Subjective Sleep Latency Research Articles

Assessment of psychometric properties of the Dari version of the Pittsburgh Sleep Quality Index (PSQI) among Afghans

BackgroundSleep helps in improving the functions of all systems of human body. Disturbance in sleep can cause immediate adverse effects on normal human physiologic functions. Main objective of this study was to explore the psychometric properties of the Dari version of the of Pittsburgh Sleep Quality Index (PSQI) among general adult population of Afghanistan.MethodsThis methodological study has been conducted during July to November 2023. Reliability and validity of PSQI were evaluated using Cronbach’s Alpha and confirmatory factor analysis, respectively. Pearson correlation analysis was conducted to assess the convergent validity of the components of PSQI, comparing results with those obtained from the DASS-21 subdomains.ResultsIn this cross-sectional study, 965 Afghan adults were studied during five months of duration between July and November, 2023. Mean age of the study participants was 35.2 years. The prevalence of sleep disturbance was 44.6% (430/965). Among them, 59.3% (572/965) reported experiencing subjective sleep quality disturbances less than once a week, 36.2% (349/965) had sleep latency issues less than once a week, 17.6% (170/965) had sleep duration disruption once or twice a week, while 36.3% (350/965) had daytime dysfunction less than once a week. The Cronbach’s alpha coefficient for the seven-component scale was 0.677, indicating acceptable internal consistency. Substantial and statistically significant positive correlations were present among the component of PSQI subjective sleep quality and sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, daytime dysfunction, DASS-Depression, DASS-Anxiety, and DASS-Stress. The overall PSQI exhibited favorable fit indices, supporting the proposed single-factor structure among adult Afghan population.ConclusionPrevalence of sleep disturbance was very high among adult population of Afghanistan. This study provided useful information that will help policy makers (such as ministry of public health as well as international donor agencies like WHO, USAID, and UNICEF) to design a better strategy to reduce the prevalence of sleep disturbance that affects health of the Afghan community at large.

THE EFFECT OF PEER EDUCATION ON SLEEP HYGIENE ON SLEEP QUALITY AND PSYCHOLOGICAL RESILIENCE IN UNIVERSITY STUDENTS LIVING IN DORMITORIES

This study was conducted to examine the effect of peer education on sleep hygiene sleep quality and psychological resilience in university students living in dormitories. In the study, a quasi-experimental method with a pretest-posttest control group was used. 240 university students staying at Akyazı Credit and Dormitories Institution in Akyazı district of Sakarya province participated in the study. Half of the students (n=120) formed the intervention group and the other half (n=120) formed the control group. Before the study, 20 students were given sleep hygiene training by the research team. The training group provided peer education to the intervention group on sleep hygiene. No intervention was made in the control group. Student diagnostic form, Sleep Hygiene Index, Pittsburgh Sleep Quality Index, and Brief Psychological Resilience Scale were used as data collection tools. There was no statistically significant difference between the Sleep Hygiene Index and Brief Psychological Resilience Scale score averages of the intervention and control group students included in the study at the beginning and the last interview (p>0.05). However, it was determined that there was an improvement in the sleep hygiene and psychological resilience levels of the students in the intervention group (p0.05). In addition, it was determined that the intervention group had a significant improvement in subjective sleep quality and sleep latency, which are sub-dimensions of the Pittsburgh Sleep Quality Index (p

Sleep conditions and sleep hygiene behaviors in early pregnancy are associated with gestational diabetes mellitus: A propensity-score matched study

