Sports medicine treatment based on relieving chronic fatigue and sub-health state / Tratamento da medicina do esporte relacionada ao alivio da fadiga crônica e saúde sub-ótima / Tratamiento de la medicina del deporte relacionada al alivio de la fatiga crónica y salud subóptima

ABSTRACT Introduction: Chronic fatigue syndrome (CFS), also known as chronic fatigue and immune dysfunction syndrome, has become a common disease in modern medicine. Objective: The paper analyzes the impact of exercise training on patients' quality of life with chronic fatigue syndrome. Methods: We conducted fatigue investigations on college students and analyzed the exercise ability of college students with chronic fatigue syndrome. We then compared the findings with healthy college students. In the process, we recorded the physiological indicators and satisfaction scores of the two groups of patients. Results: Muscle endurance and cardiopulmonary function-related exercise ability of the college students with chronic fatigue syndrome are significantly different. After completing the same exercise, the scores of personal exertions were higher. Conclusion: Appropriate and regular exercise can achieve ideal results in the treatment of chronic fatigue syndrome. In-depth research, popularization, and application by scholars is highly suggested. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: A síndrome da fadiga crônica (SFC), também conhecida como fadiga crônica e síndrome de disfunção imunológica, tem se tornado uma doença comum para a medicina moderna. Objetivo: Este estudo analisa o impacto do treinamento de exercícios na qualidade de vida de pacientes com síndrome de fadiga crônica. Métodos: Conduzimos investigações sobre a fadiga em estudantes universitários e analisamos a habilidade para exercícios de estudantes universitários com síndrome de fadiga crônica. Durante o processo, registramos indicadores fisiológicos e escores de satisfação dos dois grupos de pacientes. Resultados: A resistência muscular e habilidade em praticar exercícios relacionados à função cardiopulmonar dos estudantes universitários com síndrome de fadiga crônica são significativamente diferentes. Após completar o mesmo exercício, os escores de esforço pessoal eram mais altos. Conclusão: Exercícios adequados e regulares podem atingir resultados ideais no tratamento da síndrome de fadiga crônica. Pesquisas aprofundadas, a popularização e a aplicação por parte de pesquisadores são altamente recomendadas. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Introducción: La síndrome de la fatiga crónica (SFC), también conocida como fatiga crónica e inmunodeficiencia, se ha tornado una enfermedad común para la medicina moderna. Objetivo: Este estudio analiza el impacto del entrenamiento de ejercicios en la calidad de vida de pacientes con síndrome de fatiga crónica. Métodos: Conducimos investigaciones sobre la fatiga en estudiantes universitarios y analizamos la habilidad para ejercicios de estudiantes universitarios con síndrome de fatiga crónica. Durante el proceso, registramos indicadores fisiológicos y puntajes de satisfacción de los dos grupos de pacientes. Resultados: La resistencia muscular y habilidad en practicar ejercicios relacionados a la función cardiopulmonar de los estudiantes universitarios con síndrome de fatiga crónica son significativamente diferentes. Tras completar el mismo ejercicio, los puntajes de esfuerzo personal eran más altos. Conclusión: Ejercicios adecuados y regulares pueden atingir resultados ideales en el tratamiento de la síndrome de fatiga crónica. Investigaciones profundizadas, la popularización y la aplicación por los investigadores son altamente recomendadas. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Association between metabolic associated fatty liver disease and sleep disorders / 临床肝胆病杂志

