Sleep Position Research Articles

Influence of sleep stages on determining positional dependency in patients with obstructive sleep apnea.

Supine sleep position and rapid eye movement (REM) stage are widely known to aggravate the severity of obstructive sleep apnea (OSA). In general, position-dependent OSA is defined as an apnea-hypopnea index (AHI) at least twice as high in the supine position as in other sleep positions, but it can be misdiagnosed if a certain sleep stage, REM or NREM, is dominant in a specific sleep position. In this study, we investigated the influences of the sleep stages on positional dependency. The polysomnographic data from 111 OSA patients aged ≥ 18 years (AHI > five events/hour) who slept in both supine and non-supine positions (each ≥ 5% of the total sleep time) were retrospectively analyzed. The overall ratio of non-supine AHI/supine AHI (NS/S AHI ratio) during the entire sleep was compared between specific sleep stages, i.e., REM or NREM sleep. Additionally, the weighted NS/S AHI ratio reflecting the proportion of each sleep time was created and compared with the original NS/S AHI ratio. The mean value of the NS/S AHI ratio did not differ between the entire sleep and the specific sleep stages. However, those ratios in the individual patients showed poor agreement of the NS/S AHI ratios between the entire sleep and the specific sleep stages. The weighted NS/S AHI ratio also demonstrated poor agreement with the original NS/S AHI ratio, mainly due to the discrepancy in mild to moderate OSA patients. The weighted NS/S AHI ratio might help assess precise positional dependency.

Short apneas and periodic breathing in preterm infants in the neonatal intensive care unit-Effects of sleep position, sleep state, and age.

This observational study investigated the effects of sleep position and sleep state on short apneas and periodic breathing in hospitalized preterm infants longitudinally, in relation to postmenstrual age. Preterm infants (25-31 weeks gestation, n = 29) were studied fortnightly after birth until discharge, in prone and supine positions, and in quiet sleep and active sleep. The percentage of time spent in each sleep state (percentage of time in quiet sleep and percentage of time in active sleep), percentage of total sleep time spent in short apneas and periodic breathing, respectively, the percentage of falls from baseline in heart rate, arterial oxygen saturation and cerebral tissue oxygenation index during short apneas and periodic breathing, and the associated percentage of total sleep time with systemic (arterial oxygen saturation < 90%) and cerebral hypoxia (cerebral tissue oxygenation index < 55%) were analysed using a linear mixed model. Results showed that the prone position decreased (improved) the percentage of falls from baseline in arterial oxygen saturation during both short apneas and periodic breathing, decreased the proportion of infants with periodic breathing and the periodic breathing-associated percentage of total sleep time with cerebral hypoxia. The percentage of time in quiet sleep was higher in the prone position. Quiet sleep decreased the percentage of total sleep time spent in short apneas, the short apneas-associated percentage of falls from baseline in heart rate, arterial oxygen saturation, and proportion of infants with systemic hypoxia. Quiet sleep also decreased the proportion of infants with periodic breathing and percentage of total sleep time with cerebral hypoxia. The effects of sleep position and sleep state were not related to postmenstrual age. In summary, when sleep state is controlled for, the prone sleeping position has some benefits during both short apneas and periodic breathing. Quiet sleep improves cardiorespiratory stability and is increased in the prone position at the expense of active sleep, which is critical for brain maturation. This evidence should be considered in positioning preterm infants.

Death from Failed Protection? An Evolutionary-Developmental Theory of Sudden Infant Death Syndrome

Sudden infant death syndrome (SIDS) has been mainly described from a risk perspective, with a focus on endogenous, exogenous, and temporal risk factors that can interact to facilitate lethal outcomes. Here we discuss the limitations that this risk-based paradigm may have, using two of the major risk factors for SIDS, prone sleep position and bed-sharing, as examples. Based on a multipronged theoretical model encompassing evolutionary theory, developmental biology, and cultural mismatch theory, we conceptualize the vulnerability to SIDS as an imbalance between current physiologic-regulatory demands and current protective abilities on the part of the infant. From this understanding, SIDS appears as a developmental condition in which competencies relevant to self-protection fail to develop appropriately in the future victims. Since all of the protective resources in question are bound to emerge during normal infant development, we contend that SIDS may reflect an evolutionary mismatch situation—a constellation in which certain modern developmental influences may overextend the child’s adaptive (evolutionary) repertoire. We thus argue that SIDS may be better understood if the focus on risk factors is complemented by a deeper appreciation of the protective resources that human infants acquire during their normal development. We extensively analyze this evolutionary-developmental theory against the body of epidemiological and experimental evidence in SIDS research and thereby also address the as-of-yet unresolved question of why breastfeeding may be protective against SIDS.

