iSleepFirst: burnout, fatigue, and wearable-tracked sleep deprivation among residents staffing the medical intensive care unit.

PURPOSE: This study aimed to evaluate the relationship between sleep, burnout, and psychomotor vigilance in residents working in the medical intensive care unit (ICU). METHODS: A prospective cohort study of residents was implemented during a consecutive 4-week. Residents were recruited to wear a sleep tracker for 2 weeks before and 2 weeks during their medical ICU rotation. Data collected included wearable-tracked sleep minutes, Oldenburg burnout inventory (OBI) score, Epworth sleepiness scale (ESS), psychomotor vigilance testing, and American Academy of Sleep Medicine sleep diary. The primary outcome was sleep duration tracked by the wearable. The secondary outcomes were burnout, psychomotor vigilance (PVT), and perceived sleepiness. RESULTS: A total of 40 residents completed the study. The age range was 26-34 years with 19 males. Total sleep minutes measured by the wearable decreased from 402 min (95% CI: 377-427) before ICU to 389 (95% CI: 360-418) during ICU (p < 0.05). Residents overestimated sleep, logging 464 min (95% CI: 452-476) before and 442 (95% CI: 430-454) during ICU. ESS scores increased from 5.93 (95% CI: 4.89, 7.07) to 8.33 (95% CI: 7.09,9.58) during ICU (p < 0.001). OBI scores increased from 34.5 (95% CI: 32.9-36.2) to 42.8 (95% CI: 40.7-45.0) (p < 0.001). PVT scores worsened with increased reaction time while on ICU rotation (348.5 ms pre-ICU, 370.9 ms post-ICU, p < 0.001). CONCLUSIONS: Resident ICU rotations are associated with decreased objective sleep and self-reported sleep. Residents overestimate sleep duration. Burnout and sleepiness increase and associated PVT scores worsen while working in the ICU. Institutions should ensure resident sleep and wellness checks during ICU rotation.

The Worldwide Prevalence of Sleep Problems Among Medical Students by Problem, Country, and COVID-19 Status: a Systematic Review, Meta-analysis, and Meta-regression of 109 Studies Involving 59427 Participants.

Purpose of Review: Several studies have found that medical students have a significant prevalence of sleep issues, such as poor sleep quality, excessive daytime sleepiness, and inadequate sleep duration. The purpose of this review is to carefully evaluate the current research on sleep problems among medical students and, as a result, estimate the prevalence of these disturbances. The EMBASE, PsychINFO, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science and retrieved article reference lists were rigorously searched and rated for quality. Random effects meta-analysis was performed to compute estimates. Recent Findings: The current meta-analysis revealed an alarming estimated pooled prevalence of poor sleep quality (K = 95, N = 54894) of 55.64% [95%CI 51.45%; 59.74%]. A total of 33.32% [95%CI 26.52%; 40.91%] of the students (K = 28, N = 10122) experienced excessive sleepiness during the day. The average sleep duration for medical students (K = 35, N = 18052) is only 6.5 h per night [95%CI 6.24; 6.64], which suggests that at least 30% of them get less sleep than the recommended 7-9 h per night. Summary: Sleep issues are common among medical students, making them a genuine problem. Future research should focus on prevention and intervention initiatives aimed at these groups. Supplementary Information: The online version contains supplementary material available at 10.1007/s40675-023-00258-5.

Insomnia during coronavirus disease 2019 pandemic in Korea: a National sleep survey.

