Sleep Epidemiology

Author(s):  
Susan Redline ◽  
Brian Redline ◽  
Peter James

This chapter is a primer on sleep epidemiology—the methods of assessment on how sleep is measured (e.g., self-report [such as the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale] vs. with use of objective tools such as actigraphy); validity of sleep measurements; the different dimensions of sleep health and disorders that are of interest (e.g., sleep duration, sleep quality, sleep fragmentation, insomnia, obstructive sleep apnea, social jetlag, snoring, narcolepsy, etc.); general sleep biology and physiology; and why sleep matters (i.e., the epidemiologic consequences of poor sleep health, e.g., connection to other health behaviors and health outcomes such as drug use; sexual risk behaviors; depression; dietary behaviors such as sugar-sweetened beverage consumption; cardiometabolic diseases like obesity, diabetes, and hypertension; and cancer outcomes such as breast cancer).

2016 ◽  
Vol 2 ◽  
pp. 205521731668277 ◽  
Author(s):  
Mayis Aldughmi ◽  
Jessie Huisinga ◽  
Sharon G Lynch ◽  
Catherine F Siengsukon

Background Perceived fatigue and fatigability are constructs of multiple sclerosis (MS)-related fatigue. Sleep disturbances lead to poor sleep quality, which has been found to be associated with perceived fatigue in people with MS (PwMS). However, the relationship between fatigability and sleep quality is unknown. Objective To explore the relationship between physical and cognitive fatigability with self-reported and objective measures of sleep quality in PwMS. Methods Fifty-one ambulatory PwMS participated in the study. Physical fatigability was measured by percent-change in meters walked on the six-minute walk test (6MWT) and in force exerted on a repeated maximal hand grip test. Cognitive fatigability was measured using response speed variability on the continuous performance test. Self-report sleep quality was measured using the Pittsburgh Sleep Quality Index, and objective sleep quality was measured using 1 week of actigraphy. Results Components of the Pittsburgh Sleep Quality Index and several actigraph parameters were significantly associated with physical fatigability and cognitive fatigability. However, controlling for depression eliminated the association between the sleep outcomes and cognitive fatigability and attenuated the association between the sleep outcomes and physical fatigability. Conclusion Poor sleep quality is related to fatigability in MS but depression appears to mediate these relationships.


2018 ◽  
Vol 13 (2) ◽  
pp. 46
Author(s):  
Putwi Rizki Sakinah ◽  
Cecep Eli Kosasih ◽  
Eka Afrima Sari

AbstractPeople with hypertension experience symptoms of dizziness, headache, obstructive sleep apnea, shortness of breath, nocturia, and restless legs syndrome which disturb sleep and reduce its quality. This research’s objective was to describe the sleep quality overview of Puskesmas Rancaekek’s hypertension patients. Using descriptive quantitative method with purposive sampling technique, this research aimed at 79 Puskesmas Rancaekek’s patients who had been diagnosed with hypertension for at least one month long. The data were collected using the Pittsburgh Sleep Quality Index (PSQI) questionnaire and analysed using the total score resulted; ≤5 was good while >5 was poor. Results showed 94.6% of respondents had poor sleep quality. The dimensions that contribute to the poor sleep quality included >30 minutes sleep latency, <5 hours sleep duration, <65% of sleep efficiency, sleep disturbance due to waking up at midnight or early morning and waking up to toilet, and activity disturbance at daylight. The conclusion was that Puskesmas need to develop preventive and promotive efforts to minimize the complication of hypertension patients and optimize their quality of life by helping them improve their quality of sleep. Meanwhile, the self-management that should be done by the patients were avoiding the consumption of coffee and cigarettes, limiting physical activities, and doing physical exercise and relaxation therapies. Key Words: Hypertension, Sleep Quality, PSQI  AbstrakPenderita hipertensi mengalami gejala pusing, nyeri kepala, obstructive sleep apnea, sesak napas, nokturia, restless legs syndrome yang mengganggu tidur dan berdampak pada kualitas tidur serta mempengaruhi kualitas hidup dan tekanan darah. Penelitian bertujuan untuk melihat gambaran kualitas tidur pada penderita hipertensi di Puskesmas Rancaekek. Metode penelitian menggunakan deskriptif kuantitatif dengan teknik purposive sampling sebanyak 79 penderita hipertensi di Puskesmas Rancaekek yang telah didiagnosis dokter minimal 1 bulan. Pengambilan data menggunakan kuesioner Pittsburgh Sleep Quality Index (PSQI) dan dianalisis menggunakan total skor, jika skor ≤ 5 baik dan skor > 5 buruk. Hasil menunjukan 94,6% responden memiliki kualitas tidur buruk. Dimensi yang berkontribusi terhadap kualitas tidur buruk yaitu latensi tidur tidak dapat tertidur dalam waktu 30 menit, durasi tidur <5 jam, efisiensi kebiasaan tidur <65%, gangguan tidur karena terbangun tengah malam atau pagi sekali dan terbangun karena ingin ke toilet, serta gangguan aktivitas pada siang hari. Puskesmas perlu mengembangkan upaya preventif dan promotif untuk meminimalisir komplikasi penderita hipertensi dan pencapaian kualitas hidup optimal salah satunya dengan membantu meningkatkan kualitas tidur. Dengan mengedukasi penderita untuk menghindari konsumsi kopi dan rokok, membatasi aktivitas fisik, melakukan latihan fisik, dan terapi relaksasi. Kata Kunci: Hipertensi, Kualitas Tidur, PSQI