Objective To investigate the association between metabolic associated fatty liver disease (MAFLD) and sleep disorders. Methods A total of 222 patients with MALFD who were admitted to Panjin Central Hospital from February 2020 to February 2021 and 270 healthy individuals were enrolled as subjects. According to age, the patients with MALFD were divided into youth group with 93 patients, middle-aged group with 76 patients, and elderly group with 53 patients; according to controlled attenuation parameter (CAP) of liver fat, the patients were divided into non-steatosis group with 23 patients, mild steatosis group with 85 patients, moderate steatosis group with 76 patients, and severe steatosis group with 38 patients; according to liver stiffness measurement (LSM), the patients were divided into non-progressive fibrosis group with 124 patients and progressive fibrosis group with 98 patients. Related data were collected, including general information such as age and sex and laboratory markers such as routine blood test results and biochemistry, and after informed consent was obtained, three sleep scales, i.e., Pittsburgh Sleep Quality Index (PSQI) scale, Epworth Sleepiness Scale (ESS), and Morningness-Eveningness Questionnaire (MEQ), were completed independently. The MAFLD group and the healthy control group were compared in terms of general information and laboratory markers to investigate the association between MAFLD and sleep disorders under different grouping criteria. The chi-square test was used for comparison of categorical data between two groups; the t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the Kruskal-Wallis H test was used for comparison between the groups of MAFLD patients with different ages and degrees of hepatic steatosis and pairwise comparison within each group. A logistic regression analysis was used to investigate the independent risk factors for MAFLD, and a Spearman correlation analysis was used to investigate the correlation of hepatic steatosis degree and fibrosis degree with sleep quality, somnolence, and circadian rhythm. Results There were significant differences in age, sex, hypertension, diabetes, and smoking between the MAFLD group and the healthy control group (all P < 0.05). Compared with the healthy control group, the MAFLD group had significantly higher hemoglobin, white blood cell count, lymphocyte percentage, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, serum uric acid, low-density lipoprotein, total bilirubin, total cholesterol, triglyceride, and body mass index and significantly lower albumin and high-density lipoprotein (all P < 0.05). Compared with the healthy control group, the MAFLD group had significantly higher PSQI score ( t =35.529, P < 0.001) and ESS score ( t =24.647, P < 0.001) and significantly lower MEQ score ( t =-22.416, P < 0.001) and sleep time ( t =-8.660, P < 0.001). With the increase in age in the MAFLD group, hepatic steatosis degree, liver fibrosis degree, and PSQI score showed an increasing trend, and pairwise comparison of each scoring factor between groups showed statistical significance (all P < 0.05). Compared with the healthy control group, the MAFLD group had a significantly higher proportion of patients with definitely evening type, moderately evening type, or intermediate type and a significantly lower proportion of patients with moderately morning type or definitely morning type (all P < 0.05), and MEQ score tended to decrease with the increase in hepatic steatosis degree and liver fibrosis degree, with significant differences between two groups (all P < 0.05). The multivariate logistic regression analysis showed that overweight/obesity (odds ratio [ OR ]=3.166, P =0.027), diabetes ( OR =6.811, P =0.045), increase in white blood cell count ( OR =2.301, P < 0.001), increase in lymphocyte percentage ( OR =1.316, P =0.002), poor sleep quality ( OR =8.493, P < 0.001), a high degree of somnolence ( OR =5.420, P < 0.001), and circadian rhythm disturbance ( OR =3.805, P < 0.001) were risk factors for MAFLD. The Spearman correlation analysis showed that in the MAFLD group, hepatic steatosis degree was positively correlated with PSQI score ( r =0.444, P < 0.001) and ESS score ( r =0.339, P < 0.001) and was negatively correlated with MEQ score ( r =-0.195, P =0.004), and liver fibrosis degree was positively correlated with PSQI score ( r =0.518, P < 0.001) and ESS score ( r =0.373, P < 0.001) and was negatively correlated with MEQ score ( r =-0.250, P =0.004). Conclusion Compared with healthy individuals, the patients with MAFLD often have sleep disorders, and the severity of sleep disorders increases with age, hepatic steatosis degree, and liver fibrosis degree. Obesity, diabetes, and sleep disorders are risk factors for the onset of MAFLD.

