Pittsburgh Sleep Quality Index Research Articles

Evaluation of dry eye disease symptomatology and mental health status among patients with different COVID-19 statuses

AIM: To evaluate dry eye disease (DED) symptomatology and mental health status in different COVID-19 patients. METHODS: A cross-sectional observational design was used. Totally 123 eligible adults (46.34% of men, age range, 18-59y) with COVID-19 included in the study from August to November, 2022. Ocular Surface Disease Index (OSDI), Five-item Dry Eye Questionnaire (DEQ-5), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) were used in this study. RESULTS: OSDI scores were 6.82 (1.25, 15.91) in asymptomatic carriers, 7.35 (2.50, 18.38) in mild cases, and 16.67 (4.43, 28.04) in recurrent cases, with 30.00%, 35.56%, and 57.89%, respectively evaluated as having DED symptoms (χ2=7.049, P=0.029). DEQ-5 score varied from 2.00 (0, 6.00) in asymptomatic carriers, 3.00 (0, 8.00) in mild cases, and 8.00 (5.00, 10.00) in recurrent cases, with 27.50%, 33.33%, and 55.26%, respectively assessed as having DED symptoms (χ2=8.532, P=0.014). The prevalence of clinical anxiety (50.00%) and depression (47.37%) symptoms were also significantly higher in patients with recurrent infection (χ2=24.541, P<0.001; χ2=30.871, P<0.001). Recurrent infection was a risk factor for high OSDI scores [odds ratio, 2.562; 95% confidence interval (CI), 1.631-7.979; P=0.033] and DEQ-5 scores (odds ratio, 3.353; 95%CI, 1.038-8.834; P=0.043), whereas having a fixed occupation was a protective factor for OSDI scores (odds ratio, 0.088; 95%CI, 0.022-0.360; P=0.001) and DEQ-5 scores (odds ratio, 0.126; 95%CI, 0.039-0.405; P=0.001). CONCLUSION: Patients with recurrent COVID-19 have more severe symptoms of DED, anxiety, and depression.

Influence of sleep quality and other associated factors on glycemic control among diabetic patients: A hospital-based study

The glycemic control of diabetes patients is influenced by a variety of risk factors, some of which are adjustable and others of which are not. Diabetes and sleep quality are most frequently correlated in both directions. To evaluate the quality of sleep and pinpoint the risk factors for inadequate glycemic control in individuals with diabetes. : This cross-sectional study included seventy consecutive patients who met the inclusion criteria. The Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate the quality of sleep. Siemens- ID 29984, dimension RxL Max, Architect plus ABBOT (ci 4100), completely automatic seven-part cell-counter by Horiba Pentra Dx and Siemens ADVIA Centaur XPT (Immonoassay system) were utilized for the biochemical tests.: Of the 70 participants in the study, 22 patients [31.4%] reported having good sleep quality, while 15 patients [21.4%] had average sleep quality and 33 patients [47.1%] had poor sleep quality. Patients with managed and uncontrolled blood sugar showed varying degrees of sleep quality; 48.4% and 17.9% showed good sleep quality, 29% and 15.4% showed moderate sleep quality, and 22.6% and 66.7% showed poor sleep quality. A statistically significant difference (p<0.001) was seen in the sleep quality of the two groups. : In summary, the results of our study suggested that diabetics with poor sleep quality are more likely to have poor glycemic control. A significant modifiable risk factor for improved glycemic management in diabetic patients is sleep quality.

Maternal Sleep Quality and Executive Function are Associated with Perceptions of Infant Sleep.

This study examined the associations among maternal sleep quality, executive function, and perceptions of infant sleep in a sample of families recruited from human service and public health systems. Seventy-three mothers of infants 5-14 months old were included in the study. Mothers racially and ethnically identified as American Indian/Alaskan Native (4.1%), Asian (4.1%), Black/African American (12.3%), Latina (23.3%), more than one race (12.3%), Pacific Islander (1.4%), and White (42.5%). Mothers completed questionnaires assessing their own sleep (Pittsburgh Sleep Quality Index) and executive function (Behavior Rating Inventory of Executive Function) as well as their perceptions about their infant's sleep (Brief Infant Sleep Questionnaire). Results of the path analysis indicated significant direct effects among maternal sleep quality, executive function, and perceptions of infant sleep. Significant indirect effects were found such that poor maternal sleep quality was linked to poorer perceptions of infant sleep through maternal executive dysfunction, adjusting for infant sleep patterns, infant age, and maternal race and ethnicity. The current study highlights the potential role of maternal behavioral and cognitive factors in shaping mothers' perceptions about infant sleep. These findings support the need for health professionals and researchers to consider maternal sleep quality and executive function when addressing mothers' concerns about infant sleep.

