Subjective Daytime Research Articles

Daytime sleepiness and BMI exhibit gender and age differences in patients with central disorders of hypersomnolence.

The aim of the present study was to examine gender and age-specific effects on subjective daytime sleepiness (as measured by the Epworth Sleepiness Scale), body weight and eating behaviour in patients with central disorders of hypersomnolence. Based on the European Narcolepsy Network database, we compared 1035 patients with narcolepsy type I and 505 patients with other central disorders of hypersomnolence ("narcoleptic borderland"), including narcolepsy type II (N = 308) and idiopathic hypersomnia (N = 174), using logistic regression and general linear models. In the entire study population, the Epworth Sleepiness Scale was higher in women (N = 735, mean age = 30 years, mean Epworth Sleepiness Scale = 16.6 ± SD 3.9) than in men (N = 805, mean age = 32 years, mean Epworth Sleepiness Scale = 15.8 ± SD 4.4). In women with narcolepsy type I (N = 475), both Epworth Sleepiness Scale and body mass index increased in parallel with age. In women of the narcoleptic borderland (N = 260), the Epworth Sleepiness Scale markedly peaked in their early 30s, while body mass index only started to rise at that age. This rise in body mass index following the Epworth Sleepiness Scale peak cannot be explained by sleepiness-induced uncontrolled eating, as self-reported uncontrolled eating was negatively associated with the Epworth Sleepiness Scale in this group. We propose that the narcoleptic borderland harbours a unique cluster of women in their fertile years with an unexplored aetiology requiring further investigation towards tailored interventions.

Sleep In Europe: Changes In Prevalence Of Sleep Disturbances In Middle-aged And Older Europeans

Abstract Background We analysed the prevalence of sleep-related parameters in those aged ≥50 years in 28 countries participating in waves 8 (2019/2020) and 9 (2022) of the Survey of Health, Ageing and Retirement in Europe (SHARE). Methods Overall and per country prevalence rates of subjective trouble sleeping, daytime napping/resting and use of medication to aid sleep were analysed. Survey-weighted generalised linear models were used to assess changes between waves 8 and 9. Results A total of 34,322 people were included from wave 8 (55% female; mean age 68.27) and 50,670 from wave 9 (55% female; mean age 68.77). There was no statistically significant difference in the overall prevalence of subjective trouble sleeping (both 35%), use of medication to aid sleep (both 7%) or daytime napping/resting (both 47%) between waves 8 and 9. For trouble sleeping, prevalence ranged from 20% (Greece) to 52% (Estonia) in wave 8 and from 16% (Greece) to 50% (Portugal) in wave 9. Statistically significant reductions were observed in Estonia (52% vs. 49%, p = 0.006), Poland (49% vs. 37%, p <0.001) and Slovenia (38 vs. 33%, p = 0.001). A statistically significant increase was observed in Spain (27% vs. 37%, p = 0.004). Similarly for sleep-related medication use, statistically significant reductions were again observed in Estonia (11% vs. 9%, p = 0.028) and Poland (10% vs. 6%, p <0.001) but not Slovenia (both 4%, p = 0.858). The prevalence of daytime napping/resting remained very similar between waves 8 and 9, with the only marginally significant difference being in France (38% vs. 35%, p = 0.033). Conclusion This analysis shows the prevalence of subjective trouble sleeping, use of medication to aid sleep, and daytime napping/resting among middle-aged and older adults across Europe. Trouble sleeping remains a prevalent symptom amongst middle-aged and older adults but varies significantly across countries.

Examining the Effect of Sleep Hygiene Education Given to Nursing Students on Sleep Quality.

The study aimed to ascertain the effect of sleep hygiene training on nursing students' sleep quality. The research study group consisted of 80 nursing students studying in the nursing department. A quasi-experimental model with a pretest-posttest control group was used. Sleep hygiene training was given to nursing students in the experimental group. The sociodemographic data form for nurse students and the Pittsburg Sleep Quality Index (PSQI) were used to collect data. The t-test for independent groups was used to compare the PSQI pre-test and post-test scores of the experimental and control groups, and the dependent group t-test was used to compare the PSQI pre-test and post-test scores within groups. There was a difference in the sleep-related data of the nursing students in the experimental and control groups and between the PSQI pretest and posttest score averages according to the groups. No significant difference between the pre-test and post-test mean scores was observed in the control group for subjective sleep quality, sleep duration, sleep disturbance, and daytime dysfunction. Sleep hygiene education helps nursing students develop regular sleep behaviors.

