Severe Sleep Problems Research Articles

Study on the Health Impacts on Workers in Small Scale Industry

This journal speaks the significant of Peripheral Artery Disease, Chronic fatigue syndrome, Correct footwear fitting. have emerged as leading causes of morbidity and mortality in developed and developing regions of the world. The disease burden attributed continues to increase worldwide, with cardiovascular diseases the leading cause of mortality and morbidity. Chronic fatigue syndrome, also called myalgic encephalomyelitis, is a complex multisystem disease commonly characterized by severe fatigue, cognitive dysfunction, sleep problems, autonomic dysfunction, and post-exertional malaise severely impairing activities of daily living. Footwear fitting is acknowledged as being vitally important as in most cases fit governs function. This means that footwear cannot fulfil its intended purpose if it does not fit the foot correctly.

Food insecurity and insomnia-related symptoms among adults from low- and middle-income countries.

Little is known about the relationship between food insecurity and sleep problems in low- and middle-income countries, while the mediators of this association are largely unknown. Therefore, we investigated the association between food insecurity and insomnia-related symptoms in six low- and middle-income countries (i.e., China, Ghana, India, Mexico, Russia, South Africa), and the potential mediators of this relationship. Cross-sectional, nationally representative data from the Study on Global AGEing and Adult Health (2007-2010) were analysed. Past 12-month food insecurity was assessed with two questions on the frequency of eating less, and on hunger owing to a lack of food. Insomnia-related symptoms referred to severe or extreme sleep problems in the past 30 days. Multivariable logistic regression and mediation analysis were conducted. Data on 42,489 adults aged ≥18 years were analysed (mean [standard deviation] age 43.8 [14.4]years; 50.1% females). The prevalence of any food insecurity and insomnia-related symptoms was 11.9% and 4.4%, respectively. After adjustment, compared with no food insecurity, moderate (odds ratio=1.53, 95% confidence interval=1.11-2.10) and severe food insecurity (odds ratio=2.35, 95% confidence interval=1.56-3.55) were significantly associated with insomnia-related symptoms. Anxiety, perceived stress, and depression mediated 27.7%, 13.5%, and 12.5% of the relationship between any food insecurity and insomnia-related symptoms, respectively (total percentage=43.3%). Food insecurity was positively associated with insomnia-related symptoms in adults from six low- and middle-income countries. Anxiety, perceived stress, and depression explained a substantial proportion of this relationship. Addressing food insecurity itself or the identified potential mediators among people with food insecurity may lead to a reduction in sleep problems among adults in low- and middle-income countries, pending confirmation with longitudinal studies.

Association between negative psychology and sleep quality in dialysis patients during the COVID-19 pandemic.

The aim of this study was to assess the sleep quality in dialysis patients during the COVID-19 epidemic and explore the association between negative psychology (including depression, anxiety, and stress) and sleep quality in this population. A cross-sectional study including three centres. This cross-sectional study included 378 dialysis patients from April to May 2022 in three dialysis centres in Shanghai. Depression, anxiety, stress, and sleep quality were measured by the Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale-14 (PSS-14), and Pittsburgh sleep quality index (PSQI), respectively. With a threshold of 5 to classify participants into good and poor sleep quality, with HADS/PSS-14 scores as independent variables (per standard deviation (SD) increment), respectively and binary Logistic regression model was constructed to explore the association between the three negative psychological aspects of depression, anxiety, and stress and sleep quality. The median PSQI score was 11.0 (mean ± SD: 11.8 ± 4.8). Among them, poor sleep quality (i.e., PSQI >5) was reported by 90.2% of participants. After adjusting for sociodemographic and disease-related information, HADS-depression was associated with a significant 49% (odds ratio (OR): 1.49; 95% CI 1.02-2.18) increase in the risk of poor sleep quality for each additional SD (2.4). Correspondingly, for each SD (7.1) increase in PSS-14, the risk of poor sleep quality was significantly increased by 95% (OR: 1.95; 95% CI 1.35-2.82). During the COVID-19 pandemic, there was a significant negative association between negative psychology, such as depression and stress, and sleep quality in dialysis patients, and this relationship was independent of the dialysis modality. In the context of the rampant COVID-19, the vast majority of dialysis-dependent chronic kidney disease presents with severe sleep quality problems, and negative psychology is a potential influencing factor.

