Validity of the Pittsburgh sleep quality index in Indian university students

Despite the demonstrated utility of the Pittsburgh Sleep Quality Index [PSQI] in various demographic groups, it has never been validated in a sample of Indian subjects. To extend and confirm the PSQI's applicability for South Asian subjects, this preliminary study aimed to assess its psychometric and diagnostic validity in a sample of university students. Forty-seven male students were recruited from Jamia Millia Islamia, a public central university in New Delhi, India. The mean age of the students was 23.4 +/- 3.9 years, and they had a mean body mass index [BMI] of 23.3 +/- 3.3kg/m[2]. The PSQI was administered to all subjects and overnight polysomnographic testing was carried out as a concurrent validation measure. Cronbach's alpha for the questionnaire was found to be 0.736. Internal homogeneity was high, with the majority of correlations between questionnaire component scores and the summed global score being significant [p<0.010]. Criterion validity-correlations between the PSQI global score and polysomnography [PSG] measures were low. However, the questionnaire component scores and the related polysomnographic measures did show some significant relationships. The optimal cut-off scores for distinguishing students with/without sleep problems was >6 and was generated using receiver operating characteristic curve analysis. The area under the curve, sensitivity, specificity, positive and negative likelihood ratios at the cut-off score were 0.838 [p<0.0001], 75.0%, 88.9%, 6.75, and 0.280, respectively. The study found evidence that the PSQI had internal consistency, internal homogeneity, and diagnostic characteristics that compared well with PSG among a sample of young adult male students in India. This supports the applicability and certain aspects of the validity of the PSQI in the population

Prevalence of sleep-related accidents among drivers in Saudi Arabia

The prevalence of sleepy driving and sleep-related accidents [SRA] varies widely, and no data exist regarding the prevalence of sleepy driving in Saudi Arabia. Therefore, this study was designed to determine the prevalence and predictors of sleepy driving, near-misses, and SRA among drivers in Saudi Arabia. A questionnaire was developed to assess sleep and driving in detail based on previously published data regarding sleepy driving. The questionnaire included 50 questions addressing socio-demographics, the Epworth Sleepiness Scale [ESS], driving items, and the Berlin Questionnaire. In total, 1,219 male drivers in public places were interviewed face-to-face. The included drivers had a mean age of 32.4 +/- 11.7 years and displayed a mean ESS score of 7.2 +/- 3.8. Among these drivers, 33.1% reported at least one near-miss accident caused by sleepiness. Among those who had actual accidents, 11.6% were attributed to sleepiness. In the past six months, drivers reported the following: 25.2% reported falling asleep at least once during, driving and 20.8% had to stop driving at least once because of severe sleepiness. Young age, feeling very sleepy during driving, and having at least one near-miss accident caused by sleepiness in the past six months were the only predictors of accidents. Sleepy driving is prevalent among male drivers in Saudi Arabia. Near-miss accidents caused by sleepiness are an important risk factor for car accidents and should be considered as a strong warning signal of future accidents

Sleep disorders as a cause of motor vehicle collisions

Studies have shown that a large proportion of traffic accidents around the world are related to inadequate or disordered sleep. Recent surveys have linked driver fatigue to 16% to 20% of serious highway accidents in the UK, Australia, and Brazil. Fatigue as a result of sleep disorders [especially obstructive sleep apnea], excessive workload and lack of physical and mental rest, have been shown to be major contributing factors in motor vehicle accidents. A number of behavioral, physiological, and psychometric tests are being used increasingly to evaluate the impact of fatigue on driver performance. These include the oculography, polysomnography, actigraphy, the maintenance of wakefulness test, and others. Various strategies have been proposed for preventing or reducing the impact of fatigue on motor vehicle accidents. These have included: Educational programs emphasizing the importance of restorative sleep and the need for drivers to recognize the presence of fatigue symptoms, and to determine when to stop to sleep; The use of exercise to increase alertness and to promote restorative sleep; The use of substances or drugs to promote sleep or alertness [i.e. caffeine, modafinil, melatonin and others], as well as specific sleep disorders treatment; The use of CPAP therapy for reducing excessive sleepiness among drivers who have been diagnosed with obstructive sleep apnea. The evidence cited in this review justifies the call for all efforts to be undertaken that may increase awareness of inadequate sleep as a cause of traffic accidents. It is strongly recommended that, for the purpose of promoting highway safety and saving lives, all disorders that cause excessive sleepiness should be investigated and monitored

Sleep architecture of consolidated and split sleep due to the dawn [Fajr] prayer among Muslims and its impact on daytime sleepiness

Muslims are required to wake up early to pray [Fajr] at dawn [approximately one and one-half hours before sunrise]. Some Muslims wake up to pray Fajr and then sleep until it is time to work [split sleep], whereas others sleep continuously [consolidated sleep] until work time and pray Fajr upon awakening. To objectively assess sleep architecture and daytime sleepiness in consolidated and split sleep due to the Fajr prayer. A cross-sectional, single-center observational study in eight healthy male subjects with a mean age of 32.0 +/- 2.4 years. The participants spent three nights in the Sleep Disorders Center [SDC] at King Khalid University Hospital, where they participated in the study, which included [1] a medical checkup and an adaptation night, [2] a consolidated sleep night, and [3] a split-sleep night. Polysomnography [PSG] was conducted in the SDC following the standard protocol. Participants went to bed at 11:30 PM and woke up at 7:00 AM in the consolidated sleep protocol. In the split-sleep protocol, participants went to bed at 11:30 PM, woke up at 3:30 AM for 45 minutes, went back to bed at 4:15 AM, and finally woke up at 7:45 AM. PSG was followed by a multiple sleep latency test to assess the daytime sleepiness of the participants. There were no differences in sleep efficiency, the distribution of sleep stages, or daytime sleepiness between the two protocols. No differences were detected in sleep architecture or daytime sleepiness in the consolidated and split-sleep schedules when the total sleep duration was maintained