Sleep disturbance and association with social behavior in preschool children with autism spectrum disorder / 中国康复理论与实践

ObjectiveTo explore sleep disturbance in preschool children with autism spectrum disorder (ASD) and analyze the relationship between sleep disturbance and social behavior. MethodsFrom December, 2020 to December, 2022, 221 preschool children with ASD from Beijing Bo'ai Hospital and other two institutes, and 246 healthy preschool children socially recruited were investigated with Children's Sleep Habits Questionnaire (CSHQ). A total of 47 ASD children and 47 healthy children were selected from them to wear a sleep monitoring watch for seven days, while the ASD children were evaluated with Gesell Development Diagnosis Scale (GDDS), Psychoeducational Profile-Third Edition (PEP-3), Autism Diagnostic Observation Schedule-2 (ADOS), Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS) and Social Responsiveness Scale (SRS). ResultsAll the factor-scores were more in the ASD children than in the healthy children (t > 2.491, P < 0.05), except that of daytime sleepiness. The prevalence of sleep disturbance (CSHQ ≥ 41) was 89.6% in ASD children, which was more than that of the healthy children (76.8%) (χ2 = 13.360, P < 0.001). The sleep problems in ASD children included bedtime resistance, sleep anxiety, sleep duration, sleep onset delay, parasomnias and sleep disordered breathing. ASD children were shorter in total bedtime, shorter in total sleep time, longer in sleep latency, longer in awake time and lower in sleep efficiency (|t| > 2.001, P < 0.05), compared with those of healthy children. For ASD children, the total bedtime negatively correlated with GDDS-language, PEP-3-expressive language, PEP-3-communication and PEP-3-maladaptive behaviors (r < -0.300, P < 0.05); the sleep efficiency negatively correlated with total score of CARS (r = -0.365, P < 0.05); sleep latency correlated with GDDS-social, PEP-3-cognitive, PEP-3-expressive language, PEP-3-receptive language, PEP-3-visual-motor imitation, PEP-3-characteristic verbal behaviors, PEP-3-communication, original score of ADOS, ADOS-social affect, and total score of CARS (|r| > 2.90, P < 0.05); and total awake time positively correlated with total score of CARS (r = 0.406, P < 0.05). ConclusionSleep disturbance is prevalent and various in preschool ASD children, and influence their social behaviors.

Prevalence of sleep disturbance in patients with ankylosing spondylitis: a systematic review and meta-analysis

Abstract Background Ankylosing Spondylitis (AS) patients face several challenges due to the nature of the disease and its physical and psychological complications. Sleep disorders are among the most important concerns. Sleep disorders can aggravate the signs and symptoms of the disease and ultimately reduce the quality of patients' lives. This study uses a systematic review and meta-analysis to pool the reported prevalence of sleep disorders among AS patients. Methods To find related studies, the WoS, PubMed, ScienceDirect, Scopus, Embase, and Google Scholar databases were systematically searched without a lower time limit. Heterogeneity among the identified studies was checked using the I2 index, and the Begg and Mazumdar correlation test examined the existence of published bias. Comprehensive Meta-Analysis (v.2) software was adopted to analyze the data. Results In the review of 18 studies with a sample size of 5,840, the overall pooled prevalence of sleep disorders among AS patients based on the random effects method was found to be 53% (95% CI: 44.9-61). The highest and lowest prevalence was in Egypt at 90% and Australia at 19.2%, respectively. Our meta-regression results show that with the increase in 'sample size' and 'year of publication', the overall prevalence of sleep disorders in patients with AS decreases (p < 0.05). Conclusion The results of the present study indicate a high and significant prevalence of sleep disorders among AS patients. Thus, health policymakers and healthcare providers must focus on timely diagnosis and effective educational and therapeutic interventions for the prevention and proper treatment of sleep disorders in this population of patients.

