Total Hours Of Sleep Research Articles

A retrospective study of 5S behaviours of Physical Activity (PA) among suburban Mumbai population with Type 2 Diabetes Mellitus (T2DM)

ABSTRACT Background: T2DM is a chronic metabolic disorder to manage the same lifestyle modification is cornerstone. In 2022, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published a consensus report targeting the management of Type 2 Diabetes Mellitus (T2DM), which emphasised the importance of regular aerobic and resistance exercise. Both forms of physical activity (PA) can improve blood glucose, HbA1C levels, flexibility and balance. The ADA and EASD has categorised PA behaviours into 5 S. The 5 S stands for:- Sitting, Stepping, Sleep Sweating, Strengthening. The current study aims at auditing these 5S behaviours in suburban Mumbai population with its impact on HbA1C and body mass index (BMI). Methodology: A Retrospective, questionnaire-based study was conducted in the Endocrinology outpatient department of tertiary care institute in Mumbai suburban district. The demographic details, anthropometric measurements, HbA1C levels, sleep cycle and daily PA schedule including the 5S behaviours were recorded. The data generated was then statistically analysed using the IBM SPSS software v. 23. Results: The study included a total of 356 T2DM participants. Prolong sitting had a statistically significant correlation with BMI (P value = 0.003) and HbA1c levels (P value = 0.001), similarly strength training had a positive correlation with HbA1c (P value = 0.048) as well as with total sleep hours (P value < 0.0001). Behaviour like drowsiness was positively correlated with changing shift duty. Additionally, in the present study, it was also observed that more than half of the study population (55.8%) did not track their daily steps. Conclusion: The findings of the present study emphasize the importance of reducing sedentary time, promoting strength training and enhancing sleep quality in T2DM management. Targeted interventions in these areas can help improve health outcomes and quality of life for T2DM patients.

Psychometric evaluation of the Chinese version of the hospital-acquired insomnia scale (HAIS) and analysis of influencing factors

BackgroundAdequate sleep and rest are essential for patient recovery; however, lack of sleep has become a common problem faced by Chinese patients during hospital stays. Reduced sleep is often associated with a higher risk of disease progression and is strongly associated with increased hospital stay. However, there is no specific tool in China to assess short-term insomnia caused by hospitalization. This study aimed to translate the Hospital-acquired Insomnia Scale (HAIS) into Chinese, test its applicability to Chinese inpatients through reliability and validity indicators, and investigate the potential influencing factors of hospital-acquired insomnia.MethodsPsychometric analysis from a sample of 679 hospitalized patients to whom the HAIS questionnaire was applied. The structural validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity of the scale was assessed using the content validity index. Cronbach’s alpha coefficient, split-half reliability and test–retest reliability were calculated to evaluate the internal consistency of the scale. Multiple stepwise linear regression analysis was conducted to determine the potential correlates of hospital-acquired insomnia.ResultsEFA supported a four-factor structure with factor loadings for all dimensions greater than 0.40. CFA showed good indicators of model fit. The content validity index of the scale was 0.94. the Cronbach’s alpha of the scale was 0.915, the split-half reliability coefficient was 0.819, and the retest reliability was 0.844. Gender, age, total hours of sleep during the night, medical insurance, length of hospital stay, perceived stress level, and perceptions about sleep explained 46.2% of the variance in hospital-acquired insomnia.ConclusionThe Chinese version of HAIS has good psychometric characteristics and is an effective instrument for evaluating hospital-acquired insomnia. In addition, hospital-acquired insomnia is more common in women, of younger age, less than 5 h of sleep a night, without medical insurance, stressed, and patients with more misconceptions about sleep.

