Onsite versus home-office: differences in sleep patterns according to workplace.

Background and objective: This study aimed to evaluate the sleep patterns of students and employees working onsite versus those working from home during the COVID-19 pandemic using actigraphy. Methods: A total of 75 students/employees (onsite: N = 40, home-office: N = 35; age range: 19-56 years; 32% male; 42.7% students, 49.3% employees) were studied between December 2020 and January 2022 using actigraphy, a sleep diary, and an online questionnaire assessing sociodemographics and morningness-eveningness. Independent-sample t-tests, paired-sample tests, and a multivariate general linear model adjusting for age (fixed factors: sex and work environment) were applied. Results: Overall, onsite workers had significantly earlier rise times (7:05 [SD: 1:11] versus 7:44 [1:08] hours) and midpoints of sleep (2:57 [0:58] versus 3:33 [0:58] hours) on weekdays compared to home-office workers. Sleep efficiency, sleep duration, variability of sleep timing, and social jetlag did not differ between the groups. Discussion: Home-office workers showed a delay in sleep timing that did not affect any other sleep parameters such as sleep efficiency or nighttime sleep duration. The work environment had only marginal impact on sleep patterns and thus sleep health in this sample. Sleep timing variability did not differ between groups. Supplementary Information: The online version of this article (10.1007/s11818-023-00408-5) contains supplementary material 1 and 2, which is available to authorized users.

The relationship between sleep hygiene and the prevalence of insomnia in medical students during the COVID-19 pandemic at the Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

Background. Students with poor sleep quality will undoubtedly disturb their daily activities, such as being absent from lec-tures due to illness and falling asleep during lectures. A further impact of poor sleep quality is decreased student academic achievement.Objectives. To analyse the relationship between sleep hygiene and the prevalence of insomnia in medical students during the COVID-19 pandemic at the Faculty of Medicine, Universitas Sumatera Utara. Material and methods. The research design was analytic with a cross-sectional approach. The study population was medical students in clinical clerkships, which amounted to 152 people using consecutive sampling methods. The data was collected using a Sleep Hy-giene Index (SHI) and Insomnia Severity Index (ISI) questionnaire, conducted online via Google Forms. Data processing was carried out using SPSS and the Chi-square statistical test.Results. Most students, as many as 101 people (66.4%), had moderate sleep hygiene, and most students were without insomnia (ap-prox. 61.8%). The results of the Chi-square test bivariate analysis showed a relationship between the degree of sleep hygiene and the prevalence of insomnia in the medical students of Universitas Sumatera Utara.Conclusions. Students are exposed to psychological impacts that can affect the quality of their sleep. Sleep hygiene and sleep cycles in students change due to changes in daily activities, such as physical activity, class schedules, assigned tasks and the use of electronic equipment.

Generalized stress and sleep hygiene explain the relationship between sexual/gender identity and sleep quality

IntroductionTypically, LGBTQ + people sleep more poorly than their cisgender heterosexual (cishet) counterparts. However, there is a lack of literature investigating the impact of different lifestyle/psychosocial factors, outside of minority stress, on the negative relationship between being a sexual/gender identity minority and sleep quality. The current study aims to help fill critical gaps in the literature by looking at the effects generalized stress, COVID-19-related stress, social support, and sleep hygiene have on this relationship.MethodsTwo hundred and seventy-three participants (74 LGBTQ+;199 cishet), recruited online, completed a series of questionnaires assessing sleep quality, sleep hygiene, generalized stress, minority stress, COVID-19-related stress, and social support.ResultsAnalyses showed that LGBTQ + participants reported worse sleep quality, higher levels of generalized stress and COVID-19 stress, and smaller social networks than their cishet peers. Generalized stress fully mediated the relationship between sexual/gender identity and sleep while sleep hygiene partially mediated the relationship between generalized stress and sleep quality. Social support and COVID-19-related stress did not moderate the relationship between generalized stress and sleep.ConclusionWorse sleep quality in LGBTQ + than cishet adults is explained by differences in generalized stress and sleep hygiene. Stress management and sleep hygiene interventions may help prevent the negative associations between being LGBTQ + and poor sleep quality.

Evaluating the feasibility of delivering a sleep education programme in secondary schools

Background: School-based sleep education programmes can promote the importance of sleep health and may improve adolescent sleep. To date, only limited research has examined the feasibility of integrating sleep programmes into the school curriculum. Objectives: This study evaluated the feasibility, acceptability and preliminary efficacy of the Strathclyde intervention to encourage good sleep health in teenagers (SIESTA). Methods: A total 171 students (12–15 years, 53% women) from secondary schools in Scotland participated in the study. Recruitment and retention, data collection and design procedures were assessed to establish feasibility. Qualitative feedback on acceptability was collected via focus group discussions. Outcome measures assessing insomnia symptoms, sleep hygiene, depression, anxiety and stress were completed at baseline and post-intervention to explore the preliminary effects of SIESTA. Results: All schools that were approached consented to participate, and most students completed assessments at both time points (171) with a dropout rate of 5%. Assessment measures provided sufficient data to compare baseline and post-intervention values. Training and delivery manuals ensured successful delivery of the programme. Qualitative feedback indicated SIESTA was acceptable, and students spoke favourably about the content, delivery and techniques. Students reported that SIESTA was age-appropriate, relevant and the techniques were beneficial. There were significant improvements in insomnia and stress, but no improvements were noted for sleep hygiene, depression or anxiety. Conclusion: The findings suggest that SIESTA is feasible and acceptable for delivery via the school curriculum. The results indicate that a controlled trial is required to further investigate the efficacy of SIESTA implemented in an educational context.

