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Abstract The impact of mobile phone addiction (MPA) on college students’ sleep quality (SQ) has received increasing attention in recent years. On this basis, the mediating roles of rumination and FOMO (fear of missing out) on MPA and SQ were examined in this study. In a cross-sectional study, preliminary data were gathered via questionnaires from 1401 college students (19.35 ± 0.81) from 5 universities in Jiangxi Province, China. Mobile Phone Addiction Tendency Scale, Rumination Response Scale, Fear of Missing Out Scale and Sleep Quality Scale were employed in the research. The mediation model was tested using SPSS 26.0, with FOMO and rumination acting as the mediating variables. Between MPA and SQ, rumination and FOMO each had their own unique mediation effect. Furthermore, rumination and FOMO function as a chain of mediators between college students’ MPA and SQ. This study provided confirmation and clarification that in college students, the association between MPA and SQ was mediated by rumination and FOMO. This study improves our understanding of MPA, SQ and how MPA may affect SQ in college students. It also shows that the impact of MPA and SQ of college students should be given more consideration by educators, parents, and college students themselves.

Abstract Objective: This study aims to examine the associations between various dimensions of social support and sleep quality in a hospital psychiatric outpatient population using canonical correlation analysis, while also investigating the potential mediating roles of anxiety and depressive symptoms. Methods: Employing a cross-sectional design, survey data were collected from 10,071 individuals visiting Hangzhou Seventh People’s Hospital between October 2020 and October 2023. After excluding invalid cases, a total of 10,063 participants were included for analysis. The survey encompassed gathering basic demographic information as well as administering the Social Support Rating Scale, Self-rating Depression Scale, Self-rating Anxiety Scale, and Pittsburgh Sleep Quality Index Scale. Data analysis was conducted using SPSS 27.0 statistical software with canonical correlation analysis employed to examine the relationships. Additionally, the mediating effects of anxiety and depression symptoms were examined using the SPSS PROCESS macro. Results: Canonical correlation analysis reveals a significant positive correlation between social support dimensions and various aspects of sleep quality. The first pair of canonical variables (r = 0.586, p

Abstract The prevalence of portable media device (PMD) use has proliferated, potentially causing serious problems, particularly in critical situations. The main aim of the present study was to investigate the relationship between pre-sleep PMD use and cognitive performance, as well as the mediating effects of sleep quality among nurses. A cross-sectional study was designed, with 200 registered nurses voluntarily participating. The average time spent on PMDs was self-reported. The Pittsburgh Sleep Quality Index, the epworth sleepiness scale, the Occupational cognitive failures questionnaire, and the Nursing Errors Questionnaire were used to collect data. Correlation analyses and structural equation modeling were conducted. Significant relationships were found between pre-sleep PMD use and all variables of interest. Sleep quality was significantly related to daytime sleepiness and occupational cognitive failures, mediating the effect of pre-sleep PMD use on these two variables. Problematic use of PMDs at bedtime may be considered an unsafe act for healthcare workers. Healthcare providers should be aware of the potential risks induced by excessive PMD use. Creating a culture of proper smartphone use is crucial for overcoming these challenges.

Background Insomnia affects both quality of life and productivity at work, and it raises the risk of other diseases, such as depression, that coexist with insomnia. Nowadays, it is highly advised to treat insomnia with behavioral and psychological therapeutic methods to ensure the quality of your sleep. Aim This study aimed to find the efficacy of sleep hygiene techniques in improving sleep quality and mental ability among insomnia clients. Methods Self-structured questionnaires used to evaluate sleep quality and the McQuaig Mental Ability Test to test mental ability were used to collect data during the study’s six-week duration, which involved the recruitment of 50 participants using a purposive sample technique. A paired sample t-test and Pearson correlation were used for the statistical analysis. Results Data analysis shows that sleep quality (t = 33.35) (P = 0.0000) and mental ability (t = 35.33) (P = 0.0001) are both highly significant at P =0.0001. Correlation regression data of sleep hygiene elements such as schedule, avoiding caffeine and beverages, relaxation routine, and sleep-stimulating environment shows that there is a positive correlation with the quality of sleep at r = 0.9, 0.89, 0.75, and 0.68, whereas P = 0.000, 0.01, and 0.023, respectively. Similar to this, there is a positive association between mental ability and good sleep habits such as a relaxing routine, a sleep-promoting environment, and a schedule with r = 0.91, 0.88, and 0.92, respectively, with P values of 0.0001, 0.001, and 0.001. Conclusion The results of the study provide compelling evidence that good sleep hygiene can help enhance insomniacs’ mental ability and sleep quality. Furthermore, those with moderate levels of sleep quality, those between the ages of 18 and 38, and those with higher education benefited more than others.

Background Digital screen use has increased across the world among all age groups. Excessive screen use can affect sleep quality and mental health among young students. Objective The objective of the study is to study the association of screen time with sleep quality and anxiety levels among medical college students. Methodology A cross-sectional study was conducted with 200 medical students; sociodemographic details, Pittsburgh sleep quality index (PSQI) scale, and Beck Anxiety Inventory were administered. The data were analyzed using SPSS 21, for data on continuous scale mean, median, standard deviation, standard error and confidence intervals, for comparisons independent t-test, ANOVA for group’s analysis and for correlations spearman’s rank correlation. Results Decreased sleep quality was noticed in 41.5% of the medical students. On the Beck anxiety severity scores, 29% had mild anxiety symptoms, 17% had moderate, and 8% had severe anxiety symptoms. Sleep quality and anxiety scores had a significant positive correlation r = 0.000. Screen use on an average weekday and background screen use on regular week days were positively correlated r = 0.007. Mild, moderate, and severe anxiety level groups had higher PSQI scores though not statistically significant. Correlation is significant at 0.01 level and P value significant at or

Abstract The Cardiometabolic Index (CMI) represents an innovative metric that encompasses abdominal obesity and lipid levels, offering a comprehensive assessment of cardiometabolic health. It is derived through the multiplication of the waist-to-height ratio by the triglyceride-to-high-density lipoprotein cholesterol ratio. Although obesity and blood lipid levels are known factors affecting sleep quality, the direct correlation between CMI and sleep quality has yet to be elucidated. This study uses NHANES data to explore the potential correlation between CMI and sleep quality. Our research employed a cross-sectional design, utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011 to 2014. CMI was used as the exposure variable, with sleep quality assessed through three self-reported measures: trouble sleeping, sleep disorders, and sleep duration. We employed multivariate logistic regression models and linear regression model as well as subgroup analyses to explore the independent relationship between CMI and sleep quality. Additionally, interaction tests were conducted to examine differences across various subgroups. The study included 4298 participants, comprising 2134 males and 2164 females. There was a positive correlation between CMI and trouble sleeping (OR = 1.63, 95% CI 1.28–2.08) and sleep disorders (OR = 1.96, 95% CI 1.43–2.67), while there was a negative correlation between CMI and sleep duration (β = − 0.17, 95% CI − 0.31 to − 0.03), indicating that a higher CMI was associated with shorter sleep duration. Subgroup analyses and interaction tests revealed a consistently positive association between CMI and sleep difficulty across various populations, including gender, age, hypertension, diabetes, and cardiovascular disease history. However, the relationship between CMI and sleep disorders was more prominent among participants aged 50 and above. In American adults, a higher CMI is linked to an increased prevalence of sleep disturbances. In clinical practice, CMI can be considered as a supplementary factor in the assessment and management of sleep problems. Our study also provided new insights for improving sleep quality.

Abstract The purpose of this study is to objectively assess by polysomnography total sleep time and sleep macrostructure in glaucomatous versus non-glaucomatous individuals after adjusting for possible confounding factors affecting the quality of sleep. This is an observational, prospective, single-center, case-controlled study using a sleep research database (MARS e-Cohort) collecting clinical data, comorbidities, medications, and sleep studies of glaucomatous and non-glaucomatous individuals. The diagnosis of glaucoma was confirmed with a full comprehensive ophthalmological examination including a visual field test. Total sleep time and the main sleep parameters (time spent in stages 1, 2, 3 and 4, microarousals, apnea–hypopnea index, and indices of hypoxic burden) were compared in glaucomatous and non-glaucomatous individuals after adjusting for age, anthropometric data, and comorbidities. The study included 33 glaucomatous and 66 non-glaucomatous individuals. The median total sleep time was 325 min [273; 398] for the control group and 311 min [244; 349] for the glaucoma group. After adjusting for the potential confounding factors, there was no significant difference in total sleep time (p = 0.3) and other sleep parameters between the control group and the glaucoma group. The sleep macrostructure was comparable in the glaucomatous and non-glaucomatous individuals after careful adjustment for confounders.