Association between breastfeeding and sleep onset delay among school aged children / 中国学校卫生

Objective@#To explore the association between exclusive breastfeeding and sleep onset delay among school aged children, and to provide a reference for promoting childhood sleep health.@*Methods@#A total of 10 686 children aged 7-12 years old were recruited from 17 primary schools in Shanghai using the multi stage sampling method from April to June 2019. The duration of sleep onset delay and exclusive breastfeeding were identified using the Children s Sleep Habits Questionnaire and a self designed questionnaire, respectively. The association between the duration of exclusive breastfeeding and the score and the risk of sleep onset delay were estimated using linear regression and a Logistic regression model, respectively.@*Results@#After adjusting for confounding factors, compared with never exclusive breastfeeding, the score of sleep onset delay decreased by 0.07, 0.08 and 0.05 in cases that involved exclusive breastfeeding for less than 3 months, 3-6 months and more than 6 months, respectively; and the odds of sleep onset delay decreased by 39.0%(OR=0.61, 95%CI=0.47-0.79), 41.1%(OR=0.59, 95%CI=0.47-0.75) and 21.1%(OR=0.79, 95%CI=0.65-0.96), respectively. Similar findings were observed in analyses stratified by gender, although the association was stronger among boys. Moreover, administration of probiotics or yogurt only improved sleep onset delay in those who were exclusively breastfed for no more than 6 months.@*Conclusion@#Longer durations of exclusive breastfeeding were associated with a lower risk of sleep onset delay among school aged children. However, exclusive breastfeeding for over 6 months diminished the protective effect that was otherwise observed on sleep onset delay.

Sleep status of children aged 3-12 years in Shanghai / 中国学校卫生

Objective@#To investigate the sleep characteristics of children aged 3-12 years old in Shanghai, and to provide a reference for improving pediatric sleep health.@*Methods@#From April to June 2019, 16 542 children aged 3-12 years old were randomly selected from 31 kindergartens and 17 primary schods in Shanghai, and a cross sectional epidemiological survey was conducted using multi stage cluster sampling. The Children s Sleep Habits Questionnaire (CSHQ) was used to evaluate sleep characteristics.@*Results@#The bedtime routine of children in Shanghai was (21:27±00:36) and (21:46±00:46) on weekdays and weekends, respectively. Corresponding wake up times were (6:52±00:28) and (7:47±00:48), total sleep duration was (9.05±1.07) and (9.52±1.17)h, and the prevalence of inadequate sleep was 81.0% and 55.4%. The average score of sleep problems was (51.56±8.04), and the prevalence of disturbed sleep was 93.5%. With advancing age, the total sleep time of children in Shanghai decreased, and the difference in weekend weekday sleep patterns increased. Furthermore, two major sleep problems were observed, namely, short sleep duration and daytime sleepiness, which became increasingly more prominent. Girls usually went to bed later on weekdays and woke up later on weekends, and a greater difference in weekend weekday sleep patterns was observed. Moreover, psychological problems such as sleep anxiety were more serious among girls.@*Conclusion@#At present, children in Shanghai have insufficient sleep time and late bedtimes. Large differences in weekend weekday sleep patterns were observed, and various sleep problems were identified. Sleep related anxiety and differences in weekend weekday sleep patterns were particularly high among girls.

Distúrbios do sono: escalas subjetivas e fatores associados em profissionais da saúde em jornada de plantões / Sleep disorders: subjective scales and associated factors in healthcare professionals during their duties

