A qualidade do sono está associada a determinantes sociodemográficos e clínicos em usuários acompanhados na Atenção Primária à Saúde durante a pandemia de COVID-19 / Sleep quality is associated with sociodemographic and clinical determinants in users attended in Primary Health Care during the COVID-19 pandemic / La calidad del sueño se asocia con determinantes sociodemográficos y clínicos en usuarios monitoreados en Atención Primaria de Salud durante la pandemia de COVID-19

Introdução: O avanço da pandemia de COVID-19 acarretou alterações no sono da população. Os distúrbios do sono têm relação com as principais alterações de saúde mental e também possuem relação com os fatores psicossociais. Objetivo: Estimar a prevalência e fatores associados às alterações na qualidade do sono em usuários acompanhados na Atenção Primária à Saúde durante a pandemia de COVID-19. Métodos: Estudo do tipo transversal, com adultos (idade >18 anos) de ambos os gêneros, acompanhados por uma unidade de saúde. Foram levantadas as informações do prontuário eletrônico da unidade e, durante a visita domiciliar (entre agosto e setembro de 2021), os dados socioeconômicos, fatores de risco, sinais vitais, variáveis antropométricas, hábitos de vida, medicações em uso, uso dos serviços de saúde, internação e consultas no último ano. A qualidade de vida foi avaliada pelo questionário SF-36 e foi usado o Índice de Qualidade do sono Pittsburgh (PSQI). Resultados: A amostra foi formada predominantemente por mulheres (82,9%) com 60,5±11,7 anos de idade, da cor branca (70,7%), com companheiro (61%) e pertencentes à classe C (65,8%). 53,7% da amostra apresentou até duas comorbidades, 87,8% apresentavam sobrepeso/obesidade e 80% faziam uso de anti-hipertensivo. A prevalência de qualidade do sono ruim foi de 87,8% (IC95% 73,1­95,0). Os achados apontam para uma relação entre má qualidade do sono com consumo de álcool, presença de ≥3 comorbidades, níveis de PAS, uso de ansiolíticos, nível de escolaridade e uso de serviços de saúde durante a pandemia. Conclusões: A alta prevalência de qualidade do sono ruim na amostra estudada sugere que determinantes sociodemográficos, presença de comorbidades e hábitos de vida devem ser considerados para minimizar os efeitos das alterações do sono na pandemia.

Introduction: The advancement of the COVID-19 pandemic has resulted in changes in the sleep patterns of the population. Sleep disorders are related to major mental health changes and are also associated with psychosocial factors. Objective: To estimate the prevalence and factors associated with sleep quality changes among users attended in Primary Health Care during the COVID-19 pandemic. Methods: This was a cross-sectional study involving adults (age >18 years) of both genders who were being followed at a healthcare unit. Information was gathered from the unit's electronic medical records, and during home visits (between August and September 2021), socioeconomic data, risk factors, vital signs, anthropometric variables, lifestyle habits, current medications, healthcare service utilization, hospitalization, and consultations in the past year were collected. Quality of life was assessed using the SF-36 questionnaire, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Results: The sample consisted predominantly of women (82.9%) with an average age of 60.5±11.7 years, of white ethnicity (70.7%), with a partner (61%), and belonging to class C (65.8%). 53.7% of the sample had up to two comorbidities, 87.8% were overweight/obese, and 80% were using antihypertensive medication. The prevalence of poor sleep quality was 87.8% (95%CI 73.1­95.0). The findings indicate a relationship between poor sleep quality and alcohol consumption, the presence of ≥3 comorbidities, systolic blood pressure levels, use of anxiolytics, education level, and the use of healthcare services during the pandemic. Conclusions: The high prevalence of poor sleep quality in the study sample suggests that sociodemographic determinants, presence of comorbidities, and lifestyle habits should be considered to minimize the effects of sleep disturbances during the pandemic.

