Ansiedad, depresión y calidad del sueño en estudiantes de Odontología

La calidad del sueño en los estudiantes es un factor esencial que influye en el correcto desarrollo de los procesos cognitivos del aprendizaje, así como en la calidad de vida y la salud mental y física de los futuros profesionales. Objetivo: Evaluar la relación entre la ansiedad, la depresión y la calidad del sueño en estudiantes de la carrera de Odontología de la Universidad Nacional del Altiplano de Puno. Materiales y métodos: Estudio de tipo observacional de cohorte transversal con la participación de 78 estudiantes, con edad promedio de 22.63±2.87 años, con una distribución de género de 32 varones (41,0 %) y 46 mujeres (59,0 %). Se utilizó la escala de valoración de Hamilton para la evaluación de la ansiedad y la depresión, con una consistencia interna de α = 0,88 y 0,86, respectivamente y el cuestionario de Pittsburgh para medir el índice de calidad del sueño (α = 0,87). Resultados: En el modelo predictivo los coeficientes estandarizados ß señalan que la ansiedad psíquica (ß = -,870; p<0,001), la depresión (ß = ,119; p<0,05) y el desarrollo de prácticas clínicas (ß = -0,019; p<0,05) fueron los factores que más contribuyeron significativamente al índice de calidad del sueño de los estudiantes. Conclusión: Estos hallazgos subrayan la importancia de abordar los problemas del sueño como parte integral del tratamiento de la ansiedad y la depresión, además de resaltar la necesidad de tener en cuenta la salud mental en la evaluación y el manejo de los trastornos del sueño.

The quality of sleep-in students is an essential factor that influences the correct development of cognitive learning processes, as well as the quality of life and the mental and physical health of future professionals. Objective: To evaluate the relationship between anxiety, depression and sleep quality in students of the Dentistry program at the National University of the Altiplano of Puno. Materials and methods: Observational cross-sectional cohort study with the participation of 78 students, with an average age of 22.63±2.87 years, with a gender distribution of 32 men (41.0%) and 46 women (59.0%). The Hamilton rating scale was used to evaluate anxiety and depression, with an internal consistency of α = 0.88 and 0.86, respectively, and the Pittsburgh questionnaire was used to measure the sleep quality index (α = 0.87). Results: In the predictive model, the standardized ß coefficients indicate that psychological anxiety (ß = -.870; p<0.001), depression (ß = .119; p<0.05) and the development of clinical practices (ß = -0.019; p<0.05) were the factors that contributed most significantly to the students' sleep quality index. Conclusion: These findings underscore the importance of addressing sleep problems as an integral part of the treatment of anxiety and depression, as well as highlighting the need to consider mental health in the assessment and management of sleep disorders.

A qualidade do sono dos estudantes é um fator essencial que influencia o correto desenvolvimento dos processos de aprendizagem cognitiva, bem como a qualidade de vida e a saúde mental e física dos futuros profissionais. Objetivo: Avaliar a relação entre ansiedade, depressão e qualidade do sono em estudantes do curso de Odontologia da Universidade Nacional do Altiplano de Puno. Materiais e métodos: Estudo de coorte transversal observacional com a participação de 78 estudantes, com idade média de 22,63±2,87 anos, com distribuição por género de 32 homens (41,0%) e 46 mulheres (59,0%). A escala de avaliação de Hamilton foi utilizada para avaliar ansiedade e depressão, com consistência interna de α = 0,88 e 0,86, respectivamente, e o questionário de Pittsburgh foi utilizado para mensurar o índice de qualidade do sono (α = 0,87). Resultados: No modelo preditivo, os coeficientes ß padronizados indicam que a ansiedade psicológica (ß = -0,870; p<0,001), a depressão (ß = 0,119; p<0,05) e o desenvolvimento de práticas clínicas (ß = -0,019; p<0,05) foram os fatores que mais contribuíram significativamente para o índice de qualidade do sono dos estudantes. Conclusão: Estas descobertas sublinham a importância de abordar os problemas do sono como parte integrante do tratamento da ansiedade e da depressão, bem como realçam a necessidade de considerar a saúde mental na avaliação e gestão dos distúrbios do sono.

Relación entre la calidad de sueño y somnolencia diurna en estudiantes universitarios

Los estudiantes universitarios están propensos a sufrir alteraciones en el sueño como la somnolencia diurna, lo cual tiene repercusión directa en su calidad de vida y desempeño diario. Objetivo. Determinar la relación entre la calidad de sueño y somnolencia diurna en estudiantes de la Universidad nombre, en Perú. Materiales y Métodos. Se consideró el enfoque cuantitativo, de diseño no experimental, con la aplicación de los instrumentos de calidad del sueño de Pittsburgh y la escala de somnolencia Epworth. La población fue de 446 estudiantes y se obtuvo una muestra de 220 estudiantes universitarios, mediante un muestreo no probabilístico. Resultados. Se presentan severos problemas en relación a la calidad del sueño en un 60,9 %; así como en la calidad subjetiva del sueño en un 49,5 %, duración del sueño en un 54,5 %, uso de medicación hipnótica en un 56,8 %, disfunción diurna 50,5 %; y la latencia del sueño, eficiencia de sueño habitual y alteraciones del sueño en un 57,7 %. Entre tanto, la somnolencia diurna fue alta en un 58,6 %. Conclusiones. Existe relación positiva y significativa entre la calidad del sueño y la somnolencia diurna en los alumnos de la Universidad nombre, alcanzando una ρ = 0.000 (ρ < 0.05); del mismo modo se encontró relación significativa en cada una de las dimensiones de la calidad del sueño y la somnolencia diurna; de lo que se interpreta que la calidad del sueño de problemas de nivel leve, la somnolencia diurna se encuentra en niveles bajos en los universitarios.

University students are prone to sleep disturbances such as daytime sleepiness, which has a direct impact on their quality of life and daily performance. Objective. Determine the relationship between sleep quality and daytime sleepiness in students at the Universidad Nombre, in Peru. Materials and methods. The quantitative approach was considered, with a non-experimental design, with the application of the Pittsburgh sleep quality instruments and the Epworth sleepiness scale. The population was 446 students and a sample of 220 university students was obtained, through non-probabilistic sampling. Results. There are severe problems in relation to sleep quality in 60.9 %; as well as in the subjective quality of sleep in 49.5 %, duration of sleep in 54.5 %, use of hypnotic medication in 56.8 %, daytime dysfunction 50.5 %; and sleep latency, habitual sleep efficiency and sleep disturbances by 57.7 %. Meanwhile, daytime sleepiness was high at 58.6 %. Conclusions. There is a positive and significant relationship between sleep quality and daytime sleepiness in the students of the Name University, reaching ρ = 0.000 (ρ < 0.05); Likewise, a significant relationship was found in each of the dimensions of sleep quality and daytime sleepiness; from which it is interpreted that the quality of sleep has mild problems, daytime sleepiness is at low levels in university students.

