Poor Sleep Quality Research Articles

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.

Poor sleep hygiene practice and associated factors among adults with epilepsy attending follow up care at Mettu Karl comprehensive specialized hospitals in Illu Ababora Zone and general hospital in Buno Bedele zone, Southwest Ethiopia’

BackgroundGlobally, sleep disorders are an important global public health problem. Poor sleep hygiene is at the core of chronic insomnia and other sleep disorders. Sleep hygiene practices are effective, practical, and affordable, and have no side effects other than other therapies benefiting patients with epilepsy. However, there is no research regarding sleep hygiene practice and its awareness among people with epilepsy in Ethiopia. This study aimed to assess sleep hygiene practice and its factors in patients with epilepsy.MethodsAn institutional-based cross-sectional study was conducted. The study included 424 participants selected through systematic random sampling. An interviewer-administered Sleep Hygiene Index (SHI) questionnaire was used to collect data.The collected data was analyzed using SPSS Version 25.0. Bi-variable and multi-variable analyses were conducted to identify factors related to poor sleep hygiene.ResultsThe frequency of poor sleep hygiene practice among people with epilepsy was 59.5%. Non-adherence to AED (AOR = 1.86, 95% CI: 1.13, 3.23), depression (AOR = 2.10, 95% CI: 1.42, 4.21), poor sleep quality (AOR = 5.7, 95% CI: 3.12, 10.01), anxiety (AOR = 2.71, 95% CI: 1.67, 4.82), and current alcohol drinkers (AOR = 1.74, 95% CI: 1.27, 3.13) were associated with poor sleep hygiene practice.Conclusion and recommendationThe perception of sleep hygiene practice among patients with epilepsy was poor. Non-adherence to AED, depression, poor sleep quality, anxiety, and current use of alcohol were associated with poor sleep hygiene practices. Therefore, regular screening, sleep issue management, and expanded mental health support are crucial. Training programs and awareness strategies to improve sleep hygiene are highly recommended. Professionals should incorporate sleep hygiene in epilepsy care.

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

Abstract Objective: 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. Methods: 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. Results: 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). Conclusion: 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.

Cognitive behavioral therapy-enhanced through videoconferencing for night eating syndrome, binge-eating disorder and comorbid insomnia: a Case Report

Abstract Background Both night-eating syndrome and binge-eating disorder are characterized by episodes of excessive food consumption, significant distress, and functional impairment related to maladaptive eating behaviors. Both types of eating disorders are associated with poorer sleep quality. Cognitive behavioral therapy has demonstrated good outcomes for binge-eating disorder; however, it is unknown if it is effective for night-eating syndrome and comorbid insomnia. Case presentation The current paper presents a case report of a Dutch woman in her 40’s receiving cognitive behavioral therapy-enhanced for night-eating syndrome, as well as binge-eating disorder. However, to tailor the intervention to her specific needs, throughout the course of treatment, cognitive behavioral therapy-insomnia interventions were also implemented. Her comorbid complaints were insomnia, childhood trauma, a depressive mood disorder, and cluster B and C personality traits. She had a history of bariatric surgery, as well as alcohol addiction, and received various treatments in the past, aiming to become abstinent from binge eating. Conclusions Post-treatment, she was abstinent from binge eating and, her scores of various eating disorder measures were below clinical cut-points. However, it is unclear if she would show earlier symptom reduction if she received cognitive behavioral therapy-insomnia, prior to cognitive behavioral therapy-enhanced. In addition, the patient reported an increase in her depressive mood and commenced schema therapy after cognitive behavioral therapy- enhanced. Although common, the underlying cause of symptom shifts in patients with an eating disorder remains largely unknown.

Latent Profile Analysis of Sleep Quality in Pregnant Women With Gestational Diabetes Mellitus and Its Influencing Factors

