Availability of a Flavored Beverage and Impact on Children’s Hydration Status, Sleep, and Mood

Euhydration remains a challenge in children due to lack of access and unpalatability of water and to other reasons. The purpose of this study was to determine if the availability/access to a beverage (Creative Roots®) influences hydration in children and, therefore, sleep quality and mood. Using a crossover investigation, 46 participants were randomly assigned to a control group (CON) or an intervention group and received Creative Roots® (INT) for two-week periods. We recorded daily first morning and afternoon urine color (Ucol), thirst perception, and bodyweight of the two groups. Participants reported to the lab once per week and provided first morning urine samples to assess Ucol, urine specific gravity (USG), and urine osmolality (Uosmo). Participants also completed the questionnaires Profile of Mood States-Adolescents (POMS-a) and Pittsburgh Sleep Quality Index (PSQI). Dependent t-tests were used to assess the effects of the intervention on hydration, mood, and sleep quality. Uosmo was greater and Ucol was darker in the control group (mean ± SD) [Uosmo: INT = 828 ± 177 mOsm·kg−1, CON = 879 ± 184 mOsm·kg−1, (p = 0.037], [Ucol:INT = 5 ± 1, CON = 5 ± 1, p = 0.024]. USG, POMS-a, and PSQI were not significant between the groups. At-home daily afternoon Ucol was darker in the control group [INT = 3 ± 1, CON = 3 ± 1, p = 0.022]. Access to Creative Roots® provides a small, potentially meaningful hydration benefit in children. However, children still demonstrated consistent mild dehydration based on Uosmo, despite consuming the beverage.

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Myofunctional Therapy App for Severe Apnea–Hypopnea Sleep Obstructive Syndrome: Pilot Randomized Controlled Trial

JMIR mhealth and uhealth ◽

10.2196/23123 ◽

2020 ◽

Vol 8 (11) ◽

pp. e23123

Author(s):

Carlos O'Connor-Reina ◽

Jose Maria Ignacio Garcia ◽

Elisa Rodriguez Ruiz ◽

Maria Del Carmen Morillo Dominguez ◽

Victoria Ignacio Barrios ◽

...

Keyword(s):

Sleep Quality ◽

Epworth Sleepiness Scale ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Intervention Group ◽

Oxygen Desaturation ◽

Control Group ◽

Desaturation Index ◽

Myofunctional Therapy ◽

Oxygen Desaturation Index

Background Myofunctional therapy has demonstrated efficacy in treating sleep-disordered breathing. We assessed the clinical use of a new mobile health (mHealth) app that uses a smartphone to teach patients with severe obstructive sleep apnea–hypopnea syndrome (OSAHS) to perform oropharyngeal exercises. Objective We conducted a pilot randomized trial to evaluate the effects of the app in patients with severe OSAHS. Methods Forty patients with severe OSAHS (apnea–hypoxia index [AHI]>30) were enrolled prospectively and randomized into an intervention group that used the app for 90 sessions or a control group. Anthropometric measures, Epworth Sleepiness Scale (0-24), Pittsburgh Sleep Quality Index (0-21), Iowa Oral Performance Instrument (IOPI) scores, and oxygen desaturation index were measured before and after the intervention. Results After the intervention, 28 patients remained. No significant changes were observed in the control group; however, the intervention group showed significant improvements in most metrics. AHI decreased by 53.4% from 44.7 (range 33.8-55.6) to 20.88 (14.02-27.7) events/hour (P<.001). The oxygen desaturation index decreased by 46.5% from 36.31 (27.19-43.43) to 19.4 (12.9-25.98) events/hour (P=.003). The IOPI maximum tongue score increased from 39.83 (35.32-45.2) to 59.06 (54.74-64.00) kPa (P<.001), and the IOPI maximum lip score increased from 27.89 (24.16-32.47) to 44.11 (39.5-48.8) kPa (P<.001). The AHI correlated significantly with IOPI tongue and lip improvements (Pearson correlation coefficient −0.56 and −0.46, respectively; both P<.001). The Epworth Sleepiness Scale score decreased from 10.33 (8.71-12.24) to 5.37 (3.45-7.28) in the app group (P<.001), but the Pittsburgh Sleep Quality Index did not change significantly. Conclusions Orofacial exercises performed using an mHealth app reduced OSAHS severity and symptoms, and represent a promising treatment for OSAHS. Trial Registration Spanish Registry of Clinical Studies AWGAPN-2019-01, ClinicalTrials.gov NCT04438785; https://clinicaltrials.gov/ct2/show/NCT04438785

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Myofunctional Therapy App for Severe Apnea–Hypopnea Sleep Obstructive Syndrome: Pilot Randomized Controlled Trial (Preprint)

10.2196/preprints.23123 ◽

2020 ◽

Author(s):

Carlos O'Connor-Reina ◽

Jose Maria Ignacio Garcia ◽

Elisa Rodriguez Ruiz ◽

Maria Del Carmen Morillo Dominguez ◽

Victoria Ignacio Barrios ◽

...