Os estudantes universitários são propensos a distúrbios do sono, como a sonolência diurna, o que tem impacto direto na sua qualidade de vida e no desempenho diário. Objetivo. Determinar a relação entre qualidade do sono e sonolência diurna em estudantes da Universidad Nombre, no Peru. Materiais e métodos. Considerou-se a abordagem quantitativa, com desenho não experimental, com aplicação dos instrumentos de qualidade do sono de Pittsburgh e da escala de sonolência de Epworth. A população foi de 446 estudantes e obteve-se uma amostra de 220 estudantes universitários, através de amostragem não probabilística. Resultados. Existem problemas graves em relação à qualidade do sono em 60,9 %; bem como na qualidade subjetiva do sono em 49,5 %, duração do sono em 54,5 %, uso de medicação hipnótica em 56,8 %, disfunção diurna 50,5 %; e latência do sono, eficiência habitual do sono e distúrbios do sono em 57,7 %. Enquanto isso, a sonolência diurna foi elevada, 58,6 %. Conclusões. Existe uma relação positiva e significativa entre a qualidade do sono e a sonolência diurna nos estudantes da Universidade do Nome, atingindo ρ = 0,000 (ρ < 0,05); Da mesma forma, foi encontrada relação significativa em cada uma das dimensões da qualidade do sono e da sonolência diurna; a partir do qual se interpreta que a qualidade do sono apresenta problemas leves, a sonolência diurna é baixa em estudantes universitários.

Ansiedad, depresión y calidad del sueño en estudiantes de Odontología / Anxiety, depression and sleep quality in dental students / Ansiedade, depressão e qualidade do sono em estudantes de Odontologia

La calidad del sueño en los estudiantes es un factor esencial que influye en el correcto desarrollo de los procesos cognitivos del aprendizaje, así como en la calidad de vida y la salud mental y física de los futuros profesionales. Objetivo: evaluar la relación entre la ansiedad, la depresión y la calidad del sueño en estudiantes de la carrera de Odontología de la Universidad Nacional del Altiplano de Puno. Materiales y métodos: estudio de tipo observacional de cohorte transversal con la participación de 78 estudiantes, con edad promedio de 22.63±2.87 años, con una distribución de género de 32 varones (41,0 %) y 46 mujeres (59,0 %). Se utilizó la escala de valoración de Hamilton para la evaluación de la ansiedad y la depresión, con una consistencia interna de α = 0,88 y 0,86, respectivamente y el cuestionario de Pittsburgh para medir el índice de calidad del sueño (α = 0,87). Resultados: en el modelo predictivo los coeficientes estandarizados ß señalan que la ansiedad psíquica (ß = -,870; p<0,001), la depresión (ß = ,119; p<0,05) y el desarrollo de prácticas clínicas (ß = -0,019; p<0,05) fueron los factores que más contribuyeron significativamente al índice de calidad del sueño de los estudiantes. Conclusión: estos hallazgos subrayan la importancia de abordar los problemas del sueño como parte integral del tratamiento de la ansiedad y la depresión, además de resaltar la necesidad de tener en cuenta la salud mental en la evaluación y el manejo de los trastornos del sueño

The quality of sleep-in students is an essential factor that influences the correct development of cognitive learning processes, as well as the quality of life and the mental and physical health of future professionals. Objective: to evaluate the relationship between anxiety, depression and sleep quality in students of the Dentistry program at the National University of the Altiplano of Puno. Materials and methods: observational cross-sectional cohort study with the participation of 78 students, with an average age of 22.63±2.87 years, with a gender distribution of 32 men (41.0%) and 46 women (59.0%). The Hamilton rating scale was used to evaluate anxiety and depression, with an internal consistency of α = 0.88 and 0.86, respectively, and the Pittsburgh questionnaire was used to measure the sleep quality index (α = 0.87). Results: in the predictive model, the standardized ß coefficients indicate that psychological anxiety (ß = -.870; p<0.001), depression (ß = .119; p<0.05) and the development of clinical practices (ß = -0.019; p<0.05) were the factors that contributed most significantly to the students' sleep quality index. Conclusion: these findings underscore the importance of addressing sleep problems as an integral part of the treatment of anxiety and depression, as well as highlighting the need to consider mental health in the assessment and management of sleep disorders

A qualidade do sono dos estudantes é um fator essencial que influencia o correto desenvolvimento dos processos de aprendizagem cognitiva, bem como a qualidade de vida e a saúde mental e física dos futuros profissionais. Objetivo: avaliar a relação entre ansiedade, depressão e qualidade do sono em estudantes do curso de Odontologia da Universidade Nacional do Altiplano de Puno. Materiais e métodos: estudo de coorte transversal observacional com a participação de 78 estudantes, com idade média de 22,63±2,87 anos, com distribuição por género de 32 homens (41,0%) e 46 mulheres (59,0%). A escala de avaliação de Hamilton foi utilizada para avaliar ansiedade e depressão, com consistência interna de α = 0,88 e 0,86, respectivamente, e o questionário de Pittsburgh foi utilizado para mensurar o índice de qualidade do sono (α = 0,87). Resultados: no modelo preditivo, os coeficientes ß padronizados indicam que a ansiedade psicológica (ß = -0,870; p<0,001), a depressão (ß = 0,119; p<0,05) e o desenvolvimento de práticas clínicas (ß = -0,019; p<0,05) foram os fatores que mais contribuíram significativamente para o índice de qualidade do sono dos estudantes. Conclusão: estas descobertas sublinham a importância de abordar os problemas do sono como parte integrante do tratamento da ansiedade e da depressão, bem como realçam a necessidade de considerar a saúde mental na avaliação e gestão dos distúrbios do sono

Relación entre la calidad de sueño y somnolencia diurna en estudiantes universitarios / Sleep quality and daytime sleepiness in university students / Qualidade do sono e sonolência diurna em estudantes universitários

Los estudiantes universitarios están propensos a sufrir alteraciones en el sueño como la somnolencia diurna, lo cual tiene repercusión directa en su calidad de vida y desempeño diario. Objetivo. Determinar la relación entre la calidad de sueño y somnolencia diurna en estudiantes de la Universidad nombre, en Perú. Materiales y Métodos. Se consideró el enfoque cuantitativo, de diseño no experimental, con la aplicación de los instrumentos de calidad del sueño de Pittsburgh y la escala de somnolencia Epworth. La población fue de 446 estudiantes y se obtuvo una muestra de 220 estudiantes universitarios, mediante un muestreo no probabilístico. Resultados. Se presentan severos problemas en relación a la calidad del sueño en un 60,9 %; así como en la calidad subjetiva del sueño en un 49,5 %, duración del sueño en un 54,5 %, uso de medicación hipnótica en un 56,8 %, disfunción diurna 50,5 %; y la latencia del sueño, eficiencia de sueño habitual y alteraciones del sueño en un 57,7 %. Entre tanto, la somnolencia diurna fue alta en un 58,6 %. Conclusiones. Existe relación positiva y significativa entre la calidad del sueño y la somnolencia diurna en los alumnos de la Universidad nombre, alcanzando una ρ = 0.000 (ρ < 0.05); del mismo modo se encontró relación significativa en cada una de las dimensiones de la calidad del sueño y la somnolencia diurna; de lo que se interpreta que la calidad del sueño de problemas de nivel leve, la somnolencia diurna se encuentra en niveles bajos en los universitarios.

University students are prone to sleep disturbances such as daytime sleepiness, which has a direct impact on their quality of life and daily performance. Objective. Determine the relationship between sleep quality and daytime sleepiness in students at the Universidad Nombre, in Peru. Materials and methods. The quantitative approach was considered, with a non-experimental design, with the application of the Pittsburgh sleep quality instruments and the Epworth sleepiness scale. The population was 446 students and a sample of 220 university students was obtained, through non-probabilistic sampling. Results. There are severe problems in relation to sleep quality in 60.9 %; as well as in the subjective quality of sleep in 49.5 %, duration of sleep in 54.5 %, use of hypnotic medication in 56.8 %, daytime dysfunction 50.5 %; and sleep latency, habitual sleep efficiency and sleep disturbances by 57.7 %. Meanwhile, daytime sleepiness was high at 58.6 %. Conclusions. There is a positive and significant relationship between sleep quality and daytime sleepiness in the students of the Name University, reaching ρ = 0.000 (ρ < 0.05); Likewise, a significant relationship was found in each of the dimensions of sleep quality and daytime sleepiness; from which it is interpreted that the quality of sleep has mild problems, daytime sleepiness is at low levels in university students.

