Global PSQI Score Research Articles

Aerobic and resistance exercise improve patient-reported sleep quality and is associated with cardiometabolic biomarkers in Hispanic and non-Hispanic breast cancer survivors who are overweight or obese: results from a secondary analysis.

Poor sleep quality affects nearly one-third of breast cancer survivors and is associated with insulin resistance. The purpose of this secondary analysis was to examine the effects of a 16-week exercise intervention on patient-reported sleep quality among breast cancer survivors and assess whether changes in patient-reported sleep quality were associated with cardiometabolic biomarkers. We explored Hispanic ethnicity as a moderator of the effects of exercise on patient-reported sleep quality. Breast cancer survivors who were overweight or obese were randomized to exercise (n = 50) or usual care (n = 50). The 16-week intervention included aerobic and resistance exercise. Patient-reported sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and biomarkers of cardiometabolic health were assessed at baseline and post-intervention. Within- and between-group differences were assessed using general linear models repeated-measures analyses of variance and mixed-model repeated-measure analysis, respectively. Associations between changes in PSQI and cardiometabolic biomarkers were computed using Pearson correlations. Linear mixed-models were used to evaluate effect modification by ethnicity. Participants were 52 ± 10.4 years old, and over half were of Hispanic ethnicity. As compared to usual care, PSQI global scores improved significantly in the exercise group (mean between-group difference -2.2; 95% CI -3.2 to -0.6). Change in PSQI was inversely associated with changes in all cardiometabolic biomarkers (p < 0.01) among the exercise group. Ethnicity was found to moderate the effects of exercise training on global sleep quality (p < 0.001). An aerobic and resistance exercise intervention effectively improved patient-reported sleep quality in breast cancer survivors. Hispanic ethnicity as a moderator showed greater improvement in patient-reported sleep indicating Hispanic versus non-Hispanic breast cancer survivors may derive larger sleep benefits. NCT01140282.

Quality of sleep among social media users during the lockdown period due to COVID-19 in Spain

AimsTo analyse the quality of sleep of the Spanish population during the lockdown due to COVID-19. DesignCross-sectional descriptive study using a web based survey design. MethodsPittsburgh Sleep Quality Index questionnaire and sociodemographic, occupational, health and sleep quality variables were used to collect data during the first month of the lockdown period due to COVID-19 (March–April 2020). A snowball sampling was carried out, where participants were asked to disseminate and distribute the questionnaire among their own profiles in social networks. ResultsA representative sample of 5220 participants aged ≥18 years old took part in the study. The global PSQI score was 8.17 points (SD 4.43). A statistical association was found between the global PSQI score and several of the variables collected. Findings show that the quality of sleep was worse among women (p < 0.001), single participants (p 0.02), those working in rotating shifts (p < 0.001), on-site workers (p < 0.001), and people diagnosed with COVID-19 or who had someone in their environment diagnosed with the virus (p < 0.001). ConclusionFindings show that the Spanish population has experienced poor quality of sleep during the lockdown period. Being a woman, working in rotating shifts, having suffered from COVID-19 or having someone close suffering from COVID-19, being unemployed or being affected by a Temporary Redundancy Scheme, as well as spending long hours in bed were associated with poorer sleep quality. On the contrary, being older and sleeping longer hours were associated with a better sleep quality.

Is your physio tired? Exploring sleep deprivation in Irish physiotherapists

INTRODUCTION: Health professionals have been subject to increased levels fatigue when compared to population norms. It remains unknown if physiotherapists report high levels of sleep deprivation. This paper explores levels of sleep deprivation, and its potential impact on professional performance. METHODS: A survey was distributed through the Irish Society of Chartered Physiotherapists. The survey explored work characteristics, sleep quality using the Pittsburgh Sleep Quality Index, daytime sleepiness using the Epworth Sleepiness Scale, and the professional and non-professional causes of sleep deprivation in the profession. Pearson correlation and independent t-tests were used on SPSS to explore relationship between variables. RESULTS: There was a total of 559 valid respondents. Females accounted for 82% and public sector employees accounted for 63% of respondents. Over half (50.1%) of respondents said they felt sleep deprivation impacted on their practice. Most physiotherapists (63.3%) of respondents said they did not feel that their practice impacted sleep. The PSQI global score was 5.6 indicating “poor” quality of sleep. The ESS global score was 6.0 indicating ‘higher normal daytime sleepiness’. Potential causes of sleep deprivation included professional issues relating to burnout and work-life balance, and non-professional reasons such as parenthood. DISCUSSION AND CONCLUSION: A mismatch exists between self-reported sleep deprivation and validated measurements of sleep indicating poor self-awareness of the impact of sleep in optimising professional performance. A work-life balance is needed to facilitate a safe and efficient workforce. Individual and organizational efforts should be made to improve sleep quantity and quality to reduce personnel fatigue and enhance physiotherapists professional performance.

