Association of weekday-to-weekend sleep differences and stress response among a Japanese working population: a cross-sectional study

ObjectivesTo investigate the relationship between differences in weekday-to-weekend sleep habits and stress responses in a working population.MethodsThis cross-sectional study used data from university workers on sleep habits, differences in sleep duration between weekdays and weekends, and each midpoint of the sleep phase on weekdays and weekends. Social jetlag was defined as the difference in the midpoint of the sleep phase between weekdays and weekends. In addition, the Brief Job Stress Questionnaire assessed stress responses and stress-related factors. To examine sleep-related factors affecting stress responses, regression analysis was performed with adjustments for age, sex, and stress-related factors.ResultsAnalyzed were 2,739 participants. Sleep duration differences obtained by subtracting sleep duration on weekdays from that on weekends, social jetlag, and weekday sleep duration were significantly associated with an increased risk of stress responses in a univariate linear regression model. Adjusting for age, sex, job stressors, and stressor buffering factors did not change this trend. However, when additionally adjusting for all sleep parameters, only sleep duration differences and weekday sleep duration were significantly associated with stress responses (β 0.67 [95% CI 0.24, 1.10], p = 0.002), (−0.66 [-1.20, −0.13], p = 0.015).ConclusionsThis study provided further evidence that weekday sleep duration and weekday-to-weekend sleep duration differences were independently associated with stress responses even when considering stress-related factors. However, social jetlag was not clearly associated with stress responses. Our findings highlighted the necessity of securing sufficient sleep for stress management and mental health promotion in a working population.     

Stressful life events and poor sleep quality: a cross-sectional survey in the Chinese governmental employees

Evidence has shown that stressful life events are associated with sleep quality, yet studies on employees are scarce. In the present study, we explored the association between stressful life events and sleep quality in Chinese governmental employees. The cross-sectional data on 10,994 Chinese governmental employees aged 20–60 years were derived from a cohort study on chronic diseases of governmental employees in Hunan Province, China. Logistic regression models were used to calculate the adjusted odds ratio (OR) and the 95% confidence interval (CI). Of the participants, 3517 (32.0%) reported poor sleep quality in the past month. Participants who experienced more than two life events in the past year were associated with 3 times (OR: 3.681, 95%CI:3.287–4.123) greater likelihood of poor sleep quality. Negative life events, but not positive life events, were significantly associated with poor sleep quality. Regarding the types of events, economic-related life events were associated with poor sleep quality only in employees aged 20–35 years. Regarding the specific life events, work stress, job dissatisfaction, pregnancy or wife pregnancy,quality in Chinese governmental employees. discord with spouse's parents, separation from spouse due to work, bad relationship between spouse, unsatisfied sex life, misunderstood, blamed, false accusation or argument, and lifestyle changes were significantly associated with poor sleep quality. When stratified by sex, age and occupational position, the association of specific events and sleep quality were different. The present study showed that cumulative life events, negative life events and several specific events were significantly associated with poor sleep quality on Chinese governmental employees.     

The role of sleep in the consolidation of route learning in humans: a behavioural study

Considerable evidence support the role of sleep in learning and memory processes. In rodents, the relationships between sleep and memory consolidation have been extensively investigated by taking into account mainly spatial learning. On the contrary, in humans the relationship between sleep and spatial memory consolidation has so far been scarcely taken into account. Here, we investigated the importance of sleep in the consolidation of the spatial memory traces of a new route learned in a real-life unfamiliar environment. Fifty-one subjects followed a defined route in a neighbourhood they had never been to before. Then, they were tested in the laboratory in a sequence-recognition test requiring them to evaluate whether or not sequences of three views, taken along the route, represented a correct sequential order as seen while walking along the route. Participants were then assigned to one of three groups: the sleep group was retested after one night's sleep, the sleep-deprived group was retested after a night of sleep deprivation, and the day-control group was retested the same day after 8h of wakefulness. At retest, performance speed increased in all groups, whereas the accuracy in the sequence-recognition task was improved only in the sleep group: neither sleep deprivation nor the simple passage of time gave way to any performance improvement. These preliminary findings shed more light on the role of sleep in spatial memory consolidation by extending to humans the considerable evidence found in animals.     

