Prevalence Of Sleep Disturbances Research Articles

The implication of sleep disturbances on daily executive functioning and learning problems in children with autism without intellectual disability

BackgroundIndividuals with autism spectrum disorder (ASD) often have sleep disturbances, executive functioning difficulties, and learning problems. The aim of this study was twofold. First, to examine the quality of sleep in children with ASD without intellectual disability and typically developing (TD) children. Second, to explore the implication of sleep disturbances in the association between daily executive functioning and learning problems in children with ASD without intellectual disability. MethodThe sample included 47 children with autism without intellectual disability and 32 TD children. Parent-reported questionnaires were used to assess participants' sleep disturbances, daily executive functions, and learning problems. All statistical analyses performed were adjusted for age, IQ, and medication. ResultsAs expected, the prevalence of sleep disturbances was significantly higher in the ASD group than in the TD group. Regarding the second aim of the study, the total score of sleep disturbances was significantly associated with learning problems and the metacognition subdomain of executive functioning in children with autism without intellectual disability. In turn, executive functions and learning problems were also significantly associated. Finally, sleep disturbances were found to mediate the relationship between global executive functioning and learning problems in children with ASD without intellectual disability. ConclusionsThe findings suggest that sleep disturbances are common in children with autism, and that they play a mediating role in the association between executive functions and learning problems. Therefore, sleep should be a crucial aspect of interventions to improve the learning and academic performance of school-aged children with ASD without intellectual disability.

A cross-sectional study of sleep disturbance among middle-aged cancer patients at Vietnam National Cancer Hospital.

Sleep disorders are common in cancer patients and have negative consequences for patient well-being and treatment outcomes. This study aimed to investigate sleep quality and related factors in Vietnamese middle-aged cancer patients. A cross-sectional study was conducted on 246 middle-aged in-patient cancer patients at Vietnam National Cancer Hospital (VNCH) from 1/2021 to 7/2021. Sleep was measured by the Pittsburgh Sleep Quality Index (PSQI), with a cutoff of 5. The results showed a male/female ratio of 0.85 with an average age of 52. The five most prevalent cancer types were breast, colorectal, lung, and esophagus-stomach cancer, primarily in the late stage and treated with chemotherapy. The prevalence of sleep disturbances was 58.5%. The mean PSQI score was 7.5, with sleep duration and latency of 5.4 h and 1 h, respectively. Approximately 44% of participants reported poor sleep quality, nearly 9% had daytime dysfunction, and 10.6% used sleep medication. The multivariate logistic regression results indicate that people with depression were 8.89 times more likely to have poor sleep than those without depression (95% CI:2.63-28.27, p < .001). Sleep problems are common among middle-aged people with cancer in Vietnam, especially individuals with depression. It is necessary to have more effective approaches to sleep management for cancer patients with limited resources.

Sleep Pattern and Diabetes: Finding from a Cross-Sectional Study in Iraq

Aim: Diabetes is a seriously debilitating disease with deleterious complications associated with physical and psychological aspects of diabetic patients. Sleep quality in diabetics is affected by various factors such as the duration of the disease and its complications. The study aimed to investigate the prevalence of poor sleep quality among type 2 diabetic patients and it is relation to glycemic control. Methods: Comparative cross-sectional study to investigate the prevalence of sleep disturbances among type 2 diabetes mellitus patients was conducted. Face to face interview was used to obtain participant’s information by using a validated questionnaire. The value of fasting blood sugar or random blood sugar and HbA1c were also obtained. Results: Among 380 type 2 diabetes mellitus, 76.8% had poor sleep quality. No significant correlation was found between age, body-mass index, duration of diabetes, and duration of comorbid disease. Sleep showed a significant association with HbA1c, gender, educational level, employment and monthly income. Conclusion: Sleep disorder is a common problem among diabetic patients, in this study about two third of patients with type 2 diabetes mellitus had poor sleep quality. Bad sleep has a negative impaction on glycemic control so it is important to focus on sleep quality and try to improve it to maintain accepted glycemic control and reduce the risk of diabetic complications. Keywords: type 2 diabetes, sleep, glycemic control, sleep quality

An Artificial Intelligence Platform to Stratify the Risk of Experiencing Sleep Disturbance in University Students After Analyzing Psychological Health, Lifestyle, and Sports: A Multicenter Externally Validated Study.