Abstract Introduction Restorative sleep is essential for the maintenance of overall health and for the prevention of chronic diseases, including hypertension. The aim of this study was to determine the effect of motivational interviewing (MI) on sleep quality in patients with hypertension. Methods The study was a randomised controlled trial (PACTR202301917477205) of 250 adult patients aged 18 to 65 years (125 in each group) with hypertension presenting to the Family Medicine Clinics of Irrua Specialist Teaching Hospital, Irrua, Nigeria from April to December 2023. Patients were selected through systematic random sampling and randomised into intervention and control group with the intervention group having monthly sessions of motivational interviewing in addition to standard care for hypertension and the control group having standard care only. Data were analysed with Stata with level of significance set at p

Introduction: Aging has significant economic and social implications leading to an increase in chronic diseases and reduced autonomy of the elderly. Sleep disorders are common in the elderly, manifesting reduced sleep quality. Objective/Purpose: The study aimed to measure the prevalence of sleep disorders in older adults and assess sex differences in sleep quality and sleep problems. Method: A cross-sectional study based on an online survey was performed according to the STROBE checklist, using pre-validated questionnaires (Pittsburgh Sleep Quality Index) distributed to a sample of older adults. This is the first study evaluating sex differences in sleep quality and problems in the Italian population context using the Pittsburgh Sleep Quality Index assessment tool. The study was conducted in a university hospital in Rome from October 2020 to November 2020, on patients aged >65 years, independent in activities of daily living, with comorbidities and on treatment with up to 2 medications. Results: 59 patients were included in the study, with an average age of 71.12 years. The results show that among males, the prevalence of poor sleep quality was 51.9%, while among females, the prevalence of poor sleep quality was 62.5%. According to Shapiro-Wilk, the Pittsburgh Sleep Quality Index was not normally distributed. Pittsburgh Sleep Quality Index total scores in males did not differ significantly from females. Conclusions: Considering scientific literature, recent studies have highlighted the prevalence of sleep disorders in the elderly population and their underreporting. Providing early intervention not only improves the sleep quality of these people but may also reduce the risk of experiencing adverse health outcomes and susceptibility to frailty.

Abstract Background Adolescence is a unique stage of life accompanied by physiological and psychological modifications, along with stress, confusion, and depression. Materials and methods The present descriptive-analytical cross-sectional research was done on 267 male adolescents who studied at high schools in Zanjan, Iran. Demographic characteristics questionnaires, a 48-item food frequency questionnaire, a short version of the International Physical Activity Questionnaire (IPAQ), the Depression Anxiety Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. Results The mean ± standard deviation (SD) of age, weight, height, and sitting time was 15.94 ± 0.91 years, 68.53 ± 15.28 kg, 1.75 ± 0.06 m, and 449.25 ± 322.06 min, respectively. The study results showed that students with poor sleep quality showed a higher rate of depression than those with good sleep quality in the high and low physical activity groups (p

Objective: It was aimed to examine the relationship between sleep quality and anger levels of individuals with chronic obstructive pulmonary disease (COPD). Materials and Methods: This cross-sectional study was conducted with 195 individuals with COPD hospitalized in the chest diseases ward of Van Training and Research Hospital between January and August 2023. Data were collected using the Epworth sleepiness scale (ESS), Richard-Campbell sleep scale (RCSS), and state-trait anger expression ınventory (STAI). Results: The mean age of the individuals who participated in this study was 67.81 (10.59) years and were diagnosed with COPD 9.85 (9.27) years ago. There was a weakly significant positive correlation (r=0.278; p0.05). A significant negative correlation was found between the year of diagnosis of COPD, the number of COPD attacks in the last year, and the mean total score of RCSS (p

Objective: This study evaluated the effect of progressive muscle relaxation exercises (PMRE) applied to patients undergoing hemodialysis (HD) treatment due to chronic kidney disease on sleep quality. Materials and Methods: The research was conducted between March 1 and September 30, 2022, with 76 participants in a private dialysis center in Konya Province, Turkey. Using a randomized controlled research design, we divided the participants into 38 experimental and 38 control groups. We collected data using the “personal information form” and the “Pittsburgh sleep quality index (PSQI)”. IBM SPSS 26 software performed the statistical analysis of the obtained data. When the parametric test assumptions were met, the ““Student’s t-test” was used to evaluate differences between the two independent groups; otherwise, the “Mann-Whitney U test” was employed. The relationship between categorical variables was assessed using Fisher’s exact test and chi-square tests. Results: In the intervention group undergoing PMRE, it was determined that the PSQI total sleep score and its subdimensions, including subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, and daytime dysfunction (except for the sleep medication use subdimension), had a significantly positive effect compared to the control group at the eighth week (p

Abstract Background Amid the current mental health pandemic, research continues to investigate potential contributors associated with increasing levels of negative mental health. Among such contributors is sleep, which is vital for physiological and psychological functioning with potential downstream behavioral consequences, including in relation to impulsivity and social functioning. Given the significant rates of disordered sleep behaviors reported in the literature, our study sought to investigate the relationship between sleep quality, impulsivity and interpersonal functioning among university students. Methods An anonymous online survey was administered to university students (Ages 18 + ; N = 526; 33% male, 67% female) addressing demographics, sleep quality, impulsivity, and interpersonal functioning. Results Our findings indicate a substantial proportion of students reporting poor sleep quality and impulsivity. Moreover, higher levels of impulsivity and lower interpersonal functioning were associated with poor sleep quality. Mediation analysis revealed a significant mediating role of attentional impulsivity in the relationship between sleep quality and interpersonal functioning. Conclusions Repeated reports of significant levels of impulsivity underlying numerous psychiatric disorders, its prevalence socially, and the fundamental issue that impulsivity reflects (i.e., lack of self-control/self-discipline/self-regulation), suggests a necessity to reorient therapeutic efforts towards the root of the problem. Thus, efforts should seek to maximize preventative behaviors that strengthen the individual (e.g., improving sleep-related behaviors), and contribute to the building of character/virtue, through self-discipline, perseverance and consistency, in order to reduce negative outcomes (e.g., impulsivity, dysfunctional interpersonal functioning).

Sleep quality significantly impacts individuals’ overall health, especially in older adults. Older adults often face comorbid conditions, polypharmacy (the intake of five or more medications per day), and medication non-adherence, which are common among those with sleep disorders. The purpose of this systematic review is to examine the relationship between sleep quality and medication adherence in older adults and to describe the measuring instruments used. A systematic review was performed following the PRISMA guidelines. The PubMed, Scopus, Cochrane Library, and CINAHL databases were screened from January 2024 to March 2024. Nine articles were included in the final synthesis based on the inclusion and exclusion criteria. The review found that poor sleep quality is significantly associated with reduced medication adherence in older adults. The key sleep determinants linked to medication non-adherence include sleep disorders, sleep efficiency, sleep duration, and daytime dysfunctions. Inappropriate medication prescriptions have been associated with reduced sleep efficiency. The tools for assessing sleep quality and medication adherence are predominantly subjective and varied. To address these challenges, a comprehensive geriatric assessment should include investigations into sleep disorders and comorbidity factors. Additionally, nursing educational interventions could be pivotal in improving medication adherence among older adults.

