbance over time. The PFAS mixture was positively associated with higher risks of poor sleep quality and sleep medicine use [adjusted odds ratio (aOR) = 1.10; 95 % confidence interval (95%CI): 1.01, 1.20; and aOR = 1.25 (95%CI: 1.04, 1.50) respectively] throughout the three trimesters. Our study suggests that PFAS may increase the risk of sleep disturbance in pregnant women. Further studies are needed to confirm our results and elucidate potential mechanisms.

Racial/ethnic disparities in subjective sleep duration, sleep quality, and sleep disturbances during pregnancy: an ECHO study.

In the United States, racial/ethnic minoritized groups experience worse sleep than non-Hispanic Whites (nHW), but less is known about pregnant people. This is a key consideration since poor sleep during pregnancy is common and associated with increased risk of adverse perinatal outcomes. This study reports the prevalence of subjective sleep measures in a multi-racial/ethnic pregnant population from the Environmental influences on Child Health Outcomes (ECHO) program. Participants' self-reported race and ethnicity were grouped into: nHW, non-Hispanic Black/African American (nHB/AA), Hispanic, non-Hispanic Asian (nHA). Analyses examined trimester-specific (first (T1), second (T2), third (T3)) nocturnal sleep duration, quality, and disturbances (Pittsburgh Sleep Quality Index and ECHO maternal sleep health questionnaire). Linear or multinomial regressions estimated the associations between race/ethnicity and each sleep domain by trimester, controlling for body mass index and age, with nHW as reference group. We repeated analyses within maternal education strata. nHB/AA participants reported shorter sleep duration (T2: β = -0.55 [-0.80,-0.31]; T3: β = -0.65 [-0.99,-0.31]) and more sleep disturbances (T2: β = 1.92 [1.09,2.75]; T3: β = 1.41 [0.09,2.74]). Hispanic participants reported longer sleep duration (T1: β = 0.22 [0.00004,0.44]; T2: β = 0.61 [0.47,0.76]; T3: β = 0.46 [0.22,0.70]), better sleep quality (Reference group: Very good. Fairly good T1: OR = 0.48 [0.32,0.73], T2: OR = 0.36 [0.26,0.48], T3: OR = 0.31 [0.18,0.52]. Fairly bad T1: OR = 0.27 [0.16,0.44], T2: OR = 0.46 [0.31, 0.67], T3: OR = 0.31 [0.17,0.55]), and fewer sleep disturbances (T2: β = -0.5 [-1.0,-0.12]; T3: β = -1.21 [-2.07,-0.35]). Differences persisted within the high-SES subsample. Given the stark racial/ethnic disparities in perinatal outcomes and their associations with sleep health, further research is warranted to investigate the determinants of these disparities.

Short sleep duration and risk of gestational diabetes

Objective Sleep disturbances and short sleep duration are common in pregnancy and might contribute to the development of hyperglycemia. Therefore, we evaluated the association of sleep disturbances and gestational diabetes (GDM) in a cohort of women. Methods We collected data of 386 women consecutively screened for GDM in 2019 by 75 gr OGTT, according with IDPSG criteria. Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess self-reported poor sleep quality (PSQI score >5) and short nocturnal sleep duration (<6 h). Results Of 386 women, 148 (38.3%) had poor sleep quality and 87 (22.5%) short sleep duration. GDM prevalence was 26.9%. There was no difference in GDM prevalence between women with poor or good sleep quality (26% vs. 28%; n.s.), while GDM was more frequent in women with short sleep duration (35.6% vs. 24.4%; p = 0.038). On univariate logistic regression analysis, short sleep duration (OR 1.71; 95%CI: 1.03-2.86; p = 0.039), previous GDM (OR 3.52; 95%CI: 1.83-6.76; p < 0.0001), family history of diabetes (OR 1.96; 95%CI: 1.21-3.91; p = 0.007), pre-pregnancy overweight (OR 1.85; 95%CI: 1.06-3.23; p = 0.031) or obesity (OR 2.56; 95%CI: 1.40-4.70; p = 0.002) were associated to GDM. However, after adjustment for confounders, short sleep duration did not persist as an independent risk factor for GDM (OR: 1.55; 95%CI: 0.91-2.65; ns). Conclusions Sleep disturbances are relative common among pregnant women. Although GDM seems more common among women with short sleep duration, this sleep disturbance does not seem to be an independent risk factor for GDM in women at high risk.

