Assessment of sleep quality in school children of 6-12 years in COVID-19 pandemic

Background: Sleep disorders in children are one of the common disorders and their frequency has increased during the COVID-19 pandemic. The study aims to assess the quality of sleep and study the parameters of sleep in school children aged 6-12 years in pandemic with the help of children’s sleep habit questionnaire (CSHQ).Methods: A survey-based study was conducted from December 2020 to March 2021 using the data obtained from CSHQ. The study involved 498 school children, among which 244 were male participants and 254 were female participants. It involved students from schools of Rahata and Mumbai, Maharashtra.Results: The results of the study were withdrawn. Bedtime Resistance had mean value of 11.79±4.56, sleep onset delay had mean of 1.56±0.71. Average of sleep duration was 4.56±2.09. Sleep anxiety had mean of 7.48±3.1, night wakings had mean of 4.27±1.91. Mean of parasomnias was 10.1±4.46. Average of sleep disordered breathing was 4.09±1.86, for daytime sleepiness mean was 13.04±5.44 with significance of p˂0.0001.Conclusions: The study concluded that sleep time became lesser and bedtime became later in present scenario of COVID-19. The subscale items of CSHQ scale have increased values indicating towards altered sleep pattern. The total scoring of CSHQ for age group 6-9 years on average is higher than age group 10-12 years except “sleep onset delay” and “sleep duration”. Also, the total scores of female participants are higher as compared to male participants.

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229 Sleep-wake behavior, meal timings and digital media duration of Indians during COVID-19 Lockdown

SLEEP ◽

10.1093/sleep/zsab072.228 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A91-A92

Author(s):

Babita Pande ◽

Meenakshi Sinha ◽

Ramanjan Sinha

Keyword(s):

Digital Media ◽

Sleep Duration ◽

Sleep Onset ◽

Therapeutic Management ◽

Daily Routine ◽

Age Group ◽

Younger Age ◽

Gender And Age ◽

Delayed Sleep ◽

The Impact

Abstract Introduction Lockdown and stay home order has been imposed on people in many countries including India to prevent the community transmission of COVID-19 pandemic. However this social restriction led to disturbed daily routine and lifestyle behaviour that is needed to be attended for proper therapeutic management of overall health during such crisis. The impact of lockdown on the most apparent behavioral changes viz. sleep-wake behaviour, major meal timings, and digital screen duration of Indians were investigated. In addition the effects of gender and age were explored. Methods After seeking permission from Ethical Institution, an online questionnaire based survey was circulated within India in the first week of May, 2020 for which total 1511 male and female (age ≥18 years) subjects participated. The sleep-wake behavior observed were sleep-wake timings, sleep duration, mid sleep time (MST) as function of lockdown, and social (lockdown) jetlag (SJL = MST before lockdown-MST during lockdown). Results The sleep onset-wakeup and meal times were significantly delayed during lockdown, which was more pronounced in younger age group. The sleep duration increased, specifically in young individuals during lockdown. Females showed more delayed sleep onset-waking times and first meal timing with longer sleep duration during lockdown. Increased digital media duration was observed in all age groups, primarily in males. The younger age group and specifically female reported higher SJL and delayed MST. A positive association was obtained between sleep duration & first meal time, and SJL & major meal timings/screen duration, and a significant negative relationship of sleep duration and SJL with age. Conclusion The study shows delayed sleep-wake schedule, meal timings and increased digital media duration among Indians during COVID-19 lockdown compared to before lockdown. Also, gender and age emerged as important mediating factors for this alteration. The pandemic has given opportunity to sleep more and compensate for the sleep. In spite of that, the higher social jetlag in young age group and female showed the compromised sleep and maladaption with societal timing. These findings have applied implications in sleep health during longer social isolation conditions and for proper therapeutic management. Support (if any) No

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Delayed Lactogenesis II is Associated With Lower Sleep Efficiency and Greater Variation in Nightly Sleep Duration in the Third Trimester

Journal of Human Lactation ◽

10.1177/0890334419830991 ◽

2019 ◽

Vol 35 (4) ◽

pp. 713-724

Author(s):

Theresa Casey ◽

Hui Sun ◽

Helen J. Burgess ◽

Jennifer Crodian ◽

Shelley Dowden ◽

...

