Exploring the Mediating Role of Sleep Deficit-Related Functional Status in Subacute Stroke Survivors.

Background: Understanding post-stroke fatigue (PSF) and its associated factors is crucial for effective therapy and rehabilitation. This study aimed to assess the mediating role of the excessive daytime sleepiness-related functional status (SFS) on the relationship between sleep and the severity of fatigue in subacute stroke survivors. Methods: Subacute stroke survivors (n = 50; male = 38; female = 12), completed a cross-sectional study involving the Pittsburgh sleep quality index (PSQI), the Epworth sleepiness scale (ESS), the insomnia severity index (ISI), the functional outcome of the sleep questionnaire (FOSQ), and the fatigue severity scale (FSS). Results: The SFS mediated the association between the severity of fatigue and sleep problems. The PSQI and FOSQ (b = -0.37, p < 0.001), and the FOSQ and FSS were correlated (b = -0.18, p < 0.05), with a significant indirect effect of the PSQI on the FSS. The ISI correlated with the FOSQ (b = -0.20, p < 0.001), with significant direct (b = 0.15, p < 0.001), as well as indirect, effects of the ISI on the FSS. The ESS correlated with the FOSQ (b = -0.23, p < 0.001), with a significant indirect effect of the ESS on the FSS. Conclusions: In subacute stroke survivors, fatigue and sleep are linked. Increased understanding of sleep-PSF may help in exploring new targets for supplement therapy.

The utility of proinflammatory markers in patients with obstructive sleep apnea.

PURPOSE: To evaluate the association of recently diagnosed obstructive sleep apnea (OSA) with TNF-α and IL-6 and to measure the effect of short-term continuous positive airway pressure (CPAP) therapy on these markers. METHODS: A prospective, open-label, controlled trial was conducted among patients referred for diagnostic polysomnography (PSG). After PSG, patients were divided into 3 groups: OSA intervention group (N = 21), OSA control untreated group (N = 19), and non-OSA control group (N = 24). IL-6 and TNF-α levels were measured at baseline and 1 month after intervention. Repeated measures (RM) ANOVA and ANCOVA were used to compare the three groups regarding changes in TNF-α and IL-6 levels by analyzing between-subject and within-subject effects as a function of time and adjusting for significant covariates. RESULTS: At baseline, IL-6 (p = 0.05) and TNF-α (p = 0.04) were significantly higher in the OSA patients than in the non-OSA controls. There was no effect of time either on the TNF-α (p = 0.069) or IL-6 (p = 0.717) after 1 month of CPAP. No interaction effect between group and time was found for either TNF-α (p = 0.240) or IL-6 (p = 0.552) after 1 month of CPAP. There was neither a group effect nor an interaction effect between group and time for either IL-6 or TNF α after adjusting for age, BMI, neck circumference, and AHI. CONCLUSION: This study showed increases in proinflammatory state as illustrated by plasma TNF-α and IL-6 levels among recently diagnosed OSA patients, but there were no changes in these inflammatory markers following 1-month CPAP therapy.

Loneliness may mediate the relationship between depression and the quality of life among elderly with mild cognitive impairment.

BACKGROUND: Depression and mild cognitive impairment (MCI) are often comorbid mental health issues in older adults. The current study explored the prospective mediating role of loneliness in the relationship between depression and the quality of life in elderly with MCI. A second aim was to examine differences in depression, loneliness, and the quality of life in the elderly with MCI among gender groups, and type of residence groups. METHODS: A cross-sectional survey with purposive sampling was used. Older adults with MCI (N = 170) from old age homes in Lahore and Rawalpindi (n = 82) and family residences in Sargodha (n = 88) in Pakistan completed UCLA Loneliness Scale, Depression Anxiety Stress Scale, and Mild Cognitive Impairment Scale. RESULTS: Most of the participants had severe to extreme depression (98.2%), and moderate to moderately high levels of loneliness (85.3%). Depression was significantly associated with loneliness (b = 0.29, P < 0.05) and poor quality of life in MCI (b = 0.49, P < 0.001). The indirect effect of depression on the quality of life in MCI through loneliness was significant (95% confidence interval (CI) [0.002, 0.156]). However, the indirect effect of quality of life in MCI on depression through loneliness was not significant (95% CI [-0.001, 0.043]). The elderly with MCI living in old age homes had higher depression, loneliness, and poor quality of life. Elderly women had higher levels of depression and poor quality of life, whereas older men were lonelier. CONCLUSION: The relationship between depression and quality of life in the elderly with MCI may be bidirectional, and loneliness partially mediates only one of these relationships.

