Pittsburgh Sleep Quality Index Score Research Articles

Neglected sleep quality problems in women with gestational diabetes mellitus: a multi-center cross-sectional study

BackgroundGestational diabetes mellitus (GDM) is the most common complication of pregnancy, affecting an estimated 16.7% of live births worldwide, which translates to approximately 21 million cases annually. Although poor sleep quality is a prevalent concern in this population, most existing studies predominantly focus on the impact of sleep disorders on GDM, rather than directly assessing sleep quality in women diagnosed with GDM. This study aimed to investigate sleep quality and its associated factors specifically among women with GDM.MethodsWe originally aimed to include 287 women with GDM; ultimately, 618 were invited, of whom 393 participated in the survey through a convenience sampling method at the obstetric clinics of four general tertiary hospitals in Chongqing, China, from June to August 2022. Data were collected utilizing sociodemographic characteristics, the Pittsburgh Sleep Quality Index (PSQI), the Sleep Hygiene Scale, and the Pregnancy-related Anxiety Scale (PrAS). We employed linear regression analysis to identify factors associated with sleep quality.ResultsThe PSQI score of participants was (5.83 ± 3.41). Notably, 43.77% of participants reported an actual sleep duration of less than 8 h per night, whereas 45.55% experienced poor sleep quality. Worrying during the day about your inability to fall asleep (β = 0.204, P < 0.01), body image concern (β = 0.159, P < 0.01), going to bed thirsty (β = 0.160, P < 0.01), educational attainment (β=-0.150, P < 0.01), avoidance (β = 0.124, P < 0.01), sleep disturbed by bed partner’s sleep (β = 0.126, P < 0.01), and worrying as you prepare for bed about your inability to fall asleep (β = 0.137, P < 0.05) significantly affected the sleep quality of participants.ConclusionsThe study revealed a high prevalence of insufficient sleep duration and poor sleep quality among women with GDM, which was significantly influenced by inadequate sleep hygiene habits and pregnancy-related anxiety. These findings enhance our understanding of the factors affecting sleep quality in this population and underscore the necessity for healthcare professionals to timely identify sleep disorders. Implementing appropriate interventions, such as the development of educational programs focused on sleep hygiene and body image acceptance through cognitive behavioral therapy, could enhance the quality of care for women with GDM.

18. SLEEP QUALITY AMONG ADOLESCENTS AGED 15-17 IN DA NANG, 2024: A CROSS-SECTIONAL STUDY

Objective: (1) To determine the prevalence of sleep disorders among adolescents aged 15 to 17 years; (2) To analyze factors associated with sleep quality in adolescents aged 15 to 17 years. Design, Setting, and Participants: Cross-sectional descriptive study. Among Adolescents aged 15-17 years old at Hoa Vang High School we collected 737 eligible participants for the study. Main Outcome Measures: Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Associations between Sleep quality were evaluated with multivariable conditional logistic regression controlling for gender, exercise habits, sleep hygiene habits, pressure and expectations about academic performance (parental expectations, pressure for achievement, completing homework, extra classes). Results: The sleep quality of adolescents aged 15-17 at Hòa Vang High School is alarmingly low, with PSQI scores averaging 5.5±3.3 for 10th-grade students (15 years old), 6.1±3.3 for 11th grade (16 years old), and 6.4±3.5 for 12th grade (17 years old). The findings show that 47.5% of students have poor sleep quality, with a trend of worsening sleep quality with age. Additionally, most study participants go to bed relatively late. Factors associated with poor sleep quality include being female, excessive phone use before bed, academic pressure, homework load, and hours spent on daily extra classes. Addressing this issue requires appropriate sleep education and awareness for both students and parents. Conclusion: This study indicates an alarmingly low level of sleep quality among students at Hoa Vang High School, with a significant proportion experiencing poor sleep quality, and highlights several associated factors.