Os estudantes universitários são propensos a distúrbios do sono, como a sonolência diurna, o que tem impacto direto na sua qualidade de vida e no desempenho diário. Objetivo. Determinar a relação entre qualidade do sono e sonolência diurna em estudantes da Universidad Nombre, no Peru. Materiais e métodos. Considerou-se a abordagem quantitativa, com desenho não experimental, com aplicação dos instrumentos de qualidade do sono de Pittsburgh e da escala de sonolência de Epworth. A população foi de 446 estudantes e obteve-se uma amostra de 220 estudantes universitários, através de amostragem não probabilística. Resultados. Existem problemas graves em relação à qualidade do sono em 60,9 %; bem como na qualidade subjetiva do sono em 49,5 %, duração do sono em 54,5 %, uso de medicação hipnótica em 56,8 %, disfunção diurna 50,5 %; e latência do sono, eficiência habitual do sono e distúrbios do sono em 57,7 %. Enquanto isso, a sonolência diurna foi elevada, 58,6 %. Conclusões. Existe uma relação positiva e significativa entre a qualidade do sono e a sonolência diurna nos estudantes da Universidade do Nome, atingindo ρ = 0,000 (ρ <, 05); Da mesma forma, foi encontrada relação significativa em cada uma das dimensões da qualidade do sono e da sonolência diurna; a partir do qual se interpreta que a qualidade do sono apresenta problemas leves, a sonolência diurna é baixa em estudantes universitários.

Calidad del sueño en estudiantes de Medicina de una universidad del Perú durante el retorno a la presencialidad posrestricciones sociales por la COVID-19 / Sleep quality among School of Medicine students of a Peruvian university during the return to in-person classes after the COVID-19 social restrictions

RESUMEN Objetivo: Evaluar las características sociodemográficas y académicas asociadas a la calidad del sueño en estudiantes de Medicina Humana. Materiales y métodos: Se realizó un estudio de corte transversal en una muestra que se seleccionó de manera aleatoria de 184 estudiantes de Medicina Humana de una universidad privada ubicada en la ciudad de Lima, Perú. Se llevó a cabo entre junio y julio del 2022, periodo de retorno gradual de los estudiantes a la presencialidad. Los participantes completaron un formulario virtual anónimo que contenía preguntas sobre factores sociodemográficos y académicos, y el índice de calidad de sueño de Pittsburgh (ICSP). Este instrumento comprende siete parámetros con un puntaje cuyo rango es de 0 a 21, donde la buena calidad del sueño se definió de 0 a 5 puntos. El desenlace fue dicotómico (buena y mala calidad del sueño), por lo que se aplicó una regresión logística binaria para evaluar los factores asociados. Resultados: El 53,26 % eran mujeres y el promedio de edad fue 20,05, con una desviación estándar de 1,73. El 61,35 % de las horas de clases fueron dictadas de manera virtual. En la muestra, la prevalencia de una mala calidad del sueño fue 69,02 %; entre mujeres fue 76,53 % y en varones, 60,47 %. Entre los que tuvieron mala calidad del sueño, la media del porcentaje de virtualidad fue mayor respecto a los de buena calidad (63,48 % vs. 56,58 %, p = 0,030). Independientemente del porcentaje de clases virtuales, las mujeres tuvieron el doble de chance de tener mala calidad de sueño (OR = 2,00, IC 95 %: 1,05-3,82). Conclusiones: La mala calidad de sueño afectó a siete de cada diez estudiantes de Medicina Humana en el contexto del retorno gradual a la presencialidad posrestricciones sociales por la pandemia de la COVID-19. Las mujeres tuvieron mayor chance de mala calidad de sueño, independientemente del porcentaje de clases virtuales.

ABSTRACT Objective: To evaluate the sociodemographic and academic characteristics associated with sleep quality among School of Human Medicine students. Materials and methods: A cross-sectional study was carried out in a randomly selected sample of 184 School of Human Medicine students from a private university located in the city of Lima, Peru. The study was conducted between June and July 2022, a period of gradual return to in-person classes. The participants completed an anonymous virtual survey containing questions on sociodemographic and academic factors as well as the Pittsburgh Sleep Quality Index (PSQI). This instrument comprised seven parameters with scores ranging from 0 to 21, where a good sleep quality was established from 0 to 5 points. The outcome was dichotomous (good and poor sleep quality), so binary logistic regression was used to evaluate the associated factors. Results: Females accounted for 53.26 % and the mean age was 20.05 with a standard deviation of 1.73. Concerning the hours of class time, 61.35 % were taught online. As for the sample, the prevalence of poor sleep quality was 69.02 %, out of which 76.53 % were females and 60.47 % males. The mean percentage of online classes was higher among those with poor sleep quality compared to those with good sleep quality (63.48 % versus 56.58 %, p = 0.030). Regardless of the percentage of online classes, females were twice as likely to have poor sleep quality (OR = 2.00, 95 % CI: 1.05 to 3.82). Conclusions: Poor sleep quality affected 7 out of 10 School of Human Medicine students in the context of the gradual return to in-person classes after the COVID-19 social restrictions. Females had a higher chance of poor sleep quality, regardless of the percentage of online classes.

Qualidade de sono e saúde mental de universitários da área da saúde durante a covid-19 / Sleep quality and mental health of university students in healthcare during COVID-19 / Calidad del sueño y salud mental de estudiantes universitarios en el ámbito salud durante el covid-19

Em universitários, comprometimentos na qualidade de sono e na saúde mental estão relacionados com maior disfunção diurna e menor desempenho acadêmico. O contexto causado pela covid-19 prejudicou a qualidade de sono e a saúde mental de diversos grupos populacionais. Entretanto, mais estudos são necessários para avaliar essas variáveis em estudantes universitários matriculados em diferentes cursos da área da saúde durante a referida pandemia. Com esta pesquisa, objetivou-se avaliar a qualidade de sono e saúde mental de estudantes universitários da área da saúde durante a pandemia da covid-19, bem como investigar possíveis correlações entre os referidos aspectos nessa população. Trata-se de estudo transversal que empregou um formulário eletrônico contendo tanto perguntas para caracterização da amostra quanto questionários específicos. O índice de qualidade de sono de Pittsburgh (PSQI) foi empregado para avaliar a qualidade de sono. Já o questionário de saúde geral (QSG-12) e a escala hospitalar de ansiedade e depressão (HAD) para avaliar, respectivamente, o bem-estar psicológico e ansiedade e depressão. 324 estudantes da área da saúde participaram deste estudo. Entre eles, 87.3% apresentaram uma qualidade de sono pobre (≥ 5), 74.1% apresentaram prejuízo na saúde mental e 73.7% apresentaram quadro de ansiedade possível ou provável. Além disso, evidenciou-se correlação moderada positiva entre os valores do PSQI, do QSG-12 e da escala HAD. Nesse contexto, estudos são necessários para investigar opções terapêuticas capazes de atenuar esses impactos.

