The correlation of screen time with sleep quality: A cross-sectional study on undergraduate medical students

Background: Continuous and long-term exposure to the screens of electronic devices, especially smartphones, cell phones, and tablets, is associated with poor quality of sleep. Aim and Objectives: The study was undertaken to correlate screen time exposure and the quality of sleep in undergraduate medical students and to find out the effects of increased screen time exposure on the health of students. Materials and Methods: The study was carried out on 200 undergraduate medical students at Smt. B. K. Shah Medical Institute and Research Centre, Piparia, Vadodara, Gujarat with the help of an online pre-validated questionnaire constructed on Google Form after obtaining ethical approval. The questionnaire was comprised demographic profiles, screen time exposure, and Pittsburgh sleep quality index (PSQI) statements. Data were entered into an Microsoft Excel sheet. For the descriptive statistical part, means, standard deviations, and frequency tables were used. A Chi-square test was applied to detect the strength of the association. P < 0.05 was considered statistically significant. Results: The prevalence of increased screen time among the study population was found 79%. The prevalence of PSQI scores >5 observed in the present study was 73%. There was a significant association observed between increased screen time exposure and PSQI score >5. Conclusion: Increased screen time was significantly associated with poor sleep quality. The most common effect of increased screen time exposure among students found was a headache.

A cross-sectional study on the sleep quality and excessive daytime sleepiness of Filipino medical students in a state-run university during the coronavirus disease (COVID-19) pandemic

Introduction@#Movement restrictions and changes in medical education around the world due to the Coronavirus 2019 pandemic have been sources of stress, which affect sleep and compound the demands of medical education. In the Philippines, stay-at-home orders were implemented in the National Capital Region on 15 March 2020, and despite various readjustments and re-definitions, remain in effect to date, March 2022. Objectives. This cross-sectional study aims to determine the sleep quality and daytime sleepiness of Filipino medical students during prolonged stay-at-home orders, to compare them with pre-pandemic evaluations, and to explore associations between scores and participant characteristics.@*Methods@#The medical student population of a state-run university in the City of Manila was included, while those on a leave of absence were excluded. The Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index which measure excessive daytime sleepiness and sleep quality, respectively, were disseminated via Google Forms from April to May 2021. @*Results@#Response rate was 87.75% (n=709) with a mean age of 22.9 ± 2.0 years and a 1:1.09 male-to-female ratio. Among the respondents, 41.18% had excessive daytime sleepiness, and was significantly higher for first-year premedicine students. Compared to pre-pandemic scores, daytime sleepiness decreased during the pandemic. On the other hand, 62.34% of the respondents had poor sleep quality, with global scores being significantly higher for the first-year pre-medicine students. Relationships between participants' characteristics and their scores were extremely weak, while a moderately significant correlation existed between global daytime sleepiness and sleep quality scores.@*Conclusion@#Both excessive daytime sleepiness and poor sleep quality remain prevalent during prolonged stay-athome orders. These reflect the effect of the pandemic on stress inherent to medical education, and may be additional facets to be regarded in evaluating the general well-being of medical students.

Prevalence of Sleep Quality among Academic Staff of a Private University in Malaysia

@#Introduction: Poor sleep quality is frequently related to poor mental health and is a common medical disorder. It may differ by population, but limited studies have been done in Malaysia. This study was conducted to measure the prevalence of poor sleep quality among academic staff at Universiti Tunku Abdul Rahman (UTAR) Kampar Campus. Methods: In total, 344 randomly selected academic staff were approached to answer the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Results: Unexpectedly, 42.7 % of them were affected by poor sleep quality (global PSQI score >5). The average actual sleep duration was recorded at 6.68 hours. Age and global PSQI scores were not significantly correlated. Female staff had poorer subjective sleep quality (P= 0.027). The elder age group (P= 0.012) and associate professors and professors (P= 0.006) consumed more sleep medications. Non-Ph.D. holders had poorer subjective sleep quality (P= 0.008) and sleep latency (P= 0.032) as well as global PSQI score (P= 0.045) compared to Ph.D. holders. Conclusion: Prevalence of poor sleep quality was higher than expected among academic staff. This may affect workplace functioning and burden the staff with more health issues related to poor sleep quality.

