Sleep Medicine

Objectiveto evaluate the effectiveness of a sleep education program among young athletes in enhancing sleep quality and duration, as well as mood and academic performance. Design: prospective cohort study. MethodsWe included 639 players (11% female; mean age of 13.89{+/-}3.8 years) of 5 sports disciplines in a professional club were evaluated before and after a sport season, through 4 specific instruments: 1) sleep diaries to estimate nocturnal sleep duration, 2) the Childrens Sleep Disorder Score Scale (SDSC) to assess sleep quality, 3) the Sleep Vitality Scale (SVS) to examine mood, and 4) school records of academic performance. The sleep education program included staff, family and individual sessions. It focused on the promotion of healthy sleep habits. ResultsThe 16t-25 years-old (y-o) group exhibited an increase in nocturnal sleep duration (p=0.002), while the 12-15 y-o group showed a decrease (p=0.01). In contrast, the 7-11y-o group exhibited no change. For sleep quality, the 12-15y-o (p < 0.001) and 16-25y-o (p<0.001) groups, while the 7-11y-o group exhibited inferior sleep quality (p 0.001). Regarding mood, the 7-11y-o group showed a significant deterioration (p=0.008), while no changes were observed in the 12-15y-o and 16-25y-o groups. Academic performance exhibited a significant improvement in the 7-11y-o (p=0.001), 12-15y-o (p<0.001), and 16-25y-o (p=0.008) groups. ConclusionsAmong athletes aged 12-25y-o, participation in a sleep education program led to improvements in sleep quality and duration, accompanied by enhanced academic performance. However, this intervention did not yield positive effects for athletes between the ages of 7 and 11 years.

BackgroundGood quality sleep is essential for good health and well-being. Medical students are at no exception to this and are prone to greater risk for sleep deprivation. The major reason being challenges to maintain a high level of academic achievement and constant thirst to acquire new learning skills and knowledge. However, in this process they are circumstanced to various levels of stress that might cause potential damage to their cognitive functioning and mental exhaustion to a certain extent. ObjectivesThus, our study objectives were to evaluate the sleep pattern in first- and second-year medical students. To understand how the stress levels and academic performance are related to sleep pattern and to explore the copying strategies of stress in our study participants. MethodologyThis cross-sectional study was conducted using a self-reported, web-based, questionnaire that included questions on sleep quality and deprivation through Pittsburgh sleep quality index. All the eligible students of first and second year who were part of a premiere teaching hospital during February and March 2021 were included. Data was analysed using IBM SPSS version 24. ResultsOut of 180 participants, 91(50.55%) had their initiation of sleeping time from 12-2 am and also, majority of students 112 (62.22%) had a sleep duration of six to eight hours. However, 119 (66.1%) students had self-reported change in sleeping pattern which was found to be significantly associated with relatively greater number of academic factors as compared to social factors. Most of the students scored between 50-60% score in their four assessments amongst which their first assessment was significantly associated with change in sleep pattern (P 0.040). Also, these individual assessment score was found to significantly affect their duration of sleep. The common coping strategies adopted by students under study were talking to family members/ friends, music/ book reading (hobby). ConclusionMajority of students in our study had reported change in sleeping pattern. Also, association between stress factors and change in sleeping pattern were observed with academic stress factors proving to be more significantly associated than social stress factors. The academic performance of students was also found to be associated with change in sleeping pattern and duration of sleep.

