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Background: Data on the prevalence of sick building syndrome (SBS) and its components in medical staff working at the Semnan University of Medical Sciences are limited. Objectives: The present study investigated the prevalence of SBS and its related factors in the medical staff in Semnan, Iran. Methods: A cross-sectional study was done on 300 medical staff in Kausar Hospital in Semnan, Iran, in 2020. A standard questionnaire was used to obtain information about SBS and indoor air quality. In order to measure environmental factors, random sampling was taken from different parts of the hospital, including building inspection, dust samples, and indoor and outdoor air measurements. The condition of physical factors, including temperature, humidity, and ventilation, was checked using relevant devices. The NIOSH 0800 method was used to measure the biological status of the working spaces in terms of fungal and bacterial contamination. Data analyses were performed using SPSS 26. Results: The mean age of the participants was 32.23 ± 5.34 years, of whom 81% were women. The prevalence of SBS was 65%, with the highest prevalence in the emergency ward (18%), followed by internal (16%), intensive care unit (13%), and cardiac care unit (12%). Sleep disorder (65%), tiredness (59%), feeling heavy (47%), headache (46%) and stress (45%) were the most common components of the SBS. There was a statistically significant relationship between the presence of harmful environmental factors, including noise, static electricity, unpleasant smell, and infection, and the prevalence of SBS (all P-values < 0.05). Conclusions: Considering the high prevalence of SBS in hospital employees, re-engineering the hospital environment and improving the air quality and ventilation systems may be useful in preventing SBS. [ABSTRACT FROM AUTHOR]

Objective: Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), have been associated with sleep disturbances as extra-intestinal manifestations. We aimed to evaluate sleep quality in a group of Middle Eastern IBD patients while assessing the links between disease characteristics, sleep disturbances, and related comorbidities. Materials and Methods: Outpatient IBD cases who attended our hospital clinic from 2019 to 2021 were recruited in this prospective study. The patients filled in verified translations of the insomnia severity index, Epworth sleepiness scale, Pittsburgh sleep quality index, Berlin questionnaire for obstructive sleep apnea (OSA), and restless legs syndrome (RLS) questionnaire by means of online or phone surveys. The chi-squared test and Student's t-test were used for binary and continuous variables, respectively. The Mann-Whitney U test was used for non-normally distributed data. Results: The sleep quality of 82 IBD patients (13 CD and 69 UC) was assessed. Low sleep quality was observed in 52 cases (63.4%), and UC patients with pancolitis were significantly more likely to have sleep disturbances compared to patients with partial colitis (p=0.015). Moreover, patients with elevated C-reactive protein (CRP) displayed significantly higher frequencies of OSA and RLS (p=0.038 and p=0.040, respectively). Conclusion: Sleep impairment was identified in more than half of our IBD patient pool. Therefore, we suggest screening for sleep disturbances (particularly in UC patients with pancolitis) and related comorbidities, such as OSA and RLS (especially in patients with elevated CRP levels), in IBD patients to enhance their quality of sleep. [ABSTRACT FROM AUTHOR]

Introduction: Sleep quality is the main concern of patients after cardiac surgery. We compared the effect of two routinely used sedatives on the sleep quality of patients admitted to the intensive care unit (ICU) after cardiovascular surgery. Methods: It is a prospective, controlled, randomized clinical trial. A total of 120 patients, after cardiac surgery were enrolled. During extubating, patients were randomized into two groups: 60 patients received an infusion of dexmedetomidine (precede; 0.5 μg/kg/h), and 60 patients received 50 μg/kg/min propofol for 6 hours. Baseline characteristics were compared between the groups. The patients completed the St. Mary's Hospital Sleep Questionnaire, and the scores were compared between the groups. Results: The groups were not different in terms of demographics, underlying diseases, smoking/drug abuse/alcohol, number of vessels involved, history of non-cardiac surgery, and mean levels of serum parameters (P >0.05). Most of the medications used were similar between the groups (P >0.05), except calcium channel blockers (more frequently used in the propofol group [ P =0.027). The details of surgery were not statistically significant different (P >0.05); but, the mean volume of platelet received after the surgery was higher in propofol group (P =0.03). The propofol group had less problems with last night's sleep (0 vs 0.1±0.66), felt more clear-headed (4.9±0.6 vs 4.68±0.58, were more satisfied with their last night's sleep (52.1% vs 47.9%), but spent more time getting into sleep (0.38±1.67 vs 0) (P <0.5).> Conclusion: The sleep quality of patients under the influence of propofol seemed to be better than dexmedetomidine after cardiac surgery. [ABSTRACT FROM AUTHOR]

This study investigates the relation between eating disorder (ED) psychopathology and insomnia symptoms in Iran. Using network analysis with Iranian participants (N = 1956) who completed the Farsi versions of the Eating Disorder Examination-Questionnaire (F-EDE-Q) and the Insomnia Severity Index (F-ISI), we identified central and bridge symptoms within the ED and insomnia network. Central symptoms included a strong desire to lose weight, discomfort in seeing one's body, and fear of weight gain. Symptoms that served as bridges between ED and insomnia included difficulties in staying asleep, the impact of sleep problems on quality of life, and the influence of body shape on self-judgment. Targeting these bridge symptoms might enhance the effectiveness of interventions aimed at disrupting the linkage between ED psychopathology and insomnia. [ABSTRACT FROM AUTHOR]

Background & Objective: Pregnancy is an exceptionally delicate time in the lives of most women. Sleep disorders during pregnancy can substantially impact a healthy pregnancy. This study investigated the relationship between sleep quality during pregnancy and adverse maternal and fetal pregnancy outcomes. Materials & Methods: This was a prospective cohort study on 500 pregnant women referred to the Perinatology clinic. The Pittsburgh Sleep Quality Index questionnaire was used to evaluate sleep quality, and demographic data were collected from the case files of routine prenatal checkups. The study participants were followed until delivery. The association between sleep quality and postpartum complications, such as preterm birth, infant Apgar score, and (Neonatal Intensive Care Unit) NICU admission, was investigated. Results: This study included 500 pregnant women with a mean age of 31.12 ± 5.84 years. The number of pregnancies ranged from one to seven, with a mean of 2.55±1.30. Of the infants, 12% of infants were born prematurely and 27.8% required NICU admission. Poor sleep quality was found to be associated with preterm delivery (OR: 1.27, P = 0.039) and preeclampsia (OR: 0.543, P = 0.004). Women who experienced preeclampsia during pregnancy (P = 0.01), delivered via cesarean section (P = 0.009), and had infants weighing more than 2500 g (P = 0.07) exhibited significantly poorer sleep quality. Conclusion: We found that poor sleep quality was associated with preterm birth, cesarean section delivery, maternal preeclampsia risk, and the 5-minute Apgar score. Considering the impact of a mother's sleep quality on pregnancy outcomes, assessing mothers' sleep health appears essential in prenatal care. [ABSTRACT FROM AUTHOR]

Background: Substance abuse remains a challenging public health issue, especially among young people. It has been shown that poor sleep and substance abuse may have mutual intensifying effects. This study aimed to evaluate the rates of substance abuse, cigarette smoking, and alcohol consumption and their association with sleep disturbances among university students in 2021. Methods: The participants were the students of the Faculty of Sciences, University of Guilan, Iran in 2021. Data were collected through a researcher-made demographic questionnaire, the first two questions of the translated version of the World Health Organization (WHO) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and the Pittsburgh Sleep Quality Index (PSQI). Findings: A total of 222 students entered the study from March to August 2021. The rates of substance abuse in the past three months and lifetime were 35.6% and 45.5%, respectively. The most common type of substance abuse was related to the 'other substances' category. Substance abuse was significantly higher in students living in dormitories and those with a family history of substance abuse. Poor sleep was found in 34.2% of the students, and substance abuse and alcohol consumption both in the past three months and lifetime were significantly associated with lower sleep quality. Conclusion: This study showed that substance abuse was significantly associated with sleep disturbances. The study results also illustrated an upward trend of substance abuse in recent years among students in Rasht, which may be related to economic issues in the country and/or the effects of the COVID-19 pandemic. Considering the rising prevalence of substance abuse and its impacts on society, policymakers are highly recommended to pay special attention to its risk factors. [ABSTRACT FROM AUTHOR]