Coronavirus disease 2019 (COVID-19) pandemic has caused widespread increase in stress and affected sleep quality and quantity, with up to 30% prevalence of sleep disorders being reported after the declaration of the pandemic. This study aimed to assess perceived changes due to the pandemic in the prevalence of insomnia and excessive daytime sleepiness (EDS) in Korea, and identify the associated factors. An online survey was conducted among 4000 participants (2035 men and 1965 women) aged 20-69 years enrolled using stratified multistage random sampling according to age, sex, and residential area, between January, 2021 and February, 2022. The questionnaire included various items, such as socio-demographics, Insomnia Severity Index, and Epworth Sleepiness Scale (ESS). Insomnia was defined as difficulty falling asleep and difficulty maintaining sleep more than twice a week. EDS was classified as an ESS score ≥ 11. Insomnia was reported by 32.9% (n = 1316) of the participants (37.3% among women and 28.6% among men). Multivariate logistic regression revealed that insomnia was associated with female sex [odds ratio (OR) = 1.526, 95% confidence interval (CI) = 1.297-1.796], night workers (OR 1.561, 95% CI 1.160-2.101), and being unmarried (OR 1.256, 95% CI 1.007-1.566). EDS was reported by 12.8% (n = 510) of the participants (14.7% among men and 10.7% among women). EDS was associated with male sex (OR 1.333, 95% CI 1.062-1.674), and being employed (OR 1.292, 95% CI 1.017-1.641). During the COVID-19 pandemic, the prevalence of insomnia increased in Korea, while there was no significant change in EDS compared with pre-pandemic evidence.

Impact of the COVID-19 pandemic on stress and sleep in emergency room professionals.

AIMS AND OBJECTIVES: To analyze stress levels, sleep quality, sleepiness and chronotypes on emergency room (ER) professionals before and during the COVID-19. BACKGROUND: ER healthcare professionals are exposed to high stress levels, and they often present with poor sleep quality. DESIGN: Observational study conducted into two different phases (before the COVID-19 and during the first wave of the COVID-19). METHOD: Physicians, nurses and nursing assistants working in the ER were included. Stress, sleep quality, daytime sleepiness and chronotypes were assessed by the Stress Factors and Manifestations Scale (SFMS), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Horne and Österberg Morningness-Eveningness questionnaire, respectively. The first phase of the study was performed between December 2019 and February 2020, and the second between April and June 2020. The STROBE checklist was used to report the present study. RESULTS: In total, 189 ER professionals in the pre-COVID-19 phase and 171 (of the initial 189) during COVID-19 were included. The proportion of workers with a morning circadian rhythm increased during the COVID-19, and stress levels were significantly higher during COVID-19 compared to the previous phase (38.34 ± 10.74 vs. 49.97 ± 15.81). ER professionals with poor sleep quality presented higher stress in the pre-COVID-19 phase (40.60 ± 10.71 vs. 32.22 ± 8.19) and during COVID-19 (55.27 ± 15.75 vs. 39.66 ± 9.75). Similarly, workers with excessive sleepiness had higher stress in the pre-COVID-19 phase (42.06 ± 10.95 vs. 36.64 ± 10.24) and during COVID-19 (54.67 ± 18.10 vs. 48.44 ± 14.75). Positive associations were also found between the SFMS and the PSQI, as well as with the ESS in both phases of the study. CONCLUSIONS: Emergency room professionals had increased stress levels during the COVID-19 pandemic. Stress was particularly higher in those with poor sleep quality or with excessive daytime sleepiness. RELEVANCE TO CLINICAL PRACTICE: These results should aim to impulse the implementation of measures to improve the working conditions of ER professionals.

Association between hypersomnolence and the COVID-19 pandemic: The International COVID-19 Sleep Study (ICOSS).