Background and purposeA new version of the Sleep Hygiene Index (SHI-10) has recently been introduced, and the psychometric performance in other populations is unknown. This study aimed to determine the dimensionality, internal consistency, and nomological validity of the SHI-10 among medical students at a Colombian university. MethodsA psychometric study was designed to determine indicators of validity (construct and nomological) and reliability (internal consistency) in which 309 medical students between 18 and 39 years (M=20.83, SD=2.68), and 54.69% were female. Construct validity (dimensionality) was tested through confirmatory factor analysis, internal consistency with Cronbachs alpha and McDonalds omega coefficients, and nomological validity through correlations with the Athens Insomnia Scale, Epworth Somnolence Scale, Generalized Anxiety Disorder (GAD)-7) and Patient Health Questionnaire (PHQ-9). ResultsThe four-dimensional structure of the SHI-10 showed adequate indicators of goodness of fit (Satorra-Bentlers chi-square of 43.30 [df of 29, p=.04], chi-square/df of 1.49, RMSEA of .04 [90%CI .01-.06], CFI of .97, TLI of .96 and SRMR .04). The four dimensions of the SHI-10 showed values less than .70 and limited nomological validity (most Pearson correlations were less than .30). ConclusionsThe SHI-10 shows a four-dimensional structure of SHI-10; however, the four dimensions of the SHI-10 present low internal consistency and limited nomological validity. More studies are needed to show the psychometric performance of the SHI-10.

Sleep is a crucial factor in recovery and must be integrated into athletes training plans for optimal performance and well-being. Although professional athletes are advised to sleep for at least 8 hours, many experience shorter sleep durations or poor sleep quality. Sleep interventions have been recently proposed to improve sleep, but their effects remain unclear. This ecological study aimed to evaluate the sleep of a rugby team and to assess the effects of sleep interventions, including sleep hygiene education and relaxation techniques. Thirty-six male professional rugby players were evaluated during two pre- and post-intervention match weeks using objective (actimetric) and subjective (questionnaires) assessments. At baseline, 34 on 36 athletes slept less than 8h per night. Combining both sleep dimensions, 61.1 % of players were considered poor sleepers. After sleep interventions, subjective sleep quality improved (p = 0.001, 2 = 0.22), and athletes went to bed earlier (23:28 {+/-} 00:42 vs. 23:43 {+/-} 00:45 during pre-intervention; p = 0.01, 2 = 0.15). Positive effects of sleep interventions were especially observed among poor sleepers as their objective sleep quantity increased (405.2 min pre-intervention vs. 425.9 min post-intervention p = 0.004, 2 = 0.28). Sleep interventions, composed of theoretical and practical sessions, improved sleep characteristics and might be implemented in athletes daily routine. This study offers a simple and accessible method to assess athletes sleep, while providing adapted recommendations to optimize or enhance sleep quality and quantity. Key pointsO_LI61.1% of the rugby players exhibited both poor sleep quality and quantity during the week and weekends. C_LIO_LITheoretical and practical sleep interventions elicited objective and subjective sleep improvement, especially among poor sleepers. C_LIO_LISleep assessment and interventions represent an efficient, and feasible method among team-sport players for improving sleep quality. C_LI

ObjectivesDrug induced sleep endoscopy (DISE) is a standardly used investigation for surgical planning in obstructive sleep apnoea management once conservative treatments have proven inadequate. There are a variety of anaesthetic agents used to obtain sedation necessary for DISE. These agents may have different effect on the upper airway and other parameters important in the diagnosis of the site of collapse during sleep. We aimed to review the commonly agents and evaluate the significance of their impact on the the diagnosis. MethodsA search was conducted through PubMed looking for studies on commonly used anaesthetic agents and their effect on the upper airway and cardiopulmonary parameters. Results: Of the 109 studies yielded by the search, 19 were deemed relevant to the review and met all inclusion criteria. The agents reviewed were: propofol, dexmedetomidine, remifentanil, isoflurane, sevoflurane, midazolam and topical lidocaine. A meta-analysis was not conducted due to the limited number of relevant studies and the heterogeneity of outcomes measured. All agents examined gave some element of airway collapse and impact on cardiopulmonary measures. Most of these effects were shown to be dose-dependent. Of the agents considered dexmedetomidine and propofol gave the most consistently reliable and physiologically safe representations of upper airway collapse seen in OSA patients. ConclusionThere is limited information and no industry standard for the sedative regimen used for DISE. Of the agents reviewed those that caused least cardiopulmonary instability, respiratory depression and exaggerated upper airway collapse were deemed the most appropriate for DISE. The agent that best meet these criteria is dexmedetomidine followed by propofol.