The effects of melatonin and magnesium in a novel supplement delivery system on sleep scores, body composition and metabolism in otherwise healthy individuals with sleep disturbances.

The purpose of this study was to investigate the effects of a novel dietary supplement, including melatonin and magnesium, delivered via coffee pods on sleep quality, resting metabolic rate (RMR), and body composition in individuals with poor sleep quality disturbances. Using a double-blinded, randomized, crossover trial, we recruited 35 participants to a 4-week intervention with both supplements (1.9 mg melatonin + 200 mg elemental magnesium before sleep) and placebo conditions, considering a 7d washout period between treatments. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was applied, RMR (kcal) was measured using indirect calorimetry (canopy ventilated open-circuit system) and body composition was assessed using dual-energy X-ray absorptiometry. Decreases in PSQI and anger - hostility scores, as well as in energy intake and fat mass, were observed (p < 0.05) for both conditions, from baseline to the end of each 4-week intervention. Differences between conditions were also observed for these parameters along with energy spent in activity, number of sedentary breaks, sleep efficiency, latency time, time in bed, total sleep time, awakening time, and movement index (p < 0.05) favouring the supplement condition. However, the final PSQI questionnaire scores still indicated poor sleep quality on average (PSQI > 5), in both conditions, with no changes regarding RMR. A melatonin-magnesium supplement, in a coffee pod format, showed improvements in sleep quality in otherwise healthy individuals with sleep disturbances, however PSQI questionnaire scores still indicated poor quality on average (PSQI > 5).

The efficacy of ball blankets on insomnia in depression in outpatient clinics: A randomised crossover multicentre trial.

Many patients with depression report insomnia symptoms that profoundly affect their health and well-being. Non-pharmacological treatments of insomnia may be preferable for some patients. In this randomised crossover trial, we investigated the efficacy of the Protac Ball Blanket® on insomnia among patients with depression. Included patients (n = 45) were diagnosed with unipolar depression, and with subjective insomnia and poor sleep quality (Pittsburgh Sleep Quality Index Score > 5). Each patient slept 2 weeks with a Protac Ball Blanket® and 2 weeks with a control duvet. Randomisation defined the order of the 2-week sleep periods. Patients served as their own control in this design. The primary outcome was changes in total night-time sleep. Secondary outcomes were sleep-onset latency, number of awakenings, wake after sleep onset, daily use of pro necessitate sedatives and hypnotics, subjective sleep quality (Pittsburgh Sleep Quality Index), insomnia severity (Insomnia Severity Index), symptoms of depression (Hamilton Depression Rating Scale, Major Depression Inventory), symptoms of anxiety (Beck Anxiety Index), and patient-reported outcomes concerning interpersonal sensitivity, neurasthenia, anxiety and depression (Self-Reported Symptom State Scale). Paired two-sided t-tests were used to compare the means of the differences of the outcomes. Protac Ball Blanket® increased total night-time sleep by 12.9 min (95% confidence interval: 1.21-24.63, p = 0.031). Among the secondary outcomes, Protac Ball Blanket® decreased Hamilton Depression Rating Scale by 2.78 (95% confidence interval: -5.44; -0.11, p = 0.042) and Insomnia Severity Index by 2.98 (95% confidence interval: -5.45; -0.50, p = 0.020). No changes were observed in sleep-onset latency, number of awakenings, wake after sleep onset, Pittsburgh Sleep Quality Index, Major Depression Inventory, Beck Anxiety Index, Self-Reported Symptom State Scale, and medication use. The results suggest that some patients may benefit from Protac Ball Blanket® as an add-on non-pharmacological treatment to improve sleep in depression.

The association of comorbidities with sleep quality among Australians with multiple sclerosis: Insights from the Australian Multiple Sclerosis Longitudinal Study.