Keyword(s):

Body Mass Index ◽

Blood Glucose ◽

Sleep Duration ◽

Body Mass ◽

Sleep Disturbances ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Efficiency ◽

Delayed Onset ◽

Wrist Actigraphy

Background: Metabolic and hormonal disturbances are associated with sleep disturbances and delayed onset of lactogenesis II. Research aims: The aim of this study was to measure sleep using wrist actigraphy during gestation weeks 22 and 32 to determine if sleep characteristics were associated with blood glucose, body mass index, gestational related disease, delayed onset of lactogenesis II, or work schedule. Methods: Demographic data were collected at study intake from primiparous women who wore a wrist actigraph during gestation weeks 22 ( n = 50) and 32 ( n = 44). Start and end sleep time, total nighttime sleep, sleep efficiency, wake after sleep onset, and sleep fragmentation were measured. Night to night variability was assessed with the root mean square of successive difference. Blood glucose levels, body mass index, and gestational disease data were abstracted from medical charts. Timing of lactogenesis II was determined by survey. Results: Between gestation week 22 and 32, sleep efficiency decreased and fragmentation increased ( p < .05). During gestation week 32, blood glucose was negatively correlated with sleep duration, and positively related to fragmentation ( p < .05). Women who experienced delayed lactogenesis II had lower sleep efficiency and greater fragmentation ( p < .05), and greater night-to-night variability in sleep start and end time, efficiency, and duration during gestation week 32 ( p < .05). Conclusion: Women with better sleep efficiency and more stable nightly sleep time are less likely to experience delayed onset of lactogenesis II. Interventions to improve sleep may improve maternal health and breastfeeding adequacy.

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Sleep disturbance and quality of life in Rheumatoid Arthritis: a prospective mobile health study (Preprint)

10.2196/preprints.32825 ◽

2021 ◽

Author(s):

John McBeth ◽

William G Dixon ◽

Susan Mary Moore ◽

Bruce Hellman ◽

Ben James ◽

...

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Sleep Disturbance ◽

Mobile Health ◽

Sleep Disturbances ◽

Total Sleep Time ◽

Sleep Onset ◽

Sleep Time ◽

Domain Scores

BACKGROUND Sleep disturbance and poor health related quality of life (HRQoL) are common in people with rheumatoid arthritis (RA). Sleep disturbances, such as less total sleep time, more waking periods after sleep onset, and higher levels of non-restorative sleep, may be a driver of HRQoL. However, understanding if these sleep disturbances reduce HRQoL has, to date, been challenging due to the need to collect complex time-varying data in high resolution. Such data collection has now been made possible by the widespread availability and use of mobile health (mHealth) technologies. OBJECTIVE In a mobile health (mHealth) study we tested whether sleep disturbance (both absolute values and variability) caused poor HRQoL. METHODS The Quality of life, sleep and rheumatoid arthritis (QUASAR) study was a prospective mHealth study of adults with RA. Participants completed a baseline questionnaire, and for 30 days wore a triaxial accelerometer to objectively assess sleep, and provided daily reports via a smartphone app of sleep (Consensus Sleep Diary (CSD)), pain, fatigue, mood, and other symptoms. Participants completed the World Health Organization Quality of Life-Brief (WHOQoL-BREF) questionnaire every 10 days. Multi-level modelling tested the relationship between sleep variables and WHOQoL-BREF domains (physical, psychological, environment and social). RESULTS Of 268 recruited participants, 254 were included in this analysis. Across all WHOQoL-BREF domains, participant’s scores were lower than the population average. CSD sleep parameters predicted WHOQoL-BREF domain scores. For example, for each hour increase in the total time asleep physical domain scores increased by 1.11 points (β = 1.11 (0.07, 2.15)) and social domain scores increased by 1.65 points. These associations were not explained by sociodemographic and lifestyle factors, disease activity, medication use, levels of anxiety, sleep quality, or clinical sleep disorders. They were, however, attenuated and no longer significant when pain, fatigue and mood were included in the model. Increased variability in the total time asleep, was associated with poorer physical and psychological domain scores independently of all covariates. There were no patterns of association between actigraphy measured sleep and WHOQoL-BREF. CONCLUSIONS Optimising total sleep time, increasing sleep efficiency, decreasing sleep onset latency, and reducing the variability in total sleep time could improve HRQoL in people with RA.

