Sleep Efficiency Scores Research Articles

Sleep quality among workers in the health sector exposed to the COVID-19 pandemic.

The ongoing pandemic of coronavirus disease (COVID-19) is a global health crisis that has posed enormous pressure on workers in the health sector (WHS), having a massive impact on their mental health. In this study, we aimed to evaluate the sleep quality of WHS during the pandemic and compare frontline WHS to those who are not directly engaged in the care of COVID-19 patients. This cross-sectional, self-reported online survey assessed the sleep quality of WHS in Austria using the Pittsburgh Sleep Quality Index (PSQI). The same questionnaire was sent out two times. Due to the unequal sample and anonymity of the study participants, we analyzed the data of each time point separate from each other. The first study was conducted in April/May 2020, during the first lockdown in Austria (Study1), and the second study was conducted in July/August 2020, when the social restrictions were loosened (Study2). T-test was used to compare the mean values of PSQI scores between frontline vs. non-frontline WHS, while two two-way ANCOVAs were used to analyze differences in the PSQI mean scores (controlled for age) for male vs. female between frontline vs. non-frontline WHS. During the first lockdown in Austria (Study1) we identified a shorter sleep duration of frontline WHS compared to the non-frontline group, however the difference in global PSQI score between these groups was statistically not significant. In the period after loosened restrictions (Study2) the sleep quality, sleep latency, sleep duration, sleep efficiency and global PSQI score was worse in frontline WHS compared to the non-frontline WHS. Furthermore, female WHS scored higher in the PSQI indicating a worse sleep than male WHS. In addition, nurses and nursing assistants had a higher prevalence of poor sleep quality than other occupational groups. Our results indicate that the COVID-19 pandemic negatively impacts the sleep of WHS, affecting particularly frontline WHS. Preventive interventions aiming to promote good sleep quality in WHS during a healthcare crisis like this pandemic are essential to enhance resilience and mitigate the vulnerability of this specific population.

Sleep benefit in patients with Parkinson’s disease is associated with the dopamine transporter expression in putamen

PurposeSleep benefit (SB) is a well-known phenomenon in patients with Parkinson’s disease (PD); however, the mechanisms underlying this phenomenon remain unclear. This study aimed to evaluate whether the SB phenomenon in PD patients is associated with dopamine transporter (DAT) expression levels in the striatum. MethodsThe data of 125 PD patients were collected and divided into SB (n = 61) and non-SB (nSB) groups (n = 54) depending on whether they had SB or not. DAT expression on both sides of the striatum in PD patients was measured using 2b-carbomethoxy-3b-(4-trimethylstannylphenyl) tropane (11C-CFT) positron emission tomography imaging. The clinical variables, sleep scores, and striatum 11C-CFT uptake index of PD patients between the SB and nSB groups were compared. The associations of clinical variables, sleep scores, and striatum 11C-CFT uptake index with the SB variable were analyzed using logistic regression analysis. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of the striatum 11C-CFT uptake index in distinguishing SB patients from nSB patients. ResultsThe tremor subtype ratio (P = 0.011), levodopa equivalent daily dose (LEDD) (P < 0.001), sleep efficiency score (P = 0.025), habitual sleep efficiency (P = 0.012), and night sleep duration (P = 0.005) in the SB group were significantly different from those in the nSB group. The 11C-CFT uptake index in both the contralateral and ipsilateral striata in the SB group was significantly higher than that in the nSB group (P < 0.05). The binary logistic regression showed that SB variables were significantly and independently associated with tremor subtype (P = 0.048), LEDD (P = 0.021), sleep duration at night (P = 0.035), 11C-CFT uptake index in the contralateral (P = 0.013) and ipsilateral (P = 0.019) putamen in PD patients after correction for important clinical confounders. ROC analysis showed that the 11C-CFT uptake index on the onset side of the putamen had a high capacity (AUC: 0.916) to distinguish SB patients from nSB patients with high sensitivity (83.33 %) and specificity (88.89 %). ConclusionDAT expression in the putamen was associated with the SB phenomenon in PD patients, and the putamen DAT expression level could predict the SB phenomenon in PD patients.

