Effects of aerobic exercise on ambulatory blood pressure responses to acute partial sleep deprivation: impact of chronotype and sleep quality.

Blood pressure (BP) follows a circadian rhythm intertwined with the sleep-wake cycle. Acute partial sleep deprivation (PSD; sleep ≤ 6 h) can increase BP, associated with increased cardiovascular risk. Acute exercise can reduce BP for up to 24 h, a phenomenon termed postexercise hypotension. The present study tested whether aerobic exercise could mitigate the augmented 24-h ambulatory BP caused by acute PSD. Twenty-four young otherwise healthy adults (22 ± 3 yr; 14 females; self-reported chronotypes: 6 early/10 intermediate/8 late; Pittsburgh sleep quality index: 17 good/7 poor sleepers) completed a randomized crossover trial in which, on different days, they slept normally (2300-0700), restricted sleep [0330-0700 (PSD)], and cycled for 50 min (70-80% predicted heart rate maximum) before PSD. Ambulatory BP was assessed every 30 min until 2100 the next day. Acute PSD increased 24-h systolic BP (control 117 ± 9 mmHg, PSD 122 ± 9 mmHg; P < 0.001) and prior exercise attenuated (exercise + PSD 120 ± 9 mmHg; P = 0.04 vs. PSD) but did not fully reverse this response (exercise + PSD, P = 0.02 vs. control). Subgroup analysis revealed that the 24-h systolic BP reduction following exercise was specific to late types (PSD 119 ± 7 vs. exercise + PSD 116 ± 6 mmHg; P < 0.05). Overall, habitual sleep quality was negatively correlated with the change in daytime systolic BP following PSD (r = -0.56, P < 0.01). These findings suggest that the ability of aerobic cycling exercise to counteract the hemodynamic effects of acute PSD in young adults may be dependent on chronotype and that habitual sleep quality can predict the daytime BP response to acute PSD.NEW & NOTEWORTHY We demonstrate that cycling exercise attenuates, but does not fully reverse, the augmented 24-h ambulatory blood pressure (BP) response caused by acute partial sleep deprivation (PSD). This response was primarily observed in late chronotypes. Furthermore, daytime BP after acute PSD is related to habitual sleep quality, with better sleepers being more prone to BP elevations. This suggests that habitual sleeping habits can influence BP responses to acute PSD and their interactions with prior cycling exercise.

Sleep quality during pregnancy and fetal growth: A prospective cohort study.

The aim of this study is to investigate the association between sleep quality during pregnancy and fetal growth. Pregnant women and their fetuses at 16-20 gestational weeks in Nantong Maternal and Child Health Hospital were recruited. Women were classified as having "good sleep quality" (Pittsburgh Sleep Quality Index score ≤ 5) and "poor sleep quality" (Pittsburgh Sleep Quality Index score > 5) according to the Pittsburgh Sleep Quality Index scores. The fetal growth was evaluated by three ultrasonographic examinations, birth weight and birth length. We used general linear model and multiple linear regression models to estimate the associations. A total of 386 pairs of mother and infant were included in the data analysis. After adjusting for gestational weight gain, anxiety and depression, fetuses in the good sleep quality group had greater abdominal circumference (p = 0.039 for 28-31+6 weeks gestation, p = 0.012 for 37-40+6 weeks gestation) and femur length (p = 0.014 for 28-31+6 weeks gestation, p = 0.041for 37-40+6 weeks gestation) at 28-31+6 weeks gestation and 37-40+6 weeks gestation, and increased femur length (p = 0.007) at 28-31+6 weeks gestation. Birth weights (p = 0.018) were positively associated with sleep quality. Poor sleep quality was associated with poor intrauterine physical development, decreased abdominal circumference and femur length, and lower birth weight after adjusting for confounding factors. Attention to the fetal growth of pregnant women with poor sleep quality has the potential to decrease the risk of adverse fetal outcomes.

Spectrum of sleep-disordered breathing and quality of sleep in adolescent and adult patients with spinal muscular atrophy.