P078 Poor sleep quality in Australia: The role of disturbing dreams, nightmares, and psychological distress

Abstract Introduction Disturbing dreams and nightmares can cause night-time awakenings and disrupt sleep. Despite high rates of poor sleep quality in Australia, there has been little investigation into the impact of disturbing dreams and nightmares on sleep quality. This study aimed to determine the relationship between disturbing dreams and nightmares and sleep quality in Australia while also examining the contribution of psychological distress. Methods Four hundred and thirty-nine Australian adults (310 females, average age: 44.9 years) completed an online survey investigating sleep, dreams, nightmares, and mental health. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), nightmares were assessed with the Disturbing Dreams and Nightmares Severity Index (DDNSI), and psychological distress was assessed using the Depression Anxiety Stress Scale (DASS-21) total score. Two linear regression models (adjusted for age and sex) examined the contribution of DDNSI and DASS-21 on PSQI scores. Results In the first model, disturbing dreams and nightmares were a significant predictor of PSQI scores (p &amp;lt; 0.001), explaining 10% of the variance. Once psychological distress was added to the model, both disturbing dreams and nightmares (p = 0.004) and psychological distress (p &amp;lt; 0.001) significantly predicted PSQI scores. The final model explained 22% of the variance in PSQI scores. Discussion Disturbing dreams and nightmares contribute to poor sleep quality in Australia. Psychological distress also plays a key role. Sleep health researchers, therefore, need to include validated measures of disturbing dreams, nightmares, and psychological distress when investigating factors contributing to poor sleep quality in Australia.

Association between frailty and subjective and objective sleep indicators in Japanese community-dwelling older adults

Studies have linked frailty to sleep duration and/or quality using questionnaire-based subjective sleep assessments. This study clarified the relationship between frailty status and subjective and objective sleep indicators among community-dwelling older adults in a rural Japanese area. This cross-sectional cohort study analyzed the data of older adult participants in the FESTA Study, assessing subjective and objective sleep indicators using the Pittsburgh Sleep Quality Index (PSQI) and an actigraph, respectively. Frailty status was determined using the Japanese version of the Cardiovascular Health Study (J-CHS) and the Kihon Checklist (KCL). Its relationship was examined through multivariate logistic regression analysis. The data of 537 older adults (median age = 76 years; 177 men and 360 women) were analyzed. Aside from age, depression, and dietary variety score, the PSQI score and the number of awakening episodes after sleep onset were significantly associated with non-robustness when the J-CHS was utilized (OR 1.086 95%CI 1.017–1.159 P = .014 and OR .964 95%CI .934-.994 P = .019, respectively). When the KCL was utilized, non-robustness was significantly associated with the PSQI score (OR 1.100 95%CI 1.028–1.178 P = .006), along with age, gender, number of comorbidities, and depression. Among the seven items of the PSQI, non-robustness was significantly related to daytime dysfunction due to sleepiness. The associations between non-robustness and objective sleep indicators varied by the frailty assessment method, while non-robustness was significantly associated with subjective sleep quality, regardless of the diagnostic tool used for frailty status and age. Therefore, subjective sleep quality may be more reliable for preventing and/or managing frailty in older adults.

The relationship between the use of screen-based devices and self-reported sleep quality in adolescents aged 13–19 years in Brunei

BackgroundThe widespread use of digital devices among adolescents has raised concerns about the potential impact of screen time on sleep quality. This study aimed to investigate the relationship between screen time and self-reported sleep quality in adolescents.MethodsA cross-sectional study was conducted on adolescents (13- to 19-year-olds) using multi-stage cluster sampling with probability proportional to the size of public schools. Data were collected in November 2022 through self-administered questionnaires. The questionnaire collected sociodemographic characteristics, sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and screen time on weekdays and weekends using the Screen Time Questionnaire (STQ). A scoring system was used in the PSQI and a global score of more than 5 indicates poor sleep quality. The relationship between screen time and sleep quality was analysed using simple and multiple linear regression.ResultsA total of 547 adolescents participated in the study, with a mean (SD) age of 16.66 (1.54) years. The mean (SD) PSQI score was 5.98 (2.70), and 52% of participants had poor sleep quality. The sleep disturbance component had the highest mean (SD) score at 1.35 (0.5) out of a total score of 3.0. The mean (SD) screen time for a weekday was 537.6 (301.5) minutes, and a weekend day was 725.5 (339.2) minutes. The highest median screen time was spent on smartphones during the whole week. A significant linear relationship was observed between age and PSQI global score (p = 0.008), with a 0.2 increase in PSQI global score for each year increase in age (95% CI: 0.05, 0.35). Being female was also significantly associated with a high PSQI global score (p < 0.001). Additionally, a significant linear relationship was observed between screen time on a weekend and PSQI score (p = 0.032).ConclusionsThe study found that half of the adolescents had poor sleep quality, which was associated with being female, increased screen time on weekends, and older age. Future research endeavours should focus on conducting longitudinal studies to assess the temporal relationship between screen time and sleep quality.