Associations Between Sleep And Cognition Among Middle-Aged And Older Adults In Europe

Abstract Background The Survey of Health, Ageing and Retirement in Europe (SHARE) is a supranational longitudinal study of community-dwelling middle-aged and older adults involving 29 countries, including all continental members of the European Union. We analysed wave 8 of SHARE (2019/2020) for associations between sleep and cognition. Methods The previously validated SHARE Cognitive Instrument (SHARE-Cog), which includes 10-word registration, verbal fluency and 10-word recall, was used to assess cognition. Together with data on impairment in activities of daily living and subjective perception of cognition, participants were divided into four groups: dementia, mild cognitive impairment (MCI), subjective memory complaint (SMC), normal cognition (NC). Survey-weighted generalised linear regression models were used to compare groups. To analyse the association between sleep duration and cognition, total hours of sleep was plotted on the x-axis and mean SHARE-Cog score on the y-axis. Results 29,450 were included (55% female; mean age 68.27), categorised as: Dementia 4%, MCI 9%, SMC 14% and NC 73%. A characteristic ‘inverted U’ shaped association was observed between sleep duration and cognition. Compared to optimal sleep duration of seven hours, mean SHARE-Cog scores declined progressively with more or less sleep. Those with cognitive impairment were significantly more likely to report recent trouble sleeping: Dementia 47%; MCI 43%; SMC 46%; NC 30% (p <0.001). Cognitive impairment was also significantly associated with increased use of medication to aid sleep (Dementia 17%; MCI 13%; SMC 8%; NC 4%, p <0.001) and with daytime napping or resting (Dementia 72%; MCI 60%; SMC 45%; NC 41%, p <0.001). Conclusion This analysis of a large population-based study confirmed an ‘inverted-U’ shaped association between sleep duration and cognition. Cognitive impairment was also significantly associated with increased reports of recent trouble sleeping, increased use of medication to aid sleep, and increased daytime napping or resting.

Impact of COVID-19 lockdown on sleep patterns and the related problems among nursing students.

To evaluate the impact of the COVID-19 lockdown on sleep patterns and quality among nursing students in our college. A cross-sectional study was carried out. A total of 302 nursing students aged 18-25 years, representing both genders and various academic levels, participated in this study. A pre-validated, self-administered questionnaire was used to assess sleep quality during COVID-19 and it was distributed through various social media platforms for data collection. Female students comprised the majority (92.1%) of participants. Of 332 nursing students, 302 completed the questionnaire, yielding a 91% response rate. Statistically significant differences were observed before and during the COVID-19 lockdown regarding the need to sleep after waking, feeling refreshed upon waking, satisfaction with individual sleep patterns and experiencing restless and troubled sleep (p = 0.001). Additionally, approximately one-third of nursing students (32.9%) reported poor sleep quality during the COVID-19 pandemic, with minimal impact on the total sleep hours among the studied cohorts. The COVID-19 pandemic has statistically significant impacted nursing students' sleep quality and levels. Acknowledging these challenges and planning for providing supporting measurements is essential to ensuring that nursing students can maintain their physical and mental health, which is critical for their ability to provide quality healthcare.

Sleep quality and mental disorder symptoms among correctional workers in Ontario, Canada

Correctional workers (CWs) report high levels of work stressors, frequent exposures to potentially psychologically traumatic events (PPTEs), and substantial mental health challenges. There is evidence of associations between sleep disturbances and diverse mental health challenges, including preliminary evidence from public safety personnel; however, replications and extensions would better inform interventions to support mental health. The current study was designed to examine associations between quality of sleep, work stress, and mental health disorders in a sample of diverse CWs employed in a provincial correctional service in Ontario, Canada. Data were analyzed from 943 CWs who participated in the cross-sectional, web-based Ontario Provincial Correctional Worker Mental Health and Well-Being Study conducted from December 2017 to June 2018. Sleep quality indicators included symptoms of insomnia, total hours of sleep per night on work nights and off-shift nights, number of days feeling rested per week, and overall sleep quality. Descriptive statistics, analyses of variance, correlational analyses, and logistic regression were used to examine relationships among sleep quality, stress of shift work, and mental health disorder symptoms. CWs slept an average of 6.0 h per night when working and 7.2 h during off-shift nights. CWs reported waking up feeling rested an average of 2.6 days per week and rated their overall quality of sleep in the fair to poor range. Many CWs (64.9%) screened positive for clinically significant symptoms of insomnia. There were also differences across occupational groups such that CWs working as correctional officers reported the most sleep problems. There were statistically significant relationships between insomnia and mental health disorder symptoms. Higher levels of stress from shift work were associated with worse sleep quality. CWs, especially those working as correctional officers in a provincial prison, reported many indicators consistent with poorer quality of sleep. Poor quality of sleep was also associated with work stress and mental health disorders.

