Ansiedad, depresión y calidad del sueño en estudiantes de Odontología / Anxiety, depression and sleep quality in dental students / Ansiedade, depressão e qualidade do sono em estudantes de Odontologia

La calidad del sueño en los estudiantes es un factor esencial que influye en el correcto desarrollo de los procesos cognitivos del aprendizaje, así como en la calidad de vida y la salud mental y física de los futuros profesionales. Objetivo: evaluar la relación entre la ansiedad, la depresión y la calidad del sueño en estudiantes de la carrera de Odontología de la Universidad Nacional del Altiplano de Puno. Materiales y métodos: estudio de tipo observacional de cohorte transversal con la participación de 78 estudiantes, con edad promedio de 22.63±2.87 años, con una distribución de género de 32 varones (41,0 %) y 46 mujeres (59,0 %). Se utilizó la escala de valoración de Hamilton para la evaluación de la ansiedad y la depresión, con una consistencia interna de α = 0,88 y 0,86, respectivamente y el cuestionario de Pittsburgh para medir el índice de calidad del sueño (α = 0,87). Resultados: en el modelo predictivo los coeficientes estandarizados ß señalan que la ansiedad psíquica (ß = -,870; p<0,001), la depresión (ß = ,119; p<0,05) y el desarrollo de prácticas clínicas (ß = -0,019; p<0,05) fueron los factores que más contribuyeron significativamente al índice de calidad del sueño de los estudiantes. Conclusión: estos hallazgos subrayan la importancia de abordar los problemas del sueño como parte integral del tratamiento de la ansiedad y la depresión, además de resaltar la necesidad de tener en cuenta la salud mental en la evaluación y el manejo de los trastornos del sueño

The quality of sleep-in students is an essential factor that influences the correct development of cognitive learning processes, as well as the quality of life and the mental and physical health of future professionals. Objective: to evaluate the relationship between anxiety, depression and sleep quality in students of the Dentistry program at the National University of the Altiplano of Puno. Materials and methods: observational cross-sectional cohort study with the participation of 78 students, with an average age of 22.63±2.87 years, with a gender distribution of 32 men (41.0%) and 46 women (59.0%). The Hamilton rating scale was used to evaluate anxiety and depression, with an internal consistency of α = 0.88 and 0.86, respectively, and the Pittsburgh questionnaire was used to measure the sleep quality index (α = 0.87). Results: in the predictive model, the standardized ß coefficients indicate that psychological anxiety (ß = -.870; p<0.001), depression (ß = .119; p<0.05) and the development of clinical practices (ß = -0.019; p<0.05) were the factors that contributed most significantly to the students' sleep quality index. Conclusion: these findings underscore the importance of addressing sleep problems as an integral part of the treatment of anxiety and depression, as well as highlighting the need to consider mental health in the assessment and management of sleep disorders

A qualidade do sono dos estudantes é um fator essencial que influencia o correto desenvolvimento dos processos de aprendizagem cognitiva, bem como a qualidade de vida e a saúde mental e física dos futuros profissionais. Objetivo: avaliar a relação entre ansiedade, depressão e qualidade do sono em estudantes do curso de Odontologia da Universidade Nacional do Altiplano de Puno. Materiais e métodos: estudo de coorte transversal observacional com a participação de 78 estudantes, com idade média de 22,63±2,87 anos, com distribuição por género de 32 homens (41,0%) e 46 mulheres (59,0%). A escala de avaliação de Hamilton foi utilizada para avaliar ansiedade e depressão, com consistência interna de α = 0,88 e 0,86, respectivamente, e o questionário de Pittsburgh foi utilizado para mensurar o índice de qualidade do sono (α = 0,87). Resultados: no modelo preditivo, os coeficientes ß padronizados indicam que a ansiedade psicológica (ß = -0,870; p<0,001), a depressão (ß = 0,119; p<0,05) e o desenvolvimento de práticas clínicas (ß = -0,019; p<0,05) foram os fatores que mais contribuíram significativamente para o índice de qualidade do sono dos estudantes. Conclusão: estas descobertas sublinham a importância de abordar os problemas do sono como parte integrante do tratamento da ansiedade e da depressão, bem como realçam a necessidade de considerar a saúde mental na avaliação e gestão dos distúrbios do sono

