Subjective Sleep Quality Research Articles

Profiling the sleep architecture of ageing adults using a seven-state continuous-time Markov model.

Sleep is a complex biological process regulated by networks of neurons and environmental factors. As one falls asleep, neurotransmitters from sleep-wake regulating neurones work in synergy to control the switching of different sleep states throughout the night. As sleep disorders or underlying neuropathology can manifest as irregular switching, analysing these patterns is crucial in sleep medicine and neuroscience. While hypnograms represent the switching of sleep states well, current analyses of hypnograms often rely on oversimplified temporal descriptive statistics (TDS, e.g., total time spent in a sleep state), which miss the opportunity to study the sleep state switching by overlooking the complex structures of hypnograms. In this paper, we propose analysing sleep hypnograms using a seven-state continuous-time Markov model (CTMM). This proposed model leverages the CTMM to depict the time-varying sleep-state transitions, and probes three types of insomnia by distinguishing three types of wake states. Fitting the proposed model to data from 2056 ageing adults in the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep study, we profiled sleep architectures in this population and identified the various associations between the sleep state transitions and demographic factors and subjective sleep questions. Ageing, sex, and race all show distinctive patterns of sleep state transitions. Furthermore, we also found that the perception of insomnia and restless sleep are significantly associated with critical transitions in the sleep architecture. By incorporating three wake states in a continuous-time Markov model, our proposed method reveals interesting insights into the relationships between objective hypnogram data and subjective sleep quality assessments.

Use of mHealth Technologies to Increase Sleep Quality among Older Adults: A Scoping Review.

Sleep disorders increase with age and are known risk factors for several mental and physical diseases. They also significantly contribute to a lower quality of life. Nonpharmaceutical approaches, such as cognitive behavioral therapy for insomnia, sleep hygiene advice, relaxation exercises, and physical activity programs, can be delivered directly to patients via mHealth technologies, thereby increasing the accessibility of such interventions and reducing health care-related costs. This scoping review aims to evaluate the effectiveness of mHealth interventions for improving sleep quality among older adults. Published studies in the last 10 years (2013-2023) were identified by searching electronic medical databases (PubMed, PsycINFO, CINAHL, and Scopus) in July 2023 and were independently reviewed by two different authors. The analysis of the data was performed in 2023. The research retrieved 693 records; after duplicates were removed, 524 articles were screened based on their title and abstract, and 28 of them were assessed in full text. A total of 23 studies were excluded because they did not meet the inclusion criteria in terms of population age (60 years or over) or type of intervention (mHealth-based) or because they addressed secondary insomnia. A total of five studies were included in this review, and all of them reported improvements in subjective sleep quality after the application of the mHealth interventions. Two studies also conducted objective assessments of sleep outcomes using actigraphy, reporting improvements only in some of the variables considered. Despite the limited number of available studies, these results are promising and encourage further research.

The Impact of DAZZEON αSleep® Far-Infrared Blanket on Sleep, Blood Pressure, Vascular Health, Muscle Function, Inflammation, and Fatigue.

The application of far-infrared blankets has shown certain benefits in health promotion and therapy, such as improving blood circulation and alleviating muscle pain. However, the effects of such blankets on increasing deep sleep, reducing blood pressure, enhancing memory, dilating microvessels for blood flow, reducing chronic inflammation, and decreasing fatigue remain to be studied. We aim to investigate the effects of the DAZZEON αSleep® far-infrared blanket on these indicators. This study adopted a double-blind design, recruiting 24 male participants aged over 45 years, divided into two groups of 12 each: (A) a placebo group and (B) a DAZZEON αSleep® group. The participants used the blanket every night for two weeks, with sleep records taken using a wearable device and blood pressure, blood oxygen levels, arterial stiffness, and surface temperature measured before and after the intervention. Blood samples were collected for an analysis of inflammation and sleep-related blood indicators (serotonin and melatonin), and exercise tests were conducted to assess fatigue improvement. Compared with before the intervention, the blanket significantly increased changes in grip strength and reaction time. Additionally, it significantly increased blood serotonin, melatonin, and nitric oxide concentrations (p < 0.05), thus significantly increasing deep sleep and REM sleep durations (p < 0.05) and improving subjective sleep quality (p < 0.05). This study confirmed that using the DAZZEON αSleep® far-infrared blanket for 14 consecutive days helps to improve blood circulation, reduce vascular age and arterial stiffness, increase serotonin and melatonin levels, and improve sleep quality, as well as enhances muscle strength and reaction time.