Introducción: El avance de la pandemia de COVID-19 ha ocasionado cambios en el sueño de la población. Los trastornos del sueño están relacionados con los principales cambios en la salud mental y también se asocian con factores psicosociales. Objetivo: Estimar la prevalencia y los factores asociados con alteraciones en la calidad del sueño en usuarios atendidos en la Atención Primaria de Salud durante la pandemia de COVID-19. Métodos: Estudio transversal con adultos (edad >18 años) de ambos géneros que son atendidos en una unidad de salud. Se recopilaron datos del historial clínico electrónico de la unidad y durante la visita domiciliaria (entre agosto y septiembre de 2021) se obtuvieron datos socioeconómicos, factores de riesgo, signos vitales, variables antropométricas, hábitos de vida, medicamentos utilizados, uso de servicios de salud, hospitalización y consultas en el último año. La calidad de vida se evaluó mediante el cuestionario SF-36 y se utilizó el Índice de Calidad del Sueño de Pittsburgh (PSQI). Resultados: La muestra estuvo compuesta predominantemente por mujeres (82,9%) con una edad de 60,5±11,7 años, de raza blanca (70,7%), con pareja (61%) y pertenecientes a la clase C (65,8%). El 53,7% de la muestra presentó hasta dos comorbilidades, el 87,8% tenían sobrepeso/obesidad y el 80% utilizaba medicación antihipertensiva. La prevalencia de mala calidad del sueño fue del 87,8% (IC95% 73,1­95,0). Los hallazgos señalan una relación entre la mala calidad del sueño y el consumo de alcohol, la presencia de ≥3 comorbilidades, los niveles de presión arterial sistólica (PAS), el uso de ansiolíticos, el nivel de escolaridad y el uso de servicios de salud durante la pandemia. Conclusiones: La alta prevalencia de mala calidad del sueño en la muestra estudiada sugiere que se deben considerar los determinantes sociodemográficos, la presencia de comorbilidades y los hábitos de vida para minimizar los efectos de los trastornos del sueño en la pandemia.

Chronotype, sleep quality, impulsivity and aggression in patients with borderline personality disorder and healthy controls.

Impulsivity, aggression, and suicide are the major clinical symptoms of borderline personality disorder (BPD). Although previous studies indicated poor sleep quality and its relationship with clinical symptoms in patients with BPD, chronotype, an important sleep parameter, was not investigated in these patients. This study aimed to analyze chronotype and its relationship with clinical symptoms in patients with BPD. Participants in this study consisted of 68 BPD patients and 65 healthy controls. Subjective sleep characteristics, impulsivity, aggression, suicide probability, and chronotype were assessed using the Pittsburgh Sleep Quality Index (PSQI), Barratt Impulsivity Scale, Buss-Perry Aggression Scale (BPAQ), Suicide Probability Scale, and Morningness - Eveningness Questionnaire, respectively. PSQI total and subscale scores subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, and daytime drowsiness were significantly higher in the BPD group (p < 0.001). There was a positive correlation between the PSQI total score and the BPAQ total score (r = 0.268, p = 0.027). The rate of evening type was significantly higher in the control group (p = 0.004). Suicide attempts and the subscale of suicide probability hopelessness, suicidal ideation, and negative self-evaluation scores were significantly higher in evening type BPD patients. (p = 0.017, p = 0.009, p = 0.001, p = 0.047). Sleep quality is associated with aggression, and the eveningness chronotype is associated with suicide. It may be useful to focus on sleep problems in treating BPD patients.

A Longitudinal Investigation on the Reciprocal Relationship of Problematic Smartphone Use with Bedtime Procrastination, Sleep Quality, and Mental Health Among University Students.

Background: Problematic smartphone use (PSU) is linked to various mental health issues, but the relationship between PSU, bedtime procrastination, and mental health symptoms is unclear. Sleep factors related to PSU and its mental health effects have been understudied. This study explores the longitudinal associations between PSU, bedtime procrastination, sleep quality, and mental health in university students. Methods: In this study, a total of 683 university students participated by completing questionnaires on Smart Phone Addiction (SAS) scale, Bedtime Procrastination Scale (BPS), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety Stress Scales 21 (DASS-21) across two different time points with six-months interval between them. The participants were selected using a cluster sampling technique from Quaid-e-Azam University, Islamabad, Pakistan. A cross-lagged model was utilized to assess the longitudinal association between these variables. Results: Statistically significant reciprocal associations were found between PSU, bedtime procrastination, and mental health symptoms. PSU at Time 1 significantly predicted PSU at Time 2, bedtime procrastination at Time 2, sleep quality at Time 2, and mental health symptoms at Time 2. Bedtime procrastination at Time 1 predicted PSU at Time 2, sleep quality at Time 2, and mental health symptoms at Time 2. Sleep quality at Time 1 predicted bedtime procrastination at Time 2 and mental health symptoms at Time 2. Mental health symptoms at Time 1 predicted PSU at Time 2 and sleep quality at Time 2. Conclusion: The research findings have significantly advanced understanding of the longitudinal connections between PSU, bedtime procrastination, sleep quality, and mental health indicators. This enhanced comprehension is instrumental for psychological practitioners in devising targeted interventions to mitigate such issues among the university student demographic.

