Pittsburgh Sleep Quality Index Score Research Articles

Associations between Recession hardships and subjective and objective sleep measures in the midlife in the United States study: race and gender differences

ObjectivesThis study investigates the associations of retrospective reports of Recession hardships with 10-year changes in subjective and objective indicators of sleep, and whether these associations differ by race and gender.MethodsFive hundred and one adults (14.57% Black; 54.49% female) from the Midlife in the United States (MIDUS) study reported on the subjective Pittsburgh Sleep Quality Index (PSQI) across two waves (pre-Recession, collected 2004–2009; post-Recession, collected 2017–2022), as well as Recession hardships since 2008. A sub-sample of 201 adults (25.37% Black; 58.21% female) provided objective actigraphy-measured sleep data (total sleep time, sleep onset latency, and sleep efficiency) across the two waves.ResultsDescriptive analyses revealed Black participants had higher average Recession hardships, poorer post-Recession PSQI scores, and poorer post-Recession actigraphy sleep quantity and quality compared to white participants. Females had higher average Recession hardships compared to males; and reported poorer post-Recession PSQI, but had better objective post-Recession sleep quantity and quality compared to males. Regression models showed Recession hardships (across overall events, and sub-domains of financial and housing hardships) were associated with poorer PSQI and actigraphy-measured sleep efficiency following the Recession, adjusting for sociodemographic covariates, corresponding pre-Recession sleep variables, and pre-Recession chronic conditions. There was no evidence for significant moderation by race on sleep outcomes. However, gender moderation indicated associations between housing hardships and poorer actigraphy-measured sleep efficiency were more apparent for females than for males.ConclusionsFindings indicate that Recession hardships (particularly in financial and housing domains) may be manifested in poor sleep. Racial and gender groups may have differential exposure and sleep-related reactivity to Recession hardships.

Sleep Quality Assessment and Its Predictors Among Saudi Adults with Type 1 and Type 2 Diabetes: A Cross-Sectional Study

Background: Poor sleep quality is prevalent among adults with diabetes, impacting their physical, psychological, and functional well-being. Our goals were to assess the prevalence of poor sleep quality and its association with glycemic control and to identify predictors of poor sleep quality among adults with diabetes mellitus. Methods: This cross-sectional study took place at a tertiary hospital, from October 2022 to March 2023, including 192 adults with type 1 and type 2 diabetes. We collected demographic and clinical data and utilized the Pittsburgh Sleep Quality Index (PSQI) scale to evaluate sleep quality. Results: A total of 65.9% of the participants experienced poor sleep quality (PSQI score > 5), with an average global sleep quality score of 7.36 ± 3.53 for all patients. Poor sleep quality was higher among older and married patients, those with lower education levels, housewives, and those with type 2 diabetes mellitus and associated comorbidities, such as hypertension and dyslipidemia. None of these factors were significantly associated with sleep quality in a multiple linear regression analysis. The mean glycated hemoglobin was 8.68 ± 1.91% and did not correlate with the overall PSQI score and its components. Conclusions: This study revealed a notably high prevalence of poor sleep quality among Saudi adults with diabetes, potentially associated with specific sociodemographic and clinical factors. These findings emphasize the importance of integrating sleep quality education into diabetes management strategies.

Characteristics and correlated factors of preoperative sleep disorders in cardiac surgical patients

Objective: To investigate the clinical characteristics and correlated factors of preoperative sleep disorders in patients undergoing various types of cardiac surgery. Methods: The data of patients at the Structural Heart Surgery Center of Beijing Anzhen Hospital, Capital Medical University, from April 2023 to February 2024 were retrospectively collected. Patients were categorized into five groups based on cardiac surgical diagnosis: coronary heart disease, valvular disease, large vessel disease, congenital heart disease, and others. Each group was further subdivided into normal sleep (NS) and sleep disorder (SD) groups based on the Pittsburgh Sleep Quality Index (PSQI) scores. Demographic information, cognitive function, psychiatric symptoms, and other relevant data were collected. Clinical characteristics were compared between groups, and factors associated with preoperative sleep disorders were analyzed using multivariate logistic regression. Results: A total of 1 016 patients aged (58.6±12.7) years were included in the study, including 701 males and 315 females. The incidence of SD was 45.6% (463/1 016). Multivariate logistic regression analysis showed that aging was a risk factor for sleep disorders in patients with coronary heart disease (OR=1.050, 95%CI: 1.026-1.077) and valvular disease (OR=1.033, 95%CI: 1.013-1.053). High Self-rating Depression Scale (SDS) score was a risk factor for sleep disorders in patients with valvular disease (OR=1.050, 95%CI: 1.013-1.091). High score on the Montreal Cognitive Assessment (MoCA) subitem-abstraction ability was a protective factor for sleep disorders in patients with coronary heart disease (OR=0.695, 95%CI: 0.490-0.981). Conclusions: The risk factors of preoperative sleep disorders in cardiac surgery patients vary based on the type of cardiac disease. Aging, depression and abstraction ability correlate with sleep disorders in cardiac surgical patients.

