Sleep Quality Disturbances Research Articles

The Improvement of Sleep Quality through the Combination of Progressive Muscle Relaxation and Murottal Therapy among Elderly

Elderly gradually experience various changes in their aspects of life. Changes that occur during this periodmaydisturb the stability of physiological and psychological processes which result in the sleep quality disturbance. It is necessary to prevent it by providing combination therapy to them. Objective: To determine the effect of thecombination therapy on the quality of sleep among elderly. Research Methods: this research used quasi-experimental design with non-equivalent control group design. We involved 28 elderly who had poor sleep quality. The samples were chosen by using purposive sampling method. We gave progressive muscle relaxation and murottal therapy to the intervention group, whilst we only gave progressive muscle relaxation therapy to the control group. The results indicated that 71.4% of elderly experienced sleep quality improvement after being treated bycombinationtherapy, while only 28.6% of the elderly experienced sleep quality improvement in the control group. The Mann Whitney Test results showed the number of p(0.000) <α(0.05) which means there was a difference in the quality of sleep between elderly in the intervention group and the control group.

Relationships between sleep patterns and metabolic profile in patients maintained on antipsychotics: a cross-sectional comparative study.

BackgroundDisturbances in sleep duration and quality have been associated with obesity and other metabolic changes. Patients with mental disorders (MD) are known to have more sleep problems, and antipsychotics (AP), used in the treatment of these patients, can also cause weight gain. This study aimed to compare the self-reported sleep patterns between psychiatric patients (on or off AP) and controls. We also evaluated the associations between the clinical and metabolic profiles with short or long sleep duration.MethodsA total of 339 subjects was recruited: Mentally ill patients maintained on AP for at least six months (MD+AP, n=112), patients not taking AP for at least the last six months before enrollment (MD/noAP, n=101), and non-psychiatry controls (HC, n=126). Multinomial regression analysis was applied to find the predictors of irregular sleep duration in this sample.ResultsMore mentally ill patients (MD+AP and MD/noAP) reported a sleep duration of >8 hrs than HC. Patients from MD/noAP showed more insomnia than HC. Sleep disturbances were significantly more frequent in MD+AP than HC. Participants who reported sleeping >8 hrs had higher body mass index and waist circumference than those who slept <7 hrs.ConclusionFemale gender, central obesity and being mentally ill were independently associated with long sleep duration (>8h) in the population of Qatar.

Sleep quality in cigarette smokers and nonsmokers: findings from the general population in central China

BackgroundSleep problems are common in the general population. Cigarette smoking is common in the general population of China. Examinations of the prevalence of poor sleep quality among Chinese smokers and nonsmokers are still lacking. This study was designed to examine sleep quality and sleep disturbances among cigarette smokers and nonsmokers in the general population in central China.MethodsIn this population-based sampling project, we used a multi-stage sampling method to recruit survey participants from September 2012 to October 2012 in rural and urban areas of Hunan province, China. A total of 27,300 subjects were sampled from the general population and 26,282 completed the self-report of cigarette smoking characteristics. Cigarette smoker was defined as having smoked ≥100 cigarette in a lifetime and smoked during the last 28 days. Cigarette smoking characteristics were obtained from smokers, including cigarettes per day, years of smoking, quit attempts, and smoking cravings. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess quality of sleep and sleep disturbances (PSQI score > 5).ResultsSignificantly more smokers than nonsmokers demonstrated poor sleep quality and sleep disturbances. Among smokers, linear regression analyses showed that poor sleep was inversely associated with cigarettes per day, and positively associated with years of smoking, quit attempts, and smoking craving. Logistic regression analysis showed that quit attempts and smoking cravings were associated with higher odds of sleep disturbances.ConclusionsSleep disturbances were more prevalent among cigarette smokers than nonsmokers. Smokers also varied in sleep problems on the basis of the characteristics of their smoking. Smokers should be informed about the link between cigarette smoking and poor sleep quality, and should be advised that one of several important health benefits from smoking cessation could be the improvement of sleep quality. Sleep therapy should be recommended as an adjunctive treatment for smoking cessation.