SELF-REPORTED SLEEP QUALITY AND ITS ASSOCIATION WITH DEMOGRAPHIC AND HEALTH-RELATED FACTORS AMONG EMERGENCY DEPARTMENT NURSES

Continual sleep loss and disorder among Emergency Department (ED) nurses may negatively impact the quality of care. ED nurses are expected to act with great pace and accuracy in a crowded and high-risk environment. Detail information regarding sleep quality (SQ) and its components among ED nurses is still limited in Indonesia. The study aimed to explore SQ of ED nurses and its relation to demographic and health-related factors. This study utilized a cross-sectional, correlational descriptive design with 65 samples recruited using total sampling technique from 3 EDs in Central Sulawesi. Descriptive statistics and bivariate analysis were performed to examine the association between variables. Global PSQI score was 5.5±2.0 with the prevalence of poor sleepers was 43.1%. Only body mass index (BMI) had correlation with SQ (r=0.26; p&lt;0.05). ED nurses are recommended to reach the ideal body weight to get a bigger chance of having a better sleep. Further studies are required to evaluate interventions that might enhance SQ of ED nurses.&#x0D;

Prevalence and associated factors of poor sleep quality among Chinese returning workers during the COVID-19 pandemic

ObjectivesThe 2019 novel coronavirus (COVID-19) pandemic is a severe global crisis which has resulted in many public health problems. This study aimed to investigate the prevalence of poor sleep quality and its related factors among employees who returned to work during the COVID-19 pandemic. MethodsOur online cross-sectional study included 2,410 participants aged ≥17 years in Deqing and Taizhou, Zhejiang Province, China from 5th to 14th March 2020. The questionnaire covered information on demographic characteristics, health status, workplace, lifestyle, attitude towards COVID-19, assessment of anxiety, depression and sleep quality. The Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) was administered to measure the poor sleep quality. Poor sleep quality was defined as a global PSQI score>5. Factors associated with sleep quality were analyzed by logistic regression models. ResultsIn sum near half (49.2%) of 2,410 returning workers were females and the average year of subjects was 36.3 ± 9.1 years. The overall prevalence of poor sleep quality was 14.9% (95%CI: 13.5%–16.3%). The average score of PSQI was 3.0 ± 2.5 and average sleep duration was 7.6 ± 1.2 h. Independent related factors of poor sleep quality included age older than 24 years, higher education level, negative attitude towards COVID-19 control measures, anxiety and depression. ConclusionsPoor sleep quality was common and there was a shorter sleep duration among returning workers during the COVID-19 pandemic. Possible risk factors identified from this study may be of great importance in developing proper intervention for the targeted population to improve the sleep health during the COVID-19 public health emergency.

Association of sleep disorder with academic performance among medical students in Sudan

Background — Sleep disorder is a common problem amongst medical students. The objective of this study is to determine the association of sleep disorder with academic performances among medical students in Sudan. Methods — A cross-sectional study was conducted in which 199 medical students were selected through simple random sampling techniques. Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were used to assess the sleep pattern and daytime sleepiness respectively. Logistic regression analysis was used to determine the association of sleep disorder with academic performance. Results — Majority of the students (82.5%) suffered poor sleep quality and 56.5% were suffered from severe day time sleepiness. All the characteristics of sleep quality were associated with poor academic performance but only sleep duration, use of sleep medication, global PSQI score and day time sleepiness were a statistically significant association with poor academic performance. Conclusion — A high prevalence of sleep disorder and its associated with poor academic performance was found in medical students. There is a need for a formulation of policies to address the factors which affect sleep of students.

