Short Term Outcome in Sleep Disturbance Intervention in Children with ASD in a Tertiary Care Hospital in Bangladesh

Aim: The aim of this study was to identify the relationship between sleep patterns and behavioral difficulties in children with ASD using sleep disturbance treatments. Methods: We selected a total 41 children with sleep disorders as study population. The sleep services (behavioral sleep management techniques) were given by the child development center team of Dhaka Shishu Hospital comprising of physician , developmental therapist and psychologist. Children were split into eight groups and two gender divisions based on their age, and they were then studied over a period of 6 months . Sleep disorders were investigated both before and after intervention. Results: The results revealed that the children’s sleep dysfunction improved from before, with the lowest improvement percentage decreasing from 62.9 percent to 51.8 percent and the greatest improvement percentage increasing from 100 percent to 59.2 percent, whereas a sleep problem showed no change at all (sleepwalking). Conclusion: The study has tried and succeeded to an extent to intervene in the sleep dysfunction process of children with ASD in a tertiary care hospital. However, there is still much to learn about the clinical efficacy of these types of behavioral interventions in children with ASD who have sleep disruption.

Anxiety Profile of PWD and Caregiver During COVID-19 Pandemic in ALZI Surabaya Community, Indonesia

The consequence of COVID-19 pandemic conditions in vulnerable groups such as Patients with Dementia (PWD) and their caregivers are required to be urgently addressed. This study was conducted to collect data on PWD and caregiver characteristics, also concluding the profile of anxiety during the COVID-19 pandemic in Alzi Surabaya Community. This research is an observational descriptive cross-sectional study using the Beck Anxiety Inventory and Rating Anxiety in Dementia questionnaire to apprehend the profile of anxiety in PWD and caregivers in the Alzi Surabaya Community during the COVID-19 pandemic. PWD in this community experience significant anxiety (82.35%) with symptoms such as sleep disturbance (100%) worry over trifles (92.85%), complaints of headache and body aches or pains (92.85%) also sweating, flushes or chills, tingling or numbness of extremities (42.85%) and insignificant anxiety (17.65%) with symptoms such as fatigue and tiredness (100%), worry about physical health (66.57%), irritability (66.57%), heart racing or thumping (33.33%). Caregivers of PWD in this community all experience low anxiety with symptoms such as fear of something worst happening (80%), unable to relax (65%), indigestion and dizziness or lightheadedness (55%). Intervention, in order to reduce anxiety in PWD and caregiver during and post-pandemic, is substantial as establishing a good quality of life is important for PWD to increase fulfilment in life and also important for caregivers in order to maintain quality of care.

Hyperthyroidism in Graves’ disease causes sleep disorders related to sympathetic hypertonia

Context It is well known that Graves’ disease (GD) causes sleep disorders (SD). However, the characteristics and associated factors of SD and its clinical course post-hyperthyroidism normalization remain unclear. Objective To clarify the characteristics and associated factors of subjective SD and its clinical course after GD treatment. Design, setting, and study participants From November 2017 to October 2020, we enrolled 72 participants (22 newly diagnosed with GD with untreated hyperthyroidism, 20 previously diagnosed with GD with normal thyroid function, and 30 normal controls) with no other underlying sleep disorder-related diseases. We compared the groups at enrollment and conducted prospective observations after 12 months of treatment on participants with newly diagnosed GD. Main outcome measures Differences and changes in the Pittsburgh Sleep Quality Index (PSQI) global and component sleep quality scores. Results PSQI global sleep quality scores (p = 0.036) and sleep disturbance scores (p = 0.011) were significantly different among the three groups, and were highest in the untreated hyperthyroidism group. Multiple regression analysis demonstrated that free thyroxine level, which was positively correlated with sympathetic tone (ST) as evaluated by pulse rate and urinary total metanephrines, was associated with poorer PSQI global sleep quality scores independently of other factors (p = 0.006). Prospective observation showed that PSQI global sleep quality scores (p = 0.018) and sleep disturbance scores (p = 0.011) significantly improved with thyroid function normalization and ST attenuation. Conclusions Hyperthyroidism caused by GD augmented ST and exacerbated subjective SD. Normalization of hyperthyroidism caused by GD improved subjective SD.