Sleep Health Patterns in Romania: Insights from a Nationwide Cross-Sectional Online Survey

Background: Sleep is one of the most essential processes for sustaining cognitive, emotional, and physical health across all age groups. Insomnia or inadequate sleep significantly impacts health and poses economic burdens due to increased healthcare costs and reduced productivity. Objectives and Methods: This study aimed to investigate sleep quality in the Romanian active population using an online survey incorporating the Pittsburgh Sleep Quality Index (PSQI). Conducted over four months in 2023, the survey gathered 2243 complete responses from urban and rural residents over the age of 18. Results: The results highlight gender and urban–rural disparities in sleep quality, revealing that females and urban residents experienced poorer sleep compared to their counterparts. Additionally, sleep quality was found to significantly worsen with age, with elders (56+ years) reporting the highest PSQI scores, indicating greater sleep difficulties compared to middle-aged adults and youngsters. A high prevalence of sleep disturbances, daytime dysfunctions, and sleep medication use was reported. Common pre-sleep activities included using electronic devices and watching TV, while fewer participants engaged in reading books or consuming alcohol and caffeine. Additionally, participants’ bedding preferences were documented. Conclusions: Our study highlights the influence of various factors on sleep quality and emphasizes the need for targeted public health interventions to improve sleep health in Romania.

Echocardiographic associates of impaired sleep quality in patients with anxiety and depression

Abstract Objective Sleep health, mental health and cardiovascular health are multidimensional constructs that are strongly associated with each other. Anxiety and depression are the most common psychiatric diseases in the community and frequently comorbid in routine clinical practice. This study sought to investigate whether there is an association between sleep quality and echocardiographic parameters in patients with anxiety and/or depression. Methods The clinical and instrumental find­ings of consecutive patients diagnosed with either of anxiety disorders and/or depressive disorders and underwent cardiac examination in our tertiary center on the same day were retrospectively reviewed. The diagnosis was made by a psychiatrist according to the criteria listed in the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders. Afterwards, Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) were applied to patients to assess symptom severity and sleep quality, respectively. Subsequent to psychiatric examination, the patients underwent echocardiographic examination that includes two-dimensional conventional echocardiography, tissue doppler imaging (TDI) echocardiography, atrial conduction times, and left atrium (LA) volumes and functions. Results The final study population consisted of 167 patients and divided into two groups according to their PSQI score: PSQI<5 (normal sleep quality) (n=32) and PSQI≥5 (impaired sleep quality) (n=135). Aortic diameter, left ventricular (LV) end-systolic diameter, LV end-diastolic and -systolic volume, LV stroke volume and LV stroke volume index, LV outflow tract velocity–time integral (LVOT-VTI), and LA conduit volume calculations were significantly lower in patients with impaired sleep quality compared to patients with normal sleep quality. The other echocardiographic parameters including LV systolic functions, doppler and TDI echocardiography indices, atrial conduction times, atrial mechanical functions including LA function index (LAFI) were similar among groups. Correlation analysis yielded a negative, weak but statistically significant correlation between LAFI and PSQI score (r=-0.17, p=.030) (Figure 1A). Left intra-AEMD positively and significantly correlated with PSQI score at a weak level (r=0.16, p=.043) (Figure 1B). Aortic diameter, LV stroke volume index, LVOT-VTI and conduit volume were determined as echocardiographic parameters significantly associated with impaired sleep quality in univariate analysis. Among these parameters, only conduit volume remained as significant and independent associate of impaired sleep quality in multivariate logistic regression analysis (Odds ratio:0.91, 95% Confidence interval:0.85-0.98, p=.018) (Table 1). Conclusion There is an independent association between LA conduit volume and impaired sleep quality in patients suffering from anxiety and/or depressive disorders.Figure 1Table 1

Endothelial dysfunction in acute coronary syndrome: a complex association with cardiovascular risk factors, sleep quality and cardiorespiratory capacity

