Pittsburgh Sleep Quality Index Scores Of Patients Research Articles

Cardiopulmonary Coupling Spectrogram as an Ambulatory Method for Assessing Sleep Disorders in Patients With Autoimmune Encephalitis.

Sleep disorders are a common and important clinical feature in patients with autoimmune encephalitis (AE); however, they are poorly understood. We aimed to evaluate whether cardiopulmonary coupling (CPC), an electrocardiogram-based portable sleep monitoring technology, can be used to assess sleep disorders in patients with AE. Patients fulfilling the diagnostic criteria of AE were age- and sex-matched with recruited healthy control subjects. All patients and subjects received CPC testing between August 2020 and December 2022. Demographic data, clinical information, and Pittsburgh Sleep Quality Index (PSQI) scores were collected from the medical records. Data analysis was performed using R language programming software. There were 60 patients with AE (age 26.0 [19.8-37.5] years, male 55%) and 66 healthy control subjects (age 30.0 [25.8-32.0] years, male 53%) included in this study. Compared with healthy subjects, patients with AE had higher PSQI scores (7.00 [6.00-8.00] vs 3.00 [2.00-4.00], p < 0.001), lower sleep efficiency (SE 80% [71%-87%] vs 92% [84%-95%], p < 0.001), lower percentage of high-frequency coupling (25% [14%-43%] vs 45% [38%-53%], p < 0.001), higher percentage of REM sleep (19% ± 9% vs 15% ± 7%, p < 0.001), higher percentage of wakefulness (W% 16% [11%-25%] vs 8% [5%-16%], p = 0.074), higher low-frequency to high-frequency ratio (LF/HF 1.29 [0.82-2.40] vs 0.91 [0.67-1.29], p = 0.001), and a higher CPC-derived respiratory disturbance index (9.78 [0.50-22.2] vs 2.95 [0.40-6.53], p < 0.001). Follow-up evaluation of 14 patients showed a decrease in the PSQI score (8.00 [6.00-9.00] vs 6.00 [5.00-7.00], p = 0.008), an increased SE (79% [69%-86%] vs 89% [76%-91%], p = 0.030), and a decreased W% (20% [11%-30%] vs 11% [8%-24], p = 0.035). Multiple linear regression indicated that SE (-7.49 [-9.77 to -5.21], p < 0.001) and LF/HF ratio (0.37 [0.13-0.6], p = 0.004) were independent factors affecting PSQI scores in patients with AE. Sleep disorders with autonomic dysfunction are common in patients with AE. Improvements in the PSQI score and SE precede the restoration of sleep microstructural disruption in the remission stage. CPC parameters may be useful in predicting sleep disorders in patients with AE.

Genetic polymorphism in HTR2A rs6313 is associated with internet addiction disorder.

Internet addiction disorder (IAD) has grown into public health concern of global proportions. Previous studies have indicated that individuals with IAD may exhibit altered levels of serotonin and dopamine, which are known to play crucial roles in depression, anxiety, impulsivity, and addiction. Therefore, polymorphisms in the receptors that mediate the effects of serotonin and dopamine and affect their functional states as well as their activities are suspect. In this study, we aimed to investigate the association between IAD and rs6313 (T102C) polymorphism in the serotonin 2A receptor (5-HT2A) gene, (HTR2A). Twenty patients with IAD and twenty healthy controls (HCs) were included in this study. Young's Internet Addiction Test (IAT), Self-Rating Anxiety Scale, Self-Rating Depression Scale, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Barratt Impulse Scale, Pittsburgh Sleep Quality Index (PSQI), and Social Support Rating Scale (SSRS) were used to assess the severity of internet addiction, mental status, impulsive traits, sleep quality, and social support. Genotyping was performed to identify rs6313 polymorphisms in the HTR2A gene of all participants. The frequencies of the C and T alleles of HTR2A T102C were 28% and 72% in the IAD group and 53% and 47% in the HCs group, respectively, indicating that the differences between these two groups were significant. No significant difference was observed in the distribution of the CC, CT, and TT genotypes of HTR2A gene T102C between the IAD and the HCs groups. Additionally, there was no difference in the distribution of the frequencies of the HTR2A gene T102C CC and CT+TT genotypes between the two groups. However, the distribution between the TT and CC+CT genotypes showed an apparent statistical difference in the HTR2A gene T102C between the two groups. Correlation analysis indicated that the IAT score was positively correlated with the Y-BOCS and BIS scores for the CC+CT genotype in patients with IAD. Moreover, the IAT score was positively correlated with the PSQI score in patients with IAD carrying the TT genotype. The present study demonstrates that rs6313 in HTR2A is associated with IAD, and that the T allele of rs6313 in HTR2A may be a risk factor for IAD.

