A composite measure of sleep health is associated with symptoms of depression among Japanese female hospital nurses

The Association of Multidimensional Sleep Health With HbA1c and Depressive Symptoms in African American Adults With Type 2 Diabetes

OBJECTIVE

Sleep is important for diabetes-related health outcomes. Using a multidimensional sleep health framework, we examined the association of individual sleep health dimensions and a composite sleep health score with hemoglobin A1c (HbA1c) and depressive symptoms among African American adults with type 2 diabetes.

METHODS

Participants (N = 257; mean age = 62.5 years) were recruited through local churches. Wrist-worn actigraphy and sleep questionnaire data assessed multidimensional sleep health using the RuSATED framework (regularity, satisfaction, alertness, timing, efficiency, duration). Individual sleep dimensions were dichotomized into poor or good sleep health and summed into a composite score. HbA1c was assessed using the DCA Vantage™ Analyzer or A1CNow® Self Check. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Regression models examined the association of individual sleep dimensions and composite sleep health with HbA1c and depressive symptoms.

RESULTS

Higher composite sleep health scores were associated with a lower likelihood of having greater than minimal depressive symptoms (PHQ-9 ≥ 5) (odds ratio [OR] = 0.578, 95% confidence interval [CI] = 0.461-0.725). Several individual sleep dimensions, including irregularity (OR = 1.013, CI = 1.005-1.021), poor satisfaction (OR = 3.130, CI = 2.095-4.678), and lower alertness (OR = 1.866, CI = 1.230-2.833) were associated with a greater likelihood of having depressive symptoms. Neither composite sleep health scores nor individual sleep dimensions were associated with HbA1c.

CONCLUSIONS

Better multidimensional sleep health is associated with lower depressive symptoms among African American adults with type 2 diabetes. Longitudinal research is needed to determine the causal association between multidimensional sleep health and depressive symptoms in this population.

TRIAL REGISTRY

ClinicalTrials.gov identifier NCT04282395.

Relationship between mid-sleep time and depression, health-related quality of life, and sleep deprivation in the 2018 Korea Community Health Survey

This cross-sectional study examined the relationship of mid-sleep time (MST) with depression, quality of life, and sleep deprivation. This study included 173 284 adults aged ≥ 19 years who participated in the 2018 Korea Community Health Survey. The Patient Health Questionnaire-9 for depression, EuroQol-5 dimension for health-related quality of life, and the Pittsburgh Sleep Quality Index for MST, daytime sleepiness, and sleep quality were used. Regression and logistic regression analysis was used for complex sample analysis. The results showed that individuals with later MST had a higher risk of depression, poor quality of life, poor sleep quality, and excessive daytime sleepiness than intermediate-type individuals, whereas earlier MST was associated with good sleep quality in the total population. This association was significant in both men and women. The later type was associated with all items of health-related quality of life in both men and women. These findings suggest that the later type is a significant predictor of mental health, quality of life, sleep quality, and daytime sleepiness. Identifying an individual's mid-sleep time may help tailor interventions and treatment strategies that optimize sleep, mental health outcomes, and quality of life.

Application of Braided Piezoelectric Poly-l-Lactic Acid Cord Sensor to Sleep Bruxism Detection System with Less Physical or Mental Stress

For many years, we have been developing flexible sensors made of braided piezoelectric poly-l-lactic acid (PLLA) fibers that can be tied and untied for practical applications in society. To ensure good quality of sleep, the occurrence of bruxism has been attracting attention in recent years. Currently, there is a need for a system that can easily and accurately measure the frequency of bruxism at home. Therefore, taking advantage of the braided piezoelectric PLLA cord sensor's unique characteristic of being sewable, we aimed to provide a system that can measure the frequency of bruxism using the braided piezoelectric PLLA cord sensor simply sewn onto a bed sheet on which the subject lies down. After many tests using trial and error, the sheet sensor was completed with zigzag stitching. Twenty subjects slept overnight in a hospital room on sheets integrated with a braided piezoelectric PLLA cord. Polysomnography (PSG) was simultaneously performed on these subjects. The results showed that their bruxism could be detected with an accuracy of more than 95% compared with PSG measurements, which can only be performed in a hospital by a physician and are more burdensome for the subjects, with the subjects simply lying on the bed sheet with a braided piezoelectric PLLA cord sensor sewn into it.

