Sleep Hygiene Research Articles

The Experience and Impact of a Fitbit-Based Physical Activity and Sleep Hygiene Intervention for Older Adults Experiencing Cognitive Decline

The Experience and Impact of a Fitbit-Based Physical Activity and Sleep Hygiene Intervention for Older Adults Experiencing Cognitive Decline

A Psychological Study of the Impact of Social Media Addiction on Sleep Patterns

This study presents findings from a comprehensive psychological investigation aimed at exploring the impact of social media addiction on sleep patterns among young adults. The research utilized a mixed-methods approach, incorporating quantitative surveys, objective sleep assessments, and qualitative interviews to provide a holistic understanding of the complex relationship between social media use and sleep disturbances. Eightyparticipants aged 18-35 were recruited from diverse demographic backgrounds and assessed for social media addiction using validated scales such as the Bergen Social Media Addiction Scale (BSMAS). Sleep patterns were evaluated using self-report measures (e.g., Pittsburgh Sleep Quality Index) and objective measures such as actigraphy. Psychological factors including anxiety, depression, stress, and self-esteem were also assessed. Results revealed a significant association between social media addiction and disrupted sleep patterns, with higher levels of social media addiction correlating with poorer sleep quality and decreased sleep duration. Qualitative analysis of interviews provided insights into the psychological mechanisms underlying this relationship, highlighting factors such as fear of missing out (FOMO), heightened cognitive arousal, and maladaptive coping strategies. The findings underscore the importance of addressing social media addiction as a potential risk factor for sleep disturbances and suggest the need for targeted interventions to promote healthier digital habits and improve sleep hygiene among young adults.

A Delirium Prevention and Management Initiative: Implementing a Best Practice Recommendation for the NICU.

Medically complex infants experiencing NICU stays can be difficult to manage, exhibiting refractory agitation, disengagement, or both-all signs of delirium, which can present in a hypoactive, hyperactive, or mixed form. Though documented in other settings, delirium is under-recognized in NICUs. Pediatric studies show that a high percentage of patients with delirium are under the age of 12 months. Delirium is associated with increased ventilation days, hospital days, and costs. It negatively affects neurodevelopment and social interaction. Studies show that pediatric nurses are unprepared to recognize delirium. Our nurse-led multidisciplinary group created a best practice recommendation (BPR) focused on detecting delirium and minimizing risk through thoughtful sedation management, promotion of sleep hygiene and mobility, and facilitation of meaningful caregiver presence. Occasionally, medications, including melatonin and risperidone, are helpful. In 2019, we introduced this BPR to reduce delirium risk in our NICU. Practice changes tied to this initiative correlate with a significant reduction in delirium scores and risk including exposure to deliriogenic medications. A multidisciplinary care bundle correlates with decreased delirium screening scores in NICU patients.

Mild obstructive sleep apnoea in females:post hocanalysis of the MERGE randomised controlled trial

BackgroundApost hocanalysis of the MERGE trial was conducted, to investigate whether sex differences are evident at the mildest end of the disease spectrum, for symptoms associated with obstructive sleep apnoea (OSA) and the response to continuous positive airway pressure (CPAP) treatment.MethodsMERGE participants with mild OSA (apnoea–hypopnoea index 5–15 events·h−1; American Academy of Sleep Medicine 2012 criteria) were randomised to either CPAP plus standard care (sleep hygiene counselling) or standard care alone for 3 months. Quality of life (QoL) was measured by questionnaires completed before and after the 3 months. Thispost hocanalysis of participants of the MERGE trial compared the symptom presentation, and response to CPAP, between the sexes.Results233 patients were included; 71 (30%) were female. Females were more symptomatic at baseline in all QoL questionnaires. Specifically, females had lower 36-item Short-Form Health Survey (SF-36) Vitality scores (mean±sd39.1±10.1versus44.8±10.3) and higher Epworth Sleepiness Scale (ESS) scores (mean±sd11.0±4.2versus9.5±4.4). Both sexes experienced snoring, but more females reported fatigue and more males reported witnessed apnoeas. All symptoms improved with CPAP for both sexes; however, females had larger improvements in SF-36 Vitality scores, which was the primary outcome of the MERGE trial (mean change 9.4 (95% CI 6.8–12.0)versus6.0 (95% CI 4.3–7.7); p=0.034), and ESS (mean change −4.1 (95% CI −5.1– −3.0)versus−2.5 (95% CI −3.1– −1.8); p=0.015), after adjustment for baseline scores and CPAP usage.ConclusionsSex differences are apparent in patients with mild OSA. Females experience worse QoL symptoms than males at presentation to the sleep clinic; however, these improve significantly with CPAP treatment.

