Subjective Sleep Quality Research Articles

Does a Multidisciplinary Pain Management Treatment Improve Sleep Quality in Patients with Chronic Widespread Pain and Sleep Problems? Results from the AMS-Pain Cohort

Background: Poor sleep quality is a significant concern for patients with chronic widespread pain (CWP), impacting their emotional, cognitive, and physical well-being. While there is little specific attention given to the treatment of sleep in such programs, it is possible that its ingredients, such as cognitive behavioral therapy, improving body awareness, relaxation, having a balanced daily routine, and physical activity, have a positive effect on sleep. The objectives of this study are to examine: 1. whether sleep improves after a multidisciplinary pain management treatment. 2. and to explore predictors of treatment outcome, in patients with chronic widespread pain (CWP) and sleep problems. Methods: Data were used from pre- and post-treatment measurements of 121 patients with CWP and sleep problems, treated with a multidisciplinary pain management treatment (not specifically focusing on sleep). Mean difference in subjective sleep quality and standard outcome of multidisciplinary treatment, as measured with Pittsburg Sleep Quality Index (PSQI) and IMMPACT outcome measures, were analyzed and Cohens d were calculated. Regression models were used to assess whether pretreatment variables predicted poor improvement of subjective sleep quality post treatment. Results: The effect size of improvement in sleep quality was small (Cohen’s d=0.3) and 94% of the patients still experienced poor sleep quality after treatment (PSQI ≥ 6). Moderate effects sizes were found for pain (d=0.6), fatigue (d=0.56) and disability (d=0.53). Pretreatment poorer sleep quality, higher levels of pain related disability, psychological distress and less concern predicted poorer sleep quality post-treatment. Conclusion: The improvement of sleep quality after following a multidisciplinary pain management treatment not specifically focusing on sleep was limited. To improve sleep, specific strategies targeting sleep (e.g., sleep education, sleep hygiene and /or cognitive behavioral therapy for sleep) may need to be included into multidisciplinary treatment. Addressing pain related disability and psychological distress, may also help to improve sleep quality.

Association Between Sleep Characteristics and Likelihood of Prodromal Parkinson's Disease: A Cross-Sectional Analysis in the HABIT Study.

Sleep is critical in health problems including Parkinson's disease (PD). This study examined the association between sleep characteristics and the likelihood of prodromal PD. At baseline examination of the Heart and Brain Investigation in Taicang (HABIT) study, potential PD biomarkers were obtained for 8777 participants aged over 50 years, and the probability of prodromal PD was assessed based on the Chinese expert consensus and Movement Disorder Society (MDS) criteria. General and component sleep characteristics were evaluated by the Pittsburgh Sleep Quality Index (PSQI). Median regression was applied to examine the association between sleep and the probability of prodromal PD, adjusting for age, sex, education level, physical activity, obesity, fast plasma glucose, lipids, and hypertension. Based on China criteria, a higher level of PSQI score was significantly associated with a higher probability of prodromal PD (β = 0.02, 95% CI: 0.01-0.03) and a higher risk of having an increased probability of prodromal PD (OR = 1.04, 95% CI: 1.02-1.05). Compared to participants with good quality sleep, those with poor quality sleep had a 0.07% increased probability of prodromal PD (95% CI: 0.01-0.13) and a 19% increased risk of having a high prodromal PD probability (95% CI: 1.04-1.20). Similar associations between sleep quality and the probability of prodromal PD were also observed using the MDS criteria. Subjective sleep quality, sleep latency, habitual sleep efficiency, daytime dysfunction, and use of sleep medications were also associated with the probability of prodromal PD. Poor sleep quality was associated with a high probability of prodromal PD. Sleep may be helpful for understanding and intervention of prodromal PD.

Cerebral blood flow in the paracentral lobule is associated with poor subjective sleep quality among patients with a history of methadone maintenance treatment.

