An Umbrella Review and a Meta-analysis of Meta-analyses of Disordered Eating Among Medical Students.

Objective: To prevent eating disorders in future physicians, this umbrella review and meta-analysis of previous meta-analyses estimates the prevalence of disordered eating (DE) among medical students worldwide and identifies key risk factors. Methods: Four databases were searched electronically between their inception and February 1, 2023. The search was later updated to December 31, 2023. Results: The search yielded prevalence rates for medical students who scored above established cutoffs on validated assessment measures for DE. These were computed to provide an overall pooled estimate. The data was taken from 2 previous reviews. Both these systematic reviews found a 15.1% (95% confidence interval [CI]: 14.7%-15.6%) prevalence rate of DE among medical students. The equivalent Hedges' G = 0.30 (95% CI: 0.29-0.31), the equivalent odds ratio = 1.74 (95% CI: 1.71-1.77), I2 = 97.6%, and the excess of statistical significance is P = .001. The trim and fill adjusted effect size was 16.0% (95% CI: 14.0%-20.0%). Conclusion: Because eating disorders put students' safety and well-being at risk and because the health of early-stage physicians is vital to the welfare of a country, early signs of disordered eating must become a priority of medical schools and a signal for effective prevention and intervention. The recommendation is to ensure supportive environments, provide easy access to effective care, and hold clear expectations for student eating behavior.

Examining the reliability and validity of the arabic version of the Glasgow Sleep Effort Scale (GSES).

BACKGROUND: Sleep effort refers to the cognitive and behavioral exertion involved in initiating and maintaining sleep. High sleep effort is increasingly recognized as perpetuating insomnia and poor sleep quality. Validated sleep effort scales enable the quantification of this construct in clinical and research settings. However, no Arabic version has been available. This study translated and validated the Glasgow Sleep Effort Scale (GSES) into Arabic to assess sleep effort in Arabic-speaking populations. METHOD: The GSES was translated into Arabic using the forward-backward translation approach. This involved an initial Arabic translation from the source followed by a back translation into English to ensure accuracy. A total of 369 participants were recruited to assess the psychometric properties of the Arabic version of the GSES, specifically its reliability and validity. The reliability analysis included Cronbach's α, McDonald's ω, and test-retest reliability. Validity was examined using confirmatory factor analysis (CFA) to evaluate the unidimensionality of the scale and assess model fit. Convergent validity was also assessed through correlation analysis with the Athens Insomnia Scale (AIS) and the Generalized Anxiety Disorder-7 Scale (GAD-7). RESULTS: The Cronbach's α reliability coefficient and McDonald's ω for the scale were found to be 0.87 (95% CI: 0.85-0.89). The test-retest reliability was 0.95 (95% CI: 0.93 - 0.97) after two weeks. The one-factor model showed an acceptable fit, with a CFI of 0.96, a TLI of 0.94, and an SRMR of 0.04. Invariance analysis revealed that male and female participants conceptualized and responded to the GSES items similarly, without differences in factor loadings or scale characteristics between the sexes. The Arabic version of the GSES has good convergent validity, as shown by the significant correlation between the AIS and the GSES (r = 0.72, p < 0.001). Similarly, the GAD-7 score was significantly correlated with the GSES score (r = 0.77, p < 0.001). CONCLUSION: This is the first study in which the GSES was validated in Arabic. This allows the scale to reliably gauge sleep effort among Arabic speakers, providing new clinical and research opportunities to understand how maladaptive sleep effort may contribute to insomnia and suboptimal sleep in this demographic population.

Development and Validation of a Food Frequency Questionnaire for Evaluating the Nutritional Status of Patients with Serious Mental Illnesses (DIETQ-SMI) in Bahrain.

