Occupational Difference in Association of Poor Sleep Quality and Metabolic Syndrome: Differences between Workers and Employees

Background. Regarding insufficient data about interaction of job in association of sleep quality with metabolic syndrome (MS), this study has been designed to evaluate this association in workers and employees. Methods. This cross-sectional study was conducted on 448 municipal staff (employee group: N = 295 ; worker group: N = 153 ) referring for periodic examinations. The relationship between sleep quality and MS and their relevant components was investigated in both groups. Results. In the worker group, poor sleep quality was independently associated with the risk of MS by 3.04 times ( P < 0.01 ). Among the components of metabolic syndrome, hypertriglyceridemia was associated with a greater number of sleep disorder components. There was no association between metabolic syndrome and sleep quality in the employee group. Conclusion. Poor sleep quality exerts different effects on metabolic complications in employees and workers.

Gender Differences in Sleep and Mental Health among Saudi Adolescents

Among adolescents, mental health issues (i.e., stress and depressive symptoms) negatively affect sleep. We assessed whether the association between mental health and sleep varied between genders among Saudi adolescents. A total of 2206 school students (grades 7-12) from 40 randomly selected schools in four cities of Al-Qassim province in Saudi Arabia participated in this cross-sectional study. The survey assessed demography, lifestyle, sleep (12-item Medical Outcomes Study Sleep Scale), depression (Depression, Anxiety, Stress Scale (DASS-21)) and stress (10-item Perceived Stress Scale). Adjusted associations with sleep were tested with linear and logistic regressions. Of the sample, 55% were girls, and their average sleep score was lower than that of the boys (58.7 vs. 63.4, p < 0.001 ). Girls had worse mental health than boys; the proportion of girls with both severe stress and severe depressive symptoms was three times higher than that of the boys (12% vs. 4%, p < 0.001 ). For both boys and girls, those with severe depressive symptoms only or both severe depressive symptoms and severe stress had significantly lower sleep scores than those who had neither of the two conditions (reference group). On the other hand, among those who had severe stress only, the sleep score was significantly lower for the girls ( p = 0.002 ) than for the boys ( p = 0.19 ). Overall, girls had a significantly lower sleep score and worse mental health than boys. The association between mental health and sleep significantly differed between the sexes. Severe stress was negatively associated with sleep in girls but not in boys.

Electronic Media Use and Sleep Disorders among Adolescents during the COVID-19 Pandemic

Background. One of the negative impacts of electronic media use is the occurrence of sleep disturbances. Due to the COVID-19 pandemic, the use of electronic media in families, including in adolescents, has been increasing. Objective. This study was aimed at describing the association between electronic media use and sleep disturbances in adolescents in Palembang. Methods. A cross-sectional study was conducted in January to February 2021. Participants were 14–17-year-old high school students who completed a questionnaire to assess electronic media use and a Sleep Disturbance Scale for Children (SDSC) questionnaire to assess sleep disturbances. Results. One hundred and fifty-seven participants enrolled in this study. The majority of the participants were 16 years old or older (56.7%) and used smartphones (93%) with a median of media use of 10 hours a day. None of the participants’ characteristic variables showed statistically significant correlations. Similarly, none of the electronic media use variables showed statistically significant correlations. Conclusion. Most of adolescents in this study have used electronic media for more than 6 years, with median use of 10 hours per day, for noneducative purposes. Despite findings that most of them experience sleep disturbances, there was no statistically significant association between electronic media use and sleep disturbances in adolescents.

Sleep Quality and Its Correlates among Adolescents of Western Nepal: A Population-Based Study

Sleep quality has a long-term impact on health leading to depression among adolescent students. We conducted a cross-sectional study to assess the prevalence of sleep quality and its associated factors among adolescents of western, Nepal. 514 adolescents from different schools were selected by the probability proportionate to size (PPS) method. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality among adolescents. The collected data were entered in EpiData 3.2 version, then extracted to excel 2019 and was analyzed with the help of RStudio (version 1.2.5033). Frequency distribution and percentage were identified as descriptive analysis whereas chi-square test was done. Variables that were found statistically significant ( P < 0.05 ) were further analyzed using the logistic regression model. The prevalence of sleep quality in this study was 39.1%. In a bivariate analysis, ethnicity, religion, place of residence, drinking status of father, reason for selecting the currently studying faculty, satisfaction with academic performance, use of tobacco, relationship with friends or classmates, more use of internet per day, and use of internet before falling asleep were found to be statistically significant with sleep quality. Those students who left their home without informing their parents were more than three times at the risk of sleep quality than those students who never ran away from their home without informing their parents ( AOR = 3.435 , CI: 1.237-9.540). The overall prevalence of sleep quality among school going adolescent students was 39.1 percent which was comparatively high.