Exploration of sleep quality and rest-activity rhythms characteristics in Bilateral Vestibulopathy patients

Sleep and circadian timing systems are constantly regulated by both photic and non-photic signals. Connections between the vestibular nuclei and the biological clock raise the question of the effect of peripheral vestibular loss on daily rhythms, such as the sleep-wake cycle and circadian rhythm. To answer this question, we compared the sleep and rest-activity rhythm parameters of 15 patients with bilateral vestibulopathy (BVP) to those of 15 healthy controls. Sleep and rest-activity cycle were recorded by a device coupling actimetry with the heart rate and actigraphy at home over 7 days. Subjective sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Sleep efficiency and subjective sleep quality were significantly reduced, and sleep fragmentation was increased in BVP patients compared to controls. BVP patients displayed a damped amplitude of the rest-activity rhythm and higher sleep fragmentation, reflected by a higher nocturnal activity compared to controls. These results suggest that both rest-activity and sleep cycles are impaired in BVP patients compared to healthy controls. BVP patients seem to have greater difficulty maintaining good sleep at night compared to controls. BVP pathology appears to affect the sleep-wake cycle and disturb the circadian rhythm synchronization. Nevertheless, these results need further investigation to be confirmed, particularly with larger sample sizes.

Impact of Promoting a Healthy Lifestyle on Anthropometric Characteristics, Climacteric Symptoms, Sleep Quality and Quality of Life in Women During Menopausal Transition

Objective: The purpose of the study was to assess the effects of a lifestyle promotion based on the principles of the Mediterranean diet (MD) combined with regular physical exercise on climacteric symptoms, sleep quality, and quality of life in women in the menopausal transition. Methods: Among 100 perimenopausal women recruited, 80 (48 ± 2 years) with climacteric symptoms were eligible for the study and were randomized into two groups: an intervention group (n=40) that received nutritional counselling based on the principles of MD with the practice of regular activity during 8 weeks, and a control group (n=40). At baseline and 8 weeks after the initiation of nutritional intervention, we assessed daily energy expenditure and food intake, anthropometric characteristics, climacteric symptoms, sleep quality, and quality of life. Results: Results showed that in the intervention group, compared to the control group, after 8 weeks of nutritional counselling, a significant decrease was noted in somatic and psychologic (p&lt;0.01) symptoms. No significant difference was noted in urogenital symptoms. The quality of life was improved by the decrease of the Menopause Rating Score (-25%, p&lt;0.001). A decrease was observed in subjective sleep quality (-27%, p&lt;0.05), sleep duration (-39%, p&lt;0.05), habitual sleep efficiency (-43%, p&lt;0.05), and daytime dysfunction (-43%, p&lt;0.01). The score of PSQI was decreased by (-31%, p&lt;0.01), which meant that the quality of sleep improved. Conclusion: Anthropometric characteristics, climacteric symptoms, sleep quality and quality of life were improved in women on menopausal transition adopting a healthy lifestyle based on the principles of Mediterranean eating pattern combined with regular physical activity.

Social Media Addiction and its Association with Sleep Quality Among Medical Students in A Medical College In Tamil Nadu, India

Background: Medical students' social media addiction disrupts and lowers sleep quality, hurting their everyday life and academic performance, stressing the need for effective ways to promote their well-being and achievement. The study aims to estimate the prevalence of social media addiction and to find out the association with sleep quality among medical students in private medical college. Methodology: A cross-sectional study involving 792 MBBS students from a private medical college in Chengalpattu district, Tamil Nadu, utilized the Bergen Social Media Addiction Scale (BSMAS) to assess social media addiction and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Data were collected through a pre-tested semi-structured questionnaire and analysed using SPSS version 25. Results: The study revealed a 17.7% prevalence of social media addiction among medical students, significantly associated with poor sleep quality, female gender, and morning social media use. Other factors included dependence on social media for updates, more than three hours of daily use, eye discomfort, Snapchat use, compulsion to post at least six photos and subjective sleep quality, sleep latency, duration, disturbances, use of sleeping medication, and Daytime dysfunction. Conclusions: Research demonstrates a significant correlation between social media addiction and poor sleep quality among medical students, highlighting the need for focused interventions and awareness activities to counteract its harmful influence.

