Variance In Sleep Quality Research Articles

PREDICTORS OF PSYCHOLOGICAL DISTRESS AND SLEEP QUALITY IN FORMER FAMILY CAREGIVERS OF PEOPLE WITH DEMENTIA

The detrimental effects of active caregiving on the health of caregivers has been examined, but less is known about caregiver health after caregiving ends. Research revealed stress-related health conditions diagnosed during caregiving failed to improve for many years post-caregiving. The purpose of this cross-sectional, correlational study was to examine the influence of caregiver personal variables (e.g. personality traits, coping strategies, pre-loss depression), environmental variables (e.g. length of nursing home placement, length of post-caregiving), and post-caregiving guilt on psychological health (e.g. depression, anxiety, sleep quality) in former family caregivers of people with dementia. A convenience sample of former dementia caregivers (N=171) completed a 147-item online survey, containing 6 standardized instruments and demographic questions. Using Richard Lazarus’ transactional theory of stress as a foundation, the relationships between post-caregiving guilt, personal and environmental variables, and psychological health were examined with Pearson correlation coefficients and hierarchical linear regression models. Post-caregiving guilt was moderately correlated with depression (r=.39) and anxiety (r=.34). After controlling for relevant covariates, use of dysfunctional coping strategies and neurotic personality explained 32% of the variance in depression and 24% of the variance in anxiety. Dysfunctional coping, pre-loss depression, and extraverted personality explained 17% of the variance in sleep quality. The study’s findings highlighted a prominent relationship between personal variables, guilt, and psychological health in former dementia caregivers. Implications for future research and practice include: further exploratory studies of associations between caregiver characteristics and post-caregiving health, and increasing health care providers’ awareness about risk factors for poor psychological health in this population.

Self-Reported Sleep Quality Modulates Amygdala Resting-State Functional Connectivity in Anxiety and Depression.

Sufficient sleep plays an important role in neurocognitive function, yet, problematic sleep is ubiquitous in the general population. It is also frequently predictive of, and concurrent with, internalizing psychopathologies (IPs) such as anxiety and depression suggesting sleep quality is dimensional and transdiagnostic. Along with problematic sleep, IPs are characterized by negative affectivity, therefore, prominent neurobiological models of internalizing conditions involve the amygdala, a region central to emotion. In resting-state studies (independent of sleep considerations), abnormalities in amygdala-frontal functional connectivity are commonly observed suggesting emotion dysregulation may contribute to clinically-relevant phenotypes. In a separate line of research, studies of sleep deprivation, and insomnia disorder suggest sleep loss may alter amygdala-frontal connectivity. Taken together, findings point to shared neurobiology between sleep and emotion systems, however, the impact of sleep quality on the amygdala circuit in anxiety or depression is unclear. Therefore, we evaluated variance in naturalistic sleep quality on amygdala-based circuity in individuals with and without psychiatric illness. Resting-state fMRI data was collected in 87 un-medicated, treatment-seeking adults diagnosed with a primary anxiety disorder (n = 68) or primary depressive disorder (n = 19) in addition to healthy individuals (n = 40). Regression analysis was conducted with bilateral anatomical amygdala as seed regions and self-reported sleep quality was indexed with a validated self-report measure, the Pittsburgh Sleep Quality Index (PSQI). Post-hoc analysis was performed to evaluate whether diagnostic status (primary anxiety, primary depression, healthy) significantly explained functional connectivity results. Whole-brain regression analysis, controlling for anxiety and depression symptoms, revealed worse sleep quality (i.e., higher PSQI total scores) predicted increased left amygdala-subgenual anterior cingulate functional connectivity and reduced connectivity with posterior cerebellar lobe and superior temporal gyrus. For right amygdala, increased coupling with postcentral gyrus corresponded with worse sleep. Post-hoc analysis did not detect a significant relationship between diagnostic status and whole-brain findings. Results expand on previous studies and indicate variance in sleep quality tracks brain pathways involved in cognitive-emotion functions implicated in the neurobiology of IPs that may extend to individuals at risk for clinical anxiety or depression. Altogether, the clinical relevance of identifying phenotypes to improve our understanding of psychopathology may be improved by incorporating sleep quality.

