Pittsburgh Sleep Quality Index Total Score Research Articles

Effect of electroacupuncture on serum melatonin and dopamine in aged insomnia

To observe the clinical effect of electroacupuncture (EA) on aged insomnia, and explore its possible mechanism. A total of 60 patients with aged insomnia were randomly divided into an EA group (30 cases) and a sham EA group (30 cases, 1 case dropped off). The patients in the EA group were treated with acupuncture at Baihui (GV 20), Yintang (GV 29), Shenmen (HT 7), Sanyinjiao (SP 6), Xinshu (BL 15) and Shenshu (BL 23), and EA was used at Baihui (GV 20) and Yintang (GV 29), with intermittent wave, 2 Hz in frequency. In the sham EA group, the acupoints and the EA connection acupoints were the same as those in the EA group, 2-3 mm in depth, but no current was connected. The intervention was given 30 min each time, once every other day, 3 times a week for 4 weeks in the both groups. Before and after treatment, the Pittsburgh sleep quality index (PSQI) and Montreal cognitive assessment (MoCA) scale were used to assess sleep quality and cognitive function, and serum melatonin (MT) and dopamine (DA) levels were detected. After treatment, the total score and sub-item scores of PSQI in the EA group were lower than those before treatment (P<0.01, P<0.05), among them, the sub-item scores of sleep quality, time to fall asleep, sleep time and sleep efficiency, daytime dysfunction and total score were all lower than those in the sham EA group (P<0.01, P<0.05). After treatment, the MoCA score and serum MT and DA levels in the EA group were higher than those before treatment (P<0.01), and the MoCA score and serum MT level in the EA group were higher than the sham EA group (P<0.01, P<0.05). Electroacupuncture can improve sleep quality and cognitive function in aged insomnia patients, and its mechanism may be related to regulating serum MT and DA levels.

Observation of acupoint application of gel plaster on insomnia

To observe the effect of acupoint application of gel plaster on quality of sleep and life in patients with insomnia. A total of 63 patients with insomnia were randomized into a gel plaster group (32 cases, 1 case dropped off) and a placebo plaster group (31 cases). Acupoint application of gel plaster was applied at Yintang (GV 29) and Yongquan (KI 1) in the gel plaster group, placebo plaster was applied at the same acupoints in the placebo plaster group. The treatment was given from bedtime to early moming of the next day, 5 days were as one course, with 2-day interval, totally 4 courses were required in the both groups. Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS) and Flinders fatigue scale were used to evaluate the sleep quality and fatigue level of the patients in the both groups before and after treatment and at 2 weeks of follow-up. The variations of insomnia TCM syndrome score and the 36-item short-form health survey (SF-36) score before and after treatment were observed. Compared before treatment, the scores of PSQI, ESS and FFS after treatment and at follow-up were decreased in the both groups (P<0.01), and the variations of PSQI total scores and ESS scores in the gel plaster group were larger than those in the placebo plaster group (P<0.05). Compared before treatment, the insomnia TCM syndrome scores were decreased (P<0.01), the scores of physiological function, physiological role, general health, role emotion, mental health of SF-36 were improved after treatment in the both groups (P<0.05), and the social function score after treatment in the gel plaster group was superior to that in the placebo plaster group (P<0.05). Acupoint application of gel plaster can effectively improve the quality of sleep and life in patients with insomnia.