Resilience among pediatric healthcare workers during the COVID-19 pandemic in a tertiary hospital

OBJECTIVES@#Healthcare workers are at the center of the pandemic, dealing with cases while being at risk of acquiring the infection themselves, causing work-related stress. Despite this, they continue reporting for duty. This paper aims to determine the factors that affect resilience of pediatric healthcare-workers in close contact with patients suspected with COVID infection and its association to sleeping disturbance during the first two years of COVID – 19 pandemic in a tertiary hospital in the Philippines.@*METHODOLOGY@#This is a cross-sectional study. Healthcare-workers who render bedside patient care for those suspected or with COVID-19 infection, not diagnosed with any mental health illness, and fit the inclusion criteria were chosen through purposive sampling and asked to answer questionnaires with demographic survey, BRS and PSQI tool.@*RESULTS@#Among 89 participants, females were predominant (60.67% ). Majority were in the 30- 39 age group (44.94%) and are nurses (40.45%) or doctors (39.33%) who were single (76.40%). Many have normal resilience as measured from their BRS scores with an average PSQI per category equal to or exceeded 5.00. The correlation coefficient was at -0.338 (p-value 0.001) between the BRS and PSQI scores, indicating that a significant negative correlation exists between the two scores.@*CONCLUSION@#Normal resilience was reported in the majority of the healthcare workers. All study participants had poor sleep quality as determined in the overall average PSQI score. A negative correlation between resilience and sleep quality was observed, denoting that poor sleep quality can be associated with lower resilience, and vice versa. However, temporality cannot be assumed with this study.

Obesity effects on sleep quality with anthropometric and metabolic changes

SUMMARY OBJECTIVE: Obesity is one of the etiological factors of sleep disorders (e.g., obstructive sleep apnea and restless leg syndrome). The aim of this study was to determine the effect of obesity on sleep quality by using the Pittsburgh Quality İndex and Berlin Question are and evaluate the association of sleep with anthropometric and metabolic parameters. METHODS: A total of 76 patients (41 females and 35 males) between the ages of 18 and 70 years with a body mass index >30 kg/m2 were included in this study. Homeostatic model assessment-insulin resistance, hemoglobin A1c, alanine aminotransferase, aspartate transaminase, total cholesterol, low-density lipoprotein, triglyceride, high-density lipoprotein, and thyroid-stimulating hormone levels were analyzed. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index, Berlin Questionnaire, and the Restless Leg Syndrome Questionnaire. RESULTS: A significant correlation was observed between Pittsburgh sleep quality index and body mass index, neck circumference, body fat index, muscle mass, hip and waist circumference, hemoglobin A1c, and homeostatic model assessment-insulin resistance (ps<0.005). The Pittsburgh sleep quality index median (2.5-97.5 percentile) value was 8 (2-18.6) in the patient group and 3.5 (0.1-7.9) in the control group (p<0.0001). Body mass index was found to be the predictor on Pittsburgh sleep quality index (R2=0.162, F=3.726, analysis of variance p=0.008). Notably, 88% (67) and 95% (57) of the poor sleepers were found to be at high risk for obstructive sleep apnea according to Berlin Questionnaire and Pittsburgh Sleep Quality Index, respectively. Also, the frequency of restless leg syndrome was 45% in obese individuals. CONCLUSIONS: We observed a significant correlation between Pittsburgh sleep quality index and the anthropometric and metabolic parameters. Also, the frequency of obstructive sleep apnea and restless leg syndrome was 88% and 45%, respectively, in obese individuals.

Sleep quality and its contributing factors in patients with gout / 中华健康管理学杂志

Objective:To evaluate the incidence and its impact fortors of sleep disorders among patients with gout.Methods:A total of 414 patients with gout were included in the study. A series of questionnaires including socio-economical and disease related scale, the Pittsburgh Sleep Quality Index (PSQI), Fatigue Scale-14, the Patient Health Questionnaire, the Generalized Anxiety Disorder questionnaire, the 10 cm Visual Analog Scale for total pain, patient self-reported confidence in gout treatment and the Health Assessment Questionnaire-Disability Index were carried out in the patients. The statistical methods used in the study included t test, rank sum test, chi-square test and regression analysis. Results:The median age of gout patients in this study was 54 years and 96.4% were men, the mean serum uric acid level was (474.98±120.14) μmol/L. Among them, 201 (48.6%) patients showed sleep disorders, and the worse sleep quality was reflected in subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency and each dimension of PSQI. It was found that sleep disorders in gout patients were associated with living in rural areas, unemployment, long disease duration, disease stage, depression, anxiety, lack of confidence in regular blood examination and some other factors. In addition, patients with severe pain ( OR=1.087, P=0.029), fatigue ( OR=1.125, P=0.002), tophi ( OR=1.843, P=0.014) and functional disability ( OR=2.916, P<0.001) were more likely to get sleep disorders. Conclusions:The incidence of sleep disorders in patients with gout is high, and it′s associated with disease duration, psychological status, pain, tophi, disease stage, functional disability.