Effects of preoperative quetiapine on postoperative delirium and sleep quality in elderly orthopaedic patients

Objective: To investigate the effects of preoperative quetiapine on postoperative delirium (POD) and sleep quality in elderly orthopedic patients. Methods: Prospectively, 111 elderly patients, American Society of Anesthesiologists (ASA) grade Ⅱ-Ⅲ, scheduled to undergo knee or hip surgery in the Affiliated Huangyan Hospital of Wenzhou Medical University under continuous spinal anesthesia from August 2021 to March 2023, were selected and randomly divided into two groups by random number table: control group (group C, 1 h preoperative placebo) and quetiapine group (group Q, 1 h preoperative quetiapine 12.5 mg). In group C, 54 cases were enrolled, including 25 males and 29 females, with an average age of (73.5±4.9) years. In group Q, 57 cases were enrolled, including 26 males and 31 females, with an average age of (74.8±5.0) years. The primary outcome measures were the incidence of POD evaluated by using confusion assessment method (CAM) at 24, 48, and 72 hours after surgery, and the secondary outcome measures included Pittsburgh sleep quality index (PSQI) scores at 24 and 48 hours after surgery and satisfaction of pain management within 24 hours after surgery. Results: The incidence of POD at 24, 48, and 72 h after surgery in group Q was 5.4% (3/57), 12.5% (7/57), 14.3% (8/57), respectively, while that in group C was 18.2% (10/54), 21.8% (12/54), 21.8% (12/54), respectively. The incidence of POD at 24 h after surgery in group Q was lower than that in group C (P=0.036). There was no significant difference in the incidence of POD at 48 and 72 h after surgery between two groups (all P>0.05). The PSQI score of patients in group Q at 24 and 48 h after surgery were (3.8±1.2) and (6.9±1.1) scores, respectively, which in group C were (10.5±2.8) and (7.3±1.3) scores, respectively. Compared with group C, the PSQI score of patients in group Q at 24 h after surgery was significantly higher (P<0.001), but there was no significant difference at 48 h after surgery (P=0.068). The satisfaction scores of pain management at 24 h after surgery in group Q was (91±7) scores, which was higher than that in group C of (81±6) scores (P<0.001). Conclusion: Oral intake of low-dose quetiapine 1 h preoperatively can reduce the incidence of POD, improve postoperative sleep quality and enhance postoperative satisfaction of pain management at 24 hours after surgery in elderly orthopedic patients undergoing knee or hip surgery.

Effect of White Noise Intervention Combined with Multi-dimensional Nursing Mode on Sleep Quality and Incidence of Nosocomial Infection in Patients Undergoing Hip Replacement.

To investigate the clinical effects of white noise intervention combined with multi-dimensional nursing mode in patients receiving hip replacement (HR). The study selected the clinical data of 161 patients who underwent HR in our hospital from February 2020 to February 2022 for retrospective analysis. According to patients' willingness, they were divided into the study group (n = 77, receiving white noise intervention combined with multi-dimensional nursing mode) and the control group (n = 84, receiving routine nursing). Pittsburgh sleep quality index (PSQI) scale was used to evaluate patients' sleep quality in the two groups, and the incidence of nosocomial infection in the both groups was counted. Before nursing and white noise intervention, the PSQI scores of patients' sleep quality in the two groups were all lower, with no obvious difference (P > 0.05). After nursing and white noise intervention, the sleep quality of the two groups was all improved, and the study group had overtly lower PSQI score and score of psychological status than the control group (P < 0.05). After nursing and white noise intervention, the study group had remarkably lower incidence of nosocomial infection than the control group (p < 0.05). White noise intervention combined with multi-dimensional nursing mode can effectively improve the sleep quality of patients undergoing HR and reduce the incidence of nosocomial infection, which is of positive significance for promoting the recovery of postoperative limb function.

The pittsburg sleep quality index in asthmatic patients: A case-control study

Introduction: Sleep disturbances are common in asthmatic patients. The purpose of this study was to evaluate sleep quality in asthmatic patients in local setting. Materials and methods: In the present case-conrol study, sleep quality of asthma patients was assessed using Pittsburgh Sleep Quality Index (PSQI), in 76 clinically stable asthmatic patients at the outpatient clinic compared to 76 healthy subjects in control group. Poor sleep quality is classified as PSQI score more than 5. Results: Mean PSQI score in patients was significanly higher than the control group. The number and percent of cases with poor sleep quality and all subdomains of PSQI score were statistically more than control group. Conclusion: According to the results of the present study, sleep quality of the majority of asthma patients was not desirable. It is necessary for policy makers and health managers as well as physicians to focus on this aspect of the patients’ health as well. It is recommended to have sleep health consultation in pulmonary clinic.