Sleep problems are prevalent among university students, yet there is a lack of effective models to assess the risk of sleep disturbance. Artificial intelligence (AI) provides an opportunity to develop a platform for evaluating the risk. This study aims to develop and validate an AI platform to stratify the risk of experiencing sleep disturbance for university students. A total of 2243 university students were included, with 1882 students from five universities comprising the model derivation group and 361 students from two additional universities forming the external validation group. Six machine learning techniques, including extreme gradient boosting machine (eXGBM), decision tree (DT), k-nearest neighbor (KNN), random forest (RF), neural network (NN), and support vector machine (SVM), were employed to train models using the same set of features. The models' prediction performance was assessed based on discrimination and calibration, and feature importance was determined using Shapley Additive exPlanations (SHAP) analysis. The prevalence of sleep disturbance was 44.69% in the model derivation group and 49.58% in the external validation group. Among the developed models, eXGBM exhibited superior performance, surpassing other models in metrics such as area under the curve (0.779, 95% CI: 0.728-0.830), accuracy (0.710), precision (0.737), F1 score (0.692), Brier score (0.193), and log loss (0.569). Calibration and decision curve analyses demonstrated favorable calibration ability and clinical net benefits, respectively. SHAP analysis identified five key features: stress score, severity of depression, vegetable consumption, age, and sedentary time. The AI platform was made available online at https://sleepdisturbancestudents-xakgzwectsw85cagdgkax9.streamlit.app/, enabling users to calculate individualized risk of sleep disturbance. Sleep disturbance is prevalent among university students. This study presents an AI model capable of identifying students at high risk for sleep disturbance. The AI platform offers a valuable resource to guide interventions and improve sleep outcomes for university students.

The Association of Salivary Flow Rate and Sleep Quality among Head and Neck Cancer Survivors after Radiotherapy

BackgroundHead and neck cancer survivors suffer from xerostomia and sleep disturbances after radiotherapy, both of which affect their quality of life. This study aimed to explore the role of salivary flow in the oral health and sleep quality of head and neck cancer survivors.MethodsWe recruited 120 head and neck cancer survivors who were experiencing symptoms of dry mouth or sleep disturbances post-radiotherapy from a dental clinic. We gathered their socio-demographic and clinical data, measured their salivary flow rate, and recorded their dry mouth score using the summated xerostomia inventory. Additionally, a dentist collected the DMFT (Decayed, Missing, and Filled Teeth) index. The Pittsburgh Sleep Quality Index was employed to assess their sleep quality.ResultsIn this study, xerostomia was observed in nearly 80% of the cancer survivors. The concurrent prevalence of sleep disturbance and xerostomia was at 55%. After five years post-radiotherapy, there was a significant improvement observed in both the quality of sleep (p = 0.03) and the stimulated salivary flow rate (p = 0.04). Additionally, these improvements were noted to have commenced from the third year onwards. A significant association was found between stimulated salivary flow and dry mouth scores with poor sleep quality (p < 0.05).ConclusionsWe recommend that dental professionals prioritize managing both dental and mental health issues equally for head and neck cancer survivors who have undergone radiotherapy within the past 3 years.

The prevalence of sleep disturbance and its possible associated factors among iranian medical students: A cross-sectional study with a national meta-analysis

BackgroundThe aim of this cross-sectional study was to investigate the prevalence of sleep disturbance and its possible associated factors among Iranian medical students. Additionally, a national meta-analysis was conducted to provide a comprehensive overview of sleep disturbance in this population. MethodsA sample of medical students from Guilan University of Medical Sciences, Iran was included in the study. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep disturbance. Demographic and lifestyle factors, as well as academic performance, were collected through a self-administered questionnaire. The data collected from this study were combined with existing studies through a meta-analysis to estimate the overall prevalence of sleep disturbance among Iranian medical students using the random effects model. ResultsA total of 249 medical students participated in the study. The prevalence of sleep disturbance among Guilan University of Medical Sciences medical students was found to be 71.1%. A significant difference was observed in total PSQI means regarding medical students’ residency (p < 0.001) and their duration of sleep in the last 24 h (p = 0.006). The national prevalence of sleep disturbances was 59% (95% CI: [51%–66%], I2 = 97%). ConclusionSleep disturbance is highly prevalent among Iranian medical students, with various factors contributing to its occurrence. The findings of this study highlight the need for interventions and strategies to improve sleep quality and overall well-being among this population. The national meta-analysis provides valuable insights into the overall burden of sleep disturbance among Iranian medical students and can serve as a reference for future studies and public health initiatives targeting this issue.

