Sleep hygiene and sleep quality in Iranian adolescents during the COVID-19 pandemic.

OBJECTIVES: Sleep is one of the issues that attracted the attention of researchers during the COVID-19 pandemic. Researchers focused their studies on the prevalence of sleep disorders, sleep quality, and sleep duration. Sleep hygiene is a set of guidelines that play an important role in the sleep quality, the present study sought to evaluate the amount of sleep hygiene and sleep quality in Iranian adolescents and their relationship during the COVID-19 pandemic. METHODS: The present study was conducted using a cross-sectional design. The research population consisted of all adolescents living in Kermanshah (western Iran) in 2021. The participants were a sample of 610 adolescents. They completed the Pittsburgh Sleep Quality Inventory and Adolescent Sleep Hygiene Scale. RESULTS: The mean sleep quality score for the participants was 7.14 ± 2.47, indicating the high frequency of sleep problems affecting the participants. There were significant correlations between all components of sleep hygiene and sleep quality. There was also a significant correlation (r = - 0.46 between sleep hygiene and sleep quality (p < 0.001). No significant difference was observed in sleep hygiene and sleep quality between the male and female adolescents. The results showed that sleep hygiene subscales can predict sleep quality (R = 0.53, F = 39.20, p < .01). CONCLUSIONS: The data in this study confirmed the poor observance of sleep hygiene in adolescents during the COVID-19 pandemic and reported frequent sleep problems among the participants. The results also indicated a moderate relationship between sleep hygiene and sleep quality in adolescents. Thus, sleep hygiene components can be related to sleep quality.

O sono na pandemia COVID-19 e influência na saúde mental na população infantil e pediátrica / Sleep in the COVID-19 pandemic and its influence on mental health in the infant and pediatric population

Introdução: A pandemia COVID-19 e medidas associadas provocaram alterações na qualidade e quantidade do sono, com impactos na saúde mental. Objetivos: Compreender como a pandemia e o confinamento interferiu nas rotinas e/ou hábitos de sono em crianças e adolescentes e a influência na saúde mental. Metodologia: Revisão da literatura na MEDLINE, partindo da questão: Quais são as alterações nas rotinas ou hábitos de sono em crianças e adolescentes durante a pandemia? Resultados e discussão: Dos 370 artigos, foram selecionados 35. Devido ao confinamento e o ensino à distância, a quantidade de horas de sono aumentou. Porém, com a diminuição da atividade física, desequilíbrio alimentar e aumento do tempo frente aos ecrãs a qualidade do sono diminuiu. Consequentemente, verificou-se uma influência negativa na saúde mental. Conclusão: Verificou-se o aumento dos distúrbios de sono e sua influência na saúde mental, com necessidade de desenvolvimento de estratégias de consciencialização e literacia na temática. (AU)

Introduction: The COVID-19 pandemic and preventive measures led to changes in the quality and quantity of sleep, impacting mental health. Objectives: To understand how the pandemic and confinement interfered with the routines and/or sleeping habits of children and adolescents and influenced mental health. Methodology: A literature review on MEDLINE was conducted, with the research question: What are the changes in the routines or sleep habits of children and adolescents during the pandemic? Results and discussion: From the 370 articles analysed, 35 were selected. Due to confinement and online learning, the number of hours of sleep increased. However, the quality of sleep decreased due to decreased physical activity, an unbalanced diet, and increased time in front of screens. Consequently, there was a negative influence on mental health. Conclusion: The increase in sleep disorders and their influence on mental health was observed, with the need to develop awareness and literacy strategies addressing this area. (AU)

Protecting Sleep Hygiene in the PICU: A Quality Improvement Project.