The Relationship Between Leg Muscle Cramps and Sleep Quality in Pregnant Women Visited the Health Centers in Tabriz

Abstract Background: Leg muscle cramps (LMCs) and sleep disorders are a common problem during pregnancy, and may be correlated. Objectives: The aims of this study were to determine the features of LMCs and sleep quality as well as their association in the third trimester of pregnancy. Methods: This cross-sectional study was conducted on 439 pregnant women referred to health centers/posts of Tabriz, Iran, in 2014. The participants were selected through double stage cluster sampling method. Data were collected by using a socio-demographic questionnaire, Pittsburgh sleep quality index and leg muscle cramp characteristics questionnaire. Chi-square, Independent t, Pearson and Spearman correlation and Mann-Whitney U tests were used for data analysis. Results: The mean ± SD total sleep quality score was 8.8 ± 3.9, within a possible score range of 0 to 21. About 84% of the women had sleep quality disturbances. LMCs were observed in more than half of the participants and there was a statistically significant correlation between the occurrence of LMCs and total sleep quality score (P = 0.001) and sub domains of sleep disturbances and daytime dysfunction (P < 0.001). There was also a significant relationship between occurrence of sleep quality disturbances and occurrence of LMCs (P = 0.006). Conclusions: The present study showed that leg muscle cramps and sleep disorder are common during pregnancy and sleep quality disturbances are correlated with occurrence of leg muscle cramps. Prevention and treatment actions should be considered in the prenatal care.

Corrigendum: Trajectories of sleep quality from late pregnancy to 36 months postpartum and association with maternal mood disturbances: a longitudinal and prospective cohort study.

Study objectives To examine trajectories of poor sleep quality from late pregnancy to 36 months postpartum, baseline indicators, and association with prospective maternal mood disturbances. Methods A cohort of 262 nonclinical women was followed at late pregnancy, 42 days, 3, 6, 9, 12, 18, 24, and 36 months postpartum. Sleep quality was measured with the Pittsburgh Sleep Quality Index at all time points, and mood disturbances were assessed at late pregnancy and 36 months postpartum. Results The rate of poor sleep quality followed an inverted U-shaped curve. Women reporting poor sleep quality at late pregnancy held a consistently higher risk of poor sleep quality at postpartum points. Three sleep trajectories were distinguished, namely, the stable-low (29.4%), the decreasing-mild (56.5%), and the stable-high (14.1%). Poor sleep quality, depression, and anxiety at baseline were linked to trajectory groups with poorer sleep quality. Adjusting for covariates, the trajectory of the poorer sleep quality group demonstrated increased mood disturbances at 36 months postpartum. Replicating the analyses in women without baseline symptoms of depression and anxiety above clinical cutoffs obtained similar results. Conclusions Women are vulnerable to poor sleep quality from late pregnancy to postpartum years, but follow distinct trajectories. Poor sleep quality, depression, and anxiety at late pregnancy help us to anticipate the sleep trajectories. Trajectories of poor sleep quality indicate increased mood disturbances at 36 months postpartum. A flexible suite of interventions targeting both poor sleep quality and mood disturbances should be implemented and tailored to women in the prenatal and postpartum periods.

Investigations of Sleep Quality Disturbances and Its Associations with Respiratory Functions and Depression Level among Young Adults with Down’s Syndrome

Investigations of Sleep Quality Disturbances and Its Associations with Respiratory Functions and Depression Level among Young Adults with Down’s Syndrome

Evaluating an 80 Hz tonal noise from a hydropower plant.