Longitudinal PTSD network structure: Measuring PTSD symptom networks over a five year period

Background: Network modeling has been applied in a range of trauma exposed samples, yet results are limited by an over reliance on cross-sectional data. The current analyses used posttraumatic stress disorder (PTSD) symptom data collected over a five-year period to estimate a more robust between-subject network and an associated symptom change network. Methods: A PTSD symptom network is measured in a sample of military veterans across four time points (Ns = 1254, 1231, 1106, 925). The repeated measures permits isolating between-subject associations by limiting effects of within-subject variability. The result is a highly reliable PTSD symptom network. A symptom slope network depicting covariation of symptom change over time is also estimated. Results: Negative trauma-related emotions had particularly strong associations with the network. Trauma-related amnesia, sleep disturbance, and self-destructive behavior had weaker overall associations with other PTSD symptoms. Conclusions: PTSD’s network structure appears stable over time. There is no single “most important” node or node cluster. The relevance of self-destructive behavior, sleep disturbance, and trauma-related amnesia to the PTSD construct may deserve additional consideration.

Quality of Life of Emirati Women With Breast Cancer

Background: This study examined the quality of life of Emirati women with breast cancer (BC).Methods: This study was a population-based study of a random sample of 250 Emirati women with BC. Quality of life (QoL) was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Cancer-Specific version (EORTC QLQ-C30, v.3.0) and the EORTC QoL Breast Cancer-Specific version (EORTC QLQ-BR23) translated into Arabic.Results: The mean age and median age of the 250 participants were 53.4 (SD ±11.3) and 52 years, respectively.Participants had a mean global health score of 74.73 (SD ±18.25), with a minimum of 16.67, indicating a good level of wellbeing.On the QLQ-C30, the Emirati women seemed to perform well on the functional scales but poorly on the symptom scales. While social functioning scored the highest (82.33 ±28.38) among the functional scales, emotional functioning scored the lowest (68.43 ±30.02). The most worrying symptom was sleep disturbance (47.87±38.46), followed by fatigue (38.18±30.31) and pain (29.13±28.01). Financial impact scored the lowest, indicating that most women did not have financial issues related to their cancer.On the QLQ-BR23, we found that participants performed above average to very good on the functional scales but poorly on the symptom scales. While sexual functioning scored the highest (86.07±22.61) among the functional scales, future perspective scored the lowest (50.80±37.92). The most worrying symptom was upset by hair loss (61.01±37.35), followed by arm symptoms (33.73±28.08).Conclusions: Emirati BC survivors reported good QoL overall. The most bothersome symptoms were sleep disturbance, fatigue, pain, hair loss and arm symptoms. Emirati women scored average on all functional scales, which indicates mediocre functioning, but high on the symptom scales, which indicates worse symptoms. Factors associated with a decline in the domains of QoL included age, income, education, metastases, mastectomy, and lymph node dissection. Recommendations to address these issues are discussed.Trial Registration: NA

Using 24-h Heart Rate Variability to Investigate the Sleep Quality and Depression Symptoms of Medical Students

There have been numerous studies on the relationship between sleep and depression, as well as the relationship between sleep and depression, and heart rate variability (HRV), respectively. Even so, few studies have combined 24-h HRV analysis to study sleep quality and depressive symptoms. The purpose of this cross-sectional study was to investigate the relationship between depressed symptoms, sleep quality, and 24-h HRV in medical students. The particiants were all students at a medical university in Guangdong province, China. A total of 74 college students participated. They were asked to complete a questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), the Beck Depression Inventory-II (BDI-II), the Positive and Negative Affect Scale (PANAS), and 24-h ECG monitoring. The results showed that 41.7% of the medical students had poor sleep quality, with higher levels of depressive symptoms and more negative emotions, and there was no difference in 24-h HRV indices between the low PSQI group and the high one. Correlation analysis showed that there was a significant relationship between sleep quality and depressive symptoms (r = 0.617), but the relationship between 24-h HRV indices and PSQI global scores, BDI scores were not significant. However, the correlation analysis of PSQI components and 24-h HRV showed that sleep disturbance was significantly negatively correlated with SDNN and LF in waking period (r = −0.285, −0.235), and with SDNN in sleeping period (r = −0.317). In general, the sleep disturbance in PSQI components can sensitively reflect the relationship between sleep quality and 24-h HRV of medical students. Individuals with higher sleep disturance may have lower SDNN during awake period and bedtime period, and lower LF in awake period. Twenty-four hour HRV has certain application value in clinical sleep quality monitoring, and its sensitivity and specificity in clinical application and daily life are still worth further investigation.