Abstract Although it is generally recognized that sleep quality, depressive symptoms, and cognitive functions are related respectively, the main ambiguity comes from difficulties in determining their cause-effect relationships. The present study aimed to explore the longitudinal causation relationships among sleep quality, depressive symptoms, and cognitive functions in older people with mild cognitive impairment (MCI). A total of 134 patients from 24 communities in Ningbo City, Zhejiang Province, China with MCI were interviewed at baseline, while 124 of them were re-interviewed 2 months later, and 122 were re-interviewed 4 months later. The Patient Health Questionnaire-9, the Pittsburgh Sleep Quality Index and the Montreal Cognitive Assessment Scale were assessed in the interview. Cross-lagged models were tested to disentangle the relationships among sleep quality, depressive symptoms, and cognitive functions using structural equation modeling with latent variables on the four-mouth longitudinal data. The correlation coefficients between sleep quality and depressive symptoms were significant showing the stability across time points of assessment, while the correlation coefficient of cognitive function was not significant (r = 0.159, p > 0.05). The results of index of model fit indicated that the cross-lagged model was acceptable (CFI = 0.934, TLI = 0.899, RMSEA = 0.075, χ2/df = 1.684). The results of cross-lagged model analysis supported the complete mediating role of depressive symptoms in the association between sleep quality and cognitive functions, where worse sleep quality may lead to more severe depressive symptoms, which in turn leads to more severe cognitive decline. In Conclusion, sleep quality is significantly correlated with cognitive functions in patients with mild cognitive impairment, which association is fully mediated by depressive symptoms. Approaches addressing sleep quality and depressive symptoms are recommended and hold promise for the management of mild cognitive impairment.

A randomized, double-blind and controlled study was conducted to assess the effectiveness of the intake of 250 mL of lactose-free skimmed milk enriched with ashwagandha (Withania somnifera) alone or combined with tryptophan vs. non-enriched milk (control) on the subjective quality of sleep in healthy adults with sleep problems. The duration of supplementation was 90 days. Fifty-two eligible subjects were assigned to the study arms of ashwagandha 250 mg, ashwagandha 250 mg plus tryptophan 175 mg, ashwagandha 600 mg, and control with 13 subjects in each group. It was hypothesized that ashwagandha plus tryptophan could be superior to ashwagandha alone for improving sleep-related variables. Changes in the visual analogue scale (VAS) for sleep quality were significantly higher in the three experimental groups as compared with controls (p = 0.014). Improvements in the subscales of the Pittsburg Sleep Quality Index (PSQI) were found in all groups, but between-group differences were not significant. In the index of insomnia severity, decreases were higher in the three experimental groups as compared with controls especially in the group of ashwagandha 600 mg. Daytime somnolence was also reduced in the three experimental groups. Changes in anxiety levels and Morningness–Eveningness Questionnaire were not observed. The study products did not elicit changes in body composition and were well tolerated and safe. The data did not support the hypothesis, as the combination of ashwagandha and tryptophan did not show greater benefits in improving sleep quality than ashwagandha alone. However, the results from the three experimental groups containing ashwagandha were more favorable compared to the placebo group.

Abstract In recent years, sleep problems among college students have become increasingly prominent, especially in the context of the COVID-19 pandemic, and their sleep quality has deteriorated dramatically, severely affecting their physical and mental health. Numerous research studies have investigated the relationship between mindfulness and sleep quality; however, it is still unclear what psychological process underlies this relationship. In the current study, college students’ bed procrastination and self-control as mediating factors in the association between mindfulness and sleep quality were investigated. Using the convenience sampling method, 763 Chinese college students (mean age = 19.48 years, SD = 2.06) were recruited to complete self-reported questionnaires that included the Mindful Attention Awareness Scale, Self-Control Scale, Bed Procrastination Scale, and Sleep Quality Scale. All statistical analyses were performed using SPSS 23.0 software. Results showed that (a) mindfulness was positively associated with sleep quality; (b) both self-control and bed procrastination mediated the relationship between mindfulness and sleep quality, and (c) self-control and bed procrastination sequentially mediated the relationship between mindfulness and sleep quality. These findings collectively suggest a potential mechanism for how mindfulness influences sleep quality, providing a therapeutic target for mindfulness-based interventions aimed at helping college students improve sleep quality.

Introduction: This study aimed to determine eating mindfulness (EM), night eating syndrome (NES), and sleep quality in adult subjects presenting to a psychiatric outpatient clinic and to evaluate possible differences according to diagnoses and clinical variables. Methods: This study included 381 outpatients. Sociodemographic data were collected, the Night Eating Questionnaire (NEQ), Pittsburgh Sleep Quality Index (PSQI), and the Mindful Eating Questionnaire (MEQ) were completed, and body mass index was measured. Results: The median PSQI score was 3.0 (0.0-7.0), the median NEQ total score was 4.0 (0.0-14.0), and the median MEQ total score was 76.0 (59.0-95.0). Sixteen percent of the participants met the NES criteria. The patient group with the poorest sleep quality was the group with alcohol/substance use disorder and atypical psychosis. The patient groups with the lowest EM were those with schizophrenia, impulse control disorder, attention deficit disorder, and hyperactivity disorder. The highest NEQ score was found in individuals diagnosed with alcohol/substance use disorder. As the NEQ scores increased, so did the PSQI. A significant negative correlation was found between NEQ and MEQ total, disinhibition, emotional eating, eating control, and focus. The PSQI (β=1.169, p

Abstract Background Sleep disturbances are frequently reported among people living with HIV infection. In Ethiopia, approximately half of people living with HIV/AIDS experience mental health issues, which further degrade sleep quality. This systematic review and meta-analysis aims to assess the national prevalence of poor sleep quality and identify key determinants. Methods A systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, focusing on English-published studies. The search spanned Google Scholar, HINARI, Scopus, PubMed, EMBASE, Web of Science, and AJOL from April 4, 2023, to May 15, 2023. Three reviewers independently extracted data and evaluated study quality using a modified Newcastle‒Ottawa scale for cross-sectional studies. Stata version 11 was used for the meta-analysis, employing a random-effects model to estimate poor sleep quality. Study heterogeneity was assessed using I2 and Cochran's Q test. Results A total of 6,070 articles regarding poor sleep quality and/or associated factors among people attending antiretroviral treatment clinics in Ethiopia were retrieved. The pooled estimate of poor sleep quality among people living with HIV in Ethiopia was 52.64 (95% CI: 44.08, 61.20). Depression (AOR = 4.61; 95% CI: 1.15, 18.51), a CD4 count 1000 copies (AOR = 1.42; 95% CI: 0.19, 10.61), and anxiety (AOR = 17.16; 95% CI: 4.47, 65.91) were identified as factors associated with poor sleep quality. Conclusion A systematic review and meta-analysis found that about half of people living with HIV/AIDS in Ethiopia experience poor sleep quality. Key factors contributing to poor sleep quality include CD4 count, viral load, depression, and anxiety. Policymakers and relevant organizations should address these issues to improve sleep quality and manage the factors affecting it.

Background and Objectives This study aimed to evaluate the factors that influence deep sleep restoration in patients with obstructive sleep apnea (OSA) following positive airway pressure (PAP) therapy. Methods In total, 363 patients diagnosed with OSA who received PAP therapy over at least 3 months were enrolled in the study. Polysomnographic parameters, anatomical characteristics, and subjective sleep-related parameters were evaluated according to the presence of daytime sleepiness and morning headache before and after 3 months of PAP treatment. Results Age was significantly different according to whether excessive daytime sleepiness (EDS) was alleviated (average: 49.35 years) or persisted (average: 52.82 years) (p=0.001). Age was also significantly associated with morning headache (p=0.037). Body mass index (BMI) was higher in the alleviated EDS group (28.70 kg/m2) than in the persistent EDS group (27.13 kg/m2; p=0.002). The apnea-hypopnea index (AHI) was correlated with the EDS outcome (p=0.011). The group with alleviated EDS had a longer mandibular plane to hyoid distance (MPH) than the group with persistent EDS (17.95 mm vs. 15.38 mm; p