Comorbidities and poor sleep quality are prevalent among individuals with multiple sclerosis (MS). Our understanding of the effects of comorbidities on sleep quality in MS remains limited. The objectives were to investigate whether the number and presence of specific comorbidities have associations with sleep quality and to assess the relative contribution of comorbidity groups to sleep quality. We collected data on sleep quality (using Pittsburgh Sleep Quality Index (PSQI)) and presence of comorbidities in people with MS (n = 1597). Associations between comorbidities and sleep quality were examined using linear regression and dominance analysis. Having more comorbidities was associated with poorer sleep quality (p for trend < 0.001). All 13 groups of comorbidities explained 12.9% of the variance in PSQI from which half of the variance was contributed by mental health disorders. In total, 16 of the 28 comorbidities were associated with significantly worse sleep quality, with the strongest associations seen for 'other autoimmune diseases' (β = 1.98), depression (β = 1.76), anxiety (β = 1.72) and rheumatoid arthritis (β = 1.62). Many individual comorbidities are associated with poorer sleep quality, with mental health disorders making the largest relative contribution. Optimal management of comorbidities that make the greatest contributions could have the largest benefit for improving sleep in MS.

The validity and reliability of the Chinese version of the biological rhythms interview of assessment in neuropsychiatry in the community: a large Chinese college student population

ObjectiveTo test the psychometric properties of the Chinese version of the biological rhythms interview of assessment in neuropsychiatry (C-BRIAN) in a group of young adults with and without depressive symptoms.MethodsThree hundred and seventy-eight university students were recruited as participants. Based on the scores from Center for Epidemiological Survey Depression Scale (CES-D), students were divided into the depressed group and healthy group. Explorative factor analysis was applied to assess the construct validity of the C-BRIAN. The Pittsburgh Sleep Quality Index (PSQI) and CES-D were compared with the C-BRIAN to test the convergent validity. The internal consistency of the C-BRIAN was also examined.ResultsThree factors were extracted (activities, eating patterns, and sleep factors) explaining 63.9% of the total variance. The internal consistencies were very good with a coefficient of 0.94 (overall) and 0.89–0.91 for three factors. The domains of activities, eating patterns, and sleep were moderately correlated with PSQI (r=0.579) and CES-D (r=0.559) (ps&amp;lt;0.01).ConclusionOur findings suggest that C-BRIAN has good validity and reliability which can be used to assess the biological rhythm in the young adult population with depressive symptoms. C-BRIAN would be a reliable tool to detect depressive symptoms for timely prevention and intervention in the community.

Prevalence of Risk Factors Associated With Poor Quality of Sleep in People Living with HIV and the Correlation between Quality of Sleep and Cd4+ T Lymphocyte Reconstitution: A Cross-Sectional Study from Turkey.

The prevalence of sleep disorders in people living with HIV (PLWH) is higher than in the general population. Even if viral suppression is achieved with Antiretroviral Therapy (ART), the chronic immune activation and increased inflammation due to immune reconstitution persist. The aim of our study was to determine the prevalence of poor quality of sleep (QoS) and associated risk factors in PLWH and to investigate the relationship between poor QoS and CD4 T lymphocyte count and CD4 reconstitution. PLWH ≥18 years old, attending for routine HIV monitoring were recruited. PLWH with conditions that may affect their QoS (pregnant, hospitalized, malignancy, substance-alcohol abuse, psychiatric disease or treatment, sleeping pill) were excluded. Pittsburgh Sleep Quality Index (PSQI, score ≥5 indicates poor QoS), Epworth Sleepiness Scale (ESS, score ≥11 indicates daytime sleepiness), and Beck Depression Scale (BDS, score ≥10 indicates clinical depression) were applied. CD4+ T lymphocyte reconstitution (current-baseline CD4+ count) and CD4+ T lymphocyte reconstitution rate [(current-baseline CD4+ count)/duration of HIV infection in years] were calculated for PLWH on ART. Student t-test and Pearson's chi-squared test were used for analysing the data, and p<0.05 was considered significant. A total of 131 (15 newly diagnosed, 116 on ART for at least six months) PLWH were enrolled. Poor QoS was detected in 60.3% of PLWH. When compared, the ratio was higher in newly diagnosed PLWH (vs PLWH on ART, p>0,05). Daytime sleepiness in PLWH with poor Qos (p=0.04) was significantly increased (vs good QoS). Clinical depression (p=0.001) was significantly more common in PLWH with poor QoS (vs good QoS). Although statistically nonsignificant (p>0,05), younger age, female sex, being single, homosexüel sexual preference, high income and living with the family were associated with poor QoS. No association was found between the ART regime and QoS. PLWH with poor QoS had a higher CD4+ T lymphocyte count (p>0,05), a higher number of CD4+ T lymphocyte reconstitution (p<0.05), and a higher reconstitution rate than PLWH with good QoS (p<0.05). Prevalence of poor QoS was high in our cohort. Poor QoS was associated with CD4+ T lymphocyte reconstitution and reconstitution rate.