BACKGROUND: The COVID-19 pandemic and related restriction measures have affected our daily life, sleep, and circadian rhythms worldwide. Their effects on hypersomnolence and fatigue remain unclear. METHODS: The International COVID-19 Sleep Study questionnaire which included items on hypersomnolence such as excessive daytime sleepiness (EDS), and excessive quantity of sleep (EQS), as well as sociodemographic factors, sleep patterns, psychological symptoms, and quality of life was distributed in 15 countries across the world from May to September in 2020. RESULTS: Altogether responses from 18,785 survey participants (65% women, median age 39 years) were available for analysis. Only 2.8% reported having had COVID-19. Compared to before the pandemic, the prevalence of EDS, EQS, and fatigue increased from 17.9% to 25.5%, 1.6%-4.9%, and 19.4%-28.3% amid the pandemic, respectively. In univariate logistic regression models, reports of having a COVID-19 were associated with EQS (OR 5.3; 95%-CI 3.6-8.0), EDS (2.6; 2.0-3.4), and fatigue (2.8; 2.1-3.6). In adjusted multivariate logistic regression, sleep duration shorter than desired (3.9; 3.2-4.7), depressive symptoms (3.1; 2.7-3.5), use of hypnotics (2.3; 1.9-2.8), and having reported COVID-19 (1.9; 1.3-2.6) remained strong predictors of EDS. Similar associations emerged for fatigue. In the multivariate model, depressive symptoms (4.1; 3.6-4.6) and reports of having COVID-19 (2.0; 1.4-2.8) remained associated with EQS. CONCLUSIONS: A large increase in EDS, EQS, and fatigue occurred due to the COVID-19 pandemic, and especially in self-reported cases of COVID-19. These findings warrant a thorough understanding of their pathophysiology to target prevention and treatment strategies for long COVID condition.

Associations between Sleep, Depression, and Cognitive Performance in Adolescence.

The relevance of cognitive performance during adolescence requires further studies that analyze potential associated factors. This study aimed to analyze inductive reasoning, reading comprehension, and mathematical thinking (problem-solving and number and calculation) in relation to sleep and depression in 244 students aged 12-17 years (47.6% boys and 52.4% girls). Daytime sleepiness, sleep quality, dysthymia, and euthymia (state and trait) were assessed by self-reported questionnaires. Moreover, correlations between these variables and cognitive performance, and differences depending on sociodemographic variables (sex, age, or academic year) were analyzed using non-parametric tests. Robust regression models were also conducted to evaluate the predictive role of significant variables on cognitive performance. The results showed significant bidirectional relationships between sleep- and depression-related variables, and between the latter ones and cognitive performance. Depression-trait was more related to cognitive performance than depression-state, and euthymia more than dysthymia, but neither daytime sleepiness nor sleep quality significantly correlated with it. As for sociodemographic variables, girls reported worse sleep and more depressive symptoms than boys did, and younger students reported better sleep but performed worse than the older ones. Although these findings should be further explored in forthcoming studies adding other promising variables, they highlight the importance of promoting euthymia to improve cognitive performance in adolescents.

Assessment of Sleep Quality among Medical Students During the Covid- 19 Pandemic

Objective: To assess the sleep quality among medical students, comparing their sleep cycles during physical and online studies along with other factors associated with sleep patterns. Study Design: Cross-sectional Questionnaire based survey Place and Duration of Study: Department of Community Medicine, HITEC Institute of Medical Sciences Taxila from 1st January 2020 to 31st March 2020 Methodology: One hundred and forty seven students were surveyed in a time period of 1 month. The questionnaire included PSQI Pittsburgh Sleep Quality Index and other clinically validated questions. Students with known sleeping disorders were excluded from this survey. Result(s): There were 81 (55.1%) females and 65 (44.2%) males with mean age 20+/-1.4 years. Out of these 94(63.9%) were classified as "Poor Sleepers" and only 53 (36.1%) were "Good Sleepers". Poor sleep quality was associated with female gender (p<0.05), day-scholar residence status (p<0.054), excessive time required to sleep (p<0.00), excessive screen time usage (p<0.007), increased hours of study (p<0.089), experiencing trouble while driving, eating and socializing (p<0.002), lack of enthusiasm (p<0.000), unsatisfactory daily activities (p<0.000) and poor daytime alertness levels (p<0.360). 104 (70.7%) were aware of the effects of melatonin on sleep, only 51 (34.7%) admitted to have used coffee to stay awake at night. 98 (66.7%) subjects were pre-exam workers, 95 (64.6%) admitted not being able to wake up easily in the morning. Conclusion(s): The students and hostelites that used less screen time slept better. Excessive daytime tiredness was also a result of poor sleeping habits. Students who studied for longer periods of time and had difficulty waking up in the morning slept poorly. Poor sleepers also find it difficult to interact and are often unambitious about performing their daily menial tasks, as well as displeased with their daily activities. As a matter of fact, we deduce that sleep quality has unanticipated consequences for medical students' social and mental health.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