Sleep disturbances and their association with behaviour in children with autism spectrum disorder: A cross-sectional study.

In this study, we aimed to determine the prevalence of sleep disturbances among children aged 2-5 years with autism spectrum disorder (ASD) and their association with behaviour in these children. A cross-sectional study was conducted at Hospital Tunku Azizah, Kuala Lumpur, Malaysia, from June 2020 to December 2020. Children between 2 and 5 years old, diagnosed with ASD based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, were recruited. Two parent-reported questionnaires, the Children's Sleep Habits Questionnaire (CSHQ) and the Child Behaviour Checklist (CBCL/1.5-5), were used to assess sleep and behaviour, respectively. Children were classified as good sleepers (CSHQ score <41) and poor sleepers (CSHQ score ≥41). Poor sleepers were further categorised into those with mild or moderate to severe sleep problems (based on the 75th percentile CSHQ score). The CBCL/1.5-5 raw scores were converted to standardise T-scores, yielding scores of three summary scales (internalising, externalising and total problems). A total of 134 children participated in this study. Their mean age was 42.23 ± 9.95 months, and 81.3% were males. Mean CSHQ score was 49.77 ± 6.90, and 93.3% were poor sleepers. Internalising, externalising and total problems scores were significantly higher in poor sleepers (62, 59 and 62, respectively) compared to good sleepers (56, 47 and 51, respectively). Children with moderate to severe sleep problems had clinical scores of internalising (median 65) and externalising (median 65) problems, as compared to mild sleep problems (median internalising score 61, median externalising score 57). Sleep disturbances are prevalent among children with ASD. Poor sleep quality is associated with more behavioural problems.

How sensitive is the compensating income variation to severity and adaptation?

Knowing the monetary value individuals place on health is essential in tackling resource allocation between health and other uses. However, health conditions vary greatly, not only with respect to main characteristics but also by severity and duration. We apply the compensating income variation (CIV) method to data from the Swiss Household Panel, years 2004–2019, to explore the sensitivity of CIV estimates to severity and adaptation across five different health conditions: headaches, back problems, sleep problems, fatigue, and chronic illness. Accounting for income endogeneity in the life-satisfaction equations and adjusting for individual random effects, we found the CIV estimates to range from $3184 for moderate headaches (women) to $100,066 for severe fatigue (men). Individuals with severe conditions needed to be compensated about three times more than those suffering less. Across the five conditions with two severity levels explored for adaptation, individuals only adapted to moderate headaches and severe sleep problems. In conclusion, not only does the value of health conditions vary greatly, but within each health condition its value on average triples when severe condition is reported as opposed to moderate. Adaptation plays a minor role in CIV estimates for the five health conditions explored.

People with passive sleep delay have more severe depression and sleep problems than those with active sleep delays-a cross-sectional study after the COVID-19 pandemic

ObjectiveThis study was designed to investigate the effect of different types of sleep delay in depression and sleep characteristics after the pandemic. Meanwhile, risk factors for depression were also explored. MethodsThe survey was conducted in Wuhan from March 1 to May 30, 2021, and participants were recruited through a snowball process. A total of 1,583 people with sleep delays responded to the invitation, of which 1,296 were enrolled. Participants filled out a questionnaire including social demographics, sleep characteristics, Social Support Rating Scale (SSRS), Pittsburgh Sleep Quality Index (PSQI) and Patient Health Questionnaire-9 (PHQ-9). ResultsThere were no significant differences in sex, social support and level of education between the two types of sleep delay (p = 0.961, p = 0.110, p = 0.090), but the average age of the passive sleep delay group was higher (p = 0.015). And most people with active sleep delay were caused by the use of electronic devices (73.6%), while most people with passive sleep delay were caused by work or study tasks (73.2%), with a significant difference between the two groups (p < 0.001). People who actively delayed sleep had more regular sleep (p < 0.001), better sleep quality and longer sleep duration (p < 0.001, p < 0.001). In addition, although they delayed sleep more frequently (p < 0.001), they had significantly lower depression degree than people who passively delayed sleep (p < 0.001). ConclusionsPassive sleep delays, usually caused by work or study, has higher levels of depression and more adverse sleep behaviors than active sleep delay. The findings help further understand the effects of delayed sleep and provide insight for people with delayed sleep to evaluate their own condition. Future studies are required to standardize and accurately classify sleep delay and further explore it.

