Prevalence of sleep disorders among medical students and their association with poor academic performance: A cross-sectional study

The Sleep Condition Indicator and the Idiopathic Hypersomnia Severity Scale: Measurement Invariance and an Exploratory Network Approach in a French Sample of University Students

Insomnia and hypersomnolence symptoms are prevalent among university students, yet their assessment methods face limitations, and the relationship between these symptoms remains underexplored. We examined the structural invariance of the Sleep Condition Indicator (SCI) and the Idiopathic Hypersomnia Severity Scale (IHSS) in university students. In addition, we proposed a network approach to the insomnia and hypersomnolence symptoms. A total of 433 university students underwent a clinical interview for sleep and socio-demographics and completed the SCI and the IHSS. Confirmatory factorial and network analyses were conducted. The SCI demonstrated a two-factor structure, while the IHSS exhibited a three-factor structure. Over 70% of students scored above the IHSS clinical threshold, while 36.5% were diagnosed with insomnia. For the SCI, a threshold of ≤ 13 demonstrated the highest predictive value for diagnosing insomnia. Network analyses highlighted the central role of cognitive consequences of insomnia and hypersomnolence. Cognitive and emotional consequences of insomnia and hypersomnolence were moderately interconnected. Higher cognitive complaints related to insomnia were associated with increased feelings of insufficient sleep and more pronounced sleep inertia. Additionally, greater wakefulness after sleep onset was linked to both a shorter ideal night-time sleep duration and increased difficulty staying awake during low-stimulation activities throughout the day. The SCI and IHSS showed structural invariance in university students when compared to the general population. Insomnia and hypersomnolence represent critical clinical issues among French students. We underscored the intricate relationship between insomnia and hypersomnolence, highlighting the urgent need for targeted interventions that address both daytime and nighttime sleep-wake disturbances.

Eating behavior and physical activity in relation to obesity among medical students at Mansoura University, Egypt

Background/Aim

Medical students are subjected to the risk of obesity due to various factors. Understanding behavioral issues may provide an important insight into obesity development, prevention, and treatment. Emotional, uncontrolled, and restrictive eating practices are problematic eating behaviors characterized by food intake independent of hunger but based on emotional state. Limited data from Egypt are currently available; therefore, this study was undertaken with the objective to find the frequency of overweight and obesity among medical students at Mansoura University, Egypt. Eating behavior and physical activity in relation to overweight/obesity were also assessed.

Methods

A total of 368 undergraduate medical students were included in this study. Eating behavior was described using the French translation of Three-Factor Eating Questionnaire-R18. Obesity and physical activity were assessed according to WHO recommendations.

Results

Among the total students, 54% were normal weight, 32% were overweight, 9% were obese class I, 2% were obese class II, 1% were obese class III, and 2% were underweight. Overweight/obese students had significantly lower physical activity than nonoverweight/obese. Cognitive restraint, uncontrolled eating, and emotional eating were significantly higher in overweight/obese compared with nonoverweight/obese students. Cognitive restraint, uncontrolled eating, and emotional eating were significantly correlated with body mass index. Uncontrolled eating was negatively correlated with sex and residence, whereas emotional eating was negatively correlated with physical activity. Female sex, physical inactivity, increased cognitive restraint, and increased emotional eating scores were significant predictors of obesity in the studied medical students.

Conclusion

Medical students are likely to be overweight or obese. The main risk factors associated with overweight and obesity are female sex, lack of physical activity, and cognitive and emotional restraint but not uncontrolled eating.

Perceptions of Medical Residents About Sleep Disorders and Sleep Medicine in Qassim Province, Saudi Arabia

Background Sleep disorders have increased drastically over the past few decades due to lifestyle, environmental, and geographical factors and individual high-level financial goals and requirements. The study aims to identify the prevalence of sleep disorders among Qassim residents and to determine the risk factors associated with sleep disorders. Methods A cross-sectional study was conducted among 150 Saudi Board residents of different postgraduate programs in Qassim Province using a self-administered questionnaire through Google Forms (Google, Inc., Mountain View, CA), and 105 participants responded. Data was analyzed using the SPSS version 21.0 (IBM Corp., Armonk, NY) and necessary statistical tests; the chi-square test was applied for sleep disorder symptoms and risk factors, with the prevalence of sleep disorder as a category. Results In our study, 43.8% (n=46) were men; the mean age and standard deviation in the study population was 28.30±2.77 years. Approximately 98.1% (n=103) of residents were aware of sleep disorders. About 82.9% (n=87) of residents were aware of breathing difficulty for a sleep disorder. Regarding symptoms of obstructive sleep apnea (OSA), hypersomnia and hyposomnia prevalence were 40% (n=42) and 41.9% (n=44), respectively. Concerning challenges, about 98.5% (n=68) believed that training is required to treat sleep disorders. About suggestions, 22.7% (n=10) stated that lifestyle modifications are required, and 20.5% (n=9) mentioned the establishment of sleep clinics. There was a statistically significant association observed between sleep disorder prevalence with sleepwalking, hypersomnia, and hyposomnia (P<0.05). Conclusions Based on the study findings, the Qassim Board residents' awareness of sleep disorders is excellent. More than two-fifths of residents (40% and 41.9%) had hypersomnia and hyposomnia symptoms, respectively. Most residents (98.5%) mentioned that training is required to treat sleep disorders as a challenge and suggested lifestyle modifications and sleep clinics.

