Physical activity and sleep pattern in relation to incident Parkinson's disease: a cohort study.

BACKGROUND: How physical activity (PA) and different sleep traits and overall sleep pattern interact in the development of Parkinson's disease (PD) remain unknown. OBJECTIVE: To prospectively investigate the joint associations of PA and sleep pattern with risk of PD. METHODS: Included were 339,666 PD-free participants from the UK Biobank. Baseline PA levels were grouped into low (< 600 MET-mins/week), medium (600 to < 3000 MET-mins/week) and high (≥ 3000 MET-mins/week) according to the instructions of the UK Biobank. Healthy sleep traits (chronotype, sleep duration, insomnia, snoring, and daytime sleepiness) were scored from 0 to 5 and were categorized into "ideal sleep pattern" (≥ 3 sleep scores) and "poor sleep pattern" (0-2 sleep scores). Hazard ratios (HRs) and 95% confidence intervals (CIs) of PD were estimated by Cox proportional hazards models. RESULTS: During a median of 11.8 years of follow-up, 1,966 PD events were identified. The PD risk was lower in participants with high PA (HR = 0.73; 95% CI: 0.64, 0.84), compared to those with low PA; and participants with ideal sleep pattern also had a lower risk of PD (HR = 0.78; 95% CI: 0.69, 0.87), compared to those with poor sleep pattern. When jointly investigating the combined effect, participants with both high PA and ideal sleep pattern had the lowest risk of incident PD (HR = 0.55; 95% CI: 0.44, 0.69), compared to those with low PA and poor sleep pattern; notably, participants with high PA but poor sleep pattern also gained benefit on PD risk reduction (HR = 0.74; 95% CI: 0.55, 0.99). CONCLUSIONS: Both high PA and ideal sleep pattern were independently associated with lower risk of developing PD, and those with both high PA level and ideal sleep pattern had the lowest risk. Our results suggest that improving PA levels and sleep quality may be promising intervention targets for the prevention of PD.

Adherence to a healthy sleep pattern and risk of urologic cancers: A large prospective cohort study.

OBJECTIVE: A variety of unhealthy sleep behaviors have been shown to be associated with an increased risk of urologic cancers. However, little is known about the association between the overall sleep patterns and urologic cancers. To prospectively investigate the associations between a healthy sleep pattern and the risks of urologic cancers, including bladder cancer (BCa) and renal cell carcinoma (RCC). METHODS: In this prospective cohort study, 377,144 participants free of cancer at baseline were recruited from the UK Biobank. Data on sleep behaviors were collected through questionnaires at recruitment. The incident urologic cancer cases were determined through linkage to national cancer and death registries. We established a healthy sleep score according to five sleep traits (sleep duration, chronotype, insomnia, snoring, and daytime sleepiness). Cox proportional hazard regression models were used to calculate the adjusted hazard ratios and 95% confidence intervals to assess the relationship between the healthy sleep score and the risk of urologic cancers. RESULTS: During a median of ≥9 years of follow-up, we identified 1986 incident urologic cancer cases, including 1272 BCa cases and 706 RCC cases. Compared with the participants with a poor sleep pattern (score of 0-2), the multivariable-adjusted hazard ratio and 95% confidence interval were 0.85 (0.75 to 0.96) for urologic cancers, 0.80 (0.68 to 0.93) for BCa, and 0.91 (0.74, 1.12) for RCC, respectively, for those with the healthier sleep pattern (score of 4-5). CONCLUSION: Our results indicate that a healthy sleep pattern is associated with lower risks of urologic cancers.

Association between co-sleeping in the first year of life and preschoolers´ sleep patterns.

This study aimed to investigate the association between co-sleeping practiced during the first year of life and preschoolers' sleep patterns. A cross-sectional study including toddlers was designed to analyze their sleep patterns. The Brief Infant Sleep Questionnaire, validated in Spanish, was used to measure sleep quality. A latent class analysis was performed to identify qualitative subgroups in the sample and explore the effects of co-sleeping. The sleep patterns of 276 children were analyzed. A total of 181 (65%) parents reported having practiced co-sleeping with their children. The latent class analysis identified a two-class solution with two different sleep patterns. One of them showed a worse quality sleep pattern, which had a significant association with having practiced co-sleeping during the first year of life, and with the fact that they were still sleeping in the parents' room, among other characteristics related to co-sleeping and parental concerns. Breastfeeding also showed association with a worse quality sleep pattern.  Conclusion: Based on the present findings, co-sleeping during the first year of life appears to be associated with poor sleep patterns in young preschoolers. What is Known: • Co-sleeping shows benefits for infants and parents, mainly facilitating successful breastfeeding. • Literature on the effect of co-sleeping in lately sleep quality in children and their parents is very limited. What is New: • Co-sleeping practiced during the first year of life could be associated with a worse sleep pattern measured with BISQ-E tool. • A balance between the correct practice of co-sleeping and the achievement of a healthy sleep routine in preschool should probably be part of parents' health education.