The Abnormal N-Acetylaspartate to Creatine Ratio of the Right Putamen is Linked to Wakefulness in Patients with Insomnia Disorder.

Converging evidence implicates the putamen in sleep-wake regulation. However, its role remains unclear. We hypothesized that metabolic abnormalities in the putamen are linked to insomnia disorder, which has not been previously addressed, and investigated putaminal N-acetylaspartate (NAA), choline (Cho), and creatine (Cr) in patients with insomnia disorder compared to healthy controls. In the present study, the concentrations of NAA, Cho, and Cr in the putamen of 23 patients with insomnia disorder and 18 healthy controls were determined using proton magnetic resonance spectroscopy. Sociodemographic, psychometric, and polysomnography data were obtained from all participants. We found that the mean NAA/Cr ratio of the right putamen was significantly greater in the insomnia group compared to the control group and also greater than the left putamen within the insomnia group. The NAA/Cr ratio of the right putamen distinguished insomnia disorder from normal sleep with 78.3% sensitivity and 61.1% specificity. Furthermore, this ratio positively correlated with both objective and subjective insomnia severity and sleep quality. Our findings provide critical evidence for the dysfunctional putaminal metabolism of NAA/Cr in insomnia disorder, suggesting that the abnormal NAA/Cr ratio of the right putamen is linked to wakefulness in patients with insomnia disorder and may serve as a potential biomarker of insomnia disorder.

Ramadan-Induced Lifestyle Changes: Effects on Sleep and Physical Activity in Non-Fasting Type 1 Diabetes Patients

ObjectivesIn this study we aimed to identify sleep patterns, physical fitness, and barriers to physical activity (PA) during Ramadan observance in a cohort of nonfasting individuals with type 1 diabetes (T1D). MethodsSixty-one nonfasting patients with T1D, age 28.34±9.43 years, ranging from 15 to 54 years, completed questionnaires before and during Ramadan. The questionnaires included 3 assessment instruments: the Barriers to Physical Activity in Type 1 Diabetes (BAPAD1), the Pittsburgh Sleep Quality Index (PSQI), and the International Physical Activity Questionnaire. ResultsDuring Ramadan, there was no significant change in BAPAD1 scores compared to before Ramadan (p=0.378). The primary barriers encompassed hypoglycemia risk, work schedules, diabetes control, and fatigue. Moreover, subjective sleep quality deteriorated during Ramadan compared to the pre-Ramadan period (p<0.001). Sleep duration decreased by 58 minutes (p<0.01) and was associated with later bedtimes and more awakenings. There was a notably decrease in PA levels (p=0.042), particularly for vigorous activities (p=0.017), whereas sedentary time showed a significant increase (p=0.008). ConclusionsRamadan observance did not affect barriers to PA in individuals with T1D despite alteration of sleep patterns and PA levels. Lifestyle alterations associated with Ramadan observance significantly impact individuals with T1D who are not fasting, resulting in reduced PA, shortened sleep duration, and increased sedentary time.

Matcha Does Not Affect Electroencephalography during Sleep but May Enhance Mental Well-Being: A Randomized Placebo-Controlled Clinical Trial.

Although theanine in matcha improves sleep quality and cognitive function, the caffeine in green tea is thought to worsen sleep quality. Therefore, this study investigated the factors behind the observed improvements in subjective sleep quality in matcha. A placebo-controlled randomized double-blind parallel-group study was conducted on healthy Japanese men and women aged 27-64 years. After 4 weeks of consuming 2.7 g of matcha daily (containing 50.3 mg theanine, 301.4 mg catechins, and 71.5 mg caffeine), no significant differences were observed between the control and matcha groups on total sleep time, sleep latency, wake after sleep onset, or sleep efficiency measured by electroencephalography (EEG). However, the sleep questionnaire Oguri-Shirakawa-Azumi Sleep Inventory, the Middle-age and Aged version (OSA-MA), administered immediately after waking showed a trend toward increased satisfaction with sleep time (p < 0.1), and EEG measurements indicated significantly shortened wake-up times after waking with matcha intake (p < 0.05). The Beck Depression Inventory-II scores also tended to decrease (p < 0.1). The continuous intake of matcha may offer improved subjective sleep quality and emotional stability despite not offering significant changes in objective sleep parameters.

