Quality of sleep among hypertensive patients attending a rural health training centre.

Introduction: Sleep is a vital biological, reparative, and restorative phenomenon, and poor sleep has a serious detrimental effect on health. Poor sleep quality is a serious problem as it adversely affects a person's ability to function physically and socially, as well as their potential for profession and quality of life. The degree of hypertension directly affects sleep quality, and poor sleep can exacerbate hypertensive symptoms. This study assesses hypertension patients' sleep quality in a rural health training centre in Chennai. Objectives: 1. To study the prevalence of poor sleep quality among hypertensive patients. 2. To determine the association between selected socio-demographic factors and sleep quality among these patients. Materials and Methods: Hypertensives attending the outpatient department of a rural health and training centre were selected in a systematic manner and administered a semi-structured interview schedule and the Pittsburgh Sleep Quality Index (PSQI) questionnaire followed by a basic clinical examination. Using the PSQI, they were categorised as having either poor or good sleep quality and the association between selected socio-demographic factors and sleep quality was assessed. Results: Out of the 179 study participants, there were almost equal numbers of male and female participants. The mean age of participants was 57.80 years (standard deviation (SD) = 9.8 yrs.). Among the study participants, 44.13% had completed secondary level of school as an education qualification and 6.70% were illiterate. By the modified BG Prasad classification 2022, most of the study participants (34.08%) came under the class II socioeconomic classification. A large proportion (78.8%) of study participants had poor sleep quality. The difference in sleep quality was observed with respect to gender, socio-economic class, alcohol consumption and body mass index (BMI). Conclusion: This observational study shows that individuals with hypertension suffer significantly from poor sleep. A poor quality of sleep was reported by 78.77% of the patients in this study. Statistically significant factors that influenced sleep quality were gender, alcohol consumption and BMI.

The Association Between Sleep and Quality of Life Among Visitors of Lifestyle Clinics at the Ministry of National Guard-Health Affairs, Western Region, Saudi Arabia.

BACKGROUND: Sleep quality significantly impacts health-related quality of life (QoL). However, the link between sleep quality and QoL needs further exploration, especially in the context of Saudi Arabia. OBJECTIVE: To assess the effect of sleep quality on QoL among visitors of lifestyle clinics at the National Guard primary healthcare centers in the Western region of Saudi Arabia in 2023. METHODS: A cross-sectional study was conducted among 369 participants. Data were collected using a questionnaire that addressed sociodemographic characteristics, sleep quality, and perceived QoL. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while QoL was measured using the Short Form-20 (SF-20) QoL scale. Statistical analysis was performed using SPSS (IBM Corp., Armonk, NY). RESULTS: The median age of participants was 38 years, and the median PSQI score was 9, indicating poor sleep quality. Significant differences in sleep quality were found relating to gender and income. Male gender and low-income status were associated with lower sleep quality. The scores for sleep quality varied between 3 and 16, with a median score of 9, while QoL scores ranged from 34 to 92, with a median score of 72. Good sleep quality was found only among 4.9% of the participants and was associated with higher QoL scores. The correlation between sleep quality and QoL was significant, with a correlation coefficient of -0.399 (p-value < 0.001). CONCLUSION: The study identifies a significant correlation between poor sleep quality and lower QoL among visitors of lifestyle clinics in the Western region of Saudi Arabia. These findings suggest the necessity of addressing sleep quality in interventions aimed at improving overall well-being.

Analysis of the Improvement Sequence in Insomnia Symptoms and Factors Influencing the Treatment Outcomes of Smartphone-Delivered CBT in Patients with Insomnia Disorder.