745 Association of Longitudinal Sleep Profiles with Cognitive Functioning in Bipolar Disorder

Abstract Introduction Emerging evidence suggests that some cognitive deficits in bipolar disorder may be attributed to sleep disturbance. However, current findings are limited by cross sectional analyses or longitudinal studies with sparse follow up on sleep quality. The current study examined longitudinal profiles of sleep as predictors of cognitive performance across a series of domains to better understand how sleep disturbance may impact in bipolar patients. Methods 241 bipolar disorder and 103 control participants had their sleep measured at baseline, 6- and 12-months using the Pittsburgh Sleep Quality Index (PSQI). Individuals with a “poor” categorical PSQI sleep rating (PSQI total score &amp;gt;5) at all time points were categorized as “Poor Sleepers” (n = 134). Those rated “good” at each time point were “Healthy Sleepers” (n = 107), and those with at least one discrepant sleep rating at any time point were labeled “Unstable Sleepers” (n = 103). Cognitive performance was assessed at 12-months, testing domains of memory, processing speed, and executive function. ANOVAs controlling for demographics, mood symptom severity, and diagnostic group examined effects of sleep profiles on cognitive function. Results Main effects for sleep group were found for the California Verbal Learning Test across all short and long delay recall conditions (F’s 4.45 – 5.8, p &amp;lt;.02 for all). The poor sleep group performed the worst, while no main effects for diagnosis were observed. Main effects of sleep group were found for time conditions of the Trail making task (F = 4.18, p = .016), but not for errors. Conclusion Sleep quality was more strongly related to verbal and visual memory than bipolar diagnosis, with weaker effects for executive function. Some cognitive domains in bipolar disorder may be more closely related to sleep disturbance than endogenous factors. Future studies should explore how improvements in sleep functioning relate to neurocognitive outcomes, and whether cognitive performance varies as a function of sleep instability independent of mood instability. Support (if any) Support: Heinz C. Prechter Bipolar Research Fund at the University of Michigan Depression Center, the Department of Veterans Affairs (IK2-CX001501; PI: Boland), the VISN 4 MIRECC, and National Institute of Mental Health (K23MH118580; PI: Goldschmied).

778 Poor Sleep Quality is Associated with Reduced Myelination in Patients with Psychotic Disorders

Abstract Introduction Recent studies show that sleep favors oligodendrocyte proliferation and myelination, and sleep loss is associated with alterations in white matter structure and decreased myelination. Psychotic disorders are characterized by disrupted white matter integrity, and abnormal axon and myelin structure. Despite common sleep disturbances in these disorders, little is known about the relationship between sleep quality and white matter findings. A novel in vivo neuroimaging technique that combines diffusion tensor spectroscopy (DTS) and magnetization transfer ratio (MTR) allows separately examining the axon structure and glial function, and myelin content, respectively. Using this method, we examined the association of sleep quality with white matter biology in a sample of patients with psychotic disorders and matched healthy controls. Methods Participants included patients diagnosed with bipolar disorder with psychotic features (euthymic or depressed, n=12) and schizophrenia spectrum disorders (n=9), and age and sex matched healthy controls (n=20). DTS and MTR data was collected from the right prefrontal white matter at 4T. DTS measures included apparent diffusion coefficients of water, NAA, creatine and choline. Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI). Results PSQI total score was significantly higher in patients. and patient sample included a higher percentage of poor sleepers (PSQI total score&amp;gt;5). In patients, total PSQI score and sleep onset latency were significantly and negatively associated with MTR (F=6.9, p=0.02 and F=9.7, p=0.007, respectively). There was no difference in any DTS measures between groups. Conclusion Our preliminary results show that poor sleep quality is associated with decreased myelin content in the frontal lobe, in patients with psychotic disorders. This finding suggests that sleep loss may be a mediator of white matter alterations in psychosis. Support (if any) This work is supported by National Institute of Mental Health K23MH119322 to Cagri Yuksel

367 A sleep hygiene and relaxation training program after the Great East Japan Earthquake: What aspects of sleep could be improved?

Abstract Introduction After a natural disaster, the incidence of sleep difficulties tends to increase. Specifically, the prevalence of suspected insomnia was reported to have increased among disaster victims after the Great East Japan Earthquake of March 11, 2011. In a previous study, we have reported that education on sleep hygiene and relaxation training was effective in improving nighttime sleep in students of universities in Sendai city after the earthquake of March 2011. According to analyses of subscale scores of the Pittsburgh Sleep Quality Index (PSQI), the present study aimed to determine what aspects of sleep difficulties were successfully improved. Methods University undergraduates and graduates who reported having sleep difficulties were asked to respond to a questionnaire including the PSQI thrice, before attending a 90-min lecture on sleep hygiene and relaxation training, and a month and three months after attending the program. All participants who reported the total PSQI score of the cutoff point (6) or more were divided into two groups based on their PSQI scores before the program, that attending the course and that not attending it, that is, the “waiting list” group. Results The “attending” group exhibited a decrease in the total PSQI score in the first month after attending the program, and the score in this group reduced further three months later; Nine of twenty (45.0%) attending participants reported the score of less than 6 after a month, while only three of seventeen (17.6%) wait-list participants did. The PSQI subscale scores reported by the nine successful attending participants indicated a significant decrease in the subscale scores on subjective sleep quality, sleep latency, sleep duration, and sleep disturbance from before the program to one month later. Conclusion These results suggest that the short course on sleep hygiene and relaxation training intended for university students was effective, and about a half of the attended participants reported the PSQI score of less than the PSQI cutoff score one month later. This substantial effect would be mainly based on the improvement of their subjective sleep quality, latency, duration, and disturbance. Support (if any) This study was supported by a research grant from the Japanese Psychological Association, Tokyo, Japan.