Sleep duration, napping behaviors and restless legs syndrome during pregnancy and the trajectories of ultrasonographic measures of fetal growth: Findings from the NICHD Fetal Growth Studies–Singletons

ObjectivesGiven the plausible mechanisms and the lacking of empirical evidence, the study aims to investigate how gestational sleep behaviors and the development of sleep disorders, such as restless legs syndrome, influence ultrasonographic measures of fetal growth. MethodsThe study included 2457 pregnant women from the NICHD Fetal Growth Studies - Singletons (2009-2013), who were recruited between 8-13 gestational weeks and followed up to five times during pregnancy. Women were categorized into six groups based on their total sleep hours and napping frequency. The trajectory of estimated fetal weight from 10-40weeks was derived from three ultrasonographic measures. Linear mixed effect models were applied to model the estimated fetal weight in relation to self-reported sleep-napping behaviors and restless legs syndrome status, adjusting for age, race and ethnicity, education, parity, prepregnancy body mass index category, infant sex, and prepregnancy sleep-napping behavior. ResultsFrom enrollment to near delivery, pregnant women’s total sleep duration and nap frequency declined and restless legs syndrome symptoms frequency increased generally. No significant differences in estimated fetal weight were observed by sleep-napping group or by restless legs syndrome status. Results remained similar in sensitivity analyses and stratified analyses by women’s prepregnancy body mass index category (normal vs. overweight/obese) or by infant sex. ConclusionsOur data indicate that there is no association between sleep during pregnancy—assessed as total sleep duration and napping frequency, nor restless legs syndrome symptoms—and fetal growth from weeks 10 to 40 in healthy pregnant women.

Sleep characteristics and changes in sleep patterns among infants in Bhaktapur, Nepal

ObjectiveSleep undergoes major changes during the first year of life, but the characteristics of sleep among infants in low and middle-income countries are not well documented. This study describes sleep characteristics and changes in sleep patterns in infants at 6 and 12months of age from Bhaktapur, Nepal. MethodsThis was a community-based longitudinal study comprising 735 infants. Sleep characteristics were obtained by interview with the mother using the Brief Infant Sleep Questionnaires. The stability of sleep duration and night awakenings were estimated by logistic regression analysis. ResultsCosleeping in the parent’s bed at 6 and 12months of age was almost universal (>97%). At 6months of age, 254 (35%) and at 12months of age, 341 (46%) infants had a total 24-hour sleep duration <12 hours. Night awakenings >3 times per night were common (65%) both at 6 and 12months of age. Infants with frequent nightly awakenings at 6months had increased odds of frequent nightly awakenings at 12months (OR=2.2; 95% CI: 1.6, 2.9). Very few (<3%) mothers reported sleep problems in their infants at 6 and 12months of age. ConclusionsCosleeping was almost universal among Nepalese infants, and very few of the mothers reported sleep problems in their infants. Infants at 6 and 12months had similar patterns for both sleep duration and nocturnal awakenings. For infants, there were increased odds of having similar sleep duration and nocturnal awakening at 6 and 12months.

Food sufficiency status and sleep outcomes in older adults: the National Health and Aging Trends Study (NHATS)

BackgroundStudies investigating the relationship between food insecurity and sleep among older populations are limited. This study aimed to cross-sectionally examine the associations between food sufficiency status and sleep outcomes in a nationally representative sample of older adults.MethodsOur study included 1,665 older adults (≥ 65 years), using data from the 2013 and 2014 National Health and Aging Trends Study (NHATS). Food insufficiency was determined via participants’ experience and utilization of food assistance programs (FAP). Sleep outcomes, including nighttime and total sleep hours, sleep latency, and sleep quality, were derived from self-reported data. Multivariable linear regression and logistic regression models were used to estimate the associations between food sufficiency status and sleep outcomes.ResultsIn 2013–2014, 86.1% of older adults were classified as food sufficient without FAP, 9.85% as food sufficient with FAP, and 4.08% as food insufficient. Adjusting for sociodemographic characteristics, food sufficient older adults with FAP reported more total sleep hours (\U0001d6fd = 0.31, 95% CI: -0.02, 0.64) than those participants who are food sufficient without FAP. Further adjusting for health factors, food sufficient participants with FAP had more nighttime sleep hours and greater total sleep hours compared to those participants food sufficient without FAP. Compared to those deemed as food sufficient without FAP, food sufficient participants with FAP had lower odds of having longer sleep latency (OR = 0.50, 95% CI: 0.28, 0.89), after further adjusting for physical function performance.ConclusionsAmong older adults, food sufficiency with FAP is associated with greater total sleep hours, greater nighttime sleep hours, and lower odds of longer sleep latency. Our findings may help inform nutrition food assistance programs targeting older populations.