Effect of electroacupuncture on the characteristic signal of electroencephalogram in the patients with chronic insomnia： a randomized controlled trial

To observe the effect of electroacupuncture (EA) on sleep quality and electroencephalogram (EEG) signal in the patients with chronic insomnia and to explore its mechanism. Sixty patients with chronic insomnia were randomized into an EA group (30 cases, 3 cases dropped out) and a health learning group (30 cases, 3 cases dropped out). In the health learning group, the sleep health education was provided. In the EA group, besides the health education as the health learning group, EA was delivered at Baihui (GV20), Yintang (GV24+), bilateral Shenmen (HT7), bilateral Sanyinjiao (SP6), with continuous wave, 2 Hz in frequency, once every other day, and 3 interventions a week. EA was given for 4 weeks successi-vely, composed of 12 treatments. The score of Pittsburgh sleep quality index (PSQI), Hamilton anxiety scale (HAMA), and patient health questionnaire-9 (PHQ-9) before and after treatment were compared between the two groups. The EEG signals were collected and the relative power and entropy of EEG before and after treatment were compared between the two groups. After treatment, the scores of PSQI, HAMA and PHQ-9, the relevant power of β wave in F8 and T3 channels, and that of α wave in T4 channel, and the entropy in T3 channel under the eyes-open (EO) resting state, as well as the relevant power and the entropy of γ wave in F8 channel under the eyes-closed (EC) resting state in the EA group were lower (P<0.05) than those before the treatment. All of the above results were lower than those of the health learning group at the same time points (P<0.05). Under the EO resting state, the relevant power of the θ and δ waves of T3 channel and θ wave of T4, O2 and Pz channels of patients in the EA group after the treatment were increased (P<0.05) than those before the treatment, and higher (P<0.05) than those of the health learning group at the same time points. Acupuncture is effective on chronic insomnia, which may be related to the regulation EEG signals.

Effect of "Xingshen-Jieyu" electroacupuncture on serum differential metabolites in patients with depression based on metabolomics

To explore the effect of "Xingshen-Jieyu" (inducing resuscitation and dispel ling melancholy) electroacupuncture (EA) on serum metabolites in patients with depression and its underlying mechanisms through serum non-targeted metabolomics. Fifteen depression patients were subjected into the EA group, and 15 healthy volunteers were matched into the healthy group. EA (2 Hz/15 Hz, a tolerable strength) was applied to Baihui (GV20), Shenting (GV24), Toulinqi (GB15), Benshen (GB13), Touwei (ST8), Xuanli (GB6) and Qubin (GB7) for 30 min, 3 times a week for 6 weeks. The severity of depression was assessed using Hamilton Depression Scale-17 (HAMD-17) and Hamilton Anxiety Scale (HAMA), the degree of fatigue was evaluated using Fatigue Scale-14 (FS-14). The subjects sleep quality was assessed using Pittsburgh sleep quality index (PSQI). Blood samples were collected before and after the treatment for processing serum to perform non-targeted metabolomics profile detection using ultra-high-performance liquid chromatography coupled with mass spectrometry (UPLC-MS), and Partial Least Squares Discriminant Analysis (PLS-DA, a statistical approach). Differential metabolites were screened and pathway enrichment analysis was performed. After the treatment, the scores of HAMD-17, HAMA, PSQI and FS-14 of depression patients were significantly lowered in the EA group (P<0.05). Compared with the healthy subjects, 46 differential metabolites (21 up-regulated, 25 down-regulated) were screened in patients with depression. Compared with pre-treatment in the EA group, 19 differential (17 up-regulated, and 2 down-regulated) metabolites were screened. Four down-regulated metabolites of the 46 differential metabolites in depression patients were recovered after EA treatment. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of differential metabolites before and after EA showed that 19 metabolic pathways were enriched, mainly involving glutaminergic synapses, GABAergic synapses and several amino acid metabolism related pathways. "Xingshen-Jieyu" EA mainly regulates the metabolism of amino acids, and activities of neurotransmitter glutamate and GABA, and restores the excitatory/inhibitory balance, thus playing a role in improving depression.

Paroxysmal atrial fibrillation is associated with poor sleep quality: Tamagawa cross-sectional study on the relationship between lifestyle and atrial fibrillation (TAMAGAWA-AF study).