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Consecutive Days of Racing Does Not Affect Sleep in Professional Road Cyclists

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2021-0102 ◽

2021 ◽

pp. 1-4

Author(s):

Charli Sargent ◽

Shona L. Halson ◽

David T. Martin ◽

Gregory D. Roach

Keyword(s):

Sleep Duration ◽

Sleep Onset ◽

Self Report ◽

Activity Monitors ◽

Sleep Diaries ◽

Time In Bed ◽

Road Cycling ◽

Offset Time ◽

The Impact

Purpose: Professional road cycling races are physiologically demanding, involving successive days of racing over 1 to 3 weeks of competition. Anecdotal evidence indicates that cyclists’ sleep duration either increases or deteriorates during these competitions. However, sleep duration in professional cyclists during stage races has not been assessed. This study examined the amount/quality of sleep obtained by 14 professional cyclists competing in the Australian Tour Down Under. Methods: Sleep was assessed using wrist activity monitors and self-report sleep diaries on the night prior to start of the race and on each night during the race. The impact of each day of the race on sleep onset, sleep offset, time in bed, sleep duration, and wake duration was assessed using separate linear mixed effects models. Results: During the race, cyclists obtained an average of 6.8 (0.9) hours of sleep between 23:30 and 07:27 hours and spent 13.9% (4.7%) of time in bed awake. Minor differences in sleep onset (P = .023) and offset times (P ≤.001) were observed during the week of racing, but these did not affect the amount of sleep obtained by cyclists. Interestingly, the 3 best finishers in the general classification obtained more sleep than the 3 worst finishers (7.2 [0.3] vs 6.7 [0.3] h; P = .049). Conclusions: Contrary to anecdotal reports, the amount of sleep obtained by cyclists did not change over the course of the 1-week race and was just below the recommended target of 7 to 9 hours for adults.

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1144 Actigraphy-defined Sleep And Neurocognitive Decline In Middle-age Hispanic/Latino Adults

SLEEP ◽

10.1093/sleep/zsaa056.1138 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A435-A436

Author(s):

C Agudelo ◽

W Tarraf ◽

B Wu ◽

D M Wallace ◽

S R Patel ◽

...

Keyword(s):

Sleep Duration ◽

Verbal Memory ◽

Middle Age ◽

Verbal Learning ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Onset Latency ◽

Onset Latency ◽

Latino Adults ◽

Neurocognitive Decline

Abstract Introduction Few studies have evaluated objective sleep measures and longitudinal neurocognitive decline, particularly in middle-age or Hispanic/Latino adults. We evaluated prospective associations between actigraphy-defined sleep and 7-year neurocognitive change among Hispanic/Latino adults. We hypothesized that sleep duration would be associated with neurocognitive decline. Methods We analyzed data from 1,036 adults 45-64 years of age from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multi-center prospective cohort study of diverse community-dwelling Hispanic/Latino adults. At Visit 1 (2008-2011), participants underwent neurocognitive assessments, 7-days of actigraphy, home sleep testing, and sleep questionnaires (including the Insomnia Severity Index). Seven years later, participants repeated neurocognitive assessments. The neurocognitive battery included the Six-Item Screener, Brief Spanish-English Verbal Learning Test, phonemic word fluency test, and Digit Symbol Subtest. Survey linear regression was used to evaluate prospective associations between actigraphy-defined or self-reported sleep variables and neurocognitive change. Final models adjusted for objectively-defined variables (age, body-mass index, Field Center, and time between neurocognitive assessments), and self-reported variables (sex, education, Hispanic/Latino background, alcohol consumption, physical activity, heart failure, cerebrovascular events, depression and anxiety symptoms, and antidepressant use). Results At Visit 1, the sample was 55% female and mean age was 54.9±2.2 years. The mean sleep duration was 402.6±27.6 minutes, mean sleep-onset latency was 11.3±9.7 minutes, mean number of days with naps of ≥ 15 minutes duration was 1.1±0.7, and mean sleep-time per nap was 51±14.1 minutes. Increased sleep-onset latency was associated with 7-year declines in global neurocognitive function (β=-0.0026, p<0.01), verbal learning (β=-0.0028, p<0.001) and verbal memory (β=-0.036, p<0.05). Increased sleep-time per nap predicted better verbal memory (β=0.0038, p<0.05). In contrast, sleep duration, sleep fragmentation, and self-reported sleep measures were not associated with neurocognitive change. Conclusion Among middle-age adults, sleep-onset latency and nap duration were associated with neurocognitive change. These findings may serve as targets for intervention of neurocognitive decline. Support This work is supported by the National Institute on Aging: R01AG048642, RF1AG054548, R01AG061022, R21AG056952, and R21HL140437 (AR).