PurposeTo explore the influence of sleep conditions and sleep hygiene behaviors in early pregnancy on gestational diabetes mellitus (GDM) development.MethodsThis 1:1 propensity-score matched study included 1,216 pregnant women divided into GDM and control groups based on diagnosis via the oral glucose tolerance test at 24–28 gestational weeks. Sleep conditions and hygiene behaviors were evaluated using structural questionnaires, including the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Sleep Hygiene Practice Scale. Univariate and multivariate logistic regression analyses and Spearman’s correlation were conducted to identify the associations.ResultsAfter adjusting for baseline clinical characteristics, women with GDM were more likely to have poor sleep quality (adjusted odds ratio [AOR] = 1.585, 95% confidence interval [CI]: 1.261–1.992) and higher scores for subjective sleep quality, latency, duration, efficiency, and sleep disturbances (all P < 0.01). Mild sleepiness (AOR = 1.311, 95% CI: 1.012–1.699) and worrying about not being able to fall asleep (AOR = 1.123, 95% CI: 1.005–1.255) were more likely to occur in the GDM group. Sleep quality and hygiene behaviors such as sleep-irrelevant activities, staying in bed after waking up, weekend catch-up sleep, and overeating before bedtime were significantly correlated with gestational diabetes variables.ConclusionPoor sleep conditions and specific sleep hygiene behaviors in early pregnancy may be independent risk factors for GDM. This suggests that sleep assessment and behavior education can be used as new approaches for the early implementation of surveillance and prevention of GDM.

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.

Effectiveness of Pranic Healing as complementary therapy on lower urinary tract symptoms and sleep: Single-blind randomized trial

BackgroundBenign Prostatic Hyperplasia (BPH) commonly affects older men, leading to lower urinary tract symptoms (LUTS) that affect sleep and quality of life. This study evaluates the effect of Pranic Healing (PH) as a complementary therapy for bothersome LUTS by normalising biofield energy centres called Chakras. MethodologyA single blind trial involving 76 men with LUTS was conducted, randomised into Medication-only (MED) and Medication-plus-Pranic Healing (MEDPH) groups. The MEDPH received PH sessions twice weekly for 5 weeks. ResultsThe study compared MED (n = 30) and MEDPH (n = 36) participants, finding significant improvements in IPSS scores (p ≤ .001) in both groups. The MEDPH group showed a greater reduction in incomplete bladder emptying and intermittency. The post void residual volume increased significantly in the MED group (Wilcoxon Z = −2.335, p = .02), while the MEDPH group reduced non-significantly. Sleep quality index improved significantly (McNemar=.013) in the MEDPH group, while the MED group showed no significant change. Subjective sleep quality, duration, and latency improved significantly in the MEDPH group. Healers reported improved energy balance in chakras of MEDPH group. Perceived energy by healers in lower chakra relates to urinary parameters. ConclusionPH could alleviate LUTS, enhancing quality of life due to urination, and improved sleep, among moderate BPH patients. Trial registrationThis study has been registered under the Clinical Trial Registry of India. (CTRI No: CTRI/2023/01/049004)

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.

Yoga Exercises as a Therapeutic Approach for Adults with Insomnia to Promote better Sleep: A Randomized Control Trial

Background: Insomnia is a prevalent sleep disorder that significantly impacts the quality of life and is associated with various health complications, including high blood pressure, heart disease, diabetes, anxiety, and depression. Traditional treatments for insomnia often involve pharmacological interventions, but there is growing interest in alternative therapies such as yoga. This study investigates the efficacy of yoga as a therapeutic approach to improving sleep quality in adults with insomnia. Objective: The objective of this study was to evaluate the effects of a structured yoga program on sleep quality and sleep latency in adults diagnosed with insomnia. Methods: The study employed a cross-sectional design conducted at multiple healthcare facilities, including the Physiotherapy Outpatient Department at Holy Family Hospital, Benazir Bhutto Hospital, and District Headquarters Hospital in Rawalpindi. The study duration was four months, involving 54 participants selected through random sampling techniques. Inclusion criteria included adults aged 18 to 65 years diagnosed with insomnia according to the International Classification of Sleep Disorders (ICSD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM). Exclusion criteria included severe medical or psychiatric disorders, substance abuse, pregnancy, or recent changes in sleep medication. Participants in the intervention group engaged in a standardized yoga program consisting of gentle yoga postures, controlled breathing techniques, and mindfulness meditation, conducted twice weekly for eight weeks, with each session lasting 60 minutes. The control group received standard care for insomnia. Data collection involved subjective assessments of sleep quality using validated questionnaires and objective measures through polysomnography. Statistical analysis was performed using SPSS version 25.0, with independent sample t-tests comparing means between groups and repeated measures ANOVA for within-group analysis. Results: The yoga group showed significant improvements in subjective sleep quality and sleep latency. The mean sleep quality score improved from 2.18 ± 0.66 pre-intervention to 0.92 ± 0.37 post-intervention (p=0.0001), while the control group showed a less marked improvement from 2.37 ± 0.48 to 2.03 ± 0.18 (p=0.0012). Sleep latency in the yoga group decreased from 3.00 ± 0.00 to 1.29 ± 0.40 (p=0.0002), whereas the control group showed a reduction from 2.44 ± 0.49 to 2.11 ± 0.31 (p=0.0013). ANOVA results confirmed the statistical significance of these findings, with an F-value of 69.897 for sleep quality (p=0.0001) and 361.947 for sleep latency (p=0.0002). Conclusion: The findings indicate that a structured yoga program significantly improves sleep quality and reduces sleep latency in adults with insomnia. Yoga appears to be an effective non-pharmacological intervention for managing insomnia, offering a viable alternative to traditional treatments.