OBJECTIVES: To increase the number of nights without sleep interruptions for routine tasks in recovering PICU patients. DESIGN: Prospective quality improvement project. SETTING: Single-center, free-standing, tertiary children's hospital. PATIENTS: Patients admitted to the PICU for greater than 72 hours and eligible for early mobilization. INTERVENTIONS: A multidisciplinary sleep hygiene team was created to improve sleep hygiene in critically ill patients eligible for early mobilization. This team rewrote local nursing policies to avoid routine tasks between 11 pm and 5 am . The team provided periodic control chart updates to staff detailing progress made protecting sleep. Discussions of sleep hygiene were added to the daily goal sheet and a sleep hygiene order set was created. Finally, the PICU quality dashboard was modified to show whether a sleep hygiene order set was initiated in eligible patients. MEASUREMENTS AND MAIN RESULTS: Routine tasks were defined as daily chest radiographs, baths, routine tracheostomy care, central line dressing changes, twice daily medications, weights, and Foley care. After a year of data collection, avoidance of routine pupillary examinations was added to the sleep protection criteria. Baseline data was collected for 2 months prior to the creation of the sleep hygiene team. Screening of eligible patients occurred 1 week each month. The data were analyzed utilizing control charts. Baseline data demonstrated 32% of PICU patients without sleep interruptions. The centerline increased to 58% after the initial interventions but dropped to 33% after inclusion of pupillary checks. Following the introduction of the daily goal sheet, sleep hygiene order set, and tracking on the quality board, 49% of patients went without interruptions. CONCLUSIONS: The initiation of a sleep hygiene team along with retiming routine tasks, daily discussions on rounds with the daily goal sheet, introduction of a sleep hygiene order set, and transparent tracking improved the percentage of patients with protected sleep.

Sleep hygiene strategies for individuals with chronic pain: a scoping review.

OBJECTIVES: Up to a quarter of the world's population experience chronic pain, which, in addition to interfering with daily activities and waking function, is often associated with poor sleep. Individuals experiencing poor sleep are often encouraged to implement sleep hygiene strategies. However, current sleep hygiene strategies have not been developed considering the unique challenges faced by individuals with chronic pain and therefore they might not be as effective in this population. The aim of this scoping review is to map the state of the existing literature examining sleep hygiene strategies in individuals with chronic pain. DESIGN: This scoping review included a search of four online databases (Medline, Embase, PsycINFO and CINAHL) to identify articles examining the use of sleep hygiene strategies in populations with chronic pain. RESULTS: Thirty articles investigated at least one sleep hygiene strategy in individuals with chronic pain, with improvements to sleep reported for six sleep hygiene strategies (education, exercise, limiting alcohol use, limiting tobacco use, prebed state and sleep environment). However, the timing of these strategies was often not reported which limits the degree to which these strategies can be generalised for use as a presleep strategy. CONCLUSION: This scoping review examined the existing literature focusing on sleep hygiene strategies for people with chronic pain. There are limitations to the methodology of the existing literature and gaps in our understanding of sleep hygiene strategies in some chronic pain conditions that must be addressed in future research before the effectiveness of these strategies can be understood.

Associations between sedentary behavior and negative emotions in adolescents during home confinement: Mediating role of social support and sleep quality

Background: Prolonged periods of sedentary behaviour, for instance, engendered by home confinement in Shenzhen city, has led to negative mental health consequences, especially in adolescents. Previous research suggests, in general, that sedentary behavior can increase negative emotions. However, the specific mechanism driving the relationship between sedentary behavior and negative emotions is still relatively unclear. Social support and sleep quality might partly explain the effect of sedentary behavior on negative emotions. Thus, the current study aimed to examine the associations between sedentary behavior and negative emotions, and to investigate if social support and sleep quality mediate such a relationship. Method: During home confinement due to the COVID-19 Omicron variant outbreak, 1179 middle and high school students in Shenzhen were invited to voluntarily complete an e-questionnaire, including the 21-item Depression Anxiety Stress Scale (DASS-21), the short form of the International Physical Activity Questionnaire (IPAQ-SF), the Social Support Rating Scale (SSRS) and the Pittsburgh Sleep Quality Index (PSQI). Data from 1065 participants were included in the analysis. Results: We observed significant sex-related and demografic-related differences in emotional (e.g., anxiety, stress and social support) and other outcome variables (e.g., sitting duration and PSQI score). Furthermore, sedentary behavior, social support, and sleep quality were associated with negative emotions (p < .01), even after controlling for sex, age, only-child case, body mass index, and metabolic equivalent level. In addition, social support and sleep quality partially mediated the association between sedentary behavior and negative emotions. (AU)

The interplay between emotion dysregulation, psychological distress, emotional eating, and weight status: A path model