Postoperative Sleep Quality of Insomnia Patients After TIVA Anesthesia: A Prospective Study.

PURPOSE: The purpose of this study is to observe the postoperative sleep quality of insomnia patients undergoing laparoscopic gynecologic oncology surgery after total intravenous anesthesia. DESIGN: Prospective study. METHODS: We conducted a prospective, observational study in our hospital. All patients underwent propofol-remifentanil anesthesia without other sedative medications before or during the operation. Pittsburgh Sleep Quality Index (PSQI) scores of the baseline value, night-1 (the first night after surgery), night-3, night-5, and night-30 were observed. FINDINGS: Sixty-nine female insomnia patients were allocated based on the results of the PSQI and the diagnostic criteria of insomnia. The PSQI global scores were respectively 6 (5-8), 5 (4-6), 5 (3-6), and 6 (5-7) on night-1, night-3, night-5, and night-30, significantly lower than the baseline 7 (6-8) (P < 0.05). The 5 components (subjective sleep quality, sleep latency, sleep duration, sleep efficiency and daytime dysfunction) had significant changes at different postoperative time points (P < 0.05). The daytime dysfunction could also be improved 1 month after the surgery (P < 0.05). In contrast, the variations of sleep disturbance and use of sleep medication had no statistical differences. CONCLUSIONS: The sleep quality of female patients with insomnia was improved on the first night after surgery in the sides of sleep latency and daytime dysfunction, and the improvement could also be obtained 1 month after propofol-remifentanil general anesthesia.

Association of Breastfeeding Practices During the First 3 Months with Infant Sleep Trajectories: A Prospective Cohort Study.

BACKGROUND: Breastfeeding has numerous effects on maternal and child health. The effect of breastfeeding on infant sleep remains inconclusive. OBJECTIVES: We aimed to examine whether full breastfeeding (FBF) during the first 3 mo is associated with longitudinal infant sleep trajectories in their first 2 y of life. METHODS: The study was embedded in the Tongji Maternal and Child Health Cohort study. Information on infant feeding practices was collected at 3 mo of age, and maternal/child pairs were assigned to the FBF or the non-FBF group (including partially breastfeeding and exclusive formula feeding) on the basis of feeding practices during the first 3 mo of life. Sleep data of infants were obtained at 3, 6, 12, and 24 mo. Total, night, and day sleep trajectories across 3 to 24 mo were estimated with group-based models. Each sleep trajectory was differentiated on the basis of sleep duration at 3 mo (long/moderate/short) and the interval from 6 to 24 mo (moderate/short). Multinomial logistic regression was used to investigate the association of breastfeeding practices with infant sleep trajectories. RESULTS: Among the 4056 infants studied, 2558 (63.1%) received FBF for 3 mo. When compared with FBF infants, non-FBF infants had shorter sleep duration at 3, 6, and 12 mo (P < 0.01). Non-FBF infants were more likely to experience Moderate-Short (OR: 1.31; 95% CI: 1.06, 1.61) and Short-Short (OR: 1.56; 95% CI: 1.12, 2.16) total sleep trajectories and more likely to experience Moderate-Short (OR: 1.84; 95% CI: 1.22, 2.77), and Short-Moderate (OR: 1.40; 95% CI: 1.06, 1.85) night sleep trajectories than FBF infants. CONCLUSIONS: Full breastfeeding for ≥3 mo were positively associated with longer infant sleep duration. Infants fully breastfed were more likely to experience better sleep trajectories characterized by longer duration in their first 2 y of life. Full breastfeeding may benefit infants through healthy sleep.

Association between healthy sleep patterns and depressive trajectories among college students: a prospective cohort study.