Background: Ensuring patient safety is of paramount importance in healthcare services. Sleep disorders not only have detrimental effects on the health of healthcare students but also significantly impair their performance, leading to an increased risk of medication errors. These errors can pose a grave threat to the safety and well-being of patients. It is crucial to address and mitigate sleep disorders among internship healthcare students to safeguard the quality of care and minimize potential patient harm. Objectives: This study aimed to investigate the predictors of Patient Safety Competency (PSC) based on the sleep quality of internship healthcare students. Methods: A study was conducted on 331 students from the Ardabil School of Nursing and Midwifery at Ardabil University of Medical Sciences in northwest Iran from August to December 2022. The participants were selected by stratified random sampling. Data were collected using a demographic information form, the Pittsburgh Sleep Quality Index (PSQI), and the Health Professional Education in Patient Safety Survey (H-PEPSS). The collected data were analyzed using SPSS software version 22.0. Person correlation coefficients were used to examine the relationship between PSC level, its dimensions, and sleep quality, while multiple linear regression was conducted to identify the predictors of PSC. Results: The competency of nurses in patient safety was average in both classroom and clinical settings. However, their ability to work as a team with other healthcare professionals scored the lowest. In addition, the quality of sleep was found to be a predictor of patient safety competency among healthcare students during their internships. Conclusions: It is important to note that healthcare students tend to have moderate patient safety competence (PSC), which is positively correlated with their sleep quality. Therefore, it is vital to identify the key factors that directly affect PSC. This would enable nursing and midwifery faculty administrators to take preventive measures to enhance patient safety competence in both classroom and clinical settings. Additionally, organizing educational workshops that engage students and improve their sleep quality could improve patient care. Practical courses are recommended for health professionals and students in clinical settings to enhance patient safety competencies. Additionally, student internships should receive hands-on training to improve teamwork and rest conditions. [ABSTRACT FROM AUTHOR]

Introduction: Pandemics and subsequent lockdowns can profoundly impact the mental well-being of college students. This study aimed to assess the extent of mental health challenges among college students during the initial COVID-19 lockdown in Iran, while also identifying associated factors. Material & Methods: Conducted as an online cross-sectional study, data were gathered during the first COVID-19 lockdown in Iran (between March 21,2020, and April 21, 2020). A total of 330 college students participated in an online survey, addressing questions across two parts. The first part encompassed demographic information such as age, gender, marital status, residency status, field of study, academic year, history of COVID-19 infection, presence of COVID-19-infected relatives, and adherence to a regular study schedule. In the second part, students completed the General Health Questionnaire-28 (GHQ-28). Descriptive and linear regression analyses were employed for data analysis. Results: Among participants, 38.6% reported probable somatic symptoms, 41.8% reported probable anxiety symptoms and sleep disturbances, 91% indicated potential issues with social functioning, and 23.9% reported probable depressive symptoms. Overall, 57.9% experienced potential psychological distress. Notably, adherence to a regular study routine (ß = -0.396) emerged as a negative predictor for potential psychological distress, whereas having COVID-19-infected loved ones (ß = 0.159) was identified as a positive predictor. Conclusion: The prevalence of probable somatic symptoms, anxiety, sleep problems, social functioning issues, depressive symptoms, and overall psychological distress was notably high among college students during the initial COVID-19 lockdown. However, maintaining a consistent study schedule, being married, and older age were associated with lower levels of potential psychological distress. Additionally, having loved ones infected with COVID-19 emerged as a risk factor for probable mental health challenges. [ABSTRACT FROM AUTHOR]

Background. Considering the increasing use of the Internet in Iranian society, especially among students, and the importance of sleep quality, the present study investigated the relationship between sleep quality and Internet addiction among medical students in Shiraz. Methods. In this descriptive-analytical study, the sample included students of the Shiraz University of Medical Sciences who were selected by a multistage sampling method in 2018. Each faculty was considered to be stratified, and the samples were selected from all strata by simple random sampling. A total of 400 student questionnaires were eligible for analysis. The level of sleep disturbance was measured using the Pittsburgh Sleep Quality Index (PSQI), and Young's Internet Addiction Test (IAT) was used to evaluate Internet addiction. Cronbach's alpha for PSQI and IAT was 0.77 and 0.93, respectively. Results. 109 (%28.9) and 58 (%14.4) of all the people under study were at risk of Internet addiction or poor sleep quality, respectively. The highest percentage of poor sleep quality was in those who were addicted to the Internet (60%), but the lowest percentage was observed in the group without addiction (27%). In addition, there was a significant correlation between Internet addiction and subjective sleep quality (r = 0.191, p = 0.05), sleep latency (r = 0.129, p = 0.01), sleep duration (r = 0.119, p = 0.01), habitual sleep efficiency (r = 0.186, p = 0.05), sleep disturbances (r = 0.169, p = 0.01), use of sleeping medication (r = 0.203, p = 0.05), and daytime dysfunction (r = 0.188, p = 0.05). Conclusion. These findings help national health officials and planners in Iran to design appropriate and effective interventions to improve students' health and prevent Internet addiction. [ABSTRACT FROM AUTHOR]

Objective: The sleep/wake cycle plays a vital role in mental health and daily life. Therefore, this study aimed to investigate the prevalence of circadian rhythm sleep disorders in the young population and their effect on psychological health and mental disability. Materials and Methods: The present study is part of the first phase of the Ravansar cohort (a branch of the Prospective Epidemiological Research Studies in Iran cohort) and included 2991 participants from Ravansar, Iran. Data were collected using standard questionnaires, including the Kessler Psychological Distress (PD) Scale (K10), Sheehan Disability Scale, and sleep timing. Results: The prevalence of advanced sleep phase disorder (ASPD) was 0.4% in the sample, the prevalence of delayed sleep phase disorder (DSPD) was 4.1%, and the prevalence of the desire to change sleep patterns was 61.3%. The results also showed that the level of PD in people with and without ASPD was not significant, but the level of PD was significantly higher in people with DSPD compared to those without (p<0.001). In another section, the results showed that there was no association between ASPD and disability, but there was a positive association between DSPD and disability. This means that the higher the DSPD, the greater the severity of disability. Additionally, the prevalence of ASPD and DSPD was higher in males. Conclusion: According to our results, the sleep/wake cycle in the sample did not follow a fixed pattern, and this irregularity was present in both sexes. Furthermore, the results demonstrated that the sleep/wake cycle and circadian rhythm are important factors in mental health and individual performance. [ABSTRACT FROM AUTHOR]

Background & aims: To examine the link between dietary insulin index (DII) and load (DIL) and sleep duration/quality for the first time. Methods: This cross-sectional study conducted on data from the recruitment phase of Yazd Health Study (YaHS)-Yazd Nutrition Study (TAMYZ), prospective study in Yazd, central Iran. Data on demographic characteristics, dietary intakes, sleep quantity and quality, and potential confounders were gathered by interview. Sleep quality and its components (insufficient sleep, delay in falling asleep, medication use for sleep, and sleep disorder) were assessed by a modified version of Pittsburgh questionnaire. The link between DII/DIL and low sleep quality and short/long sleep duration was studied using multivariable logistic regression. Results: In total, 5925 individuals aged 20 to 70 were eligible to take part in the current study. After adjustment for all potential confounders, participants in the highest DIL score tertile had a lower chance for sleep disorder (OR = 0.38; 95%CI: 0.17–0.85, Ptrend = 0.02) and delay in falling asleep (OR = 0.66; 95%CI: 0.42–1.03, Ptrend = 0.05) compared to those in the lowest tertile. The DII was also linked to a lower chance for sleep disorder (OR = 0.61; 95% CI: 0.39–0.93, P trend = 0.02). The DIL was inversely associated with sleep medication use and delay in falling sleep in men and women, respectively (P < 0.05). Moreover, DII was linked to a decreased odds of sleep disorder in women (P < 0.05). The associations were observed in those with overweight or obesity but not in those without overweight (P < 0.05). Conclusion: Higher DIL and DII might be associated with sleep quality and its components. Prospective investigations are needed in the future to confirm these findings. [ABSTRACT FROM AUTHOR]

Aims This research has been conducted to investigate the effects of eight weeks of sports exercises in water on sleep disturbance and alexithymia on inactive veterans of Ilam city. Materials & Methods The method of this study was a quasi-experimental with pre-test-post-test design with control group. The Statistical Population of the research consists of all veterans of the Ilam city from whom a sample of 28 individuals was selected by using available and voluntary sampling method in two experimental groups (14 people) and control (14 people) as samples. The library method was used to collect the background and theoretical foundations of the research and two standard sleep quality questionnaires of Pittsburgh (1989) and Toronto Alexithymia (1994) were used to collect data. For analysing the data, univariate and multivariate analysis of covariance with SPSS-v24 was employed. Findings The results of this study indicated that before the exercise intervention, there were no significant differences in sleep disturbance and alexithymia between the experimental and control groups and the two groups were homogeneous. however, after the exercise intervention, improvements in sleep disturbance and alexithymia were observed in the experimental group compared to the control group (p=0.05). Thus, sports exercises in water have a significant impact on reducing sleep disturbance and alexithymia in the experimental group. Conclusion Sports exercises in water lead to improvements in sleep disturbance and alexithymia in veterans. Therefore, the Foundation of Martyrs and Veterans Affairs can utilize this intervention method to enhance sleep disturbance and alexithymia among veterans. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine the environmental factors associated in Iranian patients with inflammatory bowel disease (IBD). Background: The role of environmental factors in the development of IBD remains uncertain. Methods: In this case-control study, the patients with IBD referred to the Taleghani Hospital, Tehran, Iran, were recruited from 2017 to 2019. Controls were matched by sex. Data were collected using the designed questionnaire and also valid questionnaire such Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) for sleep quality and anxiety/depression, respectively. Conditional logistic regression models were used to estimate adjusted odds ratios (ORs). Results: The study population included 200 individuals: 100 (50%) IBD patients and 100 (50%) controls. Age under 50, marital status, sleep difficulties, vitamin D insufficiency, anxiety/depression, dietary fiber deficit, post-menopausal hormone treatment, oral contraceptives, and antibiotics were all prognostic factors for IBD on the univariate analysis (P< 0.005). In multivariate analysis, the risk of IBD was significantly increased with 50 years (OR: 6.699, 95%CI: 3.271-8.662, P=0.017), abnormal sleep status (OR: 6.383, 95%CI: 3.389-7.19, P=0.001), and using oral contraceptive (OR: 7.426, 95%CI: 5.327-9.865, P=0.001). However, the risk of IBD was significantly decreased with older age (OR: 0.795, 95%CI: 0.697-0.907, P=0.001) and married status (OR: 0.008, 95%CI: 0.001- 0.438, P=0.018). Conclusion: Data suggest that the environmental factors play a significant role in the etiology of IBD and probably on the disease course. While the evidence for some factors is strong, many factors require further supportive data. [ABSTRACT FROM AUTHOR]