A pumped storage power plant produces significant noise such that adjacent areas were deemed uninhabitable for the local population. In recent years, the population in the area has increased, and the noise levels are now causing significant distress to the local population. The company operating the power plant and a citizens' initiative have both commissioned noise measurements. The measurements showed that the continuous pump noise was audible over many kilometers. The A-weighted sound-pressure level of 50 dBA at the next residential area underestimates the perceived noise, given the clear tonal nature in the low frequency range. Interviews of the exposed population, together with detailed "annoyance diaries" by a sample of the residents, proved their high level of annoyance. Their reported observations on distress and sleep disturbances coincide with the time course of the pumping operation. The pumping noise leads to annoyance in a large area, and to considerable nuisance in a smaller one. For the most exposed homes, long-term exposure might be considered a health hazard due to stress and disturbances in sleep quality. Therefore, the operator committed to developing a technical noise control plan. This case shows that a scientific approach within a complex environmental noise problem can foster an agreement about noise protection measures. However, this can only be successful if all involved parties participate in the process. Pilot studies are underway to test the impact of damping material layers on the pipes, the housing of the pipes, and the kind of air vessel solutions between the pumps and the pipes. Int J Occup Med Environ Health. 2019;32(3):401-11.

Use of the Pittsburgh Sleep Quality Index in People With Schizophrenia Spectrum Disorders: A Mixed Methods Study.

The Pittsburgh Sleep Quality Index (PSQI) is a measure of self-reported sleep quality and sleep disturbance. Though the PSQI is widely used, it is unclear if it adequately assesses self-reported sleep disturbance in people with schizophrenia spectrum disorders. We used mixed methods to examine the relationship between scores on the PSQI and qualitative self-report during in-depth interview in a group of participants diagnosed with schizophrenia spectrum disorders (N = 15). Although the PSQI appears to accurately capture issues related to sleep initiation, average duration, and interruption by physical complaints, it did not adequately assess other salient issues including irregularity in sleep duration and timing, shallow unrefreshing sleep, prolonged sleep inertia, hypersomnia, and sleep interrupted by mental or psychological complaints. In interview by contrast these types of problems were readily reported and described as important by participants. Our findings suggest that using the PSQI summary score as a measurement of general sleep disturbance in this population may be misleading, as this failed to capture some of the types of sleep problems that are particularly common in this group.

Modeling the Effects of Stress, Anxiety, and Depression on Rumination, Sleep, and Fatigue in a Nonclinical Sample.

Stress and affective distress have previously been shown to predict sleep quality, and all the factors have been shown to predict fatigue severity. However, few prior studies have examined the likely indirect mediational relationships between stress, affective distress, and sleep quality in predicting fatigue severity, and the potential role played by ruminative thinking. A short questionnaire asked 229 participants about their recent experiences of stress, affective distress, rumination, sleep, and fatigue in a community sample. High stress, anxiety, and depression were related to more ruminative thinking, which in turn was related to poor sleep quality (composed of subjective sleep quality, daytime dysfunction, sleep latency, and sleep disturbance) and poor sleep quality predicted worse fatigue. The results suggest that rumination parsimoniously explains the tendency of stress and affective distress to contribute to poor sleep quality, and together with poor sleep, it may also contribute to worse fatigue in some individuals.

Calidad del sueño y déficit de memoria en el envejecimiento sano

ObjectiveTo study the relationship between sleep quality and memory in healthy ageing. MethodsThe study included 99 people older than 50 years (69 women and 30 men; mean age, 68.74±7.18 years) with no associated diseases. Patients completed digital versions of the Word Learning and Visual Paired Associates tests and the Pittsburgh Sleep Quality Index questionnaire to assess the quality of sleep. ResultsPittsburgh Sleep Quality Index score was negatively correlated with Visual Paired Associates and Word Learning test performance. Performance in these 2 memory tests decreased in line with sleep quality. In addition, performance in Visual Paired Associates test was negatively correlated with subjective sleep quality, duration, and sleep disturbances. Performance on the Word Learning test was negatively correlated with subjective sleep quality and efficiency. Participants’ sex showed a weak effect on Visual Paired Associates performance and sleep latency. ConclusionsMedical professionals working with elderly patients should take into consideration the effect of poor sleep quality on memory. Cognitive impairment in these patients may be a manifestation of a neuroendocrine imbalance due to a disrupted circadian rhythm. More research is needed to prove this hypothesis.

Effects of physical and mind-body exercise on sleep problems during and after breast cancer treatment: a systematic review and meta-analysis.