Sleep hygiene and sleep quality in Iranian adolescents during the COVID-19 pandemic.

OBJECTIVES: Sleep is one of the issues that attracted the attention of researchers during the COVID-19 pandemic. Researchers focused their studies on the prevalence of sleep disorders, sleep quality, and sleep duration. Sleep hygiene is a set of guidelines that play an important role in the sleep quality, the present study sought to evaluate the amount of sleep hygiene and sleep quality in Iranian adolescents and their relationship during the COVID-19 pandemic. METHODS: The present study was conducted using a cross-sectional design. The research population consisted of all adolescents living in Kermanshah (western Iran) in 2021. The participants were a sample of 610 adolescents. They completed the Pittsburgh Sleep Quality Inventory and Adolescent Sleep Hygiene Scale. RESULTS: The mean sleep quality score for the participants was 7.14 ± 2.47, indicating the high frequency of sleep problems affecting the participants. There were significant correlations between all components of sleep hygiene and sleep quality. There was also a significant correlation (r = - 0.46 between sleep hygiene and sleep quality (p < 0.001). No significant difference was observed in sleep hygiene and sleep quality between the male and female adolescents. The results showed that sleep hygiene subscales can predict sleep quality (R = 0.53, F = 39.20, p < .01). CONCLUSIONS: The data in this study confirmed the poor observance of sleep hygiene in adolescents during the COVID-19 pandemic and reported frequent sleep problems among the participants. The results also indicated a moderate relationship between sleep hygiene and sleep quality in adolescents. Thus, sleep hygiene components can be related to sleep quality.

Assessment of Sleep Quality and Sleep Hygiene among Nursing officers during COVID pandemic in a Tertiary Care Hospital in a Southern District of Karnataka, India

Introduction: Nursing officers are one of the susceptible groups prone to have sleep disturbances, which may not only influence their own health but also affect the nursing quality and treatment process. During COVID Pandemic, because of high work demand, nurses were made to run more shifts than regular days which can be quite stressful for them. Our study was conducted to assess the sleep quality and sleep hygiene among Nursing officers during COVID pandemic andto determine the factors influencing the Sleep quality and Sleep Hygiene Methods: A cross sectional study was conducted from September 2021-October 2021 among nursing officers of Kodagu district hospital attached to Kodagu Institute of Medical sciences. Pittsburgh Sleep Quality Index questionnaire was used to assess the sleep quality, Epworth Sleepiness Scale was used to determine the presence of tendency of daytime sleepiness and Sleep hygiene index was used to assess the sleep hygiene among the respondents. Result(s): Poor sleep quality was high(70.4%) among nursing officers. A significant association (p<0.05) of poor sleep quality was found with 31-40 years age group, nuclear family, less than 10 years of work experience and >15 nights shifts per month when logistic regression was applied. Poor sleep quality was high among the nursing officers who were practicing poor sleep hygiene (79.16 %).The assessment of daytime sleepiness showed that majority of the nursing officers (94%) were unlikely to be abnormally sleepy. Conclusion(s): The prevalence of poor sleep quality was high among nurses which was done during COVID pandemic. Poor sleep quality was associated age, type of family, years of work experience and nights shifts. Recruitment of adequate number of nursing staff and scrupulously planned night shifts are needed to improve the sleep health and well being of nurses which sequentially will result in better and efficient patient care.Copyright © 2023, Institute of Medico-legal Publication. All rights reserved.

Pandemi Döneminde Çocuk ve Ergen Psikiyatrisi Polikliniğine Başvuran Çocuklarda Uyku Bozukluğu ve Ílişkili Faktörler