Female Gender Was Associated With Increased Odds of Sleep Disturbance in Adult Chinese With Moderate-to-Severe Psoriasis: A Cross-Sectional Study

Objective: Up to 85.3% of patients with psoriasis experience sleep disturbance (SD). However, SD has not been characterized in Chinese patients with psoriasis, and the factors that affect SD among adult patients with psoriasis remain unclear. This study was performed to examine the risk of SD in patients with psoriasis compared with a control group of healthy individuals and to identify factors contributing to SD in patients with psoriasis. Methods: This was a cross-sectional, questionnaire-based, case-control study involving 142 adult participants with psoriasis and 142 healthy controls. The Pittsburgh Sleep Quality Index (PSQI) was administered to assess SD. Mild psoriasis was defined by Psoriasis Area and Severity Index and body surface area cut-offs of &lt;10, and mild to severe psoriasis was determined by Psoriasis Area and Severity Index and body surface area cut-offs of ≥10. Logistic regression was performed to investigate the associations. Results: The prevalence of SD (PSQI score of ≥6) was 47.9% in adult patients with psoriasis. The mean PSQI score in patients with psoriasis was 6.1 ± 3.7, which was higher than that in the control group (4.9 ± 2.5, P &lt; 0.001). The risk of SD in the psoriasis group was 1.669 times higher (95% confidence interval, 1.008–2.761; P = 0.046) than that in the healthy group. Female sex (adjusted odds ratio, 4.130; 95% confidence interval, 1.306–13.058; P = 0.016) was significantly associated with an increased risk of SD in patients with moderate to severe psoriasis, whereas there were no significant factors affecting the risk of SD in patients with mild psoriasis. Conclusion: Patients with psoriasis were more likely than healthy controls to develop SD. In patients with moderate to severe psoriasis, but not in those with mild psoriasis, female sex was associated with a higher likelihood of SD.

Efficacy analysis of lidocaine plaster combined with gabapentin in the treatment of herpes zoster neuralgia

Objective: To evaluate the efficacy and safety of lidocaine plaster combined with gabapentin in the treatment of herpes zoster neuralgia (HZN). Methods: A total of 93 patients diagnosed with HZN from June 4, 2021 to January 5, 2022 in the Department of Pain Clinic of Nanjing Drum Tower Hospital were selected, and their gender was not limited. They were divided into 3 groups by random number table method: group A (n=32) prescribed gabapentin alone, group B (n=30) lidocaine plaster alone, and group C (n=31) lidocaine plaster combined with gabapentin. After excluding patients who did not meet the criteria, there were 28 cases in group A, 28 cases in group B, and 29 cases in group C. The visual analogue scale (VAS), the short-form McGill pain questionnaire (SF-MPQ) score, and drug dosage and adverse reaction in each group at pre-treatment (T0), post-treatment in one week (T1), in two weeks (T2), in four weeks (T4), and in 12 weeks (T12) were recorded and evaluated; Pittsburgh Sleep Quality Index (PSQI) score and Medical Outcomes Study short-form 36 (SF-36) score at T0, T4, and T12 were recorded. Adverse reactions and drug dosage in each group were documented. Repeated measures ANOVA was used to compare the curative effects of the three groups at different time points before and after treatment. Results: The ages of the three groups of patients were (67.8±10.0), (60.9±11.4) and (63.5±12.5) years old respectively (P=0.318), and the proportions of men were 46.4 % (13 cases), 35.7% (10 cases) and 44.8 % (13 cases), respectively (P=0.472). After treatment, the VAS scores and SF-MPQ scores of patients in the three groups were decreased at each time point compared with those before treatment (all P<0.05), the VAS and SF-MPQ scores of patients in group C at T12 time point were 1.2±0.4 and 5.2±2.4 respectively, which were lower than those of patients in groups A and B (both P<0.05). The dosages of gabapentin and lidocaine plaster in group C were lower than those in groups A and B at each time point after treatment (all P<0.05). The PSQI scores of patients in the three groups at T4 and T12 were lower than those before treatment (all P<0.05). The PSQI scores of patients in group C at T4 and T12 were 5.7±1.2 and 4.5±1.2, which were lower than those of patients in groups A and B. (all P<0.05), The SF-36 scores of patients in three groups at T4 and T12 were higher than those before treatment (all P<0.05), and the SF-36 scores of group C at T4 and T12 were 91.7±8.5, 93.1±6.3, which were higher than that of patients in groups A and B (both P<0.05). The incidence of adverse reactions in the three groups were 35.7% (9 cases), 10.7% (3 cases), and 13.8% (4 cases) respectively (P<0.05), the adverse reactions in groups B and C were less than those in group A (P<0.05), and there was no statistical difference between groups B and C (P>0.05). Conclusion: Lidocaine plaster combined with gabapentin has better analgesic effect in the treatment of HZN, with less incidence of adverse reactions, and can reduce the dosage of systemic drugs, improve patients' sleep and quality of life, and thus could provide a safe and effective method for the treatment of HZN.