Ansiedad, depresión y calidad del sueño en estudiantes de Odontología

La calidad del sueño en los estudiantes es un factor esencial que influye en el correcto desarrollo de los procesos cognitivos del aprendizaje, así como en la calidad de vida y la salud mental y física de los futuros profesionales. Objetivo: Evaluar la relación entre la ansiedad, la depresión y la calidad del sueño en estudiantes de la carrera de Odontología de la Universidad Nacional del Altiplano de Puno. Materiales y métodos: Estudio de tipo observacional de cohorte transversal con la participación de 78 estudiantes, con edad promedio de 22.63±2.87 años, con una distribución de género de 32 varones (41,0 %) y 46 mujeres (59,0 %). Se utilizó la escala de valoración de Hamilton para la evaluación de la ansiedad y la depresión, con una consistencia interna de α = 0,88 y 0,86, respectivamente y el cuestionario de Pittsburgh para medir el índice de calidad del sueño (α = 0,87). Resultados: En el modelo predictivo los coeficientes estandarizados ß señalan que la ansiedad psíquica (ß = -,870; p<0,001), la depresión (ß = ,119; p<0,05) y el desarrollo de prácticas clínicas (ß = -0,019; p<0,05) fueron los factores que más contribuyeron significativamente al índice de calidad del sueño de los estudiantes. Conclusión: Estos hallazgos subrayan la importancia de abordar los problemas del sueño como parte integral del tratamiento de la ansiedad y la depresión, además de resaltar la necesidad de tener en cuenta la salud mental en la evaluación y el manejo de los trastornos del sueño.

The quality of sleep-in students is an essential factor that influences the correct development of cognitive learning processes, as well as the quality of life and the mental and physical health of future professionals. Objective: To evaluate the relationship between anxiety, depression and sleep quality in students of the Dentistry program at the National University of the Altiplano of Puno. Materials and methods: Observational cross-sectional cohort study with the participation of 78 students, with an average age of 22.63±2.87 years, with a gender distribution of 32 men (41.0%) and 46 women (59.0%). The Hamilton rating scale was used to evaluate anxiety and depression, with an internal consistency of α = 0.88 and 0.86, respectively, and the Pittsburgh questionnaire was used to measure the sleep quality index (α = 0.87). Results: In the predictive model, the standardized ß coefficients indicate that psychological anxiety (ß = -.870; p<0.001), depression (ß = .119; p<0.05) and the development of clinical practices (ß = -0.019; p<0.05) were the factors that contributed most significantly to the students' sleep quality index. Conclusion: These findings underscore the importance of addressing sleep problems as an integral part of the treatment of anxiety and depression, as well as highlighting the need to consider mental health in the assessment and management of sleep disorders.

A qualidade do sono dos estudantes é um fator essencial que influencia o correto desenvolvimento dos processos de aprendizagem cognitiva, bem como a qualidade de vida e a saúde mental e física dos futuros profissionais. Objetivo: Avaliar a relação entre ansiedade, depressão e qualidade do sono em estudantes do curso de Odontologia da Universidade Nacional do Altiplano de Puno. Materiais e métodos: Estudo de coorte transversal observacional com a participação de 78 estudantes, com idade média de 22,63±2,87 anos, com distribuição por género de 32 homens (41,0%) e 46 mulheres (59,0%). A escala de avaliação de Hamilton foi utilizada para avaliar ansiedade e depressão, com consistência interna de α = 0,88 e 0,86, respectivamente, e o questionário de Pittsburgh foi utilizado para mensurar o índice de qualidade do sono (α = 0,87). Resultados: No modelo preditivo, os coeficientes ß padronizados indicam que a ansiedade psicológica (ß = -0,870; p<0,001), a depressão (ß = 0,119; p<0,05) e o desenvolvimento de práticas clínicas (ß = -0,019; p<0,05) foram os fatores que mais contribuíram significativamente para o índice de qualidade do sono dos estudantes. Conclusão: Estas descobertas sublinham a importância de abordar os problemas do sono como parte integrante do tratamento da ansiedade e da depressão, bem como realçam a necessidade de considerar a saúde mental na avaliação e gestão dos distúrbios do sono.