General food frequency questionnaires (FFQs) have not been tailored for or validated in individuals with psychiatric disorders. Given the unique eating behaviors of patients with serious mental illnesses (SMIs), custom-made tools are needed. Therefore, we developed and validated an FFQ customized to individuals with SMIs. A total of 150 adults with SMIs (schizophrenia, bipolar disorder, or major depression) were recruited from Bahrain. The participants completed the 50-item Dietary Intake Evaluation Questionnaire for Serious Mental Illness (DIETQ-SMI) FFQ and a 3-day food record (FR). The validity of the FFQ was assessed by comparing nutrient intake to FR intake using correlation and reliability statistics. The DIETQ-SMI demonstrated a good ranking validity compared to the FR based on correlation coefficients (rho 0.33 to 0.92) for energy and macro- and micronutrients. The FFQ had high internal consistency (McDonald's omega = 0.84; Cronbach's alpha = 0.91) and test-retest reliability (ICC > 0.90). The FFQ tended to estimate higher absolute intakes than the FR but adequately ranked the intakes. The FFQ value was correlated with the FR for all the items (p < 0.001). The DIETQ-SMI is a valid and reliable FFQ for ranking dietary intake in individuals with an SMI. It can help assess nutritional status and, subsequently, guide interventions in high-risk psychiatric populations.

The Translation and Preliminary Psychometric Validation of the Ghosting Questionnaire in Urdu.

BACKGROUND: "Ghosting" refers to the practice of abruptly cutting off all contact with a person with whom you have been in constant correspondence. The break comes without warning and without understandable provocation. The term most commonly applies to online romantic relationships. The motives for and effects of ghosting have been studied, and validated research questionnaires have been developed; however, there are no such questionnaires available for Urdu speakers. The purpose of this study was to adapt the "Ghosting Questionnaire (GQ)" for use in Pakistan and India, two of the world's most populous countries-a process that involves translation, adaptation, and validation. METHODS: The study's methodology involved translating the GQ into Urdu using both forward and backward translation techniques. Convergent validity, test-retest reliability, internal consistency, confirmatory factor analysis, and goodness of fit were all components of the psychometric analyses. CONCLUSIONS: The Urdu version of the GQ demonstrated a good internal consistency, with the Cronbach's alpha and McDonald's omega both exceeding 0.90. It also showed a high test-retest reliability-(0.96). The one-factor structure was confirmed by the confirmatory factor analysis, which agreed with the original English version of the GQ.

An umbrella review and meta-analysis of meta-analyses of the impact of Ramadan fasting on the metabolic syndrome components.

CONTEXT: Ramadan is a holy month of fasting, spiritual reflection, and worship for Muslims worldwide. However, the Ramadan fast - which involves abstaining from all food and drink, sunrise to sunset for 29 days-30 days annually - may also influence physical health outcomes, especially relating to the risk of metabolic syndrome. OBJECTIVE: The literature from the top of the pyramid of evidence was gathered and synthesized for this comprehensive umbrella review and meta-analysis of meta-analyses in order to provide an overall conclusion on the impact of Ramadan fasting with regard to metabolic syndrome components. DATA EXTRACTION: Eleven systematic reviews and meta-analyses were included in the current umbrella review. Nine components, including waist circumference, body weight), high-density lipoprotein, low-density lipoprotein, total cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure), and fasting blood plasma glucose were analyzed. DATA ANALYSIS: The random-effects meta-analysis results revealed standard mean differences as follows: waist circumference -0.30 (95% confidence interval [CI] -0.33 to -0.27), body weight -0.34 (95% CI -0.39 to -0.29), high-density lipoprotein 0.20 (95% CI 0.10 to 0.30), low-density lipoprotein -0.10 (95% CI -0.13 to -0.07), total cholesterol -0.15 (95% CI -0.21 to -0.09), triglycerides -0.16 (95% CI -0.24 to -0.08), systolic blood pressure -0.20 (95% CI -0.23 to -0.17), diastolic blood pressure -0.20 (95% CI -0.22 to -0.18), fasting blood plasma glucose -0.10 (95% CI -0.12 to -0.08). CONCLUSION: Ramadan fasting appears to benefit body weight, lipid profile, blood pressure, and fasting blood glucose levels. Therefore, engaging in fasting during Ramadan may contribute to weight reduction, decreased cardiovascular disease risk, improved blood pressure, and enhanced glycemic control. Nevertheless, the methodological quality of the included reviews ranged from low to critically low, necessitating cautious interpretation of conclusions drawn from these data. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework Identifier: DOI 10.17605/OSF.IO/9WVJZ.

