Self-perceived Sleep Quality Research Articles

Neurofeedback to enhance sleep quality and insomnia: a systematic review and meta-analysis of randomized clinical trials

ObjectiveThis systematic review and meta-analysis of randomized-clinical trials aims to analyze the effect of interventions incorporating surface neurofeedback techniques on self-perceived sleep quality and insomnia in patients with or without sleep disturbances.MethodsThe review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and was deposited in the Prospero international prospective registry of systematic reviews (CRD42024528401). Seven clinical trials with different main outcomes but with pre-post intervention records of self-perceived sleep quality or insomnia symptoms assessed by questionnaires met our inclusion criteria, including a publication date within the last 10 years. Five trials investigated sleep quality through scores on the Pittsburgh sleep quality Index (PSQI) and three trials signs of insomnia severity assessed with validated scales. The methodological quality of the included studies was assessed using the Cochrane Collaboration’s tool for assessing the risk of bias and showed a high quality of them.ResultsA total of 5 studies that evaluated sleep quality with the PSQI total score were included in the meta-analysis. The results revealed that control conditions succeeded in improving PSQI-assessed sleep quality more than the analyzed Neurofeedback interventions (PSQI total score 0.57; 95% CI 0.13 to 1.01; p = 0.01). On the other hand, a total of 3 studies that evaluated insomnia severity with various insomnia scales were included in the meta-analysis The results revealed that neither the NF interventions nor the control conditions show a favorable outcome relative to each other (−0.13; 95% CI −0.44 to 0.18; p = 0.41).ConclusionThe interventions studied mostly apply a neurofeedback training protocol based on maintaining alpha waves in a range between 8 and 12 Hz, with electrode positioning in the frontal area or in the sensorimotor cortex and with a number of neurofeedback sessions ranging from 8 to 20 sessions. The meta-analysis showed that interventions incorporating surface neurofeedback do not produce additional benefits in self-perception of sleep quality or insomnia compared to a wide variety of control conditions including cognitive behavioral treatment or other biofeedback modalities.Systematic review registrationPROSPERO – International prospective register of systematic reviews – CRD42024528401 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=528401.

Self-perceived sleep quality during the covid pandemic: risk and protective factors

The situation derived from the Coronavirus disease (COVID-19) and lockdowns ordered to control the pandemic led to unprecedented problems in different areas of people’s well-being. This study aimed to explore the acute effects of the first lockdown on self-perceived sleep quality, as well as the risk/protective factors that modulated this impact. The sample was composed by 1,275 respondents ranging in age from 18 to 55 years. Participants wererecruited during the COVID-19 first lockdown in Spain. They wereevaluated regarding theirself reported sleep problems before and during lockdown, as well as other areas related to the impact of lockdown (e.g., on diet, physical activity, or use of digital media), psychological states (positive and negative affect), and traits (impulsivity). Most participants (66.7%) reported a decrease in their self-perceived sleep quality during the pandemic. Correlational analyses showed that maintaining good levels of physical activity and diet quality during the pandemic were positively associated with sleep quality; furthermore, greater levels of positive affect, living in bigger homes during lockdown, and age were positively associated with sleep quality as well. On the contrary, negative affect, female sex, and the impact of the pandemic on various domains (mental health, relationship quality, personal finances, and the use of digital media) were negatively related to self-perceived sleep quality. In brief, this study supports the impact of the COVID-19 pandemic on self-perceived sleep quality and provides a preliminary foundation for identifying protective and risk factors contributing to sleep quality during lockdowns and other situations of distress.

Association of morning and evening physical exercise with sleep quality and insomnia: differences between chronotypes

Objective: to investigate the association of morning and evening physical exercise with sleep quality (duration, latency, awakenings, and self-perceived sleep quality) and insomnia, depending on the chronotype. Methods: Participants (n=2,050; 18-65y) were part of a population-based research, with virtual data collection. Multiple logistic regression models were conducted to analyze the association of physical exercise (yes/no; frequency; morning/evening) with sleep variables (outcome), among all participants and according to chronotype. Linear regression analysis assessed differences in sleep duration, latency, and nocturnal awakenings (outcomes) associated with physical exercise variables. Multiple analyzes were adjusted for age, sex, diet quality, BMI, smoking, and evening alcohol consumption. Results: Participants who performed physical exercise had better sleep parameters and its practice in the morning was associated with shorter sleep latency among early (OR=-0.49; 95%CI=0.25;0.94; p<0.05) and late chronotypes (β=-15.10; 95%CI=-28.39;-1.81; p<0.05). There was no effect of exercising in the evening among intermediate and late chronotypes, however, among early types, it was associated with a higher frequency of awakenings (OR=1.78; 95%CI=1.06;2.96; p<0.05) and insomnia (OR=1.91; 95%CI=1.04;3.53; p<0.05). Conclusions: Such findings suggest the need to consider chronotypes, along with existing recommendations for sleep hygiene and circadian hygiene, in clinical-epidemiological physical activity strategies focused on promoting sleep quality and circadian health.