Sleep disturbance and suicidal ideation mediated by psychotic-like experiences in adolescents: a two-wave longitudinal study.

Sleep disturbance may cause suicidal ideation (SI). This study aimed to examine their co-occurrence rate among adolescents and investigate whether psychotic-like experiences (PLEs) mediate this association. A total of 17 722 Chinese adolescents were included in this two-wave longitudinal study. The baseline survey (time 1, T1) was conducted between April 21 and May 12, 2021, and the follow-up survey (time 2, T2) was implemented between December 17 and 26, 2021. At T1, participants completed questionnaires to assess their sleep disturbance, sleep duration, PLEs, SI, depressive symptoms, and sociodemographic characteristics. At T2, participants reported their PLEs, SI, and negative life events. The SI prevalence decreased from 20.2% (T1) to 18.4% (T2). Participants with SI showed significantly higher prevalence of sleep disturbance and short sleep duration compared to those without SI. Baseline sleep disturbance and short sleep duration were both associated with the increased risk of SI 6 months later. These longitudinal links were mediated by PLEs, independent of baseline covariates and negative life events. These findings provide a novel insight into the mechanism linking sleep problems and suicidality, and stress the significance of assessing and addressing sleep problems and PLEs for adolescent suicide prevention and intervention.

Sleep disturbance and its associated factors among pregnant women in Ethiopia: systematic review and meta-analysis

IntroductionGlobally, sleep disturbance is the foremost public health issue among pregnant women which might have undesirable birth outcome including neurocognitive impairment, preterm birth, low birth weight, and neonatal morbidity and mortality. In Ethiopia, inconsistent findings have been reported on the prevalence of sleep disturbance among pregnant women. Therefore, this review aims to estimate the pooled prevalence sleep disturbance and its associated factors among pregnant women in Ethiopia.MethodsThis systematic review and meta-analysis of observational studies was designed according to the PRISMA guideline. A systematic search of literature was conducted in PubMed, Scopus, Web of science, and Google Scholar using relevant searching key terms. The Newcastle-Ottawa scale was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger’s test and funnel plot. Cochran’s chi-squared test and I2 values were used to assess heterogeneity. A fixed-effects model was applied during meta-analysis.ResultsIn this review, six studies were included after reviewing 17,100 articles. The pooled prevalence of sleep disturbance among pregnant women in Ethiopia was 50.43% (95%CI: 39.34–61.52). Third trimester pregnancy AOR = 4.03; 95% CI: 2.84,5.71), multigravidity (AOR = 1.99; 95% CI: 1.54, 2.59), unplanned pregnancy (AOR = 2.56; 95% CI: 1.52,4.31), depression (AOR = 3.57; 95% CI: 2.04, 6.27), stress (AOR = 2.77; 95% CI: 1.57, 4.88), anxiety (AOR = 3.69; 95% CI: 1.42, 9.59) and poor sleep hygiene (AOR = 2.49; 95% CI: 1.56, 3.99) and were statistically associated with sleep disturbance among pregnant women.ConclusionThis review revealed that the magnitude of sleep disturbance among pregnant woman in Ethiopia was relatively high and multiple factors determined the likelihood of having a disturbed sleep-awake pattern. Thus, the implementation of interventions for sleep disturbance after screening pregnant women is needed. Moreover, public health interventions targeted on the prevention of unintended pregnancy and depression during pregnancy should be implemented.

Sleep In Infants –A Pilot Study In North Karnataka

Background: Normal growth and development, emotional wellness, and immune function all require adequate sleep. Sleep is commonly thought to be a time when the mind and body relax and recover, but in reality, sleep is a period of significant neuronal and physiological activity. This study intends to find the prevalence of sleep disturbance in typically developing infants.Methodology:The study included 60 participants. The parents of the participants who met the study criteriawere administered a questionnaire including demographic details of the child and questions pertaining to the sleep behaviour of their child during the first 12 months of life. The data collected was subjected to appropriate statistical analysis.Result: The study included 60 participants of either gender in the age group of 12-24 months. The mean birthweight of all the children was 2891.6 (±553.9) grams. The mean age of sleep development of all participants was 4.18 (±2.61) months. Pearson’s correlation analysis revealed that there was no statistical significance between mother’s age at delivery and birth weights or sleep development age of children. Also,the birth weight and sleep development age of children didn’t correlate with each other.A large number [50(83%)] of children developed the sleep pattern by 6 months of age, which was significant at a z-value of 7.303 at p-value of &lt;0.00001.Discussion: The mean birth weight of boys was higher than the girls. The boys also developed the circadiansleep wake cycle slightly later than girls. However, no significant correlation was found between birth weights and sleep development ages of children. Majority of the infants developed the sleep rhythm in first 6 months of life whereas a small proportion developed it later till 12 months of age.Conclusion: The boys developed the circadian sleep wake cycle slightly later than the girls. However,maximumchildren developed the sleep pattern by 6 months.