Covariance patterns between sleep health domains and distributed intrinsic functional connectivity

Sleep health is both conceptually and operationally a composite concept containing multiple domains of sleep. In line with this, high dependence and interaction across different domains of sleep health encourage a transition in sleep health research from categorical to dimensional approaches that integrate neuroscience and sleep health. Here, we seek to identify the covariance patterns between multiple sleep health domains and distributed intrinsic functional connectivity by applying a multivariate approach (partial least squares). This multivariate analysis reveals a composite sleep health dimension co-varying with connectivity patterns involving the attentional and thalamic networks and which appear relevant at the neuromolecular level. These findings are further replicated and generalized to several unseen independent datasets. Critically, the identified sleep-health related connectome shows diagnostic potential for insomnia disorder. These results together delineate a potential brain connectome biomarker for sleep health with high potential for clinical translation.

The Interactive Role of Sleep and Circadian Rhythms in Episodic Memory in Older Adults

Adequate sleep is essential for healthy physical, emotional, and cognitive functioning, including memory. However, sleep ability worsens with increasing age. Older adults on average have shorter sleep durations and more disrupted sleep compared with younger adults. Age-related sleep changes are thought to contribute to age-related deficits in episodic memory. Nonetheless, the nature of the relationship between sleep and episodic memory deficits in older adults is still unclear. Further complicating this relationship are age-related changes in circadian rhythms such as the shift in chronotype toward morningness and decreased circadian stability, which may influence memory abilities as well. Most sleep and cognitive aging studies do not account for circadian factors, making it unclear whether age-related and sleep-related episodic memory deficits are partly driven by interactions with circadian rhythms. This review will focus on age-related changes in sleep and circadian rhythms and evidence that these factors interact to affect episodic memory, specifically encoding and retrieval. Open questions, methodological considerations, and clinical implications for diagnosis and monitoring of age-related memory impairments are discussed.

Multi-dimensional sleep and mortality: The Multi-Ethnic Study of Atherosclerosis

STUDY OBJECTIVES

Multiple sleep characteristics are informative of health, sleep characteristics cluster, and sleep health can be described as a composite of positive sleep attributes. We assessed the association between a sleep score reflecting multiple sleep dimensions, and mortality. We tested the hypothesis that more favorable sleep (higher sleep scores) is associated with lower mortality.

METHODS

The Multi-Ethnic Study of Atherosclerosis (MESA) is a racially and ethnically-diverse multi-site, prospective cohort study of US adults. Sleep was measured using unattended polysomnography, 7-day wrist actigraphy, and validated questionnaires (2010-2013). 1726 participants were followed for a median of 6.9 years (Q1-Q3, 6.4-7.4 years) until death (171 deaths) or last contact. Survival models were used to estimate the association between the exposure of sleep scores and the outcome of all-cause mortality, adjusting for socio-demographics, lifestyle, and medical comorbidities; follow-up analyses examined associations between individual metrics and mortality. The exposure, a sleep score, was constructed by an empirically-based Principal Components Analysis on 13 sleep metrics, selected a priori.

RESULTS

After adjusting for multiple confounders, a 1 standard deviation (sd) higher sleep score was associated with 25% lower hazard of mortality (Hazard Ratio [HR]: 0.75; 95% Confidence interval: [0.65, 0.87]). The largest drivers of this association were: night-to-night sleep regularity, total sleep time, and the Apnea-Hypopnea Index.

CONCLUSION

More favorable sleep across multiple characteristics, operationalized by a sleep score, is associated with lower risk of death in a diverse US cohort of adults. Results suggest that interventions that address multiple dimensions may provide novel approaches for improving health.

Food insecurity, sleep, and cardiometabolic risks in urban American Indian/Alaska Native youth

OBJECTIVES

Food insecurity contributes to racial/ethnic disparities in health. This is the first study to examine associations among food insecurity, sleep, and cardiometabolic outcomes in urban American Indian/Alaska Native (AI/AN) youth.