Associations between sleep habits, quality, chronotype and depression in a large cross-sectional sample of Swedish adolescents.

To investigate behavioral sleep habits, self-perceived quality of sleep, and chronotype, and to examine their association with clinically relevant levels of depression in Swedish adolescents. Questionnaire data were obtained from a representative sample of Swedish adolescents (n = 8449; 50.8% girls; aged 12-16). Depression was defined as >13 BDI-II scores. Logistic regression modelling estimated the effects of sleep duration, sleep quality, and chronotype on depression, adjusted for socio-demographic factors. On weekdays, approximately 46% of adolescents slept less than the recommended length of eight hours per night (depressed: 68%, non-depressed: 40%). On weekends, however, only 17% slept shorter than recommended. Short weekday sleep duration was more common among girls than boys (53% vs. 38%) and girls reported worse sleep quality. The regression model showed that depression was predicted by weekday sleep duration (OR = 0.773, p < .0001), sleep quality (OR = 0.327, p < .0001), and late chronotype (OR = 1.126, p = .0017), but not by weekend sleep duration. A 30-minute increase in weekday sleep duration was associated with about 10% lower odds of depression. A substantial proportion of Swedish adolescents do not seem to meet the sleep recommendations of eight hours per night. Short sleep duration on weekdays, poor sleep quality, and late chronotype were associated with increased risk of depression. Interventions promoting longer weekday sleep duration (e.g., later school start times) seem relevant in this context, but further research is needed to investigate the directionality and underlying mechanisms of these associations.

Effect of Sleep Quality and Duration on Jitter, Shimmer, and Harmonics-to-Noise Ratio among Colombian University Professors

Professors who sleep 6 or fewer hours are more likely to report voice symptoms. However, only three studies have been published on this topic, basing their conclusions on self-reported surveys and displaying an overall weak methodological quality, which hinders the generalization of these results. This exploratory, correlational, and longitudinal study aimed to determine the association between sleep quality and duration and three acoustic parameters linked to voice harmonicity and quality (jitter, shimmer, and Harmonics-to-Noise Ratio [HNR]) among 24 Colombian university professors. Generalized linear models with gamma distribution were used to analyze this association. Our results indicate that the professors who reported good sleep quality had significantly lower HNR values compared with those who had a low sleep quality. Additionally, increased jitter (B= 0.10) and shimmer (B= 0.10), and decreased HNR (B= -0.05) values were found when the duration of sleep increased. In contrast, participants with good self-perceived sleep quality and a shorter sleep duration presented lower voice harmonicity compared to those with bad sleep quality and shorter sleep duration, which may be associated with the physiological and emotional effects of sleep on voice production. Considering the multifactorial nature of voice production and the exploratory nature of the present study, it is important to note that a statistically significant correlation between sleep quality and duration and voice harmonicity does not necessarily imply that sleep directly causes voice disorders, but rather suggests that sleep is a variable to be considered when analyzing and treating individuals with voice issues. These findings provide insight into the complex interplay of variables that may contribute to voice disorders and highlight the importance of considering sleep as a potential contributing factor in the assessment and management of individuals with voice issues.

The prevalence of sleep paralysis in medical students in Buenos Aires, Argentina.