A Survey of Sleep Quality From a Post-COVID Clinic.

To assess the prevalence of sleep disturbance among patients evaluated at a clinic for patients afflicted with Post-acute sequelae of COVID-19 (PASC). Sleep disturbance was assessed with the Patient-Reported Outcomes Measurement Information System-Sleep Disturbance (PROMIS-SD) framework among adult patients of the PASC clinic. Among 312 patients, the mean age was 46.2 years, and 70.2% were women. About 41.0% of patients had no sleep disturbance; sleep disturbance was mild to moderate in 51.3% and severe in 7.7%. PROMIS-SD score was negatively correlated with the time from the initial positive COVID-19 test to the initial consultation in the PASC clinic (Pearson r = -.094; r2 = .0088). The PROMIS-Sleep Disturbance framework can serve as a tool to assess the burden of sleep disturbances in PASC patients.

SLEEP DISPARITIES AMONG ASIAN AMERICANS: IMPACTS OF DISCRIMINATION AND ACCULTURATIVE STRESS

Abstract Although Asian Americans have shorter sleep duration and more sleep difficulty compared to Whites or Hispanics, research on Asians remains scarce. 60% of Asians are foreign-born and have high levels of limited English proficiency, which is positively associated with a range of immigrant stressors, such as discrimination and acculturative stress. Importantly, COVID-19 has exacerbated discrimination towards Asian Americans giving rise to ‘Asian hate’. In a study using data from the National Epidemiology Study of Alcohol and Related Conditions III (n=1,765), we found that individuals with high discrimination were sleeping 14.4 minutes less (SE: 6.0, p &amp;lt; .05) and had a higher prevalence of sleep difficulty (prevalence ratio (PR): 1.73, 95% Confidence Interval (CI): 1.33-2.24) compared to those with low discrimination. An interaction effect was observed in sleep difficulty by nativity. The association between discrimination and sleep difficulty was stronger among the U.S.-born than the foreign-born. In another study of Chinese and Korean Americans (n=400), Poisson models revealed that greater acculturative stress was associated with a higher prevalence of sleep disturbance (PR: 1.18, 95% CI: 1.06% to 1.31%). Interaction tests indicated that only women had a significant association between acculturative stress and sleep disturbance (PR: 1.30; 95% CI: 1.13 to 1.49), while the association was significant for individuals identifying as “very Asian” (PR: 1.21; 95% CI: 1.08 to 1.35), but not for those identifying as “mostly Asian” or “bicultural/western”. Future sleep health research in Asian Americans should consider the critical role of discrimination and acculturative stress.

Sleep Disturbances and Emotional and Behavioral Difficulties Among Preschool-Aged Children