Women with lipoedema: a national survey on their health, health-related quality of life, and sense of coherence

BackgroundLipoedema is a chronic disease in adipose tissue that almost exclusively affects women during periods of hormonal alterations. Its main symptoms include an abnormal accumulation of subcutaneous fat in the buttock, hips, and legs, which is associated with pain, swelling, and easy bruising. Herein, a grading in three stages is used to determine disease progression. Problematically, lipoedema manifestations are often confused with lifestyle-induced obesity, which is why the various health problems among affected women often remain unrecognized. Overall, research on lipoedema is scarce. As such, this study examined the health, health-related quality of life (HRQOL), and sense of coherence (SOC) among women with lipoedema.MethodsWe conducted a national cross-sectional study using an online survey assessing sociodemographic data, lipoedema characteristics, symptom severity, comorbidities, HRQOL (RAND-36), and SOC (SOC-13). In total, 245 women with lipoedema, recruited from all Lipoedema Association groups in Sweden, participated. Data were compiled with descriptive statistics, and mean differences between groups were analysed by using parametric and non-parametric tests.ResultsModerate and severe leg heaviness, pain, numbness, cold skin, feeling cold, easy bruising, and sleep problems were found to occur in all lipoedema stages. Moreover, almost all participants reported having comorbidities. Worse physical health and most substantial limitations in daily life were reported among women with the most progressive lipoedema (i.e., stage 3). Social and emotional functioning and SOC were found to be, on the other hand, primarily related to respondents’ sociodemographic data and their ages at lipoedema onset. Even though approximately 70% of the women had experienced lipoedema onset before age 30, only three (1.6%) had been diagnosed by a healthcare professional before that age.ConclusionHaving lipoedema is associated with several health problems and a lower HRQOL. In addition, the extent of delay in diagnosis within this sample indicates that many women with lipoedema are often underdiagnosed and are left without support from healthcare. These findings call for the need for greater attention on lipoedema. Moreover, further studies on how women with lipoedema manage their health and symptoms, as well as on their experiences of healthcare services and lipoedema treatments, are needed.

Assessment Of Sleep Quality By The Athlete Sleep Screening Questionnaire In Chinese Collegiate Athletes

Purpose: This study aimed to characterize sleep quality and to explore the factors that are associated with the severity of sleep difficulty among Chinese collegiate athletes. Methods: Sleep quality and associated factors were assessed by the Athlete Sleep Screening Questionnaire (ASSQ) in college athletes (n = 395, 73.6% response rate, aged 18 to 32 years, 47.6% female, 22.5% were master level, 47.6% national level and 29.9% second level in 15 different sports events). A sleep difficulty score (SDS) and level of sleep problem (0-4, none; 5-7, mild; 8-10, moderate; 11-17, severe) were used to classify participants. In addition, sports-related information such as sports events and training years were collected. Categorical variables were analyzed by Chi-squared (ꭓ2) or fisher’s exact test. An ordinal logistic regression analysis was used to explore factors with poor sleep (SDS > 8). Results: Approximately 14.2% of participants were found to have moderate to severe sleep problem (SDS > 8). When athletes travelled to participate in sports competitions, those who have experienced sleep disturbance were more diagnosed in the moderate-to-severe problem category than those without sleep disturbance (11.4% Vs. 2.8%, ꭓ2, 27.5; P < 0.001). While athletes who experienced daytime dysfunction when traveling fell more into the moderate-to-severe sleep problem category than athletes without daytime dysfunction (7.6% Vs. 6.6%, ꭓ2, 20.7; P < 0.001). No significant difference was found in SDS category between gender, sports level and sports events (All P > 0.05). Athletes with evening chronotype were more likely to report worse sleep compared to athletes with morning chronotype (OR, 2.25; 95%CI, 1.44 - 3.52; P < 0.001). For each additional year of age, there was an increase in odds ratio for poor sleep quality (OR1.15; 95% CI, 1.04 - 1.26; P = 0.004). However, increasing each additional year of training reduced the odds ratio for poor sleep quality (OR,0.95; 95% CI, 0.91 - 0.99; P = 0.044). Conclusion: To improve sleep health in collegiate athletes, chronotype, travel-related issues, age and training years should be taken into consideration in sleep counseling.