Quality of Sleep Among Shift Work Nurses at the Baguio General Hospital: A Pilot Cross - Sectional Study

&#x0D; &#x0D; &#x0D; &#x0D; ABSTRACTObjective: The primary objective of this study was to determine the quality of sleep among 12- hour shift-work nurses at the Baguio General Hospital using the Pittsburg Sleep Quality Index (PSQI).&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Methods: This was a preliminary cross-sectional study with a primary endpoint of assessing the sleep quality of the participants using the PSQI. The association of sleep quality with individual and work factors was also determined.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Design:Cross - Sectional Study&#x0D; Setting:Tertiary Government Training Hospital &#x0D; Patient:154 12-hour shiftwork nurses&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Results: The majority (88.96%) of the participants self-reported having poor sleep quality. Among the components of the PSQI, current shift was significantly associated with habitual sleep efficiency (Fisher exact test p &lt; .049). No significant associations were found between demographic characteristics and PSQI Global score, with most respondents having poor sleep quality regardless of participant characteristics.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Conclusion: Majority of nurses working in 12-hour shifts had poor sleep quality. Night shift nurses had higher habitual sleep efficiency scores compared to day shift nurses indicating that those working in the night shift had poorer habitual sleep efficiency.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

The relationship between physical activity and sleep status among older adults requiring nursing care in the community

We investigated the relationship between physical activity and sleep status among older adults requiring nursing care in the community. We included 45 participants ≥65 years old (33 females; mean age, 83.2±4.4 years old) requiring nursing care. Physical activity was evaluated using the Life Space Assessment (LSA), and sleep status was measured by the Pittsburg Sleep Quality Index (PSQI) to determine the total sleep time, sleep efficiency, and PSQI total score. The physical function was measured by the timed up and go test (TUG) and grip strength. We performed a multiple regression analysis with the LSA as the dependent variable and sleep indicators (total sleep time, sleep efficiency, PSQI total score) and TUG as independent variables (demonstrating significant correlations with the LSA), and gender and age as adjusted variables. The analysis was divided into sleep time (Model 1), sleep efficiency (Model 2), and PSQI total score (Model 3). We used R commander, and < 0.05 was considered statistically significant. TUG (β=-0.375) and sleep time (β=0.383) in Model 1, TUG (β=-0.368) and sleep efficiency (β=0.570) in Model 2, and TUG (β=-0.392) and PSQI total score (β=-0.590) in Model 3 were independently selected as significant variables. In addition to TUG, sleep status, such as the sleep duration and sleep quality, was shown to be related to physical activity in older adults who require nursing care. To improve physical activity, it is necessary to consider not only the physical function but also quantitative and qualitative assessments of sleep.

Abnormal Spontaneous Brain Activity and Cognitive Impairment in Obstructive Sleep Apnea.

PurposeThis study aimed to explore the alterations in spontaneous brain activity in obstructive sleep apnea (OSA) using percent amplitude of fluctuation (PerAF) and investigate the relationship between abnormal spontaneous brain activity and cognitive impairment in OSA.Patients and MethodsOverall, 52 patients with moderate to severe OSA and 61 healthy controls (HCs) were eventually enrolled in this study. All participants underwent resting-state functional magnetic resonance (rs-fMRI) and T1-weighted imaging. The PerAF was calculated and compared between patients with OSA and HCs, with voxel level P < 0.001 and cluster level P < 0.05 corrected with Gaussian Random Field was be considered statistically different. A partial correlation analysis was used to assess the relationship between altered PerAF and clinical assessments in patients with OSA.ResultsCompared to HCs, patients with OSA had significantly lower PerAF values in the right rectal gyrus and left superior frontal gyrus, but higher PerAF values in the right cerebellum posterior lobe and left middle frontal gyrus. The PerAF values of some specific regions in patients with OSA correlated with sleep efficiency and Montreal Cognitive Assessment scores. Additionally, support vector machine analysis showed that PerAF values in all differential brain regions could differentiate patients with OSA from HCs with good accuracy.ConclusionSpecific brain areas in OSA patients may exhibit aberrant neuronal activity, and these anomalies may be linked to decreased cognitive performance. This discovery offers fresh perspectives on these patients’ neurocognition.

