Maternal sleep quality during early pregnancy,risk factors and its impact on pregnancy outcomes: a prospective cohort study

ObjectivesWe aimed to assess the prevalence of poor sleep quality during early pregnancy and its risk factors, and to explore the association between sleep quality and adverse pregnancy outcomes.MethodsThis was a prospective birth cohort study that included 4352 pregnant women. Sleep quality were assessed using the Pittsburgh Sleep Quality Index (PSQI). The risk factors for poor sleep quality were analyzed by a logistic regression model. Log-binomial regression models were used to analyze the association between sleep quality and pregnancy outcomes.ResultsThe prevalence of maternal poor sleep quality during early pregnancy was 34.14%. The multivariate logistic model showed that stillbirth history (OR = 2.45; 95% CI: 1.34, 4.47), history of induced abortion (OR = 1.26; 95% CI: 1.07, 1.49), general health-related quality of life (OR = 3.98; 95% CI: 2.97, 5.34), insufficient physical activity (OR = 1.18; 95% CI: 1.03, 1.36), smoking (OR = 1.59; 95% CI: 1.18, 2.15), and vegetarian (OR = 2.18; 95% CI: 1.54, 3.08) were risk factors for poor sleep quality, while taking folic acid consistently before pregnancy (OR = 0.83; 95% CI: 0.72,0.97) was the protective factor. After controlling for all the confounders, poor sleep quality during early pregnancy increased the risk of premature rupture of membranes by 12% (95% CI: 1.00, 1.25).ConclusionPregnant women with a history of stillbirth and induced abortion, general health-related quality of life, insufficient physical activity, smoking, and a vegetarian diet tended to have poor sleep quality. More attention should be paid to healthy lifestyle of pregnant women to improve sleep quality and better pregnancy outcomes.     

高中学生睡眠质量与应对方式的相关性

目的：了解高中学生的睡眠质量,探讨高中学生睡眠质量与应对方式的关系。方法：应用匹兹堡睡眠质量指数（ PSQI）、应付方式问卷（ CSQ）对608名高中学生进行调查。结果：①高中学生睡眠问题的检出率为20．2％;②有睡眠问题组解决问题、求助因子得分低于无睡眠问题组,自责、幻想、退避、合理化因子得分高于无睡眠问题组,差异有统计学意义（t＝－9．982～5．198,P＜0．05）;③多元线性逐步回归分析示PSQI总分与解决问题呈负相关,与自责、退避呈正相关（t＝－4．788～7．531,P＜0．05）。结论：高中学生睡眠问题不容忽视,其睡眠质量与应对方式有关。     

某部新兵睡眠质量及影响因素调查

目的了解某部新兵的睡眠质量状况。方法整群抽取某部495名新兵采用自制的新兵心理卫生调查问卷及匹兹堡睡眠质量指数(PSQI)量表进行测试。结果新兵的睡眠质量异常检出率为13.54%,高于正常男性群体(χ2=7.96,P=0.005);新兵的主观睡眠质量(SSQ)、入睡潜伏时间(SL)、睡眠干扰因素(Sdi)、应用催眠药物(USM)、白天功能障碍(DD)分值及PSQI总分均高于正常男性群体(U=2.76~39.01,P0.01);Logistic回归分析显示:非自愿入伍(P0.001,OR=9.987,95%CI=4.609-22.866)、认为不适应部队生活(P0.001,OR=7.001,95%CI=3.018-16.981)及认为部队管理方式严格(P0.001,OR=3.096,95%CI=1.887-9.087)为新兵睡眠质量异常的显著危险因子。结论新兵的睡眠质量状况不容乐观,应当给予持续关注;乐观向上的心态有助于新兵睡眠质量的提升。     

Clinical Research of Acupuncture on Malignant Tumor Patients for Improving Depression and Sleep Quality

Objective:To study the effect of acupuncture on depression and insomnia of malignant tumor patients.Methods:Eighty cases of cancer related depression and sleep disorders were randomly divided into 2 groups:treatmentl group(acupuncture n=40) and control group(Fluoxetione n=40).All patients were assessed by Self-rating Depression Scale(SDS),Hemilton Depression Rating Scale(HAMD) and Pittsburgh Sleep Quality Index(PSQI) after treatment for 30 days.Results:Before treatment the SDS and HAMD scores of the trial group were 64.12±5.34 and 20.92±2.38,those of the control group were 64.24±4.98 and 20.72±2.74,after treatment the SDS and HAMD scores of the trial group were 43.64±5.28 and 9.88±1.27 respectively,significantly lower than those of the control group(50.76±5.42 and 13.72±2.05 respectively,both P<0.05).Before treatment the PSQI score of the trial group and the control group were 14.48±1.71 and13.92±2.59,after treatment the PSQI score of the trial group was 7.92±1.22 after treatment,significantly lower than those of the control group(11.44±1.89,P<0.01).Conclusion:Acupuncture can effectively reduce malignant-related depression,improve sleep quality,and help to improve the quality of life of cancer patients.     