Longitudinal developmental trajectories in young autistic children presenting with sleep problems, compared to those presenting without sleep problems, gathered via parent-report using a mobile application

The effect of sleep problems in 2- to 5-year-old autistic children was investigated in the largest and the longest observational study to-date. Parents assessed the development of 8540 children quarterly for three years on five orthogonal subscales: combinatorial receptive language, expressive language, sociability, sensory awareness, and health. 57% of caregivers reported no sleep problems, 31% reported mild sleep problems, 10% reported moderate sleep problems, and 2% reported severe sleep problems. In order to investigate the effect of sleep problems, children with moderate and severe sleep problems (N = 651) were matched to those with no sleep problems using a propensity score based on age, gender, expressive language, combinatorial receptive language, sociability, sensory awareness, and health at the 1st evaluation. There were 643 matched participants in each group. Children with no sleep problems developed faster compared to matched children with sleep problems in all subscales. The greatest difference in trajectories was detected in the health subscale. When controlling for the health score (in addition to each subscale score at baseline as well as gender and ASD severity), the effect of sleep problems decreased in all subscales except the combinatorial receptive language subscale (where the effect of sleep problems was increased), suggesting that sleep problems affect combinatorial language acquisition regardless of the overall health. This study confirms a high prevalence of sleep problems in autistic children and provides information on the effect of sleep problems on various aspects of children’s development.

Hot flushes and sweating, sleep problems, joint and muscular discomfort, and physical and mental exhaustion in breast cancer survivors during the first 24 months of tamoxifen therapy: a prospective observational study.

PurposeThis study aimed to explore symptom trajectories over 24 months for hot flushes and sweating, sleep problems, joint and muscular discomfort, and physical and mental exhaustion experienced by premenopausal women diagnosed with tamoxifen-treated breast cancer.MethodsA total of 104 patients participated in the study. The menopausal symptoms were examined using the Menopausal Rating Scale at baseline, 3–6, 12, and 18–24 months after initiating tamoxifen. The changes over four time points were analyzed using repeated measures analysis of variance. The chi-square test was used to examine the differences between “no symptom-to-mild” and “moderate-to-extremely severe” 3–6 months after initiating tamoxifen according to the patients’ chemotherapy treatment experiences.ResultsAll menopausal symptoms occurred in > 70% of patients with breast cancer and persisted until 24 months. More than 50% of patients experienced four menopausal symptoms, with at least two at a serious severity level after initiating tamoxifen. Hot flushes and sweating occurred in the highest number of patients, recording high scores. Sleep problems and physical and mental exhaustion exhibited relatively high scores, even before tamoxifen initiation. There were significant changes over four time points in all symptoms. Young patients aged < 40 years experienced more severe sleep problems, and patients who had previously received chemotherapy experienced more severe joint and muscular discomfort.ConclusionsThis study’s findings may assist in alerting healthcare providers to menopausal symptoms that develop during tamoxifen therapy and the need for early and active intervention to minimize symptom occurrence and distress.