Migraine screen questionnaire: further psychometric evidence from categorical data methods.

BACKGROUND: Psychometric investigations of tools used in the screening of migraine including the migraine screen questionnaire (MS-Q), using an adequate statistical approach is needed. We assessed the psychometric properties of the migraine screen questionnaire (MS-Q) using categorical data methods. MATERIAL AND METHODS: A total of 343 students at Mizan-Tepi University, Ethiopia, age range = 18-35 years were selected by a simple random sampling method to participate in a cross-sectional study. The respondents completed the MS-Q, a semi-structured socio-demographic questionnaire, and a visual analog scale for attention (VAS-A). RESULTS: The cumulative variance rule (> 40%), the Kaiser's criteria (Eigenvalue> 1), the Scree test and, the parallel analysis (minimum rank) identified a 1-factor model for the MS-Q with the factor loadings in the range of 0.78 to 0.84. Fit indices favored a 1-factor model of the MS-Q as indicated by comparative fit index (0.993), weighted root mean square residual (0.048), root mean square error of approximation (0.067), the goodness of fit index (1.00), and non-normed fit index (0.987). The values of the Factor Determinacy Index (0.953), marginal reliability (0.909), H-latent (0.909), H-observed (0.727), explained common variance (0.906) and the mean item residual absolute loadings (0.225) further complimented finding of the 1-Factor model. McDonald's Omega (0.903) suggested adequate internal consistency. Discriminative validity was supported by significantly higher scores for the total and all the MS-Q items except one among those with complaints of attention. CONCLUSION: The categorical methods support the psychometric validity of the MS-Q in the study population.

Prevalence of poor sleep quality in the Ethiopian population: a systematic review and meta-analysis.

BACKGROUND: Only a limited amount of data is available from lower-income countries regarding the prevalence of poor quality of sleep. This meta-analysis of the scientific literature was performed to estimate the pooled prevalence of poor sleep quality in the Ethiopian population. METHODS: The study protocol followed was the Preferred Reporting of Items for Systematic Review and meta-analysis (PRISMA) statement. RESULTS: The nine studies which met the inclusion criteria provided data based on a total of 9103 participants who were studied at various health and academic institutions. The incidences of self-reported poor sleep quality ranged from 26 to 66.2%. The pooled estimate of poor sleep quality was 53%.There was a high prevalence of reported poor quality of sleep among younger subjects and among those who were studied in community (noninstitutional) settings. CONCLUSION: The pooled prevalence of poor sleep quality is quite high among Ethiopians.

Psychometric properties of the Insomnia Severity Index in Ethiopian adults with substance use problems.

This study investigated the psychometric properties of the Insomnia Severity Index (ISI) in substance-using Ethiopian adults. A simple random sampling of houses and a purposive sampling selection was performed in Mizan city, Ethiopia (n = 406). Participants completed the ISI and a meta-cognition questionnaire and sociodemographic information. IBM SPSS software with Amos was used for data analysis. There was no major ceiling or floor effect in the ISI scores. The internal consistency (Cronbach's alpha = 0.68 and 0.78) and internal homogeneity (moderate to strong item-total ISI score correlations; r ≥ 0.47) were adequate. All of the ISI (item as well as total) scores correlated with the meta-cognition total scores (r = 0.16-0.44; p < .01). The exploratory factor analysis results were heterogeneous. However, the confirmatory factor analysis favored a 2-factor model. The ISI has good psychometric validity among Ethiopian adults with substance use.

Psychometric properties of the Epworth sleepiness scale in Ethiopian university students.