The effectiveness of melissa officinalis l. Versus citalopram on quality of life of menopausal women with sleep disorder: a randomized double-blind clinical trial

Abstract Objective The present study aimed to assess the effect of Melissa Officinalis L. (a combination of lemon balm with fennel fruit extract) compared with citalopram and placebo on the quality of life of postmenopausal women with sleep disturbance. Methods The present study is a randomized, double-blind, placebo clinical trial among 60 postmenopausal women with sleep disturbance who were referred to a university hospital from 2017 to 2019. The participants were randomized to receive M. Officinalis L. (500 mg daily), citalopram (30 mg) or placebo once daily for 8 weeks. The Menopause-Specific Quality of Life (MENQOL) questionnaire was self-completed by each participant at baseline and after 8 weeks of the intervention and was compared between groups. Results The mean for all MENQOL domain scores were significantly improved in the M. Officinalis L. group compared with citalopram and placebo (p < 0.001). The mean ± standard deviation (SD) after 8 weeks in the M. Officinalis L., citalopram and placebo groups was 2.2 ± 0.84 versus 0.56 ± 0.58 versus 0.36 ± 0.55 in the vasomotor (p < 0.001), 1.02 ± 0.6 versus 0.28 ± 0.2 versus 0.17 ± 0.1 in the psychomotor-social (p < 0.001), 0.76 ± 0.4 versus 0.25 ± 0.1 versus 0.11 ± 0.1 in the physical and 2.3 ± 1.0 versus 0.35 ± 0.5 versus 0.41 ± 0.5 in the sexual domain, respectively. Conclusions The results revealed that M. Officinalis L. may be recommended for improving the quality of life of menopausal women with sleep disturbance. Trial registration The present study was registered by the name "Comparison of the efficacy of citalopram and compound of Asperugo procumbens and foeniculum vulgare in treatment of menopausal disorders" with the code IRCT2013072714174N1 in the Iranian Registry of Clinical Trials (IRCT).

Establishment and validation of prediction model for postoperative sleep disturbance in patients undergoing non-cardiac surgery / 中华麻醉学杂志

Objective:To establish and validate the prediction model for postoperative sleep disturbance (PSD) in patients undergoing non-cardiac surgery.Methods:A total of 454 patients of both sexes, aged≥18 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, underwent non-cardiac surgery under general anesthesia from November 2019 to September 2020 were selected.The perioperative data were collected.The patients were divided into training set and validation set with a ratio of 7∶3 by using a simple random sampling method.The characteristic variables of PSD were selected using LASSO regression analysis and the independent risk factors were identified using multivariate logistic regression analysis in training set.Akaike′s information criterion was used to evaluate the quality of fit of the model.The nomogram of PSD in non-cardiac surgery patients was constructed based on the identified factors.The discrimination of the model was evaluated using receiver operating characteristic (ROC) curve, and the agreement of the model was evaluated using Hosmer-Lemeshow goodness-of-fit test and Brier score.Results:Seven risk factors (gender, preoperative anxiety, satisfaction with the ward environment, anesthesia time, the intraoperative consumption of midazolam and sufentanil and numerical rating scale (NRS) score at 3 days after operation) and two related factors (preoperative NRS score and general anesthesia combined with nerve block) were used to establish and verify the PSD nomogram.The area under the ROC curve was 0.805 (95% confidence interval [CI] 0.721-0.848) in training set.The area under the ROC curve was 0.773 (95% CI 0.684-0.876) in validation set.In training and validation sets, the calibration curves were tested by Hosmer-Lemeshow good of fit test, the P values were 0.590 and 0.950, respectively, and the Brier scores were 0.154 and 0.156, respectively.The nomogram predicated that the sensitivity (95% CI) and specificity (95%CI) were 81.83% (60.32%-95.14%) and 78.15% (71.83%-83.25%), respectively, in training set, and the sensitivity (95% CI) and specificity (95%CI) were 77.86% (39.84%-97.25%) and 78.15% 77.86% (68.74%-85.48%), respectively, in validation set.The optimal cut-off value of nomogram score was 113. Conclusion:In this study, the nomogram prediction model for PSD in patients undergoing non-cardiac surgery has been successfully established, which can visually and individually predict the risk of PSD.