Effects of the low Fowler's sleep position and methazolamide treatment on sleep bruxism: A randomized controlled trial.

Intracranial pressure is one of the determinants of sympathetic activities, and sleep bruxism is associated with increased sympathetic activities. This study aimed to investigate effects of the low Fowler's sleep position and methazolamide treatment on the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes in patients with sleep bruxism in a randomized controlled trial. Polysomnographic recordings were performed on the patients with sleep bruxism sleeping in the low Fowler's (15°-30°) or supine position (n = 11), and with methazolamide or placebo treatment (100 mg, 3-4 hr before bedtime, P.O., n = 9), and changes in sleep variables and heart rate variance during sleep in the low Fowler's position or with methazolamide treatment were determined. Sleep bruxism index, number of masseter muscle electromyographic bursts per hour of sleep, ratio of rhythmic masticatory muscle activities/sleep bruxism duration to the total sleep duration, index of total limb movements, index of limb movements with rhythmic masticatory muscle activities, and number of sleep bruxism clusters per hour of sleep in the low Fowler's position and after methazolamide intake were significantly smaller (p < 0.05-0.001) than those in the supine position and after placebo intake, respectively. The low-frequency heart rate variance powers during non-rapid eye movement sleep stage 2 (N2) in the low Fowler's position and with methazolamide treatment were significantly lower (p < 0.05) than those during sleep in the supine position and with placebo treatment, respectively. In conclusion, sleep in the low Fowler's position and methazolamide treatment were associated with significant decreases in the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes, which might be due to a reduction in intracranial pressure and sympathetic activities mainly during non-rapid eye movement sleep stage 2.

Diagnostic and therapeutic process of respiratory disorders during sleep

Introduction and purpose Sleep apnea is a disturbance of sleep that affects about 10% of adult population and is not easily detected due to unspecific symptoms. The aim of this literature review is to present, respectively, obstructive sleep apnea and central sleep apnea symptoms and integrate the available data in the literature regarding the pathogenesis and treatment methods. Materials and methods A review of literature was performed using PubMed and Google Scholar database. The search criteria included keywords such as sleep apnea, obstructive sleep apnea treatment, central sleep apnea treatment. State of knowledge Sleep disturbances that involve breathing can be categorized as obstructive sleep apnea (OSA) and central sleep apnea. First one is associated with the obstruction of the upper airways and the second one – with malfunctioning breathing generator in the pontomedullary breathing pacemaker. Symptoms are unspecific which makes diagnostic process difficult. However, the right diagnosis and treatment may prevent patients from developing many cardiovascular diseases. Treatment options for OSA include: CPAP, reducing body weight, changing sleep position, braces and surgeries; for CSA: CPAP and acetazolamide. Conclusions OSA and CSA need to be further investigated in order to find more precise ways of diagnosis and treatment, as these diseases remain underreported. It is worth noting, that these conditions predispose to serious diseases, e.g. stroke. Therefore, developing new treatment techniques would beneficial for the health of population.

0788 Effect of Sleep State and Position on Obstructive Respiratory Events in 12 - 24-month-old Toddlers

0788 Effect of Sleep State and Position on Obstructive Respiratory Events in 12 - 24-month-old Toddlers

0589 Evaluating the Impact of Sleep Position on Efficacy of Hypoglossal Nerve Stimulation

0589 Evaluating the Impact of Sleep Position on Efficacy of Hypoglossal Nerve Stimulation

The effect of sleep position on sleep bruxism in adults with obstructive sleep apnea.