BACKGROUND: The purpose of this study was to identify different develpment trajectories of depression symptoms during college period, and prospectively investigate the associations healthy sleep patterns with trajectories of depression symptoms among college students from freshman through junior year. METHODS: A total of 999 participants from the College Student Behavior and Health Cohort Study were included between April 2019 and June 2021. Healthy sleep patterns were defined by chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. Latent growth curve model was used to identify trajectories of depression symptoms. Then binary logistic regression was used to examine association of the healthy sleep patterns with these trajectories. RESULTS: In baseline survey, we found that a total of 100 (10.0%) participants had healthy sleep patterns' score equal to 5. Then, we used 5 surveys' data to identify 2 distinct trajectories of depression symptoms during college (decreasing: 82.5%; increasing: 17.5%). The healthy sleep patterns were associated with these trajectories, the better healthy sleep patterns significantly decrease the risk of increasing trajectories of depression symptoms in males (OR: 0.72, 95%CI: 0.54 ~ 0.97, P = 0.031). Moreover, we found out that the healthy sleep patterns of college students can predict the future depressive symptoms in this study (all P < 0.001). CONCLUSION: Our findings indicate that the better healthy sleep patterns may significantly decrease the risk of increasing trajectory of depression symptoms only in male college students. The results speak to a need for college student with depression symptoms to identify and address sleep problems when present, which could prevent or reduce depression detriments in later life.

Anxiety, depressive symptoms, sleep patterns & associated factors among Bangladeshi wage earners during the COVID-19 pandemic: a cross-sectional study.

The economic vulnerability imposed by the COVID-19 pandemic induces stress on mental health of wage earners in Bangladesh which is largely unexplored. This evidence gap was addressed in this study aiming to evaluate the mental health difficulties among Bangladeshi wage earners by assessing the associated factors influencing anxiety, depressive symptoms and sleep patterns. This cross-sectional study was conducted among 707 individual Bangladeshi wage earners in May 2020. The questionnaire included information about sleep duration, the Patient health questionnaire (PHQ-9), and the Generalized anxiety disorder (GAD-7) scales. The study revealed that anxiety and depressive symptoms were associated with male sex, higher educational status, service holder occupation and lower monthly income (p ≤ 0.01). Fear of COVID-19 when working outside during the pandemic situation was inextricably linked with anxiety (AOR = 2.08; 95% CI: 1.42-3.04) and depressive symptoms (AOR = 1.51; 95% CI = 1.04-2.20). Respondents who were responsible to financially support their family experienced significantly decreased duration of sleep (ß = -0.68; 95% CI: -1.18 to -0.20). The results of this study provided novel evidence on psychological difficulties among Bangladeshi wage earners which calls for an in-depth and longitudinal evaluation and immediate low-intensity psychosocial interventions.

[The Impact of Psychostimulants on Sleep in Children with Attention Deficit Hyperactivity Disorder: A Systematic Review of Polysomnography Studies]. / A pszichostimulánsok alkalmazásának alvásra gyakorolt hatása fi gyelemhiányos hiperaktivitás zavarral élo gyerekek körében: a poliszomnográfi ás vizsgálatok szakirodalmának szisztematikus áttekintése.

OBJECTIVE: Psychostimulants are widely used pharmacotherapeutic tools in the treatment process of severe or non-responsive childhood attention-deficit/hyperactivity disorder. Despite their efficacy, stimulants can influence the quality and quantity of sleep as a side effect, but this issue remains insufficiently clarified in the existing literature, with partly contradictory findings. The aim of this review is to provide a comprehensive analysis of research results based on polysomnography, shedding light on the current state of knowledge in this area. This insight can be valuable for guiding the design of future research and optimizing therapeutic plans. METHODS: Following the PRISMA guidelines, we systematically reviewed and analyzed studies that assessed the quality of sleep using polysomnography during stimulant treatment. As a result of our search, we identified 331 potential publications, which were independently screened, and a total of 13 relevant articles were analyzed in detail. RESULTS: Based on the results of the examined studies, there were a total of 5 instances of sleep-facilitating effects reported in the context of stimulant treatments, while 5 studies indicated sleep-inhibiting effects, and in three cases, no effects were observed. CONCLUSIONS: Although it is important to consider the impact of medication on sleep in the treatment of childhood attention-deficit/hyperactivity disorder, further research is required to clarify this issue. This will enable the customization of therapeutic recommendations and plans, aligning with the principles of precision medicine, taking into account the varying research designs and sample sizes.

Investigation of the Relationship Between Mental Health Status and Sleep Patterns of Children Who Experienced the Kahramanmaras Earthquake: Data From the Earthquake Region.