Keyword(s):

Sleep Quality ◽

Epworth Sleepiness Scale ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Intervention Group ◽

Oxygen Desaturation ◽

Control Group ◽

Desaturation Index ◽

Myofunctional Therapy ◽

Oxygen Desaturation Index

BACKGROUND Myofunctional therapy has demonstrated efficacy in treating sleep-disordered breathing. We assessed the clinical use of a new mobile health (mHealth) app that uses a smartphone to teach patients with severe obstructive sleep apnea–hypopnea syndrome (OSAHS) to perform oropharyngeal exercises. OBJECTIVE We conducted a pilot randomized trial to evaluate the effects of the app in patients with severe OSAHS. METHODS Forty patients with severe OSAHS (apnea–hypoxia index [AHI]>30) were enrolled prospectively and randomized into an intervention group that used the app for 90 sessions or a control group. Anthropometric measures, Epworth Sleepiness Scale (0-24), Pittsburgh Sleep Quality Index (0-21), Iowa Oral Performance Instrument (IOPI) scores, and oxygen desaturation index were measured before and after the intervention. RESULTS After the intervention, 28 patients remained. No significant changes were observed in the control group; however, the intervention group showed significant improvements in most metrics. AHI decreased by 53.4% from 44.7 (range 33.8-55.6) to 20.88 (14.02-27.7) events/hour (P<.001). The oxygen desaturation index decreased by 46.5% from 36.31 (27.19-43.43) to 19.4 (12.9-25.98) events/hour (P=.003). The IOPI maximum tongue score increased from 39.83 (35.32-45.2) to 59.06 (54.74-64.00) kPa (P<.001), and the IOPI maximum lip score increased from 27.89 (24.16-32.47) to 44.11 (39.5-48.8) kPa (P<.001). The AHI correlated significantly with IOPI tongue and lip improvements (Pearson correlation coefficient −0.56 and −0.46, respectively; both P<.001). The Epworth Sleepiness Scale score decreased from 10.33 (8.71-12.24) to 5.37 (3.45-7.28) in the app group (P<.001), but the Pittsburgh Sleep Quality Index did not change significantly. CONCLUSIONS Orofacial exercises performed using an mHealth app reduced OSAHS severity and symptoms, and represent a promising treatment for OSAHS. CLINICALTRIAL Spanish Registry of Clinical Studies AWGAPN-2019-01, ClinicalTrials.gov NCT04438785; https://clinicaltrials.gov/ct2/show/NCT04438785

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Clinical Efficacy of a New Robot-assisted Gait Training System for Acute Stroke Patients

Journal of Medical and Biological Engineering ◽

10.1007/s40846-020-00590-z ◽

2021 ◽

Author(s):

Andy Chien ◽

Fei-Chun Chang ◽

Nai-Hsin Meng ◽

Pei-Yu Yang ◽

Ching Huang ◽

...

Keyword(s):

Sleep Quality ◽

Acute Stroke ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Gait Training ◽