Background: Sleep problems are prevalent among individuals diagnosed with gestational diabetes mellitus (GDM), significantly impacting their overall quality of life. Objective: This study sought to adopt a person-centered methodology to unveil the latent profiles of sleep quality and identify factors influencing sleep patterns in patients with GDM. Methods: The cross-sectional study gathered sociodemographic features, clinical information, sleep problems (Pittsburgh Sleep Quality Index), personality traits (Type D Personality Scale), social support (Perceived Social Support Scale), and self-efficacy (General Self-efficacy Scale). Latent profile analysis was conducted to identify profiles of sleep quality, while multinomial logistic regression was employed to ascertain the factors influencing these identified profiles. Results: Among the 431 participants, 423 (98.1%) completed the questionnaire, with 53.0% reporting moderate-to-poor sleep quality. This study identified 4 distinct profiles of sleep quality among patients with GDM: the “good sleep quality” group (47.0%), the “poor sleep quality—long sleep duration” group (10.0%), the “moderate sleep quality” group (25.3%), and the “poor sleep quality—short sleep duration” group (17.7%). Individuals with type D personality were associated with the “poor sleep quality—long sleep duration” [odds ratio (OR) = 3.21, P = .005], “moderate sleep quality” (OR = 2.65, P = .003), and “poor sleep quality—short sleep duration” group (OR = 2.31, P = .018). Individuals with a history of GDM were associated with “poor sleep quality—long sleep duration” group (OR = 3.46, P = .005). Conclusions: The research revealed significant classification characteristics of sleep quality in patients with GDM, offering valuable insights for tailoring interventions to address distinct subcategories of sleep-related issues.

Does sleep moderate the effects of exercise training or complex mental and social activities on cognitive function in adults with chronic stroke? Secondary analysis of a randomized trial

Abstract Background Exercise (EX) or cognitive and social enrichment (ENRICH) are two strategies for promoting cognition post-stroke. Whether sleep moderates the effects of EX or ENRICH on cognition in adults with chronic stroke is unknown. Methods A three-arm parallel randomized clinical trial among community-dwelling adults aged 55+ years with chronic stroke (i.e., ≥12 months since stroke). Participants were randomized to 2x/week EX, ENRICH, or balance and tone control (BAT). At baseline, device-measured sleep duration and efficiency were measured using wrist-worn actigraphy; self-reported quality was measured by Pittsburgh Sleep Quality Index (PSQI). Participants were categorized at baseline as having good or poor device-measured duration, device-measured efficiency, or self-reported quality based on PSQI. The primary cognitive outcome was Alzheimer’s Disease Assessment Scale Plus (ADAS-Cog-Plus) measured at baseline, 6 months (end of intervention), and 12 months (6-month follow-up). We examined if baseline sleep categorizations (i.e., good/poor) moderated effects of EX or ENRICH on ADAS-Cog-Plus. Results We enrolled 120 participants in the trial (EX=34; ENRICH=34; BAT=52). Sleep quality (i.e., device-measured sleep efficiency or self-reported sleep quality) categorization moderated effects of EX (but not ENRICH) on ADAS-Cog-Plus. Compared with BAT participants with poor sleep quality, EX participants with poor sleep quality had better ADAS-Cog-Plus performance at 6 months (estimated mean difference for those with poor device-measured sleep efficiency: -0.48; 95% CI:[-0.85, -0.10]; p=0.010); estimated mean difference for those with poor self-reported sleep quality: -0.38; 95% CI:[-0.70, -0.07]; p=0.014). There was no effect of EX on ADAS-Cog-Plus for participants with good sleep quality. Device-measured sleep duration did not moderate intervention effects. Conclusion Exercise is particularly beneficial in improving cognitive function in adults with chronic stroke and poor sleep quality.

Sleeping habits and aortic stiffness in middle-aged men and women from the general population: insights from the SCAPIS study

Background The relationship between sleeping habits and aortic stiffness remains inconclusive and is not fully explored in the European general population. Methods We examined cross-sectionally 8659 participants from the Swedish population-based cohort Swedish CArdioPulmonary bioImage Study (SCAPIS), mean age 57.5 years, 52.1% women. A self-administered questionnaire on sleeping habits (duration, quality, insomnia, and daytime sleepiness) was administered. Aortic stiffness was examined by the gold-standard method, carotid-femoral pulse wave velocity (c-f PWV) using Sphygmocor® XCEL, continuously and stratified by cut-off of >10 m/s. Multivariable linear and logistic regression were performed stratified by sex. Results Out of 8659 subjects (mean c-f PWV of 9.4 ± 1.9 m/s), 32.3% had c-f PWV >10 m/s, defined as aortic stiffness. Compared with subjects with c-f PWV ≤10 m/s, individuals with aortic stiffness reported more insomnia (p = 0.01) but less daytime sleepiness (p = 0.008). Men and women with poor sleep quality had 0.2 m/s lower mean c-f PWV compared with subjects with good sleep quality (p = 0.004). No difference in mean PWV was found in men and women with shorter/longer sleep duration (p > 0.05). In the multivariable regression models, no significant association was found between poor sleep quality, shorter (≤6 h) or longer (≥9 h) sleep duration and aortic stiffness in the total population, neither among men nor women (all p > 0.05), independently of cardiovascular risk factors. Conclusions Short and long sleep duration and poor sleep quality are not associated with aortic stiffness, measured with the gold-standard method c-f-PWV, in middle-aged men and women from the Swedish general population, independently of cardiovascular risk factors.