Sleep and restless legs syndrome in female adolescents with idiopathic musculoskeletal pain / Sono e síndrome das pernas inquietas em adolescentes do sexo feminino com dor musculoesquelética idiopática

Abstract Objectives: To assess the presence of restless legs syndrome, periodic leg movement, and sleep disorders in female adolescents with idiopathic musculoskeletal pain through a sleep scale and polysomnography, and to compare these data in adolescents without pain history. Method: Twenty-six adolescents diagnosed with idiopathic musculoskeletal pain followed in a pain outpatient clinic and 25 healthy controls matched by age and education were recruited. The restless legs syndrome criteria were evaluated according to the International Restless Legs Syndrome Study Group, the Sleep Disturbance Scale for Children was completed, nocturnal polysomnography was performed, and anxiety symptoms were recorded. Results: The mean age of idiopathic musculoskeletal pain adolescents was 13.9 ± 1.6 years; in controls, it was 14.4 ± 1.4 years. One adolescent in the control group (4 %) and nine patients with idiopathic musculoskeletal pain (34.6 %) fulfilled the restless legs syndrome criteria (p = 0.011). The authors did not observe significant differences in Sleep Disturbance Scale for Children scores between the groups in all components: disorders of initiating and maintaining sleep (p = 0.290), sleep breathing disorders (p = 0.576), disorders of arousal (p = 0.162), sleep-wake transition disorders (p = 0.258), disorder of excessive daytime somnolence (p = 0.594), and sleep hyperhidrosis (p = 0.797). The neurophysiological, respiratory, and periodic leg movement parameters were similar in both groups. Having anxiety was not associated with restless legs syndrome (p = 0.11). Three patients with idiopathic musculoskeletal pain (11.5 %) presented restless legs syndrome and periodic leg movement simultaneously, which was absent in the control group. Conclusion: Female adolescents with idiopathic musculoskeletal pain present criteria for RLS more frequently than healthy adolescents. However, this study did not observe relevant changes in objective and subject sleep variables.

Resumo Objetivos: Avaliar a presença de síndrome das pernas inquietas, movimento periódico das pernas e distúrbios do sono em adolescentes do sexo feminino com dor musculoesquelética idiopática por meio da escala do sono e da polissonografia e comparar esses dados em adolescentes sem histórico de dor. Método: Foram recrutados 26 adolescentes diagnosticados com dor musculoesquelética idiopática acompanhados em um ambulatório de dor e 25 controles saudáveis pareados por idade e escolaridade. Avaliamos os critérios da síndrome das pernas inquietas de acordo com o Grupo Internacional de Estudos de Síndrome das Pernas Inquietas, a Escala de Distúrbios do Sono em Crianças, a polissonografia noturna e os sintomas de ansiedade. Resultados: A idade média dos adolescentes com dor musculoesquelética idiopática foi 13,9 ± 1,6 anos e dos controles foi 14,4 ± 1,4 anos. Um adolescente no grupo de controle (4%) e nove pacientes com dor musculoesquelética idiopática (34,6%) atenderam aos critérios da síndrome das pernas inquietas (p = 0,011). Não observamos diferenças significativas nos escores da Escala de Distúrbios do Sono em Crianças entre os grupos em todos os componentes: distúrbios do início e da manutenção do sono (p = 0,290), distúrbios respiratórios do sono (p = 0,576), distúrbios do despertar (p = 0,162), distúrbios da transição sono-vigília (p = 0,258), sonolência diurna excessiva (p = 0,594) e hiperidrose do sono (p = 0,797). Os parâmetros neurofisiológicos, respiratórios e o movimento periódico das pernas foram semelhantes nos dois grupos. Ansiedade não foi associada à síndrome das pernas inquietas (p = 0,11). Três pacientes com dor musculoesquelética idiopática (11,5%) apresentaram síndrome das pernas inquietas e movimento periódico das pernas simultaneamente, situação ausente no grupo de controle. Conclusão: As adolescentes do sexo feminino com dor musculoesquelética idiopática apresentaram critérios para síndrome das pernas inquietas com mais frequência do que as adolescentes saudáveis. Contudo, não observamos mudanças relevantes nas variáveis do sono objetivas e subjetivas.

