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.

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.

The Limitations of Using the Pittsburgh Sleep Quality Index to Assess Athletes' Sleep Quality: Evidence from Reliability and Validity in Chinese Professional Athletes.

Purpose: This study aimed to assess the structural validity of the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) among Chinese professional athletes and examine its test-retest reliability and convergent validity across different timeframes. Methods: 581 Chinese professional athletes participated. Exploratory and confirmatory factor analyses were conducted on the Chinese version of the PSQI. Test-retest reliability was assessed over 2 weeks, 1 week, and 2-3 days within a 1-month timeframe. Additional reliability analysis over a 2-day interval was conducted within a 1-week timeframe. Convergent validity was assessed using Chinese versions of the Insomnia Severity Index (ISI), the Athlete Sleep Screening Questionnaire (ASSQ), and actigraphy. A 1-month tracking was conducted, with weekly completion of the PSQI using a one-week timeframe, supplemented by assessments in the second and fourth week using two-week and one-month timeframes. Relationships between weekly results and those over two weeks and one month examined, along with convergent validity, using sleep diary and actigraphy. Results: The PSQI exhibited a two-factor structure (sleep quality and sleep efficiency), with good model fit (CFI = 0.960, AGFI = 0.924, TLI = 0.925, RMSEA = 0.085). Test-retest reliability was satisfactory for intervals of one week or more (r = 0.721 ~ 0.753). Using a one-week timeframe, the total score and two dimensions exhibited good reliability (r = 0.769 ~ 0.881), but only the total score and sleep quality showed high correlations with ISI and ASSQ (r = 0.701 ~ 0.839). Throughout the tracking, monthly responses correlated well with the most recent weeks (r = 0.732 ~ 0.866). Conclusion: The PSQI demonstrates a two-factor structure in Chinese athletes, with sleep quality being predominant. Test-retest reliability within a one-month timeframe is unstable, suggesting a one-week timeframe performs better. Distinguishing between the two dimensions, employing shorter timeframes, and incorporating objective measures are recommended.

Hot flashes and sleep disruption in a randomized trial in menopausal women.

BACKGROUND: Hot flashes, common during menopause, affect up to 80% of the Western menopausal women and are reported to contribute to sleep disturbances in midlife. Few prospective data are available to confirm the specific role of hot flashes in disrupting sleep in midlife women, however, or confirm whether changes in hot flashes in response to clinical therapies result in improvement in sleep. OBJECTIVE: To examine the effects of continuous nitroglycerin therapy on sleep quality in perimenopausal and postmenopausal women with frequent hot flashes (pre-specified secondary trial endpoint) and to examine prospective associations between hot flashes and sleep disruption in this population. STUDY DESIGN: Sleep data were analyzed from a randomized, double-blinded, placebo-controlled trial of continuous transdermal nitroglycerin (NTG) therapy to suppress nitric oxide-mediated vasodilation in perimenopausal or postmenopausal women with hot flashes. Participants were randomized to uninterrupted use of transdermal NTG (0.2-0.6 mg/hour) or placebo for 12 weeks. Nocturnal hot flashes awakening participants from sleep were evaluated using 7-day symptom diaries at baseline, 5 weeks, and 12 weeks. Sleep disruption (wakefulness after sleep onset, WASO) was assessed using validated sleep diaries, and global sleep quality was assessed by the validated Pittsburgh Sleep Quality Index (PSQI: range 0 [best] 21 [worst]) questionnaire. Mixed linear models examined changes in sleep quality and disruption, as well as the strength of associations between nocturnal hot flash frequency and sleep outcomes, over 5 and 12 weeks, adjusting for baseline values, age, race, and ethnicity. RESULTS: Among the 141 participants (70 to NTG and 71 to placebo, mean age 54.6 [±3.9] years), the mean baseline hot flash frequency was 10.8 (±3.5) per day, including 2.6 (±1.7) nocturnal hot flashes awakening participants. At baseline, hot flashes were the most commonly reported reason for nocturnal awakening, with 62.6% of participants reporting waking due to hot flashes at least twice nightly. Over 5 and 12 weeks, mean frequency of nocturnal hot flashes causing awakenings decreased in both groups (NTG: -0.9 episodes/night, placebo: -1.0 episodes/night). Sleep disruption as measured by average nightly WASO also decreased (NTG: -10.1 minutes, placebo: -7.3 minutes), and mean PSQI score improved (NTG: -1.3 points, placebo: -1.2 points). No significant between-group differences in change in sleep outcomes were detected from baseline to 5 and 12 weeks, including PSQI sleep quality score as a prespecified secondary trial endpoint (P≥.05 for all). Greater improvement in nocturnal hot flash frequency over 5 and 12 weeks was associated with greater improvement in PSQI sleep quality score (ß= -0.30, P=.01) and sleep disruption reflected by WASO (ß= -1.88, P=.02) in the combined sample. CONCLUSION: Among menopausal women in a randomized trial of continuous NTG therapy for hot flashes, hot flashes were the most frequently reported cause of nocturnal awakenings. Compared to placebo, continuous NTG therapy did not result in greater improvements in sleep quality from baseline to 5 and 12 weeks. Based on night-by-night symptom diaries and questionnaires, however, greater improvement in nocturnal hot flash frequency in both groups was associated with greater improvement in sleep quality and disruption.