DESIGN

Participants were 142 urban AI/AN youth (mean age = 14 years, 58% female). Food insecurity and self-reported sleep disturbance were measured using validated surveys. A multi-dimensional sleep health composite was derived using questionnaires (ie, satisfaction, alertness) and actigraphy-derived indices (ie, duration, efficiency, regularity, timing). Cardiometabolic measures included body mass index, blood pressure, glycosylated hemoglobin, waist circumference, cholesterol, and triglycerides. Covariates were sex, age, and single-parent household.

RESULTS

Greater food insecurity was significantly associated with greater body mass index (b = 0.12, p = .015), higher systolic blood pressure (b = 0.93, p = .03), and greater sleep disturbance (b = 1.49, p < .001), and marginally associated with lower sleep health composite scores (b = -0.09, p = .08). There was a significant indirect path from greater food insecurity to greater waist circumference through poorer sleep health (0.11, 95% bootstrapping CI: [0.01, 0.30]).

CONCLUSION

Food insecurity is an important correlate of sleep and cardiometabolic health among urban AI/AN youth and should be addressed to reduce emerging health risks during this important developmental period. Policies to reduce food insecurity and increase access to healthy foods as well as sleep interventions for these youth could help, as preliminary findings suggest that sleep health may mediate the negative impact of food insecurity on cardiometabolic risks.

Application of Piezoelectric PLLA Braided Cord as Wearable Sensor to Realize Monitoring System for Indoor Dogs with Less Physical or Mental Stress

We attempted to realize a prototype system that monitors the living condition of indoor dogs without physical or mental burden by using a piezoelectric poly-l-lactic acid (PLLA) braided cord as a wearable sensor. First, to achieve flexibility and durability of the piezoelectric PLLA braided cord used as a sensor for indoor dogs, the process of manufacturing the piezoelectric PLLA fiber for the piezoelectric braided cord was studied in detail and improved to achieve the required performance. Piezoelectric PLLA braided cords were fabricated from the developed PLLA fibers, and the finite element method was used to realize an e-textile that can effectively function as a monitoring sensor. As a result, we realized an e-textile that feels similar to a high-grade textile and senses the complex movements of indoor dogs without the use of a complex computer system. Finally, a prototype system was constructed and applied to an actual indoor dog to demonstrate the usefulness of the e-textile as a sensor for indoor dog monitoring.

Prevalence and variables associated with depression, anxiety, and stress among Chilean higher education students, post-pandemic

Background

Mental health among university students is a public health problem in Chile, understanding that this population is susceptible to mental disorders.

Objective

The present study aimed to determine the prevalence and variables influencing depression, anxiety, and stress in Chilean university students.

Method

A representative sample (n = 1,062) of Chilean university students and a cross-sectional study design were used. Bivariate analysis and multiple logistic regression were performed to identify risk factors associated with symptomatology. They were analyzed using descriptive statistics. A questionnaire with sociodemographic variables was applied in November 2022, in addition to the depression anxiety stress scale (DASS-21), instruments with excellent reliability in this population (α = 0.955; ω = 0.956). On the other hand, the Questionnaire of Problematic Alcohol and Drug Consumption (DEP-ADO) was applied. A descriptive analysis was performed, followed by bivariate analysis and multiple logistic regression using SPSS version 25. The variables showed a value of p <0.05; they were declared statistically significant in the final model. Odds ratios (OR) were adjusted to a 95% confidence interval (95% CI), which was used to determine the independent predictors.

Results

The prevalence of mental health problems in this population was high, with depressive symptoms in 63.1% of the sample; 69.2% with anxiety; 57% with stress; 27.4% with problematic alcohol consumption; and 14.9% with inappropriate marijuana consumption. Some 10.1% of the sample reported daily medication with antidepressants and/or anxiolytics. Concerning significant variables for depression, these were: being female, belonging to sexual, not having children, having problematic marijuana use, and using prescription drugs. Concerning anxiety, the significant variables were being a woman, belonging to sexual minorities, being an adolescent, and consuming prescription medication. Finally, concerning stress, the significant variables were being a woman, belonging to sexual minorities, being a student dedicated exclusively to academic activities, and taking prescription medication.

Conclusion

Chilean university students presented a high prevalence of anxiety, depression, and stress, where being female and belonging to sexual minorities seem to be the variables that have the greatest impact on susceptibility to mental health problems. These results should call the attention of political and university authorities in Chile to improve this population's mental health and quality of life since they are the following professional generation of our country.