Sleep-disordered breathing is common among children with spinal muscular atrophy, but has been hardly studied among adult subjects. Little is known about sleep quality in spinal muscular atrophy. The aims of this study were to evaluate occurrence and characteristics of sleep-disordered breathing and subjective sleep quality among adolescent and adult patients with spinal muscular atrophy type 2 or 3. Twenty patients aged 33.9 ± 15.2 years were studied. They underwent nocturnal cardiorespiratory monitoring, lung and muscular function evaluation, and were administered the Pittsburgh Sleep Quality Index questionnaire. Nineteen patients showed sleep-disordered breathing, with obstructive events in seven subjects and non-obstructive events in the remaining 12. In the latter group, 10 patients showed pseudo-obstructive hypopneas. Patients with non-obstructive sleep-disordered breathing were younger (p = 0.042), had a lower body mass index (p = 0.0001), were more often affected by spinal muscular atrophy type 2 (p = 0.001), and showed worse impairment of respiratory function than patients with obstructive sleep-disordered breathing. Ten patients were classified as poor sleepers and 10 patients good sleepers. In the whole sample, sniff nasal inspiratory pressure proved to be the only independent predictor of sleep quality (p = 0.009). In conclusion, sleep-disordered breathing is common even among adult patients with spinal muscular atrophy type 2 and 3, and may show either obstructive or different types on non-obstructive features. A worse respiratory muscle function is associated to non-obstructive sleep-disordered breathing and poorer sleep quality. Sleep quality should receive greater attention especially in patients with spinal muscular atrophy type 2, who have a poorer respiratory muscle function, as it could affect their quality of life.

Fatigue and sleep quality improvement through complete decongestive therapy in postmastectomy lymphedema: An investigative analysis.

OBJECTIVE: To evaluate the effects of complete decongestive therapy (CDT) on cancer-related fatigue, sleep quality, and lymphedema-specific quality of life using validated and reliable questionnaires in cancer patients being commendable. MATERIAL AND METHODS: This prospective study includes 94 patients who had postmastectomy lymphedema syndrome. The demographic characteristics of the patients were recorded. The participants' stages of lymphedema (The International Society of Lymphology), Hirai Cancer Fatigue Scale (HCFS) score, Pittsburgh Sleep Quality Index (PSQI) Global score, lymphedema-specific quality of life questionnaire (LYMQOL-ARM) score, and Global health status were recorded before and after CDT. RESULTS: The mean age of the patients was 58.49 ± 10.96 years. Strong correlations were found between the severity of edema and global health status. There was a significant positive relationship between the HCFS score, PSQI Global score, LYMQOL-ARM score, and CDT. After decongestive physiotherapy, the majority of the lymphedema stages were downstaging (p < 0.05), respectively. There was also a trend toward improvement in general well-being (p < 0.05). CONCLUSION: Cancer-related fatigue and sleep disturbance can persist for years after surgery in women with breast cancer. This can negatively affect the patient physically, socially and cognitively. Our study, which is the first study to investigate the HCFS score in postmastectomy patients and the relationship between PSQI Global score and CDT. The findings identify the risk factors that affect these outcomes in women with lymphedema and can provide valuable insights for targeted interventions and improved patient care.

Predictors and disturbances of sleep quality between men and women: results from a cross-sectional study in Jordan.

BACKGROUND: Sleep disturbances, a public health concern that may lead to critical physiological conditions, are associated with personal characteristics such as gender. Limited evidence is available from the Middle East population on the gender disparities in sleep quality. Therefore, the current study examined gender-specific differences in sleep quality and disturbances among Jordanian citizens. METHOD: A cross-sectional design was used to recruit a convenient sample of 1,092 adults from different Jordanian cities. Data was collected using a self-reported questionnaire comprising the Pittsburgh Sleep Quality Index (PSQI), which was distributed online via social media networks. The participants were categorized according to their global PSQI scores into poor (PSQI ≥ 5) and good sleepers (PSQI < 5). The analysis focused on finding differences between women and men in terms of sleep quality and the effects of demographic, lifestyle, and socioeconomic factors on reported sleep problems. RESULTS: Women were revealed to have a higher prevalence of all types of sleep disturbances than men. Women who were over 55 (compared to younger than 20 years), did not smoke, had multiple jobs or part-time employment (compared to unemployed women), and had a monthly income of more than 500 JD (compared to those with an income of < 500 JD) were less likely to experience poor sleep than other women. In contrast, men who neither smoked nor drank coffee, ate no sweets or only one to two pieces daily (compared to participants who ate more than two pieces daily), and worked fixed night shifts (compared to alternating shifts workers) were less likely to experience poor sleep than other men. CONCLUSION: This study builds a more nuanced understanding of how different demographic, lifestyle, and socioeconomic factors - such as a participant's age, time of working duty, income, daily sweet consumption, daily caffeine consumption, and smoking - affect the sleep quality of men and women. Thus, promoting a healthier lifestyle for both genders by modifying risk factors - such as smoking cessation, as well as reducing their intake of caffeine and sweets - is the first step toward improving their sleep quality. Further studies are needed to examine how the social role of Arabic women affects their sleep.