Sleep, hopelessness, and suicidal ideation: An ecological momentary assessment and actigraphy study.

Recent research shows that sleep disturbances are linked to increased suicidal ideation. In the present longitudinal cohort study, we used subjective (ecological momentary assessment, EMA) and objective (actigraphy) measures to examine the effects of sleep parameters on next-day suicidal ideation. Further, we examined hopelessness as a mediator between insufficient sleep and increased suicidal ideation. Individuals with current suicidal ideation (N = 82) completed 21 days of EMA and actigraphy to estimate suicidal ideation, hopelessness and sleep parameters. Multilevel linear-mixed models were used to examine the effects of sleep parameters on next-day suicidal ideation, as well as for the mediating effect of hopelessness (in the morning) on the association between previous night's sleep and suicidal ideation levels the next day. Significant concordance existed between subjective and objective sleep measures, with moderate-to-large correlations (r = 0.44-0.58). Lower subjective sleep quality and efficiency, shorter total sleep time and increased time awake after sleep onset were significantly associated with increased next-day suicidal ideation (controlling for previous-day suicidal ideation). Actigraphy-measured sleep fragmentation was also a significant predictor of next-day ideation. Hopelessness mediated the effects of the subjective sleep parameters on suicidal ideation, but did not account for the association with sleep fragmentation. Therefore, individuals' psychological complaints (hopelessness, suicidal ideation) were better predicted by subjective sleep complaints than by objective sleep indices. Increased hopelessness following from perceived insufficient sleep appears an important explanatory factor when considering the link between sleep disturbances and suicidal ideation.

Non-invasive neurostimulation to improve sleep quality and depressive symptoms in patients with major depressive disorder: A meta-analysis of randomized controlled trials.