Objective: This study determined whether children have sleep disorders during the Coronavirus disease-2019 (COVID-19) pandemic restriction process, and if they do, to determine in which areas they have problems with sleep, as well as to examine the relationship of sleep disorder with chronotype and coronavirus anxiety. Materials and Methods: In April-November 2020, 98 patients attending Kocaeli University Child Psychiatry clinics and attending primary school 1-4th grade were recruited. "Sociodemographic Form", "Child Sleep Habits Questionnaire", and "Children's Chronotype Questionnaire" were applied to the parents. The short form of the "Coronavirus Anxiety Scale" and the information form about the pandemic process were applied to the children. Results: According to the sleep habits questionnaire, 70.4% of the group had clinically significant sleep problems. The most common sleep disorders observed in our study;are bedtime resistance, delayed falling asleep, and nighttime awakenings. A significant relationship was found between physical illness in the family (p=0.019), smoking (p=0.032), sleep pattern change during the pandemic (p=0.002), sleep change of the mother (p=0.006) and/or father (p=0.035), change in appetite (p=0.010), and sleep disorder. According to the chronotype scale, 66 children were morning and children's anxiety toward coronavirus was low. Conclusion: Our study shows that sleep disturbance in children is marked during the pandemic period, but this is due to changes in sleep patterns and parents' sleep rather than problems related to anxiety or chronotype associated with the pandemic. It will be useful to question these factors and make arrangements in this direction when evaluating the sleep-related problems of patients who apply to outpatient clinics. Amaç: Bu çalışmada, Koronavirüs hastalığı-2019 (COVID-19) pandemisi kısıtlama sürecinde çocukların uyku bozukluğu yaşayıp yaşamadığının, eğer yaşıyorlarsa uyku ile ilgili hangi alanlarda sorun yaşadıklarının saptanması, ayrıca uyku bozukluğunun kronotip ve Koronavirüs anksiyetesi ile ilişkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Nisan-Kasım 2020 tarihleri arasında Kocaeli Üniversitesi Çocuk ve Ergen Psikiyatri polikliniklerine başvuran;ilkokul 1-4. sınıfa giden 98 hasta çalışmaya dahil edilmiştir. Ebeveynlere "Sosyodemografik Bilgi Formu", "Çocuk Uyku Alışkanlıkları Anketi", "Çocukluk Dönemi Kronotip Anketi";çocuklara ise "Koronavirus Anksiyete Ölçeği Kısa Formu" ve pandemi süreci ile ilgili beş maddeden oluşan bilgi formu uygulanmıştır. Bulgular: Uyku alışkanlıkları anketi toplam puanına bakıldığında, grubun %70,4'ünün klinik olarak anlamlı düzeyde uyku sorunu yaşadığı saptanmıştır. Çalışmamızda gözlenen en yaygın uyku bozuklukları;yatma zamanı direnci, uykuya dalmanın gecikmesi ve gece uyanmalarıdır. Ailede fiziksel hastalık (p=0,019), sigara kullanımı (p=0,032), pandemide uyku düzen değişikliği (p=0,002), annenin uyku değişimi (p=0,006), babanın uyku değişimi (p=0,035), ve iştah değişimi (p=0,010) ile uyku bozukluğu arasında anlamlı ilişki saptanmıştır. Kronotip ölçeğine göre 66 çocuğun sabahçı, 31 çocuğun ara form, bir çocuğun ise akşamcı olduğu gözlenmiştir. Çocukların Koronavirüse yönelik anksiyetesinin düşük olduğu saptanmıştır. Sonuç: Çalışmamız, çocuklarda pandemi döneminde uyku bozukluğunun belirgin düzeyde olduğunu ancak bu durumun pandemi ile ilişkili anksiyete ya da kronotip ile ilgili sorunlardan çok, uyku düzenlerindeki değişiklik ve ebeveynlerin uykusundaki değişimlerden kaynaklandığını göstermektedir. Polikliniklere başvuran hastaların uyku ile ilgili sorunları değerlendirilirken bu faktörlerin sorgulanması ve bu yönde düzenlemeler yapılması yararlı olacaktır.

Sleep Disorders and Associated Factors in Children Who Admitted to the Child and Adolescent Psychiatry Outpatient Clinics During the Pandemic.

Objective: This study determined whether children have sleep disorders during the Coronavirus disease-2019 (COVID-19) pandemic restriction process, and if they do, to determine in which areas they have problems with sleep, as well as to examine the relationship of sleep disorder with chronotype and coronavirus anxiety. Materials and Methods: In April-November 2020, 98 patients attending Kocaeli University Child Psychiatry clinics and attending primary school 1-4th grade were recruited. "Sociodemographic Form", "Child Sleep Habits Questionnaire", and "Children's Chronotype Questionnaire" were applied to the parents. The short form of the "Coronavirus Anxiety Scale" and the information form about the pandemic process were applied to the children. Results: According to the sleep habits questionnaire, 70.4% of the group had clinically significant sleep problems. The most common sleep disorders observed in our study;are bedtime resistance, delayed falling asleep, and nighttime awakenings. A significant relationship was found between physical illness in the family (p=0.019), smoking (p=0.032), sleep pattern change during the pandemic (p=0.002), sleep change of the mother (p=0.006) and/or father (p=0.035), change in appetite (p=0.010), and sleep disorder. According to the chronotype scale, 66 children were morning and children's anxiety toward coronavirus was low. Conclusion: Our study shows that sleep disturbance in children is marked during the pandemic period, but this is due to changes in sleep patterns and parents' sleep rather than problems related to anxiety or chronotype associated with the pandemic. It will be useful to question these factors and make arrangements in this direction when evaluating the sleep-related problems of patients who apply to outpatient clinics. (English) [ FROM AUTHOR] Amaç: Bu çalışmada, Koronavirüs hastalığı-2019 (COVID-19) pandemisi kısıtlama sürecinde çocukların uyku bozukluğu yaşayıp yaşamadığının, eğer yaşıyorlarsa uyku ile ilgili hangi alanlarda sorun yaşadıklarının saptanması, ayrıca uyku bozukluğunun kronotip ve Koronavirüs anksiyetesi ile ilişkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Nisan-Kasım 2020 tarihleri arasında Kocaeli Üniversitesi Çocuk ve Ergen Psikiyatri polikliniklerine başvuran;ilkokul 1-4. sınıfa giden 98 hasta çalışmaya dahil edilmiştir. Ebeveynlere "Sosyodemografik Bilgi Formu", "Çocuk Uyku Alışkanlıkları Anketi", "Çocukluk Dönemi Kronotip Anketi";çocuklara ise "Koronavirus Anksiyete Ölçeği Kısa Formu" ve pandemi süreci ile ilgili beş maddeden oluşan bilgi formu uygulanmıştır. Bulgular: Uyku alışkanlıkları anketi toplam puanına bakıldığında, grubun %70,4'ünün klinik olarak anlamlı düzeyde uyku sorunu yaşadığı saptanmıştır. Çalışmamızda gözlenen en yaygın uyku bozuklukları;yatma zamanı direnci, uykuya dalmanın gecikmesi ve gece uyanmalarıdır. Ailede fiziksel hastalık (p=0,019), sigara kullanımı (p=0,032), pandemide uyku düzen değişikliği (p=0,002), annenin uyku değişimi (p=0,006), babanın uyku değişimi (p=0,035), ve iştah değişimi (p=0,010) ile uyku bozukluğu arasında anlamlı ilişki saptanmıştır. Kronotip ölçeğine göre 66 çocuğun sabahçı, 31 çocuğun ara form, bir çocuğun ise akşamcı olduğu gözlenmiştir. Çocukların Koronavirüse yönelik anksiyetesinin düşük olduğu saptanmıştır. Sonuç: Çalışmamız, çocuklarda pandemi döneminde uyku bozukluğunun belirgin düzeyde olduğunu ancak bu durumun pandemi ile ilişkili anksiyete ya da kronotip ile ilgili sorunlardan çok, uyku düzenlerindeki değişiklik ve ebeveynlerin uykusundaki değişimlerden kaynaklandığını göstermektedir. Polikliniklere başvuran hastaların uyku ile ilgili sorunları değerlendirilirken bu faktörlerin sorgulanması ve bu yönde düzenlemeler yapılması yararlı olacaktır. (Turkish) [ FROM AUTHOR] Copyright of Journal of Turkish Sleep Medicine is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Challenges of Singapore's First Acute Geriatric Isolation Facility During the COVID-19 Pandemic