In university students, sleep quality and mental health impairments are related to greater daytime dysfunction and lower academic performance. COVID-19 has harmed the quality of sleep and mental health of several population groups. However, more studies are needed to evaluate the quality of sleep and mental health of university students enrolled in health courses during the COVID-19 pandemic. To evaluate the quality of sleep and mental health of university students in healthcare during the COVID-19 pandemic and to investigate possible correlations between the aforementioned aspects in this population. An electronic form containing questions to characterize its sample and other specific questionnaires were used in this cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality and the General Health Questionnaire (QSG-12) and the Hospital Anxiety and Depression Scale (HAD) were used to evaluate psychological well-being, anxiety, and depression, respectively. Overall, 324 health students participated in this study. Of these, 87.3% of students had poor sleep quality (≥ 5), 74.1% had impaired mental health, and 73.7% had possible or probable anxiety. Furthermore, the PSQI, QSG-12, and HAD scale values showed a moderately positive correlation. During the COVID-19 pandemic, university students in healthcare experienced significant losses in their sleep quality and mental health. In this context, studies must investigate therapeutic options to mitigate these impacts.

Las alteraciones en la calidad del sueño y la salud mental de estudiantes universitarios se relacionan con una mayor disfunción diurna y menor rendimiento académico. El contexto provocado por el covid-19 ha perjudicado la calidad del sueño y la salud mental de varios grupos de la población. Sin embargo, se necesitan más estudios para evaluar la calidad del sueño y la salud mental de estudiantes universitarios matriculados en diferentes carreras de salud durante la pandemia del covid-19. El objetivo de este estudio fue evaluar la calidad del sueño y la salud mental de estudiantes universitarios en el campo de la salud durante la pandemia del covid-19, así como investigar posibles correlaciones entre los aspectos antes mencionados en esta población. Se trata de un estudio transversal que utilizó un formulario electrónico que contenía preguntas para caracterizar la muestra y cuestionarios específicos. Se utilizó el Índice de Calidad del Sueño de Pittsburg (PSQI) para evaluar la calidad del sueño. El Cuestionario de Salud General (CSG-12) y la Escala Hospitalaria de Ansiedad y Depresión (HADS) se utilizaron para evaluar, respectivamente, el bienestar psicológico y la ansiedad y depresión. En este estudio participaron 324 estudiantes del campo de la salud. De estos, el 87,3% de los estudiantes tenía mala calidad del sueño (≥ 5), el 74,1% presentaban problemas de salud mental y el 73,7% tenía posible o probable ansiedad. Además, hubo una correlación positiva moderada entre los valores de las escalas PSQI, CSG-12 y HADS. Durante la pandemia del covid-19, los estudiantes universitarios del campo de la salud experimentaron pérdidas significativas en su calidad de sueño y salud mental. En este contexto, son necesarios estudios que investiguen opciones terapéuticas capaces de mitigar estos impactos.

Avaliação da qualidade de sono e ansiedade em profissionais e estudantes da saúde no contexto da pandemia pela covid-19 / Evaluación de la calidad del sueño y la ansiedad en profesionales y estudiantes de la salud en el contexto de la pandemia de COVID-19 / Assessment of sleep quality and anxiety in healthcare professionals and students in the context of the COVID-19 pandemic

Introdução: Na pandemia desencadeada pela COVID-19, o desenvolvimento progressivo de sintomas de ansiedade e a má qualidade do sono devem ser investigados em profissionais e estudantes da área da saúde para o adequado manejo. Objetivo: Identificar a prevalência de problemas de sono e sintomas ansiosos em profissionais e estudantes da saúde, e analisar o efeito de variáveis sociodemográficas-clínicas na ansiedade e sono dessa população.Metodologia: Neste estudo transversal de caráter quantitativo aplicou-se um formulário online a 3.337 profissionais e estudantes da saúde do Brasil participantes de um congresso virtual, contendo 51 perguntas subdivididas em três categorias: Perfil sociodemográfico-clínico, Escala de Sono de Jenkins e Inventário de Ansiedade de BECK.Resultados: Dentre os participantes, 81,4% eram estudantes da área da saúde e 12,8% profissionais de saúde. Os achados obtidos indicam que 41% dos participantes apresentaram problemas de sono muito frequentes e 46,6% sinais de ansiedade moderada a grave. Houve associação estatisticamente significativa entre as variáveis sociodemográficas-clínicas e os questionários validados de sono e ansiedade. Conclusão: Essa pesquisa identificou importante prevalência de problemasde sono e sintomas ansiosos em profissionais e estudantes da saúde, sendo primordial a identificação precoce dessas alterações para um manejo efetivo (AU).

Introduction: In the pandemic triggered by COVID-19, the progressive development of anxiety symptoms and poor sleep quality should be investigated in healthcare professionals and students for proper management.Objective: To identify the prevalence of sleep problems and anxious symptoms in healthcare professionals and students, and to analyze the effect of sociodemographic-clinical variables on anxiety and sleep in this population. Methodology: In this cross-sectional quantitative study, an online form was applied to 3,337 healthcare professionals and students from Brazil participating in a virtual congress, containing 51 questions subdivided into three categories: Sociodemographic-clinical profile, Jenkins Sleep Scale and BECK Anxiety Inventory.Results: Among the participants, 81.4% were healthcare students and 12.8% were healthcare professionals. The findings indicate that 41% of the participants had very frequent sleep problems and 46.6% showed signs of moderate to severe anxiety. There was a statistically significant association between the sociodemographic-clinical variables and the validated sleep and anxiety questionnaires. Conclusion:This study identified a high prevalence of sleep problems and anxiety symptoms among healthcare professionals and students, and early identification of these alterations is essential for effective management (AU).

Introducción: En la pandemia desencadenada por el COVID-19, el desarrollo progresivo de síntomas de ansiedad y la mala calidad del sueño deben ser investigados en profesionales y estudiantes de la salud para su adecuado manejo. Objetivo: Identificar la prevalencia de problemas de sueño y síntomas ansiosos en profesionales y estudiantes de la salud, y analizar el efecto de las variables sociodemográficas-clínicas sobre la ansiedad y el sueño en esta población. Metodología:En este estudio transversal y cuantitativo, se aplicó un formulario línea 3.337 profesionales y estudiantes de la salud de Brasil que participaron en un congreso virtual, conteniendo 51 preguntas subdivididas en tres categorías: perfil sociodemográfico-clínico, Escala de Sueño de Jenkins e Inventario de Ansiedad de BECK. Resultados: Entre los participantes, 81,4% eran estudiantes de salud y 12,8% profesionales de la salud. Los resultados indican que el 41% de los participantes tenía problemas de sueño muy frecuentes y el 46,6% mostraba signos de ansiedad de moderada a grave. Hubo una asociación estadísticamentesignificativa entre las variables sociodemográficas-clínicas y los cuestionarios validados de sueño y ansiedad. Conclusión:Este estudio identificó una alta prevalencia de problemas de sueño y síntomas de ansiedad en profesionales de la salud y estudiantes, y la identificación precoz de estas alteraciones es esencial para un manejo eficaz (AU).