Evaluation of daytime sleepiness and insomnia symptoms in OSA patients with a characterization of symptom-defined phenotypes and their involvement in depression comorbidity

IntroductionRecent studies have emphasized the importance of clinical manifestations, such as insomnia and sleepiness, in defining phenotypes of obstructive sleep apnea (OSA), shifting from a focus on OSA severity and sleep structure.ObjectivesThe study aimed to characterize insomnia and sleepiness associated with OSA phenotypes and assess their involvement in depression symptoms (DS) in OSA.Methods A total of 181 participants undergoing polysomnography (PSG) were asked to fill out questionnaires, including Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Back Depression Index (BDI). They were categorized into phenotypes: insomnia-sleepiness (I+S; ESS≥11; ISI≥15; n=20), sleepiness (S; ESS≥11; ISI&lt;15; n=22), insomnia (I; ESS&lt;11; ISI≥15) and asymptomatic (A; ESS&lt;11; ISI&lt;15; n=55).ResultsA linear regression model for BDI score (R2=0.357, p&lt;0.001) included ISI score and subjective to objective sleep latency ratio. ISI score was a predictive factor for mild and moderate DS (OR=1.226, p&lt;0.001 and OR=1.392, p=0.002, respectively). I and I+S phenotypes are characterized by higher BDI scores (p&lt;0.001 and p=0.015), longer subjective sleep latency (p=0.008 and p=0.041), and shorter subjective total sleep time (TST; p=0.049 and p=0.006), compared to A. Furthermore, the I and I+S groups had shorter subjective TST than S (p=0.028 and p=0.047). I and I+S had higher BDI scores than A (p&lt;0.001 and p=0.015, respectively) and S (p&lt;0.001 and p=0.017, respectively). I phenotype was associated with the risk of mild and moderate DS (OR=5.614, p&lt;0.001 and OR=9.550, p=0.008 respectively). Moreover, the I+S phenotype presented an even greater risk for mild DS (OR=10.286, p&lt;0.001).ConclusionsThe study suggests that using clinical features for OSA phenotyping holds promise for finding OSA individuals with increased risk for the occurrence of DS.Disclosure of InterestNone Declared

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.

Efficacy of health literacy interventions aimed to improve health gains of higher education students—a systematic review