A latent class approach to understanding longitudinal sleep health and the association with alcohol and cannabis use during late adolescence and emerging adulthood

OBJECTIVE

Sleep is a multi-dimensional health behavior associated with elevated risk of substance use. This is the first study to utilize a latent class approach to characterize sleep health across multiple dimensions and across time from late adolescence to emerging adulthood, and to examine associations with alcohol and cannabis use trajectories.

METHODS

The sample included 2995 emerging adults (mean ages = 18 to 24 years across six waves of data collection; 54% female) who provided data on sleep dimensions (quality, duration, and social jetlag) and frequency and consequences of alcohol and cannabis use. Longitudinal latent class analysis (LLCA) models characterized participants according to the three sleep dimensions. Latent growth models examined trajectories of frequency and consequences of alcohol or cannabis use over time among emergent sleep classes, with and without controlling for covariates.

RESULTS

LLCA models identified four sleep classes: good sleepers (n = 451; 15.2%); untroubled poor sleepers (n = 1024; 34.2%); troubled, moderately good sleepers (n = 1056; 35.3%); and suboptimal sleepers (n = 460; 15.4%). Good sleepers reported significantly lower levels of alcohol or cannabis use and consequences, and less of an increase in alcohol consequences as compared to suboptimal sleepers.

CONCLUSIONS

Persistent poor sleep health was associated with higher levels of alcohol and cannabis use and consequences, and greater increases in alcohol-related consequences during the transition from late adolescence to emerging adulthood. Findings have important clinical implications, highlighting that addressing multi-dimensional sleep health may be an important, novel target of intervention to reduce substance use frequency and consequences.

Holistic sleep improvement strategies for frontline nurses served during a public health emergency (COVID-19) in Wuhan, China: A quasi-experimental study

AIM

To examine effects of holistic sleep improvement strategies on frontline nurses who served in Wuhan, China, during a public health emergency (COVID-19).

DESIGN

A pre-post-test design with single group was conducted with a convenience sample applied the Transparent Reporting of Evaluations with Non-randomized Designs statement.

METHODS

Fifty-two nurses were recruited from a COVID-19 designated hospital, receiving holistic sleep improvement intervention, which concentrated on scientific human resource management, comfortable sleep environment establishment, self-relaxation and self-adjustment training and humanistic care. Data was collected at baseline and 4-week follow-up post intervention using self-reported questionnaires.

RESULTS

The total score of Pittsburgh Sleep Quality Index scale was 8.69 ± 4.346 at baseline. After 4 weeks of follow-up, the score statistically significantly decreased to 7.48 ± 3.691. Subjective sleep quality (p = .016), sleep efficiency (p = .015), sleep disturbances (p = .007) were statistically significantly improved after the intervention, while there were no statistically significant differences in sleep latency (p = .205), sleep duration (p = .375), sleep medication (p = .723) or daytime dysfunction (p = .747).

Chronotype, circadian rhythm, and psychiatric disorders: Recent evidence and potential mechanisms

The circadian rhythm is crucial for physiological and behavioral functions. Chronotype, which represents individual preferences for activity and performance, is associated with human health issues, particularly psychiatric disorders. This narrative review, which focuses on the relationship between chronotype and mental disorders, provides an insight into the potential mechanism. Recent evidence indicates that (1) the evening chronotype is a risk factor for depressive disorders and substance use disorders, whereas the morning chronotype is a protective factor. (2) Evening chronotype individuals with bipolar disorder tend to have more severe symptoms and comorbidities. (3) The evening chronotype is only related to anxiety symptoms. (4) The relationship between chronotype and schizophrenia remains unclear, despite increasing evidence on their link. (5) The evening chronotype is significantly associated with eating disorders, with the majority of studies have focused on binge eating disorders. Furthermore, the underlying mechanisms or influence factors are described in detail, including clock genes, brain characteristics, neuroendocrinology, the light/dark cycle, social factors, psychological factors, and sleep disorders. These findings provide the latest evidence on chronotypes and psychiatric disorders and serve as a valuable reference for researchers.