Quality of life (QOL) is reduced in patients with atrial fibrillation (AF). However, data regarding the association between sleep quality, one of the major components of QOL, and AF are insufficient. This cross-sectional study aimed to elucidate whether sleep quality is reduced in patients with AF. We recruited 2054 consecutive outpatients (64 ± 10 years, 1089 men) who had regularly presented to 26 clinics affiliated with the Tamagawa Medical Association, Tokyo, Japan. The patients were divided into paroxysmal AF (PaAF), persistent or permanent AF (PeAF), and non-AF groups. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The global PSQI score was calculated according to the answer to each question, and poor sleep quality was defined as a global PSQI score ≥6 points. Logistic regression analysis was used to obtain odds ratio for poor sleep quality in the PaAF and PeAF groups, relative to the non-AF group. The PaAF group showed significantly increased odds ratio for poor sleep quality (1.49, 95% confidence interval 1.02-2.17), after adjusting for multiple potential confounders. In contrast, no significant odds ratio for poor sleep quality was observed in the PeAF group (1.09, 95% confidence interval 0.70-1.71). Among the PSQI components, poor subjective sleep quality and sleep disturbances were the main determinants of poor sleep quality in the PaAF group. Sleep quality was found to be reduced in patients with PaAF, and this may be attributed to poor subjective sleep quality and sleep disturbances.

The relationship between sleep, pain,and musculoskeletal injuries in US Army Soldiers

IntroductionThe purpose of this study was to investigate the relationship between sleep and pain in military personnel and to determine if metrics of sleep and pain intensity differ between the...

Gong's acupuncture treatment for mid pregnancy insomnia and anxiety: A case report.

Gong's brain acupuncture (GBA) is a acupuncture technique that restores the balance of the central nervous system by stimulating specific acupoints on the skull to transmit stimulation to the nerves. Insomnia during pregnancy is an increasingly concerning issue, and GBA provides new solutions. The patient, a 26-year old woman at 26 + 1 weeks of pregnancy, presented with unexplained insomnia for 3 weeks. Her symptoms included difficulty initiating sleep, light sleep, and intermittent wakefulness throughout the night. The patient was diagnosed with primary insomnia, scoring 16 on the Pittsburgh sleep quality index, which indicates poor sleep quality. Her self-rating anxiety scale (SAS) score was 49 points, suggesting that she had not yet reached a state of mild anxiety. The patient received 15 sessions of GBA treatment. One month after treatment completion, the patient's Pittsburgh sleep quality index score improved to 3 points, indicating good sleep quality. Her self-rating anxiety scale score decreased to 39 points. This case report demonstrated the successful treatment of mid pregnancy insomnia with GBA, providing preliminary evidence for further research on the therapeutic potential of GBA. However, further research is still needed to enhance persuasiveness.

Effect of Biofeedback Combined with Psychotherapy on Functional Constipation Complicated with Anxiety and Depression.

Biofeedback combined with psychotherapy has been recognized as a potential treatment for patients with functional constipation, anxiety and depression disorder. To validate the therapeutic effect of the biofeedback therapy, 120 patients with a clear diagnosis of functional constipation combined with anxiety and depression disorder were recruited, and then randomly divided into the control group (patients received gastrointestinal medication and anti-anxiety and depression medication) and the treatment group (patients received combined biofeedback and psychotherapy on the basis of the control group's treatment program). The treatment group was treated with biofeedback exercise twice a day for 7 days, supplemented with psychotherapy for a period of 2 months (half-month intervals for one time). Intestinal medications in the treatment group were stopped after one month of treatment. While for the control group, patients were maintained with gastrointestinal motivational drugs, probiotics, anti-anxiety and depression medications. Both groups reduced the dosage of anxiolytics and depressants after 3 months. The control and the treatment group were both effective and the latter had a more significant effect compared to the former. Moreover, the anxiety/depression symptom for patients in the treatment group was significantly milder than those in the control group. Notably, compared with pre-treatment symptoms, the treatment group showed a significant reduction in Pittsburgh sleep quality index (PSQI) scores in the sixth month (F = 0.008, P = 0.008). In summary, biofeedback combined with psychotherapy may improve relieve constipation patients' clinical symptoms, anxiety/depression state and sleep quality. The treatment is durable, safe, and easy to implement, so it is suitable for widely used.

Acupuncture for cancer-related insomnia: systematic review and meta-analysis of randomised controlled trials

BackgroundAcupuncture has been demonstrated to be a safe and effective treatment for insomnia in patients without cancer. A lack of evidence, however, supports its application in the treatment of cancer-related...