Influence of respiratory allergy and restless sleep on definite sleep bruxism: a cross-sectional clinical study

ObjectiveThis cross-sectional clinical study evaluated the associations between sociodemographic, occupational, clinical conditions, psychological and sleep quality variables on definite sleep bruxism (SB).MethodsAll records obtained from adults (aged 20–60 years) and the elderly (aged >60 years) who had undergone polysomnography (PSG) at a private medical outpatients’ clinic from July 2017 to February 2018 were reviewed. Data from a questionnaire, based on the criteria of the American Academy of Sleep Medicine (AASM), were also gathered. Definite SB data pattern distribution was analyzed, and multivariate Poisson regression with robust variance was used to assess the associations between definite SB diagnosis, determined via PSG recordings, and the independent variables. A significance level of 5% was adopted.ResultsA total of 240 individuals were included in the study and the SB prevalence was 7.08% (n = 17). The adjusted Poisson regression analysis revealed association between definitive SB and individuals with respiratory allergy (PR = 3.63; 95% CI:1.01–13; P = 0.047) and restless sleep (PR = 2.97; 95% CI:1.04–8.50; P = 0.042).ConclusionThis study found associations between definite SB and clinical conditions (respiratory allergy) and sleep behavior (restless sleep). Knowledge regarding factors associated with definite SB can contribute to decision making in the clinical setting and management strategies involving a multidisciplinary approach.     

Perceived stress and sleep quality among the non-diseased general public in China during the 2019 coronavirus disease: a moderated mediation model

BackgroundThe 2019 coronavirus disease (COVID-19) has spread worldwide, and its associated stressors have resulted in decreased sleep quality among front-line workers. However, in China, the general public displayed more psychological problems than the front-line workers during the pandemic. Therefore, we investigated the influence of perceived stress on the sleep quality of the non-diseased general public and developed a moderated mediation model to explain said relationship.MethodsQuestionnaire-based surveys were conducted online from February 18–25, 2020 with 1630 Chinese participants (aged 18–68 years).ResultsAround one-third (36.38%) of participants were poor sleepers during the COVID-19 pandemic. Moreover, higher perceived stress was significantly associated with higher anxiety levels, which, in turn, was associated with lower sleep quality. Self-esteem moderated the indirect effect of perceived stress on sleep quality through its moderation of the effect of perceived stress on anxiety. This indicated that the mediation effect of anxiety was stronger in those with low levels of self-esteem than in those with high levels of self-esteem.ConclusionsThese findings suggest that both the sleep quality and perceived stress levels of the non-diseased general public required attention during the COVID-19 pandemic. Our findings also identify personality characteristics related to better sleep quality, demonstrating the important role of self-esteem in environmental adaptation.     

癫痫患者认知功能与睡眠质量的关系

目的 探讨癫痫患者认知功能与睡眠质量的关系.方法 对50例癫痫患者(试验组)及40例正常人(对照组)行蒙特利尔认知评估量表(MoCA)、Epworth嗜睡量表(ESS)和匹兹堡睡眠质量指数问卷(PSQI)评定,分析认知功能与睡眠质量的关系.结果 试验组与对照组认知功能障碍、嗜睡和睡眠紊乱检出例数分别为:42/50(84.00%):3/40(7.50%)(P＜0.05)、26/50(52.00%):9/40(22.50%)(P＜0.05)和13/50(26.00%):5/40(12.50%)(P＜0.05).两组患者的MoCA总分、MoCA 7个子项目、ESS总分、PSQI总分、PSQI子项目睡眠效率和睡眠障碍计分比较,差异有统计学意义(P＜0.05).相关分析显示MoCA总分与身高和文化程度呈正相关(r分别为0.361和0.321,P＜0.05),与年龄和发作频率呈负相关(r分别为-0.273和-0.271,P＜0.05).MoCA子项目记忆力和抽象能力分别与PSQI子项目催眠药物和日间功能障碍呈负相关(r分别为-0.262和-0.270,P＜0.05).结论 癫痫患者存在认知功能障碍和睡眠紊乱,癫痫患者认知功能影响因素有身高、文化程度、年龄和发作频率,记忆力和抽象能力分别与催眠药物及日间功能障碍相关.     