Acupoint compatibility effect and mechanism of Shenmen (HT7) and Sanyinjiao (SP6) in improving daytime fatigue and sleepiness of insomnia

To observe the acupoint compatibility effect of Shenmen (HT7) and Sanyinjiao (SP6) in improving daytime fatigue and sleepiness of insomnia, and its mechanism in regulating hypothalamic-pituitary-adrenal (HPA) axis and suprachiasmatic nucleus-pineal gland-melatonin (SCN-PG-MT) system. Ninety patients with insomnia were randomly divided into HT7, SP6 and HT7-SP6 (HT7 plus SP6) groups, with 30 cases in each group. Electroacupuncture (EA,5 Hz/25 Hz) was applied to HT7, SP6 or HT7-SP6 in each group for 30 min. The EA treatment was conducted once daily, 5 days a week for 2 weeks. Before and after treatment, the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were observed, separately. The contents of serum adrenocorticotrophic hormone (ACTH), cortisol (CS) and melatonin (MT) were detected by ELISA. Compared with before treatment, the sleep quality, sleep time, sleep efficiency, sleep disturbance, daytime dysfunction scores and total score of PSQI in the three groups after treatment were decreased (P<0.05), the time to fall asleep score of PSQI and total score of ESS were decreased in the SP6 and HT7-SP6 groups (P<0.05). After treatment, the sleep quality, time to fall asleep, sleep efficiency, daytime dysfunction scores, total score of PSQI and total score of ESS in the HT7-SP6 group were lower than those in the HT7 group (P<0.05), the sleep quality, sleep efficiency and total score of PSQI in the SP6 group were lower than those in the HT7 group (P<0.05). Compared with before treatment, the serum ACTH and CS levels in the three groups were decreased (P<0.05), and the serum MT levels in the SP6 and HT7-SP6 groups were increased (P<0.05). After treatment, the ACTH and CS levels in the HT7-SP6 group were lower than those in the HT7 group (P<0.05), and the serum MT levels in the SP6 and HT7-SP6 groups were higher than that in the HT7 group (P<0.05). The compatibility of HT7 and SP6 has a synergism effect on the improvement of night sleep quality and daytime fatigue and sleepiness of insomnia patients, the mechanism may be related with its function in down-regulating the serum ACTH and CS levels and increasing the serum MT content. SP6 has a better effect than HT7, and plays a major role in acupoint compatibility.

Remote monitoring of sleep activity in patients diagnosed with glioblastoma.

e14036 Background: Sleep disturbance is a common symptom experienced in patients diagnosed with glioblastoma (GBM) and has been correlated with poor physical and psychological outcomes. Advancements in wearable technologies have allowed for the opportunity to obtain objective measures of sleep quality outside of a laboratory setting. Thus, we conducted a secondary analysis of remotely monitored sleep data from a phase 1 study of newly diagnosed GBM patients following a classic ketogenic diet (KD) in addition to standard-of-care treatment. Methods: Patients with GBM were recruited between 04/2018-02/2021 to take part in a 16-week KD intervention with dietitian support. Patients’ physical activity (PA) (average step counts, duration of light/moderate/vigorous activity), nocturnal sleep data (total sleep time, restlessness and duration in light/deep/REM sleep), and sleep efficiency were collected through the use of a wearable activity monitor (Fitbit Charge HR3). Patient-reported quality of life (QoL) (QLQC30), PA, and sleep metrics were summarized at baseline, week 8, and week 16 (end of study). Correlation statistics were calculated between sleep measures, PA, and QoL outcomes. Results: Patients with available sleep data (n = 16) were included in the analysis (53% women, median age 55 years). Among the 16 included patients, adherence to wearing the device was 100% at baseline, 94% at 8 weeks, and 75% at week 16. Overall, mean sleep duration at baseline (days 1-7) was 6.5 hours (SD: 0.94) (n = 16), with an average sleep efficiency score of 92.9 (SD: 2.7), and an average number of sleep disturbances of 20.1 (SD: 6.7). Average duration in light, deep, and REM sleep (hours) was 4.6 (SD:0.98), 0.78 (SD:0.5), and 1.1 (SD:0.34), respectively. Longer baseline sleep duration was significantly correlated with daily step counts (correlation coefficient (r):0.55, p = 0.02), duration in PA (r: 0.55, p = 0.03), and improved QOL, although not statistically significant (r: 0.5, p = 0.06). Longer duration in REM sleep was also significantly correlated with higher patient-reported physical function (r: 0.64, p = 0.01), cognitive function (r: 0.61, p = 0.02), decreased fatigue (r: -0.67, p = 0.01), and increased duration in PA (r: 0.59, p = 0.01). Conclusions: Our findings suggest that it was feasible to remotely monitor sleep activity in this population. This cohort of GBM patients present with shorter sleep duration than the recommended 7 hours and as compared to adults living with cancer and other chronic disease. Significant correlations were observed between sleep outcomes, notably in regard to duration in REM sleep, PA levels, patient-reported physical and cognitive function and fatigue. The use of wearable technology can provide additional insight into a patient’s sleep patterns and inform the development of tailored interventions for sleep disturbances. Given the small sample size, further research is warranted to validate these findings. Clinical trial information: NCT03451799.