Efficacy study comparing a CBT-I developed for shift workers (CBT-I-S) to standard CBT-I (cognitive behavioural therapy for insomnia) on sleep onset latency, total sleep time, subjective sleep quality, and daytime sleepiness: study protocol for a parallel group randomised controlled trial with online therapy groups of seven sessions each

BackgroundShift workers are at an increased risk of developing sleep disorders. The standard therapy recommended for sleep disorders is cognitive behavioural therapy for insomnia (CBT-I). Many of its interventions are based on a regular sleep and wake rhythm, which is difficult to apply for shift workers. We have therefore developed a new therapy manual specifically for shift workers (CBT-I-S), which should be more applicable to their needs. In particular, all interventions that require regularity have been removed, and instead, interventions that address factors that proved to be relevant to sleep in our preliminary study have been integrated. We now want to test this manual for its effectiveness.MethodsA randomised controlled trial with N = 142 will be conducted to compare two conditions: the newly developed therapy manual will be carried out in the experimental group, while cognitive behavioural therapy for insomnia will be employed in the standard group. Both treatments will be conducted online via MS Teams in a group setting with seven sessions each. Data will be collected at three measurement points (pre, post, 6-month follow-up) and analysed using linear mixed models. The study will investigate whether the two treatments have led to significant improvements in total sleep time, sleep onset latency, subjective sleep quality and daytime sleepiness in shift workers. It will also examine whether the new therapy manual is superior to standard therapy in shift workers and whether these effects are stable.DiscussionWe assume that interventions designed to address depressive mood, anxiety, worry, rumination, dysfunctional thought patterns and attitudes towards sleep will also improve sleep. If this is indeed the case, these interventions could replace previous ones that require regularity. This could significantly improve the treatment of insomnia in shift workers.Trial registrationGerman Clinical Trials Registry DRKS DRKS00032086. Registered on August 16, 2023.

An examination of sleep problems and parental well-being, comparing families with and without autistic children

BackgroundSleep problems are a common comorbidity in autistic children and adolescents. Little is known about the role of sleep problems in parental well-being in the context of autism. MethodThe current study utilised actigraphy and questionnaire-based measures in mothers of autistic children and adolescents (n = 11), and mothers of typically developing (TD) children and adolescents (n = 11). Actigraphy is an objective, non-intrusive method for examining sleep. It involves wearing a wristwatch-like microcomputer that records motion. Measures included the Pittsburgh Sleep Quality Index, Autoimmune Disease in Family Members Questionnaire, Parenting Stress Index-Short Form, World Health Organization Quality of Life Abbreviated Version (WHOQOL-BREF), Hospital Anxiety and Depression Scale, and the Multidimensional Scale of Perceived Social Support. ResultsMothers of autistic children had significantly greater difficulties with subjective sleep quality, sleep duration, sleep efficiency, and daytime dysfunction, than mothers of TD children. In mothers of autistic children, parental use of sleep medication on the PSQI was positively associated with objective sleep onset latency using actigraphy, with a large effect size. Families with an autistic child had significantly more family members with osteoarthritis and rheumatoid arthritis than did families of TD children. Families of autistic children had significantly more autistic family members than did families of TD children. ConclusionsMothers of autistic children had significantly higher levels of stress, anxiety, depression, and lower levels of quality of life and perceived social support, than parents of TD children. Sleep problems identified via actigraphy were associated with parental stress, anxiety and depression, and quality of life.