321 Subjective Sleep and NEO Five Factor Personality Domains in Individuals with Primary Insomnia Compared to Good Sleeper Controls

Abstract Introduction Insomnia is a common sleep disorder in adults. Primary Insomnia (PI) can be specified in cases where the insomnia symptoms cannot be overtly attributed to medical, psychiatric, or environmental reasons. Although the underlying predisposing causes of insomnia are unclear, one possible contributing factor may be personality traits. To date no consensus on the relationship between insomnia and personality has been determined, although many studies have found a general association with neuroticism. To better explore these associations, this study compared NEO Five Factor Model (FFM) personality traits with measures of subjective sleep in PIs and Good Sleeper (GS) controls. Methods Nine PI and nine GS matched for age, sex, and education were studied. Each participant was administered the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and NEO FFM. Participants also completed a sleep diary for 1-week. ANOVAs compared PI vs GS on ISI, PSQI, NEO FFM, and 7-day averaged data from the sleep diary. Lastly, sleep variables were collapsed across groups and Pearson correlations were run to explore the relationship between sleep and personality. Results PIs (4M/5F, age=39.6+/-10.1, education=16.0+/-1.7) and GSs (4M/5F, age=38.6+/-7, education=15.1+/-1.5) showed significant differences in ISI (p&amp;lt;.001) and PSQI (p&amp;lt;.001) total scores. Additionally, the groups differed on diary measures of total sleep (p=.001), sleep efficiency (SE: p&amp;lt;.001), sleep latency (p=.005), and wake after sleep onset (p&amp;lt;.001). On the NEO FFM only the Agreeableness domain was found to differentiate the two groups (p=.004). Pearson correlations found significant negative relationships for Agreeableness with ISI (r= -.625/p=.006), PSQI (r= -.611/p=.007), and a significant positive relationship with SE from the sleep diary (r=.602/p=.008). Conclusion In a small but well-matched study of PI and GS, significant differences in Agreeableness on the NEO FFM were observed. Lower levels of agreeableness were associated with poorer sleep on the ISI and PSQI, and lower SE on the sleep diaries. Unlike other published reports this study did not find a relationship between insomnia and neuroticism, which may reflect the use of a well-screened Primary Insomnia sample with limited comorbidities. Future research should determine if other insomnia subtypes (e.g., psychophysiological, paradoxical insomnia) are associated with different personality profiles. Support (if any):

696 Quality of sleep is the only predictor of suicide during Covid-19 lockdown in University students?

IntroductionCOVID-19 epidemic led to great psychological and social stress, related to anxiety, depression, sleep disorders, suicidal risk and behavior, and changes in daily routine. The aim of this study was to assess the psychological impact of COVID-19 lockdown in Italian students. We focused on perceived sleep quality, anxiety and depression symptoms, and mostly on risk of suicide.MethodsA total of 307 students (mean age 22.84±2.68) completed Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II). In our study, we focused on item 9 of BDI-II, that is related to suicide. We divided our sample on presence or absence of suicidal ideation based on this item.ResultsWe found that 30.1% showed depressive, while 38.2% anxious symptoms. Concerning item 9 of BDI-II (suicidal thoughts or wishes), 84.7% answered that they do not have any thoughts of killing themselves, while 15.3% answered that they have some suicidal ideation. Concerning sleep variables, we found that 58% of our sample showed a PSQI total score higher than 5 (poor quality of sleep), and a global worsening in sleep quality and increase of insomnia both in student with and without suicidal ideation.ConclusionOur results on risk of suicide are in line with literature. Recent reviews focused on suicidal ideation in medical students found that depressive symptoms and suicidal ideation are common among medical students, finding a prevalence of suicidal ideation of 11%. Several studies suggest that sleep disorders are a risk factor for suicidal thoughts and behaviours. Our findings show that sleep cannot considered a predictive factor of risk of suicide during health emergency, because the risk is polyfactorial.Support (if any)None

Daytime Neuromuscular Electrical Therapy of Tongue Muscles in Improving Snoring in Individuals with Primary Snoring and Mild Obstructive Sleep Apnea.