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.

Efficacy of balneotherapy on pain, function, and sleep quality in patients with chronic low-back pain: a prospective observational study.

The aim of this prospective observational study was to evaluate the efficacy of a cycle of sulfate-arsenical-ferruginous mud bath therapy on pain, function, and sleep quality in patients with chronic low-back pain (CLBP). One hundred twenty-three patients treated at Levico Spa Center (Italy) with 12 daily local mud packs and generalized thermal baths were included in this experience. General medical assessments were performed before starting the therapy, at the end of the treatment, and 3 months later. Pain intensity and stiffness were measured by a 0 to 10 cm visual analogue scale (VAS); the range of mobility of the lumbar spine was evaluated using the Schober test and functional disability by the Roland-Morris Disability Questionnaire (RMDI). The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. The VAS score for pain and stiffness showed a significant reduction (p < 0.0001) at the end of the treatment persisting for 3 months of follow-up. Similarly, a significant improvement was found for the Schober test and RMDQ. Finally, we showed a significant decrease of PSQI score at the end of the cycle of mud bath and at 3 months of follow-up. The Spearman analysis showed a significant positive correlation between the score of PSQI and VAS pain, VAS stiffness, and RMDQ. In conclusion, this preliminary study confirms the beneficial and long-term efficacy of balneotherapy on pain and function and, for the first one, shows the positive effect on quality of sleep in patients with CLBP treated with a cycle of mud bath therapy.

The John N. Insall Award: Does Melatonin Improve Subjective Sleep Quality After Total Knee Arthroplasty? A Randomized, Placebo-Controlled Trial.

BACKGROUND: Sleep disturbance is a common problem following total knee arthroplasty (TKA). The objective of this study was to determine if exogenous melatonin improves sleep quality following primary TKA. METHODS: A randomized, double-blind, placebo-controlled trial was conducted. A total of 172 patients undergoing unilateral TKA for primary knee osteoarthritis were randomized to receive either 5 mg melatonin (n = 86) or 125 mg vitamin C placebo (n = 86) nightly for 6 weeks. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) at 6 weeks and 90 days postoperatively. Secondary outcomes included 6-week and 90-day patient-reported outcome measures (PROMs), morphine milligram equivalents prescribed, medication compliance, adverse events, and 90-day readmissions. RESULTS: Mean PSQI scores worsened at 6 weeks before returning to the preoperative baseline at 90 days in both groups. There were no differences in PSQI scores between melatonin and placebo groups at 6 weeks (10.2 ± 4.2 versus 10.5 ± 4.4, P = .66) or 90 days (8.1 ± 4.1 versus 7.5 ± 4.0, P = .43). Melatonin did not improve the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, Lower Extremity Activity Scale, Visual Analog Scale for pain, or Veterans Rand 12 Physical Component Score or Mental Component Score at 6 weeks or 90 days. Poor sleep quality was associated with worse PROMs at 6 weeks and 90 days on univariate and multivariable analyses, but melatonin did not modify these associations. There were no differences in morphine milligram equivalents prescribed, medication compliances, adverse events, or 90-day readmissions between both groups. CONCLUSIONS: Exogenous melatonin did not improve subjective sleep quality or PROMs at 6 weeks or 90 days following TKA. Poor sleep quality was associated with worse patient-reported function and pain. Our results do not support the routine use of melatonin after TKA.

Evaluating the role of heart rate variability in monitoring stress and sleep quality among nurses in the aftermath of the COVID-19 pandemic.

AIM: To assess heart rate variability (HRV) as a measure to assess job stress and sleep quality among nurses in the post-COVID-19 period. BACKGROUND: The COVID-19 pandemic significantly affected nurses, with heightened job stress and impaired sleep quality impacting their well-being and effectiveness in patient care. HRV could offer insights for supporting strategies in the pandemic aftermath. DESIGN: A quantitative cross-sectional study. METHODS: This study involved 403 clinical nurses recruited from a teaching hospital in Taiwan. Data on job stress, work frustration, sleep quality and HRV were collected and analysed. RESULTS: Among the nurses surveyed during the COVID-19 pandemic, 72.7% reported poor sleep quality (PSQI = 9.369). Job stress emerged as a strong predictor of work frustration. High stress levels and poor sleep quality were correlated with significantly decreased HRV, indicating a potential physiological impact of stress on the nurses' health and well-being. CONCLUSIONS: HRV is a valuable and cost-effective measure for monitoring and managing nurses' well-being in the post-COVID-19 era. Targeted interventions can be implemented to support nurses' overall performance and promote their well-being by identifying those at high risk of job stress and poor sleep quality.