The indirect relationship between sleep and cognition in the PREVENT cohort: identifying targets for intervention

IntroductionAs the global population ages, the economic, societal, and personal burdens associated with worsening cognition and dementia onset are growing. It is therefore becoming ever more critical to understand the factors associated with cognitive decline. One such factor is sleep. Adequate sleep has been shown to maintain cognitive function and protect against the onset of chronic disease, whereas sleep deprivation has been linked to cognitive impairment and the onset of depression and dementia.ObjectivesHere, we aim to identify and explore mechanistic links between several sleep parameters, depressive symptoms and cognition in a cohort of middle-aged adults.MethodsWe investigated data from the PREVENT dementia programme via structural equation modeling to illustrate links between predictor variables, moderator variables, and two cognitive constructs (i.e., Executive Function and Memory).ResultsOur model demonstrated that sleep quality, and total hours of sleep were related to participants' depressive symptoms, and that, participant apathy was related to higher scores on the Epworth Sleepiness and Lausanne NoSAS Scales. Subsequently, depressive symptoms, but not sleep or apathy ratings, were associated with Executive Function.ConclusionsWe provide evidence for an indirect relationship between sleep and cognition mediated by depressive symptoms in a middle-aged population. Our results provide a base from which cognition, dementia onset, and potential points of intervention, may be better understood.

12 Measuring effort on a continuum provides improved insight into concussion baseline cognitive assessments

Objective:Baseline assessment of cognitive performance is common practice under many concussion management protocols and is required for collegiate athletes by the NCAA. The purpose of baseline cognitive assessment is to understand an athlete’s individual uninjured cognitive performance, as opposed to using population normative data. This baseline can then serve as a reference point for recovery after concussion and can inform return-to-play decisions. However, multiple factors, including lack of effort, can contribute to misrepresentation of baseline results which raises concern for reliability during return-to-play decision-making. Measuring effort across a continuum, rather than as a dichotomous variable (good versus poor effort) may provide informative insight related to cognitive performance at baseline.Participants and Methods:Collegiate athletes (n = 231) completed the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) as part of their baseline pre-participation concussion evaluation. ImPACT creates composite scores of Verbal Memory, Visual Memory, Visual-Motor Speed, and Reaction Time. Baseline self-reported symptoms and total hours of sleep the night prior to testing are also collected through ImPACT. ImPACT has one embedded indicator within the program to assess effort, and research has identified an additional three embedded indicators. Athletes were also administered one stand-alone performance validity test, either the Medical Symptom Validity Test (n = 130) or the Rey Dot Counting Test (n = 101), to independently measure effort. Effort was estimated across a continuum (zero, one, two, or three or more failed effort indicators) with both stand-alone and embedded effort indicators. We evaluated the relationship between effort, symptoms, self-reported sleep, Reaction Time composite score and Visual-Motor Speed composite score using a linear regression model.Results:We found that 121 athletes passed all effort indicators, while 39 athletes failed only one effort indicator, 40 athletes failed two effort indicators, and 31 athletes failed three or four (three+) effort indicators. Self-reported symptoms and total hours of sleep were not related to effort, but Reaction Time and VisualMotor Speed composites were. Specifically, performance on the Visual-Motor Speed composite was significantly worse for athletes who failed two or three+ effort indicators compared to athletes who did not fail any, and performance on the Reaction Time composite was significantly worse only for athletes who failed three+ effort indicators. Additionally, athletes who failed one or more effort indicators and reported less sleep performed worse on both the Visual-Motor Speed and Reaction Time composites, compared to those who reported less sleep and did not fail any effort indicators.Conclusions:Athletes who failed one effort indicator did not perform significantly worse on Reaction Time and Visual-Motor Speed composites compared to those who passed all effort indicators. However, 31% of athletes failed two or more effort indicators and these athletes performed worse on cognitive tests, likely due to factors impacting their ability to put forth good effort. These results suggest that effort is more complex than a previously used dichotomous variable and highlights the importance of using several indicators of effort throughout baseline assessments. In addition, the importance of sleep should be emphasized during baseline assessments, especially when effort is questionable.