Training System ◽

Control Group ◽

Stroke Patients ◽

Robot Assisted ◽

Significant Difference

Abstract Purpose Robot-assisted gait rehabilitation has been proposed as a plausible supplementary rehabilitation strategy in stroke rehabilitation in the last decade. However, its exact benefit over traditional rehabilitation remain sparse and unclear. It is therefore the purpose of the current study to comparatively investigate the clinical benefits of the additional robot-assisted training in acute stroke patients compared to standard hospital rehabilitation alone. Methods Ninety acute stroke patients (< 3 month) were recruited. All participants received the standard hospital neurorehabilitation comprises 45–60 min sessions daily for 3 weeks. Sixty patients also received an additional 30 min of robot-assisted gait training with the HIWIN MRG-P100 gait training system after each of the standard neurorehabilitation session. Outcome measures included: 1. Berg Balance Scale (BBS); 2. Brunnstrom Stage; 3. Pittsburgh Sleep Quality Index and 4. Taiwanese Depression Questionnaire (TDQ) which were assessed pre-treatment and then after every five training sessions. Results Both groups demonstrated significant improvement pre- and post-treatment for the BBS (robotic group p = 0.023; control group p = 0.033) but no significant difference (p > 0.1) between the groups were found. However, the robotic training group had more participants demonstrating larger BBS points of improvement as well as greater Brunnstrom stage of improvement, when compared to the control group. No significant within and between group statistical differences (p > 0.3) were found for Pittsburgh Sleep Quality Index and Taiwanese Depression Questionnaire. Conclusion The addition of robotic gait training on top of standard hospital neurorehabilitation for acute stroke patients appear to produce a slightly greater improvement in clinical functional outcomes, which is not transferred to psychological status.

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Influence of Craniosacral Therapy on Anxiety, Depression and Quality of Life in Patients with Fibromyalgia

Evidence-based Complementary and Alternative Medicine ◽

10.1093/ecam/nep125 ◽

2011 ◽

Vol 2011 ◽

pp. 1-9 ◽

Cited By ~ 17

Author(s):

Guillermo A. Matarán-Peñarrocha ◽

Adelaida María Castro-Sánchez ◽

Gloria Carballo García ◽

Carmen Moreno-Lorenzo ◽

Tesifón Parrón Carreño ◽

...

Keyword(s):

Quality Of Life ◽

Placebo Group ◽

Sleep Quality ◽

Treatment Period ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Intervention Group ◽

Craniosacral Therapy

Fibromyalgia is considered as a combination of physical, psychological and social disabilities. The causes of pathologic mechanism underlying fibromyalgia are unknown, but fibromyalgia may lead to reduced quality of life. The objective of this study was to analyze the repercussions of craniosacral therapy on depression, anxiety and quality of life in fibromyalgia patients with painful symptoms. An experimental, double-blind longitudinal clinical trial design was undertaken. Eighty-four patients diagnosed with fibromyalgia were randomly assigned to an intervention group (craniosacral therapy) or placebo group (simulated treatment with disconnected ultrasound). The treatment period was 25 weeks. Anxiety, pain, sleep quality, depression and quality of life were determined at baseline and at 10 minutes, 6 months and 1-year post-treatment. State anxiety and trait anxiety, pain, quality of life and Pittsburgh sleep quality index were significantly higher in the intervention versus placebo group after the treatment period and at the 6-month follow-up. However, at the 1-year follow-up, the groups only differed in the Pittsburgh sleep quality index. Approaching fibromyalgia by means of craniosacral therapy contributes to improving anxiety and quality of life levels in these patients.

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Effects of Three Oral Nutritional Supplements on Human Hydration Indices

International Journal of Sport Nutrition and Exercise Metabolism ◽

10.1123/ijsnem.2015-0244 ◽

2016 ◽

Vol 26 (4) ◽

pp. 356-362 ◽

Cited By ~ 3

Author(s):

Lindsay A. Ellis ◽

Brandon A. Yates ◽

Amy L. McKenzie ◽

Colleen X. Muñoz ◽

Douglas J. Casa ◽

...

Keyword(s):

Assessment Tool ◽

Urine Volume ◽

Urine Osmolality ◽

Ease Of Use ◽

Urine Specific Gravity ◽

Hydration Status ◽

Urine Color ◽

Significant Difference ◽

Oral Nutritional Supplements ◽

Double Blinded

Urine color (Ucol) as a hydration assessment tool provides practicality, ease of use, and correlates moderately to strongly with urine specific gravity (Usg) and urine osmolality (Uosm). Indicative of daily fluid turnover, along with solute and urochrome excretion in 24-hr samples, Ucol may also reflect dietary composition. Thus, the purpose of this investigation was to determine the efficacy of Ucol as a hydration status biomarker after nutritional supplementation with beetroot (880 mg), vitamin C (1000 mg), and riboflavin (200 mg). Twenty males (Mean ± SD; age, 21 ± 2 y; body mass, 82.12 ± 15.58 kg; height, 1.77 ± 0.06 m) consumed a standardized breakfast and collected all urine voids on one control day (CON) and 1 day after consuming a standardized breakfast and a randomized and double-blinded supplement (SUP) over 3 weeks. Participants replicated exercise and diet for one day before CON, and throughout CON and SUP. Ucol, Usg, Uosm, and urine volume were measured in all 24-hr samples, and Ucol and Usg were measured in all single samples. Ucol was a significant predictor of single sample Usg after all supplements (p < .05). Interestingly, 24-hr Ucol was not a significant predictor of 24-h Usg and Uosm after riboflavin supplementation (p = .20, p = .21). Further, there was a significant difference between CON and SUP 24-h Ucol only after riboflavin supplementation (p < .05). In conclusion, this investigation suggests that users of the UCC (urine color chart) should consider riboflavin supplementation when classifying hydration status and use a combination of urinary biomarkers (e.g., Usg and Ucol), both acutely and over 24 hr.

