The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis

BackgroundSleep quality is an essential component of athlete’s recovery. However, a better understanding of the parameters to adequately quantify sleep quality in team sport athletes is clearly warranted.ObjectiveTo identify which parameters to use for sleep quality monitoring in team sport athletes.MethodsSystematic searches for articles reporting the qualitative markers related to sleep in team sport athletes were conducted in PubMed, Scopus, SPORTDiscus and Web of Science online databases. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. For the meta-analysis, effect sizes with 95% CI were calculated and heterogeneity was assessed using a random-effects model. The coefficient of variation (CV) with 95% CI was also calculated to assess the level of instability of each parameter.ResultsIn general, 30 measuring instruments were used for monitoring sleep quality. A meta-analysis was undertaken on 15 of these parameters. Four objective parameters inferred by actigraphy had significant results (sleep efficiency with small CV and sleep latency, wake episodes and total wake episode duration with large CV). Six subjective parameters obtained from questionnaires and scales also had meaningful results (Pittsburgh Sleep Quality Index (sleep efficiency), Likert scale (Hooper), Likert scale (no reference), Liverpool Jet-Lag Questionnaire, Liverpool Jet-Lag Questionnaire (sleep rating) and RESTQ (sleep quality)).ConclusionsThese data suggest that sleep efficiency using actigraphy, Pittsburgh Sleep Quality Index, Likert scale, Liverpool Jet-Lag Questionnaire and RESTQ are indicated to monitor sleep quality in team sport athletes.PROSPERO registration numberCRD42018083941.

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Comparative Utility of Acupuncture and Western Medication in the Management of Perimenopausal Insomnia: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/5566742 ◽

2021 ◽

Vol 2021 ◽

pp. 1-16

Author(s):

Fei-Yi Zhao ◽

Qiang-Qiang Fu ◽

Gerard A. Kennedy ◽

Russell Conduit ◽

Wen-Zhong Wu ◽

...

Keyword(s):

Systematic Review ◽

Psychotropic Drugs ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Meta Analysis ◽

Hormone Replacement ◽

Controlled Trials ◽

Limited Evidence ◽

Randomized Controlled ◽

Kupperman Index

Background. Many women with perimenopausal insomnia (PMI) have sought alternative therapies such as acupuncture because of concerns about risks associated with hormone replacement therapy (HRT) and/or psychotropic drugs. This systematic review aimed to clarify if acupuncture alone or combined with standard Western pharmacotherapy (HRT and/or psychotropic drugs) is more effective in ameliorating PMI in comparison to pharmacotherapy alone. Methods. Randomized controlled trials (RCTs) of PMI treatment via acupuncture alone or combined with Western pharmacotherapy versus Western pharmacotherapy were searched for from eleven databases from inception to March 2020. Cochrane criteria were followed. Results. Fifteen studies involving 1410 women were analyzed. Meta-analysis indicated that acupuncture significantly reduced the global scores of Pittsburgh Sleep Quality Index (PSQI) [MD = −2.38, 95% CI (−3.38, −1.37), p < 0.01] and Kupperman Index [MD = −5.95, 95% CI (−10.68, −1.21), p = 0.01], compared with hypnotics. Acupuncture combined with hypnotics was more effective than hypnotics alone in decreasing PSQI scores [MD = −3.13, 95% CI (−5.43, −0.83), p < 0.01]. Too few RCTs were available to investigate the clinical efficacy differences between acupuncture and HRT/psychotropic drugs other than hypnotics. Conclusions. Despite limited evidence, in comparison to hypnotics, acupuncture was associated with significant improvements in PMI, and reductions of other menopausal symptoms. This finding suggests that acupuncture may be a useful addition to treatment for PMI.

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