Objetivo: Demonstrar fatores envolvidos nos distúrbios do sono em profissionais que fazem plantões. Métodos: Trata-se de estudo transversal, cuja amostra foi composta de 244 voluntários, plantonistas da área da saúde, sendo 191 do sexo feminino, que responderam a um questionário socioeconômico, associado à aplicação da Escala de Sonolência de Epworth e ao Índice de Qualidade do Sono de Pittsburgh. Os dados foram analisados pelos coeficientes de Spearman e de Kendall Tau, com distribuição de probabilidade gama. Resultados: Houve significância (p<0,05) com o Índice de Qualidade do Sono de Pittsburgh e a atividade física (+0,216), ergonomia (+0,148), filhos (-0,146), valor da remuneração (+0,112) e disfunção durante o dia (+0,352). Também houve significância com a Escala de Sonolência de Epworth e atividade física (+0,138), renda familiar (-0,118), trabalho semanal (-0,151), latência do sono (-0,106), duração do sono (-0,107), eficiência do sono (-0,139) e disfunção durante o dia (+0,170). Por fim, a eficiência do sono teve significiância com profissão (-0,209), tabagismo (+0,402), Escala de Sonolência de Epworth (-0,139) e dissonias com a obesidade (índice de massa corporal >30; razão de chance de 1,40; intervalo de confiança de 95% de 1,02-1,94). Conclusão: As medidas autorrelatadas são prontamente obtidas com questionários validados, como a Escala de Sonolência de Epworth e o Índice de Qualidade do Sono de Pittsburgh, encontrando-se correlações com renda familiar, ter ou não filhos, índice de massa corporal, atividade física, ergonomia, condições de trabalho, tabagismo e componentes biopsicossociais. Em virtude do caráter transversal deste estudo é indispensável mais estudos com maior follow-up.

Objective: To demonstrate factors involved in sleep disorders in professionals who take shifts. Methods: This is a cross-sectional study whose sample consists of 244 volunteers, on-duty health workers, 191 females, who answered a socioeconomic questionnaire, associated with application of the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index. Data were analyzed with Spearman's and Kendall Tau coefficients, and gamma probability distribution. Results: There was significance (p<0,05) with the Pittsburgh Sleep Quality Index and physical activity (+0,216), ergonomics (+0,148), children (-0,146), the wage (+0,112), dysfunction during the day (+0,352). Also there was significance with the Epworth Sleepiness Scale and physical activity (+0,138), family income (-0,118), weekly workload (-0,151), sleep latency (-0,106), sleep duration (-0,107), sleep efficiency (-0,139), and dysfunction during the day (+0,170). Finally, sleep efficiency was significant with occupation (-0,209), smoking habits (+0,402), Epworth Sleepiness Scale (-0,139), dyssomnia with obesity (body index mass >30; OR of 1,40; CI 95% 1,02-1,94). Conclusion: Self-reported measures are readily obtained with validated questionnaires such as Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index, with correlations with family income, having children or not, body mass index, physical activity, ergonomics, working conditions, smoking habits, and biopsychosocial components. Due to the cross-sectional nature of this study, further research with longer follow-up is indispensable.

Comparison between sleep disorders and polysomnographic records of young adults with and without sleep bruxism: a cross-sectional study / Comparación entre trastornos del sueño y registros polisomnográficos de adultos jóvenes con y sin bruxismo del sueño: un estudio transversal

Objectives: To compare sleep disorders and polysomnographic records among a group of young adults with sleep bruxism (SB) and a control group (C). Material and methods: This cross-sectional study considered a consecutive sampling of students from the target population, searching for cases of SB until 20 individuals with and without SB were obtained. Sleep disorders were determined by applying both medical records and physiological records during sleep which were gathered from a polysomnography exam. To establish the difference of the means according to SB, the T-Student or Mann-Whitney U tests were used, depending on the data. A Logistic Regression analysis was also applied. Results: The study found differences (p-value<0.05) in the variables related to the sleep disorder: the possibility of major depressive episode (SB: 30% - C: 5%), degree of nasal airway obstruction (SB: 20% - C: 10%) and in polysomnographic registers: sleep time stage 1 (SB: 9 min - C: 18 min), Rapid Eye Movement (REM) stage (SB: 123 min C: 93 min ), number of periodic movement of the limbs (SB: 84.2 - C: 49.7), bruxism index (SB: 40.2 - C: 10.1) and average of total arousals (SB: 71.9 - C: 57.5). According to the logistic regression model, the Odds Ratio (OR) of SB, in relation to the periodic movement of the limbs and the degree of airway obstruction, it showed a statistically significant relationship (p-value<0.05). Conclusion: There were significant differences recorded in two sleep disorders between the two groups: the degree of airway obstruction and the possibility of having a major depressive episode. Differences were found in sleep and REM time stages, periodic movement of limbs and bruxism events.