Effects of combined acupuncture and medication on hyperarousal state and serum copeptin in patients with chronic insomnia / 针灸推拿医学（英文版）

Objective:To observe the effect of combined acupuncture and medication on hyperarousal state and serum copeptin(CPT)in patients with chronic insomnia(CI),and to explore its possible mechanism of action.Methods:A total of 70 CI patients meeting the inclusion criteria were divided into an observation group and a control group by the random number table method,with 35 cases in each group.The control group was given estazolam tablets before bedtime,1 mg/time,once a day.The observation group was treated with additional Yi Nao An Shen acupuncture therapy(acupuncture for benefiting the brain and tranquillization)on the basis of the medication treatment,4 times a week.After 4 weeks of treatment,the Pittsburgh sleep quality index(PSQI)score,insomnia severity index(ISI)score,pre-sleep arousal scale(PSAS)score,hyperarousal scale(HAS)score,and the change in serum CPT level were compared between the two groups.Results:During the study,there were 2 dropout cases in the observation group and 1 dropout case in the control group.After treatment,the PSQI,ISI,PSAS,and HAS scores and the serum CPT level in both groups decreased compared with the same group before treatment,and the intra-group differences were statistically significant(P<0.05).After treatment,changes in each above scale score and the serum CPT level in the observation group were much more significant and were statistically different from those in the control group(P<0.05).Conclusion:Acupuncture plus medication can improve sleep quality,reduce the degree of insomnia,and regulate hyperarousal state in patients with CI,and its mechanism of action may be related to the down-regulation of serum CPT level.

Effects of low-frequency repetitive transcranial magnetic stimulation combined with music biofeedback on insomnia / 中国基层医药

Objective:To investigate the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with music biofeedback on insomnia.Methods:Sixty patients with insomnia who received treatment in Outpatient Department of Seventh People's Hospital of Dongyang from January to August 2021 were included in this study. They were randomly divided into an observation group ( n = 30) and a control group ( n = 30) using the random number table. The control group was given music biofeedback therapy and conventional drug treatment, and the observation group was treated with rTMS based on music biofeedback therapy. The changes in polysomnography sleep structure and Pittsburgh Sleep Quality Index score after 1 month of treatment relative to before treatment were determined in each group. Results:After 1 month of treatment, the total sleep time, sleep efficiency, rapid eye movement (REM) sleep, non-REM sleep phase II (N2%) and non-REM sleep phase III (N3%) in the observation group were (419.87 ± 42.63) minutes, (83.69 ± 13.39)%, (25.27 ± 3.26)%, (53.75 ± 11.36)% and (16.27 ± 2.25)%, respectively, and they were (388.74 ± 40.39) minutes, (76.38 ± 13.17)%, (23.16 ± 2.68)%, (51.62 ± 12.27)%, and (14.36 ± 2.21)%, respectively. There were significant differences in these indices between the two groups ( t = -2.90, -2.13, -2.22, -2.26, -3.31, P = 0.005, 0.037, 0.030, 0.027, 0.002). The sleep latency, actual wake time, numbet of awakenings, non-REM sleep phase I (N1%), and total score of Pittsburgh Sleep Quality Index in the observation group were (24.16 ± 7.82) minutes, (23.18 ± 6.95) minutes, (1.76 ± 0.28) times, (9.74 ± 2.12)%, (9.17 ± 1.56) minutes, respectively. They were (28.35 ± 7.74) minutes, (28.36 ± 7.21) minutes, (2.25 ± 0.79) times, (11.12 ± 1.17)%, and (10.26 ± 1.42) minutes, respectively in the control group. There were significant differences in these indices between the two groups ( t = 2.09, 2.83, 3.20, 3.12, 2.83, P = 0.041, 0.006, 0.002, 0.003, 0.038). Conclusion:rTMS combined with music biofeedback for the treatment of insomnia can effectively improve sleep quality in patients with insomnia.