BACKGROUND: Non-invasive neurostimulation, including bright light therapy (BLT), repetitive transcranial magnetic (rTMS) and transcranial direct current stimulation (tDCS), has been shown to alleviate depressive symptoms in major depressive disorder (MDD). However, the efficacy of these interventions in addressing sleep disturbances in MDD patients remains a subject of debate. OBJECTIVE: We aimed to conduct a meta-analysis of available randomized controlled trials (RCTs) to assess the effectiveness of non-invasive neurostimulation in improving sleep disturbances and depressive symptoms in MDD patients. METHODS: Systematic searches for relevant RCTs were conducted in the databases PubMed, Cochrane Library, Web of Science, EMBASE, Wanfang and China National Knowledge Infrastructure up to January 2024. Data on outcomes comparable across the studies were meta-analyzed using Review Manager 5.3 and Stata 14. The pooled results were reported as standardized mean differences (SMD) with their respective 95% confidence intervals (CI). RESULTS: Our analysis encompassed 15 RCTs involving 1348 patients. Compared to sham or no stimulation, non-invasive neurostimulation significantly improved sleep quality (SMD -0.74, 95%CI -1.15 to -0.33, p = 0.0004) and sleep efficiency (SMD 0.35, 95%CI 0.10 to 0.60, p = 0.006). It also significantly reduced severity of depressive symptoms (SMD -0.62, 95%CI -0.90 to -0.35, p < 0.00001). Subgroup analysis further demonstrated that patients experiencing sleep improvements due to neurostimulation showed a marked decrease in depressive symptoms compared to the control group (SMD = -0.90, 95% CI [-1.26, -0.54], p < 0.0001). CONCLUSION: Current evidence from RCTs suggests that neurostimulation can enhance sleep quality and efficiency in individuals with MDD, which in turn may be associated with mitigation of depressive symptoms. PROSPERO REGISTRATION: CRD42023423844.

Pharmacologic Sleep Aids in the Intensive Care Unit: A Systematic Review.

Background: Patients in the intensive care unit (ICU) often experience poor sleep quality. Pharmacologic sleep aids are frequently used as primary or adjunctive therapy to improve sleep, although their benefits in the ICU remain uncertain. This review aims to provide a comprehensive assessment of the objective and subjective effects of medications used for sleep in the ICU, as well as their adverse effects. Methods: PubMed, Web of Science, Scopus, Embase, and Cochrane Central Register of Controlled Trials were systematically searched from their inception until June 2023 for comparative studies assessing the effects of pharmacologic sleep aids on objective and subjective metrics of sleep. Results: Thirty-four studies with 3498 participants were included. Medications evaluated were melatonin, ramelteon, suvorexant, propofol, and dexmedetomidine. The majority of studies were randomized controlled trials. Melatonin and dexmedetomidine were the best studied agents. Objective sleep metrics included polysomnography (PSG), electroencephalography (EEG), bispectral index, and actigraphy. Subjective outcome measures included patient questionnaires and nursing observations. Evidence for melatonin as a sleep aid in the ICU was mixed but largely not supportive for improving sleep. Evidence for ramelteon, suvorexant, and propofol was too limited to offer definitive recommendations. Both objective and subjective data supported dexmedetomidine as an effective sleep aid in the ICU, with PSG/EEG in 303 ICU patients demonstrating increased sleep duration and efficiency, decreased arousal index, decreased percentage of stage N1 sleep, and increased absolute and percentage of stage N2 sleep. Mild bradycardia and hypotension were reported as side effects of dexmedetomidine, whereas the other medications were reported to be safe. Several ongoing studies have not yet been published, mostly on melatonin and dexmedetomidine. Conclusions: While definitive conclusions cannot be made for most medications, dexmedetomidine improved sleep quantity and quality in the ICU. These benefits need to be balanced with possible hemodynamic side effects.

Effect of Peanut Butter Intake on Sleep Health in Firefighters: A Randomized Controlled Trial.

Sleep is often impaired in firefighters due to the psychologically and physiologically intense nature of their work and working shift schedules. Peanut butter is affordable and a substantial source of monounsaturated fatty acids, which may aid sleep health. Thus, this study sought to determine if a daily serving of peanut butter consumed before bedtime for seven weeks altered sleep quality and quantity among full-time firefighters. Forty firefighters (peanut butter group = 20; control group = 20) participated in this eight-week randomized controlled trial. All participants completed a subjective questionnaire on mood, focus, and alertness twice daily and wore an Actigraph wristwatch to measure sleep variables, including latency, efficiency, time in bed, time asleep, wake after sleep onset, number of awakenings, and time spent awake. After a baseline week, the peanut butter group consumed two tablespoons of peanut butter two hours prior to bedtime for seven weeks. Compared to the control group, the peanut butter group did not demonstrate significant changes (p > 0.05) in sleep measures or subjective feelings of mood, focus, or alertness after consuming peanut butter for seven weeks. Therefore, peanut butter as a source of peanuts did not alter sleep quality or quantity in this group of firefighters.