Evaluating the reliability of the athlete sleep behavior questionnaire (ASBQ): a meta-analysis of Cronbach's alpha and intraclass correlation coefficient.

BACKGROUND: The Athlete Sleep Behavior Questionnaire (ASBQ) was designed to identify maladaptive sleep practices among athletes. The aim of this meta-analysis was to evaluate the internal consistency and the test-retest reliability coefficients of the ASBQ. METHODS: A systematic search across 10 databases from inception of the ASBQ to August 2023 was performed. Publications that reported estimates of internal consistency and/or test-retest reliability of the ASBQ were included. A random-effects model was employed to estimate the overall reliability measures of the ASBQ. RESULTS: Meta-analytic results demonstrated a good level of internal consistency within the ASBQ, evidenced by a Cronbach's alpha of 0.73 (95% CI: 0.63 to 0.80). This suggests a modest correlation among the questionnaire items, supporting its reliability as an effective measure of sleep behavior. In terms of test-retest reliability, our meta-analysis revealed a very good degree of consistency (ICC = 0.88; 95% CI: 0.87 to 0.89), suggesting that the ASBQ can serve as an instrument for monitoring and evaluating changes in athletes' sleep behavior over time. No evidence of publication bias was identified. CONCLUSION: While the ASBQ demonstrates a moderate level of internal consistency, its test-retest reliability suggests that it can serve as an instrument for longitudinal assessments of athletes' sleep behavior. Future studies focusing on refining the ASBQ to optimize its internal consistency and validate its applicability across diverse athletic populations are warranted.

Reliability generalization meta-analysis of the Athens Insomnia Scale and its translations: Examining internal consistency and test-retest validity.

The Athens Insomnia Scale (AIS) is a widely used self-report measure to evaluate insomnia symptoms based on the International Classification of Diseases criteria version 10 (ICD-10). Despite its extensive use in clinical and research settings, the reliability of the AIS has not been systematically investigated. This systematic review reports a reliability generalization meta-analysis study to assess the internal consistency and the test-retest reliability of the AIS across various populations and settings. A systematic literature search was conducted to identify studies reporting Cronbach's alpha and test-retest coefficients for the AIS. Pooled estimates of reliability, along with moderator analyses, were calculated. The AIS has an excellent internal consistency of 0.84 (95% CI: 0.81 to 0.86), and re-test reliability of 0.86 (95% CI: 0.80 to 0.92). The significant heterogeneity levels support the recommendation that future studies using the AIS include and discuss reliability estimates based on their own data.

Translating and validating the hoarding rating scale-self report into Arabic.

BACKGROUND: Hoarding disorder is characterized by a persistent inability to part with possessions due to a perceived need to keep them, regardless of their actual value. Arabic-speaking populations currently lack a validated tool specifically designed to assess hoarding symptoms. OBJECTIVE: This study aimed to translate, adapt, and validate the Hoarding Rating Scale-Self Report (HRS-SR) into the Arabic-language. METHODS: The study employed the gold standard approach to translation, involving forward translation by independent translators and back translation review. We conducted a cross-sectional study using an online survey completed by 500 participants from four Arabic-speaking countries. Psychometric analyses included internal consistency, test-retest reliability, convergent validity against generalized anxiety disorder (GAD-7), and confirmatory factor analysis. RESULTS: With a McDonald's omega and Cronbach's alpha of approximately 0.80, the Arabic translation of the HRS-SR showed acceptable test-retest reliability as well as good internal consistency. The survey also showed strong convergent validity with the 7-item survey for GAD-7. Confirmatory factor analysis supported a one-factor structure, confirming that each item measured the same construct. CONCLUSION: The HRS-SR is a trustworthy and valid tool for evaluating hoarding symptoms in Arabic-speaking people. This survey could be helpful for both clinical and academic research. Future research should examine cultural variations in hoarding behavior in Arabic-speaking populations and validate the questionnaire in clinical populations.