Introduction: Sleep disorders are the most common behavioral complaints in children. Therefore, this study was conducted to determine the sleep habits of children admitted to Amirkabir Hospital, Arak, Iran. Material & Methods: In this descriptive cross-sectional study, children aged 4 to 12 years admitted to Amirkabir Hospital clinic in 2021 were randomly studied. Data obtained from the Children's Sleep Habits Questionnaire were analyzed using SPSS24.0 software. Findings: A total of 295 children with a mean age of 7.26±2.27 years were studied. The prevalence of the disorder in sleep habits was 67.4%. Among the children with disturbed sleep habits, 193 (96.9%) had poor sleep habits and 6 (3.1%) had average sleep habits. The total sleep habits score was significantly higher in girls, unwanted children, and children with divorced parents, low parental education level, and incompatible parents (P<0.05). However, there was no significant association between the total sleep habits score and children's age (P>0.05). Discussion & Conclusion:In this study, most children showed disturbed sleep habits. Considering that children's poor sleep habits may be a contributing factor for stress, pressure, and tension in the family, mass education and psychiatric intervention are needed in this regard. [ABSTRACT FROM AUTHOR]

Introduction: Sleep disorders are one of the most common disorders among hemodialysis patients which is associated with the demographic and laboratory factors of such patients. Objectives: The present study aims to investigate the quality of sleep and its relationship with some demographic and biochemical factors in a group of hemodialysis patients. Patients and Methods: This study is cross-sectional conducted on end-stage renal disease (ESRD) patients who underwent regular and continuous hemodialysis in Amin hospital of Isfahan. The Pittsburgh Sleep Quality Index (PSQI) was completed face-to-face for each individual. Other data included age, hemoglobin and hematocrit, adequacy of hemodialysis, serum alkaline phosphatase, ferritin, iron, calcium, phosphorus, parathyroid hormone and body mass index were receded too. Results: In this study, 110 hemodialysis patients were investigated (71 men). In this study, 41.8% of the patients had sleep disorder. We found, no difference between demographic and laboratory factors of patients with and without sleep disorder (P > 0.05 for all parameters). No significant difference was detected among men and women regarding sleep disorder (P > 0.05). Accordingly, no significant difference in sleep disorder between patients with and without diabetes was found too (P > 0.05). However, our study showed a significant direct relationship between age and sleep disorder (P = 0.026) particularly in women (P = 0.011). Conclusion: Sleep disorder is common in patients undergoing hemodialysis and is directly related to the patients' age; however, larger studies in this field are necessary. [ABSTRACT FROM AUTHOR]

The aim of the present study was to explore the potential relationships between menopausal symptoms, sleep quality, hot flash, and depressive symptoms in postmenopausal women. A cross-sectional study was designed with 150 healthy postmenopausal women (45–60 years of age) who had referred to the menopausal clinic in Babol. The participants completed the following instruments throughout the study: the Beck Depression Inventory for depressive symptoms, the Modified Blatt-Kupperman Menopausal Index for measuring menopausal symptoms, and the NEO-FFI for identifying the personality traits. After controlling all the covariates, high depressive symptoms were found to be associated with moderate/sever menopausal symptoms, poor sleep quality, and the average and high level of neuroticism. The results also demonstrated that the risk of depressive symptoms was lower in menopausal women with high level extroversion, high level agreeableness, and the average and high level of conscientiousness. The findings of the present study indicated that personality traits, menopausal symptoms, and poor sleep quality in particular can partially account for depression in Iranian menopausal women. It is highly imperative that effective health education or implement appropriate strategies to improve the quality of life for these women. [ABSTRACT FROM AUTHOR]

Background: Shift work disrupts the sleep rhythm and leads to daily sleepiness and physical and mental complications. Objectives: This study aimed to investigate the predictive role of shift work in poor sleep quality and daytime sleepiness in railway personnel. Methods: This descriptive-analytical and cross-sectional study was conducted on the employees of the Khorasan railway in Iran in 2021, 450 individuals of whom were selected as a sample using the census sampling method. The data collection method was through a checklist containing demographic information and related factors (e.g., employment history) and through a physician to evaluate underlying diseases, body mass index (BMI), smoking and use of substances (past medical history), and completion of standard questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Karolinska Sleepiness Scale (KSS), and STOP-BANG questionnaire. The data were analyzed using the t-test and simultaneous multivariate regression analysis by SPSS software (version 24). Results: Out of 450 employees, 144 (32%) and 306 (68%) subjects were day workers and shift workers, respectively. The average age of the participants was 40 ± 5.97 years. A significant difference was observed between the BMI with PSQI, KSS, and STOP-BANG scores (P = 0.001). Additionally, binary logistic regression analysis showed that shift work had a significant effect as a risk factor on both PSQI scores (CR = 1.25, 95% CI: 1.16-1.32, P = 0.001) and KSS scores (CR = 1.43, 95% CI: 1.29 - 1.59, P = 0.001). Conclusions: Shift work could increase the amount of sleepiness during work in personnel as the main cause, along with other effective factors, such as personal and occupational characteristics. [ABSTRACT FROM AUTHOR]

Introduction: Given the high prevalence of poor sleep quality in late adulthood, older adults might be involved with different physical, mental and social consequences of this disorder. Current research was conducted to examine the association between sleep quality and cognitive function in community-dwelling older adults. Methods: This cross-sectional study was carried out on 800 community-dwelling people aged = 60 years living in Amirkola, North of Iran. The participants were selected by simple random sampling method. Mini-Mental State Examination, and the Pittsburgh Sleep Quality Index (PSQI) were used for data collection. Seven components of the sleep quality were categorized into the four groups (very good, relatively good, relatively poor, and very poor condition). The participants were divided into the two groups based on their cognitive function, and sleep quality was compared between these two groups. Mann-Whitney, Spearman's correlation analysis, Chi-square, Pearson's correlation test and Logistic regression analysis were used to analyze the collected data. Results: Mean PSQI score among the older adults with normal and abnormal cognitive function was 5.5 ± 3.2 and 5.8 ± 3.3, respectively (p = 0.508). Poor sleep quality was slightly more prevalent in the elderly with cognitive dysfunction (p = 0.775). Logistic regression analysis revealed age (adjusted OR = 1.06; 95% CI: 1.03-1.08; p < 0.001) and level of education (adjusted OR = 0.14; 95% CI: 0.09-0.20; p < 0.001) had a significant impact on cognitive function; PSQI score (p = 0.254), gender (p = 0.661), and administration of sleeping drugs showed no significant effect (p = 0.081). Conclusion: Among different components of sleep quality, a significant positive association was observed between the frequency of sleep disturbances with cognitive function in older adults; furthermore, older age and lower level of education showed a significant negative effect on cognitive function. [ABSTRACT FROM AUTHOR]

Background: With increased life expectancy and changes in lifespan, now women spend more years after menopause. Women with menopausal symptoms may experience a lower quality of life (QoL) and complain about poor sleep quality. This study aimed to examine the relationship between QoL and sleep quality in postmenopausal women. Methods: This research was a predictive correlational study. The study sample was 200 postmenopausal women referred to the healthcare centers affiliated with Mashhad University of Medical Sciences in Mashhad City, Iran, in 2021. The subjects were selected through multistage cluster sampling. To assess the quality of sleep and life quality, the Pittsburgh Sleep Quality Index (PSQI) and Menopause-Specific QoL questionnaire (MENQOL) were used. The obtained data were analyzed by the Pearson correlation coefficient and multiple linear regression in SPSS software, version 21. The significance level was set at P<0.05. Results: The Mean±SD age of the subjects was 53.92±6.13 years. Their Mean±SD scores of sleep quality and QoL were 48.62±21.98 and 4.93±2.74, respectively, and 37% of women had sleep disorders. The multiple determination coefficient for the linear regression model was equal to 0.35, and there was a significant direct relationship between sleep quality and QoL (b=3.72, 95% CI =2.70-4.74, P<0.001). So for each unit change in sleep quality, the average QoL score increased by 3.72 units. Conclusion: Considering the relationship between sleep quality and QoL in postmenopausal women, it is recommended that these women use appropriate methods to improve sleep quality. Also, health professionals should keep this issue in mind when examining the health status of this group of women. [ABSTRACT FROM AUTHOR]