Sleep disorders are prevalent and significant among individuals receiving methadone maintenance treatment (MMT), adversely affecting their quality of life and treatment adherence. While cerebral blood flow (CBF) plays a crucial role in the development of various diseases, its relationship with sleep disorders remains uncertain. This observational study focuses on possible correlations between CBF and poor subjective sleep quality in MMT patients. A total of 75 participants with a history of MMT were recruited and assessed using pseudo-continuous arterial spin labeling magnetic resonance imaging to determine CBF. A LAASO regression model was employed to identify the region of interest (ROI) most associated with sleep disturbance. The association between the CBF of the ROI and the Pittsburgh Sleep Quality Index (PSQI) was examined using regression analyses. Age, gender, BMI, history of hypertension, diabetes, hyperlipidemia, and methadone withdrawal were included as covariates. Among MMT patients with poor subjective sleep quality, significantly higher CBF was observed in the right paracentral lobule (56.1057 ± 11.1624 ml/100 g/min, p = 0.044), right cerebelum_3 (56.6723 ± 15.3139 ml/100 g/min, p = 0.026), right caudate nucleus (48.9168 ± 6.9910 ml/100 g/min, p = 0.009), and left caudate nucleus (47.6207 ± 6.1374 ml/100 g/min, p = 0.006). Furthermore, a positive correlation was found between CBF in the right paracentral lobule and the total PSQI score (β = 0.1135, p = 0.0323), with the association remaining significant even after adjustment for covariates (β = 0.1276, p = 0.0405). MMT patients with poor subjective sleep quality exhibited significantly altered CBF in multiple brain regions. The association between increased CBF in the right paracentral lobule and subjective sleep quality in MMT patients could be crucial in understanding sleep disorders in individuals undergoing MMT. https://www.chictr.org.cn/, identifier: ChiCTR2100051931.

A systematic review and meta-analysis of music interventions to improve sleep in adults with mental health problems.

Music listening has been used as a sleep intervention among different populations. This systematic review and meta-analysis aimed to explore whether music is an effective sleep aid in adults with mental health problems. We searched for studies investigating music interventions for sleep in adults with mental health problems. The primary outcome was subjective sleep quality; secondary outcomes were objective sleep outcomes, quality of life, and other mental health symptoms. Risk of bias assessment (RoB1) and random-effect model were used for the systematic review and meta-analyses. The initial screening (n=1492) resulted in 15 studies in the systematic review. Further qualified studies led to the meta-analysis of sleep quality (n=7), depression (n=5), and anxiety (n=5). We found that the music listening intervention showed a potential effect on subjective sleep quality improvement compared to treatment-as-usual or no-intervention groups. When excluding an outlier study with an extreme effect, the meta-analysis showed a moderate effect on sleep quality (Hedges' g=-0.66, 95% CI [-1.19, -0.13], t=-3.21, p=0.0236). The highest risk of bias was the blinding of participants and researchers due to the nature of the music intervention. Our results suggest that music interventions could have the potential to improve sleep quality among individuals with mental health problems, even though more high-quality studies are needed to establish the effect fully.

Sleep Characteristics, Magnetic Resonance Imaging- and Dual-Energy X-Ray Absorptiometry-Based Morphological Parameters, Muscle Strength, and Risk of Falls in Sedentary Older Subjects.