Abstract Introduction It is widely acknowledged that normal endothelial function plays a pivotal role in conferring cardioprotective effects against ischemia-reperfusion injury following acute myocardial infarction (AMI) treated by a primary percutaneous coronary intervention (PCI), thereby limiting infarct size (1). However, endothelial dysfunction (ED) has been extensively documented in patients with cardiovascular (CV) risk factors (2). This study proposes a novel perspective, positing that ED could be intricately linked not only with traditional CV risk factors, but also it can be associated with poor sleep quality. Consequently, this interplay might significantly contribute to the attenuation of exercise capacity. Objective The aim of this study was to assess endothelial function following AMI treated with a PCI and investigate the link between endothelial function, CV risk factors, sleep quality and exercise capacity. Furthermore, the study aimed to determine if endothelial function could serve as a predictive factor for future major adverse acute cardiac events (MAACE) following AMI. Materials and methods Sixty-three patients with AMI (56.21 ± 7.6 years) volunteered to participate in this study, . Endothelial function was assessed using the Endothelium Quality Index (EQI) . Sleep quality was evaluated using both actigraphy and the PSQI (Pittsburgh Sleep Quality Index) questionnaire. Exercise capacity was quantified through the 6-minute walking test (6mwt). Results ED was evident, as indicated by an EQI of 1.4 ± 0.7. Furthermore, ED was notably influenced by CV risk factors such as low physical activity level, age, and smoking. A significant correlation was found between EQI and both sleep efficiency (r = 0.340; p = 0.006) and PSQI score (r = -0.533; p < 0.001). Additionally, a strong association was observed between endothelial function and the results of the 6mwt (r = 0.291; p = 0.021). Furthermore, during a follow up period ( near 4 months) following PCI, MAACE were observed in patients with severe ED only. Conclusion In summary, findings of this study may emphasize the importance of enhancing sleep quality and advocating for an active lifestyle as modifiable elements to enhance endothelial function, which can be regarded as a prognostic tool subsequent to AMI, ultimately contributing to improved clinical outcomes. Moreover, this study concluded that AMI patients with severe endothelial dysfunction were more likely to develop MAACE.Endothelial Dysfunction after AMIED following AMI : Causes and effect

Anxiety, depression, and poor sleep quality in COVID-19 survivors of the first year of the pandemic

Abstract Background Psychological outcomes after SARS-CoV-2 infection have been reported primarily among patients with post-COVID-19 condition followed at COVID-specific clinics who may not represent the population of COVID-19 survivors. This study compares the frequency, 2 years after infection, of symptoms of anxiety and depression and poor sleep quality between COVID-19 survivors from the first year of the pandemic and comparison groups matched for sex, age, and level of care. Methods Participants are users of the Local Health Unit of Matosinhos (comprising almost all citizens of this municipality) classified according to hospitalization and SARS-CoV-2 infection between March, 2020 and February, 2021 in 4 groups: group#1, hospitalized due to COVID-19 (n = 101); group#2, hospitalized, uninfected (n = 87); group#3, infected, non-hospitalized (n = 252); group#4, uninfected, non-hospitalized (n = 258). They were evaluated between July, 2022 and October, 2023, with the Hospital Anxiety and Depression Scale (HADS-A, anxiety, and HADS-D, depression) and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was used to compute OR and 95%CI adjusted for sex, age, education, marital status, employment, smoking, and level of care of the associations between the study group and clinically significant symptoms of anxiety (HADS-A scores>10), depression (HADS-D scores>10) and poor sleep (PSQI scores>5). Results No significant differences (p < 0.05) were observed for the prevalence of clinically significant symptoms of depression (overall 9.2%) and poor sleep quality (overall 59.8%) between SARS-COV-2 infected participants and comparison groups, but HADS-A scores>10 were more frequent in infected individuals (19.3% vs. 13.6%; OR = 1.92; 95%CI:1.21,3.05). Conclusions Healthcare services should pay special attention to COVID-19 survivors from the first year of the pandemic to identify and treat anxiety symptoms. Funding: FCT UIDB/ 04750/2020 LA/P/0064/2020 PTDC/SAU-EPI/6275/2020 Key messages • COVID-19 survivors from the 1st year of the pandemic present more frequently high levels of anxiety than the general population 2 years after COVID-19. • Specific care for anxiety symptoms are needed for COVID-19 survivors from the 1st year of the pandemic

Heart rate variability and insomnia in depressed patients with breast cancer

ObjectivesDepression is associated with unhealthy autonomic regulation. However, whether patients with breast cancer (BC) with different degrees of depression can be identified from linear and non-linear dynamics in the autonomic...