Background/objective: The aim of the current cross-sectional study is to assess the relations between emotion dysregulation, psychological distress, emotional eating, and BMI in a sample of Italian young adults (20-35).Methods: A total sample of 600 participants frm the general population, were asked to fill in demographical and physical data, the Difficulties in Emotion Regulation Scale, the Depression Anxiety and Stress Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire via an online anonymous survey. Relations between variables have been inspected using a path model. Results: Results showed that emotion dysregulation was a contributor to higher levels of psychological distress [b= 0.348; SE: 0.020; p=<0.001; 95% BC-CI (0.306–0.387)] and emotional eating [b= 0.010; SE: 0.002; p=<0.001; 95% BC-CI (0.006–0.014)] which in turn, was related to higher Body Mass Index [b= 0.0574; SE: 0.145; p=<0.001; 95% BC-CI (0.286–0.863)]. Conclusions: By providing additional evidence concerning the role of emotion dysregulation for physical and psychological outcomes, the current study could inform for improving psychological interventions aimed to promote emotion regulation strategies aimed at fostering physical and psychological well-being. (AU)

Prevalence of poor sleep quality and associated lifestyle habits: A cross-sectional study in community pharmacies / Prevalencia de la mala calidad del sueño y hábitos de vida relacionados en farmacias comunitarias

Introduction: Many lifestyle habits can negatively affect sleep quality (SQ) and lead to poor quality of life. This makes it important to determine the prevalence of poor SQ in the population and the lifestyle habits that may be associated with it, with a view to designing appropriate interventions for improving SQ. The aim of this study was to examine the prevalence of poor SQ among the population of Salamanca (Spain) and its relationship with specific lifestyle habits. Method: A cross-sectional study was carried out between July and November 2019. SQ was studied in 261 patients using the Pittsburgh Sleep Quality Index, and the frequency with which patients performed a series of lifestyle hab-its was quantified. The association between variables was assessed using multivariate binary logistic regression. Results: Almost half of the study population (48.7%) was found to have poor SQ. Physical exercise was a protective factor against poor SQ (OR = 0.221; CI95%: 0.081-0.603). Risk factors for poor SQ included being disturbed at night (OR = 3.606; CI95%: 1.892-6.872), going to bed preoccupied (OR = 3.145; CI95%: 1.528-6.471), reading trivial material (OR = 2.475; CI95%: 1.208-5.070), and playing video games (OR = 3.639; CI95%: 1.326-9.984). Conclusions: In Salamanca (Spain), almost half of the study population stated that they suffered poor SQ. Although numerous lifestyle habits that may relate to poor SQ were studied, a statistically significant relationship was only found for a few of them. (AU)

Introducción: Muchos de los hábitos de vida pueden influir negativamente en la calidad de sueño (CS) y por lo tanto pueden desembocar en una mala calidad de vida. Por esa razón es importante determinar la prevalencia de mala CS en la población y qué hábitos de vida pueden estar relacionados con ella. De este modo se podrán diseñar intervenciones adecuadas que permitan mejorar la CS. El objetivo de este estudio fue estudiar la prevalencia de mala CS de la población de Salamanca (España) y su relación con ciertos hábitos de vida. Método: Se estudió la CS de 261 pacientes mediante el “Pittsburg Sleep Quality Index” y se cuantificó la frecuencia con la que éstos realizaban una serie de hábitos de vida. La asociación entre variables se estudió mediante una regresión logística binaria multivariante. Resultados: Casi la mitad de la población (48,7%) mostró tener mala CS. El ejercicio físico fue un factor protector para la mala CS (OR = 0,221; 95%CI: 0,081-0,603). Fueron factores de riesgo para la mala CS ser molestado por la noche (OR = 3,606; 95%CI: 1,892-6,872), ir a la cama preocupado (OR = 3,145; 95%CI: 1,528-6,471), leer cosas no transcendentales (OR = 2,475; 95%CI: 1,208-5,070), o jugar a videojuegos (OR = 3,639; 95%CI: 1,326-9,984). Conclusiones: Casi la mitad de la población de estudio indicó padecer una mala CS en Salamanca (España). Pese a que muchos hábitos de vida están relacionados con la mala CS, solo se encontró relación estadísticamente significativa con algunos de ellos. (AU)

Effectiveness of one-week internet-delivered cognitive behavioral therapy for insomnia to prevent progression from acute to chronic insomnia: A two-arm, multi-center, randomized controlled trial.