The objectives of this study were to determine the prevalence of sleep paralysis (SP) in medical students from the University of Buenos Aires (UBA). An ad hoc questionnaire based on the diagnosis of SP and a demographic survey was electronically presented to students of Internal Medicine at the School of Medicine of the UBA. The respondents answered both questionnaires using Google Forms®. The prevalence of SP was 40.7% (95% CI 33.5-47.8). A higher percentage of the respondents (76%) reported experiencing SP-related anxiety. An association between self-perceived quality of sleep and the incidence of SP was found (χ2: 12.712, P = 0.002). The highest frequency was hypnopompic SP (55.55%), and the highest percentage (55.4%) suffered from SP less than once every 6 months. Most respondents (59.5%) reported having started with SP symptoms after 18 years of age, and the highest percentage (66.2%) had exacerbated their symptoms at college. The frequency of the Incubus phenomenon was 14.5% (95% CI 6.2-23). Most respondents (70.8%) denied the association of SP with religious or paranormal beliefs. SP is highly prevalent in medical students and is associated with poor sleep habits and perceived poor sleep quality. Clinicians should be aware of this parasomnia to avoid a misdiagnosis of psychosis and inform sufferers of the nature of SP.

Changes in sleep performance and chronotype behaviour after vestibular rehabilitation in unilateral vestibular hypofunction.

This study aimed to investigate changes in sleep parameters and self-perceived sleep quality in unilateral vestibular hypofunction participants after vestibular rehabilitation. Forty-six unilateral vestibular hypofunction participants (before and after vestibular rehabilitation) along with a control group of 60 healthy patients underwent otoneurological examination, a one-week actigraphy sleep analysis and a series of self-report and performance measures. After vestibular rehabilitation, unilateral vestibular hypofunction participants showed a significant score decrease in the Pittsburgh Sleep Quality Index, a self-rated reliable questionnaire depicting sleep quality during the last month, as well as a reduction in sleep onset latency and an increase in total sleep time, indicating an objective improvement in sleep quality as measured by actigraphy analysis. However, after vestibular rehabilitation, unilateral vestibular hypofunction participants still showed statistically significant differences with respect to the control group in both self-rated and objective measurements of sleep quality. Vestibular rehabilitation may impact on sleep performance and chronotype behaviour, possibly by opposing long-term structural changes along neural pathways entangled in sleep activity because of the deafferentation of the vestibular nuclei.

Web survey during COVID-19 pandemic in São Paulo state: how are medical students sleeping and living?

This study aimed at characterizing medical students' sleep and life quality during the COVID-19 pandemic in São Paulo (SP) state. All public higher education institutions (HEIs) of SP state were invited to participate. From a list of 56 private HEIs, 16 were randomly selected. The web survey collected: sociodemographic data; factors related to COVID-19; sleep self-assessment; scores in the Epworth sleepiness scale, Pittsburgh sleep quality index, and student and resident life in the health area - questionnaire. The HEIs' acceptance rate was 25% (8), resulting in 200 participants (response rate 5.04%), aged ≥18 years, 60.5% females. Concerning COVID-19, 89.00% never showed symptoms and/or tested positive, 82.00% declared full adherence to epidemiological measures to prevent the infection's spread, and 45.00% completed the vaccination schedule against SARS-CoV-2. Sleep deprivation was accompanied by a drop of self-perceived sleep quality from 8 to 6 (in a Likert scale) during COVID-19 pandemics (p≤0.0001), 76.50% were poor sleepers, and 40.00% had drowsiness, especially women (p≤0.05). They also had lower quality of life and unfavorable psychological and physical outcomes than men (p≤0.05). Internship students had a more negative perception of the educational environment (p≤0.05), characterized by an excessive workload. Women and internship students are a representative fraction that requires special attention and focused strategies to cope with sleep problems and medical education during COVID-19 pandemics.