The worldwide prevalence of self-reported psychological and behavioral symptoms in medical students: An umbrella review and meta-analysis of meta-analyses.

OBJECTIVE: Medical students frequently experience a range of stressors, such as demanding academic requirements, competition and rivalry, self-doubt, and financial distress. As a result, they are at risk for psychological and behavioral symptoms (PBS) including: depression, anxiety, and sleep difficulties as well as maladaptive substance use. METHODS: To determine the degree of risk for these symptoms, 13 databases, without language restriction., were searched. RESULTS: A total of 32 meta-analyses were included in this umbrella review. A global analysis of all self-reported PBS combined yielded a pooled prevalence rate of 30.3% [26.9%; 33.7%]; 95% PI [2.2%; 58.3%]. The highest reported prevalence was for sleep problems 42.0% [35.6%; 48.4%], followed by stress 41.7% [35.3%; 48.1%], burnout 35.8% [25.7%; 45.8%], anxiety 32.5% [27.9%; 37.1%], depression 32.5% [28.8%; 36.1%], internet addiction 26.0% [5.5%; 46.5%], substance use 25.2% [18.9%; 31.6%], eating disorders 9.8% [1.1%; 18.4%], and suicidal thoughts/gestures/acts 8.9% [4.8%; 12.9%]. The prevalence estimates were deemed acceptable for all PBS. CONCLUSION: The evidence shows that fully one-third of medical students experience a range of problematic PBS, likely attributable to the demanding and intense study environment, the hierarchical structure of medical training facilities, and the vulnerability of the young adulthood time period. Appropriately targeted assessment and intervention efforts are clearly warranted to decrease the psychological burden of medical student training. PROSPERO Identifier: CRD42023391800. Open Science Network (OSF) Identifier: DOI 10.17605/OSF.IO/SXQYN.

Development and validation of a questionnaire (GHOST) to assess sudden, unexplained communication exclusion or "ghosting".

The topic of "ghosting" as a method of terminating a relationship has been discussed in both popular media and academic circles. Although research on this issue is scarce, the concept has acquired popularity and gained scholarly attention. A reliable and valid measure of this phenomenon does not, however, exist. GHOST (The Ghosting Questionnaire) was designed and psychometrically tested to explore ghostee experiences. A total of 811 adults participated in an online survey to test this instrument. It was developed based on a thorough analysis of research on the topic of ghosting using a phenomenological qualitative method to identify ghosting domains and generate questionnaire items. In terms of content validity and construct validity, the final version of the measure was found to be satisfactory. GHOST was found to have adequate internal consistency - scores of 0.74, 0.74, and 0.80, indicating acceptable Cronbach's alpha, McDonald's omega, and ordinal's alpha coefficients, respectively. Factor analyses found the GHOST questionnaire to be a valid and reliable instrument that can be used for screening ghosting experiences and for designing community-based distress prevention and intervention programs. A dynamic fit index (DFI) cutoffs approach was also used and showed robust fitting.

Internal consistency and structural validity of the nomophobia questionnaire (NMP-Q) and its translations: A systematic review with meta-analysis.