Residual kidney function and sleep quality in hemodialysis patients.

Background: Sleep disorders frequently affect end-stage renal disease patients on dialysis. However, the relationship between sleep quality and residual kidney function is still unclear. Therefore, this study aimed to investigate this relationship. Methods: In this analytical cross-sectional study, 225 patients who were referred to dialysis centers were studied, and based on renal function, they were classified into two groups with and without residual kidney function. The study employed the Pittsburgh Sleep Quality Index questionnaire to evaluate sleep quality. Multiple linear regression was utilized to determine the factors affecting sleep quality with a significance level consideration at p<0.05. Results: The mean age of patients was 58.23 ± 13.50 years. 58.7% of patients were males. The problem of serious and very serious sleep in the Sleep latency and sleep duration has been more than other components. 72% of hemodialysis patients had poor sleep quality. In the multiple linear regression model, age (ß = 0.442, 95% CI: 0.096, 0.788), sex (ß = -0.847, 95% CI: -1.641, -0.054), Body mass index (ß = 0.153, 95% CI: 0.058, 0.249) and dialysis duration (ß = 0.097, 95% CI: 0.002, 0.192) were independently and significantly associated with sleep quality score. However, there was no statistically significant relationship between sleep quality and residual kidney function. Conclusion: In conclusion, poor sleep quality is very common in patients undergoing hemodialysis. Therefore, sleep disorders in hemodialysis patients should be considered as one of the most challenging problems by healthcare providers, and early diagnosis and intervention are essential to improve sleep quality.

Perceptions of Sleep Quality, Fatigue, and Cognition Among Women Shift Workers.

OBJECTIVE: To explore the perceptions of sleep quality, levels of fatigue, and cognitive executive function in women shift workers. DESIGN: Qualitative, descriptive study of a sample of participants who participated in a cross-sectional, mixed-methods study. SETTING: Online focus groups. PARTICIPANTS: Women shift workers (N = 14) recruited from the southeastern United States. METHODS: Four focus groups were conducted using the Zoom online videoconferencing platform. Transcripts were coded inductively, and data were analyzed using a thematic analysis approach. RESULTS: Five major themes were developed from the data: Lots of Sleep Lost, Day Sleep Difficulties, Negative Consequences, Missing Out, and Not in My Own Thoughts. CONCLUSION: Shift work is associated with sleep loss, which has a negative impact on women's emotional, mental, and physical health. Further nursing science investigation into strategies to enable women to improve their sleep quality, sleep quantity, and social/domestic environment is warranted. Education to increase sleep knowledge and decrease accidents and errors that can result from insufficient sleep is vital.

Investigation of the influence of 45-minute pre-sleep social media use on sleep quality and memory consolidation in adolescents.

Adolescents devote a significant portion of their time to smartphone usage, often engaging in social media activities. Social media use has previously been linked to diminished sleep quality and reduced sleep durations in correlational studies. In this experimental study, we aimed to investigate the influence of pre-sleep social media use on memory consolidation, subjective arousal and objectively assessed sleep quality in adolescents. We compared the social media condition to two reading conditions, one involving reading a book on a smartphone and the other reading from a physical book in a within-subjects design. Twenty participants between 12 and 14 years engaged in these activities for 45 min before bedtime. Contrary to our expectations, the results indicated that pre-sleep social media use did not have a discernible impact on sleep quality, pre-sleep arousal or memory consolidation. All assessed sleep measures remained consistent across the three conditions. Subjectively, the social media condition was rated less thrilling than the reading conditions. This suggests that, within the confines of this experiment, pre-sleep social media exposure did not significantly disrupt adolescents' sleep or their ability to consolidate memories during sleep. This deviation from previous correlational studies might be explained by a possible impact of mental health factors on media consumption and sleep or the fact that contrary to their daily routines participants had to sleep after our intervention and could not continue to engage in their activities. This highlights the need for further investigations into the complexities of this interaction.

Chronotype, sleep quality, depression and pre-sleep rumination: A diary and actigraphy study.