Comparison of Sleep Quality in Pregnant Women With Preeclampsia and Control: A Case-Control Study

Background and Aim Preeclampsia is a common complication of the second half of pregnancy. Sleep disorders can cause high blood pressure by causing oxidative stress and endothelial dysfunction. Therefore, the present study was performed to determine the relationship between sleep disorders and preeclampsia. Methods &amp; Materials This is a case-control study that was performed on 240 women referred to the affiliated university hospitals in Mashhad. Sampling was performed in the case group of hospitalized women with a definite diagnosis of preeclampsia (n=90) and in the control group (n=150) among pregnant women without preeclampsia referred to the obstetrics clinic. Data collection tools included demographic information questionnaire and gynecological/obstetric records, Pittsburgh Sleep Quality Questionnaire and clinical evaluation form to determine the symptoms and severity of preeclampsia. Data analysis was performed using SPSS statistical software (version 22) and Mann-Whitney, Chi-square and Fisher tests. A P value of less than 0.05 was considered significant. Ethical Considerations The present paper is the result of a research project approved by the Vice-Chancellor for Research of Mashhad University of Medical Sciences (Code: IR.MUMS.NURSE.REC.1397.042). Results The mean amount of real sleep at night in the group of healthy individuals (8.4±2.3) was significantly higher than patients (8.0±‌2.2) (P‌=‌0.028). In terms of loud snoring, waking up in the middle of the night was most frequent in the affected group (P‌&lt;0.001). There was a statistically significant difference between the two groups in terms of sleep quality score level (P‌&lt;0.001) based on logistic regression test in women with severe sleep problems at risk of preeclampsia (P‌&lt;0.001, 95% CI 2.9-42.2, OR‌: 11‌/‌11) (11/11) was equal compared to healthy women. Conclusion The present study showed that sleep disorders in pregnancy are associated with an increased risk of preeclampsia.

Association between sleep disturbance and mental health of healthcare workers: A systematic review and meta-analysis.

ObjectivesSleep disturbance and mental health are challenges for healthcare workers (HCWs). Especially during the COVID-19 pandemic, they experienced more severe sleep and mental health problems. However, the association between sleep disturbance and the mental health of HCWs is still controversial. This study aimed to systematically review the relationship by conducting a systematic review and meta-analysis.MethodTwo researchers retrieved the literature from Web of Science, PubMed, EMBASE, CINAHL, Psyclnfo, and Cochrane Library from the establishment of the databases until November 20, 2021. We used the New Castle-Ottawa Scale (NOS) and Agency for Healthcare Research and Quality (AHRQ) to evaluate the risk of bias in prospective research and cross-sectional research, respectively. The major exposure was HCWs’ sleep disturbance, and the major outcome was mental health. The correlation coefficients (r), regression coefficients (β) and odds ratios (OR) of the included studies were integrated.ResultFifty-nine studies were included for qualitative analysis, of which 30 studies could be combined and entered into quantitative analysis. There were 23 studies during the COVID-19 pandemic among the 59 included studies. The results of the meta-analysis showed that the correlation coefficient between sleep disturbance and mental health was 0.43 (95% CI: 0.39–0.47). HCWs with sleep disturbance had a 3.74 (95% CI: 2.76–5.07) times higher risk of mental health problems than those without sleep disturbance. The correlation coefficient during the COVID-19 epidemic was 0.45 (95% CI: 0.37–0.53), while it was 0.40 (95% CI: 0.36–0.44) during the non-epidemic period. Subgroup analysis compared the OR results in epidemic and non-epidemic periods of COVID-19, which were 4.48 (95% CI: 2.75–5.07) and 3.74 (95% CI: 2.74–7.32), respectively.ConclusionSleep disturbance and mental health problems were positively correlated among HCWs. Particularly in the COVID-19 pandemic, more attention should be given to this issue.