Sleep Quality Among a Sample of Medical Students and the Association with Academic Performance: An Updated Data

Sleep is influenced by various factors, including social, economic, genetic, and medical factors, and work and study schedules. Medical students are highly susceptible to sleep-related problems. In this study, we aimed to evaluate the sleep patterns and quality of medical students and determine their correlation with academic achievement. This cross-sectional study was conducted at the King Abdulaziz University between November 2022 and April 2023. The participants completed an online questionnaire distributed to all medical students via social media channels. The questionnaire included the Pittsburgh Sleep Quality Index to assess sleep quality and Epworth Sleepiness Scale to measure excessive daytime sleepiness (EDS). Academic performance was self-reported by students based on their grade point average. Of the 274 participants, 54.0% were males with a mean age of 22.81 years. Only 21.5% of students reported normal sleep quality during the previous month, with almost 78.5% reporting poor sleep quality and 40.9% experiencing EDS. Notably, no associations were observed between the sleep quality and sleep-wake patterns and academic performance of the students (p = 0.324 and 0.784, respectively). These findings highlight the substantial prevalence of poor sleep quality and EDS among Saudi medical students, consistent with global trends. Unexpectedly, no significant correlation was observed between sleep quality and student academic performance. These findings suggest that the demanding nature of medical education significantly impacts the sleep patterns and overall well-being of students.

Obstructive Sleep Apnea: Prevalence, Risk Factors, and Impact on the Academic Performance of Medical Students at a Saudi Arabian University

Background

Obstructive sleep apnea (OSA) is a common condition, but there is a lack of evidence from Saudi Arabia regarding its impact on the academic performance of medical students.

Objectives

To determine the prevalence and associated factors of OSA among medical students at a Saudi Arabian university and its impact on academic performance.

Methods

This cross-sectional study was conducted between October and December 2021 and selected first- to fifth-year medical students at King Saudi University, Riyadh, using a disproportionate stratified random sampling according to gender and academic year. The questionnaire comprised two sections: the first elicited sociodemographic information, self-reported GPA, and presence of chronic diseases, while the second included the English and Arabic versions of the Berlin Questionnaire.

Results

A total of 621 responses were received, of which 61.8% were male and the mean age was 21.1 (±1.7) years. The prevalence of high-risk OSA was 14.5%. There was a significant association between being at a high risk of OSA and male gender (P < 0.001). In the multiple logistic regression model, male gender (odds ratio [OR] = 1.69, 95% CI: 1.01-3.9; P = 0.047) and overweight/obesity (OR = 2.59, 95% CI: 1.92-3.5; P = 0.001) were significant predictors of OSA. OSA was not a significant predictor of academic performance (OR: 0.7, 95% CI: 0.48-1.03; P = 0.07).

Conclusion

This study found that among first- to fifth-year medical students at a Saudi Arabian university, male gender and obesity were significant predictors of obstructive sleep apnea. On the other hand, obstructive sleep apnea was not a significant predictor of academic performance.

Linguistic validation of the Epworth Sleep Scale among healthy individuals into Moroccan dialect

BACKGROUND/AIM

We performed a linguistic validation of the original version of the Epworth Sleep Scale (ESS) into the Moroccan dialect according to Guillemin's guidelines.

MATERIALS AND METHODS

After translating the English version of the ESS according to the standard guidelines, we asked 120 healthy subjects to complete the questionnaire twice with an interval of 10 days. We assess the acceptability and internal reliability by Cronbach's alpha coefficient, while for the test-retest reproducibility we use the interclass correlation coefficient (ICC) (95% confidence interval (CI)) and the kappa coefficient.