The Influence of Autogenic Relaxation Therapy on Sleep Quality in Elderly Residents at the Rumoh Seujahtra Geunaseh Sayang Social Home, Ulee Kareng, Banda Aceh

Aging is a stage in life marked by a decline in the body’s ability to adapt to its surroundings, leading to various health issues, including impaired sleep quality. One non-pharmacological intervention to address sleep disturbances is autogenic relaxation therapy, which helps modulate physiological responses and can enhance sleep quality for elderly. This study aimed to assess the impact of autogenic relaxation therapy on the sleep quality of elderly residents at the Rumoh Seujahtra Geunaseh Sayang Social Home in Ulee Kareng, Banda Aceh. This pre-experimental research employed a one-group pretest-posttest design. The population consisted of 59 elderly individuals, with a purposive sampling technique used to select a sample of 37 participants. Data were collected using a structured questionnaire. The study was conducted from May 17-19, 2024, at the Rumoh Seujahtra Geunaseh Sayang Social Home. The findings revealed that prior to the intervention, the majority of participants (78.9%, or 29 respondents) had poor sleep quality, while after receiving autogenic relaxation therapy, 59.5% (22 respondents) exhibited good sleep quality. Statistical analysis using the non-parametric Wilcoxon test showed a significant improvement in sleep quality with a p-value of 0.000 (p < 0.05). The study concluded that autogenic relaxation therapy has a positive effect on improving sleep quality in the elderly at the Rumoh Seujahtra Geunaseh Sayang Social Home, Ulee Kareng, Banda Aceh. It is recommended that elderly residents incorporate autogenic relaxation therapy into their routines to enhance sleep quality.

Long-term health outcomes of COVID-19 in ICU- and non-ICU-treated patients up to 2 years after hospitalization: a longitudinal cohort study (CO-FLOW)

BackgroundMany patients hospitalized for COVID-19 experience long-term health problems, but comprehensive longitudinal data up to 2 years remain limited. We aimed to (1) assess 2-year trajectories of health outcomes, including comparison between intensive care unit (ICU) treated and non-ICU-treated patients, and (2) identify risk factors for prominent health problems post-hospitalization for COVID-19.MethodsThe CO-FLOW multicenter prospective cohort study followed adults hospitalized for COVID-19 at 3, 6, 12, and 24 months post-discharge. Measurements included patient-reported outcomes (a.o., recovery, symptoms, fatigue, mental health, sleep quality, return to work, health-related quality of life [HRQoL]), and objective cognitive and physical tests. Additionally, routine follow-up data were collected.Results650 patients (median age 60.0 [IQR 53.0–67.0] years; 449/650 [69%] male) surviving hospitalization for COVID-19 were included, of whom 273/650 (42%) received ICU treatment. Overall, outcomes improved over time. Nonetheless, 73% (322/443) of patients had not completely recovered from COVID-19, with memory problems (274/443; 55%), concentration problems (259/443; 52%), and dyspnea (251/493; 51%) among most frequently reported symptoms at 2 years. Moreover, 61% (259/427) had poor sleep quality, 51% (222/433) fatigue, 23% (102/438) cognitive failures, and 30% (65/216) did not fully return to work. Objective outcome measures showed generally good physical recovery. Most outcomes were comparable between ICU- and non-ICU-treated patients at 2 years. However, ICU-treated patients tended to show slower recovery in neurocognitive symptoms, mental health outcomes, and resuming work than non-ICU-treated patients, while showing more improvements in physical outcomes. Particularly, female sex and/or pre-existing pulmonary disease were major risk factors for poorer outcomes.Conclusions73% (322/443) of patients had not completely recovered from COVID-19 by 2 years. Despite good physical recovery, long-term neurocognitive complaints, dyspnea, fatigue, and impaired sleep quality persisted. ICU-treated patients showed slower recovery in neurocognitive and mental health outcomes and resumption of work. Tailoring long-term COVID-19 aftercare to individual residual needs is essential. Follow-up is required to monitor further recovery.Trial registration: NL8710, registration date 12-06-2020.