Relationship between stress coping and sleep disorders among the general Japanese population: a nationwide representative survey

ObjectiveTo clarify the prevalence of stress, and examine the relationship between sleep disorders and stress coping strategies among highly stressed individuals in the general Japanese population.MethodsA cross-sectional nationwide survey was undertaken in November 2007. Men and women were randomly selected from 300 districts throughout Japan. Data from 7671 (3532 men (average age 53.5 ± 17.0 years) and 4139 women (average age 53.9 ± 17.7 years)) were analyzed. Participants completed a self-reported questionnaire on stress, sleep disorders, and stress coping strategies in the previous month.ResultsHighly stressed individuals comprised 16.6% (95% confidence interval 15.8–17.5%) of the total sample, and most were aged 20–49 years. In multiple logistic regression, symptoms of insomnia (ie, difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening), excessive daytime sleepiness, nightmares, daytime malfunction, and lack of rest due to sleep deprivation were more prone to occur in highly stressed individuals. In addition, logistic regression analysis controlling for other adjustment factors revealed that stress coping strategies such as ‘giving up on problem-solving’, ‘enduring problems patiently’, ‘smoking’ and ‘drinking alcohol’ were positively associated with the above-mentioned sleep disorders. On the other hand, stress coping strategies such as ‘exercising’, ‘enjoying hobbies’, and ‘sharing worries’ were inversely associated with the above-mentioned sleep disorders.ConclusionsDistraction-based stress coping (eg, hobbies, exercise, and optimistic thinking) was found to be preferable to problem-based stress coping in a highly stressed Japanese general population.     

临床干预对颈椎病患者抑郁情绪和睡眠质量的效果分析

目的观察临床干预对颈椎病患者抑郁情绪和睡眠质量的效果。方法选取我院2013—2015年住院接受治疗的颈椎病患者82例为研究对象,使用数字表法随机分组为观察组和对照组各41例,对照组给予常规护理,观察组给予焦点解决护理,观察2组睡眠质量和抑郁情绪改善情况。结果护理后,2组抑郁情绪与睡眠质量均得到改善,观察组优于对照组,差异有统计学意义(P0.05)。结论针对颈椎病患者实施焦点解决护理,可有效提高睡眠治疗,同时使得患者的抑郁情绪得到明显改善,值得应用推广。     

The impact of sleep quality on the mental health of a non-clinical population

IntroductionSleep quality relates to mental health in clinical and non-clinical populations. However, there is more evidence of this relationship in clinical populations. Therefore, there is lack of evidence on how these variables relate and on which sociodemographic factors influence this relationship in non-clinical populations. In this study we hypothesize that in a non-clinical population sleep quality predicts mental health indicators and that age, country and gender moderate this relationship.MethodsIn a sample of 1552 subjects from Portugal, Spain and Brazil, self-reported sleep quality and mental health indicators were assessed through the Pittsburgh Sleep Quality Index and the Depression, Anxiety and Stress Scale-21, respectively. A multivariate linear regression model was used to test the research hypotheses.ResultsThis adjusted model explained 10.1%, 12.3% and 13.1% of the variability of Depression, Anxiety and Stress, respectively, suggesting multiple sources of variance.ConclusionsOur results confirmed that sleep quality predicts mental health in non-clinical populations, and that the variable country is a significant moderator of this relationship.     

Associations between sleep bruxism,sleep quality,and exposure to secondhand smoke in Japanese young adults: a cross-sectional study

ObjectiveSleep bruxism, a major sleep disorder that causes serious harm to oral health, is considered a multifactorial disease. Sleep bruxism can be induced by smoking, which also adversely affects sleep quality. The objective of present study was to clarify the associations between sleep bruxism, sleep quality, and exposure to secondhand smoke (SHS).MethodsTo assess the prevalence of sleep bruxism, sleep quality, and SHS exposure, we conducted oral examinations and self-report questionnaires on university students in Japan. Sleep bruxism and quality were screened using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI) and the third edition of the International Classification of Sleep Disorders (ICSD-3). The inclusion criteria were adults aged between 18 and 19 years, non-smokers and non-alcohol drinkers. The exclusion criteria was failing to complete the questionnaire in full.ResultsWe analyzed a total of 1781 Japanese young adults. Young adult females who had been exposed to SHS had worse sleep quality (p = 0.019) than those who had not. Young adult female with worse sleep quality showed a higher prevalence of sleep bruxism (p = 0.034) than those with better sleep quality. Using structural equation modeling, direct associations were identified between SHS exposure and poor sleep quality (standardized coefficients, 0.153; p = 0.008) and between sleep bruxism and poor sleep quality (standardized coefficients, 0.187; p = 0.022) in young adult females. However, no association was found among young adult males.ConclusionSHS exposure is indirectly associated with sleep bruxism through poor sleep quality in Japanese young adult females.     