Effectiveness of Acupuncture, Mind and Body Practices, and Natural Products for Insomnia: an overview of systematic reviews.

ObjectivesThis overview summarizes the evidence for the effectiveness and safety of complementary therapies for insomnia through systematic reviews (SRs) and meta-analyses (MAs).MethodsA comprehensive literature search on SRs and MAs for complementary therapies for insomnia was conducted using six databases.ResultsThis overview included 30 SRs/MAs. The Pittsburgh Sleep Quality Index (PSQI) analysis of insomnia included 383 randomized controlled trials and 31,748 participants. Twenty-four SRs/MAs (80%) out of 30 SRs/MAs reported a positive result, and six SRs/MAs reported a partially positive result. The most frequently used form of acupuncture reported a positive effect in 89.5% (17/19) of SRs/MAs and a superior effect to western medicine, sham/placebo, and no treatment. The lack of protocol registration and the excluded studies list resulted in generally poor methodological and reporting quality in SRs/MAs with AMSTAR 2.ConclusionThis overview confirmed that complementary therapies positively affected the PSQI scores in patients with insomnia. However, better-designed primary studies are needed to strengthen the relevant evidence in the future. A more stringent assessment of multiple systematic reviews 2 must be followed when performing SR and MA.

The relationshipof the quality of sleep in patients with stage 5 chronickidney disease, treated with hemodialysis, with melatonin-producing function

The researcheddemonstrated the relationship between functional state of the pineal gland and sleepdeterioration. However, impaired melatonin-producing function of the pineal gland (MFE) in patients with chronic kidney disease (CKD), treated with hemodialysis (HD), and its association with sleep disturbance in this cohort of patients required further investigations.Aim — to assess the quality of sleepin patients with stage 5 CKD treated with HD and investigate itsrelationship with the pineal dysfunction.Materials and methods. Examinations involved 130 patients (50 % of men) with stage 5 CKD, treated with hemodialysis, with the mean age 58.5 [43; 66]. The day and night melatoninlevels (MT) in saliva were determined and based on the results the patients were divided into two groups: group I — 110 patients with impaired MFE, group II — 20 patients with normal MFE. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. All patients underwent clinical and laboratory tests: general and biochemical blood tests, office blood pressure (BP) measurements, Holter blood pressure monitoring.Results. Analysis of the insomniastructure in patients with stage 5 CKD, treated with HD, according to the PSQI questionnaire, demonstrated the problems with falling asleep in 96.2 % of patients, feeling of heat in 56.8 %, frequent awakenings in 52.9 %, daytime dysfunction in 40.8 %, breathing problems in 40.5 %, sleep problems due to coughing or snoring in 37.8 %, having bad dreams in 18.9 %, the use of sleeping meds in 8 % of patients. The total PSQI score in patients with impaired MFE was higher by 71.4 % (p &lt; 0.001) compared to the value obtained in the group with preserved pineal gland function, demonstrating the effects of MFE on sleep quality.The component of «sleep delay» and «sleep duration» in patients with pineal gland dysfunction was 66.7 % higher than in the group with preserved MFE (p &lt; 0.001). Comparative analysis of the number of minutes required for patients to fall asleep in the study groups demonstrateda greater sleep delay in HD-treated patients with impaired MFE. From them, the majority of subjects (71.8 %) needed more than 60 minutes to fall asleep, while in the group with preserved MFE such patients were not identified (p &lt; 0.05). The number of patients with the period of falling asleep of 31 to 60 minutes in the group with pineal gland dysfunction was 30 % less than in patients with preserved MFE (p &lt; 0.05). The number of patients in whom it took 16—30 minutes to fall asleep in the group with preserved MFE was 92.5 % (p &lt; 0.05) more than in patients with pineal gland dysfunction, and patientswith the period of falling asleep of less than 15 minutes was by 62 % higher than patients with impaired MFE (p &lt; 0.05). The decreased sleep duration was established in all patients treated with HD, however the most worsening of the sleep quality was revealed in the groupof MFE disorders. Thus, thenumber of patients with sleep duration &lt; 5 hourswas by 90.8 % (р &lt; 0.05) higher in the groupof impairedMFEvs group with the preserved MFE, with sleep duration of 5—6 hours by 81.7 % (р &lt; 0.05), the number of subjects with duration of 6—7 hours by 76.4 % lower (р &lt; 0.05), and those who slept &gt; 7 hours by 84.0 % (р &lt; 0.05).Conclusions. Patients with stage 5 CKD, treated with HD, were characterized with combination of MFE impairment (84.6 %) with poor sleep quality (86.2 %), including problems withfalling asleep, felling hot, frequent waking up, and daytime dysfunction. The low quality of sleep was determined bylow melatonin levels in saliva, the presence of hypoalbuminemia and arterial hypertension, hypertension duration and HDtreatment

Sleep Quality and Cancer-Related Fatigue in Patients with Cancer.