Relationship between night eating syndrome and sleep quality among university students in Palestine

BackgroundNight eating syndrome (NES) is an eating disorder in which at least one-third of one’s daily caloric intake is consumed after the last meal of the day or throughout the nocturnal evening on at least two consecutive occasions each week. In the literature, the prevalence of NES among university students ranged from 4.2 to 15%.AimThe purpose of this study was to find out how common NES is among Palestinian university students, as well as the association between NES, sleep quality, BMI, socioeconomic factors, and lifestyle factors.MethodsStudents from An-Najah National University completed an online questionnaire. The Pittsburgh Sleep Quality Index (PSQI) and the Eating Questionnaire (NEQ) were employed.ResultsA total of 333 participants took part in the study. The average age of the participants was 21.66 years (range: 16 to 33). The presence of NES was identified in 82.6% of the study subjects. There was no evidence of a link between NES and BMI, sociodemographic variables, or lifestyle factors. Higher scores on subjective sleep quality (p < .01), sleep latency (p < .01), and daytime dysfunction (p < .05) scores were found to be linked with NES. Additional to this, the NEQ scores were shown to be substantially connected with these scores, as well as the sleep duration scores (p < .05). Subjective sleep quality (p < .01) and sleep latency (p < .01) were revealed to be significant predictors of the NEQ score.ConclusionNES was significantly related to sleep quality subscales among Palestinian university students. Moreover, subjective sleep quality and sleep latency predicted NEQ score.

Validation and performance of the sleep inertia questionnaire in central disorders of hypersomnolence

BackgroundOptimal measurement tools for problematic sleep inertia, common in some central disorders of hypersomnolence (CDH), have not yet been determined. We evaluated the performance of the Sleep Inertia Questionnaire (SIQ) in CDH, and how well it distinguished hypersomnolent groups from controls, and IH (idiopathic hypersomnia) from narcolepsy type 1 (NT1). MethodsThis prospective, bi-centric study included 63 control, 84 IH, 16 NT1, 18 narcolepsy type 2 (NT2), and 88 subjective excessive daytime sleepiness (sEDS) participants, using ICSD-3 criteria. 126 (47.2 %) participants were on any medication at the time of SIQ completion. We assessed construct validity of SIQ scores, and sleep inertia duration (SID), and compared them across diagnoses, controlling for age and center. We derived cutpoints to distinguish hypersomnolent patients from controls and IH from NT1. Sensitivity analyses for depression, chronotype, and medication were performed. ResultsThe SIQ sum and composite score were significantly lower in controls than in other groups (p < 0.0001), demonstrating outstanding ability to distinguish patients from controls (AUCs 0.92), without differences among hypersomnolent groups. SID (AUC 0.76) was significantly shorter in controls than in all hypersomnolent groups except NT1, and was shorter in NT1 than in IH or sEDS. Optimal SIQ sum cutpoint was 42 (J = 0.71) for patients versus controls. Optimal SID cutpoint in distinguishing IH from NT1 was 25 min (J = 0.39). ConclusionThe SIQ has excellent ability to distinguish hypersomnolent patients from healthy controls, after controlling for depression, eveningness, and medication. SID is best at distinguishing IH from NT1.

Effects of high-intensity interval training on subjective sleep quality and daytime sleepiness in patients with obstructive sleep apnea: A secondary analysis from a randomized controlled trial

This study aimed to verify the effect of 12 weeks of HIIT on the perceived sleep quality and excessive daytime sleepiness in patients with obstructive sleep apnea (OSA). For this, a secondary analysis of a randomized controlled trial, including 36 adults with moderate-severe OSA (19 males; 52.2 ± 9.8 years; body mass index = 34.2 ± 5.8; AHI = 42.0 ± 22.9 e/h) was performed. Participants were randomly assigned to HIIT [5 periods of 4 min of walking or running on a treadmill at 90–95 % of maximum heart rate (HRmax) interspersed with 3 min of walking at 50–55 % of HRmax performed three times per week for 12 weeks] or a control group (CG; stretching exercises performed two times per week for 12 weeks). Specific domains of subjective sleep quality and EDS were assessed at baseline and post 12 weeks. Generalized estimated equation were used to verify between groups and times differences. There were no group × time interactions for the domains sleep duration (0.416), sleep efficiency (0.198), sleep disturbance (0.523), and sleep medications (0.915). However, significant group × time interactions were observed for global sleep score (0.022), and for the domains sleep quality (0.001), sleep latency (0.029), and daytime dysfunction (0.012). In addition, there was a significant group × time interaction for EDS (HIIT = −3.4 ± 0.9; CG change = −1.0 ± 1.0; p = 0.023). Thus, in patients with OSA, 12 weeks of HIIT improves perceived sleep quality and daytime sleepiness.