Sleep disorder experienced by healthcare nurses after terminating Zero-COVID-19 policy.

OBJECTIVE: Medical staff, especially nurses, suffered great anxiety and stress from the COVID-19 pandemic, which negatively affected their sleep quality. In this study, we aimed to analyze the sleep quality of nursing staff after terminating the Zero-COVID-19 policy in China. METHODS: 506 participants were involved in our study. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep status of the participants. Binary regression was performed to evaluate the impact factors related to sleep difficulty. RESULTS: The majority of participants (96.44%) suffered from sleep disturbances. There were significant differences in age, education level and front-line activity between participants with good sleep quality and sleep difficulty. Younger age (16-25 years old) was independently associated with less sleep difficulty, while front-line activity was independently associated with severe sleep difficulty. CONCLUSION: Sleep disorder was very common among nurses after ending the Zero-COVID-19 policy in China. More front-line nurses suffered severe sleep difficulty in particular, which should be worthy of attention.

The Association of Salivary Flow Rate and Sleep Quality among Head and Neck Cancer Survivors after Radiotherapy.

BACKGROUND: Head and neck cancer survivors suffer from xerostomia and sleep disturbances after radiotherapy, both of which affect their quality of life. This study aimed to explore the role of salivary flow in the oral health and sleep quality of head and neck cancer survivors. METHODS: We recruited 120 head and neck cancer survivors who were experiencing symptoms of dry mouth or sleep disturbances post-radiotherapy from a dental clinic. We gathered their socio-demographic and clinical data, measured their salivary flow rate, and recorded their dry mouth score using the summated xerostomia inventory. Additionally, a dentist collected the DMFT (Decayed, Missing, and Filled Teeth) index. The Pittsburgh Sleep Quality Index was employed to assess their sleep quality. RESULTS: In this study, xerostomia was observed in nearly 80% of the cancer survivors. The concurrent prevalence of sleep disturbance and xerostomia was at 55%. After five years post-radiotherapy, there was a significant improvement observed in both the quality of sleep (p = 0.03) and the stimulated salivary flow rate (p = 0.04). Additionally, these improvements were noted to have commenced from the third year onwards. A significant association was found between stimulated salivary flow and dry mouth scores with poor sleep quality (p <  0.05). CONCLUSIONS: We recommend that dental professionals prioritize managing both dental and mental health issues equally for head and neck cancer survivors who have undergone radiotherapy within the past 3 years.

Effect of Third Molar Surgery on Sleep Health Parameters of Young Adults: An Observational Study.

Background and Objectives: The role of surgical extraction of the third molar in patients' sleep quality remains unclear, although it is one of the most common oral surgical procedures. The aim of this study is to assess the changes in patient-reported sleep health outcomes after third molar surgery and to investigate any associations between sleep parameters and post-extraction pain. Materials and Methods: Young adults without known comorbidities who were in need of mandibular third molar surgical extraction were included. All participants completed a sleep diary, the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) questionnaires, which were used to assess sleep habits, daytime sleepiness, sleep quality and insomnia severity one week before and after extraction. In addition, a visual analog scale was completed postoperatively to assess the perception of pain. Results: Out of 75 patients who completed the study protocol, 32 (42.7%) were males and 43 (57.3%) were females, with a mean age of 24.01 (±3.43) years. Postoperatively, statistically significant higher scores were observed for PSQI [4.85 (±2.32) before vs. 5.39 (±2.75) after, p = 0.041], AIS [5.56 (±3.23) before vs. 6.91 (±4.06) after, p < 0.001] and average weekly number of nocturnal awakenings [2.01 (±3.72) before vs. 4.19 (±5.20) after, p < 0.001] but not for ESS, average weekly sleep duration and average weekly sleep onset latency. Pain perception was increased in patients who slept worse on almost all seven postoperative days, although this did not reach statistical significance. Conclusions: Third molar surgery impacts sleep quality and insomnia severity in the first week after extraction, while there is no effect on daytime sleepiness. The worsening of subjective sleep symptoms after extraction may be associated with an increased perception of pain.