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Sleep Quality and Depression in Vitiligo Patients

Eurasian Journal of Family Medicine ◽

10.33880/ejfm.2020090105 ◽

2020 ◽

Vol 9 (1) ◽

pp. 35-41

Author(s):

Aynure Öztekin ◽

Coşkun Öztekin

Keyword(s):

Sleep Quality ◽

Patient Group ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Healthy Control Group ◽

Psychiatric Evaluation ◽

Control Group ◽

Subjective Sleep Quality ◽

Dermatology Clinic ◽

Healthy Control

Aim: Vitiligo is a common disorder that has not only dermatological but also psychological consequences. The aim of this study was to compare depression and sleep quality of vitiligo patients with healthy control group. Methods: In this cross-sectional case-control study, patients admitted to the Dermatology Clinic of Skin and Venereal Diseases Department of Hitit University Erol Olçok Education and Research Hospital between August 2018 and August 2019 were compared with healthy control group. The study included 67 patients and 69 control group participants who were matched for age, sex, marriage status, and education level. The subjects were asked to complete a sociodemographic data form, the Beck Depression Inventory, and the Pittsburgh Sleep Quality Index. Results: The median total Pittsburgh Sleep Quality Index score was higher in the patient group compared with the control group. The median scores for subjective sleep quality, sleep latency, and sleep disturbance were also higher in the patient group compared with the control group. A family history of vitiligo was present in 18 (26.9%) patients. The most common type was acrofacial vitiligo, which was present in 29 (43.3%) patients. Conclusions: Increased probability levels of depression and impaired sleep quality in vitiligo patients suggest that psychiatric evaluation and treatment should be provided for vitiligo patients as a part of a multidisciplinary approach in order to increase the success of the treatment. Keywords: Vitiligo, depression, sleep quality

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1079 Is PTSD In Young Women Associated With Rem Sleep Abnormalities?

SLEEP ◽

10.1093/sleep/zsaa056.1075 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A411-A411

Author(s):

D Martinez ◽

M Yeh ◽

L Oliveira ◽

B Coimbra ◽

A F Mello ◽

...

Keyword(s):

Sleep Quality ◽

Posttraumatic Stress ◽

Young Women ◽

Rem Sleep ◽

Muscle Activity ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Sleep Fragmentation ◽

Control Group ◽

Ptsd Group

Abstract Introduction The increase in violence against young women has a high impact on the prevalence of Posttraumatic stress disorder (PTSD). The lifetime prevalence of PTSD is twice as high in women. However, most studies assessing sleep disturbances in PTSD were conducted predominantly in male samples and combat veterans. Objective: To analyze the sleep of young women with and without PTSD. Hypothesis: Women with PTSD have worse sleep quality, higher arousability, and higher muscle activity during REM sleep. Methods Case-controlled study with young women. Seventy-four women who suffered sexual assault and developed PTSD (DSM-5); and 64 women from the community without PTSD. Women were recruited from the PTSD outpatient clinic (Universidade Federal de São Paulo, Brazil).Clinician-Administered Posttraumatic Stress Scale (CAPS 5), Beck Depression and Anxiety Inventories (BDI) (BAI), full in-lab Polysomnography (PSG), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Índex (PSQI), Fatigue Impact Scale (FIS), and Insomnia Severity Índex (ISI) were applied to all participants. Analysis of variance, regression models, and general linear modeling were used. Results Patients mean age was 28 vs 24 for the control group (p=0.004). CAPS mean score in PTSD-group was 42.5±9.1. BDI, BAI, FIS, PSQI, ISI scores were worse in PTSD-group (p<0.05, all). Pittsburgh Sleep Quality Index (PSQI) score was significantly associated with CAPS 5 independently of depression, fatigue, and sleep fragmentation. The PTSD women had lower total sleep time (p= 0.01) and lower REM sleep percentage (p=0.04). However, the control group had higher arousal index (p=.0.01) and had higher muscle activity during REM sleep (p=0.03) than PTSD. Conclusion Women with PTSD had significantly worse score in PSQI, FIS, and ISI. PSQI score was associated with PTSD severity. However, when PSG results are concerned, we found higher sleep fragmentation in the control group. We speculate that women with PTSD may have felt safer and taken care of in the lab, which might explain the difference between objective and subjective measures of sleep quality in PTSD. Support Acknowledgments: FAPESP: Fundação de Apoio à pesquisa de São Paulo, AFIP: Associação Incentivo a Pesquisa