BackgroundHealth literacy (HL) among higher education students is low, making them vulnerable about their health. To reverse this trend, higher education institutions promote HL interventions with various topics and methods. A comprehensive understanding of HL interventions is essential to determine whether these interventions meet the health information needs to improve health outcomes (health gains). The aim of this review was to identify and synthesise evidence on the efficacy of HL interventions implemented in academic settings to improve health outcomes.MethodsA systematic review was performed followed the PRISMA guidelines, protocol was registered in PROSPERO (CRD42022369869). A search strategy was performed in the EBSCO Host Web platform, the time limit placed was: 01/01/2017 to 30/09/2022. Eligible studies were those published in peer-reviewed journals and involved higher education students over the age of 18 as the subject of the intervention. Eligible interventions included any interventions evaluated in a study with comparison group that included a pre-post measure of health outcomes, were conducted in an academic setting. To methodology quality of included studies, it was used the Joanna Briggs Institute critical appraisal tool. To synthesise results narrative and thematic synthesis was conducted.ResultsA total of 9 articles were included in this review, identified health literacy interventions with an impact on health outcomes. The total studies involved 2902 higher education students. All 9 studies were randomised controlled trials. The synthesised evidence supports the efficacy of interventions that contributed to positive changes in mental health, attitudes, norms, and self-efficacy of condom use, emotional, social, and psychological well being, subjective sleep quality, sleep latency, and habitual sleep efficiency, physical activity, and self-reported servings fried foods. HL interventions were educational or motivational and related to health promotion, disease prevention or healthcare.ConclusionsHL interventions in higher education students can significantly improve health outcomes protecting them from the negative effects of threats for their health. The interventions designed with different strategies are more effective. HL interventions are associated with health benefits on health promotion, disease prevention and healthcare. For the attendance of higher education to be a successful experience, continuity of HL interventions developed in academic settings is necessary.

Evaluation of daytime sleepiness and insomnia symptoms in OSA patients with a characterization of symptom-defined phenotypes and their involvement in depression comorbidity-a cross-sectional clinical study.

Recent research highlights the significance of insomnia and sleepiness, shifting from obstructive sleep apnea (OSA) severity and sleep structure, in defining OSA phenotypes. This study aimed to characterize insomnia and sleepiness associated with OSA phenotypes and assess their involvement in depression symptoms (DS) in OSA. This cross-sectional, clinical study included 181 participants who underwent polysomnography (PSG) and filled out questionnaires, including the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Index (BDI). They were categorized into phenotypes: insomnia-sleepiness (I + S; ESS ≥ 11; ISI ≥ 15; n = 20), sleepiness (S; ESS ≥ 11; ISI < 15; n = 22), insomnia (I; ESS < 11; ISI ≥ 15), and asymptomatic (A; ESS < 11; ISI<15; n=55). A linear regression model for the BDI score (R2=0.357, p < 0.001) included ISI score and subjective-to-objective sleep latency ratio. The ISI score was a predictive factor for mild and moderate DS [OR = 1.23 (95% CI: 1.09-1.38), p < 0.001 and OR = 1.39 (95% CI: 1.13-1.72), p = 0.002]. The I and I + S phenotypes are characterized by higher BDI scores (p < 0.001 and p = 0.02), longer subjective sleep latency (p = 0.008 and p = 0.04), and shorter subjective total sleep time (TST; p = 0.049 and p = 0.006) compared to A. Furthermore, the I and I + S groups had shorter subjective TST than S (p = 0.03 and p = 0.047). The I and I + S had higher BDI scores than A (p < 0.001 and p = 0.02, respectively) and S (p < 0.001 and p = 0.02, respectively). The I phenotype was associated with the risk of mild and moderate DS (OR = 5.61 (95% CI: 1.91-16.53), p < 0.001 and OR = 9.55 (95% CI: 1.81-50.48), p = 0.008 respectively). Moreover, the I + S phenotype presented an even greater risk for mild DS (OR = 10.29 (95% CI: 2.95-35.85), p < 0.001). Using clinical features for OSA phenotyping holds promise for finding OSA individuals with increased risk for DS occurrence.

Neurophysiological Parameters Influencing Sleep-Wake Discrepancy in Insomnia Disorder: A Preliminary Analysis on Alpha Rhythm during Sleep Onset.