Aim: The COVID-19 pandemic has seen hospitals isolating suspect cases. Geriatric populations are at a risk of severe COVID-19 disease and often present with concomitant geriatric syndromes requiring holistic interdisciplinary care. However, isolation of older people poses challenges to care delivery. This study shares the experience of Singapore's first acute geriatric isolation facility geriatric PARI (Pneumonia-Acute Respiratory Infection) ward and describes the geriatric-related outcomes and pitfalls in care delivery. Method(s): This is a retrospective cross-sectional study performed in 7 negative pressure isolation rooms in an acute care public hospital in Singapore. 100 patients admitted consecutively to the geriatric PARI ward were included. Patient demographics, presenting symptoms and geriatric-related adverse outcomes associated with hospitalisation were collected and analysed. Result(s): Patients' mean age was 86.4 years (standard deviation [SD]: 6.8) with significant comorbidities being hypertension (81%), hyperlipidaemia (74%) and renal disease (70%). 51% of patients had dementia and 24% had behaviour and psychological symptoms of dementia (BPSD). 27% of patients presented atypically with delirium and 15% presented with a fall. Delirium was associated with restraint use (OR: 3.88;p-value 0.01). Falls rate was 1.64 per 1000 occupied bed. 1 patient screened positive for COVID-19. Conclusion(s): The geriatric PARI ward is essential for curbing nosocomial transmission of COVID-19. This is important in the older people with comorbidities who are more likely to develop morbidity and mortality. Our study reveals challenges in delivering person-centred care to the older patients in isolation rooms, especially in the management of delirium and falls prevention. Innovative strategies should be developed to minimise isolation-related adverse outcome.Copyright © The Author(s) 2022.

Life Habits of Healthcare Professionals during the Third Wave of COVID-19: A Cross-Sectional Study in a Spanish Hospital.

(1) Background: To describe sleep quality, eating behaviour and alcohol, tobacco and illicit drug use among healthcare staff in a Spanish public hospital. (2) Methods: Cross-sectional descriptive study examining sleep quality (Pittsburg Sleep Quality Index), eating behaviour (Three Factor Eating Questionnaire (R18)), tobacco and drug use (ESTUDES questionnaire) and alcohol use (Cut down, Annoyed, Guilty, Eye-opener). (3) Results: 178 people, of whom 87.1% (155) were women, with an average age of 41.59 ± 10.9 years. A total of 59.6% of the healthcare workers had sleep problems, to a greater or lesser degree. The average daily consumption was 10.56 ± 6.74 cigarettes. The most commonly used drugs included cannabis, occasionally used by 88.37%, cocaine (4.75%), ecstasy (4.65%) and amphetamines (2.33%). A total of 22.73% of participants had increased their drug use, and 22.73% had increased their consumption during the pandemic, with beer and wine accounting for 87.2% of drinks consumed during this period. (4) Conclusions: In addition to the psychological and emotional impact already demonstrated, the COVID-19 crisis has repercussions on sleep quality, eating behaviour and alcohol, tobacco and drug consumption. Psychological disturbances have repercussions on physical and functional aspects of healthcare workers. It is feasible that these alterations are due to stress, and it is necessary to act through treatment and prevention as well as promote healthy habits.