PurposeOptimal sleep is essential for supporting athletes health, performance and facilitating recovery. However, athletes sleep is impaired in both quality and quantity. Previous research has shown athletes sleep quality and quantity to be improved using sleep interventions, however very few studies have evaluated sleep and investigated it among female athletes. Therefore, this exploratory study aimed to evaluate the sleep of adult female team-sport athletes over a match week in an ecological context and to assess the effects of a one-to-one sleep intervention (comprising both educational and practical components). MethodsNine female rugby players completed a two-week protocol including a sleep evaluation (PRE week) and an intervention (POST week). The first week was dedicated to sleep assessment via both actigraphy and self-report questionnaires, and during the second week, players received educational and practical sleep interventions. ResultsDuring the PRE week, 88.9% of the participants were classified as poor sleepers, compared to only 44% during the POST week. A significant positive effect of sleep interventions was particularly found on subjective sleep (from 10.3 {+/-} 1.1 to 8.8 {+/-} 1.8, p = 0.03, 2 = 0.38) and psychological state (from 3.7 {+/-} 0.6 to 2.9 {+/-} 0.9, p = 0.002, 2 = 0.55). ConclusionThese positive effects highlight the need for sleep among female athletes and the potential benefits of targeted sleep interventions, though confirmation in larger samples of athletic women is needed. This feasible and tailored approach could be effectively implemented among female team-sport athletes over the competitive season.

IntroductionInsomnia triggers an enormous burden on peoples physical and mental health, especially for the elderly. Traditional Chinese medicine (TCM) therapies were widely used for curing senile insomnia, while the efficiency among various external treatments of TCM (ETs-TCM) was rarely reported. MethodOur network meta-analysis aims to compare and evaluate the optimal ETs-TCM to cure insomnia in the geriatric population. We systematically searched randomized controlled trials (RCTs) published until April 27, 2023 from nine databases. All participants satisfying the diagnosis criteria were recruited without limiting sex, nationality, or race. ResultFrom the initial 13,846 terms searched, we read 2,936 full-text articles and finally included 85 studies (12,724 participants) in our network meta-analysis. The total effective (TE) rate and Pittsburgh Sleep Quality Index (PSQI) score were selected standards for evaluating the effects of ETs-TCM. Evaluated by TE, Qigong plus acupressure massage has the highest probability (83.5%) of being the most effective treatment from its Surface Under the Cumulative Ranking Curves (SUCRA) at 96.7. Additionally, when evaluated using the PSQI, Acupressure Massage had the highest probability (32.9%) of being the most effective treatment (SUCRA=90.9). ConculsionOur findings suggest that the combination of acupressure massage and Qigong, or either method alone, may be effective treatments for insomnia in the elderly. This study provides valuable insight for future senile insomnia interventions using ETs-TCM, emphasizing the significance of manual therapy and gentle mind-body exercise as an alternative to medication.

Main sleep disturbances during motherhood occur during the first weeks after childbirth, but sleep continues to be affected until the baby sleeps through the night. However, most studies focus their attention up to 18 months after delivery. It is our interest to determine sleep quality of mothers with children from 0 to 10 years sleep, and the sociocultural factors associated with it. We designed a cross-sectional quantitative study consisting of an anonymous survey online that included the Pittsburgh Sleep Quality Index (PSQI), sociodemographic data and nocturnal family dynamic questions. The main findings reveal that the quality of maternal sleep was poor for all mothers regardless of the childs age. Specifically, during the first two years after childbirth maternal sleep quality was particularly low, with a significant improvement towards age 3, worsening again at the ages of 4 and 5 of the child, to finally improve towards the ages of 8 to 10. Additionally, higher levels of education and performing physical activity increased the probability of having good sleep quality. Conversely, childs awakenings increased the odds for the mother of having poor sleep quality at all stages of the child. For mothers with younger children, additional aspects of their childrens sleep and social and nocturnal family dynamic also predict their sleep quality. The current results expose that maternal sleep disturbances extend far beyond the postpartum period. To the best of our knowledge, this is the first report that focuses on maternal sleep until the age of 10 years of the child.