Acute insomnia is common and a substantial proportion of people with acute insomnia (i.e. 3 days to 3 months) transit into chronic insomnia (i.e. 3 months or longer). Therefore, early intervention for acute insomnia is vital to prevent chronicity. Previous trials with small sample sizes have shown that brief versions of both individual and group-based face-to-face cognitive behavioral therapy for insomnia (CBT-I) can improve insomnia symptoms among those with acute insomnia. However, it is unknown whether one-week internet-delivered cognitive behavioral therapy for insomnia (CBT-I) is effective in treating acute insomnia. This was a randomized controlled trial and 192 participants were randomly assigned to the CBT-I group (n = 95) or control group (n = 97). The primary outcome was the incidence of chronic insomnia, determined via a structured diagnostic questionnaire for insomnia disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Secondary outcomes were Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep (DBAS), Epworth Sleepiness Scale (ESS), Pre-sleep Arousal Scale (PSAS), Ford Insomnia Response to Stress Test (FIRST), Sleep Hygiene and Practices Scale (SHPS), Hospital Anxiety and Depression Scale (HADS), and Short-Form 12-Item Health Survey version 2 (SF-12v2). At week 12, the incidence of chronic insomnia was significantly lower in the CBT-I group compared with control group (33.3% [27/81] vs. 65.8% [52/79]). Participants in the CBT-I group achieved significantly more improvements in ISI, ESS, PSAS, FIRST, SHPS, HADS-Depression, and the mental component summary and physical component summary of SF-12v2 than control group, but not DBAS and HADS-Anxiety. This one-week internet-delivered CBT-I program is an effective tool to prevent the chronicity of acute insomnia.

Impacto de los turnos de trabajo en la calidad del sueño del personal de enfermería en dos hospitales de tercer nivel de Canarias / Impact of shift work on the sleep quality of nursing staff attending two tertiary hospitals in the Canary Island

Fundamentos: Se sabe que las características de la actividad laboral influyen en la calidad del sueño de los trabajadores. Un elemento de la actividad laboral es la turnicidad. El objetivo de este estudio fue analizar la calidad del sueño del personal de enfermería de dos hospitales de tercer nivel en Canarias y su correlación con el turno de trabajo. Métodos: Estudio observacional, analítico y transversal, de una muestra no aleatoria de 275 enfermeros y técnicos en cuidados auxiliares de enfermería (TCAEs). Se midió calidad de sueño mediante el test de Pittsburgh Sleep Quality Index (PSQI) y características sociodemográficas y laborales con un cuestionario creado ad hoc. Resultados: El 65,8% del personal de enfermería tiene una mala calidad del sueño. Se observó que la turnicidad laboral afecta a la calidad del sueño. Los trabajadores con turno antiestrés (D/N) tienen mejor calidad de sueño (M=7,31; ±DE=4,0) comparado con el turno rotatorio (M/T/N) (M= 9,06; ± DE=4,3); p=0,01. Conclusiones: Las alteraciones del sueño son frecuentes entre el personal de enfermería, siendo el turno antiestrés (D/N) el que menos afecta a la calidad del sueño (AU)

Factores asociados al sueño nocturno de los adolescentes / Factors associated with night sleep in adolescents

Introducción: durante la adolescencia se producen numerosos cambios en los hábitos de vida que afectan también a los patrones de sueño; patrones que son clave en el desarrollo de los jóvenes y en su estado de salud. Por ello, el objetivo del estudio fue analizar la relación e influencia de diversos hábitos de vida, indicadores de salud física y psicosocial, y variables sociodemográficas sobre la duración del sueño nocturno. Material y métodos: el estudio se llevó a cabo sobre una muestra de 761 estudiantes (14,51 ± 1,63 años) de 25 centros educativos de una región del norte de España. Se valoró el número de horas de sueño nocturno, así como la adherencia a la dieta mediterránea, nivel de actividad física, calidad de vida relacionada con la salud, autoestima, consumo máximo de oxígeno, índice de masa corporal, rendimiento académico y diversos factores sociodemográficos. Resultados: tener mayor edad e índice de masa corporal, así como una menor adherencia a la dieta mediterránea y estudiar en centros de zonas urbanas fueron predictores de un menor número de horas de sueño nocturno, llegando a explicar el 26,2% de su varianza. Asimismo, los adolescentes que no cumplían con las recomendaciones de sueño nocturno presentaron menores índices de calidad de vida relacionada con la salud y autoestima, así como niveles más bajos de actividad física y consumo máximo de oxígeno. Conclusiones: las intervenciones dirigidas a la prevención de los trastornos del sueño deberían tener en cuenta los factores predictores citados, orientando los esfuerzos hacia el fomento de hábitos saludables y entornos propicios para el descanso, especialmente, en zonas urbanas (AU)