Sleep Quality and its Predictors among Undergraduate Medical Students of a Teaching Institute in Telangana, South India: A Cross-sectional Study

Abstract Background: Medical students are vulnerable to sleep disturbances as they navigate life through academic stress, long on-call duties, emotional challenges, and exhaustion. Insufficient sleep negatively affects cognitive functions and fine motor skills, leading to deficiencies in attention, increased drowsiness while driving, propensity for risk-taking behavior, heightened risk of depression, impaired interpersonal relationships, and the potential to impact learning technical aspects of curriculum as well as delivering quality patient care. Objectives: The objective of this study was to measure the sleep quality and its determining factors among undergraduate medical students of a teaching institute in Telangana, South India. Methodology: A cross-sectional study was conducted among 401 undergraduate medical students. A semi-structured questionnaire including the sociodemographic details, medical history, and screen time, followed by the Pittsburgh Sleep Quality Index (PSQI) which assesses the time of quality sleep, frequency of troubled sleep, etc., over the last 1 month was used. The quality of sleep score of >5 indicates poor sleep quality. Results: The mean age was 20.41 years (standard deviation [SD] =2.08). Known comorbidities were present among 17 (4.2%), and 13 (3.2%) had psychiatric conditions. Poor sleep quality was present among 70% of medical undergraduates. The mean global PSQI score was 6.22 (SD = 2.9). The factors found significantly associated with poor sleep quality were academic stress (P = 0.009; odds ratio [OR] = 2.154 [CI = 1.250–3.713]), headache and self-medication (P = 0.008; OR = 1.868 [CI = 1.178–2.964]), and nighttime screen use (P < 0.001; OR = 18.12 [CI = 5.48–59.87]). Conclusion: Sleep deprivation and poor sleep quality is a major concern among medical undergraduates. It is important to have a proper sleep–wake routine and maintain good sleep hygiene. This includes reducing the use of screens before bedtime and addressing any underlying health conditions, including mental health issues, to improve sleep quality and overall well-being.

“Active Feedback” Fitbit-Based Physical Activity and Sleep Hygiene Intervention for Memory Assessment Service (MAS) Patients with Cognitive Deficits: Feasibility, Acceptability, Sleep Quality, Stress, and Wellbeing Outcomes

“Active Feedback” Fitbit-Based Physical Activity and Sleep Hygiene Intervention for Memory Assessment Service (MAS) Patients with Cognitive Deficits: Feasibility, Acceptability, Sleep Quality, Stress, and Wellbeing Outcomes

Sleep Disturbance among Chronic Low Back Patients: A Short Survey

Introduction: In the realm of modern health challenges, Chronic Low Back Pain (CLBP) and sleep disturbances is an issue of concern, casting a shadow over millions worldwide CLBP has a direct impact on the sleep disturbance leading to physical and mental disabilities. Physiotherapy is pivotal in management of Primary and secondary complications like sleep disturbances associated with CLBP. Aim: To evaluate and analyse various domains of sleep hygiene among CLBP patients through Pittsburgh Sleep Quality Index (PSQI). Materials and Methods: A survey using the gold standard method was conducted in the Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India, among 8 patients with CLBP and the sleep was evaluated through PSQI which serves as a seven component subjective questionnaire that evaluated the state of sleep and interruptions during a one-month period. Results: Data analysis showed that PSQI has significant improvements (p<0.05) after manual and conventional physiotherapy. Conclusion: Physiotherapy plays a crucial role in management of chronic low back pain and secondary complications such as sleep disturbance associated with it. Using both manual and conventional physiotherapy techniques greatly improves the outcome of treating CLBP.