Variables associated with sleep quality in chronic tension-type headache: A cross-sectional and longitudinal design.

ObjectiveTo investigate variables associated at baseline (cross-sectional design) and at one year (longitudinal design) with the quality of sleep in chronic tension-type headache (CTTH).MethodsOne hundred and eighty (n = 180) and 135 individuals with CTTH participated in the cross-sectional and longitudinal design respectively. Clinical features were collected with a 4-weeks headache diary at baseline and one-year follow-up. Sleep quality was assessed at baseline and 1-year follow-up with the Pittsburgh Sleep Quality Index. Anxiety and depression (Hospital Anxiety and Depression Scale-HADS), burden of headache (Headache Disability Inventory-HDI), quality of life (SF-36 questionnaire), and pressure pain thresholds (PPTs) at trigeminal, extra-trigeminal and widespread area were assessed at baseline. Hierarchical regression analyses were conducted to determine the associations between variables at baseline and 1-year follow-up with sleep quality.ResultsAt baseline positive correlations between sleep quality and headache intensity, headache frequency, headache duration, emotional and physical burden of headache and depression were observed. The regression analyses found that depression and emotional burden of headache explained 27.5% of the variance in sleep quality at baseline (r2 = .262; F = 23.72 P < .001). At one-year, sleep quality was significantly associated with baseline burden of headache, depression, widespread PPTs, vitality and mental health domains. Regression analyses revealed that vitality, PPT over the second metacarpal and PPT over the neck explained 30.0% of the variance of sleep quality at one-year (r2 = .269, F = 9.71, P < .001).ConclusionsIt seems that sleep quality exhibits a complex interaction in individuals with CTTH since depression and the emotional burden were associated with sleep quality at baseline, but vitality and PPTs over extra-trigeminal areas were associated with the quality of sleep at one-year.

Factors Affecting Sleep Quality of Clinical Nurses Working in a Hospital

Purpose: The purpose of this study was to identify factors affecting sleep quality in nurses working in a tertiary hospital in Korea. Methods: The sample of two hundred and sixty three nurses was drawn from one tertiary care hospital in Korea. Using a descriptive study design, clinical nurses completed the standardized questionnaires, including sleep quality, depressive symptoms, and resilience. Descriptive statistics were computed to describe the sample and study variables. Logistic regression analyses were used to identify factors affecting sleep quality which was classified into two categories. Results: A total of 263 registered nurses participated in this study. Most of the participants were female (n=252, 95.8%) and single (n=148, 75.9%), with a mean age of 30.09±7.51 years. The average score of sleep quality was 8.57±3.24. Using a cut-off point of 5.0, 84.0% (n=221) were poor sleepers. After controlling for demographic and job-related variables, the depressive symptoms and resilience were associated with poor sleep quality among clinical nurses (Odds Ratio [OR]=4.56, 95% Confidence Interval [CI]=1.02~20.49; OR=0.97, 95% CI=0.94~0.99, respectively). This model explained 19.5% of the variance in sleep quality. Conclusion: The two factors reported to impact the quality of sleep were increased depressive symptoms and lower resilience levels. In order to improve nurses’ sleep quality, researchers and nursing administrators need to develop and provide some strategies for decreasing depressive symptoms and enhancing their resilience.