Epidemiology of Sleep Disorders Among Adolescents in Kerman, Iran, in 2019

ABSTRACT It is an important fact that the onset of adolescence is a time of both physiological and social changes that affect sleep. In this study, the prevalence of sleep disorders in adolescents and the association between them were investigated. Anthropometric dimensions (such as height and weight) of individuals in Kerman in 2019 were also assessed. A total of 451 adolescents (mean age: 14.72 years; 51.88% females) of Kerman, Iran, took part in this cross-sectional study. Participants completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and then demographic (age, gender) and anthropometric data (weight and height) were collected. The prevalence of sleep disorders in this population was 31.9%. Among those with self-rated sleep disorders, 53.5% were males. Participants with sleep disorders were younger and showed lower anthropometric values such as height, weight, and body mass index. However, there was no difference between sleep disorders and gender (P-value > .05). This study revealed a relatively high prevalence of sleep disorders among adolescents. This research was done with the aim of encouraging the healthcare organization to design educational programs to evaluate and reduce sleep disorders.

Using a Wearable Device and Patient Reported Outcome to Evaluate the Influence of Sleep on Quality of Life Among Breast and Prostate Cancer Patients.

Few studies have used the combination of subjective and objective measures to investigate sleep problems as a primary outcome of concern in cancer patients. This study highlights the influence of sleep quality and duration on quality of life among breast and prostate cancer patients. Thirty-one participants were included in this study. Sleep quality and duration was assessed using a wearable actigraphy device and Pittsburgh Sleep Quality Index questionnaire. Quality of life was measured by European-Organization-For-Research-And-Treatment-Of-Cancer Quality of Life Questionnaire. t-test statistics further investigates the influence of sleep quality and duration with quality of life in participants. Results implied that those breast cancer patients who were poor sleepers and short sleepers showed greater deficits in areas of quality of life. In contrast, those prostate cancer patients who were long sleepers and good sleepers displayed poorer quality of life using actigraphy.

COVID-19 related sleep disorders and the mental health

IntroductionCOVID-19 affects nervous system and the mental health of patients.ObjectivesThe aim of the study was to determine the prevalence of depression, anxiety, and insomnia among patients hospitalized with COVID-19 in order to understand mediating factors and inform tailored intervention.MethodsTo the study patients with mild and moderate COVID -19 were included. It was no included patients with diagnosed psychiatric disorders. It was conducted an interview, including using telemedicine technologies, assessed HADS, MFI-20, Pittsburgh Sleep Quality Index (PSQI) questionnaire.ResultsIt was analyzed the data of 119 patients, 34% patients was female, mean age 58,7±11,1 range 47 to 69 years. Anxiety-depressive symptoms were observed in 33/119 (28%) patients by HADS scale. Clinically significant anxiety and depression were seen in 11% and 4% of the patients, respectively. In 13% patients was observed as anxiety as depression. An increase in the MFI-20 scale (more than 20 points) was found in 87 (73.0%) patients, sleep disorders in accordance with the PSQI questionnaire was recorded in 32 (27.0%) patients. Sleep disorders were manifested by dissatisfaction with sleep quantity or quality that is associated with difficulty falling asleep. All patients have asthenic symptom.ConclusionsIt was noted that in most patients with COVID-19, along with a depressive and anxiety disorders, an asthenic symptom complex, sleep disturbances are recorded. The choice of the medical intervention should be based on the severity of the violations identified taking into account the side effects of the prescribed drugs, drug interactions and somatic status of patientsDisclosureNo significant relationships.

Comparison of the Effect of Reflexology and Swedish Massage on Restless Legs Syndrome and Sleep Quality in Patients Undergoing Hemodialysis: a Randomized Clinical Trial.