0407 Sleep, Stress, Cardiovascular, and Psychological Health in College Students

Abstract Introduction Epidemiological studies have long established that sleep factors, stress, and cardiovascular health are related. College students often struggle with the demands of college life, which leads to increased stress, symptoms of depression and anxiety, and poor sleep. The focus of the current study was to examine habitual sleep habits in college students, in association with psychological factors and physiological factors. Methods Participants included 51 undergraduate students (18 men, average age M=20.25 years, SD=1.78) who wore wrist actigraphs to measure their typical sleep habits. After one week, participants completed questionnaires about psychological symptoms (i.e., depression, anxiety, and stress; Depression Anxiety Stress Scale, DASS-21) and subjective physiological symptoms (i.e., fatigue; Multidimensional Assessment of Fatigue Scale, MAF). Blood pressure and heart rate were measured using a wrist cuff. Results Overall total sleep time was 6.59 hours and sleep efficiency was 82.55%. Pearson correlational analyses revealed a negative moderate association between sleep efficiency and diastolic blood pressure (r(49) = -.318, p = .024). Global PSQI scores were moderately associated with stress (r(49) = .419, p = .002). MAF Global Fatigue Index scores revealed positive associations with depression (r(49) = .344, p =.014), anxiety (r(49) = .474, p&amp;lt;.001), and stress (r(49) = .620 p&amp;lt;.001). Heart rate was positively associated with depressive symptoms r(49) = .296, p= .035), stress symptoms r(49) = .447, p= .001), and fatigue r(49) = .456, p= .001). Conclusion As expected, college students’ sleep was short in duration and poor in efficiency. Sleep factors, cardiovascular factors, psychological factors, and stress were all related, demonstrating the importance of sleep on physiological and psychological health. More research should be conducted to further examine the relationships and directionality between sleep, psychological factors, and stress as there may be underlying mechanisms important for cardiovascular health. Support None.

Poor Subjective Sleep Quality Is Associated with Poor Occupational Outcomes in Elite Soldiers.

We aimed to assess the relationship between subjective sleep quality and occupationally-relevant outcomes in military personnel. Participants were from an elite unit of US Army soldiers who worked extended (~30 h) shifts (with minimal recovery time between shifts) during 3-week work sessions. Questionnaires assessing subjective sleep quality during the month prior (Pittsburgh Sleep Quality Index [PSQI]) were administered at the beginning of the session. Occupational outcomes (emotional exhaustion, functional impairment, role overload, daytime sleepiness) were assessed on the final day of the session. Regression analyses were conducted to link sleep quality and occupational outcomes. The study sample participants had relatively poor sleep prior to the exercise (PSQI Global score average = 6.3 ± 3.1). Higher PSQI Global Scores prior to the work session longitudinally predicted daytime sleepiness (f2: 0.56) after the work session. PSQI component 7, which queries daytime dysfunction attributed to poor sleep quality, longitudinally predicted emotional exhaustion, functional impairment, and role overload (f2 range: 0.19–0.70). In conclusion, poor sleep quality—in aggregation with occupationally-mandated sleep loss—is predictive of poorer subsequent occupational outcomes. Future work should aim to increase sleep opportunities prior to occupationally-mandated sleep loss in order to build resilience when sleep loss is unavoidable.

Sleep Quality Moderates the Relationship between Anxiety Sensitivity and PTSD Symptoms in Combat-exposed Veterans

ABSTRACT Objective/Background: Posttraumatic stress disorder (PTSD) and related conditions (e.g., depression) are common in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) veterans. High anxiety sensitivity (AS), defined as fear of anxiety and anxiety-related consequences, is related to greater PTSD and depressive symptoms; however, few studies have identified possible modifiers of these associations. The current study examined the moderating role of sleep quality in the associations between AS and PTSD and depressive symptoms. Participants: Participants were 155 OEF/OIF/OND community veterans ages 21–40 (12.3% women). Methods: Participants completed a semi-structured clinical interview for DSM-IV PTSD symptoms (Clinician Administered PTSD Scale; CAPS) and self-report measures of anxiety sensitivity (Anxiety Sensitivity Index), sleep quality (Pittsburgh Sleep Quality Index global score; PSQI), and depressive symptoms (Beck Depression Inventory-II; BDI–II). Results: Results of hierarchical linear regression models indicated that the main effects of AS and global PSQI score were significantly associated with greater PTSD and depressive symptoms (both with sleep items removed), above and beyond the covariates of trauma load and military rank. Sleep quality moderated the relationship between AS and PTSD symptoms (but not depressive symptoms), such that greater AS was associated with greater PTSD symptoms for individuals with good sleep quality, but not poor sleep quality. Conclusions: Sleep quality and AS account for unique variance in PTSD and depressive symptoms in combat-exposed veterans. AS may be less relevant to understanding risk for PTSD among combat-exposed veterans experiencing poor sleep quality.