Most of the respiratory events in adults with obstructive sleep apnea (OSA) occurs in supine position. It has been reported that the contraction of masseter muscles is dependent on the occurrence of arousals rather than on the occurrence of respiratory events. This study had two aims: (1) to compare the rhythmic masticatory muscle activity (RMMA) index in supine position (RMMA_sup) and in non-supine positions (RMMA_nsup) in adults with OSA; and (2) to determine the associations between RMMA index in both supine position and non-supine positions on the one hand, and several demographic and polysomnographic variables on the other hand. One hundred OSA participants (36 females and 64 males; mean age = 50.3 years (SD = 10.5)) were selected randomly from among patients with a full-night polysomnographic recording. RMMA_sup index and RMMA_nsup index were compared using Mann-Whitney U-test. Multivariate linear regression analyses were used to predict RMMA index both in supine and non-supine positions based on several demographic and polysomnographic variables. In patients with OSA, the RMMA_sup index was significantly higher than the RMMA_nsup index (p < .001). RMMA_sup index was significantly associated with the arousal index (p = .002) and arousal index in supine position (p < .001). RMMA_nsup index was only significantly associated with the arousal index in non-supine positions (p = .004). Within the limitations of this study, RMMAs occur more frequently in supine position than in non-supine positions in patients with OSA. In both sleep positions, RMMAs are associated with arousals.

Sleep and Mood Among Women With Histories of Depression When They Used a Responsive Infant Bassinet During the COVID-19 Pandemic

ObjectiveTo describe the experiences of women with histories of depression who used a responsive infant bassinet during the first 6 months after birth during the COVID-19 pandemic. DesignSecondary qualitative descriptive study with analytic expansion. SettingUnited States. ParticipantsWomen (N = 139) who gave birth up to 6 months previously and had histories of depression. MethodsWe used Kyngäs’s method of inductive content analysis to analyze 109 open-ended responses that were collected between August 2020 to November 2021 as part of a previously conducted longitudinal study of women who used a responsive bassinet. ResultsMost participants indicated that the responsive bassinet improved their infants’ sleep, which, in turn, subjectively improved their sleep and mood. External stressors and challenges presented barriers to good sleep for the participants and their infants, and participants described how these challenges contributed to their symptoms related to mood. When participants reported that they used the responsive bassinet, they shared that their infants were swaddled in the supine sleep position. Participants who did not use the bassinet commonly reported unsafe sleep practices. We identified seven themes from the data: Improved Maternal Sleep Quality, Barriers to Good Maternal Sleep, Mood and Sleep Go Hand and Hand, External Stressors Impair Mood, Improved Infant Sleep Quality, Barriers to Good Infant Sleep, and Safe Sleep Positioning. ConclusionThese findings can be used to inform clinicians on how a responsive bassinet may offer women at high risk for postpartum depression improved sleep and instrumental support. Future researchers should use validated measures to objectively evaluate rates of postpartum depression and sleep quality in high-risk women when using a responsive bassinet.

The Tension Between AAP Safe Sleep Guidelines and Infant Sleep.

To understand tension mothers experience when attempting to follow American Academy of Pediatrics safe sleep guidelines and enhancing infant and parental sleep. Surveys and focus groups were conducted from November 2022 and March 2023 with United States-based English-speaking mothers of infants <6 months of age recruited via social media and who reported a nonrecommended sleep position and/or location ≥2 times the prior week. Twenty-five mothers participated in focus groups and surveys. A total of 80% reported holding or rocking their infant to sleep; 76% fed their infant to sleep. Almost all were aware of the ABCs (Alone, Back, Crib) of safe sleep and intended to follow them before delivery. Many felt that ABCs were unrealistic and placed their infants in nonrecommended locations or positions because they perceived them as more comfortable and helping their infant fall and stay asleep. Mothers were more likely to use nonrecommended practices when they were awake or sleeping nearby and believed they could closely monitor their infant. Some questioned whether ABCs were the only way to achieve safe sleep. Some prioritized other safety concerns (eg, fall prevention) over sudden infant death syndrome or sudden unexpected infant death prevention. Mothers expressed confidence about getting their baby to sleep in general but were less confident that they could do this while following guidelines. Despite awareness of the ABCs, mothers regularly engaged in nonrecommended practices with the goal of improving their own and their infant's sleep. Interventions focused on improving infant and parental sleep while maintaining sleep safety are needed.