College students became more morning in the second year of the COVID-19 pandemic: impacts on sleep, mood, sunlight exposure and physical activity

The aim of the study was to evaluate the sleep, sunlight exposure, chronotype, mood and physical activity of college students in two consecutive years during the COVID-19 pandemic (Brazilian Clinical Trials Registry: RBR-4m5j4s). The students (n = 318) answered questionnaires in two moments (2020 - time 1 and 2021 – time 2). The data showed that there was less sunlight exposure and a chronotype with more morning tendencies in the time 2, but with no difference in sleep quality. College students walked more and sat less on weekends, but with no difference in the physical activity level. Physical activity and morning chronotype were associated with lower psychological impact. Therefore, college students, despite being less exposed to sunlight and having greater morning trends in 2021, maintained psychological symptoms, sleep quality and physical activity in the first two years of the pandemic. However, students who practiced physical activity and were mornings suffered less psychological impact. [ FROM AUTHOR] Copyright of Biological Rhythm Research is the property of Taylor & Francis Ltd 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.)

Impact of Taiwan's 2021 COVID-19 lockdown on the symptom severity and quality of life of patients with narcolepsy.

COVID-19 lockdowns can influence the sleep quality and daytime condition of patients with narcolepsy. Using data from our cohort study, we investigated changes in the quality of life and the symptom severity of patients with narcolepsy during Taiwan's 2021 lockdown and investigated differences by narcolepsy subtype, sex, and age. Patients with type 1 and type 2 narcolepsy (NT1 and NT2, respectively) aged 6-40 years were retrospectively recruited from our narcolepsy cohort study. These patients were regularly evaluated using the Short Form 36 Health Survey questionnaire (SF-36), the Epworth Sleepiness Scale (ESS), the visual analog scale (VAS) for hypersomnolence, the VAS for cataplexy and sleep diary. We compared the differences between the lockdown and the prelockdown periods by narcolepsy subtype, sex, and age. We used a paired t test analysis to compare differences in the SF-36, ESS, VAS scores and data of sleep diary between the prelockdown and lockdown periods (p1), and an independent t test analysis was used to compare the changes in different subgroups between the prelockdown and lockdown periods (p2). A total of 120 patients with narcolepsy were recruited (mean age 24.22 ± 6.87 years; 58% male); 80 of the patients had NT1 (mean age 25.25 ± 6.79 years; 60% male) and 40 had NT2 (mean age 22.16 ± 6.64, 53% male). During the lockdown period, the ESS score of total patients was decreased (p = 0.039) and body mass index was increased (p = 0.02). The NT1 group decreased significantly (p1 = 0.017), especially in men (p1 = 0.016) and adults (p1 = 0.04); scores for the VT domain of the SF-36 increased significantly in male and adult patients with NT2 (p1 = 0.048 and 0.012). Additionally, male patients with NT2 exhibited significantly decreased scores in the physical and emotional role functioning domains (p1 = 0.028, 0.024). The children and adolescents with NT1 had significantly decreased scores in the general health domain of the SF-36, but no significant change was noted in that of adults (p1 = 0.027, p2 = 0.012). We observed both negative and positive impacts of Taiwan's 2021 lockdown on patients with narcolepsy. A more flexible but structured daily routine with adequate sleep time should be considered for this population during lockdown and nonlockdown periods.