Tiaoshen acupuncture for primary insomnia: a pilot randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effects of Tiaoshen (regulating the spirit) acupuncture on cognitive function and sleep quality in patients with primary insomnia (PI).@*METHODS@#Sixty patients with PI were randomly divided into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 2 cases dropped off, 1 case was excluded). The patients in the observation group were treated with acupuncture at Baihui (GV 20), Shenting (GV 24), Sishencong (EX-HN 1), and bilateral Benshen (GB 13), Shenmen (HT 7), Neiguan (PC 6), Sanyinjiao (SP 6). The patients in the control group were treated with shallow needling at non-effective points. Each treatment was provided for 30 min, once every other day, 3 treatments per week for 4 weeks. The Montreal cognitive assessment (MoCA), digit span test (DST), trail making test (TMT)-A, Pittsburgh sleep quality index (PSQI), and fatigue scale-14 (FS-14) were used to assess cognitive function and sleep quality before and after treatment, as well as in follow-up of 4-week after treatment completion. Correlation analysis was conducted between the differences in PSQI scores and differences in MoCA scores before and after treatment in the observation group.@*RESULTS@#Compared with before treatment, the total score, visuospatial and executive function score and delayed memory score of MoCA as well as DST backward score were increased (P<0.01), while TMT-A time, PSQI and FS-14 scores were significantly reduced (P<0.01) after treatment and in follow-up in the observation group. Compared with before treatment, the PSQI score in the control group was reduced (P<0.01, P<0.05). After treatment and in follow-up, the observation group had significantly higher total score, visuospatial and executive function score, delayed memory score of MoCA, and DST backward score compared to the control group (P<0.05, P<0.01). In the observation group, the TMT-A time was significantly shorter than that in the control group (P<0.05, P<0.01), and the PSQI and FS-14 scores were significantly lower than those in the control group (P<0.01). In the observation group, there was a negative correlation between the difference in PSQI scores (post-treatment minus pre-treatment) and the difference in MoCA scores (post-treatment minus pre-treatment) (r=-0.481, P<0.01). A similar negative correlation was found between the difference in PSQI scores (follow-up minus pre-treatment) and the difference in MoCA scores (follow-up minus pre-treatment) (r=-0.282, P<0.05).@*CONCLUSION@#Tiaoshen acupuncture could improve cognitive function, enhance sleep quality, and alleviate daytime fatigue in patients with PI. The improvement in cognitive function in patients with PI is correlated with the improvement in sleep quality.

Bushen Anshen acupuncture for perimenopausal insomnia of kidney-yin deficiency: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy of Bushen Anshen acupuncture (acupuncture for tonifying kidney and calming spirit ) in treating perimenopausal insomnia (PMI) of kidney-yin deficiency.@*METHODS@#A total of 72 patients with PMI of kidney-yin deficiency were randomized into an observation group (36 cases, 1 case dropped off) and a control group (36 cases, 1 case dropped off). Acupuncture was applied at Baihui (GV 20) and bilateral Shenshu (BL 23), Taixi (KI 3), Anmian (Extra) in the observation group, while sham acupuncture of shallow needling at non-acupoints was applied in the control group. The treatment was required once every other day, 3 times a week for 10 times in the two groups. Before and after treatment, Pittsburgh sleep quality index (PSQI) was used to evaluate the subjective sleep quality, and polysomnography (PSG) was used to monitor the objective sleep quality in the two groups.@*RESULTS@#After treatment, the scores of sleep quality, sleep latency, sleep duration, sleep efficiency, hypnotic, daytime dysfunction and total score of PSQI were decreased compared with those before treatment in the observation group (P<0.01), the scores of sleep duration, sleep efficiency and total score of PSQI were decreased compared with those before treatment in the control group (P<0.05); the scores of sleep quality, sleep latency, sleep efficiency, hypnotic and total score of PSQI in the observation group were lower than those in the control group (P<0.05). After treatment, the sleep time was prolonged, the sleep efficiency was improved, the sleep latency and the awake time after falling asleep were shortened, the arousal awake index was reduced (P<0.01) when PSG indexes were monitored, and the percentage of non-rapid eye movement sleep period 1 (N1%) was decreased while the percentage of non-rapid eye movement sleep period 3 (N3%) was increased (P<0.05) compared with those before treatment in the observation group; there was no statistical difference in the PSG indexes compared with those before treatment in the control group (P>0.05). After treatment, compared with the control group, the sleep time was prolonged, the sleep efficiency was improved, the sleep latency and the awake time after falling asleep were shortened, the arousal awake index and N1% were decreased in the observation group (P<0.01).@*CONCLUSION@#Bushen Anshen acupuncture can effectively improve the subjective and objective sleep quality in PMI patients of kidney-yin deficiency.