An ever-increasing burden of non-communicable diseases, especially in the post pandemic times and an association of sleep problems with them highlighted a felt need to estimate the sleep problem in India. A meta-analysis of the studies conducted on Indian data was planned adhering to PRISMA guidelines. An electronic search of available literature was performed on databases including PubMed, Google Scholar, PsycNet, and Epistemonikos. 100 eligible articles were analysed. To assess the methodological quality 10-points Joanna Briggs Institute (JBI) checklist for prevalence studies was used. The pooled estimates for prevalence of Insomnia found were 25.7%, OSA 37.4%, and RLS 10.6%. An increased prevalence was seen in patients of diabetes, heart disease patients and in otherwise healthy population. Subgroup analysis showed a higher prevalence in patient population and in the otherwise healthy population too,; e.g. Insomnia 32.3% (95% CI: 18.6% to 49.9%, I2=99.4%) and 15.1% (95% CI: 8.0% to 26.6%, I2=99.1%); OSA 48.1% (95% CI: 36.1% to 60.3%, I2=97.4%) and 14.6% (95% CI: 9.2% to 22.5%, I2=97.4%) and RLS 13.1% (95% CI: 8.7% to 19.3%, I2=91.9%) and 6.6% (95% CI: 2.4% to 16.4%, I2=99.1%) respectively. Excessive daytime sleepiness remained prevalent (19.6%) (95 % CI: 8.4% to 39.1%, I2=99.8%) in the healthy, which was alarming. A multipronged approach for sleep management, evaluation and research is the need of the hour for managing non communicable disorders and for promoting sleep health in the healthy population.

PurposeObstructive sleep apnea (OSA) is a highly prevalent disease, and positional OSA (pOSA) is a subgroup whose OSA severity is highly affected by sleeping position. This study investigated differences in demographic and sleep characteristics between patients with and without pOSA and developed a simple discrimination model. MethodsWe reviewed polysomnography records of patients admitted to the Sleep Center at Shuang-Ho Hospital between March 2015 and March 2019. They were categorized into pOSA and non-pOSA groups, and their demographic and sleep characteristics were compared. The receiver operating characteristic (ROC) curve was used to estimate the feasibility of discrimination model. ResultsOf the patients, 33% received diagnoses of pOSA; they had smaller neck circumference and waistline and lower weight, body mass index (BMI), OSA severity, heart rate, and snoring and respiratory-related limb movement indexes but higher sleep efficiency and mean oxygen saturation compared with patients without pOSA. Sleep stage analysis revealed that as severity increased, the proportion of sleep time spent in N2, N3, and rapid eye movement stages decreased, but the proportion of time spent in the N1 stage increased in both populations. Sleep position analysis revealed a higher proportion of sleep time in a supine position among patients with pOSA after adjustment for severity. The corresponding area under the ROC curve of our discrimination model was 0.924. ConclusionsDemographic and sleep characteristics differed significantly between patients with and without pOSA. Our model uses readily available measurements such as BMI and waistline and can aid physicians in the timely identification of patients with pOSA. Trial registration numberTMU-JIRB No.: N201911007 Date of registration2019/11/12

PurposeIntermittent hypoxia and transient arousals in obstructive sleep apnea (OSA) can lead to poor sleep quality and acute stress. Rising levels of obesity and increased incidence of OSA in young adults predisposes them to acute stress. We propose a mediation model to assess if risk of OSA is associated with acute stress and if the relationship between risk for OSA and acute stress is mediated by sleep quality. Methods493 healthy individuals (F=237, M=256) from 18-25 years of age (mean age=20.3{+/-}1.53 years) were screened for OSA, sleep quality and acute stress using STOP-BANG questionnaire, Pittsburg Sleep Quality Index and American Psychiatry Associations National Stressful Events Survey Acute Stress Disorder Short Scale (NSESS-S) respectively. Binary and logistic regression were used establish the relationships between the variables. Sobel test for mediation analysis was conducted. Results73 participants (17.3%) were found at an intermediate and high risk of OSA by STOP BANG questionnaire. 79 (16%) participants reported level of stress as None. Mild, moderate and severe stress was present in 248 (50.3%), 109 (22.1%), 51 (10.3%) and 16 (3.2%) participants respectively. The odds of having severe and extreme stress among those at risk of sleep apnea is 2.18 times higher than that among those not at risk of sleep apnea (OR: 2.18, 95% Confidence Interval: 1.37-3.51). Sobel test established that the relationship between OSA and acute stress is mediated by sleep quality. ConclusionSleep quality mediates the relationship between risk for sleep apnea and acute stress. This highlights the importance of screening for OSA in young adults, particularly young men with high BMI, presenting with high stress levels.