Serum levels of neurotensin, pannexin-1, and sestrin-2 and the correlations with sleep quality or/and cognitive function in the patients with chronic insomnia disorder

ObjectivesTo examine serum concentrations of neurotensin, pannexin-1 and sestrin-2, and their correlations with subjective and objective sleep quality and cognitive function in the patients with chronic insomnia disorder (CID).MethodsSixty-five CID patients were enrolled continuously and fifty-six good sleepers in the same period were served as healthy controls (HCs). Serum levels of neurotensin, pannexin-1 and sestrin-2 were measured by enzyme-linked immunosorbent assays. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and polysomnography, and mood was evaluated by 17-item Hamilton Depression Rating Scale. General cognitive function was assessed with the Chinese-Beijing Version of Montreal Cognitive Assessment and spatial memory was evaluated by Blue Velvet Arena Test (BVAT).ResultsRelative to the HCs, the CID sufferers had higher levels of neurotensin (t=5.210, p&amp;lt;0.001) and pannexin-1 (Z=−4.169, p&amp;lt;0.001), and lower level of sestrin-2 (Z=−2.438, p=0.015). In terms of objective sleep measures, pannexin-1 was positively associated with total sleep time (r=0.562, p=0.002) and sleep efficiency (r=0.588, p=0.001), and negatively with wake time after sleep onset (r=−0.590, p=0.001) and wake time (r=−0.590, p=0.001); sestrin-2 was positively associated with percentage of rapid eye movement sleep (r=0.442, p=0.016) and negatively with non-rapid eye movement sleep stage 2 in the percentage (r=−0.394, p=0.034). Adjusted for sex, age and HAMD, pannexin-1 was still associated with the above objective sleep measures, but sestrin-2 was only negatively with wake time (r=−0.446, p=0.022). However, these biomarkers showed no significant correlations with subjective sleep quality (PSQI score). Serum concentrations of neurotensin and pannexin-1 were positively associated with the mean erroneous distance in the BVAT. Adjusted for sex, age and depression, neurotensin was negatively associated with MoCA score (r=−0.257, p=0.044), pannexin-1 was positively associated with the mean erroneous distance in the BVAT (r=0.270, p=0.033).ConclusionsThe CID patients had increased neurotensin and pannexin-1 and decreased sestrin-2 in the serum levels, indicating neuron dysfunction, which could be related to poor sleep quality and cognitive dysfunction measured objectively.

Targeted metabolomics-based understanding of the sleep disturbances in drug-naïve patients with schizophrenia

BackgroundSleep disturbances are a common occurrence in patients with schizophrenia, yet the underlying pathogenesis remain poorly understood. Here, we performed a targeted metabolomics-based approach to explore the potential biological mechanisms contributing to sleep disturbances in schizophrenia.MethodsPlasma samples from 59 drug-naïve patients with schizophrenia and 36 healthy controls were subjected to liquid chromatography-mass spectrometry (LC-MS) targeted metabolomics analysis, allowing for the quantification and profiling of 271 metabolites. Sleep quality and clinical symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Positive and Negative Symptom Scale (PANSS), respectively. Partial correlation analysis and orthogonal partial least squares discriminant analysis (OPLS-DA) model were used to identify metabolites specifically associated with sleep disturbances in drug-naïve schizophrenia.Results16 characteristic metabolites were observed significantly associated with sleep disturbances in drug-naïve patients with schizophrenia. Furthermore, the glycerophospholipid metabolism (Impact: 0.138, p<0.001), the butanoate metabolism (Impact: 0.032, p=0.008), and the sphingolipid metabolism (Impact: 0.270, p=0.104) were identified as metabolic pathways associated with sleep disturbances in drug-naïve patients with schizophrenia.ConclusionsOur study identified 16 characteristic metabolites (mainly lipids) and 3 metabolic pathways related to sleep disturbances in drug-naïve schizophrenia. The detection of these distinct metabolites provide valuable insights into the underlying biological mechanisms associated with sleep disturbances in schizophrenia.