We conducted a meta-analysis evaluating the effects of different exercise interventions on self-reported and objective sleep measurements during or after breast cancer treatment. Three databases were systematically searched for randomized controlled trials with any type of exercise intervention in women with breast cancer. Outcomes were self-reported or objective sleep measurements. Standardized mean differences (SMDs) were calculated using random-effects models. The meta-analysis included 22 trials with 2107 participants. Of these, 17 studies used the Pittsburgh Sleep Quality Index (PSQI), six studies included objective sleep assessments (ActiGraph). Physical exercise interventions included walking, aerobic exercise, resistance exercise or a combination of both. Mind-body exercise interventions included yoga, Tai Chi and Qigong. Most interventions were supervised. Both, physical (SMD - 0.32; 95% CI - 0.54 to - 0.10) and mind-body exercise interventions (SMD - 0.27; 95% CI - 0.44 to - 0.09), resulted in improvements of total sleep scores. Subgroup analyses revealed no clear differences between interventions conducted during versus after breast cancer treatment. Considering the PSQI subscales, exercise resulted in improvements of sleep quality (SMD - 0.28; 95% CI - 0.44 to - 0.11) and sleep disturbances (SMD - 0.26; 95% CI - 0.45 to - 0.06). Regarding the objective measurements, no significant effects were found. Physical as well as mind-body exercise can improve subjective sleep problems in breast cancer patients. In contrast, there was no effect of exercise on objective sleep measures. Future studies should clarify which type of intervention might be most effective depending on individual patients' and treatments' characteristics.

Sleep and weight loss in low-income overweight or obese postpartum women

BackgroundWe conducted secondary data analyses to examine the associations between sleep duration, sleep quality, sleep disturbance and ≥ 5% of weight loss in low-income overweight or obese postpartum women enrolled in a community-based lifestyle behavior intervention study aimed at prevention of weight gain.MethodsParticipants were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in Michigan. The Pittsburgh Sleep Quality Index was used to assess sleep duration, sleep quality, and sleep disturbance. All participants were assessed and weighed at baseline (T1, 569 participants), 4-month (T2, 367 participants), and 7-month from T1 (T3, 332 participants). Descriptive statistics and mixed-effects regression analysis were performed.ResultsParticipants reported longer sleep duration (p = 0.048), better sleep quality (p = 0.003) and less sleep disturbance (p < 0.001) over time. There were no significant mean body weight changes at T2 and T3. However, a significantly higher proportion of women lost ≥5% of body weight at T3 (23.1%) than T2 (12.5%, p = 0.001). Sleep duration, quality, and disturbance were not significantly associated with ≥5% of weight loss.ConclusionImprovements in sleep duration, sleep quality and sleep disturbance over time were not associated with ≥5% of weight loss in low-income overweight or obese postpartum women.Trial registrationClinical Trials NCT01839708; retrospectively registered February 28, 2013.

Sleep Quality Among Teenagers and Young Adults With Cancer.

Teenagers and young adults (TYAs) with cancer are known to suffer poor sleep quality and sleep disturbances; understanding the level of burden is essential to improving patient outcomes via supportive care interventions. To compare sleep quality and the prevalence of sleep disturbances among TYA cancer patients, TYA survivors, and general population TYAs with no history of cancer. Teenager and young adult patients receiving active cancer treatment (n = 70), TYA cancer survivors (n = 151), and general population TYAs (n = 324) aged between 13 and 24 years completed the Pittsburgh Sleep Quality Index. Analyses of covariance were used to investigate potential group differences. Age at survey diagnosis, gender, ethnicity, and health status were included as covariates. 84.29% of TYA patients, 62.91% of TYA cancer survivors, and 65.12% of general population TYAs reported Pittsburgh Sleep Quality Index scores greater than 5, suggesting clinically significant sleep disorders. Teenager and young adult patients reported significantly poorer global sleep quality compared with TYA survivors (mean difference, 0.99; 95% confidence interval, 0.03-1.96; P = .044) and general population TYAs (mean difference, 1.34; 95% confidence interval, 0.26-2.41; P = .009). Teenager and young adult patients and survivors reported significantly poorer sleep latency (P = .003 for TYA patients, P = .035 for TYA survivors off treatment) and habitual sleep efficiency (P < .001 for TYA patients, P = .014 for TYA survivors) than general population controls. The significant differences observed suggest young people with cancer, particularly those on treatment, may benefit from specialized sleep interventions. Efforts to ensure health professionals have the knowledge and skills to provide advice about sleep to young people with cancer are needed.