Gender differences in variables associated with sleep quality in chronic tension type headache

ABSTRACTWe aimed to evaluate gender differences in the relationships between headache features, sleep quality, anxiety, depressive symptoms, and burden of headache in 193 patients (73 percent women) with chronic tension type headache (CTTH). Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Headache features were collected with a four-week diary. The Hospital Anxiety and Depression Scale was used to assess anxiety/depressive symptoms. Headache Disability Inventory was used to evaluate the burden of headache. In men with CTTH, sleep quality was positive correlated with headache frequency (r = 0.310; p = .018), emotional (r = 0.518; p < .001) and physical (r = 0.468; p < .001) burden of headache, and depressive symptoms (r = 0.564; p < .001). In women, positive correlations were observed between sleep quality and headache intensity (r = 0.282; p < .001), headache frequency (r = 0.195; p = .021), emotional burden (r = 0.249; p = .004), and depressive symptoms (r = 0.382; p < .001). The results of stepwise regression analyses revealed that depressive symptoms and emotional burden of headache explained 37.2 percent of the variance in sleep quality in men (p < .001), whereas depressive symptoms and headache intensity explained 17.4 percent of the variance in sleep quality in women (p < .001) with CTTH. Gender differences associated with poor sleep should be considered for proper management of individuals with CTTH.

Perceived sleep quality: The interplay of neuroticism, affect, and hyperarousal

IntroductionMany adults experience poor sleep quality, and personality traits have emerged as important predictors of self-reported sleep. However, it is still unclear whether personality predicts sleep quality independent of other correlates, including mood, emotion regulation, and hyperarousal. Aims and methodThe aim of this study was twofold. First, using an online survey, we assessed the relationship between perceived sleep quality (defined here as the total score of the Pittsburgh Sleep Quality Index) and personality in 498 Italians (M age=26.6±7.4 years, 353 Female). Second, using multiple regressions, we investigated whether this association was independent of affect, emotion regulation strategies, and hyperarousal. ResultsResults replicate previous findings, showing that neuroticism is the best personality predictor of sleep quality in Italians. When examined separately, hyperarousal explained the most variance in sleep quality (R2=.18), followed by personality traits (R2=.12), affect (R2=.12), and emotion regulation strategies (R2=.01). However, when all predictors were entered into a single regression model (R2=.20), only agreeableness, positive affect, and hyperarousal remained statistically significant. ConclusionOverall, our data replicate the association between personality and perceived sleep quality in Italians, showing that neuroticism is the best predictor of worse sleep quality. Finally, we also demonstrate important roles for hyperarousal and positive affect, but not for emotion regulation strategies. Results have implications for applied research and interventions that may want to identify individuals at risk for poor sleep.

The Impact of Positive Psychological States in Predicting Sleep Quality Amongst Pregnant Women

Background: During pregnancy, due to special hormonal and physiological changes that occur in the body, sleep disorders are very prevalent; therefore, positive psychological states and emotions can have major impacts on overall sleep quality among pregnant women. Objectives: The aim of this study was to examine the effect of 15 positive psychological states (trust in God, optimism, a sense of efficacy, accepting responsibilities, a sense of control, purposefulness, hope, meaningfulness in life, life satisfaction, positive mood and happiness, being social, self-esteem and self-worth, a sense of peace, appreciation, and forgiveness) on predicting sleep quality among pregnant women. Materials and Methods: This descriptive study followed a correlational-predictive design. The statistical population of this study included all pregnant women referred to health care centers in Khash in the first half of 2015, which included 890 individuals. The sampling method was multistage cluster sampling. Overall, 268 questionnaires were distributed among pregnant women, who had the inclusion criteria of the current study, in order to be answer freely and voluntarily. Moreover, to collect data, two questionnaires including positive psychological states (PPS) and the Pittsburgh sleep quality index (PSQI) were used. Results: The results of the correlation coefficient indicated that optimism, purposefulness, hope, meaningfulness in life, life satisfaction, positive mood and happiness, a sense of peace, trust in God and forgiveness were significantly related to high sleep quality (P ≤ 0.01). However, sleep quality was not correlated with a sense of efficacy, accepting responsibilities, a sense of control, being social, and a sense of self-esteem and self-worth (P ≥ 0.05). Additionally, the results of stepwise regression analysis showed that positives mood, meaningfulness in life and hope together predicted 0.47 of the variance in sleep quality among pregnant women (P ≤ 0.01). Conclusions: Since psychological states and emotions have great impacts on sleep quality of pregnant women, paying attention to women’s psychological states and emotions, especially in the last trimester of pregnancy, seems essential.