The aims of this cross-sectional study were to (a)assess actigraphy-based sleep parameters (total sample and gender differences), (b)assess differences in morphological parameters and physical function between short- versus normal-sleepers and poor- versus good-sleepers, and (c)assess the possible correlations between sleep variables and morphological and physical function parameters in older subjects. This study enrolled 42 healthy older participants (60-80years). Participants completed the following clinical evaluations: (1)whole-body dual-energy X-ray absorptiometry to assess the appendicular skeletal muscle mass index; (2)magnetic resonance imaging acquisition to determine the cross-sectional muscle area of thigh muscles and intermuscular adipose tissue; (3)risk of fall assessment through the mini-Balance Evaluation Systems Test; (4)strength assessment: (a)chair stand test and (b)handgrip strength test; (5)sleep monitoring by actigraphy to assess total sleep time, sleep efficiency, wake after sleep onset, sleep latency, fragmentation index, mobile time, and subjective sleep quality. 31.0% of subjects were short-sleepers (total sleep time < 6hr), 19.1% were poor-sleepers (sleep efficiency < 85%), and gender differences were detected in mobile time (males: 15.8 ± 6.0 and females: 13.4 ± 6.8; p < .001) and fragmentation index (males: 35.3 ± 14.3 and females: 29.6 ± 14.6; p < .001); no significant differences were observed between groups (short- vs. normal-sleepers and poor- vs. good-sleepers) in morphological and physical function variables; correlation analysis showed that sleep latency negatively correlated with Mini-Balance Evaluation Systems Test (r = -.352; p = .022) and a positive correlation was detected between cross-sectional muscle area and mobile time (r = .349, p = .023). No differences were observed in morphological and function parameters between good- versus poor-sleepers, those subjects with worse sleep onset latency (i.e.,longer time to fall asleep) registered higher for risk of fall. The potential role of sleep in the physiological mechanisms of muscular aging must be explored through cross-sectional cohort studies with a larger population.

The effect of electro-magnetic-energy-regulation therapy on subjective sleep among elite players in Norwegian women's football.

The current study investigated if Bio-Electro-Magnetic-Energy-Regulation (BEMER) therapy is affecting subjective sleep among a sample of 21 elite female football players in a Norwegian top series club. Subjective sleep was measured each day over a period of 273 consecutive days by using a smartphone application, PM Reporter Pro, which scheduled push messages to remind the participants to report sleep every morning. The study was conducted as a quasi-experimental design, with a control period before the introduction of BEMER therapy that lasted for 3 months, followed by an intervention period where BEMER therapy was used that lasted for 5 months. The collected data from the players in the control period served as their control compared to the data collected from the players in the intervention period. Analyses of variance (ANOVA) with False Discovery Rate adjusted p-values show that subjective sleep duration and subjective sleep quality are significantly reduced on game nights, both in the control period and in the experiment period. The results also show that subjective sleep duration and subjective sleep quality significantly increase in the experiment period compared to the control period. The findings indicate that BEMER therapy might serve as a tool to improve sleep.

Sleep quality and related factors among healthcare workers in designated quarantine hospital site in post-pandemic based on the health ecological model: a cross-sectional study in Nanjing, China.

This study aims to assess the status and related factors among healthcare workers (HCWs) in designated quarantine-hospital-site (DQHS) based on the model of health ecology. The cross-sectional study was conducted from April to May, 2022, which included 351 valid samples. We measured sleep quality using the Pittsburgh Sleep Quality Index, which encompasses seven dimensions: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Each dimension is scored individually, contributing to an overall sleep quality score. Factors associated with the sleep quality of HCWs in DQHS were divided into individual, behavioral, interpersonal and social dimensions. Hierarchical linear regressions were conducted to identify the potential factors associated with sleep quality among HCWs in DQHS. HCWs in DQHS had a statistically higher sleep quality than the Chinese national norm. HCWs who were female, afraid of Coronavirus disease, had more negative emotions, frequently worked overtime, were married, and had a higher income were more likely to experience worse sleep quality (p < 0.05), while those who worked between 51 and 70 h weekly, treated over 10 patients daily, and engaged in more health behaviors may have better sleep quality (p < 0.05). This study revealed a worrying level of sleep quality among HCWs in DQHS. The government, hospital managers, and families should collaborate to ensure the sleep quality of HCWs in DQHS.

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

Rate and Associated Factors of Fatigue in Chinese Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Survey.