BACKGROUND: The psychological conditions of children exposed to earthquakes, such as somatization, obsessive-compulsive, hostility, and paranoid thought, have not been adequately studied. AIM: This study was conducted to examine the relationship between the mental states and sleep patterns of children who experienced the Kahramanmaras earthquake. METHOD: This is a descriptive, cross-sectional, and relational study that included 867 children from 11 provinces of Turkey affected by the earthquake that occurred in Kahramanmaras on February 6th. The Child Follow-up Form, Mental Symptom Screening Scale, and Child Sleep Habits Scale were used to collect data. RESULTS: The psychological symptoms (anxiety, depression, somatization, anger-hostility, obsessive-compulsive symptoms, interpersonal sensitivity, phobic anxiety, paranoid ideation, psychotic symptoms, and other issues) experienced by children after the earthquake explained 96.9% of their sleep disturbance. Some of the demographic characteristics, such as age, the status of experiencing loss in the earthquake, the survival status of their mother and father, the survival status of their siblings, the total number of losses after the earthquake, the total number of losses in the nuclear family, total hours spent under the rubble, the hours children waited for their father, mother, and siblings to come out of the rubble, accounted for 77.9% of the mental symptoms (SCL-90). CONCLUSIONS: These results showed the importance of early recognition and treatment of sleep disturbances to prevent possible psychiatric disorders after children have been exposed to natural disasters. It is of great importance to evaluate the mental states of children after the earthquake and to apply appropriate psychiatric interventions.

Adherence to a healthy sleep pattern is associated with lower risks of all-cause, cardiovascular and cancer-specific mortality.

BACKGROUND: Individual unhealthy sleep behaviours have been associated with increased risks of all-cause mortality and deaths due to cardiovascular disease (CVD) or cancer. The evidence regarding the association of sleep patterns with these risks is limited. OBJECTIVE: To examine the associations of sleep patterns with all-cause, CVD and cancer mortality in a large prospective cohort. METHODS: This prospective cohort study included 283,443 adults from UK Biobank without CVD and cancer at baseline. We created a healthy sleep score and sleep patterns combining five individual sleep behaviours. RESULTS: During a mean (standard deviation) of 8.9 (1.1) years (2.5 million person-years) of follow up, a total of 7936 all-cause deaths, 762 CVD-caused deaths, and 4540 cancer-caused deaths occurred during follow up. One point increase of the healthy sleep score was associated with a 4-11% lower risk of all-cause mortality (Hazard Ratio [HR], 0.94; 95% CI, 0.92-0.96), CVD mortality (HR, 0.89; 95% CI, 0.83-0.95) and cancer mortality (HR, 0.96; 95% CI, 0.93-0.99), with adjustment for age, sex, assessment centres, smoking status, alcohol intake status, socioeconomic status and physical activity. Compared with participants with an unfavourable sleep pattern, those with a favourable sleep pattern had 24-42% lower risks of all-cause and CVD mortality. The association with all-cause mortality tended to be stronger among underweight participants and those with insufficient physical activity. CONCLUSIONS: A healthy sleep pattern was associated with lower risks of all-cause mortality and mortality from CVD and cancer. Our findings highlight the importance of improving overall sleep behaviours in lowering mortality.

Validation of actigraphy in hospitalised newborn infants using video polysomnography.

Actigraphy has been established as a reliable sleep assessment tool in adults; however, its utility in newborns remains unknown. Validation of actigraphy in newborns may provide a significant insight into the physiological and pathological acquisition process of mature diurnal sleep patterns and subsequent morbidities in both newborns and their mothers. Thus, the present study aimed to evaluate the accuracy of sleep-wake detection by overnight actigraphy in a cohort of newborns. Simultaneous recording of polysomnography and actigraphy data was performed in 40 newborns admitted to a tertiary neonatal intensive care unit (NICU). A mixed-effects logistic regression model to explain the sleep state identified by polysomnography was employed using the actigraphic activity score as a fixed independent variable and the individual newborn's identity as a random effect. To evaluate the usefulness of the actigraphic activity score as a surrogate marker of sleep, a receiver operating characteristic (ROC) curve analysis was performed using the variables that were used in the mixed-effects logistic regression model, and the area under the curve (AUC) was assessed. The results showed that polysomnography-determined sleep epochs were associated with a smaller activity index on actigraphy (odds ratio per 10 activity indices increase 0.81, 95% confidence interval [CI] 0.79-0.84). The AUC for the ROC curve was 0.87 (95% CI 0.87-0.88, range 0.54-0.99). An activity score of 124 showed the maximum overall accuracy (90.2%, 95% CI 87.7-92.1). Our present study suggests that sleep-wake states of NICU-hospitalised newborns can be precisely determined using actigraphy on the ankle.

Changes in sleep pattern and dream activity across and after the COVID-19 lockdown in Italy: A longitudinal observational study.