Study Objectives: Evaluating daytime neuromuscular electrical training (NMES) of tongue muscles in individuals with Primary Snoring and Mild Obstructive Sleep Apnea (OSA). Methods: A multicenter prospective study was undertaken in patients with primary snoring and mild sleep apnea where daytime NMES (eXciteOSA® Signifier Medical Technologies Ltd., London W6 0LG, UK) was used for 20 min once daily for 6 weeks. Change in percentage time spent snoring was analyzed using a two-night sleep study before and after therapy. Participants and their bed partners completed sleep quality questionnaires: Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI), and the bed partners reported on the nighttime snoring using a Visual Analogue Scale (VAS). Results: Of 125 patients recruited, 115 patients completed the trial. Ninety percent of the study population had some reduction in objective snoring with the mean reduction in the study population of 41% (p < 0.001). Bed partner-reported snoring reduced significantly by 39% (p < 0.001). ESS and total PSQI scores reduced significantly (p < 0.001) as well as bed partner PSQI (p = 0.017). No serious adverse events were reported. Conclusions: Daytime NMES (eXciteOSA®) is demonstrated to be effective at reducing objective and subjective snoring. It is associated with effective improvement in patient and bed partner sleep quality and patient daytime somnolence. Both objective and subjective measures demonstrated a consistent improvement. Daytime NMES was well tolerated and had minimal transient side effects.

Sleep Quality and Physical Activity as Predictors of Mental Wellbeing Variance in Older Adults during COVID-19 Lockdown: ECLB COVID-19 International Online Survey.

Background. The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults. Methods. A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses “pre” and “during” the lockdown period. Participants responded to the Short Warwick–Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire. Results. Replies from older adults (aged >55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p < 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F(2, 514) = 66.41 p < 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p < 0.001, R2: 0.20). Conclusion. COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing.

The Association between Cardiorespiratory Fitness and Reported Physical Activity with Sleep Quality in Apparently Healthy Adults: A Cross-Sectional Study.

Background: Recently, poor cardiorespiratory fitness (CRF) has been postulated as an adverse health outcome related to poor sleep quality. However, studies investigating the relationship between CRF and a subjective sleep quality index are scarce. Thus, the current study aimed to investigate the association between CRF and the Pittsburgh Sleep Quality Index (PSQI) in apparently healthy people. The secondary aim was to investigate the association between reported physical activity (PA) and PSQI. Methods: Thirty-three healthy male participants volunteered to participate. CRF (VO2PEAK) was measured via cardiopulmonary exercise testing on a treadmill. A short form of the International Physical Activity Questionnaire (IPAQ) was used to measure PA, and PSQI was used for the sleep quality index. Results: There was no correlation between CRF and PSQI total score or any component of the PSQI. There was a significant inverse correlation between IPAQ and PSQI total score (r = −0.36, p = 0.04). Categorical data analysis of the two questionnaires revealed that 42.4% of the participants who reported low physical activity also had poor sleep quality. Conclusions: The current study showed no association between CRF and the subjective sleep quality index but demonstrated a moderate inverse association between reported PA and subjective sleep quality index. The findings suggest that the more reported PA, the better the overall sleep quality.

Pittsburgh Sleep Quality Index score predicts all-cause mortality in Chinese dialysis patients.