Background: A psychological condition known as NOMOPHOBIA causes individuals to fear losing ability to use or reach their mobile phones. The NMP-Q (nomophobia questionnaire) is a commonly used survey for assessing symptoms related to nomophobia. Materials and methods: We performed a meta-analysis using reliability generalization (RG) on the NMP-Q. Thirteen studies involving 15,929 participants have reported original reliability estimates of the NMP-Q determined through a comprehensive and methodical examination of the available literature. Results: For the total scores, the pooled internal consistency reliability was 0.93 [0.91; 0.95] and for the subscales it ranged from 0.83 to 0.91. Specifically, 0.91 [0.88; 0.93], 0.84 [0.80; 0.88], 0.83 [0.78; 0.88, and 0.83 [0.80; 0.85] for the subscales. Subscale 1 = not being able to communicate; subscale 2 = losing connectedness; subscale 3 = not being able to access information; and subscale 4 = giving up convenience", respectively. All reported effect sizes are Cronbach's alphas. Structural validity supported a solution of four-factors. Conclusions: NMP-Q has an excellent internal consistency. Structural validity of four factors appears to be vigorous in fitting NMP-Q items. Our recommendation is to require future studies using NMP-Q to provide a reliability estimate based on their own data.

The impact of Ramadan fasting on the metabolic syndrome severity in relation to ethnicity and sex: Results of a systematic review and meta-analysis.

AIMS: The primary goal of this meta-analysis was to examine the changes in various components of metabolic syndrome (MetS) in healthy adults who observed Ramadan fasting (RF) before Ramadan (T1) and at the end of RF (T2). A secondary goal was to assess the impact of RF on MetS severity in various ethnic and sex groups using the MetS z-score. DATA SYNTHESIS: Using PRISMA2020, seven databases were searched for relevant studies published between January 1950 and March 2022. Data extraction involved high-density lipoprotein cholesterol (HDL), triglycerides (TG), fasting blood glucose (FBG), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) for T1 and T2, respectively. The MetS z-score was computed according to international diabetes federation criteria. At T1, the pooled estimates of HDL, TG, FBG, WC, SBP, DBP, and MAP were 1.20 [1.13; 1.27] mmol/L, 1.32 [1.23; 1.42] mmol/L, 4.98 [4.82; 5.15] mmol/L, 87.21 [84.21; 90.21] Cm, 114.22 [101.45; 126.99] mmHg, 76.80 [70.12; 83.47] mmHg, and 89.27 [80.56; 97.98] mmHg, respectively. At T2, the pooled estimates of HDL, TG, FBG, WC, SBP, DBP, and MAP were 1.24 [1.18; 1.31] mmol/L, 1.24 [1.14; 1.34] mmol/L, 4.77 [4.55; 4.99] mmol/L, 85.73 [82.83; 88.64] Cm, 109.48 [97.20; 121.75] mmHg, 74.43 [68.01; 80.85] mmHg, and 86.11 [77.74; 94.48] mmHg, respectively. The MetS z-score showed improvement at T2 for all ethnic groups and both sexes by -0.22 [-0.24; -0.01]. CONCLUSIONS: The current meta-analysis suggests that the RF positively impact the MetS components and the overall MetS z-score. PROSPERO REGISTRATION NUMBER: ID CRD42022329297 OPEN SCIENCE FRAMEWORK IDENTIFIER: DOI 10.17605/OSF.IO/U9H7T.

A Social Media Outage Was Associated with a Surge in Nomophobia, and the Magnitude of Change in Nomophobia during the Outage Was Associated with Baseline Insomnia.

We examined the immediate impact of a social media outage on nomophobia and associated symptoms using a longitudinal cohort design. Data were collected at two timepoints, baseline (T1) and during the social media outage of 4 October 2021 (T2). T1 was collected in August-September 2021 as part of the baseline of an ongoing study. The nomophobia questionnaire (NMP-Q), Generalized Anxiety Disorder-7 scale (GAD-7), and Athens insomnia scale (AIS) were administered to 2706 healthy participants from the general Bahraini population (56% females, mean age 33.57 ± 11.65 years). Approximately one month later, during the social media outage, 306 of the study participants were opportunistically assessed using the NMP-Q. At baseline, we found that nomophobia levels strongly correlated positively with both insomnia (p = 0.001) and anxiety symptoms (p = 0.001). This is the first report to examine the impact of a social media outage on nomophobia. Our findings indicate that symptoms of nomophobia increased significantly during a social media outage. Baseline insomnia scores predicted a surge in the global scores of nomophobia symptoms during a social media outage.