Cross-cultural adaptation and validation of the Pittsburgh Sleep Quality Index (PSQI) in the Igbo language

BackgroundSleep disturbances are associated with decreased quality of life, increased use of healthcare resources, and poor mood. The Pittsburgh Sleep Quality Index (PSQI) is a standardised questionnaire that was created to help measure sleep quality and to alert medical professionals to the need for additional evaluation of patients exhibiting sleep-related complaints in seven domains based on the previous month. The non-availability of the Igbo version can affect its effective use among Igbo speakers in Southeast Nigeria.AimTo translate and cross-culturally adapt the PSQI scale to the Igbo Culture and Environment among Igbo language speakers in Southeast Nigeria using established guidelines.MethodThe PSQI was translated, combined, back-translated, and reviewed by an expert panel, leading to the development of the final Igbo version (I-PSQI). A sample size of 100 was calculated using G-power, and the PSQI and I-PSQI were distributed to 100 apparently healthy adults (40% males and 60% females) recruited conveniently in Otolo Nnewi, Nigeria. The data were analysed using frequency counts, percentages, means, standard deviations, Spearman rank order tests, Cronbach’s alpha, and principal component analysis (PCA). The level of significance was set at 0.05.ResultsThere was no statistically significant difference observed between the PSQI and I-PSQI scores (p < 0.001). The correlations between the corresponding domains and total scores on both versions of the PSQI were excellent (ρ = 0.86–1.0). The Cronbach’s alpha value of the I-PSQI was 0.7, indicating acceptable internal consistency between the items on the I-PSQI.ConclusionThe I-PSQI proved to be a valid and reliable instrument, making it suitable for assessing sleep quality among Igbo language speakers.

Sleep Quality in Parkinson Disease: Clinical Insights and PSQI Reliability Assessment

AbstractSleep disturbances are prevalent in Parkinson disease (PD), encompassing a spectrum from parasomnias like REM sleep behavior disorder to symptoms of sleep-wake cycle dysregulation, such as insomnia and daytime sleepiness. This research investigates sleep quality in PD patients compared with a matched healthy control group and explores the relationships between PD clinical characteristics and sleep parameters. Additionally, the study assesses the reliability of the Pittsburgh Sleep Quality Index (PSQI) for PD patients by examining internal consistency. The study comprises 52 participants, 27 in the PD group and 25 in the healthy control group, matched for sex and age. Sleep quality revealed that PD patients experienced significantly poorer sleep quality than the control group (p = 0.009). Weak correlations were found between PSQI scores and the modified Hoehn and Yahr scale (p = 0.062), with no correlation observed with the daily equivalent dose of levodopa (L-DOPA). The prevalence of poor sleep quality (PSQI score &gt; 5) was 85.1% for PD patients and 68% for the control group. The internal consistency analysis of the PSQI yielded a Cronbach's α of 0.588 for the PD group. While the PSQI demonstrates utility in detecting general sleep abnormalities and gauging patient perceptions of sleep quality in PD, its limitation as a global score is emphasized. The index prioritizes sleep habits and may not fully capture important sleep disorders in this population. These findings underscore the complex relationship between PD and sleep quality, suggesting the need for a comprehensive approach to assess and address sleep disturbances in PD patients.

Chronotype, sleep hygiene, and sleep characteristics among athletes of different disciplines.

The objective of the study was to assess chronotype, sleep hygiene, and sleep characteristics of Italian athletes in order to identify differences among sport disciplines (team- vs individual-sports), level of competition (Elite vs Non-Elite) and sexes. Moreover, correlations between chronotype, sleep hygiene and sleep quality were evaluated. Two hundred eighty Italian athletes (Females:113; Males:167) participated in the study. They completed the Pittsburgh Sleep Quality Index (PSQI), the Sleep Hygiene Index (SHI) and the MorningnessEveningness Questionnaire (MEQ). Among the athletes, 66.4% were intermediate-type, 21.8% were morning-type and 11.8% were evening-type. 55.4% of the sample was classified as good sleeper (PSQI<5), while 16.1% had poor sleep hygiene (SHI≥35). Females had higher total sleep time (p=0.022) than males. Individual-sports showed more morning-oriented score (p=0.001) and lower PSQI (p=0.006) and SHI (p<0.001) scores, with earlier timing of sleep (bedtime:p<0.001; wake-up time:p<0.001) compared to teamsports. Elite athletes exhibited greater sleep efficiency (p=0.009), and lower sleep latency (p=0.018) and wake after sleep onset (p=0.043) than Non-Elite athletes. Additionally, significant correlations were found between PSQI and SHI (r=0.43, p<0.001), and between MEQ and SHI (r=-0.35, p<0.001). This study yields crucial insights into the sleep behaviors of Italian athletes, revealing that nearly half of the sample were bad sleepers.