RESULTS

11-13% of subjects reported excessive sleepiness. The translated version was acceptable. A Cronbach's alpha coefficient of 0.71 and 0.70 was obtained for the entire 8-item scale on test and retest, respectively. Intra-observer reproducibility (test-retest) was satisfactory for the ESS scale with an ICC (95% CI) of 0.71 (0.618; 0.779). The kappa coefficient was 0.88, indicating excellent agreement.

CONCLUSION

These results indicate that the psychometric properties are adequate compared to the original version. Therefore, this translated version should be used to assess sleep in the Moroccan population.

The prevalence of sleep disorders in Iranian adults - an epidemiological study

BACKGROUND

Sleep disorders can be harmful to our health and treating them can also be expensive. Due to the widespread occurrence and impact of sleep disorders, it is valuable to investigate and study them from an epidemiological perspective. Therefore, this study aimed to determine the prevalence of sleep disorders among Iranian adults in 2022.

METHOD

This is a cross-sectional study that examines the prevalence of sleep disorders and problems in Iranian society. The participants were selected using a mixed sampling approach (utilizing virtual space and cluster sampling). A two-part package was used for evaluating participants sleep problems, which included a demographic profile form and the Holland Sleep Disorders Questionnaire. After collecting the data, appropriate statistical tests in SPSS version 25 were utilized for analysis.

RESULTS

A total of 6013 questionnaires were fully filled out for this research, with participants answering the specific questions. The participants' score on sleep disorders was 1.94, which means 44.1% of them suffer from sleep disorders. The results indicated that the prevalence of sleep disorders in this study was as follows: insomnia (35%), parasomnia (35.3%), circadian rhythm sleep disorder (38.4%), hypersomnia and excessive daytime sleepiness (39%), restless leg syndrome and leg movements during sleep (43%), and breathing disorders related to sleep (38.4%). The prevalence of sleep disorders among the study participants demonstrated a significant relationship with most of their demographic variables (P < 0.001). The Pearson correlation coefficient also revealed an inverse and significant relationship between the prevalence of sleep disorders in the study participants and their age, monthly household income, and BMI (P < 0.001).

CONCLUSION

Overall, the results depicted a relatively high prevalence of sleep disorders in the studied community. These findings emphasize the need for interventions to prevent and treat sleep disorders in society.

Prevalence of Sleep Disturbance Potential-Associated Factors among Undergraduate Pharmacy Students in Saudi Arabia

Background

Many studies across the globe have observed the significant effect of sleep disturbance on the academic achievement of medical students. Objective: This research was conducted to define the prevalence of sleep disturbance and to discover the consequences and management of this condition among undergraduate pharmacy students of Mohammed Al-Mana College for Medical Sciences (MACHS).

Methods

We conducted a questionnaire-based online survey among different levels of MACHS pharmacy students.

Results

A total of 165 students participated in the study, of whom 132 (80%) were females and 33 (20%) were males. Most of the participants, 142 (86.06%), were staying with their parents, whereas few of them were staying alone (23; 13.94%). While a handful of them, 29 (17.58%), did not have their bedrooms, most of them had their bedrooms (136; 82.42%). When asked about drinking caffeine-rich products in the afternoon or at night, most of them responded "sometimes" (78; 47.27%), followed by the category "always" (61; 36.97%), "rarely" (15; 9.09%), and then the category of students who responded "not at all" (11; 6.67%). Overall, 35 (21.21%) of the study participants had a smoking habit, 72 (43.63%) tried to treat their sleep disturbance, whereas 42 (25.45%) were getting treatment for insomnia.

Conclusion

Most pharmacy students at MACH College, especially females, have sleep problems. Mostly, the prevalence is common during exam periods, and it mildly affects their grade point average.

Comparing the Prevalence of Sleep Disorders Among Underweight, Normal, Overweight, and Obese Adults in Riyadh, Saudi Arabia

Background Sleep disorders are prevalent worldwide and can have a negative impact on physical and psychological well-being. Numerous studies have explored the reciprocal connection between obesity and sleep disorders. This study aimed to compare the prevalence of sleep disorders among underweight, normal, overweight, and obese adults in Riyadh, Saudi Arabia. Methods This cross-sectional study was conducted on 378 adults visiting primary healthcare centers in Riyadh, Saudi Arabia, from August to November 2022. Data were collected using a self-administered questionnaire that included a section for demographic data and the SLEEP-50 questionnaire in both English and Arabic languages. Results Most of the participants were aged between 25 and 34 years (37.6%), 79.1% were females and 59.5% were either overweight or obese. Most participants (78.3%) had at least one sleep disorder, with narcolepsy being the most frequent disorder (65.1%), and 23% had two combined sleep disorders. Obese and overweight patients were significantly more likely to have sleep disorders (p=0.011), and obese patients were more likely to have all sleep disorders (p=0.049). Conclusion The prevalence of sleep disorders, namely narcolepsy and insomnia, is high among adults in Riyadh, Saudi Arabia. Moreover, sleep disorders are significantly associated with obesity. Evaluation and management of sleep disorders in clinical settings among patient with overweight or obese is important to improve their quality of life and to prevent physical and psychological complications.