Study on the correlation between meibomian gland dysfunction and sleep quality / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the correlation between meibomian gland dysfunction(MGD)patients and their sleep quality.METHODS: Retrospective case-control study. A total of 150 MGD patients treated in our hospital from January 2021 to October 2022 were selected and divided into sleep disorder group(75 cases, PSQI&#x003E;10 points)and control group(75 cases, PSQI≤10 points)according to the Pittsburgh sleep quality index(PSQI). Both groups were scored using the ocular surface disease index(OSDI), underwent meibomian gland-related examinations(eyelid margin morphology, meibomian gland secretion ability, meibomian gland secretion quality score), corneal fluorescein staining(FL)score, Schirmer Ⅰ test(SⅠt), tear film break-up time(BUT)was measured, and sleep indicators(sleep quality, sleep latency, subjective sleep quality, sleep time)were evaluated.RESULTS: There were significant differences in OSDI score, FL score, SⅠt, BUT, eyelid margin morphology score, meibomian gland secretion ability score, and meibomian gland secretion quality score between the two groups(P&#x003C;0.05). In the sleep disorder group, PSQI score, sleep latency score, subjective sleep quality score, and sleep time score were significantly positively correlated with OSDI score, FL score, meibomian gland secretion ability score, and meibomian gland secretion quality score(P&#x003C;0.05); PSQI score, subjective sleep quality score, and sleep time score were significantly positively correlated with eyelid margin morphology score(P&#x003C;0.05); PSQI score, sleep latency score, and subjective sleep quality score were significantly negatively correlated with BUT and SⅠt(P&#x003C;0.05); sleep time score was significantly negatively correlated with BUT(P&#x003C;0.05); sleep latency score was not significantly correlated with eyelid margin morphology score(P&#x003E;0.05); sleep time score was not significantly correlated with SⅠt(P&#x003E;0.05).CONCLUSION:The ocular surface condition of MGD patients is correlated with multiple sleep quality indicators, and a decline in sleep quality may increase the risk of MGD.

Assessment of sleep quality among postgraduate residents of a tertiary care hospital in Kashmir: Using the Pittsburgh Sleep Quality Index

Introduction: The Postgraduate medical training is long and emotionally taxing. These occupations are associated with stress and good workload along with night shifts which effects the sleep quality. Studies have documented that high levels of stress among medical residents have been associated with sleep problems. Our study aims to investigate sleep quality among the postgraduate residents of a tertiary care hospital using Pittsburgh Sleep Quality Index. Material and Methods: It was a cross sectional study that was conducted from 1 November 2021 to 31 December 2021. Study participants included Postgraduate medical residents working at a tertiary care hospital in district Srinagar of Kashmir valley. A total of 400 participants took part in the study. Results: The mean age of the participants was 33.4 years (S.D 4.9). Majority of the participants (54%) were females. The mean global Pittsburgh Sleep Quality Index score (±SD) for sleep quality was 8.46 (±4.5) with a median score of 6 and Inter Quartile Range of 6.5. Conclusion: Poor sleep quality was reported in 75% of the residents. This highlights the need for awareness about this problem. There is a need for early interventions in order to introduce flexible working hours for medical residents and to provide shifts of manageable durations.

A cross-sectional study of quality of sleep in medical healthcare workers from a tertiary healthcare center during COVID-19 pandemic

Background: Intractable COVID-19 outbreak has placed extraordinary demands on health-care systems worldwide. Increased workload, inadequate personal equipment, nosocomial transmission, and the need to make ethically difficult decisions on the rationing of care may have dramatic effects on their physical and mental well-being. Healthcare workers (HCWs) are, therefore, especially vulnerable to mental health problems. Aim and Objectives: This study was conducted to assess the quality of sleep in medical HCWs during COVID-19 pandemic and to assess its relation with demographic variables. Materials and Methods: This cross-sectional study was conducted using anonymized and self-reported questionnaire survey which includes sociodemographic characteristics and Pitsburgh sleep quality index (PSQI) questionnaire. The questionnaire was completed by participant on their own smartphone. Chi-square tests were used to compare categorical variables. P < 0.05 was considered statistically significant. Results: Out of 208 respondents who served in COVID-19 pandemic, 137 were having poor sleep quality (PSQI score >5). It has been observed that 20–40 years age group was more affected than 40–60 years group. Nurses were more affected than doctors and technicians. Conclusion: During COVID-19 pandemic, medical healthcare workers had poor sleep quality due to stress of workload and social pressure. This can lead to physical or psychological health problems in the future. Further interventions should be administrated for them, aiming to maintain their health.