Assessment of sleep quality in patients with orofacial pain and headache complaints: A polysomnographic study.

Sleep is a physiological function essential for survival, recovery, tissue repair, memory consolidation, and brain function. Pain is also an indispensable aspect of human life. The coexistence of sleep disorders and pain is often described in the literature, yet it is critical to define sleep not only subjectively but also using objective instrumental methods, such as polysomnography, that provide data on sleep quality. The aim of the study was to determine the relationship between orofacial pain (OFP), headache (HA) and sleep quality using subjective and objective sleep quality assessment methods. Additionally, we aimed to explore whether poor sleep quality was related to OFP and HA alone or was influenced by the coexistence of psycho-emotional factors such as depression, anxiety and stress. A single-night video-polysomnography was performed on patients from the Outpatient Clinic for Temporomandibular Disorders at Wroclaw Medical University, Poland, who had been diagnosed with OFP and HA. Additionally, questionnaires were employed to assess sleep quality, pain, HA, and the psycho-emotional state. There was no statistically significant relationship between the severity of OFP and HA and polysomnographic sleep quality parameters. On the other hand, the quality of sleep as determined by questionnaire studies correlated markedly with the severity of experienced pain. The severity of pain was found to be significantly correlated with depression, anxiety and perceived stress scores. The psycho-emotional aspects are of critical importance in the perception of OFP and HA. They can be associated with worsened subjective sleep quality, insomnia or daytime sleepiness. Therefore, the treatment of such patients must be preceded by a comprehensive assessment of their psychoemotional state, as anxiety, stress and depression can significantly influence the course of the disease and the response to treatment procedures.

Effectiveness of galcanezumab on sleep quality, migraine outcome, and multidimensional patient-reported outcome measures: a real-world experience in Turkish patients with episodic and chronic migraine.

This real-world study aimed to investigate the impact of galcanezumab on sleep quality, migraine outcome and multidimensional patient-reported outcomes measures (PROMs) in patients with episodic migraine (EM) and chronic migraine (CM). Fifty-four patients with episodic migraine (n = 24) or chronic migraine (n = 30) received a 3-month series of galcanezumab injections and were evaluated for sleep quality, measured using the Pittsburgh Sleep Quality Index (PSQI), as well as migraine outcomes such as monthly headache days (MHDs), monthly migraine days (MMDs), and headache severity. Patient-reported outcome measures (PROMs) such as the Migraine Disability Assessment Scale (MIDAS), Headache Impact Test-6 (HIT-6), SF-36 Health-related Quality of Life (HRQoL), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were additionally included in the assessment. The percentage of patients with poor sleep quality (total PSQI scores ≥ 5) was 72.7% at baseline, decreasing to 57.5% and 56.2% at the 1st and 2nd months, respectively. By the 3rd month of galcanezumab injections, significant improvement was observed in the sleep disturbances domain in the overall study population (p = 0.016), and in subgroups of patients with low anxiety levels (p = 0.016) and none/minimal depression (p = 0.035) at baseline. Patients with sleep disorder at baseline exhibited marked improvements in total PSQI scores (p = 0.027) and in the subjective sleep quality (p = 0.034) and daytime dysfunction (p = 0.013) domains, by the 3rd month. Over the 1st, 2nd, and 3rd months, there were significant improvements in MHDs (p < 0.001), MMDs (p < 0.001), HIT-6 scores (p < 0.001 for each), BAI scores (p < 0.001 for each), BDI scores (p ranged from 0.048 to <0.001), and HRQoL scores (p ranged from 0.012 to <0.001). Galcanezumab demonstrates notable benefits in improving sleep quality, along with a comorbidity-based and domain-specific effect on sleep parameters, which involved sleep disturbances domain in patients without depression or anxiety at baseline but the total PSQI scores, subjective sleep quality and daytime dysfunction in those with sleep disorder at baseline. The treatment also facilitates rapid-onset enhancements in migraine outcomes as well as various PROMs.