Background: The effectiveness of medication combined with smartphone-delivered cognitive behavioral therapy for insomnia (CBT-I) has been well verified, but there are few studies on the sequence of remission of insomnia symptoms. This study aims to understand the sequence of symptom improvement and the factors influencing the treatment effectiveness in patients with insomnia. Methods: Smartphone-delivered CBT, as a form of Online CBT, allows for training through mobile devices at any time and place. We utilized the Good Sleep 365 app to conduct a survey, involving 2820 patients who met the baseline inclusion criteria. These patients were assessed using a general demographic questionnaire and the Pittsburgh Sleep Quality Index (PSQI) to evaluate general demographic information and insomnia symptoms, and subsequently underwent CBT training using the Good Sleep 365 app. A total of 1179 patients completed follow-ups at 4 weeks, 8 weeks, 16 weeks, and 24 weeks. Results: At 4 weeks and 8 weeks, the descending order of the reduction rates of PSQI components (excluding component 6: use of sleeping medication) was: sleep latency, subjective sleep quality, sleep efficiency, sleep disturbance, sleep maintenance, and daytime dysfunction. At 16 weeks and 24 weeks, the descending order was subjective sleep quality, sleep latency, sleep efficiency, daytime dysfunction, sleep maintenance, and sleep disturbance. There were significant differences in the reduction rates of PSQI components (excluding component 6: use of sleeping medication) both at the same follow-up times and at different follow-up times (all P<0.05). Multivariable logistic regression analysis showed that patients older than 30 years and those with a college degree or above had better treatment outcomes, whereas those with a disease duration of more than three years had worse outcomes. Conclusion: The sequence of symptom improvement in patients with insomnia changes over time, and age, educational level, and duration of disease are factors influencing treatment outcomes.

Corrigendum: Role of dietary fiber and lifestyle modification in gut health and sleep quality.

[This corrects the article DOI: 10.3389/fnut.2024.1324793.].

Menopausal stage transitions and their associations with overall and individual sleep quality in middle-aged Korean women.

BACKGROUND: Understanding the association between the menopausal transition and declining sleep quality can guide optimal timing for preventive interventions in transitioning women. However, studies lack representation of Asian women and sufficient data on the progression of menopausal stages and sleep quality changes over time in this population. METHODS: This study included 3305 women in the pre-menopause stage at baseline. The sleep quality and its components were assessed using the Pittsburgh Sleep Quality Index (PSQI). Menopausal stages were classified as pre-menopause, early transition, late transition, and post-menopause according to the Stages of Reproductive Aging Workshop+10 (STRAW+10) criteria. We estimated the longitudinal association between menopausal stage changes over time and the PSQI score, and examined the effect of being overweight. RESULTS: The trends in the PSQI scores and its components according to the menopausal stage changes over time showed that with the exception of sleep duration and habitual sleep efficiency, an overall decline was noted in sleep health during late transition and post-menopause compared to pre-menopause. These associations were independent of time-variant annual chronological aging, which was not significantly associated with sleep deterioration. Additionally, although the associations between menopausal stages and sleep quality did not significantly differ by adiposity level, the overweight group exhibited worse PSQI scores and components than did the non-overweight group. LIMITATION: Sleep quality and menopausal stage were assessed using self-reported questionnaires without objective measures. CONCLUSION: Our study underscores the importance of screening for sleep quality deterioration and implementing appropriate measures for women experiencing menopausal transition.

Pittsburgh Sleep Quality Index (PSQI) Changes in Virologically Suppressed People Living with HIVSwitching to Long-Acting Cabotegravir and Rilpivirine.

BACKGROUND: Limited evidence is available about sleep quality changes associated with the use of Cabotegravir (CAB), a new, long-acting (LA) antiretroviral (ARV) drug belonging to the class of Integrase Strand Transfer Inhibitors (INSTIs). METHODS: Pittsburgh Sleep Quality Index (PSQI) was calculated in 53 people living with HIV (PLWH) under the care of the outpatient services of two Italian Infectious Diseases Centers in Apuliabefore (M0) and seven months after (M7) the switch to LA CAB. Global scores and relative subitems were compared using paired sample tests. The same analysis was repeated in subgroups of PLWH switching from INSTIs-, Dolutegravir-(DTG), and Bictegravir (BIC)-based regimens. RESULTS: A significant reduction was reported in global mean (±StandardDeviation, SD) PSQI at M7 compared to M0 (4 (±3) vs. 3 (±2), p = 0.01), particularly in the areas of sleep latency and sleep disturbances. The improvement was also significant in PLWH already on INSTIs- (from median 3 to 2 points, p = 0.02) and DTG-based (from median 4 to 2, p = 0.01) ARV regimens, but not among those who switched from BIC-based regimens. CONCLUSIONS: PLWH reported improved sleep quality after switching from ARV treatment to LA CAB. Further studies are needed to give deeper insights into this phenomenon.

Subjective sleep parameters: A marker to PTSD symptoms evolution? A 4-year longitudinal study.