Trajectories of actigraphy-derived sleep duration, quality, and variability from childhood to adolescence: downstream effects on mental health.

STUDY OBJECTIVES: We examined growth trajectories of four actigraphy-derived sleep parameters (sleep minutes, sleep efficiency, and variability in sleep minutes and efficiency across a week of assessments) across childhood and adolescence and examined individual differences in trajectories according to participants' race/ethnicity and sex. We also assessed the predictive effect of growth trajectories of sleep parameters on growth trajectories of mental health outcomes and moderation by race and sex. METHOD: Youth (N = 199, 49% female, 65% white, 32% black, 3% biracial) and their parents participated in five waves of data (M ages were 9, 10, 11, 17, and 18 across waves). Participants were from a diverse range of socioeconomic backgrounds. RESULTS: Across participants, sleep minutes, sleep efficiency, and variability in sleep minutes and efficiency demonstrated significant linear change across childhood and adolescence. Whereas sleep duration shortened over time, sleep efficiency improved. Youth exhibited increases in night-to-night variability in sleep minutes and reductions in night-to-night variability in sleep efficiency. Highlighting the importance of individual differences, some race- and sex-related effects emerged. Black youth and male youth experienced steeper declines in their sleep duration across development relative to their respective counterparts. Black youth also demonstrated smaller improvements in sleep efficiency and greater variability in sleep efficiency compared to white youth. Finally, trajectories of sleep efficiency and variability in sleep minutes predicted trajectories of internalizing symptoms and externalizing behaviors. CONCLUSIONS: Findings showed significant changes in developmental trajectories of four sleep parameters across childhood and adolescence. We discuss the empirical and translational implications of the findings.

Routine, Routine, Routine: Sleep Regularity and its Association with Sleep Metrics in Professional Rugby Union Athletes.

BACKGROUND: Maintaining a consistent sleep and wake time is often reported as a key component of circadian rhythmicity and quality sleep. However, the impact of sleep onset and offset time variability on overall sleep outcomes are underreported in elite athlete populations. This study investigated the relationship between sleep onset and offset time variability using the sleep regularity index (SRI) and measures of sleep and well-being in professional rugby union athletes. Twenty-three professional male rugby union athletes (mean ± SD, age: 23 ± 3 y) underwent sleep monitoring via wrist actigraphy for three weeks during a pre-season phase of training and completed a daily wellness questionnaire. Median SRI was calculated and used to stratify the trainees into two quantile groups: >76.4 SRI (Regular, n = 11) and < 76.4 SRI (Irregular, n = 12). RESULTS: The regular sleep group showed significantly longer total sleep duration (p = 0.02, d = 0.97) compared to the irregular group (7:42 ± 0:29 vs. 7:18 ± 0:20 h: min per night, respectively). Furthermore, while not statistically significant, the regular sleep group showed greater sleep efficiency and less wake episodes compared to irregular sleepers, as demonstrated by moderate effect sizes (d = 0.71 and 0.69, respectively). CONCLUSIONS: The results from this study indicate that minimizing variability in sleep onset and offset time is beneficial for increasing sleep duration and may improve sleep efficiency during pre-season training in elite male rugby union athletes. This study provides evidence for the importance of including sleep-wake routines as a key component of sleep education interventions.

Assessing sleep quality in elite and junior cyclists.