Sleep disorders and associated factors among medical students in the Middle East and North Africa: a systematic review and meta-analysis

Sleep disturbances like poor and insufficient sleep are common among medical students in the Middle East and North Africa (MENA) countries; however, the extent of medically defined sleep disorders (SDs) remains unclear. This meta-analysis determines SD prevalence and identifies associated factors among medical students in the MENA. PubMed, Web of Science, Google Scholar, and reference lists of included studies were searched (latest search: June 2022). Meta-analyses included 22 studies and were performed using random-effect models. Included studies used self-reported screening tools for assessing SDs and then estimated the proportion of participants at high risk of developing a SD. Central disorders of hypersomnolence were the most prevalent SD [prevalencepooled range: 30.9% (Jordan) to 62.5% (Saudi Arabia)], followed by insomnia disorders [prevalencepooled range: 30.4% (Jordan) to 59.1% (Morocco)], circadian rhythm sleep-wake disorders [prevalencepooled range: 13.5% (Jordan) to 22.4% (Saudi Arabia)], sleep-related breathing disorders [prevalencepooled range: 12.2% (Jordan) to 22.5% (Pakistan)], sleep-related movement disorders [prevalencepooled range: 5.9% (Egypt) to 30.6% (Saudi Arabia)], and parasomnias [prevalencepooled range: 5.6% (Jordan) to 17.4% (Saudi Arabia)]. Female sex, studying in the latter academic years, having anxiety, excessive internet use, and poor academic performance were significantly associated with SDs. SDs are prevalent among MENA medical students. Implementing student-centered interventions targeting high risk groups in medical schools should be considered to improve students' health and wellbeing.

Impact of traditional Chinese Baduanjin exercise on menstrual health among international female students studying in China: a randomized controlled trial

Background

Menstrual symptoms were the common complaints of international female students during the acculturation period, and the symptoms negatively affected the daily life and school performance of those women. The present study aimed to evaluate the effectiveness of the traditional Chinese Baduanjin exercise on reducing menstrual symptoms for international female students studying in China during the acculturation period.

Methods

We conducted a randomized controlled trial among 62 international female students who suffered menstrual symptoms during the first 6 months after arriving in China. The study was carried out at three campuses of the two largest universities in the capital of a province in south-central China from March to October 2021. After screening, participants were randomly assigned to a control or intervention group. The intervention group engaged in 24 weeks of Baduanjin exercise for at least 30 min per day. The menstrual symptoms, sociocultural adaptation, perceived stress, and sleep quality were evaluated at baseline, the 12th week, and the 24th week. The chi-square test or Fisher's exact test, paired sample t-test, and multivariate analysis of variance (MANOVA)were adopted to analyze the data using SPSS 25.0.

Results

Totally, 62 participants were enrolled in this study from 30 countries. Their mean age was 27.87 ± 5.58 years. None of the participants reported an adverse event. The results of the MANOVA test showed that the traditional Chinese Baduanjin exercise reduced the total score of MSQ among international female students (intervention: 47.83 ± 8.71 vs. control: 65.12 ± 16.86; F = 19.49, P < 0.01). In addition, the results of the MANOVA indicated statistically significant decreases in scores for the two subscales of MSQ: premenstrual symptoms (intervention: 17.07 ± 3.33 vs. control: 28.42 ± 7.56; F = 44.70, P < 0.01)and menstrual pain (16.03 ± 4.53 vs. 19.58 ± 5.14; F = 6.50, P < 0.05). Moreover, the results showed that traditional Chinese Baduanjin exercise reduced the scores of the sociocultural adaptation level, the perceived stress level, and sleep quality and improved the blood progesterone hormone and blood estrogen hormone.

Conclusion

Regular Baduanjin exercise is a safe, acceptable, and effective form of exercise to promote international female students' menstrual health, reduce stress levels, and improve sleep quality.

Trial registration

www.chictr.org.cn, Chinese Clinical Trial Registry: ChiCTR2300072376.

