Pittsburgh Sleep Quality Index Research Articles

Development, Validation, and Visualization of a Web-Based Nomogram to Predict the Risk of Psychological Distress in Patients Undergoing Chemotherapy After Breast Cancer Surgery

Background Psychological distress of postoperative chemotherapy patients with breast cancer is significant and has a serious impact on their quality of survival. Risk prediction models can efficiently assess patients’ psychological distress and risk factors. Objectives To investigate the factors influencing psychological distress in postoperative chemotherapy patients with breast cancer and construct a nomogram model to predict the occurrence of psychological distress in patients. Methods Two hundred forty-seven women in treatment for breast cancer who were postoperative and receiving chemotherapy were recruited. Participants completed a distress management screening measure, a numerical rating scale, the Pittsburgh Sleep Quality Index, and demographic and clinical items. Results Experiencing significant psychological distress was reported by 65.6% of participants. The psychological distress risk prediction model included 5 variables: financial problems, appearance/shape, distant metastases, the Numerical Rating Scale Pain score, and fatigue. A web calculator was designed based on the model (https://77nomogram.shinyapps.io/dynnomapp/). Conclusions This study found that financial and appearance/shape problems, distant metastases, pain scores, and fatigue were predictors of greater psychological distress in women undergoing chemotherapy after breast cancer surgery. The model constructed in this study has good predictive efficacy. Implications for practice This web-based nomogram model can help healthcare professionals quickly assess the likelihood of psychological distress in patients and screen for risk factors for psychological distress.

Sling Results in Better Sleep Quality and Less Anxiety Early After Arthroscopic Rotator Cuff Repair: A Randomized Single-Blinded Trial.

Sleep disturbance is commonly reported by patients wearing an abduction brace after arthroscopic rotator cuff repair (ARCR). Although a sling has been proven noninferior to an abduction brace for function and repair integrity, there is no evidence-based medical support for the advantage of the sling in improving sleep quality compared with a brace. This study aimed to compare the effects of a sling and an abduction brace on sleep quality and clinical outcomes after ARCR. It was hypothesized that immobilization in a sling would result in better sleep quality while not deteriorating clinical outcomes and bone-tendon healing compared with an abduction brace. Randomized controlled trial; Level of evidence, 1. A total of 142 consecutive patients with rotator cuff tears were randomly assigned to 2 groups: (1) the brace group, receiving abduction brace immobilization for 6 weeks, and (2) the sling group, receiving sling immobilization after ARCR for 6 weeks. The primary outcome was the Pittsburgh Sleep Quality Index at 6 weeks postoperatively. Secondary outcomes-American Shoulder and Elbow Surgeons score, Self-rating Anxiety Scale, pain, satisfaction, and tendon healing (using ultrasonography)-were evaluated until 1 year postoperatively. Complete outcome measurements were obtained for 131 patients. The Pittsburgh Sleep Quality Index at 6 weeks was 11.1 ± 2.7 for the brace group and 9.2 ± 2.3 for the sling group (P < .001), indicating a statistically significant advantage for the sling group. The sling group also reported significantly lower Self-rating Anxiety Scale, lower pain level, and higher satisfaction scores at 6 weeks. No significant difference was observed in outcome measures between groups at 1 year. The tendon healing rates (91% vs 88%, respectively) were comparable between the brace and sling groups within the first 1 year (risk ratio, 1.03 [95% CI, 0.92-1.16]; P = .59). The use of a sling resulted in better sleep quality, less anxiety, and higher satisfaction compared with an abduction brace in the first 6 weeks after ARCR; nevertheless, functional outcomes and repair integrity were similar at 1 year postoperatively between the 2 groups. These findings indicate that a sling is appropriate for the postoperative care of ARCR. However, caution should be used when interpreting these results because the clinical relevance of sling-related benefits warrants further investigation. ChiCTR2200059967 (Chinese Clinical Trial Registry).