A large body of evidence has documented the impact of the global COVID-19 outbreak - and especially the lockdown period - on sleep quality and quantity. Here, we present the first Italian longitudinal study on sleep and COVID-19 considering four different time points collected during lockdown (from 29 March 2020 to 3 May 2020) and a subsequent follow-up period (October 2020). We used an online survey to collect socio-demographic and COVID-19 related information. Subjects were also asked to complete a sleep diary at each time point of the study. Our longitudinal sample included 147 participants. Statistical comparison across time intervals showed remarkable changes in sleep patterns during and after the lockdown. In particular, during lockdown we observed longer sleep latency, less ease of falling asleep, a higher total bedtime, and a lower dream frequency. The week-by-week evaluation described relatively stable patterns in the observed measures during the lockdown period, except for dream frequency, affected by a rapid increase in the early phase of lockdown. Our findings are in line with the current literature. Furthermore, the prospective longitudinal investigation comprising several time points offered the possibility of (a) observing the temporal dynamics and the different entities of such changes over time, and (b) reducing the typical memory bias for these studies.

Non-alcoholic fatty liver disease, sleep behaviors, and incident type 2 diabetes.

BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD) is associated with incident type 2 diabetes; however, the extent to which NAFLD may confer its risk remains uncertain, especially in Europeans. Emerging evidence suggests that sleep behaviors are linked to NAFLD and diabetes. We aimed to measure whether sleep behaviors modified the association between NAFLD and incident type 2 diabetes. METHODS: This prospective cohort study included 365 339 participants without type 2 diabetes at baseline in UK Biobank data. Five sleep behaviors, including sleep duration, insomnia, snoring, chronotype, and daytime sleepiness, were collected from the questionnaire. Overall sleep patterns were created by summing the five scores. Liver steatosis was based on the fatty liver index. RESULTS: During a median follow up of 11.0 years, we documented 8774 patients with incident type 2 diabetes. NAFLD was significantly associated with increased diabetes risk. Sleeping 7-8 h/day, no insomnia, no self-reported snoring, and no frequent daytime sleepiness were independently associated with incident type 2 diabetes, with a 20%, 18%, 16%, and 31% lower risk, respectively. About 33.8% and 33.5% of type 2 diabetes events in this cohort could be attributed to NAFLD and poor sleep pattern, respectively. Participants with NAFLD and poor sleep pattern showed the highest risk of type 2 diabetes (relative risk 3.17, 95% confidence interval 2.80, 3.59). Sleep pattern (healthy, intermediate, and poor) did not significantly modify the association between NAFLD and type 2 diabetes. However, when studying separately, we found a significant interaction between NAFLD and insomnia on the risk of incident type 2 diabetes (P for interaction = 0.003). CONCLUSION: In this large prospective study, both NAFLD and some sleep behaviors were risk factors for type 2 diabetes. Although overall sleep pattern did not modify the association between NAFLD and type 2 diabetes, certain sleep behavior, especially insomnia, showed the modification effect.

Infant sleep patterns and maternal postpartum fatigue: A cross-sectional study.

AIM: Unpredictable nature of infant sleep-wake cycles go against that of the adult sleep. Maternal sleep quality is acknowledged as a main factor to postpartum fatigue. This study explored the effects of infant sleep patterns on maternal postpartum fatigue. METHODS: A total of 319 mothers of infants from two teaching hospitals in the Nantong City were enrolled. Maternal fatigue status and infant sleep patterns were assessed by the Fatigue Scale (FS-14) and the Brief Infant Sleep Questionnaire (BISQ). Generalized estimating equation analyses were perform to explored the effect of infant sleep patterns on maternal fatigue. RESULTS: Sleep-onset time later than 10 p.m., and nocturnal wakefulness more than 60 min were risk factors of postpartum fatigue. After controlling the confounding variables, infant sleep patterns were still the determinant factors of postpartum fatigue. CONCLUSION: Infant sleep pattern is a factor of maternal postpartum fatigue. It is recommended to promote infant sleep so as to improve maternal sleep quality and finally alleviate postpartum fatigue.

Sleep Pattern Analysis in Unconstrained and Unconscious State.

Sleep accounts for one-third of an individual's life and is a measure of health. Both sleep time and quality are essential, and a person requires sound sleep to stay healthy. Generally, sleep patterns are influenced by genetic factors and differ among people. Therefore, analyzing whether individual sleep patterns guarantee sufficient sleep is necessary. Here, we aimed to acquire information regarding the sleep status of individuals in an unconstrained and unconscious state to consequently classify the sleep state. Accordingly, we collected data associated with the sleep status of individuals, such as frequency of tosses and turns, snoring, and body temperature, as well as environmental data, such as room temperature, humidity, illuminance, carbon dioxide concentration, and ambient noise. The sleep state was classified into two stages: nonrapid eye movement and rapid eye movement sleep, rather than the general four stages. Furthermore, to verify the validity of the sleep state classifications, we compared them with heart rate.