Sleep Quality Worsens While Perceived Stress Improves in Healthcare Workers over Two Years during the COVID-19 Pandemic: Results of a Longitudinal Study.

The purpose of the study was to measure changes in sleep quality and perceived stress and their interrelationships in a sample of healthcare workers two years post the COVID-19 pandemic. Using a cohort design, data were collected from frontline healthcare workers (FLHCW, n = 70) and non-frontline healthcare workers (NFLHCW, n = 74) in April 2020 (T1) and in February 2022 (T2). The Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS-10) were administered at both time points. There were no differences in sleep quality or perceived stress between FLHCW and NFLHCW at either timepoint. For the entire sample, the PSQI scores at T2 were significantly higher than at T1 (7.56 ± 3.26 and 7.25 ± 3.29, respectively) (p = 0.03, Cohen's d = 0.18). PSS-10 scores at T2 were significantly lower than at T1 (19.85 ± 7.73 and 21.13 ± 7.41, respectively) (p = 0.001, Cohen's d = 0.78). Baseline sleep quality PSQI (T1) was a significant predictor for changes in sleep quality. During the initial months of the outbreak of the COVID-19 pandemic, poor sleep quality and perceived stress were common for healthcare workers. Two years into the pandemic, the perceived stress was reduced, but sleep quality worsened.

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.

The prevalence and risk factors of screen-based disordered eating among university students: a global systematic review, meta-analysis, and meta-regression.

PURPOSE: The purpose of this review was to estimate the prevalence of screen-based disordered eating (SBDE) and several potential risk factors in university undergraduate students around the world. METHODS: An electronic search of nine data bases was conducted from the inception of the databases until 1st October 2021. Disordered eating was defined as the percentage of students scoring at or above established cut-offs on validated screening measures. Global data were also analyzed by country, research measure, and culture. Other confounders in this review were age, BMI, and sex. RESULTS: Using random-effects meta-analysis, the mean estimate of the distribution of effects for the prevalence of SBDE among university students (K = 105, N = 145,629) was [95% CI] = 19.7% [17.9%; 21.6%], I2 = 98.2%, Cochran's Q p value = 0.001. Bayesian meta-analysis produced an estimate of 0.24, 95% credible intervals [0.20, 0.30], τ = 92%. Whether the country in which the students were studying was Western or non-Western did not moderate these effects, but as either the mean BMI of the sample or the percentage of the sample that was female increased, the prevalence of SBDE increased. CONCLUSIONS: These findings support previous studies indicating that many undergraduate students are struggling with disordered eating or a diagnosable eating disorder, but are neither receiver effective prevention nor accessing accurate diagnosis and available treatment. It is particularly important to develop ever more valid ways of identifying students with high levels of disordered eating and offering them original or culturally appropriate and effective prevention or early treatment. LEVEL OF EVIDENCE: I, systematic review and meta-analysis.

Sleep dissatisfaction is a potential marker for nomophobia in adults.

INTRODUCTION: NOMOPHOBIA is a term used to describe an anxiety disorder in which people fear being disconnected from their mobile phones. Strong associations between nomophobia and insomnia have previously been documented. However, there is no clear explanation for this relationship between the two disorders. The present study was designed to first determine the diagnostic precision of the Insomnia Severity Index (ISI) various components in detecting or classifying nomophobia; and second, examine the diagnostic performance of the identified ISI components in classifying nomophobia. METHODS: From a previous study 549 participants completed demographic information, the Nomophobia Questionnaire (NMP-Q), and the ISI. The sample was divided into two parts so that each part represented the original sample, using a 40% (n = 209) allocation for sample 1 and 60% (n = 340) for sample 2. To determine common components between nomophobia and insomnia, an exploratory factor analysis was performed using sample 1 to determine the diagnostic precision of the ISI's various components in detecting or classifying nomophobia. A test of the ISI and a cut-off value (ISI-4 ≥2) was then conducted on Sample 2 to determine whether they would accurately identify significant nomophobia. RESULTS: Sleep dissatisfaction was a common component of insomnia and nomophobia. Sleep dissatisfaction had excellent diagnostic accuracy in detecting individuals with nomophobia (sensitivity 75.13%, specificity 100%, Youden' index 0.75, area under curve 0.88). CONCLUSION: Questioning patients sleep dissatisfaction may serve as a marker for both nomophobia and insomnia, both of which may demand more comprehensive evaluation.

Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression.

This systematic review and meta-analysis evaluated the extent of sleep disturbances during the COVID-19 pandemic. Eleven databases and six preprint repositories were searched for the period from November 1, 2019, to July 15, 2021. The DerSimonian and Laird method was used to develop random-effect meta-analyses. Two hundred and fifty studies comprising 493,475 participants from 49 countries were included. During COVID-19, the estimated global prevalence of sleep disturbances was 40.49% [37.56; 43.48%]. Bayesian meta-analysis revealed an odds of 0.68 [0.59; 0.77] which translates to a rate of approximately 41%. This provides reassurance that the estimated rate using classical meta-analysis is robust. Six major populations were identified; the estimated prevalence of sleep problem was 52.39% [41.69; 62.88%] among patients infected with COVID-19, 45.96% [36.90; 55.30%] among children and adolescents, 42.47% [37.95; 47.12%] among healthcare workers, 41.50% [32.98; 50.56%] among special populations with healthcare needs, 41.16% [28.76; 54.79%] among university students, and 36.73% [32.32; 41.38%] among the general population. Sleep disturbances were higher during lockdown compared to no lockdown, 42.49% versus 37.97%. Four in every ten individuals reported a sleep problem during the COVID-19 pandemic. Patients infected with the disease, children, and adolescents appeared to be the most affected groups.

Eight-week high-intensity interval training is associated with improved sleep quality and cardiorespiratory fitness in patients with depressive disorders.

PURPOSE: This study aimed to examine the effect of high-intensity interval training (HIIT) on both sleep and cardiorespiratory fitness in patients with depression. METHODS: Using a single pre- and post-test study design with no control group, 82 patients diagnosed with depressive disorders underwent HIIT comprising a total of 24 15-min sessions, three times per week for 8 weeks. Depressive symptoms, sleep quality, and cardiorespiratory fitness were evaluated using the Beck depression inventory-II, the Pittsburgh sleep quality index (PSQI), and cardiopulmonary exercise testing (CPET) in the form of maximum oxygen uptake (VO2 max), respectively. RESULTS: All 82 patients completed the intervention. HIIT training was associated with significant improvements in BDI-II score (diff = - 1.57 [95% CI - 2.40 to - 0.73], P = 0.001), PSQI score (diff = - 1.20 [95% CI - 2.10 to - 0.32], P = 0.008), and CPET VO2 max (diff = 0.95 [95% CI 0.62-1.28], P = 0.001). Effect size calculations revealed that the greatest improvement occurred in CPET VO2 max (Cohen's d = 0.64) and that improvements in the BDI-II and PSQI scores were somewhat smaller in magnitude (Cohen's d = - 0.41 and - 0.30, respectively). Sleep quality improvements were observed in sleep latency, habitual sleep efficiency, and the use of sleep-promoting medications (Cohen's d = 0.18, 0.19, and 0.25, respectively). Change in cardiorespiratory fitness successfully predicted change in sleep quality but not in depressive symptoms. Adverse effects were limited to minor injuries which did not interfere with completion of training. CONCLUSIONS: HIIT training delivered over 8 weeks was associated with improvements in depression symptoms, sleep quality, and cardiorespiratory fitness in patients with depressive disorders.