The Pittsburgh Sleep Quality Index: Reliability, Factor Structure, and Related Clinical Factors among Children, Adolescents, and Young Adults with Chronic Pain

This study is aimed at assessing the psychometric properties and the factorial structure of the Pittsburgh Sleep Quality Index (PSQI) in a clinical sample of children, adolescents, and young adults with chronic pain. Data of 482 participants (aged 8-21 years) from two crosssectional studies and a chronic pain services outpatient clinic were analyzed. Exploratory and confirmatory factor analysis and reliability analysis of PSQI component scores were performed. Relationships between the PSQI global score and various clinical measures were investigated to assess external validity. The findings exhibit the reliability and validity of a single-factor model of the PSQI in a clinical sample of youth with chronic pain and support the relationship in this specific population between poor sleep quality and important clinical measures of well-being. These results support an informed decision regarding its use with this specific population and underscore the clinical relevance of assessing sleep quality.

Use of Laser in Sleep Disorders: A Review on Low Laser Uvulopalatoplasty

Study Objective. The objective of this study is to find the effectiveness of the low laser therapy on uvulopalatoplasty/soft palate in sleep apnea patients and snoring. Also, this study aims to touch base on the effectiveness of the Er:YAG and combined use of Er:YAG and Nd:YAG lasers for the uvulopalatoplasty. Methods. A comprehensive and systematic literature review was conducted using PubMed, Google Scholar, Cochrane Central Register of Controlled Trials, Embase, Web of Science, the US National Institutes of Health Trials Registry, WHO Library, and Medline. The search strategies were developed to cover publications from January 2010 through March 2020. The past 10 years of the search were performed to report the data following systematic review and meta-analysis protocol (PRISMA-P) 2015 statement. Results. With the help of keywords, the total number of abstracts identified was 946. These abstracts were further reviewed as per inclusion and exclusion criteria, and 106 abstracts were identified to match the selection criteria. Further review of full articles resulted in 12 articles that matched the inclusion criteria for the study. Conclusion. Er:YAG can be a good alternative and least invasive therapy for managing snoring and obstructive sleep apnea. Er:YAG therapy is considered to nonsurgical intervention with minimum side effects and can be performed chairside.

Magnitude of Poor Sleep Hygiene Practice and Associated Factors among Medical Students in Ethiopia: A Cross-Sectional Study

Background. Good sleep hygiene plays an important role in human health. Medical students are notorious for insufficient and irregular sleep habits which are linked with students’ learning abilities, poor academic performance, and poor interpersonal relationship which predispose them to mental illnesses. However, it has not been studied among medical students in Ethiopia. Method. This institution-based cross-sectional study was conducted among 576 undergraduate medical students selected by using a stratified sampling technique. Sleep hygiene (SHI) was assessed by a 13-item sleep hygiene questionnaire. Binary logistic regression was used to identify the potential determinants of poor sleep hygiene among undergraduate medical students. Variables with p values less than 0.05 were considered statistically significant, and the strength of the association was presented by adjusted odds ratio with 95% C.I. Result. The prevalence of poor sleep hygiene practice among undergraduate medical students was 48.1% (95% 43.7, 52.1). After adjusting for the possible confounders, being female ( AOR = 1.53 , 95% CI 1.03, 2.26), having depressive symptoms ( AOR = 3.55 , 95% CI 2.26, 5.59), with stress symptoms ( AOR = 2.41 , 95% CI 1.61, 3.60), and having anxiety symptoms ( AOR = 2.2 , 95% CI 1.42, 3.31) were associated with poor sleep hygiene practice at p value < 0.05. Conclusion. Almost half of the medical students had poor sleep hygiene practice. Routine screening of depressive and stress symptoms and education about sleep hygiene are warranted among medical students.

Quality of Sleep and Its Correlates among Yemeni Medical Students: A Cross-Sectional Study

Background. Sleep disturbance is particularly common among medical students worldwide and affects their wellbeing and academic performance. However, little is known about this issue in Yemen. This study looks at sleep quality and its association with personal and life-style factors and self-reported academic performance among medical students at the largest Yemeni university. Methods. A cross-sectional survey was conducted at Sana’a University, Yemen, in 2017. The Pittsburgh Sleep Quality Index (PSQI), consisting of 19 items and 7 components ( score range = 0 ‐ 3 ), was used to assess sleep quality. The summation of the components’ scores yields the global PSQI score ( range = 0 ‐ 21 ). A global PSQI value higher than 5 indicates poor quality of sleep. Logistic regression was applied to look at relationships. Results. 240 male (41%) and female (59%) medical students took part in the study with 54% being preclinical and 46% clinical with an average age of 23.3 years ( SD = 1.7 ). The mean global score (SD) was 6.85 (2.8), and 68% of the students ( N = 163 ) were identified as poor sleepers. The mean global PSQI score (SD) and proportion of poor sleepers were higher among males (7.7 (2.8) and 81%, respectively) than females (6.27 (2.42) and 59.2%, respectively), p ≤ 0.001 . Good sleep quality was more likely (OR (95% CI)) among females (3.4 (1.3-8.8)), the unmarried (2.8 (1-7.8)), those in good health (2.3 (1.1-4.5)), and nonkhat chewers (4.9 (1.4-17.1)). Nonsmokers were less likely to have good quality sleep compared to occasional smokers (0.185 (0.071-.485)). Stress (30%) and academic workload (21%) were the most commonly reported causes of poor sleep quality. Almost two-thirds of the students (65%) mentioned that disturbed sleep undermined their academic performance. Conclusions. Poor sleep quality is common among Sana’a medical students and impacts their academic performance. Specific stress management and sleep hygiene promoting programs should be incorporated early on in medical education.