Effects of COVID-19 pandemic and lockdown on lifestyle and mental health of students: A retrospective study from Karachi, Pakistan.

Introduction: Due to the COVID-19 pandemic, many countries imposed lockdowns on their citizens in an attempt to contain the disease. Pakistan is one of these countries. A government mandated lockdown can have mitigating psychological effects on young adults, out of which a large fraction is made up of students. This study aims to investigate the correlations between changes in sleep pattern, perception of time, and digital media usage. Furthermore, it explores the impact of these changes on the mental health of students of different educational levels. Methods: This cross-sectional study was conducted via a web-based questionnaire, from March 24 to April 26, 2020. The survey was targeted at students and 251 responses were obtained. It was a 5-section long questionnaire. The first section inquired about demographics of participants. Each of the other 4 sections was devoted to changes in sleep pattern, perception of time flow, digital media usage and mental health status of students. Close-ended questions with multiple choice responses, dichotomous, interval and 4-point Likert scales were used in the construction of the survey questionnaire. Chi2 T-tests multinomial and binary logistic regression were used as primary statistical tests. All data were analysed using Statistical Package for Social Science (SPSS) version 23.0 (IBM Corp., Armonk, NY). Results: Out of 251 adolescents that participated in our study, the majority (70.2%) were females. The mean age of the participants was 19.40 ± 1.62 years. Two-thirds of the respondents did not have much trouble falling asleep (66.5%). The analysis found no significant association between longer sleep periods and procrastination level (P = 0.054). Nearly three-fourths (72.9%) of our participants felt that getting through quarantine would have been more difficult if they did not have any electronic gadgets. Of these, a majority (85.8%) had a general feeling of tiredness and lacked motivation (P = 0.023). Additionally, a large number of students (69.7%) had reported that time is seemingly moving faster. A significant relationship between increased usage of electronic items and longer sleep periods was also noted (P = 0.005). With respect to the level of education, statistically significant values were noted for alarm use both before and after quarantine began (P = 0.021 and P = 0.004, respectively). Further analysis showed that there was a significant difference in the median difference of time spent on social media before the outbreak (3.0 ± 32.46) and time spent on social media after the outbreak (6.0 ± 3.52) in a single day (P = 0.000). Conclusions: Our research has revealed that due to the lockdown imposed by the government in response to COVID-19, the sleeping patterns of the students was affected the most. Our findings show that the increase in use of social media applications led to a widespread increase in the length of sleep, worsening of sleep habits (people sleeping at much later hours than usual), and a general feeling of tiredness. A general lack of recollection regarding what day of the week it was, as well as a change in the perceived flow of time were also notable. All these findings indicate the decline in mental health of students due to the lockdown. Promoting better sleep routines, minimising the use of digital media, and encouragement of students to take up more hobbies could collectively improve the health and mood of students in self-quarantine.