An Empirical Investigation of a Biopsychosocial Model of Pain in Multiple Sclerosis.

Pain is a significant problem for many individuals with multiple sclerosis (MS). Pain is often associated with other MS symptoms (eg, physical, sensorimotor, cognitive declines), and both pain and MS symptoms are hypothesized to contribute to psychosocial problems (eg, depression), other symptoms (eg, fatigue, sleep disturbance), and functional impairments (eg, pain interference). On the basis of a biopsychosocial model, we sought to: (1) examine the associations between pain, MS symptoms, depression, psychosocial, and functional variables and (2) identify possible risk and protective factors associated with pain in MS. A cross-sectional survey was completed by 424 individuals with MS. Pain, MS symptoms, demographics, MS diagnostic factors, and psychosocial and functional variables were assessed. Data were analyzed by structural equation models. Participants were predominantly white (92%), middle-aged (mean=50.7 y), and female (80%). Results indicated that pain severity and depression accounted for >50% of the variance in pain interference. Although pain contributed minimally to fatigue and sleep quality, depression and MS symptoms predicted 49% of the variance in fatigue, and depression was largely responsible for the 40% of predicted variance in sleep quality. Identified risk factors for pain were low educational attainment and lack of a committed/marital relationship, even while controlling for diagnostic and other key demographic variables. Results highlight the importance of targeting interventions toward improving coping skills and social support within the context of pain and MS. Research is needed to determine whether effectively targeting depression in MS results in improvements of other critical psychosocial and physical functioning domains.

Mediator Effect of Sleep Hygiene Practices on Relationships Between Sleep Quality and Other Sleep-Related Factors in Chinese Mainland University Students

This study examined the mediator effect of sleep hygiene practices (SHP) on relationships between sleep quality and other sleep-related factors in Chinese mainland university students using structural equation modeling analysis. Of the 413 students, 41.4% had poor sleep quality. Gender, academic stress, relaxed psychological status, good physical status, and SHP had significant direct effects on sleep quality; relaxed psychological status had significant direct effect on SHP and indirect effect on sleep quality via SHP. The direct, indirect, and total effects of gender, academic stress, relaxed psychological status, good physical status, and SHP explained 25% of the variance in sleep quality. The Chinese mainland university students had relative poor sleep quality. SHP was a mediator between sleep quality and relaxed psychological status.

Factors affecting sleep in the critically ill: An observational study

PurposeThe aims of the current study were to describe the extrinsic and intrinsic factors affecting sleep in critically ill patients and to examine potential relationships with sleep quality. Materials and MethodsSleep was recorded using polysomnography (PSG) and self-reports collected in adult patients in intensive care. Sound and illuminance levels were recorded during sleep recording. Objective sleep quality was quantified using total sleep time divided by the number of sleep periods (PSG sleep period time ratio). A regression model was specified using the “PSG sleep period time ratio” as a dependent variable. ResultsSleep was highly fragmented. Patients rated noise and light as the most sleep disruptive. Continuous equivalent sound levels were 56 dB (A). Median daytime illuminance level was 74 lux, and nighttime levels were 1 lux. The regression model explained 25% of the variance in sleep quality (P = .027); the presence of an artificial airway was the only statistically significant predictor in the model (P = .007). ConclusionsThe presence of an artificial airway during sleep monitoring was the only significant predictor in the regression model and may suggest that although potentially uncomfortable, an artificial airway may actually promote sleep. This requires further investigation.

Effects of polypharmacy on sleep in psychiatric inpatients

The relationship between psychotropic drugs and sleep remains poorly understood. In this study, we examined the relationship between the number (and dosage) of concurrently-taken antipsychotic medications and sleep in a psychiatric inpatient population. Eighty-three long-stay inpatients with severe mental disorders were administered the Pittsburgh Sleep Quality Index questionnaire (PSQI). Results showed that increasing antipsychotics dosages were linked to better sleep, although antipsychotic medications only accounted for a relatively small amount of the variance in sleep quality. The results also showed that, when taken in combination with several antipsychotics, SSRI/SNRI antidepressants failed to show the expected disruptive effects on sleep patterns and daytime functions. Altogether, sleep complaints remained pervasive in 70% of this medicated clinical sample. This suggests that the use of the sedative properties of antipsychotic medication has limited efficacy as a treatment option for sleep dysfunctions, and is not an appropriate substitute for other sleep interventions. Altogether, the results support the case for more systematic screening and interventions for sleep problems in patients with severe psychiatric illness.