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Sleep During “Lockdown” in the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17239094 ◽

2020 ◽

Vol 17 (23) ◽

pp. 9094 ◽

Cited By ~ 1

Author(s):

Athanasia Trakada ◽

Pantelis T. Nikolaidis ◽

Marilia dos Santos Andrade ◽

Paulo José Puccinelli ◽

Nicholas-Tiberio Economou ◽

...

Keyword(s):

Sleep Duration ◽

Health Professionals ◽

Close Contact ◽

Sleep Time ◽

Quality Of Sleep ◽

Web Based ◽

Final Sample ◽

Main Effect ◽

Qualitative Characteristics

The aim of this study was to determine if the lockdown measures applied due to the pandemic of Coronavirus Disease 2019 (COVID-19) affected the sleep of the general population and health professionals in six different countries (Greece, Switzerland, Austria, Germany, France, and Brazil). We used a web-based survey with a short questionnaire of 13 questions, translated into four languages (Greek, German, French, and Portuguese). The questionnaire included information about demographic and professional data, quantitative and qualitative characteristics of sleep, degree of abidance in lockdown measures, and data about illness or close contact with active confirmed cases of COVID-19. Initially, 2093 individuals participated. After exclusion of those who did not report their duration of sleep, the final sample comprised 1908 participants (Greek, n = 1271; German, n = 257, French, n = 48; Portuguese, n = 332), aged 42.6 ± 12.7 years, who were considered for further analysis. A main effect of the lockdown week on sleep duration was observed (+0.25 h; 95% confidence intervals, CI, 0.17, 0.32; p < 0.001), with the total sleep time of the lockdown week being longer than that under normal conditions. A week*occupation interaction on sleep duration was demonstrated (p < 0.001, η2 = 0.012). Sleep duration remained stable in health professionals (−0.18 h; 95% CI −0.36, 0.01; p = 0.063), whereas it increased in other occupations by 0.31 h (95% CI, 0.24, 0.39; p < 0.001). In terms of sleep quality, 15% of participants characterized their sleep as bad and 37.9% as average during the lockdown week. Almost 1 in 3 individuals (31.3%) reported worse quality of sleep during the lockdown week than under normal conditions. Sleep during the lockdown week was characterized as good by 47.1%, but only 38% of the health professionals group. In conclusion, the COVID−19 pandemic and lockdown affected sleep in different ways, depending on age, level of education, occupation, and country of residence.

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P084 Is Cognitive Behaviour Therapy for insomnia (CBTi) responsiveness a function of objective sleep efficiency rather than objective sleep duration?

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.128 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A48-A48

Author(s):

N Lovato ◽

G Micic ◽

L Lack

Keyword(s):