Persian version of brief infant sleep questionnaire (BISQ): a psychometric evaluation

BackgroundThe high prevalence of sleep problems and their negative consequences on children and parents highlight the need to design early screening instruments to evaluate sleep problems in early childhood. We aimed to determine the validity and reliability of the Brief Infant Sleep Questionnaire (BISQ) among the Iranian population.Methods and materialsThis study included 646 one-year-old infants by random sampling from the PERSIAN birth cohort study. Following the forward-backward translation of the BISQ, its psychometric properties, including construct validity in terms of concurrent and convergent validities as well as reliability, were evaluated.ResultsThe CVIs and CVR ranged between 0.8 and 1.00 for all items. Therefore, we keep all the items of the original version of the BISQ in the Persian BISQ. Concurrent validity was assessed by comparing items of the Persian BISQ among different maternal views regarding their infant’s sleep. All BISQ items were significantly different among the two levels of maternal view about the infant’s sleep problem except daytime sleep duration. The convergent validity of the BISQ was evaluated by calculating the correlation between BISQ items and the ISQ (infant sleep questionnaire) total score as a similar tool. ISQ score was adequately correlated with nocturnal sleep latency and the number of waking at night (rs ranged from 0.59 to 0.72). In addition, the associations of mothers’ and infants’ demographic variables and nutritional and gestational variables with BISQ items were presented to confirm construct validity. Strong correlations were found between the repeated sleep measures for sleep arrangement, sleep position, and sleep situation (kappa ranged from 0.65 to 0.84), nocturnal sleep duration, daytime sleep duration number of wakings at night, night waking duration, nocturnal sleep latency and sleep-onset time (ICC ranged 0.91 to 0.99).ConclusionThe Persian version of the BISQ is a reliable and valid measure for assessing sleep problems in infants. It would be helpful to be utilized for the early diagnosis of infants’ sleep problems.

Heart rate detection method based on Ballistocardiogram signal of wearable device：Algorithm development and validation

BackgroundHeart rate, as the four vital signs of human body, is a basic indicator to measure a person's health status. Traditional electrocardiography (ECG) measurement, which is routinely monitored, requires subjects to wear lead electrodes frequently, which undoubtedly places great restrictions on participants' activities during the normal test. At present, the boom of wearable devices has created hope for non-invasive, simple operation and low-cost daily heart rate monitoring, among them, Ballistocardiogram signal (BCG) is an effective heart rate measurement method, but in the actual acquisition process, the robustness of non-invasive vital sign collection is limited. Therefore, it is necessary to develop a method to improve the robustness of heart rate monitoring. ObjectiveTherefore, in view of the problem that the accuracy of untethered monitoring heart rate is not high, we propose a method aimed at detecting the heartbeat cycle based on BCG to accurately obtain the beat-to-beat heart rate in the sleep state. MethodsIn this study, we implement an innovative J-wave detection algorithm based on BCG signals. By collecting BCG signals recorded by 28 healthy subjects in different sleeping positions, after preprocessing, the data feature set is formed according to the clustering of morphological features in the heartbeat interval. Finally, a J-wave recognition model is constructed based on bi-directional long short-term memory (BiLSTM), and then the number of J-waves in the input sequence is counted to realize real-time detection of heartbeat. The performance of the proposed heartbeat detection scheme is cross-verified, and the proposed method is compared with the previous wearable device algorithm. ResultsThe accuracy of J wave recognition in BCG signal is 99.67%, and the deviation rate of heart rate detection is only 0.27%, which has higher accuracy than previous wearable device algorithms. To assess consistency between method results and heart rates obtained by the ECG, seven subjects are compared using Bland-Altman plots, which show no significant difference between BCG and ECG results for heartbeat cycles. ConclusionsCompared with other studies, the proposed method is more accurate in J-wave recognition, which improves the accuracy and generalization ability of BCG-based continuous heartbeat cycle extraction, and provides preliminary support for wearable-based untethered daily monitoring.

Association between overnight repetitive respiratory events and the accumulation of genioglossus fatigue in male patients with severe obstructive sleep apnea.