Influence of the continuing COVID-19 epidemic on sleep quality and psychological status of healthcare workers in private institutions.

On January 22, 2020, Macao reported its first case of coronavirus disease 2019 (COVID-19) infection. By August 2021, the situation had escalated into a crisis of community transmission. In response, the government launched a recruitment campaign seeking assistance and services of healthcare workers (HCWs) from the private sector throughout Macao. These participants faced concerns about their own health and that of their families, as well as the responsibility of maintaining public health and wellness. This study aims to determine whether the ongoing epidemic has caused them physical and psychological distress. To examine the influence of COVID-19 on the sleep quality and psychological status of HCWs in private institutions in Macao during the pandemic. Data were collected from December 2020 to January 2022. Two consecutive surveys were conducted. The Pittsburgh Sleep Quality Index (PSQI) scale, Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were employed as investigation tools. In the first-stage survey, 32% of HCWs experienced a sleep disorder, compared to 28.45% in the second-stage survey. A total of 31.25% of HCWs in the first-stage survey and 28.03% in the second had varying degrees of anxiety. A total of 50.00% of HCWs in the first-stage survey and 50.63% in the second experienced varying degrees of depression. No difference in PSQI scores, SAS scores, or SDS scores were observed between the two surveys, indicating that the COVID-19 epidemic influenced the sleep quality and psychological status of HCWs. The negative influence persisted over both periods but did not increase remarkably for more than a year. However, a positive correlation was observed between the PSQI, SAS, and SDS scores (r = 0.428-0.775, P < 0.01), indicating that when one of these states deteriorated, the other two tended to deteriorate as well. The sleep quality, anxiety, and depression of HCWs in private institution in Macao were affected by the COVID-19 epidemic. While these factors did not deteriorate significantly, the negative effects persisted for a year and remained noteworthy.

Effectiveness of a novel multicomponent treatment in women with fibromyalgia: A randomized clinical trial.

Multicomponent treatment is commonly used. However, there are no studies that included graded motor imagery and therapeutic neuroscience education to multicomponent treatment for patients with fibromyalgia This study aims to compare the short-term effects (at 12weeks) of a multicomponent treatment combined with graded motor imagery and therapeutic neuroscience education versus standard treatment in patients with FM. The study was a single-blinded randomized controlled trial. Sixty-five women with a clinical diagnosis of FM were randomly allocated (1:1) into two groups. The experimental group (n = 33) received a novel multicomponent treatment combined with graded motor imagery and neuroscience education. The control group (n = 32) received a standard treatment including pharmacotherapy and standard physician education. The primary outcome was pain intensity assessed with the Numeric Pain Rating Scale (NPRS). The secondary outcomes were changes in the Fibromyalgia Impact Questionnaire (FIQ), the Pain Catastrophizing Scale (PCS), the Tampa Scale of Kinesiophobia (TSK-17), and the Pittsburgh Sleep Quality Index (PSQI) scores. All outcomes were assessed at baseline and 12 weeks. All of the participants completed the trial. The between-group mean differences at 12weeks were: NPRS-1.18 points (95% confidence interval [CI] -0.4 to -1.8; η2 = 0.47; p < .001); FIQ-16.21 points (95% CI -10.9 to -22.1; η2 = 0.58; p < .001); PCS total domain -12.5 points (95% CI -7.2 to -17.8; η2 = 0.61; p < .001); TSK-17-6.15 points (95% CI -3.5 to -8.7; η2 = 0.52; p < .001); and PSQI-2.74 points (95% CI -1.4 to 4.0; η2 = 0.54; p < .001). All differences were statistically significant in favor of the novel multicomponent treatment group and had a large effect size. In the short term, a novel multicomponent treatment, including graded motor imagery and neuroscience education, was an effective therapeutic intervention for improving clinical outcomes compared with standard treatment in women with FM. Additional studies are needed to support long-term clinical effectiveness in these patients.

Key Associations Found in the Struggle With Sleep in Lung Transplant Recipients.