A cross-cultural comparison of sleep patterns between typically developing children and children with ASD living in Saudi Arabia and the United Kingdom

BackgroundSleep is crucial for child development, especially for children with ASD. While it is known that children with ASD experience more severe sleep problems and that these problems tend to persist compared to their typically developing counterparts, these findings tend to come from only Western countries. A cross-cultural study is important to understand if the prevailing understanding of sleep in children with ASD can be extended to different cultural backgrounds. AimA cross-cultural study is conducted, involving typically developing children and children with ASD aged 5–12 across two countries: Saudi Arabia and the United Kingdom. Methods and proceduresUsing a combination of questionnaires measuring ASD severity (CARS-2), sleep quality (CSHQ), sociodemographic and lifestyle variables and sleep diaries, 244 children were sampled using a mixture of snowball and convenience sampling methods. Outcomes and resultsChildren with ASD experience more sleep problems compared to typically developing children in Saudi Arabia, and these problems similarly persist across time. Specifically, it was found that children with ASD in Saudi Arabia experience greater sleep onset latency and a greater number of night awakenings. Additionally, across the ASD groups, it was found that children from Saudi Arabia generally experienced poorer sleep than children in the United Kingdom in terms of shorter sleep duration, although children in the United Kingdom tended to report more instances of sleep anxiety and parasomnias. Conclusions and implicationsSeveral reasons such as parental education about sleep hygiene, cultural influences and social hours were put forward as potential explanations for cross-cultural differences. Findings served to emphasise the importance of culturally-appropriate interventions and public education regarding child sleep.

Sleep Quality and Sleep Behaviors in Varsity Athletes: A Pilot Study.

Sleep hygiene practices may hinder university athletes from obtaining quality sleep to support health and performance. We sought to provide a comprehensive evaluation of sleep quality and behaviors in varsity athletes using validated sleep questionnaires: the Athlete Sleep Screening Questionnaire (ASSQ) and the Athlete Sleep Behavior Questionnaire (ASBQ). Sixty-four (n = 64) athletes participated (54% female; 71% Caucasian). The mean age was 20.3 ± 1.7 years and the mean BMI was 23.3 ± 3.3. Fifty-one percent met the threshold for adequate sleep (7+ h) and 54% reported being somewhat/very satisfied with sleep quality. Global scores for ASSQ Sleep Difficulty and ASBQ sleep behaviors were significantly correlated (r = 0.31; p = 0.014) and not significantly different across age, academic year, or residence. According to the ASSQ, 11% and 24% were classified as having severe or moderate sleep problems, respectively. The ASBQ categorized 62% as having “poor” sleep behaviors. Notable sleep-influencing factors included a high frequency of emotional/cognitive processing of sport-performance issues (46.9%), frequent use of light-emitting devices before bed (90%), training after 7 pm (65%), and the use of sleep medication (19%). Half of the university athletes did not meet the thresholds for adequate sleep, and some may require a referral for clinical sleep issues. The majority of these athletes' sleep behaviors do not promote adequate sleep. The ASSQ shows utility to assess gradations in clinical sleep difficulty; the ASBQ could be used in concert with the ASSQ to discern “cognitive and physiological arousal” targets for use in educational workshops designed to promote optimal sleep hygiene in university athletes.

Inconsistency between objective and subjective comparisons of sleep quality is found between sea level and moderate terrestrial altitude (2,320m) in high-performance swimmers

It is popular for high-performance athletes to attend training camps at natural moderate altitude (1800–2500m), which may have direct and indirect effects on the quantity and quality of sleep athletes obtain. This can potentially influence the ability to maximise training responses and optimise recovery from exercise. This study aimed to compare objective and subjective markers of sleep quality between sea level (SL) and moderate altitude (ALT) in a sample of 14 (male n = 5, female n = 9) high-performance collegiate swimmers. Sleep was objectively (wristwatch actigraphy) and subjectively (Athlete Sleep Screening Questionnaire; ASSQ) assessed at SL and an ALT of 2,320m. A significant increase ( p = 0.028, d = 0.76) in the ‘sleep difficulty score’ calculated from the ASSQ was identified from SL (4.9 ± 1.7 au) to ALT (6.6 ± 2.3 au), with a greater number of the swimmers judged to have a more severe clinical sleep problem at ALT. Of the seven sleep characteristics assessed objectively, there were no significant differences identified between the two environments. Sleep disruption was found to substantially improve following rest/recovery days while at ALT. Although this study highlights possible inconsistencies between objective and subjective measures of sleep quality while at ALT, any suggestion of reduced sleep quality should be considered seriously. Practically, the present study demonstrates the importance of, at altitude, using both objective and subjective measures to monitor athlete sleep quality, and ensuring training schedules are carefully periodised, incorporating rest or recovery days within intense training blocks for optimal sleep quality to be achieved.