Association between sleep quality and subjective cognitive decline: evidence from a community health survey

ObjectivesLittle is known concerning whether subjective cognitive decline (SCD) is associated with sleep quality. This study aimed to identify the association between self-reported quality of sleep and SCD in a large population of middle-aged and older adults in Korea.MethodsWe conducted this study based on data collected from the 2018 Korean Community Health Survey. Individuals aged 40 years and older who responded to the Behavioral Risk Factor Surveillance System (BRFSS) and Pittsburgh Sleep Quality Index (PSQI) assessments and did not lack data about multiple covariates were included. A total of 37,712 respondents with SCD and 135,119 those without SCD were included. Sleep quality was estimated using the PSQI, which includes seven self-reported components for sleep health assessment. SCD was assessed using the BRFSS. Logistic regression models adjusted for confounders were used to examine whether each component of the sleep quality index was related to SCD. Additional analysis of the correlation between quantified scores for each component and SCD-related functional limitations as ordinal variables was performed.ResultsThe mean age was 62.7 years in the SCD group and 56.4 years in the control group. In total, 13,777 (28.9%) respondents were male in the SCD group and 62,439 (50.7%) in the control group. The adjusted odds ratios of SCD were 1.25 for very bad sleep quality, 1.26 for long sleep latency, 1.16 for <5 h of sleep duration, 1.08 for <65% habitual sleep efficiency, 2.29 for high sleep disturbance, 1.26 for use of sleep medication ≥3 times a week, and 2.47 for high daytime dysfunction due to sleep problems compared to good sleep conditions. Furthermore, a higher score for each component of the sleep quality index correlated with greater SCD-related functional limitations.ConclusionsOur study provides evidence that poor sleep quality is closely related to both SCD and SCD-related functional limitations.     

The association between sleep quality and quality of life: a population-based study

ObjectivesThis study aimed to evaluate the association between sleep quality and quality of life (QoL).MethodsThis cross-sectional study included 225,541 adults (101,133 men, 124,408 women) who participated in the 2018 Korean Community Health Survey. Multiple sociodemographic and psychosocial variables were evaluated and compared between participants with poor (n = 67,619) and good sleep quality (n = 157,922); sleep quality was subjectively determined using the Pittsburgh Sleep Quality Index (PSQI). The EuroQol five-dimension (EQ-5D) index scores were adjusted for multiple confounding factors and compared between the good and poor sleep quality groups. A logistic regression analysis was used to identify determinants of the lowest quartile of QoL.ResultsThe mean EQ-5D index scores were significantly lower in the poor sleep quality group (score 0.85) than in the good sleep quality group (score 0.92; p < 0.001). The multivariate odds ratio (OR) for the lowest quartile of the EQ-5D index scores in the poor sleep quality group versus that in the good sleep quality group was 1.95 (95% confidence interval [CI], 1.89–2.00). Participants with poor sleep quality were more likely than those with good sleep quality to have some or severe problems with physical activity (OR, 1.46; 95% CI, 1.41–1.51), self-control (OR, 1.35; 95% CI, 1.29–1.42), daily activity (OR, 1.44; 95% CI, 1.39–1.50), pain (OR, 1.81; 95% CI, 1.77–1.86), and anxiety/depression (OR, 2.24; 95% CI, 2.17–2.31).ConclusionPoor sleep quality is associated with impaired QoL, particularly if some or severe problems with anxiety/depression are present.     