Introduction: Sleep problems and fatigue are common symptoms reported by cancer patients. In this study, the researchers used a specialized tool to measure fatigue in cancer patients and its relationship with sleep quality in Yazd, Iran. Methods: This descriptive correlational study included 149 cancer patients (age range: over 18 years) referred to Shahid Sadoughi Hospital in Yazd, Iran. Data were collected by the Pittsburgh Sleep Quality Index (PSQI) and Cancer-Related Fatigue Questionnaire. A PSQI score of ≥5 indicated a poor sleep. Data were analyzed using SPSS Statistics for Windows, version 13.0 (SPSS Inc., Chicago, IL, USA), Pearson’s correlation, t test, analysis of variance (ANOVA), and linear regression. Results: The mean (SD) PSQI score of patients was 13 (4.85) out of 21. About 69.3% of patients had a poor sleep quality. While the mean (SD) of sleep duration was 5.57 (0.54) hours, it was 69.44 (46.58) minutes for sleep latency. Also, with increasing the mean of sleep quality, the mean of fatigue significantly increased (P < 0.001, R=0.63). Conclusion: According to the results, there was a relationship between the sleep quality and fatigue in cancer patients, so that patients with better sleep quality had less fatigue.

Evaluation of Sleep Quality in Patients with Multiple Sclerosis: A Case-Control Study

Background and Objective: Studies indicate that people with multiple sclerosis (MS) are at increased risk of sleep disorders and the resulting negative outcomes. The aim of this study was to evaluate sleep quality in patients with MS.&#x0D; Materials and Methods: In this case-control study, 110 patients with all confirmed types of MS as a case group and 110 healthy subjects as control group were evaluated in terms of sleep quality using Pittsburgh Sleep Quality Index (PSQI). The data collected was analyzed using t-test and chi-square tests.&#x0D; Results: Total score of PSQI was significantly higher in patients with MS than that of the control group (7.32 ± 2.78 vs. 5.30 ± 2.00, P = 0.001). Furthermore, PSQI scores of patients with MS was significantly higher than that of the control group in subscales including sleep latency (1.14 ± 0.99 vs 0.85 ± 0.91, P = 0.029), sleep duration (1.09 ± 0.80 vs. 0.83 ± 0.88, P = 0.048), habitual sleep efficiency (1.15 ± 0.92 vs. 0.85 ± 0.83, P = 0.017), sleep disturbance (1.25 ± 0.96 vs 0.96 ± 0.88, P = 0.013), use of sleep medication (0.69 ± 0.94 vs. 0.33 ± 0.65, P = 0.001), and daytime dysfunction (0.88 ± 0.93 vs. 32.2 ± 0.69, P = 0.001).&#x0D; Conclusion: Patients with MS had a significantly more improper sleep quality compared to the control group. So, poor sleep quality has a negative effect on daily activities and social communication of these patients and generally reduce their quality of life (QOL).

Central sensitization and its relationship with health profile in Behçet’s disease

Objectives In this study, we aimed to evaluate the level of central sensitization (CS) and its relationship with health profile, including neuropathic pain and sleep quality in Behçet’s disease (BD). Method Eighty-eight patients with BD and 60 healthy controls (HCs) were included in the study between May 2018 and February 2019. Nottingham health profile (NHP), pain DETECT, Pittsburgh sleep quality index (PSQI) questionnaires and the central sensitization inventory (CSI) were administered to all participants. To evaluate the correlations of the NHP, PSQI, and PDQ scores with the CSI score, the CSI was modified for each questionnaire. The activity of BD was determined by the Behçet’s disease current activity form (BDCAF). Results CSI scores were significantly higher in patients with BD than HCs (BD: 41.2 ± 21.1 vs HCs: 20.4 ± 16.9, p < .001). Clinical CS was detected in 69.3% of patients with BD and 28.3% of HCs (p < .001). Severe or extreme CS (CSI score ≥ 50) was present in 37.5% of patients with BD and 5.0% of HCs (p < .001). There were high correlations between the modified CSI scores and the NHP, PDQ and PSQI scores in patients with BD (R = 0.804; p < .001, Rho = 0.698; p < .001, and Rho = 0.734; p < .001, respectively). There was significant correlation between CSI and BDCAF scores (Rho= 0.470, p < .001). Conclusion CS is more frequent and more severe in patients with BD than in HCs. There is a strong correlation between the severity of CS and poor health profile in patients with BD.