Introduction: En raison de la pandémie de COVID-19, de nombreux pays ont imposé des verrouillages à leurs citoyens pour tenter de contenir la maladie. Le Pakistan est l'un de ces pays. Un verrouillage mandaté par le gouvernement peut avoir des effets psychologiques atténuants sur les jeunes adultes, dont une grande partie est composée d'étudiants. Cette étude vise à étudier les corrélations entre les changements dans les habitudes de sommeil, la perception du temps et l'utilisation des médias numériques. De plus, il explore l'impact de ces changements sur la santé mentale des élèves de différents niveaux d'éducation. Méthodes: Cette étude transversale a été menée via un questionnaire en ligne, du 24 mars au 26 avril 2020. L'enquête visait les étudiants et 251 réponses ont été obtenues. C'était un questionnaire de 5 sections. La première section a posé des questions sur la démographie des participants. Chacune des 4 autres sections était consacrée aux changements dans les habitudes de sommeil, à la perception de l'écoulement du temps, à l'utilisation des médias numériques et à l'état de santé mentale des élèves. Des questions fermées avec des réponses à choix multiples, des échelles dichotomiques, d'intervalle et de Likert à 4 points ont été utilisées dans la construction du questionnaire d'enquête. Le chi carré, les tests T multinomiaux et la régression logistique binaire ont été utilisés comme tests statistiques primaires. Toutes les données ont été analysées en utilisant Statistical Package for Social Science (SPSS) version 23.0 (IBM Corp., Armonk, NY). Résultats: Sur 251 adolescents qui ont participé à notre étude, la majorité (70,2 %) étaient des femmes. L'âge moyen des participants était de 19,40 ± 1,62 ans. Les deux tiers des répondants n'avaient pas beaucoup de mal à s'endormir (66,5 %). L'analyse n'a trouvé aucune association significative entre des périodes de sommeil plus longues et le niveau de procrastination (p = 0,054). Près des trois quarts (72,9 %) de nos participants ont estimé que passer la quarantaine aurait été plus difficile s'ils n'avaient pas de gadgets électroniques. Parmi ceux-ci, une majorité (85,8 %) avait une sensation générale de fatigue et manquait de motivation (p = 0,023). De plus, un grand nombre d'étudiants (69,7 %) ont déclaré que le temps passe apparemment plus vite. Une relation significative entre une utilisation accrue des articles électroniques et des périodes de sommeil plus longues a également été notée (p = 0,005). En ce qui concerne le niveau d'éducation, des valeurs statistiquement significatives ont été notées pour l'utilisation des alarmes avant et après le début de la quarantaine (p = 0,021 et p = 0,004, respectivement). Une analyse plus approfondie a montré qu'il y avait une différence significative dans la différence médiane entre le temps passé sur les réseaux sociaux avant l'épidémie (3,0 ± 32,46) et le temps passé sur les réseaux sociaux après l'épidémie (6,0 ± 3,52) en une seule journée (p = 0,000). Conclusions: Notre recherche a révélé qu'en raison du verrouillage imposé par le gouvernement en réponse au COVID-19, les habitudes de sommeil des étudiants étaient les plus affectées. Nos résultats montrent que l'augmentation de l'utilisation des applications de médias sociaux a conduit à une augmentation généralisée de la durée du sommeil, à une aggravation des habitudes de sommeil (personnes qui dorment beaucoup plus tard que d'habitude) et à une sensation générale de fatigue. Un manque général de souvenir du jour de la semaine, ainsi qu'un changement dans l'écoulement perçu du temps, étaient également notables. Tous ces résultats indiquent le déclin de la santé mentale des étudiants en raison du verrouillage. La promotion de meilleures habitudes de sommeil, la minimisation de l'utilisation des médias numériques et l'encouragement des étudiants à adopter plus de passe-temps pourraient collectivement améliorer la santé et l'humeur des étudiants en quarantaine.

Relationship between sleep habits and academic performance in university Nursing students.

BACKGROUND: Sleep disorders are composed of a group of diseases of increasing prevalence and with social-health implications to be considered a public health problem. Sleep habits and specific sleep behaviors have an influence on the academic success of students. However, the characteristics of sleep and sleep habits of university students as predictors of poor academic performance have been scarcely analyzed. In the present study, we aimed to investigate sleep habits and their influence on academic performance in a cohort of Nursing Degree students. METHODS: This was a cross-sectional and observational study. An anonymous and self-administered questionnaire was used, including different scales such as the 'Morningness and Eveningness scale', an author-generated sleep habit questionnaire, and certain variables aimed at studying the socio-familial and academic aspects of the Nursing students. The association of sleep habits and other variables with poor academic performance was investigated by logistic regression. The internal consistency and homogeneity of the 'sleep habits questionnaire' was assessed with the Cronbach's alpha test. RESULTS: Overall, 401 students (mean age of 22.1 ± 4.9 years, 74.8 % females) from the Nursing Degree were included. The homogeneity of the 'sleep habits questionnaire' was appropriate (Cronbach's alpha = 0.710). Nursing students were characterized by an evening chronotype (20.2 %) and a short sleep pattern. 30.4 % of the Nursing students had bad sleep habits. Regarding the academic performance, 47.9 % of the students showed a poor one. On multivariate logistic regression analysis, a short sleep pattern (adjusted OR = 1.53, 95 % CI 1.01-2.34), bad sleep habits (aOR = 1.76, 95 % CI 1.11-2.79), and age < 25 years (aOR = 2.27, 95 % CI 1.30-3.98) were independently associated with a higher probability of poor academic performance. CONCLUSIONS: Almost 1/3 of the Nursing students were identified as having bad sleep habits, and these students were characterized by an evening chronotype and a short sleep pattern. A short sleep pattern, bad sleep habits, and age < 25 years, were independently associated with a higher risk of poor academic performance. This requires multifactorial approaches and the involvement of all the associated actors: teachers, academic institutions, health institutions, and the people in charge in university residences, among others.

Inactograms and objective sleep measures as means to capture subjective sleep problems in patients with a bipolar disorder.