BACKGROUND: Daytime sleepiness is highly prevalent across the globe. The Epworth sleepiness scale (ESS) is the most widely used tool for screening daytime sleepiness. The psychometric properties of the ESS have not been comprehensively examined in African populations. MATERIAL AND METHODS: A cross-sectional design with simple random sampling was used in the present study. The study recruited 600 students from Mizan-Tepi University, Ethiopia, of which 329 (age = 18-28 years and body mass index = 21.19 ± 3.17 kg/m2) completed the study. ESS, a semi-structured socio-demographics questionnaire and a clinical interview to diagnose insomnia according to the International Classification of Sleep Disorders were employed. RESULTS: All except one item of the ESS showed a floor effect, while only one item score showed ceiling effect. However, no ceiling/floor effect was observed in the ESS total score. The Cronbach's alpha (0.75) and composite reliability (0.75), indicated good internal consistency, while a moderate item-total score correlation (r = 0.55-0.67) implied favorable internal homogeneity. The known-group validity was established by significantly higher scores for all the ESS item scores and the ESS total scores among those with symptoms of insomnia than among non-symptomatic students. Fit indices along with the consideration of inter-factor correlation coefficient, measures of item retention favored the unidimensional structure of the ESS. CONCLUSION: The ESS has excellent psychometric validity for screening daytime sleepiness in Ethiopian university students.

Insomnia severity index: a psychometric investigation among Saudi nurses.

BACKGROUND: Insomnia is the most prevalent sleep disorder, but it is widely untreated and under-diagnosed in Saudi Arabia. Moreover, no tool to screen insomnia has been validated in the Saudi population in general or nurses in particular. This study, therefore, assessed the psychometric validity of the Insomnia Severity Index (ISI) in Saudi nurses. METHODS: A cross-sectional study with purposive sampling was performed with nurses (n = 134, age = 21-48 years) from Al Majmaah, Saudi Arabia. Both conventional and online survey methods using the ISI, a brief measure of metacognition, and a socio-demographics questionnaire were employed. RESULTS: No ceiling or floor effects were found in the ISI total score (8.84 ± 5.07) or the factor scores, but the floor effect was found in the item scores. A two-factor model showed the best fit (Pclose .97, comparative fit index [CFI] 1.00, root mean square error of approximation [RMSEA] 0.00, non-significant χ2test, χ2/df 0.904). This model showed favorable configural, metric, scalar, and partial strict invariance across gender groups (CFI > .95, RMSEA < .05, χ2/df < 3, non-significant Δχ2, ΔCFI ≤ .01). The internal consistency was adequate (Cronbach's alpha = 0.75, 0.78 for the two factors of the ISI). The lack of correlations between the ISI scores and the scores of the brief measure of the metacognition favored its divergent validity. CONCLUSION: The ISI showed adequate psychometric validity for screening insomnia among Saudi nurses.

Psychometric properties of the perceived stress scale in Ethiopian university students.

BACKGROUND: Stress is a common psychological condition usually associated with many psycho-physical disorders. Stress and its risk factors are frequently seen in Ethiopians including university students. In such circumstances, a valid measure to screen for stress in Ethiopians is necessary. Therefore, we assessed the psychometric properties of the Perceived Stress Scale (PSS) in Ethiopian university students. METHODS: A cross-sectional study with a simple random sampling method was performed on students of Mizan-Tepi University, Mizan-Aman, Ethiopia. The study presents a psychometric investigation on a sample of 387 students (age = 21.8 ± 3.8 years, and body mass index = 20.8 ± 3.2 kg/m2) who completed PSS, Generalized anxiety disorder-7 scale (GAD-7), and a socio-demographics tool. McDonald's Omega (internal consistency), factor validity for ordinal data and convergent validity (Spearman's correlation) were assessed. RESULTS: No ceiling/floor effect was seen for the total or factor scores of the PSS-10 and PSS-4. Two factor model of the PSS-10 was favored by fit indices with Comparative Fit Index> 0.95, Weighted root mean square residual<.05 and root mean square error of approximation<.08. McDonald's Omega was 0.78 and 0.68 for the PSS-10: Factor-1 and PSS-10: Factor-2, respectively. McDonald's Omega was 0.70 and 0.54 for the PSS-4: Factor-1 and PSS-4: Factor-2, respectively. There were moderate-strong correlations (r = 0.62-0.83) between PSS factors and respective items loading on them. PSS scores were correlated with GAD-7 (r = .27-.40, p < .01). CONCLUSION: The psychometric measures support the validity of the PSS-10 in Ethiopian university students.

Validation of the adapted Leeds sleep evaluation questionnaire in Ethiopian university students.