Objectives: This study aims to investigate predictors of insomnia and their prevalence among medical students from different levels, as well as the impact of insomnia on academic performance. Methods: This multicenter cross-sectional study was conducted on medical students of different levels at 37 medical colleges in Saudi Arabia from March 2020 to June 2020. An online survey was used for data collection. The survey included questions on the demographics of students and two scales: the Insomnia Severity Index (ISI) and the Pittsburgh Sleep Quality Index (PSQI). The Statistical Package for the Social Sciences Program was used to analyze the data, and demographics were represented using descriptive statistics. Associations were tested using either the Chi-square test, Pearson correlation, or Spearman’s correlation based on the types of variables. P

Sleep quality (SQ) is a crucial aspect of overall health. Poor sleep quality may cause cognitive impairment, mood disturbances, and an increased risk of chronic diseases. Therefore, assessing sleep quality helps identify individuals at risk and develop effective interventions. SQ has been demonstrated to affect heart rate variability (HRV) and skin temperature even during wakefulness. In this perspective, using wearables and contactless technologies to continuously monitor HR and skin temperature is highly suited for assessing objective SQ. However, studies modeling the relationship linking HRV and skin temperature metrics evaluated during wakefulness to predict SQ are lacking. This study aims to develop machine learning models based on HRV and skin temperature that estimate SQ as assessed by the Pittsburgh Sleep Quality Index (PSQI). HRV was measured with a wearable sensor, and facial skin temperature was measured by infrared thermal imaging. Classification models based on unimodal and multimodal HRV and skin temperature were developed. A Support Vector Machine applied to multimodal HRV and skin temperature delivered the best classification accuracy, 83.4%. This study can pave the way for the employment of wearable and contactless technologies to monitor SQ for ergonomic applications. The proposed method significantly advances the field by achieving a higher classification accuracy than existing state-of-the-art methods. Our multimodal approach leverages the synergistic effects of HRV and skin temperature metrics, thus providing a more comprehensive assessment of SQ. Quantitative performance indicators, such as the 83.4% classification accuracy, underscore the robustness and potential of our method in accurately predicting sleep quality using non-intrusive measurements taken during wakefulness.

Chronotype reflects the morningness–eveningness preference over a 24 h period. Significant data indicate meaningful differences between evening types (ETs) and morning types (MTs) in behavior, personality traits, health, and well-being. This study explores the interactions between chronotype, sleep, personality, and life satisfaction among 254 undergraduate college students (mean age 23.79 ± 1.85). Using online questionnaires, the participants provided demographic information and completed assessments, including the Morningness–Eveningness Questionnaire (MEQ), the Pittsburg Sleep Quality Index (PSQI), a shortened version of the Big Five Inventory (BFI-10), and a life satisfaction uniscale measure. The results revealed a significant association between chronotype and both life satisfaction and sleep quality, where ETs exhibited poorer outcomes compared to MTs. Additionally, the chronotype correlated with agreeableness and conscientiousness, with later chronotypes linked to reduced scores in these personality traits. A key finding in this study was revealed in a mediation analysis in which sleep quality was found to mediate the relationship between chronotype and life satisfaction. The mediation analysis highlighted sleep quality as a crucial process connecting chronotype to life satisfaction. The findings emphasize the importance of addressing sleep quality in interventions aimed at enhancing life satisfaction and overall well-being among ETs. Overall, our results provide valuable insights into the intricate relationships between chronotype, personality, sleep quality, and subjective well-being.

Introduction: Sleep is a vital biological, reparative, and restorative phenomenon, and poor sleep has a serious detrimental effect on health. Poor sleep quality is a serious problem as it adversely affects a person’s ability to function physically and socially, as well as their potential for profession and quality of life. The degree of hypertension directly affects sleep quality, and poor sleep can exacerbate hypertensive symptoms. This study assesses hypertension patients’ sleep quality in a rural health training centre in Chennai. Objectives: 1. To study the prevalence of poor sleep quality among hypertensive patients. 2. To determine the association between selected socio-demographic factors and sleep quality among these patients. Materials and Methods: Hypertensives attending the outpatient department of a rural health and training centre were selected in a systematic manner and administered a semi-structured interview schedule and the Pittsburgh Sleep Quality Index (PSQI) questionnaire followed by a basic clinical examination. Using the PSQI, they were categorised as having either poor or good sleep quality and the association between selected socio-demographic factors and sleep quality was assessed. Results: Out of the 179 study participants, there were almost equal numbers of male and female participants. The mean age of participants was 57.80 years (standard deviation (SD) = 9.8 yrs.). Among the study participants, 44.13% had completed secondary level of school as an education qualification and 6.70% were illiterate. By the modified BG Prasad classification 2022, most of the study participants (34.08%) came under the class II socioeconomic classification. A large proportion (78.8%) of study participants had poor sleep quality. The difference in sleep quality was observed with respect to gender, socio-economic class, alcohol consumption and body mass index (BMI). Conclusion: This observational study shows that individuals with hypertension suffer significantly from poor sleep. A poor quality of sleep was reported by 78.77% of the patients in this study. Statistically significant factors that influenced sleep quality were gender, alcohol consumption and BMI.

Background: This research is conducted to observe the effects of diabetes mellitus (DM) and arthritis on sleep efficiency and sleep outcomes. Inconsistent sleep schedule or night to night sleep variability are the arising concerns and lead to harmful health consequences. DM and arthritis are two chronic and widespread disorders causing sleep disturbance. However, limited studies investigated the association of variation of sleep efficiency in people with DM and arthritis. Methods: This research used the Midlife in United States Second Wave Research (MIDUS-2). The design was a cross-sectional research which consisted of 434 participants. Data were collected from all the participants after taking informed consent. Participants were divided into four groups based on the presence of one of the above-mentioned systemic disorders, including a control group (i.e, healthy participants. Age, gender, body mass index, symptoms of depression, and prescribed medicines were included as the control variables). Data has been analyzed on the Statistical Package for the Social Sciences (SPSS), for Macintosh Version-25 (SPSS Inc., Chicago, IL), using Chi-Squared and the Kruskal–Wallis tests. Results: Of 434 participants, 61.05% were female, 39.63% only had arthritis, 0.06% had DM alone, and 44.23% were healthy; that is, they were the control group. The sleep efficiency of the healthy group was 81.55%; of patients having only arthritis was 78.37%; of patients having only DM was 75.35%; and the group having both disorders was 74%. The average of sleep efficiency was lower in people with DM and arthritis compared to other groups (P = 0.001). There was an association between combined arthritis and DM with increased variability of sleep efficiency and poor sleep quality compared to healthy group (P = 0.007). Conclusion: DM is a chronic condition that leads to a lack of capability to produce energy. Arthritis occurs when the protective cartilage that cushions the ends of bones in a joint gradually wears down over time. The research’s results showed a significant difference in sleep efficiency of healthy people compared to other groups. Clinicians may recommend following enough sleep hygiene for patients with DM or arthritis.

Background: Medical students are vulnerable to sleep disturbances as they navigate life through academic stress, long on-call duties, emotional challenges, and exhaustion. Insufficient sleep negatively affects cognitive functions and fine motor skills, leading to deficiencies in attention, increased drowsiness while driving, propensity for risk-taking behavior, heightened risk of depression, impaired interpersonal relationships, and the potential to impact learning technical aspects of curriculum as well as delivering quality patient care. Objectives: The objective of this study was to measure the sleep quality and its determining factors among undergraduate medical students of a teaching institute in Telangana, South India. Methodology: A cross-sectional study was conducted among 401 undergraduate medical students. A semi-structured questionnaire including the sociodemographic details, medical history, and screen time, followed by the Pittsburgh Sleep Quality Index (PSQI) which assesses the time of quality sleep, frequency of troubled sleep, etc., over the last 1 month was used. The quality of sleep score of >5 indicates poor sleep quality. Results: The mean age was 20.41 years (standard deviation [SD] =2.08). Known comorbidities were present among 17 (4.2%), and 13 (3.2%) had psychiatric conditions. Poor sleep quality was present among 70% of medical undergraduates. The mean global PSQI score was 6.22 (SD = 2.9). The factors found significantly associated with poor sleep quality were academic stress (P = 0.009; odds ratio [OR] = 2.154 [CI = 1.250–3.713]), headache and self-medication (P = 0.008; OR = 1.868 [CI = 1.178–2.964]), and nighttime screen use (P < 0.001; OR = 18.12 [CI = 5.48–59.87]). Conclusion: Sleep deprivation and poor sleep quality is a major concern among medical undergraduates. It is important to have a proper sleep–wake routine and maintain good sleep hygiene. This includes reducing the use of screens before bedtime and addressing any underlying health conditions, including mental health issues, to improve sleep quality and overall well-being.