Sleep Duration ◽

Cognitive Behaviour Therapy ◽

Sleep Onset ◽

Past Research ◽

Severity Index ◽

Sleep Time ◽

Sleep Efficiency ◽

Behaviour Therapy ◽

Cognitive Behaviour ◽

Pre Treatment

Abstract Introduction Past research and our own has not shown a differential response to Cognitive Behaviour Therapy for insomnia (CBTi) based on objective sleep duration. It is valuable to investigate CBTi responsiveness is a function of objective sleep efficiency (SE) instead of objective sleep duration. This study is a secondary exploratory analysis of our earlier clinical trial to assess the differential therapeutic response to CBTi for older insomniacs based on SE prior to treatment. Method Seventy-nine adults (male=34, mean age=63.38, SD=6.25) with sleep maintenance insomnia were selected. Participants were grouped into 3 ordinal groups; the top 50% of participants (above the median percent sleep time-normal SE), the 25% of participants in the third quartile (moderately low SE), and the bottom 25% of participants (severely low SE) based on 1-night of home-based polysomnography. Participants were randomly allocated to CBTi or wait-list control. One-week sleep diaries, actigraphy and a battery of questionnaires evaluated the efficacy of CBTi for each SE group. Outcome measures were taken at pre-treatment, post-treatment, and 3-month follow-up. Results CBTi produced robust improvements in sleep quality including reduced wake after sleep onset, and improved sleep efficiency. Participants reported a reduction of scores on the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. All improvements were significant relative to waitlist and comparable regardless of objective SE at pre-treatment. Discussion CBTi responsiveness did not differ as a function of objective SE.

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ITEM ANALYSIS AND INTERNAL CONSISTENCY OF CHILDREN’S SLEEP HABIT QUESTIONNAIRE (CSHQ) IN INDONESIAN VERSION

Belitung Nursing Journal ◽

10.33546/bnj.184 ◽

2017 ◽

Vol 3 (6) ◽

pp. 645-655

Author(s):

Sri Hartini ◽

Sunartini ◽

Elsisabeth Siti Herini ◽

Satoshi Takada

Keyword(s):

Behavior Problems ◽

Internal Consistency ◽

Item Analysis ◽

Sleep Onset ◽

Primary School Children ◽

Cross Sectional ◽

Sleep Behavior ◽

Sleep Habit ◽

Cross Sectional Design ◽

Children’S Sleep

Background: The Children’s Sleep Habit Questionnaire (CSHQ) has been utilized for assessing sleep behavior problems in children aged 4-10 years in many countries. However, a proper tool to detect of sleep behavior problems in Indonesian children has not been proven. Aims: The aim of our study was to test the item analysis and internal consistency of the Children’s Sleep Habit Questionnaire (CSHQ) in Indonesian version.Methods: We used a cross-sectional design and 305 mothers of pre- and primary school children in Yogyakarta Indonesia participated in this study. The Indonesian version of the Children’s Sleep Habit Questionnaire was used for assessing the sleep behavior problems in children. Internal consistency was evaluated by using the Cronbach α method. The internal consistency was tested with Cronbach alpha coefficients. Pearson’s Product Moment was completed to estimate the correlation between all items of CSHQ with Subscales and total scores of CSHQ.Results: Internal consistency of all items of the Children’s Sleep Habit Questionnaire was 0.80. Internal consistency of subscales ranged from 0.42 (parasomnias) to 0.66 (night wakening). 31 of 33 items had significant positive correlation with total score of Children’s Sleep Habit Questionnaire. Inter-subscales with the highest correlation were sleep onset delay with parasomnias, parasomnias with sleeps disordered breathing, and sleep disorder breathing with night waking.Conclusions: The Indonesian version of the Children’s Sleep Habit Questionnaire is suitable for screening sleep behavior problems in Indonesian children aged 4-10 years.

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626 Association between Co-Sleep and Behavioral Problems among Preschoolers in Taiwan

SLEEP ◽

10.1093/sleep/zsab072.624 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A245-A246

Author(s):

Yu-Ting Wu ◽

Ya-Chuan Huang ◽

Yung-Sen Chang ◽

Chien-Ming Yang

Keyword(s):