Fatigue was a common symptom of non-alcoholic fatty liver disease (NAFLD), which seriously affected patients' quality of life. The aim of this study was to detect fatigue rate and to evaluate factors associated with fatigue in NAFLD patients. A cross-sectional study was carried out from the Huadong Sanatorium between April 2022 and May 2023, and 133 NAFLD patients were included in this study. They completed Fatigue Severity Scale to assess fatigue, the Hospital Anxiety and Depression Scale to estimate psychological status, and the Pittsburgh Sleep Quality Index for sleep quality. Data were analyzed by independent samples t-tests, χ2 tests and logistic regression models. We found that 51.1% of NAFLD patients had fatigue. Exercise, anxiety, depression, subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disorders, daytime dysfunction and overall sleep quality were related to fatigue among NAFLD patients. Moreover, logistic regression models indicated anxiety, habitual sleep efficiency and sleep disorders as important predictors of fatigue. This was the first time to explore demographic, clinical, psychological and sleeping correlated factors for fatigue in Chinese NAFLD patients. Our study showed that more than half of NAFLD patients had fatigue, and anxiety, habitual sleep efficiency and sleep disorders were significantly associated with fatigue in NAFLD. The findings indicated that it was very necessary to pay more attention to fatigue of NAFLD patients, especially those with negative emotions and poor sleep quality by favorable intervention to relieve fatigue symptoms, so as to improve quality of life.

Impact of subjective sleep quality on objective measures of neurocognitive dysfunction in patients with major depressive disorder

Background: Sleep disturbances are prevalent in major depressive disorder (MDD). MDD and sleep disturbances are both linked to cognitive impairments. Studies exploring the mechanisms and impact of sleep disturbances on neurocognitive functioning in depressed patients are lacking and proper assessment and therapeutic interventions for sleep disturbances are not part of clinical management of MDD. Aim: We investigated the association between subjective sleep quality and neurocognitive dysfunction in patients with MDD. Materials and Methods: Patients with moderate MDD episode were matched and assigned to two groups with poor and good sleep quality. We used Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. To measure frontotemporally mediated cognitive functioning, following tests were administered: Wisconsin Card Sorting Test (WCST) and degraded continuous performance test (CPT-DS). Two-tailed independent samples t tests or Mann–Whitney U tests and Pearson’s correlation coefficient were performed for the statistical analysis of sleep latency, sleep duration, overall sleep quality, CPT d’ value, WCST correct answers, errors, and perseverative errors. Results: Participants with MDD and poor sleep quality performed worse on cognitive tests compared to patients with MDD and good sleep quality. Scores of subjective sleep on PSQI positively correlated with WCST errors (r (60) =0.8883 P = .001) and negatively correlated with WCST correct answers (r (60) = -.869 P = .001) and measures of CPT-DS d’ value (r (60) = -.9355 P = .001). Conclusions: Poor sleep quality, notably sleep duration and sleep latency, worsens the neurocognitive impairments of MDD patients. As these impairments are found to be associated with treatment outcomes, sleep disturbances should be additionally assessed and treated in MDD episode.

Does inadequate sleep predispose to weight gain? A cross-sectional analysis among medical undergraduates

Background: Adequate sleep is essential for optimal health. Sleep deprivation has been shown to be associated with adverse health outcomes, including weight gain and obesity. Medical students represent one of the at-risk populations for sleep deprivation. Aims and Objectives: This study was aimed at exploring the relationship between inadequate sleep and weight gain in the medical student population. Materials and Methods: The present analytical and cross-sectional study was conducted in a sample of 126 undergraduate medical students (95 males and 31 females) within the age range 18–25 years at an institute in Southern Haryana, India. Sociodemographic and usual sleep-wake habits during the preceding month information about the participants were gathered through self-administration of a structured pro forma compiled as Google Forms. Height and weight of each subject were measured reliably using standard instruments and body mass index (BMI) was calculated. Data were expressed using suitable statistical measures and analyzed using appropriate statistical tests. Results: Our study revealed a significant association between subjective sleep quality and weight gain with those perceiving their sleep as poor being much more likely to be overweight (Crude Odd’s ratio; 95% confidence interval: 3.45; 1.33–8.95). Students reporting usually getting inadequate sleep and difficulty in falling asleep were also found to have a higher frequency of being overweight (76.9% vs. 23.1%, 61.5% vs. 38.5%, respectively). A small, though statistically insignificant, difference in mean BMI was also seen; students who reported getting insufficient sleep (&lt;7 h), taking ≥30 min to fall asleep, and rated their sleep quality as poor outweighed their counterparts. Conclusion: The findings of our study suggest that inadequate sleep might predispose to weight gain and obesity, though the same needs to be explored through a longitudinal approach controlling for potential confounders to arrive at a definitive conclusion.