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 prevalence and clinical correlation factors of cognitive impairment in patients with major depressive disorder hospitalized during the acute phase

ObjectiveThis study aimed to investigate the prevalence of cognitive impairment among patients with major depressive disorder (MDD) hospitalized during the acute phase and to analyze the in-depth association between this cognitive impairment and clinical correlation factors.MethodsIn this cross-sectional study, we recruited 126 patients aged between 18 and 65 years who were diagnosed with MDD. All these patients were inpatients from the Department of Psychiatry at the Second People’s Hospital of Hunan Province. We employed a series of assessment tools, including the Pittsburgh Sleep Quality Index (PSQI), the 16-item Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), the Pre-sleep Arousal Scale (PSAS), the Morningness-Eveningness Questionnaire (MEQ), the Hamilton Anxiety Rating Scale (HAMA), and the 17-item Hamilton Depression Rating Scale (HAMD-17). The patients were divided into a cognitive impairment group and a non-cognitive impairment group based on their scores on the Montreal Cognitive Assessment Scale (MoCA). Through Spearman’s correlation analysis, we explored the correlation between the total MoCA score and the score of each factor. Additionally, we utilized binary logistic regression analysis to investigate the relationship between cognitive impairment and clinically relevant factors in MDD patients hospitalized during the acute phase and plotted ROC curves to evaluate their clinical efficacy.ResultsIn this study, we found that the prevalence of cognitive impairment among MDD patients hospitalized during the acute phase was as high as 63.49%. Through statistical analysis, we observed significant differences between the cognitive impairment group and the non-cognitive impairment group in terms of age, place of residence, education level, and HAMD-17 scores. In the Spearman correlation analysis, we noted the following trends: visuospatial and executive abilities were negatively correlated with the HAMD-17 score (P &amp;lt; 0.05); naming ability was positively correlated with the PSAS score but negatively correlated with the MEQ score (P &amp;lt; 0.05); memory was also negatively correlated with the MEQ score (P &amp;lt; 0.05); attention was negatively correlated with the HAMA score; and abstract cognitive ability was negatively correlated with the MEQ score (P &amp;lt; 0.05). Through binary logistic regression analysis, we further revealed the relationship between cognitive impairment and factors such as living in a rural area (OR = 2.7, 95% CI = 1.083-6.731, P &amp;lt; 0.05), increased age (OR = 1.049, 95% CI = 1.013-1.087, P &amp;lt; 0.01), and the HAMD-17 score (OR = 1.10295, 95% CI = 1.031-11.79, P &amp;lt; 0.01). Additionally, ROC curve analysis demonstrated a significant correlation between the HAMD-17 score and the prediction of cognitive function in MDD patients hospitalized during the acute phase (P &amp;lt; 0.001). Specifically, the AUC for the HAMD-17 score was 0.73, with an optimal cut-off value of 19.5, sensitivity of 70.0%, and specificity of 63.0%. Furthermore, the AUC for age was 0.71, with an optimal cut-off value of 33.5, sensitivity of 59.0%, and specificity of 80.0%.ConclusionsThis study indicates that MDD patients hospitalized during the acute phase have a higher prevalence of cognitive impairment. This phenomenon reflects a significant correlation between clinical factors such as age, sleep-related characteristics, and the severity of depression with cognitive impairment. Therefore, regular assessment of cognitive function in MDD patients and early intervention may be crucial for the treatment and prognosis of the disease.

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

The 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. We 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). In 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). This randomized neuroimaging study provides preliminary evidence that acupuncture may improve insomnia symptoms by restoring circuits associated with hypothalamic subregions. This trial has been registered on the Chinese Clinical Trial Registry ( www.chictr.org.cn ) with the identifier (ChiCTR1800017092). Registered date: 11/07/2018.

A Study to Determine Sleeplessness as a Potential Predisposing Factor for Myocardial Infarction