Eveningness has been associated with both disturbed sleep and depression. It is unclear, however, if deprived sleep explains evening types' vulnerability to depression. The role of pre-sleep rumination in these associations also remains understudied. The present study assessed the relationship between eveningness and sleep quality, as well as the possible mediating effect of pre-sleep rumination and the moderating effect of a history of depression, under naturalistic conditions. Eighty-eight Dutch-speaking participants (87.5% females, 21.4 ± 3.7 years) were selected on the basis of their non-intermediate chronotype using the Morningness Eveningness Questionnaire (evening types (n = 53); morning types (n = 35)). Depression status was assessed through a diagnostic interview (healthy (n = 61); remitted depressed (n = 27)). Participants' sleep characteristics were monitored via actigraphy and sleep diaries for seven consecutive days and nights. Pre-sleep rumination was measured via a self-report questionnaire. Evening types had longer subjective and actigraphic sleep onset latency than morning types. Pre-sleep rumination did not mediate the former associations but predicted longer subjective sleep onset latency. Furthermore, the relationship between chronotype and subjective sleep onset latency was moderated by depression history. Remitted depressed evening types reported longer sleep onset latency than healthy evening and morning types, possibly posing the former at a higher risk for depressive relapse. Overall, the current findings address the need to further investigate the physiological signature of circadian rhythms and sleep latency. This could serve as a foundation for the development of prevention and early intervention programs, tailored for mood and sleep disorders.

The impact of smartphone dependence on college students' sleep quality: the chain-mediated role of negative emotions and health-promoting behaviors.

Objective: Sleep disturbances among college students have become a significant issue affecting their daily lives. This study aims to explore the relationship between smartphone dependence and sleep quality and examine the mediating roles of negative emotions and health-promoting behaviors. Methods: A total of 23,652 college students were included in the study, and 21,314 valid questionnaires were collected. The survey assessed demographic factors, smartphone dependence, sleep quality, negative emotions, and health-promoting behaviors. A chain mediation analysis was conducted to examine the relationships among these factors. Results: Smartphone dependence was significantly positively correlated with sleep quality (r = 0.272, p < 0.001) and negative emotions (r = 0.414, p < 0.001), and significantly negatively correlated with health-promoting behaviors (r = -0.178, p < 0.001). Sleep quality was positively correlated with negative emotions (r = 0.472, p < 0.001) and negatively correlated with health-promoting behaviors (r = -0.218, p < 0.001).Smartphone dependence was a significant positive predictor of sleep quality. Moreover, negative emotions and health-promoting behaviors influenced the relationship between smartphone dependence and sleep quality. The total effect, direct effect, and indirect effect values were 0.304, 0.122, and 0.170, respectively. Conclusion: Different demographic factors (such as gender and place of residence) can lead to variations in different variables. Smartphone dependence and negative emotions have a positive impact on sleep quality among college students, while health-promoting behaviors have a negative impact. Smartphone dependence directly and positively affects sleep quality and can also influence it indirectly through the mediating effects of negative emotions and health-promoting behaviors, both individually and in a chain-like manner.

Sleep quality disparities in different pregnancy trimesters in low- and middle-income countries: a systematic review and meta-analysis.

INTRODUCTION: Sleep is a crucial determinant of maternal and fetal health, significantly impacting the well-being of both the mother and her developing fetus. Poor sleep quality, characterized by difficulties in falling asleep or staying asleep, can cause poor pregnancy outcome. Conversely, studies came with inconsistent result in the prevalence of poor sleep quality in different trimester of pregnancy. Therefore, this systematic review and meta-analysis study aimed to compare the prevalence of poor sleep quality in different trimesters. METHOD: A systematic review and meta-analysis were done on published studies. Electronic data base search was done from PubMed, Hinari, Medline and Google Scholar. Data were extracted with Excel and the analysis were done using STATA version 17. Publication bias was assessed both graphically and statistically. I-square test was used to identify heterogeneity. RESULT: In this meta-analysis, 38 studies that measured poor sleep quality using the Pittsburg Sleep Quality Index (PSQI ≥ 5) were included. The pooled prevalence of poor sleep quality was identified as 37.46% (95% CI: 29.26, 45.67) in the first trimester, 47.62% (95% CI: 42.23, 53.02) in the second trimester, and 60.05% (95% CI: 51.32, 68.78) in the third trimester. CONCLUSION: This study identified a significant discrepancy in the prevalence of poor sleep quality, which increases as gestational age advances. Therefore, this discrepancy should be addressed, and additional support should be provided to pregnant women to help them achieve adequate sleep, especially as gestational age advances.