Objetivo: Comparar los trastornos del sueño y los registros polisomnográficos entre un grupo de adultos jóvenes con bruxismo del sueño (BS) y un grupo control (C). Material y Métodos: Este estudio transversal consideró una muestra consecutiva de estudiantes de la población objetivo, buscando casos de BS hasta obtener 20 individuos con y sin BS. Los trastornos del sueño se determinaron aplicando registros médicos y fisiológicos durante el sueño que se obtuvieron de un examen de polisomnografía. Para establecer la diferencia de las medias según BS se utilizaron las pruebas t-Student o U de Mann-Whitney, según los datos. También se aplicó un análisis de regresión logística. Resultados: El estudio encontró diferencias (p<0,05) en las variables relacionadas con el trastorno del sueño: posibilidad de episodio depresivo mayor (BS: 30% - C: 5%), grado de obstrucción de la vía aérea nasal (BS: 20% - C: 10%) y en registros polisomnográficos: tiempo de sueño etapa 1 (BS: 9 min - C: 18 min), etapa de Movimiento Ocular Rápido (REM) (SB: 123 min C: 93 min), número de movimientos periódicos del extremidades (BS: 84.2 - C: 49.7), índice de bruxismo (BS: 40.2 - C: 10.1) y promedio de despertares totales (BS: 71.9 - C: 57.5). Según el modelo de regresión logística, el Odds Ratio (OR) del BS, en relación al movimiento periódico de las extremidades y al grado de obstrucción de la vía aérea, mostró una relación estadísticamente significativa (p<0,05). Conclusión: Se registraron diferencias significativas en dos trastornos del sueño entre los dos grupos: el grado de obstrucción de la vía aérea y la posibilidad de tener un episodio depresivo mayor. Se encontraron diferencias en las etapas de sueño y tiempo REM, movimiento periódico de extremidades y eventos de bruxismo.

Evaluation of Sleep Quality and Daytime Sleepiness in Dentistry Students

Abstract Objective: To evaluate sleep quality and excessive daytime sleepiness in undergraduate dentistry students. Material and Methods: This research is characterized as an observational study of transversal type, having analysed undergraduate students in dentistry from a public university in the State of Pernambuco, Brazil. The sample consisted of 325 students enrolled between the 1st and 10th academic semester. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), while excessive daytime sleepiness was analysed through the Epworth Sleepiness Scale (ESS). The t-Student and Mann-Whitney tests were used for the numerical values, with the F-test (ANOVA) or the Kruskal-Wallis test being used to compare more than two categories. Results: It was observed that 71.1% of students presented a poor sleep quality, with more than half of the students exhibiting excessive daytime sleepiness (58.1%). A relationship between sleep quality and the academic semester was verified. However, gender and age were not associated with sleep quality or with excessive daytime sleepiness. Conclusion: A high prevalence of poor sleep quality and excessive daytime sleepiness was observed among undergraduate students in dentistry. The data suggest that the undergraduate degree in Dentistry can influence the students' quality of sleep, regardless of age or gender.