Background It is well-established that insufficient sleep is related to more than one acute and persistent illness and leads to elevated mortality and morbidity for cardiovascular illnesses. In recent years, there has been growing interest in sleep-associated investigations. Significant interest has currently been focused on the impacts of sleep deficiency and disturbance on various organs and how they modulate an increasing listing of disease processes. This study aims to bring awareness about the importance of sleep in Myocardial Infarction patients and makes it necessary to counsel patients to change their lifestyle which could help reduce the possible morbidity and mortality rates in the population.  Methodology A prospective observational study was conducted on 400 MI patients (males and females) aged between 20- 60 years who were enrolled in Sri Jayadeva Institute of Cardiovascular Science and Research Hospital from February 2021 to April 2021 to assess sleep duration and quality in MI patients using Pittsburgh Sleep Quality Index (PSQI) scoring scale and a self-designed patient profile form.  Results It was observed that males (77%) were more prone to cardiovascular conditions due to impaired sleep as compared to females (23%) with the baseline age of 50- 60 years (46.8%) at the highest risk. Patients who were married (98.8%) and had a habit or abstinence from smoking and drinking (61.3% and 76.5% respectively), staying in urban places (63.5%), and without any significant medical history were observed to have cardiovascular diseases attributed to their poor sleep practice. Daily wagers were often sleep-deprived due to physical and financial stress which can cause high morbidity rates in the population.  Conclusion The study suggests a positive correlation between sleep deprivation and myocardial injury. Patients with impaired sleep might be at moderate risk of poor cardiac prognosis followed by a subsequent attack of MI.

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

PurposeDue 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.MethodsBetween 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.ResultsThe 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 &amp;lt; 0.001). Furthermore, interpersonal relationships moderated the effects of adaptation problems (β = −0.015, p &amp;lt; 0.001), academic stress (β = −0.012, p &amp;lt; 0.001), and anxiety (β = 0.003, p = 0.002) on sleep quality.ConclusionElevated 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.

Impact of sleep quality on health-related quality of life domains and the mediating effects of symptoms in people with multiple sclerosis.

Many people living with multiple sclerosis (PwMS) experience poor sleep, which is associated with diminished overall health-related quality of life (HRQoL). We quantified associations between sleep quality and HRQoL domains and examined the extent to which other MS symptoms could account for these associations. In this cross-sectional survey of 1,717 Australians with MS, we used Assessment of Quality of Life (AQoL) 8D and Pittsburgh Sleep Quality Index (PSQI) to assess HRQoL and sleep quality, respectively. Total, direct, and indirect effects of sleep quality on HRQoL domains were determined using mediation regression analysis. Poor sleep quality was significantly associated with all domains of HRQoL, with strongest associations seen for mental health (β=-0.08) and pain (β=-0.11), and weaker associations for independent living (β=-0.05) and senses (β=-0.03). Poor sleep quality had the largest direct effect on mental health (60.8%), happiness (48.7%), and pain (49.7%). MS symptom clusters mostly contributing to indirect effects were "feelings of anxiety and depression" for psychosocial, and "pain and sensory symptoms" for physical HRQoL super dimensions. Improving sleep could lead to substantial improvements in all HRQoL domains and the improvement in HRQoL could be partially achieved through indirect improvements in sleep on MS symptoms.

Effects of time-of-day resistance training on muscle strength, hormonal adaptations, and sleep quality during Ramadan fasting

ObjectivesWe investigated the timing of resistance training (RT) during Ramadan fasting (RF) on muscle strength, hormonal adaptations, and sleep quality.MethodsForty healthy and physically active male Muslims (age = 25.7 ± 5.6 years, body mass = 85.1 ± 17.5 kg, height = 175 ± 9 cm, BMI = 28.3 ± 5.7 kg/m2) were enrolled in this study and 37 completed pre and post-tests. Subjects were randomly allocated into two experimental groups. Group 1 (FAST, n = 20) completed an 8-week whole-body RT in the late afternoon (between 16 h and 18 h) while fasting. Group 2 (FED, n = 20) completed the similar RT protocol compared with FAST at night (between 20 h and 22 h). The following parameters were analyzed at various time-points: 2 weeks before the start of RF (T0), on the 15th day of Ramadan (T1), on the 29th day of Ramadan (T2), and 21 days after the last day of RF (T3) where both groups were in a fed state. One-repetition maximum tests (1-RM) were conducted for the squats (1-RMSQ), the deadlift (1-RMDL) and the bench press (1-RMBP). Sleep quality was assessed using the full Pittsburgh Sleep Quality Index (PSQI). Blood samples were taken to determine cortisol, testosterone and IGF-1 levels. Additionally, acute hormonal responses were evaluated before (BF), immediately after (AF), and 30 min after a RT session (AF-30 min) at T0, T1, T2, and T3.ResultsSignificant group-by-time interactions were identified for 1-RMSQ (p = 0.001; effect size [ES] = 0.43) and 1-RMDL (p = 0.001; ES = 0.36). Post-hoc tests indicated significant 1-RMSQ (p = 0.03; ES = 0.12) and 1-RMDL (p = 0.04; ES = 0.21) improvements from T0-T2 for FED. Additionally, significant group-by-time interactions were observed for the chronic effects on cortisol (p = 0.03; ES = 0.27) and testosterone levels (p = 0.01; ES = 0.32). Post-hoc tests indicated significant increases of cortisol levels among FAST at T1 and T2 compared to T0 (p = 0.05; ES = 0.41, p = 0.03; ES = 0.34) and a significant increase in cortisol levels in FED at T1 (p = 0.05; ES = 0.29) and T2 (p = 0.04; ES = 0.25). However, the observed increase was lower compared to FAST. Post-hoc tests also indicated significant increases of testosterone only among FED at T2 (p = 0.04; ES = 0.31). A significant group-by-time interaction was found for the acute effect of exercise on cortisol level (p = 0.04; ES = 0.34). The cortisol level immediately after RT was higher in FAST only at T1 (p = 0.03; ES = 0.39) and T2 (p = 0.05; ES = 0.22) compared with T0. No significant group-by-time interactions were identified for sleep quality (p = 0.07; ES = 0.43).ConclusionMuslims can safely practice RT during RF. However, training in a fed state during Ramadan might be more effective than during fasted state for the enhancement of maximal strength with better hormonal responses observed.