Association between dysphagia risk and sleep quality in community-dwelling older adults: A cross-sectional study

ObjectivesExploring the effects of swallowing function on sleep quality could provide valuable insights into the potential impact of reduced swallowing function on sleep. However, pertinent studies are limited. Therefore, this study aimed to investigate the relationship between dysphagia risk and sleep health in community-dwelling older adults. MethodsData for this cross-sectional study were obtained from the Shizuoka and Daiko studies conducted as part of the Japan Multi-Institutional Collaborative Cohort Study. Information on demographics, overall lifestyle, dysphagia risk, as well as sleep quality, duration, satisfaction, and regularity, was obtained using a self-administered questionnaire. Dysphagia risk and sleep quality were assessed using the Dysphagia Risk Assessment Questionnaire for the Community-dwelling Elderly and the Japanese version of the Pittsburgh Sleep Questionnaire Index, respectively. Multivariate logistic regression, adjusted for covariates, was employed to assess the association between dysphagia risk and sleep health. ResultsAmong the 3058 participants (1633 males, 1425 females) aged ≥60 years, 28.0 % exhibited dysphagia risk, and 19.1 % reported poor sleep quality. Those with dysphagia risk were more likely to experience poor sleep quality than those without dysphagia risk. In male participants, dysphagia was significantly associated with poor sleep quality, unsatisfactory sleep, and sleep irregularity, but was not significantly associated with unsatisfactory or irregular sleep in female participants. The Japanese version of the Pittsburgh Sleep Questionnaire Index components—subjective sleep quality, sleep latency, sleep disturbances, and daytime dysfunction—were associated with dysphagia risk in both sexes. ConclusionsDysphagia risk is associated with sleep quality in older individuals in Japan. Thus, preserving swallowing function may contribute to enhancing sleep quality.

Association between sleep quality and habits of electronic media use among young adults with different circadian typology

Background: Circadian preference refers to individual differences for mental and physical activity in the morning and evening. We hypothesized, that inadvertent use of electronic media can cause circadian misalignment that influences sleeping habits and sleep quality of young adults. Aims and Objectives: The aim of the study was to investigate the effect of circadian preferences on sleeping habits and the association of electronic media use with sleep quality and sleep disturbances. Materials and Methods: A total of 188 subjects were enrolled and divided into three groups: Evening, intermediate, and morning chronotype based on the Morningness-Eveningness score. Electronic media use at bedtime and duration of use were assessed subjectively. Sleep quality and subjective sleep disturbances, daytime sleepiness, and chronotype were assessed by the Pittsburgh Sleep Quality Index, Epworth Sleepiness Score, and Morningness-Eveningness Questionnaire Self-assessment version, respectively. Results: The majority of subjects with the evening chronotypes suffered from poor sleep quality compared to other chronotypes and the difference was statistically significant. In evening-type subjects, electronic media use at bedtime, long sleep latency, short sleep duration, and daytime sleepiness were significantly associated with poor sleep quality with odds ratios of 2.34 (1.08–5.08), 11.42 (4.98–26.19), 8.54 (1.01–68.24), and 1.68 (1.03–2.73), respectively. Conclusion: The majority of evening-type subjects had poor sleep quality, altered sleeping habits, and electronic media use at bedtime is significantly associated with poor sleep quality. Hence, history regarding sleep habits and lifestyle, especially electronic media use, should be taken from young adults, who are coming to the outpatient department for other than sleep disorders, to prevent the development of health-related problems.