0495 Sleep Disturbance Features Differentially Influence Inflammatory Markers in Adolescents

Abstract Introduction Sleep disruption has profound effects on immune function. Many adolescents do not get adequate amounts of sleep each night, and chronic sleep disturbance has been associated with increased risk of several inflammatory diseases. However, the relationship between sleep disturbances and inflammation during adolescence is not well understood. In this study, we examined the relationship between specific features of sleep disruption and cytokine levels in adolescents. Methods A total of 88 adolescents (18.36 ± 0.51 years, 56.8% female) completed the Pittsburgh Sleep Quality Index (PSQI), a self-reported questionnaire used to assess subjective sleep quality over a 1-month time period. Blood plasma samples were obtained for each participant at the same timepoint to measure levels of pro-inflammatory cytokines (Interleukin (IL)-6, IL-8, tumor-necrosis factor (TNF)-alpha, and interferon (IFN)-gamma), anti-inflammatory cytokine (IL-10), and C-reactive protein (CRP). Samples were assayed using a Meso Scale Discovery multiplex immunoassay. Linear regression models were used to test the effect of PSQI sleep latency, duration, efficiency, quality, disturbance, and total score on each cytokine level, while covarying for sex and body mass index. We corrected for multiple comparisons using a False Discovery Rate (FDR) correction. Results Overall, disruption in sleep was associated with distinct cytokine differences. Worse sleep, reflected by the PSQI total score and greater sleep disturbance, was associated with lower IL-6 levels (p=0.013, p=0.015, respectively), however theses associations were attenuated to a trend after FDR correction (q=0.083, q=0.092, respectively). Longer sleep latency was also associated with lower IL-6 (p=0.028), and IFN (p=0.016) levels, however these effects were also attenuated after FDR correction (q=0.138, q=0.094, respectively). Reduced sleep efficiency was associated with higher TNF (q=0.046) and CRP (q=0.021) levels. Conclusion Our findings show that different components of sleep disruption have varying effects on cytokine release, resulting in an overall blunted immune response. This underscores the significant impact of sleep disturbances on perturbing immune function during this critical developmental period. Support (If Any)

Early To Bed, Early To Rise: LVAD Patients And Sleep Patterns

Early To Bed, Early To Rise: LVAD Patients And Sleep Patterns

Abstract P080: Health-related Quality Of Life Predictors Of Exercise Intervention Dropout

Introduction: Though many individuals know the health benefits of participating in exercise, few report sufficient activity to meet the US 2018 Physical Activity Guidelines. Current research assessing predictors of exercise adherence and dropout has primarily focused on cognitive factors, physiological factors, and demographic characteristics. The purpose of this analysis was to determine if baseline self-rated HrQoL measures are predictive of dropout from an exercise intervention across two STRRIDE trials. Methods: A total of 444 adults with dyslipidemia (STRRIDE AT/RT) or prediabetes (STRRIDE-PD) were randomized to one of seven exercise interventions, ranging from doses of 10-16 kcal/kg/week (KKW); intensities of 50-75% V̇O 2peak ; and durations of 6-9 months. Six groups included aerobic exercise, two groups included resistance training, and one group included dietary intervention (weight loss goal of 7%). Dropout was defined as a participant who did not complete the exercise intervention due to one or more of several reported reasons (e.g., time, motivation, re-occurring injury). Backwards stepwise logistic regression determined significant baseline HrQoL predictors of exercise intervention dropout, while controlling for age, sex, race, and intervention group assignment. Results: A total of 117 individuals were classified as being exercise intervention dropouts (STRRIDE AT/RT: n=55; STRRIDE-PD: n=62). In STRRIDE AT/RT, the logistic regression identified baseline sleep quality, sleep latency, sleep efficiency, sleep disturbance, bodily pain, and social functioning scores as predictors of dropout (R 2 =0.39). In STRRIDE-PD, the logistic regression identified baseline role-emotional, satisfaction with appearance, and physical component scores as predictors of dropout (R 2 =0.08). Conclusion: Among individuals with dyslipidemia, baseline HrQoL measures were able to explain about 39% of the variance in dropout from an exercise intervention, with primarily sleep measures, bodily pain, and social functioning being identified as important predictors of dropout. In contrast, among individuals farther along the disease spectrum, with prediabetes, baseline HrQoL measures only explained about 8% of the variance in dropout, with emotional well-being, perceived appearance, and physical function being important predictors of dropout. Future research should investigate molecular and biological predictors of dropout in combination with HrQoL, physiological, cognitive, and demographic factors to improve predictive power.