Author(s):  
Marco Fabbri ◽  
Alessia Beracci ◽  
Monica Martoni ◽  
Debora Meneo ◽  
Lorenzo Tonetti ◽  
...  

Sleep quality is an important clinical construct since it is increasingly common for people to complain about poor sleep quality and its impact on daytime functioning. Moreover, poor sleep quality can be an important symptom of many sleep and medical disorders. However, objective measures of sleep quality, such as polysomnography, are not readily available to most clinicians in their daily routine, and are expensive, time-consuming, and impractical for epidemiological and research studies., Several self-report questionnaires have, however, been developed. The present review aims to address their psychometric properties, construct validity, and factorial structure while presenting, comparing, and discussing the measurement properties of these sleep quality questionnaires. A systematic literature search, from 2008 to 2020, was performed using the electronic databases PubMed and Scopus, with predefined search terms. In total, 49 articles were analyzed from the 5734 articles found. The psychometric properties and factor structure of the following are reported: Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Insomnia Severity Index (ISI), Mini-Sleep Questionnaire (MSQ), Jenkins Sleep Scale (JSS), Leeds Sleep Evaluation Questionnaire (LSEQ), SLEEP-50 Questionnaire, and Epworth Sleepiness Scale (ESS). As the most frequently used subjective measurement of sleep quality, the PSQI reported good internal reliability and validity; however, different factorial structures were found in a variety of samples, casting doubt on the usefulness of total score in detecting poor and good sleepers. The sleep disorder scales (AIS, ISI, MSQ, JSS, LSEQ and SLEEP-50) reported good psychometric properties; nevertheless, AIS and ISI reported a variety of factorial models whereas LSEQ and SLEEP-50 appeared to be less useful for epidemiological and research settings due to the length of the questionnaires and their scoring. The MSQ and JSS seemed to be inexpensive and easy to administer, complete, and score, but further validation studies are needed. Finally, the ESS had good internal consistency and construct validity, while the main challenges were in its factorial structure, known-group difference and estimation of reliable cut-offs. Overall, the self-report questionnaires assessing sleep quality from different perspectives have good psychometric properties, with high internal consistency and test-retest reliability, as well as convergent/divergent validity with sleep, psychological, and socio-demographic variables. However, a clear definition of the factor model underlying the tools is recommended and reliable cut-off values should be indicated in order for clinicians to discriminate poor and good sleepers.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 428-429
Author(s):  
Breann LaRocque ◽  
Christina Mu ◽  
Soomi Lee

Abstract Nightly sleep impacts next-day alertness and cognitive functioning. For healthcare professions, work impairment can be life-threatening for patients. Thus, understanding how sleep affects work quality is imperative to promoting medical safety and overall health of workers. The current study investigated whether nightly sleep health is associated with next-day work impairment in nurses and whether this association is mediated by daily fatigue. Sixty nurses reported their sleep characteristics, fatigue, and work impairment using ecological momentary assessment for two weeks. We used a series of multilevel models (a path: sleep→fatigue, b path: fatigue→work impairment, c path: sleep→work impairment, c′ path: sleep and fatigue→work impairment), adjusting for sociodemographics and work shift. At the between-person level, poorer sleep quality was associated with greater work impairment (βc=-23.36, p&lt;.001). This association was mediated by fatigue such that poorer sleep quality was associated with greater fatigue (βa=-19.54, p&lt;.01), which was further associated with greater work impairment (βb=0.79, p&lt;.001). After including fatigue, the association of sleep quality with work impairment was reduced (βc′ =-7.07, p=.08). Similarly, fatigue mediated the relationship between sleep sufficiency and work impairment (βa=-16.49; βb=0.79; βc=-19.36; p&lt;.001; βc′ =-6.32, p=.05). At the within-person level, on days after long sleep duration (&gt;8hrs), nurses reported greater work impairment (βc=10.08, p&lt;.01), however, this was not mediated by fatigue. Our results suggest that poor sleep health may impair next-day work performance, mostly through increased fatigue. Future interventions for nurses can target daily fatigue to reduce the adverse effects of poor sleep on work impairment.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1565-1565 ◽  
Author(s):  
A. Sahraian ◽  
A. Javadpour ◽  
A. Mani