BACKGROUND: Current evidence supports the applicability of the Leeds Sleep Evaluation Questionnaire (LSEQ) in screening for insomnia. The psychometric properties of the LSEQ have never been investigated in an African population. Therefore, this study aimed to validate the adapted version of the LSEQ-Mizan (LSEQ-M) in Ethiopian university students. METHODS: Of a preliminary sample of 750 (random sampling), 424 students (age = 21.87 ± 4.13 years and body mass index = 20.84 ± 3.18 kg/m2) from Mizan-Tepi University, Mizan-Aman, South-west Ethiopia completed the LSEQ-M, the General Anxiety Disorder Scale-7 and a semi-structured questionnaire for socio-demographics. Insomnia was screened in accordance with the International Classification of Sleep Disorders as a measure of concurrent validity. RESULTS: Although, individual items showed ceiling and floor effect, the LSEQ-M as a scale did not have these effects. Good internal consistency (Cronbach's alpha of 0.84) and strong internal homogeneity as measured by the correlation coefficient between items scores and the LSEQ-M global score was found. The LSEQ-M showed excellent screening applicability for insomnia with optimal cut-off scores of 52.6 (sensitivity 94%, specificity 80%), and the area under the curve, 0.95 (p < 0.0001). The original 4-Factor model was valid in Ethiopian university students for screening for insomnia. CONCLUSION: The LSEQ-M has excellent psychometric validity in screening for insomnia among Ethiopian university students.

Dimensionality of the Pittsburgh Sleep Quality Index: a systematic review.

BACKGROUND: The Pittsburgh Sleep Quality Index (PSQI) dimensionality is much debated, with the greatest number of reported factor structures. Therefore, this review appraised the methodologies of studies investigating the factor structure of the PSQI. MATERIAL AND METHODS: MEDLINE, PsycInfo, AJOL, BASE, Cochrane Library, Directory of Open Access Journals (Lund University), CINAHL, and Embase were searched systematically to include articles published till 23rd March, 2018. The articles with the objective of factor analysis of the PSQI (20 articles) or with a major section on the same subject (25 articles) were included. There was no limitation about participant characteristics. Descriptive analysis of articles for measures of the suitability of the data for factor analysis, details of the exploratory factor analysis (EFA) and details of the confirmatory factor analysis (CFA) was performed. RESULTS: The analysis used by the majority did not employ the simplest scheme for interpreting the observed data: the parsimony principle. Other shortcomings included under- or non-reporting of sample adequacy measures (11 out of 45 articles), non-use of EFA (20 out of 45 articles), use of EFA without relevant details, non-use of CFA (11 out of 45 articles), and use of CFA without relevant details. Overall, 31 out of 45 articles did not use either EFA or CFA. CONCLUSION: We conclude that the various PSQI factor structures for standard sleep assessment in research and clinical settings may need further validation. TRIAL REGISTRATION: Not applicable because this was a review of existing literature.

Psychometric properties of the severity of the dependence scale for Khat (SDS-Khat) in polysubstance users.

BACKGROUND: Current evidence suggests that the addiction on one substance may underpin or affect addiction on another in polysubstance users. However, there is no tool that has been shown to have psychometric validation for assessment of the severity of khat addiction in polysubstance users. METHODS: Polysubstance users with khat chewing habit (n = 178, age = 25.8 ± 3.6, BMI = 23.3 ± 2.8 kg/m2) were recruited from randomly selected houses for a cross-sectional study in Mizan, Ethiopia. The survey including severity of dependence scale for khat (SDS-khat), a brief metacognition questionnaire, and a semi-structured socio-demographics tool were administered by trained interviewers. RESULTS: There was no ceiling effect or floor effect in the SDS-Khat scores. Internal consistency was moderate (Cronbach's alpha = 0.58). Internal homogeneity was adequate (Item-total correlations of the SDS-Khat; r ≥ 0.55). Significant negative correlations between the SDS-Khat and the metacognition (r = -.19 to -.34, p < 0.05 or p < 0.01) indicated convergent validity. The findings of exploratory factor analysis were non-unanimous with a suggestion of two models, i.e., a 2-factor and a 1-factor model, while the confirmatory factor analysis favored 1-Factor model. CONCLUSION: The SDS-Khat has adequate psychometric validity for the assessment of psychological severity of khat addiction in the polysubstance users.

Validation of the Pittsburgh sleep quality index in community dwelling Ethiopian adults.