BackgroundUniversity students frequently experience challenges that affect their sleep quality, including academic stress, lifestyle habits, and socio-demographic factors. Common sleep disturbances, such as delayed sleep onset and poor sleep efficiency, often result in daytime dysfunction and difficulty maintaining enthusiasm. MethodsThis cross-sectional study appraised sleep quality among undergraduate students in Bangladesh during the COVID-19 pandemic. A total of 530 undergraduate students were purposively selected from three public universities. Participants were chosen through convenience sampling, with students who had contracted COVID-19 during the study excluded from the sample. ResultsThe mean age of the university students was 21.1 ({+/-}2.0) years. Regarding PSQI components, the participants showed moderate sleep latency (55.7%) and habitual sleep efficiency (56.0%), with mild levels of sleep disturbances at night (68.1%), daytime dysfunction (51.1%), and difficulty maintaining enthusiasm (48.5%). The global PSQI scores were poor for 59.4% of participants, while 40.6% had good scores, with a mean of 6.5({+/-}2.9). Among the students, 44.9% reported fair subjective sleep quality, followed by good (24.7%), very good (18.1%), and poor (12.3%) sleep quality. Lifestyle factors such as class attendance, online media usage, BMI, physical exercise, tea/coffee consumption, and smoking were significantly associated with sleep quality (p<0.05). Sleep quality factors like daytime sleep duration, nighttime sleep latency, and sleeping pill usage were also significantly associated with sleep quality (p<0.05). Significant associations were found between sleep quality and factors such as age, household income, daily study hours, BMI, daytime sleep, and sleep latency (p<0.05). ConclusionThe study revealed that longer sleep latency, daytime sleep, and sleeping pill usage were related with poorer sleep quality. It also emphasized that sleep disturbances, daytime dysfunction, and difficulty maintaining enthusiasm were significant predictors of sleep quality.

BackgroundEmerging research indicates that light exposure may influence sleep quality. Identifying key light-exposure behaviours associated with poor sleep quality in athletes may allow practitioners to efficiently screen for sleep difficulties and prioritise athletes for further assessment. Translating these findings into a practical screening tool could enhance willingness of high-performance professionals to monitor sleep and light exposure in athletes. HypothesisKey predictor variables identified by feature reduction techniques will lead to higher predictive accuracy in determining which light behaviours are associated with poor sleep quality in athletes. Study DesignCross-sectional study. Level of EvidenceLevel 3. Methods121 athletes from varying competitive levels completed questionnaires, including the Light Exposure Behaviour Assessment (LEBA) and Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was defined using the PSQI cut-off >5. Least absolute shrinkage and selection operator (LASSO) regression identified light exposure variables from the LEBA questionnaire most strongly associated with good and poor sleep quality in athletes. Three models were compared: a full-variable model (23 items), a factor-specific model (Factor 3: screen/device use), and a feature-reduced model (LASSO-selected items). ResultsPhone use before bed, checking phone/watch during the night, were identified as variables of greatest association with poor sleep quality and used for reduced feature set modelling. On an independent test set, the feature-reduced model achieved area under the curve (AUC) 0.83, sensitivity 0.70, and specificity 0.92. ConclusionsOur findings report that phone-related behaviours before and in bed are associated with a higher likelihood of poor sleep quality. These behaviours, combined with the developed nomogram, provide a preliminary, low-burden screening tool to identify athletes who may be experiencing sleep difficulties. The high specificity indicates that athletes flagged by the tool are likely to have genuine poor sleep quality, warranting further assessment to identify underlying causes and appropriate interventions. Clinical RelevanceEducation and interventions focused on light exposure factors were identified as most influencing sleep quality in a multifaceted athletic population and could be prioritised to optimise sleep quality. The developed sleep quality nomogram may be useful as a decision-making tool to improve sleep monitoring practice among practitioners.