The relationship between Pittsburgh Sleep Quality Index (PSQI) score and survival of dialysis patients has not been well studied. The aim of this study was to explore the association between PSQI score and all-cause mortality in dialysis patients. Fifty-one hemodialysis and 58 peritoneal dialysis patients were enrolled in this study. PSQI score > 5 and ≤ 5 indicated "poor sleepers" and "good sleepers", respectively. The primary outcome was all-cause mortality. Kaplan-Meier survival curve and Cox proportional hazards regression analysis were performed. The median PSQI score was 7.0 (4.0-10.0). Sixty-seven (61.5%) patients had poor sleep quality (SQ). Compared with good sleepers, poor sleepers had significantly lower levels of hemoglobin [74.0 (61.0, 85.0) vs. 78.0 (68.0, 97.0), P = 0.03] and serum bicarbonate (18.0 ± 4.5 vs. 20.0 ± 3.7, P = 0.022). The follow-up time was 69.1 ± 29.9months. By multivariate Cox proportional hazards analysis, PSQI total score was the independent risk factor of all-cause mortality [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.05-1.36, P = 0.007]. Restricted cubic spline (RCS) analysis showed that 7 was the cutoff value at which the effect of PSQI score on mortality changed. Patients with a PSQI score > 7 had a 2.96-fold increased risk of all-cause mortality (HR 2.96, 95% CI 1.15-7.61, P = 0.025). PSQI score can be used as a predictor of all-cause mortality in dialysis patients, and those with PSQI > 7 were associated with increased odds of mortality.

Prevalence, Risk Factors, and Psychological Effects of Primary Nocturnal Enuresis in Chinese Young Adults.

PurposeThis study aimed to investigate the prevalence, risk factors, and effects of primary nocturnal enuresis (PNE) on physical and mental health in young adults in mainland China.MethodsAn anonymous questionnaire was used to collect information including the sociodemographic characteristics, history of PNE, family history, daytime voiding symptoms, Pittsburgh Sleep Quality Index (PSQI) scores, Self-Esteem Scale (SES), and Self-Rating Depression Scale (SDS). A total of 22,500 university students from 23 provinces and 368 cities in mainland China were included.ResultsIn total, 21,082 questionnaires were collected, and 20,345 of them qualified for statistical analysis. The PNE prevalence was 1.17%, and the distribution of monosymptomatic nocturnal enuresis (MNE) and nonmonosymptomatic nocturnal enuresis (NMNE) was 66.1% and 33.9%, respectively. In total, 28% of respondents with PNE reported bedwetting daily, 31.6% between 1 and 7 times weekly, and 40.4% between 1 and 4 times monthly; 80% of PNE cases had no history of treatment. The prevalence of PNE in patients with a family history, frequency, urgency, urinary incontinence, and recurrent urinary tract infections was significantly higher than in those without these conditions (P<0.001). PNE was significantly correlated with the PSQI total score (sleep quality) (P=0.011). The SES score was lower and the SDS was higher (P<0.001) in the PNE group than in those without PNE.ConclusionsIn mainland China, the PNE prevalence among young adults was found to be high, and PNE had significant effects on physical and mental health. Risk factors included a family history, daytime voiding symptoms, and lack of treatment.

Effect of acupuncture at Tiaoshen acupoints on hyperarousal state in chronic insomnia

To observe the clinical effect of acupuncture at Tiaoshen (regulating the spirit) acupoints on chronic insomnia and hyperarousal state, and explore its possible mechanism. A total of 60 patients with chronic insomnia were randomly divided into an acupuncture group (30 cases, 1 case dropped off) and a sham acupuncture group (30 cases, 1 cases dropped off). Both groups were given basic sleep health education. The acupuncture group was treated with acupuncture at Tiaoshen acupoints including Baihui (GV 20), Shenting (GV 24), Yintang (GV 29), Shenmen (HT 7) and Sanyinjiao (SP 6). The sham acupuncture group was treated with non-effective point shallow acupuncture. Both groups were treated once every other day, 3 times a week for 4 weeks. The Pittsburgh sleep quality index (PSQI) score, pre-sleep arousal scale (PSAS) score, hyperarousal scale (HAS) score, and serum gamma-aminobutyric acid (GABA) level before and after treatment were compared between the two groups. Compared before treatment, the sleep quality, time to fall asleep, sleep time, sleep efficiency, sleep disturbance, daytime dysfunction scores and total score of PSQI, various scores and total score of PSAS, and HAS score in the acupuncture group after treatment were decreased (P<0.05, P<0.01); in the sham acupuncture group, the time to fall asleep, daytime dysfunction scores and total score of PSQI, and cognitive arousal score of PSAS after treatment were decreased (P<0.05). After treatment, the sleep quality, time to fall asleep, sleep time, sleep efficiency, sleep disturbance, daytime dysfunction scores and total score of PSQI, various scores and total score of PSAS, and HAS score in the acupuncture group were lower than those in the sham acupuncture group (P<0.05, P<0.01). Compared before treatment, the serum GABA level in the acupuncture group were increased (P<0.05), and the serum GABA level in the acupuncture group was higher than that in the sham acupuncture group after treatment (P<0.05). Acupuncture at Tiaoshen acupoints can obviously improve the sleep and hyperarousal state of patients with chronic insomnia, and up-regulating serum GABA content is one of its possible mechanisms.