Night eating habits, sleep quality, and depression, are they associated with vitamin D status?

INTRODUCTION

In addition to the well-established roles of vitamin D on bone health, it also appears to be an effective factor on mental health and circadian behaviors, that include eating and sleeping habits.

OBJECTIVE

This study aimed to assess the association between vitamin D status with night eating habits, sleep quality and depression in female college students.

MATERIALS AND METHODS

This cross-sectional study studied healthy female students from Shiraz University of Medical Sciences, Iran. Demographic and anthropometric information as well as data on sleep quality and depression were recorded and serum levels of 25-hydroxyvitamin D were measured. A 3-day food record questionnaire was completed to assess night eating habits. Data analyses were undertaken using Chi-square, Mann-Whitney U test and logistic regression. A P-value of <0.05 was considered significant.

RESULTS

The study participants comprised of 272 female students with median (Inter Quartile Range) age of 22 (21-24) years. The majority of the participants (82.3 %) were classified as night eaters, who had higher rates of poor sleep quality compared to non-night eaters (P < 0.05). With 1 ng/ml increase in serum levels of 25-hydroxyvitamin D, the odds of being a night eater fell by 3 % (OR = 0.97; 95%CI = 0.95, 0.99), and the odds of having depression or poor sleep quality decreased by 5 % (OR = 0.95; 95%CI = 0.93, 0.97) and 6 % (OR = 0.94; 95%CI = 0.91, 0.97), respectively.

CONCLUSION

There was an inverse association between serum 25-hydroxyvitamin D level with night eating habits, depression and poor sleep quality. This association needs be confirmed using cohort and interventional studies.

Sleep Disorders' Prevalence and Impact on Academic Performance among Undergraduate Nursing Students in a Selected University, United Arab Emirates

Introduction

Throughout their academic pursuits, students may encounter various sleep-related issues, including insomnia, sleep apnea, hypersomnia, or sleep terror disorder. These disorders can profoundly impact their well-being, emotional state, and academic achievements.

Objective

This study, of significant relevance to the field of nursing and sleep disorders, aimed to investigate the prevalence of sleep disorders and their impact on academic performance among undergraduate nursing students in the United Arab Emirates.

Methods

A cross-sectional research method was implemented among 177 undergraduate nursing students. Two tools were used: Too I consisted of two parts: sociodemographic and academic performance classifications, whereas Tool II comprised the SLEEP-50 questionnaire.

Results

Our findings revealed that 30.6% of nursing students had one or more sleep disorders. Insomnia was the most prevalent among the nursing students (37.5%), followed by circadian rhythm (33.3%), narcolepsy (26.6%), sleep apnea and restless leg syndrome (25%), nightmares (22.2%), and sleepwalking (11.11%). There was a significant relation between restless leg syndrome and academic performance, while in linear regression analysis, it was found that the variable that most affects sleep is gender.

Conclusion

The implications of this study's findings are clear-nursing schools must intensify their efforts to raise awareness about the detrimental effects of sleep problems on academic performance. Furthermore, subsequent research is crucial to evaluate the execution of interventions aimed at preventing such disorders.

Assessment of Sleeping Disorders, Characteristics, and Sleeping Medication Use Among Pharmacy Students in Saudi Arabia: A Cross-Sectional Quantitative Study

BACKGROUND Insomnia is a growing problem, especially among university students, and is associated with sleep disorders, poor academic performance, and quality of sleep. The purpose of this study was to assess the prevalence of insomnia sleeping characteristics, managing techniques, and attitudes toward sleeping pill usage among pharmacy students. MATERIAL AND METHODS A cross-sectional web-based study was conducted among pharmacy students of King Saud University, College of Pharmacy, Riyadh, Saudi Arabia between February and March 2023. SPSS version 26 was used for data analysis. A P value of <0.05 and was considered statistically significant. RESULTS In this study, 61.7% (n=108) of the students' slept an average of 6-10 h and 35.4% (n=62) slept an average of 6 h. Regarding sleeping patterns, nearly two-thirds (n=112, 64%) of the students had day and night sleeping patterns while more than one-third (n=63, 36%) had only night sleeping patterns. In this study, 2.9% (n=5) of the students had severe clinical insomnia, while 21.7% (n=38) reported moderately severe clinical insomnia, 44% (n=77) of them had subthreshold insomnia, and 31.4% (n= 55) had no clinically significant insomnia. The mean scores of the insomnia severity index were significantly related to the usage of stimulants (P=0.048), average hours of sleep (P=0.0001), and average minutes needed to fall asleep (P=0.0001). CONCLUSIONS The current findings demonstrated varying levels of insomnia among students, yet few students used sleeping pills.