EXPLORING THE AWARENESS GAP:A STUDY TO ASSESS THE PREVELENCE OF BREAKFAST SKIPPING PATTERN AND ITS ASSOCIATED FACTOR AMONG NURSING STUDENTS AT SMT NAGARATHNAMMA SCHOOL OF NURSING BANGALURU

Background: Skipping breakfast is the omission or lack of consumption of one of the most traditional main meals (lunch or dinner) throughout the day. Thenumberofbreakfastteenagersmissandeatawayfromhomeincreasesfromearlyadolescence to late adolescence, reflecting the growing need for independence and time away from home. The evening meal appears to be the most regularly eaten made of the day. Girls are found to skip the breakfast, lunch and evening meal more often than boys. In some homewith limited resources, the adolescent may not even receive adequate number of breakfast or amounts leading to nutrient deficiency. Breakfast is frequently neglected and is omitted more often by teenagersandyoungadultsunder25yearsofagethanbyanyotheragegroupsinthepopulation. 1st year nursing student who are staying away from home or experiencing difficulties in adjusting in new environment, experiencing study pressure or any mal-practice that affects normal diet pattern has high chance of suffering from skipping breakfast. 1. To assess the level of knowledge on breakfast skipping regarding among nursing students of Smt. Nagarathnamma College of Nursing,Bengaluru. 2. To evaluate the effectiveness of structured teaching programme regarding Skipping breakfast among nursing students in Smt. NagarathnammaSchool of Nursing. 3. Tofindtheassociationbetweenpre-testandpost-testknowledgescoreregarding Skipping breakfast with selected socio demographicvariable Method: ThisisaDiscriptivestudywhereclosedendeddemographicquestionnaireweregiven to 60 first year student to assess their current situation and self-administered knowledge questionnaire were used as a tool to access sleep hygiene and sleep quality respectivelyamong those 60 first year nursing student by using purposive sampling technique. Data was collected by direct distribution of tools to each nursing student and data was analysed and results were interpreted by using quasi experimentalstatistics. Results: The overall mean percentage knowledge score in the pre-test and post-test were 22.5 % and 59.00%, respectively. Enhancements in mean percentage score were found to be 36.50%.Thestatisticalpairedttestindicatesthatenhancementinthemeanpercentage knowledgescorewasfoundtobesignificantat 0.05level foralltheaspectunderstudy.The association found to be partly significant between pre-test knowledge scores and selected socio demographic variables at 0.05 level(p<0.05). Conclusion: The study findings suggested that ppt assisted structured teaching programmeis an effective instructional method in improving the knowledge regarding Skipping breakfast among nursing students.

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.

Sleep Quality and Its Related Factors Among Older Adults in Malayer City: A Cross-sectional Study

Introduction: With age, major changes in sleep pattern and structure occur that causes sleep disturbances and frequent complaints resulting from it. The aim of this study was to determine sleep quality and its related factors among the older adults of Malayer city, west of Iran. Methods: This descriptive and analytical study was conducted on 298 elderly people in Malayer city. The participants were selected by multi-stage random sampling from the elderly referring to comprehensive health centers in Malayer city. The data collection tool included demographic characteristics and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed in SPSS version 18 using independent t-tests and one-way analysis of variance (ANOVA). Results: The mean and standard deviation of the age of the participants was 68.3±6.7 years. According to the results, 25.5% of the elderly did not have a desirable sleep quality and were suspicious of sleep disorders. Also, there is a statistically significant association between age, number of children and having an underlying disease with sleep quality (P<0.05). Conclusion: The findings of this study showed that the sleep quality of a significant part of the older adults is poor, so it seems necessary to emphasize the importance of performing sleep hygiene behaviors.