To evaluate the correlation between median frequency (MF) as a measure of genioglossus (GG) fatigue and overnight repetitive respiratory events in male patients with severe obstructive sleep apnea (OSA). GG electromyography (EMG) data were collected synchronously with polysomnography (PSG). Overnight respiratory events were divided based on whether they occurred during the first or second halves of the total number of overnight respiratory events, and differences in MF in the respiratory phase were compared in the same segments. Events were then sampled in pairs to compare MF. The correlation between MF and the order of respiratory events, as well as interindividual differences, were analyzed. Twenty-two male patients were enrolled in this study and 2210 respiratory events were recorded. Before and during respiratory events, MF decreased significantly in the second half, especially during the inspiratory phase (segments 1-4: P = 0.014, P < 0.001, P < 0.001, P < 0.001, respectively). This trend was observed in non-rapid eye movement sleep and lateral position, but not in rapid eye movement sleep or the supine position, and remained after pairing for duration, stage, and position. MF correlated negatively with the order of respiratory events during the inspiratory phase. The trend of decrease in MF only existed in patients with apnea-hypopnea index > 30 events/h. Overnight repetitive respiratory events were associated with increased GG fatigue, influenced by sleep stage and body position in male patients with severe OSA. GG fatigue depends on the order and frequency of respiratory events.

Hubungan Kualitas Tidur, Durasi, dan Posisi Penggunaan Smartphone dengan Kejadian Asthenopia pada Mahasiswa Fakultas Kedokteran Universitas Islam Al-Azhar Angkatan 2022

Asthenopia or eye strain (eye strain) is a collection of symptoms related to vision, eye (ocular) and musculoskeletal problems. In Indonesia, as many as 60 million people suffer from eye problems, the number increasing by one million per year. This study aims to determine the relationship between sleep quality, duration and position of smartphone use with the incidence of asthenopia in students at the Faculty of Medicine, Al-Azhar Islamic University class of 2022. This research is a type of quantitative observational research using a cross sectional design. The sampling technique is total sampling. The research sample was 98 samples according to the inclusion and exclusion criteria. The data obtained were analyzed using the Spearman rank correlation test The results of this study showed that there were 40 respondents who experienced asthenopia (40.8%), and 58 respondents who did not experience asthenopia (59.2%). Respondents who had good sleep quality were 52 people (53.1%), respondents who had poor sleep quality were 46 people (46.9%). Respondents who used smartphones for a duration of 3-8 hours in one day were 48 people (49.0%), respondents who used smartphones for a duration of &gt;8 hours in one day were 50 people (51.0%). Respondents who more often used smartphones in a sitting position were 58 people (52.9%), and respondents who more often used smartphones in a lying position were 40 people (40.8%). There is a relationship between sleep quality and the incidence of asthenopia with a p-value of 0.000 and a correlation coefficient of -0.800. There is a relationship between the duration of smartphone use and the incidence of asthenopia with a p-value of 0.000 and a correlation coefficient of 0.731. There is a relationship between the position of smartphone use and the incidence of asthenopia with a p-value of 0.000 and a correlation coefficient of 0.916. There is a significant relationship between sleep quality, duration and position of smartphone use and the incidence of asthenopia in students at the Faculty of Medicine, Al-Azhar Islamic University class of 2022.

Exploring the dynamics of snoring in relation to sleep stages: Implications for gender differences, sleep position, and upper airway collapsibility.

The purpose of this study was to determine the sleep stage during which isolated snoring occurs in children and adults, and to analyze changes after treatment of obstructive sleep apnea (OSA). This retrospective study examined duration of snoring time and respiratory events during each sleep stage in adults and children who underwent polysomnography, had an apnea-hypopnea index (AHI) < 15/h and had snoring time ≥ 10% of total sleep time. Changes in duration of snoring time were also examined in adult patients after treatment with an oral appliance (OA). Snoring time was shown to be predominant during N3 and N2 sleep and less dominant during REM sleep in both children (n = 47) and adults (n = 93). These results were seen even in children with REM dependency. The percentage of snoring time during N3 sleep was more pronounced in women than in men among young adult patients aged < 40 years but was not significantly different between men and women overall. There were no significant differences in the percentage of snoring time in each sleep stage between young women with mild OSA and non-OSA. In children, there were no significant differences between boys and girls in the percentage of snoring time in any sleep stage. The percentage of snoring time during N3 was significantly higher sleep in the non-supine position than in the supine position in children, whereas no significant differences were noted between the supine and non-supine positions in any sleep stage in adults. OA treatment for adult patients (n = 20) significantly increased the percentage of snoring time during N3 sleep, although it significantly decreased AHI, total snoring time, and snoring time during N1 sleep and REM sleep. Snoring presented exclusively during the N3 sleep stage, especially in young women with mild OSA, and in children with OSA, especially in the non-supine position. Snoring time during N3 sleep increased during OA treatment for OSA.