Sleep quality and the need for recovery among nurses working irregular shifts: A cross-sectional study.

Shift work affects the mental and physical health of nurses, yet the effect of working irregular shifts on sleep and its association with the need for recovery is under-explored. The purpose of this study was to investigate the sleep quality of nurses working irregular shifts, including night shifts, and to determine whether sleep quality is associated with the need for recovery. This cross-sectional study included 405 nurses working irregular shifts. Data were collected using an online questionnaire that included sociodemographic characteristics, the Sleep-Wake Experience List, sleep problems, sleep duration, and the Need for Recovery scale. Data analyses included descriptive statistics, chi-square tests, t-tests, logistic and multiple linear regressions. Nurses who worked irregular shifts had poor sleep quality. Those who also worked night shifts, had significantly poorer sleep quality and experienced more difficulties in daily functioning than those who did not work night shifts. Sleep quality was significantly associated with the need for recovery and this remained so after controlling for confounding variables (β= .554, p = .001). The findings indicate that in nurses who work irregular shifts, the sleep quality is low. In this group, the sleep quality in nurses who work night shifts is lower than in nurses who do not work night shifts. Furthermore, better sleep quality was associated with lower need for recovery. These findings suggest that improving sleep quality in nurses working irregular shifts may lower their need for recovery, which may improve health, and reduce burnout and sickness absence.

Deterioration Patterns in Patients Admitted for Severe COPD Exacerbation

Background: Chronic obstructive pulmonary disease (COPD) exacerbations represent significant clinical events marked by worsening respiratory symptoms, often necessitating changes in medication or hospitalization. Identifying patterns of exacerbation and understanding their clinical implications are critical for improving patient outcomes. This study aimed to identify exacerbation patterns in COPD patients using variations in the COPD Assessment Test (CAT) scores and compare clinical characteristics and comorbidities among patients with different exacerbation patterns. Methods: An observational study was conducted involving COPD patients admitted for severe exacerbations. The administered CAT questionnaire referred to two periods: 1) the period during hospital admission and 2) the stable period two months prior to admission. Results: Fifty patients (60% male, mean age 70.5 years, standard deviation [SD] 9.6) were included; of these, eight (16%) were active smokers. Significant worsening in CAT scores during the exacerbation compared to the stable period was observed (25 vs. 13.5, p < 0.001). Three exacerbation patterns were identified: increased cough and sputum (cluster 1); increased dyspnea and activity limitation (cluster 2); and poorer sleep quality and lower energy (cluster 3). No significant differences were found regarding demographics and lung function. Conclusions: Three distinct exacerbation patterns were identified in COPD patients based on CAT score variations, suggesting that exacerbations are heterogeneous events. Future studies with larger sample sizes and prospective follow-up are necessary to validate these findings and explore their clinical and prognostic implications.

Beyond dialysis: Assessing therapeutic regimen compliance and sleep quality in chronic renal failure patients undergoing maintenance hemodialysis in Saudi Arabia.

Given its potential to impact physical and mental health, sleep quality is one of the most significant clinical outcomes among hemodialysis patients. Patients undergoing hemodialysis are required to adhere to an intricate treatment plan that consists of regular hemodialysis treatments, dietary and fluid restrictions, and a multi-drug regimen. Investigate the relationship between adherence to a therapeutic regimen and sleep quality among chronic renal failure patients undergoing maintenance hemodialysis. A descriptive correlational research design was followed. The study was conducted at the hemodialysis units in Hafr Albatin City, specifically at Hafr Albatin Central Hospital and King Khaled Hospital, Saudi Arabia. A convenience sample of 100 adult patients was selected for the study. The Hemodialysis Patients Adherence Questionnaire and Pittsburgh Sleep Quality Index were utilized to collect the data in 5 months from September 20, 2023 to February 15, 2024. The study revealed that more than half of the studied patients adhered to the therapeutic regimen, while (46%) did not adhere to it. More than half of the patients had poor sleep quality and were nonadherent to diet and fluid restrictions. Overall adherence score is negatively correlated with the global sleep quality score (r = -0.368, p < 0.001), indicating that poorer sleep quality is associated with lower overall adherence to the therapeutic regimen. While a significant proportion of the patients demonstrated adherence to overall therapeutic regimens, including dialysis sessions and medication intake, there was notable nonadherence to fluid and diet restrictions. Poor sleep quality, prevalent among two-thirds of the participants, correlates negatively with adherence to therapeutic regimens.