Doctors’ alertness, contentedness and calmness before and after night shifts: a latent profile analysis

BackgroundWhile night shifts are crucial for patient care, they threaten doctors’ well-being and performance. Knowledge of how the impact of night shifts differs for doctors is needed to attenuate the adverse effects of night shifts. This study aimed to obtain more precise insight into doctors’ feelings surrounding night shift by: identifying profiles based on doctors’ alertness, contentedness and calmness scores before and after night shifts (research question (RQ) 1); assessing how doctors’ pre- and post-shift profiles change (RQ2); and determining associations of doctors’ demographics and shift circumstances with alertness, contentedness and calmness change (RQ3).MethodsLatent Profile Analysis using doctors’ pre- and post-shift self-rated alertness, contentedness and calmness scores was employed to identify pre- and post-shift profiles (RQ1). A cross-tabulation revealed pre- and post-shift profile changes (RQ2). Multiple regressions determined associations of demographics (i.e. age, sex, specialty) and night shift circumstances (i.e. hours worked pre-call, hours awake pre-call, shift duration, number of consecutive shifts, total hours of sleep) with alertness, contentedness and calmness change (RQ3).ResultsIn total, 211 doctors participated with a mean age of 39.8 ± 10 years; 47.4% was male. The participants included consultants (46.4%) and trainees (53.6%) of the specialties surgery (64.5%) and obstetrics/gynaecology (35.5%). Three pre-shift (Indifferent, Ready, Engaged) and four post-shift profiles (Lethargic, Tired but satisfied, Excited, Mindful) were found. Most doctors changed from Ready to Tired but satisfied, with alertness reducing most. Age, specialty, sleep, shift duration and the number of consecutive shifts associated with alertness, contentedness and calmness changes.ConclusionsThe results provided nuanced insight into doctors’ feelings before and after night shifts. Future research may assess whether specific subgroups benefit from tailored interventions.

Online Learning and Its Short-term Impact on Digital Engagement and Digital-related Health Symptoms Amongst University Students During the COVID-19 Pandemic

Introduction: The COVID-19 pandemic has precipitated a rapid shift of learning and education from traditional means to digital platforms. This paper aims to examine the impact of online learning on digital engagement and digital-related health symptoms among university students one year into the coronavirus pandemic. Methods: Data was collected through a self-administered online questionnaire after ethical approval. The questionnaire was adapted from the previously published Lifestyle Study in Youth Questionnaire. Through the questionnaire, the perception of students toward online learning was probed and recorded. Digital engagement and digital-related health symptoms were compared before and during the COVID-19 lockdown. Results: The majority (97.5%) of respondents preferred face-to-face learning. The time spent on digital devices was 1.8 times higher during COVID-19 than before the COVID-19 lockdown (t-test = -18.86, p&lt;0.0001). The total hours of sleep were reduced during COVID-19 lockdown (0.6 hours lesser) (t-test = -3.92, p&lt;0.0001). The Wilcoxon Signed Ranks Test revealed significant changes in digital-related health symptoms (15 out of 17) due to the COVID-19 lockdown. Digital eye strain, dry eye syndrome, carpal tunnel syndrome, and upper quadrant postural and muscle strain emerged (p&lt;0.05). Conclusion: Most university students favoured face-to-face learning compared to online learning. There was a two-fold rise in digital engagement during the COVID-19 lockdown. As a result, it has seemed to translate into reduced sleeping hours. The short-term impact of the coronavirus pandemic on digital-related health symptoms amongst university students was apparent. The long-term effects require further investigations to facilitate fact-based decision-making.