Investigating sleep quality and sleep hygiene awareness among Chinese adults: an association and network analysis study.

PURPOSE: The relationships between sleep quality and sleep hygiene awareness in the Chinese population were unclear. We aimed to investigate the associations and related factors between sleep quality and sleep hygiene awareness in adults and to identify the most central domain for sleep quality using network analysis. METHODS: A cross-sectional survey was conducted from April 22 to May 5, 2020. Adults (18 years old or above) who had access to smartphones were invited to participate in this survey. The Pittsburg Sleep Quality Index (PSQI) and the Sleep Hygiene Awareness and Practice Scale (SHAPS) were used to evaluate the sleep quality and sleep hygiene awareness of the participants. Propensity score matching (PSM) was used as sensitivity analysis to reduce the confounding effects. Multiple logistic regression was performed to evaluate the associations. The R packages "bootnet" and "qgraph" were used to estimate the connection and calculate the network centrality indices between good and poor sleepers. RESULTS: In total, 939 respondents were included in the analysis. Of them, 48.8% (95% CI: 45.6-52.0%) were identified as poor sleepers. Participants with nervous system diseases, psychiatric diseases, and psychological problems were more likely to have poor sleep quality. The notion that using sleep medication regularly was beneficial to sleep was associated with poor sleep quality. Similarly, the notion that waking up at the same time each day disrupted sleep was also associated with poor sleep quality. The findings were consistent before and after PSM. Subjective sleep quality was the most central domain for sleep quality in good and poor sleepers. CONCLUSION: Poor sleep quality was positively associated with certain sleep hygiene notions in Chinese adults. Effective measures such as self-relief, sleep hygiene education, and cognitive behavioral treatment may have been needed to improve sleep quality, especially during the COVID-19 outbreak.

Retrospective analysis of individualised melatonin regimens and a multidisciplinary targeted approach in managing insomnia during the second wave of COVID-19

Introduction: The therapeutic benefits of sleep in the critically ill has been extensively studied in the medical literature.1 Chronic insomnia increases a patient's risk of delirium, cortical atrophy, diabetes, cancer, cardiovascular death from arterial hypertension, myocardial infarction and heart failure.2 Insomnia reduces interaction during videocalls with family and limits co-operation with physiotherapy, medical and nursing interventions, potentially delaying rehabilitation and recovery. Objectives: To improve sleep by introducing an individualised melatonin regimen and a multidisciplinary targeted approach to managing insomnia in an adult intensive care unit. Methods: A retrospective analysis was conducted in a single centre UK adult ICU. Data was retrieved from pharmacy dispensing records, electronic medical notes and prescriptions from September 2020 to March 2021. The primary outcome was resolution of insomnia. Other information collected included causes of insomnia, referral to psychology for cognitive behavioural therapy (CBT), prevalence and resolution of delirium, adverse effects, and death. Each patient received a tailor made regimen based on Bellapart et al's original concept of mimicking the natural endogenous secretion of melatonin.3 However, unlike previous studies3,4,5 dosing was modified and adjusted according to patient response. A loading dose of 0.75 to 3mg was administered at 21:00 followed by a smaller hourly dose of 0.25 to 0.5mg between 22:00 and 03:00. Additionally, the duration of treatment continued for as long as therapeutic benefit was realised, which included post discharge from ICU. Prior experience of conventional melatonin dosing did not demonstrate therapeutic benefit from the original pilot study and when nursing staff inadvertently omitted the hourly dose between 10pm and 3am. Adverse effects were documented. Sleep hygiene measures were introduced and standardised where possible e.g. ear plugs, eye mask, dim lights, environmental noise reduction and minimal night time physical interventions from nursing and medical staff. The principal investigator referred to psychology patients who expressed fear and anxiety as a cause of insomnia. Results: 132 patients were admitted during September 2020 to March 2021. 30 patients received tailor made melatonin regimens (22.7%). The medical notes of four (13.3%) patients could not be accessed for data collection and were, therefore, excluded from the study. The primary outcome of resolution of insomnia occurred in 23 out of 26 (88.4%) patients. At the time of ICU discharge, delirium had occurred in 15 patients (57.7%), resolved in 10 patients (66.7%), three (20%) patients remained intermittently delirious, one remained continuously delirious, and one died. Mechanical ventilation, environmental noise, necessary medical and nursing interventions throughout the night and infection accounted for 23 (88.4%) of patients' insomnia. Fear or anxiety were expressed by eight (30.8%) patients as a cause of insomnia whilst medicines e.g. steroids, beta blockers accounted for six patients (26.1%). Seven patients (26.9%) expressing fear or anxiety were referred to psychology for adjunctive CBT. One patient experienced excessive daytime drowsiness, which resolved with dose regimen adjustment. One patient died of a cause unrelated to melatonin. Conclusion: An individualised melatonin regimen combined with a multidisciplinary targeted approach can result in resolution of insomnia in ICU patients, with minimal risk of adverse effects.

The prevalence and severity of insomnia symptoms during COVID-19: A global systematic review and individual participant data meta-analysis.