Pre- to post-inpatient treatment of subjective sleep quality in 5,481 patients with mental disorders: A longitudinal analysis.

There is only limited evidence of the course of sleep quality and sleep disturbances during acute inpatient treatment and the prediction of/association with treatment outcome in mental disorders. Within this naturalistic study, 5,481 consecutively admitted inpatients completed the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory (BDI-II) at admission and at discharge. Treatment included both individual and group psychotherapy (but no specific interventions for sleep disturbances) and pharmacotherapy based on current national treatment guidelines. Correlation analyses, analyses of variance and linear models were calculated to analyse the datasets. The PSQI improved significantly (p<0.001) from admission (mean score 9.51 [±4.11]) to discharge (mean score 8.08 [±4.20]) in all diagnostic subgroups. Despite this improvement, 47% of the patients still showed elevated PSQI scores (>5) at discharge. Patients with post-traumatic stress disorder showed the largest sleep disturbances at both time-points; patients with obsessive-compulsive disorder were the least impaired. An improvement of the PSQI was found to be significantly correlated (p<0.001) to the change of BDI-II values (without the sleep item) during treatment. The likelihood of achieving remission of depressive symptoms (BDI-II total score <14) was significantly associated with less sleep disturbances at admission. The results suggest that almost half of inpatients with mental disorders treated successfully with state-of-the art specific psychotherapy and pharmacotherapy do not have remission of their sleep problems. Therefore, specific treatment programmes for insomnia should be evaluated and implemented in daily clinical routines.

Association of Atopic Dermatitis With Sleep Quality in Children

Pruritus, a hallmark of atopic dermatitis (AD), is thought to disrupt sleep, yet little is known about how variations in disease activity and severity of this common childhood condition may be associated with sleep patterns over time. To determine whether children with active AD have impaired sleep duration and quality at multiple time points throughout childhood and whether disease severity affects sleep outcomes. This longitudinal cohort study used data of children enrolled in the Avon Longitudinal Study of Parents and Children, a population-based birth cohort in Avon, United Kingdom. Participants were children (N = 13 988) alive at 1 year and followed up with repeated measures of self-reported AD and sleep through 16 years of age. This study was based on data collected from 1990 to 2008. Data analysis was performed from September 2017 to September 2018. Standardized measure of sleep duration and composite measure of sleep quality, including nighttime awakenings, early morning awakenings, difficulty falling asleep, and nightmares, were repeated at multiple time points between 2 and 16 years of age. The study sample comprised 13 988 children (7220 male [51.6%]) followed up for a median (interquartile range [IQR]) duration of 11 (5-14) years. Of this total, 4938 children (35.3%) met the definition of having atopic dermatitis between 2 and 16 years of age. Total sleep duration was similar between children with active AD and without AD at all ages, and the average estimated difference across childhood was a clinically negligible difference of 2 minutes less per day for children with AD (95% CI, -4 to 0 minutes). In contrast, children with active AD were more likely to report worse sleep quality at all time points, with a nearly 50% higher odds of experiencing more sleep-quality disturbances (adjusted odds ratio [aOR], 1.48; 95% CI, 1.33 to 1.66). Children with more severe active disease (quite bad or very bad AD: aOR, 1.68; 95% CI, 1.42 to 1.98) and with comorbid asthma or allergic rhinitis (aOR, 1.79; 95% CI, 1.54 to 2.09) had worse sleep quality. However, even children with mild AD (OR, 1.40; 95% CI, 1.27 to 1.54) or inactive AD (OR, 1.41; 95% CI, 1.28 to 1.55) had statistically significantly increased odds of impaired sleep quality. Atopic dermatitis appeared to be associated with impaired sleep quality throughout childhood; thus, it is suggested that clinicians should consider sleep quality among all children with AD, especially those with comorbid asthma or allergic rhinitis and severe disease, and that interventions to improve sleep quality are needed.