Sleep state misperception (SSM) is a common issue in insomnia disorder (ID), causing a discrepancy between objective and subjective sleep/wake time estimation and increased daytime impairments. In this context, the hyperarousal theory assumes that sustained central nervous system activation contributes to the SSM. This study investigates factors influencing SSM during sleep latency (SL) and total sleep time (TST). Objective polysomnographic sleep variables (the alpha density index, latency-to-sleep stages and the first K-complex, and Rapid Eye Movement (REM) arousal density) and subjective sleep indices, taken from sleep diaries, were analyzed in 16 ID patients. Correlation analyses revealed a positive association between the degree of SL misperception (SLm) and the percentage of epochs that contained a visually scored stereotyped alpha rhythm during objective SL. A regression analysis showed that the REM arousal density and alpha density index significantly predicted TST misperception (TSTm). Furthermore, the degree of SLm was associated with an increased probability of transitioning from stage 1 of non-REM sleep to wakefulness during subjective SL. These findings support the role of hyperarousal in SSM and highlight the importance of alpha activity in unravelling the heterogeneous underpinnings of SSM.

Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults

Chronic insomnia disorder is highly prevalent, disabling, and costly. Cognitive behavioral therapy for insomnia (CBT-I), comprising various educational, cognitive, and behavioral strategies delivered in various formats, is the recommended first-line treatment, but the effect of each component and delivery method remains unclear. To examine the association of each component and delivery format of CBT-I with outcomes. PubMed, Cochrane Central Register of Controlled Trials, PsycInfo, and International Clinical Trials Registry Platform from database inception to July 21, 2023. Published randomized clinical trials comparing any form of CBT-I against another or a control condition for chronic insomnia disorder in adults aged 18 years and older. Insomnia both with and without comorbidities was included. Concomitant treatments were allowed if equally distributed among arms. Two independent reviewers identified components, extracted data, and assessed trial quality. Random-effects component network meta-analyses were performed. The primary outcome was treatment efficacy (remission defined as reaching a satisfactory state) posttreatment. Secondary outcomes included all-cause dropout, self-reported sleep continuity, and long-term remission. A total of 241 trials were identified including 31 452 participants (mean [SD] age, 45.4 [16.6] years; 21 048 of 31 452 [67%] women). Results suggested that critical components of CBT-I are cognitive restructuring (remission incremental odds ratio [iOR], 1.68; 95% CI, 1.28-2.20) third-wave components (iOR, 1.49; 95% CI, 1.10-2.03), sleep restriction (iOR, 1.49; 95% CI, 1.04-2.13), and stimulus control (iOR, 1.43; 95% CI, 1.00-2.05). Sleep hygiene education was not essential (iOR, 1.01; 95% CI, 0.77-1.32), and relaxation procedures were found to be potentially counterproductive(iOR, 0.81; 95% CI, 0.64-1.02). In-person therapist-led programs were most beneficial (iOR, 1.83; 95% CI, 1.19-2.81). Cognitive restructuring, third-wave components, and in-person delivery were mainly associated with improved subjective sleep quality. Sleep restriction was associated with improved subjective sleep quality, sleep efficiency, and wake after sleep onset, and stimulus control with improved subjective sleep quality, sleep efficiency, and sleep latency. The most efficacious combination-consisting of cognitive restructuring, third wave, sleep restriction, and stimulus control in the in-person format-compared with in-person psychoeducation, was associated with an increase in the remission rate by a risk difference of 0.33 (95% CI, 0.23-0.43) and a number needed to treat of 3.0 (95% CI, 2.3-4.3), given the median observed control event rate of 0.14. The findings suggest that beneficial CBT-I packages may include cognitive restructuring, third-wave components, sleep restriction, stimulus control, and in-person delivery but not relaxation. However, potential undetected interactions could undermine the conclusions. Further large-scale, well-designed trials are warranted to confirm the contribution of different treatment components in CBT-I.