A Survey of Knowledge and Practices of Balinese Culture Sleep Hygiene Modification among Health Faculty Students at Hindu Indonesia University

Background: Sleep disorders were reported among 15−35% of adolescents and adults’ population. Around 27% of college students potentially experience at least one sleep disorder. Poor sleep quality is one of the negative impacts of sleep disorders. Sleep hygiene or good sleeping habits are essential to get good sleep quality. Balinese culture has its own rules on sleeping habits related to sleep hygiene. Good knowledge and practices of Balinese culture sleep hygiene modification are expected to improve sleep quality. Methods: The study design of this research is cross sectional descriptive observational study using total sampling as the sampling method, which included all Health Faculty students at Hindu Indonesia University who met the inclusion criteria. Data was collected through a survey by distributing offline questionnaires from April to May 2023. The questionnaires used in this research modified Sleep Beliefs Scale (SBS) and Sleep Hygiene Index (SHI) questionnaires by adding sleep hygiene perspectives according to Balinese culture and customs. Validity and reliability tests were applied to the questionnaires before the survey (Pearson Correlation shows sig. < 0.05 and reliability analysis showed Cronbach Alpha > 0.60). Data collected in this research were analyzed using crosstab tabulation. Results: Thirty-one students of the Health Faculty at Hindu Indonesia University met the inclusion criteria (20 females and 11 males aged 19 to 57 years). The result of this study regarding the knowledge and practices of Balinese culture sleep hygiene modification shows 16 students (51.6%) had both adequate knowledge and practices, 4 students (12.9%) had adequate knowledge but poor practices, 2 students (6.5%) had poor knowledge but good practices, and 9 students (29%) had both poor knowledge and practices. Conclusion: Most of the Health Faculty students at Hindu Indonesia University had adequate knowledge and practices of Balinese culture sleep hygiene modification. Additionally, several students had adequate knowledge but poor practices and several students had poor knowledge but good practices, which indicates that adequate knowledge about Balinese culture sleep hygiene modification does not guarantee good practices. Keywords: Balinese culture sleep hygiene modification, knowledge, practices

Effects of sleep quality in early pregnancy on pregnancy outcomes and mood state.

To clarify the relationship between quality of sleep and pregnancy outcomes and to explore how sleep quality affects mood state in the first trimester of pregnancy. This prospective cohort study enrolled pregnant women from June 2020 to June 2021. Maternal sleep conditions, daytime sleepiness, and mood state in the first trimester were assessed using four Chinese self-rating scales, namely, the Pittsburgh Sleep Quality Index (PSQI), the Sleep Hygiene Practice Scale (SHPS), Epworth Sleepiness Scale (ESS), and the abbreviated version of the Profile of Mood States (a-POMS). Participants were divided into an exposed group (PSQI score > 5, poor sleep quality group) and a non-exposed group (PSQI score ≤ 5, good sleep quality group). Maternal characteristics, pregnancy outcomes, and the relationship among sleep quality, sleepiness, and mood state were analyzed. Comparisons of sleep hygiene behavior variables between the two subgroups were also analyzed. A total of 2703 pregnantwomen were enrolled in the study. Poor sleep quality increased the probability of gestational diabetes mellitus (GDM) (1.573, 1.315-1.863), liver function damage (1.467, 1.021-2.107), preterm delivery (1.468, 1.077-2.002), mild sleepiness (1.612, 1.357-1.915), and excessive sleepiness (2.134, 1.686-2.701). Poor maternal sleep quality was significantly associated with the occurrence of preterm premature rupture of membranes (1.947, 1.168-3.243) and perinatal death (1.003, 1.000-1.006). Additionally, a significant positive correlation between the PSQI score and the total mood disturbance (TMD) score was revealed by Spearman's correlation analysis (r = 0.378, P < 0.01). Enter Regression analysis demonstrated that sleep quality (R2 = 0.390, P < 0.01) and sleepiness (R2 = 0.234, P < 0.01) exerted significant direct effects on mood state during pregnancy. Furthermore, Spearman's correlation analysis indicated a positive association between the PSQI score and the SHPS total score (r = 0.227, P < 0.01). Poor sleep quality is significantly associated with elevated rates of maternal mood disturbances, obstetric complications, and adverse outcomes in infants. The findings suggest that it may be useful toprovide comprehensive sleep assessment and education on sleep hygiene during the early stages of pregnancy.

The Effect of Sleep Hygiene Education on Sleep Quality of Children with Intellectual Disabilities and Their Mothers According to The Health Promotion Model

The Effect of Sleep Hygiene Education on Sleep Quality of Children with Intellectual Disabilities and Their Mothers According to The Health Promotion Model

Unintended consequences: college students' melatonin usage, sleep disturbance, and depressive symptoms.