Study of Exogenous Melatonin as a Treatment Modality for Sleep and Psychiatric Disorders in Hemodialysis Patients.

The pineal hormone melatonin plays a major role in numerous physiological functions such as circadian sleep-wake rhythm, mood, immunity, and reproduction. Patients on hemodialysis (HD) frequently suffer from sleep and psychiatric disturbances. The aim of this study is to assess the effect of exogenous oral melatonin in HD patients regarding sleep disturbances, depression, and anxiety alongside the quality of life (QoL). In this randomized double-blind placebo-controlled study, 60 stable HD patients suffering from sleep disorders [according to Pittsburgh sleep quality index (PSQI) equal or more than 5] were randomized to receive melatonin 3 mg at 10 pm every night or placebo tablets for three months. Routine laboratory investigations were done, moreover, patients were asked to fill the following six questionnaires at the beginning of the study and after three months of treatment; PSQI, Epworth Sleepiness Scale (ESS), and the Insomnia Severity Index (ISI) to assess sleep disorders, assessment of depression by Hamilton Depression Rating Scale (HDRS), assessment of anxiety by Hamilton Anxiety Rating Scale (HARS), and assessment of QoL using Quality of Life Index-dialysis version (QLI). This study showed a significant improvement in serum calcium, low-density lipoprotein level (P ≤0.005), and scores of HDRS, HARS, and total QLI in the melatonintreated group (P ≤0.001, 0.001, and 0.002, respectively). Moreover, there was a highly significant improvement in sleep disorders in melatonin-treated patients regarding total score of PSQI, ISI, subjective sleep quality, and daytime dysfunction (P ≤0.001), also regarding sleep duration, latency, and disturbances (P ≤0.05). However, there was no significant difference in sleep efficiency and ESS scores. Exogenous melatonin treatment was well-tolerated, safe, and efficient in improving sleep disturbances, depression, anxiety, and QoL in HD patients.

Effects of eszopiclone on sleep quality and cognitive function in elderly patients with Alzheimer's disease and sleep disorder: A randomized controlled trial.

ObjectiveTo investigate the effects of eszopiclone on sleep quality and cognitive function in elderly patients with Alzheimer's disease (AD) and sleep disorders.MethodsThis study was a prospective study of 96 elderly patients with AD and sleep disturbance treated in our hospital from April 2019 to December 2020. All patients were divided into a control group (48 patients, given alprazolam tablets) and a study group (48 patients, given eszopiclone) according to the random number table method.ResultsAfter treatment, compared with the control group, the study group had lower sleep latency, daytime function, sleep disturbance, sleep efficiency, sleep quality, sleeping time, and hypnotic medication scores (p < .05). After treatment, sleep progression and sleep architecture improvement were more obvious in the study group compared with the control group (p < .05). After treatment, compared with the control group, the rhythm disturbance, psychotic disorder, hallucination, phobic anxiety, and disorder in the study group improved more significantly (p < .05). After treatment, compared with the control group, the scores of orientation, attention, memory, calculation, recall, and language ability in the study group improved more significantly (p < .05). After treatment, the scores of the physical life self‐care scale and instrumental activities of daily living scale in the study group were improved more obviously compared with the control group, with significant differences (p < .05).ConclusionEszopiclone can effectively improve the quality of sleep and cognitive function in elderly patients with AD and sleep disorder.

Sleep Patterns and Their Association with Blood Pressure and Heart Rate Variability Parameters in Young Saudi Females.