The Worldwide Prevalence of Sleep Problems Among Medical Students by Problem, Country, and COVID-19 Status: a Systematic Review, Meta-analysis, and Meta-regression of 109 Studies Involving 59427 Participants

Abstract

Purpose of Review

Several studies have found that medical students have a significant prevalence of sleep issues, such as poor sleep quality, excessive daytime sleepiness, and inadequate sleep duration. The purpose of this review is to carefully evaluate the current research on sleep problems among medical students and, as a result, estimate the prevalence of these disturbances. The EMBASE, PsychINFO, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science and retrieved article reference lists were rigorously searched and rated for quality. Random effects meta-analysis was performed to compute estimates.

Recent Findings

The current meta-analysis revealed an alarming estimated pooled prevalence of poor sleep quality (K = 95, N = 54894) of 55.64% [95%CI 51.45%; 59.74%]. A total of 33.32% [95%CI 26.52%; 40.91%] of the students (K = 28, N = 10122) experienced excessive sleepiness during the day. The average sleep duration for medical students (K = 35, N = 18052) is only 6.5 h per night [95%CI 6.24; 6.64], which suggests that at least 30% of them get less sleep than the recommended 7-9 h per night.

Summary

Sleep issues are common among medical students, making them a genuine problem. Future research should focus on prevention and intervention initiatives aimed at these groups.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40675-023-00258-5.

Immune fitness and lifestyle habits of Saudi medical students: a cross sectional study

Introduction

Immune function reaches an optimum level in young adults. However, young adults are more likely to adopt potentially harmful habits that may pose a risk to their long-term health and immune fitness, and which eventually may put a substantial burden on the healthcare system. This study aimed to assess the status of medical students' immune fitness, using the immune status questionnaire (ISQ) and exploring the association with the commonly adopted lifestyle habits hypothesized to have an impact on immune functions.

Methods

A descriptive, cross-sectional study was conducted among preclinical students attending the medical school of King Abdulaziz University. An online self-reported questionnaire was used to assess the immune status (ISQ), perceived (momentary) immune fitness, general health, lifestyle habits and students' perception of these lifestyle-associated impacts on immune fitness. Descriptive, Spearman's correlation and stepwise linear regression analyses were performed.

Results

In a pooled sample of 211 participants, the overall ISQ score was 6.00 ± 5.0 with statistically significant abnormally lower scores in females (ISQ 5.00 ± 5.0, p < 0.001). 49.29% of respondents experienced poor immune fitness as measured by the ISQ (<6). The ISQ score was significantly correlated with fast and fatty food consumption (p = 0.003), daytime sleepiness (p = 0.001), and BMI subgroups (p = 0.028) negatively and positively correlated with adherence to a program of exercise (p = 0.005). A total of 41.23% of participants who reported a normal immune health, rated at ≥6 were graded below 6 on the ISQ score. Only 62.6% of students were able to correctly identify the effects of fast and fatty food consumption on immune fitness.

Conclusion

Poor immune fitness was common among medical students in KAU and associated significantly with their adopted lifestyle habits. Although, other factors can be significant contributors, biased immune health perception and lack of awareness of these lifestyle-associated impacts on immune fitness and general health may hinder the adoption of healthier habits. Immune biomarkers should be implemented in future work.

Adjustment to lockdown in children and adolescents with narcolepsy in France

STUDY OBJECTIVES

The goal of the current study was to explore the effect of a 2-month quarantine on children and adolescents with narcolepsy and to describe the changes in their sleep, mood, and metabolism during this period.

METHODS

The study involved 77 patients aged 7 to 23 years with a diagnosis of narcolepsy. Participants had to answer multiple-choice questions to characterize the changes and modifications in their own habits and state of health.

RESULTS

Participants reported changes in daytime sleep, nighttime sleep schedules, treatment intake, food intake, weight, and amount of screen time. Most patients reported deterioration in their memory and attention abilities as well as a decrease in their work efficiency. Mood appeared to be less affected, although it deteriorated in less than one-third of the participants who reported feeling sad more often.

CONCLUSIONS

The prolonged and complete lockdown seemed to have an effect on children and adolescents with narcolepsy, and changes are often considered by the participants to depend on or to determine an overall quality of adaptation to the situation. This study highlights the importance of maintaining and strengthening time markers in individuals with narcolepsy and should help to establish guidelines that would apply in future quarantine situations.