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.

Moving for Better Sleep: A Narrative Review of Exercise and Sleep Quality

Objective: This narrative review aims to bridge the knowledge gap regarding the influence of exercise on sleep quality, exploring how various types, intensities, and timings of exercise impact sleep across different populations. Materials and Methods: A systematic search for relevant literature was conducted in scholarly databases such as Google Scholar, PubMed, MEDLINE, SPORTDiscus, CINAHL, and Web of Science. The search included terms related to physical activity and sleep, focusing on studies published in English from the past 10 years (2014-2024). Studies involving human participants and employing randomized controlled trials (RCTs) or observational study designs were prioritized. Results: Regular moderate-intensity aerobic exercise, such as brisk walking or cycling, significantly reduces sleep onset latency, improves sleep efficiency, and enhances subjective sleep quality across various populations. Potential mechanisms include stress hormone reduction, neurotransmitter regulation, and body temperature control. Emerging evidence suggests that resistance training can improve sleep onset latency and subjective sleep quality, particularly in older adults and individuals with chronic conditions. The benefits may be linked to muscle repair processes and stress reduction. The effects of High-Intensity Interval Training (HIIT) on sleep are mixed, with moderate-intensity programs showing potential benefits while excessive intensity or duration may disrupt sleep. Timing also plays a crucial role, with late-night HIIT potentially having negative impacts on sleep quality. Conclusion: Regular exercise, especially moderate-intensity aerobic exercise, is a powerful tool for improving sleep quality. Resistance training also holds promise, particularly for specific populations. The impact of HIIT on sleep requires further research to determine optimal training parameters. Healthcare professionals should guide patients in tailoring exercise programs to optimize sleep benefits.

Dreaming while awake: The beneficial effects of yoga Nidra on mental and physical recovery in two elite karate athletes

Yoga Nidra (YN) naturally stimulates a hypnagogic state wherein an individual is physiologically asleep yet maintains a certain awareness to follow a guide's instructions. The aim of this study was to investigate the effects of this aware sleep state on recovery-stress balance in two elite karate athletes adopting an idiosyncratic and multimodal approach. One male and one female athlete underwent a YN intervention. Before intervention, after intervention and three weeks later, recovery-stress balance specific scales, perceived stress, cognitive and somatic anxiety, subjective and objective sleep quality, and individual alpha peak frequency (iAPF) values were assessed. Perceived quality of recovery was continuously monitored for three months including the period of the investigation. Feelings and arousal levels before and after each YN session were also examined. Our results showed a YN general positive effect; however, the intervention had higher sport specific effects in the male compared to the female athlete. On the other hand, in the female athlete, YN seems to have effects both from an emotional and physical point of view. We also noted the intertwined relationship among interoception, perceived stress and YN effects. Also, findings suggest that iAPF modulation reflected improved recovery skills or a better control of stressful situations, while the acute effects on arousal levels were expression of anxiety or energy reduction. Overall, YN improved both the perceived quality of recovery and sleep quality, shedding light on the importance of YN for recovery-stress balance enhancement in the sport context.

Evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive decline.