Insomnia and sleep disorders are common and can be severe amongst patients with cancer, especially during chemotherapy. The aim of this study was to evaluate the efficacy of lettuce seed syrup in breast cancer patients who suffer from insomnia or disordered sleep. This pilot study was a double-blinded randomized controlled clinical trial conducted in Shoha-e-Tajrish Hospital (Tehran, Iran) from September 2018 to June 2019. 50 adult patients with breast cancer with insomnia or sleep disorders were enrolled. Participants were randomly allocated to lettuce seed syrup (5 mL twice daily), or placebo syrup at the same dose for four weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality before and after the intervention. Compared to placebo, the mean of the total PSQI score decreased significantly in participants who received lettuce seed syrup (p=0.014). In addition, there were statistically significant reductions in the mean scores of subject quality sleep (p=0.002), sleep duration (p=0.038), habitual sleep efficacy (p=0.029) and sleep disturbance (p=0.032) in patients who received lettuce seed syrup. Lettuce seed syrup may improve self-reported sleep quality in participants with breast cancer. Larger trials are indicated in diverse samples of participants with caner to learn if these finds are generalizable. [ABSTRACT FROM AUTHOR]

It is an important fact that the onset of adolescence is a time of both physiological and social changes that affect sleep. In this study, the prevalence of sleep disorders in adolescents and the association between them were investigated. Anthropometric dimensions (such as height and weight) of individuals in Kerman in 2019 were also assessed. A total of 451 adolescents (mean age: 14.72 years; 51.88% females) of Kerman, Iran, took part in this cross-sectional study. Participants completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and then demographic (age, gender) and anthropometric data (weight and height) were collected. The prevalence of sleep disorders in this population was 31.9%. Among those with self-rated sleep disorders, 53.5% were males. Participants with sleep disorders were younger and showed lower anthropometric values such as height, weight, and body mass index. However, there was no difference between sleep disorders and gender (P-value >.05). This study revealed a relatively high prevalence of sleep disorders among adolescents. This research was done with the aim of encouraging the healthcare organization to design educational programs to evaluate and reduce sleep disorders. [ABSTRACT FROM AUTHOR]

One of the most important problems that the older adults is sleep disorders, where poor quality sleep claims the third rank of problems of the older adults. This study aims to determine the prevalence of sleep disorders among Iranians older adults through a systematic review and meta-analysis. The present study was conducted through meta-analysis method within the year range of March 2000–July 2018 by searching in ScienceDirect, Medline (PubMed), Barakat and Magiran, SID, and Google Scholar databases. Analysis was conducted in Comprehensive Meta-analysis software. Prevalence of the sleep disorder in the older adults Iranians was obtained as 48.9% (95%CI: 40.4–57.4%). The maximum prevalence of sleep disorder among the older adults in Tehran was observed in 2011 with 88.4% (95%CI: 82.6–92.5%), while the minimum prevalence of sleep disorder in Tehran was observed in 2013 with 22.8% (95%CI: 18.9–27.1%). Based on Meta regression, with the increase in the sample size and the year of the research, prevalence of sleep disorder in the older adults grows, which is statistically significant (p < 0.05). The results of this study suggest that prevalence of sleep disorder in the older adults in Iran is high, which requires serious interventional measures on the part of health policymakers. [ABSTRACT FROM AUTHOR]

Background Organizations, like humans, are exposed to diseases. Nurses in medical centers interact with the organization; therefore, the disease in organization have adverse effects on them. Objective This study aims to find different types of organizational diseases in the hospitals of Guilan province and their effect on nurses Methods This is a qualitative study using thematic analysis. It was conducted in Guilan University of Medical Sciences and the hospitals in Rasht,Iran. Data were collected by interviewing 10 faculty members and the nursing managers of Razi Hospital. Results The major known diseases were divided into 3 categories: physical, psychophysical, and psychological diseases. The physical diseases included organizational constipation, organizational paralysis, and organizational sepsis. The psychological diseases included depression, aggression, and sleep disorders. The psychophysical diseases illnesses were posttraumatic damage, organizational shock, and organizational cancer. Conclusion By generalizing human diseases to organizations, a clear path to diagnosis of the sick organization and its symptoms can be achieved. Identification of diseases, such as organizational asthma, organizational trauma, organizational paralysis, organizational sepsis and cancer and other diseases in the organization prevents the development of organizational challenges. The improved health of the organization can lead to the development of nurses' health. [ABSTRACT FROM AUTHOR]

Objective: Marital commitments and mental health are the important indicators of marital quality. Considering the modern and mixed marriage pattern in recent years, compared to the traditional pattern, as well as the increase in divorce rates due to reduced marital commitment, the present study was conducted to compare marital commitment and mental health in various patterns of mate selection among married women. Method: This cross-sectional study was performed on 160 married women aged 15-49 years in Babol city, Iran, who were selected by convenience sampling from health centers under the auspices of Babol University of Medical Sciences. Data collection tools included the spouse-selecting style, marital commitment (Adams and Jones), and general health questionnaires. Data analysis was performed in SPSS V.25 software, using analysis of variance (ANOVA), and Chi square tests. Results: Results showed that the mean score of marital commitment and its three dimensions (commitment to spouse, commitment to marriage and sense of commitment); general health; physical, anxiety and sleep disorders; as well as social function of married women are not significantly different in traditional, mixed and modern marriage patterns. There was a significant difference in the mean score of depression between traditional, mixed and modern marriage patterns. Pairwise, ANOVA revealed that the mean of the depression score was significantly higher in traditional marriage than in the mixed marriage pattern (P = 0.012). Different marriage patterns had statistically significant differences in demographic variables such as age, the place of birth of the wife and the husband, duration of marriage, number of children and the level of education (P < 0.05). Conclusion: It seems that there is a kind of convergence in marital commitment in various patterns of marriage among married women in Babol city. [ABSTRACT FROM AUTHOR]

Background: The demand for home care services has increased not only due to the increase in the elderly population but also due to consumer preference and technological advances that allow for the provision of sophisticated home care. Home healthcare services aim to help people improve their performance, live a more independent life, improve their well-being, and help them stay at home, and avoid hospitalization. Objective: This study was conducted to compare the quality of life (QoL) of COVID-19 patients under home care at a hospital in Qazvin City, Iran. Methods: his study was a cohort study. The samples included two groups of patients, hospitalized patients due to COVID-19 and patients with COVID-19 who received medical and nursing care at home. Patients were matched for age, underlying disease, and severity of the COVID-19 disease. In this study, a 3-month follow-up on changes in QoL compared to before hospitalization and receiving care at home was performed using a QoL questionnaire (SF-12). Findings: The mean score of QoL in the home care group was 32.36±2.15 and in the hospitalized group, it was 29.70±2.94, which shows a statistically significant difference, and the quality of home care patients reported to be higher than hospitalized patients (P<0.001, t=7.20) Conclusion: Receiving hospital care at home increases the QoL for patients with COVID-19. This finding can be generalized during different epidemics, and home care can be an excellent alternative to hospitalization for some patients. [ABSTRACT FROM AUTHOR]

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Background: The aim of this study was to comparing the complications (depression, anxiety, sleep disorders and sexual dysfunction) of buprenorphine, methadone and opium tincture as an alternative drug treatment in patients referred to the National Center for Addiction Studies of Tehran during 2020–2021. This cross-sectional study was concocted on 197 patients referred to the National Center for Addiction Studies of Tehran who were treated with one of the alternative treatments of opioids buprenorphine (n = 24), methadone (n = 116), and opium tincture (n = 57) during 2020–2021. Three questionnaires were used to assess the side effects of drugs including Anxiety and Depression Hospital Scales (HADS), AIS (Athens insomnia scale) and the International Index of Erectile Function (IIEF). Data were analyzed using Stata 14.0. The multinomial logistic regression model was used in order to compare complications in the three groups and adjusted odds ratio (OR) with 95% confidence interval (CI) were estimated. Results: The mean age in the buprenorphine, methadone and opium tincture groups were 46.80 ± 9.90, 48.31 ± 13.33 and 55.30 ± 10.34 years, respectively. The numbers of men were 17 (70.80), 90 (77.60), and 50 (78.70); respectively. Multinomial logistic regression model showed OR = 0.73 (95% CI 0.61–0.88) for anxiety in the methadone group in compared to buprenorphine. Likewise, OR = 1.22 (95% CI 1.001–1.48) and OR = 1.34 (95% CI 1.10–1.63) was observed for sleep disorder in the methadone and opium tincture groups in compared to buprenorphine; respectively. Conclusions: Sleep disturbance in buprenorphine group is less than opium tincture and methadone. Also, anxiety in the methadone group was lower than the buprenorphine, however, there was no significant difference between the three groups in term of sexual function and depression. In addition to control measures for sleep disorders in receiving methadone and buprenorphine, the cohort studies with a higher sample size are recommended. [ABSTRACT FROM AUTHOR]