Exploring the Relationship Between Sleep Quality, Sleep-Related Biomarkers, and Motor Skill Acquisition Using Virtual Reality in People With Parkinson's Disease: A Pilot Study.

Background and Objectives: Despite the fact that sleep disturbances are among the most common and disabling manifestations of Parkinson's disease (PD), no study has investigated the effect of sleep quality and sleep-related biomarkers on motor skill acquisition in people with Parkinson's disease (PwPD).Objective: To examine the relationship between skill acquisition, sleep quality, and sleep-related biomarkers in PwPD using virtual reality (VR) system.Methods: This is a cross sectional study conducted on 31 PwPD and 31 healthy controls. To assess skill acquisition, each participant practiced a VR game 6 times (blocks). The main outcomes from the VR game were the required time to complete the VR game and the recorded errors. Motor skill acquisition was calculated as the difference of scores between block 6 and block 2 for both outcomes. Sleep was assessed subjectively using Pittsburgh Sleep Quality Index (PSQI) and objectively using the Actisleep. To assess sleep related biomarker, plasma serotonin level was examined.Results: PwPD and healthy controls demonstrated a practice-related improvement in performance as shown by the main effect of block for each of the VR outcome measures (p < 0.000, time required to complete VR game; p < 0.000, recorded errors). There was no interaction effect between Block X Group for both outcome measures. There were significant correlations in both groups (p < 0.05) between motor skill acquisition (as indicated by the difference of time required to complete the VR game between block 6 and block 2) and PSQI total score, wake after sleep onset, and sleep efficiency. Additionally, a significant correlation was observed in both groups between motor skill acquisition (as indicated by the difference of time required to complete the VR game between block 6 and block 2) and the plasma serotonin level (p < 0.05). These correlations in PwPD remained significant, even after adjusting for disease motor severity, cognitive status, depression, and daily dose of L-dopa.Discussion and Conclusions: Sleep quality may influence motor skill acquisition in PwPD. Healthcare professionals are encouraged to be aware about sleep quality and sleep assessment tools. Therapies may target improving sleep quality which could result in improving motor skill acquisition.

Evaluation of Sleep Quality in Patients with Multiple Sclerosis: A Case-Control Study

Background and Objective: Studies indicate that people with multiple sclerosis (MS) are at increased risk of sleep disorders and the resulting negative outcomes. The aim of this study was to evaluate sleep quality in patients with MS. Materials and Methods: In this case-control study, 110 patients with all confirmed types of MS as a case group and 110 healthy subjects as control group were evaluated in terms of sleep quality using Pittsburgh Sleep Quality Index (PSQI). The data collected was analyzed using t-test and chi-square tests. Results: Total score of PSQI was significantly higher in patients with MS than that of the control group (7.32 ± 2.78 vs. 5.30 ± 2.00, P = 0.001). Furthermore, PSQI scores of patients with MS was significantly higher than that of the control group in subscales including sleep latency (1.14 ± 0.99 vs 0.85 ± 0.91, P = 0.029), sleep duration (1.09 ± 0.80 vs. 0.83 ± 0.88, P = 0.048), habitual sleep efficiency (1.15 ± 0.92 vs. 0.85 ± 0.83, P = 0.017), sleep disturbance (1.25 ± 0.96 vs 0.96 ± 0.88, P = 0.013), use of sleep medication (0.69 ± 0.94 vs. 0.33 ± 0.65, P = 0.001), and daytime dysfunction (0.88 ± 0.93 vs. 32.2 ± 0.69, P = 0.001). Conclusion: Patients with MS had a significantly more improper sleep quality compared to the control group. So, poor sleep quality has a negative effect on daily activities and social communication of these patients and generally reduce their quality of life (QOL).