BACKGROUND: The applicability of the Pittsburgh Sleep Quality Index (PSQI) in screening of insomnia is demonstrated in various populations. But, the tool has not been validated in a sample of Ethiopians. Therefore, this study aimed to assess its psychometric properties in community dwelling Ethiopian adults. MATERIAL AND METHODS: Participants (n = 311, age = 25.5 ± 6.0 years and body mass index = 22.1 ± 2.3 kg/m2) from Mizan-Aman town, Southwest Ethiopia completed the PSQI and a semi-structured questionnaire for socio-demographics. Clinical interview for screening of insomnia according to the International Classification of Sleep Disorders was carried out as a concurrent validation measure. RESULTS: Overall, the PSQI scale did not have floor effect and ceiling effects. Moderate internal consistency (Cronbach's alpha was 0.59) and sufficient internal homogeneity as indicated by correlation coefficient between component scores and the global PSQI score was found. The PSQI was of good value for screening insomnia with optimal cut-off scores of 5.5 (sensitivity 82%, specificity 56.2%) and the area under the curve, 0.78 (p < 0.0001). The PSQI has unidimensional factor structure in the Ethiopian community adults for screening insomnia. CONCLUSION: The PSQI has good psychometric validity in screening for insomnia among Ethiopians adults.

Sleep correlates of substance use in community-dwelling Ethiopian adults.

PURPOSE: The relationship between sleep disturbances and substance use can have harmful effects. Evidence shows widespread use of substances, including khat, in the Ethiopian population. However, to the best of our knowledge, no study has investigated the sleep correlates of substance use in community-dwelling Ethiopian adults. MATERIALS AND METHODS: A cross-sectional study using simple random sampling was performed on community-dwelling adults (n = 371, age = 25.5 ± 5.7 years, body mass index = 22.0 ± 2.2 kg/m2) in Mizan-Aman, Ethiopia. Dichotomized sleep measures (sleep quality and sleep latency) assessed by the Pittsburgh Sleep Quality Index (PSQI) were used in association analysis using binary logistic regression with substance use (khat, smoking, and alcohol). RESULT: Sleep latency was associated with khat chewing (adjusted odds ratio (AOR) = 2.8, 95% confidence interval (CI) 1.7-4.4) and tobacco smoking (AOR = 2.1, 95% CI 1.4-3.0). Sleep quality was associated with khat chewing (AOR = 3.1, 95% CI 1.8-5.2), tobacco smoking (AOR = 1.7, 95% CI 1.2-2.5), and alcohol intake (AOR = 1.9, 95% CI 1.1-3.1). CONCLUSION: Sleep correlates of substance use were found in community-dwelling Ethiopians. These findings may aid in the development of targeted strategies to manage substance use-related sleep disturbances.

Association between sleep quality and inflammatory complement components in collegiate males.

BACKGROUND: An accumulating amount of evidence has linked humoral mediators of inflammation with sleep measures. Nevertheless, important details of this association, in particular the role of the complement components in the context of chronic sleep attributes, have remained largely uncharacterized. MATERIALS AND METHODS: Fifty university students (age, 23.3 ± 3.8 years; BMI, 23.7 ± 2.9 kg/m(2)) completed the study. Four dichotomized sleep measures assessed by the Pittsburgh Sleep Quality Index (PSQI) were used in association analysis using binary logistic regression with complement component 3, 4, and complement factor I (CFI). The sleep measures were defined as sleep quality (good sleep/poor sleep; PSQI ≤5/PSQI >5), bedtime (early/late; before 00:00 h/after 0:00 h), sleep duration (short/normal ≤6 h/>6 h), and sleep onset latency (normal/disturbed; 0-1 score/2-3 score on the PSQI component of sleep latency). RESULTS: The complement component 4 was associated with sleep quality (unadjusted, OR = 1.025, p < 0.05; adjusted for age, OR = 1.025, p < 0.05; adjusted for BMI, OR = 1.027, p < 0.05) and sleep duration (unadjusted, OR = 1.041, p < 0.01; adjusted for age, OR = 1.041, p < 0.01; adjusted for BMI, OR = 1.046, p < 0.01). CFI was associated with bedtime (unadjusted, OR = 0.737, p < 0.01; adjusted for age, OR = 0.717, p < 0.01; adjusted for BMI, OR = 0.677, p < 0.01) and with sleep duration (unadjusted, OR = 0.796, p < 0.05; adjusted for age, OR = 0.796, p < 0.05). CONCLUSION: The findings indicate the importance of the role of complement components in the dynamics of sleep. Therefore, sleep should be assessed in conditions where complement components are affected.