OSA patients' opinions concerning their disease and treatment during the pandemic

The COVID-19 pandemic has changed the operation of healthcare systems worldwide reducing hospital based services, and increasing telemedicine solutions for the diagnosis and treatment of obstructive sleep apnoea (OSA). Aim(s): to evaluate the opinion of OSA patients concerning their disease during the COVID pandemic,their treatment and follow up. Method(s): A telephone questionnaire based survey was conducted on OSA patients treated with CPAP including basic information (age, gender, marriage, education level, etc.), opinion towards the changes of medical practice during the pandemic, history of OSA, Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS), DAR-5 (anger), PHQ-4(depression and anxiety), Heaviness of Smoking Index (HSI) and Loneliness scale (LS). Adherence on CPAP was assessed objectively by telemonitoring. Result(s): 100 OSA patients 54.3+/-12.5 years (72% males) were evaluated presenting with ESS: 4.3+/-2.95, AIS: 3.14+/-3.3, PHQ-4: 2.29+/-1.72, DAR-5: 6.7+/-1.95 and HSI 3.5+/-.1.7. Mean CPAP use was 5.8+/-1.65 with 2.9+/-2.5years OSA history (96% used CPAP the same as before the pandemic). 41% considered themselves as high risk group for severe disease due to COVID because they suffered from OSA, and 25% believed CPAP could be protective from COVID. Patients infected with COVID (31%) did not change their CPAP use. 30% believed they received worse healthcare facilities than before and 16% presented worse sleep quality. Conclusion(s): During the pandemic, OSA patients continued to use their CPAP as before;however they believed that they should have better healthcare facilities. They considered themselves as a high risk group for COVID infection.

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.

Evaluation of sleep quality among post-COVID patients: findings from a 6- month follow-up study

Background: The current literature concerning sleep quality among post-COVID patients is limited. The aim of this observational cohort study was to evaluate if there is significant and persistent sleep disturbance in patients after recovery from COVID-19. The patients were followed up 1, 3, and 6 months after hospital discharge (in-person visits). Sleep quality was evaluated in each visit with the aid of multiple structured questionnaires: Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS), Fatigue Severity Scale (FSS), Stop-BANG (S-B) questionnaire. Result(s): 131 patients (59.5% males) aged 56.1+/- 11.2 with prior hospitalization due to SARS-CoV-2 infection were enrolled. The most common comorbidities were arterial hypertension (30.6% of patients), cardiovascular disease other than arterial hypertension (17.4%) and chronic obstructive lung disease (11.6%), while 38% of patients had no comorbid conditions. The mean values of the global PSQI were 8.28 +/-3.8, 7.43+/-3.7, and 7.46+/-3.5 in the first, second and third follow up respectively. Statistically significant differences were found for sleep quality (PSQI) between the first and second (p=0.001) and between the first and third visit (p=0.046). During the first visit, the ESS was 6.3+/-4.2, AIS: 7.1+/-4.9, S-B: 2.9+/-1.5 and FSS : 3.65+/-1.8. Statistically significant differences were found for FSS between the first and second (p=0.003) and for FSS (p=0.001) and AIS (p=0.048) between the first and third visit. Conclusion(s): Our findings reveal significant and persistent sleep disturbance up to 6 months after hospital discharge, although there was notable amelioration over time.

Long term sleep disturbances in Tunisian COVID-19 patients discharged from hospital: a cohort study