Sleep quality and mental health of medical workers during the coronavirus disease 2019 pandemic.

The purpose of this study is to assess the sleep quality, mental health status, and associated factors among medical workers during the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study was conducted and medical workers in Ningbo, China were recruited. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI). Mental health status was evaluated by Symptom Checklist 90 (SCL-90). Logistic regression and generalized multi-factor dimensionality reduction (GMDR) analysis were utilized to explore the risk factors and their interactions on sleep quality and mental health status. 207 participants were surveyed, and 34.30% were found with poor sleep quality (total PSQI score > 10), mainly manifested as sleep disturbance (92.75%). 27.05% were found with mental symptoms (Global severity index > 1.50), mainly manifested as obsessive–compulsive (25.60%). Multivariate logistic analysis showed that male (OR 3.89, 95% CI 1.06–14.24, P = 0.04), working years > 15 years (OR 4.51, 95% CI 1.56–13.00, P = 0.01), nurse (OR 5.64, 95% CI 1.35–23.63, P = 0.02), more night shifts (OR 3.10, 95% CI 1.31–7.34, P = 0.01), and supporting Wuhan (OR 3.41, 95% CI 1.12–10.40, P = 0.03) were associated with poor sleep quality. GMDR analysis showed that there was a two-factor interaction between working years and working shifts (P = 0.01). No significant factors and interactions were found associated with mental symptoms. In conclusions, about one-third of medical workers suffered from sleep and mental problems during the COVID-19 pandemic in the current study. Interventions for sleep and mental problems among medical workers were needed based on related factors.

Effect of Tai Chi on depression symptoms and sleep quality among older adult women after exercise cessation

ABSTRACT This study investigated the effects of Tai Chi exercise on the psychological health and sleep quality of older adult women after exercise cessation. Nineteen Tai Chi practitioners and 20 controls completed the final tests. All participants completed the Profile of Mood States (POMS) and the Pittsburgh Sleep Quality Index (PSQI) at 0, 24 and 28 weeks (4 weeks after Tai Chi cessation). Compared with baseline, the fatigue, depression, total mood disturbance and PSQI scores in the Tai Chi group decreased at week 24 by 18.8%, 24.7%, 5.7% and 24.6%, and the vigour score increased by 18.3%. At week 28, depression and PSQI scores in the Tai Chi group decreased by 24.0% and 20.4%, respectively. Practicing Tai Chi for 24 weeks positively affected fatigue, depression, vigour and sleep quality among older adult women. The effect on reducing depression and improving sleep quality was sustained 4 weeks after Tai Chi was stopped.

Evaluation of psychological status of 82 patients with rectal cancer after operation in Wuhan epidemic area of COVID‑19 and the value of WeChat follow‑up by doctors

Objective: To investigate the postoperative psychological status of rectal cancer patients during the outbreak of coronavirus disease 2019 (COVID‑19) epidemic in Wuhan, and to evaluate the outcomes of WeChat follow‑up. Methods: A total of 41 patients with rectal cancer after operation were included into observation group and were followed up by doctors through WeChat, and another 41 postoperative cases without WeChat follow⁃up were set as control group. The Symptom Checklist 90 (SCL‑90), Self‑Rating Depression Scale (SDS), Self‑Rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) were adopted to evaluate all the patients' postoperative psychological status before discharge from hospital and two months later. Results: After two months, the scores of SCL‑90, SAS, and SDS, respectively,of all patients showed significantly changes (t=1.487, 1.203, and 1.578, respectively, all P 0.05), but the total scores of PSQI in observation group showed a significant decrease after two months' WeChat follow⁃up and were lower than in control group (t=8.369, P<0.05). Conclusion: During the outbreaking of COVID⁃19 epidemic in Wuhan, the scores of SCL‑90, SAS, and SDS in the post⁃operative patients were all decreased, but the total scores of PSQI in WeChat follow‑up group was significantly lower than that in the control group. Doctors' active WeChat follow‑up on patients can alleviate their fear, anxiety, depression, and especially, and improve their sleep quality. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.

Restless leg syndrome in adult patients with β-thalassemia major.