Relationship between temporomandibular and sleep disorders in adults: An overview of systematic reviews.

OBJECTIVE: This study emphasizes the general relevance of sleep disorders (SD) and temporomandibular disorders (TMD), explores their bidirectional relationship, and describes the importance of systematic reviews in the critical analysis of the literature. This review aimed to comprehensively summarize the relationship between SD and TMD in adults while ensuring a reliable and objective analysis of data from the existing literature. METHODS: Systematic reviews were evaluated to investigate this association between two conditions in adults. The study was registered with Prospero and followed the PECOT structure in identifying the research question. Searches in multiple databases were conducted until February 2024 using relevant keywords. The risk of bias was assessed using the Risk of Bias in Systematic Reviews tool, involving two independent reviewers. RESULTS: Data were extracted using different evaluation instruments, and results were analyzed and presented through the synthesis of information collected in selected systematic reviews. The selection included seven systematic reviews of observational studies, with exclusion criteria defined to ensure methodological quality. The results showed that reviewed studies presented clarity and relevance in defining the eligibility criteria, but that the identification and selection of studies, data collection, and synthesis of results varied. Most studies considered the potential risks, but some require greater transparency and methodological rigor. CONCLUSIONS: This review points out the association between SD and TMD in adults, with most studies presenting a low risk of bias, although some uncertainties were observed.

Correlation between physical exercise levels, depressive symptoms, and sleep quality in college students: Evidence from electroencephalography.

BACKGROUND: In recent years, depression has increasingly become a major global public health issue. Among its common physical symptoms, sleep disturbances are prevalent in individuals with depression and are considered a risk factor for the progression of the disorder. Poor sleep quality may be a significant contributor to depression among college students. However, the EEG indicators that are commonly associated with depressive symptoms and sleep quality, as well as the effects of physical exercise on these EEG indicators, remain unclear. PURPOSE: This study aims to explore the relationship between physical activity levels, depressive symptoms, and sleep quality among college students, based on resting-state electroencephalography (EEG) data in a cross-sectional study. METHODS: A total of 342 college students were recruited to assess physical activity levels, depressive symptoms, sleep quality, and EEG data. Pearson correlation coefficients were used to evaluate the relationships among these variables, and the PROCESS macro (Model 4) for SPSS was applied to examine the mediating role of sleep quality in the relationship between physical activity levels and depressive symptoms, with mediation effects tested using the bootstrap method. RESULTS: A significant difference was observed in the Pittsburgh Sleep Quality Index (PSQI) total scores between students with and without depressive symptoms (T = 9.746, P < 0.001). Students with depressive symptoms showed poorer sleep quality across various dimensions, including sleep duration, sleep onset latency, sleep disturbances, and daytime dysfunction. Depression symptom were positively correlated with Sleep Quality (r = 0.547, P < 0.001), indicating that higher depression symptoms are associated with poorer sleep quality. Correlations between depressive symptoms and EEG power values revealed significant associations with theta and beta2 frequencies in multiple brain regions (P < 0.05). Physical exercise showed a significant negative correlation with Sleep Quality scores (r = -0.158, P = 0.004), and with sleep duration (r = -0.141, P = 0.011) and daytime dysfunction (r = -0.142, P = 0.010). Additionally, physical exercise was negatively correlated with theta band power at F8 (P < 0.05). Mediation analysis demonstrated that physical exercise has a direct effect on depressive symptoms (ß = -0.123, 95 % CI = -0.287 to -0.069) and an indirect effect through improved sleep quality (ß = -0.074, 95 % CI = -0.089 to -0.016), accounting for 60.16 % and 40.65 % of the total effect, respectively. CONCLUSION: These findings provide a theoretical basis for developing precise exercise intervention programs to improve depressive symptoms and sleep quality among college students. The results indicate that moderate physical activity can help alleviate depressive symptoms and improve sleep quality, thereby enhancing the overall health of college students.

Internet Addiction and Sleep Quality Among School Children in South India.