BackgroundThe COVID-19 pandemic has spread worldwide, affecting millions of people and exposing them to home quarantine, isolation, and social distancing. While recent reports showed increased distress and depressive/anxiety state related to COVID-19 crisis, we investigated how home quarantine affected sleep parameters in healthy individuals. Methods160 healthy individuals who were in home quarantine in April 2020 for at least one month participated in this study. Participants rated and compared their quantitative sleep parameters (time to go to bed, sleep duration, getting-up time) and sleep quality factors, pre-and during home quarantine due to the COVID-19 pandemic. Furthermore, participants chronotype was determined to see if sleep parameters are differentially affected in different chronotypes. ResultsThe time to fall asleep and get-up in the morning were significantly delayed in all participants, indicating a significant circadian misalignment. Sleep quality was reported to be significantly poorer in all participants and chronotypes, and included more daily disturbances (more sleep disturbances, higher daily dysfunctions due to low quality of sleep) and less perceived sleep quality (lower subjective sleep quality, longer time taken to fall asleep at night, more use of sleep medication for improving sleep quality) during home quarantine. ConclusionsHome quarantine due to COVID-19 pandemic has a detrimental impact on sleep quality. Online interventions including self-help sleep programs, stress management, relaxation practices, stimulus control, sleep hygiene, and mindfulness training are available interventions in the current situation.

Study ObjectivesTo determine the prevalence of obstructive sleep apnea (OSA) in adults with Down syndrome (DS), to investigate factors related to OSA severity and to identify which sleep questionnaire is the most appropriate for the screening of OSA in this population. MethodsCross-sectional study that consecutively included 60 adults with DS. All patients underwent type III polysomnography and clinical and laboratory data were collected; sleep assessment questionnaires were applied. Multiple linear regression models evaluated the associations between OSA severity (measured by the respiratory event index - REI) and clinical and laboratory data and sleep questionnaires (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, BERLIN and STOP-Bang questionnaires). ResultsResults show that 60 (100%) adults with DS had OSA, with moderate-severe OSA identified in 49 (81.6%). At the multivariate linear regression, REI significantly correlated with hematocrit levels, BMI and STOP-Bang questionnaire (SBQ) results (P <0.001). The positive STOP-Bang [&ge;]3 points) showed 100% of sensitivity (95%CI: 92.75-100%), 45.45% of specificity (95%CI: 16.75-76.62), positive predictive value of 89.09% (95%CI: 82.64-93.34%), negative predictive value of 100%, accuracy of 90% (95%CI: 79.49-96.24%) and OR of 24.29. ConclusionsAdults with DS have a very high prevalence of OSA. Hematocrit levels, BMI and SBQ showed a strong correlation with OSA severity. The SBQ performed well in identifying moderate to severe OSA in this population. Considered together, these results point to the need to perform OSA screening in all adults with DS, and STOP-Bang may play a role in this screening.