Sleep quality of patients with myocardial infarction in two diabetic and non-diabetic groups

Background &amp; objective Poor sleep quality is common among patients with diabetes. It has destructive effects on physical and mental health as well as quality of life. This study was conducted with the aim of investigating the sleep quality of patients with myocardial infarction in two diabetic and non-diabetic groups. Subjects and MethodsThis descriptive and analytical study was conducted in 1402. 282 patients with myocardial infarction were included in the study as available. The data collection tool was a demographic information and standard sleep quality questionnaire. The data was analyzed in SPSS version 26 using descriptive and analytical statistics. The significance level of the tests in this study was evaluated with P&lt;0.05. Results:The mean and standard deviation of age in diabetic group patients was 58.19±10.02. The type of myocardial infarction (p=0.3) and the level of education (p=0.2) were not significantly different between the two groups. The results of the Mann-Whitney test showed that the subjective sleep quality, sleep latency, daytime dysfunction, and the overall sleep score in the two diabetic and non-diabetic groups had statistically significant differences (p-value &lt;0.05). Conclusion: The results of this study showed that the subjective sleep quality, sleep latency, daytime dysfunction and overall sleep score of patients with myocardial infarction were different in diabetic and non-diabetic groups. Therefore, it is recommended to create appropriate strategies to improve the treatment of these patients and effective training on improving their sleep quality

Structural validity of the Pittsburgh Sleep Quality Index among medical students in Iran

The Pittsburgh Sleep Quality Index (PSQI) is a self-reported questionnaire evaluating sleep quality based on seven domains of sleep disorders. However, the factor structure of PSQI needs to be well-established among medical students. This study was conducted to establish the factor structure of PSQI among medical students. Four-hundred and four medical students completed the PSQI. Considering each PSQI component as an "observed variable," exploratory factor analysis was conducted. Six models explaining the factor structure of PSQI were compared by confirmatory factor analysis to achieve the best model. All PSQI components were loaded on three factors. The first factor included sleep duration and habitual sleep efficiency, the second was subjective sleep quality and sleep latency, and the third was sleep disturbances, sleeping medications, and daytime dysfunction (root mean square error of approximation = < 0.01, goodness of fit index = 0.99). The differences in Bayesian information criteria and root mean square error of approximation between our best-fit model and each of the other resulted in rejection of all other Models. Besides confirming the structural validity among medical students, our findings indicated the adequacy of the 3-factor structure of PSQI, including sleep efficiency, perceived sleep quality, and daily disturbances in this population.

PROGNOSTIC VALUES OF CIRCADIAN RHYTHM AND SLEEP PARAMETERS IN ASSESSMENT OF STATE ANXIETY IN PARKINSON’S DISEASE WITH REGARD TO MOTOR SUBTYPE

Introduction. Parkinson’s disease is characterized by motor and non-motor symptoms, the connection between which has recently attracted much attention from researchers. Sleep disturbances and anxiety can be non-motor signs of Parkinson’s disease. The specificity of non-motor symptoms in different motor subtypes is being actively studied, with the PIGD (postural instability and gait difficulty) subtype being associated with more severe non-motor symptoms. Methods. We conducted a clinical monocentric cross-sectional study that included 64 patients with Parkinson’s disease. Patients were assessed according to the Unified Parkinson’s Disease Rating Scale, and their motor subtype was determined by calculations using the method of Jankovich and Stebbins. We assessed circadian rhythm using the Ukrainian version of the Munich Chronotype Questionnaire, sleep quality – using the Pittsburgh Sleep Quality Index, excessive daytime sleepiness – using the Epworth Sleepiness Scale, and state anxiety – using the first block of the State-Trait Anxiety Inventory. Results. Our sample consisted of approximately equal numbers of men and women with a mean age of 63.80 ± 9.30 years. All patients were approximately equally distributed by motor subtype and sleep quality. At the same time, our sample was dominated by patients with a high level of state anxiety, morning chronotype, and the absence of excessive daytime sleepiness. State anxiety demonstrated a moderate direct correlation with sleep latency, mid-sleep, subjective sleep quality, subjective sleep latency, sleep disturbance, and total score of Pittsburgh Sleep Quality Index and a moderate indirect association with average weekly light exposure. It was found that an increased mid-sleep time, a decreased average weekly light exposure during the day, poor sleep quality, and PIGD subtype elevated the odds of more severe situational anxiety. Conclusions. Our study demonstrates the relationship between the level of situational anxiety and parameters of sleep and circadian rhythm in patients with Parkinson’s disease, considering their motor subtype. It was found that a later mid-sleep, lower average weekly light exposure, poor sleep quality, and PIGD subtype of Parkinson’s disease had a prognostic role regarding the increase in state anxiety

Analysis of the Improvement Sequence in Insomnia Symptoms and Factors Influencing the Treatment Outcomes of Smartphone-Delivered CBT in Patients with Insomnia Disorder.