Disturbed sleep is a common feature after exposure to a traumatic event, especially when PTSD develops. However, although there is evidence suggesting a potential role of sleep disturbance in the progression of PTSD symptoms, the interrelationship between sleep and PTSD symptoms has yet to be determined. In order to address this knowledge gap, we have investigated the influence of initial sleep characteristics on the evolution of post-traumatic stress disorder (PTSD) symptoms over 4 years of follow-up among individuals exposed to the Brazilian Kiss nightclub fire. Participants were individuals exposed to the 2013 Kiss nightclub fire in Brazil. Sleep characteristics and PTSD symptoms were measured within the 4 years following the fire by self-report questionnaires, such as The Pittsburgh Sleep Quality Index (PSQI), and PTSD Checklist - Civilian version (PCL-C). Generalized estimating equations (GEE) models were used to examine the longitudinal associations (by estimating the relative effects of initial sleep problems on PTSD symptoms after adjusting for covariates). Comprehensive information concerning socio-demographic factors, health status, and sleep complaints were obtained. A total of 232 individuals were included. In GEE models, no significant interactions were observed between sociodemographic variables and PTSD symptoms in the follow-up period, however, associations were found between PTSD at baseline and the following factors: the female gender, the victim individuals and the existence of prior psychiatric disease. Initial subjective sleep parameters were strongly associated with PTSD symptoms over 4 years, mainly the presence of disturbed dreams (p = 0.012), increased sleep latency (p = 0.029), and reduced sleep duration (p = 0.012). Sleep complaints and PTSD symptoms were common among individuals after the disaster. The current study has found that the presence of sleep complaints, especially increased sleep latency, presence of disturbed dreams and short sleep duration, in the initial presentation after the fire was consistently associated with the perpetration of PTSD symptoms in the next 4 years of follow-up. These findings suggest that interventions addressing these sleep complaints have the potential to reduce the persistence and/or severity of PTSD symptoms.

Dimensionality and cross-language invariance of Pittsburgh Sleep Quality Index among Indian adolescents and adults.

Sleep quality, key to physical and mental health, requires regular assessment in clinical and non-clinical settings. Despite widespread use, the dimensionality of the Pittsburgh Sleep Quality Index (PSQI) is debated, and its Hindi version's factor structure remains unexplored. Our study evaluates the PSQI's dimensionality among Indian adolescents and adults aiming to demonstrate cross-language (Hindi and English) invariance of its factor structure. The PSQI showed satisfactory item reliability, and a best-fitting two-factor model: "sleep efficiency" (comprising sleep duration and habitual sleep efficiency), and "perceived sleep quality" (comprising remaining five PSQI components). This model showed configural invariance across age groups, sexes, and languages. Metric invariance was noted across age groups, but a partial metric non-invariance was observed across languages and sexes as reflected by differences in factor loadings. The second-order factor structure model had an excellent fit indicating the usefulness of aggregate scores of the two factors as a single index of sleep quality. Our findings better support a two-factor structure of sleep quality (both for English and Hindi versions of PSQI) in India. However, further validation in diverse clinical and non-clinical samples is warranted.

Relationship between sleep quality and quantity and lower-body neuromuscular performance characteristics in semi-professional male basketball players.

Sleep has been recognized as one of the most essential recovery methods necessary for achieving optimal performance. However, there is still a lack of scientific literature focused on examining its impact on one of the most prevalent skills in the game of basketball, the countermovement vertical jump (CVJ). Therefore, the purpose of the present study was to examine the relationship between sleep quality and quantity, and lower-body neuromuscular performance characteristics within a cohort of semi-professional male basketball players. Twenty-eight athletes competing in a first-tier regional league in Serbia volunteered to participate in this investigation. Upon arrival at the gym, all athletes completed the Pittsburgh Sleep Quality Index (PSQI) self-rated questionnaire. Immediately after completion of the PSQI, each athlete stepped on a force plate system and performed three maximum-effort CVJs with no arm swing. The following force-time metrics were obtained for the analysis: eccentric and concentric absolute and relative mean and peak force and power, vertical jump height, and reactive strength index-modified. Pearson product-moment correlation coefficients were used to examine the strength of the linear relationships between sleep quality and quantity and lower-body neuromuscular performance characteristics (p < 0.05). The results indicated that sleep quality appears to have a greater impact on the concentric than the eccentric phase of the CVJ (e.g., concentric mean force [r = -0.830; p < 0.001], relative concentric peak force [r = -0.466; p = 0.013, eccentric mean power (r = -0.162; p = 0.409)], while no significant relationship was found between sleep quantity and lower-body neuromuscular performance (e.g., concentric peak force [r = -0.055; p = 0.782], relative eccentric mean power [r = -0.301; p = 0.107]). Overall, these findings offer valuable insights into the importance of good sleep hygiene (e.g., efficiency, duration) in an athletic population, and can help practitioners develop more effective training and recovery programs.