Study ObjectivesExcessive daytime sleepiness (EDS) is common in participants with sleep disorders, particularly obstructive sleep apnea (OSA), and can be assessed using the Epworth Sleepiness Scale (ESS) and the Psychomotor Vigilance Test (PVT). However, the relationship between these measures of sleepiness/attention, and their relationships to OSA severity and treatment, remains understudied. This study examined these associations in a sleep center population. MethodsA total of 167 participants, primarily diagnosed or suspected of OSA (n=128 [76.6%]), completed the ESS and PVT during their clinical visit. Associations among ESS, PVT, OSA severity and CPAP adherence were examined using Pearsons correlations, unadjusted and controlling for age, sex and body mass index. ResultsResults showed no significant correlations between ESS and PVT measures of attention/vigilance. While higher ESS scores correlated with more severe apnea-hypopnea index (AHI) in participants with OSA, no association was found with PVT measures. Among participants using continuous positive airway pressure (CPAP), greater hours/night of usage was associated with lower ESS scores, but not with better PVT performance. ConclusionsOur data indicate that ESS scores track more closely than PVT to OSA severity and treatment. The findings suggest that the tendency to fall asleep as measured by the ESS and attention deficits on PVT may capture different aspects of "sleepiness". While the ESS is commonly used in sleep clinics, further research is needed to determine if PVT should also be used routinely in clinical practice. Brief summaryExcessive daytime sleepiness (EDS) is a prevalent symptom among individuals with obstructive sleep apnea (OSA), but the relationship between a subjective measure (Epworth Sleepiness Scale) and an objective measure (Psychomotor Vigilance Test) of sleepiness or attention, as well as how each relates to OSA severity and treatment, is not well understood. This study found no association between the ESS and measures from a 3-minute PVT, suggesting that these assessments are not evaluating the same aspects of "sleepiness" reported by participants. Higher ESS scores, but not worse PVT performance, was related to more severe OSA and less adherence to CPAP, indicating that the ESS tracks more closely than the PVT to OSA severity and treatment use.

AbstractO_ST_ABSStudy objectiveC_ST_ABSThis study aimed to assess the validity of the Yaounde Sleepiness Scale (YSS), a new tool for excessive daytime sleepiness (EDS) screening, using Epworth Sleepiness Scale (ESS) as reference. MethodologyA 6-item questionnaire was assessed for content validity (based on sleep physiology, face validity (by 4 sleep specialists), criterion and construct validity (in a cross-sectional study led in Lille University Hospital). For criterion validity, we used Pearson correlation, area under the receiver operator characteristics (AUROC) curve and a graphical method to find the YSS thresholds. We performed a simple linear regression to seek the association between YSS and EDS predictors for construct validity. ResultsA total of 566 patients (mean age = 53.1 {+/-} 14.6 years, female = 47%) were enrolled. The mean YSS and ESS were 9.8 {+/-} 4.7 and 9.1 {+/-} 5.3, respectively. The Pearson correlation between YSS and ESS was 0.74% (p<0.0001). The AUROC curves (95% confidence interval, 95CI) for ESS- based EDS and severe EDS prediction were 0.856 (0.829 - 0.889) and 0.871 (0.829 - 0.913), respectively. The YSS thresholds for EDS and severe EDS were 9 and 15, respectively. The sensitivity and specificity of YSS were 92.3 (88.7 - 95.9)% and 60.6 (55.3 - 65.9)%. The YSS was positively associated with psychiatric conditions and psychotropic drugs use, and negatively with age. ConclusionWe found a good criterion validity of the YSS compared with ESS. This questionnaire could be proposed as an alternative to ESS.

This study examined the usefulness for improving sleep quality of the Healing Fit program, which provides micro-electrical stimulation of the brain (transcranial electrical stimulation) and music therapy, in healthy adults who experienced sleep deprivation. A randomized controlled pretest-posttest design was used to evaluate effects on sleep quality, stress, and concentration. The study began after approval from the Institutional Review Board of Eulji University before conducting the study (EU22-90). Healing Fit was applied to the experimental group (n = 25) at a volume of 50 dB (about the level of normal conversation) for 30 min. Transcranial electrical stimulation intensity was set individually from 1 to 10 to the extent that the participant had no pain. Afterwards, interventions corresponding to learning, healing, and sleep music within Healing Fit were applied three times a day (30 min per session) for 14 days while participants continued their normal daily routines. The 25 control participants rested without any treatment for 30 min. Subjective/objective sleep quality, subjective/objective stress, concentration, and general characteristics were measured on day 1 of the experiment in both groups. Objective/subjective sleep quality was measured on day 7 and objective/subjective sleep quality, objective/subjective stress, and concentration were measured on day 14. The total sleep time, waking time after sleep onset, sleep efficiency, deep sleep, and subjective sleep quality were significantly better in the experimental group than in the control group. Objective and subjective stress decreased significantly in the experimental group compared to the control group, but there were no significant differences in autonomic nervous system activity. However, sympathetic and parasympathetic nervous system activity was balanced when Healing Fit was applied. There were no significant differences in concentration between groups; however, concentration tended to increase over time in the experimental group. Clinical Trial RegistrationClinical Research Information Service (https://cris.nih.go.kr/; KCT0009045).