INTRODUCTION: There have been no previous meta-analytic studies that have looked at the prevalence of insomnia symptoms in different COVID-19 groups using a single assessment instrument to evaluate insomnia symptoms while maintaining data homogeneity. The current review's associated goal is to undertake an individual participant data (IPD) analysis to further investigate past meta-analyses, a method that has been shown to be more robust than standard meta-analyses. MEETHODS: Only studies that used the Insomnia Severity Index (ISI) to assess insomnia are used in this analysis. The IPDMA was performed and registered in PROSPERO in compliance with the PRISMA IPD Statement (CRD42021275817). From November 2019 to August 2021, researchers explored seventeen databases and six preprint services for relevant studies. RESULTS: The pooled estimate of insomnia symptoms (subthreshold and clinically significant) was 52.57%. An estimated 16.66% of the population suffered from clinically significant insomnia, of which 13.75% suffered from moderate insomnia, and 2.50% suffered from severe insomnia. The different populations' grouping had no statistically significant differences in the prevalence of insomnia symptoms. Insomnia symptoms did not appear to be associated with age or sex. CONCLUSION: Our findings imply that the COVID-19 pandemic is linked to a significant rise in subthreshold insomnia symptoms, but not to moderate or severe insomnia. Educating people from all walks of life about the importance of sleep and the risk of acquiring insomnia symptoms during this or future pandemics should be a top concern.

Effectiveness of digitally delivered sleep interventions on sleep and mental health outcomes in postsecondary students: A systematic review

Introduction: Students pursuing postsecondary education are a population at significant risk for both sleep problems and poor mental health outcomes such as depression and anxiety. Interventions such as sleep hygiene education and cognitive behavioural therapy (CBT) are commonly used treatments for sleep problems and have been effective in improving sleep and mental health in the university student population. Digitally-delivered CBT has also been shown to be effective in improving sleep in youth, however it has not been evaluated in the postsecondary student population. Materials and Methods: We conducted a systematic review of the quantitative and qualitative evidence on the effectiveness and user experiences of digital sleep interventions to improve sleep and mental health outcomes in postsecondary students. We searched MEDLINE, CINAHL, Embase, and APA PsycInfo for studies published from 2000 to 2021. We included randomized controlled trials (RCTs), cohort studies, case-control studies, qualitative studies, and mixed methods studies. Pairs of reviewers independently screened and critically appraised studies, and extracted data. We aimed to use a sequential approach at the review level to synthesize and integrate data across qualitative and quantitative research studies. Results: We screened 5361 citations and 58 full text articles. Eight relevant RCTs and one cohort study were critically appraised. Three interventions were assessed including CBT, digital sleep hygiene education, and relaxation music. Most studies were assessed as high risk of bias. Given the methodological limitations of the included studies, we are unable to conclude on the effectiveness of digital sleep interventions for postsecondary students. We did not identify any qualitative studies. Conclusions: Methodological limitations preclude firm conclusions. Further research is needed to assess the effectiveness of digital alternatives for delivering sleep interventions to improve sleep and mental health outcomes in postsecondary students. Qualitative studies exploring the views and preferences of students and providers are required to inform the development of novel interventions that are acceptable in this population. Acknowledgements: Canadian Institutes of Health Science (CIHR) Operating Grant: Knowledge Synthesis: COVID-19 in Mental Health & Substance Use

Sleep disturbances in craniopharyngioma: a challenging diagnosis

Introduction: The hypothalamus plays a crucial role in regulating vital functions and circadian rhythms. Both the tumor involving the hypothalamic area and its treatment can lead to hypothalamic dysfunction, resulting in disturbances in sleep-wake patterns, sleep fragmentation, and increased daytime sleepiness. We describe two patients with craniopharyngioma who came to our attention due to the occurrence of episodes characterized by psychomotor slowing and afinalistic limb movements, temporal and spatial disorientation, psychomotor agitation, and oneiric stupor like episodes diagnosed as severe sleep disturbances. Case reports: Patient 1 is a 19-year-old male diagnosed with surgically treated craniopharyngioma. Subsequently, episodes of psychomotor slowing, afinalistic movements of the upper limbs diagnosed as seizures in another neurological center appeared;antiepileptic treatment was started without improvement. At the first examination in our center, excessive daytime sleepiness (EDS), fragmented nighttime sleep, episodes characterized by bimanual automatic gestures occurring during drowsy state, hypnagogic hallucinations, and sudden loss of muscle tone while awake were recognized. Actigraphy demonstrated irregular bedtimes, frequent nocturnal activity, and inappropriate daytime rest episodes. The Epworth Sleepiness Scale (ESS) showed subjective EDS (ESS=19). At PSG, hypersomnolence, severe sleep-related breathing disorder (SRBD), and no interictal and ictal seizure abnormalities were found. A BiPAP NIV was started, and antiepileptic therapy was discontinued. In the following months, PSG revealed marked improvement in SRBD and 1 SOREMP, and the MSLT a mean SOL of 6 min and 10 sec and 3 SOREMPs. These data allowed the diagnosis of secondary narcolepsy, and treatment with pitolisant was initiated with clinical improvement and reduced daytime sleepiness (ESS=9). Patient 2 is a 12-year-old male, surgically treated for craniopharyngioma at the age of 4 years, who developed episodes of myoclonic jerks, temporal and spatial disorientation, and psychomotor agitation during the lockdown period for COVID-19 emergency. Surmising paroxysmal epileptic episodes, the patient was hospitalized. The anamnestic data collection revealed a sleep-wake rhythm dysregulation, fragmented nighttime sleep, EDS, oneiric stupor-like episodes during which the patient performed simple automatic gestures mimicking daily-life activity, and severe impairment of alertness. The Long-term video-EEG, including polygraphic measurements, showed destruction of the wake-NREM sleep-REM sleep boundaries, episodes of undetermined state of vigilance, and concurrence of elements typical of different sleep stages. Moreover, a severe SRBD (AHI 19/h) has been observed. The MRI showed a volumetric increase in the post-surgical interpeduncular fossa and right paramedian cysts. Therefore, a multifactorial therapeutic plan including sleep hygiene and slow-release melatonin was started with improvement in nighttime sleep, but EDS persisted. Surgical treatment of cyst fenestration improved sleep-wake rhythm and behavior;BiPAP NIV was initiated with very poor adherence. Discussion: We aim to focus on sleep disorders as a possible complication of tumors involving the hypothalamic region. Our cases highlight that the clinical manifestation of these dysfunctions can be challenging to diagnose and can lead to misdiagnosis and inappropriate treatment that can harm patients' health and the quality of life of patients and their families. Conclusion: These findings support the need to incorporate comprehensive sleep assessment in survivors from childhood brain tumors involving the suprasellar/hypothalamic region.