Introduction: during adolescence there are many changes in lifestyle that also affect sleep patterns, patterns that are key in the development of young people and their health status. Therefore, the objective of the study was to analyse the relationship and influence of various lifestyle habits, physical and psychosocial health indicators, and sociodemographic variables on the duration of night sleep.Method: a cross-sectional study was applied to a sample of 761 students (14.51±1.63 years) from 25 educational centers in a region of northern Spain. Their hours of nightly sleep were assessed, as well as their adherence to the Mediterranean diet, physical activity engagement, health-related quality of life, self-esteem, maximum oxygen uptake, body mass index, academic performance, and various sociodemographic factors.Results: being older and having a higher body mass index, as well as lower adherence to the Mediterranean diet and studying in urban centers were predictors of a lower number of hours of nightly sleep, explaining 26.2% of its variance. Likewise, adolescents who did not meet the nightly sleep recommendations had lower rates of health-related quality of life and self-esteem, as well as lower levels of physical activity and maximal oxygen uptake.Conclusions: interventions aimed at preventing sleep disorders should take into account the aforementioned predictive factors, directing efforts towards promoting healthy habits and environments favourable to rest, especially in urban areas. (AU)

[Adolescents' sleep quality in the context of Internet use]. / Serdülok alvásminosége az internethasználattal összefüggésben.

Background and purpose: Background and purpose - The present study is a continuation of our previous research, our aim is to assess the sleep quality of adolescents in light of Internet use. Methods: We conducted a cross-sectional, quantitative, descriptive questionnaire survey among students aged 12-18 in primary and secondary education (n = 308). A self-edited questionnaire, a scale of sleep hygiene rules, and the Athens Insomnia Scale were used. Results: On the Athens Insomnia Scale, they scored an average of 5.39 (3.93) points, with 17% of adolescents considered insomniac. Students watch an average of 1.27 (1.04) hours of film a day, and 47% of them use the Internet for more than two hours a day. Excessive internet use (p < 0.001) and use of smart devices before falling asleep (p = 0.002) have a negative effect on sleep quality. Stress increases in parallel with Internet use (p = 0.001). Those who sleep better perform better in school (p = 0.034). Conclusion: Excessive use of smart devices is associated with higher stress levels and poorer sleep quality. Our goal is to draw the attention of parents and adolescents to the reduction of Internet use and the possible consequen-ces of deteriorating sleep quality.

Resting and Recharging: A Narrative Review of Strategies to Improve Sleep During Residency Training.

Background: Residency involves demanding training with long hours that may cause fatigue and sleep deprivation and adversely impact residents and patients under their care. Objective: To identify, using a narrative review, evidence-based interventions to reduce the physiologic effects of fatigue and sleep deprivation from overnight and night shift work. Methods: A PubMed literature search was conducted through August 30, 2021, using the terms "resident" and "sleep" in the title or abstract and further narrowed using a third search term. Observational studies, randomized controlled trials, systematic reviews, and meta-analyses of human subjects written and published in English were included. Studies that were not specific to residents or medical interns or did not investigate an intervention were excluded. Additional studies were identified by bibliography review. Due to the heterogeneity of study design and intervention, a narrative review approach was chosen with results categorized into non-pharmacological and pharmacological interventions. Results: Initially, 271 articles were identified, which were narrowed to 28 articles with the use of a third search term related to sleep. Bibliography review yielded 4 additional articles. Data on interventions are limited by the heterogeneity of medical specialty, sample size, length of follow-up, and reliance on self-report. Non-pharmacological interventions including strategic scheduling and sleep hygiene may improve sleep and well-being. The available evidence, including randomized controlled trials, to support pharmacological interventions is limited. Conclusions: Non-pharmacological approaches to mitigating fatigue and sleep deprivation have varying effectiveness to improve sleep for residents; however, data for pharmacological interventions is limited.

Effect of Sleep Hygiene Education on Sleep Quality in Patients With Liver Transplantation.