Physical activity, sleep and affective wellbeing on the following day: An experience sampling study.

This study aims to investigate the temporal links between physical activity, sleep and affective wellbeing in young adults. In particular, the aim was to examine whether physical activity is associated with sleep indicators in subsequent nights and, in turn, whether sleep was associated with improved affective wellbeing the next morning. Relatedly, moderation by baseline levels of depressive symptoms, sleep quality, habitual physical activity and gender was analysed. One-hundred and forty-seven individuals (85.7% female) aged 18-25 years old participated in an experience sampling study over 14 consecutive days. Participants received seven prompts per day, and answered questions about their physical activity and affective states. Every morning, participants also reported their sleep. Physical activity throughout the day was not related to sleep during the following night or to affective wellbeing the next morning. An exception to that pattern was that physical activity before 14:00 hours was associated with longer subsequent sleep duration. Better subjective sleep quality predicted affective wellbeing the next morning. Associations of physical activity, sleep and affective wellbeing were not moderated by baseline depressive symptoms, sleep quality or habitual physical activity. However, investigation of gender as a moderator revealed that moderate physical activity was associated with better subsequent sleep quality for males, but not for females. Overall, we found that physical activity is associated with better subsequent sleep for males, but not for females. Also, our study provides further evidence that better sleep quality is associated with the next morning's affective wellbeing.

Memory performance mediates subjective sleep quality associations with cerebrospinal fluid Alzheimer's disease biomarker levels and hippocampal volume among individuals with mild cognitive symptoms.

Sleep disturbances are prevalent in Alzheimer's disease (AD), affecting individuals during its early stages. We investigated associations between subjective sleep measures and cerebrospinal fluid (CSF) biomarkers of AD in adults with mild cognitive symptoms from the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study, considering the influence of memory performance. A total of 442 participants aged >50 years with a Clinical Dementia Rating (CDR) score of 0.5 completed the Pittsburgh Sleep Quality Index questionnaire and underwent neuropsychological assessment, magnetic resonance imaging acquisition, and CSF sampling. We analysed the relationship of sleep quality with CSF AD biomarkers and cognitive performance in separated multivariate linear regression models, adjusting for covariates. Poorer cross-sectional sleep quality was associated with lower CSF levels of phosphorylated tau and total tau alongside better immediate and delayed memory performance. After adjustment for delayed memory scores, associations between CSF biomarkers and sleep quality became non-significant, and further analysis revealed that memory performance mediated this relationship. In post hoc analyses, poorer subjective sleep quality was associated with lesser hippocampal atrophy, with memory performance also mediating this association. In conclusion, worse subjective sleep quality is associated with less altered AD biomarkers in adults with mild cognitive symptoms (CDR score 0.5). These results could be explained by a systematic recall bias affecting subjective sleep assessment in individuals with incipient memory impairment. Caution should therefore be exercised when interpreting subjective sleep quality measures in memory-impaired populations, emphasising the importance of complementing subjective measures with objective assessments.

Relationship between disease activity index and sleep disorders in children with inflammatory bowel diseases.

The aim of the study was to assess the prevalence of sleep disturbance in pediatric IBD patients and evaluate the relationship between clinical features of IBD, disease activity, inflammatory markers and quality of sleep. A total of 99 patients who were followed-up with the diagnosis of IBD (44 Crohn's disease (CD), 55 Ulcerative colitis (UC)) between 2015-2020 and 80 healthy controls were enrolled in the study. The clinical and demographic characteristics, laboratory parameters and disease activities were obtained from medical reports retrospectively. Pittsburgh sleep quality index (PSQI) was administered to all participants. PSQI score was significantly higher in patient group than the control group (P < 0.001). The sleep time of patient group, especially patients with UC was later than the control group (P = 0.008). Sleep duration was longer in control group than the patient group (P < 0.001). A positive strong correlation was obtained in disease activity index (r = 0.886; P < 0.001) and abdominal pain (r = 0.781; P < 0.001) with PSQI scores of CD patients. Disease activity index, rectal bleeding, diarrhea and number of stool had statistically significant positive strong correlation with PSQI scores of UC patients (P < 0.001). Pediatric Crohn's disease activity index and Pediatric ulcerative colitis activity index were the only independent risk factors affecting sleep disturbances (80% sensitivity and 91.67% specificity, 93.1% sensitivity and %96.15 specificity, respectively).   Conclusion: Increased disease activity has adverse effects on sleep quality. PSQI and PCDAI were strong tests for predicting sleep disorders in pediatric patients with IBD. What is Known: • Sleep disturbances are common complaint in inflammatory bowel disease (IBD), even in clinical remission. • Pittsburgh sleep quality index (PSQI) was used to evaluate the subjective sleep quality of patients. What is New: • PSQI and Pediatric Crohn Disease Activity index (PCDAI) were strong tests for predicting sleep disorders in pediatric patients with IBD. • PSQI and PCDAI scores correlated significantly with the severity of the sleep disturbances.