ImportanceSleep disturbances and mental health problems are highly comorbid and bidirectionally correlated across childhood. The association between the natural history of sleep disturbances and the transition of mental health problems has not been quantified.ObjectiveTo examine the association between the natural history of sleep disturbances and resolved and incident emotional and behavioral difficulties (EBDs).Design, Setting, and ParticipantsThis cohort study used data from the Shanghai Children’s Health, Education and Lifestyle Evaluation–Preschool (SCHEDULE-P), a prospective and population-based longitudinal cohort study of children enrolled in preschools in Shanghai, China, from November 10 to 24, 2016. A total of 20 324 children aged 3 to 4 years were recruited from the junior class of 191 kindergartens, of whom 17 233 (84.8%) participated in the 2-year follow-up. A multilevel regression model was used to evaluate the association between the development of sleep disturbances and the occurrence of resolved and incident EBDs. The data analysis spanned from August 4, 2021, to October 31, 2023.ExposuresSleep disturbances were assessed using the Children’s Sleep Habit Questionnaire; EBDs were assessed using the Strengths and Difficulties Questionnaire.Main Outcomes and MeasuresOccurrence of incident and resolved EBDs at the 2-year follow-up.ResultsThe cohort included 17 182 participants, with a mean (SD) age of 3.73 (0.29) years at enrollment; 52.0% were boys. The prevalence of EBDs at school entry and graduation years was 27.8% and 18.7%, respectively, while the prevalence of sleep disturbances was 41.3% and 31.5%, respectively. Among those with EBDs at the entry year, 35.0% maintained stability in the graduation year, while sleep disturbances were stable in 50.0% of those with sleep disturbances. After controlling for confounding factors, the odds ratio (OR) for resolved EBDs was lower in the incident sleep disturbance (ISD) group (OR, 0.50 [95% CI, 0.41-0.62]; P &amp;amp;lt; .001) and stable sleep disturbance (SSD) group (OR, 0.47 [95% CI, 0.40-0.56]; P &amp;amp;lt; .001) compared with the group with no sleep disturbances. The ORs for incident EBDs among the ISD group (OR, 2.58 [95% CI, 2.22-3.01]; P &amp;amp;lt; .001) and SSD group (OR, 2.29, [95% CI, 1.98-2.64]; P &amp;amp;lt; .001) were higher than among the group with no sleep disturbances.Conclusions and RelevanceIn this prospective cohort study, the natural history of sleep disturbances among preschool-aged children was associated with both resolved and incident EBDs. Routine screening and precise intervention for sleep disturbances may benefit the psychosocial well-being of this population.

Sleep disturbances in children and adolescents after kidney transplantation.

Disturbances of sleep are prevalent among children with chronic kidney disease. However, the aetiology of sleep disorders in children particularly after kidney transplantation is not clear. We sought to ascertain the prevalence and type of sleep disturbances in paediatric kidney transplant recipients and to identify predictors of sleep disturbances in this population. Caregivers of kidney transplant recipients completed online questionnaires about their child's sleep. The questionnaires utilised were the Sleep Disturbance Scale for Children (SDSC), the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), questions about sleep hygiene, and questions about restless leg syndrome. Demographic and clinical details were collected from medical records. Thirty-five children were included in the study, with a median (IQR) age of 14.1years (9.5-16.1) and median years (IQR) since transplant of 3.7 (0.7-8.7) years, and 72.0% were identified to have at least one category of sleep disturbance according to scores on the SDSC. The most common sleep disturbances reported were disorders of initiating and maintaining sleep (DIMS) (40.0%) and disorders of excessive somnolence (DOES) (31.4%). Statistically significant predictors of sleep disturbances include low estimated glomerular filtration rate and increased age. Among children who screened positive for DIMS and DOES, the majority indicated use of electronic devices in 1h before bed. A high prevalence of sleep disturbances has been identified in children after kidney transplants, and some risk factors may be modifiable. Further studies are required to understand whether there are other readily modifiable predictors of sleep disturbances.

Prevalence of Sleep Disturbances in Latin American Populations and Its Association with Their Socioeconomic Status-A Systematic Review and a Meta-Analysis.

The worldwide increase in the prevalence and incidence of sleep disturbances represents a major public health issue. Among multiple determinants affecting sleep health, an individual's socioeconomic status (SES) is the most ignored and underestimated throughout the literature. No systematic review on the relation between SES and sleep health has been previously conducted in Latin America. PRISMA guidelines were used. Twenty articles were included in the final sample (all cross-sectional studies), and twelve among them were rated as fair or poor quality. Among these studies, 80.0% (n = 16) were performed in Brazil, 10.0% (n = 2) were performed in Peru, 5.0% (n = 1) were performed in Chile, and 5.0% (n = 1) were multicentric (11 countries). The combined total number of participants was N = 128.455, comprising 3.7% (n = 4693) children, 16.0% (n = 20,586) adolescents, and 80.3% (n = 103,176) adults. The results show the following: (1) The sleep outcomes analyzed were sleep duration, sleep quality/sleep disturbance, insomnia, excessive daytime sleepiness (EDS), obstructive sleep apnea (OSA)/sleep-disordered breathing (SDB) symptoms, and bruxism. (2) The most used determinants were income, education level, employment status/occupation, wealth/assets, and composite indices. (3) Higher SES was associated with shorter sleep duration. (4) Lower SES was associated with a decrease in sleep quality, less frequent snoring, more prevalent EDS, and sleep bruxism. (5) Lower education was associated with insomnia. (6) Higher education was associated with more sleep bruxism. (7) The pooled prevalence using a meta-analysis of the random effects model was 24.73% (95%CI, 19.98-30.19), with high heterogeneity (I2 = 100%). (8) The prevalence of sleep disturbances decreased with high education (OR, 0.83; 95%CI, [0.69-0.99]; I2 = 79%), while it increased with low income (OR, 1.26; 95%CI, [1.12-1.42]; I2 = 59%), unemployment (OR, 2.84; 95%CI, [2.14-3.76]; I2 = 0%), and being a housewife (OR, 1.72; 95%CI, [1.19-2.48]; I2 = 55%). This meta-analysis shows that lower SES (education, income, and work) was associated with sleep disturbances in Latin America. Therefore, sleep disturbance management should be addressed with a multidimensional approach, and a significant investment in targeted public health programs to reduce sleep disparities and support research should be made by the government before the situation becomes uncontrollable.