In the pursuit of optimal recovery, the significance of sleep cannot be overstated for elite cyclists, including high-level cyclists within the junior category. This study aims to assess the sleep quality of elite athletes of different categories and disciplines, including junior. The sleep quality of 112 high-level cyclists (males n = 80; females n = 32) participating in endurance and sprint disciplines was evaluated using the Pittsburgh Sleep Quality Index (PSQI). A noteworthy 41% of both elite and junior cyclists displayed poor sleep quality. No significant differences were observed between elite and junior cyclists in terms of sleep quality, but there was a medium effect size, indicating greater sleep efficiency in junior cyclists [0.36 (0.16, 0.53)]. Gender differences were found, with females exhibiting worse PSQI scores (males = 4.00 [2.25]; females 5.00 [3.00]; p = 0.035). Endurance cyclists spent more time in bed compared to cyclists from sprinting disciplines (8:30 [1.00] and 8:00 [1:03], respectively; p = 0.019). These findings reveal poor sleep habits, even among individuals classified as good sleepers by the PSQI, emphasizing the importance of preventing sleep disorders in cyclists. This study provides valuable insights into athlete sleep quality, encompassing various categories, genders, and cycling disciplines. In conclusion, elite cyclists demonstrate suboptimal sleep quality, suggesting the potential for interventions utilizing the PSQI. These findings advocate for the incorporation of sleep quality assessments into routine evaluations for athletes.

The interpersonal benefits of goal adjustment capacities: the sample case of coping with poor sleep in couples.

Introduction: This study examined the role of goal adjustment capacities and coping in the association between spousal sleep efficiency and relationship satisfaction in romantic couples. Method: A community lifespan sample of 113 heterosexual couples (age range = 21-82 years) was recruited using newspaper advertisements in the Greater Montreal Area from June 2011 to December 2012. Participants completed study measures (i.e., Goal Adjustment Scale, Brief Pittsburgh Sleep Quality Index, Relationship Assessment Scale, and the Brief Cope) at two time points, ~1 year apart. Results: The results of actor-partner interdependence models with moderation (MIXED procedure in SPSS) reveal that goal disengagement buffered people from worsening relationship satisfaction associated with poor spousal sleep [95% CI B (-1.17, -0.12)], in part via increases in actor active coping [95% CI B (-0.32, -0.02)] and decreases in partner self-blame [95% CI B (-0.28, -0.01)]. Goal reengagement was related to diminished relationship satisfaction in response to poor own sleep [95% CI B (0.59, 1.79)], in part through increases in actor behavioral disengagement [95% CI B (0.05, 0.41)]. Discussion: These findings point to a need for future studies to examine goal adjustment capacities and relationship-specific coping strategies as potential targets of intervention to maintain peoples' relationship satisfaction in the face of sleep problems.

Association Between Sleep Efficiency Variability and Cognition Among Older Adults: Cross-Sectional Accelerometer Study.