Sleep Quality and Sleep Hygiene Behaviors of Adolescents during Chemotherapy

Describe the self-reported sleep quality and sleep hygiene behaviors of adolescents before diagnosis and during chemotherapy (CTX), compare their sleep quality and sleep hygiene behaviors with published normative data for healthy adolescents and adolescents with chronic pain, and explore factors that predict sleep quality. Subjects were 51 adolescents (10 to 19 years) receiving CTX for cancer. A questionnaire was used to assess sleep patterns prior to the adolescent's cancer diagnosis, and a 7-day sleep diary was used to assess subjective sleep-wake activity during CTX. Sleep quality was assessed using the Adolescent Sleep Wake Scale, and sleep-facilitating and sleep-inhibiting behaviors using the Adolescent Sleep Hygiene Scale. Adolescents receiving CTX reported significantly worse sleep quality and sleep hygiene behaviors than healthy adolescents, and better sleep quality but similar sleep hygiene behaviors to adolescents with chronic pain. Significant interactions were found between bedtimes and wake-times on weekdays and weekends before diagnosis and during CTX. Sleep hygiene and demographic variables accounted for 24% of the variance in sleep quality. The cognitive and emotional subscales of the sleep hygiene scale and demographic variables accounted for 36% of the variance in sleep quality. Both the weekday and weekend sleep-wake patterns of adolescents receiving CTX resembled their weekend sleep patterns prior to diagnosis.

Associations among perceptions of social support, negative affect, and quality of sleep in caregivers and noncaregivers.

The authors used structural equation modeling to examine associations among perceptions of negative affect, social support, and quality of sleep in a sample of caregivers (n = 175) and noncaregiver control participants (n = 169). The authors hypothesized that caregiver status would be related to sleep quality directly and also indirectly by way of negative affect and social support. This hypothesis was partially supported in that caregiving was found to be indirectly related to sleep quality. However, after accounting for the indirect effects of negative affect and social support, the direct effect of caregiving on sleep quality was no longer statistically significant. The structural model accounted for approximately 43% of the variance in sleep quality. The present findings may be useful in the development of successful sleep interventions for caregivers.

Sleep in Parkinson's Disease: The Role of Depression and Anxiety

Sleep disorders are frequent and well documented in patients with Parkinson's disease (PD). The effect of depression and anxiety on sleep in PD patients has not been carefully studied however, despite the fact that both depression and anxiety are common in PD and well known to affect sleep in patients without PD. In this questionnaire study, sleep, anxiety, and depression were evaluated in 99 patients with PD and 47 control subjects. PD patients had significantly higher scores on a variety of sleep variables as well as on measures of anxiety and depression. While anxiety and depression were correlated with some sleep measures, neither contributed significantly to overall variance in sleep quality. The effect on sleep variables was dominated by on-off symptom phenomena, levodopa dose, and age.

Evidence for Genetic Influences on Sleep Disturbance and Sleep Pattern in Twins

The etiologic role of genotype and environment in sleep pattern (daytime napping, habitual bedtime, and sleep duration) and subjective sleep quality and sleep disturbance was examined using a general population sample of 3,810 adult Australian twin pairs, aged 17-88 years. Genetic differences accounted for at least 33% of the variance in sleep quality and sleep disturbance and 40% of the variance in sleep pattern. There was no evidence for a decline in the importance of genetic predisposition with age. Short-term environmental fluctuations accounted for as much as 30% of the variance, and more stable nonfamilial environmental effects accounted for the remainder. No effect of shared family environment on sleep characteristics was found.