IntroductionSleep-wake cycle is one of human biological rhythm highly correlated to well being and general health status.Poor sleep quality, sleep disruption and changes in regular Sleep-wake pattern may cause physical and psychological burden such as impairment in job performance, decreased work efficiency and learning disability.ObjectiveHealth care students trained in medical, nursing and midwifery fields is a population who are at great risk to develop sleep disruption and its subsequent physical and mental morbidity.AimThe aim of this study was to describe how sleep quality correlated to general health status among 280 health care students.Methods280 health care students studying in health related fields participated in this cross section study. Pittsburg sleep quality index (PSQI), sleep- wake questionnaire and the general health questionnaire (GHQ) administered to gather data describing sleep quality, sleep wake disruption and the general health status.ResultsPreliminary results showed that 61.4% of subjects defined as poor sleeper. In further co relational analysis there was a significant correlation between sleep quality and general health status (r = .6, p = . 000, n = 280). Regression analysis showed that number of nights with sleep disruption due to shift work or academic needs was a strong predictor for both poor sleep quality and general health status.ConclusionIn conclusion, Sleep disruption due to shift work or other academic demands is a predictor for poor sleep and its subsequent mental health morbidity, which should be considered as a part of mental health policy for health related college students.


2017 ◽  
Vol 63 (12) ◽  
pp. 1055-1060 ◽  
Author(s):  
Marcelo Rodrigues Bacci ◽  
Jonathan Naim Mora Emboz ◽  
Beatriz da Costa Aguiar Alves ◽  
Glaucia Luciano da Veiga ◽  
Neif Murad ◽  
...  

Summary Introduction: Obstructive sleep apnea and hypopnea syndrome (OSAHS) is one of the developmental factors of high blood pressure (HBP), a relevant global public health problem. OSAHS is characterized by the reduction or complete cessation of respiratory airflow due to intermittent airway collapse. Additionally, significant changes in sleep rhythm and pattern are observed in these patients. Objective: To evaluate the association between OSAHS and sleep quality in essential and resistant hypertensives. Method: A cross-sectional, observational study evaluated 43 hypertensive patients treated at the outpatient clinics of the Faculdade de Medicina do ABC (FMABC) who were medicated with two or more antihypertensive drugs and divided into nonresistant or resistant to treatment. Results: Group I (using up to two antihypertensive agents – 60.47% of the sample) presented mean systolic blood pressure (SBP) of 127.5±6.4 mmHg, mean diastolic blood pressure (DBP) of 79.6±5.2 mmHg, mean body mass index (BMI) of 27.2±5.3 kg/m2 and mean age of 51.2±15.1 years. Group II (using more than two antihypertensive drugs – 37.2% of the sample) presented mean SBP of 132.1±9.3 mmHg, mean DBP of 84.5±5.8 mmHg, mean BMI of 27.2±7.2 kg/m2 and mean age of 55.5±13.4 years. The patients presented low quality of sleep/sleep disorder evaluated by the Pittsburgh Sleep Quality Index (PSQI), which represents a preponderant factor for OSAHS. Conclusion: Patients at high risk for OSAHS had poor sleep quality and high levels of DBP, suggesting a causal relation between these parameters. However, they did not present a higher prevalence of resistant high blood pressure (RHBP).


Author(s):  
Jessica Murphy ◽  
Christopher Gladney ◽  
Philip Sullivan

Student athletes balance academic, social, and athletic demands, often leading to increased levels of stress and poor sleep. This study explores the relationship between sleep quality, sleep hygiene, and psychological distress in a sample of student athletes. Ninety-four student athletes completed the six-item Kessler Psychological Distress Scale (K6), Sleep Hygiene Practice Scale, and four components from the Pittsburgh Sleep Quality Index. Age, gender, and sport were also collected. The Pittsburgh Sleep Quality Index revealed that 44.7% of student athletes received ≥6.5 hr of sleep each night; 31% of athletes showed signs of severe mental illness according to the K6. Stepwise regression predicted K6 scores with the Pittsburgh Sleep Quality Index and the Sleep Hygiene Practice Scale scores as independent variables. A significant model accounting for 26% of the variation in K6 scores emerged; sleep schedule and sleep disturbances were significant predictors. Athletic staff should highlight the importance of sleep for mental health; suggestions on how to help athletes are provided.