Ansiedade, qualidade do sono e sonolência diurna em estudantes de enfermagem de uma instituição privada / Ansiedad, calidad del sueño y somnolencia diurna en estudiantes de enfermería de un centro privado / Anxiety, sleep quality and daytime sleepiness in nursing students at a privateinstitution

Objetivo:Avaliar a correlação entre a ansiedade com qualidade do sono e sonolência diurna dos estudantes universitários em curso de graduação em enfermagem, assim como caracterizar o perfil sociodemográfico dos estudantes. Metodologia:Estudodescritivo transversalcom abordagem quantitativa envolvendo 255 acadêmicos do curso de Enfermagem de uma instituição privada. A coleta dos dados ocorreu em Outubro de 2022 em salas de aula. Os instrumentos utilizados na coleta dos dados foram o Inventário de Ansiedade de Beck,Índice de Qualidade do Sono de Pittsburgh, Escala de Sonolência de Epwort-th e um questionário sociodemográfico. Utilizou-se o software estatístico R versão 4.0.2 e foram feitas suas correlações. Resultados: Foram encontrados padrões de ansiedade grave, com níveis de sonolência diurna anormal. A correlação entre o Inventário de Ansiedade de Beckcom a Escala de Sonolência de Epworth e o Índice de Qualidade de sono de Pittsburgh, que embora tenha sido considerada fraca a moderada, por sua vez mostrou-se significativa (r=0,29; p=0,01). Ademais, temos que, a relação entre oinventário de Becke o Índice de qualidade de sono de Pittsburgh mostrou-se também com valor de significância (r=0,35; p=0,01). Conclusões:Foi possível compreender que a ansiedade pode interferir na qualidade do sono e sonolência diurna do público de estudantes de Enfermagem (AU).

Objective: To evaluate the correlation between anxiety and sleep quality and daytime sleepiness among undergraduate nursing students, as well as to characterize the students' sociodemographic profile. Methodology: A cross-sectional descriptive study with a quantitative approach involving 255 nursing students from a private institution. Data collection took place in October 2022 in classrooms. The instruments used to collect the data were the Beck Anxiety Inventory, the Pittsburgh Sleep Quality Index, the Epwort-Th Sleepiness Scale and a sociodemographic questionnaire. Statistical software R version 4.0.2 was used and correlations were made. Results:Patterns of severe anxiety were found, with abnormal levels of daytime sleepiness. The correlation between the Beck Anxiety Inventory, the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index, although considered weak to moderate, was significant (r=0.29; p=0.01). Furthermore, the relationship between the Beck Inventory and the Pittsburgh Sleep Quality Index was also found to be significant (r=0.35; p=0.01). Conclusions:It was possible to understand that anxiety can interfere with the quality of sleep and daytime sleepiness among nursing students (AU).

Objetivo:Evaluar la correlación entre la ansiedad y la calidad del sueño y la somnolencia diurna en estudiantes universitarios de enfermería, así como caracterizar el perfil sociodemográfico de los estudiantes. Metodología:Estudio descriptivo transversal con enfoque cuantitativo en el que participaron 255 estudiantes universitarios de enfermería de una institución privada. La recogida de datos tuvo lugar en octubre de 2022 en las aulas. Los instrumentos utilizados para la recogida de datos fueron el Inventario de Ansiedad de Beck, el Índice de Calidad del Sueño de Pittsburgh, la Escala de Somnolencia de Epwort-Th y un cuestionario sociodemográfico. Se utilizó el software estadístico R versión 4.0.2 y se realizaron correlaciones. Resultados:Se encontraron patrones de ansiedad severa, con niveles anormales de somnolencia diurna. La correlación entre el Inventario de Ansiedad de Beck con la Escala de Somnolencia de Epworth y el Índice de Calidad del Sueño de Pittsburgh, aunque se consideró de débil a moderada, fue significativa (r=0,29; p=0,01). Además, la relación entre el Inventario de Beck y el Índice de Calidad del Sueño de Pittsburgh también resultó significativa (r=0,35; p=0,01). Conclusiones: Se pudo comprender que la ansiedad puede interferir en la calidad del sueño y en la somnolencia diurna de los estudiantes de enfermería (AU).

Sintomatología ansioso-depresiva y calidad de sueño en alumnos becarios de una universidad privada en Piura, Perú / Anxious-depressive symptoms and sleep quality in scholarship students of a private university in Piura, Peru

RESUMEN Evaluar la asociación entre sintomatología ansioso-depresiva y la calidad de sueño en alumnos de la Universidad de Piura, Perú, pertenecientes al programa Beca 18. Estudio observacional transversal, en el que se utilizó el Índice de Calidad de Sueño de Pittsburgh (PSQI), la Escala de Autodiagnóstico de Ansiedad de Zung (SAS) y la Escala de Depresión de Zung (SDS). De los 293 alumnos becarios participantes en el estudio, 62,5 % reportaron ser «malos dormidores¼, y el 47,8 % y el 56,0 % presentaban algún grado de sintomatología ansiosa y depresiva, respectivamente. Se encontró también que, a medida que aumentaba la sintomatología ansioso-depresiva, la calidad de sueño empeoraba. Se evidenció así una relación significativa (p < 0,005) entre la calidad de sueño y los síntomas depresivos y ansiosos. Existe una tendencia significativa a que los universitarios del programa Beca 18 con sintomatología ansioso-depresiva experimenten concomitantemente un patrón de sueño de mala calidad.

ABSTRACT Objective: To evaluate the association between anxious-depressive symptomatology and sleep quality in students of the Universidad de Piura (Perú) belonging to the "Beca 18" Program. Methods: Cross-sectional observational study that used the Pittsburgh Sleep Quality Index (PSQI), the Zung's Self-Anxiety Scale (SAS) and the Zung Depression Scale (SDS). Results: From the 293 participating scholarship students, 62.5% were "poor sleepers", wheras 47.8% and 56.0%, respectively, presented some degree of anxious and depressive symptomatology; as well, it was found that as the anxious-depressive symptomatology increased, the quality of the students' sleep worsened. Thus, a significant relationship (p(p<0.005) between sleep quality and anxiety and depressive symptoms, was documented. Conclusions: There is a significant tendency for Beca 18 university students with anxious-depressive symptoms to concomitantly experience a sleep pattern of poor quality.

Clinical Observation on Therapeutic Effect of Huatan Jieyu Anshen Decoction Combined with Abdominal Vibration Tuina Manipulations on Chronic Insomnia in the Elderly / 广州中医药大学学报

Objective To investigate the therapeutic effect of Huatan Jieyu Anshen Decoction(mainly with the actions of resolving phlegm,relieving depression and calming mind)combined with abdominal vibration tuina manipulations on chronic insomnia in the elderly.Methods Ninety-four cases of elderly patients with chronic insomnia of phlegm-heat harassing the interior type were randomly divided into the observation group and the control group,with 47 cases in each group.The control group was given Huatan Jieyu Anshen Decoction orally,while the observation group was given oral use of Huatan Jieyu Anshen Decoction combined with abdominal vibration tuina manipulations.The course of treatment for the two groups lasted for 4 weeks.Before and after the treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,Pittsburgh Sleep Quality Index(PSQI)score,Athens Insomnia Scale(AIS)score,Fatigue Scale-14(FS-14)score,World Health Organization Quality-of-Life Brief Scale(WHOQOL-BREF)score,and the serum levels of melatonin(MT),dopamine(DA),and cortisol(CORT).After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 97.88%(46/47),while that of the control group was 87.23%(41/47),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the observation group was superior to that of the control group(P＜0.01).(2)After treatment,the scores of primary and secondary TCM symptoms in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of the scores of primary and secondary TCM symptoms in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the PSQI scores,AIS scores,and FS-14 scores in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the WHOQOL-BREF scores were significantly increased compared with those before treatment(P＜0.05).The decrease of the PSQI scores,AIS scores and FS-14 scores as well as the increase of the WHOQOL-BREF scores in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the serum MT level of both groups was significantly higher than that before treatment(P＜0.05),and the serum DA and CORT levels were significantly lower than those before treatment(P＜0.05).The increase in serum MT level and the decrease in serum DA and CORT levels of the observation group were significantly superior to those of the control group(P＜0.01).Conclusion The combined therapy of Huatan Jieyu Anshen Decoction combined with vibration tuina manipulations can achieve satisfactory efficacy in the elderly patients with chronic insomnia of phlegm-heat harassing the interior syndrome.The therapy is effective on regulating the central nervous system of the patients,improving the quality of the sleep,and promoting the relief of fatigue and the enhancement of the quality of life,which has great significance to the enhancement of the overall therapeutic efficacy of insomnia.