110 Sleep After Discharge: A Cohort Study of Burn Participants in a Home-Based Virtual Rehabilitation Trial

Abstract Introduction Patients with major burns experience physiologic changes that can impact their recovery for months after hospital discharge. Little is known about sleep quantity and quality in the post-discharge period. Here, we report on actigraphy sleep data for participants enrolled in a prospective trial of home-based virtual rehabilitation. Methods We conducted a randomized controlled trial to evaluate the effect of home-based rehabilitation using Jintronix® modules and Kinect® motion sensor on adherence to therapy. In both intervention and control (usual care) groups, participants were provided a wrist actigraphy accelerometer device (Vivofit®) to wear for the 12-weeks intervention. Sleep data were retrieved remotely and analyzed. Actigraphy data were defined as complete and analyzable if participants had 5 out of 7 days of actigraphy wear and upload in a week. Average weekly sleep was calculated and reported by group assignment. Descriptive statistics were used for comparisons, with p&amp;lt; 0.05 deemed as significant. Results Forty-four participants were enrolled with a 1:1 group assignment. Mean age was 38.5 years (SD=14.8), mean TBSA was 15.6% and most were male (68%). Average sleep was well within healthy population norms, with little difference between intervention and controls (7.29 vs.7.20 hours respectively, p=0.25) in the 90 days after discharge. Participants in control group spent more time in light sleep (4.05 vs. 3.88 hours, p&amp;lt; 0.01). The percent deep sleep, however, was comparable to healthy population norms (2.92 and 2.75 respectively, p=0.25). Participants in the control group experienced a higher proportion of nights with sleep disturbances (0.75 vs. 0.70, p=0.006). Conclusions Remote wrist wearable-wearable actigraphy data provide an important glimpse into sleep duration and quality for burn injured individuals in the 12 weeks after hospital discharge. An encouraging finding was that total sleep and deep sleep proportion for this cohort were comparable to healthy population norms. Though intervention and control groups were similar in total sleep hours, there were important differences in sleep quality. Applicability of Research to Practice Remote data acquisition on post-discharge sleep is feasible.

Lithium levels and lifestyle in patients with bipolar disorder: a new tool for self-management

BackgroundPatients should get actively involved in the management of their illness. The aim of this study was to assess the influence of lifestyle factors, including sleep, diet, and physical activity, on lithium levels in patients with bipolar disorder.MethodsA multicenter study was performed. In total, 157 lithium measurements were done biweekly in a sample of 65 patients (35 women) over 6 weeks. Lifestyle, based on total sleep hours and physical activity, was assessed by actigraphy. Diet was evaluated using the Mediterranean Lifestyle Index (Medlife).Results35.4% of patients had a normal weight. The mean Medlife score was 14.5 (± 2.5) (moderate-good adherence to Mediterranean diet). BMI, daily dose of lithium and intensity of physical activity had a combined effect on lithium levels, after adjustment for other variables. Patients who practiced intense physical exercise, who took lower doses and had a higher BMI exhibited lower levels of lithium.ConclusionsHigher physical activity and BMI contribute to lower lithium levels. Patients should be made aware of these relationships to improve their perception of control and self-management. Lifestyle-based interventions contribute to establishing a more personalized medicine.

Temporal relationship between sleep duration and obesity among Chinese Han people and ethnic minorities