Analysis of Sleep Quality and Positive and Negative Emotions among Trainee Nursing Students

Objective: To investigate the current situation of sleep quality and may analyse the correlation between sleep quality and positive and negative emotions. Methods Using the convenient sampling method, the Pittsburgh Sleep Quality (PSQI) scale and the positive and negative emotion scale, we selected the nursing students who worked in a Grade A hospital in Beijing from July 2022 to January 2023. Results PSQI score (8.63 ± 4.06), factors score subjective sleep quality (1.49 ± 0.99), time to sleep (1.54 ± 0.9), sleep time (1.23 ± 0.93), sleep efficiency (1.27 ± 1.07), sleep disorder (1.02 ± 0.7), hypno-drugs (0.37 ± 0.81), daytime dysfunction (1.44 ± 0.8). Positive emotions (26.8 ± 5.61) and negative emotions (27.4 ± 2.74), Pearson correlation analysis found that except for "sleep time", positive emotions of trainee nursing students showed a significantly negative correlation with PSQI total score, subjective sleep quality, sleep time, sleep efficiency, sleep disorder, hypnotic medication, and daytime dysfunction; negative emotions positively correlated with seven factors and total PSQI score. Conclusion The sleep quality of nursing students is generally poor. Expressing positive emotions is conducive to improving the sleep quality of nursing students, and negative emotions reduce the sleep quality of nursing students.

Subjective sleep more predictive of global cognitive function than objective sleep in older adults: A specification curve analysis

ObjectivesSleep is associated with cognitive function in older adults. In the current study, we examined this relationship from subjective and objective perspectives, and determined the robustness and dimensional specificity of the associations using a comprehensive modelling approach. MethodsMultiple dimensions of subjective (sleep quality and daytime sleepiness) and objective sleep (sleep stages, sleep parameters, sleep spindles, and slow oscillations), as well as subjectively reported and objectively measured cognitive function were collected from 55 older adults. Specification curve analysis was used to examine the robustness of correlations for the effects of sleep on cognitive function. ResultsRobust associations were found between sleep and objectively measured cognitive function, but not with subjective cognitive complaints. In addition, subjective sleep showed robust and consistent associations with global cognitive function, whereas objective sleep showed a more domain-specific association with episodic memory. Specifically, subjective sleep quality and daytime sleepiness correlated with global cognitive function, and objective sleep parameters correlated with episodic memory. ConclusionsOverall, associations between sleep and cognitive function in older adults depend on how they are measured and which specific dimensions of sleep and domains of cognitive function are considered. It highlights the importance of focusing on specific associations to ameliorate the detrimental effects of sleep disturbance on cognitive function in later life.

Evaluation of the Relationship Between Subjective Excessive Daytime Sleepiness and Polysomnographic Respiratory Variables in Adult Obstructive Sleep Apnea Syndrome

Evaluation of the Relationship Between Subjective Excessive Daytime Sleepiness and Polysomnographic Respiratory Variables in Adult Obstructive Sleep Apnea Syndrome

0491 Exploring COMISA, Sleep-related Symptoms, and Healthcare Utilization in Military Personnel

Abstract Introduction Insomnia and obstructive sleep apnea (OSA) are the two most common sleep disorders seen in clinical practice. Comorbid insomnia and OSA (COMISA) is a very common clinical presentation. The purpose of this study was to estimate the effect of COMISA on sleep, daytime symptoms, and healthcare resource utilization compared to OSA or insomnia alone among military personnel. Methods Military personnel with sleep problems were recruited from two military treatment facilities. Insomnia and OSA were defined using validated cutoffs on the Insomnia Severity Index and Berlin Questionnaire, respectively, and COMISA was defined as comorbid insomnia and OSA. Subjective and objective sleep were measured via standardized sleep diaries and a commercial wearable (Fitbit Inspire 2) over ten days. Daytime symptoms (e.g., sleepiness, depression, anxiety, pain) were assessed using standardized self-report questionnaires. Subjective cognition was assessed via three Likert items. Healthcare resource utilization (HCRU) was assessed using an established questionnaire tailored for this study. To compare differences between COMISA, OSA, and insomnia groups, one-way ANOVA was performed. Results The final sample included 201 participants (n=113, 43.8[%] men, mean age=44.5 [SD=12.7]) who self-reported being of White (111, 55.2%), Black (50, 24.9%), Hispanic (21, 10.5%) or Other (19, 9.5%) race. Of these, 22 (10.9%) were categorized as insomnia alone, 98 (48.8%) as OSA alone, and 81(40.3%) as COMISA. Relative to individuals with OSA, individuals with COMISA demonstrated worse subjective (but not objective) sleep; worse subjective daytime symptoms; worse subjective memory, attention, and executive function; and increased healthcare utilization including total HCRU and outpatient visits to internal medicine, neurology, emergency department, and urgent care. Some but few significant differences were observed between participants with insomnia relative to those with COMISA. Conclusion Among military personnel with sleep problems and relative to OSA alone, COMISA was associated with worse subjective sleep, worse daytime symptoms, worse subjective cognition, and greater HCRU. Future research should seek to seek to improve health and economic outcomes among individuals with COMISA. Support (if any) DoD (W81XWH1990006 via the Medical Technology Enterprise Consortium)