The relationship between activities of daily living and mental health in community elderly people and the mediating role of sleep quality / 复旦学报（医学版）

Objective To explore the relationship and internal path between activities of daily living(ADL),sleep quality and mental health of community elderly people in Shanghai.Methods A questionnaire survey was conducted among community residents aged 60 years and older seeing doctors in community health care center of five streets in Shanghai during Sept to Dec,2021 using convenience sampling.Activities of Daily Living(ADL),Pittsburgh Sleep Quality Index(PSQI)and 10-item Kessler Psychological Distress Scale(K10)were adopted in the survey.Single factor analysis,correlation analysis and multiple linear regression were used to analyze the data.The effect relationship between the variables was tested using Bootstrap's mediated effects test.Results A total of 1 864 participants were included in the study.The average score was 15.53±4.47 for ADL,5.60±3.71 for PSQI and 15.50±6.28 for K10.The rate of ADL impairment,poor sleep quality,poor and very poor mental health of the elderly were 23.6%,27.3%,11.9%and 4.9%,respectively.ADL and sleep quality were all positively correlated with mental health(r=0.321,P＜0.001;r=0.466,P＜0.001);ADL was positively correlated with sleep quality(r=0.294,P＜0.001).Multiple linear results of factors influencing mental health showed that ADL(β= 0.457,95%CI:0.341-0.573),sleep quality(β =0.667,95%CI:0.598-0.737)and mental health were positively correlated(P＜0.001).Sleep quality partially mediated the relationship between ADL and mental health(95%CI:0.078-0.124)with an effect size of 33.0%.Conclusion Sleep quality is a mediator between ADL and mental health among community elderly people.Improving ADL and sleep quality may improve mental health in the population.

Effects of mindfulness-based stress reduction therapy on fear of the disease progression, sleep and quality of life in patients with acute ischemic stroke / 中国实用护理杂志

Objective:To explore the effects of mindfulness-based decompression therapy on fear of disease progression, quality of life and sleep quality in patients with acute ischemic stroke, in order to provide intervention measures to alleviate fear of the disease progression degree and improve sleep and quality of life in patients with acute ischemic stroke.Methods:This study was a randomized controlled study. Using the convenience sampling method, 98 patients with acute ischemic stroke who attended the Department of Neurology at the Third Hospital of Hebei Medical University from November 2021 to September 2022 were selected for the study, and the study population was divided into experimental group ( n=49) and control group ( n=49) using the random number table method. The control group received conventional care, and the experimental group received mindfulness-based stress reduction therapy for 8 weeks in addition to conventional care. Compared the scores of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Stroke-Specific Quality of Life Scale (SS-QOL), and Pittsburgh Sleep Quality Index (PSQI) between the two groups of patients before and after intervention using two independent sample t-tests, and further compared the score spread of each scale before and after intervention between the two groups of patients using Mann-Whitney U test. Results:In the experimental group, 4 cases fell off and 3 cases had imperfect questionnaire information, while in the control group, 2 cases fell off and 5 cases had imperfect questionnaire information. Finally, 42 cases were included in each group. The 23 males and 19 females in the control group aged (48.31 ± 7.61) years old, while 25 males and 17 females in the experimental group aged (50.19 ± 8.64) years old. There was no significant difference in FoP-Q-SF, SS-QOL and PSQI scores between the two groups before intervention (all P>0.05). After intervention, the scores of FoP-Q-SF and PSQI in the experimental group (35.79 ± 7.04, 7.19 ± 2.58) were lower than those in the control group (38.52 ± 4.02, 9.45 ± 2.28), while the SS-QOL score (200.36 ± 21.75) was higher than that in the control group (185.41 ± 15.90), the differences were statistically significant ( t=2.19, -4.26, 3.60, all P<0.05). After intervention, the scores of FoP-Q-SF and PSQI in the experimental group were lower than those before intervention (39.69 ± 4.15, 10.00 ± 2.85), while the SS-QOL score was higher than that before intervention (176.93 ± 23.54), the differences were statistically significant ( t=4.80, 10.45, -11.43, all P<0.05). The score spreads of FoP-Q-SF, SS-QOL, and PSQI in the experimental group before and after intervention were 1.00 (0.00, 9.25), 20.00 (12.75, 32.75), 3 (1, 4), which were higher than 1.00 (-1.25, 2.00), 5.50 (1.00, 10.25), 0 (-1, 2) in the control group, the differences were statistically significant ( Z=-2.30, -5.74, -5.53, all P<0.05). Conclusions:Mindfulness-based decompression therapy can effectively relieve the fear of disease progression and improve the quality of sleep and life in patients with acute ischemic stroke.

Analysis on the current situation and influencing factors of occupational burnout among bus drivers in Wuhu City / 沈阳医学院学报

Objective:To investigate the current situation of occupational burnout among bus drivers in Wuhu City and analyze its influencing factors.Methods:A survey was conducted in 1 388 bus drivers in Wuhu City from Sep to Nov 2022 using the general information questionnaire,the Maslach Burnout Inventory-General Survey(MBI-GS),and the Pittsburgh Sleep Quality Index(PSQI).Multivariable logistic regression analysis was used to analyze the influencing factors of occupational burnout in bus drivers.Spearman correlation analysis was used to analyze the correlation between occupational burnout and sleep quality.Results:Among 1 388 bus drivers,642(46.3%)were positive for occupational burnout,and 139(10.0%)were found to have sleep disorders.Multivariable logistic regression analysis showed that longer bus driving experience(OR=1.873,95%CI:1.325-2.648),lower monthly income(OR=0.376,95%CI:0.158-0.774),higher smoking frequency(OR=1.313,95%CI:1.188-2.163),higher drinking frequency(OR=1.342,95%CI:1.018-1.769),lower weekly physical exercise frequency(OR=0.367,95%CI:0.243-0.555),and poor sleep quality(OR=13.110,95%CI:7.284-23.594)were the influencing factors of bus driver occupational burnout(P＜0.05).Spearman correlation analysis showed that the total score of occupational burnout and its dimension scores were positively correlated with the total score of sleep quality and its dimension scores(rs=0.12-0.83,P＜0.01).Conclusion:The problem of occupational burnout among bus drivers in Wuhu City is relatively serious,and a part of people have sleep problems,which should be paid great attention to and active measures should be taken in time.