Correlation of sleep quality with fatigue and disease activity among patients with primary Sjögrens syndrome: a cross-sectional study

ABSTRACT BACKGROUND: Fatigue is a frequent symptom in patients with primary Sjögren's syndrome (pSS) and can be a cause of or be associated with sleep disorders. OBJECTIVE: To assess the sleep quality of pSS patients and its relationship with fatigue and disease activity. DESIGN AND SETTING: Analytical observational study conducted at an exercise psychobiology laboratory. METHODS: Sleep quality was evaluated using the Pittsburg sleep quality index (PSQI) and actigraphy. Fatigue was evaluated through the Profile of Fatigue and Discomfort - Sicca Symptoms Inventory (PROFAD-SSI-SF) and a visual analogue scale for fatigue (VAS-fatigue). Disease activity was evaluated using a visual analogue scale for pain (VAS-pain), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) and Disease Activity Index (ESSDAI). We summarized the data through descriptive statistics. RESULTS: A total of 50 female patients with pSS, of average age 56.4 years, were included in the study; 80% presented low disease activity. The total PSQI score showed that 74% had poor sleep. The actigraphy showed mean sleep latency of 26.2 minutes and mean nightly awakening of 48.2 minutes (duration of wakings after sleep onset, WASO). There were correlations between PSQI and VAS-pain, VAS-fatigue, PROFAD-SSI and ESSPRI. Actigraphy showed a correlation between the duration of WASO and ESSDAI. CONCLUSION: The present study provides important information regarding correlations between sleep disorders and disease activity. There is a need for proper control over disease activity and for development of strategies to help patients to sleep better in order to diminish their fatigue.

Assessment of sleep quality of patients with panic disorder and generalized anxiety disorder during remission: a case-control study

Abstract Background Sleep disorders are common in psychiatric diseases. Panic disorder (PD) and generalized anxiety disorder (GAD) are two major anxiety disorders that are associated with sleep disorders. Objective We hypothesized that poor sleep quality continues in PD and GAD during remission. Therefore, in this study we aimed to compare the sleep quality of patients with PD and GAD to that of healthy controls. Methods The study included patients with PD (n = 42) and GAD (n = 40) who had been in remission for at least 3 months and healthy control volunteers (n = 45). The patients were administered the Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Results The total PSQI scores of the GAD group were significantly increased in comparison to those of the PD (p = 0.009) and control (p < 0.001) groups. The rate of poor sleep quality in GAD during remission (77.5%) was greater than that of the PD (47.6%) and control (51.1%) groups (p = 0.011). Discussion GAD is a chronic and recurrent disease. In this study, it was found that the deterioration in sleep quality of patients with GAD may continue during remission. In the follow-up and treatment of patients, it is appropriate to question about sleep symptoms and to plan interventions according to these symptoms.

A study on sleep patterns and sleep problems in children aged 6 to 15 years as perceived by their parents

Background: The objective is to study the sleep pattern and occurrence of sleep problems in children aged 6 to 15 years, visiting the Outpatient clinic at a tertiary care hospital, as perceived by the parents and to establish the common causal association as perceived by the parents for developing sleep problems. 'Methods: The study design was based on the descriptive study. The duration of the study was from 1st June to 31st July. Data was collected from all the children visiting the Pediatric OPD and those who are admitted, Department of Pediatrics, Father Muller Medical College. Sample size: convenient sampling. Considering the prevalence of sleep disturbance in children as 10%, estimated error of 5% and confidence interval of 5%, sample size was 139. Children who followed the inclusion and exclusion criteria were considered for the study. Informed consent was taken from the parent. Relevant details were asked to the parents of the child and a pre-designed proforma was filled by the investigator accordingly. SDSC questionnaire was used and a cut off score of 39 was considered.Results: Out of the 140 children who completed the survey, 48% of the children had sleep disturbances.' The most common was disorder of initiating and maintaining sleep. The most common association was with need for accompaniment, followed by use of gadgets. The prevalence of sleep disorders is underestimated, and it is important to recognize them early.Conclusions: The increasing use of electronic gadgets could be a possible cause of sleep disturbances, which suggests that the exposure of children to these gadgets maybe reduced.