Gaps exist in the understanding of the etiology of poor sleep quality after lung transplantation. Research Question: What factors are associated with poor sleep quality in lung transplant recipients? A quantitative, single-site, cross-sectional study used an anonymous survey based on 3 scales. The Pittsburgh Sleep Quality Index scale with scores dichotomized to poor versus good sleepers based on the cutoff score > 8. The Hospital Anxiety and Depression Scale evaluated symptoms of anxiety and depression, and the Short Form-12 measured health-related quality of life using the mental and physical component scores. Additional self-reported data included demographic and transplant-related variables. The response rate was 38.4% (61/158), and 52.5% of the sample (32/61) evidenced a Pittsburgh Sleep Quality Index score > 8, suggestive of poor sleep quality. Bivariate analyses demonstrated that poor sleep was significantly related to symptoms of depression (P < .01), anxiety (P < .01), stressors of hospitalization (P < .05), and treatment of acute rejection (P < .05). Multivariate analysis demonstrated that anxiety was significantly associated with poor sleep (odds ratio = 1.34, P < .05). Poor subjective sleep quality remains prevalent in lung transplant recipients. Individuals with anxiety symptoms were at a greater risk for poor sleep. Guidance for strategies to improve sleep quality requires further in-depth exploration before implementation of interventions.

Sex differences in the risk of excessive daytime sleepiness in mild and moderate ischaemic stroke patients: a retrospective database study

BackgroundExcessive daytime sleepiness (EDS) is a common complication of stroke that has a detrimental effect on patients’ daily life and functional recovery. The clinical characteristics and risk factors for poststroke EDS may differ between males and females.MethodsA retrospective study based on hospital medical records was conducted on patients with a diagnosis of stroke who participated in polysomnographic monitoring at the Affiliated Hospital of Yangzhou University from February 2022 to May 2024. Baseline data, laboratory test data, polysomnographic data, and related scale scores were retrospectively collected. The Epworth Sleepiness Scale (ESS) score was used to assess EDS after stroke. Binary logistic regression was used to determine the risk factors for daytime sleepiness. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Statistical analysis was performed via IBM SPSS 26.0.ResultsESS scores were higher in males than in females, whereas females had higher Pittsburgh Sleep Quality Index (PSQI) scores and Hospital Anxiety and Depression Scale (HADS) scores. Male sex and higher depression scores were risk factors for EDS; among male patients, higher anxiety scores were a risk factor for EDS, whereas smoking was a protective factor. Depression, a higher arousal index and a reduced proportion of N3 sleep periods were risk factors for EDS in females.ConclusionsThe characteristics and influencing factors of EDS differ between the sexes in patients with mild and moderate ischaemic stroke. Our study may provide evidence and guidance for clinical diagnosis and treatment. Interventional studies are needed to assess the impact of treating these risk factors in the future.

Treatment of post-stroke fatigue with point-toward-point insertion of elongated needle and Tongdu Tiaoshen therapy of acupuncture: a randomized controlled trial

To observe the effect of point-toward-point insertion of elongated needle on post-stroke fatigue and explore its underlying mechanism. Sixty-four patients with post-stroke fatigue were randomly divided into an observation group (32 cases, 2 cases dropped out) and a control group (32 cases, 2 cases dropped out). In addition to the conventional treatment of western medicine and rehabilitation exercises, Tongdu Tiaoshen (regulating the governor vessel and the spirit) therapy of acupuncture was used in the control group, and acupuncture was applied to Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Fengfu (GV 16) and bilateral Fengchi (GB 20) and the needles were retained for 30 min in one treatment. In the observation group, besides the interventions as the control group, point-toward-point insertion of elongated needle was adopted. The needle was inserted from Zhiyang (GV 9) toward Dazhui (GV 14), from Shendao (GV 11) toward Yaoyangguan (GV 3) and from Yaoqi (EX-B 9) toward Yaoyangguan (GV 3); and the needles were retained for 30 min in one treatment. In the two groups, the acupuncture was delivered once daily, 6 times a week, consecutively for 4 weeks. The scores of the fatigue severity scale (FSS), Pittsburgh sleep quality index (PSQI), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and Fugl-Meyer assessment (FMA) were observed before and after treatment completion in the two groups. Using ELISA, the levels of serum interleukin (IL)-1β, IL-6, IL-10, high-sensitivity C-reactive protein (hs-CRP), and homocysteine (Hcy) were detected before and after treatment completion; and clinical effect was evaluated. The scores of FSS, PSQI, HAMA and HAMD, as well as the levels of serum IL-1β, IL-6, hs-CRP and Hcy were reduced (P<0.05), and the scores of FMA and the levels of serum IL-10 were increased (P<0.05) after treatment in comparison with those before treatment in the two groups. Compared with the control group, in the observation group, the scores of FSS, PSQI, HAMA and HAMD, and the levels of serum IL-1β, IL-6, hs-CRP and Hcy were reduced (P<0.05, P<0.01), and the score of FMA and the level of serum IL-10 were increased (P<0.05). The total clinical effective rate was 83.3% (25/30) in the observation group, which was higher than 73.3% (22/30) of the control group (P<0.05). The point-toward-point insertion of elongated needle alleviates fatigue, anxiety and depression, and ameliorates sleep and motor function in the patients with post-stroke fatigue. It may be related to the attenuation of inflammatory responses.