Effect of photon cervical vertebra massage instrument on improving neck pain and related functions in patients with chronic neck pain / 中国组织工程研究

BACKGROUND:Red light therapy has the non-invasive and cost-effective characteristics,and is widely used in various acute and chronic pains in clinic.However,currently,the phototherapy equipment used in clinic is expensive and has certain site limitations,so it is necessary to explore more convenient and economical phototherapy applications. OBJECTIVE:To observe the clinical efficacy of a self-developed photon cervical vertebra massage instrument for chronic neck pain. METHODS:From November 2022 to February 2023,24 patients with chronic neck pain were recruited from the Department of Rehabilitation Medicine,Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,including 18 females and 6 males,with a mean age of(29.67±6.40)years.The body mass index was(21.39±3.52)kg/m2.Photon cervical vertebra massage instrument was used twice a day for 20 minutes each time for four weeks.The changes in visual analog scale score,pressure pain threshold,neck active activity,neck disability index,and Pittsburgh sleep quality index were observed before,after 2 and 4 weeks of treatment. RESULTS AND CONCLUSION:(1)Compared with before treatment,after four weeks of treatment,visual analog scale score,pressure pain threshold,neck disability index,and Pittsburgh sleep quality index were all improved(P<0.05),while some cervical motion(extension,left and right rotation)improved(P<0.05)after 4 weeks of treatment.(2)Bilateral visual analog scale scores,left trapezius muscle pressure pain threshold,C5C6 pressure pain threshold,and neck disability index improved after 2 weeks of treatment(P<0.05).(3)It is indicated that the application of photon cervical vertebra massage instrument can improve the pain score,muscle tenderness,sleep quality,functional level,and partial active activity of patients with chronic neck pain in a short period,and is a convenient,effective,and safe treatment method.

Effectiveness of exercise on sleep quality in patients with Parkinson's disease:a Meta-analysis / 中华护理杂志

Objective To evaluate the effectiveness of exercise for people with Parkinson's disease on sleep quality.Methods Computerized retrieval of PubMed,Web of Science,Embase,the Cochrane Library,CINAHL,CN-KI,WanFang Data,VIP,CBM was conducted to collect randomized controlled trials about the effect of exercise on people with Parkinson's disease from inception to December,2022.There were 2 researchers who independently screened the literature,extracted the data and evaluated the risks of bias in the included studies.Meta-analysis was performed using RevMan 5.4 software.Results A total of 13 studies were included,with 874 patients.The result of meta-analysis show that the overall effect size of exercise intervention on sleep quality for people with Parkin-son's disease is significant(SMD=-0.54,95％CI=[-0.90,-0.19],P＜0.01).Subgroup analysis show that the maxi-mum effect size of intervention frequency is 4-5 times/week(SMD=-0.75);the maximum effect size of exercise intensity is light intensity(SMD=-2.19);the maximum effect size of a single intervention time is 40-55 minutes(SMD=-0.69);the maximum effect size of exercise type is traditional Chinese exercise(SMD=-0.63);the maximum ef-fect size of intervention cycle is 12 weeks(SMD=-0.66).Conclusion Exercise intervention has significantly ef-fects to improve sleep quality on Parkinson's disease patients.It is a more effective way to improve sleep quality by exercising 4-5 times per week,while each exercise lasts about 40-55 min for 12 weeks in Traditional Chinese Medicine exercise with light intensity.

Effect of mindfulness-based therapy on postoperative cognitive function and sleep quality in elderly patients after surgery under local anesthesia / 四川精神卫生

BackgroundPostoperative cognitive dysfunction （POCD） is a common complication in elderly patients after surgery， and has a great impact on postoperative rehabilitation of patients. ObjectiveTo explore the effect of mindfulness-based therapy on cognitive function and sleep quality in elderly patients after surgery under local anesthesia， so as to provide references for reducing their incidence risk of POCD and improving sleep quality. MethodsThe simple random sampling method was utilized to select 78 elderly patients who underwent surgery under local anesthesia in The Third Hospital of Mianyang from March 2022 to March 2023. Participants were assigned into study group and control group， each with 39 cases. All patients were subjected to conventional treatment and nursing interventions， and study group added mindfulness-based therapy on this basis. Mini-Mental State Examination （MMSE） was administered to patients on 1 day before surgery， and on the 1st， 3rd and 5th day after surgery. Pittsburgh Sleep Quality Index （PSQI） was employed on 1 day before surgery and on the 3rd day after surgery. ResultsMMSE scores revealed a significant time effect， group effect and time×group interaction effect （F=78.251， 197.071， 371.915， P<0.05）. Analysis of simple effect denoted that study group scored higher on MMSE on the 1st， 3rd and 5th day after surgery compared with control group， with statistical significance （t=-3.579， -1.764， -0.253， P<0.05）. Study group reported lower incidence rates of POCD on the 1st， 3rd and 5th day after surgery compared with control group， with statistical significance （χ2=2.631， 3.471， 5.135， P<0.05）. On the 3rd day after surgery，study group scored lower on PSQI than control group（P<0.05）， and PSQI total score， sleep latency， subjective sleep quality， daytime dysfunction and hypnotic drug use factor scores of study group were lower than baseline， with statistical significance（F=43.175， 12.594， 11.092， 4.579， 3.514， P<0.01）. ConclusionMindfulness-based therapy may have certain value in reducing incidence of POCD and improving sleep quality in elderly patients who underwent surgery under local anesthesia.

Relationship between occupational stress and sleep quality among locomotive engineers: Mediating role of response strategy and moderating role of overcommitment / 环境与职业医学

Background The occurrences of occupational stress and sleep disorders are closely related. As a high-risk group of occupational stress, the sleep quality of locomotive engineers is of great significance for road traffic safety. Objective To explore the direction and degree of occupational stress affecting the sleep quality among locomotive engineers, and to analyze potential mediating and moderating roles of response strategy and overcommitment in the relationship. Methods From July 1st to July 31st, 2022, a total of 6219 locomotive engineers from three locomotive depots of China Railway Lanzhou Group Corporation were selected. We conducted an online survey on occupational stress, overcommitment, response strategy and sleep quality using the Effort-Reward Imbalance, Personal Resources Questionnaire, and Pittsburgh Sleep Quality Index. Single factor analysis and correlation analysis were conducted using SPSS 25.0 software, mediation and moderation models were constructed using the Process V3.3 macro program plugin, and Harman's single factor test was used for common method bias testing. Results A total of 6219 questionnaires were distributed, and 5738 valid questionnaires were collected, with an effective response rate of 92.27%. The average locomotive engineers' occupational stress score (1.22±0.29), overcommitment score (16.38±3.55), response strategy score (50.00±10.00), and sleep quality score (11.51±3.95) were calculated. The Pearson correlation analysis results showed that occupational stress was positively correlated with overcommitment and sleep quality (r=0.435, 0.321, P<0.01), and negatively correlated with response strategy (r=−0.286, P<0.01); overcommitment was positively correlated with sleep quality (r=0.367, P<0.01), and negatively correlated with response strategy (r=−0.210, P<0.01); there was a negative correlation between response strategy and sleep quality (r=−0.244, P<0.01). Occupational stress positively associated with sleep quality in locomotive engineers (b=3.658, t=21.177, P<0.001); response strategy exhibited a partial mediating role between occupational stress and sleep quality, with an effect size of 0.581, accounting for 15.88% of the total effect; overcommitment presented a significant moderating effect in the first half of the mediating process of "occupational stress-response strategy-sleep quality" (P<0.001). Conclusion Occupational stress has an impact on the sleep quality of locomotive engineers through the mediating effect of response strategy, and the first half of this mediating pathway is moderated by overcommitment.