With such high rates of undergraduate sleep problems, students have chosen to take melatonin, an over-the-counter supplement that can facilitate sleep. Questions remain as to the effectiveness of melatonin for sleep problems, and questions have emerged about its impact on mental health. Accordingly, the current study examined how ongoing melatonin usage might impact relative changes in college students' sleep disturbance and ultimately their depressive symptoms. The two-wave (baseline and 2-month follow-up), online sample consisted of 331 undergraduates (86% female; Mage = 21.3, SD = 2.4), who reported on melatonin usage, sleep disturbance, and depressive symptoms. Controlling for sleep hygiene, socio-economic status, and gender, our model demonstrated a significant indirect effect from ongoing melatonin usage to depressive symptoms. Specifically, melatonin consumption predicted relative increases in sleep disturbance, which, in turn, predicted corresponding increases in students' depressive symptoms. Given the increasing prevalence of melatonin usage, the potential for unforeseen consequences remains high. Results suggest that the negative consequences of melatonin use can include both college students' mental health and their sleep. Given the efficacy of addressing sleep problems with cognitive or behavioral strategies, it is essential that student support services highlight alternatives to melatonin and the potential problems associated with its use.

TARGETING HEALTH-PROMOTING ACTIVITY IN OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS AND FUNCTIONAL LIMITATIONS

Abstract Nearly half of older adults in the U.S. have multiple chronic health conditions in addition to functional limitations (MCC + FL) that restrict health self-management activities. We tested an innovative combination of occupational therapy (OT) and behavioral activation (BA) to improve health self-management using the goal setting, scheduling/monitoring activities, and problem-solving components of the BA approach, as well as skill building, environmental modification, activity adaptation, and focus on daily routines from OT (BA+OT). BA+OT was delivered by occupational therapists over 10 sessions in the homes of participants. We present descriptive statistics from this single-blind randomized control pilot study of 11 older adults with MCC + FL who received BA+OT (n = 6) or enhanced usual care (UC; n = 5). Participants in both groups were given a Fitbit, and the UC group received a handout on managing chronic conditions. The BA+OT group was required to set at least one goal for improving physical activity. On average, participants were 73.1 years old (SD = 8.4), majority female (n = 8), and white (n = 1 Hispanic/Latino). They had an average of 3.9 chronic conditions (SD = 1.5), and 2.0 functional limitations (SD = 1.8). The most common chronic conditions were depression, high blood pressure, and arthritis. Aside from physical activity, the most common participant-identified goal areas were sleep hygiene and positioning, medication routines, and community access. This study is in progress (aiming for n = 40) but shows promise for improving health self-management by targeting meaningful, goal-directed, and health-promoting daily activity.

Quality of Sleep in the Saudi Population During the Holy Month of Ramadan.

Background The holy month of Ramadan carries a massive change in a Muslim's lifestyle. During these 30 days of all-day fasting, people in Saudi Arabia prefer staying up all night and sleeping in the daytime, thus highly impacting their regular sleeping schedule, with a sizable effect on the quality of sleep. This study aimed to measure the quality of sleep and sleep hygiene practices in the Saudi population. Methodology This cross-sectional study was conducted among the Saudi population during the holy month of Ramadan. A self-administered questionnaire was sent to the targeted population using social media platforms. Our questionnaire included demographic data, the Sleep Quality Scale (SQS) to measure sleep quality, and the Sleep Hygiene Index (SHI) to measure sleep hygiene practices. Results Of the 386 participants, 71.2% were females, and 64.5% were single. The total mean SQS score was 35.8 (SD = 10.9) out of 84 points, while the total mean SHI score was 19.8 (SD = 8.61) out of 52 points. Overall, 63.5% of the respondents had poor sleep hygiene practices. Significant factors for increased SHI included being unmarried, a student, not the main provider in the family, not a parent, and earning less than 5,000 SAR per month while having more than six individuals in the family was a significant factor for increased SQS. Conclusions During the month of Ramadan, poor sleep quality and inadequate sleep hygiene practices were common among the Saudi population. A significant risk factor for poor sleep quality was having more than six individuals at home while being unmarried, a student, not being the family's main provider, and earning less than 5,000 SAR per month were the significant risk factors for poor sleep hygiene practices. Further research is needed to establish the effect of poor sleep quality and inadequate sleep hygiene practices during Ramadan fasting in our region.