2013年某部新兵睡眠质量和疲劳状况及关系

目的了解新兵的睡眠质量和疲劳状况及二者的关系,为改善新兵的睡眠质量提供参考依据。方法于2013年1月在某部1100名男性新兵中随机抽取200名为研究对象,并应用匹兹堡睡眠质量指数量表(PSQI)和疲劳量表-14(FS-14)进行问卷调查。结果 PSQI总分平均分为(5.21±2.71)分,FS-14总分平均分为(4.92±3.12)分。躯体疲劳与主观睡眠质量(SSQ)、睡眠时间(Sdu)、睡眠效率(HSE)、睡眠干扰因素(Sdi)、应用催眠药物(USM)、白天功能障碍(DD)及PSQI总分呈正相关;脑力疲劳与SSQ、Sdi、DD及PSQI总分呈正相关(r=0.628～0.226,P0.05);疲劳总分与SSQ、Sdu、HSE、Sdi、DD及PSQI总分呈正相关(r=0.578～0.269,P0.001)。结论新兵的睡眠质量和疲劳状况较2010年新兵及普通男性相对差;改善新兵的疲劳状况有助于提升新兵的睡眠质量。     

The role of sleep disturbance in the relationship between post-traumatic stress disorder and suicidal ideation

We tested if the risk of suicidal ideation in individuals with PTSD symptoms was dependent on comorbid sleep disturbance. Our cross-sectional sample included 2465 participants with complete data from the 21 year follow-up of the Mater University Study of Pregnancy (MUSP), a birth cohort study of young Australians. Using structural equation modelling with indirect pathways we found that 12 month PTSD symptoms did not directly predict suicidal ideation at 21 when adjusting for major depression symptoms, polyvictimization and gender. However, PTSD symptoms had an indirect effect on suicidal ideation via past-month sleep disturbance. Our results suggest that increased suicidal ideation in those with PTSD may result from the fact that PTSD sufferers often exhibit other comorbid psychiatric conditions which are themselves known to predict suicidal behaviours. Sleep disturbance may be targeted in those who experience PTSD to help prevent suicidal ideation.     

Posttraumatic stress and sleep: differential relations across types of symptoms and sleep problems

Posttraumatic stress symptoms and self-reported sleep problems reliably covary. The current study investigated how posttraumatic stress symptom clusters (i.e., hyperarousal, avoidance, and reexperiencing) relate to trouble initiating and maintaining sleep and nightmares. Participants included traumatic event-exposed respondents from the NCS-R. Results suggested that posttraumatic stress symptom severity is related to trouble initiating and maintaining sleep and nightmares. Investigation of symptom clusters indicated that reexperiencing symptoms were related to trouble initiating and maintaining sleep and nightmares, while hyperarousal symptoms were related to trouble maintaining sleep and nightmares. Findings partially support both reexperiencing and hyperarousal-based models of the relation between sleep and posttraumatic stress.     

Health-related quality of life and sleep quality among North Indian type 2 diabetes mellitus patients: evidence from a cross-sectional study

ObjectiveThe objective of this study is to measure the relationship between sleep quality and health-related quality of life (HRQOL), in Indian population with type 2 diabetes mellitus (T2DM).MethodsA cross-sectional study, included a total of 300 patients with T2DM. All participants were responding to the Pittsburgh Sleep Quality Index (PSQI) and European Quality of Life-5 Dimensions Questionnaire (EQ-5D). A PSQI global score ≥5 was defined as poor sleep quality. EQ-5D visual analogue scale (VAS), determining the overall health status. Logistic regression analysis was used to examine the association between PSQI and EQ-5D. All the study data were analysed using the SPSS software version 20.0. Values of p < 0.05 were considered statistically significant.ResultsThe mean age of included participants were 55.29. Majority of the participants (55.3%) were identified as “poor sleepers” and female (31.3%) contributing higher proportion. Poor sleepers had significantly lower the HRQoL (p < 0.001). After adjustment, poor sleep quality was significantly associated with a lower HRQoL; EQ-5D index (OR = 1.080, 95%, CI: 1.015–1.148, p < 0.05), and EQ-5D VAS (OR = 1.092, 95%, CI: 1.021–1.176, p < 0.01). Overall, the EQ-5D index and EQ-5D VAS were found to be an independent predictors of sleep quality.ConclusionsPoor sleep quality is prevalent in Indian T2DM population, and it imparts negative impact on several dimensions of EQ-5D that characterising the daily activities performance. Therefore, further real-world studies are needed to determine the causal relationship between T2DM patients and measure of objective sleep and their impact on health.