Anxiety, Depression and Sleep Disturbance among Customer-Facing Workers

Transtornos do sono: atualização (parte2/2) / Sleep disorders: up to date (2/2)

Este artigo (2/2) compõe uma revisão sobre fundamentos do sono e transtornos do sono (TS), sendo aqui considerados: 1-Incapacidade de dormir na hora desejada-atraso de fase, avanço de fase, ''jet lag'', ritmo sono-vigília irregular, sono/vigília de livre curso, transtornos dos trabalhadores em turnos; 2-Movimentos ou comportamentos anormais durante o sono. Este segundo grupo é aqui subdividido em: A1-Parassonias relacionadas ao sono NREM (Non-rapid eye movement) ­ despertar confusional, sonambulismo, terror noturno, síndrome da cabeça explosiva, alucinações relacionadas ao sono, enurese noturna e parassonias causadas por doenças e medicações; A2-Parassonias relacionadas ao sono REM (rapid eye movement) - transtorno comportamental do sono REM, pesadelos, paralisias recorrentes isoladas do sono, promulgação sono ''dream enactment behavior"; B-Transtornos do movimento relacionados ao sono-bruxismo, síndrome das pernas inquietas, movimentos periódicos das pernas, câimbras do sono, movimentos rítmicos relacionados ao sono, mioclonias proprioespinhais do início do sono, movimentos relacionados à medicação, mioclonias em doenças sistêmicas e mioclonias benignas do sono em bebês.(AU)

This is the second part (2/2) of an article that intends to review major topics regarding sleep fundamentals and sleep disorders (SD), now considering: 1-Circadian rhythm disorders-delayed onset sleep phase disorder, advanced onset sleep phase disorder, jet lag, irregular sleep-wake rhythm, free-running type, shift work type; 2-Abnormal movements or behaviours during sleep. This second category is divided in two groups: A1-NREM (Non-rapid eye movement) parasomnias ­ confusional awakening, sleepwalking, night terrors, explosive head syndrome, sleep-related hallucinations, nocturnal enuresis and parasomnias related to diseases or medications; A2-REM (Rapid eye movement) parasomnias-REM sleep behaviour disorder, nightmares, recurrent isolated sleep paralysis, dream enactment behaviour; B-Sleep related movement disorders-bruxism, restless legs syndrome, periodical limb movement disorders, nocturnal leg cramps, sleep related rhythmic movement disorder, propriospinal myoclonus, movements related to medication use, myoclonus related to systemic diseases and benign myoclonus of sleep.(AU)

Relationship between Smoking and Sleep Disturbance / 수면정신생리

Smoking is one of the most harmful causes of disease. Many previous researches have shown that cigarette smoking leads to cardiovascular, respiratory, oncologic, and cerebrovascular diseases. In addition to such adverse effects, the literature indicates that cigarette smoking can worsen sleep quality and induce sleep disorders. This review focuses on the relationship between smoking/nicotine and sleep and sleep disorders of insomnia, obstructive sleep apnea, and restless legs syndrome. Because smoking is a behavioral pattern that can be changed, it is important to quit smoking to improve overall health and sleep.

Association of Sleep Disturbance, Fatigue, Job Stress and Exposure to Blood and Body Fluid in Shift-work Nurses

PURPOSE: The purpose of this study was to identify associations among the sleep disturbance, fatigue, job stress, and blood and body fluid (BBF) exposure of shift-work nurses. METHODS: A total of 299 shift-work nurses from two tertiary hospitals were enrolled in this study. We used the Insomnia Severity Index (ISI), and the Fatigue Severity Scale (FSS), and the Korean Occupational Stress Scale-Short Form (KOSS-SF) to evaluate sleep disturbance, fatigue, and job stress, respectively. The data were analyzed using t-test or chi-squared test and Logistic regression analysis using the SPSS 23.0 program. RESULTS: We found that 43.8% of participants reported BBF exposure over the past year. Splash or exposure to broken skin of BBF were most frequent (56.9%), and followed by needlestick injuries (30.4%) and sharp injuries (12.8%). Age, hospital, working period, level of stress, sleep disturbance (ISI≥15), fatigue (FSS score≥4), job demand and organizational climate subset in KOSS-SF were significantly associated with BBF exposure in shift-work nurses. In multivariate analysis after adjusting age and hospital, the risk factors of BBF exposure in shift-work nurses were the level of stress and fatigue (FSS score≥4). CONCLUSION: Fatigue and job stress were related to BBF exposure in shift-work nurses. Our results suggest that management of sleep disturbance, fatigue, and high job stress in shift-work nurses is needed to reduce risk of BBF exposure.