Assessment of psychometric properties of the Dari version of the Pittsburgh Sleep Quality Index (PSQI) among Afghans

Abstract Background Sleep helps in improving the functions of all systems of human body. Disturbance in sleep can cause immediate adverse effects on normal human physiologic functions. Main objective of this study was to explore the psychometric properties of the Dari version of the of Pittsburgh Sleep Quality Index (PSQI) among general adult population of Afghanistan. Methods This methodological study has been conducted during July to November 2023. Reliability and validity of PSQI were evaluated using Cronbach’s Alpha and confirmatory factor analysis, respectively. Pearson correlation analysis was conducted to assess the convergent validity of the components of PSQI, comparing results with those obtained from the DASS-21 subdomains. Results In this cross-sectional study, 965 Afghan adults were studied during five months of duration between July and November, 2023. Mean age of the study participants was 35.2 years. The prevalence of sleep disturbance was 44.6% (430/965). Among them, 59.3% (572/965) reported experiencing subjective sleep quality disturbances less than once a week, 36.2% (349/965) had sleep latency issues less than once a week, 17.6% (170/965) had sleep duration disruption once or twice a week, while 36.3% (350/965) had daytime dysfunction less than once a week. The Cronbach’s alpha coefficient for the seven-component scale was 0.677, indicating acceptable internal consistency. Substantial and statistically significant positive correlations were present among the component of PSQI subjective sleep quality and sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, daytime dysfunction, DASS-Depression, DASS-Anxiety, and DASS-Stress. The overall PSQI exhibited favorable fit indices, supporting the proposed single-factor structure among adult Afghan population. Conclusion Prevalence of sleep disturbance was very high among adult population of Afghanistan. This study provided useful information that will help policy makers (such as ministry of public health as well as international donor agencies like WHO, USAID, and UNICEF) to design a better strategy to reduce the prevalence of sleep disturbance that affects health of the Afghan community at large.

Abstract 4122679: Associations Between Recent and Cumulative Lifetime Cannabis Use and Sleep Health in Middle-Aged Adults: 35-Year Insights from the Coronary Artery Risk Development in Young Adults (CARDIA) and CARDIA Sleep Studies