A study of Samoan, Tongan, Cook Island Māori, and Niuean infant care practices in the Growing Up in New Zealand study

BackgroundDespite a low rate of infant mortality, Aotearoa New Zealand has a high rate of Sudden Unexpected Death in Infants (SUDI), with disproportionate impact for Pacific infants. This study explored the infant care practices, factors and relationships associated with increased risk of SUDI amongst Tongan, Samoan, Cook Islands Māori, and Niuean mothers in New Zealand, to inform evidence-based interventions for reducing the incidence of SUDI for Pacific families and their children.MethodsAnalysis comprised of data collected in 2009–2010 from 1089 Samoan, Tongan, Cook Islands Māori and Niuean mothers enrolled in the Growing Up in New Zealand longitudinal cohort study. The sleeping environment (bed-sharing and sleep position) of the infants was assessed at 6 weeks. Multivariable logistic regression analysis were conducted, controlling for sociodemographic factors to explore the association between selected maternal and pregnancy support and environment factors and the sleeping environment for infants.ResultsMothers who converse in languages other than English at home, and mothers who consulted alternative practitioners were less likely to follow guidelines for infant sleeping position. Similarly language, smoking, alcohol, household dwelling, crowding and access to a family doctor or GP were associated with mothers following guidelines for bed-sharing.ConclusionThe impact of SUDI on Pacific infants may be lessened or prevented if communication about risk factors is more inclusive of diverse ethnic, cultural worldviews, and languages. Societal structural issues such as access to affordable housing is also important. This research suggests a need for more targeted or tailored interventions which promote safe sleeping and reduce rates of SUDI in a culturally respectful and meaningful way for Pasifika communities in Aotearoa, New Zealand.

Lumbar spinal stenosis and surgical decompression affect sleep quality and position in patients. A prospective cross-sectional cohort study

IntroductionIt is reasonable to assume that lumbar spinal stenosis (LSS) affects the cauda nerve roots also at night. Research questionDoes microsurgical decompression influence sleep quality and position? Materials and methodsA study nurse interviewed 140 patients scheduled for LSS decompression using the Pittsburgh Sleep Quality Index (PSQI), Spinal Stenosis Measure (SSM), Numeric Rating Scale (NRS) for back and leg pain, Douleur Neuropathique (DN4), and Charlson Comorbidity Index. Epidemiologic and MRI data were collected along with self-reported rankings of preferred sleep positions (prone, supine, side, and fetal). Follow-up interviews were conducted by telephone six and 18 months after discharge. Statistical analysis was performed using SSPS 24, with significance set at p < 0.05. Results132 patients (55% female, mean age 73 years) were evaluated. Preoperatively, 45 (34.1%) patients were classified as good sleepers (GS: PSQI ≤5, range 1–21 (worst)) and 87 (65.9%) as poor sleepers (PS: PSQI ≥6). Decompression surgery reversed the relationship between PS (31.8%) and GS (68.2%, recovered/improved). Protective fetal sleeping position was the most common (≥70%) before and after surgery for both PS and GS. Risk factors for PS included female sex (p = 0.03), obesity (p = 0.03), high NRS back pain score (p = 0.008), and high SSM symptom score (p = 0.004). MRI imaging did not differ between PS and GS. Discussion and conclusionLSS had a negative effect on sleep quality, whereas surgical decompression had a positive effect. The protective fetal sleeping position was the preferred position both before and after surgery.

Safe Infant Sleep Practices and Associated Factors Among Mothers Attending Vaccination Service at Dessie Town Governmental Health Care Facilities, 2021