The mediation role of sleep quality in the relationship between cognitive decline and depression

Objectives

Associations between cognitive decline and depression have been inconclusive. We examined 1) whether sleep quality mediates these relationships and 2) which factor of sleep quality mediates these relationships.

Methods

This study utilized baseline data from the 2018 West China Health and Aging Trend study (WCHAT), a large cohort data-set that including participants aged over 50 years old. We defined depression using the 15-item Geriatric Depression Scale (GDS-15). Cognitive status was measured using the Short Portable Mental Status Questionnaire (SPMSQ) and sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Direct relationships between cognitive decline, sleep quality and depression were assessed using multiple linear regression. Mediation models and structural equation model (SEM) pathway analysis were used to test the mediating role of specific aspects of sleep (e.g., quality, duration) in the relationship between cognitive decline and depression.

Results

Of 6828 participants aged 50 years old or older, the proportion of depression was 17.4%. Regression analysis indicated a total association between cognitive scores (β = 0.251, 95% CI 0.211 to 0.290, p < 0.001) and depression status. After adjusted PSQI scores, the association between cognitive scores and depression status was still significant (β = 0.242, 95% CI 0.203 to 0.281, p < 0.001), indicating a partial mediation effect of sleep quality. Mediation analysis verified sleep quality partially mediate the associations between cognitive decline and depression (indirect effect estimate = 0.0308, bootstrap 95% CI 0.023 to 0.040; direct effect estimate = 0.3124, bootstrap 95% CI 0.269 to 0.350). And daytime dysfunction had a highest mediation effect with a proportion of mediation up to 14.6%.

Conclusions

Sleep quality partially mediated the relationship between cognitive decline and depression. Daytime dysfunction had a highest mediation effect. Further research is necessary to examine the effects of sleep quality on the relationship of cognitive decline and depression.

Calidad de sueño, variables personales, laborales y estilo de vida de enfermeros de hospital

Resumen Objetivo: identificar posibles asociaciones entre la calidad de sueño, las variables personales y laborales y los estilo de vida de los enfermeros de hospital. Método: estudio transversal, exploratorio, correlacional, cuantitativo, realizado de octubre a diciembre de 2019. Los datos fueron recolectados mediante un cuestionario que abordó las características personales, estilo de vida y condiciones de trabajo de los encuestados. Para evaluar la calidad de sueño, se utilizó el Pittsburgh Sleep Quality Index (PCSI), versión en portugués de Brasil. Resultados: participaron 42 profesionales, 31 (73,8%) mujeres, con edad entre 26 y 66 años (media 40,2); el 61,9% trabajaba horas extras; el 26,2% tenía dos vínculos laborales y el 40,5% faltó al trabajo. La calidad de sueño fue considerada buena por el 9,5% de los participantes, mala por el 64,3% y con trastornos del sueño por el 26,2%. El 26,2% de la población que hacía turnos rotativos, calificó la calidad como mala. Los peores resultados se encontraron en la franja etaria de 30 a 39 años y hubo significación estadística en la variable “vive en pareja”. Conclusión: la calidad de sueño de los enfermeros se vio afectada; es necesario monitorear a estos trabajadores, en particular a los que trabajan por turnos, a fin de implementar medidas preventivas que reduzcan los daños a su salud.

Prevalence and factors associated with poor sleep quality among nursing professionals during the COVID-19 pandemic

ABSTRACT Objective: to identify the prevalence and factors associated with poor sleep quality among nursing professionals during the COVID-19 pandemic. Method: a cross-sectional study, conducted in June and July 2020, with 890 nursing professionals. To screen the outcome, question 3 of the Self-Reporting Questionnaire was used, assessing poor sleep quality 30 days preceding the application of the questionnaire. Associations between variables of interest were tested using Poisson regression models. Results: the prevalence of poor sleep quality was 68%. Associated factors were moderate or heavy workload, poor assessment of working conditions, suspected infection with COVID-19, more than two thirds of the workload for pandemic and the use of psychotropic drugs. Conclusion: the study pointed out a high prevalence of poor sleep quality among nursing workers with an important relationship with working conditions.

Sleep quality, personal and work variables and life habits of hospital nurses

OBJECTIVE

to identify the possible associations between sleep quality, personal and work variables and the life habits of hospital nurses.