Evaluation of sleeping patterns during the pandemic

Background: As the ongoing pandemic has triggered negative psychological effects and these negative effects have a role to play in affecting the quality of sleep, leading to sleep disorders. This demonstrates the need to implement the strategies which would be helpful in preventing and reducing the complications caused due to altered sleeping patterns. Aim and Objectives: The aim of the study was to evaluate the alteration in the sleep quality during pandemic. Materials and Methods: A questionnaire-based survey scheduled for a month was conducted in the students, office, and health-care workers. Questionnaire was based on Pittsburgh Sleep Quality Index (PSQI). This is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. The PSQI differentiates “poor” from “good” sleep by measuring seven components: Subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction over the past 4 weeks. Consent was obtained from all participants and participation was voluntary. Results: There was observed a decline in all the seven components of PSQI score, namely, subjective quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction in COVID times as compared to the pre-COVID times. Conclusion: Pandemic has led to the alteration of the sleeping patterns and has led to decline in the sleep quality index.

Impact Of Screen Time Exposure On Sleeping Habits Amongst Young Adults

Background:Lack of adequate sleep affects the mental health, emotional balance, immune function and reaction times. The alarming sedentary habit which would affect the sleep quality in the recent time is screen media exposure or increased screen time. Moderate use of ST (4hours/day) associated with lower psychological well-being. Objective: Tostudy the association between ST usage and sleep quality amongst young adults. Material And Methods:The study was conducted among medical students at Physiology department, Government medical college, Vadodara. Google form was created, which consisted of basic information. Self-reported ST usage per day. PSQI scale assessed 7components of sleep scaling from 0 to 3, and higher global score (>5) means lower sleep quality. The Google form was sent to participants who were given informed consent and the results were computed. Result:Among 204 participants, 78 males and 126 females, the median age was 19 years, the mean duration of screen time was 5.3 Hrs.(SD=2.7). ST > 5Hrs. in 57.8% and PSQI ?5 in 52.9% was seen. Chi Square test analysis for ST& PSQI, the p-value came out to be 0.094(p-value > 0.005), and was not statistically significant. Conclusion:This study shows more than half of participants had poor sleep quality and increased screen time usage. Though the results came out statistically insignificant we cannot exclude the association without further research. However,exposure to high screen time may negatively impact sleep outcome.

A study on the effect of mobile phone use on sleep

Background & objectives: Several studies have been conducted globally to assess the impact of usage of mobile phones on quality and duration of sleep as also on day time sleepiness. The objective of the present study was to assess the effect of mobile phone usage on the quality and composition of sleep in a sample from Indian population. Methods: The study was conducted at two tertiary care hospitals in north India from July 2014 to September 2019. A total of 566 participants were recruited in this study from both the centres. Sleep quality was assessed with the help of the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Subsequently, actigraphy was done in 96 participants and polysomnography in 95 participants. Results: Of the 566 participants, 128 (22.61%) had PSQI ?5, reflecting poor sleep quality. A higher use of mobile phone was significantly associated with a poor sleep quality as a component of PSQI questionnaire (P=0.01) and higher overall PSQI score (P=0.01). The latency from sleep onset to N2 and N3 sleep stages was significantly shorter in participants having a higher mobile phone usage as compared to those with a lower usage [Median (range): 13.5 min (1.5-109) vs. 6.5 min (0-89); P=0.02] and [Median (range): 49 min (8.5-220.5) vs. 28.75 min (0-141); P=0.03], respectively. Interpretation & conclusions: This study focused on the maladaptive changes brought on by mobile phone usage on sleep. More studies with larger sample sizes need to be done that may serve to confirm the hypothesis generating findings of our study

Sleep Quality among Healthcare Professionals in a Tertiary Care Hospital

Introduction: A person spends one third life in sleep, so the quality and quantity of sleep is of utmost importance. Health Care Professionals (HCPs) are more prone to inconsistency in sleep both in quality and quantity, which leads to deflection from health and well-being of themselves and care of others. This study aims to assess the various factors influencing sleep quality and daytime sleepiness among medical and nursing healthcare professionals. Methodology: A cross sectional study was conducted using a structured questionnaire to collect socio-demographic and work-related information, co-morbidity and quality of Sleep using ESS (Epworth Sleepiness Scale) and PSQI (Pittsburgh Sleep Quality Index) scale. Results: Among the 150 HCPs, 64.7% were medical and 35.3% were nursing professionals. 53.6% of medical and 66% of nursing professionals reported poor sleep quality. Increased coffee consumption influences sleep quality and it was found to be statistically significant. Nursing professionals had more excessive daytime sleepiness (58.5%) with significant p-value (p=0.01). Conclusion: According to our study results, sleep quality was poor among nursing professionals which highlights the need for measures to improve their quality of sleep.