Explorations of the application of polysomnographic sleep monitor in patients with schizophrenia and the monitoring effect of that on sleep quality and sleep structure of them / 中国医学装备

Objective:To explore and analyze the application of polysomnographic sleep monitor in patients with schizophrenia and the monitoring effect of that on sleep quality and sleep structure of them.Methods:A total of 90 patients with schizophrenia admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2021 to May 2023 were selected as the observation group,and 80 healthy volunteers were selected as the health control group.All subjects were monitored by polysomnographic sleep monitor.Pittsburgh Sleep Quality Index(PSQI)score,sleep quality index of polysomnographic sleep monitor,the indicators of sleep structure and spindle wave index between two groups were compared.At the same time,Pearson correlation analysis was used to explore the correlation between PSQI score and sleep parameters.Results:PSQI score of the health control group was(5.36±0.65)scores,and that of the observation group was(14.24±3.58)scores,and the PSQI score of the observation group was significantly higher than that of the health control group,and the difference was statistically significant(t=23.115,P<0.05).Compared with the health control group,the observation group had shorter total sleep time,longer sleep latency,shorter rapid eye movement(REM)period and more awakening times,with statistical significances(t=15.136,40.355,36.620,24.226,P<0.05),respectively.There was no significant difference in REM latency between the observation group and the control group before treatment(P>0.05).Compared with the observation group before treatment,the observation group after treatment had longer total sleep time,shorter sleep latency,longer REM period and less awakening times,with statistical significances(t=3.145,12.021,8.668,9.101,P<0.05),respectively.Compared with health control group after treatment,the observation group after treatment had shorter total sleep time,longer sleep latency,shorter REM period and more awakening times,and the differences of them between two groups were statistically significant(t=9.704,14.781,15.899,9.901,P<0.05).Compared with the observation group before treatment,the N1%value was higher,the N2%value was higher and the N3%value was lower in the health control group before treatment,and the differences were statistically significant(t=10.163,9.483,10.065,P<0.05),respectively.There were no significant differences in REM%between the health control group and the observation group before and after treatment(P>0.05),respectively.Compared with the observation group before treatment,that after treatment had lower N1%value and N2%value,and higher N3%value(t=10.163,9.483,10.065,P<0.05),respectively.Compared with the health control group after treatment,the observation group after treatment had higher N1%value and N2%value,and lower N3%value,and the differences of them between two groups were statistically significant(t=7.628,4.210,7.153,P<0.05),respectively.Compared with the observation group before treatment,that after treatment had higher spindle wave density,amplitude and time.Compared with the health control group after treatment,the observation group after treatment had lower spindle wave density,amplitude and time,and the differences of them between two groups were significant(t=2.514,2.665,2.014,P<0.05),respectively.Pearson correlation analysis showed that PSQI score appeared significantly negative correlation with total sleep time,REM period,N3%value,spindle wave density and spindle amplitude,and appeared significantly positive correlation with sleep latency,awakening times,N1%value and N2%value,respectively,and the differences were statistically significant(r=-0.612,-0.269,-0.812,-0.778,-0.841,r=0.382,0.226,0.654,0.778,P<0.05).Conclusion:Abnormal sleep quality and structure,as well as abnormal sleep spindle wave activity,of patients with schizophrenia can be observed by using polysomnographic sleep monitor,which indicators is closely related to PSQI.

Vibration-Kneading Abdominal Tuina as An Adjunct Treatment for Insomnia of Phlegm-Heat Harassing the Interior Syndrome with "Stomach Disharmony"： A Randomised Controlled Trial / 中医杂志