METHOD

a cross-sectional, exploratory, correlational and quantitative study, carried out from October to December 2019. The data were collected with the application of a questionnaire that addressed the respondents' personal characteristics, life habits and working conditions. The Pittsburgh Sleep Quality Index (PSQI), Brazilian Portuguese version, was used to assess sleep quality.

RESULTS

the participants were 42 professionals: 31 (73.8%) women, aged between 26 and 66 years old (mean of 40.2); 61.9% worked overtime; 26.2% had two employment contracts and 40.5% had absences from work. Sleep quality was considered good by 9.5% of the participants, poor by 64.3% and categorized as with sleep disorders by 26.2%. In the population that worked rotating shifts, this quality was identified as poor by 26.2%. The worst results were found in the age group from 30 to 39 years old and there was a statistical significance in the "living with a partner" variable.

CONCLUSION

there was impairment in the nurses' sleep quality and there is a need to monitor these workers, particularly those who work in shifts, in order to provide preventive measures to mitigate the harms to their health.

Association between sleep disturbance and mental health of healthcare workers: A systematic review and meta-analysis

OBJECTIVES

Sleep disturbance and mental health are challenges for healthcare workers (HCWs). Especially during the COVID-19 pandemic, they experienced more severe sleep and mental health problems. However, the association between sleep disturbance and the mental health of HCWs is still controversial. This study aimed to systematically review the relationship by conducting a systematic review and meta-analysis.

METHOD

Two researchers retrieved the literature from Web of Science, PubMed, EMBASE, CINAHL, Psyclnfo, and Cochrane Library from the establishment of the databases until November 20, 2021. We used the New Castle-Ottawa Scale (NOS) and Agency for Healthcare Research and Quality (AHRQ) to evaluate the risk of bias in prospective research and cross-sectional research, respectively. The major exposure was HCWs' sleep disturbance, and the major outcome was mental health. The correlation coefficients (r), regression coefficients (β) and odds ratios (OR) of the included studies were integrated.

RESULT

Fifty-nine studies were included for qualitative analysis, of which 30 studies could be combined and entered into quantitative analysis. There were 23 studies during the COVID-19 pandemic among the 59 included studies. The results of the meta-analysis showed that the correlation coefficient between sleep disturbance and mental health was 0.43 (95% CI: 0.39-0.47). HCWs with sleep disturbance had a 3.74 (95% CI: 2.76-5.07) times higher risk of mental health problems than those without sleep disturbance. The correlation coefficient during the COVID-19 epidemic was 0.45 (95% CI: 0.37-0.53), while it was 0.40 (95% CI: 0.36-0.44) during the non-epidemic period. Subgroup analysis compared the OR results in epidemic and non-epidemic periods of COVID-19, which were 4.48 (95% CI: 2.75-5.07) and 3.74 (95% CI: 2.74-7.32), respectively.

CONCLUSION

Sleep disturbance and mental health problems were positively correlated among HCWs. Particularly in the COVID-19 pandemic, more attention should be given to this issue.

Sleep quality, personal and work variables and life habits of hospital nurses

Abstract Objective: to identify the possible associations between sleep quality, personal and work variables and the life habits of hospital nurses. Method: a cross-sectional, exploratory, correlational and quantitative study, carried out from October to December 2019. The data were collected with the application of a questionnaire that addressed the respondents’ personal characteristics, life habits and working conditions. The Pittsburgh Sleep Quality Index (PSQI), Brazilian Portuguese version, was used to assess sleep quality. Results: the participants were 42 professionals: 31 (73.8%) women, aged between 26 and 66 years old (mean of 40.2); 61.9% worked overtime; 26.2% had two employment contracts and 40.5% had absences from work. Sleep quality was considered good by 9.5% of the participants, poor by 64.3% and categorized as with sleep disorders by 26.2%. In the population that worked rotating shifts, this quality was identified as poor by 26.2%. The worst results were found in the age group from 30 to 39 years old and there was a statistical significance in the “living with a partner” variable. Conclusion: there was impairment in the nurses’ sleep quality and there is a need to monitor these workers, particularly those who work in shifts, in order to provide preventive measures to mitigate the harms to their health.