The mediating role of surface and deep acting and the moderating effect of occupational identity in workplace violence and sleep quality among psychiatric nurses: a cross-sectional study.

Psychiatric nurses often encounter patients with mental health disorders and consequently experience prolonged periods of high stress, increased workload, and frequent incidents of workplace violence. These aspects can lead to a higher incidence of poor sleep quality. This study examined the interplay between workplace violence and emotional labour (surface and deep acting) to suggest measures for enhancing sleep quality among psychiatric nurses. A total of 300 completed and valid online questionnaires were collected. The Pittsburgh Sleep Quality Index was used to measure sleep quality, Workplace Violence Scale (WVS) to measure the occurrence of workplace violence, and Emotional Labour Scale to measure surface and deep acting. The data were analysed using Hayes' PROCESS macro with SPSS. Independent samples t-tests and one-way ANOVA were used to compare differences in sleep quality and emotional labour (surface and deep acting) between psychiatric nurses with different demographics. The prevalence of poor sleep quality (PSQI > 5) was 55% among the nurses. Surface acting in emotional labour partially mediated the relationship between workplace violence and sleep quality(a1*b1=0.035,95%CI: 0.002, 0.079), whereas deep acting had a suppressive effect(a2*b2=-0.033,95%CI: -0.071, -0.003). Occupational identity had a positive moderating effect on the relationship between workplace violence and surface acting(Effect=0.091,95%CI: 0.004, 0.179). The relationship between workplace violence and poor sleep quality was partially mediated by surface acting and suppressed by deep acting. Moreover, nurses with higher occupational identity engaged in more surface acting after workplace violence. Workplace violence, surface acting, and deep acting emerged as significant factors influencing sleep quality among psychiatric nurses. Deep acting can reduce the impact of workplace violence on sleep quality. The results provide a new and expanded view of the interplay between workplace violence and emotional labour concerning sleep quality. Interprofessional collaboration with clinicians, administrators, educators, and spiritual leaders can contribute to the development of related education and training. Chinese Clinical Trial Registry ChiCTR2200062347. https://www.chictr.org.cn/showproj.html?proj=173264.

Sleep quality and hypertension in an indigenous African population: a cross-sectional investigation from the COMBAT-CVDs study.

Hypertension is a major risk factor for cardiovascular events worldwide, and little is known about its association with sleep quality (SQ) among Africans. We evaluated the association of SQ with hypertension among adults in Ibadan, Nigeria. In Ibadan and its suburbs, we identified 3635 participants in the door-to-door Community-based Investigation of the Risk Factors for Cardiovascular Diseases (COMBAT-CVDs) study. SQ was self-reported, and SQ scores were classified by the tertile distribution in this sample as good(<9), moderate(10-18), and poor(≥19), and hypertension was defined as one of the following conditions: systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg or prior diagnosis by a certified health professional or current use of blood pressure-lowering drugs. Using good SQ as a reference, logistic regression models were used to estimate the multivariable-adjusted odds ratio and 95% confidence interval (CI) for odds of hypertension by tertiles of SQscores in a two-sided test at p < 0.05. In all, 1182 (32.5%) had poor SQ, 903 (24.8%) had hypertension, and the mean(±SD) age was 35.3 ± 15.2 years in this sample. The multivariable-adjusted odds of hypertension by tertiles of SQ scores (using good SQ as reference) were OR: 1.13 (95% CI: 0.92, 1.38) for moderate SQ, and OR: 1.29 (95% CI: 1.05, 1.59) for poor SQ; P for trend = 0.06 after adjusting for relevant covariates. Poor SQ is associated with higher odds of hypertension in this sample. The imperative of culturally sensitive interventions to improve SQ would be promising in managing poor sleep-associated hypertension burdenin this population.