Background: Sleep efficiency is often used as a measure of sleep quality. Getting sufficiently high-quality sleep has been associated with better cognitive function among older adults; however, the relationship between day-to-day sleep quality variability and cognition has not been well-established. Objective: We aimed to determine the relationship between day-to-day sleep efficiency variability and cognitive function among older adults, using accelerometer data and 3 cognitive tests. Methods: We included older adults aged >65 years with at least 5 days of accelerometer wear time from the National Health and Nutrition Examination Survey (NHANES) who completed the Digit Symbol Substitution Test (DSST), the Consortium to Establish a Registry for Alzheimer's Disease Word-Learning subtest (CERAD-WL), and the Animal Fluency Test (AFT). Sleep efficiency was derived using a data-driven machine learning algorithm. We examined associations between sleep efficiency variability and scores on each cognitive test adjusted for age, sex, education, household income, marital status, depressive symptoms, diabetes, smoking habits, alcohol consumption, arthritis, heart disease, prior heart attack, prior stroke, activities of daily living, and instrumental activities of daily living. Associations between average sleep efficiency and each cognitive test score were further examined for comparison purposes. Results: A total of 1074 older adults from the NHANES were included in this study. Older adults with low average sleep efficiency exhibited higher levels of sleep efficiency variability (Pearson r=-0.63). After adjusting for confounding factors, greater average sleep efficiency was associated with higher scores on the DSST (per 10% increase, ß=2.25, 95% CI 0.61 to 3.90) and AFT (per 10% increase, ß=.91, 95% CI 0.27 to 1.56). Greater sleep efficiency variability was univariably associated with worse cognitive function based on the DSST (per 10% increase, ß=-3.34, 95% CI -5.33 to -1.34), CERAD-WL (per 10% increase, ß=-1.00, 95% CI -1.79 to -0.21), and AFT (per 10% increase, ß=-1.02, 95% CI -1.68 to -0.36). In fully adjusted models, greater sleep efficiency variability remained associated with lower DSST (per 10% increase, ß=-2.01, 95% CI -3.62 to -0.40) and AFT (per 10% increase, ß=-.84, 95% CI -1.47 to -0.21) scores but not CERAD-WL (per 10% increase, ß=-.65, 95% CI -1.39 to 0.08) scores. Conclusions: Targeting consistency in sleep quality may be useful for interventions seeking to preserve cognitive function among older adults.

Mid-to-Late-Life Anxiety and Sleep during Initial Phase of COVID-19: Age- and Sex-Specific Insights to Inform Future Pandemic Healthcare.

This study examined associations between COVID-19-related anxiety and sleep in middle-aged and older adults and tested whether these varied by age or sex. In June/July 2020, middle-aged/older adults aged 50+ (n = 277, 45% women, Mage = 64.68 ± 7.83) in the United States completed measures of sleep and COVID-19-related anxiety. Multiple regressions examined whether anxiety was independently associated with or interacted with age or sex in its associations with sleep health, controlling for age, education, medical conditions, sleep/pain medication use, and COVID-19 status. Greater COVID-19 anxiety was associated with worse sleep quality and daytime dysfunction. COVID-19-related anxiety interacted with age (not sex) in associations with total sleep time and sleep efficiency. Greater anxiety was associated with shorter total sleep time and lower sleep efficiency in oldest-older adults (~73 years old) and youngest-older adults (~65 years old) but not middle-aged adults (~57 years old). In mid to late life, older adults may be most vulnerable to the impact of COVID-19-related anxiety on sleep health. Social and behavioral (e.g., knowledge on age-related vulnerability to COVID-19 risk/morbidity/mortality, uncertainty, and changes to daily routines) and physiological factors (sleep disruption and age-related autonomic dysfunction) may underlie these associations. Interventions that mitigate negative pandemic-related psychological and sleep outcomes may be particularly relevant for older adults.

Effectiveness of Partially Hydrolyzed Guar Gum on Cognitive Function and Sleep Efficiency in Healthy Elderly Subjects in a Randomized, Double-Blind, Placebo-Controlled, and Parallel-Group Study.

The consumption of functional foods in a daily diet is a promising approach for the maintenance of cognitive health. The present study examines the effects of water-soluble prebiotic dietary-fiber, partially hydrolyzed guar gum (PHGG), on cognitive function and mental health in healthy elderly individuals. Participants consumed either 5 g/day of PHGG or a placebo daily for 12 weeks in this randomized, double-blind, placebo-controlled, and parallel-group study. An assessment of cognitive functions, sleep quality, and subjective mood evaluations was performed at baseline and after 8 and 12 weeks of either PHGG or placebo intake. The visual memory scores in cognitive function tests and sleepiness on rising scores related to sleep quality were significantly improved in the PHGG group compared to the placebo group. No significant differences were observed in mood parameters between the groups. Vigor-activity scores were significantly improved, while the scores for Confusion-Bewilderment decreased significantly in the PHGG group when compared to the baseline. In summary, supplementation with PHGG was effective in improving cognitive functions, particularly visual memory, as well as enhancing sleep quality and vitality in healthy elderly individuals (UMIN000049070).