Multidimensional sleep health is associated with mental well-being in Australian adults

The few studies assessing the relationship between mental health and a multidimensional measure of sleep have been conducted in samples of almost exclusively women. In the present study, we therefore assessed associations of multidimensional sleep health with mental well-being in Australian adults. A cross-sectional, national online survey of sleep health was conducted in 2019 in 2,044 community dwelling adults aged 18-90 years. Composite scores of self-reported healthy sleep were based on Ru-SATED (R-SATED) dimensions of satisfaction, alertness, timing, efficiency and duration scored 0 (never/rarely), 1 (sometimes) or 2 (usually/always), and regularity (social jet lag) was scored 0 (≥1 hr) or 1 (<1 hr). Mental well-being was identified by a report of no problem on the EuroQol (European quality of life) five dimension five level scale (EQ-5D-5L) anxiety/depression scale, as well as absence of six chronic depressive symptoms. Ordinal logistic regression analyses determined associations of mental well-being with sleep dimensions, and total R-SATED (range 0-11) and SATED scores (0-10), adjusted for sociodemographic and health factors. In males and females, healthy categories of SATED dimensions (but not regularity) were associated with mental well-being. A 1 unit increase in the total SATED score (mean [SD] 6.6 [2.1]) was associated with less problems on the EQ-5D-5L (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.08-1.14) and fewer chronic depressive symptoms (OR 1.20, 95% CI 1.17-1.23). These estimates did not differ when the total R-SATED score was considered. Sleep health promotion focussing solely on traditional messaging around healthy sleep duration may limit mental health gains. Rather, a more holistic approach to public health messaging to improve sleep health literacy may be beneficial for mental well-being.

Sociodemographic Factors and Depressive Symptoms Among Cardiac Nurses: A Cross-Sectional Study

Background: The nursing profession is predisposed toward depressed mood and depressive symptoms. The multidirectionality and intensity of stressors in the nurses' occupational environment are of great significance in this respect. The study aimed to evaluate the impact of selected sociodemographic factors on depressive symptoms among cardiac nurses.

Methods: This cross-sectional study included 336 cardiac nurses (302 women and 34 men) and was conducted between December 2019 and September 2020 in four hospital cardiac units in Wroclaw, Poland. Sociodemographic data were collected using a self-developed survey. The following standardized instruments were used for the study outcomes: Patient Health Questionnaire-9 (PHQ-9) and Beck Depression Inventory (BDI).

Results: The study among cardiac nurses showed mild depression in 11.61%, moderate depression in 5.06%, and severe depression in 2.68%. Linear regression models showed that significant (p < 0.05) predictors of the PHQ-9 score included (1) higher occupational education (bachelor's degree), graduation “only” from medical high school or “other” education; (2) work experience of 16–20 years; (3) living in a relationship; (4) living in a rural area. Linear regression models showed that significant (p < 0.05) predictors of the BDI score included (1) higher occupational education (bachelor's degree); (2) graduation “only” from medical high school or “other” education; (3) living in a relationship.

Conclusions: Depressive symptoms are a significant problem among Polish cardiac nurses. The prevalence of depressive symptoms is affected by the education level, employment form, marital status, and place of residence.

A Prototype Sensor System Using Fabricated Piezoelectric Braided Cord for Work-Environment Measurement during Work from Home

We proposed a new prototype sensor system to understand the workload of employees during telework. The goal of sensing using such a system is to index the degree of stress experienced by employees during work and recognize how to improve their work environment. Currently, to realize this, image processing technology with a Web camera is generally used for vital sign sensing. However, it creates a sense of discomfort at work because of a strong sense of surveillance. To truly evaluate a working environment, it is necessary that an employee be unaware of the sensor system and for the system to be as unobtrusive as possible. To overcome these practical barriers, we have developed a new removable piezoelectric sensor incorporated in a piezoelectric poly-L-lactic acid (PLLA) braided cord. This cord is soft and flexible, and it does not cause any discomfort when attached to the cushion cover sheet. Thus, it was possible to measure the workload of an employee working from home without the employee being aware of the presence of a sensor. Additionally, we developed a system for storing data in a cloud system. We succeeded in acquiring continuous long-term data on the vital signs of employees during telework using this system. The analysis of the data revealed a strong correlation between behavior and stress.