Effects of repeated cryostimulation exposures on sleep and wellness in healthy young adults

The aim of this study was to evaluate the effects of daily whole-body cryostimulation (WBC) sessions during 5 consecutive days on wellness and sleep parameters in healthy young men and women. Twenty healthy subjects (9 women; 11 men) aged 23.1 ± 2.6 years old participated in this randomized protocol, with 5 consecutive days with (CRYO) or without WBC (CONT) exposure. Sleep was analyzed over the 5 nights in each condition. Sleep quality and quantity were assessed via actimetry, cerebral activity and questionnaires. Nocturnal heart rate variability (HRV) was also recorded and questionnaires were given to assess wellness and mood. Repeated WBC exposures had a beneficial impact on mood and anxiety. It also improved subjective sleep quality (scored from 3.6 ± 0.5 pre to 3.9 ± 0.3), especially in women. Also, repeated WBC sessions modulated sleep architecture by increasing slow wave sleep duration (+7.3 ± 16.8 min) during the nights without impacting other sleep parameters, nor nocturnal HRV. In conclusion, repeated WBC seems to be an effective strategy to improve slow wave sleep duration in healthy young subjects. The reported psychological improvements may better benefit women than men.

Subjective and objective sleep quality assessment in adolescent patients with inflammatory bowel disease

ObjectivesThere is a link between inflammatory bowel disease (IBD) and poor sleep quality that is presumed to be multifactorial. The purpose of this study was to identify factors that impact sleep quality in this group including clinical disease activity, depression, anxiety, quality of life, and disordered social media use through questionnaires. MethodsThis prospective study analyzed sleep quality in adolescent patients ages 13 to 18 with a diagnosis of IBD using objective data from wrist actigraphy and subjective report from the Pittsburgh Sleep Quality Index (PSQI). Additional screeners including the Short Pediatric Crohn's Disease Activity Index or Pediatric Ulcerative Colitis Activity Index, Pediatric Quality of Life Inventory Gastrointestinal Symptoms Module, Generalized Anxiety Disorder 7-item screener, Patient Health Questionnaire depression screener, and Social Media Disorder scale were also collected. ResultsTwenty-three subjects enrolled and 16 completed questionnaires. 62.5 % of participants were in clinical remission and the remaining 37.5 % had mild to severe clinical IBD activity. Poor subjective sleep quality was associated with a shorter duration of sleep time and an increased clinical disease activity score. Patients in clinical remission slept for a longer duration than those with mild IBD activity. ConclusionsThis study did not identify a significant relationship between sleep quality and psychosocial factors in the adolescent population with IBD, though their influence cannot be discounted. There was a connection between the presence of disease activity and shorter sleep duration. Similarly, PSQI scores correlated with sleep time but not sleep quality.

Virtual reality improves sleep quality and associated symptoms in patients with chronic insomnia

PurposeThe present study aimed to explore the effectiveness of virtual reality (VR) therapy on sleep quality and associated symptoms, such as depression and anxiety, cognitive decline and autonomic nervous dysfunction, in chronic insomnia patients. MethodsSixty-three chronic insomnia patients were randomly divided into VR group (n = 32) and control group (n = 20) based on a standard drug therapy. Patients were instructed to use VR at home once a day at evening for 6-week treatment. All participants received evaluations of subjective sleep quality measured with the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS), depression and anxiety symptoms measured with the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA), cognitive function, and objective sleep structure and autonomic nerve function examination measured with the sleep respiration monitoring device at baseline and after 6-week treatment. The main objective of this study was sleep quality assessment as the primary outcome. ResultsAfter 6-week treatment, the decreases in PSQI score (−5.60 ± 2.37 vs −4.10 ± 1.80, P = 0.020) and ISI score (−8.81 ± 4.52 vs −6.35 ± 2.89, P = 0.038) of the VR group were significantly greater compared with the control group. The VR group showed more reduction in HAMD score (−9.96 ± 4.41 vs −7.50 ± 2.89, P = 0.035) and HAMA score (−8.96 ± 3.80 vs −6.80 ± 3.22, P = 0.046), and more increase in processing speed (0.54 ± 0.60 vs 0.00 ± 0.79, P = 0.011) than the control group. Moreover, the low-frequency coupling (−10.00 ± 17.40 vs. 8.25 ± 20.03, P = 0.001) was lowered and the high-frequency coupling (9.99 ± 17.40 vs. −8.24 ± 20.03, P = 0.001) was elevated in the VR group relative to the control group. ConclusionOur findings offered preliminary evidence that VR therapy enhanced sleep quality and also lessened depressive and anxious symptoms, and improved cognitive and autonomic functioning in patients with chronic insomnia.