Sleep quality in patients with non-functioning pituitary adenoma: impact of replacement therapies with an emphasis on the time of hydrocortisone.

PURPOSE: Sleep disturbances are widespread and associated with pituitary diseases, even those under long-term therapeutic management. The aim of this study was to investigate sleep quality in patients with non-functioning pituitary adenoma (NFPA) and determine the factors that might influence sleep quality, including the detailed features of replacement therapy. METHODS: Eighty-two patients with NFPA and 82 age- and gender-matched control subjects were included. Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS) and International Physical Activity Questionnaire (IPAQ) were used. RESULTS: In the NFPA group, 57.3% of patients had decreased sleep quality, compared to 35.4% in the control group (p=0.005). Although there was no relationship between the presence of hydrocortisone replacement and sleep quality (p>0.05), a strong positive correlation was observed between PSQI and morning hydrocortisone replacement time in patients with secondary adrenal insufficiency (r=0.834, p<0.001). Diabetes insipidus was found to be significantly higher in the group with decreased sleep quality (p=0.01). Moreover, there was a negative correlation between PSQI and IGF-1 in patients with NFPA (r=-0.259, p=0.01). A multivariate logistic regression model revealed that depression score and free T4 level in the upper half of the normal limit influence the sleep quality of patients with NFPA. CONCLUSION: Our study indicated the presence of depression, and a free T4 level in the upper half of the normal range have an impact on the sleep quality of patients with NFPA. The time of hydrocortisone replacement might be important factor for improved sleep quality in patients with secondary adrenal insufficiency.

Self-reported sleep quality and oligo/astheno/teratozoospermia among men attending an infertility clinic: a longitudinal study.

OBJECTIVE: We aimed to examine the influence of sleep disturbances on the risk of oligo/astheno/teratozoospermia (OAT) in men attending an infertility clinic. METHODS: We consecutively enrolled men attending an infertility clinic from July 2020 to June 2021. Semen parameters were obtained at initial presentation, and the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale score, and the STOP-BANG Questionnair were completed to assess sleep quality. Embryo outcomes were evaluated after infertility treatment. RESULTS: Of 466 men enrolled, 119 had OAT (OAT group) and 347 had normozoospermia (NS group). There were no differences between the two groups regarding Epworth Sleepiness Scale and STOP-BANG Questionnaire scores. The prevalence of poor sleep quality (Pittsburgh Sleep Quality Index score ≥ 5) in the OAT group was significantly higher than that in the NS group (42% vs. 29%, p = 0.009). A higher rate of poor subjective sleep quality was observed in the OAT group compared with the NS group (p = 0.005) and Pearson's correlations revealed a negative relationship between subjective sleep quality and semen quality. Logistic regression found that subjective sleep quality was independently associated with an increased risk of OAT (adjusted odds ratio = 0.610, p = 0.007). CONCLUSIONS: Men with OAT attending an infertility clinic exhibited poor subjective sleep quality. Improving sleep disturbances may be a target intervention to reduce the risk of OAT. This possibility warrants further investigation.

Validity and reliability of the Danish version of the Pittsburgh Sleep Quality Index.