Increased Serum Cystatin C in Early Parkinson's Disease with Objective Sleep Disturbances / 中华医学杂志(英文版)

<p><b>Background</b>Sleep disturbance is one of the major non-motor symptoms which cause the disability of Parkinson's disease (PD) patients. Cystatin C (CysC) is a more sensitive biomarker than serum creatinine or estimated glomerular filtration rate. Previous studies have reported altered CysC levels in neurodegenerative disorders and sleep disorders. This study aimed to explore the correlations of serum CysC levels and objective sleep disturbances in early PD.</p><p><b>Methods</b>We recruited 106 early PD patients and 146 age- and sex-matched controls. All participants underwent clinical investigation and video-polysomnography. Sleep parameters and serum levels of CysC were measured. Then, we investigated the relationships between CysC and clinical variables and objective sleep disturbances in early PD patients.</p><p><b>Results</b>The mean serum level of CysC was significantly higher in patients with early PD (1.03 ± 0.19 mg/L) compared to controls (0.96 ± 0.15 mg/L, P = 0.009). There were significantly positive correlations between serum CysC levels and age (r = 0.334, P < 0.001), gender (r = 0.264, P = 0.013), and creatinine levels (r = 0.302, P = 0.018) in early PD patients. Increased serum CysC levels in early PD patients were significantly associated with higher apnea and hypopnea index (AHI) (r = 0.231, P = 0.017), especially hypopnea index (r = 0.333, P < 0.001). In early PD patients, elevated serum CysC levels were positively correlated with oxygen desaturation index (r = 0.223, P = 0.021), percentage of time spent at oxygen saturation (SaO) <90% (r = 0.644, P < 0.001), arousal with respiratory event during sleep (r = 0.247, P = 0.013). On the contrary, the elevated serum CysC levels were negatively correlated with mean and minimal SaO(r = -0.323, -0.315, both P = 0.001) in PD patients.</p><p><b>Conclusions</b>The level of serum CysC was higher in early PD patients. PD patients with elevated serum CysC levels had more respiratory events and more severe oxygen desaturation. Therefore, the serum CysC levels may predict the severities of sleep-disordered breathing problems in early PD patients.</p>

Effect of dexmedetomidine plus sufentanil administered for postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy / 临床麻醉学杂志

Objective To evaluate the effects of dexmedetomidine plus sufentanil during postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy.Methods Sixty patients (aged 30-55 years,ASA Ⅰ or Ⅱ) scheduled for hysterectomy were randomly divided into the following 2 groups: group C (n=30,sufentanil) and group D (n=30,sufentanil plus dexmedetomidine).Polysomnography measures were performed,the night before surgery (PSG1),the first night after surgery (PSG2),and the second night after surgery (PSG3).In addition,pain levels (visual analogue scale,VAS),sedation levels,sufentanil consumptions,and possible adverse effects on MAP,HR and SpO2 were investigated.Results Compared with PSG1,N1 stage sleep in group C and N2 stage sleep in group D were significantly increased (P<0.05),N1 stage sleep at PSG2 and PSG3 in group D was decreased (P<0.05);N3 and REM stage sleep,sleep efficiency index and subjective sleep quality were decreased,arousal index was increased in two groups (P<0.05).Compared with group C,N1 stage sleep was decreased,and N2 stage sleep was increased at PSG2 and PSG3 in group D (P<0.05);sleep efficiency index,subjective sleep quality were increased,arousal index in group D was decreased (P<0.05).Patients in group D had a lower VAS score and cumulative sufentanil consumption,MAP,HR at 6,24,48 h after surgery (P<0.05) and a higher sedation score at 6,24 h after surgery than those in group C (P<0.05).Conclusion Besides offering effective analgesia,postoperative dexmedetomidine infusion has positive effects on sleep disturbance in patients undergoing hysterectomy.

Interventional effect of mindfulness-based stress reduction on perceived stress and sleep disturbance in cancer patients:a systematic review / 重庆医学

Objective To systematically the effect of mindfulness-based stress reduction(MBSR) on improving perceived stress and sleep disturbance in cancer patients.Methods The databases of PubMed(Medline),Cochrane,BIOSIS Previews,Web of Science,CBM,CNKI,VIP and Wanfang Data were retrieved by computer,moreover the related journals and included reference literatures were retrieved by manual searching for finding the randomized controlled trials(RCTs) on the application of MBSR in perceived stress and sleep disturbance of cancer patients.Two reviewers independently screened the literatures according to the inclusion and exclusion criteria,extracted the data,and assessed the quality of RCTs.The meta analysis was conducted by adopting the RevMan 5.3 software.Results Nine RCTs involving 974 patients were included.The meta analysis results indicated that the improvement of perceived stress and sleep disturbance after intervention had statistical difference between the MBSR group and control group[MD=-4.63,95％CI(-5.10,-4.17),P＜0.01,MD=-2.18,95％CI (-2.35,-2.01),P＜0.01],but the difference after 3-month intervention between the two groups was not statistically significant.Conclusion The present evidences show that the MBSR method can relieve the perceived stress and sleep disturbance in cancer patients during a short period,but long term effect still needs to carry out more researches to be verified.