The Effect of Kinesio Tape Application on Clinical Parameters in Postmenopausal Women With Chronic Low Back Pain: A Randomized Controlled Study.

Background With rising life expectancy, women are expected to spend a third of their lives in the postmenopausal stage. Consequently, focusing research on postmenopausal women is considered crucial. Objective This study was conducted to determine the effects of kinesiotaping (KT) and sham KT applied with exercise programs on clinical parameters such as pain, sleep, and quality of life in postmenopausal women with chronic low back pain. Methods A randomized controlled experimental design, characteristic of quantitative research, was utilized. The subjects consisted of 60 postmenopausal women. The visual analog scale (VAS), Roland Morris Disability Questionnaire (RMDQ), and Pittsburgh Sleep Quality Index (PSQI) were used as data collection tools. Results At the end of the eighth week, the mean VAS score of the experimental group was 6.7±1.0, the mean PSQI score was 5.16±1.82, and the mean RMDQ score was 8.83±2.19. In contrast, the mean VAS score of the control group was 7.2±1.5, the mean PSQI score was 6.26±1.74, and the mean RMDQ score was 10.83±3.01.At the end of the eighth week, there was no difference between the two groups in terms of VAS (p=0.128), but there was a significant difference in PSQI (p=0.020) and RMDQ (p=0.005) scales. Conclusion The results of this study showed that the combination of KT and exercise therapy had ameliorative effects on pain severity, dysfunction, and sleep quality in chronic low back pain experienced during the postmenopausal period.

The impact of insomnia on prefrontal activation during a verbal fluency task in patients with major depressive disorder: A preliminary fNIRS study

BackgroundInsomnia often co-occurs with major depressive disorder (MDD) and significantly affects patient recovery and prognosis. However, how insomnia affects prefrontal cortex activation in MDD patients and its association with both subjective and objective sleep quality remains unclear. This study combined functional near-infrared spectroscopy (fNIRS) with polysomnography (PSG) to investigate differences in prefrontal activation during a verbal fluency task (VFT) in patients with MDD, with and without insomnia. MethodsSeventy-eight patients with MDD and 42 healthy controls underwent polysomnography and sleep and mood assessments including the Pittsburgh Sleep Quality Index (PSQI) and Self-Rating Depression Scale (SDS). Prefrontal activation was measured using fNIRS during the VFT. ResultsPatients with MDD and insomnia had higher PSQI scores than patients with MDD without insomnia. fNIRS revealed increased left prefrontal cortex activation in these patients, which was negatively correlated with the total sleep time and sleep efficiency and positively correlated with the PSQI score. ConclusionThis study combined fNIRS and PSG to demonstrate that MDD patients with insomnia showed increased levels of prefrontal cortex activation, associated with both subjective and objective sleep quality.

Determining the Relationship Between Sleep Problems, Shock Pain, and Shock Anxiety in Patients With ICD.

This study aimed to determine the relationship between sleep problems, shock pain, and shock anxiety in patients with implantable cardioverter defibrillator (ICD) and the affecting factors. The population of this descriptive cross-sectional study consisted of all patients who underwent ICD implantation in university hospital (N = 200), and the sample consisted of patients who met the inclusion criteria of the study (n = 132). Data were obtained using a "General Information Form", the "Florida Shock Anxiety Scale (FSAS)", the "Epworth Sleepiness Scale (ESS)", the "Pittsburgh Sleep Quality Index (PSQI)", and the "Visual Pain Scale (VPS)". The mean age of the patients was 66.13 years. The VPS was 6.40±3.36; the mean FSAS score was 29.98±8.46; the mean PSQI score was 8.02±3.81; the mean ESS score was 7.59±4.10. PSQI had a statistically significant correlation with the total FSAS score (p<0.001) and a statistically insignificant correlation with ESS (p>0.001). Age, sex, marital status, smoking status, cohabitants, previous ICD shocks, the status of lying on ICD, and fear of dislocation of ICD affected the total FSAS score; sex, employment status, history of heart attack, defined sleep disorder, awakening from sleep due to nightmares, and cessation of breathing during sleep affected the total PSQI score; history of previously defined sleep disorder, history of heart attack, use of medication for a sleep disorder, the pain felt when lying on ICD, and pain experienced during ICD shocks affected the total ESS score. The mean shock VPS scores differed between patients who received an ICD shock during sleep and those who were awakened by nightmares. It was found that the shock anxiety and shock pain scores of ICD patients were above average, that they had poor sleep quality, and that their sleepiness was at the level of "normal but increased daytime sleepiness".