Frequency and Amount of Caffeine Consumption and Its Effects on Sleep Quality Among the General Population in Makkah City, Saudi Arabia, in 2024.

BACKGROUND: Caffeine is a commonly consumed psychoactive substance with potential effects on sleep quality. However, few studies have examined this relationship in the general population of Makkah, Saudi Arabia. OBJECTIVE: To investigate the impact of caffeine consumption on sleep quality and identify demographic factors associated with caffeine intake and sleep quality in Makkah's general population. METHODS: This cross-sectional study used a convenient sampling approach to recruit 390 individuals residing in Makkah. Data were collected via a Google Forms questionnaire distributed through various social media platforms. Caffeine intake and sleep quality were assessed using a validated questionnaire adapted for Saudi Arabia and the Pittsburgh Sleep Quality Index (PSQI), respectively. RESULTS: The median total daily caffeine intake was 324.20 mg, with 43.1% of participants consuming more than the suggested cutoff of 400 mg daily. There were significant positive correlations between PSQI and total caffeine consumption in the morning, evening, and overall daily consumption. The results also indicated significant relationships between demographic factors, such as marital status, educational level, income, and BMI groups, and caffeine consumption. CONCLUSION: Caffeine intake was found to be high among the general population of Makkah, with a significant portion consuming more than the suggested daily limit. There was a significant positive correlation between caffeine consumption and poor sleep quality. Additionally, demographic factors such as marital status, educational level, income, and BMI groups were found to be associated with caffeine consumption.

The Impact of Sleep on Haematological Parameters in Firefighters.

Sleep is a vital process that impacts biological functions such as cell renewal, bone regeneration, and immune system support. Disrupted sleep can interrupt erythropoiesis, leading to fewer red blood cells, reduced haemoglobin concentration, and decreased haematocrit levels, potentially contributing to haematological disorders. This is particularly concerning for shift workers for example firefighters. While previous studies have explored sleep's adverse effects on various professions, research specific to firefighters is limited. This study investigates the relationship between sleep quality and haematological parameters among firefighters in Northeast Portugal. From a sample of 201 firefighters, variations in red blood cells, haemoglobin, and haematocrit values were linked to sleep quality. The study utilised non-parametric tests (Wilcoxon-Mann-Whitney, Spearman's correlation) to explore the connection between sleep quality and haematological profile. The impact of covariates on haematological parameters was assessed using non-parametric ANCOVA (Quade's). A multiple regression analysis was employed to further understand how sleep quality and various confounding variables impact haematological levels. Findings suggest a negative link between sleep quality and haematological levels, meaning that as sleep quality deteriorates, there is a tendency for haematological levels to decrease, as indicated by Spearman's correlation (rRBC = -0.157, pRBC = 0.026; rHb = -0.158, pHb = 0.025; rHCT = -0.175, pHCT = 0.013). As observed in scientific literature, the correlation found suggests a possible inhibition of erythropoiesis, the process responsible for red blood cell production. Despite firefighters presenting a haematological profile within the reference range (RBC: 5.1 × 106/mm3 (SD ± 0.4), Hb: 15.6 g/dL (SD ± 1.3), 47% (SD ± 1.0), there is already an observable trend towards lower levels. The analysis of co-variables did not reveal a significant impact of sleep quality on haematological levels. In conclusion, this study underscores the importance of sleep quality in determining haematological parameters among firefighters. Future research should investigate the underlying mechanisms and long-term implications of poor sleep quality on firefighter health. Exploring interventions to enhance sleep quality is vital for evidence-based strategies promoting firefighter well-being.

The association between sleep quality and accelerated epigenetic aging with metabolic syndrome in Korean adults.