CITATION

de Laclause AP, Konofal E, Bokov P, Delclaux C, Lecendreux M. Adjustment to lockdown in children and adolescents with narcolepsy in France. J Clin Sleep Med. 2022;18(9):2247-2252.

Trends in Insomnia, Burnout, and Functional Impairment among Health Care Providers over the First Year of the COVID-19 Pandemic

Background

COVID-19 pandemic has negatively impacted the psychological well-being and quality of life of health care providers (HCPs).

Objectives

This study assessed the trends in prevalence and predictors of insomnia, burnout, and functional impairment among HCPs over the first year of the pandemic.

Methods

An online survey was conducted one month after the pandemic's onset (onset group) and a year later (one-year group). The demographic features of participants were collected. Insomnia, burnout, and functional impairment were assessed using Insomnia Severity Index (ISI), Mini-Z survey, and Sheehan Disability Scale (SDS), respectively.

Results

The onset group included 211 HCPs (mean (SD) age 34.7 (9.3) years and 73% men), while 212 HCPs participated in the one-year survey (mean (SD) age 35.9 (10.5) years and 69% men). High prevalence estimates were found in both onset and one-year groups of symptoms of insomnia (52% vs. 49%), of diagnosis of clinical insomnia (15% vs. 18%), with a high mean ISI score (8.4 vs. 8.7), but with no significant difference between the onset and one-year groups. Risk factors for clinical insomnia included age in both groups, lower income and contact level with COVID-19 patients/samples in the onset group, and lower Mini-Z scores and higher SDS scores in the one-year group. Approximately one-third of respondents reported at least one or more burnout symptoms, with a higher percentage in the one-year group (35.4%) than in the onset group (24.2%) (p=0.012). Younger age, lower monthly income, and higher ISI and SDS scores were risk factors for burnout in both groups. Greater perceived changes in social life were associated with burnout in the onset group. In contrast, higher weekly working hours, worse participants' evaluation of their institution's preparation, and more changes in workload were risk factors for burnout in the one-year group. The SDS score and its subscales scores were higher in the one-year group than in the onset group. Changes in workload and social life predicted higher SDS scores among both groups. Living with older people predicted higher SDS scores among the onset group, while contact level and estimated number of COVID-19 patients that participants engaged in during caring predicted higher SDS scores among the one-year group. ISI scores were significantly correlated with the Mini-Z scores and SDS scores in both groups, while the Mini-Z and SDS scores were significantly correlated only in the one-year group.

Conclusion

This study demonstrated high rates of insomnia, burnout, and functional impairment among HCPs during the pandemic. It reveals a significant rise in job burnout and functional impairment of HCPs overtime during the pandemic. Furthermore, high-risk subgroups are also highlighted for whom comprehensive psychosocial and occupational interventions might be warranted.

Trends of Prevalence Estimates and Risk Factors of Depressive Symptoms among Healthcare Workers Over one Year of the COVID-19 Pandemic

Background

COVID-19 pandemic has an overwhelming psychologic burden on healthcare workers (HCWs). This study aims to investigate the changes in the prevalence, estimates, severity, and risk factors of depressive symptoms among HCWs within the first year of the COVID-19 pandemic.

Methods

An observational e-survey collected data on HCWs' socio-demographic characteristics, occupational situation, and depressive symptoms as measured by Patient Health Questionnaire-9 (PHQ-9). The e-survey was distributed one month after the onset of the COVID-19 pandemic (onset group) and again after one year (one-year group).

Results

A total of 422 HCWs were included (Mean (SD) age, 35.3 (9.9) years; 71.3% males), with 211 (50%) participants in each group. In the total cohort, the mean PHQ-9 score was 8.5, and 36.7% reported clinically significant levels of depressive symptoms with a PHQ-9 score of ≥10. Compared to the onset group, the one-year group reported a higher risk of major depressive disorder (41.7% vs. 31.8%; OR 1.538; 95%CI 1.032-2.291; p=0.034), a higher mean PHQ-9 score (9.5 (6.8) vs. 7.4 (5.3), p<0.001), and more severe depressive symptoms (p<0.005). Participants who were younger, unmarried, underwent testing for COVID-19, reported lower monthly income, did not receive special COVID-19 education, or had lower satisfaction with institutional preparedness had significantly higher depression scores and symptoms in both onset and one-year groups (p<0.05 for each category). Female gender and direct contact with COVID-19 patients or samples were significant risk factors within the onset group. Occupation as a physician, history of COVID-19 testing or infection, and perception of significant changes in work schedule or intensity were significantly associated with higher depression scores and symptoms among the one-year group.