Clinical observation of acupuncture plus acupoint sticking therapy for insomnia and its influence on subjective and objective sleep indicators / 针灸推拿医学（英文版）

Objective: To observe the effects of acupoint sticking therapy of different dosages and durations on the subjective and objective sleep indicators in insomnia patients.Methods: Ninety-six patients with insomnia due to liver-Qi stagnation and spleen deficiency were divided into a high-dosage 7 d group (25 cases), a high-dosage 14 d group (22 cases), a low-dosage 7 d group (21 cases), and a low-dosage 14 d group (28 cases) using the random numbers generated in a stratified and stage-by-stage manner in combination with the visiting sequence. The four groups all received the same acupuncture treatment, but acupoint sticking therapy varied in dosage and duration. Before and after treatment, the actigraphic readings (total time in bed, total sleep time, sleep efficiency, number of wake bouts, length of wakes after asleep, and sleep latency), Pittsburgh sleep quality index (PSQI) score, and symptoms score of traditional Chinese medicine (TCM) were observed. A correlation analysis was conducted among the subjective and objective indicators. Results: The PSQI score was positively correlated with the total time in bed and total sleep time (P<0.05). After treatment, the sleep latency, PSQI scores, and TCM symptoms scores changed significantly in the four groups (P<0.05). The total sleep time and sleep efficiency gained improvements after treatment in the high-dosage 14 d and low-dosage 14 d groups (P<0.05). The high-dosage acupoint sticking groups had longer total sleep time compared with the low-dosage groups of the same treatment duration (P<0.05). After treatment, the length of wakes after asleep, PSQI scores, and TCM symptoms scores were better in the 14 d groups than in the 7 d groups of the same acupoint sticking dosage (P<0.05). Conclusion: Given the same acupuncture treatment, acupoint sticking therapy of different treatment durations produces different effects on the length of wakes after asleep, PSQI score, and TCM symptoms score in insomnia patients, and the 14-day acupoint sticking treatment is superior to the 7-day treatment.

Acupuncture for perimenopausal early-wake insomnia: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture for perimenopausal early-wake insomnia.@*METHODS@#A total of 60 patients with perimenopausal early-wake insomnia were randomly divided into an observation group (30 cases, 3 cases dropped off) and a control group (30 cases, 2 cases dropped off, 2 cases were removed). In the observation group, acupuncture was applied at Baihui (GV 20), Yintang (GV 24+), Anmian (Extra), Hegu (LI 4), Shenmen (HT 7), Taichong (LR 3), Taixi (KI 3), etc., once every other day, 3 times a week. In the control group, oryzanol tablets were taken orally, 20 mg each time, 3 times a day. Both groups were treated for 4 weeks. Before and after treatment, the sleep actigraphy (ACT) was used to measure the effective sleep time, sleep quality, wake-up time, wake-up frequency, each wake-up time, and the Pittsburgh sleep quality index (PSQI) score and early-wake score were compared in the two groups, and the clinical effect was assessed.@*RESULTS@#After treatment, compared before treatment, the effective sleep time was prolonged and the sleep quality was improved (P<0.05), the wake-up time, each wake-up time were shortened and wake-up frequency was decreased (P<0.05), the PSQI score and early-wake score were decreased (P<0.05) in the observation group. After treatment, the wake-up frequency, PSQI score and early-wake score were decreased in the control group (P<0.05). The effective sleep time, sleep quality, wake-up time, wake-up frequency, each wake-up time, PSQI score and early-wake score after treatment in the observation group were superior to the control group (P<0.05). The total effective rate was 88.9% (24/27) in the observation group, which was higher than 38.5% (10/26) in the control group (P<0.05).@*CONCLUSION@#Acupuncture can increase the effective sleep time and improve sleep quality in patients with perimenopausal early-wake insomnia.