BACKGROUND: Healthy sleep is vital for maintaining optimal mental and physical health. Accumulating evidence suggests that sleep loss and disturbances play a significant role in the biological aging process, early onset of disease, and reduced lifespan. While numerous studies have explored the association between biological aging and its drivers, only a few studies have examined its relationship with sleep quality. In this study, we investigated the associations between sleep quality and epigenetic age acceleration using whole blood samples from a cohort of 692 Korean adults. Sleep quality of each participant was assessed using the validated Pittsburgh Sleep Quality Index (PSQI), which encompassed seven domains: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction. Four epigenetic age accelerations (HorvathAgeAccel, HannumAgeAccel, PhenoAgeAccel, and GrimAgeAccel) and the pace of aging, DunedinPACE, were investigated for epigenetic aging estimates. RESULTS: Among the 692 participants (good sleepers [n = 441, 63.7%]; poor sleepers [n = 251, 36.3%]), DunedinPACE was positively correlated with PSQI scores in poor sleepers ( γ =0.18, p < 0.01). GrimAgeAccel ( ß =0.18, p = 0.02) and DunedinPACE ( ß =0.01, p < 0.01) showed a statistically significant association with PSQI scores only in poor sleepers by multiple linear regression. In addition, every one-point increase in PSQI was associated with a 15% increase in the risk of metabolic syndrome (MetS) among poor sleepers (OR = 1.15, 95% CI = 1.03-1.29, p = 0.011). In MetS components, a positive correlation was observed between PSQI score and fasting glucose ( γ = 0.19, p < 0.01). CONCLUSIONS: This study suggests that worsening sleep quality, especially in poor sleepers, is associated with accelerated epigenetic aging for GrimAgeAccel and DundinePACE with risk of metabolic syndrome. This finding could potentially serve as a promising strategy for preventing age-related diseases in the future.

The Limitations of Using the Pittsburgh Sleep Quality Index to Assess Athletes' Sleep Quality: Evidence from Reliability and Validity in Chinese Professional Athletes.

Purpose: This study aimed to assess the structural validity of the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) among Chinese professional athletes and examine its test-retest reliability and convergent validity across different timeframes. Methods: 581 Chinese professional athletes participated. Exploratory and confirmatory factor analyses were conducted on the Chinese version of the PSQI. Test-retest reliability was assessed over 2 weeks, 1 week, and 2-3 days within a 1-month timeframe. Additional reliability analysis over a 2-day interval was conducted within a 1-week timeframe. Convergent validity was assessed using Chinese versions of the Insomnia Severity Index (ISI), the Athlete Sleep Screening Questionnaire (ASSQ), and actigraphy. A 1-month tracking was conducted, with weekly completion of the PSQI using a one-week timeframe, supplemented by assessments in the second and fourth week using two-week and one-month timeframes. Relationships between weekly results and those over two weeks and one month examined, along with convergent validity, using sleep diary and actigraphy. Results: The PSQI exhibited a two-factor structure (sleep quality and sleep efficiency), with good model fit (CFI = 0.960, AGFI = 0.924, TLI = 0.925, RMSEA = 0.085). Test-retest reliability was satisfactory for intervals of one week or more (r = 0.721 ~ 0.753). Using a one-week timeframe, the total score and two dimensions exhibited good reliability (r = 0.769 ~ 0.881), but only the total score and sleep quality showed high correlations with ISI and ASSQ (r = 0.701 ~ 0.839). Throughout the tracking, monthly responses correlated well with the most recent weeks (r = 0.732 ~ 0.866). Conclusion: The PSQI demonstrates a two-factor structure in Chinese athletes, with sleep quality being predominant. Test-retest reliability within a one-month timeframe is unstable, suggesting a one-week timeframe performs better. Distinguishing between the two dimensions, employing shorter timeframes, and incorporating objective measures are recommended.

Is caregiver sleep quality an important clinical issue?

Sleep quality is directly related to general health and quality of life. Caregivers' sleep disturbances affect not only their own health, but also the optimal care of their patients, with negative consequences such as neglect and medication errors. This study was conducted prospectively in the palliative care unit. The participants were divided into two groups: the caregivers and the control group. The caregiver groups were categorized into two subgroups: family and paid caregivers. The sleep quality of the caregivers was evaluated with the Pittsburgh Sleep Quality Index (PSQI). The demographics, body mass index, educational level, the presence of chronic diseases and medications, need for spiritual support, daytime sleepiness, duration of caregiving, nighttime awakening, and tea/coffee consumption were recorded. The study included 250 caregivers (female: 74.8%, mean age: 50.6 ± 12.1) and 103 control group members. Family caregivers significantly had an advanced age, lower educational level, more chronic diseases, and medications, need for spiritual support, and longer duration of caregiving compared to the paid caregivers (p = 0.018, < 0.001, 0.001, 0.005, < 0.001, and 0.003, respectively). The total PSQI scores of caregivers were significantly higher in the FDR, family group, females, those with need of spiritual support, and tea/coffee consumption close to bedtime (p = 0.002 < 0.004. 0.026. < 0.001, and 0.022, respectively). The fact that the sleep quality of family group caregivers is worse than that of paid caregivers may prevent healthy medical service delivery. The provision of care by paid professional caregivers will improve quality of care and quality of life.