2019 ◽  
Vol 23 ◽  
pp. 1-26
Author(s):  
Andrea Wendt ◽  
Thaynã Ramos Flores ◽  
Inácio Crochemore Mohnsam Silva ◽  
Fernando César Wehrmeister

The aim of this study was to systematically examine the literature on physical activity and sleep in non-clinical and population-based settings. The inclusion criteria were original studies testing the association between physical activity (as exposure) and sleep (as outcome) in representative samples of the general population, workers, or undergraduate students. Sleep health included sleep duration, sleep quality and insomnia. Studies evaluating samples including only individuals with some disease or a health condition were excluded. A search was performed in the PubMed, Scopus, Lilacs, CINAHL, and SPORTdiscus databases in March 2018. Data extraction was performed using the following items: year, author, country, population, age group, sample size, study design, sleep measurement/definition, physical activity measurement/definition, adjustment and main results. A total of 57 studies were selected, which markedly used heterogeneous instruments to measure physical activity and sleep. The majority were conducted in high-income countries and with cross-sectional design. Physical activity was associated with lower odds of insomnia (observed in 10 of 17 studies), poor sleep quality (observed in 12 of 19 studies) and long sleep duration (observed in 7 of 11 studies). The results about short sleep or continuous sleep duration remain unclear. Physical activity seems to be associated with sleep quality and insomnia, especially among adult and elderly populations in which these outcomes are more usually measured. The short- and long-term effects of physical activity intensities and dose-response on sleep should be better evaluated.


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 1025-1025
Author(s):  
Vence L. Bonham ◽  
Kayla Cooper ◽  
Caterina P. Minniti ◽  
Khadijah Abdallah ◽  
Ashley Buscetta

Background: Approximately 57% of individuals with Sickle Cell Disease (SCD) suffer from sleep disorders and poor sleep quality. Poor sleep quality may cause excessive daytime sleepiness and is often associated with psychosocial and clinical factors contributing to disease burden and stress levels. One of these psychosocial factors is John Henryism (JH). Defined as a high-effort, active coping style, JH is used by persons with a strong determination to succeed in the face of chronic stressors. Both sleep and JH have mostly been shown to be negatively associated with cardiovascular health. Living with SCD is a unique stressor and how persons cope with their disease may impact their quality of life and health outcomes. The objective of this study is to 1) evaluate the impact of sleep quality and 2) quantify the effect of sleep quality on high-effort coping among persons with SCD. Methods: The sample comprised 191 adults aged 19-71 with SCD. Most participants were women (57%) and had a mean age of 39 years (SD+12.2) (see Table 1). All participants were enrolled in the Insights into Microbiome and Environmental Contributions to SCD and Leg Ulcers (INSIGHTS) study (NCT02156102). All participants were administered a variety of psychosocial measures, a comprehensive medical history and physical exam, and provided blood and saliva samples for clinical and research analysis. Our binary outcome assessed participants' high or low utilization of JH coping style by using the John Henryism Active Coping Scale (JHAC12). JHAC12 scores were measured from participant responses to a 12-item Likert scale. Scores range from 12 to 60 with higher scores indicting higher utilization of JH active coping. Based on the median JH score of our participants, scores between 12-50.9 were categorized as low utilization of JH and scores between 51-60 were categorized as high utilization of JH. Predictors included demographic data and psychosocial measures. Sleep quality was assessed via clinical and survey measures. Clinically, obstructive sleep apnea was self-reported during a comprehensive medical exam. The ASCQ-ME sleep survey is a 5-item measure, and was used to ascertain participant sleep patterns within the past seven days. Scores range from 40 to 60. Scores less than 50 are considered abnormal. Multivariable logistic regression was performed to evaluate differences within the cohort. Results: Mean ASCQ-ME sleep score of the entire cohort was 46, indicating worse sleep quality for participants compared to the ASCQ-ME national SCD reference cohort. Obstructive sleep-apnea was self-reported by 23 participants (12%). The mean JH score was 52, indicating high utilization of active coping. Poorer sleep quality was associated with higher JH coping (OR:1.14, 95% CI: [1.06-1.22]) (see Table 2). There were no significant associations between utilization of JH active coping with the demographic data including sex, age, education and marital status. Worse sleep quality within the SCD cohort was associated with increased usage of hydroxyurea (r= .16, p<.05), history of cardiovascular disease (r= .13, p<.05), higher pain score at study visit (r=.15, p<.05) and increased systolic blood pressure (r=.18, p<.01). Conclusion: Preliminary findings support a relationship between JH and sleep quality in a SCD cohort. In a disease population with high sleep apnea prevalence, these findings have potential clinical implications. Future work should focus on how these psychosocial factors impact sleep and clinical presentation. Disclosures Minniti: Doris Duke Foundation: Research Funding.


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