Purpose: The rapid and limitless outbreak of the coronavirus in 2019 caused athletes to quarantine in their homes, resulting in stress and anxiety and the experience of negative symptoms, such as sleep disorder. The present study aims to investigate the effect of 8 weeks of yoga exercise on athletes’ anxiety and sleep quality during the pandemic. Methods: Twenty-four athletes with an average age of 18 to 25 years were selected and classified into two experimental and control groups. Before and after the intervention, Beck’s anxiety inventory and Pittsburgh’s sleep quality inventory were used to collect data. The experimental group training protocol consisted of 24 Hatha yoga exercise sessions (60 minutes, three times a week). Due to the coronavirus epidemic, online training was conducted by an experienced yoga coach. The statistical method of covariance analysis was used to investigate the difference between the pre-test and post-test. Results: Data analysis showed that in the experimental group, the anxiety mean scores in the pre-test decreased in the post-test, and the quality of sleep scores improved after yoga sessions. Also, a significant difference was observed between the experimental and control groups regarding anxiety (P

Background: Working as a nurse in a hospital required to work with a shift system. Working with the shift system (morning, afternoon, and night) can affect the circadian rhythm, which has the potential to cause sleep disturbances and fatigue. Purpose: This research aims to analyze the influence of shift work rotation 2-2-2(2) on sleep quality and fatigue in nurses with shift work systems in inpatient rooms at General Hospital Ibnu Sina Gresik. Method: This research was an observational analytics study with a cross-sectional design. The total sample was 80 nurses in an inpatient care unit with a shift work system chosen through purposive sampling techniques. The Subjective Self-Rating Test (SSRT) issued by the Industrial Fatigue Research Committee (IFRC) questionnaire was used for the measurement of fatigue, and the Pittsburgh Sleep Quality Index questionnaire (PSQI) was used for the assessment of sleep quality. Univariate and bivariate analyses were done with a Chi-square statistical test. Result: The study showed that most respondents had good sleep quality (87.5%), and most had low tiredness (71.2%). The Chi-square test results obtained a p-value of 0.224 > 0.05 and a p-value of 0.108 > 0.05, meaning there were no correlations between shift work and sleep quality and fatigue. Conclusion: Shift work had no relationship with sleep quality and fatigue. Appropriate shift work arrangements can contribute to reducing the negative impact of shift work.

Abstract Background Night eating syndrome (NES) is an eating disorder in which at least one-third of one’s daily caloric intake is consumed after the last meal of the day or throughout the nocturnal evening on at least two consecutive occasions each week. In the literature, the prevalence of NES among university students ranged from 4.2 to 15%. Aim The purpose of this study was to find out how common NES is among Palestinian university students, as well as the association between NES, sleep quality, BMI, socioeconomic factors, and lifestyle factors. Methods Students from An-Najah National University completed an online questionnaire. The Pittsburgh Sleep Quality Index (PSQI) and the Eating Questionnaire (NEQ) were employed. Results A total of 333 participants took part in the study. The average age of the participants was 21.66 years (range: 16 to 33). The presence of NES was identified in 82.6% of the study subjects. There was no evidence of a link between NES and BMI, sociodemographic variables, or lifestyle factors. Higher scores on subjective sleep quality (p

Abstract With the substantial increase in the use of stimulants, especially methamphetamine, in recent years, the present study aimed to cluster methamphetamine users based on personality traits and self-efficacy, and compare their mental health, sleep quality, and the risk of relapse in the identified clusters. This cross-sectional study was conducted through convenience sampling on 501 methamphetamine users in addiction treatment centers in Kermanshah, western Iran. The data were collected using the Schwarzer General Self-Efficacy Scale, Zuckerman–Kuhlman Personality Questionnaire, Goldberg and Hiller General Health Questionnaire (GHQ), Zuckerman–Kuhlman Personality Questionnaire, and Stimulant Relapse Risk Scale (SRRS). A total of 501 methamphetamine users were distinguished into three clusters with frequencies of 111 (22.2%), 298 (59.5%), and 92 (18.4%) members through hierarchical cluster analysis. The participants in the first cluster were characterized by low self-efficacy, high neuroticism, sensation seeking, and aggressiveness, along with low extroversion and activity, low positive health, high negative health, low sleep quality, and high risk of drug relapse. The participants in the second cluster reported moderate levels of self-efficacy, neuroticism, sensation seeking, activity, and aggressiveness, high extroversion, and moderate levels of mental health, sleep quality, and the risk of relapse. Moreover, the participants in the third cluster reported the highest level of self-efficacy, the lowest level of neuroticism, sensation seeking, and aggressiveness, moderate extroversion and high activity, low relapse risk, high sleep quality, as well as high positive and low negative health symptoms. The third cluster was significantly different from the other two clusters in terms of the mentioned factors. The findings of this study suggest that low self-efficacy and the presence of neuroticism, sensation seeking, and high aggressiveness contribute to reduced mental health and sleep quality, as well as an increased risk of relapse in methamphetamine users.

Abstract The objective of this cross-sectional study was to examine the extent of sleep quality among individuals undergoing maintenance hemodialysis (MHD) and to scrutinize whether hope and family function serve as mediators in the association between anxiety and sleep quality in this cohort. A convenience sampling method was used to recruit 227 patients receiving maintenance hemodialysis from two tertiary hospitals in Wuhan. Participants completed several self-report questionnaires, including the Sociodemographic questionnaire, Hospital Anxiety and Depression Scale, Athens Insomnia Scale, Herth Hope Index, and Family APGAR Index. As per the findings of the chain mediation analysis, it was observed that the sleep quality scores were directly predicted by anxiety. Moreover, anxiety positively predicted sleep quality scores through hope and family function as mediators. The observed types of mediation were partial mediation. The total indirect effect value was 0.354, indicating the mediating effect of hope and family function, while the total effect value was 0.481, representing the overall effect of anxiety on sleep quality. The total effect size was 73.60% (0.354/0.481), indicating that the mediation accounted for a significant portion of the relationship. This study established the chain mediating effect of hope and family function between anxiety and sleep quality in patients receiving maintenance hemodialysis. The findings highlight the importance of addressing anxiety and promoting hope and family function to improve sleep quality in this population. The findings suggest that healthcare professionals should be attentive to the anxiety levels of these patients and implement targeted interventions to help alleviate anxiety, enhance hope, and improve family functioning, with the ultimate goal of improving sleep quality in this population.

Abstract Posttraumatic stress disorder (PTSD) can develop after trauma exposure. Some studies report that women develop PTSD at twice the rate of men, despite greater trauma exposure in men. Lipids and their metabolites (lipidome) regulate a myriad of key biological processes and pathways such as membrane integrity, oxidative stress, and neuroinflammation in the brain by maintaining neuronal connectivity and homeostasis. In this study, we analyzed the lipidome of 40 adults with PTSD and 40 trauma-exposed non-PTSD individuals (n = 20/sex/condition; 19–39 years old). Plasma samples were analyzed for lipidomics using Quadrupole Time-of-Flight (QToF) mass spectrometry. Additionally, ~ 90 measures were collected, on sleep, and mental and physical health indices. Poorer sleep quality was associated with greater PTSD severity in both sexes. The lipidomics analysis identified a total of 348 quantifiable known lipid metabolites and 1951 lipid metabolites that are yet unknown; known metabolites were part of 13 lipid subclasses. After adjusting for BMI and sleep quality, in women with PTSD, only one lipid subclass, phosphatidylethanolamine (PE) was altered, whereas, in men with PTSD, 9 out of 13 subclasses were altered compared to non-PTSD women and men, respectively. Severe PTSD was associated with 22% and 5% of altered lipid metabolites in men and women, respectively. Of the changed metabolites, only 0.5% measures (2 PEs and cholesterol) were common between women and men with PTSD. Several sphingomyelins, PEs, ceramides, and triglycerides were increased in men with severe PTSD. The correlations between triglycerides and ceramide metabolites with cholesterol metabolites and systolic blood pressure were dependent upon sex and PTSD status. Alterations in triglycerides and ceramides are linked with cardiac health and metabolic function in humans. Thus, disturbed sleep and higher body mass may have contributed to changes in the lipidome found in PTSD.