Bruxism, Lifestyle, Anxiety, and Sleep Impairment in Dental Students

AbstractThe aim of this study was to verify the correlation of self-reported sleep and awake bruxism with demographic characteristics, oral behaviors, anxiety, temporomandibular disorder (TMD) signs and symptoms, sleep quality, and orthodontic treatment history in dental students. A total of 104 students of Dentistry located in Paraná (South Brazilian State) answered the following self-administered questionnaires: Oral Behavior Checklist, State Anxiety Inventory, TMD signs and symptoms questionnaire, and the Pittsburgh Sleep Quality Index. Associations between possible awake bruxism (AB) and sleep bruxism (SB) with sleep quality, anxiety, and TMD were analyzed by Poisson Regression with robust variance. The significance level adopted was 5%. The frequency of AB and SB was 76% and 55.8%, respectively. A statistically higher frequency of AB was observed in students who had the following conditions: use of psychotropic medication, physical activity practitioners, moderate or high level of anxiety, more oral behaviors, sleep disorders, and sleep bruxism. Sleep bruxism was diagnosed more frequently in students who presented moderate or high levels of anxiety, oral behaviors, and sleep disorders. The frequency of TMD reported was higher in students with SB, as well as in those with AB. In conclusion, lifestyle, moderate and high anxiety levels, and sleep disorders are associated with a higher prevalence of AB and SB. Furthermore, AB and SB are associated with a higher frequency of TMD reporting.

Sleep Quality Moderates the Associations between Cardiorespiratory Fitness and Hippocampal and Entorhinal Volume in Middle-Aged and Older Adults.

As individuals age, the entorhinal cortex (ERC) and hippocampus-crucial structures for memory-tend to atrophy, with related cognitive decline. Simultaneously, lifestyle factors that can be modified, such as exercise and sleep, have been separately linked to slowing of brain atrophy and functional decline. Yet, the synergistic impact of fitness and sleep on susceptible brain structures in aging adults remains uncertain. We examined both independent and interactive associations of fitness and subjective sleep quality with regard to ERC thickness and hippocampal volume in 598 middle-aged and older adults from the Human Connectome Lifespan Aging Project. Cardiorespiratory fitness was assessed using the 2-minute walk test (2MWT), while subjective sleep quality was measured with the continuous Pittsburgh Sleep Quality Index (PSQI) global score. High-resolution structural magnetic resonance imaging was used to examine mean ERC thickness and bilateral hippocampal volume. Through multiple linear regression analyses, we investigated the moderating effects of subjective sleep quality on the association between fitness and brain structure, accounting for age, sex, education, body mass index, gait speed, and subjective physical activity. We found that greater cardiorespiratory fitness, but not subjective sleep quality, was positively associated with bilateral hippocampal volume and ERC thickness. Notably, significant interaction effects suggest poor subjective sleep quality was associated with a weaker association between fitness and both hippocampal volume and ERC thickness. Findings suggest the potential importance of both cardiorespiratory fitness and subjective sleep quality in preserving critical, age-vulnerable brain structures. Interventions targeting brain health should consider potential combined effects of sleep and fitness on brain health.

Hyperglycemic Impact On Sleep Quality In Patients With Type 2 Diabetes Mellitus-A Cross Sectional Study