Sleep in nasopharyngeal carcinoma patients before chemotherapy, after induction chemotherapy, and after concurrent chemoradiotherapy

Sleep disturbance is frequently observed in cancer patients before, during and after oncology treatment. We explored the sleep features of patients before treatment, after induction chemotherapy, and after concurrent chemoradiotherapy for nasopharyngeal carcinoma (NPC). Ninety eligible patients diagnosed with NPC (stages III to IVc) and treated with induction chemotherapy plus concurrent chemoradiotherapy were included. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess sleep before treatment, after induction chemotherapy, and after concurrent chemoradiotherapy. The median global PSQI scores in patients with NPC before treatment, after induction chemotherapy, and after concurrent chemoradiotherapy were 5, 6, and 10, respectively. The median scores of daytime dysfunction, sleep disturbance and habitual sleep efficiency were statistically significant at the pretreatment, after induction chemotherapy and after concurrent chemoradiotherapy timepoints (P < 0.049, P < 0.001 and P < 0.001, respectively). However, minimal changes were observed in all subscores after induction chemotherapy. Patients with poor sleep quality after induction chemotherapy were more prone to suffer worse sleep after concurrent chemoradiotherapy (OR = 12.6, 95%; CI = 2.4–67.3). Induction chemotherapy had less effect on the quality of sleep in NPC patients. Patients experienced a significant increase in sleep disturbance after concurrent chemoradiotherapy, particularly those with bad sleep after induction chemotherapy.

Restless legs syndrome and arterial stiffness in pre-dialysis chronic kidney disease

Despite plenty of restless legs syndrome (RLS) studies conducted with hemodialysis patients, it has been scarcely studied in patients with predialysis chronic kidney disease (CKD). In the present study, we aimed to investigate the frequency of RLS in patients with nondialysis chronic kidney disease and explore the relationship between RLS with sleep quality, depression, pulse wave velocity (PWV), and clinical parameters. This cross-sectional study included 259 stage 3–5 predialysis CKD patients. The diagnosis of RLS was defined according to the diagnostic criteria defined by the international RLS study group. Beck depression inventory (BDI) was employed to assess depression while Pittsburgh Sleep Quality Index (PSQI) was employed to assess sleep quality. 41 patients (16%) were diagnosed with RLS. BDI and PSQI scores of patients with RLS were significantly higher than those without RLS (p = 0.01, p = 0.03, respectively). Pulse wave velocity (PWV) was significantly lower in patients with RLS (8.0 ± 1.8) than those without RLS (8.6 ± 1.9) (p = 0.05). Decrease in PWV and increase in BDI score demonstrated by multivariate analysis were shown as independent predictors of RLS development (ExpB = 1.266, p = 0.02 and ExpB = 0.957, p = 0.007 and p = 0.04, respectively). RLS is a significant problem in predialysis CKD patients and depression, and poor sleep quality is typical in these patients. Arterial stiffness is lower in these patients and any factors related to the pathophysiology of RLS might play important roles in modulating atherosclerosis.

Effect of standardized nursing intervention on sleep quality and cardiac function in patients with chronic heart failure

Objective To evaluate the effects of standardized nursing on the sleep quality and cardiac function of CHF (chronic heart failure) patients. Methods A total of 96 patients with CHF were randomly divided into control group and intervention group according to the random number table.Patients in the control group received routine cardiology nursing, patients in the intervention group received standardized nursing intervention.The Pittsburgh sleep quality index (PSQI) was used to evaluate the sleep quality of patients in the two groups before and after nursing.The 6 minutes walking test was carried out to determine the walking distance. Results Before the implementation of nursing, there was no significant difference in the scores of PSQI evaluation dimensions between the two groups(P>0.05). After the implementation of nursing, PSQI scores of patients in the intervention group were lower than those in the control group, with statistically significant differences (P<0.05). Before nursing, the 6-minutes walking distance of patients in the intervention group was(352.90±41.40) meters, and the difference was not statistically significant compared with(349.80±40.90) meters in the control group(P<0.05). Conclusion The implementation of standardized nursing intervention can improve the sleep quality of CHF patients and the 6-minutes walking test distance, which plays an important role in the improvement of patients' rehabilitation and quality of life. Key words: Chronic heart failure; Standardized nursing; Sleep quality

Relationship between serum IL-1β and insomnia and liver depression in patients with perimenopausal non-organic sleep disorder.