Mental health service use and its associated factors among nurses in China: a cross-sectional survey

Background

To facilitate mental health service planning for nurses, data on the patterns of mental health service use (MHSU) among nurses are needed. However, MHSU among Chinese nurses has seldom been studied. Our study aimed to explore the rate of MHSU among Chinese nurses and to identify the factors associated with MHSU.

Methods

A self-designed anonymous questionnaire was used in this study. MHSU was assessed by the question, “Have you ever used any kind of mental health services, such as mental health outpatient services or psychotherapies, when you felt that your health was suffering due to stress, insomnia, or other reasons?” The answer to the question was binary (yes or no). Sleep quality, burnout, and depressive symptoms were assessed using the Chinese version of the Pittsburgh Sleep Quality Index , the Chinese version of the Maslach Burnout Inventory-General Survey and the two-item Patient Health Questionnaire, respectively. Chi-square tests and binary logistic regression were used for univariate and multivariate analyses.

Results

A total of 10.94% (301/2750) of the nurses reported MHSU. 10.25% (282/2750) of the nurses had poor sleep quality, burnout and depressive symptoms, and only 26.95% of these nurses reported MHSU. Very poor sleep quality (OR 9.36, 95% CI [5.38-16.29]), mid-level professional title (OR 1.48, 95% CI [1.13-1.93]) and depressive symptoms (OR 1.66, 95% CI [1.28-2.13]) were independent factors associated with MHSU.

Conclusions

Most of the nurses have experienced burnout, poor sleep quality or depressive symptoms and the MHSU rate among them was low. Interventions to improve the mental health of nurses and to promote the use of mental health services are needed.

Sleep quality and mood symptoms in conscripted frontline nurse in Wuhan, China during COVID-19 outbreak: A cross-sectional study

The aim of this study was to investigate the prevalence of sleep problems, depression and anxiety symptoms among conscripted frontline nurses fighting coronavirus disease 2019 (COVID-19) in Wuhan.This study was a cross-sectional study conducted with 100 frontline nurses. Sleep quality, depression, and anxiety symptoms were measured using the Pittsburgh sleep quality index (PSQI), the Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), respectively.Mean sleep duration was 5.71 hours (SD = 1.09) and mean sleep latency was 33.49 minutes (SD = 28.87). A total of 76%, 81%, 45%, and 19% reported difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS) or early morning awakening (EMA), nightmares and using hypnotics respectively. Among 100 participants in this study, 60 (60%) had poor sleep quality, 46 (46%) suffered depression symptoms and 40 (40%) reported anxiety symptoms. Sleep quality (OR = 3.16, 95% CI: 1.17-8.52) and anxiety symptoms (OR = 8.07, 95% CI: 2.92-22.33) were significantly associated with depression symptoms. Depression symptoms (OR = 7.92, 95% CI: 2.89-21.73) were related to anxiety symptoms. Similarly, depression symptoms (OR = 3.24, 95% CI: 1.19-8.79) were associated with poor sleep quality.Sleep disturbance, depression, and anxiety symptoms are very common among frontline nurses who treating patients with COVID-19 in Wuhan, China. Comprehensive measures that involve psychosocial and personal behaviors should be implemented to improve sleep quality and prevent depression and anxiety symptoms.

Caring for the carers: Advice for dealing with sleep problems of hospital staff during the COVID-19 outbreak

Hospital staff are at the frontline in the COVID‐19 outbreak. The stressors they experience may induce sleep problems in a population already at risk. Sleep deprivation, long shifts and insomnia in hospital staff have been associated with individual, organizational and public health hazards. These include increased risk of mental and somatic disorders, altered immune responses, medical errors, misunderstandings, drowsy driving and burnout. In March 2020, the World Health Organization called for providing access to mental health and counselling for health professionals involved in the COVID‐19 outbreak. To answer this call, we propose practical advice for the management of sleep problems (sleep deprivation, insomnia and shift work) that can be included in supportive interventions. The advice is based on psychobiological principles of sleep regulation and on guidelines for the treatment of insomnia and was implemented within an initiative offering psychological support to the staff of three university hospitals in Rome.