Background: Diabetes mellitus (DM) causes high morbidity and mortality and loss of quality of life significantly. It is an important public health concern. In epidemiologic studies, people with poor sleep quality are more prone to develop diabetes or metabolism disorder of glucose. Sleep has an important role for metabolic function and specifically homeostasis of glucose metabolism. Many studies have shown a correlation between increased diabetes risk and poor sleep quality or sleep deprivation. DM creates a negative effect impact on quality of sleep on patients. Prevalence of obesity and diabetes becomes greater among aged people, it is of vital importance to fix on sleep for overall medical management. This is aimed to determine hyperglycaemia with sleep quality among the patient. Methods: This was a cross sectional study carried out at Ibrahim General Hospital, National Health Care Network (NHN), Mirpur-10, Dhaka during the period of January 2014 to December 2014. Total 129 respondents were selected purposively for this study. Semi-structured questionnaire was pretested first and then it was used for data collection. Pittsburgh Sleep Quality Index score (PSQI) was used to assess sleep quality. Statistical Package for Social Sciences (SPSS) version 22.0. was used for analysis of the collected data. Results: Among 129 respondents, 98(76%) were male and 31(24%) were female. 93.8% respondents were married and rest 6.2% of them were unmarried. Mean(±SD) age was found 53.64(±9.26) years and range 35 to 70 years. 79.1% of the respondents had co-morbidity of DM, 70(54.3%) had diabetes more than 10 years duration. Mean(±SD) of overall sleep quality score was 9.04(±3.965) and range 1 to 18. Among the respondents of age group &gt;64, 95.70% had poor sleep quality, 76.14% respondents sleep less than 6 hours in a day. So association between sleep quality and glycemic status of type 2 DM was significant(p&lt;0.05). Conclusion: The prevalence of high blood sugar level in Type 2 DM patients have poor sleep quality. Type 2 DM patients with high blood sugar level have to overcompensate kidneys to visit washroom more frequent and lead to disturbance in sleep. Type 2 DM patients with controlled blood sugar level have good sleep quality. It is evident from the study that Type 2 DM patients with high sugar level (Hyperglycaemia) frequently experience sleep difficulties. Bangladesh Armed Forces Med J Vol 56 No (1) June 2023, pp 21-27

The positive impact of smoking on poor sleep quality is moderated by IGF1 levels in cerebrospinal fluid: a case-control study among Chinese adults

ObjectivePrevious research indicates associations between cigarette smoking, insulin-like growth factor-1 (IGF1), and sleep disturbances. This study aimed to examine the association between smoking and sleep quality and investigate the moderating role of IGF1.MethodsThis case-control study involved 146 Chinese adult males (53 active smokers and 93 non-smokers) from September 2014 to January 2016. Sleep quality and disturbances were evaluated using the Pittsburgh Sleep Quality Index (PSQI), which includes seven scales. Pearson correlation analysis and logistic regression analysis were utilized to examine the link between IGF1 levels in cerebrospinal fluid (CSF) and PSQI scores. The effect of IGF1 was assessed using the moderation effect and simple slope analysis, with adjustments made for potential confounders.ResultsActive smokers exhibited significantly higher global PSQI scores and lower IGF1 levels in CSF compared to non-smokers. A significant negative correlation was observed between IGF1 and PSQI scores (â = -0.28, P &amp;lt; 0.001), with a stronger association in non-smokers (Pearson r = -0.30) compared to smokers (Pearson r = -0.01). Smoking was associated with higher global PSQI scores (â = 0.282, P &amp;lt; 0.001), and this association was moderated by IGF1 levels in CSF (â = 0.145, P &amp;lt; 0.05), with a stronger effect at high IGF1 levels (Bsimple = 0.402, p &amp;lt; 0.001) compared to low IGF1 levels (Bsimple = 0.112, p = 0.268). Four subgroup analysis revealed similar results for sleep disturbances (Bsimple = 0.628, P &amp;lt; 0.001), with a marginal moderation effect observed on subjective sleep quality (Bsimple = 0.150, P = 0.070). However, independent associations rather than moderating effects were observed between IGF1 and sleep efficiency and daytime disturbance.ConclusionWe provided evidence to demonstrate the moderation effect of IGF1 on the relationship between smoking and sleep in CSF among Chinese adult males.

Bimodal diurnal preference in undergraduate students is associated with negative health and sleep outcomes

ABSTRACT The bimodal preference is a fourth diurnal preference proposed by re-scoring the Morningness-Eveningness Questionnaire. The present work aimed to describe the prevalence of the bimodal preference in a sample of undergraduate students and to characterize the bimodal type in terms of their health and sleep-related outcomes. A web-based cross-sectional study conducted between September 2018 and March 2021 (convenience sampling method). The sample was composed of undergraduate students who completed an electronic form that included the Morningness and Eveningness Questionnaire, the Pittsburgh Sleep Quality Index, the Self-Compassion Scale, the Epworth Sleepiness Scale, the Hospital Anxiety and Depression Scale, and the World Health Organization Subjective Well-Being Index. The final sample consisted of 615 students (82% female, mean age: 23.4 ± 6.5 years), of whom 108 (18%) had positive bimodality indexes. Bimodal subjects comprised 48 students, 8% of the total sample. Bimodal subjects had poorer subjective sleep quality, more daytime sleepiness, lower subjective well-being, greater anxiety and depression symptoms, and lower self-compassion than morning and/or intermediate types; they did not differ from evening types. The description of bimodal diurnal preference in this population may be of interest for the design of academic policies more in line with the circadian reality of students.