Relationship between sleep problems and non-suicidal self-injury behavior among college students / 中国学校卫生

Objective@#To explore the relationship between sleep problems and non-suicidal self-injury behavior in Chinese college students, and to provide scientific basis for the prevention and intervention of non-suicidal self-injury behavior.@*Methods@#A cross-sectional survey of 11 689 college students from three universities in Guangzhou were selected as the research subjects. A questionnaire survey of college students’ mental health was conducted to investigate non-suicidal self-injury behavior, sleep problems, demographic information, lifestyle, and depressive symptoms.@*Results@#In the past year, the prevalence rates of non-suicidal self-injury in college students was 7.8%. Univariate Logistic analysis showed that all sleep problems were associated with non-suicidal self-injury behavior(P<0.05). After controlling for potential confounders,including grade,gender,parents’ education level,health conditon,family income,smoking,drinking and depression,multivariate Logistic regression showed that shorter sleep time at weekend (<7 h/d), insomnia symptoms and frequent nightmares significantly increased the risk of nonsuicidal selfinjury behavior in college students (OR=1.32-3.25, P<0.05), while longer sleep time at weekdays (≥9 h/d) was an important protective factor (OR=0.60, P<0.05).@*Conclusion@#These findings indicate that short sleep time, insomnia and nightmares are important risk factors for college students’ non-suicidal self-injury behavior. Intervention and management on sleep problems can effectively reduce the occurrence of self-injury behaviors.

Nonlinear association study of sleep duration with behavioral problems in school-age children / 中国学校卫生

Objective@#To evaluate the association between nocturnal sleep duration and behavioral problems in Chinese school-age Children, and to provide reference for the development of recommended nocturnal sleep duration for school-age children.@*Methods@#A total of 4 160 school-age children selected through cluster random sampling in Guangzhou urban areas. Caregivers reported children’s behavioral problems and sleep habits using parent version of the Strengths and Difficulties Questionnaire (SDQ) and sleep quality questionnaires.@*Results@#The average nocturnal sleep duration per day of school-age children is (9.07±0.76)h, the proportion of children having slept less than 9 h/d was 46%(1 912). There were statistically significant differences in the distribution of sleep duration among children with different chronotype and maternal education levels(P<0.05). There were statistically significant differences in children’s sedentary behavior duration and nap duration at different sleep duration(P<0.05). The association between children’s nocturnal sleep duration and behavioral problems was typically nonlinear and U-shaped(P<0.05). The inflection points of nocturnal sleep duration for total difficulties, emotional problems, conduct problems and peer problems were 9.65, 9.25, 9.42 and 9.30 h, respectively.@*Conclusion@#Nocturnal sleep duration shows a nonlinear association with behavioral problems in school-age children. The optimal range of nocturnal sleep duration for mental health is between 9 to 10 hours and the problems of psychological behavior were the least among school-age children.

Síndrome de piernas inquietas/Willis Ekbom desde la mirada del psiquiatra / Restless legs syndrome from the perspective of psychiatry

Restless Legs Syndrome (RLS) or Willis-Ekbom Disease is an under-diagnosed chronic and progressive primary sensory-motor disorder. It can lead to severe sleep disturbances, a usual cause of consultation. It is characterized by an urgent need to move the legs in resting situations, a cardinal symptom that is usually accompanied by an unpleasant sensation in legs. These symptoms appear or aggravate at the end of the day and in resting situations and are alleviated with movement. Based on these clinical characteristics, it has been defined as a quiescegenic focal akathisia. The diagnosis is essentially clinical. As a guide, there are five cardinal diagnostic criteria. The treatment consists of non-pharmacological measures and the use of medications such as dopamine agonists. Despite the treatment, the symptoms persist in 40% of patients. Psychiatrists should be aware of the syndrome since many drugs used by them such as antipsychotics, antidepressants and anxiolytics can worsen the symptoms. Moreover, the syndrome may be associated with depressive and anxiety diseases.