The aim of the study was to detect the expression of interleukin-1β (IL-1β) in serum of patients with perimenopausal non-organic sleep disorder (PNSD) and to study the relationship between IL-1β and the severity of insomnia and liver depression, so as to benefit the prevention of PNSD. A total of 268 cases of perimenopausal patients from the Department of Traditional Chinese Medicine of Fujian Provincial Hospital and the Department of Traditional Chinese Medicine of Jinshan Branch of Fujian Provincial Hospital were selected from March 2014 to June 2017. Among them, 182 patients developed non-organic insomnia (observation group). The remaining 86 patients were included in the control group. Serum levels of IL-1β were measured by enzyme-linked immunosorbent assay (ELISA). Scores of liver depression were determined and graded. Pittsburgh Sleep Quality Index (PSQI) was used to assess the severity of insomnia. Spearman's correlation analysis was used to analyze the correlation between PSQI, IL-1β and liver depression grade. Scores of liver depression in the observation group were significantly higher than those in control group (p<0.05). In the observation group, and PSQI scores in patients with different grades of liver depression are significantly different (p<0.05). Average level of IL-1β in the observation group was significantly higher than that in control group (p<0.05). With the increase of liver depression grade, the expression level of IL-1β was also increased (p<0.05). Spearman's correlation analysis showed that PSQI was positively correlated with liver depression score, and the level of IL-1β was positively correlated with the liver depression grade in patients with PNSD. (r=0.724, p=0.012; r=0.765, p=0.008). Expression of IL-1β in women with PNSD is significantly upregulated, and different degrees of liver depression also exist. Higher expression level of IL-1β is accompanied by more serious liver depression and higher degree of insomnia.

Correlation analysis of subjective sleep quality and mental resilience in colorectal cancer patients during the chemotherapy treatment period

Objective To explore the subjective sleep quality and mental resilience in colorectal cancer patients during the treatment period. Methods A total of 72 colorectal cancer patients undergoing chemotherapy from May to September 2016 in First Affiliated Hospital of Xi'an Jiaotong University were selected by convenience sampling method. Pittsburgh sleep quality index (PSQI) and Conner-Davidson Resilience Scale (CD-RISC) were applied to investigate patients' sleep quality and mental resilience before discharge, and at the 1st month, 3rd month and 6th month of the chemotherapy. Single factor repeated measurement analysis of variance was applied to compare the difference between sleep quality score and mental resilience score, and Pearson correlation coefficient was used to analyze the correlation between them. Results The PSQI scores at the 4 follow-up time points were (9.43±4.26) , (9.02±3.68) , (7.58±4.01) and (6.16±3.22) , and the difference was statistically significant (F=9.861, P<0.05) . The CD-RISC scores at the 4 follow-up time points were (60.13±15.80) , (66.56±16.17) , (69.82±17.46) and (73.03±17.85) , and the difference was statistically significant (F=7.681, P<0.05) . The difference of PSQI scores of patients in different age groups was statistically significant (F=2.792, P<0.05) , and the differences of CD-RISC in patients with different education degree and in different cancer stages were statistically significant (F=3.321, 3.534; P<0.05) . There were a negative correlations between sleep quality and mental resilience at the each time point (r=-0.32--0.53; P<0.05) . The CD-RISC score of the patients with early stage sleep disturbances was lower than that of non-sleep disturbances patients at each time point (P<0.05) . Conclusions Health professionals should pay close attention to the sleep status of colorectal cancer patients at the early stage of treatment, and take appropriate interventions to improve the quality of life and resilience development. Key words: Colorectal neoplasms; Questionnaires; Chemotherapy; Sleep disorders; Resilience, psychological

Does frequency of restless legs syndrome and poor sleep quality increase with age in irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a common gastrointestinal disease which leads to a reduction in the quality of life. Restless legs syndrome (RLS) and the incidence of poor sleep quality (PSQ) are known to increase in IBS. In this study, we aimed to investigate the prevalence and association of RLS and PSQ in a young population. A total of 112 IBS patients (46 constipation predominant IBS, 17 diarrhea predominant IBS, 23 mixed IBS and 26 unsubtyped IBS) and 106 healthy controls were included in the study. The Pittsburgh Sleep Quality Index (PSQI) and the 2012 revised diagnostic criteria of the International Restless Legs Syndrome Study Group were used in the groups. In the patients with IBS and the control group, the respective results obtained were as follows: presence of PSQ 16 (13.4%) and 5 (4.7%) and presence of RLS 10 (8.9%) and 4 (3.7%), respectively. There were significant differences between the two groups in terms of these values. According to the PSQI, the mean global PSQI scores of patients with IBS and control group were 7.61±3.9 and 4.5±3.7, respectively (P=0.01). While PSQ was detected in 21 out of 218 participants, RLS was detected in 14. PSQ and RLS coexisted in nine of the participants and all of them were IBS patients. Previous studies and our study reveal that the frequency of RLS and PSQ increases in IBS. However, this result is a lower rate compared to previous studies. The controlled and prospective studies with larger numbers of cases which demonstrate the real frequency.