Background and rationaleSleep is essential for overall health, but many people experience disruptions in their sleep patterns due to busy schedules and technology use. This study aims to examine the impact of screen time on sleep quality, considering factors such as smoking, caffeine use, napping, physical activity, and stress levels. MethodologyWe enrolled 371 participants from Ahmedabad for a cross-sectional study. 278 participants were included after the screening. They completed a questionnaire covering demographics, screen time, covariates, stress using the PSS10 scale, and sleep quality using the PSQI scale. Data was analyzed using IBM SPSS Statistics 22 after entering it into MS Excel. ResultThis study examines the relationships between lifestyle factors and sleep quality among adults aged 18 to 40 in Ahmedabad. The findings suggest that increased screen time (r = 0.518, p < 0.001) and higher stress levels (r = 0.530, p < 0.001) are associated with lower sleep quality. Additionally, nap frequency and physical activity show significant associations with sleep ratings. However, no significant connections were found between caffeine use at night or smoking/tobacco usage and sleep quality. ConclusionThe Spearman correlation indicates a moderate correlation between screen time and sleep quality, as well as between stress and sleep quality. The chi-square test shows significant associations between screen time before bed, napping, and physical activity with sleep quality. However, there is no association between nighttime caffeine consumption or smoking/tobacco use and sleep quality.

Background and ObjectiveAccurate measurements of peripheral blood oxygen saturation (SpO2) are important in evaluating sleep patients with frequent desaturations due to pathological breathing events. This project compared synchronised SpO2 measurements at the finger, forehead and toe of patients undergoing Type 1 polysomnography (PSG) to evaluate potential SpO2 variability across the sites. MethodsPulse oximetry SpO2 measurements were simultaneously and continuously recorded for 41 sleep patients at the finger, forehead and toe, and synchronised with PSG data. Recordings were scored for desaturations of [&le;] 3% (peak to trough, lasting [&le;]10 seconds), signal dropouts, and artefact occurrences. Forehead and toe SpO2 measurements were compared against the finger as the standard PSG oximetry site. ResultsDifferences between anatomical sites for mean SpO2, mean number of SpO2 desaturations per hour, and time spent below an SpO2 level of 95% during total sleep time were significant (P < 0.01). The forehead pulse oximeter had the highest mean SpO2, least number of SpO2 desaturations per hour, and experienced the least number of artefact occurrences. Dropouts were lowest for the forehead and toe pulse oximeters. ConclusionDifferences between SpO2 measurements, dropouts and artefact occurrences at the finger, forehead and toe may have diagnostic and prognostic implications for sleep patients. The differences in SpO2 measurements may be attributed to variability in perfusion of the extremities and core during sudden oscillating blood pressure changes associated with breathing events. Further research is required to determine which anatomical site correlates closest to arterial oxygenation for pulse oximetry in sleep patients. BRIEF SUMMARYO_ST_ABSStudy rationaleC_ST_ABSAn absence of research investigating anatomical site location for pulse oximetry during overnight polysomnography exists. Our study was performed to fill this gap, as accurate pulse oximetry measurements are key for the diagnosis, treatment and monitoring of sleep patients; a patient cohort where SpO2 desaturations are recurrent. Study impactOur findings demonstrate there are significant differences between finger, forehead and toe pulse oximetry measurements, particularly SpO2 desaturations per hour, which may have diagnostic and clinical implications. This research is applicable and important to not only sleep physicians and scientists, but also other disciplines where continuous SpO2 monitoring is required.