Preliminary Assessment of a Novel Watchstanding Schedule for a Crew on a Small Surface Combatant of the United States Navy

We assessed the utility of a fixed, 3-section, watchstanding schedule in a small surface combatant of the United States Navy. Sailors on the “5 hrs-daytime/3 hrs-nighttime” or “D5/N3” schedule stood two watches every day, one a 5-hour daytime shift and one a 3-hour nighttime shift. Crewmembers (N = 27) completed a questionnaire while the ship was underway to assess the utility and the crew’s acceptance of the D5/N3. Crewmembers reported sleeping 5.6 ± 1.3 hours daily. The average PSQI Global score was 8.3 ± 3.5, with ~81% of the participants identified as “poor sleepers.” Approximately 94% of the respondents noted that the D5/N3 was either better (53%) or the same (41%) compared to their previous watch schedule. The predictability of the daily schedule, the ability to plan daily activities, the adequacy of time to complete watch duties, the availability of time for off-watch duties/shipboard-departmental qualifications, and higher alertness/better ability to focus were considered the strengths of the D5/N3. Overall, the D5/N3 has the potential to be a useful alternative to existing 3-section watch standing schedules in terms of crew alertness levels, acceptance by the crewmembers, and workload management when working in a Navy vessel. Because it is a novel schedule, however, more effort should be focused on how to best implement the D5/N3 on a ship, and on the factors that affect its use at sea.

Poor Postpartum Sleep Quality Predicts Subsequent Postpartum Depressive Symptoms in a High-Risk Sample.

Postpartum depression (PPD) occurs in 15% to 20% of mothers worldwide and is associated with adverse outcomes for mother and child. Prior research has established a relationship between concurrent sleep quality and PPD. We conducted a secondary analysis in 45 women with mood disorders to study overall sleep quality (and individual components of sleep), measured in the early postpartum period, as a predictor of subsequent PPD. We measured sleep quality using the Pittsburgh Sleep Quality Index (PSQI; subscale and total scores) at 1 month postpartum (and during the third trimester). We measured depressive symptoms using the Inventory of Depressive Symptoms, Self-Report (IDS-SR) at 3 months postpartum. We used bivariate and multivariate linear regression models to study the association between PSQI and IDS scores. We found that higher global PSQI scores as well as higher component scores for self-reported sleep quality, sleep latency, sleep efficiency, sleep medication usage, and daytime dysfunction, measured 1 month postpartum, were associated with increased IDS scores (at 3 months postpartum (P = .01, .01, .01, .003, < .001, respectively). We did not find an association between poor sleep quality in the third trimester and PPD. Poor sleep quality in the early postpartum period independently predicts development of later PPD. This is clinically significant and highlights the importance of sleep interventions as an immediate postpartum therapeutic tool. McEvoy KM, Rayapati D, Washington Cole KO, Erdly C, Payne JL, Osborne LM. Poor postpartum sleep quality predicts subsequent postpartum depressive symptoms in a high-risk sample. J Clin Sleep Med. 2019;15(9):1303-1310.

Sleep habits in adolescents with type 1 diabetes: Variability in sleep duration linked with glycemic control.

To describe adolescents' sleep on school and weekend nights using multiple methods and to examine the links between sleep variability, quality, and duration with diabetes indicators. Adolescents with type 1 diabetes (N = 65, mean age = 15.0, 52.3% female, mean HbA1c = 8.9% or 74 mmol/mol) wore an actigraph and kept daily diaries recording sleep, activities, and blood glucose monitoring (BGM) habits for at least 7 days. Average daily BGM and blood glucose (BG) levels were obtained through glucometer downloads. HbA1c was obtained as part of clinic visits. Adolescents completed a sleep quality questionnaire (Pittsburgh sleep quality index [PSQI]), and adolescents and caregivers reported on adherence to diabetes treatment. Adolescents reported a mean PSQI global score of 5.37, which is above the clinical cutoff for poor sleep quality. Actigraphy data revealed that mean adolescent total sleep time was 6:54 (h:min), and participants slept more on weekend nights than on school nights (P < .001). Additionally, variability in sleep duration was significantly related to HbA1c, frequency of BGM, and average BG. Total sleep time and self-reported sleep quality were not significantly associated with adherence or glycemic control. Few adolescents with type 1 diabetes met recommendations for sleep duration, and many reported poor sleep quality. We identified significant associations between variability in sleep duration with poorer glycemic control and less frequent BGM, supporting the need to consider sleep patterns as a modifiable factor that may affect adherence and glycemic control.