0685 Sleep, mental health and socioeconomic factors concomitantly influence the risk in tobacco consumption

Abstract Introduction Extensive evidence points that sleep, psychiatric symptoms and sociodemographic factors separately affect the risk involved in substance use. Due to the well-known relationship between these 3 pillars, an investigation of the combined effect of this factors on substance use is necessary. The objective of this study was to build a model including the 3 factors simultaneously and their effect on risk in substance use. Methods Volunteers of the EPISONO (2007) study underwent assessment through validated questionnaires concerning their general health and a night of polysomnographic examination. For this study, scores in the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were evaluated considering responses to questionnaires concerning sleep, psychiatric symptoms, and socioeconomic parameters, as well as polysomnographic findings. A structured equation modelling (SEM) protocol was conducted to build a theoretical model in which variables pertaining to the 3 factors of interest (sleep, mental health and socioeconomic influence) could have their simultaneous effect on substance use measured. Results 793 participants of the EPISONO were included (mean age=43.4 years; 452 women). Significant effects were found for the tobacco consumption model. Subjective sleep quality (SSQ), psychiatric symptoms (PS) and socioeconomic status (SES) influenced the ASSIST score for tobacco consumption. Influence of PS on tobacco consumption was also mediated by SSQ. Models for other substances assessed in the ASSIST questionnaire, such as alcohol, did not find any statistically significant effect. Conclusion The lack of significance of models for alcohol and other substances may be related to the nature of our sample, in which not many individuals presented a substantial risk of substance involvement that could be detected by the ASSIST questionnaire. However, in the model for tobacco consumption, subjective sleep quality, socioeconomic status and psychiatric symptoms exerted an effect on tobacco consumption risk, with psychiatric symptoms having their influence mediated by self-perceived sleep quality. Support (If Any) Our studies are supported by Associação Fundo de Incentivo à Pesquisa (AFIP), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES Finance Code 001 to GLF) and Conselho Nacional de Desenvolvimento Científico Tecnológico (CNPq – Grant #141445/2021-1 to GLF); S.T. and M.L.A. received CNPq fellowships.

Effects of Exercise Frequency and Intensity on Reducing Depressive Symptoms in Older Adults With Insomnia: A Pilot Randomized Controlled Trial.

BackgroundThe effects of exercise frequency and intensity on alleviating depressive symptoms in older adults with insomnia are unclear.PurposeThe purpose of this study was to investigate the influence of different exercise frequencies and intensities on prescribed aerobic-type physical activity (i.e., 75 min of vigorous-intensity exercise or 150 min of moderate-intensity exercise weekly) for reducing depressive symptoms in older adults living with insomnia, as recommended by the WHO.DesignThis study is a randomized, controlled, assessor-blinded trial.SettingThis study is conducted at a single research site in Hong Kong.ParticipantsThis study includes older adults aged 50 years or above with depressive symptoms and insomnia.InterventionParticipants were randomly assigned in a 1:1:1:1:1 ratio to the following groups: attention control (CON), moderate walking once weekly (MOD × 1/week), moderate walking thrice weekly (MOD × 3/week), vigorous walking once weekly (VIG × 1/week), and vigorous walking thrice weekly (VIG × 3/week). The total weekly exercise volumes among the walking groups were matched to the minimum recommended physical activity volume.MeasurementsDepression, anxiety, self-perceived sleep quality, insomnia severity, actigraphy-assessed 7-day sleep data, 7-day sleep diary, cardiorespiratory fitness, adherence, and habitual physical activity were examined at baseline and after 12 weeks of intervention.ResultsBoth MOD × 3/week and VIG × 3/week groups demonstrated reduced depression (Hospital Anxiety and Depression Scale [HADS] – Depression: MOD × 3/wk: −68.6%; VIG × 3/week: −67.4%) and anxiety levels (HADS – Anxiety: MOD × 3/week: −54.3%; VIG × 3/week: −59.8%) compared with CON (both p < 0.01). Self-perceived sleep quality was improved in MOD × 3/week (−31.4% of the Pittsburgh Sleep Quality Index [PSQI]), VIG × 1/week (−34.1% of PSQI), and VIG × 3/week (−38.3% of PSQI), but not in MOD × 1/week, when compared with CON (p < 0.05). No serious adverse events were observed in this study.ConclusionThe effects of walking training on reducing depressive symptoms appeared to be dependent on exercise frequency. Our findings suggest that three sessions of walking per week at either moderate or vigorous-intensity effectively alleviate depressive symptoms in older adults with insomnia. Additional research is needed to further verify the effects of exercise frequency on depression.Clinical Trial Registration[ClinicalTrials.gov], identifier [NCT04354922].

Multiple Logistic Regression Analysis of Smartphone Use in University Students.

Problematic smartphone use (PSU) is an expanded public health heed that requires more study to clarify the influence elements of different populations. The aim of this study was to investigate the relationship between smartphone use, and sleep quality, self-perceived health, and exercise participation in university students. A total of 1,575 Taiwanese undergraduate students from 7 universities participated in the study. Three questionnaires were completed by the study individuals. The results show the overall PSU rate was 11.8%. Average smartphone users were more likely to feel in good health, better sleep quality and less unsatisfactory exercise participation than those who were problematic smartphone users. Multiple logistic regression analysis indicated that PSU, low weekly exercise frequency, and poor sleep quality were significant indicators of poor self-perceived health. We concluded that both low physical activity and PSU did have negative impacts on self-perceived health and sleep quality for undergraduate students.