Background: A spectrum of long-term COVID19 effects have been reported. Much less data areavailable about how COVID19 will affect sleep over time in recovered patients. We Assessed the long-term impact of COVID 19 infection on sleep. Methodology:A prospective cohort study including 84 Tunisian COVID19 patients discharged fromhospital. Patients were asked about the period before SARS COV2 related hospital stay, and the 6-9 month-period after hospital discharge, using several self- reported evaluation scales (Pittsburgh Sleep Quality Inde, the Insomnia Severity Index, Epworth Sleepiness Scale, Patient Health Questionnaire (PHQ)-9 and the EuroQol five-dimension five-level questionnaire). Result(s): The mean age was 57,59 years with 46 men and 38 women. As compared with baseline statue of patients, all assessed outcomes were significantly impaired (VAS pain: 1,71+/-1,1 Vs 3,8+/-2,84;PSQI: 3,25+/-2,4 VS 6,39+/-4,73;ESS: 1,94+/-2,44 VS 3,59+/-4,53;ISI: 1,95+/-2,76 VS 6,07+/-5,96, and PHQ-9: 1,45+/-2,74 VS 7,47 +/- 6,61;p=0.0001). The percentage of poor sleepers (PSQI global score higher than 5) and patients with insomnia had significantly increased from 15,5% to 48,8% and from 1,2 to 11%, respectively (p=0.0001). The percentage of patients experiencingdepression symptoms has also doubled (25% to 58,3%), while severe pain was reported by more than one out of five patients against only 1,2% at baseline. The post-COVID -19 PSQI was significantly correlated with body mass index (r=0,328, p=0,003);the post-COVID-19 VAS pain (r=0,479, p=0,0001) as well as the post-COVID-19 PHQ-9 scale (r=0,712, p=0,0001). Conclusion(s): Sleep disturbances, depression symptoms as well as chronic pain are highly prevalent in long-term follow-up period in hospitalized COVID19 survivors therefore,they should be systematically screened.

Sleep disturbances in children with cystic fibrosis and primary ciliary dyskinesia at the beginning and in the first year of COVID-19 pandemic

Introduction: During the COVID-19 pandemic, the lifestyle and sleep habits of children with chronic lung disease have changed. Aims and objectives: To evaluate the differences in sleep habits in the first year of the pandemic in children with cystic fibrosis (CF) and primary ciliary dyskinesia (PCD). Method(s): Primary caregivers of children with CF and PCD aged 3-16 years who were evaluated for sleep habits at the beginning of the pandemic were re-evaluated at the end of the first year of the pandemic. The Sleep Disturbance Scale for Children (SDSC) was used and questions were asked about sleep habits and weight changes during the first year of the pandemic. Result(s): Primary caregivers of 31 children with CF and 14 children with PCD were included in the study. The median age of the children were 10.0 (7.5-12.0) years, 42.2% of the children were female. The mean BMI of children with CF was 15.8+/-1.8, and 20.0+/-3.5 in children with PCD (p:0.001). The mean daily screen time was 2h (1-3) at the beginning and 5h (4-6) in the first year of the pandemic among children with CF, 2h (1-2.2) at the beginning and 5h (4.7-6) in the first year of the pandemic among children with PCD (p<0.001, p:0.001, respectively). There were no differences in terms of disorders of initiating and maintaining sleep, sleep breathing disorders, disorders of arousal, sleep-wake transition disorders, disorders of excessive somnolence, sleep hyperhidrosis scores between two groups during first year of pandemic. Conclusion(s): While daily screen time increased in children with CF and PCD, sleep disturbances and changes in daily habits continued in the first year of the pandemic.

Sleepiness and safety at work among night shift NHS nurses.

BACKGROUND: Sleepiness associated with night shift working (NSW) is known to adversely affect workers' health and well-being. It has been associated with adverse safety outcomes and is a recognized workplace hazard among healthcare workers. AIMS: This study was aimed to assess the prevalence of self-reported sleepiness in NSW nurses and midwives. This study also explored the consequences of sleepiness on safety at work and driving. METHODS: A cross-sectional study of NSW nurses and midwives was conducted at an National Health Service (NHS) hospital trust from 16 March 2020 to 1 June 2020. Data were collected by online questionnaire and included information on demographics, shift work and safety aspects. Sleepiness was assessed with the Epworth Sleepiness Scale (ESS). RESULTS: Data collection coincided with the first coronavirus pandemic peak in England. Out of 1985 eligible NSW nurses and midwives, 229 participated in the study, with a response rate of 12%. The prevalence of sleepiness was 28%. Following a night shift, 49% of nurses reported nodding off at the wheel and 44% reported a near-miss car accident in past 12 months. An abnormal ESS score was significantly associated with near-miss car accidents (odds ratio [OR] 2.75, 95% confidence interval [CI] 1.31-5.77) and with low confidence in undertaking complex tasks at night (OR 2.64, 95% CI 1.20-5.84). CONCLUSIONS: More than a quarter of NSW nurses and midwives reported excessive daytime sleepiness although, due to the low response rate, this may not be representative. Adverse driving events were common. Elevated ESS scores correlated well with safety issues relating to work and driving.