Changes in lifestyle during the COVID-19 lockdown in Brazil: Impact on sleep quality.

This study examined the influence of lifestyle changes made during the COVID -19 lockdown on sleep quality in a Brazilian population. We conducted an online cross-sectional study with 589 Brazilians that completed an online questionnaire about sociodemographic variables (age/status/cohabitation/education), general habits (exercise/work), and sleep quality (Mini Sleep Questionnaire). Poisson regression (log-linear) was used to examine sleep quality risk factors. 41.93% of the population reported impaired sleep quality during lockdown. Increased alcohol consumption, worsened diet quality, and use of bed for work during lockdown were risk factors for worsening sleep quality. Increased or beginning physical activity during lockdown was protective against poor sleep quality, as was male sex. Our results suggest that habit change during COVID -19 affected sleep quality in a general Brazilian population. However, it is important to be aware of whether these positive/negative habits acquired during the interdiction persist after the pandemic.

Depressed, tension and anger mood in the university student population during COVID-19 pandemic: association with sleep quality and sleepiness

Introduction: To verify the association among the mood state variables (total mood, depression, tension, and anger domains), sleep quality and the sleepiness of the university students during the COVID-19 Pandemic. Objective: To estimate whether mood is associated with the sleep quality and sleepiness in the university student during the COVID-19 Pandemic. Methods: Two hundred and four university students of both sexes, with a mean age of 23.72±5.95 years, registered from the 2nd to the 7th period of both shifts (day and night classes) in three health courses of Brazilian private universities were participated of this study. Sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI), sleepiness by Epworth Sleepiness Scale (ESS) and mood state was measured by Brazil Mood Scale (BRAMS) before classes (day = 7h00 and night = 19h00). The Kolmogorov- Smirnov test was applied to verify the normality of the data. Spearman correlation coefficient was used to calculate the correlation between the following variables. The α-level for all analysis was set at 0.05. Results: The results showed there was a significant positive association among poor sleep quality (PSQI>5) and the total mood state (r=0.53;p<0.01), depression mood domain (r=0.42;p<0.01), tension mood domain (r=0.38;p<0.001), and anger mood domain (r=0.28;p=0.02). In addition, there was a significant association among sleepiness (ESS>9) and the total mood state (r=0.59;p<0.01), depression mood domain (r=0.40;p<0.01), and the anger mood domain (r=0.25;p=0.05). Depressed, high levels of tension and anger mood were associated with poor sleep quality (PSQI>5) and increased sleepiness (ESS>9). Conclusion: Therefore, university students were poor sleep quality, high levels of sleepiness, depression, tension, and anger mood before classes in the day-night shifts. The sleep quality and the sleepiness presented positive moderate correlation with the total mood state. In addition, the sleep quality and sleepiness presented positive weak correlation with depressed, stress and anger mood domains. In this context, it is important to highlight that it is necessary to improve the quality of sleep, alertness, and mood state of the university students during the COVID-19 pandemic to increase their academic performance and positive mood.

Relationship between the application of sleep hygiene measures and the perception of sleep by parents of children and adolescents during the COVID-19 pandemic