Investigation on anxiety, depression and sleep quality in primary glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the anxiety, depression and sleep status of patients with primary angle-closure glaucoma(PACG)and primary open angle glaucoma(POAG).<p>METHODS: Retrospective clinical study. The Anxiety Self-Rating Scale(SAS), Depression Self-Rating Scale(SDS)and Pittsburgh Sleep Quality Index(PSQI)were used to evaluate 60 patients with primary glaucoma(30 PACG, 30 POAG)diagnosed in the department of ophthalmology in our hospital during the period from June 2019 to December 2020 and 30 healthy adults from the physical examination department of our hospital as a control group. The scores of anxiety, depression and sleep quality in the three groups were compared.<p>RESULTS: The scores of SAS, SDS and PSQI in PACG and POAG groups(48.40±9.302, 53.40±8.625, 9.57±2.861; 42.57±9.684, 48.80±10.320, 7.23±2.223)were significantly higher than those in control group(37.03±6.805, 38.63±7.881, 4.87±2.688)(<i>P</i><0.05). The scores of SAS and PSQI in PACG group were higher than those in POAG group(all <i>P</i><0.05). With SAS≥45, SDS≥50 and PSQI>7, the positive rates of anxiety, depression and insomnia in the PACG group(77%, 73%, 70%)were higher than those in the POAG group(43%, 40%, 37%)and the control group(13%, 10%, 20%)(<i>P</i><0.05).<p>CONCLUSION: Patients with PACG has more severe anxiety, depression and insomnia than POAG, so necessary psychological intervention should be given.

Observation of acupoint application of gel plaster on insomnia / 中国针灸

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

Association between sleep quality and risk of acute exacerbation of mild and moderate chronic obstructive pulmonary disease： a community-based prospective study / 上海预防医学

Objective:To investigate the association between sleep quality and the risk of acute exacerbation in mild and moderate chronic obstructive pulmonary disease （COPD） patients in Pudong New Area of Shanghai. Methods:This was a prospective study involving eligible mild and moderate COPD patients from 10 communities randomly selected in Pudong New District of Shanghai. A structured questionnaire was used to collect demographic characteristics， clinical information and information on acute exacerbation. Sleep quality was assessed using the Pittsburgh Sleep Quality Index （PSQI） in Chinese. Multiple negative binomial regression was used to estimate the association between sleep quality and risk of exacerbation. Results:Altogether 212 mild/moderate COPD patients participated and completed the entire survey， of whom the majority （95.8%） were mild COPD patients， 110 persons female and over half （54.2%） over 65 years old. 32.9% of the patients had poorer sleep quality at baseline. 18.9% of the patients reported exacerbation over the past year during follow-ups. Multiple negative binomial regression suggested that increased PSQI was related to higher risk of exacerbation （RRad=1.12， 95%CI：1.02-1.24）， and patients with poorer sleep efficiency had a higher risk of exacerbation （RRad=1.66， 95%CI：1.17-5.43）. Conclusion:Poorer sleep quality is associated with a higher risk of exacerbation in community mild/moderate COPD patients， especially in those with problem of sleep efficiency. More attention to sleep disorders is warranted in community management or self-management of patients with COPD.

A randomized and controlled study of transcranial magnetic stimulation for the treatment of non-organic insomnia / 中华物理医学与康复杂志

Objective:To observe the clinical effect of repeated transcranial magnetic stimulation (rTMS) on non-organic insomnia using college students.Methods:A total of 72 college students with non-organic insomnia were recruited and randomly divided into an observation group and a control group, each of 36, according to a random number table. The observation group was given rTMS treatment on the left dorsolateral prefrontal cortex at 1Hz and an intensity 130% of the resting motor threshold for 20min once daily, 5 days a week for 4 weeks. The control group was given sham magnetic stimulation. Depression, anxiety, sleep status and cognitive functioning were quantified before and after the treatment.Results:After 4 weeks of treatment, significant improvement was observed in the treatment group (though not in the control group) in total Pittsburgh sleep quality index scores, and in all of its dimensions except hypnotic medicine. The average Hamilton depression and anxiety scale scores of both groups had improved significantly after the intervention, but the improvement was significantly greater in the treated group. Significant improvement was also observed in the average visual space and executive function score, attention score, delayed memory score and total score of the observation group using the Montreal cognitive assessment compared with before the treatment and compared with the control group.Conclusions:Repeated transcranial magnetic stimulation can improve the sleep quality, emotional state and cognitive functioning of college students with non-organic insomnia.