Association of Sleep Quality with Socio-Demographic Characteristics in Elderly Referred to Health Centers in Qazvin, Iran

ABSTRACT Background and aim: Sleep disorders are not innately harmful to quality of life, they can induce or complicate physical and mental sicknesses and increase the risk of mortality. The aim of this study was to determine the association of sleep quality components with socio-demographic characteristics in elderly people in Qazvin, Iran. Materials and Methods: This descriptive cross-sectional study was performed on 400 elderly patients referred to health centers in Qazvin. Data were collected by using a demographic questionnaire and the Pittsburgh sleep quality index (PSQI). Data were analyzed by SPSS 19 software, descriptive and inferential statistics (Mann-Whitney, Chi-square, logistic regression). Results: The prevalence of poor sleep quality was 80%. Statistically signifcant difference were observed between total global PSQI score and economic condition (p<0.03) and had chronic physical disease (P<0.001). Highest component scores was sleep latency (1.55±1.06) and lowest was habitual sleep efciency (0.16±0.57). Older women had worse sleep quality compared with older men (P < 0.05). Multivariate logistic regression model indicated that female sex is associated with greater tendency towards poor sleep quality (OR=1.78, 95% CI=1.08-2.94, P=0.022). Conclusion: This study provides evidences that poor sleep quality was high among the elderly of Qazvin. It seems sleep quality assessment of older adults is necessary to identify the factors affecting sleep quality and to adopt appropriate measures and strategies to eliminate or reduce the effect of these factors. Keywords: elderly, sleep quality, community health centers

Extended Long-Term Effects of Cervical Vagal Nerve Stimulation on Headache Intensity/Frequency and Affective/Cognitive Headache Perception in Drug Resistant Complex-Partial Seizure Patients

Invasive vagal nerve stimulation (iVNS) is an established treatment option for drug-resistant focal seizures and has been assumed to diminish frequent co-incidental daily headache/migraine. However, long-term effects on cognitive/affective head pain perception, headache intensity/frequency are lacking. We therefore investigated potential iVNS-induced effects in patients with drug-resistant focal seizure and daily headache/migraine. A clinical database was used to select 325 patients with drug-resistant epilepsy treated by either iVNS plus best medical treatment (BMT) or BMT alone, compared to a healthy control group (HC). We assessed headache intensity (VAS), headache frequency, affective/cognitive pain perception (PASS; FSVA), migraine disability scores (MIDAS), sleep architecture (PSQI), depressive symptoms (BDI), and body weight (BMI). Nineteen patients with daily headache/migraine composed the clinical groups (10 iVNS and 9 BMT; iVNS mean age 49 years, range 36-61 years; BMT mean age 45 years, range 23-63 years; equally distributed gender). Cervical iVNS was applied from 5-13 years (mean 8 years) with following stimulation patterns: 1.3 mA (0.5-2 mA), 20 Hz, 250 μsec, 30 sec on/1.9 min off (0.5-5 min). The iVNS group had significantly lower VAS scores (iVNS 5.4; BMT 7.8; p = 0.03) and PASS cognitive/anxiety subscores (iVNS 21; BMT 16; p = 0.02) compared to BMT and HC. Global PASS (p = 0.07), FSVA, PSQI, BDI, and BMI scores did not differ significantly between groups. iVNS appears to have positive modulatory long-term effects on headache and affective/cognitive head pain perception in patients with drug-resistant focal epilepsy, thus deserving further attention.