This study aimed to determine the effects of sleep hygiene education on sleep quality in liver transplant patients. In the literature, the efficacy of various pharmacological methods for reducing poor sleep quality associated with liver transplant patients and studies on nonpharmacological methods are limited. This study was conducted using a quasiexperimental design with a pre- and posttest, and a control group. When the power analysis was made, a sample size with 5% double-sided significance, 95% confidence interval, and 95% ability to represent the population was calculated to have a total of 100 liver transplant patients. The data were collected using a patient information form, and the Richard Campbell Sleep Quality Questionnaire. In the experimental group, the researcher gave a sleep hygiene training for 1 week. No treatment was performed in the control group. To analyze the data, descriptive statistics, a χ2 test, a t test for dependent groups, and a t test for independent groups were used. According to sleep hygiene training follow-ups after liver transplantation, the mean scores of sleep quality was similarly poor, with a statistical significance in the experimental group compared with the control group in all measurements before and after sleep hygiene training (P < .001). The sleep hygiene training applied to liver transplant patients positively affected and decreased the severity of sleep quality.

Disparities in sleep duration among American children: effects of race and ethnicity, income, age, and sex.

Children in the United States sleep less than the recommended amount and sleep deficiencies may be worse among disadvantaged children. Prior studies that compared sleep time in children of different race/ethnic groups mostly relied on questionnaires or were limited to small sample sizes. Our study takes advantage of the Adolescent Brain Cognitive Development study to compare total sleep time using a week of actigraphy data among American children (n = 4,207, 9 to 13 y old) of different racial/ethnic and income groups. We also assessed the effects of neighborhood deprivation, experience of discrimination, parent's age at child's birth, body mass index (BMI), and time the child fell asleep on sleep times. Daily total sleep time for the sample was 7.45 h and race/ethnicity, income, sex, age, BMI, were all significant predictors of total sleep time. Black children slept less than White children (∼34 min; Cohen's d = 0.95), children from lower income families slept less than those from higher incomes (∼16 min; Cohen's d = 0.44), boys slept less than girls (∼7 min; Cohen's d = 0.18), and older children slept less than younger ones (∼32 min; Cohen's d = 0.91); mostly due to later sleep times. Children with higher BMI also had shorter sleep times. Neither area deprivation index, experience of discrimination, or parent's age at child's birth significantly contributed to sleep time. Our findings indicate that children in the United States sleep significantly less than the recommended amount for healthy development and identifies significant racial and income disparities. Interventions to improve sleep hygiene in children will help improve health and ameliorate racial disparities in health outcomes.

Effects of mindfulness-based therapy for insomnia and a sleep hygiene/exercise programme on subjective-objective sleep discrepancy in older adults with sleep disturbances: Exploratory secondary analysis of a randomised clinical trial.

Older adults with poor sleep tend to show a discrepancy between objective and self-reported sleep parameters, which can trigger a vicious cycle that worsens their sleep complaints. Cognitive-behavioural therapy can reduce this discrepancy, but alternative behavioural therapies remain untested. The present exploratory study aimed to investigate the effects of mindfulness-based therapy for insomnia (MBTI) on reducing sleep discrepancies in comparison with a sleep hygiene, education, and exercise programme (SHEEP). Older adults were randomly allocated into the mindfulness-based therapy for insomnia group (n = 55) or the sleep hygiene, education, and exercise programme group (n = 58). Subjective and objective sleep parameters were measured using sleep diaries, polysomnography (PSG), and actigraphy. Sleep discrepancies were calculated using the Bland-Altman method for sleep onset latency (SOL) and wake after sleep onset (WASO). Additionally, correlations between the change in sleep discrepancies and the change in subjective sleep quality and trait mindfulness were measured within each group. Sleep onset latency discrepancy measured by polysomnography and actigraphy decreased significantly after the MBTI and SHEEP interventions. In contrast, there was no significant change in wake after sleep onset discrepancy in either group. The change in sleep onset latency discrepancy was correlated with the change in insomnia symptoms and objectively measured trait mindfulness. Mindfulness-based therapy for insomnia was effective in reducing sleep onset latency discrepancies and improving sleep perception in older adults with sleep disturbances, which in turn drove an improvement in sleep quality and insomnia symptoms. Increases in trait mindfulness may have been an important mechanism in improving sleep perception in the mindfulness-based therapy for insomnia group.