Brian effects of electroacupuncture on sleep quality and cognitive function in patients with insomnia related to cerebral infarction

To observe the effects of electroacupuncture (EA) on sleep quality, sleep structure, and cognitive function in patients with insomnia related to cerebral infarction, and to explore the brain effect mechanism of EA on insomnia related to cerebral infarction. Thirty-six patients with insomnia related to cerebral infarction were randomly divided into an EA group (18 cases, 1 case was eliminated and 1 case dropped out) and a sham acupuncture group (18 cases, 1 case was eliminated and 2 cases dropped out). Both groups received conventional treatment for cerebral infarction. The EA group received EA at Sishencong (EX-HN 1) with continuous waves at a frequency of 2 Hz, at an intensity tolerable to the patient. The sham acupuncture group received sham acupuncture at non-acupoints with the same EA parameters but electrical stimulation was interrupted after 30 s. Both groups were treated for 20 min each session, once daily, 5 days per week, for a total of 4 weeks. Pittsburgh sleep quality index (PSQI), Montreal cognitive assessment-basic (MoCA-B) scores, and short-term memory (STM) encoding test accuracy and average reaction time were observed before and after treatment in the two groups. Polysomnography (PSG) was used to evaluate sleep structure, and electroencephalogram (EEG) data were collected to observe the standardized power value of the Theta frequency band before and after treatment. Compared with before treatment, PSQI score was decreased and MoCA-B score was increased in the EA group after treatment (P<0.001); the EA group had lower PSQI score and higher MoCA-B score than those in the sham acupuncture group (P<0.001, P<0.01). Compared with before treatment, STM encoding test accuracy was increased and average reaction time was shortened in the EA group after treatment (P<0.01, P<0.001); sleep efficiency (SE) was increased (P<0.01), total sleep time (TST), REM, and N3 stages were prolonged (P<0.01, P<0.05), and sleep latency (SL) was shortened (P<0.01). The standardized power value of the Theta frequency band in EEG channels F3, C3, C4, O1 and O2 was decreased (P<0.05). After treatment, the EA group had higher STM encoding test accuracy, shorter average reaction time (P<0.05), higher SE (P<0.01), longer TST, REM and N3 stages (P<0.01), and shorter SL (P<0.01) than those in the sham acupuncture group. There was no statistically significant difference in the standardized power value of the Theta frequency band between the two groups (P>0.05). EA could regulate sleep quality and structure in patients with insomnia related to cerebral infarction, and improve cognitive function, possibly related to the reduction of slow-wave activity in EEG.

Health Education Nursing Based on BCW Theory Improve Negative Psychology, Sleep and Quality of Life in Elderly Patients After Cardiac Interventional Surgery: A Retrospective Study

Objective: Guided by Behavior Change Wheel (BCW) theory, a rehabilitation nursing intervention program for patients after percutaneous coronary intervention (PCI) was constructed. This study aimed to explore the impact of this intervention program on the negative emotions, sleep quality, and quality of life of patients after PCI. Methods: Patients with coronary heart disease after PCI who visited the cardiology department in our hospital from September 2022 to February 2024 were selected as the research subjects. The patients were divided into two groups according to the order of the operation time: 57 cases in the conventional group and 56 in the BCW group. The systolic blood pressure, diastolic blood pressure, and resting heart rate (RHR) of the two groups before the administration (T1) and at the end of 3 month administration (T2) were evaluated. The Self-Rating Anxiety Scale (SAS), self-rating depression scale, Pittsburgh sleep quality index, and quality of life scale were used in measuring the anxiety, depression, sleep quality, and quality of life levels of the two groups of patients at two-time points. Results: A total of 113 cases were included: 57 cases in the conventional group and 56 in the BCW group. The BCW group had larger improvements in RHR and blood pressure than the conventional group (p &lt; 0.05). The SAS and Self-rating Depression Scale (SDS) scores of the BCW group were significantly lower than those in the conventional group (p &lt; 0.05). After nursing based on the BCW model was implemented, the Pittsburgh Sleep Quality Index (PSQI) scores of the patients in the BCW group were lower than those in the conventional group (p &lt; 0.001). After 3 months of administration, the SF-36 total score and other dimensional scores in the BCW group were higher than those in the conventional group (p &lt; 0.05), and no significant difference was observed between the groups before administration (p &gt; 0.05). Conclusion: Intervention programs based on BCW theory may help to reduce patients' depression and anxiety levels, potentially exerting positive effects that improve RHR and cardiac function in patients after coronary intervention and improving patients' sleep and life quality.