A comparative analysis of sleep quality and time management skills between shift and non-shift police officers.

The sleep quality of police officers working in shifts is negatively affected due to long working hours and sleeping less during the day. In our study, we aimed to examine the differences in sleep quality and time management skills in police officers working with shift and non-shift system. 106 police officers, 46 of whom worked in the shift system, 60 of whom worked in the non-shift system, and whose mean age was 27.6 ± 0.9 [min 20, max 40] were included in the study. Sleep quality was assessed with the Pittsburgh Sleep Quality Index[PSQI] and time management skills with the Time Management Questionnaire[TMQ]. While the TMQ total score was 80.91 ± 12.61 for police officers working in shifts, it was 72.41 ± 12.62 for police officers working non-shift. The PSQI total score was 5 in both groups. There was a difference between the TMQ time planning, TMQ time attitudes sub-dimensions, and TMQ total scores of police officers working in the shift system and those working in the non-shift system[p < 0.05]. While poor sleep quality was observed between both groups, there was no difference in sleep quality[p > 0.05]. There was no difference in sleep quality between police officers working in shifts and non-shifts. However, the time management skills of police officers working in shifts were better than those of police officers working in non-shifts. We believe that training programs to improve sleep health and time management skills in police officers are needed for both the sleep quality and well-being of police officers and public safety.

Effects of 12 weeks of functional and resistance training on stress perception and sleep quality in Bra-zilian older people

The study investigated the effects of a 12-week functional and resistance training program on the perception of stress and sleep quality in Brazilian older people, involving 49 participants. The Perceived Stress in older adults and the Pittsburgh Sleep Quality Index (PSQI) was used. The training protocol included a general warm-up, resistance and functional training sessions, followed by a cool-down phase, held twice a week, lasting an average of 60 minutes over the 12 weeks. Data analysis was performed using the Kolmogorov-Smirnov test, bootstrapping, t-tests and Pearson correlation, with a significance level of p &lt; 0.05. The results showed a significant reduction in sleep disturbance and total sleep quality score after the intervention. Men initially had lower stress and better sleep quality in some aspects compared to women, while older people between 60 and 69 years old had improvements in sleep quality in certain aspects before and after the intervention, compared to older people aged 70 and over. Furthermore, a positive correlation was observed between the perception of stress and several components of sleep quality, such as subjective quality, duration and total score. In short, the study demonstrated that the exercise program had varying impacts on sleep quality, but not on the perception of stress among the older people, highlighting a significant improvement in sleep quality after the intervention. Keywords: Aging. Exercise Therapy. Sleep Quality. Psychological stress. Physical education.

The Frequency and Associated Factors of Restless Leg Syndrome among Pregnant Women in 3rd Trimester

Background: Restless leg syndrome (RLS), also known as Willis-Ekbom disease, is characterized by an uncomfortable sensation in the legs, often occurring at the onset of sleep, which triggers an irrepressible urge to move the legs. This condition is particularly prevalent among pregnant women, with symptoms typically worsening during the third trimester. Despite its impact, many pregnant women are unaware of RLS, attributing their discomfort to normal pregnancy symptoms. Objective: To assess the frequency and associated factors of RLS in pregnant females during the third trimester and to evaluate its impact on their quality of life. Methods: A cross-sectional study was conducted involving 250 pregnant females in their third trimester, recruited from Shalimar Hospital, Nawaz Sharif Hospital, Zahida Welfare Trust, Alshad Clinic, Ali Hospital, Ahsan Hospital, Nargis Clinic, Manawa Government Hospital, and Sultan Medical Center. Participants aged 15-45 years were included, while those with rheumatoid arthritis, diabetes mellitus, neurological disorders, preeclampsia, and gestational diabetes mellitus were excluded. Data were collected using structured questionnaires incorporating the International Restless Legs Syndrome Study Group (IRLSSG) criteria and the Pittsburgh Sleep Quality Index (PSQI). Ethical approval was obtained, and the study adhered to the Declaration of Helsinki principles. Statistical analysis was performed using SPSS version 25, with descriptive statistics, frequencies, and graphical representations employed to summarize and analyze the data. Results: The mean age of participants was 26.32 years (SD = 5.08). The prevalence of RLS in the third trimester was found to be 89.2%. The age group most affected was 18-23 years. Factors associated with RLS included inadequate calcium intake (40.4%), insufficient daily water intake (40.4%), poor food intake (48%), mood disturbances (89.2%), lack of movement or light exercise (78%), caffeine consumption (16%), disturbances in sexual activities (48%), and disruption in daily activities (45.2%). Conclusion: RLS is highly prevalent among pregnant women, particularly in the third trimester, significantly impacting their quality of life. Despite its prevalence, many women remain unaware of RLS, mistaking it for typical pregnancy discomfort. Raising awareness and implementing screening and management strategies during prenatal care could improve the quality of life for affected women.