Is physical inactivity or sitting time associated with insomnia in older men? A cross-sectional study

Sleep disorders, among which insomnia is the most common, have a significant impact on public health and might be connected to lower levels of physical activity. However, there is no evidence linking physical inactivity or extended sitting time to insomnia in older men. In this study, the associations between physical inactivity and sitting time with insomnia in older male participants from the São Paulo Epidemiologic Sleep Study (EPISONO) were assessed. We investigated a sub-sample of older men from the EPISONO study who completed a series of questionnaires evaluating self-perceived sleep quality and potential associated factors. Sitting time was not associated with poorer sleep in older men. However, physical inactivity and symptoms of depression were positively correlated with self-perceived sleep quality. Our results demonstrated that low levels of physical activity are associated with poor sleep quality. Strategies and policies that encourage and enable older men to be more physically active deserve attention.

Self-perceived quality of sleep among COPD patients in Greece: the SLEPICO study

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide accompanied by a substantial social and economic burden for the patient and the society. Poor sleep quality among COPD patients is frequently unnoticed and unaddressed by physicians and patients themselves, although it is a major source of further deterioration of these patients’ quality of life. The aim of the present study was to record the quality of sleep in COPD patients among the Greek population and correlate these findings with various features of these patients, using the COPD and Asthma Sleep Impact Scale (CASIS). This was a cross-sectional observational study. Forty different variables (demographics, vital sign measurements, COPD-related medical history parameters, comorbidities, CASIS questionnaire results, COPD assessment test, COPD severity based on spirometry measurements, COPD stage based on the ABCD assessment approach, inhaled COPD treatment report) were collected from 3454 nation-wide COPD patients (Greece). The study sample consisted of COPD patients, mainly male (73%) with a median age of 69 years and a median BMI of 27.2. More than half of COPD patients (60.6%) suffered from moderate disease severity and 23.8% from severe disease, while less than half (42.1%) suffered from at least one exacerbation of the disease over the last year prior study enrollment. About 14% reported frequent to very frequent issues affecting their sleep quality, between a fourth and a third of them reported occasional night sleep disturbances, and at least half of them reported no or very infrequent problems in their night sleep. Our study indicates that the COPD assessment test (CAT) and the spirometry-based disease severity can predict the poorness in the quality of sleep (F2,3451 = 1397.5, p < 0.001, adj. R2 = 0.45) as assessed by CASIS score, and that the latter also correlates with age (ρ = 0.122, p < 0.001) and disease duration (ρ = 0.104, p < 0.001). On the contrary, there appears to be no correlation between sleep quality and number of exacerbations. Finally, untreated patients with COPD suffer from poorer quality of sleep compared to treated subjects, independently of the use of inhaled corticosteroids (F2,3451 = 21.65, p < 0.001). The results of the SLEPICO study show that increased age, prolonged disease duration, and especially CAT score ≥ 10, and severe COPD stage, might act as important indicators for deterioration in the quality of sleep, with potential consequences in the daily routine of those patients, thus urging potentially for further pharmacological interventions or modifications.

Sleep quality and emotion recognition in individuals with and without internalizing psychopathologies

Background and objectivesSeparate lines of research indicate sleep quality may impact recognition of facial expressions in anxious or depressed individuals. This study examined facial emotion recognition ability in the context of self-perceived sleep quality and anxiety and depression symptom levels in individuals with and without internalizing psychopathologies. MethodsSeventy anxious and/or depressed patients and 24 demographically matched healthy controls completed the Pittsburgh Sleep Quality Index (PSQI), standard measures of anxiety and depression, and an Emotion Recognition Task comprising negative and positive facial expressions. ResultsAnalyses of variance results revealed patients reported worse sleep quality than controls. Linear mixed-effects models indicated that all participants demonstrated better emotion recognition abilities in identifying positive versus negative emotions. For reaction time, but not accuracy, regression results revealed significant individual differences, with worse sleep quality predicting slower reaction times for positive faces, specifically for happiness. LimitationsThe use of a subjective measure of sleep quality and a specific behavioral paradigm for emotion recognition may impact the generalizability of the findings. ConclusionsAssociations between task performance and emotional valence of facial expression implies that poor sleep quality, beyond internalizing symptom severity, may disrupt emotion processing.