Background Respiratory problems in chronic obstructive pulmonary disease (COPD) patients are prone to poor sleep quality, anxiety and depression, but they are often ignored by medical staff and patients themselves. Understanding the sleep quality, anxiety and depression symptoms of patients with COPD and their influencing factors can help to improve the quality of life of patients, however, there are few relevant studies. Objective To investigate the sleep quality, anxiety and depression of patients with COPD and explore the influencing factors. Methods Convenience sampling was used to recruit COPD patients who visited the Department Respiratory Diseases and Critical Care Medicine of seven hospitals in Anhui Province from August to November 2022. Demographic characteristics, dyspnea grade, airflow restriction severity, risk of malnutrition, physical activity level, vaccination, and acute exacerbations in the last 1 year were collected. The Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS) were used to evaluate the sleep quality and anxiety and depression symptoms of COPD patients, and the influencing factors were analyzed by multivariate Logistic regression. Results A total of 248 patients with COPD were investigated, among which the incidence of poor sleep quality was 60.9% (151/248), only 8.9% (22/248) of the patients thought they had good sleep quality, and more than half of the patients actually had insufficient sleep time (54.4%) or low sleep efficiency (60.1%). 29.4% (73/248) of COPD patients had at least one of the symptoms of anxiety or depression, of which 35 had anxiety symptoms, 61 had depression symptoms, and 23 had both anxiety and depression symptoms. Multivariate Logistic regression analysis showed that older ages (OR=1.052, 95%CI=1.018-1.086) and risk of malnutrition (OR=3.393, 95%CI=1.855-6.206) were risk factors for poor sleep quality in COPD patients. Regular physical activity was a protective factor for poor sleep quality in COPD patients (OR=0.450, 95%CI=0.242-0.834) (P

BACKGROUND: Aging is associated with a wide range of sleep complaints. Health-promoting behaviors are the most important and effective factor in maintaining and improving the health of the elderly. The present research aims to investigate the relationship between sleep quality and health-promoting behaviors in older people. METHODS: This descriptive correlational research was conducted in Imam Khomeini Hospital affiliated to Shahid Beheshti University of Medical Sciences, Firozkoh City, Tehran Province, Iran, in 2020. 384 old people were selected by available sampling. For data collection, the hospital information system (HIS), health-promoting lifestyle profile II (HPLP-II), and Pittsburgh Sleep Quality Index (PSQI) were used. Data were analyzed using a t-test and Pearson's correlation coefficient by SPSS software. RESULTS: The highest frequency was related to people with bad sleep quality (72%). Sleep quality had a significant correlation with nutrition (r = -0.129, P = 0.010), stress management (r = -0.096, P = 0.058), and health-promoting behaviors (r = -0.128, P = 0.001). There was an inverse correlation between taking responsibility for health, physical activity, interpersonal relationships, and spiritual growth with sleep quality, but it was not statistically significant (P = 0.56). CONCLUSION: Health-promoting behaviors depend on a deep link with the sleep quality index, and it is necessary to emphasize sleep quality and other factors of appropriate health-promoting behaviors in the elderly more than anything else.

This systematic review and meta-analysis study aimed to examine the effect of Coronavirus disease-2019 (COVID-19), which causes psychosocial stressors such as long-term isolation, fear of being infected, fear of death, uncertainty, and economic challenges, on sleep quality of individuals with chronic diseases.Searches were made from PubMed, National Thesis Center, DergiPark, Web of Science, EBSCOhost, TürkMedline databases between 12.08.2022 and 31.08.2022. Studies conducted in Turkey between 01.01.2018 and 12.08.2022 were included in the review. In total, 503 data were obtained in the search. The total sample size of 12 cross-sectional studies that met the inclusion criteria was 5.175. The results of seven studies investigating sleep quality/problem in adults revealed that those with chronic diseases had lower sleep quality [standardized mean difference (SMD): 0.30, 95% confidence interval (CI): 0.20 0.40, Z=5.81, p

Objective: The aim of this study was to evaluate the sleep perceptions and factors influencing sleep during the early postoperative period in patients who underwent coronary artery bypass graft (CABG) surgery. Materials and Methods: This descriptive study included 92 volunteer patients who underwent CABG surgery between September 1, 2019, and February 1, 2020. Data were collected using the 2nd, 3rd, 4th Richards-Campbell sleep questionnaire (RCSQ) and a postoperative sleep-affecting factors form. The study was reported using the STROBE checklist. Statistical significance was set at p0.05). During the postoperative period, patients reported that factors such as pain, frequent medical interventions, fear of sudden deterioration of their condition, fear of death, and being away from home in an unfamiliar environment had a significant impact on their sleep. Conclusion: The mean RCSQ scores of patients who underwent CABG surgery were found to be very poor on the second and third days postoperatively and worsened on the fourth day.

Background and purpose: Previous reports on the symptoms and quality of life of patients with pituitary adenomas have paid little attention to physical activity. However, numerous studies have shown that physical activity can significantly influence prolactin secretion. Prolactin secretion levels, in turn, can affect various clinical outcomes, including tumor size, sleep quality, and fatigue levels in patients with pituitary adenomas. Given the intricate relationship between these factors, it is crucial to investigate how they interact to impact the overall health and quality of life of these patients. This study aims to bridge this gap by exploring the relationship between tumor size and fatigue levels, sleep quality, and physical activity in patients with pituitary adenomas. Understanding these relationships can provide insights into potential therapeutic strategies to improve patient outcomes. Materials and methods: A total of 116 patients diagnosed with pituitary adenomas from the Neurosurgery and Internal Medicine departments of Imam Khomeini Hospital in Sari were included in the study via census sampling. The inclusion criteria ensured that all participants had a confirmed diagnosis of pituitary adenoma. Demographic characteristics, tumor size (from patients' imaging records), prolactin levels (from patient records), physical activity levels (using the International Physical Activity Questionnaire), sleep quality (using the Pittsburgh Sleep Quality Index), and fatigue levels (using the Multidimensional Fatigue Inventory 20) were measured using checklists and validated questionnaires. Results: In the present study, 68 participants (58.6%) were female, and 48 (41.4%) were male. A total of 108 participants (93.1%) were aged 55 years or younger, and 8 participants (6.9%) were older than 55, with a mean age of 43.72±7.70 years. Of the participants, 71(61.2%) had prolactinomas, and 39(33.6%) had non-functional tumors. Tumor sizes ranged from 2.1 to 42.9 mm, with a mean size of 16.16±8.71 mm. The mean prolactin level was 561.52±413 ng/mL, with a minimum level of 8 ng/mL and a maximum of 1578 ng/mL. The results showed significant differences in the mean scores of sleep quality (5.81±1.91 vs. 6.73±2.14), fatigue (55.86±8.79 vs. 60.32±8.39), and physical activity (1203.95±258.65 vs. 1085.20±310.99) between patients with microadenomas and macroadenomas (P=0.048, P=0.008, P=0.038). Furthermore, correlation coefficients for age (r=0.415), fatigue (r=0.336), sleep quality (r=0.253), physical activity (r=-0.230), and prolactin (r=0.496) with tumor size were significant. The findings indicated that with increasing age, fatigue scores, sleep quality scores, and prolactin levels, tumor size also increases, while higher physical activity levels are associated with smaller tumor sizes. Additionally, as tumor size increases, prolactin levels, fatigue scores, and sleep quality scores increase, whereas physical activity scores decrease. Conclusion: The study concludes that with increasing age, fatigue and sleep quality scores worsen, but physical activity levels decrease. Moreover, as tumor size increases, prolactin levels, fatigue scores, and sleep quality scores increase, while physical activity scores decrease. An increase in prolactin levels is also associated with increased fatigue.