Analysis of Changes in Sleep Quality and Patterns after Hip Fracture Using Real Evidence of Artificial Intelligence Linked (REAL) Hip Cohort Data.

Background and Objectives: Hip fractures are commonly found in elderly patients, and often result in chronic pain and decreased physical function, as well as worsening of overall health. It is known that early surgical intervention during the acute phase and rehabilitation are important for improving clinical outcomes for these patients. However, the importance of management for improving the quality of life of these patients is becoming more emphasized. Studies on changes in sleep patterns after hip fractures are rare overseas. Therefore, the aim of this study is to investigate the prevalence of sleep disturbance in patients with hip fractures and to analyze the changes in sleep disturbance after surgery by comparing the preoperative and postoperative results. Materials and Methods: During the period from August 2022 to January 2023, patients who underwent surgical treatment for hip fractures and were recruited into the REAL Hip Cohort were selected as research subjects. The sleep survey was conducted using the Pittsburgh Sleep Quality Index (PSQI). The PSQI is composed of 18 questions, each divided into areas of sleep quality, sleep latency, duration, efficiency, disturbance, use of medication, and daytime dysfunction. Each area is scored 0-3 points and the total is 0-21. A score greater than five indicates sleep disorder. The PSQI was surveyed during hospitalization and three months after surgery for post-fracture sleep status. To analyze changes before and after the fracture, paired T-tests and chi-square tests were performed. Results: From August 2022 to January 2023, a total of 40 patients who were recruited into the REAL Hip Cohort responded to the PSQI survey. The average age was 77.4 years and 36 were female. Sleep quality worsened from 0.75 ± 1.0 before surgery to 1.4 ± 1.0 three months after surgery (p = 0.019), and sleep efficiency also worsened from 0.4 ± 0.6 to 1.4 ± 1.0 (p < 0.001). The PSQI increased from an average of 5.2 ± 2.8 before surgery to 8.2 ± 4.2 three months after surgery (p = 0.007), and the number of patients who could be diagnosed with sleep disorders also increased from 12 (40%) to 24 (60%) (p = 0.030). Conclusions: A decline in overall sleep status was observed in patients in a survey on sleep patterns three months after hip fracture. Additional management is needed to improve their sleep patterns.

FC14: Measuring the prevalence of sleep disturbance in people living with dementia in the community. A systematic review and meta-analysis

Objectives:Sleep disturbance affects all aspects of mental and physical functioning and quality of life and may lead to or worsen Alzheimer’s disease. Sleep disturbances in people with dementia living at home predicts care home admission and carer distress. Estimates of the prevalence of sleep disturbance vary, and it is unclear how prevalence rates differ according to setting. We conducted the first systematic review and meta-analysis on the prevalence of sleep disturbances in people living with dementia in the community. We aimed to examine demographic predictors and whether overall prevalence has changed over time.Methods:We searched Embase, MEDLINE and PsycINFO for studies reporting the prevalence of sleep disturbances in people with dementia living at home. We meta-analysed data and calculated the pooled prevalence of sleep disturbances in people with dementia overall and in dementia subtypes. We used meta-regressions to investigate the effects of study characteristics, publication dates and participant demographics.Results:Eleven studies fulfilled the inclusion criteria. The pooled prevalence of any symptoms of sleep disturbance was 26% (95% confidence intervals (CI): 23-30%; n= 2719) and of clinically significant sleep disturbance 19% (95% CI: 13-25%; n= 2753). The pooled prevalence of sleep disturbance symptoms was significantly lower among people with Alzheimer’s disease (24%; 95% CI: 16-33%, n=310) than Lewy body dementia (49%; 95% CI: 37-61%, n=65). Meta-regression analysis did not find that publication year, participant’s age, sex and study quality predicted prevalence.Conclusion:Sleep disturbances are common among people with dementia living in the community, especially in Lewy body dementia. There was no change in prevalence according to publication dates (between 2002 and 2018). This suggests that possible advances in treatment of sleep disturbance are not reflected in improvements for people living with dementia. This highlights the need to develop effective intervention strategies, reducing the prevalence of sleep disturbances in people living with dementia living at home in the community.