The association between nicotine dependence and sleep quality in patients referred to a smoking cessation outpatient clinic: A cross-sectional study.

Nicotine addiction is one of the most common forms of dependence. It is shown to be associated with many chronic diseases that develop mostly through smoking. The association between sleep quality and smoking or nicotine addiction has not been clarified yet. This study aimed to investigate the association between nicotine addiction and sleep quality. In this cross-sectional study, the Epworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), Fagerström test for nicotine dependence (FTND), and Hospital anxiety-depression scale (HADS) were administered to patients who applied to the smoking cessation outpatient clinic of a reference hospital between April and June 2023. FTND measured nicotine dependence, and its association with sleep quality estimated by PSQI was assessed by binary logistic regression with the potential confounders. In the study group of 280 participants, 67.1% were male, and 57.8% had poor sleep quality. The median (IQR) FNTD score was 7.0 (3.0), and the median global PSQI score was 6.0 (5.0). Poor sleep quality increased by 1.12 times (AOR=1.12; 95% CI: 1.02-1.22, p=0.016) for each unit increase in hospital anxiety score and by 1.22 times (AOR=1.22; 95% CI: 1.05-1.42, p=0.011) for each unit increase in FTND score. Increased nicotine dependence and anxiety are independently associated with poor sleep quality. The findings support smoking cessation efforts. It is recommended to study the effect of combating anxiety and tobacco addiction to improve sleep quality.

Mental health and sleep in the post-COVID-19 era among Thai undergraduate students

The purpose of this study was to examine mental health problems and sleep quality among undergraduate students in the post-COVID-19 era, as well as related factors. This cross-sectional study involved 627 undergraduate students from Chiang Mai University in northern Thailand between October and December 2022. Data were collected using a self-administered online questionnaire that included the General Health Questionnaire-12 (GHQ-12), the Center for Epidemiologic Studies-Depression Scale (CES-D), and the Pittsburgh Sleep Quality Index (PSQI). The study found that 57.9% of participants experienced mental health problems (95% CI: 54.0–61.8), 32.2% experienced depression (95% CI: 28.5–35.9), and 68.1% reported poor sleep quality (95% CI: 64.4–71.8). Multiple logistic regression analysis revealed that medical conditions, relationships with family members, relationships with friends or other people, having problems while studying at university, and self-perceived COVID-19 impact score were all associated with mental health problems and poor sleep quality (p < 0.05). Depression was associated with the field of study, relationships with family members, relationships with friends or other people, having problems while studying at university, and self-perceived COVID-19 impact score (p < 0.05). The findings highlight a significant occurrence of poor sleep and mental health issues, including depression, among undergraduate students in the post-COVID-19 era, underscoring the need for ongoing mental health monitoring and interventions to mitigate negative outcomes.

The moderating role of protective factors in shift work disorder and health outcomes: A cross-sectional study

ABSTRACT This study investigated whether sleep-specific (e.g. chronotype) and traditional (e.g. resilience) protective factors were associated with reduced shift work disorder (SWD) risk and explored their role as moderators in the relationship between SWD risk and health. Shift workers (n = 126) participated in a cross-sectional study evaluating SWD risk (i.e. low vs. high; SWD-screening Questionnaire), mental health (Patient Health Questionnaire-9; Generalized Anxiety Disorder Questionnaire-7), physical health (Subjective Health Complaints Inventory), sleep (Pittsburgh Sleep Quality Index; Insomnia Severity Index; Epworth Sleepiness Scale), and protective factors (Resilience Scale; Social Provisions Scale; Survey of Perceived Organizational Support; Short Impulsive Behavior Scale; Circadian Type Inventory; reduced-Morningness-Eveningness Questionnaire). Logistic regressions revealed lower sleep languidity was associated with reduced odds (OR = 0.88 [0.79,0.96]) for having high SWD risk. Multiple regression analyses showed in shift workers with high social support or morningness, having high SWD risk was not associated with increased depression symptoms, or insomnia severity and poor sleep quality, respectively. Finally, in those with high or medium levels of perceived organizational support, high SWD risk was not associated with increased gastrointestinal and allergy complaints. Longitudinal research with larger samples is needed to confirm the moderating role of protective factors in the relationship between SWD risk and health.