Improvement in patient-reported sleep in type 2 diabetes and prediabetes participants receiving a continuous care intervention with nutritional ketosis

ObjectiveSleep disruption is frequently associated with type 2 diabetes (T2D) and hyperglycemia. We recently reported the effectiveness of a continuous care intervention (CCI) emphasizing nutritional ketosis for improving HbA1c, body weight and cardiovascular risk factors in T2D patients. The present study assessed the effect of this CCI approach on sleep quality using a subjective patient-reported sleep questionnaire. MethodsA non-randomized, controlled longitudinal study; 262 T2D and 116 prediabetes patients enrolled in the CCI and 87 separately recruited T2D patients continued usual care (UC) treatment. Patients completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire. A PSQI score of >5 (scale 0 to 21) was used to identify poor sleepers. ResultsGlobal sleep quality improved in the CCI T2D (p < 0.001) and prediabetes (p < 0.001) patients after one year of intervention. Subjective sleep quality (component 1), sleep disturbance (component 5) and daytime dysfunction (component 7), also showed improvements in the CCI T2D (p < 0.01 for sleep quality and sleep disturbance; and p < 0.001 for daytime dysfunction) and prediabetes patients (p < 0.001 for all three components); compared to the UC T2D group after one year. The proportion of patients with poor sleep quality was significantly reduced after one year of CCI (T2D; from 68.3% at baseline to 56.5% at one year, p = 0.001 and prediabetes; from 77.9% at baseline to 48.7% at one year, p < 0.001). ConclusionThis study demonstrates improved sleep quality as assessed by PSQI in patients with T2D and prediabetes undergoing CCI including nutritional ketosis but not in T2D patients receiving UC. The dietary intervention benefited both sleep quality and the severity of T2D symptoms suggesting that nutritional ketosis improves overall health via multiple mechanisms.

A comparative study of the quality of sleep in patients in the ward: Pre and postsurgery in a tertiary care hospital in South India

Background: Sleep deprivation has a deleterious effect on recovery in postoperative patients as it can lead to potentially dangerous side effects. The stress of poor sleep along with surgical stress can lead to increased sympathetic activity, which causes increase in catabolic processes, wakefulness, postoperative fatigue, hemodynamic instability, and neurological dysfunction, all of which will adversely affect postoperative recovery of patients. Aims and Objectives: (i) To compare the quality of sleep in patients, pre and postsurgery. (ii) To identify factors causing postoperative sleep disturbance. (iii) To discuss management strategies for improving postoperative sleep quality in surgical patients. Materials and Methods: The study included sixty patients admitted in the general surgical ward, with participants selected by convenience sampling. The Pittsburgh Sleep Quality Index was used to assess pre- and post-operative sleep quality and scores were compared to assess various components of sleep. Comparisons were also drawn with respect to difference in sleep according to age, sex, type of anesthesia administered, history of past use of sleep medications, and room type. Results and Conclusion: Our study showed poor postoperative sleep quality across all subgroups, i.e., age, sex, use of sleep medications, type of anesthesia administered, and room type. During the postoperative period, subjective sleep quality, sleep latency, and sleep disturbance worsened along with reduced duration of sleep, without significant changes in the habitual sleep efficiency and day-time dysfunction. Sleep is an extremely important physiological requirement for recovery after surgical stress. By identifying which component of sleep is being affected more than others, targeted interventions can be designed by the way of pharmacological or non-pharmacological methods to effectively combat sleep disturbance in surgical patients.

Trajectories of sleep quality from late pregnancy to 36 months postpartum and association with maternal mood disturbances: a longitudinal and prospective cohort study.