1035 EXPLORING DISRUPTED SLEEP IN A POPULATION OF OLDER ADULTS LIVING WITH HIV

Over 1.2 million people in the United States are living with HIV, and more than half are 50 years of age and older. Disrupted sleep negatively impacts this aging population. Aging is known to alter circadian and thermoregulatory mechanisms essential to regulating the sleep cycle, and HIV itself may speed the aging process, contributing to earlier onset, and increased prevalence of disrupted sleep. Poor sleep adversely affects medication adherence, quality of life, and survival, and contributes to daytime sleepiness and fatigue. The purpose of this study was to assess determinants of cognitive function. This data is from a randomized controlled pilot study examining cognitive function in older adults with HIV. Twenty-four adults with HIV 50 years of age and older were recruited from an infectious disease clinic at a Midwestern University. Participants’ mean age was 56.2 (SD = 5.15), with 14.3 years of education (SD = 1.80). The majority were male (88%), African American (67%), and had been living with HIV for 19.88 years (SD = 8.14). Instruments included the Pittsburgh Sleep Quality Index, the Montreal Cognitive Assessment, and the Center for Epidemiological Studies Depression Scale. Eighty-eight percent of study participants were classified as poor sleepers (PSQI Global Score >5). Two-thirds of participants reported sleep duration of less than 7 hours most nights over the last month. Nearly 60% experienced delayed sleep onset latency (>30 minutes to fall asleep). Sleep efficiency was also problematic with over half reporting sleep efficiency scores of <75% (total hours of sleep / total hours in bed). Global sleep scores were positively correlated with increased depressive symptoms (p = .001), as were the component scores of sleep quality (p = .001) and sleep disturbance (p = .017). Sleep duration had a positive significant correlation with cognitive function (p = .018). Sleep problems are negatively impacting a large segment of the older HIV population, and advances in HIV care have not included improved sleep for this aging population. Determining specific sleep issues adversely affecting this population is a necessary first step in developing non-pharmacological interventions designed to improve sleep.

Association of sleep quality with hypertension in the elderly of Jino nationality: a multilevel model analysis

Objective: To evaluate the association of sleep quality with hypertension in the elderly population aged 60 years and older of Jino nationality. Methods: In August 2015, a cross-sectional population-based survey was conducted to investigate the prevalence of hypertension in 805 subjects sampled by multistage stratified and cluster sampling from the elderly population of Jino nationality, the sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI, a poor sleep group was defined as having a global PSQI score>7, a good sleep group was with a score of 7 or less), and the multilevel Logistic regression model was applied to analyze the association of sleep quality with hypertension. Results: A total of 793 eligible participants were available for analysis. Overall, 118 participants (14.9%) were in the poor sleep group, and 675 participants (85.1%) were in the good sleep group. The prevalence of hypertension, prevalence of isolated systolic hypertension, average systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the poor sleep group were significantly high than those of the good sleep group[73.7%, 22.0%, (139.2±17.7) and (82.5±10.6) mmHg (1 mmHg=0.133 kPa) vs 33.0%, 9.0%, (131.2±15.0) and (78.5±8.9) mmHg, all P<0.05]. The results of covariate-adjusted multilevel Logistic regression model indicated that subjective sleep quality (OR=2.64, 95% CI: 1.08-6.44), sleep latency (OR=2.98, 95% CI: 1.52-5.86), sleep disturbance (OR=2.93, 95% CI: 1.06-8.10), daytime dysfunction (OR=3.86, 95% CI: 1.74-8.58) and poor sleep (OR=3.98, 95% CI: 2.05-7.73) had the positive correlation with hypertension. Conclusions: The elderly population of Jino nationality with poor sleep have high SBP and DBP. There are positive associations of PSQI and its components with hypertension in the elderly population of Jino nationality.

Psychometric Evaluation of the PSQI in U.S. College Students.

Examine the psychometric properties of the PSQI in two U.S. college samples. Study I assessed convergent and divergent validity in 866 undergraduates who completed a sleep diary, PSQI, and other sleep and psychosocial measures. Study II assessed PSQI insomnia diagnostic accuracy in a separate sample of 147 healthy undergraduates with and without insomnia. The PSQI global score had only moderate convergent validity with sleep diary sleep efficiency (prospective global measure of sleep continuity; r = 0.53), the Insomnia Severity Index (r = 0.63), and fatigue (r = 0.44). The PSQI global score demonstrated good divergent validity with measures of excessive daytime sleepiness (r = 0.18), circadian preference (r = -0.08), alcohol (r = 0.08) and marijuana (r = 0.05) abuse scales, and poor divergent validity with depression (r = 0.48), anxiety (r = 0.40), and perceived stress (r = 0.33). Examination of other analogous PSQI and sleep diary components showed low to moderate convergent validity: sleep latency (r = 0.70), wake after sleep onset (r = 0.37), sleep duration (r = 0.51), and sleep efficiency (r = -0.32). Diagnostic accuracy of the PSQI to detect insomnia was very high (area under the curve = 0.999). Sensitivity and specificity were maximized at a cutoff of 6. The PSQI demonstrated moderate convergent validity compared to measures of insomnia and fatigue and good divergent validity with measures of daytime sleepiness, circadian phase preference, and alcohol and marijuana use. The PSQI demonstrated considerable overlap with depression, anxiety, and perceived stress. Therefore, caution should be used with interpretation.