Objective: Sleep disorders are associated with many health problems including anxiety, depression and coronary artery disease (CAD). This study investigated the prevalence, predictors and health impacts of insomnia and hypersomnia in southeastern Iran as well as the five-year incidence rate (IR) of these sleep disorders. Method: The present study was a cross-sectional, single-stage, cluster sampling study examining nine CAD risk factors (KERCADR study phase two), including sleep disorders, carried out in Kerman on 9997 participants, 15 to 80 years old. Medical examination along with demographic, sleep status, Physical activity level (GPAQ), anxiety and depression status (Beck Inventories) were assessed and fasting blood sample was taken for blood glucose and lipids analysis. STATA v15 software was used for data analysis using survey data analysis package and a univariable survey logistic regression model. Results: From 9997 participants, 59.4% were female. 45.3% of the participants were suffering from insomnia and hypersomnia, which was 15% more than the phase 1 prevalence (P < 0.001). Participants with insomnia had higher chance of being anxious, but participants with hypersomnia had higher chance of being depressed, be a cigarette smoker, opium user, and sedentary (P < 0.001). In regards to marital status, prevalence of hypersomnia was as follows in ascending order of prevalence: singles > married > widowed > divorced. While the IR of insomnia was higher in females, males had higher IR of hypersomnia. In addition, the IR of both sleep disorders was higher in participants with Low Physical Activity (LPA). Conclusion: The results showed high current prevalence and increasing trends of sleep disorders in the past five years. If left unaddressed, burden of CVDs in the community will demonstrate a significant increase in the future as a result of sleep disorders and other associated risk factors. [ABSTRACT FROM AUTHOR]

Background: Delirium is a neurobehavioral syndrome, which is characterized by a fluctuation of mental status, disorientation, confusion and inappropriate behavior, and it is prevalent among hospitalized patients. Recognizing modifiable risk factors of delirium is the key point for improving our preventive strategies and restraining its devastating consequences. This study aimed to identify and investigate various factors predisposing hospitalized patients to develop delirium, focusing mostly on underlying diseases and medications. Method: In a prospective, observational trial, we investigated 220 patients who had been admitted to the internal, emergency, surgery and hematology-oncology departments. We employed the Confusion Assessment Method (CAM) questionnaire, The Richmond Agitation Sedation Scale (RASS), the General Practitioner Assessment of Cognition (GPCOG), demographic questionnaire, patient interviews and medical records. Multivariate logistic regression models were used to analyze the predictive value of medications and underlying diseases for daily transition to delirium.; demographics were analyzed using univariate analysis to identify those independently associated with delirium. Results: Two hundred twenty patients were enrolled; the emergency department had the most incident delirium (31.3%), and the surgery section had the least (2.4%); delirium was significantly correlated with older ages and sleep disturbance. Among multiple underlying diseases and the medications evaluated in this study, we found that a history of dementia, neurological diseases and malignancies increases the odds of transition to delirium and the use of anticoagulants decreases the incident delirium. Conclusion: Approximately 1 out of 10 overall patients developed delirium; It is important to evaluate underlying diseases and medications more thoroughly in hospitalized patients to assess the risk of delirium. [ABSTRACT FROM AUTHOR]

Background: Hospitalization of patients in an intensive care unit (ICU) is associated with a series of psychological problems for their family members called family intensive care unit syndrome (FICUS). Nonetheless, family members of patients in ICU often receive little attention from health care providers. Exploring family members' experiences of their patients' hospitalization in ICU helps health care providers focus more clearly on their problems. Aims and objectives: This study aimed to explore FICUS‐related experiences among the family members of patients in ICU. Design: This was a qualitative content analysis study. Methods: This qualitative study was conducted in 2019. Participants were 14 family members of patients in ICU who were purposively selected from three hospitals in Tehran, Iran. Data were collected using semi‐structured interviews and were analyzed using qualitative content analysis. Results: Participants' experiences of FICUS fell into four categories, that is, threat to psychological well‐being (with four subcategories), threat to physical health (with three subcategories), threat to social health (with three subcategories), and change in spiritual orientation (with two subcategories). The 12 subcategories of these categories were emotional disturbances, hopelessness, changes in sleep pattern, mood changes, physical symptoms, aggravation of the existing illnesses, negligence towards personal health, alteration in social interactions, alteration in the burden of responsibility, alternation in the life process, resort to spiritual beliefs, and spiritual conflict, respectively. Conclusion: FICUS symptoms are not limited to psychological problems, rather they include a wide range of psychological, physical, social, and spiritual problems, which can affect the different aspects of family members' lives. Along with care delivery to patients in ICU, health care providers should provide care and support to patients' family members. Relevance to clinical practice: FICUS is a major threat to health among the family members of patients in ICU. Careful assessment of these family members helps identify family members who are at risk for FICUS and identify FICUS effects on their decisions and health status. [ABSTRACT FROM AUTHOR]

Background. Improving living conditions and increasing life expectancy have led to aging of societies. Lifestyles of the elderly and its related chronic diseases have changed by all of these factors, so this study was conducted to assess the correlation between lifestyle and chronic diseases of the elderly in Gonabad in 2019. Methods. In this descriptive-analytical study, 600 elderly residents of Gonabad were selected randomly from population covered by the three community health centers of Gonabad. Data was collected using lifestyle and its related chronic diseases questionnaires. These questionnaires were completed by interview method. The data were analyzed using independent t-test, paired t-test, ANOVA, Pearson test and chi-square test (SPSS software version 23). Results. Of the 600 participants, 321 (53.5%) were male and 279 (46.5%) were female with a mean age of 47.68 years. The lifestyle of the elderly was 0.7% favorable, 36.2% relatively favorable and 62.7% unfavorable. The prevalence of diseases in the elderly was heart disease 31.3%, blood pressure 42.8%, heart attack 8.2%, stroke 4.8%, diabetes 17.8%, cancer 6.5%, shortness of breath 17.3%, malnutrition 5.2%, constipation 16.3%, arthritis 27.3%, osteoporosis 21.3%, depression 12.8%, urinary problems 20%, vision problems 12.3%, hearing problems 12.2% and sleep problems 14%. There was a significant relationship between lifestyle and gender (P=0.001) so that the lifestyle average value of men was higher than women. There was also a negative and significant relationship between age and lifestyle (r=- 0.34) (P<0.001) so that with increasing age, lifestyle mean value decreased. Mean value of lifestyle based on educational levels was significant difference. Conclusion. Due to the high percentage of chronic diseases, low lifestyle in the elderly and relationship between lifestyle and chronic diseases of the elderly, screening and monitoring of chronic diseases should be given more attention. Also, improving the lifestyle of the elderly should be considered. Practical Implications. There is no clear and accurate information about the lifestyle of the elderly and related diseases in different parts of the country, so this study helps to better understand the lifestyle of the elderly and related chronic diseases, and by knowing them, strategies can be And designed more effective interventions to improve the lifestyle of the elderly in order to prevent and control chronic diseases threatening the elderly. [ABSTRACT FROM AUTHOR]

Background: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition, which can reduce the quality of life (QoL). Objectives: This study aimed to evaluate the impact of FMS on health-related quality of life (HRQoL) and the possible related factors such as sociodemographic and psychological variables. Methods: In this cross-sectional study, 150 women patients with FMS were included who visited a psychosomatic clinic at a referral center in northern Iran. The samples were selected in a consecutive procedure from April 2019 to March 2019. Sociodemographic variables, HRQoLscore [36-Item Short Form (SF-36) Health Survey], and the Pittsburgh Sleep Quality Index (PSQI) were recorded. Data were analyzed using the SPSS Statistics software (ver. 24). The quantitative data were reported as mean -- SD, and the qualitative variables were presented as frequency and percentage. Also, analysis was performed using analytical tests such as chi-square test (χ²). P < 0.05 was considered to be significant. Results: The mean (SD) age was 42.35 (11.73) years. The mean physical and mental health scores were 33.45 (16.22) and 48.99 (18.19), respectively. Moreover, 88% of patients had moderate-to-severe sleep disorder, and those who did not, had a better physical and mental health status [42.7 (14.1) vs. 32.2 (16.1), P-value = 0.009 and 62.2 (16.3) vs. 47.2 (17.7), P-value = 0.001, respectively]. History of depression according to self-reporting was associated with worse mental health subscale scores [44.4 (16.8 Vs. 52.4 (18.5), P-value = 0.007], and lower scores in social functioning and emotional well-being (P-value = 0.012, P-value = 0.001, respectively). Being postmenopausal was associated with a lower physical health quality (P-value = 0.049). Body Mass Index (BMI) reversely correlated with HRQoL subscales (r = -0.163, P-value = 0.046), but the subscales were not affected by the level of income (P-value = 0.644, P-value = 0.170, respectively). Conclusions: Patients with fibromyalgia report a considerable significant impact on their quality of life and impaired sleep quality. Assessment of sleep quality and QoL are needed in patients with fibromyalgia. [ABSTRACT FROM AUTHOR]