Background: Cannabis use has become common, but its effects on sleep health—an important contributor to cardiovascular health—remain poorly understood. We investigated associations between recent and cumulative lifetime cannabis use and objective and subjective sleep measures in middle-aged adults. Method: We assessed recent cannabis use (last 30 days) repeatedly from young adulthood (age 18-30 at baseline in 1985-86) to middle age (after 35 years) in the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) study. Cumulative lifetime cannabis use (1 year = 365 days of use) was estimated by summing days of use during follow-up. At Year 35 (Y35), we obtained objective sleep measures (duration, efficiency, fragmentation, wake after sleep onset [WASO]) via 7-day wrist actigraphy from CARDIA Sleep Ancillary Study II. Subjective sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Robust regression models adjusted for Y35 age, sex, race, education, cumulative cigarette smoking, alcohol use, other substance use, physical activity, body mass index, sleep medication, and comorbidities. We also examined race, sex, and cigarette smoking status differences in associations. Result: Of 571 participants, mean age was 61.9 years; 65% were female, and 35% Black. Means (SD) for sleep duration, efficiency, fragmentation, WASO, and PSQI were 6.9 (1.1) hours, 90.5 (4.2)%, 20.6 (7.6)%, 43.5 (20.9) minutes, and 6.1 (3.6) scores, respectively. At Y35, 13.8% reported recent cannabis use, 56% reported former use, mean (SD) cumulative use was 1.6 (4.4) years. With adjustment, recent cannabis use was associated with longer sleep duration, lower efficiency, and higher WASO; former cannabis use was associated with longer sleep duration (Table). Compared to those with cumulative cannabis exposure years in the first quartile, fourth quartile users had longer sleep duration, lower efficiency, and higher WASO (β/p-value: 0.3/0.01, -1.2/0.01, and 8.9/&lt;.001, respectively). PSQI was not associated with recent or cumulative cannabis use. Associations were similar across race, sex, and cigarette smoking status. Conclusion: Recent and cumulative lifetime cannabis use is associated with longer sleep duration and poorer sleep quality in objective, but not subjective, measures. Further longitudinal studies are needed to identify interventions aimed at improving sleep health and promoting cardiovascular health in cannabis users.

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.

Abstract 4136745: How do sleep quality and heart failure symptoms impact functional status among patients with heart failure?

Background: Patients with heart failure (HF) frequently experience poor sleep quality and multiple HF symptoms, both of which are linked to diminished functional status. Poor sleep quality can manifest as prolonged latency, short duration, low efficiency, or difficulty staying asleep. HF symptoms encompass different dimensions: presence, frequency, severity, and distress of HF symptoms. Different dimensions of sleep quality and HF symptoms may uniquely influence functional status, necessitating tailored interventions, yet how individual dimensions of sleep quality and HF symptoms impact functional status remains unexplored. Research Question: how do individual dimensions of sleep quality and HF symptoms impact functional status in patients with HF? Methods: We studied 197 adults with HF (male: 66%, age: 62±11 yrs). The Pittsburgh Sleep Quality Index was used to assess seven dimensions of sleep quality: subjective sleep quality, latency, duration, efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction over the last month. Four dimensions (i.e., presence, frequency, severity, distress) of 7 HF symptoms (e.g., shortness of breath, fatigue, swelling) were assessed using the Symptom Status Questionnaire-HF. Functional status was measured using the Duke Activity Status Index. Correlations and two multiple linear regression models (1 st model: 7 dimensions of sleep quality on functional status, and 2 nd model: 4 dimensions of HF symptoms on functional status) were conducted for data analysis. Results: Worse subjective sleep quality, longer latency, more sleep disturbances, use of sleeping medications, and higher levels of daytime dysfunction were correlated with poor functional status. All four dimensions of HF symptoms were negatively correlated with functional status. In the 1 st multiple linear regression model, more sleep disturbances (B=-3.91, p =.006) and higher daytime dysfunction (B=-5.70, p &lt;.001) were predictive of poor functional status (model R 2 =0.23, p &lt;.001). In the 2 nd multiple linear regression model, only higher frequency of HF symptoms (B=-.70, p =.022) predicted poor functional status (model R 2 =0.34, p &lt;.001). Conclusion: Increased sleep disturbances, daytime dysfunction, and frequency of HF symptoms were associated with poorer functional status in patients with HF. These findings underscore the importance of developing tailored interventions to address individual sleep problems and HF symptoms to improve functional status.

Functional and vascular neuroimaging in maritime pilots with long-term sleep disruption.