The prevalence of poor sleep quality and sleep apnea differs by race and ethnicity and may contribute to racial disparities in cognitive aging. We investigated whether sleep quality and sleep apnea risk were associated with cognitive function and decline and whether the associations differed by race/ethnicity. Participants from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE; N = 1690; mean age: 75.7 years) study, a cohort of Asian, Black, Latino, and White participants, completed a modified Pittsburgh Sleep Quality Index assessing subjective sleep quality, latency, duration, disturbances, sleep medication use, and daytime dysfunction. Sleep apnea risk was measured by questions about snoring, tiredness, and whether apnea was observed. Executive function and verbal episodic memory were assessed at three time points over an average of 2.7 years with the Spanish and English Neuropsychological Assessment Scale. We fit linear mixed-effect models and stratified analyses by race/ethnicity. Higher sleep apnea risk was associated with faster declines in verbal episodic memory ( sleep apnea = -0.02, 95% confidence interval [CI], -0.04, -0.001) but not in executive function. Poorer sleep quality was associated with lower levels of and faster decline in executive function but not in verbal episodic memory. Race/ethnicity modified these associations: compared to estimated effects among White participants, poorer global sleep quality ( sleep*time = -0.02, 95% CI, -0.02, -0.01) was associated with larger effects on decline in executive function among Black participants. Estimated effects of some individual sleep quality components were also modified by race/ethnicity; for example, sleep medication use was associated with faster declines in executive function ( sleep*time = -0.05, 95% CI, -0.07, -0.03) and verbal episodic memory sleep*time = -0.04, 95% CI, -0.07, -0.02) among Black participants compared to White participants. Observational evidence indicates sleep quality is a promising target for addressing racial/ethnic disparities in cognitive aging, especially among Black older adults. Sleep apnea risk was associated with faster declines in verbal episodic memory but not executive function among all participants.Global sleep quality was associated with lower levels of and faster decline in executive function but not verbal episodic memory among all participants.Black older adults were particularly susceptible to the estimated adverse cognitive impacts of global sleep quality, particularly the use of sleep medication.

Impact of 6-months of an advanced hybrid closed-loop system on sleep and psychosocial outcomes in youth with type 1 diabetes and their parents

IntroductionYouth with type 1 diabetes (T1D) and parents experience reduced quality of life and sleep quality due to nocturnal monitoring, hypoglycemia fear, and diabetes-related disruptions. This study examined the sleep and quality of life impact of advanced technology. MethodsThirty-nine youth with T1D, aged 2–17 years, starting an advanced hybrid closed-loop (HCL) system and a parent participated in an observational study. Surveys, actigraphy, sleep diaries, and glycemic data (youth) were captured prior to HCL, at one week, 3 months, and 6 months. Outcomes were modeled using linear mixed effects models with random intercepts to account for within-subject correlation, with least-squares means at each timepoint compared to baseline. ResultsParents and youth reported improvements in health-related quality of life and fear of hypoglycemia after HCL initiation. Concurrently, nocturnal glycemia improved. Actigraphy-derived sleep outcomes showed improved 6 month adolescent efficiency and 3 and 6 month parent wake after sleep onset. Additionally, parents reported improved subjective sleep quality and child sleep-related impairment at 3 months. ConclusionsWith nocturnal glycemic improvements in youth using HCL technology, some aspects of parent and youth sleep and quality of life improved. This may reflect decreased parental monitoring and worry and highlights benefits for youth beyond glycemia.

Poor Subjective Sleep Quality; A Clinical Correlate to Depression and Quality of Life Among Breast Cancer Patients

Poor Subjective Sleep Quality; A Clinical Correlate to Depression and Quality of Life Among Breast Cancer Patients

A life of research on everyday sleep(iness).