Background & Aims: Sleep and epilepsy are complex interactions and are completely interdependent, so that some patients experience seizures while asleep or deprived of sleep or when waking up, and for some they occur during the day or night (1). The American Psychiatric Association defines sleepiness as symptoms of excessive quantity of sleep (e.g., extended nocturnal sleep or involuntary daytime sleep), deteriorated quality of wakefulness (i.e., sleep propensity during wakefulness as shown by difficulty awakening or inability to remain awake when required), and sleep inertia (i.e., a period of impaired performance and reduced vigilance following awakening from the regular sleep episode or from a nap) (2). Its prevalence is higher in seizures than in the control group (3, 4) and in different groups seizures have been reported between 31 to 60% (5-7). According to common clinical beliefs, sleep disruption can have a significant effect on memory, as REM sleep or slow-wave sleep is essential for optimal cognitive function (3), and excessive daily sleepiness can increase seizures (8, 9) and pain (10) in patients; However, the exact function of sleep remains unclear, and the findings have not always been consistent. These discrepancies require the conduct of research in which, through a comprehensive look, a large number of parameters related to sleepiness are present in seizures. In other words, the heterogeneity of the previous findings highlights the variability of the course of the disease as a result of the interaction of sleepiness and seizures, which makes it necessary to conduct more research to better understand the problems of patients. Therefore, the aim of the present study was to investigate the comorbidity effect of sleepiness and epilepsy on cognitive functions, quality and severity of pain and disease severity markers in patients with epilepsy. Methods: The present research was conducted as a case-control study in 2020 in Shiraz Namazi Hospital. The statistical population of this study included all patients with focal epileptic seizures (temporal lobe epilepsy) (n = 30) and generalized (idiopathic generalized epilepsy) (n = 21) and psychogenic non-epileptic seizures (n = 17) in Shiraz. Through their follow-up treatment process, they referred to the epilepsy and seizure ward of Shiraz Namazi Hospital, from which 68 patients with inclusion criteria were selected through purposive sampling method. According to the inclusion and exclusion criteria, each patient completed a comprehensive list of demographic and clinical variables, the Stanford Sleepiness Scale, the Montreal Cognitive Assessment, the McGill Pain Questionnaire, and the Visual Analogue Scale under the supervision of an on-site clinical psychology PhD student. After collecting research data, patients with seizures were divided into two groups with sleepiness (n = 45) and no sleepiness (n = 23) through a cut score equal to or greater than 3 on the Stanford Sleepiness Scale. Data were analyzed using parametric and non-parametric tests in version 24 of SPSS software. Results: Preliminary findings showed that there was a significant difference between the two groups of patients with epilepsy with and without sleepiness in terms of mean age and frequency of antiepileptic drugs (P <0.05); While there was no difference between the two groups in terms of type of seizure, education, gender, marital status and employment status. In order to investigate the effect of sleepiness on cognitive function and components related to pain quality, multivariate and univariate analysis of covariance was used to control age variables and use antiepileptic drugs. The results showed that patients with sleepiness in functions of language, Abstraction, delayed recall, as well as achieving the overall Montreal Cognitive Assessment score performed worse. These patients had higher sensory perception of pain experience, rated their pain higher, scored higher in pain quality, and chose more words to describe their pain (P<0.05). Evaluations of disease severity markers through nonparametric tests also showed that compared to patients without sleepiness, patients with epilepsy with sleepiness have experienced more pain, more seizures, a higher incidence of comorbid physical diseases, a longer history of psychiatric diagnoses, and they have more concomitant use of antiepileptic and psychiatric drugs (P<0.05). Conclusion: The results showed that patients with epilepsy with sleepiness had lower mean scores on some cognitive subscales than their counterparts without sleepiness; However, the two groups did not differ in terms of spatial visual function, naming, attention, and orientation. Using a methodology similar to this study, Vascouto et al. Found that there was no difference between the two groups of patients with seizures with and without sleepiness in most cognitive components such as attention and spatial visual skills; Only from the point of view of the total score of auditory verbal learning, there is a significant difference (11) that is relatively consistent with the present study. Although more research is needed to draw more detailed discussions, the discrepancies in some findings can be explained by differences in the type of patient samples in the two studies and the reduction in attention and performance resulting from sleepiness. The results also showed that patients with epilepsy with sleepiness compared to their counterparts, evaluated the qualitative dimensions of their pain higher and experienced more severe pain. Consistent with these findings, Gutter et al. Found that sleepiness comorbidity in epileptic seizures leads to increased chronic pain in patients (10) and Jaussent et al. Also reported that chronic pain is a significant predictor of sleepiness (12). In this regard, potential underlying mechanisms such as structural and functional changes in the prefrontal cortex (13), anterior cingulate cortex (14), hippocampus (15), amygdala (16), insula (17), subcortical regions (17) and shock spinal cord passages (18); Neural-glial interactions; Abnormalities in autonomic function and hypothalamic-pituitary-adrenal axis and other biological factors may contribute to the relationship between sleepiness and pain. Finally, the results showed that the frequency of seizures, the presence of comorbidities of physical disease, the history of psychiatric diagnoses and the simultaneous use of antiepileptic and psychiatric drugs in patients with epilepsy with sleepiness were higher than their counterparts. In this regard, Pizzatto et al. (19) and Xu et al. (20) evaluated patients with epileptic seizures and did not find a relationship between daily sleepiness scores and the frequency of seizures. But Lee et al. Showed that the presence of psychiatric symptoms is an independent predictor of sleepiness in patients (21). It seems that sleepiness reduces the ability to control seizures in patients (22) and contributes to their recurrence and worsening of the disease. Disruption of patients' circadian rhythms can also be involved as a consequence of sleepiness; Because circadian rhythms affect the frequency of seizures depending on the epileptogenic region (23,24). According to the findings, measuring sleep habits, sleep hygiene and comorbidity of sleepiness is an unavoidable necessity. In particular, early diagnosis and treatment of comorbid sleepiness and seizures can improve the prognosis and reduce the negative health consequences in patients (25). Lack of objective measurements of sleepiness and self-reported nature of the data are the limitations of the present study. Future studies can complement these findings by using objective measures of sleepiness. Patients with epilepsy with sleepiness have a poorer cognitive and clinical status than their counterparts. [ABSTRACT FROM AUTHOR]