Associations between Sleep Duration and Smoked Cigarettes per Day, Heavy Smoking in Smokers

BACKGROUND: This study was performed to evaluate the associations between sleep duration and smoked cigarettes per day, prevalence of heavy smoking. METHODS: This study was based on the data of 9,893 subjects who are currently smoking, from the 4th to 6th Korea National Health and Nutrition Examination Survey. Based on appropriate sleep duration from National Sleep Foundation, study subjects were categorized into short, appropriate and over sleep group. Multiple regression analysis was performed to evaluate the association between sleep duration and smoked cigarettes per day, prevalence of heavy smoking. Age, gender, household income, education, marital status, occupation, alcohol use, body weight, hypertension, diabetes mellitus, depression, and level of stress were controlled. RESULTS: Compared with appropriate sleep group, smoked cigarettes per day and prevalence of heavy smoking were higher in short sleep group, and lower in over sleep group. CONCLUSIONS: There is association between sleep duration and smoked cigarettes per day, prevalence of heavy smoking.

Facing Complaining Customer and Suppressed Emotion at Worksite Related to Sleep Disturbance in Korea

This study aimed to investigate the effect of facing complaining customer and suppressed emotion at worksite on sleep disturbance among working population. We enrolled 13,066 paid workers (male = 6,839, female = 6,227, age < 65 years) in the 3rd Korean Working Condition Survey (2011). The odds ratio (OR) and 95% confidence intervals (CI) for sleep disturbance occurrence were calculated using multiple logistic regression models. Among workers in working environments where they always engage complaining customers had a significantly higher risk for sleep disturbance than rarely group (The OR [95% CI]; 5.46 [3.43–8.68] in male, 5.59 [3.30–9.46] in female workers). The OR (95% CI) for sleep disturbance was 1.78 (1.16–2.73) and 1.63 (1.02–2.63), for the male and female groups always suppressing their emotions at the workplace compared with those rarely group. Compared to those who both rarely engaged complaining customers and rarely suppressed their emotions at work, the OR (CI) for sleep disturbance was 9.66 (4.34–20.80) and 10.17 (4.46–22.07), for men and women always exposed to both factors. Sleep disturbance was affected by interactions of both emotional demands (engaging complaining customers and suppressing emotions at the workplace). The level of emotional demand, including engaging complaining customers and suppressing emotions at the workplace is significantly associated with sleep disturbance among Korean working population.

Assessment of depression, anxiety, sleep disturbance, and quality of life in patients with chronic low back pain in Korea / 대한마취과학회지

BACKGROUND: Chronic low back pain (CLBP) has a significant effect on quality of life and imposes a great economical burden on society. In a number of studies, validated questionnaires had been given to CLBP patients to determine their health-associated quality of life, sleep disturbance, and psychological status. However, such outcome studies had not been performed previously in Korea. METHODS: We used self-report questionnaires to compare CLBP patients with an age- and sex-matched healthy control group. Between September 2012 and August 2013, we enrolled 47 patients who had CLBP for more than 3 months (group P) and 44 healthy age- and sex-matched controls (group C), who completed the following self-report questionnaires: 36-Item Short Form Health Survey (SF-36), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Oswestry Disability Index (ODI), and Pittsburgh Sleep Quality Index (PSQI). RESULTS: The scores from the ODI, BDI, and BAI were significantly higher in group P than in group C. The SF-36 scores were significantly lower in group P than in group C, suggesting lower quality of life in group P. The incidence of depression and anxiety was significantly higher in group P than in group C. However, neither the PSQI score nor the incidence of sleep disturbance was significantly different between the groups. CONCLUSIONS: Patients with CLBP showed considerable functional disability and significant impairment of psychological status with a low quality of life. Hence, it is important to evaluate CLBP patients to provide adequate psychological support.