BACKGROUND AND AIM: Today's internet is an unavoidable component of educational sources, the entertainment field, and telecommunication processes. Internet usage is more likely among adolescents and young adults in the form of surfing, chatting, playing games, and fulfilling their social needs. The present study has been planned to assess the effect of internet addiction (IA) on sleep quality in school children. METHODS: This cross-sectional school-based study was conducted among school students in Pondicherry. A total of 350 school students of both genders studying in grades six to 10 and having access to at least one device with internet for more than one year were recruited from government and private schools located in five randomly selected communes in Pondicherry by convenient sampling method. Assessment of IA was done using Young's Internet Addiction Test (YIAT). The Pittsburgh Sleep Quality Index (PQSI) questionnaire assessed the participants' sleep quality. All the data was tested for normality using the Kolmogorov-Smirnov test. Chi-square and unpaired t-tests were used for analysis. RESULTS: The average age of the participants is 13 years. 49 (26.1%) are children and 139 (73.9%) are adolescents. The majority of them are females belonging to the adolescent age group (169, 89.4%). Around 17 (19.5%) children and 70 (80.5%) adolescents reported mild IA. Thirteen (59.1%) children and nine (40.9%) adolescents reported moderate IA. There is no significant difference in sleep quality between children and adolescents (4±2.33 vs. 3.62±2.61, p=0.37) but there is a considerable difference in their levels of IA (32.98±21.06 vs. 25.6±15.08, p=0.01).  Conclusion: This study found a significant relationship between IA and poor sleep quality among adolescents. Thus, adolescents, parents, school authorities, and researchers should understand the importance of regulating internet usage and encouraging sleep hygiene. Thus, appropriate measures should be taken to address the effects of IA on sleep quality.

Quality of sleep after COVID-19 infection: a cross-sectional study in the Southern Italy.

Introduction: This study investigated the quality of sleep in a sample of individuals from Southern Italy after the major waves of the COVID-19 pandemic, with the aim of evaluating how sleep patterns changed. Methods: A cross-sectional study was conducted between March 2022 and January 2023 and involved adults who had a COVID-19 infection, who were invited to complete a self-administered online questionnaire. Results: A total of 408 individuals participated in the survey. Overall, 66.4% had a reduction in social relations; 72.1% had an increase in the use of social media; and 86%, 77.2%, and 71.1% reported an extremely severe level of anxiety, stress, and depression, respectively. Almost all of the respondents had a Pittsburgh Sleep Quality Index score (PSQI) ≥5, indicating poor sleep quality. Subjects with a severe or extremely severe depression score, a severe or extremely severe stress score, who had a job, and who had someone close who died because of a COVID-19 infection were more likely to have a high PSQI global score. The use of sleep medication in the past months was significantly higher in those who were older, who had a job, who had a COVID-19 infection in the first and second waves, who had someone close who died from COVID-19, and who did not have changes in social relationships during the pandemic. Moreover, participants with severe or extremely severe depression scores, with severe or extremely severe stress scores, who were women, and who were older had troubles staying awake while engaging in social activities during the past month. Conclusion: The results bring to light the high prevalence of poor sleep quality among individuals who were infected with SARS-CoV-2. Future research is needed to understand whether these disturbances are still present in the endemic period and whether it is necessary to investigate further determinants that have affected and/or are affecting sleep quality.

Effects of endoscopic lobectomy and conventional lobectomy on psychological and sleep quality in patients with papillary thyroid microcarcinoma-a prospective observational study.

BACKGROUND: Both endoscopic thyroid lobectomy and conventional thyroid lobectomy are effective modalities for treating papillary thyroid microcarcinoma (PTMC). However, their respective psychological and sleep quality ramifications in patients remain largely unexplored. MATERIALS AND METHODS: Patients diagnosed with PTMC who underwent thyroid lobectomy at our institution between July 15, 2021, and July 15, 2022, were prospectively recruited. Psychological distress and sleep quality were assessed at five intervals (hospital admission, hospital discharge, and 1, 3, and 6 months posttreatment) utilizing four validated scales. The PTMC patients who completed the questionnaires diligently were subsequently categorized into either the endoscopic thyroid lobectomy group (trial group) or the conventional thyroid lobectomy group (control group). A propensity score matching (PSM) cohort was then established to examine longitudinal and cross-sectional alterations in psychological parameters. RESULTS: Out of 602 eligible PTMC patients, 560 individuals completed all the questionnaires diligently during the follow-up period (response rate: 93.02%). This cohort comprised 176 patients (31.43%) who underwent endoscopic thyroid lobectomy and 384 patients (68.57%) who underwent conventional thyroid lobectomy. Following PSM, a comprehensive set of 176 matched patient pairs was successfully established. Both groups of patients exhibited a decline in sleep quality throughout the 6-month postoperative follow-up period; however, patients in the control group experienced concomitant elevation in anxiety levels. The PSQI scores of patients in the control group were markedly higher than those in the trial group across all follow-up time points, whereas the HAMA, HADS, and HEI scale scores did not significantly differ between the two groups. CONCLUSIONS: In terms of sleep quality and psychological well-being, endoscopic thyroid lobectomy is superior to conventional thyroid lobectomy for PTMC patients.