Background & Aims: About one-third of human life is in sleep (2). Adequate sleep plays a vital role in mental and cognitive motor development in children and adults (3). Lack of sleep can have adverse effects on endocrine function, cognitive function, metabolism and inflammatory responses (4). With sleep problems, cognitive and emotional issues such as depression, anxiety, cognitive impairment, learning disability and intellectual development disability (2). Sleep complaints are very common in the normal population and about 37% of people suffer from sleep problems, sleep problems are one of the associated problems in autistic patients (7). Autism spectrum disorders ASD (1) is a type of autism spectrum disorder It is a pervasive developmental disorder that starts before 36 months of age and begins before the age of 3 and its prevalence is estimated to be 5 to 10 cases per 10,000 births. Children with autism are also susceptible to sleep disturbances (8). Due to the high prevalence of sleep problems in children with autism, effective treatment is necessary in these children. Many of the behaviors that fertilizer has with autism such as hypersensitivity to environmental disturbances, repetitive behaviors, difficulty in social understanding, etc. are likely to contribute to sleep disturbances in children. Behavioral approaches improve sleep onset. These approaches include behaviors that make it easier to fall asleep and stay asleep (10). In the process of story therapy, children are trying to become more aware of their feelings and thoughts, face their painful emotions and feelings, and express them throughout the story (11). Recent studies have shown that behavioral interventions that are present in early life. Autistic children are considered as a valuable and effective treatment for behavioral symptoms of autism. Blossom fard and Mazaheri in 2015, a study aimed at investigating the effectiveness of attachment-based storytelling on reducing sleep time problems and improving the child-mother relationship, the results of this study showed that attachment-based storytelling, in addition to being a solution for female routines, showed that attachment-based storytelling, in addition to being a solution for female-born routines, showed that the results of this study were based on attachment-based storytelling. Beth was able to reduce the disturbances of the child's sleep time, leading to a significant improvement in the parent-child relationship as one of the correlatives of sleep problems, so the clinical work of attachment-based storytelling is not only about improving sleep problems, but also for improving the emotional and mental health of the child and their families (18). It is controlling diseases and considering the educational and therapeutic aspects of storytelling that can be used as a valuable and efficient tool for improving life and social skills as well as treatment of sleep disorders, therefore, the researcher has decided to study the effect of storytelling education on sleep disorders of children with autism in order to prove the hypothesis that "teaching storytelling" It is effective for parents to "perform sleep disorders in children with autism" that ultimately provide a successful way of treating with minimal cost and time so that children with autism benefit from reduced sleep problems. Methods: This study is a clinical trial study, in which the research population consists of children with autism and their parents who have a medical record with a definite diagnosis of autism. The sample in this study is parents of children with autism who have records in Tehran autism center in 2018 and meet the inclusion criteria. Researcher after reviewing the records of children with autism, a certain number of them are used. The available method and the sample size were randomly assigned to the intervention group using a pre-test-post-test experimental design with 45 parents in the Autism Society and 45 as the control group. In this stage, sleep disorders were measured using the CSHQ children's sleep habits questionnaire. The questionnaire consists of 45 questions, some of which have only diagnostic and therapeutic value and not research, so in scoring it only 33 questions are identified, most of which are scored on likert scale from 1 to 3 and its options are usually (7-5 nights per week), sometimes (2-4 nights per week) and rarely (0-1 nights per week). The score is between 33-99 and the total score is more than 41 indicating sleep disturbances in the child. In Iran, the validity of the instrument in the research of Shoghi, Khanjari, Farmani, and Hosseini (2005) was evaluated by content validity method and its validity was determined by two-week interval testing for 10 children between 11-6 years old, 97.97. The Cronbach's alpha coefficient was obtained from two studies, 0.77 and 0.79 (23). The researcher used the treatment method only for the intervention group in five sessions each for 60 minutes and finally obtained the scores of the questionnaire from both intervention and control groups. Results: In describing the characteristics of the research units, the demographic and contextual characteristics of the sample were compared and tested in two groups and the homogeneity of each of these variables was evaluated in the intervention and control groups. Nominal variables were compared and tested using Chi-Square test, precision chi-square (for tables larger than two and expected low frequency) and Fisher's accurate test (for tables two in two and expected low frequency) in both groups. In the inferential statistics section, the main variable, i.e. sleep disorder score in the sample, was compared in the intervention and control groups and in the previous stage with after the intervention, it was compared and tested. Classical tests were used due to the high sample size and according to the central limit theorem in the statistics, which with the increase of the sample size, the average distribution of the sample is close to the normal distribution. For comparing the two groups before the intervention, independent T-test was used for intra-group tests and comparison of two stages before and after the intervention for each group, and finally, using covariance analysis (ANCOVA) by eliminating the effect of pre-test, the effect of storytelling education to parents on sleep disorders of children with autism was investigated. Comparison of sleep disorders in children with autism was done in the intervention and control groups after teaching storytelling to parents and in the control group after the second test using independent T-test. There was a significant difference between the mean score of sleep disorder in the control group and the intervention after teaching storytelling to parents and in the control group after the second test. Conclusion: Table information regarding the research hypothesis about determining the effect of storytelling education to parents on sleep disorders in children with autism indicates that the score of sleep disorder in the intervention group decreased by 5.7 ± 7.3 and in the control group increased by 0.1 ± 2.1 the independent T-test showed this significant difference (P<0.001). Therefore, based on the data and findings, it can be claimed that the research hypothesis has been confirmed. Comparative diagram of sleep disorder score in children with autism before and after the intervention in the intervention and control groups shows that the difference before and after the intervention in the intervention group is higher than the control group. Comparative diagram of sleep disorder score in children with autism studied Before and after the intervention in the intervention and control groups. [ABSTRACT FROM AUTHOR]

COVID-19 disease has quickly become a major threat and epidemic in the world. Many people are experiencing psychological disorders due to the rapid spread of the COVID-19 disease. The present study aimed to investigate the psychosocial status of the Iranian citizens during the prevalence of COVID-19. One thousand one hundred and sixteen citizens of Rafsanjan city participated in the cross-sectional study from March 15 to 30, 2020. The data were collected using demographic and COVID-19 related-items, and Health General Questionnaire (GHQ −28). The results showed that 35% of the participant had mental health problems. All participants had social functioning disorder, while 22.8% had physical symptoms, 26.8 had anxiety symptoms and sleep disorders. In addition, the risk of psychosocial disorder was higher in females, those who were living in the city, earning less than 1 million, thinking of being at risk for infection with the coronavirus, and those whose most important concern about COVID-19 was death (P < 0.05). The results of the present study showed that all participants had social dysfunction. Therefore, health-care providers are suggested to evaluate the psychosocial consequences routinely, design and implement appropriate interventions to deal with these complications. [ABSTRACT FROM AUTHOR]

Objective: Effective rehabilitation and better quality of life among stroke patients are functions of several factors such as quality and pattern of sleep. The present study aimed to evaluate sleep quality and related determinants in such patients. Method: The present cross-sectional study was performed from October to December 2019 among stroke patients who were admitted to Sina Hospital, Hamadan, Iran. We used the Pittsburgh Sleep Quality Index (PSQI) questionnaire to determine sleep quality in these patients. Significant determinants of the global score of PSQI were identified via multivariable linear regression. Results: A total of 97 stroke patients (age 67±79 years, 55.7% male) were enrolled into the study. Prevalence of poor sleep was 0.84 (95% CI: 0.75, 0.91) in stroke patients. Patients with nervous tension and those with surgical treatment and with Non-hemorrhagic CT scan had a predicted increase of 1.65, 2.91 and 3.25 in the mean of the global PSQI score (P ≤ 0.05), respectively. Conclusion: Nervous tension, treatment method, results of CT scan and cardiac problems may be associated with poststroke sleep disorder. [ABSTRACT FROM AUTHOR]

Background: Sleep disorder is one of the main complaints of patients with cancer that could affect their quality of life and clinical outcomes. We aimed to investigate major contributors of poor quality sleep in patients with cancer that underwent treatment. Methods: We performed a cross-sectional study on 250 patients with cancer referred to the oncology department of Shohaday-eHaftome-Tir Hospital, Tehran, Iran. Sleep quality as the main outcome of the study was evaluated using the Persian version of the self-report PSQI questionnaire. Global PSQI score >5 was categorized as the poor quality sleep. We also collected demographic and clinical data and physical performance status based on ECOG scale which grading is from 0:Fully active to 12:Death. Collecting the data regarding each patient was performed through medical records and face-to-face interviews. Results: Mean age (±SD) of the study participants was 52.8 (±11.9) and 177 (70.8%) patients were female. The overall proportion of poor quality sleep was 66.8%. Sleep disorders were observed more frequent in patients with partial (OR=2.0, 95% CI=1.0, 3.8) and complete (OR=7.4, 95% CI=1.5, 36.4) physical dysfunction (p-value<0.05). There was also a strong association between a history of sleep disorder and cancer-related insomnia (OR=4.4, 95% CI=1.9, 10.1). No association was found between age, marital status, metastasis status, and cancer location with poor quality sleep. Conclusion: Poor sleep quality had a high prevalence among our patients. Patients with physical functional impairment and those with psychiatric disorders (mood disorder) and pre-existing insomnia were the main groups of patients with a higher likelihood of cancer-related insomnia. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has significantly impacted the working conditions of nurses, leading to a detrimental effect on their sleep quality. This cross-sectional study aimed to investigate the prevalence of poor sleep quality and its associated factors among nurses working in COVID-19 wards in Kermanshah, Iran. A total of 97 nurses were selected through simple random sampling from COVID-19 wards. Data was collected using a demographic information sheet and the Pittsburgh Sleep Quality Index. Descriptive and inferential statistical methods, including chi-square and multiple logistic regression, were used for data analysis. The results showed that 74.2% (n = 72) of the nurses experienced poor sleep quality. Significant associations were found between poor sleep quality and work experience (p = 0.045) as well as the type of work shift (p = 0.001). However, no significant relationships were observed between poor sleep quality and factors such as age, sex, body mass index, overtime hours per month, physical activity, or underlying diseases. The high prevalence of poor sleep quality among nurses working in COVID-19 wards underscores the necessity of implementing targeted interventions to address this issue. In this regard, in addition to periodic shift schedule changes and reductions in working hours, it is necessary to adopt purposeful measures to improve working conditions and enhance the physical and mental health of nurses. These measures may include providing sufficient human resources to reduce the workload and fatigue of nurses, appropriate scheduling of working hours, and the implementation of stress management programs., (© 2024. The Author(s).)