BackgroundNo studies have assessed the association between sleep duration and obesity in Chinese ethnic minorities. Whether the relationship between sleep duration and obesity is different between Chinese Han people and Chinese ethnic minorities remains unclear. The study aimed to explore the relationship between sleep duration and obesity among Chinese Han people and Chinese ethnic minorities.MethodsWe applied data from the Guizhou Population Health Cohort Study (GPHCS), which 9,280 participants were recruited in the baseline survey from 2010 to 2012, and 8,163 completed the follow-up survey from 2016 to 2020. A total of 5,096 participants (3,188 Han Chinese and 1,908 ethnic minorities) were included in the ultimate analysis. Information on sleep duration (total 24-hour sleep time), body mass index (BMI), and waist circumference (WC) was collected at the baseline and follow-up survey, respectively. Cross-lagged panel analyses were conducted to explore the temporal relationship between sleep duration and obesity for Han people and ethnic minorities.ResultsFor Han people, the results from cross-lagged panel analyses indicated that baseline sleep duration was significantly associated with follow-up BMI (βBMI = -0.041, 95% CIBMI: -0.072 ~ -0.009) and follow-up WC (βWC = -0.070, 95%CIWC: -0.103 ~ -0.038), but baseline BMI (βBMI = -0.016, 95% CIBMI: -0.050 ~ 0.018) and baseline WC (βWC = -0.019, 95% CIWC: -0.053 ~ 0.016) were not associated with follow-up sleep duration. In addition, the relationship between baseline sleep duration and follow-up BMI was gender-specific and significant only in the Han people female (βBMI = -0.047, 95% CIBMI: -0.090 ~ -0.003) but not in the Han people male (βBMI = -0.029, 95% CIBMI: -0.075 ~ 0.016). For ethnic minorities, the results indicated that there was no relationship between sleep duration and obesity at all, either from sleep duration to obesity (βBMI = 0.028, 95%CIBMI: -0.012 ~ 0.068; βWC = 0.020, 95%CIWC: -0.022 ~ 0.062), or from obesity to sleep duration (βBMI = -0.022, 95%CIBMI: -0.067 ~ 0.022; βWC = -0.042, 95%CIWC: -0.087 ~ 0.003).ConclusionThe relationship pattern between sleep duration and obesity across Han people and ethnic minorities is different. Future sleep-aimed overweight and obesity intervention should be conducted according to population characteristics.

Improving performance on night shift: a study of resident sleep strategies.

To identify sleep strategies of internal medicine residents transitioning to night shift and report their effect on performance. Residents logged hours of sleep and work starting 3 days prior to the first night shift and continuing through the next 8 days. Cohorts were defined by sleep logs and compared separately by transition strategy, total hours of sleep, amount of sleep occurring at work, weekend sleep schedule, and residency training year. Data from logs were entered into the Fatigue Avoidance Scheduling Tool to measure predicted Performance Effectiveness (PE) during each night shift. Twenty-three residents were evaluated. The Sleep Banking transition strategy (n = 2) had higher PE (mean = 88.6%) than all other sleep strategies combined (n = 21, mean = 80.9%; P = .016). Additionally, residents who slept an average of 8-9 hours daily during their week of night shifts had a higher mean PE compared to those who slept < 6 hours (86.8% vs 78.6%; P = .014). Residents who engaged in Sleep Banking prior to the first night shift had higher PE and spent less time above a 0.05% blood alcohol concentration equivalent compared to all other strategies. Similarly, PE and time spent above a 0.05% blood alcohol concentration equivalent improved with increased average hours slept per day during the week of night shifts. Optimizing performance on night shift through the adoption of efficacious sleep strategies is imperative to mitigate patient safety issues that may result from poor alertness and cognitive abilities. Cushman P, Scheuller HS, Cushman J, Markert RJ. Improving performance on night shift: a study of resident sleep strategies. J Clin Sleep Med. 2023;19(5):935-940.

Comparison between pericapsular nerve group block and morphine infusion in reducing pain of proximal femur fracture in the emergency department: A randomized controlled study

ABSTRACT Background This study aimed to assess the safety and efficacy of analgesia with pericapsular nerve group (PENG) block as an adjuvant to morphine infusion for the management of preoperative pain in patients with proximal femur fractures. Methods This single-blinded, parallel-group, randomized trial enrolled 36 adult patients with proximal femur fractures who were prepared for surgery. The patients were randomly allocated to two groups. In the PENG group, 18 patients received a US-guided PENG block as an adjuvant to patient-controlled morphine analgesia (PCA), while in the PCA group, 18 patients received PCA only. The primary outcome was the total morphine consumption in 24 hours before the surgery. The secondary outcomes included the visual analogue scale (VAS), need for rescue analgesia, total sleep hours, incidence of respiratory depression, hemodynamic stability, and incidence of nausea and vomiting during the first 24 hours post-procedure. Results The PENG block significantly decreased the total dose of morphine, VAS score at one-hour post-procedure, need for rescue analgesia, incidence of respiratory depression and nausea but increased the sleeping hours. Vomiting was comparable in the two groups (p = 0.121). Significantly higher mean arterial pressures from 8 to 20 hours after the block as well as heart rates immediately after the block were observed in the PENG group compared to the PCA group. Conclusion In patients with proximal femur fractures, preoperative PENG block can be used as an adjuvant to morphine infusion for controlling the pain and the total dose of morphine usage.