AIM: The Pittsburgh Sleep Quality Index is a widely used measure of sleep quality. The validity and reliability of the Danish version of the instrument has not yet been established. The aim of this study is to establish the internal consistency, test-retest reliability and convergent validity of the Danish version of the Pittsburgh Sleep Quality Index in adolescents. METHODS: Data were collected from 719 students from 17 different upper secondary schools. The sample consisted of 55% women, and the mean age of the sample was 17.87 (2.52) years. Data was collected on two occasions approximately 6 weeks apart using online surveys. Apart from the Pittsburgh Sleep Quality Index, the students also completed the five-item World Health Organization Well-being Index and the 10-item Perceived Stress Scale. For internal consistency the Cronbach's alpha was calculated, for test-retest reliability the interclass correlation coefficient was computed, and for validity the Pearson's correlation was calculated. RESULTS: The mean global Pittsburgh Sleep Quality Index score among Danish adolescents was 5.86 (3.13). The internal consistency for the Pittsburgh Sleep Quality Index was satisfactory with a Cronbach's alpha of 0.72. Test-retest reliability was adequate with an interclass correlation coefficient of 0.68. Finally, the Pittsburgh Sleep Quality Index showed large positive correlation with the 10-item Perceived Stress Scale (0.55) and a large negative correlation with the five-item World Health Organization Well-being Index (-0.59). CONCLUSIONS: The Danish version of the Pittsburgh Sleep Quality Index showed adequate reliability and validity among Danish adolescents.

Pediatric psoriasis negatively influences parental sleep quality.

BACKGROUND: One-third of psoriasis cases occur in the pediatric population. Pediatric psoriasis has a negative long-term impact on the quality of life of children and their families. However, data regarding the impact of pediatric psoriasis on parental sleep quality are scarce. OBJECTIVES: This study examined the effects of pediatric psoriasis on the quality of parents' sleep compared to parents of healthy, non-psoriatic children. METHODS: A cross-sectional questionnaire study was conducted from September 2020 to November 2021, using the validated Pittsburgh Sleep Quality Index (PSQI). The study population included parents of patients aged 2-18 years diagnosed with psoriasis and parents of healthy children of the same gender and ethnicity. We further compared sleep quality between parents of children with mild and moderate-to-severe psoriasis, and fathers to mothers. RESULTS: A total of 301 parents were enrolled; 151 parents of 83 children diagnosed with psoriasis and 150 parents of 124 healthy controls. Parents of children with psoriasis had significantly longer sleep latency (p = 0.031), worse subjective sleep quality (p = 0.043), and greater use of sleep medications (p < 0.001). The comparison between parents of moderate-severe with mild psoriatic children as well as mothers with fathers showed no statistical significance. CONCLUSION: Poor sleep quality was demonstrated among parents of children diagnosed with psoriasis compared to parents of healthy children. This finding is crucial for the direction of treatment efforts regarding parental well-being and functioning.

Development and validation of non-invasive prediction models for migraine in Chinese adults.

BACKGROUND: Migraine is a common disabling neurological disorder with severe physical and psychological damage, but there is a lack of convenient and effective non-invasive early prediction methods. This study aimed to develop a new series of non-invasive prediction models for migraine with external validation. METHODS: A total of 188 and 94 subjects were included in the training and validation sets, respectively. A standardized professional questionnaire was used to collect the subjects' 9-item traditional Chinese medicine constitution (TCMC) scores, Pittsburgh Sleep Quality Index (PSQI) score, Zung's Self-rating Anxiety Scale and Self-rating Depression Scale scores. Logistic regression was used to analyze the risk predictors of migraine, and a series of prediction models for migraine were developed. Receiver operating characteristic (ROC) curve and calibration curve were used to assess the discrimination and calibration of the models. The predictive performance of the models were further validated using external datasets and subgroup analyses were conducted. RESULTS: PSQI score and Qi-depression score were significantly and positively associated with the risk of migraine, with the area of the ROC curves (AUCs) predicting migraine of 0.83 (95% CI:0.77-0.89) and 0.76 (95% CI:0.68-0.84), respectively. Eight non-invasive predictive models for migraine containing one to eight variables were developed using logistic regression, with AUCs ranging from 0.83 (95% CI: 0.77-0.89) to 0.92 (95% CI: 0.89-0.96) for the training set and from 0.76 (95% CI: 0.66-0.85) to 0.83 (95% CI: 0.75-0.91) for the validation set. Subgroup analyses showed that the AUCs of the eight prediction models for predicting migraine in the training and validation sets of different gender and age subgroups ranged from 0.80 (95% CI: 0.63-0.97) to 0.95 (95% CI: 0.91-1.00) and 0.73 (95% CI: 0.64-0.84) to 0.93 (95% CI: 0.82-1.00), respectively. CONCLUSIONS: This study developed and validated a series of convenient and novel non-invasive prediction models for migraine, which have good predictive ability for migraine in Chinese adults of different genders and ages. It is of great significance for the early prevention, screening, and diagnosis of migraine.