The effectiveness of medication combined with smartphone-delivered cognitive behavioral therapy for insomnia (CBT-I) has been well verified, but there are few studies on the sequence of remission of insomnia symptoms. This study aims to understand the sequence of symptom improvement and the factors influencing the treatment effectiveness in patients with insomnia. Smartphone-delivered CBT, as a form of Online CBT, allows for training through mobile devices at any time and place. We utilized the Good Sleep 365 app to conduct a survey, involving 2820 patients who met the baseline inclusion criteria. These patients were assessed using a general demographic questionnaire and the Pittsburgh Sleep Quality Index (PSQI) to evaluate general demographic information and insomnia symptoms, and subsequently underwent CBT training using the Good Sleep 365 app. A total of 1179 patients completed follow-ups at 4 weeks, 8 weeks, 16 weeks, and 24 weeks. At 4 weeks and 8 weeks, the descending order of the reduction rates of PSQI components (excluding component 6: use of sleeping medication) was: sleep latency, subjective sleep quality, sleep efficiency, sleep disturbance, sleep maintenance, and daytime dysfunction. At 16 weeks and 24 weeks, the descending order was subjective sleep quality, sleep latency, sleep efficiency, daytime dysfunction, sleep maintenance, and sleep disturbance. There were significant differences in the reduction rates of PSQI components (excluding component 6: use of sleeping medication) both at the same follow-up times and at different follow-up times (all P<0.05). Multivariable logistic regression analysis showed that patients older than 30 years and those with a college degree or above had better treatment outcomes, whereas those with a disease duration of more than three years had worse outcomes. The sequence of symptom improvement in patients with insomnia changes over time, and age, educational level, and duration of disease are factors influencing treatment outcomes.

Rozdiely v kvalite spánku medzi adolescentmi v regióne Banská Bystrica

Objective: To identify the sleep quality of sixteen-year-old adolescents in the Banská Bystrica region, with a focus on gender differences. Materials and Methods: The study focused on gender differences in adolescent sleep quality. The sample consisted of 447 students from secondary vocational schools and gymnasiums in the Banská Bystrica region. The Pittsburgh Sleep Quality index (PSQI) was used to assess sleep quality. Data were collected electronically using Google Forms from april to June 2023. Gender differences were analyzed using percentage and statistical methods, specifically the ?2 test, at significance levels of p &lt; 0.01 and p &lt; 0.05. Results: Significant gender differences (p &lt; 0.01, p &lt; 0.05) were observed in sleep onset, wake-up times, subjective sleep quality, sleep latency, sleep efficiency, sleep disturbances, and medication use. No significant differences were found in sleep duration, concentration impairment, alertness, or overall sleep activity scores. More than 50% of adolescents exhibited sleep disturbances. Conclusions: Interventions by schools, families, and the media should encourage adolescents to establish healthy sleep habits. The key objectives are to optimize sleep onset times and duration, create a sleep-supportive environment, and promote daytime physical activity.

Family history of dementia is associated with longer sleep duration and smaller volume of the thalamus in the PREVENT‐Dementia study