Topical Cannabidiol in the Treatment of Digital Ulcers in Patients with Scleroderma: Comparative Analysis and Literature Review

To explore the effect of topical cannabidiol (CBD) in treating digital ulcers in patients with systemic sclerosis (SSc). In total, 45 patients with SSc who had digital ulcers were consecutively enrolled between January 2019 and December 2019. Of the participants, 25 were treated with CBD during surgical debridement and 20 were treated with standard local therapy. A numeric rating scale for pain and Health Assessment Questionnaire Disability Index were administered at the baseline and at the end of treatment. Local treatment with CBD was significantly associated with lower pain scores, higher health assessment scores, and an increase in participants' total hours of sleep. Patients in the control group more frequently required additional analgesic therapy. Topical CBD may be a valuable tool to treat pain related to digital ulcers in patients with SSc.

PS-C34-13: LATE NIGHT EATING OR CIRCADIAN DISRUPTION COULD BE MORE DANGEROUS THAN OUR THINK FOR PATIENTS OF DIABETES WITH HYPERTENSION

Background: Our bodies function optimally when we align our eating &amp; sleeping patterns with our circadian rhythms, the innate 24-hour cycles that tell our bodies when to wake up, when to eat and when to fall asleep. Chronically disrupting this rhythm by eating late night meals &amp; sleep could be a recipe for Hypertension, CVD, and metabolic trouble. Aim &amp; Objective: The aim of this study is to investigate whether there was a relationship between morningness(MC) (110n) intermediate(IC) (100n) &amp; eveningness chronotype(EC) (35n) in T2DM. Methods: A total of 245 subjects age 18 to 60 years were recruited in Clinical OPD of General Medicine, KGMU. We have tested FBG &amp; PP level, lipid profile HbA1c, Insulin, Leptin and Cortisol level, 48 hours ABPM. Result: When we compared these 3 groups, Significant Different parameters found in FBG (P = 0.01) Postprandial (P = 0.03) HbA1c (P = 0.001) TG (P = 0.0001), Total Cholesterol (P = 0.01) &amp; VLDL (P = 0.005). It also shows the complete inversion of the cortisol level (0.003). Insulin, IL-1 beta &amp; IL-6 also show significant change in late night eating T2DM Patients. Systolic / Diastolic readings of ABPM shows significant change between MC and IC (0.005) but not b/w EC &amp; IC (0.007). And for reliability of sleep by actigraphy shows MC (6:15 + 1:35) &amp; EC (8:18 + 1:23) take complete sleep but IC total sleep hours (5:10 + 1:05) are very less. Disruption of Rev Erb &amp; Ror alpha gene expression is also a risk factor for Cardio metabolic Diseases in T2DM Patients. Conclusion: Eveniningness &amp; Intermediate Type Patients are more likely to have late night eaters &amp; are associated with greater risk of Metabolic Disorders like Blood Pressure Variability, Dyslipidemia, T2DM &amp; CVD.

Restriction of the family-centered care miracle by COVID-19: the role of the father in sleep disturbance of hospitalized pediatrics.

One of the important outcomes of hospitalization in infants with respiratory disease is sleep disturbance. This study was performed to investigate the role and participation of fathers in the sleep of hospitalized pediatrics with pneumonia during the COVID-19 pandemic. In this clinical trial study, the parents of 40 children aged from 12 to 36 months hospitalized with a diagnosis of pneumonia were randomly assigned to the control and intervention groups. After implementing a supportive training program for the fathers in the intervention group, each father made an online video communication with the infant and the mother as the primary caregiver. Mothers completed the brief infant sleep questionnaire-revised at the beginning and a week later. Data analysis showed that daytime sleep duration, setting time and total 24-hour sleep time in the intervention group improved compared to the control group. In addition, parents' behavior toward their child's sleep improved in the intervention group compared to the control group, but parents' perceptions of their child's sleep in the intervention group did not show a significant difference compared to the control group. The mean total score of the intervention group also improved compared to the control group. Planning to maintain family unity by educating and supporting fathers during the child's illness and their paternal support during the COVID-19 pandemic can improve the sleep of the hospitalized child due to pneumonia.