The Course of Sleep Disturbances in Early Alcohol Recovery: An Observational Cohort Study

Understanding the course and determinants of sleep disturbances in alcoholic patients may help identify patients at high risk of persistent sleep problems, relapse and guide treatment interventions. We prospectively administered the Pittsburgh Sleep Quality Index (PSQI) to all patients (N = 196) admitted to a 1-month residential treatment program. Our analysis excluded patients with active drug abuse/dependence. Demographic data, psychiatric diagnoses, Patient Health Questionnaire-9 (PHQ-9), Alcohol Use Disorders Identification Test (AUDIT) and Inventory of Drug Taking Situations (IDTS) scores were obtained. Univariate and logistic regression analyses were performed using sex, age, hazardous alcohol use, PHQ-9 scores, hypnotic use, and use of alcohol as a hypnotic as correlates to admission PSQI scores and improvement in PSQI scores. A total of 119 alcoholic patients met inclusion criteria (mean age 50.6 ± 13.2 years). The rates of sleep disturbances at admission and discharge were 69.3% and 49.1%, respectively. Self report of using alcohol to fall asleep and use of hypnotics were associated with elevated PSQI scores. Total PSQI scores improved over 4 weeks (p < .001). Change in PSQI scores was not effected by gender, use of hypnotics, hazardous alcohol use, use of alcohol as a hypnotic or co-morbid psychiatric diagnosis. Older age predicted improvement in PSQI scores in patients with sleep disturbances (p = .004). While a large proportion of alcoholics had sleep disturbances upon admission and at discharge from a residential treatment program, only older age was associated with improvements in sleep disturbances during early alcohol recovery.

Self‐Reported Sleep Quality of Patients with Atrial Fibrillation and the Effects of Cardioversion on Sleep Quality

Atrial fibrillation (AF) is the most common sustained cardiac rhythm disturbance encountered in clinical practice and is associated with impaired quality of life. Data from the previous studies have shown that sleep quality (SQ), as a component of life quality, may also deteriorate in patients with AF. However, it remains unclear; we do not know whether SQ improves after sinus rhythm is maintained. Therefore, we aimed to examine the relationship between SQ and AF, as well as the effects of sinus rhythm restoration with direct current cardioversion (DCC) on SQ among patients with persistent AF. One hundred fifty-three patients with a diagnosis of nonvalvular AF and 150 age-matched control subjects with sinus rhythm were recruited. SQ was assessed using the Pittsburgh Sleep Quality Index (PSQI). The study was designed with two stages. First, the difference in SQ between AF patients and age-matched controls was examined. Patients with global PSQI scores greater than 5 were defined as "poor sleepers." Thus, a higher global PSQI score indicated worsened SQ. Predictors of poor SQ were also analyzed using a regression model. Second, the effect of rhythm control on SQ was studied in patients with AF who were eligible for DCC. Of the 65 patients with persistent AF, 54 patients with successful cardioversion were followed for 6 months. The remaining 11 patients, whose cardioversion was unsuccessful, were not followed. After 6 months of follow-up, the PSQI scores of patients with sinus rhythm maintenance (n = 39) and patients with AF recurrence (n = 15) were reassessed. Changes in global PSQI scores (baseline vs after 6 months) were analyzed. The PSQI scores were significantly higher in the AF group compared to the control group (9.4 ± 4.6 vs 5.8 ± 4.1, P = 0.001, respectively). The prevalence of poor sleepers was significantly higher in the AF group (76%) than in the control group (45%) (P < 0.001 by the χ(2) test). Multivariate logistic regression analysis showed that AF (odds ratio [OR]: 3.36, 95% confidence interval [CI]: 2.00-5.55), age (OR: 1.02, 95% CI: 1.00-1.04), and diabetes mellitus (OR:1.79, 95% CI: 1.03-3.14) were independent predictors of poor SQ. In the second stage, the effect of rhythm control on the SQ of the 54 patients with successful DCC was analyzed. PSQI scores improved significantly between baseline and the 6 months in sinus rhythm maintenance group (8.7 ± 4.1 vs 7.2 ± 3.8, P < 0.001, respectively). However, in the AF recurrence group, the change in global PSQI scores between baseline and the sixth month was not statistically significant (9.8 ± 4.5 vs 9.2 ± 4.2, P = 0.56, respectively). Patients with AF have shorter sleep duration and poor SQ. Maintenance of sinus rhythm after DCC may have a favorable effect on the SQ of patients with AF. Nevertheless, AF is an independent predictor of poor SQ.