Effects of zinc supplementation on sleep quality in humans: A systematic review of randomized controlled trials.

Background and Aims: Alternative therapies, such as zinc supplementation, have been explored as potential interventions for sleep disorders. However, the efficacy of zinc supplementation in improving sleep quality remains uncertain. This systematic review aims to examine the impacts of zinc supplementation on sleep quality in humans. Methods: The Web of Science, Medline, Scopus, and Google Scholar databases were comprehensively searched to find studies investigating the effect of zinc supplementation on sleep quality. After identifying relevant studies by screening, relevant data were extracted from them. The quality assessment was conducted using the Cochrane quality assessment tool. Results: This systematic review included eight studies. The interventions ranged from 4 to 48 weeks, with a daily dose of zinc supplementation varying between 10 and 73.3 mg. The majority of the evidence examined in this review pointed to the significant improvement effect of zinc supplementation on sleep quality in adults compared to the control groups. Furthermore, zinc supplementation did not have a significant effect on sleep disorders. However, there was no consensus about these findings. Also, the effect of supplementation on sleep duration in nonadults was contradictory. Conclusions: This systematic review suggests that zinc supplementation may lead to improvements in sleep quality. However, more research, primarily clinical trials, is needed to clarify the beneficial effects of zinc supplementation on sleep quality with consideration of dietary zinc intake and the Recommended Dietary Allowances of zinc (RDA) in the different populations. It is also recommended to investigate the effect of zinc supplementation on sleep quality in people with zinc deficiency in future studies.

Aromatherapy for Sleep Promotion in the ICU: Insights and Future Directions.

BACKGROUND: The effects of inhaled aromatherapy on sleep quality in critically ill patients in the intensive care unit (ICU) have been widely studied. Specific essential oil combinations have been highlighted for their potential to promote sleep in these patients. AIM: To offer additional insights and future directions for the application of aromatherapy in improving sleep quality among critically ill patients, considering the current evidence and addressing gaps in research. DISCUSSION: While certain blends of essential oils, such as lavender, Matricaria recutita, and neroli, have shown promise, other studies have produced mixed results regarding the optimal aromatherapy interventions. Integrating aromatherapy with other non-pharmacological approaches, such as earplugs, eye masks, or music, may offer enhanced sleep benefits. Further research is needed to evaluate aromatherapy's effects on specific populations, such as intubated patients, and to assess feasibility, cost-effectiveness, and potential adverse effects. CONCLUSION: Aromatherapy shows promise for improving sleep quality in critically ill patients but should be integrated with other evidence-based, non-pharmacological interventions. Addressing research gaps is crucial for developing comprehensive strategies to enhance sleep quality in ICU settings.

The connection between sleep deficiency and coronary artery disease: Complexities and controversies.

The growing burden of coronary artery disease (CAD) has led to a deeper exploration of the pathophysiologic mechanisms underlying the disease process with the hope of finding novel treatments to reduce CAD morbidity and mortality. Sleep is a normal physiologic phenomenon essential for maintaining homeostasis. Disruption in sleep physiology has been linked to the activation of pro-inflammatory cytokines that may predispose to a greater risk of CAD. Several studies have evaluated the etiologic relationship between sleep deficiency and CAD. In this review, we attempt to highlight the key mechanisms proposed to play a role in the association of sleep with the pathophysiology of CAD, the findings and limitations of the pertinent studies, and possible future direction for evaluating and leveraging the relationship between sleep and CAD to develop new therapeutics.

The efficacy of occlusal appliance with a moisturizing gel pocket on sleep quality in patients with nocturnal xerostomia: A case series.