ObjectivesDisturbed sleep patterns might alter the autonomic tone and lead to various cardiovascular morbidities. This study aimed to determine sleep patterns (quality, duration, efficiency and daytime sleepiness) and explore their association with blood pressure (BP) and heart rate variability (HRV) in apparently healthy, young Saudi females.MethodsThis cross-sectional study was conducted in the Department of Physiology, Imam Abdulrahman Bin Faisal University, Saudi Arabia between March 2019 and December 2019. Self-reported Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires were used to collect data. In addition, the participants’ BP and HRV was measured. Based on the cut-off values of sleep quality, duration, efficiency and daytime sleepiness scores, participants were categorised into groups. HRV and BP were compared between the groups by a t-test/one-way ANOVA.ResultsA total of 98 participants were included in this study (response rate: 72.6%). Poor sleep patterns (quality, duration and efficiency) were observed, but no association was found with BP and HRV parameters among groups with different sleep quality, duration and efficiency. Systolic BP was significantly increased in the moderate to severe daytime sleepiness group (P = 0.039). Dozing off as a passenger in a car, in the afternoon and after lunch were negatively correlated with HRV parameters (P <0.05).ConclusionSleep quality, duration and efficiency were not found to be statistically significant, but various dozing-off situations were associated with fluctuations in HRV parameters. Daytime sleepiness may augment sympathetic responses in apparently healthy female participants.

Sleep Quality and Fatigue in Women with Overactive Bladder: A Case-Control Study

Background: Overactive bladder (OAB) syndrome, a condition with urgency, is often characterized by increased daytime frequency and nocturia. Overactive bladder is a highly prevalent condition that drastically impacts the quality of patients’ life. Objectives: This study was conducted to investigate sleep disturbance and fatigue in women with OAB by reliance on two validated questionnaires. Methods: This case-control study was performed among 70 patients recognized with OAB and 70 women in a control group. We employed validated questionnaires, namely Pittsburgh sleep quality index (PSQI) and Fatigue Severity Scale (FSS), to comparatively assess sleep disturbance and fatigue symptoms, respectively. Results: The participants’ mean age was 44.50 ± 12.64 years old. The mean PSQI score was 13.24 ± 3.67 (range: 6 to 22), and the mean FSS score was 39.05 ± 15.12 (range: 9 to 63). Furthermore, the mean scores of PSQI (P &lt; 0.001) and FSS (P &lt; 0.001) were significantly higher in OAB women compared to the control group. In women with OAB, there was a significant positive correlation (P = 0.007) between PSQI and FSS scores. Furthermore, this correlation was observed between urgency urinary incontinence at night and PSQI (P = 0.047) and sleep disturbance (P = 0.023) and between nocturia and sleep efficiency (P = 0.012), sleep disturbance (P = 0.001), sleep latency (P = 0.007), and FSS score (P = 0.032). In addition, a significant direct correlation (P = 0.022) was found between urgency urinary incontinence during the day and daytime dysfunction. Conclusions: The study shows that sleep disorder is common in patients with OAB, and it seems that urinary problem assessment is a prerequisite for any sleep medication prescription.

Psychometric Properties of the Turkish version of the Morningness - Eveningness Stability Scale improved (MESSi) in Adolescents

ABSTRACT Morningness–Eveningness Stability Scale improved (MESSi) is an assessment tool that evaluates distinctness of daily changes as well as the person’s propensity for morningness and eveningness. The aim of this study is to evaluate psychometric properties of the Turkish version of MESSi and associations of chronotypes and diurnal variations with personality, affect, sleep quality as well as validity of the scale in Turkish adolescents. The sample of this study consisted of 445 students between ages of 10–19. Participants filled in MESSi, Morningness/Eveningness Scale for Children, Composite Scale of Morningness, Personality Traits Scale (BIG-5), Positive and Negative Affect Scale (PANAS), Pittsburgh Sleep Quality Index (PSQI). Reliability analysis of the scale showed quite reliable internal consistency values. Confirmatory factor analysis (CFA) was used to test construct validity of three-factor model of MESSi. An acceptable model fit was demonstrated in CFA. There was a moderate and significant relationship between MA and DI subscale scores of MESSi. A moderate but negative correlation was found between MA and EV subscale scores of MESSi. MA and DI subscale scores of MESSi were found to be weakly correlated with conscientiousness, emotional stability, openness to experience and subscale scores of BIG-5, respectively. There was a positive correlation of positive affect subscale scores of PANAS with MA and DI subscale scores of MESSi. MA subscale scores of MESSi were found to be negatively correlated with scores of subjective sleep quality, latency, duration, disturbances, habitual sleep efficiency, daytime dysfunction, and global scores of PSQI. This study shows that Turkish version of MESSi is valid and reliable for use in adolescents. Three-factor MESSi provides an advantage over other chronotype scales in adolescence since it includes DI subscale as well as MA and EV subscales. Psychometric results were supported by other chronotype scales and clinical features such as sleep, affect, and personality.