Lacticaseibacillus paracasei 207-27 alters the microbiota-gut-brain axis to improve wearable device-measured sleep duration in healthy adults: a randomized, double-blind, placebo-controlled trial.

Objective: Probiotics have been reported to exert beneficial effects on sleep through the gut-brain axis. Therefore, this randomized, double-blind, placebo-controlled trial assessed the effects of Lacticaseibacillus paracasei 207-27 supplementation on sleep quality and its safety and potential mechanisms. Method and study design: Healthy adults under mild stress aged 18-35 years consumed low or high doses of L. paracasei 207-27 or a placebo for 28 days. Fecal samples, blood samples, and questionnaires were collected at the baseline and the end of the intervention. Sleep quality was measured using wearable devices and Pittsburgh sleep quality index (PSQI) questionnaire. Serum inflammatory markers, corticotropin-releasing hormone, adrenocorticotropic hormone (ACTH), cortisol (COR), γ-aminobutyric acid, and 5-hydroxytryptamine levels were detected using enzyme-linked immunosorbent assay. The gut microbiota was analyzed using 16S rRNA sequencing and bioinformatics. Short-chain fatty acids levels were detected using gas chromatography-mass spectrometry. Results: Both the low-dose and high-dose groups exhibited significant improvements in wearable device- measured sleep duration compared to the placebo group. The global scores of PSQI in three groups significantly decreased after intervention without statistical difference between groups. At the phylum level, the low-dose group exhibited a higher relative abundance of Bacteroidota and a lower Firmicutes-to-Bacteroidetes (F/B) ratio. At the genus level, two treatment groups had higher relative abundance of Bacteroides and Megamonas, alongside lower levels of Escherichia-Shigella. Furthermore, the low-dose group exhibited significant increases in acetic acid, propionic acid, butyric acid, and valeric acid levels, while two treatment groups exhibited a significant decrease in COR levels. Correlation analysis revealed that the increased levels of acetic acid and butyric acid in the low-dose group may be associated with decreased ACTH. Conclusion: L. paracasei 207-27 administration in healthy adults resulted in improvements in gut microbiota community and sleep duration. The mechanisms might involve modulation of the gut microbiota structure to regulate the function of the gut-brain axis, including increases in SCFA levels and decreases in hypothalamic-pituitary-adrenal axis activity. The Chinese clinical trial registry number is ChiCTR2300069453 (https://www.chictr.org.cn/showproj.html?proj=191193, registered 16 May 2023 - retrospectively registered).

Bruxism and Sleep Disorders in Patients Diagnosed With Depressive Disorder and Anxiety Disorder UsingAntidepressants.

To investigate the frequency of bruxism, factors associated with bruxism and sleep disorders in patients diagnosed with depressive disorder and anxiety disorder who use antidepressants. A total of 273 patients diagnosed with anxiety disorder or depression who had been using antidepressants for at least 1 month were included, along with 273 healthy control groups. The patient and control groups completed a sociodemographic data form, Epworth Daytime Sleepiness Scale (EDSS), Pittsburgh Sleep Quality Index (PSQI) and a bruxism questionnaire. Additionally, the clinician confirmed the diagnosis of bruxism through a clinical interview. Bruxism was detected in 73.3% of the patient group and 28.2% of the control group (p < 0.001). The most commonly used antidepressants among patients were selective serotonin reuptake inhibitors (SSRIs) such as escitalopram and sertraline. Within the patient group, individuals with bruxism had higher family history rates of teeth grinding (p = 0.034), PSQI scores (p < 0.001) and EDSS scores (p < 0.001) compared to those without bruxism. Positive correlations were found between the presence of bruxism and PSQI (p < 0.001) scores as well as EDSS scores (p < 0.001) in both the patient group and all participants. Regression analysis conducted on the entire sample revealed that family history rates of teeth grinding (p < 0.001), antidepressant use (p < 0.001) and PSQI score (p = 0.004) were associated with bruxism. The findings from this study suggest that a majority of patients diagnosed with depressive or anxiety disorders may experience bruxism, particularly those using SSRI-type antidepressants. Furthermore, individuals with bruxism may have poor sleep quality and excessive daytime sleepiness tendencies.