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Central sensitisation in primary Sjögren Syndrome and its effect on sleep quality

Modern Rheumatology ◽

10.1093/mr/roab075 ◽

2021 ◽

Author(s):

Burcu Metin Ökmen ◽

Koray Ayar ◽

Lale Altan ◽

Özgür Yeşilöz

Keyword(s):

Sleep Quality ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Demographic Data ◽

Sjögren Syndrome ◽

Control Group ◽

Sjogren Syndrome ◽

Central Sensitisation ◽

Primary Sjögren Syndrome ◽

Significant Difference

ABSTRACT Objective The aim of the present study is to evaluate the presence and frequency of central sensitisation (CS) in primary Sjögren Syndrome (pSS) and to determine the effect of CS on sleep quality. Materials and Methods In this cross-sectional study, 50 patients diagnosed with pSS between the ages of 18 and 75 were included. The healthy control group was composed of 43 healthcare workers. Each participant underwent a physical examination, and demographic data and the medications they used were recorded. Central sensitisation inventory and Pittsburgh Sleep Quality Index questionnaires were filled in to garner data on CS and sleep quality, respectively, from all participants. Results While central sensitisation inventory >40 was detected in 74% of pSS patients, it was 25.6% in healthy controls, and there is a statistically significant difference between the groups (p < .05). A correlation analysis of the central sensitisation inventory and Pittsburgh Sleep Quality Index values of all participants revealed a statistically significant correlation between all parameters other than the duration of sleep (p < .05). Conclusions CS was found to have a negative effect on sleep quality in patients with pSS. We suggest that the cause of widespread pain seen in patients with pSS as the possible development of CS should be considered.

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Benefits of adding stretching to a moderate-intensity aerobic exercise programme in women with fibromyalgia: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215519893107 ◽

2019 ◽

Vol 34 (2) ◽

pp. 242-251 ◽

Cited By ~ 2

Author(s):

Miguel Gómez-Hernández ◽

Tomás Gallego-Izquierdo ◽

Patricia Martínez-Merinero ◽

Daniel Pecos-Martín ◽

Alejandro Ferragut-Garcías ◽

...

Keyword(s):

Sleep Quality ◽

Aerobic Exercise ◽

Quality Index ◽

Analogue Scale ◽

Pittsburgh Sleep Quality Index ◽

Fibromyalgia Impact Questionnaire ◽

Exercise Programme ◽

Moderate Intensity ◽

Control Group ◽

Experimental Group

Objective: To investigate the effects of adding stretching to a moderate-intensity aerobic exercise programme in women with fibromyalgia. Design: Randomized controlled trial. Subjects: Sixty-four female patients who were diagnosed with fibromyalgia syndrome based on the American College of Rheumatology criteria were recruited (mean age: 54.27 ± 6.94 years). Interventions: The control group ( n = 32) underwent supervised moderate-intensity cycling (50%–70% of the age-predicted maximum heart rate) three times per week for 12 weeks. The experimental group ( n = 32) underwent the same exercise programme plus a stretching programme once per week for 12 weeks. Main measures: The main measures of this study were sleep quality assessed by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, the impact of fibromyalgia on quality of life assessed by the Fibromyalgia Impact Questionnaire, and pain perception assessed by the visual analogue scale at baseline, after 4 weeks, and after 12 weeks. Results: The experimental group experienced significant improvements at 4-week measure compared with control group: Pittsburgh Sleep Quality Index ( P < 0.001); Epworth Sleepiness Scale ( P = 0.002); Fibromyalgia Impact Questionnaire (0.93 ± 7.39, P < 0.001); and visual analogue scale (0.52 ± 0.05, P < 0.001). Also at 12-week measure, experimental group experienced significant improvements compared with control group: Pittsburgh Sleep Quality Index ( P < 0.001), Epworth Sleepiness Scale ( P < 0.001); Fibromyalgia Impact Questionnaire (1.15 ± 9.11, P < 0.001); and visual analogue scale (0.81 ± 0.62, P < 0.001). Conclusion: Adding stretching to a moderate-intensity aerobic exercise programme increased sleep quality, decreased the impact of fibromyalgia on the quality of life, and reduced pain compared with just a moderate-intensity aerobic exercise programme in our sample of women with fibromyalgia.