The effects of web-based animation-supported progressive relaxation exercises applied to individuals with epilepsy on fatigue and sleep quality: A randomized controlled study

PurposeThe study was conducted to determine the effects of Progressive Relaxation Exercise, supported by mobile-based animation, on fatigue and sleep quality of individuals with epilepsy. Material-MethodThe study was conducted in a randomized controlled design with a pretest-posttest model on epileptic individuals who applied to Giresun University, Faculty of Medicine, Neurology Outpatient Clinic between February and December 2022. By using power analysis, the sample of the study was determined as 60 epilepsy patients (30 in the Control Group, 30 in the Experimental Group). The data were collected by face-to-face interview technique with the Personal Information Form, Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS). Frequencies, percentages, arithmetic mean, standard deviations, Pearson Correlation Analysis, Paired t-Test, Student’s t-Test, and Chi-Square Test were used in the evaluation of the study data. ResultsWhen the Control Group’s mean scores in the pre-test and post-tests, which were performed with an interval of 6 weeks, were compared, a statistically significant difference was detected between the FSS and PSQI scores (p>0.05). The mean Fatigue Severity Scale score was found to be 5.24 ± 0.69 before the Progressive Relaxation Exercises and 3.82 ± 0.77 after the exercises. The mean scores of the individuals on the Fatigue Severity Scale after the relaxation exercises were found to be lower at a statistically significant level than the mean scores before the relaxation exercises (p<0.001). The differences between subjective sleep quality (p<0.001), sleep latency (p<0.001), daytime dysfunction (p<0.001), and total sleep quality (p<0.001) score averages after the Progressive Relaxation Exercises were statistically significant compared to the pre-exercises status. When the post-test scores of the participants in the Experimental Group was examined, significant, moderate, and positive differences were detected between the FSS and Total PSQI scores (r: 0.373-p: 0.042), Subjective Sleep Quality (r: 0.487-p: 0.006), which is one of the sub-dimensions of PSQI, Sleeping Pill Use (r: 0.531-p: 0.003), and Daytime Dysfunction (r: 0.461-p: 0.01) scores. ConclusionIt was determined that individuals with epilepsy experience fatigue and deterioration in sleep quality and there is a reciprocal relationship between the severity of fatigue and sleep quality in these individuals. Progressive Relaxation Exercises applied with the animation-supported web-based mobile intervention technique reduce the fatigue levels of individuals and increase sleep quality.

Abstract 25: Association Between Household Sleep Environment and Sleep Health Characteristics: The Coronary Artery Risk Development in Young Adults (CARDIA)—Sleep Study