COGNITIVE BEHAVIORAL AND VIRTUAL REALITY TREATMENTS FOR INSOMNIA (CBTI AND IVR): OFF-LABEL IMPACT ON COGNITION

Abstract Chronic insomnia (CI) is common in mid-to-late life and associated with hyperarousal and impaired cognition and mood. CBTi improves sleep and may also improve cognition, arousal and mood but evidence for these latter outcomes is limited. We examined these outcomes across 3 studies with different delivery platforms (telehealth, digital, VR), dosages (2 sessions, 4 sessions), and (primarily) mid-to-older CI populations (fibromyalgia, dementia caregivers). Study 1 compared 8-week CBTi vs sleep hygiene in women with fibromyalgia (n=43, Mage=44.45). Study 2 piloted 4-session web-based CBTi in caregivers (n=5, Mage=62.40). Study 3 piloted 4-session iVR (n=18, Mage=36.45). Participants completed 2-week daily diaries pre/post treatment (sleep onset latency-SOL; wake after sleep onset-WASO; total sleep time-TST) and Insomnia Severity Index-ISI. Other measures included: study 1(arousal/heart rate variability-RMSDNN), studies 1 and 3(Wisconsin Card Sort Test-WCST, Stroop), study 2(Cognitive Failures Questionnaire-CFQ, Beck Depression Inventory-BDI-II, Perceived Stress Scale). Group x time interactions (study 1) and within-group pre/post differences were examined. CBTi improved sleep across studies (ps&amp;lt;.05). Study 1 found and study 3 trended toward improved cognitive flexibility (WCST %perseverative errors-t(14)=2.65, p=.019 and t(10)=1.76, p=.055, respectively). Study 1 found improved attention and processing speed [Stroop reaction time(RT)-congruent trials-t(14)=2.59, p=.023], inhibition (Stroop RT-incongruent trials-t(14)=2.43, p=.031), and arousal [increased RMSDNN; F(1,41)=4.87, p=.03]. Study 2 found improved subjective cognition-CFQ (t(4)=2.44, p=.04), arousal-RMSDNN (t(4)=2.09, p=.05), and depression-BDI-II (t(4)=2.89, p=.02). CBTi improved sleep, cognition, arousal and mood in mid-to-older CI populations. Research using randomization, active controls, and follow-ups is needed to delineate temporality and explore sleep’s mechanistic contribution to cognition and other “off-label” outcomes.

Interpretation by narrative literature review of the factors involved in sleep disorders

Concern for identifying and understanding the variables that affect sleep quality has been increasing in recent years, although more studies are needed in this line of research. The aim of the study was to interpret, through a narrative literature review, the factors involved in sleep disorders. Methodologically, the study was classified as observational, descriptive, cross-sectional and retrospective. A hermeneutic approach was adopted to interpret and deeply understand the existing literature on factors influencing sleep quality and its effects on general health. The role of the glymphatic system in the elimination of brain metabolic wastes and how good sleep quality facilitates neuroprotective processes is highlighted. The findings highlight the importance of improving sleep hygiene and developing personalized interventions for its management, suggesting the adoption of innovative approaches in future research, such as the application of theories like neutrosophic. This review urges the adoption of innovative approaches to sleep research, including the application of theories such as neutrosophic, to address the complexity of these phenomena more effectively. In conclusion, this systematic review evidences the interconnectedness between multiple factors that impact sleep quality and underscores the need for multidisciplinary approaches to its management. Understanding these factors through a heuristic approach not only facilitates a better interpretation of the underlying mechanisms affecting sleep, but also guides the development of more effective and personalized intervention strategies

Sleep Hygiene, Mediating the Association Between Circadian Typology and Psychological Distress: An Association Elicited by Mediation Analysis Model Among Young Sudanese Adults, 2022-2023