Association between sleep quality and living environment among Chinese older persons: a cross-sectional study.

Sleep quality significantly affects the quality of life of older persons. Therefore, this study explored the relationship between sleep quality and living environment of older persons in China to provide a theoretical basis for therapies to alleviate sleep disorders in older persons. A total of 6211 subjects > 60 years of age in Anhui Province, China, were evaluated using the Pittsburgh Sleep Quality Index and a self-reported questionnaire. Multivariate logistic regression analysis revealed that living alone (OR = 1.26, 95% CI 1.09-1.46) and living in a rural area (OR = 1.19, 95% CI 1.06-1.34) were significantly associated with a high incidence of sleep disorders in older persons. Living near a park or foot paths suitable for exercise or walking was significantly associated with a lower incidence of sleep disorders in older persons (OR = 0.87, 95% CI 0.77-0.96). Individual factors such as female sex (OR = 1.30, 95% CI 1.14-1.48) and depression (OR = 2.80, 95% CI 2.47-3.19) were also associated with sleep quality in older persons. These data indicate a correlation exists between living environment and sleep quality.

Sleep disorders in patients with endometriosis; a cross-sectional study.

BACKGROUND: Endometriosis affects 10-15% of women of reproductive age and is considered a critical gynecological problem. Endometriosis causes pain and infertility, both of which can impair the patient's quality of life. Sleep disorders account for the most bothersome presentation of impaired quality of life. This study investigated the frequency and severity of sleep disorders in women with endometriosis. METHODS: In this analytical cross-sectional study, 665 women referred to three hospitals in Tehran, Rasool-e-Akram, Pars, and Nikan, were included (463 patients with endometriosis and 202 women without endometriosis). All of them were informed about the study design and the aim of the research, and then they were asked to sign the consent form and complete the Pittsburgh Sleep Quality Index (PSQI). After data gathering and entering, they were analyzed by SPSS version 22 and were considered significant with P < 0.05. RESULTS: The study population's mean age was 35.4 ± 7.9 years. The mean global PSQI score in the case group (endometriosis patients) was higher than in the control group (non-endometriosis patients) (10.6 vs. 7.1; P < 0.001). Patients with dyspareunia, dysuria, pelvic pain, and dyschezia had a significantly higher PSQI score (P < 0.05). CONCLUSION: According to the findings of the present study, the sleep quality in endometriosis patients is low, and there is a need to pay greater attention to these patients. This may result in some changes in the therapeutic strategies for this disease.

Association between dysphagia risk and sleep quality in community-dwelling older adults: A cross-sectional study.

Objectives: Exploring the effects of swallowing function on sleep quality could provide valuable insights into the potential impact of reduced swallowing function on sleep. However, pertinent studies are limited. Therefore, this study aimed to investigate the relationship between dysphagia risk and sleep health in community-dwelling older adults. Methods: Data for this cross-sectional study were obtained from the Shizuoka and Daiko studies conducted as part of the Japan Multi-Institutional Collaborative Cohort Study. Information on demographics, overall lifestyle, dysphagia risk, as well as sleep quality, duration, satisfaction, and regularity, was obtained using a self-administered questionnaire. Dysphagia risk and sleep quality were assessed using the Dysphagia Risk Assessment Questionnaire for the Community-dwelling Elderly and the Japanese version of the Pittsburgh Sleep Questionnaire Index, respectively. Multivariate logistic regression, adjusted for covariates, was employed to assess the association between dysphagia risk and sleep health. Results: Among the 3058 participants (1633 males, 1425 females) aged ≥60 years, 28.0 % exhibited dysphagia risk, and 19.1 % reported poor sleep quality. Those with dysphagia risk were more likely to experience poor sleep quality than those without dysphagia risk. In male participants, dysphagia was significantly associated with poor sleep quality, unsatisfactory sleep, and sleep irregularity, but was not significantly associated with unsatisfactory or irregular sleep in female participants. The Japanese version of the Pittsburgh Sleep Questionnaire Index components-subjective sleep quality, sleep latency, sleep disturbances, and daytime dysfunction-were associated with dysphagia risk in both sexes. Conclusions: Dysphagia risk is associated with sleep quality in older individuals in Japan. Thus, preserving swallowing function may contribute to enhancing sleep quality.