To investigate the quality of sleep and the presence of Restless Legs Syndrome (RLS) in the Turkish population with β-thalassemia major (TM). The second aim was to assess the risk factors of RLS in TM adults. The study sample comprised of 121 patients at least 18 years old with TM. The patients' socio-demographic information, body mass indexes (BMI), current medications, laboratory data were recorded. The patients were asked if they had a history of chronic kidney disease, diabetes mellitus (DM), and polyneuropathy. Restless legs syndrome was diagnosed according to the International Restless Legs Syndrome Study Group criteria. The sleep quality of the patients was assessed using the Pittsburgh Sleep Quality Index (PSQI) scale. The Epworth Sleepiness Scale (ESS) was used to assess excessive daytime sleepiness in the patients. The median age of the patients was 25 years (range 18-52). The mean BMI was 21.49±2.5 (R 14-26.5) for all patients. The prevalence of RLS was 5% in TM adult patients. The TM patients with RLS had no major complications of TM. The median PSQI global score of all patients was 3. Twenty-two (18.1%) patients had poor sleep quality. The reason for poor sleep quality was RLS symptoms in four patients (18%). There was no significant association between PSQI total score and blood parameters of the patients. Twelve (9.9%) patients had ESS scores greater than 10, which indicates excessive daytime sleepiness. The prevalence of RLS in TM patients was similar to that of the general Turkish adult population. These results indicate that RLS may occur in patients with TM, although they had a high level of serum ferritin.

Status quo and correlation study of sleep quality and social support of frontline medical workers fighting COVID-19 in Wuhan.

Objective To understand the status quo of sleep quality and social support of medical staffs in Wuhan who fighting against the epidemic of novel coronavirus pneumonia(COVID-19),and explore the relationship between them. Methods A total of 135 medical staffs were investigated by the cluster sampling method. The Pittsburgh sleep quality index (PSQI),social support rating scale(SSRS) and self-designed demographic information questionnaire were used to investigate the 135 first-line medical staffs. Results The total score of social support was (41. 85 ± 7. 76 ) scores, the highest score was subjective social support [(22. 87±3. 99)scores],and the lowest was utilization [(7. 92 ±2. 04)scores];the total score of sleep quality was (8. 12±4. 17)scores, the highest score was sleep time [(1. 72±0. 92)scores], and the lowest was hypnotic drug [(O. 41± 0. 84) scores]. The total score of SSRS was negatively correlated with sleep quality in PSQI (r = —0. 222,P <0. 05) ;the two dimensions of subjective social support and utilization in SSRS,and the total score of SSRS were positively correlated with daytime dysfunction in PSQI (r = 0. 245, O. 244, 0.279, P< 0. 05), the total score of PSQI was negatively correlated with utilization in SSRS (r = — 0. 234, P <0. 05). Conclusion Social support of the medical staffs in Wuhan has an impact on their sleep quality. (English) [ABSTRACT FROM AUTHOR] 目的 了解武汉抗疫一线医护人员睡眠质量和社会支持的现状并探索两者之间的关系。方法 采用整群抽样法,应用匹兹堡睡眠指数量表(PSQI)、社会支持量表(SSRS)、自制一般情况调查表对135名抗 击新型冠状病毒肺炎(COVID-19)的临床一线医护人员的睡眠质量进行调查。结果 武汉抗疫一线医护人员 社会支持总分为(41.85±7.76)分,各维度中得分最高的是主观社会支持[(22.87±3.99)分],最低的是利用度 [(7.92±2.04)分];睡眠质量总分为(8.12±4.17)分,各维度中得分最高的是睡眠时间[(1.72±0.92)分],最 低的是催眠药物[(0.41±0.84)分]。SSRS总分与PSQI中的睡眠质量维度呈显著负相关(r=-0.222,P < 0.05);SSRS中的主观社会支持、利用度等2个维度及SSRS总分与PSQI中的日间功能障碍维度呈显著正相 关(r=0.245、0.244、0.279,P <0.05),PSQI总分与SSRS的利用度维度呈显著负相关(r=-0.234,P < 0.05)。结论 武汉抗疫一线医护人员的社会支持对其睡眠质量有影响。 (Chinese) [ABSTRACT FROM AUTHOR] Copyright of Journal of Modern Medicine & Health is the property of Journal of Modern Medicine & Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)