PATIENTS: A case series of five patients (mean age, 77.0 years) with complaints of nocturnal xerostomia were subjected to occlusal appliance treatment with a reservoir of moisturizing gel during the night. An occlusal appliance covers the dental arch and hard palate, providing space in the midline of the hard palate to hold the moisturizing gel. Sleepiness was assessed using the Epworth Sleepiness Scale (ESS), and sleep quality was assessed using the Japanese version of the Pittsburgh Sleep Questionnaire (PSQI-J) before and after treatment. The total PSQI-J scores decreased in all patients after treatment. The ESS score, sleep time, and sleep efficiency improved or remained unchanged and none of the patients' symptoms worsened. DISCUSSION: This study demonstrated the efficacy of occlusal appliance treatment in patients with dry mouth in improving self-reported sleep quality. Patients included those with nocturnal xerostomia and poor sleep quality on the PSQI-J. Treatment with xerostomia resulted in improved sleep quality, as assessed by the decrease in PSQI-J scores. CONCLUSIONS: This case series suggests that sleep quality may be worse in patients with xerostomia, and that treatment for nocturnal xerostomia using occlusal appliances may improve sleep quality.

Demographic, socioconomic, and health correlates of sleep quality and sleep duration among community-dwelling older adults in India.

BACKGROUND: Recent research has revealed that today's older adults report more sleep problems than their predecessors, a trend compounded by expanding social stratification. As such, this study examined the demographic, socioeconomic, and health correlates of sleep quality and sleep duration among community-dwelling older adults in India. METHODS: The current study sample draws on data from 7118 respondents aged 50 years and over participating in the World Health Organization's Study on global AGEing and adult health (WHO-SAGE) wave-2 dataset. Sleep quality (good, moderate, and poor) and sleep duration (in hours and minutes) were self-reported. Adjusted multivariable logistic regression models were employed to examine the associations between sleep quality and sleep duration and several demographic, socioeconomic, and health indicators. RESULTS: A total of 12.84% and 36.1% of older adults reported long (> 8 h) and short (< 7 h) sleep, respectively. Older adults with primary education had lower odds of poor sleep [aOR: 0.85, CI: 0.73-0.99] than peers with no formal education. The odds of poor sleep were lower among those in higher wealth quintiles than those in the poorest quintile. Older adults with higher education had higher odds of short sleep [aOR: 1.36, CI: 1.06-1.74], and those with primary education had lower odds of long sleep [aOR: 0.70, CI: 0.54-0.91] than those without formal education (base category: age-appropriate sleep, i.e., 7-8 h). Older adults who were widowed had lower odds of both short [aOR: 0.82, CI: 0.68-0.98] and long sleep [aOR:0.74, CI: 0.58-0.95] compared to those who were currently married. Older individuals with adequate nutritional intake reported lower odds of short [aOR:0.59, CI: 0.49-0.72] and higher odds of long sleep [aOR:1.52, CI: 1.20-1.93] relative to their counterparts. Older adults who reported chronic conditions and body pain had higher odds of poor sleep and short sleep than their counterparts. CONCLUSIONS: We identified significant associations between several unmodifiable factors, including age, education, and marital status, and modifiable factors such as dietary intake, body pain, and pre-existing chronic ailments, and sleep quality and sleep duration. Our findings can assist health care providers and practitioners in developing a more holistic and empathic approach to care. Moreover, that several demographic, socioeconomic, and health-related factors are consequential for older adults' sleep health suggests that early detection through screening programs and community-based interventions is vital to improving sleep among older Indians who are most susceptible to sleep problems.

Association of macronutrient intake, physical activity, anxiety, and depression with sleep quality among Iranian male adolescents.

BACKGROUND: Adolescence is a unique stage of life accompanied by physiological and psychological modifications, along with stress, confusion, and depression. MATERIALS AND METHODS: The present descriptive-analytical cross-sectional research was done on 267 male adolescents who studied at high schools in Zanjan, Iran. Demographic characteristics questionnaires, a 48-item food frequency questionnaire, a short version of the International Physical Activity Questionnaire (IPAQ), the Depression Anxiety Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. RESULTS: The mean ± standard deviation (SD) of age, weight, height, and sitting time was 15.94 ± 0.91 years, 68.53 ± 15.28 kg, 1.75 ± 0.06 m, and 449.25 ± 322.06 min, respectively. The study results showed that students with poor sleep quality showed a higher rate of depression than those with good sleep quality in the high and low physical activity groups (p < 0.05). The stress, depression, and anxiety scores significantly correlated with sleep quality in the physical activity groups (p < 0.05). The structural equation model analysis results showed that mental health directly affected sleep quality; this association was significant in the low physical activity group. CONCLUSION: We found that sleep quality was independently related to mental health in young Iranian men. However, dietary intake was not a significant predictor of mental health or sleep quality. More studies are required to evaluate the association between dietary intake and sleep quality in adults.