To examine trajectories of poor sleep quality from late pregnancy to 36 months postpartum, baseline indicators, and association with prospective maternal mood disturbances. A cohort of 262 nonclinical women was followed at late pregnancy, 42 days, 3, 6, 9, 12, 18, 24, and 36 months postpartum. Sleep quality was measured with the Pittsburgh Sleep Quality Index at all time points, and mood disturbances were assessed at late pregnancy and 36 months postpartum. The rate of poor sleep quality followed an inverted U-shaped curve. Women reporting poor sleep quality at late pregnancy held a consistently higher risk of poor sleep quality at postpartum points. Three sleep trajectories were distinguished, namely, the stable-low (29.4%), the decreasing-mild (56.5%), and the stable-high (14.1%). Poor sleep quality, depression, and anxiety at baseline were linked to trajectory groups with poorer sleep quality. Adjusting for covariates, the trajectory of the poorer sleep quality group demonstrated increased mood disturbances at 36 months postpartum. Replicating the analyses in women without baseline symptoms of depression and anxiety above clinical cutoffs obtained similar results. Women are vulnerable to poor sleep quality from late pregnancy to postpartum years, but follow distinct trajectories. Poor sleep quality, depression, and anxiety at late pregnancy help us to anticipate the sleep trajectories. Trajectories of poor sleep quality indicate increased mood disturbances at 36 months postpartum. A flexible suite of interventions targeting both poor sleep quality and mood disturbances should be implemented and tailored to women in the prenatal and postpartum periods.

The Effects of Aromatherapy on Sleep Quality in Diabetes Patients with Restless Leg Syndrome in Taiwan

This study is a longitudinal experimental design that examine the effects of aromatherapy on sleep quality in diabetes patients with restless leg syndrome (RLS). Patients in the experimental group received the aromatherapy intervention for 6 weeks, while those in the control group received only regular nursing care. The instruments included Pittsburg Sleep Quality Index and SureStep TM of blood glucose meters. Data were collected at pre-test, 2nd week, 4th week, and 6th week after the aromatherapy. Data analysis included descriptive analysis, chi-square, independent t test, Pearson correlation, repeated measure ANOVA and general linear mixed-effect models. Forty-four diabetes patients with RLS were randomly assigned to the experimental group (n=22) and the control group (n=22) at a hospital in northern Taiwan. Sleep quality of diabetes patients with RLS was poor in this study. Sleep latency of patients in the experimental group was improved at 2nd week after aromatherapy. Subjective sleep quality and sleep disturbance of patients was also improved at 4th week after aromatherapy. At 6th week, patients in the experimental group had increased their sleep duration, and improved their overall sleep quality. The level of blood sugar was decreased at 2nd week after aromatherapy on experimental group. Based on the analysis it was concluded that Aromatherapy can ameliorate both blood sugar and sleep quality of diabetes patients with RLS. Thus aromatherapy can be a safe, noninvasive, effective approach for clinical nurses as a therapy in routine care to improve sleep quality in diabetes patients with neuropathy.

Medical and Law Graduates and their sleep disorders: Daytime oversleep and Risk Factors

Backgroud: The exogenous factors such as family dynamics, psychosocial stress, academic hours and lifestyle can alter the quality of sleep and affect the people’s physical, occupational, cognitive and social functioning. Objectives: evaluate the epidemiological profile, excessive daytime sleepiness, risk factors and the quality of sleep among university students. Method: Cross-sectional study with 701 Medical and Law students from a private Brazilian Northeastern College. The Sociodemographic profile, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires have been applied. The data were submitted to simple and percentage frequency as well as bivariate and multivariate analysis. Significance level: 5%. Results: The sample was with 659 students, 243(37%) of Medicine and 416(63%) of Law. Age group 18-24 years, predominance of females, age group 18-24 years, female 393 (60%); they self-declared being white 282 (42.7%) and brown 303 (45.9%), said they were single 604(92%) and alcohol consumers more than 60%. Poor sleep quality and sleep disturbance were found in 169(70%) medical students and 221(54%) in law ones, being statistically significant (p &lt;0.001) for the medical students. In this comparison, The Law students presented a higher risk (RR 1.34 (1.15-1.56), p &lt;0.001) for disturbance and poor sleep quality. The risk of excessive daytime sleepiness versus drug use represented 71% (RR 1.71, 95% CI 1.18-2.49) for law students. General concerns, studies, anxiety and insomnia were the most frequent risk factors. Conclusion: Risk factors which are part of Medical and Law students’ daily routine affect their sleep quality and increase the risks of excessive daytime sleepiness.