Mindfulness meditation for insomnia: A meta-analysis of randomized controlled trials

BackgroundInsomnia is a widespread and debilitating condition that affects sleep quality and daily productivity. Although mindfulness meditation (MM) has been suggested as a potentially effective supplement to medical treatment for insomnia, no comprehensively quantitative research has been conducted in this field. Therefore, we performed a meta-analysis on the findings of related randomized controlled trials (RCTs) to evaluate the effects of MM on insomnia. MethodsRelated publications in PubMed, EMBASE, the Cochrane Library and PsycINFO were searched up to July 2015. To calculate the standardized mean differences (SMDs) and 95% confidence intervals (CIs), we used a fixed effect model when heterogeneity was negligible and a random effect model when heterogeneity was significant. ResultsA total of 330 participants in 6 RCTs that met the selection criteria were included in this meta-analysis. Analysis of overall effect revealed that MM significantly improved total wake time and sleep quality, but had no significant effects on sleep onset latency, total sleep time, wake after sleep onset, sleep efficiency, total wake time, ISI, PSQI and DBAS. Subgroup analyses showed that although there were no significant differences between MM and control groups in terms of total sleep time, significant effects were found in total wake time, sleep onset latency, sleep quality, sleep efficiency, and PSQI global score (absolute value of SMD range: 0.44–1.09, all p<0.05). ConclusionsThe results suggest that MM may mildly improve some sleep parameters in patients with insomnia. MM can serve as an auxiliary treatment to medication for sleep complaints.

Preoperative and post-operative sleep quality evaluation in rotator cuff tear patients

The aim of this study was to examine the potential relationship between subjective sleep quality and degree of pain in patients with rotator cuff repair. Thirty-one patients who underwent rotator cuff repair prospectively completed the Pittsburgh Sleep Quality Index, the Western Ontario Rotator Cuff Index, and the Constant and Murley shoulder scores before surgery and at 6months after surgery. Preoperative demographic, clinical, and radiologic parameters were also evaluated. The study analysed 31 patients with a median age of 61years. There was a significant difference preoperatively versus post-operatively in terms of all PSQI global scores and subdivisions (p<0.001). A statistically significant improvement was determined by the Western Ontario Rotator Cuff Scale and the Constant and Murley shoulder scores (p˂0.001). Sleep disorders are commonly seen in patients with rotator cuff tear, and after repair, there is an increase in the quality of sleep with a parallel improvement in shoulder functions. However, no statistically significant correlation was determined between arthroscopic procedures and the size of the tear and sleep quality. It is suggested that rotator cuff tear repair improves the quality of sleep and the quality of life. IV.

The Effects of Music Intervention on Sleep Quality in Community-Dwelling Elderly

To examine the effects of music intervention on sleep quality in community-dwelling elderly people. Two-armed randomized controlled trial. Four urban communities in Xi`an, China. People aged 60 years or older with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score >7). All participants received one sleep hygiene education session and biweekly telephone calls. Each participant in the intervention group received an MP3 player with a music database. The participants selected the preferred music and listened for 30-45 minutes per night for 3 months. Sleep quality, the main study outcome, was measured by PSQI at baseline, 1 month, 2 months, and 3 months. Sixty-four elderly people with a mean age of 69.38 ± 5.46 years were randomly assigned to the control group (n = 32) or the intervention group (n = 32). All participants completed the study, and none reported discomfort related to the music intervention. The intervention group demonstrated continuous improvements in sleep quality, with a global PSQI score of 13.53 at baseline, 9.28 at 1 month, 8.28 at 2 months, and 7.28 at 3 months. Although the global PSQI score in the control group also decreased from 12.26 at baseline to 8.72 at 3 months, the intervention group achieved greater improvements at each measurement (all p < 0.05). Repeated-measures analysis of variance revealed significant group-by-time interaction effects in global PSQI score and three component scores: sleep latency, sleep efficiency, and daytime dysfunction (all p < 0.05). Music is a safe and effective nonpharmacological intervention for improving the sleep quality of community-dwelling elderly people, especially in improving sleep latency, sleep efficiency, and daytime dysfunction.