BackgroundPatients undergoing hemodialysis experience painful complications such as restless leg syndrome and poor sleep quality, which negatively affect their quality of life.PurposeThis study aimed to compare the effect of reflexology and Swedish massage on restless leg syndrome and sleep quality in patients undergoing hemodialysis.MethodThis is a randomized clinical trial conducted on 90 patients undergoing hemodialysis. The two intervention groups received either foot reflexology (n = 30) or Swedish massage (n = 30) for four weeks. In the sham group (n = 30), a simple touch of the knee down was performed with the same conditions as the intervention groups. Each sample completed the International Restless Leg Syndrome and Pittsburgh Sleep Quality Index Questionnaires before, immediately after, and one month after the intervention.ResultThe results showed that immediately after the intervention, restless leg syndrome and sleep quality were significantly better in the foot reflexology massage group than the Swedish massage and sham groups (PRLS < 0.001, PPSQI < 0.001); also, changes in restless leg syndrome and sleep quality, respectively, before and one-month follow-up after the intervention were not significant in all three groups (PRLS = 0.47, PPSQI = 0.95), (PRLS = 0.91, PPSQI = 0.87).ConclusionReflexology and Swedish massage, as complementary methods, can improve the restless leg syndrome and sleep quality of patients undergoing hemodialysis. However, foot reflexology massage had been more effective.

Maternal Circadian Rhythm and Its Association With Meal Timing and Density: A Prospective Cohort Study

ObjectivesThis prospective cohort study aimed to examine the association between chronotype with nutritional and psychosocial factors in pregnant women. MethodsChronotype of the subjects was determined using Morningness-Eveningness Questionnaire (MEQ), whereby higher scores indicate greater morningness. Sleep quality and psychological distress were assessed using the Pittsburgh Sleep Quality Index questionnaire (PSQI) and Depression, Anxiety and Stress Scale (DASS-21) respectively. Pedometer was used to measure 5-day physical activity. Pre-pregnancy weight and height were self-reported. ResultsTo date, 100 pregnant women were approached at selected government maternal and child clinics in Kuala Lumpur, Malaysia. Subjects were mostly Malay (67%). Mean age was 28 (4.3) years; 12% were underweight and 19% were overweight/obese before pregnancy. Stress, anxiety, and depression of moderate severity or above were found in 13%, 49%, and 12% of the subjects, respectively. The prevalence of poor sleepers was 70%. Sedentary behaviour was observed in 73% of the subjects (4086 ± 2247 steps/day). In the linear regression model, chronotype was a significant predictor of stress (2 = –0.421, p = 0.015) and depression (β = –0.208, p = 0.042) during pregnancy. ConclusionsPreliminary findings from this study suggested that chronobiological approaches may be important to tackle psychological distress during pregnancy, which may impact birth outcomes and subsequently, infant growth. The circadian rhythm of subjects will be determined based on salivary hormone in the upcoming analysis. Funding SourcesMinistry of Higher Education, Malaysia. The funds were provided through the Fundamental Research Grant Scheme (FRGS/1/2018/SKK06/UCSI/02/2).

A clinical trial to compare the effects of aerobic training and resistance training on sleep quality and quality of life in older adults with sleep disturbance.

ObjectivesTo compare the effects of aerobic and resistance training on sleep quality and Quality of Life (QoL) in older adults with sleep disturbance.Material and MethodsAn experimental study was conducted on 36 subjects with sleep disturbance of age ≥60 years. The subjects were assessed for sleep quality and quality of life by using Pittsburgh sleep quality index (PSQI) and WHOQOL-BREF questionnaires. Those who scored PSQI>5 were included in the study and were divided into two groups A and B. Both the groups A and B received warm up and cool down with, aerobic training for group A and resistance training for group B, respectively. The training was given for 40-45 minutes a day, 4 days/week for 4 weeks. Base line and post treatment PSQI and WHOQOL-BREF scores were recorded.ResultsRepeated measure ANOVA with Post hoc analysis was done using SPSS software version 16.0. Analysis revealed significant improvement (p<0.05) in PSQI scores within both groups but not between the groups. Post hoc analysis for sleep efficiency, sleep onset latency and sleep duration showed better improvement in resistance training group. Further QoL showed no significant difference between groups for all domains except for domain 3, i.e., social relationship which was found to be better in aerobic training group.ConclusionResistance and aerobic training improves both quality of sleep and quality of life. But resistance training has better effect on sleep efficiency, sleep onset latency and sleep duration. As both the training has beneficial effects on sleep quality and quality of life. So, either form of training can be used according to the individuals’ functional and medical status to improve sleep quality.

Sleep Disturbances Before Pregnancy and Subsequent Risk of Gestational Diabetes Mellitus.