This is a personal review of a research life focused on sleep in everyday life. It finds that irregular work hours shorten sleep duration and increase sleepiness, both subjectively and objectively (polysomnography). Also, experimental lab studies demonstrate reduced sleep duration (and sleep stages N2 and REM) when sleep is moved into the daylight hours (and the circadian upswing). Stage N3% seems not affected, and homeostatic experiments suggest that awakenings should not occur until the need for N3% or total spectral power has been satisfied. Furthermore, sleepiness is associated with increased alpha activity and slow eye movements, although the best indicator of dangerous sleepiness is subjective ratings (linked to perceptions of heavy eye lids). Everyday stress has very modest negative effects on objective sleep quality. Sleep loss as well as excessive sleep durations are linked to mortality, but with modest risk, and mainly in older individuals. Finally, objective sleep poorly reflects subjective sleep quality, and women appear to report poorer sleep than men, while objective data show better sleep quality in women. The discrepancy is considerably greater in older age groups.

A Meta-Analysis of the Effectiveness of Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation as Therapy of Insomnia

Objective: Insomnia serves as the most common sleep disorder. Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are amongst most popular treatment for insomnia. This research aimed to determine the comparative effectiveness of TMS and tDCS as therapies for insomnia.Methods: PubMed/MEDLINE, ScienceDirect, Google Scholar, ResearchGate, Wiley Library Online, and Neurona were used to search for randomized controlled trials (RCTs) comparing TMS/tDCS with sham group in insomnia. Meta-analysis was done to determine the effectiveness of TMS and tDCS as a therapy for insomnia. Weighted mean difference were computed and reported with its 95% CI. Heterogeneity was reported with I&lt;sup&gt;2&lt;/sup&gt;. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Subjective pooled-analysis was done using Mann-Whitney U test with p&lt;0.05.Results: From a total 1,000 publications, 15 studies were included, revealing varying types of insomnia as follows: 26.7% comorbid depression, 13.3% comorbid pain, 13.3% involving athletes, 13.3% primary insomnia, 6.7% due to medication, 6.7% comorbid polio, 6.7% comorbid Sjogren’s syndrome, 6.7% comorbid stroke, and 6.7% comorbid Parkinson’s disease. From 15 studies, four homogenous articles were made for pooled-analyses, which included two studies on TMS and two studies on tDCS in insomnia comorbid depression. tDCS improved sleep onset latency, N2, and REM latency better than sham. TMS (2.29, 95% CI: 1.82–2.76) was superior to sham in improving the subjective quality of sleep, and tDCS (1.05, 0.68–1.43) with p=0.121.Conclusion: No significant differences were found between TMS and tDCS as therapies for insomnia. Most RCTs studying TMS/tDCS in insomnia reported high comorbidity with depression.

Translation and Validation of the Pittsburgh Sleep Quality Index in the Moroccan Dialect

Background and Objective The Pittsburgh Sleep Quality Index (PSQI) is a standardized self-administered instrument used to evaluate subjective sleep quality. The objective of our study was to translate this scale into Moroccan dialect and assess its reliability and validity among healthy and non-clinical individuals.Methods The original version of the PSQI was translated into Moroccan dialect following the standard guidelines. The final version was administered to 120 healthy volunteers (medical students, nursing staff, and doctors). The participants filled out the final questionnaire containing the PSQI translated version and the Insomnia Severity Index validated in Moroccan dialect two times within 10 days. We studied the acceptability and internal reliability of the scale by using the Cronbach’s alpha coefficient. With respect to the test-retest reliability, we used the intra-class correlation coefficient (95% confidence interval) and the kappa coefficient. Convergent validity was studied by the Pearson’s correlation coefficient between the Insomnia Severity Index total score and the PSQI total score.Results The translated version of the scale was quite acceptable. The Cronbach’s alpha coefficient was 0.61. The intraclass correlation coefficient was 0.61 (95% CI 0.491–0.707), while the kappa coefficient was 0.77. The correlations between the items of each questionnaire and its score showed good to strong positive correlations. The majority of the correlations between the components and the total score were greater than 0.30, and they ranged from 0.302 to 0.481. The analysis of convergent validity showed significant correlations between the Insomnia Severity Index score and the global score of the translated the PSQI.Conclusions The Moroccan version of PSQI shows good validity and reliability compared to the original English version among the general population. We should further test its validity in patients with psychiatric disorders.