脑电生物反馈治疗失眠疗效评价

目的探讨脑电生物反馈治疗失眠患者的临床疗效。方法将30例失眠患者设为研究组,给予10次脑电生物反馈治疗;将30例正常人设为对照组,应用数字化脑电图仪记录两组治疗前后各波功率值及总波功率值。于治疗前后采用匹茨堡睡眠指数量表、症状自评量表评定临床疗效。结果研究组治疗前脑电波总波功率值、口波功率高于对照组,但差异无显著性;经脑电生物反馈治疗后显著低于对照组（P〈0．05）;治疗后症状自评量表总分、各因子分及匹茨堡睡眠指数量表分均较治疗前有显著下降（P〈0．01）。结论脑电生物反馈治疗可显著改善失眠患者的脑电波,提高睡眠质量。     

匹兹堡睡眠质量指数用于农村老年人群的信效度分析

目的 评价匹兹堡睡眠质量指数（PSQI）在农村老年人群中的信度和效度。 方法 采用分层整群随机抽样的方法,从四川省某市农村地区选取共318名年龄≥60岁的老年人作为研究对象。用分半信度、内在一致性信度考察其信度,用区分效度、结构效度考察其效度。 结果 观察对象PSQI分半信度系数为0.833;16个条目总体Cronbach′s α系数为0.767;7个成分间区分效度定标试验成功概率为100%;验证性因子分析显示双因子模型和三因子模型拟合较好（RMESA、NFI、CFI各自为0.037、0.972、0.992;0.000、0.992、1.000）。 结论 PSQI量表用于农村老年群具有良好的信度和效度,双因子结构和三因子结构模型均适用于农村老年人群体。考虑到三因子结构两个因子内部内在一致性较低,在农村老年人中使用PSQI量表以双因子结构更为合适。     

2010年厦门市一般人群睡眠质量现况分析

目的了解厦门市一般人群睡眠状况及影响因素,为改善睡眠质量,促进人群健康策略制定提供依据。方法采用现况研究的调查方法,以匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)评定厦门市睡眠日咨询活动现场的一般人群睡眠质量及影响因素。结果调查的497人中,有146人PSQI总分≥8分,睡眠质量差的发生率为29.38%;男性睡眠质量差的发生率为32.08%,女性睡眠质量差的发生率为27.74%,睡眠质量差发生率有随年龄增加而上升的趋势(P0.05),依次为31岁～(30.56%),41岁～(44.44%),51岁及以上(46.75%);已婚人群睡眠质量低于未婚人群(P0.05);低收入和高文化程度人群睡眠质量差发生率高。结论一般人群睡眠问题的发生率较高,应积极开展相关的健康教育,促进一般人群生活质量的整体提高。     

2010年厦门市城区一般人群睡眠质量调查

[目的]了解厦门市一般人群睡眠状况及影响因素,为改善睡眠质量、促进人群健康提出对策。[方法]2010年3月,在厦门市城区采用以匹兹堡睡眠质量指数量表（PSQI）评定497名一般人群的睡眠质量。[结果]调查497人,PSOI总分为6.36±3.67分,其中睡眠质量好的占35.21%,质量一般的占35.41%,质量差的占29.38%。睡眠质量差的所占比例,男性为32.08%,女性为27.74%（P〉0.05）;有随着年龄的增长逐渐增高的趋势,不同年龄的差异有统计学意义（P〈0.01）;未婚者为24.59%,已婚者为33.99%（P〈0.05）。睡眠质量差的人群PSQI得分,男性、女性分别为11.05±2.75分、11.08±2.84分（P〉0.05）;已婚者与未婚者分别为11.74±2.81分、10.10±2.47分（P〈0.01）。其中,入睡时间得分女性高于男性,睡眠时间得分男性高于女性（P〈0.01）;睡眠时间、睡眠效率紊乱、催眠药物得分均为已婚者高于未婚者（P〈0.01或〈0.05）。[结论]一般人群中存在睡眠问题者所占比例较高,这一比例年龄大者、已婚者较高。     

Associations of Diet Quality and Sleep Quality with Obesity

Short sleep duration or poor sleep quality has been associated with an increased risk of obesity. Although the underlying mechanism remains unclear, one proposed pathway is poor diet quality. This cross-sectional study investigated whether diet quality modifies the association between sleep status and obesity in Korean adults. We used the baseline data and samples of 737 men and 428 women (n = 1165) aged 19–64, who participated in the prospective Ewha–Boramae cohort study. Sleep duration was dichotomized into ≥7 h (adequate) and <7 h (insufficient). Pittsburgh Sleep Quality Index (PSQI) values, reflecting sleep quality, were dichotomized into >5 (poor quality) and ≤5 (good quality). Diet quality was evaluated by the Recommended Food Score (RFS). Obesity was associated with higher rates of insufficient sleep and poor sleep quality in women, but not in men. After adjustment for covariates, women with poor sleep quality had a higher risk of obesity than women with good sleep quality (OR = 2.198; 95% CI = 1.027–4.704); this association occurred only in the group with RFS ≤ median score. Our findings support a significant association between sleep quality and obesity, and this association has been potentially modified by dietary quality in women.     

Criterion validity of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale for the diagnosis of sleep disorders

Objectives(1) To examine criterion validity of the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) using obstructive sleep apnea (OSA), periodic limb movement disorder (PLMD), rapid eye movement sleep behavior disorder (RBD), and narcolepsy as criterion standard. (2) To summarize the evidence for criterion validity of the ESS for the diagnosis of OSA by a meta-analysis that combines the current and previous studies. (3) To investigate the determinants of the PSQI and ESS scores.MethodsThe PSQI and ESS as well as the Hospital Anxiety and Depression Scale (HADS), which measures anxiety and depression levels, were administered to 367 patients consecutively referred to a sleep clinic. They underwent overnight polysomnography (PSG) and the multiple sleep latency test if narcolepsy was suspected.ResultsThe area under the receiver operating characteristic curves for the ESS and PSQI (and its subscale) were <0.9, meaning that these questionnaires were not highly accurate for predicting the four sleep disorders. The meta-analysis found that the ESS had no value in identifying OSA. The variable that most strongly influenced PSQI or ESS scores was the HADS score.ConclusionThe PSQI and ESS should no longer be used as a screening or diagnostic instrument for the four PSG-defined sleep disorders, especially in a low-risk population.