Sleep and Its Disturbance in Parents of Children and Adolescents with Epilepsy: A Systematic Review and Meta-Analysis.

Sleep disturbances are commonly reported by parents of children and adolescents with epilepsy. However, evidence synthesis including quality and quantity of sleep in parents of children and adolescents with epilepsy is lacking. This systematic review and meta-analysis was conducted to quantify pooled mean estimates of parental sleep variables and to determine the prevalence of sleep disturbances in parents of children and adolescents with epilepsy. Five electronic databases, PubMed, Medline, Embase, PsychINFO, and CINAHL, were systematically searched from inception to September 2021. Eleven observational studies examining parents of pediatric patients aged <18 years with epilepsy using a quantitative measure of sleep duration, sleep quality, or sleep disturbance were reviewed. Our results showed that the pooled nocturnal sleep duration was 5.93 hours (95% CI: 4.64 to 7.21 hours). Overall sleep quality as estimated by the bias-adjusted pooled Pittsburgh Sleep Quality Index total score was 6.65 (95% CI: 5.98 to 7.33). Parents of children with epilepsy had significantly higher Pittsburgh Sleep Quality Index total scores compared to parents of healthy children (differences in means 1.84, 95% CI: 1.29 to 2.39). The pooled estimated prevalence of parental sleep disturbances was 58.1% (95% CI: 45.7% to 69.6%). Our findings demonstrate a high prevalence of sleep disturbances with poor sleep quality and substantial reductions in sleep time in parents of children and adolescents with epilepsy. Healthcare professionals in pediatric neurology clinics should proactively initiate screening for sleep disturbances in parents of children and adolescents with epilepsy and refer parents to a sleep specialist when necessary.

Tasmanian ISLAND Sleep Study: prodromal neurodegenerative disease (iRBD) is associated with subjective reports of daytime sleepiness and poor sleep quality

AbstractBackgroundIsolated REM sleep behaviour disorder (iRBD) is a prodrome to dementia with Lewy bodies (DLB) and other neurodegenerative disease (NDD) such that over 90% of people with iRBD (pwRBD) will develop a NDD within 10 years of diagnosis. Disrupted sleep and dream‐enactment episodes are frequently observed by bed partners of pwRBD but it is unclear whether pwRBD perceive reduced sleep quality themselves, as previous studies show inconsistent results. This research aims to investigate sleep quality in iRBD and we hypothesise that people with probable iRBD (pwpRBD) will report poorer sleep quality, compared to healthy controls.MethodAdults aged 50+ years in the Tasmanian ISLAND Sleep Study, Australia, completed the single REM Sleep Behaviour Disorder Screening Question (RBD1Q) and the Pittsburgh Sleep Quality Index (PSQI) online. The PSQI includes a ‘total sleep quality’ score as well as 7 subscales: duration of sleep, sleep disturbance, sleep latency, day dysfunction due to sleepiness, sleep efficiency, overall sleep quality, and need meds to sleep.Result2,905 participants were recruited (mean (SD) age 64 (7.7) years; 26% male) and 273 (9.4%) screened positive for pRBD (45% male). In the pRBD group, 66% had poor total sleep quality, compared to 57% of controls (p = 0.001). pRBD was associated with a greater prevalence of sleep disturbance (67% vs 54%) and daytime dysfunction due to sleepiness (24% vs 11%). There was no difference in sleep duration, sleep latency, or sleep efficiency between pRBD and controls.ConclusionWe found that pwpRBD report more sleep disturbance, daytime sleepiness and overall poorer sleep quality compared to those without pRBD. This suggests that pwpRBD may suffer from greater sleepiness than has previously been reported in the literature and highlights the importance of sleep enquiries in those with suspected prodromal NDD who drive or operate machinery.