Background: Babies spend a lot of their time with sleeping thus they need to have a safe sleep. Inadequate sleeping arrangements might heighten the likelihood of Sudden Unexpected mortality in Infancy (SUDI), including SIDS and lethal sleeping mishaps, which continue to be the most prevalent cause of mortality for individuals aged 1 to 1 year. Objective: The study aimed to assess safe baby sleep practices and associated factors among women receiving immunizations at government healthcare facilities in Dessie Town. Design: An institution-based cross-sectional study Methods: We conducted interviews with a total of 392 mothers using semi-structured questionnaires at public health facilities of Dessie town, in 2021. After the data were entered into the EPI data version 3.1, SPSS 23 was utilized for the analysis. Additionally, multivariate and binary logistic regression analyses were carried out. In multivariate analysis, a P-value less than .05 indicate a significant association. Results: About 38.3%, 21.9%, and 14.7% had safe infant sleep practice regarding sleep position, no soft-bedding and sleep arrangement respectively. Significant association was observed between safe infant sleep position with baby age less than 3 months (AOR = 2.96, 95% CI = 1.50-5.84), baby age of 7 to 9 months (AOR = 3.84, 95% CI = 2.15-6.85), maternal level of education(AOR = 4.48, 95% CI = 1.87-10.76), relative/friend as their source of information (AOR = 1.98, 95% CI = 1.14-3.44), grandmother as their source of information (AOR = 1.89, 95% CI = 1.00-3.57).Additionally, baby age 4 to 6 months (AOR = 0.93, 95% CI = 0.19-0.94) and maternal level of education (AOR = 0.19, 95% CI = 0.04-0.92) shows a significant safe infant bed arrangement practice. Furthermore, baby age of 10 to 12 months (AOR = 0.49, 95% CI = 0.25-0.98) and maternal education level of college and above (AOR = 3.44, 95% CI = 1.18-10.03) also shows significant association with safe soft-bedding practice. Conclusion: Mothers’ safe infant sleep practices were found to be low in Dessie town. Therefore, efforts should be made to enhance mothers’ attentiveness and engagement. This will help them follow healthy infant sleep practices.

Evaluation of mothers' knowledge about infant sudden death syndrome and its risk factors.

Sudden infant death syndrome is the third leading cause of infant death in the first year of life and is one of the most important health problems around the world. The exact etiology of this phenomenon is not clear yet, but some risk factors, especially prone sleep positions, have been described. Fortunately, by modifying some environmental factors, the SIDS incidence might be decreased. Mothers' and caregivers' knowledge about this neglected event could be an important factor in determining SIDS prevalence. This cross-sectional study was conducted in the pediatric and neonatal specialty clinic of Bahar Shahroud Hospital in 2020. Five hundred and twenty-seven pregnant women of reproductive age (18 to 45 years) were included in the study. Assessment of mothers' knowledge was done using a sudden infant death syndrome risk questionnaire. Statistical analysis of data was performed using independent t-test, Chi-square, and logistic regression. The number of 527 pregnant women of childbearing age participated in our study. 81.9% were under 35 years old. According to the study, factors such as maternal age, mother's level of education, number of pregnancies, and history of previous infant death syndrome had a significant relationship with the mother's level of knowledge about infant death syndrome. The findings showed that the mother's age is over 35 years old during pregnancy (CI: 0.95-0.46-OR: 1.53) and the level of education under a diploma (CI: 3.13-1.6: 06, OR: 1.86), and increasing parity is associated with a lower level of knowledge about infant death syndrome. According to mothers' lack of knowledge about SIDS and the availability of simple and cost-effective methods to prevent SIDS, improving mothers' knowledge about this important event in pregnancy and postpartum, educational sessions are crucial.

Effectiveness of the 30-Degree Lateral Sleeping Position on Sleep Quality in Elderly Individuals Post-Stroke

Background: Post-stroke conditions can have an impact on the sleep quality of the elderly. Sleep disorders are a common health problem for the elderly, requiring serious attention. Poor sleep quality in the elderly is caused by increased sleep potential, reduced sleep efficiency, and early awakenings due to the ageing process.&#x0D; Objective: This research aims to determine the effectiveness of a 30-degree lateral sleeping position compared to a supine sleeping position on the sleep quality of elderly individuals post-stroke.&#x0D; Method: The design of this research uses a quasi-experiment design with a non-equivalent control group design approach. The study will be conducted in 2023 in Ekasari Village, Jembrana Regency, Bali. The total research population is 126 elderly individuals, and the sample size meeting the criteria is 64 respondents, divided into 32 respondents in the intervention group and 32 respondents in the control group. Data analysis in this study uses the Mann-Whitney U Test.&#x0D; Results: The Mann-Whitney U Test shows a difference between the intervention and control groups (p = 0.000, Z score = -4.830), which means that the 30-degree lateral sleep position is better at helping older people who have had a stroke sleep better than the supine sleep position.&#x0D; Conclusion: Post-stroke elderly individuals tend to experience an improvement in sleep quality when they sleep in the lateral position of 30 degrees. Therefore, elderly people who are having sleep quality issues can adopt this sleeping position to improve their sleep.