Incidence of and Risk Ractors for Zolpidem-Induced Delirium / 대한내과학회지

BACKGROUND/AIMS: Zolpidem is a safe and effective drug for the treatment of insomnia. However, there are some reports of adverse effects, such as delirium, after administration of zolpidem. The aim of this study was to evaluate the incidence of and risk factors for zolpidem-induced delirium. METHODS: This retrospective study enrolled 481 patients who were admitted to hospital and received zolpidem between January and May 2011. We analyzed the incidence and risk factors associated with zolpidem-induced delirium. RESULTS: Zolpidem-induced delirium occurred in 19 of 481 (4.0%) patients. Zolpidem-induced delirium was significantly associated with old age (> or = 65 years; odds ratio [OR] = 4.35, 95% confidence interval [CI] = 1.52-12.44, p = 0.006) and co-administration of benzodiazepine (OR = 4.30, 95% CI = 1.52-12.12, p = 0.006). When males > 65 years-old took both benzodiazepine and zolpidem simultaneously, the incidence of delirium was notably elevated (OR = 6.04, 95% CI = 1.80-20.20, p = 0.003). Other factors, including dosage, did not influence the occurrence of delirium. CONCLUSIONS: Old age and co-administration of benzodiazepine were independent risk factors for zolpidem-induced delirium. Therefore, a detailed medical history should be taken before prescribing zolpidem to an older person, and zolpidem should be used cautiously, with careful monitoring, in these patients.

Diagnosis and Treatment of Restless Legs Syndrome / 한양의대학술지

Restless legs syndrome (RLS) is a sensorimotor neurologic disorder, in which the primary symptom is a compelling urge to move the legs accompanied by unpleasant and disturbing sensations in the legs. RLS is relatively common, affecting 2.5 to 15% of the general population, with prevalence rates increasing alongside age. Sleep disturbance is the most common symptom owing to RLS leg symptoms. In addition, daytime dysfunction, cognitive decline, and mood disturbance are also common in patients with RLS. Iron and dopamine are implicated in the pathophysiology of RLS, however, the underlying pathophysiology of RLS is still not fully understood. The diagnosis can be made based on the symptom characteristics, differential diagnosis is important because many conditions could mimic RLS symptoms. Dopaminergic agents are recommended for the first line treatment of RLS. Alpha2delta anticonvulsants such as gabapentin and pregabalin are also effective for controlling RLS symptoms.

Probe into sleep quality in the patients with irritable bowel syndrome / 中华内科杂志

Objective To investigate the sleep features in the patients with irritable bowel syndrome (IBS) and compare the sleep quality between those IBS patients who were with and without anxiety and depression.Methods Pittsburgh sleep quality index questionnaire (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were measured in the 145 IBS patients and 59 regular physical examination volunteers.IBS patients were also divided into two subgroups-patients with or without anxiety and depression based on cutoff scores of SAS and SDS.Comparisons of sleep quality were made between subgroups, and between IBS patients and volunteer controls.Results Compared with the controls,the SAS raw score, SDS raw score and SAS positive incidence in IBS patients were shown statistically significant differences (P ＜ 0.05 ), while the SDS positive incidence had no statistically significant difference(P ＞ 0.05 ).PSQI total scores were significantly higher in the IBS patients without anxiety and depression (P ＜ 0.05), 3 domains (sleep quality, sleep disturbances and daytime function disorder) were also found statistically significant differences ( P ＜ 0.05 ), compared with the controls.The IBS patients with anxiety and depression were statistically significantly different from the controls ( P ＜ 0.05 ) in 6 domains (sleep quality, sleep latency, sleep efficiency, sleep disturbances, sleep time and daytime function disorder) and significantly higher PSQI total scores( P ＜ 0.05 ).Statistically significant differences (P ＜0.05) were also found in all 7 domains and with higher PSQI total scores in IBS patients with anxiety and depression, compared with IBS patients without anxiety and depression.Conclusions IBS patients were more likely to have sleep abnormality, mainly in sleep quality, sleep disturbances and daytime function disorder and PSQI total scores.The abnormalities of these factors were independent of emotional disorder.However, emotional disorder worsened the sleep disorder in IBS patients.

The clinical analysis of the daytime sleepiness in the middle aged and elderly patients with obstructive sleep apnea syndrome / 中华老年医学杂志

0.05),excepting the significant differences in the non-elderly ( P