Advancing Measurement of Correctional Officer Health and Wellness: A Pilot Study of Wearable Biometric Sensor Devices

Correctional work is associated with high levels of stress and poor sleep quality. Although previous research has primarily relied on correctional officers’ perceptions of these outcomes, biometric indicators can provide more objective and continuous information. Using daily data points collected from smartwatches worn by 15 prison staff over a six-week period with a single-subject ABA research design involving two control phases and a mindfulness activity phase, this pilot study establishes a proof of concept for using wearable biometric sensor devices to study correctional staff health and well-being. By applying longitudinal mixed effects regression models with a GAMLSS framework, this study finds that biometric measures are sensitive to change, such that stress was reduced and sleep quality improved among participants during the mindfulness activity phase. Participating staff complied with and felt positively about the research protocols. Several important lessons for advancing measurement in future correctional health and wellness research are discussed.

Health Anxiety, Sleep Quality in Healthcare Workers Under Critical Conditions of Emerging Diseases

Background: One of the crises recently affecting human society is an emerging pandemic that has had a significant psychological impact on healthcare workers. Studies have shown that staff experience psychological disorders such as anxiety, depression, and insomnia when exposed to crises. Objectives: This study aimed to determine the association between health anxiety and the sleep quality of healthcare workers during crisis conditions. Methods: This cross-sectional, correlational descriptive-analytical study was conducted from late February 2019 to late March 2020. Using convenient sampling, 382 healthcare workers from medical universities in Golestan province participated in the survey. Data were collected via an internet link shared with participants through WhatsApp working groups. The instruments used in this research included demographic information, sleep quality, and health anxiety inventories. The data were analyzed using SPSS-21 with descriptive and analytical statistics. Results: Of the participants, 77.2% were women, 65.4% were single, 60.7% were nurses, and 64.4% had a bachelor's degree. The results revealed that 72.7% of the staff experienced moderate to high levels of anxiety. Regarding sleep quality, 28.3% (n = 108) of healthcare workers reported good sleep quality, while 71.7% (n = 274) reported poor sleep quality. Additionally, the results indicated a significant correlation between health anxiety scores and sleep quality scores (r = 0.129, P = 0.01). Conclusions: The results of this study showed that the critical conditions caused by emerging diseases have led to health anxiety among healthcare workers, negatively affecting their sleep quality. Therefore, medical center officials must address such psychological issues and implement preventive measures to maintain the mental health of healthcare workers.

Sleep quality and associated factors in adults living in the southern Brazil: A population-based study

ObjectiveTo analyze sleep quality and associated socio-demographic and lifestyle factors in participants from a city originally colonised by Germans in southern Brazil. MethodsA cross-sectional population-based study of 2333 individuals aged 20 to 79 years. Data was collected by interview using a structured questionnaire. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The prevalence of poor sleep quality (PSQI score five or more) was estimated and the associations with study variables were measured by crude and adjusted prevalence ratios using Poisson regression. Resultsparticipants were mostly women (50.9 %), with an average age of 43.3 years. The median total PSQI score was 4 (IQ = 3-7). The frequency of poor sleep quality was 32.7 % (95 % CI 30.7-34.4), higher in older adults (44.0 % vs 30.7 %; p<0.001) and women (40.0 % vs 25.2 %; p<0.001). Multivariate analysis showed that women (PR = 1.3; 95%CI 1.1- 1.5; p<0.001), former smokers (PR = 1.2; 95%CI 1.0-1.4; p = 0.014), current smokers (PR = 1.3; 95%CI 1.1-1.5; p = 0.006), depression (PR = 1.5; 95%CI 1.3-1.7; p<0.001), taking 5 or more medications (PR = 1.2; 95%CI 1.1-1.4; p = 0.001), self-perceived fair health (PR = 2.1; 95%CI 1.8-2.4; p<0.001) or poor/very poor health (PR = 2.6; 95%CI 2.1-3.1; p<0.001) were risk factors for poor sleep quality. Germanic culture (PR = 0.8; 95%CI 0.7-0.9; p<0.001), high school (PR = 0.8; 95%CI 0.6–1.0; p = 0.046) or elementary school (PR = 0.7; 95%CI 0.6-1.0; p = 0.025) or being at work (RP = 0.8; 95%CI 0.7-0.9; p = 0.002) were inversely associated with poor sleep quality. ConclusionsWomen, older adults and some clinical, social, cultural and behavioural conditions are associated with poor sleep quality.