The mechanism underlying the possible causal association between long-term sleep disruption and Alzheimer's disease remains unclear Musiek et al. 2015. A hypothesised pathway through increased brain amyloid load was not confirmed in previous work in our cohort of maritime pilots with long-term work-related sleep disruption Thomas et al. Alzheimer's Res Ther 2020;12:101. Here, using functional MRI, T2-FLAIR, and arterial spin labeling MRI scans, we explored alternative neuroimaging biomarkers related to both sleep disruption and AD: resting-state network co-activation and between-network connectivity of the default mode network (DMN), salience network (SAL) and frontoparietal network (FPN), vascular damage and cerebral blood flow (CBF). We acquired data of 16 maritime pilots (56 ± 2.3years old) with work-related long-term sleep disruption (23 ± 4.8 working years) and 16 healthy controls (59 ± 3.3years old), with normal sleep patterns (Pittsburgh Sleep Quality Index ≤ 5). Maritime pilots did not show altered co-activation in either the DMN, FPN, or SAL and no differences in between-network connectivity. We did not detect increased markers of vascular damage in maritime pilots, and additionally, maritime pilots did not show altered CBF-patterns compared to healthy controls. In summary, maritime pilots with long-term sleep disruption did not show neuroimaging markers indicative of preclinical AD compared to healthy controls. These findings do not resemble those of short-term sleep deprivation studies. This could be due to resiliency to sleep disruption or selection bias, as participants have already been exposed to and were able to deal with sleep disruption for multiple years, or to compensatory mechanisms Mentink et al. PLoS ONE. 2021;15(12):e0237622. This suggests the relationship between sleep disruption and AD is not as strong as previously implied in studies on short-term sleep deprivation, which would be beneficial for all shift workers suffering from work-related sleep disruptions.

Prevalence and determinants of poor sleep quality among patients of diabetes mellitus: A tertiary hospital based cross sectional study

Background: The effects of diabetes on sleep quality are pronounced and have a cause-effect relationship. The major aim of this study was to check for the prevalence of poor sleep quality and associated factors among patients of diabetes mellitus in Pakistan as every 1 in 4th individual is suffering from diabetes in Pakistan. Materials and Methods: A hospital based cross-sectional study was conducted on diagnosed patients of diabetes mellitus from September 2023 to March 2024 using Pittsburgh Sleep Quality Index (PSQI). SPSS v.27 was used for data analysis. Frequencies, percentages for sample characteristics and means for PSQI were calculated. Chi-square and spearman were run for association and correlations respectively. Risk factors were predicted using binary logistic regression. Results: 384 responses were collected with 12 excluded. The prevalence of poor sleepers came out to be 82% and poor sleep was significantly associated and correlated with increasing age, poor glycemic control, and metformin as well as income, education and duration of diabetes respectively. Presence of comorbidities and uncontrolled diabetes were the only associated risk factors. Conclusions: Pakistani population with diabetes mellitus have an extremely high rate of poor sleep quality which should be addressed by adding sleep quality-oriented guidelines in the management of diabetes.

Association of plant and animal protein intake with sleep quality and quality of life in hemodialysis patients: a multicenter cross-sectional study

BackgroundThe current study aimed to evaluate the association between the intake of plant-based protein, animal-based protein, total protein, and the ratio of plant to animal protein with sleep quality and quality of life in patients undergoing hemodialysis.MethodsIn this cross-sectional study, 479 adult patients undergoing dialysis for a minimum of 3 months were included. The dietary intake was calculated using information from a validated 168-item semi-quantitative food frequency questionnaire. Quality of life (QOL) was assessed using the Kidney Disease Quality of Life Short Form (KDQOL-SF 1.3). and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality.ResultsIn this study, the mean age of the participants was 58.18 years (± 14.25 years), with the majority being male (58.2%). After adjusting for potential confounders, significant positive associations were observed between total protein intake (β = 0.12, p = 0.03) and quality of life (QOL). Conversely, there were significant negative associations between the ratio of plant to animal protein intake (β = −0.94, p &amp;lt; 0.01) and QOL. Furthermore, significant negative associations were found between total protein intake (β = −0.02, p &amp;lt; 0.05) and animal protein intake (β = −0.19, p &amp;lt; 0.05) with poor sleep quality. Additionally, there were significant positive associations between the ratio of plant to animal protein intake (β = 0.188, p &amp;lt; 0.05) and poor sleep quality.ConclusionIncreased consumption of animal protein is associated with improved sleep quality and Quality of Life (QOL) in patients undergoing hemodialysis (HD). Further research, especially prospective studies, is required to confirm these associations.