BACKGROUND: Sleep problems are common in bipolar disorders (BDs). To objectively characterize these problems in BDs, further methodological development is needed to capture subjective insomnia. AIM: To test psychometric properties of the Athens Insomnia Scale (AIS), and associations with actigraphy-derived measures, applying modifications in actigraphy data processing to capture features of perturbed sleep in patients with a BD. METHODS: Seventy-four patients completed the AIS and the Quick Inventory of Depressive Symptomatology, self-report (QIDS-SR-16). Locomotor activity was continuously recorded by wrist actigraphy for ≥10 consecutive days. We computed the sleep onset/offset, the center of daily inactivity (CenDI), as a proxy for chronotype, and the degree of consolidation of daily inactivity (ConDI), as a proxy for sleep-wake rhythm strength. RESULTS: AIS showed good psychometric properties (Cronbach's alpha = 0.84; test-retest correlation = 0.84, P<.001). Subjective sleep problems correlated moderately with a later sleep phase (CenDI with AIS rho = 0.34, P = .003), lower consolidation (ConDI with AIS rho = -0.22, P = .05; with QIDS-SR-16 rho = -0.27, P = .019), later timing of sleep offset (with AIS rho = 0.49, P = ≤.001, with QIDS-SR-16 rho = 0.36, P = .002), and longer total sleep (with AIS rho = 0.29, P = .012, with QIDS-SR-16 rho = 0.41, P = ≤.001). While AIS was psychometrically more solid, correlations with objective sleep were more consistent across time for QIDS-SR-16. CONCLUSIONS: AIS and QIDS-SR-16 are suitable for clinical screening of sleep problems among patients with a BD. Subjective insomnia associated with objective measures. For clinical and research purposes, actigraphy and data visualization on inactograms are useful for accurate longitudinal characterization of sleep patterns.

Association between children's sleep patterns and problematic behaviors at age 5.

BACKGROUND: Night-shift lifestyles affect children as well as adults, and are associated with sleep and behavioral problems among children. This study aimed to investigate associations among sleep patterns, individual/environmental factors, and problematic behaviors in children at age 5 years. METHODS: Data for sleep patterns, individual / environmental factors, and problematic behaviors for 8,689 5-year-old children were collected from health-checkup records. Problematic behaviors investigated were anxious behavior (being afraid, difficulty being separated from the mother), developmental behavior (violence, restlessness, rebellious behavior, restrictive diet, stereotypic play), personal habits (thumb-sucking, nail-biting, tic, masturbation), and excretory problems. The relationships between sleep patterns (bedtime, sleep duration) and the presence of these behaviors were analyzed. Individual / environmental factors that affected problematic behaviors were statistically identified using a tree-form model. RESULTS: Late bedtime and short sleep duration showed significant adverse effects on children's problematic behaviors - odds ratio (OR): 1.07, 95% confidence interval (CI): 1.03-1.11 and OR: 0.92, 95% CI: 0.87-0.97, respectively. Long television watching time, abnormality at birth, and lack of father's support also showed significant adverse effects on problematic behaviors (OR: 2.34, 95% CI: 1.87-2.94), and significantly affected late bedtime and short sleep duration. CONCLUSIONS: There were significant associations among sleep patterns, individual / environmental factors, and problematic behaviors in 5-year-old children. Improving children's sleep patterns, reducing the duration of television watching, and improving support from fathers may reduce problematic behaviors.

Eating habits and sleep patterns of adolescents with depression symptoms in Mumbai, India.

Adolescents with depression engage in unhealthy eating habits and irregular sleep patterns and are often at an increased risk for weight-related problems. Improvement in these lifestyle behaviours may help to prevent depression, but knowledge about the associations between depression, sleep, eating habits and body weight among adolescents in India is limited. This cross-sectional study investigated the prevalence of depression and its association with sleep patterns, eating habits and body weight status among a convenience sample of 527 adolescents, ages 10-17 years in Mumbai, India. Participants completed a survey on sleep patterns such as sleep duration, daytime sleepiness and sleep problems and eating habits such as frequency of breakfast consumption, eating family meals and eating out. Depression was assessed using the Patient Health Questionnaire modified for Adolescents (PHQ-A). Anthropometric measurements were also taken. Within this sample, 25% had moderate to severe depression (PHQ-A ≥ 10) and 46% reported sleeping less than 6 h > thrice a week. Adolescents with moderate to severe depression had significantly higher body mass index than those with minimal depression (26.2 ± 6.6 vs. 20.2 ± 4.8 kg/m2 ). The odds of having clinically significant depression (PHQ-A ≥ 10) was 4.5 times higher in adolescents who had family meals ≤ once a week, 1.6 times higher among those who were sleeping <6 h and 2.3 times higher among participants having trouble falling to sleep more than thrice a week. The findings indicated that a significant proportion of adolescents had depression symptoms; improving sleep and eating habits may present potential targets for interventions.