A polysomnographic study of sleep disruptions in individuals with chronic neck pain.

Various lines of evidence suggest that a bidirectional relationship exists between poor sleep quality and chronic pain, with each condition tending to promote and exacerbate the other. This has led to the hypothesis that the two conditions may be linked by common underlying mechanisms. It has thus been suggested that inadequate sleep and chronic pain may share neurophysiological and molecular pathways that are similar or overlapping. Some studies based on self-report measures have tended to support the inference that chronic neck pain may promote sleep disturbance, but this association has not, until now, been investigated with quantitative measures. The present study is the first to evaluate the sleep quality of patients with chronic neck pain through the use of polysomnography. The study sought to identify the sleep characteristics of patients with chronic neck pain and then to determine whether these characteristics were associated with the severity of their neck pain. Laboratory testing with polysomnography was carried out on 32 males who had complaints of chronic neck pain and on 12 healthy participants who served as controls. Compared to the control subjects, patients with chronic neck pain were found to have significantly shorter times spent in sleep (p = 0.015), longer latencies to sleep onset (p = 0.015) and rapid eye movement (REM) sleep (p < 0.05), longer durations spent in Stage 1 (p < 0.05), and shorter durations spent in both Stage 2 (p = 0.001) and REM sleep (p = 0.00). The severity of discomfort was related negatively to the amount of time spent in REM sleep. The present study's quantitative measures corroborate the view that patients with chronic neck pain have poor sleep quality. These findings confirm long-held clinical observations that the sleep quality of patients with chronic neck pain is compromised, and that, in this clinical group, poor sleep is at least a correlate of and may be an amplifier of perceived pain.

Physical activity and sleep quality in relation to mental health among college students.

OBJECTIVE: To examine the associations and interactive effects of physical activity and sleep quality on mental health among Indian college students. METHOD: A cross-sectional study was conducted among Indian college students. The sociodemographic data and body mass index were obtained from a convenience sample of 617 college students, age range from 18 to 30 years, including both genders (314 men, 51%). All participants completed three questionnaires: the Hospital Anxiety and Depression Scale, the International Physical Activity Questionnaire-Short Form, and the Pittsburgh Sleep Quality Index. Questionnaires were evaluated to ascertain the subjects' mental health level, physical activity level, and sleep quality. Analyses were conducted with binary logistic regression models. RESULT: The mean (± S.D.) anxiety and depression scores were 9.3 ± 4.4 and 7.4 ± 2.5 respectively, with anxiety and depression scores ranging from 0 to 20 and 0-17, respectively. The prevalence of anxiety (30%) was more than that of depression (18%). Out of the total participants, 51% reported having low physical activity levels, and 51% had poor sleep quality. Odds ratio calculations indicated that the participants physical activity levels (moderate and high) were significantly and inversely associated with scores for anxiety (OR = 0.16 and 0.96; p = 0.001) and for depression (OR = 0.11 and 0.96; p = 0.001).The poor sleep quality was significantly positively associated with anxiety (OR = 1.38) and depression OR = 1.58 (p = 0.001). CONCLUSION: Mental health problems are common among both male and female college students. Significant associations were found between physical activity levels and sleep quality with mental health.

How We Do Harm: Do Copyrighted Scales Benefit Research in the Developing World?

One of the most difficult challenges in carrying out global health research in the developing world is the issue of copyright protection of questionnaires. The current reality is that research in the developing world is often hampered by inadequate or even non-existent budgetary support. From our point of view, an additional hindrance to carrying out research in developing countries is the insistence by holders of questionnaire copyrights that they are paid for the use of their testing instruments. One adverse consequence of demands for compensation by copyright holders may be that worthwhile research is impeded or even prevented. It is argued that the practice of charging non-funded research projects for the use of copyrighted questionnaires denies inclusion of data on world minorities, and thus prevents the potential benefits that such data could provide. In this commentary, we focus on copyrighted instruments and the restrictions that they often represent for researchers in the developing world. More broadly, we argue that to the extent that research in the developing world is impeded by demands for developed world levels of compensation for the use of proprietary tests, the development of vital health programs that are designed to serve these populations can be adversely affected. Several strategies for rectifying inequities posed by current copyright policies are suggested for the promotion of health research in the developing world.