A Combined Kundalini Yoga and Cognitive Behavioral Therapy Program for Posttraumatic Stress Disorder: A Pilot Study.

Cognitive behavioral therapy (CBT) is one of the standard conventional treatments for posttraumatic stress disorder (PTSD). However, recent studies have reported the benefits of yoga for reducing PTSD symptoms including a Kundalini Yoga (KY) intervention. The purpose of this study was to test the efficacy of a novel combined 8-week CBT and KY program for treating PTSD symptoms and improving sleep quality in a single group trial of 26 adults with PTSD. PTSD symptoms (PTSD checklist-5) and sleep quality (Pittsburgh Sleep Quality Index) were assessed at baseline, post intervention, and at 2-month follow-up. Both CBT and yoga homework compliance were also measured. Total PTSD symptom scores as well as the cluster symptoms (intrusion, avoidance, arousal/reactivity, and negative alterations in cognitions and mood) were significantly improved following the program, all p < .01. The improvements in total PTSD scores, intrusion, avoidance, arousal/reactivity were maintained at follow-up, with all values still less (p < .01) than baseline. The negative alterations in cognitions and mood symptom cluster continued to improve further at follow-up compared to post-intervention values (p < .05). Total sleep score (p < .05) and the subscales of sleep disturbance (p < .01), daytime dysfunction (p < .05), and sleep quality (p < .01) were significantly improved after the program and these improvements were maintained at follow-up compared to baseline. Sleep medication use was decreased (p < .05) and sleep latency was improved (p < .01) at follow-up only compared to baseline. There was a significant positive correlation (p < .05) between the completion of the yoga home practice and post change in total sleep scores. These results show that a combined KY and CBT intervention resulted in decreased PTSD symptoms and improved sleep quality and suggest this program may constitute an additional treatment option for PTSD.

Assessing the Role of Locus Coeruleus Degeneration in Essential Tremor and Parkinson's Disease with Sleep Disorders.

Previous studies have demonstrated the importance of the locus coeruleus (LC) in sleep-wake regulation. Both essential tremor (ET) and Parkinson's disease (PD) share common sleep disorders, such as poor quality of sleep (QoS). LC pathology is a feature of both diseases. A question arises regarding the contribution of LC degeneration to the occurrence of poor QoS. To evaluate the association between LC impairment and sleep disorders in ET and PD patients. A total of 83 patients with ET, 124 with PD, and 83 healthy individuals were recruited and divided into ET/PD with/without poor QoS (Sle/NorET and Sle/NorPD) subgroups according to individual Pittsburgh Sleep Quality Index (PSQI) score. Neuromelanin-sensitive magnetic resonance imaging (NM-MRI) and free-water imaging derived from diffusion MRI were performed. Subsequently, we evaluated the association between contrast-to-noise ratio of LC (CNRLC) and free-water value of LC (FWLC) with PSQI scores in ET and PD groups. CNRLC was significantly lower in ET (p = 0.047) and PD (p = 0.018) than in healthy individuals, whereas no significant difference was found in FWLC among the groups. No significant differences were observed in CNR/FWLC between patients with/without sleep disorders after multiple comparison correction. No correlation was identified between CNR/FWLC and PSQI in ET and PD patients. LC degeneration was observed in both ET and PD patients, implicating its involvement in the pathophysiology of both diseases. Additionally, no significant association was observed between LC integrity and PSQI, suggesting that LC impairment might not directly relate to overall QoS.