BACKGROUND: Circadian rhythms are regulated by genetic and environmental components. The association of intrinsic and extrinsic factor modulates physiological and individual sleep schedules sleep hygiene and even different chronotype. Evidence suggests evening-type individuals have a higher risk of reporting psychological distress than morning-type individuals. However, less is known regarding the underlying processes that might mediate this association among Sudanese young adults. This study aimed at assessing the mediating role of sleep hygiene on the relationship between circadian typology and psychological distress among young Sudanese adults. METHODS: This is a cross sectional study. Conducted among medical students, graduates and medical interns of Al-Neelain University. Between April and August 2022. Morningness–Eveningness 19 items Questionnaire (MEQ) was used to assess chronotype preference. Kessler10-item Questionnaire was used to assess Psychological Distress, and sleep hygiene index (SHI) was used to screen Sleep hygiene behaviors. Hayes PROCESS macro (model 4) was used to perform the mediation analysis. RESULTS: Among 303 medical students who complete the study questionnaire. Mean of age for study participants was (22.71±2.49). Sleep hygiene index mean score was (29.35±5.46) indicating poor sleep hygiene behaviors. Most of the population were Neutral in their circadian typology preference (58.1%). (89.8%) of our population had psychological distress, Chronotype correlated with severe psychological distress and poor sleep hygiene behaviors (r=-0.141, P&lt;0.05) (r=-0.292, P&lt;0.001) respectively. Poor sleep hygiene behaviors also correlated with severe psychological distress (r=0.466, P&lt;0.001). Individuals who were severely psychologically distressed mostly had higher sleep hygiene mean scores than normal individuals (29.35±5.46), (21.61±6.42) (p&lt;0.001). Sleep hygiene index scores were lower for Morning circadian typologies [definite Morning 22.50± (7.00), moderate morning 24.89± (5.63)] compared to evening typologies [definite evening 32.25± (4.43), moderate evening 29.00± (6.09)]. Which indicated good sleep hygiene behaviors for Morning chronotype groups. Figure 1.0 illustrates the distribution of mean sleep hygiene index scores across circadian preference groups. Multiple regression analysis results showed that there was no significant direct effect of chronotype on psychological distress β=-.0096, SE= .0496, t=-.1937, P=.8466, CI [-.1073-.0881]. We also found a significant indirect effect of sleep chronotype on psychological Distress (β=-0.113, SE=0.0265, CI [-.1698 - -.0649]. According to bias-corrected percentile bootstrap method the total effect was negatively significant, (β=-0.123, SE=0.0534, t=-2.30, p&lt;0.05, CI [-0.2280 - -0.0178], indicating a full complimentary mediation between evening chronotype and impaired psychological wellbeing through sleep hygiene behaviors. CONCLUSION: Sleep hygiene was found to mediate the correlation between eveningness and impaired psychological wellbeing, Improvement of Sleep hygiene behaviors is advised to enhance morning circadian typology as to prevent and reduce psychological distress. Interventions to enhance morning circadian typology should be prioritized to medical students, graduates and medical interns who are prone to eveningness to minimize the risk for psychological distress.

Internet Addiction, Sleep Habits and Family Communication: The Perspectives of a Sample of Adolescents.

With the increase in communication technologies, the internet has become an indispensable tool in the life of the individual. Several studies report on the advantages of this resource; however, there is still a group of individuals who use the internet excessively. The aim of this study was to explore the relationships between internet addiction, daytime sleepiness, and family communication in adolescents. A total of 340 adolescents aged between 12 and 17 years participated in this study. All completed the sociodemographic questionnaire, the internet addiction test, the pediatric daytime sleepiness scale, and the family communication scale. The results indicate that 64.1% of the adolescents had mild to moderate addiction to the internet. The main results suggest that internet addiction in adolescents is negatively associated with family communication and positively associated with excessive daytime sleepiness. It was also observed that gender had a significant effect on daytime sleepiness, with female participants having more excessive daytime sleepiness. Regarding age, the results indicate higher values of internet addiction among younger adolescents. In view of the above, it is considered important to develop preventive actions with a view to healthy family communication, with the adoption of sleep hygiene habits and the promotion of healthy use of the internet.