Sleep Pattern and Problems in Young Children Visiting Outpatient Department of a Tertiary Level Hospital in Kathmandu, Nepal

Background. Sleep is an important parameter of a child’s growth and development. The pattern and duration of sleep varies with age. Sleep problems are a common occurrence during childhood days, and these problems that establish in childhood are presumed to continue later in life. Many times, parental concerns regarding their child’s sleep problems like difficulty in putting to sleep, frequent night time awakening, and waking up early are overlooked during their visits to the hospital. Objective. The aim of this study was to find out the sleep patterns and problems of children aged six to thirty-six months. Methodology. A cross-sectional study was conducted at the pediatric outpatient department of Kathmandu Medical College Teaching Hospital from October, 2019 till March, 2020. Two hundred and forty-nine respondents were chosen purposively and were given questionnaires to be filled out. Research instrument was a standard, Nepali version of a structured questionnaire called Brief Infant Sleep Questionnaire (BISQ) which contained questions related to sleep parameters and sleep problems existing among young children of 6-36 months. Mean, standard deviation, frequencies, and Kruskal Wallis test were used for statistical analysis. Results. The mean duration of total sleep was 12.12 ± 2.00 hours, while that of night sleep was 9.22 ± 1.19 hours and mean daytime nap was 2.90 ± 1.66 hours. Most of the children (96%) coslept with their parents, and 55% of the children had feeding as a bedtime ritual. Overall, 19.6% of the children had sleep problems as identified by BISQ although only 5.6% of the parents perceived that their children had it. Conclusions. Sleep problems were present among young Nepalese children included in our study, and sleep assessment should be a part of every health checkup for children.

Nocturnal Continuous Positive Airway Pressure (nCPAP) Decreases High-Sensitivity C-Reactive Protein (hs-CRP) in Obstructive Sleep Apnea-Hypopnea Syndrome

Background. Systemic and airway inflammation has recently been linked to obstructive sleep apnea-hypopnea syndrome (OSAHS) and is considered to be a probable risk factor for OSAHS-induced cardiovascular damage. High-sensitivity C-reactive protein (hs-CRP), as an inflammatory mediator, may be useful for the prediction of the risk of cardiovascular disease (CVD) and assessment of nocturnal continuous positive airway pressure (nCPAP) therapy effect in OSAHS patients. Methods. A prospective, controlled, cross-sectional study was conducted on 64 consecutive adult subjects with suspected sleep-disordered breathing (SDB). Results. OSAHS was confirmed in 43 patients (24 normotensive and 19 hypertensive patients) and ruled out in 21 normotensive subjects (controls). The median plasma level of hs-CRP did not differ significantly between OSAHS patients and controls. It showed an unmarked rise with the severity of OSAHS ( p = 0.20 ) and was not correlated with AHI ( p = 0.067 ; r = 0.28 ). After adjusting for cervical perimeter (CP), waist-to-hip ratio (WHR), and blood sugar level, hs-CRP level of 1 mg/dL or greater was significantly more often observed in OSAHS patients compared with controls ( p = 0.032 ; OR = 5.60 ) and was also significantly associated with AHI ( p = 0.021 ). A significant decrease in the median plasma hs-CRP level was observed in CPAP compliant patients ( p = 0.006 ). Of those, only normotensive patients showed a significant decrease in plasma hs-CRP level. In hypertensive ones, however, the hs-CRP level dropped but not significantly. Using a linear regression model, the change in hs-CRP level (Δhs-CRP) following a 6-month-nCPAP therapy was found to positively correlate with the baseline hs-CRP level for both hypertensive ( p = 0.02 ; r = 0.68 ), and even more normotensive OSAHS patients ( p < 0.0001 ; r = 0.89 ). Conclusion. nCPAP therapy may have a cardiovascular protective effect in OSAHS patients. hs-CRP level would be useful as a valuable predictor of success in OSAHS treatment monitoring.