Background: Endometriosis affects 10-15% of women of reproductive age and is considered a critical gynecological problem. Endometriosis causes pain and infertility, both of which can impair the patient's quality of life. Sleep disorders account for the most bothersome presentation of impaired quality of life. This study investigated the frequency and severity of sleep disorders in women with endometriosis., Methods: In this analytical cross-sectional study, 665 women referred to three hospitals in Tehran, Rasool-e-Akram, Pars, and Nikan, were included (463 patients with endometriosis and 202 women without endometriosis). All of them were informed about the study design and the aim of the research, and then they were asked to sign the consent form and complete the Pittsburgh Sleep Quality Index (PSQI). After data gathering and entering, they were analyzed by SPSS version 22 and were considered significant with P < 0.05., Results: The study population's mean age was 35.4 ± 7.9 years. The mean global PSQI score in the case group (endometriosis patients) was higher than in the control group (non-endometriosis patients) (10.6 vs. 7.1; P < 0.001). Patients with dyspareunia, dysuria, pelvic pain, and dyschezia had a significantly higher PSQI score (P < 0.05)., Conclusion: According to the findings of the present study, the sleep quality in endometriosis patients is low, and there is a need to pay greater attention to these patients. This may result in some changes in the therapeutic strategies for this disease., (© 2024. The Author(s).)

Depressive disorders are a common cause of morbidity, globally. We have evaluated the prevalence of depression, aggression and sleep disorders, and their associations with each other and socio-economic characteristics, in adolescent girls from northern Iran. This cross sectional study was performed in 940 adolescent students, aged 12–18 years old. The Beck Depression Inventory II, Buss-Perry Aggression, Insomnia Severity Index, Epworth Sleepiness Scale and STOP-Bang sleep apnea questionnaires were used to evaluate depression, aggression, insomnia, sleepiness and sleep apnea among the participants, respectively. A total of 634 (67.4%), 216 (23.0%), 222 (23.6%) and 2 (0.2%) of subjects had some degree of depression, insomnia, sleepiness or sleep apnea, respectively. Girls who lived in a small family group had a significantly higher depression score than those living in a larger family group. Girls from families in which their parents were divorced had higher depression and sleepiness scores compared to their peer group. Participants with high depression scores had higher aggression, insomnia, sleepiness and sleep apnea scores than subjects without (P < 0.05). In female adolescents, emotional, behavioral and sleep disorders appear to be related to their demographic and socio-economic characteristics. Aggression score, insomnia, day time sleepiness and sleep apnea were significantly more common in individuals with a high depression score, and may be causally related, although this could not be formally assessed in this study. Individuals at risk of depression need to be identified, as this may allow interventions that may improve their quality of life outcomes. [ABSTRACT FROM AUTHOR]

Background. To date, hemodialysis (HD) is the most common therapy for chronic kidney disease (CKD) patients. However, it causes different complications such as sleep disorders. Sleep regulation is connected to vitamin D; hence, its deficiency might influence the quality and duration of sleep. This study is aimed at evaluating the correlation of sleep quality and vitamin D levels in 80 HD patients. Methods. This cross-sectional study was performed on 80 hemodialysis patients admitted to 29 Bahman hospitals in Tabriz, Iran. Before beginning of dialysis, serum 25 (OH) D levels were assessed among patients and the sleep patterns and sleep quality of patients were accurately calculated by the Pittsburgh sleep quality index (PSQI) standard questionnaire. Results. Our results showed that 22 HD patients (27.5%) had severe sleep disorders. In addition, it was found that serum levels of vitamin D had significant correlation with sleep quality (r = − 0.341 , p = 0.002) in general, even after adjusting confounding factors such as calcium (Ca), phosphate (P), and parathyroid hormone (PTH) level. In poor sleepers (PSQI ≤ 5), a negative correlation was observed between the levels of vitamin D and PSQI score (r = − 0.397 , p = 0.004). PSQI scores in the normal range of PTH (r = − 0.377 , p = 0.006) and in >600 pg/ml of PTH (r = − 0.675 , p = 0.011) had a correlation with vitamin D levels. The level of vitamin D was the single independent predictor of sleep efficiency (β coefficient = − 0.386 , p = 0.001). Conclusion. The present project reported that the positive effect of vitamin D is associated with sleep disorder in HD patients. In future studies, normal levels of Ca and P should be considered along with normal vitamin D levels among the included patients. [ABSTRACT FROM AUTHOR]

Background: Respiratory disorders during sleep are considered a health problem affecting the life quality. There is some evidence indicating the higher prevalence of apnea in substance-dependent patients. However, there is no information on the prevalence of the disease in people under methadone maintenance therapy (MMT). Therefore, the present study was designed to estimate the disease rate in these patients and consider the relationship of the increasing risk of apnea with some psychiatric problems. Methods: Study group included 152 individuals under the MMT program. Baseline data were collected with the interview, and patients were considered using the STOP-BANG questionnaire to evaluate the risk of apnea. Furthermore, Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HDRS) tests were performed for all participants. Data were analyzed using SPSS software. Findings: Based on the STOP-BANG score categories, 37.5%, 40.1%, and 22.4% of patients indicated low, intermediate, and high risk of apnea, respectively. Moreover, severe daytime sleepiness, fatigue, depression, and anxiety were observed in 5.3%, 5.5%, 6.0%, and 21.1% of participants, respectively. Sex (P = 0.007) and daytime sleepiness (P = 0.048) were significantly different between low and high-risk groups of apnea after adjustment. Besides, age (P < 0.001) and fatigue (P = 0.007) were factors predicting the STOP-BANG score. Conclusion: These findings revealed the higher prevalence of apnea in MMT patients compared to the general population of Iran and rising of the risk of apnea along with an increase in age and fatigue score. However, attention to the sleep disorders in MMT is a prominent factor that should be considered as a route of therapy. [ABSTRACT FROM AUTHOR]

Objective As age increases, different physical and mental problems, including sleep disorders, occur in the elderly. The Person-Environment-Occupation (PEO) model is one of the most common practical models in occupational therapy. The current study aims to review negative factors affecting the sleeping quality of the elderly in Iran based on the PEO model. Materials & Methods According to PRISMA (the preferred reporting items for systematic reviews and meta-analyses) guidelines and in this systematic review study, we searched Google Scholar, Scopus, PubMed, Magiran, IranMedex, and SID databases using the keywords of "Elderly", "aging", "geriatric", "older adult", "Iran", and "sleep" in English and Persian articles published from 2010 to 2019. Studies on the sleep problems of other age groups, letters to the editor, duplicate studies, studies on non-Iranian seniors, studies published in languages other than Persian and English, and those with unavailable fulltexts were excluded. In the next stage, the titles and abstracts of the retrieved articles were independently reviewed by two researchers to identify the studies that meet the inclusion criteria. The dispute was resolved through discussion and reaching an agreement. Then, the full text of eligible articles was retrieved. Articles approved based on at least 20 out of 22 items of the STROBE (strengthening the reporting of observational studies in epidemiology) checklist were included in the study. Finally, 24 articles that were in line with the research objectives were selected for an in-depth review. Results Out of 24 studies, 11 reported quantitative sleep problems, 9 of which claimed that more than 70% of the elderly had sleep problems. The negative factors affecting the sleep quality of Iranian older adults were presented and categorized based on personal, environmental, and occupational factors. Eighteen articles addressed personal factors, where the most common factor was related to personal health issues. Eleven articles reported environmental factors, where the most common factor was related to the physical environment. In three articles, the factors that had a negative effect on sleeping are occupational and included the change of sleeping place and not talking to others before going to bed. Conclusion Personal factors (e.g. aging, female gender, disease), environmental factors (e.g. lack of communication with relatives and friends, inappropriate physical environment, and living in a nursing home), and occupational factors (e.g. change of sleeping place, hospitalization, and not talking to others before going to sleep) are negative factors affecting the sleep quality of the elderly in Iran. [ABSTRACT FROM AUTHOR]

Background: Women with breast cancer undergo painful and distressing treatment procedures. Hypnotherapy and cognitive-behavioral therapy (CBT) could be considered as an effective therapy. Method: In this clinical trial, 50 women aged 25 to 65 were assigned to three groups (CBT, hypnosis, and control groups). Eight one-hour treatment sessions were run for each of the hypnosis and CBT groups. We utilized The European Organization for Research and Treatment of Breast Cancer-specific Quality of Life (QoL), The European Organization for Research and Treatment of Cancer QoL questionnaires, and The Hospital Anxiety and Depression Scale for the evaluation of the QoL, anxiety, and depression at the beginning and end of the treatment, as well as six months posttreatment. Results: The improvements in the stress, depression, and qoL amongst the three groups were significant, although these improvements in CBT group were more than those in hypnosis group, and in hypnosis and CBT groups were not significant. Physical functioning, body image, sexual functioning, arm symptoms, breast symptoms, future perspective, pain, digestive problems, and functional scale significantly changed in CBT and hypnosis groups (P<0.05). Memory and social functioning; however, did not change in the groups and across the three groups. In addition, sleeping disorders and emotional malfunctioning were recovered only in the hypnosis group, which was statistically significant. Conclusion: We found hypnosis exclusively effective on reducing certain problems of breast cancer patients, such as sleeping disorders and emotional malfunctioning; therefore, it is suggested as an efficient solution for these patients' problems. [ABSTRACT FROM AUTHOR]