ObjectiveTo explore the effectiveness and safety of vibration-kneading abdominal tuina as an adjunct treatment for insomnia of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom. MethodsSeventy-six insomnia patients of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom were recruited， and randomly divided into the treatment group and the control group with 38 cases in each group. The control group received eszopiclone 2mg once a night and sleep hygiene guidance， while the treatment group received vibration-kneading abdominal tuina additionally， 5 times a week， 30 min each time. Both groups were treated for 4 weeks. The Pittsburgh Sleep Quality Index （PSQI） （including sleep quality， time to fall asleep， sleep duration， sleep efficiency， sleep disorders， daytime functioning scores， and total scores） and traditional Chinese medicine （TCM） symptom scores of "stomach disharmony" was assessed before and after 4-week treatment and at follow-up （12 weeks after treatment）. Adverse events were also observed and recorded during the study. Pearson correlation analysis was used to assess the correlation between the pre-treatment PQSI total score and TCM symptom score of "stomach disharmony". ResultsThe PSQI scores of sleep quality， time to fall asleep， sleep duration， sleep efficiency， sleep disorders， daytime dysfunction scores， and total scores reduced in both groups decreased after treatment and at follow-up （P＜0.05 or P＜0.01）， as well as the TCM symptom score of "stomach disharmony" （P＜0.01）. After treatment， the PSQI scores of sleep quality， sleep duration， and TCM symptom score of "stomach disharmony" of the treatment group were lower than those of the control group （P＜0.05 or P＜0.01）. At follow-up， the PSQI scores of sleep quality， sleep duration， sleep efficiency， daytime dysfunction score， total score， and TCM symptom score of "stomach disharmony" of the treatment group were lower than those of the control group （P＜0.05 or P＜0.01）. No adverse reactions occurred in any participants during the study. There was a positive correlation between the patients' pre-treatment PQSI total scores and TCM symptom score of "stomach disharmony" （r=0.88， P＜0.01）. ConclusionVibration-kneading abdominal tuina as an adjunct treatment could significantly improve the symptoms of stomach and epigastric symptoms in insomnia patients of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom， and improve the quality of sleep， with good immediate and long-term therapeutic effects， and sound safety.

Sleep Patterns and Associated Insomnia in Junior and Senior Medical Students: A Questionnaire-Based Cross-Sectional Study

Abstract Introduction Appropriate quality and quantity of sleep are critical for good mental health, optimal body functioning, memory consolidation, and other cognitive processes. Objectives To evaluate the sleeping patterns of medical students in Saudi Arabia and their relationships with psychological distress. Methods This was a cross-sectional, self-administered, questionnaire-based study. The study included medical students from a university in Jeddah, Saudi Arabia. The Pittsburgh Sleep Quality Index (PSQI) and the Athens Insomnia Scale (AIS) were used to evaluate the prevalence and burden of inadequate sleep quality and insomnia in the participants. Results The majority of the participants was women (76.6%). Furthermore, most participants (96.2%) were aged between 18 and 24 years old, while 54.4% of the participants were in their senior year. According to the AIS scores (mean: 15.85 ± 4.52), 98.7% of the participants exhibited insomnia symptoms. The PSQI scores (mean: 9.53 ± 5.67) revealed that 70.5% of the participants had poor sleep quality. Students in their fundamental and junior years had significantly higher percentages of insomnia symptoms and poor sleep quality compared with students in their senior years. Conclusion The prevalence of insomnia and poor sleep quality is high among medical students. Therefore, appropriate strategies for early detection and intervention are warranted.

The Impact of Transcatheter or Surgical Defect Closure on Self-Reported Sleep Quality in Adults with Atrial Septal Defect

ABSTRACT Objective: Sleep quality in those with cardiovascular disease is significantly lower than in the general population. This study aimed to explore the effect of transcatheter or surgical closure of atrial septal defect (ASD) on sleep quality. Methods: One hundred nineteen adult patients with ASD who underwent transcatheter or surgical closure were included in the study. Sleep quality was investigated prospectively just before defect closure and six months after defect closure. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality of these patients. Results: PSQI scores were similar in both groups before the procedure in patients who underwent both transcatheter and surgical closure. The PSQI scores six months after transcatheter closure was significantly improved compared to the PSQI score before transcatheter ASD closure (3.5 ± 2.0 vs. 6.9 ± 3.4, respectively; P<0.001). The PSQI scores six months after surgical ASD closure was significantly improved compared to the PSQI score before surgical closure (4.8 ± 2.1 vs. 7.1 ± 2.0, respectively; P<0.001). Total PSQI scores were also statistically different at six months after transcatheter and surgical closure (3.5 ± 2.0 vs. 4.8 ± 2.1, P=0.014). However, six months after both transcatheter and surgical closure, PSQI scores were significantly decreased in both groups which was more pronounced in patients who underwent transcatheter closure. Conclusion: Transcatheter or surgical closure of the defect may be beneficial in improving the sleep quality of adult patients with ASD. Delayed improvement of sleep quality after surgical closure may be an important advantage for transcatheter closure.