Multiple Sclerosis, Fatigue, Expanded Disability Status Scale: A Cross-Sectional Exploration of Sleep Efficiency and Quantitative Sleep Parameters.

BACKGROUND: Poor sleep quality and sleep disorders are more prevalent in individuals with multiple sclerosis (MS) than in the general population. Poor sleep has been correlated with worse MS outcomes. Sleep efficiency (SE) is one of the most sensitive markers of sleep quality. There is very little written about SE and other polysomnography (PSG) parameters and MS measures. METHODS: This is a retrospective review of 280 consecutive individuals with MS evaluated by PSGs and other standardized MS measures over 13 years at a comprehensive MS center. In addition, the cohort was assessed with 2 fatigue scales, the Epworth Sleepiness Scale, and the Expanded Disability Status Scale. A comparison of means test (independent t test) and a correlation coefficient (r) were used. RESULTS: The PSG measures of SE and Total Sleep Time were significantly different between a group of individuals with MS with a disease duration of more than 5 years vs a group of individuals with MS with a disease duration less than or equal to 5 years. Prevalence of obstructive sleep apnea was 63%, higher than reported in the literature while the prevalence of moderate to severe obstructive sleep apnea was 33.4%, which was lower than reported. CONCLUSIONS: Longer disease duration and worse disability correlate with sleep quality as measured by SE.

Abnormal amplitude of low-frequency fluctuations associated with sleep efficiency in major depressive disorder.

BACKGROUND: Sleep disturbance is one of the most frequent somatic symptoms in major depressive disorder (MDD), but the neural mechanisms behind it are not well understood. Sleep efficiency (SE) is a good indicator of early awakening and difficulty falling asleep in MDD patients. Our study aimed to investigate the relationship between sleep efficiency and brain function in MDD patients. METHODS: We recruited 131 MDD patients from the Fourth People's Hospital in Hefei, and 71 well-matched healthy controls who were enrolled from the community. All subjects underwent resting-state functional MRI. Brain function was measured using the fractional amplitude of low-frequency fluctuation (fALFF), sleep efficiency was objectively measured by polysomnography (PSG), and clinical scales were used to evaluate depressive symptoms and sleep status. Multivariate regression analysis was performed to assess the relationship between the amplitude of the low frequency fluctuation fraction and sleep efficiency. RESULT: Three brain regions with relevance to sleep efficiency in MDD patients were found: inferior occipital gyrus (Number of voxels = 25, peak MNI coordinate x/y/z = -42/-81/-6, Peak intensity = 4.3148), middle occipital gyrus (Number of voxels = 55, peak MNI coordinate x/y/z = -30/-78/18, Peak intensity = 5.111), and postcentral gyrus (Number of voxels = 26, peak MNI coordinate x/y/z = -27/-33/60, Peak intensity = 4.1263). But there was no significant relationship between fALFF and SE in the healthy controls. CONCLUSION: The reduced sleep efficiency in MDD may be related to their lower neural activity in the inferior occipital gyrus, middle occipital gyrus, and postcentral gyrus. The findings may provide a potential neuroimaging basis for the clinical intervention in patients with major depressive disorder with sleep disturbances.

The Microbiota-Gut-Brain Axis in Metabolic Syndrome and Sleep Disorders: A Systematic Review.