The Relationship Between Thyroid Dysfunction and Sleep Quality Among Population of Saudi Arabia.

Purpose: Thyroid problems and sleep disturbances are common health problems that impact people of all ages, income levels, and genders. The clinical relationship between these conditions is still not well understood, despite their widespread occurrence. The main objectives of the study were to determine the prevalence of thyroid disorders and evaluate the relationship between them and sleep quality in the Saudi Arabian population. Patients and Methods: The study employed an observational cross-sectional design and included a representative Saudi Arabian cohort. The Pittsburgh Sleep Quality Index (PSQI) was included in a digital self-administered survey that participants were asked to complete. Results: There were 1044 responders in the study, most of whom (54%) were between the ages of 21 and 30. Female respondents made up 62% of the sample. Thyroid disorders were diagnosed in 9.2% of cases. A significant correlation was found (p=0.001 and p<0.001, respectively) between thyroid disorders and sleep disturbances as well as the use of sleep medications. Conclusion: The study revealed a significant prevalence of poor sleep quality in the Saudi population as a whole, with thyroid disorder diagnosis and female gender emerging as independent risk factors. More extensive longitudinal studies in the area are desperately needed.

Evaluation of Noise Exposure Levels in Pediatric ENT Operating Rooms.

OBJECTIVE: Operating room (OR) sounds may surpass noise exposure thresholds and induce hearing loss. Noise intensity emitted by various surgical instruments during common pediatric otolaryngologic procedures were compared at the ear-level of the surgeon and patient to evaluate the need for quality improvement measures. STUDY DESIGN: Cross-sectional study. SETTING: Single tertiary care center. METHODS: Noise levels were measured using the RISEPRO Sound Level Meter and SoundMeter X 10.0.4 at the ear level of surgeon and patient every 5 minutes. Operative procedure and instrument type were recorded. Measured noise levels were compared against ambient noise levels and the Apple Watch Noise application. RESULTS: Two hundred forty-two total occasions of noise were recorded across 62 surgical cases. Cochlear implantation surgery produces the loudest case at the ear-level of the patient (91.8 Lq Peak dB; P < .001). The otologic drill was the loudest instrument for the patient (92.1 Lq Peak dB; P < .001), while the powered microdebrider was the loudest instrument for the surgeon (90.7 Lq Peak dB; P = .036). Noise measurements between surgeon and patient were similar (P < .05). Overall agreement between the Noise application and Sound Level Meter was excellent (intraclass correlation coefficient of 0.8, with a 95% confidence interval ranging from 0.32 to 0.92). CONCLUSION: Otolaryngology OR noises can surpass normal safe thresholds. Failure to be aware of this may unwittingly expose providers to noise-related hearing loss. Mitigation strategies should be employed. Quality improvement measures, including attention to surgical instrument volume settings and periodic decibel measurements with sound applications, can promote long-term hearing conservation. DISCUSSION: Otolaryngology OR noises can surpass normal safe thresholds. Failure to be aware of this may unwittingly expose providers to noise-related hearing loss. The duration, frequency of exposure, and volume levels of noise should be studied further. IMPLICATIONS FOR PRACTICE: Mitigation strategies should be employed. Quality improvement measures, including attention to surgical instrument volume settings and periodic decibel measurements with sound applications, can promote long-term hearing conservation.

The sleep problems in individuals with Rett syndrome and their caregivers.

LAY ABSTRACT: Sleep problems are common and impactful among individuals with Rett syndrome (RTT) and their caregivers. We examined the sleep patterns of 29 RTT patients and their primary caregivers using various assessment tools. The study found that a majority of the patients experienced sleep disturbances, with younger patients showing more sleep difficulties. Caregivers also reported poor sleep quality. The findings emphasize the need to address sleep problems in RTT management, as improving sleep quality can positively impact the well-being of individuals with RTT and their caregivers.