PurposeTo investigate the relationship between sleep disturbances before pregnancy and the subsequent risk for gestational diabetes mellitus (GDM).Patients and MethodsPregnant women who attended antenatal clinic before the 12th gestational week between September 2019 and June 2020 were enrolled. The sleep status at the month before the last menstrual period was collected by filling the Pittsburgh Sleep Quality Index (PSQI) and Berlin Questionnaire (BQ) to evaluate the sleep duration, quality and the risk of obstructive sleep apnea (OSA). With monthly antenatal care, the oral glucose tolerance test (OGTT) was performed during 24–28 gestational weeks. According to the results, GDM and non-GDM group were classified. The sleep status and baseline characters were compared between the two groups.ResultsA total of 355 pregnant women were enrolled in this study, and 63 of them (17.7%) were diagnosed with GDM. Univariate analysis showed that maternal age, body mass index (BMI), family history of diabetes, PSQI score and positive BQ were associated with GDM (p < 0.05). Maternal age (aOR 1.10, 95% CI, 1.01–1.17), BMI before pregnancy (aOR 1.12, 95% CI, 1.02–1.23), family history of diabetes (aOR 2.35, 95% CI, 1.33–4.17), positive BQ (aOR 4.03, 95% CI, 1.04–15.63) were independent risk factors for GDM in multivariate analysis. The decision tree indicated that among the pregnant women with BMI >20.6 kg/m2 and age >28.5, the risk for GDM with positive BQ increased from 27.5% to 66.7%.ConclusionThe high risk of OSA before pregnancy may increase the risk for GDM during pregnancy.

Stress, Sleep Quality, and Academic Performance among Dental Students in Shiraz, Iran.

Background Quality of sleep and stress level can affect the health, capacity of learning, and academic performance of the students. This study aimed to investigate the association between stress and sleep quality with academic performance among undergraduate clinical dental students in Shiraz, Iran. Methods This cross-sectional study was conducted during the second semester of the academic year 2020–2021 among clinical dental students at Shiraz Dental School, Iran. A total of 138 students completed Pittsburgh Sleep Quality Index (PSQI) and dental environment stress (DES) questionnaire. The grade point averages (GPAs) of the previous terms of the participants were also collected. Data analysis was performed using Kolmogorov–Smirnov test, the one-way ANOVA, post hoc Duncan's test, nonparametric Kruskal–Wallis H test, Wilcoxon–Mann–Whitney test, and the chi-squared test. The p values of less than 0.05 were considered statistically significant. Results Clinical dental students participated in this study experienced moderate levels of stress and poor sleep quality. Mean total DES and PSGI scores did not differ by sex, year of study, marital status, and place of residence (p values >0.05). Most of the students (52.9%) had moderate GPAs. A significant relationship was observed between sex and GPA as well as between place of residence and GPA (p values <0.05). No significant differences were found between DES total score or PSQI score and GPA categories (p values >0.05). A significant direct relationship between DES total score and PSQI score was observed (p < 0.05). Conclusion Dental undergraduates in Shiraz, Iran, experienced moderate levels of stress and poor sleep quality. The results showed no significant difference between sleep quality or DES and academic achievement. However, a significant direct correlation was observed between sleep quality and dental environment stress.

Sleep Quality and Related Clinical Manifestations in Huntington Disease.

(1) Background: Sleep patterns are frequently disrupted in neurodegenerative disorders such as Huntington disease (HD); however, they are still poorly understood, especially their association with clinic features. Our study aimed to explore potential correlations between sleep features and motor, cognitive, behavioural and functional changes in manifest HD subjects. (2) Methods: We enrolled 42 patients who were assessed by the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires; clinical features were evaluated by the validated ENROLL-HD platform assay, including the Unified Huntington’s Disease Rating Scale (UHDRS) and the Problem Behaviours Assessment Short Form (PBA-s). (3) Results: We found a significant association between the patients’ perception of sleep abnormalities and scores of impaired independence, cognitive and motor performances. Specifically, sleep efficiency (PSQI—C4 subscores) and the use of sleep medications (PSQI—C6 subscores) seem to be more frequently associated with the severity of the disease progression. (4) Conclusion: sleep abnormalities represent an important part of the HD clinical profile and can impair patients’ quality of life by affecting their level of independence, cognition performance and mental well-being.