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The Relationship between %BML, Urine Color, Thirst Level and Urine Indices of Hydration Status

Annals of Nutrition and Metabolism ◽

10.1159/000515217 ◽

2021 ◽

Author(s):

Yasuki Sekiguchi ◽

Courteney L. Benjamin ◽

Cody R. Butler ◽

Margaret C. Morrissey ◽

Erica M. Filep ◽

...

Keyword(s):

Body Mass ◽

Pairwise Comparison ◽

Urine Osmolality ◽

Urine Specific Gravity ◽

Venn Diagram ◽

Hydration Status ◽

Urine Color ◽

Health Quality ◽

No Gold Standard ◽

The Relationship

Introduction: Dehydration is known to impair health, quality of daily life, and exercise performance [<xref ref-type="bibr" rid="ref1">1</xref>]. While several methods are utilized to assess fluid balance, there is no gold standard to assess hydration status [<xref ref-type="bibr" rid="ref2">2</xref>]. Cheuvront and Kenefick [<xref ref-type="bibr" rid="ref3">3</xref>] suggested the use of a Venn diagram, which consists of % body mass weight (BML), urine color, and thirst level (WUT) to measure hydration status and fluid needs. However, no study to date has examined the relationship between the WUT criteria and hydration status measured by urine indices. Objective: The purpose of this study was to investigate the relationships between urine-specific gravity (USG), urine osmolality (UOSM), and the WUT criteria. Methods: Twenty-two females (mean ± SD; age, 20 ± 1 year; weight, 65.4 ± 12.6 kg) and twenty-one males (age, 21 ± 1 year; body mass, 78.7 ± 14.6 kg) participated in this study. First-morning body mass, urine color, USG, UOSM, and thirst level were collected for 10 consecutive days. First 3 days were utilized to establish a euhydrated baseline body weight. %BML >1%, urine color >5, and thirst level ≥5 were used as the dehydration thresholds. The number of markers that indicated dehydration levels was summed when each variable met each threshold. One-way ANOVA with Tukey pairwise comparison was used to assess the differences in USG and UOSM, followed by a calculation of effect size (ES). Results: Figure <xref ref-type="fig" rid="f01">1</xref> indicates the differences of UOSM based on the WUT criteria. For UOSM, “2 markers indicated” (mean [M] ± SD [ES], 705 ± 253 mOsmol [0.43], p = 0.018) was significantly higher than “1 marker indicated” (M ± SD, 597 ± 253 mOsmol). Additionally, “zero marker indicated” (509 ± 249 mOsmol) was significantly lower than “3 markers indicated” (M ± SD [ES], 761 ± 250 mOsmol, [1.01], p = 0.02) and “2 markers indicated” ([ES], [0.78], p = 0.004). However, there was no statistical difference between “3 markers indicated” ([ES], [0.65], p = 0.13) and “1 marker indicated.” For USG, “3 markers indicated” (M ± SD [ES], 1.021 ± 0.007 [0.57], p = 0.025) and “2 markers indicated” (M ± SD [ES], 1.019 ± 0.010 [0.31], p = 0.026) were significantly higher than “1 marker indicated” (M ± SD, 1.016 ± 0.009). Additionally, “zero marker indicated” (1.014 ± 0.005) was significantly lower than “3 markers indicated” ([ES], [1.21], p = 0.005) and “2 markers indicated” ([ES], [0.54], p = 0.009). Conclusion: When 3 markers indicated dehydration levels, UOSM and USG were greater than euhydrated cut points. When 2 markers indicated dehydration levels, USG was higher than the euhydrated cut point. Additionally, UOSM and USG were significantly lower when zero or 1 marker indicated dehydration levels. Thus, the WUT criteria are a useful tool to assess hydration status. Athletes, coaches, sports scientists, and medical professions can use this strategy in the field settings to optimize their performance and health without consuming money and time.

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