Fatigue, sleepiness and sleep quality are SARS-CoV-2 variant independent in patients with long COVID symptoms.

Acute infections with SARS-CoV-2 variants of concerns (VOCs) differ in clinical presentation. Discrepancies in their long-term sequelae, commonly referred to as long COVID, however, remain to be explored. We retrospectively analyzed data of 287 patients presented at the post-COVID care of the Pulmonology Department, Semmelweis University, Budapest, Hungary, and infected with SARS-CoV-2 during a period of 3 major epidemic waves in Hungary (February-July 2021, VOC: B.1.1.7, Alpha, N = 135; August-December 2021, VOC: B.1.617.2, Delta, N = 89; and January-June 2022, VOC: B.1.1.529, Omicron; N = 63), > 4 weeks after acute COVID-19. Overall, the ratio of long COVID symptomatic (LC) and asymptomatic (NS) patients was 2:1. Self-reported questionnaires on fatigue (Fatigue Severity Scale, FSS), sleepiness (Epworth Sleepiness Scale, ESS) and sleep quality (Pittsburgh Sleep Quality Index, PSQI) showed higher scores for LC (4.79 ± 0.12, 7.45 ± 0.33 and 7.46 ± 0.27, respectively) than NS patients (2.85 ± 0.16, 5.23 ± 0.32 and 4.26 ± 0.29, respectively; p < 0.05 for all vs. LC). By comparing data of the three waves, mean FSS and PSQI scores of LC patients, but not ESS scores, exceeded the normal range in all, with no significant inter-wave differences. Considering FSS ≥ 4 and PSQI > 5 cutoff values, LC patients commonly exhibited problematic fatigue (≥ 70%) and poor sleep quality (> 60%) in all three waves. Comparative analysis of PSQI component scores of LC patients identified no significant differences between the three waves. Our findings highlight the importance of concerted efforts to manage both fatigue and sleep disturbances in long COVID patient care. This multifaceted approach should be followed in all cases infected with either VOCs of SARS-CoV-2.

Sleep in Residents: A Comparison between Anesthesiology and Occupational Medicine Interns.

Sleep deprivation is a significant risk to the health and judgment of physicians. We wanted to investigate whether anesthesiology residents (ARs) who work only one night shift per week have different physical and mental health from occupational medicine residents (OMRs) who do not work at night. A total of 21 ARs and 16 OMRs attending a university general hospital were asked to wear an actigraph to record sleep duration, heart rate and step count and to complete a questionnaire for the assessment of sleep quality, sleepiness, fatigue, occupational stress, anxiety, depression and happiness. ARs had shorter sleep duration than OMRs; on average, they slept 1 h and 20 min less (p < 0.001). ARs also had greater daytime sleepiness, a higher heart rate and lower happiness than OMRs. These results should be interpreted with caution given the cross-sectional nature of the study and the small sample size, but they are an incentive to promote sleep hygiene among residents.

Sleep symptoms are essential features of long-COVID - Comparing healthy controls with COVID-19 cases of different severity in the international COVID sleep study (ICOSS-II).