Associations of Sleep Characteristics with Cerebrospinal Fluid sTREM2 in Cognitively Normal Older Adults: the CABLE Study.

As brain insults, sleep disorders could enhance microglial activation and aggravate neuroinflammation. Soluble triggering receptor expressed on myeloid cells 2 (sTREM2) in cerebrospinal fluid (CSF) serves as a readout for TREM2-associated microglial responses. We aimed to study the association of sleep characteristics with CSF sTREM2 in cognitively normal (CN) older adults. Linear and non-linear regression analyses were conducted in 830 participants with measurements of sleep characteristics and CSF sTREM2, after adjusting for age, sex, education, the Chinese-Modified Mini-Mental State Examination (CM-MMSE) scores, and APOE4 status. These analyses were also performed in amyloid-negative (A -) and amyloid-positive (A +) individuals. Linear relationships between sleep characteristics and CSF sTREM2 were found. In all the participants, sleep efficiency score in Pittsburgh Sleep Quality Index (PSQI) (p = 0.037) showed a positive linear association with CSF sTREM2. In A + individuals, the grade of PSQI total score (p = 0.011) as well as subjective sleep quality score (p = 0.048) and sleep efficiency score (p < 0.001) in PSQI were positively associated with CSF sTREM2. Besides, several U-shaped relationships were revealed of sleep-time measures, such as insufficient or excessive nocturnal sleep duration, with CSF sTREM2 in A + individuals (the optimal model: bedtime 22:21 p.m., time to fall asleep 22:52 p.m., nocturnal sleep duration 7.36h). In A - individuals, the above relationships were not found. Poor self-reported sleep characteristics and sleep indicators were associated with higher CSF sTREM2, suggesting that sleep might play an important role in the regulation of TREM2-associated microglial activity.

Effect of electroacupuncture on serum melatonin and dopamine in aged insomnia

To observe the clinical effect of electroacupuncture (EA) on aged insomnia, and explore its possible mechanism. A total of 60 patients with aged insomnia were randomly divided into an EA group (30 cases) and a sham EA group (30 cases, 1 case dropped off). The patients in the EA group were treated with acupuncture at Baihui (GV 20), Yintang (GV 29), Shenmen (HT 7), Sanyinjiao (SP 6), Xinshu (BL 15) and Shenshu (BL 23), and EA was used at Baihui (GV 20) and Yintang (GV 29), with intermittent wave, 2 Hz in frequency. In the sham EA group, the acupoints and the EA connection acupoints were the same as those in the EA group, 2-3 mm in depth, but no current was connected. The intervention was given 30 min each time, once every other day, 3 times a week for 4 weeks in the both groups. Before and after treatment, the Pittsburgh sleep quality index (PSQI) and Montreal cognitive assessment (MoCA) scale were used to assess sleep quality and cognitive function, and serum melatonin (MT) and dopamine (DA) levels were detected. After treatment, the total score and sub-item scores of PSQI in the EA group were lower than those before treatment (P<0.01, P<0.05), among them, the sub-item scores of sleep quality, time to fall asleep, sleep time and sleep efficiency, daytime dysfunction and total score were all lower than those in the sham EA group (P<0.01, P<0.05). After treatment, the MoCA score and serum MT and DA levels in the EA group were higher than those before treatment (P<0.01), and the MoCA score and serum MT level in the EA group were higher than the sham EA group (P<0.01, P<0.05). Electroacupuncture can improve sleep quality and cognitive function in aged insomnia patients, and its mechanism may be related to regulating serum MT and DA levels.