Persistent sleep problems among people in recovery from substance use disorders: a mixed methods study

Background The aims of this study are to examine the one-year trajectory of sleep problems, identify clinical correlates, and describe subjective experiences related to persistent sleep problems during recovery from substance use disorders (SUD). Methods This study builds on a sequential mixed method design. The quantitative component features data from a prospective longitudinal study of 127 poly-SUD patients in the Stavanger area in Norway, while the qualitative component describes a thematic analysis of interviews with 16 persons from this study still experiencing sleep problems after at least one year of abstinence. Results The prevalence of sleep problems at baseline for the whole cohort was 79%. Among the 59 patients who were abstinent after one year, N = 20 (33.9%) had moderate and N = 11 (18.6%) had severe sleep problems. Persistent sleep problems were associated with psychological distress and were experienced as a major challenge in the struggle to stay drug free. Establishing daily routines related to work, school, and care for children were coping strategies for participants with persistent sleep problems. Conclusions Persistent sleep problems are often overlooked in a clinical setting. Based on our findings, these issues pose a major challenge in the struggle to stay drug free. For patients with psychological distress, and lack of responsibilities that established daily routines, sleep difficulties may result in increased risk of drug use episodes that result in relapse. These results argue that screening and evidence-based methods for insomnia and sleep health-programs should be commonplace adjunct intervention for patients with SUDs.

Non-suicidal Self-Injury Among Adolescents From Diverse Ethnocultural Groups in Israel: The Association With Sleep Problems and Internet Addiction

ObjectivesAlthough Non-suicidal Self-Injury (NSSI) has received more attention in recent years, most of these studies focused on samples from North American and European countries; consequently, little is known about its patterns and frequency in other cultures as well as its relation to sleep problems and internet addiction. As one of the few studies that aim to fill this gap, the current study examined the prevalence, characteristics, and types of NSSI behaviors among adolescents from diverse ethnocultural groups.MethodsA sample of 642 adolescents, aged 12–18 years, were randomly recruited from different middle and high schools in Israel, employing a snowball sampling technique. The sample included the following: 50% Jews and 34.7% Muslims born in Israel, 9.7% immigrants from the former Soviet Union (FSU), and 4.4% immigrants from Ethiopia. The participants completed self-report questionnaires that assessed their NSSI, sleep problems, internet addictions, and depressive symptoms.ResultsAlmost one-third of the sample had engaged in NSSI, while 6% frequently injured themselves. More than half of the FSU immigrants and one-third of the Muslim participants indicated that they engaged in NSSI. These two population groups also exhibited severe depressive symptoms, sleep problems, and internet addictions. The most parsimonious correlations with NSSI included being male, an immigrant/Muslim minority who exhibited severe depressive symptoms and internet addictions.ConclusionsThese results emphasize the need for routine NSSI assessments to prevent long-term sequelae, including any forms of suicidal thoughts and behaviors and adult borderline personality disorder (BPD). Primary preventive programs that include adaptive coping skills may eliminate the social contagion effect of NSSI.

Sleep disturbances among women in a Subarctic region: a nationwide study.