Effects of chamomile oil inhalation on sleep quality in young adults with insomnia: A randomized controlled trial.

Insomnia is characterized by difficulty falling asleep, staying sleep, or both. Aromatherapy is a commonly used complementary and alternative medicine practice by persons with insomnia. Previous studies have shown that use of chamomile oil during massage therapy improves the quality of sleep (QoS). However, to our knowledge, no randomized controlled trials have examined the effects of chamomile oil inhalation on the treatment of insomnia. The present study evaluated the effect of chamomile oil inhalation on QoS and insomnia severity in persons with insomnia. A total of 80-participants ages 18-35 with insomnia were randomly allocated to aromatherapy group (AG; n = 40) or a control group (CG; n = 40). Those in the AG group received chamomile oil inhalation, while those in the CG engaged in their normal routine for 10minutes a day, daily for 15 days. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were administered before and after the intervention. Within-group analysis showed a significant reduction both in PSQI and ISI scores among those in the AG (P < 0.001 for both scores), whereas the CG reported a significant reduction in PSQI score (P = 0.033) and no significant changes in ISI score (P = 0.068). The between groups analysis after the intervention demonstrated a significant reduction in PSQI and ISI scores in the AG group (P < 0.001 for both) compared to the CG. No participant in either group reported adverse events during or after the study. Fifteen days of chamomile oil inhalation before bedtime reduced insomnia severity and enhanced the quality of sleep for young adults suffering from insomnia. Further studies are needed to replicate the results of this study using an active control group.

The altered hypothalamic network functional connectivity in chronic insomnia disorder and regulation effect of acupuncture: a randomized controlled neuroimaging study

BackgroundThe hypothalamus has been recognized as a core structure in the sleep-wake cycle. However, whether the neuroplasticity of the hypothalamus is involved in the acupuncture treatment of insomnia remains elusive.MethodsWe recruited 42 patients with chronic insomnia disorder (CID) and 23 matched healthy controls (HCs), with CID patients randomly assigned to receive real acupuncture (RA) or sham acupuncture (SA) for four weeks. Insomnia severity was evaluated using the Pittsburgh Sleep Quality Index (PSQI) score, and the resting-state functional connectivity (rsFC) of the hypothalamus was assessed via functional magnetic resonance imaging (fMRI).ResultsIn the cross-sectional investigation, CID patients showed increased rsFC between the medial hypothalamus (MH) and left lateral orbital frontal cortex (LOFC), and bilateral medial orbital frontal cortex (MOFC) compared to HCs. In the longitudinal experiment, PSQI scores significantly decreased in the RA group (p = 0.03) but not in the SA group. Interestingly, the increased MH-LOFC connectivity was found to be reduced following RA treatment. In addition, the altered rsFC of MH-LOFC significantly correlated with clinical improvement in the RA group (r = -0.692, p = 0.006).ConclusionThis randomized neuroimaging study provides preliminary evidence that acupuncture may improve insomnia symptoms by restoring circuits associated with hypothalamic subregions.Trial registrationThis trial has been registered on the Chinese Clinical Trial Registry (www.chictr.org.cn) with the identifier (ChiCTR1800017092). Registered date: 11/07/2018.

Moderated serial mediation effects of adaptation problems, academic stress, and interpersonal relationships on the sleep quality of early-year university students.

Due to heightened anxiety levels, sleep disorders become more prevalent among university students. This study, centered on adaptive capacity in early-year university students, aimed to explore the underlying mechanisms through which anxiety affects sleep quality. Between February 2023 and June 2023, a cohort of first- and second-year university students (mean age 18.8 years) from Hunan Province, China, took part in an online survey. Anxiety was assessed using the Self-rating Anxiety Scale; adaptation problems, academic stress, and interpersonal relationships were assessed using the Adolescent Self-Rating Life Events Checklist; and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A moderated serial mediation model, based on Hayes' Model 92, was used to assess the hypothesized model. The survey resulted in 3,490 valid responses. Among respondents, 24% exhibited anxiety symptoms and 30.4% showed abnormal sleep patterns (i.e., PSQI score ≥ 8). The most significant path identified based on indirect effects was anxiety (β = 0.109), adaptation problems (β = 0.183), academic stress (β = 0.081), and sleep quality (all p-values < 0.001). Furthermore, interpersonal relationships moderated the effects of adaptation problems (β = -0.015, p < 0.001), academic stress (β = -0.012, p < 0.001), and anxiety (β = 0.003, p = 0.002) on sleep quality. Elevated anxiety and sleep disorders are common among university students. Adaptive capacity may play a crucial role in sleep disorders among early-year university students. Interventions such as fostering strong interpersonal relationships in campus environments, may prove beneficial in improving academic performance and sleep quality.