Effect of Mirror Therapy on Upper Limb Function in Children and Adolescents with Hemiplegic Cerebral Palsy: A Systematic Review and Meta-Analysis.

BACKGROUND: This review aimed to explore the effect of mirror therapy (MT) on upper limb function in children and adolescents with hemiplegic cerebral palsy (HCP). METHODS: MEDLINE, CENTRAL, Scopus, PEDro, and Web of Science were systematically searched. PEDro scale  was used for the quality assessment of included trials. Risk of Bias assessment was done using Cochrane Risk-of-bias tool version 2. Meta-analysis was performed on four of the seven studies included. RESULTS & CONCLUSION: The majority of the trials included in this review found MT efficacious in improving motor function in HCP. Quantitative analysis of the included trials using QUEST scores for evaluation of quality of upper extremity function revealed positive but non-significant difference between the groups (MD = -0.12; 95% CI = -2.57,2.33; Z = 0.09, p = .92). Pooled analysis of the included trials using BBT, however, favored control (MD = 4.98; 95% CI = 2.32,7.63; Z = 3.67, p = .0002).

Development and validation of a questionnaire about reasons for academic cheating by nursing students: A cross-sectional study.

Cheating behavior is spreading among nursing students worldwide, necessitating the development of a validated questionnaire evaluating the reasons for such behavior. Nursing students (N = 482) from 2 universities in Saudi Arabia participated in this observational study. A survey containing items on socio-demographics and the 33-item Reasons for Cheating Scale (RCS) was completed by the respondents. The RCS had a 1-factor structure; the model fit indices were similar between the 1-, 2-, and 3-factor models, but the inter-factor correlations were too high for the 2- and 3-factor models. The measures of the quality of the factor score estimates were as follows: factor determinacy index, 0.987; expected a posteriori marginal reliability, 0.974; sensitivity ratio, 6.178; and expected percentage of true differences, 97.3%. The measures of the closeness to unidimensionality for the overall RCS were as follows: unidimensional congruence, 0.957; explained common variance, 0.875; and mean item residual absolute loading, 0.223. The intraclass correlation coefficient and McDonald's omega were 0.96 (CI: 0.93-0.98) and 0.962 (95% CI: 0.958-0.967), respectively. The severity score, infit, and outfit ranged from -0.847 to -2.015, 0.813 to 1.742, and 0.837 to 1.661, respectively. For all RCS items, the thresholds ranked τi1 < τi2 < τi3 < τi4 and showed invariance between the sexes. The RCS showed robust psychometric validity for both classical and item response theory parameters. It also had excellent test-retest reliability, internal consistency, item discrimination, factorial validity, measurement invariance, and ordered threshold level for the responses. Therefore, the RCS is a valid and reliable tool for assessing cheating behavior among nursing students.

Prevalence of poor sleep quality among physicians and nurses in a tertiary health care center.

Objectives: Sleep quality among tertiary healthcare professionals in KSA has not been well studied. Therefore, in this study, we aimed to assess sleep quality among physicians and nurses in a tertiary care center in Jeddah City and to identify the associated factors. Methods: In this quantitative, analytical, cross-sectional study, an online, self-administered questionnaire was distributed to all physicians and nurses working at King Abdulaziz University Hospital (KAUH). A total of 395 healthcare professionals participated in this study. The questionnaire included the participants' demographic characteristics and Pittsburgh Sleep Quality Index (PSQI) values. Results: The mean age and body mass index of the participating healthcare professionals were 37.74 ± 10.35 years and 26.32 ± 4.97 kg/m2, respectively. Most participants were women (70.4%) and expatriates (55.4%). The prevalence of poor sleep quality was high: 70.4% of the participants had a PSQI score >5. Several factors, such as female sex (adjusted odds ratio (AOR) = 2.03; 95% confidence interval (CI) = 1.11-3.74), shift work (AOR = 1.87; 95% CI = 1.01-3.45), physical inactivity (AOR = 2.43; 95% CI = 1.01-5.85), and current smoking (AOR = 4.64; 95% CI = 1.68-12.80), were associated with poor sleep quality among healthcare professionals. Conclusions: Our findings are consistent with those from previous studies indicating high prevalence of poor sleep quality among healthcare professionals. Furthermore, female sex, shift work, smoking, and physical inactivity were identified as risk factors for poor sleep quality.

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.