Effectiveness of Ayush Rasayana A and B on the Quality of Life of Older Adults: Protocol for a Cluster Randomized Controlled Trial.

With advancing age among older adults, the associated debilities increase, indicating a deteriorating health status as there is a gradual loss of muscle mass, strength, and functionality. Ayush Rasayana A and B are coded Ayurvedic medicines developed from herbal extracts. This study has been planned to prevent debilitating conditions and improve the quality of life (QOL) in older adults. This study aimed to assess the effectiveness of Ayush Rasayana A and B on the QOL, quality of sleep, and functionality of older adults, along with the tolerability of the intervention. This was a multicenter, open-label, cluster randomized controlled trial conducted with 720 participants aged 60 to 75 years. The participants were divided into 2 groups (intervention and control), with both receiving Ayurvedic ancillary treatment for 3 months. The intervention group additionally received 10 g of Ayush Rasayana A orally once daily at bedtime for 6 days, followed by 1.5 g of Ayush Rasayana B orally twice daily before food for the remaining 84 days. The assessment criteria included the Older People's Quality of Life Questionnaire Brief, Katz Index of Independence in Activities of Daily Living, Pittsburgh Sleep Quality Index, Five Times Sit-to-Stand Test, and shoulder and scapular movements. Any change in hematological and biochemical parameters and occurrence of treatment-emergent adverse events were also assessed during the study period. The recruitment of the participants started in December 2023, and the final follow-up was completed in April 2024. Out of the total 720 enrolled participants, 686 (95.3%) completed the study up to the last follow-up. This study may provide evidence-based data to establish preventive treatment protocols for enhancing the QOL and functionality among older adults. The study results may also be helpful for the planning of interdisciplinary health policies for improving the health conditions of different populations. DERR1-10.2196/58186.

The Impact of Sleep Onset and Efficiency on Body Mass Index among College Students: A Factor Analysis Approach

Sleep is crucial for overall health and well-being, and college students often face sleep issues due to various factors. Inadequate sleep, which affects metabolism and behavior, increases the risk of obesity. Prior studies typically examine individual sleep factors or compare them, neglecting potential interactions and the multidimensional role of sleep in health outcomes. Hence, this study surveyed the seven sleep components using the Pittsburgh Sleep Quality Index (PSQI) to identify factors affecting sleep quality and evaluate its effect on the body mass index of GE-Science, Technology, and Society (GE-STS) students in a private university in Cebu. Three factors were determined through factor analysis: Sleep Health, Sleep Onset and Maintenance Efficiency, and Sleep Disruption Intervention. Moreover, regression analysis supported the significant relationship (p = 0.023) between the sleep onset and maintenance efficiency factor and Body Mass Index (BMI), emphasizing its importance in designing sleep interventions for college students.

Investigation of the Relationship of Sleep Disorder Occurring in Fibromyalgia with Central Nervous System and Pineal Gland Volume.

Mechanisms of sleep disorders in fibromyalgia (FM) patients, such as insomnia, early morning awakenings and poor quality sleep, have not yet been proven and no consistent and effective treatment is yet available. The aim of this study was to investigate the pineal gland volume and the relationship between total fiber count, total fiber volume and total fiber length of the spinoreticular tract involved in regulation of sleep and wakefulness in terms of the mechanism of sleep disturbance. This study included only female cases, 31 with fibromyalgia and 31 controls. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Tractography of targeted pathway from brain diffusion MR images was calculated in DSI Studio program and the volume of the pineal gland was calculated in ITK-SNAP program. The mean volume of the pineal gland was higher in control group (218.84±64.45 mm3) than in fibromyalgia group (174.77±48.65 mm3), which was statistically significant (p=0.004). However, there was no statistically significant difference between two groups in total spinoreticular tract (TSRT), total volume (TSRTV), TSRT FA, TSRT MD, TSRT AD and TSRT RD of spinoreticular tract, which is involved in the regulation of sleep and wakefulness (p>0.05). In conclusion, it is thought that the endocrine system may be more related to sleep disturbance in individuals with FM than central nervous system. Therefore, we believe that it may be more appropriate to work on the endocrine system rather than neural system in the treatment of sleep disturbance in patients with FM.