Cognitive-behavioral therapy for insomnia for primary care: Review of components and application for residents in primary care.

Healthy sleep patterns are a significant component of good physical and mental health. Quality sleep can be affected by such things as stress, age, pregnancy, physical health problems, and shift work. Behaviors related to sleep problems can be one of three types: predisposing, precipitating, and perpetuating. Additionally, cognitive processes related to sleep quality tend to be predominated by sleep thinking or insomnia thinking. Multiple medical organizations promote Cognitive Behavioral Therapy for Insomnia as a best practice for clinical management of sleep problems and disorders. Cognitive Behavioral Therapy for Insomnia consists of five components aimed at addressing both the behavioral and cognitive impediments to high quality sleep. These components are sleep hygiene, relaxation, sleep restriction, stimulus control, and cognitive therapy. This paper will address each component, as well as provide a patient education pattern well suited for primary care settings.

Tiempo frente a la pantalla, actividad física, tiempo de sueño y hábitos alimenticios en escolares en pandemia / Screen time, physical activity, sleep time and eating habits in schoolchildrenin a pandemic

Introducción: La pandemia de la Covid-19 ha modificado las actividades cotidianas de las personas a nivel mundial y el tiempo de los escolares frente a una pantalla se ha incrementado produciendo inactividad física y sedentarismo. Objetivo: Determinar la relación del tiempo frente a la pantalla (televisión, computadora, celular, tabletas) con la actividad física, tiempo de sueño y los hábitos alimenticios en escolares de 6 a 12 años de Juliaca durante el confinamiento. Materiales y Métodos: Se realizó un estudio descriptivo correlacional múltiple de corte transversal, que comprendió a 305 escolares (164 mujeres y 141 varones) con promedio de edad de (9,09 ± 1,99). La información se recolectó por medio de cuestionarios online: tiempo frente a la pantalla, actividad física y hábitos alimenticios. Resultados: Los varones permanecen más horas frente a una pantalla durante la semana (20,7%) de 6-7 horas diarias, (11,5%) de 8-9, (3,0%) > 10 horas, en contraste con las mujeres (13,4%), (5,6%) y (1,0%). Las mujeres muestran niveles de actividad física baja (26.2%) frente a los varones (6.2%). En el tiempo de sueño las mujeres prevalecen el (41.3%) duerme de 8-9 horas, a diferencia de los varones (31,5%). En los hábitos alimenticios predominó la alimentación inadecuada en los escolares. Existe correlación de Rho de Spearman inversamente proporcional entre las variables tiempo frente a la pantalla con la actividad física y los hábitos alimenticios de -0,191 y -0,197 con un valor de (p< 0.05).Conclusiones: se determinó que los escolares pasan más tiempo frente a una pantalla durante y el fin de semana, el nivel de actividad física disminuyó sustancialmente, las horas de sueño se modificaron y los hábitos alimenticios son inadecuados producto de la pandemia.(AU)

Introduction: The COVID-19 pandemic has modified thedaily activities of people worldwide and the time of school-children in front of a screen has increased, producing physi-cal inactivity and sedentary lifestyle. Objective: To determine the relationship of time in frontof the screen (television, computer, cell phone, tablets) withphysical activity, hours of sleep and eating habits in school-children aged 6 to 12 years in Juliaca during the pandemic. Materials and Methods: A descriptive cross-sectionalmultiple correlational study was carried out, which included305 schoolchildren (164 women and 141 men) with a meanage of 9.09 ± 1.99. The information was collected throughonline questionnaires: time in front of the screen, physical ac-tivity, hours of sleep and eating habits. Results: Men spend more hours in front of a screen duringthe week (20.7%) from 6-7 hours a day, (11.5%) from 8-9,(3.0%) > 10 hours, in contrast with women (13.4%), (5.6%)and (1.0%). Women show low levels of physical activity (26.2%) compared to men (6.2%). In the hours of sleep, women prevail(41.3%) sleep 8-9 hours a day, unlike men (31.5%). In eatinghabits, inadequate nutrition prevailed in schoolchildren. Conclusions: it was determined that schoolchildren spendmore time in front of a screen from 4 to 9 hours during theweek and from 1 to 5 hours on the weekend, the level ofphysical activity decreased substantially, the hours of sleepwere modified and the habits Food supplies are inadequate asa result of the pandemic.(AU)