Study ObjectivesTo date, few studies have assessed sleep problems among women residing in Subarctic regions. Therefore, the aim of this large-scale population-based study was to assess the prevalence of severe sleep problems and associated factors among Icelandic women, living at 63–66°N.MethodsParticipants were 29 681 women (18–69 years old) who took part in the Icelandic Stress-And-Gene-Analysis study in 2018–2019. Background information, health-related behavior, and mental health symptoms were assessed with an online questionnaire. The Pittsburgh Sleep Quality Index (PSQI) was used to assess severe sleep problems during the past month. Adjusting for age, marital status, number of children, education, personal income, work schedule, region, and response period, we used modified Poisson log-linear models to obtain prevalence ratios (PRs) with 95% confidence intervals (CIs).ResultsOverall, 24.2% of women reported severe sleep problems (PSQI >10). Women responding in the winter presented with an overall higher prevalence of severe sleep problems, compared to those responding in the summer (PR 1.21; 95% CI, 1.15 to 1.28). Severe sleep problems were more prevalent among young and late-midlife women, those who were single, had children, socio-economic challenges, worked shifts, and flexible hours. Furthermore, obesity, suboptimal health behaviors, excessive screen time, and mental health problems were associated with severe sleep problems.ConclusionSevere sleep problems are more common among women in Subarctic regions than elsewhere, particularly during winter. These findings motivate the development of preventive strategies and interventions for women in the Subarctic who suffer from sleep problems.

Assessment of sleep disturbances with the athlete sleep screening questionnaire in Chinese athletes

This study investigated the factors that are associated with sleep disturbances among Chinese athletes. Sleep quality and associated factors were assessed by the Athlete Sleep Screening Questionnaire (ASSQ, n ​= ​394, aged 18–32 years, 47.6% female). Sleep difficulty score (SDS) and level of sleep problem (none, mild, moderate, or severe) were used to classify participants' sleep quality. Categorical variables were analyzed by Chi-square or fisher's exact tests. An ordinal logistic regression analysis was used to explore factors with poor sleep (SDS ≥8).Approximately 14.2% of participants had moderate to severe sleep problem (SDS ≥8). Fifty-nine percent of the athletes reported sleep disturbance during travel, while 43.3% experienced daytime dysfunction when travelling for competition. No significant difference was found in the SDS category between gender, sports level and events. Athletes with evening chronotype were more likely to report worse sleep than athletes with morning and intermediate chronotype (OR, 2.25; 95%CI, 1.44–3.52; p ​< ​0.001). For each additional year of age, there was an increase of odds ratio for poor sleep quality (OR, 1.15; 95%CI, 1.04–1.26; p ​= ​0.004), while each additional year of training reduced the odds ratio (OR, 0.95; 95%CI, 0.91–0.99; p ​= ​0.044). To improve sleep health in athletes, chronotype, travel-related issues, age and years of training should be taken into consideration.

Mediators and moderators of outcome from the Transdiagnostic Sleep and Circadian Intervention for adults with severe mental illness in a community setting

This study explores mediators and moderators of outcome from the Transdiagnostic Sleep and Circadian Intervention (TranS-C). Participants were 121 adults (age mean [SD] = 45.45 [13.25] years; 52.06% female), with severe mental illness and sleep and circadian dysfunction. They were randomized to receive TranS-C and usual care, or usual care followed by delayed TranS-C. Putative mediators were the PROMIS-Sleep Disturbance Scale, PROMIS-Sleep-Related Impairment Scale, and the Sleep Health Composite. Putative moderators were symptom severity at baseline, age, housing environment, race and ethnicity. Mediation analysis indicated that changes in sleep-related impairment and sleep health, but not sleep disturbance, mediate TranS-C's effect on functional impairment (CI: [-0.28,-0.07] and [-0.18,-0.08], respectively) and general psychiatric symptoms (CI [-0.30,-0.06] and [-0.20,-0.02]) post-treatment, though mediation via sleep health was not maintained through 6-month follow up. Moderation analysis indicated that those with severe sleep-related symptoms at baseline and Black/African American individuals are particularly responsive to TranS-C, whereas older recipients had a poorer response. TranS-C reduces functional impairment and general psychiatric symptoms amongst adults with SMI by reducing sleep-related impairment and improving sleep health. Selected sleep outcomes of TranS-C are strongest among Black/African Americans and those with severe sleep problems, and weakest among older adults.