Challenges Faced by Emergency Physicians in China: An Observation From the Perspective of Burnout

Background: Burnout is considered a global problem, particularly in the emergency health sector; however, no large-sample cross-sectional study has assessed the prevalence of burnout among emergency physicians and its associated factors.Methods: A nationally representative cross-sectional survey of 15,243 emergency physicians was conducted in 31 provinces across China between July and September 2019. Multiple linear regression analysis was performed to identify correlates of burnout.Results: The participants' mean scores were 25.8 (SD = 15.9) on the emotional exhaustion (EE) subscale, 8.1 (SD = 7.9) on the depersonalization (DP) subscale, and 26.80 (SD = 12.5) on the personal accomplishment (PA) subscale, indicating a pattern of moderate EE, moderate DP, and high PA. The results of the large-sample survey found that 14.9% of emergency physicians had a high level of burnout in China, with 46.8% scoring high for EE, 24.1% scoring high for DP, and 60.5% having a high risk of low PA. Having poor self-perceived health status and sleep quality, working in developed regions and governmental hospitals, having an intermediate professional title, experiencing depression, performing shift work and experiencing workplace violence made emergency physicians more likely to experience occupational burnout.Conclusion: Positive measures should be taken to reduce the burnout of emergency physicians and improve their work enthusiasm to maintain the quality of emergency medical services.

An Association Rule Analysis of the Acupressure Effect on Sleep Quality.

Background Sleep is recognized as an all-important physiological process, which also contributes to maintaining several bodily functions and systems. According to the Pittsburgh Sleep Quality Index (PSQI), also known as the most widely used tool in the field of subjective assessment of self-perceived sleep quality, a combination of acupoints could be more effective than single acupoint treatment in improving sleep quality. Methods The present study was based on the extracted eligible studies rooted in a previous meta-analysis that worked on the basis of association rule mining and examined the potential kernel acupoint combinations for improving sleep quality. Results Depending on the Apriori algorithm, we summarized 26 acupoints as binary data from the 32 eligible studies based on a previous meta-analysis and analyzed them. The top 10 most frequently selected acupoints were HT7, SP6, PC6, KI1, GV20, EM5, EX-HN3, EX-HN16, KI3, and MA-TF1. Furthermore, as deduced from 21 association rules, the primary relevant rules in the combination of acupoints are (EX-HN3, EX-HN16)=>(GV20) and (HT7, KI1)=>(PC6). Conclusions In order to use acupuncture to improve sleep quality, integrating (EX-HN3, EX-HN16, GV20) with (HT7, KI1, PC6) acupoints could be deemed as the kernel acupoint combination.

Quality of life, distrust in health care system and adherence to medical recommendations in patients with fibromyalgia: a latent profile analysis

Introduction: Fibromyalgia is a very heterogeneous disorder. This heterogeneity is one of the reasons why researchers have tried to analyze different patient profiles and their relationship with quality of life. The aim of the present study was to identify: (1) latent profiles based on the Revised Fibromyalgia Impact Questionnaire’s scores, and (2) possible differences between them in quality of life, distrust in healthcare system, and adherence to medical recommendations. Methods : 707 FM patients (aged 18-85 years, 95% women) completed the Revised Fibromyalgia Impact Questionnaire, the 12-Item Short Form Health Survey, the Patient Adherence Scale, and the Health Care System Distrust Scale. Data were analyzed using latent profile analysis. Results : Three profiles were identified: (1) Low fibromyalgia impact profile (2) Moderate fibromyalgia impact profile, and (3) High fibromyalgia impact profile. Significant differences between these profiles were found in quality of life, adherence to medical recommendations, and distrust in healthcare system. Poor-sleep quality emerged as a significant high important symptom in the three profiles. Conclusion : The greater the fibromyalgia impact, the lower the quality of life, and the adherence to medical recommendations and the greater the mistrust in the healthcare system. Self-perceived sleep quality in fibromyalgia patients should require special attention from clinicians.