BACKGROUND: Over recent decades, a growing body of evidence has emerged linking the composition of the gut microbiota to sleep regulation. Interestingly, the prevalence of sleep disorders is commonly related to cardiometabolic comorbidities such as diabetes, impaired lipid metabolism, and metabolic syndrome (MetS). In this complex scenario, the role of the gut-brain axis as the main communicating pathway between gut microbiota and sleep regulation pathways in the brain reveals some common host-microbial biomarkers in both sleep disturbances and MetS. As the biological mechanisms behind this complex interacting network of neuroendocrine, immune, and metabolic pathways are not fully understood yet, the present systematic review aims to describe common microbial features between these two unrelated chronic conditions. RESULTS: This systematic review highlights a total of 36 articles associating the gut microbial signature with MetS or sleep disorders. Specific emphasis is given to studies evaluating the effect of dietary patterns, dietary supplementation, and probiotics on MetS or sleep disturbances. CONCLUSIONS: Dietary choices promote microbial composition and metabolites, causing both the amelioration and impairment of MetS and sleep homeostasis.

Sleep Efficiency and Sleep Onset Latency in One Saskatchewan First Nation.

BACKGROUND: Sleep efficiency and sleep onset latency are two measures that can be used to assess sleep quality. Factors that are related to sleep quality include age, sex, sociodemographic factors, and physical and mental health status. This study examines factors related to sleep efficiency and sleep onset latency in one First Nation in Saskatchewan, Canada. METHODS: A baseline survey of the First Nations Sleep Health project was completed between 2018 and 2019 in collaboration with two Cree First Nations. One-night actigraphy evaluations were completed within one of the two First Nations. Objective actigraphy evaluations included sleep efficiency and sleep onset latency. A total of 167 individuals participated, and of these, 156 observations were available for analysis. Statistical analysis was conducted using logistic and linear regression models. RESULTS: More females (61%) than males participated in the actigraphy study, with the mean age being higher for females (39.6 years) than males (35.0 years). The mean sleep efficiency was 83.38%, and the mean sleep onset latency was 20.74 (SD = 27.25) minutes. Age, chronic pain, ever having high blood pressure, and smoking inside the house were associated with an increased risk of poor sleep efficiency in the multiple logistic regression model. Age, chronic pain, ever having anxiety, heart-related illness, and smoking inside the house were associated with longer sleep onset latency in the multiple linear regression model. CONCLUSIONS: Sleep efficiency and sleep onset latency were associated with physical and environmental factors in this First Nation.

Post-PICU sleep efficiency and quality of life in infants and toddlers with acquired brain injury.

STUDY OBJECTIVES: We aimed to investigate the use of sleep efficiency (SE) as a measure of sleep disturbance in infants and toddlers with acquired brain injury (ABI) and evaluate associations between SE and child health-related quality of life and family outcomes. METHODS: Retrospective cohort study of 101 children ages 3-36 months who survived critical care for ABI. SE was quantified from the Brief Infant Sleep Questionnaire as a ratio of nighttime sleep to total time in bed; poor SE was defined as < 80%. Outcome measures included the Pediatric Quality of Life Inventory Core Total Score (health-related quality of life) and Family Impact Module Total Score. Spearman's correlation quantified associations between SE and outcomes. Multivariable linear regression tested association between poor SE and health-related quality of life controlling for significant covariates (age, diagnosis, comorbidities, worsening Functional Status Scale). RESULTS: Following ABI, median SE was 91.7 (interquartile range = 83.3, 95.5). Nineteen (19%) children had poor SE (< 80%). SE correlated significantly with quality of life (Spearman's correlation = .307) and Family Impact Module (Spearman's correlation = .309; both P < .01). When controlling for covariates, poor SE significantly increased risk for lower health-related quality of life (ß-coefficient = -7.0; 95% confidence interval= -13.4, -0.6). CONCLUSIONS: One in five infants and young children with ABI have poor SE that is associated with poorer child and family health outcomes. Our study underscores the potential importance of sleep following ABI to optimize recovery and the need for additional investigation of SE in infants and young children. CITATION: Klapp JM, Hall TA, Riley AR, Janzen D, Williams CN. Post-PICU sleep efficiency and quality of life in infants and toddlers with acquired brain injury. J Clin Sleep Med. 2024;20(1):75-83.