Sleep Duration ◽

Behavioral Problems ◽

Sleep Problems ◽

Sleep Onset ◽

Emotional And Behavioral Problems ◽

Sleep Habits ◽

Developmental Problems ◽

Bed Sharing ◽

Nighttime Sleep ◽

Children’S Sleep

Abstract Introduction ‘Co-sleep’ is defined as the sleep arrangements in which parents and their child sharing a sleeping surface (bed-sharing or room-sharing). Similar to the other Asian countries, Taiwan has a high reported rates of bed-sharing. Previous researches had shown shorter sleep duration and poorer sleep quality in children with co-sleep. However, the association between co-sleep and the children’s emotional and behavioral problems has not been well studied. This study aims to explore the association between sleeping arrangements and children’s sleep, as well as their daytime emotional and behavioral problems. Methods 9,582 caregivers of preschoolers (age= 4.70±0.806; Male: Female=52%:48%) completed a questionnaire regarding their children’s sleep schedule, the Children’s Sleep Habits Questionnaire (CSHQ) and Strength and Difficulties Questions (SDQ). The reported frequency on the items of the CHSQ question regarding co-sleep, asking whether the child falls asleep in parent’s or sibling’ s bed or sleep alone, were used to divide the children into three groups: usually co-sleep group, sometimes co-sleep group and sleep-alone group. Results Among 2,967 preschoolers, 6,272 children (65.5%) reported usually co-sleep, 816 children (8.5%) reported sometimes co-sleep, and 2,494 children (26%) reported sleeping alone. One-way ANOVAs showed significant differences among three groups in: 1) sleep patterns, including weekday nighttime sleep duration (F=24.43, p<.01), weekend nighttime sleep duration (F=3.13, p<.05), weekday nap duration (F=4.24, p<.05), and weekend nap time (F=4.39, p<.05); 2) sleep problems on the CHSQ, including bed time resistance (F=7027.25, p<.01), sleep onset delay (F=33.06, p<.01), sleep duration (F=65.51, p<.01), sleep anxiety (F=788.48, p<.01), night waking (F=37.90, p<.01), parasomnias (F=47.43, p<.01), sleep disorder breathing (F=7.58, p<.01), and sleepiness (F=13.44, p<.01); 3) behavioral problems and development on the SDQ, including hyperactivity (F=21.16, p<.01), emotional symptom (F=23.08, p<.01), conduct problem (F=8.65, p<.01), peer problems (F=20.59, p<.01), and prosocial (F=17.67, p<.01). Conclusion Our results indicate that children with more frequent co-sleep may have shorter sleep duration, more sleep problems as well as more external and internal behavioral problems, while sleep-alone children showed more prosocial behaviors, longer sleep duration, and less sleep problems. The potential developmental problems related to co-sleep may be underestimated in Asian culture and need more attentions. Support (if any):

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Eszopiclone in the treatment of insomnia

Pharmacotherapy in Psychiatry and Neurology ◽

10.33450/fpn.2020.04.002 ◽

2020 ◽

Vol 36 (1) ◽

pp. 9-21

Author(s):

Marek Jarema ◽

Adam Wichniak

Keyword(s):

Sleep Latency ◽

Total Sleep Time ◽

Subjective Evaluation ◽

Sleep Onset ◽

The Elderly ◽

Pharmacological Action ◽

Sleep Time ◽

Medical Problem ◽

Quality Of Sleep

Insomnia is an important medical problem; its treatment requires both nonpharmacological methods (education and psychotherapy) and the use of hypnotic agents. The benzodiazepine derivatives may be used as hypnotic agents but their use is substantially limited. The alternative treatment includes so-called z-drugs, which means nonbenzodiazepine hypnotic agents. Their mechanism of pharmacological action is a GABA-receptor agonism. In general, these drugs improve the quality of sleep (sleep latency, wake after sleep onset, number and duration of awakenings, total sleep time). Contrary to the benzodiazepines they do not possess anti-anxiety, myorelaxant, and anti-seizure properties, and are better tolerated. Eszopiclone for the treatment of insomnia was not available in Poland. It is not only effective in the treatment of insomnia in comparison to placebo but is also well tolerated. It may be used for a longer time than the benzodiazepines – not only a couple of weeks but per several months. Eszopiclone shortens the sleep latency, decreases the number of wakes after sleep onset and increases total sleep time. It improves the subjective evaluation of sleep by the patients, the quality of sleep and functioning during the day. Its efficacy in the treatment of insomnia in the elderly has also been proved. It is quite well-tolerated and the most frequent side-effect of eszopiclone in the unpleasant taste.

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