Effects of Jin's three-needles therapy combined with low-frequency repetitive transcranial magnetic stimulation on sleep disorders and EEG in children with spastic cerebral palsy

To investigate the effects of Jin's three-needles therapy combined with low-frequency repetitive transcranial magnetic stimulation (rTMS) on sleep disorders and EEG activity in children with spastic cerebral palsy (CP). By using stratified randomization method, 100 children of spastic CP with sleep disorders were randomly assigned to a control group and an observation group, with 50 cases in each group. The patients in the control group were treated with medication, comprehensive rehabilitation training, and low-frequency rTMS, while the patients in the observation group were treated with Jin's three-needles therapy in addition to the interventions given to the control group. Acupoints selected included temporal three needles, brain three needles, intelligence three needles, four spirits needles, and bilateral Ganshu (BL 18), Shenshu (BL 23), Shenmai (BL 62), and Zhaohai (KI 6). Treatment was given once daily, five times a week, for 12 weeks. The Pittsburgh sleep quality index (PSQI) and children's sleep habits questionnaire (CSHQ) scores, modified Ashworth grade, Peabody developmental motor scales-2 (PDMS-2) score, and relative power values of δ, θ, β1, and β2 frequency bands in EEG were observed before and after treatment in both groups. Treatment safety was also evaluated. Compared before treatment, PSQI and CSHQ scores were decreased in both groups after treatment (P<0.05), with lower scores in the observation group than the control group (P<0.05). The modified Ashworth grade showed improvement (P<0.05), with better results in the observation group (P<0.05). PDMS-2 scores were increased in all dimensions (P<0.05), with higher scores in the observation group (P<0.05). Relative power values of δ and θ frequency bands in EEG were decreased (P<0.05), with lower values in the observation group (P<0.05), while relative power values of β1 and β2 frequency bands were increased (P<0.05), with higher values in the observation group (P<0.05). Children in both groups did not occurred obvious adverse reactions. Jin's three-needles therapy combined with low-frequency rTMS can effectively improve sleep disorders, spasticity and motor function, regulate EEG activity in children with spastic CP and sleep disorder, and have good safety.

Resting-state functional connectome predicts sleep quality two months after the first negative COVID-19 antigen test

BackgroundThe COVID-19 pandemic has led to long-term neurological and psychological effects, including sleep disturbances. While prior studies have identified altered brain function post-COVID-19, specific functional connectivity (FC) patterns predicting sleep quality after recovery remain unclear. This study aims to identify FC patterns associated with sleep quality two months after the first negative COVID-19 antigen test. MethodsUsing a connectome-based predictive modeling (CPM) approach, we identified the functional connectome regulating sleep quality based on a 164-region parcellation. Significant connections were analyzed using mediation models to examine their role in the relationship between anxiety, depression, and sleep. ResultsFC between the right cerebellar peduncle and the left VIII of the cerebellum, and between the left middle temporal pole (MTP) and left ventral tegmental area (VTA), significantly predicted Pittsburgh Sleep Quality Index (PSQI) scores for sleep disturbances two months post-recovery (q2 = 0.059, MSE = 0.154, p = 0.017, r = 0.350). Mediation analysis showed a significant indirect effect of FC between the left MTP and VTA on the relationship between generalized anxiety and sleep disturbances (indirect effect = 0.013, 95% CI = [0.002, 0.03], pfdr <0.05). FC between the right dorsal raphe nucleus and ipsilateral regions—including occipital, parietal, and temporal areas—predicted PSQI scores for daytime dysfunction (q2 = 0.092, MSE = 0.678, p = 0.025, r = 0.342). ConclusionPost-COVID-19 brain connectivity and anxiety predict sleep quality. These findings highlight the potential for targeted therapeutic strategies to improve sleep and identify patients at risk for prolonged disturbances through FC biomarkers.