Many people report suffering from post-acute sequelae of COVID-19 or "long-COVID", but there are still open questions on what actually constitutes long-COVID and how prevalent it is. The current definition of post-acute sequelae of COVID-19 is based on voting using the Delphi-method by the WHO post-COVID-19 working group. It emphasizes long-lasting fatigue, shortness of breath and cognitive dysfunction as the core symptoms of post-acute sequelae of COVID-19. In this international survey study consisting of 13,628 subjects aged 18-99 years from 16 countries of Asia, Europe, North America and South America (May-Dec 2021), we show that post-acute sequelae of COVID-19 symptoms were more prevalent amongst the more severe COVID-19 cases, i.e. those requiring hospitalisation for COVID-19. We also found that long-lasting sleep symptoms are at the core of post-acute sequelae of COVID-19 and associate with the COVID-19 severity when COVID-19 cases are compared with COVID-negative cases. Specifically, fatigue (61.3%), insomnia symptoms (49.6%) and excessive daytime sleepiness (35.8%) were highly prevalent amongst respondents reporting long-lasting symptoms after hospitalisation for COVID-19. Understanding the importance of sleep-related symptoms in post-acute sequelae of COVID-19 has a clinical relevance when diagnosing and treating long-COVID.

Status of mental health among college and university students during first and second wave of COVID-19 outbreak in India: A cross-sectional study.

Background: India has been badly affected by Covid-19 not only in terms of human lives but also has a long-term effect on mental health of the population. This paper is an attempt to understand the psychological effects of the pandemic on the college and university students in India after the second wave of COVID-19 outbreak and its associated factors. Method: A web-based survey was conducted to collect information from the students both at individual and household level. The study applied binary and multivariate logistic regression to estimate the adjusted and unadjusted marginal effects of the predictor variables. Result: Results show a significant increase in mental health concerns during the second wave of the pandemic, as compared to the first year. The key factors contributing to the higher prevalence of depression, anxiety, and stress are the difficulties faced in the adaptation to the new way of learning, fear of discontinuation of education due to financial constraints faced by household, limited physical interaction, and prolonged screen-time during the pandemic. Limitation: The study has some limitations regarding selection of the sample as the survey was web-based. Also, the mental health situation of the students is self-reported and the study does not consider the prevailing mental health issues before the pandemic. Conclusion: The study recommends initiatives like offering counselling classes and strategies to cope up with mental health disorders. Further, there is a need to conduct follow-up studies to assess the long-term impacts of prolonged home quarantine on the mental health of the students.

Multidisciplinary care of patients with narcolepsy during COVID-19 pandemic in Italy via televisit: the TElemedicine for NARcolepsy (TENAR) feasibility study.

STUDY OBJECTIVES: Narcolepsy is a rare chronic central disorder of hypersomnolence with frequent endocrine-metabolic comorbidities. To address the complex care needs of patients during the COVID-19 emergency, we carried out a feasibility study of the TElemedicine for NARcolepsy (TENAR) protocol with the aim of assessing the feasibility of a multidisciplinary care approach via televisit for patients with narcolepsy. METHODS: A feasibility single open arm study on the multidisciplinary care of children (>7 y.o.) and adults with narcolepsy who required a follow-up visit was realized during the COVID-19 pandemic emergency period in Italy. The study included a sleep, metabolic, and psychosocial assessment via televisit at baseline, at 6, and at 12 months from the study inclusion period (15 th May - 26 th June 2020). RESULTS: Thirty-nine out of 44 eligible patients (89%) entered the study (30 adults, nine children); 37 patients (95%) ended the 12-month follow-up. At baseline, the median Epworth sleepiness scale score (ESS) was 10 (IQR 8-14), and the median body mass index (BMI) was 25.6 (IQR 22.1-30.9). During the follow-up period, the ESS score decreased from the 6th month onward (p=0.003), and BMI decreased at the 1-year follow-up (p=0.047), while there were no differences in depressive and anxiety symptoms, quality of life, compliance with treatment, adverse drug reactions, or accidents. CONCLUSION: High response and retention rates, stability of ESS and lack of side effects indicate that telemedicine is a feasible and safe approach for adults and children with narcolepsy.