Sleep disturbances in the memory clinic: Associations with clinical features and neuropsychological performance

AbstractBackgroundThe prevalence of sleep disturbances increases in ageing and may further increase in neurodegeneration. In a memory and cognition (MC) clinic setting, our study aims to: 1) determine the rates of various sleep disturbances including obstructive sleep apnoea (OSA), short and long sleep duration, insomnia, sleep quality, and rapid eye movement sleep behaviour disorder (RBD); and 2) examine whether these sleep disturbances are associated with neuropsychological performance in older adults without dementia.MethodWe captured data between 2009 and 2022 from a MC clinic for older adults aged over 50 with new cognitive and/or mood concerns. Self‐reported history, pulse oximetry, and polysomnography (PSG) captured rates of OSA. Actigraphy (&gt;7 days) was used to measure sleep duration (defined short duration as &lt;6 hours and long duration as &gt;9 hours). Validated self‐report questionnaires were used to capture insomnia, sleep quality, and RBD. We examined group differences between those with and without sleep disturbances in the following cognitive composites: verbal learning and memory, processing speed, executive function, and language skills.ResultsWe recruited 1016 participants (mean age = 66.9 (SD = 9.0), mean MMSE = 28.3 (SD = 2.2), male = 436 (43%)). For rates of OSA, 15% (n = 152/1016) self‐reported history of OSA, 76% (n = 383/504) had OSA as classified by PSG, 84% (n = 115/137) had OSA as classified by pulse oximetry. From actigraphy data, 10% (n = 55/566) had short sleep and 5% (n = 29/566) had long sleep duration. From self‐report data, 15% (n = 85/579) had moderate or severe clinical insomnia, 61% (n = 544/893) reported having poor sleep quality, 10% (n = 56/579) had RBD. Individuals with OSA (from PSG) performed worse in verbal learning compared to those without OSA (p&lt;0.05). Individuals who had long sleep duration performed worse on both verbal learning (p&lt;0.05) and memory (p&lt;0.05) than those with short sleep and normal sleep duration. There were no other significant group differences in cognition outcomes, amongst the other sleep disturbance groups (p&gt;0.05).ConclusionIn MC clinics, there are very high rates of sleep disturbance in this at‐risk population. The large discrepancy in rates of OSA between self‐reported history and PSG suggests OSA is under‐diagnosed. Sleep disturbances may be associated with cognitive outcomes, in particular learning and memory.

Neighborhood problems and sleep difficulties predict subjective cognitive decline in Black American men living in urban areas

AbstractBackgroundThe impact of the residential neighborhood on health and aging is being increasingly recognized in medical and health sciences. Specifically, research suggests that the neighborhood where people live can be a risk or protective factor for various health outcomes, including brain health. Similar to the impact of neighborhood on health and aging, sleep has been linked to subjective cognitive decline (SCD) in older adults, which may signal a cognitive trajectory to Alzheimer’s disease and related dementia (ADRD). This study aims to evaluate whether neighborhood problems and sleep difficulties predict subjective cognitive decline in Black men living in urban areas and, thus, may be related to elevated risks for ADRD.MethodBlack American men (N = 117), age 40 – 70 years, were recruited through a targeted advert on Amazon Mechanical Turk (MTURK) over a 3‐week period. The participants responded to a survey assessing neighborhood problems, bodily symptoms, length of residence, sleep difficulties, self‐rated health, sociodemographic characteristics, and subjective cognitive decline.ResultWe performed hierarchical regression. In Model 1, only education was a significant predictor of SCD (F (3,113) = 8.52, p&lt;.001), accounting for 18% of the variation in SCD. In Model 2, socioeconomic status, education, and bodily symptoms were significant predictors of SCD (F (5,111) = 13.99, p&lt;.001) and explained 39% of the variation in SCD. In Model 3, neighborhood problems, length of residence added, socioeconomic status, education, and bodily symptoms were significant predictors and contributed 44% of the total variance in SCD (F (7,109) = 12.10, p&lt;.001). In Model 4, sleep difficulties, length of residence, bodily symptoms, socioeconomic status, and education were significant predictors of SCD (F (9,107) = 13.59, p&lt;.001), and accounted for 50% of the variation in SCD.ConclusionGiven that Black Americans have been found to have a higher prevalence of sleep disturbances compared to white Americans, our findings could add to inform future health interventions and policy recommendations that can address modifiable sources of poorer brain health in Black men.