Objective To investigate whether nitrazepam can increase the accuracy of RigiScan measurement of nocturnal penile tumescence and rigidity （NPTR） by improving the sleep quality of patients. Methods All participants received NPTR measurement for two consecutive nights. In Trial 1， 125 normal volunteers were randomly assigned into the control group （n = 68） and experimental group （n = 57）. They took either a placebo or 10 mg of nitrazepam before NPTR testing on the second night to observe the effect of nitrazepam on nocturnal penile erections in the normal population. In Trial 2， 128 patients with erectile dysfunction were randomly assigned into the control group （n = 64） and experimental group （n = 64）. They took either a placebo or 10 mg of nitrazepam before NPTR testing to observe the effect of nitrazepam on NPTR detection parameters including effective erection times （EEE）， total erection duration （TED）， erection duration with erection rigidity≥60% （D60）， average erection rigidity （AER）， average erection tumescence circumference （AET）， rigidity activity unit （RAU） and tumescence activity unit （TAU） at the tip and base of the penis and the normal erection rates. Results In Trial 1， there were no statistically significant differences in NPTR parameters and normal rates between two groups on the second night （all P > 0.05）. The Richards-Campbell Sleep Questionnaire （RCSQ） score in the experimental group was higher than that in the control group （P < 0.001）. In Trial 2， NPTR parameters （D60tip， D60base， AERbase， RAUtip， TAUtip） on the first night were lower compared to those on the second night in the control group （all P < 0.05）， and there were no significant differences in normal erection rates （67.2% vs. 78.1%， P = 0.065）. Except for AETtip （7.85（6.83，8.98） cm vs. 8.10（7.50，8.90） cm， P = 0.014）， there were no statistically significant differences in NPTR parameters and normal erection rates between two nights in the experimental group （all P > 0.05）. In comparison between two groups， the parameters on the first night （EEE， D60tip， RAUtip and TAUtip）and those on the second night （EEE， D60tip， D60base， TED， RAUtip， RAUbase， TAUtip and TAUbase） in the experimental group were lower than those in the control group （all P < 0.05）. No significant difference was observed in the normal erection rates on the first night between two groups （67.2% vs. 65.6%， P = 0.852）， and the normal erection rate on the second night in the experimental group was lower than that in the control group （78.1% vs. 57.8%， P = 0.014）. In the experimental group， the RCSQ scores on two nights were higher compared to those in the control group， and the RCSQ scores on the first night were lower than those on the second night in both groups （both P < 0.05）. Conclusions NPTR measurement yields the first night effect. Nitrazepam can significantly inhibit the nocturnal penile erection. Improving sleep quality cannot eliminate the first night effect， whereas increase the false negative rate of NPTR measurement. Nitrazepam should be avoided in the NPTR measurement for patients with normal sleep， whereas it can be given for patients with sleep disorders or sleep difficulty after full consideration of the advantages and disadvantages.

Abstract The purpose of this study was to investigate the prevalence and relevant factors of nocturia and its impact on sleep quality in university students in Mainland China. A large-scale survey was conducted on 14,000 university students from 3 universities in Henan province, China by using an anonymous questionnaire. The questionnaire collected the information from the past six months. The relationships between the prevalence of nocturia and its relevant factors were evaluated. A total of 13,874 questionnaires were collected and 13,104 qualified for statistical analysis. A total of 659 students suffered from clinically relevant nocturia (CRN) (4.56% in male and 5.34% in female). Both univariate analysis and the logistic stepwise regression model showed that the prevalence of nocturia was significantly related to female, history of enuresis, ease of waking up, urgency, frequency and RUTI (P

Abstract This study aimed to explore the mediating effects of ADL and depression on the relationship between sleep quality and HRQOL among older people in rural China, while also exploring the moderating impact of loneliness. The study gathered data from a household survey conducted among 1587 Chinese rural older adults (mean age = 73.63 years). The collected data was analyzed using SPSS version 23.0 software (IBM, New York, USA) and the PROCESS macro version 4.0 program. The findings indicated a significant correlation between sleep quality, ADL, depression, loneliness and HRQOL. ADL and depression exhibited a chain mediation effect on the relationship between sleep quality and HRQOL. Notably, the association between sleep quality and HRQOL was entirely mediated by ADL and depression. Additionally, loneliness acted as a moderator in the relationship between ADL and HRQOL. The findings of this study suggest that interventions focusing on sleep quality should prioritize strategies for enhancing older adults’ ADL and depression as integral components of promoting older adults’ HRQOL.

Abstract Anxiety disorders are the most prevalent worldwide mental health disorder, resulting in high societal costs. Emotion regulation and sleep quality are associated with the development of psychopathologies including anxiety. However, it is unknown whether habitual emotion regulation strategy use can mediate the influence of sleep quality on anxiety symptomology. An opportunity sample in a healthy population completed the Pittsburgh Sleep Quality Index to provide a measure of sleep quality, the Emotion Regulation Questionnaire to assess habitual use of emotion regulation strategies, and the Generalized Anxiety Disorder Scale to record anxiety symptomology. Data were analysed using correlation and regression-based mediation analyses. Improved sleep quality was predictive of reduced habitual use of expressive suppression and reduced anxiety symptomology. Additionally, increased use of expressive suppression was predictive of greater anxiety symptomology. Cognitive reappraisal was not associated with sleep quality or anxiety severity. Further, novel findings using mediation analyses show that expressive suppression partially mediated the relationship between sleep quality and anxiety. Whilst longitudinal and experimental research are needed to establish causality, these findings suggest that simultaneously targeting improvements in sleep quality and the use of specific emotion regulation strategies, including expressive suppression, may improve the efficacy of interventions focussed on reducing anxiety-related symptomology.

Abstract The purpose of this research was to ascertain how progressive muscle relaxation (PMR) technique affected hip fracture patients' anxiety, sleep quality, and post-operative pain. This parallel randomized controlled trial was conducted on 100 patients with hip fracture hospitalized in one of the reference orthopedic hospitals in Tehran, Iran who were selected using convenience sampling and randomly were placed in two PMR group (n = 50) and control group (n = 50). Data were collected by Demographic information questionnaire, Visual analogue scale for pain rating, Pittsburgh Sleep Quality Index and State-Trait Anxiety Inventory. The PMR technique was the progressive muscle relaxation technique, which was started the night after the surgery for three nights before going to bed. Data were collected on two occasions, including before the PMR technique and the day after the last stage of the PMR technique. The data were analyzed by SPSS software using descriptive and inferential statistics. The results revealed significant within-group changes in both groups' post-operative pain, sleep quality, and anxiety scores (P

Background In recent years, in the context of global aging, the number of patients with chronic diseases in China has increased significantly, and the the coexistence of multiple diseases has become more and more common, which seriously threatens the life safety and quality of life of the older adults in China. Objective To investigate the status of multimorbidity of older adults, and explore the relationship and pathways of action between sleep, physical activity, social network and multimorbidity of older adults, providing ideas for the effective prevention of multimorbidity and health improvement of older adults. Methods Elderly people aged≥60 years in the Community Health and Behavior of the Elderly Panel Study (CHBEPS) established by our team in 2021 were selected as the subjects of the survey, a questionnaire was used to investigate the study population, the research objects were investigated by questionnaire, and the general situation was collected by self-designed basic information collection form, IPAQ-S-C, LSNS-6 and PSQI were used to assess the physical activity, social network and sleep of the subjects. AMOS 28.0 statistical software was used to set up the structural equation model. Results A total of 3 392 valid questionnaires were collected from 3 531 people over 60 years old, with an effective recovery rate of 96.06%. The average score of physical activity was 2 426.42 (495.00, 3 060.00) MET-min/w, the average score of social network was (15.91±6.43), and the average score of sleep was (5.49±3.53). There were 788 (23.23%) older adults with insufficient social network and 353 (10.41%) older adults with fair or very poor sleep quality. The prevalence of multimorbidity among the survey respondents was 41.13% (1 395/3 392). The results of correlation analysis showed that social network was negatively correlated with sleep level (rs=-0.113, P