A survey assessing sleep efficiency among Saudis during COVID-19 home confinement using the Pittsburgh sleep quality index: A call for health education

The COVID-19 pandemic has introduced uncertainties that have disrupted regular routines. Sleep may be adversely affected by stressful circumstances that jeopardize general health. Hence, the impact of home confinement on the sleep efficiency of the general population was assessed.An online survey was conducted by using the Pittsburgh sleep quality index (PSQI) to assess sleep duration, sleep efficiency, latency to fall asleep, and global PSQI score. Questions pertaining to demography, home confinement, and anxiety were included. Data was collected from the residents of the Southwestern region from April 15, 2020 to May 15, 2020. Data were analyzed through bivariate, multivariate logistic regression, and independent t tests.A total of 593 subjects responded to the survey. Males (OR 1.92 [1.3–2.7], p < 0.001), and subjects aged ≥51 years (OR 2.49 [1.3–4.4], p = 0.002) were more likely to be poor sleepers (<6 h). In hypertensive subjects, inadequate sleep was twice as high (OR 2.2 [1.1–4.4], p < 0.05) than other comorbidities. Males were less likely to have sleep latency (OR 0.58 [0.40–0.86], p = 0.005) but smoking increased the latency of falling asleep (OR 2.41 [1.47–4.0], p < 0.001). Sleep duration was significantly influenced by home confinement (p = 0.002), whereas sleep duration (p = 0.001), latency (p = 0.018), sleep efficiency (p = 0.005), and global PSQI scores (p = 0.005) were significantly affected by anxiety.In the southwestern region, we found sleep influenced by anxiety about COVID-19. Community pharmacists are the most accessible health care professionals and could play a pivotal role in educating the lay public on the importance of sleep hygiene through posters displayed in pharmacies and with the help of public education material.

Sleep Characteristics of Highly Trained Wheelchair Rugby Athletes With and Without a Cervical Spinal Cord Injury During the Competitive Season

Sleep behaviors although significantly relevant to exercise recovery are poorly characterized in Para-sport athletes. Therefore, the main aims of this study were to describe sleep quality and quantity of highly trained wheelchair rugby (WR) athletes during the competitive season, and to investigate whether impairment type or attending a training camp influenced sleep outcomes. Eighteen male WR athletes (mean ± SD; age: 30 ± 5 years) with cervical spinal cord injuries (n = 11) (CSCI) and without (n = 7) (NON-SCI) wore an activity monitor over a 16-day period to objectively quantify sleep parameters, while the Pittsburgh Sleep Quality Index (PSQI) and nightly sleep diary entries were used as subjective means. A sub-sample of the athletes (n = 11) had their sleep monitored during a 3-night training camp to assess the impact of environmental change on sleep. Furthermore, as an additional exploratory measure core temperature was measured for a single night-time period using ingestible telemetry capsules. The athletes had total sleep times and sleep efficiency scores of 7.06 (1.30) h.min [median (interquartile range)] and 81 (9)%, respectively. Sleep onset latency and wake after sleep onset were 13 (24) min and 1.11 (0.45) h.min, respectively. No significant differences were found in objective sleep variables between the impairment groups despite the CSCI group being significantly more likely to report a poorer night's sleep (p = 0.04). Furthermore, attending the training camp caused a significant reduction in total sleep time for both groups [Δ38 ± 33 min; (95% CI: 18–60 min) p < 0.01]. This study highlights suboptimal sleep characteristics that are present in both CSCI and NON-SCI wheelchair athletes, as defined by the National Sleep Foundation. Although objective scores did not differ between groups, athletes with a CSCI rated their sleep worse. Furthermore, the disruption of sleep during training camp reflects an additional risk factor that is important to recognize for those working with wheelchair athletes.

The effect of group cognitive behavioural therapy for insomnia in postmenopausal women.

The menopausal period is associated with several complications in women. One of these complications is sleep disorders including insomnia disorder that can affect all aspects of personal life. The present study aimed to evaluate the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) on insomnia severity and sleep quality among postmenopausal women. This was a randomised clinical trial in which 46 women were recruited and randomly allocated into two groups, one receiving CBT-I and a control group. The CBT-I group received six sessions of training, while the control group received only usual care. A demographic questionnaire, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI), were used to collect the data. The ISI and PSQI were measured at baseline, 3 and 6weeks after intervention, and in a 4-week follow-up. The Independent t test, the chi-square test, generalised estimating equation models, and Bonferroni correction were applied to analyse the data. According to our results, in the CBT-I group compared to the control group, the mean ISI, PSQI, sleep onset latency, sleep time, and sleep quality score reduced continuously from baseline to week 3 and from week 3 to week 6, and remained constant from week 6 to week 10. The mean sleep efficiency score improved significantly from baseline to week 3 in the CBT-I group and remained unchanged until the end of the study. CBT-I could significantly improve insomnia severity and sleep quality in postmenopausal women. Therefore, using this method is recommended for menopausal women with insomnia.