Introduction: Household environmental factors and sleep behaviors may contribute to poor sleep health. We identified associations between household sleep environment (HHSE) and sleep health characteristics. Hypothesis: Individuals with adverse HHSE will have poorer sleep health. Methods: We used cross-sectional data from the CARDIA sleep ancillary study at Year 35. HHSE (i.e., sleep disruptors and sleep behaviors) scores were derived from responses to questions in the questionnaire (see Table footnote), where a higher score indicated higher sleep disruptors or more detrimental sleep behaviors. Sleep outcomes were: 1) sleep quality assessed with the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness assessed with the Epworth Sleepiness Scale (ESS) (N=699) and 2) sleep duration (minutes) and efficiency (%) measured by 7-day wrist actigraphy (N=574). Robust regression estimated differences in sleep outcomes corresponding to each 1-score increment in HHSE. We adjusted for age, sex, race, education, smoking status, body mass index, depressive symptoms, and comorbidities. Racial differences in associations of interest were examined by testing for interaction. Results: Participants mean age was 61.5 years, 63.1% were female and 35.9% were Black. Means (SD) of PSQI, ESS scores, sleep duration, and sleep efficiency were 6.2 (3.7), 5.5 (3.7), 414.6 minutes (SD=60.4), and 84.4% (SD= 6.7), respectively. After multivariable adjustment, both higher sleep disruptors and more detrimental sleep behaviors were associated with poorer sleep quality and greater daytime sleepiness. HHSE showed no association with sleep duration and efficiency (Table 1). Sleep disruptors were only significantly associated with daytime sleepiness among Black participants (p-interaction= 0.01). Conclusions: Adverse household sleep environment was related to poorer subjective sleep quality and daytime sleepiness. Future studies should investigate reasons why Black adults appear more susceptible to household sleep disruptors.

Tagesschläfrigkeit bei Patienten mit unbehandeltem Restless-Legs-Syndrom

Abstract Background Restless legs syndrome (RLS), a disorder characterized by an urge to move one’s legs during sleep or rest, leads to impaired sleep quality. Many patients with RLS report increased daytime sleepiness, but this has seldom been the focus of clinical research. The current study empirically investigated the prevalence and severity of daytime sleepiness in RLS. Methods This prospective study included 29 newly diagnosed treatment-naïve patients with RLS and 31 healthy controls and assessed standardized subjective (tiredness symptom scale [TSS], Stanford Sleepiness Scale [SSS], Epworth Sleepiness Scale [ESS]), cognitive (psychomotor vigilance task [PVT], Mackworth Clock Test [MCT]), and physiological measures (pupillary unrest index [PUI]). RLS symptom severity was assessed, and the effects of RLS on general health aspects and subjective sleep quality (Pittsburgh Sleep Quality Index) were compared to control data. Results Patients had moderate to severe RLS with significant negative effects on general health, quality of life, and sleep quality. Patients with RLS showed more subjective daytime sleepiness (ESS) and current sleepiness (TSS, SSS) than controls. The objective performance of patients in sustained attention tasks (P VT, MCT) was significantly worse than that of controls. Additionally, patients showed higher PUI scores. Conclusion In the present study, RLS was associated with markedly impaired subjective sleep quality and with subjectively and objectively increased daytime sleepiness. Since daytime sleepiness can be a major factor leading to compromised quality of life, assessing and treating sleepiness should be incorporated into standard diagnostics and treatment.

Association between sleep quality and quality of life in Singapore.

Several studies have examined the relationship between sleep quality and health-related quality of life (HRQOL). However, there are a lack of generalizable data on this association in Singapore. Our study aimed to (1) investigate the association between sleep quality and HRQOL and (2) examine whether age moderated these associations. Data were obtained from nationwide Singapore Mental Health Study 2016 (n = 6126, response rate = 69.5%). Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI) where higher scores indicate poorer sleep quality. HRQOL [Physical component summary (PCS) and Mental component summary (MCS)] were measured using 12-item Short-Form Survey. Associations were investigated using multivariable linear regression models, adjusted for sociodemographic, physical, and mental comorbidities. Interactions between age and sleep quality were examined by including interaction terms individually. Poorer PSQI score was significantly associated with lower PCS (β = -0.44) and lower MCS (β = -0.73). Among PSQI components, lower PCS was significantly associated with subjective sleep quality (β = -1.06), sleep duration (β = -0.30), sleep disturbance (β = -0.33), and daytime dysfunction (β = -0.75). Lower MCS was significantly associated with subjective sleep quality (β = -1.36), sleep latency (β = -0.24), sleep disturbance (β = -0.16), using of sleeping medication (β = -1.12), and daytime dysfunction (β = -2.08). Age moderated the association between PSQI score with PCS and MCS. Stronger association between PSQI score and MCS was observed in younger individuals (β = -0.90) than older adults (β = -0.45). Our study found that poor sleep quality was associated with HRQOL of certain age groups more than others. Future studies may identify potential mediators to help people with chronic sleep problems.