AbstractBackgroundThe relationship between sleep and dementia risk is complex, with both longer and shorter sleep duration being associated with cognitive decline. The thalamus has an important role in regulating the sleep‐wake cycle and structural changes may be a good marker of sleep abnormalities. Our aim was to investigate the association between dementia risk, sleep and the volume of thalamic nuclei.MethodWe analysed baseline data from PREVENT‐dementia, a multicentre, prospective cohort study of cognitively intact participants aged 40 to 59 years, who were stratified according to presence of the ApoE4 allele and parental family history of dementia (FH+). Sleep data was collected using the Pittsburgh Sleep Quality Index (PSQI) which measures subjective sleep quality, latency, duration, efficiency, disturbances, medication use and daytime dysfunction. T1‐weighted 3T MRI images were analysed using Freesurfer (version 7.1.0) to determine the volume of the thalamus and its subnuclei, controlling for total intracranial volume. The score on the centre for epidemiologic studies depression scale and the number of analgesic medications, were also used as covariates in the analysis to control for mood and pain. The data was analysed in R Studio using robust logistic regression.ResultComplete data was available for 594 participants. The total PSQI score was lower in FH+ subjects (p = 0.046) but was not associated with ApoE4 status. FH+ subjects had smaller volumes of mediodorsal medial (p = 0.03) and lateral (p = 0.03) nuclei, longer sleep duration (p = 0.02), and counterintuitively less sleep‐related daytime dysfunction (p = 0.01) compared to controls. In the FH+ group, larger pulvinar nucleus was associated with better sleep quality (r = ‐0.17, p = 0.002). In apoE4 non‐carriers, a larger thalamus (r = ‐0.12, p = 0.02) and larger centromedian nucleus (r = ‐0.13, p = 0.01) were both associated with a lower total PSQI score. They also had an association between larger pulvinar (r = ‐0.11, p = 0.04) and centromedian (r = ‐0.14, p = 0.007) nuclei and increased sleep efficiency.ConclusionMiddle‐aged subjects with a FH+ had longer sleep duration and smaller thalamic volumes which may represent early neurodegenerative changes. Furthermore, we found an association between larger thalamic nuclei and better sleep variables, especially in ApoE4 non‐carriers, indicating that the thalamus may be an important imaging correlate of sleep quality.

Family history of dementia is associated with longer sleep duration and smaller volume of the thalamus in the PREVENT‐Dementia study

AbstractBackgroundThe relationship between sleep and dementia risk is complex, with both longer and shorter sleep duration being associated with cognitive decline. The thalamus has an important role in regulating the sleep‐wake cycle and structural changes may be a good marker of sleep abnormalities. Our aim was to investigate the association between dementia risk, sleep and the volume of thalamic nuclei.MethodWe analysed baseline data from PREVENT‐dementia, a multicentre, prospective cohort study of cognitively intact participants aged 40 to 59 years, who were stratified according to presence of the ApoE4 allele and parental family history of dementia (FH+). Sleep data was collected using the Pittsburgh Sleep Quality Index (PSQI) which measures subjective sleep quality, latency, duration, efficiency, disturbances, medication use and daytime dysfunction. T1‐weighted 3T MRI images were analysed using Freesurfer (version 7.1.0) to determine the volume of the thalamus and its subnuclei, controlling for total intracranial volume. The score on the centre for epidemiologic studies depression scale and the number of analgesic medications, were also used as covariates in the analysis to control for mood and pain. The data was analysed in R Studio using robust logistic regression.ResultComplete data was available for 594 participants. The total PSQI score was lower in FH+ subjects (p = 0.046) but was not associated with ApoE4 status. FH+ subjects had smaller volumes of mediodorsal medial (p = 0.03) and lateral (p = 0.03) nuclei, longer sleep duration (p = 0.02), and counterintuitively less sleep‐related daytime dysfunction (p = 0.01) compared to controls. In the FH+ group, larger pulvinar nucleus was associated with better sleep quality (r = ‐0.17, p = 0.002). In apoE4 non‐carriers, a larger thalamus (r = ‐0.12, p = 0.02) and larger centromedian nucleus (r = ‐0.13, p = 0.01) were both associated with a lower total PSQI score. They also had an association between larger pulvinar (r = ‐0.11, p = 0.04) and centromedian (r = ‐0.14, p = 0.007) nuclei and increased sleep efficiency.ConclusionMiddle‐aged subjects with a FH+ had longer sleep duration and smaller thalamic volumes which may represent early neurodegenerative changes. Furthermore, we found an association between larger thalamic nuclei and better sleep variables, especially in ApoE4 non‐carriers, indicating that the thalamus may be an important imaging correlate of sleep quality.