Relationship between self-perceived noise intensity and sleep quality in noise-exposed workers—A mediating role of negative emotions / 环境与职业医学

Background Studies on the relationships of environmental noise exposure with negative emotions and sleep quality have long been reported. Self-perceived noise intensity is not only related to environmental noise exposure, but also reflects an individual's susceptibility to noise; however, few studies on self-perceived noise intensity, negative emotions, and sleep quality have been reported, and it is not clear whether negative emotions play a mediating role in the relationship between self-perceived noise intensity and sleep quality. Objective To analyze the mediating role of negative emotions (anxiety, depression, and stress) in the relationship between self-perceived noise intensity and sleep quality in noise-exposed workers, and to provide a scientific basis for addressing psychological problems and sleep quality induced by noise exposure. Methods Stratified cluster sampling was used to select noise-exposed workers from a large equipment manufacturing plant in Chengdu from May to June 2023, and demographic characteristics were investigated using a self-designed general information questionnaire; self-perceived noise intensity was reported by the study subjects as the noise intensity of their workplaces; sleep quality was synthesized from three indicators: night sleep duration, self-perceived sleep quality, and sleep-related symptoms; the Anxiety-Depression-Stress Scale (DASS-21 scale) was used to evaluate anxiety, depression, and stress of a worker. Structural equation modeling was used to analyze the pathways of negative emotions (anxiety, depression, and stress) between self-perceived noise intensity and sleep quality. Results The positive rates of negative emotions were 33.1% (anxiety symptoms, 215/649), 26.0% (depression symptoms, 169/649), and 14.0% (stress symptoms, 91/649), respectively in a total of 649 noise-exposed workers. Self-perceived noise intensity was positively correlated with sleep quality score (r=0.218, P<0.001) and negative emotions (anxiety, depression, and stress) (r=0.167, 0.145, 0.167, P<0.001); sleep quality score was positively correlated with negative emotions (anxiety, depression, and stress) (r=0.512, 0.447, 0.513, P<0.001). The results of path analysis showed that the negative emotions (anxiety, depression, and stress) partially mediated between self-perceived noise intensity and sleep quality (β=0.123，P<0.001). Self-perceived noise intensity was positively correlated with negative emotions and sleep quality, and there was a path of self-perceived noise intensity → negative emotion → sleep quality (P<0.001), and the mediating effect accounted for 42.71%. Conclusion The positive rates of anxiety, depression, and stress are high among the noise-receiving workers in this manufacturing industry, and negative emotions characterized by anxiety, depression, and stress partially mediate the relationship between self-perceived noise intensity and sleep quality.

Associations of well-being and sleep quality with occupational stress among locomotive engineers in the Yangtze River Delta region / 环境与职业医学

Background Occupational stress is an important factor affecting the health of working population, wellness is a topic that has received much attention in recent years, and sleep quality and wellness have a certain impact on occupational stress. Objective To understand the current situation of occupational stress among locomotive engineers in in the Yangtze River Delta, explore the influence of well-being and sleep quality on occupational stress, and provide a theoretical basis for occupational stress intervention among locomotive engineers. Methods Sampling was conducted from October to December 2022 using stratified random sampling. The Chinese version of the Brief Occupational Tension Questionnaire based on the Job Demand-Control Model (JDC model), the World Health Organization 5-item Well-Being Index (WHO-5), and the Pittsburgh Sleep Quality Index (PSQI) scale were used to investigate the occupational stress, well-being, and sleep quality of locomotive engineers. Logistic regression was used to analyze the effects of sleep quality and well-being on occupational stress, and additive and multiplicative interaction models were applied to evaluate the interactive effects of well-being and sleep quality on occupational stress. Results A total of 8243 questionnaires were collected from five locomotive companies, and after excluding unqualified questionnaires, a total of 7976 questionnaires were included in the analysis. The number of locomotive engineers in the Yangtze River Delta reporting positive occupational stress was 4633 (58.09%), the number of low-level well-being was 4949 (62.05%), and the number of poor sleep quality was 4129 (51.77%). The distribution of occupational stress varied by age, length of service, region, technical level, nature of vehicle, education, per capita monthly family income, marital status, smoking, drinking, number of exercise sessions per week, quality of sleep, work shifts, and length of commute (P<0.01). The results of logistic regression showed that a lower level of occupational stress was associated with >11000 yuan per capita monthly household income (OR=0.795, 95%CI: 0.656, 0.964), high level of well-being (OR=0.477, 95%CI: 0.430, 0.528), and good sleep quality (OR=0.588, 95%CI: 0.531, 0.651); a higher level of occupational stress was associated with night shifts: 1 or fewer night shifts (OR=1.707, 95%CI: 1.312, 2.221), 2 to 3 night shifts (OR=2.649, 95%CI: 2.111, 3.325), and 4 or more night shifts (OR=2.804, 95%CI: 2.202, 3.571); a higher level of occupational stress was associated with 60 min or more commuting time (OR=1.353, 95%CI: 1.111, 1.646). Regarding interaction between poor sleep quality and low well-being on occupational stress, the relative excess risk ratio (RERI), attributable risk index (API), and synergy index (SI) were 1.451 (1.059, 1.844), 0.417 (0.327, 0.507), and 2.407 (1.787, 3.241), respectively, and the result of the multiplicative interaction was an OR of 1.546 (95%CI: 1.262, 1.893). Conclusion The prevalence of occupational stress among locomotive engineers in the Yangtze River Delta region is generally at a medium level compared with other industries. Good sleep quality reduces the risk of occupational stress to a greater extent than high well-being, and poor sleep quality and low well-being can interact and further increase the risk of occupational stress.

Vibration-Kneading Abdominal Tuina as An Adjunct Treatment for Insomnia of Phlegm-Heat Harassing the Interior Syndrome with "Stomach Disharmony"： A Randomised Controlled Trial / 中医杂志

ObjectiveTo explore the effectiveness and safety of vibration-kneading abdominal tuina as an adjunct treatment for insomnia of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom. MethodsSeventy-six insomnia patients of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom were recruited， and randomly divided into the treatment group and the control group with 38 cases in each group. The control group received eszopiclone 2mg once a night and sleep hygiene guidance， while the treatment group received vibration-kneading abdominal tuina additionally， 5 times a week， 30 min each time. Both groups were treated for 4 weeks. The Pittsburgh Sleep Quality Index （PSQI） （including sleep quality， time to fall asleep， sleep duration， sleep efficiency， sleep disorders， daytime functioning scores， and total scores） and traditional Chinese medicine （TCM） symptom scores of "stomach disharmony" was assessed before and after 4-week treatment and at follow-up （12 weeks after treatment）. Adverse events were also observed and recorded during the study. Pearson correlation analysis was used to assess the correlation between the pre-treatment PQSI total score and TCM symptom score of "stomach disharmony". ResultsThe PSQI scores of sleep quality， time to fall asleep， sleep duration， sleep efficiency， sleep disorders， daytime dysfunction scores， and total scores reduced in both groups decreased after treatment and at follow-up （P＜0.05 or P＜0.01）， as well as the TCM symptom score of "stomach disharmony" （P＜0.01）. After treatment， the PSQI scores of sleep quality， sleep duration， and TCM symptom score of "stomach disharmony" of the treatment group were lower than those of the control group （P＜0.05 or P＜0.01）. At follow-up， the PSQI scores of sleep quality， sleep duration， sleep efficiency， daytime dysfunction score， total score， and TCM symptom score of "stomach disharmony" of the treatment group were lower than those of the control group （P＜0.05 or P＜0.01）. No adverse reactions occurred in any participants during the study. There was a positive correlation between the patients' pre-treatment PQSI total scores and TCM symptom score of "stomach disharmony" （r=0.88， P＜0.01）. ConclusionVibration-kneading abdominal tuina as an adjunct treatment could significantly improve the symptoms of stomach and epigastric symptoms in insomnia patients of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom， and improve the quality of sleep， with good immediate and long-term therapeutic effects， and sound safety.