Introduction: Sleep is the result of reversible changes in the behavioral and physiological spheres, associated with the modification of brain activities, being an important mechanism for physical restoration, memory consolidation and learning, mood regulation and modulation of the immune system. Sleep habits are affected by stimuli and interferences of daily life, especially in a COVID-19 pandemic situation, so it is essential to apply sleep hygiene measures to improve sleep patterns, including having a regular time to sleep and wake up, dim lighting in the periods before bedtime, manage stress and use relaxation techniques. Objective: To assess the relationship between the application of sleep hygiene measures and the perception of sleep quality by parents of children and adolescents during the COVID-19 pandemic. Methods: This is a cross-sectional study, carried out using an online form sent to parents/guardians (over 18 years old) of children and adolescents of both sexes, aged between 4 and 17 years old, by convenience, in the period from October 28, 2020 to December 7, 2020. The analysis of the application of sleep hygiene measures took into account the application of 8 or more sleep hygiene measures by parents/guardians, among the 14 described in the online questionnaire. For the questioning about the perception of parents/guardians regarding the quality of sleep of children, a scale of 0 to 10 was adopted, considering from 0 to 5 for perception of poor sleep quality, and from 6 to 10 for perception of regular or good sleep. The distribution of the dependent variable according to the independent ones was verified using the Chi-square test, considering 95% CI. Results: The sample was composed of 532 children and adolescents of both sexes, mean age 9.7 (± 3.8 years), with a predominance of female sex (51.9%), residing in Rio Grande do Sul (63.7%), aged between 6 and 13 years (60.2%). It was observed that 83.3% of the parents/ guardians evaluated perceived the sleep of children and adolescents as regular or good. Of these, 87.1% applied 8 or more sleep hygiene measures, proving the positive relationship between the application of sleep hygiene measures and the perception of sleep quality (p 0.001). Conclusion: The study data allowed us to analyze how the application of sleep hygiene measures in children and adolescents caused positive outcomes in the sleep pattern, thus demonstrating the benefits that these actions have on the physiological development of children.

Negative changes in sleep patterns are observed in patients admitted by COVID 19

Introduction: Sleep is the main determinant of human wellbeing, mental and physical health. Sleep effectiveness can be reported through its quality and depth. Based on this principle, individuals infected by the SARS - CoV-2 virus from the family of coronavirus viruses, develop tissue inflammation and cell damage, causing an increase in inflammatory cytokines in the organism of the infected. There are several common causes of sleep disorders in hospitalized patients, including medical conditions and underlying psychological problems. There are also several modifiable factors that promote sleep disturbances in critically ill patients, such as noise, light, interactions with patient care, medications, mechanical ventilation and very commonly pain. The lack of sleep, therefore, can negatively compromise immunity, increasing the chances of disease onset. There is also the influence of sleep on emotional processing, with a role in maintaining mood and emotional state. Sleep deprivation also has a strong negative impact on daily behavior and, consequently, on daily mental health. Objective: The aim of the present study was to evaluate the sleep characteristics of patients during hospitalization, with a confirmed diagnosis of COVID. Methods: This is a quantitative, descriptive study, carried out from July to September 2020 in patients with positive SARS-CoV-2 infection through the RT-PCR test of nasopharyngeal swabs, aged ≥ 18 years, of both sexes, admitted to the hospital's infirmary in the north of Rio Grande do Sul. The evaluation methods used were the sleep diary and a free application (Sleep As Android) available for smartphones. Results: Thirty patients were evaluated, the majority of whom were male (53%) and the average age was 52 years. Only 1 patient was previously healthy and the main associated comorbidities were hypertension and obesity. Less than 50% of individuals used sleeping pills. However, C-reactive protein levels were altered in most patients. As for the outcomes related to sleep characteristics, significant correlations were observed between increased nighttime awakenings and prolonged hospital stay. In addition, patients diagnosed with depression (23%) had a greater total sleep deficit in a hospital setting. Conclusion: Patients with COVID admitted to hospital nurse units destined for a pandemic have important changes in sleep which are directly related to their lower quality.

Sleep and alimentation: actions for improving quality of life in times of COVID 19

Introduction: Sleep is characterized as a condition of physical and mental rest, in which the person ignores everything going on around him. There is a scientifically proven association between sleep deprivation and unhealthy eating habits, increasing cases of emotional and uncontrolled eating leading to malnutrition. In addition, a bad night's sleep has been associated with worsening mental health, especially in times of pandemic. Objective: In light of the above, this study aimed to report the experience and stimulate reflection about the results of a poll shared on the social network Instagram with the objective of analyzing the quality of sleep of students at a public higher education institution during the COVID-19 Pandemic. Methods: This is an experience report of the extension group “Sleep and Food in times of Pandemic”, composed of students of nursing, nutrition, medicine and mathematics of a public institution of higher education. The group, through its profile on the social network Instagram, shared a sleep satisfaction scale, where users reported in posts according to the condition of their sleep on a scale between good and bad. The scale was made available publicly and online, so the answers were freely accessible to everyone who followed the group's profile. Results: The project had a large significant reach of participants, since the present was observed through the social media of we can mention Instagram e Facebook, that is, an average of 600 posts observed, of these, 34.5% of students reported having a good night's sleep during the pandemic, while 65.5% responded by pointing out a bad night's sleep. Sleep deprivation is inversely related to the regulation of the circadian cycle, is associated with neuroendocrine and metabolic functions, such as reduced leptin and increased ghrelin, increasing appetite and food intake.In parallel to this, individuals in this stressful situation tend to consume foods that are pleasing to the palate, which usually contain higher amounts of sugar and/or fat, because they serve as comfort for the stress they are going through, but may contribute to the risk of developing obesity, insulin resistance, and cardiovascular disease. Conclusion: Some protective factors can help in this change, such as maintaining a daily routine, practicing physical activity, following a dietary pattern and taking care of sleep hygiene. Finally, we emphasize the need for more studies with a more rigid methodological content.