Conclusion

This study sheds light on an unspoken but significant rise in prevalence estimates and severity of depressive symptoms among HCWs over a year of the COVID-19 pandemic and shows the vulnerable subgroups for whom a psychological intervention might be warranted.

Asociación entre alteraciones en el sueño y problemas de salud mental en los estudiantes de Medicina durante la pandemia de la COVID-19

Introduction

Medical students are a population vulnerable to poor sleep quality and sleep deprivation; these problems were accentuated during the COVID-19 pandemic. The objective was to evaluate the association between sleep disturbances and the presence of depression and anxiety in medical students during the pandemic.

Materials and methods

Cross-sectional, analytical study in medical students of a private university in Peru. Data were collected from May 22 to June 14, 2020, after 3 months of mandatory social isolation. The Patient Health Questionnaire (PHQ-9; ≥ 10), the Generalized Anxiety Disorder (GAD-7; ≥ 10) scale and the Insomnia Severity Index (ISI; ≥ 8) were used to assess depression, anxiety and insomnia, respectively. Poisson regressions with robust variance were used to calculate prevalence ratios.

Results

The prevalence of depression, anxiety and insomnia was 28.5%, 29.5% and 60.1% respectively. It was found that those who had short sleep (RPa: 1.40, CI: 1.05-1.87, p: 0.024), who slept after 2:00 hours (RPa: 2.24, CI: 1.31-3.83, p: 0.003) and who presented insomnia (RPa: 7.12, CI: 3.70-13.73, p: < 0.001) had a higher prevalence of anxiety. Likewise, those who slept after 2:00 hours (RPa: 2.13, CI: 1.24-3.64, p: 0.006) and those who presented insomnia (RP: 8.82, CI: 4.17-18.68, p: < 0.001) had a higher prevalence of depression.

Conclusions

Short sleep, bedtime and insomnia are factors associated with the prevalence of depression and anxiety.

Self-Reported Obsession Toward COVID-19 Preventive Measures Among Undergraduate Medical Students During the Early Phase of Pandemic in Jordan

Background: Coronavirus disease 2019 (COVID-19) pandemic and its associated precautionary measures have substantial impacts not only on the medical, economic, and social context but also on psychological health. This study aimed to assess the obsession toward COVID-19 preventive measures among undergraduate medical students during the early phase of the pandemic in Jordan.

Methods: Online questionnaires were distributed between March 16, 2020 and March 19, 2020. Socio-demographic characteristics were collected, and self-reported obsession toward COVID-19 preventive measures was assessed using a single question.COVID-19 knowledge, risk perception, and precautionary measures were evaluated using scales. Using the chi-square test, Student t-test, and one-way ANOVA, we assessed the differences in the obsession of students with socio-demographic characteristics and scores of the scales.

Results: A total of 1,404 participants (60% were female participants) completed the survey with a participation rate of 15.6%. Obsession with preventive measures was reported by 6.8%. Obsession was significantly more common among women (9.2%) than men (3.3%) and students who attended COVID-19 lectures (9.5%) than those who did not attend such lectures (5.8%) (p < 0.001 and p = 0.015, respectively). Obsessed participants reported significantly higher levels of COVID-19 knowledge (p = 0.012) and precautionary measures (p < 0.001). COVID-19 risk perception had a mild effect size difference but with no statistical significance (p = 0.075). There were no significant differences in the academic levels of participants (p = 0.791) and universities (p = 0.807) between students who were obsessed and those who were not.

Conclusions: Obsession is one of the significant but unspoken psychological effects of COVID-19 precautionary measures among undergraduate medical students. Medical schools should be equipped with means to handle pandemic psychological effects.

Effects of an email delivered cognitive behavioral therapy for insomnia in college students

PURPOSE

This study aimed to examine the effect of an email delivered version of Cognitive Behavioral Therapy for Insomnia (CBT-I) in college students with insomnia.

DESIGN AND METHODS

The study used a two-group pre- and postdesign (N = 63). The intervention group received 6 weekly, email-delivered CBT-I sessions, and the comparison group received a link to a student wellness website for healthy sleep information.

FINDINGS

The intervention group demonstrated significant improvement in attitudes toward sleep, sleep quality, sleep hygiene, and daytime sleepiness from pretest to posttest. Furthermore, the intervention group showed more positive outcomes, compared to the comparison group at the posttest.

PRACTICE IMPLICATIONS

An email-delivered sleep intervention is a feasible and easy-to-use tool that nurses can utilize to promote sleep quality among college students.