Background: This study aims to investigate the association between sleep duration, sleep quality, and the risk of low back pain (LBP) among middle-aged and elderly individuals in China. Methods: Utilizing data from the China Health and Retirement Longitudinal Study spanning 2011 to 2020, we categorized sleep duration into long, medium, and short categories, and sleep quality into good, fair, and poor levels. LBP status was determined based on self-reported information by participants. Multivariable logistic regression analysis was employed to assess the relationship between sleep duration, sleep quality, with the risk of LBP. Results: A total of 6750 individuals were included in the longitudinal study. After 9 years of follow-up, the prevalence of LBP was 25.69 %. In the fully adjusted model, compared to individuals with medium sleep duration, those with short sleep duration had a 28 % increased risk of developing LBP (OR = 1.28, 95%CI: 1.12, 1.46). Additionally, when compared to individuals with good sleep quality, those with fair and poor sleep quality had a 35 % (OR = 1.35, 95%CI: 1.19, 1.54) and 33 % (OR = 1.33, 95%CI: 1.12, 1.58) increased risk of LBP, respectively. Joint analysis of both factors revealed that individuals with poor sleep quality and short sleep duration had the highest risk of LBP. Conclusion: Among middle-aged and elderly individuals in China, short sleep duration and poor sleep quality were associated with an increased risk of LBP. Future studies should further explore the mechanisms underlying this association and validate the findings through randomized controlled trials.

Abstract Background and Aims Alternative therapies, such as zinc supplementation, have been explored as potential interventions for sleep disorders. However, the efficacy of zinc supplementation in improving sleep quality remains uncertain. This systematic review aims to examine the impacts of zinc supplementation on sleep quality in humans. Methods The Web of Science, Medline, Scopus, and Google Scholar databases were comprehensively searched to find studies investigating the effect of zinc supplementation on sleep quality. After identifying relevant studies by screening, relevant data were extracted from them. The quality assessment was conducted using the Cochrane quality assessment tool. Results This systematic review included eight studies. The interventions ranged from 4 to 48 weeks, with a daily dose of zinc supplementation varying between 10 and 73.3 mg. The majority of the evidence examined in this review pointed to the significant improvement effect of zinc supplementation on sleep quality in adults compared to the control groups. Furthermore, zinc supplementation did not have a significant effect on sleep disorders. However, there was no consensus about these findings. Also, the effect of supplementation on sleep duration in nonadults was contradictory. Conclusions This systematic review suggests that zinc supplementation may lead to improvements in sleep quality. However, more research, primarily clinical trials, is needed to clarify the beneficial effects of zinc supplementation on sleep quality with consideration of dietary zinc intake and the Recommended Dietary Allowances of zinc (RDA) in the different populations. It is also recommended to investigate the effect of zinc supplementation on sleep quality in people with zinc deficiency in future studies.

ObjectiveTo evaluate the feasibility of the Sleep Health through University Student Habits (SHUSH) program, a brief sleep improvement intervention based upon principles of cognitive-behavioral therapy for insomnia (CBT-I) developed for Japanese university students.MethodsPretest-posttest, single-arm pilot study design with 3-month follow up was used to evaluate the feasibility of SHUSH. We developed then offered a 90-min sleep education class based upon the two-process model of sleep regulation, sleep restriction, stimulus control, and sleep hygiene. We recommended individualized sleep prescriptions (e.g., prescribed time to bed and prescribed time out of bed) from 11 days of daily sleep diary data. We then offered 15 min of individualized follow-up meetings each week for three consecutive weeks in person or online in which we supported adherence to sleep prescriptions. Fifteen university students with self-reported sleep disturbance (Insomnia Severity Index; ISI score ≥ 9) completed the SHUSH program. Participants were on average age 19.7 years old; nine were women, and they were students in occupational therapy and physical therapy. We assessed validated Japanese versions of sleep-related (e.g., ISI, Sleep hygiene practice scale; SHPS), mental health-related (e.g., Generalized Anxiety Disorder Screener) patient-reported outcomes (PROs) and daily sleep diary variables (e.g., sleep onset latency and sleep efficiency).ResultsComparing baseline and posttest data, a statistically significant difference was observed in insomnia symptom severity, daytime sleepiness, sleep hygiene practices, eveningness to morningness, anxiety, depression, sleep diary improvements (e.g., sleep onset latency, total time in bed, and sleep efficiency). Comparing posttest and 3-mo follow up data (n = 10), a statistically significant difference wasn't observed for most PRO effects. However, there was a statistically significant difference in ineffective sleep behaviors (i.e., SHPS-J). We did observe a rebound effect for some SHPS-J items.ConclusionSHUSH was developed as a brief cognitive-behavioral intervention for insomnia. SHUSH participants showed improvements on sleep-related and mental health-related PROs after 4 weeks of intervention. At 3 months follow-up sleep quality and mental health gains were maintained. SHUSH was a feasible program. Randomized controlled trials are needed to test treatment efficacy on sleep related and mental health related PROs in the future.

Summary: Background: Depressive symptoms are rising in the general population, but their associated factors are unclear. Although the link between sleep disturbances and depressive symptoms severity (DSS) is reported, the predictive role of sleep on DSS and the impact of anxiety and the brain on their relationship remained obscure. Methods: Using three population-based datasets (N = 1813), we trained the machine learning models in the primary dataset (N = 1101) to assess the predictive role of sleep quality, anxiety problems, and brain structural (and functional) measurements on DSS, then we tested our models’ performance in two independent datasets (N = 378, N = 334) to test the generalizability of our findings. Furthermore, we applied our model to a smaller longitudinal subsample (N = 66). In addition, we performed a mediation analysis to identify the role of anxiety and brain measurements on the sleep quality and DSS association. Findings: Sleep quality could predict individual DSS (r = 0.43, R2 = 0.18, rMSE = 2.73), and adding anxiety, contrary to brain measurements, strengthened its prediction performance (r = 0.67, R2 = 0.45, rMSE = 2.25). Importantly, out-of-cohort validations in other cross-sectional datasets and a longitudinal subsample provided robust similar results. Furthermore, anxiety scores, contrary to brain measurements, mediated the association between sleep quality and DSS. Interpretation: Poor sleep quality could predict DSS at the individual subject level across three datasets. Anxiety scores not only increased the predictive model's performance but also mediated the link between sleep quality and DSS. Funding: The study is supported by Helmholtz Imaging Platform grant (NimRLS, ZTI-PF-4-010), the Deutsche Forschungsgemeinschaft (DFG, GE 2835/2–1, GE 2835/4-1), the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)—Project-ID 431549029—SFB 1451, the programme “Profilbildung 2020” (grant no. PROFILNRW-2020-107-A), an initiative of the Ministry of Culture and Science of the State of Northrhine Westphalia.

Background Coronavirus 2019 (COVID-19) causes lung tissue inflammation, affects mental health, and disturbs sleep and the musculoskeletal system. This study aimed to investigate the effects of COVID-19 on physical function and quality of life by comparing the body composition, physical fitness, sleep quality and quality of life between Thai young adults with and without post COVID-19 infection. Methods A cross-sectional study was comprised of two matched groups (post COVID-19 group and non COVID-19 group) with 36 participants in each group. Data about body composition, physical fitness, sleep quality and quality of life were collected using the bioelectrical impedance analysis, the 1-min sit-to-stand test, the hand grip strength test, the Pittsburgh sleep quality questionnaire and the EuroQol-5D-5L, respectively. Independent samples T-test, Mann-Whitney U test and Chi-square test were used to compare between the two groups. Results The changes in oxygen saturation and respiratory rate after the physical fitness test and the sleep quality analysis showed a statistically significant difference between the groups with and without post COVID-19 infection (p = 0.006, p = 0.003 and p = 0.003, respectively). However, quality of life and body composition were not significantly different between groups. Conclusions COVID-19 influenced the changes in oxygen saturation and respiratory rate after the physical fitness test and the sleep quality analysis in young adults. The results should be utilized to facilitate physical rehabilitation for COVID-19-infected individuals following infection. Those who have not been infected with COVID-19 must be informed of self-protection measures to avoid contracting the virus.