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.

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.

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.

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.

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.

Clinical efficacy of cognitive and behavioral therapy assisted by five-tone therapy for insomnia in sub-healthy people / 中国基层医药

Objective:To investigate the clinical efficacy of cognitive and behavioral therapy assisted by five-tone therapy for insomnia in sub-healthy people based on digital polysomnography observation.Methods:The clinical data of 70 sub-healthy people with insomnia who received treatment in Wenzhou Hospital of Traditional Chinese Medicine, Zhejiang University of Traditional Chinese Medicine from June 2019 to June 2021 were retrospectively analyzed. These patients were divided into a control group and an observation group ( n = 35 per group) according to different treatment methods. The control group was treated with cognitive and behavioral therapy, while the observation group was treated with cognitive and behavioral therapy assisted by five-tone therapy. Clinical efficacy, syndrome score, sleep quality, quality of life, and digital polysomnography index levels were compared between the two groups. Results:After 4 weeks of treatment, the total effective rate in the observation group was 97% (29/35), which was significantly higher than 83% (34/35) in the control group ( χ2 = 8.77, P = 0.012). The syndrome score in the observation group was (3.26 ± 2.12) points, which was significantly lower than (6.00 ± 1.68) points in the control group ( t = 5.99, P < 0.001). The Pittsburgh Sleep Quality Index score in the observation group was (3.46 ± 2.36) points, which was significantly lower than (5.60 ± 3.35) points in the control group ( t = 3.09, P = 0.003). The WHOQOL-BREF score in the observation group was (67.00 ± 5.26) points, which was significantly higher than (61.54 ± 4.63) points in the control group ( t = 4.61, P < 0.001). Total sleep time, sleep efficiency, and sleep latency in the observation group were superior to those in the control group ( t = 4.56, 5.57, 3.96, all P < 0.05). Conclusion:Cognitive and behavioral therapy assisted by five-tone therapy can markedly reduce insomnia severity and improve the quality of life in sub-healthy people with insomnia. The evaluation of insomnia status based on digital polysomnography indicators can effectively objectively evaluate the causes of insomnia, which is of great significance for guiding clinical treatment.

The Effect of Baduanjin on Sleep Quality of College Students with Yang Deficiency / 中国运动医学杂志

Objective To observe the effect of Baduanjin on the sleep quality of college students with Yang deficiency.Methods Forty college students with Yang deficiency and sleep quality problems were randomly divided into a control group and a Baduanjin group,each of 20.Both groups received health education,while the Baduanjin group additionally practiced daily 60-minute Baduanjin at least 4 times a week for 10 weeks.Before and after the intervention,the Yang deficiency physical transfor-mation score and Pittsburgh sleep quality index(PSQI)of both groups were observed,and their correla-tion was analyzed.Results After the intervention,the average Yang deficiency physical transformation score of the Baduanjin group decreased significantly compared with before the intervention and the con-trol group at the same time point(P＜0.01 for both).Moreover,after the intervention,the average total PSQI scores and scores of all dimensions except the sleep time and sleep efficiency of the Baduanjin group were significantly lower than those before that,and the control group at the same time point(P＜0.05 for both).The total PSQI scores and scores except sleep time and sleep efficiency in the Baduan-jin group after the intervention were lower than those in the control group at the same time(P＜0.05).However,no significant differences were found in all the measurements of the control group before and after the intervention(P＞0.05).In addition,there was a significant positive correlation between the change in the Yang deficiency physical transformation score and the total PSQI in the Baduanjin group before and after intervention(P＜0.05),but not in the control group.Meanwhile,the total effective rate of the Baduanjin group was significantly higher than the control group(P＜0.05).Conclusion Practicing Baduanjin can effectively improve the sleep quality of college students with Yang deficiency and their biased Yang deficiency constitution,and their improvement is of positive correlation.

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.

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.

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.

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.