Sleep in adults with autism spectrum disorder and adhd: A meta-analysis

IntroductionSleep-related problems have been frequently reported in neurodevelopmental disorders, with special emphasis in Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disor-der (ADHD).ObjectivesTo perform a meta-analysis (PROSPERO’s CRD42019132916) on sleep disturbances in adults with ASD and/or ADHD.MethodsA total of 1126 studies and 66 references were identified by electronic and manual searches, respectively. Of these, 42 studies were included in the meta-analysis.Resultsshowed that both disorders share a similar sleep-impaired profile with higher sleep onset latency, poorer sleep efficiency, greater number of awakenings during sleep, and a general lower self-perceived sleep quality compared with healthy controls. A higher proportion of N1 sleep was found in ASD participants, while a greater Periodic Limb Movements in Sleep is specific in ADHD adults.ConclusionsSleep is impaired by several sleep problems and disorders in both ASD and ADHD adults. More research is needed to develop more awareness in mental healthcare, and better treatment of this impairing comorbidity in ASD and ADHDDisclosureNo significant relationships.

Poorer sleep quality predicts melatonin response in patients with traumatic brain injury: findings from a randomized controlled trial.

A recent clinical trial demonstrated that melatonin treatment was effective in improving self-perceived sleep quality in patients with traumatic brain injury (TBI); however, it remains unclear which patients benefited from melatonin treatment. To that end, findings from the clinical trial were re-examined to identify possible predictors of treatment response. Hierarchical multiple regression was used to identify patient characteristics, TBI injury characteristics, and self-report measures assessing sleep, fatigue, mood, and anxiety symptomatology that may uniquely explain a change in self-reported sleep quality scores (follow-up minus baseline score) as assessed by the Pittsburgh Sleep Quality Index (PSQI). After controlling for patient demographic and TBI injury-related variables, baseline self-report measures of sleep, fatigue, mood, and anxiety explained an additional 32% of the variance in change in PSQI scores. However, only baseline PSQI score made a unique and statistically significant contribution (β = -0.56, P = .006). After controlling for patient and TBI characteristics, baseline PSQI scores further explained 27% of the variance in change in PSQI scores (R2 change = .27, F1, 27 change = 11.79, P = .002). The standardized β for baseline PSQI score revealed a statistically significant negative relationship with change in PSQI score (β = -0.54, P = .002), revealing that higher PSQI score at baseline was associated with better sleep outcomes. In a sample comprising predominantly severe TBI and comorbid insomnia, participants who report poorer sleep quality have the most to gain from melatonin treatment irrespective of time since injury, demographics, fatigue, daytimes sleepiness, mood, and anxiety symptomology. Registry: Australian New Zealand Clinical Trials Registry; Name: Efficacy of Melatonin for Sleep Disturbance Following Traumatic Brain Injury; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=343083&showOriginal=true&isReview=true; Identifier: ACTRN12611000734965. Grima NA, Rajaratnam SMW, Mansfield D, McKenzie D, Ponsford JL. Poorer sleep quality predicts melatonin response in patients with traumatic brain injury: findings from a randomized controlled trial. J Clin Sleep Med. 2021;17(8):1545-1551.

Association between sleep disturbance with motoric cognitive risk syndrome in Chinese older adults.

Sleep disturbance and cognitive impairment are common and related in the elderly population worldwide. The aim of the present study was to explore the association between sleep disturbance and motoric cognitive risk (MCR) syndrome, which is characterized by subjective cognitive complaints and objective slow gait in older individuals without dementia or any mobility disability in the community-dwelling elderly Chinese population. We recruited 940 participants aged≥65years from November 2016 to March 2017 in the Ningbo Community Study on Aging (NCSA). Self-reported sleep duration and sleep-quality variables, comprehensive geriatric evaluation, as well as indicators for diagnosing MCR syndrome were evaluated in this cross-sectional study. Multiple logistic regression analysis showed that a 1-SD increase in night (1.1h) and 24-h sleep duration (1.3h) was associated, respectively, with a 21% (95% confidence interval [CI], 1%-47%; p=0.04) and 30% (95% CI, 3%-64%; p=0.03) higher odds of having MCR syndrome. Considering sleep duration as a categorical variable, longer night-sleep duration (>8.5h) was associated with MCR syndrome (OR, 2.03; p=0.02) compared to shorter night-sleep duration (<8h). For sleep-quality factors, increasing frequency of trouble falling asleep, waking early or easily, nightmares, and taking sleep drugs were significantly associated with MCR syndrome after adjusting for potential covariables (all p for trend<0.05), but not for self-perceived sleep quality (p for trend=0.10). Long sleep duration, poor sleep quality, and taking sleep drugs were associated with higher odds of having MCR syndrome in the community-dwelling elderly Chinese population. Further research is needed to explore the underlying mechanisms.