Association between sleep disorders and chronic diseases in patients of the brazilian national health system / Associação entre distúrbios do sono e doenças crônicas em pacientes do sistema único de saúde

ABSTRACT Many factors are associated with sleep disorders, causing an increase in health spending. The objective of this study was to analyze the association of sleep disorders and non-communicablechronic diseases in patients over 50 years of age, attended by Basic Health Care Units of Presidente Prudente. In total, 363 patients participated. The history of diseases was self-reported through the use of a questionnaire, the level of physical activity was evaluated by the Baecke questionnaire, and sleep quality was assessed using the Mini-Sleep Questionnaire. Anthropometric and body composition data were collected using a stadiometer and scale; patients in the highest (75th) percentile were considered obese. Statistical analysis was performed using the Student t test, chi-square test, and binary logistic regression. The results showed that sleep disorders are associated with osteoporosis, arthritis/osteoarthritis, low back pain, depression, and obesity. Additionally, obesity and physical inactivity influence the occurrence of non-communicable chronic diseases.

RESUMO Inúmeros fatores estão associados aos distúrbios do sono ocasionando o aumento nos gastos com saúde. O objetivo do trabalho foi analisar a associação dos distúrbios do sono e doenças crônicas não transmissíveis em pacientes com idade superior a 50 anos atendidos por Unidades Básicas de Saúde de Presidente Prudente. Participaram 363 pacientes. O histórico de doenças foi auto relatada a partir da aplicação de questionário, o nível de atividade física foi verificado através do questionário de Baecke, e a qualidade do sono foi avaliada utilizando o Mini-Sleep questionnaire. Dados antropométricos e de composição corporal foram coletados utilizando estadiômetro e balança, foram considerados obesos os pacientes dentro do percentil 75. A análise estatística foi composta pelos testes t de Student, qui-quadrado, e regressão logística binária. Os resultados mostraram que o distúrbio do sono está associado as doenças osteoporose, artrite/artrose, dor lombar, depressão e obesidade. Adicionalmente obesidade e inatividade física influenciam na ocorrência de doenças crônicas não transmissíveis.

Dietary and Lifestyle Habits and Dietary Behaviors According to Level of Smartphone Addiction in University Students in Kyungnam Province

The purpose of this study was performed to investigate dietary and lifestyle habits, dietary behaviors, and food frequency according to the level of smartphone addiction among 408 university students in Kyungnam province. Statistical analyses were performed using the SPSS software package. Based on using the Smartphone Addiction Poneness Scale, 28.4% were potential-risk smartphone users and while 13.2% were high-risk smartphone users. The levels of depression (P<0.05) and stress (P<0.05) and frequency of snacks (P<0.01) were higher in high-risk and potential-risk groups than in the normal group, and meal frequency was highest in the high-risk group (P<0.01). Percentages of using a smartphone at meal time (P<0.01) and snacking while using a smartphone (P<0.01) were higher in potential-risk and high-risk groups than in the normal group. Percentages of skipping meals (P<0.001) and slow eating speed (P<0.01) due to using a smartphone were higher in high-risk and potential-risk groups than in the normal group, and percentages of taste change (P<0.05) were higher in the high-risk group than in the potential-risk and normal groups. Percentages of exercise reduction (P<0.01), body weight increase (P<0.05), sleep disturbance (P<0.001), and increase in stress (P<0.01) due to using a smartphone were higher in the high-risk group than in the normal group. Scores of dietary behaviors avoiding salty food (P<0.01) and excessive drinking (P<0.001) were higher in the high-risk group than in the normal group. Scores for frequency of oil or nuts (P<0.05) and fatty meats (P<0.01) were highest in the high-risk group. Our results suggest that effective nutrition education programs are needed to solve unhealthy dietary and lifestyle habits from high-risk smartphone users in university students.