Rotator cuff repair: Sleep disturbance significantly improves after arthroscopic tendon repair.

The aim of this study was to quantify sleep quality and define its evolution in patients treated for rotator cuff tears (RCTs) with arthroscopic rotator cuff repair (ARCR) and to understand its correlation with patients' depression and anxiety. The patients were part of the 'ARCR_Pred cohort study', a prospective multicentre cohort of ARCR patients. adult, RCT diagnosed by magnetic resonance imaging, treated by primary ARCR. irreparable tears, revision operations, open or mini-open reconstructions, pregnancy. Subjective sleep quality (prevalence and level of disturbance) was analysed. Psychological characteristics (PROMIS Sf questionnaire) and functional outcomes (Constant and Murley Score and Oxford Shoulder Score) were investigated. A gender-based analysis was performed as well. Patients were evaluated before the operation and prospectively at 6 and 12 months. Of the 973 patients, 611 (62.8%) were men, with the mean age being 57.3 ± 9.4 years (range, 21-84). A high prevalence of sleep disturbances was found before ARCR (88.4%), with 59% of the patients complaining of disturbance every night. Sleep disturbances progressively improved at 6 (37.2%) and 12 months (22.0%). Also, nocturnal pain (frequency of night disturbed by pain) progressively improved from 94.3% to 62.4% and then 37.9%. For depression and anxiety, a statistically significant difference (p < 0.05) was retrieved among every group (undisturbed, occasionallyand always disturbed) at all follow-ups. On the other hand, the post-op improvement led to a decrease in anxiety and depression levels passing from 50.1 and 51.4 points at baseline to 45.0 and 45.4 at 12 months, respectively. Women had statistically worse sleep quality at 6 and 12 months (41% vs. 36% and 27% vs. 19%, respectively) (p < 0.05). RCTs cause a high prevalence of sleep disturbance and nocturnal pain, which progressively resolves after an arthroscopic tendon repair. Women have a higher risk than men of presenting disturbed sleep quality. Level III, prognostic cohort study.

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

To explore the influence of sleep conditions and sleep hygiene behaviors in early pregnancy on gestational diabetes mellitus (GDM) development. This 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. After 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. Poor 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.

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.

Effects and implementation of an intervention to improve sleep, fatigue and recovery among healthcare workers with night shifts: A pre- and post-test study

BackgroundPrevious intervention studies among night workers mainly focused on single interventions and found inconclusive evidence for effectiveness. A comprehensive intervention approach that includes individual and environmental components has been argued as important. Gaining insight into contributing factors for the implementation of interventions for night workers and effectiveness is important to distinguish between theory and programme failure. ObjectivesTo evaluate the effects and implementation of the PerfectFit@Night intervention to improve sleep, fatigue and recovery of night workers in healthcare, using the RE-AIM framework, which assesses reach, effectiveness, adoption, implementation and maintenance of interventions. DesignA prospective pre–post study design, with two measurements before and three and six months after the intervention. SettingTwelve different departments of a university hospital in the Netherlands. ParticipantsHealthcare workers working night shifts (n = 210). MethodsPerfectFit@Night consisted of environmental (provision of a powernap bed and healthy food, and workshop healthy rostering) and individual elements (e-learning and sleep coaching) and was implemented for three months in a phased manner. Questionnaires, logbooks and interview data were used. Effects of the intervention on sleep, fatigue and recovery were evaluated with mixed-effects models, and implementation factors of reach, adoption, implementation and maintenance were evaluated. ResultsNight shift-related insomnia (−11 %-points, 95 % CI: −19 %, −4 % at three months), need for recovery (β: −2.45, 95 % CI: −4.86, −0.03 at six months) and fatigue (OR: 0.46, 95 % CI: 0.25, 0.86 at six months) decreased significantly after the intervention. No changes were found for subjective sleep quality and sleep duration. Barriers and facilitators for implementation were identified for each intervention element at individual (e.g., dietary preferences), organisational (e.g., responsibilities at work) and workplace levels (e.g., location of power nap bed), and for the intervention itself (e.g., useful information in e-learning). Although satisfaction was high and continuation was preferred, embedding of the intervention in the daily routine was limited. Facilitators for future implementation include a positive attitude towards the intervention, clear guidelines regarding intervention elements, appointment of night workers as ambassadors, and suitable conditions in terms of work demands and for the intervention elements. ConclusionsThe multi-faceted PerfectFit@Night intervention reduced insomnia, fatigue and need for recovery in night workers in healthcare. The most important facilitators to improve the implementation of PerfectFit@Night exist at the organisational level (e.g., positive attitude within the culture and suitable work demands). Combining effect and implementation evaluation is crucial to identify barriers and facilitators that hamper or enhance intervention effects. Trial registrationThe study was registered in the Netherlands Trial Register on 17 January 2021 (trial number NL9224).

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.

Effects of early midlife ovarian removal on sleep: Polysomnography-measured cortical arousal, homeostatic drive, and spindle characteristics

Bilateral salpingo-oophorectomy (BSO; removal of ovaries and fallopian tubes) prior to age 48 is associated with elevated risk for both Alzheimer's disease (AD) and sleep disorders such as insomnia and sleep apnea. In early midlife, individuals with BSO show reduced hippocampal volume, function, and hippocampal-dependent verbal episodic memory performance associated with changes in sleep. It is unknown whether BSO affects fine-grained sleep measurements (sleep microarchitecture) and how these changes might relate to hippocampal-dependent memory. We recruited thirty-six early midlife participants with BSO. Seventeen of these participants were taking 17β-estradiol therapy (BSO+ET) and 19 had never taken ET (BSO). Twenty age-matched control participants with intact ovaries (AMC) were also included. Overnight at-home polysomnography recordings were collected, along with subjective sleep quality and hot flash frequency. Multivariate Partial Least Squares (PLS) analysis was used to assess how sleep varied between groups. Compared to AMC, BSO without ET was associated with significantly decreased time spent in non-rapid eye movement (NREM) stage 2 sleep as well as increased NREM stage 2 and 3 beta power, NREM stage 2 delta power, and spindle power and maximum amplitude. Increased spindle maximum amplitude was negatively correlated with verbal episodic memory performance. Decreased sleep latency, increased sleep efficiency, and increased time spent in rapid eye movement sleep were observed for BSO+ET. Findings suggest there is an association between ovarian hormone loss and sleep microarchitecture, which may contribute to poorer cognitive outcomes and be ameliorated by ET.

A quantitative examination of sleep quality, burnout, psychological distress, and social support availability of electrical workers in Ontario, Canada

Electrical workers experience difficult psychosocial working conditions that may expose them to poor mental health outcomes. This study aims to explore the relationships between psychological distress, access to social support, burnout, and sleep quality in Canadian electrical workers. A 30-item cross-sectional survey including the Pittsburgh Sleep Quality Index, Kessler’s Psychological Distress Scale, Copenhagen Burnout Inventory, and social support questions from the WHO-QoL-BREF were completed by 118 electrical workers. Data was analyzed to determine differences between groups, correlations between variables, and to identify predictors of poor sleep quality. No significant differences were found in burnout scores and subjective sleep quality between apprentices, electricians, and contractors. Apprentices reported being more psychologically distressed than electricians (p = 0.005) and contractors (p < 0.001). Electrical workers preferred social support from spouses, family, or friends when things get tough at work. Poor sleep quality was correlated with personal burnout (r = 0.45), work-related burnout (r = 0.37), and psychological distress (r = 0.39); however, these factors did not predict poor sleep quality. The study suggests a need for improved interpersonal communication, stress management, and help-giving behavior among electrician-apprentice and contractor-apprentice relationships in the workplace. Future research should explore the cultural and social dynamics between workers to better understand their impacts on health and wellbeing.